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AZD9977

Phase 2

Heart Failure | Small molecule | Cardiovascular |AstraZeneca PLC|Trials Updated: Sep 24, 2026

AZD9977 development status

Highest phase Phase 2
Registered trials 8 across 1 sponsor since Jun 2015

AZD9977 target and mechanism

ModalitySmall molecule

Also known as AZD9977 Oral suspension (reference), AZD9977 oral suspension, Balcinrenone

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials8
Total Enrollment3,061

FDA Designations

No designations recorded

AZD9977 clinical trials

AZD9977 · 8 trials · 8 indications

Phase 3 1Phase 2 1Phase 1 6
NCT07624305A Phase III Study to Evaluate the Effect of Balcinrenone/Dapagliflozin in Patients With CKD Stage 3b and 4 (BalanceD-CKD)Renal Insufficiency, Chronic
RECRUITING2,800 Analytics
PHASE3RECRUITING
A Phase III Study to Evaluate the Effect of Balcinrenone/Dapagliflozin in Patients With CKD Stage 3b and 4 (BalanceD-CKD)
Renal Insufficiency, ChronicUnlock trial analytics

Study Endpoints

Primary Endpoints

Time to first occurrence of cardiovascular death, death from kidney failure, kidney failure, sustained 50% or greater decline in eGFR, and heart failure event
Up to 46 months.

Time from randomization to first occurrence of any of the components of the composite: * CV death * Death from kidney failure * Onset of kidney failure * Initiation of maintenance dialysis or * Kidney transplantation * Sustained ≥ 50% decline from baseline in eGFR * HF with or without hospitalisation

Percent Change From Baseline in Urinary Albumin to Creatinine Ratio (UACR) at Week 12
Baseline (Day 1) to Week 12

The effect of AZD9977 in combination with dapagliflozin compared with dapagliflozin alone on UACR assessed. Urine samples were collected for the analysis of UACR. UACR (milligrams per gram \[mg/g\]) was calculated as 10 x urine albumin (mg per deciliter \[mg/dL\])/urine creatinine (g/dL). Change from baseline in UACR at the end of 12 weeks of study treatment was calculated as the average of the UACR values at Week 12 and was analyzed by a mixed-effects model for repeated measures (MMRM). Due to early removal of arms (AZD9977 150 mg monotherapy and Placebo), the study objectives were revised and the MMRM analysis included the 4 remaining arms (AZD9977 15 mg + Dapagliflozin, AZD9977 50 mg + Dapagliflozin, AZD9977 150 mg + Dapagliflozin, and Dapagliflozin 10 mg). Since 2 arms were removed from the study resulting in fewer participants only descriptive statistics are shown for those two arms without formal comparison.

PK parameters AUCinf
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the effect of HD on the PK of balcinrenone/dapagliflozin

PK Parameters AUClast
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the effect of HD on the PK of balcinrenone/dapagliflozin

PK Parameters Cmax
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the effect of HD on the PK of balcinrenone/dapagliflozin

PK parameters C24 from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters tmax from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters t1/2λz from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters CLNR (balcinrenone only) from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters CL/F from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters AUC(t1-t2)_out from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters CLD from dialysate
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in dialysate in participants with kidney failure on HD

PK parameters AeD from dialysate
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in dialysate in participants with kidney failure on HD

PK parameters feD from dialysate
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in dialysate in participants with kidney failure on HD

PK parameters Vz/F from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

PK parameters AUC(t1-t2) from plasma
Day 1 to 3 for each treatment period (each treatment period is 4 days)

To evaluate the PK of balcinrenone/dapagliflozin in plasma in participants with kidney failure on HD

Area under plasma concentration-time curve from time zero to the last measurable concentration (AUClast)
Day 1 to Day 5

To compare the PK of a single oral dose of balcinrenone in participants with mild and moderate hepatic impairment to those with normal hepatic function

Area under plasma concentration-time curve from zero to infinity (AUCinf)
Day 1 to Day 5

To compare the PK of a single oral dose of balcinrenone in participants with mild and moderate hepatic impairment to those with normal hepatic function

Maximum observed plasma concentration (Cmax)
Day 1 to Day 5

To compare the PK of a single oral dose of balcinrenone in participants with mild and moderate hepatic impairment to those with normal hepatic function

Absolute bioavailability of AZD9977
Collection of plasma samples from pre-dose until 72 hours post-dose.

