Comparison of Ulcer Healing in Patients Taking Rabeprazole With Different Antiplatelets
Recruitment status was Recruiting
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Purpose
Clopidogrel causes significantly less peptic ulcer disease (PUD) and ulcer bleeding than low-dose aspirin in general population. However, clopidogrel is not safe enough for gastrointestinal (GI) mucosa in patients who had past history of aspirin-associated ulcer or ulcer bleeding. Aspirin plus proton pump inhibitor (PPI) is superior to clopidogrel alone in preventing recurrent ulcer bleeding in these high risk patients.
This study is to compare the ulcer healing rate and ulcer bleeding at 12 weeks in patients with aspirin-associated PUD when they take PPI (rabeprazole 20 mg/day) to treat their PUD and simultaneously take aspirin or clopidogrel for their cardiovascular (CV) prevention. Two hundred patients will be randomly assigned rabeprazole (20 mg/day) plus aspirin (100 mg/day) or rabeprazole (20 mg/day) plus clopidogrel (75 mg/day) for 12 weeks. The primary end point is treatment success (ulcer healing rate). The secondary end point is incidence of ulcer bleeding within 12 weeks.
If rabeprazole plus aspirin in not inferior to rabeprazole plus clopidogrel in the incidence of ulcer healing and ulcer bleeding in the healing phase,PPI plus aspirin rather than PPI plus clopidogrel will be recommended during acute ulcer healing in patients who need antiplatelet therapy for their CV prevention.
| Condition | Intervention |
|---|---|
|
Gastric Ulcer Duodenal Ulcer |
Drug: rabeprazole plus aspirin versus rabeprazole plus clopidogrel |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Comparison of Ulcer Healing in Patients Taking Rabeprazole Plus Aspirin Versus Rabeprazole Plus Clopidogrel for Acute Peptic Ulcer |
- The primary end point is treatment success (ulcer healing rate). [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
- The secondary end point is incidence of ulcer bleeding within 12 weeks. [ Time Frame: 3 months ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 200 |
| Study Start Date: | October 2009 |
| Estimated Study Completion Date: | December 2010 |
| Estimated Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: aspirin
Patients who have taken aspirin for more than 1 month and are found to have PUD by upper endoscopy will receive PPI (rabeprazole 20 mg once daily) to treat their PUD.patients will be randomly assigned rabeprazole (20 mg/day) plus aspirin (100 mg/day) or rabeprazole (20 mg/day) plus clopidogrel (75 mg/day) for 12 weeks.
|
Drug: rabeprazole plus aspirin versus rabeprazole plus clopidogrel
The primary end point is treatment success (ulcer healing rate). The secondary end point is incidence of ulcer bleeding within 12 weeks.
|
|
Active Comparator: clopidogrel
Patients who have taken aspirin for more than 1 month and are found to have PUD by upper endoscopy will receive PPI (rabeprazole 20 mg once daily) to treat their PUD.patients will be randomly assigned rabeprazole (20 mg/day) plus aspirin (100 mg/day) or rabeprazole (20 mg/day) plus clopidogrel (75 mg/day) for 12 weeks.
|
Drug: rabeprazole plus aspirin versus rabeprazole plus clopidogrel
The primary end point is treatment success (ulcer healing rate). The secondary end point is incidence of ulcer bleeding within 12 weeks.
|
Eligibility| Ages Eligible for Study: | 18 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients who have taken aspirin for more than 1 month and are found to have PUD by upper endoscopy will receive PPI (rabeprazole 20 mg once daily) to treat their PUD. PUD in the upper gastrointestinal (UGI) tract is defined as
- [1] mucosal break of stomach or duodenum > 3 mm in diameter; or
- [2] more than 10 gastric or duodenal erosions, without malignancy proved by histopathological examination.
Exclusion Criteria:
- Patients will be excluded if they have PUD with bleeding (ulcer with adherent blood clot, visible vessel, oozing, or spurting) requiring endoscopic hemostasis,
- if they take other antithrombotic or anticoagulants simultaneously, if they have take NSAIDs, selective COX-2 inhibitors, or steroid,
- if they have take misoprostol or histamine receptor-2 antagonist (H2RA),
- if they have bleeding tendency (thrombocytopenia with platelet count < 80000/mm3 or prolonged pro thrombin time > 5 seconds),
- if they have anemia (hemoglobin < 10 g/dL),
- if they have received a surgical intervention due to PUD complication (bleeding, perforation, obstruction) in the past,
- if their age are > 80 year-old or < 18 year-old,
- if they have severe cardiovascular, pulmonary, hepatic, or renal disease.
Contacts and Locations| Contact: Jiing-Chyuan Luo, M.D. | 886-2-28712121 ext 3346 | jcluo@vghtpe.gov.tw |
| Taiwan | |
| Taipei Veterans General Hospital | Recruiting |
| Taipei, Taiwan, 11217 | |
| Contact: Jiing-Chyuan Luo, M.D. 886-2-28712121 ext 3346 jcluo@vghtpe.gov.tw | |
| Principal Investigator: Jiing-Chyuan Luo, M.D. | |
More Information
No publications provided
| Responsible Party: | Fang-Yue Lin, Superintendent, Taipei Veterans General Hospital |
| ClinicalTrials.gov Identifier: | NCT01037491 History of Changes |
| Other Study ID Numbers: | VGH97-10-04 |
| Study First Received: | December 21, 2009 |
| Last Updated: | June 6, 2010 |
| Health Authority: | Taiwan: Department of Health |
Keywords provided by Taipei Veterans General Hospital,Taiwan:
|
aspirin, clopidogrel, peptic ulcer, proton pump inhibitor, rabeprazole, ulcer bleeding |
Additional relevant MeSH terms:
|
Duodenal Ulcer Peptic Ulcer Stomach Ulcer Ulcer Duodenal Diseases Intestinal Diseases Gastrointestinal Diseases Digestive System Diseases Stomach Diseases Pathologic Processes Aspirin Ticlopidine Clopidogrel Rabeprazole Anti-Inflammatory Agents, Non-Steroidal |
Analgesics, Non-Narcotic Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Anti-Inflammatory Agents Therapeutic Uses Antirheumatic Agents Fibrinolytic Agents Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Cardiovascular Agents Hematologic Agents Platelet Aggregation Inhibitors |
ClinicalTrials.gov processed this record on May 19, 2013