Efficacy and Safety of Vonoprazan Compared to Lansoprazole in Participants With Erosive Esophagitis

NCT ID: NCT04124926

Last Updated: 2022-07-29

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

1027 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-28

Study Completion Date

2021-08-24

Brief Summary

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To evaluate the efficacy and safety of vonoprazan compared to lansoprazole in participants with erosive esophagitis.

Detailed Description

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Conditions

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Erosive Esophagitis

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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Healing Phase: Vonoprazan 20 mg

Participants will receive oral vonoprazan 20 mg once per day (QD) for a maximum of 8 weeks.

Group Type EXPERIMENTAL

Vonoprazan

Intervention Type DRUG

Over-encapsulated tablet administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Healing Phase: Lansoprazole 30 mg

Participants will receive oral lansoprazole 30 mg once per day (QD) for a maximum of 8 weeks.

Group Type ACTIVE_COMPARATOR

Lansoprazole

Intervention Type DRUG

Over-encapsulated capsule administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Maintenance Phase: Vonoprazan 10 mg

Participants will receive oral vonoprazan 10 mg once per day (QD) for a maximum of 24 weeks.

Group Type EXPERIMENTAL

Vonoprazan

Intervention Type DRUG

Over-encapsulated tablet administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Maintenance Phase: Vonoprazan 20 mg

Participants will receive oral vonoprazan 20 mg once per day (QD) for a maximum of 24 weeks.

Group Type EXPERIMENTAL

Vonoprazan

Intervention Type DRUG

Over-encapsulated tablet administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Maintenance Phase: Lansoprazole 15 mg

Participants will receive oral lansoprazole 15 mg once per day (QD) for a maximum of 24 weeks.

Group Type ACTIVE_COMPARATOR

Lansoprazole

Intervention Type DRUG

Over-encapsulated capsule administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Interventions

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Vonoprazan

Over-encapsulated tablet administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Intervention Type DRUG

Lansoprazole

Over-encapsulated capsule administered orally with approximately 240 mL water, 30 minutes prior to the morning meal.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. The participant is ≥18 years of age at the time of informed consent signing.
2. In the opinion of the investigator or subinvestigators, the participant is capable of understanding and complying with protocol requirements.
3. The participant signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures. The participant is informed of the full nature and purpose of the study, including possible risks and side-effects. The participant has the ability to cooperate with the investigator. Ample time and opportunity should be given to read and understand verbal and/or written instructions.
4. The participant is found to have endoscopically confirmed EE of LA Classification Grades A to D during the Screening Period (Visit 1) as assessed by a central adjudicator. The target number of participants with LA classification Grade C or D will be approximately 30% of the total number of participants (300 total). Enrollment of EE participants with Grade A or B will end when the number of participants with Grade A or B EE is approximately 700 or 70% of the total planned number of participants. Given the invasive nature of an endoscopy, any endoscopic confirmation performed in a routine clinical setting before signing the informed consent will be acceptable to use for the purpose of fulfilling the screening requirement if all of the following apply: (1) appropriate endoscopy pictures were taken; (2) appropriate gastric biopsy samples were taken; (3) the endoscopy pictures can be sent to the central adjudicator via the adjudication systems; and (4) all screening procedures (including the completion of adjudication) AND randomization can be completed within a 7-day period after the date of the endoscopy.
5. A female participant of childbearing potential who is or may be sexually active with a nonsterilized male partner agrees to routinely use adequate contraception from the signing of informed consent until 4 weeks after the last dose of study drug.

