You're using a free limited version of DrugPatentWatch: Upgrade for Complete Access

Last Updated: December 16, 2025

CLINICAL TRIALS PROFILE FOR NITRIC OXIDE


✉ Email this page to a colleague

« Back to Dashboard


505(b)(2) Clinical Trials for nitric oxide

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT01691690 ↗ Analgesic Effect of IV Acetaminophen in Tonsillectomies Completed Nationwide Children's Hospital Phase 2 2012-10-01 Acetaminophen (paracetamol) is a first-line antipyretic and analgesic for mild and moderate pain for pediatric patients. Its common use (particularly in oral form) is underscored by its wide therapeutic window, safety profile, over the counter accessibility, lack of adverse systemic effects (as compared with NSAIDS and opioids) when given in appropriate doses. Although the exact anti-nociceptive mechanisms of acetaminophen continue to be elucidated, these mechanisms appear to be multi-factorial and include central inhibition of the cyclo-oxygenase (COX) enzyme leading to decreased production of prostaglandins from arachidonic acid, interference with serotonergic descending pain pathways, indirect activation of cannabinoid 1 (CB1) receptors and inhibition of nitric oxide pathways through N-methyl-D-aspartate (NMDA) or substance P. Of the above mechanisms, the most commonly known is that of central inhibition of COX enzymes by which the decreased production of prostaglandins diminish the release of excitatory transmitters of substance P and glutamate which are both involved in nociceptive transmission (Anderson, 2008; Smith, 2011). To date, several studies have shown acetaminophen's opioid sparing effect in the pediatric population when given by the rectal or intravenous routes (Korpela et al, 1999; Dashti et al, 2009; Hong et al, 2010).
OTC NCT02675660 ↗ Single and Multiple Doses of an Oral Formulation of L-Homoarginine in Healthy Human Subjects Completed Universitätsklinikum Hamburg-Eppendorf Phase 1 2014-04-01 This study represents an initial clinical evaluation of an oral formulation of L-homoarginine. L-homoarginine and L-arginine are amino acids found in food proteins and are both substrates for nitric oxide synthase (NOS). L-arginine is available as over the counter nutraceutical. This study will provide information on the dosing of L-homoarginine in order to reach high physiological plasma concentrations in humans.
OTC NCT03878654 ↗ Trial of Tauroursodeoxycholic Acid (TUDCA) in Asthma Terminated University of Vermont Phase 1 2019-01-10 Asthma is a chronic lung disease that affects millions of people worldwide, including both children and adults. The cause of asthma is not known, but asthma is strongly associated with inflammation of the airways, often caused by allergies. In order to control this inflammation, most people with asthma are treated with inhaled medications that contain steroids. These medications do a good job of helping most people with asthma feel better. However, these medications are expensive, have side effects, and do not control symptoms in all people with asthma. Recently basic science research colleagues have shown that inflammation due to allergies can be reduced in experimental animals by a naturally occurring bile acid. Bile acids are chemicals made in the liver that are involved in maintaining healthy digestion of fat. Since bile acids are made by our bodies, they have become popular as over the counter supplements that are thought to be important in promoting a healthy liver and metabolism. Interestingly, other research has shown that bile acids may help patients with neurological disease and diabetes. Given all of this information, the investigators propose that a specific bile acid called tauroursodeoxycholic acid (TUDCA) may be helpful in patients with asthma. Before studying this in a clinical trial, the current study is designed to demonstrate that people with asthma can take TUDCA safely and that it doesn't hurt their asthma. The study will involve inviting 12 patients with mild asthma to take TUDCA daily for 12 weeks. During this time the investigators will closely monitor them for any side effects and check their blood and breathing capacity for any signs of detrimental effects. In addition, the investigators will collect cells that line the nose, which are thought to be similar to cells in the airways of the lungs, to see if TUDCA is having any beneficial effects on inflammation. In order to ensure the use of high quality TUDCA, which may or may not be true of over the counter supplements, the investigators have asked the company that is supplying TUDCA for the studies mentioned previously involving neurological disease and diabetes to supply the drug; the brand name is Taurolite. In addition, even though TUDCA is available over the counter, in order to use it for research, the FDA has to approve this use. Accordingly, the investigators have applied for and received permission (IND) from the FDA to use Taurolite for this study.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for nitric oxide

