NangibotideExperimental immunomodulatory peptide
Nangibotide targets signalling associated with TREM-1, an amplifier of inflammation. Its phase 2b septic-shock trial did not meet the primary efficacy endpoint, while exploratory findings suggested questions for further study.
What is Nangibotide?
Nangibotide is an investigational peptide developed for septic shock, targeting harmful amplification of the inflammatory response.
How it works
It modulates TREM-1-related signalling. The aim is to alter dysregulated inflammation rather than indiscriminately suppress all immune function.
Effects studied
Organ failure in septic shock
ASTONISH analysed 355 participants and did not meet its primary organ-failure-score endpoint, including in the prespecified biomarker population. 1
Evidence: Phase 2b controlled evidence with a negative primary result.
Biomarker-defined response
Exploratory analyses at a different soluble TREM-1 threshold suggested a possible signal. 1
Evidence: Hypothesis-generating; not a validated method for selecting treatment.
What does the evidence show?
Randomised ASTONISH trial abstract checked
The problem is a dysregulated response
Septic shock involves a dangerous response to infection that can damage organs and circulation. Nangibotide was developed to modulate TREM-1-related inflammatory amplification. The objective is not simply to suppress all immunity, but to change a harmful pattern of response.
What ASTONISH tested
The phase 2b ASTONISH study evaluated nangibotide against placebo in septic shock. The main analysis included 355 participants. The trial did not meet its primary endpoint based on change in organ-failure score, including in the prespecified biomarker-defined population. 1
Why the subgroup needs care
Exploratory analyses using a different soluble TREM-1 threshold suggested a possible signal. That finding can inform a more focused trial, but does not validate the threshold for selecting treatment. Reanalysing a trial can reveal possibilities while increasing the risk of chance findings.
The outcome has to matter to patients
An organ-failure score, survival, time in intensive care and recovery after discharge measure different aspects of benefit. Further research needs to establish which changes are reliable and whether they outweigh harms. The clinical result remains unresolved: nangibotide is not an established sepsis therapy or a general anti-inflammatory treatment.
Safety & status
Septic shock is a critical-care setting. The unresolved clinical benefit and adverse-effect balance cannot be replaced by the biological plausibility of the target.
Country and product status
Country-specific product availability and authorisation require a separate current check.
Frequently asked questions
Did ASTONISH meet its primary endpoint?
No, including in the prespecified biomarker-defined population. 1
Does the exploratory subgroup identify who should receive it?
No. A different threshold emerging from exploratory analysis requires prospective validation. 1
Further reading
Sources
This entry was rewritten from our research archive. References below are reading leads unless a completed check is explicitly noted; a full independent evidence and regulatory review is still pending.
- François et al. · ASTONISH nangibotide trial Primary trial abstract · Primary trial abstract checked 27 October 2026; full paper and supplementary data not independently reviewed.
- Nangibotide · retained archive reference Archive research lead · Retained archive reference; not independently checked for this draft
Research provenance
This name was discovered in the Superpower peptide index, archived 26 October 2026. Its ratings and reviewer attribution have not been adopted as our own. The archive informed this original editorial draft; independent source review is still pending.