基于沃诺拉赞的二联根除疗法vs PPI治疗对感染Hp并置入冠脉支架的ACS患者消化道出血的作用:一项开放标签、随机、对照试验

注册号:

Registration number:

ChiCTR2500110755 

最近更新日期:

Date of Last Refreshed on:

2025-10-20 15:42:59 

注册时间:

Date of Registration:

2025-10-20 00:00:00 

注册号状态:

补注册

Registration Status:

Retrospective registration

注册题目:

基于沃诺拉赞的二联根除疗法vs PPI治疗对感染Hp并置入冠脉支架的ACS患者消化道出血的作用:一项开放标签、随机、对照试验

Public title:

The effect of vonoprazan-based dual eradication therapy vs PPI treatment on gastrointestinal bleeding in ACS patients with H. pylori infection and coronary stent implantation: an open-label, randomized, controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于沃诺拉赞的二联根除疗法vs PPI治疗对感染Hp并置入冠脉支架的ACS患者消化道出血的作用:一项开放标签、随机、对照试验

Scientific title:

The effect of vonoprazan-based dual eradication therapy vs PPI treatment on gastrointestinal bleeding in ACS patients with H. pylori infection and coronary stent implantation: an open-label, randomized, controlled trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

陈玉国 

研究负责人:

陈玉国 

Applicant:

Yuguo Chen 

Study leader:

Yuguo Chen 

申请注册联系人电话:

Applicant telephone:

+86 531 8216 6009

研究负责人电话:

Study leader's
telephone:

+86 531 8216 6009

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

chen919085@126.com

研究负责人电子邮件:

Study leader's E-mail:

chen919085@126.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

山东省济南市历下区文化西路107号

研究负责人通讯地址:

山东省济南市历下区文化西路107号

Applicant address:

No. 107, Wenhua West Road, Lixia District, Jinan City, Shandong Province

Study leader's address:

No. 107, Wenhua West Road, Lixia District, Jinan City, Shandong Province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

山东大学齐鲁医院

Applicant's institution:

Qilu Hospital of Shandong University

研究负责人所在单位:

山东大学齐鲁医院

Affiliation of the Leader:

Qilu Hospital of Shandong University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

KYLL-202008-168

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

山东大学齐鲁医院科研伦理委员会

Name of the ethic committee:

Qilu Hospital of Shandong University Scientific Research Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2020-09-01 00:00:00

伦理委员会联系人:

卜丽娟

Contact Name of the ethic committee:

Bu Lijuan

伦理委员会联系地址:

山东省济南市历下区文化西路107号

Contact Address of the ethic committee:

No. 107, Wenhua West Road, Lixia District, Jinan City, Shandong Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 531 82169166

伦理委员会联系人邮箱:

Contact email of the ethic committee:

bulijuan16@sdu.edu.cn

研究实施负责(组长)单位:

山东大学齐鲁医院

Primary sponsor:

Qilu Hospital of Shandong University

研究实施负责(组长)单位地址:

山东省济南市历下区文化西路107号

Primary sponsor's address:

No. 107, Wenhua West Road, Lixia District, Jinan City, Shandong Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

山东省

市(区县):

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学齐鲁医院

具体地址:

山东省济南市历下区文化西路107号

Institution
hospital:

Qilu Hospital of Shandong University

Address:

No. 107, Wenhua West Road, Lixia District, Jinan City, Shandong Province

经费或物资来源:

2021年度山东省重点研发计划(重大科技创新工程)驻鲁部属高校“十四五”服务山东重点建设项目

Source(s) of funding:

2021 Shandong Province Key R&D Program (Major Scientific and Technological Innovation Project) '14th Five-Year Plan' Key Construction Projects in Shandong Served by Central Universities in Shandong

研究疾病:

消化道出血  

Target disease:

Gastrointestinal Bleeding

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

上市后药物 

Study phase:

