WO2003105896A1 - Utilisation combinee d'un modulateur de cd3 et d'un compose de repos de cellules beta - Google Patents

Utilisation combinee d'un modulateur de cd3 et d'un compose de repos de cellules beta Download PDF

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WO2003105896A1
WO2003105896A1 PCT/DK2003/000386 DK0300386W WO03105896A1 WO 2003105896 A1 WO2003105896 A1 WO 2003105896A1 DK 0300386 W DK0300386 W DK 0300386W WO 03105896 A1 WO03105896 A1 WO 03105896A1
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dioxide
thiadiazine
thieno
chloro
amino
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PCT/DK2003/000386
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English (en)
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Jeppe Sturis
Birgitte Koch Michelsen
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Novo Nordisk A/S
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • 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
    • A61K31/54—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
    • A61K31/542—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with heterocyclic ring systems
    • 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
    • A61K31/54—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
    • A61K31/549—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame having two or more nitrogen atoms in the same ring, e.g. hydrochlorothiazide
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K39/00—Medicinal preparations containing antigens or antibodies
    • A61K39/395—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum
    • A61K39/39533—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals
    • A61K39/39541—Antibodies; Immunoglobulins; Immune serum, e.g. antilymphocytic serum against materials from animals against normal tissues, cells
    • 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 methods and uses for the prevention and intervention of Type 1 diabetes and intervention of Latent Autoimmune Diabetes in the Adult (LADA). More specifically, the methods and uses of the invention pertain to administration of a modulator of CD3 in combination with administration of a beta cell resting compound.
  • Diabetes is a disorder of carbohydrate metabolism characterized by hyperglycemia and glucosuria resulting from insufficient production or utilization of insulin. Diabetes severely affects the quality of life of large parts of the populations in developed countries. Insufficient production of insulin is characterised as Type 1 diabetes and insufficient utilization of insulin is Type 2 diabetes.
  • Type 1 diabetes mellitus is caused by an autoimmune destruction of the pancreatic beta cells.
  • LADA Latent Autoimmune Diabetes in the Adult
  • autoimmunity accelerates the disease process in patients initially diagnosed with Type 2 diabetes, leading to rapid progression to insulin requirement in these patients.
  • T cells play an important role in this process by mediating the autoimmune destruction. It has therefore been hypothesized that it may be possible to influence the development of Type 1 diabetes mellitus as well as the disease progression in LADA patients by regulation of T cells or of the immune system's response to T cells.
  • CD3 is expressed in T cells. It has been recently demonstrated in humans that short term treatment of new onset Type 1 diabetic patients with an antibody against CD3 is able to attenuate the further destruction of beta-cells, thereby facilitating improved glycemic control of the patients. Ultimately, this gives the patients a better prognosis with respect to the development of diabetic late complications.
  • Another potential way to intervene in the destruction of beta-cells in the develop- ment of Type 1 diabetes is by treatment with compounds that inhibit insulin secretion, thereby inducing beta-cell rest.
  • Bj ⁇ rk et al have demonstrated that 3 months treatment with the potassium channel opener diazoxide results in preservation of residual C-peptide, a marker of beta-cell function.
  • the treatment can either be prophylactic, i.e. given to a subject at high risk for the development of Type 1 diabetes, or as an intervention in the disease process at the time it is clinically diagnosed.
  • the treatment can furthermore lead to an increase of beta-cell function as measured by C-peptide after treatment has been discontinued.
  • the effect will be sustained over several years, thereby having a major beneficial impact on the severity of the disease and its complications.
  • Patients will receive state-of-the art therapy with insulin and/or insulin analogs simultaneously during the treatment period in order to provide glycemic control.
  • a pharmaceutical combination is provided for use in the prevention and intervention of Type 1 diabetes and LADA, which combination comprises at least one modulator of CD3 and at least one beta cell resting compound.
  • One object of the present invention is to provide methods, which can effectively be used in the in the prevention and intervention of Type 1 diabetes and intervention of LADA.
  • the invention includes a method for the prevention and intervention of Type 1 diabetes and LADA, which method comprises administration of at least one modulator of CD3 and at least one beta cell resting compound to a patient in need thereof.
  • the present invention includes the use of at least one modulator of CD3 and at least one beta cell resting compound for the preparation of one ore more medicaments for the prevention and intervention of Type 1 diabetes and LADA in a patient in need thereof.
  • the modulator of CD3 is selected from antibody reactive with CD3 or F(ab')2 fragment of said antibody.
  • the modulator of CD3 is OKT3, hOKT3 ⁇ 1 (Ala-Ala), 145 2C11 or CAMPATH-3.
  • the beta cell resting compound is selected from a potassium channel opener.
  • the beta cell resting compound is 6-Chloro- 3-(1-methylcyclopropyl)amino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide.ln another em- bodiment of the invention the modulator of CD3 and the beta cell resting compound are administered in suboptimal dosages.
  • the modulator of CD3 and the beta cell resting compound are administered in amounts and for a sufficient time to produce a syner- gistic effect.
  • Co-administration In the context of the present application, co-administration of two compounds is defined as administration of the two compounds to the patient within one year, including separate administration of two medicaments each containing one of the compounds as well as simultaneous administration whether or not the two compounds are combined in one formulation or whether they are in two separate formulations.
  • Effective dosage An effective dosage is a dosage which is sufficient in order for the treatment of the patient to be effective compared with no treatment.
  • Medicament Pharmaceutical composition suitable for administration of the pharmaceutically active compound to a patient.
  • Suboptimal dosage A suboptimal dosage of a pharmaceutically active compound is a dosage which is below the optimal dosage for that compound when used in single- compound therapy.
  • Additive effect An additive effect of two compounds is an effect equal to the sum of the effects of the two individual compounds.
  • Synergistic effect A synergistic effect of two compounds is in terms of statistical analysis an effect which is greater than the additive effect which results from the sum of the effects of the two individual compounds.
  • Favourable effect A favourable effect of two compounds is in terms of statistical analysis an effect which is greater than the effect of either of the two compounds alone.
  • Type 1 diabetes and LADA Latent Autoimmune Diabetes in the Adult
  • prevention is defined as the management and care of an individual at risk of developing Type 1 diabetes or LADA prior to the clinical onset of the disease.
