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
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/2004—Excipients; Inactive ingredients
  • A61K9/2009—Inorganic compounds
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/2004—Excipients; Inactive ingredients
  • A61K9/2013—Organic compounds, e.g. phospholipids, fats
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/2004—Excipients; Inactive ingredients
  • A61K9/2013—Organic compounds, e.g. phospholipids, fats
  • A61K9/2018—Sugars, or sugar alcohols, e.g. lactose, mannitol; Derivatives thereof, e.g. polysorbates
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K9/00—Medicinal preparations characterised by special physical form
  • A61K9/20—Pills, tablets, discs, rods
  • A61K9/2004—Excipients; Inactive ingredients
  • A61K9/2022—Organic macromolecular compounds
  • A61K9/205—Polysaccharides, e.g. alginate, gums; Cyclodextrin
  • A61K9/2054—Cellulose; Cellulose derivatives, e.g. hydroxypropyl methylcellulose
• • 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
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• the present invention is directed to pharmaceutical compositions for oral administration which comprise the salt of a drug product and an anti-nucleating agent, wherein the drug salt tends to convert to a less soluble form (e.g., a neutral, non-salt form) under the pH conditions found in the stomach or the intestinal tract.
• a less soluble form e.g., a neutral, non-salt form
• Orally administered drugs with relatively poor aqueous solubility can exhibit poor absorption in the gastrointestinal tract.
• the solubility of such drugs can often be improved by administering the drugs in the form of salts.
• some drug salts have relatively high solubility under certain pH conditions but convert to less soluble forms when the pH changes.
• Basic salts for example, can be comparatively soluble in neutral or basic aqueous media, but can convert to a less soluble form under acidic conditions.
• acid salts can be comparatively soluble in strongly acidic media (e.g., pH ⁇ 4), but convert to a less soluble form in less acidic conditions (e.g., pH of about 5 or higher). Oral administration of these drug salts can accordingly result in sufficient solubility in the stomach, but inadequate solubility in the less acidic environment of the intestinal tract, leading to poor overall absorption.
• the problem can be overcome by administering a larger quantity of the drug salt (e.g., by increasing the size and/or frequency of the dose), so that an effective amount of the drug can enter circulation and reach the targeted site(s) in the body.
• a drawback to this approach is that it is wasteful of drug.
• Another drawback is that increasing the dose frequency can lead to inadvertent or intentional patient non-compliance with the drug regimen.
• the insolubility problem is so severe that oral administration is not a practical option. Accordingly, there exists a need for new means that provide for the efficient and effective oral administration of such drugs and drug salts.
• the present invention is directed to pharmaceutical compositions for oral administration that include a drug compound salt that converts to a less soluble form of the drug under certain acidic conditions. More particularly, the present invention includes a pharmaceutical composition for oral administration as a solid dose, which comprises (i) an effective amount of a drug compound in the form of a salt, wherein the salt is characterized by conversion of the drug compound to a less soluble form at an gastrointestinal-relevant pH (alternatively referred to herein as a "GI-relevant pH”) above or below its native pH, and (ii) an anti-nucleating agent.
• GI-relevant pH gastrointestinal-relevant pH
• a pharmaceutical composition for oral administration as a "solid dose” means a pharmaceutical composition which is orally administered in any convenient solid form including, but not limited to powders, granules, pills, powder-filled capsules, granule-filled capsules, and tablets.
• gastrointestinal-relevant pH refers to a liquid-phase aqueous medium which has a pH that is less than about 8.
• native pH refers to the pH resulting from the dissolution of the drug in water in the absence of buffer.
• the GI-relevant pH can be an acidic pH, wherein the term “acidic pH” refers to a liquid-phase aqueous medium which has a pH that is less than 7.
• the GI-relevant pH, acidic pH, and native pH are of course measured at the same temperature, which is typically physiological temperature (e.g., 37°C for humans).
• Conversion of the drug to a less soluble form refers to any chemical or non-chemical change in the form of the drug brought about by introducing the starting drug form (here a drug salt) to an aqueous medium having a GI-relevant pH (e.g., an acidic pH) that differs from the drug's native pH.
• the conversion can be a pH driven change in the ionization state of the drug (e.g., conversion from an ionized, soluble form of the drug to a charge-neutral insoluble form), or it can be a physical change in the drug (e.g., a change in its hydration state) with or without an accompanying change in ionization.
• Drug compound salts suitable for use in the present invention include, for example, those which have a native pH in the neutral or basic range and which convert to a less soluble form in a liquid- phase aqueous medium having a pH of less than about 5 (e.g., a pH in a range of from about 2 to about 5), such as the medium typically found in the human stomach.
• Oral administration of such a drug salt to a human subject can result in relatively poor absorption and thus low oral bioavailability as a result of the salt's conversion to a comparatively insoluble form (e.g., disproportionation of a metal phenoxide salt with formation of the free phenol) in the acidic conditions encountered in the stomach.
• Other drug salts suitable for use in the present invention include, for example, those salts which have a strongly acidic native pH and which convert to a less soluble form in a liquid-phase aqueous medium having a pH in a range of from about 6 to about 8.
• Such orally administered salts can convert to relatively insoluble, poorly absorbed forms in the weakly acidic (i.e., pH of 6 to less than 7) to neutral or weakly basic conditions (pH of 7 to about 8) encountered in the intestinal tract.
• the present invention solves these problems by formulating the salt with an anti-nucleating agent.
• Oral formulations of the present invention containing an anti-nucleating agent have exhibited improved solubility in in vitro dissolution tests and improved pharmacokinetics (PK) in animal studies compared to analogous formulations not containing the anti-nucleating agent. Oral formulations of the present invention have also exhibited suitable PK in humans. Without wishing to be bound by any particular theory, it is believed that the anti-nucleating agent can sufficiently inhibit and/or delay precipitation (or, stated another way, can provide prolonged supersaturation) of the drug compound under the acidic conditions of the stomach or the pH conditions of the intestine, so as to permit the drug to be more efficiently absorbed into circulation.
• Figure 1 is the X-ray powder diffraction pattern for the potassium salt of Compound A as prepared in Example 2.
• Figure 2 is the DSC curve for the potassium salt of Compound A as prepared in Example
• Drug compound salts that can benefit from incorporation into a pharmaceutical composition of the present invention can be identified by measuring the solubility of the drug as a function of pH so as to determine if there is a decrease in solubility under the pH conditions of interest relative to the solubility of the drug at its native pH.
• the following test may be used: The drug is added to a series of buffered aqueous solutions covering at suitable intervals a pH range that is above and below the pKa(s) of the drug, the native pH, and representative of physiological conditions.
• the drug may be added to each buffer solution with agitation over a period of time sufficient to achieve equilibrium conditions without compromising stability or, alternatively, for a time period relevant to residence times in the GI tract and, preferably, at 37 0 C. Drug is added until a point beyond which solid does not dissolve any further.
• the suspension is filtered and the concentration of the resulting clear solution is assayed (e.g., by spectroscopic and/or HPLC methods) to determine the actual concentration of drug in solution at each investigated pH.
• a solubility increase or decrease can be expected if there is a pH-driven ionization change in the molecule.
• the drug compound salts employed in pharmaceutical compositions embraced by the present invention are pharmaceutically acceptable salts.
• pharmaceutically acceptable salt refers to a salt which possesses the effectiveness of the parent compound and which is not biologically or otherwise undesirable (e.g., is neither toxic nor otherwise deleterious to the recipient thereof).
• Suitable salts include base salts (also referred to herein as basic salts); i.e., salts formed by reaction of the drug compound with a base, including, for example, alkali metal salts (e.g., sodium or potassium salts), alkaline earth metal salts (e.g., calcium or magnesium salts) and ammonium salts.
• Alkali metal salts of the compounds can be formed by treating the compound dissolved in a suitable solvent with an aqueous solution of the alkali metal hydroxide (e.g., NaOH or KOH).
• Suitable salts also include acid addition salts which may, for example, be formed by mixing a solution of the compound of the present invention with a solution of a pharmaceutically acceptable acid such as hydrochloric acid, sulfuric acid, acetic acid, trifluoroacetic acid, or benzoic acid.
• composition is intended to encompass a product comprising the specified ingredients, as well as any product which results, directly or indirectly, from combining the specified ingredients.
• the term "effective amount” as used herein means that amount of active compound or pharmaceutical agent that elicits the biological or medicinal response in a tissue, system, animal or human that is being sought by a researcher, veterinarian, medical doctor or other clinician.
• the effective amount can be a "therapeutically effective amount” for the alleviation of the symptoms of the disease or condition being treated.
• the effective amount can also be a "prophylactically effective amount” for prophylaxis of the symptoms of the disease or condition being prevented.
