Recent Updates
Recently added Catalysts

Fitusiran

Phase 3FDA approved 2025

Hemophilia | RNA therapy | Hematology |Sanofi|Trials Updated: Oct 19, 2026

Fitusiran development status

FDA approval Mar 28, 2025 as Qfitlia
Approval holderGenzyme Corp
ApplicationNDA219019
Highest phase Phase 3
Registered trials 7 across 2 sponsors since Jan 2018

Label indication QFITLIA is indicated for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients aged 12 years and older with hemophilia A or B with or without factor VIII or IX inhibitors. FDA label

Fitusiran target and mechanism

Molecular targetSERPINC1
Target classRnai Inhibitor
ModalityRNA therapy

Also known as Fitusiran (SAR439774), SAR439774, Qfitlia™

Success Probability

Subscribe to view

Market & Valuation

Subscribe to view

Trial Design

CONTROLLEDDMC
Total Trials8
Total Enrollment783

FDA Designations

No designations recorded

Fitusiran clinical trials

Fitusiran · 8 trials · 3 indications

Phase 3 6Phase 2 1Phase 1 1
NCT07285460A Study to Investigate the Efficacy and Safety of Fitusiran Prophylaxis in Male Participants Aged 1 to Less Than 12 Years With Hemophilia A or BHemophilia
RECRUITING85 Analytics
NCT05662319A Study to Test a Medicine (Fitusiran) Injected Under the Skin for Preventing Bleeding Episodes in Male Adolescent or Adult Participants With Severe HemophiliaHemophilia
ACTIVE NOT_RECRUITING91 Analytics
NCT03754790Long-term Safety and Efficacy Study of Fitusiran in Patients With Hemophilia A or B, With or Without Inhibitory Antibodies to Factor VIII or IXHemophilia
COMPLETED281 Analytics
NCT03549871A Study of Fitusiran in Severe Hemophilia A and B Patients Previously Receiving Factor or Bypassing Agent ProphylaxisHemophilia
COMPLETED80 Analytics
NCT03417245A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients Without InhibitorsHemophilia A
COMPLETED120 Analytics
NCT03417102A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients With InhibitorsHemophilia A
COMPLETED60 Analytics
PHASE3RECRUITING
A Study to Investigate the Efficacy and Safety of Fitusiran Prophylaxis in Male Participants Aged 1 to Less Than 12 Years With Hemophilia A or B
HemophiliaUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
A Study to Test a Medicine (Fitusiran) Injected Under the Skin for Preventing Bleeding Episodes in Male Adolescent or Adult Participants With Severe Hemophilia
HemophiliaUnlock trial analytics
PHASE3COMPLETED
Long-term Safety and Efficacy Study of Fitusiran in Patients With Hemophilia A or B, With or Without Inhibitory Antibodies to Factor VIII or IX
HemophiliaUnlock trial analytics
PHASE3COMPLETED
A Study of Fitusiran in Severe Hemophilia A and B Patients Previously Receiving Factor or Bypassing Agent Prophylaxis
HemophiliaUnlock trial analytics
PHASE3COMPLETED
A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients Without Inhibitors
Hemophilia AUnlock trial analytics
PHASE3COMPLETED
A Study of Fitusiran (ALN-AT3SC) in Severe Hemophilia A and B Patients With Inhibitors
Hemophilia AUnlock trial analytics

Study Endpoints

Primary Endpoints

Annualized treated bleeding rate (ABR) in the fitusiran primary efficacy period and in the SOC period
Day 85 to Day 421 (fitusiran primary efficacy period); Day -168 to Day -1 (SOC period)

A bleeding episode is defined as any occurrence of hemorrhage that requires administration of CFCs or BPAs

Annualized bleeding rate (ABR) in the fitusiran primary efficacy period
Day 169 to Day 505 (since the first dose of fitusiran)

A bleeding episode is defined as any occurrence of hemorrhage that requires administration of CFCs or BPAs, e.g., hemarthrosis, muscle, or mucosal bleeding.

Number of participants with treatment emergent adverse events (TEAEs)
from study baseline (day 1) up to maximum 88 months

The number of participants experiencing any TEAEs, serious TEAEs, discontinuation due to TEAEs and death will be reported

Estimated Annualized Bleeding Rate (ABR)
Factor/BPA prophylaxis period: Day -168 to Day -1 or up to last day of bleeding follow up (any day up to Day -1); 6-month fitusiran efficacy period: Day 29 to Day 190 or up to last day of bleeding follow up (any day up to Day 190), whichever was earliest

Bleeding episodes (BE): any occurrence of hemorrhage might require administration of factor/BPA. BE start time: time at which 1st BE symptoms develop; bleeding/any symptoms at same location occurred within 72 hours of last injection used to treat BE at that location was considered part of original BE and counted as 1 BE towards ABR. Bleeding began after 72 hours of last injection at that location was considered as a new event. ABR = total number of qualifying BE/total number of days in the respective period\*365.25. Estimated data were derived by using repeated measures negative binomial (NB) regression model.

