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    Clinical Trial Results:
    A Phase 3 Randomized Multicenter Study to Evaluate the Efficacy and Safety of Open-Label Dual Therapy with Oral Vonoprazan 20 mg or Double-Blind Triple Therapy with Oral Vonoprazan 20 mg Compared to Double-Blind Triple Therapy with Oral Lansoprazole 30 mg Daily in Patients with Helicobacter Pylori Infection

    Summary
    EudraCT number
    2019-002668-28
    Trial protocol
    HU   GB   CZ   PL   BG  
    Global end of trial date
    18 Mar 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    25 Mar 2022
    First version publication date
    25 Mar 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    HP-301
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04167670
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Phathom Pharmaceuticals, Inc.
    Sponsor organisation address
    2150 East Lake Cook Road, Suite 800, Buffalo Grove, Illinois, United States, 60089
    Public contact
    Phathom Medical Information, Phathom Pharmaceuticals, Inc., medicalinformation@phathompharma.com
    Scientific contact
    Phathom Medical Information, Phathom Pharmaceuticals, Inc., medicalinformation@phathompharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    18 Mar 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Mar 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial was to compare the efficacy of Helicobacter pylori (H pylori) eradication with vonoprazan dual and triple therapy regimens versus lansoprazole triple therapy regimen in participants with H pylori infection, excluding participants who had a clarithromycin or amoxicillin resistant strain of H pylori at baseline.
    Protection of trial subjects
    This study was conducted in compliance with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) E6(R2) Section 3, Institutional Review Board (IRB)/Independent Ethics Committee (IEC) guidelines, Good Clinical Practice regulations and guidelines, and all applicable local regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    10 Dec 2019
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 426
    Country: Number of subjects enrolled
    United Kingdom: 8
    Country: Number of subjects enrolled
    Bulgaria: 122
    Country: Number of subjects enrolled
    Czechia: 18
    Country: Number of subjects enrolled
    Hungary: 25
    Country: Number of subjects enrolled
    United States: 447
    Worldwide total number of subjects
    1046
    EEA total number of subjects
    591
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    828
    From 65 to 84 years
    217
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    1046 participants were randomized at 103 study sites, including 71 in the United States and 32 in Europe.

    Pre-assignment
    Screening details
    A ^13C-urea breath test (^13C-UBT) was performed within 34 days prior to treatment to establish Helicobacter pylori (H pylori) infection status. 6 gastric mucosal biopsy specimens were collected to determine resistance of bacteria to clarithromycin, amoxicillin, and metronidazole antibiotics and to document H pylori infection.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Vonoprazan Dual Therapy was open label and Vonoprazan Triple Therapy was double blinded.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Vonoprazan Dual Therapy
    Arm description
    Participants were administered 20 milligrams (mg) vonoprazan twice daily (BID) and 1000 mg amoxicillin 3 times daily (TID) from Day 1 to Day 14.
    Arm type
    Experimental

    Investigational medicinal product name
    Vonoprazan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Vonoprazan was administered orally as over-encapsulated tablets.

    Investigational medicinal product name
    Amoxicillin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Amoxicillin was administered orally as capsules.

    Arm title
    Vonoprazan Triple Therapy
    Arm description
    Participants were administered 20 mg vonoprazan BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.
    Arm type
    Experimental

    Investigational medicinal product name
    Vonoprazan
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Vonoprazan was administered orally as over-encapsulated tablets.

    Investigational medicinal product name
    Amoxicillin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Amoxicillin was administered orally as capsules.

    Investigational medicinal product name
    Clarithromycin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Clarithromycin was administered orally as tablets.

    Arm title
    Lansoprazole Triple Therapy
    Arm description
    Participants were administered 30 mg lansoprazole BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.
    Arm type
    Active comparator

    Investigational medicinal product name
    Amoxicillin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Amoxicillin was administered orally as capsules.

    Investigational medicinal product name
    Clarithromycin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Clarithromycin was administered orally as tablets.

    Investigational medicinal product name
    Lansoprazole
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Lansoprazole was administered orally as over-encapsulated capsules.

    Number of subjects in period 1
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy
    Started
    349
    349
    348
    Received Study Drugs
    348
    346
    345
    Completed
    334
    331
    334
    Not completed
    15
    18
    14
         Significant protocol deviation
    3
    1
    -
         Withdrawal of Consent
    4
    1
    3
         Pretreatment event, AE, or SAE
    1
    7
    4
         Miscellaneous
    7
    5
    3
         Lost to follow-up
    -
    3
    3
         Voluntary withdrawal
    -
    1
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Vonoprazan Dual Therapy
    Reporting group description
    Participants were administered 20 milligrams (mg) vonoprazan twice daily (BID) and 1000 mg amoxicillin 3 times daily (TID) from Day 1 to Day 14.

