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Study to Evaluate the Long-Term Safety of PA32540 in Subjects Who Are at Risk for Developing Aspirin-Associated Gastric Ulcers

Primary Purpose

Aspirin-Associated Gastric Ulcers

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
PA32540
Sponsored by
POZEN
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aspirin-Associated Gastric Ulcers focused on measuring Subjects Who are at Risk for Developing Aspirin-ASA, Subject must have a pre-existing condition for which aspirin is already indicated, Gastric Ulcers

Eligibility Criteria

55 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  1. A. Male or non-pregnant, non-breastfeeding females who have been on daily aspirin 325 mg for at least three months and who are expected to use daily aspirin 325 mg for at least six months (Daily is defined as "at least 5 days per week"):

    AND, who are

    • 55 years of age and older; or
    • 18 - 54 years of age and have a history of a documented gastric or duodenal ulcer within the past five years.
  2. A. Aspirin use should be for the secondary prevention of cardiovascular or cerebrovascular events as defined as follows:

    Have been diagnosed with or have had a history of

    • MI (myocardial infarction that has been confirmed or suspected)
    • Ischemic stroke
    • TIA (transient ischemic attack)

    Or have established, clinically significant coronary and other atherosclerotic vascular disease (meaning at high risk for surgical intervention or for MI, TIA, stroke, if left untreated), including:

    • Angina (stable or unstable)
    • Peripheral arterial disease
    • Atherosclerotic aortic disease
    • Carotid artery disease Or have had
    • CABG (coronary artery bypass graft)
    • PCI (percutaneous coronary intervention with or without stent)
    • Carotid endarterectomy
  3. A. If female, subjects are eligible if they are of

    1. non-childbearing potential (i.e., physiologically incapable of becoming pregnant); or,
    2. childbearing potential, have a negative pregnancy test at screening, and at least one of the following applies or is agreed to by the subject:

      • Female sterilization or sterilization of male partner
      • Hormonal contraception by oral route, implant, injectable, vaginal ring
      • Any intrauterine device (IUD) with published data showing that the lowest expected failure rate is less than 1% per year
      • Double barrier method (2 physical barriers or 1 physical barrier plus spermicide)
      • Any other method with published data showing that the lowest expected failure rate is less than 1% per year 4. Able to understand and comply with study procedures required and able and willing to provide written informed consent prior to any study procedures being performed

Exclusion criteria:

  1. Any current gastric, esophageal or duodenal ulcer
  2. Positive test result for H. pylori at screening 3A. Have had a revascularization procedure (i.e., Coronary Artery Bypass Graft, Percutaneous Transluminal Coronary Angioplasty, or carotid endarterectomy) less than six months prior to screening

4. Unstable hypertension as judged by the Investigator 5. Uncontrolled diabetes mellitus as judged by the Investigator 6. Unstable cardio- or cerebrovascular disease such that it would endanger the subject if they participated in the trial 7. Clinically significant valvular disease 8. Congestive heart failure or other cardiovascular symptoms according to New York Heart Association (NYHA) Functional Classification III-IV (Appendix 3) 9. History of hypersensitivity to omeprazole or to another proton pump inhibitor 10. History of allergic reaction or intolerance to aspirin and/or a history of aspirin-induced symptoms of asthma, rhinitis, and/or nasal polyps 11. History of serious UGI event, such as bleeding, perforation, or obstruction 12. Gastrointestinal disorder or surgery leading to impaired drug absorption 13. Presence of chronic or uncontrolled acute medical illness, e.g. gastrointestinal disorder (esophageal stricture, severe esophagitis, long-segment Barrett's esophagus, signs and symptoms of gastric outlet obstruction), thyroid disorder and/or infection that would endanger a subject if they were to participate in the study 14. Schizophrenia, uncontrolled bipolar disorder, or severe depression 15. History of alcoholism or drug addiction within a year prior to enrollment in the study 16. Severe hepatic dysfunction (i.e. cirrhosis or portal hypertension) 17. Blood coagulation disorder, including use of systemic anticoagulants such as warfarin or other vitamin K antagonists 18. Any condition that, in the opinion of the Investigator, may either put the subject at risk or influence the results of the study 19. Use of any excluded concomitant medication (see Section 9.2) 20. Screening laboratory ALT or AST value > two times the upper limit of normal 21A. History of renal insufficiency 22. Other than noted specifically, any screening laboratory value that is clinically significant in the Investigator's opinion and would endanger a subject if the subject was to participate in the study 23. Use of an investigational treatment in the 4 weeks before screening 24. History of malignancy, treated or untreated, within the past five years, with the exception of successfully treated basal cell or squamous cell carcinoma of the skin 25. Previous participation in another PA32540 clinical research study 26. Subjects, who are employees of the research facility, immediately related to the Investigator, or are in some way under the supervision of the Investigator.

