Synonyms: (±)-4 | (±)-SMT022357 | compound 4 [Babbs et al., 2020]
Compound class:
Synthetic organic
Comment: SMT022357 is a second-generation, oral utrophin modulator. It was developed from the same chemical series as clinically evaluated ezutromid, but with a new chemotype [1]. SMT022357 has improved physicochemical and ADME properties compared to ezutromid, and has demonstrated efficacy in dystrophin-deficient mdx mice [1-2]. The molecular target of SMT022357 has not been reported, but may be the aryl hydrocarbon receptor, in common with ezutromid.
Clinical rationale: Up-regulation of utrophin (UTRN; P46939) as being investigated as a disease-modifying approach for Duchenne muscular dystrophy (DMD). In the mdx mouse DMD model, increased levels of utrophin effectively acts as a substitute for the dystrophin (DMD; P11532) that is missing in DMD [3]. |
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Bioactivity Comments |
We show the structure of the racemate in this entry. Stereoselective synthesis showed that there was no significant difference in the activity or efficacy between the two enantiomers in preclinical studies, and the activities of the enantiomers was comparable to the racemic mixture [1]. SMT022357 increases the utrophin protein level in vitro and in vivo, and reduces skeletal, respiratory, and cardiac muscle pathology in the mdx mouse [2]. The two enantiomers had similar PK profiles in the mdx mouse, but this was not the case in rats. SMT022357 was found to be hepatotoxic in rats and its therapeutic window was considered to be too narrow to support clinical development. |