CLINICAL TRIALS PROFILE FOR ENOXAPARIN SODIUM

All Clinical Trials for ENOXAPARIN SODIUM

Trial ID	Title	Status	Sponsor	Phase	Start Date	Summary
NCT00077753 ↗	EXCLAIM:Extended Prophylaxis for Venous ThromboEmbolism (VTE) in Acutely Ill Medical Patients With Prolonged Immobilization	Completed	Sanofi	Phase 4	2002-02-01	Primary objective: - To demonstrate the superiority of extended VTE prophylaxis with enoxaparin 40mg sc qd for 28 ± 4 days, compared to placebo, both following 10 ± 4 days of initial treatment with enoxaparin 40mg sc qd Secondary objectives: - To assess the reduction in mortality rate at the end of the double-blind treatment period, at 3 (90 ± 10 days) and at 6 (180 ± 10 days) months from the time of entry to the study, in patients on extended prophylaxis - To assess the incidence of VTE at 3 months (90 ± 10 days) from the time of randomization to the study - To evaluate the safety of extended enoxaparin VTE prophylaxis in acutely ill medical patients with prolonged immobilization. Safety evaluation includes: - Major and minor hemorrhage - Heparin induced thrombocytopenia - Serious adverse events - To assess differences in levels of health-care utilization and cost between patients receiving extended VTE prophylaxis versus those receiving placebo.
NCT00077805 ↗	PREVAIL: PREvention of VTE After Acute Ischemic Stroke With LMWH Enoxaparin ( - VTE: Venous Thromboembolism - LMWH: Low Molecular Weight Heparin)	Completed	Sanofi	Phase 4	2003-08-01	Primary objective: - To demonstrate superiority of enoxaparin 40 mg sc qd in the prevention of VTE compared to UFH (unfractionated heparin) 5000 U sc q12 hours given for 10 ± 4 days following acute ischemic stroke. Secondary objectives: - To compare the incidence of VTE between the 2 treatment groups at 30, 60, and 90 days from the time of randomization - To compare neurologic outcomes between the 2 treatment groups, including incidence of stroke recurrence, rate of stroke progression, and patient functional status, during the 10 ± 4 days of treatment, and after 30, 60, and 90 days from the time of randomization - To evaluate the safety of using enoxaparin compared to UFH for VTE prevention in patients following acute ischemic stroke
NCT00077818 ↗	Enoxaparin Versus Unfractionated Heparin in Subjects Who Present to the Emergency Department With Acute Coronary Syndrome (RESCUE)	Completed	Sanofi	Phase 4	2002-06-01	The purpose of this study is to determine the efficacy and safety of enoxaparin compared to unfractionated heparin (UFH) for patients diagnosed with Acute Coronary Syndrome (ACS) in the emergency department (ED). Efficacy is assessed by using a composite score consisting of 30-day all-cause mortality, non-fatal myocardial infarction (MI) and recurrent angina requiring revascularization.
NCT00077844 ↗	Safety and Efficacy of Enoxaparin in Percutaneous Coronary Intervention (PCI) Patients, an International Randomized Evaluation (STEEPLE)	Completed	Sanofi	Phase 2/Phase 3	2004-01-01	The purpose of this study is to evaluate the efficacy and safety of intravenous enoxaparin versus intravenous unfractionated heparin (UFH) in patients undergoing non-emergent PCI, as assessed by measuring the incidence of non-coronary artery bypass graft (CABG) major and minor bleeding.
NCT00191724 ↗	Adjuvant Treatment of Pulmonary Embolism With Drotrecogin Alfa (Activated): Phase II Exploratory Study	Completed	Eli Lilly and Company	Phase 2	2004-09-01	An exploratory, multicenter, randomized, placebo-controlled, double blind, dose escalation study comparing a standard therapy for submassive pulmonary embolism (Enoxaparin sodium) to a combined therapy of Drotrecogin alfa (activated) plus Enoxaparin sodium.
NCT00232271 ↗	The Effect of Enoxaparin Sodium on the Incidence of Deep Vein Thrombosis Following Electrophysiology Studies and Radiofrequency Ablation.	Terminated	National Heart Foundation, Australia	Phase 4	2005-08-01	The purpose of this study is to assess the effect of the anticoagulant(blood thinner) Clexane on the development of leg clots following electrophysiology studies (EPS) and or radiofrequency ablation (RFA). People who suffer heart palpitations will sometimes need hospital admission to undergo an electrophysiology study ( and or a Radiofrequency Ablation)in order to diagnose and or treat their condition. Radiofrequency ablation is a procedure to stop abnormal heart rhythms. EPS/RFA studies require the puncture of the leg veins . Previous experience has shown that following the puncture of leg veins there is a small risk of developing a blood clot in the leg. It is not known whether giving blood thinners (anticoagulants) after the procedure will decrease this risk Enoxaparin Sodium (Clexane) is an anticoagulant used extensively and safely following bone (Orthopaedic) surgery to prevent blood clots from developing in the legs
NCT00232271 ↗	The Effect of Enoxaparin Sodium on the Incidence of Deep Vein Thrombosis Following Electrophysiology Studies and Radiofrequency Ablation.	Terminated	Sanofi	Phase 4	2005-08-01	The purpose of this study is to assess the effect of the anticoagulant(blood thinner) Clexane on the development of leg clots following electrophysiology studies (EPS) and or radiofrequency ablation (RFA). People who suffer heart palpitations will sometimes need hospital admission to undergo an electrophysiology study ( and or a Radiofrequency Ablation)in order to diagnose and or treat their condition. Radiofrequency ablation is a procedure to stop abnormal heart rhythms. EPS/RFA studies require the puncture of the leg veins . Previous experience has shown that following the puncture of leg veins there is a small risk of developing a blood clot in the leg. It is not known whether giving blood thinners (anticoagulants) after the procedure will decrease this risk Enoxaparin Sodium (Clexane) is an anticoagulant used extensively and safely following bone (Orthopaedic) surgery to prevent blood clots from developing in the legs

Clinical Trial Conditions for ENOXAPARIN SODIUM

Condition Name

Condition Name for ENOXAPARIN SODIUM
Intervention	Trials
Venous Thromboembolism	16
Deep Vein Thrombosis	3
Myocardial Infarction	2
Atrial Fibrillation	2

Condition MeSH

Condition MeSH for ENOXAPARIN SODIUM
Intervention	Trials
Thromboembolism	21
Venous Thromboembolism	19
Venous Thrombosis	6
Thrombosis	6

Clinical Trial Locations for ENOXAPARIN SODIUM

Trials by Country

Trials by Country for ENOXAPARIN SODIUM
Location	Trials
United States	28
Canada	10
Russian Federation	9
Mexico	8
Italy	8

Trials by US State

Trials by US State for ENOXAPARIN SODIUM
Location	Trials
New Jersey	7
Ohio	3
Pennsylvania	2
California	2
Arizona	1

Clinical Trial Progress for ENOXAPARIN SODIUM

Clinical Trial Phase

Clinical Trial Phase for ENOXAPARIN SODIUM
Clinical Trial Phase	Trials
PHASE4	1
PHASE2	1
PHASE1	1

Clinical Trial Status

Clinical Trial Status for ENOXAPARIN SODIUM
Clinical Trial Phase	Trials
Completed	36
RECRUITING	6
Terminated	4

Clinical Trial Sponsors for ENOXAPARIN SODIUM

Sponsor Name

Sponsor Name for ENOXAPARIN SODIUM
Sponsor	Trials
Sanofi	16
Daiichi Sankyo Co., Ltd.	4
Indonesia University	1

Sponsor Type

Sponsor Type for ENOXAPARIN SODIUM
Sponsor	Trials
Other	36
Industry	32

Enoxaparin Sodium Clinical Trials Update, Market Analysis and Exclusivity Timeline Projection (2026)

Last updated: July 28, 2026

Enoxaparin sodium is a widely used low molecular weight heparin (LMWH) for prevention and treatment of venous thromboembolism (VTE) and for acute coronary syndromes. Clinical trial activity is concentrated in next-generation anticoagulation comparisons, dosing/biomarker refinement, and expanded-label studies in special populations (renal impairment, obesity, pregnancy). Commercially, the product is mature and highly genericized in many markets; the investment case is anchored to manufacturing reliability, biosimilar-style “follow-on” differentiation is not applicable, and price pressure is the core risk.

What is the latest clinical trials update for enoxaparin sodium (2024–2026)?

Featured trial updates for enoxaparin sodium are typically incremental because the active ingredient is mature and heavily used. Recent focus areas in clinical databases center on comparative effectiveness, thrombosis prevention in high-risk subgroups, and practical dosing validation.

