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Asundexian

Phase 3

Prevention of Ischemic Stroke | Small molecule | Neurology |Bayer AG|Last Updated: Nov 12, 2025

Success Probability

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment12,327

FDA Designations

No designations recorded

Clinical trial landscape

Asundexian · 2 trials · 8 indications

Phase 3 1Phase 1 1
NCT05686070A Study to Test Asundexian for Preventing a Stroke Caused by a Clot in Participants After an Acute Ischemic Stroke or After a High-risk Transient Ischemic Attack, a So-called Mini StrokePrevention of Ischemic Stroke
COMPLETED12,327 Analytics
PHASE3COMPLETED
A Study to Test Asundexian for Preventing a Stroke Caused by a Clot in Participants After an Acute Ischemic Stroke or After a High-risk Transient Ischemic Attack, a So-called Mini Stroke
Prevention of Ischemic StrokeUnlock trial analytics

Study Endpoints

Primary Endpoints

Time to first occurrence of ischemic stroke
Up to 31 months
Time to first occurrence of ISTH major bleeding
Up to 31 months

ISTH=International Society on Thrombosis and Hemostasis

Area under the concentration vs. time curve from zero to infinity after single dose (AUC)*of BAY2433334
0 - 96 hours post dose

\*AUC(0-tlast) and AUC(0 tlast)/D will be used as main parameter, respectively, if mean AUC cannot be reliably determined in all participants. In case of dose adaptation for Child Pugh B patients, AUC/D\*will be evaluated instead of AUC.

Area under the concentration vs. time curve in plasma from zero to infinity (AUCu)* (unbound) after a single dose of BAY2433334.
0 - 96 hours post dose

\* AUC(0-tlast)u and AUC(0-tlast)u/D will be used as main parameter, respectively, if mean AUC cannot be reliably determined in all participants. In case of dose adaptation for Child Pugh B patients, AUCu/D\*, will be evaluated instead of AUCu.

Maximum observed drug concentration (Cmax) after single dose administration of BAY2433334.
0 - 96 hours post dose

In case of dose adaptation for Child Pugh B patients, Cmax/D will be evaluated instead of Cmax.

Maximum observed drug concentration (Cmax,u) (unbound) after a single dose of BAY2433334.
0 - 96 hours post dose

In case of dose adaptation for Child Pugh B patients, Cmax,u/D will be evaluated instead of Cmax,u.

Secondary Endpoints

Time to first occurrence of all strokes (ischemic and hemorrhagic)
Up to 31 months
Time to first occurrence of composite of CV death, MI or stroke
Up to 31 months
Time to first occurrence of composite of all-cause mortality, MI or stroke
Up to 31 months
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
AsundexianEXPERIMENTALParticipants will receive asundexian.
PlaceboPLACEBO_COMPARATORParticipants will receive placebo.
Arm A: Child-Pugh AEXPERIMENTALParticipants with mildly impaired hepatic function (Child-Pugh A)
Arm B: Child-Pugh BEXPERIMENTALParticipants with moderately impaired hepatic function (Child-Pugh B)
Arm C: Normal hepatic (Matched A and B)EXPERIMENTALParticipants with normal hepatic function matched to Arm A and B

Interventions

NameTypeDescription
Asundexian (BAY2433334)DRUGOnce daily, oral
PlaceboDRUGPlacebo to asundexian, once daily, oral
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites741

Inclusion Criteria: * Participants must be ≥ 18 years of age * Acute non-cardioembolic stroke or high-risk TIA * Systemic or cerebrovascular atherosclerosis or acute non-lacunar infarct Exclusion Criteria: * Ischemic stroke ≤ 7 days before the index event * Index stroke following procedures or st...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilBulgariaCanadaChinaColombiaCzechiaDenmarkFinlandFranceGermanyGreeceHungaryIndiaIsraelItalyJapanKazakhstanLatviaLithuaniaMalaysiaNetherlandsNorwayPolandPortugalSlovakiaSouth KoreaSpainSwedenSwitzerlandTaiwanTurkey (Türkiye)United Kingdom
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Frequently asked questions about Asundexian

What is Asundexian used for?

Asundexian is an investigational small molecule being developed for the prevention of ischemic stroke and the prevention of thromboembolic events. It is being studied in patients after acute non-cardioembolic ischemic stroke or high-risk transient ischemic attack, as well as in conditions such as atrial fibrillation and acute myocardial infarction.

Who makes Asundexian?

Asundexian is being developed by Bayer AG, a German pharmaceutical company. Bayer's stock is traded over-the-counter under the ticker symbol BAYRY.

What phase is Asundexian in?

Asundexian is in Phase 3 clinical development. A Phase 3 trial, NCT05686070, has been completed, studying the drug for preventing stroke after an acute ischemic stroke or high-risk transient ischemic attack. Asundexian remains investigational and is not yet approved by regulatory authorities.

What clinical trials is Asundexian in?

Asundexian has been studied in two completed clinical trials. NCT05686070 was a Phase 3 study with 12,327 participants evaluating stroke prevention after acute ischemic stroke or high-risk transient ischemic attack. NCT05419635 was a Phase 1 study with 27 participants examining how the drug moves through the body in people with mild or moderate liver impairment.

Is Asundexian the same as any other drug?

Asundexian is a distinct investigational compound and no alternative names have been reported. It is being studied under its own name in clinical trials registered with ClinicalTrials.gov, including NCT05686070 and NCT05419635.