Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J63/00—Steroids in which the cyclopenta(a)hydrophenanthrene skeleton has been modified by expansion of only one ring by one or two atoms
  • C07J63/008—Expansion of ring D by one atom, e.g. D homo steroids
• • 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
• • 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
• • 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
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P37/00—Drugs for immunological or allergic disorders

Definitions

• the present invention relates to novel compounds useful against HIV, and more particularly, to compounds derived from betulinic acid and other structurally related compounds which are useful as HIV maturation inhibitors, and to pharmaceutical compositions containing same, as well as to methods for their preparation and use.
• HrV-1 human immunodeficiency virus -1 infection
• HIV and AIDS immunodeficiency syndrome
• RT nucleoside reverse transcriptase
• AZT or Retrovir ® didanosine
• Videx ® stavudine
• Zerit ® lamivudine
• 3TC or Epivir ® zalcitabine
• DDC or Hivid ® abacavir succinate (or Ziagen ® ), Tenofovir disoproxil fumarate salt (or Viread ® ), emtricitabine (or FTC - Emtriva®), Combivir ® (contains -3TC plus AZT), Trizivir ® (contains abacavir, lamivudine, and zidovudine), Epzicom ® (contains abacavir and lamivudine), Truvada ® (contains Viread ® and Emtriva®); non-nucleo
• nevirapine or Viramune ®
• delavirdine or Rescriptor ®
• efavirenz or Sustiva ®
• Atripla ® Travada ® + Sustiva ®
• etravirine and peptidomimetic protease inhibitors or approved formulations: saquinavir, indinavir, ritonavir, nelfinavir, amprenavir, lopinavir, Kaletra ® (lopinavir and Ritonavir), darunavir, atazanavir (Reyataz®) and
• tipranavir (Aptivus )
• integrase inhibitors such as raltegravir (Isentress )
• HIV- 1 the high replication rate and rapid turnover of HIV- 1 combined with the frequent incorporation of mutations, leads to the appearance of drug-resistant variants and treatment failures when sub-optimal drug concentrations are present. Therefore, novel anti-HIV agents exhibiting distinct resistance patterns, and favorable pharmacokinetic as well as safety profiles are needed to provide more treatment options. Improved HIV fusion inhibitors and HIV entry coreceptor antagonists are two examples of new classes of anti-HIV agents further being studied by a number of investigators.
• HIV attachment inhibitors are a further subclass of antiviral compounds that bind to the HIV surface glycoprotein gpl20, and interfere with the interaction between the surface protein gpl20 and the host cell receptor CD4. Thus, they prevent HIV from attaching to the human CD4 T-cell, and block HIV replication in the first stage of the HIV life cycle.
• the properties of HIV attachment inhibitors have been improved in an effort to obtain compounds with maximized utility and efficacy as antiviral agents.
• US 7,354, 924 and US 2005/0209246 are illustrative of HIV attachment inhibitors.
• HIV maturation inhibitors Another emerging class of HIV treatment compounds are called HIV maturation inhibitors. Maturation is the last of as many as 10 or more steps in HIV replication or the HIV life cycle, in which HIV becames infectious as a consequence of several HIV protease-mediated cleavage events in the gag protein that ultimately results in release of the caspid (CA) protein. Maturation inhibitors prevent the HIV capsid from properly assembling and maturing, from forming a protective outer coat, or from emerging from human cells. Instead, non-infectious viruses are produced, preventing subsequent cycles of HIV infection.
• Bevirimat or PA-457 One HIV maturation compound that has been in development has been identified as Bevirimat or PA-457, with the chemical formula of C 36 H5 6 O 6 and the IUPAC name of 3 ⁇ - (3-carboxy-3-methyl-butanoyloxy) lup-20(29)-en-28-oic acid.
• the present invention provides compounds of Formulas I, II, and III below, including pharmaceutically acceptable salts thereof, their pharmaceutical formulations, and their use in patients suffering from or susceptible to a virus such as HIV.
• the compounds of Formulas I - III are effective antiviral agents, particularly as inhibitors of HIV. They are useful for the treatment of HIV and AIDS.
