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This study is to investigate the optimal clinical dose and administration methods of YH4808 in patients with reflux esophagitis by evaluating the safety and efficacy after YH4808 oral administration.
In the result of recent meta-analysis, there was no improvement in symptoms with the first administration of PPI in about 75% of GERD patients, and symptoms were still sustained in about 50% of patients after administration of more than 3 days. Especially the nocturnal secretion of gastric acid was not effectively inhibited, and about 25% of GERD patients could not achieve the proper therapeutic effects even after PPI treatment twice daily for 4-8 weeks.
YH4808, as a selective K+- competitive acid blocker (P-CAB), is no need for activation by gastric acid since it competitively inhibits proton pump with K+. Thus, the inhibition of gastric acid secretion by YH4808 is prompt and effective. In addition, the inhibitive effect of gastric acid secretion by stimulation of histamine is proved to be more powerful than PPI (esomeprazole) and sustained in in-vitro/in-vivo model, and 24-h inhibition of gastric acid secretion and especially nocturnal inhibition of gastric acid secretion was observed to be superior to esomeprazole with repeat doses for 7 days in healthy volunteers.
Based on these nonclinical and clinical outcomes, an exploratory phase-II clinical trial is to be conducted to determine the proper treatment dose and administration method of YH48084 for GERD patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| YH4808 A mg (Twice daily) | Experimental | YH4808 A mg (Twice daily, Oral administration) |
|
| YH4808 B mg (Once daily) | Experimental | YH4808 B mg (Once daily, Oral administration) |
|
| YH4808 B mg (Twice daily) | Experimental | YH4808 B mg (Twice daily, Oral administration) |
|
| YH4808 C mg (Once daily) | Experimental | YH4808 C mg (Once daily, Oral administration) |
|
| Esomeprazole 40mg (Once daily) | Active Comparator | Esomeprazole 40mg (Once daily, Oral administration) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Esomeprazole 40mg | Drug | 1 tablet = Esomeprazole 40 mg |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Healing of Reflux Esophagitis (RE) Who Were "Normal(including minimal change)" at Week 4 Out of Patients Who Were Graded "A, B, C or D" at Baseline According to Los Angeles Classification | Week 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Healing of Reflux Esophagitis (RE) Who Were "Normal(including minimal change)" at Week 8 Out of Patients Who Were Graded "A, B, C or D" at Baseline According to Los Angeles Classification | Week 8 | |
| Nocturnal Symptom Free Days & Symptom Free Days |
| Measure | Description | Time Frame |
|---|---|---|
| Nocturnal Symptom Free Days & Symptom Free Days | Follow-up period | |
| Sustained resolution of symptom | Follow-up period | |
| Symptom Score |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Myung Gyy Choi, M.D., Ph.D. | Catholic Univ. Seoul St. Mary Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul ST.MARY'S HOSPITAL | Seoul | 137-701 | South Korea |
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| ID | Term |
|---|---|
| D004942 | Esophagitis, Peptic |
| ID | Term |
|---|---|
| D004941 | Esophagitis |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| D064098 | Esomeprazole |
| ID | Term |
|---|---|
| D009853 | Omeprazole |
| D053799 | 2-Pyridinylmethylsulfinylbenzimidazoles |
| D013454 | Sulfoxides |
| D013457 | Sulfur Compounds |
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| YH4808 A mg | Drug | 1 tablet = YH4808 A mg |
|
|
| YH4808 B mg | Drug | 1 tablet = YH4808 B mg |
|
|
| YH4808 C mg | Drug | YH4808 C mg = 2 x YH4808 B mg |
|
|
| Treatment Period |
| Sustained resolution of symptom & Time to first sustained symptom resolution | Treatment Period |
| Symptom Score | Treatment Period |
| Serum Gastrin Level | Check at Baseline(Pre-dose), 2, 4, and 8 weeks. |
| Global Impression of Change (Patient, Investigator) | Check at 4, and 8 weeks. |
| Quality of Life | Check at Baseline(Pre-dose), 4, and 8 weeks. |
| Epworth Sleepiness Scale | Check at Baseline(Pre-dose), 2, 4, and 8 weeks. |
| Follow-up period |
| Healing Rate of Reflux Esophagitis by Baseline According to Los Angeles Classification(LA Grade A~D Subgroup Analysis) | Check at Baseline, Week 4 and Week 8 |
| Healing Rate of Reflux Esophagitis and Symptom related endpoints by H.pylori positive or negative | Treatement & Follow-up period |
| Adverse events, Physical examination results, ECG, Vital sign, Lab results | Treatment & Follow-up period |
| D005759 |
| Gastroenteritis |
| D010437 | Peptic Ulcer |
| D004378 | Duodenal Diseases |
| D007410 | Intestinal Diseases |
| D013272 | Stomach Diseases |
| D009930 |
| Organic Chemicals |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001562 | Benzimidazoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |