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Azelaprag is an orally bioavailable small molecule that acts as a potent agonist of the apelin receptor (APJ). It was originally developed by Amgen and later licensed to BioAge Labs. Azelaprag is designed to activate the apelin receptor, which plays a key role in cardiovascular function, energy metabolism, and muscle preservation. Mechanistically, activation of the apelin receptor promotes endothelium-dependent vasodilation, increases cardiac contractility without adverse hemodynamic effects, lowers blood pressure, and supports angiogenesis. In preclinical models and early clinical trials, azelaprag has demonstrated benefits in preserving muscle mass during periods of inactivity or bed rest and improving body composition when combined with incretin-based therapies for obesity. The drug has been investigated for heart failure, muscular atrophy (including sarcopenia), and obesity but development for these indications has been discontinued[1][3][6][7].
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