Esomeprazole Versus Pantoprazole to Prevent Peptic Ulcer Rebleeding

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00881413
Recruitment Status : Withdrawn (problems in funding)
First Posted : April 15, 2009
Last Update Posted : April 8, 2015
Tomorrow Medical Foundation
Information provided by:
Lotung Poh-Ai Hospital

Brief Summary:
The aim of this study is to compare the clinical effectiveness of intravenous esomeprazole and pantoprazole in preventing recurrent bleeding in the patients with high-risk bleeding peptic ulcers after successful standard endoscopic hemostasis.

Condition or disease Intervention/treatment Phase
Peptic Ulcer Drug: Esomeprazole Drug: Pantoprazole Phase 4

Detailed Description:
Endoscopic hemostasis and proton pump inhibitor (PPI) constitute the cornerstone in the management of peptic ulcer bleeding (PUB), which remains a prevalent disorder associated with substantial morbidity and mortality. Clinical effectiveness of PPI in the management of patients with PUB has been established by compelling evidence derived from a number of randomized trials. However, whether different PPIs are equally effective has not been investigated. Esomeprazole, the S-isomer of omeprazole, may achieve faster, more profound and steady acid suppression than other PPIs, but it remains undetermined whether the superiority of pharmacologic efficacy may be translated into advantages in clinical outcomes.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary Purpose: Treatment
Official Title: Clinical Effectiveness of Intravenous Esomeprazole Versus Pantoprazole in Preventing Peptic Ulcer Recurrent Bleeding: a Double-Blind Randomized Trial

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Peptic Ulcer

Arm Intervention/treatment
Experimental: Esomeprazole
High-dose esomeprazole
Drug: Esomeprazole
Intravenous esomeprazole (Nexium®, AstraZeneca, Sodertalje, Sweden) is administered with 80mg bolus and 8mg/hr infusion for 72 hours. After 3 days, patients receive oral esomeprazole 40 mg (Nexium®, AstraZeneca, Sodertalje, Sweden) for 2 months
Other Name: Nexium

Active Comparator: Pantoprazole
High-dose pantoprazole
Drug: Pantoprazole
After successful endoscopy, intravenous pantoprazole (Pantoloc®, Nycomed GMBH, Konstanz, Germany) is administered with 80mg bolus and 8mg/hr infusion for 72 hours. After 3 days, patients receive oral pantoprazole 40 mg (Pantoloc®, Nycomed GMBH, Oranienburg, Germany) for 2 months
Other Name: Pantoloc

Primary Outcome Measures :
  1. recurrent bleeding within 14 days of enrollment [ Time Frame: 14 days after enrollment ]

Secondary Outcome Measures :
  1. Volume of blood transfusion [ Time Frame: 14 days after enrollment ]
  2. Need for surgery [ Time Frame: 14 days after enrollment ]
  3. all-cause mortality [ Time Frame: 14 days after enrollment ]
  4. bleeding-related mortality [ Time Frame: 14 days after enrollment ]
  5. length of hospital stay [ Time Frame: probably one month after enrollment ]

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • aged more than 18 years
  • undergo emergent endoscopy within 24 hours of presentation
  • have peptic ulcers in the gastroesophageal junction, stomach, or duodenum
  • high-risk stigmata of peptic ulcers: Forrest classification IA~IIB
  • endoscopic hemostasis by thermocoagulation or clip placement

Exclusion Criteria:

  • pregnant or lactating
  • written informed consent not obtained
  • initial endoscopic hemostasis fail
  • bleeding tendency (platelet count < 50×109/L, prolonged prothrombin time for more than 3 seconds, or were taking anticoagulants)
  • PPI use within 14 days of enrollment
  • comorbid with severe hepatic or renal insufficiency (serum total bilirubin more than 5 mg/dL, serum creatinine more than 5 mg/dL, or under dialysis)
  • bleeding gastric cancers

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00881413

Sponsors and Collaborators
Lotung Poh-Ai Hospital
Tomorrow Medical Foundation
Principal Investigator: Hwai-Jeng Lin, M.D. Lotung Poh-Ai Hospital

Responsible Party: Professor Hwai-Jeng Lin, Lotung Poh-Ai Hospital Identifier: NCT00881413     History of Changes
Other Study ID Numbers: OMCP98004
First Posted: April 15, 2009    Key Record Dates
Last Update Posted: April 8, 2015
Last Verified: April 2009

Keywords provided by Lotung Poh-Ai Hospital:
Peptic ulcer bleeding
Proton pump inhibitor
Recurrent bleeding

Additional relevant MeSH terms:
Peptic Ulcer
Pathologic Processes
Duodenal Diseases
Intestinal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Stomach Diseases
Anti-Ulcer Agents
Gastrointestinal Agents
Proton Pump Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action