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Andexanet alfa

Phase 1

Healthy Participants | Small molecule | Other |AstraZeneca PLC|Last Updated: Jun 2, 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
RandomizedCONTROLLEDBiomarker
Total Trials1
Total Enrollment179
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT07312851A Study to Investigate Andexanet Dosing and the Interaction Between Andexanet and Subsequent Enoxaparin in Healthy ParticipantsPHASE1 ACTIVE NOT_RECRUITING 179Jan 19, 2026Jun 11, 2026Jun 2, 20262 Germany, United Kingdom
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Study Endpoints
Primary Endpoints
Anti-Factor (F) Xa activity
Day 1 post dose

To determine the pharmacodynamic (PD) effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured by chromogenic enzymatic anti-FXa activity assays.

Change from baseline in anti-FXa activity
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured by chromogenic enzymatic anti-FXa activity assays.

Thrombin generation potential
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured as thrombin generation potential (including Endogenous Thrombin Potential \[ETP\]).

Change from pre-direct oral anticoagulants (DOAC) in thrombin generation potential
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured as thrombin generation potential (including ETP).

Change from baseline in thrombin generation potential
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured as thrombin generation potential (including ETP).

Time to onset of coagulation
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured as time to onset of coagulation.

Change from pre-DOAC in time to onset of coagulation
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured as time to onset of coagulation.

Change from baseline in time to onset of coagulation
Day 1 post dose

To determine the PD effect of andexanet doses by assessing reversal of rivaroxaban or apixaban anticoagulation measured as time to onset of coagulation.

Anti-FXa activity following enoxaparin dosing
From Day 1 to Day 2

To determine anticoagulation by enoxaparin at different time points after andexanet treatment measured by chromogenic enzymatic anti-FXa activity assays.

Thrombin generation potential following enoxaparin dosing
From Day 1 to Day 2

To determine anticoagulation by enoxaparin at different time points after andexanet treatment measured as thrombin generation potential (including ETP).

Secondary Endpoints
Module 3: Anti-FXa activity
Day 1 post dose
Module 3: Change from baseline in anti-FXa activity
Day 1 post dose
Module 3: Thrombin generation potential
Day 1 post dose
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Study Design & Arms
AllocationRANDOMIZED
MaskingSINGLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Module 1: Rivaroxaban + Andexanet (dose A)EXPERIMENTALParticipants will receive once daily dose of 20 mg rivaroxaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose A) dosing, the participants will receive an additional dose of rivaroxaban. Participants will be further allocated to groups to receive doses of enoxaparin at different time points after the end of andexanet bolus.
Module 1: Rivaroxaban + Andexanet (dose B)EXPERIMENTALParticipants will receive once daily dose of 20 mg rivaroxaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose B) dosing, the participants will receive an additional dose of rivaroxaban.
Module 1: Rivaroxaban + Andexanet (dose C)EXPERIMENTALParticipants will receive once daily dose of 20 mg rivaroxaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose C) dosing, the participants will receive an additional dose of rivaroxaban.
Module 1: Rivaroxaban + PlaceboEXPERIMENTALParticipants will receive once daily dose of 20 mg rivaroxaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before placebo (equivalent to dose B of andexanet) dosing, the participants will receive an additional dose of rivaroxaban. Participants will be further allocated to groups to receive doses of enoxaparin at different time points after placebo administration.
Module 2: Apixaban + Andexanet (dose B)EXPERIMENTALParticipants will receive twice daily dose of 5 mg apixaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose B) dosing, the participants will receive an additional dose of apixaban. Participants will be further allocated to groups to receive doses of enoxaparin at different time points after the end of andexanet bolus.
Module 2: Apixaban + Andexanet (dose C)EXPERIMENTALParticipants will receive twice daily dose of 5 mg apixaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose C) dosing, the participants will receive an additional dose of apixaban.
Module 2: Apixaban + Andexanet (dose D)EXPERIMENTALParticipants will receive twice daily dose of 5 mg apixaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose D) dosing, the participants will receive an additional dose of apixaban.
Module 2: Apixaban + PlaceboEXPERIMENTALParticipants will receive twice daily dose of 5 mg apixaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before placebo (equivalent to dose B of andexanet) dosing, the participants will receive an additional dose of apixaban. Participants will be further allocated to groups to receive doses of enoxaparin at different time points after placebo administration.
Module 3: Rivaroxaban + Andexanet (Dose A)EXPERIMENTALParticipants will receive once daily dose of 20 mg rivaroxaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose A) dosing, the participants will receive an additional dose of rivaroxaban.
Module 3: Apixaban + Andexanet (Dose B)EXPERIMENTALParticipants will receive twice daily dose of 5 mg apixaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before andexanet (dose B) dosing, the participants will receive an additional dose of apixaban.
Module 3: Rivaroxaban + PlaceboEXPERIMENTALParticipants will receive once daily dose of 20 mg rivaroxaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before placebo (equivalent to dose A of andexanet) dosing, the participants will receive an additional dose of rivaroxaban.
Module 3: Apixaban + PlaceboEXPERIMENTALParticipants will receive twice daily dose of 5 mg apixaban from Day -3 to Day -1 to achieve steady state plasma levels. On Day 1, approximately 3 hours before placebo (equivalent to dose B of andexanet) dosing, the participants will receive an additional dose of apixaban.
Module 4: Placebo + Andexanet (dose C)EXPERIMENTALParticipants will receive daily dose of one placebo tablet from Day -3 to Day -1. On Day 1, approximately 3 hours before andexanet (dose C) dosing, the participants will receive an additional placebo tablet.
Module 4: Placebo + Andexanet (dose B)EXPERIMENTALParticipants will receive daily dose of one placebo tablet from Day -3 to Day -1. On Day 1, approximately 3 hours before andexanet (dose B) dosing, the participants will receive an additional placebo tablet. Participants will be further allocated to groups to receive doses of enoxaparin at different time points after the end of andexanet bolus.
Interventions
NameTypeDescription
Andexanet alfaDRUGAndexanet alfa will be administered as an intravenous bolus followed by an infusion, however, in Module 3, only a bolus will be given.
RivaroxabanDRUGRivaroxaban will be administered as an oral tablet.
ApixabanDRUGApixaban will be administered as an oral tablet.
EnoxaparinDRUGEnoxaparin will be administered as a subcutaneous injection.
PlaceboOTHERPlacebo will replace andexanet and be given as an IV bolus plus infusion in Modules 1 and 2; in Module 3, placebo will be IV bolus only. In Module 4, an oral placebo tablet will replace rivaroxaban and apixaban.
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Eligibility Criteria
Age Range18 Years — 55 Years
SexALL
Healthy VolunteersYes
Study Sites2

Main Inclusion Criteria: * All females must have a negative pregnancy test at the Screening Visit. * Females of childbearing potential must not be lactating and if heterosexually active must agree to use an approved method of highly effective contraception. * Sexually active fertile male participan...

Countries:GermanyUnited Kingdom
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Recent Changes (Last 90 Days)
MEDIUMJun 2, 2026NCT07312851Status: RECRUITING → ACTIVE_NOT_RECRUITING
MEDIUMJun 2, 2026NCT07312851Status: RECRUITING → ACTIVE_NOT_RECRUITING
MEDIUMJun 2, 2026NCT07312851Status: RECRUITING → ACTIVE_NOT_RECRUITING
LOWMay 26, 2026NCT07312851primaryCompletionDate: changed
LOWMay 24, 2026NCT07312851studyFirstPostDate: changed