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Merimepodib

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Chemical compound

Pharmaceutical compound

Merimepodib
Legal status

Legal status	US: Investigational drug
Identifiers
IUPAC name [(3S)-oxolan-3-yl]N-[(3-{[3-methoxy-4-(1,3-oxazol-5-yl)phenyl]carbamoylamino}phenyl)methyl]carbamate
CAS Number	198821-22-6
PubChemCID	153241
DrugBank	DB04862
ChemSpider	135060
UNII	2ZL2BA06FU
KEGG	D04936
ChEMBL	ChEMBL304087
CompTox Dashboard(EPA)	DTXSID70173639
Chemical and physical data
Formula	C₂₃H₂₄N₄O₆
Molar mass	452.467 g·mol⁻¹
3D model (JSmol)	Interactive image
SMILES COC1=C(C=CC(=C1)NC(=O)NC2=CC=CC(=C2)CNC(=O)O[C@H]3CCOC3)C4=CN=CO4
InChI InChI=1S/C23H24N4O6/c1-30-20-10-17(5-6-19(20)21-12-24-14-32-21)27-22(28)26-16-4-2-3-15(9-16)11-25-23(29)33-18-7-8-31-13-18/h2-6,9-10,12,14,18H,7-8,11,13H2,1H3,(H,25,29)(H2,26,27,28)/t18-/m0/s1 Key:JBPUGFODGPKTDW-SFHVURJKSA-N

Merimepodib (VX-497) is a drug which acts as an inhibitor of theenzyme inosine monophosphate dehydrogenase, which is required for the synthesis ofnucleotide bases containingguanine. This consequently inhibits synthesis of DNA and RNA, and results inantiviral andimmunosuppressive effects.^[1] It progressed as far as Phase 2b humanclinical trials againstHepatitis C but showed only modest benefits in comparison to existing treatments,^[2]^[3] however it continues to be researched, and also shows activity against other viral diseases such asZika virus andfoot and mouth disease virus.^[4]^[5]

Merimepodib was investigated in combination with remdesivir in a phase 2 clinical trial in the U.S. as a potential treatment ofCOVID-19 by ViralClear Pharmaceuticals.^[6]^[7] The trial stopped in October 2020, and the company announced in a news release that it was "unlikely that the trial would meet its primary safety endpoints", and that it "does not intend to further develop merimepodib".^[8]

References

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^Jain J, Almquist SJ, Shlyakhter D, Harding MW (May 2001). "VX-497: a novel, selective IMPDH inhibitor and immunosuppressive agent".Journal of Pharmaceutical Sciences.90 (5):625–637.doi:10.1002/1520-6017(200105)90:5<625::aid-jps1019>3.0.co;2-1.PMID 11288107.
^McHutchison JG, Shiffman ML, Cheung RC, Gordon SC, Wright TL, Pottage JC, et al. (2005)."A randomized, double-blind, placebo-controlled dose-escalation trial of merimepodib (VX-497) and interferon-alpha in previously untreated patients with chronic hepatitis C".Antiviral Therapy.10 (5):635–643.doi:10.1177/135965350501000503.PMID 16152757.S2CID 237218077.
^Rustgi VK, Lee WM, Lawitz E, Gordon SC, Afdhal N, Poordad F, et al. (December 2009)."Merimepodib, pegylated interferon, and ribavirin in genotype 1 chronic hepatitis C pegylated interferon and ribavirin nonresponders".Hepatology.50 (6):1719–1726.doi:10.1002/hep.23204.PMID 19852040.S2CID 2497811.
^Tong X, Smith J, Bukreyeva N, Koma T, Manning JT, Kalkeri R, et al. (January 2018). "Merimepodib, an IMPDH inhibitor, suppresses replication of Zika virus and other emerging viral pathogens".Antiviral Research.149:34–40.doi:10.1016/j.antiviral.2017.11.004.PMID 29126899.S2CID 46843542.
^Li SF, Gong MJ, Shao JJ, Sun YF, Zhang YG, Chang HY (October 2019). "Antiviral activity of merimepodib against foot and mouth disease virus in vitro and in vivo".Molecular Immunology.114:226–232.doi:10.1016/j.molimm.2019.07.021.hdl:2268/248312.PMID 31386979.S2CID 199469162.
^Clinical trial numberNCT04410354 for "Study of Merimepodib in Combination With Remdesivir in Adult Patients With Advanced COVID-19 " atClinicalTrials.gov
^Arunachalam R, Kumar KP (10 July 2020)."COVID-19: Clinical Trials and Potential Therapeutic Agents - A Narrative Review".SSRN from Elsevier.SSRN 3653031. Retrieved14 August 2020.
^"ViralClear halts its Phase 2 Hospitalized COVID-19 Trial".BioSig Technologies, Inc. (BSGM). 26 October 2020.

RNA virus antivirals (primarilyJ05, alsoS01AD andD06BB)

Hepatitis C

NS3/4A protease inhibitors (–previr)	Asunaprevir Boceprevir^‡ Ciluprevir^§ Danoprevir^† Faldaprevir^‡ Glecaprevir Grazoprevir Narlaprevir Paritaprevir Simeprevir Sovaprevir^† Telaprevir^‡ Vaniprevir Vedroprevir^§ Voxilaprevir
NS5A inhibitors (–asvir)	Coblopasvir Daclatasvir^# Elbasvir Ledipasvir Odalasvir^† Ombitasvir Pibrentasvir Ravidasvir^† Ruzasvir^† Samatasvir^† Velpatasvir
NS5B RNA polymerase inhibitors (–buvir)	Beclabuvir^† Bemnifosbuvir^† Dasabuvir^# Deleobuvir^§ Filibuvir^§ GS-6620^§ IDX-184^§ Setrobuvir^§ Sofosbuvir^# Tegobuvir^§ TMC-647055^§ Radalbuvir^† Uprifosbuvir^†
Combination drugs	Elbasvir/grazoprevir Glecaprevir/pibrentasvir Ledipasvir/sofosbuvir^# Ombitasvir/paritaprevir/ritonavir^# Sofosbuvir/daclatasvir Sofosbuvir/velpatasvir^# Sofosbuvir/velpatasvir/voxilaprevir

Hepatitis D

Bulevirtide

Picornavirus

viral entry:Pleconaril^†

Anti-influenza agents

neuraminidase inhibitors/release phase (Oseltamivir^#
Zanamivir
Peramivir,Laninamivir^†)

Multiple/general

Interferon	Interferon alfa 2b Peginterferon alfa-2a^# Peginterferon alfa-2b^#
3CL protease inhibitors (–trelvir)	Atilotrelvir Ensitrelvir^† Ibuzatrelvir Leritrelvir Lufotrelvir Nirmatrelvir^† (+ritonavir)^† Rupintrivir Simnotrelvir (+ritonavir^†)
RNA pol inhibitors	CMX521^§ Deuremidevir^† Favipiravir Galidesivir^† GS-441524^§ Remdesivir MK-608^§ Mericitabine^† Molnupiravir NITD008^§ Ribavirin^# Taribavirin^† Triazavirin Valopicitabine^†
Multiple/Unknown/Other	EICAR^§ Merimepodib^§ Moroxydine Presatovir^†

^#WHO-EM
^‡Withdrawn from market
Clinical trials:
- ^†Phase III
- ^§Never to phase III

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