Discovery of the Human Immunodeficiency Virus Type 1 (HIV-1) Attachment Inhibitor Temsavir and Its Phosphonooxymethyl Prodrug Fostemsavir
pmid: 29920093
Discovery of the Human Immunodeficiency Virus Type 1 (HIV-1) Attachment Inhibitor Temsavir and Its Phosphonooxymethyl Prodrug Fostemsavir
The optimization of the 4-methoxy-6-azaindole series of HIV-1 attachment inhibitors (AIs) that originated with 1 to deliver temsavir (3, BMS-626529) is described. The most beneficial increases in potency and pharmacokinetic (PK) properties were attained by incorporating N-linked, sp2-hybridized heteroaryl rings at the 7-position of the heterocyclic nucleus. Compounds that adhered to a coplanarity model afforded targeted antiviral potency, leading to the identification of 3 with characteristics that provided for targeted exposure and PK properties in three preclinical species. However, the physical properties of 3 limited plasma exposure at higher doses, both in preclinical studies and in clinical trials as the result of dissolution- and/or solubility-limited absorption, a deficiency addressed by the preparation of the phosphonooxymethyl prodrug 4 (BMS-663068, fostemsavir). An extended-release formulation of 4 is currently in phase III clinical trials where it has shown promise as part of a drug combination therapy in highly treatment-experienced HIV-1 infected patients.
Anti-HIV Agents, Protein Conformation, Cell Membrane, Virus Attachment, HIV Envelope Protein gp120, Triazoles, Organophosphates, Permeability, Piperazines, Rats, Molecular Docking Simulation, Drug Discovery, HIV-1, Animals, Humans, Prodrugs, Caco-2 Cells
Anti-HIV Agents, Protein Conformation, Cell Membrane, Virus Attachment, HIV Envelope Protein gp120, Triazoles, Organophosphates, Permeability, Piperazines, Rats, Molecular Docking Simulation, Drug Discovery, HIV-1, Animals, Humans, Prodrugs, Caco-2 Cells
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