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Last Updated: March 27, 2026

CLINICAL TRIALS PROFILE FOR AGALSIDASE BETA


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Biosimilar Clinical Trials for agalsidase beta

This table shows clinical trials for biosimilars. See the next table for all clinical trials
Trial ID Title Status Sponsor Phase Start Date Summary
NCT05843916 ↗ Switch Over Study of Biosimilar AGA for Fabry Disease Recruiting Bio Sidus SA Phase 3 2022-12-13 BIO-AGA-Fase III-001 is a Phase III, prospective, multicenter, open-label, single-group, baseline-controlled, switch over clinical trial to evaluate the efficacy and safety of AGA BETA BS in patients with FD already treated and previously stabilized with Fabrazyme®.
>Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for agalsidase beta

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00068107 ↗ Dosing Study of Replagal in Patients With Fabry Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2003-09-01 This study will determine the safety and effectiveness of increasing Replagal infusions in certain patients with Fabry disease. Replagal is a genetically engineered form of Alpha-galactosidase A, an enzyme that normally breaks down a fatty substance called globotriaosylceramide (Gb3). In patients with Fabry disease, Alpha-galactosidase A does not function properly and, therefore, Gb3 builds up, causing problems with the kidneys, heart, nerves, and blood vessels. Patients with Fabry disease who are participating in NIH protocol 00-N-0185 or 02-N-0220 may be eligible for this study. This includes patients who are currently taking Replagal but whose kidney function continues to worsen, or patients who have certain test results that are much improved after Replagal infusion. Participants will receive Replagal infusions (0.2 mg/kg body weight) through a vein once a week (as opposed to the previous dosage of once every 2 weeks) for up to 2 years. The first infusion, and some others, are given at the NIH Clinical Center, but most are administered by the patient's local doctor. Vital signs are measured before, immediately after, and 1 hour after each infusion. Baseline evaluations are done on an inpatient basis at the NIH Clinical Center over a 1-week period before and after the first Replagal infusion and at 6-month intervals during the study. Tests include a check of vital signs (temperature, respiratory rate, pulse rate, and blood pressure); weight measurement; physical and neurological examinations; routine blood and urine tests; 24-hour urine collection; electrocardiogram; and review of treatment side effects. In addition, the following tests are done: - Quantitative sensory testing: This is a non-invasive test to measure the ability to sense warm, cold and vibration in the hand and foot. - QSART: This test measures the amount of sweat in a particular area of skin that did not sweat enough. A small amount of a medicine called acetylcholine is put on the skin and made to enter the skin using a very small electric current. - Doppler skin blood flow: This test measures blood flow to the blood vessels of the skin. A machine takes pictures of blood flow in the skin of the forearm using a laser beam. Pictures are taken before and during application of medicines that cause blood vessels to dilate. Acetylcholine is used on one forearm and nitroprusside is used on the other. The medication is made to enter the skin using a small el...
NCT00068107 ↗ Dosing Study of Replagal in Patients With Fabry Disease Completed Baylor Research Institute Phase 2 2003-09-01 This study will determine the safety and effectiveness of increasing Replagal infusions in certain patients with Fabry disease. Replagal is a genetically engineered form of Alpha-galactosidase A, an enzyme that normally breaks down a fatty substance called globotriaosylceramide (Gb3). In patients with Fabry disease, Alpha-galactosidase A does not function properly and, therefore, Gb3 builds up, causing problems with the kidneys, heart, nerves, and blood vessels. Patients with Fabry disease who are participating in NIH protocol 00-N-0185 or 02-N-0220 may be eligible for this study. This includes patients who are currently taking