ClinicalTrials.gg
RecruitingNCT04965298TIPALUpdated Dec 22, 2025

Treating People With Idiopathic Pulmonary Fibrosis With the Addition of Lansoprazole

A Phase 3 interventional study of Lansoprazole and Matched placebo in Idiopathic Pulmonary Fibrosis, sponsored by Norfolk and Norwich University Hospitals NHS Foundation Trust. Recruiting at 57 sites in United Kingdom. Open to participants aged 40 Years and older. Per ClinicalTrials.gov, last updated 2025-12-22.

Sponsored by Norfolk and Norwich University Hospitals NHS Foundation Trust · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Feb 2026, 8 months ago, but the record still lists the study as recruiting.
  • Started Jun 2021; still recruiting 5 years 4 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
298
Allocation
Randomized
Ages
40 Years and older
Sex
All
01

Study summary

IPF is a progressive scarring lung condition causing coughing and breathlessness. IPF patients often have reflux disease meaning stomach acid may be breathed into the lungs, potentially damaging them. Medicines which stop stomach acid production, proton pump inhibitors (PPIs), can be used to reduce reflux symptoms including heartburn. Some researchers suggest PPIs also reduce IPF progression.

This research aims to see if IPF progresses slower if treated with PPIs. Based on the results, we will be able to recommend whether or not IPF patients should take PPIs.

This trial will involve 298 IPF patients from approximately 37 UK hospitals. At the beginning of the study, we will ask patients to start performing weekly breathing tests at home using equipment provided, and ask those with a cough to use a device to count the number of times they cough in 24hours. We will ask them to answer two questions rating their coughing and breathlessness, and complete questionnaires on their coughing, IPF, sleep habits and general condition. People will be given a PPI, called lansoprazole, or dummy tablets, twice per day for 12 months. They will be given a leaflet telling them what to do about reflux symptoms. At the end of the study, we will repeat these tests and analyse the results. We will record any side effects people may get. If people suffer side effects, they can reduce the dose.

People taking medicines that interact with PPIs or have other serious medical conditions won't be able to participate. People receiving PPIs will only be able to participate if they can stop taking their medication without their heartburn returning.

Read the detailed description

Idiopathic pulmonary fibrosis (IPF) is a progressive and usually fatal lung disease with a poor prognosis. IPF patients frequently have other medical conditions as well, with reflux disease being one of the most common. Previous studies and a review of data already collected suggest that treatments used to reduce reflux disease symptoms, proton pump inhibitors (PPIs), may reduce IPF disease progression and improve survival rates. Current IPF treatment guidelines cautiously advise PPI treatment for IPF patients, however there hasn't been a study which investigates this specifically yet even though doctors and government groups have said one is needed. There are thought to be links between cough, reflux, sleep and IPF. As a result we will be asking a sub-group of patients to complete two 24 hour sessions of cough frequency monitoring as a sub-study. Some of these participants may be asked to wear a wrist-based activity and sleep monitor during these periods also. In addition, we will ask patients to complete two questionnaires on their sleeping habits to further investigate this link. At the end of the trial, we will able to recommend whether or not IPF patients should take PPIs routinely or not.

This project is a clinical trial of an investigational medicinal product (drug). The drug is well established and approved for use for another medical condition. The drug will be assessed against placebo (dummy) tablets, with patients allocated to either group by chance. Patients on the drug and dummy tablets will be assessed at the same time. Neither patients nor their doctors or the research team will know which treatment they have been allocated to. We will be running the study at approximately 37 hospitals across the UK.

All study visits may take place remotely without the participant needing to attend the hospital. However, face-to-face onsite visits are also permitted if preferred/feasible. All participants will receive central training via video call, with a trained clinical physiologist, following consent on how to complete domiciliary spirometry assessments. Further training will be provided during follow-up if deemed required following a review of the data. Questionnaires will be completed either electronically or by post.

Potentially eligible patients will be approached remotely or in clinic after being identified from local patient lists/databases. They will be given/sent the relevant study literature to consider participation in the study and will be followed-up by a member of the local research team after they have had at least 24hours to consider participating.

