Light-Driven Ring Slippage in [Re(η7-C7H7)(η5-C7H9)]+ and the Inertness of Its Technetium Homologue

Here, we present the light-driven reactions of [Re(η7-C7H7)(η5-C7H9)]+ (1+) with nitriles, phosphines, and isocyanides, which are added to 1+ via a ring slippage of the tropylium cation from η7 to η3, forming [Re(η3-C7H7)(η5-C7H9)(L)2]+ (L= acetonitrile 2+; 2-phenylacetonitrile 3+; 1,3,5-triaza-5-phosphoadamantane (PTA) 4+; tert-butyl isocyanide 6+; benzyl isocyanide 7+) and [Re(η3-C7H7)(η5-C7H9)(L)]+ with L = (ethane-1,2-diyl)bis(diphenylphosphane) (dppe) 5+. To compare the reactivities of rhenium and technetium, we also investigated the synthesis of [99Tc(η6-C10H8)2]+, its substitution of naphthalene with cyclohepta-1,3,5-triene to obtain [99Tc(η7-C7H7)(η5-C7H9)]+, and its reactivity (or lack thereof) with light.

Induced fac-mer rearrangements in {M(CO)3}+ complexes (M = Re, 99(m)Tc) by a PNP ligand

The fac-mer rearrangements in [MX3(CO)3]2- (M = Re, 99Tc) induced by a pincer-type ligand (PNP) and a "halide scavenger" are reported. The reactions of fac-[99mTc(CO)3(OH2)3]+ or [99mTcO4]- in saline both yield mer-[99mTc(PNP)(CO)3]+, the first example of a mer-{99mTc(CO)3}+ type complex. In contrast, reactions with terpyridine (terpy) only gave the facial κ2-terpy complexes with Re and 99Tc.

Electrocatalytic Ammonia Oxidation with a Tailored Molecular Catalyst Heterogenized via Surface Host-Guest Complexation

Macrocyclic host molecules bound to electrode surfaces enable the complexation of catalytically active guests for molecular heterogeneous catalysis. We present a surface-anchored host-guest complex with the ability to electrochemically oxidize ammonia in both organic and aqueous solutions. With an adamantyl motif as the binding group on the backbone of the molecular catalyst [Ru(bpy-NMe2)(tpada)(Cl)](PF6) (1) (where bpy-NMe2 is 4,4'-bis(dimethylamino)-2,2'-bipyridyl and tpada is 4'-(adamantan-1-yl)-2,2':6',2″-terpyridine), high binding constants with β-cyclodextrin were observed in solution (in DMSO-d6:D2O (7:3), K11 = 492 ± 21 M-1). The strong binding affinities were also transferred to a mesoporous ITO (mITO) surface functionalized with a phosphonated derivative of β-cyclodextrin. The newly designed catalyst (1) was compared to the previously reported naphthyl-substituted catalyst [Ru(bpy-NMe2)(tpnp)(Cl)](PF6) (2) (where tpnp is 4'-(naphthalene-2-yl)-2,2':6',2″-terpyridine) for its stability during catalysis. Despite the insulating nature of the adamantyl substituent serving as the binding group, the stronger binding of this unit to the host-functionalized electrode and the resulting shorter distance between the catalytic active center and the surface led to better performance and higher stability. Both guests are able to oxidize ammonia in both organic and aqueous solutions, and the host-anchored electrode can be refunctionalized multiple times (>3) following the loss of the catalytic activity, without a reduction in performance. Guest 1 exhibits significantly higher stability in comparison to guest 2 toward basic conditions, which often constitutes a challenge for anchored molecular systems. Ammonia oxidation in water led to the selective formation of NO3- with Faradaic efficiencies of up to 100%.

Assessing the fast prediction of peptide conformers and the impact of non-natural modifications

We present an assessment of different approaches to predict peptide structures using modeling tools. Several small molecule, protein, and peptide-focused methodologies were used for the fast prediction of conformers for peptides shorter than 30 amino acids. We assessed the effect of including restraints based on annotated or predicted secondary structure motifs. A number of peptides in bound conformations and in solution were collected to compare the tools. In addition, we studied the impact of changing single amino acids to non-natural residues using molecular dynamics simulations. Deep learning methods such as AlphaFold2, or the combination of physics-based approaches with secondary structure information, produce the most accurate results for natural sequences. In the case of peptides with non-natural modifications, modeling the peptide containing natural amino acids first and then modifying and simulating the peptide using benchmarked force fields is a recommended pipeline. The results can guide the modeling of oligopeptides for drug discovery projects.

Implementation of a Systematic, Digital Oncology Workflow for Patient Distress Screening in a National, Multi-Site Radiotherapy Outpatient Setting

PURPOSE/OBJECTIVE(S)

Distress screening is recommended as standard of care in oncology to improve the quality of personalized care for patients, however previously reported barriers have led to poor uptake and reporting of clinician follow up and interventions. Our purpose was to improve the quality of personalized care for patients with high patient participation rate (>50%), clinical and nurse workflow compliance rate (>70%) and create structured data for practice improvement. To achieve this purpose, an in-house systematic digital screen and templated well-being plan (WBP) workflow was implemented across 33 outpatient Radiation Oncology sites in a multi-institutional center.

MATERIALS/METHODS

An in-house digital version of the NCCN Distress Thermometer and Problem Checklist (DT) was built in the integrated web-based portal for patients to complete at home or in a clinic setting. A digital workflow was co-designed with clinicians with automatic integration of the DT PDF document into the Electronic Medical Record (EMR), assigned for doctor review. Nurses subsequently recorded screening actions in the WBP. An extensive engagement, education and support program was completed nationally with phased implementation after an initial pilot at 3 sites. Staff and patient feedback were documented and presented with the collated data for review.