Observed Annualized Bleeding Rate (ABR)
Factor/BPA prophylaxis period: Day -168 to Day -1 or up to last day of bleeding follow up (any day up to Day -1); 6-month fitusiran efficacy period: Day 29 to Day 190 or up to last day of bleeding follow up (any day up to Day 190), whichever was earliest

A bleeding episode (BE): any occurrence of hemorrhage might require administration of factor/BPA. BE start time: time at which 1st BE symptoms develop; bleeding/any symptoms at same location that occurred within 72 hours of last injection used to treat BE at that location was considered a part of original BE and counted as 1 BE towards ABR. Any bleeding that began after 72 hours of last injection at that location was considered as a new event. ABR = total number of qualifying BE/number of days in the respective period \*365.25.

Estimated Annualized Bleeding Rate (ABR) for Treated Bleeds During the Efficacy Period
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest

ABR for a participant during efficacy period (EP) was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. Treated Bleeding episode: any occurrence of hemorrhage that required administration of by-passing agents (BPA) or factor. It started from first sign of a bleed and ended no more than 72 hours after last treatment for bleed, within which any symptoms of bleeding at same location or injections less than or equal to (\<=) 72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when antithrombin (AT) lowering capacity of fitusiran had achieved therapeutic target range to the earliest of Day 246 or last day of bleeding follow up (maximum duration of EP: from Day 29 to Day 246). This outcome measure (OM) presents estimated results (i.e., results received by applying negative binomial \[NB\] regression model on data collected during EP).

Observed Annualized Bleeding Rate (ABR) for Treated Bleeds During the Efficacy Period
From Day 29 up to Day 246 or up to the last day of bleeding follow up (any day up to Day 246), whichever was the earliest

ABR for a participant during EP was defined as annualized number of bleeding episodes during EP annualized to a 1-year interval of time. ABR= number of bleeding episodes during EP divided by total number of days during EP\*365.25. A bleeding episode was defined as any occurrence of hemorrhage that required administration of BPA or factor. It started from the first sign of a bleed and ended no more than 72 hours after the last treatment for the bleed, within which any symptoms of bleeding at the same location or injections \<=72 hours apart were considered the same bleeding episode. EP was defined as time duration starting from Day 29 when the AT lowering capacity of fitusiran had achieved therapeutic target range to the earliest of Day 246 or the last day of bleeding follow up (maximum duration of EP: from Day 29 to Day 246). This OM presents observed results (i.e., descriptive statistics values based on the data collected during EP).

Plasma antithrombin (AT) activity levels
Day 1 to the AT analysis time point at the optimal therapeutic dose (approximately 256 weeks)

Characterize the AT activity at the optimal therapeutic dose

Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (SAEs)
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An SAE is any untoward medical occurrence that results: death or life-threatening or inpatient hospitalization or prolongation of existing hospitalization or persistent or significant disability or congenital anomaly or medically important event. All AEs collected in LTE14762 were considered TEAE because all participants received dose in the parent study. AEs of special interest (AESI) are alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevations \>3× upper limit of normal (ULN) or suspected or confirmed thromboembolic events or severe or serious injection site reactions or systemic injection associated reactions or cholecystitis or cholelithiasis.

Number of Participants With Potentially Clinically Significant Abnormality (PCSA): Hematology
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

Blood samples were collected to determine the hematology laboratory significant abnormalities. Here, DFB = decrease from baseline, NB = non-black, and B = black.

Number of Participants With Potentially Clinically Significant Abnormality: Clinical Chemistry
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

Blood samples were collected to determine the clinical chemistry laboratory abnormalities. Here, mmol/L = millimoles per liter, LLN = lower limit of normal, mg/L = milligram per liter, umol/L = micromoles per liter, mL/min = milliliter per minute, m\^2 = meter square, CB = conjugated bilirubin, and DB = direct bilirubin.

Number of Participants With Potentially Clinically Significant Abnormality: Urinalysis
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

Urine samples collected to determine the significant abnormalities in urine.

