Development of Fluorinated Analogues of Perhexiline with Improved Pharmacokinetic Properties and Retained Efficacy

J Med Chem. 2017 Apr 13;60(7):2780-2789. doi: 10.1021/acs.jmedchem.6b01592. Epub 2017 Mar 21.

Abstract

We designed and synthesized perhexiline analogues that have the same therapeutic profile as the parent cardiovascular drug but lacking its metabolic liability associated with CYP2D6 metabolism. Cycloalkyl perhexiline analogues 6a-j were found to be unsuitable for further development, as they retained a pharmacokinetic profile very similar to that shown by the parent compound. Multistep synthesis of perhexiline analogues incorporating fluorine atoms onto the cyclohexyl ring(s) provided a range of different fluoroperhexiline analogues. Of these, analogues 50 (4,4-gem-difluoro) and 62 (4,4,4',4'-tetrafluoro) were highly stable and showed greatly reduced susceptibility to CYP2D6-mediated metabolism. In vitro efficacy studies demonstrated that a number of derivatives retained acceptable potency against CPT-1. Having the best balance of properties, 50 was selected for further evaluation. Like perhexiline, it was shown to be selectively concentrated in the myocardium and, using the Langendorff model, to be effective in improving both cardiac contractility and relaxation when challenged with high fat buffer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cardiovascular Agents / chemistry*
  • Cardiovascular Agents / metabolism
  • Cardiovascular Agents / pharmacokinetics*
  • Cardiovascular Agents / pharmacology
  • Cytochrome P-450 CYP2D6 / metabolism
  • Halogenation
  • Heart / drug effects
  • Heart / physiology
  • Humans
  • Male
  • Mice, Inbred BALB C
  • Myocardial Contraction / drug effects
  • Myocardium / metabolism
  • Perhexiline / analogs & derivatives*
  • Perhexiline / metabolism
  • Perhexiline / pharmacokinetics*
  • Perhexiline / pharmacology

Substances

  • Cardiovascular Agents
  • Cytochrome P-450 CYP2D6
  • Perhexiline