A phase 2, randomized, double-blind, double-dummy, positive drug parallel controlled, multicenter trial to evaluate efficacy and safety of within 8 weeks (including 8 weeks) treatment of Anaprazole 40mg QD, 60mg QD compared with Rabeprazole 20mg QD in patients with reflux esophagitis.
This is a multicenter, randomized, double-blind, double-dummy, active drug-parallel-controlled, phase 2 clinical study to evaluate the efficacy and safety of Anaprazole Sodium 40 mg QD and 60 mg QD versus Rabeprazole Sodium 20 mg QD in the treatment of reflux esophagitis in Chinese subjects with reflux esophagitis. The target population for this study was subjects with endoscopically confirmed reflux esophagitis. All potential participants will provide informed consent, and those who provide informed consent will enter the Screening Period (Day -7 to Day -1) and be assessed for screening eligibility according to the inclusion and exclusion criteria. The study is expected to enroll approximately 156 subjects with reflux esophagitis (LA classification grades A-D) who meet enrollment criteria (and none of the exclusion criteria), and eligible subjects will be randomized into 3 groups (Anaprazole Sodium 40 mg QD, 60 mg QD, and Rabeprazole Sodium 20 mg QD) in a 1:1: 1 ratio according to a predefined randomization table, with 52 subjects in each group. All subjects take the corresponding study drug within 30-60 minutes before breakfast for 4 or 8 consecutive weeks (subjects were followed up at Week 4 of treatment, and if the subject'endoscopy indicated that the reflux esophagitis was healed, the healed subject ended study treatment and entered safety follow-up. Subjects who were not cured were to continue treatment until 8 weeks if endoscopy at 4 weeks of treatment indicated that reflux esophagitis was not cured.). All subjects complete treatment at 4 or 8 weeks of treatment and were followed for safety. At the end of the study, statistical analysis will be performed on the efficacy and safety indicators of the study drug to compare the efficacy and safety of Anaprazole sodium and rabeprazole sodium in the treatment of reflux esophagitis. Participants will primarily be assessed for the cure rate of reflux esophagitis based on endoscopy of 3 groups. Participants' safety will be monitored throughout the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
156
Anaprazole sodium 2 tablets (20 mg/tablet) + Anaprazole sodium dummy tablets 1 tablet (20 mg/tablet) + Rabeprazole sodium dummy tablets 2 tablets (10 mg/tablet) orally once daily within 30-60 minutes before breakfast for 8 weeks (after 4 weeks of continuous treatment, if endoscopy shows reflux esophagitis is cured, treatment is discontinued, into the safety follow-up period).
Anaprazole sodium 3 tablets (20 mg/tablet) + Rabeprazole sodium dummy tablets 2 tablets (10 mg/tablet) orally once daily within 30-60 minutes before breakfast for 8 weeks (after 4 weeks of continuous treatment, if endoscopy shows reflux esophagitis is cured, treatment is discontinued, into the safety follow-up period).
Anaprazole sodium dummy tablets 3 tablets (20 mg/tablet) + Rabeprazole sodium 2 tablets (10 mg/tablet) orally once daily within 30-60 minutes before breakfast for 8 weeks (after 4 weeks of continuous treatment, if endoscopy shows reflux esophagitis is cured, treatment is discontinued, into the safety follow-up period).
Shanghai Changhai Hospital
Shanghai, Shanghai Municipality, China
The endoscopic healing rate of reflux esophagitis within 8 weeks (including 8 weeks)
The endoscopic ulcer healing rate is defined as the percentage of patients with reflux esophagitis healed evaluated by blinded independency central reading. Reflux esophagitis is evaluated by endoscopy as per LA Classification.
Time frame: Treatment of 4 weeks or 8 weeks
The rate of improvement in each individual symptom (daytime reflux)
The assessment of improvement of daytime reflux is evaluated in terms of severity and frequency. Mean severity scores are calculated for the first 7 days of the 4-week and 8-week visits, respectively. Mean score = sum of individual scores recorded over 7 days/number of days recorded. Complete response: mean score/score reduced to 0. Improvement:mean score/score reduced to 1. Ineffective: no change or increase in mean score/score. Complete response rate = number of complete response cases/total number of cases × 100%. Improvement rate = number of improved cases/total number of cases × 100%.
Time frame: Treatment of 4 weeks or 8 weeks
The rate of improvement in each individual symptom (daytime heartburn)
The assessment of improvement of daytime heartburn is evaluated in terms of severity and frequency. Mean severity scores are calculated for the first 7 days of the 4-week and 8-week visits, respectively. Mean score = sum of individual scores recorded over 7 days/number of days recorded. Complete response: mean score/score reduced to 0. Improvement:mean score/score reduced to 1. Ineffective: no change or increase in mean score/score. Complete response rate = number of complete response cases/total number of cases × 100%. Improvement rate = number of improved cases/total number of cases × 100%.
Time frame: Treatment of 4 weeks or 8 weeks
The rate of improvement in each individual symptom (nighttime reflux)
The assessment of improvement of nighttime reflux is evaluated in terms of severity and frequency. Mean severity scores are calculated for the first 7 days of the 4-week and 8-week visits, respectively. Mean score = sum of individual scores recorded over 7 days/number of days recorded. Complete response: mean score/score reduced to 0. Improvement:mean score/score reduced to 1. Ineffective: no change or increase in mean score/score. Complete response rate = number of complete response cases/total number of cases × 100%. Improvement rate = number of improved cases/total number of cases × 100%.
Time frame: Treatment of 4 weeks or 8 weeks
The rate of improvement in each individual symptom (nighttime heartburn)
The assessment of improvement of nighttime heartburn is evaluated in terms of severity and frequency of each of the four individual symptoms. Mean severity scores are calculated for the first 7 days of the 4-week and 8-week visits, respectively. Mean score = sum of individual scores recorded over 7 days/number of days recorded. Complete response: mean score/score reduced to 0. Improvement:mean score/score reduced to 1. Ineffective: no change or increase in mean score/score. Complete response rate = number of complete response cases/total number of cases × 100%. Improvement rate = number of improved cases/total number of cases × 100%.
Time frame: Treatment of 4 weeks or 8 weeks
Change From Baseline in gastroesophageal reflux disease health-related quality of life scale (GERD-HRQL) score
GERD related quality of life (QoL) is assessed with the "gastroesophageal reflux disease - health related quality of life" (GERD-HRQL) questionnaire. QoL is measured at baseline and at six months after treatment. The scale contains 10 questions and a symptom control satisfaction survey, which focuses on heartburn, acid reflux, swallowing function, and drug efficacy. Each question is scored according to a scoring criteria of 6 scores (0 indicates no symptoms, 5 indicates intolerable symptoms, and affects daily activities), and the total score is the sum of the scores of each item (0-50 points in total), with higher scores indicating worse quality of life. Satisfaction is divided into three levels: dissatisfaction, moderate, and satisfaction. Change in GERD-HRQL score = total GERD-HRQL score after treatment - total GERD-HRQL score before treatment.
Time frame: Treatment of 4 weeks or 8 weeks
Adverse events
Number of participants with treatment-related adverse events as assessed by CTCAE v5.0.
Time frame: Through study completion, an average of 1 year
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