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Donidalorsen

Phase 3

Hereditary Angioedema | Small molecule | Other |Ionis Pharmaceuticals, Inc.|Last Updated: May 8, 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-BlindCONTROLLEDDMCBiomarker
Total Trials4
Total Enrollment288
FDA Designations
No designations recorded
Clinical Trials (4)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT05392114A Study to Assess the Long-Term Safety and Efficacy of Donidalorsen in the Prophylactic Treatment of Hereditary Angioedema (HAE)PHASE3 ACTIVE NOT_RECRUITING 154Jul 13, 2022Mar 1, 2027Dec 12, 202550 United States, Belgium +12
NCT05139810OASIS-HAE: A Study to Evaluate the Safety and Efficacy of Donidalorsen (ISIS 721744 or IONIS-PKK-LRx) in Participants With Hereditary Angioedema (HAE)PHASE3 COMPLETED 91Dec 3, 2021Nov 9, 2023Mar 6, 202551 United States, Belgium +12
NCT04307381An Extension Study of Donidalorsen (IONIS-PKK-LRx) in Participants With Hereditary AngioedemaPHASE2 COMPLETED 20Mar 31, 2020Jan 24, 2025May 8, 20267 United States, Netherlands
NCT04030598A Study to Assess the Clinical Efficacy of Donidalorsen (Also Known as IONIS-PKK-LRx and ISIS 721744) in Participants With Hereditary AngioedemaPHASE2 COMPLETED 23Jan 7, 2020Mar 1, 2021Apr 3, 20238 United States, Netherlands
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Study Endpoints
Primary Endpoints
Percentage of Participants with at Least One Treatment-emergent Adverse Event (TEAE), Graded by Severity
Up to approximately 70 weeks, plus 104 weeks for Group 1; up to approximately 76 weeks, plus 104 weeks for Group 2
Time-Normalized Investigator-Confirmed (IC) HAE Attack Rate (Per Month) From Week 1 to Week 25
Week 1 to Week 25

The time-adjusted HAE attack rate was calculated as number of IC HAE attacks occurring from Week 1 to Week 25, divided by the number of days the participant contributed to the period multiplied by 28 days. An HAE attack was defined as an event with signs or symptoms consistent with an attack in at least 1 of the locations: peripheral angioedema (cutaneous swelling involving an extremity, the face, neck, torso, and/or genitourinary region), abdominal angioedema (abdominal pain, with or without abdominal distention, nausea, vomiting, or diarrhea), laryngeal angioedema (stridor, dyspnea, difficulty speaking, difficulty swallowing, throat tightening, or swelling of the tongue, palate, uvula, or larynx).

Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
Up to Week 221

An adverse event (AE) was defined as any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not the AE is considered related to the medicinal (investigational) product. TEAEs were defined as those AEs that either started or worsened in severity on or after the date/time of first administration of study drug in this OLE Study. TEAEs included both serious and non-serious TEAEs.

Percentage of Participants With Clinically Meaningful Changes in Clinical Laboratory Assessments
Up to Week 221

Clinical laboratory tests including clinical chemistry, hematology, coagulation, complement, inflammatory, urinalysis were performed. The percentage of participants with clinically meaningful changes were reported. Clinical meaningfulness was determined by the investigator.

Percentage of Participants With Clinically Meaningful Changes in Vital Signs
Up to Week 221

Vital sign measurements including heart rate, respiratory rate, body temperature, systolic and diastolic blood pressure and pulse pressure were assessed. Percentage of participants with clinically meaningful changes in the vital signs were reported. Clinically meaningfulness was determined by the investigator.

Percentage of Participants With Clinically Meaningful Changes in Electrocardiograms (ECGs) Parameters
Up to Week 221

The ECG parameters included ventricular rate, PR interval, QRS duration, QTc, QT corrected using the Fridericia's formula (QTcF), QT corrected using the Bazett's formula (QTcB), and overall interpretation. Percentage of participants with clinically meaningful changes in the ECG parameters were reported. Clinical meaningfulness was determined by the investigator.

Percentage of Participants Who Received At Least One Concomitant Medication
Up to Week 221

Concomitant medications include medications that participants were exposed to on or after the first dose of ISIS 721744 in the OLE study. Percentage of participants who received at least one concomitant medication were reported.

Time-normalized Number of HAE Attacks (Per Month) From Week 1 to Week 17
Week 1 to Week 17

The Week 1 to end of on-treatment period HAE attack rate was calculated for each participant as number of HAE attacks occurring from Week 1 to 28 days after the last dose date divided by the number of days the participant contributed to the period multiplied by 28 days. An HAE attack was defined as an event with signs or symptoms consistent with an attack in at least 1 of the locations: peripheral angioedema (cutaneous swelling involving an extremity, the face, neck, torso, and/or genitourinary region), abdominal angioedema (abdominal pain, with or without abdominal distention, nausea, vomiting, or diarrhea), laryngeal angioedema (stridor, dyspnea, difficulty speaking, difficulty swallowing, throat tightening, or swelling of the tongue, palate, uvula, or larynx).