4

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

急性冠脉综合征(ACS)患者冠脉支架置入术(PCI)后,需常规接受双联抗血小板(DAPT)治疗,但同时伴随高出血风险,消化道出血是最常见的大出血类型。幽门螺杆菌(Hp)感染是消化道出血的高危因素,发生率约50%。国外权威DAPT指南未给予Hp感染患者单独指导,推荐高出血风险者应联用质子泵抑制剂(PPI),但长期应用PPI的依从性并不理想。我国权威专家共识对DAPT患者推荐Hp检测和根除疗法,但证据级别较低。沃诺拉赞是新型钾离子竞争性酸阻滞剂,基于沃诺拉赞的二联Hp根除疗法简便、有效。项目组将开展一项多中心、开放标签、随机对照临床试验,采用非劣效设计,对比沃诺拉赞+阿莫西林的二联根除疗法与泮托拉唑对PCI术后患者6个月内的消化道出血事件的影响。  

Objectives of Study:

Patients with acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI) are routinely required to receive dual antiplatelet therapy (DAPT). However, this treatment is associated with a high risk of bleeding, with gastrointestinal bleeding being the most common type of major bleeding. Helicobacter pylori (Hp) infection is a high-risk factor for gastrointestinal bleeding, with an incidence rate of approximately 50%. International authoritative DAPT guidelines do not provide specific guidance for patients with Hp infection, but they recommend that patients at high risk of bleeding should be co-administered proton pump inhibitors (PPIs). However, long-term adherence to PPIs is not ideal. In China, the authoritative expert consensus recommends Hp testing and eradication therapy for DAPT patients, but the level of evidence is relatively low. Vonoprazan, a novel potassium-competitive acid blocker, is the basis for a simple and effective dual-therapy Hp eradication regimen. The project team will conduct a multicenter, open-label, randomized controlled clinical trial with a non-inferiority design to compare the effects of vonoprazan + amoxicillin dual-therapy eradication regimen with pantoprazole on gastrointestinal bleeding events within 6 months after PCI.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.既往有消化道溃疡出血病史; 2.既往长期服用PPI、H2受体抑制剂; 3.合并胃食管静脉曲张,或胃大部切除术后; 4.正在服用维生素K拮抗剂(华法林)等抗凝药物,有出血倾向者; 5.近期接受纤溶治疗(随机化前24h内使用纤维蛋白特异性药物,或随机化前48h内使用非纤维蛋白特异性药物); 6.近期接受(随机化前30天内)或计划进行冠状动脉旁路移植术(CABG); 7.合并活动性出血,或有凝血功能障碍(指标); 8.合并肝肾功能疾病患者,血清肌酐大于150 μmol/L,谷丙转氨酶、谷草转氨酶较正常值升高>=2倍; 9.合并出血性脑卒中、颅内肿瘤、动静脉畸形或动脉瘤; 10.贫血(成年男性血红蛋白低于120 g/L或红细胞少于4×10^12/L,成年女性血红蛋白低于105 g/L或红细胞少于3.5×10^12/L); 11.全身性糖皮质激素应用; 12.近1月内服用过抗生素等影响胃内菌群的药物; 13.有阿司匹林、氯吡格雷、替格瑞洛、泮托拉唑、青霉素以及其他试验用药过敏史; 14.妊娠或哺乳期女性和不愿采取避孕措施的育龄受试者; 15.合并恶性肿瘤及其他疾病,预期生存期小于1年; 16.入组前30天内参加其他药物临床试验或正在参加其他新药临床研究的患者; 17.合并精神疾病或严重神经官能症; 18.不能表达主观不适症状; 19.研究者判定不适合参加本研究者.

Exclusion criteria:

