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TD-9855

Phase 3

Attention-Deficit/Hyperactivity Disorder | Small molecule | Psychiatry |Theravance Biopharma, Inc.|Trials Updated: Sep 5, 2025

TD-9855 development status

Highest phase Phase 3 (NCT04095793)
Phase scored for TBPHPhase 2
Registered trials 9 across 1 sponsor since Oct 2011

TD-9855 target and mechanism

Molecular targetnorepinephrine
Target classNorepinephrine Reuptake Inhibitor
ModalitySmall molecule

Also known as TD-9855 Group 1, TD-9855 Group 2, Ampreloxetine

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLED
Total Trials8
Total Enrollment1,127

FDA Designations

No designations recorded

TD-9855 clinical trials

TD-9855 · 8 trials · 15 indications

Phase 3 2Phase 2 3Phase 1 3
NCT05696717Phase 3 Efficacy and Durability of Ampreloxetine for the Treatment of Symptomatic nOH in Participants With Multiple System AtrophySymptomatic Neurogenic Orthostatic Hypotension
ACTIVE NOT_RECRUITING102 Analytics
NCT03750552Clinical Effect of Ampreloxetine (TD-9855) for Treating Symptomatic nOH in Subjects With Primary Autonomic FailureSymptomatic Neurogenic Orthostatic Hypotension
COMPLETED195 Analytics
PHASE3ACTIVE NOT_RECRUITING
Phase 3 Efficacy and Durability of Ampreloxetine for the Treatment of Symptomatic nOH in Participants With Multiple System Atrophy
Symptomatic Neurogenic Orthostatic HypotensionUnlock trial analytics
PHASE3COMPLETED
Clinical Effect of Ampreloxetine (TD-9855) for Treating Symptomatic nOH in Subjects With Primary Autonomic Failure
Symptomatic Neurogenic Orthostatic HypotensionUnlock trial analytics

Study Endpoints

Primary Endpoints

Change in OHSA composite score at Week 8 during the double-blind RW period
8-week randomized withdrawal period (Week 12 to Week 20)

Score change from baseline on the composite of Questions 1 - 6 of the Orthostatic Hypotension Symptom Assessment (OHSA).

Change From Baseline in Orthostatic Hypotension Symptom Assessment (OHSA) Question #1 Score at Week 4
Baseline and Week 4

OHSA is an assessment of the severity of symptoms from low blood pressure. OHSA is a 6 question symptom assessment scale where each question uses an 11 point scale from 0 to 10, with 0 indicating no symptoms/no interference and 10 indicating the worst possible symptoms/complete interference. Question #1 assesses dizziness, lightheadedness, feeling faint, or feeling like you might blackout. A mean negative change from baseline indicates a better outcome.

Part A: Change From Time-matched Placebo in Seated Systolic Blood Pressure (SBP)
7 hours post-dose on Day 1 (Placebo dosing) and on each of Days 2 to 5 (TD-9855 dosing)

Placebo referred to the Day 1 visit, and the change from placebo referred to the time-matched difference from each TD-9855 dosing day (Days 2 through 5) relative to placebo dosing (Day 1).

Part B: Change From Baseline in Seated SBP
Baseline and 7 hours post-dose on Day 1

Baseline was defined as the pre-dose measurement on Day 1 of Part B.

Part C: Change From Baseline in Likert Scale Score at Week 4
Baseline to Week 4

The Likert Scale is question 1 of the Orthostatic Hypotension Symptom Assessment (OHSA). The question asks participants to rate the severity of their orthostatic hypotension symptoms (dizziness, lightheadedness, feeling faint, or feeling like you might black out) on an 11-point scale from 0 to 10, with 0 indicating no symptoms/no interference and 10 indicating the worst possible symptoms/complete interference. A higher score indicates a worse outcome. Baseline was defined as the pre-lunch measurement on Day -1.

Percentage Change in Pain Score Based on the Mean of the Last 7 Daily Pain Numeric Rating Scale (NRS) Scores From the Daily Pain Diaries
Baseline and Week 6

Pain NRS score is based on an 11-point scale where 0 represents no pain and 10 represents the worst possible pain.

Change From Baseline in AISRS Total Score at Day 42
Baseline and Day 42

The AISRS is a modified version of the ADHD Rating Scale that more accurately reflects the impact and severity of ADHD among adults. It is a clinician-administered scale that measures all 18 symptoms of adult ADHD using a Likert scale from 0 (not present) to 3 (severe). The total score ranges from 0 to 54 with a negative change from baseline indicating an improvement in severity/reduction in symptoms.

QTcF
Days -1, 1, 7, 8, 14 and 15

Change in QTcF from baseline

Plasma AUC0-t
Plasma AUC0-t will be measured Day 1 to Day 15

Estimation of Area under the concentration-time curve, from time zero to the last measured time point

Plasma AUC0-inf
Plasma AUC0-inf will be measured from Day 1 to Day 15

Estimation of AUC from time zero extrapolated to infinity

Plasma Cmax
up to Day 21

Estimation of maximum observed plasma concentration

To define the routes and rates of elimination and mass balance of [14C]-labeled TD-9855
1-21 Days

Urinary and fecal recovery of total radioactivity. Whole blood and plasma concentrations of total radioactivity.

Secondary Endpoints

Change from baseline in OHDAS item 1 (activities that require standing for a short time) at Week 8 post randomization
8-week randomized withdrawal period (Week 12 to Week 20)
Change from baseline in OHDAS item 3 (activities that require walking for a short time) at Week 8 post randomization
8-week randomized withdrawal period (Week 12 to Week 20)
Change From Baseline in Orthostatic Hypotension Symptom Assessment (OHSA) Composite Score at Week 4
Baseline and Week 4
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Ampreloxetine (Open Label)ACTIVE_COMPARATORParticipants will receive ampreloxetine as a single, oral, daily dose of active drug for 12 weeks.
Ampreloxetine (Randomized Withdrawal)PLACEBO_COMPARATORAfter completing the open label, participants are randomized to either ampreloxetine or placebo receiving a single, oral, daily dose of active drug or placebo for a further 8 weeks.
Long-Term Extension PeriodACTIVE_COMPARATORParticipants will receive ampreloxetine as a single, oral, daily dose of active drug for 104 weeks.
ampreloxetineEXPERIMENTALParticipants randomized to ampreloxetine will receive a single, oral, daily dose of active drug for 4 weeks.
PlaceboPLACEBO_COMPARATORParticipants randomized to Placebo will receive a single, oral, daily dose of placebo for 4 weeks.
TD-9855 Part AEXPERIMENTALSubjects will receive placebo and escalating single doses of TD-9855
TD-9855 Part BEXPERIMENTALSubjects will receive a single dose of TD-9855 or placebo.
TD-9855 Part CEXPERIMENTALSubjects will receive once daily doses of TD-9855 for up to 5 months as part of an optional outpatient open-label extension arm.
TD-9855 Group 1EXPERIMENTALGroup 1 to be dosed with TD-9855
TD-9855 Group 2EXPERIMENTALGroup 2 to be dosed with TD-9855
TD-9855 Dose 1EXPERIMENTAL -
TD-9855 Dose 2EXPERIMENTAL -
Group 1aACTIVE_COMPARATORDay 1: Single dose of Moxifloxacin Placebo; Day 1 - Day 15: Single daily dose of Ampreloxetine Placebo; Day 15: Single dose of Moxifloxacin \<Dose A\>
Group 1bACTIVE_COMPARATORDay 1: Single dose of Moxifloxacin \<Dose A\>; Day 1 - Day 15: Single daily dose of Ampreloxetine Placebo; Day 15: Single dose of Moxifloxacin Placebo
Group 2 - TreatmentEXPERIMENTALDay 1: Single dose of Moxifloxacin Placebo; Day 1 - Day 7: Single daily dose of Ampreloxetine \<Dose A\>; Day 8 - Day 14: Single daily dose of Ampreloxetine \<Dose B\>; Day 15: Single dose of Moxifloxacin Placebo; Day 15: Single dose of Ampreloxetine Placebo;
Normal Hepatic FunctionEXPERIMENTALAmpreloxetine Dose A single dose administration to subjects with normal hepatic function
Mild Hepatic FunctionEXPERIMENTALAmpreloxetine Dose A single dose administration to subjects with mild hepatic impairment
Moderate Hepatic FunctionEXPERIMENTALAmpreloxetine Dose A single dose administration to subjects with moderate hepatic impairment
Severe Hepatic FunctionEXPERIMENTALAmpreloxetine Dose A single dose administration to subjects with severe hepatic impairment
TD-9855EXPERIMENTAL -

