Discovery of SPH3127: A Novel, Highly Potent, and Orally Active Direct Renin Inhibitor

Renin is the rate-limiting enzyme in the renin-angiotensin-aldosterone system (RAAS) which regulates blood pressure and renal function and hence is an attractive target for the treatment of hypertension and cardiovascular/renal diseases. However, the development of direct renin inhibitors (DRIs) with favorable oral bioavailability has been a longstanding challenge for many years. This problem was thought to be because most of the reported DRIs were peptide-like structures or nonpeptide-like structures with a molecular weight (MW) of600. Therefore, we tried to find nonpeptidomimetic DRIs with a MW of500 and discovered the promising 2-carbamoyl morpholine derivative