Classifications

• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08G—MACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
  • C08G73/00—Macromolecular compounds obtained by reactions forming a linkage containing nitrogen with or without oxygen or carbon in the main chain of the macromolecule, not provided for in groups C08G12/00 - C08G71/00
  • C08G73/02—Polyamines
  • C08G73/0206—Polyalkylene(poly)amines
• • 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
  • A61K31/74—Synthetic polymeric materials
  • A61K31/785—Polymers containing nitrogen
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/12—Drugs for disorders of the urinary system of the kidneys
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/12—Drugs for disorders of the metabolism for electrolyte homeostasis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/12—Drugs for disorders of the metabolism for electrolyte homeostasis
  • A61P3/14—Drugs for disorders of the metabolism for electrolyte homeostasis for calcium homeostasis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P39/00—General protective or antinoxious agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P5/00—Drugs for disorders of the endocrine system
  • A61P5/14—Drugs for disorders of the endocrine system of the thyroid hormones, e.g. T3, T4
  • A61P5/16—Drugs for disorders of the endocrine system of the thyroid hormones, e.g. T3, T4 for decreasing, blocking or antagonising the activity of the thyroid hormones
• • C—CHEMISTRY; METALLURGY
  • C08—ORGANIC MACROMOLECULAR COMPOUNDS; THEIR PREPARATION OR CHEMICAL WORKING-UP; COMPOSITIONS BASED THEREON
  • C08G—MACROMOLECULAR COMPOUNDS OBTAINED OTHERWISE THAN BY REACTIONS ONLY INVOLVING UNSATURATED CARBON-TO-CARBON BONDS
  • C08G73/00—Macromolecular compounds obtained by reactions forming a linkage containing nitrogen with or without oxygen or carbon in the main chain of the macromolecule, not provided for in groups C08G12/00 - C08G71/00
  • C08G73/02—Polyamines

Definitions

• Hyperphosphatemia frequently accompanies diseases associated with inadequate renal function, hypoparathyroidism, and certain other medical conditions. Hyperphosphatemia is typically defined as possessing a serum phosphate level of over about 6 mg/dL. The condition, especially if present over extended periods of time, leads to severe abnormalities in calcium and phosphorus metabolism and can be manifested by aberrant calcification in joints, lungs, and eyes.
• Therapeutic efforts to reduce serum phosphate include dialysis, reduction in dietary phosphate, and oral administration of insoluble phosphate binders to reduce gastrointestinal absorption. Dialysis and reduced dietary phosphate are generally unsuccessful in adequately reversing hyperphosphatemia. Further difficulties in these therapeutic regimens include the invasive nature of dialysis and the difficulties in modifying dietary habits in the latter therapy.
• Phosphate binders include calcium or aluminum salts. Calcium salts have been widely used to bind intestinal phosphate and prevent absorption. The ingested calcium combines with phosphate to form insoluble calcium phosphate salts such as Ca3(PO4)2 > CaHPO ⁇ or Ca(H2PO4)2- Different types of calcium salts, including calcium carbonate, acetate (such as PhosLo® calcium acetate tablets), citrate, ? -
• alginate, and ketoacid salts have been utilized for phosphate binding.
• This class of therapeutics generally results in hypercalcemia due to absorption of high amounts of ingested calcium. Hypercalcemia has been indicated in many serious side effects. such as cardiac arrhythmias, renal failure, and skin and visceral calcification. Frequent monitoring of serum calcium levels is required during therapy with Calcium-based phosphate binders.
• Aluminum-based phosphate binders such as Amphojel® aluminum hydroxide gel, have also been used for treating hyperphosphatemia. These compounds complex with intestinal phosphate to form highly insoluble aluminum phosphate: the bound phosphate is unavailable for absorption by the patient. Prolonged use of aluminum gels leads to accumulations of aluminum, and often to aluminum toxicity, accompanied by such symptoms as encephalopathy, -osteomalacia, and myopathy. Selected ion exchange resins have also been suggested for use in binding phosphate. Those tested include Dowex ® anion-exchangc resins in the chloride form, such as XF 4331 1 " , XY 40013, XF 43254, XY 4001 1, and XY 40012. These resins have several drawbacks for treatment of hyperphosphatemia, including poor binding efficiency, necessitating use of high dosages for significant reduction of absorbed phosphate.
• Sevelamer hydrochloride As disclosed in U.S. Patent No. 5.667,775, have shown effectiveness as a phosphate sequestrant capable of lowering elevated serum phosphate levels.
• Sevelamer hydrochloride includes a polymer having pendent groups therefrom, the pendent groups having a single amino group.
• novel polymers that bind anions, typically phosphate, and can therefore be used to remove target anions from a subject in need of such treatment.
• One embodiment of the invention is a polymer or physiologically acceptable salt thereof which comprises a polymerized multifunctional amine monomer (hereinafter "amine monomer").
• amine monomer comprises at least two amine groups and at least two acyclic nitrogen atoms that are connected through a -CH 2 CH 2 - group, provided that the amine monomer is not ethylenediamine or ethylenetriamine.
