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AZD4831

Phase 2

Heart Failure With Preserved Ejection Fraction | Small molecule | Cardiovascular |AstraZeneca PLC|Last Updated: Aug 27, 2025

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment711

FDA Designations

No designations recorded

Clinical trial landscape

AZD4831 · 8 trials · 6 indications

Phase 2 2Phase 1 6
NCT05638737A Study in Participants With Non-cirrhotic NASH With FibrosisNon-Cirrhotic Non-alcoholic Steatohepatitis With Fibrosis
COMPLETED112 Analytics
NCT04986202Study to Evaluate the Efficacy and Safety of AZD4831 in Participants With Heart Failure With Left Ventricular Ejection Fraction > 40%Heart Failure With Preserved Ejection Fraction
COMPLETED711 Analytics
PHASE2COMPLETED
A Study in Participants With Non-cirrhotic NASH With Fibrosis
Non-Cirrhotic Non-alcoholic Steatohepatitis With FibrosisUnlock trial analytics
PHASE2COMPLETED
Study to Evaluate the Efficacy and Safety of AZD4831 in Participants With Heart Failure With Left Ventricular Ejection Fraction > 40%
Heart Failure With Preserved Ejection FractionUnlock trial analytics

Study Endpoints

Primary Endpoints

Relative to Baseline Alanine Aminotransferase (ALT)
Measurements on Baseline, Week 2, Week 4, Week 8, Week 12 and Week 16. Change reported from Baseline to Week 12.

ALT at 12 weeks relative to baseline. ALT is measured in Units per litre (U/L)

Kansas City Cardiomyopathy Questionnaire -Total Symptom Score
Baseline - 16 weeks

Kansas City Cardiomyopathy Questionnaire -Total Symptom Score change from baseline at 16 weeks compared with placebo Part A. The score ranges from 0 to 100, where a higher score represents a better patient outcome

Six Minute Walk Distance
Baseline - 16 weeks

Six Minute Walk Distance change from baseline at 16 weeks compared with placebo Part A

Relative bioavailability (Frel)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Maximum observed plasma (peak) drug concentration (Cmax)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Area under the plasma concentration-curve from zero to the last quantifiable concentration (AUClast)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Area under plasma concentration-time curve from zero to infinity (AUCinf)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Terminal rate constant, estimated by log-linear least squares regression of the terminal part of the concentration-time curve (λz)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Half-life associated with terminal slope (λz) of a semi-logarithmic concentration-time curve (t1/2λz)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Time of last observed (quantifiable) concentration (tlast)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Last observed (quantifiable) concentration (Clast)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Time to reach peak or maximum observed concentration or response following drug administration (tmax)
Day 1, Day 2 to Day 8 and Day 14

The relative bioavailability of a new AZD4831 formulation compared to the formulation used in an ongoing Phase 2b study and in a couple Phase 1 studies in healthy volunteers will be evaluated.

Maximum observed plasma (peak) drug concentration (Cmax) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Area under the plasma concentration curve from zero to the last quantifiable concentration (AUClast) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Area under plasma concentration time curve from zero to infinity (AUCinf) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Time to reach peak or maximum observed concentration or response following drug administration (tmax) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Half life associated with terminal slope (λz) of a semi logarithmic concentration time curve (t½λz) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Apparent total body clearance of drug from plasma after extravascular administration (CL/F) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Volume of distribution (apparent) at steady state following extravascular administration (based on terminal phase (Vz/F) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Terminal elimination rate constant (λz) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Mean residence time of the unchanged drug in the systemic circulation from zero to infinity (MRTinf) for AZD4831
Period 1: Study days 1 to 6, 8; Period 3: Study days 11 to 16, 18

To assess the effect of Itraconazole on AZD4831 only.

