USRE48286E1 - Steroids as agonists for FXR - Google Patents
Steroids as agonists for FXR Download PDFInfo
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- USRE48286E1 USRE48286E1 US16/448,503 US200216448503A USRE48286E US RE48286 E1 USRE48286 E1 US RE48286E1 US 200216448503 A US200216448503 A US 200216448503A US RE48286 E USRE48286 E US RE48286E
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Classifications
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- C07J9/005—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane containing a carboxylic function directly attached or attached by a chain containing only carbon atoms to the cyclopenta[a]hydrophenanthrene skeleton
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A—HUMAN NECESSITIES
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- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P9/00—Drugs for disorders of the cardiovascular system
- A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
- C07C215/00—Compounds containing amino and hydroxy groups bound to the same carbon skeleton
- C07C215/02—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton
- C07C215/04—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated
- C07C215/06—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated and acyclic
- C07C215/08—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated and acyclic with only one hydroxy group and one amino group bound to the carbon skeleton
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
- C07C215/00—Compounds containing amino and hydroxy groups bound to the same carbon skeleton
- C07C215/02—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton
- C07C215/04—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated
- C07C215/06—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated and acyclic
- C07C215/10—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated and acyclic with one amino group and at least two hydroxy groups bound to the carbon skeleton
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07C—ACYCLIC OR CARBOCYCLIC COMPOUNDS
- C07C215/00—Compounds containing amino and hydroxy groups bound to the same carbon skeleton
- C07C215/02—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton
- C07C215/04—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated
- C07C215/06—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated and acyclic
- C07C215/12—Compounds containing amino and hydroxy groups bound to the same carbon skeleton having hydroxy groups and amino groups bound to acyclic carbon atoms of the same carbon skeleton the carbon skeleton being saturated and acyclic the nitrogen atom of the amino group being further bound to hydrocarbon groups substituted by hydroxy groups
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07J—STEROIDS
- C07J41/00—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring
- C07J41/0033—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring not covered by C07J41/0005
- C07J41/0055—Normal steroids containing one or more nitrogen atoms not belonging to a hetero ring not covered by C07J41/0005 the 17-beta position being substituted by an uninterrupted chain of at least three carbon atoms which may or may not be branched, e.g. cholane or cholestane derivatives, optionally cyclised, e.g. 17-beta-phenyl or 17-beta-furyl derivatives
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07J—STEROIDS
- C07J43/00—Normal steroids having a nitrogen-containing hetero ring spiro-condensed or not condensed with the cyclopenta(a)hydrophenanthrene skeleton
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07J—STEROIDS
- C07J9/00—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane
-
- Y10S514/893—
Definitions
- the present invention relates to Farnesoid X receptors (FXR). More particularly, the present invention relates to compounds useful as agonists for FXR, pharmaceutical formulations comprising such compounds, and therapeutic use of the same.
- FXR Farnesoid X receptors
- Farnesoid X Receptor is an orphan nuclear receptor initially identified from a rat liver cDNA library (BM. Forman, et al., Cell 81:687-693 (1995)) that is most closely related to the insect ecdysone receptor.
- FXR is a member of the nuclear receptor family of ligand-activated transcription factors that includes receptors for the steroid, retinoid, and thyroid hormones (DJ. Mangelsdorf, et al., Cell 83:841-850 (1995)).
- Northern and in situ analysis show that FXR is most abundantly expressed in the liver, intestine, kidney, and adrenal (BM.
- FXR binds to DNA as a heterodimer with the 9-cis retinoic acid receptor (RXR).
- RXR 9-cis retinoic acid receptor
- the FXR/RXR heterodimer preferentially binds to response elements composed of two nuclear receptor half sites of the consensus AG(G/T)TCA organized as an inverted repeat and separated by a single nucleotide (IR-1 motif) (BM. Forman, et al., Cell 81:687-693 (1995)).
- the bile acids that serve as FXR ligands include chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), lithocholic acid (LCA), and the taurine and glycine conjugates of these bile acids.
- Bile acids are cholesterol metabolites that are formed in the liver and secreted into the duodenum of the intestine, where they have important roles in the solubilization and absorption of dietary lipids and vitamins. Most bile acids ( ⁇ 95%) are subsequently reabsorbed in the ileum and returned to the liver via the enterohepatic circulatory system. The conversion of cholesterol to bile acids in the liver is under feedback regulation: Bile acids down-regulate the transcription of cytochrome P450 7a (CYP7a), which encodes the enzyme that catalyzes the rate limiting step in bile acid biosynthesis.
