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ACZ885

Phase 3

Acute Gouty Arthritis Flares | Small molecule | Metabolic |Novartis AG|Last Updated: Jan 13, 2026

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Trial Design

UNCONTROLLEDDMC
Total Trials1
Total Enrollment136

FDA Designations

No designations recorded

Clinical trial landscape

ACZ885 · 14 trials · 17 indications

Phase 3 5Phase 2 5Phase 1 4
NCT02296424ß-SPECIFIC 4 Patients: Study of Pediatric EffiCacy and Safety wIth FIrst-line Use of CanakinumabSystemic Juvenile Idiopathic Arthritis (SJIA)
COMPLETED182 Analytics
NCT01576367Efficacy, Safety and Tolerability of ACZ885 in Pediatric Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory DiseaseCryopyrin-associated Periodic Syndromes
COMPLETED17 Analytics
NCT01470989β-RELIEVED - REsponse in Acute fLare and In prEVEntion of episoDes of Re-flare in Gout - Extension 3 (E3)Acute Gouty Arthritis Flares
COMPLETED136 Analytics
NCT01302860Efficacy, Safety and Tolerability of ACZ885 in Pediatric Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory DiseaseCryopyrin-associated Periodic Syndromes
COMPLETED17 Analytics
NCT00465985Efficacy, Safety, and Tolerability of ACZ885 in Patients With Muckle-Wells SyndromeMuckle Wells Syndrome
COMPLETED35 Analytics
PHASE3COMPLETED
ß-SPECIFIC 4 Patients: Study of Pediatric EffiCacy and Safety wIth FIrst-line Use of Canakinumab
Systemic Juvenile Idiopathic Arthritis (SJIA)Unlock trial analytics
PHASE3COMPLETED
Efficacy, Safety and Tolerability of ACZ885 in Pediatric Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory Disease
Cryopyrin-associated Periodic SyndromesUnlock trial analytics
PHASE3COMPLETED
β-RELIEVED - REsponse in Acute fLare and In prEVEntion of episoDes of Re-flare in Gout - Extension 3 (E3)
Acute Gouty Arthritis FlaresUnlock trial analytics
PHASE3COMPLETED
Efficacy, Safety and Tolerability of ACZ885 in Pediatric Patients With the Following Cryopyrin-associated Periodic Syndromes: Familial Cold Autoinflammatory Syndrome, Muckle-Wells Syndrome, or Neonatal Onset Multisystem Inflammatory Disease
Cryopyrin-associated Periodic SyndromesUnlock trial analytics
PHASE3COMPLETED
Efficacy, Safety, and Tolerability of ACZ885 in Patients With Muckle-Wells Syndrome
Muckle Wells SyndromeUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants in Clinical Remission on Canakinumab Who Are Able to Remain at an Initial Reduced Canakinumab Dose or Prolonged Canakinumab Dose Interval.
baseline to 24 weeks

The primary efficacy variable for Part II was the proportion of patients in clinical remission on canakinumab 4 mg/kg (+/- concomitant NSAID only) who were able to remain on a reduced dose or on prolonged dose interval for at least 24 consecutive weeks. As the primary objective was to show statistically significance in at least one of canakinumab treatment arms (reduced dose and prolonged dose interval arms) in Part II then the Type I error rate 5% was controlled and split to 2.5%. Clinical remission per protocol is defined as the maintenance of inactive disease for at least 6 months (24consecutive weeks) while on therapy. The primary analysis considered both inactive disease status and the patient dose step duration. In the event the inactive disease status was missing, yet the patient remained at the same dose level through the next visit with the same disease status, it was concluded that inactive disease was maintained during this time period and was carried forward.

The Percentage of Participants Without Disease Relapse as Determined by the Physician's Global Assessment of Autoinflammatory Disease Activity, Assessment of Skin Disease and Serological Inflammation Markers.
Week /80, 104, 128, and 152 (A minimum of 6 months and maximum of 24 months)

Disease relapse following complete response is defined as inflammation markers: C-Reactive Protein (CRP) and/or Serum Amyloid A (SAA) result \> 30 mg/L AND Physician's Global Assessment of Autoinflammatory Disease Activity \> minimal or Physician's Global Assessment \>= minimal AND Skin Disease Assessment \> minimal. Physician's Global Assessment of Autoinflammatory Disease Activity and Skin Disease Assessment (urticarial skin rash) are completed by the investigator using a 5 point rating scale: absent, minimal, mild, moderate and severe.

