Esomeprazole Versus Pantoprazole to Prevent Peptic Ulcer Rebleeding
Primary Purpose
Peptic Ulcer
Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Esomeprazole
Pantoprazole
Sponsored by
About this trial
This is an interventional treatment trial for Peptic Ulcer focused on measuring Peptic ulcer bleeding, Proton pump inhibitor, Esomeprazole, Pantoprazole, Recurrent bleeding, bleeding
Eligibility Criteria
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
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Esomeprazole
Pantoprazole
Arm Description
High-dose esomeprazole
High-dose pantoprazole
Outcomes
Primary Outcome Measures
recurrent bleeding within 14 days of enrollment
Secondary Outcome Measures
Volume of blood transfusion
Need for surgery
all-cause mortality
bleeding-related mortality
length of hospital stay
Full Information
NCT ID
NCT00881413
First Posted
April 13, 2009
Last Updated
April 7, 2015
Sponsor
Lotung Poh-Ai Hospital
Collaborators
Tomorrow Medical Foundation
1. Study Identification
Unique Protocol Identification Number
NCT00881413
Brief Title
Esomeprazole Versus Pantoprazole to Prevent Peptic Ulcer Rebleeding
Official Title
Clinical Effectiveness of Intravenous Esomeprazole Versus Pantoprazole in Preventing Peptic Ulcer Recurrent Bleeding: a Double-Blind Randomized Trial
Study Type
Interventional
2. Study Status
Record Verification Date
April 2009
Overall Recruitment Status
Withdrawn
Why Stopped
problems in funding
Study Start Date
undefined (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Name of the Sponsor
Lotung Poh-Ai Hospital
Collaborators
Tomorrow Medical Foundation
4. Oversight
Data Monitoring Committee
No
5. Study Description
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.
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.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peptic Ulcer
Keywords
Peptic ulcer bleeding, Proton pump inhibitor, Esomeprazole, Pantoprazole, Recurrent bleeding, bleeding
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Esomeprazole
Arm Type
Experimental
Arm Description
High-dose esomeprazole
Arm Title
Pantoprazole
Arm Type
Active Comparator
Arm Description
High-dose pantoprazole
Intervention Type
Drug
Intervention Name(s)
Esomeprazole
Other Intervention Name(s)
Nexium
Intervention Description
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
Intervention Type
Drug
Intervention Name(s)
Pantoprazole
Other Intervention Name(s)
Pantoloc
Intervention Description
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
Primary Outcome Measure Information:
Title
recurrent bleeding within 14 days of enrollment
Time Frame
14 days after enrollment
Secondary Outcome Measure Information:
Title
Volume of blood transfusion
Time Frame
14 days after enrollment
Title
Need for surgery
Time Frame
14 days after enrollment
Title
all-cause mortality
Time Frame
14 days after enrollment
Title
bleeding-related mortality
Time Frame
14 days after enrollment
Title
length of hospital stay
Time Frame
probably one month after enrollment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hwai-Jeng Lin, M.D.
Organizational Affiliation
Lotung Poh-Ai Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
19221370
Citation
Sung JJ, Barkun A, Kuipers EJ, Mossner J, Jensen DM, Stuart R, Lau JY, Ahlbom H, Kilhamn J, Lind T; Peptic Ulcer Bleed Study Group. Intravenous esomeprazole for prevention of recurrent peptic ulcer bleeding: a randomized trial. Ann Intern Med. 2009 Apr 7;150(7):455-64. doi: 10.7326/0003-4819-150-7-200904070-00105. Epub 2009 Feb 16.
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Esomeprazole Versus Pantoprazole to Prevent Peptic Ulcer Rebleeding
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