Absolute bioavailability based on AUC0-inf of oral formulation compared to IV adjusted for dose

The cumulative amount of AZD9977 excreted (CumAe)
Collection of urine and faecal samples from pre-dose until 168 hours post-dose.

Assessment of the total radioactivity by measuring the cumulative amount of AZD9977 excreted (CumAe)

The cumulative amount of AZD9977 excreted and expressed as a percentage of the administered dose (CumFe)
Collection of urine and faecal samples from pre-dose until 168 hours post-dose.

Assessment of the rates and routes of elimination by measuring the cumulative amount excreted and expressed as a percentage of the administered dose (CumFe)

Assessment of metabolites in plasma by liquid chromatography-radiochemical-detection and subsequent mass spectrometry
Collection of plasma samples from pre-dose until 72 hours post-dose in period 1 and from pre-dose to 168 hours post-dose in period 2.
Assessment of metabolites in urine by liquid chromatography-radiochemical-detection and subsequent mass spectrometry
Collection of urine samples from pre-dose until 72 hours post-dose in period 1 and from pre-dose to 168 hours post-dose in period 2.
Assessment of metabolites in faeces by liquid chromatography-radiochemical-detection and subsequent mass spectrometry
Collection of faecal samples from pre-dose until 168 hours post-dose.
Area under the plasma concentration-time curve from time zero to infinity (AUC)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Area under the plasma concentration-time curve from time zero to time of last quantifiable concentration (AUC0-t)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Time to reach maximum observed plasma concentration (tmax)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Half-life associated with terminal slope of a semi-logarithmic concentration time curve (t½λz)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Terminal elimination rate constant (λz)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Apparent total body clearance of drug from plasma after oral administration (CL/F)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Non-renal clearance of drug from plasma after oral administration (CLNR/F)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Apparent volume of distribution during the terminal phase after oral administration (Vz/F)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Mean residence time (MRT)
Day 1 to 3 (Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 20, 24, 36, and 48 hours post-dose), Day 4 to 7

To assess the PK of AZD9977 following administration of AZD9977

Renal clearance of the drug from plasma (CLR)
Day 1 to 3 (Pre-dose, 0-4, 4-8, 8-12, 12-24, 24-36, and 36-48 hours post-dose)

To assess the PK of AZD9977 following administration of AZD9977

Cumulative amount of unchanged drug excreted into the urine (Ae)
Day 1 to 3 (Pre-dose, 0-4, 4-8, 8-12, 12-24, 24-36, and 36-48 hours post-dose)

To assess the PK of AZD9977 following administration of AZD9977

Fraction of the drug excreted into the urine (fe)
Day 1 to 3 (Pre-dose, 0-4, 4-8, 8-12, 12-24, 24-36, and 36-48 hours post-dose)

To assess the PK of AZD9977 following administration of AZD9977

Area under plasma concentration-time curve from time zero to infinity (AUC) for AZD9977
Day 1 to 3: Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 24, 36 and 48 hours post-dose. Day 4 to 9: pre-dose on Day 7 and 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 24, 36 and 48 hours post-dose

To access pharmacokinetics (PK) of AZD9977 in healthy volunteers when administered alone and in combination with multiple doses of itraconazole

Area under the plasma concentration-time curve from time zero to time of last quantifiable concentration (AUClast) for AZD9977
Day 1 to 3: Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 24, 36 and 48 hours post-dose. Day 4 to 9: pre-dose on Day 7 and 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 24, 36 and 48 hours post-dose

To access pharmacokinetics (PK) of AZD9977 in healthy volunteers when administered alone and in combination with multiple doses of itraconazole

Maximum observed plasma concentration (Cmax) for AZD9977
Day 1 to 3: Pre-dose, 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 24, 36 and 48 hours post-dose. Day 4 to 9: pre-dose on Day 7 and 0.25, 0.5, 0.75, 1, 1.5, 2, 2.5, 3, 4, 5, 8, 12, 16, 24, 36 and 48 hours post-dose

To access pharmacokinetics (PK) of AZD9977 in healthy volunteers when administered alone and in combination with multiple doses of itraconazole

Number of participants with adverse events (AEs)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants. Serious AEs will be recorded from the time of screening.

