TY - JOUR AU - Roehrig, Susanne AU - Ackerstaff, Jens AU - Jiménez Núñez, Eloísa AU - Teller, Henrik AU - Ellerbrock, Pascal AU - Meier, Katharina AU - Heitmeier, Stefan AU - Tersteegen, Adrian AU - Stampfuss, Jan AU - Lang, Dieter AU - Schlemmer, Karl-Heinz AU - Schaefer, Martina AU - Gericke, Kersten M. AU - Kinzel, Tom AU - Meibom, Daniel AU - Schmidt, Martina AU - Gerdes, Christoph AU - Follmann, Markus AU - Hillisch, Alexander TI - Design and Preclinical Characterization Program toward Asundexian (BAY 2433334), an Oral Factor XIa Inhibitor for the Prevention and Treatment of Thromboembolic Disorders JO - Journal of medicinal chemistry VL - 66 IS - 17 SN - 0095-9065 CY - Washington, DC PB - ACS M1 - PUBDB-2023-08014 SP - 12203 - 12224 PY - 2023 AB - Activated coagulation factor XI (FXIa) is a highly attractive antithrombotic target as it contributes to the development and progression of thrombosis but is thought to play only a minor role in hemostasis so that its inhibition may allow for decoupling of antithrombotic efficacy and bleeding time prolongation. Herein, we report our major efforts to identify an orally bioavailable, reversible FXIa inhibitor. Using a protein structure-based de novo design approach, we identified a novel micromolar hit with attractive physicochemical properties. During lead modification, a critical problem was balancing potency and absorption by focusing on the most important interactions of the lead series with FXIa while simultaneously seeking to improve metabolic stability and the cytochrome P450 interaction profile. In clinical trials, the resulting compound from our extensive research program, asundexian (BAY 2433334), proved to possess the desired DMPK properties for once-daily oral dosing, and even more importantly, the initial pharmacological hypothesis was confirmed. LB - PUB:(DE-HGF)16 C6 - 37669040 UR - <Go to ISI:>//WOS:001062618600001 DO - DOI:10.1021/acs.jmedchem.3c00795 UR - https://bib-pubdb1.desy.de/record/600501 ER -