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Pegcetacoplan

Phase 3

Paroxysmal Nocturnal Hemoglobinuria | Small molecule | Hematology |Apellis Pharmaceuticals, Inc.|Last Updated: Jun 26, 2026

Success Probability
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Trial Design
RandomizedCONTROLLEDDMC
Total Trials2
Total Enrollment103
FDA Designations
PRIORITY_REVIEWFAST_TRACK
Clinical trial landscape

Pegcetacoplan · 14 trials · 22 indications

Phase 3 5Phase 2 5Phase 1 4
NCT05809531An Open-Label, Nonrandomized, Multicenter Extension Study to Evaluate the Long-term Safety and Efficacy of Pegcetacoplan in Participants With C3 Glomerulopathy or Immune-Complex Membranoproliferative GlomerulonephritisC3G
ACTIVE NOT_RECRUITING100 Analytics
NCT05067127Phase III Study Assessing the Efficacy and Safety of Pegcetacoplan in Patients With C3 Glomerulopathy or Immune-Complex Membranoproliferative GlomerulonephritisC3G
COMPLETED124 Analytics
NCT04770545An Extension Study to Evaluate the Long-term Safety and Efficacy of Pegcetacoplan (APL-2) in Subjects With Geographic Atrophy Secondary to AMDGeographic Atrophy Secondary to Age-related Macular Degeneration
COMPLETED792 Analytics
NCT03531255Pegcetacoplan Long Term Safety and Efficacy Extension StudyPNH
COMPLETED137 Analytics
NCT03500549Study to Evaluate the Efficacy and Safety of APL-2 in Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH)Paroxysmal Nocturnal Hemoglobinuria
COMPLETED80 Analytics
PHASE3ACTIVE NOT_RECRUITING
An Open-Label, Nonrandomized, Multicenter Extension Study to Evaluate the Long-term Safety and Efficacy of Pegcetacoplan in Participants With C3 Glomerulopathy or Immune-Complex Membranoproliferative Glomerulonephritis
C3GUnlock trial analytics
PHASE3COMPLETED
Phase III Study Assessing the Efficacy and Safety of Pegcetacoplan in Patients With C3 Glomerulopathy or Immune-Complex Membranoproliferative Glomerulonephritis
C3GUnlock trial analytics
PHASE3COMPLETED
An Extension Study to Evaluate the Long-term Safety and Efficacy of Pegcetacoplan (APL-2) in Subjects With Geographic Atrophy Secondary to AMD
Geographic Atrophy Secondary to Age-related Macular DegenerationUnlock trial analytics
PHASE3COMPLETED
Pegcetacoplan Long Term Safety and Efficacy Extension Study
PNHUnlock trial analytics
PHASE3COMPLETED
Study to Evaluate the Efficacy and Safety of APL-2 in Patients With Paroxysmal Nocturnal Hemoglobinuria (PNH)
Paroxysmal Nocturnal HemoglobinuriaUnlock trial analytics
Study Endpoints
Primary Endpoints
Proportion of participants with a reduction in urine protein-to-creatinine ratio (uPCR) of at least 50% from the pretreatment value over time.
2.5 years
Randomized Controlled Period: Change From Baseline in Log-Transformed Urine Protein-to-Creatinine Ratio (uPCR) at Week 26
Baseline (Day -70 to Day 1) to Week 26

Baseline uPCR value was calculated as the average of the uPCR measurements from at least 6 of the 9 first-morning spot urine (FMU) samples collected between the start of screening and Day 1, inclusive. The uPCR values used to calculate baseline included those from the samples collected on Day -2, Day -1, and before dosing on Day 1. In situations where less than 6 samples or more than 9 samples were collected, the average of all collected samples was used for baseline derivation. The difference between treatment groups using a composite contrast of equal-weighted average over Weeks 24, 25, and 26 was estimated.

Incidence and severity of ocular and systemic adverse events
Up to 36 Months
Incidence and severity of treatment-emergent adverse events
Baseline to 2 Years
Least Squares (LS) Mean Change From Baseline to Week 16 in Hemoglobin (Hb) Level During the RCP
Baseline and Week 16

Baseline was the average of measurements recorded before taking the first dose of pegcetacoplan, which included local and central laboratory values during the screening period. Analysis excluded data before the RCP and was censored for transfusions.

