WO2010020610A1 - Compounds for the treatment of peripheral neuropathies - Google Patents
Compounds for the treatment of peripheral neuropathies Download PDFInfo
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- WO2010020610A1 WO2010020610A1 PCT/EP2009/060611 EP2009060611W WO2010020610A1 WO 2010020610 A1 WO2010020610 A1 WO 2010020610A1 EP 2009060611 W EP2009060611 W EP 2009060611W WO 2010020610 A1 WO2010020610 A1 WO 2010020610A1
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- C07D205/04—Heterocyclic compounds containing four-membered rings with one nitrogen atom as the only ring hetero atom not condensed with other rings having no double bonds between ring members or between ring members and non-ring members
Definitions
- the present invention relates to immunosuppressant compounds and their use in therapy.
- the inflammatory or immune-mediated neuropathies are a diverse group of diseases which include such peripheral neuropathies as Guillain-Barre syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy with conduction block (MMN), and paraproteinaemic demyelinating peripheral neuropathy (PDN).
- GRS Guillain-Barre syndrome
- CIDP chronic inflammatory demyelinating polyradiculoneuropathy
- MNN multifocal motor neuropathy with conduction block
- PDN paraproteinaemic demyelinating peripheral neuropathy
- GBS Guillain-Barre syndrome
- ADP acute inflammatory demyelinating polyneuropathy
- GBS is frequently severe and usually exhibits as an ascending paralysis noted by weakness in the legs that spreads to the upper limbs and the face along with complete loss of deep tendon reflexes.
- the suppressor T cell response is reduced suggesting a cell-mediated immunological reaction directed at the peripheral nerves.
- Multifocal motor neuropathy is a progressive muscle disorder characterized by muscle weakness in the hands, with differences from one side of the body to the other in the specific muscles involved. Symptoms also include muscle wasting, cramping, and involuntary contractions or twitching of the leg muscles. Multifocal motor neuropathy is recognized to be an immune-mediated disorder.
- CIDP Chronic inflammatory demyelinating polyneuropathy
- CIDP Crohn's disease
- WO 2004/103306 and US 2005/0014728 describe compounds useful in the treatment of diseases or disorders mediated by lymphocyte interactions.
- the aforesaid publications are incorporated herein by reference in their entirety for all purposes, in particular the following parts of US 2005/0014728: paragraphs [0006] to [0015], [0022] to [0042], [0102] to [0124] and [0126] to [0149] and Table 1. Particularly to be mentioned are Examples 1 to 5 of US 2005/0014728.
- a peripheral neuropathy e.g. CIDP
- Another aspect of the invention resides in a method of treating a subject having a peripheral neuropathy, e.g. CIDP, comprising administering to the subject an effective amount of a compound as mentioned below.
- a further aspect of the invention is the use of a compound as mentioned below for the manufacture of a medicament for use in treating a peripheral neuropathy, e.g. CIDP.
- the compounds to which the application relates are compounds as disclosed in WO 04/103306 and US 2005/0014728, WO 05/000833, WO 05/103309 or WO 05/1 13330, e.g. compounds of formula A1 or A2
- A is COOR 5 , OPO(ORs) 2 , PO(OR 5 ) 2 , SO 2 OR 5 , POR 5 OR 5 or 1 H-tetrazol-5-yl, R 5 being H or an ester-forming group, e.g. Ci -6 alkyl;
- W is a bond, Ci -3 alkylene or C 2-3 alkenylene
- Y is C 6 -ioaryl or C 2-9 heteroaryl eg C 3- 9heteroaryl, optionally substituted by 1 to 3 radicals selected from halogen, OH, NO 2 , Ci -6 alkyl, Ci -6 alkoxy; halo-substituted Ci -6 alkyl and halo- substituted Ci -6 alkoxy;
- Z is chosen from:
- J 2 are independently methylene or a heteroatom chosen from S, O and NR 5 ; wherein R 5 is chosen from hydrogen and Ci -6 alkyl; and any alkylene of Z can be further substituted by one to three radicals chosen from halo, hydroxy, C-i- ⁇ alkyl; or R 6 can be attached to a carbon atom of Y to form a 5-7 member ring;
- Ri is C 6 -ioaryl or C 2- 9heteroaryl eg C 3-9 heteroaryl, optionally substituted by Ci -6 alkyl, C 6 -ioaryl, C 6 -ioarylCi -4 alkyl, C 3 - 9 heteroaryl, C 3-8 cycloalkyl, Cs- ⁇ heterocycloalkyl or wherein any aryl, heteroaryl, cycloalkyl or heterocycloalkyl of Ri may be substituted by 1 to 5 groups selected from halogen, Ci- 6 alkyl, Ci -6 alkoxy and halo substituted-Ci -6 alkyl or -Ci -6 alkoxy;
- R 2 is H, Ci -6 alkyl, halo substituted Ci -6 alkyl, C 2-6 alkenyl or C 2-6 alkynyl;
- each of R 3 or R 4 is H, halogen, OH, Ci -6 alkyl, Ci -6 alkoxy or halo substituted Ci -6 alkyl or Ci -6 alkoxy;
- compositions for use in treating a peripheral neuropathy comprising a compound of the disclosure and, optionally, a pharmaceutically acceptable diluent or carrier.
- the pharmaceutical formulations contain one or more additional therapeutic agents.
- the invention also provides a product comprising a compound of the disclosure and a therapeutic agent as a combined preparation for simultaneous, separate or sequential use in treating a peripheral neuropathy, e.g. CIDP.
- a peripheral neuropathy e.g. CIDP.