RESULTS

The program was successfully implemented at 33 centers across Australia in the multi-site organization between March and October 2022. A total of 7788 distress screening forms were submitted with an uptake rate of 78% at baseline and 53% at end of treatment (EOT). DT document approval rates by doctors varied (41%-98%), and WBP was completed for 48-100% of patients, with variations of rates and use noted between states and individuals for both. Referrals were recorded in the WBP for 3% of patients, however, as up to 52% of documentation was not in a WBP (for some states), true referral numbers require further manual analysis. Pairwise analysis of screening scores between time points saw 42% of scores reduced, 34% increased and 24% with no change. Analysis of a subset of patients with increased or no change in score showed 57% had some change in categories of distress, 22% had complete change and 10% had no change.

CONCLUSION

With an increasing global focus on improving patient centered care, implementation of a systematic digital workflow for distress screening and supportive care was achieved resulting in patient identified stressors being addressed as standard of care. Key barriers reported, include confidence discussing screening results with patients and manual workflows at EOT. The provision of a rich data set can also highlight opportunities for clinical practice improvement, cohort-based focus, clinical quality indicators, benchmarking and reporting.

Clinical Evaluation of an Automated Iterative Optimization System for Radiation Oncology

PURPOSE/OBJECTIVE(S)

Automation of radiotherapy treatment planning improves efficiency and consistency, while reducing planning time and errors. The objective of this study was to validate an Iterative Optimization Engine (IOE) within an existing automated IMRT/VMAT planning framework. The IOE was designed to reduce remaining manual intervention within the automation framework through measuring and codifying common user intervention within a commercial planning system.

MATERIALS/METHODS

The IOE was developed for external beam IMRT/VMAT treatment planning on the Monaco Treatment Planning System. The IOE was built on an existing automation framework, utilizing the Application Programming Interface (API) to create completely automated treatment plans. A network of 40 centers in Australia evaluated automated treatment plans for head and neck disease sites where users decided manual intervention was required post automated planning to achieve clinician approval. The modifications to automated plans were recorded, analyzed, and codified into the API to remove the requirement for manual intervention. A subset of the automated plans was then retrospectively processed by the IOE with resulting plans being scored in three categories of 1) superior, 2) equivalent and 3) inferior based on DVH assessment with the original clinician approved plan as the baseline.

RESULTS

The automation framework generated 546 head and neck plans from January 1 to February 1, 2023, of which 45% required manual intervention to achieve dosimetric criteria. After being processed by the IOE, 86% of plans showed equivalent or superior coverage and maximum dose, and 95% of plans demonstrated equivalent homogeneity or improved homogeneity. Multi-target plans showed equivalent or improved target dose for 67% of intermediate dose targets and 39% of low dose targets when multiple targets were treated simultaneously. Analysis of organs at risk showed 38% of plans with reduced Parotid mean dose, 92% improved Larynx mean dose, 43% reduced Spinal Cord maximum dose, 57% decreased Brainstem maximum dose, 85% reduced Oral Cavity mean dose and 56% reduced Pharynx mean dose.

CONCLUSION

The addition of an IOE achieved a clinical improvement to target and OAR metrics in the assessed clinical plans. The automation framework will incorporate this work into clinical production to improve the overall effectiveness of the automated planning framework.

pyPept: a python library to generate atomistic 2D and 3D representations of peptides

We present pyPept, a set of executables and underlying python-language classes to easily create, manipulate, and analyze peptide molecules using the FASTA, HELM, or recently-developed BILN notations. The framework enables the analysis of both pure proteinogenic peptides as well as those with non-natural amino acids, including support to assemble a customizable monomer library, without requiring programming. From line notations, a peptide is transformed into a molecular graph for 2D depiction tasks, the calculation of physicochemical properties, and other systematic analyses or processing pipelines. The package includes a module to rapidly generate approximate peptide conformers by incorporating secondary structure restraints either given by the user or predicted via pyPept, and a wrapper tool is also provided to automate the generation and output of 2D and 3D representations of a peptide directly from the line notation. HELM and BILN notations that include circular, branched, or stapled peptides are fully supported, eliminating errors in structure creation that are prone during manual drawing and connecting. The framework and common workflows followed in pyPept are described together with illustrative examples. pyPept has been released at: https://github.com/Boehringer-Ingelheim/pyPept .

Binding Small Molecules to a cis-Dicarbonyl 99TcI-PNP Complex via Metal-Ligand Cooperativity

Metal-ligand cooperativity is a powerful tool for the activation of various bonds but has rarely, if ever, been studied with the radioactive transition metal ⁹⁹Tc. In this work, we explore this bond activation pathway with the dearomatized PNP complex cis-[⁹⁹Tc^I(^PyrPNP^tBu*)(CO)₂] (4), which was synthesized by deprotonation of trans-[⁹⁹Tc^I(^PyrPNP^tBu)(CO)₂Cl] with KO^tBu. Analogous to its rhenium congener, the dearomatized compound reacts with CO₂ to form the carboxy complex cis-[⁹⁹Tc^I(^PyrPNP^tBu-COO)(CO)₂] and with H₂ to form the mono-hydride complex cis-[⁹⁹Tc^I(^PyrPNP^tBu)(CO)₂H] (7). Substrates with weakly acidic protons are deprotonated by the Brønsted basic pincer backbone of 4, yielding a variety of intriguing complexes. Reactions with terminal alkynes enable the isolation of acetylide complexes. The deprotonation of an imidazolium salt results in the in situ formation and coordination of a carbene ligand. Furthermore, a study with heterocyclic substrates allowed for the isolation of pyrrolide and pyrazolide complexes, which is uncommon for Tc. The spectroscopic analyses and their solid-state structures are reported.

Spotting a potential threat: Measles among pediatric solid organ transplantation recipients

BACKGROUND

Low-vaccination rates worldwide have led to the re-emergence of vaccine-preventable infections, including measles. Immunocompromised patients, including pediatric solid organ transplant (SOT) recipients, are at risk for measles because of suboptimal vaccination, reduced or waning vaccine immunity, lifelong immunosuppression, and global re-emergence of measles.

OBJECTIVES

To review published cases of measles in pediatric SOT recipients to heighten awareness of its clinical manifestations, summarize diagnostic and treatment strategies, and identify opportunities to optimize prevention.

