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Lixivaptan

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641:, placebo-controlled, randomized period during which they will receive lixivaptan or placebo for 12 months. This part of the trial will compare the change in estimated glomerular filtration rate (eGFR) measurements between the two groups to investigate the efficacy of lixivaptan in slowing the decline in kidney function. This is followed by Part 2 of the study, during which all study participants who complete Part 1 will receive lixivaptan in a single-arm, open-label phase for an additional 12 months. Part 2 will investigate whether lixivaptan's effect on kidney function continues to accrue over time. Altogether, including the titration periods, participants in the ACTION study will be taking study drug for more than two years, including lixivaptan for at least one year. It is expected that Part 1 will be completed for all participants by February 2025; Part 2 is projected to run until April 2026. 256: 233: 555:, a vasopressin antagonist in the same drug class as lixivaptan. In clinical studies, tolvaptan showed a significant decrease in the rate of disease progression in patients with ADPKD, which led to regulatory approvals for tolvaptan as a treatment of ADPKD in many countries, including the U.S., the EU, Japan, Canada, Australia, and Korea, among others. However, tolvaptan therapy is associated with potentially life-threatening 31: 413:) is an orally-active, non-peptide, selective vasopressin 2 receptor antagonist being developed as an investigational drug by Palladio Biosciences, Inc. (Palladio), a subsidiary of Centessa Pharmaceuticals plc. As of December 2021, lixivaptan is in Phase III clinical development for the treatment of 685:
that uses non-clinical and clinical drug data to predict whether a drug could cause idiosyncratic liver toxicity. DILIsym® replicated accurately the liver toxicity observed with tolvaptan in clinical studies. Conversely, results from the DILIsym® study with lixivaptan suggest that lixivaptan may be
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to an optimal dose, up to 50 patients with ADPKD will be enrolled and treated with lixivaptan for 52 weeks. They will be monitored frequently for signs of liver toxicity for as long as they are taking lixivaptan. At the completion of the 52 weeks maintenance period, patients will be eligible to
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of lixivaptan in patients with ADPKD. It is projected to enroll 1350 patients in more than 20 countries worldwide. If the ACTION study is successful, it will provide the main clinical evidence supporting the potential safety and efficacy of lixivaptan for the treatment of ADPKD.
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less likely to cause idiosyncratic liver toxicity within this modeling system. Whether this result reliably predicts a lower risk of liver injury for lixivaptan will require more clinical safety data, which will be collected as part of the two ongoing Phase III clinical studies.
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A Phase III study by Palladio to investigate whether it is safe and effective for the treatment of ADPKD was commenced in October 2021. The Phase III program with lixivaptan consists of two ongoing clinical trials: the ACTION and ALERT studies.
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receptor antagonists have shown a reduction in kidney size and cyst volume in animal models of PKD. In particular, lixivaptan has demonstrated beneficial effects on cystic disease progression in rat and mouse models of ADPKD.
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Palladio conducted the ELiSA Phase II study with lixivaptan in 31 ADPKD patients. In this study, the proportion of study subjects who showed a urine osmolality response consistent with full vasopressin
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The ACTION trial consists of two main parts. In Part 1 of the study, after completing the screening, run-in and titration periods, study subjects will enter a two-arm,
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InChI=1S/C27H21ClFN3O2/c1-17-8-9-19(29)13-23(17)26(33)30-20-10-11-22(24(28)14-20)27(34)32-16-21-6-4-12-31(21)15-18-5-2-3-7-25(18)32/h2-14H,15-16H2,1H3,(H,30,33)
331: 414: 345: 1131:"Clinical Pattern of Tolvaptan-Associated Liver Injury in Subjects with Autosomal Dominant Polycystic Kidney Disease: Analysis of Clinical Trials Database" 559:
in patients with ADPKD. Because of the risk of liver toxicity, in the US, tolvaptan is only available for ADPKD under a restricted distribution program (a
1392:"Comparison of the Hepatotoxic Potential of Two Treatments for Autosomal-Dominant Polycystic Kidney DiseaseUsing Quantitative Systems Toxicology Modeling" 1294:"Application of a Mechanistic Model to Evaluate Putative Mechanisms of Tolvaptan Drug-Induced Liver Injury and Identify Patient Susceptibility Factors" 2208: 560: 497:
receptor antagonists may have utility as therapies for ADPKD. Genetic mutations associated with ADPKD cause an increase in intracellular levels of
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formation and expansion in the kidney. Cyst growth displaces and destroys normal kidney tissue, leading to a decreased number and function of
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receptor inhibition was qualitatively and quantitatively similar to the published effect seen in clinical studies conducted with tolvaptan.
