Medicinal Chemistry, Janssen Research & Development , Beerse, Belgium.
Laboratory for Medicinal Chemistry Research, Shionogi & Co., Ltd ., Toyonaka, Osaka, Japan.
Expert Opin Ther Pat. 2021 Jan;31(1):25-52. doi: 10.1080/13543776.2021.1832463. Epub 2020 Dec 17.
Inhibition of β-site amyloid precursor protein cleaving enzyme 1 (BACE1) has been extensively pursued as potential disease-modifying treatment for Alzheimer's disease (AD). Clinical failures with BACE inhibitors have progressively raised the bar forever cleaner candidates with reduced cardiovascular liability, toxicity risk, and increased selectivity over cathepsin D (CatD) and BACE2.
This review provides an overview of patented BACE1 inhibitors between 2011 and 2020 per pharmaceutical company or research group and highlights the progress that was made in dialing out toxicity liabilities.
Despite an increasingly crowded IP situation, significant progress was made using highly complex chemistry in avoiding toxicity liabilities, with BACE1/BACE2 selectivity being the most remarkable achievement. However, clinical trial data suggest on-target toxicity is likely a contributing factor, which implies the only potential future of BACE1 inhibitors lies in careful titration of highly selective compounds in early populations where the amyloid burden is still minimal as prophylactic therapy, or as an affordable oral maintenance therapy following amyloid-clearing therapies.
β-位点淀粉样前体蛋白裂解酶 1(BACE1)的抑制作用已被广泛研究,作为治疗阿尔茨海默病(AD)的潜在疾病修饰治疗方法。BACE 抑制剂的临床失败使得人们对候选药物的要求越来越高,这些候选药物具有更低的心血管风险、更低的毒性风险、对组织蛋白酶 D(CatD)和 BACE2 的选择性更高,且更加纯净。
本综述按制药公司或研究小组提供了 2011 年至 2020 年期间已获得专利的 BACE1 抑制剂概述,并强调了在消除毒性风险方面取得的进展。
尽管知识产权(IP)情况日益拥挤,但在避免毒性风险方面,使用高度复杂的化学方法取得了重大进展,BACE1/BACE2 选择性是最显著的成就。然而,临床试验数据表明,靶标毒性可能是一个促成因素,这意味着 BACE1 抑制剂的唯一潜在未来在于在淀粉样蛋白负担仍最小的早期人群中,谨慎滴定高度选择性化合物作为预防治疗,或作为清除淀粉样蛋白治疗后的一种负担得起的口服维持治疗。