JP2010525063A - ヌクレオシドホスホナートが投与された被験者における腎毒性を減少させる方法 - Google Patents
ヌクレオシドホスホナートが投与された被験者における腎毒性を減少させる方法 Download PDFInfo
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- JP2010525063A JP2010525063A JP2010506270A JP2010506270A JP2010525063A JP 2010525063 A JP2010525063 A JP 2010525063A JP 2010506270 A JP2010506270 A JP 2010506270A JP 2010506270 A JP2010506270 A JP 2010506270A JP 2010525063 A JP2010525063 A JP 2010525063A
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Abstract
Description
本出願は、2007年4月27日に出願された米国特許仮出願第60/914,532号明細書の利益を主張するものであり、該特許の開示は全体として本明細書に引用することにより組み込まれる。
本発明は、ヌクレオシドホスホナートを用いた治療方法、該方法において有用な組成物、およびこのような化合物の使用に関する。
R1は、水素、−CH3、−CH2OH、−CH2F、−CH=CH2、もしくは−CH2N3であり、
R2は、水素であり、および
Bは、プリンもしくはピリミジンである)
の抗ウイルス化合物のホスホナート(phosphonate)またはそのエナンチオマー、ジアステレオマー、ラセミ体、立体異性体、互変異性体、回転異性体もしくはそれらの混合物、またはそれらの医薬的に許容される塩を含む。
R1は、水素、−CH3、−CH2OH、−CH2F、−CH=CH2、もしくは−CH2N3であり、
R2は、水素であり、および
Bは、プリンもしくはピリミジンである。)
の抗ウイルス化合物のホスホナートまたはそのエナンチオマー、ジアステレオマー、ラセミ体、立体異性体、互変異性体、回転異性体もしくはそれらの混合物、またはそれらの医薬的に許容される塩を含む。
本明細書で使用する「アルキル」は、1〜24個の炭素原子を有する一価の直鎖状もしくは分枝状または環状ラジカルを意味し、メチル、エチル、n−プロピル、イソプロピル、n−ブチル、イソブチル、tert−ブチル、n−ヘキシルなどが含まれる。
本発明を実施するために使用できる化合物、組成物、製剤、および被験者を治療する方法には、引用することにより本明細書に組み込まれる米国特許第6,716,825号明細書、第7,034,014号明細書、第7,094,772号明細書、および第7,098,197号明細書に記載されたものが含まれるがそれらに限定されない。
R1およびR1’は、独立して、−H、任意で置換された−O(C1−C24)アルキル、−O(C1−C24)アルケニル、−O(C1−C24)アシル、−S(C1−C24)アルキル、−S(C1−C24)アルケニル、もしくは−S(C1−C24)アシルであり、R1およびR1’のうちの少なくとも一方は−Hではなく、該アルケニルもしくはアシル部分は、任意で1〜6個の二重結合を有し、
R2およびR2’は、独立して、−H、任意で置換された−O(C1−C7)アルキル、−O(C1−C7)アルケニル、−S(C1−C7)アルキル、−S(C1−C7)アルケニル、−O(C1−C7)アシル、−S(C1−C7)アシル、−N(C1−C7)アシル、−NH(C1−C7)アルキル、−N((C1−C7)アルキル)2、オキソ、ハロゲン、−NH2、−OH、もしくは−SHであり、
R3は、任意のリンカーL上の官能基またはCα上で利用可能な酸素原子に結合した、薬理学的に活性な化合物の医薬的に活性なホスホナート、ビスホスホナートもしくはホスホナート誘導体であり、
Xは、存在する場合は、以下の構造式:
Lは、式−J−(CR2)t−G−(式中、tは1〜24の整数であり、JおよびGは独立して−O−、−S−、−C(O)O−、もしくは−NH−であり、Rは、−H、置換もしくは未置換アルキル、またはアルケニルである。)の原子価結合または二官能結合分子であり、
mは、0〜6の整数であり、および
nは、0もしくは1である。))
を有する。
を有する。
を有する。グリセロールは、光活性分子である。グリセロールのための立体特異的ナンバリング協定(numbering convention)を用いると、sn−3位置は、グリセロールキナーゼによってリン酸化される位置である。グリセロール残基を有する本発明の化合物では、−(L)n−3成分は、グリセロールのsn−3またはsn−1位のどちらかで結合されてよい。
本発明の化合物は、錠剤、カプセル剤、液剤、エマルジョン剤もしくは懸濁剤、吸入用液体もしくは固体微粒子、スプレーとしてのマイクロカプセル化微粒子の形態で経口で、例えば経皮パッチなどの適用によって皮膚を通して、または例えば坐剤の形態で経直腸により投与することができる。本発明の脂溶性プロドラッグ誘導体は、特に経皮吸収投与および送達系のために特に適し、さらにまた練り歯磨き中に使用することもできる。投与は、注射液の形態で非経口的に行うこともできる。
