Trial Outcomes & Findings for Efficacy and Safety of Vonoprazan Compared to Lansoprazole in Participants With Helicobacter Pylori Infection (NCT NCT04167670)

NCT ID: NCT04167670

Last Updated: 2022-04-05

Results Overview

H pylori eradication was determined by the \^13C-UBT test.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

1046 participants

Primary outcome timeframe

Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)

Results posted on

2022-04-05

Participant Flow

1046 participants were randomized at 103 study sites, including 71 in the United States and 32 in Europe.

A \^13C-urea breath test (\^13C-UBT) was performed within 34 days prior to treatment to establish Helicobacter pylori (H pylori) infection status. 6 gastric mucosal biopsy specimens were collected to determine resistance of bacteria to clarithromycin, amoxicillin, and metronidazole antibiotics and to document H pylori infection. 3385 participants were screened, 2339 of which were screen failures. 1046 participants were randomized and 1039 received at least 1 dose of the study drugs.

Participant milestones

Participant milestones
Measure
Vonoprazan Dual Therapy
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Overall Study
STARTED
349
349
348
Overall Study
Received Study Drugs
348
346
345
Overall Study
COMPLETED
334
331
334
Overall Study
NOT COMPLETED
15
18
14

Reasons for withdrawal

Reasons for withdrawal
Measure
Vonoprazan Dual Therapy
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Overall Study
Pretreatment Event, Adverse Event, or Serious Adverse Event
1
7
4
Overall Study
Significant protocol deviation
3
1
0
Overall Study
Lost to Follow-up
0
3
3
Overall Study
Voluntary Withdrawal
0
1
1
Overall Study
Withdrawal of Consent
4
1
3
Overall Study
Miscellaneous
7
5
3

Baseline Characteristics

Efficacy and Safety of Vonoprazan Compared to Lansoprazole in Participants With Helicobacter Pylori Infection

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Vonoprazan Dual Therapy
n=349 Participants
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
n=349 Participants
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
n=348 Participants
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Total
n=1046 Participants
Total of all reporting groups
Age, Continuous
51.9 years
STANDARD_DEVIATION 13.47 • n=5 Participants
50.7 years
STANDARD_DEVIATION 13.88 • n=7 Participants
51.6 years
STANDARD_DEVIATION 13.61 • n=5 Participants
51.4 years
STANDARD_DEVIATION 13.65 • n=4 Participants
Sex: Female, Male
Female
210 Participants
n=5 Participants
226 Participants
n=7 Participants
216 Participants
n=5 Participants
652 Participants
n=4 Participants
Sex: Female, Male
Male
139 Participants
n=5 Participants
123 Participants
n=7 Participants
132 Participants
n=5 Participants
394 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
95 Participants
n=5 Participants
99 Participants
n=7 Participants
89 Participants
n=5 Participants
283 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
251 Participants
n=5 Participants
249 Participants
n=7 Participants
259 Participants
n=5 Participants
759 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants
Race/Ethnicity, Customized
White
316 Participants
n=5 Participants
307 Participants
n=7 Participants
312 Participants
n=5 Participants
935 Participants
n=4 Participants
Race/Ethnicity, Customized
Black or African-American
22 Participants
n=5 Participants
30 Participants
n=7 Participants
25 Participants
n=5 Participants
77 Participants
n=4 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=5 Participants
6 Participants
n=7 Participants
6 Participants
n=5 Participants
16 Participants
n=4 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race/Ethnicity, Customized
Other
4 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
8 Participants
n=4 Participants
Race/Ethnicity, Customized
Unknown
1 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
3 Participants
n=4 Participants
Race/Ethnicity, Customized
Not Reported
1 Participants
n=5 Participants
3 Participants
n=7 Participants
0 Participants
n=5 Participants
4 Participants
n=4 Participants

PRIMARY outcome

Timeframe: Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)

Population: Modified Intent-to-Treat Primary (MITTp) Analysis Set - All participants randomized into the study who had a H pylori infection documented by \^13C-UBT and biopsy (ie, culture or histology) at baseline and did not have a clarithromycin- or amoxicillin-resistant strain of H pylori at baseline.

H pylori eradication was determined by the \^13C-UBT test.

