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Hit to lead Pharmaceutical chemistry Hit to lead Chemistry in R&D TARGET I D E A Exploratory research CANDIDATE Therapeutic research POC Exploratory development hit/lead identification Full development Synthesis optimization Optimization of the leads To improve potency, selectivity, PK or reduce toxicity D r u g Hit to lead Chemistry in R&D • Hit/lead identification • Leads’ optimization • Synthesis otpimization • Chemoinformatics • Combinatorial chemistry Medicinal chemistry Organic chemistry Hit to lead Research operating plan Compounds genereted by medicinal chemistry Human and rat functional assay h- and rP2Y12 h- and rP2Y12 EC50 <100 nM Emax > 80% selectivity over P2Y2,4,etc hERG, hPXR > 100 Rapid rat PK AUC > 1000 nM.hr Platelet aggregation test Further characterization in other models Rat liver slice enzyme induction CYP450 inhibition Hit to lead P2Y12 antagonists SAR From ADP to AZD6140 ADP Drug Discovery Process Massimiliano Beltramo, PhD The patent • To assure the intellectual property to the inventor. • To forbid to competitors the production, use and commercialization of the invention for 20 years. What could be claimed ? New molecules Pharmaceutical formulation Synthesis processes and industrial processes Therapeutic indication Diagnostics’ methods Biological tools (gene, transfected cell lines, assays, etc) When to patent a molecule? •In lead optimisation. This normally allow 10 years of exclusivity on the market What are the characteristics of a candidate? Biological properties • Pharmacological profile (potency, selectivity, efficacy in vivo) • Pharmacokinetic profile (Biodisponibility, long lasting effect) • Preliminary toxicological profile (tolerability, hERG, mechanism based toxicity, acute therapeutic window) Chemo-physical properties • Scalability • Pharmaceutical formulation Commercial potential • Unmet medical need • Differentiation Neuropathic pain. Gold Standards: Gabapentin/Pregabalin/D uloxetine Candidate Gold Standards’ Profile Efficacy • Some types of Neuropathic pain – (DbN, chemotherapy, HIV) • 30 % -50% responders Safety • Minimal safety issues Indication Tolerability Dosing • Dizziness, somelence (GB), nausea, vomiting (Dulox) • Oral QD • Titration ~2-4 weeks (GB) differentiator • All Neuropathic Pains • Greater responder rate ( >50%) • Similar • Superior • BID acceptable with incremental efficacy • No titration Candidate Profile High Indication Efficacy Medium UNMET NEED Tolerability Low Safety Small PERCEIVED accettabile non accettabile Dosing Medium ottimale High DIFFERENTIATION R&D process for a new drug TARGET I D E A Exploratory research CANDIDATE Therapeutic research Exploratory development Candidate development POC Full development D R U G Candidate development objectives 1. To complete the study on the candidate and to establish • Safety in human • Suitability for industrial development (exploratory development) 2. To establish the efficacy profile in human and to define the commercial value of the new drug (full development) R&D process for a new drug CANDIDATE POC Exploratory development Developpability Phase 0 or Preclinical development Safety Phase I (A and B) Full development Therapeutic efficacy Phase II Study in the patient D R U G Pre-marketing Phase III Study in the patient Registration Phase IV Post marketing Surveillance Phase 0 Preclinical development Is the molecule suitable to be developped in a drug? • ADME • Preclinical Safety e Toxicology • Chemistry development • Formulation ADME -Absorption -Distribution -Metabolism -Excretion Elimination Describes the disposition of a pharmaceutical compound within an organism. Drug exposure to the tissues influence the performance and pharmacological activity of the compound. Administration route Extravascular Intravascular Oral Sublingual Intravenous Intra-arterial • Directly into the blood streem • Immediate and full absorption Buccal Intramuscular Subcutaneous Dermal • Absorption is retarded and incomplete It is the preferred route when an immediate effect is necessary All the other cases Bioavailability • Fraction of administered dose that reaches the systemic circulation in the unchanged form and the target tissue • After intravenous administration, the drug is completely bioavailable (F=1) • For oral administration, incomplete bioavailability may be due to: – Transporter Effects – Incomplete absorption or loss in the feces – First pass metabolism in the gut lumen and/or liver • Major determinant for the differences in dose between the intravascular and extravascular routes The fate of a drug Orally Administered D Drug (D) D Heart Tissues (Site of Action) Vena Cava GI Tract •Dissolution •Acid Instability •Digestive Enzymes •Permeability •Intestinal oxidation or conjugation •p-Glycoprotein efflux •GI Transit time •Bacterial metabolism D Portal Vein M D D D Bile Duct •Re-absorption of drug •Hydrolysis of glucuronide& reabsorption of parent M •Clearance •Distribution Cp •Elimination Time M Liver Small Intestine Systemic D Circulation M D •Metabolism •Biliary Excretion •CYP Inhibition •CYP Induction •Transporters Legend D = Parent Drug M = Metabolite(s) D Kidney M •Excretion of parent •Excretion of metabolite Bioavailability Bioavailability using different route is calculated using equal doses Plasma concentration 70 60 i.v. route 50 40 oral route 30 20 Time (hours) 10 0 0 2 4 6 Bioavailability: (AUC)oral / (AUC)iv 8 10 Understanding Dose-Related Exposure (single-rising dose: SRD) Case A: Linear (i.e dose-proportional PK) Absorption & Clearance are constant AUC or Cmax Dose Case B: Saturable Elimination AUC or Cmax Dose Case C: Saturable Absorption AUC or Cmax Dose The Ideal DMPK Profile versus Lead Optimization Clinical DMPK Profile High oral bioavailability: Half-life between 12 and 24 hr: Multiple elimination pathways: No reactive metabolites: No human-specific metabolites: No inhibition of CYP450 enzymes: No induction of CYP enzymes: Rationale Low inter-subject variability/ cost of goods QD dosing/ acceptable accumulation Drug-drug interactions (DDI) less likely Avoid safety issues/ idiosyncratic AEs Simplifies safety program & risk assessment Drug unlikely to cause DDIs Avoid autoinduction or DDIs Drug Safety DMPK Profile Good PK with developable form: Acceptable exposure multiples: Stable and predictable exposure: Clean in AMES test: Crystalline form - reduced bioavailability? Human risk assessment Reliably target appropriate exposure Avoid mutagens