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| Name | Class |
|---|---|
| First Affiliated Hospital of Xinjiang Medical University | OTHER |
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This is a Phase 1/2, randomized, controlled, open-label, proof-of-concept study to evaluate the safety and tolerability, local and systemic PK profiles of TNP-2092 administered via IA injection on the basis of vancomycin IV and oral antibiotics therapy in participants with early (within 1 month of TKA) or acute hematogenous (within 3 weeks of infectious symptoms) PJI requiring or not requiring DAIR therapy after TKA, or requiring long-term antibiotic suppression therapy for PJI (including PJI occurring after various joint replacements and revision surgeries).
The study population is participants with confirmed or suspected Gram-positive bacteria causing early (ie, within 1 month of TKA) or acute hematogenous (within 3 weeks of infection symptoms) PJI requiring or not requiring DAIR therapy following TKA, or requiring long-term antibiotic suppression therapy for PJI (including PJI occurring after various joint replacement and revision surgeries). Participants will undergo screening assessments within 7 days prior to study start.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sentinel group | Experimental | In the sentinel group, participants will receive TNP-2092 50 mg IA+vancomycin IV+oral antibiotics. |
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| Experimental group | Experimental | In the experimental group, participants will receive TNP-2092 50 mg IA + vancomycin IV + oral antibiotics. |
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| Control group | Active Comparator | In the control group, participants will receive vancomycin IA + vancomycin IV + oral antibiotics. |
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| Expansion group | Experimental | In the expansion group, participants will receive TNP-2092 50 mg IA based on the background treatment. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TNP-2092 for injection | Drug | TNP-2092 for injection, 100 mg/vial, Intra-articular administration (IA), 10ml (50 mg) once daily for 14 days. TNP-2092 dose volume, dose, frequency, and duration can be adjusted according to the sentinel group synovial fluid TNP-2092 concentration, PK characteristics, and safety results at the EA visit. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability of TNP-2092 by Assessment of the Number of Adverse Events (AEs) | An Adverse Event (AE) was defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. | Day 1 to Day 187 |
| Measure | Description | Time Frame |
|---|---|---|
| TNP-2092 concentrations in synovial fluid | Synovial fluid concentrations of TNP-2092 were measured by a specific and validated assay. | At 12, 24 hours after the first dose of TNP-2092, before dosing on Day 7, before the last dose, and at 12, 24, 48 hours after the last dose. |
| Maximum Observed Plasma Concentration (Cmax) of TNP-2092 after the first dose |
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Inclusion Criteria:
Exclusion Criteria:
History of hypersensitivity or intolerance to any of the following agents: vancomycin or TNP-2092.
Definite PJI of Gram-negative infection, fungal infection, or Enterococcus infection, or Mycobacterium infection, or Gram-positive mixed Gram-negative and/or fungal infection.
Definite systemic infection (sepsis).
Expected survival less than 1 years.
Female participant is pregnant, lactating, or has a positive screening/baseline pregnancy test.
Surgical or medical conditions that, in the opinion of the investigator, could affect the participant's ability to participate in the study, or affect the administration of investigational product, or affect the interpretation of study results, including but not limited to active malignancy, metabolic disease, alcohol or drug abuse, or clinically significant laboratory abnormalities.
Presence of serious liver, blood, or immune system disorders as evidenced by the following:
Positive AIDS antibody screening.
History or evidence of severe renal disease or creatinine clearance < 30 mL/min based on the Cockcroft-Gault formula.
Treatment with an investigational agent within 30 days or 5 half-lives (whichever is longer) prior to the first dose of study intervention.
Participants who, in the opinion of the investigator, were unable to comply with the protocol and study drug administration procedures or complete the clinical study.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Li Cao | Contact | +86 991-4366553 | xjbone@sina.com | |
| Jing Chen | Contact | +86 512 86861979 | jing.chen@tennorx.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The First Affiliated Hospital of Xinjiang Medical University | Recruiting | Ürümqi | Xinjiang | China |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jul 21, 2025 | Aug 28, 2025 |
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Three eligible participants will be enrolled as sentinel group. After all sentinel participants are tolerable safety at EA assessment and complete the PK study, an additional 20 participants will be enrolled and randomize in 1:1 ratio to the experimental group and the control group.