Exclusion Criteria

1. The participant's endoscopic examination for entering this study fails to confirm EE within 7 days (no later than 10 days on rare occasion with sponsor approval) prior to randomization.
2. The participant is determined to be positive for Helicobacter pylori (HP) or has had an HP infection within 45 days of randomization.
3. The participant has endoscopic Barrett's esophagus (\>1 cm of columnar-lined esophagus) and/or definite dysplastic changes in the esophagus.
4. The participant has any other condition affecting the esophagus, including eosinophilic esophagitis; esophageal varices; viral or fungal infection; esophageal stricture; a history of radiation therapy, radiofrequency ablation, endoscopic mucosal resection, or cryotherapy to the esophagus; or any history of caustic or physiochemical trauma (including sclerotherapy or esophageal variceal band ligation). However, participants diagnosed with Schatzki's ring (mucosal tissue ring around lower esophageal sphincter) are eligible to participate.
5. The participant has scleroderma (systemic sclerosis).
6. The participant has a history of surgery or endoscopic treatment affecting gastroesophageal reflux, including fundoplication and dilation for esophageal stricture (except Schatzki's ring) or a history of gastric or duodenal surgery (except endoscopic removal of benign polyps).
7. The participant has an active gastric or duodenal ulcer at the start of the Screening Period. Additionally, participants with gastric or duodenal erosions are permitted to participate.
8. The participant has received any investigational compound (including those in post marketing studies) within 30 days prior to the start of the Screening Period. A participant who has been screen failed from another clinical study and who has not been dosed may be considered for enrollment in this study.
9. The participant is a study site employee, an immediate family member, or is in a dependent relationship with a study site employee who is involved in the conduct of this study (eg, spouse, parent, child, sibling) or who may have consented under duress.
10. The participant has cutaneous lupus erythematosus or systemic lupus erythematosus.
11. The participant has had clinically significant upper or lower gastrointestinal bleeding within 4 weeks prior to randomization.
12. The participant has Zollinger-Ellison syndrome or other gastric acid hypersecretory conditions.
13. The participant has a history of hypersensitivity or allergies to vonoprazan (including the formulation excipients: D-mannitol, microcrystalline cellulose, hydroxypropyl cellulose, fumaric acid, croscarmellose sodium, magnesium stearate, hypromellose, macrogol 8000, titanium oxide, or red or yellow ferric oxide), PPIs, or any excipients used in the 13C-urea breath test: mannitol, citric acid, or aspartame. Skin testing may be performed according to local standard practice to confirm hypersensitivity.
14. The participant has a history of alcohol abuse, illegal drug use, or drug addiction within the 12 months prior to screening, or regularly consumes \>21 units of alcohol (1 unit = 12 oz/300 mL beer, 1.5 oz/25 mL hard liquor/spirits, or 5 oz/100 mL wine) per week based on self-report. Participants must have a negative urine drug screen at screening.
15. The participant is taking any excluded medications or treatments.
16. If female, the participant is pregnant, lactating, or intending to become pregnant before, during, or within 4 weeks after participating in this study; or intending to donate ova during such time period.
17. The participant has a history or clinical manifestations of significant central nervous system, cardiovascular, pulmonary, hepatic, renal, metabolic, other gastrointestinal, urological, endocrine, or hematological disease that, in the opinion of the investigator, would confound the study results or compromise participant safety.
18. The participant requires hospitalization or has surgery scheduled during the course of the study or has undergone major surgical procedures within 30 days prior to the Screening Visit.
19. The participant has a history of malignancy (including MALToma) or has been treated for malignancy within 5 years prior to the start of the Screening Period (Visit 1). (The participant may be included in the study if he/she has cured cutaneous basal cell carcinoma or cervical carcinoma in situ).
20. The participant has acquired immunodeficiency syndrome or human immunodeficiency virus infection, or tests positive for the hepatitis B surface antigen, hepatitis C virus (HCV) antibody, or HCV RNA. However, participants who test positive for HCV antibody but negative for HCV RNA are permitted to participate.
21. The participant has any of the following abnormal laboratory test values at the start of the Screening Period:

1. Creatinine levels: \>2 mg/dL (\>177 μmol/L)
2. Alanine aminotransferase or aspartate aminotransferase \>2 × the upper limit of normal (ULN) or total bilirubin \>2 × ULN.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Phathom Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Phathom Pharmaceuticals

Locations

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Pinnacle Research Group

Anniston, Alabama, United States

Site Status

North Alabama Research Center LLC

Athens, Alabama, United States

Site Status

Synexus Clinical Research US, Inc.

Birmingham, Alabama, United States

Site Status

Medical Affiliated Research Center Inc

Huntsville, Alabama, United States

Site Status

Synexus Clinical Research US, Inc. - East Valley Family Physicians, PLC

Chandler, Arizona, United States

Site Status

Synexus Clinical Research US, Inc. - Central Arizona Medical Associates, PC

Mesa, Arizona, United States

Site Status

Synexus Clinical Research US, Inc. - Desert Clinical Research, LLC

Mesa, Arizona, United States

Site Status

Elite Clinical Studies - Phoenix - BTC - PPDS

Phoenix, Arizona, United States

Site Status

Hope Research Institute LLC

Phoenix, Arizona, United States

Site Status

Del Sol Research Management - BTC - PPDS

Tucson, Arizona, United States

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Preferred Research Partners - ClinEdge - PPDS