Interested patients will be invited to a virtual or face-to-face screening appointment where they will be counselled on the study and what it entails in order to provide informed consent to participate. The patient will then be asked to complete baseline questionnaires, provide demographic, medical history and concomitant medication, and any other relevant study information, complete spirometry assessments over 5 days at home using a domiciliary spirometer and provide a blood sample for safety in order for the investigator to confirm their eligibility for the trial. Patients may also provide a blood sample for analysis in future research if the visit takes place at the recruiting site. In addition, eligible participants may complete a 24hour period of cough frequency monitoring, and activity and sleep monitoring if applicable, if they have consented to do so. Patients in receipt of PPIs without a clear clinical indication for them at consent, will undergo a two week wash-out period (following agreement from the patient and their GP) to ascertain whether it is safe to stop this treatment and monitor whether their symptoms subside. Patients who remain asymptomatic at the end of this period will proceed to enter the study. For those whose symptoms return, PPI treatment will recommence and they will not enter the study. Once the results of all baseline assessments are known, patients will be randomised.

Participants will receive an initial 6 month supply of trial medication and be instructed to take 2 tablets twice daily (approximately 12 hours apart), 30 minutes before meals, for 12 months. Participants will commence weekly domiciliary spirometry assessments, for 12 months, from this point onwards.

At 3 months post-randomisation, participants will complete the relevant questionnaires and provide blood samples for safety checks. Domiciliary spirometry assessments remain ongoing. Participants involved in the sub-study will again undergo cough frequency monitoring, and activity and sleep monitoring if applicable, for a final 24 hour period. Patients will be asked to report any changes in their medical history, medication and any events which they have experienced since their last visit.

Participants will be contacted again at 6 months post-randomisation where they we will complete questionnaires and provide a safety blood samples. Domiciliary spirometry assessments remain ongoing. Participants will again be asked to report any changes in their medical history, medication and any events which they have experienced since their last visit. Participant adherence to the trial medication will be checked. A final supply of trial medication will be dispensed.

At 9 months post-randomisation, local site staff will contact patients to record any changes in their medical history, medication and any events experienced since their last visit. Patients will be required to complete the required questionnaires and provide a blood sample for safety checks.

The final study assessments will be at 12 months post-randomisation. Patients will be required to complete all necessary questionnaires, provide a blood sample for safety analysis and a final set of domiciliary spirometry assessments will occur over a 5 day consecutive period. If participants have consented to do so, an additional blood sample will be taken for analysis in future research studies if the visit occurs on site. Patients will be required to report any changes in their medical history, medication and any events they have experienced since their last report to site staff.

If participants are suspected of or confirmed to have experienced any of the following they may reduce the dose of their trial treatment, at any point during the study, to 1 tablet, twice daily (approximately 12 hours apart), 30 minutes before meals: infection including pneumonia, Clostridium difficile infection and/or hypomagnesaemia. Participants may also reduce dose if the participant or clinician wishes them to do so.

A blood sample for genotype analysis may be taken at any study timepoint which occurs face-to-face, if the participants consents to provide one. Safety blood samples will be taken at the participant's GP surgery where visits take place remotely. Remote follow-up may take place via video or phone call.

02

Conditions studied

  • Idiopathic Pulmonary Fibrosis

Keywords

  • Idiopathic pulmonary fibrosis
  • IPF
  • Lansoprazole
  • Proton pump inhibitors
  • Cough
  • FVC
  • Forced vital capacity
  • Domiciliary spirometry
  • Virtual clinical trial
03

In context

Idiopathic Pulmonary Fibrosis

576 studies on the registry are indexed under Idiopathic Pulmonary Fibrosis; 123 are open to participants now.

This study's planned enrollment of 298 is above the median of 55 across 389 interventional studies indexed under Idiopathic Pulmonary Fibrosis.

Browse Idiopathic Pulmonary Fibrosis studies →

Lead sponsor

Norfolk and Norwich University Hospitals NHS Foundation Trust is the lead sponsor of 30 studies on the registry; 9 are open to participants now.