METHODS

We conducted a literature review of published natural measles infections in SOT recipients ≤21 years of age, summarizing management and outcomes. We describe measles epidemiology, recommended diagnostics, treatment, and highlight prevention strategies.

RESULTS

There are seven published reports of measles infection in 12 pediatric SOT recipients, the majority of whom were unvaccinated or incompletely vaccinated. Subjects had atypical or severe clinical presentations, including lack of rash and complications, most frequently with encephalitis and pneumonitis, resulting in 33% mortality. Updated recommendations on testing and vaccination are provided. Treatment options beyond supportive care and vitamin A are limited, with no approved antivirals.

CONCLUSION

While measles is infrequently reported in pediatric SOT recipients, morbidity and mortality remain significant. A high index of suspicion is warranted in susceptible SOT recipients with clinically compatible illness or exposure. Providers must recognize this risk, educate families, and be aware of both classic and atypical presentations of measles to rapidly identify, isolate, and diagnose measles in pediatric SOT recipients. Continued efforts to optimize measles vaccination both pre- and post-SOT are warranted.

Discovery of a Novel Potent and Selective HSD17B13 Inhibitor, BI-3231, a Well-Characterized Chemical Probe Available for Open Science

Genome-wide association studies in patients revealed HSD17B13 as a potential new target for the treatment of nonalcoholic steatohepatitis (NASH) and other liver diseases. However, the physiological function and the disease-relevant substrate of HSD17B13 remain unknown. In addition, no suitable chemical probe for HSD17B13 has been published yet. Herein, we report the identification of the novel potent and selective HSD17B13 inhibitor BI-3231. Through high-throughput screening (HTS), using estradiol as substrate, compound 1 was identified and selected for subsequent optimization resulting in compound 45 (BI-3231). In addition to the characterization of compound 45 for its functional, physicochemical, and drug metabolism and pharmacokinetic (DMPK) properties, NAD⁺ dependency was investigated. To support Open Science, the chemical HSD17B13 probe BI-3231 will be available to the scientific community for free via the opnMe platform, and thus can help to elucidate the pharmacology of HSD17B13.

Accurate Non-Covalent Interaction Energies on Noisy Intermediate-Scale Quantum Computers via Second-Order Symmetry-Adapted Perturbation Theory

The computation of non-covalent interaction energies on noisy intermediate-scale quantum (NISQ) computers appears to be challenging with straightforward application of existing quantum algorithms. For example, use of the standard supermolecular method...

Collaborative Assessment of Molecular Geometries and Energies from the Open Force Field

Force fields form the basis for classical molecular simulations, and their accuracy is crucial for the quality of, for instance, protein-ligand binding simulations in drug discovery. The huge diversity of small-molecule chemistry makes it a challenge to build and parameterize a suitable force field. The Open Force Field Initiative is a combined industry and academic consortium developing a state-of-the-art small-molecule force field. In this report, industry members of the consortium worked together to objectively evaluate the performance of the force fields (referred to here as OpenFF) produced by the initiative on a combined public and proprietary dataset of 19,653 relevant molecules selected from their internal research and compound collections. This evaluation was important because it was completely blind; at most partners, none of the molecules or data were used in force field development or testing prior to this work. We compare the Open Force Field "Sage" version 2.0.0 and "Parsley" version 1.3.0 with GAFF-2.11-AM1BCC, OPLS4, and SMIRNOFF99Frosst. We analyzed force-field-optimized geometries and conformer energies compared to reference quantum mechanical data. We show that OPLS4 performs best, and the latest Open Force Field release shows a clear improvement compared to its predecessors. The performance of established force fields such as GAFF-2.11 was generally worse. While OpenFF researchers were involved in building the benchmarking infrastructure used in this work, benchmarking was done entirely in-house within industrial organizations and the resulting assessment is reported here. This work assesses the force field performance using separate benchmarking steps, external datasets, and involving external research groups. This effort may also be unique in terms of the number of different industrial partners involved, with 10 different companies participating in the benchmark efforts.

Protocol for iterative optimization of modified peptides bound to protein targets

Peptides are commonly used as therapeutic agents. However, they suffer from easy degradation and instability. Replacing natural by non-natural amino acids can avoid these problems, and potentially improve the affinity towards the target protein. Here, we present a computational pipeline to optimize peptides based on adding non-natural amino acids while improving their binding affinity. The workflow is an iterative computational evolution algorithm, inspired by the PARCE protocol, that performs single-point mutations on the peptide sequence using modules from the Rosetta framework. The modifications can be guided based on the structural properties or previous knowledge of the biological system. At each mutation step, the affinity to the protein is estimated by sampling the complex conformations and applying a consensus metric using various open protein-ligand scoring functions. The mutations are accepted based on the score differences, allowing for an iterative optimization of the initial peptide. The sampling/scoring scheme was benchmarked with a set of protein-peptide complexes where experimental affinity values have been reported. In addition, a basic application using a known protein-peptide complex is also provided. The structure- and dynamic-based approach allows users to optimize bound peptides, with the option to personalize the code for further applications. The protocol, called mPARCE, is available at: https://github.com/rochoa85/mPARCE/.

BILN: A Human-Readable Line Notation for Complex Peptides

We present an easy, human-readable line notation to describe even complex peptides.

Developing Irelands first National Student Mental Health and Suicide Prevention Framework for Higher Education

This article focuses on the development of Ireland's first National Student Mental Health and Suicide Prevention Framework for Higher Education. There is growing concern for student mental health in higher education nationally and globally. The majority of students are aged between 18 and 24, which is identified as a high-risk group for mental health difficulties. Recent surveys of student mental illness, mental distress, and low well-being have been recognized by the World Health Organization, the Union of Students in Ireland National Report on Student Mental Health in Third Level Education, the My World survey and the My World 2 study. The Higher Education Authority in Ireland made a commitment to the Department of Health Connecting for Life (Ireland's National Strategy to Reduce Suicide 2015-2020) to form national guidelines for suicide prevention in higher education. In order to deliver on this commitment, The National Student Mental Health and Suicide Prevention Framework was developed. The Framework is informed by international evidence and was the product of a collaborative cross sector and cross disciplinary team including health professionals, government representatives, educators, students, policy makers, community organizations, researchers and clinicians.