Maximum observed plasma concentration (Cmax)
From Day 1 to Day 15

Assessment of Cmax of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Time to reach maximum observed plasma concentration (tmax)
From Day 1 to Day 15

Assessment of tmax of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Half-life associated with terminal slope (λz) of a semi-logarithmic concentration-time curve (t½λz)
From Day 1 to Day 15

Assessment of t½λz of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Apparent total body clearance of drug from plasma after extravascular administration (CL/F)
From Day 1 to Day 15

Assessment of CL/F of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Apparent total non-renal body clearance of drug from plasma after extravascular administration (CLNR/F)
From Day 1 to Day 15

Assessment of CLNR/F of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Apparent volume of distribution during the terminal phase after extravascular administration (Vz/F)
From Day 1 to Day 15

Assessment of Vz/F of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Area under the plasma concentration-curve from time zero to time of last quantifiable concentration (AUClast)
From Day 1 to Day 15

Assessment of AUClast of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Area under plasma concentration-time curve from time zero to infinity (AUCinf)
From Day 1 to Day 15

Assessment of AUCinf of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Renal clearance of drug from plasma (CLR)
Days 1 and 2

Assessment of CLR of a single oral dose of AZD4831 in participants with severe renal impairment compared with that in matched healthy volunteers.

Area under plasma concentration time curve from zero to infinity (AUCinf) of Midazolam
Days 1, 2, 11, and 12

Effect of AZD4831 on AUCinf of Midazolam will be assessed.

Area under the plasma concentration curve from zero to the last quantifiable concentration (AUClast) of Midazolam
Days 1, 2, 11, and 12

Effect of AZD4831 on AUClast of Midazolam will be assessed.

Maximum observed plasma (peak) drug concentration (Cmax) of Midazolam
Days 1, 2, 11, and 12

Effect of AZD4831 on Cmax of Midazolam will be assessed.

Number of subjects with adverse events (AEs)/serious adverse events
Screening through follow-up visit (upto 9 weeks)

To assess AEs as a variable of safety and tolerability of AZD4831 following oral administration of multiple-ascending doses at steady state in healthy Japanese and Chinese subjects.

Number of subjects with abnormal blood pressure (BP) and pulse
Screening through follow-up visit (upto 9 weeks)

To assess BP and pulse rate as a variable of safety and tolerability of AZD4831 following oral administration of multiple-ascending doses at steady state in healthy Japanese and Chinese subjects.

Number of subjects with abnormal electrocardiogram (ECG)
Screening through follow-up visit (upto 9 weeks)

To assess change ECG as a variable of safety and tolerability of AZD4831 following oral administration of multiple-ascending doses at steady state in healthy Japanese and Chinese subjects.

Number of subjects with abnormal abnormal clinical chemistry/hematology/urinalysis
Screening through follow-up visit (upto 9 weeks)

To assess clinical chemistry/hematology/urinalysis as a variable of safety and tolerability of AZD4831 following oral administration of multiple-ascending doses at steady state in healthy Japanese and Chinese subjects.

Number of subjects with abormal physical examination results
Screening through follow-up visit (upto 9 weeks)

To assess physical examination as a variable of safety and tolerability of AZD4831 following oral administration of multiple-ascending doses at steady state in healthy Japanese and Chinese subjects.

Number of participants with adverse events (AEs)
From screening (Day -28 to Day -2) until final follow-up (Day 24)

An AE is the development of an undesirable medical condition or the deterioration of a preexisting medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. An undesirable medical condition can be symptoms (e.g., nausea, chest pain), signs (e.g., tachycardia, enlarged liver) or the abnormal results of an investigation (e.g., laboratory findings, ECG).

Systolic Blood pressure
At screening (Day-28 to Day-2), Day -1, treatment period (Day 1, Day 10 and Day 12) and final follow-up (Day 24)

Base line Systolic blood pressure (in mmHg) will be measured at the pre-dose assessment on Day 1. Assessment in treatment period on Day 1 at 0.5, 1, 2, 3, 4, 6, 8 and 12 hours post-dose. On Day 10 at Pre-dose and 12 hours post-dose. On Day 12 at 48 hours post last dose. Measurements will be collected after the subject had rested in the supine position for at least 10 minutes.

Twelve lead safety electrocardiography (ECG)
At screening (Day-28 to Day-2), treatment period (Day 1 to Day 12), and final follow-up period (Day 24)

A 12-lead ECG will be performed on Days 1, 2, 3, 6, 10 and 11: (collected at end of dECG recording) and any additional required by PI on Days 4, 5, 7 to 9 at Pre dose and at discharge on Day 12, plus any additional required by PI. A 12-lead ECG will be obtained after the subject rested in the supine position for at least 10 minutes (For time-points coinciding with dECG measurements, a paper printout of the Schiller Cardiovit CS-200 recorder\[ at the end of the 5- or 10-minute dECG recording\], will be used and the result recorded. For time-points not coinciding with dECG measurements, the ECG recording will be directly recorded in ClinBase™ using ClinBase™ Cardiosoft™).

