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Sisunatovir

Phase 2

Respiratory Syncytial Virus Infection | Small molecule | Infectious Disease |Pfizer, Inc.|Trials Updated: Jul 31, 2025

Sisunatovir development status

Highest phase Phase 2 (NCT06079320)
Phase scored for PFEPhase 1
Registered trials 12 across 1 sponsor since Aug 2017

Sisunatovir target and mechanism

ModalitySmall molecule

Also known as RV521, PF-07923568, RV521 oral tablet

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLED
Total Trials7
Total Enrollment152

FDA Designations

No designations recorded

Sisunatovir clinical trials

Sisunatovir · 7 trials · 6 indications

Phase 2 1Phase 1 6
NCT03258502A Study to Learn About the Effects of Multiple Doses of Sisunatovir on People With Respiratory Syncytial Virus (RSV) InfectionRespiratory Syncytial Virus Infections
COMPLETED66 Analytics
PHASE2COMPLETED
A Study to Learn About the Effects of Multiple Doses of Sisunatovir on People With Respiratory Syncytial Virus (RSV) Infection
Respiratory Syncytial Virus InfectionsUnlock trial analytics

Study Endpoints

Primary Endpoints

Change in viral load
Baseline to study day 12
Maximum Observed Plasma Concentration (Cmax) of Sisunatovir on Day 1
0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 48, 72 hours post dose on Day1

Cmax was defined as maximum observed plasma concentration. Cmax was observed directly from data.

Maximum Observed Plasma Concentration (Cmax) of Sisunatovir on Day 4
0, 1, 2, 3, 4, 5, 6, 8, 10, 12 hours post dose on Day 4

Cmax was defined as maximum observed plasma concentration.

Maximum Observed Plasma Concentration (Cmax) of Sisunatovir on Day 8
0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 48, 72 hours post dose on Day 8

Cmax was defined as maximum observed plasma concentration.

Area Under the Plasma Concentration-time Profile From Time Zero to Time 12 Hours (AUC12) of Sisunatovir on Day 1
0, 1, 2, 3, 4, 5, 6, 8, 10, 12 hours post dose on Day1

AUC12 was defined as area under the concentration-time curve from time zero to 12 hours.

Area Under the Plasma Concentration-time Profile From Time Zero to Time 12 Hours (AUC12) of Sisunatovir on Day 4
0, 1, 2, 3, 4, 5, 6, 8, 10, 12 hours post dose on Day 4

AUC12 was defined as area under the concentration-time curve from time zero to 12 hours.

Area Under the Plasma Concentration-time Profile From Time Zero to Time 12 Hours (AUC12) of Sisunatovir on Day 8
0, 1, 2, 3, 4, 5, 6, 8, 10, 12 hours post dose on Day 8

AUC12 was defined as area under the concentration-time curve from time zero to 12 hours.

Area Under the Plasma Concentration-time Profile From Time Zero to the Time of Last Quantifiable Concentration (AUClast) of Sisunatovir on Day1
0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 48, 72 hours post dose on Day1

AUClast was defined as area under the plasma concentration-time profile from time 0 to the time of the last quantifiable concentration.

Area Under the Curve From Time Zero to Extrapolated Infinite Time (AUCinf) on Day1
0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 48, 72 hours post dose on Day1

AUCinf was defined as area under the concentration-time curve from time 0 to infinity.

Maximum Observed Plasma Concentration (Cmax)
Baseline through Day 5
Area Under the Curve From Time Zero to Extrapolated Infinite Time (AUCinf)
Baseline through Day 5
Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast)
Baseline through Day 5
Plasma Maximum Concentration (Cmax) of Sisunatovir Following Administration of a Single Oral Dose
Hours 0, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 96, and 120 postdose from Day 1 to Day 6

Cmax was the highest concentration observed directly from data

Area Under the Plasma Concentration-time Profile From Time Zero to the Time of the Last Quantifiable Concentration (AUClast) of Sisunatovir Following Administration of a Single Oral Dose
Hours 0, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 96, and 120 postdose from Day 1 to Day 6

AUClast was determined using linear/Log trapezoidal method

Area Under the Plasma Concentration-time Profile From Time Zero Extrapolated to Infinite Time (AUCinf) of Sisunatovir Following Administration of a Single Oral Dose
Hours 0, 1, 2, 3, 4, 5, 6, 8, 12, 24, 48, 72, 96, and 120 postdose from Day 1 to Day 6

AUClast + (Clast\*/kel), where Clast\* was the predicted plasma concentration at the last quantifiable time point estimated from the log-linear regression analysis and kel was the terminalphase rate constant.

Number of Participants With Treatment Emergent Adverse Events (TEAEs)
From start of treatment to 28-35 days after last dose (maximum upto 66 days)

An adverse event (AE) is any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. TEAEs were any AEs that occurred following start of treatment.

