Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K51/00—Preparations containing radioactive substances for use in therapy or testing in vivo
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K51/00—Preparations containing radioactive substances for use in therapy or testing in vivo
  • A61K51/02—Preparations containing radioactive substances for use in therapy or testing in vivo characterised by the carrier, i.e. characterised by the agent or material covalently linked or complexing the radioactive nucleus
  • A61K51/04—Organic compounds
  • A61K51/041—Heterocyclic compounds
  • A61K51/044—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine, rifamycins
  • A61K51/0455—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine, rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
  • A61K31/365—Lactones
  • A61K31/375—Ascorbic acid, i.e. vitamin C; Salts thereof
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M37/00—Other apparatus for introducing media into the body; Percutany, i.e. introducing medicines into the body by diffusion through the skin
  • A61M37/0069—Devices for implanting pellets, e.g. markers or solid medicaments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/14—Drugs for disorders of the nervous system for treating abnormal movements, e.g. chorea, dyskinesia
  • A61P25/16—Anti-Parkinson drugs
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia

Definitions

• the present invention relates generally to synthesis methods for 18 F- radiolabeled brain imaging agents and more specifically to methods of synthesizing 18 F- radiolabeled styrylpyridine and its tosylale precursor and to stable pharmaceutical compositions comprising 18 F-radiolabeled brain imaging agents.
• AD Alzheimer's Disease
• cognitive decline characterized by cognitive decline, irreversible memory loss, disorientation, and language impairment.
• AD affects 10% of the population aged greater than 65 and at least 50% of the population aged greater than 85 years.
• AD has been reported in patients as young as 40-50 years of age, but because the presence of the disease is difficult to detect without histopathological examination of brain tissue, the time of onset in living subjects is unknown.
• NPs neuritic plaques
• NFTs neurofibrillary tangles
• the amyloid deposits are fo ⁇ ned by aggregation of amyloid peptides, followed by further combination with other aggregates and/or amyloid peptides.
• the fibrillar aggregates of amyloid peptides, A ⁇ l -40 and Ap 1-42 are the major peptide metabolites derived from amyloid precursor protein that are found in NPs and cerebrovascular amyloid deposits in AD patients.
• Parkinson's Disease is a progressive neurodegenerative disease characterized by resting tremors, bradykinesia, muscular rigidity, and postural instability. PD typically develops after the age of 60, though 15% of diagnosed patients are under the age of 50. Family history of PD is an etiological factor for 5-10% of patients diagnosed with the disease, yet only 1% of cases have been shown to be clearly familial. It is estimated that 1.5 million Americans are currently living with PD.
• Dementia with Le ⁇ vy Bodies (DLB) is a progressive brain disease having symptoms that fluctuate between various degrees of manifestation. These symptoms include progressive dementia, Parkinsonian movement difficulties, hallucinations, and increased sensitivity to neuroleptic drugs.
• AD 1 advanced age is considered to be the greatest risk factor for DLB, with average onset usually between the ages of 50-85. Further, 20% of all dementia cases are caused by DLB and over 50% of PD patients develop "Parkinson's Disease Dementia” (PDD), a type of DLB. It is possible for DLB to occur alone, or in conjunction with other brain abnormalities, including those involved in AD and PD, as mentioned above. At present, a conclusive diagnosis of DLB is only possible after postmortem autopsy.
• PDD Parkinson's Disease Dementia
• PD and DLB share an etiology of dopamine deficiency that is correlated with the death of dopaminergic neurons in the substantia nigra.
• the cause of dopaminergic neuronal death in PD is uncertain, although it appears that aggregates of ⁇ -synuclein in the brain may be associated with dopaminergic neuronal losses in the striatum. It is also recognized that in DLB, abnormal protein deposits containing ⁇ -synuclein, referred to as "Lewy bodies", are the cause of the death of dopaminergic neurons.
