卡维地洛治疗肝硬化门静脉高压:一项多中心、随机、双盲、安慰剂对照研究

注册号:

Registration number:

ChiCTR2300073864 

最近更新日期:

Date of Last Refreshed on:

2025-09-16 11:37:47 

注册时间:

Date of Registration:

2023-07-24 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

卡维地洛治疗肝硬化门静脉高压:一项多中心、随机、双盲、安慰剂对照研究

Public title:

Carvedilol to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by new algorithm based on liver stiffness: a randomized, double-blind, placebo-controlled, multicenter trial

注册题目简写:

卡维地洛治疗肝硬化门静脉高压

English Acronym:

Carvedilol for cirrhotic portal hypertension

研究课题的正式科学名称:

卡维地洛治疗肝硬化门静脉高压:一项多中心、随机、双盲、安慰剂对照研究

Scientific title:

Carvedilol to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension stratified by liver stiffness: a randomized, double-blind, placebo-controlled, multicenter trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

祁小龙 

研究负责人:

王岩 

Applicant:

Xiaolong Qi 

Study leader:

Yan Wang 

申请注册联系人电话:

Applicant telephone:

+86 185 8860 2600

研究负责人电话:

Study leader's
telephone:

+86 185 0246 0070

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

qixiaolong@vip.163.com

研究负责人电子邮件:

Study leader's E-mail:

professor_wangyan@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

江苏省南京市鼓楼区丁家桥87号

研究负责人通讯地址:

辽宁省沈阳市和平区和平南大街85号

Applicant address:

87 Dingjiaqiao, Gulou District, Nanjing, Jiangsu

Study leader's address:

85 Heping Street South, Heping District, Shenyang, Liaoning

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

东南大学附属中大医院

Applicant's institution:

Zhongda Hospital, Southeast University

研究负责人所在单位:

沈阳市第六人民医院

Affiliation of the Leader:

The Sixth People's Hospital of Shenyang

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

2023-05-003-01号, 2023-05-003-01(修1)号, 2023-05-003-01(修2)号, 2023-05-003-01(修3)号, 2023-05-003-01(修4)号, 2023-05-003-C01, 2023-05-003-C02

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

沈阳市第六人民医院伦理委员会

Name of the ethic committee:

Ethics Committee of the Sixth People's Hospital of Shenyang

伦理委员会批准日期:

Date of approved by ethic committee:

2023-12-21 00:00:00

伦理委员会联系人:

刘晓辉

Contact Name of the ethic committee:

Liu Xiaohui

伦理委员会联系地址:

辽宁省沈阳市和平区和平南大街85号

Contact Address of the ethic committee:

85 Heping Street South, Heping District, Shenyang, Liaoning

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 24 2326 0061

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

沈阳市第六人民医院

Primary sponsor:

The Sixth People's Hospital of Shenyang

研究实施负责(组长)单位地址:

辽宁省沈阳市和平区和平南大街85号

Primary sponsor's address:

85 Heping Street South, Heping District, Shenyang, Liaoning

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

辽宁

市(区县):

沈阳

Country:

China

Province:

Liaoning

City:

Shenyang

单位(医院):

沈阳市第六人民医院

具体地址:

辽宁省沈阳市和平区和平南大街85号

Institution
hospital:

The Sixth People's Hospital of Shenyang

Address:

85 Heping Street South, Heping District, Shenyang, Liaoning

经费或物资来源:

Source(s) of funding:

NA

研究疾病:

肝硬化门静脉高压  

Target disease:

cirrhosis and portal hypertension

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

评价卡维地洛预防基于肝脏硬度的失代偿风险评估新算法确定为高风险的代偿期肝硬化门静脉高压患者失代偿事件和肝脏相关死亡的有效性。  

Objectives of Study:

To evaluate the effectiveness of carvedilol in preventing decompensated events and liver-related death in compensated cirrhosis patients with high-risk CSPH stratified by new algorithm based on liver stiffness.

药物成份或治疗方案详述:

剂量根据临床耐受性进行滴定,试验组和对照组均从6.25 mg/天开始药物滴点,增加到12.5 mg/天,滴定过程中使心率保持在每分钟55次以上,收缩压大于90mmHg。试验组使用卡维地洛,对照组使用安慰剂。 

Description for medicine or protocol of treatment in detail:

The oral dose of NSBBs (or placebo) to be used during the study is individually determined during an open label titration period. Patients receive carvedilol, starting with 6.25 mg/day and increase up to 12.5 mg/day. The dose is titrated against clinical tolerance, keeping heart rate above 55 beats per min and systolic blood pressure greater than 90 mmHg. 

