Coupling of an Acyl Migration Prodrug Strategy with Bio-activation To Improve Oral Delivery of the HIV-1 Protease Inhibitor Atazanavir

J Med Chem. 2018 May 10;61(9):4176-4188. doi: 10.1021/acs.jmedchem.8b00277. Epub 2018 Apr 25.

Abstract

HIV-1 protease inhibitors (PIs), which include atazanavir (ATV, 1), remain important medicines to treat HIV-1 infection. However, they are characterized by poor oral bioavailability and a need for boosting with a pharmacokinetic enhancer, which results in additional drug-drug interactions that are sometimes difficult to manage. We investigated a chemo-activated, acyl migration-based prodrug design approach to improve the pharmacokinetic profile of 1 but failed to obtain improved oral bioavailability over dosing the parent drug in rats. This strategy was refined by conjugating the amine with a promoiety designed to undergo bio-activation, as a means of modulating the subsequent chemo-activation. This culminated in a lead prodrug that (1) yielded substantially better oral drug delivery of 1 when compared to the parent itself, the simple acyl migration-based prodrug, and the corresponding simple l-Val prodrug, (2) acted as a depot which resulted in a sustained release of the parent drug in vivo, and (3) offered the benefit of mitigating the pH-dependent absorption associated with 1, thereby potentially reducing the risk of decreased bioavailability with concurrent use of stomach-acid-reducing drugs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Animals
  • Atazanavir Sulfate / administration & dosage
  • Atazanavir Sulfate / metabolism*
  • Atazanavir Sulfate / pharmacokinetics
  • Atazanavir Sulfate / pharmacology*
  • Biological Availability
  • Fatty Acid Transport Proteins / metabolism
  • HIV Protease Inhibitors / administration & dosage
  • HIV Protease Inhibitors / metabolism*
  • HIV Protease Inhibitors / pharmacokinetics
  • HIV Protease Inhibitors / pharmacology*
  • Prodrugs / metabolism*
  • Rats
  • Rats, Sprague-Dawley
  • Symporters / metabolism
  • Tissue Distribution

Substances

  • Fatty Acid Transport Proteins
  • HIV Protease Inhibitors
  • Prodrugs
  • Symporters
  • biotin transporter
  • Atazanavir Sulfate