Discovery of orally active hepatoselective glucokinase activators for treatment of Type II Diabetes Mellitus
作者:Jiayi Xu、Songnian Lin、Robert W. Myers、Maria E. Trujillo、Michele J. Pachanski、Sunita Malkani、Hsuan-shen Chen、Zhesheng Chen、Brian Campbell、George J. Eiermann、Nadine Elowe、Brian T. Farrer、Wen Feng、Qinghong Fu、Roman Kats-Kagan、Michael Kavana、Daniel R. McMasters、Kaushik Mitra、Xinchun Tong、Libo Xu、Fengqi Zhang、Rui Zhang、George H. Addona、Joel P. Berger、Bei Zhang、Emma R. Parmee
DOI:10.1016/j.bmcl.2016.10.088
日期:2017.5
Systemically acting glucokinase activators (GKA) have been demonstrated in clinical trials to effectively lower blood glucose in patients with type II diabetes. However, mechanism-based hypoglycemia is a major adverse effect that limits the therapeutic potential of these agents. We hypothesized that the predominant mechanism leading to hypoglycemia is GKA-induced excessive insulin secretion from pancreatic beta-cells at (sub-)euglycemic levels. We further hypothesized that restricting GK activation to hepatocytes would maintain glucose -lowering efficacy while significantly reducing hypoglycemic risk. Here we report the discovery of a novel series of carboxylic acid substituted GKAs based on pyridine2-carboxamide. These GKAs exhibit preferential distribution to the liver versus the pancreas in mice. SAR studies led to the identification of a potent and orally active hepatoselective GKA, compound 6. GKA 6 demonstrated robust glucose lowering efficacy in high fat diet-fed mice at doses >= 10 mpk, with >= 70-fold liver:pancreas distribution, minimal effects on plasma insulin levels, and significantly reduced risk of hypoglycemia. (C) 2016 Published by Elsevier Ltd.