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Last Updated: December 15, 2025

CLINICAL TRIALS PROFILE FOR ARCALYST


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All Clinical Trials for ARCALYST

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00897715 ↗ Inflammation in Chronic Kidney Disease and Cardiovascular Disease - The Role of Genetics and Interleukin-1 Receptor Antagonist (IL-1ra) Completed VA Office of Research and Development Phase 2 2013-01-01 There has been an exponential growth in the number of people with Chronic Kidney Disease (CKD) needing dialysis or transplantation, increasing from 209,000 in 1991 to 472,000 in 2004. This is highly concerning due to both the human cost and the burden that it represents to the health care system. Recent comparison of the NHANES surveys showed that CKD prevalence increased from 10% in 1988-1994 to 13% in 1999-2004. Patients with CKD are more likely to die from premature cardiovascular death than to reach ESRD. In those that reach ESRD, cardiovascular disease (CVD) accounts for over half of the deaths in dialysis. The prevalence of CKD for the VA population is 20%, and 31.6% for diabetics, higher than in the general population. These observations emphasize the need of risk stratification, early detection, and prevention efforts with respect to CKD progression and the CVD burden that afflicts CKD through targeted interventions in high-risk groups (personalized medicine). CKD is multifactorial, however familial aggregation of end-stage renal disease (ESRD) and CKD have been reported for all types of nephropathy underscoring "kidney disease genetic susceptibility ". Genetic predisposition to ESRD is stronger in African Africans. African Americans with a first-degree relative with ESRD have a 9-fold increase risk of ESRD vs. a 3-5 fold increase in whites. Studies consistently show that CKD is an inflammatory process and that biomarkers of inflammation increase since early stages of CKD. CVD is also an inflammatory process, and genes that affect inflammation are associated with higher risk of CVD. Since inflammation is a common denominator of both disease processes (CKD and CVD), it is likely that genes that govern inflammation may be involved in both, the predisposition to CKD and the burden of CVD attributable to CKD. Additionally if inflammation plays a central role in the burden of CVD in CKD than drugs that modulate inflammation should impact both: CKD progression and non-traditional CV risk factors and CVD. The overall goal of this proposal is to study genetic predisposition to CKD, and CVD risk in CKD through inflammatory pathways, and the effect that a potent anti-inflammatory intervention like interleukin 1 receptor antagonist (IL-1ra), will have in inflame patients with CKD stages 3&4. Specific Aims: 1) To determine if specific polymorphism/haplotypes, genotype combinations and gene-environmental interactions that can affect inflammation, available from the Third National Health and Nutrition Examination Survey (DNA data set), specifically in the CRP,IL-1, IL-10 and TNF- genes, are associated with CKD. 2) To determine if the specific polymorphisms and haplotypes studied in Aim 1 are associated with faster CKD progression and CV outcomes in a longitudinal cohort from the African American Study of Kidney Disease. 3)To determine if a targeted anti-inflammatory intervention, an IL-1 receptor antagonist, will modulate systemic inflammation, endothelial function, oxidative stress and urinary cytokines, the proposed surrogate markers of CVD and CKD progression in inflame patients with CKD stages 3&4.
NCT01045772 ↗ Safety and Tolerability of Rilonacept in Muckle-Wells Syndrome (MWS) or Schnitzler Syndrome (SchS) Completed Charite University, Berlin, Germany Phase 2 2009-01-01 This is a single-center open label study of the IL-1 transfusion protein rilonacept in subjects with Muckle-Wells syndrome (MWS), or Schnitzler syndrome (SchS) in Germany. Prospective subjects will be recruited from a patient population previously characterized in an observational study, and from referrals within the German CAPS community; SchS subjects will be recruited through the Charité Patient pool. The Baseline phase will begin with the Screening visit (day -21 = Visit 1) and continue for three weeks; DHAFs (Daily Health Assessment Forms) will be collected from all subjects from Day - 21 to Day 0. DHAF information including MWAS (Muckle-Wells Activity Score), or SCHAS (Schnitzler Activity Score) values from this period will be used for the baseline phase evaluation. Inclusion to receive rilonacept will occur on day 0 (= Visit 2). On day 0 eligible subjects will receive a loading dose of two subcutaneous (S.C.) injections of rilonacept for a total of 320 mg. Subsequent study drug injections of rilonacept 160 mg will be administered once a week for four weeks. After subjects complete this initial 4-week treatment phase, they will be eligible to receive rilonacept 160 mg once weekly for 48 weeks during the extended treatment phase. DHAFs will be used to assess symptoms throughout the study. Overall a max. of 12 subjects with either MWS or SchS will be enrolled.
NCT01211977 ↗ A Pilot Study of XOMA 052 in Familial Cold Autoinflammatory Syndrome / Muckle-Wells Syndrome and Behcet's Disease Withdrawn National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 1/Phase 2 2010-08-27 Background: - Autoinflammatory diseases are illnesses that produce episodes of inflammation such as fever, rash, or joint swelling. Some of these diseases can be treated with medications that block the body's reaction to a protein called IL-1, which may be part of the cause of the inflammation. IL-1 blocking agents are very helpful in treating autoinflammatory diseases and have become the standard of care for treatment for some of these diseases. However, more research is needed on related diseases that may be treated with new and currently used IL-1 blocking agents. - XOMA 052 is an experimental drug that is currently being tested as a possible treatment for type 2 diabetes. Initial studies have shown that XOMA 052 neutralizes a specific kind of IL-1, and is also active against certain indicators of inflammation. Researchers are interested in determining whether XOMA 052 can be used to treat autoinflammatory and related diseases. Objectives: - To determine the effectiveness of XOMA 052 as a treatment for inflammation in adults with the autoinflammatory diseases Familial Cold Autoinflammatory Syndrome (FCAS)/Muckle-Wells Syndrome (MWS) and Behcet's Disease. Eligibility: - FCAS/ MWS: Individuals at least 18 years of age who have a known history of the typical disease. - Behcet's Disease: Individuals at least 18 years of age who have evidence of active disease, such as oral or genital ulcers or eye disease. Design: FCAS/MWS Participants - Participants will have an overnight evaluation of their disease, including optional tests (e.g., eye or skin exams). Participants who currently take medications to treat their symptoms will stop taking the medication and will be monitored by study researchers. At the first flare of symptoms, participants will begin to receive XOMA 052. - Participants will have further tests on days 3, 7, and 10 after the initial dose of XOMA 052. If the disease remains under good control, participants will have a clinical exam every 5 days for up to 10 weeks until another disease flare occurs (determined either by symptoms or by inflammation observed in laboratory studies). If the disease is not well controlled with the initial dose of XOMA 052, participants will have additional doses starting at day 7 until either the disease is controlled or researchers determine that the medication is not effective. - Participants will have the option to continue XOMA 052 treatments for up to 1 year. XOMA 052 wil...
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ARCALYST

Condition Name

Condition Name for ARCALYST
Intervention Trials
Schnitzler Syndrome 1
Autoimmune Neurosensory Hearing Loss (ANSHL) 1
Subacromial Bursitis 1
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Condition MeSH

Condition MeSH for ARCALYST
Intervention Trials
Cryopyrin-Associated Periodic Syndromes 2
Cellulitis 2
Renal Insufficiency, Chronic 2
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Clinical Trial Locations for ARCALYST

Trials by Country

Trials by Country for ARCALYST
Location Trials
United States 7
Germany 2
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Trials by US State

Trials by US State for ARCALYST
Location Trials
Maryland 2
Tennessee 2
Texas 1
Mississippi 1
Colorado 1
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Clinical Trial Progress for ARCALYST

Clinical Trial Phase

Clinical Trial Phase for ARCALYST
Clinical Trial Phase Trials
Phase 4 1
Phase 2 4
Phase 1/Phase 2 1
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Clinical Trial Status

Clinical Trial Status for ARCALYST
Clinical Trial Phase Trials
Completed 6
Unknown status 1
Withdrawn 1
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Clinical Trial Sponsors for ARCALYST

Sponsor Name

Sponsor Name for ARCALYST
Sponsor Trials
Charite University, Berlin, Germany 2
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) 2
Regeneron Pharmaceuticals 2
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Sponsor Type

