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CTRI Number  CTRI/2024/02/062543 [Registered on: 12/02/2024] Trial Registered Prospectively
Last Modified On: 19/09/2024
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   Effect of Fexuprazan tablets in Comparison to Esomeprazole Tablets for treatment of patients with Erosive Esophagitis 
Scientific Title of Study   A Randomized, Multi-Centric, Two-Arm, Active-Controlled, Parallel, Double-Blind, Double-Dummy, Comparative Study to Evaluate Efficacy And Safety of Fexuprazan Tablets in Comparison to Esomeprazole Tablets in Patients With Erosive Esophagitis 
Trial Acronym  FIERCE study 
Secondary IDs if Any  
Secondary ID  Identifier 
ICR/23/007, Version No.1.0; Dated 23/AUG/2023  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Pravin Ghadge 
Designation  AVP and Head – India Clinical Research  
Affiliation  Sun Pharma Laboratories Limited  
Address  Sun Pharma Laboratories Limited Sun house, Plot No. 201, B/1, Western Express Highway, Goregaon east. Mumbai (Suburban) MAHARASHTRA India

Mumbai (Suburban)
MAHARASHTRA
400063
India 
Phone  02243244324  
Fax    
Email  pravin.ghadge@sunpharma.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Shruti Saha 
Designation  Medical Monitor – India Clinical Research 
Affiliation  Sun Pharma Laboratories Limited  
Address  Sun Pharma Laboratories Limited Sun house, Plot No. 201, B/1, Western Express Highway, Goregaon east. Mumbai (Suburban) MAHARASHTRA India

Mumbai (Suburban)
MAHARASHTRA
400063
India 
Phone  02243244324  
Fax    
Email  Shruti.Saha@sunpharma.com  
 
Details of Contact Person
Public Query
 
Name  Chaitali Bornare 
Designation  Senior Manager 2 – Medical Affairs & Clinical Research 
Affiliation  Sun Pharma Laboratories Limited  
Address  Sun Pharma Laboratories Limited Sun house, Plot No. 201, B/1, Western Express Highway, Goregaon east. Mumbai (Suburban) MAHARASHTRA India

Mumbai (Suburban)
MAHARASHTRA
400063
India 
Phone  02243244324  
Fax    
Email  Chaitali.Bornare1@sunpharma.com  
 
Source of Monetary or Material Support  
Sun Pharma Laboratories Limited, Sun House, 201 B/1, Western Express Highway, Goregaon ( E),Mumbai 400 063 
 
Primary Sponsor  
Name  Sun Pharma Laboratories Limited  
Address  Sun House, 201 B/1, Western Express Highway, Goregaon ( E),Mumbai 400 063 
Type of Sponsor  Pharmaceutical industry-Indian 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 30  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Ganesh Muniappan   Ashwin Multispecialty Hospital  Ashwin Multispecialty Hospital, No 545, BKR Nagar, Alamu Nagar Road, Sathy Main Road, Coimbatore-641012, TamilNadu, India.
Coimbatore
TAMIL NADU 
9600232224

drganeshmuniappan.acr@gmail.com 
Dr Tryambak Samantha  Dr Tryambak Samantha   Department of Medical Gastroenterology Medical College, Kolkata, 88 College Street, Kolkata-73, West Bengal, India.
Kolkata
WEST BENGAL 
8777530352

drts.india@gmail.com 
Dr P Shravan Kumar  Gandhi Hospital  In Patient Block, 4th Floor, Department of Neurology, Musheerabad, Secunderabad, Telangana-500003
Hyderabad
TELANGANA 
8897930875

anithaneuroclinic@gmail.com 
Dr Godbole Varsha Yogesh   GMERS Medical College &and Hospital  Department of Medicine, 7th floor hospital building GMERS Medical College and Hospital, Gotri, Vadodara, Gujarat-390021
Ahmadabad
GUJARAT 
9879181673

drvgodbole@gmail.com 
Dr Parul Mitesh Bhatt  GMERS Medical College and Civil Hospital  GMERS Medical College and Civil Hospital, Department of Medicine, Sola, Near Gujarat High Court, Sola gram road, Ahmedabad, 380060
Ahmadabad
GUJARAT 
9879599595

parulbhatt30@yahoo.com 
Dr Anumula Kavitha   Government General Hospital  Room No-220, GMCANA building, Government General Hospital, Guntur, Ap-522001
Guntur
ANDHRA PRADESH 
9399977555

