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RecruitingNCT06712654Updated Aug 26, 2026

A Study to Evaluate Safety, Tolerability and Efficacy of AP306 at Fixed Doses in Dialysis Participants With Hyperphosphatemia

A Phase 2 interventional study of AP306 75 mg BID and AP306 125 mg BID in Hyperphosphatemia, Chronic Kidney Disease Requiring Chronic Dialysis and End Stage Renal Disease on Dialysis, sponsored by R1 Therapeutics. Recruiting at 31 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-26.

Sponsored by R1 Therapeutics · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2026; still recruiting 5 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
168
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is being conducted to characterize the safety, tolerability, and efficacy of AP306 at fixed doses in adults with hyperphosphatemia receiving maintenance hemodialysis.

Read the detailed description

Hyperphosphatemia, one of the most common complications of advanced chronic kidney disease, becomes increasingly prevalent as kidney function declines and is found almost universally in patients with end-stage kidney disease requiring dialysis. Hyperphosphatemia is an independent risk factor for cardiovascular outcomes, fractures, and mortality in patients with chronic kidney disease, especially in patients receiving dialysis.

AP306 is a pan-phosphate transporter inhibitor that may stop phosphate absorption in the gut, controlling hyperphosphatemia.

This is a randomized, double-blind, placebo-controlled, study to characterize the safety, tolerability, and efficacy of AP306 given daily for 8 weeks at fixed doses in adults with hyperphosphatemia receiving maintenance hemodialysis.

02

Conditions studied

  • Hyperphosphatemia
  • Chronic Kidney Disease Requiring Chronic Dialysis
  • End Stage Renal Disease on Dialysis

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Keywords

  • AP306
  • AP-306
  • EOS789
  • pan-phosphate transporter inhibitor
03

In context

Hyperphosphatemia

173 studies on the registry are indexed under Hyperphosphatemia; 16 are open to participants now.

This study's planned enrollment of 168 is above the median of 101 across 143 interventional studies indexed under Hyperphosphatemia.

Browse Hyperphosphatemia studies →

Lead sponsor

This is the only study on the registry with R1 Therapeutics as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Important Inclusion Criteria:

  • Signs a written form (ICF) and is willing to comply with all study requirements in the study
  • Receiving a stable hemodialysis (including hemodialysis, hemodiafiltration, and hemoadsorption) regimen, which is defined as a frequency of three times per week for at least 12 weeks before signing the ICF, and does not plan to change in the study
  • Who has a blood phosphate level within the study-required range
  • Who has a dialysis adequacy, assessed by single pooled Kt/V (SpKt/V, estimated with blood urea) ≥1.20, at screening or any documented value ≥1.20 within 12 weeks prior to signing the ICF
  • If the participant is receiving etelcalcetide, their doses must be unchanged for at least 4 weeks prior to signing the ICF
  • If the participant is receiving any of the following therapies, their doses are stable for at least 14 days prior to signing the ICF: phosphate-lowering products other than tenapanor or phosphate binders, active vitamin D and analogs, cinacalcet, calcitonin, and P-glycoprotein inhibitors
  • Agreement to use highly effective for women of childbearing potentially and non-sterile sexually active males throughout the study and for 90 days after the final dose of study drug

Important Exclusion Criteria:

  • Pregnant or breastfeeding
  • Scheduled for a living donor kidney transplant in the next 6 months, planned change to peritoneal dialysis or home hemodialysis in the study; planned relocation to another dialysis center in the study
  • Any history of a non-pharmacological parathyroid intervention within 6 months prior to the ICF sign off, or planned parathyroid intervention in the study
  • Blood calcium or blood intact parathyroid hormone abnormality
  • Adequate organ and bone marrow function
  • Acute hepatitis or significant chronic liver disease
  • Any GI disorders within 4 weeks prior to signing the ICF; or any history of gastrectomy; or any GI tract surgery (excluding appendectomy and polypectomy), within 12 weeks of signing the ICF
  • Uncontrolled hypertension
  • Hospitalization for cardiac or cardiocerebrovascular disease within 24 weeks prior to signing the ICF
  • Significant abnormalities of and heart rhythm on an electrocardiograph () test
  • Any clinically significant active infection or infestation or any treatment with systemic antimicrobial treatment within 2 weeks prior to signing the ICF
  • History or presence of within 3 years prior to signing the ICF, except basal cell skin cancer, in-situ carcinoma of the cervix, and in-situ prostate cancer
  • Taking moderate or strong cytochrome P450 (CYP) 3A inhibitors within 2 weeks or 5 half-lives, whichever is longer, prior to signing the ICF (topical use is allowed)
  • Treatment with any medication or medical device within 30 days prior to signing the ICF
  • less than 12 months
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