  • Intervention is defined as the management and care of a Type 1 or LADA diabetes patient at diagnosis or later.
  • the purpose of prevention and intervention is to combat the disease, condition, or disorder and includes the administration of the active compounds to prevent or delay the onset of the symptoms or complications, or alleviating the symptoms or complications, or eliminating the disease, condition, or disorder.
  • Modulator of CD3 In this application a modulator of CD3 is defined as a compound that interacts with CD3 and modulates the effects of CD3, such as an antibody reactive with CD3.
  • Beta cell resting compounds In this application a beta cell resting compound is de- fined as a compound reducing or inhibiting insulin release, such as potassium channel openers.
  • Specific potassium channel openers of the present invention relates to the compounds of general formula (I) and (la) wherein the below definitions of terms is used to describe the compounds.
  • Halogen designates an atom selected from the group consisting of F, CI, Br and I.
  • C L ⁇ -alkyl designates a straight or branched, saturated hydrocarbon chain having the indicated number of carbon atoms.
  • C 1-18 -alkyl as used herein also includes secondary C 3-6 -alkyl and tertiary C -6 -alkyl.
  • C 1-6 -alkoxy refers to a straight or branched monovalent substituent comprising a d-e-alkyl group linked through an ether oxygen having its free valence bond from the ether oxygen and having 1 to 6 carbon atoms.
  • Representatives groups include, but are not limited to methoxy, ethoxy, propoxy, isopropoxy, butoxy, isobutoxy, sec-butoxy, tert-butoxy, n-pentoxy, neopentoxy, tert-pentoxy, n-hexoxy, isohexoxy and the like.
  • C 2 . 6 -alkenyl refers to a straight or branched, unsaturated hydrocarbon chain having 2-6 carbon atoms and one double bond.
  • examples of such groups include, but are not limited to vinyl, 1-propenyl, 2-propenyl, allyl, isopropenyl, n-butenyl, n- pentenyl, n-hexenyl and the like.
  • C 2 . 6 -alkynyl refers to a straight or branched, unsaturated hydrocarbons which contain triple bonds. Examples of such groups include, but are not limited to -C ⁇ CH, -C ⁇ CCH 3 , -CH 2 CsCH, -CH 2 CH 2 C ⁇ CH, -CH(CH 3 )C ⁇ CH and the like.
  • C 1-6 -alkylthio refers to a straight or branched monovalent substituent comprising a lower alkyl group linked through a divalent sulfur atom having its free valence bond from the sulfur atom and having 1 to 6 carbon atoms.
  • Representative examples include, but are not limited to, methylthio, ethylthio, n-propyl- thio, isopropylthio, butylthio, isobutylthio, sec-butylthio, tert-butylthio, n-pentylthio, isopentyl- thio, neopentylthio, terf-pentylthio, n-hexylthio, isohexyl and the like.
  • C 3 . 6 -cycloalkyl refers to a radical of a saturated cyclic hydrocarbon with the indicated number of carbons. Representative examples are cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl and the like.
  • d-e-alkoxy-C e-alkyl refers to a group of 2-12 carbon at- oms interrupted by an O. Representative examples are CH 2 -O-CH 3 , CH 2 -O-CH 2 -CH 3 , CH 2 -O- CH(CH 3 ) 2 and the like.
  • perhalomethyl means trifluoromethyl, trichloromethyl, tribromomethyl or triiodomethyl.
  • d- ⁇ -monoalkylamino refers to an amino group wherein one of the hydrogen atoms is substituted with a straight or branched, saturated hydrocarbon chain having the indicated number of carbon atoms such as e.g. methylamino, ethylamino, propylamino, n-butylamino, sec-butylamino, isobutylamino, tert-butylamino, n-pentylamino, 2- methylbutylamino, n-hexylamino, 4-methylpentylamino, neopentylamino, n-hexylamino, 2,2- dimethylpropylamino and the like.
  • C 1-6 -dialkylamino refers to an amino group wherein the two hydrogen atoms independently are substituted with a straight or branched, saturated hydrocarbon chain having the indicated number of carbon atoms; such as dimethylamino, N- ethyl-N-methylamino, diethylamino, dipropylamino, N-(n-butyl)-N-methylamino, di(n- pentyl)amino, and the like.
  • acyl refers to a monovalent substituent comprising a C 1-6 - alkyl group linked through a carbonyl group; such as e.g. acetyl, propionyl, butyryl, isobutyryl, pivaloyl, valeryl, and the like.
  • C 1-6 -alkoxycarbonyl refers to a monovalent substituent comprising a C ⁇ . 6 -alkoxy group linked through a carbonyl group; such as e.g. methoxy- carbonyl, carbethoxy, propoxycarbonyl, isopropoxycarbonyl, n-butoxycarbonyl, sec-butoxy- carbonyl, tert-butoxycarbonyl, 3-methylbutoxycarbonyl, n-hexoxycarbonyl and the like.
  • 3-12 membered mono- or bicyclic system refers to a monovalent substituent of formula -NR 2 R 3 or -NR 8 R 9 where R 2 and R 3 , or R 8 and R 9 together with the nitrogen atom form a 3-12 membered mono- or bicyclic system, in which one or more of the carbon atoms may be exchanged with nitrogen, oxygen or sulfur, such as 1- pyrrolidyl, piperidino, morpholino, thiomorpholino, 4-methylpiperazin-1-yl, 7-azabi- cyclo[2.2.1]heptan-7-yl, tropanyl and the like.
  • 3-6 membered saturated ring system refers to a monovalent substituent comprising a monocyclic saturated system containing one or more hetero atoms selected from nitrogen, oxygen and sulfur and having 3-6 members and having its free valence from a carbon atom, e.g. 2-pyrrolidyl, 4-piperidyl, 3-morpholinyl, 1 ,4-dioxan-2-yl, 5- oxazolidinyl, 4-isoxazolidinyl or 2-thiomorpholinyl.
  • bicycloalkyl refers to a monovalent substituent comprising a bicyclic structure made of 6-12 carbon atoms such as e.g. 2-norbomyl, 7-norbornyl, 2- bicyclo[2.2.2]octyl and 9-bicyclo[3.3.1]nonanyl.
  • aryl refers to phenyl, 1-naphthyl or 2-naphthyl.
