The Evaluation of Triple Therapy With Vonoprazan, Amoxicillin and Bismuth for Eradication of Helicobacter Pylori

NCT ID: NCT05189444

Last Updated: 2022-03-22

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

NA

Total Enrollment

672 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-25

Study Completion Date

2022-12-31

Brief Summary

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The eradication rate of standard quadruple therapy has become less successful due to low compliance and high resistance to antibiotics. Therefore, it is necessary to develop new treatment strategies that increase the eradication rate and reduce adverse effects. The aim of this prospective study is to investigate the efficacy of Triple Therapy with Vonoprazan, Amoxicillin, and Bismuth for eradication of Hp, compared with standard quadruple therapy.

Detailed Description

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In China, the first-line therapy to treat Helicobacter pylori (Hp) consists of a bismuth-based proton pump inhibitor (PPI) and two antibiotics for 14 days.But, eradication has become less successful due to low compliance and high resistance to antibiotics. Therefore, it is necessary to develop new treatment strategies that increase the eradication rate and reduce adverse effects. Vonoprazan is a novel potassium-competitive acid blocker more effective in suppressing acid production than proton pump inhibitors (PPIs). Several studies previously suggested that vonoprazan containing antibiotic therapy was superior to other PPI-containing therapies for Hp. Most strains of Helicobacter pylori are sensitive to amoxicillin. Bismuth salts, a topical agent, which are available in our country, have a synergistic effect on antibiotics and decrease the bacterial load. Therefore, the investigators performed a prospective, multi-center, randomized trial, to investigate the efficacy of Triple Therapy with Vonoprazan, Amoxicillin, and Bismuth for eradication of Hp, compared with standard quadruple therapy.

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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Vonoprazan group

Vonoprazan + Amoxicillin + Bismuth potassium citrate Drug: Vonoprazan 20mg bid Other Names: no Drug: Amoxicillin 0.75g tid Other Names: no Drug: Bismuth potassium citrate 0.22g bid Other Names: no

Group Type EXPERIMENTAL

Vonoprazan

Intervention Type DRUG

20mg bid

Amoxicillin

Intervention Type DRUG

0.75g tid

Bismuth potassium citrate

Intervention Type DRUG

0.22g bid

control group: quadruple therapy

Drug: Esomeprazole 20mg bid Other Names: no Drug: Amoxicillin 1.0g bid Other Names: no Drug: Clarithromycin 0.5g bid Other Names:no Drug: Bismuth potassium citrate 0.22g bid Other Names:no

Group Type ACTIVE_COMPARATOR

Esomeprazole

Intervention Type DRUG

20mg bid

Amoxicillin

Intervention Type DRUG

1.0g bid

Clarithromycin

Intervention Type DRUG

0.5g bid

Bismuth potassium citrate

Intervention Type DRUG

0.22g bid

Interventions

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Vonoprazan

20mg bid

Intervention Type DRUG

Amoxicillin

0.75g tid

Intervention Type DRUG

Esomeprazole

20mg bid

Intervention Type DRUG

Amoxicillin

1.0g bid

Intervention Type DRUG

Clarithromycin

0.5g bid

Intervention Type DRUG

Bismuth potassium citrate

0.22g bid

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Helicobacter pylori infected patients comfirmed by 13C/14C UBT
* age 18\~65

Exclusion Criteria

* prior Hp eradication therapy including amoxicillin and clarithromycin
* previous gastric resection
* allergic to the drugs used in this study
* previous use of proton pump inhibitors, bismuth, H2 receptor antagonist or antibiotics, probiotics within 4 weeks of the study
* Patients who were pregnant or lactating
* Patients taking NSAIDs, alcoholic or with other serious disease (e.g. hepatopathy, heart disease, nephropathy#diabete mellitus, hypertension…) effect the evaluation of this study
* Can't express the complaint correctly
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Huazhong University of Science and Technology

OTHER

Sponsor Role lead

Responsible Party

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Bin Cheng

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bin Cheng, Doctor

Role: PRINCIPAL_INVESTIGATOR

Tongji Hospital

si xiong, Doctor

Role: STUDY_CHAIR

Tongji Hospital

Locations

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Tongji Hospital, Tongji Medical College, HUST

Wuhan, Hubei, China

Site Status

Countries

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China

Central Contacts

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Bin Cheng, Doctor

Role: CONTACT

027-83663334

si xiong, Doctor

Role: CONTACT

027-83663334

References

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Gunaratne AW, Hamblin H, Clancy A, Magat AJMC, Dawson MVM, Tu J, Borody TJ. Combinations of antibiotics and vonoprazan for the treatment of Helicobacter pylori infections-Exploratory study. Helicobacter. 2021 Oct;26(5):e12830. doi: 10.1111/hel.12830. Epub 2021 Jul 10.

Reference Type RESULT
PMID: 34247436 (View on PubMed)

Rokkas T, Gisbert JP, Malfertheiner P, Niv Y, Gasbarrini A, Leja M, Megraud F, O'Morain C, Graham DY. Comparative Effectiveness of Multiple Different First-Line Treatment Regimens for Helicobacter pylori Infection: A Network Meta-analysis. Gastroenterology. 2021 Aug;161(2):495-507.e4. doi: 10.1053/j.gastro.2021.04.012. Epub 2021 Apr 8.

Reference Type RESULT
PMID: 33839101 (View on PubMed)

Kiyotoki S, Nishikawa J, Sakaida I. Efficacy of Vonoprazan for Helicobacter pylori Eradication. Intern Med. 2020 Jan 15;59(2):153-161. doi: 10.2169/internalmedicine.2521-18. Epub 2019 Jun 27.

Reference Type RESULT
PMID: 31243237 (View on PubMed)

Ang TL, Ang D. Helicobacter pylori Treatment Strategies in Singapore. Gut Liver. 2021 Jan 15;15(1):13-18. doi: 10.5009/gnl19308.

Reference Type RESULT
PMID: 31875670 (View on PubMed)

Kao CY, Sheu BS, Wu JJ. Helicobacter pylori infection: An overview of bacterial virulence factors and pathogenesis. Biomed J. 2016 Feb;39(1):14-23. doi: 10.1016/j.bj.2015.06.002. Epub 2016 Apr 1.

Reference Type RESULT
PMID: 27105595 (View on PubMed)

Other Identifiers

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Vonoprazan-Hp-2021

Identifier Type: -

Identifier Source: org_study_id

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