US20180037595A1 - Benzoxaborole compounds and uses thereof - Google Patents

Benzoxaborole compounds and uses thereof Download PDF

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US20180037595A1
US20180037595A1 US15/550,658 US201615550658A US2018037595A1 US 20180037595 A1 US20180037595 A1 US 20180037595A1 US 201615550658 A US201615550658 A US 201615550658A US 2018037595 A1 US2018037595 A1 US 2018037595A1
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mycobacterium
pharmaceutically acceptable
compound
acceptable salt
tuberculosis
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M.R.K. (Dickon) Alley
David Barros-Aguirre
Ilaria Giordano
Vincent Hernandez
Xianfeng Li
Jacob J. Plattner
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GlaxoSmithKline Intellectual Property No 2 Ltd
Anacor Pharmaceuticals Inc
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    • C07B2200/13—Crystalline forms, e.g. polymorphs

Definitions

  • This invention relates to compounds, compositions containing them, their use in therapy, including their use as anti-mycobacterials, for example in the treatment of tuberculosis, and methods for the preparation of such compounds.
  • Mycobacterium is a genus in the class of bacteria called Actinobacteria with its own distinct family known as Mycobacteriacae.
  • Mycobacterium contains various obligate to and opportunistic pathogens of animals, which may also be transmitted to humans and cause disease in humans, thus exhibiting a considerable zoonotic potential.
  • members of the Mycobacterium avium - intracellulare complex emerged as pathogens of human diseases, including lymphadenitis in children, pulmonary tuberculosis-like disease, and disseminated infections (occurring predominantly in immunocompromised persons, particularly AIDS patients).
  • MAIC includes M. intracellulare and 4 subspecies of M. avium , namely, M. avium subsp. avium, M. avium subsp. hominissuis, M. avium subsp. silvaticum , and M. avium subsp. paratuberculosis.
  • M. avium subsp. avium M. avium subsp. hominissuis
  • M. avium subsp. silvaticum e. avium subsp. paratuberculosis.
  • Mycobacterium tuberculosis is a small aerobic non-motile high-GC bacillus with an “outer-membrane” that is unusually thick, “waxy,” hydrophobic, rich in mycolic acids, and extremely impermeable, making mycobacterium infections difficult to treat.
  • MTB Mycobacterium tuberculosis
  • One third of the world's population is thought to be infected (including latent MTB), but this number increases to upwards of 80% of the population in many Asian and African countries. If untreated, the death rate from active MTB infections is more than 50%.
  • the combination of HIV and MTB is deadly and increasing numbers of MTB strains are becoming resistant to standard of care drugs; approximately 300,000 new cases of multidrug resistant (MDR) M.
  • MDR multidrug resistant
  • MDR Multidrug resistant
  • XDR extensive drug resistant M. tuberculosis
  • FIG. 1 XDR M. tuberculosis has been reported across much of the globe.
  • the continuation phase could include Isoniazid and ethambutol for six months when adherence cannot be assessed, but according to this report, a longer continuation phase is associated with a higher rate of failure and relapse, especially in patients with HIV infection.
  • the doses of antituberculosis drugs used should conform to international recommendation and fixed-dose combinations of two (isoniazid and rifampicin), three (isoniazid, rifampicin, and pyrazinamide), and four (isoniazid, rifampicin, pyrazinamide, and ethambutol) drugs are highly recommended, especially when it is not possible to monitor the patient to ensure the treatment is ingested.
  • MDR-TB multi-drug resistant strains
  • tuberculosis drug SirturoTM (bedaquiline) was approved in the United States in late December 2012, and another, delamanid, is attempting to gain regulatory approval in the EU. However, both are reserved for drug-resistant tuberculosis, which accounts for just 5% of new cases.
  • a 2007 Editorial and News Focus in Nature Medicine discusses many aspects of TB such as pathogenesis, epidemiology, drug discovery and vaccine development to date ( Nature Medicine, 2007 , Focus on Tuberculosis , Vol 13(3), pages 263-312), noting that 125 years after the anniversary of the discovery of Mycobacterium tuberculosis , more than one-third of people in the world are infected with M. tuberculosis , and of these, more than 1 in 10 will develop the disease known as tuberculosis, formerly known as consumption, in their lifetime.
  • MDR-TB Mycobacterium tuberculosis
  • the present invention relates to substituted benzoxaboroles and certain benzoxaborole compounds that show unexpected selectivity for inhibiting replication of Mycobacterium tuberculosis ( M. tuberculosis ) versus inhibition (toxicity) of human cells compared to other benzoxaborole compounds, and exhibit sub-micromolar MIC values against mycobacterium species, particularly Mycobacterium tuberculosis and Mycobacterium tuberculosis complex (MTC), Mycobacterium avium and Mycobacterium avium complex (MAC) and Mycobacterium avium intracellulare complex (MAIC).
  • MTC Mycobacterium tuberculosis and Mycobacterium tuberculosis complex
  • MAC Mycobacterium avium and Mycobacterium avium complex
  • MAIC Mycobacterium avium intracellulare complex
  • a benzoxaborole has the following structure and substituent numbering system:
  • benzoxaboroles which are substituted at position 7 may form a benzoxaborole compound (see US20090227541, US2013165411 and WO/KR2015/016558) and may also exist as an equilibrium mixture of a tricyclic form and an open form.
  • benzoxaborole When the resulting 7-substituted benzoxaborole is additionally substituted with a halogen substituent at position 4 and an aminomethyl substituent at position 3, such compounds are surprisingly selective towards and effective against mycobacteria including M. tuberculosis .
  • the selectivity observed is assessed by comparing MIC values for such compounds relative to inhibition (toxicity) of these compounds to human cells, compared to other benzoxaborole compounds.
  • US20090227541 discloses a multitude of compounds, including two benzoxaborole compounds with differing antibacterial activity against a panel of Gram negative bacteria (See e.g. Tables 1 and 2), but does not disclose benzoxaborole compounds with halogen substitution on the benzoxaborole ring.
  • WO2012033858 discloses benzoxaborole compounds with activity against Mycobacterium tuberculosis , including certain benzoxaborole compounds (see e.g. Examples 1.A through 1.V), but again, no benzoxaborole compounds are disclosed with halogen substitution on the benzoxaborole ring.
  • US2013165411 discloses benzoxaborole compounds showing activity against Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae (see Table 1), but notes specifically that the halogen-substituted tricyclic compounds investigated (Examples 17, 18 and 19) lack activity against A. baumannii , with MIC values ⁇ 16 ⁇ g/ ⁇ L antibacterial activity (see para. [0218] discussing the structures in FIG. 1B (lower box) of US2013165411).
  • benzoxaborole compounds and certain substituted benzoxaboroles as described herein show unexpected selectivity for inhibiting replication of Mycobacterium tuberculosis ( M. tuberculosis ) versus inhibition (toxicity) of human cells compared to other benzoxaborole compounds.
  • These substituted benzoxaborole compounds exhibit sub-micromolar MIC values against M. tuberculosis , which is comparable to or better than the MIC values for current therapies available for inhibiting M. tuberculosis .
  • substituted and benzoxaborole compounds as described herein are envisioned for use in combination with current anti-tubercular compounds and are envisioned to achieve greater efficacy in treating animals, including humans, infected with M. tuberculosis.
  • TB tuberculosis
  • Compounds whose structure comprises Formula III or Formula IIIa offer a unique opportunity to address the serious issues which arise during the treatment of TB, such as multi-drug resistance, extensive-drug resistance, reactivity and/or adverse interaction between therapeutic agents in a multi-drug combination, and treatment length, thereby addressing potential patient needs.
  • anti-tuberculosis agents and certain benzoxaboroles and combinations of antituberculosis agents and substituted benzoxaboroles, for use in the treatment of Mycobacterium tuberculosis infections in animals, including humans.
  • such benzoxaboroles, and such substituted benzoxaboroles are used, in combination with other known anti-tuberculosis agents, for treating an animal subject with a Mycobacterium tuberculosis infection, particularly in an animal subject that is additionally infected with a human retrovirus, in particular a human immunodeficiency virus (HIV).
  • HIV human immunodeficiency virus
  • the invention is a compound as described herein, or a pharmaceutically acceptable salt or hydrate thereof.
  • the benzoxaborole is a compound or a salt thereof, including a pharmaceutically acceptable salt thereof, whose structure comprises Formula II:
  • R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • the substituted benzoxaborole is a compound or a salt thereof, including a pharmaceutically acceptable salt thereof, whose closed form comprises Formula II:
  • R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • the substituted benzoxaborole may exist in equilibrium, as indicated below, between a closed form (Formula II) and an open form (Formula III), in certain environments and/or solvents.
  • R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • the substituted benzoxaborole may exist in the open form of Formula III in the solid state.
  • a compound whose structure comprises Formula II or Formula III or a salt thereof, wherein X is chloro or bromo; R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • a compound whose structure comprises Formula II or Formula III or a salt thereof, wherein X is chloro or bromo, R 1 and R 2 are each independently selected from H, —CH 3 , and —CH 2 CH 3 .
  • a compound whose structure comprises Formula II or Formula III or a salt thereof, wherein X is chloro or bromo, R 1 and R 2 are each independently selected from H and —CH 3 .
  • a compound whose structure comprises Formula II or Formula III or a salt thereof, wherein X is fluoro or iodo, R 1 and R 2 are each independently selected from H and —CH 3 .
  • R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • the compound of Formula IIa may exist in equilibrium, as indicated below, between a closed form (Formula IIa) and an open form (Formula IIIa), in certain environments and/or solvents.
  • the compound of Formula IIIa may exist in the open form of Formula IIIa in the solid state.
  • a compound whose structure comprises Formula IIa or Formula IIIa wherein X is fluoro, chloro, bromo or iodo and R 1 and R 2 are each independently selected from H, —CH 3 , and —CH 2 CH 3 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • a compound whose structure comprises Formula IIa or Formula IIIa wherein X is fluoro, chloro, bromo or iodo and R 1 and R 2 are each independently selected from H and —CH 3 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • a compound whose structure comprises Formula IIa or Formula IIIa wherein X is chloro or bromo and R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • a compound whose structure comprises Formula IIa or Formula IIIa wherein X is chloro or bromo, and R 1 and R 2 are each independently selected from H, —CH 3 , and —CH 2 CH 3 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • a compound whose structure comprises Formula IIa or Formula IIIa wherein X is chloro or bromo, and R 1 and R 2 are each independently selected from H and —CH 3 , or a salt thereof, including a pharmaceutically acceptable salt thereof.
