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Pancreatic Cystic LesionPrePaCystNCT06535490

Antibiotic Prophylaxis for EUS-FNA of Pancreatic Cystic Lesions

An observational study of Pancreatic Cystic Lesion, run by Société Française d'Endoscopie Digestive at 1 site in France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Large prospective comparative observational study in numerous reference centers in France, comparing infectious complications in patients admitted for pancreatic cystic lesions (PCL) aspiration performed with or without antibiotic prophylaxis (ATBp) according to the usual practices. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Pancreatic Cystic Lesion
What is being tested?
EUS-FNA and ATBp
How many people
1,702 participants
Where
1 siteFrance
Study dates
15 Sep 2024to 15 Oct 2027
Phase
Observational
Are there results?
Not yet: the study is under way

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: Patients with pancreatic cystic lesions for whom an EUS-FNA is indicated

Who may be able to join

  • Patient referred for diagnostic aspiration of a pancreatic cystic lesion
  • Patient aged 18 years or older
  • Patient with ASA 1, ASA 2, ASA 3 status
  • No participation in another concurrent clinical study

Who cannot join

  • Patient under 18 years old
  • Patient with ASA 4 or ASA 5 status
  • Pregnant woman
  • Patient with coagulation disorders preventing the performance of an EUS-FNA: PT < 50%, platelets < 50,000/mm³, current effective anticoagulation, ongoing clopidogrel, prasugrel, or ticagrelor treatment
  • Patient unable to personally express non-opposition or legally protected adult

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site
  • Clinique Paris-Bercy

    Charenton-le-Pont, 94220

    David KARSENTI, MD, +33143967850, karsenti.paris@gmail.com

Other trials in France

About this study

Official title: Prevention of Infection After EUS-FNA of Pancreatic Cystic Lesions: A French Multicenter Prospective Comparative Observational Study

Large prospective comparative observational study in numerous reference centers in France, comparing infectious complications in patients admitted for pancreatic cystic lesions (PCL) aspiration performed with or without antibiotic prophylaxis (ATBp) according to the usual practices.

This is a prospective, comparative, observational, multicenter study, with the primary objective of comparing the infection rates in pancreatic cystic lesions (PCL) aspirated under EUS, with and without the administration of ATBp.

A sample size of 1702 patients will be needed over a 3-year study period.

Read the detailed description

The complication rate after EUS fine needle aspiration (EUS-FNA) for pancreatic cystic lesions (PCL) is low, around 1-3% according to various series. However, it has long been recommended to perform this procedure under antibiotic prophylaxis (ATBp). Due to the risk of developing resistance to certain classes of antibiotics and the risk of complications, particularly allergic reactions, the role of ATBp in this indication needs to be reconsidered. The latest recommendations from European and French societies do not support the systematic formal indication of ATBp for aspiration under EUS. Because the literature on the subject is sparse and equivocal, practices remain varied (some performing PCL aspirations with and others without ATBp), and scientific societies do not provide a formal stance on the benefit of such ATBp. Therefore, we decided to conduct a very large prospective comparative observational study in numerous reference centers in France (centers of the Research and Action Group in Endoscopy - GRAPHE), comparing infectious complications in patients admitted for EUS-FNA for PCL performed with or without ATBp according to the usual practices .

This is a prospective, comparative, observational, multicenter study.

Primary objective:

Comparison of infection rates after EUS-FNA for pancreatic cystic lesions (PCL) , with and without the administration of ATBp.

Secondary objectives:

Rates of other infectious complications (pulmonary, urinary, etc.) Rates of post-ATBp complications, particularly allergic reactions Prolongation of scheduled hospitalization Evaluation of factors associated with post-EUS aspiration infection of PCL

After the endoscopic exploration, the patient will be monitored for the potential occurrence of complications related to EUS (perforation, hemorrhage, infection, allergy, etc.). Any adverse events will be recorded at 30 days post-procedure.

A sample size of 1702 patients will be needed over a 3-year study period.

