An oral non-substrate-like DPP-4 inhibitor used for treating diabetes. dpp4 inhibitor, antidiabetic drug

Anagliptin

Description

Oral anti-diabetic drug

Target(s)

Dipeptidyl peptidase-4 (DPP-4)

Generic

anagliptin

Commercial Name

Suiny, Beskoa (Japan)

Combination Drug(s)

N/A

Other Synonyms

BMS 477118

IUPAC Name

N-[2-({2-[(2S)-2-cyanopyrrolidin-1-yl]-2-oxoethyl}amino)-2-methylpropyl]-2-methylpyrazolo[1,5-a]pyrimidine-6-carboxamide

Ligand Code in PDB

SKK

3D Structure of anagliptin bound to target protein DPP-4

PDB ID 3wqh

Table 1. Basic Profile of anagliptin

Figure 1. 2D Structure of Anagliptin

2D and 3D Structure of anagliptin.

Drug Information: 

Chemical Formula

C19H25N7O2

Molecular Weight

383.45 g/mol

Calculated Predicted Partition Coefficient: cLogP

-0.765

Calculated Predicted Aqueous Solubility: cLogS

N/A

Solubility (in water)

0.25 mg/mL (sparingly soluble) (Chemblink)

Predicted Topological Polar Surface Area (TPSA)

115 Å2

Table 2. Chemical and physical properties (PubChem).

*Note: Predicted values may slightly vary from source to source. 

Drug Target: 

Anagliptin is an orally active, potent non-substrate-like DPP-4 inhibitor. Anagliptin competitively inhibits DPP-4, an enzyme that breaks down incretin hormones GLP-1 and GIP. Therefore, anagliptin's mechanism of action for inhibiting the functionality of DPP-4 is centered around binding to its active site. This prevents the incretins from interacting with the active site region, and instead they undergo digestion by the enzyme. By preventing inactivation of incretins, anagliptin indirectly increases concentrations of active GLP-1 and GIP, which then stimulate insulin release and prevent postprandial hyperglycemia.  

Drug-Target Complex: 

Dipeptidyl peptidase-4 (DPP-4)

DPP-4 is a transmembrane glycoprotein made up of 766 amino acids and consists of five regions:

Figure 2. Overall structure of human DPP-4 monomer in ribbon representation showing the N- and C-termini and color-coded regions labeled, including cysteine-rich region (pink), the highly glycosylated region (cyan) and the catalytic domain (orange). Anagliptin is shown as a ball-and-stick representation (PDB ID: 3wqh; Watanabe et al., 2015).

Because anagliptin is a non-substrate-like inhibitor of DPP-4, it does not mimic the dipeptidic nature of the DPP-4 substrates. Instead, it binds to DPP-4 through non-covalent interactions. In this class of inhibitors an aromatic group usually occupies the S1 hydrophobic sub-pocket of the active site of DPP-4.

Figure 3. X-ray crystal structure of the DPP-4 dimer (ribbons) with bound anagliptin (ball-and-stick). The DPP-4 monomer on the right is color-coded by region as in Figure 2 and the monomer on the left is shown as a grey ribbon (PDB ID: 3wqh; Watanabe et al., 2015). Surface of the active site of DPP-4 is shown in the inset. Anagliptin is shown in a ball-and-stick representation, color-coded by atom type (C: gray; N: blue; O: red; F: green). Selected residues in the active sites are shown in the stick representation. 

The X-ray structure of DPP-4 bound to anagliptin (PDB entry 3wqh) is shown in Figure 3. The black outlined box denotes the location of the active site. The figure at the bottom right shows a close-up view of anagliptin (ball-and-stick) in the active site (grey surface).

Figure 4. Hydrogen bonding interactions (green lines) between anagliptin (ball-and-stick) and active site residues (sticks) (PDB ID: 3wqh; Watanabe et al., 2015). Figure 5. Hydrogen bonding interactions (green lines) between Diprotin A (ball-and-stick) and active site residues (sticks) (PDB ID: 1nu8; Thoma et al., 2003).
 

The co-crystal structure of DPP-4 and anagliptin (Watanabe et al., 2015) reveals the interactions of the drug with its pharmacological target, DPP-4 (Figure 4). Anagliptin does not covalently bind to Ser630 of DPP-4. Instead, a dipole interaction occurs between Ser630 and the cyano group of anagliptin; the cyanopyrrolidine binds to the S1 subsite; the amino group of the drug participates in hydrogen bonding with Glu205 and Glu206; the carbonyl group linked to the pyrazolopyrimidine ring forms a hydrogen bond with Arg358; and, this ring has pi-stacking interactions with Phe357. A comparison of the co-crystal structures of DPP-4 with anagliptin (PDB ID 3wqh, Figure 4) and DPP-4 with its substrate, Diprotin A (Ile-Pro-Ile), (PDB ID 1nu8, Figure 5) reveals that anagliptin acts by occluding the DPP-4 active site and prevents binding of incretin hormones.