• the amine monomer is represented by Structural Formula (I):
• (Cy) is a C 4 -Ci O saturated or unsaturated carbocychc ring that is optionally substituted; z is 2, 3 or 4.
• Each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Rj bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• the nitrogen atom designated with "*" is optionally quarternized with Ri a : and each na, independently, is 0 or is an integer from 1 to 10 and each n c is an integer from 2 to 10.
• the amine repeat unit comprises at least two amine groups and at least two acyclic nitrogen atoms that are connected through a -CH 2 CHo- group, provided that the repeat unit is not -NHCH 2 CH 2 NH-, -NHCH 2 CH 2 NHCH 2 CH 2 NH-, -NHCH2CH 2 (N-)CH 2 CH 2 NH-, or -NHCH 2 CH 2 (N-)CH 2 CH 2 NH 2 .
• the amine repeat unit is represented by Structural Formula (II):
• the polymer is crosslinked with multifunctional crosslinking groups.
• (Cy) is a C4-C10 saturated or unsaturated carbocyclic ring that is optionally substituted.
• z is 2, 3 or 4.
• Each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• Two or more of the groups represented by X are each a covalent bond to another atom in the polymer and the remainder of the groups represented by X are
• na is 0 or an integer from 1 to 10 and n e is an integer from 2 to 10.
• Another embodiment of the present invention is a method for removing a target anion from a subject.
• the method comprises administering an effective amount of a polymer disclosed herein or physiologically acceptable salt thereof to the subject.
• Another embodiment of the invention is directed to a pharmaceutical composition comprising a pharmaceutically acceptable carrier or diluent; and a polymer disclosed herein or a pharmaceutically acceptable salt thereof.
• the pharmaceutical composition is used for medicinal therapy.
• Another embodiment of the invention is the use of a disclosed polymer or a physiologically acceptable salt thereof for the manufacture of a medicament for removing a target anion from a subject.
• Yet another embodiment of the invention is a method for controlling serum phosphate in a patient suffering from hyperphosphatemia comprising administering to the patient a pharmaceutical composition comprising a polymer disclosed herein or a physiologically acceptable salt thereof and a pharmaceutically acceptable carrier or diluent.
• the invention is directed to a polymer or physiologically acceptable salt thereof which comprises a polymerized amine monomer.
• the amine monomer comprises at least two amine groups and at least two acyclic nitrogen atoms that are connected through a -CH 2 CH?- group, provided that the amine monomer is not ethylenediamine or ethylenetriamine.
• the amine monomer comprises at least three nitrogen atoms and more typically at least four nitrogen atoms.
• the amine monomer is represented by Structural Formula (III).
• Each R independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an R] bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• each R independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group.
• each Rj independently, is H or an alkyl group optionally substituted with -OH, alkoxy, halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH, aikoxy, halogen, haloalkyl or haloalkoxy.
• Each Ru is independently Ri or .
• each R ) a is
• R 2 is Ri a or a group represented by the following structural formula:
• each R 2 is Ri 8 .
• each R 2 independently, is H or an alkyl group optionally substituted with -OH, alkoxy, halogen or a phenyl group optionally substituted with —OH, alkoxy, halogen, haloalkyl, haloalkoxy.
• Each nitrogen atom designated with "*" is optionally quarternized with,Ri a .
• q is 0 or an integer from 1 to 10; r and s are 0, 1, or 2 with the proviso that the sum of r, s and q is greater than 1.
• n is an integer from 2 to 10 with the proviso that at least one n is 2.
• n is 2.
• the amine monomer is represented by a structural formula selected from Structural Formulas (IV)-(VI):
• am ine m onom er is represented by Structural Form ula (VII)-
• each R independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group.
• each Ri independently, is H or an alkyl group optionally substituted with —OH, alkoxy, halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with -OH, alkoxy, halogen, haloalkyl or haloalkoxy.
• each R i a is Ri.
• Each r b independently, is 0, 1 , or 2.
• n is an integer from 2 to 10 with the proviso that at least one n is 2.
• n is 2.
• the amine monomer is represented by
• Each R is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic. aromatic, or heterocyclic group.
• . independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each R]. independently, is H or an alkyl group optionally substituted with —OH.
• alkoxy, halogen, or a phenyl or pyridyl group wherein the phenyl and pyridyl groups are optionally substituted with —OH, alkoxy, halogen, haloalkyl or haloalkoxy.
• Each Ri a is independently Rj or R 1
• each R i 2 is
• Ri - p is 1 , 2, 3, or 4: each H 3 , independently, is 0, 1, or 2 with the proviso that r h is 1 or 2 if p is equal to 1.
• Each m, independently, is 0 or an integer from 1 to 10; and each n. independently, is an integer from 2 to 10 with the proviso that at least one n is 2.
• n is 2.
• the amine monomer is represented by Structural Formula (X):
• Structural Form ula (X) The variables in Structural Form ula (X) are as described for Structural Form ula (IX ).
• Each R]. independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• each R]. independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group.
• each R] is H or an alkyl group optionally substituted with -OH, alkoxy, halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH, alkoxy, halogen, haloalkyl or haloalkoxy.