Sites / Locations

  • Pozen

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PA32540 tablet

Arm Description

325 mg enteric coated (EC) ASA and 40 mg omeprazole to be taken by mouth once daily

Outcomes

Primary Outcome Measures

Number of Subjects Monitored for Long-term Safety of PA32540
Incidence of adverse events and monitoring vital signs and clinical laboratory values. All AEs were coded into preferred terms according to MedDRA (Medical Dictionary for Regulatory Activities) and classified by system organ class (SOC).

Secondary Outcome Measures

Most Frequent Treatment Emergent Adverse Events Leading to Study Drug Discontinuation
Most Frequent (≥ 1%) Treatment Emergent Adverse Events by System Organ Class leading to Discontinuation

Full Information

First Posted
October 13, 2009
Last Updated
January 20, 2016
Sponsor
POZEN
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1. Study Identification

Unique Protocol Identification Number
NCT00995410
Brief Title
Study to Evaluate the Long-Term Safety of PA32540 in Subjects Who Are at Risk for Developing Aspirin-Associated Gastric Ulcers
Official Title
A 12-Month, Phase 3, Open-Label, Multi-Center Study to Evaluate the Long-Term Safety of PA32540 in Subjects Who Are at Risk for Developing Aspirin-Associated Gastric Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
May 2011 (Actual)
Study Completion Date
May 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
POZEN

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study uses an open-label design and will be conducted in approximately 40 sites in the United States. Approximately 400 subjects will be enrolled in the study to ensure that approximately 300 subjects will have 6 months exposure to PA32540 and at least 100 subjects will have 12 months exposure to PA32540.
Detailed Description
PA32540 is proposed for the secondary prevention of cardio- and cerebrovascular events in patients at risk for developing aspirin-associated gastric ulcers. This study is designed to provide long-term safety data for PA32540 in order to gain regulatory approval to make PA32540 available for clinical use in this subject population.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aspirin-Associated Gastric Ulcers
Keywords
Subjects Who are at Risk for Developing Aspirin-ASA, Subject must have a pre-existing condition for which aspirin is already indicated, Gastric Ulcers

