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DRUG CLASS:

DHODH inhibitor

20d
CALLIPER: Study to Evaluate Efficacy, Safety, and Tolerability of IMU-838 in Patients With Progressive Multiple Sclerosis (clinicaltrials.gov)
P2, N=450, Active, not recruiting, Immunic AG | Trial completion date: Jul 2024 --> Jan 2025 | Trial primary completion date: Apr 2024 --> Jan 2025
Trial completion date • Trial primary completion date
24d
Antidepressant effect of teriflunomide via oligodendrocyte protection in a mouse model. (PubMed, Heliyon)
Additionally, TF treatment facilitated a reduction in the levels of apoptosis-related proteins while simultaneously augmenting the levels of Bcl2. Our findings indicate that TF administration effectively mitigates CORT-induced depression-like behaviors and reverses damage to oligodendrocytes and neurons in the hippocampus, suggesting TF as a promising candidate for depression.
Preclinical • Journal
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BCL2 (B-cell CLL/lymphoma 2) • SYP (Synaptophysin)
1m
OASIS: Olorofim Aspergillus Infection Study (clinicaltrials.gov)
P3, N=225, Recruiting, F2G Biotech GmbH | Trial completion date: Mar 2025 --> Nov 2025
Trial completion date
1m
TERIPET: Effect of Teriflunomide Treatment on Microglial Activation in an MS Patient Cohort at Risk of Progression (clinicaltrials.gov)
P=N/A, N=26, Active, not recruiting, Turku University Hospital | Trial primary completion date: Dec 2023 --> Dec 2024
Trial primary completion date
1m
POLQ inhibition attenuates the stemness and ferroptosis resistance in gastric cancer cells via downregulation of dihydroorotate dehydrogenase. (PubMed, Cell Death Dis)
Moreover, the combination of POLQ inhibitor and ferroptosis inducer synergistically suppressed MGC-803 xenograft tumor growth and diminished metastasis. Our results identify a POLQ-mediated stemness and ferroptosis defense mechanism and provide a new therapeutic strategy for gastric cancer.
Journal
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DHODH (Dihydroorotate Dehydrogenase (Quinone))
1m
Charge-Reversal NaCl/G-Quartets for Aggregation-Induced Mitochondrial MicroRNA Imaging and Ion-Interference Therapy. (PubMed, Anal Chem)
The negatively charged nanomedicine ensured good blood stability and high tumor accumulation, while the charge-reversal to positive in response to the acidic pH in the tumor microenvironment (TME) and lysosomes enhanced the uptake by tumor cells and lysosome escape, achieving accumulation in mitochondria. The subsequently released Na+ in mitochondria not only contributed to the formation of mitomiR-494 induced G-quadruplexes for AIE imaging diagnosis but also led to an osmolarity surge that was enhanced by brequinar to achieve effective ion-interference therapy.
Journal
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MIR494 (MicroRNA 494)
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brequinar (DUP 785)
1m
Leflunomide for the Treatment of High-Risk Smoldering Multiple Myeloma (clinicaltrials.gov)
P1, N=1, Active, not recruiting, City of Hope Medical Center | Trial completion date: Dec 2023 --> Dec 2024 | Trial primary completion date: Dec 2023 --> Dec 2024
Trial completion date • Trial primary completion date
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leflunomide
2ms
Leflunomide in Treating Patients With Steroid Dependent Chronic Graft Versus Host Disease (clinicaltrials.gov)
P1, N=18, Active, not recruiting, City of Hope Medical Center | Recruiting --> Active, not recruiting
Enrollment closed
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leflunomide
2ms
Pivotal role of dihydroorotate dehydrogenase as a therapeutic target in adult T-cell leukemia. (PubMed, Eur J Haematol)
These findings highlight DHODH as a potential therapeutic target for treating ATL.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • PTEN (Phosphatase and tensin homolog) • CCNA2 (Cyclin A2) • CDK2 (Cyclin-dependent kinase 2) • NFKBIA (NFKB Inhibitor Alpha 2) • DHODH (Dihydroorotate Dehydrogenase (Quinone))
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orludodstat (BAY2402234)
2ms
ULTIMS: Ultra-high-field Brain MRI in Multiple Sclerosis (clinicaltrials.gov)
P=N/A, N=10, Active, not recruiting, Zuyderland Medisch Centrum | Recruiting --> Active, not recruiting | Trial completion date: Mar 2024 --> Aug 2024 | Trial primary completion date: Mar 2024 --> Jul 2024
Enrollment closed • Trial completion date • Trial primary completion date
2ms
CALDOSE-1: Phase 2 Dose-finding IMU-838 for Ulcerative Colitis (clinicaltrials.gov)
P2, N=263, Terminated, Immunic AG | Active, not recruiting --> Terminated; Considering the efficacy results of the induction phase (allowed use of corticosteroids as concomitant medication) in the study population and since IMU-838 did not show superiority over placebo, the OLE was prematurely closed by the sponsor.