  • the benzoxaborole is a compound whose structure comprises Formula II as indicated below:
  • the benzoxaborole is a compound whose structure comprises Formula IIa as indicated below:
  • the benzoxaborole is a compound whose structure comprises Formula II as indicated below:
  • X is as defined herein, or a pharmaceutically acceptable salt thereof.
  • the benzoxaborole is a compound whose structure comprises Formula IIa as indicated below:
  • X is as defined herein, or a pharmaceutically acceptable salt thereof.
  • benzoxaborole is a compound whose structure comprises Formula II as indicated below:
  • benzoxaborole is a compound whose structure comprises Formula IIa as indicated below:
  • compositions comprising a compound, (S)-(3-chloro-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methanamine, comprising a structure as indicated below:
  • Still another embodiment provides a compound, (S)-(3-bromo-8,8-dimethyl-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methanamine, comprising a structure as indicated below:
  • Another embodiment provides a pharmaceutically acceptable salt of a compound, (S)-(3-bromo-8,8-dimethyl-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methanamine, comprising a structure as indicated below:
  • composition comprising a compound, (S)-(3-bromo-8,8-dimethyl-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-comprising a structure as indicated below:
  • One embodiment provides a compound whose structure comprises Formula II or Formula IIa or a salt thereof, which is:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula III as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula III as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula III as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula III as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula III as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula IIIa as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula IIIa as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula IIIa as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula IIIa as indicated below:
  • the substituted benzoxaborole is a compound in the open form, or a pharmaceutically acceptable salt thereof, comprising a structure of Formula IIIa as indicated below:
  • a pharmaceutical composition comprising a compound, (S)-(3-bromo-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methanamine, having an open form structure comprising:
  • a pharmaceutical composition comprising a compound, (S)-(3-chloro-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methanamine, having an open form structure comprising:
  • a pharmaceutical composition comprising a compound, (S)-(3-bromo-8,8-dimethyl-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methanamine, having an open form structure comprising:
  • substituted benzoxaborole is a compound, or a pharmaceutically acceptable salt thereof, in equilibrium between a closed form comprising the structure of Formula II:
  • R 1 and R 2 are each independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • the substituted benzoxaborole in the presence of water is a compound in equilibrium comprising the structure of Formula II and the structure of Formula III:
  • substituted benzoxaboroles having a structure of Formula III and the substituted benzoxaboroles having a structure of Formula IIIa are in the solid state.
  • substituted benzoxaboroles as described herein exist in an open form structure as described by Formula III or Formula IIIa, in the presence of water.
  • substituted benzoxaboroles as described herein exist in equilibrium between a closed form as described by Formula II or Formula IIa, and an open form as defined by Formula III or Formula IIIa, in certain environments, such as in aqueous solvents.
  • Another embodiment provides a compound having an XRPD pattern substantially as shown in FIG. 6 , or a pharmaceutically acceptable salt thereof.
  • Still another embodiment provides a compound whose crystal structure has an XRPD pattern with the peaks substantially as present in FIG. 6 .
  • Another embodiment provides a compound whose crystal structure has an XRPD pattern having the peaks substantially as present in FIG. 6 , wherein the crystal for the XRPD pattern was prepared by slow evaporation from water or an aqueous solvent.
  • a compound in the presence of water comprising the structure of Formula III or Formula IIIa:
  • the pharmaceutically acceptable salt is selected from hydrochloric, hydrobromic, nitric, carbonic, monohydrogencarbonic, phosphoric, monohydrogenphosphoric, dihydrogenphosphoric, sulfuric, monohydrogensulfuric, hydriodic, or phosphorous acids and the like.
  • the pharmaceutically acceptable salt is derived from organic acids including acetic acid, propionic acid, isobutyric acid, maleic acid, malonic acid, benzoic acid, succinic acid, suberic acid, fumaric acid, glucaronic acid, galacturonic acid, lactic acid, mandelic acid, phthalic acid, benzenesulfonic acid, p-tolylsulfonic acid, citric acid, tartaric acid, methanesulfonic acid, and the like. Still other related embodiments the pharmaceutically acceptable salt includes salts of amino acids such as arginate, lysinate and the like.
  • the compound comprising Formula II or Formula IIa, or the compound comprising Formula III or Formula IIIa is a mixture of diastereomers.
  • the compound of Formula II or Formula IIa and the compound of Formula III or Formula IIIa is a diastereomer.
  • the compound of Formula II and the compound of Formula III is a racemic mixture of enantiomers.
  • the compound of Formula II is a specific enantiomer.
  • R 1 and R 2 are both H or CH 3
  • the compound of Formula II or Formula IIa and the compound of Formula III or Formula IIIa has (S) stereochemistry at the chiral center.
  • One embodiment provides a combination comprising: a first therapeutic agent wherein the first therapeutic agent is a compound as described herein, or a pharmaceutically acceptable salt thereof; optionally a second therapeutic agent; optionally a third therapeutic agent; optionally a fourth therapeutic agent; optionally a fifth therapeutic agent; and optionally a sixth therapeutic agent.
  • a related embodiment provides a combination as described wherein the optional second, third, fourth, fifth and sixth therapeutic agent is independently selected from isoniazid, rifampin, pyrazinamide, ethambutol, moxifloxacin, rifapentine, clofazimine, bedaquiline (TMC207), nitroimidazo-oxazine PA-824, delamanid (OPC-67683), an oxazolidinone such as linezolid, tedizolid, radezolid, Mozolid (PNU-100480), or posizolid (AZD-5847), EMB analogue SQ109, a benzothiazinone, a dinitrobenzamide or an antiviral agent including an antiretroviral agent.
  • isoniazid isoniazid
  • rifampin pyrazinamide
  • ethambutol moxifloxacin
  • clofazimine bedaquiline
  • TMC207 beda
  • a related embodiment provides a combination as described wherein the antiretroviral agents is zidovudine, didanosine, lamivudine, zalcitabine, abacavir, stavudine, adefovir, adefovir dipivoxil, fozivudine, todoxil, emtricitabine, alovudine, amdoxovir, elvucitabine, nevirapine, delavirdine, efavirenz, loviride, immunocal, oltipraz, capravirine, lersivirine, GSK2248761, TMC-278, TMC-125, etravirine, saquinavir, ritonavir, indinavir, nelfinavir, amprenavir, fosamprenavir, brecanavir, darunavir, atazanavir, tipranavir, palinavir, lasinavir, enfuvir
  • Another embodiment of the invention provides a combination as described wherein the second, third, fourth, fifth and sixth therapeutic agent is selected from a therapeutic agent approved or recommended for the treatment of tuberculosis.
  • One embodiment of the present invention provides a pharmaceutical formulation comprising a first therapeutic agent, said first therapeutic agent being a therapeutically effective amount of a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa according to any of the embodiments described herein or a pharmaceutically acceptable salt thereof.
  • a related embodiment provides a combination as described herein and a pharmaceutically acceptable to excipient, adjuvant or diluent.
  • the pharmaceutical formulation may further comprise a second therapeutic agent.
  • Another embodiment provides a method of killing mycobacteria and/or inhibiting replication of mycobacteria that causes disease in an animal, comprising contacting the mycobacteria with an effective amount of a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof, so as to kill the mycobacteria and/or prevent the replication of the mycobacteria.
  • Another embodiment of the invention provides a method of treating a mycobacterium infection in an animal comprising: administering to the animal any one of: (i) a therapeutically effective amount of a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof; (ii) a therapeutically effective amount of a combination comprising a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof; or (iii) a therapeutically effective amount of a pharmaceutical formulation comprising a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof, so as to treat the mycobacterium infection in the animal.
  • the invention provides a method of killing mycobacteria and/or inhibiting replication of mycobactera or a method of treating a mycobacterial infection in an animal such as livestock and pets, including cattle sheep, goats, dogs and cats, or a human, including an immune-suppressed human said method comprising: contacting the mycobactera with an effective amount of a compound whose structure comprises Formula II or Formula IIa or a compound whose structure comprises Formula III or Formula IIIa as described herein, thereby killing the mycobacteria and/or inhibiting replication of the mycobacteria, or said method comprising administering to the animal with the mycobacterial infection a therapeutically effective amount of a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein, or a pharmaceutically acceptable salt thereof.
  • the compound of Formula II or compound of Formula IIa is part of a pharmaceutical formulation described herein.
  • the compound of Formula III or compound of Formula IIIa is part of a pharmaceutical formulation described herein.
  • the contacting occurs under conditions which permit entry of the combination into the mycobacterium.
  • Another embodiment of the invention provides a method as described herein, wherein the mycobacteria is selected from Mycobacterium tuberculosis, Mycobacterium avium including subspecies (subsp.) Mycobacterium avium subsp. avium, Mycobacterium avium subsp. hominissuis, Mycobacterium avium subsp. silvaticum , and Mycobacterium avium subsp.
  • the mycobacteria is selected from Mycobacterium tuberculosis, Mycobacterium avium including subspecies (subsp.) Mycobacterium avium subsp. avium, Mycobacterium avium subsp. hominissuis, Mycobacterium avium subsp. silvaticum , and Mycobacterium avium subsp.
  • Mycobacterium kansasii Mycobacterium malmoense, Mycobacterium simiae, Mycobacterium szulgai, Mycobacterium xenopi, Mycobacterium scrofulaceum, Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium haemophilum, Mycobacterium leprae, Mycobacterium marinum, Mycobacterium fortuitum, Mycobacterium parafortuitum, Mycobacterium gordonae, Mycobacterium vaccae, Mycobacterium bovis, Mycobacterium bovis BCG, Mycobacterium africanum, Mycobacterium canetti, Mycobacterium caprae, Mycobacterium microti, Mycobacterium pinnipedi, Mycobacterium leprae, Mycobacterium ulcerans, Mycobacterium intracellulare, Mycobacterium tuberculosis complex.
  • MTC Mycobacterium avium complex
  • MAIC Mycobacterium avian - intracellulare complex
  • Mycobacterium gordonae clade Mycobacterium kansasii clade
  • Mycobacterium chelonae clade Mycobacterium fortuitum clade
  • Mycobacterium parafortuitum clade Mycobacterium vaccae clade.
  • Another embodiment provides a method of treating a mycobacterium infection in an animal comprising: administering to the animal any one of: (i) a therapeutically effective amount of a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof; (ii) a therapeutically effective amount of a combination comprising a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof; or (iii) a therapeutically effective amount of a pharmaceutical formulation comprising a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof, so as to treat the mycobacterium infection in the animal, wherein the mycobacterium infection is a M. tuberculosis infection.