    Reporting group title
    Vonoprazan Triple Therapy
    Reporting group description
    Participants were administered 20 mg vonoprazan BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.

    Reporting group title
    Lansoprazole Triple Therapy
    Reporting group description
    Participants were administered 30 mg lansoprazole BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.

    Reporting group values
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy Total
    Number of subjects
    349 349 348 1046
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    51.9283668 ± 13.4524716 50.7220630 ± 13.8812741 51.6379310 ± 13.5714970 -
    Gender categorical
    Units: Subjects
        Female
    210 226 216 652
        Male
    139 123 132 394
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    95 99 89 283
        Not Hispanic or Latino
    251 249 259 759
        Unknown or Not Reported
    3 1 0 4
    Race/Ethnicity
    Units: Subjects
        White
    316 307 312 935
        Black or African- American
    22 30 25 77
        Asian
    4 6 6 16
        American Indian or Alaska Native
    0 1 1 2
        Native Hawaiian or Other Pacific Islander
    1 0 0 1
        Other
    4 1 3 8
        Unknown
    1 1 1 3
        Not Reported
    1 3 0 4

    End points

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    End points reporting groups
    Reporting group title
    Vonoprazan Dual Therapy
    Reporting group description
    Participants were administered 20 milligrams (mg) vonoprazan twice daily (BID) and 1000 mg amoxicillin 3 times daily (TID) from Day 1 to Day 14.

    Reporting group title
    Vonoprazan Triple Therapy
    Reporting group description
    Participants were administered 20 mg vonoprazan BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.

    Reporting group title
    Lansoprazole Triple Therapy
    Reporting group description
    Participants were administered 30 mg lansoprazole BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.

    Primary: Percentage of Participants With Successful Helicobacter Pylori (H Pylori) Eradication in Participants Without a Clarithromycin- or Amoxicillin-resistant Strain of H Pylori at Baseline

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    End point title
    Percentage of Participants With Successful Helicobacter Pylori (H Pylori) Eradication in Participants Without a Clarithromycin- or Amoxicillin-resistant Strain of H Pylori at Baseline
    End point description
    H pylori eradication was determined by the ^13C-UBT test. The analysis set used was the Modified Intent-to-Treat Primary (MITTp) analysis set which included all participants randomized into the study who had a H pylori infection documented by ^13C-UBT and biopsy (ie, culture or histology) at baseline and did not have a clarithromycin- or amoxicillin-resistant strain of H pylori at baseline.
    End point type
    Primary
    End point timeframe
    4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
    End point values
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy
    Number of subjects analysed
    265
    262
    255
    Units: percentage of participants
        number (not applicable)
    78.5
    84.7
    78.8
    Statistical analysis title
    Vonoprazan Dual vs Lansoprazole Triple
    Comparison groups
    Vonoprazan Dual Therapy v Lansoprazole Triple Therapy
    Number of subjects included in analysis
    520
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [1]
    P-value
    = 0.0037 [2]
    Method
    Farrington and Manning test
    Parameter type
    Percentage Difference
    Point estimate
    -0.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -7.39
         upper limit
    6.76
    Notes
    [1] - Noninferiority of vonoprazan dual therapy to lansoprazole triple therapy.
    [2] - P-value based on a Farrington and Manning test with a noninferiority margin of 10%.
    Statistical analysis title
    Vonoprazan Triple vs Lansoprazole Triple
    Comparison groups
    Lansoprazole Triple Therapy v Vonoprazan Triple Therapy
    Number of subjects included in analysis
    517
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [3]
    P-value
    < 0.0001 [4]
    Method
    Farrington and Manning test
    Parameter type
    Percentage Difference
    Point estimate
    5.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.75
         upper limit
    12.62
    Notes
    [3] - Noninferiority of vonoprazan triple therapy to lansoprazole triple therapy.
    [4] - P-value based on a Farrington and Manning test with a noninferiority margin of 10%.

