Discovery of MK-8153, a Potent and Selective ROMK Inhibitor and Novel Diuretic/Natriuretic

J Med Chem. 2021 Jun 10;64(11):7691-7701. doi: 10.1021/acs.jmedchem.1c00406. Epub 2021 May 26.

Abstract

A renal outer medullary potassium channel (ROMK, Kir1.1) is a putative drug target for a novel class of diuretics with potential for treating hypertension and heart failure. Our first disclosed clinical ROMK compound, 2 (MK-7145), demonstrated robust diuresis, natriuresis, and blood pressure lowering in preclinical models, with reduced urinary potassium excretion compared to the standard of care diuretics. However, 2 projected to a short human half-life (∼5 h) that could necessitate more frequent than once a day dosing. In addition, a short half-life would confer a high peak-to-trough ratio which could evoke an excessive peak diuretic effect, a common liability associated with loop diuretics such as furosemide. This report describes the discovery of a new ROMK inhibitor 22e (MK-8153), with a longer projected human half-life (∼14 h), which should lead to a reduced peak-to-trough ratio, potentially extrapolating to more extended and better tolerated diuretic effects.

MeSH terms

  • Action Potentials / drug effects
  • Animals
  • Benzofurans / chemistry
  • Blood Pressure / drug effects
  • Diuretics / chemistry
  • Diuretics / metabolism
  • Diuretics / pharmacology
  • Dogs
  • Half-Life
  • Haplorhini
  • Humans
  • Male
  • Natriuretic Agents / chemistry*
  • Natriuretic Agents / metabolism
  • Natriuretic Agents / pharmacology
  • Piperazines / chemistry
  • Potassium / urine
  • Potassium Channel Blockers / chemistry*
  • Potassium Channel Blockers / metabolism
  • Potassium Channel Blockers / pharmacology
  • Potassium Channels, Inwardly Rectifying / antagonists & inhibitors*
  • Potassium Channels, Inwardly Rectifying / metabolism
  • Rats
  • Rats, Inbred SHR

Substances

  • Benzofurans
  • Diuretics
  • MK-7145
  • Natriuretic Agents
  • Piperazines
  • Potassium Channel Blockers
  • Potassium Channels, Inwardly Rectifying
  • Potassium