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
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7076—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines containing purines, e.g. adenosine, adenylic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/18—Drugs for disorders of the alimentary tract or the digestive system for pancreatic disorders, e.g. pancreatic enzymes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P17/00—Drugs for dermatological disorders
  • A61P17/02—Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
  • A61P19/02—Drugs for skeletal disorders for joint disorders, e.g. arthritis, arthrosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
  • A61P19/06—Antigout agents, e.g. antihyperuricemic or uricosuric agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
  • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
  • A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
  • A61P21/04—Drugs for disorders of the muscular or neuromuscular system for myasthenia gravis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/02—Drugs for disorders of the nervous system for peripheral neuropathies
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/04—Centrally acting analgesics, e.g. opioids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • 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
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/12—Antivirals
  • A61P31/14—Antivirals for RNA viruses
  • A61P31/18—Antivirals for RNA viruses for HIV
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/12—Antivirals
  • A61P31/20—Antivirals for DNA viruses
  • A61P31/22—Antivirals for DNA viruses for herpes viruses
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders
  • A61P37/02—Immunomodulators
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • 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
  • A61P9/10—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
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
  • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
  • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
  • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Definitions

• This invention relates to analgesic- compounds and to methods of preventing, treating, or ameliorating pain using these compounds.
• Pain has two components, each involving activation of sensory neurons.
• the first component is the early or immediate phase when a sensory neuron is stimulated, for instance as the result of heat or pressure on the skin.
• the second component is the consequence of an increased sensitivity of the sensory mechanisms innervating tissue which has been previously damaged. This second component is referred to as hyperlagesia, and is involved in all forms of chronic pain arising from tissue damage, but not in the early or immediate phase of pain perception.
• hyperalgesia is a condition of heightened . ain perception caused by tissue damage.
• This condition is a natural response of the nervous system apparently designed to encourage protection of the damaged tissue by an injured individual, to give time for tissue repair to occur.
• There are two known underlying causes of this condition an increase in sensory neuron activity, and a change in neuronal processing of nociceptive information which occurs in the spinal cord.
• Hyperalgesia can be debilitating in conditions of chronic inflammation (e.g. rheumatoid arthritis), and when sensory nerve damage has occurred (i.e. neuropathic pain).
• analgesics Two major classes of analgesics are known: (i) non steroidal anti-inflammatory drugs (NSAIDs) and the related COX-2 inhibitors; and (ii) opiates based on mo ⁇ hine.
• Analgesics of both classes are effective in controlling normal, immediate or nociceptive pain. However, they are less effective against some types of hyperalgesic pain, such as neuropathic pain. Many medical practitioners are reluctant to prescribe opiates at the high doses required to affect neuropathic pain because of the side effects caused by administration of these compounds, and the possibility that patients may become addicted to them.
• NSATDs are much less potent than opiates, so even higher doses of these compounds are required. However, this is undesirable because these compounds cause irritation of the gastro-intestinal tract.
• Adenosine Al receptor agonists are known to act as powerful analgesics (Sawynok, Eur J Pharmacol. (1998) 347, 1-11), and adenosine A2A receptor agonists are known to act as anti-inflammatory agents.
• development of adenosine-based therapies has generally been precluded because they have unacceptable side effects.
