Context. AZD4831 (AstraZeneca) is an oral covalent myeloperoxidase (MPO) inhibitor being developed for heart failure. Almost half of chronic heart disease patients suffer from heart failure with a preserved ejection fraction (HFpEF) and have an estimated five-year mortality rate of 75% . Improvement in vascular structure could help these [...]

“compound 12” is a selective inhibitor of integrin αvβ5, a potential target for sepsis due to its potential role in regulating vascular leakage. Selectivity among integrin family members can be challenging to achieve and can have significant safety implications – hence, most integrin drugs have been selective biologics. Since the biological [...]

Acoramidis (AG10), an oral, second-generation stabilizer of the tetrameric transthyretin (TTR) protein, was submitted for FDA approval on Dec. 5, 2023 by BridgeBio for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM). The rare but potentially fatal disease is characterized by amyloid deposits in heart muscle. The molecule has the potential to be best-in-class relative to Pfizer’s $2.4B+/yr blockbuster tafamidis. This story highlights early experiments validating TTR stabilization, why enthalpy of binding was key, how it binds TTR, its 30-mo clinical data, and more.

The Cytokinetics next-generation myosin inhibitor, aficamten , is a phase II candidate for genetic hypertrophic cardiomyopathies, and is orally dosed between 5-30 mg QD. It follows BMS’s mavacamten ( acquired from Myokardia in a $13.1B deal), whose NDA is under review by the FDA. This class of molecules is intended to address hypertrophic [...]

asundexian (BAY2433334) is a reversible Factor XIa active site inhibitor previously disclosed at the 2021 EFMC-ISMC conference . This article highlights the Ph. I data of asundexian in healthy volunteers, showing that the drug is well tolerated, with no clinically relevant bleeding-related adverse events or any relevant CYP3A4 modulation. The [...]