Trial termination
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TNFA (Tumor Necrosis Factor-Alpha)
3ms
Leflunomide induced cardiac injury in adult male mice and bioinformatic approach identifying Nrf2/NF-κB signaling interplay. (PubMed, Toxicol Mech Methods)
Histopathological results confirmed the dose-dependent effects of LFND on cardiac muscle structure in the form of cytoplasmic, nuclear and vascular changes in addition to increased collagen deposits and apoptosis which were increased compared to controls especially with LFND 10 mg/kg. The current study elicits the dose-dependent cardiac injury induced by LFND administration with and highlighted, for the first time, dysregulation in Nrf2/NF-κB signaling.
Preclinical • Journal
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TNFA (Tumor Necrosis Factor-Alpha) • BAX (BCL2-associated X protein)
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BAX expression
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leflunomide
3ms
A Study of JNJ-74856665 in Participants With Acute Myeloid Leukemia (AML) or Myelodysplastic Syndrome (MDS) (clinicaltrials.gov)
P1, N=155, Active, not recruiting, Janssen Research & Development, LLC | Trial completion date: Dec 2023 --> Jul 2024 | Trial primary completion date: Dec 2023 --> Jul 2024
Trial completion date • Trial primary completion date
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BCL2 (B-cell CLL/lymphoma 2)
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JNJ-6665
3ms
Leflunomide in Mild COVID-19 Patients (clinicaltrials.gov)
P1, N=11, Terminated, University of Chicago | N=20 --> 11 | Recruiting --> Terminated; Terminated by PI
Enrollment change • Trial termination
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leflunomide
4ms
A Study Evaluating the Safety and Efficacy of AUR108 in Patients With Relapsed Advanced Lymphomas (ASHA-1) (clinicaltrials.gov)
P1, N=40, Recruiting, Aurigene Discovery Technologies Limited | Not yet recruiting --> Recruiting
Enrollment open
4ms
New P2 trial
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KRAS (KRAS proto-oncogene GTPase)
|
Avastin (bevacizumab) • hydroxychloroquine • leflunomide
4ms
A Phase I Study of PP-001 Eye Drops in Healthy Adult Volunteers (clinicaltrials.gov)
P1, N=45, Completed, Panoptes Pharma GmbH | Unknown status --> Completed | N=24 --> 45
Trial completion • Enrollment change
4ms
A Multi-Centre, Randomised, Controlled, Masked Phase 2 Study of the Safety and Efficacy of KIO-101 Ophthalmic Solution, Versus Vehicle Control in the Treatment of Dry Eye Disease in Patients With Autoimmune Disease (clinicaltrials.gov)
P2, N=4, Terminated, Kiora Pharmaceuticals, Inc. | N=132 --> 4 | Trial completion date: Nov 2024 --> Jan 2024 | Suspended --> Terminated | Trial primary completion date: Nov 2024 --> Jan 2024; Study halted prematurely but potentially will resume
Enrollment change • Trial completion date • Trial termination • Trial primary completion date
4ms
Effects of GABAA Receptor Modulation by AP-325 on Insulin Secretion in Patients With Type 2 Diabetes (clinicaltrials.gov)
P2, N=38, Recruiting, The Deutsche Diabetes Forschungsgesellschaft e.V. | Trial completion date: Sep 2022 --> Jun 2025 | Trial primary completion date: Jun 2022 --> Jun 2024
Trial completion date • Trial primary completion date
5ms
Teriflunomide for Steroid-resistant/Relapse Immune Thrombocytopenia (clinicaltrials.gov)
P2, N=40, Recruiting, Peking University People's Hospital
New P2 trial
5ms
Leflunomide for the Treatment of Severe COVID-19 in Patients With a Concurrent Malignancy (clinicaltrials.gov)
P1/2, N=2, Active, not recruiting, City of Hope Medical Center | Trial completion date: Dec 2023 --> Jun 2024 | Trial primary completion date: Dec 2023 --> Jun 2024
Trial completion date • Trial primary completion date
|
leflunomide
5ms
Enrollment closed
5ms
Cyclin D1 extensively reprograms metabolism to support biosynthetic pathways in hepatocytes. (PubMed, J Biol Chem)
Pharmacologic inhibition of Cdk4 along with the downstream pyrimidine synthesis enzyme dihydroorotate dehydrogenase synergistically inhibits proliferation and survival of hepatocellular carcinoma cells. These studies demonstrate that cyclin D1 promotes a broad network of biosynthetic pathways in hepatocytes, and this model may provide insights into potential metabolic vulnerabilities in cancer cells.