• Selective Al receptor agonists cause bradycardia, and A2A receptor agonists cause widespread vasodilation with consequent hypotension and tachycardia.
• analgesics particularly anti-hyperalgesics, which are sufficiently potent to control pain perception in neuropathic and other hyperalgesic syndromes, and which do not have serious side effects or cause patients to become addicted to them.
• Spongosine is a compound that was first isolated from the tropical marine sponge, Cryptotethia crypta in 1945 (Bergmann and Feeney, J. Org. Chem. (1951) 16, 981, Ibid (1956) 21, 226). Spongosine was the first methoxypurine found in nature, and is also known as 2-methoxyadenosine, or 9H-purin-6-amine, 9- ⁇ -D-arabinofuranosyl-2- methoxy.
• the affinity of spongosine for the rat adenosine Al and A2A receptors has been determined.
• the Kd values obtained (in the rat) were 340nM for the Al receptor and 1.4 ⁇ M for the A2A receptor, while the EC50 value for stimulation of the rat A2A receptor was shown to be 3 ⁇ M (Daly et al., Pharmacol. (1993) 46, 91-100).
• the efficacy of spongosine was tested in the isolated heart preparation and the EC50 values obtained were 10 ⁇ M and 0.7 ⁇ M for the adenosine Al and A2A receptors, respectively (Ueeda et al J Med Chem (1991) 34, 1334-1339).
• spongosine when administered to mammals can give significant pain relief in conditions of increased pain sensitivity (such as neuropathic and inflammatory hyperalgesia), without causing the significant side effects expected from use of purine receptor agonists.
• the activity of spongosine as an analgesic is the subject of International patent application no. PCT/GB03/05379 (unpublished at the filing date of the present application).
• R is C ⁇ alkoxy, and X is H or OH.
• R is C ⁇ alkoxy, and X is OH.
• a compound of formula (I) in the manufacture of a medicament for the prevention, treatment, or amelioration of pain, particularly hyperalgesia.
• a method of preventing, treating, or ameliorating pain (particularly hyperalgesia) which comprises administering a compound of formula (I) to a subject in need of such prevention, treatment, or amelioration.
• Preferred compounds of formula (I) are 2-methoxyadenosine (although this compound maybe excluded in view of PCT/GB03/05379), 2-ethoxyadenosine, and 2- butyloxyadenosine.
• Compounds of formula (I) are believed to be effective in inhibiting pain perception in mammals suffering from pain, in particular neuropathic and inflammatory pain, even when administered at doses expected to give plasma concentrations well below those known to activate adenosine receptors. In addition, after administration of spongosine, no effect on normal physiological nociception was observed. Therefore, compounds of formula (I) can treat pain (particularly neuropathic and inflammatory pain) without causing the significant side effects associated with administration of other adenosine receptor agonists, and also without reducing normal sensory perception.
• hyperalgesia is a consequence in most instances of tissue damage, either damage directly to a sensory nerve, or damage of the tissue innervated by a given sensory nerve. Consequently, there are many conditions in which pain perception includes a component of hyperalgesia.
• a compound of formula (I) as an analgesic (particularly an anti-hyperalgesic) v for the prevention, treatment, or amelioration of pain (particularly hyperalgesia) caused as a result of neuropathy, including Diabetic Neuropathy, Polyneuropathy, Cancer Pain, Fibromyalgia, Myofascial Pain Syndrome, Osteoarthritis, Pancreatic Pain, Pelvic/Perineal pain, Post Herpetic Neuralgia, Rheumatoid Arthritis, Sciatica/Lumbar Radiculopathy, Spinal Stenosis, Temporo-mandibular Joint Disorder, HIV pain, Trigeminal Neuralgia, Chronic Neuropathic Pain, Lower Back Pain, Failed Back Surgery pain, back pain, post-operative pain, post physical trauma pain (including gunshot, road traffic accident, burns), Cardiac pain, Chest pain, Pelvic pain/PID, Joint pain (tendonitis, bursitis, acute arthritis), Neck Pain,
• neuropathy including Diabetic
• a compound of formula (I) as an analgesic (particularly an anti-hyperalgesic) for the prevention, treatment, or amelioration of pain (particularly hyperalgesia) caused as a result of inflammatory disease, or as a result of combined inflammatory, autoimmune and neuropathic tissue damage, including rheumatoid arthritis, osteoarthritis, rheumatoid spondylitis, gouty arthritis, and other arthritic conditions, cancer, HTV, chronic pulmonary inflammatory disease, silicosis, pulmonary sarcosis, bone resorption diseases, reperfusion injury (including damage caused to organs as a consequence of reperfusion following ischaemic episodes e.g.
• myocardial infarcts, strokes autoimmune damage (including multiple sclerosis, Guillam Barre Syndrome, myasthenia gravis) graft v. host rejection, allograft rejections, fever and myalgia due to infection, ALDS related complex (ARC), keloid formation, scar tissue formation, Crohn's disease, ulcerative colitis and pyresis, irritable bowel syndrome, osteoporosis, cerebral malaria and bacterial meningitis, bowel pain, cancer pain, back pain, fibromyalgia, post-operative pain.
• autoimmune damage including multiple sclerosis, Guillam Barre Syndrome, myasthenia gravis
• graft v. host rejection allograft rejections, fever and myalgia due to infection
• keloid formation scar tissue formation
• Crohn's disease Crohn's disease
• ulcerative colitis and pyresis irritable bowel syndrome
• osteoporosis cerebral malaria and bacterial
• the amount of a compound of formula (I) that is administered to a subject is preferably an amount which gives rise to a peak plasma concentration that is less than the EC50 value of the compound at adenosine receptors at pH 7.4.
• the EC50 value of the compound is likely to be different for different adenosine receptors (i.e. the Al, A2A, A2B, A3 adenosine receptors).
• the amount of the compound, that is to be adniinistered should be calculated relative to the lowest EC50 value of the compound at the different receptors.
• the peak plasma concentration is one thousandth to one fifth, or one fiftieth to one third (more preferably one thousandth to one twentieth, one hundredth or one fiftieth to one fifth, one fiftieth to one tenth, or one tenth to one fifth) of the EC50 value.
• the amount administered gives rise to a plasma concentration that is maintained for more than one hour between one thousandth and one fifth, or one thousandth and one twentieth, or one hundredth and one fifth, or one fiftieth and one fifth, of the EC50 value of the compound at adenosine receptors at pH 7.4.
• the EC50 value of a compound is defined herein as the concentration of the compound that provokes a receptor response halfway between the baseline receptor response and the maximum receptor response (as determined, for example, using a dose-response curve).
• the EC50 value should be determined under standard conditions (balanced salt solutions buffered to pH 7.4). For EC50 determinations using isolated membranes, cells and tissues this would be in buffered salt solution at pH 7.4 (e.g. cell culture medium), for example as in (Daly et al., Pharmacol. (1993) 46, 91-100), or preferably as in Tilburg et al (J. Med. Chem. (2002) 45, 91-100).
• the EC50 could also be determined in vivo by measuring adenosine receptor mediated responses in a normal healthy animal, or even in a tissue perfused under normal conditions (i.e. oxygenated blood, or oxygenated isotonic media, also buffered at pH 7.4) in a normal healthy animal.
• the amount of a compound of formula (I) that is administered may be an amount that results in a peak plasma concentration that is one thousandth to one twentieth, one thousandth to one third, more preferably one hundredth to one fifth, or one fiftieth to one tenth, of the Kd value at adenosine receptors.
• the Kd value of the compound is likely to be different for different adenosine receptors (i.e. the Al, A2A, A2B, A3 adenosine receptors).
• the amount of the compound that is to be administered should be calculated relative to the lowest Kd value of the compound for the different receptors.
• the amount of the compound that is administered is an amount that results in a plasma concentration that is maintained for at least one hour between one thousandth and one fifth, more preferably between one thousandth and one twentieth, or one hundredth and one fifth, or one fiftieth and one fifth, of the Kd value of the compound at adenosine receptors.
• the Kd value of the compound at each receptor should be determined under standard conditions using plasma membranes as a source of the adenosine receptors derived either from tissues or cells endogenously expressing these receptors or from cells transfected with DNA vectors encoding the adenosine receptor genes. Alternatively whole cell preparations using cells expressing adenosine receptors can be used. Labelled ligands (e.g. radiolabelled) selective for the different receptors should be used in buffered (pH7.4) salt solutions (see e.g. Tilburg et al, J. Med. Chem. (2002) 45, 420-429) to determine the binding affinity and thus the Kd of the compound at each receptor.
