Clazosentan

Chemical compound

  • C04AX33 (WHO)
Legal statusLegal status
  • In general: ℞ (Prescription only)
Identifiers
  • 5-methyl-pyridin-2-sulfonic acid{6-(2-hydroxy-ethoxy)-5-(2-methoxy-phenoxy)-2-[2-(1H-tetrazol-5-yl)-pyridin-4-yl]-pyrimidin-4-yl}amide
CAS Number
  • 180384-56-9
PubChem CID
  • 6433095
DrugBank
  • DB06677
ChemSpider
  • 4938283
UNII
  • 3DRR0X4728
KEGG
  • D11664
ChEMBL
  • ChEMBL109648
CompTox Dashboard (EPA)
  • DTXSID60170955 Edit this at Wikidata
Chemical and physical dataFormulaC25H23N9O6SMolar mass577.58 g·mol−13D model (JSmol)
  • Interactive image
  • CC1=CN=C(C=C1)S(=O)(=O)NC2=C(C(=NC(=N2)C3=CC(=NC=C3)C4=NNN=N4)OCCO)OC5=CC=CC=C5OC
InChI
  • InChI=1S/C25H23N9O6S/c1-15-7-8-20(27-14-15)41(36,37)32-24-21(40-19-6-4-3-5-18(19)38-2)25(39-12-11-35)29-22(28-24)16-9-10-26-17(13-16)23-30-33-34-31-23/h3-10,13-14,35H,11-12H2,1-2H3,(H,28,29,32)(H,30,31,33,34)
  • Key:LFWCJABOXHSRGC-UHFFFAOYSA-N

Clazosentan (INN, brand name Pivlaz[1]) is a drug belonging to the class of endothelin receptor antagonists.

Mechanism

The endothelin 1 receptor is one of the strongest known vasoconstrictors. After subarachnoidal bleedings, irritation of the blood vessels can lead to a vasospasm and thus to an ischaemia, an insufficient blood supply to brain tissue. One possible effect of this is, in turn, an ischaemic stroke.

Trials

In a randomized trial with patients who had aneurysmal subarachnoid bleeding and were being treated with endovascular coiling, 15 mg/h clazosentan significantly reduced vasospasm-related morbidity and all-cause mortality. Clazosentan, however, did not improve the neurological outcome as measured by the extended Glascow Outcome Scale.[2]

References

  1. ^ "Idorsia receives Japanese PMDA approval of Pivlaz" (Press release). Idorsia. 20 January 2022. Retrieved 22 January 2022 – via GlobalNewsWire.
  2. ^ Macdonald RL, Higashida RT, Keller E, Mayer SA, Molyneux A, Raabe A, et al. (June 2012). "Randomized trial of clazosentan in patients with aneurysmal subarachnoid hemorrhage undergoing endovascular coiling". Stroke. 43 (6): 1463–1469. doi:10.1161/STROKEAHA.111.648980. PMID 22403047. S2CID 3113695.