• Each Ri a is independently R) or 31
• Each R 3 is H, Ri or an optionally substituted alkyl group or an optionally substituted aryl group.
• each R 3 independently, is H or an alkyl group optionally substituted with -OH. alkoxy.. or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH. alkoxy, halogen, haloalkyl or haloalkoxy.
• Each t independently, is 0, 1, 2, or 3.
• n is an integer from 2 to 10.
• n is " 2.
• n c - independently, is 0 or an integer from 1 to 10.
• the amine monomer is represented by Structural Formula (XII):
• Suitable amine monomers include tris(2- aminoethyl)amine, iriethyleneletramine. tetraelhylenepenlamine, pentaethylenehex amine, N-boc-ethylenediamine, Iris [(m ethyl am ino)e thy IJ amine, N,N,N 1 ,N'-tetrakis(3-aminopropyl)l .2-diamino ethane.
• Another embodiment of the invention is a polymer or physiologically acceptable salt thereof comprising a polymerized am inc monomer represented by Structural Formula (1):
• (Cy) is a C4-C10 saturated or- unsaturated carbocyclic ring.
• (Cy) is a cyclohex-yl optionally substituted with Ci-C 2 alkyl, hydroxyl, halogen or C)-C 2 alkoxy or phenyl optionally substituted with —OH. alkyl, alkoxy, halogen, haloalkyl or haloalkoxy.
• z is 2, 3 or 4.
• z is 3 or 4.
• Each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an R) bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• each R). independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each Ri, independently, is H or an alkyl group optionally substituted with —OH.
• Each Ri is R),
• each Ri n is
• each n. ⁇ . independently, is 0 or an integer from 1 to 10.
• each n ⁇ , independently, is an integer from 1 to 10.
• Each n e is an integer from 2 to 10.
• the invention is also directed to a polymer or physiologically acceptable salt thereof which comprises an amine repeat unit.
• the amine repeat unit comprises at least two amine groups and at least two acyclic nitrogen atoms that are connected through a -CH 2 CH 2 - group, provided that the repeat unit is not -NHCH 2 CH 2 NH-, -NHCH 2 CH 2 NHCH 2 CH 2 NH-, -NHCH 2 CH 2 (N-)CH 2 CH 2 NH- 5 or -NHCH 2 CH 2 (N-)CH 2 CH 2 NH 2 .
• the repeat unit comprises at least three nitrogen atoms and more typically at least four nitrogen atoms.
• the amine repeat unit is represented by Structural Formula (XIII).
• Each Ri is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• each Ri. independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each R], independently, is H or an alkyl group optionally substituted with -OH, alkoxy, halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with — OH, alkoxy. halogen, haloalkyl or haloalkoxy.
• Two or more of the groups represented by X are each a covalent bond to another atom in the polymer, and the remainder of the groups represented by X are
• R 2 is X or a group represented by the following structural formula:
• each R 2 is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each R 2 , independently, is H or an alkyl group optionally substituted with -OH, alkoxy. halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH. alkoxy. halogen, haloalkyl or haloalkoxy.
• R 1 q is 0 or an integer from 1 to 10, r and s are 0, 1, or 2 with the proviso that the sum of r, s and q is greater than 1.
• n is an integer from 2 to 10 with the proviso that at least one n is 2.
• n is 2.
• the amine repeat unit is represented by a structural formula selected from Structural Formulas (XlV)-(XXVI):
• the amine repeat unit is represented by Structural Formula (XVII):
• Each Ri is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• each R 1 is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each Ri , independently, is H or an alkyl group optionally substituted with -OH.
• alkoxy, halogen, or a phenyl or pyridyl group wherein the phenyl and pyridyl groups are optionally substituted with —OH, alkoxy, halogen, haloalkyl or haloalkoxy.
• Two or more of the groups represented by X arc each a covalcnt bond to another atom in the polymer, and the remainder of the groups represented by X arc R 1 .
• Each r b independently, is 0, 1. or 2.
• n is an integer from 2 to 10 with the proviso that at least one n is 2.
• n is 2.
• the amine repeal unit is represented by Structural Formulas (XVIII):
• the amine repeat unit is represented by Structural Formula (XlX).
• Each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an R
• each Ri 3 independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each Ri, independently, is H or an alkyl group optionally substituted with —OH. alkoxy.
• halogen or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH, alkoxy, halogen, haloalkyl or haloalkoxy.
• Two or more of the groups represented by X are each a covalent bond to another atom in the polymer, and the remainder of the groups represented by X are
• Ri- . p is 1. 2, 3. or 4: each ⁇ ,, independently, is 0. 1. or 2 with the proviso lhal ⁇ , is 1 or 2 if p is equal to 1.
• Each m independently, is 0 or an integer from 1 to 10;
• n is an integer from 2 to 10 with the proviso that at least one n is 2.
• n is 2.
• the amine repeat unit is represented by Structural Formula (XX):
• am ine repeat unit is represented by Structural Form ula (XX I):
• Each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic. aromatic, or heterocyclic group.
• each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group.
• each Ri independently, is H or an alkyl group optionally substituted with —OH, alkoxy, halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH, alkoxy, halogen, haloalkyl or haloalkoxy.
• Two or more of the groups represented by X are each a covalent bond to another atom in the polymer, and the remainder of the groups represented by X are R 1 .
• Each t independently, is 0. 1, 2, or 3:
• n c is 0 or an integer from 1 to 10.
• the amine repeat unit is represented by Structural Formulas (XXII):
• the po lym er of the inventio n com prises an am ine repeat unit represented by Structural F orm ula (II)
• (Cy) is a C4-C10 saturated or unsaturated carbocyclic ring.
• (Cy) is a cyclohexyl optionally substituted with Ci-C 2 alkyl, hydroxyl. halogen or C 1 -C 2 alkoxy or phenyl optionally substituted with -OH, alkyl, alkoxy, halogen, haloalkyl or haloalkoxv.
• z is 2, 3 or 4.
• z is 3 or 4
• Each Ri independently, is H or an optionally substituted alkyl group or an optionally substituted aryl group, or forms together with an Ri bonded to an adjacent carbon or nitrogen atom and their intervening atoms an optionally substituted alicyclic, aromatic, or heterocyclic group.
• each R 1 is H or an optionally substituted alkyl group or an optionally substituted aryl group. More preferably, each Ri, independently, is H or an alkyl group optionally substituted with -OH. alkoxy, halogen, or a phenyl or pyridyl group, wherein the phenyl and pyridyl groups are optionally substituted with —OH. alkoxy. halogen, haloalkyl or haloalkoxy.
• Two or more of the groups represented by X are each a covalent bond to another atom in the polymer and the remainder of the groups represented by X groups arc Ri .
• Each na is 0 or an integer from 1 to 10.
• each n ⁇ . independently, is an integer from 1 to 1 0.
• Each n L is an integer from 2 to 10.
• a “multifunctional amine monomer'" is a compound that comprises two or more amine groups and that can be reacted alone or with other compounds such that it is incorporated as a repeat unit into a polymer.
• a “polymerized multifunctional amine monomer” is a multifunctional amine monomer that has been reacted alone or with other compounds such that it has been incorporated into a polymer as a repeat unit. It is to be understood that when referring herein to a “polymerized multifunctional amine monomer", the polymerized multifunctional amine monomer is incorporated into the polymer by any suitable method, including, but not limited to.
• amine repeat unit means a group in a polymer that repeats or appears multiple times in the polymer.
• An “amine repeat unit” is a repeat unit comprising one or more amine groups, preferably two or more amine groups.
• the disclosed polymers include homopolymers which comprise no more 5 than one type of polymerized monomer (or one type of repeat unit).
• the disclosed polymers include copolymers which comprise two different types of • polymerized monomers (or two different types of repeat units).
• One or both of the polymerized monomers are polymerized amine monomers (or one or both of the repeat units are amine repeat units).
• both of the polymerized amine 10 monomers (or both of the amine repeat units) are described herein, in yet another alternative, the disclosed polymer comprises three or more different types of polymerized monomers (or three or more different types of repeat units).
• the disclosed polymers are typically crosslinked with multifunctional crosslinking groups.
• multifunctional crosslinking group means a group 15. which connects two or more repeat units or polymerized monomers within the polymer. Multifunctional crosslinking groups in the disclosed polymers are typically covalently bonded to the nitrogen atoms in the polymerized amine monomers or amine repeat units.
• the disclosed polymer comprises only one type of crosslinking group. Alternatively, the disclosed polymer comprises two or more 20 different crosslinking groups.
• the ratio of polymerized amine monomer to polymerized crosslinker in the disclosed polymer is typically from about ] : 1 to about 1 :6.
• the ratio can be from about 1 :1 to about 1 :2, from about 1 :1 to about 1 -.3, from about 1 :1 to about 1:4, from about 1:1 to about 1 :5, from about 1:2 to about 1 :3, from about 1 :2 25 to about 1 :4 5 from about 1 :2 to about 1 :5, from about 1 :2 to about 1 :6, from about 1 :3 to about 1 :4, from about 1 :3 to about 1 :5, from about 1 :3 to about 1 :6, from about 1 :4 to about 1 :5, from about 1 :4 to about 1 :6 or from about 1 :5 to about 1 :6.
• Multifunctional crosslinking groups in the disclosed polymers are typically formed from multifunctional crosslinking agents, which comprise two or more 30 electrophilic groups capable of reacting and forming a covalent bond with a nitrogen atom.
• suitable electrophilic groups include halide, epoxide, acrylate, arylsulfonate and alkyl sulfonate.
• Reaction of a multifunctional crosslinking agent with an amine monomer disclosed herein can form a disclosed polymer.
• the portion of a multifunctional crosslinking agent remaining after it reacts with the amine ' ⁇ ' - • . 21 monomer forms a crosslinking group and is also referred to as the "residue of the crosslinking agent".
• -(CH 2 ) ⁇ - is the crosslinking group formed from the crosslinking agent 1,6-dibromohexane and is also the residue of 1.6- dibromohexane.
• suitable types crosslinking agents include dihaloalkane, haloalkyloxirane, alkyloxirane sulfonate, di(haloalkyl)arnine, tri(haloalkyl)amine. diepoxide, triepoxide, tetraepoxide, bis(halomcthyl) benzene, tri(halomcthyl) benzene) and tetra(halomethyl) benzene.
