Dexlansoprazole MR-Based Concomitant Quadruple Therapy

NCT ID: NCT03829150

Last Updated: 2019-05-14

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

COMPLETED

Clinical Phase

NA

Total Enrollment

202 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-01

Study Completion Date

2019-04-20

Brief Summary

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Background:

Recommended proton pump inhibitor (PPI)-clarithromycin-amoxicillin or metronidazole treatment for 7 to14 days is the first choice treatment for H pylori infection. The eradication rate of the standard triple therapy has generally declined to unacceptable levels (i.e., 80% or less) recently because the increasing incidence of clarithromycin-resistant strains of H. pylori. Standard triple therapies should be abandoned in the areas with clarithromycin resistance ≥ 20%. The investigators have proven that 7-day Concomitant therapy can achieve a promising success rate of \>90 % in the presence of clarithromycin resistance. However, high dose PPI is needed with a dosage of twice daily but when a dual delayed release formulation PPI in capsules for oral administration (Dexlansoprazole MR), a once daily dose may be needed only. The capsules contain dexlansoprazole in a mixture of two types of enteric-coated granules with different pH-dependent dissolution profiles. It suppresses gastric acid secretion via inhibition of the proton pump in the gastric parietal cell, which blocks the final step of acid production. Thus, it improves acid suppression and offer benefits over conventional single release PPI formulations. by prolonging optimal plasma concentration and create a favorable condition H. pylori eradication

Aim:

The efficacy of Dexlansoprazole MR-based concomitant quadruple therapy

Detailed Description

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Background:

Recommended proton pump inhibitor (PPI)-clarithromycin-amoxicillin or metronidazole treatment for 7 to14 days is the first choice treatment for H pylori infection. The eradication rate of the standard triple therapy has generally declined to unacceptable levels (i.e., 80% or less) recently because the increasing incidence of clarithromycin-resistant strains of H. pylori. Standard triple therapies should be abandoned in the areas with clarithromycin resistance ≥ 20%. The investigators have proven that 7-day Concomitant therapy can achieve a promising success rate of \>90% in the presence of clarithromycin resistance. However, high dose PPI is needed with a dosage of twice daily but when a dual delayed release formulation PPI in capsules for oral administration (Dexlansoprazole MR), a once daily dose may be needed only. The capsules contain dexlansoprazole in a mixture of two types of enteric-coated granules with different pH-dependent dissolution profiles. It suppresses gastric acid secretion via inhibition of the proton pump in the gastric parietal cell, which blocks the final step of acid production. Thus, it improves acid suppression and offer benefits over conventional single release PPI formulations. by prolonging optimal plasma concentration and create a favorable condition H. pylori eradication

Aim:

The efficacy of Dexlansoprazole MR-based concomitant quadruple therapy

Methods:

Two hundred and two consecutive H. pylori-infected participants are randomly assigned to a 7-day Dexlansoprazole MR-based non-bismuth quadruple therapy (Dexlansoprazole MR 60 mg qd.,clarithromycin 500 mg bid., amoxicillin 1 g bid. and metronidazole 500 mg bid. for 7 days) or a 7-day lansoprazole-based non-bismuth quadruple therapy (Lansoprazole 30 mg bid. , clarithromycin 500 mg bid., amoxicillin 1 g bid. and metronidazole 500 mg bid. for 7 days). Participants are asked to return at the 2nd week to assess drug compliance and adverse events. Repeated endoscopy with rapid urease test, histological examination is performed at the 8th week after the end of anti- H. pylori therapy. If participants refuse follow-up endoscopy, urea breath tests are conducted to assess H. pylori status. The rates of eradication are analyzed by intention-to-treat and per-protocol analysis.

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

NONE

Study Groups

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Dexlansoprazole MR group

Dexlansoprazole MR 60 mg qd.,clarithromycin 500 mg bid., amoxicillin 1 g bid. and metronidazole 500 mg bid. for 7 days

Group Type EXPERIMENTAL

Dexlan

Intervention Type DRUG

Dexlansoprazole MR 60 mg qd for 7 days

Amoxicillin

Intervention Type DRUG

Amoxicillin (Amolin) 1 g bid. for 7 days

Clarithromycin 500mg

Intervention Type DRUG

clarithromycin (Klaricid) 500 mg bid for 7 days

Metronidazole

Intervention Type DRUG

Metronidazole (Flagyl) 500 mg bid daily for 7 days

lansoprazole group

Lansoprazole 30 mg bid., clarithromycin 500 mg bid., amoxicillin 1 g bid. and metronidazole 500 mg bid. for 7 days

Group Type EXPERIMENTAL

Dexlan

Intervention Type DRUG

Dexlansoprazole MR 60 mg qd for 7 days

Amoxicillin

Intervention Type DRUG

Amoxicillin (Amolin) 1 g bid. for 7 days

Clarithromycin 500mg

Intervention Type DRUG

clarithromycin (Klaricid) 500 mg bid for 7 days

Metronidazole

Intervention Type DRUG

Metronidazole (Flagyl) 500 mg bid daily for 7 days

Interventions

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Dexlan

Dexlansoprazole MR 60 mg qd for 7 days

Intervention Type DRUG

Amoxicillin

Amoxicillin (Amolin) 1 g bid. for 7 days

Intervention Type DRUG

Clarithromycin 500mg

clarithromycin (Klaricid) 500 mg bid for 7 days

Intervention Type DRUG

Metronidazole

Metronidazole (Flagyl) 500 mg bid daily for 7 days

Intervention Type DRUG

Other Intervention Names

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Dexlansoprazole MR Amolin Klaricid Flagyl

Eligibility Criteria

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Inclusion Criteria

H. pylori-infected outpatients with endoscopically proven peptic ulcer diseases or gastritis.

Exclusion Criteria

1. Previous H. pylori-eradication therapy
2. ingestion of antibiotics, bismuth, or PPIs within the prior 4 weeks
3. patients with allergic history to the medications used
4. patients with previous gastric surgery
5. the coexistence of serious concomitant illness (for example, decompensated liver cirrhosis, uremia)
6. pregnant women.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Seng-Kee Chuah

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Seng-Kee Chuah, MD

Role: PRINCIPAL_INVESTIGATOR

Kaohsiung Chang Gung Memorial Hospital,Taiwan

Locations

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Kaohsiung Chang Gung Memorial Hospital,Taiwan

Kaohsiung City, , Taiwan

Site Status

Countries

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Taiwan

References

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Tai WC, Liang CM, Bi KW, Kuo CM, Lu LS, Wu CK, Yang SC, Kuo YH, Lee CH, Huang CF, Hsu CN, Hsu PI, Wu DC, Hu TH, Wu KL, Chuah SK. A comparison between dexlansoprazole modified release-based and lansoprazole-based nonbismuth quadruple (concomitant) therapy for first-line Helicobacter pylori eradication: a prospective randomized trial. Infect Drug Resist. 2019 Sep 16;12:2923-2931. doi: 10.2147/IDR.S213998. eCollection 2019.

Reference Type DERIVED
PMID: 31571945 (View on PubMed)

Other Identifiers

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CMRPG8F1421

Identifier Type: -

Identifier Source: org_study_id

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