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| Other names | Matsupexol; AM006; AM-006; KDT-3594; KDT3594 |
| Routes of administration | Oral [1] [2] |
| Drug class | Dopamine receptor agonist; Dopamine D2 and D3 receptor agonist |
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| Formula | C22H34N6O2S |
| Molar mass | 446.61 g·mol−1 |
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Matsupexole (INN ; developmental code names AM006 and KDT-3594) is a dopamine receptor agonist which is under development for the treatment of Parkinson's disease. [1] [3] [2] [4] [5] It is taken orally. [1] [2]
The drug is a non-ergoline derivative related to pramipexole and acts as a dopamine D2 and D3 receptor agonist. [5] [4] [6] It has far lower selectivity for the dopamine D3 receptor over the dopamine D2 receptor than pramipexole and other non-ergoline dopamine receptor agonists. [5] Relatedly, whereas pramipexole and other non-ergoline dopamine receptor agonists like ropinirole and rotigotine produce somnolence in humans and pramipexole has been found to strongly promote non-REM sleep in rodents, these side effects being associated with dopamine D3 receptor agonism, matsupexole and cabergoline did not promote non-REM sleep at efficacious antiparkinsonian doses in rodents. [5] This may be due to a better balance of wakefulness-promoting dopamine D2 receptor activation versus sedating dopamine D3 receptor activation. [5] Similarly to pramipexole, but unlike cabergoline, matsupexole showed negligible activity as a serotonin 5-HT2B receptor agonist and hence is not thought to have a risk of cardiac valvulopathy. [5]
Matsupexole was first described in the scientific literature by 2017. [7] It originated by Kissei Pharmaceutical and is being developed by Kissei Pharmaceutical and AffaMed Therapeutics in Japan and China. [1] [3] [2] As of August 2025, the drug is in phase 2 clinical trials. [1] [3] [2] Matsupexole is described by its developers as a potential best-in-class dopamine receptor agonist for Parkinson's disease. [5]
KDT3594 (structure undisclosed) is a D2 agonist developed by Kissei Pharmaceuticals [16]. A phase 2 study was initiated in February 2019 to investigate the efficacy, safety, and PK of KDT3594 vs. pramipexole in patients with early PD without concomitant treatment with L-DOPA (NCT03845387).
Two other dopamine agonists have been evaluated in PD with motor fluctuations, but results are pending. KDT-3594 (matsupexole) is another non-ergot DA targeting dopamine D2 receptors [40] also currently in a phase II trial in individuals with advanced PD (ClinicalTrials.gov Identifier: NCT06722729).
Kissei Pharmaceuticals features a D2 agonist, KDT3594, on their pipeline chart in Phase 1 for PD.33 The structure has not been published, and there are no current US clinical trials listed.