A Phase 3 interventional study of TAK-438 and Lansoprazole in Gastric Ulcer, sponsored by Takeda. Completed at 81 sites in 4 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-06-18.
Sponsored by Takeda · Phase 3, Interventional, and Treatment
The purpose of this study is to demonstrate the non-inferior efficacy of TAK-438 versus lansoprazole in the treatment of participants with gastric ulcer.
The drug being tested in this study is called TAK-438. TAK-438 is being tested to treat people who have stomach ulcers and also may or may not have Helicobacter pylori (HP) infection. This study will look at stomach ulcer healing and also the elimination of HP in people who take TAK-438 versus lansoprazole.
The study will enroll approximately 830 patients.
Participants will be randomly assigned (by chance, like flipping a coin) to one of the two treatment groups-which will remain undisclosed to the participants and study doctor during the study (unless there is an urgent medical need):
Study treatment will depend upon the Helicobacter pylori infection status of the participant, and include bismuth-containing quadruple therapy for the first 2 weeks in H pylori infected (HP+) participants. HP+ participants will be asked to take a TAK- 438 tablet or a lansoprazole capsule twice daily in conjunction with bismuth-containing quadruple therapy for 2 weeks, followed up by a TAK-438 tablet or a lansoprazole capsule once daily for up to 6 weeks. HP- participants will be asked to take a TAK-438 tablet or a lansoprazole capsule once daily for up to 8 weeks.
This multi-center trial will be conducted in China, Korea, Taiwan, and Philippines. The overall time to participate in this study is up to 12 weeks. Participants will make multiple visits plus final visit at 2 weeks or 4 weeks after last dose of study drug for a follow-up assessment.
112 studies on the registry are indexed under Stomach Ulcer; 13 are open to participants now.
This study's enrollment of 234 is below the median of 265 across 86 interventional studies indexed under Stomach Ulcer.
Browse Stomach Ulcer studies →Takeda is the lead sponsor of 1,002 studies on the registry; 92 are open to participants now.
Of its 173 completed or terminated interventional studies of FDA-regulated products, 149 (86%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Laboratory tests performed prior to randomization revealed any of the following abnormalities in the participant:
Helicobacter Pylori positive (HP+) participants: TAK-438 20 mg tablet, twice daily (BID) along with lansoprazole placebo-matching, capsule BID in addition to bismuth-containing quadruple antibiotic therapy for the first 2 weeks. Following 2 weeks of eradication therapy participants received TAK-438 20 mg QD along with lansoprazole matching placebo 30 mg, capsule QD for up to 6 weeks. HP negative (HP-) participants: TAK-438 20 mg tablet, (QD) along with lansoprazole matching placebo, 30 mg capsule QD for up to 8 weeks.
Drug: TAK-438 · Drug: Lansoprazole Placebo · Drug: Bismuth-Containing Quadruple Therapy
HP+ participants: Lansoprazole 30 mg, capsule, orally, BID and TAK-438 placebo-matching tablet, orally, BID along with bismuth-containing quadruple antibiotic therapy for first 2 weeks. Following 2 weeks participants received Lansoprazole 30 mg, capsule, orally, QD along with TAK-438 placebo-matching tablet, orally, QD for up to 6 weeks. HP- participants: Lansoprazole 30 mg, capsule, orally, QD along with TAK-438 placebo-matching tablet, orally, QD for up to 8 weeks.
Drug: Lansoprazole · Drug: TAK-438 Placebo · Drug: Bismuth-Containing Quadruple Therapy
TAK-438 tablets
Also known as: Vonoprazan
Lansoprazole capsules
Also known as: Prevacid
TAK-438 placebo-matching tablets
Lansoprazole placebo-matching capsules
1 g Amoxicillin, 500 mg clarithromycin and 600 mg bismuth potassium citrate/bismuth tripotassium dicitrate, twice daily (BID).
Percentage of Participants With Endoscopically Confirmed Healing of Gastric Ulcers (GUs) at Weeks 4 or 8
Endoscopic healing was defined as the disappearance of all white coats associated with GUs confirmed endoscopically.
Time frame: Week 4 or 8
Percentage of Helicobacter Pylori Infected (HP+) Participants With Successful HP Eradication After 4 or 8 Weeks of Treatment
HP infection status was determined by 13C-UBT. The urea breath test is used to detect infection with HP, a bacteria associated with stomach ulcers, by testing individual breath samples in a central laboratory. The data is provided only for HP+ participants. The participant could take 4 or 8 weeks of treatment for GU healing, then additional 4 weeks later, to have the urea breath test (UBT) test to detect HP.
Time frame: 4 weeks post treatment (up to approximately 12 weeks)
Percentage of Participants With Endoscopically Confirmed Healing of GU at Week 4
Endoscopic healing was defined as the disappearance of all white coats associated with GUs confirmed endoscopically.
Time frame: Week 4
Percentage of Participants With Post-treatment Resolution of Gastrointestinal Symptoms Associated With GU
The gastrointestinal symptoms included epigastric pain \[postprandial, fasting, nocturnal\], abdominal bloating, nausea/vomiting, heartburn, lack of appetite. The severity of gastrointestinal symptoms associated with GU were recorded as: none = 0, mild = 1, moderate = 2 or severe = 3. The data is reported in categories for percentage of participants with resolution of gastrointestinal symptoms associated with GU.
