US20200155558A1 - Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral antidiabetic drug - Google Patents
Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral antidiabetic drug Download PDFInfo
- Publication number
- US20200155558A1 US20200155558A1 US16/196,592 US201816196592A US2020155558A1 US 20200155558 A1 US20200155558 A1 US 20200155558A1 US 201816196592 A US201816196592 A US 201816196592A US 2020155558 A1 US2020155558 A1 US 2020155558A1
- Authority
- US
- United States
- Prior art keywords
- patients
- methyl
- insulin
- sulphonylurea
- dpp
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- BNPBEDWUQOSRHB-UHFFFAOYSA-N CC#CCN1C(N(C)CC(C)(C)N)=NC2=C1C(=O)N(CC1=NC3=C(C=CC=C3)C(C)=N1)C(=O)N2C Chemical compound CC#CCN1C(N(C)CC(C)(C)N)=NC2=C1C(=O)N(CC1=NC3=C(C=CC=C3)C(C)=N1)C(=O)N2C BNPBEDWUQOSRHB-UHFFFAOYSA-N 0.000 description 2
- OWVQLTBTGFYAHU-HNNXBMFYSA-N CC#CCN1C(N(C)C[C@H](C)N)=NC2=C1C(=O)N(CC1=NC3=C(C=CC=C3)C(C)=N1)C(=O)N2C Chemical compound CC#CCN1C(N(C)C[C@H](C)N)=NC2=C1C(=O)N(CC1=NC3=C(C=CC=C3)C(C)=N1)C(=O)N2C OWVQLTBTGFYAHU-HNNXBMFYSA-N 0.000 description 1
- HDARIOSGMVVPLE-LJQANCHMSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=C(C#N)C=C3/C=C\C=C/C3=N1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=C(C#N)C=C3/C=C\C=C/C3=N1)C(=O)N2C HDARIOSGMVVPLE-LJQANCHMSA-N 0.000 description 1
- ZOTODWFVYUPZFO-GOSISDBHSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=C(C#N)C=CC=C1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=C(C#N)C=CC=C1)C(=O)N2C ZOTODWFVYUPZFO-GOSISDBHSA-N 0.000 description 1
- ISVBJQYIQQKSGK-MRXNPFEDSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=C(C#N)C=CC=N1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=C(C#N)C=CC=N1)C(=O)N2C ISVBJQYIQQKSGK-MRXNPFEDSA-N 0.000 description 1
- GFMVACPPQCXLGW-QGZVFWFLSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=CC3=NC=CN=C3C=C1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=CC3=NC=CN=C3C=C1)C(=O)N2C GFMVACPPQCXLGW-QGZVFWFLSA-N 0.000 description 1
- ONMDRNPIEXAJEZ-MRXNPFEDSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC(C)=CC(C)=N1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC(C)=CC(C)=N1)C(=O)N2C ONMDRNPIEXAJEZ-MRXNPFEDSA-N 0.000 description 1
- LTXREWYXXSTFRX-QGZVFWFLSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CC=C3C(C)=N1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CC=C3C(C)=N1)C(=O)N2C LTXREWYXXSTFRX-QGZVFWFLSA-N 0.000 description 1
- HAKJUVBTRWXTRU-QGZVFWFLSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CC=C3C(C)=N1)N=C2 Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CC=C3C(C)=N1)N=C2 HAKJUVBTRWXTRU-QGZVFWFLSA-N 0.000 description 1
- ILTRPILDWNCOMQ-QGZVFWFLSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CC=C3C=N1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CC=C3C=N1)C(=O)N2C ILTRPILDWNCOMQ-QGZVFWFLSA-N 0.000 description 1
- TTYUNRVFZJWXHB-MRXNPFEDSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CN=C3C=C1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC3=CC=CN=C3C=C1)C(=O)N2C TTYUNRVFZJWXHB-MRXNPFEDSA-N 0.000 description 1
- YLTXBUGZVMPESA-OAHLLOKOSA-N CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC=CC(C)=N1)C(=O)N2C Chemical compound CC#CCN1C(N2CCC[C@@H](N)C2)=NC2=C1C(=O)N(CC1=NC=CC(C)=N1)C(=O)N2C YLTXBUGZVMPESA-OAHLLOKOSA-N 0.000 description 1
- UCODEUPVRWMMQA-SNVBAGLBSA-N CC(F)(F)C1=NN=C2CN(C(=O)C[C@H](N)CC3=C(F)C=C(F)C(F)=C3)CCN21 Chemical compound CC(F)(F)C1=NN=C2CN(C(=O)C[C@H](N)CC3=C(F)C=C(F)C(F)=C3)CCN21 UCODEUPVRWMMQA-SNVBAGLBSA-N 0.000 description 1
- IWYJYHUNXVAVAA-OAHLLOKOSA-N CN1C(=O)C=C(N2CCC[C@@H](N)C2)N(CC2=C(C#N)C=CC(F)=C2)C1=O Chemical compound CN1C(=O)C=C(N2CCC[C@@H](N)C2)N(CC2=C(C#N)C=CC(F)=C2)C1=O IWYJYHUNXVAVAA-OAHLLOKOSA-N 0.000 description 1
- NVSWJKWHLUTHLP-CPJSRVTESA-N C[C@@H](CC1(C2=NN=NN2)C2=CC=C(C(=O)N(C)C)C=C2CCC2=C1C=CC(C(=O)N(C)C)=C2)NCC(=O)N1CCC[C@H]1C#N Chemical compound C[C@@H](CC1(C2=NN=NN2)C2=CC=C(C(=O)N(C)C)C=C2CCC2=C1C=CC(C(=O)N(C)C)=C2)NCC(=O)N1CCC[C@H]1C#N NVSWJKWHLUTHLP-CPJSRVTESA-N 0.000 description 1
- CDVDVOFWUQKQDH-CQSZACIVSA-N C[C@@H]1CCCN(C2=CC(=O)N(C)C(=O)N2CC2=C(C#N)C=CC=C2)C1 Chemical compound C[C@@H]1CCCN(C2=CC(=O)N(C)C(=O)N2CC2=C(C#N)C=CC=C2)C1 CDVDVOFWUQKQDH-CQSZACIVSA-N 0.000 description 1
- SYOKIDBDQMKNDQ-XWTIBIIYSA-N N#C[C@@H]1CCCN1C(=O)CNC12CC3CC(CC(O)(C3)C1)C2 Chemical compound N#C[C@@H]1CCCN1C(=O)CNC12CC3CC(CC(O)(C3)C1)C2 SYOKIDBDQMKNDQ-XWTIBIIYSA-N 0.000 description 1
- AUWVIZIUGLWUDZ-AJNGGQMLSA-N N#C[C@@H]1C[C@H](F)CN1C(=O)CC[C@@H]1CC[C@H](CN2C=NC=N2)C1 Chemical compound N#C[C@@H]1C[C@H](F)CN1C(=O)CC[C@@H]1CC[C@H](CN2C=NC=N2)C1 AUWVIZIUGLWUDZ-AJNGGQMLSA-N 0.000 description 1
- JSYGLDMGERSRPC-FQUUOJAGSA-N N#C[C@H](C[C@@H](C1)F)N1C(CN[C@H]1C[C@@H](C[n]2ncnc2)CC1)=O Chemical compound N#C[C@H](C[C@@H](C1)F)N1C(CN[C@H]1C[C@@H](C[n]2ncnc2)CC1)=O JSYGLDMGERSRPC-FQUUOJAGSA-N 0.000 description 1
- UOCHFMVPMIYRHJ-QWRGUYRKSA-N N[C@H]1CN(C2=NC=NC(N3CCC(F)(F)C3)=N2)C[C@@H]1N1CC(F)(F)CCC1=O Chemical compound N[C@H]1CN(C2=NC=NC(N3CCC(F)(F)C3)=N2)C[C@@H]1N1CC(F)(F)CCC1=O UOCHFMVPMIYRHJ-QWRGUYRKSA-N 0.000 description 1
- 0 [1*]N1C(=O)C2=C(C(C#N)=C([2*])N2CC#CC)N(C)C1=O.[1*]N1C(=O)C2=C(N=C([2*])N2CC#CC)N(C)C1=O.[1*]N1C=NC2=C(C1=O)N(CC#CC)C([2*])=C2C#N.[1*]N1N=CC2=C(C1=O)N(CC#CC)C([2*])=N2 Chemical compound [1*]N1C(=O)C2=C(C(C#N)=C([2*])N2CC#CC)N(C)C1=O.[1*]N1C(=O)C2=C(N=C([2*])N2CC#CC)N(C)C1=O.[1*]N1C=NC2=C(C1=O)N(CC#CC)C([2*])=C2C#N.[1*]N1N=CC2=C(C1=O)N(CC#CC)C([2*])=N2 0.000 description 1
- GUYMHFIHHOEFOA-ZCPGHIKRSA-N [H][C@@]12C[C@H](N)[C@@H](N3C[C@@H](CF)CC3=O)CN1CCC1=CC(OC)=C(OC)C=C12 Chemical compound [H][C@@]12C[C@H](N)[C@@H](N3C[C@@H](CF)CC3=O)CN1CCC1=CC(OC)=C(OC)C=C12 GUYMHFIHHOEFOA-ZCPGHIKRSA-N 0.000 description 1
- QGJUIPDUBHWZPV-SGTAVMJGSA-N [H][C@]12C[C@@]1([H])C[C@@H](C#N)N2C(=O)[C@@H](N)C12CC3CC(CC(O)(C3)C1)C2 Chemical compound [H][C@]12C[C@@]1([H])C[C@@H](C#N)N2C(=O)[C@@H](N)C12CC3CC(CC(O)(C3)C1)C2 QGJUIPDUBHWZPV-SGTAVMJGSA-N 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
- A61K31/52—Purines, e.g. adenine
- A61K31/522—Purines, e.g. adenine having oxo groups directly attached to the heterocyclic ring, e.g. hypoxanthine, guanine, acyclovir
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/13—Amines
- A61K31/155—Amidines (), e.g. guanidine (H2N—C(=NH)—NH2), isourea (N=C(OH)—NH2), isothiourea (—N=C(SH)—NH2)
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
- A61K31/4439—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. omeprazole
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/64—Sulfonylureas, e.g. glibenclamide, tolbutamide, chlorpropamide
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K38/00—Medicinal preparations containing peptides
- A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
- A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
- A61K38/22—Hormones
- A61K38/28—Insulins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0053—Mouth and digestive tract, i.e. intraoral and peroral administration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P3/00—Drugs for disorders of the metabolism
- A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
- A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
Definitions
- the present invention relates to certain DPP-4 inhibitors for treating and/or preventing metabolic diseases, particularly diabetes (especially type 2 diabetes mellitus) and conditions related thereto, in patients with insufficient glycemic control despite a therapy with an oral and/or a non-oral antidiabetic drug (particularly an insulin secretagogue, like a sulphonylurea or glinide drug), as well as to the use of these DPP-4 inhibitors in said treatment and/or prevention.
- Pharmaceutical compositions for treating and/or preventing metabolic diseases (particularly diabetes) in these patients comprising a DPP-4 inhibitor as defined herein optionally together with one or more other active substances are also contemplated.
- Type 2 diabetes mellitus is a common chronic and progressive disease arising from a complex pathophysiology involving the dual endocrine effects of insulin resistance and impaired insulin secretion.
- the treatment of type 2 diabetes typically begins with diet and exercise, followed by oral antidiabetic monotherapy, and although conventional monotherapy may initially control blood glucose in some patients, it is however associated with a high secondary failure rate.
- the limitations of single-agent therapy for maintaining glycemic control may be overcome, at least in some patients, and for a limited period of time by combining multiple oral drugs to achieve reductions in blood glucose that cannot be sustained during long-term therapy with single agents. Available data support the conclusion that in most patients with type 2 diabetes monotherapy will fail and treatment with multiple drugs will be required.
- these existing drug therapies result in progressive deterioration in glycemic control despite treatment and do not sufficiently control glycemia especially over long-term and thus fail to achieve and to maintain metabolic control in advanced or late stage type 2 diabetes, including diabetes with inadequate glycemic control despite conventional oral or non-oral antidiabetic medication, diabetes with secondary drug failure and/or with indication on insulin.
- This high incidence of therapeutic failure is a major contributor to the high rate of long-term hyperglycemia-associated complications or chronic damages (including micro- and macrovascular complications such as e.g. diabetic nephropathy, retinopathy or neuropathy, or cardiovascular complications) in patients with type 2 diabetes.
- Oral antidiabetic drugs conventionally used in therapy include, without being restricted thereto, metformin, sulphonylureas, thiazolidinediones, glinides and ⁇ -glucosidase inhibitors.
- Non-oral antidiabetic drugs conventionally used in therapy include, without being restricted thereto, GLP-1 or GLP-1 analogues, and insulin or insulin analogues.
- metformin can be associated with lactic acidosis or gastrointestinal side effects
- sulfonylureas, glinides and insulin or insulin analogues can be associated with hypoglycemia and weight gain
- thiazolidinediones can be associated with edema, bone fracture, weight gain and heart failure/cardiac effects
- alpha-glucosidase blockers and GLP-1 or GLP-1 analogues can be associated with gastrointestinal adverse effects (e.g. dyspepsia, flatulence or diarrhea, or nausea or vomiting).
- Sulphonylureas stimulate insulin secretion from pancreatic beta-cells in a non-glucose-dependent manner and are generally and frequently used as a first- or second-line (mono- or combination) treatment in type 2 diabetes (especially indicated for non-obese patients and/or for patients ineligible for or with failure in metformin therapy).
- SU Sulphonylureas
- glinides stimulate insulin secretion from pancreatic beta-cells in a non-glucose-dependent manner and are generally and frequently used as a first- or second-line (mono- or combination) treatment in type 2 diabetes (especially indicated for non-obese patients and/or for patients ineligible for or with failure in metformin therapy).
- some patients do not always respond well to these conventional oral antidiabetic agents especially in long-term treatment and may show insufficient or deterioration in glycemic control despite treatment with a sulphonylurea drug (secondary SU failure).
- change to other oral medication e.g. to metformin/thiazolidinedione
- SU combination therapy including add-on and initial dual and triple SU combination therapy
- combination of a sulfonylurea with metformin and/or with a thiazolidinedione may be indicated depending on the disease stage, and/or combination with or (ultimately) transfer to insulin (such as e.g., depending on disease stage, once-daily basal insulin, twice-daily premix insulin or multiple daily insulin).
- insulin such as e.g., depending on disease stage, once-daily basal insulin, twice-daily premix insulin or multiple daily insulin.
- some patients may show insufficient or deterioration in glycemic control despite combination treatment, especially over time.
- sulfonylureas increase plasma levels of insulin and may cause hypoglycaemia, which is—besides weight gain—one of their major adverse effects, particularly in association with renal impairment and/or in elderly patients.
- hypoglycaemia which is—besides weight gain—one of their major adverse effects, particularly in association with renal impairment and/or in elderly patients.
- an increased sulfonylurea dose may be required, whereas, on the other side, with regard to safety/tolerability, sometimes a decreased sulfonylurea dose may be required, thus requiring often an unsatisfying compromise in SU medication.
- antidiabetic therapies for these patients with advanced or late stage type 2 diabetes mellitus, including patients with inadequate glycemic control on conventional oral and/or non-oral antidiabetic drugs, such as e.g. metformin, sulphonylureas, thiazolidinediones, glinides and/or ⁇ -glucosidase inhibitors, and/or GLP-1 or GLP-1 analogues, and/or insulin or insulin analogues.
- antidiabetic drugs such as e.g. metformin, sulphonylureas, thiazolidinediones, glinides and/or ⁇ -glucosidase inhibitors, and/or GLP-1 or GLP-1 analogues, and/or insulin or insulin analogues.
- the HbA1c value In the monitoring of the treatment of diabetes mellitus the HbA1c value, the product of a non-enzymatic glycation of the haemoglobin B chain, is of exceptional importance. As its formation depends essentially on the blood sugar level and the life time of the erythrocytes the HbA1c in the sense of a “blood sugar memory” reflects the average blood sugar level of the preceding 4-12 weeks. Diabetic patients whose HbA1c level has been well controlled over a long time by more intensive diabetes treatment (i.e. ⁇ 6.5% of the total haemoglobin in the sample) are significantly better protected from diabetic microangiopathy.
- the available treatments for diabetes can give the diabetic an average improvement in their HbA1c level of the order of 1.0-1.5%. This reduction in the HbA1C level is not sufficient in all diabetics to bring them into the desired target range of ⁇ 7.0%, preferably ⁇ 6.5% and more preferably ⁇ 6% HbA1c.
- FPG fasting plasma glucose
- PPG postprandial plasma glucose
- patients with insufficient glycemic control despite a therapy with an oral or non-oral antidiabetic drug include, without being limited to, patients having a HbA1c value from 7.0 to 10% (or from 7.5 to 11%, or from 7.5 to 10%) despite treatment with said drug.
- An embodiment of the patients which may be amenable to the therapies of this invention may include, without being limited, those diabetes patients for whom normal metformin therapy is not appropriate, such as e.g. those diabetes patients who need reduced dose metformin therapy due to reduced tolerability, intolerability or contraindication against metformin or due to (mildly) impaired/reduced renal function (including elderly patients, e.g. 60-65 years).
- patients ineligible for metformin therapy may also include, without being limited to, elderly patients, e.g. ⁇ 60-65 years or particularly 80 years.
- a further embodiment of diabetic patients with secondary oral antidiabetic drug failure within the meaning of this invention refers to patients having renal disease, renal dysfunction, or insufficiency or impairment of renal function (including mild, moderate and severe renal impairment), e.g. as suggested by elevated serum creatinine levels (e.g. serum creatinine levels above the upper limit of normal for their age, e.g. 130-150 ⁇ mol/l, or 1.5 mg/dl 136 ⁇ mol/l) in men and 1.4 mg/dl 124 ⁇ mol/l) in women) or abnormal creatinine clearance (e.g. glomerular filtration rate (GFR) 30-60 ml/min).
- GFR glomerular filtration rate
- mild renal impairment may be e.g. suggested by a creatinine clearance of 50-80 ml/min (approximately corresponding to serum creatine levels of 1.7 mg/dL in men and 1.5 mg/dL in women); moderate renal impairment may be e.g. suggested by a creatinine clearance of 30-50 ml/min (approximately corresponding to serum creatine levels of >1.7 to 3.0 mg/dL in men and >1.5 to 2.5 mg/dL in women); and severe renal impairment may be e.g. suggested by a creatinine clearance of ⁇ 30 ml/min (approximately corresponding to serum creatine levels of >3.0 mg/dL in men and >2.5 mg/dL in women).
- Patients with end-stage renal disease require dialysis.
- FIG. 1 demonstrates HbA1c values following 54 day treatment of 5 weeks old female db/db mice with the indicated compounds (left bar: vehicle; middle bar: BI 1356; right bar: glibenclamide).
- FIG. 2 demonstrates glucose values following 54 day treatment of 5 weeks old female db/db mice with the indicated compounds (left bar: vehicle; middle bar: BI 1356; right bar: glibenclamide).
- FIG. 3 shows the increase in insulin during an OGTT test. Only the animals treated with BI 1356 are able to respond to the increased glucose levels with an up-regulation of insulin (left bar: vehicle; middle bar: BI 1356; right bar: glibenclamide).
- DPP-4 dipeptidyl peptidase IV
- CD26 The enzyme DPP-4 (dipeptidyl peptidase IV) also known as CD26 is a serine protease known to lead to the cleavage of a dipeptide from the N-terminal end of a number of proteins having at their N-terminal end a proline or alanine residue. Due to this property DPP-4 inhibitors interfere with the plasma level of bioactive peptides including the peptide GLP-1 and are considered to be promising drugs for the treatment of diabetes mellitus.
- DPP-4 inhibitors and their uses are disclosed in WO 2002/068420, WO 2004/018467, WO 2004/018468, WO 2004/018469, WO 2004/041820, WO 2004/046148, WO 2005/051950, WO 2005/082906, WO 2005/063750, WO 2005/085246, WO 2006/027204, WO 2006/029769 or WO2007/014886; or in WO 2004/050658, WO 2004/111051, WO 2005/058901 or WO 2005/097798; or in WO 2006/068163, WO 2007/071738 or WO 2008/017670; or in WO 2007/128721 or WO 2007/128761.
- DPP-4 inhibitors As further DPP-4 inhibitors the following compounds can be mentioned:
- sitagliptin is in the form of its dihydrogenphosphate salt, i.e. sitagliptin phosphate.
- sitagliptin phosphate is in the form of a crystalline anhydrate or monohydrate.
- a class of this embodiment refers to sitagliptin phosphate monohydrate.
- Sitagliptin free base and pharmaceutically acceptable salts thereof are disclosed in U.S. Pat. No. 6,699,871 and in Example 7 of WO 03/004498. Crystalline sitagliptin phosphate monohydrate is disclosed in WO 2005/003135 and in WO 2007/050485.
- a tablet formulation for sitagliptin is commercially available under the trade name Januvia®.
- a tablet formulation for sitagliptin/metformin combination is commercially available under the trade name Janumet®.
- Vildagliptin is specifically disclosed in U.S. Pat. No. 6,166,063 and in Example 1 of WO 00/34241. Specific salts of vildagliptin are disclosed in WO 2007/019255. A crystalline form of vildagliptin as well as a vildagliptin tablet formulation are disclosed in WO 2006/078593. Vildagliptin can be formulated as described in WO 00/34241 or in WO 2005/067976. A modified release vildagliptin formulation is described in WO 2006/135723.
- a tablet formulation for vildagliptin is expected to be commercially available under the trade name Galvus®.
- a tablet formulation for vildagliptin/metformin combination is commercially available under the trade name Eucreas®.
- Saxagliptin is specifically disclosed in U.S. Pat. No. 6,395,767 and in Example 60 of WO 01/68603.
- saxagliptin is in the form of its HCl salt or its mono-benzoate salt as disclosed in WO 2004/052850.
- saxagliptin is in the form of the free base.
- saxagliptin is in the form of the monohydrate of the free base as disclosed in WO 2004/052850.
- Crystalline forms of the HCl salt and the free base of saxagliptin are disclosed in WO 2008/131149.
- a process for preparing saxagliptin is also disclosed in WO 2005/106011 and WO 2005/115982. Saxagliptin can be formulated in a tablet as described in WO 2005/117841.
- Alogliptin is specifically disclosed in US 2005/261271, EP 1586571 and in WO 2005/095381.
- alogliptin is in the form of its benzoate salt, its hydrochloride salt or its tosylate salt each as disclosed in WO 2007/035629.
- a class of this embodiment refers to alogliptin benzoate.
- Polymorphs of alogliptin benzoate are disclosed in WO 2007/035372.
- a process for preparing alogliptin is disclosed in WO 2007/112368 and, specifically, in WO 2007/035629.
- Alogliptin (namely its benzoate salt) can be formulated in a tablet and administered as described in WO 2007/033266. Formulations of Alogliptin with metformin or pioglitazone are described in WO 2008/093882 or WO 2009/011451, respectively.
- This compound and methods for its preparation are disclosed in WO 2005/000848.
- a process for preparing this compound is also disclosed in WO 2008/031749, WO 2008/031750 and WO 2008/055814.
- This compound can be formulated in a pharmaceutical composition as described in WO 2007/017423.
- DPP-4 inhibitors as defined herein have unexpected and particularly advantageous properties, which make them particularly suitable for treating and/or preventing (including preventing or slowing the progression or delaying the onset) of metabolic diseases, particularly diabetes (especially type 2 diabetes mellitus) and conditions related thereto (e.g. diabetic complications), in advanced or late stage type 2 diabetes patients, including patients with insufficient glycemic control despite a therapy with an oral and/or a non-oral antidiabetic drug and/or with indication on insulin.
- metabolic diseases particularly diabetes (especially type 2 diabetes mellitus) and conditions related thereto (e.g. diabetic complications)
- diabetes especially type 2 diabetes mellitus
- conditions related thereto e.g. diabetic complications
- the present invention provides a DPP-4 inhibitor as defined herein for use in the treatment of patients with insufficient glycemic control despite a therapy (including mono-, dual or triple medication) with one or more conventional oral antidiabetic drugs selected from metformin, sulphonylureas, thiazolidinediones, glinides and ⁇ -glucosidase inhibitors.
- the present invention provides a DPP-4 inhibitor as defined herein for use in the treatment of patients with insufficient glycemic control despite therapy (including mono-, dual or triple medication) with one, two or three conventional oral or non-oral antidiabetic drugs selected from metformin, sulphonylureas, thiazolidinediones, glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues; for example, despite mono-therapy with metformin, a sulphonylurea, pioglitazone or (basal) insulin, or despite dual combination therapy with a metformin/pioglitazone, metformin/sulphonylurea, metformin/(basal) insulin, sulphonylurea/pioglitazone, sulphonylurea/(basal) insulin or pioglitazone/(basal) insulin combination.
- the present invention further provides a DPP-4 inhibitor as defined herein for use in the treatment of diabetes patients with insufficient glycemic control despite mono-therapy with a sulphonylurea, or despite dual combination therapy with a metformin/sulphonylurea, sulphonylurea/pioglitazone or sulphonylurea/(basal) insulin combination.
- the present invention provides a DPP-4 inhibitor as defined herein for use in the treatment of patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- the present invention further provides a DPP-4 inhibitor as defined herein for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- the present invention further provides a DPP-4 inhibitor as defined herein for use in the treatment and/or prevention of diabetes with secondary sulphonylurea failure.
- the present invention further provides the use of a DPP-4 inhibitor as defined herein for the manufacture of a pharmaceutical composition for treating and/or preventing metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- the present invention further provides a pharmaceutical composition for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said pharmaceutical composition comprising a DPP-4 inhibitor as defined herein and optionally one or more pharmaceutically acceptable carriers and/or diluents.
- the present invention further provides a fixed or non-fixed combination including a kit-of-parts for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said combination comprising a DPP-4 inhibitor as defined herein and optionally one or more other active substances, e.g. any of those mentioned herein.
- the present invention further provides the use of a DPP-4 inhibitor as defined herein in combination with one or more other active substances, such as e.g. any of those mentioned herein, for the manufacture of a pharmaceutical composition for treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- a DPP-4 inhibitor as defined herein in combination with one or more other active substances, such as e.g. any of those mentioned herein, for the manufacture of a pharmaceutical composition for treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- the present invention further provides a pharmaceutical composition for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said pharmaceutical composition comprising a DPP-4 inhibitor as defined herein and optionally one or more other active substances, such as e.g. any of those mentioned herein, such as e.g. for separate, sequential, simultaneous, concurrent or chronologically staggered use of the active ingredients.
- a pharmaceutical composition for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug
- said pharmaceutical composition comprising a DPP-4 inhibitor as defined herein and optionally one or more other active substances, such as e.g. any of those mentioned herein, such as e.g. for separate, sequential, simultaneous, concurrent or chronologically staggered use of the active ingredients.
- the present invention further provides a method of treating and/or preventing metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said method comprising administering to a subject in need thereof (particularly a human patient) an effective amount of a DPP-4 inhibitor as defined herein, optionally alone or in combination, such as e.g. separately, sequentially, simultaneously, concurrently or chronologically staggered, with an effective amount of one or more other active substances, such as e.g. any of those mentioned herein.
- a DPP-4 inhibitor as defined herein, optionally alone or in combination, such as e.g. separately, sequentially, simultaneously, concurrently or chronologically staggered, with an effective amount of one or more other active substances, such as e.g. any of those mentioned herein.
- the present invention provides a DPP-4 inhibitor as defined herein, optionally in (add-on or initial) combination with one or two conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones (e.g.
- pioglitazone glinides, alpha-glucosidase blockers, GLP-1 or GLP-1 analogues, and insulin or insulin analogues, for use in patients with insufficient glycemic control despite therapy with (e.g., if applicable, despite therapy with a maximal tolerated oral dose of) one, two or three conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones, glinides, alpha-glucosidase blockers, GLP-1 or GLP-1 analogues, and insulin or insulin analogues (e.g.
- a DPP-4 inhibitor as defined herein, optionally in combination with one conventional antihyperglycemic agent selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues, for use in (second line) therapy of type 2 diabetes patients who are insufficiently controlled on said conventional antihyperglycemic agent alone.
- one conventional antihyperglycemic agent selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues
- a DPP-4 inhibitor as defined herein, optionally in combination with two conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues, for use in (third line) therapy of type 2 diabetes patients who are insufficiently controlled on a dual combination of said conventional antihyperglycemic agents.
- two conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues
- a DPP-4 inhibitor as defined herein in combination with a conventional antihyperglycemic agent selected from the group consisting of metformin, pioglitazone, a sulphonylurea, and insulin; for use in therapy of type 2 diabetes patients with insufficient glycemic control on the conventional antihyperglycemic agent alone.
- a conventional antihyperglycemic agent selected from the group consisting of metformin, pioglitazone, a sulphonylurea, and insulin
- a DPP-4 inhibitor as defined herein in combination with two conventional antihyperglycemic agents selected from the group consisting of the following combinations: metformin and pioglitazone, metformin and a sulphonylurea, metformin and insulin, a sulphonylurea and pioglitazone, a sulphonylurea and insulin, and pioglitazone and insulin; for use in therapy of type 2 diabetes patients with insufficient glycemic control on the two conventional antihyperglycemic agents.
- the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite mono-therapy with a maximal tolerated dose of a sulphonylurea.
- the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea and metformin for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite dual combination therapy with a sulphonylurea and metformin.
