Recruiting
Phase 2

ANG003 vs. Creon

Sponsor:

Anagram Therapeutics, Inc.

Code:

NCT07450547

Conditions

Exocrine Pancreatic Insufficiency (EPI)

Cystic Fibrosis (CF)

Eligibility Criteria

Sex: All

Age: 12+

Healthy Volunteers: Not accepted

Interventions

ANG003 Dose A

ANG003 Dose B

Creon

Study Details

Brief summary:

In this study, ANG003, a pancreatic enzyme replacement therapy (PERT; commonly called "enzymes"), is being investigated as a potential treatment for exocrine pancreatic insufficiency (EPI). People with EPI due to Cystic Fibrosis (CF) may be eligible to participate in this study. The primary objective of this study is to evaluate the safety of ANG003 and see if it works as well compared to Creon, an approved PERT.

Conditions

Exocrine Pancreatic Insufficiency (EPI)

Cystic Fibrosis (CF)

Study ID

NCT07450547

Start date

Apr 24, 2026

Status verified date

Aug, 2026

Completion date

Jul, 2027

Anticipated

Primary completion date

Jul, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 12+

Healthy Volunteers: Not accepted

Inclusion Criteria:

1. Male and female subjects aged ≥12 years from the date of informed consent in the US and aged ≥18 years in the EU
2. Confirmed and documented diagnosis of CF
3. Diagnosed with severe EPI as defined by a fecal elastase ≤50 μg/g stool measured at Screening by a central laboratory.
4. Subject has controlled EPI and taking a stable dose of pancreatic enzyme replacement therapy (PERT) for 90 days prior to Screening.
5. Adequate nutritional status measured by body mass index (BMI) defined by:

1. BMI ≥25th percentile for children aged 12-17 years
2. BMI ≥18.5 kg/m2 for ≥18 years of age

Exclusion Criteria:

1. History of fibrosing colonopathy or recurring distal intestinal obstructive syndrome within 6 months of Screening.
2. History of lung or liver transplant, listing for organ transplant or significant bowel resection within the last 6 months. Subjects with a history of resection that does not result in short bowel syndrome are eligible.
3. Known hypersensitivity or other severe reaction to any ingredient of the investigational product (IP), Creon, or the stool marker (FD\&C Blue #2).
4. Any chronic diarrheal illness unrelated to pancreatic insufficiency, actively being treated for small intestinal bacterial overgrowth, requiring use of naso-gastric, J-tube, G-tube, and/or enteral feeding for the study duration, Clostridioides difficile infection within 6 months prior to Screening, or severe constipation defined as <1 bowel movement/week.

Study Design

Enrollment

113 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: ANG003 Dose A

All subjects will be acclimated to Creon for 14-days and then will undergo a baseline CFA analysis. If baseline CFA is >/= 80%, the subject may be randomized to ANG003 Dose A for a 21-day acclimation and subsequent CFA analysis.

experimental: ANG003 Dose B

All subjects will be acclimated to Creon for 14-days and then will undergo a baseline CFA analysis. If baseline CFA is >/= 80%, the subject may be randomized to ANG003 Dose B for a 21-day acclimation and subsequent CFA analysis.

active comparator: Creon

All subjects will be acclimated to Creon for 14-days and then will undergo a baseline CFA analysis. If baseline CFA is >/= 80%, the subject may be randomized to Creon for an additional 21-days and subsequent CFA analysis.

no intervention: Off Enzyme

All subjects will be acclimated to Creon for 14-days and then will undergo a baseline CFA analysis. If baseline CFA is >/= 80%, the subject may be randomized to the off enzyme arm. Subjects will receive Creon for an additional 21-day and the subsequent CFA analysis will be off enzyme. Total time off enzyme will be 4-7 days.

other: 60% to <80% CFA ANG003 Dose B

All subjects will be acclimated to Creon for 14-days and then will undergo a baseline CFA analysis. Participants with a Period A CFA result of 60% to <80% will be assigned to ANG003 Dose B.

Interventions

ANG003 Dose A

160,000 u\* lipase, 105,000 u\* protease, and 11,600 u\* amylase per dose (\*units are comparable to United States Pharmacopeiea \[USP\])

ANG003 Dose B

240,000 u\* lipase, 105,000 u\* protease, and 11,600 u\* amylase per dose (\*units are comparable to United States Pharmacopeiea \[USP\])

Creon

The commercially available pPERT Creon will be the active comparator in the study. Subjects will be instructed to take Creon according to the package insert and PI direction.

Primary outcome measure

  • Adverse events (AEs); Treatment-emergent AEs; Serious AEs; Discontinuation due to AEs; Clinical laboratory values [ Time Frame: From Visit 1 to Visit 5, anticipated average 80 days ]
  • Coefficient of Fat Absorption (CFA) [ Time Frame: Period A (baseline) and Period B 72 hour CFA collection ]

Central Contacts and Locations

Central contacts

Locations

Long Beach Memorial Medical Center

Recruiting

Long Beach, California, United States, 90806

Contacts

Center for Cystic Fibrosis at Keck Medical Center of USC

Recruiting

Los Angeles, California, United States, 90033

Contacts

National Jewish Health

Recruiting

Denver, Colorado, United States, 80206

Contacts

The Cystic Fibrosis Institute

Recruiting

Glenview, Illinois, United States, 60025

Contacts

University of Kansas Medical Center

Recruiting

Kansas City, Kansas, United States, 66160

Contacts

University of Kentucky

Recruiting

Lexington, Kentucky, United States, 40506

Contacts

Boston Children's Hospita

Recruiting

Boston, Massachusetts, United States, 02115

Contacts

University of Michigan, Michigan Medicine

Recruiting

Ann Arbor, Michigan, United States, 48109

Contacts

Wayne State University Harper University Hospital

Recruiting

Detroit, Michigan, United States, 48201

Contacts

Rutgers - Robert Wood Johnson Medical School

Recruiting

New Brunswick, New Jersey, United States, 08903

Contacts

Children's Hospital Medical Center of Akron

Recruiting

Akron, Ohio, United States, 44308

Contacts

Toledo Children's Hospital

Recruiting

Toledo, Ohio, United States, 43606

Contacts

Hershey Medical Center Pennsylvania State University

Recruiting

Hershey, Pennsylvania, United States, 17033

Contacts

University of Texas Southwestern / Children's Health

Recruiting

Dallas, Texas, United States, 75207

Contacts

University of Wisconsin

Recruiting

Madison, Wisconsin, United States, 53792

Contacts

More Information

Sponsor

Anagram Therapeutics, Inc.

Last update posted

Aug 27, 2026

Last verified

Aug, 2026

Keywords

  • Cystic Fibrosis (CF)
  • EPI

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-08. This information was provided to ClinicalTrials.gov by Anagram Therapeutics, Inc. on 2026-08-27.