Being tested
EUS-FNA, ATBp
Keywords
EUS-FNA, Pancreatic cystic lesion, Antibiotic prophylaxis

What participants receive

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

  • EUS-FNAProcedure or surgery

    Also called EUS fine needle aspiration

    Puncture of pancreatic cystic lesion with a fine needle under EUS guidance

  • ATBpDrug

    Also called Antibiotic prophylaxis

    Antibiotic prophylaxis consists of a single intravenous administration before or at the beginning of the procedure according to the common practices of each practitioner or unit

Study groups in NCT06535490
Study groupRoleWhat they receive
EUS-FNA for PCL with ATBpPatients undergoing EUS-FNA for pancreatic cystic lesions WITH ATBp
Receives: Procedure: EUS-FNA; Drug: ATBp
EUS-FNA for PCL without ATBpPatients undergoing EUS-FNA for pancreatic cystic lesions without ATBp
Receives: Procedure: EUS-FNA

What is being measured

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

  1. Post EUS-FNA PCL infection rate

    Post-EUS-FNA infection rate of PCL (patients exhibiting clinical and biological signs - fever >38.5°C, neutrophilic leukocytosis, elevated CRP, pathogen identification in blood cultures - indicative of sepsis requiring prolonged antibiotic therapy). The occurrence of the aforementioned clinical and biological signs, along with imaging evidence (such as cyst wall thickening or presence of intracystic air images) and the absence of another infection source (urinary, pulmonary, venous, etc.) will lead to the diagnosis of post-FNA infection. Centralized validation of infection cases will be conducted by an expert panel based on clinical, biological, and imaging findings.

    Measured: 30 days

Secondary outcomes (15)
  1. Rate of urinary infectious complications

    Number of patients with at least one urinary infection within 21-30 days after EUS-FNA

    Measured: 30 days

  2. Rate of post-ATBp allergic reactions

    Number of patients with at least one allergic reaction within 21-30 days after EUS-FNA

    Measured: 30 days

  3. Duration and extension of hospitalization

    Number of hospitalization days per stay within 30 days following EUS-FNA

    Measured: 30 days

  4. Diameter of the needle used for EUS-FNA

    25G, 22G, 20G, or 19G

    Measured: 1 days

  5. Associated procedures (confocal endomicroscopy or intracystic biopsy)

    Yes or No

    Measured: 1 days

  6. Appearance of the fluid

    Thin, thick, hemorrhagic

    Measured: 1 day

  7. Complete aspiration of the cyst fluid

    Yes or No

    Measured: 1 day

  8. Nature of the PCL

    mucinous vs. non-mucinous

    Measured: 30 days

  9. Age

    Years

    Measured: 1 day

  10. Gender

    Male or female

    Measured: 1 day

  11. Diabetes

    Yes or No

    Measured: 1 day

  12. Immunosuppression

    Yes or No

    Measured: 1 day

  13. BMI

    Weight/(size)2 expressed in in kg/m^2

    Measured: 1 day

  14. history of aspiration of the same lesion

    Yes or No

    Measured: 1 day

  15. Rate of pulmonary infectious complications

    Number of patients with at least one pulmonary infection within 21-30 days after EUS-FNA

    Measured: 30 days

Timeline

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

  1. First posted2 Aug 2024
  2. Study start15 Sep 2024 (estimated)
  3. Primary completion15 Sep 2027 (estimated)
  4. Study completion15 Oct 2027 (estimated)

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
Cohort
Time perspective
Prospective
Enrolment
1,702 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06535490
Sponsor's protocol ID
SFED-165
Acronym
PrePaCyst
Status last verified
Aug 2024
First submitted
28 Jul 2024
Last updated
2 Aug 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Polkowski M, Jenssen C, Kaye P, Carrara S, Deprez P, Gines A, Fernandez-Esparrach G, Eisendrath P, Aithal GP, Arcidiacono P, Barthet M, Bastos P, Fornelli A, Napoleon B, Iglesias-Garcia J, Seicean A, Larghi A, Hassan C, van Hooft JE, Dumonceau JM. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline - March 2017. Endoscopy. 2017 Oct;49(10):989-1006. doi: 10.1055/s-0043-119219. Epub 2017 Sep 12.

