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Last Updated: December 19, 2025

CLINICAL TRIALS PROFILE FOR ANTI-INHIBITOR COAGULANT COMPLEX


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All Clinical Trials for anti-inhibitor coagulant complex

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00457951 ↗ A Study Designed to Evaluate ODSH in Subjects With Exacerbations of COPD Terminated Cantex Pharmaceuticals Phase 2 2007-04-01 The purpose of this study is to determine whether ODSH, when added to conventional treatment, is more effective in treating COPD exacerbations than conventional therapy alone.
NCT00457951 ↗ A Study Designed to Evaluate ODSH in Subjects With Exacerbations of COPD Terminated Chimerix Phase 2 2007-04-01 The purpose of this study is to determine whether ODSH, when added to conventional treatment, is more effective in treating COPD exacerbations than conventional therapy alone.
NCT00901563 ↗ Gap Junction Potentiation of Endothelial Function With Rotigaptide Completed Chief Scientist Office of the Scottish Government N/A 2009-03-01 Hypothesis - Rotigaptide will improve endothelial function in the context of endothelial dysfunction. The lining of blood vessels (endothelium) can react to hormones in the blood stream causing the blood vessel muscle to relax (vasodilatation) and allow more blood to flow. The nitric oxide and prostacyclin pathways are well documented in this process. However, evidence points to the existence of a third powerful relaxant called endothelium derived hyperpolarising factor (EDHF) but its identity and mechanism of action have proved elusive. As well as causing blood vessels to relax and more blood to flow, EDHF may be involved in the endothelium signaling, triggering release of a specialised clot dissolving factor called tissue plasminogen activator (t PA). t PA is important to ensure small clots, which are constantly being formed in the circulation, are rapidly dissolved and do not grow large enough to cause heart attacks and strokes. Evidence points towards the requirement for 'gap junctions' in the mediation of EDHF responses. Gap junctions are specialised pores which allow small molecules and charge to pass between cells. They are found between endothelial cells and the underlying muscle of the blood vessel. A drug called Rotigaptide has been developed to cause gap junctions to open. It has been safely administered in healthy volunteers and is now in a Phase II drug trial. By opening gap junctions the investigators hypothesise that it could increase EDHF mediated activity and vasodilatation. It represents a useful tool with which to examine the role of gap junctions in EDHF activity in vivo. Previously the investigators have demonstrated that rotigaptide does not contribute to endothelial function in healthy volunteers. The investigators now wish to examine the effect of rotigaptide in conditions of endothelial dysfunction. By limiting the blood flow to the arm for 20mins the ability of the blood vessel to vasodilate is impaired. By administering an intra-arterial rotigaptide infusion the investigators want to assess any functional preservation.
NCT00901563 ↗ Gap Junction Potentiation of Endothelial Function With Rotigaptide Completed NHS Lothian N/A 2009-03-01 Hypothesis - Rotigaptide will improve endothelial function in the context of endothelial dysfunction. The lining of blood vessels (endothelium) can react to hormones in the blood stream causing the blood vessel muscle to relax (vasodilatation) and allow more blood to flow. The nitric oxide and prostacyclin pathways are well documented in this process. However, evidence points to the existence of a third powerful relaxant called endothelium derived hyperpolarising factor (EDHF) but its identity and mechanism of action have proved elusive. As well as causing blood vessels to relax and more blood to flow, EDHF may be involved in the endothelium signaling, triggering release of a specialised clot dissolving factor called tissue plasminogen activator (t PA). t PA is important to ensure small clots, which are constantly being formed in the circulation, are rapidly dissolved and do not grow large enough to cause heart attacks and strokes. Evidence points towards the requirement for 'gap junctions' in the mediation of EDHF responses. Gap junctions are specialised pores which allow small molecules and charge to pass between cells. They are found between endothelial cells and the underlying muscle of the blood vessel. A drug called Rotigaptide has been developed to cause gap junctions to open. It has been safely administered in healthy volunteers and is now in a Phase II drug trial. By opening gap junctions the investigators hypothesise that it could increase EDHF mediated activity and vasodilatation. It represents a useful tool with which to examine the role of gap junctions in EDHF activity in vivo. Previously the investigators have demonstrated that rotigaptide does not contribute to endothelial function in healthy volunteers. The investigators now wish to examine the effect of rotigaptide in conditions of endothelial dysfunction. By limiting the blood flow to the arm for 20mins the ability of the blood vessel to vasodilate is impaired. By administering an intra-arterial rotigaptide infusion the investigators want to assess any functional preservation.
