Integrin ␣41 plays an important role in inflammatory processes by regulating the migration of leukocytes into inflamed tissues. Previously, we identified BIO5192 [2(S)-{[1-(3,5-dichloro-benzenesulfonyl)-pyrrolidine-2(S)-carbonyl]-amino}-4-[4-methyl-2(S)- (methyl-{2-[4-(3-o-tolyl-ureido)-phenyl]-acetyl}-amino)-pentanoylamino]-butyric acid], a highly selective and potent (K D of 9 pM) small molecule inhibitor of ␣41. Although BIO5192 is efficacious in various animal models of inflammatory disease, high doses and daily treatment of the compound are needed to achieve a therapeutic effect because of its relatively short serum half-life. To address this issue, polyethylene glycol modification (PEGylation) was used as an approach to improve systemic exposure. BIO5192 was PEGylated by a targeted approach in which derivatizable amino groups were incorporated into the molecule. Two sites were identified that could be modified, and from these, five PEGylated compounds were synthesized and characterized. One compound, 2a-PEG (K D of 19 pM), was selected for in vivo studies. The pharmacokinetic and pharmacodynamic properties of 2a-PEG were dramatically improved relative to the unmodified compound. The PEGylated compound was efficacious in a rat model of experimental autoimmune encephalomyelitis at a 30-fold lower molar dose than the parent compound and required only a once-aweek dosing regimen compared with a daily treatment for BIO5192. Compound 2a-PEG was highly selective for ␣41. These studies demonstrate the feasibility of PEGylation of ␣41-targeted small molecules with retention of activity in vitro and in vivo. 2a-PEG, and related compounds, will be valuable reagents for assessing ␣41 biology and may provide a new therapeutic approach to treatment of human inflammatory diseases.Integrins are a large family of cell surface receptors that mediate cell-cell and cell-matrix interaction. They exist as noncovalent ␣ heterodimers of different combinations of ␣ and  chains and share extensive structural homology. Integrins mediate a wide variety of physiological processes and are relevant to a wide variety of pathological conditions. The integrin ␣41 regulates normal leukocyte trafficking (Lobb and Hemler, 1994) and provides a key costimulatory signal supporting cell activation (Clark and Brugge, 1995). During inflammatory responses, ␣41 regulates leukocyte migration into the damaged tissues and has been recognized as an attractive therapeutic target. In vivo studies using blocking monoclonal antibodies (Lobb and Hemler, 1994;Issekutz et al., 1996;Enders et al., 1998;Hojo et al., 1998;Schneider et al., 1999;Ramos-Barbon et al., 2001), inhibitory peptides (Molossi et al., 1995;Abraham, 1997;van der Laan et al., 2002), and small molecule antagonists (Lin et al., 1999;Kudlacz et al., 2002) have verified the critical role of ␣41 integrins in leukocyte-mediated inflammation and have implicated ␣41 inhibitors as potential treatments for diseases such as asthma and arthritis. Numerous EAE models that recapitulate i...