  • Another embodiment provides a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof, for use in the treatment of a disease resulting from a mycobacterial infection in an animal, including a human.
  • Another embodiment provides a compound as described herein, wherein the disease is selected from tuberculosis, leprosy, Johne's disease, Buruli or Bairnsdale ulcer, Crohn's disease, pulmonary disease or pulmonary infection.
  • MAC lung disease disseminated Mycobacterium avium complex (DMAC), disseminated Mycobacterium avium intracellulare complex (DMAIC), hot-tub lung, MAC mastitis, MAC pyomyositis, Mycobacterium avum paratuberculosis, or granuloma, disease.
  • DMAC disseminated Mycobacterium avium complex
  • DMAIC disseminated Mycobacterium avium intracellulare complex
  • hot-tub lung MAC mastitis, MAC pyomyositis, Mycobacterium avum paratuberculosis, or granuloma, disease.
  • One embodiment provides the use of a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein or a pharmaceutically acceptable salt thereof in the manufacture of a medicament for the treatment of mycobacterial infection in an animal.
  • Another embodiment provides a method of treating a disease resulting from a mycobacterial infection in an animal, particularly in a mammal, more particularly in a human, which method comprises administering to the animal in need of such treatment an effective amount of a compound Formula II or an effective amount of a compound of Formula III as described herein or a pharmaceutically acceptable salt thereof.
  • Another embodiment provides a method as described, wherein the disease is selected from tuberculosis, leprosy, Johne's disease, Buruli or Bairnsdale ulcer, Crohn's disease, pulmonary disease or pulmonary infection.
  • MAC lung disease disseminated Mycobacterium avium complex (DMAC), disseminated Mycobacterium avium intracellulare complex (DMAIC), hot-tub lung, MAC mastitis, MAC pyomyositis, Mycobacterium avum paratuberculosis, or granuloma disease.
  • DMAC disseminated Mycobacterium avium complex
  • DMAIC disseminated Mycobacterium avium intracellulare complex
  • hot-tub lung MAC mastitis
  • MAC pyomyositis Mycobacterium avum paratuberculosis
  • granuloma disease granuloma disease.
  • Another embodiment provides a method of treating a mycobacterial infection in an animal, particularly in a mammal, which method comprises administering to the animal in need of such treatment a therapeutically effective amount of a compound described herein, or pharmaceutically acceptable salt thereof.
  • Another embodiment provides a method of treating a mycobacterial infection in an animal, particularly a mammal, wherein the mycobacterial infection is Mycobacterium tuberculosis.
  • a pharmaceutical formulation comprising a first therapeutic agent, said first therapeutic agent being a therapeutically effective amount of a compound described herein or pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable excipient, adjuvant or diluent.
  • a pharmaceutical formulation comprising a first therapeutic agent that is a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa, said first therapeutic agent being a therapeutically effective amount of a compound as described herein or pharmaceutically acceptable salt thereof, in any embodiment as described herein; a pharmaceutically acceptable excipient, adjuvant or diluent; and a second therapeutic agent that is not a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa.
  • the pharmaceutical formulation comprises a first therapeutic agent that is a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein, or a pharmaceutically acceptable salt thereof, and optionally comprises a second therapeutic agent that is not a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa, and optionally comprises a third therapeutic agent, and optionally comprises a fourth therapeutic agent, and optionally comprises a fifth therapeutic agent, and optionally comprises a sixth therapeutic agent.
  • the second, third, fourth, fifth and sixth therapeutic agent is an anti-mycobacterial agent other than a compound whose structure comprises Formula II or Formula IIA or whose structure comprises Formula III or Formula IIIa.
  • the second, third, fourth, fifth and sixth therapeutic agent is selected from isoniazid, rifampin, pyrazinamide, ethambutol, moxifloxacin, rifapentine, clofazimine, bedaquiline (TMC207), nitroimidazo-oxazine PA-824, delamanid (OPC-67683), oxazolidinone such as linezolid, tedizolid, radezolid, Mozolid (PNU-100480), and posizolid (AZD-5847), EMB analogue SQ109, a benzothiazinone, a dinitrobenzamide and an antiviral agent including an antiretroviral agent.
  • the second, third, fourth, fifth and sixth therapeutic agent is a therapeutic agent approved and/or recommended for the treatment of tuberculosis.
  • a related embodiment provides a pharmaceutical formulation comprising a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa, or a salt thereof, and optionally comprises a second, third, fourth, fifth or sixth therapeutic agent, wherein the optional first, second, third, fourth, fifth or sixth therapeutic agent is an antiretroviral agent selected from of zidovudine, didanosine, lamivudine, zalcitabine, abacavir, stavudine, adefovir, adefovir dipivoxil, fozivudine, todoxil, emtricitabine, alovudine, amdoxovir, elvucitabine, nevirapine, delavirdine, efavirenz, loviride, immunocal, oltipraz, capravirine, lersivirine, GSK2248761, TMC-278, TMC-125, etravirine, saquinavir,
  • embodiments of the invention include coadministering, whether simultaneously, sequentially or in combination, a first therapeutic agent that is a substituted benzoxaborole or salt thereof as described herein, preferably a substituted benzoxaborole of Formula II or Formula IIa or a substituted benzoxaborole of Formula III or Formula IIIa as described herein, or a pharmaceutically acceptable salt thereof, optionally in combination with a second therapeutic agent, optionally in combination with a third therapeutic agent, optionally in combination with a fourth therapeutic agent, optionally in combination with a fifth and/or a sixth therapeutic agent, to a subject exposed to or infected with a mycobacterium species, including a Mycobacterium tuberculosis species.
  • a first therapeutic agent that is a substituted benzoxaborole or salt thereof as described herein, preferably a substituted benzoxaborole of Formula II or Formula IIa or a substituted benzoxaborole of Formula III or Formula IIIa as described herein, or a pharmaceutical
  • the first therapeutic agent is a benzoxaborole compound of Formula II or Formula IIa as described herein or a pharmaceutically acceptable salt thereof
  • the second and/or third and/or fourth therapeutic agent is an anti-tubercular agent.
  • the mycobacterium species is a drug-resistant variant; in certain embodiments the mycobacterium species is a multi-drug resistant variant.
  • a method for killing mycobacteria comprising contacting the mycobacteria or an animal, including a human, exposed to or infected with a mycobacterium with a first therapeutic agent that is a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein, or a pharmaceutically acceptable salt thereof, optionally contacting the cells or subject with a second therapeutic agent, optionally contacting the cells or subject with a third therapeutic agent, optionally contacting the cells or subject with a fourth therapeutic agent, optionally contacting the cells or subject with a fifth and/or a sixth therapeutic agent, such that contacting kills mycobacteria cells.
  • the first therapeutic agent is a substituted benzoxaborole that is a compound whose structure comprises Formula II or Formula IIa or whose structure comprises Formula III or Formula IIIa as described herein, or a pharmaceutically acceptable salt thereof and the optional second, third, fourth, fifth and/or sixth therapeutic agent is an anti-tubercular agent or a salt thereof.
  • the subject was exposed to or is infected with Mycobacterium tuberculosis.
  • Still other particular embodiments provide a method for inhibiting the replication of mycobacterial cells, the method comprising contacting the mycobacterial cells or an animal, including a human exposed to or infected with a mycobacterial cells with a first therapeutic agent that is a compound as described herein or a salt thereof, optionally contacting the mycobacterial cells or animal with a second therapeutic agent, optionally contacting the mycobacterial cells or animal with a third therapeutic agent, optionally contacting the mycobacterial cells or animal with a fourth therapeutic agent, optionally contacting the mycobacterial cells or animal with a fifth and/or a sixth therapeutic agent, such that contacting inhibits the replication of the mycobacterial cells.
  • a first therapeutic agent that is a compound as described herein or a salt thereof
  • the first therapeutic agent is a substituted benzoxaborole that is a compound as described herein or a salt thereof and the optional second, third, fourth, fifth and/or sixth therapeutic agent is an anti-tubercular agent or a salt thereof.
  • the subject was exposed to or is infected with Mycobacterium tuberculosis.
  • FIG. 1 is a world map indicating where, geographically, XDR-TB has been documented.
  • FIG. 2 shows transmission of tuberculosis.
  • FIG. 3 is a graph of MIC values (from Tables 1A and 1B) for Example 4 G4-CI against clinical isolates of M. tuberculosis.
  • FIG. 4 is a graph of MIC values (from Tables 2A, 2B, 2C and 2D) for Example 2 and Example 4 (G2-Br and G4-CI, respectively) against clinical isolates of M. tuberculosis.
  • FIG. 5 shows a view of a cation and anion from the G4-CI crystal structure.
  • Anisotropic atomic displacement ellipsoids for the non-hydrogen atoms are shown at the 50% probability level.
  • Hydrogen atoms are displayed with an arbitrarily small radius.
  • a second disorder component for the anion is not shown.
  • FIG. 7 shows a view of a hydrate crystal structure of G4-CI. Anisotropic atomic displacement ellipsoids for the non-hydrogen atoms are shown at the 50% probability level. Hydrogen atoms are displayed with an arbitrarily small radius.
  • Table A shows crystal data and data collection and refinement summary for the G4-CI X-ray diffraction study.
  • Tables 1A and 1B provide MIC values for Example 4 G4-CI tested against M. tuberculosis Clinical Isolates: Sensitive (A) and Resistant (B) Table 1A is MIC results for Example 4 against M. tuberculosis strains sensitive to known TB agents and Table 1B is MIC results for Example 4 against M. tuberculosis strains resistant to one or more known TB agents.
  • the resistance pattern of clinical isolates is indicated by the following abbreviations H: Isoniazide, R: Rifampicin, T: Ethionamide, S: Streptomycin, E: Ethambutol, Z: Pyrazynamide, K: Kanamycin, A: Amikacin and CP: Capreomycin.
  • Tables 2A and 2B provide MIC values for Example 4 G4-CI tested against various strains of M. tuberculosis Clinical Isolates: Sensitive (A) and Resistant (B).
  • Table 2A is MIC results for Example 4 against M. tuberculosis strains sensitive to known TB agents
  • Table 2B is MIC results for Example 4 against M. tuberculosis strains resistant to one or more known TB agents.