    PubMed 28898917
  • Facciorusso A, Mohan BP, Tacelli M, Crino SF, Antonini F, Fantin A, Barresi L. Use of antibiotic prophylaxis is not needed for endoscopic ultrasound-guided fine-needle aspiration of pancreatic cysts: a meta-analysis. Expert Rev Gastroenterol Hepatol. 2020 Oct;14(10):999-1005. doi: 10.1080/17474124.2020.1797486. Epub 2020 Jul 25.

    PubMed 32674699
  • Facciorusso A, Arevalo-Mora M, Conti Bellocchi MC, Bernardoni L, Ramai D, Gkolfakis P, Loizzi D, Muscatiello N, Ambrosi A, Tartaglia N, Robles-Medranda C, Stasi E, Ofosu A, Crino SF. Impact of Antibiotic Prophylaxis on Infection Rate after Endoscopic Ultrasound Through-the-Needle Biopsy of Pancreatic Cysts: A Propensity Score-Matched Study. Diagnostics (Basel). 2022 Jan 16;12(1):211. doi: 10.3390/diagnostics12010211.

    PubMed 35054378
  • Facciorusso A, Buccino VR, Turco A, Antonino M, Muscatiello N. Antibiotics Do Not Decrease the Rate of Infection After Endoscopic Ultrasound Fine-Needle Aspiration of Pancreatic Cysts. Dig Dis Sci. 2019 Aug;64(8):2308-2315. doi: 10.1007/s10620-019-05655-x. Epub 2019 May 7.

    PubMed 31065897
  • Klein A, Qi R, Nagubandi S, Lee E, Kwan V. Single-dose intra-procedural ceftriaxone during endoscopic ultrasound fine-needle aspiration of pancreatic cysts is safe and effective: results from a single tertiary center. Ann Gastroenterol. 2017;30(2):237-241. doi: 10.20524/aog.2016.0118. Epub 2016 Dec 22.

    PubMed 28243046
  • Guarner-Argente C, Shah P, Buchner A, Ahmad NA, Kochman ML, Ginsberg GG. Use of antimicrobials for EUS-guided FNA of pancreatic cysts: a retrospective, comparative analysis. Gastrointest Endosc. 2011 Jul;74(1):81-6. doi: 10.1016/j.gie.2011.03.1244.

    PubMed 21704808
  • Lee LS, Saltzman JR, Bounds BC, Poneros JM, Brugge WR, Thompson CC. EUS-guided fine needle aspiration of pancreatic cysts: a retrospective analysis of complications and their predictors. Clin Gastroenterol Hepatol. 2005 Mar;3(3):231-6. doi: 10.1016/s1542-3565(04)00618-4.

    PubMed 15765442
  • Colan-Hernandez J, Sendino O, Loras C, Pardo A, Gornals JB, Concepcion M, Sanchez-Montes C, Murzi M, Andujar X, Velasquez-Rodriguez J, Rodriguez de Miguel C, Fernandez-Esparrach G, Gines A, Guarner-Argente C. Antibiotic Prophylaxis Is Not Required for Endoscopic Ultrasonography-Guided Fine-Needle Aspiration of Pancreatic Cystic Lesions, Based on a Randomized Trial. Gastroenterology. 2020 May;158(6):1642-1649.e1. doi: 10.1053/j.gastro.2020.01.025. Epub 2020 Jan 20.

    PubMed 31972236

Questions about this trial

What is this clinical trial studying?

An observational study of Pancreatic Cystic Lesion, run by Société Française d'Endoscopie Digestive at 1 site in France.

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 4 inclusion and 5 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: opening soon, as of the sponsor's last update on 2 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact David KARSENTI, MD (+33 1 43 96 78 50, karsenti.paris@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post EUS-FNA PCL infection rate (time frame: 30 days). 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 NCT06535490, which also lists 8 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 2 Aug 2024.

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