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Helicobacter Pylori InfectionPhase 3ERADICATE Hp2NCT03198507

ERADICATE Hp2 - Treating Helicobacter Pylori With RHB-105 Compared to Active Comparator

A Phase 3 study testing RHB-105 and Active Comparator in people with Helicobacter Pylori Infection and Dyspepsia, run by RedHill Biopharma Limited at 55 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The "test and treat" strategy for treating dyspeptic patients who are H. pylori positive is rapidly becoming the standard of care. This study will test the effectiveness of RHB-105, a new triple therapy to treat H. pylori infection in dyspeptic patients against an active comparator. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Helicobacter Pylori Infection, Dyspepsia
What is being tested?
RHB-105 and Active Comparator
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
455 participants
Where
55 sitesUnited States
Study dates
18 Jun 2017to 13 Dec 2018
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Be ages 18 - 70, inclusive; non-Asian males and females (This population has been demonstrated to have significantly elevated omeprazole levels as per the prescriber information for other omeprazole products). A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam should be considered Asian, and forr this study Asian is defined as having at least one Asian grandparent (Shektar et al, 2014, FDA Guidance for Industry 2016);
  • Positive for H. pylori by 13C Urea Breath Test (UBT) and confirmed positive via gastric biopsy for campylobacter-like organism (CLO) Rapid Urease Test, or H. pylori culture or histology;
  • Symptoms consistent with dyspepsia of at least two weeks duration (defined as recurrent pain or discomfort centered in the upper abdomen, often with a relation to meals);
  • Females must not be pregnant or lactating and:
  • at no risk of pregnancy for one of the following reasons: postmenopausal for at least one year from the date of informed consent, status post hysterectomy or tubal ligation, OR
  • are prepared to and agree to use of an intrauterine device (IUD) or practice double method birth control (barrier plus spermicide) from screening through to 30 days post-end of-treatment (EOT); Acceptable double contraceptive methods include barrier (condoms or diaphragms) plus spermicide
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  • Hormonal contraceptives (birth control pills and hormone implants) are not acceptable contraception methods under this protocol;
  • Males must be surgically sterilized or are prepared to and agree to practice double method (barrier plus spermicide) birth control from screening through to 30 days post-EOT;
  • Agree to refrain from consuming alcohol from 1 week prior to screening to Test of Cure/Visit 5;
  • Agree to refrain from taking antacids from screening through day 15 and for at least 24 hours prior to Test of Cure/Visit 5 and if applicable at least 24 hours prior to Visit 8/Test of Cure;
  • Agree to refrain from taking H2 blockers at least 24 hours prior to screening 13C UBT and at least 24 hours prior to Test of Cure/Visit 5 and if applicable at least 24 hours prior to Visit 8/Test of Cure;
  • Agree to refrain from taking sucralfate from one week prior to screening through Test of Cure/Visit5;
  • Agree to refrain from taking bismuth containing medications such as Pepto-BismolTM or other proton pump inhibitors (PPIs) from two weeks prior to screening through Test of Cure/Visit 5;
  • Agrees to refrain from consuming grapefruit, or any other food or supplement known to significantly affect CYP3A4 or CYP2C19 activity from screening to day 15;
  • Provide written informed consent to participate as shown by a signature of subject on the consent form.