    Secondary: Percentage of Participants With Successful Helicobacter Pylori (H Pylori) Eradication in Participants With a Clarithromycin-resistant Strain of H Pylori at Baseline

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    End point title
    Percentage of Participants With Successful Helicobacter Pylori (H Pylori) Eradication in Participants With a Clarithromycin-resistant Strain of H Pylori at Baseline
    End point description
    H pylori eradication was determined by the ^13C-UBT test. The analysis population included all participants randomized into the study who had H pylori infection documented by ^13C-UBT and biopsy (ie, culture or histology) at baseline and had a clarithromycin-resistant strain of H pylori at baseline.
    End point type
    Secondary
    End point timeframe
    4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
    End point values
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy
    Number of subjects analysed
    56
    73
    72
    Units: percentage of participants
        number (not applicable)
    69.6
    65.8
    31.9
    Statistical analysis title
    Vonoprazan Dual vs Lansoprazole Triple
    Comparison groups
    Vonoprazan Dual Therapy v Lansoprazole Triple Therapy
    Number of subjects included in analysis
    128
    Analysis specification
    Pre-specified
    Analysis type
    superiority [5]
    P-value
    < 0.0001 [6]
    Method
    Farrington and Manning test
    Parameter type
    Percentage Difference
    Point estimate
    37.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    20.54
         upper limit
    52.56
    Notes
    [5] - Superiority of vonoprazan dual therapy to lansoprazole triple therapy.
    [6] - P-value based on a Farrington and Manning test with the null hypothesis difference ≤0 versus the alternative hypothesis difference >0.
    Statistical analysis title
    Vonoprazan Triple vs Lansoprazole Triple
    Comparison groups
    Lansoprazole Triple Therapy v Vonoprazan Triple Therapy
    Number of subjects included in analysis
    145
    Analysis specification
    Pre-specified
    Analysis type
    superiority [7]
    P-value
    < 0.0001 [8]
    Method
    Farrington and Manning test
    Parameter type
    Percentage Difference
    Point estimate
    33.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    17.74
         upper limit
    48.12
    Notes
    [7] - Superiority of vonoprazan triple therapy to lansoprazole triple therapy.
    [8] - P-value based on a Farrington and Manning test with the null hypothesis difference ≤0 versus the alternative hypothesis difference >0.

    Secondary: Percentage of All Participants With Successful Helicobacter Pylori (H Pylori) Eradication

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    End point title
    Percentage of All Participants With Successful Helicobacter Pylori (H Pylori) Eradication
    End point description
    H pylori eradication was determined by the ^13C-UBT test. The analysis set used was the modified intent-to-treat (MITT) analysis set which included all participants randomized into the study who had H pylori infection documented by ^13C-UBT and biopsy (ie, culture or histology) at baseline.
    End point type
    Secondary
    End point timeframe
    4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
    End point values
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy
    Number of subjects analysed
    324
    338
    330
    Units: percentage of participants
        number (not applicable)
    77.2
    80.8
    68.5
    Statistical analysis title
    Vonoprazan Dual vs Lansoprazole Triple
    Comparison groups
    Vonoprazan Dual Therapy v Lansoprazole Triple Therapy
    Number of subjects included in analysis
    654
    Analysis specification
    Pre-specified
    Analysis type
    superiority [9]
    P-value
    = 0.0063 [10]
    Method
    Farrington and Manning test
    Parameter type
    Percentage Difference
    Point estimate
    8.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.86
         upper limit
    15.44
    Notes
    [9] - Superiority of vonoprazan dual therapy to lansoprazole triple therapy.
    [10] - P-value based on a Farrington and Manning test with the null hypothesis difference ≤0 versus the alternative hypothesis difference >0.
    Statistical analysis title
    Vonoprazan Triple vs Lansoprazole Triple
    Comparison groups
    Lansoprazole Triple Therapy v Vonoprazan Triple Therapy
    Number of subjects included in analysis
    668
    Analysis specification
    Pre-specified
    Analysis type
    superiority [11]
    P-value
    = 0.0001 [12]
    Method
    Farrington and Manning test
    Parameter type
    Percentage Difference
    Point estimate
    12.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    5.72
         upper limit
    18.81
    Notes
    [11] - Superiority of vonoprazan triple therapy to lansoprazole triple therapy.
    [12] - P-value based on a Farrington and Manning test with the null hypothesis difference ≤0 versus the alternative hypothesis difference >0.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline to 4 weeks after the last dose of study drugs (maximum duration of treatment was 2 weeks)
    Adverse event reporting additional description
    The analysis set used was the safety analysis set which included all participants who received at least 1 dose of study drugs.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    Vonoprazan Dual Therapy
    Reporting group description
    Participants were administered 20 milligrams (mg) vonoprazan twice daily (BID) and 1000 mg amoxicillin 3 times daily (TID) from Day 1 to Day 14.

    Reporting group title
    Vonoprazan Triple Therapy
    Reporting group description
    Participants were administered 20 mg vonoprazan BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.

