Discovery of potent, efficacious, and orally bioavailable inhibitors of blood coagulation factor Xa with neutral P1 moieties

The bicyclic tetrahydropyrazolopiperidinone scaffold allowed for the incorporation of multiple neutral P1 moieties with subnanomolar binding affinities for blood coagulation factor Xa. The compound 3-[6-(2′-dimethylaminomethyl-biphenyl-4-yl)-7-oxo-3-trifluoro-methyl-4,5,6,7-tetrahydro-pyrazolo[3,4-c]pyridine-1-yl]-benzamide 6d shows good Xa potency, selectivity, in vivo efficacy, and oral bioavailability. Compound 6d was selected for further pre-clinical evaluations.