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Mitiperstat

Phase 2

Chronic Obstructive Pulmonary Disease (COPD) | Small molecule | Respiratory |AstraZeneca PLC|Last Updated: Aug 29, 2025

Success Probability

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMC
Total Trials1
Total Enrollment381

FDA Designations

No designations recorded

Clinical trial landscape

Mitiperstat · 2 trials · 2 indications

Phase 2 1Phase 1 1
NCT05492877An Efficacy and Safety Study of Mitiperstat (AZD4831) (MPO Inhibitor) vs Placebo in the Treatment of Moderate to Severe COPD.Chronic Obstructive Pulmonary Disease (COPD)
COMPLETED381 Analytics
PHASE2COMPLETED
An Efficacy and Safety Study of Mitiperstat (AZD4831) (MPO Inhibitor) vs Placebo in the Treatment of Moderate to Severe COPD.
Chronic Obstructive Pulmonary Disease (COPD)Unlock trial analytics

Study Endpoints

Primary Endpoints

To Evaluate the Effect of Mitiperstat (AZD4831) as Compared to Placebo on the Time to First COPD Composite Exacerbation (CompEx) Event in Patients With Moderate to Severe COPD.
From baseline to up to 24 weeks

COPDCompEx is a composite endpoint of exacerbations and events defined from participant e-Diaries and peak expiratory flow (PEF). COPDCompEx defined exacerbations included episodes leading to one or more of the following: hospitalization, emergency room visit, treatment with systemic corticosteroids (injected and/or oral), or treatment with antibiotics. Diary COPDCompEx events are defined by threshold and slope criteria being met for \>= 2 consecutive days using the following diary and home spirometry variables: overall symptom rating, night-time awakenings due to symptoms, reliever medication use, PEF. COPDCompEx also includes patient withdrawals for treatment failure.

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

The Cmax of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated and compared.

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

The AUCinf of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated and compared.

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

The AUClast of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated and compared.

Apparent terminal elimination half-life (t½λz)
Day 1 to Day 15

The t½λz of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Time to Cmax (tmax)
Day 1 to Day 15

The tmax of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Apparent Clearance (CL/F)
Day 1 to Day 15

The CL/F of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Volume of distribution (apparent) following extravascular administration [based on terminal phase] (Vz/F)
Day 1 to Day 15

The Vz/F of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Cumulative amount of unchanged drug excreted into urine (Ae[0-24])
Day 1 to Day 15

The Ae(0-24) of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Renal clearance of drug from plasma (CLR)
Day 1 to Day 15

The CLR of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Non-renal clearance of drug from plasma (CLNR)
Day 1 to Day 15

The CLNR of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Percentage of dose excreted unchanged in urine from time 0 to time 24 (fe[0-24)
Day 1 to Day 15

The fe(0-24) of a single dose of mitiperstat in participants with impaired hepatic function and controls with normal hepatic function will be evaluated.

Secondary Endpoints

To Assess the PK of Mitiperstat (AZD4831) in Patients With Moderate to Severe COPD
At week 12
To Assess the Pharmacokinetics (PK) of Mitiperstat (AZD4831) in Patients With Moderate to Severe COPD.
At week 12
To Evaluate the Effect of Mitiperstat (AZD4831) as Compared to Placebo on the Time to First Moderate or Severe Exacerbation.
From baseline to up to week 24
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
PlaceboPLACEBO_COMPARATORApproximately 203 participants will be randomised to receive placebo.
Mitiperstat (AZD4831)EXPERIMENTALApproximately 203 participants will be randomised to receive mitiperstat (AZD4831).
Cohort 1EXPERIMENTAL8 participants with mild hepatic impairment (Child-Pugh A) will be given Dose A of mitiperstat.
Cohort 2EXPERIMENTAL8 participants with moderate hepatic impairment (Child-Pugh B) will be given Dose A of mitiperstat.
Cohort 3EXPERIMENTAL6-8 participants with severe hepatic impairment (Child-Pugh C) will be given Dose A of mitiperstat.
Cohort 4EXPERIMENTAL8-12 participants with normal hepatic function will be given Dose A of mitiperstat.

Interventions

NameTypeDescription
Mitiperstat (AZD4831)DRUGOral dosage, once daily.
PlaceboOTHEROral dosage, once daily.
MitiperstatDRUGParticipants receive mitiperstat orally.
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Eligibility Criteria

Age Range40 Years to 80 Years
SexALL
Healthy VolunteersNo
Study Sites101

Inclusion Criteria: * Provision of informed consent. * Participants must be deemed as high risk of exacerbations as defined by: \>= 1 moderate or severe exacerbation in the previous 24 months; or frequent productive cough; or post-bronchodilator (BD) forced expiratory volume in the first second (FE...

Countries:United StatesArgentinaBulgariaCanadaDenmarkGermanyItalyMexicoNetherlandsPolandSouth AfricaSpainTurkey (Türkiye)United Kingdom
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Frequently asked questions about Mitiperstat

What is Mitiperstat used for in COPD?

Mitiperstat is an investigational small molecule being studied for the treatment of moderate to severe chronic obstructive pulmonary disease (COPD). It is also being evaluated in patients with hepatic impairment to assess its pharmacokinetics. The drug is not approved and remains in clinical development.

What does Mitiperstat target?

Mitiperstat is a myeloperoxidase (MPO) inhibitor, as indicated by its trial title. It works by inhibiting the MPO enzyme, which is involved in inflammatory processes relevant to COPD. This mechanism is being investigated for its potential to reduce disease progression.

Who makes Mitiperstat?

Mitiperstat is being developed by AstraZeneca PLC, a biopharmaceutical company listed on the stock exchange under the ticker AZN. The company is conducting clinical trials to evaluate the drug's safety and efficacy in respiratory and hepatic conditions.

What phase is Mitiperstat in?

Mitiperstat is in Phase 2 clinical development for chronic obstructive pulmonary disease (COPD). A Phase 1 study in hepatic impairment has also been completed. The drug is investigational and has not received FDA approval for any indication.

What clinical trials is Mitiperstat in?

Mitiperstat has one completed Phase 2 trial, NCT05492877, which evaluated its efficacy and safety versus placebo in 381 patients with moderate to severe COPD across multiple countries. A separate Phase 1 trial, NCT05751759, assessed its pharmacokinetics in 31 participants with hepatic impairment.

Is Mitiperstat the same as AZD4831?

Yes, Mitiperstat is also known as AZD4831. The Phase 2 COPD trial explicitly refers to Mitiperstat (AZD4831) as an MPO inhibitor, confirming that both names refer to the same investigational drug being developed by AstraZeneca.