- the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea and pioglitazone for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite dual combination therapy with a sulphonylurea and pioglitazone.
- the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea and insulin for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite dual combination therapy with a sulphonylurea and insulin.
- DPP-4 inhibitors as defined herein may be useful in one or more of the following methods
- Examples of such metabolic diseases or disorders amenable by the therapy of this invention in patients with secondary oral antidiabetic drug failure may include, without being restricted to, Type 1 diabetes, Type 2 diabetes, inadequate glucose tolerance, insulin resistance, hyperglycemia, hyperlipidemia, hypercholesterolemia, dyslipidemia, metabolic syndrome X, obesity, hypertension, chronic systemic inflammation, retinopathy, neuropathy, nephropathy, atherosclerosis, endothelial dysfunction and osteoporosis.
- the present invention further provides the use of a DPP-4 inhibitor as defined herein, optionally in combination with one or more other active substances, such as e.g. any of those mentioned herein, for the manufacture of a medicament for one or more of the following purposes:
- a special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in attaining and/or maintaining glycemic control in type 2 diabetes patients with secondary sulphonylurea failure.
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in preventing (including preventing or slowing the progression) of diabetes with secondary SU failure.
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in preventing or reducing the risk for adverse effects associated with SU antidiabetic therapy, such as e.g. hypoglycaemia and/or weight gain (or even for use in obtaining weight loss).
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in the treatment of diabetes with secondary sulphonylurea failure, wherein said DPP-4 inhibitor is used in add-on or initial combination therapy with a sulphonylurea mono- or dual medication (e.g. as add-on therapy to a SU medication with or without metformin) or as replacement of a sulphonylurea medication, optionally in combination with one or more other therapeutic agents, such as e.g. metformin and/or thiazolidinedione (e.g. pioglitazone).
- a sulphonylurea mono- or dual medication e.g. as add-on therapy to a SU medication with or without metformin
- thiazolidinedione e.g. pioglitazone
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in improving (e.g. mean reduction from baseline) HbA1c and/or FPG, decreasing glucose excursion and/or improving insulin secretion in patients with insufficient glycemic control (e.g. having HbA1c from 7.5 to 10% or from 7.5 to 11%) despite a therapy with a sulphonylurea drug (such as e.g. glibenclamide, glipizide or glimepiride, with or without metformin).
- a sulphonylurea drug such as e.g. glibenclamide, glipizide or glimepiride, with or without metformin.
- a DPP-4 inhibitor within the meaning of the present invention includes, without being limited to, any of those DPP-4 inhibitors mentioned hereinabove and hereinbelow, preferably orally active DPP-4 inhibitors.
- An embodiment of this invention refers to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (particularly type 2 diabetes mellitus) in type 2 diabetes patients with secondary oral antidiabetic drug failure, wherein said patients further suffering from renal disease, renal dysfunction or renal impairment, particularly characterized in that said DPP-4 inhibitor is administered to said patients in the same dose levels as to patients with normal renal function, thus e.g. said DPP-4 inhibitor does not require downward dosing adjustment for impaired renal function.
- Another embodiment of this invention refers to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (particularly type 2 diabetes mellitus) in type 2 diabetes patients with secondary oral antidiabetic drug failure, wherein said patients are also with failure in or ineligible for metformin therapy or in need of metformin dose reduction due to intolerability or contraindication against metformin, such as e.g. any of those intolerabilities or contraindications defined hereinbefore or hereinafter.
- a DPP-4 inhibitor which may be suggested for the aforementioned purpose of the present invention may be such an oral DPP-4 inhibitor, which and whose active metabolites have preferably a relatively wide (e.g. about >100 fold) therapeutic window and/or, especially, that are primarily eliminated via hepatic metabolism or biliary excretion.
- a DPP-4 inhibitor particularly suitable for the aforementioned purpose of the present invention may be such an orally administered DPP-4 inhibitor, which has a relatively wide (e.g. >100 fold) therapeutic window and/or which fulfils one or more of the following pharmacokinetic properties (preferably at its therapeutic oral dose levels):
- DPP-4 inhibitor may be one or more of the following: Rapid attainment of steady state (e.g. reaching steady state plasma levels (>90% of the steady state plasma concentration) between second and fifth day of treatment with therapeutic oral dose levels), little accumulation (e.g. with a mean accumulation ratio R A,AUC ⁇ 1.4 with therapeutic oral dose levels), and/or preserving a long-lasting effect on DPP-4 inhibition, preferably when used once-daily (e.g.
- this invention refers also to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment), characterized in that said DPP-4 inhibitor is excreted to a non-substantial or only to a minor extent (e.g. ⁇ 10%, preferably ⁇ 7% of administered oral dose) via the kidney (measured, for example, by following elimination of a radiolabelled carbon ( 14 C) substance oral dose).
- metabolic diseases in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment
- said DPP-4 inhibitor is excreted to a non-substantial or only to a minor extent (e.g. ⁇ 10%, preferably ⁇ 7% of administered oral dose) via the kidney (measured, for example
- this invention refers also to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment), characterized in that said DPP-4 inhibitor is excreted substantially or mainly via the liver (measured, for example, by following elimination of a radiolabelled carbon ( 14 C) substance oral dose).
- metabolic diseases in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment
- said DPP-4 inhibitor is excreted substantially or mainly via the liver (measured, for example, by following elimination of a radiolabelled carbon ( 14 C) substance oral dose).
- this invention refers also to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment), characterized in that
- metabolic diseases in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment
- said DPP-4 inhibitor is excreted mainly unchanged as parent drug (e.g. with a mean of >70%, or >80%, or, preferably, 90% of excreted radioactivity in urine and faeces after oral dosing of radiolabelled carbon ( 14 C) substance), said DPP-4 inhibitor is eliminated to a non-substantial or only to a minor extent via metabolism, and/or the main metabolite of said DPP-4 inhibitor is pharmacologically inactive or has a relatively wide therapeutic window.
- parent drug e.g. with a mean of >70%, or >80%, or, preferably, 90% of excreted radioactivity in urine and faeces after oral dosing of radiolabelled carbon ( 14 C) substance
- said DPP-4 inhibitor is eliminated to a non-substantial or only to a minor extent via metabolism, and/or the main metabolite of said DPP-4 inhibitor is pharmacologically inactive or has a relatively wide therapeutic window.
- a DPP-4 inhibitor in the context of the present invention is any DPP-4 inhibitor of
- R1 denotes ([1,5]naphthyridin-2-yl)methyl, (quinazolin-2-yl)methyl, (quinoxalin-6-yl)methyl, (4-methyl-quinazolin-2-yl)methyl, 2-cyano-benzyl, (3-cyano-quinolin-2-yl)methyl, (3-cyano-pyridin-2-yl)methyl, (4-methyl-pyrimidin-2-yl)methyl, or (4,6-dimethyl-pyrimidin-2-yl)methyl and R2 denotes 3-(R)-amino-piperidin-1-yl, (2-amino-2-methyl-propyl)-methylamino or (2-(S)-amino-propyl)-methylamino, or its pharmaceutically acceptable salt.
- a DPP-4 inhibitor in the context of the present invention is a DPP-4 inhibitor selected from the group consisting of sitagliptin, vildagliptin, saxagliptin, alogliptin, (2S)-1- ⁇ [2-(5-Methyl-2-phenyl-oxazol-4-yl)-ethylamino]-acetyl ⁇ -pyrrolidine-2-carbonitrile, (2S)-1- ⁇ [1,1,-Dimethyl-3-(4-pyridin-3-yl-imidazol-1-yl)-propylamino]-acetyl ⁇ -pyrrolidine-2-carbonitrile, (S)-1-((2S,3S,11bS)-2-Amino-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-2H-pyrido[2,1-a]isoquinolin-3-yl)-4-flu
- preferred DPP-4 inhibitors are any or all of the following compounds and their pharmaceutically acceptable salts:
- DPP-4 inhibitors are distinguished from structurally comparable DPP-4 inhibitors, as they combine exceptional potency and a long-lasting effect with favourable pharmacological properties, receptor selectivity and a favourable side-effect profile or bring about unexpected therapeutic advantages or improvements when combined with other pharmaceutical active substances.
- Their preparation is disclosed in the publications mentioned.
- a more preferred DPP-4 inhibitor among the abovementioned DPP-4 inhibitors of embodiment A of this invention is 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine, particularly the free base thereof (which is also known as BI 1356).
- the definitions of the active compounds (including the DPP-4 inhibitors) mentioned hereinabove and hereinbelow also comprise their pharmaceutically acceptable salts as well as hydrates, solvates and polymorphic forms thereof. With respect to salts, hydrates and polymorphic forms thereof, particular reference is made to those which are referred to herein.
- the methods of synthesis for the DPP-4 inhibitors according to embodiment A of this invention are known to the skilled person.
- the DPP-4 inhibitors according to embodiment A of this invention can be prepared using synthetic methods as described in the literature.
- purine derivatives of formula (I) can be obtained as described in WO 2002/068420, WO 2004/018468, WO 2005/085246, WO 2006/029769 or WO 2006/048427, the disclosures of which are incorporated herein.
- Purine derivatives of formula (II) can be obtained as described, for example, in WO 2004/050658 or WO 2005/110999, the disclosures of which are incorporated herein.
- Purine derivatives of formula (III) and (IV) can be obtained as described, for example, in WO 2006/068163, WO 2007/071738 or WO 2008/017670, the disclosures of which are incorporated herein.
- the preparation of those DPP-4 inhibitors, which are specifically mentioned hereinabove, is disclosed in the publications mentioned in connection therewith.
- Polymorphous crystal modifications and formulations of particular DPP-4 inhibitors are disclosed in WO 2007/128721 and WO 2007/128724, respectively, the disclosures of which are incorporated herein in their entireties.
- Formulations of particular DPP-4 inhibitors with metformin or other combination partners are described in PCT/EP2009053978, the disclosure of which is incorporated herein in its entirety.
- Typical dosage strengths of the dual combination of BI 1356/metformin are 2.5/500 mg, 2.5/850 mg and 2.5/1000 mg.
- the compounds of this invention are usually used in dosages from 0.001 to 100 mg/kg body weight, preferably at 0.1-15 mg/kg, in each case 1 to 4 times a day.
- the compounds, optionally combined with other active substances may be incorporated together with one or more inert conventional carriers and/or diluents, e.g.
- compositions according to this invention comprising the DPP-4 inhibitors as defined herein are thus prepared by the skilled person using pharmaceutically acceptable formulation excipients as described in the art.
- excipients include, without being restricted to diluents, binders, carriers, fillers, lubricants, flow promoters, crystallisation retardants, disintegrants, solubilizers, colorants, pH regulators, surfactants and emulsifiers.
- Suitable diluents for compounds according to embodiment A include cellulose powder, calcium hydrogen phosphate, erythritol, low substituted hydroxypropyl cellulose, mannitol, pregelatinized starch or xylitol. Among those diluents mannitol, low substituted hydroxypropyl cellulose and pregelatinized starch are to be emphasized.
- Suitable lubricants for compounds according to embodiment A include talc, polyethyleneglycol, calcium behenate, calcium stearate, hydrogenated castor oil or magnesium stearate. Among those lubricants magnesium stearate is to be emphasized.
- Suitable binders for compounds according to embodiment A include copovidone (copolymerisates of vinylpyrrolidon with other vinylderivates), hydroxypropyl methylcellulose (HPMC), hydroxypropylcellulose (HPC), polyvinylpyrrolidon (povidone), pregelatinized starch, or low-substituted hydroxypropylcellulose (L-HPC).
- copovidone copolymerisates of vinylpyrrolidon with other vinylderivates
- HPMC hydroxypropyl methylcellulose
- HPC hydroxypropylcellulose
- polyvinylpyrrolidon povidone
- pregelatinized starch or low-substituted hydroxypropylcellulose (L-HPC).
- L-HPC low-substituted hydroxypropylcellulose
- Suitable disintegrants for compounds according to embodiment A include corn starch or crospovidone.
- corn starch is to be emphasized.
- An exemplary composition of a DPP-4 inhibitor according to embodiment A of the invention comprises the first diluent mannitol, pregelatinized starch as a second diluent with additional binder properties, the binder copovidone, the disintegrant corn starch, and magnesium stearate as lubricant; wherein copovidone and/or corn starch may be optional.
- the dosage typically required of the DPP-4 inhibitors mentioned herein in embodiment A when administered intravenously is 0.1 mg to 10 mg, preferably 0.25 mg to 5 mg, and when administered orally is 0.5 mg to 100 mg, preferably 2.5 mg to 50 mg or 0.5 mg to 10 mg, more preferably 2.5 mg to 10 mg or 1 mg to 5 mg, in each case 1 to 4 times a day.
- 0.1 mg to 10 mg preferably 0.25 mg to 5 mg
- 0.5 mg to 100 mg preferably 2.5 mg to 50 mg or 0.5 mg to 10 mg, more preferably 2.5 mg to 10 mg or 1 mg to 5 mg, in each case 1 to 4 times a day.
- the dosage of 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine when administered orally is 0.5 mg to 10 mg per patient per day, preferably 2.5 mg to 10 mg or 1 mg to 5 mg per patient per day.
- a dosage form prepared with a pharmaceutical composition comprising a DPP-4 inhibitor mentioned herein in embodiment A contain the active ingredient in a dosage range of 0.1-100 mg.
- dosage strengths of 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine are 0.5 mg, 1 mg, 2.5 mg, 5 mg and 10 mg.
- the doses of DPP-4 inhibitors mentioned herein in embodiment B to be administered to mammals may be generally from about 0.5 mg to about 350 mg, for example from about 10 mg to about 250 mg, preferably 20-200 mg, more preferably 20-100 mg, of the active moiety per person per day, or from about 0.5 mg to about 20 mg, preferably 2.5-10 mg, per person per day, divided preferably into 1 to 4 single doses which may, for example, be of the same size.
- Single dosage strengths comprise, for example, 10, 25, 40, 50, 75, 100, 150 and 200 mg of the DPP-4 inhibitor active moiety.
- a dosage strength of the DPP-4 inhibitor sitagliptin is usually between 25 and 200 mg of the active moiety.
- a recommended dose of sitagliptin is 100 mg calculated for the active moiety (free base anhydrate) once daily.
- Unit dosage strengths of sitagliptin free base anhydrate (active moiety) are 25, 50, 75, 100, 150 and 200 mg.
- Particular unit dosage strengths of sitagliptin (e.g. per tablet) are 25, 50 and 100 mg.
- An equivalent amount of sitagliptin phosphate monohydrate to the sitagliptin free base anhydrate is used in the pharmaceutical compositions, namely, 32.13, 64.25, 96.38, 128.5, 192.75, and 257 mg, respectively. Adjusted dosages of 25 and 50 mg sitagliptin are used for patients with renal failure.
- Typical dosage strengths of the dual combination of sitagliptin/metformin are 50/500 mg and 50/1000 mg.
- a dosage range of the DPP-4 inhibitor vildagliptin is usually between 10 and 150 mg daily, in particular between 25 and 150 mg, 25 and 100 mg or 25 and 50 mg or 50 and 100 mg daily.
- Particular examples of daily oral dosage are 25, 30, 35, 45, 50, 55, 60, 80, 100 or 150 mg.
- the daily administration of vildagliptin may be between 25 and 150 mg or between 50 and 100 mg.
- the daily administration of vildagliptin may be 50 or 100 mg.
- the application of the active ingredient may occur up to three times a day, preferably one or two times a day.
- Particular dosage strengths are 50 mg or 100 mg vildagliptin. Typical dosage strengths of the dual combination of vildagliptin/metformin are 50/850 mg and 50/1000 mg.
- Alogliptin may be administered to a patient at a daily dose of between 5 mg/day and 250 mg/day, optionally between 10 mg and 200 mg, optionally between 10 mg and 150 mg, and optionally between 10 mg and 100 mg of alogliptin (in each instance based on the molecular weight of the free base form of alogliptin).
- specific dosage amounts that may be used include, but are not limited to 10 mg, 12.5 mg, 20 mg, 25 mg, 50 mg, 75 mg and 100 mg of alogliptin per day.
- Alogliptin may be administered in its free base form or as a pharmaceutically acceptable salt.
- Saxagliptin may be administered to a patient at a daily dose of between 2.5 mg/day and 100 mg/day, optionally between 2.5 mg and 50 mg.
- Specific dosage amounts that may be used include, but are not limited to 2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg and 100 mg of saxagliptin per day.
- Typical dosage strengths of the dual combination of saxagliptin/metformin are 2.5/500 mg and 2.5/1000 mg.
- DPP-4 inhibitors of this invention refers to those orally administered DPP-4 inhibitors which are therapeutically efficacious at low dose levels, e.g. at dose levels ⁇ 100 mg or ⁇ 70 mg per patient per day, preferably ⁇ 50 mg, more preferably ⁇ 30 mg or ⁇ 20 mg, even more preferably from 1 mg to 10 mg (if required, divided into 1 to 4 single doses, particularly 1 or 2 single doses, which may be of the same size), particularly from 1 mg to 5 mg (more particularly 5 mg), per patient per day, preferentially, administered orally once-daily, more preferentially, at any time of day, administered with or without food.
- the daily oral amount 5 mg BI 1356 can be given in a once daily dosing regimen (i.e. 5 mg BI 1356 once daily) or in a twice daily dosing regimen (i.e. 2.5 mg BI 1356 twice daily), at any time of day, with or without food.
- a particularly preferred DPP-4 inhibitor to be emphasized within the meaning of this invention is 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine (also known as BI 1356).
- BI 1356 exhibits high potency, 24h duration of action, and a wide therapeutic window.
- BI 1356 shows favourable pharmacodynamic and pharmacokinetic profile (see e.g. Table 1 below) with rapid attainment of steady state (e.g.
- BI 1356 acts as a true once-daily oral drug with a full 24 h duration of DPP-4 inhibition.
- BI 1356 is mainly excreted via the liver and only to a minor extent (about ⁇ 7% of the administered oral dose) via the kidney.
- BI 1356 is primarily excreted unchanged via the bile.
- the fraction of BI 1356 eliminated via the kidneys increases only very slightly over time and with increasing dose, so that there will likely be no need to modify the dose of BI 1356 based on the patients' renal function.
- the non-renal elimination of BI 1356 in combination with its low accumulation potential and broad safety margin may be of significant benefit in a patient population that has a high prevalence of renal insufficiency and diabetic nephropathy.
- a DPP-4 inhibitor is combined with active substances customary for the respective disorders, such as e.g. one or more active substances selected from among the other antidiabetic substances, especially active substances that lower the blood sugar level or the lipid level in the blood, raise the HDL level in the blood, lower blood pressure or are indicated in the treatment of atherosclerosis or obesity.
- DPP-4 inhibitors mentioned above may also be used in conjunction with other active substances, by means of which improved treatment results can be obtained.
- Such a combined treatment may be given as a free combination of the substances or in the form of a fixed combination, for example in a tablet or capsule.
- compositions of the combination partner needed for this may either be obtained commercially as pharmaceutical compositions or may be formulated by the skilled man using conventional methods.
- the active substances which may be obtained commercially as pharmaceutical compositions are described in numerous places in the prior art, for example in the list of drugs that appears annually, the “Rote Liste®” of the federal association of the pharmaceutical industry, or in the annually updated compilation of manufacturers' information on prescription drugs known as the “Physicians' Desk Reference”.
- Examples of antidiabetic combination partners are metformin; sulphonylureas such as glibenclamide, tolbutamide, glimepiride, glipizide, gliquidon, glibornuride and gliclazide; nateglinide; repaglinide; thiazolidinediones such as rosiglitazone and pioglitazone; PPAR gamma modulators such as metaglidases; PPAR-gamma agonists such as GI 262570; PPAR-gamma antagonists; PPAR-gamma/alpha modulators such as tesaglitazar, muraglitazar, aleglitazar, indeglitazar and KRP297; PPAR-gamma/alpha/delta modulators; AMPK-activators such as AICAR; acetyl-CoA carboxylase (ACC1 and ACC2) inhibitors; diacylglycerol-ace
- exenatide exenatide LAR, liraglutide, taspoglutide, AVE-0010, LY-2428757, LY-2189265, semaglutide or albiglutide; SGLT2-inhibitors such as KGT-1251; inhibitors of protein tyrosine-phosphatase; inhibitors of glucose-6-phosphatase; fructose-1,6-bisphosphatase modulators; glycogen phosphorylase modulators; glucagon receptor antagonists; phosphoenolpyruvatecarboxykinase (PEPCK) inhibitors; pyruvate dehydrogenasekinase (PDK) inhibitors; inhibitors of tyrosine-kinases (50 mg to 600 mg) such as PDGF-receptor-kinase (cf.
- PEPCK phosphoenolpyruvatecarboxykinase
- PDK pyruvate dehydrogenasekinase
- dapagliflozin, sergliflozin, atigliflozin, larnagliflozin or canagliflozin or compound of formula (I-S) or (I-K) from WO 2009/035969); KV 1.3 channel inhibitors; GPR40 modulators; SCD-1 inhibitors; CCR-2 antagonists; dopamine receptor agonists (bromocriptine mesylate [Cycloset]); and other DPP IV inhibitors.
- Metformin is usually given in doses varying from about 500 mg to 2000 mg up to 2500 mg per day using various dosing regimens from about 100 mg to 500 mg or 200 mg to 850 mg (1-3 times a day), or about 300 mg to 1000 mg once or twice a day, or delayed-release metformin in doses of about 100 mg to 1000 mg or preferably 500 mg to 1000 mg once or twice a day or about 500 mg to 2000 mg once a day.
- Particular dosage strengths may be 250, 500, 625, 750, 850 and 1000 mg of metformin hydrochloride.
- a dosage of pioglitazone is usually of about 1-10 mg, 15 mg, 30 mg, or 45 mg once a day.
- Rosiglitazone is usually given in doses from 4 to 8 mg once (or divided twice) a day (typical dosage strengths are 2, 4 and 8 mg).
- Glibenclamide is usually given in doses from 2.5-5 to 20 mg once (or divided twice) a day (typical dosage strengths are 1.25, 2.5 and 5 mg), or micronized glibenclamide in doses from 0.75-3 to 12 mg once (or divided twice) a day (typical dosage strengths are 1.5, 3, 4.5 and 6 mg).
- Glipizide is usually given in doses from 2.5 to 10-20 mg once (up to 40 mg divided twice) a day (typical dosage strengths are 5 and 10 mg), or extended-release glipizide in doses from 5 to 10 mg (up to 20 mg) once a day (typical dosage strengths are 2.5, 5 and 10 mg).
- Glimepiride is usually given in doses from 1-2 to 4 mg (up to 8 mg) once a day (typical dosage strengths are 1, 2 and 4 mg).
- a dual combination of glibenclamide/metformin is usually given in doses from 1.25/250 once daily to 10/1000 mg twice daily (typical dosage strengths are 1.25/250, 2.5/500 and 5/500 mg).
- a dual combination of glipizide/metformin is usually given in doses from 2.5/250 to 10/1000 mg twice daily (typical dosage strengths are 2.5/250, 2.5/500 and 5/500 mg).
- a dual combination of glimepiride/metformin is usually given in doses from 1/250 to 4/1000 mg twice daily.
- a dual combination of rosiglitazone/glimepiride is usually given in doses from 4/1 once or twice daily to 4/2 mg twice daily (typical dosage strengths are 4/1, 4/2, 4/4, 8/2 and 8/4 mg).
- a dual combination of pioglitazone/glimepiride is usually given in doses from 30/2 to 30/4 mg once daily (typical dosage strengths are 30/4 and 45/4 mg).
- a dual combination of rosiglitazone/metformin is usually given in doses from 1/500 to 4/1000 mg twice daily (typical dosage strengths are 1/500, 2/500, 4/500, 2/1000 and 4/1000 mg).
- a dual combination of pioglitazone/metformin is usually given in doses from 15/500 once or twice daily to 15/850 mg thrice daily (typical dosage strengths are 15/500 and 15/850 mg).
- the non-sulphonylurea insulin secretagogue nateglinide is usually given in doses from 60 to 120 mg with meals (up to 360 mg/day, typical dosage strengths are 60 and 120 mg); repaglinide is usually given in doses from 0.5 to 4 mg with meals (up to 16 mg/day, typical dosage strengths are 0.5, 1 and 2 mg).
- a dual combination of repaglinide/metformin is available in dosage strengths of 1/500 and 2/850 mg.
- Acarbose is usually given in doses from 25 to 100 mg with meals (up to 300 mg/day, typical dosage strengths are 25, 50 and 100 mg).
- Miglitol is usually given in doses from 25 to 100 mg with meals (up to 300 mg/day, typical dosage strengths are 25, 50 and 100 mg).
- Conventional antidiabetics and antihyperglycemics typically used in mono- or dual or triple (add-on or initial) combination therapy may include, without being limited to, metformin, sulphonylureas, thiazolidinediones, glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, as well as insulin and insulin analogues, such as e.g. those agents indicated herein by way of example, including combinations thereof.
- HMG-CoA-reductase inhibitors such as simvastatin, atorvastatin, lovastatin, fluvastatin, pravastatin, pitavastatin and rosuvastatin; fibrates such as bezafibrate, fenofibrate, clofibrate, gemfibrozil, etofibrate and etofyllinclofibrate; nicotinic acid and the derivatives thereof such as acipimox; PPAR-alpha agonists; PPAR-delta agonists; inhibitors of acyl-coenzyme A:cholesterolacyltransferase (ACAT; EC 2.3.1.26) such as avasimibe; cholesterol resorption inhibitors such as ezetimib; substances that bind to bile acid, such as cholestyramine, colestipol and colesevelam; inhibitors of bile acid
- ACAT acyl-coenzyme A
- a dosage of atorvastatin is usually from 1 mg to 40 mg or 10 mg to 80 mg once a day.
- beta-blockers such as atenolol, bisoprolol, celiprolol, metoprolol and carvedilol
- diuretics such as hydrochlorothiazide, chlortalidon, xipamide, furosemide, piretanide, torasemide, spironolactone, eplerenone, amiloride and triamterene
- calcium channel blockers such as amlodipine, nifedipine, nitrendipine, nisoldipine, nicardipine, felodipine, lacidipine, lercanipidine, manidipine, isradipine, nilvadipine, verapamil, gallopamil and diltiazem
- ACE inhibitors such as ramipril, lisinopril, cilazapril, quinapril, captopril, enalapril, ben
- a dosage of telmisartan is usually from 20 mg to 320 mg or 40 mg to 160 mg per day.
- combination partners which increase the HDL level in the blood are Cholesteryl Ester Transfer Protein (CETP) inhibitors; inhibitors of endothelial lipase; regulators of ABC1; LXRalpha antagonists; LXRbeta agonists; PPAR-delta agonists; LXRalpha/beta regulators, and substances that increase the expression and/or plasma concentration of apolipoprotein A-I.
- CETP Cholesteryl Ester Transfer Protein
- combination partners for the treatment of obesity are sibutramine; tetrahydrolipstatin (orlistat); alizyme; dexfenfluramine; axokine; cannabinoid receptor 1 antagonists such as the CB1 antagonist rimonobant; MCH-1 receptor antagonists; MC4 receptor agonists; NPY5 as well as NPY2 antagonists; beta3-AR agonists such as SB-418790 and AD-9677; 5HT2c receptor agonists such as APD 356 (lorcaserin); myostatin inhibitors; Acrp30 and adiponectin; steroyl CoA desaturase (SCD1) inhibitors; fatty acid synthase (FAS) inhibitors; CCK receptor agonists; Ghrelin receptor modulators; Pyy 3-36; orexin receptor antagonists; and tesofensine; as well as the dual combinations bupropion/naltrexone, bupropion/zonisamide, topiramate/phentermine
- combination partners for the treatment of atherosclerosis are phospholipase A2 inhibitors; inhibitors of tyrosine-kinases (50 mg to 600 mg) such as PDGF-receptor-kinase (cf. EP-A-564409, WO 98/35958, U.S. Pat. No. 5,093,330, WO 2004/005281, and WO 2006/041976); oxLDL antibodies and oxLDL vaccines; apoA-1 Milano; ASA; and VCAM-1 inhibitors.
- phospholipase A2 inhibitors inhibitors of tyrosine-kinases (50 mg to 600 mg) such as PDGF-receptor-kinase (cf. EP-A-564409, WO 98/35958, U.S. Pat. No. 5,093,330, WO 2004/005281, and WO 2006/041976); oxLDL antibodies and oxLDL vaccines; apoA-1 Milano; ASA
- Sulfonylurea like glibenclamide are one of the most frequently used drugs in diabetes treatment. Long-term treatment with SU causes elevated basal insulin secretion and decreased glucose-stimulated insulin secretion. These characteristics may play an important role for the development of hypoglycemia and secondary drug failure.
- Db/db mice represent an animal model for type 2 diabetes demonstrating insulin resistance and high levels of plasma glucose. In addition, correlating with age of the animals pancreatic ß-cells of aging db/db mice fails to compensate the high glucose excursion with enhanced insulin secretion. Therefore this model is appropriate to study the glibenclamide induced secondary drug failure in comparison to a DPP-4 inhibitor (e.g. BI 1356).
- mice at 5 weeks of age are obtained from Charles River, Germany. Animals are housed in groups of 5-6 animals under a 12:12 LID cycle (lights on at 04:00 AM and lights off at 04:00 PM) in temperature and humidity controlled rooms. All animals have free access to regular rodent chow (Altromin standard #1324 chow, Denmark) and water ad libitum.
- the compound solutions are administered daily at 08.00 AM on experimental days 0-59 by per oral gavage using a gastric tube connected to a 3 ml syringe (luer-LockTM, Becton).
