Eledon Pharmaceuticals is a clinical-stage biotech developing a single drug candidate, tegoprubart, an anti-CD40L antibody that suppresses immune activation by blocking the CD40L signaling pathway. Unlike older immunosuppressants, tegoprubart does not deplete lymphocytes. Eledon's lead program targets kidney transplant rejection, where the current standard of care relies on calcineurin inhibitors like tacrolimus — effective but associated with serious long-term side effects including kidney damage, new-onset diabetes, hypertension, and tremors. These side effects progressively damage transplanted kidneys, which last only 10-15 years on average. Eledon's thesis is that tegoprubart can replace tacrolimus with comparable rejection prevention and a cleaner safety profile. In the Phase 2 BESTOW trial, tegoprubart showed non-inferiority to tacrolimus on composite efficacy endpoints and substantially lower rates of new-onset diabetes (2% vs. 17%) and tremor (1.6% vs. 25%), though the primary endpoint did not reach statistical significance and the acute rejection rate was numerically higher in the tegoprubart arm. Eledon plans to seek FDA guidance on a Phase 3 design in 2026. Tegoprubart is also being explored in xenotransplantation, islet cell transplantation for Type 1 diabetes, and ALS, though the ALS program is on hold pending dedicated financing. Eledon is pre-revenue and funds operations through equity raises, with a long-term goal of either independently commercializing tegoprubart or licensing it to a larger pharma partner.