• One embodiment of the present invention is directed to a compound, including pharmaceutically acceptable salts thereof, which is selected from the group of: a compound of formula I
• Ri is isopropenyl or isopropyl
• J and E are -H or -C3 ⁇ 4;
• X is a phenyl or heteroaryl ring substituted with A, wherein A is at least one member selected from the group of -H, -halo, -alkyl, -alkoxy, -COOR 2 and -hydroxyl wherein R 2 is -H -Ci-6 alkyl or substituted -C e alkyl;
• R4 is selected from the group of H, C e alkyl, and Ci_6 alkyl-OH;
• R5 is selected from the group of H, C e alkyl, substituted-alkyl, Ci_6 alkyl-R ⁇ , C 2 _ 6 alkyl-
• R6 is selected from phenyl, substituted phenyl, heteroaryl, substituted heteroaryl, S0 2 Rn, S0 2 NRi 2 Ri3, Ci_ 6 cycloalkyl, substituted Ci_ 6 cycloalkyl, S0 3 H, COOR14, C(0)NRi 5 Ri 6 ;
• R 7 is selected from ORi 7 , N + (0 " )Ri 8 Ri9, NR 20 (COR 2 i) and R 22 R 23 ;
• R4 and R5 are taken together to form a cycle selected from the group of:
• R22 and R2 3 are selected from the group of H, Ci- 6 alkyl, substituted-alkyl, Ci_6 alkyl-R 32 , C 2 -6 alkyl-R 33 , S0 2 R 8 , SO 2 NR 9 Ri 0 ;
• R 3 2 is selected from phenyl, substituted phenyl, heteroaryl, substituted heteroaryl, SO2R11, SO2NR12R13, Ci- 6 cycloalkyl, substituted C 1-6 cycloalkyl, S0 3 H, COOR14, C(0)NRi 5 Ri 6 , R33 is selected from the group of OR 17 , N + (0 ⁇ )Ri 8 Ri 9 , NR 20 (COR 2 i) and NR9R10, or R22 and R2 3 are taken together to form a cycle selected from the group of:
• R 8 , R9, Rio, R11, R12, Ri3, Ri4, Ri5, Ri6, Ri7, Ri8, Ri9, R20, R21, R27, R29, R30 and R31 are each independently_selected from the group of H, Ci- 6 alkyl, substituted-alkyl, Ci_6 cycloalkyl and substituted Ci_6 cycloalkyl;
• R24, R2 6 and R2 8 are selected from the group of H, alkyl, substituted alkyl, COOR2 9 , COONR30R31;
• R25 is selected from the group of alkyl, substituted alkyl, COOR2 9 , COONR 30 R 3 1.
• a method for treating mammals infected with a virus, especially wherein said virus is HIV comprising administering to said mammal an antiviral effective amount of a compound which is selected from the group of compounds of Formulas I, II, III above, and one or more pharmaceutically acceptable carriers, excipients or diluents.
• the compound of Formulas I, II, and/or III can be administered in combination with an antiviral effective amount of another-AIDS treatment agent selected from the group consisting of: (a) an AIDS antiviral agent; (b) an anti-infective agent; (c) an immunomodulator; and (d) other HIV entry inhibitors.
• another-AIDS treatment agent selected from the group consisting of: (a) an AIDS antiviral agent; (b) an anti-infective agent; (c) an immunomodulator; and (d) other HIV entry inhibitors.
• Another embodiment of the present invention is a pharmaceutical composition
• a pharmaceutical composition comprising an antiviral effective amount of a compound which is selected from the group of compounds of Formulas I, II, and III, and one or more pharmaceutically acceptable carriers, excipients, and diluents; and optionally in combination with an antiviral effective amount of another AIDS treatment agent selected from the group consisting of: (a) an AIDS antiviral agent; (b) an anti-infective agent; (c) an immunomodulator; and (d) other HIV entry inhibitors.
• the present invention is directed to these, as well as other important ends, hereinafter described.
• the present disclosure includes the individual diastereoisomeric and enantiomeric forms of the compounds of Formulas I, II and III in addition to the mixtures thereof.
• C-3 and C-28 refer to certain positions of a triterpene core as numbered in accordance with IUPAC rules (positions depicted below with respect to an illustrative triterpene: betulin):
• H refers to hydrogen, including its isotopes, such as deuterium.
• C l _ 6 alkyl as used herein and in the claims (unless specified otherwise) mean straight or branched chain alkyl groups such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, t-butyl, amyl, hexyl and the like.
• C j -C 4 fluoroalkyl refers to F-substituted C x -C 4 alkyl wherein at least one H atom is substituted with F atom, and each H atom can be independently substituted by F atom;
• Halogen refers to chlorine, bromine, iodine or fluorine.
• An "aryl” or “Ar” group refers to an all carbon monocyclic or fused-ring polycyclic (i.e., rings which share adjacent pairs of carbon atoms) groups having a completely conjugated pi-electron system. Examples, without limitation, of aryl groups are phenyl, napthalenyl and anthracenyl. The aryl group may be substituted or unsubstituted.
• the substituted group(s) is preferably one or more selected from alkyl, cycloalkyl, aryl, heteroaryl, heteroalicyclic, hydroxy, alkoxy, aryloxy, heteroaryloxy, heteroalicycloxy, thiohydroxy, thioaryloxy, thioheteroaryloxy, thioheteroalicycloxy, cyano, halogen, nitro, carbonyl, O-carbamyl, N-carbamyl, C-amido, N-amido, C-carboxy, O-carboxy, sulfinyl, sulfonyl, sulfonamido, trihalomethyl, ureido, amino and -NR x R y , wherein R x and R y are independently selected from the group consisting of hydrogen, alkyl, cycloalkyl, aryl, carbonyl, C-carboxy, sulfonyl, trihalomethyl,
• heteroaryl refers to a monocyclic or fused ring (i.e., rings which share an adjacent pair of atoms) group having in the ring(s) one or more atoms selected from the group consisting of nitrogen, oxygen and sulfur and, in addition, having a completely conjugated pi-electron system. Unless otherwise indicated, the heteroaryl group may be attached at either a carbon or nitrogen atom within the heteroaryl group. It should be noted that the term heteroaryl is intended to encompass an N-oxide of the parent heteroaryl if such an N-oxide is chemically feasible as is known in the art.