An Isoindoline Bridged [M(η6-arene)2]+ (M = Re, 99mTc) ansa-Arenophane and its Dinuclear Macrocycles with Axial Chirality

This work presents a straightforward method for the preparation of an isoindoline bridged [M(arene)2]+ (M = Re, 99mTc) ansa-[3]arenophane. This intramolecular formation of an ansa-complex is accompanied by the intermolecular...

BRD4: quantum mechanical protein–ligand binding free energies using the full-protein DFT-based QM-PBSA method

Fully quantum mechanical approaches to calculating protein–ligand free energies of binding have the potential to reduce empiricism and explicitly account for all physical interactions responsible for protein–ligand binding.

Towards the Simulation of Large Scale Protein-Ligand Interactions on NISQ-era Quantum Computers

We explore the use of symmetry-adapted perturbation theory (SAPT) as a simple and efficient means to compute interaction energies between large molecular systems with a hybrid method combining NISQ-era quantum and classical computers. From the one- and two-particle reduced density matrices of the monomer wavefunctions obtained by the variational quantum eigensolver (VQE), we compute SAPT contributions to the interaction energy [SAPT(VQE)]. At first order, this energy yields the electrostatic and exchange contributions for non-covalently bound systems. We empirically find from ideal statevector simulations that the SAPT(VQE) interaction energy components display orders of magnitude lower absolute errors than the corresponding VQE total energies. Therefore, even with coarsely optimized low-depth VQE wavefunctions, we still obtain sub kcal mol⁻¹ accuracy in the SAPT interaction energies. In SAPT(VQE), the quantum requirements, such as qubit count and circuit depth, are lowered by performing computations on the separate molecular systems. Furthermore, active spaces allow for large systems containing thousands of orbitals to be reduced to a small enough orbital set to perform the quantum portions of the computations. We benchmark SAPT(VQE) (with the VQE component simulated by ideal statevector simulators) against a handful of small multi-reference dimer systems and the iron center containing human cancer-relevant protein lysine-specific demethylase 5 (KDM5A).

NISQ-era quantum and GPU-accelerated classical computers.

Methane emissions from above-ground natural gas distribution facilities in the urban environment: A fence line methodology and case study in Calgary, Alberta, Canada

The occurrence and emissions of methane (CH₄) from above-ground urban natural gas infrastructure is poorly understood. Compared to below-ground infrastructure, these facilities are relatively easy to monitor and maintain and present an opportunity for cost-effective CH₄ reductions. We present a case study and methodology for detecting, attributing, and quantifying CH₄ emissions from fence line measurements at above-ground natural gas facilities in the City of Calgary, Alberta, Canada. We produced bounding-box concentration maps by walking around the outer fence of 33 facilities with a backpack-configured trace gas analyzer and a tablet with integrated GPS. Wind measurements were acquired simultaneously from a fixed location on site with a 3D sonic anemometer. We fused geolocation, CH₄ concentration, and wind data to determine the likelihood each facility was emitting. We found one definitive leak by carrying out measurements directly alongside an exposed section of pipe. Based on the presence of methyl mercaptan (CH₃SH) odor, peak ΔCH₄, and the difference between downwind and upwind ΔCH₄, we interpret a high plausibility that 22 facilities were emitting CH₄, followed by 2 with a medium plausibility, and 8 with a low plausibility. Once verified to plausibly emit, these data were used to estimate emissions flux at six facilities where near-field obstructions were limited. The estimated emissions flux for six facilities was 66.31 mg CH₄ s^-1, or 2.1 tonnes CH₄ yr^-1 if this flux remained constant. Overall, this study indicates most above-ground natural gas facilities surveyed in Calgary were emitting CH₄. These facilities represent easy mitigation targets for reducing CH₄ emissions and improving environmental performance. To our knowledge, this is the first study to integrate qualitative and quantitative information to predict detection plausibility in a complex measurement setting.Implications: The fence line methodology outlined in this study represents an extension of source assessment modes in the US EPA's Other Test Method 33A for human portable systems. This has implications for standardization of emissions measurement in situations where other platforms (e.g., vehicles) are less effective due to access limitations. We believe the methodology presented could become a recognized standard based on performance from controlled testing and added to the regulatory toolkit for emissions verification and compliance.

Protein–ligand free energies of binding from full-protein DFT calculations: convergence and choice of exchange–correlation functional

Quantum mechanical binding free energies based on thousands of full-protein DFT calculations are tractable, reproducible and converge well.

Dynamic dimer-monomer equilibrium in a cycloruthenated complex of [Re(η6-C6H6)2]. Chem Commun (Camb) 2020;56:10658-10661. [PMID: 32785303 DOI: 10.1039/d0cc04180g]

Cycloruthenation is a well known process in organometallic ruthenium chemistry. In this work, we report unprecedented cycloruthenated rhenium bis-arene compounds with planar chirality. In a two-step process, the reaction of acetyl-pyridine with [Re(η6-C6H6)2]+ introduced a pyridinyl-methanol ligand at one of the arene rings. Coordination of [Ru(CO)2Cl2] led to cycloruthenation, and the products were obtained as two diastereomeric pairs of enantiomers. Under basic pH conditions, the two pairs of enantiomers undergo spontaneous and reversible dimerization. The cycloruthenated monomers were fully characterized, and the dimerization process was studied by NMR, IR spectroscopy, and DFT calculations.

THU0397 SYMPTOMS OF PERIPHERAL ARTHRITIS ARE SIGNIFICANTLY IMPROVED IN PATIENTS WITH ANKYLOSING SPONDYLITIS TREATED WITH SECUKINUMAB

Background:

Ankylosing spondylitis (AS) is a chronic inflammatory disease of the axial skeleton associated with pain, stiffness, and disability.1Up to 66% of patients (pts) with AS may also have peripheral involvement, including swollen and tender joints (STJs),2,3which are associated with worse overall disease activity.4A previous analysis showed that secukinumab, a selective inhibitor of interleukin 17A, led to significant improvements in efficacy outcomes vs placebo, regardless of peripheral joint involvement.3However, the effect of secukinumab on symptoms of peripheral arthritis in pts with AS was not assessed.