Journal
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CCND1 (Cyclin D1) • CDK4 (Cyclin-dependent kinase 4) • GAPDH (Glyceraldehyde-3-Phosphate Dehydrogenase)
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CCND1 overexpression
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Ibrance (palbociclib) • orludodstat (BAY2402234)
5ms
Trial completion date • Trial primary completion date
5ms
Trial completion date • Trial primary completion date
5ms
Leflunomide in Patients With PTEN-null Advanced Solid Malignancies (clinicaltrials.gov)
P1, N=24, Recruiting, Deborah Doroshow | Phase classification: P1a/1b --> P1
Phase classification • Metastases
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PTEN (Phosphatase and tensin homolog)
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PTEN expression
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leflunomide
5ms
Glutathione depletion and dihydroorotate dehydrogenase inhibition actuated ferroptosis-augment to surmount triple-negative breast cancer. (PubMed, Biomaterials)
The nanomedicine (ATO/SRF@BSA) was developed by loading sorafenib (SRF) and atovaquone (ATO) into bovine serum albumin (BSA). Furthermore, the anti-cancer results showed that ATO/SRF@BSA exhibited tumor-specific killing efficacy, significantly improved the tumor hypoxic microenvironment, and lessened the toxic side effects of SRF. This work presents an efficient and easily achievable strategy for TNBC treatment, which may hold promise for clinical applications.
Journal
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GPX4 (Glutathione Peroxidase 4)
|
sorafenib • atovaquone
5ms
Trial completion date • Trial primary completion date
5ms
New P2 trial
5ms
FAST-AA: Investigate the Efficacy and Safety of Farudodstat Compared With Its Placebo in Adult Alopecia Areata Participants (clinicaltrials.gov)
P2, N=60, Recruiting, ASLAN Pharmaceuticals | Phase classification: P2a --> P2 | Trial completion date: Apr 2024 --> Oct 2024 | Trial primary completion date: Feb 2024 --> Sep 2024
Phase classification • Trial completion date • Trial primary completion date
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farudodstat (ASLAN003)
6ms
An injectable subcutaneous colon-specific immune niche for the treatment of ulcerative colitis. (PubMed, Nat Biomed Eng)
Here we show, in three mouse models of established ulcerative colitis, that a subcutaneously injected colon-specific immunosuppressive niche consisting of colon epithelial cells, decellularized colon extracellular matrix and nanofibres functionalized with programmed death-ligand 1, CD86, a peptide mimic of transforming growth factor-beta 1, and the immunosuppressive small-molecule leflunomide, induced intestinal immunotolerance and reduced inflammation in the animals' lower gastrointestinal tract. The bioengineered colon-specific niche triggered autoreactive T cell anergy and polarized pro-inflammatory macrophages via multiple immunosuppressive pathways, and prevented the infiltration of immune cells into the colon's lamina propria, promoting the recovery of epithelial damage. The bioengineered niche also prevented colitis-associated colorectal cancer and eliminated immune-related colitis triggered by kinase inhibitors and immune checkpoint blockade.
Journal
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PD-L1 (Programmed death ligand 1) • TGFB1 (Transforming Growth Factor Beta 1) • CD86 (CD86 Molecule)
|
leflunomide
6ms
Leflunomide for the Treatment of Relapsed or Refractory CD30+ Lymphoproliferative Disorders (clinicaltrials.gov)
P2, N=1, Completed, City of Hope Medical Center | Active, not recruiting --> Completed
Trial completion
|
TNFRSF8 (TNF Receptor Superfamily Member 8)
|
leflunomide
6ms
Effect of acupuncture on arthritic pathological injury in rats with type Ⅱ collagen-induced rheumatoid arthritis. (PubMed, Zhen Ci Yan Jiu)
Acupuncture stimulation can improve the degree of joint inflammation and swelling in CIA rats, which may be related to its effects in inhibiting the overexpression of immunoinflammatory factors in serum and regulating expression of mt-p53, NF-κB p65, PPARγ mRNAs and proteins in the synovial tissue.
Preclinical • Journal
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TP53 (Tumor protein P53) • IL6 (Interleukin 6) • TNFA (Tumor Necrosis Factor-Alpha) • IL17A (Interleukin 17A) • PPARG (Peroxisome Proliferator Activated Receptor Gamma)
|
TP53 expression • IL6 expression
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leflunomide
6ms
Proline and dihydroorotate dehydrogenase promote a hyper-proliferative state and dampen ferroptosis in cancer cells by rewiring mitochondrial redox metabolism. (PubMed, Biochim Biophys Acta Mol Cell Res)
I then apply emerging concepts in redox homeodynamics to discuss how the rewiring of the Krebs cycle and ETC promotes shifts in the RST to favor high rates of HO generation for cell signaling. This discussion then focuses on proline dehydrogenase (PRODH) and dihydroorotate dehydrogenase (DHODH), two enzymes over expressed in cancers, and how their link to one another through the coenzyme Q (CoQ) pool generates a redox connection that forms a HO signaling platform and pyrimidine synthesome that favors a hyper-proliferative state and disables ferroptosis.
