REACT-AVB

NIHR LOGO

 

REACT-AVB -Randomised controlled trial of early transjugular intrahepatic portosystemic stent-shunt in acute variceal bleeding

 

REACT-AVB LOGO

REACT-AVB IS OPEN TO RECRUITMENT

Design

Randomised controlled trial of early transjugular intrahepatic portosystemic stent-shunt in acute variceal bleeding

Sponsor:   University of Birmingham

Chief Investigator:   Prof. Dhiraj Tripathi

Coordinating Centre:   Birmingham Clinical Trials Unit

Funder:   National Institute for Health Research (NIHR)

                 Health and Technologies Assessment (HTA) Programme

Aim of Study

To investigate the clinical and cost-effectiveness of early transjugular intrahepatic portosystemic stent-shunt (TIPSS) versus endoscopic plus pharmacological therapy in patients with cirrhosis and acute variceal bleeding after initial control of bleeding by variceal band ligation (VBL).

Setting

Acute NHS Trusts and Health Boards in the UK that admit and manage patients with acute variceal bleeding.

Target population

Patients with liver cirrhosis presenting with acute variceal bleeding which has been controlled by current therapy as recommended in the British Society of Gastroenterology (BSG) guidelines.1Sample size of 294 patients (1:1 randomisation) is required to show improved transplant free survival at one year from 60% to 80% with early TIPSS with 90% power (alpha=0.05), and allowing for 20% attrition.

Intervention

Early transjugular intrahepatic portosystemic stent-shunt (TIPSS) within 4 days of diagnostic endoscopy.

Or;

Endoscopic therapy and non-selective beta-blocker.

Latest News!

Queen Elizabeth Hospital (Birmingham) and The Royal Free Hospital (London) have now recruited their first patients into the REACT-AVB Trial!  Many congratulations to both teams on this wonderful achievement. 

John Radcliffe Hospital (Oxford) became the third site open to recruitment on the 10th April 2024.  We would like to thank our colleagues at John Radcliffe for all of their help during site set-up, and we look forward to them recruiting their first patient soon.

We are also delighted to inform you that the protocol has now been published in BMJ Open Gastroenterology: https://bmjopengastro.bmj.com/content/11/1/e001314.  Thank you to our collaborators for all of your efforts to make this happen!