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DRUG CLASS:

IMPDH inhibitor

1d
AGORAC: Tacrolimus Minimization in Kidney Transplant Recipients Selected According to the AGORA Algorithm for Their Low Immunological Risk and Medium-term Graft Failure (clinicaltrials.gov)
P3, N=332, Recruiting, Nantes University Hospital | Not yet recruiting --> Recruiting | Initiation date: Feb 2024 --> Dec 2024
Enrollment open • Trial initiation date
3d
The Effect of Mycophenolate Mofetil and Cyclophosphamide on the Lymphocyte Subsets in Patients With Proliferative Lupus Nephritis (clinicaltrials.gov)
P=N/A, N=50, Recruiting, The University of Hong Kong | Unknown status --> Recruiting | Trial completion date: Jun 2021 --> Dec 2028 | Trial primary completion date: Mar 2021 --> Dec 2028
Enrollment open • Trial completion date • Trial primary completion date
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CD4 (CD4 Molecule)
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cyclophosphamide
20d
Reduction of Maintenance Immunosuppression in Kidney Transplant Recipients during Acute Complicated Urinary Tract Infection (ACTRN12624001408572)
P4, N=112, Not yet recruiting, prof. Tomas Reischig, MD, PhD - Faculty of Medicine in Pilsen, Charles University, and Teaching Hospital
New P4 trial
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CRP (C-reactive protein)
20d
Haplo-HSCT for Myelofibrosis (clinicaltrials.gov)
P=N/A, N=39, Recruiting, Peking University People's Hospital | Not yet recruiting --> Recruiting | Initiation date: Jan 2025 --> Jan 2024
Enrollment open • Trial initiation date
22d
Mycophenolate Mofetil, an Inhibitor of Inosine Monophosphate Dehydrogenase, and Tofacitinib, a Janus Kinase Inhibitor, Attenuate Airway Inflammation and Hyperresponsiveness in a Mouse Model of Allergic Asthma. (PubMed, Molecules)
In turn, the results indicate that the anti-asthmatic action induced by the studied agents is not mediated by the generation of forkhead box protein 3-expressing CD4+ regulatory T cells. Clinical implication of the the results suggest that MMF and TFB may exert anti-asthmatic action, and thus they may be considered therapeutic options for the treatment of allergic asthma cases resistant to conventional/existing treatment.
Preclinical • Journal
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CD4 (CD4 Molecule) • IL33 (Interleukin 33) • ST2 (Suppression Of Tumorigenicity)
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CD4 expression
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tofacitinib
29d
Mycophenolate Mofetil Combined With Radiation Therapy in Glioblastoma (clinicaltrials.gov)
P1, N=68, Recruiting, University of Michigan Rogel Cancer Center | Trial completion date: Oct 2027 --> Feb 2028 | Trial primary completion date: Oct 2024 --> Feb 2025
Trial completion date • Trial primary completion date
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temozolomide
30d
Mycophenolate mofetil after tacrolimus for refractory clinically amyopathic dermatomyositis: a case report. (PubMed, Front Pharmacol)
The patient showed a limited response to a combined therapy regimen of prednisone, iguratimod, and tacrolimus. This report also discusses the potential role of inflammatory cytokines in the pathophysiology of CADM and RP-ILD. Further research is required to confirm these results and investigate the application of MMF in maintenance therapy for CADM-associated RP-ILD.
Journal
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IFIH1 (Interferon Induced With Helicase C Domain 1)
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prednisone
1m
Innovative anti-proliferative effect of the antiviral favipiravir against MCF-7 breast cancer cells using green nanoemulsion and eco-friendly assessment tools. (PubMed, Sci Rep)
The cytotoxic effect of FNE on MCF-7 cells was more potent than FAV with lower IC50 while FNE showed non-toxic effect on VERO normal cell line. Therefore, the FAV nanoemulsion formulation showed targeted cytotoxicity on MCF-7 cells while being non-toxic on normal Vero cells.