Pegcetacoplan Pharmacokinetic (PK) Parameter Area Under the Curve Limited to the End of Dosing Interval (AUC0-tau)
Week 1

Area under the concentration-time curve limited to the end of the dosing interval. The samples included in the calculation of AUC0-tau were collected at the following times: on dosing Days 1, 3 and 5, PK samples were taken up to 30 minutes pre-dose and at 15 minutes (± 5 min), 30 minutes (± 5 min), 1 hour (± 10 min), 4 hours (± 10 min), 8 hours (± 30 min), and 24 hours (± 30 min) post-dose as well as on Day 8 pre-dose.

Pegcetacoplan PK Parameter Maximal Serum Concentration (Cmax)
Week 1

Maximum observed serum concentration. Determined using the samples collected post-dose on dosing Days 1, 3 and 5.

Pegcetacoplan PK Parameter Time to Cmax (Tmax)
Week 1

Time of maximum measured serum concentration. Determined using the samples collected post-dose on dosing Days 1, 3 and 5.

Pegcetacoplan PK Parameter Observed Serum Concentration Pre-dose (Ctrough)
Week 1 up to Week 14

Observed serum concentration pre-dose. From Day 8 (Week 1) and onwards, PK samples were taken pre-dose at each visit.

Percentage of Subjects With Reduction in C3c Staining on Renal Biopsy at Week 12
Baseline (Day 1) and Week 12

C3c staining intensity is semi quantitatively graded on a scale of 0 to 3, in which negative, 1+, 2+ and 3+ staining corresponds to scores of 0 to 3, with 0 being absent and 3 being the highest intensity seen on immunofluorescence. Higher scores indicate worse outcome. Reduction in C3c staining was defined as decrease of at least 2 orders of magnitude of intensity from baseline. Baseline was defined as the most recent non-missing measurement prior to first administration of study drug for Group 1 subjects or randomization for Group 2 subjects.

Pegcetacoplan serum concentrations over the course of the 16-week treatment period
16 weeks
Change from baseline to Wk 16 in hemoglobin (Hb)
16 weeks
Incidence and severity of treatment-emergent adverse events (TEAEs) over the course of the 16-week treatment period, including monitoring bacterial infections
16 weeks
Change from baseline to wk 16 lactate dehydrogenase (LDH)
16 weeks
Change from baseline to wk 16 absolute reticulocyte count (ARC)
16 weeks
Number of Subjects With Treatment Emergent Adverse Events (TEAEs) Including by Severity
From Day 1 to 30 days after the last dose (approximately 56 weeks)

TEAEs were defined as adverse events (AE) that occurred after dosing on Day 1 and up to 30 days after the last dose of study drug. A treatment-related TEAE was defined as a TEAE with a relationship to study drug of possible, probable, or definite. TEAEs were graded according to the Common Terminology Criteria for Adverse Events (v4.03) based on: Grade 1: Mild, Grade 2: Moderate, Grade 3: Severe, Grade 4: Life-threatening, Grade 5: Death related to AE.

Mean Change From Baseline in Lactate Dehydrogenase (LDH) Level
Baseline and Day 365

Serum chemistry assessments of LDH were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the treatment period.

Mean Change From Baseline in Haptoglobin Level
Baseline and Day 365

Serum chemistry assessments of haptoglobin were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the treatment period.

Mean Change From Baseline in Hemoglobin (Hb) Level
Baseline and Day 365

Hematology assessments of Hb were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the treatment period.

Least Square (LS) Mean Change From Baseline in Square Root GA Lesion Size in the Study Eye at Month 12
Baseline (screening) and Month 12.

The square root GA lesion size (i.e. transformed area of GA) was measured by FAF photographs. Baseline was defined as the last available, non-missing observation prior to first study drug administration.

Number of Subjects With Treatment Emergent Adverse Events (TEAEs) in the Study Eye, Including by Severity
From the time of first study drug administration (Day 1) up to Month 12 (Data cut-off date).

A TEAE was defined as any adverse event (AE) that commenced or worsened on or after time of first study drug administration up to 60 days beyond last dose of study drug. A treatment-related TEAE was defined as a TEAE with a relationship to study drug of possibly related or probably related or not reported. Severity of TEAEs were categorized as mild; moderate; severe; life-threatening or death related to TEAE, according to Common Terminology Criteria for AEs v4.03. A TEAE of special interest (TEAESI) was defined as a TEAE of scientific and medical concern specific to pegcetacoplan, whether serious or non-serious.