Time frame: Week 2 up to Week 8
Participants took part in the study at 60 investigative sites in China, Korea, and Taiwan from 17 April 2017 to 26 May 2020.
| Milestone | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| Started | 115 | 119 |
| Completed | 107 | 110 |
| Not completed | 8 | 9 |
| Withdrew: Adverse event | 4 | 2 |
| Withdrew: Significant protocol deviation | 0 | 1 |
| Withdrew: Lost to follow-up | 0 | 1 |
| Withdrew: Voluntary withdrawal | 3 | 4 |
| Withdrew: Reason not specified | 1 | 1 |
Endoscopic healing was defined as the disappearance of all white coats associated with GUs confirmed endoscopically.
| percentage of participants | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| Percentage of Participants With Endoscopically Confirmed Healing of Gastric Ulcers (GUs) at Weeks 4 or 8 | 91.1 (84.193 to 95.635) | 94.7 (88.896 to 98.044) |
HP infection status was determined by 13C-UBT. The urea breath test is used to detect infection with HP, a bacteria associated with stomach ulcers, by testing individual breath samples in a central laboratory. The data is provided only for HP+ participants. The participant could take 4 or 8 weeks of treatment for GU healing, then additional 4 weeks later, to have the urea breath test (UBT) test to detect HP.
| percentage of participants | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| Percentage of Helicobacter Pylori Infected (HP+) Participants With Successful HP Eradication After 4 or 8 Weeks of Treatment | 88.0 (78.439 to 94.363) | 80.8 (69.921 to 89.099) |
Endoscopic healing was defined as the disappearance of all white coats associated with GUs confirmed endoscopically.
| percentage of participants | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| Percentage of Participants With Endoscopically Confirmed Healing of GU at Week 4 | 76.1 (67.035 to 83.788) | 82.1 (73.777 to 88.738) |
The gastrointestinal symptoms included epigastric pain \[postprandial, fasting, nocturnal\], abdominal bloating, nausea/vomiting, heartburn, lack of appetite. The severity of gastrointestinal symptoms associated with GU were recorded as: none = 0, mild = 1, moderate = 2 or severe = 3. The data is reported in categories for percentage of participants with resolution of gastrointestinal symptoms associated with GU.
| percentage of participants | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| Epigastric Pain (Postprandial) | 78.9 (54.435 to 93.948) | 80.0 (59.296 to 93.169) |
| Epigastric Pain (Fasting/Nocturnal) | 85.0 (70.165 to 94.290) | 80.5 (65.133 to 91.179) |
| Abdominal Bloating | 81.3 (54.354 to 95.953) | 65.2 (42.734 to 83.624) |
| Nausea/Vomiting | 100.0 (100.0 to 100.0) | 100.0 (100.0 to 100.0) |
| Heartburn | 95.8 (78.880 to 99.895) | 85.7 (67.335 to 95.966) |
| Lack of Appetite | 77.8 (39.991 to 97.186) | 90.0 (55.498 to 99.747) |
Collected over From first dose up to 4 weeks post dose (up to approximately 12 weeks). Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| TAK-438 20 mg | 0/115 (0%) | 3/115 (2.6%) | 43/115 (37.4%) |
| Lansoprazole 30 mg | 0/119 (0%) | 2/119 (1.7%) | 15/119 (12.6%) |
| Event | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| AppendicitisInfections and infestations | 1/115 | 0/119 |
| MeningitisInfections and infestations | 1/115 | 0/119 |
| Gastric cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/115 | 0/119 |
| Angina pectorisCardiac disorders | 0/115 | 1/119 |
| Liver abscessInfections and infestations | 0/115 | 1/119 |
| Event | TAK-438 20 mg | Lansoprazole 30 mg |
|---|---|---|
| Pepsinogen test positiveInvestigations | 29/115 | 6/119 |
| Blood gastrin increasedInvestigations | 24/115 | 5/119 |
| Pepsinogen I increasedInvestigations | 23/115 | 8/119 |
| DysgeusiaNervous system disorders | 2/115 | 7/119 |
| Alanine aminotransferase increasedInvestigations | 6/115 | 3/119 |
All Randomized Participants.
| Age, Continuous(years) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| Mean | 54.0 ± 13.68 | 53.5 ± 13.37 | 53.7 ± 13.50 |
| Sex: Female, Male(Participants) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| Female | 29 | 27 | 56 |
| Male | 86 | 92 | 178 |
| Race (NIH/OMB)(Participants) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 114 | 119 | 233 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 0 | 0 | 0 |
| White | 0 | 0 | 0 |
| More than one race | 1 | 0 | 1 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Region of Enrollment(Participants) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| China | 65 | 71 | 136 |
| Korea, Republic Of | 44 | 42 | 86 |
| Taiwan, Province Of China | 6 | 6 | 12 |
| Height(cm) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| Mean | 165.4 ± 7.49 | 167.1 ± 7.96 | 166.2 ± 7.76 |
| Weight(kg) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| Mean | 63.76 ± 10.743 | 66.83 ± 11.370 | 65.32 ± 11.149 |
| Body Mass Index(kg/m^2) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| Mean | 23.25 ± 3.224 | 23.85 ± 3.255 | 23.56 ± 3.247 |
| Smoking classification(Participants) | TAK-438 20 mg | Lansoprazole 30 mg | Total |
|---|---|---|---|
| The Participant has Never Smoked | 49 | 52 | 101 |
| The Participant is a Current Smoker | 50 | 51 | 101 |
| The Participant is an Ex-smoker | 16 | 16 | 32 |
12 further baseline measures are reported on the registry.
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.
Supporting information: Study protocol, Sap, Icf, Csr
This study is completed, as verified in May 2021. You cannot join it, but the record below documents what was studied.
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