- the invention provides a pharmaceutical formulation comprising a compound of the disclosure and a therapeutic agent, the therapeutic agent being useful for the treatment of a peripheral neuropathy, e.g. CIDP.
- a peripheral neuropathy e.g. CIDP.
- the compounds of the invention can exist in different forms, such as free acids, free bases, esters and other prodrugs, salts and tautomers, for example, and the disclosure includes all variant forms of the compounds.
- the extent of protection includes counterfeit or fraudulent products which contain or purport to contain a compound of the invention irrespective of whether they do in fact contain such a compound and irrespective of whether any such compound is contained in a therapeutically effective amount.
- packages which include a description or instructions which indicate that the package contains a species or pharmaceutical formulation of the invention and a product which is or comprises, or purports to be or comprise, such a formulation or species.
- packages may be, but are not necessarily, counterfeit or fraudulent.
- Fig 1A shows the variation of neurological score with no. of days from immunisation for
- Fig 1B shows the variation of neurological score with no. of days from immunisation for
- Fig 2A shows the variation in body weight with no. of days from immunisation for EAN rats treated with water vehicle and CMC vehicle.
- Fig 2B shows the variation in body weight with no. of days from immunisation for EAN rats treated with 3 and 10mg/kg concentration compound A suspensions.
- Alkyl alkenyl, alkynyl
- Alkyl as a group and as a structural element of other groups, for example halo-substituted- alkyl, alkoxy, acyl, alkylthio, alkylsulfonyl and alkylsulfinyl, can be either straight-chained or branched, and unless otherwise indicated may have from 1 to 6 carbon atoms.
- a CrC 6 alkyl moiety may have 1 , 2, 3, 4, 5 or 6 carbon atoms.
- Alkenyl as a group and as a structural element of other groups contains one or more carbon-carbon double bonds, and can be either straight-chain, or branched. Double bonds can be in the cis- or trans-configuration.
- Alkylene” and “alkenylene” are divalent radicals derived from “alkyl” and “alkenyl” groups, respectively.
- any alkyl group of Ri is optionally an interrupted alkyl group which has a methylene replaced by a member of the group selected from -S-, -S(O)-, -S(O) 2 -, -NR 20 - and -O- (wherein R 20 is hydrogen or Ci- 6 alkyl).
- These groups include, for example, -CH 2 -O-CH 2 -, -CH 2 -S(O) 2 -CH 2 -, -(CH 2 ) 2 -NR 20 - CH 2 , -CH 2 -O-(CH 2 ) 2 -.
- Aryl means a monocyclic or fused bicyclic aromatic ring assembly containing six to ten ring carbon atoms.
- C 6 -ioaryl can be phenyl, biphenyl or naphthyl, preferably phenyl.
- a fused bicyclic ring can be partially saturated, for example, 1 ,2,3,4-tetrahydro- naphthalene, and the like.
- Arylene means a divalent radical derived from an aryl group.
- arylene as used in this application can be phenylene, biphenylene, naphthylene and the like.
- Halo or halogen means F, Cl, Br or I, preferably F or Cl.
- Halo-substituted alkyl groups and compounds can be partially halogenated or perhalogenated, whereby in the case of multiple halogenation, the halogen substituents can be identical or different.
- a preferred perhalogenated alkyl group is for example trifluoromethyl or trifluoromethoxy.
- Heteroaryl means aryl, as defined in this application, with the inclusion in the ring structure of at least one heteroatom moiety selected from N, O or S, and each ring is comprised of 5 to 6 ring atoms, unless otherwise stated.
- C 2 heteroaryl includes oxadiazole, triazole, and the like.
- Cgheteroaryl includes quinoline, 1 ,2,3,4-tetrahydro-quinoline, and the like.
- C 2 -9heteroaryl as used in this application includes thienyl, pyridinyl, furanyl, isoxazolyl, benzoxazolyl or benzo[1 ,3]dioxolyl, preferably thienyl, furanyl or pyridinyl.
- Heteroarylene means heteroaryl, as defined in this application, provided that the ring assembly comprises a divalent radical.
- a fused bicyclic heteroaryl ring system can be partially saturated, for example, 2,3-dihydro-1 H-isoindole, 1 ,2,3,4-tetrahydro-quinoline, and the like.
- substituted as used herein in reference to a moiety means that one or more, especially up to 5, more especially 1 , 2 or 3, of the hydrogen atoms in said moiety are replaced independently of each other by the corresponding number of the described substituents.
- optionally substituted as used herein means substituted or unsubstituted.
- substituents are only at positions where they are chemically possible, the person skilled in the art being able to decide (either experimentally or theoretically) without inappropriate effort whether a particular substitution is possible.
- amino or hydroxy groups with free hydrogen may be unstable if bound to carbon atoms with unsaturated (e.g. olefinic) bonds.
- pharmaceutically acceptable includes reference to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings or animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio. This term includes acceptability for both human and veterinary purposes.
