Discovery of SPH3127: A Novel, Highly Potent, and Orally Active Direct Renin Inhibitor

J Med Chem. 2022 Aug 25;65(16):10882-10897. doi: 10.1021/acs.jmedchem.2c00834. Epub 2022 Aug 8.

Abstract

Renin is the rate-limiting enzyme in the renin-angiotensin-aldosterone system (RAAS) which regulates blood pressure and renal function and hence is an attractive target for the treatment of hypertension and cardiovascular/renal diseases. However, the development of direct renin inhibitors (DRIs) with favorable oral bioavailability has been a longstanding challenge for many years. This problem was thought to be because most of the reported DRIs were peptide-like structures or nonpeptide-like structures with a molecular weight (MW) of > 600. Therefore, we tried to find nonpeptidomimetic DRIs with a MW of < 500 and discovered the promising 2-carbamoyl morpholine derivative 4. In our efforts to improve the pharmacokinetic profile of 4 without a significant increase in the MW, we discovered compound 18 (SPH3127), which demonstrated higher bioavailability and a more potent antihypertensive effect in preclinical models than aliskiren and has completed a phase II clinical trial for essential hypertension.

MeSH terms

  • Amides / pharmacology
  • Amides / therapeutic use
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Fumarates / pharmacology
  • Fumarates / therapeutic use
  • Humans
  • Hypertension* / drug therapy
  • Morpholines / pharmacology
  • Renin* / pharmacology
  • Renin* / therapeutic use
  • Renin-Angiotensin System

Substances

  • Amides
  • Antihypertensive Agents
  • Fumarates
  • Morpholines
  • SPH3127
  • Renin