Who cannot join

  • Have alarm symptoms/signs (including unexplained anemia [iron deficiency], melena / hematemesis, anorexia, dysphagia, jaundice, weight loss);
  • Have received prior H. pylori eradication therapy;
  • Use of antibiotics in the 4 weeks immediately prior to screening 13C UBT;
  • Use of any proton pump inhibitors (PPIs) or bismuth-containing medications (such as Pepto-BismolTM) within the 2 weeks immediately prior to screening 13C UBT;
  • Use of any of the following medications within seven days prior screening: alfentanil, allopurinol, amlodipine, anti-herpes agents, anti-retroviral agents, apixaban, aprepitant, aripiprazole, astemizole, atorvastatin, boceprevir, buspirone, carbamazepine, cisapride, citalopram dosed greater than 20 mg /d, clomipramine, clopidogrel and other oral anticoagulants, colchicine, dapsone, dihydroergotamine, digoxin, diltiazem, ergotamine, felodipine, fluconazole, gleevec, hormonal contraceptives that are not exclusively norethindrone or norgestrel, imipramine, itraconazole, ketoconazole, latuda, lovastatin, mycophenolate mofetil, nifedipine, nisoldipine, nitrendipine, phenytoin, pimozide, probenecid, proguanil, quinine, roflumilast, terfenadine and voriconazole;
  • Use of amiodarone;
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  • Presence of more than two active gastric and/or duodenal ulcers;
  • History of gastric outlet obstruction; or hypersecretory state (e.g., Zollinger Ellison Syndrome);
  • History of esophageal or gastric surgery, except for simple closure of perforated ulcer;
  • History of gastric cancer;
  • History of malignancy within the past five years except for basal cell carcinoma of the skin or carcinoma in situ of the cervix that has been treated with no evidence of recurrence;
  • Positive screening laboratory results for human immunodeficiency virus (HIV) antibody (HIV1 or HIV2), or hepatitis B surface antigen (HBs Ag), or hepatitis C antibody (HCV Ab), unless patient has documented sustained viral response evidenced by prior and/or current absence of viral RNA at least 24 weeks after completing antiviral therapy;
  • Current drug or alcohol abuse or history of drug or alcohol abuse in the past 5 years from screening;
  • Known hypersensitivity or suspected history of hypersensitivity reactions to any of the study drugs or related drugs, including cephalosporins and penicillin;
  • Clinical evidence of any disease that in the opinion of the investigator might interfere with the subject's ability to participate in the trial;
  • History of QT prolongation (QTc greater than 450ms in males and 460ms in females), or ventricular arrhythmia, including torsades de pointes;
  • Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) >3x Upper Limit of Normal (ULN), or Alkaline Phosphatase (APO4) >2x ULN, or Total Bilirubin >2x ULN. Subjects with confirmed diagnosis of Gilbert's Syndrome are excluded if Total Bilirubin > 2.5x ULN;
  • Unable to communicate well with the Investigators and to comply with the study requirements;
  • Involved in any other experimental drug or device protocol (outside of this RHB-105-02 study) within the 4 weeks immediately prior to screening visit through end of study;
  • Subjects with creatinine clearance less than 30 ml/min at screening via estimated Cockcroft-Gault (eCGF) formula: eCGF or estimated creatinine clearance = [140 - age in years] * weight (kg) / 72 * Serum Creatinine (mg/dl) [multiply estimated rate by 0.85 for women], using actual body weight at screening.

Trial locations and contacts

55 sites in 1 country.