- the application relates to compounds as disclosed in WO 2004/103306 and US 2005/0014728, WO 05/000833, WO 05/103309 or WO 05/1 13330, e.g. compounds of formula A1 or A2
- A is COOR 5 , OPO(ORs) 2 , PO(OR 5 ) 2 , SO 2 OR 5 , POR 5 OR 5 or 1 H-tetrazol-5-yl, R 5 being H or an ester-forming group, e.g. Ci -6 alkyl; W is a bond, Ci -3 alkylene or C 2 -3alkenylene;
- Y is C 6- ioaryl or C 2- 9heteroaryl eg C 3 -9heteroaryl, optionally substituted by 1 to 3 radicals selected from halogen, OH, NO 2 , Ci -6 alkyl, Ci -6 alkoxy; halo-substituted Ci -6 alkyl and halo- substituted Ci -6 alkoxy;
- Z is chosen from:
- R 6 is chosen from hydrogen and Ci -6 alkyl; and Ji and J 2 are independently methylene or a heteroatom chosen from S, O and NR 5 ; wherein R 5 is chosen from hydrogen and and any alkylene of Z can be further substituted by one to three radicals chosen from halo, hydroxy, Ci -6 alkyl; or R 6 can be attached to a carbon atom of Y to form a 5-7 member ring;
- Ri is C 6- i 0 aryl or C 2-9 heteroaryl eg C 3- 9heteroaryl, optionally substituted by Ci -6 alkyl, C 6- i 0 aryl, C 6- ioarylCi. 4 alkyl, C 3-9 heteroaryl, C 3-8 cycloalkyl, C 3-8 heterocycloalkyl or wherein any aryl, heteroaryl, cycloalkyl or heterocycloalkyl of Ri may be substituted by 1 to 5 groups selected from halogen, Ci- 6 alkyl, Ci -6 alkoxy and halo substituted-Ci -6 alkyl or -Ci -6 alkoxy; R 2 is H, Ci -6 alkyl, halo substituted Ci -6 alkyl, C 2-6 alkenyl or C 2-6 alkyny; and
- each of R 3 or R 4 is H, halogen, OH, Ci -6 alkyl, Ci -6 alkoxy or halo substituted Ci -6 alkyl or Ci -6 alkoxy;
- A is COOR 5 , OPO(ORs) 2 , PO(OR 5 ) 2 , SO 2 OR 5 , POR 5 OR 5 or 1 H-tetrazol-5-yl, R 5 being H or an ester-forming group, e.g. Ci -6 alkyl.
- A is in particular COOR 5 , e.g. COOH.
- W is a bond, Ci, C 2 or C 3 alkylene or C 2- 3alkenylene. In embodiments, W is ethylene.
- Y is C 6 -ioaryl or C 2-9 heteroaryl eg C 3- 9heteroaryl, optionally substituted by 1 to 3 radicals selected from halogen, OH, NO 2 , alkyl, alkoxy; halo-substituted alkyl and halo-substituted alkoxy, wherein alkyl as a group or as part of alkoxy, whether or not halo-substituted, has 1 , 2, 3, 4, 5 or 6 carbon atoms.
- Y is in particular phenyl or C 6 heteroaryl, in either case optionally substituted as aforesaid.
- Said aryl, e.g. phenyl, or heteroaryl group may have one substituent, for example a single said alkyl substituent.
- An exemplary alkyl substituent is ethyl.
- Halogen is in particular F or Cl.
- Z is a moiety as mentioned above, particularly a heterocyclic group as indicated in WO 2004/103306, e.g. azetidine, particularly azetidine joined to the remainder of the molecule at the 1- and 3- positions. Also to be mentioned are: pyrrolidine and piperidine, in either case joined to the remainder of the molecule at the 1 - and 3- positions; and piperidine 1 ,4- disubstituted by the respective moieties forming the remainder of the molecule.
- heterocycles are in some compounds N-substituted (1 -substituted) by moiety A and substituted at the 3- or, as the case may be, 4-position by CR 3 R 4 - Ri is C 6- ioaryl or C 2- 9heteroaryl eg C 3- 9heteroaryl, optionally substituted by Ci -6 alkyl, C 6- ioaryl, C 6 -ioarylCi -4 alkyl, C 3-9 heteroaryl, C 3-9 heteroarylCi -4 alkyl, C 3-8 cycloalkyl, Cs-sheterocycloalkyl or wherein any aryl, heteroaryl, cycloalkyl or heterocycloalkyl of Ri may be substituted by 1 to 5 groups selected from halogen, Ci -6 alkyl, Ci -6 alkoxy and halo substituted-Ci -6 alkyl or -Ci -6 alkoxy.
- Ri is in particular phenyl or C 6 heteroaryl optionally substituted as aforesaid. Ri in some embodiments has two substituents selected from optionally halo-substituted alkyl having 1 , 2, 3, 4, 5 or 6 carbon atoms (e.g. trifluoromethyl), optionally halo-substituted phenyl and optionally halo- substituted C 3- 8cycloalkyl (e.g. cyclohexyl), for example Ri may have one optionally halo- substituted alkyl group and one optionally halo-substituted cyclic moiety selected from phenyl and C 3- S (e.g. C 6 )cycloalkyl groups.
- optionally halo-substituted alkyl having 1 , 2, 3, 4, 5 or 6 carbon atoms e.g. trifluoromethyl
- Ri is in some compounds phenyl or C 6 heteroaryl, particularly phenyl, 3,4-disubstituted as aforesaid, as in the case of 3-trifluoromethyl-4- cyclohexylphenyl.
- R 2 is H, Ci -6 alkyl, halo substituted Ci -6 alkyl, C 2-6 alkenyl or C 2-6 alkynyl. Alkyl, whether or not halo-substituted, may therefore have 1 , 2, 3, 4, 5 or 6 carbon atoms. R 2 is in particular methyl.
- Each of R 3 and R 4 is H, halogen, OH, Ci -6 alkyl, Ci -6 alkoxy or halo substituted Ci -6 alkyl or Ci -6 alkoxy.
- Alkyl whether or not halo-substituted and/or part opf alkoxy, may therefore have 1 , 2, 3, 4, 5 or 6 carbon atoms.
- R 3 and R 4 may by way of example each independently be H, halogen, methyl or halo-substituted methyl. In particular, R 3 and R 4 may both be H.