Little Rock, Arkansas, United States

Site Status

Applied Research Center of Little Rock

Little Rock, Arkansas, United States

Site Status

Arkansas Gastroenterology

North Little Rock, Arkansas, United States

Site Status

Atria Clinical Research - BTC - PPDS

North Little Rock, Arkansas, United States

Site Status

Anaheim Clinical Trials LLC

Anaheim, California, United States

Site Status

GW Research, Inc. - ClinEdge - PPDS

Chula Vista, California, United States

Site Status

eStudySite - Chula Vista - PPDS

Chula Vista, California, United States

Site Status

Kindred Medical Institute for Clinical Trials, LLC

Corona, California, United States

Site Status

HB Clinical Trials, Inc.

Fountain Valley, California, United States

Site Status

OM Research LLC

Lancaster, California, United States

Site Status

Torrance Clinical Research Institute

Lomita, California, United States

Site Status

LA County + USC Medical Center

Los Angeles, California, United States

Site Status

Southern California Research Institute Medical Group, Inc.

Los Angeles, California, United States

Site Status

Facey Medical Foundation

Mission Hills, California, United States

Site Status

Palmtree Clinical Research

Palm Springs, California, United States

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Precision Research Institute

San Diego, California, United States

Site Status

Medical Associates Research Group, Inc.

San Diego, California, United States

Site Status

Paragon Rx Clinical, Inc.

Santa Ana, California, United States

Site Status

Synexus Clinical Research US, Inc. - Colorado Springs Family Practice

Colorado Springs, Colorado, United States

Site Status

Western States Clinical Research, Inc.

Wheat Ridge, Colorado, United States

Site Status

Gastroenterology Associates of Fairfield County

Bridgeport, Connecticut, United States

Site Status

Connecticut Clinical Research Foundation

Bristol, Connecticut, United States

Site Status

Riverside Clinical Research

Edgewater, Florida, United States

Site Status

Research Centers of America - ERG

Hollywood, Florida, United States

Site Status

Nature Coast Clinical Research

Inverness, Florida, United States

Site Status

ENCORE Borland-Groover Clinical Research - ERN - PPDS

Jacksonville, Florida, United States

Site Status

Columbus Clinical Services LLC

Miami, Florida, United States

Site Status

Jesscan Medical Research

Miami, Florida, United States

Site Status

Nuren Medical and Research Center

Miami, Florida, United States

Site Status

Premier Research Associate, Inc.

Miami, Florida, United States

Site Status

Gutierrez Medical Center

Orlando, Florida, United States

Site Status

Advanced Gastroenterology Associates, LLC

Palm Harbor, Florida, United States

Site Status

Innovation Medical Research Center

Palmetto Bay, Florida, United States

Site Status

Synexus Clinical Research US, Inc. - St. Petersburg

Pinellas Park, Florida, United States

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Precision Clinical Research, LLC

Sunrise, Florida, United States

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Guardian Angel Research Center

Tampa, Florida, United States

Site Status

Atlanta Gastroenterology Associates

Atlanta, Georgia, United States

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Nexgen Research Center

Atlanta, Georgia, United States

Site Status

Gastroenterology Associates of Central Georgia, LLC

Macon, Georgia, United States

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In-Quest Medical Research, LLC

Peachtree Corners, Georgia, United States

Site Status

Illinois Gastroenterology Group

Gurnee, Illinois, United States

Site Status

Summit Digestive & Liver Disease Specialists State Street Clinic

Oakbrook Terrace, Illinois, United States

Site Status

MediSphere Medical Research Center, LLC

Evansville, Indiana, United States

Site Status

Gastroenterology Health Partners, PLLC

New Albany, Indiana, United States

Site Status

Iowa Digestive Disease Center

Clive, Iowa, United States

Site Status

Clinical Trials Management LLC

Covington, Louisiana, United States

Site Status

CroNOLA, LLC.

