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Pegipanermin (XPro1595) is a pegylated, dominant-negative recombinant protein variant of tumor necrosis factor (TNF) developed by INmune Bio for the treatment of neurodegenerative diseases, primarily Alzheimer's disease. Unlike traditional TNF inhibitors that non-selectively neutralize both soluble and transmembrane TNF, pegipanermin selectively targets and neutralizes soluble TNF (sTNF) while preserving the neuroprotective signaling of transmembrane TNF (tmTNF) and its receptors. It functions by forming inactive heterotrimers with native sTNF, preventing its interaction with TNF receptor 1 (TNFR1) and subsequent pro-inflammatory signaling. The drug is specifically being investigated for patients with early Alzheimer's disease who exhibit biomarkers of inflammation (ADi population). While the Phase 2 MINDFuL trial did not meet its primary endpoint in the overall population, it demonstrated efficacy signals in a prespecified subgroup with high inflammatory burden and amyloid pathology.
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