QT and QTc

On an ECG, the QT interval is the time the heart’s lower chambers take to activate electrically and recover in each beat. QTc is that time adjusted for heart rate (QTcF by Fridericia’s formula, QTcB by Bazett’s). Some medicines lengthen it, and a long QTc can raise the risk of a dangerous heart rhythm.

The study may name a correction formula and a limit in milliseconds, often around 450–480.

ECG (electrocardiogram)

A recording of the heart’s electrical activity, taken with stickers on the chest, arms and legs. It takes a few minutes and does not hurt.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
168 participants (estimated)

Study arms

  • Experimental
    Cohort 1

    Drug: AP306 75 mg BID

  • Experimental
    Cohort 2

    Drug: AP306 125 mg BID

  • Experimental
    Cohort 3

    Drug: AP306 150 mg BID

  • Experimental
    Cohort 4

    Drug: AP306 75 mg TID

  • Experimental
    Cohort 5

    Drug: AP306 100 mg TID

  • Experimental
    Cohort 6

    Drug: AP306 125 mg TID

  • Placebo comparator
    Cohort 7

    Drug: Placebo

Interventions

  • DrugAP306 75 mg BID

    AP306 75 mg by mouth, twice daily (150 mg/day). Placebo given once daily. Treatment given daily for 8 weeks.

  • DrugAP306 125 mg BID

    AP306 125 mg by mouth, twice daily (250 mg/day). Placebo given once daily. Treatment given daily for 8 weeks.

  • DrugAP306 150 mg BID

    AP306 150 mg by mouth, twice daily (300 mg/day). Placebo given once daily. Treatment given daily for 8 weeks.

  • DrugAP306 75 mg TID

    AP306 75 mg by mouth, three times daily (225 mg/day). Treatment given daily for 8 weeks.

  • DrugAP306 100 mg TID

    AP306 100 mg by mouth, three times daily (300 mg/day). Treatment given daily for 8 weeks.

  • DrugAP306 125 mg TID

    AP306 125 mg by mouth, three times daily (375 mg/day). Treatment given daily for 8 weeks.

  • DrugPlacebo

    Placebo given by mouth, three times daily. Treatment given daily for 8 weeks.

06

What researchers measure

Primary outcomes

  1. To investigate the ability of AP306 at different fixed doses to lower serum phosphate in participants with hyperphosphatemia receiving maintenance hemodialysis

    The change in serum phosphate from baseline to the end of treatment or before the initiation of rescue therapy, or before the interruption of study drug due to serum phosphate \<2.5 mg/dL (0.81 mmol/L)

    Time frame: 8 weeks

Secondary outcomes

  1. To assess the proportion of participants with serum phosphate in the target range

    Achievement of serum phosphate concentrations within the target range (between 3.5 and 5.5 mg/dL \[1.13 and 1.78 mmol/L\], inclusive) at any time during the Treatment Period

    Time frame: 8 weeks

  2. To assess the change in serum phosphate from baseline to the end of the Treatment Period

    The change in serum phosphate from baseline to the end of Treatment Week 8.

    Time frame: 8 weeks

  3. To assess the time to response on serum phosphate reduction

    * The change in serum phosphate over time * The time to the first occurrence of serum phosphate ≤5.5 mg/dL (1.78 mmol/L) and ≤4.5 mg/dL (1.45 mmol/L)

    Time frame: 8 weeks

Other outcomes

  1. To evaluate the pharmacokinetic (PK) characteristics of AP306

    * The plasma concentration of AP306 at the following time points: baseline, after 4 weeks of treatment, and after 8 weeks of treatment * The constituent and proportion of metabolites at PK sampling time points

