Smith Dennis, Schmid Esther, Jones Barry
Department of Drug Metabolism, Pfizer Global Research and Development, Sandwich, Kent, United Kingdom.
Clin Pharmacokinet. 2002;41(13):1005-19. doi: 10.2165/00003088-200241130-00001.
The alignment of drug metabolism and pharmacokinetic departments with drug discovery has not produced a radical improvement in the pharmacokinetic properties of new chemical entities. The reason for this is complex, reflecting in part the difficulty of combining potency, selectivity, water solubility, metabolic stability and membrane permeability into a single molecule. This combination becomes increasingly problematic as the drug targets become more distant from aminergic seven-transmembrane-spanning receptors (7-TMs). The leads available for aminergic 7-TMs, like the natural agonists, are invariably small molecular weight, water soluble and potent. Even moving to 7-TMs for which the agonist is a peptide invariably produces lead matter that is less drug-like (higher molecular weight and lipophilic). The role of drug metabolism departments, therefore, has been to guide chemistry to obtaining adequate, rather than optimal, pharmacokinetic properties for these 'difficult' drug targets. A consistent belief of many researchers is that a high value is placed on optimal, rather than adequate, pharmacokinetic properties. One measure of value is market sales, and when these are examined no clear pattern emerges. Part of the success of amlodipine in the calcium channel antagonist sector must be due to its excellent pharmacokinetic profile, but the best-selling drugs among the angiotensin antagonists and beta-blockers have a much greater market share than other agents with better pharmacokinetic properties. Clearly, many other factors are important in the successful launch of a medicine, some reflected in the manner the compound is developed and the subsequent structure of the labelling. Overall, therefore the presence of drug metabolism in drug discovery has probably contributed most by allowing 'difficult' drug targets to be prosecuted, rather than by guiding medicinal chemists to optimal pharmacokinetics. These 'difficult' target candidates become successful drugs when skilfully developed. There is no doubt that skilful development relies heavily on drug metabolism and pharmacokinetic departments, in this case those with a clinical rather than a preclinical orientation.
药物代谢和药代动力学部门与药物研发的结合,并未使新化学实体的药代动力学性质得到根本性改善。原因很复杂,部分反映了将效力、选择性、水溶性、代谢稳定性和膜通透性整合到单个分子中的困难。随着药物靶点与胺能七跨膜受体(7-TM)的距离越来越远,这种整合变得越来越成问题。与天然激动剂一样,用于胺能7-TM的先导化合物总是小分子量、水溶性且强效的。即使转向激动剂为肽的7-TM,得到的先导化合物也总是不太像药物(分子量更高且亲脂性更强)。因此,药物代谢部门的作用一直是指导化学研究,为这些“困难”的药物靶点获得足够而非最佳的药代动力学性质。许多研究人员一直认为,人们高度重视最佳而非足够的药代动力学性质。价值的一个衡量标准是市场销售额,但审视这些销售额时,并没有出现明显的模式。氨氯地平在钙通道拮抗剂领域取得成功的部分原因肯定是其出色的药代动力学特征,但血管紧张素拮抗剂和β受体阻滞剂中最畅销的药物比其他药代动力学性质更好的药物拥有大得多的市场份额。显然,许多其他因素对一种药物的成功上市很重要,有些因素体现在化合物的研发方式和随后的标签结构中。因此,总体而言,药物研发中药物代谢的存在可能最大的贡献在于使“困难”的药物靶点能够被研究,而不是指导药物化学家获得最佳药代动力学性质。当这些“困难”的靶点候选物得到巧妙研发时,它们就会成为成功的药物。毫无疑问,巧妙的研发在很大程度上依赖于药物代谢和药代动力学部门,在这种情况下,是那些具有临床而非临床前导向的部门。