US20160166539A1 - A novel composition for nonalcoholic fatty liver disease (nafld) - Google Patents

A novel composition for nonalcoholic fatty liver disease (nafld) Download PDF

Info

Publication number
US20160166539A1
US20160166539A1 US14/782,609 US201314782609A US2016166539A1 US 20160166539 A1 US20160166539 A1 US 20160166539A1 US 201314782609 A US201314782609 A US 201314782609A US 2016166539 A1 US2016166539 A1 US 2016166539A1
Authority
US
United States
Prior art keywords
pharmaceutical composition
sodium
fatty liver
liver
nash
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US14/782,609
Other languages
English (en)
Inventor
Pankaj Patel
Rajendrakumar Hariprasad Jani
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Zydus Lifesciences Ltd
Original Assignee
Cadila Healthcare Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cadila Healthcare Ltd filed Critical Cadila Healthcare Ltd
Assigned to CADILA HEALTHCARE LIMITED reassignment CADILA HEALTHCARE LIMITED ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: JANI, Rajendrakumar Hariprasad, PATEL, PANKAJ
Publication of US20160166539A1 publication Critical patent/US20160166539A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics

Definitions

  • the present invention relates to pharmaceutical compositions containing the formula (I)
  • the present invention further provides the composition of formula (I) useful in the prevention and treatment of nonalcoholic fatty liver disease (NAFLD)
  • Nonalcoholic fatty liver disease refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH), to cirrhosis (irreversible, advanced scarring of the liver). All of the stages of NAFLD have in common the accumulation of fat (fatty infiltration) in the liver cells (hepatocytes). In NASH, the fat accumulation is associated with varying degrees of inflammation, fibrosis and scarring of the liver.
  • NASH and NAFLD are frequently reported in both men and women, although it most often appears in women and is especially prevalent in the obese. Although the disease has been observed to be accompanied by several other pathological conditions, including diabetes mellitus, hyperlipidemia, hyperglycemia, all part of the “metabolic syndrome,” the cause and progression of the disease, as well as the causal or temporal relation to these conditions, is not well understood.
  • liver tissue and abnormalities of function are typical.
  • fatty deposits, tissue degeneration, inflammation, cell degeneration, fibrosis, cirrhosis, elevation of free fatty acids and other such abnormalities have come to be associated with nonalcoholic steatohepatitis and are frequently seen in patients suffering from different forms of NAFLD.
  • NASH The physiological condition that most commonly accompanies NASH is obesity, with approximately 70% and above of NASH sufferers also displaying clinically diagnosed obesity. NASH is particularly prevalent in obese patients who have undergone jejunal bypass to treat the obesity. In NASH patients, the extent of obesity tends to be generally correlated with the amount of steatosis and to be unrelated to non-insulin-dependent diabetes mellitus. However, non-insulin-dependent diabetes mellitus increases the prevalence of steatohepatitis especially in patients requiring insulin.
  • liver biopsy specimens tend to mimic those seen in patients suffering from alcoholic hepatitis.
  • vacuolation indicator of diabetes
  • steatosis in NASH as compared to alcoholic hepatitis.
  • Patients suffering from alcoholic hepatitis also have a higher incidence of periportal and pericellular fibrosis and proliferation of the bile ducts.
  • the symptoms and histological damage observed in alcoholic hepatitis patients are more severe than in NASH.
  • the present invention discloses a pharmaceutical composition containing the compound of the Formula (I)
  • liver cells hepatocytes
  • NAFLD nonalcoholic fatty liver disease
  • fatty liver steatosis
  • NASH nonalcoholic steatohepatitis
  • cirrhosis advanced scarring of the liver
  • the present invention provides a method and a formulation comprising an effective amount of compound of Formula (I) for treating nonalcoholic fatty liver disease (NAFLD) including fatty liver (steatosis), nonalcoholic steatohepatitis (NASH), and cirrhosis (advanced scarring of the liver).
  • NAFLD nonalcoholic fatty liver disease
  • NASH nonalcoholic steatohepatitis
  • cirrhosis advanced scarring of the liver
  • the method comprises administering to a subject an effective amount of a compound of formula (I) as a pharmaceutical formulation, as disclosed hereinafter including pharmaceutically acceptable salts of the compound of formula (I).
  • the invention further provides a pharmaceutical composition containing effective amount of compound of formula (I) suitable for treatment of nonalcoholic fatty liver disease (NAFLD) including fatty liver (steatosis), nonalcoholic steatohepatitis (NASH), and cirrhosis (advanced scarring of the liver).
  • NAFLD nonalcoholic fatty liver disease
  • NASH nonalcoholic steatohepatitis
  • cirrhosis advanced scarring of the liver
  • the present invention provides a method of treating alcoholic steatohepatitis in a subject, comprising administering to the subject an effective amount of a compound according to Formula (I), or a pharmaceutically acceptable salt thereof as a suitable pharmaceutically acceptable composition.
  • the present invention provides a method of treating liver failure in a subject, comprising administering to the subject an effective amount of a compound according to Formula (I), or a pharmaceutically acceptable salt thereof.
  • FIG. 1 Effect of Saroglitazar on ALT in PP population
  • FIG. 2 Effect of Saroglitazar on liver function test in Safety Population
  • FIG. 3 Effect of Saroglitazar on C-Peptide and HOMA Function in PP population
  • FIG. 4 Effect of Saroglitazar on Triglycerides in PP population
  • the present invention describes a pharmaceutical composition for reduction and removal of lipid accumulated in the liver cells (hepatocytes), required for treating and preventing certain diseases and conditions in subject suffering from nonalcoholic fatty liver disease (NAFLD) including fatty liver (steatosis), nonalcoholic steatohepatitis (NASH), and cirrhosis (advanced scarring of the liver) and methods for ameliorating and/or treating such disease conditions.
  • NASH nonalcoholic fatty liver disease
  • NASH nonalcoholic steatohepatitis
  • cirrhosis advanced scarring of the liver
  • the formulation comprises compound of formula (I) and the method comprises administering to a subject in need thereof an effective amount of a compound according to Formula (I), or a pharmaceutically acceptable salt thereof.
  • R is selected from hydroxy, hydroxyalkyl, acyl, alkoxy, alkylthio, thioalkyl, aryloxy, arylthio and M + represents suitable metal cations such as Na + , K + , Ca +2 , Mg +2 and the like.
  • Patient includes both human and animals. “Mammal” means humans and other mammalian animals.
  • a “subject” is a mammal, preferably a human, but can also be an animal in need of veterinary treatment, e.g., companion animals (e.g., dogs, cats, and the like), farm animals (e.g., cows, sheep, pigs, horses, and the like) and laboratory animals (e.g., rats, mice, guinea pigs, and the like).
  • companion animals e.g., dogs, cats, and the like
  • farm animals e.g., cows, sheep, pigs, horses, and the like
  • laboratory animals e.g., rats, mice, guinea pigs, and the like.
