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NCT02954848

Phase 3 Study of TAK-438 10 mg in the Treatment of Non-Erosive Gastroesophageal Reflux Disease (NERD)

Completed Phase 3 Results posted Last updated 2 August 2019
What this trial tests

Phase 3 trial testing Placebo in Non-erosive Gastroesophageal Reflux Disease in 484 participants. Completed in 26 February 2018.

Timeline
15 November 2016
Primary endpoint
25 February 2018
26 February 2018

Quick facts

Lead sponsorTakeda
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment484
Start date15 November 2016
Primary completion25 February 2018
Estimated completion26 February 2018
Sites30 locations across Japan

Drugs / interventions tested

Conditions studied

Sponsor

Takeda — full company profile →

Who can join

20 and older, any sex, with Non-erosive Gastroesophageal Reflux Disease. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Days Without Symptoms of Heartburn Primary · Up to Week 4

Heartburn symptoms were collected by participant diaries. Participants recorded the presence and severity (Without symptom \[No symptom: 0, No hindrance to daily activities: 1\], With symptom \[Mild: 2, Moderate: 3, Severe: 4\]) of heartburn in a daily participant diary. The score range was 0-4, with the higher scores reflecting the greater severity. Reported data was the percentage of days for each group, calculated by the number of days without heartburn divided by the number of days of treatment period.

GroupValue95% CI
Placebo61.500.0 – 100.0
TAK-438 10 mg72.550.0 – 100.0
Cumulative Rate of Improvement in Symptoms of Heartburn Primary · Day 0 to Day 24

Heartburn symptoms were collected by participant diaries. Participants recorded the presence and severity (Without symptom \[No symptom: 0, No hindrance to daily activities: 1\], With symptom \[Mild: 2, Moderate: 3, Severe: 4\]) of heartburn in a daily participant diary. The score range was 0-4, with the higher scores reflecting the greater severity. Cumulative rate of improvement was calculated as percentage of participants who experienced symptom improvement. Symptom improvement was defined as symptoms experienced on less than 2 days of the last 7 days. The cumulative data was collected betw

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 1
GroupValue95% CI
Placebo14.7
TAK-438 10 mg23.1
Day 2
GroupValue95% CI
Placebo15.9
TAK-438 10 mg24.4
Day 3
GroupValue95% CI
Placebo16.3
TAK-438 10 mg25.2
Day 4
GroupValue95% CI
Placebo17.6
TAK-438 10 mg26.1
Day 5
GroupValue95% CI
Placebo18.8
TAK-438 10 mg28.2
Day 6
GroupValue95% CI
Placebo19.2
TAK-438 10 mg30.4
Day 7
GroupValue95% CI
Placebo20.0
TAK-438 10 mg32.5
Severity of Symptoms of Heartburn Primary · Up to Week 4

Participants recorded the presence and severity (Without symptom \[No symptom: 0, No hindrance to daily activities: 1\], With symptom \[Mild: 2, Moderate: 3, Severe: 4\]) of heartburn in a daily participant diary. The score range was 0-4, with the higher scores reflecting the greater severity. The severity of heartburn was calculated by the number of severity score in daily diaries.

GroupValue95% CI
Placebo1.1400.00 – 2.82
TAK-438 10 mg1.0700.00 – 3.67
Percentage of Days Without Symptoms of Heartburn in Subgroup Stratified by Response (Improved or Not Improved) at Week 2 Secondary · Up to Week 4

Participants recorded the presence and severity of heartburn in a daily participant diary. Percentage of days without heartburn was calculated in each subgroup of the response (improved or not improved) according to Criteria 1, i.e. Improved: the participants experienced heartburn on less than 2 days of the 7 days prior to Week 2 \[Day 8 through Day 14\]; Not improved: the participants experienced heartburn on 2 days or more of the 7 days prior to Week 2 \[Day 8 through Day 14\] and Criteria 2, i.e. Improved: the proportion of days the participants experienced heartburn during the treatment pe