Journal
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TERT (Telomerase Reverse Transcriptase)
1m
A multicenter, observational, cohort study of mycophenolate sodium enteric-coated tablets or/and tacrolimus extended-release capsules in the treatment of systemic lupus erythematosus and lupus nephrit (ChiCTR2400088890)
P=N/A, N=1664, Not yet recruiting, Tongji Hospital, Tongji Medical College ,Huazhong University of Science and Technology; Tongji Hospital, Tongji Medical College ,Huazhong University o
New trial
1m
Critical Crossroads: The Vital Role of Timely Diagnosis in Severe Amyopathic Dermatomyositis. (PubMed, Cureus)
Treatment with prednisolone and mycophenolate mofetil was initiated, resulting in subsequent clinical improvement. In conclusion, this case of anti-MDA5 positive CADM underscores the diverse range of clinical and radiological findings and the diagnostic challenges they pose. It highlights the importance of anti-MDA5 antibodies as a valuable diagnostic and prognostic tool, given their association with an elevated risk of developing interstitial lung disease (ILD), which may follow a rapidly progressive course and can be further complicated by pneumomediastinum.
Journal
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IFIH1 (Interferon Induced With Helicase C Domain 1)
2ms
NECESSITY: New Clinical End-points in Patients With Primary Sjögren's Syndrome (clinicaltrials.gov)
P2, N=300, Recruiting, Assistance Publique - Hôpitaux de Paris | Trial completion date: Apr 2025 --> Oct 2025 | Trial primary completion date: Feb 2024 --> Apr 2025
Trial completion date • Trial primary completion date
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hydroxychloroquine • leflunomide
2ms
QSOX1 facilitates dormant esophageal cancer stem cells to evade immune elimination via PD-L1 upregulation and CD8 T cell exclusion. (PubMed, Proc Natl Acad Sci U S A)
Conversely, blocking QSOX1 with Ebselen in combination with anti-PD-1 and chemotherapy can effectively eradicate residual DCSCs by reducing PD-L1 expression and promoting CD8+ T cell infiltration. Clinically, high expression of QSOX1 predicts a poor response to anti-PD-1 treatment in patients with esophageal cancer. Thus, our findings reveal a mechanism whereby QSOX1 promotes PD-L1 upregulation and T cell exclusion, facilitating the immune escape of DCSCs, and QSOX1 inhibition, combined with immunotherapy and chemotherapy, represents a promising therapeutic approach for eliminating DCSCs and preventing recurrence.
Journal • Cancer stem • PD(L)-1 Biomarker • IO biomarker
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CD8 (cluster of differentiation 8) • GZMK (Granzyme K)
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PD-L1 expression
2ms
Trial initiation date
2ms
Sensitization of Multidrug Resistant Cancer Cells to Doxorubicin Using Ebselen by Disturbing Cellular Redox Status. (PubMed, Cell Biochem Funct)
The combination treatment also enhanced the upregulation of proapoptotic markers such as Bax, Caspase-3, -9, and cytochrome C, while downregulating the expression of the antiapoptotic marker Bcl-2. Therefore, the current discoveries suggest that Ebs could be employed as a drug candidate for reversing MDR in cancer cells by regulating cellular redox homeostasis.
Journal • IO biomarker
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TP53 (Tumor protein P53) • BCL2 (B-cell CLL/lymphoma 2) • BAX (BCL2-associated X protein) • CASP3 (Caspase 3) • CASP9 (Caspase 9) • CDKN1A (Cyclin-dependent kinase inhibitor 1A)
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BCL2 expression • TP53 expression
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doxorubicin hydrochloride
3ms
ERPL-CTP-001: Safety & Efficacy of Eyecyte-RPE™ in Patients With Geographic Atrophy Secondary to Dry Age-related Macular Degeneration. (clinicaltrials.gov)
P1/2, N=54, Recruiting, Eyestem Research Pvt. Ltd. | Trial primary completion date: Oct 2024 --> Apr 2025
Trial primary completion date
3ms
Liver transplantation plus chemotherapy versus chemotherapy alone in patients with permanently unresectable colorectal liver metastases (TransMet): results from a multicentre, open-label, prospective, randomised controlled trial. (PubMed, Lancet)
In selected patients with permanently unresectable colorectal liver metastases, liver transplantation plus chemotherapy with organ allocation priority significantly improved survival versus chemotherapy alone. These results support the validation of liver transplantation as a new standard option for patients with permanently unresectable liver-only metastases.
