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D1400147 is an experimental oral capsule formulation of omega-3-carboxylic acids, specifically a prototype developed by AstraZeneca to optimize the delivery and bioavailability of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). It was evaluated in Phase 1 clinical trials as a potential successor or alternative to Epanova (omega-3-carboxylic acids) for the treatment of hypertriglyceridemia. The mechanism of action involves the reduction of hepatic very-low-density lipoprotein (VLDL) triglyceride synthesis, likely through the inhibition of acyl-CoA:1,2-diacylglycerol acyltransferase (DGAT), increased mitochondrial and peroxisomal beta-oxidation in the liver, and activation of peroxisome proliferator-activated receptor alpha (PPAR-alpha). These actions collectively lower serum triglyceride levels by decreasing production and increasing clearance of triglyceride-rich lipoproteins.
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