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Evaluating PN 400 (VIMOVO) in Reducing Gastric Ulcers in High Risk Subjects Compared to Arthrotec

Primary Purpose

Gastric Ulcer

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
PN400 (VIMOVO)
Diclofenac/Misoprostol
Sponsored by
POZEN
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gastric Ulcer focused on measuring NSAID, Gastric Ulcer, High risk, Arthrotec, Vimovo

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or non-pregnant female subjects, 18 years and older with a history of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis or other medical condition expected to require daily NSAID therapy for at least 6 months, with a documented history of an ulcer related serious upper gastrointestinal event such as bleeding, perforation or obstruction
  2. Female subjects are eligible for participation in the study if they are of:

    • Non-childbearing potential (i.e., physiologically incapable of becoming pregnant);
    • 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; or,
      • Hormonal contraception by oral route, implant, injectable, vaginal ring; or,
      • 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); or
      • Any other method with published data showing that the lowest expected failure rate is less than 1% per year
  3. Each subject must be able to understand and comply with study procedures required of a subject and is able and willing to provide written informed consent prior to any study procedures being performed

Exclusion Criteria:

  1. History of hypersensitivity to esomeprazole or to another proton-pump inhibitor
  2. History of allergic reaction or intolerance to any NSAID (including aspirin) and/or a history of NSAID-induced symptoms of asthma, rhinitis, and/or nasal polyps
  3. Positive test result for H. pylori at screening
  4. Participation in any study of an investigational treatment in the 4 weeks before screening
  5. Presence of uncontrolled acute or chronic medical illness, e.g. gastrointestinal disorder, hypertension, diabetes, thyroid disorder, depression and/or infection that would endanger a subject if they were to participate in the study
  6. Gastrointestinal disorder or surgery leading to impaired drug absorption
  7. Evidence of uncontrolled, or unstable cardio- or cerebrovascular disorder, which in the investigator's opinion would endanger a subject if they were to participate in the study
  8. Schizophrenia or bipolar disorder
  9. Use of any excluded concomitant medication (see Section 9.2)
  10. A recent history (in the past 3 months) suggestive of alcohol or drug abuse or dependence, including overuse/abuse of narcotics for management of pain
  11. Serious blood coagulation disorder, including use of systemic anticoagulants
  12. Screening endoscopy showing >10 erosions or any gastric or duodenal ulcer at least 3 mm in diameter with depth
  13. Screening laboratory ALT or AST value > 2 times the upper limit of normal
  14. Estimated creatinine clearance < 50 ml/min
  15. Other than noted specifically, any screening laboratory value that is clinically significant in the investigator's opinion and would endanger a subject if they were to participate in the study
  16. History of malignancy, treated or untreated, within the past 5 years, with the exception of successfully treated basal cell or squamous cell carcinoma of the skin

Sites / Locations

  • POZEN

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

PN400

Diclofenac/Misoprostol

Arm Description

PN 400 (esomeprazole/naproxen) dosed twice daily

diclofenac 75mg/misoprostol 200 mcg dosed twice daily

Outcomes

Primary Outcome Measures

Number of Participants With Gastric Ulcer Confirmed by Endoscopy
Number of participants with gastric ulcers confirmed by endoscopy following administration of PN 400 (VIMOVO) or Arthrotec in a high risk population over six months.

Secondary Outcome Measures

Number of Participants With Duodenal Ulcers Confirmed by Endoscopy
Number of participants with duodenal ulcers confirmed by endoscopy following administration of PN 400 VIMOVO)or Arthrotec in a high risk population
Number of Participants With Upper Gastro-intestinal Injury Grade 4 as Measured by Lanza (1991) Score
The degree of upper gastrointestinal (UGI) injury as measured by Lanza scores (1991) during treatment with PN 400 and ARTHROTEC® in a high-risk population. The Lanza (1991) score is based on endoscopic obeservations and rating these, with no damage, petecchiae, erosions and ulcers. On the 1991 scale, a Lanza score of 0 represents normal mucosa (no damage), while a score of 4 indicates 6-10 erosions, and a score of 7 indicates an ulcer.

Full Information

First Posted
December 19, 2007
Last Updated
August 27, 2010
Sponsor
POZEN
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1. Study Identification

Unique Protocol Identification Number
NCT00594854
Brief Title
Evaluating PN 400 (VIMOVO) in Reducing Gastric Ulcers in High Risk Subjects Compared to Arthrotec
Official Title
6-Month, Randomized, Double-blind, Parallel-group, Controlled, Multi-center Study of Gastric Ulcer Incidence With PN400 (Esomeprazole/Naproxen) Versus Diclofenac/Misoprostol in Subjects at High Risk for Developing NSAID-Associated Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
August 2010
Overall Recruitment Status
Terminated
Why Stopped
POZEN agreed with FDA to stop study due to low and inadequate enrollment
Study Start Date
September 2007 (undefined)
Primary Completion Date
September 2008 (Actual)
Study Completion Date
September 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
POZEN

