Midodrine Plus Albumin Versus Midodrine Alone to Prevent Cirrhosis Related Complications in Children With Cirrhosis and Ascites - An Open Label Randomized Controlled Trial.

Status: Recruiting
Location: See location...
Intervention Type: Biological, Other, Drug
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Children with decompensated cirrhosis are more prone to develop various complications. The pathogenesis of cirrhotic complications (ascites, hyponatremia, acute kidney injury) includes release of vasodilatory molecules like nitric oxide, damage associated molecular pathogens (DAMPs) and pattern associated molecular pathogens (PAMPs) secondary to bacterial translocation, which causes splanchnic bed vasodilation resulting in activation of renin-angiotensin and aldosterone axis (RAAS) causing sodium and water retention and renal vasoconstriction. The development of complications in these children may result in death or may preclude them from reaching upto liver transplantation. Midodrine is an α1 adrenergic receptor agonist, which increases vascular tone causing rise in the blood pressure, thereby improving renal perfusion and causes RAAS deactivation. The effects of midodrine is documented in reduction of refractory ascites, hepatorenal syndrome and hyponatremia. Albumin is a protien that works by both increasing the colloidal oncotic pressure and improving systemic circulation as well as by effecting the body with anti-inflammatory and antioxidant properties. We have already demonstrated the safety and efficacy of midodrine as well as albumin in cirrhotic children. However, none of these drugs alone provided survival benefit to the patients. Hence, we have planned this study with the ojective to evaluate if combining these 2 drugs (midodrine and albumin) would further reduce the complications and improve the survival in decompensated cirrhotic children.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 12
Maximum Age: 18
Healthy Volunteers: f
View:

• Children (≤ 18 years)

• Cirrhosis based on histological/ radiological + endoscopic evidence

• Clinical ascites (≥ grade 2 ascites)

• Informed consent from parents (Assent \> 12 years)

Locations
Other Locations
India
Institute of Liver & Biliary Sciences (ILBS)
RECRUITING
New Delhi
Contact Information
Primary
Dr Samannay Das, MD
rimon100393@gmail.com
01146300000
Time Frame
Start Date: 2023-11-02
Estimated Completion Date: 2025-12-31
Participants
Target number of participants: 60
Treatments
Experimental: Midodrine+Albumin+SMT
* Albumin infusion 1g/kg/day (max 20g) every two weeks (if pre-infusion serum albumin is \< 3.5 gm/dl Plus~* Midodrine starting at 0.25mg/kg/day in divided doses, increased to 0.5mg/kg/day after 7 days if MAP does not increase by \>10% .~In addition, standard medical therapy will be administered to patients in both the arms.
Active_comparator: Midodrine+SMT
• Midodrine starting at 0.25mg/kg/day in divided doses, increased to 0.5mg/kg/day after 7 days if MAP does not increase by \>10% In addition, standard medical therapy will be administered to patients in both the arms.
Sponsors
Leads: Institute of Liver and Biliary Sciences, India

This content was sourced from clinicaltrials.gov