Helicobacter Pylori Infection Clinical Trial
Official title:
Efficacy and Safety of a Triple Eradication Scheme for Helicobacter Pylori Based on Amoxicillin 1g + Clarithromycin 500 mg and Tegoprazan 50 mg vs Amoxicillin 1g + Clarithromycin 500 mg and Esomeprazole 40 mg Twice a Day for 14 Days
In Mexico, quadruple therapy is used to treat Helicobacter pylori (H.P.) at the expense of greater adverse effects, costs, and lower adherence to treatment. According to evidence, a competitive potassium channel blocker (P-CAB) is non-inferior to a proton pump inhibitor (PPI) and can improve the eradication rate of H.P. while maintaining triple therapy antibiotics (amoxicillin-clarithromycin) without increasing adverse effects, fewer drugs and better adherence to treatment. It is proposed to study the effect of a P-CAB in the eradication of H.P. as part of a triple therapy in Mexican patients, assuming that the efficacy and safety of a triple therapy of amoxicillin-clarithromycin-tegoprazan will be superior to amoxicillin-clarithromycin-esomeprazole.
Status | Not yet recruiting |
Enrollment | 160 |
Est. completion date | February 28, 2025 |
Est. primary completion date | November 29, 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - First-degree relatives with a history of gastric cancer. - Clinical diagnosis of uninvestigated dyspepsia in patients under 50 years of age. - Diagnosis of Gastric Mucosa - Aassociated Lymphoid Tissue (MALT) Lymphoma. - Iron deficiency anemia. - Unexplained thrombocytopenic purpura. Exclusion Criteria: - Patients who have social coverage. - Previous eradication treatment for Helicobacter Pylori. - Acute upper gastrointestinal bleeding and active gastric and/or duodenal ulcer. - History of surgery that affects gastric acid secretion (vagotomy, gastrointestinal resection). - Disorders of gastric acid hypersecretion (Zollinger-Ellison Syndrome). - Any serious hematological, cardiovascular, neurological, nephro-urological, hepatic and pulmonary disorders. - Pregnancy or lactation. - Allergy to any of the study medications. |
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Hospital General de México Dr. Eduardo Liceaga |
Alarcon-Millan J, Fernandez-Tilapa G, Cortes-Malagon EM, Castanon-Sanchez CA, De Sampedro-Reyes J, Cruz-Del Carmen I, Betancourt-Linares R, Roman-Roman A. Clarithromycin resistance and prevalence of Helicobacter pylori virulent genotypes in patients from Southern Mexico with chronic gastritis. Infect Genet Evol. 2016 Oct;44:190-198. doi: 10.1016/j.meegid.2016.06.044. Epub 2016 Jun 26. — View Citation
Bosques-Padilla FJ, Remes-Troche JM, Gonzalez-Huezo MS, Perez-Perez G, Torres-Lopez J, Abdo-Francis JM, Bielsa-Fernandez MV, Camargo MC, Esquivel-Ayanegui F, Garza-Gonzalez E, Hernandez-Guerrero AI, Herrera-Goepfert R, Huerta-Iga FM, Leal-Herrera Y, Lopez-Colombo A, Ortiz-Olvera NX, Riquelme-Perez A, Sampieri CL, Uscanga-Dominguez LF, Velarde-Ruiz Velasco JA. The fourth Mexican consensus on Helicobacter pylori. Rev Gastroenterol Mex (Engl Ed). 2018 Jul-Sep;83(3):325-341. doi: 10.1016/j.rgmx.2018.05.003. Epub 2018 Jun 22. English, Spanish. — View Citation
Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017 Feb;112(2):212-239. doi: 10.1038/ajg.2016.563. Epub 2017 Jan 10. Erratum In: Am J Gastroenterol. 2018 Jul;113(7):1102. — View Citation
Choi YJ, Lee YC, Kim JM, Kim JI, Moon JS, Lim YJ, Baik GH, Son BK, Lee HL, Kim KO, Kim N, Ko KH, Jung HK, Shim KN, Chun HJ, Kim BW, Lee H, Kim JH, Chung H, Kim SG, Jang JY. Triple Therapy-Based on Tegoprazan, a New Potassium-Competitive Acid Blocker, for First-Line Treatment of Helicobacter pylori Infection: A Randomized, Double-Blind, Phase III, Clinical Trial. Gut Liver. 2022 Jul 15;16(4):535-546. doi: 10.5009/gnl220055. Epub 2022 Jul 6. — View Citation
Domingues G, Chinzon D, Moraes-Filho JPP, Senra JT, Perrotti M, Zaterka S. Potassium-competitive acid blockers, a new therapeutic class, and their role in acid-related diseases: a narrative review. Prz Gastroenterol. 2023;18(1):47-55. doi: 10.5114/pg.2022.116673. Epub 2022 Aug 15. — View Citation
Echizen H. The First-in-Class Potassium-Competitive Acid Blocker, Vonoprazan Fumarate: Pharmacokinetic and Pharmacodynamic Considerations. Clin Pharmacokinet. 2016 Apr;55(4):409-18. doi: 10.1007/s40262-015-0326-7. — View Citation
