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Selatogrel

Phase 3

Acute Myocardial Infarction | Small molecule | Cardiovascular |Viatris Inc.|Last Updated: Jul 29, 2026

Target and mechanism

Molecular targetP2RY12
Target classAntagonist
ModalitySmall molecule

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials2
Total Enrollment25,048

FDA Designations

No designations recorded

Clinical trial landscape

Selatogrel · 7 trials · 6 indications

Phase 3 1Phase 2 2Phase 1 4
NCT04957719Selatogrel Outcome Study in Suspected Acute Myocardial InfarctionAcute Myocardial Infarction
ENROLLING BY_INVITATION25,000 Analytics
PHASE3ENROLLING BY_INVITATION
Selatogrel Outcome Study in Suspected Acute Myocardial Infarction
Acute Myocardial InfarctionUnlock trial analytics

Study Endpoints

Primary Endpoints

Clinical status as assessed by a 6-point ordinal scale
Total duration: up to 7 days

The clinical status will be assessed using a 6-point ordinal scale after any study treatment self-administration. Only the worst clinical outcome will be retained as the primary efficacy outcome. The 6 mutually exclusive outcomes ranked from worst to best are: 1. Death (all causes), within 7 days after study treatment administration. 2. Acute myocardial infarction with compromised electro-hemodynamics, within 2 days after study treatment administration. 3. ST-Elevation Myocardial Infarction (STEMI), within 2 days after study treatment administration. 4. High-risk Non-ST-Elevation Myocardial Infarction (NSTEMI), within 2 days after study treatment administration. 5. NSTEMI with peak cardiac troponin greater than 10 times upper limit of normal, within 2 days after study drug administration. 6. None of the above

Occurrence of Type 3 or 5 treatment-emergent bleeding events according to the Bleeding Academic Research Consortium (BARC) definition
Total duration: up to 2 days

The number of: * Type 3 treatment-emergent bleeding events and * Type 5 treatment-emergent bleeding events will be assessed according to the Bleeding Academic Research Consortium (BARC) definition (Mehran et al. 2011), within 2 days after study treatment administration. The Bleeding Academic Research Consortium (BARC) definitions are: * Type 3, bleeding is divided into 3 categories, a through c, and includes clinical, laboratory, and/or imaging evidence of bleeding with specific healthcare provider responses. * Type 5, bleeding is fatal.

Number of Participants With a Pharmacodynamic Response as Assessed by the Inhibition of Platelet Aggregation
30 minutes after the administration of the subcutaneous injection

The pharmacodynamic response was determined by measuring the inhibition of platelet aggregation, using the VerifyNow® assay. The VerifyNow® is a point-of-care test measuring platelet reactivity. The results are expressed as P2Y12 reaction units (PRU).The target of 100 PRU corresponds to 80% inhibition of ADP-induced platelet aggregation. A participant with a PRU less than 100 at 30 minutes post-dose was counted as a participant that had a pharmacodynamic response.

Area under the plasma concentration-time curve from zero to time t of the last measured concentration above the limit of quantification (AUC0-t)
Up to 36 hours post-dose

The plasma selatogrel PK parameters will be derived by non compartmental analysis of the concentration-time profiles

Area under the plasma concentration-time curve from zero to infinity (AUC0-infinity)
Up to 36 hours post-dose

The plasma selatogrel PK parameters will be derived by non compartmental analysis of the concentration-time profiles

Maximum plasma concentration (Cmax)
Up to 36 hours post-dose

The measured individual plasma concentrations of selatogrel will be used to directly obtain Cmax

Time to reach maximum plasma concentration (tmax)
Up to 36 hours post-dose

The measured individual plasma concentrations of selatogrel will be used to directly obtain tmax

Terminal half-life (t1/2)
Up to 36 hours post-dose

The plasma selatogrel PK parameters will be derived by non compartmental analysis of the concentration-time profiles

Area under the plasma concentration-time curve (AUC0-t) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
The area under the plasma concentration-time curve from zero to infinity (AUC0-inf) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
The maximum plasma concentration (Cmax) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
Time to reach Cmax (tmax)
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
Terminal half-life (t½) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
Area under the plasma concentration-time curves (AUC0-t) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
The apparent clearance (CL/F) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
The apparent volume of distribution (Vz/F) of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose) up to Day 3.
Plasma protein binding of selatogrel
Multiple pharmacokinetic sampling at predefined times on Day 1 (pre-dose and post-dose).