Number of participants with abnormal blood pressure (BP)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants. Blood pressure includes both systolic and diastolic BP.

Number of participants with abnormal supine pulse
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal findings in 12-lead safety Electrocardiogram (ECG)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal findings in 12-lead safety Digital Electrocardiogram (dECG)
At week 5 (Visit 2)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal findings in Real-Time ECG (Cardiac Telemetry)
At week 5 (Visit 2)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal physical examination findings
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants. The complete physical examinations will include an assessment of the general appearance, skin, cardiovascular, respiratory, abdomen, head, and neck (including ears, eyes, nose, and throat), lymph nodes, thyroid, musculoskeletal and neurological systems.

Number of participants with abnormal laboratory assessments: Hematology - absolute count of Basophils, Eosinophils, Monocytes, Neutrophils, Lymphocytes and Reticulocytes; Platelets and White blood cell (WBC) count
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assesments: Hematology - Mean corpuscular volume (MCV)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Hematology-Hematocrit (HCT)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Hematology - Hemoglobin (Hb)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Hematology - Red blood cell (RBC) count
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assesments: Heamtology - Mean corpuscular hemoglobin (MCH)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assssments : Hematology - Mean corpuscular hemoglobin concentration (MCHC)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Albumin
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Urea
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - C-reactive protein (CRP)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Alkaline phosphatase
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Alanine aminotransferase
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Aspartate aminotransferase
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Creatinine kinase
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Creatinine
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Uric acid
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Glucose (fasting)
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Gamma glutamyl transpeptidase
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Phosphate
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Total Bilirubin and Unconjugated bilirubin
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Potassium
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Sodium
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Cholesterol
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Luteinizing hormone
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Triglycerides
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Sex hormone binding globulin
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Follicle-stimulating hormone
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Testosterone
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Aldosterone
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Hemoglobin A1c
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Clinical Chemistry - Electrolytes
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants. Electrolyte Measurements includes Bicarbonate, Calcium, Chloride, Potassium, Sodium

Number of participants with abnormal laboratory assessments: Clinical Chemistry - High-sensitive-CRP
At Visit 2 (Week 5)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: High-sensitivity Troponin T
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: N-terminal pro-brain Natriuretic Peptide
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal urine volume
At Visit 2 (Week 5)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Urinalysis - Glucose
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Urinalysis - Protein
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants.

Number of participants with abnormal laboratory assessments: Urinalysis - Blood
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants. Microscopy should be done (if positive for protein or blood): red blood cells (RBC), white blood cells (WBC), Casts (Cellular, Granular, Hyaline)

Number of participants with abnorml laboratory assessments: Urinalysis - Urinary Electrolytes
From screening (Day -28) till follow-up visit (Up to 6 weeks)

To investigate the safety and tolerability of AZD9977 following oral administration of single and multiple ascending doses at steady state in healthy Japanese participants. Urinary Electrolytes: Calcium, Potassium, Chloride, Sodium, Creatinine and Uric acid.

Secondary Endpoints

Time to first occurrence of cardiovascular death, death from kidney failure, kidney failure and sustained 50% or greater decline in eGFR.
Up to 46 months.
Change in urinary albumin to creatinine ratio to Week 24
Baseline to Week 24
Time to first occurrence of cardiovascular death or heart failure event.
Up to 46 months.
Unlock Study Endpoints

Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Balcinrenone/dapagliflozinEXPERIMENTALPatient receives once daily 1 capsule balcinrenone 15 mg and dapagliflozin 10 mg and 1 placebo tablet matching dapagliflozin.
DapagliflozinACTIVE_COMPARATORPatient receives once daily 1 placebo capsule matching balcinrenone and dapagliflozin and 1 tablet dapagliflozin 10 mg.
AZD9977 Dose A + dapagliflozin 10 mgEXPERIMENTALParticipants will receive once daily oral dose A of AZD9977 and 10 mg dapagliflozin for 12 weeks.
AZD9977 Dose B + dapagliflozin 10 mgEXPERIMENTALParticipants will receive once daily oral dose B of AZD9977 and 10 mg dapagliflozin for 12 weeks.
AZD9977 Dose C + dapagliflozin 10 mgEXPERIMENTALParticipants will receive once daily oral dose C of AZD9977 and 10 mg dapagliflozin for 12 weeks.
Dapagliflozin 10 mgEXPERIMENTALParticipants will receive once daily oral dose of dapagliflozin 10 mg alone for 12 weeks.
Sequence ABOTHERParticipants will receive Treatment A (balcinrenone/dapagliflozin capsule administered 1,5 hours before the start of a 4-hour hemodialysis session) on Day 1. After a wash-out period of ≥ 7 days, participants will receive Treatment B (balcinrenone/dapagliflozin capsule administered 1 hour after the completion of a 4-hour hemodialysis session)
Sequence BAOTHERParticipants will receive Treatment B (balcinrenone/dapagliflozin capsule administered 1 hour after the completionof a 4-hour hemodialysis session) on Day 1. After a wash-out period of ≥ 7 days, participants will receive Treatment A (balcinrenone/dapagliflozin capsule administered 1.5 hours before the start of a 4-hour hemodialysis session)
Group 1EXPERIMENTALSubjects with Mild Impairment will receive a single oral dose of balcinrenone under fasted conditions.
Group 2EXPERIMENTALSubjects with Moderate Impairment will receive a single oral dose of balcinrenone under fasted conditions.
Group 3EXPERIMENTALHealthy participants will receive a single oral dose of balcinrenone under fasted conditions.
AZD9977EXPERIMENTALIn Period 1, one 100 mg dose of AZD9977 capsule 50 mg (as 2 x 50 mg capsules) and one 100 µg dose of \[14C\]AZD9977 Solution for Infusion, 20 µg/mL (NMT 37.0 kBq/5 mL). In Period 2, one 100 mg dose of \[14C\]AZD9977 Oral Suspension, 100 mg (NMT 9.9 MBq).
Treatment - AZD9977EXPERIMENTALThere are 4 cohorts in this arm based on renal function (mild, moderate, severe, and normal). Each cohort will have 8 participants.
Single AZD9977EXPERIMENTALDuring this treatment period, healthy participants will be administered with a single AZD9977 (Dose 1) dose, in the fed state, on Day 1 followed by at least 3 days washout period.
Itraconazole + AZD9977EXPERIMENTALDuring this treatment period, healthy participants will be administered with Itraconazole (Dose 2) from Day 4 to Day 8 plus will be administrated with AZD9977 (Dose 1, fed state) as a single dose on Day 7. Dose of itraconazole will be taken at -1 hour (1 hour prior to AZD9977 dosing) when co-administered with AZD9977.
PlaceboPLACEBO_COMPARATOREach participant will receive placebo at the selected dose level on Day 1 and from Day 3 to 9, with single dose on Day 1 and Day 9 and twice a day (BID) dosing on Day 3 to Day 8. No dose will be given on Day 2.

Interventions

NameTypeDescription
Balcinrenone/dapagliflozinDRUGbalcinrenone/dapagliflozin 15 mg/10 mg
DapagliflozinDRUGdapagliflozin 10 mg
Placebo matching DapagliflozinDRUGmatching placebo for dapagliflozin 10 mg
Placebo matching balcinrenone/dapagliflozinDRUGmatching placebo for balcinrenone/dapagliflozin
AZD9977DRUGParticipants will receive AZD9977 as per the arms they are randomized.
BalcinrenoneDRUG50 mg, Immediate release capsule to be taken orally.
AZD9977 capsule 50 mgDRUG100 mg dose of AZD9977 capsule 50 mg (as 2 x 50 mg capusles)
[14C]AZD9977 Solution for Infusion, 20 µg/mL (NMT 37.0 kBq/5 mL)DRUGOne 100 µg dose of \[14C\]AZD9977 Solution for Infusion, 20 µg/mL (NMT 37.0 kBq/5 mL)
[14C]AZD9977 Oral Suspension, 100 mg (NMT 9.9 MBq)DRUGOne 100 mg dose of \[14C\]AZD9977 Oral Suspension, 100 mg (NMT 9.9 MBq)
ItraconazoleDRUGParticipants will receive Itraconazole daily (Dose 2) capsule orally once daily from Day 4 to Day 8 plus will be administered AZD9977 (Dose 1, fed state) as a single dose on Day 7. Dose of itraconazole has to be taken at -1 hour (1 hour prior to AZD9977 dosing) when co-administered with AZD9977.
PlaceboDRUGRandomized participants will receive oral dose of matching placebo.
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Eligibility Criteria

