Discovery of liver-directed glucokinase activator having anti-hyperglycemic effect without hypoglycemia
作者:Anil M. Deshpande、Debnath Bhuniya、Siddhartha De、Bhavesh Dave、Vinod P. Vyavahare、Santosh H. Kurhade、Sachin R. Kandalkar、Keshav P. Naik、Balasaheb S. Kobal、Rahul D. Kaduskar、Sujay Basu、Vaibhav Jain、Pratima Patil、Sandhya Chaturvedi Joshi、Ganesh Bhat、Amol A. Raje、Satyanarayana Reddy、Jayasagar Gundu、Vamsi Madgula、Suhas Tambe、Prasad Shitole、Dhananjay Umrani、Anita Chugh、Venkata P. Palle、Kasim A. Mookhtiar
DOI:10.1016/j.ejmech.2017.03.042
日期:2017.6
Glucokinase activators (GKAs) are among the emerging drug candidates for the treatment of type 2 diabetes (T2D). Despite effective blood glucose lowering in clinical trials, many pan-GKAs "acting both in pancreas and liver" have been discontinued from clinical development mainly because of their potential to cause hypoglycemia. Pan-GKAs over sensitize pancreatic GK, resulting in insulin secretion even at sub-normoglycemic level which might be a possible explanation for hypoglycemia. An alternative approach to minimize the risk of hypoglycemia is to use liver-directed GKAs, which are reported to be advancing well in clinical development. Here, we report the discovery and structure-activity relationship (SAR) studies on a novel 2-phenoxy-acetamide series with the aim of identifying a liver-directed GKA. Incorporation of a carboxylic acid moiety as an active hepatocyte uptake recognizing element at appropriate position of 2-phenoxy-acetamide core led to the identification of 26, a potent GKA with predominant liver-directed pharmacokinetics in mice. Compound 26 on oral administration significantly reduced blood glucose levels during an oral glucose tolerance test (oGTT) performed in diet-induced obese (DIO) mice, while showing no sign of hypoglycemia in normal C57 mice over a 10-fold dose range, even when dosed at fasted condition. Together, these data demonstrate a liver-directed GKA has beneficial effect on glucose homeostasis with reduced risk of hypoglycemia. (C) 2017 Elsevier Masson SAS. All rights reserved.