Twelve lead digital electrocardiography (dECG)
Treatment Period (Day 1 to Day 12)

12-lead continuous dECGs will be recorded over at least 5 minutes on Day 1, 2, 3, 6, 10, 11 \& 12. The AstraZeneca (AZ) ECG Centre will perform the digital ECG (dECG) analysis in this study, using the EClysis© system, version 3.4, or higher. At protocol-indicated time points, 12-lead continuous dECG will be recorded over at least 5 minutes with the Schiller Cardiovit CS-200 recorder (Schiller AG, Baar, Switzerland) and transmitted to the AZ central dECG repository, according to AZ ECG Centre´s standard procedures for settings, recording and transmission of dECGs. Time-points for dECG may be adjusted according to emerging PK data. All ECG recordings will be preceded by a 10-minute controlled rest period.

Telemetry
At Day -1 and treatment period (Day 1 and Day 10)

A 2-lead real-time telemetry ECG will be performed for at least 4 hours on Day -1 and from 30 minutes pre-dose until 24 hours post dose. The telemetry monitoring system will be reviewed by the Investigator or research nurse and paper printouts of any clinically important events will be stored as source data.

Hematology
At screening (Day -28 to Day -2), Day -1, treatment period (Day 1, Day 10 and Day 12), final follow-up (Day 24)

Number of clinically relevant new findings or worsening of a pre-existing findings as assessed by Haematology: Hematocrit (HCT), hemoglobin (Hb), red blood cell count (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell count (WBC), differential blood count (neutrophils, lymphocytes, monocytes, eosinophils and basophils), reticulocytes absolute count, and platelets. Assessments will be performed during treatment period on Day 1 at pre-dose, Day 10 at pre-dose and on Day 12 at 48 hour post final dose before check-out.

Physical examination
At screening (Day-28 to Day-2), Day -1, treatment period (Day 2 and Day 12), and final follow-up period (Day 24)

A full physical examination will include the assessment of the following: general appearance, skin, cardiovascular, respiratory, abdomen, head, and neck (including ears, eyes, nose, and throat), lymph nodes, thyroid, musculoskeletal and neurological systems. A full physical examination will be performed at screening visit and at final follow-up visit (Day 24). A brief physical examination will include assessment of the following: general appearance, skin, cardiovascular system, respiratory and abdomen. A brief physical examination will performed at Day-1, treatment period (Day 1 to Day12) on Day 2: 24 h post first dose, and on Day 12: 48 h post final dose before check-out.

Diastolic blood pressure
At screening (Day-28 to Day-2), Day -1, treatment period (Day 1, Day 10 and Day 12) and final follow-up (Day 24)

Base line diastolic blood pressure (in mmHg) will be measured at the pre-dose assessment on Day 1. Assessment in treatment period on Day 1 at 0.5, 1, 2, 3, 4, 6, 8 and 12 hours post-dose. On Day 10 at Pre-dose and 12 hours post-dose. On Day 12 at 48 hours post last dose. Measurements will be collected after the subject had rested in the supine position for at least 10 minutes.

Pulse rate
At screening (Day-28 to Day-2), Day -1, treatment period (Day 1, Day 10 and Day 12) and final follow-up (Day 24)

Base line pulse rate (in beats per minute (bpm)) will be measured at the pre-dose assessment on Day 1. Assessment in treatment period on Day 1 at 0.5, 1, 2, 3, 4, 6, 8 and 12 hours post-dose. On Day 10 at Pre-dose and 12 hours post-dose. On Day 12 at 48 hours post last dose. Measurements will be collected after the subject had rested in the supine position for at least 10 minutes.

Oral body temperature
At screening (Day-28 to Day-2), Day-1, treatment period (Day 1 and Day 10 pre-dose)

Oral temperature will be collected after the subject has rested in the supine position for at least 10 minutes.