Number of Participants With Clinical Laboratory Abnormalities: Part 1
Up to Day 5

Laboratory tests included haematology (Monocytes \[10\^9/L\] increase: \> 1.2\* upper limit of normal \[ULN\] and Monocytes/Leukocytes \[percentage\] {%}:\> 1.2\* ULN); clinical chemistry (serum) included Alanine Aminotransferase (units per liter \[U/L\]):\> 3.0\* ULN and Bicarbonate (milliequivalents per liter) (mEq/L): \>1.1\* ULN and in urinalysis (urine Hemoglobin (Scalar) more than equal to (\>=) 1, urine Bilirubin (Scalar) \>= 1, Hyaline Casts (/Low power field \[LPF\]) \>= 1. Number of participants with any clinical laboratory abnormalities is reported in this outcome.

Number of Participants With Newly Occurring Notable Abnormal Vital Signs: Part 1
Up to Day 5

Supine blood pressure (BP) was measured with the participant's arm supported at the level of the heart and recorded after approximately 5 minutes of rest. Pulse rate was measured in the brachial/radial artery. Notable abnormal vital sign categories included: Systolic BP: \<90 millimeter of mercury \[mmHg\]; Systolic BP change from baseline: maximum increase and decrease \>=30 mmHg; Diastolic BP \<50 mmHg; Diastolic BP change from baseline: maximum decrease and increase ≥20 mmHg; pulse rate \<40 and \>120 beats per minute. Number of participants with newly occurring notable abnormal vital sign (i.e. change in supine systolic BP \>=30 millimeter of mercury \[mmHg\] increase) is reported in this outcome measure.

Number of Participants With Clinically Significant Changes in Electrocardiogram (ECG) Findings: Part 1
Up to Day 7

Standard 12-lead ECGs utilizing limb leads were used to measure PR interval, QT interval, QTc corrected using Fridericia's formula (QTcF), and QRS complex. ECG was performed after the participant had rested quietly for at least 5 minutes in a supine position. Clinical significance was determined by the investigator.

Tmax (Time of maximum observed concentration)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

Cmax (Maximum observed concentration)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

AUC0-inf (Area under the concentration-time curve (AUC) extrapolated to infinity)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

AUC0-last (AUC from the time of dosing to the time of the last measurable concentration)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

lambdaz (Rate constant associated with the terminal elimination phase)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

t1/2 (half-life of the terminal elimination phase)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

CL/F (Apparent clearance of the drug from plasma after oral administration)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

Vz/F (Volume of distribution associated with the terminal phase)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

CLR (renal clearance)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

Fe (fraction of administered drug excreted into urine)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

Ae0-t (cumulative amount of 14C excreted into urine from time 0 to the last sampling interval)
Day 1 (time 0) to Day 29

PK parameters of total radioactivity and RV521 following a single oral administration of \[ 14C\]-RV521 to healthy male subjects

Ae0-t (Cumulative amount of 14C excreted into urine and feces from time 0 to the last sampling interval (in units of mass-equivalents/g))
Day 1 (time 0) to Day 29

Mass balance parameters in urinary and fecal excretion of radioactivity

Aet (Amount of 14C excreted into urine and feces per sampling interval (in units of mass-equivalents/g))
Day 1 (time 0) to Day 29

Mass balance parameters in urinary and fecal excretion of radioactivity

Fet (Fraction of 14C excreted into urine and feces per sampling interval (in units of %))
Day 1 (time 0) to Day 29

Mass balance parameters in urinary and fecal excretion of radioactivity

Fe0-t (Cumulative fraction of 14C excreted into urine or feces from time 0)
Day 1 (time 0) to Day 29

Mass balance parameters in urinary and fecal excretion of radioactivity

14C associated with % of AUC of the total in plasma
Day 1 (time 0) to Day 29

Metabolite Profiling and Identification

14C associated with % of administered dose of the total in urine and feces
Day 1 (time 0) to Day 29

Metabolite Profiling and Identification

Time to maximum plasma concentration (tmax) for RV521
Baseline to study day 11
Terminal half life (t1/2) for RV521
Baseline to study day 11
Maximum observed plasma concentration (Cmax) for RV521
Baseline to study day 11
Area under the plasma concentration-time curve from time zero to last detectable plasma concentration (AUC0-t) for RV521
Baseline to study day 11
Area under the plasma concentration-time curve from time zero to infinity (AUC0-inf) for RV521
Baseline to study day 11

