Open, Randomised, Multi-center Study of on Demand Versus Continuous Esomeprazole Treatment in Patient With GERD
- Registration Number
- NCT02670642
- Lead Sponsor
- AstraZeneca
- Brief Summary
The purpose of this study is to compare on demand with continuous treatment of endoscopy negative subjects with gastroesophageal reflux disease (GERD), with esomeprazole 20-mg once daily, with regards to willingness to continue in the study as a result of satisfactory treatment over a six-month long term management period, after initial symptom relief.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 877
- Symptoms suggestive of GERD, with heartburn as their predominant symptom (described as a burning feeling, rising from the stomach or lower part of the chest up towards the neck), for longer than 6 months.
- Heartburn occurring for 4 days or more during the last 7 days prior to endoscopy. Or, if PPI treatment has been started within the last 7 days prior to endoscopy, then heartburn occurring for 4 days or more during the last 7 days prior to start of PPI treatment
- Male or female, at least 18 years of age (for Austria, at least 19 years of age)
- Have given written informed consent
- Ability to read and write (literate)
- 7 symptom free (from heartburn) days in the last week prior to randomisation (day of visit not included)
-
Documented esophageal mucosal break
-
History of esophageal, gastric or duodenal surgery, except closure and oversewing of an ulcer
-
Chronic or recurrent abdominal pain associated with a chronic or recurrent bowel disturbance and/or bloating, that in the opinion of the investigator is likely to be due to irritable bowel syndrome or two or more of the following criteria:
- Symptoms relieved by defecation
- Symptoms associated with change in frequency of stools
- Symptoms associated with change in form of stools
-
Any significant "alarm symptoms" such as unintentional weight loss, haematemesis melaena, jaundice or any other sign indicating serious or malignant disease.
-
Subjects with current or historical evidence of the following diseases/conditions
- Zollinger Ellison syndrome
- Primary esophageal motility disorder(s) i.e. achalasia, scleroderma, esophageal spasm
- Complications of GERD such as esophageal stricture, ulcer and/or macroscopic Barrett's metaplasia (longer than 3 centimetres) or significant dysplastic changes in the esophagus
- Evidence of upper gastrointestinal malignancy at the screening endoscopy
- Gastric and/or duodenal ulcers within the last 2 years
- Malabsorption
- Malignancy, or significant cardiovascular, pulmonary, renal, pancreatic or liver disease as judged by the investigator
- Unstable diabetes mellitus. Stable diabetes controlled on diet, oral agents or insulin is acceptable
- Cerebrovascular disease, such as cerebral ischemia, infarction, haemorrhage or embolus
-
Subjects using a PPI for more than 10 days in the last 28 days, prior to endoscopy
-
Use of PPIs for more than 5 days in the last 7 days prior to endoscopy
-
Subjects using daily H2-receptor antagonist, prokinetics recommended in the treatment of reflux symptoms or sucralfate during the 2 weeks prior to endoscopy and between the endoscopy and visit 1 and throughout the study
-
Need for continuous concurrent therapy with
- NSAIDs (including selective COX II antagonists, salicylates (unless<165 mg daily for cardiovascular prophylaxis)
- anticholinergics
- prostaglandin analogues
- phenytoin
- ketoconazole
- itraconazole
- warfarin and other vitamin K antagonists
-
Pregnancy or lactation. Women of childbearing potential must maintain effective contraception during the study period as judged by the investigator (for Austria: Women of child-bearing potential may only be included when their pregnancy status is assessed by the investigator prior to entry and then at monthly basis. For South-Africa and Spain:
Women of child-bearing potential may only be included when their pregnancy status is assessed by the investigator prior to endoscopy)
- Use of any other investigational compound 28 days prior to start and during the study
- Requirement of an interpreter (illiterate)
- Alcohol and/or drug abuse or any condition associated with poor compliance, including expected non-co-operation, as judged by the investigator
- Previous participation in this study
- Contra-indications to study drugs, e.g. known or suspected allergy to esomeprazole and any other constituents of the formulation. Known hypersensitivity to substituted benzimidazole
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description On demand 20 mg esomeprazole Esomeprazole On demand treatment with 20-mg esomeprazole once daily when needed Continuous 20 mg esomeprazole Esomeprazole Continuous treatment with 20 mg esomeprazole once daily
- Primary Outcome Measures
