Next-generation therapeutics for obesity and its continuum of cardiometabolic diseases
Rivus Pharmaceuticals, Inc. is dedicated to improving cardiometabolic health by advancing a new class of investigational medicines called controlled metabolic accelerators (CMAs). These oral small molecules are designed to reduce excess fat and treat a broad range of cardiometabolic diseases by safely leveraging the natural process of mitochondrial uncoupling. Activating this metabolic process results in fat-specific weight loss, preservation of muscle mass, reduction of liver and visceral fat, improved glycemic control and reductions in oxidative stress and inflammation.

Rivus Pharmaceuticals, Inc. is dedicated to improving cardiometabolic health by advancing a new class of investigational medicines called controlled metabolic accelerators (CMAs). These oral small molecules are designed to reduce excess fat and treat a broad range of cardiometabolic diseases by safely leveraging the natural process of mitochondrial uncoupling. Activating this metabolic process results in fat-specific weight loss, preservation of muscle mass, reduction of liver and visceral fat, improved glycemic control and reductions in oxidative stress and inflammation.
OUR SCIENCE
Addressing a primary driver of cardiometabolic disease: obesity
Nearly half of American adults are living with cardiometabolic diseases. While numerous factors contribute to these diseases, a common thread driving pathology is obesity, the result of excess fat in the body. Associated with an elevated risk of heart failure, type 2 diabetes, dyslipidemia, MASLD/MASH and other indications, obesity presents an opportunity to target a significant risk factor for cardiometabolic disease. Newer therapies support weight loss but may also reduce lean muscle mass, which can lead to weight regain and increased cardiovascular risk.
Harnessing a natural metabolic process for fat selective weight loss
Controlled Metabolic Accelerators (CMAs) are oral small molecules which are designed to reduce excess fat and treat a broad range of cardiometabolic diseases by safely leveraging the natural process of mitochondrial uncoupling. Mitochondrial uncoupling accounts for approximately 20-40% of caloric consumption and significantly contributes to basal metabolic rate. Rivus’ CMAs provide a novel, measured approach to activating this process, reducing fat throughout the body while preserving skeletal muscle mass.
Watch Rivus CSO Shaharyar Khan, PhD, explain how CMAs differ from current obesity treatments.
Watch videoHarnessing a natural metabolic process for fat selective weight loss
Controlled Metabolic Accelerators (CMAs) are oral small molecules which are designed to reduce excess fat and treat a broad range of cardiometabolic diseases by safely leveraging the natural process of mitochondrial uncoupling. Mitochondrial uncoupling accounts for approximately 20-40% of caloric consumption and significantly contributes to basal metabolic rate. Rivus’ CMAs provide a novel, measured approach to activating this process, reducing fat throughout the body while preserving skeletal muscle mass.
Leveraging the powerhouse of the cell to achieve better health
By harnessing the natural mechanism of mitochondrial uncoupling, Rivus’ therapies accelerate metabolism with the aim of enabling healthy lives for millions.
IMPROVE CELLULAR METABOLISM
Controlled metabolic accelerators (CMAs) like HU6 are oral, small molecule therapies designed to improve cellular metabolism. CMAs harness a natural metabolic process in mitochondria, the powerhouse of cells, to increase the breakdown of fats and sugars and increase resting energy expenditure.
REDUCE FAT, PRESERVE MUSCLE
By increasing energy expenditure, CMAs decrease fat throughout the body while maintaining skeletal muscle mass. Muscle retention is critical to minimize fat regain and reduce cardiometabolic risk.
CLINICAL OPPORTUNITY
In a Phase 2 clinical trial, HU6, a first-in-class CMA, was shown to improve disease markers of blood pressure, inflammation and glycemic control. CMAs are now being studied to treat obesity and its comorbidities for patients suffering from heart failure, MASLD/MASH and type 2 diabetes.
OUR PIPELINE
CMAs have the potential to provide well-tolerated, effective treatments that improve cardiometabolic health with applicability to a broad range of diseases.
