Discovery of a Conformationally Constrained Oxazolidinone with Improved Safety and Efficacy Profiles for the Treatment of Multidrug-Resistant Tuberculosis

J Med Chem. 2020 Sep 10;63(17):9316-9339. doi: 10.1021/acs.jmedchem.0c00500. Epub 2020 Aug 5.

Abstract

Tuberculosis (TB) remains a serious public health challenge, and the research and development of new anti-TB drugs is an essential component of the global strategy to eradicate TB. In this work, we discovered a conformationally constrained oxazolidinone 19c with improved anti-TB activity and safety profile through a focused lead optimization effort. Compound 19c displayed superior in vivo efficacy in a mouse TB infection model compared to linezolid and sutezolid. The druggability of compound 19c was demonstrated in a panel of assays including microsomal stability, cytotoxicity, cytochrome P450 enzyme inhibition, and pharmacokinetics in animals. Compound 19c demonstrated an excellent safety profile in a battery of safety assays, including mitochondrial protein synthesis, hERG K+, hCav1.2, and Nav1.5 channels, monoamine oxidase, and genotoxicity. In a 4 week repeated dose toxicology study in rats, 19c appeared to have less bone marrow suppression than linezolid, which has been a major liability of the oxazolidinone class.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Chlorocebus aethiops
  • Drug Design*
  • Female
  • Hep G2 Cells
  • Humans
  • Mice
  • Microbial Sensitivity Tests
  • Molecular Conformation*
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / physiology
  • Oxazolidinones / adverse effects
  • Oxazolidinones / chemistry*
  • Oxazolidinones / pharmacokinetics
  • Oxazolidinones / pharmacology*
  • Safety*
  • Tuberculosis, Multidrug-Resistant / drug therapy*
  • Vero Cells

Substances

  • Oxazolidinones