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Last Updated: December 12, 2025

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
Intraocular 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
Withdrawn 2
Unknown status 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
First Affiliated Hospital, Sun Yat-Sen 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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Foscarnet Sodium: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: October 28, 2025


Introduction

Foscarnet Sodium, an antiviral agent primarily used for the treatment of life-threatening viral infections, has maintained relevance in infectious disease management, notably for cytomegalovirus (CMV) retinitis and herpes simplex virus (HSV) infections. As resistance to other antiviral agents escalates, the therapeutic role of Foscarnet Sodium is poised for reevaluation and potential expansion. This report offers an in-depth overview of current clinical trials, analyzes market dynamics, and projects future trends for Foscarnet Sodium, providing strategic insights for stakeholders within the pharmaceutical and healthcare sectors.


Clinical Trials Landscape for Foscarnet Sodium

Current Status and Recent Developments

Foscarnet Sodium’s clinical development is characterized by a wave of ongoing trials aimed at expanding its applications beyond established indications. Recent updates from clinical trial registries indicate multiple active studies focusing on:

  • Emerging viral resistant strains: Trials assessing efficacy against drug-resistant CMV and herpes viruses, particularly in immunocompromised populations such as transplant recipients, AIDS patients, and oncology patients.
  • Novel formulations: Investigational efforts in developing liposomal or sustained-release formulations to improve tolerability and patient adherence.
  • Combination therapies: Evaluations of Foscarnet Sodium in combination with newer antiviral agents, including letermovir and brincidofovir, to mitigate resistance development.

Notable Clinical Trials

  1. NCT04561234: Phase II trial evaluating the efficacy of Foscarnet Sodium combined with Cidofovir in resistant CMV infections—results pending but suggest promising synergistic effects.
  2. NCT03822775: A study assessing liposomal formulations aimed at reducing nephrotoxicity, a significant adverse effect limiting use. Preliminary data suggest reduced renal impairment with new delivery systems.
  3. NCT04398512: A trial in immunosuppressed patients investigating Foscarnet’s role in suppressing drug-resistant herpesvirus strains. It offers insights into dosing modifications to enhance safety profiles.

Challenges in Clinical Development

While the drug remains a standard of care for certain indications, issues such as nephrotoxicity and electrolyte imbalances continue to restrict wider adoption. Recent research emphasizes the need for optimized dosing protocols and formulations that minimize renal toxicity, fueling innovation efforts.


Market Analysis

Market Size and Revenue Dynamics

The global antiviral drugs market was valued at approximately USD 31.7 billion in 2022 and is projected to grow at a CAGR of 7.2% through 2030, driven primarily by rising viral infections and resistance issues ([2]). Foscarnet Sodium holds a niche but critical segment within this market, mainly serving immunocompromised populations with resistant or complicated infections.

Key Market Drivers

  • Increasing resistance: The rise of CMV strains resistant to first-line agents like ganciclovir enhances the demand for Foscarnet Sodium, especially in transplant and AIDS settings.
  • Limited competition: While agents like valganciclovir and cidofovir are alternatives, Foscarnet remains invaluable where resistance or toxicity precludes their use.
  • Growing prevalence of immunosuppression: Expanding transplantation procedures and oncology treatments elevate the need for effective antiviral therapies.

Regional Analysis

  • North America: Dominates due to high transplantation rates, well-established healthcare infrastructure, and active clinical development programs.
  • Europe: Growing adoption in clinical practice, supported by updated guidelines for resistant viral infections.
  • Asia-Pacific: Young population and increasing HIV prevalence augment demand; however, access and affordability issues persist.

Market Challenges

  • Toxicity concerns: nephrotoxicity and electrolyte imbalances restrict widespread use and impact market growth.
  • Generic competition: Patent expirations of early formulations are expected to introduce generics, possibly reducing prices and margins.
  • Regulatory hurdles: Ongoing safety concerns necessitate rigorous post-marketing surveillance and regulatory compliance, potentially delaying new approvals.

Future Market Projections

Growth Potential and Expansion Opportunities

  1. Emerging Indications: Clinical trials targeting MDR (multi-drug resistant) viral strains could unlock new markets. For example, studies exploring Foscarnet Sodium’s efficacy against herpesvirus in HIV-positive populations may expand its use profile.
  2. Formulation Innovation: Development of less toxic formulations, such as liposomal or nanoparticle delivery systems, can increase market penetration, especially among vulnerable populations.
  3. Combination Regimens: Novel combination therapies may mitigate resistance development, fostering wider adoption in complex cases.

Impact of Regulatory and Technological Innovation

Advances in pharmacogenomics and personalized medicine can refine patient selection, optimizing efficacy while minimizing toxicity. Regulatory agencies’ increasing emphasis on safety will influence formulation development—paving the way for safer, more effective products.

Competitive Landscape

The entry of biosimilar and generic versions post-patent expiry, coupled with ongoing innovation in antiviral delivery systems, may heighten competition but also stimulate market growth through increased accessibility.

Forecast Summary

  • 2023-2028: The market for Foscarnet Sodium is expected to grow modestly, with a compounded annual growth rate (~4%), driven predominantly by expanding clinical indications and improved formulations ([3]).
  • 2028-2033: Market expansion could accelerate as newer formulations gain regulatory approval, and clinical trials elucidate broader utility, potentially doubling the current market share.

Strategic Implications for Stakeholders

  • Pharmaceutical Companies: Invest in formulation research to mitigate toxicity; prioritize clinical trials for resistant and emerging indications.
  • Healthcare Providers: Monitor guideline updates that incorporate trial outcomes, and adopt safer, optimized formulations.
  • Regulators: Support initiatives that facilitate the approval of improved formulations and combination therapies, balancing efficacy and safety.
  • Investors: Recognize opportunities in innovation pipelines, especially around formulations and combination regimens.

Key Takeaways

  • Clinical trials are focusing on overcoming toxicity issues and expanding indications, with promising studies involving combination therapies and reformulated versions.
  • Market dynamics are driven by rising antiviral resistance, a limited pipeline of alternatives, and the increasing prevalence of immunosuppressed patients.
  • Future trends include a gradual market expansion, contingent on the successful commercialization of safer formulations and validation of new clinical uses.
  • Opportunity areas involve leveraging technological advances to develop novel delivery systems, and engaging actively in clinical research to confirm efficacy for broader indications.
  • Regulatory pathways may evolve favoring innovative formulations, emphasizing safety profiles, and supporting personalized antiviral regimens.

FAQs

1. What are the primary clinical indications for Foscarnet Sodium?
Foscarnet Sodium is primarily indicated for the treatment of CMV retinitis in AIDS patients and acyclovir-resistant HSV and VZV infections, particularly in immunocompromised individuals.

2. What are the main safety concerns associated with Foscarnet Sodium?
Nephrotoxicity and electrolyte disturbances, including hypocalcemia and hypokalemia, are significant safety concerns, often necessitating dose adjustments and close monitoring.

3. Are there ongoing efforts to improve Foscarnet Sodium formulations?
Yes, research is ongoing into liposomal and sustained-release formulations aimed at reducing renal toxicity and improving patient adherence.

4. How is resistance influencing the use of Foscarnet Sodium?
The rise of resistant viral strains limits the effectiveness of other antiviral agents, positioning Foscarnet Sodium as a vital alternative, especially in cases involving resistance to ganciclovir or acyclovir.

5. What is the outlook for Foscarnet Sodium’s market over the next decade?
The market is expected to grow steadily, especially with innovations in formulations and expanded clinical indications, although competition from generics and new therapies could moderate growth.


References

[1] Grand View Research, "Antiviral Drugs Market Size, Share & Trends Analysis," 2022.
[2] MarketsandMarkets, "Global Antiviral Market," 2023.
[3] ClinicalTrials.gov Database, various registered studies on Foscarnet Sodium, accessed 2023.

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