    Reporting group title
    Lansoprazole Triple Therapy
    Reporting group description
    Participants were administered 30 mg lansoprazole BID from Day 1 to Day 14. Participants were also administered 1000 mg amoxicillin BID and 500 mg clarithromycin BID from Day 1 to Day 14.

    Serious adverse events
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 348 (1.44%)
    6 / 346 (1.73%)
    3 / 345 (0.87%)
         number of deaths (all causes)
    0
    2
    1
         number of deaths resulting from adverse events
    0
    2
    1
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Lung cancer metastatic
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 346 (0.00%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Jaw fracture
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 346 (0.29%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 346 (0.00%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Peripheral ischaemia
         subjects affected / exposed
    0 / 348 (0.00%)
    0 / 346 (0.00%)
    1 / 345 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 346 (0.00%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 346 (0.29%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Coronary artery occlusion
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 346 (0.29%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 346 (0.00%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Duodenal polyp
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 346 (0.29%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    1 / 348 (0.29%)
    0 / 346 (0.00%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    0 / 348 (0.00%)
    0 / 346 (0.00%)
    1 / 345 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Spinal pain
         subjects affected / exposed
    0 / 348 (0.00%)
    1 / 346 (0.29%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Corona virus infection
         subjects affected / exposed
    1 / 348 (0.29%)
    1 / 346 (0.29%)
    0 / 345 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Pneumonia viral
         subjects affected / exposed
    0 / 348 (0.00%)
    0 / 346 (0.00%)
    1 / 345 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Vonoprazan Dual Therapy Vonoprazan Triple Therapy Lansoprazole Triple Therapy
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    20 / 348 (5.75%)
    27 / 346 (7.80%)
    48 / 345 (13.91%)
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    2 / 348 (0.57%)
    15 / 346 (4.34%)
    21 / 345 (6.09%)
         occurrences all number
    2
    15
    21
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    18 / 348 (5.17%)
    14 / 346 (4.05%)
    33 / 345 (9.57%)
         occurrences all number
    18
    14
    33

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Nov 2019
    The purposes of this amendment were to: • Change the primary objective and primary endpoint to exclude participants who had a clarithromycin- or amoxicillin-resistant strain of H pylori at baseline • Indicate that cytochrome P450 Family 2 Subfamily C Member 19 (CYP2C19) genotyping was optional • Remove wording that allowed a participant's legally acceptable representative as a party capable of giving consent for the study • Clarify that contraception must have been double barrier and that adequate double-barrier contraception must have been used from the signing of informed consent until Day -2 and 2 forms of adequate contraception must have been used from Day -1 until 4 weeks after the last dose of study drug • Allow rescreening of participants with approval from the medical monitor • Clarify that participants who discontinued study drug or withdrew from the study prematurely were to undergo early termination assessments • Redefine noncompliance as taking either less than 75% or more than 120% of study drug during any evaluation period • Exclude the use of cytochrome P450 3A4 (CYP3A4) substrates with a narrow therapeutic index from 14 days prior to Day 1 through the end of treatment • Update the resistance breakpoint for amoxicillin to >0.125 mcg/mL from >0.03 mcg/mL • Add overall study stopping criteria • Remove the requirement for at least 1 dose of study drug to be taken as a condition for inclusion in the MITT analysis set • Add collection of smoking status and alcohol use in the Schedule of Events and to include smoking status, alcohol use, and clinical condition as variables for subgroup analyses • Redefine the 4-week Post-Treatment Period in the Schedule of Events to be Days 42 to 70 • Remove the requirement that the Early Termination Visit be conducted within 14 days of the last dose of study drug being taken • Clarify that ^13C-UBT testing for H pylori infection status should be performed at least 4 weeks after the last dose of study drug
    11 May 2020
    The purposes of this amendment were to: • Add a pre-screen optional fingerstick test to evaluate H pylori status • Clarify that participants must have had a negative urine drug test result for cannabinoids/tetrahydrocannabinol and non-prescribed medications at screening • Add a Week 1 phone call to remind participants about study drug compliance and other assessments • Add the collection of pharmacokinetic samples on Day 15 • Clarify that pretreatment event and AE collection and reporting time windows also included those events considered serious • Clarify that serious AE electronic case report forms (eCRFs) be completed and submitted within 24 hours of the investigator first becoming aware of the serious AE (including serious AEs that were pretreatment events)

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    19 Mar 2020
    Study enrollment was paused between March 19, 2020 and May 11, 2020 due to the COVID-19 pandemic. Participants in screening were discontinued and subjects randomized were allowed to continue in the study.
    19 May 2020

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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