Secondary Endpoints
Time-normalized Number of Investigator-confirmed HAE Attacks (per Month)
Week 1 to Week 157 for Group 1 and Group 2
Percentage of Investigator-confirmed HAE Attack-free Participants
Week 1 to Week 157 for Group 1 and Group 2
Time-normalized Number of Moderate or Severe Investigator-confirmed HAE Attacks (per Month)
Week 1 to Week 157 for Group 1 and Group 2
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
OLE ParticipantsEXPERIMENTALGroup 1 and Group 2 participants will be administered donidalorsen by SC injection for up to 157 weeks.
Pooled PlaceboPLACEBO_COMPARATORParticipants with hereditary angioedema type I/type II (HAE-1/HAE-2) received placebo subcutaneously (SC) either every 4 weeks (Weeks 1, 5, 9, 13, 17, and 21) or 8 weeks (Weeks 1, 9, and 17)
Cohort A: Donidalorsen 80 mgEXPERIMENTALParticipants with HAE-1/HAE-2 received donidalorsen, 80 mg, SC, every 4 weeks at Weeks 1, 5, 9, 13, 17, and 21.
Cohort B: Donidalorsen 80 mgEXPERIMENTALParticipants with HAE-1/HAE-2 received donidalorsen, 80 mg, SC, every 8 weeks at Weeks 1, 9, and 17.
HAE-1/HAE-2EXPERIMENTALParticipants with hereditary angioedema Type I/Type II (HAE-1/HAE-2) who received placebo or donidalorsen, 80 milligrams (mg), SC once every 4 weeks, in the previous study ISIS 721744-CS2 (NCT04030598), received donidalorsen, 80 mg, SC once every 4 weeks, from Week 1 to Week 13 (Fixed Dosing Period). Starting From Week 17 (Flexible Dosing Period), participants had 3 different dosing options as: 80 mg every 4 weeks, 80 mg every 8 weeks for participants who were attack-free for ≥12 weeks, 100 mg every 4 weeks for participants who were not attack-free for ≥12 weeks up to Week 53 based on the investigator and sponsor medical monitor recommendation. Participants continued flexible dosing from Week 53 for up to approximately 209 weeks.
HAE-nC1-INHEXPERIMENTALParticipants with hereditary angioedema with normal C1-inhibitor (HAE-nC1-INH) who received donidalorsen, 80 mg, SC, once every 4 weeks, in the previous study ISIS 721744-CS2 (NCT04030598), continued to receive donidalorsen, 80 mg, SC once every 4 weeks, from Week 1 to Week 13 (Fixed Dosing Period). Starting From Week 17 (Flexible Dosing Period), participants had 2 different dosing options as: 80 mg every 4 weeks, and 100 mg every 4 weeks for participants who were not attack-free for ≥12 weeks up to Week 53 based on the investigator and sponsor medical monitor recommendation. Participants continued flexible dosing from Week 53 for up to approximately 209 weeks.
Part A: PlaceboPLACEBO_COMPARATORParticipants with hereditary angioedema type I/type II (HAE-1/HAE-2) received placebo subcutaneously (SC) every 4 weeks at Weeks 1, 5, 9, and 13.
Part A: Donidalorsen 80 mgEXPERIMENTALParticipants with HAE-1/HAE-2 received donidalorsen, 80 mg, SC, every 4 weeks at Weeks 1, 5, 9, and 13.
Part B: Donidalorsen 80 mgEXPERIMENTALParticipants with hereditary angioedema with normal C1-inhibitor (HAE-nC1-INH) received donidalorsen, 80 mg, SC, every 4 weeks at Weeks 1, 5, 9, and 13.
Interventions
NameTypeDescription
DonidalorsenDRUGDonidalorsen will be administered by SC injection.
PlaceboDRUGDonidalorsen-matching placebo was administered by SC injection.
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Eligibility Criteria
Age Range12 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites50

Inclusion Criteria 1. Participants and, as applicable, legally authorized representatives (i.e., parent(s)/legal guardian), must provide written and signed informed consent form (ICF). 2. Participants must have access to, and the ability to use, ≥ 1 acute medication(s) (e.g., plasma-derived or reco...

Countries:United StatesBelgiumBulgariaCanadaFranceGermanyIsraelItalyNetherlandsPolandPuerto RicoSpainTurkey (Türkiye)United KingdomDenmark
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Recent Changes (Last 90 Days)
MEDIUMJun 8, 2026NCT04307381TRIAL_REMOVED: changed
MEDIUMJun 8, 2026NCT04307381TRIAL_REMOVED: changed
MEDIUMJun 8, 2026NCT04307381TRIAL_REMOVED: changed
MEDIUMJun 8, 2026NCT04307381TRIAL_REMOVED: changed
MEDIUMJun 8, 2026NCT04307381TRIAL_REMOVED: changed
LOWMay 26, 2026NCT05392114primaryCompletionDate: changed
LOWMay 24, 2026NCT05392114studyFirstPostDate: changed