Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Also known as Esomeprazole, esomeprazole, Esomeprazole (D961H), Esomeprazole (Nexium), Esomeprazole IV, Double Blind Esomeprazole
Esomeprazole/ASA · 41 trials · 31 indications
Criteria for a clinically significant upper GI bleeding as: 1. Bright red blood per NG or OG tube that did not clear after NG or OG tube adjustment and 5 to 10 minutes of at least 100 ml lavage with room temperature normal saline-or, 2. Persistent gastroccult- positive coffee ground material During IMP treatment Day 1-2: Persistent gastroccult- positive coffee ground material for at least eight consecutive hours that did not clear with at least 100 ml of lavage with room temperature normal saline. During IMP treatment Day 3-14: Persistent gastroccult- positive coffee ground material in at least three consecutive gastric aspirates within 2 to 4 hours (at least 60 ±20 minutes apart), that did not clear with at least 100 ml of lavage with room temperature normal saline.
Assessments for occurrence of gastric and/or duodenal ulcers were performed every 12 weeks after randomisation. The numbers of participants with recurrence of gastric and/or duodeal ulcers were analysed every 12 weeks up to 48 weeks.
Los Angels classification consists of 5 grades (Grade O, Grade A, Grade B, Grade C and Grade D). A patient classfied into Grade O was considered no reflux esophagitis. The participants who had a healing of reflux esophagitis with Grade O at Visit 1 were randomised. Number of participants who did not have Grades A-D throughout the treatment period was evaluated.
Los Angeles classification consists of 5 grades (Grade O, Grade A, Grade B, Grade C, Grade D). The subjects who were definitely diagnosed to have RE classified into LA classification Grade A, B, C or D based on the EGD on Visit 1 were randomised. A subject classified into LA classification Grade O was considered no reflux esophagitis. The definitions of each grade are: Grade A (Mucosal break \< 5 mm in length), Grade B (Mucosal break \> 5mm), Grade C (Mucosal break continuous between \> 2 mucosal folds) and Grade D (Mucosal break \>75% of esophageal circumference).
The absence of gastric and/or duodenal ulcer throughout the treatment period
The occurrence of ulcer (mucosal break measuring \>= 3 mm over its largest diameter with a sharply demarcated margin) was determined by endoscopy performed at baseline, 8 weeks and 26 weeks or upon withdrawal.
The number of events are normalized prior to summary to correspond to a complete 8-hour monitoring period. Only patients with data at both baseline and final assessment are included.
Healed was defined as the absence of gastric ulcers. It was calculated as the proportion of subjects whose gastric ulcer(s) healed after 4 weeks treatment. (Ulcers were on S stage, stage 1 = Nonblanchable erythema of intact skin, stage 2 = Partial thickness skin loss involving epidermis, dermis, or both, stage 3 = Full thickness skin loss involving damage to or necrosis of subcutaneous tissue, stage 4 = Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures or absent).
Death is recorded on a continuous basis through reporting from trial sites. Oesophageal adenocarcinoma is recorded through endoscopies taken every two years or ad-hoc at clinician decision High Grade Dysplasia is recorded through endoscopies taken every two years or ad-hoc at clinician decision
Treatment failure in the surgical arm defined when need for medical treatment for control of symptoms from reflux disease. Treatment failure in the medical arm defined when need for treatment other than esomeprazole for control of symptoms of reflux disease.
