Structure-based Design of 4-Hydroxy-3,5-Substituted Piperidines as a New Class of Highly Efficacious Oral Direct Renin Inhibitors

Abstract

Starting from the cis-configured 3,5-disubstituted piperidine direct renin inhibitor (DRI), (rac)-1, discovered from a target-family-tailored library by high throughput screening (HTS), a structure-based design effort was performed by optimization of both the prime and non-prime site residues flanking the central piperidine transition-state surrogate. This has resulted in analogs with improved potency and pharmacokinetic (PK) properties, and culminated in the identification of the 4-hydroxy-3,5-substituted piperidine, 35 as a development candidate. This compound showed high in vitro potency toward human renin with excellent off-target selectivity, 60% oral bioavailability in rat, and dose-dependent blood pressure lowering effects in the double-transgenic rat model