Objectives:

The objective of this analysis was to assess changes in peripheral symptoms in pts with AS treated with secukinumab vs placebo.

Methods:

Data from pts with active AS and peripheral symptoms who were enrolled in MEASURE 1 (NCT01358175), 2 (NCT01649375), 3 (NCT02008916), and 4 (NCT02159053) were pooled in this post hoc, hypothesis-generating analysis. No adjustments for multiple comparisons were made. Pts with peripheral symptoms were identified by the presence of STJs, based on 44-joint counts at baseline (BL). Pts received subcutaneous (SC) secukinumab every 4 weeks at doses of 300 mg with an intravenous (IV) loading dose (MEASURE 3 only), 150 mg with an IV or SC loading dose, or placebo. Treatment response through Week 16 was assessed based on the proportions of pts who achieved improvements of 20%, 50%, 70%, or 100% in the number of swollen and number of tender joints and improvements in the BASDAI score for question 3 and Patient Global Assessment (PGA). Changes in the number of swollen and number of tender joints were assessed in pts with swollen or tender joints at BL, respectively.

Results:

This pooled analysis included 560 pts with AS and STJs at BL (Table). At Week 16, treatment with secukinumab led to significantly greater proportions of pts achieving reductions in the number of swollen (Fig 1A) or tender (Fig 1B) joints compared with placebo; the treatment effect was more pronounced in reduction of swollen joints. Furthermore, a greater proportion of secukinumab-treated pts achieved complete resolution of swollen or tender joints vs placebo (Fig 1). Secukinumab also led to significant improvements in peripheral pain/swelling (Fig 2A) and disease activity (Fig 2B) vs placebo, as assessed using BASDAI question 3 and the PGA, respectively.

Table.

Patient Characteristics at Baseline

SecukinumabPlacebo (n = 252)300 mg (n = 52)150 mg (n = 256)Age, mean, y43.643.744.9Time since diagnosis, mean, y5.67.27.3Male, %63.562.157.5PGA of Disease Activity, mean, mm73.471.770.1BASDAI question 3, mean6.36.66.4Swollen 44-joint count, mean1.92.62.5Tender 44-joint count, mean7.17.87.9

Conclusion:

In parallel with its previously reported efficacy in axial symptoms,3secukinumab led to significant improvements in symptoms of peripheral arthritis in pts with AS. Significant improvements were seen in both tender and swollen joints.

References:

[1]Braun J, Sieper J.Lancet. 2007;369:1379-1390.

[2]de Winter JJ, et al.Arthritis Res Ther. 2016;18:196.

[3]Mease P, et al.Arthritis Rheumatol. 2019;71(suppl 10):1553.

[4]de Winter JJ, et al.RMD Open. 2019;5:e000802.

Acknowledgments:

This study was funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ. The authors thank Amos Race, PhD, of ArticulateScience LLC, Hamilton, NJ, USA, for providing medical writing/editorial support, which was funded by Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3).

Disclosure of Interests:

Philip J Mease Grant/research support from: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – grant/research support, Consultant of: Abbott, Amgen, Biogen Idec, BMS, Celgene Corporation, Eli Lilly, Novartis, Pfizer, Sun Pharmaceutical, UCB – consultant, Speakers bureau: Abbott, Amgen, Biogen Idec, BMS, Eli Lilly, Genentech, Janssen, Pfizer, UCB – speakers bureau, Atul Deodhar Grant/research support from: AbbVie, Eli Lilly, GSK, Novartis, Pfizer, UCB, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myer Squibb (BMS), Eli Lilly, GSK, Janssen, Novartis, Pfizer, UCB, Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myer Squibb (BMS), Eli Lilly, GSK, Janssen, Novartis, Pfizer, UCB, Renato Calheiros Shareholder of: Novartis, Employee of: Novartis, Xiangyi Meng Shareholder of: Novartis, Employee of: Novartis, Todd Fox Shareholder of: Novartis, Employee of: Novartis, Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen

[Re(η6-arene)2]+ as a highly stable ferrocene-like scaffold for ligands and complexes

Ferrocenes are versatile ligand scaffolds, complexes of which have found numerous applications in catalysis. Structurally similar but of higher redox stabilites are sandwich complexes of the [Re(η6-arene)2]+ type. We report herein routes for conjugating potential ligands to a single or to both arenes in this scaffold. Since the arene rings can freely rotate, the [Re(η6-arene)2]+ has a high degree of structural flexibility. Polypyridyl ligands were successfully introduced. The coordination of Co(ii) to such a model tetrapyridyl-Re(i)-bis-benzene complex produced a bimetallic Re(i)-Co(ii) complex. To show the stability of the resulting architecture, a selected complex was subjected to photocatalytic reactions. It showed good activity in proton reduction over a long time and did not decompose, corroborating its extraordinary stability even under light irradiation. Its activity compares well with the parent catalyst in turn over numbers and frequencies. The supply of electrons limits catalytic turnover frequency at concentrations below ∼10 μM. We also show that other ligands can be introduced along these strategies. The great diversity offered by [Re(η6-arene)2]+ sandwich complexes from a synthetic point allows this concept to be extended to other catalytic processes, comparable to ferrocenes.

