roxadustat   Click here for help

GtoPdb Ligand ID: 8454

Synonyms: ASP-1517 | ASP1517 | Evrenzo® | FG-4592 | FG4592
Approved drug PDB Ligand
roxadustat is an approved drug (EMA (2021))
Compound class: Synthetic organic
Comment: Roxadustat is a compound which inhibits hypoxia inducible factor prolyl hydroxylase (HIF-PH) activity. HIF-PH inhibitors are being investigated as novel therapies for anemia, especially anemia caused by chronic kindney disease (CKD) [2]. It is hoped that HIF-PH inhibitors will provide a more effective alternative to the use of erythropoetin replacement therapy plus iron supplementation in CKD patients.
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2D Structure
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Physico-chemical Properties
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Hydrogen bond acceptors 5
Hydrogen bond donors 3
Rotatable bonds 6
Topological polar surface area 108.75
Molecular weight 352.11
XLogP 0.99
No. Lipinski's rules broken 0
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Canonical SMILES OC(=O)CNC(=O)c1nc(C)c2c(c1O)ccc(c2)Oc1ccccc1
Isomeric SMILES OC(=O)CNC(=O)c1nc(C)c2c(c1O)ccc(c2)Oc1ccccc1
InChI InChI=1S/C19H16N2O5/c1-11-15-9-13(26-12-5-3-2-4-6-12)7-8-14(15)18(24)17(21-11)19(25)20-10-16(22)23/h2-9,24H,10H2,1H3,(H,20,25)(H,22,23)
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Summary of Clinical Use Click here for help
Roxadustat was the first HIF-PH inhibitor to reach Phase 3 clinical trial. Click here to link to's listing of registered Phase 3 roxadustat trials.
The EMA approved roxadustat for the treatment of anemia due to chronic kidney failure in August 2021.
Mechanism Of Action and Pharmacodynamic Effects Click here for help
Under normoxic conditions HIF-PH effects the degradation of HIF1-α subunits (using O2 as a substrate to hydroxylate proline residues in HIF-1α), resulting in minimal HIF-induced transcriptional activity. When oxygen levels are limited, HIF-1α is not directed for degradation, permittinh induction of transcription. HIF-PH inhibitors mimic this natural response to hypoxia, which stablises HIFα transcription factors thereby switching on transcription of genes associated with processes such as erythropoiesis and vasculogenesis [2]. In anemic patients HIF-PH inhibitors increase erythropoietin levels and subsequently increase red blood cell counts [1]. There are three human HIF-PHs, with gene symbols EGLN1, -2 and -3.