Q1 · MEDICINE
Article
Author: Chatterjee, Arnab K. ; Chi, Victor ; Schultz, Peter G. ; Woods, Ashley K. ; Gebara-Lamb, Amal ; Dayan Elshan, N. G. R. ; Joseph, Sean B. ; Ghorai, Sourav ; Wilson, Katy ; Beutler, Nathan ; Li, Shuangwei ; Nazarian, Armen ; Grabovyi, Gennadii ; Weiss, Frank ; Nguyen-Tran, Vân T. B. ; Kirkpatrick, Melanie G. ; Gupta, Anil Kumar ; Liu, Yuyin ; Song, Lirui ; Wolff, Karen C. ; Malvin, Jacqueline ; Bakowski, Malina A. ; McNamara, Case W. ; Huang, Edward ; Okwor, Neechi ; Riva, Laura ; Rahimi, Alireza ; Rogers, Thomas F. ; Chen, Jian Jeffrey ; Mazumdar, Wrickban ; Pedroarena, James
There remains a need to develop novel SARS-CoV-2 therapeutic options that improve upon existing therapies by an increased robustness of response, fewer safety liabilities, and global-ready accessibility. Functionally critical viral main protease (Mpro, 3CLpro) of SARS-CoV-2 is an attractive target due to its homology within the coronaviral family, and lack thereof toward human proteases. In this disclosure, we outline the advent of a novel SARS-CoV-2 3CLpro inhibitor, CMX990, bearing an unprecedented trifluoromethoxymethyl ketone warhead. Compared with the marketed drug nirmatrelvir (combination with ritonavir = Paxlovid), CMX990 has distinctly differentiated potency (∼5× more potent in primary cells) and human in vitro clearance (>4× better microsomal clearance and >10× better hepatocyte clearance), with good in vitro-to-in vivo correlation. Based on its compelling preclinical profile and projected once or twice a day dosing supporting unboosted oral therapy in humans, CMX990 advanced to a Phase 1 clinical trial as an oral drug candidate for SARS-CoV-2.