Asset profile
alvelestat
Small molecule
Evidence outlook · lead readout
ASTRAEUS (NCT03636347) · Alpha 1-Antitrypsin Deficiency, Emphysema, COPD
The completed lead evidence is positive, with design limits that temper confidence; the rationale below says which.
ASTRAEUS (NCT03636347): This was a randomized, double-blind, placebo-controlled study in 99 adults with alpha-1-antitrypsin-related lung disease; both alvelestat doses significantly reduced a blood biomarker of neutrophil elastase activity compared with placebo. Because the primary measure was a laboratory biomarker rather than a direct measure of lung symptoms or function, this is supportive but not definitive clinical evidence.
Also in development:Alpha-1 Antitrypsin Deficiency · Phase 2
How the evidence outlook works ↗
Featured trials
The studies most instrumental to this drug's clinical progression, individually graded on design and result. Pick an indication; Research unlocks the trials, endpoints, key results and grades.
Competitive landscape
47 competitors in this universe: 0 direct rivals (same mechanism and indication), 0 same-class, 47 same-indication; 25 further along in development.
| Drug | Stage | Modality | Mechanism | Evidence signal | Reported efficacygraded featured trials |
|---|---|---|---|---|---|
| Alvelestat: this drug | Phase 2 | Small molecule | Neutrophil elastase | ||
| Aclidinium Bromide (Tudorza Pressair) | Approved | Small molecule | Muscarinic acetylcholine receptor (M3) | ||
| Aclidinium Bromide / Formoterol Fumarate (Duaklir Pressair) | Approved | Small molecule | Muscarinic acetylcholine receptor (M3), Beta-2 adrenergic receptor | ||
| Benralizumab (Fasenra) | Approved | Monoclonal antibody | IL-5 receptor alpha, IL-5 receptor alpha (IL-5Rα / CD125); Fc region additionally engages FcγRIIIa on NK cells (ADCC), IL-5 receptor alpha (IL5RA) on eosinophils/basophils | ||
| Budesonide / Glycopyrrolate / Formoterol Fumarate (Breztri Aerosphere) | Approved | Small molecule | Glucocorticoid receptor; Muscarinic M3; Beta-2 adrenergic | ||
| Depemokimab | Approved | Monoclonal antibody | IL-5 | ||
| Ensifentrine (Ohtuvayre) | Approved | Small molecule | PDE3/PDE4 | ||
| Fluticasone Furoate / Umeclidinium / Vilanterol (Trelegy Ellipta) | Approved | Small molecule | Muscarinic acetylcholine receptor (M3), Beta-2 adrenergic receptor, Glucocorticoid receptor, Glucocorticoid receptor / Beta-2 adrenergic receptor / Muscarinic M3 receptor (ICS/LABA/LAMA triple combination) | ||
| Glycopyrrolate / Formoterol Fumarate (Bevespi Aerosphere) | Approved | Small molecule | Muscarinic acetylcholine receptor (M3), Beta-2 adrenergic receptor | ||
| Mepolizumab (Nucala) | Approved | Monoclonal antibody | IL-5, Interleukin-5 (IL-5), ligand-neutralizing | ||
| Olodaterol | Approved | Small molecule | Beta-2 adrenergic receptor | ||
| Olodaterol / Tiotropium Bromide | Approved | Small molecule | Muscarinic acetylcholine receptor (M3), Beta-2 adrenergic receptor | ||
| Revefenacin (Yupelri) | Approved | Small molecule | Muscarinic receptors (antagonist) | ||
| Tiotropium Bromide | Approved | Small molecule | Muscarinic acetylcholine receptor (M3) | ||
| Umeclidinium (Incruse Ellipta) | Approved | Small molecule | Muscarinic acetylcholine receptor (M3), M3 muscarinic acetylcholine receptor | ||
| Umeclidinium / Vilanterol | Approved | Small molecule | Muscarinic acetylcholine receptor (M3), Beta-2 adrenergic receptor |
…and 32 more. Research shows the complete landscape.
Unlock the full comparison
Research adds each competitor's evidence grade and sourced trial results, aligned per race, so you can see who actually has the data.
Upcoming events
(1 total)
Estimated primary-completion dates from ClinicalTrials.gov. These are registry estimates, never confirmed readout dates; they can move as trials progress.
2027 (1)
December 2027 (1)
What to watch
All registered studies
Every ClinicalTrials.gov study of this drug's own program, grouped by indication and phase. Research unlocks the studies themselves: titles, statuses, dates and featured-trial cross-links.