Title

Phase III Study Comparing Zegerid® With Losec® for the Relief of Heartburn Associated With Gastroesophageal Reflux Disease
A Phase III, Multi-centre, Double-blind, Double-dummy, Randomised, Study to Assess the Superiority of Zegerid® 20 mg vs. Losec® 20 mg in the Rapid Relief of Heartburn Associated With GERD as on Demand Therapy
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    239
Heartburn is the main symptom of Gastroesophageal Reflux Disease (GERD), which, accompanied by acid regurgitation and other symptoms, has a substantial negative impact on a patients' quality of life. Although a number of treatment options are available, a more effective therapy is still required. The failure of proton pump inhibitors (PPIs) to completely resolve symptoms is an accepted problem, with approximately 25% of patients with GERD continuing to experience the symptoms of heartburn in spite of treatment. This study aims to demonstrate an earlier onset to relief of symptoms in patients suffering from heartburn associated with GERD using an immediate-release omeprazole/sodium bicarbonate formulation when compared with delayed-release omeprazole (Losec®).
Study Started
Apr 30
2011
Primary Completion
Oct 31
2011
Study Completion
Oct 31
2011
Results Posted
Aug 13
2013
Estimate
Last Update
Aug 13
2013
Estimate

Drug Zegerid

20 mg Zegerid suspension to be taken when heartburn occurs. Maximum one dose per day on 3 out of 14 days.

Drug Losec

20 mg Losec capsule to be taken when heartburn occurs. Maximum one dose per day on 3 out of 14 days.

Zegerid Experimental

Treatment of heartburn with Zegerid

Losec Active Comparator

Treatment of heartburn with Losec

Criteria

Inclusion Criteria:

Study patients will be included in the study if they satisfy the following criteria:

Male or female, between 18 and 75 years old.
History of frequent episodes of heartburn associated with GERD for at least 2 3 days per week during 2-4 weeks before screening and have responded to standard PPI therapy in the past 12 months.
Have not taken on-demand PPI therapy for > 3 consecutive days within 4 weeks before the screening period.
The patient's written informed consent must be obtained prior to inclusion.
Willing and able to complete the entire procedure and to comply with study instructions.
Females of childbearing potential must employ an adequate method of birth control.

Inclusion criteria applicable to Screening period:

Recorded at least 1 evaluable episode of heartburn on 2 separate days at level 4 or higher on the 9-point Likert severity scale (point 3 on a 0-8 point scale) prior to randomisation.
Competent in the use and completion of the e-diary.

Exclusion Criteria:

Study patients will be excluded if they meet any of the following criteria:

Age < 18 or > 75 years old.
Intake of any medication for the purpose of the eradication of Helicobacter pylori (H. pylori) during the last 28 days before the start of the study.
Intake of systemic glucocorticoids or non-steroidal anti-inflammatory drugs (NSAIDs) including COX-2-inhibitors (≥ 3 consecutive days per week) during the last 28 days before the start of the study; except regular intake of enteric coated aspirin dosages up to 150 mg/d.
Previously underwent acid-lowering surgery or other surgery of the oesophagus and/or upper gastrointestinal tract (excluding: appendectomy, cholecystectomy and polypectomy).
History of co-existing disease that affects the oesophagus (e.g. Barrett's oesophagus, Zollinger-Ellison syndrome, oesophageal stricture), and have undergone an endoscopy with results of incomplete healing of erosions following standard PPI therapy within the last 3 months.
History of active gastric or duodenal ulcers within 3 months of the first dose of the study drug or had acute upper gastrointestinal (GI) bleeding within last 6 months.
Documented presence of severe renal or hepatic insufficiency.
Known hypersensitivity to omeprazole.
Concurrent participation in a study with an investigational drug or participation within 30 days of study entry.
Females who are pregnant, or planning a pregnancy. Females of child bearing potential not using reliable methods of birth control.
Clinically significant laboratory abnormality or disease which, in the opinion of the Investigator, will create a risk for the patient, obscure the effects of study treatment or interfere with study results.
Received or require any of the following drugs within 2 weeks before the first dose of study or continue to need these drugs for concurrent therapy: theophylline, bismuth salts, warfarin, phenytoin, tacrolimus, diazepam, cyclosporine, disulfiram, benzodiazepines, barbiturates, antineoplastic agents, erythromycin, clarithromycin, sucralfate, clopidogrel or protease inhibitors.
Taking concomitant medications that rely on the presence of gastric acid for optimal bioavailability (e.g. ketoconazole, ampicillin esters or iron salts).
Onset of psychoactive medication (e.g. depressants, stimulants or hallucinogens) in the previous 6 months and during the entire course of the study.

Exclusion criteria applicable to Screening period:

Recorded < 1 episode of heartburn on 2 separate days at level 4 on the 9 point Likert severity scale (point 3 on a 0-8 point scale) during the 7 day screening period prior to randomisation
Completing < 90% (< 9 out of 10) of the time points with evaluable data on the e diary.

Summary

Zegerid

Losec

All Events

Event Type Organ System Event Term Zegerid Losec

Determination of Median Time to Sustained Partial Response as Defined by Reduction in Likert Severity Scale Used to Assess Pain Associated With Heartburn in the Patient

Reduction in severity of heartburn by 2 points or more on a 9-point Likert severity scale, which is sustained for 45 minutes or more

Zegerid Group

37.5
Minutes (Median)
95% Confidence Interval: 30.0 to 45.0

Losec Group

37.5
Minutes (Median)
95% Confidence Interval: 30.0 to 45.0

Median Time to Sustained Partial Response

Reduction in severity of heartburn by 2 points or more on a 9-point Likert severity scale, which is sustained for 45 minutes or more

Zegerid Group

37.5
Minutes (Median)
95% Confidence Interval: 30.0 to 45.0

Losec Group

37.5
Minutes (Median)
95% Confidence Interval: 30.0 to 45.0

Median Time to Sustained Total Relief

Time to sustained total relief, defined as zero severity (no heartburn) on a 9-point Likert severity scale, which is sustained for 45 minutes or more

Zegerid Group

105.0
Minutes (Median)
95% Confidence Interval: 90.0 to 120.0

Losec Group

105.0
Minutes (Median)
95% Confidence Interval: 75.0 to 120.0

Percentage of Patients Responding in 45 Minutes

percentage of patients who have achieved sustained partial response, sustained response, or sustained total relief, by 45 minutes

Zegerid Group

65.0
percentage of patients
95% Confidence Interval: 55.6 to 73.5

Losec Group

62.2
percentage of patients
95% Confidence Interval: 52.5 to 71.2

Percentage of Patients Responding in 60 Minutes

Proportion of patients who have achieved sustained response, sustained partial response or sustained total relief by 60 minutes

Zegerid Group

74.4
Percentage of patients
95% Confidence Interval: 65.5 to 82.0

Losec Group

78.4
Percentage of patients
95% Confidence Interval: 69.6 to 85.6

Percentage of Patients Responding in 90 Minutes

Proportion of patients who have achieved sustained response, sustained partial response or sustained total relief by 90 minutes

Zegerid Group

88.0
Percentage of patients
95% Confidence Interval: 80.7 to 93.3

Losec Group

85.6
Percentage of patients
95% Confidence Interval: 77.6 to 91.5

Total

239
Participants

Age Continuous

44.7
years (Mean)
Standard Deviation: 14.69

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Zegerid

Losec

Drop/Withdrawal Reasons

Zegerid

Losec