AU3893200A

AU3893200A - Treatment of osteoarthritis

Info

Publication number: AU3893200A
Application number: AU38932/00A
Authority: AU
Inventors: Carl M. Mendel; Timothy B. Seaton; Steve P. Weinstein
Original assignee: Knoll Pharmaceutical Co
Current assignee: Abbott GmbH and Co KG
Priority date: 1999-03-19
Filing date: 2000-03-17
Publication date: 2000-10-09
Anticipated expiration: 2020-03-17
Also published as: BG105999A; MXPA01009461A; NO20014477L; CA2366660A1; JP2012051904A; NZ514016A; JP2002539248A; SK13342001A3; AU773490B2; KR20020038567A; EP1169027A4; BR0009081A; HUP0200494A2; WO2000056306A1; HK1044702A1; NO20014477D0; CZ20013284A3; IL145238A0; TR200102699T2; CN1352552A

Description

WO 00/56306 PCT/US00/07072 Treatment of Osteoarthritis This invention relates to a method of treating osteoarthritis and gout. 5 According to the present invention there is provided a method of treating osteoarthritis, in which a therapeutically effective amount of a compound of formula I

CH

3

H

3

CCHCH

2 CHNR 1

R

2 Cl I R 10 including enantiomers and pharmaceutically acceptable salts thereof, in which R 1 and R 2 are independently H or methyl, is administered in conjunction with a pharmaceutically acceptable diluent or carrier to a human in need thereof. 15 Diseases which may advantageously be treated with a compound of formula I include osteoarthritis and gout. A preferred compound of formula I is N,N-dimethyl-1-[1-(4 20 chlorophenyl)cyclobutyl]-3-methylbutylamine or a salt thereof, for example the hydrochloride salt. A preferred form of this hydrochloride is its monohydrate. The preparation and use of compounds of formula I, such as N,N dimethyl-1 -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutylamine, N-{1-[1-(4 25 chlorophenyl)-cyclobutyl]-3-methylbutyl}-N-methylamine, and 1-[1-(4 chlorophenyl)-cyclobutyl]-3-methylbutylamine and salts thereof, in the treatment of depression is described in British Patent Specification 2098602 and US Patent 1 WO 00/56306 PCT/US00/07072 4,522,328. The use of compounds of formula I such as N,N-dimethyl-1-[1-(4 chlorophenyl)cyclobutyl]-3-methylbutylamine and salts thereof in the treatment of Parkinson's disease is described in published PCT application WO 88/06444. The use of N,N-dimethyl-l1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine and 5 salts thereof in the treatment of cerebral function disorders is described in US Patent 4,939,175. The use of N,N-dimethyl-1-[1-(4-chlorophenyl)cyclobutyl]-3 methylbutylamine hydrochloride in the treatment of obesity is described in published PCT application WO90/06110. A particularly preferred form of this compound is N,N-dimethyl-1 -[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine 10 hydrochloride monohydrate (sibutramine hydrochloride) which is described in European Patent Number 230742. The use of N,N-dimethyl-1-[1-(4 chlorophenyl)cyclobutyl]-3-methylbutylamine and salts thereof for improving the glucose tolerance of humans having Impaired Glucose Tolerance or Non-Insulin Dependent Diabetes Mellitus is described in published PCT application 15 WO95/20949. It will be appreciated by those skilled in the art that compounds of formula I contain a chiral centre. When a compound of formula I contains a single chiral centre it may exist in two enantiomeric forms. The present invention includes the 20 use of the individual enantiomers and mixtures of the enantiomers. The enantiomers may be resolved by methods known to those skilled in the art, for example by formation of diastereoisomeric salts or complexes which may be separated, for example, by crystallisation; via formation of diastereoisomeric derivatives which may be separated, for example, by crystallisation, gas-liquid or 25 liquid chromatography; selective reaction of one enantiomer with an enantiomer specific reagent, for example enzymatic oxidation or reduction, followed by separation of the modified and unmodified enantiomers; or gas-liquid or liquid chromatography in a chiral environment, for example on a chiral support, for example silica with a bound chiral ligand or in the presence of a chiral solvent. It 30 will be appreciated that where the desired enantiomer is converted into another chemical entity by one of the separation procedures described above, a further 2 WO 00/56306 PCT/US00/07072 step is required to liberate the desired enantiomeric form. Alternatively, specific enantiomers may be synthesised by asymmetric synthesis using optically active reagents, substrates, catalysts or solvents, or by converting one enantiomer to the other by asymmetric transformation. 5 Preferred compounds of formula I are N,N-dimethyl-1-[1-(4-chlorophenyl) cyclobutyl]-3-methylbutylamine, N-{1-[1-(4-chlorophenyl)cyclobutyl]-3 methylbutyl}-N- methylamine, and 1-[1-(4-chlorophenyl)cyclobutyl]-3 methylbutylamine including racemates, individual enantiomers and mixtures 10 thereof, and pharmaceutically acceptable salts thereof. The individual enantiomers can be prepared by enantioselective synthesis from optically active precursors, or by resolving the racemic compound which can be prepared as described above. Enantiomers of secondary amines of the 15 formula I can also be prepared by preparing the racemate of the corresponding primary amine, resolving the latter into the individual enantiomers, and then converting the optically pure primary amine enantiomer into the required secondary amine by methods described in British Patent Specification 2098602. 