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A Study to Evaluate the Efficacy and Safety of Bismuth-Containing Quadruple Therapy With Oral Vonoprazan (TAK-438) 20 mg Compared to Esomeprazole 20 mg Twice Daily in Paticipants With Helicobacter Pylori Infection

Registration Number
NCT04198363
Lead Sponsor
Takeda
Brief Summary

The purpose of this study is to evaluate the efficacy of helicobacter pylori (HP) eradication with bismuth-containing quadruple therapy with vonoprazan versus esomeprazole in all HP-positive participants.

Detailed Description

The drug being tested in this study is called vonoprazan (TAK-438). Vonoprazan is being tested to treat people who have helicobacter pylori infection.

The study is planned to enroll 425 patients at the beginning and will enroll a maximum of approximately 510 patients based on the interim analysis results. Participants will be randomly assigned (by chance, like flipping a coin) to one of the two treatment groups-which will remain undisclosed to the patient and study doctor during the study (unless there is an urgent medical need):

Vonoprazan 20 mg

Esomeprazole 20 mg

All participants will be asked to take one tablet in combination with bismuth containing quadruple therapy (amoxicillin, clarithromycin and bismuth potassium citrate) twice at the same time each day throughout the study.

This multi-center trial will be conducted in China. The overall time to participate in this study is 10 weeks. Participants will make multiple visits to the clinic, and 28 days after last dose of study drug for a follow-up assessment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
510
Inclusion Criteria
  1. Helicobacter pylori (HP)-positive participants as determined by ^13C-urea breath test (^13C-UBT) at the start of the study (Visit 1 [screening]) and who require HP eradication in Physician judgment.
Exclusion Criteria
  1. Participant had any of the following conditions at the start of the study (Visit 1, screening): acute upper gastrointestinal bleeding, active gastric ulcer (GU) or duodenal ulcer (DU) characterized by defective mucos with white coating (with or without adherent blood clots) 3 mm or more in size, acute gastric mucosal lesion (AGML), or acute duodenal mucosal lesion (ADML). However, participants with gastritis, gastric or duodenal erosion are permitted to participate.
  2. Participants with Zollinger-Ellison syndrome or gastric acid hypersecretion or those with a history of gastric acid hypersecretion.
  3. Participant has a history of malignancy or was treated for malignancy within 5 years before the start of the screening visit (the participant may be included in the study if he/she has cured cutaneous basal cell carcinoma or cervical carcinoma in situ).
  4. Participant has a known acquired immunodeficiency syndrome or hepatitis infection, including hepatitis virus carriers (hepatitis B surface antigen [HBsAg] or hepatitis C virus [HCV]- antibody-positive).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Vonoprazan 20 mgBismuth Potassium citrateVonoprazan 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Esomeprazole 20 mgBismuth Potassium citrateEsomeprazole 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Vonoprazan 20 mgVonoprazanVonoprazan 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Vonoprazan 20 mgAmoxicillinVonoprazan 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Vonoprazan 20 mgClarithromycinVonoprazan 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Esomeprazole 20 mgClarithromycinEsomeprazole 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Esomeprazole 20 mgAmoxicillinEsomeprazole 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Esomeprazole 20 mgEsomeprazoleEsomeprazole 20 mg, tablets, orally, twice daily given in combination with bismuth containing quadruple therapy (amoxicillin 1 gm, capsules, clarithromycin 500 mg, tablets, and bismuth potassium citrate 600 mg) orally, twice daily for up to 2 weeks.
Primary Outcome Measures
NameTimeMethod
Percentage of Helicobacter Pylori Positive (HP+) Participants With Successful HP Eradication at Week 4 Post-TreatmentWeek 4 post-treatment

HP infection status was determined by \^13C Urea Breath Test (\^13C-UBT). The urea breath test is used to detect infection with HP, a bacteria associated with stomach ulcers, by testing individual breath samples in a central laboratory. The percentages are rounded off to report the nearest ten.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (29)

The First People's Hospital of Foshan

🇨🇳

Foshan, Guangdong, China

Friendship Hospital, Capital Medical University

🇨🇳

Beijing, Beijing, China

Peking University Third Hospital

🇨🇳

Beijing, Beijing, China

The First Affiliated Hospital of Xiamen University

🇨🇳

Xiamen, Fujian, China

Fuzhou General Hospital of Nanjing Military Command

🇨🇳

Fuzhou, Fujian, China

Zhongshan Hospital Xiamen University

🇨🇳

Xiamen, Fujian, China

Haikou people's Hosptial

🇨🇳

Haikou, Hainan, China

Union Hospital Tongji Medical College Huazhong University of Science and Technology

🇨🇳

Wuhan, Hubei, China

Guangzhou First People's Hospital

🇨🇳

Guangzhou, Guangdong, China

Xiangya Hospital of Central South University, Digestive Department

🇨🇳

Changsha, Hunan, China

Renmin Hospital of Wuhan University

🇨🇳

Wuhan, Hubei, China

The Third Xiangya Hospital of Central South University

🇨🇳

Changsha, Hunan, China

The Second Xiangya Hospital of Central South University

🇨🇳

Changsha, Hunan, China

The First People's Hospital of Changzhou

🇨🇳

Changzhou, Jiangsu, China

Nanjing Drum Tower Hospital

🇨🇳

Nanjing, Jiangsu, China

Northern Jiangsu People's Hospital

🇨🇳

Yangzhou, Jiangsu, China

Jiangsu Province Hospital

🇨🇳

Nanjing, Jiangsu, China

Yangzhou First People's Hospital

🇨🇳

Yangzhou, Jiangsu, China

Nanjing First Hospital

🇨🇳

Nanjing, Jiangsu, China

The Third Hospital of Nanchang

🇨🇳

Nanchang, Jiangxi, China

The First Affiliated Hospital of Nanchang University Digestive Department

🇨🇳

Nanchang, Jiangxi, China

Shengjing Hospital of China Medical University

🇨🇳

Shenyang, Liaoning, China

General Hospital of Ningxia Medical University

🇨🇳

Yinchuan, Ningxia, China

The Second Affiliated Hospital of Xi'an Jiaotong University

🇨🇳

Xi'an, Shanxi, China

Ruijin Hospital Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai, Shanghai, China

Shanghai East Hospital

🇨🇳

Shanghai, Shanghai, China

Zhongshan Hospital, Fudan University

🇨🇳

Shanghai, Shanghai, China

First Affiliated Hospital of Xinjiang Medical University

🇨🇳

Urumqi, Xinjiang, China

The Second Affiliated Hospital, Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

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