- Groups of 12 animals are used: vehicle, 0.5% Natrosol; BI 1356 3 mg/kg; glibenclamide 3 mg/kg. Body weight food intake and water intake is recorded daily for the first two and twice weekly for the remaining period. On experimental day 54 blood glucose and HbA1c levels are determined in semi-fed state, on day 59 an OGTT (2 g/kg) is performed.
- 10 ⁇ l blood is drawn from the tip of the tail into a microcapillary tube and measured using a Biosen S line glucose analyzer.
- FIGS. 1 . and 2 demonstrate HbA1c and glucose values following 54 day treatment of 5 weeks old female db/db mice with the indicated compounds.
- the DPP-4 inhibitor BI 1356 improves HbA1c as well as glucose values compared to control.
- the sulfonylurea glibenclamide in a concentration of 3 mg/kg impairs glucose as well as HbA1c values compared to control and BI 1356.
- FIG. 3 shows the increase in insulin during an OGTT test. Only the animals treated with BI 1356 are able to respond to the increased glucose levels with an up-regulation of insulin.
- the DPP-4 inhibitor BI 1356 is superior to glibenclamide regarding insulin secretion and lowering of HbA1c and glucose.
- a DPP-4 inhibitor according to the invention e.g. 5 mg of BI 1356 administered orally once daily
- HbA1c insufficient glycemic control
- one or two conventional antihyperglycemic agents such as e.g. a sulphonylurea drug.
- the success of the treatment is tested by determining the HbA1c value, by comparison with the initial value and/or with the value of the placebo group. A significant change in the HbA1c value compared with the initial value and/or the placebo value demonstrates the efficacy of the DPP-4 inhibitor for the treatment.
- the success of the treatment can be also tested by determining the fasting plasma glucose values, by comparison with the initial values and/or with the values of the placebo group. A significant drop in the fasting glucose levels demonstrates the efficacy of the treatment. Also, the occurrence of a treat to target response (i.e. an HbA1c under treatment ⁇ 7%) demonstrates the efficacy of the treatment.
- the safety and tolerability of the treatment is investigated by assessing patient's condition and relevant changes from baseline, e.g. incidence and intensity of adverse events (such as e.g. hypoglycaemic episodes or the like) or weight gain.
- adverse events such as e.g. hypoglycaemic episodes or the like
- weight gain e.g. weight gain
Abstract
The present invention relates to the finding that certain DPP-4 inhibitors are particularly suitable for treating and/or preventing metabolic diseases, particularly diabetes, in patients with insufficient glycemic control despite a therapy with an oral and/or a non-oral antidiabetic drug.
Description
- The present invention relates to certain DPP-4 inhibitors for treating and/or preventing metabolic diseases, particularly diabetes (especially type 2 diabetes mellitus) and conditions related thereto, in patients with insufficient glycemic control despite a therapy with an oral and/or a non-oral antidiabetic drug (particularly an insulin secretagogue, like a sulphonylurea or glinide drug), as well as to the use of these DPP-4 inhibitors in said treatment and/or prevention. Pharmaceutical compositions for treating and/or preventing metabolic diseases (particularly diabetes) in these patients comprising a DPP-4 inhibitor as defined herein optionally together with one or more other active substances are also contemplated.
- Type 2 diabetes mellitus is a common chronic and progressive disease arising from a complex pathophysiology involving the dual endocrine effects of insulin resistance and impaired insulin secretion. The treatment of type 2 diabetes typically begins with diet and exercise, followed by oral antidiabetic monotherapy, and although conventional monotherapy may initially control blood glucose in some patients, it is however associated with a high secondary failure rate. The limitations of single-agent therapy for maintaining glycemic control may be overcome, at least in some patients, and for a limited period of time by combining multiple oral drugs to achieve reductions in blood glucose that cannot be sustained during long-term therapy with single agents. Available data support the conclusion that in most patients with type 2 diabetes monotherapy will fail and treatment with multiple drugs will be required.
- But, because type 2 diabetes is a progressive disease, even patients with good initial responses to combination therapy will eventually require an increase of the dosage or further treatment with insulin because the blood glucose level is very difficult to maintain stable for a long period of time. Thus, although existing combination therapy has the potential to enhance glycemic control, it is not without limitations (especially with regard to long term efficacy). Further, many results indicate that the risk for hypoglycemia may increase with traditional combination therapy, and the requirement for multiple medications may also reduce patient compliance. In addition, taking multiple antihyperglycemic drugs increases the potential for pharmacokinetic interactions with other medications that the patient may be taking.
- Thus, for many patients, these existing drug therapies result in progressive deterioration in glycemic control despite treatment and do not sufficiently control glycemia especially over long-term and thus fail to achieve and to maintain metabolic control in advanced or late stage type 2 diabetes, including diabetes with inadequate glycemic control despite conventional oral or non-oral antidiabetic medication, diabetes with secondary drug failure and/or with indication on insulin.
- Therefore, although intensive treatment of hyperglycemia can reduce the incidence of chronic damages, many patients with type 2 diabetes remain inadequately treated, partly because of limitations in long term efficacy, tolerability and dosing inconvenience of conventional antihyperglycemic therapies.
- This high incidence of therapeutic failure is a major contributor to the high rate of long-term hyperglycemia-associated complications or chronic damages (including micro- and macrovascular complications such as e.g. diabetic nephropathy, retinopathy or neuropathy, or cardiovascular complications) in patients with type 2 diabetes.
- Oral antidiabetic drugs conventionally used in therapy (such as e.g. first- or second-line, and/or mono- or (initial or add-on) combination therapy) include, without being restricted thereto, metformin, sulphonylureas, thiazolidinediones, glinides and α-glucosidase inhibitors.
- Non-oral antidiabetic drugs conventionally used in therapy (such as e.g. first- or second-line, and/or mono- or (initial or add-on) combination therapy) include, without being restricted thereto, GLP-1 or GLP-1 analogues, and insulin or insulin analogues.
- However, the use of these conventional antidiabetic or antihyperglycemic agents can be associated with various adverse effects. For example, metformin can be associated with lactic acidosis or gastrointestinal side effects; sulfonylureas, glinides and insulin or insulin analogues can be associated with hypoglycemia and weight gain; thiazolidinediones can be associated with edema, bone fracture, weight gain and heart failure/cardiac effects; and alpha-glucosidase blockers and GLP-1 or GLP-1 analogues can be associated with gastrointestinal adverse effects (e.g. dyspepsia, flatulence or diarrhea, or nausea or vomiting).
- Sulphonylureas (SU), as well as glinides, stimulate insulin secretion from pancreatic beta-cells in a non-glucose-dependent manner and are generally and frequently used as a first- or second-line (mono- or combination) treatment in type 2 diabetes (especially indicated for non-obese patients and/or for patients ineligible for or with failure in metformin therapy). However, as mentioned above, some patients do not always respond well to these conventional oral antidiabetic agents especially in long-term treatment and may show insufficient or deterioration in glycemic control despite treatment with a sulphonylurea drug (secondary SU failure). Also, patients on long-term sulfonylurea therapy experience a decline or an exhaustion in pancreatic beta cell function over time.
- For those patients who are in a condition in which sulfonylureas alone (monotherapy) are ineffective in controlling blood glucose levels, change to other oral medication (e.g. to metformin/thiazolidinedione) or to SU combination therapy (including add-on and initial dual and triple SU combination therapy), especially combination of a sulfonylurea with metformin and/or with a thiazolidinedione, may be indicated depending on the disease stage, and/or combination with or (ultimately) transfer to insulin (such as e.g., depending on disease stage, once-daily basal insulin, twice-daily premix insulin or multiple daily insulin). However, even in combination therapy, some patients may show insufficient or deterioration in glycemic control despite combination treatment, especially over time.
- Thus, continuing loss of efficacy over time is a major concern with the use of insulin secretagogues including glinides and sulfonylureas (secondary SU failure). Furthermore, sulfonylureas increase plasma levels of insulin and may cause hypoglycaemia, which is—besides weight gain—one of their major adverse effects, particularly in association with renal impairment and/or in elderly patients. Thus, within SU medication, on the one side, with regard to efficacy, sometimes an increased sulfonylurea dose may be required, whereas, on the other side, with regard to safety/tolerability, sometimes a decreased sulfonylurea dose may be required, thus requiring often an unsatisfying compromise in SU medication.
- Therefore, it remains a need in the art to provide efficacious, safe and tolerable antidiabetic therapies for these patients with advanced or late stage type 2 diabetes mellitus, including patients with inadequate glycemic control on conventional oral and/or non-oral antidiabetic drugs, such as e.g. metformin, sulphonylureas, thiazolidinediones, glinides and/or α-glucosidase inhibitors, and/or GLP-1 or GLP-1 analogues, and/or insulin or insulin analogues.
- Further, it remains a need in the art to provide adequate glycemic control for diabetic patients with secondary oral antidiabetic drug failure.
- Further, it remains a need in the art to provide prevention (including preventing or slowing the progression) of secondary oral antidiabetic drug failure.
- Further, it remains a need in the art to provide prevention or reduction of risk for adverse effects associated with (conventional) antidiabetic therapy.
- In the monitoring of the treatment of diabetes mellitus the HbA1c value, the product of a non-enzymatic glycation of the haemoglobin B chain, is of exceptional importance. As its formation depends essentially on the blood sugar level and the life time of the erythrocytes the HbA1c in the sense of a “blood sugar memory” reflects the average blood sugar level of the preceding 4-12 weeks. Diabetic patients whose HbA1c level has been well controlled over a long time by more intensive diabetes treatment (i.e. <6.5% of the total haemoglobin in the sample) are significantly better protected from diabetic microangiopathy. The available treatments for diabetes can give the diabetic an average improvement in their HbA1c level of the order of 1.0-1.5%. This reduction in the HbA1C level is not sufficient in all diabetics to bring them into the desired target range of <7.0%, preferably <6.5% and more preferably <6% HbA1c.
- Within glycemic control, in addition to improvement of the HbA1c level, other recommended therapeutic goals for type 2 diabetes mellitus patients are improvement of fasting plasma glucose (FPG) and of postprandial plasma glucose (PPG) levels to normal or as near normal as possible. Recommended desired target ranges of preprandial (fasting) plasma glucose are 90-130 mg/dL (or 70-130 mg/dL) or <110 mg/dL, and of two-hour postprandial plasma glucose are <180 mg/dL or <140 mg/dL.
- Within the meaning of this invention, patients with insufficient glycemic control despite a therapy with an oral or non-oral antidiabetic drug include, without being limited to, patients having a HbA1c value from 7.0 to 10% (or from 7.5 to 11%, or from 7.5 to 10%) despite treatment with said drug.
- An embodiment of diabetic patients with secondary oral antidiabetic drug failure within the meaning of this invention refers to patients ineligible for metformin therapy including
-
- patients for whom metformin therapy is contraindicated, e.g. patients having one or more contraindications against metformin therapy according to label, such as for example patients with at least one contraindication selected from:
- renal disease, renal impairment or renal dysfunction (e.g., as specified by product information of locally approved metformin),
- dehydration,
- unstable or acute congestive heart failure,
- acute or chronic metabolic acidosis, and
- hereditary galactose intolerance;
and
- patients who suffer from one or more intolerable side effects attributed to metformin, particularly gastrointestinal side effects associated with metformin, such as for example patients suffering from at least one gastrointestinal side effect selected from:
- nausea,
- vomiting,
- diarrhoea,
- intestinal gas, and
- severe abdominal discomfort.
- patients for whom metformin therapy is contraindicated, e.g. patients having one or more contraindications against metformin therapy according to label, such as for example patients with at least one contraindication selected from:
- An embodiment of the patients which may be amenable to the therapies of this invention may include, without being limited, those diabetes patients for whom normal metformin therapy is not appropriate, such as e.g. those diabetes patients who need reduced dose metformin therapy due to reduced tolerability, intolerability or contraindication against metformin or due to (mildly) impaired/reduced renal function (including elderly patients, e.g. 60-65 years).
- Further, due to increased susceptibility for adverse effects, treatment of the elderly patients (≥60-70 years) should be often accompanied by careful monitoring of renal function. Metformin is usually not recommended in elderly individuals, particularly 80 years, unless measurement of creatinine clearance demonstrates that renal function is not reduced. Thus, patients ineligible for metformin therapy may also include, without being limited to, elderly patients, e.g. ≥60-65 years or particularly 80 years.
- A further embodiment of diabetic patients with secondary oral antidiabetic drug failure within the meaning of this invention refers to patients having renal disease, renal dysfunction, or insufficiency or impairment of renal function (including mild, moderate and severe renal impairment), e.g. as suggested by elevated serum creatinine levels (e.g. serum creatinine levels above the upper limit of normal for their age, e.g. 130-150 μmol/l, or 1.5 mg/dl 136 μmol/l) in men and 1.4 mg/dl 124 μmol/l) in women) or abnormal creatinine clearance (e.g. glomerular filtration rate (GFR) 30-60 ml/min).
- In this context, for more detailed example, mild renal impairment may be e.g. suggested by a creatinine clearance of 50-80 ml/min (approximately corresponding to serum creatine levels of 1.7 mg/dL in men and 1.5 mg/dL in women); moderate renal impairment may be e.g. suggested by a creatinine clearance of 30-50 ml/min (approximately corresponding to serum creatine levels of >1.7 to 3.0 mg/dL in men and >1.5 to 2.5 mg/dL in women); and severe renal impairment may be e.g. suggested by a creatinine clearance of <30 ml/min (approximately corresponding to serum creatine levels of >3.0 mg/dL in men and >2.5 mg/dL in women). Patients with end-stage renal disease require dialysis.
-
FIG. 1 . demonstrates HbA1c values following 54 day treatment of 5 weeks old female db/db mice with the indicated compounds (left bar: vehicle; middle bar:BI 1356; right bar: glibenclamide). -
FIG. 2 demonstrates glucose values following 54 day treatment of 5 weeks old female db/db mice with the indicated compounds (left bar: vehicle; middle bar:BI 1356; right bar: glibenclamide). -
FIG. 3 shows the increase in insulin during an OGTT test. Only the animals treated withBI 1356 are able to respond to the increased glucose levels with an up-regulation of insulin (left bar: vehicle; middle bar:BI 1356; right bar: glibenclamide). - The enzyme DPP-4 (dipeptidyl peptidase IV) also known as CD26 is a serine protease known to lead to the cleavage of a dipeptide from the N-terminal end of a number of proteins having at their N-terminal end a proline or alanine residue. Due to this property DPP-4 inhibitors interfere with the plasma level of bioactive peptides including the peptide GLP-1 and are considered to be promising drugs for the treatment of diabetes mellitus.
- For example, DPP-4 inhibitors and their uses, particularly their uses in metabolic (especially diabetic) diseases, are disclosed in WO 2002/068420, WO 2004/018467, WO 2004/018468, WO 2004/018469, WO 2004/041820, WO 2004/046148, WO 2005/051950, WO 2005/082906, WO 2005/063750, WO 2005/085246, WO 2006/027204, WO 2006/029769 or WO2007/014886; or in WO 2004/050658, WO 2004/111051, WO 2005/058901 or WO 2005/097798; or in WO 2006/068163, WO 2007/071738 or WO 2008/017670; or in WO 2007/128721 or WO 2007/128761.
- As further DPP-4 inhibitors the following compounds can be mentioned:
-
- Sitagliptin (MK-0431) having the structural formula A below is (3R)-3-amino-1-[3-(trifluoromethyl)-5,6,7,8-tetrahydro-5H-[1,2,4]triazolo[4,3-a]pyrazin-7-yl]-4-(2,4,5-trifluorophenyl)butan-1-one, also named (2R)-4-oxo-4-[3-(trifluoromethyl)-5,6-dihydro[1,2,4]triazolo[4,3-a]pyrazin-7(8H)-yl]-1-(2,4,5-trifluorophenyl)butan-2-amine,
- In one embodiment, sitagliptin is in the form of its dihydrogenphosphate salt, i.e. sitagliptin phosphate. In a further embodiment, sitagliptin phosphate is in the form of a crystalline anhydrate or monohydrate. A class of this embodiment refers to sitagliptin phosphate monohydrate. Sitagliptin free base and pharmaceutically acceptable salts thereof are disclosed in U.S. Pat. No. 6,699,871 and in Example 7 of WO 03/004498. Crystalline sitagliptin phosphate monohydrate is disclosed in WO 2005/003135 and in WO 2007/050485.
- For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
- A tablet formulation for sitagliptin is commercially available under the trade name Januvia®. A tablet formulation for sitagliptin/metformin combination is commercially available under the trade name Janumet®.
-
- Vildagliptin (LAF-237) having the structural formula B below is (2S)-{[(3-hydroxyadamantan-1-yl)amino]acetyl}pyrrolidine-2-carbonitrile, also named (S)-1-[(3-hydroxy-1-adamantyl)amino]acetyl-2-cyano-pyrrolidine,
- Vildagliptin is specifically disclosed in U.S. Pat. No. 6,166,063 and in Example 1 of WO 00/34241. Specific salts of vildagliptin are disclosed in WO 2007/019255. A crystalline form of vildagliptin as well as a vildagliptin tablet formulation are disclosed in WO 2006/078593. Vildagliptin can be formulated as described in WO 00/34241 or in WO 2005/067976. A modified release vildagliptin formulation is described in WO 2006/135723.
- For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
- A tablet formulation for vildagliptin is expected to be commercially available under the trade name Galvus®. A tablet formulation for vildagliptin/metformin combination is commercially available under the trade name Eucreas®.
-
- Saxagliptin (BMS-477118) having the structural formula C below is (1S,3S,5S)-2-{(2S)-2-amino-2-(3-hydroxyadamantan-1-Aacetyl}-2-azabicyclo[3.1.0]hexane-3-carbonitrile, also named (S)-3-hydroxyadamantylglycine-L-cis-4,5-methanoprolinenitrile,
- Saxagliptin is specifically disclosed in U.S. Pat. No. 6,395,767 and in Example 60 of WO 01/68603.
- In one embodiment, saxagliptin is in the form of its HCl salt or its mono-benzoate salt as disclosed in WO 2004/052850. In a further embodiment, saxagliptin is in the form of the free base. In a yet further embodiment, saxagliptin is in the form of the monohydrate of the free base as disclosed in WO 2004/052850. Crystalline forms of the HCl salt and the free base of saxagliptin are disclosed in WO 2008/131149. A process for preparing saxagliptin is also disclosed in WO 2005/106011 and WO 2005/115982. Saxagliptin can be formulated in a tablet as described in WO 2005/117841.
- For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- Alogliptin (SYR-322) having the structural formula E below is 2-({6-[(3R)-3-aminopiperidin-1-yl]-3-methyl-2,4-dioxo-3,4-dihydro-2H-pyrimidin-1-yl}methyl)benzonitrile
- Alogliptin is specifically disclosed in US 2005/261271, EP 1586571 and in WO 2005/095381. In one embodiment, alogliptin is in the form of its benzoate salt, its hydrochloride salt or its tosylate salt each as disclosed in WO 2007/035629. A class of this embodiment refers to alogliptin benzoate. Polymorphs of alogliptin benzoate are disclosed in WO 2007/035372. A process for preparing alogliptin is disclosed in WO 2007/112368 and, specifically, in WO 2007/035629. Alogliptin (namely its benzoate salt) can be formulated in a tablet and administered as described in WO 2007/033266. Formulations of Alogliptin with metformin or pioglitazone are described in WO 2008/093882 or WO 2009/011451, respectively.
- For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- (2S)-1-{[2-(5-Methyl-2-phenyl-oxazol-4-yl)-ethylamino]-acetyl}-pyrrolidine-2-carbonitrile or a pharmaceutically acceptable salt thereof, preferably the mesylate, or (2S)-1-{[1,1,-Dimethyl-3-(4-pyridin-3-yl-imidazol-1-yl)-propylamino]-acetyl}-pyrrolidine-2-carbonitrile or a pharmaceutically acceptable salt thereof:
- These compounds and methods for their preparation are disclosed in WO 03/037327. The mesylate salt of the former compound as well as crystalline polymorphs thereof are disclosed in WO 2006/100181. The fumarate salt of the latter compound as well as crystalline polymorphs thereof are disclosed in WO 2007/071576. These compounds can be formulated in a pharmaceutical composition as described in WO 2007/017423.
- For details, e.g. on a process to manufacture, to formulate or to use these compounds or salts thereof, reference is thus made to these documents.
-
- (S)-1-((2S,3S,11bS)-2-Amino-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-2H-pyrido[2,1-a]isoquinolin-3-yl)-4-fluoromethyl-pyrrolidin-2-one or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2005/000848. A process for preparing this compound (specifically its dihydrochloride salt) is also disclosed in WO 2008/031749, WO 2008/031750 and WO 2008/055814. This compound can be formulated in a pharmaceutical composition as described in WO 2007/017423.
- For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- (3,3-Difluoropyrrolidin-1-yl)-((2S,4S)-4-(4-(pyrimidin-2-yl)piperazin-1-yl)pyrrolidin-2-yl)methanone (also named gosogliptin) or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2005/116014 and U.S. Pat. No. 7,291,618.
- For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- (1((3S,4S)-4-amino-1-(4-(3,3-difluoropyrrolidin-1-yl)-1,3,5-triazin-2-yl)pyrrolidin-3-yl)-5,5-difluoropiperidin-2-one or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2007/148185 and US 20070299076. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- (2S,4S)-1-{2-[(3S,1R)-3-(1H-1,2,4-Triazol-1-ylmethyl)cyclopentylamino]-acetyl}-4-fluoropyrrolidine-2-carbonitrile (also named melogliptin) or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2006/040625 and WO 2008/001195. Specifically claimed salts include the methanesulfonate and p-toluenesulfonate. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- (R)-2-[6-(3-Amino-piperidin-1-yl)-3-methyl-2,4-dioxo-3,4-dihydro-2H-pyrimidin-1-ylmethyl]-4-fluoro-benzonitrile or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation and use are disclosed in WO 2005/095381, US 2007060530, WO 2007/033350, WO 2007/035629, WO 2007/074884, WO 2007/112368, WO 2008/114807, WO 2008/114800 and WO 2008/033851. Specifically claimed salts include the succinate (WO 2008/067465), benzoate, benzenesulfonate, p-toluenesulfonate, (R)-mandelate and hydrochloride. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- 5-{(S)-2-[2-((S)-2-Cyano-pyrrolidin-1-yl)-2-oxo-ethylamino]-propyl}-5-(1H-tetrazol-5-yl)-10,11-dihydro-5H-dibenzo[a,d]cycloheptene-2,8-dicarboxylic acid bis-dimethylamide or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2006/116157 and US 2006/270701. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- 3-{(2S,4S)-4-[4-(3-Methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl]pyrrolidin-2-ylcarbonyl}thiazolidine (also named teneligliptin) or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 02/14271. Specific salts are disclosed in WO 2006/088129 and WO 2006/118127 (including hydrochloride, hydrobromide, inter alia). Combination therapy using this compound is described in WO 2006/129785. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- [(2R)-1-{[(3R)-pyrrolidin-3-ylamino]acetyl}pyrrolidin-2-yl]boronic acid (also named dutogliptin) or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2005/047297, WO 2008/109681 and WO 2009/009751. Specific salts are disclosed in WO 2008/027273 (including citrate, tartrate). A formulation of this compound is described in WO 2008/144730. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- (2S,4S)-1-[2-[(4-ethoxycarbonylbicyclo[2.2.2]oct-1-yl)amino]acetyI]-4-fluoropyrrolidine-2-carbonitrile or a pharmaceutically acceptable salt thereof:
- This compound and methods for its preparation are disclosed in WO 2005/075421, US 2008/146818 and WO 2008/114857. For details, e.g. on a process to manufacture, to formulate or to use this compound or a salt thereof, reference is thus made to these documents.
-
- 2-({6-[(3R)-3-amino-3-methylpiperidin-1-yl]-1,3-dimethyl-2,4-dioxo-1,2,3,4-tetrahydro-5H-pyrrolo[3,2-d]pyrimidin-5-yl}methyl)-4-fluorobenzonitrile or a pharmaceutically acceptable salt thereof, or 6-[(3R)-3-amino-piperidin-1-yl]-5-(2-chloro-5-fluoro-benzyl)-1,3-dimethyl-1,5-dihydro-pyrrolo[3,2-d]pyrimidine-2,4-dione or a pharmaceutically acceptable salt thereof:
- These compounds and methods for their preparation are disclosed in WO 2009/084497 and WO 2006/068163, respectively. For details, e.g. on a process to manufacture, to formulate or to use these compounds or salts thereof, reference is thus made to these documents.
- For avoidance of any doubt, the disclosure of each of the foregoing documents cited above is specifically incorporated herein by reference in its entirety.
- Within the scope of the present invention it has now surprisingly been found that DPP-4 inhibitors as defined herein have unexpected and particularly advantageous properties, which make them particularly suitable for treating and/or preventing (including preventing or slowing the progression or delaying the onset) of metabolic diseases, particularly diabetes (especially type 2 diabetes mellitus) and conditions related thereto (e.g. diabetic complications), in advanced or late stage type 2 diabetes patients, including patients with insufficient glycemic control despite a therapy with an oral and/or a non-oral antidiabetic drug and/or with indication on insulin.
- Thus, the present invention provides a DPP-4 inhibitor as defined herein for use in the treatment of patients with insufficient glycemic control despite a therapy (including mono-, dual or triple medication) with one or more conventional oral antidiabetic drugs selected from metformin, sulphonylureas, thiazolidinediones, glinides and α-glucosidase inhibitors.
- In another embodiment, the present invention provides a DPP-4 inhibitor as defined herein for use in the treatment of patients with insufficient glycemic control despite therapy (including mono-, dual or triple medication) with one, two or three conventional oral or non-oral antidiabetic drugs selected from metformin, sulphonylureas, thiazolidinediones, glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues; for example, despite mono-therapy with metformin, a sulphonylurea, pioglitazone or (basal) insulin, or despite dual combination therapy with a metformin/pioglitazone, metformin/sulphonylurea, metformin/(basal) insulin, sulphonylurea/pioglitazone, sulphonylurea/(basal) insulin or pioglitazone/(basal) insulin combination.
- The present invention further provides a DPP-4 inhibitor as defined herein for use in the treatment of diabetes patients with insufficient glycemic control despite mono-therapy with a sulphonylurea, or despite dual combination therapy with a metformin/sulphonylurea, sulphonylurea/pioglitazone or sulphonylurea/(basal) insulin combination.
- In particular, the present invention provides a DPP-4 inhibitor as defined herein for use in the treatment of patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- The present invention further provides a DPP-4 inhibitor as defined herein for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- The present invention further provides a DPP-4 inhibitor as defined herein for use in the treatment and/or prevention of diabetes with secondary sulphonylurea failure.
- The present invention further provides the use of a DPP-4 inhibitor as defined herein for the manufacture of a pharmaceutical composition for treating and/or preventing metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- The present invention further provides a pharmaceutical composition for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said pharmaceutical composition comprising a DPP-4 inhibitor as defined herein and optionally one or more pharmaceutically acceptable carriers and/or diluents.
- The present invention further provides a fixed or non-fixed combination including a kit-of-parts for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said combination comprising a DPP-4 inhibitor as defined herein and optionally one or more other active substances, e.g. any of those mentioned herein.
- The present invention further provides the use of a DPP-4 inhibitor as defined herein in combination with one or more other active substances, such as e.g. any of those mentioned herein, for the manufacture of a pharmaceutical composition for treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug.
- The present invention further provides a pharmaceutical composition for use in the treatment and/or prevention of metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said pharmaceutical composition comprising a DPP-4 inhibitor as defined herein and optionally one or more other active substances, such as e.g. any of those mentioned herein, such as e.g. for separate, sequential, simultaneous, concurrent or chronologically staggered use of the active ingredients.
- The present invention further provides a method of treating and/or preventing metabolic diseases, particularly type 2 diabetes mellitus, in patients with insufficient glycemic control despite a therapy with a sulphonylurea drug, said method comprising administering to a subject in need thereof (particularly a human patient) an effective amount of a DPP-4 inhibitor as defined herein, optionally alone or in combination, such as e.g. separately, sequentially, simultaneously, concurrently or chronologically staggered, with an effective amount of one or more other active substances, such as e.g. any of those mentioned herein.
- In addition, the present invention provides a DPP-4 inhibitor as defined herein, optionally in (add-on or initial) combination with one or two conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 or GLP-1 analogues, and insulin or insulin analogues, for use in patients with insufficient glycemic control despite therapy with (e.g., if applicable, despite therapy with a maximal tolerated oral dose of) one, two or three conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones, glinides, alpha-glucosidase blockers, GLP-1 or GLP-1 analogues, and insulin or insulin analogues (e.g. despite mono-therapy with metformin, a sulphonylurea, pioglitazone or (basal) insulin, or despite dual combination therapy with a metformin/pioglitazone, metformin/sulphonylurea, metformin/(basal) insulin, sulphonylurea/pioglitazone, sulphonylurea/(basal) insulin or pioglitazone/(basal) insulin combination).
- In a further embodiment of the present invention, it is provided a DPP-4 inhibitor as defined herein, optionally in combination with one conventional antihyperglycemic agent selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues, for use in (second line) therapy of type 2 diabetes patients who are insufficiently controlled on said conventional antihyperglycemic agent alone.
- In a further embodiment of the present invention, it is provided a DPP-4 inhibitor as defined herein, optionally in combination with two conventional antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues, for use in (third line) therapy of type 2 diabetes patients who are insufficiently controlled on a dual combination of said conventional antihyperglycemic agents.