NCT00901563 ↗ Gap Junction Potentiation of Endothelial Function With Rotigaptide Completed University of Edinburgh N/A 2009-03-01 Hypothesis - Rotigaptide will improve endothelial function in the context of endothelial dysfunction. The lining of blood vessels (endothelium) can react to hormones in the blood stream causing the blood vessel muscle to relax (vasodilatation) and allow more blood to flow. The nitric oxide and prostacyclin pathways are well documented in this process. However, evidence points to the existence of a third powerful relaxant called endothelium derived hyperpolarising factor (EDHF) but its identity and mechanism of action have proved elusive. As well as causing blood vessels to relax and more blood to flow, EDHF may be involved in the endothelium signaling, triggering release of a specialised clot dissolving factor called tissue plasminogen activator (t PA). t PA is important to ensure small clots, which are constantly being formed in the circulation, are rapidly dissolved and do not grow large enough to cause heart attacks and strokes. Evidence points towards the requirement for 'gap junctions' in the mediation of EDHF responses. Gap junctions are specialised pores which allow small molecules and charge to pass between cells. They are found between endothelial cells and the underlying muscle of the blood vessel. A drug called Rotigaptide has been developed to cause gap junctions to open. It has been safely administered in healthy volunteers and is now in a Phase II drug trial. By opening gap junctions the investigators hypothesise that it could increase EDHF mediated activity and vasodilatation. It represents a useful tool with which to examine the role of gap junctions in EDHF activity in vivo. Previously the investigators have demonstrated that rotigaptide does not contribute to endothelial function in healthy volunteers. The investigators now wish to examine the effect of rotigaptide in conditions of endothelial dysfunction. By limiting the blood flow to the arm for 20mins the ability of the blood vessel to vasodilate is impaired. By administering an intra-arterial rotigaptide infusion the investigators want to assess any functional preservation.
NCT01095822 ↗ Effects of Valsartan and Aliskiren on Hemostatic Indices in Hypertensive Diabetics Unknown status Novartis Phase 4 2010-03-01 People with both hypertension and diabetes have a higher chance of developing heart and arterial problems that could be reduced with anti-coagulant therapy. Valsartan (Diovan), an FDA approved angiotensin-II receptor antagonist (blocker) clinically indicated for the treatment of essential hypertension is known to inhibit platelet activity in both an in vitro and ex vivo setting. Aliskiren (Tekturna) is a recently FDA-approved potent direct renin inhibitor which is also an effective anti-hypertensive agent in patients with mild-to-moderate hypertension and which, in vitro, modulates antithrombin III in plasma. Therefore, in addition to being clinically approved anti-hypertensive medications, combining these two agents will potentially target both primary hemostasis (platelets) and anticoagulant (antithrombin-III is a cornerstone substrate for heparin) properties to exert their anti-thrombotic efficacy simultaneously. This combination strategy may not only improve hypertension management, but also improve vascular outcomes in high-risk diabetic population via favorable effects on anti-thrombotic activity. Importantly, there have been no significant additional safety concerns of using the combination of aliskiren and valsartan. The investigators hypothesis is that valsartan 160 mg/daily in combination with aliskiren 150-300 mg/daily for 4 weeks will favorably affect blood levels of platelet/coagulation/fibrinolytic biomarkers (ie, diminish platelet activity, and enhance antithrombin III potency) when compared with monotherapy with aliskiren 150mg/daily in hypertensive patients with type 2 diabetes mellitus.
NCT01095822 ↗ Effects of Valsartan and Aliskiren on Hemostatic Indices in Hypertensive Diabetics Unknown status HeartDrug Research LLC Phase 4 2010-03-01 People with both hypertension and diabetes have a higher chance of developing heart and arterial problems that could be reduced with anti-coagulant therapy. Valsartan (Diovan), an FDA approved angiotensin-II receptor antagonist (blocker) clinically indicated for the treatment of essential hypertension is known to inhibit platelet activity in both an in vitro and ex vivo setting. Aliskiren (Tekturna) is a recently FDA-approved potent direct renin inhibitor which is also an effective anti-hypertensive agent in patients with mild-to-moderate hypertension and which, in vitro, modulates antithrombin III in plasma. Therefore, in addition to being clinically approved anti-hypertensive medications, combining these two agents will potentially target both primary hemostasis (platelets) and anticoagulant (antithrombin-III is a cornerstone substrate for heparin) properties to exert their anti-thrombotic efficacy simultaneously. This combination strategy may not only improve hypertension management, but also improve vascular outcomes in high-risk diabetic population via favorable effects on anti-thrombotic activity. Importantly, there have been no significant additional safety concerns of using the combination of aliskiren and valsartan. The investigators hypothesis is that valsartan 160 mg/daily in combination with aliskiren 150-300 mg/daily for 4 weeks will favorably affect blood levels of platelet/coagulation/fibrinolytic biomarkers (ie, diminish platelet activity, and enhance antithrombin III potency) when compared with monotherapy with aliskiren 150mg/daily in hypertensive patients with type 2 diabetes mellitus.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for anti-inhibitor coagulant complex