Clinical • Journal
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BRAF (B-raf proto-oncogene)
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BRAF mutation
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everolimus • methylprednisolone sodium succinate
3ms
A Case of Autoimmune Myelofibrosis Associated With Autoimmune Hepatitis. (PubMed, J Hematol)
Prednisone was reinitiated at 1 mg/kg, and she was started on mycophenolate mofetil (MMF). Despite this, a rapid response to corticosteroids was observed including reversal of profound transfusion dependence, normalization of hemoglobin, and reversal of biochemical evidence of hepatic inflammation. A shared pathogenesis of autoimmune fibrosis in both the bone marrow and liver is speculative but suggested by the temporal association in this case.
Journal
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JAK2 (Janus kinase 2) • CALR (Calreticulin)
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prednisone
4ms
Evaluating the Safety of Myfortic (Mycophenolate Sodium) in Patients With Lupus Nephritis (clinicaltrials.gov)
P=N/A, N=72, Active, not recruiting, Novartis Pharmaceuticals | Recruiting --> Active, not recruiting
Enrollment closed
4ms
Individualized Dose Study of ATG in Haploidentical Hematopoietic Stem Cell Transplantation (clinicaltrials.gov)
P4, N=204, Completed, Chinese PLA General Hospital | Recruiting --> Completed
Trial completion
4ms
Mycophenolate Mofetil for Treatment of Relapses of Wegener's Disease or Microscopic Polyangiitis (MPA) (clinicaltrials.gov)
P3, N=84, Completed, University Medical Center Groningen | Unknown status --> Completed
Trial completion
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cyclophosphamide
4ms
MyQURE: Mycophenolate-Based Therapy for Kidney Transplant Recipients Without HLA-DQ Mismatch (clinicaltrials.gov)
P4, N=20, Recruiting, University Hospital, Antwerp | Not yet recruiting --> Recruiting
Enrollment open
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HLA-B (Major Histocompatibility Complex, Class I, B)
4ms
BK EVER: Multicenter Randomized Two-arms Study Evaluating the BK Viral Clearance in Kidney Transplant Recipients With BK Viremia. (clinicaltrials.gov)
P4, N=130, Completed, University Hospital, Strasbourg, France | Active, not recruiting --> Completed | Trial completion date: Nov 2023 --> Aug 2024 | Trial primary completion date: Nov 2023 --> Aug 2024
Trial completion • Trial completion date • Trial primary completion date
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everolimus
5ms
An Alternatively Spliced Gain-of-Function NT5C2 Isoform Contributes to Chemoresistance in Acute Lymphoblastic Leukemia. (PubMed, Cancer Res)
Incorporation of the 8-amino acid sequence SQVAVQKR into this enzyme created a putative phosphorylation site and resulted in elevated nucleosidase activity, which is a known consequence of gain-of-function mutations in NT5C2 and a common determinant of 6-mercaptopurine (6-MP) resistance. Furthermore, both the NT5C2ex6a and R238W variants induced collateral sensitivity to the inosine monophosphate dehydrogenase (IMPDH) inhibitor mizoribine. These results ascribe an important role for splicing perturbations in chemotherapy resistance in relapsed B-ALL and suggest that IMPDH inhibitors, including the commonly used immunosuppressive agent mycophenolate mofetil, could be a valuable therapeutic option for treating thiopurine-resistant leukemias.
Journal
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NT5C2 (5'-Nucleotidase Cytosolic II)
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Bredinin (mizoribine) • mercaptopurine
5ms
An Alternatively Spliced Gain-of-Function NT5C2 Isoform Contributes to Chemoresistance in Acute Lymphoblastic Leukemia. (PubMed, bioRxiv)
Incorporation of the 8-amino acid sequence SQVAVQKR into this enzyme created a putative phosphorylation site and resulted in elevated nucleosidase activity, which is a known consequence of gain-of-function mutations in NT5C2 and a common determinant of 6-mercaptopurine (6-MP) resistance. Furthermore, both the NT5C2ex6a and R238W variants induced collateral sensitivity to the inosine monophosphate dehydrogenase (IMPDH) inhibitor mizoribine. These results ascribe an important role for splicing perturbations in chemotherapy resistance in relapsed B-ALL and suggest that IMPDH inhibitors, including the commonly used immunosuppressive agent mycophenolate mofetil, could be a valuable therapeutic option for treating thiopurine-resistant leukemias.
