Discovery of Dihydrobenzoxazepinone (GS-6615) Late Sodium Current Inhibitor (Late <i>I</i><sub>Na</sub>i), a Phase II Agent with Demonstrated Preclinical Anti-Ischemic and Antiarrhythmic Properties
作者:Jeff A. Zablocki、Elfatih Elzein、Xiaofen Li、Dmitry O. Koltun、Eric Q. Parkhill、Tetsuya Kobayashi、Ruben Martinez、Britton Corkey、Haibo Jiang、Thao Perry、Rao Kalla、Gregory T. Notte、Oliver Saunders、Michael Graupe、Yafan Lu、Chandru Venkataramani、Juan Guerrero、Jason Perry、Mark Osier、Robert Strickley、Gongxin Liu、Wei-Qun Wang、Lufei Hu、Xiao-Jun Li、Nesrine El-Bizri、Ryoko Hirakawa、Kris Kahlig、Cheng Xie、Cindy Hong Li、Arvinder K. Dhalla、Sridharan Rajamani、Nevena Mollova、Daniel Soohoo、Eve-Irene Lepist、Bernard Murray、Gerry Rhodes、Luiz Belardinelli、Manoj C. Desai
DOI:10.1021/acs.jmedchem.6b00939
日期:2016.10.13
Late sodium current (late I-Na) is enhanced during ischemia by reactive oxygen species (ROS) modifying the Na-v 1.5 channel, resulting in incomplete inactivation. Compound 4 (GS-6615, eleclazine) a novel, potent, and selective inhibitor of late INa, is currently in clinical development for treatment of long QT-3 syndrome (LQT-3), hypertrophic cardiomyopathy (HCM), and ventricular tachycardia-velitricular fibrillation (VT-VF). We will describe structure-activity relationship (SAR) leading to the discovery of 4 that is vastly improved from the first generation late I-Na inhibitor 1 (ranolazine). Compound 4 was 42 times more potent than 1 in reducing ischemic burden in vivo (S-T segment elevation, 15 min left anterioior descending, LAD, occlusion in rabbits); with EC50 values of 190 and 8000 nM, respectively. Compound 4 represents a new class of potent late I-Na inhibitors that will be useful in delineating the role of inhibitors of this current in the treatment of patients.