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized, double-blind, parallel-group, controlled, multi-center clinical trial of 6 months duration is designed to assess the efficacy, tolerability and safety of PN400 versus diclofenac/misoprostol in subjects at high risk for developing NSAID-associated gastric ulcers. Approximately 100 sites will participate to enroll a total of 200 subjects (100 per arm). At least 20% of the subjects enrolled will be age 65 years and older.
Detailed Description
To determine the incidence of gastric ulcers following administration of PN 400 in a high risk population over six months. Diclofenac/misoprostol will be used as a positive control. Secondary: To determine the incidence of duodenal ulcers during treatment with PN 400 and diclofenac/misoprostol in a high risk population To evaluate the degree of upper gastrointestinal injury as measured by Lanza scores (1991) during treatment with PN400 and diclofenac/misoprostol in a high risk population To compare gastrointestinal symptoms in subjects treated with PN 400 versus diclofenac/misoprostol as measured by scores on the Gastrointestinal Symptoms Rating Scale (GSRS) instrument To evaluate the safety and tolerability of PN400 and diclofenac/misoprostol in a high risk population

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gastric Ulcer
Keywords
NSAID, Gastric Ulcer, High risk, Arthrotec, Vimovo

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PN400
Arm Type
Experimental
Arm Description
PN 400 (esomeprazole/naproxen) dosed twice daily
Arm Title
Diclofenac/Misoprostol
Arm Type
Active Comparator
Arm Description
diclofenac 75mg/misoprostol 200 mcg dosed twice daily
Intervention Type
Drug
Intervention Name(s)
PN400 (VIMOVO)
Other Intervention Name(s)
Vimovo
Intervention Description
PN400 tablet (500 mg delayed-release naproxen/20 mg immediate-release esomeprazole) given by mouth twice daily (bid).
Intervention Type
Drug
Intervention Name(s)
Diclofenac/Misoprostol
Other Intervention Name(s)
Arthrotec
Intervention Description
Over-encapsulated ARTHROTEC® 75 (75 mg diclofenac sodium/200 mcg misoprostol) capsules given by mouth bid.
Primary Outcome Measure Information:
Title
Number of Participants With Gastric Ulcer Confirmed by Endoscopy
Description
Number of participants with gastric ulcers confirmed by endoscopy following administration of PN 400 (VIMOVO) or Arthrotec in a high risk population over six months.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Number of Participants With Duodenal Ulcers Confirmed by Endoscopy
Description
Number of participants with duodenal ulcers confirmed by endoscopy following administration of PN 400 VIMOVO)or Arthrotec in a high risk population
Time Frame
6 months
Title
Number of Participants With Upper Gastro-intestinal Injury Grade 4 as Measured by Lanza (1991) Score
Description
The degree of upper gastrointestinal (UGI) injury as measured by Lanza scores (1991) during treatment with PN 400 and ARTHROTEC® in a high-risk population. The Lanza (1991) score is based on endoscopic obeservations and rating these, with no damage, petecchiae, erosions and ulcers. On the 1991 scale, a Lanza score of 0 represents normal mucosa (no damage), while a score of 4 indicates 6-10 erosions, and a score of 7 indicates an ulcer.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or non-pregnant female subjects, 18 years and older with a history of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis or other medical condition expected to require daily NSAID therapy for at least 6 months, with a documented history of an ulcer related serious upper gastrointestinal event such as bleeding, perforation or obstruction Female subjects are eligible for participation in the study if they are of: Non-childbearing potential (i.e., physiologically incapable of becoming pregnant); 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; or, Hormonal contraception by oral route, implant, injectable, vaginal ring; or, 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); or Any other method with published data showing that the lowest expected failure rate is less than 1% per year Each subject must be able to understand and comply with study procedures required of a subject and is able and willing to provide written informed consent prior to any study procedures being performed Exclusion Criteria: History of hypersensitivity to esomeprazole or to another proton-pump inhibitor History of allergic reaction or intolerance to any NSAID (including aspirin) and/or a history of NSAID-induced symptoms of asthma, rhinitis, and/or nasal polyps Positive test result for H. pylori at screening Participation in any study of an investigational treatment in the 4 weeks before screening Presence of uncontrolled acute or chronic medical illness, e.g. gastrointestinal disorder, hypertension, diabetes, thyroid disorder, depression and/or infection that would endanger a subject if they were to participate in the study Gastrointestinal disorder or surgery leading to impaired drug absorption Evidence of uncontrolled, or unstable cardio- or cerebrovascular disorder, which in the investigator's opinion would endanger a subject if they were to participate in the study Schizophrenia or bipolar disorder Use of any excluded concomitant medication (see Section 9.2) A recent history (in the past 3 months) suggestive of alcohol or drug abuse or dependence, including overuse/abuse of narcotics for management of pain Serious blood coagulation disorder, including use of systemic anticoagulants Screening endoscopy showing >10 erosions or any gastric or duodenal ulcer at least 3 mm in diameter with depth Screening laboratory ALT or AST value > 2 times the upper limit of normal Estimated creatinine clearance < 50 ml/min Other than noted specifically, any screening laboratory value that is clinically significant in the investigator's opinion and would endanger a subject if they were to participate in the study History of malignancy, treated or untreated, within the past 5 years, with the exception of successfully treated basal cell or squamous cell carcinoma of the skin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Everardus Orlemans, PhD
Organizational Affiliation
POZEN
Official's Role
Study Chair
Facility Information:
Facility Name
POZEN
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27517
Country
United States

12. IPD Sharing Statement

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Evaluating PN 400 (VIMOVO) in Reducing Gastric Ulcers in High Risk Subjects Compared to Arthrotec

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