Assessing the accuracy of octanol-water partition coefficient predictions in the SAMPL6 Part II log P Challenge

The SAMPL Challenges aim to focus the biomolecular and physical modeling community on issues that limit the accuracy of predictive modeling of protein-ligand binding for rational drug design. In the SAMPL5 log D Challenge, designed to benchmark the accuracy of methods for predicting drug-like small molecule transfer free energies from aqueous to nonpolar phases, participants found it difficult to make accurate predictions due to the complexity of protonation state issues. In the SAMPL6 log P Challenge, we asked participants to make blind predictions of the octanol-water partition coefficients of neutral species of 11 compounds and assessed how well these methods performed absent the complication of protonation state effects. This challenge builds on the SAMPL6 p[Formula: see text] Challenge, which asked participants to predict p[Formula: see text] values of a superset of the compounds considered in this log P challenge. Blind prediction sets of 91 prediction methods were collected from 27 research groups, spanning a variety of quantum mechanics (QM) or molecular mechanics (MM)-based physical methods, knowledge-based empirical methods, and mixed approaches. There was a 50% increase in the number of participating groups and a 20% increase in the number of submissions compared to the SAMPL5 log D Challenge. Overall, the accuracy of octanol-water log P predictions in SAMPL6 Challenge was higher than cyclohexane-water log D predictions in SAMPL5, likely because modeling only the neutral species was necessary for log P and several categories of method benefited from the vast amounts of experimental octanol-water log P data. There were many highly accurate methods: 10 diverse methods achieved RMSE less than 0.5 log P units. These included QM-based methods, empirical methods, and mixed methods with physical modeling supported with empirical corrections. A comparison of physical modeling methods showed that QM-based methods outperformed MM-based methods. The average RMSE of the most accurate five MM-based, QM-based, empirical, and mixed approach methods based on RMSE were 0.92 ± 0.13, 0.48 ± 0.06, 0.47 ± 0.05, and 0.50 ± 0.06, respectively.

κ3 -(N^C^C)Gold(III) Carboxylates: Evidence for Decarbonylation Processes

Gold(III) carboxylate species, stabilized by a κ³ -(N^C^C) ligand template, are presented herein. A η¹ -Au^III -C(O)-OH species has been characterized under cryogenic conditions as a result of the nucleophilic attack of an ammonium hydroxide onto a dinuclear μ-CO₂ -κ³ -(N^C^C)Au^III precursor. Thermal decomposition for these species proceeds by an unusual decarbonylation process, in contrast to typical decarboxylation pathways observed in related metallocarboxylic acids.

Spinal radiographic progression over 2 years in ankylosing spondylitis patients treated with secukinumab: a historical cohort comparison

OBJECTIVE

The aim of this study was to compare radiographic progression in patients with ankylosing spondylitis (AS) treated for up to 2 years with secukinumab (MEASURE 1) with a historical cohort of biologic-naïve patients treated with NSAIDs (ENRADAS).

METHODS

Baseline and 2-year lateral cervical and lumbar spine radiographs were independently evaluated using mSASSS by two readers, who were blinded to the chronology and cohort of the radiographs. The primary endpoint was the proportion of patients with no radiographic progression (mSASSS change ≤ 0 from baseline to year 2). The Primary Analysis Set included patients with baseline (≤ day 30) and post-baseline day 31-743 radiographs. Sensitivity analyses were performed to assess the robustness of the comparison between the two cohorts, as follows: Sensitivity Analysis Set 1 included all patients with baseline (≤ day 30) and year 2 (days 640-819) radiographs; Sensitivity Analysis Set 2 included all patients with baseline and post-baseline (> day 30) radiographs.

RESULTS

A total of 168 patients (84%) from the MEASURE 1 cohort and 69 (57%) from the ENRADAS cohort qualified for the Primary Analysis Set. Over 2 years, the LS (SE) mean change from baseline in mSASSS for the primary analysis was 0.55 (0.139) for MEASURE 1 vs 0.89 (0.216) for ENRADAS (p = 0.1852). Mean changes from baseline in mSASSS were lower in MEASURE 1 vs ENRADAS for the primary and sensitivity analyses. The proportion of patients with no radiographic progression was consistently higher in the MEASURE 1 vs ENRADAS cohort across all cutoffs for no radiographic progression (change in mSASSS from baseline to year 2 of ≤ 0, ≤ 0.5, ≤ 1, and ≤ 2), but the differences were not statistically significant.

CONCLUSION

Secukinumab-treated patients demonstrated a numerical, but statistically non-significant, higher proportion of non-progressors and lower change in mSASSS over 2 years versus a cohort of biologic-naïve patients treated with NSAIDs.

Mechanistically Driven Control over Cubane Oxo Cluster Catalysts

Predictive and mechanistically driven access to polynuclear oxo clusters and related materials remains a grand challenge of inorganic chemistry. We here introduce a novel strategy for synthetic control over highly sought-after transition metal {M₄O₄} cubanes. They attract interest as molecular water oxidation catalysts that combine features of both heterogeneous oxide catalysts and nature's cuboidal {CaMn₄O₅} center of photosystem II. For the first time, we demonstrate the outstanding structure-directing effect of straightforward inorganic counteranions in solution on the self-assembly of oxo clusters. We introduce a selective counteranion toolbox for the controlled assembly of di(2-pyridyl) ketone (dpk) with M(OAc)₂ (M = Co, Ni) precursors into different cubane types. Perchlorate anions provide selective access to type 2 cubanes with the characteristic {H₂O-M₂(OR)₂-OH₂} edge-site, such as [Co₄(dpy-C{OH}O)₄(OAc)₂(H₂O)₂](ClO₄)₂. Type 1 cubanes with separated polar faces [Co₄(dpy-C{OH}O)₄(L2)₄] ⁿ⁺ (L2 = OAc, Cl, or OAc and H₂O) can be tuned with a wide range of other counteranions. The combination of these counteranion sets with Ni(OAc)₂ as precursor selectively produces type 2 Co/Ni-mixed or {Ni₄O₄} cubanes. Systematic mechanistic experiments in combination with computational studies provide strong evidence for type 2 cubane formation through reaction of the key dimeric building block [M₂(dpy-C{OH}O)₂(H₂O)₄]²⁺ with monomers, such as [Co(dpy-C{OH}O)(OAc)(H₂O)₃]. Furthermore, both experiments and DFT calculations support an energetically favorable type 1 cubane formation pathway via direct head-to-head combination of two [Co₂(dpy-C{OH}O)₂(OAc)₂(H₂O)₂] dimers. Finally, the visible-light-driven water oxidation activity of type 1 and 2 cubanes with tuned ligand environments was assessed. We pave the way to efficient design concepts in coordination chemistry through ionic control over cluster assembly pathways. Our comprehensive strategy demonstrates how retrosynthetic analyses can be implemented with readily available assembly directing counteranions to provide rapid access to tuned molecular materials.

