Tale of Two Polymorphs: Investigating the Structural Differences and Dynamic Relationship between Nirmatrelvir Solid Forms (Paxlovid)

Mol Pharm. 2024 Aug 5;21(8):3800-3814. doi: 10.1021/acs.molpharmaceut.3c01074. Epub 2024 Jul 25.

Abstract

Two anhydrous polymorphs of the novel antiviral medicine nirmatrelvir were discovered during the development of Paxlovid, Pfizer's oral Covid-19 treatment. A comprehensive experimental and computational approach was necessary to distinguish the two closely related polymorphs, herein identified as Forms 1 and 4. This approach paired experimental methods, including powder X-ray diffraction and single-crystal X-ray diffraction, solid-state experimental methods, thermal analysis, solid-state nuclear magnetic resonance and Raman spectroscopy with computational investigations comprising crystal structure prediction, Gibbs free energy calculations, and molecular dynamics simulations of the polymorphic transition. Forms 1 and 4 were ultimately determined to be enantiotropically related polymorphs with Form 1 being the stable form above the transition temperature of ∼17 °C and designated as the nominated form for drug development. The work described in this paper shows the importance of using highly specialized orthogonal approaches to elucidate the subtle differences in structure and properties of similar solid-state forms. This synergistic approach allowed for unprecedented speed in bringing Paxlovid to patients in record time amidst the pandemic.

Keywords: computational chemistry; molecular dynamics; polymorphism; solid-state chemistry; transition dynamics.

MeSH terms

  • Antiviral Agents* / chemistry
  • COVID-19 Drug Treatment*
  • Crystallization*
  • Crystallography, X-Ray / methods
  • Magnetic Resonance Spectroscopy / methods
  • Molecular Dynamics Simulation*
  • SARS-CoV-2 / drug effects
  • Spectrum Analysis, Raman / methods
  • Transition Temperature
  • X-Ray Diffraction* / methods

Substances

  • Antiviral Agents