Nicotinamide phosphoribosyl transferase (NAMPT) is a key enzyme in the salvage pathway of mammalian nicotinamide adenine dinucleotide (NAD) biosynthesis, catalyzing the synthesis of nicotinamide mononucleotide from nicotinamide (Nam). The diverse functions of NAD suggest that NAMPT inhibitors are potential drug candidates as anticancer agents, immunomodulators, or other agents. However, difficulty in conducting high-throughput NAMPT assay with good sensitivity has hampered the discovery of novel anti-NAMPT drugs with improved profiles. We combined an in silico screening strategy with a radioisotope (RI)-based enzyme assay and rationally identified promising NAMPT inhibitors with novel structures. AS1604498 was the most potent inhibitor, with an IC 50 of 44 nM, and inhibited THP-1 and K562 cell line growth with the IC 50 of 198 nM and 673 nM, respectively. The mode of action was found to reduce intracellular NAD following apoptosis, suggesting that these compounds inhibit NAMPT in cell-based assay. This strategy can be used to discover new drug candidates with targets which are difficult to assess through high-throughput screening. Our hit compounds may be used as seed compounds for developing new therapeutics with NAMPT.Key words nicotinamide phosphoribosyl transferase; in silico screening; FK866; nicotinamide adenine dinucleotide Nicotinamide phosphoribosyl transferase (NAMPT) catalyzes a rate-limiting step in the salvage pathway of mammalian nicotinamide adenine dinucleotide (NAD) biosynthesis. Recently, intracellular NAD has received substantial attention due to the recent discovery that several enzymes, including poly(ADP-ribose) polymerase (PARP) and the Sirtuin-family proteins, use NAD as a substrate, [1][2][3] suggesting that intracellular NAD level may regulate cytokine production, 4) circadian rhythm, 5,6) metabolism, and aging 3,7) through these enzymes. FK866, an NAMPT inhibitor, has been shown to induce apoptosis of cancer cells 8) and immune cells, 9) suggesting the possibility of NAMPT inhibitors as a novel drug class. As such, FK866 and CHS-828, another NAMPT inhibitor, are currently being investigated in clinical trials for cancer treatment.10,11) However, these compounds were discovered by chance using cell-based assay, 12,13) and discovery of new NAMPT inhibitors with better structures has been hindered by the difficulty of conducting high-throughput screening (HTS) with good sensitivity. HTS presents difficulties because a radioisotope (RI)-labeled substrate is needed to retain good assay sensitivity, but a complicated procedure including separation of product from substrate prevents evaluation of large numbers of compounds.Here we report our finding of novel compounds with potent NAMPT inhibitory activity as determined using in silico screening and a 96-well-based sensitive RI-based assay.