Vicadrostat (BI 690517): A Comprehensive Profile of an Investigational Aldosterone Synthase Inhibitor

I. Introduction

Vicadrostat, also known by its development code BI 690517, is an investigational small molecule pharmaceutical agent developed by Boehringer Ingelheim.[1] It is currently undergoing extensive clinical evaluation for its therapeutic potential in managing chronic kidney disease (CKD) and heart failure, particularly heart failure with preserved ejection fraction (HFpEF).[2] As a novel, selective aldosterone synthase inhibitor (ASi), Vicadrostat represents a targeted approach to mitigating the deleterious effects of excessive aldosterone, a key hormone in the renin-angiotensin-aldosterone system (RAAS) implicated in the pathophysiology of various cardiovascular, renal, and metabolic disorders.[3] This report provides a comprehensive overview of Vicadrostat, detailing its chemical properties, mechanism of action, pharmacokinetic profile, clinical development program, safety and tolerability, and its potential positioning within the evolving therapeutic landscape for cardiorenal diseases. The information compiled is based on publicly available data from clinical trial registries, scientific publications, and regulatory sources.

II. Drug Identity and General Characteristics

A. Nomenclature and Identification Codes

Vicadrostat is the official non-proprietary name (International Nonproprietary Name - INN) for the compound BI 690517.[3] It is systematically identified by the Chemical Abstracts Service (CAS) Registry Number 1868065-21-7.[7] In chemical databases, it is also referenced by its PubChem Compound ID (CID) 118676295 [9] and InChIKey MCVIVPZYYMNCAW-OAHLLOKOSA-N.[6] These unique identifiers are crucial for unambiguous referencing in scientific literature and regulatory documentation.

B. Chemical Structure and Properties