  • heteroaryl refers to a monovalent substituent comprising a 5-6 membered monocyclic aromatic system or a 9-10 membered bicyclic aromatic system containing one or more heteroatoms selected from nitrogen, oxygen and sulfur, e.g.
  • pyrrole imidazole, pyrazole, triazole, pyridine, pyrazine, pyrimidine, pyridazine, isothiazole, isoxazole, oxazole, oxadiazole, thiadiazole, quinoline, isoquinoline, quinazoline, quinoxaline, indole, benzimidazole, benzofuran, pteridine and purine.
  • arylalkyl refers to a straight or branched saturated carbon chain containing from 1 to 6 carbons substituted with an aromatic carbohydride; such as benzyl, phenethyl, 3-phenylpropyl, 1-naphtylmethyl, 2-(1-naphtyl)ethyl and the like.
  • aryloxy refers to phenoxy, 1-naphthyloxy or 2- naphthyloxy.
  • arylalkoxy refers to a d-e-alkoxy group substituted with an aromatic carbohydride, such as benzyloxy, phenethoxy, 3-phenylpropoxy, 1-naphthyl- methoxy, 2-(1-naphtyl)ethoxy and the like.
  • heteroarylalkyl refers to a straight or branched saturated carbon chain containing from 1 to 6 carbons substituted with a heteroaryl group; such as (2- furyl) methyl, (3-furyl)methyl, (2-thienyl)methyl, (3-thienyl)methyl, (2-pyridyl)methyl, 1-methyl- 1-(2-pyrimidyl)ethyl and the like.
  • C ⁇ -6 -alkylsulfonyl refers to a monovalent substituent comprising a d. 6 -alkyl group linked through a sulfonyl group such as e.g.
  • C ⁇ . 6 -monoalkylaminosulfonyl refers to a monovalent substituent comprising a d. 6 -monoalkylamino group linked through a sulfonyl group such as e.g.
  • methylaminosulfonyl methylaminosulfonyl, ethylaminosulfonyl, n-propylaminosulfonyl, isopropylaminosulfonyl, n-butylaminosulfonyl, sec-butylaminosulfonyl, isobutylaminosulfonyl, tert-butylaminosulfonyl, n-pentylaminosulfonyl, 2-methylbutylaminosulfonyl, 3-methylbutylaminosulfonyl, n-hexyl- aminosulfonyl, 4-methylpentylaminosulfonyl, neopentylaminosulfonyl, n-hexylaminosulfonyl and 2,2-dimethylpropylaminosulfonyl.
  • dimethylaminosulfonyl N-ethyl-N-methylaminosulfonyl, diethylaminosulfonyl, dipropyl- aminosulfonyl, N-(n-butyl)-N-methylaminosulfonyl, di(n-pentyl)aminosulfonyl, and the like.
  • d- ⁇ -alkylcarbonylamino refers to an amino group wherein one of the hydrogen atoms is substituted with an acyl group, such as e.g. acetamido, propi- onamido, isopropylcarbonylamino, and the like.
  • (C 3 ⁇ -cycloalkyl)C 1-6 -alkyl refers to a straight or branched, saturated hydrocarbon chain having 1 to 6 carbon atoms and being monosubstituted with a C 3 . 6 -cycloalkyl group, the cycloalkyl group optionally being mono- or polysubstituted with C 1-6 -alkyl, halogen, hydroxy or C 1-6 -alkoxy; such as e.g. cyclopropylmethyl, (l-methylcyclopropyl)methyl, 1-(cyclopropyl)ethyl, cyclopentylmethyl, cyclohexylmethyl, and the like.
  • arylthio refers to an aryl group linked through a divalent sulfur atom having its free valence bond from the sulfur atom, the aryl group optionally being mono- or polysubstituted with C 1-6 -alkyl, halogen, hydroxy or Ci- ⁇ -alkoxy; e.g. phenylthio, (4-methylphenyl)- thio, (2-chlorophenyl) thio, and the like.
  • arylsulfonyl refers to an aryl group linked through a sulfonyl group, the aryl group optionally being mono- or polysubstituted with d- ⁇ -alkyl, halogen, hydroxy or d ⁇ -alkoxy; such as e.g. phenylsulfonyl, tosyl, and the like.
  • d. 6 -monoalkylaminocarbonyl refers to a monovalent substituent comprising a C 1-6 -monoalkylamino group linked through a carbonyl group such as e.g.
  • C 1-6 -dialkylaminocarbonyl refers to a monovalent substituent comprising a d ⁇ -dialkylamino group linked through a carbonyl group such as dimethyl- aminocarbonyl, N-ethyl-N-methylaminocarbonyl, diethylaminocarbonyl, dipropylaminocarbonyl, N-(n-butyl)-N-methylaminocarbonyl, di(n-pentyl)aminocarbonyl, and the like.
  • C 1-6 -monoalkylaminocarbonylamino refers to an amino group wherin one of the hydrogen atoms is substituted with a C 1-6 -monoalkylaminocarbonyl group, e.g.
  • C 1-6 -dialkylaminocarbonylamino refers to an amino group wherein one of the hydrogen atoms is substituted with a C 1-6 -dialkylaminocarbonyl group, such as dimethylaminocarbonylamino, N-ethyl-N-methylaminocarbonylamino, diethylaminocarbonyl- amino, dipropylaminocarbonylamino, N-(n-butyl)-N-methylaminocarbonylamino, di(n-pentyl) - aminocarbonylamino, and the like.
  • 5- or 6-membered heterocyclic system refers to: a monocyclic unsaturated or saturated system containing one, two or three hetero atoms selected from nitrogen, oxygen and sulfur and having 5 members, e.g. pyrrole, furan, thiophene, pyrroline, dihydrofuran, dihydrothiophene, imidazole, imidazoline, pyrazole, pyra- zoline, oxazole, thiazole, isoxazole, isothiazole, 1 ,2,3-oxadiazole, furazan, 1 ,2,3-triazole, 1 ,2,3-thiadiazole or 2,1 ,3-thiadiazole; an aromatic monocyclic system containing one or more nitrogen atoms and having 6 members, e.g.
