依泽替米贝为白色结晶性粉末,极易溶于乙醇、甲醇和丙酮,不溶于水,熔点约为163℃,在常温下稳定。它仅作用于小肠,通过抑制胆固醇的吸收而减少肠道胆固醇转运至肝脏并降低其储存;同时还能加强血液中胆固醇的清除,从而有效降低血浆胆固醇水平。
药理作用依泽替米贝经口服吸收后与葡萄糖醛酸苷结合生成活性物质——依泽替米贝-葡萄糖醛酸苷,并通过胆汁和肾排泄。口服后4~12小时内达血药峰浓度,Cmax为3.4~5.5mg/mL,生物利用度在35%~60%之间,t1/2约为22小时。依泽替米贝主要作用于外源性胆固醇,而他汀类药物则主要减少肝脏中胆固醇的合成,因此两药具有协同作用。依泽替米贝与他汀类降血脂药物联合应用是单用他汀类产生降胆固醇作用的8倍。
用途依泽替米贝是一类新型的选择性胆固醇吸收抑制剂,通过与小肠刷状缘膜小囊泡上膜蛋白(相对分子质量145X103)结合,抑制小肠对饮食中和经胆汁输送到肠道中的胆固醇的吸收,从而降低血清和肝脏中的胆固醇含量。依泽替米贝又称依折麦布、依替米贝,是由先灵葆雅公司和默克公司共同研制开发的首个选择性胆固醇吸收抑制剂,并于2003年获得美国FDA批准上市,商品名“益适纯”、“EZETROL”。
降胆固醇药物依泽替米贝是一类新型的选择性胆固醇吸收抑制剂,也是第一个肠道胆固醇吸收的选择性抑制剂。它的药理作用与乙酰辅酶A-胆固醇乙酰转移酶(ACAT)的抑制及LDL受体(清道夫受体)的表达无关。该药物被吸收后在肝脏中与葡萄糖醛酸结合,并经肝肠循环,几乎特异地定位于小肠黏膜细胞。它可以单独或与HMG-CoA还原酶抑制剂(他汀类)联合应用于治疗原发性(杂合子家族性或非家族性)高胆固醇血症、纯合子家族性高胆固醇血症(HoFH)和纯合子谷甾醇血症。
生物活性依泽替米贝 (SCH-58235) 是一种有效的、选择性的胆固醇吸收抑制剂,用于降低胆固醇水平。
靶点Target | Value |
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NPC1L1 |
在西式饮食且无胆固醇的小鼠中,依泽替米贝降低了血浆胆固醇水平,从964至374毫克/分升,从726至231毫克/分升以及从516至178毫克/分升。它减少了主动脉粥样硬化病变的表面积,并抑制了颈动脉粥样硬化病变的横截面面积,在临床前动物模型中有效抑制胆固醇运输穿过肠壁,从而降低血浆胆固醇水平。在胆固醇喂养的仓鼠中,依泽替米贝降低了血浆胆固醇和肝胆固醇积累,ED50为0.04毫克/千克。
用途高脂血症是冠心病的高危因素之一,临床上治疗高脂血症的药物主要包括胆固醇合成抑制剂(如他汀类)、苯氧酸类(如贝特类)、胆汁酸鳌合剂(如消胆胺)及其他(如烟酸类似物)。
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
—— | 4-(4-(benzyloxy)phenyl)-1-(4-fluorophenyl)-3-(3-(4-fluorophenyl)-3-hydroxypropyl)azetidin-2-one | —— | C31H27F2NO3 | 499.557 |
(3R,4S)-1-(4-氟苯基)-3-[(3S)-3-(4-氟苯基)-3-羟基丙基]-4-[4-(苯甲氧基)苯基]-2-氮杂环丁酮 | (3R,4S)-1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4-(4-benzyloxyphenyl)-2-azetidinone | 163222-32-0 | C31H27F2NO3 | 499.557 |
(4S)-(4-氨基苯基)-1-(4-氟苯基)-(3R)-[(3S)-(4-氟苯基)-3-羟丙基]氮杂环丁烷-2-酮 | (4S)-(4-aminophenyl)-1-(4-fluorophenyl)-(3R)-[(3S)-(4-fluorophenyl)-3-hydroxypropyl]azetidin-2-one | 1354716-98-5 | C24H22F2N2O2 | 408.448 |
—— | 4-((2S,3R)-1-(4-fluorophenyl)-3-((S)-3-(4-fluorophenyl)-3-hydroxypropyl)-4-oxoazetidin-2-yl)phenyl pivalate | 1232148-26-3 | C29H29F2NO4 | 493.55 |
—— | (3R,4S)-4-{4-[(tert-butyldimethylsilyl)oxy]phenyl}-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]azetidin-2-one | 942485-60-1 | C30H35F2NO3Si | 523.695 |
依折麦布中间体ZT-7 | (3R,4S)-1-(4-fluorophenyl)-3-((S)-3-(4-fluorophenyl)-3-(trimethylsilyloxy)propanyl)-4-(4-(trimethylsiloxy)phenyl)azetidinone | 272778-13-9 | C30H37F2NO3Si2 | 553.796 |