• Lewy bodies occur mostly in the substantia nigra and locus ceruleus sections of the brain stem, and also in the subcortical and cortical regions of the brain. Because of this particular localization in the brain, Lewy bodies may interfere with the production of acetylcholine, causing disruption of perception and thought process and impacting behavior. Lewy bodies are considered to be a type of neuritic plaque (NP) because they are comprised of aggregates of ⁇ -synuclein protein deposits.
• the etiology of neurodegeneration can also involve a mixture of pathologies including a component of microvascular, or perfusion, deficits in the brain.
• a disorder commonly referred to as “mixed dementia” often comprises both perfusion deficits and amyloid plaque pathology.
• the term “mixed dementia” possesses various meanings, but the te ⁇ n is commonly used to refer to the coexistence of AD and vascular dementia (VaD), in particular where the VaD is caused by numerous micro-thrombi in the vascular system of the brain.
• VaD vascular dementia
• this form of neurodegeneration is clinically important because the combination of AD and VaD may have a greater impact on the brain than either condition independently. Mixed dementia is traditionally very difficult to diagnose.
• amyloid deposits in the brain may be characterisiic of numerous other conditions including, but not limited to, Mediterranean fever, Muckle- Wells syndrome, idiopathetic myeloma, amyloid polyneuropathy, amyloid cardiomyopathy, systemic neuritic amyloidosis, amyloid polyneuropathy, hereditary cerebral hemorrhage with 5 amyloidosis, Down's syndrome, Scrapie, Creutzfeldt-Jacob disease, Kuru, Gerstamnn- Straussler-Scheinker syndrome, medullary carcinoma of the thyroid, isolated atrial amyloid, ⁇ 2-microglobulin amyloid in dialysis patients, inclusion body myositis, ⁇ >-amyloid deposits in muscle wasting disease, and islets of Langerhans diabetes Type II insulinoma.
• Some common imaging agents include ( 1 1 ClPlB, [ 1 1 C] 4-N-methylamino-4'-hydroxy-stilbene (SB- 13), [ 18 FIFDDNP and [ 123 I
• F]fluoroethoxy)ethoxy)ethoxy) pyridine-3-yl)vinyl)-iV-methylbenzenamine is a radiopharmaceutical for Positron Emission Tomography (PET) imaging of amyloid aggregates in the brain (see, for example, Choi, SR, et al., ./ Niicl Med, 50( 1 1), 1887- 1894, 2009).
• 18 F-AV- 45 contains the F- 18 radioisotope which, due to its 1 10 minute radioactive decay half life, may be manufactured in a centralized location and shipped within a 4 to 8 hour radius to imaging 0 centers that perform the PET brain imaging.
• the radioactive 18 F-A V-45 must be produced in a short period of time from a stable intermediate 5 compound (referred to as the "precursor"); second, the 18 F-A V-45 radiopharmaceutical must be produced in reasonable (e.g., >10%) radiochemical yield starting from the precursor reacting with F-18 fluoride ion; and third, the 18 F-AV-45 must be in a solution medium which provides adequate solubility of both the radiopharmaceutical as well as its non-radioactive counterpart ( 19 F-AV-45, which is always present at some low level due to stable F- 19 in the manufacturing 0 environment), as well as stabilization properties to inhibit the radiolytic breakdown of the compound.
• Ethanol is generally recognized as a suitable aid for solubilization of lipophilic drugs, including radiopharmaceutical drugs (see, for example, Lemaire C, et al., J Label Compd and Radiopharm, 42, 63-75, 1999). Ascorbic acid or ascorbate salts have been utilized previously as aids in inhibiting radiolysis of radiopharmaceuticals (see, for example, Tofe AJ, et al., ./.
• Embodiments of the invention are directed to a radiopharmaceutical composition for positron emission tomography (PET) imaging of neurodegenerative diseases of the brain comprising an effective amount of an ls F-radiolabeled compound, aboul 1.0% to about 20% (v/v) of ethyl alcohol, and at least aboul 0.1% (w/v) of ascorbic acid or a salt thereof.
• the l8 F-radioIabeled compound is capable of binding to a pathologic target in the brain of a patient.
• the pathologic target may include an abnormal concentration of a native or pathologically-altered protein, peptide or oligonucleotide; ⁇ - amyloid; ⁇ -synuclein; or vesicular monoamine transporter 2 (VMAT2).
• VMAT2 vesicular monoamine transporter 2
• the 18 F-radiolabeled compound is a styrylpyridine derivative.
• the 18 F-radiolabeled compound is ((£)-4-(2- (6-(2-(2-(2-
• the 18 F-A V-45 is produced from a tosylate precursor.
• the l8 F-radiolabeled compound in the radiopharmaceutical composition is (2/e,3 ⁇ ,l lb/?)-9-(3-
• the 18 F- radiolabeled compound is a derivative ofdihydrotetrabenazine (DTBZ).
• the radiopharmaceutical composition of some embodiments includes an ethyl alcohol concentration in the range of about 1.0% to about 15.0% (v/v). Other embodiments include a concentration of ascorbic acid or salt thereof in the range of about 0.1% Io about 1.0% (w/v).
• the pH of the radiopharmaceutical composition can range from about 4.5 to about 8.0. In preferred embodiments, the purity of the radiopharmaceutical composition is greater than or equal to about 90% when measured at least about 4 hours post end-of-synthesis (EOS).
• the radiopharmaceutical composition can be used in the diagnosis of neurodegenerative disease such as, for example, dementia, cognitive impairment, Alzheimer's Disease (AD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Vascular Dementia (VaD) and combinations thereof.
• neurodegenerative disease such as, for example, dementia, cognitive impairment, Alzheimer's Disease (AD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Vascular Dementia (VaD) and combinations thereof.
• Radiopharmaceutical composition for positron emission tomography (PET) imaging of the brain comprising an effective amount of an 18 F-radiolabeled compound, at least about 1.0% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) of an ascorbate salt, wherein the ls F-radiolabeled compound decomposes less than about 10% from the end-of-synthesis to about 12 hours after the end- of-synlhesis.
• PET positron emission tomography
• a "method for diagnosing a neurodegenerative disease in a patient comprising the steps of administering a radiopharmaceutical composition capable of binding to a target associated with a neurodegenerative disease to a patient, wherein said radiopharmaceutical composition includes an effective amount of 18 F-radiolabeled compound, at least about 1.0% (v/v) of ethyl alcohol, and at least about 0.1 % (w/v) sodium ascorbate; imaging at least a portion of the patient's brain including a region wherein lhe target is expected to be positioned; and detecting the target.
• the imaging step may be performed using positron emission tomography (PET) imaging, PET with concurrent computed tomography imaging (PET/CT), PET with concurrent magnetic resonance imaging (PET/MR1) or a combination thereof.
• a method for producing an 18 F-radiolabeIed composition capable of binding to ⁇ -amyloid including the steps of synthesizing a tosylate precursor; performing nucleophilic 18 F fluorination of the tosylate precursor in a dimethylsulfoxide (DMSO) solution to provide an 18 F radiopharmaceutical; and formulating the 13 F radiopharmaceutical in an aqueous-ethyl alcohol solution containing ascorbic acid or a salt thereof; wherein the ethyl alcohol is present at a minimum concentration of about 1.0% (v/v) and the minimum concentration of the ascorbic acid or salt thereof is about 0.1% (w ⁇ ') in the final 18 F-radiolabeled pharmaceutical composition.
• DMSO dimethylsulfoxide
• AV-45 (/0-2-(2-(2-(5-(4-(/er/-butoxycarbonyl(melhyl)amino)styryl)pyridin-2-yloxy)ethoxy) etho ⁇ y)ethyl 4-methylbenxenesulfonate ("AV- 105"), is provided.
• This method includes the steps of (i) preparing a mono Boc-protected vinylaniline compound; (ii) converting the vinylaniline compound to a methyl, t-butyl carbamate derivative; (iii) reacting 2-halo 5- iodopyridine with triethyleneglycol; (iv) reacting the methyl, t-butyl carbamate derivative of step (ii) with the resultant compound of step (iii) to produce (/;)-te/7-Butyl 4-(2-(6-(2-(2-(2- hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyI)carbamate; and (v) reacting the (E)-terl-Buly ⁇ 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3- yl)vinyl)phenyl(methyl)carbamate with tosyl chloride to form
• a method of producing a radiopharmaceutical composition including reacting the AV- 105 tosylate precursor with an 18 F-fluoride ion in dimethylsulfoxide (DMSO) solution or other high- boiling point aprotic solvent to produce ((E)-4-(2-(6-(2-(2-(2- [ !8 F]fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methylbenzenamine) ( 18 F- AV-45); isolating the 18 F-A V-45; and purifying the 18 F-A V-45.
• DMSO dimethylsulfoxide
• the method of producing the radiopharmaceutical composition may further include the step of formulating the 18 F-AV-45 in a solution containing about 1.0% to about 15% (v/v) of ethyl alcohol and about 0.1% to about 1.0% (w/v) of an ascorbaie salt.
• the ascorbate salt is sodium ascorbate and (he concentration is about 0.5% (w/v).
• FIG. 1 shows a schematic of the synthesis of tosylate precursor AV-105 and the synthesis of non-radioactive 19 F-AV-45 from /Moluenesulfonate according to one embodiment of the invention
• FIG. 2 shows an alternative synthesis method for tosylate precursor AV-105 according to another embodiment of the invention.
• FIG. 3 depicts a radiosynthesis method of one aspect of the invention using a losylate precursor to produce ⁇ -amyloid binding radiopharmaceutical l8 F-AV-45.
• administering when used in conjunction with an diagnostic agent, such as, for example, a radiopharmaceutical, means to administer directly into or onto a target tissue or to administer the radiopharmaceutical systemically to a patient whereby the diagnostic agent is used to image the tissue or a pathology associated with the tissue to which it is targeted.
• administering a composition may be accomplished by injection, infusion, or by either method in combination with other known techniques.
• an "effective amount” or “therapeutically effective amount”, as used herein, refers to the amount of positron-emitting radiopharmaceutical that results in a sufficient gamma radiation signal to adequately image the biological target of interest in the brain of an individual with a suspected neurodegenerative disease.
• end-of synthesis means end-of- radiosynthesis. This is the timepoint at which the radiosynthesis process, including any purification steps required for isolation of the radiopharmaceutical, are completed.
• high-boiling point aprotic solvent is defined as an aprotic solvent having a boiling point of at least about 140 0 C at one (1) aim.
• pathology refers to an altered biological process that may be, for example, associated with aberrant production of proteins, peptides, RNA, and other substances associated with a disease process.
• patient and “subject” refer to any living organism to which the compounds described herein are administered and whose brain activity is to be measured in conjunction with performing the analysis methods of the invention.
• Patients and/or subjects may include, but are not limited to, any non-human mammal, primate or human. Such patients and/or subjects may or may not be exhibiting signs, symptoms or pathology of one or more particular diseased states.
• target when used in conjunction with a diagnostic agent, such as the radiopharmaceutical of the present invention, refers to tissue or other material associated with pathology to which localization of the radiopharmaceutical or diagnostic agent is desired.
• Targets may include, but are not limited to, diseased cells, pathogens, infectious material or other undesirable material in a patient, such as abnormal proteins, peptides, RNA or DNA or normally-expressed receptors that are altered in a disease process.
• tissue refers to any aggregation of similarly specialized cells that are united in the performance of a particular function.
• Various embodiments of the invention provide a method for the synthesis of an l8 F-radiolabeled imaging agent from a tosylale precursor and a pharmaceutical composition of a stable drug product comprising such 18 F-radiolabeled imaging agent.
