Esomeprazole Plus Sucralfate for Post-ESD Ulcer Healing: A Randomized Controlled Trial

NCT ID: NCT07312370

Last Updated: 2025-12-31

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-20

Study Completion Date

2026-12-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Endoscopic submucosal dissection (ESD) is an established treatment for early gastric cancer and precancerous lesions. Post-ESD artificial ulcers may lead to complications including delayed bleeding (3-15%) and prolonged healing. Current guidelines recommend high-dose proton pump inhibitors (PPIs), but evidence for additional mucosal protective agents remains limited.

This study aims to evaluate whether combining sucralfate suspension with standard intravenous esomeprazole therapy improves ulcer healing and reduces complications after gastric ESD compared to esomeprazole alone.

This is a prospective, randomized, controlled, outcome-assessor-blinded trial. A total of 120 patients undergoing gastric ESD will be randomly assigned 1:1 to receive either:

* Intervention group: Intravenous esomeprazole 40mg twice daily (3 days) followed by oral esomeprazole 40mg once daily PLUS sucralfate suspension 1g twice daily for 8 weeks
* Control group: Intravenous esomeprazole 40mg twice daily (3 days) followed by oral esomeprazole 40mg once daily for 8 weeks The primary outcome is ulcer reduction rate at 4 weeks post-ESD, assessed by endoscopy. Secondary outcomes include complete ulcer healing rate at 8 weeks, delayed bleeding rate, symptom scores, and safety parameters.

This study will provide high-quality evidence regarding the role of sucralfate as an adjunctive therapy for post-ESD ulcer management and may inform future clinical guidelines.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Early Gastric Cancer Gastric Dysplasia Gastric Neoplasms Peptic Ulcer With Haemorrhage Gastric Ulcer

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Endoscopic Submucosal Dissection Gastric Cancer Ulcer Healing Proton Pump Inhibitor Post-ESD Ulcer Early Gastric Neoplasm

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
This is an open-label study for participants and care providers due to the nature of oral suspension that cannot be easily matched with placebo. However, outcome assessors (endoscopists evaluating images and videos) and data analysts will be blinded to treatment allocation until database lock.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Esomeprazole + Sucralfate (Intervention Group)

* Days 1-3: Esomeprazole 40mg intravenously every 12 hours
* Days 4-56: Esomeprazole 40mg orally once daily (before breakfast) + Sucralfate suspension 1g orally twice daily (1 hour before breakfast and at bedtime on empty stomach)

Group Type EXPERIMENTAL

Esomeprazole (Intravenous)

Intervention Type DRUG

Esomeprazole 40mg intravenously every 12 hours for 3 days (Days 1-3 post-ESD)

Esomeprazole (Oral)

Intervention Type DRUG

Esomeprazole 40mg orally once daily, taken before breakfast, for 8 weeks (Days 4-56)

Sucralfate Suspension

Intervention Type DRUG

Sucralfate suspension 1g (one sachet) orally twice daily for 8 weeks. Administered 1 hour before breakfast and at bedtime on empty stomach (2-3 hours after dinner). Should be taken separately from other medications (≥1-2 hours apart).

Gastric Endoscopic Submucosal Dissection (ESD)

Intervention Type PROCEDURE

Standardized gastric ESD procedure including lesion marking, submucosal injection, circumferential incision, submucosal dissection, and complete coagulation of all visible vessels at the ulcer base.

Esomeprazole Alone (Control Group)

* Days 1-3: Esomeprazole 40mg intravenously every 12 hours
* Days 4-56: Esomeprazole 40mg orally once daily (before breakfast)

Group Type ACTIVE_COMPARATOR

Esomeprazole (Intravenous)

Intervention Type DRUG

Esomeprazole 40mg intravenously every 12 hours for 3 days (Days 1-3 post-ESD)

Esomeprazole (Oral)

Intervention Type DRUG

Esomeprazole 40mg orally once daily, taken before breakfast, for 8 weeks (Days 4-56)

Gastric Endoscopic Submucosal Dissection (ESD)

Intervention Type PROCEDURE

Standardized gastric ESD procedure including lesion marking, submucosal injection, circumferential incision, submucosal dissection, and complete coagulation of all visible vessels at the ulcer base.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Esomeprazole (Intravenous)

Esomeprazole 40mg intravenously every 12 hours for 3 days (Days 1-3 post-ESD)

Intervention Type DRUG

Esomeprazole (Oral)

Esomeprazole 40mg orally once daily, taken before breakfast, for 8 weeks (Days 4-56)

Intervention Type DRUG

Sucralfate Suspension

Sucralfate suspension 1g (one sachet) orally twice daily for 8 weeks. Administered 1 hour before breakfast and at bedtime on empty stomach (2-3 hours after dinner). Should be taken separately from other medications (≥1-2 hours apart).