• buffered pH7.4
• the amount of a compound of formula (I) that is administered may be an amount that is one thousandth to one fifth, or one fiftieth to one third (preferably one thousandth to one twentieth, or one hundredth or one fiftieth to one fifth) of the minimum dose of the compound that gives rise to bradycardia, hypotension or tachycardia side effects in animals of the same species as the subject to which the compound is to be administered.
• the amount is one tenth to one fifth of the minimum dose that gives rise to the side effects.
• the amount administered gives rise to a plasma concentration that is maintained for more than 1 hour between one thousandth and one twentieth, or one hundredth or one fiftieth and one fifth of the minimum dose that gives rise to the side effects.
• the amount of a compound of formula (I) that is administered may be an amount that gives rise to plasma concentrations that are one thousandth to one fifth, or one fiftieth to one third (preferably one thousandth to one twentieth, or one hundredth or one fiftieth to one fifth) of the minimum plasma concentration of the compound that cause bradycardia, hypotension or tachycardia side effects in animals of the same species as the subject to which the compound is to be administered.
• the amount gives rise to plasma concentrations that are one tenth to one fifth of the minimum plasma concentration that causes the side effects.
• the amount administered gives rise to a plasma concentration that is maintained for more than 1 hour between one thousandth and one twentieth, or one hundredth or one fif ieth and one fifth, of the minimum plasma concentration that causes the side effects.
• the amount of a compound of formula (I) that is administered should be 0.01 to 15 mg/kg, for example 0.01 to 5 or 10 mg/kg. Preferably the amount is less than 6 mg kg, for example 0.01 to 2 mg/kg. Preferably the amount is at least 0.01 or 0.1 mg/kg, for example 0.1 to 2 mg/kg, or 0.2 to 1 mg/kg. A typical amount is 0.2 or 0.6 to 1.2 mg/kg.
• Preferred doses for a 70kg human subject are less than 420mg, preferably at least 0.7mg, more preferably at least 3.5mg, most preferably at least 7mg. More preferably 7 to 70mg, or 14 to 70mg.
• the dosage amounts specified above are significantly lower (up to approximately 100 times lower) than would be expected (based on the EC50 value of spongosine at the adenosine A2A receptor) to be required for the compounds of formula (I) to have any beneficial therapeutic effect.
• the appropriate dosage of a compound of formula (I) will vary with the age, sex, weight, and condition of the subject being treated, the potency of the compound, and the route of administration, etc.
• the appropriate dosage can readily be determined by one skilled in the art.
• a compound of formula (I) may be administered with or without other therapeutic agents, for example analgesics or anti-inflammatories (such as opiates, steroids, NSAIDs, cannabinoids, tachykinin modulators, or bradykinin modulators) or anti- hyperalgesics (such as gabapentin, pregabalin, cannabinoids, sodium or calcium channel modulators, anti-epileptics or anti-depressants).
• analgesics or anti-inflammatories such as opiates, steroids, NSAIDs, cannabinoids, tachykinin modulators, or bradykinin modulators
• anti- hyperalgesics such as gabapentin, pregabalin, cannabinoids, sodium or calcium channel modulators, anti-epileptics or anti-depressants.
• spongosine and the other analgesic agent can be administered to obtain a desired level of analgesic effect, each at a lower dose than would be required to achieve that level if either agent was administered alone. Because lower doses of each agent can be administered, side effects associated with administration of higher doses of the agents are reduced. Alternatively, an increased level of analgesic effect can be obtained by administering spongosine and the other analgesic agent at higher doses. It is believed that this will also be the case with the other compounds of formula (I).
• the preferred dosage of a compound of formula (I) when administered with another analgesic agent is lower than a preferred dosage specified above for administration of the compound alone.
• Suitable other analgesic agents that may be administered with the compound include opioid receptor agonists and partial agonists (such as morphine, diamo hine, fentanyl, bupreno ⁇ hine, codeine, or derivatives thereof), cyclooxygenase inhibitors (such as aspirin, paracetamol, ibuprofen, diclofenac, or derivatives thereof), sodium or calcium channel modulators (such as lignocaine, or gabapentin), or Selective Serotonin Reuptake Inhibitors (SSRI's) (such as paxil).
