cipargamin   Click here for help

GtoPdb Ligand ID: 9721

Synonyms: KAE609 | NITD609
Antimalarial Ligand
Compound class: Synthetic organic
Comment: Cipargamin is an antimalarial drug candidate, under clinical development. It is the optimised lead for the spiroindolones, a novel class of compounds identified from a phenotypic screen as having antimalarial activity [2,7] and awarded MMV Project of the Year (2009).
The active enantiomer is shown here, with the 1R,3S configuration essential for antimalarial activity [2].

The Malaria tab on this ligand page provides additional curator comments of relevance to the Guide to MALARIA PHARMACOLOGY.
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2D Structure
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Physico-chemical Properties
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Hydrogen bond acceptors 3
Hydrogen bond donors 3
Rotatable bonds 0
Topological polar surface area 56.92
Molecular weight 389.05
XLogP 4.62
No. Lipinski's rules broken 0
SMILES / InChI / InChIKey
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Canonical SMILES CC1Cc2c3cc(F)c(cc3[nH]c2C2(N1)C(=O)Nc1c2cc(Cl)cc1)Cl
Isomeric SMILES C[C@H]1Cc2c3cc(F)c(cc3[nH]c2[C@@]2(N1)C(=O)Nc1c2cc(Cl)cc1)Cl
InChI InChI=1S/C19H14Cl2FN3O/c1-8-4-11-10-6-14(22)13(21)7-16(10)23-17(11)19(25-8)12-5-9(20)2-3-15(12)24-18(19)26/h2-3,5-8,23,25H,4H2,1H3,(H,24,26)/t8-,19+/m0/s1
InChI Key CKLPLPZSUQEDRT-WPCRTTGESA-N
No information available.
Summary of Clinical Use Click here for help
Cipargamin is in clinical development with completion of several Phase 2a clinical trials (NCT01836458, NCT01524341, NCT01860989) and enrolment for Phase 2b having commenced (NCT03334747). Rapid parasitemia clearance has been reported in adults with uncomplicated P. falciparum or P. vivax malaria [6] (results from NCT01524341).
Evaluation of piperaquine as a potential combination therapy partner indicates no significant effect on exposure to either compound and no safety concerns [4].
Mechanism Of Action and Pharmacodynamic Effects Click here for help
The exact mechanism of action of cipargamin is not fully understood but Plasmodium non-SERCA-type Ca2+-transporting P-ATPase (PfATP4) may be a possible target because mutatations in PfATP4 confer resistance to this compound [2]. PfATP4 is thought to regulate Na+ homeostasis and play a role in maintaining the low cytosolic Na+ concentration essential for the Plasmodium parasite to survive during the intraerythrocytic stages of development [3].
Clinical Trials
Clinical Trial ID Title Type Source Comment References
NCT01524341 Efficacy, Safety, Tolerability and Pharmacokinetics of KAE609 in Adult Patients With Acute, Uncomplicated Plasmodium Falciparum or Vivax Malaria Mono-infection Phase 2 Interventional Novartis
NCT01836458 A Study to Find the Minimum Inhibitory Concentration of KAE609 in Adult Male Patients With P. Falciparum Monoinfection Phase 2 Interventional Novartis
NCT01860989 A Study to Assess Efficacy, Safety of KAE609 in Adult Patients With Acute Malaria Mono-infection Phase 2 Interventional Novartis
NCT03334747 Safety of KAE609 in Adults With Uncomplicated Plasmodium Falciparum Malaria. Phase 2 Interventional Novartis
Pharmacokinetics Click here for help
Elimination
Cipargamin has a mean terminal half-life for elimination of 20.8 hours (range, 11.3 to 37.6), supporting a once-daily oral dosing regimen [6].