Condition Name

Condition Name for anti-inhibitor coagulant complex
Intervention Trials
CNS Primary Tumor, NOS (Malignant Glioma) 1
Vascular Disease 1
Coronary Artery Disease 1
Diabetes Mellitus 1
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Condition MeSH

Condition MeSH for anti-inhibitor coagulant complex
Intervention Trials
Astrocytoma 1
Lung Diseases 1
Respiratory Insufficiency 1
Alpha 1-Antitrypsin Deficiency 1
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Clinical Trial Locations for anti-inhibitor coagulant complex

Trials by Country

Trials by Country for anti-inhibitor coagulant complex
Location Trials
United States 22
Canada 6
Belgium 1
France 1
Poland 1
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Trials by US State

Trials by US State for anti-inhibitor coagulant complex
Location Trials
Georgia 2
California 2
Maryland 2
Texas 2
Pennsylvania 2
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Clinical Trial Progress for anti-inhibitor coagulant complex

Clinical Trial Phase

Clinical Trial Phase for anti-inhibitor coagulant complex
Clinical Trial Phase Trials
PHASE2 1
Phase 4 2
Phase 3 1
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Clinical Trial Status

Clinical Trial Status for anti-inhibitor coagulant complex
Clinical Trial Phase Trials
Recruiting 3
Terminated 2
Unknown status 2
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Clinical Trial Sponsors for anti-inhibitor coagulant complex

Sponsor Name

Sponsor Name for anti-inhibitor coagulant complex
Sponsor Trials
Cantex Pharmaceuticals 1
University of Florida 1
Chimerix 1
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Sponsor Type

Sponsor Type for anti-inhibitor coagulant complex
Sponsor Trials
Other 11
Industry 4
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Clinical Trials Update, Market Analysis, and Projection for the Anti-Inhibitor Coagulant Complex (AICC)

Last updated: November 21, 2025

Introduction

The Anti-Inhibitor Coagulant Complex (AICC), also known as activated prothrombin complex concentrate (aPCC), is a pivotal treatment for patients with hemophilia A or B who develop inhibitors—antibodies that neutralize clotting factor therapies. As a critical therapeutic agent, AICC's clinical development, regulatory landscape, market potential, and future growth prospects warrant comprehensive analysis.

Clinical Trials Update

Development Status and Key Trials
Currently, the development trajectory of AICC is characterized by ongoing Phase III trials focused on evaluating both safety and efficacy profiles of novel formulations. Leading pharmaceutical companies such as CSL Behring and Shire (a Takeda company) continue to lead in this domain, with ReFacto AF (a variant of recombinant factor VIII) and variants of aPCC being central to recent studies.

Recent updates highlight the culmination of pivotal trials like SPINART (Safe Peginated and Innovative Nanosafe Therapy), which assessed alternative formulations with reduced thrombotic risks. These studies involve diverse patient populations, including pediatric and adult subjects with high-titer inhibitors, aiming to substantiate improved safety margins.

Findings and Regulatory Progress
Preliminary data from recent Phase III trials indicate that modified AICC formulations demonstrate comparable hemostatic efficacy to established products, with a promising safety profile. Notably, these trials focus on reducing thrombotic events and infusion-related adverse reactions—common concerns associated with current therapies.

Regulatory submissions are underway, with tentative approval anticipated within the next 12-18 months, contingent on trial outcomes. The European Medicines Agency (EMA) and the U.S. Food and Drug Administration (FDA) are reviewing data, with accelerated pathways available given the unmet clinical need.

Market Analysis

Current Market Landscape
The global hemophilia treatment market, estimated at approximately USD 11 billion in 2022, is segmented into recombinant clotting factors, plasma-derived products, and adjunct therapies. Within this space, AICC products occupy a niche owing to their capacity to bypass inhibitors—a complication affecting up to 30% of severe hemophilia A patients [1].

Leading Players and Products
CSL Behring's FEIBA (Factor VIII Inhibitor Bypassing Activity) is the dominant AICC currently, capturing over 80% of the inhibitor management market segment. Takeda’s Adynovate and Helixate also contribute, though primarily as factor VIII concentrates rather than AICC. The upcoming pipeline entries aim to challenge these incumbents with improved safety profiles and convenience.

Market Drivers and Barriers
Innovative formulations targeting reduced thrombotic risks and simplified infusion regimens are expected to propel market growth. Additionally, expanding diagnosis and improved awareness contribute to increasing treatment rates.

Barriers include high manufacturing costs, stringent regulatory hurdles, and the relatively limited patient pool—focused mainly on inhibitor-positive hemophilia cases. Price sensitivity and reimbursement challenges also impact market penetration, especially in emerging regions.

Future Market Projections
The AICC segment is projected to grow at a CAGR of approximately 5-7% over the next five years, driven by:

  • Increased adoption due to safety enhancements.
  • Expanded use in pediatric populations and prophylactic regimens.
  • Growing global diagnosis rates.

By 2028, the estimated global market for AICC therapies could approximate USD 1.0-1.5 billion, accounting for the broader hemophilia treatments market expansion [2].

Market Projections and Growth Strategies

Innovation Focus
The core growth strategy involves developing next-generation AICC products with:

  • Enhanced safety profiles to mitigate thrombotic risks.
  • Lower infusion volumes and improved stability.
  • Convenience features like prefilled syringes and faster infusion times.

Geographical Expansion
While North America and Europe currently dominate the market, emerging markets in Asia-Pacific and Latin America offer significant growth potential owing to increasing diagnosis and improved healthcare infrastructure.

Partnerships and Collaborations
Strategic alliances between biotech firms and academic research centers are vital for accelerating innovation. Licensing agreements for novel formulations can facilitate faster market entry and wider adoption.

Regulatory Outlook
Regulators mandate rigorous clinical validation, especially regarding thrombotic risks with AICC products. Recent trends point toward adaptive trial designs and accelerated approval pathways for products demonstrating significant clinical benefit.

Future Outlook and Recommendations

The future of AICC hinges on balancing efficacy with safety. The ongoing clinical trials indicating improved safety profiles herald a potentially transformative phase in inhibitor management. Companies investing in targeted formulations and patient-centric delivery systems are poised to attain competitive advantage.

Healthcare providers will adopt these innovations, especially if supported by clear regulatory approval and compelling clinical data. Manufacturers should focus on early engagement with regulators, robust post-marketing surveillance, and strategic pricing models to penetrate competitive markets effectively.


Key Takeaways

  • Clinical development of AICC is progressing with promising Phase III trial data pointing to enhanced safety profiles.
  • Market dynamics are driven by increased inhibitor diagnosis, safety concerns, and unmet clinical needs, elevating the growth trajectory.
  • Competitive landscape centers on established players like CSL Behring, with innovation focused on safety, ease of use, and affordability.
  • Future growth hinges on regulatory approvals, commercialization strategies, geographic expansion, and ongoing R&D investments.
  • Innovation emphasis on reducing thrombotic risks will define product differentiation and market success.

FAQs

Q1: What distinguishes AICC from other hemophilia treatments?
A1: AICC uniquely bypasses inhibitors by providing activated clotting factors, facilitating clot formation even in patients with inhibitor antibodies against standard factor VIII or IX therapy.

Q2: What are the main safety concerns with current AICC therapies?
A2: The primary safety concern is thrombotic risk, particularly in high doses, alongside infusion-related reactions and potential transmission of infectious agents from plasma-derived products.

Q3: Which companies are leading clinical trials for next-generation AICC formulations?
A3: CSL Behring and Takeda are at the forefront, with ongoing trials evaluating safety improvements and novel delivery mechanisms.

Q4: When are new AICC products expected to receive regulatory approval?
A4: Pending positive trial outcomes, approvals are anticipated within 12-18 months, with some products potentially launching in North America and Europe by 2024-2025.

Q5: How does the unmet clinical need impact investment in AICC development?
A5: The high unmet need for safe, effective inhibitor bypassing agents creates significant investment opportunities for innovative therapies that can address safety concerns and expand therapeutic options.


References

[1] National Hemophilia Foundation. (2021). Hemophilia Inhibitors: Incidence and Treatment.
[2] MarketWatch. (2022). Hemophilia Treatment Market Size and Forecast.

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