捷克科学院的有机化学与生物化学研究所首先合成了阿德福韦。不久之后,美国吉利德科学公司对其进行了研发,期望将其制成一种抗艾滋病药物。然而,在1999年11月,美国专家组建议食品药品监督管理局否决其申请,因为该药在60毫克到120毫克剂量时可能会引起肾中毒。FDA采纳了这一建议,并且随后吉利德科学公司终止了阿德福韦治疗艾滋病毒的研究,转而开始研究用于治疗乙肝的药物。
在低剂量(10毫克)下,阿德福韦对治疗乙肝有效。2002年9月20日,美国食品药品监督管理局批准阿德福韦以商品名Hepsera治疗乙肝。随后,在欧洲也获得了审批通过。
阿德福韦阿德福韦是一种单磷酸腺苷的无环核苷类似物,在细胞激酶的作用下被磷酸化为有活性的代谢产物即阿德福韦二磷酸盐。阿德福韦二磷酸盐能够通过两种方式抑制HBV DNA多聚酶(逆转录酶):一是与自然底物脱氧腺苷三磷酸竞争,二是整合到病毒DNA后引起DNA链延长终止。其Ki值分别为0.1μM、1.18μM和0.97μM。
阿德福韦酯阿德福韦酯是一种新型的抗乙肝病毒药物,为阿德福韦(一种腺嘌呤磷酸酯化合物)的前体。它在体内可迅速水解为阿德福韦,从而较好地被吸收利用,发挥较好的抗病毒作用。相比之下,阿德福韦口服后在肠道中的吸收利用率不太理想。
除了具有抗乙肝病毒的作用外,阿德福韦酯还具有抗人类免疫缺陷病毒(艾滋病病毒)的作用。因此,在使用阿德福韦酯前,应检查患者体内是否含有艾滋病病毒,以避免用药后产生耐药性艾滋病病毒株。
治疗慢性乙型肝炎效果阿德福韦酯在治疗慢性乙型肝炎方面表现出良好的疗效。全球III期临床研究和后续研究中一般定义肾毒性为血清肌酐较基线升高≥0.5mg/dl,且血清磷<1.5mg/dl。
对于HBeAg阳性患者,在治疗144周内没有一例出现肾毒性;而对于HBeAg阴性患者,有3例(2.4%)出现血清肌酐升高,但未合并血磷降低。大多数慢性乙型肝炎患者在阿德福韦酯治疗前就有潜在的肾功能损害,其中部分患者在调整剂量后仍能安全使用阿德福韦酯,约2%的患者因严重肾功能损害而停药。
肾毒性肾毒性是阿德福韦酯临床应用中最引人关注的问题。慢性乙型肝炎肝移植患者,在移植前后服用阿德福韦酯时,一部分出现血清肌酐升高,但大多伴有其他多重危险因素,例如使用免疫抑制剂和(或)其他肾毒性药物,导致很多患者在阿德福韦酯治疗前就有潜在的肾功能损害。其中大部分患者在调整剂量后仍能安全服用阿德福韦酯,约2%的患者因严重肾功能损害而停药。
不良反应常出现的不良反应包括乏力、头痛、腹痛、恶心、胀气、腹泻和消化不良等。此外,阿德福韦酯可引起血中乳酸增多,使体内酸碱平衡失调,从而引起代谢紊乱。停药后,可能会导致肝炎加重,出现肝脏肿大、肝区疼痛等情况。
用途阿德福韦酯用作抗病毒药物。
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
—— | adefovir | 107021-27-2 | C9H14N5O4P | 287.215 |
—— | {[2-(6-amino-9H-purin-9-yl)ethoxy]methyl}phosphinic acid | 159531-21-2 | C8H12N5O3P | 257.189 |
[[2-(6-氨基-9H-嘌呤-9-基)乙氧基]甲基]膦酸二乙酯 | 9-[2-(diethylphosphonomethoxy)ethyl]adenine | 116384-53-3 | C12H20N5O4P | 329.296 |
9-(2-羟乙基)腺嘌呤 | 9-(2-hydroxyethyl)adenine | 707-99-3 | C7H9N5O | 179.181 |
—— | PMEADiPE | 142340-94-1 | C14H24N5O4P | 357.349 |
—— | 9-(2-Diethoxyphosphonomethoxyethyl)adenine | —— | C12H20N5O6P | 361.294 |
阿德福韦酯 | adefovir dipivoxyl | 142340-99-6 | C20H32N5O8P | 501.477 |
—— | 9-(2-Hydroxyethyl)-N6-benzoyladenine | 55343-28-7 | C14H13N5O2 | 283.29 |
—— | O,O-diethyl((2-(6-chloro-9H-purin-9-yl)ethoxy)methyl)phosphonate | 185900-69-0 | C12H18ClN4O4P | 348.726 |
—— | 6-chloro-9-(2'-hydroxyethyl) purine | 1670-62-8 | C7H7ClN4O | 198.612 |
—— | ethyl 2-(6-chloro-9H-purin-9-yl)acetate | 56791-59-4 | C9H9ClN4O2 | 240.649 |
中文名称 | 英文名称 | CAS号 | 化学式 | 分子量 |
---|---|---|---|---|
—— | adefovir | 107021-27-2 | C9H14N5O4P | 287.215 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis(methyl ester) | 126354-61-8 | C10H16N5O4P | 301.242 |
阿德福韦酯杂质E | Ethyl Ester of 9-(2-Phosphonylmethoxyethyl)adenine | 116384-54-4 | C10H16N5O4P | 301.242 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2-hydroxyethyl ester | —— | C10H16N5O5P | 317.241 |
—— | 9-(2-phosphonomethoxyethyl)adenine propyl ester | —— | C11H18N5O4P | 315.269 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2-aminoethyl ester | 164786-59-8 | C10H17N6O4P | 316.257 |
—— | 9-(2-phosphonomethoxyethyl)adenine 3-hydroxypropyl ester | —— | C11H18N5O5P | 331.268 |
[[2-(6-氨基-9H-嘌呤-9-基)乙氧基]甲基]膦酸二乙酯 | 9-[2-(diethylphosphonomethoxy)ethyl]adenine | 116384-53-3 | C12H20N5O4P | 329.296 |
—— | dichloro-9-[2-(phosphorylmethoxy)ethaneyl]adenine | 142341-38-6 | C8H10Cl2N5O2P | 310.079 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2-cyanoethyl ester | —— | C11H15N6O4P | 326.252 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, mono-2,2,2-trichloroethyl ester | —— | C10H13Cl3N5O4P | 404.577 |
9-(2-羟乙基)腺嘌呤 | 9-(2-hydroxyethyl)adenine | 707-99-3 | C7H9N5O | 179.181 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2,2-dimethylpropyl ester | —— | C13H22N5O4P | 343.323 |
—— | 9-(2-phosphonomethoxyethyl)adenine hexyl ester | —— | C14H24N5O4P | 357.349 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2-dimethylaminoethyl ester | —— | C12H21N6O4P | 344.31 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2,2,2-trifluoroethyl ester | —— | C10H13F3N5O4P | 355.213 |
—— | 9-(2-phosphonomethoxyethyl)adenine octadecyl ester | —— | C26H48N5O4P | 525.672 |
—— | 9-(2-phosphonomethoxyethyl)adenine octyl ester | —— | C16H28N5O4P | 385.403 |
—— | 9-[2-(phosphonomethoxy)ethyl]adenine 17-hydroxy-3,6,9,12,15-pentaoxaheptadecyl ester | 1313815-63-2 | C20H36N5O10P | 537.507 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, cyclic propanyl ester | —— | C11H16N5O4P | 313.253 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2,2,2-tribromoethyl ester | —— | C10H13Br3N5O4P | 537.93 |
—— | 9-(2-phosphonomethoxyethyl)adenine 3-hydroxybutyl ester | —— | C12H20N5O5P | 345.295 |
—— | PMEADiPE | 142340-94-1 | C14H24N5O4P | 357.349 |
—— | 3-(hexadecyloxy)propyl hydrogen [2-(adenin-9-yl)ethoxy]methylphosphonate | —— | C27H50N5O5P | 555.698 |
—— | 9-(2-phosphonomethoxyethyl)adenine 1,3-dihydroxy-2-propyl ester | —— | C11H18N5O6P | 347.268 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, mono-2',2'-dimethyl-3'-hydroxypropyl ester | —— | C13H22N5O5P | 359.322 |
—— | adefovir monophosphate | 129556-87-2 | C8H13N5O7P2 | 353.168 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2,3-dihydroxypropyl ester | —— | C11H18N5O6P | 347.268 |
—— | 2-(6-Aminopurin-9-yl)ethoxymethyl-(7-azidoheptoxy)phosphinic acid | 183107-14-4 | C15H25N8O4P | 412.388 |
—— | 2-(6-Aminopurin-9-yl)ethoxymethyl-(6-azidohexoxy)phosphinic acid | 183107-13-3 | C14H23N8O4P | 398.362 |
—— | 2-(6-Aminopurin-9-yl)ethoxymethyl-(8-azidooctoxy)phosphinic acid | 183107-15-5 | C16H27N8O4P | 426.415 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis(isobutyl ester) | —— | C16H28N5O4P | 385.403 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis(2,2,2-trichloroethyl ester) | 142341-28-4 | C12H14Cl6N5O4P | 535.966 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis(isovaleryl ester) | —— | C18H32N5O4P | 413.457 |
—— | 9-[2-(Dioctoxyphosphorylmethoxy)ethyl]purin-6-amine | 158421-60-4 | C24H44N5O4P | 497.618 |
—— | 9-[2-(phosphonomethoxy)ethyl]adenine bis(3,6,9,12,15,18-hexaoxaeicosyl) ester | 1313815-78-9 | C36H68N5O16P | 857.934 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2-morpholinoethyl ester | —— | C14H23N6O5P | 386.348 |
—— | 9-[2-(phosphonomethoxy)ethyl]adenine bis(17-hydroxy-3,6,9,12,15-pentaoxaheptadecyl) ester | 1313815-73-4 | C32H60N5O16P | 801.826 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, mono(2',2'-difluoro-3'-hydroxypropyl ester) | —— | C11H16F2N5O5P | 367.249 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, cyclic 2',2'-dimethylpropanyl ester | —— | C13H20N5O4P | 341.307 |
阿德福韦单特戊酸甲酯 | 9-<2-(phosphonomethoxy)ethyl>adenine, mono(pivaloyloxy)methyl ester | 142341-05-7 | C14H22N5O6P | 387.332 |
—— | Allyloxycarbonyloxymethoxy-[2-(6-aminopurin-9-yl)ethoxymethyl]phosphinic acid | 959861-29-1 | C13H18N5O7P | 387.289 |
—— | 9-(2-phosphonomethoxyethyl)adenine benzyl ester | —— | C15H18N5O4P | 363.313 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, monophenyl ester | —— | C14H16N5O4P | 349.286 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2,3,4-trihydroxy-1-butyl ester | —— | C12H20N5O7P | 377.294 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis<(propionyloxy)methyl ester> | —— | C16H24N5O8P | 445.369 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2-amino-3-hydroxy-2-hydroxymethylpropyl ester | —— | C12H21N6O6P | 376.309 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, mono-N,N-diethylacetamide ester | —— | C14H23N6O5P | 386.348 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis<(isobutyryloxy)methyl ester> | —— | C18H28N5O8P | 473.423 |
—— | Allyl [allyloxycarbonyloxymethoxy-[2-(6-aminopurin-9-yl)ethoxymethyl]phosphoryl]oxymethyl carbonate | 873425-09-3 | C18H24N5O10P | 501.39 |
阿德福韦酯 | adefovir dipivoxyl | 142340-99-6 | C20H32N5O8P | 501.477 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis(phenyl ester) | 142341-24-0 | C20H20N5O4P | 425.384 |
