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NNC0385-0434 is an orally administered peptide drug that mimics the EGF-A domain of the human LDL receptor. It acts as a competitive inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9), binding to free PCSK9 and preventing its interaction with the LDL receptor. This mechanism increases LDL receptor availability on hepatocytes and enhances clearance of low-density lipoprotein (LDL) cholesterol from plasma. Developed by Novo Nordisk, it was investigated for hypercholesterolemia and type 2 diabetes mellitus in high-risk cardiovascular patients but was discontinued after phase II trials due to portfolio considerations[1][3][4].
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