Number of Incidence Rate (IR) of Adverse Events, Serious Adverse Events and Death Per 100 Patient-years in Participants
From start of the core studies (CACZ885H2357 [NCT01080131] and CACZ885H2361 [NCT01356602]) up to end of the current study (36 weeks)

Adverse events (AEs) were defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline,or, if present at baseline, appears to worsen. Serious adverse events (SAEs) were defined as any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgement of investigators represent significant hazards.

Percentage of Participants Aged 4 Years or Younger With at Least One Complete Response at Week 56
Week 56

Complete response was defined as clinical remission and serological remission. Clinical remission was defined as Physician global assessment of auto-inflammatory disease activity as absent or minimal (using a 5-point scale ranging from absent to severe) and assessment of skin disease as absent or minimal (using a 5-point scale ranging from absent to severe). Serological remission was defined as C reactive protein (CRP) or Serum amyloid A protein (SAA) to be less than (\<) 15 milligram per liter (mg/L) and \<10 mg/L respectively.

Percent of Participants With Disease Flare in Part II (After 24 Weeks of the Double-blind Part)
32 weeks after study start

Determined by the Physician's global assessment of autoinflammatory disease activity, assessment of skin disease and inflammation markers. Data expressed as a percent of participants who had experienced a flare by the end of Part II.

Number of Participants Who Experienced a Disease Flare in Part II
32 weeks after study start

Disease flare is determined by the Physician's global assessment of autoinflammatory disease activity, assessment of skin disease and inflammation markers. Disease Flare = the C-reactive protein and/or serum amyloid A (SAA) \> 30 mg/L and either a PGA \> minimal, or PGA equal to minimal and \> minimal SD.

Change From Baseline of 4- Week Average Daily Pain Measured by Visual Analog Score (VAS) Over the Period of Week 8 to 12
Baseline (upto 28 days prior to start of treatment), Week 8 to 12

Visual analog scale (VAS) was used to record severity. Pediatric and young adult participants rated their daily sickle cell associated pain intensity once each day in the evening using an 11-point numerical rating scale from 0 to 10 with higher ratings associated with more intense pain (0 = no pain, 10 = worst pain). For each subject, there was a maximum 28-day screening period that included recording of daily pain intensity by e-diary for at least 1 week. The average daily pain results in the screening period were used to derive the baseline value. The average over week 8 to 12 was calculated and the change from baseline in the average daily pain VAS was analyzed using a Bayesian model for repeated measures.

Change Between Baseline and Week 24 in Pulmonary Function as Measured by Spirometry
Baseline, Week 24

To compare the effect of ACZ885 versus placebo in the change between baseline and week 24 in pulmonary function as measured by spirometry (Predicted Forced Vital Capacity).

Percentage of Participants With Complete or Almost Complete Response at Day 15
Day 15

Complete response was defined as clinical remission and serological remission. Clinical remission was defined as Physician's Global Assessment of TRAPS activity absent or minimal and serological remission was defined as C reactive protein (CRP) and/or Serum amyloid A protein (SAA) to be less than (\<) 10 milligram per liter (mg/L). Almost complete response was defined as clinical remission and a partial serological remission (equal to or more than \[≥\] 70% reduction of baseline CRP and/or SAA).

Number of Participants With Adverse Events, Serious Adverse Events and Death
12 months

Participants were monitored for adverse events, serious adverse events and death throughout the study.

Change From Baseline in Aortic Distensibility
baseline, 3 months, 12 months

Two axial, ECG-gated, steady state free precession (SSFP) 'cine' images were acquired during breath-hold to determine aortic distensibility. The first image was obtained at the level of the right pulmonary artery through the ascending and proximal descending aorta and the second through the distal aorta below the diaphragm. Imaging of the aorta also enabled evaluation of the plaque burden and additional vascular function measures.

