---
title: "Zilucoplan | PepTracker Pro"
url: https://peptrackerpro.com/peptides/zilucoplan
description: "A self-administered, once-daily subcutaneous macrocyclic peptide that inhibits complement component 5 (C5), FDA- and EMA-approved for anti-AChR-positive generalized myasthenia gravis."
lang: en
---

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**Research-only content.** This page is for educational purposes and does not constitute medical advice. Read full disclaimer → (https://peptrackerpro.com/research-disclaimer)

# Zilucoplan

High Evidence

A self-administered, once-daily subcutaneous macrocyclic peptide that inhibits complement component 5 (C5), FDA- and EMA-approved for anti-AChR-positive generalized myasthenia gravis.

Aliases Zilbrysq +2 more

Evidence High Evidence

Last Updated 2026-07-03

Reading Time 3 min

## What It Is

Zilucoplan (brand name Zilbrysq, developed by UCB) is a synthetic macrocyclic peptide inhibitor of complement component 5 (C5). It belongs to a class of targeted therapeutic peptides that act on the complement cascade — part of the innate immune system — rather than on metabolic or neurotrophic pathways. Zilucoplan binds C5 with high affinity and a dual mechanism: it blocks cleavage of C5 into C5a and C5b by C5 convertase, and it also binds C5b to prevent its interaction with C6, together stopping assembly of the membrane attack complex (MAC). In anti-acetylcholine-receptor (anti-AChR) antibody-positive generalized myasthenia gravis (gMG), complement-mediated damage to the neuromuscular junction is a central driver of muscle weakness, and blocking the terminal complement pathway protects the junction. Unlike the earlier intravenous anti-C5 antibodies (eculizumab, ravulizumab), zilucoplan is a small peptide that patients self-administer as a once-daily subcutaneous injection. Its pivotal phase 3 RAISE trial (published in Lancet Neurology, 2023) randomized 174 adults with anti-AChR-positive gMG and met its primary endpoint: the least-squares mean change in MG-ADL score at week 12 was −4.39 with zilucoplan versus −2.30 with placebo (difference −2.09; p=0.0004), with consistent improvements across secondary measures (QMG, MGC). On the strength of RAISE and the RAISE-XT open-label extension, zilucoplan was approved by the U.S. FDA in October 2023 and in the EU in December 2023 for anti-AChR-positive gMG in adults. Because terminal complement inhibition raises the risk of serious meningococcal (Neisseria meningitidis) infection, it carries a boxed warning, requires meningococcal vaccination, and is dispensed under a risk-management program. In 2026 zilucoplan continues to draw attention as one of the first self-injectable peptide complement inhibitors, with ongoing long-term extension data and a 2026 medicinal-chemistry account of its discovery; it is an approved drug, not a research chemical.

Also known as: Zilbrysq, RA101495, UCB7665

## Regulatory Status

FDA-approved (2023) for anti-AChR-positive generalized myasthenia gravis; boxed warning

Zilucoplan (Zilbrysq, UCB) was approved by the U.S. FDA in October 2023 and by the EMA in December 2023 for the treatment of generalized myasthenia gravis in adults who are anti-acetylcholine-receptor (anti-AChR) antibody positive. It is a prescription drug administered as a once-daily 0.3 mg/kg subcutaneous self-injection. It carries a boxed warning for serious meningococcal infections, requires meningococcal vaccination before initiation, and is available only through a restricted risk-management/REMS program. It is not a compounding-pharmacy 'research peptide.'

Effective: June 2026

View FDA Source (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925559/)

## Why Researchers Study It

Zilucoplan is a landmark example of a macrocyclic peptide engineered into an approved drug for an autoimmune disease, and the first complement C5 inhibitor that patients can self-administer subcutaneously once daily rather than by intravenous infusion. It is studied as a proof of concept that peptide chemistry can deliver targeted, terminal-complement inhibition at the neuromuscular junction, and for what its real-world and long-term extension data reveal about durability, safety, and the place of complement inhibition relative to FcRn blockers and anti-C5 antibodies in generalized myasthenia gravis.

## Proposed Mechanisms

- Binds complement component 5 (C5) with high affinity as a synthetic macrocyclic peptide
- Blocks cleavage of C5 into the pro-inflammatory fragment C5a and into C5b by C5 convertase
- Independently binds C5b to prevent its interaction with C6, adding a second block on the terminal pathway
- Prevents assembly of the membrane attack complex (MAC), protecting the neuromuscular junction from complement-mediated damage
- Reduces anti-AChR antibody-driven, complement-mediated destruction of acetylcholine receptors in generalized myasthenia gravis
- Formulated for once-daily subcutaneous self-injection at 0.3 mg/kg

