PK Profile and Preliminary Efficacy of TNP-2092 Capsules in Liver Cirrhosis Patients With Hyperammonemia

Inclusion Criteria

• 18-65 (inclusive) years of age, male or female.
• Clinically diagnosed with liver cirrhosis.
• Fasting venous blood ammonia above upper limit of normal (ULN).
• Organ functions must meet the following criteria:
• Peripheral blood: absolute neutrophil count ≥ 0.5*109/L, platelet ≥20*109/L, hemoglobin ≥ 8 g/dL.
• Liver: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 5 × ULN; serum total bilirubin (TBL) ≤ 5 × ULN.
• Kidney: creatinine clearance ≥ 60 mL/min.
• No malabsorption or other gastrointestinal disorders that affect drug absorption.
• Weight ≥ 45 kg and body mass index [BMI = weight (kg)/height 2 (m2) ] between 18 and 34 (inclusive) kg/m2.
• Subjects (including their partners) will have no pregnancy plan and voluntarily take effective contraceptive measures within 6 months after drug withdrawal. Refer to Appendix 9 for specific contraceptive measures.
• Subjects or their legal representatives sign the Informed Consent Form and fully understand the content, procedures, and potential adverse reactions prior to the initiation of the study.
• Able to complete the study per the requirements in the study protocol.

Exclusion Criteria

• Subjects who are allergic to rifamycin or quinolone antibacterial agents or those with an allergic constitution.
• Pregnant or lactating women, or women of childbearing age with a positive pregnancy test from the screening period to initiation of the study treatment.
• Subjects with serious nervous or mental disorders.
• Subjects with Child-Pugh class C liver cirrhosis.
• Subjects with Grade 2 or above hepatic encephalopathy.
• Subjects who have been diagnosed with Clostridium difficile-induced pseudomembranous enteritis within 3 months.
• Subjects who have had systemic infection or gastrointestinal bleeding within 7 days prior to screening.
• Subjects with clinically significant abnormal clinical laboratory tests or other clinical findings indicative of clinically significant disorders that, in the opinion of the investigator, make them not eligible for this clinical study.
• Subjects who have used sedatives, probiotics, cathartics or antibacterial agents within 7 days prior to screening.
• Subjects who have used other study drugs or participated in other drug clinical trials within 1 month prior to screening.
• Subjects need to use the following concomitant drugs during the study treatment period: cathartics and drugs for ammonia reduction listed in 5.2.1 in the Guidelines on the Management of Hepatic Encephalopathy in Liver Cirrhosis 2018 (e.g., lactulose, lactitol, L-ornithine L-aspartate(LOLA), rifaximin, other antibacterial agents, etc.) ; HIV protease inhibitors (e.g., ritonavir boosted or non-boosted saquinavir, atazanavir, darunavir, fosamprenavir, tipranavir, etc.) ; praziquantel; halothane; class IA and III antiarrhythmics (disopyramide, procainamide, quinidine, amiodarone, dofetilide, dronedarone, ibutilide, sotalol, etc.) ; strong inhibitors and inducers of liver metabolic enzymes;
• Positive HIV antigen/antibody screen; positive Treponema pallidum antibody screen requires the investigator's judgment with the consideration of Rapid plasma regain（RPR） results.
• Positive urine drug screen or history of drug abuse within the past 5 years.
• Positive alcohol breath test.
• Acute diseases or concomitant medications from screening to study medication.
• Other circumstances deemed by the investigator to be unsuitable for enrollment in this study.