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Obstacles and innovations of macrocyclic drug development

Drug Target Review

Phase III trials for MK-0616 commenced in the second half of 2023. 9,10 Because many therapeutic macrocycles violate the Ro5 guidelines, the presumption was that such large molecules would have limited cell permeability. Phase 2b randomized trial of the oral PCSK9 inhibitor MK-0616. 8 Why are there not more macrocyclic drugs?