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Internal reassessment of the medicinal product development strategy by Sponsor
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The main purpose of this study is to evaluate clinical efficacy of bismuth tripotassium dicitrate (De-Nol) in combination with pantoprazole versus pantoprazole monotherapy in subjects with NSAID-induced gastropathy in 14±2 days of treatment.
This study has a screening period (up to 3±2 days duration). Randomization will be held in each stratum (H. pylori-positive and H. pylori-negative) on the Visit 1. Treatment period will consist of 2 visits: Visit 2 (up to 14±2 days after Visit 1) in subjects with completely healed ulcer(s) and erosions after control esophagogastroduodenoscopy (EGDS) and Visit 3 (up to 28±2 days after Visit 1) in subjects with not healed ulcers and erosions after control EGDS on Visit 2. The period of follow-up safety assessments will last 1 week after the end of the study treatment
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| bismuth tripotassium dicitrate and pantoprazole | Experimental | Participants will receive bismuth tripotassium dicitrate (twice daily) and pantoprazole (once daily) as single tablets |
|
| pantoprazole | Active Comparator | Participants will receive pantoprazole (once daily) as single tablet |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bismuth tripotassium dicitrate | Drug | oral |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects in each group reaching complete healing of NSAID-induced gastropathy at week 2 of therapy | Modified Lanza score 0-2 (inclusively) shall be considered as healing. The modified Lanza scale is utilized to grade the degree of gastritis | Week 2 |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in H.pylori-negative subjects in each treatment group at week 2 | Modified Lanza scale 0-2 scores (inclusively) shall be considered as complete healing | Week 2 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in H.pylori-positive subjects in each treatment group at week 2 |
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Inclusion Criteria:
Verified diagnosis of NSAID-induced gastropathy:
Negative pregnancy test at screening and at Visit 1 (for females only using test strip to detect chorionic gonadotropin in urine),
Subjects' consent to use a reliable contraception method starting from screening throughout the whole study and for 1 week after its termination.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Monitor | Astellas Pharma Russian affiliate | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Site RU70001 | Moscow | Russia | ||||
| Site RU70008 |
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| pantoprazole | Drug | oral |
|
|
Modified Lanza scale 0-2 scores (inclusively) shall be considered as complete healing |
| Week 2 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in H.pylori-negative subjects in each treatment group at week 4 | Subjects reached complete healing of NSAID-induced gastric ulcers and erosions by Visit 2 shall also be analyzed | Week 4 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in H.pylori-positive subjects in each treatment group at week 4 | Subjects reached complete healing of NSAID-induced gastric ulcers and erosions by Visit 2 shall also be analyzed | Week 4 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in subjects with NSAID-induced gastropathy with modified Lanza scale greater than or equal to 5 and <7 at screening in each treatment group at week 2 | The modified Lanza scale is utilized to grade the degree of gastritis. Modified Lanza scale 0-2 scores (inclusively) shall be considered as complete healing | Week 2 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in subjects with NSAID-induced gastropathy with modified Lanza scale =7 at screening in each treatment group at week 2 | The modified Lanza scale is utilized to grade the degree of gastritis. Modified Lanza scale 0-2 scores (inclusively) shall be considered as complete healing | Week 2 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in subjects with NSAID-induced gastropathy with modified Lanza scale greater than or equal to 5 and <7 at screening in each treatment group at week 4 | The modified Lanza scale is utilized to grade the degree of gastritis. Modified Lanza scale 0-2 scores (inclusively) shall be considered as complete healing. Subjects reached complete healing of NSAID-induced gastric ulcers and erosions by Visit 2 shall also be analyzed | Week 4 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in subjects with NSAID-induced gastropathy with modified Lanza scale =7 at screening in each treatment group at week 4 | The modified Lanza scale is utilized to grade the degree of gastritis. Modified Lanza scale 0-2 scores (inclusively) shall be considered as complete healing. Subjects reached complete healing of NSAID-induced gastric ulcers and erosions by Visit 2 shall also be analyzed | Week 4 |