  • Tables 2C and 2D provide MIC values for Example 2 G2-Br tested against 40 strains of M. tuberculosis Clinical Isolates: Sensitive (C) and Resistant (D).
  • Table 2C is MIC results for Example 2 against M. tuberculosis strains sensitive to known TB agent and Table 2D is MIC results for Example 2 against M. tuberculosis strains resistant to one or more known TB agents.
  • H Isoniazide
  • R Rifampicin
  • T Ethionamide
  • S Streptomycin
  • E Ethambutol
  • Z Pyrazynamide
  • K Kanamycin
  • A Amikacin
  • CP Capreomycin
  • Table 3 provides MIC values against non-Mycobacterial strains for compounds of Formula II or Formula IIa.
  • Table 4A provides LeuRS inhibition 1050 values, MIC values against the M. tuberculosis standard strain Mtb H37Rv, toxicity values against human HepG2 cells, and selectivity values for Certain Comparator Benzoxaborole Compounds.
  • Table 4B provides the data classifications listed in Table 4A for Compounds of Formula II or Formula IIa.
  • “Animal” as used herein means any of a kingdom (Animalia) of living things including many-celled organisms, including livestock and pets, including cattle, sheep, goats, dogs and cats, or a human, including an immune-suppressed human.
  • Combination of the invention refers to the combinations of compounds discussed herein, salts (e.g. pharmaceutically acceptable salts), prodrugs, solvates and hydrates of these compounds.
  • Diastereomer refers to one of a pair of stereoisomers that is not mirror images of the other stereoisomer.
  • Enantiomer refers to one of a pair of non-superimposable racemic compounds (racemates) that is a mirror image of the other enantiomer. Enantiomers have the property of rotating the plane of polarized light in one direction or another when in pure form but as a racemic mixture, the mixture does not rotate the plane of polarized light.
  • Effective amount of a compound, combination thereof or formulation thereof means an amount of a compound that is the active agent, including a combination of formulation thereof, such that the amount is sufficient to provide the desired local or systemic effect.
  • a “therapeutically effective” or “pharmaceutically effective” amount refers to the amount of compound, including a combination or formulation thereof, sufficient to achieve a desired therapeutic or pharmaceutical result.
  • pharmaceutically acceptable salt is meant to include a salt of a compound described herein which is prepared with relatively nontoxic acids or bases, depending on the particular substituents found on the compounds described herein.
  • base addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired base, either neat or in a suitable inert solvent.
  • pharmaceutically acceptable base addition salts include sodium, potassium, calcium, ammonium, organic amino (such as choline or diethylamine or amino acids such as d-arginine, l-arginine, d-lysine or l-lysine), or magnesium salt, or a similar salt.
  • acid addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired acid, either neat or in a suitable inert solvent.
  • pharmaceutically acceptable acid addition salts include those derived from inorganic acids like hydrochloric, hydrobromic, nitric, carbonic, monohydrogencarbonic, phosphoric, monohydrogenphosphoric, dihydrogenphosphoric, sulfuric, monohydrogensulfuric, hydriodic, or phosphorous acids and the like, as well as the salts derived from relatively nontoxic organic acids like acetic, propionic, isobutyric, maleic, malonic, benzoic, succinic, suberic, fumaric, lactic, mandelic, to phthalic, benzenesulfonic, p-tolylsulfonic, citric, tartaric, methanesulfonic, and the like.
  • salts of amino acids such as arginate and the like, and salts of organic acids like glucuronic or galactunoric acids and the like (see, for example, Berge et al., “Pharmaceutical Salts”, Journal of Pharmaceutical Science 66: 1-19 (1977)).
  • Certain specific compounds as described herein contain both basic and acidic functionalities that allow the compounds to be converted into either base or acid addition salts.
  • the neutral forms of the compounds are preferably regenerated by contacting the salt with a base or acid and isolating the parent compounds in the conventional manner.
  • the parent form of the compound differs from the various salt forms in certain physical properties, such as solubility in polar solvents.
  • the invention provides compounds which are in a prodrug form.
  • Prodrugs of the compounds described herein readily undergo chemical changes under physiological conditions to provide the compounds as described herein. Additionally, prodrugs can be converted to the compounds as described herein by chemical or biochemical methods in an ex vivo environment.
  • Certain of the compounds of Formula II and Formula IIa and certain of the compounds of Formula III and Formula IIIa may form acid addition salts with one or more equivalents of the acid.
  • the present invention includes within its scope all possible stoichiometric and non-stoichiometric forms.
  • substituted benzoxaboroles of Formula II and Formula IIa described herein may exist in equilibrium between a closed form as shown in Formula II and Formula IIa and an open form, as shown in Formula III and Formula IIIa, in certain solvent environments.
  • certain of the substituted benzoxaboroles described herein when dissolved in organic solvents, for example DMSO- ⁇ 6 and CD 3 OD, exist in the closed form, as indicated by the 1 H NMR data in the synthesis Examples below.
  • organic solvents for example DMSO- ⁇ 6 and CD 3 OD
  • XRPD single crystal X-ray, X-ray powder diffraction
  • solid state NMR indicate that certain of the substituted benzoxaboroles described herein exist in the open forms of Formula III and Formula IIIa in the solid state.
  • substituted benzoxaboroles described herein may be shown either in the closed forms of Formula II and Formula IIa, or in the open forms of Formula III and Formula IIIa. It is also understood that in certain solvent conditions, such as organic solvents, the substituted benzoxaboroles as described herein may exist the closed forms of Formula II and Formula IIa, whereas in other solvent conditions, e.g. when any water is present, the substituted benzoxaboroles described herein may exist in equilibrium between the closed forms of Formula II and Formula IIa and the open forms of Formulas III and Formula IIIa. It has also been shown that certain of the substituted benzoxaboroles described herein may exist in the open forms of Formula III and Formula IIIa in the solid state. XRPD has also shown that compounds of Formula II and Formula IIa may exist as a hydrate under certain conditions.
  • the compounds of Formula II and Formula IIa and the compounds of Formula III and Formula IIIa may be prepared in crystalline or non-crystalline form and, if crystalline, may optionally be solvated, e.g. as the hydrate.
  • This invention includes within its scope stoichiometric solvates (e.g. hydrates) as well as compounds containing variable amounts of solvent (e.g. water).
  • the subject invention also includes isotopically-labeled compounds which are identical to those recited in Formula II and Formula IIa or identical to those recited in Formula III and Formula IIIa but for the fact that one or more atoms are replaced by an atom having an atomic mass or mass number different from the atomic mass or mass number most commonly found in nature.
  • isotopes that can be incorporated into compounds as described herein include isotopes of hydrogen, carbon, nitrogen, oxygen, fluorine, iodine and chlorine such as 3 H, 11 C, 14 C, 18 F, 123 I or 125 I.
  • Isotopically labeled compounds of the present invention for example those into which radioactive isotopes such as 3 H or 14 C have been incorporated, are useful in drug and/or substrate tissue distribution assays. Tritiated, ie. 3 H, and carbon-14, ie. 14 C, isotopes are particularly preferred for their ease of preparation and detectability. 11 C and 18 F isotopes are particularly useful in PET (positron emission tomography).
  • the compounds of Formula II and Formula IIa and the compounds of Formula III and Formula IIIa as described herein are intended for use in pharmaceutical compositions it will readily be understood that they are each preferably provided in substantially pure form, for example at least 60% pure, more suitably at least 75% pure and preferably at least 85%, especially at least 98% pure (% are on a weight for weight basis). Impure preparations of the compounds may be used for preparing the more pure forms used in the pharmaceutical compositions.
  • R 1 and R 2 are each to independently H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • One embodiment provides a compound whose structure comprises Formula II wherein X is chloro or bromo and R 1 and R 2 are independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • One embodiment provides a compound whose structure comprises Formula II or a salt thereof, wherein X is chloro or bromo; R 1 and R 2 are independently H, —CH 3 , or —CH 2 CH 3 .
  • One embodiment provides a compound whose structure comprises Formula II or a salt thereof, wherein X is chloro or bromo; R 1 and R 2 are independently selected from H and —CH 3 .
  • One embodiment provides a compound whose structure comprises Formula II or a salt thereof, wherein X is fluoro or iodo; R 1 and R 2 are independently selected from H and —CH 3 .
  • X is fluoro, chloro, bromo or iodo
  • R 1 and R 2 are independently H or —CH 3 , or a pharmaceutically acceptable salt thereof.
  • R 1 and R 2 are each independently H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • One embodiment provides a compound whose structure comprises Formula III wherein X is chloro or bromo and R 1 and R 2 are independently selected from H, —CH 3 , —CH 2 CH 3 , —CH 2 CH 2 CH 3 , and —CH(CH 3 ) 2 .
  • One embodiment provides a compound whose structure comprises Formula III or a salt thereof, wherein X is chloro or bromo; R 1 and R 2 are independently H, —CH 3 , or —CH 2 CH 3 .
  • One embodiment provides a compound whose structure comprises Formula III or a salt thereof, wherein X is chloro or bromo; R 1 and R 2 are independently selected from H and —CH 3 ;
  • One embodiment provides a compound whose structure comprises Formula III or a salt thereof, wherein X is fluoro or iodo; R 1 and R 2 are independently selected from H and —CH 3 .
  • X is fluoro, chloro, bromo or iodo
  • R 1 and R 2 are independently H or —CH 3 , or a pharmaceutically acceptable salt thereof.
  • the invention provides a pharmaceutical composition
  • a pharmaceutical composition comprising a compound whose structure comprises Formula II or whose structure comprises Formula III, or a pharmaceutically acceptable salt or solvate thereof, and one or more pharmaceutically acceptable carriers, excipients or diluents.
  • Another aspect of the invention further provides a method of treatment of a mycobacterial infection in a mammal, particularly in a human, which method comprises administering to a mammal in need of such treatment an effective amount of a first therapeutic agent that is a compound whose structure comprises Formula II or a compound whose structure comprises Formula IIa, or a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt or solvate thereof.
  • Related embodiments further comprise administering to a mammal in need of such treatment an effective amount of a first therapeutic agent that is a compound whose structure comprises Formula II or a compound whose structure comprises Formula IIa, or a pharmaceutically acceptable salt thereof, optionally administering in combination with an effective amount of a second therapeutic agent, optionally administering in combination with an effective amount of a third therapeutic agent, optionally administering in combination with an effective amount of a fourth therapeutic agent, optionally administering in combination with an effective amount of a fifth therapeutic agent, optionally administering in combination with an effective amount of a sixth therapeutic agent.