  • treating includes achieving, partially or substantially, one or more of the following results: partially or totally reducing the extent of the disease, disorder or syndrome (e.g., reducing fat deposits, increasing insulin activity/sensitivity, reducing weight); ameliorating or improving a clinical symptom or indicator associated with the disorder; delaying, inhibiting or preventing the progression of the disease, disorder or syndrome; or partially or totally delaying, inhibiting or preventing the onset or development of disorder.
  • partially or totally reducing the extent of the disease, disorder or syndrome e.g., reducing fat deposits, increasing insulin activity/sensitivity, reducing weight
  • ameliorating or improving a clinical symptom or indicator associated with the disorder delaying, inhibiting or preventing the progression of the disease, disorder or syndrome
  • partially or totally delaying, inhibiting or preventing the onset or development of disorder e.g., reducing fat deposits, increasing insulin activity/sensitivity, reducing weight
  • Delaying, inhibiting or preventing the progression of the disease, disorder or syndrome includes for example, delaying, inhibiting or preventing the progression of fatty liver to NASH; delaying, inhibiting or preventing the progression of NASH to cirrhosis, end-stage liver disease and/or hepatocellular carcinoma; and delaying, inhibiting or preventing the progression of pre-diabetes to diabetes.
  • alkyl used herein, either alone or in combination with other radicals, denotes a linear or branched radical containing one to twelve carbons, such as methyl, ethyl, n-propyl, iso-propyl, n-butyl, sec-butyl, tert-butyl, amyl, t-amyl, n-pentyl, n-hexyl, iso-hexyl, heptyl, octyl and the like.
  • alkoxy used herein, either alone or in combination with other radicals, denotes a radical alkyl, as defined above, attached directly to an oxygen atom, such as methoxy, ethoxy, n-propoxy, iso-propoxy, n-butoxy, t-butoxy, iso-butoxy, pentyloxy, hexyloxy, and the like.
  • aryl or “aromatic” used herein, either alone or in combination with other radicals, refers to an optionally substituted aromatic system containing one, two or three rings wherein such rings may be attached together in a pendant manner or may be fused, such as phenyl, naphthyl, tetrahydronaphthyl, indane, biphenyl, and the like.
  • aralkyl denotes an alkyl group, as defined above, attached to an aryl, such as benzyl, phenethyl, naphthylmethyl, and the like.
  • aryloxy denotes an aryl radical, as defined above, attached to an alkoxy group, such as phenoxy, naphthyloxy and the like, which may be substituted.
  • alkoxy such as phenoxy, naphthyloxy and the like
  • aralkoxy denotes an arylalkyl moiety, as defined above, such as benzyloxy, phenethyloxy, naphthylmethyloxy, phenylpropyloxy, and the like, which may be substituted.
  • acyl used herein, either alone or in combination with other radicals, refers to a radical containing one to eight carbons such as formyl, acetyl, propanoyl, butanoyl, iso-butanoyl, pentanoyl, hexanoyl, heptanoyl, benzoyl and the like, which may be substituted.
  • hydroxyalkyl used herein, either alone or in combination with other radicals, refers to an alkyl group, as defined above, substituted with one or more hydroxy radicals, such as hydroxymethyl, hydroxyethyl, hydroxypropyl, hydroxybutyl, hydroxypentyl, hydroxyhexyl and the like.
  • thio(C 1 -C 12 )alkyl or “thio((C 1 -C 6 )alkyl” used herein, either alone or in combination with other radicals, represents an alkyl group, as defined above, attached to a group of formula —SR′, where R′ represents hydrogen, alkyl or aryl group, e.g. thiomethyl, methylthiomethyl, phenylthiomethyl and the like, which may be substituted
  • Effective amount or “therapeutically effective amount” is meant to describe an amount of compound or a composition of the present invention effective in inhibiting the above-noted diseases and thus producing the desired therapeutic, ameliorative, inhibitory or preventative effect.
  • One or more compounds of the invention may exist in unsolvated as well as solvated forms with pharmaceutically acceptable solvents such as water, ethanol, and the like, and it is intended that the invention embrace both solvated and unsolvated forms.
  • “Solvate” means a physical association of a compound of this invention with one or more solvent molecules. This physical association involves varying degrees of ionic and covalent bonding, including hydrogen bonding. In certain instances the solvate will be capable of isolation, for example when one or more solvent molecules are incorporated in the crystal lattice of the crystalline solid. “Solvate” encompasses both solution-phase and isolatable solvates.
  • One or more compounds of the invention may optionally be converted to a solvate.
  • Preparation of solvates is generally known.
  • M. Caira et al, J. Pharmaceutical Sci, 93(3), 601-611 (2004) describe the preparation of the solvates of the antifungal fluconazole in ethyl acetate as well as from water.
  • Similar preparations of solvates, hemisolvate, hydrates and the like are described by E. C. van Tonder et al, AAPS PharmSciTech., 5(1), article 12 (2004); and A. L. Bingham et al, Chem. Commun., 603-604 (2001)
  • the compounds of Formula (I) can form salts which are also within the scope of this invention.
  • Reference to a compound of Formula (I) herein is understood to include reference to salts thereof, unless otherwise indicated.
  • the term “salt(s)”, as employed herein, denotes acidic salts formed with inorganic and/or organic acids, as well as basic salts formed with inorganic and/or organic bases.
  • zwitterions inner salts may be formed and are also included within the term “salt(s)” as used herein.
  • Salts of the compounds of the Formula (I) may be formed, for example, by reacting a compound of Formula I with an amount of acid or base, such as an equivalent amount, in a medium such as one in which the salt precipitates or in an aqueous medium followed by lyophilization.
  • Exemplary acid addition salts include acetates, ascorbates, benzoates, benzenesulfonates, bisulfates, borates, butyrates, citrates, camphorates, camphorsulfonates, fumarates, hydrochlorides, hydrobromides, hydroiodides, lactates, maleates, methanesulfonates, naphthalenesulfonates, nitrates, oxalates, phosphates, propionates, salicylates, succinates, sulfates, tartarates, thiocyanates, toluenesulfonat.es (also known as tosylates,) and the like.
  • Exemplary basic salts include ammonium salts, alkali metal salts such as sodium, lithium, and potassium salts, alkaline earth metal salts such as calcium and magnesium salts, salts with organic bases (for example, organic amines) such as dicyclohexylamines, t-butyl amines, and salts with amino acids such as arginine, lysine and the like.
  • alkali metal salts such as sodium, lithium, and potassium salts
  • alkaline earth metal salts such as calcium and magnesium salts
  • salts with organic bases for example, organic amines
  • organic amines such as dicyclohexylamines, t-butyl amines
  • salts with amino acids such as arginine, lysine and the like.
  • Basic nitrogen-containing groups may be quartemized with agents such as lower alkyl halides (e.g., methyl, ethyl, and butyl chlorides, bromides and iodides), dialkyl sulfates (e.g., dimethyl, diethyl, and dibutyl sulfates), long chain halides (e.g., decyl, lauryl, and stearyl chlorides, bromides and iodides), aralkyl halides (e.g., benzyl and phenethyl bromides), and others.
  • lower alkyl halides e.g., methyl, ethyl, and butyl chlorides, bromides and iodides
  • dialkyl sulfates e.g., dimethyl, diethyl, and dibutyl sulfates
  • long chain halides e.g., decyl, lauryl,
