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Efficacy of Vonoprazan Versus Intravenous Proton Pump Inhibitors for Prevention of Rebleeding in High Risk Peptic Ulcers Bleeding After Successful Endoscopic Hemostasis

Primary Purpose

Peptic Ulcer With Haemorrhage

Status
Recruiting
Phase
Early Phase 1
Locations
Thailand
Study Type
Interventional
Intervention
Vonoprazan
PPIs IV infusion
Sponsored by
Uayporn Kaosombatwattana
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peptic Ulcer With Haemorrhage

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • High risk peptic ulcers bleeding (Forrest class Ia,Ib,IIa,IIb)

Exclusion Criteria:

  • Patients were not achieve endoscopic hemostasis
  • End stage cancer disease
  • Severe critical illness and ICU setting
  • Uncorrectable coagulopathy
  • Pregnancy or breast feeding
  • Allergy to PPIs or Vonoprazan

Sites / Locations

  • Faculty of internal medicine siriraj hospital, Mahidol universityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Vonoprazan

PPIs

Arm Description

Vonoprazan 20 mg oral every 12 hours (total 72 hours) then vonoprazan 20 mg oral once daily for 28 days

PPIs IV infusion for 72 hours then oral PPIs twice per day for 28 days

Outcomes

Primary Outcome Measures

Rebleeding rate

Secondary Outcome Measures

Rebleeding rate
Mortality rate
Number of blood transfusion unit
Rate of immobilisation or surgery
Length of stay

Full Information

First Posted
December 12, 2020
Last Updated
September 26, 2022
Sponsor
Uayporn Kaosombatwattana
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1. Study Identification

Unique Protocol Identification Number
NCT05005910
Brief Title
Efficacy of Vonoprazan Versus Intravenous Proton Pump Inhibitors for Prevention of Rebleeding in High Risk Peptic Ulcers Bleeding After Successful Endoscopic Hemostasis
Official Title
Efficacy of Vonoprazan Versus Intravenous Proton Pump Inhibitors for Prevention of Rebleeding in High Risk Peptic Ulcers Bleeding After Successful Endoscopic Hemostasis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2021 (Actual)
Primary Completion Date
June 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Uayporn Kaosombatwattana

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Upper gastrointestinal hemorrhage (UGIH) is common urgency condition.The estimate mortality rate about 7 percent from peptic ulcers disease(PUD). A proton pump inhibitors (PPIs) intravenous infusion are standard treatment for high risk ulcer bleeding. Vonoprazan,subclass of potassium-competitive acid blockers (P-CABs), have beneficial effects including rapid, long-lasting and strong acid suppression.The investigators design a randomized-controlled trial comparison between 72 hours of intravenous PPIs infusion and oral vonoprazan in high risk ulcer UGIH after achieve endoscopic hemostasis. Outcome measurement are re-bleeding rate in 30 days as primary and re-bleeding rate in 3 days, 30 days mortality, rate of angioembolisation, unit of blood transfusion, hospital cost and length of stay as secondary outcome.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peptic Ulcer With Haemorrhage