Incidence and Severity of Ocular and Systemic Treatment-Emergent Adverse Events (TEAEs)
25 Months
Mean Change From Baseline in Lactate Dehydrogenase (LDH) at Day 365
Baseline (Day 1) and Day 365.

Serum chemistry assessments of LDH were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the different parts of the treatment period. LDH results were summarized for Cohort 2 only.

Mean Percentage Change From Baseline in LDH at Day 365
Baseline (Day 1) and Day 365.

Serum chemistry assessments of LDH were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the different parts of the treatment period. LDH results were summarized for Cohort 2 only.

Mean Change From Baseline in Haptoglobin at Day 365
Baseline (Day 1) and Day 365.

Serum chemistry assessments of haptoglobin were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the different parts of the treatment period. Haptoglobin results were summarized for Cohort 2 only.

Mean Percentage Change From Baseline in Haptoglobin at Day 365
Baseline (Day 1) and Day 365.

Serum chemistry assessments of haptoglobin were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the different parts of the treatment period. Haptoglobin results were summarized for Cohort 2 only.

Mean Change From Baseline in Hemoglobin at Day 365
Baseline (Day 1) and Day 365.

Hematology assessments of hemoglobin were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the different parts of the treatment period. Hemoglobin results were summarized for Cohort 2 only.

Mean Percentage Change From Baseline in Hemoglobin at Day 365
Baseline (Day 1) and Day 365.

Hematology assessments of hemoglobin were made at the last measurement prior to the first dose of pegcetacoplan (baseline) and periodically throughout the different parts of the treatment period. Hemoglobin results were summarized for Cohort 2 only.

Number of Subjects With Treatment-Emergent Adverse Events (TEAEs), Including by Severity, During Single-dose Phase
From single dose of study drug (Day 1) up to 30 days

TEAEs were defined as AEs that developed or worsened after first dose of study drug (Day 1), and up to 30 days after last dose of study drug. The Investigator assessed AEs for severity and relatedness to study drug. AEs were graded according to the Common Terminology Criteria for Adverse Events (CTCAE, v4.03) based on: Grade 1: Mild; Grade 2: Moderate; Grade 3: Severe; Grade 4: Life-threatening; Grade 5: Death related to AE.

Number of Subjects With TEAEs, Including by Severity, During Multiple-dose Phase
From first dose of study drug up to 30 days after last dose of study drug (Cohorts 1-3: up to 58 days; Cohort 4: up to 759 days).

TEAEs were defined as AEs that developed or worsened after first dose of study drug (Day 1), and up to 30 days after last dose of study drug. The Investigator assessed AEs for severity and relatedness to study drug. AEs were graded according to CTCAE, v4.03 based on: Grade 1: Mild; Grade 2: Moderate; Grade 3: Severe; Grade 4: Life-threatening; Grade 5: Death related to AE.

Area Under the Curve (AUC) From Time 0 to the Last Measurable Concentration (AUC0-t) Over the Multiple Dosing Phase for Cohort 4
Blood samples for PK assessment were collected pre-dose and 4 hours post dose on Day 1 and pre-dose (trough) on Day 2 and up to Day 785.

Assessment of AUC0-t of pegcetacoplan over the multiple dosing phase, estimated using a non-compartmental approach and calculated by the linear-log trapezoidal method. Pegcetacoplan pharmacokinetic (PK) parameters were summarized for Cohort 4 only.

Maximum Pre-dose Serum Concentration (Ctrough,Max) Over the Multiple Dosing Phase for Cohort 4
Blood samples for PK assessment were collected pre-dose and 4 hours post dose on Day 1 and pre-dose (trough) on Day 2 and up to Day 785.

Assessment of Ctrough,max of pegcetacoplan over the multiple dosing phase, estimated using a non-compartmental approach. Pegcetacoplan PK parameters were summarized for Cohort 4 only. Ctrough,max was calculated for both 270 mg/day and 360 mg/day where subjects received both doses. Note: 1 subject in Cohort 4 who was receiving 360 mg/day was granted Sponsor and institutional review board approval to increase the dose further to the equivalent of 440 mg/day and Ctrough,max is also reported for this dose.

Number of Subjects Who Experienced Ocular and Systemic Adverse Events (AEs), Including by Severity
Day 1 to Day 113

Safety was assessed throughout the study. A TEAE was defined as any AE that started on/after the IVT injection of pegcetacoplan.

