Helen Frankenthaler Foundation

Substance P metabolite research

NCATS Inxight Drugs — SETMELANOTIDE

SETMELANOTIDE

N7T15V1FUY

US Approved Rx (2020)

First approved in 2020

Structure

Details

Stereochemistry ABSOLUTE

Molecular Formula C49H68N18O9S2

Molecular Weight 1117.3135

Optical Activity UNSPECIFIED

Defined Stereocenters 8 / 8

E/Z Centers 0

Charge 0

SMILES

C[C@H]1NC(=O)[C@H](CSSC[C@H](NC(=O)[C@H](CC2=CNC3=CC=CC=C23)NC(=O)[C@H](CCCNC(N)=N)NC(=O)[C@@H](CC4=CC=CC=C4)NC(=O)[C@H](CC5=CN=CN5)NC1=O)C(N)=O)NC(=O)[C@H](CCCNC(N)=N)NC(C)=O

InChI

InChIKey=HDHDTKMUACZDAA-PHNIDTBTSA-N

InChI=1S/C49H68N18O9S2/c1-26-41(70)63-37(20-30-22-55-25-59-30)46(75)64-35(18-28-10-4-3-5-11-28)44(73)62-34(15-9-17-57-49(53)54)43(72)65-36(19-29-21-58-32-13-7-6-12-31(29)32)45(74)66-38(40(50)69)23-77-78-24-39(47(76)60-26)67-42(71)33(61-27(2)68)14-8-16-56-48(51)52/h3-7,10-13,21-22,25-26,33-39,58H,8-9,14-20,23-24H2,1-2H3,(H2,50,69)(H,55,59)(H,60,76)(H,61,68)(H,62,73)(H,63,70)(H,64,75)(H,65,72)(H,66,74)(H,67,71)(H4,51,52,56)(H4,53,54,57)/t26-,33+,34+,35-,36+,37+,38+,39+/m1/s1

General

Description

Setmelanotide (IMCIVREE™) is a melanocortin-4 (MC4) receptor agonist developed by Rhythm Pharmaceuticals (Rhythm) for the treatment of ultrarare genetic disorders of obesity. Setmelanotide was approved on 27 November 2020 in the USA as a subcutaneous (SC) injectable formulation for chronic weight management in adult and pediatric patients 6 years of age and older with obesity due to proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency confirmed by genetic testing demonstrating variants in POMC, PCSK1, or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS). Rhythm are also developing the drug for the treatment of obesity associated with other rare genetic disorders including Bardet–Biedl Syndrome, Alström Syndrome, POMC and other MC4R pathway heterozygous defciency obesities, and POMC epigenetic disorders.

CNS Activity

CNS Penetrant 2,588

Originator

Ipsen 13

Approval Year

2020 691

Activity

Targets
Primary TargetPharmacologyConditionPotency
Melanocortin receptor 4 8Agonist 2,7520.27 nM [EC50]
Conditions
ConditionModalityTargetsHighest PhaseProduct
Obesity due to proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency confirmed by genetic testing demonstrating variants in POMC, PCSK1, or LEPR genes that are interpreted as pathogenic, likely pathogenic, or of uncertain significance (VUS). 3PrimaryApproved 8,583IMCIVREE

Pharmacokinetics

C max
ValueDoseCo-administeredAnalytePopulation
6.65 ng/mL0.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
10.4 ng/mL1 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
17.5 ng/mL1.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
25.1 ng/mL2 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
32.8 ng/mL2.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
38 ng/mL2.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
25.4 ng/mL0.0215 mg/kg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
14.2 ng/mL0.75 mg 2 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
23 ng/mL1.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
27.5 ng/mL2 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
19.7 ng/mL2 mg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
24.8 ng/mL1.5 mg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
17.5 ng/mL2 mg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
6.47 ng/mL0.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
11.5 ng/mL1 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
22.4 ng/mL1.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
24.5 ng/mL2 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
24.4 ng/mL2.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
7.21 ng/mL0.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
10.4 ng/mL1 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
17 ng/mL1.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
23.9 ng/mL2 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
31.1 ng/mL2.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
38.9 ng/mL3 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens
AUC
ValueDoseCo-administeredAnalytePopulation
35.8 ng × h/mL0.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
59.3 ng × h/mL1 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
106 ng × h/mL1.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
146 ng × h/mL2 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
188 ng × h/mL2.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
207 ng × h/mL2.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
243 ng × h/mL0.75 mg 2 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
271 ng × h/mL1.5 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
347 ng × h/mL2 mg 1 times / day steady-state, subcutaneousSETMELANOTIDE plasmaHomo sapiens
253 ng × h/mL2 mg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
111 ng × h/mL1.5 mg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
36.2 ng × h/mL2 mg single, subcutaneousSETMELANOTIDE plasmaHomo sapiens
38.3 ng × h/mL0.5 mg 1 times / day unknown, subcutaneousSETMELANOTIDE plasmaHomo sapiens