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Dexlansoprazole to Treat Laryngopharyngeal Reflux and Lingual Tonsil Hypertrophy

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified April 2011 by Advanced Center for Specialty Care.
Recruitment status was:  Not yet recruiting
Information provided by:
Advanced Center for Specialty Care Identifier:
First received: April 1, 2011
Last updated: April 4, 2011
Last verified: April 2011

Main Hypothesis: The investigators hypothesize that measurements of lingual tonsil tissue (LTT) thickness will decrease following treatment with once daily oral dexlansoprazole 60 mg in patients diagnosed with laryngopharyngeal reflux (LPR) and lingual tonsil hypertrophy (LTH) compared to matched controls receiving placebo.

Primary endpoints include:

  • 24-hour oropharyngeal pH testing, pre- and post-treatment
  • Mean lingual tonsil tissue (LTT) thickness, pre- and post-treatment, as determined by CT scan of the base of tongue

Secondary endpoints include:

  • Reflux Finding Score (RFS) on pre- and post-treatment endoscopy of the oropharynx
  • Subjective outcome metrics for assessing LPR-related symptoms and associated quality of life
  • Calgary Sleep Apnea Quality of Life Index
  • Bed-partner assessment of snoring intensity according to a Visual Analog Scale
  • Epworth Sleepiness Scale (ESS)
  • Reflux Symptom Index (RSI)

Specific Aims: The primary objective of this study is to determine whether treatment of patients diagnosed with LPR and LTH with 3 months of PPI therapy reduces LTT thickness, as measured on CT scan of the tongue base.

The secondary objectives of this study are to:

  • Evaluate changes in LPR-related symptoms and quality of life after therapy using the following subjective outcome metrics:

    • Calgary Sleep Apnea Quality of Life Index
    • Bed-partner assessment of snoring intensity according to a Visual Analog Scale
    • Epworth Sleepiness Scale
    • Reflux symptom index
  • Correlate changes in LTT thickness with the following secondary endpoints:

    • Changes in the above subjective outcome metrics
    • Changes in endoscopic findings of LPR
    • Changes in 24-hour oropharyngeal pH study results

Condition Intervention Phase
Laryngopharyngeal Reflux
Hypertrophy of Lingual Tonsil
Drug: dexlansoprazole
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Placebo-controlled Study of Dexlansoprazole to Treat Laryngopharyngeal Reflux and Lingual Tonsil Hypertrophy

Resource links provided by NLM:

Further study details as provided by Advanced Center for Specialty Care:

Primary Outcome Measures:
  • Lingual Tonsil Size [ Time Frame: 3 months ] [ Designated as safety issue: No ]
    Lingual tonsil tissue size will be measured on computed tomography image at baseline and remeasured following CT imaging after 3 months of proton pump inhibitor therapy.

Secondary Outcome Measures:
  • Calgary Sleep Apnea Quality of Life Index [ Time Frame: 1, 2 and 3 months ] [ Designated as safety issue: No ]
    Calgary Sleep Apnea Quality of Life Index measures the quality of life in sleep apnea patients.

  • Visual Analog Scale of snoring [ Time Frame: 1, 2 and 3 months ] [ Designated as safety issue: No ]
    Visual Analog Scale of snoring measures the loudness and disturbance factor related to snoring as documented by the bedpartner (when available)

  • Epworth Sleepiness scale [ Time Frame: 1, 2 and 3 months ] [ Designated as safety issue: No ]
    Epworth Sleepiness scale measures the daytime sleepiness caused by sleep disturbances and interruptions associated with sleep apnea or snoring.

  • Reflux Symptom Index [ Time Frame: 1, 2, and 3 months ] [ Designated as safety issue: Yes ]
    Reflux Symptom Index monitrors the physical signs and symptoms of laryngopharyngeal reflux during treatment obtained during fiberoptic endoscopy of the larynx, pharynx and esophagus.

  • Laryngopharyngeal Reflux [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
    Continuous 24 hour laryngopharyngeal pH monitoring

Estimated Enrollment: 80
Study Start Date: June 2011
Estimated Study Completion Date: January 2013
Estimated Primary Completion Date: August 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Proton Pump Inhibitor
Treatment with dexlansoprazole 60 mg once daily for 3 months
Drug: dexlansoprazole
dexlansoprazole 60 mg once daily for 3 months
Other Names:
  • proton pump inhibitor
  • Dexilant

  Show Detailed Description


Ages Eligible for Study:   18 Years to 59 Years   (Adult)
Genders Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosis of LPR and LTH confirmed by 24-hour pharyngeal pH monitoring and CT of the tongue base, respectively
  • Age > 20 and < 60 years
  • Failure (in the opinion of the patient and treating physician) of current treatment regimen and willingness (by the patient) to discontinue all concurrent therapies for LPR whether prescription, over-the-counter, or herbal, and to remain off of these treatments for the entire course of the study

Exclusion Criteria:

  • Pregnancy or anticipated pregnancy (confirmation of non-pregnant status will be made by urine human chorionic gonadotropin level)
  • Lactation
  • History or diagnosis of moderate to severe hepatic disease (based on liver function testing performed at screening adjusted for age, gender, race, concomitant medications and comorbidities
  • Current or within the previous (12 mo) usage of a proton pump inhibitor
  • Concurrent use of any medications, which interact adversely with dexlansoprazole or other proton pump inhibitors (e.g., penicillins, digoxin, iron salts, azole antifungals, atazanavir, tacrolimus, clopidogrel, etc.)
  • Allergy or sensitivity to dexlansoprazole (or other proton pump inhibitor) or cimetidine (or other H2 blocker)
  • History of laryngeal and/or pharyngeal surgery
  • Preexisting voice or swallowing disorder not related to LPR
  • Smoking
  • Neoplastic or infectious processes that are systemic or localized to the head and neck region
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01328652

United States, Illinois
Advanced Center for Specialty Care
Chicago, Illinois, United States, 60657
Sponsors and Collaborators
Advanced Center for Specialty Care
Principal Investigator: Michael Friedman, MD Head and Neck and Cosmetic Surgery Inc and Advanced Center for Specialty Care
Study Director: Ninos J Joseph, BS Advanced Center for Specialty Care
  More Information

Farrokhi F, Hill EM, Sun G, et al. Dx-pH Monitoring: how does it compare to the standard pH probe? Am J Gastroenterol 2007;103:S2.

Responsible Party: Michael Friedman, MD, Head and Neck and Cosmetic Surgery, Inc.and Advanced Center for Specialty Care Identifier: NCT01328652     History of Changes
Other Study ID Numbers: 004 10/10 
Study First Received: April 1, 2011
Last Updated: April 4, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by Advanced Center for Specialty Care:

Additional relevant MeSH terms:
Gastroesophageal Reflux
Laryngopharyngeal Reflux
Esophageal Motility Disorders
Deglutition Disorders
Esophageal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Pathological Conditions, Anatomical
Laryngeal Diseases
Respiratory Tract Diseases
Proton Pump Inhibitors
Anti-Ulcer Agents
Gastrointestinal Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action processed this record on January 14, 2017