• heteroaryl groups are furyl, thienyl, benzothienyl, thiazolyl, imidazolyl, oxazolyl, oxadiazolyl, thiadiazolyl, benzothiazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, pyrrolyl, pyranyl, tetrahydropyranyl, pyrazolyl, pyridyl, pyrimidinyl, quinolinyl, isoquinolinyl, purinyl, carbazolyl, benzoxazolyl, benzimidazolyl, indolyl, isoindolyl, pyrazinyl.
• the substituted group(s) is preferably one or more selected from alkyl, cycloalkyl, aryl, heteroaryl, heteroalicyclic, hydroxy, alkoxy, aryloxy, heteroaryloxy, heteroalicycloxy, thioalkoxy, thiohydroxy, thioaryloxy, thioheteroaryloxy, thioheteroalicycloxy, cyano, halogen, nitro, carbonyl, O-carbamyl, N-carbamyl, C-amido, N-amido, C-carboxy, O-carboxy, sulfinyl, sulfonyl, sulfonamido, trihalomethyl, ureido, amino, and -NR x R y , wherein R x and R y are as defined above.
• a heteroalicyclic group refers to a monocyclic or fused ring group having in the ring(s) one or more atoms selected from the group consisting of nitrogen, oxygen and sulfur. Rings are selected from those which provide stable arrangements of bonds and are not intended to encompass systems which would not exist. The rings may also have one or more double bonds. However, the rings do not have a completely conjugated pi-electron system. Examples, without limitation, of
• heteroalicyclic groups are azetidinyl, piperidyl, piperazinyl, imidazolinyl, thiazolidinyl, 3- pyrrolidin-l-yl, morpholinyl, thiomorpholinyl and tetrahydropyranyl.
• the substituted group(s) is preferably one or more selected from alkyl, cycloalkyl, aryl, heteroaryl, heteroalicyclic, hydroxy, alkoxy, aryloxy, heteroaryloxy, heteroalicycloxy, thiohydroxy, thioalkoxy, thioaryloxy, thioheteroaryloxy, thioheteroalicycloxy, cyano, halogen, nitro, carbonyl, thiocarbonyl, O-carbamyl, N-carbamyl, O-thiocarbamyl, N- thiocarbamyl, C-amido, C-thioamido, N-amido, C-carboxy, O-carboxy, sulfinyl, sulfonyl, sulfonamido, trihalomethanesulfonamido, trihalomethanesulfonyl, silyl, guanyl, guanidino,
• alkyl group refers to a saturated aliphatic hydrocarbon including straight chain and branched chain groups.
• the alkyl group has 1 to 20 carbon atoms (whenever a numerical range; e.g., "1-20", is stated herein, it means that the group, in this case the alkyl group may contain 1 carbon atom, 2 carbon atoms, 3 carbon atoms, etc. up to and including 20 carbon atoms). More preferably, it is a medium size alkyl having 1 to 10 carbon atoms. Most preferably, it is a lower alkyl having 1 to 4 carbon atoms.
• the alkyl group may be substituted or unsubstituted.
• the substituent group(s) is preferably one or more individually selected from trihaloalkyl, cycloalkyl, aryl, heteroaryl, heteroalicyclic, hydroxy, alkoxy, aryloxy, heteroaryloxy,
• thioheteroalicycloxy cyano, halo, nitro, carbonyl, thiocarbonyl, O-carbamyl, N-carbamyl, O-thiocarbamyl, N-thiocarbamyl, C-amido, C-thioamido, N-amido, C-carboxy, O- carboxy, sulfinyl, sulfonyl, sulfonamido, trihalomethanesulfonamido,
• cycloalkyl refers to an all-carbon monocyclic or fused ring (i.e., rings which share and adjacent pair of carbon atoms) group wherein one or more rings does not have a completely conjugated pi-electron system.
• examples, without limitation, of cycloalkyl groups are cyclopropane, cyclobutane, cyclopentane, cyclopentene, cyclohexane, cyclohexene, cycloheptane, cycloheptene and adamantane.
• a cycloalkyl group may be substituted or unsubstituted.
