SThe Effects of Melatonin on GERD Symptoms

NCT ID: NCT00564590

Last Updated: 2007-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE1/PHASE2

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2011-01-31

Brief Summary

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We hypothesize that melatonin as compared to PPI and to placebo, improves GERD symptoms by decreasing esophageal acid exposure and esophageal acid sensitivity in GERD. We hypothesize that melatonin as compared to PPI and to placebo reduce the frequency and duration of transient lower esophageal sphincter relaxations (TLESRs). In addition we hypothesize that melatonin as compared to PPI and to placebo improves quality of life and quality of sleep of GERD patients.

Detailed Description

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Background: Gastroesophageal reflux disease (GERD) is a chronic, persistent and common medical problem. The standard of care for GERD includes chronic administration of acid-suppressive drugs. However, clinical failure in GERD is increasingly reported.

Aim: To determine the efficacy of treatment with melatonin as compared to standard dose proton pump inhibitor (PPI) as compared to placebo in patients with GERD.

Study objectives: \[1\] To compare the degree of GERD symptoms improvement and esophageal acid sensitivity before and after treatment. \[2\] To determine the effect of treatment on the % total, upright and supine time pH \<4 using 24-hour esophageal pH monitoring. \[3\] To determine the effect of treatment on frequency and duration of lower esophageal sphincter relaxation. \[4\] To compare the quality of life and quality of sleep in GERD patients before and after treatment.

Methods: This is a randomized, double blind, parallel groups study of 150 patients with GERD. Patients with classic heartburn symptoms (heartburn and/or regurgitation) and normal upper endoscopy from the gastroenterology department at Rabin Medical Center will be enrolled into the study. At baseline, all enrolled patients will have 24-hour esophageal pH monitoring and a modified acid perfusion test to assess the extent of distal esophageal acid exposure and esophageal acid sensitivity, respectively. Patients will be evaluated by a demographics questionnaire, the GERD Symptom Questionnaire, the Quality of Sleep questionnaire and the SF-36. Baseline urinary excretion of the main melatonin metabolite, 6-sulfatoxymelatonin (6SMT) will be assessed in all subjects at baseline. Patients will be randomized to either melatonin or standard dose PPI or placebo over a period of 4 weeks. In addition patients will fill a diary on a daily basis that documents severity and frequency of GERD-related symptoms. Symptom score (frequency x severity) will be calculated for previous 7 days at baseline and at the end of treatment in all groups. After 4 weeks of treatment, patients will undergo a second 24-hour esophageal pH monitoring, a modified acid perfusion test and will complete the GERD Symptom Questionnaire, the Quality of Sleep Questionnaire and the SF-36.

Implications: This study will determine if melatonin decreases GERD symptoms, acid esophageal exposure and improves quality of life and sleep in patients with GERD. Furthermore, if there will be a significant clinical response to melatonin it will be possible to add this compound to the treatment armamentum of GERD.

Conditions

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Gastroesophageal Reflux Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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A

Melatonin treatment group

Group Type EXPERIMENTAL

Melatonin

Intervention Type DRUG

4 mg of Melatonin once a day for 3 months

B

Omeprazole 20 mg once a day for 3 months

Group Type ACTIVE_COMPARATOR

omeprazole

Intervention Type OTHER

omeprazole 20 mg once a day

C

Placebo once a day for 3 months

Group Type EXPERIMENTAL

Placebo

Intervention Type DRUG

Placebo once a day

Interventions

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Melatonin

4 mg of Melatonin once a day for 3 months

Intervention Type DRUG

omeprazole

omeprazole 20 mg once a day

Intervention Type OTHER

Placebo

Placebo once a day

Intervention Type DRUG

Other Intervention Names

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Omepradex

Eligibility Criteria

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Inclusion Criteria

* Ages 18-75.
* Male or female.
* GERD symptoms at least twice a week for the last three months.
* Able to read, understand and complete study questionnaires and diary
* Understand the study procedures and sign written informed consent.
* Able to comply with all study requirements.

Exclusion Criteria

* Subjects with erosive esophagitis (EE), Barrett's esophagus (BE) and esophageal stricture or adenocarcinoma on upper endoscopy.
* Subjects with previous upper gastrointestinal surgery.
* Subjects with clinically significant medical conditions (cardiovascular, respiratory, renal, hepatic, hematologic, endocrine, neurologic and psychiatric); examples as follows: liver cirrhosis, severe COPD, severe renal failure, severe heart failure, active malignancy.
* Subjects requiring narcotics (morphine, methadone, etc.).
* Subjects requiring melatonin
* Subjects with diabetes, scleroderma and neuromuscular disorders.
* Lactating or pregnant women.
* Subjects with an unrecognized lifestyle such as shift workers.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rabin Medical Center

OTHER

Sponsor Role lead

Principal Investigators

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Ram M Dickman, MD

Role: PRINCIPAL_INVESTIGATOR

Rabin Medical Center

Locations

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Rabin Medical Center, Beilinson Hospital

Petah Tikva, , Israel

Site Status

Countries

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Israel

Central Contacts

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Ram M Dickman, MD

Role: CONTACT

Phone: 03:9377236

Email: [email protected]

Tami Lederfine

Role: CONTACT

Phone: 03:9377040

Email: [email protected]

References

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Pereira Rde S. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. J Pineal Res. 2006 Oct;41(3):195-200. doi: 10.1111/j.1600-079X.2006.00359.x.

Reference Type BACKGROUND
PMID: 16948779 (View on PubMed)

Other Identifiers

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004548

Identifier Type: -

Identifier Source: org_study_id