jananigastro@ymail.com 
Dr Vinay Kumar  GSVM medical college  Room No 12, ground Floor, Post graduate department of Medicine, GSVM medical college, Swaroop Nagar, Kanpur UP-208002
Kanpur Nagar
UTTAR PRADESH 
8726555577

dr.vinayksacchan@gmail.com 
Dr Mehta Vatsal Kirit Kumar   Health 1 Super Specialty Hospital  Health 1 Super Specialty Hospital, Near Venitian Villa, Shilaj Circle, S.P Ring Rd, Thaltej, Ahmedabad, Gujarat- 380059
Ahmadabad
GUJARAT 
7567546444

vatsalmehta6387@gmai.com 
Dr Shekhar Puri   Janta Hospital and Maternity Centre  Janta Hospital and Maternity Centre, Near Water Head Tank, Amara Akhari Bypass, Chunar Road, Varanasi-221011, UttarPradesh, India
Varanasi
UTTAR PRADESH 
9532310199

jantahospitalvns@gmail.com 
Dr Seetaram NK   KIMS  Department of general Medicine, KIMS, Vidyanagar, Hubli, Karantaka-590022
Dharwad
KARNATAKA 
9449134858

seetaramnk76@gmail.com 
Dr Nath Preetam  KIMS Hospital  KIMS Hospital, Kusabhadra Campus, Chandaka Industrial Estate, KIIT university, Patia, Bhubaneshwar, Odisha-751024
Khordha
ORISSA 
9438870743

dr.preetamnath@gmail.com 
Dr Santosh Dhananjay Hajare   KLES Dr Prabhakar Kore Hospital and MRC  KLES Dr Prabhakar Kore Hospital and MRC, Nehru Nagar Belagavi-590010 Karnataka, India.
Belgaum
KARNATAKA 
09448111913

drsantoshhajare@gmail.com 
Dr Vivek Bhatia   Maharaja Agrasen Hospital  Maharaja Agrasen Hospital, West Punjabi Bagh ,New Delhi-110026
New Delhi
DELHI 
9811028897

drvivekbhatia@yahoo.co.in 
Dr Gupta Dhaval Vinaykumar   Mission Gastro Hospital  Mission Gastro Hospital, 603, Golden Icon, Opp. Medilink Hospital, Between Shivranjani- Shyamal Cross Road, 132 Feet Ring Road, Satellite, Ahmedabad-380015.
Ahmadabad
GUJARAT 
9819277795

drdhavalgupta@gmail.com 
Dr Gaurav Garg  Motilal Nehru Medical College  George town Civil Lines, Prayagraj, Uttar Pradesh-211002
Allahabad
UTTAR PRADESH 
9528767749

drgauravmln@gmail.com 
Dr Pinaki Roy  Nil Ratan Sarcar medical collage and Hospital  Nil Ratan Sarcar medical college and Hospital, Department of Gastroenterology, 138 AJC Bose Road Kolkata, 700014
Kolkata
WEST BENGAL 
8777423258

Drpinaki1979@gmail.com 
Dr Manoj Kolhe  Ojas Multispeciality Hospital  Ojas Multispeciality Hospital, Bhondave Chowk, DY Patil College Road Ravet, Pune-412101
Pune
MAHARASHTRA 
9099058141

manojck008@gmail.com 
Dr Gyan Prakash Rai  Om Surgical Center and Maternity Home  Om Surgical Center and Maternity Home, SA-17-3, P-4, Sri Krishna Nagar, Paharia, Ghazipur Road, Varanasi-221007, Uttar Pradesh, India
Varanasi
UTTAR PRADESH 
9828358410

gprai2992@gmail.com 
Dr Anupam Kumar Singh  Postgraduate Institute of Medical Education and Research  Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh-160012.
Chandigarh
CHANDIGARH 
8284822540

anupam.pgi@gmail.com 
Dr Rajesh P  Rajalakshmi hospital & Research Center  #21/1 Lakshmipura Main Road, Vidyaranyapura Post, Bangalore-560097 Bangalore KARNATAKA
Bangalore
KARNATAKA 
9738877298