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
194 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Vonoprazan
Arm Type
Experimental
Arm Description
Vonoprazan 20 mg oral every 12 hours (total 72 hours) then vonoprazan 20 mg oral once daily for 28 days
Arm Title
PPIs
Arm Type
Active Comparator
Arm Description
PPIs IV infusion for 72 hours then oral PPIs twice per day for 28 days
Intervention Type
Drug
Intervention Name(s)
Vonoprazan
Intervention Description
Vonoprazan 20 mg oral every 12 hours (total 72 hours)
Intervention Type
Drug
Intervention Name(s)
PPIs IV infusion
Intervention Description
Pantoprazole 80 mg IV loading then 8 mg/hr
Primary Outcome Measure Information:
Title
Rebleeding rate
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Rebleeding rate
Time Frame
3 days
Title
Mortality rate
Time Frame
30 days
Title
Number of blood transfusion unit
Time Frame
30 days
Title
Rate of immobilisation or surgery
Time Frame
30 days
Title
Length of stay
Time Frame
Until discharge, assessed up to 30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: High risk peptic ulcers bleeding (Forrest class Ia,Ib,IIa,IIb) Exclusion Criteria: Patients were not achieve endoscopic hemostasis End stage cancer disease Severe critical illness and ICU setting Uncorrectable coagulopathy Pregnancy or breast feeding Allergy to PPIs or Vonoprazan
Facility Information:
Facility Name
Faculty of internal medicine siriraj hospital, Mahidol university
City
Bangkok Noi
State/Province
Bangkok
ZIP/Postal Code
10700
Country
Thailand
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Uayporn Kaosombatwattana
Phone
+66619245953
Email
Koigi214@gmail.com
First Name & Middle Initial & Last Name & Degree
Arpapun Boonchot
Phone
+66619942914
Email
tummy_ar@hotmail.com
First Name & Middle Initial & Last Name & Degree
Somchai Leelakusolvong
First Name & Middle Initial & Last Name & Degree
Monthira Maneerattanaporn
First Name & Middle Initial & Last Name & Degree
Manus Rugivarodom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
24777150
Citation
Sung JJ, Suen BY, Wu JC, Lau JY, Ching JY, Lee VW, Chiu PW, Tsoi KK, Chan FK. Effects of intravenous and oral esomeprazole in the prevention of recurrent bleeding from peptic ulcers after endoscopic therapy. Am J Gastroenterol. 2014 Jul;109(7):1005-10. doi: 10.1038/ajg.2014.105. Epub 2014 Apr 29.
Results Reference
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PubMed Identifier
23915096
Citation
Tsoi KK, Hirai HW, Sung JJ. Meta-analysis: comparison of oral vs. intravenous proton pump inhibitors in patients with peptic ulcer bleeding. Aliment Pharmacol Ther. 2013 Oct;38(7):721-8. doi: 10.1111/apt.12441. Epub 2013 Aug 5.
Results Reference
background
PubMed Identifier
29739175
Citation
Oshima T, Miwa H. Potent Potassium-competitive Acid Blockers: A New Era for the Treatment of Acid-related Diseases. J Neurogastroenterol Motil. 2018 Jul 30;24(3):334-344. doi: 10.5056/jnm18029.
Results Reference
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PubMed Identifier
26991399
Citation
Kagami T, Sahara S, Ichikawa H, Uotani T, Yamade M, Sugimoto M, Hamaya Y, Iwaizumi M, Osawa S, Sugimoto K, Miyajima H, Furuta T. Potent acid inhibition by vonoprazan in comparison with esomeprazole, with reference to CYP2C19 genotype. Aliment Pharmacol Ther. 2016 May;43(10):1048-59. doi: 10.1111/apt.13588. Epub 2016 Mar 18.
Results Reference
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PubMed Identifier
27891632
Citation
Miwa H, Uedo N, Watari J, Mori Y, Sakurai Y, Takanami Y, Nishimura A, Tatsumi T, Sakaki N. Randomised clinical trial: efficacy and safety of vonoprazan vs. lansoprazole in patients with gastric or duodenal ulcers - results from two phase 3, non-inferiority randomised controlled trials. Aliment Pharmacol Ther. 2017 Jan;45(2):240-252. doi: 10.1111/apt.13876. Epub 2016 Nov 27.
Results Reference
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PubMed Identifier
22388884
Citation
Sugano K, Kontani T, Katsuo S, Takei Y, Sakaki N, Ashida K, Mizokami Y, Asaka M, Matsui S, Kanto T, Soen S, Takeuchi T, Hiraishi H, Hiramatsu N. Lansoprazole for secondary prevention of gastric or duodenal ulcers associated with long-term non-steroidal anti-inflammatory drug (NSAID) therapy: results of a prospective, multicenter, double-blind, randomized, double-dummy, active-controlled trial. J Gastroenterol. 2012 May;47(5):540-52. doi: 10.1007/s00535-012-0541-z. Epub 2012 Mar 3.
Results Reference
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Efficacy of Vonoprazan Versus Intravenous Proton Pump Inhibitors for Prevention of Rebleeding in High Risk Peptic Ulcers Bleeding After Successful Endoscopic Hemostasis

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