Difelikefalin is an orally bioavailable second-generation peptide. It is an investigational peripheral kappa opioid receptor agonist. Difelikefalin significantly reduced moderate to severe chronic itching while achieving across-the-board clinically meaningful improvements in quality of life measures in patients with hemodialysis-associated pruritus in a phase 2 study. In a phase 2 clinical investigation, difelikefalin was safe, well tolerated and showed robust analgesic activity for postoperative pain in female patients undergoing laparoscopy, with a significant reduction in post-operative morphine consumption and opioid-related side effects. Now difelikefalin is in phase III clinical trials for the treatment of post-operative pain and pruritus.

Tepotinib is an investigational small molecule inhibitor of the c-Met receptor tyrosine kinase. Alterations of the c-Met signaling pathway are found in various cancer types and correlate with aggressive tumor behavior and poor clinical prognosis. Tepotinib is a potent and selective c-Met inhibitor, >200-fold selective for c-Met than IRAK4, TrkA, Axl, IRAK1, and Mer. Tepotinib is currently in Phase I/II trials in liver cancer and lung cancer.

MK-8031 (also known as Atogepant) is piperidinonylcarboxamideazaindane derivative patented by Merck Sharp & Dohme Corp as CGRP receptor antagonist useful for prevention and treatment of Migraine. A press release in June 2018 announced positive results for MK-8031, in a Phase 2 trial of daily use for episodic migraine prevention. MK-8031appeared to show good efficacy in migraine prevention and no significant liver toxicity signal at any dose despite daily dosing for 3 months. Phase III clinical trial was initiated in 2019 and currently in progress.

Maralixibat (SHP625; formerly LUM001 or lopixibat) is a potent, apical, sodium‐dependent, bile acid transporter competitive inhibitor with minimal systemic absorption. Maralixibat works by reducing systemic levels of bile acids. In animal models of cholestasis, maralixibat blocked reabsorption of bile acids in the terminal ileum, thereby reducing enterohepatic recirculation to the liver and increasing fecal excretion of bile acids. Maralixibat is being evaluated as a treatment for children with rare cholestatic liver diseases, including Alagille syndrome (ALGS) and progressive familial intrahepatic cholestasis (PFIC).

MK-3118 is an orally active inhibitor of fungal β-(1,3)-glucan synthase patented by Merck Sharp & Dohme Corp for the treatment of fungal infections. MK-3118 demonstrated enhanced efficacy for most C. albicans and C. glabrata ER isolates relative to caspofungin. MK-3118 showed no or poor activity against Mucoromycotina and Fusarium spp. However, MK-3118 was highly active against Paecilomyces variotii and was the only compound displaying some activity against notoriously pan-resistant Scedosporium prolificans.

Vericiguat, discovered at Bayer, is the first soluble guanylate cyclase (sGC) stimulator. Vericiguat is currently being studied in a Phase III clinical program for the treatment of heart failure with reduced ejection fraction (HFrEF).

Cyclic pyranopterin monophosphate is a precursor to molybdenum cofactor, which is required for the enzyme activity of sulfite oxidase, xanthine dehydrogenase/oxidase, and aldehyde oxidase. The drug is being investigated in severe molybdenum cofactor deficiency type A. In a clinical study, intravenous administration of the drug resulted in greatly improved neurodevelopmental outcome when started sufficiently early.

FINERENONE is a potent and selective nonsteroidal mineralocorticoid receptor antagonist. Results in preclinical studies showed that lower doses of FINERENONE were needed to achieve similar cardiorenal protective effects compared to both spironolactone and eplerenone. It is in phase III clinical trials for the treatment of diabetic kidney disease.