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Atrasentan

Phase 3

IgA Nephropathy | Small molecule | Nephrology |Novartis AG|Last Updated: Jun 4, 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 Trials3
Total Enrollment561
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT04573478Atrasentan in Patients With IgA NephropathyPHASE3 ACTIVE NOT_RECRUITING 404Dec 11, 2020Apr 14, 2028Jun 4, 2026135 United States, Argentina +18
NCT05834738Randomized, Double-blind, Placebo-controlled, Crossover Study of Atrasentan in Subjects With IgA NephropathyPHASE2 COMPLETED 54Jul 20, 2023Oct 29, 2025Jan 30, 202630 United States, Australia +4
NCT04573920Atrasentan in Patients With Proteinuric Glomerular DiseasesPHASE2 ACTIVE NOT_RECRUITING 103Mar 15, 2021Oct 27, 2026Jun 1, 202633 United States, Australia +4
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Study Endpoints
Primary Endpoints
Double-blind period: Change in proteinuria
Up to Week 36 or approximately 9 months

The change in urine protein:creatinine ratio (UPCR) from baseline to Week 36. (non-SGLT2i stratum)

Open-label period: Number of Subjects With Treatment-Emergent Adverse Events (TEAEs)
From open-label baseline up to end of treatment visit, up to 48 weeks

Type, incidence, severity, seriousness, and relatedness of TEAEs.

Open-label period: Number of Subjects With Adverse Events of Special Interest (AESI) Including Events of Fluid Overload
From open-label baseline up to end of treatment visit, up to 48 weeks

Incidence, severity, seriousness, and relatedness AESIs.

Substudy period: Number of subjects with TEAEs
From substudy baseline to end of treatment, up to 48 weeks

Type, incidence, severity, seriousness, and relatedness of TEAEs

Substudy period: Number of subjects with AESI
From substudy baseline to end of treatment, up to 48 weeks

Incidence, severity, seriousness, and relatedness AESIs.

Change From Baseline in Proteinuria at Week 12 in Both Treatment Periods 1 and 2
Baseline and 12 weeks or approximately 3 months

The change in urine protein: creatinine ratio (UPCR) from baseline to Week 12

Change in proteinuria for IgAN, FSGS, and Alport syndrome patients receiving 0.75 mg atrasentan QD
Up to Week 12 or approximately 3 months

The change in urine protein:creatinine ratio (UPCR) from baseline to Week 12

Change in albuminuria for DKD patients
Up to Week 12 or approximately 3 months

The change in urine albumin:creatinine ratio (UACR) from baseline to Week 12

Change in proteinuria for FSGS patients at 1.5 mg dose
Up to Week 24 or approximately 6 months

The change in urine protein:creatinine ratio (UPCR) from baseline to Week 24

Secondary Endpoints
Double-blind period: Change in eGFR
Up to Week 136, 4 weeks post end of treatment
Double-blind period: Percent of subjects meeting the first composite endpoint
Up to approximately 2.6 years
Double-blind period: Percent of subjects meeting the second composite endpoint
Up to approximately 2.6 years
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Study Design & Arms
AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
AtrasentanEXPERIMENTALDouble-blind Period: Once daily oral administration of 0.75 mg atrasentan for 132 weeks. Open-label Extension Period: Once daily oral administration of 0.75 mg atrasentan for 48 weeks after completion of 132 weeks on atrasentan or placebo. Substudy period: Once daily oral administration of 0.75 mg atrasentan + zigakibart for 48 weeks after completion of OL extension period
PlaceboPLACEBO_COMPARATORDouble-blind Period: Once daily oral administration of placebo for 132 weeks
Sequence ABEXPERIMENTALOnce daily oral administration of 0.75 mg atrasentan for 12 weeks (Period A) followed by once daily oral administration of placebo for 24 weeks (Period B)
Sequence BAEXPERIMENTALOnce daily oral administration of placebo for 12 weeks (Period B) followed by once daily oral administration of 0.75 mg atrasentan for 24 weeks (Period A)
Atrasentan 0.75 mgEXPERIMENTALOnce daily oral administration of 0.75 mg atrasentan
Atrasentan 1.5 mgEXPERIMENTALOnce daily oral administration 1.5 mg atrasentan (FSGS cohorts only)
Interventions
NameTypeDescription
AtrasentanDRUGFilm-coated tablet
PlaceboDRUGFilm-coated tablet
ZigakibartDRUGpre-filled syringes with needle safety device
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites135

Inclusion Criteria: Double-Blind period: * Biopsy-proven IgA nephropathy. * Receiving a maximally tolerated dose of RAS inhibitor therapy (ACEi or ARB) that has been stable for at least 12 weeks. Exceptions from this requirement will be made for subjects who are unable to tolerate RAS inhibitor th...

Countries:United StatesArgentinaAustraliaBrazilCanadaChinaColombiaFranceGermanyHong KongIndiaItalyJapanNew ZealandPolandPortugalSouth KoreaSpainTaiwanUnited KingdomMalaysia
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Recent Changes (Last 90 Days)
MEDIUMJun 4, 2026NCT04573478primaryCompletionDate: changed
MEDIUMJun 4, 2026NCT04573478primaryCompletionDate: changed
MEDIUMJun 4, 2026NCT04573478primaryCompletionDate: changed
MEDIUMJun 4, 2026NCT04573478primaryCompletionDate: changed
LOWJun 2, 2026NCT04573920lastUpdatePostDate: changed
LOWJun 2, 2026NCT04573920lastUpdatePostDate: changed
LOWJun 2, 2026NCT04573920lastUpdatePostDate: changed
LOWMay 26, 2026NCT04573920primaryCompletionDate: changed
LOWMay 24, 2026NCT04573478studyFirstPostDate: changed
LOWMay 24, 2026NCT04573920studyFirstPostDate: changed