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Hexahydropyrrolopyrole SCD1 inhibitors are a class of small molecule inhibitors targeting stearoyl-CoA desaturase 1 (SCD1), an enzyme that catalyzes the rate-limiting step in the synthesis of monounsaturated fatty acids (such as palmitoleoyl-CoA and oleoyl-CoA) from saturated fatty acids. Developed by Sanofi, these compounds, exemplified by the representative candidate SAR707, were investigated for the treatment of metabolic disorders including obesity, type 2 diabetes, and dyslipidemia. In preclinical models (such as Zucker diabetic fatty rats), systemic administration of these inhibitors significantly reduced body weight, blood glucose, and triglyceride levels, and decreased the desaturation index. However, systemic SCD1 inhibition was associated with severe target-related toxicities in the skin and eyes, including alopecia, skin inflammation, and eyelid fissures, leading to the discontinuation of their development for chronic metabolic diseases.
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