阿德福韦-d4二磷酸三乙胺盐 | 9-[2-(phosphonomethoxy)ethyl]adenine diphosphate | 129532-77-0 | C8H14N5O10P3 | 433.148 |
—— | 2-(6-Aminopurin-9-yl)ethoxymethyl-(benzyloxycarbonyloxymethoxy)phosphinic acid | 959861-27-9 | C17H20N5O7P | 437.349 |
—— | 2-[2-(6-aminopurin-9-yl)ethoxymethyl-[2-(diethylamino)-2-oxoethoxy]phosphoryl]oxy-N,N-diethylacetamide | 1026090-29-8 | C20H34N7O6P | 499.507 |
阿德福韦酯 杂质C (阿德福韦单乙酯、单特戊酸甲酯) | 9-<2-(phosphonomethoxy)ethyl>adenine, monoethyl mono(pivaloyloxy)methyl ester | 142341-04-6 | C16H26N5O6P | 415.386 |
—— | 9-(2-phosphonomethoxyethyl)adenine 3-benzyloxy-2-hydroxypropyl ester | —— | C18H24N5O6P | 437.392 |
—— | [2-(6-Aminopurin-9-yl)ethoxymethyl-(cyclopentoxycarbonyloxymethoxy)phosphoryl]oxymethyl cyclopentyl carbonate | 873425-11-7 | C22H32N5O10P | 557.497 |
—— | [2-(6-Aminopurin-9-yl)ethoxymethyl-(benzyloxycarbonyloxymethoxy)phosphoryl]oxymethyl benzyl carbonate | 873425-10-6 | C26H28N5O10P | 601.51 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, mono-p-nitrobenzyl ester | —— | C15H17N6O6P | 408.31 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, cyclic (2',2'-dimethylpropanyl)amide | —— | C13H22N7O2P | 339.337 |
—— | [2-(6-Aminopurin-9-yl)ethoxymethyl-(cyclohexoxycarbonyloxymethoxy)phosphoryl]oxymethyl cyclohexyl carbonate | 873425-12-8 | C24H36N5O10P | 585.551 |
—— | 9-<2-(phosphonomethoxy)ethyl>adenine, bis(diethylamide) | —— | C16H30N7O2P | 383.434 |
—— | 9-(bis(N,N'-(methoxycarbonylmethyl)phosphonamido)methoxyethyl)adenine | 1041402-65-6 | C14H22N7O6P | 415.346 |
—— | 9-[2-(2-phenyl)-2-oxa-1,3,2-dioxaphosphorylhexane-2-ethyleneoxyethyl]adenine | —— | C17H20N5O4P | 389.351 |
—— | 9-(2-phosphonomethoxyethyl)adenine 2,2-dimethyl-1,3-dioxolan-4-ylmethyl ester | —— | C14H22N5O6P | 387.332 |
—— | 9-[2-[Bis[(4-nitrophenyl)methoxy]phosphorylmethoxy]ethyl]purin-6-amine | 142341-26-2 | C22H22N7O8P | 543.433 |
—— | N'-[9-[2-(dichlorophosphorylmethoxy)ethyl]purin-6-yl]-N,N-diethylmethanimidamide | 1056998-35-6 | C13H19Cl2N6O2P | 393.213 |
—— | dichloridate | 625095-59-2 | C13H19Cl2N6O2P | 393.213 |
阿德福韦酯N6羟甲基杂质 | 9-[2-({bis[(pivaloyloxy)methoxy]phosphinyl}methoxy)ethyl]-6-[(hydoxymethyl)amino]purine | 323201-04-3 | C21H34N5O9P | 531.503 |
—— | [2-(6-Aminopurin-9-yl)ethoxymethyl-phenylmethoxyphosphoryl]oxymethyl 2,2-dimethylpropanoate | 158421-65-9 | C21H28N5O6P | 477.457 |
—— | 2-(6-Aminopurin-9-yl)ethoxymethyl-[3-[2-[4-(2-methylpropyl)phenyl]propanoyloxy]propoxy]phosphinic acid | 1334143-77-9 | C24H34N5O6P | 519.538 |
