Bismuth-containing Quadruple Therapy for Helicobacter Pylori Eradication

NCT ID: NCT05049902

Last Updated: 2023-07-19

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

PHASE4

Total Enrollment

1300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-21

Study Completion Date

2023-06-30

Brief Summary

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The researchers collect treatment-naive H.pylori-positive patients from the outpatient clinic. The subjects were randomized to receive a 10-day or 14-day course of quadruple eradication therapy. 6-8 weeks after treatment, the subjects will re-take the 13C-urea breath test. Calculate the eradication rates, adverse reaction rates, patient compliance and cost-effectiveness index of each group.

Detailed Description

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The researchers collect treatment-naive H.pylori-positive patients from the outpatient clinic. If the subject meets the selection criteria but not the exclusion criteria, and signs an informed consent form, the researchers randomized the subjects in groups: subjects received a 10-day or 14-day course of bismuth-containing quadruple eradication therapy. The medication of groups are as follows. 6-8 weeks after the eradication treatment, the subjects will review the 13C-urea breath test, and the researcher records the results.

After all subjects were tested, the eradication rates, adverse reaction rates, patient compliance and cost-effectiveness index of each group were calculated.

According to the course of treatment, it is randomized into a 10-day treatment group and a 14-day treatment group. The two groups of bismuth quadruple regimens are the same, as follows:

Option 1: Amoxicillin + Clarithromycin + Bismuth + Vonoprazan fumarate Option 2: Amoxicillin + Tetracycline + Bismuth + Vonoprazan fumarate Option 3: Amoxicillin + Metronidazole + Bismuth + Vonoprazan fumarate Three options are selected according to the hospital's situation.

Conditions

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Helicobacter Pylori Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This trial is a multi-center, open-label, non-inferiority, randomized controlled trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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10-day treatment group

Use the following drug combination option for 10 days. Option 1: Amoxicillin + Clarithromycin + Bismuth + Vonoprazan fumarate Option 2: Amoxicillin + Tetracycline + Bismuth + Vonoprazan fumarate Option 3: Amoxicillin + Metronidazole + Bismuth + Vonoprazan fumarate Three options are selected according to the hospital's situation.

The dosage of each drug is:

Amoxicillin (Amoxicillin, United Laboratories Co., Ltd.) 1000mg bid Clarithromycin (Klacid, Abbott S.r.l) 500mg bid Tetracycline 500mg qid Metronidazole400mg qid Bismuth Potassium Citrate (Livzon Pharmaceutical Group Inc.) 220mg bid Colloidal Bismuth Pectin (North China Pharmaceutical Co., Ltd.) 200mg bid Vonoprazan fumarate (VOCINTI, Takeda Pharmaceutical Company Limited, Hikari Plant) 20mg bid

Group Type EXPERIMENTAL

Amoxicillin

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Clarithromycin

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Tetracycline

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Metronidazole

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Bismuth Potassium Citrate

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Colloidal Bismuth Pectin

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Vonoprazan fumarate

Intervention Type DRUG

Use according to the drug combination options selected by each center.

14-day treatment group

Use the following drug combination option for 14 days. Option 1: Amoxicillin + Clarithromycin + Bismuth + Vonoprazan fumarate Option 2: Amoxicillin + Tetracycline + Bismuth + Vonoprazan fumarate Option 3: Amoxicillin + Metronidazole + Bismuth + Vonoprazan fumarate Three options are selected according to the hospital's situation.

The dosage of each drug is:

Amoxicillin (Amoxicillin, United Laboratories Co., Ltd.) 1000mg bid Clarithromycin (Klacid, Abbott S.r.l) 500mg bid Tetracycline 500mg qid Metronidazole400mg qid Bismuth Potassium Citrate (Livzon Pharmaceutical Group Inc.) 220mg bid Colloidal Bismuth Pectin (North China Pharmaceutical Co., Ltd.) 200mg bid Vonoprazan fumarate (VOCINTI, Takeda Pharmaceutical Company Limited, Hikari Plant) 20mg bid

Group Type ACTIVE_COMPARATOR

Amoxicillin

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Clarithromycin

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Tetracycline

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Metronidazole

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Bismuth Potassium Citrate

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Colloidal Bismuth Pectin

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Vonoprazan fumarate

Intervention Type DRUG

Use according to the drug combination options selected by each center.

