Regulatory & Policy

China accepts NDA for Alebund's phosphate binder AP301 after Phase III success

China accepts NDA for Alebund's phosphate binder AP301 after Phase III success

Alebund Pharmaceuticals (Jiangsu) Limited (HKEX: 09637) announced on August 7, 2026 that China's National Medical Products Administration (NMPA) has accepted for review the New Drug Application (NDA) for AP301 capsules, a novel oral fiber-iron-based phosphate binder, for the treatment of hyperphosphatemia in chronic kidney disease (CKD) patients receiving maintenance dialysis. The filing rests primarily on results from RESPOND-1, the company's pivotal Phase III trial conducted across 50 sites in China.

The acceptance positions AP301 as a potential new entrant in a market where phosphate control remains poor despite multiple approved therapies. According to data cited by the Shanghai-based company, approximately 76% of dialysis patients in China fail to achieve target serum phosphate levels of 1.13–1.78 mmol/L, a rate materially higher than in the United States (52%) or Japan (39%), according to 2021 Dialysis Outcomes and Practice Patterns Study (DOPPS) data.

RESPOND-1 was a randomized, open-label, active-controlled Phase III trial enrolling 474 patients with hyperphosphatemia on maintenance dialysis, randomized 3:1 to AP301 (355 patients) or sevelamer carbonate (119 patients) over 52 weeks. The trial carried two pre-specified primary endpoints.

At Week 12, AP301 demonstrated non-inferiority to sevelamer carbonate in reducing serum phosphate levels, with least-squares mean reductions from baseline of 0.72 mmol/L versus 0.70 mmol/L, respectively. The upper bound of the 95% confidence interval for the between-group difference was 0.06 mmol/L, below the pre-defined non-inferiority margin of 0.19 mmol/L. At Weeks 24–27, among AP301 responders re-randomized to maintenance dose or an ineffective low dose, the maintenance-dose group achieved statistically significant superiority over the low-dose group, with a between-group difference of −0.58 mmol/L (P<0.001).

At Week 52, the AP301 group showed a greater mean serum phosphate reduction from baseline than the sevelamer carbonate group (0.76 mmol/L versus 0.72 mmol/L), a higher target attainment rate (66.7% versus 58.6%), and a lower mean daily dose (6.52 g/day versus 7.56 g/day). No iron-overload signal was observed over the 52-week period. The most common adverse events were discolored feces and diarrhea; diarrhea was predominantly early-onset, mild, and self-resolving, with a discontinuation rate of 0.6%. Full Phase III results were presented at ASN Kidney Week 2025.

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Current phosphate binders are frequently limited by high pill burden, gastrointestinal tolerability, or cumbersome administration requirements, creating opportunities for differentiated oral therapies. Existing iron-based binders such as sucroferric oxyhydroxide require chewing, while polymer binders such as sevelamer carry high daily pill burdens of six to twelve tablets. AP301 is formulated as a swallowable capsule that does not expand in gastric fluid and is not systemically absorbed, properties the company said contribute to reduced pill burden and improved tolerability relative to existing options.

In the investigational pipeline, Unicycive Therapeutics' oxylanthanum carbonate received a second Complete Response Letter from the US FDA in June 2026 and remains unapproved. Taisho Pharmaceutical is evaluating TS-172 in an ongoing Phase III trial.

The China NDA filing runs in parallel with an ongoing global multi-regional Phase III trial, RESPOND-2, which completed enrollment of 282 patients in the US and China in May 2026. Alebund said it reached agreement with the US FDA that RESPOND-2 will serve as the single pivotal study to support US registration of AP301. The company listed on the Hong Kong Stock Exchange Main Board in June 2026, raising gross proceeds of approximately HKD 1.283 billion (approximately USD 164 million). Alebund said it has completed construction of a manufacturing facility in Yangzhou, Jiangsu, and has obtained a Drug Manufacturing License to support commercial supply of AP301 upon potential approval.


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