Drug Interaction Study on Linaprazan Glurate Capsules

Drug Interaction Study on Linaprazan Glurate Capsules, Clarithromycin Tablets, Amoxicillin Capsules, and Bismuth Potassium Citrate Capsules

This study is a drug-drug interaction (DDI) investigation involving Linaprazan Glurate capsules and a combination of clarithromycin tablets, amoxicillin capsules, and bismuth potassium citrate capsules. The study plan is divided into two parts: one involving Hp-negative healthy subjects and the other involving Hp-positive subjects.

Study Overview

• Status: Completed
• Conditions: Healthy Volunteers; Patients
• Intervention / Treatment: Drug: Linaprazan Glurate Capsules; Drug: Amoxicillin Capsules; Drug: Clarithromycin tablets; Drug: Bismuth Potassium Citrate Capsules; Drug: Esomeprazole Magnesium Enteric-coated Tablets

Detailed Description

The first part of the study is designed as a single-center, randomized, open-label, four-period, four-sequence crossover trial to evaluate the changes in pharmacokinetic (PK) profiles of Linaprazan Glurate capsules when co-administered with clarithromycin tablets and amoxicillin capsules compared to their individual administration, as well as the safety and tolerability of the combination therapy in Hp-negative healthy adult Chinese subjects.

The second part of the study is designed as a single-center, randomized, open-label, parallel-group, positive-controlled trial to compare the differences in systemic exposure of bismuth potassium citrate capsules between the Linaprazan Glurate capsule-based quadruple therapy (combined with clarithromycin tablets, amoxicillin capsules, and bismuth potassium citrate capsules) and the esomeprazole magnesium enteric-coated tablet-based quadruple therapy (combined with clarithromycin tablets, amoxicillin capsules, and bismuth potassium citrate capsules), to evaluate the pharmacodynamic effects on intragastric pH, to assess the safety and tolerability of the Linaprazan Glurate capsule-based quadruple therapy, and to preliminarily explore its efficacy in eradicating Helicobacter pylori (Hp) in Hp-positive subjects.

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Phase 1

Contacts and Locations

Study Locations

• China
  • Guizhou
    • Guiyang, Guizhou, China, 550004
      • The Affiliated Hospital of Guizhou Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Age range: 18 to 55 years old (including 18 and 55);
2. Male weight ≥50.0 kg, female weight ≥45.0 kg; Body Mass Index (BMI) between 19.0 and 26.0 kg/m²(including critical value); BMI=weight/height2 (m2)

3. Part 1 Study and Part 2 Study:

   Part 1: Subjects must be Helicobacter pylori-negative at screening; Part 2: Subjects must be Helicobacter pylori-positive at screening;

4. From signing informed consent until 3 months after study completion, subjects must: Implement appropriate and effective contraception to prevent pregnancy (applies to subject or partner); Refrain from sperm donation or egg donation plans;
5. Subjects must fully comprehend the trial content, voluntarily participate in the trial, Provide written informed consent;

Exclusion Criteria:

1. Subjects known as Hypersensitivity History: Known allergy to: Linaprazan Glurate capsules, Esomeprazole (Part 2 only), Penicillin, Macrolide antibiotics, Any component of bismuth potassium citrate;History of severe immediate hypersensitivity to: Other macrolide antibiotics, β-lactam agents (e.g., cephalosporins, carbapenems, monobactams),Multiple drug hypersensitivity (e.g., allergic reactions to ≥2 medications/foods);
2. Clinically Significant Abnormalities at Screening: Abnormalities deemed clinically significant by investigators based on: Medical history review, Vital signs, Physical examination, 12-lead ECG, Laboratory tests: Complete blood count (CBC), Blood chemistry, Urinalysis, Coagulation tests ;
3. Subjects with Penicillin sodium skin test positivity during screening;
4. Subjects with use of any investigational product within 3 months prior to screening;
5. Subjects with use of potassium-competitive acid blockers (P-CABs) within 3 months prior to screening;
6. Subjects with use within 30 days prior to screening of Prescription drugs, Over-the-counter ,OTC) medications, Herbal medicines, Dietary supplements;
7. Subjects with history of diseases in the following systems (also investigator-determined as ineligible): Central nervous system, Cardiovascular system, Respiratory system, Digestive system, Endocrine system, Immune system, Neurological/Psychiatric systems, Hematologic/Lymphatic systems, Musculoskeletal system;
8. Gastrointestinal/Surgical History: History of gastrointestinal diseases or surgeries including:Gastric surgery (except pyloromyotomy for infantile pyloric stenosis), Cholecystectomy, Vagotomy, Bowel resection, Any surgery potentially affecting GI motility, pH, or absorption, Conditions impacting drug ADME: Dysphagia, Vomiting, Severe diarrhea;
9. Cardiac Abnormalities: Clinically significant ECG abnormality history, Family history of Long QT Syndrome (grandparents, parents, siblings), Screening QTcF prolongation: 450 msec in males, 470 msec in females;
10. Subjects with major surgery within 3 months prior to screening,and planned surgery during trial participation;
11. Subjects with blood donation (whole blood/component) ≥400 mL within 3 months (excluding menstrual loss),Blood transfusion or blood product use within 3 months;
12. Infectious Disease Screening: Positive results for any at screening: Hepatitis B surface antigen (HBsAg), Hepatitis C antibody (HCV-Ab), HIV antibody (HIV-Ab), Treponema pallidum antibody (TP-Ab);
13. Subjects who have used illicit drugs within the 3 months prior to screening, or have a history of drug abuse within the past 12 months, or whose urine drug abuse screening test result is positive;
14. Subjects who regularly consumed alcohol within the 3 months prior to screening (i.e., consuming more than 14 standard units per week; 1 unit = 360mL of beer, or 45mL of 40% spirits, or 150mL of wine), or who are unwilling to abstain from alcohol or any alcohol-containing products for 48 hours prior to dosing and during the trial, or whose alcohol breath test result is positive;
15. Subjects who smoked an average of >5 cigarettes per day within the 30 days prior to screening; or who cannot guarantee abstinence from smoking from the signing of the informed consent form until the end of the study;
16. Subjects who have been vaccinated within the 3 months prior to screening or plan to be vaccinated during the trial period;
17. Subjects who consumed excessive amounts of tea, coffee, or caffeinated beverages (more than 8 cups per day; 1 cup = 250mL) within the 4 weeks prior to screening;
18. Subjects who consumed special diets (including pitaya, mango, grapefruit, pomelo, lime, starfruit, or foods/beverages prepared from them, or any caffeinated foods/beverages, alcoholic beverages, or other foods/beverages known to affect drug absorption, distribution, metabolism, or excretion) within 48 hours prior to the first dose;
19. Subjects who are intolerant to venipuncture, have difficulty with blood collection, or have a history of needle or blood phobia/syncope;
20. Pregnant or lactating women;
21. Subjects with special dietary requirements who cannot comply with the standardized diet, or who have difficulty swallowing;
22. Subjects deemed unsuitable for participation by the investigator.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Linaprazan Glurate Capsules 50mg BID, consecutive 7-day dosing per period; Glurate Capsules Capsules 50mg, BID, consecutive 7-day dosing per period in Part 1.	Drug: Linaprazan Glurate Capsules; Linaprazan Glurate capsules; Other Names: Linaprazan Glurate; Drug: Amoxicillin Capsules; Amoxicillin Capsules; Other Names: Amoxicillin; Drug: Clarithromycin tablets; Clarithromycin Tablets; Other Names: Clarithromycin
Experimental: Linaprazan Glurate Capsules 50mg BID, consecutive 14-day dosing; Linaprazan Glurate Capsules 50mg BID, consecutive 14-day dosing in part 2.	Drug: Linaprazan Glurate Capsules; Linaprazan Glurate capsules; Other Names: Linaprazan Glurate; Drug: Amoxicillin Capsules; Amoxicillin Capsules; Other Names: Amoxicillin; Drug: Clarithromycin tablets; Clarithromycin Tablets; Other Names: Clarithromycin; Drug: Bismuth Potassium Citrate Capsules; Bismuth Potassium Citrate Capsules; Other Names: Bismuth Potassium Citrate
Experimental: Esomeprazole Magnesium Enteric-coated Tablets 20mg BID, consecutive 14-day dosing.; Esomeprazole Magnesium Enteric-coated Tablets 20mg, BID in Part 2.	Drug: Amoxicillin Capsules; Amoxicillin Capsules; Other Names: Amoxicillin; Drug: Clarithromycin tablets; Clarithromycin Tablets; Other Names: Clarithromycin; Drug: Bismuth Potassium Citrate Capsules; Bismuth Potassium Citrate Capsules; Other Names: Bismuth Potassium Citrate; Drug: Esomeprazole Magnesium Enteric-coated Tablets; Esomeprazole Magnesium Enteric-coated Tablets; Other Names: Esomeprazole Magnesium

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Steady state maximum concentration (Cmax,ss)	Cmax,ss of of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study.	7 days
AUC0-τ,ss(The area under the drug-time curve within the dosing interval after reaching the steady state)	AUC0-τ,ss of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study.	7 days
Cav,ss (Average steady-state blood drug concentration)	Cav,ss of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study.	7 days
Tmax,ss (Steady-state peak time)	Tmax,ss of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study.	7 days
CLss/F(Steady-state apparent clearance rate)	CLss/F of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study.	7 days
t1/2z(Terminal elimination half-life)	t1/2z of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study; and t1/2z of Pharmacokinetic Parameters of Bismuth in Part 2 study.	7, 14 days
Vz/F (Apparent volume of distribution in the terminal elimination phase)	Vz/F of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study; and Vz/F of Pharmacokinetic Parameters of Bismuth in Part 2 study.	7, 14 days
λz (Terminal elimination rate constant)	λz of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study; and λz of Pharmacokinetic Parameters of Bismuth in Part 2 study.	7, 14 days
MRT(mean residence time)	MRT of Linaprazan Glurate and its active metabolite(s), clarithromycin and its active metabolite(s), and amoxicillin in Part 1 study.	7 days
Cmax(Maximum observed plasma drug concentration)	Cmax of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days
AUC0-τ (The area under the drug-time curve within the dosing interval)	AUC0-τ of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days
Tmax (Time to reach maximum plasma concentration)	Tmax of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days
CL/F (apparent clearance)	CL/F of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days
Ae0-τ (Amount of drug excreted in urine over the dosing interval)	Ae0-τ of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days
fe (Amount of drug excreted in urine over the dosing interval)	fe of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days
CLR (renal clearance)	CLR of Pharmacokinetic Parameters of Bismuth in Part 2 study.	14 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The percentage of time over a 24-hour period that intragastric pH ≥ 4 and pH ≥ 6	Percentage of time with intragastric pH ≥ 4 and ≥ 6 during 24-hour monitoring	1, 14 days
Proportion of subjects with successful Helicobacter pylori (Hp) eradication	Proportion of subjects with successful Helicobacter pylori (Hp) eradication confirmed by ¹³C-UBT or ¹⁴C-UBT.	1, 14 days
Number of subjests With Adverse Events	Adverse event severity was graded from 1 to 5 according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.	up to 56 days
Number of subjests With Clinically Notable Electrocardiogram (ECG) Values	Record the standard 12-lead ECG.	up to 56 days

Collaborators and Investigators

• Sponsor: Jiangsu Sinorda Biomedicine Co., Ltd
• Investigators: Study Director: Ming Lu, Shanghai Sinorda Biomedicine Co., Ltd.

Study record dates

Study Major Dates

• Study Start (Actual): September 8, 2025
• Primary Completion (Actual): December 15, 2025
• Study Completion (Actual): December 15, 2025

Study Registration Dates

• First Submitted: September 4, 2025
• First Submitted That Met QC Criteria: December 8, 2025
• First Posted (Estimated): December 19, 2025

Study Record Updates

• Last Update Posted (Actual): January 6, 2026
• Last Update Submitted That Met QC Criteria: January 4, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: PK; Potassium competitive acid blocker; Acid inhibition; Adjunctive therapy for H. pylori eradication; Linaprazan Glurate Capsules
• Additional Relevant MeSH Terms: 2-Pyridinylmethylsulfinylbenzimidazoles; Sulfoxides; Sulfur Compounds; Organic Chemicals; Pyridines; Heterocyclic Compounds, 1-Ring; Heterocyclic Compounds; Benzimidazoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Amides; Macrolides; Lactones; Penicillin G; beta-Lactams; Lactams; Omeprazole; Erythromycin; Polyketides; Ampicillin; Penicillins; Amoxicillin; Clarithromycin; Esomeprazole
• Other Study ID Numbers: SND-X842-103

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No