(3R,4S)-1-(4-氟苯基)-3-[3-(4-氟苯基)-3-氧代丙基]-4-(4-羟基苯基)氮杂环丁烷-2-酮 | [14C]-Sch 57871 | 191330-56-0 | C24H19F2NO3 | 407.417 |
—— | 1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3-oxopropyl]-4-(4-hydroxyphenyl)azetidin-2-one | —— | C24H19F2NO3 | 407.417 |
—— | (3R, 4S)-4-(4-(benzyloxy)phenyl)-1-(4-fluorophenyl)-3-((S)-3- (4-fluorophenyl)-3-((trimethylsilyl)oxy)propyl)azetidin-2-one | —— | C34H35F2NO3Si | 571.739 |
(3R,4S)-1-(4-氟苯基)-2-氧代-4-[4-(苄氧基)苯基]-3-氮杂环丁烷丙酸 | (3R,4S)-1-(4-fluorophenyl)-3-(3-hydroxy-3-oxopropyl)-4-(4-benzyloxyphenyl)-2-azetidinone | 204589-82-2 | C25H22FNO4 | 419.452 |
依折麦布杂质79 | 3′-(S)-4-(S)-3-(R)-[3′-t-butyldimethylsilyloxy-3′-(4-fluorophenyl)propyl]-4-(4-hydroxyphenyl)-1-(4-fluorophenyl)azetidin-2-one | 795306-57-9 | C30H35F2NO3Si | 523.695 |
(3R,4S)-1-(4-氟苯基)-2-氧代-4-[4-(苄氧基)苯基]-3-氮杂环丁烷丙酸甲酯 | methyl 3-((2S,3R)-2-(4-(benzyloxy)phenyl)-1-(4-fluorophenyl)-4-oxoazetidin-3-yl)propanoate | 204589-80-0 | C26H24FNO4 | 433.479 |
—— | (3R,4S)-1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3-oxopropyl]-4-(4-allyloxyphenyl)azetidin-2-one | —— | C27H23F2NO3 | 447.481 |
(3R,4S)-4-[4-(苄氧基)苯基]-1-(4-氟苯基)-3-[3-(4-氟苯基)-3-氧代丙基]氮杂环丁烷-2-酮 | (3R,4S)-4-[4-(benzyloxy)phenyl]-1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3-oxopropyl]azetidin-2-one | 190595-65-4 | C31H25F2NO3 | 497.541 |
—— | 3-((3R,4S)-1-(4-fluorophenyl)-2-oxo-4-(4-(benzyloxy)phenyl)azetidin-3-yl)propionic acid chloride | 204589-84-4 | C25H21ClFNO3 | 437.898 |
—— | (3R,4S)-4-(4-(trimethylsilyloxy)phenyl)-1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3-oxopropyl]azetidin-2-one | 954109-26-3 | C27H27F2NO3Si | 479.599 |
—— | 3-[(2S,3R)-2-(4-benzyloxyphenyl)-1-(4-fluorophenyl)-4-oxoazetidin-3-yl]-N-methoxy-N-methylpropaneamide | 934245-14-4 | C27H27FN2O4 | 462.521 |
—— | 4(S)-(4-benzyloxyphenyl)-1-(4-fluorophenyl)-3(R)-{2-[2-(4-fluorophenyI)-5,5-dimethyl-[1,3]-dioxan-2-yl]-ethyl}azetidine-2-one | 953805-24-8 | C36H35F2NO4 | 583.675 |
依折麦布杂质76 | (3R,4S)-4-(4-(benzyloxy)phenyl)-1-(4-fluorophenyl)-3-((E)-3-(4-fluorophenyl)allyl)azetidin-2-one | 190595-64-3 | C31H25F2NO2 | 481.542 |