55 sites in 1 country

United States55 sites
  • Research Site

    Anaheim, California, 92801

  • Research Site

    Athens, Georgia, 30607

  • Research Site

    Aventura, Florida, 33180

  • Research Site

    Baltimore, Maryland, 21215

  • Research Site

    Bristol, Connecticut, 06010

  • Research Site

    Brockton, Massachusetts, 02302

  • Research Site

    Charlottesville, Virginia, 22911

  • Research Site

    Chesterfield, Missouri, 48047

  • Research Site

    Chevy Chase, Maryland, 20815

  • Research Site

    Christiansburg, Virginia, 24073

  • Research Site

    Chula Vista, California, 91910

  • Research Site

    Clearwater, Florida, 33765

  • Research Site

    Concord, North Carolina, 28025

  • Research Site

    Coral Springs, Florida, 33071

  • Research Site

    Davidson, North Carolina, 28036

  • Research Site

    Dothan, Alabama, 36305

  • Research Site

    Elwood, Indiana, 46036

  • Research Site

    Fayetteville, North Carolina, 28304

  • Research Site

    Great Neck, New York, 11023

  • Research Site

    Greenville, North Carolina, 27834

  • Research Site

    Greenville, South Carolina, 29615

  • Research site

    Hermitage, Tennessee, 37076

  • Research Site

    Homestead, Florida, 33030

  • Research site

    Houston, Texas, 77043

  • Research Site

    Houston, Texas, 77079

  • Research Site

    Houston, Texas, 77084

  • Research Center

    Houston, Texas, 77090

  • Research site

    Houston, Texas, 77098

  • Research Site

    Jacksonville, Florida, 28546

  • Research Site

    Las Vegas, Nevada, 89119

  • Research Site

    Las Vegas, Nevada, 89128

  • Research Site

    Lauderdale Lakes, Florida, 33319

  • Research Site

    Lomita, California, 90717

  • Research Site

    Longview, Texas, 75605

  • Research Site

    Lynchburg, Virginia, 24502

  • Research Site

    Macon, Georgia, 31201

  • Research Site

    Marietta, Georgia, 30060

  • Research Site

    Metairie, Louisiana, 70006

  • Research Site

    Miami, Florida, 33144

  • Research Site

    Miami, Florida, 33165

  • Research site

    Milwaukee, Wisconsin, 53215

  • Research Site

    Nashville, Tennessee, 37203

  • Research Site

    North Little Rock, Arkansas, 72117

  • Research Site

    Ogden, Utah, 84405

  • Research Site

    Orange City, Florida, 32763

  • Research Site

    Palm Harbor, Florida, 34684

  • Research Site

    Phoenix, Arizona, 85018

  • Research Site

    Richardson, Texas, 75082

  • Research Site

    San Antonio, Texas, 78229

  • Research site

    San Carlos, California, 94070

  • Research Site

    Shreveport, Louisiana, 71105

  • Research Site

    Sioux Falls, South Dakota, 57108

  • Research Site

    Tucson, Arizona, 85710

  • Research Site

    Tulsa, Oklahoma, 74135

  • Research Site

    Wyoming, Missouri, 49519

Other trials in United States

About this study

Official title: A Randomized Double Blind Active Comparator Controlled Phase III Study to Assess the Safety and Efficacy of RHB-105 in the Treatment of Confirmed Helicobacter Pylori (H. Pylori) Infection

The "test and treat" strategy for treating dyspeptic patients who are H. pylori positive is rapidly becoming the standard of care. This study will test the effectiveness of RHB-105, a new triple therapy to treat H. pylori infection in dyspeptic patients against an active comparator.

Read the detailed description

This is a, randomized, double blind, active comparator-controlled study of RHB-105 in adult subjects complaining of epigastric discomfort that have been screened and found to be positive for H. pylori infection via 13C UBT and gastric biopsy.

The biopsy samples will also be used to conduct H. pylori antibiotic susceptibility/resistance assessment.

The study will be conducted at up to 65 sites in the USA. Eligible subjects will be randomized in a ratio of 1:1 between the RHB-105 arm (n=222) and the active comparator arm (n=222). Subjects will receive RHB-105 or active comparator for 14 consecutive days. Eradication of H. pylori infection will be determined at Visit 5 based on 13C UBT testing conducted between 43 and 71 days after initiation of study drug therapy.

All subjects who meet inclusion and exclusion criteria and have positive13C UBT will undergo upper endoscopy with sampling for culture and sensitivity testing (to rifabutin, amoxicillin, clarithromycin, and metronidazole) prior to randomization. After test of cure at Visit 5, all H. pylori eradication failures will receive susceptibility directed Standard of Care therapy based on initial culture results for subjects, and undergo repeat upper endoscopy for post treatment antibiotic susceptibility/resistance assessment.

