Atilmotin (also known as BAX-ACC-1638), a motilin receptor agonist, is short acting, with t1/2 less than 10 min. It was shown that at doses of 6, 30 or 60 mg intravenously, it affected esophageal, lower esophageal sphincter (LES), and gastric motility. LES and gastric pressures were increased, whereas there was disruption of esophageal peristalsis characterized by lower amplitude and failed contractions. The drug can have the clinical implementation for stomach motility disorders but is needed further study.

Securinine is a plant-derived alkaloid from the Securinega plant that has been used clinically as a therapeutic for primarily neurological related diseases. Securinine is well-known GABAA antagonist and recently it was found that Securinine is able to up-regulate p53 protein and to modulate the related family member p73 protein in a p53-dependent fashion, inducing p73 in the HCT116 p53(-) cells and down-regulating it in the p53(+) cells. Securinine induces G1 phase cell cycle arrest, upregulates expression of p53 and Bax, and downregulates expression of Bcl-2, PI3K, mTOR, and p70s6k in breast cancer cells and promyelocytic leukemia cells. Securinine activates p38 MAPK, enhancing monocyte antibacterial activity in vitro as well. This compound also exhibits antimicrobial activity against Alternaria, Curvularia, and Helminthosporum. Additionally, securinine decreases AChE activity and suppresses amyloid-β (Aβ)-induced glial inflammatory responses in animal models of Alzheimer’s disease, improving cognitive deficits. Securinine’s activity as a GABA antagonist, likely explains its reported clinical success in limited studies for the treatment of neurological conditions such as amyotrophic lateral sclerosis (ALS), poliomyelitis and multiple sclerosis. Securinine has not been utilized in the United States, it has been used clinically in several other countries particularly China and Russia. In China, it is considered one of the 50 fundamental Chinese herbs and is used in Chinese herbal medicine.

Efegatran (GYKI 14766; LY 294468) is a tripeptide D-methyl-phenylalanyl-prolyl-arginal thrombin inhibitor. It was developed by IVAX for the potential treatment of thromboembolic disorders, mainly myocardial infarction. However, information about the further development is not available.

Nemifitide is a peptide analog of melanocyte-inhibiting factor (MIF) that has been reported to relieve depressive symptoms in a very short period. Tetragenex (formerly Innapharma) was developing nemifitide with potential in the treatment of depression. Clinical data obtained from two pilot clinical studies, double-blind, placebo-controlled, parallel-design, in-patient and outpatient, suggested that nemifitide may have the following advantages over current therapies: rapid onset of action (3–5 d), short period of administration (5–10 doses over a 1–2 wk period), and a relatively long duration of treatment effect (3–6 months). The mechanism of action of nemifitide was investigated by evaluating its in-vitro receptor binding and in-vivo localization in the rat brain as well as its interactions with psychoprobes indicative of specific neurotransmitter pathways in acute studies in rats. The results of these studies indicate that nemifitide readily crosses the blood–brain barrier and is localized mainly in the amygdala, hippocampus and frontal cortex of the rat brain. Its in-vitro binding to several receptors including 5-HT-2A, as well as its significant interaction with d-fenfluramine in the rat, suggest the participation of the serotonergic pathway in its mode of action in a different way than that observed with SSRI antidepressants.

Enofelast (BI-L-239) is a potent and selective 5-lipoxygenase inhibitor. It inhibited leukotriene B4 and C4 generation. In animal models, enofelast attenuates bronchoconstriction, leukocyte infiltration, inflammation and hyperresponsiveness that characterize asthma.

Edatrexate (10-ethyl-10-deazaaminopterin or 10-EDAM) is an analog of methotrexate with improved pre-clinical antitumor activity, more selective cellular uptake, and with the more extensive formation of intracellular polyglutamate metabolites. This drug is a new dihydrofolate reductase inhibitor, which was studied in phase II clinical trial for the patients with different cancers. The studies were discontinued, for example, in advanced renal cell carcinoma edatrexate in the investigated dose and schedule had minimal activity and was toxic. In case of non-small-cell lung cancer, the dosing schedule of edatrexate did not appear to be improved compared to other chemotherapeutic regimens. In addition, edatrexate was involved in the experiment for the treatemnt of rheumatoid arthritis, but this study was also discontinued.

Farglitazar is a non-thiazolidinedione insulin sensitizer and agonist of peroxisome proliferator-activated receptor-gamma. GlaxoSmithKline was developing farglitazar for the treatment of liver fibrosis and Type 2 diabetes mellitus.

Nictindole is a non-steroidal anti-inflammatory agent. It is a thromboxane synthetase inhibitor. Nictindole inhibits generation of TXA2 in human platelet rich plasma.