• the substituent group(s) is preferably one or more individually selected from alkyl, aryl, heteroaryl, heteroalicyclic, hydroxy, alkoxy, aryloxy, heteroaryloxy, heteroalicycloxy, thiohydroxy, thioalkoxy, thioaryloxy, thioheteroaryloxy, thioheteroalicycloxy, cyano, halo, nitro, carbonyl, thiocarbonyl, O-carbamyl, N-carbamyl, O-thiocarbamyl, N-thiocarbamyl, C-amido, C- thioamido, N-amido, C-carboxy, O-carboxy, sulfinyl, sulfonyl, sulfonamido, trihalo- methanesulfonamido, trihalomethanesulfony
• alkynyl group refers to an alkyl group, as defined herein, having at least two carbon atoms and at least one carbon-carbon triple bond.
• a "hydroxy” group refers to an -OH group.
• alkoxy refers to both an -O-alkyl and an -O-cycloalkyl group as defined herein.
• aryloxy refers to both an -O-aryl and an -O-heteroaryl group, as defined herein.
• heteroaryloxy refers to a heteroaryl-O- group with heteroaryl as defined herein.
• heteroalicycloxy refers to a heteroalicyclic-O- group with
• a "thiohydroxy” group refers to an -SH group.
• a “thioalkoxy” group refers to both an S-alkyl and an -S-cycloalkyl group, as defined herein.
• a “thioaryloxy” group refers to both an -S-aryl and an -S-heteroaryl group, as defined herein.
• a “thioheteroaryloxy” group refers to a heteroaryl-S- group with heteroaryl as defined herein.
• a "thioheteroalicycloxy” group refers to a heteroalicyclic-S- group with heteroalicyclic as defined herein.
• aldehyde refers to a carbonyl group where R" is hydrogen.
• An "O-carboxy” group refers to a R"C(-0)0-group, with R" as defined herein.
• a “carboxylic acid” group refers to a C-carboxy group in which R" is hydrogen.
• a “trihalomethyl” group refers to a -CZ 3 , group wherein Z is a halogen group as defined herein.
• a "trihalomethanesulfonyl” group refers to an groups with Z as defined above.
• a “trihalomethanesulfonamido” group refers to a group with Z as defined above and R x being H or (Ci-6)alkyl.
• amino refers to an -NH 2 group.
• a "cyano" group refers to a -CN group.
• a “silyl” group refers to a -Si(R")3, with R" being (Ci_6)alkyl or phenyl.
• a “hydrazino” group refers to a -NR x NR y R y2 group, with R x , R y , and R independently being H or (Ci_6)alkyl.
• "4, 5, or 6 membered ring cyclic N-lactam” group refers to
• Any two adjacent R groups may combine to form an additional aryl, cycloalkyl, heteroaryl or heterocyclic ring fused to the ring initially bearing those R groups.
• salts and prodrugs of compounds disclosed herein are within the scope of the invention.
• pharmaceutically acceptable salt as used herein and in the claims is intended to include nontoxic base addition salts. Suitable salts include those derived from organic and inorganic acids such as, without limitation, hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid, methanesulfonic acid, acetic acid, tartaric acid, lactic acid, sulfinic acid, citric acid, maleic acid, fumaric acid, sorbic acid, aconitic acid, salicylic acid, phthalic acid, and the like.
• organic and inorganic acids such as, without limitation, hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid, methanesulfonic acid, acetic acid, tartaric acid, lactic acid, sulfinic acid, citric acid, maleic acid, fumaric acid, sorbic acid, aconitic acid, salicylic acid, phthalic acid, and
• pharmaceutically acceptable salt as used herein is also intended to include salts of acidic groups, such as a carboxylate, with such counterions as ammonium, alkali metal salts, particularly sodium or potassium, alkaline earth metal salts, particularly calcium or magnesium, and salts with suitable organic bases such as lower alkylamines
• substituted lower alkylamines e.g. hydroxyl-substituted alkylamines such as diethanolamine
• the compounds of the invention also include “prodrugs".
• prodrug as used herein encompasses both the term “prodrug esters” and the term “prodrug ethers”.
• prodrug esters as employed herein includes esters and carbonates formed by reacting one or more hydroxyls of compounds of Formula I with either alkyl, alkoxy, or aryl substituted acylating agents or phosphorylating agent employing procedures known to those skilled in the art to generate acetates, pivalates, methylcarbonates, benzoates, amino acid esters, phosphates, half acid esters such as malonates, succinates or glutarates, and the like. In certain embodiments, amino acid esters may be especially preferred.
