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RecruitingNCT07788742Updated Nov 5, 2026

Efficacy of Potassium-Competitive Acid Blockers in Barrett's Esophagus (PCAB BE Study)

A Phase 4 interventional study of Potassium-Competitive Acid Blockers (PCABs) in Barrett Esophagus, sponsored by University of North Carolina, Chapel Hill. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-05.

Sponsored by University of North Carolina, Chapel Hill · Phase 4, Interventional, and Treatment

Updated Nov 5, 2026Now RecruitingSite recruiting status changed+1 moreGo to Updates ↓
Phase
Phase 4
Study type
Interventional
Enrollment
12
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This is a research study to look at how a new medication compares to standard treatment for reducing acid reflux in patients with Barrett's Esophagus. The study drug is Vonoprazan. This is a pill that is not yet FDA-approved for this purpose in this patient population.

The participants will first continue their current acid-reducing medicine (PPI) once a day for at least 7 days. After that, they will have a test to measure acid levels in their esophagus (food tube) while still taking the PPI medication. After this test, they will stop their current PPI medication and start taking the study drug, Vonoprazan, once a day for 7-28 days. They will then have a second acid test while on the study drug (Vonoprazan).

Before each test, the participants will complete a short questionnaire about their symptoms. The study team will collect their health history, including medical conditions and current medications. After they finish the study drug, they will have a follow-up visit in about 30 days. The participation in the study will then end.

Read the detailed description

This is a prospective open-label study of PCAB in adults aged 18 years or older with nondysplastic Barrett's esophagus (NDBE) on maintenance PPI therapy. At the time of enrollment, participants will continue their usual PPI (any brand), standardized to once daily dosing for at least 7 days. After ≥7 days on once daily dosing, participants will undergo ambulatory 24-hour pH impedance testing without interruption of PPI therapy. After pH testing is complete, PPIs will be discontinued and replaced with vonoprazan 20 mg once daily for 7-28 days. After ≥7 days, 24-hour pH impedance testing will be repeated without interruption of vonoprazan therapy. Participants will complete a 30 day safety follow-up after the last dose of vonoprazan. Following completion of the follow-up visit, the patient's participation in the trial will end. Safety will be monitored throughout the study via assessing adverse events and conducting pregnancy and liver function testing.

Participants will complete the validated Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire prior to each pH study to assess symptom burden. Additionally, a health history questionnaire assessing comorbidities, concurrent medications, and past acid suppressive regimens, will be collected.

PPIs and PCABs are FDA-approved but their efficacy has not been compared in the NDBE sub-group enrolled on this study, an open-label prospective cohort without a control arm is the most appropriate and feasible study design as the study aims to compare two treatment methods in the same participant. Because participants will be used as their own comparator, a placebo arm is not needed. Furthermore, maintenance of patients with known BE on a placebo may induce reflux esophagitis.

02

Conditions studied

  • Barrett Esophagus

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Keywords

  • barrett esophagus
03

In context

Barrett Esophagus

312 studies on the registry are indexed under Barrett Esophagus; 60 are open to participants now.

This study's planned enrollment of 12 is below the median of 62 across 187 interventional studies indexed under Barrett Esophagus.

Browse Barrett Esophagus studies →

Lead sponsor

University of North Carolina, Chapel Hill is the lead sponsor of 1,372 studies on the registry; 133 are open to participants now.

Of its 161 completed or terminated interventional studies of FDA-regulated products, 139 (86%) have results posted.

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

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

  • Adults aged 18 or older at time of consent.
  • Able to read and understand English and provide written .
  • History of Gastroesophageal Reflux Disease (GERD) with or without heartburn.
  • Diagnosed with nondysplastic Barrett's Esophagus (NBDE) defined as meeting the following within the past 3 years:

    • Endoscopically confirmed BE with segment length ≥2 cm (to avoid those with an irregular Z line), and
    • Histologic evidence of intestinal metaplasia without dysplasia ("dysplasia" includes indefinite for dysplasia).
  • Currently on proton pump inhibitor (PPI) maintenance therapy, defined as PPI prescribed once or twice daily for 3 or more months (defined as 90 days or more) from consent. Any formulation and dosage of PPI will be included, including pantoprazole, omeprazole, esomeprazole, lansoprazole, rabeprazole, dexlansoprazole or their generic equivalents.
  • If currently on twice daily PPI, then able to modify PPI regimen to once daily dosing as part of their routine clinical care.
  • Ability to take oral medication and willing to adhere to study intervention regimen.
  • Willing to follow lifestyle recommendations as outlined in protocol section 5.3

Exclusion criteria

Exclusion Criteria:

  • Barrett's Esophagus (BE) with dysplasia (indefinite for dysplasia, or low-grade dysplasia, or high-grade dysplasia) diagnosed within 12 months of study entry.
  • Current or prior esophageal adenocarcinoma (EAC).
  • Use of other acid suppressive medications.
  • H. pylori diagnosis or treatment within the past 6 months prior to study entry.
  • History of upper gastrointestinal tract surgery (e.g., esophagectomy or surgery for reflux disease).
  • Current to 24hr pH impedance test, including:

    • Recent broken nose, nasal surgery, or known deviated septum; or
    • Bleeding disorders or those taking certain blood-thinning medications and unable to temporarily discontinue use per current clinical guidance may also be excluded due to increased risk of bleeding during catheter insertion; or
    • Individuals with implanted devices like pacemakers or defibrillators.
  • Known or allergic reaction to any component of the study intervention.
  • Treatment with another product within 30 days prior to consent.
  • Current use of rilpivirine-containing products.
  • Pregnant, breastfeeding, or considering becoming pregnant or intending to donate ova during the study and for 30 days after the last dose of study drug.
Terms in these criteria, in plain language(4)

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.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

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 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
12 participants (estimated)

Study arms

  • Other
    Proton Pump Inhibitors (PPI) to Potassium-Competitive Acid Blockers (PCABs)

    All participants will be enrolled while receiving PPI. After participant has been on a once daily PPI therapry regimen for at least 7 days, a 24-hour ph impedance test will be conducted while still receiving PPI medication. Participants will then be switched to PCABs for 7-28 days. A second 24-hour ph impedance test will be conducted by Day 28 while participants are taking PCABs.

    Drug: Potassium-Competitive Acid Blockers (PCABs)

Interventions

  • DrugPotassium-Competitive Acid Blockers (PCABs)

    Potassium -competitive acid blockers (PCABs) are a newer class of acid-suppressing medications more potent than PPIs, with a faster onset and longer duration of action. PCABs are FDA-approved.

06

What researchers measure

Primary outcomes

  1. Difference in percent time with pH<4 during 24-hour pH monitoring on PPI and PCAB therapies. (Normal is <4.0%)

    24 hour pH impedance testing is a routine clinical care procedure that is often conducted in this patient population as part of their ongoing care and maintenance of their condition to analyze reflux events. The test is minimally invasive. Participant's esophageal pH level is measured by completing 24 hour impedance test on visits 2 and 3. The participants will be on PPI during their first impedance test and they will be on vonoprazan during their second impedance test. The findings of this test will be used to calculate the difference in percent time with pH\<4 during 24-hour pH monitoring.

    Time frame: Visit 2 (1 day after Baseline through 1 day prior to PCAB switch), Visit 3 (7-28 days after switching to PCAB)

Secondary outcomes

  1. Difference in reflux symptom severity scores as measured by the GERD-HRQL questionnaire.

    The Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) questionnaire is a patient-reported measure of GERD symptom severity and disease-specific quality of life. The total score is calculated by summing item scores, yielding a possible range of 0 to 50. Higher scores represent greater symptom burden and poorer GERD-related quality of life; lower scores represent symptom improvement and better quality of life.

    Time frame: Visit 2 (1 day after Baseline through 1 day prior to PCAB switch), Visit 3 (7-28 days after switching to PCAB)

  2. Difference in percent time with pH<5 during 24-hour pH monitoring.

    24 hour pH impedance testing is a routine clinical care procedure that is often conducted in this patient population as part of their ongoing care and maintenance of their condition to analyze reflux events. The test is minimally invasive. Participant's esophageal pH level is measured by completing 24 hour impedance test on visits 2 and 3. The participants will be on PPI during their first impedance test and they will be on vonoprazan during their second impedance test. The findings of this test will be used to calculate the difference in percent time with pH\<5 during 24-hour pH monitoring.

    Time frame: Visit 2 (1 day after Baseline through 1 day prior to PCAB switch), Visit 3 (7-28 days after switching to PCAB)

  3. Difference in mean pH during 24-hr pH monitoring.

    24 hour pH impedance testing is a routine clinical care procedure that is often conducted in this patient population as part of their ongoing care and maintenance of their condition to analyze reflux events. The test is minimally invasive. Participant's esophageal pH level is measured by completing 24 hour impedance test on visits 2 and 3. The participants will be on PPI during their first impedance test and they will be on vonoprazan during their second impedance test. The findings of this test will be used to calculate the difference in mean pH during 24-hour pH monitoring.

    Time frame: Visit 2 (1 day after Baseline through 1 day prior to PCAB switch), Visit 3 (7-28 days after switching to PCAB)

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

1 registry update since Sep 25, 2026
Status
Not yet recruiting→Recruiting
changed Nov 5, 2026
Sites
University of North carolina at Chapel Hill is now Recruiting
Nov 5, 2026
Start date
Aug 31, 2026→Nov 2026
Nov 5, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • University of North carolina at Chapel Hill · Chapel Hill, United StatesContact •••8519→•••8519
Nov 5, 2026
Show all 1 update
  1. Nov 5, 2026
    Not yet recruiting→Recruiting
    University of North carolina at Chapel Hill is now Recruiting
    Start date Aug 31, 2026→Nov 2026
    Site contacts Changed at 1 site. See the sites
    Show the site
    • University of North carolina at Chapel Hill · Chapel Hill, United StatesContact •••8519→•••8519
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07788742
Collaborators
Phathom Pharmaceuticals, Inc.
Responsible party
Sponsor
First posted
Aug 26, 2026
Start date
Nov 2026 (estimated)
Primary completion
Aug 31, 2028 (estimated)
Completion
Aug 31, 2029 (estimated)
Last update
Nov 5, 2026

Study contacts

Shilpa Karanjit, MPH
Contact
shilpa_karanjit@med.unc.edu
919-843-8519
Susan E Moist, MPH
Contact
susan_moist@med.unc.edu
919-918-5900
Nicholas Shaheen, MD, MPH
principal investigator · UNC Chapel Hill

Oversight

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

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