Houma, Louisiana, United States

Site Status

Clinical Trials Management LLC

Metairie, Louisiana, United States

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Louisiana Research Center, LLC

Shreveport, Louisiana, United States

Site Status

Meridian Clinical Research

Rockville, Maryland, United States

Site Status

Clinical Associates Research

Towson, Maryland, United States

Site Status

Oakland Medical Research Center

Troy, Michigan, United States

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Gastroenterology Associates of Western Michigan, PLC

Wyoming, Michigan, United States

Site Status

The Alliance for Multispecialty Research, LLC

Kansas City, Missouri, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Heartland Clinical Research, Inc

Omaha, Nebraska, United States

Site Status

Synexus Clinical Research US, Inc. Site 1

Henderson, Nevada, United States

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Synexus Clinical Research US, Inc. Site 2

Henderson, Nevada, United States

Site Status

Sierra Clinical Research - ClinEdge - PPDS

Las Vegas, Nevada, United States

Site Status

Site 2

Las Vegas, Nevada, United States

Site Status

Las Vegas - Site 1

Las Vegas, Nevada, United States

Site Status

Advanced Research Institute

Reno, Nevada, United States

Site Status

Drug Trials America - ClinEdge

Hartsdale, New York, United States

Site Status

Southtowns Gastroenterology, PLLC

Orchard Park, New York, United States

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Carolinas Research Center

Charlotte, North Carolina, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Medication Management LLC

Greensboro, North Carolina, United States

Site Status

Carolina Research

Greenville, North Carolina, United States

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Peters Medical Research, LLC - ClinEdge - PPDS

High Point, North Carolina, United States

Site Status

Carolina's GI Research, LLC

Raleigh, North Carolina, United States

Site Status

Dayton Gastroenterology, Inc

Dayton, Ohio, United States

Site Status

Prestige Clinical Research

Franklin, Ohio, United States

Site Status

Central Sooner Research

Norman, Oklahoma, United States

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Synexus Clinical Research US, Inc.

Anderson, South Carolina, United States

Site Status

Clinical Trials of South Carolina

Charleston, South Carolina, United States

Site Status

Coastal Carolina Research Center

Mt. Pleasant, South Carolina, United States

Site Status

Rapid City Medical Center LLP

Rapid City, South Dakota, United States

Site Status

Multi Specialty Clinical Research

Johnson City, Tennessee, United States

Site Status

Clinical Research Associates Inc

Nashville, Tennessee, United States

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Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Inquest Clinical Research

Baytown, Texas, United States

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Synexus Clinical Research US, Inc. - Dallas

Dallas, Texas, United States

Site Status

Texas Tech University Health Sciences Center El Paso

El Paso, Texas, United States

Site Status

Precision Research Institute, LLC

Houston, Texas, United States

Site Status

Biopharma Informatic, LLC

Houston, Texas, United States

Site Status

Rio Grande Gastroenterology

McAllen, Texas, United States

Site Status

Digestive System Healthcare

Pasadena, Texas, United States

Site Status

Pearland Physicians

Pearland, Texas, United States

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Synexus Clinical Research US, Inc.

Plano, Texas, United States

Site Status

Quality Research Inc

San Antonio, Texas, United States

Site Status

Gastroenterology Research of San Antonio (GERSA)

San Antonio, Texas, United States

Site Status

Southern Star Research Institute, LLC

San Antonio, Texas, United States

Site Status

Synexus Clinical Research US, Inc.

Layton, Utah, United States

Site Status

Advanced Research Institute

Ogden, Utah, United States

Site Status

New River Valley Research Institute

Christiansburg, Virginia, United States

Site Status

Verity Research, Inc.

Fairfax, Virginia, United States

Site Status

Blue Ridge Medical Research

Lynchburg, Virginia, United States

Site Status

Washington Gastroenterology

Bellevue, Washington, United States

Site Status

Harborview Medical Center, University of Washington Medical Center

Seattle, Washington, United States

Site Status

Fourth Multiprofile Hospital for Active Treatment

Sofia, Sofia-Grad, Bulgaria

Site Status

Multiprofile Hospital for Active Treatment Puls AD - PPDS

Blagoevgrad, , Bulgaria

Site Status

University Multiprofile Hospital for Active Treatment

Pleven, , Bulgaria

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Second Multiprofile Hospital for Active Treatment Sofia

Sofia, , Bulgaria

Site Status

Medical Center Excelsior OOD - PPDS

Sofia, , Bulgaria

Site Status

Diagnostic-Consultative Center Aleksandrovska EOOD

Sofia, , Bulgaria

Site Status

Synexus - Medical Center Synexus Sofia EOOD

Sofia, , Bulgaria

Site Status

Synexus - Medical Centre Synexus Sofia EOOD

Stara Zagora, , Bulgaria

Site Status

Nemocnice Pardubickeho kraje, a.s. Orlickoustecka nemocnice, Interni oddeleni, Cs.

Ústí nad Orlicí, Pardubice, Czechia

Site Status

MEDIC KRAL s.r.o.

Prague, Prague, Czechia

Site Status

PreventaMed s.r.o.