Compare on demand (taken as needed by the patient to adequately control their reflux disease) with continuous treatment of endoscopy negative subjects with gastroesophageal reflux disease (GERD), with esomeprazole 20-mg once daily, with regards to willingness to continue in the study as a result of satisfactory treatment over a six-month long term management period, after initial symptom relief
Peak expiratory flow is defined as the maximum speed of expiration as measured with the Mini-Wright® PEF Meter. Participants must have both baseline and follow up measure to be included in analysis. Results presented as a mean of all available data during the treatment period.
| Arm | Type | Description |
|---|---|---|
| Esomeprazole active treatment | EXPERIMENTAL | iv esomeprazole 30 min intermittent infusions given for maximum 14 days |
| Cimetidine active treatment | ACTIVE_COMPARATOR | iv cimetidine 30 min bolus infusion followed by iv cimetidine continuous infusion given for maximum 14 days |
| Esomeprazole 20 mg | EXPERIMENTAL | - |
| Placebo | PLACEBO_COMPARATOR | - |
| Esomeprazole 20mg | EXPERIMENTAL | Esomeprazole 20mg once daily oral |
| 1 | EXPERIMENTAL | Esomeprazole and Omeprazole |
| 2 | EXPERIMENTAL | Esomeprazole |
| 3 | ACTIVE_COMPARATOR | Omeprazole 20mg |
| Esomeprazole 40 mg | EXPERIMENTAL | Esomeprazole 40 mg |
| Arm A | EXPERIMENTAL | 20mg Esomeprazole |
| Arm B | EXPERIMENTAL | 80mg Esomeprazole |
| Arm C | EXPERIMENTAL | 20mg Esomeprazole + 300mg Aspirin |
| Arm D | EXPERIMENTAL | 80mg Esomeprazole + 300mg Aspirin |
| On demand 20 mg esomeprazole | EXPERIMENTAL | On demand treatment with 20-mg esomeprazole once daily when needed |
| Continuous 20 mg esomeprazole | ACTIVE_COMPARATOR | Continuous treatment with 20 mg esomeprazole once daily |
| Esomeprazole 40 mg twice daily | EXPERIMENTAL | - |
| Esomeprazole 40 mg once daily | EXPERIMENTAL | - |
| Name | Type | Description |
|---|---|---|
| Esomeprazole | DRUG | iv esomeprazole 30 min intermittent infusions given for maximum 14 days |
| Cimetidine | DRUG | iv cimetidine 30 min bolus infusion followed by iv cimetidine continuous infusion given for maximum 14 days |
| Placebo | DRUG | Placebo, capsule, 72 weeks |
| Omeprazole | DRUG | 10mg once daily oral administration |
| Esomeprazole 20 mg | DRUG | Esomeprazole 20 mg once daily |
| Esomeprazole 40 mg | DRUG | Esomeprazole 40 mg once daily |
| Esomeprazole IV | DRUG | - |
| Omeprazole IV | DRUG | - |
| Ranitidine | DRUG | - |
| Aspirin | DRUG | 300mg per day |
| Esomeprazole (Nexium) | DRUG | - |
| Matching placebo | DRUG | Oral Once Daily |
| Laparoscopic fundoplication (surgery) | PROCEDURE | Surgery |
| naproxen | DRUG | 250mg, oral dose |
| Clopidogrel | DRUG | Clopidogrel |
| Esomeprazole/ASA | DRUG | 20 mg/81 mg once daily for five days (Day 5-9) |
| esomeprazole/ASA Fixed Dose Combination (FDC) | DRUG | esomeprazole 20 mg/ASA 81 mg oral capsule |
| Esomeprazole/ASA Fixed Combination | DRUG | Capsule, oral, single dose |
| Esomeprazole - Nexium | DRUG | Clinical Trial Capsule or MUPS Tablet, oral, single dose |
| ASA | DRUG | Tablet, oral, single dose |
| Esomeprazole 40mg/ASA 325mg | DRUG | combination capsule, administered as a single oral dose |
| Esomeprazole (D961H) | DRUG | 20mg |
| Loxoprofen | DRUG | 60mg tablet |
Inclusion Criteria: 1. Critically ill patients 2. Requirement for mechanical ventilation 3. At least one major risk factor for stress ulcer related bleeding Exclusion Criteria: 1. History of gastric or oesophageal surgery 2. Evidence of active GI bleeding 3. Advanced renal disease 4. Treatment wi...