Ten subjects requiring long-term suppressive antibiotic therapy for PJI (including PJI occurring after various joint replacement surgeries) will be enrolled in the expansion group and could be enrolled in parallel with the sentinel group.
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| Vancomycin Hydrochloride for Injection (IA) | Drug | Vancomycin Hydrochloride for Injection, 0.5 g/vial, Intra-articular administration, 10 mL (0.5 g) once daily for 14 days. |
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| Vancomycin Hydrochloride for Injection (IV) | Drug | Vancomycin Hydrochloride for Injection, 0.5 g/vial, Intravenous infusion, 250 mL (1 g) q12h ± 1h per day, for 14 days. |
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| Oral antibiotics | Drug | Rifampicin capsules: 0.15 g/capsule. 0.45 g (3 capsules) orally once daily within 1 h before breakfast for 8 weeks (56 days). Levofloxacin Tablets: 0.5 g/tablet. 0.5 g (1 tablet) orally once daily within 1 hour before breakfast for 8 weeks (56 days). If susceptibility testing results show resistance to rifampicin and/or levofloxacin, or intolerance by the patient 's participant, treatment with oral minocycline hydrochloride capsules will be substituted as follows:Minocycline hydrochloride capsules: 100 mg/capsule. Administered orally q12h ± 1h daily, doubling the first dose, 200 mg (2 capsules) orally, then 100 mg (1 capsule) each time for 8 weeks (56 days). The total duration of oral treatment during the oral administration period was 8 weeks (56 days) regardless of whether oral medication will be changed (eg, intolerance). |
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| Background Treatment | Drug | Background treatment will be determined by the investigator. |
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Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. |
| Before administration (within 1 hour), 1, 4, 12, 24 hours after the first dose |
| Time to Reach the Maximum Observed Plasma Concentration (Tmax) after the first dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24 hours after the first dose |
| Area under the curve from the time of dosing to the last measurable concentration (AUC 0-t) after the first dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24 hours after the first dose |
| Area under the curve from the time of dosing to infinity (AUC 0-∞) after the first dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24 hours after the first dose |
| Elimination half-life (t 1/2) after the first dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24 hours after the first dose |
| Maximum observed concentration at steady state (Cmax, ss) after the last dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24, 48 hours after the last dose |
| Time to maximum concentration at steady state (Tmax, ss) after the last dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24, 48 hours after the last dose |
| Area under the curve from the time of dosing to the last measurable concentration at steady state (AUC 0-t, ss) after the last dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24, 48 hours after the last dose |
| Area under the curve from the time of dosing to infinity at steady state (AUC 0-∞, ss) after the last dose | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24, 48 hours after the last dose |
| Area under the curve over the dosing interval at steady state (AUC 0-tau, ss) | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24 hours after the last dose |
| Elimination half-life at steady state (t 1/2, ss) | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour), 1, 4, 12, 24, 48 hours after the last dose |
| Accumulation ratio (Rac) | Plasma concentrations of TNP-2092 were measured by a specific and validated assay. Plasma Pharmacokinetics (PK) parameters of TNP-2092 were read directly from the plasma concentration versus time profiles or calculated by using standard non-compartmental methods. | Before administration (within 1 hour) of the first dose, 1, 4, 12, 24 hours after the first dose; Before administration (within 1 hour) of the last dose, 1, 4, 12, 24 hours after the last dose |
| Early Assessment (EA) response rate | Participants with early or acute hematogenous PJI after TKA who met all the following criteria will be judged as responders:
| Day 14 |
| End of treatment (EOT) response rate | Participants who met all the following criteria were judged as responders:
| Day 71 to Day 77 |
| Treatment failure rate | Those who meet any of the following criteria are treatment failures:
| Within 6 months after the start of study treatment |
| Prot_001.pdf |
| ID | Term |
|---|---|
| C000619733 | TNP-2092 |
| D007267 | Injections |
| D014640 | Vancomycin |
| D000900 | Anti-Bacterial Agents |
| ID | Term |
|---|---|
| D004333 | Drug Administration Routes |
| D004358 | Drug Therapy |
| D013812 | Therapeutics |
| D006020 | Glycopeptides |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D000890 | Anti-Infective Agents |
| D045506 | Therapeutic Uses |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
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