Synthetic [5,5] trans-fused indane lactones as inhibitors of thrombin

Advances in the development of thrombin inhibitors

Thromboembolic diseases are a major cause of morbidity and mortality, particularly in the Western world, which has stimulated enormous research efforts by the pharmaceutical industry to introduce new antithrombotic therapies. One strategy is the development of direct inhibitors of the serine protease thrombin, which holds a central position in the final steps of the blood coagulation cascade and in platelet activation. At present there is only limited clinical use of some parenteral preparations of thrombin inhibitors in acute situations, especially when the common antithrombotic drugs heparin, warfarin and aspirin are ineffective or associated with side effects. However, for use in prophylaxis of thrombotic diseases such inhibitors should be orally available, must be safe to avoid bleeding complications and should have an appropriate half-life, allowing once or twice daily dosing to maintain adequate antithrombotically effective blood levels. Details of several new and potent thrombin inhibitors have been published during the last years. For some of them oral bioavailability is claimed and they are effective in in vitro coagulation assays. However, most of them showed only limited efficacy in animal studies with respect to the doses administered. For that reason, effort is concentrated on the evaluation and optimisation of the overall physicochemical characteristics of the inhibitors in order to improve the pharmacokinetics and, thus, the development of promising drug candidates. Nevertheless, only careful clinical studies can give clear answers about the true therapeutical benefit of new developments in this field. This review summarises the current status of direct thrombin inhibitors which are already in clinical use and clinical development and gives an overview on recently published and promising new compounds.

Lantana camara L. (Verbenaceae)

Lantana camara L. is regarded both as a notorious weed and a popular ornamental garden plant and has found various uses in folk medicine in many parts of the world. Some taxa of the widely variable L. camara complex are toxic to small ruminants and this effect has been associated with the types and relative amounts of some triterpene ester metabolites. However, L. camara also produces a number of metabolites in good yields and some have been shown to possess useful biological activities. All these aspects are considered in this review to allow an evaluation of the potential for utilisation of the large biomass of Lantana available. The phytochemistry of other members of the Lantana genus is included.

Thrombin inhibitors based on [5,5] trans-fused indane lactams

A series of trans-fused lactams containing the indane nucleus has been prepared. Compound 19 has much enhanced plasma stability compared with its lactone counterpart and shows appreciable in vitro anticoagulant activity.