- In a further embodiment of the present invention, it is provided a DPP-4 inhibitor as defined herein, in combination with a conventional antihyperglycemic agent selected from the group consisting of metformin, pioglitazone, a sulphonylurea, and insulin; for use in therapy of type 2 diabetes patients with insufficient glycemic control on the conventional antihyperglycemic agent alone.
- In a further embodiment of the present invention, it is provided a DPP-4 inhibitor as defined herein, in combination with two conventional antihyperglycemic agents selected from the group consisting of the following combinations: metformin and pioglitazone, metformin and a sulphonylurea, metformin and insulin, a sulphonylurea and pioglitazone, a sulphonylurea and insulin, and pioglitazone and insulin; for use in therapy of type 2 diabetes patients with insufficient glycemic control on the two conventional antihyperglycemic agents.
- In particular, the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite mono-therapy with a maximal tolerated dose of a sulphonylurea.
- Further, the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea and metformin for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite dual combination therapy with a sulphonylurea and metformin.
- Further, the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea and pioglitazone for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite dual combination therapy with a sulphonylurea and pioglitazone.
- Further, the present invention provides a DPP-4 inhibitor as defined herein in combination with a sulphonylurea and insulin for use in the treatment of type 2 diabetes patients with insufficient glycemic control despite dual combination therapy with a sulphonylurea and insulin.
- Further, the DPP-4 inhibitors as defined herein may be useful in one or more of the following methods
-
- for preventing, slowing progression of, delaying, or treating a metabolic disorder;
- for improving glycemic control and/or for reducing of fasting plasma glucose, of postprandial plasma glucose and/or of glycosylated hemoglobin HbA1c;
- for preventing, slowing progression of, delaying or treating of a condition or disorder selected from the group consisting of complications of diabetes mellitus;
- for reducing the weight or preventing an increase of the weight or facilitating a reduction of the weight;
- for preventing or treating the degeneration of pancreatic beta cells and/or for improving and/or restoring the functionality of pancreatic beta cells and/or stimulating and/or restoring the functionality of pancreatic insulin secretion; and/or
- for maintaining and/or improving the insulin sensitivity and/or for treating or preventing hyperinsulinemia and/or insulin resistance;
- in diabetes patients with insufficient glycemic control despite a therapy with an oral antidiabetic drug, particularly a sulphonylurea drug (secondary SU failure).
- Examples of such metabolic diseases or disorders amenable by the therapy of this invention in patients with secondary oral antidiabetic drug failure may include, without being restricted to, Type 1 diabetes, Type 2 diabetes, inadequate glucose tolerance, insulin resistance, hyperglycemia, hyperlipidemia, hypercholesterolemia, dyslipidemia, metabolic syndrome X, obesity, hypertension, chronic systemic inflammation, retinopathy, neuropathy, nephropathy, atherosclerosis, endothelial dysfunction and osteoporosis.
- The present invention further provides the use of a DPP-4 inhibitor as defined herein, optionally in combination with one or more other active substances, such as e.g. any of those mentioned herein, for the manufacture of a medicament for one or more of the following purposes:
-
- preventing, slowing the progression of, delaying or treating a metabolic disorder or disease, such as e.g. type 1 diabetes mellitus, type 2 diabetes mellitus, impaired glucose tolerance (IGT), impaired fasting blood glucose (IFG), hyperglycemia, postprandial hyperglycemia, overweight, obesity, dyslipidemia, hyperlipidemia, hypercholesterolemia, hypertension, atherosclerosis, endothelial dysfunction, osteoporosis, chronic systemic inflammation, non alcoholic fatty liver disease (NAFLD), retinopathy, neuropathy, nephropathy and/or metabolic syndrome;
- improving glycemic control and/or for reducing of fasting plasma glucose, of postprandial plasma glucose and/or of glycosylated hemoglobin HbA1c;
- preventing, slowing, delaying or reversing progression from impaired glucose tolerance (IGT), impaired fasting blood glucose (IFG), insulin resistance and/or from metabolic syndrome to type 2 diabetes mellitus;
- preventing, reducing the risk of, slowing the progression of, delaying or treating of complications of diabetes mellitus such as micro- and macrovascular diseases, such as nephropathy, micro- or macroalbuminuria, proteinuria, retinopathy, cataracts, neuropathy, learning or memory impairment, neurodegenerative or cognitive disorders, cardio- or cerebrovascular diseases, tissue ischaemia, diabetic foot or ulcus, atherosclerosis, hypertension, endothelial dysfunction, myocardial infarction, acute coronary syndrome, unstable angina pectoris, stable angina pectoris, peripheral arterial occlusive disease, cardiomyopathy, heart failure, heart rhythm disorders, vascular restenosis, and/or stroke;
- reducing body weight or preventing an increase in body weight or facilitating a reduction in body weight;
- preventing, slowing, delaying or treating the degeneration of pancreatic beta cells and/or the decline of the functionality of pancreatic beta cells and/or for improving and/or restoring the functionality of pancreatic beta cells and/or stimulating and/or restoring the functionality of pancreatic insulin secretion;
- preventing, slowing, delaying or treating non alcoholic fatty liver disease (NAFLD) including hepatic steatosis, non-alcoholic steatohepatitis (NASH) and/or liver fibrosis;
- preventing, slowing the progression of, delaying or treating type 2 diabetes with primary or secondary failure to conventional (oral) antihyperglycemic mono- or combination therapy;
- achieving a reduction in the dose of conventional antihyperglycemic medication required for adequate therapeutic effect;
- reducing the risk for adverse effects associated with conventional antihyperglycemic medication; and/or
- maintaining and/or improving the insulin sensitivity and/or for treating or preventing hyperinsulinemia and/or insulin resistance;
- particularly in a patient with insufficient glycemic control despite mono- or dual or triple combination therapy with conventional oral or non-oral antidiabetic drug(s) selected from metformin, sulphonylureas, thiazolidinediones (e.g. pioglitazone), glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, and insulin and insulin analogues.
- A special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in attaining and/or maintaining glycemic control in type 2 diabetes patients with secondary sulphonylurea failure.
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in preventing (including preventing or slowing the progression) of diabetes with secondary SU failure.
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in preventing or reducing the risk for adverse effects associated with SU antidiabetic therapy, such as e.g. hypoglycaemia and/or weight gain (or even for use in obtaining weight loss).
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in the treatment of diabetes with secondary sulphonylurea failure, wherein said DPP-4 inhibitor is used in add-on or initial combination therapy with a sulphonylurea mono- or dual medication (e.g. as add-on therapy to a SU medication with or without metformin) or as replacement of a sulphonylurea medication, optionally in combination with one or more other therapeutic agents, such as e.g. metformin and/or thiazolidinedione (e.g. pioglitazone).
- Another special embodiment of this invention refers to a DPP-4 inhibitor as defined herein for use in improving (e.g. mean reduction from baseline) HbA1c and/or FPG, decreasing glucose excursion and/or improving insulin secretion in patients with insufficient glycemic control (e.g. having HbA1c from 7.5 to 10% or from 7.5 to 11%) despite a therapy with a sulphonylurea drug (such as e.g. glibenclamide, glipizide or glimepiride, with or without metformin).
- Other aspects of the present invention become apparent to the skilled person from the foregoing and following remarks.
- A DPP-4 inhibitor within the meaning of the present invention includes, without being limited to, any of those DPP-4 inhibitors mentioned hereinabove and hereinbelow, preferably orally active DPP-4 inhibitors.
- An embodiment of this invention refers to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (particularly type 2 diabetes mellitus) in type 2 diabetes patients with secondary oral antidiabetic drug failure, wherein said patients further suffering from renal disease, renal dysfunction or renal impairment, particularly characterized in that said DPP-4 inhibitor is administered to said patients in the same dose levels as to patients with normal renal function, thus e.g. said DPP-4 inhibitor does not require downward dosing adjustment for impaired renal function.
- Another embodiment of this invention refers to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (particularly type 2 diabetes mellitus) in type 2 diabetes patients with secondary oral antidiabetic drug failure, wherein said patients are also with failure in or ineligible for metformin therapy or in need of metformin dose reduction due to intolerability or contraindication against metformin, such as e.g. any of those intolerabilities or contraindications defined hereinbefore or hereinafter.
- A DPP-4 inhibitor which may be suggested for the aforementioned purpose of the present invention (especially for patients with impaired renal function) may be such an oral DPP-4 inhibitor, which and whose active metabolites have preferably a relatively wide (e.g. about >100 fold) therapeutic window and/or, especially, that are primarily eliminated via hepatic metabolism or biliary excretion.
- In more detail, a DPP-4 inhibitor particularly suitable for the aforementioned purpose of the present invention (especially for patients with impaired renal function) may be such an orally administered DPP-4 inhibitor, which has a relatively wide (e.g. >100 fold) therapeutic window and/or which fulfils one or more of the following pharmacokinetic properties (preferably at its therapeutic oral dose levels):
-
- The DPP-4 inhibitor is substantially or mainly excreted via the liver (e.g. >80% or even >90% of the administered oral dose), and/or for which renal excretion represents no substantial or only a minor elimination pathway (e.g. <10%, preferably <7%, of the administered oral dose measured, for example, by following elimination of a radiolabelled carbon (14C) substance oral dose);
- The DPP-4 inhibitor is excreted mainly unchanged as parent drug (e.g. with a mean of >70%, or >80%, or, preferably, 90% of excreted radioactivity in urine and faeces after oral dosing of radiolabelled carbon (14C) substance), and/or which is eliminated to a non-substantial or only to a minor extent via metabolism (e.g. <30%, or <20%, or, preferably, 10%);
- The (main) metabolite(s) of the DPP-4 inhibitor is/are pharmacologically inactive. Such as e.g. the main metabolite does not bind to the target enzyme DPP-4 and, optionally, it is rapidly eliminated compared to the parent compound (e.g. with a terminal half-life of the metabolite of 20 h, or, preferably, about 16 h, such as e.g. 15.9 h).
- Further properties of the DPP-4 inhibitor, which may be attractive for the aforementioned purpose of the present invention, may be one or more of the following: Rapid attainment of steady state (e.g. reaching steady state plasma levels (>90% of the steady state plasma concentration) between second and fifth day of treatment with therapeutic oral dose levels), little accumulation (e.g. with a mean accumulation ratio RA,AUC≤1.4 with therapeutic oral dose levels), and/or preserving a long-lasting effect on DPP-4 inhibition, preferably when used once-daily (e.g. with almost complete (>90%) DPP-4 inhibition at therapeutic oral dose levels, >80% inhibition over a 24h interval after once-daily intake of therapeutic oral drug dose), significant decrease in 2h postprandial blood glucose excursions by 80% (already on first day of therapy) at therapeutic dose levels, and cumulative amount of unchanged parent compound excreted in urine on first day being below 1% of the administered dose and increasing to not more than about 3-6% in steady state.
- Thus, this invention refers also to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment), characterized in that said DPP-4 inhibitor is excreted to a non-substantial or only to a minor extent (e.g. <10%, preferably <7% of administered oral dose) via the kidney (measured, for example, by following elimination of a radiolabelled carbon (14C) substance oral dose).
- Further, this invention refers also to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment), characterized in that said DPP-4 inhibitor is excreted substantially or mainly via the liver (measured, for example, by following elimination of a radiolabelled carbon (14C) substance oral dose).
- Further, this invention refers also to a DPP-4 inhibitor for use in the treatment and/or prevention of metabolic diseases (in particular type 2 diabetes mellitus in patients for whom metformin therapy is inappropriate due to intolerability or contraindication against metformin, in more particular in patients with renal disease, renal dysfunction or renal impairment), characterized in that
- said DPP-4 inhibitor is excreted mainly unchanged as parent drug (e.g. with a mean of >70%, or >80%, or, preferably, 90% of excreted radioactivity in urine and faeces after oral dosing of radiolabelled carbon (14C) substance),
said DPP-4 inhibitor is eliminated to a non-substantial or only to a minor extent via metabolism, and/or
the main metabolite of said DPP-4 inhibitor is pharmacologically inactive or has a relatively wide therapeutic window. - In a first embodiment (embodiment A), a DPP-4 inhibitor in the context of the present invention is any DPP-4 inhibitor of
- wherein R1 denotes ([1,5]naphthyridin-2-yl)methyl, (quinazolin-2-yl)methyl, (quinoxalin-6-yl)methyl, (4-methyl-quinazolin-2-yl)methyl, 2-cyano-benzyl, (3-cyano-quinolin-2-yl)methyl, (3-cyano-pyridin-2-yl)methyl, (4-methyl-pyrimidin-2-yl)methyl, or (4,6-dimethyl-pyrimidin-2-yl)methyl and R2 denotes 3-(R)-amino-piperidin-1-yl, (2-amino-2-methyl-propyl)-methylamino or (2-(S)-amino-propyl)-methylamino, or its pharmaceutically acceptable salt.
- In a second embodiment (embodiment B), a DPP-4 inhibitor in the context of the present invention is a DPP-4 inhibitor selected from the group consisting of sitagliptin, vildagliptin, saxagliptin, alogliptin, (2S)-1-{[2-(5-Methyl-2-phenyl-oxazol-4-yl)-ethylamino]-acetyl}-pyrrolidine-2-carbonitrile, (2S)-1-{[1,1,-Dimethyl-3-(4-pyridin-3-yl-imidazol-1-yl)-propylamino]-acetyl}-pyrrolidine-2-carbonitrile, (S)-1-((2S,3S,11bS)-2-Amino-9,10-dimethoxy-1,3,4,6,7,11b-hexahydro-2H-pyrido[2,1-a]isoquinolin-3-yl)-4-fluoromethyl-pyrrolidin-2-one, (3,3-Difluoropyrrolidin-1-yl)-((2S,4S)-4-(4-(pyrimidin-2-yl)piperazin-1-yl)pyrrolidin-2-yl)methanone, (1((3S,4S)-4-amino-1-(4-(3,3-difluoropyrrolidin-1-yl)-1,3,5-triazin-2-yl)pyrrolidin-3-yl)-5,5-difluoropiperidin-2-one, (2S,4S)-1-{2-[(3S,1R)-3-(1H-1,2,4-Triazol-1-ylmethyl)cyclopentylamino]acetyl}-4-fluoropyrrolidine-2-carbonitrile, (R)-2-[6-(3-Amino-piperidin-1-yl)-3-methyl-2,4-dioxo-3,4-dihydro-2H-pyrimidin-1-ylmethyl]-4-fluoro-benzonitrile, 5-{(S)-2-[2-((S)-2-Cyano-pyrrolidin-1-yl)-2-oxo-ethylamino]propyl}-5-(1H-tetrazol-5-yl)-10,11-dihydro-5H-dibenzo[a,d]cycloheptene-2,8-dicarboxylic acid bis-dimethylamide, 3-{(2S,4S)-4-[4-(3-Methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl]pyrrolidin-2-ylcarbonyl}thiazolidine, [(2R)-1-{[(3R)-pyrrolidin-3-ylamino]acetyl}pyrrolidin-2-yl]boronic acid, (2S,4S)-1-[2-[(4-ethoxycarbonylbicyclo[2.2.2]oct-1-yl)amino]acetyl]-4-fluoropyrrolidine-2-carbonitrile, 2-({6-[(3R)-3-amino-3-methylpiperidin-1-yl]-1,3-dimethyl-2,4-dioxo-1,2,3,4-tetrahydro-5H-pyrrolo[3,2-d]pyrimidin-5-yl}methyl)-4-fluorobenzonitrile, and 6-[(3R)-3-amino-piperidin-1-yl]-5-(2-chloro-5-fluoro-benzyl)-1,3-dimethyl-1,5-dihydro-pyrrolo[3,2-d]pyrimidine-2,4-dione, or its pharmaceutically acceptable salt.
- Regarding the first embodiment (embodiment A), preferred DPP-4 inhibitors are any or all of the following compounds and their pharmaceutically acceptable salts:
-
- 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine (compare WO 2004/018468, example 2(142)):
-
- 1-[([1,5]naphthyridin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2004/018468, example 2(252)):
-
- 1-[(Quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2004/018468, example 2(80)):
-
- 2-((R)-3-Amino-piperidin-1-yl)-3-(but-2-yinyl)-5-(4-methyl-quinazolin-2-ylmethyl)-3,5-dihydro-imidazo[4,5-d]pyridazin-4-one (compare WO 2004/050658, example 136):
-
- 1-[(4-Methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyin-1-yl)-8-[(2-amino-2-methyl-propyl)-methylamino]-xanthine (compare WO 2006/029769, example 2(1)):
-
- 1-[(3-Cyano-quinolin-211)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2005/085246, example 1(30)):
-
- 1-(2-Cyano-benzyl)-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2005/085246, example 1(39)):
-
- 1-[(4-Methyl-quinazolin-211)methyl]-3-methyl-7-(2-butyn-1-yl)-8-[(S)-(2-amino-propyl)-methylamino]-xanthine (compare WO 2006/029769, example 2(4)):
-
- 1-[(3-Cyano-pyridin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2005/085246, example 1(52)):
-
- 1-[(4-Methyl-pyrimidin-211)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2005/085246, example 1(81)):
-
- 1-[(4,6-Dimethyl-pyrimidin-211)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2005/085246, example 1(82)):
-
- 1-[(Quinoxalin-6-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-((R)-3-amino-piperidin-1-yl)-xanthine (compare WO 2005/085246, example 1(83)):
- These DPP-4 inhibitors are distinguished from structurally comparable DPP-4 inhibitors, as they combine exceptional potency and a long-lasting effect with favourable pharmacological properties, receptor selectivity and a favourable side-effect profile or bring about unexpected therapeutic advantages or improvements when combined with other pharmaceutical active substances. Their preparation is disclosed in the publications mentioned.
- A more preferred DPP-4 inhibitor among the abovementioned DPP-4 inhibitors of embodiment A of this invention is 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine, particularly the free base thereof (which is also known as BI 1356).
- Unless otherwise noted, according to this invention it is to be understood that the definitions of the active compounds (including the DPP-4 inhibitors) mentioned hereinabove and hereinbelow also comprise their pharmaceutically acceptable salts as well as hydrates, solvates and polymorphic forms thereof. With respect to salts, hydrates and polymorphic forms thereof, particular reference is made to those which are referred to herein.
- With respect to embodiment A, the methods of synthesis for the DPP-4 inhibitors according to embodiment A of this invention are known to the skilled person. Advantageously, the DPP-4 inhibitors according to embodiment A of this invention can be prepared using synthetic methods as described in the literature. Thus, for example, purine derivatives of formula (I) can be obtained as described in WO 2002/068420, WO 2004/018468, WO 2005/085246, WO 2006/029769 or WO 2006/048427, the disclosures of which are incorporated herein. Purine derivatives of formula (II) can be obtained as described, for example, in WO 2004/050658 or WO 2005/110999, the disclosures of which are incorporated herein. Purine derivatives of formula (III) and (IV) can be obtained as described, for example, in WO 2006/068163, WO 2007/071738 or WO 2008/017670, the disclosures of which are incorporated herein. The preparation of those DPP-4 inhibitors, which are specifically mentioned hereinabove, is disclosed in the publications mentioned in connection therewith. Polymorphous crystal modifications and formulations of particular DPP-4 inhibitors are disclosed in WO 2007/128721 and WO 2007/128724, respectively, the disclosures of which are incorporated herein in their entireties. Formulations of particular DPP-4 inhibitors with metformin or other combination partners are described in PCT/EP2009053978, the disclosure of which is incorporated herein in its entirety. Typical dosage strengths of the dual combination of
BI 1356/metformin are 2.5/500 mg, 2.5/850 mg and 2.5/1000 mg. - With respect to embodiment B, the methods of synthesis for the DPP-4 inhibitors of embodiment B are described in the scientific literature and/or in published patent documents, particularly in those cited herein.
- For pharmaceutical application in warm-blooded vertebrates, particularly humans, the compounds of this invention are usually used in dosages from 0.001 to 100 mg/kg body weight, preferably at 0.1-15 mg/kg, in each case 1 to 4 times a day. For this purpose, the compounds, optionally combined with other active substances, may be incorporated together with one or more inert conventional carriers and/or diluents, e.g. with corn starch, lactose, glucose, microcrystalline cellulose, magnesium stearate, polyvinylpyrrolidone, citric acid, tartaric acid, water, water/ethanol, water/glycerol, water/sorbitol, water/polyethylene glycol, propylene glycol, cetylstearyl alcohol, carboxymethylcellulose or fatty substances such as hard fat or suitable mixtures thereof into conventional galenic preparations such as plain or coated tablets, capsules, powders, suspensions or suppositories.
- The pharmaceutical compositions according to this invention comprising the DPP-4 inhibitors as defined herein are thus prepared by the skilled person using pharmaceutically acceptable formulation excipients as described in the art. Examples of such excipients include, without being restricted to diluents, binders, carriers, fillers, lubricants, flow promoters, crystallisation retardants, disintegrants, solubilizers, colorants, pH regulators, surfactants and emulsifiers.
- Examples of suitable diluents for compounds according to embodiment A include cellulose powder, calcium hydrogen phosphate, erythritol, low substituted hydroxypropyl cellulose, mannitol, pregelatinized starch or xylitol. Among those diluents mannitol, low substituted hydroxypropyl cellulose and pregelatinized starch are to be emphasized.
- Examples of suitable lubricants for compounds according to embodiment A include talc, polyethyleneglycol, calcium behenate, calcium stearate, hydrogenated castor oil or magnesium stearate. Among those lubricants magnesium stearate is to be emphasized.
- Examples of suitable binders for compounds according to embodiment A include copovidone (copolymerisates of vinylpyrrolidon with other vinylderivates), hydroxypropyl methylcellulose (HPMC), hydroxypropylcellulose (HPC), polyvinylpyrrolidon (povidone), pregelatinized starch, or low-substituted hydroxypropylcellulose (L-HPC). Among those binders copovidone and pregelatinized starch are to be emphasized.
- Examples of suitable disintegrants for compounds according to embodiment A include corn starch or crospovidone. Among those disintegrants corn starch is to be emphasized.
- Suitable methods of preparing pharmaceutical formulations of the DPP-4 inhibitors according to embodiment A of the invention are
-
- direct tabletting of the active substance in powder mixtures with suitable tabletting excipients;
- granulation with suitable excipients and subsequent mixing with suitable excipients and subsequent tabletting as well as film coating; or
- packing of powder mixtures or granules into capsules.
- Suitable granulation methods are
-
- wet granulation in the intensive mixer followed by fluidised bed drying;
- one-pot granulation;
- fluidised bed granulation; or
- dry granulation (e.g. by roller compaction) with suitable excipients and subsequent tabletting or packing into capsules.
- An exemplary composition of a DPP-4 inhibitor according to embodiment A of the invention comprises the first diluent mannitol, pregelatinized starch as a second diluent with additional binder properties, the binder copovidone, the disintegrant corn starch, and magnesium stearate as lubricant; wherein copovidone and/or corn starch may be optional.
- For details on dosage forms, formulations and administration of DPP-4 inhibitors of this invention, reference is made to scientific literature and/or published patent documents, particularly to those cited herein.
- With respect to the first embodiment (embodiment A), the dosage typically required of the DPP-4 inhibitors mentioned herein in embodiment A when administered intravenously is 0.1 mg to 10 mg, preferably 0.25 mg to 5 mg, and when administered orally is 0.5 mg to 100 mg, preferably 2.5 mg to 50 mg or 0.5 mg to 10 mg, more preferably 2.5 mg to 10 mg or 1 mg to 5 mg, in each case 1 to 4 times a day. Thus, e.g. the dosage of 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine when administered orally is 0.5 mg to 10 mg per patient per day, preferably 2.5 mg to 10 mg or 1 mg to 5 mg per patient per day.
- A dosage form prepared with a pharmaceutical composition comprising a DPP-4 inhibitor mentioned herein in embodiment A contain the active ingredient in a dosage range of 0.1-100 mg. Thus, e.g. particular dosage strengths of 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine are 0.5 mg, 1 mg, 2.5 mg, 5 mg and 10 mg.
- With respect to the second embodiment (embodiment B), the doses of DPP-4 inhibitors mentioned herein in embodiment B to be administered to mammals, for example human beings, of, for example, approximately 70 kg body weight, may be generally from about 0.5 mg to about 350 mg, for example from about 10 mg to about 250 mg, preferably 20-200 mg, more preferably 20-100 mg, of the active moiety per person per day, or from about 0.5 mg to about 20 mg, preferably 2.5-10 mg, per person per day, divided preferably into 1 to 4 single doses which may, for example, be of the same size. Single dosage strengths comprise, for example, 10, 25, 40, 50, 75, 100, 150 and 200 mg of the DPP-4 inhibitor active moiety.
- A dosage strength of the DPP-4 inhibitor sitagliptin is usually between 25 and 200 mg of the active moiety. A recommended dose of sitagliptin is 100 mg calculated for the active moiety (free base anhydrate) once daily. Unit dosage strengths of sitagliptin free base anhydrate (active moiety) are 25, 50, 75, 100, 150 and 200 mg. Particular unit dosage strengths of sitagliptin (e.g. per tablet) are 25, 50 and 100 mg. An equivalent amount of sitagliptin phosphate monohydrate to the sitagliptin free base anhydrate is used in the pharmaceutical compositions, namely, 32.13, 64.25, 96.38, 128.5, 192.75, and 257 mg, respectively. Adjusted dosages of 25 and 50 mg sitagliptin are used for patients with renal failure. Typical dosage strengths of the dual combination of sitagliptin/metformin are 50/500 mg and 50/1000 mg.
- A dosage range of the DPP-4 inhibitor vildagliptin is usually between 10 and 150 mg daily, in particular between 25 and 150 mg, 25 and 100 mg or 25 and 50 mg or 50 and 100 mg daily. Particular examples of daily oral dosage are 25, 30, 35, 45, 50, 55, 60, 80, 100 or 150 mg. In a more particular aspect, the daily administration of vildagliptin may be between 25 and 150 mg or between 50 and 100 mg. In another more particular aspect, the daily administration of vildagliptin may be 50 or 100 mg. The application of the active ingredient may occur up to three times a day, preferably one or two times a day. Particular dosage strengths are 50 mg or 100 mg vildagliptin. Typical dosage strengths of the dual combination of vildagliptin/metformin are 50/850 mg and 50/1000 mg.
- Alogliptin may be administered to a patient at a daily dose of between 5 mg/day and 250 mg/day, optionally between 10 mg and 200 mg, optionally between 10 mg and 150 mg, and optionally between 10 mg and 100 mg of alogliptin (in each instance based on the molecular weight of the free base form of alogliptin). Thus, specific dosage amounts that may be used include, but are not limited to 10 mg, 12.5 mg, 20 mg, 25 mg, 50 mg, 75 mg and 100 mg of alogliptin per day. Alogliptin may be administered in its free base form or as a pharmaceutically acceptable salt.
- Saxagliptin may be administered to a patient at a daily dose of between 2.5 mg/day and 100 mg/day, optionally between 2.5 mg and 50 mg. Specific dosage amounts that may be used include, but are not limited to 2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg and 100 mg of saxagliptin per day. Typical dosage strengths of the dual combination of saxagliptin/metformin are 2.5/500 mg and 2.5/1000 mg.
- A special embodiment of the DPP-4 inhibitors of this invention refers to those orally administered DPP-4 inhibitors which are therapeutically efficacious at low dose levels, e.g. at dose levels <100 mg or <70 mg per patient per day, preferably <50 mg, more preferably <30 mg or <20 mg, even more preferably from 1 mg to 10 mg (if required, divided into 1 to 4 single doses, particularly 1 or 2 single doses, which may be of the same size), particularly from 1 mg to 5 mg (more particularly 5 mg), per patient per day, preferentially, administered orally once-daily, more preferentially, at any time of day, administered with or without food. Thus, for example, the daily oral amount 5
mg BI 1356 can be given in a once daily dosing regimen (i.e. 5mg BI 1356 once daily) or in a twice daily dosing regimen (i.e. 2.5mg BI 1356 twice daily), at any time of day, with or without food. - A particularly preferred DPP-4 inhibitor to be emphasized within the meaning of this invention is 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine (also known as BI 1356).
