A Study of Dexlansoprazole Modified Release Formulation to Treat Night Heartburn

A Phase 3 Multicenter, Randomized, Double-Blind, Parallel Group, Placebo Controlled Trial to Evaluate the Efficacy of TAK-390MR (30 mg QD) Compared to Placebo on Relief of Nocturnal Heartburn in Subjects With Symptomatic Gastroesophageal Reflux Disease (GERD)

The purpose of this study is to determine whether Dexlansoprazole once daily (QD) is effective in treating patients with night heartburn.

Study Overview

• Status: Completed
• Conditions: Gastroesophageal Reflux
• Intervention / Treatment: Drug: Dexlansoprazole; Drug: Placebo

Detailed Description

This 4 week study of Dexlansoprazole (TAK-390MR) will be conducted by approximately 50 investigators in the United States in patients suffering from night heartburn.

• Study Type: Interventional
• Enrollment (Actual): 305
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Tucson, Arizona, United States
  • California
    • Anaheim, California, United States
    • Garden Grove, California, United States
    • Lancaster, California, United States
    • Oakland, California, United States
    • San Diego, California, United States
    • Sherwood, California, United States
    • Westlake Village, California, United States
  • Florida
    • Jupiter, Florida, United States
    • Miami, Florida, United States
    • New Smyrna Beach, Florida, United States
    • Ocala, Florida, United States
    • Saint Petersburg, Florida, United States
    • Zephyrhills, Florida, United States
  • Illinois
    • Moline, Illinois, United States
  • Iowa
    • Clive, Iowa, United States
  • Kansas
    • Wichita, Kansas, United States
  • Louisiana
    • Metairie, Louisiana, United States
  • Maryland
    • Prince Frederick, Maryland, United States
  • Missouri
    • Jefferson City, Missouri, United States
  • New Jersey
    • Egg Harbor Town, New Jersey, United States
  • New York
    • Great Neck, New York, United States
  • North Carolina
    • Greensboro, North Carolina, United States
    • Harrisburg, North Carolina, United States
    • Winston-Salem, North Carolina, United States
  • Ohio
    • Mogadore, Ohio, United States
  • Oklahoma
    • Oklahoma City, Oklahoma, United States
  • Oregon
    • Portland, Oregon, United States
  • Pennsylvania
    • Duncansville, Pennsylvania, United States
  • Tennessee
    • Bristol, Tennessee, United States
    • Chattanooga, Tennessee, United States
    • Johnson City, Tennessee, United States
    • Kingsport, Tennessee, United States
    • Nashville, Tennessee, United States
  • Texas
    • El Paso, Texas, United States
    • Fort Worth, Texas, United States
    • Houston, Texas, United States
    • Odessa, Texas, United States
    • San Antonio, Texas, United States
  • Utah
    • Ogden, Utah, United States
  • Virginia
    • Norfolk, Virginia, United States
  • Washington
    • Spokane, Washington, United States
  • Wisconsin
    • Monroe, Wisconsin, United States

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Females of childbearing potential who are sexually active must agree to use adequate contraception, and can neither be pregnant nor lactating from Screening throughout the duration of the study.
• History of nocturnal heartburn and GERD associated sleep disturbances prior to screening.
• Meets both of the following criteria: 1) nocturnal heartburn severity of moderate, severe, or very severe on at least 3 of 7 nights and; 2) GERD related sleep disturbances on at least 3 of 7 nights.
• Subjects must have history of symptomatic GERD prior to screening with GERD symptoms that were responsive to acid-suppressive therapy.

Exclusion Criteria:

• Erosive esophagitis visualized during the screening endoscopy.
• Allergy to any proton pump inhibitor drug (lansoprazole, omeprazole, rabeprazole, pantoprazole, esomeprazole), any component of Dexlansoprazole, or Gelusil/antacid.
• Active gastric or duodenal ulcers within 30 days prior to randomization.
• Upper gastrointestinal bleeding within 6 months prior to randomization.
• Co-existing diseases affecting the esophagus (eg, eosinophilic esophagitis, esophageal varices, scleroderma, viral or fungal infection, and/or Barrett's esophagus).
• History of radiation therapy or cryotherapy to the esophagus, caustic or physiochemical trauma such as sclerotherapy to the esophagus.
• Subject requiring dilation for esophageal strictures and/or strictures preventing passage of the endoscope during the screening endoscopy. Schatzki's ring (a ring of mucosal tissue near the lower esophageal sphincter) is acceptable.
• Has another condition that could be the primary cause of the subject's sleep disturbance.
• Evidence of uncontrolled, clinically significant neurologic, cardiovascular, pulmonary, hepatic, renal, metabolic, gastrointestinal, or endocrine disease or other abnormality (other than the disease being studied) which may impact the ability of the subject to participate or potentially confound the trial results.
• Diagnosis of cancer (except basal cell carcinoma) within 5 years of screening.
• Has a condition likely to require surgery during the study.
• Currently diagnosed with acquired immunodeficiency syndrome (AIDS).
• Abnormal clinical laboratory values.
• History of alcoholism or drug addiction.
• Subject who works the night shift.
• Subject who is planning to travel beyond 3 time zones during the study.
• Chronic use (more than 12 doses/month) of non-steroidal anti-inflammatory drugs (NSAIDs), including cyclooxygenase-2 (COX 2) inhibitors within 30 days prior to randomization or anticipated use during the study.
• Use of the following medications during the 14 days prior to randomization or anticipated use during the study: proton pump inhibitors, sucralfate, misoprostol, corticosteroids, prokinetics, anticoagulant therapy, antiseizure medications (other than stable doses), psychotropic medications (other than stable doses), narcotic medications (occasional use allowed), bisphosphonates.
• Use of sleep medications, first generation antihistamines, benzodiazepines, modified cyclic antidepressants, antianxiety medications or drugs with significant anticholinergic effects such as tricyclic antidepressants or drugs with central nervous system effects that could mask perception of symptoms (eg, selective-serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors). However, subjects who remain on a stable regimen and dose of these medications during the 90 days prior to randomization and who agree to maintain the same regimen and dose during the trial will qualify. Also, short term use of anticholinergics for trial related procedures is not exclusionary. Second generation antihistamines are not excluded.
• Use of histamine (H2) receptor antagonists or antacids (except for trial supplied Gelusil) during the screening period or anticipated use during the treatment period.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo	Drug: Placebo; 1 capsule, orally, once daily for 4 weeks
Experimental: Dexlansoprazole 30 mg QD	Drug: Dexlansoprazole; 30 mg capsule, orally, once daily for 4 weeks; Other Names: TAK-390; T-168390; TAK-390MR; Kapidex; Dexilant