- CYP7a cytochrome P450 7a
- the present invention provides compounds of formula I:
- R is ethyl, and pharmaceutically acceptable salts, solvates or amino acid conjugates thereof.
- the compound of formula (I) is in the form of the glycine or taurine conjugate.
- the present invention provides 3 ⁇ ,7 ⁇ -dihydroxy-6 ⁇ -ethyl-5 ⁇ -cholan-24-oic acid and pharmaceutically acceptable salts, solvates or amino acid conjugates thereof.
- the present invention provides 3 ⁇ ,7 ⁇ -dihydroxy-6 ⁇ -allyl-5 ⁇ -cholan-24-oic acid and pharmaceutically acceptable salts, solvates or amino acid conjugates thereof.
- the present invention provides compounds which are FXR agonists.
- the present invention provides a pharmaceutical formulation comprising a compound of formula (I) and a pharmaceutically acceptable carrier or diluent.
- the present invention provides a method for the prevention or treatment of an FXR mediated disease or condition.
- the method comprises administering a therapeutically effective amount of a compound of formula (I).
- the present invention also provides the use of a compound of formula (I) for the preparation of a medicament for the prevention or treatment of an FXR mediated disease or condition.
- the present invention provides a method for the prevention or treatment of cardiovascular disease.
- the method comprises administering a therapeutically effective amount of a compound of formula (I).
- the present invention also provides the use of a compound according to claim 1 for the preparation of a medicament for the prevention or treatment of cardiovascular disease.
- the cardiovascular disease is atherosclerosis.
- the present invention provides a method for increasing HDL cholesterol.
- the method comprises administering a therapeutically effective amount of a compound of formula (I).
- the present invention also provides the use of a compound according to claim 1 for the preparation of a medicament for increasing HDL-cholesterol.
- the present invention provides a method for lowering triglycerides.
- the method comprises administering a therapeutically, effective amount of a compound of formula (I).
- The-present invention also provides the use of a compound according to claim 1 for the preparation of a medicament for lowering triglycerides.
- the present invention provides a method for the prevention or treatment of cholestatic liver disease.
- the method comprises administering a therapeutically effective amount of a compound of formula (I).
- the present invention also provides the use of a compound according to claim 1 for the preparation of a medicament for the prevention or treatment of cholestatic liver diseases.
- the present invention provides a radiolabeled compound of formula (I).
- the compound of formula (I) is tritiated.
- the present invention provides a process for preparing a compound of formula (I) and pharmaceutically acceptable salts, solvates or amino acid conjugates thereof.
- the process comprises the steps of:
- R is ethyl
- the present invention provides compounds of formula I:
- R is ethyl and pharmaceutically acceptable salts, solvates or amino acid conjugates thereof.
- Suitable pharmaceutically acceptable salts according to the present invention will be readily determined by one skilled in the art and will include, for example, basic salts such as metallic salts made from aluminium, calcium, lithium, magnesium, potassium, sodium, and zinc or organic salts made from N,N′-dibenzylethylenediamine, chlorprocaine, choline, diethanolamine, ethylendiamine, meglumine (N-methylglucamine), and procaine.
- Such salts of the compounds of formula (I) may be prepared using conventional techniques, from the compound of Formula (I) by reacting, for example, the appropriate base with the compound of Formula (I).
- salts of a compound of formula (I) should be pharmaceutically acceptable, but pharmaceutically unacceptable salts may conveniently be used to prepare the corresponding free base or pharmaceutically acceptable salts thereof.
- solvate is a crystal form containing the compound of formula (I) or a pharmaceutically acceptable salt thereof and either a stoichiometric or a non-stoichiometric amount of a solvent.
- Solvents include water, methanol, ethanol, or acetic acid.
- reference to a compound of formula (I) is to any physical form of that compound, unless a particular form, salt or solvate thereof is specified.
- amino acid conjugates refers to conjugates of the compounds of formula (I) with any suitable amino acid.
- suitable amino acid conjugates of the compounds of formula (I) will have the added advantage of enhanced integrity in bile or intestinal fluids.
- suitable amino acids include but are not limited to glycine and taurine.
- the present invention encompasses the glycine and taurine conjugates of any of the compounds of formula (I).