  • Related embodiments further comprise administering to a mammal in need of such treatment an effective amount of a first therapeutic agent that is a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt thereof, optionally administering in combination with an effective amount of a second therapeutic agent, optionally administering in combination with an effective amount of a third therapeutic agent, optionally administering in combination with an effective amount of a fourth therapeutic agent, optionally administering in combination with an effective amount of a fifth therapeutic agent, optionally administering in combination with an effective amount of a sixth therapeutic agent.
  • the optional second, third, fourth, fifth and sixth therapeutic agent is an anti-mycobacterial agent.
  • administering the first therapeutic agent and optionally administering the second, third, fourth, fifth and sixth therapeutic agent occurs concurrently, or administering the first therapeutic agent and optionally administering the second, third, fourth, fifth and sixth therapeutic agent occurs sequentially.
  • any one of the second, third, fourth, fifth or sixth therapeutic agent is selected from an antimicrobial agent, an antiviral agent, an anti-infective agent, an analgesic, a vitamin, a nutritional supplement, an anti-inflammatory agent, an analgesic, and an steroid.
  • the invention yet further provides a compound whose structure comprises Formula II, or a pharmaceutically acceptable salt or solvate thereof, for use in the treatment of a mycobacterial infection in a mammal, particularly in a human.
  • the mammal is a human wherein the mycobacterial infection is a Mycobacterium tuberculosis infection.
  • the human with a Mycobacterium tuberculosis infection is also infected with a retrovirus, including a human immunodeficiency virus.
  • the invention still further provides the use of a compound whose structure comprises Formula II or Formula IIa, or a pharmaceutically acceptable salt or solvate thereof or a compound whose structure comprises Formula III or Formula IIIa, in the manufacture of a medicament for use in the treatment of a mycobacterial infection in a mammal, particularly in a human.
  • the invention also provides a pharmaceutical composition
  • a pharmaceutical composition comprising a compound whose structure comprises Formula II or Formula IIa or a compound whose structure comprises Formula II or Formula IIa, or a pharmaceutically acceptable salt, or solvate thereof, and one or more pharmaceutically acceptable carriers, excipients or diluents, for use in the treatment of a mycobacterial infection in a mammal, particularly in a human.
  • the invention also provides a pharmaceutical composition
  • a pharmaceutical composition comprising a compound whose structure comprises Formula II or Formula IIa or a compound whose structure comprises Formula II or Formula IIa, or a pharmaceutically acceptable salt, or solvate thereof, and one or more pharmaceutically acceptable carriers, excipients or diluents, for use in the treatment of mycobacterial infections in a mammal, particularly in a human.
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the compound comprises a structure as indicated below:
  • the treatment of a mycobacterial infection or condition occurs through inhibition of an editing domain of an aminoacyl tRNA synthetase by means of binding to the editing active site.
  • the treatment of a mycobacterial infection or condition occurs through blocking of an editing domain of an aminoacyl tRNA synthetase.
  • the mycobacterial infection and/or disease is treated through oral administration of the combination of the invention.
  • the mycobacterial infection and/or disease is treated through intravenous administration of the combination of the invention.
  • the invention is a pharmaceutical formulation which includes: (a) a pharmaceutically acceptable excipient; (b) a combination of the invention.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a combination described herein.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a combination described herein, or a salt, prodrug, hydrate or solvate thereof.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a combination described herein, or a salt, hydrate or solvate thereof.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a combination described herein, or a salt, hydrate or solvate thereof.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a salt of a combination described herein.
  • the salt is a pharmaceutically acceptable salt.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a prodrug of a combination described herein.
  • the pharmaceutical formulation includes: (a) a pharmaceutically acceptable excipient; and (b) a combination described herein.
  • the pharmaceutical formulation is a unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a single unit dosage form.
  • the pharmaceutical formulation is a unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a single unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a two unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a three unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a four unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a five unit dosage form. In an exemplary embodiment, the pharmaceutical formulation is a six unit dosage form.
  • the pharmaceutical formulation is a one, two, three, four, five, six or seven unit dosage form comprising a first unit dosage form and a second, third, fourth, fifth and/or sixth unit dosage form, wherein the first unit dosage form includes a) a therapeutically effective amount of a compound as described herein and b) a first pharmaceutically acceptable excipient; and the second, third, fourth, fifth, and/or sixth unit dosage form includes c) a therapeutically acceptable amount of an additional therapeutic agent that is an anti-mycobacterial agent and d) a second pharmaceutically acceptable excipient.
  • the invention provides a) a first therapeutic agent that is a benzoxaborole compound or salt thereof as described herein; b) a second therapeutic activity.
  • the second therapeutic agent is an antibacterial agent, more specifically an anti-tubercular agent, more specifically an anti- M. tuberculosis agent.
  • the combination is part of a pharmaceutical formulation described herein.
  • a pharmaceutical formulation described herein Such conditions are known to one skilled in the art and specific conditions are set forth in the Examples appended hereto.
  • the individual components of the combinations of the invention may be administered either simultaneously or sequentially in a unit dosage form.
  • the unit dosage form may be a single or multiple unit dosage form.
  • the invention provides a combination in a single unit dosage form.
  • An example of a single unit dosage form is a capsule wherein both the benzoxaborole compound and additional therapeutic agent are contained within the same capsule.
  • the invention provides a combination in a two unit dosage form.
  • An example of a two unit dosage form is a first capsule which contains the benzoxaborole compound and a second capsule which contains the additional therapeutic agent.
  • the term ‘single unit’ or ‘two unit’ or ‘multiple unit’ refers to the object which the patient ingests, not to the interior components of the object.
  • Appropriate doses of benzoxaborole compound will be readily appreciated by those skilled in the art.
  • Appropriate doses of an additional therapeutic agent that is not a compound whose structure comprises Formula II or Formula IIa or appropriate doses of an additional therapeutic agent that is not a compound whose structure comprises Formula III or Formula IIIa will be readily appreciated by those skilled in the art.
  • the benzoxaborole compound is present in the combination in a therapeutically effective amount.
  • the additional therapeutic agent that is not a compound whose structure comprises Formula II or Formula IIa is present in the combination in an amount sufficient to kill or reduce the presence, amount or growth rate of mycobacteria exposed to the substituted benzoxaborole, including M. tuberculosis .
  • the additional therapeutic agent that is not a compound whose structure comprises Formula III or Formula IIIa is present in the combination in an amount sufficient to kill or reduce the presence, amount or growth rate of mycobacteria exposed to the substituted benzoxaborole, including M. tuberculosis.
  • the combinations of the invention may also include an additional therapeutic agent or therapeutic agents.
  • the invention thus provides, in a further aspect, a combination comprising a benzoxaborole compound described herein or a pharmaceutically acceptable salt thereof, and at least one additional therapeutic agent.
  • the invention thus provides, in a further aspect, a combination comprising a benzoxaborole compound described herein or a pharmaceutically acceptable salt thereof, and at least one additional therapeutic agent.
  • the additional therapeutic agent is an antimycobacterial agent.
  • the invention comprises: a) a combination of the invention; and b) at least one additional therapeutic agent.
  • the invention comprises: a) a combination of the invention; b) a first additional therapeutic agent; and c) a second additional therapeutic agent.
  • the invention comprises: a) a combination of the invention; b) a first additional therapeutic agent; c) a second additional therapeutic agent; and d) a third additional therapeutic agent.
  • the first additional therapeutic agent or second additional therapeutic agent or third additional therapeutic agent may be selected from the additional therapeutic agents described herein.
  • a pharmaceutical combination comprising a compound whose structure comprises Formula II, or a pharmaceutically acceptable salt or solvate thereof, together with one or more additional therapeutic agents, and one or more pharmaceutically acceptable carriers, excipients or diluents.
  • the individual components of such combinations may be administered either sequentially or simultaneously in separate or combined pharmaceutical Formulations by any convenient route.
  • each compound may differ from that when the compound is used alone. Appropriate doses will be readily appreciated by those skilled in the art. It will be appreciated that the amount of a compound as described herein required for use in treatment will vary with the nature of the condition being treated and the age and the condition of the patient and will be ultimately at the discretion of the attendant physician or veterinarian.
  • Certain benzoxaborole compounds may be prepared by a Mitsunobu reaction to convert the hydroxyl substituent of 2-bromo-3-hydroxy-benzaldehyde into the tetrahydropyranyloxyethwry ether with tetrahydropyranyloxyethanol in triphenylphosphine (PPh 3 ), tetrahydrofuran (THF) and diisopropyl azodicarboxylate (DIAD), followed by Miyaura borylation of the bromine substituent using bis(pinocolato)diboron diboron (B 2 pin 2 ) with a palladium catalyst (PdCl 2 ) and potassium acetate (KOAc), and then reductive ring closure to form the tricyclic compound using sodium borohydride (NaBH 4 ) in anhydrous methanol (MeOH), as outlined in Scheme 1.
  • Ph 3 triphenylphosphine
  • THF tetrahydrofuran
  • THP-protected alkyl bromide may also be used to attach a substituent to hydroxybenzaldehyde via a SN2 reaction to prepare benzoxaborole compounds.
  • a SN2 reaction for preparing benzoxaborole compounds can be seen in the Examples described below, such as in Example 1, step (b) and Example 4, Method B, step (c).
  • benzoxaborole compounds as described herein may be prepared as outlined in Schemes 2 and 3, wherein a nitro-aldol reaction is performed on the aldehyde substituent of, for example, 3-(2-benzyloxy-ethoxy)-2-(4,4,5,5-tetramethyl-[1,3,2]dioxaborolan-2-yl)-benzaldehyde using nitromethane (MeNO 2 ) with base (NaOH) to prepare the nitro-substituted benzyl-protected benzoxaborole compound, followed by ring-closure to and reduction of the nitro substituent to the amine with Pd(OH) 2 /C in glacial acetic acid to form the desired benzoxaborole compound.
  • nitromethane MeNO 2
  • NaOH base
  • substituted benzoxaboroles disclosed herein may exist in the closed form in organic solvents such as DMSOand CH 3 OH, may exist in an equilibrium between the closed form and open form in an aqueous solvent environment, and may exist in the open form in the solid state.
  • the wet cake was slurried in water (13.25 L) and 1,4-dioxane (66.25 L), heated to 50° C. for 20-30 minutes, cooled to 15° C., filtered and the cake washed with 1,4-dioxane (26.5 L).
  • the wet cake was dissolved in methanol (68.9 L), filtered and the filtrate concentrated under reduced pressure.
