A Study Evaluating the Effect of Esomeprazole on SYN-004 Degradation of Ceftriaxone In Adults With an Ileostomy

Study Overview
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Brief Summary
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A Phase 1b/2a, Multi-Center, Open-Label, 2-Period, Fixed-Sequence Study Evaluating the Effect of Esomeprazole on SYN-004 Degradation of Ceftriaxone In Healthy Adult Subjects with a Functioning Ileostomy

Detailed Description
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This is a Phase 1b/2a, randomized, multi-center, open-label study. Twenty otherwise healthy subjects with functioning ileostomies who are between the ages of 18 and 80 years, inclusive, will be enrolled. The entire duration of the study may be up to 63 days (from Screening to the end-of-study [EOS] visit).

Official Title
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A Phase 1b/2a, Multi-Center, Open-Label, 2-Period, Fixed-Sequence Study Evaluating the Effect of Esomeprazole on SYN-004 Degradation of Ceftriaxone In Healthy Adult Subjects With a Functioning Ileostomy

Conditions
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Healthy Volunteers With Ileostomy

Intervention / Treatment
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* Drug: SYN-004
* Drug: Esomeprazole
* Drug: Ceftriaxone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The subject has a functioning ileostomy that has been in place for ≥ 3 months. The subject is male or female between the ages of 18 and 80 years, inclusive. Other than a functioning ileostomy, the subject is free from clinically significant illnesses or disease. Exclusion Criteria: Subjects who have active hepatic, small intestine, or biliary tract disease. Subjects who have active ulcerative colitis, Crohn's disease, other inflammatory bowel disease. Subjects with known malignancy requiring treatment < 6 months prior to study screening. Subjects who have, in the opinion of the investigator, significant concurrent medical illness. Subjects who are currently taking concomitant medications which may interfere with study evaluation. Subjects who have received an investigational drug within 30 days or within a time period consistent with a washout period of 5 half-lives, whichever is longer, of the first dose of ceftriaxone. Subjects with a known history of allergy to any cephalosporin, penicillin or any β-lactam antibiotic. Subjects who have known active malabsorption syndromes(s) that, in the judgment of the investigator, could compromise the objectives of the study. Subjects who have used any oral, intramuscular, or IV anti-microbial medication during the last 3 week

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 150 mg SYN-004<br>There will be 2 in-house treatment periods: in Treatment Period 1, subjects will receive 2 oral doses of 150 mg SYN-004 (two 75 mg capsules) and 1g ceftriaxone, and in Treatment Period 2, subjects will receive 2 oral doses of 150mg SYN-004 (two 75 mg capsules) and 1g ceftriaxone in the presence of steady-state esomeprazole; Treatment Periods 1 and 2 will be separated by a 5- to 7-day run-in phase, during which subjects will self-administer 40 mg of esomeprazole once daily (QD) in the morning, at home. | Drug: SYN-004<br> <br> Drug: Esomeprazole<br> <br> Drug: Ceftriaxone<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ceftriaxone Concentration in Intestinal Chyme Period 1 | Ceftriaxone concentration in the presence of SYN-004 and the absence of esomeprazole. | 0-8.5 hours | 
| Ribaxamase Concentration in Intestinal Chyme Period 1 | Concentrations of ribaximase (SYN-004) in intestinal chyme | 0-8.5 hours | 
| Ceftriaxone Concentration in Intestinal Chyme Period 2 | Ceftriaxone concentration in the presence of SYN-004 and the absence of esomeprazole. | 0-8.5 hours | 
| Ribaxamase Concentration in Intestinal Chyme Period 2 | Concentrations of ribaximase (SYN-004) in intestinal chyme | 0-8.5 hours |