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FR104 (pegrizeprument) is a pegylated, monovalent monoclonal antibody fragment (Fab') that selectively antagonizes the CD28 receptor. It is being developed for the prophylaxis of acute rejection in de novo renal transplant patients. Unlike non-selective costimulation blockers that target both CD28 and CTLA-4, FR104 specifically inhibits CD28-mediated effector T-cell activation while sparing the CTLA-4 coinhibitory pathway, which is essential for immune regulation and the function of regulatory T cells. The drug is being evaluated in clinical trials sponsored by Nantes University Hospital in collaboration with OSE Immunotherapeutics and is licensed globally to Veloxis Pharmaceuticals.
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