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Percentage of Nights Without Heartburn Over 4 Weeks as Assessed by Daily Diary.	Percentage calculated by the number of heartburn-free nights out of the total number of nights during the treatment period with a diary entry indicating presence or absence of nighttime heartburn in subjects who had ≥1 diary entry indicating presence or absence of nighttime heartburn, as indicated by the subject's daily diary. Subjects indicate the presence (Yes/No) of nocturnal heartburn symptoms in a Daily Electronic Diary. Nights missing diary results were excluded from the numerator and denominator.	4 Weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percent of Subjects With Relief of Night Time Heartburn Over the Last 7 Days of Treatment as Assessed by Daily Diary.	Relief of nighttime heartburn was defined as 6 of 7 nights with no heartburn and at most 1 night with mild heartburn; lack of relief of nighttime heartburn was defined as 2 or more out of 7 nights with heartburn, or 1 night with at least moderate heartburn. Subjects indicate the presence and severity (mild, moderate, severe, or very severe) of nocturnal heartburn in a Daily Electronic Diary. The percentage was calculated as the number of subjects with relief of nighttime heartburn divided by the number of subjects whose relief status could be determined.	Last 7 days of treatment
Percentage of Participants With Relief of Gastro-Esophageal Reflux Disease (GERD) Associated Sleep Disturbances Over the Last 7 Days of Treatment as Assessed by Daily Diary.	Relief of GERD-associated sleep disturbance was defined as 6 of 7 nights with no GERD associated sleep disturbances; lack of relief of GERD-associated sleep disturbance was defined as 2 or more out of 7 nights with GERD-associated sleep disturbance. Subjects indicate the presence (Yes/No) of GERD associated sleep disturbance in a Daily Electronic Diary. The percentage was calculated as the number of subjects with relief of GERD-associated sleep disturbance divided by the number of subjects whose relief status could be determined.	Last 7 days of treatment

Collaborators and Investigators

• Sponsor: Takeda

Publications and helpful links

General Publications

• Fass R, Johnson DA, Orr WC, Han C, Mody R, Stern KN, Pilmer BL, Perez MC. The effect of dexlansoprazole MR on nocturnal heartburn and GERD-related sleep disturbances in patients with symptomatic GERD. Am J Gastroenterol. 2011 Mar;106(3):421-31. doi: 10.1038/ajg.2010.458. Epub 2011 Jan 11.

Study record dates

Study Major Dates

• Study Start: March 1, 2008
• Primary Completion (Actual): March 1, 2009
• Study Completion (Actual): March 1, 2009

Study Registration Dates

• First Submitted: February 21, 2008
• First Submitted That Met QC Criteria: February 28, 2008
• First Posted (Estimate): February 29, 2008

Study Record Updates

• Last Update Posted (Estimate): April 28, 2011
• Last Update Submitted That Met QC Criteria: April 25, 2011
• Last Verified: April 1, 2011

More Information

Terms related to this study

• Keywords: GERD; heartburn; sleep disturbance; Non-Erosive Gastroesophageal Reflux Disease; nocturnal Reflux
• Additional Relevant MeSH Terms: Digestive System Diseases; Signs and Symptoms, Digestive; Gastrointestinal Diseases; Stomach Diseases; Gastroenteritis; Intestinal Diseases; Esophageal Motility Disorders; Deglutition Disorders; Esophageal Diseases; Esophagitis; Peptic Ulcer; Duodenal Diseases; Gastroesophageal Reflux; Esophagitis, Peptic; Heartburn; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Gastrointestinal Agents; Anti-Ulcer Agents; Proton Pump Inhibitors; Dexlansoprazole; Lansoprazole
• Other Study ID Numbers: T-GD07-170; U1111-1113-9537 (Registry Identifier: WHO)