Name Time Method Difference between the proportion of patients who discontinued on-demand esomeprazole treatment versus continuous esomeprazole treatment due to unsatisfactory treatment as determined by the investigator in consultation with the patient 6 months Compare on demand (taken as needed by the patient to adequately control their reflux disease) with continuous treatment of endoscopy negative subjects with gastroesophageal reflux disease (GERD), with esomeprazole 20-mg once daily, with regards to willingness to continue in the study as a result of satisfactory treatment over a six-month long term management period, after initial symptom relief
- Secondary Outcome Measures
Name Time Method Change from baseline in impact of reflux symptoms on health-related quality of life using pre-specified dimensions of the Quality Of Life in Reflux And Dyspepsia (QOLRAD) questionnaire 6 months Change from baseline in impact of reflux symptoms on health-related quality of life using pre-specified dimensions of the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire 6 months Difference between the proportion of patients reporting treatment satisfaction with on-demand versus continuous esomeprazole treatment assessed by standard patient-completed electronic questionnaire at clinical visits and premature discontinuation 6 months Frequency of adverse events and assessment of hematology (hemoglobin, leukocytes, thrombocytes) and clinical chemistry (creatinine, alkaline phosphate, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyl transferase, total bilirubin) 6 months Individual patterns of esomeprazole tablet usage measured using the Medical Event Monitoring System (MEMS) container (date and time of use recorded) 6 months Reasons for discontinuation of on-demand or continuous esomeprazole treatment assessed by investigator-completed questionnaire at clinical visits 6 months Mean number of esomeprazole tablets taken measured using the Medical Event Monitoring System (MEMS) container (date and time of use recorded) 6 months
Trial Locations
- Locations (60)
Gemeinschaftspraxis
🇩🇪Köln, Germany
Frankenwaldklinik
🇩🇪Kronach, Germany
Hanusch Hospital
🇦🇹Wien, Austria
13 rue Roquebillière
🇫🇷Cannes La Bocca, France
30 boulevard du Président John Kennedy
🇫🇷Beziers, France
91 rue de Paris
🇫🇷Charenton Le Pont, France
17 villa du Petit Parc
🇫🇷Creteil, France
3 place du Marché Couvert
🇫🇷Dreux, France
62 rue Bonnabaud
🇫🇷Clermont Ferrand, France
24 quai Saint Maurand
🇫🇷Douai, France
Clinique Saint Vincent
🇫🇷Epernay, France
7 rue Parmentier
🇫🇷Epinal, France
Place du Postillon
🇫🇷Issoire, France
60 rue Jean Bart
🇫🇷Lille, France
6 avenue du Maréchal Juin
🇫🇷Narbonne, France
9 square de Liège
🇫🇷Nancy, France
74 avenue Paul Doumer
🇫🇷Paris, France
64 boulevard Marcel Sembat
🇫🇷Saint Denis, France
31 rue Henri Maréchal
🇫🇷Saint Priest, France
45bis rue d.Elbeuf
🇫🇷Rouen, France
201 boulevard Robespierre
🇫🇷Talence, France
4 rue Berlioz
🇫🇷Velizy Villacoublay, France
20 rue de la Glacière
🇫🇷Vitry Sur Seine, France
68 avenue Paul Vaillant Couturier
🇫🇷Vitry Sur Seine, France
Wartburgstraße 19
🇩🇪Berlin, Germany
Finkenstraße 31
🇩🇪Freising, Germany
Carl Gustav Carus der Tecnischen Universität
🇩🇪Dresden, Germany
Reichenbacher Str. 106 a
🇩🇪Görlitz, Germany
A.ö.Landeskrankenhaus Feldbach
🇦🇹Feldbach, Austria
Krankenhaus der Stadt Wien
🇦🇹Wien, Austria
Spitalverbund Landeskrankenhaus
🇦🇹Knittelfeld, Austria
A.ö. Krankenhaus Zell am See
🇦🇹Zell am See, Austria
A.ö. Landeskrankenhaus Kittsee
🇦🇹Kittsee, Austria
36 boulevard Gambetta
🇫🇷Ales, France
84 rue Gustave Colin
🇫🇷Arras, France
15 rue Michelet
🇫🇷Belfort, France
10 avenue Villeneuve
🇫🇷Cagnes Sur Mer, France
81 avenue du Teil
🇫🇷Montelimar, France
Gastroenterology Clinic, G73, Department of Internal Medicine, Universitas Hospital
🇿🇦Bloemfontein, South Africa
Gastroenterology Clinic, E23, Groote Schuur Hospital Observatory
🇿🇦Cape Town, South Africa
Gastroenterology Unit, Room C78, Tygerberg Hospital
🇿🇦Cape Town, South Africa
Genovevastraße 5
🇩🇪Köln, Germany
Buchentorstr. 16
🇩🇪Lienen, Germany
Hammer Str. 108
🇩🇪Münster, Germany
Albersloher Weg 455
🇩🇪Münster, Germany
Am Bahnhof 3
🇩🇪Oelde, Germany
Rudolf-Breitscheid-Str. 56
🇩🇪Potsdam, Germany
Musikantenweg 3
🇩🇪Ribnitz, Germany
Friedensstr. 14
🇩🇪Wolmirstedt, Germany
Burnside House, Room 1
🇿🇦Cape Town, South Africa
Gastroenterology Clinic, Parorama Medi-Clinic
🇿🇦Cape Town, South Africa
Unitas Hospital Lyttleton
🇿🇦Centurion, South Africa
Gastroenterology Clinic, Parklands Medical Centre
🇿🇦Durban, South Africa
Gastroenterology Unit, Chris Hani Baragwanath Hospital
🇿🇦Johannesburg, South Africa
Gastroenterology Clinic, Milpark Hospital
🇿🇦Johannesburg, South Africa
Centro Médico Teknon
🇪🇸Barcelona, Spain
Hospital General de Guadalajara
🇪🇸Guadalajara, Spain
Hospital Central de Asturias
🇪🇸Oviedo, Spain
Hospital Clínico Universitario
🇪🇸Santiago de Compostela, Spain
Hospital Virgen Macarena
🇪🇸Sevilla, Spain