The synthesis and SAR of novel nanomolar thrombin inhibitors with the common
backbone
HOOC-CH(2)-d-cyclohexylalanyl-3,4-dehydroprolyl-NH-CH(2)-aryl-C(=NH)NH(2) are
described together with their ecarin clotting time (ECT) prolongation as measure
for thrombin inhibition ex vivo. The aryl P1-moiety mimicking the arginine part
of the d-Phe-Pro-Arg derived thrombin inhibitors turned out to be a key
component for in vitro potency and in vivo activity. Optimization of this part
led to compounds with improved antithrombin activity in rats and dogs after oral
administration compared to the recently launched anticoagulant melagatran.