Fecal Microbiota Transplant as Treatment of Hepatic Encephalopathy (NCT03420482) | Clinical Trial Compass
Active — Not RecruitingPhase 2
Fecal Microbiota Transplant as Treatment of Hepatic Encephalopathy
United States30 participantsStarted 2018-04-01
Plain-language summary
A common complication of advanced liver disease is a condition called hepatic encephalopathy, which leads to confusion. The current treatment options cause side effects, are costly, and do not always work. An abnormal population of bacteria in the intestines may be causing this condition, and transplanting bacteria from the colon of a healthy person may treat it. In this research study, the investigators will first find two healthy stool donors whose stool donation improves the gut bacteria of patients with advanced liver disease and helps them think more clearly. Then, in a randomized controlled trial, the investigators will compare the ability of stool donation from these two best donors versus a placebo to improve the neurological function of patients with advanced liver disease. If the investigators find the expected results, there will be a new effective therapy for patients with advanced liver disease and the very troublesome complication of hepatic encephalopathy.
Who can participate
Age range18 Years – 75 Years
SexALL
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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Diagnosis of cirrhosis: Based on liver biopsy or clinical assessment of a hepatologist based on history, exam, laboratory and radiographic evidence
* History of at least one episode of overt HE, defined by West Haven Criteria Grades II to IV; episodes of HE that were precipitated by gastrointestinal hemorrhage requiring transfusion of at least 2 units of blood, by medication use, by renal failure requiring dialysis, or by injury to the central nervous system will not be counted as previous HE episodes
* Compliant with lactulose and rifaximin treatment (lactulose: at least one dose at least 5 days per week; rifaximin: at least one dose at least 5 days per week)
Exclusion Criteria:
* Current episode of overt HE as defined by West Haven Criteria Grades II to IV
* Expectation of liver transplantation within two months of the screening visit
* Current infection
* Variceal bleeding in the last 4 weeks
* Gut-absorbable or intravenous antibiotic therapy (including ciprofloxacin for SBP prophylaxis) in the last 3 months
* Alcohol or illicit drug intake within 3 months, by history and available serum testing; alcohol use will be characterized as \>1 alcoholic drink / month
* PSC as etiology of liver disease, as prior literature has suggested these individuals have a unique microbiome
* History of Roux-en-Y Gastric bypass
* On immunosuppressive medications
* Positive C. difficile test
* Scoring above a threshold cut-off on the Psychometric Hepatic Encephalopathy…
What they're measuring
1
Psychometric Hepatic Encephalopathy Score (PHES)
Timeframe: Before the first administration of FMT (day 0) and one week after the last administration of FMT (day 28)