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This will be a Phase I, randomized, double-blind, positive- and placebo-controlled study to evaluate the safety, tolerability, and PK/PD of multiple oral doses of H008 in healthy adult subjects.
Two dose levels of H008 at 20 mg and 40 mg will be studied in two sequential cohorts. Each cohort will be enrolled with 12 subjects (8 on H008, 2 on placebo and 2 on positive control drug). Subjects are only allowed to participate in one of the two cohorts. Both the investigational product and placebo will be given in a double blinded manner, while the positive control drug will be given in an open-label manner.Dose escalation to the next cohort will be permitted only when safety data until follow-up and PK data until 48 hours post-last dose, from all subjects in previous cohorts are reviewed, and the investigational product is deemed well tolerated.
The study will consist of a screening period, a baseline period, a 7-day repeated-dose period and a safety follow-up period.
Screening Period
After signing the informed consent, all subjects will undergo a screening assessment within 4 weeks prior to the start of study treatment (Days -28 to -3).
Baseline Period
Eligible subjects at screening will come to the clinic 2 days prior to the first dosing and begin their 11-day confinement period (Day -2 to Day 9). On Day -2, subjects will undergo baseline examinations. On Day -1, subjects will be monitored for their intragastric pH using a pH probe inserted into the stomach. The intragastric pH will be measured continuously for 48 h (Day -1 to Day 2), and data within the first 24 h will be used as baseline for PD evaluation. Subject's eligibility will be confirmed prior to first dosing (morning of Day 1).
Repeated-dose Period On each day during the treatment period, subjects will receive the investigational product (H008, 20 mg or 40 mg), matching placebos or positive control drug (Lansoprazole, 30 mg) according to the randomization schedule after a minimum 10-hour overnight fasting. No water is allowed within 1 hour before the drug administration. Subjects will be instructed to take the drugs with approximately 240 mL (8 oz) room temperature water, and swallow the tablets or capsules whole without chewing. On Days 1 to 7, no food or water is allowed within at least 2 hours post-dose, except the water ingested during dosing. Subjects should avoid lying down for 2 hours post-dose, except when ECG or vital sign measurements are performed. Standard lunch and dinner will be provided at approximately 4 and 10 hours post-dose on Days 1 and 7. On Days 2 to 6, standard breakfast, lunch and dinner will be provided at approximately 2, 5 and, 10 hours post-dose.
Serial PK blood samples will be collected for all subjects from pre-dose (Day 1) to 48 h after the last dose (Day 9). Detailed PK sampling plan is presented in Table 1.3-1. Another 24-h intragastric pH measurement will be performed from pre-dose on Day 7 until 24 h after the Day 7 dosing. All subjects will be closely monitored for safety during their stay in the clinic. Subjects will be discharged 48 hours after their last dosing (Day 9) if no clinically significant adverse events occur.
Follow-up Period
A follow-up safety assessment will be performed on Day 16 ± 1 at clinic. Unscheduled follow-ups should be performed for any clinically significant AE until it returns to normal or baseline or steady state.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| cohort 1: H008 20mg | Experimental | H008 20mg tablets, orally, once, daily, for 7 days |
|
| cohort 1: H008 placebo 20mg | Experimental | H008 placebo 20mg tablets, orally, once, daily, for 7 days |
|
| cohort 1: Lansoprazole 30mg | Experimental | Lansoprazole 30mg capsule, orally, once, daily, for 7 days |
|
| cohort 2: H008 40mg | Experimental | H008 40mg tablets, orally, once, daily, for 7 days |
|
| cohort 2: H008 placebo 40mg | Experimental | H008 placebo 40mg tablets, orally, once, daily, for 7 days |
|
| cohort 2: Lansoprazole 30mg | Experimental | Lansoprazole 30mg capsule, orally, once, daily, for 7 days |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| H008 | Drug | Drug administration after a minimum 10-hour overnight fasting. Subjects will be instructed to take the drugs with approximately 240 ml (8 oz) room temperature water. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The number and incidence of AEs in HVs of multiple oral dose of H008 (Safety and Tolerability) | AEs | Up to final follow-up (Day16) or early termination. |
| The number and incidence of subjects with clinically significant changes of physical examinations (Safety and Tolerability) | A baseline physical examination (defined as the pretreatment assessment immediately prior to the start of study drug) will consist of the following body systems: eyes、ears, nose, throat, skin, thyroid, neurological, lungs, cardiovascular, abdomen (liver and spleen), lymph nodes and extremities. All subsequent physical examinations should assess clinically significant changes from the baseline examination. | Baseline up to Day 16 |
| The number and incidence of subjects with abnormal vital signs of multiple oral dose of H008 (Safety and Tolerability) | Subjects with vital signs included body temperature(℃), blood pressure (both systolic and diastolic blood pressure ,mmHg), heart rate(beat per minute,BMP), and respiratory rate (beat per minute,BMP). | Baseline up to Day 16 |
| The number and incidence of subjects with clinical defined abnormal laboratory tests of multiple oral dose of H008 (Safety and Tolerability) | hematology,blood chemistry,urinalysis | Baseline up to Day 16 |
| The number and incidence of subjects with clinical defined abnormal of 12-lead ECG multiple oral dose of H008 (Safety and Tolerability) | Full 12-lead ECGs will be recorded using an ECG machine that automatically calculates the heart rate and measures HR、RR、PR, QRS, QT, QTc intervals. The investigator or other qualified physician will interpret each ECG using one of the following categories: within normal limits, abnormal but not clinically significant, or abnormal and clinically significant. |
| Measure | Description | Time Frame |
|---|---|---|
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | AUC0-t. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. |
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Inclusion Criteria:
Adult, male and female volunteers, 18 to 55 years of age, inclusive, at the time of dosing.
