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Tepilamide fumarate (PPC-06, XP23829) is an oral, extended-release small molecule prodrug of monomethyl fumarate (MMF), belonging to the fumaric acid ester (FAE) class. Originally developed by XenoPort and subsequently licensed to Dr. Reddy's Laboratories, the drug is designed to be absorbed throughout the gastrointestinal tract and rapidly hydrolyzed to release MMF, the active moiety. MMF acts as an immunomodulator and neuroprotective agent, primarily through the activation of the Nrf2 (nuclear factor erythroid 2-related factor 2) antioxidant pathway and agonism of the HCAR2 (hydroxycarboxylic acid receptor 2) receptor. Tepilamide fumarate has been investigated for the treatment of moderate-to-severe plaque psoriasis, relapsing forms of multiple sclerosis, and Parkinson's disease. In clinical trials for psoriasis, it demonstrated efficacy in improving PASI and IGA scores with a safety profile characterized by gastrointestinal side effects and lymphopenia, aiming for improved tolerability compared to traditional dimethyl fumarate formulations.
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