  • pyridine pyrazine, pyrimidine, pyridazine, 1 ,2,4- triazine, 1 ,2,3-triazine or tetrazine
  • 5- or 6-membered nitrogen containing ring refers to a monovalent substituent comprising a monocyclic unsaturated or saturated system containing one or more nitrogen atoms and having 5 or 6 members, e.g. pyrrolidinyl, pyrrolinyl, imidazo- lidinyl, pyrazolidinyl, pyrazolinyl, piperidyl, piperazinyl, pyrrolyl, 2H-pyrrolyl, imidazolyl, pyrazolyl, triazolyl, pyridyl, pyrazinyl, pyrimidinyl, pyridazinyl, morpholino, thiomorpholino, isothiazolyl, isoxazolyl, oxazolyl, oxadiazolyl, thiadiazolyl, 1,3-dioxolanyl and 1,4-dioxolanyl.
  • pyrrolidinyl pyrrolinyl
  • 4- to 12-membered bicyclic or tricyclic carbocyclic system refers to a a monovalent substituent comprising a bicyclic or a tricyclic structure made of 4- 12 carbon atoms such as e.g. bicyclo[2.1.1]hexane, bicyclo[2.2.1]heptane, bicyclo [2.2.2]octane, octahydrovpentalene, bicyclo[2.2.0]hexane, adamantane, noradamantane or tricyclo-(4.3.1.1 (3,8))undecane.
  • the combined treatment with at least one modulator of CD3 and at least one beta cell resting compound avoids further destruction of beta cells. It has also been discovered that the combined treatment leads to an increase of beta cell function. This increase in beta- cell function may be sustained over several years and gives the patient an improved glycemic control and improved prognosis with respect to microvascular and macrovascular complications.
  • a synergistic effect of two compounds permits the dosages of these compounds in the combined treatment to be below the optimal dosages of the individual compounds in single-compound treatment. Thus, these suboptimal dosages of the individual compounds reduce side effects since lower dosages are needed for the same therapeutic effect in the combined treatment. Furthermore, a synergistic effect of the two compounds permits the efficacy of the co-administration of the two compounds to be significantly greater than the sum of the efficacy of each individual compound.
  • the present invention relates to methods for the prevention and intervention of Type 1 diabetes and LADA, which method comprises administration of a modula- tor of CD3 and a beta cell resting compound to a patient in need thereof.
  • the methods comprise administration of an effective amount of a modulator of CD3 and administration of an effective amount of a beta cell resting compound.
  • the two compounds may be co-administered or they may be administered separately as two medicaments.
  • the first compound may be administered in a regimen, which addition- ally comprises treatment with the second compound.
  • the modulator of CD3 is a CD3 antibody or F(ab')2 fragment thereof or other CD3 binding compound with same activity.
  • the modulator of CD3 is anti-CD3 monoclonal antibody OKT3 or F(ab')2 fragment thereof.
  • the modulator of CD3 is anti-CD3 monoclonal antibody hOKT3 ⁇ 1 (Ala-Ala) or F(ab')2 fragment thereof.
  • the modulator of CD3 is anti-CD3 monoclonal antibody 145 2C11 or F(ab')2 fragment thereof. In yet another embodiment of the invention the modulator of CD3 is anti-CD3 monoclonal antibody CAMPATH-3 or F(ab')2 fragment thereof.
  • the beta cell resting compound is a potassium channel opener.
  • the beta cell resting compound is a com- pound selected from the general formula (I):
  • B represents >NR 5 or >CR 5 R 6 , wherein R 5 and R 6 independently are hydrogen; hydroxy; C 1-6 - alkoxy; or C ⁇ . 6 -alkyl, C 3 . 6 -cycloalkyl, C 2 . 6 -alkenyl or C 2 . 6 -alkynyl optionally mono- or poly substituted with halogen; or R 5 and R 4 together represent one of the bonds in a double bond between the atoms 2 and 3 of formula (I);
  • R 7 is C 1-6 -alkyl; or aryl or heteroaryl optionally mono- or poly substituted with halogen, hydroxy, d -6 -alkoxy, aryloxy, arylalkoxy, nitro, amino, C 1-6 -monoalkyl- or dialkylamino, cyano, acyl, or d. 6 -alkoxycarbonyl;
  • R 1 is hydrogen; hydroxy; d. 6 -alkoxy; or C 1-6 -alkyl, C 3-6 -cycloalkyl, C 2-6 - alkenyl or C 2 . 6 -alkynyl optionally mono- or poly substituted with halogen and R 4 is hydrogen; or R 4 together with R 5 represent one of the bonds in a double bond between the atoms 2 and 3 of formula (I); or R 1 together with R 4 represent one of the bonds in a double bond between the atoms 3 and 4 of formula (I); R 2 is hydrogen; hydroxy; C 1-6 -alkoxy; or C 1-6 -alkyl, C 3 . 6 -cycloalkyl, C 2 . 6 - alkenyl or C 2 . 6 -alkynyl optionally mono- or poly substituted with halogen;
  • R 8 is hydrogen; C 3 . 6 -cycloalkyl or (C 3 . 6 -cycloalkyl)C 1-6 -alkyl, the C 3-6 -cycloalkyl group optionally being mono- or poly substituted with C 1-6 -alkyl, halogen, hydroxy or C 1-6 -alkoxy; a 3-6 membered saturated ring system comprising one or more nitrogen-, oxygen- or sulfur atoms; or straight or branched d. 18 -alkyl optionally mono- or poly substituted with halogen, hydroxy, C 1-6 -alkoxy, d.