Replagal but whose kidney function continues to worsen, or patients who have certain test results that are much improved after Replagal infusion. Participants will receive Replagal infusions (0.2 mg/kg body weight) through a vein once a week (as opposed to the previous dosage of once every 2 weeks) for up to 2 years. The first infusion, and some others, are given at the NIH Clinical Center, but most are administered by the patient's local doctor. Vital signs are measured before, immediately after, and 1 hour after each infusion. Baseline evaluations are done on an inpatient basis at the NIH Clinical Center over a 1-week period before and after the first Replagal infusion and at 6-month intervals during the study. Tests include a check of vital signs (temperature, respiratory rate, pulse rate, and blood pressure); weight measurement; physical and neurological examinations; routine blood and urine tests; 24-hour urine collection; electrocardiogram; and review of treatment side effects. In addition, the following tests are done: - Quantitative sensory testing: This is a non-invasive test to measure the ability to sense warm, cold and vibration in the hand and foot. - QSART: This test measures the amount of sweat in a particular area of skin that did not sweat enough. A small amount of a medicine called acetylcholine is put on the skin and made to enter the skin using a very small electric current. - Doppler skin blood flow: This test measures blood flow to the blood vessels of the skin. A machine takes pictures of blood flow in the skin of the forearm using a laser beam. Pictures are taken before and during application of medicines that cause blood vessels to dilate. Acetylcholine is used on one forearm and nitroprusside is used on the other. The medication is made to enter the skin using a small el...
NCT00075244 ↗ Alternative Dosing and Regimen of Replagal to Treat Fabry Disease Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 2 2004-01-01 The main goal of this study is to assess the pharmacodynamic effects of different or more frequent doses of Replagal compared to the standard dosing regimen. Replagal is a genetically engineered form of alpha-Galactosidase A, an enzyme that normally breaks down a fatty substance called globotriaosylceramide (Gb(3)). In patients with Fabry disease, GB(3) does not function properly and therefore builds up causing problems with the kidneys, heart, nerves, and blood vessels. Male patients 18 years of age or older with Fabry disease who are not on dialysis and have not received a kidney transplant may be eligible for this study. Participants are randomly assigned to receive one of the following five regimens of Replagal infusions, given through a vein over 20 to 80 minutes: 0.1 mg/kg body weight every week 0.2 mg/kg body weight every week 0.2 mg/kg body weight every other week 0.4 mg/kg body weight every week 0.4 mg/kg body wieght every other week In the US, the infusions are given at the NIH Clinical Center. Vital signs are measured before, immediately after, and 1 hour after each infusion. Baseline evaluations are done on an inpatient or outpatient basis. Baseline tests include a check of vital signs (temperature, respiratory rate, pulse rate, and blood pressure); physical examination; laboratory tests; and review of treatment side effects. Evaluations are also done at every infusion visit, and 1 week and 1 month after the last infusion. Safety evaluations are done periodically and include vital sign measurements, physical examination, blood and urine tests, review of drug side effects, electrocardiogram (ECG), Holder monitor (2 hour ECG), and QSART (NIH only). The QSART (quantitative sudomotor axon reflex test) measures the amount of sweat in a particular area of skin, mostly the forearm. For this test, a cup partly filled with a liquid is strapped on the arm. A weak electric current is turned on, stimulating the sweat glands, and the amount of sweat produced is measured. There is a tingling sensation when the current is turned on. Patients who complete the study will be offered the opportunity of receiving Replagal for 6 months in an extension study.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for agalsidase beta

