Discovery of Potent and Selective Quinoxaline-Based Protease-Activated Receptor 4 (PAR4) Antagonists for the Prevention of Arterial Thrombosis

J Med Chem. 2024 Mar 14;67(5):3571-3589. doi: 10.1021/acs.jmedchem.3c01986. Epub 2024 Feb 22.

Abstract

PAR4 is a promising antithrombotic target with potential for separation of efficacy from bleeding risk relative to current antiplatelet therapies. In an effort to discover a novel PAR4 antagonist chemotype, a quinoxaline-based HTS hit 3 with low μM potency was identified. Optimization of the HTS hit through the use of positional SAR scanning and the design of conformationally constrained cores led to the discovery of a quinoxaline-benzothiazole series as potent and selective PAR4 antagonists. The lead compound 48, possessing a 2 nM IC50 against PAR4 activation by γ-thrombin in platelet-rich plasma (PRP) and greater than 2500-fold selectivity versus PAR1, demonstrated robust antithrombotic efficacy and minimal bleeding in the cynomolgus monkey models.

MeSH terms

  • Animals
  • Blood Platelets
  • Fibrinolytic Agents* / pharmacology
  • Fibrinolytic Agents* / therapeutic use
  • Hemorrhage
  • Macaca fascicularis
  • Platelet Aggregation
  • Quinoxalines / pharmacology
  • Quinoxalines / therapeutic use
  • Receptor, PAR-1
  • Receptors, Thrombin
  • Thrombin
  • Thrombosis* / drug therapy
  • Thrombosis* / prevention & control

Substances

  • protease-activated receptor 4
  • Fibrinolytic Agents
  • Quinoxalines
  • Receptors, Thrombin
  • Thrombin
  • Receptor, PAR-1