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Apraglutide

Phase 3

Short Bowel Syndrome | Small molecule | Gastrointestinal |Ironwood Pharmaceuticals, Inc.|Last Updated: Aug 4, 2026

Target and mechanism

Molecular targetGLP-2R
Target class-Tide (Peptide)
ModalitySmall molecule

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials3
Total Enrollment332

FDA Designations

No designations recorded

Clinical trial landscape

Apraglutide · 8 trials · 6 indications

Phase 3 3Phase 2 1Phase 1 4
NCT07742735A Study to Investigate the Efficacy and Safety of Apraglutide Compared With Placebo in Adult Participants With Short Bowel Syndrome Associated With Intestinal Failure (SBS-IF)Short Bowel Syndrome (SBS)
RECRUITING124 Analytics
NCT05018286Open-label Extension Trial to Evaluate the Long-term Safety of Apraglutide in Short Bowel Syndrome.Short Bowel Syndrome
ACTIVE NOT_RECRUITING158 Analytics
NCT04627025Trial to Evaluate Efficacy and Safety of Apraglutide in SBS-IFShort Bowel Syndrome
COMPLETED164 Analytics
PHASE3RECRUITING
A Study to Investigate the Efficacy and Safety of Apraglutide Compared With Placebo in Adult Participants With Short Bowel Syndrome Associated With Intestinal Failure (SBS-IF)
Short Bowel Syndrome (SBS)Unlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Open-label Extension Trial to Evaluate the Long-term Safety of Apraglutide in Short Bowel Syndrome.
Short Bowel SyndromeUnlock trial analytics
PHASE3COMPLETED
Trial to Evaluate Efficacy and Safety of Apraglutide in SBS-IF
Short Bowel SyndromeUnlock trial analytics

Study Endpoints

Primary Endpoints

Relative change from baseline in actual weekly PS volume at Week 24.
At Week 24
Adverse events (AE)
From baseline to week 208

System organ class, frequency and severity

Clinical chemistry
From baseline to week 208

Clinical Chemistry panel of analytes will be examined for clinically significant changes.

Hematology
From baseline to week 208

Hematology panel of analytes will be examined for clinically significant changes.

Hemostasis
From baseline to week 104

Hemostasis INR will be examined for clinically significant changes.

Urinalysis
From baseline to week 208

Urinanalysis panel of analytes will be examined for clinically significant changes.

Occurrence of clinically relevant changes in vital signs
From baseline to week 208

* Systolic and diastolic blood pressure in mmHg will be examined for clinically significant changes. * Heart rate in Beats per Minute (BPM) will be examined for clinically significant changes.

Occurrence of clinically relevant changes in electrocardiogram
From baseline to week 208

ECG; intervals and rhythm

Number of Participants Who Experienced a Treatment-Emergent Adverse Event (TEAE)
Day 1 up to approximately 55 weeks

A TEAE was any unfavorable and unintended sign, symptom, or disease temporally associated with apraglutide, whether or not related, that occurred or worsened after the dose of apraglutide. A serious TEAE was defined as any TEAE that resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, was a congenital anomaly/birth defect or was an important medical event. Clinically significant changes from baseline in clinical chemistry, hematology, hemostasis, anti-drug antibodies (ADAs), and urine analysis were reported as adverse events. Adverse events of special interest (AESI) included injection site reaction, gastrointestinal obstruction, gallbladder, biliary, and pancreatic disease, fluid overload, colorectal polyps, malignancies.

Absolute Change in Absorption of Energy Over Metabolic Balance (MB) Periods From Baseline at Week 48
Baseline and Week 48

Applicable to Protocol V3.0 implemented in France (classed as secondary endpoint in Protocol V4.0 \[implemented in Belgium\]). The absorption was defined as dietary intake minus output from fecal excretion over a 72-hour MB period at a given analysis time point. Since dietary intake and fecal excretion were measured daily, i.e., up to three measurements may contribute to absorption calculations, the average over all available daily absorption measurements over the 72-hour period were used for analysis.

