Structure- and Ligand-Based Discovery of Chromane Arylsulfonamide Na1.7 Inhibitors for the Treatment of Chronic Pain

Using structure- and ligand-based design principles, a novel series of piperidyl chromane arylsulfonamide Na1.7 inhibitors was discovered. Early optimization focused on improvement of potency through refinement of the low energy ligand conformation and mitigation of high in vivo clearance. An in vitro hepatotoxicity hazard was identified and resolved through optimization of lipophilicity and lipophilic ligand efficiency to arrive at GNE-616 (24), a highly potent, metabolically stable, subtype selective inhibitor of Na1.7. Compound 24 showed a robust PK/PD response in a Na1.7-dependent mouse model, and site-directed mutagenesis was used to identify residues critical for the isoform selectivity profile of 24.