| Proportion of subjects reaching complete healing of NSAID-induced gastropathy in each treatment group at week 4 | Subjects reached complete healing of NSAID-induced gastric ulcers and erosions by Visit 2 shall also be analyzed | Week 4 |
| Changes in modified Lanza as compared to visit 1 (baseline) in H.pylori-negative subjects in each treatment group | The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in modified Lanza as compared to visit 1 (baseline) in H.pylori-positive subjects in each treatment group | The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in modified Lanza as compared to Visit 1 (baseline) in subjects with NSAID-induced gastropathy with modified Lanza scale greater than or equal to 5 and <7 at screening in each treatment group | The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in modified Lanza as compared to Visit 1 (baseline) in subjects with NSAID-induced gastropathy with modified Lanza scale =7 at screening in each treatment group | The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in modified Lanza as compared to visit 1 (baseline) in each treatment group | The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in GSRS as compared to visit 1 (baseline) in H.pylori-negative subjects in each treatment group | Gastrointestinal Symptom Rating Scale (GSRS). The GSRS contains a list of questions on subject's well-being within the period from subject's last visit to study site | Baseline, week 2 and week 4 |
| Changes in GSRS as compared to visit 1 (baseline) in H.pylori-positive subjects in each treatment group | Gastrointestinal Symptom Rating Scale (GSRS). The GSRS contains a list of questions on subject's well-being within the period from subject's last visit to study site | Baseline, week 2 and week 4 |
| Changes in GSRS as compared to Visit 1 (baseline) in subjects with NSAID-induced gastropathy with modified Lanza scale greater than or equal to 5 and <7 at screening in each treatment group | The GSRS contains a list of questions on subject's well-being within the period from subject's last visit to study site. The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in GSRS as compared to Visit 1 (baseline) in subjects with NSAID-induced gastropathy with modified Lanza scale =7 at screening in each treatment group | The GSRS contains a list of questions on subject's well-being within the period from subject's last visit to study site. The modified Lanza scale is utilized to grade the degree of gastritis | Baseline, week 2 and week 4 |
| Changes in GSRS as compared to visit 1 (baseline) in each treatment group | The GSRS contains a list of questions on subject's well-being within the period from subject's last visit to study site | Baseline, week 2 and week 4 |
| Safety assessed by nature, frequency and severity of Adverse Events (AEs) | An AE is defined as any untoward medical occurrence in a subject administered a study drug or has undergone study procedures and which does not necessarily have a causal relationship with this treatment | Up to day 35 |
| Safety assessed by nature, frequency and severity of Serious Adverse Events (SAEs) | Adverse event (AE) is considered "serious" if the investigator or sponsor view any of the following outcomes: Death, life-threatening, persistent or significant disability/incapacity, congenital anomaly or birth defect, hospitalization, or medically important events | Up to day 35 |
| Number of participants with Physical Exam abnormalities and/or adverse events related to treatment | Number of participants with potentially clinically significant physical exam values | Up to day 35 |
| Number of participants with vital signs abnormalities and/or adverse events related to treatment | Number of participants with potentially clinically significant vital sign values | Up to day 35 |
| Safety assessed through esophagogastroduodenoscopy | Amount of gastric content and its nature (mucus, bile, blood), gastric mucosa condition (edema, hyperemia, erosions, mucosal hemorrages, atrophy, hypertrophy) shall be evaluated during esophagogastroduodenoscopy | Up to day 35 |
| Number of participants with laboratory value abnormalities and/or adverse events related to treatment | Number of participants with potentially clinically significant laboratory values | Up to day 35 |
| Saint Petersburg |
| Russia |
| Site RU70012 | Saint Petersburg | Russia |
| Site RU70006 | Volgograd | Russia |
| Site RU70013 | Volgograd | Russia |
| ID | Term |
|---|---|
| C002791 | bismuth tripotassium dicitrate |
| D000077402 | Pantoprazole |
| ID | Term |
|---|---|
| D053799 | 2-Pyridinylmethylsulfinylbenzimidazoles |
| D013454 | Sulfoxides |
| D013457 | Sulfur Compounds |
| 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 |
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