Siddu.shetty.jaya@gmail.com 
Dr Mukesh Kumar Jain  S.M.S. Superspeciality Hospital  S.M.S. Superspeciality Hospital, Department of Gestroenterology, Vivekanand marg, C-Scheme, Jaipur, Rajasthan, India -302004
Jaipur
RAJASTHAN 
9414323607

drmukeshjaingastro@gmail.com 
Dr Ashish Joshi   S.P. Medical College and A.G. of Hospitals  S.P. Medical College and A.G. of Hospitals, Department of Gastroenterlogy, Bikaner, Rajasthan–334001
Bikaner
RAJASTHAN 
9414248526

drashishspmc69@gmail.com 
Dr Vyas Kaushal Yogeshbhai   Sardar Vallabhbhai Patel Institute of Medical Science and Research  Sardar Vallabhbhai Patel Institute of Medical Science and Research, Elisbridge, Ahmedabad-380006
Ahmadabad
GUJARAT 
9825005163

kaushalv27@yahoo.com 
Dr Shah Parth Kirti Kumar DNB   Sheth Vadilal Sarabhai General and Sheth Chinai Maternity Hosptial  Sheth Vadilal Sarabhai General and Sheth Chinai Maternity Hosptial, Ellis Bridge, Ahmedabad-380006.
Ahmadabad
GUJARAT 
9924939099

doctorparthshah@gmail.com 
Dr Sasi Anand D  Silverline Hospital  Silverline Hospital, No 23 C, 4th cross, West Extention, Thillai Nagar, Trichy-620018, (Gastro room No 1)
Tiruchirappalli
TAMIL NADU 
9841799427

Drsash79@yahoo.co.in 
Dr Anil Arora  Sir Ganga Ram Hospital  Department of gastroenterology, Rajinder Nagar, New Delhi 110060, India
Central
DELHI 
9811047385

dranilarora50@gmail.com 
Dr Lokesh LV  Sparsh Super Specialty Hospital  Sparsh Super Specialty Hospital, 146 Infantry Road Opposite to police commissioners office, Bangalore, Karnataka-560001
Bangalore
KARNATAKA 
9606197707

sparshclinical@gmail.com 
Dr Haribhakti Das  Sriram Chandra Bhanja Medical Collage and Hospital  Sriram Chandra Bhanja Medical Collage and Hospital. CK-7 Medical College, Cuttack, Odisha-753007
Cuttack
ORISSA 
9861156676

hbsrho@yahoo.co.in 
Dr Mangulkar Mahesh Sudhakarrao  Supe Heart and Dibetes Hospital and Research Centre  Supe Heart and Dibetes Hospital and Research Centre, Opposite Aadharashram, Gharpure Ghat, Near Rungtha School, Ashok Stambh, Nasik-422002, Maharashtra, India
Nashik
MAHARASHTRA 
8087537224

drmaheshmagulkar22@gmail.com 
Dr Make Naveen Chand  Visakha Institute of Medical Sciences  Department of gastroenterology Hanumanthwaka, Visakhapatnam-530040, Andhra Pradesh
Visakhapatnam
ANDHRA PRADESH 
9885837772

