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Alvelestat is an orally bioavailable, selective and reversible small molecule inhibitor of human neutrophil elastase (NE), a serine protease released by neutrophils during inflammation. By inhibiting NE activity, alvelestat has potential anti-inflammatory effects and may prevent lung inflammation and injury associated with NE-induced respiratory diseases. It is being developed primarily for the treatment of alpha-1 antitrypsin deficiency-associated lung disease (AATD-LD) and has also been investigated in other respiratory conditions such as chronic obstructive pulmonary disease (COPD), bronchiectasis, cystic fibrosis, COVID-19-related lung injury, bronchiolitis obliterans syndrome following allogeneic stem cell transplant, and for organ preservation in pancreatic islet transplantation. The drug was originally developed by AstraZeneca under the code name AZD9668 and is currently being advanced by Mereo BioPharma[1][2][4][5][6][7].
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