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CH-4051 is an orally available, metabolically inert antifolate developed for the treatment of rheumatoid arthritis and other autoimmune disorders. It is the L-isomer of CH-1504 and was engineered to provide potent anti-inflammatory effects with improved safety and tolerability compared to methotrexate (MTX), particularly by reducing liver toxicity and other side effects associated with chronic MTX therapy. The drug acts as a dihydrofolate reductase (DHFR) inhibitor, blocking folate metabolism necessary for DNA synthesis in rapidly dividing cells such as those involved in autoimmune inflammation. Preclinical studies and phase II clinical trials indicated that CH-4051 has similar efficacy to MTX but with reduced hepatotoxicity. Originally developed by Chelsea Therapeutics under license from the University of South Alabama, development was later continued by Lundbeck following acquisition[1][2][5].
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