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REGN5381 is an investigational monoclonal antibody that acts as an allosteric agonist of natriuretic peptide receptor 1 (NPR1). Developed by Regeneron Pharmaceuticals, it is designed to activate NPR1 directly—mimicking the effects of endogenous natriuretic peptides such as ANP and BNP—to promote vasodilation and reduce blood pressure. This mechanism leads to beneficial hemodynamic effects including reduced venous and systolic pressures without significant changes in diuresis or natriuresis. The drug is being studied primarily for the treatment of heart failure (including both heart failure with reduced ejection fraction [HFrEF] and preserved ejection fraction [HFpEF]) and hypertension. Early clinical studies have shown sustained hemodynamic effects with acceptable safety profiles in healthy volunteers and patients with mild hypertension or heart failure[2][3][4][5][6].
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