Pharmacologic Properties and Safety: 

Features

Comment(s)

Source

Bioavailability (%)

73.2%

(Nakamura et al., 2015)

IC50 (nM)

3.8 nM

(Ervinna et al., 2013)

Ki (nM)

N/A

N/A

Half-life (hrs)

5.8-6.2 hours

(Furuta et al., 2013)

Duration of Action

N/A

N/A

Absorption

Human intestinal absorption

(“Anagliptin”)

Transporter(s)

P-glycoprotein (P-gp) and Organic anion transporting polypeptides OATP1B1-3

(May and Schindler, 2013)....??

Metabolism

Cytochrome p450

(Furuta et al., 2013)

Excretion

~73.2% urine; ~25.0% feces

(Furuta et al., 2013)

AMES Test (Carcinogenic Effect)

Negative (non AMES toxic)

(Kato et al., 2011)

hERG Safety Test (Cardiac Effect)

Negative (non-inhibitor)

(Kato et al., 2011)

Liver Toxicity

Contributes to an increased risk of hepatotoxicity

(“Anagliptin”)

Table 3. Pharmacokinetics: ADMET of anagliptin

Anagliptin is metabolized by a series of cytochrome p450 enzymes, during which the anagliptin molecule undergoes a hydrolysis reaction involving the cyano group that converts the anagliptin molecule into a carboxylate metabolite (Furuta et al., 2013). In humans, the major inactive metabolite in the plasma was SKL-12320. 50% of the concentration of the drug moves through the human body without being metabolized (Furuta et al., 2013). The metabolite and the molecule that was not metabolized are cleared from the body through both the digestive and urinary tracts. Approximately, 90% of the drug is cleared through the urinary system and the remaining remnants of the drug are cleared along with the fecal matter (Furuta et al., 2013).

Anagliptin underwent a double blind phase III trial sponsored by JW Pharmaceuticals that took place at Kangbuk Samsung Hospital in South Korea (Park, 2013). The trial involved 117 participants, began in May of 2011 and concluded in September of 2012 (Park, 2013).

Drug Interactions and Side Effects: 

Features

Comment(s)

Source

Total Number of Drugs Interactions

N/A

N/A

Major Drug Interactions

N/A

N/A

Alcohol/Food Interaction(s)

N/A

N/A

Disease Interaction(s)

N/A

N/A

On-target Side Effects

Constipation, hypoglycemia

(Park, 2013)

Off-target Side Effects

Rash, intestinal obstruction, abdominal pain

(Park, 2013)

CYP Interactions

Non-inhibitor and non-inducer of major liver metabolic enzymes (e.g. CYP3A4, CYP2C19, CYP2C8, CYP2C9, CYP1A2, and CYP2D6.

(Kato et al., 2011)

Table 4. Drug interactions and side effects of anagliptin

The only side effects when the drug is on target are hypoglycemia and constipation (Park, 2013). These are relatively explainable side effects as any drug that offers to increase the concentration of insulin in the body runs the risk of inducing hypoglycemia, especially when taken in combination therapy with medications such as alpha-glucosidase inhibitors and sulfonylureas. Additionally, because the drug also influences the activity of digestive hormones, constipation is another predictable side effect. The off-target side effects can be broken into two categories: minor and severe. The primary minor off-target side effect is a mild rash (Park, 2013). Meanwhile, the major off-target side effects include intestinal obstructions and severe abdominal pain (Park, 2013).

Concomitant administration of anagliptin and miglitol, an α-glucosidase inhibitor, improved glycemic control and increased the postprandial level of active GLP-1 more effectively than either of the drugs alone, suggesting that combination therapy these two drugs would effectively manage type 2 diabetes (Kim and Kaku, 2012). 

Regulatory Approvals/Commercial: 

Approved by Pharmaceuticals and Medical Devices Agency of Japan (PMDA) on September 28, 2012, anagliptin is prescribed as an oral tablet containing either 100 or 200 mg (Park, 2013). It was co-developed and co-marketed as Suiny® by Sanwa Kagaku Kenkyusho and Kowa as an antidiabetic treatment therapy for type 2 diabetes (“Anagliptin”). 