Interventions

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Amoxicillin

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Clarithromycin

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Tetracycline

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Metronidazole

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Bismuth Potassium Citrate

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Colloidal Bismuth Pectin

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Vonoprazan fumarate

Use according to the drug combination options selected by each center.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients aged 18-65.
* Patients with H.pylori infection (Positive for any of the following: H.pylori culture, histopathology test, rapid urease test, 13C/14C-urea breath test, stool H.pylori antigen test).
* Patients who have never received H. pylori eradication treatment.

Exclusion Criteria

* Patients with serious underlying diseases, such as liver insufficiency (Aspartate aminotransferase or alanine aminotransferase greater than 3 times the normal value), renal insufficiency (Cr≥2.0mg/dL or glomerular filtration rate \<50 ml/min), immunosuppression, malignant tumors, Coronary heart disease or coronary artery stenosis ≥75%.
* Patients who are pregnant or lactating or unwilling to take contraceptive measures during the trial.
* Patients with active gastrointestinal bleeding.
* Patients with a history of upper gastrointestinal surgery.
* Patients allergic to treatment drugs.
* Patients with medication history of bismuth agents, antibiotics, proton pump inhibitor and other drugs within 4 weeks
* Patients with other behaviors that may increase the risk of illness, such as alcohol and drug abuse
* Patients whose re-check 13C/14C-urea breath test is negative before the start of the test.
* Patients who are unwilling or incapable to provide informed consents.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Maternity and Child Care Health Center of Dezhou

UNKNOWN

Sponsor Role collaborator

Heze Municipal 3rd people's hospital

UNKNOWN

Sponsor Role collaborator

Peking University Care Luzhong Hospital

OTHER

Sponsor Role collaborator

The People's Hospital of Jimo.Qingdao

UNKNOWN

Sponsor Role collaborator

Shandong University

OTHER

Sponsor Role lead

Responsible Party

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Xiuli Zuo

Director of Qilu Hospital gastroenterology department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xiuli Zuo, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Qilu Hospital of Shandong University

Locations

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Jiangsu Province Hospital

Nanjing, Jiangsu, China

Site Status

Maternity and Child Care Health Center of Dezhou

Dezhou, Shandong, China

Site Status

Heze Municipal 3rd people's hospital

Heze, Shandong, China

Site Status

Qilu hosipital

Jinan, Shandong, China

Site Status

PKUCare Luzhong Hospital

Zibo, Shandong, China

Site Status

The People's Hospital of Jimo.Qingdao

Qingdao, , China

Site Status

Countries

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China

References

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Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, Malfertheiner P, Graham DY, Wong VWS, Wu JCY, Chan FKL, Sung JJY, Kaplan GG, Ng SC. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017 Aug;153(2):420-429. doi: 10.1053/j.gastro.2017.04.022. Epub 2017 Apr 27.

Reference Type BACKGROUND
PMID: 28456631 (View on PubMed)

Liu WZ, Xie Y, Lu H, Cheng H, Zeng ZR, Zhou LY, Chen Y, Wang JB, Du YQ, Lu NH; Chinese Society of Gastroenterology, Chinese Study Group on Helicobacter pylori and Peptic Ulcer. Fifth Chinese National Consensus Report on the management of Helicobacter pylori infection. Helicobacter. 2018 Apr;23(2):e12475. doi: 10.1111/hel.12475. Epub 2018 Mar 7.