Gatta L, Vakil N, Vaira D, Scarpignato C. Global eradication rates for Helicobacter pylori infection: systematic review and meta-analysis of sequential therapy. BMJ. 2013 Aug 7;347:f4587. doi: 10.1136/bmj.f4587. — View Citation
Kato M, Ota H, Okuda M, Kikuchi S, Satoh K, Shimoyama T, Suzuki H, Handa O, Furuta T, Mabe K, Murakami K, Sugiyama T, Uemura N, Takahashi S. Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition. Helicobacter. 2019 Aug;24(4):e12597. doi: 10.1111/hel.12597. Epub 2019 May 20. — View Citation
Leja M, Grinberga-Derica I, Bilgilier C, Steininger C. Review: Epidemiology of Helicobacter pylori infection. Helicobacter. 2019 Sep;24 Suppl 1:e12635. doi: 10.1111/hel.12635. — View Citation
Li Q. Bacterial infection and microbiota in carcinogenesis and tumor development. Front Cell Infect Microbiol. 2023 Nov 15;13:1294082. doi: 10.3389/fcimb.2023.1294082. eCollection 2023. — View Citation
Lima JJ, Thomas CD, Barbarino J, Desta Z, Van Driest SL, El Rouby N, Johnson JA, Cavallari LH, Shakhnovich V, Thacker DL, Scott SA, Schwab M, Uppugunduri CRS, Formea CM, Franciosi JP, Sangkuhl K, Gaedigk A, Klein TE, Gammal RS, Furuta T. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing. Clin Pharmacol Ther. 2021 Jun;109(6):1417-1423. doi: 10.1002/cpt.2015. Epub 2020 Sep 20. — View Citation
Luo S, Ru J, Khan Mirzaei M, Xue J, Peng X, Ralser A, Hadi JL, Mejias-Luque R, Gerhard M, Deng L. Helicobacter pylori infection alters gut virome by expanding temperate phages linked to increased risk of colorectal cancer. Gut. 2023 Nov 2:gutjnl-2023-330362. doi: 10.1136/gutjnl-2023-330362. Online ahead of print. No abstract available. — View Citation
Malfertheiner P, Camargo MC, El-Omar E, Liou JM, Peek R, Schulz C, Smith SI, Suerbaum S. Helicobacter pylori infection. Nat Rev Dis Primers. 2023 Apr 20;9(1):19. doi: 10.1038/s41572-023-00431-8. — View Citation
Malfertheiner P, Megraud F, Rokkas T, Gisbert JP, Liou JM, Schulz C, Gasbarrini A, Hunt RH, Leja M, O'Morain C, Rugge M, Suerbaum S, Tilg H, Sugano K, El-Omar EM; European Helicobacter and Microbiota Study group. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022 Aug 8:gutjnl-2022-327745. doi: 10.1136/gutjnl-2022-327745. Online ahead of print. — View Citation
Mladenova I. Epidemiology of Helicobacter pylori Resistance to Antibiotics (A Narrative Review). Antibiotics (Basel). 2023 Jul 13;12(7):1184. doi: 10.3390/antibiotics12071184. — View Citation
Murakami K, Sakurai Y, Shiino M, Funao N, Nishimura A, Asaka M. Vonoprazan, a novel potassium-competitive acid blocker, as a component of first-line and second-line triple therapy for Helicobacter pylori eradication: a phase III, randomised, double-blind study. Gut. 2016 Sep;65(9):1439-46. doi: 10.1136/gutjnl-2015-311304. Epub 2016 Mar 2. — View Citation
Ng HY, Leung WK, Cheung KS. Antibiotic Resistance, Susceptibility Testing and Stewardship in Helicobacter pylori Infection. Int J Mol Sci. 2023 Jul 20;24(14):11708. doi: 10.3390/ijms241411708. — View Citation
Okamura T, Suga T, Nagaya T, Arakura N, Matsumoto T, Nakayama Y, Tanaka E. Antimicrobial resistance and characteristics of eradication therapy of Helicobacter pylori in Japan: a multi-generational comparison. Helicobacter. 2014 Jun;19(3):214-20. doi: 10.1111/hel.12124. Epub 2014 Apr 3. — View Citation
Porras C, Nodora J, Sexton R, Ferreccio C, Jimenez S, Dominguez RL, Cook P, Anderson G, Morgan DR, Baker LH, Greenberg ER, Herrero R. Epidemiology of Helicobacter pylori infection in six Latin American countries (SWOG Trial S0701). Cancer Causes Control. 2013 Feb;24(2):209-15. doi: 10.1007/s10552-012-0117-5. Epub 2012 Dec 12. — View Citation
Sakurai Y, Nishimura A, Kennedy G, Hibberd M, Jenkins R, Okamoto H, Yoneyama T, Jenkins H, Ashida K, Irie S, Taubel J. Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Single Rising TAK-438 (Vonoprazan) Doses in Healthy Male Japanese/non-Japanese Subjects. Clin Transl Gastroenterol. 2015 Jun 25;6(6):e94. doi: 10.1038/ctg.2015.18. — View Citation
Savoldi A, Carrara E, Graham DY, Conti M, Tacconelli E. Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions. Gastroenterology. 2018 Nov;155(5):1372-1382.e17. doi: 10.1053/j.gastro.2018.07.007. Epub 2018 Jul 7. — View Citation
