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
  • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
  • A61K31/19—Carboxylic acids, e.g. valproic acid
  • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
• • 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
  • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
  • A61K31/19—Carboxylic acids, e.g. valproic acid
  • A61K31/192—Carboxylic acids, e.g. valproic acid having aromatic groups, e.g. sulindac, 2-aryl-propionic acids, ethacrynic acid 
• • 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
  • A61P3/06—Antihyperlipidemics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/04—Inotropic agents, i.e. stimulants of cardiac contraction; Drugs for heart failure
• • 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
  • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
  • A61K9/4841—Filling excipients; Inactive ingredients
  • A61K9/4866—Organic macromolecular compounds
• • 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
  • A61K9/70—Web, sheet or filament bases ; Films; Fibres of the matrix type containing drug
  • A61K9/7023—Transdermal patches and similar drug-containing composite devices, e.g. cataplasms

Definitions

• the present invention relates to a treatment for patients having congestive heart
• the present invention further relates 6 to a synthetic method to prepare 3,5-Diiodothyropropionic acid.
• thyroid hormone which has unique physiologic and biochemical actions that make it a novel and potentially useful
• Thyroid hormone has been shown to act at the
• Thyroid hormones include the L-forms of thyroxine (3,5,3'5'-L-thyronine;
• T 4 is synthesized in the thyroid gland and is the circulating form of hormone found in plasma. Although small amounts of T 3 are synthesized by
• thyroid hormones The molecular basis for the actions of thyroid hormones is though to be mediated through the binding of T 3 to chromatin-bound nuclear receptors. There are two major subtypes of the thyroid hormones
• TRarand TR? which are the products of two different genes. 1 These genes are members of the c-erbA protooncogene family and are related to a
• T 3 has a relatively short half-life of two days or
• Thyroid hormone agonists that are highly selective for the thyroid hormone 13 receptor subtype are described in U.S. Pat. No. 5,883,294.
• U.S. Pat. No. 5,284,971 j 4 describes a class of thyromimetics, which have the distinguishing characteristic of a sulfonyl bridge in the diphenyl core.
• DITPA left ventricular
• LN left ventricular
• DITPA improves myocyte function, enhances calcium transport in the sarcoplasmic reticulum 8 (SR) and prevents the down regulation of SR proteins associated with post-infarction 9 heart failure in rabbits.
• SR sarcoplasmic reticulum 8
• DITPA enhances the in vivo force- 0 frequency and relaxation-frequency relationships in a manner similar to thyroid hormone. DITPA is able to bring about these hemodynamic changes without 1 increasing cardiac mass appreciably or adversely affecting ventricular dimensions.
• a 2 morphometric analysis indicates that in post-infarction rats treated with DITPA there 3 is an increase in capillary growth in the border zone around the infarct.
• DITPA 3,5-Diiodothyropropionic acid
• DITPA binds to nuclear T 3 receptors of the c-erbA proto-oncogene family. DITPA has been shown to improve left ventricular (LN) performance in post-
• DITPA 12 frequency relationship
• DITPA 15 frequency relationships in a manner similar to thyroid hormone.
• DITPA is able to 16 bring about these hemodynamic changes without increasing cardiac mass appreciably , ⁇ or adversely affecting ventricular dimensions.
• a mo ⁇ hometric analysis indicates that in post-infarction rats treated with DITPA there is an increase in capillary growth in
• DITPA was synthesized following good manufacturing procedures by coupling dianisoleiodium trifluoroacetate with ethyl-3-(3 ,5-diiodo-4-
• compound I shown below, as a starting material.
• compound I is reacted with potassium iodide / iodine, and then with methylamine, to form 3-(3,5-
• Coupling agent dianisoleiodonium trifluoroacetate is prepared by first reacting 23 trifluoroacetic acid, compound IN, with red fuming nitric acid and iodine to form 24 iodine(III)trifluoroacetate, compound N.
• compound V is reacted with anisole, i.e. methoxybenzene, to form dianisoleiodonium trifluoroacetate, compound NI.
• anisole i.e. methoxybenzene
• NI dianisoleiodonium trifluoroacetate
• Applicants use trifluoroacetate as the counterion in compound NI because use of other counterions results in compounds that are more hygroscopic, and therefore, likely have limited shelf lives.