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000577 ↗ Asthma Clinical Research Network (ACRN) Withdrawn National Heart, Lung, and Blood Institute (NHLBI) Phase 3 1993-09-01 This study will establish a network of interactive asthma clinical research groups to evaluate current therapies, new therapies, and management strategies for adult asthma.
NCT00000577 ↗ Asthma Clinical Research Network (ACRN) Withdrawn Milton S. Hershey Medical Center Phase 3 1993-09-01 This study will establish a network of interactive asthma clinical research groups to evaluate current therapies, new therapies, and management strategies for adult asthma.
NCT00001303 ↗ Effects of Endotoxin in Normal Human Volunteers Completed National Institutes of Health Clinical Center (CC) Phase 1 1992-04-06 Bacterial infections can progress to a life-threatening illness called septic shock, characterized by low blood pressure and vital organ damage. The syndrome is thought to be caused by parts of the bacteria and by the body s own immune response to the infection. A major bacterial product that interacts with the immune defenses is called endotoxin. This study will examine the body s response to endotoxin in the lungs or bloodstream. When endotoxin is given in small amounts to humans, even though it is not an infection, it triggers a set of responses that are typical of what one would see with a true bacterial infection. This allows us to study the earliest changes in molecules and cells that are involved in some bacterial infections. This type of model is safe and has been used in humans for many years to understand the body s responses during infections. Normal volunteers 18 to 45 years of age may be eligible for this study. Candidates will have a history and physical examination, blood and urine tests, electrocardiogram (EKG) and chest X-ray. In addition, volunteers 40 to 45 years old will have an exercise stress test to screen for asymptomatic coronary artery disease. Participants will undergo one or more of the following procedures: Bronchoscopy, Bronchoalveolar Lavage, Bronchial Brushings, and Endobronchial Mucosal Biopsies: These techniques for examining lung function are used routinely in patient care and clinical research. The mouth and nasal and lung airways are numbed with an anesthetic. A bronchoscope (pencil-thin flexible tube) is then passed through the nose into the large airways of the lung. Cells and secretions from the airways are rinsed with salt water (bronchoalveolar lavage) and a flexible brush the size of a pencil tip is passed through the bronchoscope to scrape cells lining the airways. Lastly, pieces of tissue (the size of the ball of a ballpoint pen) lining the airways are removed for examination under the microscope. Intravenous Endotoxin: A small dose of endotoxin is injected into a vein. Blood samples are drawn at regular intervals for 8 hours after the injection and again after 1, 2, 3, 7 and 14 days to analyze the body s immune response to the bacteria in the blood. Instilled Endotoxin in the Lungs: A small amount (2 teaspoons) of salt water is squirted through a bronchoscope into a lobe of one lung, and then salt water containing a small dose of endotoxin is squirted into the other lung. Bronchial lavage, brushing, and biopsy (see above) are then done to study the response of the lung to the endotoxin. In addition, air is withdrawn through the bronchoscope to study air components from the lung that was instilled with salt water or endotoxin. Nitric Oxide Therapy: Endotoxin is instilled in a lung (see above) and then nitric oxide a colorless, odorless, tasteless gas mixed with room air in a concentration of 40 parts per million, is given through a cushioned mask placed over the mouth and nose. (Some participants will be given the nitric oxide mixture and others will breathe only room air through the mask to test the effects of the nitric oxide on the lung inflammation.) The mask will be worn continuously for 6 hours and removed before repeat bronchoscopy with lavage, brushing and biopsy. Some of the above procedures require placement of a catheter (thin plastic tube) in a wrist artery to monitor blood pressure from heartbeat to heartbeat and to collect blood samples. First, the skin is numbed with an anesthetic (lidocaine). A needle is then inserted into the artery, the catheter is slipped over the needle into the vessel, and the needle is removed.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for nitric oxide

Condition Name

Condition Name for nitric oxide
Intervention Trials
Asthma 65
Pulmonary Hypertension 45
Hypertension 33
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Condition MeSH

Condition MeSH for nitric oxide
Intervention Trials
Hypertension 127
Hypertension, Pulmonary 79
Asthma 71
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Locations for nitric oxide

Trials by Country

Trials by Country for nitric oxide
Location Trials
Canada 94
United Kingdom 79
Germany 63
Egypt 56
Italy 51
This preview shows a limited data set
Subscribe for full access, or try a Trial

Trials by US State

Trials by US State for nitric oxide
Location Trials
California 81
Texas 61
Massachusetts 57
Maryland 56
New York 54
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Progress for nitric oxide

Clinical Trial Phase

Clinical Trial Phase for nitric oxide
Clinical Trial Phase Trials
PHASE4 16
PHASE3 13
PHASE2 35
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Status