20 Specific examples of compounds of formula I are: (+)-N-[1 -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-methylamine; (-)-N-{1 -[1 -(4-chlorophenyl)cyclobutyl-3-methylbutyl}-N-methylamine; (+)-1 -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutylamine; 25 (-)-1 -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutylamine; (+)-N-{1 -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-N-dimethylamine; (-)-N-{1 -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-N-dimethylamine. The hydrochloride salts are preferred in each case, but the free bases 30 and other pharmaceutically acceptable salts are also suitable. 3 WO 00/56306 PCT/US00/07072 The compound of formula I may be administered in any of the known pharmaceutical dosage forms. The amount of the compound to be administered will depend on a number of factors including the age of the patient, the severity of the condition and the past medical history of the patient and always lies within the 5 sound discretion of the administering physician but it is generally envisaged that the dosage of the compound to be administered will be in the range 0.1 to 50 mg preferably 1 to 30 mg per day given in one or more doses. Oral dosage forms are the preferred compositions for use in the present 10 invention and these are the known pharmaceutical forms for such administration, for example tablets, capsules, granules, syrups and aqueous or oil suspensions. The excipients used in the preparation of these compositions are the excipients known in the pharmacist's art. Tablets may be prepared from a mixture of the active compound with fillers, for example calcium phosphate; disintegrating 15 agents, for example maize starch; lubricating agents, for example magnesium stearate; binders, for example microcrystalline cellulose or polyvinylpyrrolidone and other optional ingredients known in the art to permit tableting the mixture by known methods. The tablets may, if desired, be coated using known methods and excipients which may include enteric coating using for example 20 hydroxypropylmethylcellulose phthalate. The tablets may be formulated in a manner known to those skilled in the art so as to give a sustained release of the compounds of the present invention. Such tablets may, if desired, be provided with enteric coatings by known methods, for example by the use of cellulose acetate phthalate. Similarly, capsules, for example hard or soft gelatin capsules, 25 containing the active compound with or without added excipients, may be prepared by known methods and, if desired, provided with enteric coatings in a known manner. The contents of the capsule may be formulated using known methods so as to give sustained release of the active compound. The tablets and capsules may conveniently each contain 1 to 50 mg of the active compound. 30 4 WO 00/56306 PCT/US00/07072 Other dosage forms for oral administration include, for example, aqueous suspensions containing the active compound in an aqueous medium in the presence of a non-toxic suspending agent such as sodium carboxy methylcellulose, and oily suspensions containing a compound of the present 5 invention in a suitable vegetable oil, for example arachis oil. The active compound may be formulated into granules with or without additional excipients. The granules may be ingested directly by the patient or they may be added to a suitable liquid carrier (for example, water) before ingestion. The granules may contain disintegrants, eg an effervescent couple formed from an acid and a 10 carbonate or bicarbonate salt to facilitate dispersion in the liquid medium. The therapeutically active compounds of formula I may be formulated into a composition which the patient retains in his mouth so that the active compound is administered through the mucosa of the mouth. 15 Dosage forms suitable for rectal administration are the known pharmaceutical forms for such administration, for example, suppositories with cocoa butter or polyethylene glycol bases. 20 Dosage forms suitable for parenteral administration are the known pharmaceutical forms for such administration, for example sterile suspensions or sterile solutions in a suitable solvent. Dosage forms for topical administration may comprise a matrix in which 25 the pharmacologically active compounds of the present invention are dispersed so that the compounds are held in contact with the skin in order to administer the compounds transdermally. A suitable transdermal composition may be prepared by mixing the pharmaceutically active compound with a topical vehicle, such as a mineral oil, petrolatum and/or a wax, e.g. paraffin wax or beeswax, together with 30 a potential transdermal accelerant such as dimethyl sulphoxide or propylene glycol. Alternatively the active compounds may be dispersed in a 5 WO 00/56306 PCT/USOO/07072 pharmaceutically acceptable cream, gel or ointment base. The amount of active compound contained in a topical formulation should be such that a therapeutically effective amount of the compound is delivered during the period of time for which the topical formulation is intended to be on the skin. 5 The therapeutically active compound of formula I may be formulated into a composition which is dispersed as an aerosol into the patients oral or nasal cavity. Such aerosols may be administered from a pump pack or from a pressurised pack containing a volatile propellant. 10 The therapeutically active compounds of formula I used in the method of the present invention may also be administered by continuous infusion either from an external source, for example by intravenous infusion or from a source of the compound placed within the body. Internal sources include implanted 15 reservoirs containing the compound to be infused which is continuously released for example by osmosis and implants which may be (a) liquid such as an oily suspension of the compound to be infused for example in the form of a very sparingly water-soluble derivative such as a dodecanoate salt or a lipophilic ester or (b) solid in the form of an implanted support, for example of a synthetic resin or 20 waxy material, for the compound to be infused. The support may be a single body containing all the compound or a series of several bodies each containing part of the compound to be delivered. The amount of active compound present in an internal source should be such that a therapeutically effective amount of the compound is delivered over a long period of time. 25 In some formulations it may be beneficial to use the compounds of the present invention in the form of particles of very small size, for example as obtained by fluid energy milling. 6 WO 00/56306 PCT/US00/07072 In the compositions of the present invention the active compound may, if desired, be associated with other compatible pharmacologically active ingredients. 5 The invention further provides the use of compounds of formula I in the manufacture of a medicament for treating osteoarthritis or gout. In another aspect, the invention further provides a pharmaceutical composition for treating osteoarthritis or gout, comprising a compound of formula 10 I in conjunction with a pharmaceutically acceptable diluent or carrier. Obesity is associated with the development of osteoarthritis and gout and, in obese middle -aged women at or after menopause, pain at the medial aspect of the knee (adiposa dolorosa juxtarticularis). Possible mechanisms 15 underlying the relationship between obesity and osteoarthritis include mechanical stresses related to increased load of obesity, metabolic changes associated with increased fatness, and dietary elements that are related to the development of obesity. The increased risk of gout associated with obesity may be related to the accompanying hyperuricaemia although central fat distribution may also be 20 involved, particularly in women. Monoamine reuptake inhibitors have been used to treat certain of the disorders described in the present invention. However, these compounds are known to suffer from a number of disadvantages. Firstly such compounds are not effective in all patients. Secondly where the compounds are effective they 25 may not provide a complete cure of the disorder. Thirdly, there are many undesirable side-effects known with this type of compound. Such side-effects include nausea, sexual dysfunction, light headedness, somnolence, sweating, tremor, dry mouth, asthenia, insomnia, diarrhoea, headache, vomiting, anxiety, drowsiness, dizziness, fever, rash or allergic reactions, arthralgia, myalgia, 30 convulsions, hypomania and mania. 7 WO 00/56306 PCT/US00/07072 Sibutramine (Formula I, R, = CH 3 , R2 = CH 3 ) has a pharmacological profile which is unique amongst monoamine reuptake inhibitors. Through its pharmacologically active metabolites, (metabolite 1, R, = H, R 2 = CH 3 in Formula I and metabolite 2, R 1 = H, R 2 = H in Formula I) sibutramine inhibits the reuptake 5 of all three monoamines differentiating it from serotonin (5-HT)-selective reuptake inhibitors, e.g. fluoxetine, noradenaline-selective reuptake inhibitors, e.g. desipramine, dopamine-selective reuptake inhibitors, e.g. bupropion, and serotonin-noradenaline reuptake inhibitors, e.g. venlafaxine (Table 1). It is this unique combination of pharmacological actions which renders sibutramine, and 10 the other compounds of formula I, efficacious in the treatment of osteoarthritis and gout. The assays below are performed in a similar manner to those described in WO98/41528. TABLE 15 Comparison of the in vitro monoamine reuptake inhibition profiles of Examples 1 and 2, and various reference monoamine reuptake inhibitors in rat brain tissue Ki (nM) [3H]Noradenaline [3H]5-HT [ 3 H]Dopamine Example 1 3 18 24 Example 2 5 26 31 Bupropion 2590 18312 409 Desipramine 2 200 4853 Fluoxetine 320 11 2025 Venlafaxine 196 26 2594 The results are the means of 3 separate determinations 8 WO 00/56306 PCT/US00/07072 Example 1 R 1 = H, R 2 = CH 3 in Formula I Example 2 R 1 = H, R 2 = H in Formula I 5 The efficacy of compounds of formula I in treating osteoarthritis or goutis demonstrable through clinical trials in a relevant population set. The invention has been described with reference to various specific embodiments. However, many variations and modifications may be made while 10 remaining within the scope and spirit of the invention. 9

Claims

1. A method of treating osteoarthritis or gout comprising administering to a human in need thereof a therapeutically effective amount of a compound of 5 formula I CH 3 3 CCHCH 2 CHNR 1 R 2 Cl I including enantiomers and pharmaceutically acceptable salts thereof in which R 1 and R 2 are independently H or methyl, in conjunction with a pharmaceutically 10 acceptable diluent or carrier.

2. A method as claimed in claim 1 in which osteoarthritis is treated.

3. A method as claimed in claim 1 or 2 wherein the compound of formula I is 15 N,N-dimethyl-1 -[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine hydrochloride.

4. A method as claimed in claim 1 or 2 wherein the compound of formula I is N,N-dimethyl-1l-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine hydrochloride in the form of its monohydrate. 20

5. A method as claimed in claim 1 or 2 wherein the compound of formula 1 is (+)-N-[1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-methylamine.

6. A method as claimed in claim 1 or 2 wherein the compound of formula 1 is 25 (-)-N-{1-[1-(4-chlorophenyl)cyclobutyl-3-methylbutyl}-N-methylamine.

7. A method as claimed in claim 1 or 2 wherein the compound of formula 1 is 10 WO 00/56306 PCT/USOO/07072 (+)-1l-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine.

8. A method as claimed in claim 1 or 2 wherein the compound of formula 1 is (-)-l -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutylamine. 5

9 A method as claimed in claim 1 or 2 wherein the compound of formula 1 is (+)-N-{l -[1 -(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-N-dimethylamine.

10. The method as claimed in claim 1 or 2 wherein the compound of formula I 10 is (-)-N-{1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-N-dimethylamine.

11. The method as claimed in claim 1 or 2 wherein the compound of formula I is (±)-N-{1-[1-(4-chlorophenyl)cyclobutyl-3-methylbutyl}-N-methylamine. 15

12. The method as claimed in claim 1 or 2 wherein the compound of formula I is (±)-1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine.

13. The method as claimed in claim 1 or 2 wherein the compound of formula I is (±)-N-{1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutyl}-N-N-dimethylamine. 20

14. The use of a compound of formula I CH 3 H 3 CCHCH 2 CHNR 1 R 2 Cl including enantiomers and pharmaceutically acceptable salts thereof in which R 1 25 and R 2 are independently H or methyl, in the manufacture of a medicament for treating osteoarthritis or gout. 11 WO 00/56306 PCT/US00/07072

15. The use as claimed in claim 14 in which osteoarthritis is treated.

16. The use as claimed in claim 14 or 15 in which the compound of formula I is N,N-dimethyl-1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine 5 hydrochloride.

17. The use as claimed in claim 14 or 15 in which the compound of formula I is N,N-dimethyl-1-[1-(4-chlorophenyl)cyclobutyl]-3-methylbutylamine hydrochloride monohydrate. 10

18. A pharmaceutical composition for treating osteoarthritis or gout, comprising a therapeutically effective amount of a compound of formula I CH 3 H 3 CCHCH 2 CHNR 1 R 2 CII Cl /~ 15 including enantiomers and pharmaceutically acceptable salts thereof in which R 1 and R 2 are independently H or methyl, in conjunction with a pharmaceutically acceptable diluent or carrier.

19. A pharmaceutical composition as claimed in claim 18 in which the 20 compound of formula I is N,N-dimethyl-1-[1-(4-chlorophenyl)cyclobutyl]-3 methylbutylamine hydrochloride.

20. A pharmaceutical composition as claimed in claim 18 in which the compound of formula I is N,N-dimethyl-1-[1-(4-chlorophenyl)cyclobutyl]-3 25 methylbutylamine hydrochloride monohydrate. 12