Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
  • C07H19/00—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/16—Purine radicals
  • C07H19/20—Purine radicals with the saccharide radical esterified by phosphoric or polyphosphoric acids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/66—Phosphorus compounds
  • A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7076—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines containing purines, e.g. adenosine, adenylic acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • 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
• • 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
  • 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

Definitions

• the invention relates generally to salts of compounds with antiviral activity and more specifically with anti-HIV properties.
• HIV Human immunodeficiency virus
• AIDS acquired immunodeficiency syndrome
• Inhibitors of HIV are useful to treat HIV infection in a mammal (e.g., reduce and limit the establishment and progression of infection by HIV) as well as in diagnostic assays for HIV.
• the usefulness of currently marketed inhibitors of HIV is to some extent limited by toxicity and other side effects. Thus, there is a need for new HIV therapeutic agents.
• a pharmaceutical formulation of a therapeutic agent must reproducibly and consistently deliver the therapeutic agent to a patient in need thereof. This consistency of delivery can be achieved, at least in part, by incorporation of a stable, soluble, solid-state form of the therapeutic agent into the pharmaceutical composition. Moreover, the synthesis of the desired solid-state form of the therapeutic agent should be technically and econonioically feasible, and should be suitable for full-scale commercial production.
• Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-pu ⁇ n-9-yl)-4-fluoro -2,5-dihydrofuran-2- yl]oxy ⁇ methyl)phenoxyphosphinoyl]-L-alaninate is a reverse transcriptase inhibitor that blocks the replication of IiIV viruses, in vivo and in vitro, and has limited undesirable side effects when administered to human beings.
• Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino -9H-purin-9-yl)-4-fluoro -2, 5-dihydrofuran-2- yl]oxy ⁇ methyl )phenoxyphosphinoyl]-L-alaninate is a low melting point, amorphous, solid which is difficult to isolate, purify, store for an extended period, and formulate as a pharmaceutical composition.
• the present invention provides stable salts of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-purin- 9-yl)-4-fluoro -2,5-dihydrofuran-2-yl]oxy ⁇ methy])phenoxyphosphinoyl]-L-ala ⁇ inate that are more physically stable, and are more readily isolated and formulated, than the free base form of the compound.
• the salts of the present invention are useful, for example, for treating human patients infected with human immunodeficiency vims (strains of HIV-I or HIV-2) which causes AIDS.
• the salts of the present invention are also useful, for example, for preparing a medicament for treating HIV or an HIV associated disorder.
• the salts of the present invention are also useful, for example, for inhibiting the replication of H ⁇ V viruses in vitro, and can be used, therefore, in biological assays as a control compound for identifying other reverse transcriptase inhibitors, or for investigating the mechanism of action of HIV reverse transcriptase and its inhibition.
• the present invention provides citrate, succinate and malonate salts of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran-2- yI]oxy ⁇ methyl)phenoxyphosphinoyl]-L-alaninate, and methods of making the foregoing salts.
• the salts of the present invention are anhydrous, while in other embodiments the salts of the present invention are at least partially hydrated.
• the salts of the present invention exist as crystalline forms.
• crystalline materials are generally more stable thermodynamically than amorphous forms of the same substance. Thus, with only a few notable exceptions, it is generally preferred to use crystalline materials in pharmaceutical applications.
• a measure of the degree of crystallinity of the inventive compounds can be seen, for example, in the sharpness of the DSC and XRPD absorption bands (peaks). The sharper the peak, the higher the degree of crystallinity. Conversely, the broader the peak, the lower the degree of crystallinity.
• a citrate salt of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-ptiHn-9-yl)-4-fluoro-2,5-dihydrofuran-2- yl]oxy ⁇ methyI)phenoxyphosphinoyl]-L-aIaninate is characterized by absorption bands, obtained from an X-ray powder diffraction pattern, at spectral d-spacings of 4.48, 3.12 and 6.05 angstroms; a succinate salt of Ethyl N-[(S)( ⁇ [(2R,5R )-4-fluoro-2,5-dihydrofuran-2- yl]oxy ⁇ methyl)phenoxyphosphinoyl]- by absorption bands, obtained from an X-ray powder diffraction pattern, at spectral d-spacings of 3.57, 4.80 and 4.99
• the present invention provides a citrate salt of Ethyl N-[(S)( ⁇ [(2R.5R)-5-(6- amino-9H-purin-9-yl)-4-fluoro-2,5-dihydrofui-an-2-yl]oxy ⁇ methy])phenoxyphosphinoyl]-L-alaninate having a melting point of from 142°C to 150°C.
• EthyJ N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-purin-9-yl)-4-fluoro-2,5-dthydrofuran-2- yl]oxy ⁇ methy!phenoxyphosphinoyl]-L-alaninale is an amidate prodrug which undergoes reaction with and decomposition in protic solvents. The rate of the reaction depends on pH and temperature.
• the present invention provides pharmaceutical compositions that each include a therapeutically effective amount of a salt of the present invention and a pharmaceutically acceptable carrier or excipient.
• Pharmaceutical compositions of the present invention may also include an additional therapeutic agent, such as an antiviral, antibacterial, antifungal or anticancer agent.
• the pharmaceutical compositions of the invention may be in the form of unit dosage forms, such as tablets or capsules.
• the unit dosage forms typically provide an effective daily dose of a sait of the present invention to a human being in need thereof.
• Effective daily doses of the salts of the present invention are typically from 1 mg to 100mg, such as from 10mg to 30mg.
• the present invention provides methods of making the citrate, succinate and maionate salts of the present invention.
• the present invention provides a process for preparing a citrate salt of Ethyl N-[(S)( ⁇ K2R,5R)-5-(6-amino -9H-purin-9-yl)-4-fluoro-2,5- diliydrofuran-2-yI]oxy ⁇ methyI)phenoxyphosphinoyl]-L-alaninate, wherein the process inciiides the step of contacting about one equivalent of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-p ⁇ irin-9-yl) ⁇ 4-fluoro -2,5-dihydrofuran-2-yl]oxy ⁇ methyl)phenoxyphosphmoy!]-L-alaninate free base in a suitable solvent (e.g., acetonit
• the present invention provides a process for preparing a malonat ⁇ salt of Ethyl N- [(SX ⁇ [(2R,5R)-5-(6-amino-9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran-2-yl]oxy ⁇ methyl) phenoxyphosphinoyl]-L-a!aninate, wherein the process includes the step of contacting about one equivalent of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino -9H-purin-9-yl)-4-f!uoiO-2,5-dihydrofu ran-2- yI]oxy ⁇ methy])phenoxyphosphinoyl]-L-alaninate free base in a suitable solvent (e.g., 2-butanone) with from about one equivalent to about 1.2 equivalents of malorric acid at a temperature in the range of from about 50°C to about 70°C to form the malon
• the present invention provides methods of treating or prophylactically preventing AFDS, wherein the methods include the step of administering to a human being suffering from AIDS a therapeutically effective amount of a salt of the invention, or a hydrate thereof.
• FIGURE 1 shows a characteristic differential scanning calorimetry (DSC) trace for the malonate salt of Ethyl N-[(S ⁇ [(2R,5R)-5-(6-amino -9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran-2- yl]oxy ⁇ methyl)phenoxyphosphinoyI]-L-alaninate.
• DSC differential scanning calorimetry
• FIGURE 2 shows a characteristic DSC tr Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6- amino -9H- ⁇ urin-9-yl)-4-fluoro-2,5-dihyd henoxyphosphinoyl]-L-alaninate.
• FIGURE 3 shows a characteristic DSC trace for the citrate salt of Ethyl N-[(S)( [[(2R,5R)-5-(6-amino- 9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran-2-yl]oxy ⁇ methyI)phenoxyphosphinoyl]-L-alaninate.
• FIGURE 4 shows a characteristic X-ray powder diffraction (XRPD) pattern for the malonate salt of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino -9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran -2- yI]oxy ⁇ methy!phenoxyphosphinoyI]-L-alaninate.
• XRPD characteristic X-ray powder diffraction
• FIGURE 5 shows a characteristic XRPD pattern for the succinate salt of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6- amino-9H-purin-9-yI)-4-fluoro-2,5-dihydrofuran -2-yl]oxy ⁇ methyl)phenoxyphosphinoy!3-L-alaninate.
• the citrate salt is shown in Formula I :
• the succinate salt is shown in Formula II •
• Example 8 herein shows that Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-purin-9-yl)-4-fluoro-2,5- dihydrofuran-2-yl]oxy ⁇ methy!)phenoxyphosphinoyl]-L-alaninate causes a greater accumulation of the active metabolite in white blood cells, which are the cells that harbor the HIV virus, than does the parent compound.
• Example 9 herein presents in vitro data showing that Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6-amino-9H-p ⁇ rin-9-yl)-4-fluoro-2,5- dihydrofuran -2-yl]oxy ⁇ methyl ⁇ phenoxyphosphinoyl]-L-aIaninate is a more potent anti-HlV drug than the parent compound as assessed in an in vitro assay. Additionally.
• the citrate salt of Ethyl N- [(S)( ⁇ [(2R,5R)-5-(6-amino-9H-p ⁇ rin-9-yl)-4-fluoro-2,5-dihydrofura ⁇ -2- yl]oxy ⁇ methyl)phenoxyphosphinoyl]-L-alaninate is a physically and chemically stable composition of matter that can be administered orally to a living subject, to provide a therapeutically effective amount of Ethyl N-[(SX ⁇ [(2R,5R)-5-(6-amino -9H-p ⁇ i ⁇ -in-9-yl)-4-fluoro- 2,5-dihydrofuran -2-yl]oxy ⁇ methyI)phenoxyphosphinoyI3-L-alantnate, which is a more effective anti-HlV agent than the parent compound.
• the present invention provides pharmaceutical compositions, also referred to as pharmaceutical formulations that include a therapeutically effective amount of one or more salts of the invention, and a pharmaceutically acceptable earner or excipient.
• the pharmaceutical compositions of the invention are formulated with conventional carriers and excipients, which are selected in accord with ordinary practice.
• the carrier(s) must be "acceptable'' in the sense of being compatible with the other ingredients of the formuiation and physiologically innocuous to the recipient thereof. Tablets contain such components as excipients, glidants, fillers, binders and the like.
• Aqueous formulations are prepared in sterile form, and when intended for delivery by other than oral administration they are generally isotonic.
• AU formulations optionally contain excipients such as those set forth in the Handbook of Pharmaceutical Excipients (R.C. Rowe et al.,
• Excipie ⁇ ts include ascorbic acid and other antioxidants, chelating agents such as EDTA, carbohydrates such as dextrin, hydroxyalkylccllulose, hydroxyalkylraethylcellulose, stearic acid and the like.
• the pH of the fomvulations ranges from about 3 to about ] 1 , but is ordinarily about 7 to 10.
• the formulations may conveniently be presented in unit dosage form (e.g., tablet) and may be prepared by any of the methods well known in the art of pharmacy. Techniques and formulations generally are found in Remington's Pharmaceutical Sciences (Mack Publishing Co., Easton, PA). Such methods include the step of bringing into association the active ingredient with the earner which constitutes one or more accessory ingredients. In general the formulations are prepared by uniformly arid intimately bringing into association the active ingredient with liquid carriers or finely divided solid carriers or both, and then, if necessary, shaping the product.
• compositions containing the active ingredient may be in any form suitable for the intended method of administration, When used for oral use for example, tablets, troches, lozenges, aqueous or oil suspensions, dispersible powders or granules, emulsions, hard or soft capsules, syrups or elixirs may be prepared.
• Compositions intended for oral use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents including sweetening agents, flavoring agents, coloring agents and preserving agents, in order to provide a palatable preparation. Tablets containing the active ingredient in admixture with non-toxic pharmaceutically acceptable excipient which are suitable for manufacture of tablets are acceptable.
• excipients may be, for example, inert diluents, such as calcium or sodium carbonate, lactose, lactose monohydrate, croscarmellose sodium, povidone, calcium or sodium phosphate; granulating and disintegrating agents, such as maize starch, or alginic acid; binding agents, such as cellulose, microcrystalline cellulose, starch, gelatin or acacia; and lubricating agents, such as magnesium stearate, stearic acid or talc. Tablets may be uncoated or may be coated by known techniques including microencapsulation to delay disintegration and adsorption in the gastrointestinal tract and thereby provide a
• Formulations for oral use may be also presented as hard gelatin capsules where the active ingredient is mixed with an inert solid diluent, for example calcium phosphate or kaolin, or as soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, such as peanut oil, liquid paraffin or olive oil.
• an inert solid diluent for example calcium phosphate or kaolin
• an oil medium such as peanut oil, liquid paraffin or olive oil.
• Aqueous suspensions of salts of the invention contain the active materials in admixture with excipienls suitable for the manufacture of aqueous suspensions.
• cxcipients can include a suspending agent, such as sodium carboxymethylcellulose, methylcellulose, hydroxypropyl methylccllulose, sodium alginate, polyvinylpyrrolidone, gum tragacanth and gum acacia, and dispersing or wetting agents such as a naturally occurring phosphatide ⁇ e.g., lecithin), a condensation product of an alkylene oxide with a fatty acid (e.g., polyoxyethylene stearate), a condensation product of ethylene oxide with a long chain aliphatic alcohol (e.g., heptadecaethyleneoxycetanol), a condensation product of ethylene oxide with a partial ester derived from a fatty acid and a hexitol anhydride (e.g...).
• a suspending agent such
• the aqueous suspension may also contain one or more preservatives such as ethyl or n-propyl p-hydroxy-benzoate, one or more coloring agents, one or more flavoring agents and one or more sweetening agents, such as sucrose or saccharin.
• Oil suspensions may be formulated by suspending the active ingredient in a vegetable oil, such as arachis oii, olive oil, sesame oil or coconut oil, or in a mineral oil such as liquid paraffin.
• the oral suspensions may contain a thickening agent, such as beeswax, hard paraffin or cetyl alcohol.
• Sweetening agents, such as those set forth above, and flavoring agents may be added to provide a palatable oral preparation.
• These compositions may be preserved by the addition of an antioxidant such as ascorbic acid.
• Dispersible powders and granules of the invention suitable for preparation of an aqueous suspension by the addition of water provide the active ingredient in admixture with a dispersing or welting agent, a suspending agent, and one or more preservatives.
• a dispersing or welting agent e.g., a suspending agent
• Suitable dispersing or wetting agents and suspending agents are exemplified by those disclosed above. Additional excipients, for example sweetening, flavoring and coloring agents, may also be present.
• the pharmaceutical compositions of the invention may also be in the form of oil- in-water emulsions.
• the oily phase may be a vegetable oil, such as olive oil or arachis oil, a mineral oil, such as liquid paraffin, or a mixture of these.
• Suitable emulsifying agents include naturally-occurring gums, such as gum acacia and gum tragacanth, naturally occurring phosphatides, such as soybean lecithin, esters or partial esters derived from fatty acids and hexitol anhydrides, such as sorbitan monooleate, and condensation products of these partial esters with ethylene oxide, such as polyoxyethylene sorbitan monooleate.
• the emulsion may also contain sweetening and flavoring agents.
• compositions of the invention may be in the form of a sterile injectable preparation, such as a sterile injectable aqueous or oleaginous suspension.
• a sterile injectable preparation such as a sterile injectable aqueous or oleaginous suspension.
• This suspension may be formulated according to the known art using those suitable dispersing or wetting agents and suspending agents which have been mentioned above.
• the sterile injectable preparation may also be a sterile injectable solution or suspension in a nontoxic parenlerally acceptable diluent or solvent, such as a solution in 1 ,3-butane-diol or prepared as a lyophilized powder.
• acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution.
• sterile fixed oils may conventionally be employed as a solvent or suspending medium.
• any bland Fixed oil may be employed including synthetic mono- or diglycerides,
• fatty acids such as oleic acid may likewise be used in the preparation of injectables.
• Formulations suitable for administration to the eye include eye drops wherein the active ingredient Ls dissolved or suspended in a suitable carrier, especially an aqueous solvent for the active ingredient.
• Formulations for rectal administration may be presented as a suppository with a suitable base comprising for example cocoa butter or a salicylate.
• Formulations suitable for intrapulmonary or nasal admimstration have a particle size for example in the range of 0.1 to 500 microns (including particle sizes in a range between 0.1 and 500 microns in increments of microns such as 0.5, 1 , 30 microns, 35 microns, etc.). which is administered by rapid inhalation through the nasal passage or by inhalation through the mouth so as to reach the alveolar sacs.
• Suitable formulations include aqueous or o ⁇ y solutions of the active ingredient.
• Formulations suitable for aerosol or dry powder administration may be prepared according to conventional methods and may be delivered with other therapeutic agents such as compounds heretofore used in the treatment or prophylaxis of conditions associated with HlV activity.
• Formulations suitable for vaginal administration may be presented as pessaries, tampons, creams, gels, pastes, foams or spray formulations containing in addition to the active ingredient such carriers as are known in the art to be appropriate.
• formulations of this invention may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavoring agents.
• compositions that are also within the scope of the invention provide controlled release of the active ingredient to allow less frequent dosing or to improve the pharmacokinetic or toxicity profile of the active ingredient. Accordingly, the invention also provides pharmaceutical compositions comprising one or more salts of the invention formulated for sustained or controlled release.
• An effective dose of a salt of the present invention depends, for example, on whether the salt is being used prophylactically (typically a lower dose is required compared to therapeutic use of the same salt), the method of delivery, and the pharmaceutical formulation, and will be determined by the clinician using conventional dose escalation studies.
• An effective dose can be expected to be from about 0.0001 mg/kg body weight per day to about 100 mg/kg body weight per day. Typically, from about 0.0 J to about 10 mg/kg body weight per day. More typically, from about .01 to about 5 mg/kg body weight per day. More typically, from about .05 to about 0.5 mg/kg body weight per day.
• the daily dose for an aduli human of approximately 70 kg body weight will typically range from 1 mg to 1000 rag, preferably between 5 mg and 500 mg, and may take the form of single or multiple doses.
• the dose of a salt of the present invention in a unit dose formulation to be administered once per day may be from 1 mg to 100 mg, such as from 30mg to 60 ⁇ ng, such as a 30mg daily dose or a 60mg daily dose.
• Each of the citrate, succinate and malonate salts of Ethyl N-[(S)( ⁇ [(2R,5R)-5-(6- amino-9H-puriii-9-yl)-4-fluoro-2.5-dihydrofuran-2-yl]oxy ⁇ methyl)phenoxyphosphinoyl]- L-alaninate may be employed in combination with other therapeutic agents for the treatment or prophylaxis of AIDS and/or one or more other diseases present in a human subject suffering from AIDS (e.g., bacterial and/or fungal infections, other viral infections such as hepatitis B or hepatitis C, or cancers such as Kaposi's sarcoma).
• the additional therapeutic agent(s) may be coformulated with one or more salts of the invention (e.g., coformulaled in a tablet).
• agents that are effective for the treatment or prophylaxis of viral, parasitic or bacterial infections, or associated conditions, or for treatment of tumors or related conditions include 3'-azido-3'- deoxythymidine (zidovudine, AZT), 2'-deoxy-3'-thiacytidine (3TC), 2',3'-dideoxy-2',3'- didehydroadenosine (D4A), 2',3'-dideoxy-2',3'-didehydrolhymidine (D4T), carbovir (carbocyciic 2',3'-dideoxy-2',3'-didehydroguanosine), 3'-azido-2',3'-dideoxyuridine, 5- fiuorot ⁇ rymidinc, (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU), 2- chlorodeoxyadenosine, 2-deoxycoforrnycin,
• 2',3'-dideoxynucleosides such as 2 ⁇ 3'- dideoxycytidine (ddC), 2',3'-dideoxyadenosine (ddA) and 2',3'-dideoxyinosine (ddl); acyclic nucleosides such as acyclovir, penciclovir, famciclovir, ganciclovir, HPMPC, PMEA, PMEG, PMPA, PMPDAP, FPMPA, HPMPA, HPMPDAP, (2R, 5R)-9- >terrahydro-5-(phosphonomethoxy)-2-furanyladenine, (2R, 5R)-l ->tetrabydro-5-
• antibacterial agents including bactericidal fluoroquinolones (ciprofloxacin, pefloxacin and the like); aminoglycoside bactericidal antibiotics (streptomycin, gentamicin, amicacin and the like) ; ⁇ -lactamase inhibitors (cephalosporins, penicillins and tlie like); other antibacterials including tetracycline, isoniazid, rifampin, cefoperazone, claithromycin and azithromycin, antiparasite or antifungal agents including pentamidine (1,
• Suitable active therapeutic agents or ingredients which can be combined with the salts of the invention, and which have activity against HIV, include I) HIV protease inhibitors, e.g., amprenavir, atazanavir, fosamprenavir, indinavir, lopinavir, ritonavir, lopinavir + ritonavir, nelfinavir, saquinavir, tipranavir, brecanavir, muddyavir, TMC- 126, TMC- 114, mozenavir (DMP-450), JE-2147 (AG1776), AG1859, DG35, L- 756423, RO0334649, KNI-272, DPC-681, DPC-684, and GW640385X, DG 17, PPL-I ⁇ , 2) a HIV non-nucleoside inhibitor of reverse transcriptase, e.g., capravirine, emivirine, delaviridine, efavirenz,
• abacavir + lamivudine abacavir +- lamivudine + zidovudine, zidovudine + lamivudine
• a HIV nucleotide inhibitor of reverse transcriptase e.g., tenofovir, tenofovir disoproxil fumarate + emtricitabine, tenofovir disoproxil fumarate + emtricitabine -+ efavirenz, and adefovir
• a HIV integrase inhibitor e.g., curcumin, derivatives of curcumin, chicoric acid, derivatives of chicoric acid, 3,5-dicaffeoylquinic acid, derivatives of 3,5-dicaffeoylquinic acid, aurintricarboxylic acid, derivatives of aurintricarboxylic acid, caffeic acid phenethyl ester, derivatives of caffeic acid
• rIFN-alpha 2b IFN alpha-2b XL
• rIFN-alpha 2a consensus IFN alpha
• infergen rebif, locteron
• AVI-005 PEG-infergen. pegylated IFN-beta, oral
• ribavirin analogs e.g.. rebetol, copegus, lcvovirin, VX-497, and viramidine (taribavirin) 13
• NS 5a inhibitors e.g., A-831 and A
• Retrovir Zadovudine; Azidothymidine, US 4,724,232
• vaginal and parenteral including subcutaneous, intramuscular, intravenous, intradermal, intrathecal and epidural, and the like. It will be appreciated that the preferred route may vary with, for example, the condition of the recipient.
• An advantage of the salts of the present invention is that they are orally bioavailable and can be dosed orally.
• Compound (2) was synthesized according to the synthetic schemes disclosed in Tann et. al., JOC, 1985, Vol. 50 pg. 3644 and HoweJI et. al., JOC, 1988, VoL 53, pg. 85.
• the mixture was cooled lo -60°C and then a cold solution of iodine monobromide 2 g, 9.6 mmot) in CH 2 Cl 2 (10 ml) was added.
• the reaction mixture was warmed to -10°C and then kept at -10°C for 1 h.
• the reaction mixture was diluted with CH 2 Cl 2 , washed with saturated aqueous NaHCO 3 , and then with aqueous sodium thiosulfate.
• the organic phase was separated, dried over MgSO ⁇ t, and concentrated under reduced pressure to dryness.
• the reaction mixture was purified by silica gel chromatography (eluting with 25% ethyl acetate in CH2CI 2 , then switching to 3% methanol in CH 2 Cl 2 ) to afford product 6 (0.9 g, 33 %).
• Solids were obtained with three of the foregoing acids when mixed with Ethyl N- [(S)( ⁇ t(2R,5R)-5-(6-amino-9H-purin-9-yl)-4-fluoro-2,5-dihydroruran-2- yl]oxy] methyl)phenoxyphosphinoyl]-L-alaninate: trifluoroacetic acid, malonic acid, and succinic acid. Trifluoroacetic acid is not considered to be pharmaceutically acceptable.
• Ethyl N-[(SX ⁇ [(2R,5R)-5-(6-amino-9H-purin-9-yl)-4-iluoiO-2,5-dihydrofuran -2- yl]oxy ⁇ metliyl)phenoxyphosphinoyl]-L-aIaninate is an atnidate prodrug which undergoes decomposition in protic solvents under acidic or basic conditions. For this reason, acids with potentially nucleophilic moieties were not included in the initial round of screening.
• citric acid includes a hydroxyl group which can act as a nucleophile toward the amidatc moiety of Ethyl N- [(S)( ⁇ [(2R,5R)-5-(6-ami ⁇ o-9H-purin-9-yI)-4-fluoro-2,5-dihydrofuran-2- yl]oxy ⁇ methyl)phenoxyphosphinoy]]-L-alaninate and potentially undergo a reaction therewith in which a covalent bond is fo ⁇ ned between Ethyl N-[(S)( ([ ⁇ 2R,5R)-5-(6- amino-9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran-2-yl]oxy ⁇ methyl)phenoxyphosphinoyl]- L-alaninate and the hydroxyl group of citric acid with the cxpuLsion of either phenol or alanine ethyl ester.
• Ethyl N-[(S)( ⁇ [ ⁇ 2R,5R)-5-(6-amino-9H-purin-9-yl)-4- fiuoro-2,5-dihydrofuran -2-yl]oxy ⁇ inethyl)phenoxyphosphmoyl]-L-alanir»aie is amorphous, hygroscopic and chemically unstable when stored under open condition at 40°C and 75% relative humidity (RH). As shown in Table 2, the corresponding succinate, malonate and citrate salts were not hygroscopic at room temperature when exposed to a relative humidity of 92% for several days.
• the citrate salt of Ethyl N-[(S)( ⁇ [ ⁇ 2R,5R)-5-(6-amJno-9H-purin-9-y3)-4-fluoro- 2,5-dihydrofuran-2-yI]oxy) methyl)phenoxyphosphinoyl]-L-alaninate was foi ⁇ nulated into 10 mg and 30 mg tablets using the roller compaction process.
• the active ingredient, lactose anhydrous, microcrystalline cellulose and croscarmellose sodium were first blended * the mixture was then lubricated with one third of the total amount of magnesium stearate, then roller compacted, followed by milling. The resulting granules were lubricated with the remaining amount of magnesium stearate and pressed into tablets.
• Table 4 shows the compositon of tablets that include the citrate salt of Ethyl N- [(S) ⁇ [(2R,5R)-5-(6-amino-9H-purin-9-y!)-4-fluoro-2,5-dihydrofuran-2- yl]oxy ⁇ methyl)phenoxyphosphinoyl3-L-alamnate, and that provide either 10 mg or 30 mg of the free base form of the compound when the citrate salt dissociates in an aqueous medium.
• Ethyl N-[(S) ⁇ [(2R,5R)-5-(6-amino -9H-pu ⁇ n-9-yl)-4-fluoro-2,5-dihydrofuran -2- yi]oxy ⁇ methyl)phenoxyphosphinoyl]-L-ala ⁇ i ⁇ ate is a prodrug that is hydrolyzed in the human body to yield a hydroiysis product that is hereinafter referred Io as "the parent compound”.
• the parent compound is phosphorylated within the human body to produce a biologically active phosphorylated product (hereinafter "the active metabolite") which inhibits the activity of reverse transcriptase enzyme.
• lymphocyte cells were treated with either 1 uM prodrug or 100 ⁇ M parent compound for 2, 6, and 24 hours.
• Peripheral blood mononuclear ceils were isolated from human buffy coats (Stanford Blood Bank, Palo Alto, CA) using centrifugation in Ficoll Paque Plus (GE Healthcare, Piscataway, NJ) according to manufacturer's procedure.
• PBMCs isolated from 3 to 4 independent donors were maintained in RPMI- 1640 media with 20% fetal bovine serum and antibiotics (quiescent state) or were activated in the presence of interleukin 2 (20 units/mL, Roche Biochemicals, Indianapolis, IN) and phytohemaggiutinin PHA-P (1 ⁇ g/mL, Sigma) for 3 to 4 days before the initiation of experiments.
• interleukin 2 (20 units/mL, Roche Biochemicals, Indianapolis, IN) and phytohemaggiutinin PHA-P (1 ⁇ g/mL, Sigma
• Human transformed CCRF-CEM T-cells were obtained from The American Type Culture Collection (Manassas, VA) and cultured in RPMI-1640 medium supplemented with 10% FBS and antibiotics. An aliquot of cells (2-3x10 6 cells) was collected at each time point, counted, pelleted by centrifugation, resuspended in 0.5 mL of the original treatment media and layered onto 0.5 mL of Nyosil M25 oil. The samples were spun in a microcentrifuge for 20 seconds at the maximum speed (approximately 800 x g). The top layer of media was removed and the oil layer was washed twice with 0.8 mL phosphate- buffered saline.
• Transient ion-pairing high-performance liquid chromatography coupled to positive ion electrospray tandem mass spectrometery was used to quantitate intracellular nucleotides.
• Methods were adapted from those described for the acyclic phosphonate nucleotide analog adefovir, its phosphorylated metabolites and natural nucleotides (Vela, .1.E. et al. Simultaneous quantitation of the nucleotide analog adefovir, its phosphorylated anabolites and 2'-deoxyadenosine triphosphate by ion-pairing
• the parent compound was incubated at a 100-fold higher concentration (100 ⁇ M) than the prodrug ( 1 ⁇ M) to facilitate accurate analysis of the much lower intracellular accumulation of metabolites observed following incubation of lymphocytes with the parent compound.
• the prodrug induced 76-, 290- and 140-fold increased levels of the active metabolite relative to the parent compound following incubation with CEM-CCRF, quiescent PBMCs and activated PBMCs, respectively. Active metabolite levels were normalized based on extracellular concentration following incubations with 1 ⁇ M prodrug or with 100 ⁇ M parent compound.
• MT- 2 cells were maintained in RPMl-1640 medium supplemented with antibiotics and 10% fetal bovine serum (FBS).
• FBS fetal bovine serum
• MT-2 cells were infected with HlV-I IIEB at a multiplicity of infection (moi) of 0.01 and added to 96-well plates with serial dilutions of tested compounds at a density of 20,000 cells/well. After a 5-day incubation, the virus-induced cytopathic effect was determined using a CellTiter-GloTM cell viability assay (Promega, Madison, WI) and expressed as a percentage of the signal from samples with fully suppressed virus replication after the subtraction of signal from the untreated control.
• moi multiplicity of infection
• the concentration of each drag that inhibited the virus-induced cylopathic effect by 50% (EC 5 0) was determined by non-linear regression.
• Activity against NRTl-resistant mutants was determined in parallel with wild-type control virus and fold change in EC so was calculated.
• PBMC Human peripheral blood mononuclear cells
• the prodrug was 71 - and 2,300-fold more potent than the parent compound in MT-2 and activated PBMC, respectively.
• Example 10 Oral Bioavailability of the Citrate Salt of Ethyl N-[(S)( ⁇ [(2R,5R>5-(6- amino-9H-purin-9-yl)-4-fl ⁇ oro-2,5-dihydrofuran -2-y!]oxy ⁇ raethyI)phenoxyphosphinoyl]- L-aianinate After Administration in Tablet Form to Beagle Dogs
• the dosing group consisted of 3 non-na ⁇ ve male beagle dogs. The animals were fasted overnight prior to dose administration and up to 4 hr after dosing.
• Dogs were administered a single tablet containing 41.38 mg of the citrate salt of the prodrug (providing 30 mg of the prodrug per tablet).
• the tablet consisted of 13.79% of the citrate salt of the prodrug, 66% anhydrous lactose, 15.21 % microcrystalline cellulose, 3.5% sodium croscamellose and 1.5% magnesium stearate on a weight per weight basis.
• Plasma samples were obtained prior to dosing (0 hr) and at 0.083, 0.25, 0.50, 1.0, 2.0, 4,0, 8.0, 12, 24 hr.
• the blood samples were collected into VacutainerTM tubes containing EDTA-K 3 .
• the blood samples were centrifuged at 4°C to separate plasma.
• An aliquot of 100 ⁇ l of each plasma sample was first diluted with 300 ⁇ l 80% acetonitrile/water containing 200 nM internal standard. Following centrifugation of the protein precipitate, 100 ⁇ l of the supernatant was removed and used for analysis. Standard curves and quality control samples were prepared in dog plasma from animals not dosed with the prodrug. Samples were analyzed by a partially validated liquid chromatography couple to triple quadrupole mass spectrometry method.
• Example 11 Differential Scanning Calorimetry (DSC) of Citrate, Malonate and Succinate Salts of Ethyl rJ-[(S)( ⁇ [ ⁇ 2R ; 5R)-5-(6-amino-9H-purin-9-yl)-4-fl ⁇ ioro-2,5-dihydrofuran -2- ylJoxy ⁇ methyl)phenoxyphosphinoyl]-L-alaninate.
• DSC Differential Scanning Calorimetry
• Figure 2 shows the characteristic DSC trace for the succinate salt of Ethyl N- [(S)( ⁇ [(2R 5 5R)-5-(6-amino -9H-purin-9-y ⁇ )-4-fluoro-2,5-dihydrofuran-2- yl]oxy ⁇ methy])phenoxyphosphi ⁇ oyl]-L-alaninate.
• FIG. 3 shows the characteristic DSC trace for the citrate salt of Ethyl N-[(S)((l(2R,5R)- 5-(6-amino-9H-purin-9-yl)-4-fluoro-2,5-dihydrofuran-2-yl]oxy ⁇ methyl)phenoxyphosphinoyl]-L- alaninate.
• the citrate salt has a significantly greater heat of fusion than the maionate and succinate salts, indicating a higher degree of solid-state crystal unity.
• a Shimadzu XRD 6000 instrument with the following attributes was used: Cu X-ray tube, 2.2KW, NF (normal focus); monochromat ⁇ r curved graphite; goniometer vertical, 1 85 mm radius; divergence slits: 0.5°, 1.0°, 0.05 mm; soller slits: 0.05°, 1°, 2°; receiving slits: 0.15 mm, 0.3 mm; scintillation detector (NaI) HV 500-1200.
• a Shimadzu XRD 6000 instrument with the following attributes was used: Cu target X-ray tube, 35 kv, current 40 ma; continuous scan, monochromator, divergence slit, 1 °: soller slit 1", receiving slit 0.3 mm.
• Figure 5 shows the characteristic XRPD pattern for the succinate salt.
• the principal and characteristic peaks that define this crystalline form of the succinate sail are shown in Tables 9A and 9B .
• Figure 6 shows the characteristic XRPD pattern for the citrate salt.
• the principal and characteristic peaks that define this crystalline form of the citrate salt are shown in Tables 1 OA and 1 OB .

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