    Time frame: 8 weeks

  2. To evaluate the overall safety and tolerability of AP306

    * The nature, frequency, and severity of all treatment emergent and serious adverse events (AEs) * The effects on laboratory values, vital signs, electrocardiogram (ECG) parameters, and Bristol Stool Form Scale

    Time frame: 12 weeks

  3. To assess the effects of AP306 on intact parathyroid hormone (iPTH) and fibroblast growth factor (FGF23) concentration

    The change in iPTH and FGF23 from the baseline to the end of Treatment Week 8 (or early termination (ET) visit for those who terminate study drug), and the end of the study

    Time frame: 12 weeks

07

Study locations

31 of 31 sites recruiting
  • Apogee Clinical Research, LLC
    Huntsville, Alabama 35801, United States
    Recruiting
  • California Institute of Renal Research
    Chula Vista, California 91910, United States
    Recruiting
  • Academic Medical Research Institute
    Los Angeles, California 90022, United States
    Recruiting
  • North America Research Institute
    San Dimas, California 91773, United States
    Recruiting
  • Colorado Kidney Care
    Denver, Colorado 80220, United States
    Recruiting
  • DaVita Clinical Research
    Middlebury, Connecticut 06762, United States
    Recruiting
  • PACT Kidney Care
    Orange, Connecticut 06477, United States
    Recruiting
  • US Renal Care - Fort Myers South
    Fort Myers, Florida 33912, United States
    Recruiting
  • Nephrology & Hypertension Specialists
    Dalton, Georgia 30720, United States
    Recruiting
  • St. Clair Nephrology Research
    Shelby, Michigan 48315, United States
    Recruiting
  • DaVita Clinical Research Edina
    Edina, Minnesota 55435, United States
    Recruiting
  • Johnson County Clinical Trials
    Kansas City, Missouri 64111, United States
    Recruiting
  • DaVita Clinical Research
    Las Vegas, Nevada 89107, United States
    Recruiting
  • R1 Therapeutics Clinical Trial Site
    Albuquerque, New Mexico 87109, United States
    Recruiting
  • NY Kidney & Hypertension Medicine
    Ridgewood, New York 11385, United States
    Recruiting
  • US Renal Care - Alexis
    Toledo, Ohio 43613, United States
    Recruiting
  • Sunbeam Research
    Greenville, Texas 75402, United States
    Recruiting
  • DaVita Clinical Research
    Houston, Texas 77054, United States
    Recruiting
  • Gamma Medical Research
    McAllen, Texas 78503, United States
    Recruiting
  • US Renal Care - South San Antonio
    San Antonio, Texas 35801, United States
    Recruiting
  • US Renal Care - Westover Hills
    San Antonio, Texas 78251, United States
    Recruiting
  • DaVita Clinical Research San Antonio
    San Antonio, Texas 78258, United States
    Recruiting
  • US Renal Care
    Waxahachie, Texas 75165, United States
    Recruiting
  • DaVita Clinical Research Norfolk
    Norfolk, Virginia 23502, United States
    Recruiting
  • Peking University First Hospital
    Beijing, Beijing Municipality 100035, China
    Recruiting
  • Peking University People's Hospital
    Beijing, Beijing Municipality 100044, China
    Recruiting
  • Zhengzhou University-First Affiliated Hospital
    Zhengzhou, Henan 450003, China
    Recruiting
  • The Second Affiliated Hospital of Nanjing Medical University
    Nanjing, Jiangsu 210003, China
    Recruiting
  • Zhongda Hospital Southeast University
    Nanjing, Jiangsu 210009, China
    Recruiting
  • Shanghai Jiao Tong University School of Medicine, Renji Hospital
    Shanghai, Shanghai Municipality 201112, China
    Recruiting
  • Sichuan Provincial People's Hospital
    Chengdu, Sichuan 610072, China
    Recruiting
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 26, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06712654
Lead sponsor
R1 Therapeutics
Collaborators
Alebund Pharmaceuticals
Responsible party
Sponsor
First posted
Dec 2, 2024
Start date
Jun 1, 2026
Primary completion
Feb 28, 2027 (estimated)
Completion
Mar 31, 2027 (estimated)
Last update
Aug 26, 2026

Study contacts

Clinical Trials Information
Contact
ClinicalTrials@r1therapeutics.com
(844) 697-3339

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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