Number of Dose Limiting Toxicities (DLTs)
Day 1 to Day 15

The occurrence of any of the following AEs were considered DLTs: intraocular inflammation (vitritis or uveitis), endophthalmitis, sustained elevation of intraocular pressure ≥30 millimeters (mm) of mercury, and/or sustained loss of visual acuity ≥15 letters not attributable to the injection procedure or progression of disease.

Median Area Under the Serum Concentration-Time Curve From Time Zero to Last Measurable Concentration (AUC[0-t])
Predose (screening), postdose Day 3 to Day 113

The AUC(0-t) was measured using the linear trapezoidal method when concentrations were increasing and the logarithmic trapezoidal method when concentrations were decreasing. The median AUC(0-t) is presented for each cohort.

Median Dose Normalized AUC(0-t)
Predose (screening), postdose Day 3 to Day 113

The AUC(0-t) was measured using the linear trapezoidal method when concentrations were increasing and the logarithmic trapezoidal method when concentrations were decreasing. The dose normalized AUC(0-t) was calculated for each subject by dividing the parameter by the subject's respective dose in milligrams. The median dose normalized AUC(0-t) is presented for each cohort.

Maximum Observed Serum Concentration (Cmax)
Predose (screening), postdose Day 3 to Day 113

The median Cmax is presented for each cohort.

Median Dose Normalized Cmax
Predose (screening), postdose Day 3 to Day 113

The dose normalized Cmax was calculated for each subject by dividing the parameter by the subject's respective dose in milligrams. The median dose normalized Cmax is presented for each cohort.

Median Time to the Maximum Measured Serum Concentration (Tmax)
Predose (screening), postdose Day 3 to Day 113

The median Tmax is presented for each cohort. If the maximum value occurred at more than 1 time point, Tmax was defined as the first time point with this value.

Secondary Endpoints
Randomized Controlled Period: Percentage of Subjects Who Achieved the Composite Renal Endpoint at Week 26
Week 26
Randomized Controlled Period: Percentage of Subjects With a Reduction of At Least 50% From Baseline in Urine Protein-to-Creatinine Ratio at Week 26
Baseline (Day -70 to Day 1) and Week 26
Randomized Controlled Period: Change From Baseline in the C3 Glomerulopathy (C3G) Histologic Index Activity Score at Week 26
Baseline (Day 1) and Week 26
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Pegcetacoplan administered subcutaneouslyEXPERIMENTALPegcetacoplan administered subcutaneously twice weekly according to protocol defined dosing regimen
Group 1: Pegcetacoplan administrationEXPERIMENTALSubcutaneous infusion of 20mL (1080 mg), twice weekly (for adults or adolescents \>50kg), and the three other weight-based doses either of 10mL (540mg), 12mL (648mg), or 15mL (810mg)
Group 2: Placebo administrationPLACEBO_COMPARATORSubcutaneous infusion of either 10mL, 12mL, 15mL, or 20mL, twice weekly
Pegcetacoplan, 15 mg/100 μL, monthly for up to 36 monthsEXPERIMENTALParticipants from Study APL2-103 (NCT03777332) or those who completed the treatment at Month 24 from either Study APL2-303 (Derby, NCT03525613) or Study APL2-304 (Oaks, NCT03525600) and were administered monthly intravitreal (IVT) pegcetacoplan (15 mg/100 μL) or monthly sham will receive IVT pegcetacoplan (15 mg/100 μL) monthly for up to approximately 36 months.
Pegcetacoplan, 15 mg/100 μL, every other month (EOM) for up to 36 monthsEXPERIMENTALParticipants from Study APL2-103 (NCT03777332) or those who completed the treatment at Month 24 from either Study APL2-303 (Derby, NCT03525613) or Study APL2-304 (Oaks, NCT03525600) and were administered every other month (EOM) intravitreal (IVT) pegcetacoplan (15 mg/100 μL) or EOM sham will receive IVT pegcetacoplan (15 mg/100 μL) EOM for up to approximately 36 months.
1,080 mg pegcetacoplan administered subcutaneouslyEXPERIMENTAL1,080mg pegcetacoplan administered subcutaneously twice weekly or every three days.
PegcetacoplanEXPERIMENTAL1080 mg pegcetacoplan administered subcutaneously twice-weekly or every three days.
EculizumabACTIVE_COMPARATORComplement (C5) Inhibitor.
Group 1EXPERIMENTALPegcetacoplan treatment of 1080 mg (sub-cutaneous infusion) twice weekly will be given throughout the entire study.
Group 2OTHERNo intervention given during the randomized controlled portion of the study (through week 12). After week 12, subjects will receive pegcetacoplan treatment.
Experimental: Cohort 1EXPERIMENTAL270 mg/day (up to 360 mg/day from Day 29) from Day 1 to Day 364\*
Pegcetacoplan 15 mg/100 µL Monthly for 12 monthsEXPERIMENTALA single dose of 15 mg pegcetacoplan/100 µL will be administered via intravitreal injection in this study. Subjects will receive an injection every month for 12 consecutive months.
Pegcetacoplan 15 mg/100 µL EOM for 12 monthsEXPERIMENTALA single dose of 15 mg pegcetacoplan/100 µL will be administered via intravitreal injection in this study. Subjects will receive an injection every other month (EOM) for 12 consecutive months.
Sham Monthly for 12 monthsSHAM_COMPARATORSubjects will receive a Sham procedure every month for 12 consecutive months.
Sham EOM for 12 monthsSHAM_COMPARATORSubjects will receive a Sham procedure every other month (EOM) for 12 consecutive months.
(Cohort 1) Pegcetacoplan, 15 mg/100 μL, monthly for up to 60 monthsEXPERIMENTAL -
(Cohort 2) Pegcetacoplan, 15 mg/100 μL, monthly for up to 36 monthsEXPERIMENTAL -
(Cohort 2) Pegcetacoplan, 15 mg/100 μL, every other month for up to 36 monthsEXPERIMENTAL -
Cohort 1EXPERIMENTAL180 mg pegcetacoplan/day
Cohort 2EXPERIMENTAL270 mg pegcetacoplan/day
Cohort 3EXPERIMENTALRepeated Dose 180 mg/day
Cohort 4EXPERIMENTALRepeated Dose 270 mg/day
Pegcetacoplan Cohort 1EXPERIMENTAL4 mg of pegcetacoplan 100 μL IVT injection
Pegcetacoplan Cohort 2EXPERIMENTAL10 mg of pegcetacoplan 100 μL IVT injection
Pegcetacoplan Cohort 3EXPERIMENTAL20 mg of pegcetacoplan 100 μL IVT injection
Interventions
NameTypeDescription
PegcetacoplanDRUGComplement (C3) Inhibitor
PlaceboOTHERSterile solution of equal volume to active arm
PEGCETACOPLAN (APL-2)DRUGComplement (C3) Inhibitor
SolirisDRUGComplement (C5) Inhibitor
Sham ProcedureOTHER -
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Eligibility Criteria
Age Range12 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites47

