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Albumin To prevenT Infection in chronic liveR failurE: study protocol for a single-arm feasibility trial

Skene, Simon, China, L, Muirhead, N, Shabir, Z, De Maeyer, R P H, Maini, A A N, Gilroy, D W and O'Brien, AJ (2016) Albumin To prevenT Infection in chronic liveR failurE: study protocol for a single-arm feasibility trial BMJ Open, 6 (1). pp1-6.

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Official URL: http://bmjopen.bmj.com

Abstract

Abstract Introduction Circulating prostaglandin E2 levels are elevated in acutely decompensated cirrhosis and have been shown to contribute to immune suppression. Albumin binds and inactivates this hormone. Human albumin solution could thus be repurposed as an immune restorative drug in these patients. This feasibility study aims to determine whether it is possible and safe to restore serum albumin to >30 g/L and maintain it at this level in patients admitted with acute decompensated cirrhosis using repeated 20% human albumin infusions according to daily serum albumin levels. Methods and analysis Albumin To prevenT Infection in chronic liveR failurE (ATTIRE) stage 1 is a multicentre, open label dose feasibility trial. Patients with acutely decompensated cirrhosis admitted to hospital with a serum albumin of <30 g/L are eligible, subject to exclusion criteria. Daily intravenous human albumin solution will be infused, according to serum albumin levels, for up to 14 days or discharge in all patients. The primary end point is daily serum albumin levels for the duration of the treatment period and the secondary end point is plasma-induced macrophage dysfunction. The trial will recruit 80 patients. Outcomes will be used to assist with study design for an 866 patient randomised controlled trial at more than 30 sites across the UK. Ethics and dissemination Research ethics approval was given by the London-Brent research ethics committee (ref: 15/LO/0104). The clinical trials authorisation was issued by the medicines and healthcare products regulatory agency (ref: 20363/0350/001-0001). Results Will be disseminated through peer reviewed journals and international conferences. Recruitment of the first participant occurred on 26/05/2015. Trial registration number The trial is registered with the European Medicines Agency (EudraCT 2014-002300-24) and has been adopted by the NIHR (ISRCTN 14174793). This manuscript refers to V.4.0 of the protocol; Pre-results.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > Surrey Clinical Research Centre
Faculty of Health and Medical Sciences
Authors :
NameEmailORCID
Skene, Simons.skene@surrey.ac.uk
China, L
Muirhead, N
Shabir, Z
De Maeyer, R P H
Maini, A A N
Gilroy, D W
O'Brien, AJ
Date : 25 January 2016
DOI : 10.1136/bmjopen-2015-010132
Copyright Disclaimer : Copyright 2016 the authors
Related URLs :
Depositing User : Diane Maxfield
Date Deposited : 24 Apr 2018 10:52
Last Modified : 16 Jan 2019 19:09
URI: http://epubs.surrey.ac.uk/id/eprint/846294

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