Pylori Duo for Adjunctive Treatment and Prevention of Recurrence of Helicobacter Pylori Infection

Official title

A Randomized, Double-Blind, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of Pylori Duo as an Adjunctive Treatment and for the Prevention of Recurrence of Helicobacter Pylori Infection

Overview

This randomized, double-blind, placebo-controlled, single-center clinical trial will evaluate the efficacy and safety of Pylori Duo as an adjunctive treatment in adult patients with confirmed Helicobacter pylori infection. Approximately 140 participants will be randomized to receive standard quadruple therapy (omeprazole plus Pylera®) combined with either placebo or Pylori Duo for 10 days, followed by placebo or Pylori Duo for 3 months. The primary objective is to assess the effect of Pylori Duo on gastrointestinal adverse effects associated with standard eradication therapy. Secondary objectives include assessment of H. pylori eradication, recurrence at 3 and 12 months, gastrointestinal symptoms, quality of life, and safety.

Detailed description

This is a randomized, double-blind, placebo-controlled, single-center interventional clinical trial designed to evaluate the efficacy and safety of Pylori Duo as an adjunctive treatment in adult patients with confirmed Helicobacter pylori infection. Approximately 140 patients aged 18 to 70 years with a positive 13C-urea breath test and gastric biopsy performed before study initiation will be enrolled.

Participants will be randomly assigned to one of two parallel treatment groups. Group A will receive standard quadruple therapy consisting of omeprazole plus Pylera® in combination with placebo for 10 days, followed by placebo for 3 months. Group B will receive the same standard quadruple therapy in combination with Pylori Duo for 10 days, followed by Pylori Duo for 3 months. Both investigators and participants will remain blinded to treatment allocation throughout the study.

The primary objective of the study is to evaluate the effect of Pylori Duo on the management of gastrointestinal adverse effects associated with standard eradication therapy. Secondary objectives include evaluation of H. pylori eradication rate, recurrence of infection at 3 and 12 months after treatment, gastrointestinal symptoms assessed using the Gastrointestinal Symptom Rating Scale (GSRS), gastrointestinal quality of life assessed using the Nepean Dyspepsia Index-Short Form (NDI-SF), and safety and tolerability. Safety assessments will include the recording of adverse events, evaluation of their potential relationship to the study product, and treatment adherence monitoring.

Participants will attend scheduled follow-up visits during treatment and post-treatment follow-up. A 13C-urea breath test will be performed 6 to 8 weeks after completion of Phase I treatment to assess eradication. Follow-up will continue for 3 months after treatment completion, and a telephone assessment will be conducted at 12 months to evaluate recurrence. Statistical analyses will be performed using both intention-to-treat and per-protocol populations.

Interventions

• Drug Omeprazole
  Omeprazole will be administered as part of the standard quadruple eradication therapy for Helicobacter pylori infection during the 10-day treatment phase.
• Drug Pylera (Bismuth subcitrate potassium, metronidazole, tetracycline) given in combination with omeprazole
  Pylera® will be administered in combination with omeprazole as part of the standard quadruple eradication therapy for Helicobacter pylori infection during the 10-day treatment phase.
• Dietary supplement Pylori Duo
  Pylori Duo is a dietary supplement containing Lactobacillus rhamnosus and dried licorice extract. Participants assigned to the experimental arm will receive Pylori Duo in combination with standard quadruple therapy for 10 days, followed by Pylori Duo for 3 months during the post-treatment phase.
• Other Placebo
  Placebo capsules identical in appearance to Pylori Duo, but without pharmacologically active ingredients, will be administered in combination with standard quadruple therapy for 10 days, followed by placebo for 3 months during the post-treatment phase.

Primary outcome measures

• Gastrointestinal adverse effects associated with standard eradication therapy [Time frame: Up to 3 months after treatment initiation]

Secondary outcome measures (7)

• Helicobacter pylori eradication rate [Time frame: 6 to 8 weeks after completion of the 10-day treatment phase]
• Recurrence of Helicobacter pylori infection [Time frame: 3 months and 12 months after completion of treatment]
• Change from baseline in Gastrointestinal Symptom Rating Scale overall score [Time frame: Baseline and 3 months after treatment initiation]
• Change from baseline in Short Form Nepean Dyspepsia Index total score [Time frame: Baseline and 3 months after treatment initiation]
• Participants with adverse events [Time frame: Up to 3 months after the first dose]
• Participants with study product-related adverse events [Time frame: Up to 3 months after the first dose]
• Treatment adherence [Time frame: Up to 3 months after the first dose]

Eligibility criteria

Inclusion criteria

• Adults aged 18 to 70 years.
• Confirmed Helicobacter pylori infection prior to treatment, as determined by a positive 13C-urea breath test (13C-UBT) and gastric biopsy.
• No previous H. pylori eradication therapy.
• Ability and willingness to provide written informed consent.

Exclusion criteria

• Significant underlying conditions that, in the opinion of the treating physician, would preclude participation in the study, including hepatic insufficiency (aspartate aminotransferase or alanine aminotransferase >3 times the upper limit of normal), renal insufficiency (creatinine ≥2.0 mg/dL or glomerular filtration rate <50 mL/min), immunosuppression, malignant tumors, coronary heart disease or coronary artery stenosis ≥75%, thyroid disease, pulmonary disease, or any other serious medical condition.
• Pregnancy, breastfeeding, or unwillingness to use contraception during the study.
• Active gastrointestinal bleeding.
• History of upper gastrointestinal tract surgery.
• History of allergic reactions to medications included in the treatment regimen.
• Use of bismuth-containing agents, antibiotics, proton pump inhibitors, or other relevant medications within 4 weeks prior to treatment.
• Behaviors that may increase the risk of illness, including excessive alcohol consumption or substance abuse.
• Negative repeat urea breath test prior to treatment initiation.
• Unwillingness or inability to provide informed consent.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

Spain · 1 center

• GALA Laboratories — Don Benito

Identifiers

NCT: NCT07729293 · 20260836

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