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Mitiperstat (AZD4831) is an orally available, small molecule, irreversible inhibitor of myeloperoxidase (MPO), an enzyme involved in inflammation and oxidative stress. It was developed primarily for the treatment of heart failure with preserved ejection fraction (HFpEF), chronic obstructive pulmonary disease (COPD), and non-alcoholic steatohepatitis. The drug acts by covalently inhibiting MPO, thereby reducing the formation of hypohalous acids and other toxic intermediates that contribute to vascular damage and inflammation. Mitiperstat demonstrated high selectivity for MPO at low oral doses, a long half-life (~40–70 hours), and dose-dependent inhibition of plasma MPO activity in clinical studies. Development was led by AstraZeneca, with contributions from the University of Cologne[1][3][4][5][6][8].
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