Biochemistry
At screening (Day -28 to Day -2), Day -1, treatment period (Day 1 pre-dose, Day 10 pre-dose and Day 12 - 48 hours post final dose before check-out) and final follow-up (Day 24)

Number of clinically relevant new findings or worsening of a pre-existing findings as assessed by serum biochemistry. Electrolytes: Sodium, potassium, calcium, and phosphate. Enzymes: Aspartate aminotransferase (AST), alanine aminotransferase (ALT), Alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), high-sensitivity C-reactive protein (hs-CRP). Substrates: Glucose (fasting), creatinine, total bilirubin, unconjugated bilirubin, conjugated bilirubin, albumin, and urea. For serum creatinine testing, blood samples will be collected on Day -1, pre-dose on Day 1, Day 5 and Day 10, follow-up (Day 14, Day 16 and Day 20) and final follow-up (Day 24)

Urinalysis
At Day -1, treatment period (pre-dose - Day 1, day 5 and Day 10), follow-up (Day 14, day 16 and Day 20) and final follow-up (Day 24)

Dipstick analysis will be performed at the centre and includes: glucose, creatinine, protein, and blood.

Microscopy
At Day -1, treatment period (pre-dose - Day 1, day 5 and Day 10), follow-up (Day 14, day 16 and Day 20) and final follow-up (Day 24)

Microscopy (RBC, WBC and casts \[Hyaline, Granular and Cellular\]) by thermodilatometry (TDL) may be performed at additional urinalysis time points if clinically relevant abnormalities are detected (positive result for protein or blood in dipstick).

Immunology
At Day -1, treatment period (Day 1 to Day 12), follow-up visits

Number of clinically relevant new findings or worsening of a pre-existing findings as assessed by Immunology: Anti-neutrophil cytoplasmic antibodies (ANCA - a \& p) testing and complements (C3a, C5a \& Bb). ANCA serum testing will be performed on samples collected on Day -1, pre-dose on Day 1 and on Day 10 and at the final Follow-up Visit (Day 24). Complement testing will be performed on samples collected on Day -1, pre-dose on Day 1, Day 5 and Day 10, follow-up (Day 14, Day 16 and Day 20) and final follow-up (Day 24)

Secondary Endpoints

Relative to Baseline Pro-C3
Measurements on Baseline, Week 4 and Week 12
Kansas City Cardiomyopathy Questionnaire-Total Symptom Score
Baseline - 24 and 48 weeks
Six Minute Walk Distance
Baseline - 24 and 48 weeks
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
AZD4831EXPERIMENTALAZD4831
PlaceboPLACEBO_COMPARATORPlacebo
Part A 2.5 mgEXPERIMENTALAZD4831 2.5 mg
Part A 5 mgEXPERIMENTALAZD4831 5 mg
Part A PlaceboPLACEBO_COMPARATORPlacebo
Part B Dose based on Part AEXPERIMENTALAZD4831 Dose based on Part A
Part B PlaceboPLACEBO_COMPARATORPlacebo
Sequence 1 (Formulation A + Formulation B)EXPERIMENTALParticipants will receive a single oral dose of Treatment 1: Formulation A followed by a washout period of at least 14 days from first dose of AZD4831. After the washout period, participants will receive a single oral dose of Treatment 2: AZD4831 Formulation B.
Sequence 2 (Formulation B + Formulation A)EXPERIMENTALParticipants will receive a single oral dose of Treatment 2: Formulation B followed by a washout period of at least 14 days from first dose of AZD4831. After the washout period, participants will receive a single oral dose of Treatment 1 Formulation A.
Treatment ArmEXPERIMENTALSubjects will receive AZD4831 on Day 1; Itraconazole only on Days 8 through 10 , and AZD4831 and Itraconazole on Day 11 oral dosing of Itraconazole only on Days 12 through 17.
Cohort 1: Participants with severe renal impairmentEXPERIMENTALParticipants with severe renal impairment will receive a single oral dose of AZD4831 on Day 1.
Cohort 2 :Healthy participantsEXPERIMENTALHealthy participants will receive a single oral dose of AZD4831 on Day 1.
Cohort 1 (Part 1): AZD4831 Dose 1EXPERIMENTALRandomized subjects will receive oral suspension of AZD4831 Dose 1 once daily in the morning for a period of 10 days
Cohort 2 (Part 1): AZD4831 Dose 2EXPERIMENTALRandomized subjects will receive oral suspension of AZD4831 Dose 2 once daily in the morning for a period of 10 days.
Cohort 3 (Part 1): AZD4831 Dose 3EXPERIMENTALRandomized subjects will receive oral suspension of AZD4831 Dose 3 once daily in the morning for a period of 10 days.
Cohort 4 (Part 2): AZD4831 Dose 2EXPERIMENTALRandomized subjects will receive oral suspension of AZD4831 Dose 2 once daily in the morning for a period of 10 days.
Placebo (Part 1)EXPERIMENTALRandomized subjects will receive oral suspension of placebo once daily in the morning for a period of 10 days.
Placebo (Part 2)EXPERIMENTALRandomized subjects will receive oral suspension of placebo once daily in the morning for a period of 10 days.
Cohort 1ACTIVE_COMPARATORParticipants will receive AZD4831 5 mg/placebo oral suspension.
Cohort 2ACTIVE_COMPARATORParticipants will receive AZD4831 (Additional dose 1)/placebo oral suspension.
Cohort 3ACTIVE_COMPARATORParticipants will receive AZD4831 (Additional dose 2)/placebo oral suspension.
Cohort 4ACTIVE_COMPARATORParticipants will receive AZD4831 (Additional dose 3)/placebo oral suspension.