Criteria 1, Improved
GroupValue95% CI
Placebo92.0041.4 – 100.0
TAK-438 10 mg96.0046.4 – 100.0
Criteria 1, Not Improved
GroupValue95% CI
Placebo50.950.0 – 92.9
TAK-438 10 mg48.050.0 – 92.9
Criteria 2, Improved
GroupValue95% CI
Placebo71.403.3 – 100.0
TAK-438 10 mg81.1514.3 – 100.0
Criteria 2, Not Improved
GroupValue95% CI
Placebo39.300.0 – 83.3
TAK-438 10 mg24.150.0 – 84.0
Cumulative Rate of Improvement in Symptoms of Heartburn in Subgroup Stratified by Response (Improved Per Criteria 1) at Week 2 Secondary · Day 0 to Day 22

Participants recorded presence and severity (Without symptom \[No symptom:0, No hindrance to daily activities:1\], With symptom \[Mild:2, Moderate:3, Severe:4\]) of heartburn in daily participant diary. The score range was 0-4, with the higher scores reflecting the greater severity. Cumulative rate of improvement was calculated as percentage of participants who experienced symptom improvement. The response was evaluated per Criteria 1, i.e. Improved: the participants experienced heartburn on less than 2 days of the 7 days prior to Week 2 \[Day 8 through Day 14\]; Not improved: the participants

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 1
GroupValue95% CI
Placebo43.4
TAK-438 10 mg55.6
Day 2
GroupValue95% CI
Placebo47.0
TAK-438 10 mg58.6
Day 3
GroupValue95% CI
Placebo48.2
TAK-438 10 mg60.6
Day 4
GroupValue95% CI
Placebo51.8
TAK-438 10 mg62.6
Day 5
GroupValue95% CI
Placebo55.4
TAK-438 10 mg67.7
Day 6
GroupValue95% CI
Placebo56.6
TAK-438 10 mg72.7
Day 7
GroupValue95% CI
Placebo59.0
TAK-438 10 mg77.8
Cumulative Rate of Improvement in Symptoms of Heartburn in Subgroup Stratified by Response (Not Improved Per Criteria 1) at Week 2 Secondary · Day 0 to Day 24

Participants recorded presence and severity (Without symptom \[No symptom:0, No hindrance to daily activities:1\], With symptom \[Mild:2, Moderate:3, Severe:4\]) of heartburn in daily participant diary. The score range was 0-4, with the higher scores reflecting the greater severity. Cumulative rate of improvement is calculated as percentage of participants who experienced symptom improvement. The response was evaluated per Criteria 1, i.e. Improved: the participants experienced heartburn on less than 2 days of the 7 days prior to Week 2 \[Day 8 through Day 14\]; Not improved: the participants

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 9
GroupValue95% CI
Placebo3.7
TAK-438 10 mg2.2
Day 10
GroupValue95% CI
PlaceboNA
TAK-438 10 mg4.4
Day 11
GroupValue95% CI
Placebo6.8
TAK-438 10 mg8.1
Day 12
GroupValue95% CI
Placebo9.3
TAK-438 10 mg12.6
Day 13
GroupValue95% CI
Placebo11.7
TAK-438 10 mg18.5
Day 14
GroupValue95% CI
Placebo14.2
TAK-438 10 mg22.2
Day 15
GroupValue95% CI
Placebo15.4
TAK-438 10 mg25.2
Cumulative Rate of Improvement in Symptoms of Heartburn in Subgroup Stratified by Response (Improved Per Criteria 2) at Week 2 Secondary · Day 0 to Day 24

Participants recorded presence and severity (Without symptom \[No symptom:0, No hindrance to daily activities:1\], With symptom \[Mild:2, Moderate:3, Severe:4\]) of heartburn in daily participant diary. The score range was 0-4, with higher scores reflecting the greater severity. Cumulative rate of improvement calculated as percentage of participants who experienced symptom improvement. Response evaluated per Criteria 2, i.e. Improved: proportion of days participant experienced heartburn during treatment period up to Week 2 \[Day 14\] was lower than that during run-in period; Not improved: prop