Number of Participants With Potentially Clinically Significant Abnormality: Vital Signs
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

Participants vital signs were examined to determine the abnormalities. Vital signs included weight, supine systolic blood pressure (SSBP) and supine diastolic blood pressure (SDBP). Here, mmHg = millimeter of mercury, and IFB = increase from baseline.

Number of Participants With Potentially Clinically Significant Abnormality: Electrocardiogram (ECG)
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

Standard 12-lead ECGs were recorded after at least 15 minutes in the supine position using an electrocardiographic device. The following were assessed: heart rate, rhythm, interval between the peaks of successive QRS complexes (RR), interval from the beginning of the P wave until the beginning of the QRS complex (PR), interval from start of the Q wave to the end of the S wave (QRS), interval between the start of the Q wave and the end of the T wave (QT), QT interval corrected for heart rate (QTc) automatic correction evaluation, QRS axis, left ventricular hypertrophy criteria, right ventricular hypertrophy criteria, repolarization charges, and overall cardiac impression for each participant. Here, msec = milliseconds.

Number of Participants With Potentially Clinically Significant Abnormality: Physical Examination
From first dose of study drug (Day 1) up to end of the study (SAS 1: up to 76 months and SAS 2: up to 40 months)

Physical examination included, at a minimum, an assessment of the participant's general appearance; skin; head, eyes, ears, nose, and throat; examinations of lymph nodes, abdomen, extremities/joints, neurological and mental status; heart and respiratory auscultation; peripheral arterial pulse; and pupil, knee, achilles, and plantar reflexes.

Secondary Endpoints

Annualized spontaneous bleeding rate (AsBR) in the fitusiran primary efficacy period and in the SOC period
Day 85 to Day 421 (fitusiran primary efficacy period); Day -168 to Day -1 (SOC period)
Annualized joint bleeding rate (AjBR) in the fitusiran primary efficacy period and in the SOC period
Day 85 to Day 421 (fitusiran primary efficacy period); Day -168 to Day -1 (SOC period)
ABR in the fitusiran treatment period (160 weeks) for fitusiran-naïve participants
Day 1 to Day 1121
Unlock Study Endpoints

Study Design & Arms

AllocationNA
MaskingNONE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Fitusiran-naïve armEXPERIMENTALParticipants will go through a 24-week standard of care (SOC) period before receiving a selected dose of fitusiran at regular interval. If a fitusiran dose adjustment is needed during the study, participants will follow a specific dosing regimen as per study protocol.
EFC15647 roll-over armEXPERIMENTALParticipants will continue receiving their current fitusiran dose from EFC15467. If a fitusiran dose adjustment is needed during the study, participants will follow a specific dosing regimen as per study protocol.
All participantsEXPERIMENTALIn standard of care (SOC) period, participants will receive on-demand or prophylactic treatment with clotting factor concentrates (CFCs) or bypassing agents (BPAs) for 6 months (from Day -168 to Day -1). In fitusiran treatment period, participants will receive subcutaneous fitusiran prophylaxis once every other month (Q2M) or once monthly (QM) for 36 months (from Day 1 to Day 1009). In case of bleeding events participants will receive IV CFCs or BPAs. Participants may receive Antithrombin concentrate (ATIIIC) as rescue medicine. .
FitusiranEXPERIMENTALParticipants will be administered fitusiran as a subcutaneous injection once monthly or every other month for up to 48 months post initiation of modified IMP dose/frequency or until fitusiran becomes commercially available, whichever comes first.
Factor On-demandEXPERIMENTALParticipants received on-demand factor concentrates (as needed, for episodic bleeding episodes, and not on a regular regimen intended to prevent spontaneous bleeding) per Investigator discretion for the treatment of breakthrough bleeding episodes from Day 1 up to a total of 9 months.
Fitusiran 80 mg ProphylaxisEXPERIMENTALParticipants received open-label fitusiran 80 milligram (mg) administered subcutaneously (SC) as prophylaxis once monthly from Day 1 up to a total of 9 months. Participants received on-demand factor concentrates (per investigator's discretion and within bleeding dosing guidelines) for the treatment of breakthrough bleeding episodes.
Bypassing Agents (BPA) On-demandACTIVE_COMPARATORParticipants received On-demand BPAs (use of these agents, as needed, for episodic bleeding episodes, and not on a regular regimen intended to prevent spontaneous bleeding) per Investigator discretion from Day 1 for treatment of breakthrough bleeding episodes, up to a total of 9 months.