• Certain embodiments of the invention are directed to a radiopharmaceutical composition
• a radiopharmaceutical composition comprising an effective amount of an 18 F-radiolabeled compound, such as an l8 F-radiolabeled styrylpyridine or an 1S F-Iabeled dihydrotetrabenazine (DTBZ) derivative, in a solution containing about 1.0% to about 30% (w/v) of ethyl alcohol, and at least about 0.1 % (w/v) sodium ascorbate.
• an 18 F-radiolabeled compound such as an l8 F-radiolabeled styrylpyridine or an 1S F-Iabeled dihydrotetrabenazine (DTBZ) derivative
• Radiopharmaceutical composition comprising an effective amount of an 18 F-radiolabeled compound in a solution for intravenous injection containing about 1.0% to about 20% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) sodium ascorbate with a pH of between approximately 4.5 and 8.0.
• This radiopharmaceutical composition is a clear solution, without insoluble matter, which is stable for at least 6 hours following production at concentrations up to 100 mCi/mL (37 to 3700 MBq/mL) or more of the F-18 radiopharmaceutical.
• the parenteral radiopharmaceutical composition of embodiments of the invention may contain a F-18 radiolabeled compound which is capable of binding to a pathologic target in a brain of a patient such as, for example, an abnormal concentration of a native or pathologically-altered protein, peptide or oligonucleotide, ⁇ -amyloid, ⁇ -synuclein, or to a normally-expressed endogenous target that is impaired in the presence of certain degenerative disorders such as the vesicular monoamine transporter (VMAT2) in Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), or diabetes.
• VMAT2 vesicular monoamine transporter
• PD Parkinson's Disease
• DLB Dementia with Lewy Bodies
• Various embodimenis of the invention provide radiopharmaceutical compositions having characteristics including: a high affinity and selectivity for the target, low molecular weight ( ⁇ 400 g/mol), medium lipophilicty (log P in the range of 1 -3) to ensure high initial brain uptake with rapid clearance, functional groups in the molecule for introduction of positron emitting radionuclides such as, for example, "C or 18 F, high stability in the brain as well as no brain uptake of peripherally generated metabolites of the tracer compound, and high availability of the tracer compound for clinical centers.
• the relatively longer half-life of 18 F is advantageous in that more time is provided for clearance of non-specifically bound tracer with less loss of signal strength due to radioactive decay.
• the 18 F-radiolabeled compound in the radiopharmaceutical composition comprises an l8 F-radiolabeled compound, which is capable of binding to amyloid aggregates for use in positron emission tomography (PET) imaging of the brain.
• the l8 F-radiolabeled compound is ((/ ⁇ )-4-(2-(6-(2-(2- (2-f ls F
• the 18 F-A V-45 is produced from a tosylate precursor.
• the 1!i F-radiolabeled compound is a derivative of dihydrotetrabenazine (DTBZ).
• the 18 F-radiolabeled compound in the radiopharmaceutical composition is (2 ⁇ ,3/?,1 lb ⁇ )-9-(3-[ 18 F]Fluoropropoxy)-3-isopropyl-10- methoxy-1 lb-methyl-2,3,4,6,7,1 lb-hexahydro-lH-pyrido[2,l-cr
• a radiopharmaceutical composition comprising an effective amount of an l8 F-radiolabeled compound, at least about 1.0% (w/v) of ethyl alcohol, and at least about 0.1% (w/v) ascorbate salt (e.g., sodium ascorbate), wherein the radiopharmaceutical composition retains a radiochemical purity of the desired radiopharmaceutical of >90% over a period of at least 4 hours after radiosynthesis, and more preferably over a period of up to 8 hours after radiosynthesis.
• ascorbate salt e.g., sodium ascorbate
• the radiopharmaceutical composition of certain embodiments includes ethyl alcohol in a concentration range of about 1.0% to about 15.0% (v/v) and ascorbate salt (e.g., sodium ascorbate or other salt of ascorbic acid) in a concentration range of about 0.1% to about 1.0% (w/v).
• sodium ascorbate is used at a concentration of 0.5% (w/v).
• the pH of the composition can range from about 4.5 to about 8.0.
