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C21

Phase 3

COVID-19 | Small molecule | Infectious Disease |Vicore Pharma Holding AB American Depositary Shares|Last Updated: May 23, 2025

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials2
Total Enrollment478

FDA Designations

No designations recorded

Clinical trial landscape

C21 · 6 trials · 7 indications

Phase 3 1Phase 2 3Phase 1 2
NCT04880642A Trial to Investigate Recovery From COVID-19 With C21 in Adult SubjectsCOVID-19
COMPLETED272 Analytics
PHASE3COMPLETED
A Trial to Investigate Recovery From COVID-19 With C21 in Adult Subjects
COVID-19Unlock trial analytics

Study Endpoints

Primary Endpoints

All-cause Mortality up to Day 60
Day 1 to Day 60

Proportion of subjects in the mITT (all randomised, including 5 subjects not treated) with death up to Day 60 follow-up

Number of Participants With Adverse Events Occurring Over the Trial Period
Trial period of 36 weeks

Number of participants with adverse events occurring over the trial period incl. number of participants with any TEAE, serious TEAEs, TEAEs leading to withdrawal from trial, TEAEs leading to discontinuation of treatment, treatment-related TEAEs leading to discontinuation of treatment, TEAEs leading to death, and serious treatment-related TEAEs. Adverse events were recorded from signing of informed consent until end of trial. Nature and frequency of adverse events are presented in details in the adverse events section.

Change From Baseline in C-reactive Protein (CRP) After Treatment With C21 200 mg Daily Dose (100 mg b.i.d.)
Treatment period of 7 days (Day 1 to Day 8)

Change in C-reactive protein (CRP) from baseline to the average of the last two assessments in the treatment period

Area Under the Curve for Rewarming of Each Finger After Cold Challenge (AUC) as Measured by Thermography
For 15 min after cold challenge (40-55 min after IMP [investigational manufacturing product] administration)

Area under the curve for rewarming of each finger after cold challenge as measured by thermography for 15 min

Pharmacodynamic Effect
Maximum 15 days after first Investigational Medical Product (IMP) intake.

Reactive hyperemia index (RHI) score as measured by EndoPAT (Endothelial pulse amplitude tonometry (PAT)). The EndoPAT software, provided with the device, is calculating the RHI using a computerised, automated algorithm. Reactive Hyperemia Index (RHI) score is a post-to-pre occlusion pulse amplitude tonometry signal ratio in the occluded arm relative to the same ratio in the control arm, and corrected for baseline vascular tone. RHI is a measure of endothelial function. Normal value: RHI \> 1.67. Abnormal value: RHI ≤ 1.67. There is no theoretical minimum and/or maximum values for the RHI score. A lower RHI score following C21 compared to placebo is the desired outcome.

Percentage Change From Baseline in Forearm Blood Flow in Response to Increasing Intraarterial Doses of C21
85 minutes

Percentage change from baseline in forearm blood flow (FBF) in response to increasing intraarterial doses of C21 (3, 10, 30, 100, and 200 μg/min)

Secondary Endpoints

Time to Sustained Hospital Discharge up to Day 60
Day 1 to Day 60
Supplemental Oxygen-free Days up to Day 29
Day 1 to Day 29, maximum 28 Days
Proportion of Subjects Free of Respiratory Failure, Defined as an 8-point Ordinal Scale Score ≤5, at Day 15
Day 15
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
C21EXPERIMENTAL50 mg capsules, oral administration twice daily,for 14 days
PlaceboPLACEBO_COMPARATORplacebo capsules, oral administration twice daily,for 14 days
C21 100 mg twice dailyEXPERIMENTALOral C21 treatment 100 mg twice daily for 7 days
C21 followed by placeboEXPERIMENTAL -
Placebo followed by C21EXPERIMENTAL -
Treatment arm 1EXPERIMENTALA single dose of C21 at visit 2 followed by a single dose of placebo at visit 3.
Treatment arm 2EXPERIMENTALA single dose of placebo at visit 2 followed by a single dose C21 at visit 3.
C21 combinedEXPERIMENTAL15 µg C21 (infusion rate 3 µg/min) 50 µg C21 (infusion rate 10 µg/min) 150 µg C21 (infusion rate 30 µg/min) 500 µg C21 (infusion rate 100 µg/min) 1000 µg C21 (infusion rate 200 µg/min)
Positive controlEXPERIMENTAL4 µg nitroprusside (infusion rate 0.8 µg/min) 8 µg nitroprusside (infusion rate 1.6 µg/min) 16 µg nitroprusside (infusion rate 3.2 µg/min)

Interventions

NameTypeDescription
C21DRUGC21
PlaceboDRUGPlacebo
Sodium NitroprussideDRUGAscending doses of 4, 8 and 16 µg sodium nitroprusside Positive control
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites60

Inclusion Criteria: 1. Age ≥18 years or the legal age of consent in the jurisdiction in which the trial was taking place at the time of signing the informed consent (Specific for India; Age ≥18 to ≤65 years at the time of signing the informed consent) 2. Hospitalized due to SARS-CoV-2 infection con...

Countries:United StatesArgentinaBrazilColombiaCzechiaIndiaPhilippinesRussiaSouth AfricaUkraineUnited KingdomSweden
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Frequently asked questions about C21

What is C21 used for?

C21 is an investigational small molecule being studied for several conditions, including COVID-19, idiopathic pulmonary fibrosis, Raynaud phenomenon, type 2 diabetes, and endothelial dysfunction. It has been evaluated in clinical trials for its safety, efficacy, and vasodilatory effects. The drug is not approved and remains in clinical development.

Who makes C21?

C21 is being developed by Vicore Pharma Holding AB, a biopharmaceutical company listed on the stock exchange under the ticker VCRE. The company is conducting clinical trials to evaluate the drug's safety and efficacy in various patient populations.

What phase is C21 in?

C21 is currently in Phase 3 clinical development. It has completed Phase 2 trials for COVID-19 and idiopathic pulmonary fibrosis, as well as Phase 1 trials for vasodilatory effects and type 2 diabetes. The drug is investigational and has not been approved by regulatory authorities.

What clinical trials is C21 in?

C21 has been studied in several completed clinical trials, including NCT04452435 for COVID-19, NCT04533022 for idiopathic pulmonary fibrosis, NCT05277922 for vasodilatory effects, and NCT05831644 for type 2 diabetes and endothelial dysfunction. These trials were randomized, double-blind, and placebo-controlled.

Is C21 the same as Vicore Pharma's other drugs?

C21 is a distinct investigational drug developed by Vicore Pharma. It is not the same as other drugs in the company's pipeline. The drug has been evaluated in clinical trials for multiple indications, including COVID-19 and idiopathic pulmonary fibrosis, and is currently in Phase 3 development.