Erosive Esophagitis Clinical Trial
Official title:
A Phase 3, Randomized, Double-Blind, Two Phase, Multicenter Study to Evaluate the Efficacy and Safety of Vonoprazan 20 mg Compared to Lansoprazole 30 mg for Healing in Patients With Erosive Esophagitis and to Evaluate the Efficacy and Safety of Vonoprazan (10 mg and 20 mg) Compared to Lansoprazole 15 mg for the Maintenance of Healing in Patients With Healed Erosive Esophagitis
Verified date | July 2022 |
Source | Phathom Pharmaceuticals, Inc. |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
To evaluate the efficacy and safety of vonoprazan compared to lansoprazole in participants with erosive esophagitis.
Status | Completed |
Enrollment | 1027 |
Est. completion date | August 24, 2021 |
Est. primary completion date | July 29, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: 1. The participant is =18 years of age at the time of informed consent signing. 2. In the opinion of the investigator or subinvestigators, the participant is capable of understanding and complying with protocol requirements. 3. The participant signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures. The participant is informed of the full nature and purpose of the study, including possible risks and side-effects. The participant has the ability to cooperate with the investigator. Ample time and opportunity should be given to read and understand verbal and/or written instructions. 4. The participant is found to have endoscopically confirmed EE of LA Classification Grades A to D during the Screening Period (Visit 1) as assessed by a central adjudicator. The target number of participants with LA classification Grade C or D will be approximately 30% of the total number of participants (300 total). Enrollment of EE participants with Grade A or B will end when the number of participants with Grade A or B EE is approximately 700 or 70% of the total planned number of participants. Given the invasive nature of an endoscopy, any endoscopic confirmation performed in a routine clinical setting before signing the informed consent will be acceptable to use for the purpose of fulfilling the screening requirement if all of the following apply: (1) appropriate endoscopy pictures were taken; (2) appropriate gastric biopsy samples were taken; (3) the endoscopy pictures can be sent to the central adjudicator via the adjudication systems; and (4) all screening procedures (including the completion of adjudication) AND randomization can be completed within a 7-day period after the date of the endoscopy. 5. A female participant of childbearing potential who is or may be sexually active with a nonsterilized male partner agrees to routinely use adequate contraception from the signing of informed consent until 4 weeks after the last dose of study drug. Exclusion Criteria: 1. The participant's endoscopic examination for entering this study fails to confirm EE within 7 days (no later than 10 days on rare occasion with sponsor approval) prior to randomization. 2. The participant is determined to be positive for Helicobacter pylori (HP) or has had an HP infection within 45 days of randomization. 3. The participant has endoscopic Barrett's esophagus (>1 cm of columnar-lined esophagus) and/or definite dysplastic changes in the esophagus. 4. The participant has any other condition affecting the esophagus, including eosinophilic esophagitis; esophageal varices; viral or fungal infection; esophageal stricture; a history of radiation therapy, radiofrequency ablation, endoscopic mucosal resection, or cryotherapy to the esophagus; or any history of caustic or physiochemical trauma (including sclerotherapy or esophageal variceal band ligation). However, participants diagnosed with Schatzki's ring (mucosal tissue ring around lower esophageal sphincter) are eligible to participate. 5. The participant has scleroderma (systemic sclerosis). 6. The participant has a history of surgery or endoscopic treatment affecting gastroesophageal reflux, including fundoplication and dilation for esophageal stricture (except Schatzki's ring) or a history of gastric or duodenal surgery (except endoscopic removal of benign polyps). 7. The participant has an active gastric or duodenal ulcer at the start of the Screening Period. Additionally, participants with gastric or duodenal erosions are permitted to participate. 8. The participant has received any investigational compound (including those in post marketing studies) within 30 days prior to the start of the Screening Period. A participant who has been screen failed from another clinical study and who has not been dosed may be considered for enrollment in this study. 