  • X is O or S
  • R 9 is hydrogen; C ⁇ . 6 -alkyl; C 2-6 -alkenyl; C 3 . 6 -cycloalkyl optionally mono- or poly substituted with d- ⁇ -alkyl, halogen, hydroxy or C 1-6 -alkoxy; or
  • R 8 and R 9 together with the nitrogen atom form a 3-12 membered mono- or bicyclic system, in which one or more of the carbon atoms may be exchanged with nitrogen, oxygen or sulfur, each of these ring systems optionally being mono- or poly substituted with halogen, d -6 - alkyl, hydroxy, C 1-6 -alkoxy, d- 6 -alkoxy-d- 6 -alkyl, nitro, amino, cyano, trifluoromethyl, C 1-6 - monoalkyl- or dialkylamino, oxo; or R 3 is
  • n, m, p independently are 0,1 ,2,3 and R 10 is hydrogen; hydroxy; C 1-6 -alkoxy; C 3-6 - cycloalkyl optionally mono- or poly substituted with d. 6 -alkyl, halogen, hydroxy or d-e- alkoxy; C 1-6 -alkyl, C 2 . 6 -alkenyl or C 2-6 -alkynyl optionally mono- or poly substituted with halogen; or
  • R 2 and R 3 together with the nitrogen atom forms a 3-12 membered mono- or bicyclic system, in which one or more of the carbon atoms may be exchanged with nitrogen, oxygen or sulfur, each of these ring systems optionally being mono- or poly substituted with halogen, d-e- alkyl, hydroxy, C ⁇ -alkoxy, d. 6 -alkoxy-C ⁇ . 6 -alkyl, nitro, amino, cyano, trifluoromethyl, C 1-6 - monoalkyl- or dialkylamino or oxo;
  • a together with carbon atoms 5 and 6 of formula (I) represents a 5 or 6 membered hetero- cyclic system comprising one or more nitrogen-, oxygen- or sulfur atoms, the heterocyclic systems optionally being mono- or poly substituted with halogen; d. 12 -alkyl; C 3 . 6 -cycloalkyl; hydroxy; C ⁇ . 6 -alkoxy; C 1 . 6 -alkoxy-C 1 . 6 -alkyl; nitro; amino; cyano; cyanomethyl; perhalomethyl; d-e-monoalkyl- or dialkylamino; sulfamoyl; d. 6 -alkylthio; d.
  • 6 -alkyl halogen, hydroxy or C 1-6 -alkoxy; (1 ,2,4-oxadiazol-5-yl)- or (1 ,2,4-oxadiazol-3-yl)-d. 6 -alkyl the oxadiazolyl group optionally being substituted with d. 6 -alkyl or C 3 . 6 -cycloalkyl; or a 5 - 6 membered nitrogen containing ring, optionally substituted with phenyl or C 1-6 -alkyl; or a pharmaceutically acceptable salt thereof.
  • the invention includes all optical isomers of compounds of the pre- sent invention, some of which are optically active, and also their mixtures including racemic mixture thereof.
  • the scope of the invention also includes all tautomeric forms of the compounds of the present invention as well as metabolites or prodrugs.
  • a “metabolite” of a compound disclosed in this application is an active derivative of a compound disclosed herein which is produced when the compound is metabolized. Metabolites of compounds disclosed herein can be identified either by administration of a compound to a host and an analysis of blood samples from the host, or by incubation of compounds with hepatic cells in vitro and analysis of the incubant.
  • a “prodrug” is a compound that either is converted into a compound disclosed in the application in vivo or has the same active me- tabolite as a compound disclosed in this application.
  • the salts include pharmaceutically acceptable acid addition salts, pharmaceutically acceptable metal salts or optionally alkylated ammonium salts, such as hydrochloric, hydro- bromic, hydroiodic, phosphoric, sulfuric, trifluoroacetic, trichloroacetic, oxalic, maleic, pyruvic, malonic, succinic, citric, tartaric, fumaric, mandelic, benzoic, cinnamic, methanesulfonic, eth- ane sulfonic, picric and the like, and include acids related to the pharmaceutically acceptable salts listed in Journal of Pharmaceutical Science, 66, 2 (1977) and incorporated herein by reference, or lithium, sodium, potassium, magnesium and the like.
  • pharmaceutically acceptable acid addition salts such as hydrochloric, hydro- bromic, hydroiodic, phosphoric, sulfuric, trifluoroacetic, trichloroacetic, oxalic, maleic, pyruvic, malonic, succ
  • B of formula (I) is >NR 5 and R 5 and R 4 together represent one of the bonds in a double bond between the atoms 2 and 3 of formula (I).
  • R 2 is hydrogen or d. 6 -alkyl.
  • R 3 is R 8 , -OR 8 , NR 8 R 9 or aryl, the aryl groups optionally being substituted with C 1-6 -alkyl; wherein R 8 is hydrogen; C 3-6 -cycloalkyl; 6 - cycloalkyl)C 1-6 -alkyl; a 3 - 6 membered saturated ring system comprising one, two or three nitrogen-, oxygen- or sulfur atoms; or straight or branched C 1-18 -alkyl optionally substituted with halogen, hydroxy, C 1-6 -alkoxy, C 1-6 -alkylthio, C 3-6 -cycloalkyl or aryl, R 9 is hydrogen, C 1-6 - alkyl or C 3 . 6 -cycloalkyl; or R 8 and R 9 together with the nitrogen atom form a 4 - 6 membered ring.
  • R 3 is secondary C 3-6 -alkyl, tertiary C 4 . 6 -alkyl, C 3 . 6 -cycloalkyl or (C 3-6 -cycloalkyl)methyl.
  • a together with carbon atoms 5 and 6 of formula (I) forms a 5 membered heterocyclic system containing one hetero atom selected from nitrogen and sulfur, the heterocyclic system optionally being mono- or disubstituted with halogen; d. 12 -alkyl; C 3 . 6 -cycloalkyl; cyano; cyanomethyl; perhalomethyl; sulfamoyl; C 1-6 - alkylthio; d.
  • 6 -alkylsulfonyl C 1-6 -alkylsulfinyl; arylthio, arylsulfinyl, arylsulfonyl, the aryl group optionally being mono- or polysubstituted with d-e-alkyl, halogen, hydroxy or C 1-6 -alkoxy; d- 6 -alkoxycarbonyl-d. 6 -alkyl; carbamylmethyl; carboxy-d.
  • 6 -alkyl aryloxy; (1 ,2,4-oxadiazol-5- yl)- or (1 ,2,4-oxadiazol-3-yl)C 1-6 -alkyl, the oxadiazolyl group optionally being substituted with Ci-e-alkyl or C 3 .
  • 6 -cycloalkyl acyl or a 5 - 6 membered nitrogen containing ring, optionally sub- stituted with phenyl or C 1-6 -alkyl.
  • a together with carbon atoms 5 and 6 of formula (I) forms a 5 membered heterocyclic system containing two hetero atoms selected from nitrogen, oxygen and sulfur, the heterocyclic system optionally being substituted with halogen; C 1-12 -alkyl; C 3 .