Long-term safety of secukinumab in patients with moderate-to-severe plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis: integrated pooled clinical trial and post-marketing surveillance data

BACKGROUND

Secukinumab, a fully human immunoglobulin G1-kappa monoclonal antibody that directly inhibits interleukin (IL)-17A, has been shown to have robust efficacy in the treatment of moderate-to-severe psoriasis (PsO), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) demonstrating a rapid onset of action and sustained long-term clinical responses with a consistently favorable safety profile in multiple Phase 2 and 3 trials. Here, we report longer-term pooled safety and tolerability data for secukinumab across three indications (up to 5 years of treatment in PsO and PsA; up to 4 years in AS).

METHODS

The integrated clinical trial safety dataset included data pooled from 21 randomized controlled clinical trials of secukinumab 300 or 150 or 75 mg in PsO (14 Phase 3 trials and 1 Phase 4 trial), PsA (3 Phase 3 trials), and AS (3 Phase 3 trials), along with post-marketing safety surveillance data with a cut-off date of June 25, 2017. Adverse events (AEs) were reported as exposure-adjusted incident rates (EAIRs) per 100 patient-years. Analyses included all patients who received ≥ 1 dose of secukinumab.

RESULTS

A total of 5181, 1380, and 794 patients from PsO, PsA, and AS clinical trials representing secukinumab exposures of 10,416.9, 3866.9, and 1943.1 patient-years, respectively, and post-marketing data from patients with a cumulative exposure to secukinumab of ~ 96,054 patient-years were included in the analysis. The most frequent AE was upper respiratory tract infection. EAIRs across PsO, PsA, and AS indications were generally low for serious infections (1.4, 1.9, and 1.2, respectively), Candida infections (2.2, 1.5, and 0.7, respectively), inflammatory bowel disease (0.01, 0.05, and 0.1, respectively), and major adverse cardiac events (0.3, 0.4, and 0.6, respectively). No cases of tuberculosis reactivation were reported. The incidence of treatment-emergent anti-drug antibodies was low with secukinumab across all studies, with no discernible loss of efficacy, unexpected alterations in pharmacokinetics, or association with immunogenicity-related AEs.

CONCLUSIONS

Secukinumab demonstrated a favorable safety profile over long-term treatment in patients with PsO, PsA, and AS. This comprehensive assessment demonstrated that the safety profile of secukinumab was consistent with previous reports in patients with PsO, PsA, and AS, supporting its long-term use in these chronic conditions.

Nickel catalyzed synthesis of 4,4′-bichromenes/4,4′-bithiochromenes and their Atropisomerism

4,4′-bichromenes and 4,4′-bithiochromenes have been synthesized by a Ni catalyzed homocoupling method and their Atropisomeric behavior has been studied.

Patient perceptions of clear/almost clear skin in moderate-to-severe plaque psoriasis: results of the Clear About Psoriasis worldwide survey

BACKGROUND

Therapeutic advances have made the achievement of clear/almost clear skin possible for many patients with moderate-to-severe plaque psoriasis.

OBJECTIVE

To determine patient perceptions of the impact of psoriasis and of attaining clear/almost clear skin.

METHODS

Global survey of patients with moderate-to-severe psoriasis.

RESULTS

A total of 8338 patients from 31 countries participated. The majority (57%) had not achieved self-assessed clear/almost clear skin with their current therapy, and 56% of those who had not met this goal believed it would be impossible to do so. Among the patients who had clear/almost clear skin, 73% had not initiated their current treatment until >1 year after psoriasis diagnosis, and 28% had to wait >5 years. Eighty-four percent of all respondents experienced discrimination and/or humiliation due to psoriasis, and many reported negative effects on work, intimate relationships, sleep and mental health. Patients without clear/almost clear skin reported that such achievement would open new possibilities, such as swimming (58%), a wider choice of clothing (40%), and meeting new people (26%). A limitation of this study, as with any survey-based research, is that selection and recall bias may have been present. Additionally, respondent definitions of clear/almost clear skin were subjective and may have varied.

CONCLUSION

Despite the importance of clear/almost clear skin to psoriasis patients, most are still not achieving it, and many are unaware it is possible.

Hepatitis E infection in stem cell and solid organ transplantpatients: A cross-sectional study: The importance of HEV RNA screening in peri-transplant period

BACKGROUND

Hepatitis E Virus (HEV) is a common cause of acute viral hepatitis worldwide. Typically associated with a self-limiting illness, infection may persist in immunosuppressed populations with significant morbidity and mortality. Based on clinical data published world-wide, UK blood safety guidance recommends the universal screening for HEV RNA of blood donors and donors of tissue, organs and stem cells.

OBJECTIVES

This cross-sectional study aimed to determine the point prevalence of HEV viraemia and clinical course of viraemic patients in the peri-transplant period in solid organ transplant (SOT) and haematopoietic stem cell transplant (HSCT) recipients transplanted over a 3-year period (2013-2015).

STUDY DESIGN

Nucleic acid extracts of whole blood from patients undergoing SOT or HSCT were tested by an in-house real-time reverse-transcriptase polymerase chain reaction assay for HEV RNA. Samples were tested at baseline (time of transplant), 30, 60 and 90 days post-transplant.

RESULTS

870 patients (259 HSCT, 262 liver and 349 kidney transplant) were included with 2554 samples meeting the inclusion criteria. No kidney transplant patients had HEV viraemia at time of testing. One HSCT and three liver transplant patients were found to be HEV RNA positive. Overall this represented 0.46% of the patients testing positive for HEV viraemia.