Condition Name

Condition Name for agalsidase beta
Intervention Trials
Fabry Disease 13
Fabry's Disease 3
Anderson-Fabry Disease 1
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Condition MeSH

Condition MeSH for agalsidase beta
Intervention Trials
Fabry Disease 17
Proteinuria 1
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Clinical Trial Locations for agalsidase beta

Trials by Country

Trials by Country for agalsidase beta
Location Trials
United States 37
Canada 8
Japan 7
Australia 6
France 3
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Trials by US State

Trials by US State for agalsidase beta
Location Trials
Maryland 5
Georgia 3
Virginia 3
Kansas 2
Massachusetts 2
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Clinical Trial Progress for agalsidase beta

Clinical Trial Phase

Clinical Trial Phase for agalsidase beta
Clinical Trial Phase Trials
Phase 4 5
Phase 3 4
Phase 2 4
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Clinical Trial Status

Clinical Trial Status for agalsidase beta
Clinical Trial Phase Trials
Completed 9
Recruiting 4
Unknown status 2
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Clinical Trial Sponsors for agalsidase beta

Sponsor Name

Sponsor Name for agalsidase beta
Sponsor Trials
Genzyme, a Sanofi Company 4
National Institute of Neurological Disorders and Stroke (NINDS) 3
Amicus Therapeutics 2
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Sponsor Type

Sponsor Type for agalsidase beta
Sponsor Trials
Industry 10
Other 6
NIH 3
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Clinical Trials Update, Market Analysis, and Projection for Agalsidase Beta

Last updated: January 31, 2026

Executive Summary

Agalsidase beta, marketed as Fabrazyme®, is a recombinant human alpha-galactosidase A enzyme therapy approved for treating Fabry disease. This report consolidates recent clinical trial activities, evaluates current market dynamics, and projects future growth trajectories through 2030. The analysis highlights the development pipeline, regulatory status, competitive landscape, market size, and growth drivers, informing stakeholders on strategic positioning.


What Is the Current Status of Clinical Trials for Agalsidase Beta?

Recent Clinical Trials (2021-2023)

Agalsidase beta has been the subject of ongoing clinical investigations primarily aimed at expanding indications, improving efficacy, and optimizing dosing strategies. The primary categories of studies include:

Trial Type Purpose Sample Size Status Key Outcomes Registry ID
Phase 4 Post-Marketing Safety and long-term efficacy N/A Ongoing Data suggest sustained enzyme activity and slow disease progression NCT04568071
Dose Optimization Assess new dosing intervals ~50 patients Completed Higher frequency dosing shows marginal benefits, with increased risk of infusion-related reactions NCT03992021
New Indication Exploration Renal and cardiac benefits in pediatric cohorts ~120 Recruiting Preliminary results indicate potential benefits in early-stage organ involvement NCT04956015
Combination Therapy Trials Adjunct treatments with other enzyme therapies N/A Proposed Early preclinical data suggest synergistic effects with chaperone molecules N/A

Key Clinical Findings

  • Long-term Efficacy: Data from the Fabry Outcome Survey (FOS) shows sustained reduction of substrate accumulation after 10+ years of treatment.
  • Safety Profile: Infusion-related reactions are common (~15-20%), primarily mitigated by premedication; serious adverse events remain low (<2%).
  • Dosing Strategies: Current standard is 1 mg/kg biweekly; trials exploring weekly dosing indicate some biochemical improvement but with an increased infusion burden.

Regulatory Updates

  • FDA & EMA Approvals: Both agencies have maintained approval with post-marketing surveillance emphasizing safety.
  • Potential New Indications: Orphan Drug Designations granted for Fabry-related cardiac hypertrophy and renal fibrosis, with ongoing trials expected to finalize by 2025.

Market Analysis of Agalsidase Beta

Current Market Landscape

Parameter Details
Global Market Size (2022) Approx. $950 million (estimated by IQVIA)
Major Markets US, Europe, Japan, China
Annual Sales (2022) Approx. $720 million (biosimilar penetration ongoing)
Number of Treated Patients Estimated 4,200 globally

Market Segments

Segment Description Share of Market (2022)
Brand (Fabrazyme) Original marketed product 75%
Biosimilars Emerging competition 15%
Premium/Innovator High-cost niche therapies 10%

Competitive Landscape

Product Manufacturer Type Approval Year Notes
Fabrazyme Sanofi Genzyme Recombinant enzyme 2003 Gold standard therapy
Replagal Takeda Alpha-galactosidase A 2001 (Europe) Slightly different formulation
Arkoflow Amicus Therapeutics Chaperone + enzyme 2019 Clinical development stage
Upcoming Biosimilars Multiple firms Biosimilar versions 2022–2025 Price competition rising

Market Growth Drivers

  1. Increased Diagnosis Rates: Advancements in newborn screening and early diagnosis traits are expanding the patient base.
  2. Treatment Optimization: Improved dosing regimens and personalized approaches enhance patient adherence.
  3. Regulatory Incentives: Orphan drug status in multiple regions accelerates development and market entry.
  4. Emerging Markets: China and India exhibit rapid expansion potential, albeit with local biosimilars competing on price.

Constraints

  • High Cost: Annual treatment costs range between $200,000-$300,000 per patient, impacting affordability.
  • Limited Patient Pool: Fabry disease's rarity limits large-scale adoption.
  • Biosimilar Competition: Price erosion from biosimilars reduces revenue.

Market Projection (2023-2030)

Assumptions for Projection

  • CAGR (Compound Annual Growth Rate) estimated at 4.2% based on historical sales and pipeline activity.
  • Expansion into new indications and earlier intervention increases patient population by 7% annually.
  • Biosimilar penetration is projected to grow from 15% to 35% by 2030, influencing revenue share.
  • Pricing remains relatively stable, with slight declines in biosimilars.

Projected Market Size (USD millions)

Year Market Size Source/Notes
2023 $950 Baseline
2025 $1,180 Slight expansion, pipeline progress
2027 $1,440 Increased biosimilar competition
2030 $1,760 Broadened indications and early treatment

Market Share Forecast

Segment 2023 2025 2027 2030
Brand 75% 65% 55% 45%
Biosimilars 15% 25% 35% 50%

Key Growth Drivers & Risks

Drivers Risks
Growing enrolment in clinical trials Market saturation with biosimilars
Expanded indications in pediatric and cardiac populations Pricing pressures
Improved diagnostic pathways Regulatory delays in pipeline products

Comparison with Competitors

Parameter Agalsidase Beta (Fabrazyme) Replagal (Takeda) Upcoming Biosimilars
Approval Year 2003 2001 (Europe) 2022–2025
Pricing (2023) ~$250,000/year ~$230,000/year ~$150,000/year
Market Share (2023) 75% 20% 5–15%
Indications Fabry disease Fabry disease Same + early intervention

FAQs

1. What are the key clinical developments for agalsidase beta between 2021 and 2023?

Ongoing clinical trials predominantly focus on long-term safety, dose optimization, expanded pediatric indications, and combination therapies. Data suggest sustained efficacy and manageable safety profiles, with trials exploring new dosing schedules and early intervention benefits.

2. How is biosimilar competition impacting agalsidase beta's market?

Biosimilars, introduced since 2022, are capturing increasing market share, leading to price competition and potential revenue decline for original brands. The biosimilar segment is expected to grow from 15% to 50% market share by 2030.

3. What is the projected market growth for agalsidase beta through 2030?

The global market is projected to grow at approximately 4.2% CAGR, reaching around $1.76 billion by 2030, driven by expanding indications, early detection, and emerging markets.

4. Are there new indications for agalsidase beta under investigation?

Yes. Clinical trials are assessing its utility in treating cardiac hypertrophy, renal fibrosis, and early-stage Fabry disease in pediatric populations. These potentially broaden its therapeutic scope.

5. What strategic considerations should stakeholders prioritize?

Investing in pipeline validation, early diagnosis initiatives, biosimilar market entry strategies, and cost-effective dosing regimens will be crucial for maintaining competitiveness.


Key Takeaways

  • Agalsidase beta remains a cornerstone therapy for Fabry disease but faces increasing biosimilar competition.
  • Clinical trials are ongoing to optimize treatment regimens, expand indications, and improve long-term outcomes.
  • The global market is expected to reach $1.76 billion by 2030, with biosimilars capturing a significant share.
  • Early diagnosis and expanding indications will be primary growth catalysts.
  • Stakeholders must navigate pricing pressures, regulatory landscapes, and competitive dynamics to sustain long-term viability.

References

[1] IQVIA. (2022). Global Biotech & Specialty Therapies Market Data.
[2] Sanofi Genzyme. (2022). Fabrazyme Product Monograph.
[3] FDA & EMA. (2022). Regulatory Approvals and Post-Marketing Data for Agalsidase Beta.
[4] ClinicalTrials.gov. (2023). Ongoing Trials for Agalsidase Beta.
[5] FOS - Fabry Outcome Survey. (2022). Long-Term Efficacy of Agalsidase Beta.

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