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Azeliragon is an orally administered small molecule inhibitor of the receptor for advanced glycation end-products (RAGE), a cell-surface receptor of the immunoglobulin superfamily. RAGE is expressed on multiple cell types and binds to various ligands including advanced glycation end products (AGEs), S100 proteins, HMGB1, and beta-amyloid. Activation of RAGE is implicated in chronic inflammation, neurodegeneration (notably Alzheimer's disease), diabetes complications, and cancer progression. Azeliragon blocks ligand binding to RAGE and inhibits downstream signaling pathways associated with inflammation, oxidative stress, tumor proliferation, survival, metastasis, and amyloid transport into the brain. It was originally developed for Alzheimer's disease but failed in Phase 3 trials for that indication; it has since received orphan drug designation from the FDA for pancreatic cancer and glioblastoma[1][2][4][5][7].
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