Intervention Type DRUG

Gastric Endoscopic Submucosal Dissection (ESD)

Standardized gastric ESD procedure including lesion marking, submucosal injection, circumferential incision, submucosal dissection, and complete coagulation of all visible vessels at the ulcer base.

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Esomeprazole Sodium Esomeprazole Magnesium

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Age 18-80 years, male or female
2. Diagnosed with early gastric cancer or high-grade intraepithelial neoplasia planned for gastric ESD
3. Lesion location: Gastric corpus, antrum, or angle (cardiac lesions may be included but will require subgroup analysis)
4. Successful en bloc resection achieved by ESD
5. Post-ESD artificial ulcer diameter ≥2 cm
6. Complete coagulation of all visible vessels during ESD procedure
7. ECOG performance status 0-1
8. Able to comply with follow-up visits and endoscopic examinations
9. Voluntary participation with written informed consent

Exclusion Criteria

1. Previous gastric surgery history
2. Active peptic ulcer disease (confirmed by pre-ESD endoscopy) within 1 month
3. Recent upper gastrointestinal bleeding (within 1 month, excluding tumor-related bleeding)
4. Severe heart, liver, or kidney dysfunction (Child-Pugh class C, NYHA class III-IV, or CKD stage 4-5)
5. Coagulation disorders (INR \>1.5 or platelet count \<50×10⁹/L)
6. Uncontrolled diabetes (HbA1c \>9%)
7. Known allergy or hypersensitivity to PPIs or sucralfate
8. Use of PPIs, H2 receptor antagonists, or mucosal protective agents within 2 weeks prior to ESD
9. Long-term anticoagulant therapy that cannot be discontinued (e.g., warfarin, direct oral anticoagulants)
10. Long-term NSAIDs or aspirin (\>100mg/day) that cannot be discontinued
11. Unsuccessful complete (en bloc) resection (piecemeal resection)
12. Intraoperative perforation
13. Uncontrolled active bleeding during ESD
14. Pregnancy or lactation
15. Women of childbearing potential not using adequate contraception
16. Concurrent participation in another clinical trial
17. Any condition that, in the investigator's opinion, makes the patient unsuitable for study participation
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

LanZhou University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Zhaofeng Chen

Clinical Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

The First Hospital of Lanzhou University

Lanzhou, Gansu, China

Site Status

Countries

Review the countries where the study has at least one active or historical site.

China

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Qiangqiang Tian

Role: CONTACT

Phone: 86+15009460497

Email: [email protected]

Zhaofeng Chen

Role: CONTACT

Phone: 86+15009460497

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Qiangqiang Tian

Role: primary

Role: backup

References

Explore related publications, articles, or registry entries linked to this study.

Takeuchi T, Ota K, Harada S, Edogawa S, Kojima Y, Tokioka S, Umegaki E, Higuchi K. The postoperative bleeding rate and its risk factors in patients on antithrombotic therapy who undergo gastric endoscopic submucosal dissection. BMC Gastroenterol. 2013 Sep 6;13:136. doi: 10.1186/1471-230X-13-136.

Reference Type BACKGROUND
PMID: 24010587 (View on PubMed)

Tanaka S, Terasaki M, Kanao H, Oka S, Chayama K. Current status and future perspectives of endoscopic submucosal dissection for colorectal tumors. Dig Endosc. 2012 May;24 Suppl 1:73-9. doi: 10.1111/j.1443-1661.2012.01252.x.

Reference Type BACKGROUND
PMID: 22533757 (View on PubMed)

Pimentel-Nunes P, Libanio D, Bastiaansen BAJ, Bhandari P, Bisschops R, Bourke MJ, Esposito G, Lemmers A, Maselli R, Messmann H, Pech O, Pioche M, Vieth M, Weusten BLAM, van Hooft JE, Deprez PH, Dinis-Ribeiro M. Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) Guideline - Update 2022. Endoscopy. 2022 Jun;54(6):591-622. doi: 10.1055/a-1811-7025. Epub 2022 May 6.

Reference Type BACKGROUND
PMID: 35523224 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

LDYYczf2025121701

Identifier Type: -

Identifier Source: org_study_id