1.Previous history of gastrointestinal ulcer bleeding; 2.Previous long-term use of PPI (proton pump inhibitors) and H2 receptor antagonists; 3.Complicated with gastric esophageal varices or post-gastrectomy; 4.Taking anticoagulant medications such as vitamin K antagonists (warfarin) and having a tendency to bleed; 5.Received fibrinolytic therapy recently (administration of fibrin-specific drugs within 24 hours prior to randomization or administration of non-fibrin-specific drugs within 48 hours prior to randomization); 6.Recently underwent (within 30 days prior to randomization) or planned to undergo coronary artery bypass grafting surgery (CABG); 7.Complicated with active bleeding or coagulation dysfunction (indicated by specific markers); 8.Patients with concurrent liver and kidney dysfunction, serum creatinine greater than 150 μmol/L, aspartate transaminase and alanine transaminase levels elevated more than twice the normal values; 9.Complicated with hemorrhagic stroke, intracranial tumor, arteriovenous malformation, or aneurysm; 10.Anemia (hemoglobin less than 120 g/L or red blood cells less than 4×10^12/L in adult males, hemoglobin less than 105 g/L or red blood cells less than 3.5×10^12/L in adult females); 11.Systemic corticosteroid administration; 12.Taken antibiotics or other medications that affect the gastric microbiota in the past month; 13.History of allergies to aspirin, clopidogrel, ticagrelor, pantoprazole, penicillin, and other investigational medications; 14.Pregnant or lactating women and reproductive-age participants who are unwilling to use contraception measures; 15.Complicated with malignant tumors and other diseases, with an expected survival period of less than 1 year; 16.Patients who participated in other drug clinical trials or are currently participating in other new drug clinical studies within 30 days prior to enrollment; 17.Complicated with mental illness or severe neurological disorders; 18.Unable to express subjective discomfort symptoms; 19.The researcher determines that the participant is not suitable for participating in this study.

研究实施时间:

Study execute time:

From 2021-12-01 00:00:00 To 2026-06-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2023-04-12 00:00:00 To 2025-06-30 00:00:00

干预措施:

Interventions:

组别:

试验组

样本量:

1300

Group:

Treatment group

Sample size:

干预措施:

基于沃诺拉赞的双联抗hp药物干预预防DAPT所致消化道出血

干预措施代码:

Intervention:

Vonoprazan-based dual anti-H. pylori medication intervention for preventing DAPT-related gastrointestinal bleeding

Intervention code:

组别:

对照组

样本量:

1300

Group:

Control group

Sample size:

干预措施:

基于PPI预防DAPT所致消化道出血

干预措施代码:

Intervention:

PPI-based prevention of gastrointestinal bleeding caused by DAPT

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学齐鲁医院 

单位级别:

三级甲等 

Institution
hospital:

Qilu Hospital of Shandong University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

贵州省 

市(区县):

 

Country:

China

Province:

Guizhou

City:

单位(医院):

遵义市第一人民医院 

单位级别:

三级甲等 

Institution
hospital:

The First People's Hospital of Zunyi

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

潍坊市中医院 

单位级别:

三级甲等 

Institution
hospital:

Weifang Hospital of Traditional Chinese Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

聊城市人民医院 

单位级别:

三级甲等 

Institution
hospital:

Liaocheng People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

临沂市人民医院 

单位级别:

三级甲等 

Institution
hospital:

Linyi People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

东营市第二人民医院 

单位级别:

三级乙等 

Institution
hospital:

The Second People’s Hospital of Dongying

Level of the institution:

Tertiary B

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

济宁市第一人民医院 

单位级别:

三级甲等 

Institution
hospital:

Jining No.1 People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

乳山市人民医院 

单位级别:

三级医院 

Institution
hospital:

Rushan People’s Hospital

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

北京市 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

中日友好医院 

单位级别:

三级甲等 

Institution
hospital:

China-Japan Friendship Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

平原县第一人民医院 

单位级别:

二级甲等 

Institution
hospital:

The First People's Hospital of Pingyuan

Level of the institution:

Secondary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东中医药大学附属医院(山东省中医院) 

单位级别:

三级甲等 

Institution
hospital:

Affiliated Hospital of Shandong University of Traditional Chinese Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京市 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

航空总医院 

单位级别:

三级乙等 

Institution
hospital:

Aviation General Hospital

Level of the institution:

Tertiary B

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学齐鲁医院(青岛) 

单位级别:

三级医院 

Institution
hospital:

Qilu Hospital of Shandong University (Qingdao)

Level of the institution:

Tertiary

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

青岛大学附属医院 

单位级别:

三级甲等 

Institution
hospital:

The Affiliated Hospital of Qingdao University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

青海省 

市(区县):

 

Country:

China

Province:

Qinghai

City:

单位(医院):

青海红十字医院 

单位级别:

三级甲等 

Institution
hospital:

Qinghai Red Cross Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

安徽省 

市(区县):

