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Pralnacasan is an orally bioavailable, potent, non-peptide small molecule inhibitor of interleukin-1 beta converting enzyme (ICE), also known as caspase-1. It was originally discovered by Vertex Pharmaceuticals and licensed to Aventis Pharma for development. Pralnacasan acts by selectively inhibiting caspase-1, thereby blocking the production of pro-inflammatory cytokines such as interleukin-1 beta (IL-1β) and interferon gamma (IFNγ), which are key mediators in inflammatory processes. The drug was investigated primarily for the treatment of rheumatoid arthritis and osteoarthritis, with additional studies in partial epilepsy. Clinical trials advanced to Phase II before development was voluntarily discontinued in 2003 due to liver toxicity observed in long-term animal studies at high doses; no similar toxicity had been seen in human trials up to that point[1][2][5][7].
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