Sequential Versus Quadruple Therapy in the Second-line Treatment

NCT ID: NCT03208426

Last Updated: 2018-06-04

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

PHASE4

Total Enrollment

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-01

Study Completion Date

2020-12-31

Brief Summary

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Objectives: A recent randomized trial showed that 14-day sequential therapy containing high dose proton pump inhibitor was higher than 95% in the first line treatment. However, whether the 14-day sequential therapy is more effective than 10-day bismuth quadruple therapy remains unknown. Therefore, the investigators aimed to compare the eradication rates and long term re-infection rates of sequential therapy for 14 days versus bismuth quadruple therapy for 10 days in the second line treatment.

Detailed Description

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This will be a multi-center, open labeled, randomized comparative trial Patients: 240 patients with H. pylori infection who failed after first-line therapy will be eligible

Interventions: eligible patients will be randomized into one of the two groups Group (A): sequential therapy for 14 days (S14)

D1-D7: (esomeprazole 40mg bid + amoxicillin 1000mg bid) for 7 days

D8-D14: (esomeprazole 40mg bid + clarithromycin 500mg bid + metronidazole 500mg bid) for another 7 days

Group (B): bismuth quadruple therapy for 10 days (Q10)

D1-D10: (esomeprazole 40mg bid + dibismuth trioxide 120mg qid + metronidazole 500mg tid + tetracycline 500mg qid) for 10 days

Primary End Point: Eradication rate in the second line treatment according to intention to treat (ITT) analysis in the two treatment groups

Conditions

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Helicobacter Pylori Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The technicians who performed the UBT test are blind to the treatment allocation

Study Groups

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Sequential therapy for 14 days

Sequential therapy for 14 days (experimental) D1-D7: (Nexium, esomeprazole 40mg bid + amoxicillin (Brand name: Amoxicillin Capsule) 1000mg bid) for 7 days D8-D14: (Nexium, esomeprazole 40mg bid + Klaricid XL, clarithromycin 500mg bid + Flagyl, metronidazole 500mg bid) for another 7 days

Group Type EXPERIMENTAL

Esomeprazole (S14)

Intervention Type DRUG

Nexium, esomeprazole 40mg bid, 14 days

Amoxicillin (ST14)

Intervention Type DRUG

Day 1-7 amoxicillin (Brand name: Amoxicillin Capsule) 1000mg bid for 7 days

Clarithromycin (ST14)

Intervention Type DRUG

Klaricid-XL, clarithromycin, 500mg, bid, for 7 days, (day 8-14)

Metronidazole (ST14)

Intervention Type DRUG

Flagyl, metronidazole, 500mg bid, for 7 days (day 8-14)

bismuth quadruple therapy for 10 days

Bismuth quadruple therapy for 10 days (active comparator) D1-D10: (Nexium, esomeprazole 40mg bid + KCB F.C. TABLETS, dibismuth trioxide 120mg qid + Flagyl, metronidazole 500mg tid + tetracycline (Brand name: Tetracycline Capsule ) 500mg qid) for 10 days

Group Type ACTIVE_COMPARATOR

Esomeprazole (BQ10)

Intervention Type DRUG

Nexium, esomeprazole, 40mg bid for 10 days

dibismuth trioxide 120mg (BQ10)

Intervention Type DRUG

KCB F.C. TABLETS, dibismuth trioxide 120mg qid for 10 days

Metronidazole (BQ10)

Intervention Type DRUG

Flagyl, metronidazole 500mg tid for 10 days

tetracycline (BQ10)

Intervention Type DRUG

Tetracycline (Brand name: Tetracycline Capsule ) 500mg qid for 10 days

Interventions

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Esomeprazole (S14)

Nexium, esomeprazole 40mg bid, 14 days

Intervention Type DRUG

Esomeprazole (BQ10)

Nexium, esomeprazole, 40mg bid for 10 days

Intervention Type DRUG

Amoxicillin (ST14)

Day 1-7 amoxicillin (Brand name: Amoxicillin Capsule) 1000mg bid for 7 days

Intervention Type DRUG

Clarithromycin (ST14)

Klaricid-XL, clarithromycin, 500mg, bid, for 7 days, (day 8-14)

Intervention Type DRUG

Metronidazole (ST14)

Flagyl, metronidazole, 500mg bid, for 7 days (day 8-14)

Intervention Type DRUG

dibismuth trioxide 120mg (BQ10)

KCB F.C. TABLETS, dibismuth trioxide 120mg qid for 10 days

Intervention Type DRUG

Metronidazole (BQ10)

Flagyl, metronidazole 500mg tid for 10 days

Intervention Type DRUG

tetracycline (BQ10)

Tetracycline (Brand name: Tetracycline Capsule ) 500mg qid for 10 days

Intervention Type DRUG

Other Intervention Names

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Nexium Nexium (BQ10) amoxicillin capsule Klaricid-XL 500mg Flagyl KCB F.C. TABLETS Flagyl Tetracycline Capsule

Eligibility Criteria

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Inclusion Criteria

* H. pylori infected patients who fail from first line standard triple therapy with clarithromycin, amoxicillin, and a proton pump inhibitor will be eligible in this study.

Exclusion Criteria

Patients will be excluded from the study if any one of the following criteria was present:

* children and teenagers aged less than 20 years,
* history of gastrectomy,
* gastric malignancy, including adenocarcinoma and lymphoma,
* previous allergic reaction to antibiotics (bismuth, metronidazole, levofloxacin, tetracycline) and PPI (esomeprazole),
* contraindication to treatment drugs,
* pregnant or lactating women,
* severe concurrent disease, or
* Unwilling to accept random assignment of subjects.
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jyh-Ming Liou, MD, PhD

Role: STUDY_CHAIR

National Taiwan University Hospital

Yu-Jen Fang, MD

Role: PRINCIPAL_INVESTIGATOR

National Taiwan University Hospital, Yun-Lin Branch

Locations

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Jyh-Ming Liou

Taipei, Taiwan, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Jyh-Ming Liou, MD, PhD

Role: CONTACT

886-2-23123456 ext. 63541

Ming-Shiang Wu, MD, PhD

Role: CONTACT

886-2-23123456 ext. 65043

Facility Contacts

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Jyh-Ming Liou

Role: primary

References

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Liou JM, Fang YJ, Chen CC, Bair MJ, Chang CY, Lee YC, Chen MJ, Chen CC, Tseng CH, Hsu YC, Lee JY, Yang TH, Luo JC, Chang CC, Chen CY, Chen PY, Shun CT, Hsu WF, Hu WH, Chen YN, Sheu BS, Lin JT, Wu JY, El-Omar EM, Wu MS; Taiwan Gastrointestinal Disease and Helicobacter Consortium. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet. 2016 Nov 12;388(10058):2355-2365. doi: 10.1016/S0140-6736(16)31409-X. Epub 2016 Oct 18.

Reference Type RESULT
PMID: 27769562 (View on PubMed)

Liou JM, Chen CC, Chen MJ, Chen CC, Chang CY, Fang YJ, Lee JY, Hsu SJ, Luo JC, Chang WH, Hsu YC, Tseng CH, Tseng PH, Wang HP, Yang UC, Shun CT, Lin JT, Lee YC, Wu MS; Taiwan Helicobacter Consortium. Sequential versus triple therapy for the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet. 2013 Jan 19;381(9862):205-13. doi: 10.1016/S0140-6736(12)61579-7. Epub 2012 Nov 16.

Reference Type RESULT
PMID: 23158886 (View on PubMed)

Other Identifiers

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201611053MINA

Identifier Type: -

Identifier Source: org_study_id

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