- Preferred compounds of formula (I) include compounds selected from the group consisting of 3 ⁇ ,7 ⁇ -dihydroxy-6 ⁇ -ethyl-5 ⁇ -cholan-24-oic acid and their pharmaceutically acceptable salts, solvates or amino acid conjugates thereof.
- the compounds of formula (I) are FXR agonists.
- the term “agonist” refers to compounds which achieve at least 50% activation of FXR relative to CDCA, the appropriate positive control in the assay methods described in PCT Publication No. WO 00/37077 published 29 Jun. 2000 to Glaxo Group Limited, the subject matter of which is incorporated herein by reference in its entirety. More preferably, the compounds of this invention achieve 100% activation of FXR in the scintillation proximity assay or the HTRF assay as described in PCT Publication No. WO 00/37077.
- the compounds of the formula (I) are useful for a variety of medicinal purposes.
- the compounds of formula (I) may be used in methods for the prevention or treatment of FXR mediated diseases and conditions.
- FXR mediated diseases or conditions include cardiovascular diseases including atherosclerosis, arteriosclerosis, hypercholesteremia, and hyperlipidemia.
- cardiovascular diseases including atherosclerosis, arteriosclerosis, hypercholesteremia, and hyperlipidemia.
- the compounds of formula (I) are useful in the treatment and prevention of cardiovascular disease including atherosclerosis and hypercholesteremia.
- the compounds of formula (I) are also useful for increasing HDL-cholesterol, and lowering triglycerides.
- the compounds of the present invention are useful for the prevention and treatment of cholestatic liver diseases.
- the compounds of the present invention increase the flow of bile acid. Increased flow of bile acids improves the flux of bile acids from the liver to the intestine. See, C. Sinal, Cell 102: 731-744 (9000).
- FXR null mice demonstrate that FXR plays a central role in bile acid homeostasis, and is therefore critical to lipid homeostasis by virtue of the regulation of enzymes and transporters that are critical to lipid catabolism and excretion. FXR therefore is an important target for the treatment of a number of cholestatic liver disease and other lipid related diseases and conditions.
- the methods of the present invention are useful for the treatment of mammals generally and particularly humans.
- the methods of the present invention comprise the step of administering a therapeutically effective amount of the compound of formula (I).
- therapeutically effective amount refers to an amount of the compound of formula (I) which is sufficient to achieve the stated effect. Accordingly, a therapeutically effective amount of a compound of formula (I) used in the method for the prevention or treatment of FXR mediated diseases or conditions will be an amount sufficient to prevent or treat the FXR mediated disease or condition. Similarly, a therapeutically effective amount of a compound of formula (I) for use in the method for the prophylaxis or treatment of cholestatic liver diseases or increasing bile flow will be an amount sufficient to increase bile flow to the intestine.
- a typical daily dose for the treatment of FXR mediated diseases and conditions may be expected to lie in the range of from about 0.01 mg/kg to about 100 mg/kg. This dose may be administered as a single unit dose or as several separate unit doses or as a continuous infusion. Similar dosages would be applicable for the treatment of other diseases, conditions and therapies including the prophylaxis and treatment of cholestatic liver diseases.
- compositions comprising, as active ingredient, a compound of formula (I) or a pharmaceutically acceptable salt or solvate thereof, together with at least one pharmaceutical carrier or diluent.
- These pharmaceutical compositions may be used in the prophylaxis and treatment of the foregoing diseases or conditions and in cardiovascular therapies as mentioned above.
- the carrier must be pharmaceutically acceptable and must be compatible with, i.e. not have a deleterious effect upon, the other ingredients in the composition.
- the carrier may be a solid or liquid and is preferably formulated as a unit dose formulation, for example, a tablet which may contain from 0.05 to 95% by weight of the active ingredient. If desired other physiologically active ingredients may also be incorporated in the pharmaceutical compositions of the invention.
- Possible formulations include those suitable for oral, sublingual, buccal, parenteral (for example subcutaneous, intramuscular, or intravenous), rectal, topical including transdermal, intranasal and inhalation administration. Most suitable means of administration for a particular patient will depend on the nature and severity of the disease or condition being treated or the nature of the therapy being used and on the nature of the active compound, but where possible, oral administration is preferred for the prevention and treatment of FXR mediated diseases and conditions.
- Formulations suitable for oral administration may be provided as discrete units, such as tablets, capsules, cachets, lozenges, each containing a predetermined amount of the active compound; as powders or granules; as solutions or suspensions in aqueous or non-aqueous liquids; or as oil-in-water or water-in-oil emulsions.