Journal
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NT5C2 (5'-Nucleotidase Cytosolic II)
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Bredinin (mizoribine) • mercaptopurine
5ms
SPI-1005 for Prevention and Treatment of Tobramycin Induced Ototoxicity (clinicaltrials.gov)
P2, N=40, Completed, Sound Pharmaceuticals, Incorporated | Enrolling by invitation --> Completed | N=80 --> 40
Trial completion • Enrollment change
5ms
STOPMD-3: SPI-1005 for the Treatment of Meniere's Disease (clinicaltrials.gov)
P3, N=254, Completed, Sound Pharmaceuticals, Incorporated | Active, not recruiting --> Completed
Trial completion
5ms
IMPDH2 suppression impedes cell proliferation by instigating cell cycle arrest and stimulates apoptosis in pediatric hepatoblastoma. (PubMed, J Cancer Res Clin Oncol)
The present study unveiled a significant overexpression of inosine monophosphate dehydrogenase 2 (IMPDH2) in hepatoblastoma (HB) tissues, particularly in association with metastasis and recurrence of the disease. The pronounced upregulation of IMPDH2 was found to be intimately correlated with adverse outcomes in HB patients. This overexpression appears to accelerate the progression of the cell cycle, suggesting that IMPDH2 may serve as a promising candidate for both a prognostic marker and a therapeutic target in the context of HB.
Journal
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AFP (Alpha-fetoprotein)
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doxorubicin hydrochloride
5ms
New P2 trial
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cyclophosphamide
5ms
Asymptomatic and slowly progressive anti-MDA5 ILD: A report of three cases deviating from a notoriously rapidly progressive ILD. (PubMed, Respir Med Case Rep)
She was treated with mycophenolate mofetil monotherapy for her skin manifestations...He was started on nintedanib...Given her lack of respiratory symptoms and normal PFTs, she was not initiated on ILD-specific treatment. While anti-MDA5 ILD is certainly associated with RP-ILD, clinicians should maintain awareness that there may be cases of asymptomatic or slowly progressive ILD as well.
Journal
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IFIH1 (Interferon Induced With Helicase C Domain 1)
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nintedanib
5ms
Up-front Hematopoietic Stem Cell Transplantation in Acute Myeloid Leukemia Patients Aged 65-75 (clinicaltrials.gov)
P2, N=19, Completed, Fondazione Policlinico Universitario Agostino Gemelli IRCCS | Unknown status --> Completed | Trial completion date: Mar 2021 --> Jun 2024 | Trial primary completion date: Mar 2021 --> Mar 2024
Trial completion • Trial completion date • Trial primary completion date
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cytarabine • cyclophosphamide
5ms
Modified Second Haplo-transplantation for Graft Failure (clinicaltrials.gov)
P=N/A, N=12, Recruiting, Peking University People's Hospital
New trial
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cyclophosphamide
5ms
Second Haplo-transplantation for Graft Failure (clinicaltrials.gov)
P=N/A, N=34, Recruiting, Peking University People's Hospital
New trial
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cyclophosphamide
5ms
A real-world study of autoimmune encephalitis patients treated with mycophenolate mofetil or azathioprine (ChiCTR2200067032)
P=N/A, N=100, Recruiting, Renji Hospital, Shanghai Jiao Tong University School of Medicine; Renji Hospital, Shanghai Jiao Tong University School of Medicine | Not yet recruiting --> Recruiting
Enrollment open
5ms
New P4 trial
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HLA-B (Major Histocompatibility Complex, Class I, B)
6ms
Recurrent rejections after liver transplantation for hepatocellular carcinoma with stem cell features in an adult patient. (PubMed, Acta Clin Belg)
Despite being on conventional immunosuppressive regimens (tacrolimus and mycophenolate mofetil with initial corticosteroids tapered), this patient still developed two severe rejection episodes, one of which necessitated retransplantation (DCD). Both episodes were preceded by alterations in tacrolimus trough levels, either intentionally, when tacrolimus was reduced within a nephroprotective regimen, or unintentionally, when rifampicin, a CYP3A4 inducer, significantly lowered the trough levels...Furthermore, the patient experienced an everolimus-linked drug-induced thrombotic microangiopathy, underwent multiple ERCPs for an anastomotic stricture and only one and a half year after the first liver transplantation she already suffers from long-term immunosuppressive-related side effects such as impaired glucose tolerance, hypertension and a potential cardiomyopathy. At present, she is still alive and experienced no recurrence of her primary tumor. Her case underscores the significant challenges in post-liver transplantation care.