9. The participant is a study site employee, an immediate family member, or is in a dependent relationship with a study site employee who is involved in the conduct of this study (eg, spouse, parent, child, sibling) or who may have consented under duress. 10. The participant has cutaneous lupus erythematosus or systemic lupus erythematosus. 11. The participant has had clinically significant upper or lower gastrointestinal bleeding within 4 weeks prior to randomization. 12. The participant has Zollinger-Ellison syndrome or other gastric acid hypersecretory conditions. 13. The participant has a history of hypersensitivity or allergies to vonoprazan (including the formulation excipients: D-mannitol, microcrystalline cellulose, hydroxypropyl cellulose, fumaric acid, croscarmellose sodium, magnesium stearate, hypromellose, macrogol 8000, titanium oxide, or red or yellow ferric oxide), PPIs, or any excipients used in the 13C-urea breath test: mannitol, citric acid, or aspartame. Skin testing may be performed according to local standard practice to confirm hypersensitivity. 14. The participant has a history of alcohol abuse, illegal drug use, or drug addiction within the 12 months prior to screening, or regularly consumes >21 units of alcohol (1 unit = 12 oz/300 mL beer, 1.5 oz/25 mL hard liquor/spirits, or 5 oz/100 mL wine) per week based on self-report. Participants must have a negative urine drug screen at screening. 15. The participant is taking any excluded medications or treatments. 16. If female, the participant is pregnant, lactating, or intending to become pregnant before, during, or within 4 weeks after participating in this study; or intending to donate ova during such time period. 17. The participant has a history or clinical manifestations of significant central nervous system, cardiovascular, pulmonary, hepatic, renal, metabolic, other gastrointestinal, urological, endocrine, or hematological disease that, in the opinion of the investigator, would confound the study results or compromise participant safety. 18. The participant requires hospitalization or has surgery scheduled during the course of the study or has undergone major surgical procedures within 30 days prior to the Screening Visit. 19. The participant has a history of malignancy (including MALToma) or has been treated for malignancy within 5 years prior to the start of the Screening Period (Visit 1). (The participant may be included in the study if he/she has cured cutaneous basal cell carcinoma or cervical carcinoma in situ). 20. The participant has acquired immunodeficiency syndrome or human immunodeficiency virus infection, or tests positive for the hepatitis B surface antigen, hepatitis C virus (HCV) antibody, or HCV RNA. However, participants who test positive for HCV antibody but negative for HCV RNA are permitted to participate. 21. The participant has any of the following abnormal laboratory test values at the start of the Screening Period: 1. Creatinine levels: >2 mg/dL (>177 µmol/L) 2. Alanine aminotransferase or aspartate aminotransferase >2 × the upper limit of normal (ULN) or total bilirubin >2 × ULN. |
Country | Name | City | State |
---|---|---|---|
Bulgaria | Multiprofile Hospital for Active Treatment Puls AD - PPDS | Blagoevgrad | |
Bulgaria | University Multiprofile Hospital for Active Treatment | Pleven | |
Bulgaria | Diagnostic-Consultative Center Aleksandrovska EOOD | Sofia | |
Bulgaria | Fourth Multiprofile Hospital for Active Treatment | Sofia | Sofia City |
Bulgaria | Medical Center Excelsior OOD - PPDS | Sofia | |
Bulgaria | Second Multiprofile Hospital for Active Treatment Sofia | Sofia | |
Bulgaria | Synexus - Medical Center Synexus Sofia EOOD | Sofia | |
Bulgaria | Synexus - Medical Centre Synexus Sofia EOOD | Stara Zagora | |
Czechia | PreventaMed s.r.o. | Olomouc | |
Czechia | Synexus Czech s.r.o. | Prague | |
Czechia | MEDIC KRAL s.r.o. | Praha | Prague |
Czechia | Krajska zdravotni, a.s. - Masarykova nemocnice v Usti nad Labem, o.z. Oddeleni gastroenterolgie | Usti nad Labem | |
Czechia | Nemocnice Pardubickeho kraje, a.s. Orlickoustecka nemocnice, Interni oddeleni, Cs. | Usti nad Orlici | Pardubice |
Hungary | Synexus (DRS) - Synexus Magyarország Kft. Budapest | Budapest | |
Hungary | Debreceni Egyetem Klinikai Kozpont Nagyerdei Krt. 98, Belgyogyaszati Klinika | Debrecen | Hajdú-Bihar |
Hungary | Synexus Affiliate - Synexus Magyarorszag Kft. Debrecen | Debrecen | |
Hungary | Synexus (DRS) - Synexus Magyarorszag Kft. Gyula | Gyula | |
Hungary | Synexus Affiliate BKS Research Kft. Hatvan | Hatvan | Heves |
Hungary | Szabolcs-Szatmar-Bereg Megyei Korhazak es Egyetemi Oktatokorhaz | Nyíregyháza | Szabolcs-Szatmár-Bereg |