• Ethyl-3-(3,5-diiodo-4-hydroxyphenyl)propionate, compound III, is next reacted with dianisoleiodonium trifluoroacetate, compound NI, to form ethyl-3-(4'- methoxy-3,5-diiodothyro)propionate, compound NIL
• ethyl-3-(4'-methoxy-3,5- diiodothyro)propionate, compound Nil is reacted with hydrogen iodide and glacial 7 acid to hydrolyze both the ethyl ester and the methyl ether to give DITPA.
• Step 1 Weigh out 50 g of KI. Transfer to the pressure equalizing dropping funnel with a closed stopcock and add 60 ml of H 2 O and swirl until the salt is dissolved. Weigh 52 g of I 2 and add to the dropping funnel, swirl until completely dissolved. Add 90 ml of H 2 O (total of 150 ml) and stopper the dropping funnel. Place in a secure location and go on to step 2.
• Step 2 Weigh 16.2 g of 3-(4-hydroxyphenyl)-propionic acid and transfer into a 1.0 liter round bottom flask. Add a magnetic stir bar, 100 ml of 40% aqueous methylamine and 100 ml of H 2 O. Stopper the flask.
• Step 3 Remove the stopper and replace it with the dropping funnel. Open the stopcock so that the iodine solution drips into the round bottom flask during a period of approximately 20 minutes. Allow the reaction to stir for 10 minutes after the addition is complete.
• Step 4 Filter the reaction mixture, then pour into a 1 liter beaker and acidify with 2 N HC1 (approximately
• Step 1 Weigh 100 g of 3-(3,5-diiodo-4-hydroxyphenyl) propionic acid, transfer into a 500 ml round bottom flask, and add a magnetic stir bar. Add 15 ml of absolute ethanol and mix. Add 2.0 g of p- toluenesulfonic acid and then 150 ml of chloroform. Clamp the round bottom flask and place in the oil bath, but do not turn on the heat. Set up an Allihn condenser and a complete distillation assembly with a condenser to be cooled with recirculating ice water.
• Step 2 With the recirculating pump running and a bucket of extra ice near by turn on the oil bath (setting 40 on the Nariac).
• Step 3 Add enough chloroform to bring the total volume to 100 ml. Transfer to a separatory funnel with the stopcock closed. Extract with an equal volume of a saturated sodium bicarbonate solution. Repeat the extraction with sodium bicarbonate and then extract with H 2 O. Dry over calcium chloride powder.
• Step 4 Collect and weigh the product.
• Step 1 In the hood, pour 14 ml of acetic anhydride into a 250 ml round bottom flask and cool to about -15°C (dry ice and isopropyl alcohol). While stirring with a magnetic stir bar, carefully add 5.4 ml of red fuming nitric acid (90%, sp. gr. 1.51). Remove the round bottom flask from the dry ice/isopropanol bath. Weigh out 5.0 g iodine and, with the o temperature below 20 C, add the iodine to the round bottom flask together with 9.4 ml of trifluoroacetic acid. Stir the mixture for one-half hour. As the iodine dissolves, nitrous o oxide is generated and the temperature increases to 40-45 C. If the production of nitrous oxide continues, the iodine is still reacting.
• -15°C dry ice and isopropyl alcohol
• Step 2 If necessary, flush out the remaining nitrous oxide with N 2 gas and then set up for low pressure distillation. o
• Step 1 Dissolve the iodine(III)trifluoroacetate in 30 ml of acetic anhydride. Cool to -10 C and hold the temperature while adding a solution containing 17.4 ml anisole, 70 ml acetic anhydride, and 10 ml trifluoroacetic acid over 20 minutes. Stopper the flask and store in the refrigerator overnight and then allow 3 hours to come to room temperature.
• Step 2 Vacuum distill at the lowest temperature practical. A thick dark oil will remain. Note: Caution must be used when adding to the acid waste from the trap or the receiving flask as the reactive anhydride will rapidly and vigorously react with an aqueous solution. Add diethyl ether to the oil.
• Step 3 Filter the precipitate and wash with ice cold dry diethyl ether to give the crude dianisoleidonium trifluoroacetate. Recrystallize from toluene to give white feathery needles (mp 134-136 C). Weigh the product. Save some of the product for NMR, if necessary, or a melting point determination.
