Clinical Study Evaluating The Role of Vonoprazan Versus Pantoprazole in Patients With Gastroesophageal Reflux Disease

Last updated: December 4, 2024
Sponsor: Tanta University
Overall Status: Active - Recruiting

Phase

4

Condition

Heartburn

Stomach Discomfort

Heartburn (Pediatric)

Treatment

Vonoprazan 20 mg (vonseca) versus Pantoprazole 40 mg (Pantoloc)

Vonoprazan and placebo of pantoloc versus Pantoprazole 40 mg (Pantoloc) and placebo of vonseca

Vonoprazan 20 mg versus Pantoprazole 40 mg

Clinical Study ID

NCT06564246
PT(829)
  • Ages 17-60
  • All Genders

Study Summary

This study aims to investigate the possible efficacy of vonoprazan versus Pantoprazole in patients with gastroesophageal reflux disease.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age 17-60 years.

  • Both genders.

  • Patients with a score ≥ 8 on the Gastroesophageal Reflux Disease Questionnaire (GerdQ) are defined as having GERD and will enroll in this study and it will be done atbaseline and after 8 weeks.

Exclusion

Exclusion Criteria:

  • Subjects with history of gastrointestinal disease, gastroduodenal surgery,inflammatory bowel disease and Barrett's esophagus.

  • Subjects with an earlier or current history of Zollinger-Ellison syndrome, or othergastric acid hypersecretion disorders (gastric or duodenal ulcer).

  • Subjects with history of total/subtotal gastrectomy and esophageal achalasia.

  • Subjects with Corona virus disease (COVID19).

  • Subjects with major cardiological, respiratory, endocrine metabolic disease andneuro-psychological disease.

  • Pregnancy or lactation.

  • Subjects with total bilirubin level ≥ 1.2 mg/dl and ALT level > 100 IU/l.

  • Subjects with renal impairment (Crcl less than 30 ml/min).

  • Patients receiving atazanavir sulphate, nelfinavir and rilpivirine hydrochloride dueto potential drug interactions.

Study Design

Total Participants: 44
Treatment Group(s): 3
Primary Treatment: Vonoprazan 20 mg (vonseca) versus Pantoprazole 40 mg (Pantoloc)
Phase: 4
Study Start date:
September 18, 2024
Estimated Completion Date:
October 31, 2026

Study Description

Gastroesophageal reflux disease (GERD) occurs when stomach acid repeatedly flows back into the esophagus with or without histological changes. However, the excessive reflux of gastric acid induces some complications, such as esophagitis, esophageal stenosis, cancer or Barrett's esophagus. GERD is classified into two categories: nonerosive reflux disease (NERD) and erosive esophagitis. NERD is characterized by the presence of the typical symptoms of GERD without visible erosive esophagitis on endoscopy. Erosive esophagitis is characterized by injury to the esophageal mucosa on endoscopy. The major symptoms of GERD include heartburn, acid regurgitation and decrease the patient's quality of life (QOL). Therefore, improvement in the QOL of these patients by supplying rapid relief of symptoms is the primary objective of treatment.

For decades, proton pump inhibitors (PPIs) have been the mainstay of treatment for erosive esophagitis. Long-term maintenance therapy with PPIs is also recommended to keep healing in patients with more severe erosive esophagitis, given that recurrence occurs in nearly 100% of such patients without therapy. Furthermore, PPIs are restricted in their time of dosing. PPIs are prodrugs that are converted to their active form in the acidic environment of the secretory canaliculus, which is also the sole location of active proton pumps in the parietal cell. Thus, PPIs only inhibit active proton pumps. Given their limited duration of action (half-life nearly 1-2 hours), PPI are taken 30 to 60 minutes before a meal so their presence in the secretory canaliculus coincides with the postprandial peak in active proton pumps.

An alternative therapy for patients who may not respond to PPIs and that does not have the requirement for dosing around meals might be of utility. Such a potential alternative therapy is a potassium competitive acid blocker (PCAB), a new class of antisecretory agent that supplies more potent inhibition of gastric acid than PPI.

PCAB exhibits a more rapid onset of action than PPIs and achieves a maximum acid inhibitory effect on the 1st day after treatment, while PPIs require 3-5 days. However, few studies have examined whether the rapid onset of vonoprazan contributes to the clinical effects on the typical GERD symptoms of heartburn and acid regurgitation.

The previously mentioned findings highlight the need for further studies to evaluate the role of vonoprazan in patients with gastroesophageal reflux disease.

Aim of the Work The aim of this study is to investigate the possible efficacy of vonoprazan versus Pantoprazole in patients with gastroesophageal reflux disease.

Connect with a study center

  • Theodore Billiharz Institute for Researchs

    Giza,
    Egypt

    Active - Recruiting

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