Age Range18 Years to 99 Years
SexALL
Healthy VolunteersNo
Study Sites478

Inclusion Criteria: * Age ≥ 18 years * Diagnosis of CKD and at least one of the following: 1. eGFR ≥ 15 to \< 45 mL/min/1.73 m2 AND: UACR ≥ 30 mg/g (central laboratory) or UACR ≥ 100 mg/g (local laboratory ) or UPCR ≥ 200 mg/g (local laboratory). 2. eGFR ≥ 15 to \< 30 mL/min/1.73 m2 and UACR \...

Countries:United StatesArgentinaAustriaBrazilBulgariaCanadaChinaFranceGermanyGreeceIndiaItalyJapanMalaysiaMexicoPeruPhilippinesPolandRomaniaSouth KoreaSpainTaiwanThailandTurkey (Türkiye)UkraineUnited KingdomVietnamBelgiumCzechiaDenmarkHungaryLithuaniaRussiaSlovakiaSweden
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Recent Changes (Last 90 Days)

MEDIUMSep 24, 2026NCT07624305Status: NOT_YET_RECRUITING → RECRUITING
MEDIUMSep 24, 2026NCT07624305Status: NOT_YET_RECRUITING → RECRUITING
MEDIUMSep 4, 2026NCT07754331Status: NOT_YET_RECRUITING → RECRUITING
MEDIUMSep 4, 2026NCT07754331Status: NOT_YET_RECRUITING → RECRUITING
LOWAug 11, 2026NCT07754331NEW_TRIAL: changed
LOWAug 11, 2026NCT07754331NEW_TRIAL: changed
LOWAug 11, 2026NCT07754331NEW_TRIAL: changed

Frequently asked questions about AZD9977

What is AZD9977?

AZD9977 is an investigational oral small molecule developed by AstraZeneca PLC for cardiovascular conditions. It has been studied in heart failure, heart failure with preserved ejection fraction (HFpEF), chronic kidney disease, and renal impairment. It remains in clinical development and is not approved for any indication.

Who makes AZD9977?

AZD9977 is developed by AstraZeneca PLC, which trades on the Nasdaq under the ticker AZN. AstraZeneca sponsored the clinical program evaluating the compound, including a Phase 2 study in heart failure and chronic kidney disease and several Phase 1 pharmacokinetic studies.

What phase is AZD9977 in?

AZD9977 is in Phase 1 development overall, though a Phase 2 study has also been completed. The program includes completed Phase 1 pharmacokinetic and bioavailability studies and a completed Phase 2 study of AZD9977 with dapagliflozin in heart failure and chronic kidney disease.

What clinical trials is AZD9977 in?

Four completed trials are registered for AZD9977: NCT04686591, an absolute bioavailability and ADME study in healthy men; NCT04595370, a Phase 2 study with dapagliflozin in heart failure and chronic kidney disease; NCT04469907, a pharmacokinetic and safety study in renal impairment; and NCT03843060, a drug interaction study with itraconazole.

Is AZD9977 the same as AZD9977 oral suspension?

Yes. AZD9977 oral suspension, AZD9977 oral suspension (reference), and AZD9977 capsule 50 mg are formulation and dosage descriptions of the same investigational compound, AZD9977. These names refer to how the drug was prepared and administered in studies, not to separate products.

How many patients have been enrolled in AZD9977 trials?

Across the registered AZD9977 studies, total enrollment is 181 participants. This includes 8 healthy male volunteers in the bioavailability study, 153 participants in the Phase 2 heart failure and chronic kidney disease study, 18 participants with renal impairment, and 14 healthy volunteers in the itraconazole interaction study.