drmnaveenchandresearch@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 30  
Name of Committee  Approval Status 
Ethics Committee S.M.S. Medical College and Attached Hospitals  Approved 
Ethics committee S.P. Medical College  Approved 
Ethics Committee-GSVM Medical College  Approved 
Health1 super Specialty hospital EC   Approved 
Institutional Ethics Committee Aatman Hospital   Approved 
Institutional Ethics Committee for Human Research   Submittted/Under Review 
Institutional Ethics Committee GMC and GGH  Submittted/Under Review 
Institutional Ethics Committee GMERS medical college   Submittted/Under Review 
Institutional Ethics Committee NHLIEC  Approved 
Institutional Ethics Committee PGIMER   Approved 
Institutional Ethics Committee Sparsh Hospital   Approved 
Institutional Ethics Committee, Harshmitra Super specialty Cancer centre and Research Institute   Approved 
Institutional Ethics Committee, Sriram Chandra Bhanja Medical Collage and Hospital  Submittted/Under Review 
Institutional Ethics Committee-Ashwin Hospital  Approved 
Institutional Ethics Committee-Gandhi Hospital  Approved 
Institutional Ethics Committee-KIMS Hospital-Bhubhaneshwar  Approved 
Institutional Ethics Committee-KLE University  Approved 
Institutional Ethics Committee-Motilal Nehru Medical College  Approved 
Institutional Ethics Committee-NRS medical college   Approved 
Institutional Ethics Committee-Om Surgical Center and Maternity Home  Approved 
Institutional Ethics Committee-Rajalakshmi hospital and Research Center  Approved 
Institutional Ethics Committee-Visakha Institute of Medical Sciences  Approved 
Institutional Human Ethics Committee GMERS Medical College and Hospital  Approved 
Janta Hospital Ethics Committee   Submittted/Under Review 
KIMS Ethics Committee-Hubli  Approved 
Maharaja Agrasen Hospital-Institutional Ethics Committee   Approved 
Medilink Ethics Committee   Approved 
Ojas Multispeciality Hospital Ethics Committee  Approved 
Sir Ganga Ram Hospital Ethics Committee  Submittted/Under Review 
Supe Hospital Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: K208||Other esophagitis,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Esomeprazole 40 mg tablet and matching placebo tablet for Fexuprazan.   One tablet of Esomeprazole tablets 40 mg and matching placebo for Fexuprazan to be taken approximately 1 hour before the first meal of the day for 8 Weeks.  
Intervention  Fexuprazan 40 mg tablet and matching placebo tablet for Esomeprazole.   One tablet of Fexuprazan 40 mg and matching placebo for Esomeprazole to be taken orally OD approximately 1 hour before the first meal of the day for 8 Weeks.  
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  1. Patients of either gender with age between 18 to 65 years (both inclusive) and willing to provide written informed consent
2. Patients with erosive GERD on the upper GI endoscopy at Screening
3. Women of childbearing potential must have a negative urine pregnancy test prior to Screening and Randomization and agree to use highly effective methods of contraception to prevent pregnancy from study entry till EOS (such contraception may include hormonal birth control e.g. combined estrogen and progestogen containing [oral, intravaginal, or transdermal] or progesterone only [oral, injectable, or implantable] hormonal contraception associated with inhibition of ovulation, intrauterine devices, intrauterine hormone releasing system OR bilateral tubal occlusion, vasectomized partner, or total sexual abstinence OR non-hormonal contraception [e.g. condoms with spermicide]).
4. Male patients must have had a successful vasectomy (confirmed azoospermia) or they and their female partners must meet the criteria above (i.e. not of childbearing potential or practicing highly effective contraception throughout the study period) [No sperm donation is allowed during the study period] 
 
ExclusionCriteria 
Details  1. Patients having hypersensitivity or any other contraindication to any of the Investigational product or its component
2. Patients taking any treatment for GERD modifying gastric acid secretion (such as oral antacids, PPIs etc) within 7 days prior to Randomization
3. Patients with current or past history of
a) GERD complications like Barrett’s esophagus (Greater than 3 cm) and or definite dysplastic changes in the esophagus
b) Acute peptic ulcer and or ulcer complications (like ulcer related stenosis)
c) Active gastric or duodenal ulcers within 4 weeks prior to Screening
d) Increased GI motility eg in patients with GI hemorrhage, mechanical obstruction or perforation
e) Active GI bleeding or GI bleeding within 4 weeks prior to Screening
f) Inflammatory bowel disease or irritable bowel syndrome
g) Atrophic gastritis or gastric malignancy or any other GI malignancy
h) Zollinger-Ellision syndrome or any other hypersecretory condition
i) Pyloric stenosis, eosinophilic esophagitis, esophageal stricture, Schatzkis ring, esophageal varices, hiatus hernia, achalasia (esophageal motility disorder)
j) Gastric acid suppression surgery
4) Patient with alarm features in symptomatology, including odynophagia, severe dysphagia, bleeding, weight loss, anemia, and blood in stool, pointing to a possible malignant disease of the GI tract
5) Patients with history of any bleeding disorder
6) Patients with conditions requiring surgical treatment or planned surgery during the study duration
7) Patient chronically using (Greater than 5 doses on demand or for 3 consecutive days) systemic steroids or nonsteroidal anti-inflammatory drugs which included COX-2 inhibitors other than aspirin (Less than or equal to 165 mg per day is allowed) within last 28 days prior to Screening
8) Patients taking high dose methotrexate, bisphosphonate, strong CYP3A4 or CYP2C19 inhibitors, CYP3A4, CYP2B6, CYP2D6 or CYP2C19 inducers, agents affecting digestive organs (e.g. M3 receptor antagonists, prokinetics, anticholinergic agents, prostaglandins, mucosal protective agents), anticoagulant therapy or clopidogrel within 14 days (or 5 half lives of particular drug, whichever is longer) prior to Screening or required to take during the study
9) Patients with history of any surgical condition that, in the judgement of the Investigator or Sponsor, could interfere with absorption, distribution, metabolism, or excretion of the study drugs
10) Patients with history of any clinically significant medical and/or psychological condition that, in the opinion of the Investigator would jeopardize the safety of the patient or affect the validity of the study results [for example but not limited to: cardiovascular disorders (like long QT syndrome, myocardial infarction, angina, etc.), respiratory impairment, hepatic impairment, epilepsy or seizure disorder or any neurological disorder, haematological disorder, metabolic disorder (like thyroid disorder), uncontrolled diabetes (HbA1c Greater than or equal to 9%)]
11) Patients with history of osteoporosis or hypomagnesemia
12) Pregnant and or lactating female
13) Patient with history of HIV and or HBV and or HCV
14) Patient with history of malignancy in the last 5 years prior to Screening or undergoing cancer chemo or radiotherapy [Note: Patients who have been in remission for more than 5 years and not received any cancer treatment in last 5 years prior to screening can be included in the study]
15) Patient with known alcohol or other substance abuse within last one year prior to Screening
16) Patient who have participated in another Investigational study within the 3 months prior to Screening or planning to participate in another clinical trial during the study
17) Employee of the Sponsor, Investigator, or study center, with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as family members of the employees of Sponsor or the Investigator 
 
