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www.guidetopharmacology.org

Capturing BIA-10-2474 and related FAAH inhibitor data in the IUPHAR/BPS Guide to

PHARMACOLOGY (GtoPdb)

Dr Christopher Southan, Senior Database Curator, IUPHAR/BPS Guide to PHARMACOLGY, University of Edinburgh

BioIT Boston, 2016, Thu 7th ´April, Track 5, Bioinformatics 11:40

http://www.slideshare.net/cdsouthan/capturing-bia102474-and-related-faah-inhibitor-data-in

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Abstract (will skip for presentation)The clinical trial disaster in France where a fatality was associated with the Phase 1 FAAH inhibitor BIA-10-2474 has been widely reported on since January 15th 2016. Commentaries in Science, Nature News, Forbes and Chemical and Engineering News have included interviews with two of us (SPHA and CS). While the unfortunate events will have wide repercussions, the immediate consequence was a deficit of pharmacologically-relevant information. Because the IUPHAR/BPS Guide to PHARMACOLOGY database (GtoPdb) has a primary focus on the annotation of drugs and clinical candidates (PMID 26464438) we endeavoured to fill the gap. We already had entries for the primary target FAAH and the possible secondary target FAAH2, so we extended these with such provenanced data we could find. This is particularly important to support the in silico modelling community as soon as possible (e.g. for off-target prediction, cross-docking and ADMET computation). Since there were neither journal articles, nor name-to-structure declarations nor an open clinical trials entry, BIA-10-2474 was completely blinded until the release of a clinical protocol by Le Figaro newspaper on Jan 21st. This enabled us to curate N-cyclohexyl-N-methyl-4-(1-oxidopyridin-1-ium-3-yl) imidazole-1-carboxamide as ligand ID 9001 for BIA-10-2474. In addition, this is now name-mapped in PubChem via our submission. While the only document mapping was to a Bial patent, this included 388 analogues for interested parties to follow up. However, no IC50s were reported for the purified human enzyme, only % inhibition from a crude rat brain preparation. To expand key topics beyond what we typically capture according to our curation rules (see the database FAQ) we make use of blog posts. In this case we have used this avenue to highlight low activity analogues (i.e. SAR pairs) for Bial leads, JNJ-42165279 and PF-04457845. In addition we have connected patents to access extended SAR results. This information is valuable for the in silico modelling community since it provides comparator controls and sets for pharmacophore alignments. A set of links related to this abstract can be found as the NC-IUPHAR “Hot Topics” bulletin http://www.guidetopharmacology.org/hotTopics.jsp#FAAH.

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Outline

• Context of the BIA 10-2474 tragedy• Data gaps• The GtoPdb response • FAAH related database entries• Extending connections • Blog utility• GtoPdb plans• Wider issues • Conclusions

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Introduction

• BIA 10-2747 is an Fatty Acid Amide Hydrolase (FAAH) inhibitor developed by Bial, Portugal as a potential analgesic

• On 6th of Jan 2016, during a Phase I trial in Rennes run by BioTrial, 6 male patients started the 50 mg per day, high dose arm

• On Jan 10th Jan, after cumulative dosing, one was hospitalised, went into a coma and died on the 17th of Jan

• The remaining five were hospitalised• The trial was halted on 11th of Jan, publically announced on 15th Jan• Brain MRI showed variable haemorrhagic and necrotic lesions in the

fatality and four of the remaining five, with possible chronic damage • 84 volunteers given lower doses showed no symptoms • Other FAAH inhibitors have completed Phase I without safety issues

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Persistent data gaps

• Protocol registered on 16th October last year (EudraCT No. 2015-001799-24) but not indexed in the search interface

• Protocol released by ANSM on 22nd Jan and Le Figaro on 24th

• Until then BIA 10-2474 was blinded with only a Bial portfolio listing, no structure, no papers, no trials entry

• The protocol specified a structure from WO2010074588 • The patent remains (as of 27 March) the only source of in vitro data • The patent has no activity measurements against purified human FAAH • French “Temporary Specialist Scientific Committee” meeting report of 15

February details safety testing but extrapolates to unlikely in vitro potencies and irreversibility not supported by results

• Many questions remain, including the multi-species tox outcomes and metabolite identification

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Primary patent filing: patchy data

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GtoPdb remit and response

• Our Wellcome-funded mission is described in : “The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands” PMID 26464438

• We had already captured clinical FAAH inhibitors• We initially surfaced the BIA 10-2474 structure in our 4th February

release, as ligand 9001• PubChem submission on the 5th (SID 310264779) added name-to-

structure mapping into CID 46831476• Since WO2010074588 only had % inhibition from crude rodent extracts, it

did not pass our curation stringency for target mapping• However, in the interests of surfacing important relationships, we “bent

our rules” by estimating an IC50 and adding the link to Swiss-Prot O00519 (will appear in our March release)

• Given intense interest in FAAH inhibition we utilised curators comments, a personal blog and our “Hot Topics” to provide ancillary information not typically covered by curation

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GtoPdb entry for BIA 10-2474

http://guidetopharmacology.org/GRAC/LigandDisplayForward?ligandId=9001

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Capturing FAAH inhibitors and dual inhibitors

http://www.guidetopharmacology.org/GRAC/ObjectDisplayForward?objectId=1400

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FAAH2

http://www.guidetopharmacology.org/GRAC/ObjectDisplayForward?objectId=1401

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Extending connections, metadata and context

GtoPdb“Hot tips”

Personal blog

GtoPdb Blog

GtoPdb records and

curators comments

Social media

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“Hot Topics” a useful dissemination route

http://www.guidetopharmacology.org/hotTopics.jsp#FAAH

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Personal blog: useful cross-pointing to ancillary data

http://cdsouthan.blogspot.se/2016/01/the-unfortunate-case-of-bia-10-2474.html

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Using the blog for SAR controls

• We typically only curate lead compounds for GtoPdb ligand entries• Blog specifies low-activity analogues useful for in silico modelling and

comparative testing • Can also cross-points to patent SAR data sets, including other Bial patents

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Blog adds bioinformatics context

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GtoPdb plans

• Continue to update FAAH inhibitors and their x-reactivity, based on data curated from papers and patents

• Grapple with unit incompatibilities (e.g. % inhib. vs Ki vs IC50 vs Kinact)• Updates will be surfaced via approximately quarterly database releases

and new ligand structures submitted to PubChem • Consider non-published but provenanced data, if parties contact us• Continue to use blog posts to surface useful data going beyond our

curated relationships (e.g. low activity analogues and new patents)• Will continue to support parties involved with modelling and/or

experimental x-screening related to mechanistic toxicology of BIA 10-2474, including benchmarking against other FAAH leads

• Eventual documented insights into the molecular pathology will be pointed to via curators comments, blog posts and Hot Topics

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Wider data-related issues

• Experiments to illuminate mechanistic causality (and, crucially, avoidance) need to be performed outside Bial by other teams with FAAH expertise

• FAAH drug development is likely to cease until this happens• Given that Bial has not only at least a Kg of BIA 10-2474 but also ~350

analogues (including radiolabelled) the scientific imperative is to distribute these to engaging parties (unprecedented, but then so is the tragedy)

• As a response to this event and mounting pressure for transparency, drug development organisations should rethink blinding lead structures by codes (e.g. V158866, at Phase II, is still blinded)

• They should be encouraged (mandated?) to publish detailed journal reports of in vitro and in vivo characterisation that facilitate curation into open pharmacology sources such as GtoPdb and subsequent data mining

• Incidents like this bring the questionable patenting practices of obfuscation and data-thin applications into sharp focus

• Clinical trial databases have proliferated globally but have yet to meet expectations for compliance and translational data mining of results

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Conclusions

• The BIA 10-2474 disaster raises issues and will have global consequences • Data paucity has fuelled speculation across the web• Since GtoPdb’s remit includes clinical compound capture, we filled data

gaps from patents • We chose to “rule bend” to add target connectivity value• Beyond database records per se we used ancillary options to surface more

data for the modelling community• Insights into molecular toxicology need to be verified at the community level• The longer it takes to close information gaps, the greater the risk of

reputational damage reflecting across the entire industry• GtoPdb is well positioned to capture and link new data, ideally from the

peer-reviewed literature

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Acknowledgments and sources: questions welcome

• The GtoPdb team, Elena Faccenda, Joanna L. Sharman, Adam J. Pawson, Simon D. Harding and Jamie A Davies

• Stephen PH Alexander, Chair of NC-IUPHAR• CS and SA appreciated the diligent reporting of news outlets we

were interviewed by and/or attributed quotes• We also appreciated the active dissemination of our various

surfacing's on social media (e.g. re-tweets )• The anonymous Wikipedian for corroborative cross-pointing to

GtoPdb and the personal blog• Documentation on the ANSM (French National Agency for Medicines

and Health Products Safety) website section http://ansm.sante.fr/Dossiers/Essai-Clinique-Bial-Biotrial/Essai-clinique-BIA-102474-101-du-laboratoire-BIAL/%28offset%29/0