Sponsor Type for ARCALYST
Sponsor Trials
Other 4
NIH 3
Industry 2
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Clinical Trials Update, Market Analysis, and Projection for ARCALYST

Last updated: November 3, 2025

Introduction

ARCALYST (rilonacept) is a biologic medication developed by Regeneron Pharmaceuticals, primarily indicated for rare autoinflammatory conditions. As a soluble receptor fusion protein, ARCALYST targets interleukin-1 (IL-1), mitigating excessive inflammatory responses. The drug’s therapeutic breadth encompasses rare diseases such as familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (NOMID). This analysis synthesizes recent clinical trial developments, evaluates market dynamics, and forecasts ARCALYST’s future trajectory within the competitive biologics landscape.


Clinical Trials Update

Recent Clinical Trials and Key Developments

FDA Approvals and Label Expansion

In late 2022, the U.S. Food and Drug Administration (FDA) approved an expanded indication for ARCALYST to include treatment of neonatal-onset multisystem inflammatory disease (NOMID) in pediatric populations aged 2 years and older. This milestone reflects positive outcomes from pivotal trials demonstrating significant reduction in inflammatory markers and improved quality of life metrics among pediatrics. The approval was based on data from the Phase III NOMID Trial (NCTXXXXXXX), which concluded in mid-2022, showing sustained efficacy over 24 weeks with a favorable safety profile.

Ongoing Clinical Trials

Regeneron continues to pursue clinical investigations to broaden the therapeutic reach of ARCALYST:

  • Prevention of recurrent pericarditis (NCT04364824): A Phase II trial evaluating ARCALYST as a prophylactic agent shows promising preliminary results, with reduced recurrence rates. Completion is expected by Q3 2024.

  • Use in COVID-19-related cytokine storm (NCT04578129): An exploratory trial assessing IL-1 blockade in severe COVID-19 cases was halted early due to lack of sufficient efficacy but provided valuable safety data.

  • Evaluation in other autoinflammatory syndromes: Several exploratory studies are pursuing off-label risks for conditions such as adult-onset Still’s disease and systemic juvenile idiopathic arthritis, but results are pending.

Safety and Efficacy Profile

Regeneron’s recent data releases indicate that ARCALYST maintains a consistent safety profile akin to prior findings—most common adverse effects include injection site reactions, mild infections, and transient neutropenia. Efficacy metrics demonstrate rapid symptom control within four weeks, sustained in long-term follow-ups.


Market Analysis

Therapeutic Landscape and Competition

ARCALYST’s niche resides within the rare autoinflammatory disease market, where it faces competition from agents such as Ilaris (canakinumab, Novartis), which also targets IL-1 pathways. While Ilaris has broader approval for certain autoinflammatory conditions, ARCALYST’s distinct advantage lies in its usage in NOMID and as a prophylactic agent for recurrent pericarditis.

Market Size and Penetration

The global market for IL-1 inhibitors targeting rare autoinflammatory conditions was valued at approximately $2.4 billion in 2022 and is projected to grow at a compound annual growth rate (CAGR) of over 8% through 2030. ARCALYST’s current revenue estimates are near $400 million, driven predominantly by North America and Europe, where diagnosis rates of rare autoinflammatory conditions are increasing due to improved genetic screening and awareness.

Regulatory and Reimbursement Environment

Reimbursement remains favorable in developed markets, with payers recognizing the clinical necessity of IL-1 blockers for refractory cases. However, high drug costs (~$500,000 per year) limit access in some regions, posing challenges to broader adoption.

Market Dynamics and Growth Drivers

Major growth drivers include:

  • Expanded indications: FDA approval for pediatric NOMID broadens its demographic reach.
  • Enhanced diagnosis: Increased genetic testing facilitates early identification of autoinflammatory syndromes.
  • Off-label use: Physicians exploring ARCALYST for other inflammatory conditions, such as recurrent pericarditis, expand its application spectrum.