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 1
GroupValue95% CI
Placebo21.4
TAK-438 10 mg31.6
Day 2
GroupValue95% CI
Placebo23.2
TAK-438 10 mg33.3
Day 3
GroupValue95% CI
Placebo23.8
TAK-438 10 mg34.5
Day 4
GroupValue95% CI
Placebo25.6
TAK-438 10 mg35.6
Day 5
GroupValue95% CI
Placebo26.2
TAK-438 10 mg38.5
Day 6
GroupValue95% CI
Placebo26.8
TAK-438 10 mg41.4
Day 7
GroupValue95% CI
Placebo28.0
TAK-438 10 mg44.3
Cumulative Rate of Improvement in Symptoms of Heartburn in Subgroup Stratified by Response (Not Improved Per Criteria 2) at Week 2 Secondary · Day 0 to Day 24

Participants recorded presence and severity (Without symptom \[No symptom:0, No hindrance to daily activities:1\], With symptom \[Mild:2, Moderate:3, Severe:4\]) of heartburn in daily participant diary. The score range was 0-4, with higher scores reflecting the greater severity. Cumulative rate of improvement calculated as percentage of participants who experienced symptom improvement. The response evaluated per Criteria 2, i.e. Improved: proportion of days participant experienced heartburn during treatment period up to Week 2 \[Day 14\] was lower than that during run-in period; Not improved:

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 5
GroupValue95% CI
Placebo2.6
TAK-438 10 mgNA
Day 9
GroupValue95% CI
Placebo5.2
TAK-438 10 mg1.6
Day 11
GroupValue95% CI
Placebo6.5
TAK-438 10 mgNA
Day 12
GroupValue95% CI
PlaceboNA
TAK-438 10 mg4.9
Day 13
GroupValue95% CI
Placebo7.8
TAK-438 10 mg8.2
Day 14
GroupValue95% CI
Placebo13.0
TAK-438 10 mg14.8
Day 15
GroupValue95% CI
Placebo14.3
TAK-438 10 mg18.0
Severity of Symptoms of Heartburn in Subgroup Stratified by Response (Improved or Not Improved) at Week 2 Secondary · Up to Week 4

Participants recorded the presence and severity (Without symptom \[No symptom: 0, No hindrance to daily activities: 1\], With symptom \[Mild: 2, Moderate: 3, Severe: 4\]) of heartburn in a daily participant diary. The score range was 0-4, the higher scores indicates greater severity. The severity was calculated in each subgroup of response (improved or not improved) according to Criteria 1, i.e. Improved: participants experienced heartburn on less than 2 days of the 7 days prior to Week 2 \[Day 8 through Day 14\]; Not improved: participants experienced heartburn on 2 days or more of the 7 days

Criteria 1, Improved
GroupValue95% CI
Placebo0.4200.00 – 1.44
TAK-438 10 mg0.3100.00 – 1.56
Criteria 1, Not Improved
GroupValue95% CI
Placebo1.4300.25 – 2.82
TAK-438 10 mg1.4200.14 – 2.64
Criteria 2, Improved
GroupValue95% CI
Placebo0.9600.00 – 2.14
TAK-438 10 mg0.6750.00 – 2.04
Criteria 2, Not Improved
GroupValue95% CI
Placebo1.6100.44 – 2.82
TAK-438 10 mg1.7400.43 – 3.67
Percentage of Days Without Symptoms of Heartburn in Subgroup Stratified by Endoscopic Findings (the Modified LA Classification Grade N or M) at Baseline Secondary · Up to Week 4

Heartburn symptoms were collected by participant diaries. Participants recorded the presence and severity (Without symptom \[No symptom: 0, No hindrance to daily activities: 1\], With symptom \[Mild: 2, Moderate: 3, Severe: 4\]) of heartburn in a daily participant diary. The score range was 0-4, higher scores indicates greater severity. The percentage was calculated in each subgroup of the endoscopic findings where Grade N: normal mucosa; Grade M: minimal changes to the mucosa, such as erythema and/or whitish turbidity; Grade A: non-confluent mucosal breaks \<5mm in length; Grade B: non-conflu

Grade N
GroupValue95% CI
Placebo64.150.0 – 100.0
TAK-438 10 mg76.700.0 – 100.0
Grade M
GroupValue95% CI
Placebo60.700.0 – 100.0
TAK-438 10 mg67.900.0 – 100.0
Cumulative Rate of Improvement in Heartburn in Subgroup Stratified by Endoscopic Findings (the Modified LA Classification Grade N) at Baseline Secondary · Day 0 to Day 24