Review • Journal
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PRODH (Proline Dehydrogenase 1)
6ms
PROMISE: Montpellier PROspective Cohort in Relapsing Remitting Multiple Sclerosis Using Imaging and Serologic (clinicaltrials.gov)
P=N/A, N=400, Recruiting, University Hospital, Montpellier | Not yet recruiting --> Recruiting
Enrollment open
7ms
Mitochondrial-targeted brequinar liposome boosted mitochondrial-related ferroptosis for promoting checkpoint blockade immunotherapy in bladder cancer. (PubMed, J Control Release)
Furthermore, the in vivo studies revealed that BQR@MLipo could remarkably accumulate into the bladder tumor and successfully initiate the infiltration of CD8 T cells into tumor microenvironment for enabling efficient CBI to inhibit bladder tumor growth. Therefore, BQR@MLipo may represent a clinically promising modality for enhancing CBI in bladder tumor.
Journal • Checkpoint inhibition • Checkpoint block
|
CD8 (cluster of differentiation 8) • HMGB1 (High Mobility Group Box 1) • CALR (Calreticulin) • IFNB1 (Interferon Beta 1)
|
brequinar (DUP 785)
7ms
The Potent Dihydroorotate Dehydrogenase Inhibitor, Hosu-53, Exhibits Compelling Monotherapy Efficacy in Multiple Myeloma and Augments CD47 Targeted Therapy (ASH 2023)
Among the most promising MM SOC agents is monoclonal antibodies (mAb) such as the CD38 antibody daratumumab, which significantly improved the management of newly diagnosed and relapsed/refractory MM...We further verified HOSU-53 efficacy using the disseminated MM1.S luciferase CDX model and found a significant prolonged survival in the HOSU-53 cohort (median survival53-days) compared to vehicle (median survival28-days) that was further enhanced with isatuximab combination resulting in superior survival benefit (median survival 69-days)...Currently there is significant clinical interest in CD47 antibody therapy such as magrolimab for both solid tumors and hematological malignancies...In summary, we show compelling survival benefit for HOSU-53 as a monotherapy which is further enhanced when combined with anti-CD38 or anti-CD47 therapies. HOSU-53 is expected to enter phase 1 clinical trials in 2024 and our data is supportive for its expansion into MM.
Clinical • IO biomarker
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CALR (Calreticulin)
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CD38 expression
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Darzalex (daratumumab) • Sarclisa (isatuximab-irfc) • magrolimab (ONO-7913)
7ms
TP53 Aberrant B-Cell Precursor Acute Lymphoblastic Leukemia (BCP-ALL) Are Uniquely Sensitive to a Combination of Pyrimidine De Novo Synthesis Blockade and Replication Checkpoint Inhibition (ASH 2023)
Preliminary results from in vivo experiments using p53 deficient patient derived xenografts indicate that the combination of Orludodstat and Berzosertib is well tolerated, while significantly delaying leukemic growth (Figure 1 B). ConclusionTogether, our findings suggest that the combined targeting of de novo pyrimidine synthesis and ATR signaling may present a specific and non-genotoxic vulnerability for TP53 aberrant ALL.
Checkpoint inhibition
|
TP53 (Tumor protein P53) • CHEK1 (Checkpoint kinase 1)
|
berzosertib (M6620) • orludodstat (BAY2402234)
7ms
Dihydroorotate dehydrogenase promotes cell proliferation and suppresses cell death in esophageal squamous cell carcinoma and colorectal carcinoma. (PubMed, Transl Cancer Res)
Z-VAD-FMK (an apoptosis inhibitor) partially rescued blockade of DHODH-induced death of ESCC cells, and ferroptosis inhibitors (ferrostatin-1 and liproxstatin-1) together with the necroptosis inhibitor (necrostatin-1) partially rescued inhibition of DHODH-induced death of CRC cells, respectively. Pathways including rheumatoid arthritis, salmonella infection, cytokine-cytokine receptor interaction, pertussis, and nuclear factor-κB (NF-κB) were enriched in DHODH-silenced ESCC cells. Overexpression of DHODH augments cell proliferation and suppresses cell death in ESCC and CRC, and DHODH might be developed as a potential anticancer target.
Journal
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GPX4 (Glutathione Peroxidase 4) • AIFM2 (Apoptosis Inducing Factor Mitochondria Associated 2) • DHODH (Dihydroorotate Dehydrogenase (Quinone))
|
liproxstatin-1