ABSTRACT:We report the development of a new trifluoromethyltriazolobenzoxazepine series of squalene synthase inhibitors. Structure−activity studies and pharmacokinetics optimization on this series led to the identification of compound 23 (DF-461), which exhibited potent squalene synthase inhibitory activity, high hepatic selectivity, excellent rat hepatic cholesterol synthesis inhibitory activity, and plasma lipid lowering efficacy in nonrodent repeated dose studies.KEYWORDS: Squalene synthase, inhibitor, dyslipidemia, triazolobenzoxazepine I n recent years, the number of arteriosclerosis, ischemic heart diseases, and ischemic brain diseases attributed to arteriosclerosis is increasing around the world due to the spread of the Western dietary pattern and the growing number of elderly affected people. Hypercholesterolemia is one of the primary risk factors of arteriosclerosis. To treat the disease, it is effective to administer medicines for reducing the serum low density lipoprotein (LDL) cholesterol level. The cardiovascular risk reduction of hydroxymethylglutraryl-CoA (HMG-CoA) reductase inhibitors (statins) is principally attributed to their LDL lowering effects as demonstrated in numerous randomized clinical trials. 1−3 However, statins have potential adverse effects, such as myotoxicity, muscle pain, and, in very rare cases, rhabdomyolysis 4,5 because the inhibition of HMG-CoA reductase also interferes with the synthesis of many nonsteroidal isoprenoid molecules. Cerivastatin, one of the second generation statins, was withdrawn from the world market in 2001, due to its adverse effects. 6 Thus, it is preferable to prevent the cholesterol biosynthesis by targeting an enzyme, which lies downstream of farnesyl pyrophosphate in the cholesterol biosynthesis pathway, without interruption to the biosynthesis of essential physiological components, such as ubiquinone and dolichol.Squalene synthase is an attractive target mainly because it is the first enzyme involved in the sterol biosynthesis. 7,8 The inhibitors of the enzyme do not inhibit nonsteroidal biomolecules. 9−12 Although there are already known inhibitors of squalene synthase, it is still difficult to confirm that these compounds have the required sufficient cholesterol lowering potential. 7,8,13−18 Our research group has already reported the lead identifications and initial optimizations of two series of small molecule squalene synthase inhibitors; one is an open form benzhydrol series, another is a tricyclic pyrrolobenzoxazepine series, demonstrating plasma lipid-lowering efficacies in preclinical animal models.Exploratory medicinal chemistry efforts focused on initial lead 1. 19 The highly potent alkoxy-aminobenzhydrol compound 2 was obtained, 20 through incorporations of both the nipecotic acid part at the end of the side chain and the bulky alkoxy part at the aniline ring's ortho position; the benzhydrol compounds formed unique 11-membered ring active conformations with intramolecular hydrogen bonds, between the benzhydrol hydroxyl part and the side...