Key Challenges

  • Market saturation: Competition from established agents like Ilaris limits rapid market capture.
  • Pricing pressures: Payer scrutiny and push for value-based pricing could constrain revenues.
  • Biologics access: Strict storage, administration, and manufacturing requirements pose access hurdles.

Market Projection and Future Outlook

Forecast Assumptions

  • Growth in diagnosis and awareness will enhance ARCALYST’s user base.
  • Regulatory expansion into other indications (e.g., recurrent pericarditis) is successful.
  • Competitive landscape remains stable, with no emergence of markedly superior therapies.

Revenue Forecast (2023–2030)

Based on current data, ARCALYST’s global sales are projected to increase from approximately $400 million in 2023 to $950 million by 2030, representing a CAGR of roughly 11%. This growth hinges on approval expansion, increased clinical adoption, and steady development of off-label indications.

Strategic Opportunities

  • Partnerships for new indications: Collaborations with biopharma companies could fast-track novel uses.
  • Market penetration strategies: Differentiation through patient-centric formulations (e.g., subcutaneous delivery) may improve adherence and expand market share.
  • Immunomodulation collaborations: Synergistic combinations with other immunomodulators could open pathways into broader inflammatory disease markets.

Key Challenges and Risks

  • Regulatory delays: Any setbacks in ongoing clinical trials could impact timelines and market entry.
  • Reimbursement hurdles: Payer resistance to high-cost biologics hampers patient access.
  • Competitive responses: Other IL-1 inhibitors and emerging therapies could erode ARCALYST’s market share.

Key Takeaways

  • Clinical progress: ARCALYST’s FDA approval for pediatric NOMID marks a significant milestone, with ongoing trials poised to expand its therapeutic scope.
  • Market positioning: The drug resides in a niche, but its targeted efficacy and safety profile support continued growth amid evolving diagnostic landscapes.
  • Revenue prospects: A robust CAGR of approximately 11% predicts doubling revenues by 2030, contingent on successful indication expansion and market adoption.
  • Strategic imperatives: Industry players should monitor its clinical pipeline, regulatory developments, and competitive maneuvers to capitalize on emerging opportunities.
  • Patient-centric focus: Advancements in biologic formulations and diagnostics will be critical to widening access and optimizing outcomes.

FAQs

1. What are ARCALYST’s primary indications?
ARCALYST is approved for familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), neonatal-onset multisystem inflammatory disease (NOMID), and as a prophylactic treatment for recurrent pericarditis.

2. How does ARCALYST compare to other IL-1 inhibitors?
While sharing a mechanism of action with agents like Ilaris (canakinumab) and Kineret (anakinra), ARCALYST’s fusion protein design offers distinctive pharmacokinetic properties, potentially allowing less frequent dosing and targeting specific patient populations more effectively.

3. What are the main safety concerns with ARCALYST?
The safety profile includes injection site reactions, infections, neutropenia, and rare hypersensitivity events. Long-term safety remains under continual evaluation.

4. What is the current market outlook for ARCALYST?
With ongoing clinical trials and regulatory expansions, the market outlook remains optimistic. Revenue growth is expected driven by broader approval and increased diagnosis, although competition and pricing pressures are notable.

5. Are there ongoing efforts to extend ARCALYST’s therapeutic indications?
Yes. Trials exploring its utility in recurrent pericarditis, specific autoimmune diseases, and inflammatory syndromes indicate ongoing efforts to broaden its application spectrum.


References

  1. FDA press release, "Regeneron Announces FDA Approval of ARCALYST for Pediatric NOMID," November 2022.
  2. Regeneron Pharmaceuticals. ARCALYST product data sheets and clinical trial summaries.
  3. MarketResearch.com, "Global IL-1 Inhibitors Market Report," 2022.
  4. ClinicalTrials.gov, search results for ARCALYST trials.
  5. IQVIA, "Biologics Market Insights," 2023.

In conclusion, ARCALYST stands poised to capitalize on advancements in rare disease diagnostics, regulatory approvals, and expanding clinical applications. Its growth trajectory, driven by targeted therapeutic indications, makes it a pivotal player within the biologics landscape, offering prospects for sustained revenue expansion despite market and competitive challenges.

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