• opioid receptor agonists and partial agonists such as morphine, diamo hine, fentanyl, bupreno ⁇ hine, codeine, or derivatives thereof
• cyclooxygenase inhibitors such as aspirin, paracetamol, ibuprofen, diclofenac, or derivatives thereof
• sodium or calcium channel modulators such as lignocaine, or gabapentin
• Example 5 shows that the anti-hyperalgesic properties of spongosine are unaffected by co-administration of the opioid receptor antagonist naloxone indicating that spongosine does not act via an opioid receptor.
• Example 6 demonstrates the additive analgesic effects of co-administration of spongosine and gabapentin. Gabapentin is effective against neuropathic pain. It is expected that other analgesic agents that are designed to treat neuropathic pain may have additive analgesic effects with compounds of formula (I). Such agents include topamax, pregabalin, ziconitide, and cannabinoid derivatives.
• a compound of formula (I) may be administered by known means, in any suitable formulation, by any suitable route.
• a compound of the invention is preferably administered orally, parenterally, sublingually, transdermally, intrathecally, or transmucosally.
• Other suitable routes include intravenous, intramuscular, subcutaneous, inhaled, and topical. The amount of drug administered will typically be higher when administered orally than when administered, say, intravenously.
• a compound of formula (I) may be administered together with a physiologically acceptable carrier, excipient, or diluent.
• compositions for example for oral administration, include solid unit dose forms, and those containing liquid, e.g. for injection, such as tablets, capsules, vials and ampoules, in which the active agent is formulated, by known means, with a physiologically acceptable excipient, diluent or carrier.
• Suitable diluents and carriers are known, and include, for example, lactose and talc, together with appropriate binding agents etc.
• a unit dosage of a compound of the invention typically comprises up to 500 mg (for example 1 to 500 mg, preferably 5 to 500 mg) of the active agent.
• the active agent is in the form of a pharmaceutical composition comprising the active agent and a physiologically acceptable carrier, excipient, or diluent.
• the preferred dosage is 0.1 to 2, e.g. 0.5 to 1, typically about 0.2 or 0.6, mg of the active agent per kg of the (human) subject. At these levels, effective treatment can be achieved substantially without a concomitant fall (for example, no more than 10%) in blood pressure.
• a compound of formula (I) is administered at a frequency of 2 or 3 times per day.
• Embodiments of the invention may exclude 2-propoxyadenosine, 2- isopropoxyadenosine, 3' deoxy 2 methoxyadenosine and 3' deoxy 2 ethoxyadenosine.
• Figure 1 shows the anti-hyperalgesic actions of spongosine (0.6 mg/kg p.o.) on carrageenan induced hyperalgesia.
• A time course
• B dose dependency of the anti- hyperalgesic effect
• Figure 2 shows the anti-hyperalgesic actions of spongosine (0.6 mg/kg p.o.) in the chronic constriction injury model of neuropathic pain;
• Figure 3 shows the effect of spongosine (0.6 mg/kg p.o.) on A: blood pressure in normal rats; B: heart rate;
• Figure 4 shows the change in plasma concentration over time after administration of spongosine
• Figure 5 shows the effect of spongosine (0.6 mg/kg p.o.) in the presence and absence of naloxone in the chronic constriction injury model of neuropathic pain
• Figure 6 shows the additive effect of spongosine and gabapentin in the chronic constriction injury model of neuropathic pain.
• FIG. 1 A. Spongosine (0.624mg/kg p.o.) inhibits carrageenan (CGN) induced thermal hyperalgesia (CITH) with comparable efficacy to indomethacin (3mg/kg, po).
• Carrageenan 2%, 10 microlitres was administered into the right hind paw. A heat source was placed close to the treated and untreated hind paws, and the difference in the paw withdrawal latencies is shown.
• Spongosine was administered at the same time as carrageenan. Spongosine was as effective as indomethacin (Jhdo, 3 mg/kg p.o.).
• FIG 2 Spongosine (0.624mg/kg p.o.) inhibits thermal hyperalgesia caused by chronic constriction injury of the rat sciatic nerve. Under anaesthesia the sciatic nerve was displayed in the right leg, and four loose ligatures tied round the nerve bundle. After approximately two weeks the rats developed thermal hyperalgesia in the operated leg as judged by the difference in paw withdrawal latencies of the right and left paws. Administration of spongosine reduced the hyperalgesia as shown by the reduction in the difference between the withdrawal latencies. Spongosine was as, or more, effective than carbamazepine (CBZ, lOOmg/kg s.c.)