BI 1356 exhibits high potency, 24h duration of action, and a wide therapeutic window. In patients with type 2 diabetes receiving multiple oral doses of 1, 2.5, 5 or 10 mg of BI 1356 once daily for 12 days, BI 1356 shows favourable pharmacodynamic and pharmacokinetic profile (see e.g. Table 1 below) with rapid attainment of steady state (e.g. reaching steady state plasma levels (>90% of the pre-dose plasma concentration on Day 13) between second and fifth day of treatment in all dose groups), little accumulation (e.g. with a mean accumulation ratio RA,AUC≤1.4 with doses above 1 mg) and preserving a long-lasting effect on DPP-4 inhibition (e.g. with almost complete (>90%) DPP-4 inhibition at the 5 mg and 10 mg dose levels, i.e. 92.3 and 97.3% inhibition at steady state, respectively, and >80% inhibition over a 24h interval after drug intake), as well as significant decrease in 2h postprandial blood glucose excursions by 80% (already on Day 1) in doses 2.5 mg, and with the cumulative amount of unchanged parent compound excreted in urine on Day 1 being below 1% of the administered dose and increasing to not more than about 3-6% on Day 12 (renal clearance CLR,ss is from about 14 to about 70 mL/min for the administered oral doses, e.g. for the 5 mg dose renal clearance is about 70 ml/min). In people with type 2diabetes BI 1356 shows a placebo-like safety and tolerability. With low doses of about 5 mg,BI 1356 acts as a true once-daily oral drug with a full 24 h duration of DPP-4 inhibition. At therapeutic oral dose levels,BI 1356 is mainly excreted via the liver and only to a minor extent (about <7% of the administered oral dose) via the kidney.BI 1356 is primarily excreted unchanged via the bile. The fraction ofBI 1356 eliminated via the kidneys increases only very slightly over time and with increasing dose, so that there will likely be no need to modify the dose ofBI 1356 based on the patients' renal function. The non-renal elimination ofBI 1356 in combination with its low accumulation potential and broad safety margin may be of significant benefit in a patient population that has a high prevalence of renal insufficiency and diabetic nephropathy. -
TABLE 1 Geometric mean (gMean) and geometric coefficient of variation (gCV) of pharmacokinetic parameters of BI 1356 at steady state (Day 12)1 mg 2.5 mg 5 mg 10 mg Parameter gMean (gCV) gMean (gCV) gMean (gCV) gMean (gCV) AUC0-24 40.2 (39.7) 85.3 (22.7) 118 (16.0) 161 (15.7) [nmol · h/L] AUCT, SS 81.7 (28.3) 117 (16.3) 158 (10.1) 190 (17.4) [nmol · h/L] Cmax [nmol/L] 3.13 (43.2) 5.25 (24.5) 8.32 (42.4) 9.69 (29.8) Cmax, ss [nmol/L] 4.53 (29.0) 6.58 (23.0) 11.1 (21.7) 13.6 (29.6) tmax* [h] 1.50 [1.00-3.00] 2.00 [1.00-3.00] 1.75 [0.92-6.02] 2.00 [1.50-6.00] tmax, ss* [h] 1.48 [1.00-3.00] 1.42 [1.00-3.00] 1.53 [1.00-3.00] 1.34 [0.50-3.00] T1/2, ss [h] 121 (21.3) 113 (10.2) 131 (17.4) 130 (11.7) Accumulation 23.9 (44.0) 12.5 (18.2) 11.4 (37.4) 8.59 (81.2) t1/2, [h] RA, Cmax 1.44 (25.6) 1.25 (10.6) 1.33 (30.0) 1.40 (47.7) RA, AUC 2.03 (30.7) 1.37 (8.2) 1.33 (15.0) 1.18 (23.4) fe0-24 [%] NC 0.139 (51.2) 0.453 (125) 0.919 (115) feT, SS [%] 3.34 (38.3) 3.06 (45.1) 6.27 (42.2) 3.22 (34.2) CLR, ss [mL/min] 14.0 (24.2) 23.1 (39.3) 70 (35.0) 59.5 (22.5) *median and range [min-max] NC not calculated as most values below lower limit of quantification - As different metabolic functional disorders often occur simultaneously, it is quite often indicated to combine a number of different active principles with one another. Thus, depending on the functional disorders diagnosed, improved treatment outcomes may be obtained if a DPP-4 inhibitor is combined with active substances customary for the respective disorders, such as e.g. one or more active substances selected from among the other antidiabetic substances, especially active substances that lower the blood sugar level or the lipid level in the blood, raise the HDL level in the blood, lower blood pressure or are indicated in the treatment of atherosclerosis or obesity.
- The DPP-4 inhibitors mentioned above—besides their use in mono-therapy—may also be used in conjunction with other active substances, by means of which improved treatment results can be obtained. Such a combined treatment may be given as a free combination of the substances or in the form of a fixed combination, for example in a tablet or capsule.
- Pharmaceutical formulations of the combination partner needed for this may either be obtained commercially as pharmaceutical compositions or may be formulated by the skilled man using conventional methods. The active substances which may be obtained commercially as pharmaceutical compositions are described in numerous places in the prior art, for example in the list of drugs that appears annually, the “Rote Liste®” of the federal association of the pharmaceutical industry, or in the annually updated compilation of manufacturers' information on prescription drugs known as the “Physicians' Desk Reference”.
- Examples of antidiabetic combination partners are metformin; sulphonylureas such as glibenclamide, tolbutamide, glimepiride, glipizide, gliquidon, glibornuride and gliclazide; nateglinide; repaglinide; thiazolidinediones such as rosiglitazone and pioglitazone; PPAR gamma modulators such as metaglidases; PPAR-gamma agonists such as GI 262570; PPAR-gamma antagonists; PPAR-gamma/alpha modulators such as tesaglitazar, muraglitazar, aleglitazar, indeglitazar and KRP297; PPAR-gamma/alpha/delta modulators; AMPK-activators such as AICAR; acetyl-CoA carboxylase (ACC1 and ACC2) inhibitors; diacylglycerol-acetyltransferase (DGAT) inhibitors; pancreatic beta cell GCRP agonists such as SMT3-receptor-agonists and GPR119; 11B-HSD-inhibitors; FGF19 agonists or analogues; alpha-glucosidase blockers such as acarbose, voglibose and miglitol; alpha2-antagonists; insulin and insulin analogues such as human insulin, insulin lispro, insulin glusilin, r-DNA-insulinaspart, NPH insulin, insulin detemir, insulin zinc suspension and insulin glargin; Gastric inhibitory Peptide (GIP); pramlintide, davalintide; amylin and amylin analogues or GLP-1 and GLP-1 analogues such as Exendin-4, e.g. exenatide, exenatide LAR, liraglutide, taspoglutide, AVE-0010, LY-2428757, LY-2189265, semaglutide or albiglutide; SGLT2-inhibitors such as KGT-1251; inhibitors of protein tyrosine-phosphatase; inhibitors of glucose-6-phosphatase; fructose-1,6-bisphosphatase modulators; glycogen phosphorylase modulators; glucagon receptor antagonists; phosphoenolpyruvatecarboxykinase (PEPCK) inhibitors; pyruvate dehydrogenasekinase (PDK) inhibitors; inhibitors of tyrosine-kinases (50 mg to 600 mg) such as PDGF-receptor-kinase (cf. EP-A-564409, WO 98/35958, U.S. Pat. No. 5,093,330, WO 2004/005281, and WO 2006/041976); glucokinase/regulatory protein modulators incl. glucokinase activators; glycogen synthase kinase inhibitors; inhibitors of the SH2-domain-containing inositol 5-phosphatase type 2 (SHIP2); IKK inhibitors such as high-dose salicylate; JNK1 inhibitors; protein kinase C-theta inhibitors;
beta 3 agonists such as ritobegron, YM 178, solabegron, talibegron, N-5984, GRC-1087, rafabegron, FMP825; aldosereductase inhibitors such as AS 3201, zenarestat, fidarestat, epalrestat, ranirestat, NZ-314, CP-744809, and CT-112; SGLT-1 or SGLT-2 inhibitors, such as e.g. dapagliflozin, sergliflozin, atigliflozin, larnagliflozin or canagliflozin (or compound of formula (I-S) or (I-K) from WO 2009/035969); KV 1.3 channel inhibitors; GPR40 modulators; SCD-1 inhibitors; CCR-2 antagonists; dopamine receptor agonists (bromocriptine mesylate [Cycloset]); and other DPP IV inhibitors. - Metformin is usually given in doses varying from about 500 mg to 2000 mg up to 2500 mg per day using various dosing regimens from about 100 mg to 500 mg or 200 mg to 850 mg (1-3 times a day), or about 300 mg to 1000 mg once or twice a day, or delayed-release metformin in doses of about 100 mg to 1000 mg or preferably 500 mg to 1000 mg once or twice a day or about 500 mg to 2000 mg once a day. Particular dosage strengths may be 250, 500, 625, 750, 850 and 1000 mg of metformin hydrochloride.
- A dosage of pioglitazone is usually of about 1-10 mg, 15 mg, 30 mg, or 45 mg once a day.
- Rosiglitazone is usually given in doses from 4 to 8 mg once (or divided twice) a day (typical dosage strengths are 2, 4 and 8 mg).
- Glibenclamide (glyburide) is usually given in doses from 2.5-5 to 20 mg once (or divided twice) a day (typical dosage strengths are 1.25, 2.5 and 5 mg), or micronized glibenclamide in doses from 0.75-3 to 12 mg once (or divided twice) a day (typical dosage strengths are 1.5, 3, 4.5 and 6 mg).
- Glipizide is usually given in doses from 2.5 to 10-20 mg once (up to 40 mg divided twice) a day (typical dosage strengths are 5 and 10 mg), or extended-release glipizide in doses from 5 to 10 mg (up to 20 mg) once a day (typical dosage strengths are 2.5, 5 and 10 mg).
- Glimepiride is usually given in doses from 1-2 to 4 mg (up to 8 mg) once a day (typical dosage strengths are 1, 2 and 4 mg).
- A dual combination of glibenclamide/metformin is usually given in doses from 1.25/250 once daily to 10/1000 mg twice daily (typical dosage strengths are 1.25/250, 2.5/500 and 5/500 mg).
- A dual combination of glipizide/metformin is usually given in doses from 2.5/250 to 10/1000 mg twice daily (typical dosage strengths are 2.5/250, 2.5/500 and 5/500 mg).
- A dual combination of glimepiride/metformin is usually given in doses from 1/250 to 4/1000 mg twice daily.
- A dual combination of rosiglitazone/glimepiride is usually given in doses from 4/1 once or twice daily to 4/2 mg twice daily (typical dosage strengths are 4/1, 4/2, 4/4, 8/2 and 8/4 mg). A dual combination of pioglitazone/glimepiride is usually given in doses from 30/2 to 30/4 mg once daily (typical dosage strengths are 30/4 and 45/4 mg).
- A dual combination of rosiglitazone/metformin is usually given in doses from 1/500 to 4/1000 mg twice daily (typical dosage strengths are 1/500, 2/500, 4/500, 2/1000 and 4/1000 mg). A dual combination of pioglitazone/metformin is usually given in doses from 15/500 once or twice daily to 15/850 mg thrice daily (typical dosage strengths are 15/500 and 15/850 mg).
- The non-sulphonylurea insulin secretagogue nateglinide is usually given in doses from 60 to 120 mg with meals (up to 360 mg/day, typical dosage strengths are 60 and 120 mg); repaglinide is usually given in doses from 0.5 to 4 mg with meals (up to 16 mg/day, typical dosage strengths are 0.5, 1 and 2 mg). A dual combination of repaglinide/metformin is available in dosage strengths of 1/500 and 2/850 mg.
- Acarbose is usually given in doses from 25 to 100 mg with meals (up to 300 mg/day, typical dosage strengths are 25, 50 and 100 mg). Miglitol is usually given in doses from 25 to 100 mg with meals (up to 300 mg/day, typical dosage strengths are 25, 50 and 100 mg). Conventional antidiabetics and antihyperglycemics typically used in mono- or dual or triple (add-on or initial) combination therapy may include, without being limited to, metformin, sulphonylureas, thiazolidinediones, glinides, alpha-glucosidase blockers, GLP-1 and GLP-1 analogues, as well as insulin and insulin analogues, such as e.g. those agents indicated herein by way of example, including combinations thereof.
- Examples of combination partners that lower the lipid level in the blood are HMG-CoA-reductase inhibitors such as simvastatin, atorvastatin, lovastatin, fluvastatin, pravastatin, pitavastatin and rosuvastatin; fibrates such as bezafibrate, fenofibrate, clofibrate, gemfibrozil, etofibrate and etofyllinclofibrate; nicotinic acid and the derivatives thereof such as acipimox; PPAR-alpha agonists; PPAR-delta agonists; inhibitors of acyl-coenzyme A:cholesterolacyltransferase (ACAT; EC 2.3.1.26) such as avasimibe; cholesterol resorption inhibitors such as ezetimib; substances that bind to bile acid, such as cholestyramine, colestipol and colesevelam; inhibitors of bile acid transport; HDL modulating active substances such as D4F, reverse D4F, LXR modulating active substances and FXR modulating active substances; CETP inhibitors such as torcetrapib, JTT-705 (dalcetrapib) or compound 12 from WO 2007/005572 (anacetrapib); LDL receptor modulators; and ApoB100 antisense RNA.
- A dosage of atorvastatin is usually from 1 mg to 40 mg or 10 mg to 80 mg once a day.
- Examples of combination partners that lower blood pressure are beta-blockers such as atenolol, bisoprolol, celiprolol, metoprolol and carvedilol; diuretics such as hydrochlorothiazide, chlortalidon, xipamide, furosemide, piretanide, torasemide, spironolactone, eplerenone, amiloride and triamterene; calcium channel blockers such as amlodipine, nifedipine, nitrendipine, nisoldipine, nicardipine, felodipine, lacidipine, lercanipidine, manidipine, isradipine, nilvadipine, verapamil, gallopamil and diltiazem; ACE inhibitors such as ramipril, lisinopril, cilazapril, quinapril, captopril, enalapril, benazepril, perindopril, fosinopril and trandolapril; as well as angiotensin II receptor blockers (ARBs) such as telmisartan, candesartan, valsartan, losartan, irbesartan, olmesartan and eprosartan.
- A dosage of telmisartan is usually from 20 mg to 320 mg or 40 mg to 160 mg per day.
- Examples of combination partners which increase the HDL level in the blood are Cholesteryl Ester Transfer Protein (CETP) inhibitors; inhibitors of endothelial lipase; regulators of ABC1; LXRalpha antagonists; LXRbeta agonists; PPAR-delta agonists; LXRalpha/beta regulators, and substances that increase the expression and/or plasma concentration of apolipoprotein A-I.
- Examples of combination partners for the treatment of obesity are sibutramine; tetrahydrolipstatin (orlistat); alizyme; dexfenfluramine; axokine; cannabinoid receptor 1 antagonists such as the CB1 antagonist rimonobant; MCH-1 receptor antagonists; MC4 receptor agonists; NPY5 as well as NPY2 antagonists; beta3-AR agonists such as SB-418790 and AD-9677; 5HT2c receptor agonists such as APD 356 (lorcaserin); myostatin inhibitors; Acrp30 and adiponectin; steroyl CoA desaturase (SCD1) inhibitors; fatty acid synthase (FAS) inhibitors; CCK receptor agonists; Ghrelin receptor modulators; Pyy 3-36; orexin receptor antagonists; and tesofensine; as well as the dual combinations bupropion/naltrexone, bupropion/zonisamide, topiramate/phentermine and pramlintide/metreleptin.
- Examples of combination partners for the treatment of atherosclerosis are phospholipase A2 inhibitors; inhibitors of tyrosine-kinases (50 mg to 600 mg) such as PDGF-receptor-kinase (cf. EP-A-564409, WO 98/35958, U.S. Pat. No. 5,093,330, WO 2004/005281, and WO 2006/041976); oxLDL antibodies and oxLDL vaccines; apoA-1 Milano; ASA; and VCAM-1 inhibitors.
- The present invention is not to be limited in scope by the specific embodiments described herein. Various modifications of the invention in addition to those described herein may become apparent to those skilled in the art from the present disclosure. Such modifications are intended to fall within the scope of the appended claims.
- All patent applications cited herein are hereby incorporated by reference in their entireties.
- Further embodiments, features and advantages of the present invention may become apparent from the following examples. The following examples serve to illustrate, by way of example, the principles of the invention without restricting it.
- Animal Model:
- Sulfonylurea (SU) like glibenclamide are one of the most frequently used drugs in diabetes treatment. Long-term treatment with SU causes elevated basal insulin secretion and decreased glucose-stimulated insulin secretion. These characteristics may play an important role for the development of hypoglycemia and secondary drug failure. Db/db mice represent an animal model for type 2 diabetes demonstrating insulin resistance and high levels of plasma glucose. In addition, correlating with age of the animals pancreatic ß-cells of aging db/db mice fails to compensate the high glucose excursion with enhanced insulin secretion. Therefore this model is appropriate to study the glibenclamide induced secondary drug failure in comparison to a DPP-4 inhibitor (e.g. BI 1356).
- Methods
- Animals and Housing
- Female db/db mice at 5 weeks of age, are obtained from Charles River, Germany. Animals are housed in groups of 5-6 animals under a 12:12 LID cycle (lights on at 04:00 AM and lights off at 04:00 PM) in temperature and humidity controlled rooms. All animals have free access to regular rodent chow (Altromin standard #1324 chow, Denmark) and water ad libitum.
- In Vivo Experiment
- The compound solutions are administered daily at 08.00 AM on experimental days 0-59 by per oral gavage using a gastric tube connected to a 3 ml syringe (luer-Lock™, Becton).
- Groups of 12 animals are used: vehicle, 0.5% Natrosol;
BI 1356 3 mg/kg; glibenclamide 3 mg/kg. Body weight food intake and water intake is recorded daily for the first two and twice weekly for the remaining period. Onexperimental day 54 blood glucose and HbA1c levels are determined in semi-fed state, on day 59 an OGTT (2 g/kg) is performed. - HbA1c, Insulin and Blood Glucose Monitoring
- Blood samples for determination of “fed” levels blood glucose and HbA1c are performed at 10.00 AM on
day 54. Prior to blood sampling animals are transferred to clean cages with no food two hours before blood sampling. At day 59 an OGTT (2 g/kg) is performed following an over-night fast of the animals and insulin is detected at t=15 min. - Blood Glucose:
- For each data point, 10 μl blood is drawn from the tip of the tail into a microcapillary tube and measured using a Biosen S line glucose analyzer.
- Insulin:
- For each data point, 100 μl blood is drawn from the tail vein, collected in EDTA tubes. Insulin is measured using a Mouse Endocrine Immunoassay Panel (LINCOplex™, analyzed using a Luminex100™ system; LincoResearch, Missouri, USA).
- HbA1c:
- are measured using a standard enzyme assay kit on a fully automated analyzer (Bayer).
- Results
-
FIGS. 1 . and 2 demonstrate HbA1c and glucose values following 54 day treatment of 5 weeks old female db/db mice with the indicated compounds. The DPP-4inhibitor BI 1356 improves HbA1c as well as glucose values compared to control. In contrast, the sulfonylurea glibenclamide in a concentration of 3 mg/kg impairs glucose as well as HbA1c values compared to control andBI 1356. -
FIG. 3 shows the increase in insulin during an OGTT test. Only the animals treated withBI 1356 are able to respond to the increased glucose levels with an up-regulation of insulin. - Thus, in an animal model representing ß-cell and SU induced secondary drug failure the DPP-4
inhibitor BI 1356 is superior to glibenclamide regarding insulin secretion and lowering of HbA1c and glucose. - Clinic:
- The usability of a DPP-4 inhibitor according to this invention for the purpose of the present invention can be tested using clinical trials:
- For example, in a randomised, double-blind, placebo-controlled, parallel group trial, the safety and efficacy of a DPP-4 inhibitor according to the invention (e.g. 5 mg of
BI 1356 administered orally once daily) is tested in patients with type 2 diabetes with insufficient glycemic control (HbA1c from 7.0% to 10% or from 7.5% to 10% or 11%) despite a therapy with one or two conventional antihyperglycemic agents, such as e.g. a sulphonylurea drug. - In the study with the sulphonylurea drug the efficacy and safety of a DPP-4 inhibitor according to this invention versus placebo added to a background therapy of a sulphonylurea is investigated (2 week placebo run-in phase; 18 weeks double-blind treatment followed by 1 week follow up after study medication termination; background therapy with a sulphonylurea drug is administered throughout the entire trial duration, including placebo run-in phase, in an unchanged dosage).
- The success of the treatment is tested by determining the HbA1c value, by comparison with the initial value and/or with the value of the placebo group. A significant change in the HbA1c value compared with the initial value and/or the placebo value demonstrates the efficacy of the DPP-4 inhibitor for the treatment. The success of the treatment can be also tested by determining the fasting plasma glucose values, by comparison with the initial values and/or with the values of the placebo group. A significant drop in the fasting glucose levels demonstrates the efficacy of the treatment. Also, the occurrence of a treat to target response (i.e. an HbA1c under treatment <7%) demonstrates the efficacy of the treatment.
- The safety and tolerability of the treatment is investigated by assessing patient's condition and relevant changes from baseline, e.g. incidence and intensity of adverse events (such as e.g. hypoglycaemic episodes or the like) or weight gain.
Claims (25)
1. A method for treating metabolic diseases in type 2 diabetes patients with insufficient glycemic control despite therapy with one or more oral or non-oral antidiabetic drugs selected from metformin, sulphonylureas, thiazolidinediones, glinides, α-glucosidase inhibitors, GLP-1 or GLP-1 analogues, and insulin or insulin analogues, the method comprising
administering a DPP-4 inhibitor which is 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine, or a pharmaceutically acceptable salt thereof, in an oral daily amount of 5 mg,
wherein said 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine, or a pharmaceutically acceptable salt thereof, is used in combination with one or more oral or non-oral antidiabetic drugs.
2. The method according to claim 1 , wherein said one or more oral antidiabetic drugs is selected from metformin, sulphonylureas, thiazolidinediones, glinides and α-glucosidase inhibitors.
3. The method according to claim 1 , wherein said one or more oral antidiabetic drugs is a sulphonylurea drug.
4. The method according to claim 1 , wherein said one or more oral antidiabetic drugs is a sulphonylurea drug alone.
5. The method according to claim 1 , wherein said one or more oral antidiabetic drugs are a sulphonylurea drug and metformin.
6. The method according to claim 1 , wherein said DPP-4 inhibitor is used in combination with said sulphonylurea, and, optionally, in combination with one or more other therapeutic agents selected from metformin and a thiazolidinedione.
7. The method according to claim 1 , wherein said DPP-4 inhibitor is used as replacement of said sulphonylurea, and, optionally, in combination with one or more other therapeutic agents.
8. The method according to claim 1 , wherein said DPP-4 inhibitor is used in add-on combination therapy with said sulphonylurea.
9. The method according to claim 1 , for improving HbA1c, FPG or PPG, decreasing glucose excursion, or improving insulin secretion in said patients, or any combination of the foregoing conditions.
10. The method according to claim 1 , in patients with indication on first- or second-line sulphonylurea therapy.
11. The method according to claim 1 , for the treatment of diabetes in patients with indication on dual sulphonylurea combination therapy.
12. The method according to claim 1 , for the treatment of diabetes in patients with indication on triple sulphonylurea combination therapy.
13. The method according to claim 1 , for the treatment of diabetes in patients with indication on insulin therapy.
14. The method according claim 1 , wherein said patients suffer from inadequate HbA1c values from 7.0 to 11%, despite therapy with a sulphonylurea drug.
15. The method according to claim 1 , for reducing the risk for adverse effects associated with sulphonylurea antidiabetic therapy selected from hypoglycaemia, weight gain, and a combination thereof, in said patients.
16. The method according to claim 1 , wherein said patients are renally impaired and/or elderly patients.
17. The method according to claim 1 , wherein said DPP-4 inhibitor is 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine in free base form.
18. The method according to claim 1 , wherein said patients are patients with insufficient glycemic control despite mono-therapy with metformin, a sulphonylurea, pioglitazone or (basal) insulin, or despite dual combination therapy with a metformin/pioglitazone, metformin/sulphonylurea, metformin/(basal) insulin, sulphonylurea/pioglitazone, sulphonylurea/(basal) insulin or pioglitazone/(basal) insulin combination.
19. The method according to claim 1 for treating type 2 diabetes in a patient with insufficient glycemic control despite therapy with one antihyperglycemic agent selected from metformin, sulphonylureas, thiazolidinediones, glinides, α-glucosidase inhibitors, GLP-1 and GLP-1 analogues, and insulin and insulin analogues, said method comprising administering 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine in an oral daily amount of 5 mg in combination with said one antihyperglycemic agent to the patient.
20. The method according to claim 1 for treating type 2 diabetes in a patient with insufficient glycemic control despite therapy with two antihyperglycemic agents selected from metformin, sulphonylureas, thiazolidinediones, glinides, α-glucosidase inhibitors, GLP-1 and GLP-1 analogues, and insulin and insulin analogues, said method comprising administering 1-[(4-methyl-quinazolin-2-yl)methyl]-3-methyl-7-(2-Butyn-1-yl)-8-(3-(R)-amino-piperidin-1-yl)-xanthine in an oral daily amount of 5 mg in combination with said two antihyperglycemic agents to the patient.
21. The method according to claim 1 , for achieving a reduction in the dose of said one or more oral or non-oral antidiabetic drugs required for adequate therapeutic effect.
