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Efficacy and Safety of Quadruple Therapy in Eradication of H. Pylori: A Comparison to Triple Therapy

This study has been completed.
Sponsor:
Information provided by:
Axcan Pharma
ClinicalTrials.gov Identifier:
NCT00669955
First received: April 29, 2008
Last updated: August 3, 2010
Last verified: August 2010
Results First Received: June 21, 2010  
Study Type: Interventional
Study Design: Allocation: Randomized;   Endpoint Classification: Safety/Efficacy Study;   Intervention Model: Parallel Assignment;   Masking: Open Label;   Primary Purpose: Treatment
Condition: Helicobacter Infections
Interventions: Drug: Omeprazole, amoxicillin, clarithromycin
Drug: Pylera (Bismuth subcitrate potassium, metronidazole, tetracycline) given in combination with omeprazole

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
First patient in: 11 June 2008 Last patient out: 22 June 2009 Patients were recruited from clinics and hospitals located in seven European Countries: Germany, Poland, Italy, France, Ireland, Spain, United Kingdom.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
If patient was on any contraindicated medications, such as H2 antagonists, sucralfate, or proton pump inhibitors, a washout period of 2 weeks began following informed consent signature, and patient returned to the clinic to perform the endoscopy and the C-13 urea breath test. Presence of H pylori needed to be confirmed by C-13 UBT and RUT at least.

Reporting Groups
  Description
Quadruple Therapy (OBMT) 10 Days Omeprazole 20 mg BID (twice a day), and the 3 in 1 capsule, Pylera, containing Bismuth Subcitrate potassium 140 mg, metronidazole 125 mg and tetracycline 125 mg, administered as 3 capsules QID (four times day)
Triple Therapy (OAC) 7 Days Ompeprazole 20 mg BID, Amoxicilin 500 mg 2 capsules BID and Clarithromycin 500 mg 1 tablet BID

Participant Flow:   Overall Study
    Quadruple Therapy (OBMT) 10 Days     Triple Therapy (OAC) 7 Days  
STARTED     218 [1]   222  
COMPLETED     204     195  
NOT COMPLETED     14     27  
Adverse Event                 3                 5  
Death                 0                 1  
Withdrawal by Subject                 2                 3  
Lost to Follow-up                 5                 7  
Protocol Violation                 2                 7  
Investigator Sponsor Jugement                 0                 1  
not compliant with study drug/visit                 2                 3  
[1] 216 patients received study drug. 2 patients were dispensed study drug but did not take it



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Quadruple Therapy (OBMT) 10 Days Omeprazole 20 mg BID (twice a day), and the 3 in 1 capsule, Pylera, containing Bismuth Subcitrate potassium 140 mg, metronidazole 125 mg and tetracycline 125 mg, administered as 3 capsules QID (four times day)
Triple Therapy (OAC) 7 Days Ompeprazole 20 mg BID, Amoxicilin 500 mg 2 capsules BID and Clarithromycin 500 mg 1 tablet BID
Total Total of all reporting groups

Baseline Measures
    Quadruple Therapy (OBMT) 10 Days     Triple Therapy (OAC) 7 Days     Total  
Number of Participants  
[units: participants]
  218     222     440  
Age  
[units: participants]
     
<=18 years     0     0     0  
Between 18 and 65 years     184     194     378  
>=65 years     34     28     62  
Age  
[units: years]
Mean ± Standard Deviation
  48.53  ± 14.64     47.95  ± 14.52     48.24  ± 14.58  
Gender  
[units: participants]
     
Female     105     100     205  
Male     113     122     235  
Region of Enrollment  
[units: participants]
     
Italy     10     10     20  
Spain     7     6     13  
France     15     17     32  
Germany     92     91     183  
Poland     91     93     184  
United Kingdom     3     5     8  



  Outcome Measures
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1.  Primary:   Helicobacter Pylori Eradication Confirmed by Urea Breath Test   [ Time Frame: Week 6 and week 10 follow-up visits ]

2.  Secondary:   Number of Patients Experiencing Treatment Emergent Adverse Events.   [ Time Frame: at the end of treatment (day 8-14), week 6 and wek 10 follow-up visits. ]

3.  Secondary:   H. Pylori Eradication and Presence or Past History of Peptic Ulcers   [ Time Frame: Week 6 and week 10 follow-up visits ]

4.  Secondary:   Clarithromycin Resistance   [ Time Frame: Measured at baseline ]

5.  Secondary:   Metronidazole Resistance   [ Time Frame: Measured at baseline ]

6.  Secondary:   Overall Compliance to Study Medications   [ Time Frame: At the end of the treatment phase (days 8-14) ]

7.  Secondary:   Number of Patients With Bismuth Plasma Concentrations Above the Toxic Level   [ Time Frame: Baseline (both arms), end of treatment (Day 11-14) and end of study (Day 70) OBMT arm only ]


  Serious Adverse Events
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Time Frame Adverse events were recorded starting at the signing of the informed consent until the final visit (Day 70) or early withdrawal visit. Serious adverse events were followed until 30 days after the patient had stopped study participation.
Additional Description Systematic assessment done for laboratory evaluations and bismuth plasma levels.

Reporting Groups
  Description
Quadruple Therapy (OBMT) 10 Days Omeprazole 20 mg BID (twice a day), and the 3 in 1 capsule, Pylera, containing Bismuth Subcitrate potassium 140 mg, metronidazole 125 mg and tetracycline 125 mg, administered as 3 capsules QID (four times day)
Triple Therapy (OAC) 7 Days Ompeprazole 20 mg BID, Amoxicilin 500 mg 2 capsules BID and Clarithromycin 500 mg 1 tablet BID

Serious Adverse Events
    Quadruple Therapy (OBMT) 10 Days     Triple Therapy (OAC) 7 Days  
Total, serious adverse events      
# participants affected / at risk     4/216 (1.85%)     3/222 (1.35%)  
Cardiac disorders      
Ventricular extrasystoles * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Gastrointestinal disorders      
Pancreatitis * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Vomiting * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
General disorders      
Condition aggravated * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Pyrexia * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Infections and infestations      
Appendicitis * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Proteus infection * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
e coli urinary tract infection * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
Metabolism and nutrition disorders      
Dehydration * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Malnutrition * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Neoplasms benign, malignant and unspecified (incl cysts and polyps)      
Gastrointestinal carcinoma * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
Nervous system disorders      
Vascular dementia * 1    
# participants affected / at risk     0/216 (0.00%)     1/222 (0.45%)  
# events     0     1  
Psychiatric disorders      
Schizophrenia * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
Renal and urinary disorders      
Renal artery stenosis * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
Renal failure acute * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
Skin and subcutaneous tissue disorders      
Eczema * 1    
# participants affected / at risk     1/216 (0.46%)     0/222 (0.00%)  
# events     1     0  
* Events were collected by non-systematic assessment
1 Term from vocabulary, PT




  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
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