NCT02923856

Brief Summary

As the resistant rate of the Helicobacter pylori to some common antibiotics was rising,the eradication rate of the Helicobacter pylori with the standard triple therapy failed to exceed 70% in China,and had to drop out of the first-line treatment recommendations. However, with the increase of treatment time, patients burden, adverse reactions of antibiotics or proton pump inhibitor (PPI) will also increase. Resistance to clarithromycin is the major cause of the failure to eradicate Helicobacter pylori. But, in terms of population, there are still more than 70% of the patients with clarithromycin sensitive. Under the guidance with susceptibility test,7-day standard triple therapy could be used. In this study, investigators will select the patients with infection of H. pylori and with clarithromycin sensitive. Eradication of Helicobacter pylori with triple therapy based on accurate susceptibility testing of clarithromycin will be studied. The treatment time will be assigned into 7 days,10 days and 14 days groups. Then, investigators will perform a sequencing for failed treatment patients in groups, such as drug resistance gene mutation, phenotype and genotype. Finally, investigators will compare the differences between the patients with triple therapy and traditional quadruple therapy.The incidence of adverse effects in the eradicate treatment will reduce at least 10% and avoid patients' unnecessary economic losses at least 400RMB per person.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
672

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jan 2017

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 23, 2016

Completed
1 month until next milestone

First Posted

Study publicly available on registry

October 5, 2016

Completed
3 months until next milestone

Study Start

First participant enrolled

January 1, 2017

Completed
2.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2019

Completed
Last Updated

February 19, 2019

Status Verified

August 1, 2018

Enrollment Period

2.9 years

First QC Date

August 23, 2016

Last Update Submit

February 16, 2019

Conditions

Keywords

Helicobacter pyloriAntibiotic resistanceSequencing

Outcome Measures

Primary Outcomes (2)

  • The accurate determination of clarithromycin susceptibility.

    Assess bacterial susceptibility to antibiotics using the agar diffusion method. The Resistance point of clarithromycin was divided into 0.125μg/ml,0.25μg/ml,0.5μg/ml and 1μg/ml.Test clarithromycin resistance of Helicobacter pylori for patients.

    2 years

  • Establish individualized precision triple therapy based on minimal inhibitory concentration.

    Based on the clarithromycin accurate susceptibility,pinpoint different courses of triple treatment therapy targeted to different people based on minimal inhibitory concentration of clarithromycin.

    2.5 years

Secondary Outcomes (1)

  • The incidence of adverse effects

    3 years

Other Outcomes (1)

  • Impact of mixed infection and CYP2C19 genotype on eradication rate for Helicobacter pylori with triple therapy using clarithromycin.

    3 years

Study Arms (7)

Clarithromycin resistance group

EXPERIMENTAL

Patients who are resistant to clarithromycin in susceptibility test were classified into clarithromycin resistance group.

Device: The results of clarithromycin susceptibility test of H. pylori isolates

7 days Successful treatment

EXPERIMENTAL

The successful treatment of H. pylori group were treatment successful patients after the 7days standardized treatment.

Device: The results of clarithromycin susceptibility test of H. pylori isolatesDevice: Computer generated random number, randomly assigned into groupsDevice: The result of 13C-urea breath test of patient in 7days/10days/14days treatment groups

7 days failed treatment

EXPERIMENTAL

The failed treatment of H. pylori group were treatment failure patients after the 7days standardized treatment.

Device: The results of clarithromycin susceptibility test of H. pylori isolatesDevice: Computer generated random number, randomly assigned into groupsDevice: The result of 13C-urea breath test of patient in 7days/10days/14days treatment groups

10 days Successful treatment

EXPERIMENTAL

The successful treatment of H. pylori group were treatment successful patients after the 10days standardized treatment.

Device: The results of clarithromycin susceptibility test of H. pylori isolatesDevice: Computer generated random number, randomly assigned into groupsDevice: The result of 13C-urea breath test of patient in 7days/10days/14days treatment groups

10 days failed treatment

EXPERIMENTAL

The failed treatment of H. pylori group were treatment failure patients after the 10days standardized treatment.

