Cinclus Pharma Holding AB has launched its pivotal Phase III HEEALING 1 study to evaluate linaprazan glurate for treating erosive gastroesophageal reflux disease (GERD), marking a significant milestone in the development of next-generation acid-blocking therapies. The clinical-stage pharmaceutical company received positive regulatory feedback before initiating the trial, with the first patient expected to be screened in September 2025 and topline results anticipated in 2026.
Study Design and Objectives
The HEEALING 1 study (Healing of Erosive Esophagitis with unique Acid control using Linaprazan Glurate) will enroll approximately 500 patients across up to 100 clinical sites in seven European countries. The primary endpoint aims to demonstrate superiority to the proton pump inhibitor lansoprazole in healing patients with moderate to severe erosive GERD (LA grade C/D) after 4 weeks of treatment. Secondary endpoints will evaluate healing and symptom relief for up to 8 weeks.
The study focuses on patients with erosive GERD, a condition characterized by visible damage to the esophageal lining caused by stomach acid reflux. This represents a more severe form of GERD that often requires more intensive treatment approaches than current therapies can provide.
Novel Mechanism of Action
Linaprazan glurate represents a new class of acid-blocking medications known as potassium-competitive acid blockers (PCABs). If approved, it would become the first PCAB available on the European market, offering a potentially superior alternative to existing proton pump inhibitors. Cinclus Pharma and its commercial partner Zentiva view this as representing "a significant commercial opportunity in this area of high unmet need."
Strategic Partnership and Market Expansion
Earlier this year, Cinclus Pharma entered into a strategic partnership and licensing agreement with Zentiva, a leading European pharmaceutical company, for the commercialization and manufacturing of linaprazan glurate in Europe. The total transaction value amounts to EUR 220 million, in addition to tiered royalties starting just below 20% and exceeding 20% at the highest sales levels. Part of this agreement includes a milestone payment linked to the topline results of HEEALING 1, expected in the second half of 2026.
US Market Development Plans
The company has also received feedback from the US Food and Drug Administration (FDA), permitting initiation of the study contingent on certain protocol adjustments. While the initial Phase III study focuses on Europe, Cinclus plans to extend development to the US through a second healing study, HEEALING 2, which will also evaluate maintenance therapy. This study is expected to begin following the topline results of HEEALING 1.
"Initiating this Phase 3 study in collaboration with Zentiva marks a major and important milestone for both our company and the GERD community," said Christer Ahlberg, CEO of Cinclus Pharma. "By first initiating Europe and subsequently starting a US study, we are optimizing the path and the timing to market approval across all key regions. We see linaprazan glurate as having a strong potential to set a new standard in the treatment of severe erosive GERD."
Clinical Significance
The development of linaprazan glurate addresses a significant unmet medical need in GERD treatment. Current standard-of-care proton pump inhibitors, while effective for many patients, may not provide adequate healing and symptom relief for all individuals with severe erosive GERD. The novel PCAB mechanism could offer improved efficacy in this challenging patient population, potentially establishing a new treatment paradigm for acid-related diseases of the upper gastrointestinal tract.