Hungary | Synexus (DRS) - Synexus Magyarország Kft. Zalaegerszeg | Zalaegerszeg | |
Poland | Gabinet Lekarski-Janusz Rudzinski ul. Powstancow Warszawy 5 | Bydgoszcz | |
Poland | Szpital Uniwersytecki Nr 2 im. Dr Jana Biziela w Bydgoszczy Centrum Endoskopii Zabiegowej - Poradnia Chorob Jelitowych | Bydgoszcz | |
Poland | Synexus - Czestochowa | Czestochowa | |
Poland | Synexus - Gdansk | Gdansk | |
Poland | Synexus - Gdynia | Gdynia | |
Poland | Synexus - Katowice | Katowice | |
Poland | Synexus Affiliate - Krakowskie Centrum Medyczne | Kraków | |
Poland | Centrum Opieki Zdrowotnej Orkan-Med Stec-Michalska Sp. J. | Ksawerów | |
Poland | Santa Familia Centrum Badan Profilaktyki i Leczenia | Lódz | |
Poland | Synexus - Lodz | Lódz | |
Poland | GASTRO MED Zaklad Opieki Zdrowotnej | Lublin | |
Poland | Synexus - Poznan | Poznan | |
Poland | Korczowski Bartosz, Gabinet Lekarski | Rzeszów | |
Poland | Twoja Przychodnia - Szczecinskie Centrum Medyczne | Szczecin | |
Poland | Gastromed Specjalistyczne Centrum Gastrologii i Endoskopii | Torun | |
Poland | REUMATIKA - Centrum Reumatologii NZOZ | Warszawa | |
Poland | Synexus - Warszawa | Warszawa | |
Poland | Melita Medical | Wroclaw | |
Poland | Synexus - Wroclaw | Wroclaw | |
United Kingdom | Synexus - Wales Clinical Research Centre | Cardiff | |
United Kingdom | Synexus - Lancashire Clinical Research Centre | Chorley | |
United Kingdom | Synexus - Midlands Clinical Research Centre | Edgbaston | West Midlands |
United Kingdom | CPS Research | Glasgow | |
United Kingdom | Synexus - Hexham Clinical Research Centre | Hexham | |
United Kingdom | Synexus - Merseyside Clinical Research Centre | Liverpool | |
United Kingdom | Synexus - Manchester Clinical Research Centre | Manchester | |
United Kingdom | Synexus Thames Valley Clinical Research Centre | Reading | Berkshire |
United Kingdom | Synexus - North Tees Clinical Research Centre | Stockton-on-Tees | |
United States | Anaheim Clinical Trials LLC | Anaheim | California |
United States | Synexus Clinical Research US, Inc. | Anderson | South Carolina |
United States | Pinnacle Research Group | Anniston | Alabama |
United States | North Alabama Research Center LLC | Athens | Alabama |
United States | Atlanta Gastroenterology Associates | Atlanta | Georgia |
United States | Nexgen Research Center | Atlanta | Georgia |
United States | Inquest Clinical Research | Baytown | Texas |
United States | Washington Gastroenterology | Bellevue | Washington |
United States | Synexus Clinical Research US, Inc. | Birmingham | Alabama |
United States | Gastroenterology Associates of Fairfield County | Bridgeport | Connecticut |
United States | Connecticut Clinical Research Foundation | Bristol | Connecticut |
United States | Synexus Clinical Research US, Inc. - East Valley Family Physicians, PLC | Chandler | Arizona |
United States | Clinical Trials of South Carolina | Charleston | South Carolina |
United States | Carolinas Research Center | Charlotte | North Carolina |
United States | New River Valley Research Institute | Christiansburg | Virginia |
United States | eStudySite - Chula Vista - PPDS | Chula Vista | California |
United States | GW Research, Inc. - ClinEdge - PPDS | Chula Vista | California |
United States | Iowa Digestive Disease Center | Clive | Iowa |
United States | Synexus Clinical Research US, Inc. - Colorado Springs Family Practice | Colorado Springs | Colorado |
United States | Kindred Medical Institute for Clinical Trials, LLC | Corona | California |
United States | Clinical Trials Management LLC | Covington | Louisiana |
United States | Synexus Clinical Research US, Inc. - Dallas | Dallas | Texas |
United States | Dayton Gastroenterology, Inc | Dayton | Ohio |
United States | Duke University Medical Center | Durham | North Carolina |
United States | Riverside Clinical Research | Edgewater | Florida |
United States | Texas Tech University Health Sciences Center El Paso | El Paso | Texas |
United States | MediSphere Medical Research Center, LLC | Evansville | Indiana |
United States | Verity Research, Inc. | Fairfax | Virginia |
United States | HB Clinical Trials, Inc. | Fountain Valley | California |
United States | Prestige Clinical Research | Franklin | Ohio |
United States | Medication Management LLC | Greensboro | North Carolina |
United States | Carolina Research | Greenville | North Carolina |
United States | Illinois Gastroenterology Group | Gurnee | Illinois |
United States | Drug Trials America - ClinEdge | Hartsdale | New York |
United States | Synexus Clinical Research US, Inc. Site 1 | Henderson | Nevada |
United States | Synexus Clinical Research US, Inc. Site 2 | Henderson | Nevada |
