TheraRadar
Data updated: Sep 20, 2026

ELAPRASE (idursulfase) · Takeda

Trial Activity: Stable 3 active trials
Rare Disease Approved 2006-07-24

ELAPRASE is a hydrolytic lysosomal glycosaminoglycan-specific enzyme indicated for the treatment of patients with Hunter syndrome, also known as Mucopolysaccharidosis II (MPS II). The therapy is approved for use in adults and pediatric patients 16 months of age and older. In patients five years and older, the drug is used to improve walking capacity, while in patients aged 16 months to five years, it has been shown to reduce spleen volume.

Source: FDA Label • Hydrolytic Lysosomal Glycosaminoglycan-specific Enzyme

How ELAPRASE Works

Hunter syndrome is characterized by insufficient levels of iduronate-2-sulfatase, an enzyme required to break down glycosaminoglycans (GAG) that otherwise accumulate and cause organ system dysfunction. ELAPRASE provides an exogenous replacement enzyme that binds to mannose-6-phosphate receptors on the cell surface, allowing it to be internalized and targeted to intracellular lysosomes. Once inside the lysosomes, the enzyme catabolizes accumulated GAG by cleaving specific sulfate moieties, thereby reducing cellular engorgement and tissue destruction.

Development Insights

Takeda conducting 4 trials (57%)
3 indications explored (Focused)
hunter syndrome (5 trials)
mucopolysaccharidosis ii (2 trials)
mucopolysaccharidosis (mps) (1 trials)
2
Indications
--
Phase 3 Trials
2
Priority Reviews
20
Years on Market

Details

Status
Prescription
First Approved
2006-07-24
Patent Cliff
2013
Revenue
$170M (Q3-FY2025)

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Patent cliff and revenue data

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Routes
IV (INFUSION)
Dosage Forms
INJECTABLE

Companies

Active Ingredient: IDURSULFASE

ELAPRASE Approval History

2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
7 FDA actions from 2006 to 2018 · 1 indication expansions
Nov 2018 SUPPL
Label · Labeling
Jun 2013 SUPPL Priority
Efficacy
Mar 2011 SUPPL
Label · Labeling

What ELAPRASE Treats

2 indications

ELAPRASE is approved for 2 conditions since its original approval in 2006. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Hunter Syndrome
  • Mucopolysaccharidosis II
Source: FDA Label

ELAPRASE Boxed Warning

RISK OF ANAPHYLAXIS Life-threatening anaphylactic reactions have occurred in some patients during and up to 24 hours after ELAPRASE infusions. Anaphylaxis, presenting as respiratory distress, hypoxia, hypotension, urticaria and/or angioedema of throat or tongue have been reported to occur during and after ELAPRASE infusions, regardless of duration of the course of treatment. Closely observe patients during and after ELAPRASE administration and be prepared to manage anaphylaxis. Inform patients o...

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Clinical Trial Registry

7 trials
Trial Sponsor ID Phase Status Title
NCT04573023 JR-141-GS31 Ph 3 active not recruiting A Phase III Study of JR-141 in Patients With Mucopolysaccharidosis II (STARLIGHT)
NCT05494593 TAK-665-4003 Ph 4 withdrawn A Study of ELAPRASE in Treatment-naïve Participants With Hunter Syndrome (Mucopolysaccharidosis [MPS] II)
NCT06031259 TAK-609-3001 2023-504127-90-00 Ph 2, Ph 3 active not recruiting Extension Study of Idursulfase-IT Along With Elaprase in Children and Adults With Hunter Syndrome and Cognitive Impairment
NCT01506141 results posted HGT-HIT-046 2011-000212-25 Ph 1, Ph 2 completed An Extension Study of HGT-HIT-045 Evaluating Long-Term Safety and Clinical Outcomes of Idursulfase-IT in Conjunction With Elaprase in Pediatric Participants With Hunter Syndrome and Cognitive Impairment
NCT05371613 COMPASS DNLI-E-0007 2024-510990-21-00, 2021-005200-35 Ph 2, Ph 3 active not recruiting A Study to Determine the Efficacy and Safety of Tividenofusp Alfa (DNL310) vs Idursulfase in Pediatric and Young Adult Participants With Neuronopathic (nMPS II) or Non-Neuronopathic Mucopolysaccharidosis Type II (nnMPS II)
NCT02412787 results posted SHP609-302 2014-004143-13 Ph 2, Ph 3 completed Study of Long Term Safety and Clinical Outcomes of Idursulfase IT and Elaprase Treatment in Pediatric Participants Who Have Completed Study HGT-HIT-094
NCT05058391 results posted TAK-665-4001 2022-004193-39 Ph 4 completed A Study of Elaprase in Children and Adults With Hunter Syndrome (Mucopolysaccharidosis II) in India
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Active Pipeline

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Key Completed Trials

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Completed studies with published results, ranked by significance

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

ELAPRASE FDA Label Details

Indications & Usage

FDA Label (PDF)

ELAPRASE is indicated for patients with Hunter syndrome (Mucopolysaccharidosis II, MPS II). ELAPRASE has been shown to improve walking capacity in patients 5 years and older. In patients 16 months to 5 years of age, no data are available to demonstrate improvement in disease-related symptoms or long term clinical outcome; however, treatment with ELAPRASE has reduced spleen volume similarly to that of adults and children 5 years of age and older. The safety and efficacy of ELAPRASE have not been established in pediatric patients less than 16 months of age [see Use in Specific Populations ]. ELA...

⚠️ BOXED WARNING

WARNING: RISK OF ANAPHYLAXIS Life-threatening anaphylactic reactions have occurred in some patients during and up to 24 hours after ELAPRASE infusions. Anaphylaxis, presenting as respiratory distress, hypoxia, hypotension, urticaria and/or angioedema of throat or tongue have been reported to occur d...

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Deep insights for ELAPRASE

Revenue Insights

  • Q3-FY2025: $170M
  • Historical trend analysis

Patent Timeline

  • Cliff: 2013
  • Generic/biosimilar risk

Trial Analysis

  • 7 total trials
  • Stage: Stable

Competitive Landscape

  • Competitor tracking
  • Same target/indication analysis
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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.

How We Calculate These Metrics

Trial Activity Stage

Measures the current development activity pattern based on trial phases, status, and trends. Important: This measures R&D activity, not commercial lifecycle.

Trial statuses: "Active" means recruiting or ongoing. "Completed" means reached planned endpoint. "Terminated" means stopped early—often due to safety, efficacy, or business reasons.

  • Growth: High proportion of early-phase trials (Phase 1/2), active development
  • Expansion: Significant Phase 3 activity, approaching or pursuing approvals
  • Mature: Substantial Phase 4 post-marketing studies
  • Stable: Mixed phase distribution, steady development
  • Declining: Low active trial ratio, reduced R&D investment