  • composition is intended to encompass a product comprising the specified ingredients in the specified amounts, as well as any product which results, directly or indirectly, from combination of the specified ingredients in the specified amounts
  • the present invention provides a suitable pharmaceutical composition of compounds of formula (I) or their derivatives, which comprises one or more pharmaceutical excipients, antioxidants and chelating agents, wherein the pH of the composition is above 6, preferably in the range from about pH 6 to pH of about 10.
  • liver One function of the liver is to process fats and proteins from digested food.
  • Fatty liver disease covers a range of conditions where there is a build-up of fat in the liver cells.
  • the liver cells normally contain some fat and related fatty chemicals (triglycerides, fatty acids, etc). Excess fat is normally passed out of liver cells, into the bloodstream, and then taken up and stored in fat cells (adipose cells) throughout the body. In fatty liver disease, excess fat builds up in liver cells. This is thought to happen if there is some problem or disruption in the normal processing of fat and related fatty chemicals in the liver cells.
  • Simple fatty liver also called “hepatic steatosis” is present when the fat content inside liver cells makes up more than 5-10% of the liver's weight. Simple fatty liver is not associated with serious damage or harm to the liver.
  • Nonalcoholic fatty liver disease refers to a wide spectrum of liver disease ranging from: i) simple fatty liver (steatosis), in which there are fat deposits on the liver; ii) nonalcoholic steatohepatitis (NASH) in which there are fat deposits on the liver along with inflammation and damage of the liver; and iii) cirrhosis in which there is irreversible, advanced scarring of the liver.
  • simple fatty liver steatosis
  • NASH nonalcoholic steatohepatitis
  • cirrhosis in which there is irreversible, advanced scarring of the liver.
  • NAFLD nonalcoholic steatohepatitis
  • steatosis Fatty liver
  • NASH nonalcoholic steatohepatitis
  • the fat accumulation is associated with varying degrees of inflammation and scarring of the liver, and in many cases insulin resistance, dyslipidemia and hypertension.
  • NASH can progresses to fibrosing, steatohepatitis and may trigger cirrhosis, end-stage liver disease, acute live failure and hepatocellular carcinoma. It most often occurs in people with excess body weight, elevated blood lipids, such as cholesterol and triglycerides, and insulin resistance.
  • the present invention also provides methods of treating liver failure.
  • Acute liver failure occurs when the cells in the liver die or become damaged in a short period of time. This causes the liver to fail to work normally and can be fatal.
  • liver failure Any progressive liver disease, such as cirrhosis, can result in liver failure. Signs of liver failure include encephalopathy (altered brain function, jaundice, ascites, fetor hepaticus and failure of coagulation).
  • encephalopathy altered brain function, jaundice, ascites, fetor hepaticus and failure of coagulation.
  • Effective amounts of such compounds are administered to a subject with one or more of these conditions.
  • the compounds according to Formula (I) can be used alone or in combination e.g., as an adjunct therapy, with at least one other therapeutic agent.
  • Compounds according to formula (I) can be subject with NASH, a compound according to formula (I) can be co-administered with a therapeutic agent used to reduce one or more of the symptoms of NASH or NAFLD including, but not limited to, an agent used to control blood glucose levels, an agent used to control lipid levels, e.g., an agent used to lower or control cholesterol, an antioxidant, an appetite suppressing agent, an anti-obesity agent, to control blood glucose levels, such as, sulfonylureas, an antibiotic/probiotic or an anti-inflammatory agent.
  • a therapeutic agent used to reduce one or more of the symptoms of NASH or NAFLD including, but not limited to, an agent used to control blood glucose levels, an agent used to control lipid levels, e.g., an agent used to lower or control cholesterol, an antioxidant, an appetite suppressing agent, an anti
  • agents examples include chlorpropamide, glipizide, glyburide, and glimepiride; meglitinides, such as, repaglinide and nateglinide; biguanides, such as, metformin and acarbose; thiazolidinediones, such as, rosiglitazone, and pioglitazone; and insulin and its derivatives, such as, pramlintide, exenatide, humalog, novolog, humulin, novolin, ultralente, and lanrus; an agent used to control lipid levels, such as, vytorin, Clofibrate and Gemfibrozil, a plasma HDL-raising agent, a cholesterol lowering agent, a cholesterol biosynthesis inhibitor, for example an HMG-CoA reductase inhibitor (such as a statin, such as, Atorvastatin, Fluvastatin, Lovastatin, Pravastatin, Rosuvastat
  • a compound according to formula (I) when methods of the present invention is used to treat a subject with alcoholic steatohepatitis, a compound according to formula (I) can be co-administered with a therapeutic agent used to reduce one or more of the symptoms of alcoholic steatohepatitis including, but not limited to, an agent used to control blood glucose levels, an agent used to control lipid levels, e.g., an agent used to lower control cholesterol, an antioxidant, an appetite suppressing agent, an anti-obesity agent, an antibiotic or an anti-inflammatory agent, such as those described above.
  • a therapeutic agent used to reduce one or more of the symptoms of alcoholic steatohepatitis including, but not limited to, an agent used to control blood glucose levels, an agent used to control lipid levels, e.g., an agent used to lower control cholesterol, an antioxidant, an appetite suppressing agent, an anti-obesity agent, an antibiotic or an anti-inflammatory agent, such as those described above.
  • a compound according to formula (I) when used in the methods of the present invention to treat a subject with liver failure, can be co-administered with a therapeutic agent used to reduce one or more of the symptoms of alcoholic steatohepatitis including, but not limited to, an agent used to control blood glucose levels, an agent used to control lipid levels, such as those described above.
  • the present invention discloses a suitable pharmaceutical composition of the compound of formula (I), for the treatment of one or more of the diseases disclosed above.
  • a preferred pharmaceutical composition of the compound of formula (I) comprises of
  • Each of the components may be selected from those known in the art.
  • suitable stabilizers may be selected from the classes of antioxidants or chelating agents.
  • the pharmaceutical excepients according to the present invention can be selected from solubilizers, diluents, fillers, disintegrants, binder, lubricants, glidants, wetting agents, solvents and the like as is known in the art.
  • suitable additives are selected from sodium benzoate, sodium hydroxide, sodium sulfite and sodium carbonate.
  • antioxidants used according to the present invention include, but are not limited to citric acid, alpha tocopherol, sodium sulphite, sodium metabisulphite, butylated hydroxy anisole (BHA), BHT (2,6-di-tert-butyl-4-methylphenol), monothioglycerol, Vitamin C (ascorbic acid), and propyl gallate and combinations thereof and other similar material known to those of ordinary skilled in the art.
  • Chelating agent used according to the present invention include, but are not limited to Disodium EDTA, citric acid and or its salts, maleic acid, chlorambutol, chlorhexidine or its salts, chlorocresol, combinations thereof and other similar material known to those of ordinary skill in the art.
  • binder is intended to mean substances used to cause adhesion of powder particles in tablet granulations.
  • Such compounds include, by way of example and without limitation, acacia alginic acid, tragacanth, carboxymethylcellulose sodium, poly (vinylpyrrolidone), compressible sugar (e.g., NuTab), ethylcellulose, gelatin, liquid glucose, methyl cellulose, povidone and pregelatinized starch, combinations thereof and other similar material known to those of ordinary skill in the art.
  • binders include starch, poly(ethylene glycol), guar gum, polysaccharide, bentonites, sugars, invert sugars, poloxamers (PLURONIC F68, PLURONIC F127), collagen, albumin, celluloses in non-aqueous solvents, and the like or their suitable combinations.
  • Other binders which may be included may be, for example, poly(propylene glycol), polyoxyethylene-polypropylene copolymer, polyethylene ester, polyethylene sorbitan ester, poly(ethylene oxide), microcrystalline cellulose, poly(vinylpyrrolidone), combinations thereof and other such materials known to those of ordinary skill in the art.
  • the term “diluent” or “filler” is intended to mean inert substances used as fillers to create the desired bulk, flow properties, and compression characteristics in the preparation of tablets and capsules.
  • Such compounds include, by way of example and without limitation, dibasic calcium phosphate, kaolin, sucrose, mannitol, microcrystalline cellulose, powdered cellulose, precipitated calcium carbonate, sorbitol, starch, combinations thereof and other such materials known to those of ordinary skill in the art.
  • glidant is intended to mean agents used in tablet and capsule formulations to improve flow-properties during tablet compression and to produce an anti-caking effect.
  • Such compounds include, by way of example and without limitation, colloidal silica, calcium silicate, magnesium silicate, silicon hydrogel, cornstarch, talc, combinations thereof and other such materials known to those of ordinary skill in the art.
  • lubricant is intended to mean substances used in tablet formulations to reduce friction during tablet compression.
  • Such compounds include, by way of example and without limitation, calcium stearate, magnesium stearate, mineral oil, stearic acid, zinc stearate, suitable combinations thereof and other such materials known to those of ordinary skill in the art.
  • disintegrant is intended to mean a compound used in solid dosage forms to promote the disruption of the solid mass into smaller particles which are more readily dispersed or dissolved.
  • exemplary disintegrants include, by way of example and without limitation, starches such as corn starch, potato starch, pre-gelatinized and modified starched thereof, sweeteners, clays, such as bentonite, microcrystalline cellulose (e.g. AvicelTM.), carsium (e.g. Amberlite.TM.), alginates, sodium starch glycolate, gums such as agar, guar, locust bean, karaya, pectin, tragacanth, combinations thereof and other such materials known to those of ordinary skill in the art.
  • starches such as corn starch, potato starch, pre-gelatinized and modified starched thereof, sweeteners, clays, such as bentonite, microcrystalline cellulose (e.g. AvicelTM.), carsium (e.g. Amberlite.TM.), alginates, sodium starch glycolate, gum
  • the term “wetting agent” is intended to mean a compound used to aid in attaining intimate contact between solid particles and liquids.
  • exemplary wetting agents include, by way of example and without limitation, poloxamers, gelatin, casein, Glycerol mono-oleate, lecithin (phosphatides), gum acacia, cholesterol, tragacanth, stearic acid, benzalkonium chloride, calcium stearate, glycerol monostearate, cetostearyl alcohol, sodium lauryl sulphate, sodium dodecyl sulfate, salts of bile acids (taurocholate, glycocholate, cholate, deoxycholate, etc.), cetomacrogol emulsifying wax, sorbitan esters, polyoxyethylene alkyl ethers (e.g., macrogol ethers such as cetomacrogol 1000), polyoxyethylene castor oil derivatives, polyoxyethylene sorbitan fatty acid esters, (e.g.
  • Tyloxapol a nonionic liquid polymer of the alkyl aryl polyether alcohol type, also known as superinone or triton
  • the stable pharmaceutical composition according to the present invention may be in the form of tablet or capsule or a powder or a suspension in a liquid or an aerosol formulation or solutions, preferably in the form of tablet or capsule.
  • the stable pharmaceutical composition may be made by direct compression, wet granulation or dry granulation methods by techniques known to persons skilled in the art.
  • direct compression wet granulation or dry granulation methods by techniques known to persons skilled in the art.
  • the drug is mixed with one or more pharmaceutical excepients and granulated with suitable binding solution as described earlier, to form wet granules, the wet granules are dried and optionally sieved. The dried granules are mixed with one or more suitable excipients from those described elsewhere and then compressed into tablets or filled into capsules.
  • the drug In direct compression process, the drug is mixed with all the pharmaceutical excipients required and then is either compressed into tablets or filled in capsules.
  • the drug is mixed with one or more pharmaceutical excipients and compressed into slugs and these slugs are passed through required sieve.
  • the sieved granules are mixed with one or more suitable excipients from those described elsewhere and then compressed into tablets or filled into capsules.
  • One or more solvents used in the formulation are selected from acetone, chloroform, dichloromethane, ethyl alcohol, ethyl acetate, methyl alcohol, isopropyl alcohol and combinations thereof and other such materials known to those of ordinary skill in the art.
  • the compound of formula (I) or pharmaceutical compositions containing the compound of formula (I) is given to a subject in need thereof at a dose of about 0.5 mg to 5 g.
  • a skilled person is aware how to decide the optimum dose based on the patient profile, the severity of disease, the presence of secondary medicines and the like.
  • the compound of formula (I), when R is —SMe and M + is Mg, is commercially known as Saroglitazar.
  • This compound (Saroglitazar) is dosed to patients in need thereof for the treatment of one or more of the diseases described above as per the following general protocol:
  • NASH Non-alcoholic steatohepatitis
  • Subjects was diagnosed by biopsy as suffering from NASH in last one year and willing to participate in study were invited for screening programme for inclusion in the study.
  • Subjects were screened for the inclusion and exclusion criteria and those qualifying were invited to participate in the study. Clinical evaluation was done for baseline characteristics and anthropometry
  • Subjects were screened for inclusion in the study after obtaining informed consent, out of which 32 subjects were enrolled into the study. Out of these 32 subjects, 29 subjects completed the study.
  • the compounds of the present invention and the pharmaceutical composition as described in the specification are suitable for reduction and removal of lipid accumulated in the liver cells (hepatocytes) for the treatment of Nonalcoholic fatty liver disease (NAFLD) which refers to a wide spectrum of liver diseases ranging from simple fatty liver (steatosis) to nonalcoholic steatohepatitis (NASH).
  • NAFLD Nonalcoholic fatty liver disease
  • steatosis simple fatty liver
  • NASH nonalcoholic steatohepatitis

Landscapes

  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Chemical & Material Sciences (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Epidemiology (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Organic Chemistry (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Medicinal Preparation (AREA)
US14/782,609 2013-04-22 2013-06-25 A novel composition for nonalcoholic fatty liver disease (nafld) Abandoned US20160166539A1 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
IN1468/MUM/2013 2013-04-22
IN1468MU2013 IN2013MU01468A (es) 2013-04-22 2013-06-25
PCT/IN2013/000391 WO2014174524A1 (en) 2013-04-22 2013-06-25 A novel composition for nonalcoholic fatty liver disease (nafld)
INPCT/IN2013/000391 2013-06-25

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
PCT/IN2013/000391 A-371-Of-International WO2014174524A1 (en) 2013-04-22 2013-06-25 A novel composition for nonalcoholic fatty liver disease (nafld)

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US15/343,859 Division US9814697B2 (en) 2013-04-22 2016-11-04 Composition for nonalcoholic fatty liver disease (NAFLD)

Publications (1)

Publication Number Publication Date
US20160166539A1 true US20160166539A1 (en) 2016-06-16

Family

ID=49253372

Family Applications (3)

Application Number Title Priority Date Filing Date
US14/782,609 Abandoned US20160166539A1 (en) 2013-04-22 2013-06-25 A novel composition for nonalcoholic fatty liver disease (nafld)
US15/343,859 Active US9814697B2 (en) 2013-04-22 2016-11-04 Composition for nonalcoholic fatty liver disease (NAFLD)
US15/801,738 Abandoned US20180185330A1 (en) 2013-04-22 2017-11-02 Novel composition for nonalcoholic fatty liver disease (nafld)

Family Applications After (2)

Application Number Title Priority Date Filing Date
US15/343,859 Active US9814697B2 (en) 2013-04-22 2016-11-04 Composition for nonalcoholic fatty liver disease (NAFLD)
US15/801,738 Abandoned US20180185330A1 (en) 2013-04-22 2017-11-02 Novel composition for nonalcoholic fatty liver disease (nafld)

Country Status (21)

Country Link
US (3) US20160166539A1 (es)
EP (1) EP2988736A1 (es)
JP (1) JP6246895B2 (es)
KR (1) KR101617812B1 (es)
CN (1) CN105377246B (es)
AP (1) AP2015008674A0 (es)
AU (1) AU2013387996B2 (es)
BR (1) BR112015020600A2 (es)
CA (1) CA2900435C (es)
EA (1) EA201592020A1 (es)
GE (1) GEP201706663B (es)
HK (1) HK1214968A1 (es)
IL (2) IL240183A (es)
IN (1) IN2013MU01468A (es)
MA (1) MA38385A1 (es)
MX (1) MX346943B (es)
MY (1) MY180160A (es)
PH (1) PH12015501795A1 (es)
SG (1) SG11201506218UA (es)
UA (1) UA114360C2 (es)
WO (1) WO2014174524A1 (es)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9656954B2 (en) 2013-07-05 2017-05-23 Cadila Healthcare Limited Synergistic compositions
US9783495B2 (en) 2011-01-31 2017-10-10 Cadila Healthcare Limited Treatment for lipodystrophy
US9814697B2 (en) 2013-04-22 2017-11-14 Cadila Healthcare Limited Composition for nonalcoholic fatty liver disease (NAFLD)
US10098868B2 (en) 2013-07-25 2018-10-16 Cadila Healthcare Limited Formula comprising a hypolipidemic agent
US10112898B2 (en) 2013-09-06 2018-10-30 Cadila Healthcare Limited Process for the preparation of saroglitazar pharmaceutical salts
US10385017B2 (en) 2015-10-14 2019-08-20 Cadila Healthcare Limited Pyrrole compound, compositions and process for preparation thereof
US10435363B2 (en) 2013-05-30 2019-10-08 Cadila Healthcare Limited Process for preparation of pyrroles having hypolipidemic hypocholesteremic activities
US11433050B2 (en) 2016-12-09 2022-09-06 Cadila Healthcare Ltd. Treatment for primary biliary cholangitis

Families Citing this family (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20130158077A1 (en) 2011-12-19 2013-06-20 Ares Trading S.A. Pharmaceutical compositions
WO2018183193A1 (en) 2017-03-28 2018-10-04 Gilead Sciences, Inc. Therapeutic combinations for treating liver diseases
GB201710229D0 (en) * 2017-06-27 2017-08-09 Tdeltas Ltd Compounds for new use
CA3077273A1 (en) * 2017-10-06 2019-04-11 Gilead Sciences, Inc. Combination therapy comprising an acc inhibitor
CN110934866B (zh) * 2018-09-25 2023-12-01 深圳微芯生物科技股份有限公司 西格列羧及其相关化合物的应用
WO2020128815A1 (en) 2018-12-18 2020-06-25 Cadila Healthcare Limited Saroglitazar for the treatment of hepatocellular carcinoma
US20220175721A1 (en) * 2019-02-13 2022-06-09 Cadila Healthcare Limited Treatment for polycystic ovarian syndrome (pcos)
WO2022246243A1 (en) * 2021-05-21 2022-11-24 HepQuant, LLC Methods of defining functional change and slowing progression in chronic liver disease

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003009841A1 (en) * 2001-07-26 2003-02-06 Cadila Healthcare Limited Novel pyrroles having hypolipidemic hypocholesteremic activities, process for their preparation and pharmaceutical compositions containing them and their use in medicine
WO2012104869A1 (en) * 2011-01-31 2012-08-09 Cadila Healthcare Limited Treatment for lipodystrophy