• the drug compound inhibits the action of an enzyme (e.g., HTV integrase - see below)
• the term also refers to the amount of active compound sufficient to inhibit the enzyme and thereby elicit the response being sought (i.e., an "inhibition effective amount").
• Anti-nucleating agents suitable for use with a particular salt of a drug compound can be identified by performing solubility tests with the salt under the appropriate pH conditions (e.g., an aqueous medium buffered at a suitable pH and held at ambient — 20 to 25 0 C — or physiological - 37 0 C - temperature) in the presence and absence of a particular anti-nucleating agent, wherein exhibition of prolonged supersaturation of the compound in the presence of the anti-nucleating agent indicates the agent's suitability.
• the tests can be conducted with a single anti-nucleating agent at a series of concentrations to find a suitable concentration for further testing.
• the tests can also be conducted with a series of agents, each at the same concentration or series of concentrations, to select one or more agents for further screening via additional in vitro tests and/or in vivo PK studies.
• a USP II dissolution vessel i.e., a dissolution vessel equipped with a stirring paddle connected by a stirring shaft to a variable speed motor
• the solution is stirred (e.g., 50 rpm), and may become turbid due to precipitation of the neutral form of the drug.
• Samples are removed from the medium at periodic time intervals (e.g., 5, 10, 15, 20, 30, 60, 120, 180 and 240 minutes) and filtered (0.2 ⁇ m filter).
• the filtrate is diluted with a suitable solvent in which the solubility of the drug is higher than the initial total drug concentration in the media.
• Example 4 The use of this test is exemplified in Example 4 below.
• the same type of test with suitable adjustment of the pH range, can be used to identify anti-nucleating agents suitable for use with drug salts characterized by a native pH in the strongly acidic pH range and by conversion to a less soluble form under weakly acidic or basic conditions.
• An embodiment of the present invention is the pharmaceutical composition as originally defined above (i.e., the composition set forth in the Summary of the Invention), wherein the anti-nucleating agent comprises a water-soluble polymer.
• water-soluble polymer refers herein to any polymer which is freely soluble in water or which dissolves or solubilizes in water in an amount sufficient to provide anti-nucleating activity in compositions of the present invention (e.g., in an amount of at least about 0.005 mg/ml).
• Suitable water-soluble polymers include hydroxyalkylcelluloses, alkylcelluloses, polyvinylpyrrolidones, and polyacrylic acids.
• Suitable hydroxyalkylcelluloses include hydroxypropylmethylcellulose (HPMC), hydroxyethylcellulose, and hydroxypropylcellulose.
• HPMC hydroxypropylmethylcellulose
• a suitable alkylcellulose is methylcellulose.
• the water-soluble polymers can be employed in the present invention singly or in mixtures. It is known in the art to use the water-soluble polymers just described as stabilizing agents in pharmaceutical formulations; e.g., they can be employed to prevent or minimize settling of drug particles in dispersions before their administration (oral or otherwise) to patients. In the present invention, these polymers are employed as anti-nucleating agents; i.e., their primary role is to inhibit and/or delay precipitation of the drug in the subject's stomach and/or intestine after oral administration.
• the anti-nucleating agent comprises a low-viscosity, water-soluble polymer.
• the low-viscosity, water-soluble polymer typically produces a 2 wt.% solution having a viscosity in a range of from about 2 to about 50 cps (e.g., from about 3 to about 20 cps) at 2O 0 C.
• Suitable low-viscosity, water-soluble polymers include hydroxyalkylcelluloses, alkylcelluloses, polyvinylpyrrolidones, and polyacrylic acids.
• Suitable hydroxyalkylcelluloses include hydroxypropylmethylcellulose (HPMC), hydroxyethylcellulose, and hydroxypropylcellulose.
• HPMC hydroxypropylmethylcellulose
• HPMC hydroxyethylcellulose
• hydroxypropylcellulose methylcellulose.
• the low-viscosity, water-soluble polymers can be used singly or in mixtures of two or more (e.g., two or more HPMC polymers), wherein the polymer mixture produces a 2 wt.% solution with an average viscosity in the low viscosity range.
• the average viscosity of the polymer mixture typically differs from the viscosity of each component polymer.
• Still another embodiment of the present invention is the pharmaceutical composition as originally set forth above, wherein the anti-nucleating agent comprises a hydroxyalkylcellulose.
• the anti-nucleating agent is HPMC (or a mixture of two or more HPMCs).
• HPMCs include those (whether singly or in mixtures) that produce 2 wt.% aqueous solutions of polymer in water with viscosities in a range of from about 3 to about 150,000 cps at 2O 0 C.
• Suitable HPMCs include those sold under the trademark METHOCEL® (Dow Chemical) (e.g., METHOCEL grades KlOOLVP, K4M, K15M, and KlOOM) and METOLOSE® (Shin-Etsu). Suitable HPMCs also include U.S. Pharmacopeia standard substitution types 2208, 2906 and 2910.
• Still another embodiment of the present invention is the pharmaceutical composition as originally set forth above, wherein the anti-nucleating agent comprises a low-viscosity hydroxyalkylcellulose.
• the anti-nucleating agent is HPMC (or a mixture of two or more HPMCs) that produces a 2 wt.% aqueous solution having a viscosity in a range of from about 2 to about 100 cps at 2O 0 C.
• the anti-nucleating agent is an HPMC (or a mixture of two or more HPMCs) that produces a 2 wt.% aqueous solution having a viscosity in a range of from about 2 to about 50 cps (e.g., from about 3 to about 20 cps) at 2O 0 C.
• the anti-nucleating agent is an HPMC having a hydroxypropyl content of from about 7 to about 12 wt.%, a methoxy content of from about 28 to about 30 wt.%, and a viscosity for 2% w/w aqueous solutions of from about 3 to about 20 cps.
• the HPMC is U.S. Pharmacopeia standard substitution type 2208, 2906 or 2910, such as HPMC 2910 (6 cps) which is available as PHARMACOAT from Shin-Etsu Chemical Co.
• Another embodiment of the present invention is the pharmaceutical composition as originally set forth above or as set forth in any one of the preceding embodiments, wherein the salt of the drug compound is employed in an amount of at least about 5 wt.% (e.g., at least about 10 wt.%) with respect to the total weight of the composition.
• any reference herein to the amount of the drug compound salt is to the amount of the free form of the compound.
• the salt of the drug compound is employed in an amount which is equivalent to at least about 5 wt.% of the free (i.e., non-salt) form of the drug compound.
• Another embodiment of the present invention is the pharmaceutical composition as originally set forth above or as set forth in any one of the preceding embodiments, wherein the anti-nucleating agent is employed in an amount of at least about 0.5 wt.% (e.g., at least about 1 wt.%) based on the total weight of the composition.
• Another embodiment of the present invention is the pharmaceutical composition as originally set forth above or as set forth in any one of the preceding embodiments, wherein the salt of the drug compound is employed in an amount of from about 5 to about 75 wt.% and the anti-nucleating agent is employed in an amount of at least about 0.5 wt.% (e.g., at least about 1 wt.%), based on the total weight of the composition.
• aspects of this embodiment include the pharmaceutical composition as just set forth, in which the following amounts of the drug compound salt and anti-nucleating agent (e.g., HPMC, such as a low-viscosity HPMC) are employed:
• Another embodiment of the present invention is the pharmaceutical composition as originally set forth above or as set forth in any one of the preceding embodiments, which further comprises a diluent, a disintegrant and a lubricant.
• Another embodiment of the present invention is the pharmaceutical composition as originally set forth above or as set forth in any one of the preceding embodiments, wherein the composition is encapsulated or compressed into a tablet.
• composition Cl a pharmaceutical composition for oral administration as a solid dose
• Composition Cl a pharmaceutical composition for oral administration as a solid dose
• Compound I an effective amount of a base salt of a compound of Formula I (alternatively and more simply referred to herein as "Compound I”) and an anti-nucleating agent, wherein Formula I is:
• Rl is ; C 1-6 alkyl substituted with:
• R3 is -H or -C 1-6 alkyl
• R5 is:
• R6 is -H or -C 1-6 alkyl
• n is an integer equal to 1 or 2;
• each RA is independently -H or -Ci -6 alkyl
• each RB is independently -H or -Ci -6 alkyl
• RC and RD are each independently -H or -C 1-6 alkyl, or together with the nitrogen to which they are attached form a saturated 5- or 6-membered heterocyclic ring optionally containing a heteroatom in addition to the nitrogen attached to RC and RD selected from N, O, and S, where the S is optionally oxidized to S(O) or S(O)2, and wherein the saturated heterocyclic ring is optionally substituted with 1 or 2 C 1-6 alkyl groups;
• HetA is a 5- or 6-membered heteroaromatic ring containing from 1 to 4 heteroatoms independently selected from N, O and S, wherein the heteroaromatic ring is optionally substituted with 1 or 2 substituents each of which is independently -C 1.4 alkyl, -Ci .4 haloalkyl, -O-C1.4 alkyl, -O-C1-4 haloalkyl, or -C ⁇ 2R A ; and HetB is a 5- to 7-membered saturated heterocyclic ring containing from 1 to 4 heteroatoms independently selected from N, O and S, wherein each S is optionally oxidized to S(O) or S(O)2, and the heterocyclic ring is optionally substituted with from 1 to 3 substituents each of which is independently halogen, -Ci-4 alkyl, -C 1.4 fluoroalkyl, -C(O)-C] .4 alkyl, or -Ci .4 alkyl
• R.2 is methyl; R.3 is -H; and R.4 is CH2-phenyl wherein the phenyl is optionally substituted with 1 or 2 substituents each of which is independently bromo, chloro, fluoro, CH3, CF3, C(O)NH2, C(0)NH(CH3), C(O)N(CH3)2, SCH3, SO2CH3, or S ⁇ 2N(CH3)2; and all other variables are as defined above.
• R4 is 4-fluorobenzyl, 3,4-dichlorobenzyl, 3-chloro-4-fluorobenzyl, or 4-fluoro-3-methylbenzyl.
• R4 is 4-fluorobenzyl.
• the compounds of Formula I are HTV integrase inhibitors. More particularly, representative compounds embraced by Formula I have been tested in an integrase inhibition assay in which strand transfer is catalyzed by recombinant integrase, and have been found to be active inhibitors of HTV integrase. Integrase inhibition activity can be determined, for example, using the assay described in Hazuda et al., J. Virol. 1997, 21: 7005-7011. Representative compounds have also been found to be active in an assay for the inhibition of acute HTV infection of T-lymphoid cells conducted in accordance with Vacca et al., Proc. Natl. Acad. Sci. USA 1994, 91.: 4096-4100.
• the base salts e.g., the alkali metal salts
• the base salts of these compounds are typically soluble in neutral or basic aqueous media (i.e., they typically have a native pH > 7), but convert via disproportionation to a less soluble, free phenol form under acidic conditions, as a result of which the compounds can exhibit poor absorption and low bioavailability when administered orally.
• Formulating the Compound I base salts with anti-nucleating agents can result in improved oral bioavailability.
• composition Cl is Composition Cl as set forth above, wherein the base salt of Compound I is an alkali metal salt of Compound I (e.g., a Na or K salt of Compound I).
• the base salt of Compound I is an alkali metal salt of Compound I (e.g., a Na or K salt of Compound I).
• composition Cl is Composition Cl as set forth above, wherein the base salt of Compound I is a base salt of Compound A (e.g., an alkali metal salt of Compound A such as the Na salt or the K salt), wherein Compound A is:
• the base salt of Compound I is a base salt of Compound A (e.g., an alkali metal salt of Compound A such as the Na salt or the K salt)
• Compound A is:
• composition Cl as set forth above, wherein the base salt of Compound I is a potassium salt of Compound A.
• the potassium salt of Compound A is Form 1 crystalline potassium salt of Compound A, wherein the Form 1 K salt is an anhydrous crystalline salt characterized by an X-ray powder diffraction pattern obtained using copper K ⁇ radiation (i.e., the radiation source is a combination of Cu K ⁇ i and K ⁇ 2 radiation) which comprises 2 ⁇ values (i.e., reflections at 2 ⁇ values) in degrees of 5.9, 12.5, 20.0, 20.6 and 25.6.
• composition Cl as originally set forth above and as set forth in any of the preceding embodiments of Composition Cl, in which one or more of the following features (i) to (v) is (are) incorporated:
• the Compound I base salt is employed in an amount of at least about 5 wt.%;
• the Compound 1 base salt is employed in an amount of at least about ⁇ 0 wt.%; or
• the Compound I base salt is employed in an amount in a range of from about 5 to about 75 wt.%, or from about 5 to about 60 wt.%, or from about 15 to about 50 wt.%;
• the anti-nucleating agent is employed in an amount of at least about 0.5 wt.%;
• the anti-nucleating agent is employed in an amount of at least about 1 wt.%; or
• the anti-nucleating agent is employed in an amount in a range of from about 0.5 to about 20 wt.%, or from about 1 to about 20 wt.%, or from about 2 to about 15 wt.%;
• the anti-nucleating agent comprises a water-soluble polymer selected from the group consisting of hydroxyalkylcellulose, alkylcellulose, polyvinylpyrrolidone and polyacrylic acid, and methylcellulose;
• the anti-nucleating agent comprises a low-viscosity, water-soluble polymer selected from the group consisting of hydroxyalkylcellulose, alkylcellulose, polyvinylpyrrolidone and polyacrylic acid, and methylcellulose;
• the anti-nucleating agent comprises a hydroxyalkylcellulose (e.g., a low- viscosity hydroxyalkylcellulose); or
• the anti-nucleating agent is HPMC (e.g. a low-viscosity HPMC such as HPMC 2910);
• Composition Cl further comprises a diluent, a disintegrant, and a lubricant;
• Composition Cl further comprises a diluent which is microcrystalline cellulose, a disintegrant which is croscarmellose sodium, and a lubricant which is magnesium stearate;
• Composition Cl further comprises a first diluent, a second diluent, a disintegrant, and a lubricant;
• Composition Cl further comprises a first diluent which is microcrystalline cellulose, a second diluent with is lactose or dibasic calcium phosphate, a disintegrant which is croscarmellose sodium, and a lubricant which is magnesium stearate; or
• Composition Cl further comprises from about 10 to about 85 wt.% of a first diluent (e.g., microcrystalline cellulose), from about 10 to about 85 wt.% of a second diluent (e.g., lactose or dibasic calcium phosphate), from about 1 to about 10 wt.% of a disintegrant (e.g., croscarmellose sodium), and from about 0.5 to about 10 wt.% of a lubricant (e.g., magnesium stearate); and
• a first diluent e.g., microcrystalline cellulose
• a second diluent e.g., lactose or dibasic calcium phosphate
• a disintegrant e.g., croscarmellose sodium
• a lubricant e.g., magnesium stearate
• composition Cl is encapsulated
• Composition Cl is encapsulated to provide a capsule containing the Compound I base salt in an amount of from about 5 mg to about 1000 mg (e.g., from about 5 mg to about 900 mg, or from about 5 mg to about 600 mg, or from about 10 mg to about 400 mg);
• composition Cl is compressed into a tablet
• Composition Cl is compressed into a tablet containing the Compound I base salt in an amount of from about 5 mg to about 1000 mg (e.g., from about 5 mg to about 900 mg, or from about 5 mg to about 600 mg, or from about 10 mg to about 400 mg).
• any reference herein to an amount the drug compound salt means the amount of the drug in its free, non-salt form.
• a tablet composition containing Compound I base salt in an amount of from about 5 mg to about 1000 mg means a tablet composition containing an amount of the drug salt equivalent to about 5 mg to about 1000 mg of the Compound 1 parent (free phenol).
• composition C2 is a pharmaceutical composition for oral administration (alternatively referred to herein as "Composition C2" or the “C2 composition”) as a solid dose, which comprises from about 5 to about 75 wt.% (e.g., from about 5 to about 60 wt.%) of a potassium salt of Compound A, from about 0.5 to about 20 wt.% (e.g., from about 2 to about 15 wt.%) HPMC (e.g., a low-viscosity HPMC such as HPMC 2910), from about 10 to about 85 wt.% (e.g., from about 15 to about 75 wt.%) microcrystalline cellulose, from about 10 to about 85 wt.% (e.g., from about 10 to about 50 wt.%) lactose or dibasic calcium phosphate, from about 1 to about 10 wt.% (e.g., from about 1 to about 5 wt.%) croscarmellose sodium, and from about 0.5 to
• the potassium salt of Compound A in Composition C2 is Form 1 potassium salt of Compound A.
• Composition C2 is encapsulated or compressed into a tablet.
• the capsule or tablet contains the potassium salt of Compound A (e.g., Form 1) in an amount of from about 5 mg to about 900 mg (e.g., from about 5 mg to about 600 mg, or from about 10 mg to about 400 mg).
• composition C3 a pharmaceutical composition for oral administration
• Composition C3 a pharmaceutical composition for oral administration
• a solid dose which comprises about 50 wt.% of a potassium salt of Compound A and from about 0.5 to about 20 wt.% (e.g., from about 1 to about 20 wt.%, or from about 2 to about 15 wt.%, or about 5 wt.%) HPMC (e.g., a low-viscosity HPMC such as HPMC 2910).
• HPMC e.g., a low-viscosity HPMC such as HPMC 2910
• the composition further comprises from about 10 to about 85 wt.% (e.g., from about 15 to about 75 wt.%) microcrystalline cellulose, from about 10 to about 85 wt.% (e.g., from about 10 to about 50 wt.%) lactose or dibasic calcium phosphate, from about 1 to about 10 wt.% (e.g., from about 1 to about 5 wt.%) croscarmellose sodium, and from about 0.5 to about 10 wt.% (e.g., from about 0.5 to about 3 wt.%) magnesium stearate.
• the potassium salt of Compound A in Composition C3 is Form 1 potassium salt of Compound A.
• Composition C3 is encapsulated or compressed into a tablet.
• the capsule or tablet contains the potassium salt of Compound A (e.g., Form 1) in an amount of from about 5 mg to about 900 mg (e.g., from about 5 mg to about 600 mg, or from about 10 mg to about 400 mg).
• weight percents herein are based on the total weight of all the components in the composition (keeping in mind that, as noted earlier, the weight percent of the drug salt compound is expressed as the weight percent of the parent drug).
• compositions of the present invention can include a diluent, a disintegrant, and a lubricant.
• a diluent also referred to in the art as a "filler" is a substance used to impart bulk to the composition.
• a diluent can be employed, for example, to provide sufficient bulk to permit the composition to be compressed into a tablet having a practical size.
• Suitable diluents include anhydrous dibasic calcium phosphate, dibasic calcium phosphate dihydrate, tribasic calcium phosphate, calcium sulfate, carboxymethylcellulose calcium, microcrystalline cellulose, powdered cellulose, glucose, fructose, lactose, mannitol, dextrin, dextrose, dextrates, kaolin, lactitol, magnesium carbonate, magnesium oxide, maltitol, maltodextrin, maltose, starch, sucrose, and talc.
• the diluent employed in the pharmaceutical composition of the invention is lactose, microcrystalline cellulose, mannitol, anhydrous dibasic calcium phosphate or dibasic calcum phosphate dihyrate.
• the diluent is lactose or microcrystalline cellulose.
• the diluent is microcrystalline cellulose.
• Suitable forms of microcrystalline cellulose for use in pharmaceutical compositions of the invention include, but are not limited to, the materials sold as AVICEL PH-IOl, AVICEL PH-102, AVICEL PH-103, and AVlCEL PH-105 (all of which are available from FMC Corporation), and mixtures thereof.
• the microcrystalline cellulose employed in Composition Cl can be AVICEL PH- 102 or AVICEL PH-105 or a mixture thereof.
• compositions of the invention can contain two or more diluents (e.g., microcrystalline cellulose and lactose or dibasic calcium phosphate), which can be employed as a mixture in preparing the composition or can be added separately at the same time or can be added in separate steps in the preparation process (methods for preparing pharmaceutical compositions of the invention are described below).
• the pharmaceutical composition of the present invention comprises a first diluent (e.g., microcrystalline cellulose) and a second diluent (e.g., lactose or dibasic calcium phosphate).
• the disintegrant is a substance, or a mixture of substances, employed in the composition to facilitate its breakup or disintegration after administration. Suitable disintegrants include alginic acid, carboxymethylcellulose calcium, carboxymethylcellulose sodium, colloidal silicon dioxide, croscarmellose sodium, crospovidone, guar gum, magnesium aluminum silicate, methylcellulose, microcrystalline cellulose, polyacrilin potassium, povidone, sodium alginate, sodium starch glycolate, and starch.
• the disintegrant employed in the pharmaceutical composition of the invention can be a superdisintegrant, such as croscarmellose sodium, crospovidone, or sodium starch glycolate. In an aspect of the invention, when the pharmaceutical composition is Composition Cl , the disintegrant is the superdisintegrant croscarmellose sodium.
• the lubricant can have one or more functions depending upon the dosage form of the composition.
• the lubricant can, for example, prevent adhesion of compressed tablets to the compression equipment, it can improve the flow of granules prepared via granulation of the composition prior to their compression or encapsulation, and/or it can improve the flow of an ungranulated powder in the filling of a capsule.
• Suitable lubricants include calcium stearate, glyceryl monostearate, glyceryl palmitostearate, hydrogenated castor oil, hydrogenated vegetable oil, light mineral oil, magnesium stearate, mineral oil, polyethylene glycol, stearic acid, talc, zinc stearate, and sodium stearyl fumarate.
• the lubricant employed in the composition of the invention is magnesium stearate or stearic acid.
• the pharmaceutical composition is Composition Cl
• the lubricant is magnesium stearate.
• An antioxidant can be employed in the pharmaceutical composition of the invention to prevent or minimize oxidative degradation of the active ingredient and/or other components of the pharmaceutical composition. Suitable antioxidants include a tocopherol or an ester thereof, an alkyl gallate (e.g, propyl gallate), butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), ascorbic acid, sodium ascorbate, citric acid, and sodium metabisulfite.
• Pharmaceutical compositions of the present invention can, for example, include BHA.
• compositions of the present invention can be formulated into compressed tablets or capsules.
• Compressed tablets can be prepared via granulation, wherein the overall particle size of a formulation is increased through the permanent aggregation of smaller particles.
• Wet or dry granulation can be employed. Wet granulation can be accomplished, for example, by wetting a well- mixed blend of the dry ingredients (e.g., the drug compound salt, anti-nucleating agent, diluent or two diluents, disintegrant, and optionally an antioxidant) with sufficient solvent (e.g., water or water with an alcohol co-solvent) to moisten the dry blend such that particles in the blend tack to one another to form larger particles, and then sieving, comminuting, or otherwise manipulating the size of the particles.
• the dry ingredients e.g., the drug compound salt, anti-nucleating agent, diluent or two diluents, disintegrant, and optionally an antioxidant
• sufficient solvent e.g.
• the resulting wet granulate can then be dried and milled into suitably sized particles (i.e., granules), the granules blended with a lubricant, and the lubricated granules compressed into tablets.
• granulation can be accomplished either by wet granulating with a non-aqueous solvent or by dry granulation. Dry granulation can also be an attractive alternative to wet granulation when the composition is thermally sensitive and subject to degradation at the temperatures employed during the drying of the wet granules. Dry granulation can be accomplished, for example, by dry blending the drug compound salt, the anti-nucleating agent, a first portion of a lubricant and optionally other ingredients (e.g., a diluent and a disintegrant, or two diluents and a disintegrant), and then compressing the blended mixture into slugs or rolling the blended mixture into a compact.
• dry granulation can be accomplished, for example, by dry blending the drug compound salt, the anti-nucleating agent, a first portion of a lubricant and optionally other ingredients (e.g., a diluent and a disintegrant, or two diluents and a
• the slugs or compact can then be sized (e.g., by passing through a mesh screen or a comminuting mill) to afford the dry granules, which can then be blended with the remaining portion of the lubricant (and optionally, when a diluent or diluents is employed in the blend, an additional amount of the diluent or diluents), and the lubricated granules compressed into tablets.
• the compressed tablets can be sugar coated to mask any unpleasant taste or film coated to protect the tablet from atmospheric degradation.
• Suitable film coating suspensions include combinations of one, two or three of the following components: carboxymethylcellulose sodium, carnauba wax, cellulose acetate phthalate, cetyl alcohol, confectioner's sugar, ethyl cellulose, gelatin, hydroxyethyl cellulose, hydroxypropyl cellulose, hydroxypropyl methylcellulose, liquid glucose, maltodextrin, methyl cellulose, microcrystalline wax, Opadry I and Opadry ⁇ , polymethacrylates, polyvinyl alcohol, shellac, sucrose, talc, titanium dioxide, and zein.
• the films can be applied by spraying the suspension on the tablets and then drying. Film coating techniques and materials suitable for use with the present invention are described in Remington's Pharmaceutical Sciences. 18 th edition, edited by A. R. Gennaro, 1990, Mack Publishing Co., pp. 1665-1675.
• Encapsulated pharmaceutical compositions of the present invention can be formed, for example, by dry blending the ingredients of the pharmaceutical composition (i.e., the drug compound salt and the anti-nucleating agent, and optionally one or more other ingredients such as a diluent and/or lubricant), filling capsules (e.g., hard gelatin capsules) with a suitable amount of the blended ingredients, and sealing the capsules.
• the ingredients can be formed into granules via wet or dry granulation as described above and the capsules filled with a suitable amount of the granules and sealed. The use of granules is preferred when the ungranulated blend has poor bulk flow properties.
• compositions of the present invention e.g., capsules and compressed tablets
• solid dosage forms of the pharmaceutical compositions of the present invention are described in Remington's Pharmaceutical Sciences. 18 th edition, edited by A. R. Gennaro, 1990, Chapter 89.
• the present invention includes a process (alternatively referred to herein as "Process P 1 " or the "Pl process”) for preparing a compressed tablet pharmaceutical composition
• a process for preparing a compressed tablet pharmaceutical composition
• a base salt of a compound of Formula I as defined above an anti-nucleating agent, a first diluent, a second diluent, a disintegrant, and a lubricant; wherein the method comprises:
• the base salt of Compound I is an alkali metal salt of Compound I;
• the base salt of Compound I is a sodium salt or a potassium salt of Compound I;
• the base salt of Compound I is an alkali metal salt of Compound A;
• the base salt of Compound I is a potassium salt of Compound A; or (i-f) the base salt of Compound I is the Form 1 crystalline potassium salt of Compound A;
• the base salt of Compound I is employed in an amount of at least about 5 wt.% (or at least about 10 wt.%, or in a range of from about 5 to about 75 wt.%, or in a range of from about 5 to about 60 wt.%, or in a range of from about 15 to about 50 wt.%);
• the anti-nucleating agent is a hydroxyalkylcellulose (e.g., a low-viscosity hydroxyalkylcellulose); or
• the anti-nucleating agent is HPMC (e.g., a low-viscosity HPMC such as HPMC 2910);
• the anti-nucleating agent is employed in an amount of at least about 0.5 wt.% (or at least about 1 wt.%, or in a range of from about 0.5 to about 20 wt.%, or in a range of from about 1 to about 20 wt.%, or in a range of from about 2 to about 15 wt.%);
• the first diluent is microcrystalline cellulose
• the first diluent is employed in an amount in a range of from about 10 to about 85 wt.% (or from about 15 to about 75 wt.%);
• the second diluent is lactose or dibasic calcium phosphate
• the second diluent is employed in an amount in a range of from about 10 to about 85 wt.% (or from about 10 to about 50 wt.%);
• the disintegrant is croscarmellose sodium
• the disintegrant is employed in an amount in a range of from about 1 to about 10 wt.% (or from about 1 to about 5 wt.%)
• the lubricant is magnesium stearate
• the lubricant is employed in an amount in a range of from about 0.5 to about 10 wt.% (or from about 0.5 to about 3 wt.%);
• the process further comprises: (E) coating the compressed tablet; or
• the process further comprises: (E) coating the compressed tablet with a film coating suspension to afford a coated tablet in which the coating is from about 1 to about 5% of the weight of the compressed tablet; and
• the base salt of Compound I e.g., potassium salt of Compound A
• a per tablet amount in a range of from about 5 mg to about 1000 mg;
• the base salt of Compound I e.g., potassium salt of Compound A
• a per tablet amount of about 5 to about 600 mg e.g., about 100 mg, about 200 mg, about 300 mg, about 400 mg, about 500 mg, or about 600 mg.
• Another embodiment of the Pl process is a process for preparing a compressed tablet pharmaceutical composition comprising an effective amount of a potassium salt of Compound A, low viscosity HPMC, microcrystalline cellulose, dibasic calcium phosphate, croscarmellose sodium, and magnesium stearate; wherein the method comprises:
• (E) optionally coating the compressed tablet with an aqueous film coating suspension (e.g., a suspension of Opadry I).
• an aqueous film coating suspension e.g., a suspension of Opadry I.
• the potassium salt of Compound A is employed in an amount of at least about 5 wt.% (or at least about 10 wt.%, or in a range of from about 5 to about 75 wt.%, or in a range of from about 5 to about 60 wt.%, or in a range of from about 15 to about 50 wt.%);
• the HPMC is employed in an amount of at least about 0.5 wt.% (or at least about 1 wt.%, or in a range of from about 0.5 to about 20 wt.%, or in a range of from about 1 to about 20 wt.%, or in a range of from about 2 to about 15 wt.%);
• the microcrystalline cellulose is employed in an amount in a range of from about 10 to about 85 wt.% (or from about 15 to about 75 wt.%);
• the dibasic calcium phosphate is employed in an amount in a range of from about 10 to about 85 wt.% (or from about 10 to about 50 wt.%);
• the croscarmellose sodium is employed in an amount in a range of from about 1 to about 10 wt.% (or from about 1 to about 5 wt.%);
• the magnesium stearate is employed in an amount in a range of from about 0.5 to about 10 wt.% (or from about 0.5 to about 3 wt.%);
• the optional coating is from about 1 to about 5% of the weight of the compressed tablet.
• the present invention also includes a compressed tablet pharmaceutical composition prepared by the Process Pl as originally set forth above or as set forth in any of the foregoing embodiments of the Pl process.
• the present invention includes a process (alternatively referred to herein as "Process P2" or the "P2 process") for preparing a compressed tablet pharmaceutical composition comprising an effective amount of a base salt of a compound of Formula I as defined above, an anti-nucleating agent, a first diluent, optionally a second diluent, a disintegrant, and a lubricant; wherein the method comprises:
• the base salt of Compound I is an alkali metal salt of Compound I;
• the base salt of Compound I is a sodium salt or a potassium salt of Compound I;
• the base salt of Compound I is an alkali metal salt of Compound A;
• the base salt of Compound I is a potassium salt of Compound A;
• the base salt of Compound 1 is employed in an amount of at least about 5 wt.% (or at least about 10 wt.%, or in a range of from about 5 to about 75 wt.%, or in a range of from about 5 to about 60 wt.%, or in a range of from about 15 to about 50 wt.%);
• the anti-nucleating agent is hydroxyalkylcellulose (e.g., a low-viscosity hydroxyalkylcellulose); or
• the anti-nucleating agent is HPMC (e.g., a low-viscosity HPMC such as HPMC 2910);
• the anti-nucleating agent is employed in an amount of at least about 0.5 wt.% (or at least about 1 wt.%, or in a range of from about 0.5 to about 20 wt.%, or in a range of from about 1 to about 20 wt.%, or in a range of from about 2 to about 15 wt.%);
• the first diluent is microcrystalline cellulose
• the first diluent is employed in an amount in a range of from about 10 to about 85 wt.% (or from about 15 to about 75 wt.%);
• the optional second diluent is lactose or dibasic calcium phosphate; (viii) the optional second diluent is employed in an amount in a range of from about 10 to about 85 wt.% (or from about 10 to about 50 wt.%);
• the disintegrant is croscarmellose sodium
• the disintegrant is employed in an amount in a range of from about 1 to about 10 wt.% (or from about 1 to about 5 wt.%)
• the lubricant is magnesium stearate
• the lubricant is employed in an amount in a range of from about 0.5 to about 10 wt.% (or from about 0.5 to about 3 wt.%);
• the process further comprises: (F) coating the compressed tablet; or
• the process further comprises: (F) coating the compressed tablet with a film coating suspension to afford a coated tablet in which the coating is from about 1 to about 5% of the weight of the compressed tablet.
• the present invention also includes a compressed tablet pharmaceutical composition prepared by the Process P2 as originally set forth above or as set forth in any of the foregoing embodiments of the P2 process.
• the present invention also includes a method for treatment or prophylaxis of a disease or condition in a subject in need of such treatment or prophylaxis, which comprises orally administering as a solid dose a pharmaceutical composition which comprises (i) an effective amount of a drug compound suitable for the treatment or prophylaxis of the disease or condition, wherein the drug compound is in the form of a salt and the salt is characterized by conversion of the drug compound to a less soluble form at a GI-relevant pH (e.g., an acidic pH) above or below its native pH, and (ii) an anti-nucleating agent.
• This pharmaceutical composition corresponds to the composition as originally defined in the Summary of the Invention. Embodiments of this method include the method as just described wherein the pharmaceutical composition as originally defined is replaced with the above-described embodiments thereof.
• the Cl, C2 and C3 compositions of the present invention and the compressed tablet compositions prepared by the Pl and the P2 processes are useful in the inhibition of HIV integrase, the treatment or prophylaxis of infection by HIV and the treatment, prophylaxis, or the delay in the onset of consequent pathological conditions such as AIDS.
• Treating AIDS, the prophylaxis of AIDS, delaying the onset of AIDS, treating HTV infection, or prophylaxis of HIV infection is defined as including, but not limited to, treatment or prophylaxis of a wide range of states of HTV infection: AIDS, ARC, both symptomatic and asymptomatic, and actual or potential exposure to HTV.
• compositions of this invention are useful in treating or prophylaxis of infection by HTV after suspected past exposure to HIV by such means as blood transfusion, exchange of body fluids, bites, accidental needle stick, or exposure to patient blood during surgery.
• the present invention includes a method for inhibiting HTV integrase in a subject in need thereof which comprises administering to the subject Composition Cl as originally defined above or administering the compressed tablet composition prepared by the Pl or the P2 process as first described above.
• the invention also includes a method for treating or prophylaxis of HTV infection or for treating, prophylaxis, or delaying the onset of AIDS in a subject in need thereof, which comprises administering to the subject Composition Cl as originally defined above or administering the compressed tablet composition prepared by the Pl or the P2 process as first described above.
• the Cl composition and the Pl- and P2-prepared compressed tablet compositions of the present invention can optionally be employed in combination with one or more anti-HIV agents selected from HlV antiviral agents, anti-infective agents, and immunomodulators.
• Embodiments of these methods include the methods as just described wherein the Cl composition is a Cl composition as set forth in any one of the foregoing embodiments thereof (which include, inter alia, the C2 and C3 compositions) and the compressed tablet composition is a composition resulting from the embodiments of the Pl and P2 processes as set forth above.
• subject refers to an animal, preferably a mammal, most preferably a human, who has been the object of treatment, observation or experiment.
• compositions of the present invention When a pharmaceutical composition of the present invention is employed or administered in combination with another agent (e.g., when the Cl composition is administered in combination with an anti-HTV agent), the composition and agent can be administered separately or together, and when administered separately, the composition and agent can be given concurrently or at different times (e.g., alternately).
• another agent e.g., when the Cl composition is administered in combination with an anti-HTV agent
• the composition and agent can be administered separately or together, and when administered separately, the composition and agent can be given concurrently or at different times (e.g., alternately).
• the present invention also includes a pharmaceutical composition for oral administration as a solid dose, which comprises a drug compound in the form of a salt and an anti-nucleating agent as originally defined and described in the Summary of the Invention (i) for use in, (ii) for use as a medicament for, or (iii) for use in the preparation of a medicament for: treatment or prophylaxis of the disease or condition being treated or prevented by the drug compound.
• a pharmaceutical composition for oral administration as a solid dose which comprises a drug compound in the form of a salt and an anti-nucleating agent as originally defined and described in the Summary of the Invention (i) for use in, (ii) for use as a medicament for, or (iii) for use in the preparation of a medicament for: treatment or prophylaxis of the disease or condition being treated or prevented by the drug compound.
• a pharmaceutical composition for oral administration as a solid dose which comprises a drug compound in the form of a salt and an anti-nucleating agent as originally defined and
• the present invention also includes Composition Cl of the present invention as originally defined (i) for use in, (ii) for use as a medicament for, or (iii) for use in the preparation of a medicament for: (a) inhibiting HlV integrase, (b) treating or prophylaxis of infection by HFV, or (c) treating, prophylaxis of, or delaying the onset of AIDS.
• Embodiments of these uses include the uses as just described wherein the Cl composition as originally defined is replaced with the above-described embodiments thereof (which include, inter alia, the C2 and C3 compositions).
• the C 1 compositions of the present invention can optionally be employed in combination with one or more anti- HTV agents selected from HTV antiviral agents, anti-infective agents, and immunomodulators.
• anti-HTV agent means an agent (other than a compound of Formula I) which is effective in one or more of the following uses: inhibiting integrase or another enzyme required for HTV replication or infection, prophylaxis of HTV infection, treating HTY infection, delaying the onset of AIDS, prophylaxis of AIDS, and treating AIDS.
• Suitable HTV antiviral agents for use in combination with Composition Cl include, for example, HTV protease inhibitors (e.g., indinavir, lopinavir optionally with ritonavir, saquinavir, or nelfinavir), nucleoside HTV reverse transcriptase inhibitors (e.g., abacavir, lamivudine (3TC), zidovudine (AZT), or tenofovir), and non-nucleoside HIV reverse transcriptase inhibitors (e.g., efavirenz or nevirapine). These agents can be used in their free form or in the form of pharmaceutically acceptable salts. These agents can also be used per se, but are typically incorporated into suitable pharmaceutical compositions.
• HTV protease inhibitors e.g., indinavir, lopinavir optionally with ritonavir, saquinavir, or nelfinavir
• the present invention also includes a method for improving the pharmacokinetics of a drug compound orally administered in the form of a salt, wherein the salt is characterized by conversion of the drug compound to a less soluble form at a GI-relevant pH (e.g., an acidic pH) above or below its native pH; wherein the method comprises administering the drug compound salt as a component in a solid-dosage pharmaceutical composition that includes an anti-nucleating agent.
• a GI-relevant pH e.g., an acidic pH
• An improvement in the pharmacokinetics (PK) of a drug means herein an increase in one or more of the following PK parameters as a result of oral administration of the drug compound salt in a composition with an anti-nucleating agent compared to the corresponding value obtained by oral administration of the drug compound salt in the same manner and using an analogous composition that does not contain the anti-nucleating agent: peak plasma concentration (C max ), the trough plasma concentration (C mm ), the amount of drug in the bloodstream as measured by the area under the curve of plasma concentration versus time (AUC ⁇ -t; where t is the time of last sampling, such as 24 hours), and half-life (T >/ 2 ).
• Embodiments of this method include the method as just described in which the recited pharmaceutical composition is replaced with embodiments of the pharmaceutical compositions set forth above.
• the present invention also includes use of an anti-nucleating agent in a pharmaceutical composition for oral administration as a solid dose, wherein the composition comprises a drug compound in the form of a salt and wherein the salt is characterized by conversion of the drug compound to a less soluble form at a GI-relevant pH (e.g., an acidic pH) above or below its native pH, wherein the use is for improving the PK of the drug compound.
• a GI-relevant pH e.g., an acidic pH
• the present invention further includes the use of an anti-nucleating agent in a pharmaceutical composition for oral administration as a solid dose, wherein the composition comprises a drug compound in the form of a salt and wherein the salt is characterized by conversion of the drug compound to a less soluble form at a GI-relevant pH (e.g., an acidic pH) above or below its native pH, wherein the use is in the manufacture of a medicament for improving the PK of the drug compound.
• a GI-relevant pH e.g., an acidic pH
• compositions of this invention can be administered in a solid form suitable for oral administration.
• the compositions can, for example, be administered in the form of capsules or tablets.
• the compositions can be administered so as to provide the active ingredient in a dosage range of from about 0.001 to about 1000 mg/kg of mammal (e.g., human) body weight per day in a single dose or in divided doses.
• mammal e.g., human
• One preferred dosage range is from about 0.01 to about 500 mg/kg body weight per day in a single dose or in divided doses.
• Another preferred dosage range is from about 0.1 to about 100 mg/kg body weight per day in single or divided doses.
• composition Cl and embodiments thereof can suitably be provided in the form of tablets or capsules for oral administration, wherein each tablet or capsule contains from about 1 to about 1000 milligrams of the active ingredient, particularly 1, 5, 10, 15, 20, 25, 50, 75, 100, 150, 200, 250, 300, 400, 500, 600, 700, 800, 900 and 1000 milligrams of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated.
• pharmaceutical compositions of the present invention containing a potassium salt of Compound A e.g., Form 1
• a potassium salt of Compound A are preferably dosed to adult humans as capsules or tablets, wherein the dosage is 100 mg to 600 mg of Compound A twice per day.
• the specific dose level and frequency of dosage for any particular patient will depend upon a variety of factors including the activity of the specific drug compound employed, the metabolic stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, the severity of the particular condition, and the host undergoing therapy.
• the appropriate dose level of a particular drug suitable for a particular patient can be determined by the person of ordinary skill in the art without undue experimentation.
• alkyl refers to any linear or branched chain alkyl group having a number of carbon atoms in the specified range.
• Ci -6 alkyl (or “Ci-C ⁇ alkyl”) refers to any of the hexyl alkyl and pentyl alkyl isomers as well as n-, iso-, sec- and t-butyl, n- and isopropyl, ethyl and methyl.
• C 1.4 alkyl refers to n-, iso-, sec- and t-butyl, n- and isopropyl, ethyl and methyl.
• alkylene refers to any linear or branched chain alkylene group (or alternatively “alkanediyl”) having a number of carbon atoms in the specified range.
• -C] -6 alkylene- refers to any of the Cl to C6 linear or branched alkylenes.
• a class of alkylenes of particular interest with respect to the invention is -(CH2)l-6- > and sub-classes of particular interest include -(CH2)l-4-, -(CH2)i-3-, -(CH2)l-2-, and -CH2-. Also of interest is the alkylene -CH(CH3)-.
• halogen refers to fluorine, chlorine, bromine and iodine (alternatively referred to as fluoro, chloro, bromo, and iodo).
• haloalkyl refers to an alkyl group as defined above in which one or more of the hydrogen atoms has been replaced with a halogen (i.e., F, Cl, Br and/or I).
• a halogen i.e., F, Cl, Br and/or I.
• C]-6 haloalkyl or “Ci-C ⁇ haloalkyl” refers to a Cl to Cg linear or branched alkyl group as defined above with one or more halogen substituents.
• fluoroalkyl has an analogous meaning except that the halogen substituents are restricted to fluoro. Suitable fluoroalkyls include the series (CH2) ⁇ -4CF3 (i.e., trifluoromethyl, 2,2,2-trifluoroethyl, 3,3,3-trifluoro-n-propyl, etc.).
• aryl refers to (i) phenyl or (ii) a 9- or 10-membered bicyclic, fused carbocylic ring system in which at least one ring is aromatic.
• Aryl is typically phenyl or naphthyl, and is more typically phenyl.
• FfetA refers to an optionally substituted a 5- or 6-membered heteroaromatic ring containing from 1 to 4 heteroatoms independently selected from N, O and S.
• HetA is an optionally substituted heteroaromatic ring selected from the group consisting of pyridinyl, pyrrolyl, pyrazinyl, pyrimidinyl, pyridazinyl, triazinyl, furanyl, thienyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, oxazolyl, isooxazolyl, thiazoly, isothiazolyl, and oxadiazolyl; wherein the optional substitution is with 1 or 2 substituents each of which is independently -C 1.4 alkyl, -Ci .4 haloalkyl, -O-C1.4 alkyl, -O-Cl-4 haloalkyl, or
• HetB refers to an optionally substituted a 5- to 7-membered saturated heterocyclic ring containing from 1 to 4 heteroatoms independently selected from N, O and S.
• HetB is an optionally substituted saturated heterocyclic ring selected from the group consisting of pyrrol idinyl, imidazolidinyl, piperidinyl, piperazinyl, morpholinyl, thiomorpholinyl, thiazinanyl, and tetrahydropyranyl, wherein the optional substitution is with 1 or 2 substituents each of which is independently -Ci -4 alkyl, -C1-4 haloalkyl, -C(O)CF3, -C(O)CH3, or -CH2CH2OH. It is understood that HetA can be attached to the rest of the compound of Formula I at any ring atom (i.e., any carbon atom or any heteroatom) provided that a stable compound results. In another HetB
• R.C and RP together with the nitrogen to which they are attached can form a saturated 5- or 6-membered heterocyclic ring optionally containing a heteroatom in addition to the nitrogen attached to R.C and RD selected from N, O, and S, where the S is optionally oxidized to S(O) or S(O)2, and wherein the saturated heterocyclic ring is optionally substituted with 1 or 2 Ci-6 alkyl groups.
• the saturated heterocyclic ring formed by RC and RD and the nitrogen to which they are attached is selected from the group consisting of 4-morpholinyl, 4- thiomorpholinyl, 1-piperidinyl, 1 -piperazinyl optionally substituted with Ci_4 alkyl (e.g., methyl), and 1- pyrrolidinyl.
• a heterocyclic ring described as containing from “1 to 4 heteroatoms” means the ring can contain 1, 2, 3 or 4 heteroatoms.
• a pharmaceutical composition comprising a compound drug salt in a range of from about 5 to about 75 wt.% means the composition can contain about 5 wt.% of the parent drug, about 75 wt.% of the parent drug, or any amount therebetween.
• any variable e.g., RA and RB
• its definition on each occurrence is independent of its definition at every other occurrence.
• combinations of substituents and/or variables are permissible to the extent such combinations result in stable compounds.
• a “stable” compound is a compound which can be prepared and isolated and whose structure and properties remain or can be caused to remain essentially unchanged for a period of time sufficient to allow use of the compound for the purposes described herein (e.g., use in the form of a salt in a pharmaceutical composition of the invention).
• AIDS acquired immunodeficiency syndrome
• ARC AIDS related complex
• Cbz benzyloxycarbonyl
• DIEA diisopropylethylamine
• DMADC dimethylacetylene dicarboxylate
• DMF N,N-dimethylformamide
• DMSO dimethylsulfoxide
• EtOH ethanol Eq.
• Step 1 Strecker Amine Formation
• Acetone cyanohydrin (11.5 kg, 12.3 L) was charged to a 5-gallon autoclave and the vessel placed under 5 psi nitrogen pressure.
• the autoclave was cooled to 10 0 C, and ammonia gas ( ⁇ 3.44 kg), pressurized to 30 psi, was fed into the vessel until the reaction reached complete conversion as determined by GC assay (less than 0.5% a).
• the resulting suspension was transferred to a polyjug and the autoclave rinsed with MTBE (approximately 17 L).
• the reaction mixture and rinse were then charged to a 100-L extractor followed by MTBE (15 L), the mixture agitated, and the layers carefully separated.
• the aqueous layer was back-extracted with MTBE (5 L) and the layers carefully separated.
• the organic layers were combined and charged to a 100 L flask, equipped with a batch concentrator, through an inline filter, and the batch was concentrated (15-20 0 C, low vacuum) to about 20 L to remove any excess ammonia.
• the aminonitrile was obtained in 91 % assay yield (11.1 kg) by NMR as a solution in MTBE.
• Step 2 Addition of Benzyloxycarbonyl (CBz) Protective Group
• thermocouple and nitrogen inlet was charged a 59 wt.% solution of cyanoamine b in MTBE (4.44 assay kg). The solution was further diluted with MTBE (62.5 L) to bring the concentration to approximately 15 mL/g.
• Benzylchloroformate (1.20 equiv, 10.42 kg, 61.10 mol) was then charged in over 15 minutes via the addition funnel at such a rate as to maintain the batch temperature below 35 0 C.
• DIEA 1.3 equiv, 8.88 kg, 68.70 mol
• the reaction mixture was aged for 16 hours at 20-25 0 C, after which DI water (20 L, 4.5 mL/g) was charged into the batch.
• the batch was then transferred to a 100-L extractor and the phases were separated.
• the organic layer was then washed with 3 x 10 L of water and then 15 L of brine.
• the organic layer was transferred via a 10 ⁇ m inline filter to a 100 L round bottom flask and subsequently solvent switched to 90: 10 heptane:MTBE. Crystallization occured during the solvent switch and the resulting white crystalline product was filtered and washed with 3 x 5 L of 90: 10 heptane:MTBE.
• a total of 10.1 kg of product (88% yield) was obtained in greater than 99 HPLC A%.
• a total of 26.7 kg of product was obtained in 3 batches with an average isolated yield of 86%.
• the temperature was then increased in 10 0 C increments over 3.5 hours to 125°C and held at this temperature for 2 hours. The temperature was then finally increased to 135 0 C for 5 hours.
• the reaction mixture was then cooled to 60 0 C and MeOH (2.5 L) was added. After 30 minutes MTBE (9 L) was added slowly to build a seed bed. The batch was then cooled to 0 0 C for 14 hours, and then further cooled to -5°C and aged 1 hour before filtration.
• the solids were displacement washed with 10% MeOH/MTBE (6 L then 4 L; pre-chilled to 0 0 C) and dried on the filter pot under a nitrogen sweep to afford 2.17 kg (51.7 % corrected yield; 99.5 wt %).
• a stainless steel hydrogenation vessel was preconditioned with MeOH, Pd/C catalyst and MSA under the reaction conditions described below.
• Cbz-amide g (IOg) was then slurried in MeOH (80 mL) in the preconditioned vessel.
• MSA (1.45 mL) was added to the slurry in one portion at room temperature.
• 5% Pd/C (0.15g, 50% wet) was also added to the hydrogenation vessel.
• Hydrogen was charged to the vessel in three successive vacuum/hydrogen purge cycles, after which the mixture was hydrogenated at 40 psig for 3-4 hour at 50 0 C. Following hydrogenation, water (8 mL) was added to the reaction mixture, the mixture was stirred, and the catalyst was filtered and washed with 4:1 MeOH:water (20 mL).
• Ethyl oxalylchloride (4.01 kg) was slowly added to a mixture of 5-methyltetrazole (2.50 kg), triethylamine (3.03 kg) in toluene (32 L) at O 0 C at such a rate that the temperature stays below 5 0 C.
• the resulting slurry was stirred for 1 hour at 0-5 0 C then the triethylamine/HCl salt was filtered off. The solid was washed with 27 L of cold toluene (5 0 C).
• the combined filtrates were kept at 0 0 C and were slowly added to a hot solution of toluene (5O 0 C, 15L) over 40-50 minutes (N 2 gas evolution), then the solution was aged at 60-65 0 C for 1 hour. After cooling at 2O 0 C, the toluene solution was washed with 5 L of 10% brine, then solvent switched to ethanol (reduced to 8 L, then 17 L of EtOH was added, then concentrated down to 8 L, then 33 liters of EtOH were added to adjust final volume of 41 L). The ethanol solution was cooled to 1O 0 C and KOH aq.
• Step 9 Formation of a crystalline potassium salt of Compound A
• Acetonitrile (50 mL) and anhydrous Compound A (5.8 g, 97.4 wt.%) were charged at room temperature to a jacketed 125 mL round bottom flask equipped with a mechanical stirrer and equipped with a nitrogen inlet (i.e., the crystallization was conducted under nitrogen).
• the resulting slurry was agitated at 45 0 C until the solids were completely in solution.
• Form 1 crystalline Compound A K salt was then charged to the solution as seed (0.184 g, 3 wt% to theoretical K salt).
• Aqueous KOH 30% w/v solution (0.98 eq., 2.33 mL, 0.0125 moles) was then added with the following charge profile while maintaining batch at 45°C:
• the resulting slurry was cooled to 2O 0 C and aged at 2O 0 C until the concentration of Compound A in the mother liquor was measured to be less than 4 g/L.
• the batch was filtered, the cake washed with ACN (3 x 12 mL), and then dried under vacuum at 45°C, with a small nitrogen sweep, until the amount of ACN and water present as determined by thermogravimetric analysis was less than 1 wt.%.
• the K salt of Compound A was obtained in >99 A% by HPLC analysis.
• the resulting suspension was agitated for 0.5 hour resulting in the dissolution of a majority of the solids, after which the batch was filtered through a 1 ⁇ m filter directly into a 5 L round bottom flask equipped with mechanical stirrer, addition funnel, nitrogen inlet, and thermocouple.
• the 1 L flask was rinsed with 1 : 1 (v/v) water/EtOH ( 48 mL) and the rinse was filtered into the 5 L crystallization vessel.
• the filtered solution was seeded with crystalline Form 1 Compound A K salt ( 200 mg) at room temperature and then aged for 1 hour to build a good seed bed, after which the suspension was diluted with EtOH ( 1.57 L) at 20 0 C over 1.5 hour The batch was then cooled to about 4 °C and aged until the concentration of Compound A in the mother liquor was measured to be 4.7 g/L.
• the batch was filtered, the crystallization vessel rinsed with 50 mL EtOH into the filter,the cake washed with EtOH (4 x 100 mL), and then dried under vacuum and a nitrogen tent until the amount of EtOH present by NMR was about 0.4 mol% relative to the potassium salt.
• the potassium salt of Compound A was obtained in 88% yield ( 91.5 g assay by HPLC, 99 area % by HPLC analysis).
• a K salt prepared in the manner described in Part A was also analyzed by a TA Instruments DSC 2910 differential scanning calorimeter at a heating rate of 10°C/min from room temperature to 350 0 C in a crimped pinhole aluminum pan in a nitrogen atmosphere.
• the DSC curve (shown in Figure 2) exhibited a single, sharp endotherm with a peak temperature of about 279°C and an associated heat of fusion of about 230.0 J/gm. The endotherm is believed to be due to-melting.
• thermogravimetric analysis was performed with a Perkin-Elmer Model TGA 7 under nitrogen at a heating rate of 10°C/min from room temperature to about 350 0 C.
• the TG curve showed a 0.3% weight loss during heating to 250 0 C.
• Hygroscopicity data was obtained on a VTI Symmetrical Vapor Sorption Analyzer Model SGA-I. Data was collected at room temperature from 5-95% relative humidity and back, 5% relative humidity change per step. Equilibrium conditions were 0.01 weight percent change in 5 minutes with a maximum equilibration time of 180 minutes. The data indicated that the material had a 1.8% weight increase when equilibrated at 95% RH at 25 0 C. When equilibrated back down to 5% RH, the material returned back to approximately its dry weight. An XRPD analysis of the material after the hygroscopicity experiment showed that the material had not changed phases.
• K salt prepared as described in Part A was also assayed by HCl titration using a Brinkmann Metrohm 716 DMS Titrino. The assay results indicated the salt was a monopotassium salt.
• HPMC 2910 (6 centipoise) 20.0 5.0 magnesium stearate (intragranular) 2.0 0.5 magnesium stearate (extragranular) 2.0 0.5
• Compressed tablets containing 100 mg of Compound A on a free phenol basis were prepared by blending all of the ingredients listed above, except for the extragranular magnesium stearate, in a blender (Turbula® Type T2F shaker-mixter, Basel, Switzerland) for 10 minutes. Portions of the blended material weighing approximately 1 gram were compressed into compacts (or slugs) in a benchtop press (Auto Carver Model Auto "C", Catalog No. 3888, Carver, Inc., Wabash, Indiana) using 1 x 0.5 inch rectangular tooling to 12 MPa (4 KN). The slugs were then sized into granules by passing them through a sieve with 1 mm openings.
• the granules were blended with the extragranular magnesium stearate in the Turbula blender for 5 minutes, and the lubricated granules were compressed into tablets using the Auto Carver press with 13/32-inch standard concave round tooling. Tablets employed in the pharmacokinetic studies described below (see Example 5) were prepared by compressing with a force to 15 KN, and tablets for the in vitro dissolution study (see Example 4) were prepared by compressing to forces in a range from 5 to 15 KN.
• Tablets of the same size but containing 10 wt.% and 15 wt.% HPMC were prepared in the manner described in the preceding paragraph for the in vitro dissolution study, wherein the amounts of lactose and microcrystalline cellulose were reduced to 14.6 and 12.8 wt.% and 43.9 and 38.4 wt.% respectively to accommodate the additional HPMC.
• tablets of the same size but containing no HPMC i.e., "reference" tablets
• HPMC 2910 (6 centipoise) 20.0 5.0 magnesium stearate (intragranular) 4.0 1.0 magnesium stearate (extragranular) 8.0 2.0
• Compressed tablets having the composition set forth in the above table were prepared using a procedure similar to that set forth in Part A.
• Tablets containing HPMC showed prolonged drug supersaturation relative to the reference tablets containing no HPMC, wherein drug concentrations for the HPMC-containing tablets at dissolution times of 120 and 180 minutes were at least 2-fold greater than achieved for the reference tablets.
• Tablets with 10 wt.% and 15 wt.% HPMC exhibited slower disintegration in the dissolution vessel and slower drug release than the tablets containing 5 wt.% HPMC, but nonetheless achieved prolonged supersaturation as well.
• PK values for Compound A were determined in Beagle dogs orally dosed with compressed tablets prepared in the manner described in Part A of Example 3 and containing 100 mg of Compound A K salt (free phenol basis) and 5 wt.% HPMC.
• Male, purpose-bred beagle dogs (Marshall Farms) were used in all the studies.
• the dogs were housed in an AAALAC-accredited facility in accordance with USDA guidelines.
• Studies were conducted under a protocol approved by the WP- IACUC. Dog weights were measured and recorded prior to dosing. Dog weights ranged from approximately 8 to 10 kg. Dogs having similar weights were employed in each of the studies. Three or four dogs were employed in each study.
• the dose was approximately 10 mg per kg of body weight (i.e., lO mpk).
• Plasma samples were extracted using solid phase extraction. Plasma extracts were injected onto a Waters Xterra MS C 18, 2x50 mm, 5 ⁇ m HPLC column and analyzed using a 4.61 -minute gradient consisting of 0.1% formic acid in water and 0.1% formic acid in acetonitrile. The sample extracts were ionized using a TurboIonSpray interface and were monitored by selected reaction monitoring (SRM) in the positive ionization mode. The dynamic range of the LC/MS/MS assay was 5-8000 ng/mL based on a 50 ⁇ L aliquot of dog plasma .
• SRM reaction monitoring
• PK Calculations Area under the curve for a plot of plasma concentration v. time to last sampling (AUC ⁇ -24 hrs) > observed maximum plasma concentration (C ma ⁇ ), and time of C ma ⁇ (T max ) were calculated using a linear trapezoidal, non-compartmental model of WinNonLin v3.1. Means and SD were calculated using Excel® 97 SR-2(f). Plasma profiles were generated using SigmaPlot v. 8.0 for Windows.
• HPMC 2910 (6 centipoise) 40.0 5.0 magnesium stearate (intragranular) 6.0 0.75 magnesium stearate (extragranular) 14.0 1.75
• Compressed tablets containing 400 mg of Compound A on a free phenol basis were prepared by blending all of the ingredients listed above, except for the extragranular microcrystalline cellulose, magnesium stearate and Opadry White, in a blender (Patterson-Kelly V blender; hereinafter the "V-blender") for 10 minutes, followed by lubrication for 5 minutes with intragranular magnesium stearate in the same blender.
• V-blender Powderson-Kelly V blender
• the blend was then roller compacted into ribbons in an Alexanderwerk WP 120 roller compactor using a 25 mm knurled roll at 60 bar roll pressure.
• the ribbons were subsequently milled into granules using the rotary fine granulator (an integral part of the WP 120 roller compactor) equipped with 2.0 mm and 0.8 mm size screens.
• the granules were then blended with extragranular microcrystalline cellulose in the V-blender for 10 minutes, followed by 5 minutes lubrication with the extragranular magnesium stearate in the same blender.
• the lubricated granules were then compressed on a rotary tablet press (Korsch) to 800 mg image tablets using 2 x 16/32" standard round concave tooling.
• the core tablets were then coated with Opadry White in a Vector film coater (1.3 L pan) to afford film-coated tablets with approximately a 4% weight gain with respect to the core tablet.

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