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ilkodostat (S42909) is an orally bioavailable small molecule inhibitor of hypoxia-inducible factor prolyl hydroxylase (PHD) enzymes, developed for the treatment of chronic wounds, specifically venous leg ulcers (VLU). Originally discovered by Servier and subsequently licensed to its spin-off Ilkos Therapeutics, the compound acts by preventing the prolyl hydroxylation of Hypoxia-Inducible Factor 1-alpha (HIF-1α), which normally marks it for proteasomal degradation under normoxic conditions. By stabilizing HIF-1α, ilkodostat induces the transcription of a suite of genes involved in angiogenesis, cell proliferation, and survival, facilitating the healing of ulcers that are resistant to standard compression therapy. The drug has been evaluated in Phase II clinical trials to assess its efficacy in accelerating ulcer closure.
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