Device: The results of clarithromycin susceptibility test of H. pylori isolatesDevice: Computer generated random number, randomly assigned into groupsDevice: The result of 13C-urea breath test of patient in 7days/10days/14days treatment groups

14 days Successful treatment

EXPERIMENTAL

The successful treatment of H. pylori group were treatment successful patients after the 14days standardized treatment.

Device: The results of clarithromycin susceptibility test of H. pylori isolatesDevice: Computer generated random number, randomly assigned into groupsDevice: The result of 13C-urea breath test of patient in 7days/10days/14days treatment groups

14 days failed treatment

EXPERIMENTAL

The failed treatment of H. pylori group were treatment failure patients after the 14days standardized treatment.

Device: The results of clarithromycin susceptibility test of H. pylori isolatesDevice: Computer generated random number, randomly assigned into groupsDevice: The result of 13C-urea breath test of patient in 7days/10days/14days treatment groups

Interventions

According to the results of antibiotic susceptible testing, patients who were resistant to clarithromycin were belonged into clarithromycin resistance group.Patients who were sensitive to clarithromycin were belonged into the 7days/10days/14days treatment groups.

10 days Successful treatment10 days failed treatment14 days Successful treatment14 days failed treatment7 days Successful treatment7 days failed treatmentClarithromycin resistance group

The patients with clarithromycin sensitive. Computer generated random number,randomly assigned into 7days/10days/14days treatment groups.

10 days Successful treatment10 days failed treatment14 days Successful treatment14 days failed treatment7 days Successful treatment7 days failed treatment

The intervention focused on the results from the result of 13C-urea breath test at 8 weeks after treatment in patients. All patients were taking 75mg 13C-urea and analysis with a modified isotope ratio mass spectrometer to determine the 13CO2 content.The successful treatment groups were patients with negative in 13C-urea breath tests.The failed treatment of H. pylori groups were patients with positive in 13C-urea breath tests after the standardized triple therapy treatment.

10 days Successful treatment10 days failed treatment14 days Successful treatment14 days failed treatment7 days Successful treatment7 days failed treatment

Eligibility Criteria

Age18 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 18\~70 years old, male or female, the first eradication therapy of H. pylori infection patients.
  • Symptoms of abdominal pain, bloating, acid efflux, belching, nausea, vomiting, heartburn, chest pain, vomiting, melena, etc.
  • Unused antibiotics, bismuth, H2 receptor antagonists or PPI by nearly 4 weeks
  • C-labelled urea breath test positive.
  • Agreed to Helicobacter pylori culture and sensitivity testing taken by endoscopy gastric biopsy specimens,and the result of culture was positive.
  • Agreed to Helicobacter pylori eradication therapy and cooperate with the eradication efficacy follow-up survey.

You may not qualify if:

  • Severe heart, liver, kidney dysfunction.
  • Pregnant or lactating women.
  • Complications of bleeding, perforation, pyloric obstruction, cancer.
  • Within 3 months before with the drugs involved in other drugs research.
  • Esophageal,gastrointestinal surgery history.
  • Patients can not properly express their complaints,such as psychosis, severe neurosis.
  • Taking NSIAD or alcohol abusers.
  • Allergic to amoxicillin or clarithromycin tested by susceptibility testing.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Sanmen People's hospital

Taizhou, Zhejiang, 317199, China

RECRUITING

MeSH Terms

Conditions

Gastritis

Condition Hierarchy (Ancestors)

GastroenteritisGastrointestinal DiseasesDigestive System DiseasesStomach Diseases

Central Study Contacts

zhang hong Li, doctor

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director of Sanmen People's Hospital

Study Record Dates

First Submitted

August 23, 2016

First Posted

October 5, 2016

Study Start

January 1, 2017

Primary Completion

December 1, 2019

Study Completion

December 1, 2019

Last Updated

February 19, 2019

Record last verified: 2018-08

Locations