—— | (3S,4S)-1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-1-hydroxy-3-oxopropyl]-4-(4-phenylmethoxyphenyl)azetidin-2-one | 231301-00-1 | C31H25F2NO4 | 513.541 |
—— | (2S,3S)-2-(4-(benzyloxy)phenyl)-1-(4-fluorophenyl)-4-oxazetidine-3-carbaldehyde | 221349-58-2 | C23H18FNO3 | 375.399 |
(3S,4S)-4-(4-(苄氧基)苯基)-3-((S)-1,2-二羟基乙基)-1-(4-氟苯基)氮杂环丁-2-酮 | (3S,4S)-4-(4-(Benzyloxy)phenyl)-3-((S)-1,2-dihydroxyethyl)-1-(4-fluorophenyl)azetidin-2-one | 221349-56-0 | C24H22FNO4 | 407.441 |
—— | (3R,4S)-4-(4-(Benzyloxy)phenyl)-1-(4-fluorophenyl)-3-(3-(4-fluorophenyl)-3-oxoprop-1-en-1-yl)azetidin-2-one | 221349-60-6 | C31H23F2NO3 | 495.525 |
(4S)-3-[(2R,5S)-5-(4-氟苯基)-2-[(S)-[(4-氟苯基)氨基](4-羟基苯基)甲基]-5-羟基-1-氧代戊基]-4-苯基-2-恶唑烷酮 | (S)-3-((2R,5S)-5-(4-fluorophenyl)-2-((S)-((4-fluorophenyl)amino)(4-hydroxyphenyl)methyl)-5-hydroxypentanoyl)-4-phenyloxazolidin-2-one | 1185883-40-2 | C33H30F2N2O5 | 572.608 |
3-[(2R,5S)-5-(4-氟苯基)-2-[(S)-[(4-氟苯基(氨基)]][4-(三甲基硅)氧]苯基]甲基]-1-氧代-5-[(三甲基硅)氧]苯基]-4-苯基-(4S)-2-恶唑烷酮 | (4S)-3-[(2R,5S)-5-(4-fluorophenyl)-2-[(S)-[(4-fluorophenyl)amino]({4-[(trimethylsilyl)oxy]phenyl})methyl]-5-[(trimethylsilyl)oxy]pentanoyl]-4-phenyl-1,3-oxazolidin-2-one | 272778-12-8 | C39H46F2N2O5Si2 | 716.972 |
—— | (4S)-phenyl-3-[(5S)-(4-fluorophenyl)-(2R)-[(1S)-(4-fluorophenylamino)-1-(4-nitrophenyl)methyl]-5-hydroxypentanoyl]oxazolidin-2-one | 1354716-96-3 | C33H29F2N3O6 | 601.607 |
—— | benzyl [4-[(1S,2R,5S)-1-(4-fluoroanilino)-5-(4-fluorophenyl)-2-[(4S)-2-oxo-4-phenyl-1,3-oxazolidine-3-carbonyl]-5-trimethylsilyloxypentyl]phenyl] carbonate | 1197343-05-7 | C44H44F2N2O7Si | 778.925 |
依折麦布杂质75 | (1'S,3R,6S)-3-[(4-benzyloxyphenyl)-(4-fluorophenylamino)-methyl]-6-(4-fluorophenyl)-tetrahydro-2H-pyran-2-one | 1416263-36-9 | C31H27F2NO3 | 499.557 |
—— | (S)-3-((R)-2-((S)-(4-((tert-butyldimethylsilyl)oxy)phenyl)((4-fluorophenyl)amino)methyl)-4-(2-(4-fluorophenyl)-5,5-dimethyl-1,3-dioxan-2-yl)butanoyl)-4-phenyloxazolidin-2-one | —— | C44H52F2N2O6Si | 770.989 |
—— | (3S,4S,6R,1'S)-[(4-benzyloxyphenyl)-(4-fluorophenylamino)-methyl]-6-(4-fluorophenyl)-4-hydroxy-tetrahydro-2H-pyran-2-one | 1416263-32-5 | C31H27F2NO4 | 515.556 |
—— | (3S,3aS,6R,7aS)-3-(4-(benzyloxy)phenyl)-2,6-bis(4-fluorophenyl)tetrahydro-2H-pyrano[3,4-d]isoxazol-4(6H)-one | 1416263-31-4 | C31H25F2NO4 | 513.541 |
