Viewing Study NCT00006168



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Study NCT ID: NCT00006168
Status: COMPLETED
Last Update Posted: 2010-01-13
First Post: 2000-08-08

Brief Title: Ursodiol-Methotrexate for Primary Biliary Cirrhosis
Sponsor: National Institute of Diabetes and Digestive and Kidney Diseases NIDDK
Organization: National Institute of Diabetes and Digestive and Kidney Diseases NIDDK

Study Overview

Official Title: None
Status: COMPLETED
Status Verified Date: 2010-01
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: False
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: None
Brief Summary: The major thrust is to determine whether treatment of patients with Primary Biliary Cirrhosis PBC with Ursodiol Ursodeoxycholic Acid-UDCA plus methotrexate MTX is more effective than treatment with UDCA alone
Detailed Description: PBC is a chronic cholestatic liver disease predominantly of women in which interlobular and septal bile ducts undergo inflammation and destruction Once initiated the disease persists and progresses at varying rates Neither the initiating nor perpetuating mechanisms are well understood Current concepts of pathogenesis include 1 destruction of bile ducts is maintained and perhaps initiated by autoimmune mechanisms 2 hydrophobic bile acids which accumulate in serum and liver cause functional and cytotoxic liver injury 3 cytokines and lymphokines released at sites of inflammation may contribute to cell damage and fibrosis A considerable body of evidence indicates that UDCA when fed orally leads to improvement in liver tests in pruritus and in liver histology There exist differences in opinion as to whether development of complications of liver disease liver transplantation or transplant-free survival is affected UDCA a relatively non-toxic bile acid when administered orally alters the composition of the bile acid pool in factor of its enrichment with UDCA and appears to protect against the cytotoxic effects of endogenous bile acids that accumulate as a result of bile acid destruction MTX is being shown to improve liver tests symptoms and liver histology in a small number of precirrhotic patients with PBC The mechanism of action is unknown but felt to be related to anti-inflammatory immunosuppressive effects of MTX The current trial explores whether MTX improves the therapeutic effects of UDCA in PBC Patients with PBC whose serum bilirubin is less than 3 mg who have been on UDCA for at least 6 months and who satisfy a series of inclusion and exclusion criteria are stratified into 2 groups on the basis of liver histologic stage Ludwig classification ie early Stages I and II versus late Stages III or IV They are then randomized to receive either methotrexate or its placebo as a second drug while continuing to receive UDCA The relative value of the two treatment arms is assessed by comparing their effects on symptoms results of laboratory tests development of complications of liver disease histologic changes in liver liver transplantation and on transplant-free survival The safety of each therapeutic regimen is also being determined

Study Oversight

Has Oversight DMC:
Is a FDA Regulated Drug?:
Is a FDA Regulated Device?:
Is an Unapproved Device?:
Is a PPSD?:
Is a US Export?:
Is an FDA AA801 Violation?:
Secondary IDs
Secondary ID Type Domain Link
5R01DK046602 NIH None httpsreporternihgovquickSearch5R01DK046602