Which trial types dominate enoxaparin sodium in 2024–2026?

Common categories include:

• Head-to-head comparisons versus other LMWHs or unfractionated heparin in perioperative prophylaxis and acute care pathways.
• Trials evaluating dosing adjustment strategies in populations with altered pharmacokinetics: renal impairment, extremes of body weight, and pregnancy.
• Studies linking anti-Xa monitoring or biomarkers with safety endpoints (bleeding) and efficacy endpoints (VTE).
• Trials evaluating practical implementation in real-world or pragmatic designs for hospital prophylaxis protocols.

What endpoints are used most often in enoxaparin sodium studies?

• Primary: symptomatic VTE (DVT/PE), major bleeding, clinically relevant non-major bleeding.
• Secondary: asymptomatic VTE detected on imaging, anti-Xa levels, transfusion requirement, need for reversal, hospital length of stay.
• Special population endpoints: bleeding in renal impairment, maternal and fetal outcomes in pregnancy, and protocol adherence.

What regulatory reality shapes enoxaparin sodium trial programs?

• For originators and line extensions, clinical programs often support labeling specificity rather than new mechanism claims.
• For manufacturers of “generic” enoxaparin sodium, development is typically anchored to bioequivalence and process validation rather than large-scale clinical efficacy trials in most jurisdictions.

What is the enoxaparin sodium market size, growth outlook, and pricing trajectory?

The global market for enoxaparin sodium is large and stable in volume terms, with revenue growth constrained by generic competition and reimbursement pressure. The major swing factors are regional tendering dynamics, list-price erosion, and scope of formularies.

How is demand distributed by indication?

• VTE prophylaxis in hospitalized medical patients
• VTE prophylaxis in orthopedic surgery (particularly hip/knee procedures)
• Treatment of DVT and PE
• Acute coronary syndrome indications (NSTEMI/unstable angina)

Because these indications map to recurrent hospital pathways, utilization is often “sticky” once protocols are established, even as price per dose declines.

What drives market growth versus market erosion?

Growth drivers:

• Aging populations increasing baseline VTE incidence
• Expansion of prophylaxis protocols in inpatient care
• Uptake in outpatient or post-discharge prophylaxis where supported

Erosion drivers:

• Patent and exclusivity roll-offs for originator products across jurisdictions
• High ease of incremental supply for DMFs and contract manufacturers once regulatory approvals exist
• Tendering and rebate structures favoring lowest cost per unit

Market projection (2026–2031): what is the baseline outlook?

• Unit volumes: modest growth in most geographies.
• Revenue: mid-single-digit declines to low-single-digit growth depending on price erosion speed.
• Competitive implication: differentiation moves from clinical superiority to availability, device/form factor, and supply chain performance.

How do enoxaparin sodium exclusivity and patent expiration timelines affect competition?

Enoxaparin sodium faces broad commercial accessibility in most major markets because the active ingredient is long out of new-molecule novelty. The remaining friction is tied to formulation device patents, manufacturing-process IP, and country-specific exclusivity for specific presentations.

What patents protect enoxaparin sodium products in 2026?

Typical residual IP clusters in LMWHs include:

• Manufacturing/process patents (synthetic and purification steps, impurity profiles)
• Formulation patents for specific presentations (prefilled syringes, excipients, packaging)
• Method-of-use patents for specific dosing schedules or patient subgroups, when granted
• Filings tied to specific strengths, concentrations, or regional presentation variants

When does enoxaparin lose exclusivity?

For practical business planning, exclusivity is usually “presentation-specific and jurisdictional.” Most markets already permit generic entry of enoxaparin sodium; the incremental risk is tied to:

• Remaining formulation/process patents still in-force in select jurisdictions
• Litigation outcomes affecting specific presentations
• Regulatory exclusivity tied to specific label expansions, if any, in a given country

What is the Orange Book status of enoxaparin sodium (and what does it imply for generic entry risk)?

In the US, market access is driven by the FDA’s drug listings for enoxaparin sodium presentations and the existence (or absence) of Orange Book-listed patents. The generic entry risk profile depends on:

• Whether listed patents are still in force
• Whether paragraph IV certifications are used against expiring patents
• Whether an injunction or settlement blocks launch

How do Orange Book listings typically map to enoxaparin sodium competitive dynamics?

• When Orange Book patents are absent or already expired: generic entry proceeds without Para IV risk.
• When patents remain: launch depends on FDA approval timing, patent term, and whether litigation triggers exclusivity stays.

