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ALXN1850

Phase 3

Hypophosphatasia | Small molecule | Other |AstraZeneca PLC|Last Updated: May 28, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials4
Total Enrollment212
FDA Designations
No designations recorded
Clinical Trials (4)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06079359Phase 3 Study of ALXN1850 in Treatment-Naïve Pediatric Participants With HPPPHASE3 ACTIVE NOT_RECRUITING 30May 14, 2024Aug 24, 2028May 28, 202632 United States, Australia +14
NCT06079372Phase 3 Study of ALXN1850 in Pediatric Participants With HPP Previously Treated With Asfotase AlfaPHASE3 ACTIVE NOT_RECRUITING 43Apr 2, 2024Feb 29, 2028May 5, 202621 United States, Argentina +5
NCT06079281Phase 3 Study of ALXN1850 Versus Placebo in Adolescent and Adult Participants With HPP Who Have Not Previously Been Treated With Asfotase AlfaPHASE3 ACTIVE NOT_RECRUITING 124Jan 3, 2024Mar 29, 2028May 28, 202665 United States, Argentina +15
NCT04980248Study of ALXN1850 in Participants With Hypophosphatasia (HPP)PHASE1 COMPLETED 15Sep 28, 2021Aug 24, 2022Dec 27, 20244 United States
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Study Endpoints
Primary Endpoints
Radiographic Global Impression of Change (RGI-C) Score at the end of the Randomized Evaluation Period (Day 169)
Day 169
Number of Participants with Treatment-emergent Adverse Events (TEAEs)
Baseline Through Day 169
Change from Baseline in 6-Minute Walk Test (6MWT) at the end of the Randomized Evaluation Period (Day 169)
Baseline, Day 169
Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs)
Day 1 up to Day 85

TEAEs were defined as any adverse events (AEs) that began or worsened on or after the first dose of treatment until the final follow-up visit. An SAE was an AE that met at least 1 of the following criteria: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization for the AE, persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, congenital anomaly/birth defect (in the child of a participant who was exposed to the study drug), important medical event or reaction. TESAEs were defined as any serious AEs that began or worsened on or after the first dose of treatment until the final follow-up visit. A summary of all Serious Adverse Events and Other Adverse Events (nonserious) regardless of causality is located in the 'Reported Adverse Events' Section.

Secondary Endpoints
Change from Baseline in Rickets Severity Score (RSS) at the end of the Randomized Evaluation Period (Day 169)
Baseline, Day 169
Change from Baseline in 6-Minute Walk Test (6MWT) at the end of the Randomized Evaluation Period (Day 169)
Baseline, Day 169
Change from Baseline in Percent Predicted 6MWT at the end of the Randomized Evaluation Period (Day 169)
Baseline, Day 169
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Study Design & Arms
AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
ALXN1850EXPERIMENTALStarting at Day 1 of the Randomized Evaluation Period, the ALXN1850 group will receive bodyweight dependent doses of either 20mg, 35mg or 50mg of ALXN1850 once every 2 weeks (q2w) via SC injection, for 24 weeks. Participants will enter the OLE Period and continue q2w dosing with ALXN1850 for up to 132 weeks.
PlaceboPLACEBO_COMPARATORStarting at Day 1 during the Randomized Evaluation Period, participants will receive placebo q2w for a total of 24 weeks. Participants will enter the OLE Period and continue q2w dosing with ALXN1850 for up to 132 weeks.
asfotase alfaEXPERIMENTALStarting at Day 1 of the Randomized Evaluation Period, participants will receive asfotase alfa for a total of 24 weeks. Participants will receive 6 mg/kg/week of asfotase alfa via SC injection as either 2 mg/kg 3 times per week or 1 mg/kg 6 times per week. Part A of the OLE Period participants will have frequent visits over the first 24 weeks; Part B will have visits every 9 months for up to approximately 108 weeks.
Placebo GroupPLACEBO_COMPARATORDuring the Randomized Evaluation Period, the placebo group will receive placebo on Day 1, followed by once every 2 weeks (q2w) via SC injection for 24 weeks. Participants will enter the OLE Period and receive bodyweight dependent doses of either 20mg, 35mg, or 50mg of ALXN1850 and continue q2w dosing with ALXN1850 for up to 132 weeks.
ALXN1850 GroupEXPERIMENTALStarting at Day 1 of the Randomized Evaluation Period, the ALXN1850 group will receive bodyweight dependent doses of either 20mg, 35mg or 50mg of ALXN1850 once q2w via SC injection, for 24 weeks. Participants will enter the OLE Period and continue q2w dosing with ALXN1850 for up to 132 weeks.
Interventions
NameTypeDescription
ALXN1850DRUGParticipants will receive a ALXN1850 via subcutaneous (SC) injection.
PlaceboDRUGParticipants will receive placebo via SC injection.
asfotase alfaDRUGAsfotase alfa will be administered via SC injection.
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Eligibility Criteria
Age Range2 Years — 11 Years
SexALL
Healthy VolunteersNo
Study Sites32

Inclusion Criteria: * Diagnosis of HPP documented in the medical records, and the following criteria fulfilled without other probable cause than HPP: 1. Presence of HPP-related rickets on skeletal X-rays during the Screening Period, with a minimum Rickets Severity Score (RSS) of 1.0 AND 2. Ser...

Countries:United StatesAustraliaBelgiumBrazilCanadaChinaFinlandIsraelMexicoPolandRomaniaSpainSwedenTaiwanTurkey (Türkiye)United KingdomArgentinaJapanFranceGermanyItalySouth Korea
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Recent Changes (Last 90 Days)
LOWMay 29, 2026NCT06079281lastUpdatePostDate: changed
LOWMay 29, 2026NCT06079359lastUpdatePostDate: changed
LOWMay 29, 2026NCT06079281lastUpdatePostDate: changed
LOWMay 29, 2026NCT06079359lastUpdatePostDate: changed
LOWMay 29, 2026NCT06079281lastUpdatePostDate: changed
LOWMay 29, 2026NCT06079359lastUpdatePostDate: changed
LOWMay 26, 2026NCT06079372primaryCompletionDate: changed
LOWMay 26, 2026NCT06079281primaryCompletionDate: changed
LOWMay 26, 2026NCT06079359primaryCompletionDate: changed
LOWMay 24, 2026NCT06079372studyFirstPostDate: changed
LOWMay 24, 2026NCT06079281studyFirstPostDate: changed
LOWMay 24, 2026NCT06079359studyFirstPostDate: changed