United States | Peters Medical Research, LLC - ClinEdge - PPDS | High Point | North Carolina |
United States | Research Centers of America - ERG | Hollywood | Florida |
United States | CroNOLA, LLC. | Houma | Louisiana |
United States | Biopharma Informatic, LLC | Houston | Texas |
United States | Precision Research Institute, LLC | Houston | Texas |
United States | Medical Affiliated Research Center Inc | Huntsville | Alabama |
United States | Nature Coast Clinical Research | Inverness | Florida |
United States | ENCORE Borland-Groover Clinical Research - ERN - PPDS | Jacksonville | Florida |
United States | Multi Specialty Clinical Research | Johnson City | Tennessee |
United States | The Alliance for Multispecialty Research, LLC | Kansas City | Missouri |
United States | OM Research LLC | Lancaster | California |
United States | Las Vegas - Site 1 | Las Vegas | Nevada |
United States | Sierra Clinical Research - ClinEdge - PPDS | Las Vegas | Nevada |
United States | Site 2 | Las Vegas | Nevada |
United States | Synexus Clinical Research US, Inc. | Layton | Utah |
United States | Applied Research Center of Little Rock | Little Rock | Arkansas |
United States | Preferred Research Partners - ClinEdge - PPDS | Little Rock | Arkansas |
United States | Torrance Clinical Research Institute | Lomita | California |
United States | LA County + USC Medical Center | Los Angeles | California |
United States | Southern California Research Institute Medical Group, Inc. | Los Angeles | California |
United States | Blue Ridge Medical Research | Lynchburg | Virginia |
United States | Gastroenterology Associates of Central Georgia, LLC | Macon | Georgia |
United States | Rio Grande Gastroenterology | McAllen | Texas |
United States | Synexus Clinical Research US, Inc. - Central Arizona Medical Associates, PC | Mesa | Arizona |
United States | Synexus Clinical Research US, Inc. - Desert Clinical Research, LLC | Mesa | Arizona |
United States | Clinical Trials Management LLC | Metairie | Louisiana |
United States | Columbus Clinical Services LLC | Miami | Florida |
United States | Jesscan Medical Research | Miami | Florida |
United States | Nuren Medical and Research Center | Miami | Florida |
United States | Premier Research Associate, Inc. | Miami | Florida |
United States | Facey Medical Foundation | Mission Hills | California |
United States | Coastal Carolina Research Center | Mount Pleasant | South Carolina |
United States | Clinical Research Associates Inc | Nashville | Tennessee |
United States | Vanderbilt University Medical Center | Nashville | Tennessee |
United States | Gastroenterology Health Partners, PLLC | New Albany | Indiana |
United States | Central Sooner Research | Norman | Oklahoma |
United States | Arkansas Gastroenterology | North Little Rock | Arkansas |
United States | Atria Clinical Research - BTC - PPDS | North Little Rock | Arkansas |
United States | Summit Digestive & Liver Disease Specialists State Street Clinic | Oakbrook Terrace | Illinois |
United States | Advanced Research Institute | Ogden | Utah |
United States | Heartland Clinical Research, Inc | Omaha | Nebraska |
United States | Southtowns Gastroenterology, PLLC | Orchard Park | New York |
United States | Gutierrez Medical Center | Orlando | Florida |
United States | Advanced Gastroenterology Associates, LLC | Palm Harbor | Florida |
United States | Palmtree Clinical Research | Palm Springs | California |
United States | Innovation Medical Research Center | Palmetto Bay | Florida |
United States | Digestive System Healthcare | Pasadena | Texas |
United States | In-Quest Medical Research, LLC | Peachtree Corners | Georgia |
United States | Pearland Physicians | Pearland | Texas |
United States | Elite Clinical Studies - Phoenix - BTC - PPDS | Phoenix | Arizona |
United States | Hope Research Institute LLC | Phoenix | Arizona |
United States | Synexus Clinical Research US, Inc. - St. Petersburg | Pinellas Park | Florida |
United States | Synexus Clinical Research US, Inc. | Plano | Texas |
United States | Carolina's GI Research, LLC | Raleigh | North Carolina |
United States | Rapid City Medical Center LLP | Rapid City | South Dakota |
United States | Advanced Research Institute | Reno | Nevada |
United States | Meridian Clinical Research | Rockville | Maryland |
United States | Washington University School of Medicine | Saint Louis | Missouri |
United States | Gastroenterology Research of San Antonio (GERSA) | San Antonio | Texas |
United States | Quality Research Inc | San Antonio | Texas |
United States | Southern Star Research Institute, LLC | San Antonio | Texas |
