Status:

RECRUITING

Stop of Proton-pump Inhibitor Treatment in Patients With Liver Cirrhosis - a Double-blind, Placebo-controlled Trial

Lead Sponsor:

Universitätsklinikum Hamburg-Eppendorf

Collaborating Sponsors:

German Federal Ministry of Education and Research

University Hospital Heidelberg

Conditions:

Liver Cirrhosis

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

Proton-pump inhibitors (PPI) are commonly prescribed in an uncritical manner to patients with liver cirrhosis without a clear evidence-based indication. Observational studies suggests that PPI use in ...

Eligibility Criteria

Inclusion

  • Patients with liver cirrhosis. The diagnosis of liver cirrhosis may be based on histology or a combination of clinical, laboratory and radiological criteria.
  • Hospitalization or recent hospitalization (0 to 42 days prior to the baseline visit) with complications of liver cirrhosis.
  • Treatment with proton pump inhibitors (PPI) for at least 28 days prior to the screening visit.
  • PPI treatment with a single standard dose/day or less for at least 7 days prior to the screening visit.
  • Females/males who agree to comply with the applicable contraceptive requirements of the protocol.
  • Non-pregnant, non-lactating females.
  • Ability to understand the patient information and to personally sign and date the informed consent to participate in the study, before completing any study related procedures.
  • The patient is co-operative and available for the entire study.
  • Provided written informed consent.

Exclusion

  • Diagnosis of severe reflux esophagitis (LA grade C or D) by EGD \< 2 months prior to the screening visit without PPI-therapy for at least 8 weeks prior to the screening visit.
  • Peptic ulcers diagnosed by EGD \< 28 days prior to the screening visit.
  • History of endoscopic therapy for esophageal varices \< 14 days prior to the screening visit.
  • Life-expectancy \< 1 year (at the discretion of the investigator) due to extrahepatic malignancies, metastasized hepatocellular carcinoma (HCC) or other severe extrahepatic diseases. Importantly, HCC without extrahepatic metastases or a reduced life-expectancy of \< 1 year due to liver cirrhosis are not regarded as exclusion criteria.
  • Regular intake of non-steroidal anti-inflammatory drugs (NSAID) on a daily basis with the exemption of acetylsalicylic acid (ASS) 100mg/day orally.
  • Hypersensitivity or intolerance to esomeprazole, substituted benzimidazoles or other excipients of the IMP.
  • Ongoing therapy with nelfinavir.
  • Participation in a clinical trial or use of an IMP within 30 days or five times the half-life of the IMP - whichever is longer - prior to receiving the first dose within this study.
  • Positive urine pregnancy test at screening or positive serum pregnancy test before the first treatment or is breast feeding.
  • Patient is not willing to use adequate contraceptive precautions during the study and for up to 5 days after the last scheduled dose of IMP.

Key Trial Info

Start Date :

April 22 2021

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

February 1 2028

Estimated Enrollment :

476 Patients enrolled

Trial Details

Trial ID

NCT04448028

Start Date

April 22 2021

End Date

February 1 2028

Last Update

April 24 2025

Active Locations (1)

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1

University Medical Center Hamburg-Eppendorf

Hamburg, Hamburg, Germany, 20246