Study of EPN-701 for the Treatment of Calciphylaxis
Calciphylaxis
What this study involves
The registry does not currently label this study as recruiting. Ask about its status before planning a screening visit.
- Study type
- Interventional
- Phase
- Phase 2
- Age range
- 18 years - Not specified
- Sex eligible
- All sexes
- Healthy volunteers
- Not accepted
- Participants
- 60 Estimated
These are starting points, not an eligibility decision. The research team must review the full requirements.
About the research
Calciphylaxis is a rare but serious condition that leads to painful skin lesions. At present, there is no approved treatment for calciphylaxis. This research study is planned to examine the potential benefits of a new treatment (EPN-701) in patients with calciphylaxis. The present early clinical study will also evaluate the pharmacology of EPN-701 and whether it can be safely used in patients with calciphylaxis. Findings will inform the planning of a future definitive study to establish EPN-701 as an approved treatment for calciphylaxis.
Read the full description
This is a phase 2 double-blind RCT that will randomly assign 60 adult dialysis-dependent patients with calciphylaxis to either EPN-701 (10 mg/day administered orally) or a matched placebo in a 1:1 ratio for 24 weeks. Standardized background clinical care will be applied to all participants.
Primary objective will be to determine the clinical efficacy and safety of EPN-701 in dialysis-dependent patients with calciphylaxis. The clinical efficacy will be assessed by pre-post (Baseline-Week 24) change in pain intensity and calciphylaxis wound surface area.
Secondary objective will be to examine the safety of EPN-701 in dialysis-dependent patients with calciphylaxis. Safety will be assessed by active monitoring for adverse events throughout the trial period.
The pharmacodynamic efficacy will be primarily assessed by pre-post (Baseline-Week 12) change in plasma ucMGP among the trial arms. EPN-701 plasma concentration time profiles and other pharmacokinetic assessments will also be assessed.
Exploratory outcomes will be pre-post (Baseline-Week 24) changes in radiotracer uptake indicative of calcification burden, wound severity scores, hospitalization, mortality, and quality of life. The Investigators will also explore novel biomarkers of calciphylaxis via plasma proteomics and examine the associations between changes in ucMGP, radiotracer uptake, and novel biomarkers with patient-oriented clinical outcomes to inform the selection of efficacy endpoints for a future phase 3 RCT.
Findings from the proposed trial will inform the end point selection and design of a future phase 3 trial aimed at establishing a targeted novel therapy for calciphylaxis.
Who may be able to participate?
The list below is the sponsor’s full registry wording. It can include conditions, prior treatment, test results and other requirements. A match in search does not mean you qualify.
Inclusion Criteria:
1. Participant must provide written or electronic consent after the nature of the study has been explained, and prior to any research-related procedures, per the International Conference on Harmonization (ICH) Good Clinical Practice (GCP)
2. Clinical diagnosis of calciphylaxis confirmed by the Investigator with presence of at least one ulcerated skin lesion and moderate or severe pain (worst pain intensity in the preceding 24 hours of at least 5 on a 0-10 scale). Consistent with the clinical practice and expert recommendations, histological confirmation of calciphylaxis diagnosis by a skin biopsy is not a requirement for participation.
3. ESKD requiring thrice weekly hemodialysis
4. Male or female aged ≥18 years
5. Women of childbearing potential (WOCBP) as defined in Clinical Trials Facilitation and Coordination Group (CTFG, 2020) must have a negative serum pregnancy test (defined as serum hCG ≤25 mIU/mL \[Haninger-Vacariu, 2020\]) at Screening
6. Women of childbearing potential (WOCBP) must be using or agree to use one highly effective form of contraception and a barrier method from Screening through 30 days after the last dose of study treatment. See Appendix C for further information about highly effective forms of contraception.
7. Males who are sexually active must agree to use condoms from the period following first dose of study treatment through four weeks after the last dose of study treatment. Males with a WOCBP partner must agree to use one highly effective form of contraception in addition to condoms from Screening through 30 days after the last dose of study treatment.
8. Males must agree to not donate sperm from the period following the first dose of study treatment through 4 weeks after last dose of study treatment. WOCBP who are participants or partners of fertile male participants must agree not to donate ova from the period following the first dose of study treatment through 4 weeks after last dose of study treatment.
Exclusion Criteria:
1. In the opinion of the Investigator, presence of any clinically significant disease outside of calciphylaxis that may impact study participation and/or confound interpretation of the study results
2. Hospitalized at the time of Screening. Patients discharged from a hospital admission ≥24 hours prior to Screening may be eligible for participation.