Clinical research demonstrates the potential of Rivus’ lead candidate HU6, a first-in-class CMA, to address a broad range of cardiometabolic diseases by increasing fat selective weight loss and improving key markers of glycemic control and inflammation. Importantly, no loss of lean muscle mass has been observed, suggesting reduced risk of weight regain and reduced cardiovascular risk.
For its lead program HU6, Rivus Pharmaceuticals has completed Phase 1 clinical studies and a Phase 2a metabolic study, which was published in The Lancet Gastroenterology & Hepatology. Building on data from the metabolic study, results from a Phase 2a study in patients with obese heart failure with preserved ejection fraction (HFpEF) were published in JAMA Cardiology. In addition, Rivus has completed dosing in a Phase 2 study in patients with metabolic dysfunction-associated steatohepatitis (MASH). Rivus is expanding its pipeline of CMAs targeting diseases where the evidence for safe metabolic acceleration is strong and the therapeutic need is great.
RIVUS CONTROLLED METABOLIC ACCELERATOR PIPELINE
Target Indication |
Candidate/Target |
Preclinical |
Phase I |
Phase II |
Phase III |
---|---|---|---|---|---|
Obese HFpEF, MASH, T2D, Obesity
|
HU6
ANT-Activator |
||||
Obesity, CVD
|
RV-200
ANT-Activator |
||||
Obesity
|
RV-300
GLP1R / ANT-Activator |
ANT-activator
ANT-activator
GLP1R / ANT-Activator
HFpEF – heart failure with preserved ejection fraction; MASH – metabolic dysfunction-associated steatohepatitis; T2D – type 2 diabetes; CVD – cardiovascular disease; ANT – adenine nucleotide translocase; GLP1R – glucagon-like peptide 1 receptor
Clinical Data and Scientific Publications
Safety and efficacy of once-daily HU6 versus placebo in people with non-alcoholic fatty liver disease and high BMI: a randomised, double-blind, placebo-controlled, phase 2a trial
The Lancet Gastroenterology & Hepatology 2023
Noureddin, Mazen, et al.
A Novel Controlled Metabolic Accelerator for the Treatment of Obesity-Related HFpEF: Rationale and Design of the Phase 2a HuMAIN Trial
European Journal of Heart Failure 2024
Kitzman, W., Dalane, et al.
Novel Controlled Metabolic Accelerator for Obesity-Related HFpEF: The HuMAIN-HFpEF Randomized Clinical Trial
JAMA Cardiology 2025
Pandey, Ambarish, et al.
Clinical Data Presentations
HuMAIN HU6 Phase 2a Obesity-Related HFpEF Clinical Trial
Pandey, Ambarish, et al.
Presented by Rivus CMO Rob Schott
Relevant Literature
Mitochondrial Uncoupling and Weight Loss►
Beyond appetite regulation: Targeting energy expenditure, fat oxidation, and lean mass preservation for sustainable weight loss
Obesity 2021
Christoffersen, Berit, et al.
Implications of mitochondrial uncoupling in skeletal muscle in the development and treatment of obesity
The Federation of European Biochemical Societies Journal 2013
Thrush, Brianne A., et al.
Mitochondrial uncoupling as a target for drug development for the treatment of obesity
Obesity Reviews 2001
Harper, J. A., et al.
Mitochondrial uncoupling attenuates sarcopenic obesity by enhancing skeletal muscle mitophagy and quality control
Journal of Cachexia, Sarcopenia and Muscle 2022
Dantas, Wagner S., et al.
Therapeutic Benefits of Mitochondrial Uncouplers Beyond Weight Loss►
Small Molecule Mitochondrial Uncouplers and Their Therapeutic Potential
Journal of Medicinal Chemistry 2018
Childress, Elizabeth S., et al.
Therapeutic potential of mitochondrial uncouplers for the treatment of metabolic associated fatty liver disease and NASH
Molecular Metabolism 2021
Goedeke, Leigh, et Shulman, Gerald I.