Family Cites Families (40)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4231938A (en) 1979-06-15 1980-11-04 Merck & Co., Inc. Hypocholesteremic fermentation products and process of preparation
US4444784A (en) 1980-08-05 1984-04-24 Merck & Co., Inc. Antihypercholesterolemic compounds
DK149080C (da) 1980-06-06 1986-07-28 Sankyo Co Fremgangsmaade til fremstilling af derivater af ml-236b-carboxylsyre
US5354772A (en) 1982-11-22 1994-10-11 Sandoz Pharm. Corp. Indole analogs of mevalonolactone and derivatives thereof
FI94339C (fi) 1989-07-21 1995-08-25 Warner Lambert Co Menetelmä farmaseuttisesti käyttökelpoisen /R-(R*,R*)/-2-(4-fluorifenyyli)- , -dihydroksi-5-(1-metyylietyyli)-3-fenyyli-4-/(fenyyliamino)karbonyyli/-1H-pyrroli-1-heptaanihapon ja sen farmaseuttisesti hyväksyttävien suolojen valmistamiseksi
US5089514A (en) 1990-06-14 1992-02-18 Pfizer Inc. 3-coxazolyl [phenyl, chromanyl or benzofuranyl]-2-hydroxypropionic acid derivatives and analogs as hypoglycemic agents
EP1000938A1 (en) 1992-07-03 2000-05-17 Smithkline Beecham Plc Heterocyclic compounds as pharmaceuticals
GB9225386D0 (en) 1992-12-04 1993-01-27 Smithkline Beecham Plc Novel compounds
US5387613A (en) 1993-07-23 1995-02-07 Ribogene, Inc. Treatment of tachyarrhythmias of supraventricular origin
GB9326171D0 (en) 1993-12-22 1994-02-23 Smithkline Beecham Plc Novel compounds
WO1996004261A1 (en) 1994-07-29 1996-02-15 Smithkline Beecham Plc Benzoxazoles and pryridine derivatives useful in the treatment of the type ii diabetes
BR9608040B1 (pt) 1995-04-28 2010-02-23 composto taxàide pentacÍclico.
GB9600464D0 (en) 1996-01-09 1996-03-13 Smithkline Beecham Plc Novel method
GB9606805D0 (en) 1996-03-30 1996-06-05 Glaxo Wellcome Inc Medicaments
CN1280574A (zh) 1997-10-27 2001-01-17 雷迪研究基金会 新的杂环化合物及其在医药中的应用、它们的制备方法和含有它们的药物组合物
WO1999019313A1 (en) 1997-10-27 1999-04-22 Dr. Reddy's Research Foundation Novel tricyclic compounds and their use in medicine; process for their preparation and pharmaceutical compositions containing them
WO1999020614A1 (en) 1998-05-27 1999-04-29 Dr. Reddy's Research Foundation Bicyclic compounds, process for their preparation and pharmaceutical compositions containing them
AU1120599A (en) 1998-04-23 1999-03-08 Dr. Reddy's Research Foundation New heterocyclic compounds and their use in medicine, process for their reparation and pharmaceutical compositions containing them
EP1123292A1 (en) 1998-10-21 2001-08-16 Novo Nordisk A/S New compounds, their preparation and use
WO2000023417A1 (en) 1998-10-21 2000-04-27 Novo Nordisk A/S New compounds, their preparation and use
JP2002527520A (ja) 1998-10-21 2002-08-27 ノボ ノルディスク アクティーゼルスカブ 新規化合物、その製造及び使用
CO5150173A1 (es) 1998-12-10 2002-04-29 Novartis Ag Compuestos n-(glicilo sustituido)-2-cianopirrolidinas inhibidores de peptidasa de dipeptidilo-iv (dpp-iv) los cuales son efectivos en el tratamiento de condiciones mediadas por la inhibicion de dpp-iv
AP1522A (en) 2000-01-19 2005-12-22 Cadila Healthcare Ltd Compounds having hypolipedemic and hypocholesteremic activities, process for their preparation and pharmaceutical compositions containing them.
US6395767B2 (en) 2000-03-10 2002-05-28 Bristol-Myers Squibb Company Cyclopropyl-fused pyrrolidine-based inhibitors of dipeptidyl peptidase IV and method
AU2001286163A1 (en) 2000-09-22 2002-04-02 Dr. Reddy's Research Foundation An improved process for the preparation of 3-aryl-2-hydroxy propanoic acid derivatives
UA74912C2 (en) 2001-07-06 2006-02-15 Merck & Co Inc Beta-aminotetrahydroimidazo-(1,2-a)-pyrazines and tetratriazolo-(4,3-a)-pyrazines as inhibitors of dipeptylpeptidase for the treatment or prevention of diabetes
US7407955B2 (en) 2002-08-21 2008-08-05 Boehringer Ingelheim Pharma Gmbh & Co., Kg 8-[3-amino-piperidin-1-yl]-xanthines, the preparation thereof and their use as pharmaceutical compositions
JP4261546B2 (ja) 2003-09-26 2009-04-30 三菱レイヨン株式会社 電気泳動装置および電気泳動法
CN102127053A (zh) 2004-03-15 2011-07-20 武田药品工业株式会社 二肽基肽酶抑制剂
BRPI0616158A2 (pt) * 2005-09-19 2011-06-07 Johnson & Johnson Pharmaceutical Res & Dev L L C modulação de expressão de receptor de glucagon
EP2069380B1 (en) * 2006-09-18 2014-11-12 Alnylam Pharmaceuticals Inc. Rnai modulation of scap and therapeutic uses thereof
JP2008184429A (ja) * 2007-01-30 2008-08-14 Japan Health Science Foundation 肝臓トリグリセリド濃度低下剤
JP5833016B2 (ja) 2009-11-26 2015-12-16 ジェンフィＧｅｎｆｉｔ 肝障害を処置するための１，３−ジフェニルプロパ−２−エン−１−オン誘導体の使用
AU2011316565A1 (en) 2010-10-12 2013-05-02 Cerecor Inc. Antitussive compositions comprising memantine
MA38385A1 (fr) 2013-04-22 2017-09-29 Cadila Healthcare Ltd Nouvelle composition pour la stéatose hépatique non alcoolique (nafld)
WO2014195967A2 (en) 2013-05-30 2014-12-11 Cadila Healthcare Limited A process for preparation of pyrroles having hypolipidemic hypocholesteremic activities
TW201636015A (zh) 2013-07-05 2016-10-16 卡地拉保健有限公司 協同性組成物
IN2013MU02470A (es) 2013-07-25 2015-06-26 Cadila Healthcare Ltd
WO2015029066A1 (en) 2013-08-29 2015-03-05 Cadila Healthcare Limited Polymorphic form of pyrrole derivative and intermediate thereof
WO2015033357A2 (en) 2013-09-06 2015-03-12 Cadila Healthcare Limited An improved process for the preparation of pyrrole derivatives