纳入标准:

Inclusion criteria

排除标准:

1.既往失代偿; 2.LSM ≤15kPa 且 血小板>150×10^9/L; 3.影响门静脉主干或主要肝脏分支,或脾脏、肠系膜静脉的门静脉血栓形成; 4.由影像学检查证明的肝细胞癌; 5.胆红素>3 mg/dl,血小板< 30 × 10^9/L,或快速凝血酶原实验<30%; 6.存在肾功能不全(血肌酐>2 mg/dl); 7.任何涉及治疗限制的疾病或预期生存时间小于12月; 8.β受体阻滞剂治疗绝对禁忌证(严重支气管痉挛、主动脉狭窄A-V阻滞、间歇性跛行、严重精神病、支气管哮喘、严重的心动过缓、病窦综合征、严重低血压、心源性休克等); 9.β受体阻滞剂过敏; 10.妊娠或哺乳期; 11.接受抗凝治疗; 12.ALT >5 ULN 或 AST >5 ULN; 13.入组前两周曾接受过硝酸甘油或β受体阻滞剂治疗; 14.非酒精脂肪肝肝硬化且BMI ≥30 kg/m2。

Exclusion criteria:

1. Previous decompensation of liver cirrhosis associated with portal hypertension; 2. LSM <= 15kPa and PLT > 150×10^9/L; 3. Portal axis thrombosis affecting the portal trunk or main hepatic branches, or the splenic or mesenteric vein; 4. Hepatocellular carcinoma demonstrated by imaging tests; 5. Bilirubin > 3 mg/dl, platelets < 30 × 10^9/L, or Quick prothrombin time test < 30%; 6. Presence of renal insufficiency (serum creatinine > 2 mg/dl); 7. Any comorbidity involving a therapeutic limitation and/or a prognosis of life < 12 months; 8. Absolute contraindication to treatment with β-blockers (severe bronchospasm, stenosis aortic A-V block, intermittent claudication, severe psychosis, bronchial asthma, severe bradycardia, sick sinus syndrome, severe hypotension, cardiogenic shock, etc); 9. Hypersensitivity to beta blocker; 10. Pregnancy or lactation; 11. Receive anticoagulant treatment; 12. ALT > 5 ULN or AST > 5 ULN; 13. Past treatment with nitrated or β-blockers in the two weeks prior inclusion; 14. Nonalcoholic steatohepatitis related cirrhosis and body mass index >= 30kg/m2.

研究实施时间:

Study execute time:

From 2023-07-27 00:00:00 To 2026-07-27 00:00:00  

征募观察对象时间:

Recruiting time:

From 2024-01-23 00:00:00 To 2026-07-27 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

223

Group:

experimental group

Sample size:

干预措施:

卡维地洛:患者从每天6.25毫克开始服用卡维地洛,逐渐增加至每天12.5毫克。剂量根据临床耐受性调整,保持心率在每分钟55次以上,收缩压高于90毫米汞柱。滴定期最长为两周。

干预措施代码:

Intervention:

Carvedilol: patients receive carvedilol, starting with 6.25 mg/day and increased up to 12.5 mg/day. The dose is titrated against clinical tolerance, keeping heart rateabove 55 beats per minute and systolic blood pressure greater than 90 mm Hg. The titration period lasts up to 2 weeks.

Intervention code:

组别:

对照组

样本量:

223

Group:

control group

Sample size:

干预措施:

安慰剂:患者从每天6.25毫克开始服用安慰剂,逐渐增加至每天12.5毫克。剂量根据临床耐受性调整,保持心率在每分钟55次以上,收缩压高于90毫米汞柱。滴定期最长为两周。

干预措施代码:

Intervention:

Placebo: patients receive placebo, starting with 6.25 mg/day and increased up to 12.5 mg/day. The dose is titrated against clinical tolerance, keeping heart rate above 55 beats per minute and systolic blood pressure greater than 90 mm Hg. The titration period lasts up to 2 weeks.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山西 

市(区县):

 

Country:

China

Province:

Shanxi

City:

单位(医院):

山西医科大学第一医院 

单位级别:

三级 

Institution
hospital:

The First Hospital of Shanxi Medical University

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

青岛市第六人民医院 

单位级别:

三级 

Institution
hospital:

The Sixth People's Hospital of Qingdao

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

丽水市人民医院 

单位级别:

三级 

Institution
hospital:

Lishui People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

西藏 

市(区县):

 

Country:

China

Province:

Tibet

City:

单位(医院):

西藏自治区第三人民医院 

单位级别:

三级 

Institution
hospital:

The Third People's Hospital of Tibet Autonomous Region

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

宁夏 

市(区县):

 

Country:

China

Province:

Ningxia

City:

单位(医院):

宁夏回族自治区人民医院 

单位级别:

三级 

Institution
hospital:

The People's Hospital of Ningxia Hui Autonomous Region

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

哈尔滨 

市(区县):

