- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04918017
Treatment Outcomes For Functional Dyspepsia Based On Current International Guidelines In Multi-Ethnic Asian Patients
Functional dyspepsia (FD) is among the most established and common functional gastrointestinal disorders (FGIDs). FD is subdivided into two subtypes based on symptoms: epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS).
Based on international guidelines (Asian Consensus and Rome Consensus), a prokinetic, medication which promotes gut movement (such as Itopride) should be the 1st line treatment for the PDS sub-type and a proton pump inhibitor, medication which reduces stomach acid production (such as Esomeprazole) should be the 1st line treatment for the EPS sub-type.
However, in the routine practice in Malaysia, proton pump inhibitor is still commonly used as 1st line treatment for FD, regardless of subtypes. This may be one of the reasons why FD continues to be inadequately treated locally and causes poor health-related quality of life (QOL) in FD patients.
The purpose of this study is to compare the clinical symptoms and quality of life improvement in patients with functional dyspepsia (FD) after treatment according to international guidelines versus treatment according to routine practice. Adverse effects when managed according to guidelines versus routine practice will also be evaluated.
Study Overview
Status
Conditions
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Kee-Huat Chuah, MBBS
- Phone Number: +60379492965
- Email: chuah319@yahoo.com
Study Locations
-
-
-
Kuala Lumpur, Malaysia
- Recruiting
- University Malaya Medical Centre
-
Contact:
- Kee Huat Chuah, MBBS
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients diagnosed with Functional Dyspepsia using Rome IV diagnostic criteria: patients on prior dyspepsia treatment can be recruited after washout period of 2 weeks
- Subject who has ability to provide written informed consent and willingness to comply with the requirement of the protocol
- Able to communicate in English, Malay or Mandarin languages
Exclusion Criteria:
- Patients with known hypersensitivity to Itopride and/or proton pump inhibitors or to any of the excipients of the study medication
- Patients with a contraindication to any of the study drugs
- Pregnant / breast feeding women
- Presence of family history of GI malignancy or alarm features suggested malignancy - e.g. Unintentional weight loss (≥ 10% of body weight in recent 6 months), GI bleeding
- Patients consuming regular Aspirin or NSAIDs (except low-dose Aspirin at a dose of 325 mg/day or less for cardiovascular prophylaxis)
- History of erosive esophagitis, peptic ulcer disease within 1 year prior to the screening
- History of gastrointestinal (GI) malignancy, primary esophageal motility disorder, documented upper GI surgery
- Patients with any hepatobiliary or pancreatic diseases
- Patients with severe depression, anxiety, or other psychological disorder
- Patients with any terminal disease
- Presence of irritable bowel syndrome (Rome IV criteria) or inflammatory bowel disease (IBD)
- Other conditions determined by the investigator to be inappropriate for this clinical study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment based on subtypes: Epigastric Pain Syndrome (EPS)
EPS: treat with esomeprazole 40mg OD (proton pump inhibitor)
|
Esomeprazole 40mg OD for EPS and Itopride 50mg TDS for PDS In overlapped EPS/ PDS: treat with Itopride 50mg TDS first and then add Esomeprazole 40mg OD (if partially responded- assessed at week 4) or treat with Itopride 50mg TDS first and then change to Esomeprazole 40mg OD (if not responded- assessed at week 4) |
Experimental: Treatment based on subtypes: Post Prandial Distress Syndrome (PDS)
PDS: treat with itopride 50mg TDS (prokinetic)
|
Esomeprazole 40mg OD for EPS and Itopride 50mg TDS for PDS In overlapped EPS/ PDS: treat with Itopride 50mg TDS first and then add Esomeprazole 40mg OD (if partially responded- assessed at week 4) or treat with Itopride 50mg TDS first and then change to Esomeprazole 40mg OD (if not responded- assessed at week 4) |
Experimental: Treatment based on subtypes: Overlapped EPS/ PDS
Overlapped EPS/PDS: treat with itopride 50mg TDS first and add esomeprazole 40mg OD (if partially responded) or change to esomeprazole 40mg OD (if not responded)
|
Esomeprazole 40mg OD for EPS and Itopride 50mg TDS for PDS In overlapped EPS/ PDS: treat with Itopride 50mg TDS first and then add Esomeprazole 40mg OD (if partially responded- assessed at week 4) or treat with Itopride 50mg TDS first and then change to Esomeprazole 40mg OD (if not responded- assessed at week 4) |