• the purity of the radiopharmaceutical is at least 90% when measured at least about 2 hours post end-of-synthesis (EOS). In preferred embodiments, the purity of the radiopharmaceutical composition is at least 90% when measured at least about 4 hours post EOS.
• a method for producing an 18 F-radiolabeled composition capable of binding to ⁇ -amyloid including synthesizing a tosylate precursor; performing nucleophilic 18 F fluorination of the tosylate precursor; formulating the 18 F fluorinated tosylate precursor in an aqueous solution; adding ethyl alcohol to achieve a minimum concentration of about 1.0% (w/v) in the final 18 F-
• a method of producing the tosylate precursor of 18 F- AV-45, (/i)-2-(2-(2-(5-(4-(te ⁇ 7-butoxycarbonyl(methyl)amino)slyryl)pyridin-2-yloxy)ethoxy) elhoxy)ethyl 4-methylbenzenesulfonate (“AV- 105") is provided.
• This method includes the
• a method of producing a radiopharmaceutical composition including reacting the AV-105 tosylate
• the method of producing the radiopharmaceutical composition may further include the step of formulating the ls F-AV-45 in a solution containing about 1.0% to about 15% (v/v) of ethyl 0 alcohol and about 0.1% to about 1.0% or more (w/v) of sodium ascorbate or other ascorbate salt.
• the sodium ascorbate concentration is 0.5% (w/v).
• a radiopharmaceutical composition comprising an effective amount of an l8 F-radiolabeled compound, at least about 1.0% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) sodium ascorbate, wherein the radiopharmaceutical composition decomposes at a rate measured in vitro that substantially corresponds to the following: (a) from about 0.01 to about 5% of the total decomposition after about 2 hours of measurement; (b) from about 0.01 to about 10% of the total decomposition after about 10 hours of measurement; (c) from about 0.01 to about 20% of the total decomposition after about 15 hours of measurement; and (d) not more than about 25% of the total decomposition after about 24 hours of measurement.
• the invention involves synthesis methods for an 18 F- radiolabeled slyrylpyridine tosylate precursor, AV-105 (shown in FlG. 1).
• the AV-105 synthesis method utilizes a primary tosylate instead of a primary mesylate as an active leaving group.
• Use of the tosylate precursor for radiofluorination is beneficial, at least for the reason that the tosylate generated during the radiofluorination reaction is readily removed by chromatographic means from the 18 F-radiolabeled imaging product.
• FIG. 1 depicts an initial synthesis of AV-105 and a synthesis of cold AV-45 in one embodiment of the invention.
• /Moluenesulfonate (tosylate) as an active leading group eliminates the need for methansulfonate (mesylate), which is not preferred due to genotoxic properties of methane sulfonic acid, a side product formed when mesylate is utilized. Further, /Moluenesulfonic acid is more readily detected than methane sulfonic acid and therefore, can be purified more easily using liquid chromatography with UV detection. As further shown in FIG. 1, 4- dimethylaminopyridine (DMAP) is included in the Boc protection step (6 to 7) and the tosylation step (8) to produce AV-105.
• DMAP 4- dimethylaminopyridine
• FIG. 2 An alternative synthesis method for AV-105 is illustrated in FIG. 2.
• This convergent synthesis method uses /Moliienesulfonyl chloride rather than the typical methanesulfonyl chloride to generate a pseudo-halide.
• the use of the Heck reaction as shown in FIG. 2 increases the convergency of synthesis, thereby making the synthesis more efficient and leading to higher yields.
• the yields reported in FIGS. 1 and 2 are for illustrative purposes only and do not represent maximum obtainable yields.
• the synthetic methods for producing AV-105 described herein may be further optimized by use of purification techniques applied to the intermediate reactants or the AV- 105 itself. Such techniques may include, for example, recrystallization,
• the saline solution comprises at least about 1.0% (v/v) of ethyl alcohol and at least about 0.1 % (w/v) sodium ascorbate and has a pH between 4.5 and 8.0.
• the ethyl alcohol concentration is in the range of about 1.0% to about 10.0% (v/v) and the sodium ascorbaie concentration is in the range of about 0.1% to about 1.0% (w/v).
• the presence of sodium ascorbate minimizes radiolysis during the purification of crude 18 F-A V-45 and in the final product diluent to increase stability and shelf life.
• the nominal concentration of sodium ascorbate is 0.5% (w/v).
• a method for detecting a neurodegenerative disease in a patient including administering a radiopharmaceutical composition capable of binding to a target associated with a neurodegenerative disease comprising an effective amount of an " ⁇ -radiolabeled amyloid imaging compound, such as IR F-AV-45, or an alternative F-18 labeled amyloid binding radiopharmaceutical, with about 1.0% to 15% (v/v) of ethyl alcohol, and about 0.1% to 1% (w/v) of sodium ascorbate to the patient; imaging a portion of the patient comprising a region of the patient wherein the target is expected to be positioned; and detecting the target.
• the region of the patient may include at least a portion of the brain.
• the radiopharmaceutical composition can be used in the diagnosis of neurodegenerative disease such as, for example, dementia, cognitive impairment, Alzheimer's Disease (AD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Vascular Dementia (VaD), and combinations thereof.
• the l8 F-radiolabeled pharmaceutical composition of embodiments of the present invention may be administered by any method known in the art.
• the radiopharmaceutical composition may be administrated by injection.
• methods of administration may include, but are not limited to, intravascular injection, intravenous injection, intraperitoneal injection, subcutaneous injection, and intramuscular injection
• the ls F-radiolabeIed pharmaceutical composition may also be administered in unit dosage form, e.g., as an intravenous administration.
• the radiopharmaceutical composition may be prepared in a unit dose syringe containing an appropriate quantity of the radiopharmaceutical.
• the IX F-radiolabeled pharmaceuticals of various embodiments of the invention may be imaged using any suitable technique known in the art including Positron Emission Tomography (PET). Single Photon Emission Computed Tomography (SPECT), PET with concurrent computed tomography imaging (PET/CT), PET with concurrent magnetic resonance imaging (PET/MRI) or a combination thereof.
• PET Positron Emission Tomography
• SPECT Single Photon Emission Computed Tomography
• PET/CT concurrent computed tomography imaging
• PET/MRI PET with concurrent magnetic resonance imaging
• the ' ⁇ -radiopharmaceutical compositions of embodiments of the invention possess both high radiochemical purity and high radiosynthetic yield.
• the shelf-lives of the i8 F-radiolabeled pharmaceuticals may vary among embodiments and may depend upon various aspects of the procedure. Generally, the shelf-lives of the 18 F-radiolabeled pharmaceuticals are greater 8 hours after production when formulated in the compositions described herein.
• Certain embodiments of the invention further provide a formulation of the ls F-labeled compound that is both safe for administration to humans and stable to radiolysis or other chemical degradation over the time period (e.g., up to 8- 10 hours) of shipment to hospitals or other imaging centers.
• an '"F-AV-45 radiopharmaceutical composition comprising ethyl alcohol and sodium ascorbaie maintains stability (greater than 90% RCP) for up to 20 hours post-production
• Example 1.0 Synthesis of AV-105 Tosylate Precursor to 18 F-A V-45.
• Mono-Boc- piotected vinylaniline 10 was prepared by vigorously stirring vinylaniline with di-/e ⁇ v-butyl dicarbonate in water at room temperature for 2 hours. Mono-Boc-protected vinylaniline 10 was precipitated and filtered to provide a 98% yield, which was used without further purification. Mcthylation of the intermediate using sodium hydride and methyl iodide in dimethylformamide (DMF) gave crude product lert-Buly ⁇ melhyl(4-vinylphenyl)carbamafe 11 (88% yield), which was also used without further purification. 2-Bromo-5-iodopyridine was alkylated with triethylene glycol using potassium /m-butoxide.
