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PA21

Phase 3

Chronic Kidney Disease Requiring Chronic Dialysis | Small molecule | Nephrology |Fresenius Medical Care AG|Last Updated: Jun 2, 2021

Success Probability

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Market & Valuation

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Trial Design

RandomizedACTIVE_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment2,004

FDA Designations

No designations recorded

Clinical trial landscape

PA21 · 3 trials · 2 indications

Phase 3 3
NCT01464190A Phase 3 Extension Study to Investigate the Long-term Safety, Tolerability and Efficacy of PA21, a Phosphate Binder in Dialysis PatientsChronic Kidney Disease Requiring Chronic Dialysis
COMPLETED659 Analytics
NCT01324128A Phase 3 Study to Investigate the Safety and Efficacy of PA21, a Phosphate Binder, in Dialysis PatientsChronic Kidney Disease Requiring Chronic Dialysis
COMPLETED1,059 Analytics
NCT03644264PA21 Safety and Efficacy in Adult Chinese SubjectsChronic Kidney Disease Requiring Chronic Dialysis
COMPLETED286 Analytics
PHASE3COMPLETED
A Phase 3 Extension Study to Investigate the Long-term Safety, Tolerability and Efficacy of PA21, a Phosphate Binder in Dialysis Patients
Chronic Kidney Disease Requiring Chronic DialysisUnlock trial analytics
PHASE3COMPLETED
A Phase 3 Study to Investigate the Safety and Efficacy of PA21, a Phosphate Binder, in Dialysis Patients
Chronic Kidney Disease Requiring Chronic DialysisUnlock trial analytics
PHASE3COMPLETED
PA21 Safety and Efficacy in Adult Chinese Subjects
Chronic Kidney Disease Requiring Chronic DialysisUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline and Levels at Each Time Point for Serum Phosphorus
Every 4 weeks from baseline to Week 28

Endpoint is Week 28 or the latest available measurement after baseline when Week 28 data is missing.

Change From Baseline and Levels at Each Time Point for Serum Calcium
Every 4 weeks from baseline to Week 28

Endpoint is Week 28 or the latest available measurement after baseline when Week 28 data is missing.

Change From Baseline and Levels at Each Time Point for Serum Intact Parathyroid Hormone (iPTH)
Every 4 weeks from baseline to Week 28

Endpoint is Week 28 or the latest available measurement after baseline when Week 28 data is missing.

Change in Serum Phosphorus Levels From Week 24 to Week 27
Week 24, Week 27

Change in serum phosphorus levels compared between PA21 Maintenance Dose (MD) and PA21-1 Low Dose (LD) in Stage 2 from Week 24 to Week 27

Serum phosphorus (mmol/l )
baseline and 12 weeks

Change from baseline in serum phosphorus levels at Week 12: comparison between PA21 group and sevelamer carbonate group.

Secondary Endpoints

Change in Serum Phosphorus Levels From Baseline to Week 12
Week 12 post Baseline
Serum phosphorus (mmol/l )
baseline, weeks 1, 2, 4, 6, 8, 12
Serum phosphorus (mmol/l)
baseline, weeks 1, 2, 4, 6, 8, 12
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Study Design & Arms

AllocationRANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
PA21EXPERIMENTAL -
Sevelamer carbonateACTIVE_COMPARATOR -
PA21 (2.5 g tablet)EXPERIMENTAL -
PA21-1 (1.25 g tablet)OTHER -
PA21 tablets containing 500 mg of ironEXPERIMENTALPA21 chewable tablets standardised to contain 500 mg of iron. PA21 500 mg (iron) chewable tablet contains approximately 2.5 g PA21 drug substance (sucroferric oxyhydroxide). Starting dose will be 1,500 mg/day (3 tablets/day (1 tablet per meal)). Dose increases or decreases of 500 mg/day (1 tablet/day) are permitted. The maximum dose of PA21 will be 3,000 mg/day (6 x 500 mg tablets/day) and the minimum dose will be 1,000 mg/day (2 x 500 mg tablets/day).
Sevelamer carbonate: Renvela® tabletsACTIVE_COMPARATORStarting dose will be 2.4 g/day (3 tablets/day). Dose increases or decreases of 2.4 g/day (3 tablets/day (1 tablet per meal)) The maximum dose of sevelamer carbonate will be 14.4 g/day (18 tablets/day) and the minimum dose will be 2.4 g/day (3 tablets/day).

Interventions

NameTypeDescription
PA21 (2.5 g tablet containing 500 mg iron)DRUGDose range of 5.0 g/day (2 tablets/day) to 15.0 g/day (6 tablets/day).
Sevelamer carbonateDRUGFilm coated, compressed tablets. Dose range of 2.4 g/day (3 tablets/day) to 14.4 g/day (18 tablets/day).
PA21-1 (1.25 g tablet containing 250 mg iron)DRUGLow dose comparator (1.25 g/day)
PA21DRUGsucroferric oxyhydroxide is a mixture of polynuclear iron(III)-oxyhydroxide (about 33% m/m), sucrose (about 30% m/m), and starches (about 28% m/m) and contains ≤10% m/m water.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites15

Inclusion Criteria: * Subjects who have completed treatment in Protocol PA-CL-05A * Written Informed Consent Exclusion Criteria: * Hyper/hypo calcemia; hyper intact parathyroid hormone (iPTH) * Other significant medical conditions * Pregnancy

Countries:United StatesAustriaBelgiumCroatiaCzechiaGermanyLatviaLithuaniaPolandRomaniaRussiaSerbiaSouth AfricaUkraineUnited KingdomChina
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Frequently asked questions about PA21

What is PA21 used for?

PA21 is an investigational small molecule phosphate binder being developed for chronic kidney disease requiring chronic dialysis. It is designed to manage hyperphosphatemia, or elevated blood phosphate levels, in adult dialysis patients. The drug has been studied in Phase 3 clinical trials, but it is not yet approved and remains in clinical development.

Who makes PA21?

PA21 is being developed by Fresenius Medical Care AG, a German dialysis company traded on the New York Stock Exchange under the ticker FMS. The company has sponsored multiple Phase 3 clinical trials of PA21 in dialysis patients across the United States, Europe, and Asia.

What phase is PA21 in?

PA21 is in Phase 3 clinical development. Three Phase 3 trials have been completed, with a total enrollment of 2,004 patients. The drug is investigational and has not been approved by regulatory authorities. All three trials are completed, and no active trials are currently listed.

What clinical trials is PA21 in?

PA21 has completed three Phase 3 trials: NCT01324128, a safety and efficacy study in 1,059 dialysis patients; NCT01464190, a long-term extension study in 659 patients; and NCT03644264, a safety and efficacy study in 286 Chinese patients with hyperphosphatemia. All trials were completed and enrolled adults aged 18 years and older.

Is PA21 the same as any other drug?

PA21 is a phosphate binder developed by Fresenius Medical Care. No alternative names for PA21 have been disclosed in the clinical trial records. The drug is being studied under the name PA21 across all its Phase 3 trials, including the extension study and the Chinese patient study.