Chemistry:Emestedastat
Emestedastat (proposed brand name Xanamem; developmental code name UE-2343) is a steroidogenesis inhibitor which is under development for the treatment of Alzheimer's disease, major depressive disorder, and fragile X syndrome.[1][2] It is taken orally.[1]
The drug specifically acts as a centrally penetrant inhibitor of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) and thereby inhibits the synthesis of the glucocorticoid steroid hormone cortisol.[1][3][4][2]
Emestedastat was originated by the University of Edinburgh and is under development by Actinogen Medical.[1] As of June 2026, it is in phase 2/3 clinical trials for Alzheimer's disease and phase 2 trials for major depressive disorder, whereas no recent development has been reported for fragile X syndrome.[1][2]
Clinical effectiveness for Alzheimer's disease has been mixed.[2] In a phase 2 clinical trial for major depressive disorder published in July 2026, emestedastat showed no significant benefit on depressive or cognitive symptoms.[5] In addition, it produced mild-to-moderate transaminase elevations in 10% of people, whereas this occurred in 1% in the placebo group.[5]
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 "Emestedastat (UE-2343; Xanamem)". 28 August 2024. https://adisinsight.springer.com/drugs/800042157.
- ↑ 2.0 2.1 2.2 2.3 "11β-Hydroxysteroid dehydrogenase and the brain: Not (yet) lost in translation". Journal of Internal Medicine 295 (1): 20–37. January 2024. doi:10.1111/joim.13741. PMID 37941106.
- ↑ "Mild cognitive impairment due to Alzheimer disease: Contemporary approaches to diagnostics and pharmacological intervention". Pharmacological Research 129: 216–226. March 2018. doi:10.1016/j.phrs.2017.11.021. PMID 29170097.
- ↑ "Is AD a Stress-Related Disorder? Focus on the HPA Axis and Its Promising Therapeutic Targets". Frontiers in Aging Neuroscience 11. 2019. doi:10.3389/fnagi.2019.00269. PMID 31611783.
- ↑ 5.0 5.1 "A Phase 2 randomised, double-blind, placebo-controlled trial of emestedastat in patients with major depressive disorder and cognitive impairment". Br J Psychiatry: 1–8. July 2026. doi:10.1192/bjp.2026.10689. PMID 42464916.
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