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Emestedastat

Cortisol synthesis inhibitor From Wikipedia, the free encyclopedia

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]

Other namesXanamem; UE-2343; UE2343
Routes of
administrationOral[1]
Drug class11β-Hydroxysteroid dehydrogenase type 1 inhibitor
CAS Number
Quick facts Clinical data, Other names ...
Emestedastat
Clinical data
Other namesXanamem; UE-2343; UE2343
Routes of
administration		Oral[1]
Drug class11β-Hydroxysteroid dehydrogenase type 1 inhibitor
Identifiers
  • [(1R,5S)-3-hydroxy-3-pyrimidin-2-yl-8-azabicyclo[3.2.1]octan-8-yl]-[5-(1H-pyrazol-4-yl)thiophen-3-yl]methanone
CAS Number
PubChem CID
ChemSpider
UNII
KEGG
Chemical and physical data
FormulaC19H19N5O2S
Molar mass381.45 g·mol−1
3D model (JSmol)
  • C1C[C@H]2CC(C[C@@H]1N2C(=O)C3=CSC(=C3)C4=CNN=C4)(C5=NC=CC=N5)O
  • InChI=1S/C19H19N5O2S/c25-17(12-6-16(27-11-12)13-9-22-23-10-13)24-14-2-3-15(24)8-19(26,7-14)18-20-4-1-5-21-18/h1,4-6,9-11,14-15,26H,2-3,7-8H2,(H,22,23)/t14-,15+,19?
  • Key:MMZFGTAMARVHAF-RTHVDDQRSA-N
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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]

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