Links: 

chemBlink

http://www.chemblink.com/products/739366-20-2.htm

Pharmacodia

http://www.pharmacodia.com/web/drug/1_225.html

PubChem

https://pubchem.ncbi.nlm.nih.gov/compound/44513473

Tripod

https://tripod.nih.gov/ginas/app/substance/K726J96838

Table 5. Links to relevant resources

References: 

"Anagliptin". Pharmacodia. N.p., 28 Mar. 2016. Web. <http://www.pharmacodia.com/yaodu/html/v1/chemicals/635440afdfc39fe37995fed127d7df4f.html>.

Chemblink: Anagliptin. <http://www.chemblink.com/products/739366-20-2.htm>.

Desai, M.C. (2013). “Anagliptin (Antidiabetic)”. Annual Reports in Medicinal Chemistry, 1st Edition. 48: 483-85. Print.

Ervinna, N., Mita, T., Yasunari, E., Azuma, K., Tanaka, R., Fujimura, S., Sukmawati, D., Nomiyama, T., Kanazawa, A., Kawamori, R., Fujitani, Y., Watada, H. (2013). Anagliptin, a DPP-4 Inhibitor, Suppresses Proliferation of Vascular Smooth Muscles and Monocyte Inflammatory Reaction and Attenuates Atherosclerosis in Male Apo E-Deficient Mice. Endocrinology, 154(3): 1260-70. doi: 10.1210/en.2012-1855.

Furuta, S., Smart, C., Hackett, A., Benning, R., Warrington, S. (2013). Pharmacokinetics and Metabolism of [14C]Anagliptin, a Novel Dipeptidyl Peptidase-4 Inhibitor, in Humans. Xenobiotica, 43(5): 432-42. doi: 10.3109/00498254.2012.731618.

Kato, N., Oka, M., Murase, T., Yoshida, M., Sakairi, M., Yamashita, S., Yasuda, Y., Yoshikawa, A., Hayashi, Y., Makino, M., Takeda, M., Mirensha, Y., Kakigami, T. (2011). Discovery and Pharmacological Characterization of N-[2-({2-[(2S)-2-Cyanopyrrolidin-1-Yl]-2-Oxoethyl}Amino)-2-Methylpropyl]-2-Methylpyrazolo[1,5-A]Pyrimidine-6-Carboxamide Hydrochloride (Anagliptin Hydrochloride Salt) as a Potent and Selective DPP-IV Inhibitor. Bioorganic & Medicinal Chemistry, 19(23): 7221-27. doi: 10.1016/j.bmc.2011.09.043.

Kim. H., Kaku, K. (2012). Drug Interaction between Anagliptin, a Novel Dipeptidyl Peptidase-4 Inhibitor, and Miglitol, an α-glucosidase Inhibitor, in Japanese Patients with Type 2 Diabetes. Japan Pharmacology & Therapeutics, 40(10): 871–81.

Nakamura, Y., Hasegawa, H., Tsuji, M., Udaka, Y., Mihara, M., Shimizu, T., Inoue, M., Goto, Y., Gotoh, H., Inagaki, M., Oguchi, K. (2015). Diabetes Therapies in Hemodialysis Patients: Dipeptidase-4 Inhibitors. World Journal of Diabetes, 6(6): 840. doi: 10.4239/wjd.v6.i6.840.

Park, S.W.. "A Study to Efficacy and Safety of CWP-0403 in Type 2 Diabetes Mellitus Patients”. Clinicaltrials.gov. N.p., 2 Jan. 2013. < https://clinicaltrials.gov/ct2/show/NCT01529528>

PubChem: Anagliptin. https://pubchem.ncbi.nlm.nih.gov/compound/Anagliptin#section=2D-Structure.

Thoma, R., Loffler, B., Stihle, M., Huber, W., Ruf, A., Hennig, M. (2003). Structural basis of proline-specific exopeptidase activity as observed in human dipeptidyl peptidase-IV. Structure. 11(8), 947-959.  doi: 10.1016/S0969-2126(03)00160-6.

Watanabe, Y.S., Yasuda, Y., Kojima, Y., Okada, S., Motoyama, T., Takahashi, R., Oka, M. (2015). Anagliptin, a Potent Dipeptidyl Peptidase IV Inhibitor: its Single-Crystal Structure and Enzyme Interactions. Journal of Enzyme Inhibition and Medicinal Chemistry, 30(6): 981-88. doi: 10.3109/14756366.2014.1002402. 


Summer 2016, Matthew J. Brown, Jennifer Jiang, Sutapa Ghosh; Reviewed by ***