Drug-Drug Interactions Between TNP-2198 and Midazolam, Clarithromycin

NCT06551623 | Completed Phase 1 FDA Drug

• 1 other identifier: TNP-2198-10
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

This is a single center, open label, drug-drug interaction, Phase 1 study of TNP-2198 in approximately 32 healthy participants, includes 2 cohorts (16 participants per cohort): Midazolam cohort and Clarithromycin cohort. Midazolam cohort will evaluate the effect of multiple oral doses of TNP-2198 capsules on the pharmacokinetics (PK) parameters of a single oral dose of midazolam, a cytochrome P-450 (CYP) 3A sensitive substrate, in healthy participants; Clarithromycin cohort will evaluate the effect of multiple oral doses of clarithromycin tablets, a strong CYP3A and P-gp inhibitor, on the PK parameters of multiple oral doses of TNP-2198 in healthy participants.

Conditions

Helicobacter Pylori Infection

Outcome Measures

Primary Outcomes (6)

• Midazolam cohort: PK parameters of midazolam-Area under the plasma concentration versus time curve (AUC0-t)

  Area under the plasma concentration versus time curve from time 0 to the last quantifiable concentration (AUC0-t)

  Within 1 hour prior to midazolam dosing and at 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36, and 48 hours following midazolam dosing on Day 1 and Day 10, respectively.

• Midazolam cohort: PK parameters of midazolam-Area under the plasma concentration versus time curve (AUC0-∞)

  Area under the plasma concentration versus time curve from time 0 extrapolated to infinity (AUC0-∞)

  Within 1 hour prior to midazolam dosing and at 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36, and 48 hours following midazolam dosing on Day 1 and Day 10, respectively.

• Midazolam cohort: PK parameters of midazolam-Maximum observed plasma concentration (Cmax)

  Maximum observed plasma concentration (Cmax)

  Within 1 hour prior to midazolam dosing and at 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36, and 48 hours following midazolam dosing on Day 1 and Day 10, respectively.

• Clarithromycin cohort: PK parameters of TNP-2198-Area under the plasma concentration versus time curve(AUC0-t)

  Area under the plasma concentration versus time curve from time 0 to the last quantifiable concentration

  Within 1 hour prior to TNP-2198 dosing and at 1, 2, 3, 3.5, 4, 5, 6, 8, 10, 12, 24, 48, and 72 hours following TNP-2198 dosing on Day 8 and Day 23, respectively.

• Clarithromycin cohort: PK parameters of TNP-2198-Area under the plasma concentration versus time curve from time 0 extrapolated to infinity (AUC0-∞)

  Area under the plasma concentration versus time curve from time 0 extrapolated to infinity

  Within 1 hour prior to TNP-2198 dosing and at 1, 2, 3, 3.5, 4, 5, 6, 8, 10, 12, 24, 48, and 72 hours following TNP-2198 dosing on Day 8 and Day 23, respectively.

• Clarithromycin cohort: PK parameters of TNP-2198-Maximum observed plasma concentration (Cmax)

  Cmax

  Within 1 hour prior to TNP-2198 dosing and at 1, 2, 3, 3.5, 4, 5, 6, 8, 10, 12, 24, 48, and 72 hours following TNP-2198 dosing on Day 8 and Day 23, respectively.

Secondary Outcomes (6)

• Midazolam cohort: Percentage of Participants With Adverse Events (AEs)

  Day 1 to Day 12

• Clarithromycin cohort:Percentage of Participants With Adverse Events (AEs)

  Day 1 to Day 26

• Midazolam cohort: PK parameters of midazolam Time to Maximum Plasma Concentration (Tmax)

  Within 1 hour prior to midazolam dosing and at 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36, and 48 hours following midazolam dosing on Day 1 and Day 10, respectively.

• Midazolam cohort: PK parameters of midazolam Terminal Elimination Half-life (T1/2)

  Within 1 hour prior to midazolam dosing and at 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36, and 48 hours following midazolam dosing on Day 1 and Day 10, respectively.

• Clarithromycin cohort: PK parameters of TNP-2198 Time to Maximum Plasma Concentration (Tmax)

  Within 1 hour prior to TNP-2198 dosing and at 1, 2, 3, 3.5, 4, 5, 6, 8, 10, 12, 24, 48, and 72 hours following TNP-2198 dosing on Day 8 and Day 23, respectively.

Study Arms (2)

Midazolam cohort

EXPERIMENTAL

Midazolam Oral Solution will be given orally once daily within 0.5 hours after breakfast on Day 1 and Day 10. TNP-2198 Capsules will be given orally twice daily within 0.5 hours after breakfast and dinner from Day 3 to Day 11.

Drug: Midazolam; Drug: TNP-2198

Clarithromycin cohort

EXPERIMENTAL

Clarithromycin tablets will be given orally within 0.5 hours after breakfast and dinner from Day 16 to Day 25. TNP-2198 Capsules will be given orally twice daily within 0.5 hours after breakfast and dinner from Day 1 to Day 7 and from Day16 to Day 22, and once daily within 0.5 hours after breakfast on Day 8 and Day 23.

Drug: Clarithromycin; Drug: TNP-2198

Interventions

Midazolam DRUG

Midazolam Oral Solution 2 mg

Midazolam cohort

Clarithromycin DRUG

Clarithromycin tablets 0.5 g

Clarithromycin cohort

TNP-2198 DRUG

TNP-2198 Capsules 400 mg

Clarithromycin cohort; Midazolam cohort

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Be able to provide written Informed consent forms (ICF) and fully understand the study procedures and potential AEs.
• Be able to comply with all protocol requirements.
• Willing to voluntarily take effective contraceptive measures from signing the ICF to 3 months after the last dose of investigational product, and male subjects must refrain from sperm donation during this period.
• Male or female, 18 to 55 years of age, inclusive.
• Have a body mass index (BMI) 18 to 28 kg/m2, inclusive, and body weight ≥ 50 kg for male or ≥ 45 kg for female.
• The results of physical examination and vital signs are normal or abnormal but without clinical significance.

You may not qualify if:

• Have a history of allergy to the investigational products (TNP-2198, midazolam \[Midazolam cohort\] or clarithromycin \[Clarithromycin cohort\]), and/or allergic constitution (such as allergic to multiple drugs, food or pollen, or prone to allergic reactions without knowing the causes of allergy).
• Have abnormal laboratory tests with clinical significance, or have dysphagia, or have diseases that can affect drug absorption or excretion within 6 months before screening, or other clinical findings within 12 months before screening indicating clinically significant diseases, including but not limited to gastrointestinal tract, kidney, liver, nerve, blood, endocrine, tumor, lung, immune, mental or cardiovascular and cerebrovascular diseases.
• Have an abnormal result of ECG with clinical significance at screening/baseline.
• Have a positive test result for Hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV-Ab), AIDS antibody or Treponema pallidum antibody at screening/baseline.
• Female participants have a positive result for pregnancy test at screening or admission or are lactating.
• Have a positive result for orthostatic hypotension at screening, or have a history of orthostatic hypotension, when screening for Midazolam cohort.
• Have used CYP3A inducers or inhibitors (such as clarithromycin, erythromycin, verapamil, diltiazem, ketoconazole, itraconazole, ritonavir, etc.), P-glycoprotein (P-gp) or breast cancer resistance protein (BCRP) inhibitors or inducers (such as itraconazole, ketoconazole or dronedarone, etc.) within 30 days before screening.
• Participants who must take prescription or non-prescription drugs (including vitamins and dietary or herbal supplements, etc.) within 7 days or 5 half-lives (whichever is longer) before the administration of investigational products or throughout the study, unless the investigator considers that the drug will not interfere with the study. Any exceptions will be discussed with the sponsor case-by-case and the reasons will be documented.
• Participants enrolled in other clinical trials, or received other investigational products, or used medical devices within 3 months before the administration of investigational products in this study, or 5 half-lives of other investigational products, or twice the duration of biological effect of other investigational products (whichever is longer).
• Smoke more than 5 cigarettes or equivalent cigarettes per day on average within 3 months prior to the first dose, or unable to stop smoking during the study.
• Have alcohol abuse within 6 months before screening, that is, drink more than 14 units of alcohol per week on average (1 unit = 285 mL of beer, or 45 mL of 40% liquor, or 100 mL of wine), or cannot stop drinking any alcohol-containing products during the study, or drinking or taking any alcohol-containing products within 48 hours before the first dose, or alcohol breath test result is positive at screening/baseline.
• Have a history of drug abuse within 6 months prior to screening or have positive results for drug screening tests at baseline.
• Have received live or attenuated vaccines within 1 month before screening, or plan to receive live or attenuated vaccines during the study.
• Have a blood donation more than 400 mL within 3 months before the first dose of investigational products or have received a blood transfusion within 1 month before screening.
• Have special food (such as chocolate, dragon fruit, mango, grapefruit, any diet containing caffeine or xanthine) or be involved in strenuous exercise within 48 hours before the first dose of investigational product.

Sponsors & Collaborators

• TenNor Therapeutics Inc.: lead

Study Sites (1)

The First Hospital of Jinlin University

Changchun, Jilin, China

Location

MeSH Terms

Interventions

Midazolam; Clarithromycin

Intervention Hierarchy (Ancestors)

Benzodiazepines; Benzazepines; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Heterocyclic Compounds; Erythromycin; Macrolides; Polyketides; Lactones; Organic Chemicals

Study Officials

• Xiaojiao Li

  The First Hospital of Jilin University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 9, 2024
• First Posted: August 13, 2024
• Study Start: August 26, 2024
• Primary Completion: October 14, 2024
• Study Completion: October 14, 2024
• Last Updated: October 24, 2024

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)