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Ninerafaxstat (IMB-1018972) is a first-in-class, investigational small molecule cardiac mitotrope being developed by Imbria Pharmaceuticals. It acts as a partial fatty acid oxidation (pFOX) inhibitor, designed to shift the heart's metabolic preference from fatty acids toward glucose. This metabolic shift enhances mitochondrial energy efficiency, potentially improving cardiac function without affecting heart rate, blood pressure, or rhythm. It is currently being evaluated in Phase 2 clinical trials for cardiovascular conditions including stable angina due to obstructive coronary artery disease, non-obstructive hypertrophic cardiomyopathy (nHCM), and heart failure with preserved ejection fraction (HFpEF).
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