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Gattone VH, Wang X, Harris PC, Torres VE (October 2003). "Inhibition of renal cystic disease development and progression by a vasopressin V
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for "Safety of Lixivaptan in Subjects Previously Treated With Tolvaptan for Autosomal Dominant Polycystic Kidney Disease (ALERT)" at
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with lixivaptan is the ALERT study. The goal of this study is to investigate whether lixivaptan can be safely used in patients with
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receptor antagonists can restore normal levels of intracellular cAMP, thereby delaying cyst growth. Treatment with specific V
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Results of ELiSA, a Phase 2 Clinical Study with Lixivaptan in Patients with Autosomal Dominant Polycystic Kidney Disease
422: 172: 759:"Review and analysis of differing regulatory indications and expert panel guidelines for the treatment of hyponatremia" 212: 1261:
for "Efficacy and Safety of Lixivaptan in the Treatment of Autosomal Dominant Polycystic Kidney Disease (ACTION)" at
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who were previously treated with tolvaptan, but who had to permanently discontinue tolvaptan therapy due to
589: 1545: 1177:"Jynarque- tolvaptan kit Jynarque- tolvaptan tablet". DailyMed. March 31, 2020. Retrieved November 12, 2021 251: 514: 477:, or electrolyte free water excretion. This property of vaptans explains their use as therapies to treat 466: 201: 132: 1715: 1470: 908:
receptor antagonists OPC-31260 and OPC-41061 on polycystic kidney disease development in the PCK rat"
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sponsored by Cardiokine, Inc. Across these studies, lixivaptan showed prolonged inhibition of the
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Torres VE, Chapman AB, Devuyst O, Gansevoort RT, Perrone RD, Koch G, et al. (November 2017).
708:"Lixivaptan - an evidence-based review of its clinical potential in the treatment of hyponatremia" 1540: 1535: 1473: 1280: 1262: 1212: 1129:
Watkins PB, Lewis JH, Kaplowitz N, Alpers DH, Blais JD, Smotzer DM, et al. (November 2015).
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Ku E, Nobakht N, Campese VM (May 2009). "Lixivaptan: a novel vasopressin receptor antagonist".
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Woodhead JL, Brock WJ, Roth SE, Shoaf SE, Brouwer KL, Church R, et al. (January 2017).
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Di Mise A, Wang X, Ye H, Pellegrini L, Torres VE, Valenti G (October 2021).
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Receptor Antagonist on Polycystic Kidney Disease Development in a Rat Model"
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Lixivaptan was previously administered to more than 1600 subjects across 36
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R as therapeutic strategy for autosomal dominant polycystic kidney disease"
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R) in kidney tubular epithelial cells, thereby having a net effect of
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as part of a prior clinical development program for the treatment of
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Chebib FT, Sussman CR, Wang X, Harris PC, Torres VE (August 2015).
1002:"Pre-clinical evaluation of dual targeting of the GPCRs CaSR and V 872: 654: 548: 330: 321: 947:
Wang X, Constans MM, Chebib FT, Torres VE, Pellegrini L (2019).
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Woodhead JL, Pellegrini L, Shoda LK, Howell BA (January 2020).