Reference Type BACKGROUND
PMID: 29512258 (View on PubMed)

Malfertheiner P, Megraud F, O'Morain CA, Gisbert JP, Kuipers EJ, Axon AT, Bazzoli F, Gasbarrini A, Atherton J, Graham DY, Hunt R, Moayyedi P, Rokkas T, Rugge M, Selgrad M, Suerbaum S, Sugano K, El-Omar EM; European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017 Jan;66(1):6-30. doi: 10.1136/gutjnl-2016-312288. Epub 2016 Oct 5.

Reference Type BACKGROUND
PMID: 27707777 (View on PubMed)

Liou JM, Malfertheiner P, Lee YC, Sheu BS, Sugano K, Cheng HC, Yeoh KG, Hsu PI, Goh KL, Mahachai V, Gotoda T, Chang WL, Chen MJ, Chiang TH, Chen CC, Wu CY, Leow AH, Wu JY, Wu DC, Hong TC, Lu H, Yamaoka Y, Megraud F, Chan FKL, Sung JJ, Lin JT, Graham DY, Wu MS, El-Omar EM; Asian Pacific Alliance on Helicobacter and Microbiota (APAHAM). Screening and eradication of Helicobacter pylori for gastric cancer prevention: the Taipei global consensus. Gut. 2020 Dec;69(12):2093-2112. doi: 10.1136/gutjnl-2020-322368. Epub 2020 Oct 1.

Reference Type BACKGROUND
PMID: 33004546 (View on PubMed)

Dore MP, Farina V, Cuccu M, Mameli L, Massarelli G, Graham DY. Twice-a-day bismuth-containing quadruple therapy for Helicobacter pylori eradication: a randomized trial of 10 and 14 days. Helicobacter. 2011 Aug;16(4):295-300. doi: 10.1111/j.1523-5378.2011.00857.x.

Reference Type BACKGROUND
PMID: 21762269 (View on PubMed)

Rowland M, Daly L, Vaughan M, Higgins A, Bourke B, Drumm B. Age-specific incidence of Helicobacter pylori. Gastroenterology. 2006 Jan;130(1):65-72; quiz 211. doi: 10.1053/j.gastro.2005.11.004.

Reference Type BACKGROUND
PMID: 16401469 (View on PubMed)

O'Ryan ML, Rabello M, Cortes H, Lucero Y, Pena A, Torres JP. Dynamics of Helicobacter pylori detection in stools during the first 5 years of life in Chile, a rapidly developing country. Pediatr Infect Dis J. 2013 Feb;32(2):99-103. doi: 10.1097/INF.0b013e318278b929.

Reference Type BACKGROUND
PMID: 23076385 (View on PubMed)

Qiao C, Li Y, Liu J, Ji C, Qu J, Hu J, Ji R, Wan M, Lin B, Lin M, Qi Q, Zuo X, Li Y. Clarithromycin versus furazolidone for naive Helicobacter pylori infected patients in a high clarithromycin resistance area. J Gastroenterol Hepatol. 2021 Sep;36(9):2383-2388. doi: 10.1111/jgh.15468. Epub 2021 Mar 10.

Reference Type BACKGROUND
PMID: 33691344 (View on PubMed)

Ding YM, Duan M, Han ZX, Song XH, Zhang FL, Wang Z, Ning Z, Zeng SY, Kong QZ, Zhang WL, Liu J, Wan M, Lin MJ, Lin BS, Nan XP, Wang H, Li YY, Zuo XL, Li YQ. Bismuth-Containing Quadruple Therapy for Helicobacter pylori Eradication: A Randomized Clinical Trial of 10 and 14 Days. Dig Dis Sci. 2024 Jul;69(7):2540-2547. doi: 10.1007/s10620-024-08460-3. Epub 2024 May 3.

Reference Type DERIVED
PMID: 38700630 (View on PubMed)

Other Identifiers

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2021-SDU-QILU-G001-2

Identifier Type: -

Identifier Source: org_study_id

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