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Completed

NCT Number: NCT02632812

Gastrointestinal Integrity After Naproxen + Rebamipide Versus Naproxen + Placebo

This is a double-blind, placebo-controlled, randomized, parallel trial to evaluate if rebamipide reduces the number of gastric events caused by naproxen. Sample size is 24 participants (12 per treatment group), male or female, aged 18 years-old and above.

Primary objective is to compare rebamipide effervescent granules 100 mg twice daily, plus naproxen (coated tablets) 550 mg twice daily to placebo plus naproxen 550 mg twice daily, for seven days, in reduction of gastric events caused by naproxen. Secondary objective is to evaluate safety and tolerability of rebamipide after multiple administrations.

Participants will receive either rebamipide + naproxen or placebo + naproxen, as above, during 7 consecutive days, which will be accompanied by a follow-up visit.

Gastric integrity will be assessed, before and after treatment, by endoscopy, with stomach biopsies and detection of H. pylori. Additionally, detection of occult blood in the stool will be performed, before and after treatment.

From the above-mentioned biopsies, dosage of prostaglandin E2 and histopathological analysis will be performed.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female study participants, aged 18 years-old and above; women cannot be pregnant or breastfeeding;
  • Body mass index (BMI) greater than or equal to 19 and less than or equal to 28.75 Kg/m2;
  • Good health conditions or without significant diseases, according to best medical judgement, according to protocol requirements and study evaluations: medical history, blood pressure and heart rate measurements, physical examination, electrocardiogram (ECG) and screening laboratory tests;
  • Ability to understand the nature and objectives of the trial, including risks and adverse events; willingness to cooperate with the researcher and proceed according to all study requirements, which shall be confirmed by Informed Consent Form signature.

Exclusion criteria

  • Known hypersensitivity to the investigational products (naproxen or rebamipide) or chemically related compounds; history of serious adverse reactions or hypersensitivity to any drug;
  • Subject does not present intact superior gastrointestinal mucosa, i.e., presenting bleeding, ulcers and apparent injuries in baseline endoscopy;
  • Subject has achlorhydria (intragastric pH > 6.5);
  • History or presence of hepatic or gastrointestinal diseases, or other condition that interferes with drug absorption, distribution, excretion or metabolism;
  • Chronic therapy with any drugs, except oral contraceptives;
  • History of hepatic, kidney, lungs, gastrointestinal, epileptic, hematologic or psychiatric disease; hypotension or hypertension, of any etiology, that requires pharmacological treatment; history of myocardial infarction, angina and/or heart failure;
  • Occult blood in the stool before treatment;
  • Electrocardiographic findings that, at investigator criteria, are not recommended for study participation;
  • Deviations on screening laboratory results that are considered as clinically relevant by the principal investigator;
  • History of drugs and alcohol addiction or excessive alcohol consumption (> 35 g/day);
  • Use of regular medications within 2 weeks prior study enrollment or use of any medications within one week prior to study enrollment, except oral contraceptives or cases which, based on drug's or metabolite's half-life, complete elimination can be assumed;
  • Treatment, within 6 months before the trial, with any drugs known to have a well-established toxic potential to major organs;
  • Participation in any other experimental research or administration of any experimental drug within 6 months before this trial;
  • Any condition, according to investigator's best judgement, that prevents the subject to participate in the trial;
  • Pregnancy, labor or miscarriage with 12 weeks before admission predicted date.

Treatment and study plan

Rebamipide effervescent granules

Drug

Rebamipide effervescent granules 100mg (oral), twice daily for 7 days

Placebo effervescent granules

Drug

Placebo effervescent granules (oral), twice daily for 7 days

Naproxen tablet

Drug

Naproxen tablet 550mg (tablet), twice daily for 7 days

Primary outcomes

  1. Endoscopic Score - Cryer Score

    Time frame: 8 days

    Cryer score according to gastroduodenal mucosal injury:

    0 = Normal or erythema

    • = Any amount of submucosal hemorrhage or edema without erosions
    • = 1 erosion +- submucosal hemorrhage or edema
    • = 2-4 erosions +- submucosal hemorrhage or edema
    • = 5 or more erosions and/or a single ulcer +- submucosal hemorrhage or edema
    • = Multiple ulcers +- submucosal hemorrhage or edema - Ulcer
  2. Endoscopic Score - Modified Lanza Score

    Time frame: 8 days

    Modified Lanza score according to gastroduodenal mucosal injury:

    0 = No hemorrhage or erosion observed

    • = One or two hemorrhages or erosions observed in one gastric area
    • = Three to five hemorrhages or erosions observed in one gastric area
    • = Hemorrhages or erosions observed in two gastric areas, six or more hemorrhages or erosions observed in one gastric area, with the total number not exceeding ten in the entire stomach
    • = Hemorrhages or erosions observed in three or more gastric areas; eleven or more hemorrhages or erosions observed widely in the entire stomach
    • = Ulcer
  3. Histopathological Score

    Time frame: 8 days

    Histopathologic grade score developed for microscopic injury evaluation 0 = Normal gastric mucosa or mild chronic inflammation

    • = Chronic gastritis without activity
    • = Chronic gastritis with activity on antrum
    • = Chronic gastritis with activity on the body
    • = Chronic gastritis with activity on antrum and on the body
  4. Intragastric pH

    Time frame: 8 days

  5. Presence of H. Pylori by Biopsy

    Time frame: 8 days

    Giemsa stain was used to diagnose H. pylori (positive = presence of H. pylori)

  6. Prostaglandin Level (PGE2 Quantification)

    Time frame: 8 days

    Tissue prostaglandin concentration quantified by enzyme-linked immunosorbent assay (ELISA) using Cayman Chemical Monoclonal Prostaglandin E2 EIA Kit (item number 514010)

Secondary outcomes

  1. Number of Adverse Events

    Time frame: 60 days

Sponsors and collaborators

Lead sponsor

Biolab Sanus Farmaceutica

Industry

Registry information

Official study title

Double-blind Trial on the Gastrointestinal Integrity Evaluation After Daily Naproxen 1100 mg + Rebamipide 200mg for 7 Days Versus Naproxen 1100mg + Placebo for 7 Days

Important dates

Study start
2014
Primary completion
2014
Study completion
2014
First posted
Dec 17, 2015
Registry last updated
Mar 20, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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