Alcohol-related Liver Disease

An adaptive-design randomised placebo-controlled trial of baclofen in the treatment of alcohol use disorder in patients with liver cirrhosis (BASIS)

Addressing priority 1:  NIHR research in progress

This research will evaluate whether baclofen is an effective treatment option in patients with alcohol-related liver cirrhosis, and which dose(s) is/are safe and effective.

Primary Antibiotic Prophylaxis using Cotrimoxazole to Prevent Spontaneous Bacterial Peritonitis in Cirrhosis ACRONYM: ASEPTIC - Antibiotic SpontanEous PeritoniTIs Cirrhosis

Addressing priority 8NIHR research in progress

This research aims to determine the effectiveness of giving antibiotics to adults with cirrhosis and ascites but no previous episode of spontaneous bacterial peritonitis (SBP) to improve overall survival by
reducing bacterial infections, especially SBP; this is termed “primary prophylaxis”. In patients with liver cirrhosis, bacterial infection or sepsis carries a terrible mortality. SBP is the most common serious infection in people with cirrhosis.  While antibiotic prophylaxis to prevent further infection has been established for those with a prior episode of SBP or presentation to hospital with upper gastrointestinal bleeding, there is uncertainty over primary prophylaxis for SBP. 

A PROspective double-blind placebo-controlled multicentre trial of faecal MIcrobiota tranSplantation to improve outcomEs in patients with cirrhosis - PROMISE trial

Addressing priority 8NIHR research in progress

Patients with cirrhosis are very susceptible to infections, antibiotics become ineffective and patients may become infected with 'super bugs'. There is an urgent need for antibiotic-free approaches. Our body contains trillions of microscopic organisms called bacteria which play an important role in keeping us healthy. Many of these bacteria live within our bowel and help our immune system fight infection. There are increased numbers of 'unfriendly' bowel bacteria in patients with cirrhosis which emit substances which are harmful to health and disrupt the immune system. It could be beneficial to replace the unfriendly bowel bacteria in patients with cirrhosis with bacteria donated from a healthy person by performing a type of bowel bacteria transplant (known as faecal microbiota transplantation or FMT).  This trial tests the effectiveness of treating patients with FMT capsules, rather than by endoscopy.