Tabimorelin

Last updated
Tabimorelin
Tabimorelin skeletal.svg
Clinical data
Other names((2E)-5-amino-5-methylhex-2-enoic acid N-methyl-N-((1R)-1-(N-methyl-N-((1R)-1-(methylcarbamoyl)-2-phenylethyl)carbamoyl)-2-(2-naphthyl)ethyl)amide)
ATC code
  • none
Identifiers
  • N-[(2E)-5-amino-5-methylhex-enoyl]-N-methyl-3-(2-naphthyl)alanyl-N,Nα-dimethyl-D-phenylalaninamide
CAS Number
PubChem CID
ChemSpider
UNII
Chemical and physical data
Formula C32H40N4O3
Molar mass 528.697 g·mol−1
3D model (JSmol)
  • CC(C)(C/C=C/C(=O)N(C)[C@H](CC1=CC2=CC=CC=C2C=C1)C(=O)N(C)[C@H](CC3=CC=CC=C3)C(=O)NC)N
  • InChI=1S/C32H40N4O3/c1-32(2,33)19-11-16-29(37)35(4)28(22-24-17-18-25-14-9-10-15-26(25)20-24)31(39)36(5)27(30(38)34-3)21-23-12-7-6-8-13-23/h6-18,20,27-28H,19,21-22,33H2,1-5H3,(H,34,38)/b16-11+/t27-,28-/m1/s1
  • Key:WURGZWOTGMLDJP-ZCYANPAGSA-N
   (verify)

Tabimorelin (INN) (developmental code name NN-703) is a drug which acts as a potent, orally-active agonist of the ghrelin/growth hormone secretagogue receptor (GHSR) and growth hormone secretagogue, mimicking the effects of the endogenous peptide agonist ghrelin as a stimulator of growth hormone (GH) release. It was one of the first GH secretagogues developed and is largely a modified polypeptide, but it is nevertheless orally-active in vivo. [1] Tabimorelin produced sustained increases in levels of GH and insulin-like growth factor 1 (IGF-1), along with smaller transient increases in levels of other hormones such as adrenocorticotropic hormone (ACTH), cortisol, and prolactin. [2] [3] However actual clinical effects in adults with growth hormone deficiency were limited, with only the most severely GH-deficient patients showing significant benefit, [4] and tabimorelin was also found to act as a CYP3A4 inhibitor which could cause it to have undesirable interactions with other drugs. [5]

See also

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Relamorelin

Relamorelin is a synthetic peptide, centrally penetrant, selective agonist of the ghrelin/growth hormone secretagogue receptor (GHSR) which is under development by Allergan pharmaceuticals for the treatment of diabetic gastroparesis, chronic idiopathic constipation, and anorexia nervosa. It is a pentapeptide and an analogue of ghrelin with improved potency and pharmacokinetics. In humans, relamorelin produces increases in plasma growth hormone, prolactin, and cortisol levels, and, like other GHSR agonists, increases appetite. As of June 2015, relamorelin is in phase II clinical trials for diabetic gastroparesis and constipation. The United States Food and Drug Administration (FDA) has granted Fast Track designation to relamorelin for diabetic gastroparesis.

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Ulimorelin

Ulimorelin is a drug with a modified cyclic peptide structure which acts as a selective agonist of the ghrelin/growth hormone secretagogue receptor (GHSR-1a).. Unlike many related drugs, ulimorelin has little or no effect on growth hormone (GH) release in rats. However, like ghrelin and other ghrelin agonists, ulimorelin does stimulate GH release with concomitant increases in insulin-like growth factor 1 (IGF-1) in humans. It has been researched for enhancing gastrointestinal motility, especially in gastroparesis and in aiding recovery of bowel function following gastrointestinal surgery, where opioid analgesic drugs used for post-operative pain relief may worsen existing constipation. While ulimorelin has been shown to increase both upper and lower gastrointestinal motility in rats, and showed promising results initially in humans, it failed in pivotal clinical trials in post operative ileus.

References

  1. Hansen BS, Raun K, Nielsen KK, Johansen PB, Hansen TK, Peschke B, et al. (August 1999). "Pharmacological characterisation of a new oral GH secretagogue, NN703". European Journal of Endocrinology. 141 (2): 180–9. doi: 10.1530/eje.0.1410180 . PMID   10427162.
  2. Zdravkovic M, Søgaard B, Ynddal L, Christiansen T, Agersø H, Thomsen MS, et al. (August 2000). "The pharmacokinetics, pharmacodynamics, safety and tolerability of a single dose of NN703, a novel orally active growth hormone secretagogue in healthy male volunteers". Growth Hormone & IGF Research. 10 (4): 193–8. doi:10.1054/ghir.2000.0152. PMID   11032702.
  3. Zdravkovic M, Christiansen T, Eliot L, Agersoe H, Thomsen MS, Falch JF, et al. (February 2001). "The pharmacokinetics, pharmacodynamics, safety and tolerability following 7 days daily oral treatment with NN703 in healthy male subjects". Growth Hormone & IGF Research. 11 (1): 41–8. doi:10.1054/ghir.2000.0188. PMID   11437473.
  4. Svensson J, Monson JP, Vetter T, Hansen TK, Savine R, Kann P, et al. (May 2003). "Oral administration of the growth hormone secretagogue NN703 in adult patients with growth hormone deficiency". Clinical Endocrinology. 58 (5): 572–80. doi:10.1046/j.1365-2265.2003.01754.x. PMID   12699438. S2CID   33510538.
  5. Zdravkovic M, Olsen AK, Christiansen T, Schulz R, Taub ME, Thomsen MS, et al. (February 2003). "A clinical study investigating the pharmacokinetic interaction between NN703 (tabimorelin), a potential inhibitor of CYP3A4 activity, and midazolam, a CYP3A4 substrate". European Journal of Clinical Pharmacology. 58 (10): 683–8. doi:10.1007/s00228-002-0539-1. PMID   12610745. S2CID   22546247.