Interventions

NameTypeDescription
AZD4831DRUGAZD4831
PlaceboOTHERPlacebo
ItraconazoleDRUGSubjects will receive Itraconazole orally on Days 8 followed by dosing from Day 9 to Day 17.
MidazolamDRUGSubjects will receive oral single doses on Day 1 and Day 11.
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Eligibility Criteria

Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites65

Inclusion Criteria: 1. Participant must be ≥ 18 to ≤ 75 years of age at the time of signing the informed consent. 2. Histological confirmed NASH per Clinical Research Network (CRN) criteria as diagnosed by liver biopsy (within 12 months prior screening, participants without historical biopsy should...

Countries:United StatesArgentinaDenmarkItalyMexicoNorwayPortugalSpainSwedenAustraliaBelgiumBrazilBulgariaCanadaCzechiaFranceHungaryJapanNetherlandsPolandRussiaSlovakiaTaiwanTurkey (Türkiye)United Kingdom
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Frequently asked questions about AZD4831

What is AZD4831 used for?

AZD4831 is an investigational small molecule being developed by AstraZeneca for cardiovascular conditions. It has been studied in healthy volunteers and in patients with heart failure with preserved ejection fraction (HFpEF), non-cirrhotic non-alcoholic steatohepatitis with fibrosis, renal impairment, and cardiovascular disease. It is currently in Phase 1 clinical development.

What does AZD4831 target?

AZD4831 is a small molecule developed by AstraZeneca. Its molecular target has not been disclosed in the available information. The drug is being investigated for its effects in cardiovascular disease and related conditions, but its specific mechanism of action is not publicly detailed.

Who makes AZD4831?

AZD4831 is being developed by AstraZeneca PLC, a multinational pharmaceutical company listed on the NASDAQ under the ticker symbol AZN. The drug is an investigational small molecule currently in Phase 1 clinical trials for cardiovascular and metabolic conditions.

What phase is AZD4831 in?

AZD4831 is in Phase 1 clinical development. It is an investigational drug, not yet approved by regulatory authorities. AstraZeneca has completed four Phase 1 trials studying the drug in healthy volunteers and patients with conditions such as heart failure with preserved ejection fraction and cardiovascular disease.

What clinical trials is AZD4831 in?

AZD4831 has been studied in four completed Phase 1 clinical trials. These include NCT03136991 in patients with cardiovascular disease, NCT05052710 and NCT05236543 in healthy volunteers to assess drug interactions, and NCT05457270 to evaluate different formulations. All trials are completed, with a total enrollment of 103 participants.

Is AZD4831 the same as other drugs?

AZD4831 is a unique investigational compound developed by AstraZeneca. No alternative names or brand names have been reported for this drug. It is currently in Phase 1 clinical trials and has not been approved for any indication.