Rabeprazole Based Sequential-Concommitant Hybrid Therapies for H. Pylori Infections
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Purpose
This prospective controlled randomized open-label clinical trial is designed to determine the optimal eradication rate of rabeprazole based sequential-concommitant hybrid therapies for adults infected with Helicobacter pylori in Eastern Taiwan. Enrolled patients will receive 3, 5 or 7 days of pre-concommitant (sequential part) treatment with rabeprazole + amoxicillin, then 7 days of concommitant treatment with rabeprazole + amoxicillin + clarithromycin + metronidazole.
| Condition | Intervention | Phase |
|---|---|---|
|
Helicobacter Pylori Infection |
Drug: RA5-RACM7 Drug: RA3-RACM7 Drug: RA7-RACM7 |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Rabeprazole Based Sequential-Concommitant Hybrid Therapies for H. Pylori Infections |
- Eradication rate [ Time Frame: 4 weeks after complete use of drug for treatment ] [ Designated as safety issue: No ]A negative post-treatment 13C-urea breath test result at more than 4 weeks after complete use of drug for treatment.
| Estimated Enrollment: | 231 |
| Study Start Date: | January 2011 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Hybrid-10
RA3-RACM7: rabeprazole + amoxicillin x 3 days, then rabeprazole + amoxicillin + clarithromycin + metronidazole x 7 days.
|
Drug: RA3-RACM7
rabeprazole 20mg bid + amoxicillin 1g bid treated for 3 days, then rabeprazole 20mg bid + amoxicillin 1g bid + clarithromycin 0.5g bid + metronidazole 0.5g bid for other 7 days
Other Names:
|
|
Experimental: Hybrid-12
RA5-RACM7: rabeprazole + amoxicillin x 5 days, then rabeprazole + amoxicillin + clarithromycin + metronidazole x 7 days
|
Drug: RA5-RACM7
rabeprazole 20mg bid + amoxicillin 1g bid treated for 5 days, then rabeprazole 20mg bid + amoxicillin 1g bid + clarithromycin 0.5g bid + metronidazole 0.5g bid for other 7 days
Other Names:
|
|
Experimental: Hybrid-14
RA7-RACM7: rabeprazole + amoxicillin x 7 days, then rabeprazole + amoxicillin + clarithromycin + metronidazole x 7 days
|
Drug: RA7-RACM7
rabeprazole 20mg bid + amoxicillin 1g bid treated for 7 days, then rabeprazole 20mg bid + amoxicillin 1g bid + clarithromycin 0.5g bid + metronidazole 0.5g bid for other 7 days
Other Names:
|
Detailed Description:
Background: Antimicrobial resistance has decreased the worldwide eradication rates of common used triple therapy for Helicobacter pylori infection (less than 80%).
Objective: To determine the optimal pre-concommitant treatment length for rabeprazole based sequential-concomitant hybrid therapies for adults infected with Helicobacter pylori in Eastern Taiwan.
Design: Randomized, open-label, prospective controlled trial.
Patients: 231 patients with dyspepsia or peptic ulcers and infected by Helicobacter pylori.
Measurements: 13C-urea breath test, upper endoscopy, histologic evaluation, rapid urease test, bacterial culture, assessment of antibiotic resistance and CYP2C19 genotype of host.
Intervention: 231 patients with Helicobacter pylori infection are recruited and randomly assigned to receive one of the following therapeutic schemes: group 1, 14-days hybrid therapy: rabeprazole 20mg bid + amoxicillin 1g bid treated for 7 days, then rabeprazole 20mg bid + amoxicillin 1g bid + clarithromycin 0.5g bid + metronidazole 0.5g bid for other 7 days; group 2, 12-days hybrid therapy: rabeprazole 20mg bid + amoxicillin 1g bid treated for 5 days, then rabeprazole 20mg bid + amoxicillin 1g bid + clarithromycin 0.5g bid + metronidazole 0.5g bid for other 7 days; group 3, 10-days hybrid therapy: rabeprazole 20mg bid + amoxicillin 1g bid treated for 3 days, then rabeprazole 20mg bid + amoxicillin 1g bid + clarithromycin 0.5g bid + metronidazole 0.5g bid for other 7 days. Repeat upper endoscopy for histologic evaluation, rapid urease test or 13C-urea breath test after 4 week of treatment to assess the treatment result. The influence on the hybrid therapies of antibiotic resistance of Helicobacter pylori and CYP2C19 genotype of host were determined.
Expected results: The rabeprazole based sequential-concomitant therapies for eradication of Helicobacter pylori is very effective, and the outcome is not affected by antibiotic resistance of Helicobacter pylori and CYP2C19 genotype of host.
Eligibility| Ages Eligible for Study: | 20 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patient proved with infection of H. pylori in gastric mucosa (at least two of four tests positive)
Exclusion Criteria:
- woman in breast feeding or pregnancy.
- allergy to drugs used in study.
- previously treated for H. pylori.
- intolerance to fructose, lactose.
- patients with hematologic, brain or spinal disorders
- patients under 20 years old
- patients under aspirin or clopidogrel
- patients with history of gastric cancer or gastric resection operation.
Contacts and Locations| Contact: Ming-Cheh CHEN, MD | +886-910-521003 | MingCheh_chen@tzuchi.com.tw |
| Taiwan | |
| Buddhist Tzu Chi General Hospital | Recruiting |
| Hualien, Taiwan, 97002 | |
| Contact: Ming-Cheh CHEN, MD +886-910-521003 MingCheh_chen@tzuchi.com.tw | |
| Principal Investigator: Ming-Cheh CHEN, MD | |
| Sub-Investigator: Chi-Tan HU, PhD, MD | |
| Sub-Investigator: Wei-Yi RAY, MD | |
| Principal Investigator: | Ming-Cheh CHEN, MD | Buddhist Tzu Chi General Hospital |
More Information
No publications provided
| Responsible Party: | Ming-Cheh Chen, Principal Investigator, Buddhist Tzu Chi General Hospital |
| ClinicalTrials.gov Identifier: | NCT01566643 History of Changes |
| Other Study ID Numbers: | TCRD100-16, IRB099-71 |
| Study First Received: | March 27, 2012 |
| Last Updated: | April 4, 2012 |
| Health Authority: | Taiwan: Institutional Review Board |
Keywords provided by Buddhist Tzu Chi General Hospital:
|
Helicobacter pylori antibiotic resistance sequential-concomitant hybrid therapy |
Additional relevant MeSH terms:
|
Helicobacter Infections Gram-Negative Bacterial Infections Bacterial Infections Amoxicillin Clarithromycin Metronidazole Rabeprazole Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses |
Pharmacologic Actions Radiation-Sensitizing Agents Physiological Effects of Drugs Antiprotozoal Agents Antiparasitic Agents Protein Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Anti-Ulcer Agents Gastrointestinal Agents |
ClinicalTrials.gov processed this record on June 18, 2013