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TerminatedNCT01373970CLARIFYUpdated Dec 6, 2013

The Clinical Significance of Acid Rebound in Functional Dyspepsia

A Phase 4 interventional study of Placebo and Pantoprazole + Placebo in Functional Dyspepsia, sponsored by Zealand University Hospital. Terminated at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2013-12-06.

Sponsored by Zealand University Hospital · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
184
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Proton pump inhibitors (PPI) have been shown to cause acid reflux related symptoms at withdrawal in healthy volunteers, a phenomenon known as Rebound Acid Hyper Secretion. Whether this also applies for patients with dyspeptic symptoms but without true reflux disease (functional dyspepsia) treated with PPI is unknown. If this is the case, it could lead to an unfortunate long term use of PPI, since the acid rebound renders withdrawal too difficult.

This is a single centre, randomized, double-blinded, placebo-controlled cross over study. Study period is 12 weeks per study subject. Study subjects are referred to the study from General Practitioner (GP) and the gastroenterology department or endoscopy clinic of the investigational centre.

The study population consists of patients who seek their GP because of dyspepsia without alert signs, and whom the GP may consider starting on PPI. Out patients referred to the gastroenterology department or endoscopy clinic of the investigational centre because of dyspepsia without specific exclusion criteria are also invited to participate.

Baseline interview, upper endoscopy and pH monitoring are performed one week before inclusion to exclude patients with GERD. Helicobacter Pylori (Hp.) status is assessed by Helicobacter Urease Test (HUT). Hp. positive subjects without ulcus are not excluded.

Patients with a positive pH monitoring will not be included in the analysis regarding the primary endpoint (Development of GERD) but will be included in the analysis regarding one of the secondary endpoints (Effect of PPI on Functional Dyspepsia).

Study subjects are randomized to either pantoprazol followed by cross over to placebo or to placebo. Escape medication in the form of Gaviscon can be used on demand.

Internet based questionnaires are answered weekly. Questionnaires consist of the Gastrointestinal Symptom rating Scale (GSRS) in combination with items assessing postprandial fullness and items assessing the Montreal Criteria for Gastro Esophageal Reflux Disease (GERD).

Compliance to protocol is assessed at hospital visits every fourth week. At the end of study endoscopy and pH monitoring are repeated.

02

Conditions studied

  • Functional Dyspepsia

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Keywords

  • Functional Dyspepsia
  • Protonpump inhibitor
  • Rebound Acid HyperSecretion
03

In context

Dyspepsia

363 studies on the registry are indexed under Dyspepsia; 51 are open to participants now.

This study's enrollment of 184 is above the median of 87 across 297 interventional studies indexed under Dyspepsia.

Browse Dyspepsia studies →

Lead sponsor

Zealand University Hospital is the lead sponsor of 234 studies on the registry; 51 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Symptoms indicating dyspepsia, including:

    • Epigastric pain or epigastric discomfort
    • Bothersome postprandial fullness
    • Early satiation
    • Epigastric burning
  • Access to internet

Exclusion criteria

Exclusion Criteria:

  • Daily use of PPI or H2-receptor antagonists in more than 28 days within the last 120 days OR more than two days within the last 28 days OR more than five non-consecutive days within the last 28 days.
  • Mild heartburn or regurgitation more than once per week
  • Moderate or severe heartburn or regurgitation at least once per week
  • Complications to GERD (esophagitis, stricture or Barrett's esophagus) prior to enrolment or at screening
  • Abnormal findings at upper endoscopy necessitating treatment
  • Abnormal pH-monitoring prior to enrolment or at screening (pH \<4 in ≥5.5 % of the time on "worst day" of 48-h monitoring)

    • Excludes data from analysis regarding primary endpoint (see summary)
  • Previous surgery on esophagus, stomach or duodenum
  • Regular use of NSAIDs through the last six months
  • Potential language problems in understanding information and registering symptoms
  • Pregnancy or breast feeding
  • Other diseases which can interfere with the symptom registration (severe congestive heart disease, malignant disease, schizophrenia ect.)
  • Abuse of alcohol/narcotics
  • Allergy/intolerance to gelatine or lactose used in placebo
  • Patients with pacemaker, Implantable Cardioverter Defibrillator or Implantable Neurostimulator
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Investigator)
Enrollment
184 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    Drug: Placebo

  • Active comparator
    PPI + Placebo

    PPI followed by cross over to placebo

    Drug: Pantoprazole + Placebo

Interventions

  • DrugPlacebo

    Placebo, one tablet daily for 12 weeks

  • DrugPantoprazole + Placebo

    Pantoprazole 40 mg, one tablet daily in eight weeks followed by a blinded cross over to placebo, one tablet daily for four weeks

06

What researchers measure

Primary outcomes

  1. Development of GERD

    Comparison of number of study subjects that develop GERD according to the Montreal definition including endoscopic findings and pH monitoring in weeks 9-12 in the PPI group versus the placebo group.

    Time frame: week 9 - 12

Secondary outcomes

  1. Use of escape medication

    Difference in use of escape medication in weeks 9 - 12 between PPI- and placebo group

    Time frame: Week 9 - 12

  2. Endoscopic findings

    Number of study subjects who have esophagitis, peptic stricture or Barrett's esophagus at inclusion without having symptoms of reflux.

    Time frame: 0 - 2 weeks before inclusion

  3. pH monitoring

    Number of study subject who have an abnormal pH monitoring at inclusion with-out symptoms of reflux

    Time frame: 0 - 2 weeks before inclusion

  4. Irritable Bowel Syndrome (IBS)

    Number of study subjects with ROME III score indicating IBS at inclusion

    Time frame: 0 - 2 weeks before inclusion

  5. Irritable Bowel Syndrome (IBS) and treatment

    Difference in symptom scores between study subjects with and without IBS in the PPI- and placebo group in weeks 0 - 12

    Time frame: Week 0 - 12

  6. Effect of PPI on Functional Dyspepsia

    Number of study subjects in the PPI group versus the placebo group that answer "no discomfort at all" or "slight discomfort" to dyspepsia related questions ("ache/pain in the upper part of the abdomen" and "hunger pains/hollow feeling in the stomach") in week 8.

    Time frame: Week 8

  7. Helicobacter Pylori

    Difference in symptom score for subject with and without H. Pylori between PPI- and placebo group in weeks 9 - 12.

    Time frame: Week 9 - 12

07

Study locations

1 site
  • Koege Hospital
    Koege, 4600, Denmark
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 6, 2013, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT01373970
Lead sponsor
Zealand University Hospital
Responsible party
Anders Bergh Loedrup (Doctor, Zealand University Hospital) — Principal investigator
First posted
Jun 15, 2011
Start date
May 2011
Primary completion
May 2013
Completion
Sep 2013
Last update
Dec 6, 2013

Study contacts

Anders B. Lødrup, MD
principal investigator · Zealand University Hospital

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Dec 2013. You cannot join it, but the record below documents what was studied.

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