- a preferred compound useful for the purposes of the invention is 1- ⁇ 4-[1-(4-Cyclohexyl-3- trifluoromethyl-benzyloxyimino)-ethyl]-2-ethyl-benzyl ⁇ -azetidine-3-carboxylic acid:
- compositions of the invention may be in the form of pharmaceutically acceptable salts.
- the pharmaceutically acceptable salts of the present disclosure can be synthesized from the parent compound which contains a basic or acidic moiety by conventional chemical methods. Generally, such salts can be prepared by reacting the free acid or base forms of these compounds with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred. Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., US, 1985, p. 1418, the disclosure of which is hereby incorporated by reference; see also Stahl et al, Eds, "Handbook of Pharmaceutical Salts Properties Selection and Use", Verlag Helvetica Chimica Acta and Wiley-VCH, 2002.
- the disclosure thus includes pharmaceutically-acceptable salts of the disclosed compounds wherein the parent compound is modified by making acid or base salts thereof.
- the conventional non-toxic salts or the quaternary ammonium salts which are formed, e.g. from inorganic or organic acids or bases.
- acid addition salts include acetate, adipate, alginate, aspartate, benzoate, benzenesulfonate, bisulfate, butyrate, citrate, camphorate, camphorsulfonate, cyclopentanepropionate, digluconate, dodecylsulfate, ethanesulfonate, fumarate, glucoheptanoate, glycerophosphate, hemisulfate, heptanoate, hexanoate, hydrochloride, hydrobromide, hydroiodide, 2- hydroxyethanesulfonate, lactate, maleate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, oxalate, pamoate, pectinate, persulfate, 3-phenylpropionate, picrate, pivalate, propionate, succinate, tartrate, thiocyanate, to
- Base salts include ammonium salts, alkali metal salts such as sodium and potassium salts, alkaline earth metal salts such as calcium and magnesium salts, salts with organic bases such as dicyclohexylamine salts, N-methyl-D-glucamine, and salts with amino acids such as arginine, lysine, and so forth.
- the basic nitrogen-containing groups may be quaternized with such agents as lower alkyl halides, such as methyl, ethyl, propyl, and butyl chloride, bromides and iodides; dialkyl sulfates like dimethyl, diethyl, dibutyl; and diamyl sulfates, long chain halides such as decyl, lauryl, myristyl and stearyl chlorides, bromides and iodides, aralkyl halides like benzyl and phenethyl bromides and others.
- lower alkyl halides such as methyl, ethyl, propyl, and butyl chloride, bromides and iodides
- dialkyl sulfates like dimethyl, diethyl, dibutyl
- diamyl sulfates long chain halides
- the invention includes prodrugs for the active pharmaceutical species of the invention, for example in which one or more functional groups are protected or derivatised but can be converted in vivo to the functional group, as in the case of esters of carboxylic acids convertible in vivo to the free acid, or in the case of protected amines, to the free amino group.
- prodrug represents in particular compounds which are rapidly transformed in vivo to the parent compound, for example, by hydrolysis in blood.
- Prodrugs therefore include drugs having a functional group which has been transformed into a reversible derivative thereof. Typically, such prodrugs are transformed to the active drug by hydrolysis. As examples may be mentioned the following:
- Carboxylic acid Esters including e.g. alkyl and acyloxyalkyl esters; amides
- Alcohol Esters including e.g. sulfates and phosphates as well as carboxylic acid (e.g. alkanoic acid) esters
- Amine Amides carbamates, imines, enamines,
- Prodrugs also include compounds convertible to the active drug by an oxidative or reductive reaction. As examples may be mentioned:
- metabolic activations of prodrugs are nucleotide activation, phosphorylation activation and decarboxylation activation.
- the compounds of the disclosure may also contain one or more asymmetric carbon atoms and may therefore exhibit optical and/or diastereoisomerism. All diastereoisomers may be separated using conventional techniques, e.g. chromatography or fractional crystallisation. The various stereoisomers may be isolated by separation of a racemic or other mixture of the compounds using conventional, e.g. fractional crystallisation or HPLC, techniques. Alternatively the desired optical isomers may be made by reaction of the appropriate optically active starting materials under conditions which will not cause racemisation or epimerisation, or by derivatisation, for example with a homochiral acid followed by separation of the diastereomeric derivatives by conventional means (e.g. HPLC, chromatography over silica).
- HPLC chromatography over silica
- Geometric isomers may also exist in the compounds of the present disclosure.
- the present disclosure contemplates the various geometric isomers and mixtures thereof resulting from the arrangement of substituents around a carbon-carbon double bond and designates such isomers as of the Z or E configuration, wherein the term "Z” represents substituents on the same side of the carbon— carbon double bond and the term “E” represents substituents on opposite sides of the carbon-carbon double bond.
- the disclosure therefore includes all variant forms of the defined compounds, for example any tautomer or any pharmaceutically acceptable salt, ester, acid or other variant of the defined compounds and their tautomers as well as substances which, upon administration, are capable of providing directly or indirectly a compound as defined above or providing a species which is capable of existing in equilibrium with such a compound.
- the compounds may be synthesised as described in the patent specifications referenced above, e.g. WO 04/103306 and US 2005/0014728.
- the compounds of the invention will normally be administered orally, intravenously, subcutaneously, buccally, rectally, dermally, nasally, tracheally, bronchially, by any other parenteral route, as an oral or nasal spray or via inhalation,
- the compounds may be administered in the form of pharmaceutical preparations comprising prodrug or active compound either as a free compound or, for example, a pharmaceutically acceptable nontoxic organic or inorganic acid or base addition salt, in a pharmaceutically acceptable dosage form.
- the compositions may be administered at varying doses.