Change From Baseline in Plaque Burden (Aortic Vessel Wall Area and Carotid Vessel Wall Area)
baseline, 3 months, 12 months

For assessment of atherosclerotic plaque burden of the aorta, vessel wall images of the aorta were acquired with an ECG gated double-inversion recovery (black blood) fast spin echo sequence applied breath-holding. Using an oblique sagittal image of the aorta as a pilot, serial axial images were acquired to cover a section of the descending thoracic aorta. The midpoint of the right pulmonary artery in cross section was used as the anatomical reference for the first slice in baseline and follow-up scans. For assessment of the atherosclerotic plaque burden in the carotids, vessel wall images were acquired with an axial ECG gated PD (proton density) weighted black blood sequence. The carotid bifurcation was used as the anatomical reference for all three imaging time points (baseline, 12 weeks, 48 weeks) with axial slice planes acquired below the bifurcation region. The mean values reported here for the carotid are reported for the proximal common carotid region.

Response to Treatment (ACR20) in Adult Patients With Established Rheumatoid Arthritis (RA)
6 weeks and 12 weeks

At each post-dose visit, an ACR20 responder was defined as someone who achieved at least 20% improvement in the tender and the swollen 28-joint count, and 20% improvement in at least 3 of the following 5 measures:: * Patient's pain assessment (Visual Analogue Scale (VAS) 100 mm) * Patient's global assessment of disease activity (VAS 100 mm) * Physician's global assessment of disease activity (VAS 100 mm) * Patient self-assessed disability (Health Assessment Questionnaire (HAQ) score) * Acute phase reactant (high sensitivity C-reactive Protein (hsCRP))

Safety and tolerability
Safety, tolerability and immunogenicity of subcutaneous (s.c.) ACZ885
To assess the initial efficacy profile of s.c. ACZ885: % responder to treatment and time to relapse and control the systemic manifestations of SJIA such as fever.
pharmacokinetics of ACZ885
To assess pharmacokinetics (PK) / pharmacodynamics (PD) relationships in order to derive a dose and dosing regimen
Rates of adverse events and serious adverse events, as well as changes in ophthalmic evaluations, laboratory values, electrocardiograms (ECGs) and vital signs over 6 months, following single intravenous infusion of ACZ885.
Adverse events and infections occurrence throughout the study.
throughout the study
Presence of anti-ACZ885 antibodies in serum at baseline, Days 43, 71 and end of study (Day 113).
throughout the study

Secondary Endpoints

Number and Percentage of Patients With Adverse Events as a Measure of Long-term Safety and Tolerability of Canakinumab - PART 1
During study parts I and II. The estimated study duration is not more than 216 weeks (with an average expected duration of 108 weeks).
Number and Percentage of Patients With Adverse Events as a Measure of Long-term Safety and Tolerability of Canakinumab - PART 2
During study parts I and II, estimated study duration was not more than 216 weeks (with an average duration of 108 weeks).
Immunogenicity of Canakinumab (ACZ885). Number of Participants With Anti-canakinumab Antibodies
minimum of 6 months and maximum of 24 months
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Canakinumab Dose ReductionEXPERIMENTALAll patients received canakinumab 4mg/kg (300 mg max) every 4 weeks in Part I of the study. Patients eligible for Part II of the study were randomized to one of two treatment arms. This is Treatment Arm 1 in Part II of the study: Canakinumab was administered at a reduced dose (2 mg/kg every 4 weeks). If the patient continued to maintain inactive disease for 24 additional weeks, canakinumab was administered at 1mg/kg every 4 weeks. If the patient continued to maintain inactive disease for another 24 additional weeks, canakinumab treatment was discontinued.
Canakinumab Dose Interval ProlongationEXPERIMENTALAll participants received canakinumab 4mg/kg (300 mg max) every 4 weeks in Part I of the study. Patients eligible for Part II of the study were randomized to one of two treatment arms. This is Treatment Arm 2 in Part II of the study: Canakinumab dose interval was prolonged to a regimen of 4mg/kg every 8 weeks. If the patient continued to be stable with inactive disease for 24 additional weeks, canakinumab dose interval was prolonged to a regimen of 4mg/kg every 12 weeks. If the patient was clinically stable with inactive disease for another 24 additional weeks, canakinumab treatment was discontinued.
canakinumabEXPERIMENTALPatients will receive a standard dose at an equivalent of 2 mg/kg s.c. of canakinumab (ACZ885) every 8 weeks. Possible dose and/or dosing regimen adjustments that can be administered include: 4 mg/kg s.c. (every 4 to 8 weeks) 6 mg/kg s.c. (every 4 to 8 weeks) 8 mg/kg s.c. (every 4 to 8 weeks)
Part I, Part II-arm1, & Part IIIEXPERIMENTAL -
Part II - arm 2PLACEBO_COMPARATOR -
PlaceboPLACEBO_COMPARATORMonthly doses of 4 mg/kg for subjects weighing ≤40 kg and 300 mg for all other subjects
ACZ885EXPERIMENTALMonthly doses of 300 mg (4 mg/kg for patients ≤ 40 kg) canakinumab s.c.
1EXPERIMENTALACZ885
2PLACEBO_COMPARATOR -

