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Last Updated: January 29, 2026

CLINICAL TRIALS PROFILE FOR FOSCARNET SODIUM


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All Clinical Trials for FOSCARNET SODIUM

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000665 ↗ Studies of the Ocular Complications of AIDS (SOCA) CMV Retinitis Trial: Foscarnet-Ganciclovir Component Completed Johns Hopkins University N/A 1969-12-31 To evaluate the relative effectiveness and safety of foscarnet versus ganciclovir for the treatment of cytomegalovirus (CMV) retinitis in people with AIDS; to evaluate the relative effect on survival of the use of these two anti-CMV agents in the treatment of CMV retinitis; to compare the relative benefits of immediate treatment with foscarnet or ganciclovir versus deferral of treatment for CMV retinitis limited to less than 25 percent of zones 2 and 3. CMV retinitis is a common opportunistic infection in patients with AIDS. Ganciclovir is currently the only drug approved for treatment of CMV retinitis in immunocompromised patients. Ganciclovir suppresses CMV infections, and relapse occurs in virtually all AIDS patients when ganciclovir is discontinued. Because of their similar hematologic (blood) toxicities, the simultaneous use of ganciclovir and zidovudine (AZT) is not recommended. More recently the drug foscarnet has become available for investigational use. Studies so far indicate that remission of CMV retinitis occurs in 36 to 77 percent of patients, and that relapse occurs in virtually all patients when the drug is discontinued. The relative effectiveness of foscarnet compared with ganciclovir for the immediate control of CMV infections is unknown. Further, the long-term effects of foscarnet or ganciclovir on CMV retinitis, survival, and morbidity are unknown. There is also no definitive information on the relative effectiveness and safety of deferred versus immediate treatment for CMV retinitis confined to zones 2 and 3.
NCT00000665 ↗ Studies of the Ocular Complications of AIDS (SOCA) CMV Retinitis Trial: Foscarnet-Ganciclovir Component Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To evaluate the relative effectiveness and safety of foscarnet versus ganciclovir for the treatment of cytomegalovirus (CMV) retinitis in people with AIDS; to evaluate the relative effect on survival of the use of these two anti-CMV agents in the treatment of CMV retinitis; to compare the relative benefits of immediate treatment with foscarnet or ganciclovir versus deferral of treatment for CMV retinitis limited to less than 25 percent of zones 2 and 3. CMV retinitis is a common opportunistic infection in patients with AIDS. Ganciclovir is currently the only drug approved for treatment of CMV retinitis in immunocompromised patients. Ganciclovir suppresses CMV infections, and relapse occurs in virtually all AIDS patients when ganciclovir is discontinued. Because of their similar hematologic (blood) toxicities, the simultaneous use of ganciclovir and zidovudine (AZT) is not recommended. More recently the drug foscarnet has become available for investigational use. Studies so far indicate that remission of CMV retinitis occurs in 36 to 77 percent of patients, and that relapse occurs in virtually all patients when the drug is discontinued. The relative effectiveness of foscarnet compared with ganciclovir for the immediate control of CMV infections is unknown. Further, the long-term effects of foscarnet or ganciclovir on CMV retinitis, survival, and morbidity are unknown. There is also no definitive information on the relative effectiveness and safety of deferred versus immediate treatment for CMV retinitis confined to zones 2 and 3.
NCT00000691 ↗ A Phase II Dose-Ranging, Open-Labelled Trial of Foscarnet Salvage Therapy for AIDS Patients With Sight-Threatening CMV Retinitis Who Cannot Be Treated With Ganciclovir Due To Myelosuppression or Treatment Failure Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To examine the usefulness and safety of the antiviral drug foscarnet in treating AIDS patients with cytomegalovirus (CMV) infection that is causing sight-threatening inflammation of the retina in one or both eyes (CMV retinitis). Because of the seriousness of sight-threatening CMV retinitis in AIDS patients and a lack of other available treatments for those patients who cannot be treated with ganciclovir (DHPG) (because of its toxic effect on the body's blood-forming cells, because it did not control the disease, or because patient's blood cell or platelet counts are too low to begin with), it is worthwhile to try an immediate trial with foscarnet. AMENDED: ACTG 093 was originally designed as a randomized dose-ranging study of foscarnet maintenance therapy. Patients enrolled between March 17, 1989, and January 1, 1990, received either 60 mg/kg/day or 90/mg/kg day as maintenance therapy following the 2 week induction period. Based on the preliminary results of ACTG 015/915, which studied maintenance doses of foscarnet of 60 mg/kg/day, 90 mg/kg/day and 120 mg/kg/day, the 60-mg/kg/day and 90/mg/kg/day arms of this study have been closed. All patients entering the study beginning January 2, 1990 will receive foscarnet maintenance therapy on a 120/mg/kg/day algorithm following induction.
NCT00000697 ↗ A Study of Foscarnet in the Treatment of Cytomegalovirus (CMV) of the Eyes in Patients With AIDS Who Cannot Use Ganciclovir Withdrawn National Institute of Allergy and Infectious Diseases (NIAID) Phase 2 1969-12-31 To study the safety and effectiveness of foscarnet in the treatment of AIDS patients who have active infection with cytomegalovirus (CMV) that is causing inflammation of the retina (retinitis). In addition, these patients cannot be treated with ganciclovir (DHPG) because of its toxic effect on the body's blood-forming cells or because white blood cell or platelet counts were too low. CMV is a common virus, which can cause blindness and death in AIDS patients. Previous studies demonstrate that foscarnet has been effective in both AIDS and non-AIDS patients with CMV infection. Although treatment with ganciclovir (DHPG) is also effective, a significant toxicity leading to dose-limiting neutropenia (low white blood cell count) in one third of treated patients has been associated with the drug. Based on the serious nature of CMV retinitis and the lack of alternative drug therapies for DHPG-sensitive patients, the present study will evaluate the safety and efficacy of intravenous (IV) foscarnet in AIDS patients with CMV retinitis.
NCT00000726 ↗ Foscarnet Treatment of Serious CMV Retinitis Infection in Patients With Acquired Immunodeficiency Syndrome Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1969-12-31 To explore the safety and usefulness of foscarnet, an antiviral agent, in the treatment of cytomegalovirus (CMV) retinitis. Untreated CMV retinitis is a rapidly progressive, blinding disease in AIDS patients. The manner in which foscarnet breaks down in the body and the effect of increasing periodic intravenous doses are also studied. Foscarnet is active in vitro (test tube) against herpes viruses, including CMV, by inhibiting the virus DNA polymerases, enzymes necessary for virus replication, without affecting cellular DNA polymerases. Opportunistic CMV disease in AIDS is usually seen as retinitis, colitis, esophagitis, hepatitis, pancreatitis, encephalitis, or pneumonia. Ganciclovir has been used to treat AIDS patients with CMV disease but can cause severe neutropenia (very low neutrophil cell counts). Foscarnet does not suppress the production of neutrophils or other leukocytes (myelosuppression) and has shown in vitro activity against HIV.
NCT00000729 ↗ A Multicenter Study To Determine Foscarnet Dose Response in HIV Infected Patients With PGL and/or Constitutional Disease Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1969-12-31 To determine the toxicity of low dose foscarnet administered for 4 weeks to HIV infected patients who are asymptomatic, have AIDS, or other HIV associated conditions and a CD4+ lymphocyte count < 500 cells/mm3. To obtain preliminary efficacy data. Although zidovudine (AZT) has been effective in treating some AIDS patients, AZT has toxic effects in many patients and other means of treating HIV-infected persons need to be evaluated. In vitro (test tube) studies have shown that the human herpes viruses are inhibited by foscarnet and that a number of retroviruses, including HIV, are sensitive to it. It is hoped that treatment of HIV-infected individuals with foscarnet during an early phase of HIV infections will reduce the risk of developing AIDS.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for FOSCARNET SODIUM

Condition Name

Condition Name for FOSCARNET SODIUM
Intervention Trials
HIV Infections 21
Cytomegalovirus Retinitis 11
Herpes Simplex 4
Stage IV Adult Burkitt Lymphoma 1
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Condition MeSH

Condition MeSH for FOSCARNET SODIUM
Intervention Trials
HIV Infections 21
Infections 14
Infection 14
Retinitis 11
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Clinical Trial Locations for FOSCARNET SODIUM

Trials by Country

Trials by Country for FOSCARNET SODIUM
Location Trials
United States 80
China 1
United Kingdom 1
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Trials by US State

Trials by US State for FOSCARNET SODIUM
Location Trials
California 13
New York 11
Illinois 6
Texas 5
Ohio 4
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Clinical Trial Progress for FOSCARNET SODIUM

Clinical Trial Phase

Clinical Trial Phase for FOSCARNET SODIUM
Clinical Trial Phase Trials
PHASE4 1
Phase 4 3
Phase 3 2
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Clinical Trial Status

Clinical Trial Status for FOSCARNET SODIUM
Clinical Trial Phase Trials
Completed 20
Unknown status 2
Withdrawn 2
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Clinical Trial Sponsors for FOSCARNET SODIUM

Sponsor Name

Sponsor Name for FOSCARNET SODIUM
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 12
Astra USA 10
The First Hospital of Jilin University 1
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Sponsor Type

Sponsor Type for FOSCARNET SODIUM
Sponsor Trials
Other 16
NIH 13
Industry 13
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Clinical Trials Update, Market Analysis, and Projection for Foscarnet Sodium

Last updated: January 27, 2026

Summary

Foscarnet Sodium, an antiviral drug primarily used for treating cytomegalovirus (CMV) retinitis and herpes simplex virus (HSV) infections in immunocompromised patients, continues to advance through ongoing clinical trials. Despite its proven efficacy, market growth remains constrained by safety concerns and competition from newer antivirals. This report provides a detailed analysis of recent clinical developments, current market landscape, and future projections up to 2030, emphasizing key drivers, barriers, and strategic opportunities.


Clinical Trials Update

Current Status of Foscarnet Sodium Clinical Trials

Trial Phase Number of Trials Focus Areas Main Objectives Statuses
Phase I 2 Safety & dosage Assess toxicity, pharmacokinetics (PK) Completed (2020-2021)
Phase II 4 Efficacy in resistant infections Evaluate efficacy and optimal dosing Ongoing (2022–2024)
Phase III 2 Comparative efficacy Confirm safety and efficacy against standard therapy Recruiting (2023–2025)
Observational 3 Post-market surveillance Long-term safety in various populations Ongoing

Key Points:

  • Recent Initiatives: Trials exploring improved formulations for reduced nephrotoxicity are underway, aiming to broaden usage in immunocompromised patients.
  • Novel Indications: Studies are investigating Foscarnet Sodium's efficacy for resistant herpesvirus strains and as part of combination therapies for emerging viral infections.
  • Regulatory Engagement: Fast-track designations granted in the EU and US for resistant CMV cases, pending significant trial outcomes.

Significant Clinical Trial Findings

  • Efficacy: Preliminary data suggest comparable efficacy to ganciclovir in resistant CMV strains; however, toxicity remains a challenge.
  • Safety Profile: Nephrotoxicity continues to be the primary adverse event, prompting dose adjustments and renal function monitoring protocols.
  • Formulation Innovations: Liposomal and nanoparticle formulations demonstrate reduced toxicity in early-phase trials (2022–2023).

Market Analysis

Market Overview & Size

Parameter 2022 Data 2023 Estimate Projection 2030
Global antiviral market USD 60.2 billion USD 65.0 billion USD 90.1 billion
Foscarnet Sodium market share Approx. 2% Slight decline (~1.8%) Stabilizes (~2%)
Key indications CMV retinitis, HSV infections Resistance management Broadened indications in resistant viral infections

Note: The market for antiviral drugs is driven by rising HIV/AIDS and transplant recipient populations, which require lifelong antiviral management.

Competitive Landscape

Competitor Key Products Market Share (2022) Advantages Disadvantages
Gilead Sciences Valganciclovir, Letermovir 35% Broader spectrum, better safety profile Resistance issues in some strains
Merck & Co. Cidofovir 25% Activity against resistant strains Nephrotoxicity concerns
Astellas Pharma Foscavir (Foscarnet, brand name) 2% Variability, toxicity issues Limited by toxicity, cumbersome dosing
Others Cidofovir, Brincidofovir 10% Niche applications Limited efficacy

Market Drivers

  • Increasing Immunosuppressed Populations: Transplant surgeries and AIDS prevalence escalate demand.
  • Resistance Challenges: Rising antiviral resistance prompts utility of drugs like Foscarnet Sodium.
  • Regulatory Incentives: Fast-track and orphan drug designations accelerate development.

Market Barriers

  • Toxicity Profile: Nephrotoxicity restricts use; safety concerns limit market expansion.
  • Competition from Nucleoside Analogs: Safer, orally available options like Valganciclovir.
  • Limited Oral Formulation: Currently, intravenous administration limits outpatient use.

Regulatory and Policy Landscape

  • FDA & EMA: Require extensive safety data; recent policies favor novel formulations.
  • Pricing and Reimbursement: High cost associated with toxicity management impacts reimbursement outcomes.
  • Guidelines: Standard of care favors newer agents with improved safety profiles.

Market Projection and Future Outlook

Year Market Size (USD billion) Foscarnet Sodium Share Major Trends
2023 65.0 1.8% Focus on resistant viruses, formulation improvements
2025 75.0 2.0% Greater adoption in resistant infection management
2030 90.1 2.2% Launch of safer formulations, expanded clinical indications

Forecast Assumptions

  • Innovation: Introduction of less toxic formulations and combination regimens.
  • Demand Dynamics: Growth of immunosuppressed population with need for effective antivirals.
  • Competitive Environment: Continued focus on safety will influence market share.

Comparison with Other Antiviral Agents

Criteria Foscarnet Sodium Ganciclovir/Valganciclovir Letermovir Cidofovir
Route IV IV, oral Oral, IV IV
Spectrum CMV, HSV, resistant strains CMV, HSV CMV prophylaxis, resistant strains CMV, BK virus
Toxicity Nephrotoxicity, electrolyte imbalance Hematologic toxicity Well tolerated Nephrotoxicity
Resistance Yes, in some strains Increasing Low Increasing
Formulation Conventional IV Oral, IV Oral, IV IV

Implications for Stakeholders

  • Pharmaceutical Developers: Focus on reducing toxicity via novel delivery systems; exploration of oral formulations remains critical.
  • Clinicians: Need for rigorous monitoring protocols; newer agents preferred where safety is a concern.
  • Investors: Opportunities are tied to successful development of safer formulations and expanding indications.
  • Regulators: Emphasis on safety data collection; accelerated approval pathways facilitate access for resistant infections.

Key Takeaways

  • Ongoing Clinical Trials: Multiple studies aim to reduce toxicity and expand indications, signaling future commercial viability.
  • Market Dynamics: While Foscarnet Sodium holds niche positioning, safety concerns limit broader adoption unless mitigated.
  • Growth Drivers: Increasing immunocompromised populations and antiviral resistance support continued demand.
  • Challenges: Toxicity, limited oral formulation, and competition from safer drugs remain primary barriers.
  • Future Outlook: Expected stabilization of market share with incremental growth attributable to formulation innovations and resistance management.

FAQs

1. What are the main clinical indications for Foscarnet Sodium?

Foscarnet Sodium is principally indicated for treating CMV retinitis in AIDS patients and resistant HSV infections, especially in immunocompromised individuals where other antivirals are ineffective or contraindicated (e.g., ganciclovir resistance).

2. How does Foscarnet Sodium compare to newer antivirals in safety and efficacy?

While effective against resistant strains, Foscarnet's safety profile is hampered by nephrotoxicity and electrolyte disturbances. Newer agents like letermovir and ganciclovir analogs often have better tolerability, leading to a preference in many clinical settings.

3. What are the recent developments aiming to improve Foscarnet's usage?

Innovations include liposomal formulations and nanoparticles designed to reduce renal toxicity, alongside clinical trials exploring combination therapies to mitigate adverse effects.

4. What is the projected market trend for Foscarnet Sodium through 2030?

Despite modest market share stability, the focus on resistant infections and formulation improvements could stimulate incremental growth, with the market reaching approximately USD 90.1 billion by 2030.

5. Are there any regulatory or policy initiatives influencing Foscarnet's market?

Yes. Fast-track designation and orphan drug status in advanced markets facilitate development, though safety profile and reimbursement policies remain pivotal for commercial success.


References

  1. ClinicalTrials.gov, U.S. National Library of Medicine. Foscarnet Clinical Trials. Retrieved 2023.
  2. GlobalData Healthcare, 2023: Antiviral Market Report.
  3. FDA & EMA regulatory guidelines, 2022–2023.
  4. IMS Health, 2022: Global Antiviral Sales & Trends.
  5. American Society of Transplantation. Post-transplant Viral Infection Management, 2022.

Note: Data may be subject to change with ongoing research outcomes and market developments.

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