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A Multi-center, Double-blinding, Parallel and Positive-controlled Phase III Clinical Trial for Efficacy and Safety Evaluation of Ilaprazole Sodium for Injection on Prevention of Stress Ulcer Bleeding

Primary Purpose

Stress Ulcer Bleeding

Status
Completed
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
Esomeprazole 40mg
Ilaprazole Sodium
Placebo 1
Placebo 2
Sponsored by
Livzon Pharmaceutical Group Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stress Ulcer Bleeding

Eligibility Criteria

18 Years - 74 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: voluntarily signed informed consent form by subjects per se or their guardians. 18-74 years of age, female or male; required by the ICU treatment, and is intended to be treated over 72 hours. intragastrically intubated for at least 72 hours; APACHE II scoring within 15 to 25 (containing upper and lower value) intubated by mechanical assistance for breath for intended 48 hours without permission of assistance withdrawal. (Combing clinical observation, patients judged cannot breathing without artificial assistance within 48 hours should meet the any of criteria as following: 1) PEEP > 5; 2) FiO2 > 0.4; 3) Pressure of assisting breathing machine > 13 cmH2O; 4) body temperature over 38℃; 5) CRP ≥ 100 mg/L. in addition to mechanical ventilation, at least one major factor that may lead to irritable ulcer bleeding occurred as following within 48 hours prior to random group-assignment. complex organ surgery at Level 3 or above (surgery duration > 3 hours); disease history of gastrointestinal ulcer or hemorrhage; multiple injuries (score (ISS) ≥ 16); shock multiple organ dysfunction syndrome (MODS); sepsis (as per definition of issued by the Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) in 2016) acidosis (arterial pH < 7.3); coagulation dysfunction (INR > 1.5, platelets < 50 * 109/L or APTT > 2 times normal value; coma (GCS ≤ 10); receiving high dose corticosteroids (over 250 mg/d hydrocortisone or other equivalent dose corticosteroids); 30%-70% body surface burn; Exclusion Criteria: a history of gastric or esophageal surgery, intestinal obstruction, or hospitalization in the ICU after esophageal, gastric, or duodenal surgery in the past 3 months; lesions of the upper digestive tract (e.g., duodenal ulcer, gastric ulcer, acute gastric mucosa lesions, esophageal varices, malignant tumors, etc.) that are known to be likely to bleed, and other evidences indicating gastrointestinal bleeding occurs (esophageal and gastric varices bleeding, duodenal ulcer bleeding); hemoglobin < 60g/L (6.0g/dl); significant factor indicating bleed occurs during swallowing (such as oral and maxillofacial injuries, hemoptysis, etc.); renal failure; cardiopulmonary resuscitation conducted during hospitalization period; serious liver disease, defined as Child-Pugh C-grade; contraindicated for gastric intubation (such as esophageal stenosis); pregnancy or pregnancy test showing positive; documented or supposed to be hypersensitive to PPIs (Ilaprazole, Esomeprazole, Omeprazole, Lansoprazole, Dextran lansoprazole, Rabeprazole or Pantoprazole); participated in other clinical studies within 30 days prior to random assignment; use any PPI or treated by H2RA within 12 hours prior to random assignment; co-administering or unavoidable using drugs that may interact with Ilaprazole Sodium or Esomeprazole Sodium: e.g., Warfarin (including other vitamin K antagonists), Cisapride, Phenytoin, Atazanavir, Nefenavir, Ritonavir, Saquinavir, Digoxin, Tacrolimus, Methotrexate.

Sites / Locations

  • Shanghai Jiaotong University Affiliate Ruijin Hospital
  • The First Affiliated Hopspital of Xinjiang Medical University

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Esomeprazole Sodium

Ilaprazole Sodium

Arm Description

40 mg twice daily (q12h)

10 mg once daily, 20 mg dosed in the first day.

