While
several farnesoid X receptor (FXR) agonists under clinical investigation
for the treatment of nonalcoholic steatohepatitis
(NASH) have shown beneficial effects, adverse effects such as pruritus
and elevation of plasma lipids have limited their clinical efficacy
and approvability. Herein, we report the discovery and preclinical
evaluation of compound 32 (BMS-986339), a nonbile acid
FXR agonist with a pharmacologically distinct profile relative to
our previously reported agonist BMS-986318. Compound 32 exhibited potent in vitro and in vivo activation of FXR, albeit
with a context-dependent profile that resulted in tissue-selective
effects in vivo. To our knowledge, this is the first report that demonstrates
differential induction of Fgf15 in the liver and
ileum by FXR agonists in vivo. Compound 32 demonstrated
robust antifibrotic efficacy despite reduced activation of certain
genes in the liver, suggesting that the additional pharmacology of
BMS-986318 does not further benefit efficacy, possibly presenting
an opportunity for reduced adverse effects. Further evaluation in
humans is warranted to validate this hypothesis.
There is a significant unmet medical need for more efficacious and rapidly acting antidepressants. Toward this end, negative allosteric modulators of the -methyl-d-aspartate receptor subtype GluN2B have demonstrated encouraging therapeutic potential. We report herein the discovery and preclinical profile of a water-soluble intravenous prodrug BMS-986163 () and its active parent molecule BMS-986169 (), which demonstrated high binding affinity for the GluN2B allosteric site ( = 4.0 nM) and selective inhibition of GluN2B receptor function (IC = 24 nM) in cells. The conversion of prodrug to parent was rapid in vitro and in vivo across preclinical species. After intravenous administration, compounds and have exhibited robust levels of ex vivo GluN2B target engagement in rodents and antidepressant-like activity in mice. No significant off-target activity was observed for ,, or the major circulating metabolites and. The prodrug BMS-986163 () has demonstrated an acceptable safety and toxicology profile and was selected as a preclinical candidate for further evaluation in major depressive disorder.
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