• prodrug esters examples include
• prodrug ethers include both phosphate acetals and O-glucosides. Representative examples of such prodrug ethers include
• the invention is directed to a compound, including pharmaceutically acceptable salts thereof, which is selected from the group of: a compound of formula I
• Ri is isopropenyl or isopropyl
• J and E are -H or -C3 ⁇ 4
• E is absent when the double bond is present
• X is a phenyl or heteroaryl ring substituted with A, wherein A is at least one member selected from the group of -H, -halo, -alkyl, -alkoxy, -COOR2 and -hydroxyl wherein R 2 is -H -Ci-6 alkyl, or substituted -C e alkyl; Y is selected from the group of -COOR 2 , -C(0)NR 2 S0 2 R 3 , -C(0)NR 2 S0 2 NR 2 R 2 ,
• R5 is selected from the group of H, C h alky!, substituted-alkyl, Ci_6 alkyl-R ⁇ , C2- 6 alkyl-
• R6 is selected from phenyl, substituted phenyl, heteroaryl, substituted heteroaryl, SO2R11, SO2NR12R13, Ci_ 6 cycloalkyl, substituted C 1-6 cycloalkyl, S0 3 H, COOR14, C(0)NRi 5 Ri 6 ;
• R 7 is selected from ORi 7 , N + (0 " )Ri 8 Ri9, NR 20 (COR 2 i) and R 22 R 2 3; or R4 and R5 are taken together to form a cycle selected from the group of:
• R22 and R23 are selected from the group of H, Ci-6 alkyl, substituted-alkyl, Ci-6 alkyl-R32, C 2 -6 alkyl-R 3 3, S0 2 R 8 , SO 2 NR 9 Ri 0 ;
• R 3 2 is selected from phenyl, substituted phenyl, heteroaryl, substituted heteroaryl, S0 2 R lls SO2NR12R13, Ci_6 cycloalkyl, substituted C 1-6 cycloalkyl, S0 3 H, COOR14, C(0)NRi 5 Ri 6 ;
• R33 is selected from ORi 7 , N + (0 " )Ri 8 Ri9, NR 20 (COR 2 i) and NR9R10; or R22 and R2 3 are taken together to form a cycle selected from the group of:
• R-8, R9, Rio, R11, R12, Ri3, Ri4, Ri5, Ri6, Ri7, Ri8, Ri9, R20, R 2 i, R27, R29, R30 and R31 are each independently_selected from the group of H, Ci-6 alkyl, substituted-alkyl, C e cycloalkyl and substituted Ci_6 cycloalkyl;
• R24, R26 and R28 are selected from the group of H, alkyl, substituted alkyl, -COOR2 9 , - COONR30R31;
• R25 is selected from the group of alkyl, substituted alkyl, -COOR29, -COONR30R31. More preferred compounds include those which are encompassed by Formula I.
• A is at least one member selected from the group of-H, -OH, -halo, -C 1-3 alkyl, and -C 1-3 alkoxy, wherein -halo is selected from the group of -CI, -F and -Br, with -F being more preferred.
• A is at least one member selected from the group of-H, -halo, -OH, -C 1-3 alkyl and -C 1-3 alkoxy. It is particularly preferred that A at least one member selected from the group of -H, -flouro, -chloro, -OH, -methyl and - methoxy.
• Also preferred as part of the invention are the compounds of Formula I wherein X -membered heteroaryl ring.
• the compounds of Formula I wherein X embered heteroaryl ring having the following structure are particularly preferred:
• each of U, V and W is selected from the group consisting of C, N, O and S, with the proviso that at least one of U, V and W is other than C.
• X is selected from the group of thiophene, pyrazole, isoxaxole, and oxadiazole groups, with thiophene being even more preferred.
• X is a 6-membered heteroaryl ring selected from the group of pyridyl and pyrimidine rings.
• Preferred examples of the compounds of Formula Ila include the following:
• embodiments described above may be administered orally, parenterally (including subcutaneous injections, intravenous, intramuscular, intrasternal injection or infusion techniques), by inhalation spray, or rectally, and by other means, in dosage unit formulations containing non-toxic pharmaceutically acceptable carriers, excipients and diluents available to the skilled artisan.
• One or more adjuvants may also be included.
• a method of treatment for treating viral infections such as HIV infection and AIDS.
• the treatment involves administering to a patient in need of such treatment a pharmaceutical composition which contains an antiviral effective amount of one or more of the compounds of Formulas I, II, and/or III, together with one or more pharmaceutically acceptable carriers, excipients or diluents.
• antiviral effective amount means the total amount of each active component of the composition and method that is sufficient to show a meaningful patient benefit, i.e., inhibiting, ameliorating, or healing of acute conditions characterized by inhibition of the HIV infection.
• the term refers to that ingredient alone.
• the term refers to combined amounts of the active ingredients that result in the therapeutic effect, whether administered in combination, serially or simultaneously.
• the terms "treat, treating, treatment” as used herein and in the claims means preventing, ameliorating or healing diseases associated with HIV infection.
• compositions of the invention may be in the form of orally administrable suspensions or tablets; as well as nasal sprays, sterile injectable
• compositions for example, as sterile injectable aqueous or oleaginous suspensions or suppositories.
• Pharmaceutically acceptable carriers, excipients or diluents may be utilized in the pharmaceutical compositions, and are those utilized in the art of pharmaceutical preparations.
