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Review of preclinical data of PF-07304814 and its active metabolite derivatives against SARS-CoV-2 infection

Chen et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.1035969, NCT05011812
Nov 2022  
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Review of preclinical data for lufotrelvir and active metabolites for SARS-CoV-2. Lufotrelvir (PF-07304814) is a phosphate ester prodrug that is rapidly metabolized by alkaline phosphatase into the active compound PF-0835231, which suppresses SARS-CoV-2 replication by inhibiting the main protease (Mpro). Authors note that PF-07304814 increased the bioavailability of PF-00835231 by enhancing plasma protein binding. P-glycoprotein inhibitors and cytochrome P450 3A inhibitors increased the efficacy of PF-00835231 by suppressing its efflux from target cells and metabolism, respectively. PF-00835231 inhibited SARS-CoV-2 infection in various cell lines, human respiratory epithelial organ models, and animal models. PF-07304814 exhibited a short terminal elimination half-life and was cleared primarily through renal elimination, with no significant adverse effects observed in rats.
Chen et al., 11 Nov 2022, placebo-controlled, China, peer-reviewed, 6 authors, trial NCT05011812 (history). Contact:,
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Review of preclinical data of PF-07304814 and its active metabolite derivatives against SARS-CoV-2 infection
Wujun Chen, Yingchun Shao, Xiaojin Peng, Bing Liang, Jiazhen Xu, Dongming Xing
Frontiers in Pharmacology, doi:10.3389/fphar.2022.1035969
Main protease (M pro ) is a superior target for anti-SARS-COV-2 drugs. PF-07304814 is a phosphate ester prodrug of PF-00835231 that is rapidly metabolized into the active metabolite PF-00835231 by alkaline phosphatase (ALP) and then suppresses SARS-CoV-2 replication by inhibiting M pro . PF-07304814 increased the bioavailability of PF-00835231 by enhancing plasma protein binding (PPB). P-glycoprotein (P-gp) inhibitors and cytochrome P450 3A (CYP3A) inhibitors increased the efficacy of PF-00835231 by suppressing its efflux from target cells and metabolism, respectively. The life cycle of SARS-CoV-2 is approximately 4 h. The mechanisms and efficacy outcomes of PF-00835231 occur simultaneously. PF-00835231 can inhibit not only cell infection (such as Vero E6, 293T, Huh-7.5, HeLa +angiotensin- converting enzyme 2 (ACE2) , A549 +ACE2 , and MRC-5) but also the human respiratory epithelial organ model and animal model infection. PF-07304814 exhibits a short terminal elimination half-life and is cleared primarily through renal elimination. There were no significant adverse effects of PF-07304814 administration in rats. Therefore, PF-07304814 exhibits good tolerability, pharmacology, pharmacodynamics, pharmacokinetics, and safety in preclinical trials. However, the Phase 1 data of PF-07304814 were not released. The Phase 2/3 trial of PF-07304814 was also suspended. Interestingly, the antiviral activities of PF-00835231 derivatives (compounds 5-22) are higher than, similar to, or slightly weaker than those of PF-00835231. In particular, compound 22 exhibited the highest potency and had good safety and stability. However, the low solubility of compound 22 limits its clinical application. Prodrugs, nanotechnology and salt form drugs may solve this problem. In this review, we focus on the preclinical data of PF-07304814 and its active metabolite derivatives to hopefully provide knowledge for researchers to study SARS-CoV-2 infection.
Author contributions Conception and design: DX and JX. Manuscript writing: WC and YS. Acquisition and assembly of data: XP and BL. Final discussions and approval of the manuscript: All authors contributed to the article and approved the submitted version. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Supplementary material The Supplementary Material for this article can be found online at: 2022.1035969/full#supplementary-material
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