WO2006127289A1 - Traitement de l'hepatite c (hcv) au moyen de doses sous-therapeutiques de ribavirine - Google Patents

Traitement de l'hepatite c (hcv) au moyen de doses sous-therapeutiques de ribavirine Download PDF

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Publication number
WO2006127289A1
WO2006127289A1 PCT/US2006/018228 US2006018228W WO2006127289A1 WO 2006127289 A1 WO2006127289 A1 WO 2006127289A1 US 2006018228 W US2006018228 W US 2006018228W WO 2006127289 A1 WO2006127289 A1 WO 2006127289A1
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WO
WIPO (PCT)
Prior art keywords
ribavirin
amount
antiviral agent
less
administered
Prior art date
Application number
PCT/US2006/018228
Other languages
English (en)
Inventor
Zhi Hong
Original Assignee
Valeant Research & Development
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 Valeant Research & Development filed Critical Valeant Research & Development
Priority to EP06759554A priority Critical patent/EP1881828A4/fr
Publication of WO2006127289A1 publication Critical patent/WO2006127289A1/fr

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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
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/4196—1,2,4-Triazoles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/17—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • A61K38/19—Cytokines; Lymphokines; Interferons
    • A61K38/21—Interferons [IFN]
    • A61K38/212—IFN-alpha
    • 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

Definitions

  • the present invention relates to the field of antiviral therapy with nucleic acid analogues, more specifically it relates to combination drug therapies for the treatment of hepatitis C.
  • Ribavirin has been used for many years as a first-line therapy for the treatment of hepatitis C.
  • the combination of ribavirin with interferon alpha, and more recently in combination with PEG-interferon alpha have been the standard of care for treatment of hepatitis C infections. M. Fried et al, N. E. J. Med. 347:975-982 (2003).
  • ribavirin is directly toxic to red blood cells, and interferon causes bone marrow suppression, so that the maximum dose of ribavirin is typically limited by anemia, and the dose of interferon is limited by thrombocytopenia and neutropenia.
  • these hematologic side effects of ribavirin- interferon therapy have been managed through dose reduction or even cessation of treatment.
  • Ribavirin has been shown to exhibit synergy with drugs other than interferon alpha, including didanosine (M. Klein et al, AIDS, 17:1001-1008 (2003)); quercetin (W. Li et al, Oncol. Res. 11:243-247 (1999)); pokeweed antiviral protein (E. Weaver and G. Aron, Can. J. Microbiol./Rev. Can. Microbiol. 44:702-705 (1998)); neuraminidase inhibitors (D. Smee et al, Chemotherapy 48:88-93 (2002)); docosanol (J. Marcelletti, Antiviral Res.
  • didanosine M. Klein et al, AIDS, 17:1001-1008 (2003)
  • quercetin W. Li et al, Oncol. Res. 11:243-247 (1999)
  • pokeweed antiviral protein E. Weaver and G. Aron, Can. J. Microbiol./Rev
  • the ribavirin and the additional antiviral agent or agents may be administered at one time, for convenience, or they may be administered separately on separate dosing schedules, to accommodate differing absorption, distribution, metabolism, and excretion kinetics.
  • the amount of ribavirin administered according to the methods of the invention is less than 800 mg per day for a human patient. In certain embodiments, the amount of ribavirin administered is less than 600 mg per day, and in other embodiments it is less than 400. In certain embodiments the amount of ribavirin administered may be less than 200 mg per day.
  • compositions comprising ribavirin as a first antiviral agent, and at least one additional antiviral agent selected from the group consisting of NS3/4A protease inhibitors, RNA-dependent RNA polymerase (NS5B) inhibitors, and IMPDH inhibitors, are provided.
  • the amount of ribavirin is an amount ineffective for treating HCV infection when administered alone, and the combination is more effective for treating an HCV infection than the additional antiviral agent when administered alone at the same dose.
  • the amount of the additional antiviral agent is an amount ineffective for treating HCV infection when administered alone.
  • the amount of ribavirin in the compositions of the invention will be such that a daily dose will total less than 800 mg, less than 600, less than 400, or less than 200 mg, as desired by the practitioner.
  • the daily dose may be contained in a single unit dose intended for once-daily administration, or it may be divided into two or more unit doses for administration at intervals over the course of a day.
  • Suitable NS3/4A protease inhibitors include, but are not limited to, compounds 1 and 2
  • R 1 is an aryl or 5- or 6-membered heteroaryl ring optionally substituted with lower alkyl, amino, or lower acylamino
  • R 2 is H or lower alkyl
  • R 3 is lower alkyl
  • X is OH, NH 2 , NHCOR 4 , or NHSO 2 R 4 , where R 4 is aryl or lower alkyl.
  • lower alkyl encompasses linear, branched, and cyclic C 1 to C 6 hydrocarbon radicals
  • the term “lower acyl” encompasses (lower alkyl)carbonyl radicals.
  • Other suitable compounds are 3 and 4
  • X is N or CH
  • Y is CH 2 or SO 2
  • R 1 is halogen or lower acyl
  • R 2 is H or lower alkyl
  • R 3 is phenyl or naphthyl optionally substituted with lower alkoxy or lower alkoxycarbonyl
  • R 4 is lower alkyl or allyl
  • L is -CH 2 -CH 2 -CH 2 - or -NH-CO-NH-;
  • R 1 is cyclohexyl, cyclopentyl, or isopropyl
  • R 2 is t-butyl or isopropyl
  • R 3 is methyl, ethyl, or propyl
  • R is benzyl or 1-phenylethyl
  • L is CH 2 or CO
  • R 5 is phenyl, 2-naphthyl, or l,2,3,4-tetrahydroisoquinolin-2-yl; and compounds 7 and 8
  • R 1 and R 2 are independently lower alkyl, and X is O or NH.
  • RNA-dependent RNA polymerase inhibitors include, but are not limited to, compounds of structures 9 and 10
  • Ar is a 5- or 6-membered heterocyclic group such as a furan, thiophene, or pyrazine ring;
  • Ar' is indoly-3-yl or phenyl, optionally substituted with hydroxyl, carboxyl, or carboxymethoxy groups; and
  • R 1 and R 2 are independently H, CH 3 , or CO 2 H; any of structures 13 - 15
  • R and R' are independently propyl, isopropyl, butyl, or isobutyl; and compounds 20, 21 and 22
  • Ar and Ar' are independently phenyl substituted with one or more halogen, nitrile, thiazol-2-yl, or lower alkyl groups
  • X represents one or more halogen or lower alkyl groups
  • R 1 is optionally substituted alkyl, aryl, or heteroaryl
  • R 2 is optionally substituted cyclopentyl
  • n 0-6.
  • Solid pharmaceutical compositions according to the invention may be prepared by methods of compounding and tablet and capsule formation well-known in the pharmaceutical arts.
  • a typical unit dose composition will comprise ribavirin, in an amount less than 800 mg, and optionally less than 600 mg, or less than 400 mg, or less than 200 mg.
  • the composition will also comprise a second antiviral agent, in a therapeutically effective amount, or in certain embodiments, in a sub-therapeutic amount.
  • composition may also include pharmaceutically acceptable carriers, including but not limited to solvents, diluents, or other liquid vehicles, dispersion or suspension aids, surface active agents, isotonic agents, thickening or emulsifying agents, preservatives, solid binders, lubricants and the like, as suited to the particular dosage form desired.
  • pharmaceutically acceptable carriers including but not limited to solvents, diluents, or other liquid vehicles, dispersion or suspension aids, surface active agents, isotonic agents, thickening or emulsifying agents, preservatives, solid binders, lubricants and the like, as suited to the particular dosage form desired.
  • Remington's Pharmaceutical Sciences, 15th Edition, E. W. Martin (Mack Publishing Co., Easton, Pa., 1975) discloses various carriers used in formulating pharmaceutical compositions, and known techniques for their compounding and use. Insofar as any conventional carrier medium is compatible with the antiviral compounds of the invention, its use is contemplated to be within
  • Materials which can serve as pharmaceutically acceptable disintegrants and carriers include, but are not limited to, sugars such as lactose, glucose and sucrose; starches such as corn starch and potato starch; cellulose and its derivatives such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate, powdered tragacanth, malt, gelatin, silica, and talc.
  • Suitable excipients include but are not limited to cocoa butter and suppository waxes; oils such as peanut oil, cottonseed oil; safflower oil; sesame oil; olive oil; corn oil and soybean oil; glycols; such a propylene glycol; esters such as ethyl oleate and ethyl laurate; and agar.
  • Buffering agents include materials such as magnesium hydroxide, aluminum hydroxide, monobasic and dibasic phosphate salts, and alginic acid.
  • Other additives include but are not limited to compatible lubricants such as sodium lauryl sulfate and magnesium stearate, coloring agents, releasing agents, coating agents, and sweetening, flavoring and perfuming agents. Preservatives and antioxidants can also be present in the composition, at the discretion of the practitioner.
  • Liquid pharmaceutical compositions according to the invention may be prepared for oral or parenteral administration.
  • Suitable carriers for parenteral administration include pyrogen-free water, isotonic saline, Ringer's solution, and phosphate buffer solutions. Solutions and suspensions may be lyophilized for storage and shipment, and reconstituted with saline for injection just prior to administration.
  • Liquid compositions suitable for oral administration may be prepared with any of the carriers listed above, and in addition may comprise oils, emulsifiers, and non-aqueous solvents such as ethyl alcohol.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Virology (AREA)
  • Epidemiology (AREA)
  • Communicable Diseases (AREA)
  • Zoology (AREA)
  • Oncology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Molecular Biology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Immunology (AREA)
  • Proteomics, Peptides & Aminoacids (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Abstract

L'invention concerne des combinaisons de ribavirine avec d'autres médicaments antiviraux dans lesquelles une dose sous-thérapeutique normale de ribavirine est rendue efficace par interaction synergique avec un ou plusieurs agents(s) antiviral/antiviraux. L'invention concerne également des combinaisons de ribavirine avec d'autres médicaments antiviraux dans lesquelles une dose sous-thérapeutique normale de l'autre médicament est rendue efficace par interaction synergique avec la ribavirine.
PCT/US2006/018228 2005-05-20 2006-05-09 Traitement de l'hepatite c (hcv) au moyen de doses sous-therapeutiques de ribavirine WO2006127289A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP06759554A EP1881828A4 (fr) 2005-05-20 2006-05-09 Traitement de l'hepatite c (hcv) au moyen de doses sous-therapeutiques de ribavirine

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US68341605P 2005-05-20 2005-05-20
US60/683,416 2005-05-20

Publications (1)

Publication Number Publication Date
WO2006127289A1 true WO2006127289A1 (fr) 2006-11-30

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PCT/US2006/018228 WO2006127289A1 (fr) 2005-05-20 2006-05-09 Traitement de l'hepatite c (hcv) au moyen de doses sous-therapeutiques de ribavirine

Country Status (2)

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EP (1) EP1881828A4 (fr)
WO (1) WO2006127289A1 (fr)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8466159B2 (en) 2011-10-21 2013-06-18 Abbvie Inc. Methods for treating HCV
US8492386B2 (en) 2011-10-21 2013-07-23 Abbvie Inc. Methods for treating HCV
WO2013116592A1 (fr) * 2012-02-01 2013-08-08 Kadmon Pharmaceuticals, Llc Traitement une fois par jour de l'hépatite c avec de la ribavirine et de la taribavirine
US8809265B2 (en) 2011-10-21 2014-08-19 Abbvie Inc. Methods for treating HCV
US8853176B2 (en) 2011-10-21 2014-10-07 Abbvie Inc. Methods for treating HCV
US11192914B2 (en) 2016-04-28 2021-12-07 Emory University Alkyne containing nucleotide and nucleoside therapeutic compositions and uses related thereto

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6878727B2 (en) * 2002-04-01 2005-04-12 Agouron Pharmaceuticals, Inc. Inhibitors of hepatitis C virus RNA-dependent RNA polymerase, and compositions and treatments using the same

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
PL194025B1 (pl) * 1996-10-18 2007-04-30 Vertex Pharma Inhibitory proteaz serynowych, a zwłaszcza proteazy wirusa NS3 zapalenia wątroby C, kompozycja farmaceutyczna i zastosowanie inhibitorów proteaz serynowych
WO2000024725A1 (fr) * 1998-10-26 2000-05-04 Vertex Pharmaceuticals Incorporated Composes pentacycliques utiles en tant qu'inhibiteurs de l'helicase de ns3 du virus de l'hepatite c
AU2003249659A1 (en) * 2002-05-31 2003-12-19 Schering Corporation Combination therapy for rna virus infections involving ribavirin and impdh inhibitors
UY29017A1 (es) * 2004-07-16 2006-02-24 Boehringer Ingelheim Int Inhibidores de polimerasa viral
SG155967A1 (en) * 2004-10-01 2009-10-29 Vertex Pharma Hcv ns3-ns4a protease inhibition

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6878727B2 (en) * 2002-04-01 2005-04-12 Agouron Pharmaceuticals, Inc. Inhibitors of hepatitis C virus RNA-dependent RNA polymerase, and compositions and treatments using the same

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
REICHARD O.: "Randomise, double-blind, placebo-controlled trial of Interferon alpha-2b with and without ribavirin for chronic hepatitis C", THE LANCET, vol. 351, January 1998 (1998-01-01), pages 83 - 87, XP004265243 *
See also references of EP1881828A4 *

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8466159B2 (en) 2011-10-21 2013-06-18 Abbvie Inc. Methods for treating HCV
US8492386B2 (en) 2011-10-21 2013-07-23 Abbvie Inc. Methods for treating HCV
US8680106B2 (en) 2011-10-21 2014-03-25 AbbVic Inc. Methods for treating HCV
US8685984B2 (en) 2011-10-21 2014-04-01 Abbvie Inc. Methods for treating HCV
US8809265B2 (en) 2011-10-21 2014-08-19 Abbvie Inc. Methods for treating HCV
US8853176B2 (en) 2011-10-21 2014-10-07 Abbvie Inc. Methods for treating HCV
US8969357B2 (en) 2011-10-21 2015-03-03 Abbvie Inc. Methods for treating HCV
US8993578B2 (en) 2011-10-21 2015-03-31 Abbvie Inc. Methods for treating HCV
US9452194B2 (en) 2011-10-21 2016-09-27 Abbvie Inc. Methods for treating HCV
WO2013116592A1 (fr) * 2012-02-01 2013-08-08 Kadmon Pharmaceuticals, Llc Traitement une fois par jour de l'hépatite c avec de la ribavirine et de la taribavirine
US11192914B2 (en) 2016-04-28 2021-12-07 Emory University Alkyne containing nucleotide and nucleoside therapeutic compositions and uses related thereto

Also Published As

Publication number Publication date
EP1881828A4 (fr) 2009-06-03
EP1881828A1 (fr) 2008-01-30

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