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NCX-899 is a nitric oxide (NO)-releasing derivative of the ACE inhibitor enalapril, developed by NicOx SA. It is a dual-action small molecule designed to inhibit the angiotensin-converting enzyme (ACE) while simultaneously acting as a nitric oxide donor. This hybrid pharmacological approach was intended to provide enhanced cardiovascular benefits by combining the blood pressure-lowering effects of ACE inhibition with the vasodilatory and anti-remodeling properties of nitric oxide. In preclinical studies, NCX-899 demonstrated superior efficacy compared to enalapril alone, showing improved cardiac function and prevention of unfavorable cardiac remodeling in models such as cardiomyopathic hamsters and spontaneously hypertensive rats. Despite these promising preclinical results, the development of NCX-899 has been discontinued.
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