Bioorganic & Medicinal Chemistry Letters 18 (2008) 2167–2171
Adenosine analogues as inhibitors of P2Y12 receptor
mediated platelet aggregation
James G. Douglass, J. Bryan deCamp, Emilee H. Fulcher, William Jones, Sanjoy Mahanty,
*
´
Anna Morgan, Dima Smirnov, Jose L. Boyer and Paul S. Watson
Inspire Pharmaceuticals, Inc., Department of Medicinal Chemistry, 4222 Emperor Boulevard, Suite 200, Durham, NC 27703, USA
Received 15 November 2007; revised 8 January 2008; accepted 10 January 2008
Available online 13 January 2008
Abstract—Modified adenosine derivatives may lead to the development of P2Y12 antagonists that are potent, selective, and bind
reversibly to the receptor. Analogues of 20,30-trans-styryl acetal-N6-ureido-adenosine monophosphate were prepared by modifica-
tion of the 50-position. The resulting analogues were tested for P2Y12 antagonism in a platelet aggregation assay.
Ó 2008 Elsevier Ltd. All rights reserved.
PlavixÒ (clopidogrel bisulfate tablets), an inhibitor of
ADP-induced platelet aggregation,1 acts by irreversible
inhibition of activation of the P2Y12 receptor.2 It has
been shown clinically that the incidence of myocardial
infarction and stroke are reduced by irreversible inhibi-
tion of ADP-induced platelet aggregation.3
for the discovery of new chemotypes that antagonize
the P2Y12 receptor. In fact, this approach has led to
the discovery of a novel reversible short-acting antag-
onist, cangrelor (1),6 and AZD6140 (2),7 a reversible
orally available antagonist discovered by AstraZeneca
scientists (Fig. 1).
However, several limitations regarding the use of irre-
versible P2Y12 receptor antagonists have been identi-
fied which include (1) a low level of inhibition in
approximately one third of the patient population,
(2) variability of the response from patient to patient
with the available dosing regimens,4 (3) the current
drugs require hepatic activation, and (4) irreversible
inhibition complicates the drug’s usefulness when pro-
cedures, such as coronary artery bypass graft surgery
(CABG), become necessary in a patient’s treatment
protocol.5 In the past decade, there have been several
efforts to design and develop improved irreversible
P2Y12 receptor antagonists and to explore the useful-
ness of reversible intravenous and orally administered
P2Y12 receptor antagonists. Most of these efforts focus
on the fact that adenosine triphosphate (ATP) acts as
an antagonist of the P2Y12 receptor. This invites the
possibility of exploring ATP mimetics as a foundation
Although the ATP mimetic approach has been suc-
cessful, several other reversible P2Y12 antagonists have
been described that do not mimic the ATP structural
components necessary for inhibition (Fig. 1).8,9 Work
in our own laboratories led to the discovery of
INS50589 (3), an adenosine monophosphate derivative
with 20,30-cyclic acetal and N6-urea modifications
(Fig. 2).10
Compound 3 inhibits platelet aggregation with an IC50
of 16 nM. This compound was evaluated in early clinical
trials as an intravenously delivered drug for cardiovas-
cular use.
This letter describes our initial efforts to discover non-
phosphate50-substituentsthatwouldmaintain thepotency
of our phosphate analogues and might also be useful for
developing an orally active reversible antagonist.
Based on previous results in the phosphate series, we
decided to focus on derivatives that contain the trans-
acetal derived from the reaction of the 20- and 30-hydro-
xyl groups of adenosine with trans-cinnamaldehyde and
an N6-ethyl urea. Our previous work demonstrated
Keywords: Adenosine derivatives; P2Y12 antagonists; Platelet aggre-
gation assay.
*
Corresponding author. Tel.: +1 919 287 1268; fax: +1 919 941
0960-894X/$ - see front matter Ó 2008 Elsevier Ltd. All rights reserved.
doi:10.1016/j.bmcl.2008.01.038