E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Clinically Diagnosed Gastroesophageal Reflux Disease (GERD) in Pediatric and Adolescent Patients 12 to 17 Years of Age, Inclusive |
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E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10017885 |
E.1.2 | Term | Gastrooesophageal reflux disease |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Primary: The primary objective of this study was to evaluate the safety and tolerability of once daily treatment with esomeprazole in pediatric and adolescent patients 12 to 17 years of age, inclusive, with clinically diagnosed GERD. |
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E.2.2 | Secondary objectives of the trial |
Secondary: The secondary objective of this study was to evaluate the clinical outcome of once daily treatment with esomeprazole in relieving GERD-associated signs and symptoms in pediatric and adolescent patients 12 to 17 years of age, inclusive, with clinically diagnosed GERD. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provision of signed written informed consent from the patient’s parent/guardian, and assent from the patient prior to conducting any study-related procedures.
2. Males or females between the age of 12 and 17 years inclusive.
3. Females of childbearing potential were either not sexually active or were using an adequate birth control method throughout the duration of the study. The investigator determined if the birth control method was adequate on a case-by-case basis. All females of childbearing potential had to have a negative urine pregnancy test at Visit 1 (Screening Visit) and Visit 4 (Study Day 28) to participate or continue to participate. A third urine pregnancy test was performed at the end of the study or Visit 6 (Study Day 56).
4. Had a clinical diagnosis of GERD made by the investigator based on any of the following factors: medical history including a review of systems, physical examination, laboratory test results, or information from diagnostic testing. Notes in the patient’s medical record along with other source documentation were used to support the diagnosis.
5. Eligible for treatment with an acid suppression agent, based on investigator-judgement.
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E.4 | Principal exclusion criteria |
1. PPI use within 14 days prior to randomization (Visit 2), including over-the-counter (OTC) PRILOSEC® (AstraZeneca LP).
2. Any prescription or OTC treatment use for symptoms of GERD, such as H2RA or prokinetics, within 3 days (72 hours) prior to randomization (Visit 2). Antacids were allowed, except for those containing bismuth.
3. A history of (within 1 year) or a current need for resectional or reconstructive surgery of the esophagus, stomach, duodenum, or jejunum.
4. Need for any of the following concomitant medications during the course of the study: bismuth-containing products, barbiturates, anti-convulsants, warfarin, narcotics, antineoplastic agents, H2RAs, sucralfate, anti-emetics (ie, metoclopramide), pro-motility drugs (ie, cisapride), systemic steroids (oral and intravenous), or macrolide antibiotics (such as erythromycin). Use of topical erythromycin was permissible. Occasional doses of nonsteroidal anti-inflammatory drugs (NSAID) or salicylates (3 days) to treat acute conditions was permissible.
5. Any of the following diseases/conditions: active gastrointestinal bleed, acute peptic ulcer disease, inflammatory bowel disease, allergic gastroenteropathies, eosinophilic gastroenteritis, bleeding disorders, active seizure disorder, ongoing treatment for seizure disorder, acute pancreatitis, metabolic diseases, or meningitis.
6. Any acute or chronic illness that, in the opinion of the investigator, placed the patient at risk because of their participation in the study or potentially would confound the study data by including the patient. Conditions that were considered for exclusion (however, exclusion was neither required nor limited to): severe cerebral palsy, acute pneumonia, recent trauma, known or suspected abuse or neglect, severe malabsorption, fever of undetermined origin, or any unstable or severe renal, hepatic, cardiac, pulmonary, metabolic or congenital problems that could put the patient at risk by participating in the study. The decision to exclude a patient from study participation in these cases was made by the investigator or AstraZeneca based on the severity of the condition and potential risk to the patient.
7. H. pylori infection was evaluated on a case-by-case basis. Absolute exclusions were those children with active gastric or duodenal ulceration associated with H. pylori. If there was no documentation of active ulcerations or recent GI bleed, the principal investigator could have, at their discretion, planned for their anti-helicobacter antibiotic course after this study was completed, provided the patient’s parents/guardian agreed with course of treatment.
8. Acute respiratory distress within 72 hours prior to randomization (Visit 2). These patients were eligible for reevaluation for inclusion once acute symptoms had subsided.
9. Any condition that required surgery during the course of the study.
10. A known hypersensitivity, allergy, or intolerance to any component of esomeprazole or omeprazole.
11. Use of any other investigational compound within 28 days prior to the screening visit. Patients who used investigational devices or products that were not systemically absorbed within 28 days prior to the screening visit were to be discussed with the sponsor on a case-by-case basis prior to randomization (Visit 2).
12. Any condition that, in the judgment of the investigator, made performance of any of the study procedures unsafe, or which made it unlikely that the patient would complete the study and all study procedures including behavioral problems such as Attention Deficit Disorder or Pervasive Development Disorders.
13. Had parents who had any condition that, in the judgment of the investigator, made it difficult for the patient to complete the study and all study procedures. Examples included substance abuse or a serious medical condition that compromised the patient’s participation in the study.
14. Clinically significant abnormal values at screening from laboratory measurements, physical examinations, or vital signs which, in the opinion of the investigator and/or AstraZeneca, would either put the patient at risk when participating in the study or would affect the patient’s ability to participate in the study. In addition, if the values from the laboratory measurements were both unexplained and potentially significant, in the opinion of the investigator and/or AstraZeneca, the patient was excluded. This did not include abnormal values for those directly related to some concurrent and stable disease.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary variables were the changes from baseline in medical history, physical examinations, clinical laboratory evaluations, and AEs. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
During the course of the study, treatment period 8 weeks and up to 2 weeks post last dosing. |
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E.5.2 | Secondary end point(s) |
Secondary outcome variable
Assessment of changes from baseline in daily patient symptom assessment as reported by the patient.
Assessment of changes from baseline in Physician Global Assessment.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
During the 8 weeks treatment period. Last assessement last day of treatment. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
Will this trial be conducted at a single site globally?
| No |
E.8.4 | Will this trial be conducted at multiple sites globally? | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | Specify the countries outside of the EEA in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |