Hostname: page-component-5c6d5d7d68-sv6ng Total loading time: 0 Render date: 2024-08-16T15:00:20.377Z Has data issue: false hasContentIssue false

The Development of Single-Isomer Molecules: Why and How

Published online by Cambridge University Press:  07 November 2014

Abstract

Until relatively recently the three-dimensional nature of drug molecules has been largely neglected, with approximately 25% of marketed drugs being mixtures of agents rather than single chemical entities. These mixtures are not combinations of drugs but mixtures of stereoisomers, generally racemates of synthetic chiral drugs. The individual enantiomers present in such mixtures frequently differ in both their pharmacodynamic and pharmacokinetic profiles as a result of stereochemical discrimination on interaction with chiral biological macromolecules (enzymes and receptors). The use of such mixtures may present problems if their adverse effects are associated with the less active stereoisomer or do not show stereoselectivity. In addition, interactions between enantiomers may occur such that the observed activity of the racemate is not simply the product of the effects of the individual enantiomers. Since the mid-1980s there has been an ongoing “racemate-versus-enantiomer” debate with the potential advantages of single-isomer products, including improved selectivity of action and potential increase in therapeutic index, being highlighted. As a result, regulatory authorities have issued guidelines for dealing with chiral molecules, and the number of single enantiomer agents presented for evaluation has increased. Racemic mixtures may still be developed but require justification such that the risk-benefit ratio may be assessed. In addition to new chemical entities, a number of “old” mixtures are being re-examined as potential single-isomer products, the chiral switches, with the potential for an improved therapeutic profile and possibly new indications. However, for the majority of agents currently marketed as mixtures, relatively little is known concerning the pharmacological or toxicological properties of the individual enantiomers.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Cornforth, JW. In: Eggerer, H, Huber, R, eds. Structure and Functional Aspects of Enzyme Catalysis 32 Colloquium-Mosbach. Berlin, Germany: Springer-Verlag; 1981:3.CrossRefGoogle Scholar
2.Mason, S. The left hand of nature. New Sci. 1984;101:1014.Google Scholar
3.Matteson, D. Through the chemical looking glass. New Sci. 1991;132:3539.Google Scholar
4.Amato, I. Looking glass chemistry. Science. 1992;256:964966.CrossRefGoogle ScholarPubMed
5.Moran, N. Drug firms sort their lefts from their rights. Independent. Sunday 11 7, 1993.Google Scholar
6.Hawkes, N. Lateral thinking. The Times Magazine. 06 5, 1993.Google Scholar
7.Lister, T. Mirror images. Guardian. 01 11, 1994.Google Scholar
8.Aliëns, EJ, Wuis, EW, Veringa, EJ. Stereoselectivity of bioactive xenobiotics. A pre-Pasteur attitude in medicinal chemistry, pharmacokinetics and clinical pharmacology. Biochem Pharmacol. 1988;37:918Google Scholar
9.Hyttel, J, Bøgesø, KP, Perregaard, J, Sánchez, C. The pharmacological effect of citalopram resides in the (S)-(+)-enantiomer. J Neural Transm. 1992;88:157160.CrossRefGoogle ScholarPubMed
10.Sánchez, C, Hogg, S. The antidepressant effect of Citalopram resides in the S-enantiomer (Lu 26-054). Poster presented at the Annual Meeting of the Society of Biological Psychiatry, 05 11-13, 2000, Chicago IL.Google Scholar
11.Kernan, WN, Viscoli, CM, Brass, LM, et al.Phenylpropanolamine and the risk of hemorrhagic stroke. New Engl J Med. 2000;343:18261832.CrossRefGoogle ScholarPubMed
12.Fleming, GA. The FDA, regulation, and the risk of stroke. New Engl J Med. 2000;343:18861887.CrossRefGoogle ScholarPubMed
13.Mason, SF. The development of concepts of chiral discrimination. Chirality. 1989;1:183191.CrossRefGoogle ScholarPubMed
14.Mason, SF. The origin of biomolecular chirality in nature. In: Krstulovic, AM, ed. Chiral Separations byHPLC. Chichester, UK: Ellis Horwood; 1989:1330.Google Scholar
15.Holmstedt, B. The use of enantiomers in biological studies: an historical review. In: Hohnstedt, B, Frank, H, Testa, B, eds. Chirality and Biological Activity. New York, NY: Alan R. Liss; 1990:114.Google Scholar
16.Cushny, AR. Biological Relations of Optically Isomeric Substances. London, UK: Bailliere, Tindall and Cox; 1926.Google Scholar
17.Easson, LH, Stedman, E. Studies on the relationship between chemical constitution and physiological action V. Molecular dissymmetry and physiological activity. Biochem J. 1933;27:12571266.CrossRefGoogle Scholar
18.Booth, TD, Wahnon, D, Wainer, IW. Is chiral recognition a three-point process? Chirality. 1997;9:9698.3.0.CO;2-E>CrossRefGoogle Scholar
19.Mesecar, AD, Koshland, DE. A new model for protein stereospecificity. Nature. 2000;403:614615.CrossRefGoogle ScholarPubMed
20.Lehmann, PAF, DeMiranda, JFR, Ariëns, EJ. Stereoselectivity and affinity in molecular pharmacology. In: Jucker, E, ed. Progress in Drug Research. Volume 20. Basel, Switzerland: Birkhauser Verlag; 1976:101142.Google Scholar
21.Lehmann, PAF. Quantifying stereoselectivity or how to choose a pair of shoes when you have two left feet. Trend Pharmacol Sci. 1982;3:103106.CrossRefGoogle Scholar
22.Cornwall, P. Body of Evidence. London, UK: Warner Books; 1991:(1998 Reprint).Google Scholar
23.Walshe, JM. Penicillamine, a new oral therapy for Wilson's Disease. Am J Med. 1956;21:487495.CrossRefGoogle ScholarPubMed
24.Tu, J-B, Blackwell, RQ, Lee, PF. D, L-Penicillamine as a cause of optic axial neuritis. JAMA. 1963;185:8386.CrossRefGoogle Scholar
25.Walshe, JM. Chirality of penicillamine. Lancet. 1992;339:254.CrossRefGoogle ScholarPubMed
26.Lee, A, Lawton, NF. Penicillamine treatment of Wilson's disease and optic neuropathy. J Neurol Neurosurg Psych. 1991;58:746.CrossRefGoogle Scholar
27.Crossley, R. Chirality and the Biological Activity of Drugs. Boca Raton, Fla: CRC Press; 1995.Google Scholar
28.Hutt, AJ. Drug chirality and its pharmacological consequences. In: Smith, HJ, ed. Introduction to the Principles of Drug Design and Action, 3rd edition. Reading, UK: Harwood Academic; 1998:97166.Google Scholar
29.Hutt, AJ, Tan, SC. Drug chirality and its clinical significance. Drugs. 1996;52 (Suppl 5):112.CrossRefGoogle ScholarPubMed
30.Kohrs, R, Durieux, ME. Ketamine: teaching an old drug new tricks. Anesth Analg. 1998;87:11861193.Google ScholarPubMed
31.Powell, JR, Ambre, JJ, Ruo, TJ. The efficacy and toxicity of drug stereoisomers. In: Wainer, IW, DE, Drayer, eds. Drug Stereochemistry. Analytical Methods and Pharmacology. New York, NY: Marcel Dekker; 1988:245270.Google Scholar
32.Jenner, P, Testa, B. The influence of stereochemical factors on drug disposition. Drug Metab Rev. 1973;3:117184.Google Scholar
33.Tucker, GT, Lennard, MS. Enantiomer specific pharmacokinetics. Pharmacol Ther. 1990;45:309329.CrossRefGoogle ScholarPubMed
34.Levy, RH, Boddy, AV. Stereoselectivity in pharmacokinetics: a general theory. Pharm Res. 1991;8:551556.CrossRefGoogle ScholarPubMed
35.Mason, JP, Hutt, AJ. Stereochemical aspects of drug metabolism. In: HY, Aboul-Enein, Wainer, IW, eds. The Impact of Stereochemistry on Drug Development and Use. New York, NY: John Wiley; 1997:45105.Google Scholar
36.Wade, DN, Mearrick, PT, Morris, JL. Active transport of L-dopa in the intestine. Nature. 1973;242:463465.CrossRefGoogle ScholarPubMed
37.Hendel, J, Brodthagen, H. Entero-hepatic cycling of methotrexate estimated by use of the D-isomer as a reference marker. Eur J Clin Pharmacol. 1984;26:103107.CrossRefGoogle ScholarPubMed
38.Itoh, T, Ono, K, Koido, K-I, Li, Y-H, Yamada, H. Stereoselectivity of the folate transporter in rabbit small intestine: studies with amethopterin enantiomers. Chirality. 2001;13:164169.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
39.Testa, B. Mechanisms of chiral recognition in xenobiotic metabolism and drug receptor interactions. Chirality. 1989;1:79.CrossRefGoogle ScholarPubMed
40.Hsyu, P, Giacomini, KM. Stereoselective renal clearance of pindolol in humans. J Clin Invest. 1985;76:17201726.CrossRefGoogle ScholarPubMed
41.Ariëns, EJ. Stereochemistry, a basis for sophisticated nonsense in pharmacokinetics and clinical pharmacology. Eur J Clin Pharmacol. 1984;26:663668.CrossRefGoogle ScholarPubMed
42.Evans, AM, Nation, RL, Sansom, LN, Bochner, F, Somogyi, AA. Stereoselective drug disposition: potential for misinterpretation of drug disposition data. Br J Clin Pharmacol. 1988;26:771780.CrossRefGoogle ScholarPubMed
43.Giacomini, KM, Nelson, WL, Pershe, RA, Valdivieso, L, Turner-Tamiyasu, K, Blaschke, TF. In vivo interaction of the enantiomers of disopyramide in human subjects. J Pharmacokin Biopharm. 1986;14:335356.CrossRefGoogle ScholarPubMed
44.Carter, RB, Dykstra, LA. Quantitative analysis of the interaction between the agonist and antagonist isomers of picenadol (LY 150720) on electric shock titration in the squirrel monkey. Eur J Pharmacol. 1985;106:469476.CrossRefGoogle Scholar
45.Baldwin, JJ, Abrams, WB. Stereochemically pure drugs, an industrial perspective. In: Wainer, IW, DE, Drayer, eds. Drug Stereochemistry. Analytical Methods and Pharmacology. New York, NY: Marcel Dekker. 1988;311356.Google Scholar
46.Vlasses, PH, Irvin, JD, Huber, PB, et al.Pharmacology of enantiomers and (−)-p-OH metabolite of indacrinone. Clin Pharmacol Ther. 1981;29:798807.CrossRefGoogle ScholarPubMed
47.Tobert, JA, Cirillo, VJ, Hitzenberger, G, et al.Enhancement of uricosuric properties of indacrinone by manipulation of the enantiomer ratio. Clin Pharmacol Ther. 1981;29:344350.CrossRefGoogle ScholarPubMed
48.Shah, RR, Midgley, JM, Branch, SK. Stereochemical origin of some clinically significant drug safety concerns: lessons for future drug development. Adverse Drug React Toxicol Rev. 1998;17:145190.Google ScholarPubMed
49.Echizen, H, Vogelgesang, B, Eichelbaum, M. Effects of d,l-verapamil on atrioventricular conduction in relation to its stereoselective first-pass metabolism. Clin Pharmacol Ther. 1985;38:7176.CrossRefGoogle ScholarPubMed
50.Karim, A, Piergies, A. Verapamil stereoisomerism: enantiomeric ratios in plasma dependent on peak concentrations, oral input rate, or both. Clin Pharmacol Ther. 1995;58:174184.CrossRefGoogle ScholarPubMed
51.Lennard, MS, Tucker, GT, Woods, HF. Stereoselectivity in pharmacokinetics and drug metabolism. In: Taylor, JB, ed. Comprehensive Medicinal Chemistry. Volume 5. Biopharmaceutics. Oxford, UK: Pergamon Press. 1990;187204.Google Scholar
52.Chandler, MHH, Scott, SR, Blouin, RA. Age associated stereoselective alterations in hexobarbital metabolism. Clin Pharmacol Ther. 1988;43:436441.CrossRefGoogle ScholarPubMed
53.Li, G, Treiber, G, Maier, K, Walker, S, Klotz, U. Disposition of ibuprofen in patients with liver cirrrhosis. Stereochemical considerations. Clin Pharmacokinet. 1993;25:154163.CrossRefGoogle Scholar
54.Hooper, WD, Qing, MS. The influence of age and gender on the stereoselective metabolism and pharmacokinetics of mephobarbital in humans. Clin Pharmacol Ther. 1990;48:633640.CrossRefGoogle ScholarPubMed
55.Lennard, MS, Tucker, GT, Silas, JH, Freestone, S, Ramsay, LE, Woods, HF. Differential stereoselective metabolism of metoprolol in extensive and poor debrisoquin metabolisers. Clin Pharmacol Ther. 1983;34:732737.CrossRefGoogle Scholar
56.Johnson, JA, Burlew, BS. Racial differences in propranolol pharmacokinetics. Clin Pharmacol Ther. 1992;51:495500.CrossRefGoogle ScholarPubMed
57.Blashke, G, Kraft, HP, Fickentscher, K, Köhler, F. Chromatographische racemattrennung von thalidomid und teratogene Wirkung der enantiomere. Arzneimittel Forschung. 1979;29:16401642.Google Scholar
58.Scott, WJ, Fradkin, R, Wilson, JG. Non-confirmation of thalidomide-induced teratogenesis in rats and mice. Teratology. 1977;16:333336.CrossRefGoogle ScholarPubMed
59.Fabro, S, Smith, RL, Williams, RT. Toxicity and teratogenicity of optical isomers of thalidomide. Nature. 1967;215:269.CrossRefGoogle ScholarPubMed
60.Testa, B, Carrupt, P-A, Gal, J. The so-called “interconversion” of stereoisomeric drugs: an attempt at clarification. Chirality. 1993;5:105111.CrossRefGoogle ScholarPubMed
61.Eriksson, T, Björkman, S, Roth, B, Fyge, A, Hoglund, P. Stereospecific determination, chiral inversion in vitro and pharmacokinetics in humans of the enantiomers of thalidomide. Chirality. 1995;7:4452.CrossRefGoogle ScholarPubMed
62.Eriksson, T, Björkman, S, Roth, B, Fyge, A, Hoglund, P. Enantiomers of thalidomide: blood distribution and the influence of serum albumin on chiral inversion and hydrolysis. Chirality. 1998;10:223228.3.0.CO;2-A>CrossRefGoogle ScholarPubMed
63.Reist, M, Carrupt, P-A, Francotte, E, Testa, B. Chiral inversion and hydrolysis of thalidomide: mechanisms and catalysis by bases and serum albumin, and chiral stability of teratogenic metabolites. Chem Res Toxicol. 1998;11:15211528.CrossRefGoogle ScholarPubMed
64.Richards, R, Tattersfield, AE. Bronchial β-adrenoceptor blockade following eyedrops of timolol and its isomer L-714,465 in normal subjects. Br J Clin Pharmacol. 1985;20:459462.CrossRefGoogle ScholarPubMed
65.Fraunfelder, FT, Barker, AF. Respiratory effects of timolol. New Engl J Med. 1985;311:1441.Google Scholar
66.Chiou, GCW, Zhao, F, Shen, Z-H, Li, BHP. Effects of D-timolol and L-timolol on ocular blood flow and ocular blood pressure. J Ocular Pharmacol. 1990;6:2329.CrossRefGoogle Scholar
67.Kato, R, Ikeda, N, Yabek, S, Kannen, R, Singh, BN. Electrophysiologic effects of the levo- and dextrorotatory isomers of sotalol in isolated cardiac muscle and their in vivo pharmacokinetics. J Am Coll Cardiol. 1986;7:116125.CrossRefGoogle ScholarPubMed
68.Advani, SV, Singh, BN. Pharmacodynamic, pharmacokinetic and antiarrhythmic properties of d-sotalol, the dextro-isomer of sotalol. Drugs. 1995;49:664679.CrossRefGoogle ScholarPubMed
69.Waldo, AL, Camm, AJ, de Ruyter, H, et al.Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. Lancet. 1996;348:712.CrossRefGoogle ScholarPubMed
70.Colatsky, TJ. Antiarrhythmic drugs: where are we going? Pharmaceutical News. 1995;2:1723.Google Scholar
71.DeCamp, WH. The FDA perspective on the development of stereoisomers. Chirality. 1989;1:26.CrossRefGoogle Scholar
72.Cayen, MN. Racemic mixtures and single stereoisomers: industrial concerns and issues in drug development. Chirality. 1991;3:9498.CrossRefGoogle Scholar
73.Nation, RL. Chirality in new drug development. Clinical pharmacokinetic considerations. Clin Pharmacokinet. 1994;27:249255.CrossRefGoogle ScholarPubMed
74.Rauws, AG, Groen, K. Current regulatory (draft) guidance on chiral medicinal products: Canada, EEC, Japan, United States. Chirality. 1994;6:7275.CrossRefGoogle ScholarPubMed
75.Caldwell, J. St Mary's Discussion Forum: “Racemates and enantiomers: scientific and regulatory aspects.” Chirality. 1989;1:249250.CrossRefGoogle Scholar
76.Hutt, AJ. Drug chirality: Impact on pharmaceutical regulation. Chirality. 1991;3:161164.CrossRefGoogle ScholarPubMed
77.Gross, M, Cartwright, A, Campbell, B, et al.Regulatory requirements for chiral drugs. Drug Info J. 1993;193:453457.CrossRefGoogle Scholar
78.FDA's Policy statement for the development of new stereoisomeric drugs. Chirality. 1992;4:338340.CrossRefGoogle Scholar
79.Investigation of Chiral Active Substances (CPMP/III/3501/91) In: The Rules Governing Medicinal Products in the European Union, EUDRALEX, Volume 3C “Efficacy Guidelines” European Commission. Brussels, Belgium; 1998:381391.Google Scholar
80.Branch, S. International regulation of chiral drugs. In: Subramanian, G, ed. Chiral Separation Techniques. A Practical Approach. 2nd edition. Weinheim, Germany: Wiley-VCH; 2001:319342.Google Scholar
81.Daniels, JM, Nestmann, ER, Kerr, A. Development of stereoisomeric (chiral) drugs: A brief review of scientific and regulatory considerations. Drug Info J. 1997;31:639646.CrossRefGoogle Scholar
82.Shindo, H, Caldwell, J. Regulatory aspects of the development of chiral drugs in Japan: a status report. Chirality. 1991;3:9193.CrossRefGoogle Scholar
83.Shindo, H, Caldwell, J. Development of chiral drugs in Japan: an update on regulatory and industrial opinion. Chirality. 1995;7:349352.CrossRefGoogle Scholar
84.Tucker, GT. Chiral switches. Lancet. 2000;355:10851087.CrossRefGoogle ScholarPubMed
85. Anon. Side effects kill “new Prozac.” Chem Br. 2000;36:11.Google Scholar
86.Thayer, A. Eli Lilly pulls the plug on prozac isomer drug. Chem Engin News. 2000;78:8.CrossRefGoogle Scholar
87.Shah, RR. The influence of chirality on drug development. Future Prescriber. 2000;1:1447.Google Scholar