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Download fileDiscovery of AZD4831, a Mechanism-Based Irreversible Inhibitor of Myeloperoxidase, As a Potential Treatment for Heart Failure with Preserved Ejection Fraction
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posted on 2022-04-22, 18:05 authored by Tord Inghardt, Thomas Antonsson, Cecilia Ericsson, Daniel Hovdal, Petra Johannesson, Carina Johansson, Ulrik Jurva, Johan Kajanus, Bengt Kull, Erik Michaëlsson, Anna Pettersen, Tove Sjögren, Henrik Sörensen, Kristina Westerlund, Eva-Lotte LindstedtMyeloperoxidase is
a promising therapeutic target for treatment
of patients suffering from heart failure with preserved ejection fraction
(HFpEF). We aimed to discover a covalent myeloperoxidase inhibitor
with high selectivity for myeloperoxidase over thyroid peroxidase,
limited penetration of the blood–brain barrier, and pharmacokinetics
suitable for once-daily oral administration at low dose. Structure–activity
relationship, biophysical, and structural studies led to prioritization
of four compounds for in-depth safety and pharmacokinetic studies
in animal models. One compound (AZD4831) progressed to clinical studies
on grounds of high potency (IC50, 1.5 nM in vitro) and selectivity (>450-fold vs thyroid peroxidase in vitro), the mechanism of irreversible inhibition, and
the safety profile. Following phase 1 studies in healthy volunteers
and a phase 2a study in patients with HFpEF, a phase 2b/3 efficacy study of AZD4831 in patients with HFpEF started in 2021.
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promising therapeutic targetpreserved ejection fractiondaily oral administrationselectivity (> 450phase 2a studybased irreversible inhibitorstructural studies ledcovalent myeloperoxidase inhibitorphase 2irreversible inhibitionhigh selectivitypharmacokinetic studiesclinical studiesvs </vitro </thyroid peroxidasesafety profilepharmacokinetics suitableone compoundlow doselimited penetrationhigh potencyheart failurehealthy volunteersfour compoundsdepth safetyb </animal models5 nm
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