Active Comparator: Treatment with Proton Pump Inhibitor regardless of subtype
Treat with esomeprazole 40mg OD (proton pump inhibitor) regardless of subtype of functional dyspepsia
|
Esomeprazole 40mg OD
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Global symptom change in patients with FD when managed according to guidelines, compare to routine practice
Time Frame: 8 weeks
|
Assessment of global symptom change using 'Overall Treatment Effect' (OTE) questionnaire from baseline to 8 weeks of treatment. Patients who were 'extremely improved' or 'improved' on the OTE scale are considered responders. This will be compared with intervention arm and routine practice arm. |
8 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Individual upper gastrointestinal (UGI) symptoms change
Time Frame: 8 weeks
|
Change in individual upper gastrointestinal (UGI) symptoms (total 9 symptoms). Patients will be assessed on nine UGI symptoms (upper abdominal pain, upper abdominal discomfort, postprandial fullness, upper abdominal bloating, early satiety, excessive belching, nausea, vomiting and heartburn) and they will rate each symptom on a severity scale of 0-3 (none, mild, moderate and severe). On assessment of individual symptoms, patients who have a decrease in symptom severity of ≥50% from baseline are considered responders. Nine individual symptoms are evaluated and compared between intervention and routine practice group. |
8 weeks
|
Change of quality of life
Time Frame: 8 weeks
|
The change in Health-Related Quality of Life (HRQOL) score based on Short Form-Napean Dyspepsia Index Questionnaire (SF-NDI). It is a 10-item questionnaire with 5 sub-scales each examining the influence of dyspepsia on domains of health in patients, namely tension/anxiety, interference with daily activities, disruption to regular eating/drinking, knowledge towards/control over disease symptoms and interference with work/study, with each sub-scale containing two items [10]. Each item is measured by a 5-point Likert scale ranging from 0 (not at all or not applicable), 1 (a little), 2 (moderately), 3 (quite a lot) to 4 (extremely). Individual items in each sub-scale are aggregated to obtain a score range from 0 (lowest HRQoL score) to 100 (highest HRQoL score) as per the developers' original calculation formula. A total, overall SF-NDI total score is obtained using the mean of 5 subscale scores. |
8 weeks
|
Incidence of Adverse effects
Time Frame: 12 weeks
|
Incidence of adverse events of treatment will be assessed.
|
12 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Kee-Huat Chuah, University Malaya
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 12345676
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Functional Dyspepsia
-
King Chulalongkorn Memorial HospitalRecruiting
-
Wuhan Central HospitalNot yet recruiting
-
Dong-A ST Co., Ltd.Not yet recruitingFunctional DyspepsiaKorea, Republic of
-
Universitaire Ziekenhuizen KU LeuvenRecruiting
-
Universitaire Ziekenhuizen KU LeuvenRecruiting
-
Zeria PharmaceuticalRecruitingFunctional DyspepsiaJapan
-
Hong Kong Baptist UniversityXiyuan Hospital of China Academy of Chinese Medical SciencesRecruitingFunctional DyspepsiaHong Kong
-
Seoul National University HospitalCompletedFunctional DyspepsiaKorea, Republic of
-
Wonju Severance Christian HospitalCompletedFunctional DyspepsiaKorea, Republic of
-
Daewoong Pharmaceutical Co. LTD.CompletedFunctional DyspepsiaKorea, Republic of
Clinical Trials on Treatment based on subtypes: Esomeprazole or Itopride
-
Fondazione Policlinico Universitario Agostino Gemelli...Fundacion Clinic per a la Recerca Biomédica; Newcastle University; University...RecruitingRheumatoid ArthritisItaly, Spain, United Kingdom
-
Medical University of ViennaCompleted
-
Scottsdale HealthcareTranslational Genomics Research InstituteCompleted
-
M.D. Anderson Cancer CenterEuropean CommissionCompletedAdvanced CancersUnited States, Spain, France, Israel
-
Göteborg UniversitySahlgrenska University Hospital, SwedenCompletedArthritis, Rheumatoid | Inflammatory Response | Diet, Healthy | Dietary ExposureSweden
-
Hospital Nacional de Parapléjicos de ToledoCompletedSpinal Cord Injury CervicalSpain
-
Nagaoka Red Cross HospitalCompletedHypertension | Type 2 Diabetes
-
Hadassah Medical OrganizationWithdrawn
-
Nagaoka Red Cross HospitalUnknownType 2 Diabetes Mellitus | Blood PressureJapan
-
Le WangCompletedDeglutition Disorders | Lateral Medullary SyndromeChina