• these compositions When administered orally as a suspension, these compositions are prepared according to techniques typically known in the art of pharmaceutical formulation and may contain microcrystalline cellulose for imparting bulk, alginic acid or sodium alginate as a suspending agent, methylcellulose as a viscosity enhancer, and sweeteners/flavoring agents known in the art.
• these compositions may contain microcrystalline cellulose, dicalcium phosphate, starch, magnesium stearate and lactose and/or other excipients, binders, extenders, disintegrants, diluents, and lubricants known in the art.
• the injectable solutions or suspensions may be formulated according to known art, using suitable non-toxic, parenterally acceptable diluents or solvents, such as mannitol, 1,3-butanediol, water, Ringer's solution or isotonic sodium chloride solution, or suitable dispersing or wetting and suspending agents, such as sterile, bland, fixed oils, including synthetic mono- or diglycerides, and fatty acids, including oleic acid.
• suitable non-toxic, parenterally acceptable diluents or solvents such as mannitol, 1,3-butanediol, water, Ringer's solution or isotonic sodium chloride solution, or suitable dispersing or wetting and suspending agents, such as sterile, bland, fixed oils, including synthetic mono- or diglycerides, and fatty acids, including oleic acid.
• suitable dispersing or wetting and suspending agents such as sterile, bland, fixed oils, including synthetic mono- or diglycerides,
• Another preferred dosage range is about 1 to 20 mg/kg body weight in divided doses. It will be understood, however, that the specific dose level and frequency of dosage for any particular patient may be varied and will depend upon a variety of factors including the activity of the specific compound employed, the metabolic stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, the severity of the particular condition, and the host undergoing therapy.
• Famciclovir Smith Kline herpes zoster Famciclovir Smith Kline herpes zoster
• Interferon Beta (Almeda, CA) sarcoma, ARC
• ARC asymptomatic HIV positive, also in combination with AZT/ddl/ddC
• Ribavirin (Costa Mesa, CA) positive, LAS, ARC
• VX-478 Vertex HIV infection, AIDS,
• Emtriva R (Emtricitabine) Gilead HIV infection
• Interleukin-2 CD4 cell counts (aldeslukin) Immune Globulin Cutter Biological Pediatric AIDS, in Intravenous (Berkeley, CA) combination w/AZT (human)
• Enkephalin (Chicago, IL) MTP-PE Ciba-Geigy Corp. Kaposi's sarcoma
• Tumor Necrosis Genentech ARC in combination Factor; TNF w/gamma Interferon
• the compounds of the disclosure herein set forth may be used in combination with HIV entry inhibitors.
• HIV entry inhibitors are discussed in DRUGS OF THE FUTURE 1999, 24(12), pp. 1355-1362; CELL, Vol. 9, pp. 243-246, Oct. 29, 1999; and DRUG DISCOVERY TODAY, Vol. 5, No. 5, May 2000, pp. 183-194 and Inhibitors of the entry of HIV into host cells. Meanwell, Nicholas A.;
• Preferred combinations are simultaneous or alternating treatments with a compound of the present disclosure and an inhibitor of HIV protease and/or a non- nucleoside inhibitor of HIV reverse transcriptase.
• An optional fourth component in the combination is a nucleoside inhibitor of HIV reverse transcriptase, such as AZT, 3TC, ddC or ddl.
• a preferred inhibitor of HIV protease is Reyataz ® (active ingredient
• Atazanavir typically a dose of 300 to 600mg is administered once a day. This may be co-administered with a low dose of Ritonavir (50 to 500mgs).
• Another preferred inhibitor of HIV protease is Kaletra .
• indinavir is the sulfate salt of N-(2(R)-hydroxy-l-(S)-indanyl)-2(R)-phenylmethyl- 4-(S)-hydroxy-5-(l-(4-(3-pyridyl-methyl)-2(S)-N'-(t-butylcarboxamido)-piperazinyl))- pentaneamide ethanolate, and is synthesized according to U.S. 5,413,999.
• Indinavir is generally administered at a dosage of 800 mg three times a day.
• Other preferred protease inhibitors are nelfinavir and ritonavir.
• HIV protease is saquinavir which is administered in a dosage of 600 or 1200 mg tid.
• Preferred non- nucleoside inhibitors of HIV reverse transcriptase include efavirenz. These combinations may have unexpected effects on limiting the spread and degree of infection of HIV.
• Preferred combinations include those with the following (1) indinavir with efavirenz, and, optionally, AZT and/or 3TC and/or ddl and/or ddC; (2) indinavir, and any of AZT and/or ddl and/or ddC and/or 3TC, in particular, indinavir and AZT and 3TC; (3) stavudine and 3TC and/or zidovudine; (4) tenofovir disoproxil fumarate salt and emtricitabine.
• the compound of the present invention and other active agents may be administered separately or in conjunction.
• the administration of one element may be prior to, concurrent to, or subsequent to the administration of other agent(s).
• the present invention comprises compounds of Formulas I, II, and III, their pharmaceutical formulations, and their use in patients suffering from or susceptible to HIV infection.