• FIG. 3 Spongosine (0.624 mg/kg p.o.) has no significant effect on blood pressure or heart rate.
• An implantable radiotelemetry device was placed in the abdominal cavity of 6 rats per group. The pressure catheter of the device was inserted in the abdominal aorta and two electrodes tunnelised under the skin in a lead LI position (left side of abdominal cavity/right shoulder). Individual rats were placed in their own cage on a radioreceptor (DSI) for data acquisition.
• A blood pressure
• B heart rate.
• the EC50 value of spongosine at adenosine receptors is 900ng/ml (3 ⁇ M).
• Figure 4 shows the change in plasma concentration over time after administration of spongosine at 0.6 mg/kg "to a rat. It can be seen that the plasma concentration remains above 2% of the EC50 value for more than 3 hours. Anti- hyperalgesic effects have been observed (without blood pressure changes) when the peak plasma concentration is between 1% and 30% of the EC50 value determined in vitro. If the peak plasma concentration reaches the EC50 value profound reductions in blood pressure occur that last for hours.
• FIG. 5 Spongosine (1.2 mg/kg p.o.) inhibits static allodynia caused by chronic constriction injury of the rat sciatic nerve, both in the presence and absence of naloxone (1 mg/kg s.c). Under anaesthesia the sciatic nerve was displayed in the right leg, and four loose ligatures tied round the nerve bundle. After approximately two weeks the rats developed static allodynia in the operated leg as judged by the difference in paw withdrawal thresholds of the right and left paws. Administration of spongosine reduced the hyperalgesia as shown by the increased paw withdrawal threshold (PWT) in the presence and absence of naloxone. Veh: vehicle.
• PWT paw withdrawal threshold
• Example 6 Figure 6 Spongosine and gabapentin inhibit static allodynia caused by chronic constriction injury of the rat sciatic nerve.
• Spongosine and gabapentin were administered (p.o.) in different proportions as indicated in the drawing.
• the total dose administered is shown on the horizontal axis, and the paw withdrawal threshold (PWT) on the vertical axis.
• the predicted anti-hyperalgesic effect (derived from the dose response curves obtained with each agent alone) if the effects of the two compounds are additive is shown (•).
• the observed effects are indicated by ( ⁇ ). It is apparent that the observed effects are not significantly different from those predicted by additivity.
• Spongosine is effective in inhibiting pain perception in mammals suffering from neuropathic and inflammatory pain even when administered at doses expected to give concentrations well below those known to activate adenosine receptors. At these doses it can be seen that neither the heart Al receptors nor the vascular A2A receptors are sufficiently stimulated to cause a change in the cardiovascular status of the arhmals.
• Compounds of formula (I) can be used as analgesics (particularly anti-hyperalgesics) which can be administered orally for the treatment of pain (particularly hyperalgesia) caused as a result of neuropathy and/or inflammatory disease, including Diabetic Neuropathy, polyneuropathy,Cancer Pain, Fibromyalgia, Myofascial Pain Syndrome, Pancreatic Pain, Pelvic/Perineal pain, back pain, Post Herpetic Neuralgia, Rhematoid Arthritis, Sciatica / Lumbar Radiculopathy, Spinal Stenosis, Temporo-mandibular Joint Disorder, HTV pain, Trigeminal Neuralgia, Chronic Neuropathic Pain, Lower Back/ pain, Failed Back Surgery pain, post operative pain, post physical trauma pain (including gunshot, RTA, burns), Cardiac pain, Chest pain, Pelvic pain/PLD, Joint pain (tendonitis, bursitis, acute arthritis), Neck Pain, Bowel pain, Phantom limb
• myocardial infarcts strokes
• autoimmune damage including multiple sclerosis, GuiUam Barre Syndrome, myasthenia gravis
• graft v. host rejection allograft rejections
• fever and myalgia due to infection, AIDS related complex (ARC), keloid formation, scar tissue formation, Crohn's disease, ulcerative colitis and pyresis, irritable bowel syndrome, osteoporosis, cerebral malaria and bacterial meningitis.
• ARC AIDS related complex
• keloid formation scar tissue formation
• Crohn's disease Crohn's disease
• ulcerative colitis and pyresis irritable bowel syndrome
• osteoporosis cerebral malaria and bacterial meningitis.

