Gastro Esophageal Reflux Clinical Trial
Official title:
A Placebo Controlled Trial With Baclofen for the Treatment of GERD Patients With Incomplete PPI Response
Reflux (acid and non-acid) mainly occurs during transient LES relaxations (TLESRs). The
gamma-aminobutyric acid (GABA) receptor type B agonist baclofen was shown to inhibit TLESRs,
thereby significantly decreasing acid reflux after a meal in healthy controls and in patients
with GERD.
The primary objective of this study is to assess the efficacy (assessed by reflux symptom
questionnaire and pH-impedance recordings) of baclofen 10mg three times daily vs. placebo in
GERD patients with an incomplete response to PPI therapy.
The secondary objective is to assess the predictive value of reflux assessment (by
pH-impedance recordings) on the primary outcome.
This is a randomized, parallel, double-blind, placebo-controlled, out-patient, single-center
study. Eligible subjects will be randomly assigned to receive either oral baclofen 10 mg or
placebo t.i.d for a period 4 weeks. After 4 weeks all patients will be given the standard
dose of baclofen 10 mg t.i.d. (open label), for another 4 weeks. The b.i.d. PPI therapy will
be continued for the entire study duration.
Approximately 90 evaluable subjects with typical GERD symptoms (heartburn and/or
regurgitation) will participate in this study and will be randomized on a 1:1 basis: 45
subjects each will be in the placebo and baclofen 10 mg three times daily group. Subjects
will be considered to have completed the study if they complete the week 4 visit.
Medication will consist of identically-looking capsules of baclofen or placebo. Patients will
take 1 capsule containing 5 mg baclofen with meals t.i.d for 7 days and then 1 capsule
containing 10 mg baclofen with meals t.i.d for the remaining 21 days.
Prior to visit 1, all subjects included in the study will undergo a 24 hr pH-impedance study
which was requested by the treating physician. This investigation is part of the standard
clinical work up and will not be part of the study protocol.
Informed consent is to be signed and dated by the subject before any study related procedures
are performed. The date of each visit to the clinic and the date and time of the last dose of
test article will be recorded.
Throughout the study patients will be asked to complete daily a short questionnaire (ReQuest)
for reflux symptoms.
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