3. Septic shock
4. Hospice or comfort care including withdrawal from dialysis
5. Malignancy within the last year, except non-melanoma skin cancers, cervical carcinoma in situ, or localized prostate cancer.
6. Concurrent participation in another interventional clinical study and/or receipt of any other investigational new drug within four weeks prior to the first dose of study treatment, or use of an investigational device, through completion of participation in the study
7. Previous participation in a study of EPN-701
8. Participants who are pregnant, trying to become pregnant, or breastfeeding
9. Participants who are trying to father a child
10. Peritoneal dialysis participants
11. Kidney transplant recipients who are receiving immunosuppression at the time of Screening and patients who have an imminent transplant plan. Patients who have received a kidney transplant that has failed, necessitating dialysis, and who are no longer on immunosuppression may participate.
12. History of or current diagnosis of cirrhosis
13. Current use of prohibited medications, including vitamin K-containing medications and warfarin. Patients who have discontinued warfarin treatment upon the diagnosis of calciphylaxis will be eligible for Screening.
Treatment, groups and participation
The registry may describe treatments and study duration without a complete visit calendar. Ask the study team for the exact schedule, procedures, risks, costs and alternatives. Keep your usual care plan unless your treating clinician tells you otherwise.
- Assignment
- Random assignment
- Masking
- Quadruple masked
EPN-701
EPN-701 will be administered daily by mouth
Drug: EPN-701 (Oral)
Placebo
Placebo will be taken daily by mouth
Drug: Placebo (Normal Saline)
EPN-701 (Oral) DRUG
Randomized subjects will receive EPN-701 or placebo
Placebo (Normal Saline) DRUG
Randomized subjects will receive EPN-701 or placebo.
What researchers are measuring
Outcome measures describe what is being studied. They are not proof that a treatment works.
Primary measures
Change in pain intensity (Alternate Primary Endpoint)
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) change in the worst calciphylaxis associated pain intensity as measured on the 0 to 10 scale among the trial arms. Score of 0 indicates no pain. Score of 10 indicates most severe pain
Change in total calciphylaxis lesion(s) surface area (Alternate Primary Endpoint)
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) change in total surface area of ulcerated skin lesions of calciphylaxis among the trial arms
Other measures
Plasma level of uncarboxylated matrix Gla protein (uc-MGP)
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) change in plasma uncarboxylated matrix Gla protein (uc-MGP) among the trial arms
Change in calcification burden
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) change in radiotracer uptake on 18-sodium fluoride positron emission tomography/computerized tomography (18F-NaF PET/CT)
Changes in additional biomarkers and plasma proteomic
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) changes in biomarkers such as plasma Protein induced by vitamin K absence or antagonist-II (PIVKA- II), fetuin A, and novel markers identified via plasma proteomic analyses
Change in pain interference
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) change in the pain interference score recorded on Brief Pain Inventory/Short Form (BPI/SF). Score of 0 indicates no pain interference. Score of 10 indicates most severe pain interference.
Change in wound Quality of Life
Time frame: Baseline-24 weeks
Pre-post (Baseline-Week 24) score on Wound QOL. Scores range from 0 to 4. A lower score indicates better quality of life (0=not at all impaired, 4=very much impaired.
EPN-701 plasma concentration
Time frame: Baseline-24 weeks
EPN-701 plasma concentration
Rates of clinical events
Time frame: Baseline-24 weeks
Calciphylaxis associated hospitalization, mortality, infection, or new lesion development
Review the complete result tables and limitations in the official record.
Open official results ↗Research locations (1)
The overall study status and a local site’s status can differ. Confirm that location’s availability before traveling.
1 locations
Renal AssociatesBoston, Massachusetts, United StatesStatus unknown
Study team and timeline
- Lead sponsor
- Sagar U. Nigwekar, MD, MMSc
- Study start
- Dec 7, 2026 Estimated
- Primary completion
- Sep 30, 2030 Estimated
- Study completion
- Sep 30, 2030 Estimated
- First posted
- May 13, 2026 Actual
- Last updated
- Nov 10, 2026 Actual
Official study contacts
No central contact is listed. Check the locations and the official record.
Official study title
Phase 2 Study of EPN-701 for the Treatment of Calciphylaxis
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Source: ClinicalTrials.gov API v2. Information is submitted by sponsors and investigators. NLM does not approve the safety or science of all listed studies. Registry disclaimer.
Retrieved: Nov 12, 2026 · Last registry update: Nov 10, 2026