• the compounds of Formulas I, II, and III also include pharmaceutically acceptable salts thereof.
• General procedures to construct compounds of Formulas I, II, and III and intermediates useful for their synthesis are described in the following
• the synthesis starts with introduction of a suitable carboxylic acid protective group.
• Oxidation of the C-3 alcohol using standard oxidation reagents affords the C-3 ketone which is converted into the triflate by methods available to those skilled in the art.
• the ketone can be subjected to standard Suzuki couping with boronic acids; Stille coupling using tin reagents can also be used.
• Selective deprotection of the carboxylic acid in the C- 28 position allowed the preparation of the corresponding acid chloride which can be reacted with amines to afford the desired amide.
• the amines can carry a protective group that can be deprotected sequentially or simultaneously with the deprotection of the carboxylic acid.
• the C-28 amides can be prepared from the C-28 acid intermediate as shown in scheme B:
• compounds of formula II can be prepared from betulinic acid by hydrogenation of the double bond, followed by protection of the carboxylic acid with a suitable protecting group. Then oxidation of the hydroxyl group to ketone and triflate formation followed by palladium promoted cross coupling such as Suzuki or Stille coupling provide the benzoic ester intermediate. Selective deprotection of the ester in the C-28 position affords the corresponding carboxylic acid which is converted to the acid chloride and reacted with the desired amine to provide the C-28 amide. Deprotection of the benzoic ester provides the final compound.
• Some of the amides can be further modified as exemplified in the following schemes: Scheme 1
• the amine in the amide side chain can be derivatized with an alkylating reagent containing a carboxylic ester or by Michal addition to and ⁇ , ⁇ -unsaturated carboxylic ester followed by deprotection of the two carboxylic esters.
• Amides containing amines can be alkylated with an alkyl halide as shown above. Deprotection of the carboxylic esters affords the final compounds.
• Amides containing amines can be also derivatized using a Michael acceptor as shown above. Deprotection of the carboxylic esters affords the final compounds.
• a compound with an amine group can be acylated with and acid chloride or by treatment with a carboxylic acid and the appropriate coupling reagent in the presence of a base to provide an amide. Unmasking of the carboxylic acid afford the final compounds.
• the preparation of amides with a pending carboxylic amide can be done as shown above.
• the C-28 acid chloride can be treated with an amine containing a carboxylic ester.
• a compound with a hydroxyl group can be acylated with an acid chloride or by treatment with a carboxylic acid and coupling reagent in the presence of a base to provide an ester. Unmasking of the terminal carboxylic acids afford the final compounds. Amides containing an amine can be converted into the corresponding N-oxide under standard oxidation conditions.
• CDCI 3 ( ⁇ ⁇ 7.26), CD 3 OD ( ⁇ ⁇ 3.30), Acetic-d4 (Acetic Acid d 4 ) ( ⁇ ⁇ 1 1.6, 2.07), DMSOmix or DMS0-D6_CDC1 3 (( H 2.50 and 8.25) (ratio 75%:25%), and DMSO-D6 ( ⁇ ⁇ 2.50).
• Solvent A 95% Water/ 5% Methanol/ 10 mM Ammonium Acetate
• Solvent B 5% Water/ 95% Methanol/ 10 mM Ammonium Acetate
• Solvent A 90% Water/ 10% Acetonitrile/ 0.1% TFA
• Solvent B 10% Water/ 90% Acetonitrile/ 0.1% TFA
• Solvent A 95% Water/ 5% methanol/ 10 mM Ammonium Acetate
• Solvent B 5% Water/ 95% methanol/ 10 mM Ammonium Acetate
• Solvent A 95% Water/ 5% methanol/ 10 mM Ammonium Acetate
• Solvent B 5%> Water/ 95%> methanol/ 10 mM Ammonium Acetate
• Solvent A 95% Water/ 5% acetonitrile/ 10 mM Ammonium Acetate
• Solvent B 5% Water/ 95% acetonitrile/ 10 mM Ammonium Acetate
• reaction mixture was stirred for 1 hour at -78 °C. TLC indicated starting material was consumed and desired product was formed.
• the reaction mixture was quenched with brine, extracted with diethyl ether. The extracts were dried over Na 2 S0 4 , filtered and concentrated under reduced pressure. The residue was dissolved in toluene and purified by biotage 2-10% toluene/hexanes and 5-10% ethyl acetate/hexanes to provide the title compound as a white solid ( 5.0 g, 58%).
• the flask was attached to a reflux condenser, was flushed with N 2 , and was heated to reflux overnight. After heating the mixture for 14.5 h, it was cooled to rt and was diluted with water (75 mL). The mixture was extracted with ethyl acetate (3 x 75 mL) and washed with brine. The combined organic layers were dried with MgS0 4 , filtered, and concentrated under reduced pressure. The residue was adsorbed to silica gel and was purified by Biotage flash chromatography using a 0-20% ethyl acetae in hexanes gradient.