Outcome measures

Outcome measures
Measure
Vonoprazan Dual Therapy
n=265 Participants
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
n=262 Participants
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
n=255 Participants
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Percentage of Participants With Successful Helicobacter Pylori (H Pylori) Eradication in Participants Without a Clarithromycin- or Amoxicillin-resistant Strain of H Pylori at Baseline
78.5 percentage of participants
84.7 percentage of participants
78.8 percentage of participants

SECONDARY outcome

Timeframe: Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)

Population: All participants randomized into the study who had H pylori infection documented by \^13C-UBT and biopsy (ie, culture or histology) at baseline and had a clarithromycin-resistant strain of H pylori at baseline.

H pylori eradication was determined by the \^13C-UBT test.

Outcome measures

Outcome measures
Measure
Vonoprazan Dual Therapy
n=56 Participants
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
n=73 Participants
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
n=72 Participants
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Percentage of Participants With Successful Helicobacter Pylori (H Pylori) Eradication in Participants With a Clarithromycin-resistant Strain of H Pylori at Baseline
69.6 percentage of participants
65.8 percentage of participants
31.9 percentage of participants

SECONDARY outcome

Timeframe: Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)

Population: Modified Intent-to-Treat (MITT) Analysis Set - All participants randomized into the study who had H pylori infection documented by \^13C-UBT and biopsy (ie, culture or histology) at baseline.

H pylori eradication was determined by the \^13C-UBT test.

Outcome measures

Outcome measures
Measure
Vonoprazan Dual Therapy
n=324 Participants
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
n=338 Participants
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
n=330 Participants
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Percentage of All Participants With Successful Helicobacter Pylori (H Pylori) Eradication
77.2 percentage of participants
80.8 percentage of participants
68.5 percentage of participants

Adverse Events

Vonoprazan Dual Therapy

Serious events: 5 serious events
Other events: 20 other events
Deaths: 0 deaths

Vonoprazan Triple Therapy

Serious events: 6 serious events
Other events: 27 other events
Deaths: 2 deaths

Lansoprazole Triple Therapy

Serious events: 3 serious events
Other events: 48 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Vonoprazan Dual Therapy
n=348 participants at risk
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
n=346 participants at risk
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
n=345 participants at risk
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Cardiac disorders
Atrial fibrillation
0.29%
1/348 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Cardiac disorders
Cardiac arrest
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/346 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Cardiac disorders
Coronary artery occlusion
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/346 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Infections and infestations
Corona virus infection
0.29%
1/348 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/346 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Infections and infestations
Pneumonia viral
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/345 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Gastrointestinal disorders
Abdominal pain upper
0.29%
1/348 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Gastrointestinal disorders
Duodenal polyp
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/346 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Hepatobiliary disorders
Cholecystitis
0.29%
1/348 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Hepatobiliary disorders
Cholecystitis acute
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/345 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Injury, poisoning and procedural complications
Jaw fracture
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/346 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Injury, poisoning and procedural complications
Lower limb fracture
0.29%
1/348 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Musculoskeletal and connective tissue disorders
Spinal pain
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/346 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung cancer metastatic
0.29%
1/348 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/345 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Vascular disorders
Peripheral ischaemia
0.00%
0/348 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.00%
0/346 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
0.29%
1/345 • Number of events 1 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.

Other adverse events

Other adverse events
Measure
Vonoprazan Dual Therapy
n=348 participants at risk
Participants were administered oral doses of 20 milligrams (mg) vonoprazan tablets twice daily (BID) and oral doses of 1000 mg amoxicillin capsules 3 times daily (TID) from Day 1 to Day 14.
Vonoprazan Triple Therapy
n=346 participants at risk
Participants were administered oral doses of 20 mg vonoprazan tablets BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Lansoprazole Triple Therapy
n=345 participants at risk
Participants were administered oral doses of 30 mg lansoprazole capsules BID from Day 1 to Day 14. Participants were also administered oral doses of 1000 mg amoxicillin capsules BID and 500 mg clarithromycin tablets BID from Day 1 to Day 14.
Gastrointestinal disorders
Diarrhoea
5.2%
18/348 • Number of events 18 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
4.0%
14/346 • Number of events 14 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
9.6%
33/345 • Number of events 33 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
Nervous system disorders
Dysgeusia
0.57%
2/348 • Number of events 2 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
4.3%
15/346 • Number of events 15 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.
6.1%
21/345 • Number of events 21 • Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
Safety Analysis Set - All participants who received at least 1 dose of study drugs.

Additional Information

Phathom Medical Information

Phathom Pharmaceuticals, Inc.

Phone: Please email

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: OTHER