Interventions

NameTypeDescription
FitusiranDRUGPharmaceutical form: solution for injection in PBS Route of administration: subcutaneous
Clotting factor concentrates (CFC) or bypassing agents (BPA)BIOLOGICALPharmaceutical form: solution for injection Route of administration: intravenous injection
Antithrombin concentrate (ATIIIC)BIOLOGICALPharmaceutical form: solution for injection Route of administration: intravenous injection
BPA prophylaxisDRUGPharmaceutical form: solution for injection Route of administration: Intravenous
Factor (FVIII or FIX) prophylaxisDRUGPharmaceutical form: solution for injection Route of administration: Intravenous
factor concentratesDRUGby intravenous (IV) injection
Bypassing agentsDRUGsolution for injection; by intravenous (IV) injection
Fitusiran (SAR439774)DRUGPharmaceutical form: solution for injection Route of administration : subcutaneous (sc)
Unlock Study Design Details

Eligibility Criteria

Age Range1 Year to 11 Years
SexMALE
Healthy VolunteersNo
Study Sites41

Inclusion Criteria: Participants not previously exposed to fitusiran are eligible to be included in the study only if all of the following criteria apply: * Participant must be 1 to \<12 years of age at the time of enrollment. * Participants must have severe hemophilia A or B (FVIII \<1% or FIX ≤2...

Countries:United StatesBelgiumBrazilCanadaChinaIndiaItalyPolandRomaniaSaudi ArabiaSpainTaiwanTurkey (Türkiye)FranceGermanyGreeceJapanMexicoSouth AfricaSouth KoreaAustraliaDenmarkHungaryIrelandIsraelMalaysiaUkraineUnited KingdomBulgariaRussiaSwitzerland
Unlock Eligibility Criteria

Recent Changes (Last 90 Days)

LOWOct 19, 2026NCT07285460lastUpdatePostDate: changed
LOWOct 19, 2026NCT07285460lastUpdatePostDate: changed
LOWOct 19, 2026NCT07285460lastUpdatePostDate: changed
HIGHSep 30, 2026NCT03754790Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHSep 30, 2026NCT03754790Status: ACTIVE_NOT_RECRUITING → COMPLETED
LOWSep 28, 2026NCT03974113Phase: PHASE3 → PHASE2
LOWSep 28, 2026NCT03974113Phase: PHASE3 → PHASE2
HIGHSep 8, 2026NCT03974113Status: ACTIVE_NOT_RECRUITING → COMPLETED
HIGHSep 8, 2026NCT03974113Status: ACTIVE_NOT_RECRUITING → COMPLETED
LOWAug 17, 2026NCT07285460lastUpdatePostDate: changed
LOWAug 17, 2026NCT07285460lastUpdatePostDate: changed

Frequently asked questions about Fitusiran

What is Fitusiran used for?

Fitusiran is an investigational RNA therapy being developed for hemophilia, including hemophilia A. It is studied as a prophylactic treatment to prevent bleeding episodes in people with hemophilia A or B, including those with or without inhibitory antibodies to factor VIII or IX. It is given by subcutaneous injection.

What does Fitusiran target?

Fitusiran targets SERPINC1, the gene encoding antithrombin. As an RNAi inhibitor, it is designed to reduce antithrombin production, which is intended to increase thrombin generation and support clot formation in patients with hemophilia. This mechanism is independent of factor VIII or factor IX replacement.

Who is developing Fitusiran?

Fitusiran is developed by Sanofi, which trades under the ticker SNY. The drug is also referred to as SAR439774 in company documentation. Sanofi is running the clinical development program for fitusiran across hemophilia A and hemophilia B populations, including pediatric and adult participants.

What phase is Fitusiran in?

Fitusiran is in Phase 3 clinical development. It is investigational and has not been approved by the FDA. The program includes Phase 3 studies in pediatric, adolescent, and adult males with hemophilia A or B, along with a completed Phase 2 pediatric study.

What clinical trials is Fitusiran in?

Fitusiran trials include NCT07285460, a recruiting Phase 3 study in boys aged 1 to under 12 with hemophilia A or B, and NCT05662319, an active Phase 3 study in adolescents and adults with severe hemophilia. Completed studies include the Phase 3 long-term study NCT03754790 and the Phase 2 pediatric study NCT03974113.

Is Fitusiran the same as SAR439774?

Yes, fitusiran is also known as SAR439774. SAR439774 is Sanofi's internal compound designation for the same investigational RNA therapy. Both names refer to the subcutaneous RNAi therapeutic targeting SERPINC1 that is being studied for bleeding prevention in hemophilia A and hemophilia B.