United States | Medical Associates Research Group, Inc. | San Diego | California |
United States | Precision Research Institute | San Diego | California |
United States | Paragon Rx Clinical, Inc. | Santa Ana | California |
United States | Harborview Medical Center, University of Washington Medical Center | Seattle | Washington |
United States | Louisiana Research Center, LLC | Shreveport | Louisiana |
United States | Precision Clinical Research, LLC | Sunrise | Florida |
United States | Guardian Angel Research Center | Tampa | Florida |
United States | Clinical Associates Research | Towson | Maryland |
United States | Oakland Medical Research Center | Troy | Michigan |
United States | Del Sol Research Management - BTC - PPDS | Tucson | Arizona |
United States | Western States Clinical Research, Inc. | Wheat Ridge | Colorado |
United States | Gastroenterology Associates of Western Michigan, PLC | Wyoming | Michigan |
Lead Sponsor | Collaborator |
---|---|
Phathom Pharmaceuticals, Inc. |
United States, Bulgaria, Czechia, Hungary, Poland, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Healing Phase: Percentage of Participants Who Had Complete Healing of EE by Week 8 | A participant was considered to have complete healing of EE if healing was demonstrated during endoscopy. | Week 8 | |
Primary | Maintenance Phase: Percentage of Participants Who Maintained Complete Healing of EE at Week 24 | A participant was considered to have complete healing of EE if healing was demonstrated during endoscopy. | Week 24 | |
Secondary | Healing Phase: Percentage of 24-hour Heartburn-free Days | A 24-hour heartburn-free day was defined as a day having no heartburn among all diary entries for that day. The percentage of 24-hour heartburn-free days was calculated using all days with at least 1 evening or morning diary entry during the treatment period of this phase. | Day 1 to Week 8 | |
Secondary | Healing Phase: Percentage of Participants With Baseline LA Classification Grades C or D Who Had Complete Healing of EE at Week 2 | A participant was considered to have complete healing of EE if healing was demonstrated during endoscopy.
LA Classification of Esophagitis Grading Scale: Grade C: One or more mucosal breaks that are continuous between the tops of 2 or more mucosal folds, which involves less than 75% of the circumference. Grade D: One or more mucosal breaks, which involves at least 75% of the circumference. |
Week 2 | |
Secondary | Healing Phase: Percentage of Participants With Onset of Sustained Resolution of Heartburn by Day 3 | Sustained resolution was defined as at least 7 consecutive days with no daytime or night time heartburn as assessed by the daily diary. A participant was considered to have sustained resolution of heartburn by Day 3 if the first day of the 7 consecutive days without symptoms was on Days 1, 2, or 3. | Day 1 to maximum of Day 10 (inclusive of 7 day heartburn assessment) | |
Secondary | Healing Phase: Percentage of Participants With Baseline LA Classification Grades C or D Who Had Complete Healing of EE by Week 8 | A participant was considered to have complete healing of EE if healing was demonstrated during endoscopy.
LA Classification of Esophagitis Grading Scale: Grade C: One or more mucosal breaks that are continuous between the tops of 2 or more mucosal folds, which involves less than 75% of the circumference. Grade D: One or more mucosal breaks, which involves at least 75% of the circumference. |
Week 8 | |
Secondary | Healing Phase: Percentage of Participants Who Had Complete Healing of EE at Week 2 | A participant was considered to have complete healing of EE if healing was demonstrated during endoscopy. | Week 2 | |
Secondary | Maintenance Phase: Percentage of Participants With Baseline LA Classification Grades C or D Who Maintained Complete Healing of EE at Week 24 | A participant was considered to have complete healing of EE if healing was demonstrated during endoscopy.
LA Classification of Esophagitis Grading Scale: Grade C: One or more mucosal breaks that are continuous between the tops of 2 or more mucosal folds, which involves less than 75% of the circumference. Grade D: One or more mucosal breaks, which involves at least 75% of the circumference. |
Week 24 | |
Secondary | Maintenance Phase: Percentage of 24-hour Heartburn-free Days | A 24-hour heartburn-free day was defined as a day having no heartburn among all diary entries for that day. The percentage of 24-hour heartburn-free days was calculated using all days with at least 1 evening or morning diary entry during the treatment period of this phase. | Day 1 to Week 24 |
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