Interventions

NameTypeDescription
AmpreloxetineDRUGOral tablet, QD
PlaceboDRUGOral tablet, QD
TD-9855DRUGAdministered orally.
TD-9855 Group 1DRUG -
TD-9855 Group 2DRUG -
Ampreloxetine <Dose A>DRUGAmpreloxetine \<Dose A\> will be administered as 1 tablet of \<Dose A\> and 3 tablets of Ampreloxetine Placebo.
Ampreloxetine <Dose B>DRUGAmpreloxetine \<Dose B\> will be administered as 4 tablets of \<Dose A\>
Ampreloxetine PlaceboDRUGAmpreloxetine Placebo will be administered as 4 tablets of placebo. The placebo tablet will match (in appearance) the ampreloxetine \<Dose A\> tablet.
MoxifloxacinDRUGMoxifloxacin will be administered orally as a single tablet.
Moxifloxacin PlaceboDRUGMoxifloxacin placebo will be administered orally as a single tablet. The placebo tablet will match (in appearance) the moxifloxacin tablet.
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Eligibility Criteria

Age Range30 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites79

Inclusion Criteria: * Participant is male or female and at least 30 years old. * Participant has a diagnosis of possible or probable MSA of the Parkinsonian subtype (MSA-P) or cerebellar subtype (MSA-C) according to The Gilman Criteria (2008). * Participant has a diagnosis of possible or probable M...

Countries:United StatesArgentinaAustraliaAustriaBrazilCanadaDenmarkEstoniaFranceGermanyHungaryIsraelItalyNew ZealandPolandPortugalSerbiaSpainTaiwanUnited KingdomBulgariaRussiaUkraine
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Frequently asked questions about TD-9855

What is TD-9855?

TD-9855 is an investigational small molecule developed by Theravance Biopharma, Inc. (TBPH). It has been studied in clinical trials for attention-deficit/hyperactivity disorder, fibromyalgia, and neurogenic orthostatic hypotension. It is not an approved product and remains in clinical development.

What does TD-9855 target?

TD-9855 targets norepinephrine reuptake. It is a norepinephrine reuptake inhibitor, meaning it acts on norepinephrine signaling. This target class underlies its study in psychiatric and autonomic conditions such as ADHD, fibromyalgia, and neurogenic orthostatic hypotension.

Who makes TD-9855?

TD-9855 is developed by Theravance Biopharma, Inc., which trades under the ticker TBPH. The company sponsored the clinical studies of TD-9855, including Phase 1 and Phase 2 trials conducted in the United States.

What phase is TD-9855 in?

TD-9855 is in Phase 1 development. It is investigational and has not been approved by the FDA. Completed studies include Phase 1 and Phase 2 trials, and no active trials are currently listed for TD-9855.

What clinical trials is TD-9855 in?

TD-9855 has been studied in completed trials including NCT02705755 in neurogenic orthostatic hypotension, NCT01924143, a mass balance study, NCT01693692 in fibromyalgia, and NCT01458340 in adults with ADHD. These trials are completed and no active trials are listed.

Is TD-9855 the same as TD-9855 Group 1 or TD-9855 Group 2?

Yes. TD-9855 Group 1 and TD-9855 Group 2 are alternative names used for TD-9855, which is developed by Theravance Biopharma, Inc. (TBPH). Searches for any of these names refer to the same investigational norepinephrine reuptake inhibitor.