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Nomacopan is a recombinant small protein derived from the saliva of the Ornithodoros moubata tick, designed as a bifunctional inhibitor targeting both complement component C5 and leukotriene B4 (LTB4). By tightly binding to C5, it prevents its cleavage and activation, thereby inhibiting the formation of pro-inflammatory mediators such as C5a and the membrane attack complex (C5b–9/MAC). Independently, it also captures LTB4 within its structure to block its inflammatory activity. This dual mechanism allows nomacopan to modulate key pathways involved in inflammation and thrombosis. It is under development for several rare autoimmune and inflammatory diseases including bullous pemphigoid, paroxysmal nocturnal haemoglobinuria (PNH), thrombotic microangiopathies, geographic atrophy in age-related macular degeneration, among others. Nomacopan has received orphan drug designation for multiple indications in both the US and Europe[1][3][4][6][8].
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