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**Rondaptivon pegol (BT200)** is a first-in-class, pegylated (40 kDa PEG), 2′-O-methylated RNA aptamer that binds with high affinity to the A1 domain of von Willebrand factor (VWF). By sterically inhibiting VWF clearance via the macrophage low-density lipoprotein receptor–related protein 1 (LRP1), it prolongs the half-life of endogenous and substituted VWF/FVIII complexes, elevating plasma VWF antigen, activity, multimers, FVIII levels, and platelet counts. Developed by Band Therapeutics LLC (formerly Bioverativ), it is under investigation primarily for type 2B von Willebrand disease (VWD2B) to correct thrombocytopenia and bleeding risk, as well as hemophilia A to enable less frequent FVIII prophylaxis.
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