Being tested
RHB-105, Active Comparator
Medical subject headings
Dyspepsia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RHB-105Drug

    Also called Amoxicillin, Omeprazole and Rifabutin

    The intended dose of RHB-105 (12.5 mg rifabutin, 250 mg amoxicillin, and 10 mg omeprazole capsules) 4 capsules every eight hours, is equivalent to a total daily dose of:

    • Rifabutin 150 mg
    • Amoxicillin 3000 mg
    • Omeprazole 120 mg

    One 50mg Riboflavin tablet to be taken once daily to maintain the blind.

  • Active ComparatorDrug

    Also called Amoxicillin and Omeprazole

    The intended dose of the Active Comparator (250 mg amoxicillin, and 10 mg omeprazole capsules) 4 capsules every eight hours, equivalent to a total daily dose of:

    • Amoxicillin 3000 mg
    • Omeprazole 120 mg

    One 50mg Riboflavin tablet to be taken once daily to maintain the blind.

Study groups in NCT03198507
Study groupRoleWhat they receive
RHB-105ExperimentalRHB-105 is an 'all-in-one' combination oral capsule consisting of combination therapy of Amoxicillin, Omeprazole and Rifabutin; as well as separate Riboflavin
Receives: Drug: RHB-105
Active ComparatorActive comparatorActive comparator is an 'all-in-one' combination oral capsule consisting of combination therapy of Amoxicillin and Omeprazole; as well as separate Riboflavin
Receives: Drug: Active Comparator

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants With Eradication of H. Pylori

    Eradication of H. pylori confirmed via 13C Urea Breath Test (UBT) testing. Subjects with negative test results (eradication of H. pylori) were considered treatment successes. Subjects who tested positive for H. pylori infection (no eradication) were considered treatment failures.

    Measured: 43-71 days after initiation of treatment

Secondary outcomes (2)
  1. Number of Participants With H. Pylori Cultures That Presented Antibiotic Resistance and Susceptibility

    The primary endpoint was summarized within subgroups formed by the presence of H. pylori susceptibility and resistance to amoxicillin, clarithromycin, metronidazole, and rifabutin from H. pylori cultures from samples obtained prior to initiating study treatment (i.e. baseline).

    A participant is considered a responder when H. pylori is eradicated after treatment as confirmed via 13C Urea Breath Test (UBT). A participant is considered a non-responder when H. pylori is not eradicated after treatment.

    Measured: 43-71 days after initiation of treatment

  2. Number of Participants With Adverse Events That Are Related to Treatment

    The number of participants that presented treatment emergent adverse events (TEAE) during the study overall, TEAEs related to study drug and severe TEAEs.

    Measured: After first dose of study drug until 28 days following last dose.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jun 2017
  2. Study start18 Jun 2017
  3. Primary completion24 Oct 2018
  4. Study completion13 Dec 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
455 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03198507
Sponsor's protocol ID
RHB-105-02
Acronym
ERADICATE Hp2
Status last verified
Aug 2018
First submitted
7 Jun 2017
Last updated
16 Mar 2020
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Howden CW, Sheldon KL, Almenoff JS, Chey WD. Pitfalls of Physician-Directed Treatment of Helicobacter pylori: Results from Two Phase 3 Clinical Trials and Real-World Prescribing Data. Dig Dis Sci. 2022 Sep;67(9):4382-4386. doi: 10.1007/s10620-021-07323-5. Epub 2021 Dec 4.

    PubMed 34862940
  • Graham DY, Canaan Y, Maher J, Wiener G, Hulten KG, Kalfus IN. Rifabutin-Based Triple Therapy (RHB-105) for Helicobacter pylori Eradication: A Double-Blind, Randomized, Controlled Trial. Ann Intern Med. 2020 Jun 16;172(12):795-802. doi: 10.7326/M19-3734. Epub 2020 May 5.

    PubMed 32365359

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing RHB-105 and Active Comparator in people with Helicobacter Pylori Infection and Dyspepsia, run by RedHill Biopharma Limited at 55 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 55 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 16 Mar 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants With Eradication of H. Pylori (time frame: 43-71 days after initiation of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03198507, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Mar 2020.

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