Secondary Endpoints

Time to Reach Cmax (Tmax) on Day 1, Day 4 and Day 8
0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 48, 72 hours post dose on Day1, and Day 8. 0, 1, 2, 3, 4, 5, 6, 8, 10, 12 hours post dose on Day 4.
Terminal Elimination Half-life (t½) on Day 1 and Day 8
0, 1, 2, 3, 4, 5, 6, 8, 10, 12,14, 24, 48, 72 hours post dose on Day1, and Day 8
Accumulation Ratio for Sisunatovir (Rac)
0, 1, 2, 3, 4, 5, 6, 8, 10, 12 hours post dose on Day 4 and Day 8
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
RV521EXPERIMENTALRV521 drug substance in capsule for oral administration
PlaceboPLACEBO_COMPARATORMicro-crystalline cellulose in capsule for oral administration
Arm 1EXPERIMENTALThis only arm will be given as a single dose on Day 1 in a fasted state followed by repeated twice daily doses (200 mg BID, Q12 hours) from Days 4-7 plus 1 morning dose on Day 8 in a fed state
Cohort 1: Severe Renal ImpairmentEXPERIMENTALParticipants with severe renal impairment will receive a single oral dose of PF-07923568
Cohort 2: Normal Renal FunctionEXPERIMENTALParticipants with normal renal function will receive a single oral dose of PF-07923568
Cohort 3 (Optional): Moderate Renal ImpairmentEXPERIMENTALParticipants with moderate renal impairment will receive a single oral dose of PF-07923568
Healthy subjectsEXPERIMENTALOne time dose of 4 capsules taken orally.
Mild Hepatic impaired subjectsEXPERIMENTALOne time dose of 4 capsules taken orally.
Moderate hepatic impaired subjectsEXPERIMENTALOne time dose of 4 capsules taken orally
Severe Hepatic Impaired SubjectsEXPERIMENTALOne time dose of 4 capsules taken orally.
Group A: Higher dose sisunatovirEXPERIMENTALhigher dose of sisunatovir dosed every 12 hours
Group B: Lower dose sisunatovirEXPERIMENTALLower dose of sisunatovir dosed every 12 hours
Group C: PlaceboPLACEBO_COMPARATORPlacebo for sisunatovir dosed every 12 hours
Group D: Higher dose of sisunatovirEXPERIMENTALHigher dose of sisunatovir dosed every 12 hours under fasted conditions
Group E: sisunatovir palatabilityEXPERIMENTALSisunatovir in 4 vehicles (water, saline, apple juice, infant formula) to assess the palatability of sisunatovir in each vehicle. sisunatovir will not be swallowed, participants will swirl and spit to assess various aspects of the taste.
200 mg RV521/78 µCi [ 14C]-RV521EXPERIMENTAL200 mg RV521/78 µCi \[ 14C\]-RV521

Interventions

NameTypeDescription
RV521DRUGRV521 drug in capsules
PlaceboDRUGPlacebo in capsules
SisunatovirDRUGWill be given as a single dose on Day 1 in a fasted state followed by repeated twice daily doses (200 mg BID, Q12 hours) from Days 4-7 plus 1 morning dose on Day 8 in a fed state
Drug: PF-07923568DRUGA single dose of PF-07923568 administered orally as 4 capsules
PF-07923568DRUGOne time dose of 4 capsules taken orally.
200 mg RV521/78 µCi [ 14C]-RV521.DRUG200 mg RV521/78 µCi \[ 14C\]-RV521
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Eligibility Criteria

Age Range18 Years to 45 Years
SexALL
Healthy VolunteersYes
Study Sites1

Inclusion Criteria: * Age 18 to 45 years, inclusive * In good health with no history of major medical conditions * A total body weight ≥ 50 kg and a body mass index (BMI) of \>/=18kg/m2 and \</=30kg/m2 Exclusion Criteria: * Evidence of any clinically significant or currently active major medical ...

Countries:United KingdomChinaUnited StatesBelgium
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Frequently asked questions about Sisunatovir

What is Sisunatovir used for?

Sisunatovir is an investigational small molecule being developed for the treatment of respiratory syncytial virus infection. It is not yet approved for any indication and remains in clinical development. The completed Phase 1 studies enrolled healthy adult volunteers rather than patients with active RSV disease.

Who is developing Sisunatovir?

Sisunatovir is being developed by Pfizer, Inc., which trades on the New York Stock Exchange under the ticker PFE. Pfizer holds the development program for this small molecule antiviral candidate targeting respiratory syncytial virus infection.

What phase is Sisunatovir in?

Sisunatovir is in Phase 1 clinical development. Two Phase 1 studies have been completed, one in China and one in Belgium, and both enrolled healthy adult volunteers. No later-phase trials in patients with respiratory syncytial virus infection have been reported for this candidate.

What clinical trials is Sisunatovir in?

Sisunatovir has been studied in two completed Phase 1 trials. NCT05987072 evaluated how the study medicine is tolerated and acts in the bodies of Chinese healthy adults. NCT05712460 assessed the safety, effects, and palatability of sisunatovir in healthy adult participants in Belgium. Both trials enrolled 12 participants each.

Is Sisunatovir FDA approved?

Sisunatovir is not approved. It is an investigational small molecule still in Phase 1 clinical development for respiratory syncytial virus infection. The completed studies were early-stage trials in healthy volunteers, which is consistent with a candidate that has not yet advanced to regulatory review.