- the pharmaceutical compounds of the invention may be administered orally or parenterally ("parenterally” as used herein, refers to modes of administration which include intravenous, intramuscular, intraperitoneal, intrasternal, subcutaneous and intraarticular injection and infusion) to a host.
- parenterally refers to modes of administration which include intravenous, intramuscular, intraperitoneal, intrasternal, subcutaneous and intraarticular injection and infusion
- the compounds may be administered alone as an alternative to administration as compositions in combination with pharmaceutically acceptable diluents, excipients or carriers.
- Actual dosage levels of active ingredients in the pharmaceutical compositions of this invention may be varied so as to obtain an amount of the active compound(s) that is effective to achieve the desired therapeutic response for a particular patient, compositions, and mode of administration.
- the selected dosage level will depend upon the activity of the particular compound, the route of administration, the severity of the condition being treated and the condition and prior medical history of the patient being treated. However, it is within the skill of the art to start doses of the compound at levels lower than required to achieve the desired therapeutic effect and to gradually increase the dosage until the desired effect is achieved.
- an appropriate dosage level will generally be about 0.01 to 500 mg per kg patient body weight per day which can be administered in single or multiple doses.
- the dosage level may be about 0.1 to about 250 mg/kg per day; e.g. about 0.5 to about 100 mg/kg per day.
- a suitable dosage level may be about 0.01 to 250 mg/kg per day, about 0.05 to 100 mg/kg per day, or about 0.1 to 50 mg/kg per day. Within this range the dosage may be 0.05 to 0.5, 0.5 to 5 or 5 to 50 mg/kg per day.
- compositions may be provided in the form of tablets containing 1.0 to 1000 milligrams of the active ingredient, particularly 1.0, 5.0, 10.0, 15.0, 20.0, 25.0, 50.0, 75.0, 100.0, 150.0, 200.0, 250.0, 300.0, 400.0, 500.0, 600.0, 750.0, 800.0, 900.0 or 1000.0 milligrams of the active ingredient.
- the compounds may be administered on a regimen of 1 to 4 times per day, preferably once or twice per day. The dosage regimen may be adjusted to provide the optimal therapeutic response.
- a pharmaceutical composition including a compound of the disclosure, in admixture with a pharmaceutically acceptable adjuvant, diluent or carrier.
- compositions of this invention for parenteral injection suitably comprise pharmaceutically acceptable sterile aqueous or nonaqueous solutions, dispersions, suspensions or emulsions as well as sterile powders for reconstitution into sterile injectable solutions or dispersions just prior to use.
- suitable aqueous and nonaqueous carriers, diluents, solvents or vehicles include water, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol and the like), and suitable mixtures thereof, vegetable oils (such as olive oil) and injectable organic esters such as ethyl oleate.
- Proper fluidity can be maintained, for example, by the use of coating materials such as lecithin, by the maintenance of the required particle size in the case of dispersions and by the use of surfactants.
- compositions may also contain adjuvants such as preservative, wetting agents, emulsifying agents and dispersing agents. Prevention of the action of microorganisms may be ensured by the inclusion of various antibacterial and antifungal agents, for example, paraben, chlorobutanol or phenol sorbic acid. It may also be desirable to include isotonic agents such as sugars or sodium chloride, for example. Prolonged absorption of the injectable pharmaceutical form may be brought about by the inclusion of agents (for example aluminum monostearate and gelatin) which delay absorption.
- adjuvants such as preservative, wetting agents, emulsifying agents and dispersing agents.
- the absorption of the drug in order to prolong the effect of the drug, it is desirable to slow the absorption of the drug from subcutaneous or intramuscular injection. This may be accomplished by the use of a liquid suspension of crystalline or amorphous material with poor water solubility. The rate of absorption of the drug then depends upon its rate of dissolution which, in turn, may depend upon crystal size and crystalline form. Alternatively, delayed absorption of a parenterally administered drug form is accomplished by dissolving or suspending the drug in an oil vehicle.
- Injectable depot forms are suitably made by forming microencapsule matrices of the drug in biodegradable polymers, for example polylactide-polyglycolide. Depending upon the ratio of drug to polymer and the nature of the particular polymer employed, the rate of drug release can be controlled. Examples of other biodegradable polymers include poly(orthoesters) and poly(anhydrides). Depot injectable formulations may also prepared by entrapping the drug in liposomes or microemulsions which are compatible with body tissues.
- the injectable formulations can be sterilized, for example, by filtration through a bacterial- retaining filter or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable media just prior to use.
- Solid dosage forms for oral administration include capsules, tablets, pills, powders and granules.
- the active compound is typically mixed with at least one inert, pharmaceutically acceptable excipient or carrier such as sodium citrate or dicalcium phosphate and/or one or more: a) fillers or extenders such as starches, lactose, sucrose, glucose, mannitol and silicic acid; b) binders such as carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidone, sucrose and acacia; c) humectants such as glycerol; d) disintegrating agents such as agar-agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates and sodium carbonate; e) solution retarding agents such as paraffin; f) absorption accelerators such as quaternary ammonium compounds; g) wetting agents such as cetyl alcohol and glycerol monostearate;
- the dosage form may also comprise buffering agents.
- Solid compositions of a similar type may also be employed as fillers in soft and hard-filled gelatin capsules using such excipients as lactose or milk sugar as well as high molecular weight polyethylene glycol, for example.
- oral formulations contain a dissolution aid.
- the dissolution aid is not limited as to its identity so long as it is pharmaceutically acceptable. Examples include nonionic surface active agents, such as sucrose fatty acid esters, glycerol fatty acid esters, sorbitan fatty acid esters (e.g.
- sorbitan trioleate polyethylene glycol, polyoxyethylene hydrogenated castor oil, polyoxyethylene sorbitan fatty acid esters, polyoxyethylene alkyl ethers, methoxypolyoxyethylene alkyl ethers, polyoxyethylene alkylphenyl ethers, polyethylene glycol fatty acid esters, polyoxyethylene alkylamines, polyoxyethylene alkyl thioethers, polyoxyethylene polyoxypropylene copolymers, polyoxyethylene glycerol fatty acid esters, pentaerythritol fatty acid esters, propylene glycol monofatty acid esters, polyoxyethylene propylene glycol monofatty acid esters, polyoxyethylene sorbitol fatty acid esters, fatty acid alkylolamides, and alkylamine oxides; bile acid and salts thereof (e.g.,
- ionic surface active agents such as sodium laurylsulfate, fatty acid soaps, alkylsulfonates, alkylphosphates, ether phosphates, fatty acid salts of basic amino acids; triethanolamine soap, and alkyl quaternary ammonium salts; and amphoteric surface active agents, such as betaines and aminocarboxylic acid salts.
- the solid dosage forms of tablets, dragees, capsules, pills, and granules can be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art. They may optionally contain opacifying agents and may also be of a composition such that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, and/or in delayed fashion. Examples of embedding compositions include polymeric substances and waxes.
- the active compounds may also be in micro-encapsulated form, if appropriate, with one or more of the above-mentioned excipients.
- the active compounds may be in finely divided form, for example it may be micronised.
- Liquid dosage forms for oral administration include pharmaceutically acceptable emulsions, solutions, suspensions, syrups and elixirs.
- the liquid dosage forms may contain inert diluents commonly used in the art such as water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol, isopropyl alcohol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1 ,3-butylene glycol, dimethyl formamide, oils (in particular, cottonseed, groundnut, corn, germ, olive, castor, and sesame oils), glycerol, tetrahydrofurfuryl alcohol, polyethylene glycols and fatty acid esters of sorbitan and mixtures thereof.
- inert diluents commonly used in the art such as water or other solvents, solubilizing agents and emulsifiers such as ethyl alcohol
- the oral compositions may also include adjuvants such as wetting agents, emulsifying and suspending agents, sweetening, flavoring and perfuming agents.
- Suspensions in addition to the active compounds, may contain suspending agents such as ethoxylated isostearyl alcohols, polyoxyethylene sorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite, agar-agar, and tragacanth and mixtures thereof.
- compositions for rectal or vaginal administration are preferably suppositories which can be prepared by mixing the compounds of this invention with suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at room temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.
- suitable non-irritating excipients or carriers such as cocoa butter, polyethylene glycol or a suppository wax which are solid at room temperature but liquid at body temperature and therefore melt in the rectum or vaginal cavity and release the active compound.
- Liposomes are generally derived from phospholipids or other lipid substances. Liposomes are formed by mono- or multi-lamellar hydrated liquid crystals which are dispersed in an aqueous medium. Any non-toxic, physiologically acceptable and metabolisable lipid capable of forming liposomes can be used.
- the present compositions in liposome form can contain, in addition to a compound of the present invention, stabilisers, preservatives, excipients and the like.
- the preferred lipids are the phospholipids and the phosphatidyl cholines (lecithins), both natural and synthetic. Methods to form liposomes are known in the art, for example, Prescott, Ed., Methods in Cell Biology, Volume XIV, Academic Press, New York, N.Y. (1976), p 33 et seq.
- the compounds of the invention may be orally active, have rapid onset of activity and low toxicity.
- the compounds of the invention may have the advantage that they are more efficacious, less toxic, longer acting, have a broader range of activity, more potent, produce fewer side effects, more easily absorbed than, or have other useful pharmacological properties over, compounds known in the prior art.
- Compounds of the invention may be administered in combination with one or more additional therapeutic agents. Accordingly, the invention provides a pharmaceutical composition comprising an additional agent. The invention also provides a product comprising a compound of the invention and an agent; as a combined preparation for simultaneous, separate or sequential use in therapy.
- a composition or product of the invention may further comprise a therapeutic agent selected from, for example, a compound of the disclosure may be administered in combination with an agent useful for treating a peripheral neuropathy, for example a demyelinating peripheral neuropathy; as examples of such second agents may be mentioned an immunosuppresant (e.g., cyclosporin A, cyclosporin G, FK-506, ABT-281 , ASM981 , rapamycin, 40-O-(2-hydroxy)ethyl-rapamycin, corticosteroids, cyclophosphamide, azathiopri ⁇ e, methotrexate, leflunomide, mizoribine, mycophenolate mofetil, or 15- deoxyspergualine), a steroid (e.g., prednisone or hydrocortisone), an immunoglobulin, or type 1 interferon.
- an immunosuppresant e.g., cyclosporin A, cyclosporin G, FK-50
- Compounds of the invention may be useful in the therapy of a variety of peripheral neurapathies, particularly acute or chronic demyelinating neuropathies.
- the compounds of the disclosure therefore may be useful in the therapy of one or more of Guillain-Barre syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multifocal motor neuropathy with conduction block (MMN), and paraproteinaemic demyelinating peripheral neuropathy (PDN).
- GBS Guillain-Barre syndrome
- CIDP chronic inflammatory demyelinating polyradiculoneuropathy
- MNN multifocal motor neuropathy with conduction block
- PDN paraproteinaemic demyelinating peripheral neuropathy
- the neuropathy is CIDP.
- the effectiveness of the compounds may vary between patients.
- the term "therapy” includes treatment to alleviate one or more symptoms of a peripheral neurapathy or to delay progression of such a disease e.g. by preventing or slowing demyelination e.g. peripheral demyelination; it also includes treatment to cure such a disease, to put a subject into a functional state and/or maintain a subject in a functional state, or to prolong time to relapse.
- the therapeutic use of the compound may include prophylactic use to prevent, control or reduce the severity of a peripheral neurapathy which the subject is at risk of suffering, as well as treatment to control or reduce the severity of existing disease.
- the compound may be administered before the onset of symptoms; it may be administered after the onset of symptoms. It may be administered to a subject at risk of suffering a a peripheral neurapathy.
- the treatments for which the compounds may be used may therefore improve, maintain or delay the deterioration of the medical condition and/or comfort of a patient having, suspected of having, or at risk of having, a peripheral neurapathy.
- rats were immunized by subcutaneous injection into both hind footpads with 100 ⁇ l_ of an inoculum containing 100 ⁇ g of synthetic neuritogenic P2 57-81 peptide
- PBS phosphate buffered saline
- CFA Freund's adjuvant
- Compound A was separately tested at two concentrations of suspension (3 and 10 mg/kg, suspended in 1 % carboxymethylcellulose (CMC, Blanose, Hercules-Aqualon, D ⁇ sseldorf, Germany)). The compound A suspensions were intragastrically administrated immediately after induction and then once daily until Day 22 (5 rats per group). For control EAN rats, the same volume of 1 % CMC in water was given.
- CMC carboxymethylcellulose
- IR immunoreactivity
- the unpaired t-test was performed to compare difference between Compound A and control EAN rats (Graph Pad Prism 4.0 for windows). For all statistical analyses, significance levels were set at p ⁇ 0.05.
- EAN was induced by subcutaneous injection of neuritogenic synthetic P2 peptide.
- 1 % CMC in water (the control group) or compound A were orally administrated immediately after immunization and then once daily until Day 22.
- the first neurologic signs (reduced tail tonus) of control EAN rats were observed at Day 9 (mean clinical score: 0.20 ⁇ 0.13).
- the neurologic severity of EAN increased fast in the control group with a maximal score at Day 13 (mean neurologic score: 4.80 ⁇ 0.51 ). Thereafter, the severity of EAN slowly decreased and rats fully recovered by Day 22 (mean clinical scores: 0 ⁇ 0).
- EAN rats greatly reduced neurological signs were seen at Day 14, with maximal scores at Day 15 and full recovery of rats was seen by Day 19. Therefore, compound A treatment almost prevented the development of clinical signs of EAN, dramatically delayed its onset, decreased neurologic severity and shortened duration of EAN very effectively relative to the water/cmc vehicle (Fig 1 A and 1 B).
- a further feature of EAN is progressive weight loss after onset of disease.
- control and Compound A-treated EAN rats a slow and continuous weight gain was observed until onset of EAN (Day 9). Thereafter, control EAN rats showed significant weight loss during the period of neurologic disease from Day 10 to 18 post immunization, followed by weight gain during the recovery period (Fig 2A).
Abstract
Description
Claims
Priority Applications (17)
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JP2011523409A JP5624037B2 (en) | 2008-08-18 | 2009-08-17 | Compounds for the treatment of peripheral neuropathy |
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BRPI0916968A BRPI0916968A2 (en) | 2008-08-18 | 2009-08-17 | compounds for treating peripheral neuropathies, pharmaceutical formulations comprising said compounds, and uses thereof |
PL09807933T PL2326325T3 (en) | 2008-08-18 | 2009-08-17 | Azetidine derivative for the treatment of peripheral neuropathies |
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RU2011110115/04A RU2523281C2 (en) | 2008-08-18 | 2009-08-17 | Compounds for treating peripheral neuropathies |
ES09807933.8T ES2526119T3 (en) | 2008-08-18 | 2009-08-17 | Azetidine derivative for the treatment of peripheral neuropathies |
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AU2009284128A AU2009284128B2 (en) | 2008-08-18 | 2009-08-17 | Compounds for the treatment of peripheral neuropathies |
CN200980140885.2A CN102186473B (en) | 2008-08-18 | 2009-08-17 | Compounds for the treatment of peripheral neuropathies |
US13/059,346 US20110144082A1 (en) | 2008-08-18 | 2009-08-17 | Compounds for the treatment of peripheral neuropathies |
TN2011000065A TN2011000065A1 (en) | 2009-08-17 | 2011-02-08 | Compounds for the treatment of peripheral neuropathies |
ZA2011/01043A ZA201101043B (en) | 2008-08-18 | 2011-02-09 | Compounds for the treatment of peripheral neuropathies |
IL211189A IL211189A (en) | 2008-08-18 | 2011-02-10 | Immunosupressant compounds for use in the treatment of a demyelinating peripheral neuropathy |
MA33677A MA32616B1 (en) | 2008-08-18 | 2011-03-07 | Compounds for the treatment of peripheral neuropathies |
HK11110488.5A HK1156229A1 (en) | 2008-08-18 | 2011-10-04 | Azetidine derivative for the treatment of peripheral neuropathies |
US13/787,423 US8809316B2 (en) | 2008-08-18 | 2013-03-06 | Use of immunosuppressant compounds in a new indication |
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Cited By (4)
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WO2012093161A1 (en) | 2011-01-07 | 2012-07-12 | Novartis Ag | Immunosuppressant formulations |
WO2012095853A1 (en) | 2011-01-10 | 2012-07-19 | Novartis Pharma Ag | Modified release formulations comprising sip receptor modulators |
WO2017120124A1 (en) | 2016-01-04 | 2017-07-13 | Auspex Pharmaceuticals, Inc. | Azetidine modulators of the sphingosine 1-phosphate receptor |
US11629124B2 (en) | 2017-03-09 | 2023-04-18 | Novartis Ag | Solid forms comprising an oxime ether compound, compositions and methods of use thereof |
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KR101958368B1 (en) | 2018-11-12 | 2019-03-14 | 윤종익 | Exclusive Barge for Lower Water Deep Cement Mixing |
CN113262225B (en) * | 2021-03-25 | 2022-09-23 | 浙江大学医学院附属第一医院 | Application of Torin1 in preparation of medicine for relieving drug-induced peripheral neurotoxicity |
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WO2004103306A2 (en) | 2003-05-19 | 2004-12-02 | Irm Llc | Immunosuppressant compounds and compositions |
WO2008000419A1 (en) * | 2006-06-27 | 2008-01-03 | Novartis Ag | S1p receptor modulators for treating multiple sclerosis |
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RU2300521C2 (en) * | 2000-12-01 | 2007-06-10 | Астразенека Аб | Novel derivatives of mandelic acid and their using as thrombin inhibitors |
KR20070085465A (en) * | 2004-11-29 | 2007-08-27 | 노파르티스 아게 | Dosage regimen of an s1p receptor agonist |
US7737835B2 (en) * | 2006-06-29 | 2010-06-15 | Siemens Vdo Automotive, S.A. De C.V. | Hand held tire pressure monitoring system |
PT2056807E (en) * | 2006-08-17 | 2012-12-21 | Univ Chicago | Treatment of inflammatory diseases |
EP3733162A1 (en) * | 2007-10-12 | 2020-11-04 | Novartis AG | Compositions comprising sphingosine 1 phosphate (s1p) receptor modulators |
US9149459B2 (en) * | 2008-07-23 | 2015-10-06 | Novartis Ag | Sphingosine 1 phosphate receptor modulators and their use to treat muscle inflammation |
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KR20190025727A (en) * | 2011-01-07 | 2019-03-11 | 노파르티스 아게 | Immunosuppressant formulations |
JP2014501770A (en) * | 2011-01-07 | 2014-01-23 | ノバルティス アーゲー | Immunosuppressive preparation |
KR20140037815A (en) * | 2011-01-07 | 2014-03-27 | 노파르티스 아게 | Immunosuppressant formulations |
AU2012204835B2 (en) * | 2011-01-07 | 2015-07-09 | Novartis Ag | Immunosuppressant formulations |
EA026144B1 (en) * | 2011-01-07 | 2017-03-31 | Новартис Аг | Solid phase pharmaceutical composition comprising a hemifumarate salt of 1-{4-[1-(4-cyclohexyl-3-trifluoromethyl-benzyloxyimino)ethyl]-2-ethyl-benzyl}azetidine-3-carboxylic acid and a tablet comprising same |
JP2017141248A (en) * | 2011-01-07 | 2017-08-17 | ノバルティス アーゲー | Immunosuppressant formulation |
KR101951966B1 (en) | 2011-01-07 | 2019-02-25 | 노파르티스 아게 | Immunosuppressant formulations |
WO2012093161A1 (en) | 2011-01-07 | 2012-07-12 | Novartis Ag | Immunosuppressant formulations |
EP3590507A1 (en) | 2011-01-07 | 2020-01-08 | Novartis AG | Immunosuppressant formulations |
KR102166885B1 (en) | 2011-01-07 | 2020-10-19 | 노파르티스 아게 | Immunosuppressant formulations |
WO2012095853A1 (en) | 2011-01-10 | 2012-07-19 | Novartis Pharma Ag | Modified release formulations comprising sip receptor modulators |
WO2017120124A1 (en) | 2016-01-04 | 2017-07-13 | Auspex Pharmaceuticals, Inc. | Azetidine modulators of the sphingosine 1-phosphate receptor |
US11629124B2 (en) | 2017-03-09 | 2023-04-18 | Novartis Ag | Solid forms comprising an oxime ether compound, compositions and methods of use thereof |
Also Published As
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IL211189A (en) | 2015-05-31 |
MA32616B1 (en) | 2011-09-01 |
RU2011110115A (en) | 2012-09-27 |
JP2012500247A (en) | 2012-01-05 |
CL2011000344A1 (en) | 2011-06-17 |
JP5624037B2 (en) | 2014-11-12 |
RU2523281C2 (en) | 2014-07-20 |
CA2733508A1 (en) | 2010-02-25 |
IL211189A0 (en) | 2011-04-28 |
CN102186473A (en) | 2011-09-14 |
NZ606276A (en) | 2013-10-25 |
SG193803A1 (en) | 2013-10-30 |
US20140011797A1 (en) | 2014-01-09 |
MX2011001832A (en) | 2011-04-28 |
PT2326325E (en) | 2015-02-05 |
US8809316B2 (en) | 2014-08-19 |
US20110144082A1 (en) | 2011-06-16 |
HK1156229A1 (en) | 2012-06-08 |
KR101618906B1 (en) | 2016-05-09 |
EP2326325B1 (en) | 2014-11-12 |
PL2326325T3 (en) | 2015-04-30 |
EP2326325A1 (en) | 2011-06-01 |
BRPI0916968A2 (en) | 2015-11-24 |
ZA201101043B (en) | 2011-11-30 |
AU2009284128B2 (en) | 2013-07-18 |
ES2526119T3 (en) | 2015-01-07 |
CN102186473B (en) | 2014-07-02 |
AU2009284128A1 (en) | 2010-02-25 |
CN103271905A (en) | 2013-09-04 |
KR20110043774A (en) | 2011-04-27 |
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