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Discovery and activity of (1R,4S,6R)-N-[(1R)-2-[4-cyclohexyl-4-[[(1,1- dimethylethyl)amino]carbonyl]-1-piperidinyl]-1-[(4- fluorophenyl)methyl]-2-oxoethyl]-2-methyl-2- azabicyclo[2.2.2]octane-6-carboxamide (3, RY764), a potent and selective melanocortin subtype-4 receptor agonist

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During a median follow-up of 27.5 months, lobar ICH events (OR 0.10, p = 0.015), presence of cSS (OR 0.19, p = 0.028), high white matter hyperintensities Fazekas score (OR 0.41, p = 0.007) were negatively associated with favorable outcome after adjustment for age, sex and immunosuppressive treatments