  • a together with carbon atoms 5 and 6 of formula (I) forms a 6 membered aromatic heterocyclic system containing one, two or three nitrogen atoms, the heterocyclic system optionally being substituted with halogen; d. ⁇ 2 -alkyl; d- 6 -cycloalkyl; cyano; cyanomethyl; perhalomethyl; sulfamoyl; C 1-6 -alkylthio; Ci. 6 alkylsulfonyl; C 1-6 -alkylsulfinyl; arylthio, arylsulfinyl, arylsulfonyl, the aryll group optionally being mono- or polysubstituted with d.
  • 6 -alkyl halogen, hydroxy or d. 6 -alkoxy; C1-6- alkoxycarbonyl-C ⁇ -6 -alkyl; carbamylmethyl; carboxy-C 1-6 -alkyl: aryloxy; (1 ,2,4-oxadiazol-5-yl)- or (1 ,2,4-oxadiazol-3-yl)d. 6 -alkyl, the oxadiazolyl group optionally being substituted with C 1-6 - alkyl or C 3 . 6 -cycloalkyl; acyl; or a 5 - 6 membered nitrogen containing ring, optionally substituted with phenyl or C ⁇ -6 -alkyl.
  • Examples of specific compounds of formula (I) to be used according to this invention are: 6-Chloro-3-(1 ,2-dimethylpropyl)amino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide; 6- Chloro-3-ethylamino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 , 1 -dioxide; 6-Chloro-3-isopropyl- amino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide; (R)-6-Chloro-3-(1-phenylethyl)amino- 4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide; 3-Allylamino-6-chloro-4H-thieno[3,2-e]-1 ,2,4- thiadiazine 1 ,1-dioxid
  • Another example of a specific compound of formula (I) to be used according to this invention is 6-Chloro-3-isopropylamino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide.
  • X and Y independently are hydrogen, halogen, perhalomethyl, d- ⁇ - -alkyl or C 1-6 -alkoxy;
  • R 11 , R 21 and R 31 independently are d-e-alkyl, C 2-6 -alkenyl, C 2-6 -alkynyl, C 3-6 -cycloalkyl, car- boxy, C 1-6 -alkoxycarbonyl or aryl, all of which are optionally being mono- or polysubstituted with halogen, hydroxy, oxo, or aryl; or
  • R 11 is as defined above and R 21 -C-R 31 form a C 3 . 6 -cycloalkyl group, optionally being mono- or polysubstituted with C ⁇ -e -alkyl, perhalomethyl, halogen, hydroxy or aryl; or
  • R 11 , R 21 and R 3 all are d-e- alkyl.
  • R 11 is methyl
  • R 21 -C-R 31 forms a C 3-6 - cycloalkyl group.
  • Examples of specific compounds of formula (la) to be used according to this invention are: 3-tert-Butylamino-6-chloro-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide; 6- Chloro-3-(1 , -dimethylpropylamino)-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 , 1 -dioxide; 6- Chloro-3-(1-methylcyclopropyl)amino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1-dioxide; 6- Chloro-3-(2-hydroxy-1 , 1 -dimethylethylamino)-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 , 1 -dioxide; 6-Chloro-3-(1 ,1 ,3,3-tetramethylbutylamino)-4H-thien
  • Another example of a specific compound of formula (la) to be used according to this invention is 6-Chloro-3-(1-methylcyclopropyl)amino-4H-thieno[3,2-e]-1 ,2,4-thiadiazine 1 ,1- dioxide.
  • Potassium channel openers can readily be determined by those skilled in the art. Methods therefore has been described in e.g. WO 97/26264 , WO 97/26265, WO 99/03861 , WO 00/37474 , and recently reviewed: McClenaghan: Diabetes, Obesitas and Metabolism, 1, 137-150, (1999); Yokoshiki: Am. J. Physiol. . 274. C25-C37, (1998); Aguliar-Bryan: Endocrine Reviews, 20, 101-135, (1999).
  • the compounds of formula (I) and (la) of the present invention may be prepared by using the methods taught in e.g. WO 97/26264 , WO 97/26265, WO 99/03861 and WO 00/37474 , which are hereby incorporated by reference.
  • the modulator of CD3 and the beta cell resting compound are co-administered to the patient.
  • the two compounds may be administered as separately formulated compounds or they may be administered as one formulation comprising both compounds.
  • the modulator of CD3 is administered in a regimen, which additionally comprises administration of the beta cell resting compound.
  • the modulator of CD3 and the beta cell resting compound are administered in suboptimal dosages, i.e. dosages lower than the optimal dosages for single compound therapy.
  • the modulator of CD3 and the beta cell resting compound are administered in sufficient amount and for a sufficient time to produce a synergistic effect.
  • the modulator of CD3 and the beta cell resting compound are administered in amounts and for a sufficient time to produce an additive effect.
  • the modulator of CD3 and the beta cell resting compound are administered in amounts and for a sufficient time to produce a favourable effect.
  • the subject or patient is preferably a mammal, more preferably a human.
  • the route of administration may be any route, which effectively transports the active compound to the appropriate or desired site of action, such as oral, nasal, buccal, pulmonal, transdermal or parenteral.
  • compositions (or medicaments) containing the modulator of CD3, such as OKY3, hOKT3 ⁇ 1 (Ala-Ala), 145 2C11 or CAMPATH-3, may be administered by suitable dosage forms such as parenteral.
  • compositions (or medicaments) containing the beta cell resting compound may be administered by suitable dosage forms such as oral, nasal, pulmonal, buccal or transdermal to patients in need of such a treatment.
  • suitable dosage forms such as oral, nasal, pulmonal, buccal or transdermal to patients in need of such a treatment.
  • the preferred route of administration of said beta cell resting compound is orally.
  • Pharmaceutical compositions containing the beta cell resting compound may be prepared by conventional techniques, e.g. as described in Remington: The Science and Practice of Pharmacy, 19th Edition, Gennaro, Ed., Mack Publishing Co., Easton, PA, 1995.
  • compositions of the beta cell resting compounds include a compound of the present invention associated with a pharmaceutically acceptable excipient, which may be a carrier or a diluent or be diluted by a carrier, or enclosed within a carrier, which can be in the form of a capsule, sachet, paper or other container.
  • a pharmaceutically acceptable excipient which may be a carrier or a diluent or be diluted by a carrier, or enclosed within a carrier, which can be in the form of a capsule, sachet, paper or other container.
