How many of these have genuinely new mechanisms? By my count, 23. Vepdegestrant – first PROTAC Daraxonrasib – first multi-selective RAS inhibitor Oveporexton – first orexin receptor agonist Baxdrostat – first aldosterone synthase inhibitor Atacicept - first dual BAFF/APRIL inhibitor Icotrokinra – first IL23 receptor antagonist Apitegromab – first myostatin activation inhibitor Pivekimab sunirine – first CD123 ADC Gedatolisib – first combined pan-PI3K and mTORC1/2 inhibitor Brepocitinib – first combined TYK2/JAK1 inhibitor Bulevirtide – first NTCP inhibitor (blocks hepatitis D entry receptor) Islatravir – first nucleoside reverse-transcriptase translocation inhibitor Rusfertide – first hepcidin mimetic Zilganersen - first GFAP-targeting antisense therapy Garetosmab - first activin A-neutralising antibody Zilurgisertib – first ALK2/ACVR1 kinase inhibitor Pegzilarginase – first arginase-1 enzyme replacement therapy Pritelivir – first HSV helicase–primase inhibitor Relacorilant – first glucocorticoid receptor antagonist to improve chemotherapy sensitivity Tavapadon - first selective D1/D5 agonist Tividenofusp alfa – first TfR-mediated IDS enzyme delivery Centanafadine – first triple noradrenaline/dopamine/serotonin reuptake inhibitor Tiratricol – first thyroid hormone analogue that works independently of MCT8