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Last Updated: January 7, 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...
NCT01663103 ↗ Interleukin-1 Trap to Treat Vascular Dysfunction in Chronic Kidney Disease (CKD) Completed University of Colorado, Denver Phase 4 2012-08-01 Risk of cardiovascular diseases (CVD) is significantly elevated in patients with chronic kidney disease (CKD); however, this increased risk is only partially explained by traditional cardiovascular risk factors. Patients with CKD exhibit chronic inflammation, a key mechanism contributing to vascular dysfunction (i.e., large elastic artery stiffening and endothelial dysfunction). Inhibiting inflammation improves vascular dysfunction in other populations characterized by chronic inflammation. However, it is currently unknown if reducing inflammation with an interleukin-1 (IL-1) blocker enhances vascular function in CKD patients. Aim 1 will assess the efficacy of IL-1 blocking with rilonacept for treating vascular dysfunction in patients with stage III or IV CKD (estimated glomerular filtration rate 15-60 mL/min/1.73 m2). Aim 2 will determine if blocking IL-1 with rilonacept also reduces inflammation and oxidative stress. These studies could shift clinical practice guidelines by establishing a novel therapy for reducing CVD risk in CKD patients not requiring chronic hemodialysis.
NCT01801449 ↗ Rilonacept for Deficiency of the Interleukin-1 Receptor Antagonist (DIRA) Completed National Institutes of Health Clinical Center (CC) Phase 2 2013-02-12 Background: - Deficiency of the IL-1 receptor antagonist (DIRA) is a condition that causes repeated episodes of inflammation. People with DIRA can have rashes, fever, and joint pain. Most treatments for DIRA are intended to control the immune system to stop these inflammations. There are drugs that can treat DIRA, but they have to be given daily as injections. Researchers want to try another drug, rilonacept, as a treatment for DIRA. It needs to be given only once a week. Rilonacept will be given to individuals who are at least 3 months old and who have DIRA. Objectives: - To test the safety and effectiveness of rilonacept for children and adults with DIRA. Eligibility: - Individuals at least 3 months old who have DIRA. Design: - Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected. Other tests to study pain and movement will be given. Imaging studies such as bone density scans and x-rays may also be taken. - Participants will have a minimum of four to five study visits over 12 months. Those who are on different anti-inflammatory drugs (such as anakinra) will stop taking them before beginning the study visits. - Participants will have rilonacept injections weekly while on this study. The dose will be adjusted as needed to help treat the DIRA symptoms. Participants will keep a diary to monitor their symptoms and any side effects. - Treatment with rilonacept will be given for 1 year. Participants will have study visits to monitor the treatment. They will provide blood samples and have other tests at these study visits.
NCT01801449 ↗ Rilonacept for Deficiency of the Interleukin-1 Receptor Antagonist (DIRA) Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 2 2013-02-12 Background: - Deficiency of the IL-1 receptor antagonist (DIRA) is a condition that causes repeated episodes of inflammation. People with DIRA can have rashes, fever, and joint pain. Most treatments for DIRA are intended to control the immune system to stop these inflammations. There are drugs that can treat DIRA, but they have to be given daily as injections. Researchers want to try another drug, rilonacept, as a treatment for DIRA. It needs to be given only once a week. Rilonacept will be given to individuals who are at least 3 months old and who have DIRA. Objectives: - To test the safety and effectiveness of rilonacept for children and adults with DIRA. Eligibility: - Individuals at least 3 months old who have DIRA. Design: - Participants will be screened with a physical exam and medical history. Blood and urine samples will be collected. Other tests to study pain and movement will be given. Imaging studies such as bone density scans and x-rays may also be taken. - Participants will have a minimum of four to five study visits over 12 months. Those who are on different anti-inflammatory drugs (such as anakinra) will stop taking them before beginning the study visits. - Participants will have rilonacept injections weekly while on this study. The dose will be adjusted as needed to help treat the DIRA symptoms. Participants will keep a diary to monitor their symptoms and any side effects. - Treatment with rilonacept will be given for 1 year. Participants will have study visits to monitor the treatment. They will provide blood samples and have other tests at these study visits.
NCT01830699 ↗ Rilonacept (Arcalyst ®) in the Treatment of Subacromial Bursitis Completed Keesler Air Force Base Medical Center N/A 2013-03-01 To date no trials have been performed looking at whether or not intra-bursal injection of an IL-1 antagonist provides pain relief similar to that of a corticosteroid injection. The subcutaneous injection of anakinra, an IL-1 receptor antagonist, in patients with shoulder pain due to rotator cuff tendonitis and subacromial bursitis was efficacious in relieving pain but this information was presented as a case series in a letter to the editor format, so the validity of these results would require additional testing [Omoigui S, et al. 2004]. Based mainly on the data from the intra-articular administration of anakinra, there have not been any adverse trends in outcomes or safety to suggest that intra-bursal injection of rilonacept will carry an increase risk of adverse events. The purpose of this trial is to compare the improvement in pain and function of patients with clinical symptoms and signs of subacromial bursitis of rilonacept vs. corticosteroid injection (standard of care).
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ARCALYST