• crosslinking agents include epichlorohydrin, 0 epibromohyd ⁇ n, (iodomethyl)oxirane, glycidyl tosylate. glycidyl 3- nitrobenzenesulfonate, 4-tosyloxy-1.2-epoxybutane, bromo-l ,2-epoxybutane, 1.2- dibromoethane, l-bromo-2-chloroethane, 1,3-dibromopropane, bis(2- chloroethyl)amine, tris(2-chloroethyl)amine, and bis(2-chloroethyl)methylamine, 1,3-butadiene diepoxide, 1 ,5-hexadiene diepoxide, diglycidyl ether, 1.2,7,8- 5 diepoxyoctane, 1.2.9-10-diepoxydecane, ethylene glycol diglycidyl ether, propylene
• the disclosed polymers include those comprising polymerized tris(2- aminoethyl)aminc, tricthylcnetetramine, tetraethylenepentamine, pentaethylenehexamine, N-boc-ethylenediamine. tris[(methylamino)ethyl]ammc and N,N.N',NMetrakis(3-aminopropyl)l ,2-diaminoethane crosslinked with epichlorohydrin.
• the average number of connections from the polymerized amine monomers (or amine repeat units) to the rest of the polymer is typically above 2.05, and more commonly in the range from about 2 to about 6.
• the range can be from about 2 to about 2.5, about 2.05 to about 3, 2.05 to about 4, about 2.05 to about 5, about 2.5 to about 3, about 2.5 to about 4. about 2.5 to about 5, about 2.5 to about 6.
• Each "X" group in Structural Formulas (XIII)-(XXII) that is a covalent bond to another atom in the polymer is a "connection".
• the average number of connections in a polymer is the total number of connections per total number of polymerized amine monomer (or repeat units).
• a "connection” is typically from a polymerized amine monomer (or amine repeat unit) to a crosslinking group. For example, when an "X' ' group connects to another atom in the polymer, the connection is typically to a crosslinking group.
• the molecular weight of the disclosed polymers is not believed to be critical, provided that the molecular weight is large enough so that the polymer is not readily absorbed by the gastrointestinal tract.
• the molecular weight is at least 1000.
• the molecular weight can be from about 1000 to about 5 million, about 1000 to about 3 million, about 1000 to about 2 million or about 1000 to about 1 million.
• Crosslinked polymers are not generally characterized by molecular weight.
• Physiologically acceptable salts of the disclosed polymers are also encompassed within the invention.
• “Physiologically acceptable” means suitable for pharmaceutical use.
• the term “salt” as used with reference to any of the disclosed phosphate binding polymers refers to protonization of the polymer into the form of a ZJ sail.
• some or all of the nitrogen-bearing functional groups in the disclosed polymers may be protonated to create a positively charged nitrogen atom associated with a negatively charged counterion.
• less than about 50%, for example, less than 30%, such as less than 20% or less than 10% of the amine groups in the disclosed polymers are protonated.
• ' 35% to 45% of the amines are protonated (e.g., approximately 40%).
• Physiologically acceptable salts of the disclosed polymers are prepared from physiologically acceptable acids including inorganic acids and organic acids.
• Negatively charged counterions can be organic ions, inorganic ions, or a combination thereof.
• the inorganic ions suitable for use with embodiments of the invention include halide (especially chloride), carbonate, bicarbonate, sulfate, bisulfate, hydroxide, nitrate, persulfate and sulfite.
• Suitable organic ions include acetate, ascorbate. benzoate. citrate, dihydrogen citrate, hydrogen citrate, oxalate, succinate, tartrate, taurocholate, glycocholate, and choiate.
• Protonated polymers can optionally comprise two or more different negatively charged counterions.
• the term "optionally quaternarized" indicates that the designated amine group may optionally be bonded to a designated fourth group, yielding the corresponding positively charged ammonium group.
• An ammonium group is associated with a physiologically acceptable counteranion, as described above. Suitable counteranions are as provided above with reference to physiologically acceptable salts.
• acyclic nitrogen atom is a nitrogen atom that is not a ring atom of a heteroaryl or heterocyclic group.
• amine or amine group includes primary, secondary and tertiary amines, as well as quaternary amines (ammonium groups).
• alkyl group or alkyl is a saturated straight chained or branched or cyclic hydrocarbon. Cyclic hydrocarbons are also referred to herein as “alicyclic groups " . Typically, straight chained or branched groups have from one to ten carbons, or more typically one to five carbons. Cyclic alkyl groups typically have three to eight ring carbon atoms.
• alkyl groups include, but are not limited to, methyl, ethyl, /7-propyl, isopropyl, «-butyl, sec-butyl, /e/7-butyl, pentyl, wo-pentyl, neopentyl, hexyl, heptyl, octyl, nonyl, decyl. undecyl, dodecyl, cyclopropyl, cyclopentyl, cyclohexyl and the like.
• An alkyl group may be substituted with one or more substituents independently selected for each position.
• Aryl group may be used interchangeably with “aryl,” “aryl ring.” “aromatic group.” and “aromatic ring.”
• Aryl groups include carbocyclic aromatic groups, typically with six to fourteen ring carbon atoms (e.g., phenyl, naphthyl, and anthracyl groups).
• Aryl groups also include heteroaryl groups, which typically have five to fourteen ring -atoms with one or more heteroatoms selected from nitrogen, oxygen and sulfur.
• a heteroaryl group can be monocyclic or a fused polycyclic aromatic ring systems in which a carbocyclic aromatic ring or heteroaryl ring is fused to one or more other heteroaryl rings.
• heteroaryl groups include furanyl, imidazolyl, isoxazolyl, oxadiazolyl, oxazolyl, pyrazolyl, pyrrolyl, pyridyl. pyrimidinyL pyridazinyl, thiazolyl, triazolyl, tetrazolyl, thienyl, benzimidazolyl, benzothienyl, benzofuranyl, indolyl, quinolinyl, benzotriazolyl, benzothiazolyl. benzoxazolyl, benzimidazolyl, isoquinolinyl. indolyL isoindolyl, or benzisoxazolyl.
• the aryl group is a phenyl group.
• a “heterocyclic group” is a non-aromatic mono or bicyclic group with three to twelve ring atoms. One, two or three of the ring atoms are heteroatoms selected from oxygen, nitrogen or sulfur. Moncyclic rings with three to eight ring atoms, one or two of which are oxygen, nitrogen or sulfur are more commonly used. Examples include morpholinyl, thiomorpholinyl, pyrrolidinyl, prperazinyl, piperidinyl, thiazolidinyl and oxazolinidyl.
• a “carbocyclic ring” is ring in which the ring atoms are all carbons.
• Optionally substituted alkyl, heterocyclic or aryl groups may carry one or more substituents which do not significantly adversely affect the phosphate binding ability of the polymers.
• Suitable substituents include amino, alkylamino, dialkylamino, aminocarbonyl, ammonium, dialkylammonium, trialkylammonium, halogen, alkyl, alkylaminocarbonyl, dialkylaminocarbonyl, alkylaminocarbonyloxy, dialkylaminocarbonyloxy, alkoxy, nitro, cyano, carboxy, alkoxycarbonyl, alkylcarbonyl. hydroxy, haloalkoxy, or haloalkyl.
• Preferred substituents include Cl- C3 alkyl group, C1-C3 haloalkyl group, hydroxy, amino, alkylamino, dialkylamino, ammonium, dialkylammonium, trialkylammonium. halo, C1-C3 alkoxy or Cl -C3 haloalkoxy.
• target anions can be used to remove target anions from a subject in need of such treatment.
• a "target anion” is an anion that is present at elevated levels in a subject and is causing or contributing to a pathological condition or disease.
• target anions include phosphate, bile acids, oxalate, and fatty acids.
• the disclosed polymers are commonly used to treat subjects with elevated phosphate levels.
• Subjects with elevated phosphate levels include those with hyperphosphatemia, end stage renal disease, chronic kidney disease. hyperthyroidism, overmedication with phosphate salts, acromegaly, depressed renal synthesis of calcitrioL renal insufficiency, hypocalcemia, tetany due to hypocalcemia, ectopic calcification in soft tissues, and acute tissue destruction as occurs during rhabdomyolysis and treatment of malignancies.
• a "subject” is a mammal, preferably a human, but can also be an animal in nee ' d of veterinary treatment, such as a companion animal (e.g., dogs, cats, and the like), a farm animal (e.g . cows, sheep, pigs, horses, and the like) or a laboratory animal (e.g.. rats, mice, guinea pigs, and the like).
• a companion animal e.g., dogs, cats, and the like
• a farm animal e.g . cows, sheep, pigs, horses, and the like
• a laboratory animal e.g. rats, mice, guinea pigs, and the like.
• the disclosed polymers are also used to control the serum phosphate in subjects with elevated phosphate levels.
• controlling serum phosphate means changing the serum level of phosphate towards a normal or near normal level, for example, towards a level that is within 10% of the normal level of a healthy subject.
• a “patient” is a subject, typically a human subject.
• An “effective amount” of a disclosed polymer is an amount that decreases the serum level of the target anion.
• an “effective amount "" of the •disclosed polymer is a quantity sufficient to achieve a therapeutic and/or prophylactic effect on a particular condition being treated, such as an amount which results in the prevention of or a decrease in the symptoms associated with the disease associated.
• the precise amount of the disclosed polymers that is administered to the individual will depend on the type and severity of the disease and on the characteristics of the individual, such as general health, age, sex, body weight and tolerance to drugs. The skilled artisan will be able to determine appropriate dosages depending on these and other factors.
• Typical dosages of polymers of the invention range from about 5 milligrams/day to about 10 grams/day, preferably from about 50 milligrams/day to about 9 grams/day, more preferably from about 1 gram/day to about 8 grams/day, even more preferably about 2 grams to about 7 grams, most preferably about 4 grams/day to about 6 grams/day. These dosages can be administered several times/day (e.g.. 2. 3, 4 or 5 times/day) or once/day.
• the disclosed polymers can be administered, for example, at least four times per day, preferably with, before or after meals, at least three times per day with, before or after meals, at least twice per day with, before or after meals, at least once per day with, before or after meals, In one specific example, about 0.8-7.2 u (e.g., 2.4 g or 3.2 g per dose for 2-3 times per day, or 4.0 or 4.8 g per dose for 2-3 times per day, or 7.2 or 8.0 or 8.8 or 9.6 g per dose for once per day) of the disclosed polymers is administered per day.
• 0.8-7.2 u e.g., 2.4 g or 3.2 g per dose for 2-3 times per day, or 4.0 or 4.8 g per dose for 2-3 times per day, or 7.2 or 8.0 or 8.8 or 9.6 g per dose for once per day
• the disclosed polymers can be administered before ' or after a meal, or with a meal.
• "before” or “after” a meal is typically within two hours, preferably within one hour, more preferably within thirty minutes, most preferably within ten minutes of commencing or finishing a meal, respectively.
• the disclosed polymers can be administered by any suitable route, but arc typically administered orally, for example, in capsules, suspensions or tablets.
• Still other embodiments of the invention are directed towards pharmaceutical compositions comprising at least one of the disclosed polymers or a pharmaceutically acceptable salt of the polymer, and a diluent of pharmaceutically acceptable carrier.
• the disclosed polymers may be lyophilized or dried under vacuum or oven before formulating.
• one or more other therapeutic ingredients, including other phosphate binding agents, are included in such pharmaceutical compositions.
• the polymer may be any of the polymers described by embodiments of the invention herein.
• the carriers of diluents are "acceptable" in the sense of being compatible with the other ingredients of the formulation and not deleterious to the recipient thereof.
• the formulations can conveniently be presented in unit dosage form and can be prepared by any suitable method known to the skilled artisan. The methods typically include the step of bringing into association the agent with the carrier or diluent which constitutes one or more accessory ingredients. In general, the formulations arc prepared by uniformly and intimately bringing into association the disclosed polymer with the carriers and then, if necessary, dividing the product into unit dosages thereof.
• compositions of the invention to be administered in accordance with the method of the invention to a subject will depend upon those factors noted above. Such amounts may correspond with a dosage to be administered over a particular period of time to a subject (e.g., one or more tablets containing a single dose, or a sachet, slurry, food formulation, suspension, or syrup comprising a single dose).
• compositions of the invention can be formulated as a tablet, sachet, slurry, food formulation, troche, capsule, elixir, suspension, syrup, wafer, chewing gum or lozenge.
• a syrup formulation will generally consist of a suspension or solution of the disclosed polymer or salt in a liquid carrier, for example, ethanol, glycerine or water, with a flavoring or coloring agent.
• a liquid carrier for example, ethanol, glycerine or water
• a flavoring or coloring agent for example, ethanol, glycerine or water
• one or more pharmaceutical carriers routinely used for preparing solid formulations can be employed. Examples of such carriers include magnesium stearate, starch, lactose and sucrose.
• compositions are in the form of a capsule
• use of routine encapsulation is generally suitable, for example, using the aforementioned carriers in a hard gelatin capsule shell.
• composition is in the form of a soft gelatin shell capsule
• pharmaceutical carriers routinely used for preparing dispersions or suspensions can be considered, for example, aqueous gums, celluloses, silicates or oils, and are incorporated in a soft gelatin capsule shell.
• the disclosed polymers can be administered or formulated alone or in combination with other pharmaceutically active agents, e.g., other agents which bind phosphate or other target anions, agents which inhibit phosphate transport, alkaline phosphatase inhibitors, HMG-CoA reductase inhibitors, cholesteroal absorption inhibitors and bile acid sequestrants.
• An agent which binds phosphate and can advantageously be used in combination with the disclosed polymers is a pharmaceutically acceptable magnesium compound (see, for example, US 60/734,593, the entire teachings of which are incorporated herein by reference), which refers to a compound comprising a magnesium cation and which does not cause unacceptable side effects at the dosages which are being administered.
• the pharmaceutically acceptable magnesium compound can be water-soluble or water-insoluble.
• Preferred pharmaceutically acceptable magnesium compounds have a high weight percentage of magnesium, and/or have a high density. These magnesium compounds can minimize daily dose volume.
• magnesium compounds suitable for the invention include magnesium oxide, magnesium hydroxide, magnesium halides (e g., magnesium fluoride, magnesium chloride, magnesium bromide and magnesium iodide), magnesium alkoxides (e.g., magnesium ethoxide and magnesium isopropoxidc).
• organic acids such as fumaric acid, maleic acid, acrylic acid, methacrylic acid, itaconic acid and slyrenesulfonic acid, and a combination thereof.
• phosphate binders include pharmaceutically acceptable lanthanum, calcium, aluminum, iron and zinc salts (see. for example, US 60/640,643, the entire teachings of which are incorporated herein by reference), such as acetates, carbonates, oxides, hydroxides, citrates, alginates, and ketoacids.
• Calcium salts including calcium carbonate, acetate (such as PhosLo® calcium acetate tablets), citrate, alginate, and ketoacids, have been utilized for phosphate binding.
• the ingested calcium combines with phosphate to form insoluble calcium phosphate salts such as Ca3(PO4)2 : Cal- ⁇ PO. ⁇ , or Ca(HbPO ⁇ .
• Aluminium-based phosphate binders such as
• Amphojel® aluminium hydroxide gel have also been used for treating hyperphosphatemia. These compounds complex with intestinal phosphate to form highly insoluble aluminum phosphate; the bound phosphate is unavailable for absorption by the patient. More recently lanthanide salts have been used. T he most commonly used lanthanide salt, lanthanum carbonate (Fosrenol®) behaves similarly to calcium'carbonate.
• Other compositions which may be used with the disclosed polymers of the present invention include other types of phosphate-binding polymers (e.g., sevelamer hydrochloride as described in U.S. Patent No. 5.667,775, which is hereby incorporated herein by reference in its entirety).
• HMG-CoA reductase inhibitors include lovastatin (mevinolin) (e.g.. Altocor ⁇ and Mevacor ® ) and related compounds; pravastatin (e.g.. Pravachol ® , Selektine ® , and Lipostat ® ) and related compounds; simvastatin (e.g.. Zocor ® ) and related compounds.
• Other HMG-CoA reductase inhibitors which can be employed in the present invention include fluvastatin (e.g.. Lescol ® ; cerivastatin (e.g.. Baycol ® and Lipobay ® ); atorvastatin (e.g...
• Zarator ® and Lipilor ® pitavastatin; rosuvastatin (visastatin)(e.g., Crestor ® ); quinoline analogs of mevalonolactone and derivatives thereof (see U.S. Patent No. 5,753.675); pyrazole analogs of mevalonolactone - ' derivatives (see U.S. Patent No. 4,613,610); indene analogs of mevalonolactone derivatives (see WO 86/03488); 6-[2-(substituted-pyrrol-l-yl)-alkyl)pyran-2-ones and derivatives thereof (sec U.S. Pat. No.
• pravastatin simvastatin, rosuvastatin, cerivastatin and pitavastatin
• An example of a cholesterol absorption inhibitor is ezetimibe.
• Examples of phosphate transport inhibitors are found in co-pending U.S. Application Nos. 2004/00191 13 and 2004/0019020 and WO 2004/085448, the entire teachings of each of these are incorporated herein by reference.
• Examples of alkaline phosphatase inhibitors include orthophosphate. arsenate,
• - L-phenylalanine L-homoarginine, tetramisole, levamisole, L-p-Bromotetramisole, 5.6-Dihydro-6-(2-naphthyl) imidazo-[2,l-b]thiazole (napthyl) and derivatives thereof.
• the preferred inhibitors include, but are not limited to, levamisole, bromotetramisole. and 5,6-Dihydro-6-(2-naphthyl)imidazo-[2,] -b]thiazole and derivatives thereof.
• bile acid sequestrants include colesevelam, cholestyramine, and colestipol.
• the polymer was then suspended in deionized water (500 mL), stirred for at least 30 minutes, and filtered.
• the polymer was suspended again m deionized water (500 mL). stirred for at least 30 minutes.
• the pH of the suspension was adjusted to 7 with the addition of concentrated hydrochloric acid.
• the suspension was filtered and the polymer was dried in a forced air oven at 60° C.
• the dried polymer (rubbery solid) was suspended in deionized water (3 L) and stirred for 1 h.
• the pH of the suspension was adjusted to 1 with the addition of concentrated HCl
• the suspension was filtered and the wet polymer (431.65 g) was dried in a forced air oven at 60° C to afford 17.25 g of a solid which was ground to a powder in a coffee mill.
• Polymers 1 -26 were prepared similarly to Example 1 using the reactants and reaction conditions as listed in Table 1.
• Example 2 Effects of amine condensation polymers for reducing urinary phosphate levels.
• SD rats House male Sprague Dawley (SD) rats were used for the experiments. The rats were placed singly in wire-bottom cages, fed with Purina 5002 diet, and allowed to acclimate for at least 5 days prior to experimental use.
• the rats were placed in metabolic cages for 48 hours. Their urine was collected and its phosphorus content analyzed with a Hitachi analyzer to determine phosphorus excretion in mg/day.” Any rats with outlying values were excluded; and the remainder of the rats were distributed into groups.
• Purina 5002 was used as the standard diet. The polymer being tested was mixed with Purina 5002 to result in a final concentration 0.5% by weight. Cellulose at 0 5% by weight was used as a negative control. For each rat, 20Og of diet was prepared. Each rat was weighed and placed on the standard diet. After 4 days the standard diet was replaced with the treatment diet (or control diet for the control group). On days 5 and 6, urine samples from the rats at 24 hours (+/- 30 minutes) were collected and analyzed. The test rats were again weighed, and any weight loss or gain was calculated. Any remaining food was also weighed to calculate the amount of food consumed per day. A change in phosphorus cxcrciion relative to baseline and cellulose negative control was calculated using Excel program. A summary of comparison of the amounts 'of urinary phosphate obtained from the test rats is shown in Table 2. Table 2. In Vivo Phosphate Sequestration Data
• Example 26 0.5 98.2 *Negative control has a value of 100%

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