  • a pharmaceutically acceptable excipient which may be a carrier or a diluent or be diluted by a carrier, or enclosed within a carrier, which can be in the form of a capsule, sachet, paper or other container.
  • the active compound will usually be mixed with a carrier, or diluted by a carrier, or enclosed within a carrier, which may be in the form of a ampoule, capsule, sachet, paper, or other
  • the carrier When the carrier serves as a diluent, it may be solid, semi-solid, or liquid material, which acts as a vehicle, excipient, or medium for the active compound.
  • the active compound can be adsorbed on a granular solid container for example in a sachet.
  • suitable carriers are water, salt solutions, alcohol's, polyethylene glycol's, polyhydroxyethoxy- lated castor oil, peanut oil, olive oil, gelatine, lactose, terra alba, sucrose, cyclodextrin, amy- lose, magnesium stearate, talc, gelatine, agar, pectin, acacia, stearic acid or lower alkyl ethers of cellulose, silicic acid, fatty acids, fatty acid amines, fatty acid monoglycerides and diglyc- erides, pentaerythritol fatty acid esters, polyoxyethylene, hydroxymethylcellulose and polyvi- nylpyrrolidone.
  • the carrier or diluent may include any sustained release material known in the art, such as glyceryl monostearate or glyceryl distearate, alone or mixed with a wax.
  • the formulations may also include wetting agents, emulsifying and suspending agents, preserving agents, sweetening agents or flavouring agents.
  • the formulations of the invention may be formulated so as to provide quick, sustained, or delayed release of the active ingre- der after administration to the patient by employing procedures well known in the art.
  • compositions can be sterilized and mixed, if desired, with auxiliary agents, emulsifiers, salt for influencing osmotic pressure, buffers and/or colouring substances and the like, which do not deleteriously react with the active compound.
  • the preparation may be tabletted, placed in a hard gelatine capsule in powder or pellet form or it can be in the form of a troche or lozenge. If a liquid carrier is used, the preparation may be in the form of a syrup, emulsion, soft gelatine capsule or sterile injectable liquid such as an aqueous or non-aqueous liquid suspension or solution.
  • the preparation may contain the compound of the present invention dissolved or suspended in a liquid carrier, in particular an aqueous carrier, for aerosol application.
  • a liquid carrier in particular an aqueous carrier
  • the carrier may contain additives such as solubilizing agents, e.g. propylene glycol, surfactants, absorption enhancers such as lecithin (phosphatidylcholine) or cyclodextrin, or preservatives such as parabenes.
  • injectable solutions or suspen- sions preferably aqueous solutions with the active compound dissolved in polyhydroxylated castor oil.
  • Tablets, dragees, or capsules having talc and/or a carbohydrate carrier or binder or the like are particularly suitable for oral application.
  • Preferable carriers for tablets, dragees, or capsules include lactose, cornstarch, and/or potato starch.
  • a syrup or elixir can be used in cases where a sweetened vehicle can be employed.
  • a typical tablet which may be prepared by conventional tabletting techniques, may contain:
  • the beta cell resting compounds are effective over a wide dosage range.
  • dosages from 0.1 mg/day to 10000 mg/day, preferably from 10 mg/day to 5000 mg/day may be used.
  • a most preferable dosage is from 100 mg/day to 4000 mg/day.
  • the exact dosage will depend upon the mode of administration, on the therapy desired, the administration form, the subject to be treated and the body weight of the subject to be treated.
  • dosage forms suitable for oral, nasal, pulmonary or transdermal administration comprise from about 0.1 mg to about 2000 mg, preferably from about 10 mg to about 1000 mg of the compound of the invention admixed with a pharmaceutically acceptable carrier or diluent.
  • the treatment with the modulator of CD3 may be repeated at intervals ranging from every 3 months to every 10 years.
  • the treatment with the beta-cell resting compound may be repeated at intervals ranging from every 3 months to every 10 years.
  • the treatment with the beta-cell resting compound may be daily for the lifetime of the patient.
  • kits for the prevention and intervention of Type 1 diabetes may contain a single dosage form or it may contain two dosage forms, i.e. one for each compound to be administered.
  • the combined treatment with a modulator of CD3 and a beta cell resting compound may also be combined with a third or more further pharmacologically active substances, e.g. selected from antidiabetic agents, antiobesity agents, appetite regulating agents, antihyper- tensive agents, agents for the treatment and/or prevention of complications resulting from or associated with diabetes and agents for the treatment and/or prevention of complications and disorders resulting from or associated with obesity.
  • antidiabetic agents e.g. selected from antidiabetic agents, antiobesity agents, appetite regulating agents, antihyper- tensive agents, agents for the treatment and/or prevention of complications resulting from or associated with diabetes and agents for the treatment and/or prevention of complications and disorders resulting from or associated with obesity.
  • antidiabetic agents e.g. selected from antidiabetic agents, antiobesity agents, appetite regulating agents, antihyper- tensive agents, agents for the treatment and/or prevention of complications resulting from or associated with
  • Examples of these pharmacologically active substances are : Insulin, GLP-1 agonists, sulphonylureas, biguanides, meglitinides, glucosidase inhibitors, glucagon antagonists, DPP-IV (dipeptidyl peptidase-IV) inhibitors, in- hibitors of hepatic enzymes involved in stimulation of gluconeogenesis and/or glycogenoly- sis, glucose uptake modulators, compounds modifying the lipid metabolism such as anti- hyperlipidemic agents as HMG CoA inhibitors (statins), compounds lowering food intake, RXR agonists and agents acting on the ATP-dependent potassium channel of the ⁇ -cells; Cholestyramine, colestipol, clofibrate, gemfibrozil, lovastatin, pravastatin, simvastatin, probu- col, dextrothyroxine; ⁇ -blockers such as alprenolol, atenol
  • Example 1 The synergistic effects of the combined use of a modulator of CD3 and a beta cell resting compound can be measured as follows:
  • Study design and treatment protocols Upon enrollment and following informed consent, patients are be randomized into one of four groups: one receiving anti-CD3 and placebo for a beta cell resting compound, one receiving placebo for anti-CD3 and a beta cell resting compound, one receiving both anti-CD3 and a beta cell resting compound and one receiving placebo for both anti-CD3 and a beta cell resting compound.
