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NCT03427125

A Phase 3 Study of Tenapanor to Treat Hyperphosphatemia in ESRD Patients on Dialysis

Completed Phase 3 Results posted Last updated 29 June 2023
What this trial tests

Phase 3 trial testing Tenapanor in Hyperphosphatemia in 1,559 participants. Completed in 27 February 2020.

Timeline
8 January 2018
Primary endpoint
15 November 2019
27 February 2020

Quick facts

Lead sponsorArdelyx
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment1,559
Start date8 January 2018
Primary completion15 November 2019
Estimated completion27 February 2020
Sites2 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Ardelyx — full company profile →

Who can join

Adults 18 to 80, any sex, with Hyperphosphatemia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change in Serum Phosphorus Levels During Placebo Controlled Randomized Withdrawal Period in the Responder Population Primary · 12 weeks (randomized withdrawal period)

Patients with at least a 1.2 mg/dL decrease in serum phosphorus during the first 26 weeks of the study were defined as the responder population.

GroupValue95% CI
Tenapanor 10 mg, 20 mg, 30 mg BID0.43± 0.199
Placebo1.80± 0.196
Change in Serum Phosphorus Levels During Placebo Controlled Randomized Withdrawal Period in the ITT Population Secondary · 12 weeks (randomized withdrawal period)

Placebo Adjusted Change in Serum Phosphorus from the beginning to the end of the Randomized Withdrawal Period in all patients

GroupValue95% CI
Tenapanor 10 mg, 20 mg, 30 mg BID0.22± 0.149
Placebo0.88± 0.150
Serum Phosphorus From Baseline Secondary · 26 weeks (open label treatment period)

Serum Phosphorus from baseline (post washout) to end of 26 week period

Baseline Serum Phosphorus
GroupValue95% CI
Tenapanor 10 mg, 20 mg, 30 mg BID7.44± 1.439
End of Period serum Phosphorus
GroupValue95% CI
Tenapanor 10 mg, 20 mg, 30 mg BID5.88± 1,455

Adverse events — posted to ClinicalTrials.gov

Time frame: 1 year. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Tenapanor 10 mg, 20 mg, 30 mg BID
Serious: 47/419 (11%)
Deaths: 12/419
Placebo
Serious: 4/126 (3%)
Deaths: 1/126
Sevelamer Carbonate
Serious: 39/137 (28%)
Deaths: 5/137

Serious adverse events (8 terms)

ReactionSystemTenapanor 10 mg, 20 mg, 30…PlaceboSevelamer Carbonate
pneumoniaInfections and infestations
Acute Respiratory FailureRespiratory, thoracic and mediastinal disorders
Fluid OverloadMetabolism and nutrition disorders
Acute Myocardial InfarctionCardiac disorders
CellulitisInfections and infestations
SepsisInfections and infestations
Atrial FibrillationCardiac disorders
HyperkalemiaMetabolism and nutrition disorders
Other adverse events (1 terms — click to expand)

ReactionSystemTenapanor 10 mg, 20 mg, 30…PlaceboSevelamer Carbonate
DiarrheaGastrointestinal disorders

Most-reported serious reactions: pneumonia, Acute Respiratory Failure, Fluid Overload, Acute Myocardial Infarction, Cellulitis, Sepsis, Atrial Fibrillation, Hyperkalemia.

Data from ClinicalTrials.gov NCT03427125 adverse events section.

Sponsor's own description

This Phase 3, 26-week, open label study with a 12-week, placebo-controlled, randomized withdrawal period followed by an open label long term safety extension will evaluate the safety and efficacy of tenapanor to treat hyperphosphatemia in end-stage renal disease (ESRD) on hemodialysis and peritoneal dialysis.

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Gut-Heart Axis: The Role of Gut Microbiota and Metabolites in Heart Failure.
    Snelson M, R Muralitharan R, Liu CF, Markó L, et al · · 2025 · cited 30× · PMID 40403109 · DOI 10.1161/circresaha.125.325516
  2. Safety and Efficacy of Tenapanor for Long-term Serum Phosphate Control in Maintenance Dialysis: A 52-Week Randomized Phase 3 Trial (PHREEDOM).
    Block GA, Bleyer AJ, Silva AL, Weiner DE, et al · · 2021 · cited 24× · PMID 35372979 · DOI 10.34067/kid.0002002021
  3. Inhibition of sodium-proton-exchanger subtype 3-mediated sodium absorption in the gut: A new antihypertensive concept.
    Linz B, Saljic A, Hohl M, Gawałko M, et al · · 2020 · cited 15× · PMID 32760780 · DOI 10.1016/j.ijcha.2020.100591
  4. Tenapanor as Therapy for Hyperphosphatemia in Maintenance Dialysis Patients: Results from the OPTIMIZE Study.
    Sprague SM, Weiner DE, Weiner DE, Tietjen DP, et al · · 2024 · cited 9× · PMID 38323855 · DOI 10.34067/kid.0000000000000387
  5. Tenapanor Improves Long-Term Control of Hyperphosphatemia in Patients Receiving Maintenance Dialysis: the NORMALIZE Study.
    Silva AL, Chertow GM, Hernandez GT, Lynn RI, et al · · 2023 · cited 6× · PMID 37853560 · DOI 10.34067/kid.0000000000000280
  6. Tenapanor in Chinese ESRD patients with hyperphosphatemia on haemodialysis: a randomised, phase 3 trial.
    Gan L, Xing L, Xu Y, Zhou L, et al · · 2024 · cited 3× · PMID 38186905 · DOI 10.1093/ckj/sfad216
  7. Efficacy and safety of tenapanor in end-stage renal disease patients with hyperphosphatemia: a systematic review and meta-analysis.
    Yu S, Sun J, Guo X. · · 2024 · cited 2× · PMID 39351794 · DOI 10.1080/0886022x.2024.2410389

Verify or expand the search:

Other trials of Tenapanor

Trials testing the same drug.

Other recruiting trials for Hyperphosphatemia

Currently open trials in the same condition.

Other Ardelyx trials

Trials by the same sponsor.

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