Q1 · MEDICINE
Article
Author: Conlon, Kelly M. ; Jessiman, Alan S. ; Roberts, Lee R. ; Root, James A. ; Wright, John ; Brennan, Paul E. ; Bungay, Peter J. ; Shanmugasundaram, Veerabahu ; Wheeler, Simon ; Storer, R. Ian ; Whitlock, Gavin A. ; McMurray, Gordon ; Corbett, Matthew S. ; Heifetz, Alexander ; Brown, Alan D. ; Westbrook, Dominique ; Ho, Danny K. H. ; de Oliveira, Cesar Augusto F. ; Shapiro, Michael J. ; Skerten, Melanie ; DePianta, Robert P. ; Fish, Paul V.
A series of 4-substituted pyrimido[4,5-d]azepines that are potent, selective 5-HT2C receptor partial agonists is described. A rational medicinal chemistry design strategy to deliver CNS penetration coupled with SAR-based optimization of selectivity and agonist potency provided compounds with the desired balance of preclinical properties. Lead compounds 17 (PF-4479745) and 18 (PF-4522654) displayed robust pharmacology in a preclinical canine model of stress urinary incontinence (SUI) and no measurable functional agonism at the key selectivity targets 5-HT2A and 5-HT2B in relevant tissue-based assay systems. Utilizing recent advances in the structural biology of GPCRs, homology modeling has been carried out to rationalize binding and agonist efficacy of these compounds.