Plasma apraglutide primary PK parameter: Maximum observed plasma concentration (Cmax)
0 to 312 hours post dose in each period
Plasma apraglutide primary PK parameter: AUCinf or AUClast
0 to 312 hours post dose in each period
Maximum plasma concentration (Cmax) of acetaminophen
0-300 Minutes
Time at which the maximum plasma concentration is observed (tmax) of acetaminophen
0-300 Minutes
Area under the acetaminophen concentration-time curve: AUCinf (AUClast in case AUCinf cannot be estimated)
0-14 hours
Area under the acetaminophen concentration-time curve: AUC0-300min
0-300 Minutes
Area under the acetaminophen concentration-time curve: AUC0-60min
0-60 Minutes
Area Under the Curve to Infinity (AUCinf) of Apraglutide
Pre-dose Day 1; 6, 12, 24, 28, 36, 40, 48, 60, 72, 96, 120, 144, 168, 240, and 312 hours post-dose

Apraglutide was quantified in human plasma samples using a fully validated liquid chromatography mass spectrometry-based method, with a lower limit of quantification (LLOQ) of 1 ng/mL and an upper limit of 200 ng/mL. Plasma pharmacokinetic (PK) parameters for apraglutide were estimated using non-compartmental methods from the concentration-time profiles. Actual sampling times, rather than scheduled sampling times, were used. AUCinf was calculated as: AUCinf = AUC from time zero to the last quantifiable concentration (AUClast) + (Clast/kel) where Clast was the observed concentration at the last time point with concentrations above the lower limit of quantification and kel was the terminal elimination rate constant.

Area Under the Curve (AUC) From Time Zero to 168 Hours Post-dose (AUC0-168h) of Apraglutide
Pre-dose Day 1; 6, 12, 24, 28, 36, 40, 48, 60, 72, 96, 120, 144, and 168 hours post-dose

Apraglutide was quantified in human plasma samples using a fully validated liquid chromatography mass spectrometry-based method, with a LLOQ of 1 ng/mL and an upper limit of 200 ng/mL. Plasma PK parameters for apraglutide were estimated using non-compartmental methods from the concentration-time profiles. Actual sampling times, rather than scheduled sampling times, were used.

Maximum Observed Plasma Concentration (Cmax) of Apraglutide
Pre-dose Day 1; 6, 12, 24, 28, 36, 40, 48, 60, 72, 96, 120, 144, 168, 240, and 312 hours post-dose

Apraglutide was quantified in human plasma samples using a fully validated liquid chromatography mass spectrometry-based method, with a LLOQ of 1 ng/mL and an upper limit of 200 ng/mL. Plasma PK parameters for apraglutide were estimated using non-compartmental methods from the concentration-time profiles. Actual sampling times, rather than scheduled sampling times, were used. Cmax was the observed peak analyte concentration obtained directly from the experimental data without interpolation, expressed in concentration units.

Maximum Plasma Concentration (Cmax) of Apraglutide
5 minutes pre-dose up to 240 hours after dosing on Day 1

Pharmacokinetic (PK) samples collected for the measurement of plasma concentration of apraglutide were analyzed using a validated analytical method in compliance with applicable standard operating procedures.

Area Under the Concentration-time Curve From Time Zero to Infinity (AUCinf) of Apraglutide
5 minutes pre-dose up to 240 hours after dosing on Day 1

PK samples collected for the measurement of plasma concentration of apraglutide were analyzed using a validated analytical method in compliance with applicable standard operating procedures.