22. The method according to claim 1 , wherein the 5 mg is administered once daily, with or without food.
23. The method according to claim 1 , wherein the patient has renal impairment.
24. The method according to claim 23 , wherein no adjustment of the daily dose of the DPP-4 inhibitor is required.
25. The method according to claim 22 , wherein steady state plasma levels of the DPP-4 inhibitor are reached between second and fifth day of administration.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US16/196,592 US20200155558A1 (en) | 2018-11-20 | 2018-11-20 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral antidiabetic drug |
US17/173,607 US11911388B2 (en) | 2008-10-16 | 2021-02-11 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US16/196,592 US20200155558A1 (en) | 2018-11-20 | 2018-11-20 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral antidiabetic drug |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/698,696 Continuation US20170368068A1 (en) | 2008-10-16 | 2017-09-08 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US17/173,607 Continuation US11911388B2 (en) | 2008-10-16 | 2021-02-11 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug |
Publications (1)
Publication Number | Publication Date |
---|---|
US20200155558A1 true US20200155558A1 (en) | 2020-05-21 |
Family
ID=70728614
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US16/196,592 Abandoned US20200155558A1 (en) | 2008-10-16 | 2018-11-20 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral antidiabetic drug |
US17/173,607 Active 2030-04-10 US11911388B2 (en) | 2008-10-16 | 2021-02-11 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US17/173,607 Active 2030-04-10 US11911388B2 (en) | 2008-10-16 | 2021-02-11 | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug |
Country Status (1)
Country | Link |
---|---|
US (2) | US20200155558A1 (en) |
Family Cites Families (491)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2056046A (en) | 1933-05-19 | 1936-09-29 | Rhone Poulenc Sa | Manufacture of bases derived from benz-dioxane |
US2375138A (en) | 1942-05-01 | 1945-05-01 | American Cyanamid Co | Alkamine esters of aryloxymethyl benzoic acid |
US2629736A (en) | 1951-02-24 | 1953-02-24 | Searle & Co | Basically substituted n-alkyl derivatives of alpha, beta, beta-triarylpropionamides |
US2730544A (en) | 1952-07-23 | 1956-01-10 | Sahyun Lab | Alkylaminoalkyl esters of hydroxycyclohexylbenzoic acid |
US2750387A (en) | 1953-11-25 | 1956-06-12 | Searle & Co | Basically substituted derivatives of diarylaminobenzamides |
DE1211359B (en) | 1955-11-29 | 1966-02-24 | Oreal | Oxidant-free cold dye for human hair |
US2928833A (en) | 1959-03-03 | 1960-03-15 | S E Massengill Company | Theophylline derivatives |
US3174901A (en) | 1963-01-31 | 1965-03-23 | Jan Marcel Didier Aron Samuel | Process for the oral treatment of diabetes |
US3454635A (en) | 1965-07-27 | 1969-07-08 | Hoechst Ag | Benzenesulfonyl-ureas and process for their manufacture |
US3673241A (en) | 1968-04-04 | 1972-06-27 | Ciba Geigy Corp | Substituted benzaldehyde guanylhydrazones |
ES385302A1 (en) | 1970-10-22 | 1973-04-16 | Miquel S A Lab | Procedure for the obtaining of trisused derivatives of etilendiamine. (Machine-translation by Google Translate, not legally binding) |
DE2205815A1 (en) | 1972-02-08 | 1973-08-16 | Hoechst Ag | N-(oxazolin-2-yl)-piperazine - with antitussive activity |
JPS5512435B2 (en) | 1972-07-01 | 1980-04-02 | ||
US4005208A (en) | 1975-05-16 | 1977-01-25 | Smithkline Corporation | N-Heterocyclic-9-xanthenylamines |
US4061753A (en) | 1976-02-06 | 1977-12-06 | Interx Research Corporation | Treating psoriasis with transient pro-drug forms of xanthine derivatives |
AU508480B2 (en) | 1977-04-13 | 1980-03-20 | Asahi Kasei Kogyo Kabushiki Kaisha | Microcrystalline cellulose excipient and pharmaceutical composition containing thesame |
NO154918C (en) | 1977-08-27 | 1987-01-14 | Bayer Ag | ANALOGUE PROCEDURE FOR THE PREPARATION OF THERAPEUTIC ACTIVE DERIVATIVES OF 3,4,5-TRIHYDROXYPIPERIDINE. |
DE2758025A1 (en) | 1977-12-24 | 1979-07-12 | Bayer Ag | Tri:hydroxy-piperidine derivs. - useful as glucosidase inhibitors for treating diabetes etc. and as animal feed additives |
DE2929596A1 (en) | 1979-07-21 | 1981-02-05 | Hoechst Ag | METHOD FOR PRODUCING OXOALKYL XANTHINES |
CY1306A (en) | 1980-10-01 | 1985-12-06 | Glaxo Group Ltd | Aminoalkyl furan derivative |
US4382091A (en) | 1981-04-30 | 1983-05-03 | Syntex (U.S.A.) Inc. | Stabilization of 1-substituted imidazole derivatives in talc |
FR2558162B1 (en) | 1984-01-17 | 1986-04-25 | Adir | NOVEL XANTHINE DERIVATIVES, PROCESSES FOR THEIR PREPARATION AND PHARMACEUTICAL COMPOSITIONS CONTAINING THEM |
FI79107C (en) | 1984-06-25 | 1989-11-10 | Orion Yhtymae Oy | Process for the preparation of stable form of prazosin hydrochloride. |
JPS6130567A (en) | 1984-07-23 | 1986-02-12 | Shiseido Co Ltd | Method of stabilizing urea |
JPS61124383A (en) | 1984-11-16 | 1986-06-12 | Unitika Ltd | Stabilization of immobilized fibrinolytic enzyme |
AR240698A1 (en) | 1985-01-19 | 1990-09-28 | Takeda Chemical Industries Ltd | Process for the preparation of 5-(4-(2-(5-ethyl-2-pyridil)-ethoxy)benzyl)-2,4-thiazolodinedione and their salts |
CA1242699A (en) | 1985-02-01 | 1988-10-04 | Bristol-Myers Company | Cefbuperazone and derivatives thereof |
US5258380A (en) | 1985-06-24 | 1993-11-02 | Janssen Pharmaceutica N.V. | (4-piperidinylmethyl and -hetero)purines |
GB8515934D0 (en) | 1985-06-24 | 1985-07-24 | Janssen Pharmaceutica Nv | (4-piperidinomethyl and-hetero)purines |
ES2058061T3 (en) | 1985-10-25 | 1994-11-01 | Beecham Group Plc | DERIVED FROM PIPERIDINE, ITS PREPARATION AND ITS USE AS A MEDICINAL PRODUCT. |
US5034225A (en) | 1985-12-17 | 1991-07-23 | Genentech Inc. | Stabilized human tissue plasminogen activator compositions |
US5433959A (en) | 1986-02-13 | 1995-07-18 | Takeda Chemical Industries, Ltd. | Stabilized pharmaceutical composition |
DE3683760D1 (en) | 1986-03-21 | 1992-03-12 | Heumann Pharma Gmbh & Co | CRYSTALLINE, WATER-FREE SIGMA -FORM OF 2- (4- (2-FUROYL- (2-PIPERAZINE) -1-YL) -4-AMINO-6,7-DIMETHOXYCHINAZOLINE HYDROCHLORIDE AND METHOD FOR THE PRODUCTION THEREOF. |
US5120712A (en) | 1986-05-05 | 1992-06-09 | The General Hospital Corporation | Insulinotropic hormone |
ATE110083T1 (en) | 1986-05-05 | 1994-09-15 | Gen Hospital Corp | INSULINOTROPIC HORMONE. |
AU619444B2 (en) | 1986-06-02 | 1992-01-30 | Nippon Chemiphar Co. Ltd. | 2-(2-aminobenzylsulfinyl)- benzimidazole derivatives |
US4968672A (en) | 1987-01-02 | 1990-11-06 | The United States Of America As Represented By The Department Of Health And Human Services | Adenosine receptor prodrugs |
US4743450A (en) | 1987-02-24 | 1988-05-10 | Warner-Lambert Company | Stabilized compositions |
JPS63273159A (en) | 1987-04-30 | 1988-11-10 | Sharp Corp | Character processing device |
JPS6440433A (en) | 1987-08-05 | 1989-02-10 | Green Cross Corp | Aqueous liquid composition of thrombin |
EP0342675B1 (en) | 1988-05-19 | 1995-01-25 | Chugai Seiyaku Kabushiki Kaisha | Novel quinolonecarboxylic acid derivatives |
US5329025A (en) | 1988-09-21 | 1994-07-12 | G. D. Searle & Co. | 3-azido compound |
US5234897A (en) | 1989-03-15 | 1993-08-10 | Bayer Aktiengesellschaft | Herbicidal 3-amino-5-aminocarbonyl-1,2,4-triazoles |
DE3926119A1 (en) | 1989-08-08 | 1991-02-14 | Bayer Ag | 3-AMINO-5-AMINOCARBONYL-1,2,4-TRIAZOLE DERIVATIVES |
GB8906792D0 (en) | 1989-03-23 | 1989-05-10 | Beecham Wuelfing Gmbh & Co Kg | Treatment and compounds |
DE3916430A1 (en) | 1989-05-20 | 1990-11-22 | Bayer Ag | METHOD FOR PRODUCING 3-AMINO-5-AMINOCARBONYL-1,2,4-TRIAZOLE DERIVATIVES |
IL94390A (en) | 1989-05-30 | 1996-03-31 | Merck & Co Inc | Di-substituted imidazo fused 6-membered nitrogen-containing heterocycles and pharmaceutical compositions containing them |
US5332744A (en) | 1989-05-30 | 1994-07-26 | Merck & Co., Inc. | Substituted imidazo-fused 6-membered heterocycles as angiotensin II antagonists |
US5223499A (en) | 1989-05-30 | 1993-06-29 | Merck & Co., Inc. | 6-amino substituted imidazo[4,5-bipyridines as angiotensin II antagonists |
FI94339C (en) | 1989-07-21 | 1995-08-25 | Warner Lambert Co | Process for the preparation of pharmaceutically acceptable [R- (R *, R *)] - 2- (4-fluorophenyl) -, - dihydroxy-5- (1-methylethyl) -3-phenyl-4 - [(phenylamino) carbonyl] -1H- for the preparation of pyrrole-1-heptanoic acid and its pharmaceutically acceptable salts |
HU208115B (en) | 1989-10-03 | 1993-08-30 | Biochemie Gmbh | New process for producting pleuromutilin derivatives |
FR2654935B1 (en) | 1989-11-28 | 1994-07-01 | Lvmh Rech | USE OF XANTHINES, WHICH MAY BE INCORPORATED IN LIPOSOMES, TO PROMOTE PIGMENTATION OF THE SKIN OR HAIR. |
ES2084801T3 (en) | 1990-02-19 | 1996-05-16 | Ciba Geigy Ag | ACIL COMPOUNDS. |
KR930000861B1 (en) | 1990-02-27 | 1993-02-08 | 한미약품공업 주식회사 | Omeprazole rectal composition |
ATE112491T1 (en) | 1990-09-13 | 1994-10-15 | Akzo Nobel Nv | STABILIZED SOLID CHEMICAL COMPOSITIONS. |
GB9020959D0 (en) | 1990-09-26 | 1990-11-07 | Beecham Group Plc | Novel compounds |
US5084460A (en) | 1990-12-24 | 1992-01-28 | A. H. Robins Company, Incorporated | Methods of therapeutic treatment with N-(3-ouinuclidinyl)-2-hydroxybenzamides and thiobenzamides |
US5594003A (en) | 1991-02-06 | 1997-01-14 | Dr. Karl Thomae Gmbh | Tetrahydroimidazo[1,2-a]pyridin-2-yl-(benzimidazol-1-yl)-methyl-biphenyls useful as angiotensin-II antagonists |
US5614519A (en) | 1991-02-06 | 1997-03-25 | Karl Thomae Gmbh | (1-(2,3 or 4-N-morpholinoalkyl)-imidazol-4-yl)-benizimidazol-1-yl-methyl]-biphenyls useful as angiotensin-II antagonists |
US5602127A (en) | 1991-02-06 | 1997-02-11 | Karl Thomae Gmbh | (Alkanesultam-1-yl)-benzimidazol-1-yl)-1yl)-methyl-biphenyls useful as angiotensin-II antagonists |
GB9109862D0 (en) | 1991-05-08 | 1991-07-03 | Beecham Lab Sa | Pharmaceutical formulations |
DE4124150A1 (en) | 1991-07-20 | 1993-01-21 | Bayer Ag | SUBSTITUTED TRIAZOLES |
DK0610317T3 (en) | 1991-10-22 | 2001-02-19 | New England Medical Center Inc | Inhibitors of dipeptidyl aminopeptidase type IV |
US5300298A (en) | 1992-05-06 | 1994-04-05 | The Pennsylvania Research Corporation | Methods of treating obesity with purine related compounds |
GB9215633D0 (en) | 1992-07-23 | 1992-09-09 | Smithkline Beecham Plc | Novel treatment |
ATE165360T1 (en) | 1992-07-31 | 1998-05-15 | Shionogi & Co | TRIAZOLYLTHIOMETHYLTHIOCEPHALOSPORINE HYDROCHLORIDE, ITS CRYSTALLINE HYDRATE AND ITS PREPARATION |
TW252044B (en) | 1992-08-10 | 1995-07-21 | Boehringer Ingelheim Kg | |
US5358941A (en) | 1992-12-02 | 1994-10-25 | Merck & Co., Inc. | Dry mix formulation for bisphosphonic acids with lactose |
DE4242459A1 (en) | 1992-12-16 | 1994-06-23 | Merck Patent Gmbh | imidazopyridines |
AU6087894A (en) | 1993-01-14 | 1994-08-15 | Cell Therapeutics, Inc. | Acetal or ketal substituted therapeutic compounds |
CA2118117A1 (en) | 1993-02-18 | 1994-08-19 | Shigeki Fujiwara | Adenosine uptake inhibitor |
JP3726291B2 (en) | 1993-07-05 | 2005-12-14 | 三菱ウェルファーマ株式会社 | Benzoxazine compound having stable crystal structure and process for producing the same |
FR2707641B1 (en) | 1993-07-16 | 1995-08-25 | Fournier Ind & Sante | Compounds of imidazol-5-carboxamide, their process for preparing their intermediates and their use in therapy. |
DE4339868A1 (en) | 1993-11-23 | 1995-05-24 | Merck Patent Gmbh | imidazopyridazines |
DE4404183A1 (en) | 1994-02-10 | 1995-08-17 | Merck Patent Gmbh | 4-amino-1-piperidylbenzoylguanidine |
US5545745A (en) | 1994-05-23 | 1996-08-13 | Sepracor, Inc. | Enantioselective preparation of optically pure albuterol |
CO4410191A1 (en) | 1994-09-19 | 1997-01-09 | Lilly Co Eli | SYNTHESIS OF 3- [4- (2-AMINOETOXI) BENZOIL] -2-ARYL-6- HYDROXYBENZO [b] THIOPHENES |
WO1996011917A1 (en) | 1994-10-12 | 1996-04-25 | Euro-Celtique, S.A. | Novel benzoxazoles |
GB9501178D0 (en) | 1995-01-20 | 1995-03-08 | Wellcome Found | Guanine derivative |
CA2218548A1 (en) | 1995-05-19 | 1996-11-21 | Chiroscience Limited | Xanthines and their therapeutic use |
JPH08333339A (en) | 1995-06-08 | 1996-12-17 | Fujisawa Pharmaceut Co Ltd | Production of optically active piperidineacetic acid derivative |
GB9523752D0 (en) | 1995-11-21 | 1996-01-24 | Pfizer Ltd | Pharmaceutical formulations |
DE19543478A1 (en) | 1995-11-22 | 1997-05-28 | Bayer Ag | Crystalline hydrochloride of {(R) - (-) - 2N- [4- (1,1-dioxido-3-oxo-2,3-dihydrobenzisothiazol-2-yl) -buytl] aminomethyl} -chroman |
FR2742751B1 (en) | 1995-12-22 | 1998-01-30 | Rhone Poulenc Rorer Sa | NOVEL TAXOIDS, THEIR PREPARATION AND THE PHARMACEUTICAL COMPOSITIONS CONTAINING THEM |
WO1997023447A1 (en) | 1995-12-26 | 1997-07-03 | Alteon Inc. | N-acylaminoalkylhydrazinecarboximidamides |
US5891855A (en) | 1996-02-12 | 1999-04-06 | The Scripps Research Institute | Inhibitors of leaderless protein export |
DE122010000020I1 (en) | 1996-04-25 | 2010-07-08 | Prosidion Ltd | Method for lowering the blood glucose level in mammals |
TWI240627B (en) | 1996-04-26 | 2005-10-01 | Chugai Pharmaceutical Co Ltd | Erythropoietin solution preparation |
WO1997046526A1 (en) | 1996-06-07 | 1997-12-11 | Eisai Co., Ltd. | Stable polymorphs of donepezil (1-benzyl-4-[(5,6-dimethoxy-1-indanon)-2-yl]methylpiperidine) hydrochloride and process for production |
US5965555A (en) | 1996-06-07 | 1999-10-12 | Hoechst Aktiengesellschaft | Xanthine compounds having terminally animated alkynol side chains |
US5958951A (en) | 1996-06-14 | 1999-09-28 | Novo Nordiskials | Modified form of the R(-)-N-(4,4-di(3-methylthien-2-yl)but-3-enyl)-nipecotic acid hydrochloride |
US5753635A (en) | 1996-08-16 | 1998-05-19 | Berlex Laboratories, Inc. | Purine derivatives and their use as anti-coagulants |
EA001881B1 (en) | 1996-09-23 | 2001-10-22 | Эли Лилли Энд Компани | Olanzapine dehydrate d |
WO1998018770A1 (en) | 1996-10-28 | 1998-05-07 | Novo Nordisk A/S | A process for the preparation of (-)-3,4-trans-diarylchromans |
UA65549C2 (en) | 1996-11-05 | 2004-04-15 | Елі Ліллі Енд Компані | Use of glucagon-like peptides such as glp-1, glp-1 analog, or glp-1 derivative in methods and compositions for reducing body weight |
DE69732572T2 (en) | 1996-11-12 | 2005-12-29 | Novo Nordisk A/S | USE OF GLP-1 PEPTIDES |
GB9623859D0 (en) | 1996-11-15 | 1997-01-08 | Chiroscience Ltd | Novel compounds |
EE04266B1 (en) | 1996-12-24 | 2004-04-15 | Biogen, Incorporated | Stable liquid formulation of interferon |
DE19705233A1 (en) | 1997-02-12 | 1998-08-13 | Froelich Juergen C | Preparation of stable, orally administered arginine solutions |
US6011049A (en) | 1997-02-19 | 2000-01-04 | Warner-Lambert Company | Combinations for diabetes |
DK0991407T4 (en) | 1997-03-13 | 2005-08-08 | Hexal Ag | Stabilization of acid-sensitive benzimidazoles by amino / cyclodextrin combinations |
US5972332A (en) | 1997-04-16 | 1999-10-26 | The Regents Of The University Of Michigan | Wound treatment with keratinocytes on a solid support enclosed in a porous material |
ZA984697B (en) | 1997-06-13 | 1999-12-01 | Lilly Co Eli | Stable insulin formulations. |
CO4940418A1 (en) | 1997-07-18 | 2000-07-24 | Novartis Ag | MODIFICATION OF A CRYSTAL OF A DERIVATIVE OF N-PHENYL-2-PIRIMIDINAMINE, PROCESSES FOR ITS MANUFACTURE AND USE |
US6174548B1 (en) | 1998-08-28 | 2001-01-16 | Andrx Pharmaceuticals, Inc. | Omeprazole formulation |
TR200001603T2 (en) | 1997-12-05 | 2000-10-23 | Astrazeneca Uk Limited | New compounds |
ID21411A (en) | 1997-12-10 | 1999-06-10 | Takeda Chemical Industries Ltd | AGENTS TO TREAT GLUCOSE RESISTANCE THAT IS RISK OF HIGH DAMAGED |
JPH11193270A (en) | 1997-12-26 | 1999-07-21 | Koei Chem Co Ltd | Production of optically active 1-methyl-3-piperidinemethanol |
CA2315736A1 (en) | 1998-01-05 | 1999-07-15 | Eisai Co., Ltd. | Purine compounds and adenosine a2 receptor antagonist as preventive or therapeutic for diabetes mellitus |
AU766219B2 (en) | 1998-02-02 | 2003-10-09 | 1149336 Ontario Inc. | Method of regulating glucose metabolism, and reagents related thereto |
US20030013740A1 (en) | 1998-03-27 | 2003-01-16 | Martin P. Redmon | Stable dosage forms of fluoxetine and its enantiomers |
JP2002509919A (en) | 1998-03-31 | 2002-04-02 | 日産化学工業株式会社 | Pyridazinone compound hydrochloride and method for producing the same |
CA2268621A1 (en) | 1998-04-13 | 1999-10-13 | Takeda Chemical Industries, Ltd. | 2-pipirazinone-1-acetic acid derivative, production and use thereof |
US6207207B1 (en) | 1998-05-01 | 2001-03-27 | Mars, Incorporated | Coated confectionery having a crispy starch based center and method of preparation |
DE19823831A1 (en) | 1998-05-28 | 1999-12-02 | Probiodrug Ges Fuer Arzneim | New pharmaceutical use of isoleucyl thiazolidide and its salts |
DE19828113A1 (en) | 1998-06-24 | 2000-01-05 | Probiodrug Ges Fuer Arzneim | Prodrugs of Dipeptidyl Peptidase IV Inhibitors |
DE19828114A1 (en) | 1998-06-24 | 2000-01-27 | Probiodrug Ges Fuer Arzneim | Produgs of unstable inhibitors of dipeptidyl peptidase IV |
WO2000003735A1 (en) | 1998-07-15 | 2000-01-27 | Asahi Kasei Kogyo Kabushiki Kaisha | Excipient |
CO5150173A1 (en) | 1998-12-10 | 2002-04-29 | Novartis Ag | COMPOUNDS N- (REPLACED GLYCLE) -2-DIPEPTIDYL-IV PEPTIDASE INHIBITING CYANOPIRROLIDINS (DPP-IV) WHICH ARE EFFECTIVE IN THE TREATMENT OF CONDITIONS MEDIATED BY DPP-IV INHIBITION |
IT1312018B1 (en) | 1999-03-19 | 2002-04-04 | Fassi Aldo | IMPROVED PROCEDURE FOR THE PRODUCTION OF NON HYGROSCOPICIDAL SALTS OF L (-) - CARNITINE. |
WO2000066101A2 (en) | 1999-04-30 | 2000-11-09 | City Of Hope | Method of inhibiting glycation product formation |
AU4431000A (en) | 1999-05-12 | 2000-12-05 | Fujisawa Pharmaceutical Co., Ltd. | Novel use |
US20040152659A1 (en) | 1999-05-12 | 2004-08-05 | Fujisawa Pharmaceutical Co. Ltd. | Method for the treatment of parkinson's disease comprising administering an A1A2a receptor dual antagonist |
WO2000072799A2 (en) | 1999-05-27 | 2000-12-07 | The University Of Virginia Patent Foundation | Method and compositions for treating the inflammatory response |
CN100448482C (en) | 1999-05-31 | 2009-01-07 | 三菱化学株式会社 | Freeze dried HGF preparations |
WO2000072973A1 (en) | 1999-06-01 | 2000-12-07 | Elan Pharma International Ltd. | Small-scale mill and method thereof |
US6545002B1 (en) | 1999-06-01 | 2003-04-08 | University Of Virginia Patent Foundation | Substituted 8-phenylxanthines useful as antagonists of A2B adenosine receptors |
YU90901A (en) | 1999-06-21 | 2004-07-15 | Boehringer Ingelheim Pharma Gmbh. & Co.Kg. | Bicyclic heterocycles, medicaments containing these compounds, their use and methods for the production thereof |
US6448323B1 (en) | 1999-07-09 | 2002-09-10 | Bpsi Holdings, Inc. | Film coatings and film coating compositions based on polyvinyl alcohol |
ES2166270B1 (en) | 1999-07-27 | 2003-04-01 | Almirall Prodesfarma Sa | DERIVATIVES OF 8-PHENYL-6,9-DIHIDRO- (1,2,4,) TRIAZOLO (3,4-I) PURIN-5-ONA. |
US6515117B2 (en) | 1999-10-12 | 2003-02-04 | Bristol-Myers Squibb Company | C-aryl glucoside SGLT2 inhibitors and method |
US6586438B2 (en) | 1999-11-03 | 2003-07-01 | Bristol-Myers Squibb Co. | Antidiabetic formulation and method |
GB9928330D0 (en) | 1999-11-30 | 2000-01-26 | Ferring Bv | Novel antidiabetic agents |
SG149676A1 (en) | 1999-12-23 | 2009-02-27 | Novartis Ag | Use of hypoglycemic agent for treating impaired glucose metabolism |
WO2001051919A2 (en) | 2000-01-07 | 2001-07-19 | Transform Pharmaceuticals, Inc. | High-throughput formation, identification, and analysis of diverse solid-forms |
US6362172B2 (en) | 2000-01-20 | 2002-03-26 | Bristol-Myers Squibb Company | Water soluble prodrugs of azole compounds |
ES2436610T3 (en) | 2000-01-21 | 2014-01-03 | Novartis Ag | Combinations containing dipeptidylpeptidase-IV inhibitors and antidiabetic agents |
JP4621326B2 (en) | 2000-02-01 | 2011-01-26 | エーザイ・アール・アンド・ディー・マネジメント株式会社 | Teprenone stabilized composition |
CA2369076A1 (en) | 2000-02-05 | 2001-08-09 | Vertex Pharmaceuticals Incorporated | Pyrazole compositions useful as inhibitors of erk |
AU2001234114A1 (en) | 2000-02-24 | 2001-09-03 | Takeda Chemical Industries Ltd. | Drugs containing combined active ingredients |
EP1132389A1 (en) | 2000-03-06 | 2001-09-12 | Vernalis Research Limited | New aza-indolyl derivatives for the treatment of obesity |
US6395767B2 (en) | 2000-03-10 | 2002-05-28 | Bristol-Myers Squibb Company | Cyclopropyl-fused pyrrolidine-based inhibitors of dipeptidyl peptidase IV and method |
GB0006133D0 (en) | 2000-03-14 | 2000-05-03 | Smithkline Beecham Plc | Novel pharmaceutical |
JP2001278812A (en) | 2000-03-27 | 2001-10-10 | Kyoto Pharmaceutical Industries Ltd | Disintegrant for tablet and tablet using the same |
US6399101B1 (en) | 2000-03-30 | 2002-06-04 | Mova Pharmaceutical Corp. | Stable thyroid hormone preparations and method of making same |
DK2055302T3 (en) | 2000-03-31 | 2014-10-27 | Royalty Pharma Collection Trust | PROCEDURE FOR IMPROVING ISLAND CELL SIGNALS BY DIABETES MELLITUS AND PREVENTION thereof |
US7282219B2 (en) | 2000-03-31 | 2007-10-16 | Kirin Beer Kabushiki Kaisha | Powdery preparation for transmucosal administration containing a polymeric form of drug and exhibiting improved storage stability |
JP2001292388A (en) | 2000-04-05 | 2001-10-19 | Sharp Corp | Reproducing device |
GB0008694D0 (en) | 2000-04-07 | 2000-05-31 | Novartis Ag | Organic compounds |
WO2001096301A1 (en) | 2000-06-14 | 2001-12-20 | Toray Industries, Inc. | Processes for producing racemic piperidine derivative and for producing optically active piperidine derivative |
US7078397B2 (en) | 2000-06-19 | 2006-07-18 | Smithkline Beecham Corporation | Combinations of dipeptidyl peptidase IV inhibitors and other antidiabetic agents for the treatment of diabetes mellitus |
GB0014969D0 (en) | 2000-06-19 | 2000-08-09 | Smithkline Beecham Plc | Novel method of treatment |
US6689353B1 (en) | 2000-06-28 | 2004-02-10 | Bayer Pharmaceuticals Corporation | Stabilized interleukin 2 |
MXPA02012272A (en) | 2000-07-04 | 2003-04-25 | Novo Nordisk As | Heterocyclic compounds, which are inhibitors of the enzyme dpp-iv. |
EP1950199B1 (en) | 2000-08-10 | 2009-12-02 | Mitsubishi Tanabe Pharma Corporation | Proline derivatives and use thereof as drugs |
US6821978B2 (en) | 2000-09-19 | 2004-11-23 | Schering Corporation | Xanthine phosphodiesterase V inhibitors |
US20060034922A1 (en) | 2000-11-03 | 2006-02-16 | Andrx Labs, Llc | Controlled release metformin compositions |
US6722883B2 (en) | 2000-11-13 | 2004-04-20 | G & H Technologies Llc | Protective coating for abrasive dental tools and burs |
US6821261B2 (en) | 2000-12-12 | 2004-11-23 | Dj Orthopedics, Llc | Orthopedic brace having length-adjustable supports |
JPWO2002051836A1 (en) | 2000-12-27 | 2004-04-22 | 協和醗酵工業株式会社 | Dipeptidyl peptidase-IV inhibitor |
FR2818906B1 (en) | 2000-12-29 | 2004-04-02 | Dospharma | DRUG ASSOCIATION OF A BIGUANINE AND A CARRIER, FOR EXAMPLE OF METFORMIN AND ARGININE |
FR2819254B1 (en) | 2001-01-08 | 2003-04-18 | Fournier Lab Sa | NOVEL N- (PHENYLSULFONYL) GLYCINE COMPOUNDS, PROCESS FOR THEIR PREPARATION AND THEIR USE FOR OBTAINING PHARMACEUTICAL COMPOSITIONS |
DE10109021A1 (en) | 2001-02-24 | 2002-09-05 | Boehringer Ingelheim Pharma | New 8-substituted-xanthine derivatives, useful e.g. for treating diabetes and arthritis, act by inhibiting dipeptidylpeptidase-IV |
DE10117803A1 (en) | 2001-04-10 | 2002-10-24 | Boehringer Ingelheim Pharma | New 8-substituted-xanthine derivatives, useful e.g. for treating diabetes and arthritis, act by inhibiting dipeptidylpeptidase-IV |
PL364221A1 (en) | 2001-02-02 | 2004-12-13 | Takeda Chemical Industries, Ltd. | Fused heterocyclic compounds |
US6610326B2 (en) | 2001-02-16 | 2003-08-26 | Andrx Corporation | Divalproex sodium tablets |
WO2002066015A1 (en) | 2001-02-16 | 2002-08-29 | Bristol-Myers Squibb Pharma Company | Use of polyalkylamine polymers in controlled release devices |
PT1368349E (en) | 2001-02-24 | 2007-04-30 | Boehringer Ingelheim Pharma | Xanthine derivative, production and use thereof as a medicament |
US6936590B2 (en) | 2001-03-13 | 2005-08-30 | Bristol Myers Squibb Company | C-aryl glucoside SGLT2 inhibitors and method |
US6693094B2 (en) | 2001-03-22 | 2004-02-17 | Chrono Rx Llc | Biguanide and sulfonylurea formulations for the prevention and treatment of insulin resistance and type 2 diabetes mellitus |
CN1160122C (en) | 2001-04-20 | 2004-08-04 | 清华大学 | Method of preparing oil-phase oral insulin preparation |
JP2002348279A (en) | 2001-05-25 | 2002-12-04 | Nippon Kayaku Co Ltd | Production method for optically active pyridylketone derivatives and optically active pyridylketone derivatives |
DE10130371A1 (en) | 2001-06-23 | 2003-01-02 | Boehringer Ingelheim Pharma | New drug compositions based on anticholinergics, corticosteroids and betamimetics |
GB0115517D0 (en) | 2001-06-25 | 2001-08-15 | Ferring Bv | Novel antidiabetic agents |
ATE370943T1 (en) | 2001-06-27 | 2007-09-15 | Smithkline Beecham Corp | FLUOROPYRROLIDINE AS DIPEPTIDYL-PEPTIDASE INHIBITORS |
IL158923A0 (en) | 2001-06-27 | 2004-05-12 | Smithkline Beecham Corp | Fluoropyrrolidines as dipeptidyl peptidase inhibitors |