Condition Name

Condition Name for ARCALYST
Intervention Trials
Subacromial Bursitis 1
Autoinflammatory 1
Behcet's Disease 1
Cardiovascular Disease 1
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Condition MeSH

Condition MeSH for ARCALYST
Intervention Trials
Eosinophilia 2
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
U.S. Fed 2
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ARCALYST Market Analysis and Financial Projection

ARCALYST: Clinical Trials, Market Analysis, and Projections

Introduction to ARCALYST

ARCALYST, also known as rilonacept, is a weekly, subcutaneously injected recombinant dimeric fusion protein developed by Regeneron Pharmaceuticals. It is designed to block interleukin-1 alpha (IL-1α) and interleukin-1 beta (IL-1β) signaling, making it a crucial treatment for various inflammatory and autoimmune conditions.

Clinical Trials and Efficacy

Recurrent Pericarditis Trials

The efficacy of ARCALYST in treating recurrent pericarditis has been extensively studied. The RHAPSODY clinical trial demonstrated significant reductions in pericarditis recurrence rates. Here are some key findings:

  • Recurrence Rates: In the randomized withdrawal (RW) period, only 7% of patients treated with ARCALYST experienced a recurrence, compared to 74% of patients on placebo. The median time to recurrence on ARCALYST could not be estimated due to the low number of recurrences[4].
  • Long-term Prevention: In the long-term extension (LTE) period, 99% of eligible patients chose to continue treatment with ARCALYST for up to an additional 24 months, with a median treatment duration of approximately 24 months. This extended treatment significantly reduced recurrences, with only 3% of patients experiencing a recurrence compared to 75% of those who suspended treatment[4].

Other Indications

ARCALYST is also approved for cryopyrin-associated periodic syndromes (CAPS), including Familial Cold Autoinflammatory Syndrome and Muckle-Wells Syndrome, and deficiency of IL-1 receptor antagonist (DIRA). The drug has received Breakthrough Therapy designation for recurrent pericarditis and Orphan Drug exclusivity for several indications[1][3].

Market Analysis

Current Market Performance

As of the second quarter of 2024, ARCALYST has shown robust market performance. Key highlights include:

  • Revenue Growth: ARCALYST net product revenue reached $103.4 million in Q2 2024, representing a 90% year-over-year growth. The full-year 2024 revenue guidance has been increased to $405-415 million[3].
  • Market Penetration: ARCALYST has achieved an 11% penetration in the target population of 14,000 multiple-recurrence pericarditis patients, with an average therapy duration extended to 26 months[3].

Market Size and Projections

The global market for ARCALYST is expected to grow steadily:

  • Current Market Size: The global market for ARCALYST was estimated to be worth $13 million in 2023[2].
  • Projected Growth: The market is forecast to reach $17 million by 2030, with a Compound Annual Growth Rate (CAGR) of 4.1% during the forecast period of 2024-2030[2].
  • Long-term Projections: The broader Rilonacept Drugs market, which includes ARCALYST, is projected to expand at a CAGR of 4.1% from 2025 to 2033, driven by the rising prevalence of autoimmune diseases and technological advancements[5].

Key Drivers and Trends

Growing Prevalence of Autoimmune Diseases

The increasing incidence of inflammatory and autoimmune diseases is a significant driver for the growth of the ARCALYST market. This trend is expected to continue, fueling the demand for effective and well-tolerated treatments[5].

Technological Advancements

Advancements in drug development, such as targeted delivery systems, are enhancing the efficacy and patient outcomes of treatments like ARCALYST. These innovations are crucial for maintaining market competitiveness[5].

Personalized Medicine

The adoption of personalized medicine is another trend shaping the market. Patients are increasingly seeking tailored treatment options, which ARCALYST, with its specific mechanism of action, is well-positioned to provide[5].

