The American Chemical Society 239th National Meeting, held in San Francisco, included topics covering developments related to the chemical optimization of therapeutics. This conference report highlights selected presentations on second-generation cholesterol absorption inhibitors (CAIs), CCK2 receptor antagonists to prevent acid rebound, HIF-PH inhibitors for anemia, the neonatal Fc receptor (FcRn) as a target for autoimmune disease, and GPR119 agonists and GLP-1 receptor agonists for the treatment of diabetes. Investigational drugs discussed include LPD-608 (Lipideon Biotechnology AG), a second-generation CAI series from Merck & Co Inc, JNJ-26070109 and JNJ-42041935 (both Johnson & Johnson), SYN-1436 (Syntonix Pharmaceuticals Inc), a series of GPR119 agonists from Roche Holding AG and Schering-Plough Research Institute, and a series of GLP-1 receptor agonists from Bristol-Myers Squibb Co.