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Research for Prevention and Treatment of NSAIDs Related Gastrointestinal Side Effects

Sun Yat-sen University logo

Sun Yat-sen University

Status

Unknown

Conditions

Non-steroidal Anti-inflammatory Drug Adverse Reaction

Treatments

Drug: part2:GGA group
Drug: part1:EA-EMC-T
Drug: part1:EAC-T
Drug: part1:teprenone

Study type

Interventional

Funder types

Other

Identifiers

NCT01547559
5010-2007005

Details and patient eligibility

About

We aim to evaluate the protective effects of eradication of HP and continue using Geranylgeranylacetone (GGA) on NSAIDs related gastroenterological lesions. We further aim to explore the effect of GGA on small-intestinal mucosal injuries induced by diclofenac sodium in patients with rheumatic diseases who didn't take NSAIDs in the preceding 6 months.

Full description

NSAIDs are mainly used drugs in rheumatic disease and cardiologic disease. However the gastroenterological lesions prevent patients get benefits from continuing taking NSAIDs. HP is another important factor that increase gastroenterological lesions. Both HP and NSAIDs increase risk of peptic ulcers, however, no exact relation between these two factors has been found. It is important to evaluate the protective effects of eradication of HP in NSAIDs-taking patients. In many countries ,PPI is recommended as maintain treatment in NSAIDs-taking patients to prevent gastroenterological lesions. A multicenter, open-label, randomized, parallel-group study is needed to prove the effects of Teprenone as a replacer of PPI in maintain treatment.On the other hand, Small-intestinal mucosal injuries induced by non-steroidal anti-inflammatory drugs (NSAIDs) are common. However, there are still no effective and reliable interventions established. Geranylgeranylacetone (GGA) is a mucosal protective agent, so we develop an additional trail to clarify the discrepancies of GGA effects on NSAIDs-induced small-intestinal mucosal injuries.

Enrollment

369 patients

Sex

All

Ages

18 to 80 years old

Volunteers

Accepts Healthy Volunteers

Inclusion and exclusion criteria

part1:

Inclusion Criteria:

  1. informed consents be given before treatment
  2. NSAIDs taking patients
  3. not taking PPI or other digestive drugs during previous 1 months
  4. age ranging from 18~80 years old

Exclusion Criteria:

  1. having any severe acute or chronic complications
  2. renal dysfunction, blood creatinine≥150µmol/L
  3. blood aminotransferase level rising up(more than 2 times of the normal level)
  4. any severe cardiac disease including congestive cardiac failure, unstable angina and myocardial infarct in 12 months
  5. serious hypertension (systolic pressure≥180mmHg and/ or diastolic pressure≥110mmHg)
  6. chronic or acute pancreatic disease
  7. severe systematic diseases or malignant tumor
  8. allergic to the drugs using in the trial
  9. any factors interfering the result
  10. female patients incline to be pregnant
  11. being treated with drugs influencing gastroenterological conditions.
  12. poor compliance part2:

Inclusion Criteria:

1.18 to 65 years of age 2.patients with rheumatic diseases such as ankylosing spondylitis , rheumatoid arthritis and undifferentiated arthritis 3.planning to take diclofenac sodium for at least 12 weeks 4.having freely been given their fully informed consent based on their full understanding

Exclusion Criteria:

  1. Patients were excluded if they had a history of peptic ulcer or gastrointestinal bleeding
  2. had serious liver, kidney, heart, or lung disease
  3. had suspected small-bowel obstruction
  4. had a history of gastrointestinal surgery except for appendectomy
  5. had a drug addiction or alcoholism; were pregnant or hoped to become pregnant during the study period
  6. were taking anti-secretory drugs such as PPIs or H2 receptor antagonists (H2RA), or other gastric mucosal protective drugs
  7. had a lack of consent to the surgery required if the capsule endoscope was retained in the body
  8. were judged to be inappropriate for this study by the investigator

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

369 participants in 7 patient groups

part1:blank control
No Intervention group
Description:
NO maintain drugs with Hp negative patients.
part1:teprenone 1
Experimental group
Description:
maintain treatment with Teprenone for Hp negative patients
Treatment:
Drug: part1:teprenone
Drug: part1:teprenone
part1:EAC-T
Experimental group
Description:
eradication of Hp with triple treatment
Treatment:
Drug: part1:EAC-T
part1:EA-EMC-T
Experimental group
Description:
eradication of Hp with sequential therapy
Treatment:
Drug: part1:EA-EMC-T
part1:T-T
Active Comparator group
Description:
Teprenone as maintain drugs for Hp positive patients
Treatment:
Drug: part1:teprenone
Drug: part1:teprenone
part2:GGA group
Experimental group
Description:
Geranylgeranylacetone plus diclofenac sodium for patients with rheumatic diseases
Treatment:
Drug: part2:GGA group
part2:control group
No Intervention group
Description:
diclofenac sodium only for patients with rheumatic diseases

Trial contacts and locations

2

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Data sourced from clinicaltrials.gov

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