• the mixture was flushed with 2 and was heated to 60 °C. After 2 h, the reaction was cooled to rt, was filtered through a pad of celite and silica gel to remove the solids which were washed with 25% EtOAc in hexanes. The filtrate was concentrated under reduced pressure and was treated with 20 mL of acetic acid, 10 mL of THF and 3 mL of water.
• the C-28 amide formed above was dissolved in 1,4-dioxane and either aq. IN or 10 N NaOH was added to the mixture and it was heated to 50-85 °C. After heating for 2- 24 h, the mixture was cooled to rt.
• the crude mixture was either purified by prep HPLC or was made acidic by dropwise addition of IN HCL and the final product was crystallized from dioxane/water or dioxane/methanol/water.
• the deprotection can be carried out as follows: The C-28 amide formed above was dissolved in 1,4-dioxane. To the solution was added water (4: 1 dioxane: water or 5: 1 dioxane: water) followed by LiOH-I3 ⁇ 40 (5-12 equiv.). The mixture was heated to 50-85 °C. After heating for 2-24 h, the mixture was cooled to rt. The crude mixture was either purified by prep HPLC or was made acidic by dropwise addition of IN HCL and the final product was crystallized from dioxane/water or
• the title compound was prepared following the general procedures described above for the C-28 amide formation and hydrolysis using 4-N-(2-aminoethyl)-l-N-Boc- piperazine as the reactant amine.
• the product was isolated as a white solid (69 mg, 56 %).
• the title compound was prepared following the general procedures described above for the C-28 amide formation and hydrolysis using l-(2-aminoethyl)pyrrolidin-2- one as the reactant amine.
• the product was isolated as a white solid (52 mg, 45 %).
• the title compound was prepared following the method described above for the general procedure for C-28 amide formation using beta-alanine, ethyl ester hydrochloride as the reactant amine.
• the resulting ethyl ester was hydrolyzed using 4 equiv. of IN NaOH and 1,4-dioxane as the solvent at rt. After 1.5h the mixture was acidified with IN HC1 and was extracted with dichloromethane (3 x 20 mL). The organic layers were combined, dried with a2S0 4 , filtered, and concentrated under reduced pressure.
• the mixture was heated to 85 °C for 15 h then was cooled to rt.
• the mixture was diluted with 5 mL of IN HCl and was extracted with dichloromethane (4 x 5 mL).
• the combined organic layers were dried with Na 2 S0 4 , the drying agent was removed by filtration and the filtrate was concentrated under reduced pressure.
• the residue was purified by Biotage flash chromatography using a 0-10% MeOH in dichloromethane gradient with 0.1% HOAc added to the mixture.
• the compound was further purified by prep HPLC. The fractions containing the expected product were combined and concentrated under reduced pressure to give the title compound (41.5 mg, 0.056 mmol, 74.3 % yield) as a white solid.
• the mixture was flushed with 2 and was put on the Parr shaker under 30 psi 3 ⁇ 4. After 2 h, the reaction was checked by X H NMR. The benzyl group had been removed, but the alkene still remained. The mixture was again flushed with N 2 . An additional 50 mg of 10% Pd/C was added and the mixture was pressurized to 40 psi H 2 . After stirring the mixture overnight, it reaction was removed from the Parr shaker and the palladium catalyst was removed by filtration.
• Example 54 Preparation of 4-((lS,3aS,5aR,5bR,7aS,9S,l laS,l lbR,13aR,13bR)-l-isopropyl- 5a,5b,8,8, 11 a-pentamethyl-3a-(2-(pyridin-2-yl)ethylcarbamoyl)icosahydro- 1H- cyclopenta[a]chrysen-9-yl)benzoic acid.
• dichloromethane (2 mL) was added (lR,3aS,5aR,5bR,7aR, l laR, l lbR, 13aR, 13bR)- 5a,5b,8,8, l la-pentamethyl-9-oxo-l-(prop-l-en-2-yl)icosahydro-lH- cyclopenta[a]chrysene-3a-carbonyl chloride (200 mg, 0.423 mmol). The reaction mixture was stirred for 16 h. LCMS indicated the formation of desired product. The reaction mixture was concentrated under reduced pressure.
• the title compound was prepared following the method described above for (lR,3aS,5aR,5bR,7aR, 1 laR, 1 IbR, 13aR, 13bR)-N-(2-(dimethylamino)ethyl)- 5a,5b,8,8,l la-pentamethyl-9-oxo-l-(prop-l-en-2-yl)icosahydro-lH- cyclopenta[a]chrysene-3a-carboxamide using l, l-diisopropylethane-l,2-diamine as the reactant amine.
• the product was isolated as a white solid (150 mg, 64%).
• the title compound was prepared following the general procedures described above for the C-28 amide formation and hydrolysis using l, l-diisopropylethane-l,2- diamine as the reactant amine.
• the product was isolated as a white solid (19 mg, 31%).

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