Ability to understand and willingness to sign a written informed consent form (the consent form must be signed by the subject prior to any study-specific procedures).
Willingness and ability to comply with study procedures and follow-up examination.
Body mass index (BMI) ≥18 to ≤30 kg/m2 and total body weight ≥50.0 kg for males and ≥45.0 kg for females at screening.
If male, the subject agrees to:
Use of hormonal contraceptive methods will not be allowed.
Medically healthy on the basis of medical history, and physical examination (including but not limited to an evaluation of the cardiovascular, gastrointestinal, respiratory and central nervous systems), as determined by the Investigator at Screening and each Check-In visit.
Medically healthy based on the absence of clinically significant abnormal vital sign measurements, clinical laboratory test results (especially tests for renal and hepatic function) as determined by the Investigator at Screening and Check-In visit.
Medically healthy based on the absence of clinically significant abnormal vital sign measurements, clinical laboratory test results (especially tests for renal and hepatic function) as determined by the Investigator at Screening and each Check-In visit.
Non-smokers (including nicotine-containing products) for at least 3 continuous months prior to the first dose.
Exclusion Criteria:
A subject is not eligible for the study if any of the following criteria is met:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Syneos Health | Miami | Florida | 33136 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7605854 | Background | Bardhan KD, Hawkey CJ, Long RG, Morgan AG, Wormsley KG, Moules IK, Brocklebank D. Lansoprazole versus ranitidine for the treatment of reflux oesophagitis. UK Lansoprazole Clinical Research Group. Aliment Pharmacol Ther. 1995 Apr;9(2):145-51. doi: 10.1111/j.1365-2036.1995.tb00363.x. | |
| 32095968 | Background | Cheng Y, Liu J, Tan X, Dai Y, Xie C, Li X, Lu Q, Kou F, Jiang H, Li J. Direct Comparison of the Efficacy and Safety of Vonoprazan Versus Proton-Pump Inhibitors for Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. Dig Dis Sci. 2021 Jan;66(1):19-28. doi: 10.1007/s10620-020-06141-5. Epub 2020 Feb 24. |
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| ID | Term |
|---|---|
| C000626726 | 1-(5-(1H-indol-5-yl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine |
| D064747 | Lansoprazole |
| ID | Term |
|---|---|
| D053799 | 2-Pyridinylmethylsulfinylbenzimidazoles |
| D013454 | Sulfoxides |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
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Two dose levels of H008 at 20 mg and 40 mg will be studied in two sequential cohorts. Each cohort will be enrolled with 12 subjects (8 on H008, 2 on placebo and 2 on positive control drug). Subjects are only allowed to participate in one of the two cohorts. Dose escalation to the next cohort will be permitted only when safety data until follow-up and PK data until 48 hours post-last dose, from all subjects in previous cohorts are reviewed, and the investigational product is deemed well tolerated.
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Both the investigational product and placebo will be given in a double blinded manner, while the positive control drug will be given in an open-label manner.
|
| H008 placebo | Drug | Drug administration after a minimum 10-hour overnight fasting. Subjects will be instructed to take the drugs with approximately 240 ml (8 oz) room temperature water |
|
| Lansoprazole | Drug | Drug administration after a minimum 10-hour overnight fasting. Subjects will be instructed to take the drugs with approximately 240 ml (8 oz) room temperature water |
|
| Baseline up to Day 16 |
AUC0-tau.
