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Upamostat (RHB-107) is an orally bioavailable, first-in-class serine protease inhibitor originally developed by Heidelberg Pharma (formerly WILEX AG) and currently being developed by RedHill Biopharma. It acts as a prodrug of WX-UK1, targeting several human serine proteases including urokinase-type plasminogen activator (uPA), matriptase, and transmembrane protease serine 2 (TMPRSS2). By inhibiting these host-cell proteases, upamostat prevents viral entry (relevant for COVID-19 and potentially Ebola) and interferes with tumor cell invasion and metastasis. It is primarily being evaluated for the early outpatient treatment of COVID-19 in the Phase 2 ACESO PROTECT trial and has historical development in various cancers and inflammatory gastrointestinal diseases.
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