  • Methyl tertiary butyl ether (66.25 L) was added to the residue and the mixture concentrated under reduced pressure.
  • Methyl tertiary butyl ether (78.7 L), isopropanol (8.7 L) and sulphuric acid (4.6 L) were added, the mixture heated to 50° C.
  • the compounds as described herein may be formulated for administration in any convenient way for use in human or veterinary medicine, by analogy with formulation of anti-mycobacterial agents, or formulation of other anti-tubercular agents.
  • the invention is directed to a pharmaceutical composition comprising a compound whose structure comprises Formula II or compound of Formula IIa, or a pharmaceutically acceptable salt.
  • a pharmaceutical composition comprising a compound whose structure comprises Formula II or a compound whose structure comprises Formula IIa, or a pharmaceutically acceptable salt, and one or more pharmaceutically acceptable carriers, excipients or diluents.
  • the carrier, excipient or diluent must be “acceptable” in the sense of being compatible with the other ingredients of the Formulation and not deleterious to the recipient thereof.
  • the invention is directed to a pharmaceutical composition comprising a compound whose structure comprises Formula III or Formula IIIa, or a pharmaceutically acceptable salt.
  • a pharmaceutical composition comprising a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt, and one or more pharmaceutically acceptable carriers, excipients or diluents.
  • the carrier, excipient or diluent must be “acceptable” in the sense of being compatible with the other ingredients of the Formulation and not deleterious to the recipient thereof.
  • compositions described herein include those in a form adapted for oral, or parenteral use and may be used for the treatment of a mycobacterial infection in a mammal including a human.
  • compositions described herein include those in a form adapted for oral, topical or parenteral use and may be used for the treatment of mycobacterial infections in a mammal including a human.
  • compositions may be formulated for administration by any convenient route.
  • the compositions may be in the form of tablets, capsules, powders, granules, lozenges, aerosols or liquid preparations, such as oral or sterile parenteral solutions or suspensions.
  • Tablets and capsules for oral administration may be in unit dose presentation form, and may contain conventional excipients such as binding agents, for example syrup, acacia, gelatin, sorbitol, tragacanth, or polyvinylpyrrolidone; fillers, for example lactose, sugar, maize-starch, calcium phosphate, sorbitol or glycine; tabletting lubricants, for example magnesium stearate, talc, polyethylene glycol or silica; disintegrants, for example potato starch; or acceptable wetting agents such as sodium lauryl sulphate.
  • the tablets may be coated according to methods well known in normal pharmaceutical practice.
  • Oral liquid preparations may be in the form of, for example, aqueous or oily suspensions, solutions, emulsions, syrups or elixirs, or may be presented as a dry product for reconstitution with water or other suitable vehicle before use.
  • Such liquid preparations may contain conventional additives, such as suspending agents, for example sorbitol, methyl cellulose, glucose syrup, gelatin, hydroxyethyl cellulose, carboxymethyl cellulose, aluminium stearate gel or hydrogenated edible fats, emulsifying agents, for example lecithin, sorbitan monooleate, or acacia; non-aqueous vehicles (which may include edible oils), for example almond oil, oily esters such as glycerine, propylene glycol, or ethyl alcohol; preservatives, for example methyl or propyl p-hydroxybenzoate or sorbic acid, and, if desired, conventional flavouring or colouring agents.
  • suspending agents for example sorbitol, methyl cellulose, glucose syrup, gelatin, hydroxyethyl cellulose, carboxymethyl cellulose, aluminium stearate gel or hydrogenated edible fats, emulsifying agents, for example lecithin, sorbitan monooleate, or
  • Suppositories will contain conventional suppository bases, e.g. cocoa-butter or other glyceride.
  • fluid unit dosage forms are prepared utilizing the compound and a sterile vehicle, water being preferred.
  • the compound depending on the vehicle and concentration used, can be either suspended or dissolved in the vehicle.
  • the compound can be dissolved in water for injection and filter sterilised before filling into a suitable vial or ampoule and sealing.
  • agents such as a local anaesthetic, preservative and buffering agents can be dissolved in the vehicle.
  • the composition can be frozen after filling into the vial and the water removed under vacuum.
  • the dry lyophilized powder is then sealed in the vial and an accompanying vial of water for injection may be supplied to reconstitute the liquid prior to use.
  • Parenteral suspensions are prepared in substantially the same manner except that the compound is suspended in the vehicle instead of being dissolved and sterilization cannot be accomplished by filtration.
  • the compound can be sterilised by exposure to ethylene oxide before suspending in the sterile vehicle.
  • a surfactant or wetting agent is included in the composition to facilitate uniform distribution of the compound.
  • compositions may contain from 0.1% by weight, preferably from 10-60% by weight, of the active material, depending on the method of administration. Where the compositions comprise dosage units, each unit will preferably contain from 20-1000 mg of the active ingredient.
  • the dosage as employed for adult human treatment will typically range from 50 to 300 mg per day, for instance 150 to 200 mg per day depending on the route and frequency of administration. Such a dosage corresponds to 0.5 to 5 mg/kg per day. Preferably the dosage is from 0.5 to 2 mg/kg per day and more preferably the dose is less than 1 mg/kg per day.
  • the compound whose structure comprises Formula II or Formula IIa, or a pharmaceutically acceptable pharmaceutically acceptable salt or solvate thereof may be the sole therapeutic agent in the compositions described herein, or it may be present in the Formulation in combination with one or more additional therapeutic agents.
  • the invention thus provides, in a further aspect, a combination comprising a compound whose structure comprises Formula II, or a pharmaceutically acceptable salt, solvate thereof together with one or more additional therapeutic agents.
  • the compound whose structure comprises Formula III or Formula IIIa, or a pharmaceutically acceptable pharmaceutically acceptable salt or solvate thereof may be the sole therapeutic agent in the compositions described herein, or it may be present in the formulation in combination with one or more additional therapeutic agents.
  • the invention thus provides, in a further aspect, a combination comprising a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt, solvate thereof together with one or more additional therapeutic agents.
  • the one or more additional therapeutic agent is, for example, an agent useful for the treatment of tuberculosis in a mammal.
  • therapeutic agents include, rifampin, pyrazinamide, ethambutol, moxifloxacin, rifapentine, clofazimine, bedaquiline (TMC207), nitroimidazo-oxazine PA-824, delamanid (OPC-67683), oxazolidinone such as linezolid, tedizolid, radezolid, Mozolid (PNU-100480), and posizolid (AZD-5847), EMB analogue SQ109, a benzothiazinone, a dinitrobenzamide and an antiviral agent including an antiretroviral agent, or any TB agent being developed for the treatment of TB with a positive response in Phase IIa EBA trials, or any TB agent under development by the Global Alliance for Tuberculosis.
  • the dose of the compound or agent may differ from that when the compound or agent is used alone. Appropriate doses will be readily appreciated by those skilled in the art. It will be appreciated that the amount of a compound described herein and the one or more additional therapeutic agents required for use in treatment will vary with the nature of the condition being treated and the age and the condition of the patient and will be ultimately at the discretion of the attendant physician or veterinarian.
  • a pharmaceutical combination comprising a compound whose structure comprises Formula II, or a pharmaceutically acceptable salt or solvate thereof, together with one or more additional therapeutic agents, and one or more pharmaceutically acceptable carriers, excipients or diluents.
  • a pharmaceutical combination comprising a compound whose structure comprises Formula III or Formula IIIa, or a pharmaceutically acceptable salt or solvate thereof, together with one or more additional therapeutic agents, and one or more pharmaceutically acceptable carriers, excipients or diluents.
  • the individual components of such combinations may be administered either sequentially or simultaneously in separate or combined pharmaceutical Formulations by any convenient route.
  • either the compound of the present invention or one or more additional therapeutic agent may be administered first.
  • the combination may be administered either in the same or different pharmaceutical composition.
  • the compound and agents must be stable and compatible with each other and the other components of the formulation.
  • they may be provided in any convenient formulation, conveniently in such manner as are known for such compounds in the art.
  • the compounds exemplied and described herein, and combinations of desbried compounds are expected to exhibit potency against mycobacteria and therefore have the potential to kill mycobacteria and/or inhibit the replication of mycobacteria.
  • the combinations as described herein are expected to exhibit potency against mycobacteria possessing resistance to standard-of-care anti-mycobacterial agents, and thus have the potential to kill mycobacteria and/or inhibit the replication of such “resistant” mycobacteria.
  • compounds as described herein possess a remarkable activity against a selection of drug sensitive mycobacterial isolates, including, MDR-TB (multidrug resistant TB) and XDR-TB (extensively-drug resistant TB) clinical isolates, exhibiting MIC values of ⁇ 0.32 ⁇ M and the majority have MIC values at between 0.04-0.08 ⁇ M in 96 isolates investigated.
  • a compound as described herein may be used for inhibiting or killing mycobacteria.
  • the invention provides a method of killing mycobacteria and/or inhibiting replication of mycobactera or a method of treating a mycobacterial infection in an animal such as livestock and pets, including cattle, sheep, goats, dogs and cats, or a human, including an immune-suppressed human said method comprising: contacting the mycobactera with an effective amount of a compund as described herein, thereby killing the mycobacteria and/or inhibiting replication of the mycobacteria, or said method comprising administering to the animal with the mycobacterial infection a therapeutically effective amount of a pharmaceutical composition of the invention, wherein the pharmaceutical composition comprises a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt thereof.
  • the combination is part of a pharmaceutical formulation described herein.
  • the contacting occurs under conditions which permit entry of the combination into the mycobacterium
  • the invention provides a method of killing mycobacteria and/or inhibiting replication of mycobactera or a method of treating a mycobacterial infection in an animal such as livestock and pets, including cattle, sheep, goats, dogs and cats, or a human, including an immune-suppressed human said method comprising: contacting the mycobactera with an effective amount of a compound or combination as described herein, thereby killing the mycobacteria and/or inhibiting replication of the mycobacteria, or said method comprising administering to the animal with the mycobacterial infection a therapeutically effective amount of a pharmaceutical composition of compound or a combination as described herein, wherein the pharmaceutical composition comprises a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt thereof.
  • the combination is part of a pharmaceutical formulation described herein.
  • the contacting occurs under conditions which permit entry of the combination into the mycobacterium.
  • the mycobacteria is killed or its replication is inhibited, or the mycobacterial infection is treated, through oral administration of a combination as described herein. In an exemplary embodiment, the mycobacteriais killed or its replication is inhibited, or the mycobacterial infection is treated, through intravenous administration of a compound or combination thereof as described herein.