Participants recorded presence and severity (Without symptom \[No symptom:0, No hindrance to daily activities:1\], With symptom \[Mild:2, Moderate:3, Severe:4\]) of heartburn in participant diary. The score range was 0-4, higher scores indicates greater severity. Cumulative rate of improvement calculated as percentage of participants who experienced symptom improvement. Cumulative rate calculated in subgroup of Grade N per modified LA classification. Modified LA classification Grade N: normal mucosa; Grade M: minimal changes to mucosa; Grade A: nonconfluent mucosal breaks \<5mm in length; Grad

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 1
GroupValue95% CI
Placebo18.3
TAK-438 10 mg22.2
Day 2
GroupValue95% CI
PlaceboNA
TAK-438 10 mg23.5
Day 3
GroupValue95% CI
Placebo19.5
TAK-438 10 mg24.7
Day 4
GroupValue95% CI
PlaceboNA
TAK-438 10 mg27.2
Day 5
GroupValue95% CI
Placebo23.2
TAK-438 10 mg29.7
Day 6
GroupValue95% CI
Placebo24.4
TAK-438 10 mg32.3
Day 7
GroupValue95% CI
Placebo26.8
TAK-438 10 mg36.0
Cumulative Rate of Improvement in Heartburn in Subgroup Stratified by Endoscopic Findings (the Modified LA Classification Grade M) at Baseline Secondary · Day 0 to Day 24

Participants recorded presence and severity (Without symptom \[No symptom:0, No hindrance to daily activities:1\], With symptom \[Mild:2, Moderate:3, Severe:4\]) of heartburn in participant diary. Score range was 0-4, higher scores indicates greater severity. Cumulative rate of improvement calculated as percentage of participants who experienced symptom improvement. Cumulative rate calculated in subgroup of Grade M per modified LA classification. Modified LA classification Grade N: normal mucosa; Grade M: minimal changes to mucosa; Grade A: nonconfluent mucosal breaks \<5mm in length; Grade B:

Day 0
GroupValue95% CI
Placebo0.0
TAK-438 10 mg0.0
Day 1
GroupValue95% CI
Placebo12.9
TAK-438 10 mg23.6
Day 2
GroupValue95% CI
Placebo14.7
TAK-438 10 mg24.9
Day 3
GroupValue95% CI
PlaceboNA
TAK-438 10 mg25.5
Day 4
GroupValue95% CI
Placebo16.6
TAK-438 10 mgNA
Day 5
GroupValue95% CI
PlaceboNA
TAK-438 10 mg27.5
Day 6
GroupValue95% CI
PlaceboNA
TAK-438 10 mg29.4
Day 7
GroupValue95% CI
PlaceboNA
TAK-438 10 mg30.7

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to Week 4. Reporting threshold: 2%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Placebo
Serious: 1/245 (0%)
Deaths: 0/245
TAK-438 10 mg
Serious: 0/238 (0%)
Deaths: 0/238

Serious adverse events (1 terms)

ReactionSystemPlaceboTAK-438 10 mg
Colitis ulcerativeGastrointestinal disorders
Other adverse events (1 terms — click to expand)

ReactionSystemPlaceboTAK-438 10 mg
Viral upper respiratory tract infectionInfections and infestations

Most-reported serious reactions: Colitis ulcerative.

Data from ClinicalTrials.gov NCT02954848 adverse events section.

Sponsor's own description

The purpose of this study was to evaluate the efficacy and safety of oral TAK-438 10 mg once-daily in the treatment of non-erosive gastroesophageal reflux disease (NERD).

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Vonoprazan fumarate, a novel potassium-competitive acid blocker, in the management of gastroesophageal reflux disease: safety and clinical evidence to date.
    Sugano K. · · 2018 · cited 109× · PMID 29383028 · DOI 10.1177/1756283x17745776
  2. Efficacy and Safety of Vonoprazan in Patients With Nonerosive Gastroesophageal Reflux Disease: A Randomized, Placebo-Controlled, Phase 3 Study.
    Kinoshita Y, Sakurai Y, Takabayashi N, Kudou K, et al · · 2019 · cited 34× · PMID 31770139 · DOI 10.14309/ctg.0000000000000101

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