—— | (3S,3aS,6S,7aS)-3-(4-(benzyloxy)phenyl)-2,6-bis(4-fluorophenyl)tetrahydro-2H-pyrano[3,4-d]isoxazol-4(6H)-one | 1416263-37-0 | C31H25F2NO4 | 513.541 |
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
(3R,4S)-1-(4-氟苯基)-3-[(3S)-3-(4-氟苯基)-3-羟基丙基]-4-[4-(苯甲氧基)苯基]-2-氮杂环丁酮 | (3R,4S)-1-(4-fluorophenyl)-3-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4-(4-benzyloxyphenyl)-2-azetidinone | 163222-32-0 | C31H27F2NO3 | 499.557 |
—— | (3R,4S)-4-[4-(4-bromomethylbenzyloxy)phenyl]-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]azetidin-2-one | 847694-38-6 | C32H28BrF2NO3 | 592.48 |
—— | (3R,4S)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-(4'-hydroxybiphenyl-4-yl)azetidin-2-one | —— | C30H25F2NO3 | 485.53 |
—— | 4-((2S,3R)-1-(4-fluorophenyl)-3-((S)-3-(4-fluorophenyl)-3-hydroxypropyl)-4-oxoazetidin-2-yl) phenyltrifluoromethanesulfonate | 847781-45-7 | C25H20F5NO5S | 541.496 |
(3R,4S)-1-(4-氟苯基)-3-[3-(4-氟苯基)-3-氧代丙基]-4-(4-羟基苯基)氮杂环丁烷-2-酮 | [14C]-Sch 57871 | 191330-56-0 | C24H19F2NO3 | 407.417 |
—— | 4(S)-(4-acetyloxyphenyl)-3(R)-(3(S)-acetyloxy-3-(4-fluorophenyl)propyl)-1-(4-fluorophenyl)-2-azetidinone | 163380-20-9 | C28H25F2NO5 | 493.507 |
依折麦布杂质79 | 3′-(S)-4-(S)-3-(R)-[3′-t-butyldimethylsilyloxy-3′-(4-fluorophenyl)propyl]-4-(4-hydroxyphenyl)-1-(4-fluorophenyl)azetidin-2-one | 795306-57-9 | C30H35F2NO3Si | 523.695 |
—— | [4-[(2S,3R)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-oxoazetidin-2-yl]phenyl] benzenesulfonate | 866918-10-7 | C30H25F2NO5S | 549.595 |
—— | 4'-{(2S,3R)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-oxoazetidin-2-yl}biphenyl-3-carboxylic acid | —— | C31H25F2NO4 | 513.541 |
—— | (3R,4S)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-(3'-nitrobiphenyl-4-yl)azetidin-2-one | —— | C30H24F2N2O4 | 514.528 |
—— | (1S)-3-[(2S,3R)-2-[4-(benzyloxy)phenyl]-1-(4-fluorophenyl)-4-oxoazetidin-3-yl]-1-(4-fluorophenyl)propyl (2S)-2-aminopropanoate | —— | C34H32F2N2O4 | 570.636 |
—— | (3R,4S)-3-[(S)-3-(tert-Butyl-dimethyl-silanyloxy)-3-(4-fluoro-phenyl)-propyl]-4-[4-(tert-butyl-dimethyl-silanyloxy)-phenyl]-1-(4-fluoro-phenyl)-azetidin-2-one | 849799-39-9 | C36H49F2NO3Si2 | 637.958 |
—— | [4-[(2S,3R)-3-[(3S)-3-[tert-butyl(dimethyl)silyl]oxy-3-(4-fluorophenyl)propyl]-1-(4-fluorophenyl)-4-oxoazetidin-2-yl]phenyl] methanesulfonate | 849799-23-1 | C31H37F2NO5SSi | 601.787 |
—— | 1-(4-fluorophenyl)-(3R)-[(4-fluorophenyl)-(2E)-propenyl]-(4S)-(4-hydroxyphenyl)-2-azetidinone | 204589-68-4 | C24H19F2NO2 | 391.417 |
—— | [4-[(2S,3R)-3-[(3S)-3-[tert-butyl(dimethyl)silyl]oxy-3-(4-fluorophenyl)propyl]-1-(4-fluorophenyl)-4-oxoazetidin-2-yl]phenyl] benzenesulfonate | 866918-19-6 | C36H39F2NO5SSi | 663.858 |
—— | [4-[(2S,3S)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]azetidin-2-yl]phenyl] methanesulfonate | 849799-26-4 | C25H25F2NO4S | 473.541 |
—— | 4-((2S,3R)-1-(4-fluorophenyl)-3-((S)-3-(4-fluorophenyl)-3-hydroxypropyl)-4-oxoazetidin-2-yl)phenyl 6-((7-nitrobenzo[c][1,2,5]-oxadiazol-4-yl)amino)hexanoate | —— | C36H33F2N5O7 | 685.684 |
—— | [4-[(2S,3R)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-oxoazetidin-2-yl]phenyl] [(2S,3S,4S,5R,6S)-3,4,5-trihydroxy-6-methoxyoxan-2-yl]methanesulfonate | 849799-31-1 | C31H33F2NO10S | 649.667 |
—— | 4'-{(2S,3R)-1-(4-fluorophenyl)-3-[(3S)-3-(4-fluorophenyl)-3-hydroxypropyl]-4-oxoazetidin-2-yl}biphenyl-3-yl β-L-glucopyranosiduronic acid | —— | C36H33F2NO9 | 661.656 |
—— | [4-[(2S,3S)-3-[(3S)-3-[tert-butyl(dimethyl)silyl]oxy-3-(4-fluorophenyl)propyl]-1-(4-fluorophenyl)azetidin-2-yl]phenyl] methanesulfonate | 849799-25-3 | C31H39F2NO4SSi | 587.803 |
—— | [4-[(2S,3R)-3-[(3S)-3-[tert-butyl(dimethyl)silyl]oxy-3-(4-fluorophenyl)propyl]-1-(4-fluorophenyl)-4-oxoazetidin-2-yl]phenyl] [(2S,3S,4S,5R,6S)-6-methoxy-3,4,5-tris(phenylmethoxy)oxan-2-yl]methanesulfonate | 849799-29-7 | C58H65F2NO10SSi | 1034.3 |
—— | 5-(4-fluorophenyl)-5-hydroxy-2-[(4-fluorophenylamino)-(4-hydroxyphenyl)methyl]pentanoic acid | 1618657-29-6 | C24H23F2NO4 | 427.448 |
—— | (2R,5S)-5-[tert-butyl(dimethyl)silyl]oxy-2-[(S)-[4-[tert-butyl(dimethyl)silyl]oxyphenyl]-(4-fluoroanilino)methyl]-5-(4-fluorophenyl)pentan-1-ol | 866918-08-3 | C36H53F2NO3Si2 | 641.99 |
依折麦布四氢吡喃 | (2R,3R,6S)-N,6-bis(4-fluorophenyl)-2-(4-hydroxyphenyl)-3,4,5,6-tetrahydro-2H-pyran-3-carboxamide | 1296129-15-1 | C24H21F2NO3 | 409.432 |