• Tosylation of the styrylpyridine 14 was performed using tosyl chloride, triethylamine, and DMAP in DCM to obtain AV- 105, which was purified using Biotage medium pressure flash chromatography. The overall yield starting from 2-bromo-5- iodopyridine was 40% (3 steps).
• the 18 F-A V -45 was then loaded onto a semi-preparative HPLC column and subjected to purification
• the HPLC fraction containing the purified !x F-AV-45 was collected in a reservoir containing 20 mL of WFI containing 0.5% w/v sodium ascorbaie.
• the diluted solution was passed through a SEP- PAKSKs C- 18 cartridge and the trapped 18 F-A V-45 was washed with 15 mL of WFl containing 0.5% w/v sodium ascorbate.
• the l8 F-AV-45 was eluted olT the SEP-PAK* Light C- 18 cartridge using I mL of EtOH (USP) into 9 mL of 0.9% Sodium Chloride Injection (sterile, USP) containing 0.5% w v sodium ascorbate (USP). This solution was then dispensed through a 0.22 ⁇ m sterilizing filter into a 10 or 30 mL sterile pre-crimped septum-sealed container.
• the lx F-AV-45 drug product may be diluted with Sodium Chloride Injection (0.9%, USP, sterile) containing NMT 10% v/v EtOH (USP) and 0.5% w/v sodium ascorbate (USP).
• Example 3.0 Formulation for Solubilization of 19 F-A V-45 and Stabilization of 18 F-AV- 45.
• 0068] The ls F-AV-45 radiopharmaceutical formulation/composition was evaluated for the solubility of the non-radioactive 19 F-A V-45. which is also formed in quantities of 1-5 ⁇ g/mL during the radiosynthesis of lx F-AV-45 due to the presence of small quantities of ⁇ y F- fluoride from tubing, valves and other sources in the radiosynthesis system. In the absence of ethanol in the composition, particulate matter may be observed due to the low solubility of V ')" 1 F-AV -45.
• the addition of 10% ethanol to the radiopharmaceutical composition was, therefore, evaluated to determine if the solubility of 19 F-A V-45 was sufficient to avoid the potential of precipitate formation.
• the solubility limit of AV-45 in the drug product composition (10% (v/v) EtOH and 0.5% (w/v) sodium ascorbate in 0.9% aqueous sodium chloride) was determined to be 17 ⁇ g/mL at ambient temperature. A visible precipitate was noticeable in solutions with concentrations > 22 ⁇ g/mL. Samples prepared at concentrations ⁇ 20 ⁇ g/mL were evaluated by HPLC analysis following centrifugation. Samples with ⁇ 20 ⁇ g/mL were also tested after storage for one week at ambient temperature.
• the li! F- ⁇ V-45 radiopharmaceutical compositions of embodiments of the invention are remarkably stable to radiolysis or chemical degradation.
• Sodium ascorbate is used to minimize radiolysis during the purification of 18 F-A V-45 and in the final drug product solution to increase stability and shelf life.
• Ethanol at 1- 10% (v/v) in aqueous solution aids in the solubilization of ls F-AV-45.
• research compositions were manufactured with and without sodium ascorbate.
• compositions were analyzed at end-of-synthesis (EOS) using reverse HPLC, equipped with both an ultra violet (UV) detector and radiochemical detector
• EOS end-of-synthesis
• UV ultra violet
• radiochemical purity of ls F-AV-45 was monitored by HPLC with radiometric detection and the purity of 19 F-AV- 45 was monitored by HPLC UV detection in the drug product by Area Percent Normalization.
• the area percent values for both radiochemical and ultraviolet analysis are shown in Tables 1 and 2.
• the radiochemical purity of the 18 F-A V-45 composition prepared without sodium ascorbaie was 84% and decomposed further such that at 2 hours the purity was 80%.
• the purity of the 18 F-A V-45 composition manufactured with sodium ascorbate was significantly higher.
• the purity was 96% with negligible decomposition at 2 hours post EOS (purity of 95%).

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