• Step 1 Weigh out and combine in a 250 ml round bottom flask 0.1 mole of the ethyl-3-(3,5-diiodo-4-hydroxyphenol) propionate, 50 ml of methanol with 1.5 ml of triethylamine, and 0.1 g of untarnished metallic copper powder. Add 5.9 g of the dianesoleiodonium trifluoroacetate to 70 ml of methanol and then add this mixture to the round bottom flask. A stirring bar is added, the flask stoppered and stirred at room temperature for 24 hours.
• Step 2 Filter to remove unreacted copper. Under reduced pressure, remove the methanol to yield a syrup. Dissolve in toluene. Add 1 N HC1 and shake for 5 minutes. A large amount of triethylamine will precipitate and must be removed by filtration. Wash the organic layer in the 1 separatory funnel with 10% NaOH and the with H 2 O. The
• Step 3 Weigh the product and prepare a sample for NMR
• Step 1 Weigh out 50 g of the coupled product and transfer
• Step 2 Remove most of the acid with reduced pressure distillation. Add 200 ml of H 2 O and adjust the pH to 5 with 2 1 N NaOH. The precipitate is collected by filtration. The 3 filtrate is washed with ice cold H 2 O and dried under a 4 blanket of CO 2 . 5 Step 3: Recrystallize the product from ethanol. Prepare a sample for NMR analysis and melting point determination. 6 0
• Step 4 Store the final product in a desiccator below 0 C in a 7 freezer that is locked and has limited access.
• DITPA may be 9 further compounded with one or more ingredients selected from the group consisting of a carrier, a stabilizer, an excipient, a solubilizer, an antioxidant, a pain-alleviating 0 agent, an isotonic agent, and combinations thereof.
• 1 DITPA may be formulated in various ways such as liquid preparations, solid 2 preparations, capsule preparations, implant preparations and the like.
• DITPA may be formulated for parenteral administration for injection with an appropriate conventional carrier and for oral administration with an appropriate conventional 4 carrier.
• the formulation for parenteral administration for injection may be prepared 1 by conventional methods known to a person skilled in the art, such as a method comprising the steps of; dissolving DITPA in an appropriate solvent such as sterilized
• An amount of DITPA in the 4 parenteral formulation is from about 0.0002 to about 0.2 (W/N %), and preferred amount is from about 0.001 to about 0.1 (W/N %).
• the formulation may be prepared
• DITPA may be administered in the form of inhalation or insufflation.
• a DITPA solution is conveniently delivered in the form of an aerosol spray presentation from pressurized packs or nebulizer, with the use of suitable propellants such as carbon dioxide or other suitable
• DITPA may be administered using conventional drug delivery 10 systems well known to a person skilled in the art.
• preparations for - - drug delivery system are microspheres (nanoparticle, microparticle, microcapsule, bead, liposome, multiple emulsion, etc.) and the like.
• a stabilizer may be added to the formulation, and the examples of a stabilizer 13 include albumin, globulin, gelatin, mannitol, glucose, dextran, ethylene glycol and the , . like.
• the formulation of the present invention may include a necessary additive such as an excipient, a solubilizer, an antioxidant agent, a pain-alleviating agent, an
• the liquid formulation may be stored in frozen condition, 6 or after removal of water by a process such as freeze-drying.
• the freeze-dried ⁇ ⁇ preparations are used by dissolving in pure water for injection and the like before use. Effective dosages and schedules for administering DITPA may be determined
• 19 route of the preparation may vary depending on the form of preparation.
• the parenteral preparation may be administered intravenously, intraarterially, subcutaneously or intramuscularly.
• DITPA may also be formulated for transdermal or implant
• Such long acting implantation administrations include subcutaneous
• DITPA may be formulated with suitable polymeric or hydrophobic materials (for example as an emulsion in an
• Applicants' transdermal delivery system includes a carrier, such as a liquid, gel, 3 solid matrix, or pressure sensitive adhesive, into which DITPA is inco ⁇ orated.
• a carrier such as a liquid, gel, 3 solid matrix, or pressure sensitive adhesive, into which DITPA is inco ⁇ orated.
• Applicants' invention does not include a backing material.
• Applicants' method includes use of a backing in combination with a carrier.
• the portions of the carrier that are not in physical 6 contact with the skin or mucosa are covered with a backing.
• the backing serves to
• Backings suitable for use with Applicants' o method include metal foils, metalized plastic films, and single layered and multilayered
• Applicants' method comprises transdermal delivery of
• the solvent system includes water, and optionally one or more lower alcohols such as ethanol, isopropyl alcohol, propyl alcohol, and the
• such alcohols have carbon contents between 2 and about 6.
• the solvent system may additionally include glycols such as ethylene glycol,
• the solvent system may also include one or more dialkylsulfoxides and/or dialkylsulfones.
• the solvent system may also include one
• ketones 15 or more ketones, ethers, and esters.
• examples include acetone, methylethylketone,
• 18 emulsions may be aqueous, wherein the aqueous phase is the major and continuous
• a water-insoluble solvent system comprises the
• Applicants' 1 transdermal delivery DITPA formulation may optionally be included in Applicants' 1 transdermal delivery DITPA formulation at a level of between about 0.0001 weight
• transdermal formulation may also contain agents known to
• enhancers include polyhydric alcohols such as 6 dipropylene glycol; oils such as olive oil, squalene, and lanolin; polyethylene glycol 7 ethers and fatty ethers such as cetyl ether and oleyl ether; fatty acid esters such as ⁇ isopropyl myristate; fatty acid alcohols such as oleyl alcohol; urea and urea derivatives such as allantoin; polar solvents such as dimethyldecylphosphoxide,
• Applicants' transdermal delivery system of this embodiment can be prepared ⁇ using conventional methods to apply an appropriate carrier to an appropriate backing.
• a DITPA-in-adhesive device can be prepared by using the following
• CBC complete blood count
• blood chemistries including liver enzymes and lipids profile
• thyroid function studies total T 3 , total T 4 , free T 4 , rT 3 , and thyrotropin
• total T 3 total T 4 , free T 4 , rT 3 , and thyrotropin
• Volunteer data were analyzed using Student's paired t-test. Baseline data in DITPA and placebo groups were compared by Student's unpaired t-test.
• Data are means ⁇ SE.
• Table II summarizes thyroid hormone measurements after two and four weeks of treatment with DITPA in normal volunteers. TABLE II
• Thyrotropin levels were decreased at both doses of DITPA administered but plasma T remained within the normal range. Total T 3 could not be measured during drug
• Data are means ⁇ SE for 9 patients receiving DITPA and 10 patients receiving placebo.
• Diastolic Function Isovolumic 94.0--7.0 92.2 ⁇ 9.5 0.88 107.7 ⁇ 7.8 87.5 ⁇ 9.2 ++ 109.0 ⁇ 8.2 84.4 ⁇ 8.5 0.045 relaxation time
• Data are means ⁇ SE for 9 patients receiving DITPA and 10 patients receiving placebo.
• Echocardiographic data are shown in Table IN.
• DITPA produced no significant changes in ventricular mass or size after two weeks or four weeks of treatment.
• Indices of systolic function such as fractional shortening and the velocity of circunlferential fiber shortening were unchanged.
• the ratio of early to late diastolic ventricular filling was unchanged.
• Data are means ⁇ SE for 9 patients receiving DITPA and 10 patients receiving placebo.
• P values are for t-test of baseline values for DITPA vs. placebo groups. + P values are for difference scores for DITPA vs. placebo groups at 4 weeks.
• Thyrotropin 1.65 ⁇ 0.2 2.47 ⁇ 0.6 0.17 1.85 ⁇ 0.3 0.04 ⁇ 01 4+ 2.13 ⁇ 0.3 0.018 ⁇ 0.0004 ⁇ 0.001
• Data are means ⁇ SE for 9 patients receiving DITPA and 10 patients receiving placebo.
• Thyroid hormone replacement in hypothyroidism is thought to lower 13 cholesterol by increasing the activity of LDL-cholesterol receptors and lipoprotein , A lipase.
• DITPA has never previously been clinically tested for its cholesterol lowering activity. After two weeks in the group receiving DITPA there '
• LV systolic function 1 probably was unaffected by treatment with DITPA. However, there was almost j uniform improvement in diastolic function as assessed by shortening of isovolumic relaxation time. Interestingly, echocardiographic changes were not seen in normal

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• 2001
  • 2001-01-31 US US09/774,994 patent/US6534676B2/en not_active Expired - Fee Related
• 2002
  • 2002-01-31 AU AU2002243801A patent/AU2002243801B2/en not_active Ceased
  • 2002-01-31 JP JP2002560585A patent/JP2004522747A/ja active Pending
  • 2002-01-31 EP EP02709310A patent/EP1432310A4/en not_active Withdrawn
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