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
380 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PA32540 tablet
Arm Type
Experimental
Arm Description
325 mg enteric coated (EC) ASA and 40 mg omeprazole to be taken by mouth once daily
Intervention Type
Drug
Intervention Name(s)
PA32540
Other Intervention Name(s)
YOSPRALA
Intervention Description
PA32540 tablets contain 325 mg enteric coated (EC) aspirin and 40 mg immediate-release omeprazole to be taken by mouth once daily
Primary Outcome Measure Information:
Title
Number of Subjects Monitored for Long-term Safety of PA32540
Description
Incidence of adverse events and monitoring vital signs and clinical laboratory values. All AEs were coded into preferred terms according to MedDRA (Medical Dictionary for Regulatory Activities) and classified by system organ class (SOC).
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Most Frequent Treatment Emergent Adverse Events Leading to Study Drug Discontinuation
Description
Most Frequent (≥ 1%) Treatment Emergent Adverse Events by System Organ Class leading to Discontinuation
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: A. Male or non-pregnant, non-breastfeeding females who have been on daily aspirin 325 mg for at least three months and who are expected to use daily aspirin 325 mg for at least six months (Daily is defined as "at least 5 days per week"): AND, who are 55 years of age and older; or 18 - 54 years of age and have a history of a documented gastric or duodenal ulcer within the past five years. A. Aspirin use should be for the secondary prevention of cardiovascular or cerebrovascular events as defined as follows: Have been diagnosed with or have had a history of MI (myocardial infarction that has been confirmed or suspected) Ischemic stroke TIA (transient ischemic attack) Or have established, clinically significant coronary and other atherosclerotic vascular disease (meaning at high risk for surgical intervention or for MI, TIA, stroke, if left untreated), including: Angina (stable or unstable) Peripheral arterial disease Atherosclerotic aortic disease Carotid artery disease Or have had CABG (coronary artery bypass graft) PCI (percutaneous coronary intervention with or without stent) Carotid endarterectomy A. If female, subjects are eligible if they are of non-childbearing potential (i.e., physiologically incapable of becoming pregnant); or, childbearing potential, have a negative pregnancy test at screening, and at least one of the following applies or is agreed to by the subject: Female sterilization or sterilization of male partner Hormonal contraception by oral route, implant, injectable, vaginal ring Any intrauterine device (IUD) with published data showing that the lowest expected failure rate is less than 1% per year Double barrier method (2 physical barriers or 1 physical barrier plus spermicide) Any other method with published data showing that the lowest expected failure rate is less than 1% per year 4. Able to understand and comply with study procedures required and able and willing to provide written informed consent prior to any study procedures being performed Exclusion criteria: Any current gastric, esophageal or duodenal ulcer Positive test result for H. pylori at screening 3A. Have had a revascularization procedure (i.e., Coronary Artery Bypass Graft, Percutaneous Transluminal Coronary Angioplasty, or carotid endarterectomy) less than six months prior to screening 4. Unstable hypertension as judged by the Investigator 5. Uncontrolled diabetes mellitus as judged by the Investigator 6. Unstable cardio- or cerebrovascular disease such that it would endanger the subject if they participated in the trial 7. Clinically significant valvular disease 8. Congestive heart failure or other cardiovascular symptoms according to New York Heart Association (NYHA) Functional Classification III-IV (Appendix 3) 9. History of hypersensitivity to omeprazole or to another proton pump inhibitor 10. History of allergic reaction or intolerance to aspirin and/or a history of aspirin-induced symptoms of asthma, rhinitis, and/or nasal polyps 11. History of serious UGI event, such as bleeding, perforation, or obstruction 12. Gastrointestinal disorder or surgery leading to impaired drug absorption 13. Presence of chronic or uncontrolled acute medical illness, e.g. gastrointestinal disorder (esophageal stricture, severe esophagitis, long-segment Barrett's esophagus, signs and symptoms of gastric outlet obstruction), thyroid disorder and/or infection that would endanger a subject if they were to participate in the study 14. Schizophrenia, uncontrolled bipolar disorder, or severe depression 15. History of alcoholism or drug addiction within a year prior to enrollment in the study 16. Severe hepatic dysfunction (i.e. cirrhosis or portal hypertension) 17. Blood coagulation disorder, including use of systemic anticoagulants such as warfarin or other vitamin K antagonists 18. Any condition that, in the opinion of the Investigator, may either put the subject at risk or influence the results of the study 19. Use of any excluded concomitant medication (see Section 9.2) 20. Screening laboratory ALT or AST value > two times the upper limit of normal 21A. History of renal insufficiency 22. Other than noted specifically, any screening laboratory value that is clinically significant in the Investigator's opinion and would endanger a subject if the subject was to participate in the study 23. Use of an investigational treatment in the 4 weeks before screening 24. History of malignancy, treated or untreated, within the past five years, with the exception of successfully treated basal cell or squamous cell carcinoma of the skin 25. Previous participation in another PA32540 clinical research study 26. Subjects, who are employees of the research facility, immediately related to the Investigator, or are in some way under the supervision of the Investigator.
Facility Information:
Facility Name
Pozen
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27519
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
26725920
Citation
Goldstein JL, Whellan DJ, Scheiman JM, Cryer BL, Eisen GM, Lanas A, Fort JG. Long-Term Safety of a Coordinated Delivery Tablet of Enteric-Coated Aspirin 325 mg and Immediate-Release Omeprazole 40 mg for Secondary Cardiovascular Disease Prevention in Patients at GI Risk. Cardiovasc Ther. 2016 Apr;34(2):59-66. doi: 10.1111/1755-5922.12172.
Results Reference
derived

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Study to Evaluate the Long-Term Safety of PA32540 in Subjects Who Are at Risk for Developing Aspirin-Associated Gastric Ulcers

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