Normal Subjects Clinical Trial
Official title:
Rapid Protection of the Gastroduodenal Mucosa Against Aspirin-Induced Damage by Rabeprazole
To determine the effectiveness of rabeprazole in preventing or decreasing acute gastroduodenal injury caused by therapeutic doses of aspirin in a placebo-controlled, randomized, double-blind parallel group study.
Thirty (30) eligible normal subjects will be randomized to one of two study groups:
rabeprazole 20 mg OD (n=15) or placebo OD (n=15). Both rabeprazole and identically appearing
placebo will be given to Temple from Janssen Pharmaceuticals. The randomization schedule
will be prepared by John Gaughan, PhD of Temple University School of Medicine Department of
Biostatistics using a random number generator. The coded medications will be dispensed by
Temple's Department of Pharmacy. Study subjects and the investigators will be blinded as to
the subject receiving either placebo or rabeprazole. The sealed code will not be broken
until after the data analysis.
Study subjects will be admitted to the Temple Clinical Research Center for the duration of
the study. Appendix I has the study time line. Study subjects will arrive at the CRC at 6:00
A.M. on study day 1. Female subjects will have a urine pregnancy test performed. Blood tests
will be obtained for salicylate and alcohol levels. Each study subject will receive a single
dose of study drug (rabeprazole or placebo) at 7:00 A.M. on study days 1, 2 and 3—one hour
before breakfast on days 1 and 3 and 90 minutes before breakfast on study day 2. All
research subjects will receive aspirin (ASA), 325 mg tablets as 2 tablets with 8 oz. water
every 4 hours at 8:30 A.M., 12:30 P.M., 4:30 P.M., 8:30 P.M., 12:30 A.M. and 4:30 A.M. daily
for study days 1, 2 and 3 (a total of 3900 mg aspirin per day). Esophagogastroduodenoscopy
will be performed at 8:00 A.M. on the mornings of days 2 and 4; that is, 24 hours and 72
hours after initiation of aspirin and test drug. During each endoscopy, the maximum number
of submucosal hemorrhages and erosions in an endoscopic field from the anterior and
posterior walls of the antrum will be counted. In addition, a Lanza score will be assigned
for each endoscopic examination (Appendix II). Endoscopic photographs will be obtained for
each endoscopic examination. A blood sample will be obtained at 7:00 A.M. on study days 2, 3
and 4 for measurement of hemoglobin and serum salicylate. Meals will be standardized as
follows for each day of the study:
Breakfast: 8:00 A.M. (study days 1 and 3); 8:30 A.M. (study day 2) 2 eggs, 2 slices of soft
white bread, 4 oz unsweetened orange juice Lunch: 1:00 P.M. (study days 1, 2 and 3) Turkey
sandwich, 2 slices of wheat bread, lettuce, tomato, 1 orange, 8 oz apple juice Dinner: 6:00
P.M. (study days 1, 2 and 3) Two plain hamburgers, ketchup, mustard, lettuce and tomato;
tossed green salad with thousand island dressing, 1 cup of French fries, 8 oz whole milk
Snack: 10:00 P.M. (study days 1, 2 and 3) 4 graham crackers, 4 oz orange juice
If the Lanza score reaches 4 for any subject indicating widespread involvement of the
stomach with submucosal hemorrhages, erosions, or ulcerations, that subject will not receive
any more aspirin, but continue with study drug of placebo or rabeprazole. If this was
detected on day 2 of the study, the subject will continue to receive the study drug with the
repeat study endoscopy on day 4. If the Lanza score day 4 (the end of the study) is 4, the
subject will be treated with rabeprazole 20 mg po qd for one month. If there was an ulcer, a
repeat upper endoscopy will then be performed at 4 weeks to ensure healing.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Prevention
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