 

Country:

China

Province:

Anhui

City:

单位(医院):

亳州市人民医院 

单位级别:

三级甲等 

Institution
hospital:

The People's Hospital of Bozhou

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

东营市人民医院 

单位级别:

三级甲等 

Institution
hospital:

Dongying People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

菏泽市立医院 

单位级别:

三级甲等 

Institution
hospital:

Heze Municipal Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

济南市人民医院 

单位级别:

三级甲等 

Institution
hospital:

Jinan City People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

济南市第四人民医院 

单位级别:

三级甲等 

Institution
hospital:

The Fourth Peoples Hospital of Jinan

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

枣庄市立医院 

单位级别:

三级甲等 

Institution
hospital:

Zaozhuang Municipal Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学齐鲁医院德州医院(德州市人民医院) 

单位级别:

三级甲等 

Institution
hospital:

Shandong University Qilu Hospital Dezhou Hospital (Dezhou People's Hospital)

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

安徽省 

市(区县):

 

Country:

China

Province:

Anhui

City:

单位(医院):

滁州市第一人民医院 

单位级别:

三级甲等 

Institution
hospital:

Chuzhou First People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东省公共卫生临床中心 

单位级别:

三级甲等 

Institution
hospital:

Shandong Provincial Public Health Clinical Center

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

安徽省 

市(区县):

 

Country:

China

Province:

Anhui

City:

单位(医院):

安徽医科大学第一附属医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Anhui Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

辽宁省 

市(区县):

 

Country:

China

Province:

Liaoning

City:

单位(医院):

大连医科大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Dalian Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

河南省 

市(区县):

 

Country:

China

Province:

Henan

City:

单位(医院):

郑州大学第一附属医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Zhengzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东省 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

威海市中心医院 

单位级别:

三级甲等 

Institution
hospital:

Weihai Central Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

消化道出血

指标类型:

主要指标

Outcome:

Gastrointestinal bleeding

Type:

Primary indicator

测量时间点:

治疗期6-8周和24周进行2次访视

测量方法:

Measure time point of outcome:

Two visits will be conducted at weeks 6-8 and 24 during the treatment period

Measure method:

指标中文名:

Hp根除情况

指标类型:

主要指标

Outcome:

H. pylori eradication status

Type:

Primary indicator

测量时间点:

1个月

测量方法:

Measure time point of outcome:

one month

Measure method:

指标中文名:

心脑血管不良事件

指标类型:

次要指标

Outcome:

Cardiovascular and cerebrovascular adverse events

Type:

Secondary indicator

测量时间点:

治疗期6-8周和24周进行2次访视

测量方法:

Measure time point of outcome:

Two visits will be conducted at weeks 6-8 and 24 during the treatment period

Measure method:

指标中文名:

复合消化道事件

指标类型:

次要指标

Outcome:

Composite gastrointestinal event

Type:

Secondary indicator

测量时间点:

治疗期6-8周和24周进行2次访视

测量方法:

Measure time point of outcome:

Two visits will be conducted at weeks 6-8 and 24 during the treatment period

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

None

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

研究者使用区组竞争随机进行产生随机数

Randomization Procedure (please state who generates the random number sequence and by what method):

Researchers use block competition randomization to generate random numbers.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

开放标签

Blinding:

Open-label study

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

共享时间预计2035年6月30日,研究者可在 http://www.vihp.portal.zhinanmed.com上查阅相关信息。在最终共享提交数据时,需与山东大学齐鲁医院报备,经过审核后方可共享。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

The estimated shared access period is ​​June 30, 2035​​. Researchers may access relevant information at http://www.vihp.portal.zhinanmed.com. ​​For the final submission of shared data​​, prior ​​notification and approval​​ from ​​Qilu Hospital of Shandong University​​ are required. Data can only be shared after undergoing the hospital’s ​​review and authorization process​​.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

CRF表和EDC系统采集和保存数据,具有电子版和纸质版数据

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data are collected and stored using ​​CRF forms (Case Report Forms)​​ and the ​​EDC system (Electronic Data Capture system)​​, available in both ​​electronic and paper versions​​.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2025-10-20 15:42:50