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Imisopasem manganese (M40403) is a small molecule, manganese-based non-peptidyl mimetic of the human mitochondrial enzyme manganese superoxide dismutase (MnSOD). Developed by MetaPhore Pharmaceuticals (and later ActivBiotics), it functions as a superoxide dismutase stimulant that selectively scavenges reactive oxygen species (ROS), specifically the superoxide anion, without interfering with other signaling molecules like nitric oxide. In clinical development, it was primarily investigated as an analgesic adjunct to be co-administered with opioids for the treatment of cancer pain, based on evidence that superoxide radicals contribute to pain signaling and opioid tolerance. Although it reached Phase 2 clinical trials for cancer pain and received orphan drug designation for stomatitis, its development for these indications was ultimately discontinued.
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