- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02923856
A Multi-center Study for Eradication of Helicobacter Pylori With Triple Therapy Using Clarithromycin
February 16, 2019 updated by: Hongzhang Li, Sanmen People's Hospital
A Multi-center Study for Eradication of Helicobacter Pylori With Triple Therapy Based on Accurate Susceptibility Testing of Clarithromycin
As the resistant rate of the Helicobacter pylori to some common antibiotics was rising,the eradication rate of the Helicobacter pylori with the standard triple therapy failed to exceed 70% in China,and had to drop out of the first-line treatment recommendations.
However, with the increase of treatment time, patients burden, adverse reactions of antibiotics or proton pump inhibitor (PPI) will also increase.
Resistance to clarithromycin is the major cause of the failure to eradicate Helicobacter pylori.
But, in terms of population, there are still more than 70% of the patients with clarithromycin sensitive.
Under the guidance with susceptibility test,7-day standard triple therapy could be used.
In this study, investigators will select the patients with infection of H. pylori and with clarithromycin sensitive.
Eradication of Helicobacter pylori with triple therapy based on accurate susceptibility testing of clarithromycin will be studied.
The treatment time will be assigned into 7 days,10 days and 14 days groups.
Then, investigators will perform a sequencing for failed treatment patients in groups, such as drug resistance gene mutation, phenotype and genotype.
Finally, investigators will compare the differences between the patients with triple therapy and traditional quadruple therapy.The incidence of adverse effects in the eradicate treatment will reduce at least 10% and avoid patients' unnecessary economic losses at least 400RMB per person.
Study Overview
Status
Unknown
Conditions
Study Type
Interventional
Enrollment (Anticipated)
672
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: zhang hong Li, doctor
- Email: smyylhz@163.com
Study Locations
-
-
Zhejiang
-
Taizhou, Zhejiang, China, 317199
- Recruiting
- Sanmen People's Hospital
-
Contact:
- zhang hong Li, doctor
- Email: smyylhz@163.com
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 70 years (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 18~70 years old, male or female, the first eradication therapy of H. pylori infection patients.
- Symptoms of abdominal pain, bloating, acid efflux, belching, nausea, vomiting, heartburn, chest pain, vomiting, melena, etc.
- Unused antibiotics, bismuth, H2 receptor antagonists or PPI by nearly 4 weeks
- 13C-labelled urea breath test positive.
- Agreed to Helicobacter pylori culture and sensitivity testing taken by endoscopy gastric biopsy specimens,and the result of culture was positive.
- Agreed to Helicobacter pylori eradication therapy and cooperate with the eradication efficacy follow-up survey.
Exclusion Criteria:
- Severe heart, liver, kidney dysfunction.
- Pregnant or lactating women.
- Complications of bleeding, perforation, pyloric obstruction, cancer.
- Within 3 months before with the drugs involved in other drugs research.
- Esophageal,gastrointestinal surgery history.
- Patients can not properly express their complaints,such as psychosis, severe neurosis.
- Taking NSIAD or alcohol abusers.
- Allergic to amoxicillin or clarithromycin tested by susceptibility testing.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Clarithromycin resistance group
Patients who are resistant to clarithromycin in susceptibility test were classified into clarithromycin resistance group.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
|
Experimental: 7 days Successful treatment
The successful treatment of H. pylori group were treatment successful patients after the 7days standardized treatment.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
The patients with clarithromycin sensitive.
Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.
The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients.
All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.
|
Experimental: 7 days failed treatment
The failed treatment of H. pylori group were treatment failure patients after the 7days standardized treatment.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
The patients with clarithromycin sensitive.
Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.
The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients.
All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.
|
Experimental: 10 days Successful treatment
The successful treatment of H. pylori group were treatment successful patients after the 10days standardized treatment.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
The patients with clarithromycin sensitive.
Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.
The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients.
All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.
|
Experimental: 10 days failed treatment
The failed treatment of H. pylori group were treatment failure patients after the 10days standardized treatment.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
The patients with clarithromycin sensitive.
Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.
The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients.
All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.
|
Experimental: 14 days Successful treatment
The successful treatment of H. pylori group were treatment successful patients after the 14days standardized treatment.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
The patients with clarithromycin sensitive.
Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.
The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients.
All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.
|
Experimental: 14 days failed treatment
The failed treatment of H. pylori group were treatment failure patients after the 14days standardized treatment.
|
According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.
The patients with clarithromycin sensitive.
Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.
The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients.
All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The accurate determination of clarithromycin susceptibility.
Time Frame: 2 years
|
Assess bacterial susceptibility to antibiotics using the agar diffusion method.
The Resistance point of clarithromycin was divided into 0.125μg/ml,0.25μg/ml,0.5μg/ml and 1μg/ml.Test clarithromycin resistance of Helicobacter pylori for patients.
|
2 years
|
Establish individualized precision triple therapy based on minimal inhibitory concentration.
Time Frame: 2.5 years
|
Based on the clarithromycin accurate susceptibility,pinpoint different courses of triple treatment therapy targeted to different people based on minimal inhibitory concentration of clarithromycin.
|
2.5 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The incidence of adverse effects
Time Frame: 3 years
|
Drugs targeted, it could reduce the intake of antibiotics for patients.The incidence of adverse effects in the eradicate treatment will reduce.
Avoid patients' unnecessary economic losses.
|
3 years
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Impact of mixed infection and CYP2C19 genotype on eradication rate for Helicobacter pylori with triple therapy using clarithromycin.
Time Frame: 3 years
|
Investigators will perform a sequencing for failed treatment patients in groups, such as drug resistance gene mutation,and CYP2C19 genotype.
Evaluating the impact of mixed infection and CYP2C19 genotype on eradication rate for Helicobacter pylori with triple therapy.
|
3 years
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
January 1, 2017
Primary Completion (Anticipated)
December 1, 2019
Study Completion (Anticipated)
December 1, 2019
Study Registration Dates
First Submitted
August 23, 2016
First Submitted That Met QC Criteria
October 4, 2016
First Posted (Estimate)
October 5, 2016
Study Record Updates
Last Update Posted (Actual)
February 19, 2019
Last Update Submitted That Met QC Criteria
February 16, 2019
Last Verified
August 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Gastrointestinal Diseases
- Stomach Diseases
- Gastroenteritis
- Gastritis
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Anti-Bacterial Agents
- Cytochrome P-450 CYP3A Inhibitors
- Cytochrome P-450 Enzyme Inhibitors
- Protein Synthesis Inhibitors
- Clarithromycin
Other Study ID Numbers
- SanmenPH
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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