Secondary Endpoints

Occurrence of death, non-fatal acute myocardial infarction, hospitalization or unplanned emergency department visit for heart failure (Composite endpoint)
Total duration: up to 30 days
Maximum Selatogrel Plasma Concentration (Cmax)
Pre-dose, and from 15 minutes after administration of the subcutaneous injection up to 24 hours
Time to Reach Maximum Selatogrel Plasma Concentration (Tmax)
Pre-dose, and from 15 minutes after administration of the subcutaneous injection up to 24 hours
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
SelatogrelEXPERIMENTALStudy treatment administration may occur at any time between the randomization visit and the final study visit when the participant experiences symptoms suggestive of an acute myocardial infarction. Study treatment administration triggers protocol pre-defined assessments or visits.
PlaceboPLACEBO_COMPARATORStudy treatment administration may occur at any time between the randomization visit and the final study visit when the participant experiences symptoms suggestive of an acute myocardial infarction. Study treatment administration triggers protocol pre-defined assessments or visits.
Selatogrel 8 mgEXPERIMENTALSelatogrel (ACT-246475) is given as a single subcutaneous dose of 8 mg administered in a volume of 0.8 mL. Administration will be performed at the investigational site by qualified personnel.
Selatogrel 16 mgEXPERIMENTALSelatogrel (ACT-246475) is given as a single subcutaneous dose of 16 mg administered in a volume of 0.8 mL. Administration will be performed at the investigational site by qualified personnel.
Treatment A: liquid formulation via auto-injectorEXPERIMENTALSelatogrel will be administered as a liquid formulation in a sealed prefilled syringe in an auto-injector forming an integral ready-to-use single-dose drug delivery system.
Treatment B: liquid formulation via syringeEXPERIMENTALSelatogrel will be administered as a liquid formulation in a sealed prefilled syringe.
Treatment C: lyophilizate-based formulation via syringeEXPERIMENTALSelatogrel will be administered as a reconstituted lyophilizate-based formulation for injection.
Participants with mild hepatic impairment (Group 1)EXPERIMENTALParticipant with Child-Pugh Grade A Score of 5-6.
Participants with moderate hepatic impairment (Group 2)EXPERIMENTALParticipant with moderate hepatic impairment with a Child-Pugh Grade B Score of 7-9.
Healthy participants (Group 3)EXPERIMENTAL -

Interventions

NameTypeDescription
SelatogrelCOMBINATION_PRODUCTSelatogrel is a reversible P2Y12 receptor antagonist for subcutaneous administration. Selatogrel will be administered as a liquid formulation in a sealed prefilled syringe in an autoinjector forming an integral ready-to-use, single-dose drug delivery system. Participants will self-administer 16 mg of selatogrel subcutaneously with the autoinjector upon occurrence of symptoms suggestive of an acute myocardial infarction. Self-administration encompasses the use of the autoinjector by another person (e.g., partner, close relative, friend, caregiver) who may be called for help during the emergency situation of a suspected AMI.
PlaceboCOMBINATION_PRODUCTPlacebo will be administered as a liquid formulation in a sealed prefilled syringe in an autoinjector forming an integral ready-to-use, single-dose drug delivery system. Participants will self-administer placebo subcutaneously with the autoinjector upon occurrence of symptoms suggestive of an acute myocardial infarction. Self-administration encompasses the use of the autoinjector by another person (e.g., partner, close relative, friend, caregiver) who may be called for help during the emergency situation of a suspected AMI.
Selatogrel 8 mgDRUGSelatogrel is a reversible P2Y12 receptor antagonist for subcutaneous administration. It is supplied in sealed glass vials at a strength of 20 mg. The vials with ACT-246475A (hydrochloride salt of ACT-246475) will be reconstituted with 1 mL of water and further diluted with 1 mL sodium chloride (NaCl) 0.9%.
Selatogrel 16 mgDRUGSelatogrel is a reversible P2Y12 receptor antagonist for subcutaneous administration. It is supplied in sealed glass vials at a strength of 20 mg. The vials with ACT-246475A (hydrochloride salt of ACT-246475) will be reconstituted with 1 mL of water for injection.
Matching placeboCOMBINATION_PRODUCTA single dose of placebo will be administered as a liquid formulation from a sealed prefilled syringe in an autoinjector forming an integral ready-to-use, single-dose drug delivery system.
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites821

Main Inclusion Criteria: * Confirmed diagnosis of symptomatic type 1 acute myocardial infarction (AMI) ST-Elevation Myocardial Infarction (STEMI) or Non-ST-Elevation Myocardial Infarction (NSTEMI), no longer than 4 weeks prior to randomization. * Diagnosis of multivessel coronary artery disease def...