501:(cAMP), which results in increased cellular proliferation and 78:- benzodiazepine-5-carbonyl)phenyl]-5-fluoro-2-methylbenzamide 217: 757:
Verbalis JG, Grossman A, Höybye C, Runkle I (July 2014).
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was studied in DILIsym®, a state of the art, multiscale
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C1c2cccn2Cc3ccccc3N1C(=O)c4ccc(cc4Cl)NC(=O)c5cc(F)ccc5C
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Wang X, Gattone V, Harris PC, Torres VE (April 2005).
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designation to lixivaptan for the treatment of ADPKD.
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The ACTION study is a pivotal registration-enabling
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Poster PO844. 254: 231: 160: 29: 2204:Drugs acting on the cardiovascular system 1415: 1366: 1317: 1251: 1249: 1247: 1245: 1154: 1072: 1031: 1021: 976: 923: 831: 774: 733: 723: 561:Risk Evaluation and Mitigation Strategies 180: 567:for the risk of serious liver toxicity. 1189:Expert Opinion on Investigational Drugs 695: 370: 350: 227: 72: 245: 20: 666:continue to receive lixivaptan in an 200: 7: 763:Current Medical Research and Opinion 602:estimated glomerular filtration rate 1061:The New England Journal of Medicine 111: 1347:Clinical and Translational Science 14: 417:(ADPKD), the most common form of 2209:Vasopressin receptor antagonists 291: 288: 285: 279: 904:"Effectiveness of vasopressin V 443:vasopressin receptor antagonist 378:Key:PPHTXRNHTVLQED-UHFFFAOYSA-N 2199:Drugs not assigned an ATC code 957:American Journal of Nephrology 547:receptor antagonists to treat 499:cyclic adenosine monophosphate 297: 273: 1: 706:Bowman BT, Rosner MH (2013). 539:Receptor Antagonists in ADPKD 776:10.1185/03007995.2014.920314 592:, as measured by changes in 423:Food and Drug Administration 661:. In the study, following 2225: 949:"Effect of a Vasopressin V 812:Nature Reviews. Nephrology 263:Chemical and physical data 2027:Vasotocin (argiprestocin) 2022:Vasopressin (argipressin) 1913:Vasotocin (argiprestocin) 1908:Vasopressin (argipressin) 1769:Vasotocin (argiprestocin) 1764:Vasopressin (argipressin) 1551:Vasotocin (argiprestocin) 1408:10.1007/s11095-019-2726-0 1341:Watkins PB (March 2019). 1201:10.1517/13543780902889760 1147:10.1007/s40264-015-0327-3 419:polycystic kidney disease 386: 361: 341: 63: 28: 631:Phase III clinical trial 445:. It is a member of the 437:Lixivaptan is a potent, 1396:Pharmaceutical Research 600:, plasma copeptin, and 590:vasopressin V2 receptor 543:Proof of efficacy for V 1943:ORG-52186 (SCH-740935) 1665:Catabolism inhibitors: 1298:Toxicological Sciences 1273:Clinical trial number 1255:Clinical trial number 925:10.1681/ASN.2004121090 859:receptor antagonist". 824:10.1038/nrneph.2015.39 515:vasopressin receptor 2 467:vasopressin receptor 2 1310:10.1093/toxsci/kfw193 1074:10.1056/NEJMoa1710030 1023:10.1096/fj.202100774R 1471:vasopressin receptor 1109:Otsuka press release 463:arginine vasopressin 1673:Bestatin (ubenimex) 683:computational model 674:DILIsym simulations 433:Mechanism of action 25: 1281:ClinicalTrials.gov 1263:ClinicalTrials.gov 425:(FDA) has granted 2186: 2185: 2166:Carrier proteins: 2154: 2153: 2145:lithium carbonate 2133:Other inhibitors: 1685: 1541:PF-06655075 (PF1) 1359:10.1111/cts.12629 1141:(11): 1103–1113. 1067:(20): 1930–1942. 969:10.1159/000500667 867:(10): 1323–1326. 725:10.2147/CE.S36744 670:extension study. 404: 403: 332:Interactive image 213:CompTox Dashboard 16:Chemical compound 2216: 1721: 1696:o-Phenanthroline 1683: 1460: 1453: 1446: 1437: 1430: 1429: 1419: 1387: 1381: 1380: 1370: 1338: 1332: 1331: 1321: 1289: 1283: 1271: 1265: 1253: 1240: 1239: 1227: 1221: 1220: 1184: 1178: 1175: 1169: 1168: 1158: 1126: 1120: 1119: 1117: 1115: 1101: 1095: 1094: 1076: 1052: 1046: 1045: 1035: 1025: 997: 991: 990: 980: 944: 938: 937: 927: 899: 893: 892: 852: 846: 845: 835: 803: 797: 796: 778: 769:(7): 1201–1207. 754: 748: 747: 737: 727: 703: 625:The ACTION study 598:urine osmolality 596:markers such as 582:clinical studies 571:Clinical studies 449:class of drugs. 400: 399: 392: 334: 314: 299: 293: 290: 287: 281: 275: 258: 247: 236: 235: 221: 219: 204: 184: 164: 144: 124: 114: 113: 99: 33: 26: 24: 2224: 2223: 2219: 2218: 2217: 2215: 2214: 2213: 2189: 2188: 2187: 2182: 2150: 2081: 1976: 1967: 1872: 1863: 1728: 1710: 1516:Lipo-oxytocin-1 1476: 1464: 1434: 1433: 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1019: 1015: 1011: 1010:FASEB Journal 1007: 996: 993: 988: 984: 979: 974: 970: 966: 962: 958: 954: 943: 940: 935: 931: 926: 921: 917: 913: 909: 898: 895: 890: 886: 882: 878: 874: 873:10.1038/nm935 870: 866: 862: 851: 848: 843: 839: 834: 829: 825: 821: 817: 813: 809: 802: 799: 794: 790: 786: 782: 777: 772: 768: 764: 760: 753: 750: 745: 741: 736: 731: 726: 721: 717: 713: 712:Core Evidence 709: 702: 700: 696: 689: 687: 684: 680: 673: 671: 669: 664: 660: 656: 652: 644: 642: 640: 635: 632: 624: 622: 618: 607: 605: 603: 599: 595: 591: 587: 583: 575: 570: 568: 566: 565:boxed warning 562: 558: 554: 550: 534: 529: 527: 516: 508: 504: 500: 488: 486: 484: 480: 476: 468: 464: 452: 450: 448: 444: 440: 432: 430: 428: 424: 420: 416: 412: 408: 398: 391: 385: 376: 371: 367: 360: 351: 347: 340: 333: 329: 328: 326: 323: 318: 311: 309: 305: 272: 270: 266: 261: 257: 253: 250: 248: 246:ECHA InfoCard 242: 234: 230: 226: 225: 223: 214: 210: 203: 199: 198: 196: 194: 190: 183: 179: 178: 176: 174: 170: 163: 159: 158: 156: 154: 150: 143: 139: 138: 136: 134: 130: 123: 119: 118: 116: 109: 105: 98: 94: 93: 91: 89: 85: 77: 73: 69: 62: 57: 50: 49: 47: 45: 41: 38:Clinical data 36: 32: 27: 19: 2165: 2132: 2093:Antagonists: 2092: 2046: 2042:JNJ-17079166 2034:Antagonists: 2033: 2017:Terlipressin 1987:Desmopressin 1983: 1959: 1953:TASP-0390325 1948:TASP-0233278 1920:Antagonists: 1919: 1903:Terlipressin 1883:Desmopressin 1879: 1804:JNJ-17308616 1799:JNJ-17079166 1776:Antagonists: 1775: 1759:Terlipressin 1735: 1664: 1600:Non-peptide: 1599: 1587: 1585:Antagonists: 1584: 1555:Non-peptide: 1554: 1492: 1489: 1399: 1395: 1385: 1350: 1346: 1336: 1304:(1): 61–74. 1301: 1297: 1287: 1274: 1269: 1256: 1235: 1231: 1225: 1192: 1188: 1182: 1173: 1138: 1134: 1124: 1114:November 12, 1112:. Retrieved 1108: 1099: 1064: 1060: 1050: 1013: 1009: 995: 960: 956: 942: 915: 911: 897: 864: 860: 850: 815: 811: 801: 766: 762: 752: 715: 711: 677: 648: 639:double-blind 636: 628: 619: 611: 586:hyponatremia 579: 576:Hyponatremia 542: 492: 483:hypervolemic 456: 453:Hyponatremia 441:, selective 436: 410: 406: 405: 394:   388:   75: 18: 2169:Neurophysin 2007:Ornipressin 1992:Felypressin 1933:Brezivaptan 1898:Ornipressin 1888:Felypressin 1824:Relcovaptan 1754:Selepressin 1749:Ornipressin 1739:Felypressin 1716:Vasopressin 1686:-Methionine 1536:PF-06478939 1511:Demoxytocin 1276:NCT04152837 1258:NCT04064346 1135:Drug Safety 649:The second 439:non-peptide 427:orphan drug 421:. The U.S. 315: g·mol 252:100.126.016 202:ChEMBL49429 97:168079-32-1 59:Identifiers 2193:Categories 2106:RWJ-339489 2101:Ribuvaptan 2096:Balovaptan 2062:Satavaptan 2057:RWJ-351647 2052:Mozavaptan 2047:Lixivaptan 2037:Conivaptan 1938:Nelivaptan 1844:WAY-267464 1789:Conivaptan 1784:Balovaptan 1658:WAY-162720 1653:SSR-126768 1608:Cligosiban 1573:WAY-267464 1526:Nacartocin 1506:Cargutocin 1501:Carbetocin 1496:Aspartocin 1474:modulators 690:References 668:open label 407:Lixivaptan 320:3D model ( 308:Molar mass 182:8F5X4B082E 153:ChemSpider 133:IUPHAR/BPS 88:CAS Number 68:IUPAC name 23:Lixivaptan 2126:YM-222546 2067:Tolvaptan 2002:Lypressin 1984:Agonists: 1893:Lypressin 1880:Agonists: 1819:PF-184563 1814:LY-307174 1794:FR-218944 1744:Lypressin 1736:Agonists: 1706:Puromycin 1691:Leupeptin 1668:Amastatin 1648:Retosiban 1643:Nolasiban 1638:L-372,662 1633:L-371,257 1628:L-368,899 1618:Erlosiban 1613:Epelsiban 1603:Barusiban 1521:Merotocin 1490:Agonists: 1402:(2): 24. 718:: 47–56. 