Interventions

NameTypeDescription
ACZ885 150 mg (Canakinumab)DRUGActive canakinumab in individual 2 mL glass vials, each containing 150 mg canakinumab liquid in vial.
ACZ885BIOLOGICAL -
Triamcinolone acetonide 40 mgDRUGParticipants received 40 mg intramuscular (IM)
PlaceboDRUG -
ACZ885 (investigational)DRUGThe ACZ885 was supplied in 6 mL colorless glass vials each containing nominally 150 mg ACZ885 (with 20% overfill). The vials were kept at 2-8°C. At the investigator's site, solutions for infusion were prepared depending on the volume and dose administered.
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Eligibility Criteria

Age Range2 Years to 20 Years
SexALL
Healthy VolunteersNo
Study Sites50

Inclusion Criteria: Cohort 1: • Patients who are receiving canakinumab treatment (4 mg/kg every 4 weeks) for Systemic Juvenile Idiopathic Arthritis (SJIA) and have inactive disease at the last visit in Study CACZ885G2301E1 Cohort 2: * Confirmed diagnosis of SJIA as per International League Again...

Countries:United StatesAustriaBelgiumBrazilCanadaFranceGermanyHungaryIsraelItalyNetherlandsPolandRussiaSpainSwedenTurkey (Türkiye)SwitzerlandUnited KingdomAustraliaEstoniaLatviaLithuaniaUkraineIndiaSouth AfricaIrelandJapan
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Frequently asked questions about ACZ885

What is ACZ885?

ACZ885 is an investigational small molecule being developed by Novartis AG (NVS). It is being studied for multiple conditions including arthritis, juvenile rheumatoid arthritis, type 2 diabetes, sickle cell anemia, systemic juvenile idiopathic arthritis (SJIA), acute gouty arthritis flares, and pulmonary sarcoidosis. It is currently in Phase 3 clinical development.

What does ACZ885 target?

ACZ885 is a small molecule therapeutic developed by Novartis. While its specific molecular target is not disclosed in the available information, it is being investigated for inflammatory and metabolic conditions such as arthritis, type 2 diabetes, and sickle cell anemia. The drug is currently in Phase 3 clinical trials.

Who makes ACZ885?

ACZ885 is developed by Novartis AG, a multinational pharmaceutical company traded on the New York Stock Exchange under the ticker symbol NVS. The drug is currently in Phase 3 clinical development for multiple indications including systemic juvenile idiopathic arthritis and other inflammatory conditions.

What phase is ACZ885 in?

ACZ885 is in Phase 3 clinical development. It has completed two Phase 3 trials, including one in patients with Muckle-Wells Syndrome (NCT00465985) and one in patients with systemic juvenile idiopathic arthritis (NCT02296424). The drug remains investigational and is not yet approved by regulatory authorities.

What clinical trials is ACZ885 in?

ACZ885 has been studied in several clinical trials. Notable completed trials include NCT00465985, a Phase 3 study in patients with Muckle-Wells Syndrome, and NCT02296424, a Phase 3 study in patients with systemic juvenile idiopathic arthritis. Phase 1 trials include NCT00421226 in healthy Japanese male volunteers and NCT00503022 in patients with wet age-related macular degeneration.

Is ACZ885 the same as canakinumab?

ACZ885 is also known as canakinumab. One of its Phase 3 trials, NCT02296424, is titled 'Study of Pediatric EffiCacy and Safety wIth FIrst-line Use of Canakinumab' in patients with systemic juvenile idiopathic arthritis. This confirms that ACZ885 and canakinumab refer to the same drug candidate.