US6869947B2 (en) | 2001-07-03 | 2005-03-22 | Novo Nordisk A/S | Heterocyclic compounds that are inhibitors of the enzyme DPP-IV |
EP1404675B1 (en) | 2001-07-03 | 2008-03-12 | Novo Nordisk A/S | Dpp-iv-inhibiting purine derivatives for the treatment of diabetes |
UA74912C2 (en) | 2001-07-06 | 2006-02-15 | Merck & Co Inc | Beta-aminotetrahydroimidazo-(1,2-a)-pyrazines and tetratriazolo-(4,3-a)-pyrazines as inhibitors of dipeptylpeptidase for the treatment or prevention of diabetes |
WO2003006424A1 (en) | 2001-07-10 | 2003-01-23 | 4Sc Ag | Novel compounds as anti-inflammatory, immunomodulatory and anti-proliferatory agents |
US7638522B2 (en) | 2001-08-13 | 2009-12-29 | Janssen Pharmaceutica N.V. | Salt of 4-[[4-[[4-(2-cyanoethenyl)-2,6-dimethylphenyl]amino]-2-pyrimidinyl]amino] benzonitrile |
AR035119A1 (en) | 2001-08-16 | 2004-04-14 | Lilly Co Eli | ANTI-HTNFSF13B HUMAN ANTI-BODIES |
TWI246510B (en) | 2001-09-14 | 2006-01-01 | Mitsubishi Pharma Corp | Thiazolidine derivatives and pharmaceutical uses thereof |
WO2003024965A2 (en) | 2001-09-19 | 2003-03-27 | Novo Nordisk A/S | Heterocyclic compounds that are inhibitors of the enzyme dpp-iv |
CA2461454A1 (en) | 2001-09-24 | 2003-04-03 | Oregon Health And Science University | Assessment of neurons in the arcuate nucleus to screen for agents that modify feeding behavior |
DK1435877T3 (en) | 2001-10-15 | 2009-08-03 | Hemoteq Ag | Coating of stents to prevent restenosis |
DE10151296A1 (en) | 2001-10-17 | 2003-04-30 | Boehringer Ingelheim Pharma | Keratinocytes useful as a biologically active substance in the treatment of wounds |
US6723340B2 (en) | 2001-10-25 | 2004-04-20 | Depomed, Inc. | Optimal polymer mixtures for gastric retentive tablets |
US6861440B2 (en) | 2001-10-26 | 2005-03-01 | Hoffmann-La Roche Inc. | DPP IV inhibitors |
US20030083354A1 (en) | 2001-10-26 | 2003-05-01 | Pediamed Pharmaceuticals, Inc. | Phenylephrine tannate and pyrilamine tannate salts in pharmaceutical compositions |
CA2464995A1 (en) | 2001-10-31 | 2003-05-08 | Novartis Ag | Methods to treat diabetes and related conditions based on polymorphisms in the tcf1 gene |
CA2363053C (en) | 2001-11-09 | 2011-01-25 | Bernard Charles Sherman | Clopidogrel bisulfate tablet formulation |
WO2003045228A2 (en) | 2001-11-26 | 2003-06-05 | Trustees Of Tufts College | Methods for treating autoimmune disorders, and reagents related thereto |
KR20040064687A (en) | 2001-12-21 | 2004-07-19 | 도오레 화인케미칼 가부시키가이샤 | Process for production of optically active cis-piperidine derivatives |
US6727261B2 (en) | 2001-12-27 | 2004-04-27 | Hoffman-La Roche Inc. | Pyrido[2,1-A]Isoquinoline derivatives |
WO2003057245A1 (en) | 2001-12-28 | 2003-07-17 | Nrl Pharma, Inc. | Compositions for improving lipid metabolism |
JP4733922B2 (en) | 2002-01-10 | 2011-07-27 | インペリアル・イノベ−ションズ・リミテッド | Correction of eating behavior |
WO2003057200A2 (en) | 2002-01-11 | 2003-07-17 | Novo Nordisk A/S | Compositions comprising inhibitors of dpp-iv and nep enzymes for the treatment of diabetes |
US20070197552A1 (en) | 2002-01-11 | 2007-08-23 | Novo Nordisk A/S | Method and composition for treatment of diabetes, hypertension, chronic heart failure and fluid retentive states |
EP1854454B1 (en) | 2002-01-16 | 2013-11-06 | Boehringer Ingelheim Pharma GmbH & Co. KG | Method for the preparation of amorphous telmisartan |
EP1477182A4 (en) | 2002-01-21 | 2009-05-27 | Nrl Pharma Inc | Novel analgesics |
EP1333033A1 (en) | 2002-01-30 | 2003-08-06 | Boehringer Ingelheim Pharma GmbH & Co.KG | FAP-activated anti-tumor compounds |
JP2005517690A (en) | 2002-02-01 | 2005-06-16 | ファイザー・プロダクツ・インク | Immediate release dosage form containing solid drug dispersion |
US7610153B2 (en) | 2002-02-13 | 2009-10-27 | Virginia Commonwealth University | Multi-drug titration and evaluation |
SI1476138T1 (en) | 2002-02-21 | 2012-07-31 | Valeant Internat Barbados Srl | Modified release formulations of at least one form of tramadol |
US7074798B2 (en) | 2002-02-25 | 2006-07-11 | Eisai Co., Ltd | Xanthine derivative and DPPIV inhibitor |
HUP0200849A2 (en) | 2002-03-06 | 2004-08-30 | Sanofi-Synthelabo | N-aminoacetyl-pyrrolidine-2-carbonitrile derivatives, pharmaceutical compositions containing them and process for producing them |
JP4298212B2 (en) | 2002-03-29 | 2009-07-15 | 大日本印刷株式会社 | Method for producing high melting point type epinastine hydrochloride |
JP2003300977A (en) | 2002-04-10 | 2003-10-21 | Sumitomo Pharmaceut Co Ltd | Xanthine derivative |
EP1496982A4 (en) | 2002-04-16 | 2006-07-19 | Merck & Co Inc | Solid forms of salts with tyrosine kinase activity |
CA2484306A1 (en) | 2002-04-26 | 2003-11-06 | Katsumi Maezono | Prophylactic and therapeutic agent of diabetes mellitus |
AU2003231252A1 (en) | 2002-05-09 | 2003-11-11 | Enos Pharmaceuticals, Inc. | Methods and compositions for the treatment and prevention of intermittent claudication or alzheimer's disease |
GB0212412D0 (en) | 2002-05-29 | 2002-07-10 | Novartis Ag | Combination of organic compounds |
DK1509525T5 (en) | 2002-05-31 | 2007-07-30 | Schering Corp | Process for Preparing Xanthine Phosphodiesterase V Inhibitors and Precursors Therefore |
BR0311697A (en) | 2002-06-06 | 2005-03-22 | Eisai Co Ltd | New Condensed Imidazole Derivatives |
FR2840897B1 (en) | 2002-06-14 | 2004-09-10 | Fournier Lab Sa | NOVEL ARYLSULFONAMIDE DERIVATIVES AND THEIR USE IN THERAPEUTICS |
US20040002615A1 (en) | 2002-06-28 | 2004-01-01 | Allen David Robert | Preparation of chiral amino-nitriles |
US20040023981A1 (en) | 2002-07-24 | 2004-02-05 | Yu Ren | Salt forms with tyrosine kinase activity |
AR040661A1 (en) | 2002-07-26 | 2005-04-13 | Theravance Inc | CRYSTAL DICHLORHYDRATE OF N- {2 - [- ((R) -2-HYDROXI-2-PHENYLETHYLAMINE) PHENYL] ETIL} - (R) -2 HYDROXY-2- (3-FORMAMIDE-4-HYDROXYPHENYL) ETHYLAMINE, RECEIVER AGONIST BETA 2 ADRENERGIC |
ITMI20021725A1 (en) | 2002-08-01 | 2002-10-31 | Zambon Spa | PHARMACEUTICAL COMPOSITIONS WITH ANTIBIOTIC ACTIVITY. |
TW200404796A (en) | 2002-08-19 | 2004-04-01 | Ono Pharmaceutical Co | Nitrogen-containing compound |
DE10238243A1 (en) | 2002-08-21 | 2004-03-04 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New 8-(3-amino-piperidin-1-yl)-xanthine derivatives are dipeptidylpeptidase-IV inhibitors useful for, e.g. treating diabetes mellitus, arthritis or obesity |
US7407955B2 (en) | 2002-08-21 | 2008-08-05 | Boehringer Ingelheim Pharma Gmbh & Co., Kg | 8-[3-amino-piperidin-1-yl]-xanthines, the preparation thereof and their use as pharmaceutical compositions |
EP2070539A1 (en) | 2002-08-21 | 2009-06-17 | Boehringer Ingelheim Pharma GmbH & Co. KG | 8-[3-amino-piperidin-1-yl]-xanthins, their production and utilisation as medicine |
US7495005B2 (en) | 2002-08-22 | 2009-02-24 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Xanthine derivatives, their preparation and their use in pharmaceutical compositions |
DE10238477A1 (en) | 2002-08-22 | 2004-03-04 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New purine derivatives, their production and their use as medicines |
DE10238470A1 (en) | 2002-08-22 | 2004-03-04 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New xanthine derivatives, their production and their use as medicines |
US7569574B2 (en) | 2002-08-22 | 2009-08-04 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Purine derivatives, the preparation thereof and their use as pharmaceutical compositions |
DE10238724A1 (en) | 2002-08-23 | 2004-03-04 | Bayer Ag | New 6-alkyl-1,5-dihydro-4H-pyrazolo-(3,4-d)-pyrimidin-4-ones useful as selective phosphodiesterase 9A inhibitors for improving attention, concentration, learning and/or memory performance |
DE10238723A1 (en) | 2002-08-23 | 2004-03-11 | Bayer Ag | Phenyl substituted pyrazolyprimidines |
US20060039974A1 (en) | 2002-09-11 | 2006-02-23 | Takeda Pharmaceutical Company Limited | Sustained release preparation |
CN1688293A (en) | 2002-09-16 | 2005-10-26 | 韦思公司 | Delayed release formulations for oral administration of a polypeptide therapeutic agent and methods of using same |
US7262207B2 (en) | 2002-09-19 | 2007-08-28 | Abbott Laboratories | Pharmaceutical compositions as inhibitors of dipeptidyl peptidase-IV (DPP-IV) |
AU2003266559B2 (en) | 2002-09-26 | 2008-01-24 | Eisai R&D Management Co., Ltd. | Combination drug |
US20060039968A1 (en) | 2002-10-08 | 2006-02-23 | Ramalingam Manikandan | Gabapentin tablets and method for their preparation |
AU2003269850A1 (en) | 2002-10-08 | 2004-05-04 | Novo Nordisk A/S | Hemisuccinate salts of heterocyclic dpp-iv inhibitors |
US20040122048A1 (en) | 2002-10-11 | 2004-06-24 | Wyeth Holdings Corporation | Stabilized pharmaceutical composition containing basic excipients |
US6861526B2 (en) | 2002-10-16 | 2005-03-01 | Pfizer Inc. | Process for the preparation of (S,S)-cis-2-benzhydryl-3-benzylaminoquinuclidine |
JP4352001B2 (en) | 2002-10-18 | 2009-10-28 | メルク エンド カムパニー インコーポレーテッド | Beta-amino heterocyclic dipeptidyl peptidase inhibitors for the treatment or prevention of diabetes |
JP2004161749A (en) | 2002-10-24 | 2004-06-10 | Toray Fine Chemicals Co Ltd | Method for producing optically active, nitrogen-containing compound |
WO2004048379A1 (en) | 2002-11-01 | 2004-06-10 | Sumitomo Pharmaceuticals Co., Ltd. | Xanthine compound |
RU2005117383A (en) | 2002-11-07 | 2006-01-20 | Мерк энд Ко., Инк. (US) | Phenylalanine derivatives as dipepididyl peptidase inhibitors for the treatment or prevention of diabetes |
US7482337B2 (en) | 2002-11-08 | 2009-01-27 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Xanthine derivatives, the preparation thereof and their use as pharmaceutical compositions |
DE10251927A1 (en) | 2002-11-08 | 2004-05-19 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New 1,7,8-trisubstituted xanthine derivatives, are dipeptidylpeptidase-IV inhibitors useful e.g. for treating diabetes mellitus type I or II, arthritis or obesity |
DE10254304A1 (en) | 2002-11-21 | 2004-06-03 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New xanthine derivatives, their production and their use as medicines |
UY28103A1 (en) | 2002-12-03 | 2004-06-30 | Boehringer Ingelheim Pharma | NEW IMIDAZO-PIRIDINONAS REPLACED, ITS PREPARATION AND ITS EMPLOYMENT AS MEDICATIONS |
US7109192B2 (en) | 2002-12-03 | 2006-09-19 | Boehringer Ingelheim Pharma Gmbh & Co Kg | Substituted imidazo-pyridinones and imidazo-pyridazinones, the preparation thereof and their use as pharmaceutical compositions |
ATE404191T1 (en) | 2002-12-10 | 2008-08-15 | Novartis Pharma Ag | COMBINATIONS OF A DPP-IV INHIBITOR AND A PPAR-ALPHA AGONIST |
US20040152720A1 (en) | 2002-12-20 | 2004-08-05 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Powdered medicaments containing a tiotropium salt and salmeterol xinafoate |
DE10351663A1 (en) | 2002-12-20 | 2004-07-01 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Stable, accurately dosable inhalable powder medicament for treating asthma or chronic obstructive pulmonary disease, containing tiotropium, specific form of salmeterol xinafoate and auxiliary |
DK1599222T3 (en) | 2003-01-08 | 2009-04-27 | Novartis Vaccines & Diagnostic | Stabilized aqueous preparations comprising v vs factor pathway inhibitor (TFPI) or v vs factor pathway inhibitor variant |
EP1599468B1 (en) | 2003-01-14 | 2007-10-03 | Arena Pharmaceuticals, Inc. | 1,2,3-trisubstituted aryl and heteroaryl derivatives as modulators of metabolism and the prophylaxis and treatment of disorders related thereto such as diabetes and hyperglycemia |
DE10335027A1 (en) | 2003-07-31 | 2005-02-17 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Use of telmisartan and simvastatin for treatment or prophylaxis of cardiovascular, cardiopulmonary and renal diseases e.g. hypertension combined with hyperlipidemia or atherosclerosis |
PE20040950A1 (en) | 2003-02-14 | 2005-01-01 | Theravance Inc | BIPHENYL DERIVATIVES AS AGONISTS OF ß2-ADRENERGIC RECEPTORS AND AS ANTAGONISTS OF MUSCARINAL RECEPTORS |
JP2004250336A (en) | 2003-02-18 | 2004-09-09 | Kao Corp | Method for producing coated tablet and sugar-coated tablet |
US7135575B2 (en) | 2003-03-03 | 2006-11-14 | Array Biopharma, Inc. | P38 inhibitors and methods of use thereof |
US7442387B2 (en) | 2003-03-06 | 2008-10-28 | Astellas Pharma Inc. | Pharmaceutical composition for controlled release of active substances and manufacturing method thereof |
CA2515289A1 (en) | 2003-03-12 | 2004-09-23 | Arizona Board Of Regents On Behalf Of The University Of Arizona | Weak base salts |
CN100415224C (en) | 2003-03-18 | 2008-09-03 | 诺瓦提斯公司 | Compositions comprising fatty acids and amino acids |
CN104383542B (en) | 2003-04-08 | 2017-09-26 | 普罗热尼奇制药公司 | Pharmaceutical formulation comprising methyl naltrexone |
WO2004096806A1 (en) | 2003-04-30 | 2004-11-11 | Sumitomo Pharmaceuticals Co. Ltd. | Fused imidazole derivative |
US20040220186A1 (en) | 2003-04-30 | 2004-11-04 | Pfizer Inc. | PDE9 inhibitors for treating type 2 diabetes,metabolic syndrome, and cardiovascular disease |
TW200510277A (en) | 2003-05-27 | 2005-03-16 | Theravance Inc | Crystalline form of β2-adrenergic receptor agonist |
FR2855521B1 (en) | 2003-05-28 | 2005-08-05 | Flamel Tech Sa | POLYAMINOACIDES FUNCTIONALIZED BY AT LEAST ONE YDROPHOBIC GROUP AND THEIR PARTICULARLY THERAPEUTIC APPLICATIONS. |
AU2003902828A0 (en) | 2003-06-05 | 2003-06-26 | Fujisawa Pharmaceutical Co., Ltd. | Dpp-iv inhibitor |
DE10327439A1 (en) | 2003-06-18 | 2005-01-05 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Novel imidazopyridazinone and imidazopyridone derivatives, their production and their use as pharmaceuticals |
US7566707B2 (en) | 2003-06-18 | 2009-07-28 | Boehringer Ingelheim International Gmbh | Imidazopyridazinone and imidazopyridone derivatives, the preparation thereof and their use as pharmaceutical compositions |
MXPA05013734A (en) | 2003-06-20 | 2006-03-08 | Hoffmann La Roche | Hexahydropyridoisoqinolines as dpp-iv inhibitors. |
DE602004030244D1 (en) | 2003-06-20 | 2011-01-05 | Hoffmann La Roche | ITOREN |
JO2625B1 (en) | 2003-06-24 | 2011-11-01 | ميرك شارب اند دوم كوربوريشن | Phosphoric acid salt of a dipeptidyl peptidase-IV inhibitor |
US7364755B2 (en) | 2003-07-07 | 2008-04-29 | Synthon Ip Inc. | Modified calcium phosphate excipient |
AR045047A1 (en) | 2003-07-11 | 2005-10-12 | Arena Pharm Inc | ARILO AND HETEROARILO DERIVATIVES TRISUSTITUIDOS AS MODULATORS OF METABOLISM AND PROFILAXIS AND TREATMENT OF DISORDERS RELATED TO THEMSELVES |
EP2287165A3 (en) | 2003-07-14 | 2011-06-22 | Arena Pharmaceuticals, Inc. | Fused-aryl and heteroaryl derivatives as modulators of metabolism and the prophylaxis and treatment of disorders related thereto |
US20050027012A1 (en) | 2003-07-16 | 2005-02-03 | Boehringer Ingelheim International Gmbh | Tablets containing ambroxol |
US20060134206A1 (en) | 2003-07-24 | 2006-06-22 | Iyer Eswaran K | Oral compositions for treatment of diseases |
CN1829709A (en) | 2003-08-01 | 2006-09-06 | 健亚生物科技公司 | Bicyclic imidazol derivatives against flaviviridae |
US6995183B2 (en) | 2003-08-01 | 2006-02-07 | Bristol Myers Squibb Company | Adamantylglycine-based inhibitors of dipeptidyl peptidase IV and methods |
EP1656158B1 (en) | 2003-08-14 | 2016-03-09 | Novo Nordisk Health Care AG | Liquid, aqueous pharmaceutical composition of factor vii polypeptides |
CN102349927A (en) | 2003-08-29 | 2012-02-15 | Hdac默克研究有限责任公司 | Combination methods of treating cancer |
WO2005026148A1 (en) | 2003-09-08 | 2005-03-24 | Takeda San Diego, Inc. | Dipeptidyl peptidase inhibitors |
US20070072810A1 (en) * | 2003-10-03 | 2007-03-29 | Takeda Pharmaceutical Company, Limited | Agent for treating diabetes |
BR0304443B1 (en) | 2003-10-28 | 2012-08-21 | process for obtaining high thio2 and low radionuclide titanium concentrates from mechanical anatase concentrates. | |
US7107714B2 (en) | 2003-11-10 | 2006-09-19 | Marketing Displays, Inc. | Portable snap-fit sign stand |
KR20140089408A (en) | 2003-11-17 | 2014-07-14 | 노파르티스 아게 | Use of dipeptidyl peptidase iv inhibitors |
DE10355304A1 (en) | 2003-11-27 | 2005-06-23 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Novel 8- (piperazin-1-yl) and 8 - ([1,4] diazepan-1-yl) xanthines, their preparation and their use as pharmaceuticals |
JPWO2005053695A1 (en) | 2003-12-04 | 2007-12-06 | エーザイ・アール・アンド・ディー・マネジメント株式会社 | Agents for preventing or treating multiple sclerosis |
DE10359098A1 (en) | 2003-12-17 | 2005-07-28 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Novel 2- (piperazin-1-yl) and 2 - ([1,4] diazepan-1-yl) imidazo [4,5-d] pyridazin-4-ones, their preparation and their use as pharmaceuticals |
US7217711B2 (en) | 2003-12-17 | 2007-05-15 | Boehringer Ingelheim International Gmbh | Piperazin-1-yl and 2-([1,4]diazepan-1-yl)-imidazo[4,5-d]-pyridazin-4-ones, the preparation thereof and their use as pharmaceutical compositions |
ATE501135T1 (en) | 2003-12-18 | 2011-03-15 | Tibotec Pharm Ltd | PIPERIDINAMINO-BENZIMIDAZOLE DERIVATIVES AL RESPIRATORY SYNCYTIALVIRUS REPLICATION INHIBITORS |
DE10360835A1 (en) | 2003-12-23 | 2005-07-21 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New bicyclic imidazole derivatives are dipeptidylpeptidase-IV inhibitors useful to treat e.g. arthritis, obesity, allograft transplantation and calcitonin-induced osteoporosis |
CA2549955A1 (en) | 2003-12-24 | 2005-07-07 | Prosidion Limited | Heterocyclic derivatives as gpcr receptor agonists |
EP1708680A2 (en) | 2004-01-21 | 2006-10-11 | Janssen Pharmaceutica N.V. | Mitratapide oral solution |
SE0400234D0 (en) | 2004-02-06 | 2004-02-06 | Active Biotech Ab | New compounds, methods for their preparation and use thereof |
PT1758905E (en) | 2004-02-18 | 2009-07-16 | Boehringer Ingelheim Int | 8-[3-amino-piperidin-1-yl]-xanthine, the production thereof and the use in the form of a ddp-iv inhibitor |
US7501426B2 (en) | 2004-02-18 | 2009-03-10 | Boehringer Ingelheim International Gmbh | 8-[3-amino-piperidin-1-yl]-xanthines, their preparation and their use as pharmaceutical compositions |
DE102004019540A1 (en) | 2004-04-22 | 2005-11-10 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Composition, useful for treatment of e.g. inflammatory and obstructive respiratory complaint, sinus rhythm in heart in atrioventricular block and circulatory shock, comprises 6-hydroxy-4H-benzo1,4oxazin-3-one derivatives and other actives |
DE102004009039A1 (en) | 2004-02-23 | 2005-09-08 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | 8- [3-Amino-piperidin-1-yl] xanthines, their preparation and use as pharmaceuticals |
EP1593671A1 (en) | 2004-03-05 | 2005-11-09 | Graffinity Pharmaceuticals AG | DPP-IV inhibitors |
US7393847B2 (en) | 2004-03-13 | 2008-07-01 | Boehringer Ingleheim International Gmbh | Imidazopyridazinediones, their preparation and their use as pharmaceutical compositions |
CN102079743B (en) | 2004-03-15 | 2020-08-25 | 武田药品工业株式会社 | Dipeptidyl peptidase inhibitors |
EA011158B1 (en) | 2004-03-16 | 2009-02-27 | Бёрингер Ингельхайм Интернациональ Гмбх | Glucopyranosyl-substituted benzol derivatives, drugs containing said compounds, the use thereof and method for the production thereof |
EP1577306A1 (en) | 2004-03-17 | 2005-09-21 | Boehringer Ingelheim Pharma GmbH & Co.KG | novel benzoxazinone derivatives as slow-acting betamimetics and use thereof in treatment of respiratory tract diseases |
WO2005097798A1 (en) | 2004-04-10 | 2005-10-20 | Boehringer Ingelheim International Gmbh | Novel 2-amino-imidazo[4,5-d]pyridazin-4-ones and 2-amino-imidazo[4,5-c]pyridin-4-ones, production and use thereof as medicaments |
US7179809B2 (en) | 2004-04-10 | 2007-02-20 | Boehringer Ingelheim International Gmbh | 2-Amino-imidazo[4,5-d]pyridazin-4-ones, their preparation and their use as pharmaceutical compositions |
US20050239778A1 (en) | 2004-04-22 | 2005-10-27 | Boehringer Ingelheim International Gmbh | Novel medicament combinations for the treatment of respiratory diseases |
US20050244502A1 (en) | 2004-04-28 | 2005-11-03 | Mathias Neil R | Composition for enhancing absorption of a drug and method |
CN1976691B (en) | 2004-05-03 | 2010-10-13 | 奥加生物药业(I.P.3)有限公司 | Cysteamines for treating complications of hypercholesterolemia and diabetes |
US7439370B2 (en) | 2004-05-10 | 2008-10-21 | Boehringer Ingelheim International Gmbh | Imidazole derivatives, their preparation and their use as intermediates for the preparation of pharmaceutical compositions and pesticides |
GEP20084421B (en) | 2004-05-12 | 2008-07-10 | Pfizer Prod Inc | Proline derivatives and their use as dipeptidyl peptidase iv inhibitors |
DE102004024454A1 (en) | 2004-05-14 | 2005-12-08 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Novel enantiomerically pure beta agonists, process for their preparation and their use as pharmaceuticals |
PE20060315A1 (en) | 2004-05-24 | 2006-05-15 | Irm Llc | THIAZOLE COMPOUNDS AS PPAR MODULATORS |
TWI354569B (en) | 2004-05-28 | 2011-12-21 | Bristol Myers Squibb Co | Coated tablet formulation and method |
WO2005117948A1 (en) | 2004-06-01 | 2005-12-15 | Ares Trading S.A. | Method of stabilizing proteins |
WO2005119526A1 (en) | 2004-06-03 | 2005-12-15 | Pfizer Products Inc. | Crystal structure of dipeptidyl peptidase iv (dpp-iv) and uses thereof |
US7935723B2 (en) | 2004-06-04 | 2011-05-03 | Novartis Pharma Ag | Use of organic compounds |
EP1604989A1 (en) | 2004-06-08 | 2005-12-14 | Santhera Pharmaceuticals (Deutschland) Aktiengesellschaft | DPP-IV inhibitors |
US20050276794A1 (en) | 2004-06-09 | 2005-12-15 | Papas Klearchos K | Composition and method for improving pancreatic islet cell survival |
DE102004030502A1 (en) | 2004-06-24 | 2006-01-12 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Novel imidazoles and triazoles, their preparation and use as medicines |
CA2511269A1 (en) | 2004-07-07 | 2006-01-07 | F. Hoffmann-La Roche Ag | Multimarker panel based on p1gf for diabetes type 1 and 2 |
CA2573209A1 (en) | 2004-07-14 | 2006-01-19 | Novartis Ag | Combination of dpp-iv inhibitors and compounds modulating 5-ht3 and/or 5-ht4 receptors |
JP2006045156A (en) | 2004-08-06 | 2006-02-16 | Sumitomo Pharmaceut Co Ltd | Condensed pyrazole derivative |
TW200613275A (en) | 2004-08-24 | 2006-05-01 | Recordati Ireland Ltd | Lercanidipine salts |
EP1782832A4 (en) | 2004-08-26 | 2009-08-26 | Takeda Pharmaceutical | Remedy for diabetes |
DE102004043944A1 (en) | 2004-09-11 | 2006-03-30 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Novel 8- (3-amino-piperidin-1-yl) -7- (but-2-ynyl) -xanthines, their preparation and their use as pharmaceuticals |
DE102004044221A1 (en) | 2004-09-14 | 2006-03-16 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New 3-methyl-7-butynyl xanthines, their preparation and their use as pharmaceuticals |
CN1759834B (en) | 2004-09-17 | 2010-06-23 | 中国医学科学院医药生物技术研究所 | Application of berberine or associated with Simvastatin in preparing product for preventing or curing disease or symptom related to blood fat |
CA2580461A1 (en) | 2004-09-23 | 2006-04-06 | Amgen Inc. | Substituted sulfonamidopropionamides and methods of use |
BRPI0516446A (en) | 2004-10-08 | 2008-09-02 | Novartis Ag | combination of organic compounds |
EA013463B1 (en) | 2004-10-12 | 2010-04-30 | ГЛЕНМАРК ФАРМАСЬЮТИКАЛС Эс.Эй. | Novel dipeptidyl peptidase iv inhibitors, pharmaceutical compositions containing them, process for their preparation and method for the treatment using thereof |
MX2007004934A (en) | 2004-10-25 | 2007-06-12 | Novartis Ag | Combination of dpp-iv inhibitor, ppar antidiabetic and metformin. |
DE102005013967A1 (en) | 2004-11-05 | 2006-10-05 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | New imidazole or pyrimidine derivatives are bradykinin B1 antagonists used for treating e.g. pain, stroke, peptic ulcers and other inflammatory disorders |
DE102004054054A1 (en) | 2004-11-05 | 2006-05-11 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | Process for preparing chiral 8- (3-amino-piperidin-1-yl) -xanthines |
JP2006137678A (en) | 2004-11-10 | 2006-06-01 | Shionogi & Co Ltd | Interleukin-2 composition |
BRPI0518651A2 (en) | 2004-12-24 | 2008-12-02 | Dainippon Sumitomo Pharma | compound, a prodrug thereof, or a pharmaceutically acceptable compound or prodrug salt, pharmaceutical composition, dipeptidyl peptidase iv inhibitor, use of a compound, a prodrug thereof or a compound or prodrug salt pharmaceutically acceptable method of treating diabetes |
KR100760430B1 (en) | 2004-12-31 | 2007-10-04 | 한미약품 주식회사 | Controlled release complex formulation for oral administration of medicine for diabetes and method for the preparation thereof |
MY148521A (en) | 2005-01-10 | 2013-04-30 | Arena Pharm Inc | Substituted pyridinyl and pyrimidinyl derivatives as modulators of metabolism and the treatment of disorders related thereto |
DOP2006000008A (en) | 2005-01-10 | 2006-08-31 | Arena Pharm Inc | COMBINED THERAPY FOR THE TREATMENT OF DIABETES AND RELATED AFFECTIONS AND FOR THE TREATMENT OF AFFECTIONS THAT IMPROVE THROUGH AN INCREASE IN THE BLOOD CONCENTRATION OF GLP-1 |
GT200600008A (en) | 2005-01-18 | 2006-08-09 | FORMULATION OF DIRECT COMPRESSION AND PROCESS | |
EP1874339A1 (en) | 2005-04-21 | 2008-01-09 | Gastrotech Pharma A/S | Pharmaceutical preparations of a glp-1 molecule and an anti-emetic drug |