Outcomes

Primary Outcome Measures

Preventing clinically significant gastrointestinal bleeding
(1) Bright red blood is observed in gastric tube and not cleared by gavage washing with at least 100mL of standard physiological saline at room temperature for 5 to 10 minutes;
Preventing clinically significant gastrointestinal bleeding
(2) During the Day 1 to Day 2 days of the treatment: If coffee-like substances are observed in the gastric tube, immediately rinse the stomach with at least 100ml of standard physiological saline at room temperature, every 2 hours (± 20 minutes) from the time of first observation, and the coffee-like substances were still observed after 8 hours (the occult blood screening reagent remains positive, and the occult blood result is required to be positive);
Preventing clinically significant gastrointestinal bleeding
(3) On the Day 3 of the treatment - end of treatment: If coffee-like substances are observed in the gastric tube, immediately rinse the stomach with at least 100ml of standard physiological saline at room temperature, once per hour (± 20 minutes), and the coffee-like substances are still observed after 4 hours (occult blood screening reagent continues to be positive, and occult blood results are required to be positive).
Preventing clinically significant gastrointestinal bleeding
(4) Hematemesis or bloody stools originating from the upper gastrointestinal tract (as determined by the researchers, such as tarry stools and positive gastric occult blood).

Secondary Outcome Measures

Full Information

First Posted
April 22, 2023
Last Updated
April 22, 2023
Sponsor
Livzon Pharmaceutical Group Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05841394
Brief Title
A Multi-center, Double-blinding, Parallel and Positive-controlled Phase III Clinical Trial for Efficacy and Safety Evaluation of Ilaprazole Sodium for Injection on Prevention of Stress Ulcer Bleeding
Official Title
A Multi-center, Double-blinding, Parallel and Positive-controlled Phase III Clinical Trial for Efficacy and Safety Evaluation of Ilaprazole Sodium for Injection on Treatment of Prevention of Stress Ulcer Bleeding (Ilaprazole i.v. vs Esomeprazole, i.v.)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
July 16, 2021 (Actual)
Primary Completion Date
April 28, 2022 (Actual)
Study Completion Date
April 28, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Livzon Pharmaceutical Group Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the efficacy of the study drug (Ilaprazole Sodium for Injection) for potential effect on preventing stress ulcer bleeding in vulnerable population by comparing the radio of upper gastrointestinal bleeding when they are administered Ilaprazole Sodium for Injection and Esomeprazole Sodium for Injection respectively.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stress Ulcer Bleeding

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
449 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Esomeprazole Sodium
Arm Type
Active Comparator
Arm Description
40 mg twice daily (q12h)
Arm Title
Ilaprazole Sodium
Arm Type
Experimental
Arm Description
10 mg once daily, 20 mg dosed in the first day.
Intervention Type
Drug
Intervention Name(s)
Esomeprazole 40mg
Intervention Description
40 mg i.v. twice daily (q12h)
Intervention Type
Drug
Intervention Name(s)
Ilaprazole Sodium
Intervention Description
10 mg i.v. once daily, 20 mg i.v. in the first day.
Intervention Type
Drug
Intervention Name(s)
Placebo 1
Intervention Description
Physiologic saline for injection, 100 ml/bag, q24h, following Ilaprazole Sodium with a time interval of 12 h.
Intervention Type
Drug
Intervention Name(s)
Placebo 2
Intervention Description
Physiologic saline for injection, 100 ml/bag, q12h, dosing on the first day.
Primary Outcome Measure Information:
Title
Preventing clinically significant gastrointestinal bleeding
Description
(1) Bright red blood is observed in gastric tube and not cleared by gavage washing with at least 100mL of standard physiological saline at room temperature for 5 to 10 minutes;
Time Frame
Day 1 to Day 3
Title
Preventing clinically significant gastrointestinal bleeding
Description
(2) During the Day 1 to Day 2 days of the treatment: If coffee-like substances are observed in the gastric tube, immediately rinse the stomach with at least 100ml of standard physiological saline at room temperature, every 2 hours (± 20 minutes) from the time of first observation, and the coffee-like substances were still observed after 8 hours (the occult blood screening reagent remains positive, and the occult blood result is required to be positive);
Time Frame
Day 1 and Day 2
Title
Preventing clinically significant gastrointestinal bleeding
Description
(3) On the Day 3 of the treatment - end of treatment: If coffee-like substances are observed in the gastric tube, immediately rinse the stomach with at least 100ml of standard physiological saline at room temperature, once per hour (± 20 minutes), and the coffee-like substances are still observed after 4 hours (occult blood screening reagent continues to be positive, and occult blood results are required to be positive).
Time Frame
Day 3
Title
Preventing clinically significant gastrointestinal bleeding
Description
(4) Hematemesis or bloody stools originating from the upper gastrointestinal tract (as determined by the researchers, such as tarry stools and positive gastric occult blood).
Time Frame
Day 1 to Day 3

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: voluntarily signed informed consent form by subjects per se or their guardians. 18-74 years of age, female or male; required by the ICU treatment, and is intended to be treated over 72 hours. intragastrically intubated for at least 72 hours; APACHE II scoring within 15 to 25 (containing upper and lower value) intubated by mechanical assistance for breath for intended 48 hours without permission of assistance withdrawal. (Combing clinical observation, patients judged cannot breathing without artificial assistance within 48 hours should meet the any of criteria as following: 1) PEEP > 5; 2) FiO2 > 0.4; 3) Pressure of assisting breathing machine > 13 cmH2O; 4) body temperature over 38℃; 5) CRP ≥ 100 mg/L. in addition to mechanical ventilation, at least one major factor that may lead to irritable ulcer bleeding occurred as following within 48 hours prior to random group-assignment. complex organ surgery at Level 3 or above (surgery duration > 3 hours); disease history of gastrointestinal ulcer or hemorrhage; multiple injuries (score (ISS) ≥ 16); shock multiple organ dysfunction syndrome (MODS); sepsis (as per definition of issued by the Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) in 2016) acidosis (arterial pH < 7.3); coagulation dysfunction (INR > 1.5, platelets < 50 * 109/L or APTT > 2 times normal value; coma (GCS ≤ 10); receiving high dose corticosteroids (over 250 mg/d hydrocortisone or other equivalent dose corticosteroids); 30%-70% body surface burn; Exclusion Criteria: a history of gastric or esophageal surgery, intestinal obstruction, or hospitalization in the ICU after esophageal, gastric, or duodenal surgery in the past 3 months; lesions of the upper digestive tract (e.g., duodenal ulcer, gastric ulcer, acute gastric mucosa lesions, esophageal varices, malignant tumors, etc.) that are known to be likely to bleed, and other evidences indicating gastrointestinal bleeding occurs (esophageal and gastric varices bleeding, duodenal ulcer bleeding); hemoglobin < 60g/L (6.0g/dl); significant factor indicating bleed occurs during swallowing (such as oral and maxillofacial injuries, hemoptysis, etc.); renal failure; cardiopulmonary resuscitation conducted during hospitalization period; serious liver disease, defined as Child-Pugh C-grade; contraindicated for gastric intubation (such as esophageal stenosis); pregnancy or pregnancy test showing positive; documented or supposed to be hypersensitive to PPIs (Ilaprazole, Esomeprazole, Omeprazole, Lansoprazole, Dextran lansoprazole, Rabeprazole or Pantoprazole); participated in other clinical studies within 30 days prior to random assignment; use any PPI or treated by H2RA within 12 hours prior to random assignment; co-administering or unavoidable using drugs that may interact with Ilaprazole Sodium or Esomeprazole Sodium: e.g., Warfarin (including other vitamin K antagonists), Cisapride, Phenytoin, Atazanavir, Nefenavir, Ritonavir, Saquinavir, Digoxin, Tacrolimus, Methotrexate.
Facility Information:
Facility Name
Shanghai Jiaotong University Affiliate Ruijin Hospital
City
Shanghai
State/Province
Shanghai
ZIP/Postal Code
200025
Country
China
Facility Name
The First Affiliated Hopspital of Xinjiang Medical University
City
Urumchi
State/Province
Xinjiang
Country
China

12. IPD Sharing Statement

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A Multi-center, Double-blinding, Parallel and Positive-controlled Phase III Clinical Trial for Efficacy and Safety Evaluation of Ilaprazole Sodium for Injection on Prevention of Stress Ulcer Bleeding

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