Countries:United StatesAustraliaAustriaBelgiumBrazilBulgariaCanadaChileChinaCroatiaCzechiaDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIndiaIsraelItalyJapanLatviaLithuaniaMalaysiaNetherlandsNew ZealandNorwayPhilippinesPolandPortugalRomaniaSerbiaSlovakiaSouth AfricaSouth KoreaSpainSwedenSwitzerlandTaiwanThailandTurkey (Türkiye)United Arab EmiratesUnited KingdomSingapore
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Recent Changes (Last 90 Days)

MEDIUMAug 29, 2026NCT03384966TRIAL_REMOVED: changed
MEDIUMAug 29, 2026NCT03487445TRIAL_REMOVED: changed
MEDIUMAug 29, 2026NCT03487445TRIAL_REMOVED: changed
MEDIUMAug 29, 2026NCT03384966TRIAL_REMOVED: changed
MEDIUMAug 29, 2026NCT03487445TRIAL_REMOVED: changed
MEDIUMAug 29, 2026NCT03384966TRIAL_REMOVED: changed
MEDIUMAug 14, 2026NCT07133191TRIAL_REMOVED: changed
MEDIUMAug 14, 2026NCT07133191TRIAL_REMOVED: changed
MEDIUMAug 14, 2026NCT07133191TRIAL_REMOVED: changed
MEDIUMJul 24, 2026NCT04957719primaryCompletionDate: changed
MEDIUMJul 24, 2026NCT04957719primaryCompletionDate: changed
LOWJul 14, 2026NCT07615868Status: NOT_YET_RECRUITING → RECRUITING
LOWJul 14, 2026NCT04957719lastUpdatePostDate: changed
LOWJul 14, 2026NCT07615868Status: NOT_YET_RECRUITING → RECRUITING
LOWJul 14, 2026NCT04957719lastUpdatePostDate: changed

Frequently asked questions about Selatogrel

What is Selatogrel used for?

Selatogrel is an investigational small molecule being studied for use in acute myocardial infarction (heart attack), stable coronary artery disease, and chronic coronary syndrome. It is also studied in healthy subjects and volunteers for research purposes. The drug is in Phase 3 clinical development for suspected acute myocardial infarction.

How does Selatogrel work?

Selatogrel is a small molecule that targets the P2Y12 receptor on platelets, inhibiting platelet aggregation. By blocking this receptor, it reduces the ability of platelets to clump together and form clots, which is relevant in acute myocardial infarction and other cardiovascular conditions.

Who is developing Selatogrel?

Selatogrel is being developed by Viatris Inc., a pharmaceutical company traded on the NASDAQ under the ticker symbol VTRS. The company is conducting clinical trials to evaluate the drug's safety and efficacy for cardiovascular indications.

What phase is Selatogrel in?

Selatogrel is in Phase 3 clinical development. The most advanced trial, NCT04957719, is a Phase 3 outcome study in suspected acute myocardial infarction with an enrollment of 25,000 participants. Earlier Phase 1 and Phase 2 studies have been completed.

What clinical trials is Selatogrel in?

Selatogrel has been studied in several clinical trials. NCT04957719 is a Phase 3 outcome study in suspected acute myocardial infarction, currently enrolling by invitation. Completed trials include NCT03487445 (Phase 2 in acute myocardial infarction), NCT04406896 (Phase 1 in hepatic impairment), and NCT04557280 (Phase 1 in healthy subjects).

Is Selatogrel the same as ACT-246475?

Yes, Selatogrel is also known as ACT-246475. Clinical trial records reference both names, with NCT03487445 titled 'A Medical Research Study to Evaluate the Effects of ACT-246475 in Adults With Heart Attack' and other studies using the name Selatogrel.