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This is a double-blind, placebo-controlled, randomized, parallel trial to evaluate if rebamipide reduces the number of gastric events caused by naproxen. Sample size is 24 participants (12 per treatment group), male or female, aged 18 years-old and above.
Primary objective is to compare rebamipide effervescent granules 100 mg twice daily, plus naproxen (coated tablets) 550 mg twice daily to placebo plus naproxen 550 mg twice daily, for seven days, in reduction of gastric events caused by naproxen. Secondary objective is to evaluate safety and tolerability of rebamipide after multiple administrations.
Participants will receive either rebamipide + naproxen or placebo + naproxen, as above, during 7 consecutive days, which will be accompanied by a follow-up visit.
Gastric integrity will be assessed, before and after treatment, by endoscopy, with stomach biopsies and detection of H. pylori. Additionally, detection of occult blood in the stool will be performed, before and after treatment.
From the above-mentioned biopsies, dosage of prostaglandin E2 and histopathological analysis will be performed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rebamipide & Naproxen | Experimental | Rebamipide 100 mg effervescent granules (oral) Twice daily (total dose = 200 mg) for 7 days |
|
| Placebo & Naproxen | Placebo Comparator | Sugar pill manufactured to mimic Rebamipide 100 mg effervescent granules (oral) Twice daily for 7 days |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rebamipide effervescent granules | Drug | Rebamipide effervescent granules 100mg (oral), twice daily for 7 days |
|
| Measure | Description | Time Frame |
|---|---|---|
| Endoscopic Score - Cryer Score | Cryer score according to gastroduodenal mucosal injury: 0 = Normal or erythema
| 8 days |
| Endoscopic Score - Modified Lanza Score | Modified Lanza score according to gastroduodenal mucosal injury: 0 = No hemorrhage or erosion observed
| 8 days |
| Histopathological Score | Histopathologic grade score developed for microscopic injury evaluation 0 = Normal gastric mucosa or mild chronic inflammation
| 8 days |
| Intragastric pH | 8 days | |
| Presence of H. Pylori by Biopsy | Giemsa stain was used to diagnose H. pylori (positive = presence of H. pylori) | 8 days |
| Prostaglandin Level (PGE2 Quantification) |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Adverse Events | 60 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gilberto De Nucci, PhD | Galeno Desenvolvimento de Pesquisas Ltda. | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27259970 | Derived | Gagliano-Juca T, Moreno RA, Zaminelli T, Napolitano M, Magalhaes AF, Carvalhaes A, Trevisan MS, Wallace JL, De Nucci G. Rebamipide does not protect against naproxen-induced gastric damage: a randomized double-blind controlled trial. BMC Gastroenterol. 2016 Jun 4;16(1):58. doi: 10.1186/s12876-016-0472-x. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Rebamipide 200 mg | Rebamipide 100 mg effervescent granules (oral) Twice daily (total dose = 200 mg) Rebamipide effervescent granules Naproxen tablet |
| FG001 | Placebo | Placebo effervescent granules (oral) Twice daily Placebo effervescent granules Naproxen tablet |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Rebamipide 200 mg | Rebamipide 100 mg effervescent granules (oral) Twice daily (total dose = 200 mg) Rebamipide effervescent granules Naproxen tablet |
| BG001 | Placebo | Placebo effervescent granules (oral) Twice daily Placebo effervescent granules Naproxen tablet |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Endoscopic Score - Cryer Score | Cryer score according to gastroduodenal mucosal injury: 0 = Normal or erythema
| All recruited volunteers completed the trial. | Posted | Median | Full Range | Cryer score | 8 days |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Rebamipide 200 mg | Rebamipide 100 mg effervescent granules (oral) Twice daily (total dose = 200 mg) Rebamipide effervescent granules Naproxen tablet |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Addominal distress | Gastrointestinal disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gilberto De Nucci, PhD, principal investigator | Galeno Desenvolvimento de Pesquisas Ltda. | 55.19.32516928 | denucci@gilbertodenucci.com |
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| ID | Term |
|---|---|
| D009288 | Naproxen |
| ID | Term |
|---|---|
| D009280 | Naphthaleneacetic Acids |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
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| Placebo effervescent granules | Drug | Placebo effervescent granules (oral), twice daily for 7 days |
|
| Naproxen tablet | Drug | Naproxen tablet 550mg (tablet), twice daily for 7 days |
|
Tissue prostaglandin concentration quantified by enzyme-linked immunosorbent assay (ELISA) using Cayman Chemical Monoclonal Prostaglandin E2 EIA Kit (item number 514010) |
| 8 days |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Median | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| OG001 |
| Placebo & Naproxen |
Sugar pill manufactured to mimic Rebamipide 100 mg effervescent granules (oral) Twice daily for 7 days Placebo effervescent granules: Placebo effervescent granules (oral), twice daily for 7 days Naproxen tablet: Naproxen tablet 550mg (tablet), twice daily for 7 days |
|
|
| Primary | Endoscopic Score - Modified Lanza Score | Modified Lanza score according to gastroduodenal mucosal injury: 0 = No hemorrhage or erosion observed
| Posted | Median | Full Range | Modified Lanza score | 8 days |
|
|
|
| Primary | Histopathological Score | Histopathologic grade score developed for microscopic injury evaluation 0 = Normal gastric mucosa or mild chronic inflammation
| Posted | Median | Full Range | Histopathologic grade score | 8 days |
|
|
|
| Primary | Intragastric pH | Intragastric PH measurement was not performed and for this reason it will not be available. | Posted | 8 days |
|
|
| Primary | Presence of H. Pylori by Biopsy | Giemsa stain was used to diagnose H. pylori (positive = presence of H. pylori) | Posted | Number | participants | 8 days |
|
|
|
| Primary | Prostaglandin Level (PGE2 Quantification) | Tissue prostaglandin concentration quantified by enzyme-linked immunosorbent assay (ELISA) using Cayman Chemical Monoclonal Prostaglandin E2 EIA Kit (item number 514010) | Posted | Mean | 95% Confidence Interval | pg/mL (mean tissue PGE2 concentration) | 8 days |
|
|
|
| Secondary | Number of Adverse Events | Posted | Number | adverse events | 60 days |
|
|
|
| 0 |
| 12 |
| 3 |
| 12 |
| EG001 | Placebo | Placebo effervescent granules (oral) Twice daily Placebo effervescent granules Naproxen tablet | 0 | 12 | 3 | 12 |
| Abdominal pain | Gastrointestinal disorders |
|
| Heartburn | Gastrointestinal disorders |
|
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| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011083 | Polycyclic Compounds |