| through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | AUC0-inf (if feasible). | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Cmax. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Ctroughs. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Tmax. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Kel. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | T1/2. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | CL/F. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Vd/F. | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Accumulation index (with steady state dosing). | through study completion,an average of 1 year |
| To characterize the PK profiles of multiple oral doses of H008 in HVs. | Peak/trough fluctuation after single and multiple oral doses of H008. | through study completion,an average of 1 year |
| Percentage of Time the pH is Greater than pH 3, pH 4 and pH 5 over a 24 Hour Period | Over a 24-hour period at Baseline and over a 24-hour period following the administration of study on Days 1 and 7 | Using a calibrated gastric pH monitor, the measurement of stomach pH will be made continuously over a 24-hour period at Baseline and over a 24-hour period following the administration of study on Days 1 and 7. |
| Percentage of Time the PH is Greater than pH 3, pH 4 and pH 5 from 8 PM to 8 AM | Over a 12-hour period from 8 PM to 8 AM on Days 1 and 7 | Using a calibrated gastric pH monitor, the measurement of stomach pH will be made continuously over a 12-hour period from 8 PM to 8 AM to assess nocturnal pH |
| 9178669 | Background | Chiba N, De Gara CJ, Wilkinson JM, Hunt RH. Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta-analysis. Gastroenterology. 1997 Jun;112(6):1798-810. doi: 10.1053/gast.1997.v112.pm9178669. |
| 15831922 | Background | Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005 May;54(5):710-7. doi: 10.1136/gut.2004.051821. |
| 26369775 | Background | Echizen H. The First-in-Class Potassium-Competitive Acid Blocker, Vonoprazan Fumarate: Pharmacokinetic and Pharmacodynamic Considerations. Clin Pharmacokinet. 2016 Apr;55(4):409-18. doi: 10.1007/s40262-015-0326-7. |
| 23853213 | Background | El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014 Jun;63(6):871-80. doi: 10.1136/gutjnl-2012-304269. Epub 2013 Jul 13. |
| 17245209 | Background | Fass R. Erosive esophagitis and nonerosive reflux disease (NERD): comparison of epidemiologic, physiologic, and therapeutic characteristics. J Clin Gastroenterol. 2007 Feb;41(2):131-7. doi: 10.1097/01.mcg.0000225631.07039.6d. |
| 19365600 | Background | Fujiwara Y, Arakawa T. Epidemiology and clinical characteristics of GERD in the Japanese population. J Gastroenterol. 2009;44(6):518-34. doi: 10.1007/s00535-009-0047-5. Epub 2009 Apr 14. |
| 10452674 | Background | Furukawa N, Iwakiri R, Koyama T, Okamoto K, Yoshida T, Kashiwagi Y, Ohyama T, Noda T, Sakata H, Fujimoto K. Proportion of reflux esophagitis in 6010 Japanese adults: prospective evaluation by endoscopy. J Gastroenterol. 1999 Aug;34(4):441-4. doi: 10.1007/s005350050293. |
| Background | Kusano. M, Hashizume. K, Ehara. Y, Mori M. Size of Hiatus Hernia Is Correlated with Kyphosis, Not with Obesity, in Elderly Japanese Women. Gastrointest Endosc. 2006;63(5):AB121. doi:10.1016/j.gie.2006.03.176 |
| 9794192 | Background | Maekawa T, Kinoshita Y, Okada A, Fukui H, Waki S, Hassan S, Matsushima Y, Kawanami C, Kishi K, Chiba T. Relationship between severity and symptoms of reflux oesophagitis in elderly patients in Japan. J Gastroenterol Hepatol. 1998 Sep;13(9):927-30. doi: 10.1111/j.1440-1746.1998.tb00763.x. |
| 15882117 | Background | Parsons ME, Keeling DJ. Novel approaches to the pharmacological blockade of gastric acid secretion. Expert Opin Investig Drugs. 2005 Apr;14(4):411-21. doi: 10.1517/13543784.14.4.411. |
| 11095320 | Background | Richter JE, Bochenek W. Oral pantoprazole for erosive esophagitis: a placebo-controlled, randomized clinical trial. Pantoprazole US GERD Study Group. Am J Gastroenterol. 2000 Nov;95(11):3071-80. doi: 10.1111/j.1572-0241.2000.03254.x. |
| 24466441 | Background | Maradey-Romero C, Fass R. New and future drug development for gastroesophageal reflux disease. J Neurogastroenterol Motil. 2014 Jan;20(1):6-16. doi: 10.5056/jnm.2014.20.1.6. Epub 2013 Dec 30. |
| 11148442 | Background | Sharma VK, Leontiadis GI, Howden CW. Meta-analysis of randomized controlled trials comparing standard clinical doses of omeprazole and lansoprazole in erosive oesophagitis. Aliment Pharmacol Ther. 2001 Feb;15(2):227-31. doi: 10.1046/j.1365-2036.2001.00904.x. |
| 16928254 | Background | Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R; Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006 Aug;101(8):1900-20; quiz 1943. doi: 10.1111/j.1572-0241.2006.00630.x. |
| 28028689 | Background | Yadlapati R, Dakhoul L, Pandolfino JE, Keswani RN. The Quality of Care for Gastroesophageal Reflux Disease. Dig Dis Sci. 2017 Mar;62(3):569-576. doi: 10.1007/s10620-016-4409-6. Epub 2016 Dec 27. |
| D011725 |
| Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001562 | Benzimidazoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |