WO2005094797A2 - Nouveaux antagonistes de recepteur ampa - Google Patents

Nouveaux antagonistes de recepteur ampa Download PDF

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Publication number
WO2005094797A2
WO2005094797A2 PCT/EP2005/002305 EP2005002305W WO2005094797A2 WO 2005094797 A2 WO2005094797 A2 WO 2005094797A2 EP 2005002305 W EP2005002305 W EP 2005002305W WO 2005094797 A2 WO2005094797 A2 WO 2005094797A2
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WO
WIPO (PCT)
Prior art keywords
dementia
aliphatic
treatment
combination according
hydrogen
Prior art date
Application number
PCT/EP2005/002305
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English (en)
Other versions
WO2005094797A3 (fr
Inventor
Kurt LINGENHÖHL
Ferenc Martenyi
Original Assignee
Novartis Ag
Novartis Pharma Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Novartis Ag, Novartis Pharma Gmbh filed Critical Novartis Ag
Publication of WO2005094797A2 publication Critical patent/WO2005094797A2/fr
Publication of WO2005094797A3 publication Critical patent/WO2005094797A3/fr

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    • 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
    • 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
    • A61K31/66—Phosphorus compounds
    • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
    • 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
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia

Definitions

  • the present invention relates to methods and materials for the treatment of dementia.
  • the present invention relates to a method for the treatment and/or prevention dementia comprising the step of administering to a warm-blooded animal, including a human, in need thereof an effective amount of AMPA receptor antagonist alone or in combination with nootropics.
  • AMPA receptor antagonists as used herein includes, but is not limited to the quinoxaline-dione aminoalkylphosphonates of formula I
  • Ri represents hydroxy or an aliphatic, aryl aliphatic or aromatic group
  • X represents an aliphatic, cycloaliphatic, cycloaliphatic aliphatic, aryl aliphatic, heteroar l aliphatic or aromatic group
  • R 2 represents hydrogen or an aliphatic or aryl aliphatic group, alk stands for C1-C7alkylene, and
  • R 3 , R 4 and R 5 represent independently of each other hydrogen, C1-C7alkyl, halogen, trifluoromethyl, cyano or nitro, and wherein the radicals have the meanings as defined in WO 98/17672.
  • the term “dementia” as used herein includes, but is not restricted to, Alzheimer's dementia with or without psychotic symptoms.
  • the methods and materials described herein are suitable for the treatment of behavioral disturbances observed with such types of dementia.
  • nootropics as used herein includes, but is not limited to nootropical plant extracts, calcium antagonists, cholinesterase inhibitors, dihydroergotoxin, nicergoline, piracetame, purine derivates, pyritinol, vincamine and vinpocetine.
  • the combination partner is a cholinesterase inhibitor.
  • nootropical plant extracts includes, but is not limited to extracts from Ginkgo leafs.
  • calcium antagonists includes, but is not limited to cinnarizine and nimodipine.
  • cholinesterase inhibitors includes, but is not limited to donepezil hydrochloride, rivastigmine and galantamine hydrobromide.
  • purine derivates includes, but is not limited to pentifyllin.
  • Extracts from Ginkgo leafs can be administered, e.g., in the form as marketed, e.g. under the trademark GinkodilatTM according to the information provided by the package insert.
  • Cinnarizine can be administered, e.g., in the form as marketed, e.g. under the trademark Cinnarizin forte-ratiopharmTM.
  • Nimodipine can be administered, e.g., in the form as marketed, e.g. under the trademark NimotopTM.
  • Donepezil hydrochloride can be administered, e.g., in the form as marketed, e.g. under the trademark AriceptTM.
  • Rivastigmine can be prepared as disclosed, in US 5,602,176.
  • Galantamine hydrobromide can be administered, e.g., in the form as marketed, e.g. under the trademark ReminylTM.
  • Dihydroergotoxin can be administered, e.g., in the form as marketed, e.g. under the trademark HyderginTM.
  • Nicergoline can be administered, e.g., in the form as marketed, e.g. under the trademark SermionTM.
  • Piracetam can be administered, e.g., in the form as marketed, e.g. under the trademark CerebroforteTM.
  • Pentifyllin can be administered, e.g., in the form as marketed, e.g. under the trademark CosaidonTM.
  • Pyritinol can be administered, e.g., in the form as marketed, e.g. under the trademark EncephabolTM.
  • Vinpocetin can be administered, e.g., in the form as marketed, e.g. under the trademark CavintonTM.
  • the invention relates to a combination, such as a combined preparation or pharmaceutical composition, which comprises at least one AMPA receptor antagonist and at least one nootropic, in which the active ingredients are present in each case in free form or in the form of a pharmaceutically acceptable salt and optionally at least one pharmaceutically acceptable carrier; for simultaneous, separate or sequential use.
  • a combination such as a combined preparation or pharmaceutical composition, which comprises at least one AMPA receptor antagonist and at least one nootropic, in which the active ingredients are present in each case in free form or in the form of a pharmaceutically acceptable salt and optionally at least one pharmaceutically acceptable carrier; for simultaneous, separate or sequential use.
  • a combined preparation defines especially a "kit of parts" in the sense that the first and second active ingredient as defined above can be dosed independently or by use of different fixed combinations with distinguished amounts of the ingredients, i.e., simultaneously or at different time points.
  • the parts of the kit of parts can then, e.g., be administered simultaneously or chronologically staggered, that is at different time points and with equal or different time intervals for any part of the kit of parts.
  • the time intervals are chosen such that.the effect on the treated disease in the combined use of the parts is larger than the effect which would be obtained by use of only any one of the active ingredients.
  • the ratio of the total amounts of the active ingredient 1 to the active ingredient 2 to be administered in the combined preparation can be varied, e.g., in order to cope with the needs of a patient sub-population to be treated or the needs of the single patient which different needs can be due to age, sex, body weight, etc. of the patients.
  • there is at least one beneficial effect e.g., a mutual enhancing of the effect of the first and second active ingredient, in particular a synergism, e.g. a more than additive effect, additional advantageous effects, less side effects, a combined therapeutic effect in a non- effective dosage of one or both of the first and second active ingredient, and especially a strong synergism the first and second active ingredient.
  • references to the active ingredients are meant to also include the pharmaceutically acceptable salts. If these active ingredients have, for example, at least one basic center, they can form acid addition salts. Corresponding acid addition salts can also be formed having, if desired, an additionally present basic center.
  • the active ingredients having an acid group (for example COOH) can also form salts with bases.
  • the active ingredient or a pharmaceutically acceptable salt thereof may also be used in form of a hydrate or include other solvents used for crystallization.
  • a pharmaceutical combination which comprises at least one AMPA receptor antagonist and at least one nootropic in which the active ingredients are present in each case in free form or in the form of a pharmaceutically acceptable salt, if at least one salt-forming group is present, will be referred to hereinafter as a COMBINATION OF THE INVENTION.
  • the pharmacological activity of an AMPA receptor antagonist or a COMBINATION OF THE INVENTION may, for example, also be demonstrated in a clinical study.
  • Such clinical studies are preferably randomized, double-blind, clinical studies in patients with Alzheimer's Disease.
  • Such studies demonstrate, in particular, the synergism of the active ingredients of the COMBINATIONS OF THE INVENTION.
  • the beneficial effects on Alzheimer's Disease can be determined directly through the results of these studies or by changes in the study design which are known as such to a person skilled in the art.
  • the studies are, in particular, suitable to compare the effects of a monotherapy using the active ingredients and a COMBINATION OF. THE INVENTION.
  • a further benefit is that lower doses of the active ingredients of the COMBINATION OF THE INVENTION can be used, for example, that the dosages need not only often be smaller but are also applied less frequently, or can be used in order to diminish the incidence of side effects. This is in accordance with the desires and requirements of the patients to be treated.
  • the COMBINATIONS OF THE INVENTION can be used, in particular, for the treatment of dementia which is refractory to monotherapy.
  • the AMPA receptor antagonists used in the present invention are competitive AMPA receptor antagonists.
  • the COMBINATION OF THE INVENTION comprises an AMPA receptor antagonist, which is a quinoxalinedione aminoalkylphosphonate, in particular a quinoxalinedione aminoalkylphosphonate of formula I wherein
  • R-i represents hydroxy or an aliphatic, aryl aliphatic or aromatic group
  • X represents an aliphatic, cycloaliphatic, cycloaliphatic aliphatic, aryl aliphatic, heteroaryl aliphatic or aromatic group
  • R 2 represents hydrogen or an aliphatic or aryl aliphatic group, alk stands for C1-C7alkylene, and
  • R 3 , R and R 5 represent independently of each other hydrogen, C1-C7alkyl, halogen, trifluoromethyl, cyano or nitro, and wherein the radicals have the meanings as defined in WO 98/17672.
  • the AMPA receptor antagonists is selected from EGIS 8332 (7-acetyl-5-(4-aminophenyl)-8,9-dihydro-8-methyl-7H-1 ,3- dioxolo[4,5-h][2,3]benzodiazepine-8-carbonitrile), GYKI 47261 4-(7-chloro-2-methyl- 4H-3,10,10a-triaza-benzo[f
  • YM90K (6-imidazol-1-yl-7-nitro-1 ,4-dihydro-quinoxaline-2,3-dione), S-34730 (7-chloro-6-sulfamoyl-2-(1H)-quinolinone-3-phosphonic acid), Zonampanel (YM-872; (7-imidazol-1-yl-6-nitro-2,3-dioxo-3,4-dihydro-2H-quinoxalin-1-yl)-acetic acid), GYKI- 52466 (4-(8-methyl-9H-1 ,3-dioxa-6,7-diaza-cyclohepta[f]inden-5-yl)-phenylamine), ZK- 200775 (MPQX, (7-morpholin-4-yl-2,3-dioxo-6-trifluoromethyl-3,4-dihydro-2H- quinoxalin-1-ylmethyl)-phosphonic acid), CP
  • It is one objective of this invention to provide a pharmaceutical composition comprising a quantity, which is jointly therapeutically effective against dementia, comprising at least one AMPA receptor antagonist, at least one nootropic and at least one pharmaceutically acceptable carrier.
  • the first and second active ingredient can be administered together, one after the other or separately in one combined unit dosage form or in two separate unit dosage forms.
  • the unit dosage form may also be a fixed combination.
  • compositions according to the invention can be prepared in a manner known per se and are those suitable for enteral, such as oral or rectal, and parenteral administration to mammals (warm-blooded animals), including man, comprising a therapeutically effective amount of at least one pharmacologically active ingredient, alone or in combination with one or more pharmaceutically acceptable carries, especially suitable for enteral or parenteral application.
  • enteral such as oral or rectal
  • parenteral administration to mammals (warm-blooded animals), including man, comprising a therapeutically effective amount of at least one pharmacologically active ingredient, alone or in combination with one or more pharmaceutically acceptable carries, especially suitable for enteral or parenteral application.
  • the preferred route of administration of the dosage forms of the present invention is orally.
  • the novel pharmaceutical composition contain, for example, from about 10 % to about 100 %, preferably from about 20 % to about 60 %, of the active ingredients.
  • Pharmaceutical preparations for the combination therapy for enteral or parenteral administration are, for example, those in unit dosage forms, such as sugar-coated tablets, tablets, capsules or suppositories, and furthermore ampoules. If not indicated otherwise, these are prepared in a manner known per se, for example by means of conventional mixing, granulating, sugar- coating, dissolving or lyophilizing processes. It will be appreciated that the unit content of active ingredient or ingredients contained in an individual dose of each dosage form need not in itself constitute an effective amount since the necessary effective amount can be reached by administration of a plurality of dosage units.
  • any of the usual pharmaceutical media may be employed, such as, for example, water, glycols, oils or alcohols; or carriers such as starches, sugars, microcristalline cellulose, diluents, granulating agents, lubricants, binders, disintegrating agents and the like in the case of oral solid preparations such as, for exam le, powders, capsules and tablets. Because of their ease of administration, tablets and capsules represent the most advantageous oral dosage unit form in which case solid pharmaceutical carriers are obviously employed.
  • the present invention relates to the use of a COMBINATION OF THE INVENTION for the preparation of a medicament for the treatment of dementia.
  • the present invention provides a method of treating a warm-blooded animal having dementia comprising administering to the animal a COMBINATION OF THE INVENTION in a quantity which is jointly therapeutically effective against dementia and in which the compounds can also be present in the form of their pharmaceutically acceptable salts.
  • the present invention provides a commercial package comprising as active ingredients COMBINATION OF THE INVENTION, together with instructions for simultaneous, separate or sequential use thereof in the treatment of dementia.
  • the COMBINATION OF THE INVENTION is used for the treatment of dementia which is refractory to monotherapy.
  • a therapeutically effective amount of each of the active ingredients of the COMBINATION OF THE INVENTION may be administered simultaneously or sequentially and in any order, and the components may be administered separately or as a fixed combination.
  • the method of treatment of dementia according to the invention may comprise (i) administration of the first active ingredient in free or pharmaceutically acceptable salt form and (ii) administration of the second active ingredient in free or pharmaceutically acceptable salt form, simultaneously or sequentially in any order, in jointly therapeutically effective amounts, preferably in synergistically effective amounts, e.g. in daily dosages corresponding to the amounts described herein.
  • the individual active ingredients of the COMBINATION OF THE INVENTION can be administered separately at different times during the course of therapy or concurrently in divided or single combination forms.
  • administering also encompasses the use of a pro-drug of an active ingredient that convert in vivo to the active ingredient.
  • the instant invention is therefore to be understood as embracing all such regimes of simultaneous or alternating treatment and the term "administering" is to be interpreted accordingly.
  • the effective dosage of each of the active ingredients employed in the COMBINATION OF THE INVENTION may vary depending on the particular compound or pharmaceutical composition employed, the mode of administration, the severity of the condition being treated.
  • the dosage regimen the COMBINATION OF THE INVENTION is selected in accordance with a variety of factors including the route of administration and the renal and hepatic function of the patient.
  • a physician, clinician or veterinarian of ordinary skill can readily determine and prescribe the effective amount of the single active ingredients required to prevent, counter or arrest the progress of the condition.
  • Optimal precision in achieving concentration of the active ingredients within the range that yields efficacy without toxicity requires a regimen based on the kinetics of the active ingredients' availability to target sites. This involves a consideration of the distribution, equilibrium, and elimination of the active ingredients.
  • Cinnarizine may be administered to a patient in a total daily dosage of between about 75 to about 150 mg.
  • Nimodipine may be administered to a patient in a total daily dosage of between about 60 to about 120 mg.
  • Donepezil hydrochloride may be administered to a patient in a total daily dosage of between about 5 mg and 10 mg.
  • Rivastigmine may be administered to a patient in a total daily dosage of between about 6 and about 12 mg.
  • Galantamine may be administered to a patient in a total daily dosage of between about 12 and 24 mg, e.g. 12 mg twice daily.
  • Dihydroergotoxin may be administered in the form of its methansulfonate to a patient in a total daily dosage of between about 4 mg and 10 mg, e.g. about 8 mg.
  • Nicergoline may be administered in the form of its tartrate by intramuscular injection to a patient in a total daily dosage of between about 4 mg and 8 mg.
  • Piracetam may be administered to a patient in a total daily dosage of between about 1200 and 5000 mg, e.g. 4800 mg/day.
  • Pentifyllin may be administered to a patient in a total daily dosage of between about 400 and 800 mg.
  • Pyritinol may be administered in the form of its hydrochloride to a patient in a total daily dosage of about 600 mg.
  • Vinpocetin may be administered to a patient in a total daily dosage of between about 10 and 15 mg.
  • the apparatus is an open box made of black perspex (60 cm L; 60 cm W; 30 cm H). The box is placed on the floor of the experimental room allowing even illumination from indirect ceiling light and is filled to a depth of 2 cm with soiled sawdust (mixture sawdust from all cages of rats involved in the experiment).
  • Two boxes run in parallel and a camera is mounted approximately 1 m above the boxes and behavior is recorded on videotape.
  • Test protocol The experiment is carried out over three days: '
  • both objects (A1 and B1) are randomly moved in the anti-clockwise position (see Figure 1, day 3).
  • the animal is placed into the arena again in the same position as the previous day and allowed to explore objects A1 and/or B1 for a period of 3 minutes.
  • the total exploration time directed towards each object in the arena is calculated for each subject during sessions 2 and 3.
  • the time spent exploring each object time spent exploring the object A1 and A2, on day 2 and time spent on exploring the object A1 and B2 on day 2 is recorded. Comparing the time spent exploring each object during the second trial assesses recognition memory.
  • the discrimination index (on day 3) expressed in seconds is calculated as the time spent exploring the novel object (time B1 ) minus the time spent at the familiar object (time A1 ).
  • a recognition index is calculated for each animal and expressed as a ratio (time B1 x 100)/ (time A1 on day 2 + time B2). The recognition index is around 50% when animals do not remember (thus time A and time B are equivalent) but the recognition index is more than

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  • Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
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Abstract

L'invention concerne un procédé destiné au traitement et/ou à la prévention de la démence qui comprend les étapes consistant à administrer à un animal à sang chaud, notamment un être humain, le nécessitant une quantité efficace d'un antagoniste récepteur AMPA seul ou en combinaison avec des nootropes.
PCT/EP2005/002305 2004-03-05 2005-03-04 Nouveaux antagonistes de recepteur ampa WO2005094797A2 (fr)

Applications Claiming Priority (2)

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GBGB0405034.0A GB0405034D0 (en) 2004-03-05 2004-03-05 Organic compounds
GB0405034.0 2004-03-05

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WO2005094797A2 true WO2005094797A2 (fr) 2005-10-13
WO2005094797A3 WO2005094797A3 (fr) 2005-12-01

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023042888A1 (fr) * 2021-09-15 2023-03-23 国立大学法人 琉球大学 Composition pharmaceutique destinée à être mise en œuvre dans le traitement soit du déclin des fonctions cognitives, soit de la surcharge pondérale ou de l'obésité

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Publication number Priority date Publication date Assignee Title
EP0784054A1 (fr) * 1994-09-27 1997-07-16 Yamanouchi Pharmaceutical Co. Ltd. Derive de 1,2,3,4-tetrahydroquinoxalindione
US5756495A (en) * 1994-08-01 1998-05-26 Schering Aktiengesellschaft 3-substituted 3H-2, 3-benzodiazepine derivatives, the production and use as pharmaceutical agents
EP0884316A1 (fr) * 1997-06-09 1998-12-16 Pfizer Products Inc. Quinazoline-4-ones antagonistes d'AMPA
WO2000027851A1 (fr) * 1998-11-09 2000-05-18 Gyógyszerkutató Intézet Kft. Nouveaux types de composes de pyridazinone condenses
US6117873A (en) * 1996-10-24 2000-09-12 Novartis Ag Substituted aminoalkane phosphonic acids
WO2003020289A1 (fr) * 2001-08-30 2003-03-13 Ortho-Mcneil Pharmaceutical, Inc. Traitement de la demence et des troubles de la memoire par le biais d'anticonvulsifs et d'inhibiteurs de l'acetylcholinesterase
WO2003092701A2 (fr) * 2002-04-30 2003-11-13 Novartis Ag Utilisation d'acides amino-alcane-phosphoniques substitués

Patent Citations (7)

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Publication number Priority date Publication date Assignee Title
US5756495A (en) * 1994-08-01 1998-05-26 Schering Aktiengesellschaft 3-substituted 3H-2, 3-benzodiazepine derivatives, the production and use as pharmaceutical agents
EP0784054A1 (fr) * 1994-09-27 1997-07-16 Yamanouchi Pharmaceutical Co. Ltd. Derive de 1,2,3,4-tetrahydroquinoxalindione
US6117873A (en) * 1996-10-24 2000-09-12 Novartis Ag Substituted aminoalkane phosphonic acids
EP0884316A1 (fr) * 1997-06-09 1998-12-16 Pfizer Products Inc. Quinazoline-4-ones antagonistes d'AMPA
WO2000027851A1 (fr) * 1998-11-09 2000-05-18 Gyógyszerkutató Intézet Kft. Nouveaux types de composes de pyridazinone condenses
WO2003020289A1 (fr) * 2001-08-30 2003-03-13 Ortho-Mcneil Pharmaceutical, Inc. Traitement de la demence et des troubles de la memoire par le biais d'anticonvulsifs et d'inhibiteurs de l'acetylcholinesterase
WO2003092701A2 (fr) * 2002-04-30 2003-11-13 Novartis Ag Utilisation d'acides amino-alcane-phosphoniques substitués

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Title
CACABELOS R ET AL: "THE GLUTAMATERGIC SYSTEM AND NEURODEGENERATION IN DEMENTIA: PREVENTIVE STRATEGIES IN ALZHEIMER'S DISEASE" INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, JOHN WILEY AND SONS, CHICHESTER, GB, vol. 14, no. 1, 1999, pages 3-47, XP000924811 ISSN: 0885-6230 *
KHAN S A ET AL: "TOPIRAMATE ATTENUATES EXAGGERATED ACOUSTIC STARTLE IN AN ANIMAL MODEL OF PTSD" SOCIETY FOR NEUROSCIENCE ABSTRACTS, SOCIETY FOR NEUROSCIENCE, US, vol. 2003, 8 November 2003 (2003-11-08), page ABSTRNO41605, XP008048316 ISSN: 0190-5295 *

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023042888A1 (fr) * 2021-09-15 2023-03-23 国立大学法人 琉球大学 Composition pharmaceutique destinée à être mise en œuvre dans le traitement soit du déclin des fonctions cognitives, soit de la surcharge pondérale ou de l'obésité

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WO2005094797A3 (fr) 2005-12-01

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