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Apraglutide

Phase 3

Short Bowel Syndrome | Small molecule | Gastrointestinal |Ironwood Pharmaceuticals, Inc.|Last Updated: Jul 10, 2025

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 · 7 trials · 4 indications

Phase 3 2Phase 2 1Phase 1 4
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
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

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

Relative change from baseline in actual weekly PS volume at Week 24.
At week 24 of treatment
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

Change from baseline in PS volume
From baseline to week 208
Change from baseline in PS frequency
From baseline to week 208
Clinically significant changes in PS total energy
From baseline to week 208
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Apraglutide subcutaneous (SC) injections, once weeklyEXPERIMENTALPeptide analogue of Glucagon-like Peptide 2 (GLP-2)
Apraglutide SC injections, once weeklyEXPERIMENTALPeptide analogue of GLP-2
PlaceboPLACEBO_COMPARATORPlacebo for apraglutide, SC injection once weekly
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 GLP-2 under development for treatment of SBS-IF, which acts as a full agonist at the GLP-2 receptor with in vitro potency and selectivity comparable with native GLP-2
PlaceboDRUGMatching placebo to apraglutide
AcetaminophenDRUGAcetaminophen mixed with a liquid meal
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites66

Inclusion Criteria: 1. Males and females with a diagnosis of SBS-IF secondary to surgical resection of the small intestine, with Colon-in-Continuity (CIC) or stoma, who were trial subjects of parent trials TA799-007 or TA799-013 2. Able to give informed consent and agree to follow the details of pa...

Countries:United StatesArgentinaBelgiumCzechiaDenmarkFranceGermanyHungaryIsraelItalyJapanNorwayPolandSouth KoreaSpainSwedenTaiwanUnited KingdomNetherlandsSlovakia
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Competitive Landscape -Short Bowel Syndrome 9 trials

Frequently asked questions about Apraglutide

What is Apraglutide used for?

Apraglutide is an investigational peptide being studied for Short Bowel Syndrome, a condition where the intestine cannot absorb enough nutrients. It is also being evaluated in clinical trials involving healthy subjects, Hepatic Impairment, and Chronic Kidney Disease. The drug is in clinical development and has not been approved by the FDA.

What does Apraglutide target?

Apraglutide is a peptide-based drug, classified under the -tide (peptide) target class. It is being studied for its effects in Short Bowel Syndrome and other conditions. The specific molecular target is not disclosed in the available information.

Who makes Apraglutide?

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

What phase is Apraglutide in?

Apraglutide is in Phase 3 clinical development for Short Bowel Syndrome, with an active open-label extension trial. It has also completed Phase 1 studies in Chronic Kidney Disease and Hepatic Impairment, and a Phase 2 study in Short Bowel Syndrome. The drug is investigational and not yet approved.

What clinical trials is Apraglutide in?

Apraglutide has been studied in several clinical trials, including NCT04699032 (Phase 1, Chronic Kidney Disease), NCT04964986 (Phase 2, Short Bowel Syndrome), NCT05018286 (Phase 3, Short Bowel Syndrome, active), and NCT05706623 (Phase 1, Hepatic Impairment). These trials assess pharmacokinetics, safety, and long-term outcomes.

Is Apraglutide the same as any other drug?

Apraglutide is a distinct investigational peptide drug developed by Ironwood Pharmaceuticals. No alternative names for Apraglutide have been reported in the available clinical trial information. It is being studied under its own name across multiple trials for Short Bowel Syndrome and other conditions.