Reflux Esophagitis
Conditions
Keywords
Reflux Esophagitis, X842, Population Pharmacokinetics, PopPK, Lansoprazole
Brief summary
To evaluate the efficacy and safety of X842 Capsules 50 mg compared to Lansoprazole Enteric Capsules for the treatment of reflux esophagitis, and to characterize the population pharmacokinetics of X842 capsules in this patient population.
Detailed description
This study uses a multicenter, randomized, double-blind, double-dummy, active-controlled parallel-group, non-inferiority design to compare the efficacy and safety of X842 capsules (50 mg) in the treatment of reflux esophagitis over 4 to 8 weeks in comparison with lansoprazole enteric-coated capsules(30 mg) . Additionally, the population pharmacokinetics characteristics of X842 capsules in patients with reflux esophagitis is observed.
Interventions
DRUGX842
X842 capsules
DRUGX842 Placebo
X842 placebo-matching capsules
DRUGLansoprazole
Lansoprazole capsules
Lansoprazole placebo-matching capsules
Sponsors
Jiangsu Sinorda Biomedicine Co., Ltd
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
This trial uses a double-blind double-dummy design, where the investigator, the subject and the other parties involved in the trial are blinded to the drug given to the subject. X842 capsules (test group)and and placebo, lansoprazole enteric-coated capsules (control group)and placebo, are provided by Jiangsu Sinorda Biomedicine Co., Ltd. The physical appearance, shape, specification and dosage of the test drug and comparator as well as the placebo are generally similar.
Intervention model description
After completing the relevant laboratory tests and endoscopic examinations at screening, subjects who meet the inclusion criteria and do not meet the exclusion criteria are randomly under blinding at a 3:1 ratio assigned to test group(X842 Capsule)and control group ( Lansoprazole enteric-coated Capsules) for for 4-week treatment and then receive endoscopy. If endoscopy shows healed esophagitis, treatment will be discontinued; if esophagitis remains unhealed, treatment continues for an additional 4 weeks. The minimum treatment duration with either test or control drug is 4 weeks, and the maximum is 8 weeks in this study.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Males or females, 18 years ≤ age ≤ 75 years; 2. Within 7 days prior to randomization, the subjects are endoscopically diagnosed with reflux esophagitis from Los Angeles (LA) grade A to D (notes: the percent of the subjects with LA grade A of RE should be no more than 20% of the all subjects who are planned to be enrolled in the study); 3. Subjects who can independently complete the subject diary cards; 4. Subjects fully understand the trial contents, participate in the trial voluntarily, and sign the informed consent forms.
Exclusion criteria
1. Subjects who receive X842 capsules or other P-CAB drugs in previous clinical studies; 2. Subjects known to be allergic to X842 capsules or lansoprazole enteric-coated capsules, or relevant excipients of X842 capsules or lansoprazole enteric-coated capsules, such as lactose, microcrystalline cellulose, croscarmellose sodium, sodium dodecyl sulfate, sodium stearyl fumarate, and silicon dioxide; 3. Subjects unable to receive upper gastrointestinal endoscopy; 4. Endoscopic examination revealed concomitant diseases potentially affecting the esophagus, excluding hiatal hernia, and excluding Barrett's esophagus with metaplastic columnar epithelium that either does not involve the entire esophageal circumference or is short-segment (\< 3 cm in length). 5. Patients with rheumatic/autoimmune diseases potentially affecting esophageal motility (e.g., scleroderma, undifferentiated connective tissue disease), or those with a history of esophageal radiotherapy or cryotherapy; 6. Subjects who have acute upper gastrointestinal hemorrhage within 4 weeks prior to enrollment; 7. Subjects with active peptic ulcer discovered during upper gastrointestinal endoscopy, or subjects with suspicious or definite malignancies; 8. Subjects known to have Zollinger-Ellison syndrome or inflammatory bowel disease (IBD); 9. Subjects with history of surgery affecting the structure or function of the esophagus, stomach, or duodenum, or surgery altering gastric acid secretion. 10. Subjects who plan to undergo surgical procedures during the study period that may alter gastric acid secretion (e.g., abdominal surgery, vagotomy, or craniectomy). 11. Subjects with a history of malignancies within 5 years prior to screening (a subject can participate in the study if his /her skin basal cell carcinoma or carcinoma in situ of uterine cervix has been cured); 12. Subjects with concomitant serious diseases of central nervous system, cardiovascular system, respiratory system, liver, kidney, gastrointestinal tract, urinary system, endocrine system, or hematological system, and the investigator thinks these diseases may mix the study results up or affect the safety of the subject; 13. Laboratory test results at screening showing that ALT or AST is larger than 1.5 times of the upper limit of normal, or kidney function index Cr is larger than the upper limit of normal (a re-examination is permitted in the study, and subjects will be excluded if they still fail to meet the inclusion criteria); 14. Subjects who use of therapeutic doses of GERD medications within 7 days prior to randomization, eg. proton pump inhibitors (PPIs), P-CABs, histamine2 receptor antagonists (H2RAs), or gastric mucosal protectors (except hydrotalcite), prokinetic drugs, and traditional Chinese medicines; 15. Subjects who chronically use non-steroidal anti-inflammatory drug (including cyclooxygenase-2 inhibitor), anti-platelet drug (such as aspirin and clopidogrel), or anticoagulant (such as Warfarin) prior to randomization, and can not stop the medication during the trial; 16. At screening, subjects with clinically significant ECG abnormalities, including serious arrhythmia, multifocal ventricular premature complexes, grade II or above atrioventricular block, and prolongation of the Q-Tc interval (QTc≥450 ms in males and QTc≥470 ms in females); 17. Subjects who are using atazanavir sulfate or ripivirin hydrochloride at screening; 18. Subjects with a history of long-term abuse of drug or alcohol within 6 months prior to screening; 19. Female subjects with known pregnancy, those in breast-feeding period, or those who are planned to become pregnant during the trial. At the investigator's discretion, women of childbearing age who cannot use a medically-proven and reliable method of contraception from signing the informed consent forms to 4 weeks after the last dose of the study; 20. Subjects who participate in other drug/medical device clinical studies and use the drug/medical device within 3 months prior to randomization; 21. Subjects who are considered unsuitable for participating in this trial by investigators.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of Subjects Whose Reflux Esophagitis is Cured as Confirmed by Endoscopy at Week 8 | 8 weeks | Healing of reflux esophagitis is defined as endoscopic confirmation of resolved esophagitis (absence of esophageal mucosal breaks) in subjects. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of Subjects Whose Reflux Esophagitis is Cured as Confirmed by Endoscopy at Week 4 | 4 weeks | Healing of reflux esophagitis is defined as endoscopic confirmation of resolved esophagitis (absence of esophageal mucosal breaks) in subjects. |
| Improvement rate in the frequency and severity of individual clinical symptoms (heartburn, regurgitation) of reflux esophagitis at Weeks 2, 4, and 8 after treatment initiation. | 2,4,8 weeks | Improvement in the frequency of clinical symptom occurrence: Defined as subjects whose symptom frequency score before treatment was ≥1 point had a reduction of ≥1 point after treatment compared to before treatment. Improvement in the severity of clinical symptoms: Defined as a reduction of ≥1 point in the symptom severity score of subjects with a score of ≥1 point before treatment after treatment compared to before treatment. |
| Response rates for individual symptom domains (heartburn, regurgitation) in reflux esophagitis at Weeks 2, 4, and 8 post-baseline. | 2.4.8 weeks | Resolution of individual clinical symptoms: defined as the achievement of score 0 in both severity and frequency for symptoms with baseline scores ≥1. |
| Overall symptomatic resolution rate for reflux esophagitis at Weeks 2, 4, and 8 | 2,4,8 weeks | Overall Clinical Symptom Resolution: Defined as the achievement of a score of 0 (i.e., complete disappearance) for all symptoms of reflux esophagitis in subjects with any individual symptom score ≥1 at baseline. |
| Change in serum gastrin levels from baseline at Weeks 4 and 8 of treatment | 4, 8 weeks | Serum gastrin testing will be conducted at the central laboratory. The change between the serum gastrin values collected at Weeks 4 and 8 relative to baseline. |
| Vital signs | up to 8 weeks | Blood pressure, respiration, heart rate and body temperature were evaluated at each visit during the screening period and the double-blind treatment period |
| Number of Subjects With Markedly Abnormal Clinical Laboratory assessment of blood serum Number of Subjects With Markedly Abnormal Clinical Laboratory assessment of blood serum | up to 8 weeks | Number of subjects with any markedly abnormal values in laboratory tests of blood serum collected throughout study is reported. |
| Number of Subjects With Markedly Abnormal Clinical Laboratory assessment of blood | up to 8 weeks | Number of subjects with any markedly abnormal values in laboratory tests of blood collected throughout study is reported. |
| Number of Subjects With Markedly Abnormal Clinical Laboratory assessment of urine | up to 8 weeks | Number of subjects with any markedly abnormal values in laboratory tests of urine collected throughout study is reported.collected throughout study is reported. |
| Number of Subjects With Markedly Abnormal Electrocardiogram (ECG) Findings | up to 8 weeks | The investigator or the sub-investigator interpreted the ECG using one of the following categories: within normal limits, abnormal but not clinically significant, or abnormal and clinically significant |
| Pharmacokinetic evaluation | up to 8 weeks | Quantification of plasma concentrations of X842 and its metabolites to characterize the population pharmacokinetic profile of X842 capsules in GERD patients. |
| Number of Subjects Reporting Who Had One or More Treatment-emergent Adverse Event (TEAE) | up to 8 weeks | Adverse event is defined as any adverse medical event that is observed in a subject who is receiving a drug treatment or in a clinical study, and that does not necessarily have a causal relationship with the treatment. |
Countries
China
Outcome results
None listed