Regulatory Support

Favorable regulatory designations, such as Breakthrough Therapy and Orphan Drug exclusivity, have supported the market growth of ARCALYST. These designations highlight the drug's potential in addressing unmet medical needs[1][3].

Competitive Landscape

Key Players

Regeneron Pharmaceuticals, the developer of ARCALYST, holds a substantial market share. Other notable companies in the Rilonacept Drugs market include I-Mab, Y-mAbs Therapeutics, and Nanjing Legend Biotechnology. However, the competitive landscape is also influenced by the emergence of biosimilars, which could pose challenges to market expansion[5].

Regional Market Insights

Dominant Regions

  • North America: This region holds the dominant share due to high healthcare spending and a high prevalence of chronic diseases[5].
  • Europe: Europe is the second-largest market, with a focus on biosimilar development and a significant patient population[5].
  • Asia Pacific: This region is rapidly growing due to an increasing burden of inflammatory diseases and improving healthcare infrastructure[5].

Future Outlook

Clinical Milestones

Kiniksa Pharmaceuticals, which commercializes ARCALYST, is committed to advancing its pipeline. The company is pursuing collaborative study agreements to evaluate the potential of mavrilimumab in rare cardiovascular diseases and is building an autoimmune franchise with the clinical trial of KPL-404 in rheumatoid arthritis. These efforts are expected to enhance Kiniksa's reputation and credibility in the biopharmaceutical sector[1].

Market Expansion

Strategic partnerships, such as those with the American Heart Association and awareness campaigns, are likely to further enhance ARCALYST's market presence. These initiatives can improve patient outcomes and drive higher adoption rates, contributing to long-term revenue stability[3].

Key Takeaways

  • Clinical Efficacy: ARCALYST has demonstrated significant efficacy in reducing pericarditis recurrence rates and is approved for several inflammatory and autoimmune conditions.
  • Market Growth: The global market for ARCALYST is projected to grow at a CAGR of 4.1% from 2024 to 2030, reaching $17 million by 2030.
  • Key Drivers: Growing prevalence of autoimmune diseases, technological advancements, and personalized medicine are driving the market growth.
  • Competitive Landscape: Regeneron Pharmaceuticals is a key player, but the market is also influenced by emerging biosimilars and other competitors.
  • Regional Insights: North America, Europe, and Asia Pacific are the dominant regions, with varying growth dynamics.

FAQs

What is ARCALYST used for?

ARCALYST (rilonacept) is used for the treatment of recurrent pericarditis, cryopyrin-associated periodic syndromes (CAPS), including Familial Cold Autoinflammatory Syndrome and Muckle-Wells Syndrome, and deficiency of IL-1 receptor antagonist (DIRA)[1][3].

What are the key findings from the RHAPSODY clinical trial?

The RHAPSODY trial showed that ARCALYST significantly reduced the risk of pericarditis recurrence, with only 7% of patients experiencing a recurrence compared to 74% on placebo. The trial also demonstrated long-term prevention of recurrences with extended treatment[4].

What is the current market size and projected growth for ARCALYST?

The global market for ARCALYST was estimated to be $13 million in 2023 and is forecast to reach $17 million by 2030, with a CAGR of 4.1% during the forecast period[2].

Who are the key players in the Rilonacept Drugs market?

Regeneron Pharmaceuticals is the primary developer and commercializer of ARCALYST. Other notable companies include I-Mab, Y-mAbs Therapeutics, and Nanjing Legend Biotechnology[5].

What are the main drivers of the ARCALYST market growth?

The main drivers include the growing prevalence of autoimmune diseases, technological advancements, and the increasing adoption of personalized medicine[5].

What are the dominant regions for the ARCALYST market?

North America, Europe, and Asia Pacific are the dominant regions, driven by high healthcare spending, biosimilar development, and an increasing burden of inflammatory diseases[5].

Sources

  1. Kiniksa Pharmaceuticals Provides Corporate and Portfolio Update. Globenewswire, January 9, 2023.
  2. Arcalyst - Market, Report Size, Worth, Revenue, Growth, Industry. Valuates Reports.
  3. Kiniksa Pharmaceuticals Reports Second Quarter 2024 Financial. Stocktitan, July 23, 2024.
  4. ARCALYST (rilonacept) RHAPSODY Clinical Trial Results. Arcalysthcp.com.
  5. Rilonacept Drugs Competitive Strategies: Trends and Forecasts. Datainsightsmarket.com, December 23, 2024.

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