Title:Should the Incorporation of Structural Alerts be Restricted in Drug Design? An Analysis of Structure-Toxicity Trends with Aniline-Based Drugs
Volume: 22
Issue: 4
Author(s): A.S. Kalgutkar
Affiliation:
关键词:
药物不良反应，苯胺，药物，细胞色素P450，谷胱甘肽，特殊的，活性代谢物
摘要: Certain idiosyncratic adverse drug reactions (IADRs) can be triggered by electrophilic protein-reactive metabolites
that are formed in the process of drug metabolism. While methodologies (e.g., structural alert concept in drug design,
glutathione (GSH) trapping, and protein covalent binding) for examining reactive metabolite (RM) formation are available,
predicting the IADR potential applying these parameters remains a significant challenge. The present work examines
toxicity trends associated with the aniline structural alert in the top 200 prescribed drugs of 2011 and recently approved
(2009-2013) small molecule drugs, in relation with 30 aniline-based drugs withdrawn from commercial use or associated
with a black box warning for IADRs. The aniline sub-structure was found in several drugs from the toxic, mostprescribed,
and recently approved category. RMs resulting from the bioactivation of the aniline alert was also noted in the
three categories chosen for comparison. A major discriminator between the toxic drugs and the majority of drugs in the
most-prescribed list, however, was the daily dose – drugs most frequented associated with IADRs were the ones with
higher daily doses (exceeding hundreds of milligrams). A greater tolerance for IADRs was also noted with certain drugs
intended to treat rare, unmet medical needs (e.g., cancer). Overall, the analysis suggests that optimization of pharmacologic
potency and pharmacokinetics that would lead to a lower daily dose, and therefore, a lower body burden of parent
drug/metabolites, should be taken into consideration in drug discovery.