多数の稀少疾患は、小児期以降に感染症に対する増大した易感染性を特徴とする。これらの疾患の多くは遺伝性であり、常染色体劣性もしくはX連鎖性である。80を超える認定された原発性免疫不全症候群が存在する。それらは一般に、リンパ球もしくは顆粒球のように、機能不全である免疫系の一部によって分類される。原発性免疫不全症の治療は、欠陥の性質に依存し、抗体注入、長期抗生物質投与および(所定の場合には)幹細胞移植を含むことがある。
以下の表1〜2に要約したように、CMX001の前臨床試験は、マウスおよびウサギにおける致死性オルトポックスウイルス感染症に対して本質的に完全に保護的であることを示している。これらの動物モデルにおける有効量は、低力価接種材料では5日間については1日1〜2mg/kgの範囲にわたるが、後期には単回用量として20〜30mg/kgを必要とする。
健常志願者におけるCMX001の安全性および薬物動態を評価するために、初期試験を実施した。本試験は、単回投与群(SD)および複数回投与群(MD)から構成した。単回投与群では、6被験者からなる7コホートを治療した(4被験者が活性薬物を摂取し、2被験者はプラセボを摂取した)。登録は、2被験者(1例は活性薬、1例はプラセボ)、次に4被験者(A群およびB群)を試験するようにずらした。体重75kgの被験者のために治療される2つの最高用量について推定される単回用量は、40mg(0.6mg/kg、コホート6)および70mg(1mg/kg、コホート7)であった。複数回投与群では、コホート6MDは第0、6および12日に0.1mg/kgを摂取した。コホート7MDは第0、6および12日に0.2mg/kgを摂取した。シドフォビル、CMX001およびCMX064(主要代謝産物)のレベルは、本試験の進行中に被験者の血中および尿中で測定した。被験者の消化管(GI)監視は、(a)GI有害事象の臨床徴候についての監視、(b)視覚的アナログ尺度を用いた臨床症状についての監視、(c)食欲消失/食欲不振、悪心、嘔吐、下痢、便秘および腸内ガス/鼓腸についての監視、(d)便潜血、血清中電解質、尿比重、BUN/クレアチニン比、血清アルブミン、および脂質についての検査室試験、ならびに(e)診断学試験(無線カプセル内視鏡(PillCam(登録商標)、Given Imaging社)を含んでいた。
投与後に薬物を原因とする臨床的に有意な消化管カプセル内視鏡検査所見は見られない。
腎機能障害を示す数値を含む、臨床検査値への薬物に関連する臨床的に有意な変化は見られない。
重篤な有害事象(SAE)なし、有意な有害事象(AE)なし(すなわち、≧グレード2)、薬物に直接的に起因するAEなし。
単回用量投与後のCMX001の血漿濃度曲線は図1に示し、CMX001の単回投与後のシドフォビルの血漿濃度曲線は図2に示した。
Claims (28)
- 免疫不全被験者におけるウイルス感染症の治療的および/または予防的処置のための、脂質に共有結合した非環状ヌクレオシドホスホナートを含む共役化合物。
- アルキルグリセロール、アルキルプロパンジオール、1−S−アルキルチオグリセロール、アルコキシアルカノール、アルキルエタンジオール、ヘキサデシルプロパンジオールもしくはオクタデシルプロパンジオールに共有結合した、以下の構造式:
R1は、水素、−CH3、−CH2OH、−CH2F、−CH=CH2、もしくは−CH2N3であり、
R2は、水素であり、および
Bは、プリンもしくはピリミジンである。)
の抗ウイルス化合物のホスホナートまたはそのエナンチオマー、ジアステレオマー、ラセミ体、立体異性体、互変異性体、回転異性体もしくはそれらの混合物、またはそれらの医薬的に許容される塩を含む、請求項1に記載の共役化合物。 - 前記共役化合物が、エナンチオマー、ジアステレオ異性体、ラセミ体またはそれらの混合物である、請求項1または2に記載の共役化合物。
- 前記非環状ヌクレオシドホスホナートが、シドフォビル、環状シドフォビル、テノフォビル、およびアデフォビルからなる群から選択される、請求項1〜3のいずれかに記載の共役化合物。
- 前記免疫不全被験者が、原発性または後天性免疫不全症を有する、請求項1〜5のいずれかに記載の共役化合物。
- 前記免疫不全被験者が、特にシクロスポリンによる免疫抑制療法の結果として後天性免疫不全症を有する、請求項6に記載の共役化合物。
- 前記免疫不全被験者が、臓器移植患者である、請求項1〜7のいずれかに記載の共役化合物。
- 前記被験者が、腎臓移植患者、肝臓移植患者または骨髄移植患者である、請求項8に記載の共役化合物。
- 前記被験者が、慢性疲労症候群に罹患している、請求項1〜9のいずれかに記載の共役化合物。
- 前記ウイルス感染症が、非共役の非環状ヌクレオシドホスホナートによる治療に耐性である、請求項1〜10のいずれかに記載の共役化合物。
- 非共役の非環状ヌクレオシドホスホナートが、前記免疫不全被験者において毒性副作用を示す、請求項1〜11のいずれかに記載の共役化合物。
- 前記免疫不全被験者が、少なくとも1つのdsDNAウイルスに感染している、請求項1〜12のいずれかに記載の共役化合物。
- 前記dsDNAウイルスが、ヒト免疫不全ウイルス(HIV)、インフルエンザ、単純ヘルペスウイルス(HSV)、ヒトヘルペスウイルス6(HHV−6)、サイトメガロウイルス(CMV)、B型およびC型肝炎ウイルス、エプスタイン・バーウイルス(EBV)、水痘帯状疱疹ウイルス、大痘瘡および小痘瘡、ワクシニア、天然痘、ウシ痘、ラクダ痘、サル痘、エボラウイルス、乳頭腫ウイルス、アデノウイルスまたはJCウイルス、BKウイルスを含むポリオーマウイルスおよびSV40ウイルスからなる群のいずれかから選択される、請求項13に記載の共役化合物。
- 前記免疫不全被験者が、HCMV、BKウイルス、HHV−6、アデノウイルスおよびEBVからなる群から選択されるウイルスもしくはウイルスの任意の組み合わせに感染している、請求項13または14に記載の共役化合物。
- 前記免疫不全被験者が、2つ以上のウイルスに感染し、前記2つ以上のウイルスが相乗作用を示す、請求項13〜15のいずれかに記載の共役化合物。
- 前記ウイルスが、HCMVおよびBKである、請求項16に記載の共役化合物。
- 前記共役化合物が、免疫不全被験者におけるdsDNAウイルス感染症を治療するために使用されるが、前記被験者が塩酸バルガンシクロビル(もしくはガンシクロビル)に対して耐性であるか、または前記被験者が塩酸バルガンシクロビル(もしくはガンシクロビル)に対する副作用を示す、請求項1〜17のいずれかに記載の共役化合物。
- 前記共役が、サイトメガロウイルス(CMV)を治療するために(バル)ガンシクロビルによる治療に引き続いて使用される、請求項1〜18のいずれかに記載の共役化合物。
- 前記免疫不全被験者が、ヒト被験者である、請求項1〜19のいずれかに記載の共役化合物。
- 共役化合物が、5mg/kg未満の用量で前記被験者に投与される、請求項1〜20のいずれかに記載の共役化合物。
- 前記共役化合物が、10もしくは20から200もしくは5,000μg/kgまでの用量で前記被験者に投与される、請求項1〜21のいずれかに記載の共役化合物。
- 免疫不全被験者におけるウイルス感染症の治療的および/または予防的処置のための医薬品の製造における、脂質に共有結合した非環状ヌクレオシドホスホナートを含む共役化合物の使用。
- 免疫不全被験者におけるウイルス感染症の治療的および/または予防的処置のための方法であって、前記被験者に共役化合物を投与する工程を含み、前記共役化合物が、脂質に共有結合した非環状ヌクレオシドホスホナートを含む方法。
- アルキルグリセロール、アルキルプロパンジオール、1−S−アルキルチオグリセロール、アルコキシアルカノール、アルキルエタンジオール、ヘキサデシルプロパンジオールもしくはオクタデシルプロパンジオールに共有結合した、以下の構造式:
R1は、水素、−CH3、−CH2OH、−CH2F、−CH=CH2、もしくは−CH2N3であり、
R2は、水素であり、および
Bは、プリンもしくはピリミジンである。)
の抗ウイルス化合物のホスホナートまたはそのエナンチオマー、ジアステレオマー、ラセミ体、立体異性体、互変異性体、回転異性体もしくはそれらの混合物、またはそれらの医薬的に許容される塩を含む、請求項24に記載の方法。 - 前記化合物が、エナンチオマー、ジアステレオ異性体、ラセミ体またはそれらの混合物である、請求項24または25に記載の方法。
- 前記非環状ヌクレオシドホスホナートが、シドフォビル、環状シドフォビル、テノフォビル、およびアデフォビルからなる群から選択される、請求項24〜26のいずれかに記載の方法。
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WO2011100698A2 (en) | 2010-02-12 | 2011-08-18 | Chimerix, Inc. | Methods of treating viral infection |
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US8492386B2 (en) | 2011-10-21 | 2013-07-23 | Abbvie Inc. | Methods for treating HCV |
CN103826627B (zh) | 2011-10-21 | 2016-02-24 | 艾伯维公司 | 包含至少两种直接抗病毒剂和利巴韦林的组合物在制备治疗hcv的药物中的用途 |
WO2013059638A1 (en) | 2011-10-21 | 2013-04-25 | Abbvie Inc. | Combination treatment (eg. with abt-072 or abt -333) of daas for use in treating hcv |
US8466159B2 (en) | 2011-10-21 | 2013-06-18 | Abbvie Inc. | Methods for treating HCV |
EP3578563B1 (en) | 2011-12-22 | 2021-04-14 | Geron Corporation | Guanine analogs as telomerase substrates and telomere length affectors |
US20140011769A1 (en) * | 2012-07-03 | 2014-01-09 | Chimerix, Inc. | Methods of Treating Retroviral Infections and Related Dosage Regimes |
SG10201800188SA (en) | 2013-03-15 | 2018-02-27 | Univ California | Acyclic nucleoside phosphonate diesters |
JP6150949B2 (ja) | 2013-11-15 | 2017-06-21 | キメリックス インコーポレイテッド | ヘキサデシルオキシプロピル−ホスホン酸エステルの形態型 |
ES2915381T3 (es) | 2014-09-15 | 2022-06-22 | Univ California | Análogos de nucleótidos |
EP3350191B9 (en) | 2015-09-15 | 2021-12-22 | The Regents of the University of California | Nucleotide analogs |
JP7129703B2 (ja) | 2016-04-28 | 2022-09-02 | エモリー ユニバーシティー | アルキン含有ヌクレオチド及びヌクレオシド治療組成物並びにそれらに関連した使用 |
WO2018156879A1 (en) * | 2017-02-23 | 2018-08-30 | Chimerix, Inc. | Treatment of adenovirus with brincidofovir |
TW202322824A (zh) | 2020-02-18 | 2023-06-16 | 美商基利科學股份有限公司 | 抗病毒化合物 |
WO2022221514A1 (en) | 2021-04-16 | 2022-10-20 | Gilead Sciences, Inc. | Methods of preparing carbanucleosides using amides |
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Cited By (5)
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JP2019519570A (ja) * | 2016-06-28 | 2019-07-11 | キメリックス インコーポレイテッド | ブリンシドフォビルの製剤 |
JP2021143178A (ja) * | 2016-06-28 | 2021-09-24 | キメリックス インコーポレイテッド | ブリンシドフォビルの製剤 |
JP7221485B2 (ja) | 2016-06-28 | 2023-02-14 | エマージェント バイオディフェンス オペレーションズ ランシング エルエルシー | ブリンシドフォビルの製剤 |
JP2023033538A (ja) * | 2016-06-28 | 2023-03-10 | エマージェント バイオディフェンス オペレーションズ ランシング エルエルシー | ブリンシドフォビルの製剤 |
JP7407984B2 (ja) | 2016-06-28 | 2024-01-04 | エマージェント バイオディフェンス オペレーションズ ランシング エルエルシー | ブリンシドフォビルの製剤 |
Also Published As
Publication number | Publication date |
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US20160303147A1 (en) | 2016-10-20 |
ES2609095T3 (es) | 2017-04-18 |
CA2685285A1 (en) | 2008-11-06 |
CN102702260A (zh) | 2012-10-03 |
EP2155257B1 (en) | 2016-10-05 |
US20120010170A1 (en) | 2012-01-12 |
EP2155257A1 (en) | 2010-02-24 |
MX2009011573A (es) | 2010-01-20 |
CN101678122A (zh) | 2010-03-24 |
AU2008246195A1 (en) | 2008-11-06 |
JP2015063538A (ja) | 2015-04-09 |
AU2008246195B2 (en) | 2014-06-05 |
WO2008133966A1 (en) | 2008-11-06 |
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