Secondary Endpoints

Participants who achieve clinical response in actual weekly PS volume (at least 20% reduction from baseline) at both Week 20 and Week 24.
At both Week 20 and Week 24
Participants who achieve a reduction of PS days per week (categorical) from baseline at Week 24.
At Week 24
Participants who achieve a reduction of at least 1 PS day per week from baseline at Week 24.
At Week 24
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
ActiveEXPERIMENTALApraglutide subcutaneous (SC) injections, once weekly
PlaceboPLACEBO_COMPARATORPlacebo SC injections, once weekly
Apraglutide subcutaneous (SC) injections, once weeklyEXPERIMENTALPeptide analogue of Glucagon-like Peptide 2 (GLP-2)
Apraglutide SC injections, once weeklyEXPERIMENTALPeptide analogue of GLP-2
ApraglutideEXPERIMENTALAll participants received apraglutide administered subcutaneously (SC) once weekly for 52 weeks.
Single SC dose of 5 mg from DCSEXPERIMENTAL -
Two concomitant single SC doses of 2.5 mg from DCSEXPERIMENTAL -
Single SC dose of 5 mg from vialACTIVE_COMPARATOR -
Apraglutide SC injectionsEXPERIMENTAL -
Part 1: Moderate hepatic impairmentEXPERIMENTALChild-Pugh B
Part 1: Normal hepatic functionEXPERIMENTAL -
Part 2: Mild hepatic impairmentEXPERIMENTALChild-Pugh A
Severe Renal ImpairmentEXPERIMENTALeGFR (mL/min/1.73 m2): \<30 not on hemodialysis
Normal Healthy MatchEXPERIMENTALeGFR (mL/min/1.73 m2): ≥90
Moderate Renal ImpairmentEXPERIMENTALeGFR (mL/min/1.73 m2): ≥30 to 60
Mild Renal ImpairmentEXPERIMENTALeGFR (mL/min/1.73 m2): ≥60 to 90

Interventions

NameTypeDescription
ApraglutideDRUGApraglutide is a synthetic peptide analogue of glucagon-like peptide-2 (GLP-2), which acts as a full agonist at the GLP-2 receptor with in vitro potency and selectivity comparable with native GLP-2. Participants will be administered or will self-administer a weekly SC injection of apraglutide.
PlaceboDRUGParticipants will be administered or will self-administer a weekly single SC injection of placebo in the matching injection volumes.
AcetaminophenDRUGAcetaminophen mixed with a liquid meal
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites94

Inclusion Criteria: * Participant must be ≥18 years of age, at the time of signing the informed consent. * Male and female participants with SBS-IF, receiving PS secondary to surgical resection of the small intestine with residual length ≥10 cm to \<200 cm from duodeno-jejunal flexure, based on ava...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilCanadaCzechiaDenmarkFranceGermanyHungaryIsraelItalyJapanNetherlandsPolandSouth KoreaSpainTaiwanThailandUnited KingdomNorwaySwedenSlovakia
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Competitive Landscape -Short Bowel Syndrome 8 trials

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Recent Changes (Last 90 Days)

LOWAug 4, 2026NCT07742735startDate: changed
LOWAug 4, 2026NCT07742735startDate: changed
LOWAug 3, 2026NCT07742735NEW_TRIAL: changed

Frequently asked questions about Apraglutide

What is Apraglutide used for?

Apraglutide is an investigational drug being studied for Short Bowel Syndrome (SBS), including SBS associated with intestinal failure (SBS-IF), as well as for Chronic Kidney Disease and Hepatic Impairment. It is also used in clinical trials involving healthy subjects to evaluate its pharmacokinetics and effects.

What does Apraglutide target?

Apraglutide targets the glucagon-like peptide-2 receptor (GLP-2R). It is a peptide-based small molecule being developed by Ironwood Pharmaceuticals. Its mechanism involves acting on this receptor, which is relevant to its studied indications, particularly Short Bowel Syndrome.

Who makes Apraglutide?

Apraglutide is being developed by Ironwood Pharmaceuticals, Inc., a biopharmaceutical company traded on NASDAQ under the ticker IRWD. The company is conducting clinical trials to evaluate the drug's safety and efficacy across several indications.

What phase is Apraglutide in?

Apraglutide is in Phase 3 clinical development for Short Bowel Syndrome associated with intestinal failure (SBS-IF), based on an ongoing trial. It has also completed Phase 1 studies in healthy subjects and in individuals with hepatic impairment. It remains investigational and is not yet approved.

What clinical trials is Apraglutide in?

Apraglutide is being studied in a Phase 3 trial (NCT07742735) for Short Bowel Syndrome with intestinal failure, which is currently recruiting. Completed Phase 1 trials include NCT06002555 and NCT05995704 in healthy subjects, and NCT05706623 in subjects with hepatic impairment.

Is Apraglutide the same as other names?

Apraglutide is the drug name used in clinical trials and by its developer, Ironwood Pharmaceuticals. No alternative names have been established in the available clinical trial records, so it is referred to solely as Apraglutide in the studies listed.