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

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Male or female, aged greater than or equal to 40 years.
  2. A diagnosis of Idiopathic Pulmonary Fibrosis (IPF) based on local or regional multi-disciplinary consensus according to the latest international guidelines (50).
  3. Patients may be receiving licensed anti-fibrotic medication (for at least 4 weeks prior to randomisation with no planned amendments for at least 4 weeks post-randomisation).
  4. Able to provide .

Additional Inclusion Criteria for cough count sub-study:

1. Pre-existing diagnosis of persistent cough (defined as troublesome for more than 8 weeks prior to study enrolment).

Exclusion criteria

Exclusion Criteria:

  1. Patients unable to comply with study assessments including the ability to complete reliable spirometry assessments.
  2. Concomitant use of a proton pump inhibitor (PPI) or prokinetic drugs (cisapride, domperidone, metoclopramide, erythromycin, prucalopride etc.) within 2 weeks prior to randomisation.
  3. Patients with a self-reported respiratory tract infection within 4 weeks of screening (defined as two or more of: increased cough, sputum or breathlessness and requiring antimicrobial therapy).
  4. Significant co-existing respiratory disease (defined as a respiratory condition that exhibits a effect on respiratory symptoms and disease progression as determined by the PI). The presence of traction bronchiectasis is permitted.
  5. Patients with an /FVC\<0.7.
  6. Significant medical, surgical or psychiatric disease that in the opinion of the patient's attending physician would affect subject safety or influence the study outcomes including liver failure (e.g. serum transaminase > 2 x (ULN), > 1.5 x ULN (unless the patient has Gilbert's Syndrome) and chronic kidney disease (CKD) greater than stage 3 , erosive oesophagitis, Barrett's oesophagus or any condition requiring lifelong proton pump inhibitor use.
  7. Known allergy to proton pump inhibitors or the contents of placebo.
  8. Concomitant use of atazanavir, ketoconazole, itraconazole, tacrolimus, methotrexate, fluvoxamine (see section 6.4.5).
  9. Females who are of or lactating. A state is defined as no menses for 12 months without an alternative medical cause. A high FSH level in the postmenopausal range may be used to confirm a post-menopausal state in women not using hormonal or hormonal replacement therapy. However in the absence of 12 months of amenorrhea, a single FSH measurement is insufficient.
  10. Receipt of another drug or biological agent associated with another clinical trial within the 4 weeks prior to TIPAL study enrolment or 5 times the drug half-life, whichever is the longer.
  11. Receiving long-term oxygen therapy.
  12. Patients with hypomagnesemia (defined as magnesium ≤0.6 mmol/L).
Terms in these criteria, in plain language(9)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
298 participants (estimated)

Study arms

  • Experimental
    Active treatment arm

    Lansoprazole 30mg (as 2 x 15mg capsules) twice daily, 12 hours apart, for 12 months. IMP should be taken at least 30 minutes before food.

    Drug: Lansoprazole

  • Placebo comparator
    Matched-Placebo arm

    Matched placebo 2 capsules twice daily, 12 hours apart, for 12 months. Treatment should be taken at least 30 minutes before food.

    Other: Matched placebo

Interventions

  • Lansoprazole 30mg (as 2 x 15mg capsules) twice daily, 12 hours apart, for 12 months. IMP should be taken at least 30 minutes before food.

  • OtherMatched placebo

    Matched placebo 2 capsules twice daily, 12 hours apart, for 12 months. Treatment should be taken at least 30 minutes before food.

06

What researchers measure

Primary outcomes

  1. Absolute change in percent predicted (%) forced vital capacity (FVC)

    Absolute change in percent predicted (%) forced vital capacity (FVC) at 12 months post-randomisation of lansoprazole versus placebo.

    Time frame: 12 months post-randomisation

Secondary outcomes

  1. Cough frequency

    Cough frequency measured using a VitaloJAK cough monitor over a 24h period.

