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Neladenoson bialanate is a first-in-class, orally administered, small molecule that acts as a partial and highly selective agonist of the adenosine A1 receptor. It was developed for the treatment of chronic heart failure, including both heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). The drug was designed to maintain the cardioprotective effects of adenosine while minimizing side effects associated with full agonists. Clinical trials included phase 2 studies in patients with chronic heart failure; however, development was discontinued after these studies did not demonstrate significant clinical benefit[1][3][4][6].
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