Controlled-release mitochondrial protonophore reverses diabetes and steatohepatitis in rats
Science (AAAS) 2015
Perry, Rachel J., et al.
Neuroprotective Potential of Mild Uncoupling in Mitochondria. Pros and Cons
Brain Sciences 2021
Zorov, Dmitry B., et al.
Mitochondrial Dysfunction and Disease►
Mitochondrial dysfunction in vascular endothelial cells and its role in atherosclerosis
Frontiers in Physiology 2022
Qu, Kai, et al.
Mitochondrial Dysfunction: The Hidden Player in the Pathogenesis of Atherosclerosis?
International Journal of Molecular Sciences 2023
Ciccarelli, Giovanni, et al.
Nitric oxide deficiency is a primary driver of hypertension
Biochemical Pharmacology 2022
Bryan, Nathan S.
Oxidative capacity in failing hearts
American Journal of Physiology 2003
Gong, Guangrong, et al.
Mitochondrial Function and Longevity►
Further Support to the Uncoupling-to-Survive Theory: The Genetic Variation of Human UCP Genes Is Associated with Longevity
PLOS One 2011
Giuseppina, Rose, et al.
Cellular energetics and mitochondrial uncoupling in canine aging
GeroScience 2019
Nicholatos, Justin W., et al.
Mild mitochondrial uncoupling in mice affects energy metabolism, redox balance and longevity
Aging Cell 2008
Caldeira da Silva, Camille C., et al.
Mitochondrial Mechanics and Energy Metabolism►
Use the Protonmotive Force: Mitochondrial Uncoupling and Reactive Oxygen Species
Journal of Molecular Biology 2018
Berry, Brandon J., et al.
Mitochondrial uncouplers induce proton leak by activating AAC and UCP1
Nature 2022
Bertholet, Ambre M., et al.
Increased substrate oxidation and mitochondrial uncoupling in skeletal muscle of endurance-trained individuals
Proceedings of the National Academy of Sciences of the United States of America 2008
Befroy, Douglas E., et al.
The Obesity Phenotype of HFpEF►
Clinical Trials
For more information on any Rivus-sponsored clinical trials, please contact our clinical operations team at info@rivuspharma.com.
Expanded Access PolicyEXPANDED ACCESS TO INVESTIGATIONAL MEDICINES
At this time, Rivus Pharmaceuticals does not provide access to investigational products outside of clinical trials. We encourage patients to participate in clinical trials of our investigational therapies whenever possible. Clinical trials are designed, conducted, and monitored to ensure that the safety and efficacy are appropriately evaluated before they are submitted to regulatory agencies for review with the intent to make them more broadly available to patients.
Our Team
The Rivus team is a group of forward-thinking scientists and proven biotech leaders deeply committed to the field of cardiometabolic health. Our team of experts is driven to provide patients and physicians with a new and highly effective solution to one of the most challenging issues in healthcare today.
CAREERS
Join the Rivus Pharmaceuticals team
Rivus has offices in South San Francisco, California and Charlottesville, Virginia and is seeking candidates to join our growing team as we expand our pipeline of controlled metabolic accelerators (CMAs).
CONTACT
hr@rivuspharma.com
NEWS
Learn more about Rivus and controlled metabolic accelerators (CMAs).
Press Releases
2025
Rivus Pharmaceuticals Provides Senior Leadership Update
Rivus Pharmaceuticals Announces Positive Topline Results from Phase 2 M-ACCEL Trialof HU6 Showing Significant Reductions in Liver Fat in Patients with MASH
Rivus Pharmaceuticals Expands Leadership Team and Establishes New San Francisco Bay Area Office Ahead of Phase 2 Read-Out in MASH
Rivus Pharmaceuticals Announces Publication of Phase 2a HuMAIN Trial of HU6 in Patients with Obesity-Related Heart Failure in JAMA Cardiology
Rivus Pharmaceuticals to Present Corporate Update at 2025 J.P. Morgan Healthcare Conference
Media Contact
info@rivuspharma.com