 

Country:

China

Province:

Harbin

City:

单位(医院):

哈尔滨医科大学附属第四医院 

单位级别:

三级 

Institution
hospital:

The Fourth Affiliated Hospital of Harbin Medical University

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

深圳市第三人民医院 

单位级别:

三级 

Institution
hospital:

Shenzhen Third People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

东南大学附属中大医院 

单位级别:

三甲 

Institution
hospital:

Zhongda Hospital Southeastern University

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

辽宁 

市(区县):

 

Country:

China

Province:

Liaoning

City:

单位(医院):

沈阳市第六人民医院 

单位级别:

二级 

Institution
hospital:

Shenyang Sixth People's Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

辽宁 

市(区县):

 

Country:

China

Province:

Liaoning

City:

单位(医院):

大连市第六人民医院 

单位级别:

三级 

Institution
hospital:

Dalian Sixth People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

邢台市人民医院 

单位级别:

三级 

Institution
hospital:

Xingtai People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

秦皇岛市第三医院 

单位级别:

三级 

Institution
hospital:

The Third Hospital of Qinhuangdao

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

河北 

市(区县):

 

Country:

China

Province:

Hebei

City:

单位(医院):

邯郸市传染病医院 

单位级别:

二级 

Institution
hospital:

Handan infectious disease Hospital

Level of the institution:

Secondary

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

南京大学附属鼓楼医院 

单位级别:

三级 

Institution
hospital:

Gulou Hospital affiliated to Nanjing University

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

镇江市第三人民医院 

单位级别:

三级 

Institution
hospital:

Zhenjiang Third People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

连云港市第一人民医院 

单位级别:

三级 

Institution
hospital:

Lianyungang First People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

安徽 

市(区县):

 

Country:

China

Province:

Anhui

City:

单位(医院):

毫州市人民医院 

单位级别:

三级 

Institution
hospital:

Bozhou People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

金华市人民医院 

单位级别:

三级 

Institution
hospital:

Jinhua People's Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

宁波市第二医院 

单位级别:

三级 

Institution
hospital:

The Second Hospital of Ningbo

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

浙江 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

湖州市中心医院 

单位级别:

三级 

Institution
hospital:

Huzhou Central Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

青海 

市(区县):

 

Country:

China

Province:

Qinghai

City:

单位(医院):

青海大学附属医院 

单位级别:

三级 

Institution
hospital:

qinghai university affiliated hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

河南 

市(区县):

 

Country:

China

Province:

He'nan

City:

单位(医院):

郑州市中心医院 

单位级别:

三级 

Institution
hospital:

Zhengzhou Central Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

遂宁市中心医院 

单位级别:

三级 

Institution
hospital:

Suining Central Hospital

Level of the institution:

Tertiary

测量指标:

Outcomes:

指标中文名:

首次失代偿事件或肝脏相关的死亡

指标类型:

主要指标

Outcome:

first decompensation or Liver-related death

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

显性腹水

指标类型:

主要指标

Outcome:

overt ascites

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

食管胃静脉曲张出血

指标类型:

主要指标

Outcome:

esophagogastric variceal bleeding

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

显性肝性脑病

指标类型:

次要指标

Outcome:

overt hepatic encephalopathy

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

自发性细菌性腹膜炎及其他细菌性感染的发展

指标类型:

次要指标

Outcome:

the development of spontaneous bacterial peritonitis and other bacterial infections

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

静脉曲张的进展

指标类型:

次要指标

Outcome:

development of varices

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肝硬度的改变

指标类型:

次要指标

Outcome:

changes in spleen and liver stiffness

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

脾脏硬度改变

指标类型:

次要指标

Outcome:

changes in spleen stiffness

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肝功能

指标类型:

次要指标

Outcome:

liver function

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肝细胞癌

指标类型:

次要指标

Outcome:

hepatocellular carcinoma

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

门静脉血栓

指标类型:

次要指标

Outcome:

development of portal vein thrombosis

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不良事件

指标类型:

次要指标

Outcome:

adverse events

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血小板计数的变化

指标类型:

主要指标

Outcome:

Changes in platelet count

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 75 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

中心随机化法

Randomization Procedure (please state who generates the random number sequence and by what method):

Center randomization

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

双盲(研究对象及研究者)

Blinding:

Double blind (subjects and researchers)

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

研究公开发表后6月内,如有合适的理由,可通过联系研究者 qixiaolong@vip.163.com 获得原始数据。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Within six months after publication, if there are appropriate reasons, the original data can be obtained by contacting the researcher at qixiaolong@vip.163.com.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表和电子采集和管理系统(91trial: https://www.91trial.com/)

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

CRF and EDC(91trial: https://www.91trial.com/)

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2023-07-24 14:40:44