- Formulations suitable for sublingual or buccal administration include lozenges comprising the active compound and, typically a flavoured base, such as sugar and acacia or tragacanth and pastilles comprising the active compound in an inert base, such as gelatine and glycerine or sucrose acacia.
- a flavoured base such as sugar and acacia or tragacanth
- pastilles comprising the active compound in an inert base, such as gelatine and glycerine or sucrose acacia.
- Formulations suitable for parenteral administration typically comprise sterile aqueous solutions containing a predetermined concentration of the active compound; the solution is preferably isotonic with the blood of the intended recipient. Additional formulations suitable for parenteral administration include formulations containing physiologically suitable co-solvents and/or complexing agents such as surfactants and cyclodextrins. Oil-in-water emulsions are also suitable formulations for parenteral formulations. Although such solutions are preferably administered intravenously, they may also be administered by subcutaneous or intramuscular injection.
- Formulations suitable for rectal administration are preferably provided as unit-dose suppositories comprising the active ingredient in one or more solid carriers forming the suppository base, for example, cocoa butter.
- Formulations suitable for topical or intranasal application include ointments, creams, lotions, pastes, gels, sprays, aerosols and oils.
- Suitable carriers for such formulations include petroleum jelly, lanolin, polyethyleneglycols, alcohols, and combinations thereof.
- Formulations of the invention may be prepared by any suitable method, typically by uniformly and intimately admixing the active compound with liquids or finely divided solid carriers or both, in the required proportions and then, if necessary, shaping the resulting mixture into the desired shape.
- a tablet may be prepared by compressing an intimate mixture comprising a powder or granules of the active ingredient and one or more optional ingredients, such as a binder, lubricant, inert diluent, or surface active dispersing agent, or by moulding an intimate mixture of powdered active ingredient and inert liquid diluent.
- one or more optional ingredients such as a binder, lubricant, inert diluent, or surface active dispersing agent, or by moulding an intimate mixture of powdered active ingredient and inert liquid diluent.
- Suitable formulations for administration by inhalation include fine particle dusts or mists which may be generated by means of various types of metered dose pressurised aerosols, nebulisers, or insufflators.
- the particle size of the powder or droplets is typically in the range 0.5-10 ⁇ m, preferably 1-5 ⁇ m, to ensure delivery into the bronchial tree.
- a particle size in the range 10-500 ⁇ m is preferred to ensure retention in the nasal cavity.
- Metered dose inhalers are pressurised aerosol dispensers, typically containing a suspension or solution formulation of the active ingredient in a liquefied propellant. During use, these devices discharge the formulation through a valve adapted to deliver a metered volume, typically from 10 to 150 ⁇ l, to produce a fine particle spray containing the active ingredient.
- Suitable propellants include certain chlorofluorocarbon compounds, for example, dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane and mixtures thereof.
- the formulation may additionally contain one or more co-solvents, for example, ethanol surfactants, such as oleic acid or sorbitan trioleate, anti-oxidants and suitable flavouring agents.
- Nebulisers are commercially available devices that transform solutions or suspensions of the active ingredient into a therapeutic aerosol mist either by means of acceleration of a compressed gas typically air or oxygen, through a narrow venturi orifice, or by means of ultrasonic agitation.
- Suitable formulations for use in nebulisers consist of the active ingredient in a liquid carrier and comprising up to 40% w/w of the formulation, preferably less than 20% w/w.
- the carrier is typically water or a dilute aqueous alcoholic solution, preferably made isotonic with body fluids by the addition of, for example, sodium chloride.
- Optional additives include preservatives if the formulation is not prepared sterile, for example, methyl hydroxy-benzoate, anti-oxidants, flavouring agents, volatile oils, buffering agents and surfactants.
- Suitable formulations for administration by insufflation include finely comminuted powders which may be delivered by means of an insufflator or taken into the nasal cavity in the manner of a snuff.
- the powder is contained in capsules or cartridges, typically made of gelatin or plastic, which are either pierced or opened in situ and the powder delivered by air drawn through the device upon inhalation or by means of a manually-operated pump.
- the powder employed in the insufflator consists either solely of the active ingredient or of a powder blend comprising the active ingredient, a suitable powder diluent, such as lactose, and an optional surfactant.
- the active ingredient typically comprises from 0.1 to 100 w/w of the formulation.
- formulations of the present invention may include other agents known to those skilled in the art of pharmacy, having regard for the type of formulation in issue.
- formulations suitable for oral administration may include flavouring agents and formulations suitable for intranasal administration may include perfumes.
- R is ethyl
- the compounds of the present invention can be prepared by the process comprising a) reacting 3 ⁇ -hydroxy-7-keto-5 ⁇ -cholan-24-oic acid with 3,4-dihydropyrane to prepare 3 ⁇ -tetrahydropyranyloxy-7-keto-5 ⁇ -cholan-24-oic acid; b) reacting 3 ⁇ -tetrahydropyranyloxy-7-keto-5 ⁇ -cholan-24-oic acid with an alkyl bromide of the formula R—Br where R is ethyl to prepare a compound of formula (II); c) reacting the compound of formula (II) with sodium borohydride to prepare a compound of formula (III); d) reacting the compound of formula (III) with sodium hydroxide to prepare the compound of formula (I).
- the compounds of formula (I) are conveniently prepared by reacting the compounds of formula (III) with sodium hydroxide in a suitable solvent at ambient temperature.
- suitable solvents include lower alcohols, such as ethanol.
- the reaction mixture may optionally be acidified with an appropriate acid such as hydrochloric acid.
- the compounds of formula (III) are conveniently prepared by reacting compounds of formula (II) with sodium borohydride in a suitable solvent at ambient temperature.
- suitable solvents include lower alcohols such as ethanol.
- the compounds of formula (II) are conveniently prepared by reacting 3 ⁇ -tetrahydropyranyloxy-7-keto-5 ⁇ -cholan-24-oic acid with an alkyl bromide of the formula R—Br where R is ethyl in a suitable solvent and in the presence of n-Butyl lithium and HMPA in diisopropylamine.
- Polar solvents such as tetrahydrofuran are useful for conducting the reaction.
- the reaction is carried out at cold temperatures such as about ⁇ 70 to ⁇ 80° C.
- 3 ⁇ -Tetrahydropyranyloxy-7-keto-5 ⁇ -cholan-24-oic acid can conveniently be prepared from 3 ⁇ -hydroxy-7-keto-5 ⁇ -cholan-24-oic acid by reacting with 3,4-dihydropyrane in p-toluenesulfonic acid.
- Radiolabeled compounds of formula (I) can be prepared using conventional techniques.
- radiolabeled compounds of formula (I) can be prepared by reacting the compound of formula (I) with tritium gas in the presence of an appropriate catalyst to produce radiolabeled compounds of formula (I).
- the compounds of formula (I) are tritiated.
- radiolabeled compounds of formula (I) are useful in assays for the lo identification of compounds which interact with FXR such as those described in PCT Publication No. WO 00/37077 already incorporated herein.
- n-Butyl lithium (21.1 ml, 1.6M solution in hexane) and HMPA (4.3 ml) were added dropwise at ⁇ 78° C. to a solution of diisopropylamine (4.1 ml, 33.7 mmol) in 250 ml of dry THF.
- the system was held at ⁇ 78° C. for an additional 30 min and then, 3 ⁇ -tetrahydropyranyloxy-7-keto-5 ⁇ -cholan-24-oic acid (2) (5 g, 10.5 mmol) dissolved in 50 ml of dry THF was cooled to ⁇ 78° C. and added dropwise to the mixture.
- Ethyl 3 ⁇ ,7 ⁇ -dihydroxy-6 ⁇ -ethyl-5 ⁇ -cholan-24-oate (4) (0.10 g, 0.22 mmol) was dissolved in 15 ml of 96% EtOH and added to 10% NaOH in 96% EtOH (2 ml, 5 mmol). The mixture was refluxed for 4 hours. The mixture was acidified with 3N HCl and extracted with ethyl acetate (3 ⁇ 20 ml). The combined organic fractions were washed with a saturated NaCl solution (1'50 ml), dried with Na 2 SO 4 and evaporated under vacuum.
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US10/471,549 US7138390B2 (en) | 2001-03-12 | 2002-02-21 | Steroids as agonists for FXR |
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US12/547,147 Expired - Fee Related US8058267B2 (en) | 2001-03-12 | 2009-08-25 | Steroids as agonists for FXR |
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US15/645,136 Expired - Fee Related US10421772B2 (en) | 2001-03-12 | 2017-07-10 | Steroids as agonists for FXR |
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