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003009841A1 (en) * 2001-07-26 2003-02-06 Cadila Healthcare Limited Novel pyrroles having hypolipidemic hypocholesteremic activities, process for their preparation and pharmaceutical compositions containing them and their use in medicine
US20030236254A1 (en) * 2001-07-26 2003-12-25 Lohray Braj Bhushan Novel heterocyclic compounds having hypolipidemic, hypocholesteremic activities process for their preparation and pharmaceutical compositions containing them and their use in medicine
US6987123B2 (en) * 2001-07-26 2006-01-17 Cadila Healthcare Limited Heterocyclic compounds, their preparation, pharmaceutical compositions containing them and their use in medicine
US20070238776A1 (en) * 2001-07-26 2007-10-11 Cadilla Healthcare Limited Novel Pyrroles Having Hypolipidemic Hypocholesteremic Activities, Process for Their Preparation and Pharmaceutical Compositions Containing Them and Their Use in Medicine
US8110598B2 (en) * 2001-07-26 2012-02-07 Cadila Healthcare Limited Heterocyclic compounds, their preparation, pharmaceutical compositions containing them and their use in medicine
US8212057B2 (en) * 2001-07-26 2012-07-03 Cadila Healthcare Limited Pyrroles having hypolipidemic hypocholesteremic activities, process for their preparation and pharmaceutical compositions containing them and their use in medicine
US8558009B2 (en) * 2001-07-26 2013-10-15 Cadila Healthcare Limited Pyrroles having hypolipidemic hypocholesteremic activities, process for their preparation and pharmaceutical compositions containing them and their use in medicine
WO2012104869A1 (en) * 2011-01-31 2012-08-09 Cadila Healthcare Limited Treatment for lipodystrophy

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
Gennaro, Remington's Pharmaceutical sciences, Mack Pub., 19th Edition, 1995, Pages 1380-1383 *
Lieberman et al., Pharmaceutical Dosage Forms: Tablets - Lubricants, Volume 1, second edition, 1989, Marcel Dekker Inc., Pages 111-114 *

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9783495B2 (en) 2011-01-31 2017-10-10 Cadila Healthcare Limited Treatment for lipodystrophy
US10017470B2 (en) 2011-01-31 2018-07-10 Cadila Healthcare Limited Treatment for lipodystrophy
US9814697B2 (en) 2013-04-22 2017-11-14 Cadila Healthcare Limited Composition for nonalcoholic fatty liver disease (NAFLD)
US10435363B2 (en) 2013-05-30 2019-10-08 Cadila Healthcare Limited Process for preparation of pyrroles having hypolipidemic hypocholesteremic activities
US9656954B2 (en) 2013-07-05 2017-05-23 Cadila Healthcare Limited Synergistic compositions
US9957230B2 (en) 2013-07-05 2018-05-01 Cadila Healthcare Limited Synergistic compositions
US10315993B2 (en) 2013-07-05 2019-06-11 Cadila Healthcare Limited Synergistic compositions
US10098868B2 (en) 2013-07-25 2018-10-16 Cadila Healthcare Limited Formula comprising a hypolipidemic agent
US10112898B2 (en) 2013-09-06 2018-10-30 Cadila Healthcare Limited Process for the preparation of saroglitazar pharmaceutical salts
US10385017B2 (en) 2015-10-14 2019-08-20 Cadila Healthcare Limited Pyrrole compound, compositions and process for preparation thereof
US11433050B2 (en) 2016-12-09 2022-09-06 Cadila Healthcare Ltd. Treatment for primary biliary cholangitis
US11872209B2 (en) 2016-12-09 2024-01-16 Zydus Lifesciences Limited Treatment for primary biliary cholangitis

Also Published As

Publication number Publication date
KR20150118990A (ko) 2015-10-23
JP6246895B2 (ja) 2017-12-13
SG11201506218UA (en) 2015-09-29
KR101617812B1 (ko) 2016-05-03
MA38385A1 (fr) 2017-09-29
PH12015501795A1 (en) 2015-11-09
AP2015008674A0 (en) 2015-08-31
EP2988736A1 (en) 2016-03-02
MX2015010769A (es) 2015-11-26
CA2900435A1 (en) 2014-10-30
BR112015020600A2 (pt) 2017-07-18
US20180185330A1 (en) 2018-07-05
JP2016515608A (ja) 2016-05-30
CA2900435C (en) 2017-02-14
IL247231A (en) 2017-03-30
HK1214968A1 (zh) 2016-08-12
US9814697B2 (en) 2017-11-14
WO2014174524A8 (en) 2015-10-01
IN2013MU01468A (es) 2015-04-17
EA201592020A1 (ru) 2016-05-31
MY180160A (en) 2020-11-23
AU2013387996A1 (en) 2015-09-24
CN105377246A (zh) 2016-03-02
GEP201706663B (en) 2017-05-10
IL240183A0 (en) 2015-09-24
IL240183A (en) 2016-08-31
CN105377246B (zh) 2018-03-20
MX346943B (es) 2017-04-06
UA114360C2 (uk) 2017-05-25
WO2014174524A1 (en) 2014-10-30
US20170087127A1 (en) 2017-03-30
AU2013387996B2 (en) 2015-12-10

Similar Documents

Publication Publication Date Title
US9814697B2 (en) Composition for nonalcoholic fatty liver disease (NAFLD)
US11872209B2 (en) Treatment for primary biliary cholangitis
US10806735B2 (en) Use of neutrophil elastase inhibitors in liver disease
US20240293416A1 (en) TREATMENT OF LIVER DISORDERS WITH A THR-ß AGONIST
CN113332287A (zh) 用于治疗或预防心血管疾病的胆固醇酯转移蛋白抑制剂和含所述抑制剂的药物组合物
US20220304982A1 (en) System for enhancing therapeutic compliance of the anti-cancer compound e7766
US20220175721A1 (en) Treatment for polycystic ovarian syndrome (pcos)
US20230015823A1 (en) Methods of administering voxelotor
OA17459A (en) A novel composition for nonalcoholic fatty liver disease (NAFLD).
US20220071954A1 (en) Saroglitazar for the treatment of hepatocellular carcinoma
RU2530889C2 (ru) Соединения и составы для доставки активных веществ

Legal Events

Date Code Title Description
AS Assignment

Owner name: CADILA HEALTHCARE LIMITED, INDIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:PATEL, PANKAJ;JANI, RAJENDRAKUMAR HARIPRASAD;REEL/FRAME:036733/0971

Effective date: 20150828

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION