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Lexaptepid pegol (NOX-H94) is a pegylated Spiegelmer (an L-enantiomer RNA aptamer) that acts as a high-affinity antagonist of hepcidin. Developed by TME Pharma (formerly NOXXON Pharma), it is designed to treat anemia of chronic disease (ACD) and functional iron deficiency, particularly in patients who are hyporesponsive to erythropoiesis-stimulating agents (ESAs). Hepcidin is a key regulatory hormone that inhibits iron absorption and recycling by binding to ferroportin; by neutralizing hepcidin, lexaptepid pegol increases iron availability for erythropoiesis. The drug has been investigated in clinical trials for patients with dialysis-dependent chronic kidney disease, multiple myeloma, and lymphoma.
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