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Enlicitide decanoate (MK-0616) is an orally bioavailable macrocyclic peptide inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9), developed by Merck (MSD). It represents a significant advancement in lipid-lowering therapy as the first oral PCSK9 inhibitor to reach late-stage clinical development. By binding to PCSK9, enlicitide decanoate prevents the degradation of low-density lipoprotein receptors (LDLR) on the surface of hepatocytes, thereby increasing the clearance of LDL cholesterol from the bloodstream. It is primarily indicated for the treatment of primary hypercholesterolemia and mixed dyslipidemia, offering an oral alternative to injectable monoclonal antibodies like evolocumab and alirocumab.
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