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Livoletide (AZP-531) is a first-in-class unacylated ghrelin (UAG) analogue developed for the treatment of hyperphagia and food-related behaviors in patients with Prader-Willi syndrome (PWS). The drug was designed to counteract the effects of acylated ghrelin (the "hunger hormone"), which is typically elevated in PWS patients and contributes to extreme hunger and obesity. Livoletide was originally developed by Alizé Pharma, which was acquired by Millendo Therapeutics in 2017. Despite showing efficacy in a Phase 2a trial, the drug failed to meet its primary endpoint of significantly reducing hunger scores in the pivotal Phase 2b/3 ZEPHYR trial. Consequently, Millendo Therapeutics announced the discontinuation of the livoletide program for PWS in April 2020.
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