Discovery of Clinical Candidate 2-((2S,6S)-2-Phenyl-6-hydroxyadamantan-2-yl)-1-(3'-hydroxyazetidin-1-yl)ethanone [BMS-816336], an Orally Active Novel Selective 11 beta-Hydroxysteroid Dehydrogenase Type 1 Inhibitor.
Ye, X.Y., Chen, S.Y., Wu, S., Yoon, D.S., Wang, H., Hong, Z., O'Connor, S.P., Li, J., Li, J.J., Kennedy, L.J., Walker, S.J., Nayeem, A., Sheriff, S., Camac, D.M., Ramamurthy, V., Morin, P.E., Zebo, R., Taylor, J.R., Morgan, N.N., Ponticiello, R.P., Harrity, T., Apedo, A., Golla, R., Seethala, R., Wang, M., Harper, T.W., Sleczka, B.G., He, B., Kirby, M., Leahy, D.K., Li, J., Hanson, R.L., Guo, Z., Li, Y.X., DiMarco, J.D., Scaringe, R., Maxwell, B., Moulin, F., Barrish, J.C., Gordon, D.A., Robl, J.A.(2017) J Med Chem 60: 4932-4948
- PubMed: 28537398 
- DOI: https://doi.org/10.1021/acs.jmedchem.7b00211
- Primary Citation of Related Structures:  
5PGU, 5PGV, 5PGW, 5PGX, 5PGY, 5PGZ - PubMed Abstract: 
BMS-816336 (6n-2), a hydroxy-substituted adamantyl acetamide, has been identified as a novel, potent inhibitor against human 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) enzyme (IC 50 3.0 nM) with >10000-fold selectivity over human 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2). 6n-2 exhibits a robust acute pharmacodynamic effect in cynomolgus monkeys (ED 50 0.12 mg/kg) and in DIO mice. It is orally bioavailable (%F ranges from 20 to 72% in preclinical species) and has a predicted pharmacokinetic profile of a high peak to trough ratio and short half-life in humans. This ADME profile met our selection criteria for once daily administration, targeting robust inhibition of 11β-HSD1 enzyme for the first 12 h period after dosing followed by an "inhibition holiday" so that the potential for hypothalamic-pituitary-adrenal (HPA) axis activation might be mitigated. 6n-2 was found to be well-tolerated in phase 1 clinical studies and represents a potential new treatment for type 2 diabetes, metabolic syndrome, and other human diseases modulated by glucocorticoid control.
Organizational Affiliation: 
Discovery Chemistry, ‡Pharmaceutical Candidate Optimization, §Computer-Assisted Drug Design, ∥Metabolic Diseases Biology, ⊥Lead Evaluation, #Process Chemistry, ∇Chemical Synthesis, ○Discovery Toxicology, Research and Development, Bristol-Myers Squibb , 350 Carter Road, Princeton, New Jersey 08540, United States.