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Zetomipzomib is a novel, first-in-class, selective immunoproteasome inhibitor being developed as a small molecule therapy for a range of autoimmune diseases. Its mechanism of action involves dual inhibition of the immunoproteasome subunits LMP7 and LMP2, leading to broad suppression of pro-inflammatory cytokine production and modulation of T and B cell activation. Zetomipzomib has demonstrated efficacy in preclinical models by reducing proteinuria in lupus nephritis and modulating immune cell function without causing overt immunosuppression. It is administered as a subcutaneous injection and is currently under clinical investigation for conditions including lupus nephritis, systemic lupus erythematosus (SLE), autoimmune hepatitis, dermatomyositis, and polymyositis. The drug was originally discovered by Onyx Pharmaceuticals and is being developed by Kezar Life Sciences with Everest Medicines also involved in its development[1][2][3][4][5][6][7].
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