Landscapes

• Health & Medical Sciences (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Pharmacology & Pharmacy (AREA)
• Chemical & Material Sciences (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• Medicinal Chemistry (AREA)
• General Health & Medical Sciences (AREA)
• Organic Chemistry (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• General Chemical & Material Sciences (AREA)
• Chemical Kinetics & Catalysis (AREA)
• Engineering & Computer Science (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Physical Education & Sports Medicine (AREA)
• Neurology (AREA)
• Molecular Biology (AREA)
• Virology (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Rheumatology (AREA)
• Diabetes (AREA)
• Biomedical Technology (AREA)
• Epidemiology (AREA)
• Immunology (AREA)
• Neurosurgery (AREA)
• Pain & Pain Management (AREA)
• Oncology (AREA)
• Heart & Thoracic Surgery (AREA)
• Endocrinology (AREA)
• Cardiology (AREA)
• Communicable Diseases (AREA)
• Vascular Medicine (AREA)
• Obesity (AREA)
• Hematology (AREA)
• Emergency Medicine (AREA)
• Biotechnology (AREA)
• Urology & Nephrology (AREA)
• Tropical Medicine & Parasitology (AREA)
• Reproductive Health (AREA)

Priority Applications (12)

Applications Claiming Priority (2)

Publications (1)

Family

ID=9954247

Family Applications (1)

Country Status (19)

Cited By (8)

Families Citing this family (12)

Citations (1)

Family Cites Families (14)

• 2003
  • 2003-03-07 GB GBGB0305149.7A patent/GB0305149D0/en not_active Ceased
• 2004
  • 2004-03-05 CA CA002514098A patent/CA2514098A1/en not_active Abandoned
  • 2004-03-05 CN CN200480004454A patent/CN100579533C/zh not_active Expired - Fee Related
  • 2004-03-05 PT PT04717707T patent/PT1603577E/pt unknown
  • 2004-03-05 AU AU2004216889A patent/AU2004216889B2/en not_active Ceased
  • 2004-03-05 PL PL04717707T patent/PL1603577T3/pl unknown
  • 2004-03-05 AT AT04717707T patent/ATE401087T1/de not_active IP Right Cessation
  • 2004-03-05 JP JP2006505920A patent/JP2006519823A/ja active Pending
  • 2004-03-05 EP EP04717707A patent/EP1603577B1/en not_active Expired - Lifetime
  • 2004-03-05 KR KR1020057016699A patent/KR20050115273A/ko not_active Ceased
  • 2004-03-05 WO PCT/GB2004/000935 patent/WO2004078183A1/en not_active Ceased
  • 2004-03-05 DK DK04717707T patent/DK1603577T3/da active
  • 2004-03-05 DE DE602004015085T patent/DE602004015085D1/de not_active Expired - Lifetime
  • 2004-03-05 ES ES04717707T patent/ES2310288T3/es not_active Expired - Lifetime
  • 2004-03-05 US US10/547,455 patent/US7759321B2/en not_active Expired - Fee Related
  • 2004-03-05 NZ NZ541521A patent/NZ541521A/en unknown
  • 2004-03-05 SI SI200430876T patent/SI1603577T1/sl unknown
• 2005
  • 2005-09-27 NO NO20054476A patent/NO20054476L/no not_active Application Discontinuation
• 2008
  • 2008-10-15 CY CY20081101141T patent/CY1108416T1/el unknown

Patent Citations (1)

Non-Patent Citations (1)

Also Published As

Similar Documents

Legal Events