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Liver Cirrhosis With Acute DecompensationPREDICTNCT03056612

Predicting Acute-on-Chronic Liver Failure in Cirrhosis (PREDICT) Study

An observational study of Liver Cirrhosis With Acute Decompensation, run by Jonel Trebicka at 45 sites in 14 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this study is to assess prospectively the critical period prior to the development of Acute-on-Chronic Liver Failure (ACLF) (1), to uncover mechanistic and pathophysiological processes associated with the development and clinical course of ACLF (2) and to identify the precipitating events of ACLF (3). Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Observation protocol
How many people
1,314 participants
Where
45 sitesin 14 countries
Study dates
31 Mar 2017to 31 Oct 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The population of patients would include ca. 1,200 cirrhotic patients over a twelve-months period. These patients will be admitted/referred to the study center because of acute decompensation of cirrhosis (ascites, overt encephalopathy, GI-hemorrhage, new onset of non-obstructive jaundice and/or bacterial infections), without ACLF (as defined according to the CANONIC study ) at hospitalization.

Who may be able to join

  • The patients admitted/referred to study center with AD of cirrhosis (ascites, overt encephalopathy, new onset of non-obstructive jaundice, GI-hemorrhage and/or bacterial infections), but without ACLF (as defined according to the CANONIC study) at study inclusion.

Who cannot join

  • Presence of ACLF at inclusion;
  • Pregnancy;
  • Age <18 years;
  • Patients with acute or subacute liver failure without underlying cirrhosis;
  • Patients with cirrhosis who develop decompensation in the postoperative period following partial hepatectomy;
  • Evidence of current malignancy except for non-melanocytic skin cancer and hepatocellular carcinoma within Milan criteria;
Show all 12Show fewer
  • Presence or history of severe extra-hepatic diseases (e.g., chronic renal failure requiring hemodialysis, severe heart disease (NYHA > II); severe chronic pulmonary disease (GOLD > III), severe neurological and psychiatric disorders);
  • HIV-positive patients
  • Previous liver or other transplantation
  • Admission/referral of more than 72 hours before inclusion
  • Patients who decline to participate or who cannot provide prior written informed consent and when there is documented evidence that the patient has no legal surrogate decision maker and it appears unlikely that the patient will regain consciousness or sufficient ability to provide delayed informed consent;
  • Physician´s denial (e.g. the investigator considers that the patient will not follow the protocol scheduled).

Trial locations and contacts

45 sites in 14 countries.

45 sites in 14 countries

Germany8 sites
  • RTWH Aachen

    Aachen

  • University Hospital Bonn

    Bonn

  • JW Goethe University Hospital

    Frankfurt am Main

  • University Hospital Halle-Wittenberg

    Halle

  • Hannover Medical School

    Hanover

  • University Hospital Jena

    Jena

  • University Hospital Leipzig

    Leipzig

  • University Hospital Munich LMU

    Munich

Other trials in Germany

Spain6 sites
  • Hospital Clinic y Provencial de Barcelona

    Barcelona

  • Hospital de Sant Pau

    Barcelona

  • Hospital Universitari Vall d´Hebron

    Barcelona

  • Hospital General Universitario Gregorio Maranon

    Madrid

  • Hospital Ramon y Cajal

    Madrid

  • Virgen del Rocio

    Seville

Other trials in Spain

United Kingdom6 sites
  • Birmingham University Hospitals

    Birmingham

  • Imperial College

    London

  • King´s College

    London

  • Royal Free Hospital

    London

  • Nottingham University Hospitals

    Nottingham

  • Derriford Hospital, Plymouth Hospitals Trust

    Plymouth

Other trials in United Kingdom

Italy5 sites
  • University of Bologna

    Bologna

  • Internal Medicine PO Ostuni

    Brindisi

  • University Clinic Padova

    Padova

  • Universita Sapienza

    Rome

  • A.O.U. Torino

    Torino

Other trials in Italy

Belgium4 sites
  • University Hospital Antwerp

    Antwerp

  • C.U.B Erasmo

    Brussels

  • Ghent University Hospital

    Ghent

  • University Hospital Leuven

    Leuven

Other trials in Belgium

Austria3 sites
  • Medical University Graz

    Graz

  • Medical University of Innsbruck

    Innsbruck

  • Medical University of Vienna

    Vienna

Other trials in Austria

France3 sites
  • Hospital Jean Verdier

    Bondy

  • Hopital Beaujon

    Paris

  • Hopital Paul Brousse

    Paris

Other trials in France

Switzerland3 sites
  • Inselspital

    Bern

  • Hôpitaux Universitaires Geneve

    Geneva

  • Cantonal Hospital St. Gallen

    Sankt Gallen

Other trials in Switzerland

Denmark2 sites
  • Aarhus University Hospital

    Aarhus

  • Hvidovre University Hospital

    Copenhagen

Other trials in Denmark

Hungary1 site
  • University of Debrecen

    Debrecen

Other trials in Hungary

Netherlands1 site
  • Leiden University Medical Center

    Leiden

Other trials in Netherlands

Portugal1 site
  • CHTMAD Vila Real

    Vila Real

Other trials in Portugal

Slovakia1 site
  • Pavol Jozef Sfarik University Kosice/Roosevelt Hospital Bystrica

    Košice

Other trials in Slovakia

Turkey (Türkiye)1 site
  • Marsara University

    Istanbul

Other trials in Turkey (Türkiye)

About this study

The aim of this study is to assess prospectively the critical period prior to the development of Acute-on-Chronic Liver Failure (ACLF) (1), to uncover mechanistic and pathophysiological processes associated with the development and clinical course of ACLF (2) and to identify the precipitating events of ACLF (3).

Read the detailed description
  1. This International-European, investigator-initiated, multicenter, prospective, observational study will be performed in centers that belong to the European Foundation for the Study of Chronic Liver failure (EF-CLIF)-European Association for Study of the Liver (EASL)-EASL-CLIF Consortium.
  2. The population of patients would include ca. 1,200 cirrhotic patients over a twelve-months period. These patients will be admitted/referred to the study center because of acute decompensation (AD) of cirrhosis (ascites, overt encephalopathy, GI-hemorrhage, new onset of non-obstructive jaundice and/or bacterial infections), without ACLF (as defined according to the Canonic study ) at hospitalization.
  3. After the enrolment visit, the patients will be stratified into two groups: Group 1 patients with high risk of ACLF development (CLIF-C AD score ≥ 50) and in Group 2 patients with low risk of ACLF (CLIF-C AD score <50). The whole cohort will be followed for 3 months, while Group 1 will be followed more closely. Development of ACLF is an end-point and in this case a final visit 7-10 days after ACLF development is planned. Data on liver transplantation, mortality and causes of mortality 3 months, 6 months and 12 months will be collected in the whole cohort.
  4. Prospective collection of biological material and performance of ancillary studies investigating predictors for development and pathogenesis of ACLF.

Specific goals of the study:

  • To identify early clinical predictors, biomarkers, mechanisms and precipitating events during the critical period prior to and involved in the development and clinical course of ACLF (with special emphasis to medical trajectory and drug history) in patients admitted/referred to study center with acute decompensation of cirrhosis (ascites, GI-hemorrhage, overt encephalopathy, new onset of non-obstructive jaundice and/or bacterial infections) and the chronological relationship of the events with occurrence and dynamics of ACLF development.
  • To develop a score predicting ACLF development (CLIF-PREDICT score) and assess 28-day, 90-day, 6-month and 1-year all-cause mortality in cirrhotic patients with acute AD, but without ACLF.
  • To serve as a core (hub) study for prospective ancillary studies regarding diagnosis, prognosis and pathogenesis of AD and ACLF.

Main endpoints

  • Assessment of the critical period prior to ACLF development
  • Characterization of mechanisms responsible for ACLF development
  • Predictors of clinical course dynamics of ACLF evolution and mortality.
  • Identification and role of precipitating events for ACLF development.
  • To elaborate a CLIF-PREDICT score 2. Secondary endpoints
  • Prospective core ancillary studies to investigate the pathogenesis of ACLF.
Being tested
Observation protocol

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Observation protocolOther

    The whole cohort will be followed for 3 months, while Group 1 will be followed more closely.

Study groups in NCT03056612
Study groupRoleWhat they receive
Group 1Group 1 patients with high risk of ACLF development (CLIF-C AD score ≥ 50)
Receives: Other: Observation protocol
Group 2Group 2 patients with low risk of ACLF (CLIF-C AD score <50)
Receives: Other: Observation protocol
ACLFACLF-patients were specified the patients who were admitted at hospital with ACLF,
Receives: Other: Observation protocol

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of patients developing ACLF within 12 weeks and severity of ACLF development

    • Characterization of mechanisms responsible for ACLF development
    • Predictors of clinical course dynamics of ACLF evolution and mortality.
    • Identification and role of precipitating events for ACLF development.

    Measured: 12 weeks

Secondary outcomes (1)
  1. Score to PREDICT ACLF

    -Calculate a Score to predict ACLF

    Measured: 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Feb 2017
  2. Study start31 Mar 2017
  3. Primary completion31 Jul 2018
  4. Study completion31 Oct 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
1,314 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03056612
Sponsor's protocol ID
PREDICT
Acronym
PREDICT
Status last verified
Apr 2019
First submitted
13 Feb 2017
Last updated
12 Apr 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Van Espen L, Brol MJ, Close L, Schierwagen R, Gu W, Keller MI, Balogh B, Fullam A, De Coninck L, Nakamura T, Kuhn M, Bork P, Laleman W, Bajaj JS, Papp M, Schnabl B, Trebicka J, Matthijnssens J; MICROB-PREDICT. L actococcus A phages predict ACLF while Enterococcus B phages predict bacterial infection in decompensated cirrhosis. JHEP Rep. 2025 Oct 10;8(1):101622. doi: 10.1016/j.jhepr.2025.101622. eCollection 2026 Jan.

    PubMed 41438339
  • Weiss E, de la Pena-Ramirez C, Aguilar F, Lozano JJ, Sanchez-Garrido C, Sierra P, Martin PI, Diaz JM, Fenaille F, Castelli FA, Gustot T, Laleman W, Albillos A, Alessandria C, Domenicali M, Caraceni P, Piano S, Saliba F, Zeuzem S, Gerbes AL, Wendon JA, Jansen C, Gu W, Papp M, Mookerjee R, Gambino CG, Jimenez C, Giovo I, Zaccherini G, Merli M, Putignano A, Uschner FE, Berg T, Bruns T, Trautwein C, Zipprich A, Banares R, Presa J, Genesca J, Vargas V, Fernandez J, Bernardi M, Angeli P, Jalan R, Claria J, Junot C, Moreau R, Trebicka J, Arroyo V. Sympathetic nervous activation, mitochondrial dysfunction and outcome in acutely decompensated cirrhosis: the metabolomic prognostic models (CLIF-C MET). Gut. 2023 Aug;72(8):1581-1591. doi: 10.1136/gutjnl-2022-328708. Epub 2023 Feb 14.

    PubMed 36788015
  • Trebicka J, Fernandez J, Papp M, Caraceni P, Laleman W, Gambino C, Giovo I, Uschner FE, Jansen C, Jimenez C, Mookerjee R, Gustot T, Albillos A, Banares R, Jarcuska P, Steib C, Reiberger T, Acevedo J, Gatti P, Shawcross DL, Zeuzem S, Zipprich A, Piano S, Berg T, Bruns T, Danielsen KV, Coenraad M, Merli M, Stauber R, Zoller H, Ramos JP, Sole C, Soriano G, de Gottardi A, Gronbaek H, Saliba F, Trautwein C, Kani HT, Francque S, Ryder S, Nahon P, Romero-Gomez M, Van Vlierberghe H, Francoz C, Manns M, Garcia-Lopez E, Tufoni M, Amoros A, Pavesi M, Sanchez C, Praktiknjo M, Curto A, Pitarch C, Putignano A, Moreno E, Bernal W, Aguilar F, Claria J, Ponzo P, Vitalis Z, Zaccherini G, Balogh B, Gerbes A, Vargas V, Alessandria C, Bernardi M, Gines P, Moreau R, Angeli P, Jalan R, Arroyo V; PREDICT STUDY group of the EASL-CLIF CONSORTIUM. PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis. J Hepatol. 2021 May;74(5):1097-1108. doi: 10.1016/j.jhep.2020.11.019. Epub 2020 Nov 20.

    PubMed 33227350
  • Trebicka J, Fernandez J, Papp M, Caraceni P, Laleman W, Gambino C, Giovo I, Uschner FE, Jimenez C, Mookerjee R, Gustot T, Albillos A, Banares R, Janicko M, Steib C, Reiberger T, Acevedo J, Gatti P, Bernal W, Zeuzem S, Zipprich A, Piano S, Berg T, Bruns T, Bendtsen F, Coenraad M, Merli M, Stauber R, Zoller H, Ramos JP, Sole C, Soriano G, de Gottardi A, Gronbaek H, Saliba F, Trautwein C, Ozdogan OC, Francque S, Ryder S, Nahon P, Romero-Gomez M, Van Vlierberghe H, Francoz C, Manns M, Garcia E, Tufoni M, Amoros A, Pavesi M, Sanchez C, Curto A, Pitarch C, Putignano A, Moreno E, Shawcross D, Aguilar F, Claria J, Ponzo P, Jansen C, Vitalis Z, Zaccherini G, Balogh B, Vargas V, Montagnese S, Alessandria C, Bernardi M, Gines P, Jalan R, Moreau R, Angeli P, Arroyo V; PREDICT STUDY group of the EASL-CLIF Consortium. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology. J Hepatol. 2020 Oct;73(4):842-854. doi: 10.1016/j.jhep.2020.06.013. Epub 2020 Jul 13.

    PubMed 32673741

Questions about this trial

What is this clinical trial studying?

An observational study of Liver Cirrhosis With Acute Decompensation, run by Jonel Trebicka at 45 sites in 14 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Apr 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 45 sites in Germany, Spain, United Kingdom, Italy, Belgium and 9 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of patients developing ACLF within 12 weeks and severity of ACLF development (time frame: 12 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03056612, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Apr 2019.

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