29 research outputs found

    Discovery of Novel Indazole Derivatives as Highly Potent and Selective Human β<sub>3</sub>‑Adrenergic Receptor Agonists with the Possibility of Having No Cardiovascular Side Effects

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    Novel indazole derivatives were prepared and evaluated for their biological activity and cardiovascular safety profile as human β<sub>3</sub>-adrenergic receptor (AR) agonists. Although the initial hit compound <b>5</b> exhibited significant β<sub>3</sub>-AR agonistic activity (EC<sub>50</sub> = 21 nM), it also exhibited agonistic activity at the α<sub>1A</sub>-AR (EC<sub>50</sub> = 219 nM, selectivity: α<sub>1A</sub>/β<sub>3</sub> = 10-fold). The major metabolite of <b>5</b>, which was an oxidative product at the indazole 3-methyl moiety, gave a clue to a strategy for improvement of the selectivity for β<sub>3</sub>-AR agonistic activity versus α<sub>1A</sub>-AR agonistic activity. Thus, modification of the 3-substituent of the indazole moiety effectively improved the selectivity to develop compound <b>11</b> with potent β<sub>3</sub>-AR agonistic activity (EC<sub>50</sub> = 13 nM) and high selectivity (α<sub>1A</sub>/β<sub>3</sub> = >769-fold). Compound <b>11</b> was also inactive toward β<sub>1</sub> and β<sub>2</sub>-ARs and showed dose dependent β<sub>3</sub>-AR mediated relaxation of marmoset urinary bladder smooth muscle, while it did not obviously affect heart rate or blood pressure (iv, 3 mg/kg) in anesthetized rats

    Eligible patient population from the JMDC claims database (ABA-1L vs. ABA-2L+).

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    1L, first line; 2L+, second or later line; ABA, abatacept; df, degrees of freedom; JMDC, Japan Medical Data Center Inc; SD, standard deviation. aMcNemar’s chi-squared test or paired t-tests were used. bDisease duration (from date of initial diagnosis to ABA start date). (DOCX)</p

    Scenario analyses: Differences in cost per patient achieving endpoints (ABA-1L vs. ABA-2L+).

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    Difference in costs per health gain PMPM (ABA-1L –ABA-2L+). Costs per health gain PMPM were calculated by dividing total costs by the number of responders, patients in CDAI or SDAI remission for each group. The more positive the vertical axis, the more cost-effective the ABA-2L+ was. 1L, first line; 2L+, second or later line; ABA, abatacept; ACR50, American College of Rheumatology response of at least 50% improvement; CDAI, Clinical Disease Activity Index; J-HAQ, Japanese version of Health Assessment Questionnaire; JPY, Japanese Yen; PMPM, per member per month; SDAI, Simplified Disease Activity Index.</p

    Eligible patient population from the JMDC claims database (ABA-1L vs. TNFi-1L).

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    aPaired t-tests were used. bDisease duration (from date of initial diagnosis to ABA/TNFi start date). 1L, first line; ABA, abatacept; df, degrees of freedom; JMDC, Japan Medical Data Center Inc; SD, standard deviation; TNFi, tumour necrosis factor inhibitor. (DOCX)</p

    One-way sensitivity analysis: ABA 1L vs. ABA 2L+.

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    Ten most influential parameters on the difference in total costs (JPY). Minimum: -719,173, 388; Maximum: 1,040,202,718; Base case: 1,941,292. 1L, first line; 2L+, second or later line; ABA, abatacept; MTX, methotrexate; NSAID, non-steroidal anti-inflammatory drug. (DOCX)</p

    Effectiveness from the IORRA database (ABA-1L vs. TNFi-1L).

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    1L, first line; ABA, abatacept; ACR50, American College of Rheumatology response of at least 50% improvement; CDAI, Clinical Disease Activity Index; IORRA, Institute of Rheumatology, Rheumatoid Arthritis; J-HAQ, Japanese version of Health Assessment Questionnaire; SDAI, Simplified Disease Activity Index; TNFi, tumour necrosis factor inhibitor. (DOCX)</p
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