Olomouc, , Czechia

Site Status

Synexus Czech s.r.o.

Prague, , Czechia

Site Status

Krajska zdravotni, a.s. - Masarykova nemocnice v Usti nad Labem, o.z. Oddeleni gastroenterolgie

Ústí nad Labem, , Czechia

Site Status

Debreceni Egyetem Klinikai Kozpont Nagyerdei Krt. 98, Belgyogyaszati Klinika

Debrecen, Hajdú-Bihar, Hungary

Site Status

Synexus Affiliate BKS Research Kft. Hatvan

Hatvan, Heves County, Hungary

Site Status

Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktatokorhaz

Nyíregyháza, Szabolcs-Szatmár-Bereg, Hungary

Site Status

Synexus (DRS) - Synexus Magyarország Kft. Budapest

Budapest, , Hungary

Site Status

Synexus Affiliate - Synexus Magyarorszag Kft. Debrecen

Debrecen, , Hungary

Site Status

Synexus (DRS) - Synexus Magyarorszag Kft. Gyula

Gyula, , Hungary

Site Status

Synexus (DRS) - Synexus Magyarország Kft. Zalaegerszeg

Zalaegerszeg, , Hungary

Site Status

Szpital Uniwersytecki Nr 2 im. Dr Jana Biziela w Bydgoszczy Centrum Endoskopii Zabiegowej - Poradnia Chorob Jelitowych

Bydgoszcz, , Poland

Site Status

Gabinet Lekarski-Janusz Rudzinski ul. Powstancow Warszawy 5

Bydgoszcz, , Poland

Site Status

Synexus - Czestochowa

Częstochowa, , Poland

Site Status

Synexus - Gdansk

Gdansk, , Poland

Site Status

Synexus - Gdynia

Gdynia, , Poland

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Synexus - Katowice

Katowice, , Poland

Site Status

Synexus Affiliate - Krakowskie Centrum Medyczne

Krakow, , Poland

Site Status

Centrum Opieki Zdrowotnej Orkan-Med Stec-Michalska Sp. J.

Ksawerów, , Poland

Site Status

Synexus - Lodz

Lodz, , Poland

Site Status

Santa Familia Centrum Badań Profilaktyki i Leczenia

Lodz, , Poland

Site Status

GASTRO MED Zaklad Opieki Zdrowotnej

Lublin, , Poland

Site Status

Synexus - Poznan

Poznan, , Poland

Site Status

Korczowski Bartosz, Gabinet Lekarski

Rzeszów, , Poland

Site Status

Twoja Przychodnia - Szczecińskie Centrum Medyczne

Szczecin, , Poland

Site Status

Gastromed Specjalistyczne Centrum Gastrologii i Endoskopii

Torun, , Poland

Site Status

REUMATIKA - Centrum Reumatologii NZOZ

Warsaw, , Poland

Site Status

Synexus - Warszawa

Warsaw, , Poland

Site Status

Synexus - Wroclaw

Wroclaw, , Poland

Site Status

Melita Medical

Wroclaw, , Poland

Site Status

Synexus Thames Valley Clinical Research Centre

Reading, Berkshire, United Kingdom

Site Status

Synexus - Midlands Clinical Research Centre

Edgbaston, West Midlands, United Kingdom

Site Status

Synexus - Wales Clinical Research Centre

Cardiff, , United Kingdom

Site Status

Synexus - Lancashire Clinical Research Centre

Chorley, , United Kingdom

Site Status

CPS Research

Glasgow, , United Kingdom

Site Status

Synexus - Hexham Clinical Research Centre

Hexham, , United Kingdom

Site Status

Synexus - Merseyside Clinical Research Centre

Liverpool, , United Kingdom

Site Status

Synexus - Manchester Clinical Research Centre

Manchester, , United Kingdom

Site Status

Synexus - North Tees Clinical Research Centre

Stockton-on-Tees, , United Kingdom

Site Status

Countries

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United States Bulgaria Czechia Hungary Poland United Kingdom

References

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Laine L, DeVault K, Katz P, Mitev S, Lowe J, Hunt B, Spechler S. Vonoprazan Versus Lansoprazole for Healing and Maintenance of Healing of Erosive Esophagitis: A Randomized Trial. Gastroenterology. 2023 Jan;164(1):61-71. doi: 10.1053/j.gastro.2022.09.041. Epub 2022 Oct 10.

Reference Type DERIVED
PMID: 36228734 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2019-002579-33

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

EE-301

Identifier Type: -

Identifier Source: org_study_id

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