Shah A, Usman O, Zahra T, Chaudhari SS, Mulaka GSR, Masood R, Batool S, Saleem F. Efficacy and Safety of Potassium-Competitive Acid Blockers Versus Proton Pump Inhibitors as Helicobacter pylori Eradication Therapy: A Meta-Analysis of Randomized Clinical Trials. Cureus. 2023 Nov 7;15(11):e48465. doi: 10.7759/cureus.48465. eCollection 2023 Nov. — View Citation
Shah SC, Iyer PG, Moss SF. AGA Clinical Practice Update on the Management of Refractory Helicobacter pylori Infection: Expert Review. Gastroenterology. 2021 Apr;160(5):1831-1841. doi: 10.1053/j.gastro.2020.11.059. Epub 2021 Jan 29. — View Citation
Shakir SM, Shakir FA, Couturier MR. Updates to the Diagnosis and Clinical Management of Helicobacter pylori Infections. Clin Chem. 2023 Aug 2;69(8):869-880. doi: 10.1093/clinchem/hvad081. Erratum In: Clin Chem. 2023 Dec 1;69(12):1437. — View Citation
Sugimoto M, Furuta T. Efficacy of tailored Helicobacter pylori eradication therapy based on antibiotic susceptibility and CYP2C19 genotype. World J Gastroenterol. 2014 Jun 7;20(21):6400-11. doi: 10.3748/wjg.v20.i21.6400. — View Citation
Sun Q, Yuan C, Zhou S, Lu J, Zeng M, Cai X, Song H. Helicobacter pylori infection: a dynamic process from diagnosis to treatment. Front Cell Infect Microbiol. 2023 Oct 19;13:1257817. doi: 10.3389/fcimb.2023.1257817. eCollection 2023. — View Citation
Torres J, Camorlinga-Ponce M, Perez-Perez G, Madrazo-De la Garza A, Dehesa M, Gonzalez-Valencia G, Munoz O. Increasing multidrug resistance in Helicobacter pylori strains isolated from children and adults in Mexico. J Clin Microbiol. 2001 Jul;39(7):2677-80. doi: 10.1128/JCM.39.7.2677-2680.2001. — View Citation
Torres J, Ferreira RM, Kato I. Editorial: The role of Helicobacter pylori in gastric carcinogenesis. Front Oncol. 2023 Jun 26;13:1233890. doi: 10.3389/fonc.2023.1233890. eCollection 2023. No abstract available. — View Citation
World gastroenterology organisation global guideline: Helicobacter pylori in developing countries. J Dig Dis. 2011 Oct;12(5):319-26. doi: 10.1111/j.1751-2980.2011.00529.x. No abstract available. — View Citation
Zhou BG, Yan XL, Wan LY, Zhang Q, Li B, Ai YW. Effect of enhanced patient instructions on Helicobacter pylori eradication: A systematic review and meta-analysis of randomized controlled trials. Helicobacter. 2022 Apr;27(2):e12869. doi: 10.1111/hel.12869. Epub 2022 Feb 18. Erratum In: Helicobacter. 2022 Jun;27(3):e12892. — View Citation
* Note: There are 30 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Response to treatment by determining the eradication rate | The eradication rate will be measured by a carbon-13 urea breath test that will verify the eradication of Helicobacter pylori. The eradication rate of the triple regimen based on clarithromycin - amoxicillin - esomeprazole vs clarithromycin - amoxicillin - tegoprazan will be compared. | Two months | |
Primary | Compared Treatment-related adverse events | Treatment-related adverse events will be evaluated by complementary serum studies and interrogated according to system organ classes and preferred terms using MedDRA. Adverse events related to the treatment of the triple regimen based on clarithromycin - amoxicillin - esomeprazole vs clarithromycin - amoxicillin - tegoprazan will be compared. | Two months | |
Secondary | Brief Medication Questionnaire | Identify the factors associated with medication consumption, by applying the Brief Medication Questionnaire on day 7 and 14 of treatment, via telephone call and in person. | Two weeks | |
Secondary | Percentage of patients with adherence to treatment | Adherence to treatment will be evaluated by calculating the percentage of compliance and tablet count, which is based on the count of the number of tablets left in the container compared to the amount initially indicated, and the time between the indication and the count. The percentage of adherence to eradication treatment will be compared in patients treated with the scheme based on tegoprazan vs. proton pump inhibitor. | Two weeks | |
Secondary | Report all Treatment-related adverse events | Treatment-related adverse events will be evaluated by complementary serum studies and interrogated according to system organ classes and preferred terms using MedDRA. | Two months |
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