Design, synthesis, and biological evaluation of substituted oxopyridine derivatives as selective FXIa inhibitors.

To explore selective FXIa inhibitors, a series of compounds was rationally designed using computer-aided drug design (CADD) and synthesized by introducing hydrophobic P1 fragments, which could strengthen the interaction with the S1 pocket of FXIa and weaken the interaction with plasma kallikrein. All the compounds were tested for the inhibition of FXIa, and some of them were further evaluated via plasma kallikrein selectivity and clotting assays. Compound 4c exhibited excellent in vitro potency, good membrane permeability and higher selectivity than asundexian. Furthermore, 4c showed an excellent pharmacokinetic property in rats after intravenous or oral administration. These results indicate that 4c can serve as a novel FXIa inhibitor that has potential clinical applications in patients.