679:Tolvaptan 663:titration 553:tolvaptan 479:euvolemic 475:aquaresis 2121:VMAX-382 2116:VMAX-372 2111:VMAX-367 2086:Unsorted 2077:YM-35471 2012:TC OT 39 1963:TASP-699 1960:Ligands: 1859:YM-35471 1839:TC OT 39 1779:Atosiban 1591:Atosiban 1588:Peptide: 1568:TC OT 39 1531:Oxytocin 1493:Peptide: 1482:Oxytocin 1467:Oxytocin 1426:31909447 1377:30762301 1328:27655350 1217:72325634 1209:19379124 1165:26188764 1091:41483400 1083:29105594 1042:34486176 987:31117065 934:15728778 889:30926917 881:14502283 842:25870007 793:21539659 785:24809970 744:23874242 530:Research 507:nephrons 397:(verify) 44:ATC code 2141:Lithium 1997:LIT-001 1928:ABT-558 1923:ABT-436 1809:LIT-001 1563:LIT-001 1417:6944674 1368:6440570 1319:5216653 1156:4608984 1033:9290345 978:6647848 833:4539141 735:3712664 411:VPA-985 269:Formula 108:PubChem 2159:Others 2072:YM-471 1854:YM-471 1849:YM-218 1834:SRX251 1829:SRX246 1578:WJ0679 1424:  1414:  1375:  1365:  1326:  1316:  1215:  1207:  1163:  1153:  1089:  1081:  1040:  1030:  985:  975:  932:  887:  879:  840:  830:  791:  783:  742:  732:  447:vaptan 346:SMILES 313:473.93 193:ChEMBL 162:151067 122:172997 1623:IX-01 1213:S2CID 1087:S2CID 885:S2CID 789:S2CID 655:ADPKD 608:ADPKD 549:ADPKD 489:ADPKD 366:InChI 322:JSmol 1678:EDTA 1546:TGOT 1469:and 1422:PMID 1373:PMID 1324:PMID 1205:PMID 1161:PMID 1116:2021 1079:PMID 1038:PMID 983:PMID 930:PMID 877:PMID 838:PMID 781:PMID 740:PMID 517:), V 503:cyst 481:and 173:UNII 142:2238 51:none 1558:CA7 1412:PMC 1404:doi 1363:PMC 1355:doi 1314:PMC 1306:doi 1302:155 1197:doi 1151:PMC 1143:doi 1069:doi 1065:377 1028:PMC 1018:doi 973:PMC 965:doi 920:doi 869:doi 828:PMC 820:doi 771:doi 730:PMC 720:doi 513:R ( 465:to 218:EPA 112:CID 2195:: 2177:II 2175:, 1871:1B 1727:1A 1598:; 1553:; 1420:. 1410:. 1400:37 1398:. 1394:. 1371:. 1361:. 1351:12 1349:. 1345:. 1322:. 1312:. 1300:. 1296:. 1244:^ 1211:. 1203:. 1193:18 1191:. 1159:. 1149:. 1139:38 1137:. 1133:. 1107:. 1085:. 1077:. 1063:. 1059:. 1036:. 1026:. 1014:35 1012:. 1008:. 981:. 971:. 961:49 959:. 955:. 928:. 916:16 914:. 910:. 883:. 875:. 863:. 836:. 826:. 816:11 814:. 810:. 787:. 779:. 767:30 765:. 761:. 738:. 728:. 714:. 710:. 698:^ 469:(V 286:Cl 283:21 277:27 2179:) 2173:I 2171:( 2147:) 2143:( 1975:2 1973:V 1869:V 1725:V 1684:L 1459:e 1452:t 1445:v 1428:. 1406:: 1379:. 1357:: 1330:. 1308:: 1219:. 1199:: 1167:. 1145:: 1118:. 1093:. 1071:: 1044:. 1020:: 1004:2 989:. 967:: 951:2 936:. 922:: 906:2 891:. 871:: 865:9 857:2 844:. 822:: 795:. 773:: 746:. 722:: 716:8 615:2 613:V 545:2 537:2 535:V 523:2 519:2 511:2 495:2 493:V 471:2 459:2 457:V 409:( 324:) 301:2 298:O 295:3 292:N 289:F 280:H 274:C 220:) 216:( 76:N

Index


ATC code
IUPAC name
CAS Number
168079-32-1
PubChem
172997
IUPHAR/BPS
2238
ChemSpider
151067
UNII
8F5X4B082E
ChEMBL
ChEMBL49429
CompTox Dashboard
DTXSID00168472
Edit this at Wikidata
ECHA InfoCard
100.126.016
Edit this at Wikidata
Formula
Molar mass
JSmol
Interactive image
SMILES
InChI
(what is this?)
(verify)
Autosomal dominant polycystic kidney disease

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