Discovery of Ervogastat (PF-06865571): A Potent and Selective Inhibitor of Diacylglycerol Acyltransferase 2 for the Treatment of Non-alcoholic Steatohepatitis

J Med Chem. 2022 Nov 24;65(22):15000-15013. doi: 10.1021/acs.jmedchem.2c01200. Epub 2022 Nov 2.

Abstract

Discovery efforts leading to the identification of ervogastat (PF-06865571), a systemically acting diacylglycerol acyltransferase (DGAT2) inhibitor that has advanced into clinical trials for the treatment of non-alcoholic steatohepatitis (NASH) with liver fibrosis, are described herein. Ervogastat is a first-in-class DGAT2 inhibitor that addressed potential development risks of the prototype liver-targeted DGAT2 inhibitor PF-06427878. Key design elements that culminated in the discovery of ervogastat are (1) replacement of the metabolically labile motif with a 3,5-disubstituted pyridine system, which addressed potential safety risks arising from a cytochrome P450-mediated O-dearylation of PF-06427878 to a reactive quinone metabolite precursor, and (2) modifications of the amide group to a 3-THF group, guided by metabolite identification studies coupled with property-based drug design.

MeSH terms

  • Diacylglycerol O-Acyltransferase*
  • Drug Design
  • Humans
  • Liver Cirrhosis
  • Non-alcoholic Fatty Liver Disease* / drug therapy

Substances

  • Diacylglycerol O-Acyltransferase
  • ervogastat