Rational design, synthesis, and biological activity of benzoxazinones as novel factor Xa inhibitors

Inappropriate thrombus formation within blood vessels is the leading cause of mortality in the industrialized world. Factor Xa (FXa) is a trypsin-like serine protease that plays a key role in the blood coagulation cascade and represents an attractive target for anticoagulant drug development, From a high-throughput in vitro mass screen of our chemical library, we identified 4-[5-[(2R,6S)-2,6-dimethyltetrahydro-1(2H)-pyridinyl]pentyl]-2-phenyl-2H-1,4-benzoxazin-3(4H)-one (1a) as an inhibitor of FXa with an IC50 of 27 muM. Through a combination of SAR studies and molecular modeling, we synthesized 3-(4-[5-[(2R,6S)-2,6-dimethyltetrahydro-1(2N)-pyridinyl]pentyl]-3-oxo-3,4-dihydro-2H-1,4-benzoxazin-2-yl)-1-benzenecarboximidamide (1n) which was a potent FXa inhibitor with an IC50 of 3 nM. This compound exhibited high selectivity for FXa over other related serine proteases and was efficacious when dosed intravenously in rabbit and dog antithrombotic models.