    Time frame: 3 months post-randomisation

  2. Cough score

    Cough score measured using a 100mm visual analogue scale (VAS).

    Time frame: 3, 6, 9 and 12 months post-randomisation

  3. Cough related

    Cough related quality of life measured by the Leicester Cough Questionnaire (LCQ).

    Time frame: 3, 6, 9 and 12 months post-randomisation

  4. Breathlessness

    Breathlessness measured by the Medical Research Council Dyspnoea scale.

    Time frame: 3, 6, 9 and 12 months post-randomisation

  5. Disease specific quality of life

    Disease specific quality of life measured using the King's Brief Interstitial Lung Disease (K-BILD) questionnaire.

    Time frame: 3, 6, 9 and 12 months post-randomisation

  6. Health related quality of life

    Health related quality of life measured using the EQ-5D-5L questionnaire (quality adjusted life years will be estimated).

    Time frame: 3, 6, 9 and 12 months post-randomisation

  7. Total lung diffusing capacity of carbon monoxide

    Total lung diffusing capacity of carbon monoxide (DLCO) measured (corrected for haemoglobin) where possible.

    Time frame: 3, 6 and 12 months post-randomisation

  8. Laboratory assessment

    Laboratory assessment of FVC and FEV1 where possible.

    Time frame: 3, 6 and 12 months post-randomisation

  9. Sleep quality

    Sleep quality measured by the short Pittsburgh Sleep Quality Index (PSQI).

    Time frame: 3 and 12 months post-randomisation

  10. Reflux characteristics

    Reflux characteristics measured by the DeMeester score.

    Time frame: 3 and 12 months post-randomisation

  11. Participant acceptability

    Participant acceptability measured by a study-specific questionnaire.

    Time frame: 12 months post-randomisation

  12. Risk of sleep apnoea

    Risk of sleep apnoea measured by the STOP-Bang questionnaire.

    Time frame: 12 months post-randomisation

  13. Progression free survival

    Progression free survival (with progression defined as time from date of randomisation to week of all-cause death, lung transplant or a 10% absolute reduction in FVC % predicted from baseline measured by weekly domiciliary spirometry).

    Time frame: 12 months post-randomisation

  14. Hospital-free survival defined as death

    Hospital-free survival defined as death (all-cause) or first non-elective (all-cause) hospital admission.

    Time frame: 12 months post-randomisation

  15. Respiratory related hospital free survival

    Respiratory related hospital free survival.

    Time frame: 12 months post-randomisation

  16. The decline and rate of decline in absolute %FVC

    The decline and rate of decline in absolute %FVC based on %FVC measured weekly by domiciliary spirometry.

    Time frame: Measured over the course of 12 months

07

Study locations

41 of 57 sites recruiting
08

References and documents

Publications

  • Jones M, Cahn A, Chaudhuri N, Clark AB, Forrest I, Hammond M, Jones S, Maher TM, Parfrey H, Raghu G, Simpson AJ, Smith JA, Spencer LG, Thickett D, Vale L, Wahed S, Ward C, Wilson AM. The effectiveness and risks of Treating people with Idiopathic Pulmonary fibrosis with the Addition of Lansoprazole (TIPAL): study protocol for a randomised placebo-controlled multicentre clinical trial. BMJ Open. 2025 Feb 5;15(2):e088604. doi: 10.1136/bmjopen-2024-088604. PubMed 39909521 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 22, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04965298
Lead sponsor
Norfolk and Norwich University Hospitals NHS Foundation Trust
Collaborators
Norwich Clinical Trials Unit
Responsible party
Sponsor
First posted
Jul 16, 2021
Start date
Jun 16, 2021
Primary completion
Feb 28, 2026 (estimated)
Completion
Feb 28, 2026 (estimated)
Last update
Dec 22, 2025

Study contacts

Emily Harvey
Contact
emily.harvey@uea.ac.uk
01603 591224
TIPAL team
Contact
tipal@uea.ac.uk
Professor Andrew Wilson
study chair · Norfolk and Norwich University Hospitals NHS Foundation Trust

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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