  • the mycobacterium is killed or its replication is inhibited, or the mycobacterial infection is treated, through subcutaneous administration of a combination as described herein, wherein the combination comprises a compound whose structure comprises Formula II or a compound whose structure comprises Formula IIa, or wherein the combination comprises a compound whose structure comprises Formula III or a compound whose structure comprises Formula IIIa, or a pharmaceutically acceptable salt thereof.
  • the mycobacteria is contacted or the mycobacterial infection is treated with a combination as described herein comprising a first therapeutic agent that is a compound whose structure comprises Formula II or a compound whose structure comprises Formula IIa or a salt thereof, or the mycobacterial infection is treated with a combination whose structure comprises Formula III or a compound whose structure comprises Formula IIIa or salt thereof, and optionally comprising a second, third, fourth, fifth and sixth therapeutic agent in a population of mycobacteria comprising a resistant mycobacterium with a mutation conferring resistance to any one or more of the optional second, third, fourth, fifth and sixth therapeutic agent.
  • the optional second, third, fourth, fifth and sixth therapeutic agent, or a salt thereof is an anti-mycobacterial agent, particularly a known anti-mycobacterial agent, more preferably a standard-of-care anti-mycobacterial agent.
  • a method of killing and/or inhibiting replication of mycobacteria that causes or is associated with a disease in an animal, or a method of treating a mycobacterial infection in an animal comprising contacting the mycobacteria with an effective amount of a compound whose structure comprises Formula II or Formula IIa or a salt thereof, or contacting the mycobacteria with an effective amount of a compound whose structure comprises Formula III or Formula IIIa or salt thereof, so as to kill and/or prevent replication of the mycobacterium , or administering to the animal a therapeutically effective amount of a compound whose structure comprises Formula II or Formula IIa or a salt thereof, wherein the mycobacteria is selected from Mycobacterium tuberculosis, Mycobacterium avium including subspecies (subsp.) Mycobacterium avium subsp.
  • Mycobacterium balnei Mycobacterium sherrisii, Mycobacterium africanum, Mycobacterium microti, Mycobacterium silvaticum, Mycobacterium colombiense, Mycobacterium indicus pranii, Mycobacterium gastri, Mycobacterium gordonae, Mycobacterium hiberniae, Mycobacterium nonchromagenicum, Mycobacterium terrae, Mycobacterium trivial, Mycobacterium kansasii; Mycobacterium malmoense; Mycobacterium simiae; Mycobacterium triplex, Mycobacterium genavense, Mycobacterium florentinum, Mycobacterium lentiflavum, Mycobacterium palustre, Mycobacterium
  • the mycobacterium is Mycobacterium tuberculosis .
  • the mycobacterium is Mycobacterium avium, Mycobacterium kansasii, Mycobacterium malmoense, Mycobacterium simiae, Mycobacterium szulgai, Mycobacterium xenopi, Mycobacterium scrofulaceum, Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium haemophilum, Mycobacterium leprae, Mycobacterium marinum, M. fortuitum, Mycobacterium bovis, M. bovis BCG, M. africanum, M. canetti, M. caprae, M.
  • the mycobacterium is a subspecies (subsp.) of Mycobacterium avium , including Mycobacterium avium subsp. avium, Mycobacterium avium subsp. hominissuis, Mycobacterium avium subsp. silvaticum , and Mycobacterium avium subsp. paratuberculosis.
  • the mycobacterium is Mycobacterium intracellulare .
  • the mycobacterium is a member of the Mycobacterium tuberculosis complex.
  • the mycobacterium is a non-tuberculosis complex or clade, including: Mycobacterium avium complex; Mycobacterium gordonae clade; Mycobacterium kansasii clade; Mycobacterium chelonae clade; Mycobacterium fortuitum clade; Mycobacterium parafortuitum clade; and Mycobacterium vaccae clade.
  • the mycobacteria in the methods described herein comprises a resistant mycobacterium .
  • the resistant mycobacterium is a mutation of a mycobacteria described herein.
  • the combinations of the present invention exhibit potency against mycobacteria, and therefore have the potential to achieve therapeutic efficacy in animals, including humans.
  • the invention provides a method of treating and/or preventing a disease.
  • the method includes administering to the animal a therapeutically effective amount of a compound as described herein, or a combination thereof, sufficient to treat and/or prevent the disease.
  • the compound or the combination described herein can be used in human or veterinary medical therapy, particularly in the treatment or prophylaxis of mycobacterial-associated disease.
  • the combination is described herein.
  • the animal is as defined herein.
  • the disease a systemic disease or a cutaneous disease.
  • the disease is a respiratory disease.
  • Reactions involving metal hydrides including lithium hydride, lithium aluminium hydride, di-isobutylaluminium hydride, sodium hydride, sodium borohydride and sodium triacetoxyborohydride are carried out under argon unless otherwise specified.
  • the solid was filtered and washed with ethanol (1 L).
  • the filtrate was diluted with water (20 L) and then heated to 50° C.
  • the solution was stirred at 50° C. for 30 min and then conc. HCl (1.5 L) was added dropwise over 1 h.
  • the mixture was cooled to 0° C. and held at 0° C. for additional 30 min.
  • the product was filtered and washed with 20% aqueous ethanol (1 L) to afford the hydrochloric salt of desired product (5.00 kg, 63% over two steps) as a colourless solid.
  • LC-MS 268.0 [M+H-100]+.
  • tert-butyl ((3-chloro-8-(hydroxymethyl)-8-methyl-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methyl)carbamate (240 mg, crude) was dissolved in a solution of TFA (1 mL) in DCM (10 mL). The solution was stirred at room temperature for 1 h, and then was concentrated in vacuum. The crude product was purified by preparative-HPLC using Daisogel 10 ⁇ C18 column (250 ⁇ 50 mm) and eluted with a gradient of water/acetonitrile (0.05% TFA). The collected fraction was concentrated under reduced pressure to afford the title compounds.
  • tert-butyl ((3-bromo-8-(hydroxymethyl)-8-methyl-7,8-dihydro-2H-1,6,9-trioxa-9a-borabenzo[cd]azulen-2-yl)methyl)carbamate (230 mg, crude) was dissolved in a solution of TFA (1 mL) in DCM (10 mL). The solution was stirred at room temperature for 1 h, and then was concentrated in vacuum. The crude product was purified by preparative-HPLC using Daisogel 10 ⁇ C18 column (250 ⁇ 50 mm) and eluted with a gradient of water/acetonitrile (0.05% TFA). The collected fraction was concentrated under reduced pressure to afford the title compounds.
  • a single crystal grown of the free base of G4-CI was grown from ethanol and used to obtain a crystal structure of the free base of G4-CI ( FIG. 7 ). When this crystal structure was combined with a simulated XRPD pattern these studies confirm that the free base of G4-CI exists as a hydrate under certain conditions.
  • MIC Minimum Inhibitory Concentration
  • M. tuberculosis strains The measurement of the Minimum Inhibitory Concentration (MIC) against M. tuberculosis strains for each tested compound was performed in 96-well flat-bottom, polystyrene microtiter plates in a final volume of 100 uL. Ten two-fold drug dilutions in neat DMSO starting at 50 mM were performed. Drug solutions were added to Middlebrook 7H9 medium (Difco) and isoniazid (INH) (Sigma Aldrich) was used as a positive control with 2-fold dilutions of INH starting at 160 ug/mL. The inoculum was standardized to approximately 1 ⁇ 107 cfu/ml and diluted 1 in 100 in Middlebrook 7H9 broth (Difco).
  • This inoculum (100 uL) was added to the entire plate but G-12 and H-12 wells were used as blank controls. All plates were placed in a sealed box to prevent drying out of the peripheral wells and incubated at 37° C. without shaking for six days.
  • a Resazurin solution was prepared by dissolving one tablet of Resazurin (Resazurin Tablets for Milk Testing; Ref 330884Y VWR International Ltd) in 30 mL of sterile PBS (phosphate buffered saline). Of this solution, 25 uL were added to each well. Fluorescence was measured (Spectramax M5 Molecular Devices, Excitation 530 nm, Emission 590 nm) after 48 hours to determine the MIC value.
  • the BACTEC MGIT 960 System (Becton Dickinson) was used to carry out MIC determination in clinical isolates (Institute Carlos III) following the manufacturer instructions.
  • the resistance pattern of clinical isolates is indicated by the following abbreviations H: Isoniazide, R: Rifampicin, T: Ethionamide, S: Streptomycin, E: Ethambutol, Z: Pyrazynamide, K: Kanamycin, A: Amikacin and CP: Capreomycin.
  • Results for compound EXAMPLE 4 G4-CI are shown in Tables 1A, 1B, 2A and 2B, and FIGS. 3 and 4 .
  • Results for EXAMPLE 2 G2-Br are shown in Tables 2C and 2D, and FIG. 4 .
  • Table 1 provides MIC values for EXAMPLE 4 G4-CI tested against M. tuberculosis Sensitive (A) and Resistant (B) Clinical Isolates
  • FIG. 3 provides a graphical representation of the MIC data in Tables 1A and 1B for EXAMPLE 4 G4-CI, plotted as number of strains with a particular MIC value (y) versus the particular MIC value obtained (x) in ⁇ M.
  • G4-CI Example 4
  • the breakdown is a measured MIC of ⁇ 0.2 ⁇ M for 1 strain; a measured MIC of 0.04 ⁇ M for 8 strains; a measured MIC of 0.08 ⁇ M for 76 strains; a measured MIC of 0.16 ⁇ M for 8 strains; and a measured MIC of 0.31 ⁇ M for 3 strains.
  • Tables 2A and 2B provide MIC values for EXAMPLE 4 G4-CI tested against M. tuberculosis Sensitive (A) and Resistant (B) Clinical Isolates
  • Tables 2C and 2D provide MIC values for EXAMPLE 2 G2-Br tested against the same M. tuberculosis Sensitive (A) and Resistant (B) Clinical Isolates tested in 2A and 2B with G4-CI
  • FIG. 4 provides a graphical representation of the MIC data in Tables 2A through 2D for G2-Br (Example 2—light bar) and G4-CI (Example 4—dark bar), plotted as number of strains with a particular MIC value (y) versus the particular MIC value obtained (x), in ⁇ M.
  • G4-CI (Example 4) and G2-Br (Example 2) exhibited a MIC value of less than 0.1 ⁇ M for nearly all of the M. tuberculosis clinical isolate strains tested in this experiment.