—— | 9-[2-(phosphonomethoxy)ethyl]adenine (5-methyl-2-oxo-1,3-dioxolen-4-yl)methyl ester | 1313815-83-6 | C13H16N5O7P | 385.273 |
—— | 9-[2-(bis(2,2-dimethylpropoxy-L-alaninyl)phosphonomethoxy)ethyl]adenine | 1607015-09-7 | C24H42N7O6P | 555.615 |
—— | Methyl 2-[[2-(6-aminopurin-9-yl)ethoxymethyl-phenoxy-phosphoryl]amino]acetate | —— | C17H21N6O5P | 420.365 |
—— | O-[{[2-(6-amino-9H-purin-9-yl)ethoxy]methyl}(hydroxy)phosphoryl]-N-octyl-L-tyrosinamide | —— | C25H38N7O5P | 547.594 |
2-(6-氧代-3H-嘌呤-9-基)乙氧基甲基膦酸 | 9-(2-phosphonylmethoxyethyl)-hypoxanthine | 113884-65-4 | C8H11N4O5P | 274.173 |
—— | 9-(2-phosphonomethoxyethyl)adenine 6-O-(D-mannopyranosyl) ester | —— | C14H22N5O9P | 435.331 |
—— | 9-[2-(phosphonomethoxy)ethyl]adenine bis[(N-Boc-L-isoleucyloxy)ethyl] ester | 928651-81-4 | C34H58N7O12P | 787.848 |
—— | 9-[2-(bis(benzyloxy-L-alaninyl)phosphonomethoxy)ethyl]adenine | 168537-50-6 | C28H34N7O6P | 595.595 |
—— | methyl (2R)-2-[[2-(6-aminopurin-9-yl)ethoxymethyl-phenoxy-phosphoryl]amino]propanoate | —— | C18H23N6O5P | 434.392 |
—— | methyl (2S)-2-[[2-(6-aminopurin-9-yl)ethoxymethyl-phenoxy-phosphoryl]amino]propanoate | —— | C18H23N6O5P | 434.392 |
—— | (rac)-cis-9-{2-[4-(3-chlorophenyl)-2-oxo-1,3,2-dioxaphosphorinan-2-methyleneoxy]eth-1-yl}adenine | —— | C17H19ClN5O4P | 423.796 |
—— | 9-[2-[[(2S,4S)-4-(3-chlorophenyl)-2-oxo-1,3,2lambda5-dioxaphosphinan-2-yl]methoxy]ethyl]purin-6-amine | 625095-66-1 | C17H19ClN5O4P | 423.796 |
—— | pradefovir | —— | C17H19ClN5O4P | 423.796 |
—— | trans-9-{2-[4-(R)-(3-chlorophenyl)-2-oxo-1,3,2-dioxaphosphorinan-2-methyleneoxy]eth-1-yl}adenine | —— | C17H19ClN5O4P | 423.796 |
帕拉德福韦 | (+)-cis-9-{2-[4-(S)-(3-chlorophenyl)-2-oxo-1,3,2-dioxaphosphorinan-2-methyleneoxy]eth-1-yl}adenine | 625095-60-5 | C17H19ClN5O4P | 423.796 |
—— | 9-[[[bis((benzo[1,3]dioxolan-4-yl)oxyl)phosphonyl]methoxyl]ethyl]adenine | —— | C22H20N5O8P | 513.403 |
—— | 9-[2-(phenyloxy(2,2-dimethylpropoxy-L-alaninyl)phosphonomethoxy)ethyl]adenine | —— | C22H31N6O5P | 490.499 |
—— | 9-[2-(3-methylcycloAmb-phosphonylmethoxy)ethyl]adenine | —— | C16H19N6O3P | 374.339 |
—— | 9-[2-(δ-napthyloxy(2,2-dimethylpropoxy-L-alaninyl)phosphonomethoxy)ethyl]adenine | —— | C26H33N6O5P | 540.559 |
—— | 9-[2-(6-fluorocycloAmb-phosphonylmethoxy)ethyl]adenine | —— | C15H16FN6O3P | 378.303 |
—— | 9-[2-(5,6,7,8-tetrahydro-1-naphthyloxy(2,2-dimethylpropoxy-L-alaninyl)phosphonomethoxy)ethyl]adenine | —— | C26H37N6O5P | 544.591 |