Discovery of 2-[3,5-Dichloro-4-(5-isopropyl-6-oxo-1,6-dihydropyridazin-3-yloxy)phenyl]-3,5-dioxo-2,3,4,5-tetrahydro[1,2,4]triazine-6-carbonitrile (MGL-3196), a Highly Selective Thyroid Hormone Receptor β Agonist in Clinical Trials for the Treatment of Dyslipidemia
Abstract
The beneficial effects of thyroid hormone (TH) on lipid levels are primarily due to its action at the thyroid hormone receptor β (THR-β) in the liver, while adverse effects, including cardiac effects, are mediated by thyroid hormone receptor α (THR-α). A pyridazinone series has been identified that is significantly more THR-β selective than earlier analogues. Optimization of this series by the addition of a cyanoazauracil substituent improved both the potency and selectivity and led to MGL-3196 (53), which is 28-fold selective for THR-β over THR-α in a functional assay. Compound 53 showed outstanding safety in a rat heart model and was efficacious in a preclinical model at doses that showed no impact on the central thyroid axis. In reported studies in healthy volunteers, 53 exhibited an excellent safety profile and decreased LDL cholesterol (LDL-C) and triglycerides (TG) at once daily oral doses of 50 mg or higher given for 2 weeks.
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Resmetirom is an orally active, liver-directed thyroid hormone receptor agonist with high selectivity for the beta1 receptor.
“Resmetirom is an orally active, liver-directed, thyroid hormone receptor agonist with high selectivity for the b 1 receptor.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [349]
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Emerging Therapeutic Targets and Experimental Drugs for the Treatment of NAFLD
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Thyroid hormone resistance: mechanisms and therapeutic development
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Current and Emerging Approaches for Nonalcoholic Steatohepatitis Treatment
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Main Factors Involved in Thyroid Hormone Action
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Resmetirom (MGL-3196) in Patients With Heterozygous Familial Hypercholesterolemia
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Thyroid hormone analogs for the treatment of dyslipidemia: past, present, and future
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Effects of Thyroid Hormones on Lipid Metabolism Pathologies in Non-Alcoholic Fatty Liver Disease
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Resmetirom: the first approved therapy for treating metabolic dysfunction associated steatohepatitis
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Lipid Hormones at the Intersection of Metabolic Imbalances and Endocrine Disorders
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- Authors
- Kelly, M. J., Pietranico-Cole, S., Larigan, J. D., Haynes, N.-E., Reynolds, C. H., Scott, N., Vermeulen, J., Dvorozniak, M., Conde-Knape, K., Huang, K.-S., So, S.-S., Thakkar, K., Qian, Y., Banner, B., Mennona, F., Danzi, S., Klein, I., Taub, R., & Tilley, J.
- Affiliations
- Madrigal Pharmaceuticals (United States) (US)
- Hoffmann-La Roche, Inc., Nutley, New Jersey 07110, United States
- Gfree Bio LLC, Doylestown, Pennsylvania 18902, United States
- Queensborough Community College, CUNY (US)
- New York University (US)
- Corresponding author
- Kelly, Martha J.
- Venue
- Journal of Medicinal Chemistry
- Publisher
- American Chemical Society (ACS)
- Published
- 2014-04-08
- Volume
- 57
- Issue
- 10
- Pages
- 3912-3923
- ISSN
- 0022-2623 (ISSN-L)
- 1520-4804
- OpenAlex
- W2325544658
- Cited by
- 231
- References
- 32
- Citations by year
- 2026: 29 · 2025: 73 · 2024: 42 · 2023: 15 · 2022: 19 · 2021: 9 · 2020: 15 · 2019: 14 · 2018: 7 · 2017: 4 · 2016: 3 · 2015: 1
- Type
- other
- Language
- en
- Open access
- closed
- Locations
- Journal of Medicinal Chemistry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Earth Sciences
- Ministry of Education, India
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Physical Sciences › Chemistry › Organic Chemistry › Synthesis and Characterization of Heterocyclic Compounds
- Physical Sciences › Chemistry › Organic Chemistry › Synthesis and biological activity
- Keywords
- thyroid hormone receptor beta agonist, pyridazinones, dyslipidemia, LDL cholesterol lowering, triglyceride lowering, cardiac safety, drug discovery
- MeSH terms
- Animals, Clinical Trials as Topic, Humans, Male, Mice, Inbred C57BL, Pyridazines, Structure-Activity Relationship, Uracil, Bone Density, Rats, Sprague-Dawley, Thyroid Hormone Receptors beta, Dyslipidemias, Mice, Rats, Drug Discovery
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