CONCLUSIONS

Prevalence of HEV viraemia in SOT and HSCT patients in U.K. although higher than in the general population is low at baseline and remains low throughout the early post-transplant phase. Clearance of viraemia can be maintained despite ongoing immunosuppression. Prospective U.K. studies are necessary to inform screening policies in this population.

Peptidic Macrocycles - Conformational Sampling and Thermodynamic Characterization

Macrocycles are of considerable interest as highly specific drug candidates, yet they challenge standard conformer generators with their large number of rotatable bonds and conformational restrictions. Here, we present a molecular dynamics-based routine that bypasses current limitations in conformational sampling and extensively profiles the free energy landscape of peptidic macrocycles in solution. We perform accelerated molecular dynamics simulations to capture a diverse conformational ensemble. By applying an energetic cutoff, followed by geometric clustering, we demonstrate the striking robustness and efficiency of the approach in identifying highly populated conformational states of cyclic peptides. The resulting structural and thermodynamic information is benchmarked against interproton distances from NMR experiments and conformational states identified by X-ray crystallography. Using three different model systems of varying size and flexibility, we show that the method reliably reproduces experimentally determined structural ensembles and is capable of identifying key conformational states that include the bioactive conformation. Thus, the described approach is a robust method to generate conformations of peptidic macrocycles and holds promise for structure-based drug design.

Ruthenium water oxidation catalysts containing the non-planar tetradentate ligand, biisoquinoline dicarboxylic acid (biqaH2)

Two ruthenium complexes containing the tetradentate ligand [1,1'-biisoquinoline]-3,3'-dicarboxylic acid, and 4-picoline or 6-bromoisoquinoline as axial ligands have been prepared. The complexes have been fully characterised and initial studies on their potential to function as molecular water oxidation catalysts have been performed. Both complexes catalyse the oxidation of water in acidic media with Ce^IV as a stoichiometric chemical oxidant, although turnover numbers and turnover frequencies are modest when compared with the closely related Ru-bda and Ru-pda analogues. Barriers for the water nucleophilic attack and intermolecular coupling pathways were obtained from density functional theory calculations and the crucial influence of the ligand framework in determining the most favourable reaction pathway was elucidated from a combined analysis of the theoretical and experimental results.

Ruthenium Water Oxidation Catalysts based on Pentapyridyl Ligands

Ruthenium complexes containing the pentapyridyl ligand 6,6''-(methoxy(pyridin-2-yl)methylene)di-2,2'-bipyridine (L-OMe) of general formula trans-[Ru^II (X)(L-OMe-κ-N⁵ )]ⁿ⁺ (X=Cl, n=1, trans-1⁺ ; X=H₂ O, n=2, trans-2²⁺ ) have been isolated and characterized in solution (by NMR and UV/Vis spectroscopy) and in the solid state by XRD. Both complexes undergo a series of substitution reactions at oxidation state Ru^II and Ru^III when dissolved in aqueous triflic acid-trifluoroethanol solutions as monitored by UV/Vis spectroscopy, and the corresponding rate constants were determined. In particular, aqueous solutions of the Ru^III -Cl complex trans-[Ru^III (Cl)(L-OMe-κ-N⁵ )]²⁺ (trans-1²⁺ ) generates a family of Ru aquo complexes, namely trans-[Ru^III (H₂ O)(L-OMe-κ-N⁵ )]³⁺ (trans-2³⁺ ), [Ru^III (H₂ O)₂ (L-OMe-κ-N⁴ )]³⁺ (trans-3³⁺ ), and [Ru^III (Cl)(H₂ O)(L-OMe-κ-N⁴ )]²⁺ (trans-4²⁺ ). Although complex trans-4²⁺ is a powerful water oxidation catalyst, complex trans-2³⁺ has only a moderate activity and trans-3³⁺ shows no activity. A parallel study with related complexes containing the methyl-substituted ligand 6,6''-(1-pyridin-2-yl)ethane-1,1-diyl)di-2,2'-bipyridine (L-Me) was carried out. The behavior of all of these catalysts has been rationalized based on substitution kinetics, oxygen evolution kinetics, electrochemical properties, and density functional theory calculations. The best catalyst, trans-4²⁺ , reaches turnover frequencies of 0.71 s^-1 using Ce^IV as a sacrificial oxidant, with oxidative efficiencies above 95 %.

Secukinumab sustains good efficacy and favourable safety in moderate-to-severe psoriasis after up to 3 years of treatment: results from a double-blind extension study

BACKGROUND

Secukinumab has demonstrated significant efficacy with a good safety profile through 1 year in plaque psoriasis. Given the chronic nature of this disease, long-term follow-up is needed to evaluate psoriasis therapies fully.

OBJECTIVES

To determine the long-term (3-year) efficacy and safety of secukinumab in moderate-to-severe psoriasis.

METHODS

Patients completing 52 weeks of secukinumab treatment in the SCULPTURE core study entered an extension in which they continued the same double-blind regimens. Dosing regimens included a fixed-interval schedule (FI; every 4 weeks) and retreatment as needed (RAN), in which patients were withdrawn from secukinumab and received placebo until the start of relapse, at which time secukinumab every 4 weeks was reinitiated. The study was registered with number NCT01640951.

RESULTS

In total 168 patients receiving secukinumab 300 mg FI and 172 receiving secukinumab 300 mg RAN entered the extension. Secukinumab 300 mg FI sustained high efficacy: at the end of year 3, the proportion of responders achieving ≥ 90% improvement in Psoriasis Area and Severity Index (PASI 90) was 63·8%, and of PASI 100 responders it was 42·6%. The mean absolute PASI remained low (2-4) from week 52 to week 152 with 300 mg FI, with approximately two-thirds of patients reporting no impact of skin disease on their lives (Dermatology Life Quality Index of 0 or 1). Improvements in overall and subscale scores on all quality-of-life instruments were well sustained. As in the core study, FI dosing was consistently more efficacious than RAN. No new safety signals were identified to year 3.

CONCLUSIONS

Secukinumab 300 mg FI sustained high responses and improved quality of life with no new safety concerns through 3 years.