Method of Generating Random Sequence   Stratified block randomization 
Method of Concealment   Centralized 
Blinding/Masking   Double Blind Double Dummy 
Primary Outcome  
Outcome  TimePoints 
Cumulative proportion of patients with endoscopically confirmed healed EE [Time frame: Upto Week 8]  Upto Week 8 
 
Secondary Outcome  
Outcome  TimePoints 
Cumulative proportion of patients with endoscopically confirmed healed EE  Upto Week 4 
Proportion of 24 hours (with neither daytime nor nighttime) heartburn free days   Baseline, Weeks 4 and 8 
Proportion of days without nighttime heartburn   Baseline, Weeks 4 and 8 
Proportion of days without daytime heartburn   Baseline, Weeks 4 and 8 
Proportion of 24 hours (with neither daytime nor nighttime) regurgitation free days   Baseline, Weeks 4 and 8 
Proportion of days without nighttime regurgitation   Baseline, Weeks 4 and 8 
Proportion of days without daytime regurgitation  Baseline, Weeks 4 and 8 
Proportion of patients who achieved sustained resolution of heartburn (7 consecutive heartburn free days [24-hour period])  Weeks 4 and 8 
Proportion of patients who achieved sustained resolution of regurgitation (7 consecutive regurgitation-free days [24-hour period])   Weeks 4 and 8 
Proportion of days without rescue medicines   Baseline, Weeks 4 and 8 
Change from Baseline in FSSG Score   Baseline, Weeks 4 and 8 
Change from Baseline in the GERD-HRQOL questionnaire   Baseline, Weeks 4 and 8 
Proportion of responders (Very much improved, or much improved) as per CGI-I Scale   Weeks 4 and 8 
Proportion of patients with TEAEs and SAEs  Throughout the study period  
 
Target Sample Size   Total Sample Size="210"
Sample Size from India="210" 
Final Enrollment numbers achieved (Total)= "0"
Final Enrollment numbers achieved (India)="0" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   18/02/2024 
Date of Study Completion (India) 18/09/2024 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="0"
Months="3"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

This study will be a phase III, randomized, parallel-group, multi-center, double-blind, double-dummy, two-arm, active-controlled, comparative study. The study will be conducted at approximately 15-20 centers in India, having qualified Investigators. The study will be initiated only after the receipt of Regulatory and Ethics committee (EC) approval.

Screening period:

The patient will be screened only after obtaining written informed consent. After obtaining consent, the patients will undergo a screening period of minimum 7 days and maximum 14 days. At screening visit, study-specific screening (including inclusion and exclusion criteria, medical and surgical history, demography, vital signs and physical examination, laboratory examination, 12-Lead ECG) will be performed.

Treatment period:

After confirming the eligibility, patients will be randomized by allotting the randomization number. Patients will be either randomized to Test arm (Fexuprazan 40 mg) OR to Comparator arm (Esomeprazole 40 mg). During the study, assessments will be performed as planned in the study.

 
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