Which generic or biosimilar-like challengers impact enoxaparin sodium pricing?

Enoxaparin is not a biologic; it is an anticoagulant drug product classed as a small molecule/chemical drug, so biosimilar pathways do not apply. Competition is “generic follow-on” via ANDA or equivalent pathways.

What’s the typical competitive playbook for enoxaparin sodium challengers?

• Secure regulatory approval for multiple strengths to maximize formulary share.
• Compete on tender pricing and contract volume.
• Build physician and hospital adherence through reliability of supply and stable device specifications.

How strong is the patent estate for enoxaparin sodium (by claim category)?

In LMWHs, patent strength varies by category:

• Process/manufacturing patents often have narrower, more technical claim scope.
• Formulation/presentation patents can still matter because hospital purchasing is per presentation and strength.
• Method-of-use claims are claim-hard but can be relevant if tightly defined to subgroups and dosing strategies.

What is the practical implication for licensing and litigation?

• Licensing leverage tends to be concentrated in manufacturing and presentation IP, not around broad “enoxaparin efficacy” claims.
• Litigation tends to focus on whether the competitor’s process or presentation infringes specific claim limitations.

What patent litigation affects enoxaparin sodium products?

Patent litigation affects enoxaparin sodium primarily at the product-presentation level in specific jurisdictions, with outcomes typically controlling launch timing rather than altering clinical standards.

How do settlements typically shape market entry?

• Authorized generic licensing or delayed launch agreements.
• Staggered entry by strength or presentation.
• Carve-outs tied to particular dosing regimens or device configurations.

What formulations and strengths are commercially important for enoxaparin sodium?

Commercial demand clusters around injectable strengths aligned with prophylaxis and therapeutic dosing.

Key commercial dimensions

• Strength (e.g., mg/mL concentration and per-syringe dosing)
• Prefilled syringe format versus vial format
• Device and needle configuration
• Packaging and traceability (hospital procurement standards)
• Supply chain capability for large tender volumes

How does enoxaparin sodium compare with alternative anticoagulants in clinical practice?

Enoxaparin sodium sits in the anticoagulation algorithm alongside:

• Other LMWHs
• Unfractionated heparin
• Fondaparinux in selected prophylaxis pathways
• Direct oral anticoagulants (DOACs) for many long-term VTE indications where approved

What drives substitution risk for enoxaparin sodium?

Substitution risk increases when:

• DOACs are favored by payer formularies for indicated populations
• Clinical guidelines shift prophylaxis choices away from LMWHs in select settings
• Safety profiles, dosing convenience, or renal impairment considerations favor alternatives

Key takeaways for enoxaparin sodium market projection

• Clinical development is incremental: trials concentrate on special populations, dosing refinement, and comparative protocols rather than new mechanism breakthroughs.
• Market growth is volume-driven with revenue constrained by generic price erosion.
• Competitive timing is driven by jurisdiction-specific residual patents, Orange Book listings, and presentation-level IP, not by the core molecule.
• Business risk centers on pricing and supply reliability; litigation risk is typically episodic and presentation-specific.

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Key Takeaways

• Enoxaparin sodium remains a high-utilization LMWH with ongoing studies focused on subgroup optimization and comparative effectiveness.
• The 2026–2031 outlook is characterized by modest unit growth and continued revenue pressure from generic competition.
• Exclusivity is mainly presentation- and jurisdiction-specific; in many markets generic entry is already established.
• Competitive advantage is operational: manufacturing scale, product availability, and portfolio breadth across strengths.

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FAQs

1. Which enoxaparin sodium indications have the most active ongoing clinical trials?
2. How does renal impairment dosing strategy for enoxaparin sodium differ across labeling regions?
3. What presentation-level factors (strength, device, packaging) most affect formulary uptake for enoxaparin sodium generics?
4. How do DOAC substitution patterns impact hospital prophylaxis and VTE treatment use of enoxaparin sodium?
5. What are the typical settlement structures that delay or permit generic enoxaparin sodium launches?

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References

1. FDA. Orange Book: Approved Drug Products with Therapeutic Equivalence Evaluations. US FDA database.
2. ClinicalTrials.gov. Search results for enoxaparin sodium (last updated per database records).
3. EMA. European public assessment reports and product information for enoxaparin sodium-containing products.
4. WHO/IMS/industry market reports (latest available licensing terms depending on access).