  • Anti-CD3 treatment or placebo is administered at a schedule as described by Herold et. al. N Engl J Med 346:1692-98, 2002. Starting the same day as the anti-CD3 treatment, the beta cell resting compound is administered 4 times daily for a period of 3 months. This 3 month period is referred to as the treatment period.
  • Patients receive state-of-the art therapy with insulin and/or insulin analogs simultaneously during the treat- ment period in order to provide glycemic control.
  • the primary endpoint is area under the curve for insulin secretion rates quantified by deconvolution of C-peptide concentrations for the meal test performed after the three month treatment period. Secondary endpoints is fasting C-peptide, insulin secretion rates after the oral glucose tolerance test, use of exogenous insulin, and HbAlc. The statistical analysis is based on baseline subtracted data.
  • Baseline assessment and data collection At baseline, subjects or patients have fasting C-peptide, an oral glucose tolerance test and a meal tolerance test performed. Their islet cell antibodies are assessed. The following period, treatment occur. They receive intensive insulin therapy in order to provide glycemic control. They are also receiving (anti-CD3 or placebo) and (the beta cell resting compound or placebo). Between one and seven days after the treatment period has ended and every three months thereafter for an indefinite period, HbAlc fasting C-peptide, oral glucose tolerance tests and meal tests are repeated.
  • the statistical analysis shows a synergistic effect on the primary endpoint, i.e. the effect of combining anti-CD3 and the beta cell resting compound is greater than the additive effect of either treatment regimen alone.
  • the effect of administering placebo for anti-CD3 and placebo for the beta cell resting compound is designated A
  • the effect of administering anti-CD3 and placebo for the beta cell resting compound is designated B
  • the effect of administering placebo for anti-CD3 and the beta cell resting compound is designated C
  • the effect of administering anti-CD3 and the beta cell resting compound is designated D
  • the statistical analysis shows that D-A is greater than (B-A)+(C-A) with statistical significance at the 0.05 level.
  • the statistical test used is a two-way analysis of variance with anti-CD3 and the beta cell resting compound as the two factors.
  • the interaction term is used to ascertain the presence of synergy.

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Abstract

Méthodes et utilisations pour la prévention et l'intervention du diabète de type 1 et le diabète auto-immun latent chez l'adulte (LADA) consistant en l'administration d'un modulateur de CD3 et d'un composé de repos de cellules bêta.
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EP1968601A2 (fr) * 2006-01-05 2008-09-17 Essentialis, Inc. Sels d'ouvreurs des canaux potassiques atp-dépendants et leurs utilisations
EP2094302A2 (fr) * 2006-12-21 2009-09-02 Magrogenics, Inc. Procedes pour le traitement du diabete de type lada et d'autres diabetes auto-immuns de l'adulte à l'aide d'anticorps monoclonaux immunosuppresseurs presentant une toxicite reduite
US8663634B2 (en) 2005-07-11 2014-03-04 Macrogenics, Inc. Methods for the treatment of autoimmune disorders using immunosuppressive monoclonal antibodies with reduced toxicity
US9782416B2 (en) 2004-08-25 2017-10-10 Essentialis, Inc. Pharmaceutical formulations of potassium ATP channel openers and uses thereof
WO2020130836A1 (fr) * 2018-12-21 2020-06-25 ACADEMISCH ZIEKENHUIS LEIDEN (h.o.d.n. LUMC) Composé destiné à être utilisé dans le traitement et la prévention du diabète de type i
NL2022291B1 (en) * 2018-12-21 2020-07-21 Academisch Ziekenhuis Leiden Compound for Use in Treatment and Prevention of Type I Diabetes

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Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9782416B2 (en) 2004-08-25 2017-10-10 Essentialis, Inc. Pharmaceutical formulations of potassium ATP channel openers and uses thereof
US8663634B2 (en) 2005-07-11 2014-03-04 Macrogenics, Inc. Methods for the treatment of autoimmune disorders using immunosuppressive monoclonal antibodies with reduced toxicity
US10085998B2 (en) 2006-01-05 2018-10-02 Essentialis, Inc. Salts of potassium ATP channel openers and uses thereof
US7799777B2 (en) 2006-01-05 2010-09-21 Essentialis, Inc. Salts of potassium ATP channel openers and uses thereof
EP2404604A1 (fr) * 2006-01-05 2012-01-11 Essentialis, Inc. Sels d'ouverture de canal ATP du potassium et leurs utilisations
US7572789B2 (en) 2006-01-05 2009-08-11 Essentialis, Inc. Salts of potassium ATP channel openers and uses thereof
EP1968601A4 (fr) * 2006-01-05 2009-02-25 Essentialis Inc Sels d'ouvreurs des canaux potassiques atp-dépendants et leurs utilisations
EP1968601A2 (fr) * 2006-01-05 2008-09-17 Essentialis, Inc. Sels d'ouvreurs des canaux potassiques atp-dépendants et leurs utilisations
EP3545958A1 (fr) * 2006-01-05 2019-10-02 Essentialis, Inc. Sels d'ouverture de canal atp du potassium et leurs utilisations
US11045478B2 (en) 2006-01-05 2021-06-29 Essentialis, Inc. Salts of potassium ATP channel openers and uses thereof
US11786536B2 (en) 2006-01-05 2023-10-17 Essentialis, Inc. Salts of potassium ATP channel openers and uses thereof
EP2094302A2 (fr) * 2006-12-21 2009-09-02 Magrogenics, Inc. Procedes pour le traitement du diabete de type lada et d'autres diabetes auto-immuns de l'adulte à l'aide d'anticorps monoclonaux immunosuppresseurs presentant une toxicite reduite
EP2094302A4 (fr) * 2006-12-21 2010-12-08 Macrogenics Inc Procedes pour le traitement du diabete de type lada et d'autres diabetes auto-immuns de l'adulte à l'aide d'anticorps monoclonaux immunosuppresseurs presentant une toxicite reduite
WO2020130836A1 (fr) * 2018-12-21 2020-06-25 ACADEMISCH ZIEKENHUIS LEIDEN (h.o.d.n. LUMC) Composé destiné à être utilisé dans le traitement et la prévention du diabète de type i
NL2022291B1 (en) * 2018-12-21 2020-07-21 Academisch Ziekenhuis Leiden Compound for Use in Treatment and Prevention of Type I Diabetes

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