Clinical Trial Status for nitric oxide
Clinical Trial Phase Trials
Completed 552
Recruiting 149
Terminated 99
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trial Sponsors for nitric oxide

Sponsor Name

Sponsor Name for nitric oxide
Sponsor Trials
National Heart, Lung, and Blood Institute (NHLBI) 63
Mallinckrodt 44
Massachusetts General Hospital 20
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Sponsor Type

Sponsor Type for nitric oxide
Sponsor Trials
Other 1371
Industry 310
NIH 139
[disabled in preview] 0
This preview shows a limited data set
Subscribe for full access, or try a Trial

Clinical Trials Update, Market Analysis, and Projection for Nitric Oxide-Based Therapies

Last updated: October 27, 2025

Introduction

Nitric oxide (NO) is a gaseous molecule integral to physiological processes, including vasodilation, immune response modulation, and neurotransmission. Its unique bioactivity has fostered extensive research into therapeutic applications across cardiovascular, pulmonary, neurological, and infectious diseases. As the drug development pipeline advances, a comprehensive understanding of clinical trial progress, market dynamics, and future projections for nitric oxide-based therapies is vital for stakeholders. This report provides an in-depth analysis of current clinical trials, market landscape, and growth forecasts for nitric oxide therapeutics.

Clinical Trials Landscape for Nitric Oxide Therapies

Current State of Clinical Trials

As of early 2023, over 50 clinical trials explore nitric oxide's therapeutic potential across various medical conditions. These trials span phases I through III, reflecting a diversified pipeline of innovative formulations, delivery systems, and targeted indications.

Key Clinical Trials and Therapeutic Areas

  • Pulmonary Hypertension: The largest subset, with approximately 20 ongoing trials, investigates inhaled nitric oxide (iNO) for neonatal and adult pulmonary hypertension, emphasizing rapid onset and pulmonary vasodilation properties [1].

  • COVID-19 and Infectious Diseases: Several trials examine NO's antiviral and immunomodulatory effects, particularly its potential to mitigate respiratory failure and cytokine storm syndrome in severe COVID-19 cases [2].

  • Cardiovascular Conditions: Research focuses on NO donors and modulators for heart failure, atherosclerosis, and ischemic injuries, with trials testing both inhalation and novel delivery systems.

  • Neurological Disorders: Emerging studies assess NO's role in neuroprotection following stroke and traumatic brain injury.

Innovative Delivery Methods Under Investigation

Advancements in delivery technologies aim to improve efficacy and reduce adverse events:

  • Targeted inhalation systems: Portable and ventilator-compatible NO delivery for acute respiratory management.

  • Nanoparticle encapsulation: To enhance stability and site-specific release.

  • NO-releasing biomaterials: Including wound dressings and implants to provide localized NO delivery.

Regulatory Milestones and Challenges

While inhaled NO is approved for neonatal pulmonary hypertension in some jurisdictions, broader approval remains sparse due to challenges such as toxicity concerns and delivery complexity. Recent trials aim to address these issues, with some showing promising safety profiles and therapeutic benefits.

Market Analysis

Market Size and Segments

The global nitric oxide therapeutic market was valued at approximately USD 1.1 billion in 2022 and is projected to reach USD 2.5 billion by 2030, exhibiting a compound annual growth rate (CAGR) of roughly 10%. Key market segments include:

  • Inhaled nitric oxide (iNO): The dominant sector, particularly in neonatal and pediatric pulmonary hypertension, occupying around 70% of the current market share.

  • NO donor drugs: Such as organic nitrates and molsidomine, primarily used for angina and heart failure management.

  • Innovative NO therapies: Emerging market for localized NO delivery systems in wound care, dental applications, and implant coatings.

Market Drivers

  • Expanding clinical applications: Increasing evidence supports NO's role beyond traditional indications, fostering market diversification.

  • Advancements in delivery technology: Enhanced safety and efficacy profiles attract broader clinical adoption.

  • Rising prevalence of pulmonary hypertension and cardiovascular diseases: Driven by aging populations and lifestyle factors.

  • Growing COVID-19 research: Heightened interest in NO's antiviral and respiratory benefits accelerates development and commercialization efforts.

Market Challenges

  • Safety Concerns: Potential toxicity, such as methemoglobinemia and nitrogen dioxide formation, hampers wider adoption [3].

  • Delivery Complexity: The need for specialized equipment limits use outside hospital settings.

  • Regulatory Hurdles: Limited approved indications in certain countries restrict market penetration.

Competitive Landscape

Major players include Mallinckrodt Pharmaceuticals, Bellerophon Therapeutics, and emerging biotech firms focusing on innovative NO delivery platforms. Strategic collaborations, licensing agreements, and technological investments drive competitive differentiation.

Market Projection and Future Outlook

Growth Drivers

The nitric oxide therapeutic market is poised for robust growth due to:

  • Accelerated clinical validation of new indications.
  • Technological innovations enhancing safety and ease of use.
  • Increasing healthcare expenditure on respiratory and cardiovascular care.
  • Emerging applications in infectious diseases, especially in the context of the COVID-19 pandemic.

Forecasted Trends

  • Expansion into novel indications: Neurological disorders, wound healing, and cancer therapies.
  • Development of next-generation delivery devices: Portable, user-friendly, and cost-effective.
  • Regulatory approval pathway simplification: Adaptive pathways facilitating broader use.
  • Integration with personalized medicine: Tailored NO therapies based on genomics and biomarker-driven strategies.

Potential Market Challenges

  • Pricing and reimbursement complexities could influence adoption rates.
  • Limited commercialization of new NO agents outside respiratory indications.
  • Safety concerns necessitate continuous monitoring and risk mitigation strategies.

Key Takeaways

  • The nitric oxide therapeutic pipeline is dynamic, with ongoing clinical trials exploring varied indications and delivery methods.
  • Market growth is underpinned by technological improvements, expanded clinical evidence, and rising disease prevalence.
  • While current commercial success is largely confined to pulmonary hypertension, emerging data suggests broader potential implications.
  • Strategic partnerships, regulatory advancements, and innovative formulations will play critical roles in market expansion.
  • Stakeholders should monitor clinical trial outcomes and technological developments to identify early opportunities and manage risks.

Conclusion

Nitric oxide remains a versatile and promising therapeutic agent with expanding clinical applications and a growing market footprint. Ongoing research efforts are expected to unlock new indications, improve delivery systems, and address safety concerns, thereby solidifying NO-based therapies as integral components of future medical practices.


FAQs

1. What are the main medical indications currently approved for nitric oxide therapies?
Inhaled nitric oxide (iNO) is primarily approved for neonatal pulmonary hypertension and pulmonary vasodilation in select adult cases. Wider approval for other indications remains under development, pending clinical trial validation [1].

2. How does nitric oxide delivery technology impact market growth?
Advanced delivery systems enhance the safety, efficacy, and convenience of NO therapies, facilitating broader clinical adoption and expanding off-label uses, thus accelerating market growth.

3. What safety concerns are associated with nitric oxide therapies?
Potential adverse effects include methemoglobinemia, nitrogen dioxide toxicity, and oxidative stress. Innovations in delivery aim to minimize these risks.

4. Which emerging applications of nitric oxide are attracting the most research interest?
Wound healing, antiviral therapies, neuroprotection, and cancer treatment are gaining momentum, driven by nitric oxide's diverse biological activities.

5. How might regulatory pathways influence future market development?
Streamlined approval processes and adaptive regulatory strategies could expedite commercial availability, particularly for novel indications and devices, fostering market expansion.


References

[1] NIH Clinical Trials Database. (2022). ClinicalTrials.gov.

[2] Smith, J. et al. (2021). "Nitric oxide therapy in COVID-19: Opportunities and challenges." Respiratory Medicine.

[3] Rajan, S. et al. (2020). "Safety considerations in inhaled nitric oxide therapy." Pulmonary Pharmacology & Therapeutics.

More… ↓

⤷  Get Started Free

Make Better Decisions: Try a trial or see plans & pricing

Drugs may be covered by multiple patents or regulatory protections. All trademarks and applicant names are the property of their respective owners or licensors. Although great care is taken in the proper and correct provision of this service, thinkBiotech LLC does not accept any responsibility for possible consequences of errors or omissions in the provided data. The data presented herein is for information purposes only. There is no warranty that the data contained herein is error free. We do not provide individual investment advice. This service is not registered with any financial regulatory agency. The information we publish is educational only and based on our opinions plus our models. By using DrugPatentWatch you acknowledge that we do not provide personalized recommendations or advice. thinkBiotech performs no independent verification of facts as provided by public sources nor are attempts made to provide legal or investing advice. Any reliance on data provided herein is done solely at the discretion of the user. Users of this service are advised to seek professional advice and independent confirmation before considering acting on any of the provided information. thinkBiotech LLC reserves the right to amend, extend or withdraw any part or all of the offered service without notice.