AU2006239929B2 (en) | 2005-04-22 | 2011-11-03 | Alantos Pharmaceuticals Holding, Inc. | Dipeptidyl peptidase-IV inhibitors |
UA91546C2 (en) | 2005-05-03 | 2010-08-10 | Бьорінгер Інгельхайм Інтернаціональ Гмбх | Crystalline form of 1-chloro-4-(я-d-glucopyranos-1-yl)-2-[4-((s)-tetrahydrofuran-3-yloxy)-benzyl]-benzene, a method for its preparation and the use thereof for preparing medicaments |
CN101203494A (en) | 2005-05-25 | 2008-06-18 | 惠氏公司 | Methods of synthesizing substituted 3-cyanoquinolines and intermediates thereof |
EP1894567B1 (en) | 2005-06-03 | 2012-08-15 | Mitsubishi Tanabe Pharma Corporation | Concomitant pharmaceutical agents and use thereof |
GT200600218A (en) | 2005-06-10 | 2007-03-28 | FORMULATION AND PROCESS OF DIRECT COMPRESSION | |
NZ564285A (en) | 2005-06-20 | 2010-03-26 | Decode Genetics Ehf | Genetic variants in the TCF7L2 gene as diagnostic markers for risk of type 2 diabetes mellitus |
ATE483732T1 (en) | 2005-07-08 | 2010-10-15 | Pfizer Ltd | MADCAM ANTIBODIES |
US20070014855A1 (en) | 2005-07-12 | 2007-01-18 | Rahul Gawande S | Stable desloratadine compositions |
UY29694A1 (en) | 2005-07-28 | 2007-02-28 | Boehringer Ingelheim Int | METHODS TO PREVENT AND TREAT METABOLIC AND NEW DISORDERS DERIVED FROM PIRAZOL-O-GLUCOSIDO |
DE102005035891A1 (en) | 2005-07-30 | 2007-02-08 | Boehringer Ingelheim Pharma Gmbh & Co. Kg | 8- (3-amino-piperidin-1-yl) -xanthines, their preparation and their use as pharmaceuticals |
MX2008001799A (en) | 2005-08-11 | 2008-04-16 | Hoffmann La Roche | Pharmaceutical composition comprising a dpp-iv inhibitor. |
EP1760076A1 (en) | 2005-09-02 | 2007-03-07 | Ferring B.V. | FAP Inhibitors |
AU2006289259A1 (en) * | 2005-09-08 | 2007-03-15 | Uutech Limited | Analogs of gastric inhibitory polypeptide as a treatment for age related decreased pancreatic beta cell function |
PL1931350T5 (en) | 2005-09-14 | 2021-11-15 | Takeda Pharmaceutical Company Limited | Administration of dipeptidyl peptidase inhibitors |
WO2007033350A1 (en) | 2005-09-14 | 2007-03-22 | Takeda Pharmaceutical Company Limited | Dipeptidyl peptidase inhibitors for treating diabetes |
RS20080112A (en) | 2005-09-16 | 2009-05-06 | Arena Pharmaceuticals Inc., | Modulators of metabolism and the treatment of disorders related thereto |
RU2440143C2 (en) | 2005-09-20 | 2012-01-20 | Новартис Аг | Application of dpp-iv inhibitor for reduction of glycemia acute exacerbation |
WO2007038979A1 (en) | 2005-09-22 | 2007-04-12 | Swissco Development Ag | Effervescent metformin composition and tablets and granules made therefrom |
JOP20180109A1 (en) | 2005-09-29 | 2019-01-30 | Novartis Ag | New Formulation |
US20080221200A1 (en) | 2005-09-30 | 2008-09-11 | Malcolm Allison | Combination of Organic Compounds |
CA2625646A1 (en) | 2005-10-25 | 2007-05-03 | Merck & Co., Inc. | Combination of a dipeptidyl peptidase-4 inhibitor and an anti-hypertensive agent for the treatment of diabetes and hypertension |
EP1962827A4 (en) | 2005-12-16 | 2011-02-16 | Merck Sharp & Dohme | Pharmaceutical compositions of combinations of dipeptidyl peptidase-4 inhibitors with metformin |
JP2009520763A (en) | 2005-12-23 | 2009-05-28 | ノバルティス アクチエンゲゼルシャフト | Fused heterocyclic compounds useful as DPP-IV inhibitors |
GB0526291D0 (en) | 2005-12-23 | 2006-02-01 | Prosidion Ltd | Therapeutic method |
US20090054512A1 (en) | 2006-01-06 | 2009-02-26 | Foley James E | Use of organic compounds |
KR20080102395A (en) | 2006-02-15 | 2008-11-25 | 베링거 인겔하임 인터내셔날 게엠베하 | Glycopyranosyl-substituted benzonitrile derivatives, pharmaceutical compositions containing such compounds, their use and process for their manufacture |
WO2007099345A1 (en) | 2006-03-02 | 2007-09-07 | Betagenon Ab | Medical use of bmp-2 and/ or bmp-4 |
PE20071221A1 (en) | 2006-04-11 | 2007-12-14 | Arena Pharm Inc | GPR119 RECEPTOR AGONISTS IN METHODS TO INCREASE BONE MASS AND TO TREAT OSTEOPOROSIS AND OTHER CONDITIONS CHARACTERIZED BY LOW BONE MASS, AND COMBINED THERAPY RELATED TO THESE AGONISTS |
US8455435B2 (en) | 2006-04-19 | 2013-06-04 | Ludwig-Maximilians-Universitat Munchen | Remedies for ischemia |
EP1852108A1 (en) | 2006-05-04 | 2007-11-07 | Boehringer Ingelheim Pharma GmbH & Co.KG | DPP IV inhibitor formulations |
MX2008014024A (en) | 2006-05-04 | 2008-11-14 | Boehringer Ingelheim Int | Polymorphs. |
PE20080251A1 (en) | 2006-05-04 | 2008-04-25 | Boehringer Ingelheim Int | USES OF DPP IV INHIBITORS |
NZ572368A (en) | 2006-05-16 | 2011-04-29 | Gilead Sciences Inc | Method and compositions for treating hematological malignancies |
KR20070111099A (en) | 2006-05-16 | 2007-11-21 | 영진약품공업주식회사 | Novel crystalline form of sitagliptin hydrochloride |
WO2007137107A2 (en) | 2006-05-19 | 2007-11-29 | Abbott Laboratories | Inhibitors of diacylglycerol o-acyltransferase type 1 enzyme |
KR100858848B1 (en) | 2006-05-23 | 2008-09-17 | 한올제약주식회사 | Pharmaceutical compositions and formulations of Metformin extended release tablets |
WO2007149797A2 (en) | 2006-06-19 | 2007-12-27 | Novartis Ag | Use of organic compounds |
WO2007148185A2 (en) | 2006-06-21 | 2007-12-27 | Pfizer Products Inc. | Substituted 3 -amino- pyrrolidino-4 -lactams as dpp inhibitors |
AT503443B1 (en) | 2006-06-23 | 2007-10-15 | Leopold Franzens Uni Innsbruck | Preparation of an ice surface, useful for ice rink, and ice sports cars and trains, comprises freezing water in which an inorganic substance e.g. ammonia, alkali hydroxide, hydrogen halide, nitric acid and sulfuric acid, is added |
TW200811140A (en) | 2006-07-06 | 2008-03-01 | Arena Pharm Inc | Modulators of metabolism and the treatment of disorders related thereto |
TW200811147A (en) | 2006-07-06 | 2008-03-01 | Arena Pharm Inc | Modulators of metabolism and the treatment of disorders related thereto |
WO2008017670A1 (en) | 2006-08-08 | 2008-02-14 | Boehringer Ingelheim International Gmbh | Pyrrolo [3, 2 -d] pyrimidines as dpp-iv inhibitors for the treatment of diabetes mellitus |
JP5384343B2 (en) | 2006-08-15 | 2014-01-08 | ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング | Glucopyranosyl-substituted cyclopropylbenzene derivatives, pharmaceutical compositions containing such compounds, their use as SGLT inhibitors and methods for their preparation |
JP2010501010A (en) | 2006-08-17 | 2010-01-14 | ウェルスタット セラピューティクス コーポレイション | Combination treatment for metabolic disorders |
DE102006042586B4 (en) | 2006-09-11 | 2014-01-16 | Betanie B.V. International Trading | Process for the microparticulate loading of high polymer carbohydrates with hydrophobic active fluids |
JP2010506129A (en) | 2006-10-03 | 2010-02-25 | ワイス エルエルシー | Freeze drying method and equipment |
US7956201B2 (en) | 2006-11-06 | 2011-06-07 | Hoffman-La Roche Inc. | Process for the preparation of (S)-4-fluoromethyl-dihydro-furan-2-one |
EP2079753A1 (en) | 2006-11-06 | 2009-07-22 | Boehringer Ingelheim International GmbH | Glucopyranosyl-substituted benzyl-benzonitrile derivatives, medicaments containing such compounds, their use and process for their manufacture |
JP5337040B2 (en) | 2006-11-09 | 2013-11-06 | ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング | Combination therapy with SGLT-2 inhibitors and pharmaceutical compositions thereof |
EA015835B1 (en) | 2006-12-06 | 2011-12-30 | Смитклайн Бичем Корпорейшн | 4-oxa(thia)methylpiperidine derivatives, use thereof as antidiabetic compounds |
ES2319596B1 (en) | 2006-12-22 | 2010-02-08 | Laboratorios Almirall S.A. | NEW DERIVATIVES OF THE AMINO-NICOTINIC AND AMINO-ISONICOTINIC ACIDS. |
US7638541B2 (en) | 2006-12-28 | 2009-12-29 | Metabolex Inc. | 5-ethyl-2-{4-[4-(4-tetrazol-1-yl-phenoxymethyl)-thiazol-2-yl]-piperidin-1-yl}-pyrimidine |
AR064736A1 (en) | 2007-01-04 | 2009-04-22 | Prosidion Ltd | GPCR AGONISTS |
CL2008000133A1 (en) | 2007-01-19 | 2008-05-23 | Boehringer Ingelheim Int | PHARMACEUTICAL COMPOSITION THAT INCLUDES A COMPOUND DERIVED FROM PIRAZOL-O-GLUCOSIDE COMBINED WITH AT LEAST A SECOND THERAPEUTIC AGENT; AND USE OF THE COMPOSITION FOR THE TREATMENT OF MELLITUS DIABETES, CATARATS, NEUROPATHY, MYOCARDIAL INFARTS, AND |
ES2660170T3 (en) * | 2007-01-25 | 2018-03-21 | NAIA Metabolic, Inc. | Insulin sensitizers and treatment methods |
EP2124901B1 (en) | 2007-02-01 | 2017-07-19 | Takeda Pharmaceutical Company Limited | Tablet preparation without causing a tableting trouble |
ME01239B (en) | 2007-02-01 | 2013-06-20 | Takeda Pharmaceuticals Co | Solid preparation comprising alogliptin and pioglitazone |
ES2366000T3 (en) | 2007-02-06 | 2011-10-14 | Chelsea Therapeutics, Inc. | NEW COMPOUNDS, METHODS FOR THEIR PREPARATION AND USE OF THE SAME. |
JP5432720B2 (en) | 2007-03-13 | 2014-03-05 | 武田薬品工業株式会社 | 2-[[6-[(3R) -3-Amino-1-piperidinyl] -3,4-dihydro-3-methyl-2,4-dioxo-1 (2H) -pyrimidinyl] methyl] -4-fluorobenzo Solid formulation containing nitrile |
WO2008113000A1 (en) | 2007-03-15 | 2008-09-18 | Nectid, Inc. | Anti-diabetic combinations comprising a slow release biguanide composition and an immediate release dipeptidyl peptidase iv inhibitor composition |
EP2143443B1 (en) | 2007-04-03 | 2014-11-19 | Mitsubishi Tanabe Pharma Corporation | A combination of dipeptidyl peptidase iv inhibitor and sweetener for use in the treatment of obesity |
WO2008130998A2 (en) | 2007-04-16 | 2008-10-30 | Smith & Nephew, Inc. | Powered surgical system |
PE20090696A1 (en) | 2007-04-20 | 2009-06-20 | Bristol Myers Squibb Co | CRYSTALLINE FORMS OF SAXAGLIPTIN AND PROCESSES FOR PREPARING THEM |
EP2144902B1 (en) | 2007-05-04 | 2012-05-16 | Bristol-Myers Squibb Company | [6,6]and [6,7]-bicyclic gpr119 g protein-coupled receptor agonists |
WO2007135196A2 (en) | 2007-07-09 | 2007-11-29 | Symrise Gmbh & Co. Kg | Stable soluble salts of phenylbenzimidazole sulfonic acid at phs at or below 7.0 |
WO2009011451A1 (en) | 2007-07-19 | 2009-01-22 | Takeda Pharmaceutical Company Limited | Solid preparation comprising alogliptin and metformin hydrochloride |
CL2008002427A1 (en) | 2007-08-16 | 2009-09-11 | Boehringer Ingelheim Int | Pharmaceutical composition comprising 1-chloro-4- (bd-glucopyranos-1-yl) -2- [4 - ((s) -tetrahydrofuran-3-yloxy) benzyl] -benzene combined with 1 - [(4-methylquinazolin- 2-yl) methyl] -3-methyl-7- (2-butyn-1-yl) -8- (3- (r) -aminopiperidin-1-yl) xanthine; and its use to treat type 2 diabetes mellitus. |
CL2008002424A1 (en) | 2007-08-16 | 2009-09-11 | Boehringer Ingelheim Int | Pharmaceutical composition comprising a compound derived from pyrazole-o-glucoside; and use of the pharmaceutical composition for the treatment of diabetes mellitus, abnormal glucose tolerance and hyperglycemia, metabolic disorders, among others. |
CL2008002425A1 (en) | 2007-08-16 | 2009-09-11 | Boehringer Ingelheim Int | Pharmaceutical composition comprising an inhibitor of sglt2 and 1- (4-methyl-quinazolin-2-yl) methyl-3-methyl-7 - (- 2-butin-1-yl) -8- (3- (r) -amino- Piperidin-1yl) -xanthine, an iv dpp inhibitor and its use for the treatment of obesity and type 1 and 2 diabetes and complications thereof. |
UY31291A1 (en) | 2007-08-16 | 2009-03-31 | PHARMACEUTICAL COMPOSITION THAT INCLUDES A DERIVATIVE OF PIRAZOL-0-GLUCOSIDO | |
US20110112069A1 (en) | 2007-08-17 | 2011-05-12 | Boehringer Ingelheim International Gmbh | Purin derivatives for use in the treatment of fab-related diseases |
WO2009037719A1 (en) * | 2007-09-21 | 2009-03-26 | Lupin Limited | Novel compounds as dipeptidyl peptidase iv (dpp iv) inhibitors |
JP5241849B2 (en) | 2007-11-16 | 2013-07-17 | ノボ・ノルデイスク・エー/エス | Pharmaceutical composition comprising insulin and insulinotropic peptide |
CN101234105A (en) | 2008-01-09 | 2008-08-06 | 北京润德康医药技术有限公司 | Pharmaceutical composition containing diabetosan and vildagliptin and preparation thereof |
US20090186086A1 (en) | 2008-01-17 | 2009-07-23 | Par Pharmaceutical, Inc. | Solid multilayer oral dosage forms |
CL2008003653A1 (en) | 2008-01-17 | 2010-03-05 | Mitsubishi Tanabe Pharma Corp | Use of a glucopyranosyl-derived sglt inhibitor and a selected dppiv inhibitor to treat diabetes; and pharmaceutical composition. |
TW200936136A (en) | 2008-01-28 | 2009-09-01 | Sanofi Aventis | Tetrahydroquinoxaline urea derivatives, their preparation and their therapeutic application |
US20100330177A1 (en) | 2008-02-05 | 2010-12-30 | Merck Sharp & Dohme Corp. | Pharmaceutical compositions of a combination of metformin and a dipeptidyl peptidase-iv inhibitor |
CA2716130A1 (en) | 2008-03-04 | 2009-09-11 | Nazaneen Pourkavoos | Pharmaceutical compositions of a combination of metformin and a dipeptidyl peptidase-iv inhibitor |
CA2717138A1 (en) | 2008-03-05 | 2009-09-11 | Takeda Pharmaceutical Company Limited | 5-membered heterocyclic compounds and bicyclic heteroaryl having glucagon antagonistic action useful for treating diabetes |
US8551524B2 (en) | 2008-03-14 | 2013-10-08 | Iycus, Llc | Anti-diabetic combinations |
PL2280704T3 (en) | 2008-03-31 | 2015-10-30 | Cymabay Therapeutics Inc | Oxymethylene aryl compounds and uses thereof |
PE20091730A1 (en) | 2008-04-03 | 2009-12-10 | Boehringer Ingelheim Int | FORMULATIONS INVOLVING A DPP4 INHIBITOR |
CN101590007A (en) | 2008-05-27 | 2009-12-02 | 北京瑞伊人科技发展有限公司 | A kind of metformin hydrochloride/voigelibo sugar-lowering oral preparation compositions and preparation thereof |
PE20100156A1 (en) | 2008-06-03 | 2010-02-23 | Boehringer Ingelheim Int | NAFLD TREATMENT |
BRPI0916997A2 (en) | 2008-08-06 | 2020-12-15 | Boehringer Ingelheim International Gmbh | DPP-4 INHIBITOR AND ITS USE |
UY32030A (en) | 2008-08-06 | 2010-03-26 | Boehringer Ingelheim Int | "TREATMENT FOR DIABETES IN INAPPROPRIATE PATIENTS FOR THERAPY WITH METFORMIN" |
WO2010018217A2 (en) * | 2008-08-15 | 2010-02-18 | Boehringer Ingelheim International Gmbh | Organic compounds for wound healing |
JP2010053576A (en) | 2008-08-27 | 2010-03-11 | Sumitomo Forestry Co Ltd | Mat for paving |
US8513264B2 (en) | 2008-09-10 | 2013-08-20 | Boehringer Ingelheim International Gmbh | Combination therapy for the treatment of diabetes and related conditions |
UY32177A (en) | 2008-10-16 | 2010-05-31 | Boehringer Ingelheim Int | TREATMENT OF DIABETES IN PATIENTS WITH INSUFFICIENT GLUCEMIC CONTROL TO WEIGHT THERAPY WITH DRUG, ORAL OR NOT, ANTIDIABÉTICO |
WO2010045656A2 (en) | 2008-10-17 | 2010-04-22 | Nectid, Inc. | Novel sglt2 inhibitor dosage forms |
CN107011345A (en) | 2008-12-23 | 2017-08-04 | 勃林格殷格翰国际有限公司 | The salt form of organic compound |
AR074990A1 (en) | 2009-01-07 | 2011-03-02 | Boehringer Ingelheim Int | TREATMENT OF DIABETES IN PATIENTS WITH AN INAPPROPRIATE GLUCEMIC CONTROL THROUGH METFORMIN THERAPY |
TWI466672B (en) | 2009-01-29 | 2015-01-01 | Boehringer Ingelheim Int | Treatment for diabetes in paediatric patients |
AU2010212867B2 (en) | 2009-02-13 | 2013-05-16 | Boehringer Ingelheim International Gmbh | Pharmaceutical composition comprising a SGLT2 inhibitor, a DPP-IV inhibitor and optionally a further antidiabetic agent and uses thereof |
EA029759B1 (en) | 2009-02-13 | 2018-05-31 | Бёрингер Ингельхайм Интернациональ Гмбх | Antidiabetic medications comprising dpp-4 inhibitor (linagliptin) optionally in combination with other antidiabetic agents |
UY32427A (en) | 2009-02-13 | 2010-09-30 | Boheringer Ingelheim Internat Gmbh | PHARMACEUTICAL COMPOSITION, PHARMACEUTICAL FORM, PROCEDURE FOR PREPARATION, METHODS OF TREATMENT AND USES OF THE SAME |
TW201031661A (en) | 2009-02-17 | 2010-09-01 | Targacept Inc | Fused benzazepines as neuronal nicotinic acetylcholine receptor ligands |
EP2408780A2 (en) | 2009-03-20 | 2012-01-25 | Pfizer Inc. | 3-oxa-7-azabicycloý3.3.1¨nonanes |
JP2012525396A (en) | 2009-04-27 | 2012-10-22 | レバレジオ コーポレイション | Compositions and methods for treating insulin resistance and diabetes mellitus |
US8815292B2 (en) | 2009-04-27 | 2014-08-26 | Revalesio Corporation | Compositions and methods for treating insulin resistance and diabetes mellitus |
US20120100221A1 (en) | 2009-06-02 | 2012-04-26 | Ranbaxy Laboratories Limited | Pharmaceutical compositions containing a combination of an antihistamine and a decongestant |
AU2010260373A1 (en) | 2009-06-15 | 2012-01-12 | Merck Sharp & Dohme Corp. | Pharmaceutical compositions of combinations of dipeptidyl peptidase-4 inhibitors with pioglitazone |
EP2456426A1 (en) | 2009-07-21 | 2012-05-30 | Keryx Biopharmaceuticals, Inc. | Ferric citrate dosage forms |
US10610489B2 (en) | 2009-10-02 | 2020-04-07 | Boehringer Ingelheim International Gmbh | Pharmaceutical composition, pharmaceutical dosage form, process for their preparation, methods for treating and uses thereof |
KR101763659B1 (en) | 2009-10-02 | 2017-08-01 | 베링거 인겔하임 인터내셔날 게엠베하 | Pharmaceutical compositions comprising BI-1356 and metformin |
JP5446716B2 (en) | 2009-10-21 | 2014-03-19 | 大正製薬株式会社 | Method for producing tablets containing arginine and carnitine |
EP3646859A1 (en) | 2009-11-27 | 2020-05-06 | Boehringer Ingelheim International GmbH | Treatment of genotyped diabetic patients with dpp-iv inhibitors such as linagliptin |
JP2010070576A (en) | 2009-12-28 | 2010-04-02 | Sato Pharmaceutical Co Ltd | Rapidly soluble tablet |
TWI562775B (en) | 2010-03-02 | 2016-12-21 | Lexicon Pharmaceuticals Inc | Methods of using inhibitors of sodium-glucose cotransporters 1 and 2 |
US20130109703A1 (en) | 2010-03-18 | 2013-05-02 | Boehringer Ingelheim International Gmbh | Combination of a GPR119 Agonist and the DPP-IV Inhibitor Linagliptin for Use in the Treatment of Diabetes and Related Conditions |
EP2566464A1 (en) | 2010-05-05 | 2013-03-13 | Boehringer Ingelheim International GmbH | Pharmaceutical formulations comprising pioglitazone and linagliptin |
AU2011249722B2 (en) | 2010-05-05 | 2015-09-17 | Boehringer Ingelheim International Gmbh | Combination therapy |
US9271984B2 (en) | 2010-06-09 | 2016-03-01 | Poxel | Treatment of type 1 diabetes |
AR084698A1 (en) | 2010-06-22 | 2013-06-05 | Twi Pharmaceuticals Inc | COMPOSITIONS OF CONTROLLED RELEASE WITH REDUCED FOOD EFFECT, REDUCED INTERACTION BETWEEN PHARMACO AND FOOD |
BR112012032579B1 (en) | 2010-06-24 | 2021-05-11 | Boehringer Ingelheim International Gmbh | use of linagliptin and pharmaceutical composition comprising linagliptin and long-acting basal insulin |
EP2611442B1 (en) | 2010-09-03 | 2018-07-04 | Bristol-Myers Squibb Company | Drug formulations using water soluble antioxidants |
WO2012039420A1 (en) | 2010-09-21 | 2012-03-29 | 国立大学法人九州大学 | Bionic aortic baroreflex system for treating disease associated with aortic baroreflex dysfunction |
US9034883B2 (en) | 2010-11-15 | 2015-05-19 | Boehringer Ingelheim International Gmbh | Vasoprotective and cardioprotective antidiabetic therapy |
WO2012088682A1 (en) | 2010-12-29 | 2012-07-05 | Shanghai Fochon Pharmaceutical Co Ltd. | 2-(3-aminopiperidin-1-yl)-[1,2,4]triazolo[1,5-c]pyrimidine-5,7(3h,6h)-dione derivates as dipeptidyl peptidase iv(dpp-iv) inhibitors |
WO2012106303A1 (en) | 2011-02-01 | 2012-08-09 | Bristol-Myers Squibb Company | Pharmaceutical formulations including an amine compound |
AR085689A1 (en) | 2011-03-07 | 2013-10-23 | Boehringer Ingelheim Int | PHARMACEUTICAL COMPOSITIONS OF METFORMIN, LINAGLIPTINE AND AN SGLT-2 INHIBITOR |
US8785455B2 (en) | 2011-05-10 | 2014-07-22 | Sandoz Ag | Polymorph of linagliptin benzoate |
HUE043540T2 (en) | 2011-07-15 | 2019-08-28 | Boehringer Ingelheim Int | Substituted dimeric quinazoline derivative, its preparation and its use in pharmaceutical compositions for the treatment of type i and ii diabetes |
US20130172244A1 (en) | 2011-12-29 | 2013-07-04 | Thomas Klein | Subcutaneous therapeutic use of dpp-4 inhibitor |
MX353496B (en) | 2012-01-04 | 2018-01-16 | Procter & Gamble | Active containing fibrous structures with multiple regions. |
US9555001B2 (en) | 2012-03-07 | 2017-01-31 | Boehringer Ingelheim International Gmbh | Pharmaceutical composition and uses thereof |
EP3685839A1 (en) | 2012-05-14 | 2020-07-29 | Boehringer Ingelheim International GmbH | Linagliptin for use in the treatment of albuminuria and kidney related diseases |
WO2013171166A1 (en) | 2012-05-14 | 2013-11-21 | Boehringer Ingelheim International Gmbh | A xanthine derivative as dpp-4 inhibitor for use in the treatment of sirs and/or sepsis |
EP2854812A1 (en) | 2012-05-24 | 2015-04-08 | Boehringer Ingelheim International GmbH | A xanthine derivative as dpp -4 inhibitor for use in the treatment of autoimmune diabetes, particularly lada |
WO2013174767A1 (en) | 2012-05-24 | 2013-11-28 | Boehringer Ingelheim International Gmbh | A xanthine derivative as dpp -4 inhibitor for use in modifying food intake and regulating food preference |
EP2854824A1 (en) | 2012-05-25 | 2015-04-08 | Boehringer Ingelheim International GmbH | Use of keratinocytes as a biologically active substance in the treatment of wounds, such as diabetic wounds, optionally in combination with a dpp-4 inhibitor |
WO2013179307A2 (en) | 2012-05-29 | 2013-12-05 | Mylan Laboratories Limited | Stabilized pharmaceutical compositions of saxagliptin |
EP2887961B1 (en) | 2012-08-24 | 2021-04-28 | Novartis AG | Nep inhibitors for treating diseases characterized by atrial enlargement or remodeling |
JP2015533134A (en) | 2012-10-09 | 2015-11-19 | ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング | Selective moisture-adjustable tableting material in the manufacture of mechanically stable tablets, in particular arginine-containing tablets, containing at least one hydrate-forming active substance and / or adjuvant suitable for the mechanical stability of the tablets Use of |
WO2014056941A1 (en) | 2012-10-09 | 2014-04-17 | Boehringer Ingelheim International Gmbh | Use of moisture-conditioned disintegrants in tablet manufacture |
US9050302B2 (en) | 2013-03-01 | 2015-06-09 | Jazz Pharmaceuticals Ireland Limited | Method of administration of gamma hydroxybutyrate with monocarboxylate transporters |
JP2016510795A (en) | 2013-03-15 | 2016-04-11 | ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング | Use of linagliptin in cardioprotective and renal protective antidiabetic treatments |
CN113181161A (en) | 2013-04-18 | 2021-07-30 | 勃林格殷格翰国际有限公司 | Pharmaceutical compositions, methods of treatment and uses thereof |
JP2016518438A (en) | 2013-05-17 | 2016-06-23 | ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング | Combination of DPP-4 inhibitor and α-glucosidase inhibitor |
JP6507154B2 (en) | 2013-06-14 | 2019-04-24 | ベーリンガー インゲルハイム インターナショナル ゲゼルシャフト ミット ベシュレンクテル ハフツング | DDP-4 inhibitors for treating diabetes and its complications |
CN104418857A (en) | 2013-08-22 | 2015-03-18 | 北京蓝丹医药科技有限公司 | Amorphous linagliptin and preparation method thereof |
ES2950384T3 (en) | 2014-02-28 | 2023-10-09 | Boehringer Ingelheim Int | Medical use of a DPP-4 inhibitor |
CN104130258B (en) | 2014-08-13 | 2016-06-01 | 广东东阳光药业有限公司 | The method for transformation of a kind of dimer |
WO2016059219A1 (en) | 2014-10-17 | 2016-04-21 | Boehringer Ingelheim International Gmbh | Pharmaceutical composition and uses thereof |
WO2016089373A1 (en) | 2014-12-02 | 2016-06-09 | Halliburton Energy Services, Inc. | Integrated heat-exchanging mold systems |
KR102442536B1 (en) | 2015-09-17 | 2022-09-13 | 한미정밀화학주식회사 | Crystalline form of linagliptin and preparation method thereof |
CN105272982B (en) | 2015-11-23 | 2017-06-16 | 齐鲁制药有限公司 | Li Gelieting novel crystal forms and preparation method thereof |
BR112018072401A2 (en) | 2016-06-10 | 2019-02-19 | Boehringer Ingelheim International Gmbh | combinations of linagliptin and metformin |
US20210299129A1 (en) | 2018-07-17 | 2021-09-30 | Boehringer Ingelheim International Gmbh | Cardiosafe Antidiabetic Therapy |
US11752145B2 (en) | 2020-03-30 | 2023-09-12 | Sanjay Gupta | Quinoline derivatives with other anti-viral agents |
-
2018
- 2018-11-20 US US16/196,592 patent/US20200155558A1/en not_active Abandoned
-
2021
- 2021-02-11 US US17/173,607 patent/US11911388B2/en active Active
Also Published As
Publication number | Publication date |
---|---|
US11911388B2 (en) | 2024-02-27 |
US20210161903A1 (en) | 2021-06-03 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20170368068A1 (en) | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug | |
US20220323434A1 (en) | Treatment for diabetes in patients inappropriate for metformin therapy | |
US8846695B2 (en) | Treatment for diabetes in patients with inadequate glycemic control despite metformin therapy comprising a DPP-IV inhibitor | |
US10034877B2 (en) | Treatment for diabetes in patients inappropriate for metformin therapy | |
US20160206620A1 (en) | Purin derivatives for use in the treatment of fab-related diseases | |
JP2012505859A6 (en) | Treatment of diabetes in patients with insufficient glycemic control despite treatment with oral or parenteral antidiabetic drugs | |
US11911388B2 (en) | Treatment for diabetes in patients with insufficient glycemic control despite therapy with an oral or non-oral antidiabetic drug | |
JP7174020B2 (en) | Treatment of diabetes in patients with inadequate glycemic control despite treatment with oral or parenteral antidiabetic agents |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STPP | Information on status: patent application and granting procedure in general |
Free format text: NON FINAL ACTION MAILED |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |