Discovery
of the potent antileishmanial effects of antitubercular
6-nitro-2,3-dihydroimidazo[2,1-b][1,3]oxazoles and
7-substituted 2-nitro-5,6-dihydroimidazo[2,1-b][1,3]oxazines
stimulated the examination of further scaffolds (e.g., 2-nitro-5,6,7,8-tetrahydroimidazo[2,1-b][1,3]oxazepines), but the results for these seemed less
attractive. Following the screening of a 900-compound pretomanid analogue
library, several hits with more suitable potency, solubility, and
microsomal stability were identified, and the superior efficacy of
newly synthesized 6R enantiomers with phenylpyridine-based
side chains was established through head-to-head assessments in a Leishmania donovani mouse model. Two such leads (R-84 and R-89) displayed promising activity in the more stringent Leishmania
infantum hamster model but were unexpectedly found to be
potent inhibitors of hERG. An extensive structure–activity
relationship investigation pinpointed two compounds (R-6 and pyridine R-136)
with better solubility and pharmacokinetic properties that also provided
excellent oral efficacy in the same hamster model (>97% parasite
clearance
at 25 mg/kg, twice daily) and exhibited minimal hERG inhibition. Additional
profiling earmarked R-6 as the favored
backup development candidate.