A Phase 2 interventional study of EPN-701 (Oral) and Placebo (Normal Saline) in Calciphylaxis, sponsored by Sagar U. Nigwekar, MD, MMSc. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-11-10.
Sponsored by Sagar U. Nigwekar, MD, MMSc · Phase 2, Interventional, and Treatment
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.
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.
23 studies on the registry are indexed under Calciphylaxis; 10 are open to participants now.
This study's planned enrollment of 60 is above the median of 28 across 12 interventional studies indexed under Calciphylaxis.
Browse Calciphylaxis studies →This is the only study on the registry with Sagar U. Nigwekar, MD, MMSc as lead sponsor.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
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.
A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.
Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
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.
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.
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.
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.
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Biopsy and archival tissue
A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.
Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Childbearing potential
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Immunosuppression
A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.
Read whether the line is about a condition or about medicines, and which medicines and doses it means.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
EPN-701 will be administered daily by mouth
Drug: EPN-701 (Oral)
Placebo will be taken daily by mouth
Drug: Placebo (Normal Saline)
Randomized subjects will receive EPN-701 or placebo
Randomized subjects will receive EPN-701 or placebo.
Change in pain intensity (Alternate Primary Endpoint)
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
Time frame: Baseline-24 weeks
Change in total calciphylaxis lesion(s) surface area (Alternate Primary Endpoint)
Pre-post (Baseline-Week 24) change in total surface area of ulcerated skin lesions of calciphylaxis among the trial arms
Time frame: Baseline-24 weeks
Plasma level of uncarboxylated matrix Gla protein (uc-MGP)
Pre-post (Baseline-Week 24) change in plasma uncarboxylated matrix Gla protein (uc-MGP) among the trial arms
Time frame: Baseline-24 weeks
Change in calcification burden
Pre-post (Baseline-Week 24) change in radiotracer uptake on 18-sodium fluoride positron emission tomography/computerized tomography (18F-NaF PET/CT)
Time frame: Baseline-24 weeks
Changes in additional biomarkers and plasma proteomic
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
Time frame: Baseline-24 weeks
Change in pain interference
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.
Time frame: Baseline-24 weeks
Change in wound Quality of Life
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.
Time frame: Baseline-24 weeks
EPN-701 plasma concentration
EPN-701 plasma concentration
Time frame: Baseline-24 weeks
Rates of clinical events
Calciphylaxis associated hospitalization, mortality, infection, or new lesion development
Time frame: Baseline-24 weeks
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is not yet recruiting, as verified in Nov 2026. You cannot join it, but the record below documents what was studied.
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