Journal
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CYP3A4 (Cytochrome P450, family 3, subfamily A, polypeptide 4)
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everolimus • rifampicin
6ms
ADIVKT: Impact of Immunosuppression Adjustment on COVID-19 Vaccination Response in Kidney Transplant Recipients (clinicaltrials.gov)
P4, N=50, Recruiting, University of California, Davis | Trial completion date: Jan 2023 --> Jan 2025 | Trial primary completion date: Dec 2022 --> Dec 2024
Trial completion date • Trial primary completion date
6ms
IMPDH Inhibition Decreases TERT Expression and Synergizes the Cytotoxic Effect of Chemotherapeutic Agents in Glioblastoma Cells. (PubMed, Int J Mol Sci)
In U251 cells, MPA displayed strong cytotoxic synergy with BCNU and moderate synergy with irinotecan, oxaliplatin, paclitaxel, or temozolomide (TMZ). In U87 cells, MPA displayed strong cytotoxic synergy with all except TMZ, acting primarily through the apoptotic pathway. Our work expands the mechanistic potential of IMPDH inhibition to TERT/telomere regulation and reveals a synthetic lethality between MPA and anti-GBM drugs.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • TERT (Telomerase Reverse Transcriptase)
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paclitaxel • temozolomide • oxaliplatin • irinotecan
6ms
Evaluating the Safety of Myfortic (Mycophenolate Sodium) in Patients With Lupus Nephritis (clinicaltrials.gov)
P=N/A, N=64, Recruiting, Novartis Pharmaceuticals | Active, not recruiting --> Recruiting | Trial completion date: Aug 2024 --> Jul 2025 | Trial primary completion date: Aug 2024 --> Jul 2025
Enrollment open • Trial completion date • Trial primary completion date
7ms
Enrollment open
7ms
Thiophenyl Derivatives of Nicotinamide Are Metabolized by the NAD Salvage Pathway into Unnatural NAD Derivatives That Inhibit IMPDH and Are Toxic to Peripheral Nerve Cancers. (PubMed, ACS Chem Biol)
AD analogues derived from compound 9 inhibit IMPDH in vitro and cause cell death by inhibiting IMPDH in cells. These findings nominate these compounds as preclinical candidates for the development of tumor-activated IMPDH inhibitors to treat neuronal cancers.
Journal
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NAMPT (Nicotinamide Phosphoribosyltransferase)
7ms
Subcellular distribution and Nrf2/Keap1-interacting properties of Glutathione S-transferase P in hepatocellular carcinoma. (PubMed, Arch Biochem Biophys)
Higher levels and a preferential nuclear localization of GSTP protein were also observed in HepG2 and Huh-7 hepatocarcinoma cells compared to HepaRG non-cancerous cells, along with increased basal and Ebselen-stimulated levels of free GSH and PSSG...Nrf2 nuclear translocation and β-TrCP expression also increased in HCC cells, whereas the GSTP transfection in HepaRG cells induced Nrf2 transcriptional activation. In conclusion, GSTP expression and subcellular distribution can contribute to the GSH-dependent redox reprogramming of HCC cells directly influencing the Nrf2/Keap1 system.
Journal
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KEAP1 (Kelch Like ECH Associated Protein 1) • NFE2L2 (Nuclear Factor, Erythroid 2 Like 2) • GSTP1 (Glutathione S-transferase pi 1) • JUN (Jun proto-oncogene)