## Evidence Snapshot

High Evidence

Low

Medium

High

| Study Type | Model | Outcome | Link |
| --- | --- | --- | --- |
| RCT (human, phase 3 — RAISE) | Anti-AChR-positive generalized myasthenia gravis — 174 adults, 0.3 mg/kg subcutaneous once daily, 12 weeks | Positive: MG-ADL change at week 12 −4.39 vs −2.30 placebo (difference −2.09; p=0.0004); QMG and MGC also improved. Lancet Neurology 2023 | Source: https://pubmed.ncbi.nlm.nih.gov/37059508/ |
| Open-label extension (human — RAISE-XT) | Long-term zilucoplan in generalized myasthenia gravis | Interim analysis reported sustained MG-ADL/QMG improvement and a consistent long-term safety profile | Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11025429/ |
| Regulatory review / first approval | Anti-AChR-positive gMG, adults | Approved by U.S. FDA (Oct 2023) and EMA (Dec 2023); boxed warning for meningococcal infection | Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925559/ |
| Medicinal-chemistry / discovery (2026) | Macrocyclic peptide design and optimization | Detailed account of zilucoplan's discovery as a self-administered subcutaneous C5 inhibitor. J Med Chem 2026 | Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751008/ |

## Commonly Discussed Benefits

Immune Modulation: https://peptrackerpro.com/benefits/immune-modulation
Neuromuscular Function: https://peptrackerpro.com/benefits/neuromuscular-function

Researching Zilucoplan? Track it, set reminders, and keep notes in the free app.

Track in App (https://app.peptrackerpro.com/?add=zilucoplan)

## Safety & Cautions

- Boxed warning: increases the risk of serious, life-threatening meningococcal (Neisseria meningitidis) infection
- Requires meningococcal vaccination before starting and is dispensed only through a restricted risk-management/REMS program
- Indicated specifically for anti-AChR antibody-positive generalized myasthenia gravis in adults — not for seronegative or MuSK-positive disease
- A prescription biologic-class drug that must be used under specialist neurology supervision — not a self-experimentation research peptide
- May raise the risk of other encapsulated-organism infections; injection-site reactions are common
- Long-term comparative positioning versus FcRn inhibitors and anti-C5 antibodies is still being established

## Comparisons

See how Zilucoplan compares to related peptides:

Zilucoplan vs Ara-290: https://peptrackerpro.com/compare/zilucoplan-vs-ara-290

Zilucoplan vs Batoclimab: https://peptrackerpro.com/compare/zilucoplan-vs-batoclimab

Zilucoplan vs Efgartigimod: https://peptrackerpro.com/compare/zilucoplan-vs-efgartigimod

Zilucoplan vs Efzofitimod: https://peptrackerpro.com/compare/zilucoplan-vs-efzofitimod

Zilucoplan vs Larazotide: https://peptrackerpro.com/compare/zilucoplan-vs-larazotide

Zilucoplan vs Motixafortide (Aphexda): https://peptrackerpro.com/compare/zilucoplan-vs-motixafortide

Zilucoplan vs Nipocalimab: https://peptrackerpro.com/compare/zilucoplan-vs-nipocalimab

Zilucoplan vs Pegcetacoplan: https://peptrackerpro.com/compare/zilucoplan-vs-pegcetacoplan

Zilucoplan vs Rozanolixizumab: https://peptrackerpro.com/compare/zilucoplan-vs-rozanolixizumab

Zilucoplan vs Thymosin Alpha-1: https://peptrackerpro.com/compare/zilucoplan-vs-thymosin-alpha-1

Zilucoplan vs Zosurabalpin: https://peptrackerpro.com/compare/zilucoplan-vs-zosurabalpin

Zilucoplan vs Povetacicept: https://peptrackerpro.com/compare/zilucoplan-vs-povetacicept

## Calculator Tools

Use our research tools to explore dosing and reconstitution data:

Reconstitution Calculator: https://peptrackerpro.com/calculators

## Citations

1. [1] Howard JF et al. — Safety and efficacy of zilucoplan in generalised myasthenia gravis (RAISE): a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Neurol. 2023 PubMed (https://pubmed.ncbi.nlm.nih.gov/37059508/)
2. [2] Zilucoplan: First Approval. Drugs 2024 (PMC) PubMed (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925559/)
3. [3] Long-term safety and efficacy of zilucoplan in gMG: interim analysis of the RAISE-XT open-label extension. PMC PubMed (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11025429/)
4. [4] Zilucoplan: A Newly Approved Macrocyclic Peptide for Anti-AChR-Positive Myasthenia Gravis (review). MDPI 2024 PubMed (https://www.mdpi.com/2813-2998/3/2/18)
5. [5] Discovery of Zilucoplan: A Complement C5 Inhibitor for AChR-Positive gMG. J Med Chem 2026 (PMC) PubMed (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751008/)
6. [6] ZILBRYSQ (zilucoplan) mechanism of action — UCB PubMed (https://www.zilbrysqhcp.com/moa)

### Keep researching in the app

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- Set a dosing reminder
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View Details: https://peptrackerpro.com/peptides/povetacicept

\+ Compare: https://peptrackerpro.com/compare?select=povetacicept
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