Inclusion Criteria: * Completed participation in Study APL2-C3G-310 through the week 52 visit requirements * Experienced clinical benefit from pegcetacoplan while participating in the previous trial, in the opinion of the investigator * Must remain on a stable regimen for C3G or IC-MPGN treatment a...

Countries:United StatesArgentinaAustraliaBelgiumBrazilCzechiaFranceIsraelItalyJapanNetherlandsSouth KoreaSpainSwitzerlandUnited KingdomAustriaCanadaGermanyPolandNew ZealandBulgariaColombiaHong KongMalaysiaMexicoPeruPhilippinesRussiaSerbiaSingaporeThailandGreece
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Recent Changes (Last 90 Days)
MEDIUMJul 19, 2026NCT04770545TRIAL_REMOVED: changed
MEDIUMJul 19, 2026NCT04770545TRIAL_REMOVED: changed
MEDIUMJul 19, 2026NCT04770545TRIAL_REMOVED: changed
MEDIUMJul 19, 2026NCT04770545TRIAL_REMOVED: changed
MEDIUMJul 6, 2026NCT03531255TRIAL_REMOVED: changed
MEDIUMJul 6, 2026NCT03531255TRIAL_REMOVED: changed
MEDIUMJul 6, 2026NCT03531255TRIAL_REMOVED: changed
LOWJun 26, 2026NCT04901936lastUpdatePostDate: changed
LOWJun 26, 2026NCT04901936lastUpdatePostDate: changed
HIGHJun 5, 2026NCT03531255Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHJun 5, 2026NCT03531255Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHJun 5, 2026NCT03531255Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHJun 5, 2026NCT03531255Status: ACTIVE_NOT_RECRUITING → COMPLETED
LOWJun 4, 2026NCT03531255Enrollment: 160 → 137
LOWJun 4, 2026NCT03531255Enrollment: 160 → 137
LOWJun 4, 2026NCT03531255Enrollment: 160 → 137
LOWJun 4, 2026NCT03531255Enrollment: 160 → 137