  • the breakdown is a measured MIC of ⁇ 0.2 ⁇ M for 1 strain G4-CI (Example 4); a measured MIC of 0.04 ⁇ M for 1 strain (G2-Br (Example 2)); a measured MIC of 0.08 ⁇ M for 40 strains (G2-Br (Example 2) and G4-CI (Example 4)); a measured MIC of 0.16 ⁇ M for 1 strain (G2-Br (Example 2) and G4-CI (Example 4)); and no measured MIC of 0.31 ⁇ M for G2-Br (Example 2) or G4-CI (Example 4) for any strain.
  • Table 3 provides MIC values against bacterial strains K12; E. coli K12 tolC/Tn10; A. baumannii ATCC 17978; and P. aeruginosa PA01 for compounds disclosed in the Examples.
  • the Example compounds do not generally possess significant activity across several pathogenic Gram negative bacteria, as well as an efflux pump deficient E. coli . But as shown in Table 4 below, the compounds disclosed in the Examples do possess significant activity against M. tuberculosis .
  • tricyclic comparator benzoxaboroles lacking a 4-halogen have greater activity against these bacterial strains
  • benzoxaborole compounds with the third ring being a seven-membered ring between the 1 and 7 positions of the benzoxaborole, additionally having 4-halo, 3-aminomethyl substitution with (S) stereochemistry at the 3 position (eg G2-Br and G4-CI) have very poor activity against these bacteria.
  • This is in marked contrast to their respective activities against M. tuberculosis , where the 4-halo compounds generally display very good activity but the benzoxaboroles without a 4-halogen are poorer (compare the M. tuberculosis MIC values for the same set of compounds in Tables 4A and 4B).
  • Table 3 provides MIC values against bacterial strains K12; E. coli K12 tolC/Tn10; A. baumannii ATCC 17978; and P. aeruginosa PA01 for compounds disclosed in the Examples.
  • Example 1 >64 >64 >64 >64 >64 G1-Br
  • Example 2 64 64 64 64 G2-Br
  • Example 3 >64 >64 >64 >64 G3-Cl
  • Example 4 64 64 64 64 64 G4-Cl
  • Example 5 32 64 >64 4 G5-F
  • Example 6 — — — — — G6-I
  • Example 7 >64 >64 >64 >64 G7-Cl
  • Example 8 >64 >64 >64 >64 >64 G8-Br
  • Example 9 >64 >64 >64 >64 >64 >64 >64 G9-Br
  • Example 10 >64 >64 >64 >64 >64 >64 G10-Br
  • Example 11 >64 >64 >64 >64 >64 >64 G11-Cl
  • Example 12 >64 >64 >64 >64 >64 >64 G12-Cl C1-
  • N-terminal six histidine-tagged LeuRS was over-expressed in Escherichia coli which were E. coli codon-optimised (GenScript, Piscataway N.J., USA), from human mitochondria and cytoplasm, and M. tuberculosis .
  • E. coli codon-optimised GeneScript, Piscataway N.J., USA
  • M. tuberculosis M. tuberculosis .
  • N-terminal six histidine-tagged LeuRS proteins were over-expressed and purified according to Novagen (Madison, Wis., USA) using an E. coli BL21(DE3) T7 RNA polymerase over-expression strain.
  • IC 50 concentration of compound (Anacor Pharmaceuticals Inc., Palo Alto, Calif., USA) were incubated with LeuRS enzyme, tRNA and L-leucine 20 minutes. Reactions were initiated by the addition of 4 mM ATP. Reactions were stopped after 7 minutes then precipitated and counted to quantify radioactivity. IC50 values were determined using the Graphpad Prism software package (Graphpad Software Inc. (La Jolla, Calif., USA).
  • HepG2 cells (HB-8065) were fed fresh medium (Essential Minimum Eagle Medium, EMEM, supplemented with 5% fetal calf serum and 2 mM L-glutamine) the day before subculturing the plates.
  • fresh medium Essential Minimum Eagle Medium, EMEM, supplemented with 5% fetal calf serum and 2 mM L-glutamine
  • EMEM Extra Minimum Eagle Medium
  • fetal calf serum 2 mM L-glutamine
  • test substances It was made up a range of 10 doses of test substances by preparing serial dilutions 1:2 from the stock solution in 100% DMSO and made a dilution of 1:200 of each dose in medium, to achieve a final concentration of 0.5% of DMSO.
  • culture medium was removed from the plate and 150 uL of test compound dilutions were added in two replicates and 150 uL of 0.5% DMSO in culture medium to columns 11 and 12 (blank control). Plates were incubated for 48 and at 37° C., 5% CO2, 95% relative humidity. The medium was then removed and 200 uL of fresh culture medium was added and 50 uL of Resazurin solution to each well and incubated for 1 h and a half.
  • Resazurine BDH
  • Resazurin is used as an oxidation-reduction indicator that yields a colorimetric change and a fluorescent signal in response to metabolic activity.
  • metabolic activity results in a chemical reduction of Resazurin indicated by a change from non-fluorescent blue to the reduced fluorescent pink form.
  • the degree of Resazurin fluorescence is therefore, an indicator of the number of viable cells in the culture system. Fluorescence was measured at an excitation wavelength of 515 nm and an emission wavelength of 590 nm in a Microplate reader1420 Multilabel HTS counter, Victor 2, (Wallac).
  • the fluorescence value of each well is corrected by subtracting the background value (average of column 11) from the absolute value.
  • the percentages of inhibition are calculated relatively to the DMSO control wells (average of column 12).
  • the average value of the duplicate samples is calculated and the curve is fitted to Sigmoidal dose-response (variable slope) nonlinear regression curve adjustment (GraphPad) in order to calculate the IC50 (Tox50).
  • Table 4A provides LeuRS inhibition IC50 values, MIC values against the M. tuberculosis standard strain Mtb H37Rv, toxicity values against human HepG2 cells, and selectivity values for Certain Comparator Benzoxaborole Compounds
  • Table 4B provides LeuRS inhibition IC50 values, MIC values against the M. tuberculosis standard strain Mtb H37Rv, toxicity values against human HepG2 cells, and selectivity values for compounds of the Examples set forth below.
  • Tables 4A and 4B show a comparison of certain benzoxaborole compounds with and without halogen substitution, certain benzoxaborole compounds with and without halogen substitution at position 4 of the benzoxaborole ring structure, and certain bicyclic compounds. From the Mtb H37Rv MIC values (B), and the HepG2 cell 48 h Tox 50 values (A), it is possible to determine selectivity for inhibition of M. tuberculosis versus inhibition (toxicity) of human cells for these compounds (see far right column of Tables 4A and 4B).
  • Example 2 G2-Br and Example 4 G4-CI were found to have selectivity indices against M. tuberculosis of 4177 and >12,500, respectively (see Table 4B). Further, as seen in Table 4B the IC 50 values for these compounds against M. tuberculosis were found to be sub-micromolar, at 0.13 and 0.1, respectively. As can be seen, the selectivity index (SI) of Example 2 G2-Br and Example 4 G4-CI against M. tuberculosis is unexpectedly improved over other benzoxaborole compounds.
  • Example 2 G2-Br and Example 4 G4-CI which are benzoxaborole compounds having a halogen substituent at the C-4 position of the benzoxaborole ring and an aminomethyl substituent at position C3 of the benzoxaborole ring having “(S)” relative stereochemistry at that stereocenter, are surprisingly more selective for activity against M. tuberculosis than other benzoxaborole compounds lacking some of these features versus inhibition (toxicity) of human cells for these compounds.
  • the MIC values against M. tuberculosis H 37Rv strain for Example. 2 G2-Br and Example 4 G4-CI are both ⁇ 0.1 ⁇ M in contrast to other benzoxaborole compounds in this study.
  • Example 2 G2-Br and Example 4 G4-CI were found to have a SI against Mycobacterium tuberculosis of 4177 (Example 2 G2-Br) and >12,500 (Example 4 G4-CI), respectively. These SI values are surprisingly better than any of the comparator compounds tested to date.
  • C6-CI the (S) enantiomer of a non-benzoxaborole comparator compound with a CI at the C4 position of the benzoxaborole ring
  • SI the SI of 363
  • G4-CI the (S) enantiomer of a benzoxaborole with a CI at the C-4 position
  • Example 2 G2-Br and Example 4 G4-CI compares the SI of Example 2 G2-Br and Example 4 G4-CI to the SI of C5-H, the (S) enantiomer of a non-benzoxaborole comparator compound with a H at the C4 position of the benzoxaborole ring, one can see the SI of such a compound without a halogen substituent at C4 is only 3, indicating such a compound has very little selectivity for inhibiting M. tuberculosis compared to killing human cells.
  • Table 4B shows Example 9 G9-Br and Example 11 G11-CI with SI indices of >167 and >185, respectively, whereas comparator compounds C9-CI (a benzoxaborole with a chloro substituent at C4 and —CH 3 substitution at R 3 and R 4 of the 7-membered ring) and C10-H (a benzoxaborole with a hydrogen at C4 and —CH 3 substitution at R 3 and R 4 of the 7-membered ring) have SI indices of 10. This arguably indicates that substitution at the R 3 and R 4 positions is not favored for selectivity for M.
  • tuberculosis versus inhibition (toxicity) of human cells for these compounds. It also suggests that the presence of a halogen at position C4 of the benzoxaborole ring (see C9-CI) is not sufficient to overcome the negative effect of methyl substitution at both R 3 and R 4 of the 7-membered tricyclic ring at the R 3 /R 4 position.
  • Example 2 G2-Br and Example 4 G4-CI also have SI values unexpectedly higher than related open ring benzoxaboroles (substituted benzoxaboroles) lacking a halogen substituent at the C4 position of the benzoxaborole ring. Compare the SI for C5-H (5) to the SIs for Example 2 G2-Br and Example 4 G4-CI.
  • Benzoxaboroles that are not benzoxaboroles but which have a halogen at the C4 position of the benzoxaborole ring show improved SIs relative to no halogen, but still exhibit SI values significantly lower than the SIs for Example 2 G2-Br and Example 4 G4-CI (compare C5-H to C3-Br and C6-CI; but then compare all three C5-H, C3-Br and C6-CI to the SI values of Example 2 G2-Br and Example 4 G4-CI).
  • the benzoxaboroles of the invention show surprisingly higher SIs relative to the SIs of related benzoxaboroles for M. tuberculosis versus human cells.

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