Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07K—PEPTIDES
  • C07K7/00—Peptides having 5 to 20 amino acids in a fully defined sequence; Derivatives thereof
  • C07K7/64—Cyclic peptides containing only normal peptide links
  • C07K7/645—Cyclosporins; Related peptides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
  • A61P27/02—Ophthalmic agents
• • 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
  • A61P37/08—Antiallergic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K38/00—Medicinal preparations containing peptides

Definitions

• the present invention relates to novel cyclosporin analogs, processes for preparing them, pharmaceutical compositions containing them, and methods for using these analogs and the compositions containing them for the treatment of medical conditions, including but not limited to ocular conditions such as dry eye.
• Cyclosporins are a class of poly-N-methylated cyclic undecapeptides.
• the first cyclosporin to be isolated was cyclosporin A (CAS Registry Number: 59865-13-3), a naturally occurring fungal metabolite having the following structure:
• Cyclosporin A As shown by the structure above, Cyclosporin A consists of 11 amino acids and can be further represented as follows:
• MeBmt is (4R)-4-[(E)-2-butenyl]-4-methyl-L-threonine;
• aAbu is L-a-aminobutyric acid
• Sar is sarcosine
• MeLeu is N-methyl-L-leucine
• Val is L-valine
• Ala is L-alanine
• DAla is D-alanine
• MeVal is N-methyl-L- valine.
• MeBMT is the amino acid at position 1; sarcosine, the amino acid at position 3.
• the description herein may refer to the amino acid side chain at any one of positions 1-11.
• the carbon to which the amino acid side chain is attached is referred to as the alpha (a) carbon.
• Cyclosporin A is best known for its immunosuppressive properties and is commonly prescribed for use in patients that have undergone bone marrow or organ transplantation.
• the present invention relates to the discovery of water-soluble analogs of cyclosporin A that are potent inhibitors of cyclophilin.
• R 1 is -H, -Ci_ 6 alkyl, -OCi_ 6 alkyl, -CH 2 F, -CH 2 OCH 3 , -SCi_ 6 alkyl, -CH 3 , -CH 2 CH 3 , -SCH(CH 3 ) 2 , -CH 2 OH, -SCH 3 , -OCH 3 , -R 13 R 14 ,
• R 2 is -CH 3 , -CH 2 CH 3 , or -CH 2 CH 2 CH 3 ;
• R 3 is -CH 2 CH(CH 3 ) 2 , -CH(CH 3 ) 2 , -CH 2 C(CH 3 ) 2 (OH), -CH(CH 3 )(CH 2 CH 3 ), or -CH 2 CH(R 7 )(CH 2 CH 3 );
• R 4 is -CH 3 , or -CH 2 OH;
• R 6 is -CH 2 C3 ⁇ 4, -CH(CH 3 )(OH), -CH(CH 3 ) 2 , or -CH 2 CH 2 CH 3 ;
• R 7 is OCi_5 alkyl;
• R 8 is O, S, CH 2 0, CH 2 S, or CH 2 ;
• R 9 is -H, -Ci_5 alkyl, -C 2 _ 4 fluoroalkyl, -C 1-5 alkyl-heterocycle, cyanoalkyl,
• R is -H, -Ci_5 alkyl, -C 2 - 4 fluoroalkyl, -C 1-5 alkyl-heterocycle, cyanoalkyl,
• R 11 is O, NR 12 , S(0) q , CF 2 , Ci_ 5 alkylene, CH(OC 6 alkyl), divalent C 3 _ 8 cycloalkyl, divalent heterocycle, carbonyl, or taken together with R 9 , R 10 , and the N to which R 9 and R 10 are attached forms a heterocycle;
• R 12 is H, CH 3 , or Ci_ 5 alkyl
• R 13 is O, S, CH 2 0, CH 2 S, CH 2 SO, or CH 2 S0 2 ;
• the invention provides for a compound having Formula I, wherein:
• R 1 is -H, -Ci_ 6 alkyl, -OCi_ 6 alkyl, -CH 2 F, -CH 2 OCH 3 , -SCi_ 6 alkyl, -CH 3 , -CH 2 CH 3 , -SCH(CH 3 ) 2 , -CH 2 OH, -SCH 3 , -OCH 3 , -R 13 R 14 ,
• R 2 is -CH 3 , -CH 2 CH 3 , or -CH 2 CH 2 CH 3 ;
• R 3 is -CH 2 CH(CH 3 ) 2 , -CH(CH 3 ) 2 , -CH 2 C(CH 3 ) 2 (OH), -CH(CH 3 )(CH 2 CH ), or -CH 2 CH(R 7 )(CH 2 CH 3 );
• R 4 is -CH 3 , or -CH 2 OH;
• R 6 is -CH 2 CH 3 , -CH(CH 3 )(OH), -CH(CH 3 ) 2 , or -CH 2 CH 2 CH 3 ;
• R 7 is OCi_5 alkyl;
• R 8 is O, S, CH 2 0, CH 2 S, or CH 2 ;
• R 9 is -H, -Ci-5 alkyl,
• R 10 is -H, -Ci_5 alkyl
• R 11 is O, NR 12 , S(0) q , Ci_ 5 alkylene, divalent C 3 _ 8 cycloalkyl, divalent heterocycle, carbonyl, or taken together with R 9 , R 10 , and the N to which R 9 and R 10 are attached forms a heterocycle ;
• R 12 is H, CH 3 , or Ci_ 5 alkyl
• R 13 is O, S, CH 2 0, CH 2 S, CH 2 SO, or CH 2 S0 2 ;
• R 14 is H, Ci_ 6 alkyl, C 2 _ 6 alkenyl, C 2 _ 6 alkynyl, C 3 _ 8 cycloalkyl, CH 2 CH 2 N(CH 2 CH 3 ) 2 ,
• a compound having Formula I according to any of the embodiments set forth above may further include the proviso that when R 2 is -CH 3 , and R 3 is -CH 2 CH(CH 3 ) 2 , and R 4 is -CH 3 , and R 6 is -CH 2 CH 3 , then the group
• the invention provides a compound having Formula I, wherein R 1 is not hydrogen (H).
• the invention provides a compound having Formula I, wherein R 6 is -CH 2 CH 3 . In another embodiment the invention provides a compound having Formula I, wherein R 6 is -CH(CH 3 )(OH).
• the invention provides a compound having Formula I, wherein R 6 is -CH(CH 3 ) 2 .
• the invention provides a compound having Formula I, wherein R 6 is -CH 2 CH 2 CH 3 .
• the invention provides a compound having Formula I, wherein R 2 is -CH 3 or -CH 2 CH 3 ; R 3 is -CH 2 CH(CH 3 ) 2 , -CH(CH 3 ) 2, or - CH 2 C(CH 3 ) 2 (OH); R 4 is -CH 3 ; R 6 is -CH 2 CH 3 ; and R 8 is CH 2 .
• the invention provides a compound having Formula I, wherein R 2 is -CH 3 ; R 3 is -CH 2 CH(CH 3 ) 2 ; R 4 is -CH 3 ; R 6 is -CH 2 CH 3 ; and R 8 is CH 2 .
• the invention provides a compound having Formula I, wherein R 1 is -CH 3, -CH 2 CH 3, or -SCH 3 ; R 2 is -CH 3 ; R 3 is -CH 2 CH(CH 3 ) 2 ; R 4 is -CH 3 ; R 6 is -CH 2 CH 3 ; and R 8 is CH 2 .
• the invention provides a compound having Formula I, wherein R 2 is -CH 3 , R 3 is -CH 2 CH(CH 3 ) 2 , R 4 is -CH 3 , R 6 is -CH 2 CH 3 , and R 8 is CH 2 .
• the invention provides a compound having Formula I, wherein R 2 is -CH 3 , R 3 is -CH 2 CH(CH 3 ) 2 , R 4 is -CH 3 , R 6 is -CH 2 CH 3 , and R 8 is CH 2 0.
• the invention provides a compound having Formula I, wherein R 2 is -CH 3 , R 3 is -CH 2 CH(CH 3 ) 2 , R 4 is -CH 3 , R 6 is -CH(CH 3 ) 2 , and R 8 is CH 2 .
• the invention provides a compound having Formula I, wherein R 1 is -CH 3 and R 6 is -CH 2 CH 3 .
• R 9 and R 10 taken together form wherein " " represents the point of attachment to R 5 .
• R 2 is -CH 3
• R 3 is -CH 2 CH(CH 3 ) 2
• R 4 is -CH 3
• R 6 is - CH 2 CH 3 .
• R 5 is -CH 2 , -CH 2 CH 2 - -CH 2 CH 2 CH 2 -, or -
• R 5 is -CH 2 OCH 2 CH 2 -, for example.
• Non-limiting examples of R 11 include O, NCH 3 , NH, S0 2 , S, CH 2 , CF 2 , and
• Ci_6alkyl-heterocycle examples include -CH 2 Pyrid-2-yl, - CH 2 Pyrid-3-yl, -CH 2 Pyrimidin-2-yl, -CH 2 Pyrazin-2-yl, -CH 2 -3-Me-Imidazol-4-yl, -CH 2 - 2-Me-Pyrazol-3-yl, -CH 2 Pyrid-4-yl, -CH 2 -l-Me-Pyrazol-4-yl, and -CH 2 -l-Me-3-CF 3 - Pyrazol-5-yl.
• a non-limiting example of a cyanoalkyl includes -CH 2 CH(CH 3 )CN.
• R 9 , R 10 , R 11 , and the N to which R 9 and R 10 are attached taken together form a heterocycle.
• the heterocycle is a non-aromatic heterocycle.
• the heterocycle is an aromatic heterocycle.
• the R 9 and R 10 heterocycle, or the heterocycle formed from R 9 , R 10 , and the N to which R 9 and R 10 are attached is independently selected from the group consisting of piperidyl, pyrrolidinyl, piperazinyl, morpholinyl, thiomorpholmyl, thiazolidinyl, 1 ,4-dioxanyl, tetrahydro furanyl, tetrahydrothiophenyl, lactam, lactone, pyridyl, pyrazinyl, furanyl, thienyl, pyrimidinyl, pyridone (including N-substituted pyridones), isoxazolyl, isothiazolyl, oxazolyl, thiazolyl, pyrazolyl, furazanyl, pyrrolyl, pyrazolyl, triazolyl, 1,2,4-thiadiazolyl, pyraziny
• the heterocycle formed by R 9 , R 10 , R 11 , and the N to which R 9 and R 10 are attached taken together may be optionally substituted by an alkyl, halogen, or haloalkyl.
• a haloalkyl is -CF 3 .
• one or more hydrogen atoms on the heterocycle is replaced with fluorine (F).
• the fluorinated heterocycle is a saturated, non-aromatic heterocycle.
• the fluorinated heterocycle is
• the compound having Formula I is any one of those listed in Tables 1-27. Accordingly, non-limiting examples of a compound according to the present invention include any of the compounds listed in Tables 1-27.
• the present invention also provides for a pharmaceutical composition comprising or consisting of a therapeutically effective amount of a compound having Formula I and a pharmaceutially acceptable excipient.
• R 1 -CH 3
• R 2 - CH 3
• 3 — CH 2 CH(CH 3 ) 2
• R 4 — CH 3
• R 6 — CH 2 CH 3
• R 8 CH 2
• R 9 — H
• Another embodiment is a compound having Formula I, wherein R 1
• R 3 -CH 2 CH(CH 3 ) 2
• R 4 -CH 3
• R 6 -CH 2 CH 3
• R 8 CH 2
• n 1
• m 1
• p 1
• q 2
• R 11 is S(0) q
• R 9 , R 10 , R 11 , and the N to which R 9 and R 10 are attached taken together form:
• R 9 , R 10 , R 11 , and the N to which R 9 and R 10 are attached taken together form:
• Compounds of the present invention include but are not limited to the following:
• the excipient can be an ophthalmically acceptable excipient.
• the pharmaceutical composition can be in the form of a liquid, solid, or emulsion.
• the pharmaceutical compositions can be in the form of an aqueous solution.
• a compound of Formula I can be in a purified form.
• the purified form is the form obtained from medium pressure liquid chromatography (MPLC).
• the present invention includes pharmaceutically acceptable salts of any compound having Formula I.
• pharmaceutically acceptable salts refers to salts or complexes that retain the desired biological activity of the compound of Formula I and exhibit minimal or no undesired toxicological effects to the patient, animal, or cell system to which they are administered.
• pharmaceutically acceptable salts according to the invention include therapeutically active non-toxic base or acid salt forms of Formula I.
• the acid addition salt form of a compound of Formula I that occurs in its free form as a base can be obtained by treating the free base with an appropriate acid such as an inorganic acid, for example, hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid and the like; or an organic acid such as for example, acetic acid, hydroxyacetic acid, propanoic acid, lactic acid, pyruvic acid, malonic acid, fumaric acid, maleic acid, oxalic acid, tartaric acid, succinic acid, malic acid, ascorbic acid, benzoic acid, tannic acid, pamoic acid, citric acid, methylsulfonic acid, ethanesulfonic acid, benzenesulfonic acid, or formic acid and the like (Handbook of Pharmaceutical Salts, P.Heinrich Stahal& Camille G.
• an appropriate acid such as an inorganic acid, for example, hydrochloric acid, hydrobromic acid, sulfur
• the base addition salt form of a compound of Formula I that occurs in its free form as an acid can be obtained by treating the acid with an appropriate base such as an inorganic base, for example, sodium hydroxide, magnesium hydroxide, potassium hydroxide, calcium hydroxide, ammonia and the like; or an organic base such as for example, L-arginine, ethanolamine, betaine, benzathine, morpholine and the like.
• an appropriate base such as an inorganic base, for example, sodium hydroxide, magnesium hydroxide, potassium hydroxide, calcium hydroxide, ammonia and the like
• an organic base such as for example, L-arginine, ethanolamine, betaine, benzathine, morpholine and the like.
• the present invention further concerns the use of a compound of Formula I, or a pharmaceutically acceptable salt thereof, for the manufacture of a pharmaceutical composition.
• the present invention further encompasses a method for treating a medical condition in a patient in need thereof, the method comprising administering to the patient a therapeutically effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof.
• the medical condition is selected from the group consisting of dry eye, dry eye disease, ocular surface inflammation, blepharitis, meibomian gland disease, allergic conjunctivitis, pterygia, ocular symptoms of graft versus host disease, ocular allergy, atopic keratoconjunctivitis, vernal
• keratoconjunctivitis uveitis, anterior uveitis, Behcet's disease, Stevens Johnson syndrome, ocular cicatricial pemphigoid, chronic ocular surface inflammation caused by viral infection, herpes simplex keratitis, adenoviral keratoconjunctivitis, ocular rosacea, or Pinguecula.
• Another embodiment is a method for reducing corneal transplant rejection in a patient in need thereof, the method comprising administering to the patient a
• Another embodiment is a method for reducing inflammation of the eye caused by an ocular surgery, the method comprising administering to the eye(s) of a patient who has received ocular surgery a therapeutically effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof.
• Another embodiment is a method for treating dry eye in a patient in need thereof, the method comprising administering to the eye(s) of the patient a therapeutically effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof.
• Another embodiment is a method for increasing tear production in a patient whose tear production is suppressed or presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca, the method comprising administering to the eye(s) of the patient a therapeutically effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof.
• Another embodiment is a method for reducing or preventing an ocular condition in a patient, the method comprising administering a therapeutically effective amount of a compound of Formula I to the patient.
• the ocular condition is selected from the group consisting of dry eye, ocular surface inflammation, blepharitis, meibomian gland disease, allergic conjunctivitis, pterygia, ocular symptoms of graft versus host disease, ocular allergy, atopic keratoconjunctivitis, vernal keratoconjunctivitis, uveitis, anterior uveitis, ocular cicatricial pemphigoid, chronic ocular surface inflammation caused by viral infection, herpes simplex keratitis, adenoviral keratoconjunctivitis, ocular rosacea, and Pinguecula.
• a compound of Formula I may be administered in the form of a pharmaceutical composition, topically, orally, systemically, or by other suitable routes.
• R 1 is -H, -Ci_ 6 alkyl, -OCi_ 6 alkyl, -CH 2 F, -CH 2 OCH 3 , -SCi_ 6 alkyl, -CH 3 , -CH 2 CH 3
• R is -CH 3 , -CH 2 CH 3 , or -CH 2 CH 2 CH 3 ;
• R 3 is -CH 2 CH(CH 3 ) 2 , -CH(CH 3 ) 2 , -CH 2 C(CH 3 ) 2 (OH), -CH(CH 3 )(CH 2 CH 3 ), or -CH 2 CH(R 7 )(CH 2 CH 3 );
• R 4 is -CH 3 or -CH 2 OH
• R 6 is -CH 2 CH 3 , -CH(CH 3 )(OH), -CH(CH 3 ) 2 , or -CH 2 CH 2 CH 3 ;
• R 7 is OCi_5 alkyl;
• R 8 is O, S, CH 2 0, CH 2 S, or CH 2 ;
• R 9 is -H, -Ci_5 alkyl,
• C3_ 8 Cycloalkyl, heterocycle, aryl, or cycloalkenyl, or taken together with R 11 , R 10 , and the N to which R 9 and R 10 are attached forms a heterocycle;
• R 1U is -H, -Ci_5 alkyl,
• R 12 is H, CH 3 , or Ci_ 5 alkyl
• R 13 is O, S, CH 2 0, CH 2 S, CH 2 SO, or CH 2 S0 2 ;
• R 14 is H, Ci_ 6 alkyl, C 2 _ 6 alkenyl, C 2 _ 6 alkynyl, C 3 _ 8 cycloalkyl, CH 2 CH 2 N(CH 2 CH 3 ) 2 ,
• a compound according to embodiment 1, wherein when R 1 is H, then m 0 and R 9 , R 10 , R 11 , and the N to which R 9 and R 10 are attached together form a heterocycle. 5.
• R 2 is -CH 3 or -CH 2 CH 3 ;
• R 3 is - CH 2 CH(CH 3 ) 2 , -CH(CH 3 ) 2, or -CH 2 C(CH 3 ) 2 (OH);
• R 4 is -CH 3 ;
• R 6 is -CH 2 CH 3 ; and R 8 is CH 2 .
• R 4 is -CH 3 ;
• R 6 is -CH 2 CH 3 ; and
• R 8 is CH 2 .
• R 1 is -CH 3, -CH 2 CH 3, or -SCH 3 ;
• R 2 is -CH 3 ;
• R 3 is -CH 2 CH(CH 3 ) 2 ;
• R 4 is -CH 3 ;
• R 6 is -CH 2 CH 3 ; and
• R 8 is CH 2 .
• a pharmaceutical composition comprising as active ingredient a therapeutically
• composition of embodiment 10, wherein the composition is in the form of an aqueous solution.
• composition of embodiment 11, wherein the composition is acceptable for administration to the eye(s) of a mammal.
• a method of treating a medical condition in a patient in need thereof comprising administering to the patient a therapeutically effective amount of a compound, or a pharmaceutically acceptable salt thereof, according to any one of embodiments 1-8.
• the patient is a human patient.
• the medical condition is dry eye, dry eye disease, ocular surface inflammation, blepharitis, meibomian gland disease, allergic conjunctivitis, pterygia, ocular symptoms of graft versus host disease, ocular allergy, atopic keratoconjunctivitis, vernal keratoconjunctivitis, uveitis, anterior uveitis, Behcet's disease, Steven Johnson syndrome, ocular cicatricial pemphigoid, chronic ocular surface inflammation caused by viral infection, herpes simplex keratitis, adenoviral keratoconjunctivitis, ocular rosacea, or Pinguecula.
• a method for reducing corneal transplant rejection in a patient in need thereof comprising administering to the patient a therapeutically effective amount of a compound, or a pharmaceutically acceptable salt thereof, according to any one of embodiments 1-8.
• a method for reducing inflammation of the eye caused by an ocular surgery comprising administering to the eye(s) of a patient who has received ocular surgery a therapeutically effective amount of a compound, or a pharmaceutically acceptable salt thereof, according to any one of embodiments 1-8.
• a method for treating dry eye in a patient in need thereof comprising administering to the eye(s) of the patient a therapeutically effective amount of a compound, or a pharmaceutically acceptable salt thereof, according to any one of embodiments 1-8.
• the method comprising administering to the eye(s) of the patient a therapeutically effective amount of a compound according to any one of embodiments 1-8, or a pharmaceutically acceptable salt thereof.
• the present invention further includes a method for making a compound having the
• the method comprising a) adding 10% palladium on carbon to a solution comprising
• step c) filtering the mixture from step b through a filter and collecting the filtrate;
• step c washing the filter used in step c and collecting the filtrate together with the filtrate from step c;
• P is and the filter comprises celite.
• washing the filter used in step c comprises washing the filter with ethyle acetate.
• a "patient in need in need of treatment” or “patient in need thereof refers to a human or non-human mammal afflicted with a medical condition, as specified in context.
• a non-human mammal include a horse, pig, monkey, dog, rabbit, guinea pig, rat, or mouse.
• a “therapeutically effective amount” refers to the amount of a compound sufficient to reduce the severity of one or more symptoms associated with, accompanying, or resulting from a medical condition affecting a subject.
• "Treating” and “to treat” refers to relieving or reducing at least one symptom associated with or accompanying a medical condition. For example, treatment of dry eye and relief of inflammation of the ocular surface, as may occur in an individual suffering from dry eye, may be observed or experienced as an improvement in vision, and/or as a reduction in swelling, pain, redness, dryness, scratchiness, grittiness, foreign body sensation, stinging, burning, or itching.
• Treating an inflammation of the ocular surface or ocular surface adnexa may improve the visual performance and the optical quality of the eye. Improvement in visual performance may include improved optical quality, improved tear film production, secretion, quality, and/or stability, reduced blurring, improved central and/or peripheral field vision, improved visual performance, acuity, or perception, and/or reduced blinking frequency.
• the symptom(s) positively affected by the treatment will depend on the particular condition.
• inflammation refers to the biological response of the living body to injury or other harmful insults. Symptoms of "an inflammation at the ocular surface” can include redness, swelling, heat, pain, and/or loss of function of glands or tissue in the ocular surface or ocular surface adnexa. Other symptoms may include sensations of (and lead a patient to complain of) dryness, burning, itching, or scratchiness. A subject may report a feeling of dust, dirt, sand, or gravel in the eye.
• a “Medical condition” refers to a deviation from or interruption of the normal structure or function of any body part, tissue, organ, or system and that is characterized by an identifiable group of signs or symptoms whose etiology, pathology, and prognosis may be known or unknown.
• a medical condition of a body part, tissue, organ, or system of a human or non-human mammal may result from various causes, including but not limited to injury, surgical trauma, infection, nutritional deficiency, genetic defect, exposure to toxins or radiation, and environmental stress. Medical conditions include ocular conditions such as, for example, inflammation of the ocular surface, and dry eye; and dermatological conditions such as an inflammation of the skin.
• an "ocular condition” is a disease, ailment or condition which affects or involves the eye or one or more parts or regions of the eye.
• Opt surface condition refers to a medical condition that affects or involves one or more parts, regions, or tissues of the ocular surface.
• An ocular surface condition can be an inflammation of an ocular surface tissue, and includes an acute, chronic, and surgically- induced inflammation of an ocular surface tissue.
• optical surface refers to the cornea, the corneal epithelium, the conjunctiva (palpebral, bulbar, and forniceal), the conjunctival blood vessels, Tenon's capsule, the sclera, and the limbus.
• ocular surface adnexa refers to structures in close proximity to the ocular surface, including the lacrimal gland, the eye lids, eyelashes, and eyebrows, the orbital wall, the periocular or extraocular muscles, and the meibomian glands.
• the "eye” is the sense organ for sight, and includes the eyeball, or globe, the orbital sense organ that receives light and transmits visual information to the central nervous system.
• the eye includes the eyeball and the tissues and fluids which constitute the eyeball, the periocular muscles (such as the oblique and rectus muscles) and the portion of the optic nerve which is within or adjacent to the eyeball.
• the "eye lids” are the structures covering the front of the eye that protect it, limit the amount of light entering the pupil, and help distribute tear film over the exposed corneal surface.
• alkyl refers to saturated monovalent or divalent hydrocarbon moieties having linear or branched moieties or combinations thereof and containing 1 to 6 carbon atoms.
• One methylene (-CH 2 -) group, of the alkyl can be replaced by oxygen, sulfur, sulfoxide, nitrogen, carbonyl, carboxyl, sulfonyl, amide, sulfonamide, by a divalent C 3 _ 6 cycloalkyl, by a divalent heterocycle, or by a divalent aryl group.
• Alkyl groups can be independently substituted by halogen, hydroxyl, cycloalkyl, amine groups, heterocyclic groups, carboxylic acid groups, phosphonic acid groups, sulphonic acid groups, phosphoric acid groups, nitro groups, amide groups, or sulfonamides groups.
• suitable alkyl groups include methyl (-CH 3 ), ethyl (-CH 2 CH 3 ), n- propyl (-CH 2 CH 2 CH 3 ), isopropyl (-CH(CH 3 ) 2 ), and t-butyl (-C(CH 3 ) 3 ).
• alkylene is a divalent alkyl.
• alkylene include methylene, ethylene (-CH 2 CH 2 -), and n- propylene (-CH 2 CH 2 CH 2 -).
• cycloalkyl refers to a monovalent or divalent group of 3 to 8 carbon atoms derived from a saturated cyclic hydrocarbon. Cycloalkyl groups can be monocyclic or polycyclic. Cycloalkyl can be independently substituted by halogen, nitro groups, cyano groups, -OCi_ 6 alkyl groups, -SCi_ 6 alkyl groups, -C 1-6 alkyl groups, -C 2 _ 6 alkenyl groups, - C 2 _ 6 alkynyl groups , C 3 _g cycloalkyl groups, carboxylic acid groups, ester groups, ketone groups, aldehyde groups, amide groups, amine groups, sulfonamide groups or hydroxyl groups.
• cycloalkenyl refers to a monovalent or divalent group of
• Cycloalkenyl groups can be monocyclic or polycyclic. Cycloalkenyl groups can be independently substituted by halogennitro groups, cyano groups, -OCi_ 6 alkyl groups, - SCi_6 alkyl groups, -C 1-6 alkyl groups, -C 2 _ 6 alkenyl groups, -C 2 _ 6 alkynyl groups , carboxylic acid groups, ester groups, ketone groups, aldehyde groups, amide groups, amine groups, sulfonamide groups, C 3 _g cycloalkyl groups or hydroxyl groups.
• halogen refers to an atom of chlorine, bromine, fluorine, iodine.
• haloalkyl refers to an alkyl in which one or more hydrogen atoms on the alkyl have been replaced with a halogen atom.
• Non-limiting examples of a haloalkyl include fluoroalkyls such as -CF 3 and -CH 2 CH 2 CF 3 .
• heterocycle refers to a 3 to 10 membered ring, which can be aromatic or non-aromatic, monvalent or divalent, saturated or unsaturated, containing at least one heteroatom selected form O or N or S or combinations of at least two thereof, interrupting the carbocyclic ring structure.
• Heterocycles can be monocyclic or polycyclic.
• a heterocyle can be bicyclic.
• the rings in a bicyclic or polycyclic heterocycle can be fused or non-fused.
• Heterocyclic ring moieties can be substituted by halogen, nitro groups, cyano groups,
• -OCi_6 alkyl groups -SCi_ 6 alkyl groups, -C 1-6 alkyl groups, -C 2 _ 6 alkenyl groups, -C 2 _ 6 alkynyl groups, carboxylic acid groups, ester groups, ketone groups, aldehyde groups, amide groups, amine groups, sulfonamide groups, C 3 _g cycloalkyl groups, or hydroxyl groups.
• alkenyl refers to a monovalent or divalent hydrocarbon radical having 2 to 6 carbon atoms, derived from a saturated alkyl, having at least one double bond.
• a C 2 _ 6 alkenyl can be in the E or Z configuration.
• Alkenyl groups can be substituted by Ci_ 3 alkyl, as defined above, or by halogen.
• alkynyl refers to a monovalent or divalent hydrocarbon radical having 2 to 6 carbon atoms, derived from a saturated alkyl, having at least one triple bond.
• Alkynyl groups can be substituted by Ci_ 3 alkyl, as defined above, or by halogen.
• aryl refers to an organic moiety derived from an aromatic hydrocarbon consisting of a ring containing 6 to 10 carbon atoms by removal of one hydrogen, which can be substituted by halogen, nitro groups, cyano groups, -OCi_ 6 alkyl groups, -SCi_ 6 alkyl groups, -Ci_ 6 alkyl groups, -C 2 _ 6 alkenyl groups, - C 2 _ 6 alkynyl groups , carboxylic acid groups, ester groups, ketone groups, aldehyde groups, amide groups, amine groups, sulfonamide groups, C 3 _g cycloalkyl groups or hydroxyl groups.
• a non-limiting example of an aryl is phenyl.
• Preferred substitution site on aryl are the meta and the para positions. Most preferred substitution sites on aryl are the para positions.
• the term "ketone" as used herein, represents an organic compound having a carbonyl group linked to a carbon atom such as -(CO)R x wherein R x can be alkyl, aryl, cycloalkyl, cycloalkenyl, heterocycle as defined herein.
• aldehyde represents a group of formula -C(0)H.
• ester represents a group of formula -C(0)OR x , wherein
• R x can be alkyl, aryl, cycloalkyl, cycloalkenyl, heterocycle as defined herein.
• hydroxyl as used herein, represents a group of formula -OH.
• carboxyl as used herein, represents a group of formula -C(0)0-.
• sulfate represents a group of formula -0-S(0) 2 -0-.
• nitro represents a group of formula -N0 2 .
• cyano as used herein, represents a group of formula -CN.
• phosphonic acid as used herein, represents a group of formula - P(0)(OH) 2 .
• phosphoric acid as used herein, represents a group of formula - OP(0)(OH) 2 .
• amide represents a group of formula -C(0)NR x R y , wherein R x and R y can be the same or independently H, alkyl, aryl, cycloalkyl, cycloalkenyl, or heterocycle, as defined above.
• amine represents a group of formula -NR x R y ,wherein R x and R y can be the same or independently H, alkyl, aryl, cycloalkyl, cycloalkenyl, or heterocycle as defined above.
• sulfonamide represents a group of formula -S(0) 2 NR x R y wherein R x and R y can be the same or independently H, alkyl, aryl, cycloalkyl, cycloalkenyl, heterocycle as defined above.
• sulfoxide as used herein, represents a group of formula -S(O)-.
• sulphonic acid represents a group of formula -S(0) 2 OH.
• N represents a nitrogen atom
• morpholinyl as used herein represents a group of formula
• N-methylpiperazinyl as used herein represents a group of formula
• substituted means that one or more hydrogens on the designated atom is replaced with a selection from the indicated group, provided that the designated atom's normal valency under the existing circumstances is not exceeded, and that the substitution results in a stable compound.
• purified refers to the physical state of said compound after being isolated from a synthetic process (e.g. from a reaction mixture), or natural source or combination thereof.
• purified refers to the physical state of said compound after being obtained from a purification process or processes described herein or well known to the skilled artisan (e.g., chromatography, recrystallization and the like) in sufficient purity to be
• any carbon as well as heteroatom with unsatisfied valences in the text, schemes, examples and Tables herein is assumed to have the sufficient number of hydrogen atom(s) to satisfy the valences. And any one or more of these hydrogen atoms can be deuterium.
• a functional group in a compound is termed "protected”, this means that the group is in modified form to preclude undesired side reactions at the protected site when the compound is subjected to a reaction. Suitable protecting groups will be recognized by those with ordinary skill in the art and in standard textbooks such as, for example, T. W. Greene et al, Protective Groups in organic Synthesis (1981), Wiley, New York.
• the present invention is directed in part to pharmaceutical compositions comprising a compound having Formula I.
• a pharmaceutical composition comprising a compound of Formula I may be useful for treating dry eye, dry eye disease (i.e., keratoconjunctivitis sicca), ocular surface inflammation (i.e, inflammation of the ocular surface), blepharitis, meibomian gland disease, allergic conjunctivitis, pterygia, ocular symptoms of graft versus host disease, ocular allergy, atopic keratoconjunctivitis, vernal keratoconjunctivitis, uveitis, anterior uveitis, Behcet's disease, Stevens Johnson syndrome, ocular cicatricial pemphigoid, chronic ocular surface inflammation caused by viral infection, herpes simplex keratitis, adenoviral keratoconjunctivitis, ocular rosacea, and pmguecula, and to prevent or reduce the risk of corneal transplant rejection in a patient or subject in need thereof. Additionally, one embodiment of
• compositions of the invention may be useful for treating an inflammation of the ocular anterior segment of the eye. More specifically, the
• compositions of the invention may be useful for treating an inflammation of the ocular surface or ocular surface adnexa.
• compositions comprising a compound of Formula I may be useful for reducing one or symptoms associated with an inflammatory
• dermatological condition One example of an inflammatory dermatological condition that may be subject to treatment is psoriasis. Additionally, a pharmaceutical composition comprising a compound of Formula I may be useful for treating a viral infection.
• viral infections may include Hepatitis C infection and Hepatitis B infection.
• one embodiment is a method for reducing one or more or symptoms associated with an inflammatory dermatological condition in a patient in need thereof, comprising administering a pharmaceutical composition comprising a compound of Formula I to the patient.
• Another embodiment is a method for reducing or preventing an inflammatory dermatological condition in a patient, comprising administering a therapeutically effective amount of a compound of Formula I to the patient.
• the method may reduce one or more signs or symptoms of the inflammatory dermatological condition.
• an inflammatory dermatological condition is psoriasis.
• Another embodiment is a method for treating an inflammation of the skin in a patient in need thereof comprising administering a pharmaceutical composition comprising a compound of Formula I to the patient.
• Another embodiment is a method for reducing an inflammation of the skin in a patient, comprising administering a therapeutically effective amount of a compound of Formula I to the patient.
• Another embodiment is a method for treating a viral infection in a patient in need thereof, comprising administering a pharmaceutical composition comprising a compound of Formula I to the patient.
• Another embodiment is a method for reducing one or more signs or symptoms of a viral infection, or for inhibiting the progress of a viral infection in a patient, comprising administering a pharmaceutical composition comprising a compound of Formula I to the patient.
• One embodiment is a method for treating dry eye in a patient in need thereof, comprising administering a pharmaceutical composition comprising a compound of
• Another embodiment is a method for increasing tear production in a patient whose tear production is suppressed (or presumed to be suppressed) due to ocular inflammation associated with keratoconjunctivitis sicca.
• Another embodiment is a method for reducing ocular surface inflammation in a patient, comprising administering a therapeutically effective amount of a compound having Formula I to the patient.
• the ocular surface inflammation is associated with keratoconjunctivitis sicca.
• the compound having Formula I is administered topically to the patient's eye(s).
• One embodiment is a method for reducing or preventing an ocular condition in a patient, the method comprising administering a therapeutically effective amount of a compound of Formula I to the patient.
• the method may reduce one or more signs or symptoms of the ocular condition.
• “Dry eye” as used herein includes “dry eye disease” as defined by the International Dry Eye Workshop (DEWS) in Lemp et al. (2007) "The Definition and Classification of Dry Eye Disease: Report of the Definition and Classification Subcommittee of the International Dry Eye Workshop” Ocul. Surf. 5:75-92.
• Dry eye disease is considered to be synonymous with “dry eye syndrome” and "keratoconjunctivitis sicca.” Dry eye disease includes the aqueous deficient (Sjogren and non-Sjogren) and evaporative categories of dry eye disease. An individual with dry eye disease may present with symptoms of both aqueous deficiency (e.g., insufficient tear production) and excessive evaporation of the tear film.
• the pharmaceutical composition can be administered to a patient topically, orally, or systemically (including intravenously or intraarterially). Administration may be to the eye, such as the surface of the eye.
• the actual amount of the compound to be administered in any given case will be determined by a physician taking into account the relevant circumstances, such as the severity of the condition, the age and weight of the patient, the patient's general physical condition, the cause of the condition, and the route of administration.
• the present invention includes methods for treating any of the above ocular conditions in a patient in need thereof by administering a pharmaceutical composition comprising a compound of Formula I to the patient.
• the composition can be administered directly to the ocular surface of the eye or to an ocular region in the eye.
• Modes of direct administration to the eye can include topical delivery and intraocular injection.
• compositions of the invention may also be useful for restoring corneal sensitivity that has been impaired due to surgery on the cornea or other surface of the eye. Impaired corneal sensitivity may also occur after viral infection, such as by HSV- 1, HSV-2, and VZV viruses. Patients with impaired corneal sensitivity often complain that their eyes feel dry, even though tear production and evaporation may be normal, suggesting that "dryness" in such patients may actually be a form of corneal neuropathy that results when corneal nerves are severed by surgery or inflamed after viral infection.
• a patient in need of treatment of an "ocular surface inflammation" or more specifically "dry eye” may complain of superficial scratchy pain, abrasiveness, eye dryness, foreign body sensation, scratchiness, ocular discomfort, ocular pain, burning, itching, decreased vision, visual blurriness or cloudiness, irritation or pain from bright light, or decreased visual acuity. Dryness may be experienced and reported as a feeling that moisture is absent, foreign body sensation, and/or as a feeling of dust, sand, or gravel in the eye.
• a patient with dry eye may experience one or more of the following symptoms: stinging and/or burning, dryness, sensation of foreign body (gritty or sandy feeling), itching, sensitivity to light, pain or soreness, intermittent blurred vision, tired or fatigued eyes, and frequent blinking.
• Dry eye may be due to inadequate tear production, a disruption in tear secretion, decreased tear film quality, or excessive evaporation of the tear film at the ocular surface, any and all of which can lead to sensations of dry eye and eye dryness and/or be associated with dry eye disease.
• An individual having dry eye may exhibit one or more of the characteristics or symptoms associated with dry eye disease (keratoconjunctivitis sicca).
• Methods for diagnosing and monitoring dry eye disease may include those described in Bron et al. (2007) "Methodologies to Diagnose and Monitor Dry Eye Disease:Report of the
• a common feature of dry eye disease is an unstable tear film due to abnormal or deficient tear production, increased tear evaporation, or imbalance of tear components.
• An unstable tear film may lead to or promote inflammation of the ocular surface (Pflugfelder et al. 2004, Am. J. Ophthalmol. 137:337-342).
• An individual suffering from or in need of treatment of "dry eye,” for the present invention can be one that presents with, is suffering from, or exhibits one or more symptoms of dry eye disease, or ocular surface dryness, or eye dryness, which depending on the individual may include sensations of dry eye (i.e., sensations of eye dryness), tear film instability, decreased tear secretion, delayed clearance, and altered tear composition, or tear hyperosmolarity.
• sensations of dry eye i.e., sensations of eye dryness
• tear film instability i.e., decreased tear secretion, delayed clearance, and altered tear composition, or tear hyperosmolarity.
• dry eye that may potentially be treated with the present pharmaceutical compositions may be chronic or temporary, may occur in one or both eyes of an individual, and in particular patients may be due to or caused by changes in physiological condition; use of contact lenses; allergy to a medication; in response to an external environmental factor such as pollen, dust, particulates, or low humidity; due to a side effect of a medication; aging; low blink rate; vitamin A deficiency; a chemical burn; radiation; blepharitis; rosacea; reaction to the use preservative-containing topical eye drops, such as wetting drops; disorders of the lid aperature; meibomian oil deficiency; lacrimal deficiency; disruption or damage of the lacrimal gland or obstruction of the lacrimal gland duct; reflex block; infection; changes in hormonal balance; eye surgery, including but not limited to refractive laser eye surgery, including LASIK, LASEK, and PRK; or as a result of exposure to an environmental contaminant encountered during
• the dry eye disease may be caused by nutritional disorders or deficiencies (including vitamins), pharmacologic side effects, eye stress and glandular and tissue destruction, environmental exposure to smog, smoke, excessively dry air, airborne particulates, autoimmune and immunodeficient disorders, and may be prevalent in patients who are unable to blink.
• the present invention may be directed to treating dry eye associated with rheumatoid arthritis, lupus erythematosus, polymyositis, rosacea, scleroderma, polyarteritis, thyroiditis, hepatobiliary disease, lymphoma, pulmonary fibrosis, macroglobulinemia, or coeliac disease.
• Blepharitis is a disorder of the meibomian glands, which produce the lipid layer of tear film. With blepharitis, the glands may become inflamed. Symptoms of blepharitis may include eye irritation, soreness, redness and an accumulation of matter on the eyelids. Patients may also experience dry eye as well. Patients suffering from blepharitis may complain of a sandy or itchy feeling of their eyes. There is usually redness, thickening, and irregularity of the lid margins. Accordingly, blepharitis involves an inflammation of the eye lid margins. Blepharitis can also affect the conjunctiva, tear film, and the corneal surface in advanced stages and may be associated with dry eye. Blepharitis is commonly classified into anterior or posterior blepharitis, with anterior affecting the lash bearing region of the lids, and posterior primarily affecting the meibomian gland orifices.
• Meibomian gland disease most often occurs as one of three forms: primary meibomitis, secondary meibomitis, and meibomian seborrhea.
• Meibomian seborrhea is characterized by excessive meibomian secretion in the absence of inflammation
• Secondary meibomitis represents a localized inflammatory response in which the meibomian glands are secondarily inflamed in a spotty fashion from an anterior lid margin blepharitis.
• Impaired corneal sensitivity often occurs after refractive surgery, such as photorefractive keratectomy, laser assisted sub-epithelium keratomileusis (LASEK), EPI- LASEK, customized transepithelial non-contact ablation, or other procedures in which the corneal nerves are severed.
• Impaired corneal sensitivity may also occur after viral infection, such as by HSV-1, HSV-2, and VZV viruses.
• Allergic conjunctivitis is an inflammation of the conjunctiva resulting from hypersensitivity to one or more allergens. It may be acute, intermittent, or chronic. It occurs seasonally, that is, at only certain time of the year, or it occurs perennially, that is, chronically throughout the year. Symptoms of seasonal and perennial allergic
• conjunctivitis include, in addition to inflammation of the conjunctiva, lacrimation, tearing, conjunctival vascular dilation, itching, papillary hyperlasia, chemosis, eyelid edema, and discharge from the eye.
• the discharge may form a crust over the eyes after a night's sleep.
• Atopic keratoconjunctivitis is a chronic, severe form of allergic conjunctivitis that often leads to visual impairment. Symptoms include itching, burning, pain, redness, foreign body sensation, light sensitivity and blurry vision.
• the lower conjunctiva is often more prominently affected than the upper conjunctiva.
• the conjunctiva may range from pale, edematous, and featureless to having the characteristics of advanced disease, including papillary hypertrophy, subepithelial fibrosis, formix foreshortening, trichiasis, entropion, and madurosis.
• the disease progresses to punctate epithelial erosions, corneal neovascularization, and other features of keratopathy which may impair vision.
• lymphocytes, macrophages, and dendritic cells are significantly elevated in the substantia basement membrane.
• vernal keratoconjunctivitis is a severe form of allergic conjunctivitis, but it tends to affect the upper conjunctiva more prominently than the lower. It occurs in two forms. In the palpebral form, square, hard, flattened, closely packed papillae are present; in the bulbar (limbal) form, the circumcorneal conjunctiva becomes hypertrophied and grayish. Both forms are often accompanied by a mucoid discharge. Corneal epithelium loss may occur, accompanied by pain and photophobia, as may central corneal plaques and Trantas' dots.
• Uveitis the inflammation of the uvea, is responsible for about 10% of the visual impairment in the United States.
• Phacoanaphylactic endophthalmitis is a human autoimmune disease.
• Panuveitis refers to inflammation of the entire uveal (vascular) layer of the eye.
• Posterior uveitis generally refers to chorioentinitis
• anterior uveitis refers to iridocyclitis.
• the inflammatory products i.e. cells, fibrins, excess proteins
• these inflammations are commonly found in the fluid spaces if the eye, i.e. anterior chamber, posterior chamber and vitreous space as well as infiltrating the tissue intimately involved in the inflammatory response.
• Uveitis may occur following surgical or traumatic injury to the eye; as a component of an autoimmune disorder, such as rheumatoid arthritis, Behcet's disease, ankylosing spondylitis, and sarcoidosis; as an isolated immune mediated ocular disorder, such as pars planitis, iridocyclitis etc., unassociated with known etiologies; and following certain systemic diseases which cause antibody-antigen complexes to be deposited in the uveal tissues. Together these disorders represent the non-infectious uveitities.
• an autoimmune disorder such as rheumatoid arthritis, Behcet's disease, ankylosing spondylitis, and sarcoidosis
• an isolated immune mediated ocular disorder such as pars planitis, iridocyclitis etc., unassociated with known etiologies
• systemic diseases which cause antibody-antigen complexes to be deposited in the uveal tissues. Together
• Phacoanaphylaxis is a severe form of uveitis in which the lens in the causative antigen.
• the lens proteins are normally secluded by the lens capsule since before birth. When these proteins are released into the eye by injury or by surgery or occasionally during cataract development, they can become intensely antigenic and incite an autoimmune response. If the response is moderate it is seen as chronic uveitis. If it is very fast in progression the eye becomes seriously inflamed in all segments. This latter response is named phacoanaphylaxis.
• Uveitis is a prominent feature of Behcet's disease, a multi-system inflammatory disorder also characterized by oral and genital ulcers, cutaneous, vascular, joint, and neurological manifestations
• Rosacea is a chronic and common skin disorder with no identified cause or cure.
• the pathogenesis of rosacea is thought to have multiple factors. Possible factors include exposure to the demodex folliculorum mite, gastrointestinal disease or a vasodilation disorder, and other triggers such as diet or sunlight.
• Patients may present with a variety of symptoms, including inflammatory papules, edema, telangiectasia, rhinophyma and ocular symptoms.
• the ocular signs of rosacea include blepharitis, including anterior blepharitis, conjunctivitis, ulceris, iridocyclitis, keratitis, meibomian gland dysfunction, telangiectasia, erythema, chalazion, hordeolum, interpalpebral hyperemia, conjuctival hyperemia, ciliary base injection, bulbar injection, crusts, sleeves, and superficial punctuate keratopathy.
• blepharitis including anterior blepharitis, conjunctivitis, ulceris, iridocyclitis, keratitis, meibomian gland dysfunction, telangiectasia, erythema, chalazion, hordeolum, interpalpebral hyperemia, conjuctival hyperemia, ciliary base injection, bulbar injection, crusts, sleeves, and superficial punctuate keratopathy.
• the ocular symptoms are nonspecific and may include burning, tearing, decreased tear secretion, redness, and foreign body or gritty or dry sensation, irritation, Itchiness, Blurred vision, Photosensitivity, Watery eyes, bloodshot eyes, Burning, telangiectasia, irregularity of the lid margins, and meibomian gland dysfunction.
• Pinguecula is a benign, yellowish brown proliferative growth that forms on the conjunctiva. Pinguecula may cause irritation and scratchiness of the eye, dry eye, inflammation of the conjunctiva and effect appearance of the eye. Inflamed Pinguecula, which cause ocular irritation or become unsightly, may require surgical removal. However, the post-operation scar may be as cosmetically objectionable as the Pinguecula and Pinguecula regrowth may occur following surgical removal. Allogeneic bone marrow transplantation (BMT) is a well-established treatment for malignant and non-malignant hematological diseases, and is performed in tens of thousands of patients each year.
• BMT Allogeneic bone marrow transplantation
• Mature donor T cells within the stem cell graft are the main mediators of the beneficial immune effects, but they are also responsible for the induction of graft-versus-host disease (GVHD), the major cause of morbidity and mortality in BMT patients.
• GVHD occurs when transplanted donor-derived T cells recognize proteins expressed by recipient antigen-presenting cells. Consequently, this recognition induces donor T-cell activation, proliferation, and differentiation, leading to a cellular and inflammatory attack on recipient target tissues.
• Acute or chronic GVHD occurs within a 100-day period post-BMT that leads to dermatitis, enteritis, and hepatitis. Ocular symptoms include blurry vision, foreign body sensation, burning sensation, severe light sensitivity, chronic conjunctivitis, dry eye, and eye pain.
• the present invention includes pharmaceutical compositions comprising, consisting of, or consisting essentially of a compound having Formula I , or a
• a pharmaceutically acceptable excipient may improve the stability or effectiveness of the composition.
• a "pharmaceutically acceptable excipient” is one that is compatible with the compound of Formula I and that is not harmful to the person receiving the pharmaceutical composition. Mixtures of two or more of such suitable excipients may be used.
• a pharmaceutical composition may comprise two or more compounds having Formula I, or two or more salts thereof.
• compositions of the present invention can be in the form of a liquid (such as an aqueous solution), solid, gel, or emulsion.
• the composition can be sterilized and therefore prepared in sterile form for pharmaceutical use.
• the pharmaceutical composition may be prepared in a unit dosage form suitable for oral, systemic (arterial or intravenous), or topical administration to a patient.
• the pharmaceutical composition may be prepared in an aqueous liquid or emulsion form suitable or acceptable for administration or topical application to the eye(s) of the patient.
• compositions may be prepared by combining a therapeutically effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, as an active ingredient, with one or more pharmaceutically acceptable excipients.
• the excipient is further preferably ophthalmically acceptable, that is, is causes little or no injury to the eye.
• a therapeutically effective amount of a compound of Formula I can be from about 0.001% (w/v) to about 5% (w/v), from about 0.001% (w/v) to about 1.0% (w/v), from about 0.01%) (w/v) to about 0.5%> (w/v), from about 0.01% to about 1%> (w/v), from about 0.1%) to about 0.5%) (w/v), or from about 0.5%> to about 1%> (w/v) in liquid and emulsion formulations.
• the actual dose of the active compounds of the present invention depends on the specific compound, and on the condition to be treated.
• Emulsions may be prepared by combining a compound of Formula I in a sterile lipophilic vehicle or fixed oil.
• the lipophilic vehicle or fixed oil may be selected from the group consisting of synthetic mono- and diglycerides, fatty acids (including oleic acid), naturally occurring vegetable oils, sesame oil, coconut oil, peanut oil, cottonseed oil, castor oil, olive oil, mineral oil, synthetic fatty vehicles, and ethyl oleate. Buffers, emulsifiers, dispersing agents, preservatives, antioxidants, and the like can be incorporated as required.
• compositions for use with the invention may include but are not limited to preservatives, buffering agents, antioxidants, lipophilic vehicles, hydrophilic vehicles, tonicity agents, electrolytes, thickeners, neutralizing agents, emulsifiers, dispersing agents, demulcents, plasticizers, occlusive agents, and film formers, and combinations thereof.
• Certain compositions may include both a buffer component and a tonicity component.
• Useful preservatives may include benzalkonium chloride, PURITE®, sodium bisulfite, sodium bisulfate, sodium thiosulfate, ascorbate, benzalkonium chloride, chlorobutanol, thimerosal, phenylmercuric acetate, phenylmercuric borate, phenylmercuric nitrate, methyl and ethyl parabens, methylparaben, polyvinyl alcohol, benzyl alcohol, phenylethanol, hexetidine, chlorite components, such as stabilized chlorine dioxide, metal chlorite, and other ophthalmically acceptable preservatives.
• concentration of the preservative component, if any, in the present compositions is a concentration effective to preserve the composition, and is often in a range of about 0.00001% to about 0.05% or about 0.1%) (w/w) of the composition.
• Acceptable buffering agents may include HEPES and those prepared from a suitable combination of the acid and/or base forms of acetates, citrates, phosphates, carbonates, succinates, and borates, such as sodium citrate dihydrate and boric acid.
• Phosphate buffers may be composed of sodium phosphate dibasic and sodium phosphate monobasic. Examples include monosodium phosphate, monohydrate, sodium phosphate dibasic heptahydrate, and sodium phosphate monobasic monohydrate. Buffering agents may be provided in any of the compositions in an amount effective to control the pH of the composition.
• the pH of the composition can be in a range of about 6 to about 8, about 7 to about 8, about 7 to about 7.6, or about 7.5 to about 8.
• Useful tonicity agents may include glycerin, sugar alcohols, xylitol, sorbitol, glycerol, erythritol, mannitol, salts, potassium chloride and/or sodium chloride.
• Tonicity agents may be provided in an amount effective to control the tonicity or osmolality of the compositions.
• the osmolality of the composition can be in a range of about 200 to about 400, or about 250 to about 350, mOsmol/kg respectively.
• the composition is isotonic.
• An isotonic solution is a solution that has the same solute concentration as that inside normal cells of the body and the blood. An isotonic solution in contact with a cell produces no net flow of water across the cell membrane.
• Useful lipophilic vehicles may include castor oil, squalane, diethylene glycol monoethyl ether, propylene glycol, isostearyl isostearate, isopropyl myristate, dipropylene glycol dimethyl ether, diethylene glycol, dipropylene glycol, mineral oil, silicone oil, caprylic/capric triglycerides, cetyl alcohols, and stearyl alcohols.
• Useful hydrophilic vehicles include water.
• a pharmaceutical composition may optionally comprise an acceptable amount of dimethyl sulfoxide as an excipient. Additional examples of excipients that may be optionally included in the pharmaceutical compositions of the present invention may include those listed in Table A.
• polysorbate 20 polysorbate 40
• polymeric emulsifiers carboxymethylcellulose sodium,
• polyvinyl alcohol povidone, glycerin
• Silicone oils isostearyl alcohol, cetyl alcohol, and
• Occlusive Agent silicone oils, petrolatum, waxes acrylate/octylacrylamide copolymer,
• the present invention includes processes (i.e., methods) for preparing compounds having Formula I.
• Compounds having Formula I may be prepared according to the following reaction schemes and accompanying discussions. Unless otherwise indicated, the R 1 , R 2 , R 3 , R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11 , R 12 , R 13 , and R 14 , and m, n, p, and q variables; and structure of Formula I; in the following reaction schemes and discussion are as defined above in the Summary of the Invention.
• the present invention includes isotopically-labeled compounds of Formula I.
• a compound having Formula I may contain one or more isotopic atoms such as deuterium 2 H (or D) in place of proton 1H (or H) or 13 C in place of 12 C and the like.
• isotopes may assist in analytical as well as therapeutic aspects of the invention.
• use of deuterium may increase the in vivo half-life by altering the metabolism (rate) of the compounds of the invention.
• These compounds can be prepared in accord with the preparations described by use of isotopically enriched reagents.
• Isotopically-labeled compounds of the present invention are identical to those recited herein, except that one or more atoms in the compound are replaced by an atom having an atomic mass or mass number different from the atomic mass or mass number usually found in nature.
• isotopes that can be incorporated into compounds of the invention include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorus, fluorine and chlorine and iodine, such as 2 H, 3 H, U C, 13 C, 14 C, 15 N, 18 0, 17 0, 31 P, 32 P, 35 S, 18 F, 36 C1 and 123 I, respectively.
• the present invention can further include the Intermediates formed by the following schemes.
• Cyclosporin A (CAS Number 59865-13-3). Cyclosporin A may be obtained commercially from suppliers such as Sigma-Aldrich (St. Louis, Missouri, United States) or TCI America (Portland, Oregon, United States). Other cyclosporin starting materials such as Cyclosporin D (CAS Registry Number 63775-96-2) may also be obtained through commercial suppliers such as Enzo Life Sciences (Ann Arbor, Michigan, United States; Farmingdale, New York, United States). Other cyclosporin starting materials may be prepared from cyclosporin A as described by M. Mutter et al. Tet. Lett. 2000, 41, 7193- 7196 and US 5,214,130.
• characterization of the compounds is performed according to the following methods: Proton nuclear magnetic resonance ( ⁇ ⁇ NMR, written occasionally as 1H NMR) and carbon nuclear magnetic resonance ( 13 C NMR, written occasionally as 13C NMR) spectra were recorded on a Bruker 300 or 500 MHz spectrometer in deuterated solvent. Chemical shifts were reported as ⁇ (delta) values in parts per million (ppm) relative to tetramethylsilane (TMS) as an internal standard (0.00 ppm) and multiplicities were reported as s, singlet; d, doublet; t, triplet; q, quartet; m, multiplet; bs, broad singlet; dd, doublet of doublets; and bt, broad triplet. Data were reported in the following format: chemical shift (multiplicity, integrated intensity, assignment).
• Electron spray mass spectra were recorded on a Micromass ZQ.
• Grubbs catalyst second generation also known as (1,3- Bis(2,4,6-trimethylphenyl)-2-imidazolidinylidene) dichloro (phenylmethylene)(tricyclohexylphospine)ruthenium
• Pd(PPh 3 ) 4 Tetrakis(triphenylphospine) palladium(O) OTBDMS t-Butyldimethylsilyloxy iBuOC(0)Cl Isobutyl chloroformate MeS02Cl Methane sulphonyl chloride
• aqueous extracts were extracted with t-butyl methyl ether (100ml), and the combined organics washed with H 2 0 (2 x 100ml), brine (100ml) then dried (MgS04), filtered and evaporated under reduced pressure to yield
• reaction mixture was cooled to room temperature then purified by silicagel chromatography using a solvent gradient of 100% dichloromethane 96% dichloromethane / 4% methanol to provide [(3E,6R,7R,8S)-1- bromo-7-hydroxy-6-methyl-8-(methylamino)-non-3-enoic acid] 1 cyclosporin A
• Grubbs' catalyst second generation (Grubbs II catalyst) is described in U.S. Patent Application Publication No. 2003/0186855. Longer chain brominated alkenes may be used at Step 1 if desired to produce a longer side chain at position 1.
• Morpholine (385uL, 0.4mmol), cesium carbonate (255mg, 0.8mmol) and a catalytic amount of potassium iodide were added.
• the reaction mixture was stirred at room temperature for 18 hours. Further amount of morpholine (lOOuL, O. lmmol) was added and the reaction mixture stirred for 3 hours before evaporating the volatiles.
• the residue was purified by SCX chromatography using a solvent gradient of 100% methanol 0.21M ammonia in methanol.
• Scheme III describes the use of metathesis using Grubbs II catalyst while Scheme IV describes the use of Wittig chemistry.
• the metathesis route (scheme III) is two steps shorter than the Wittig route (scheme IV) starting from intermediate 1.
• reaction mixture was cooled to room temperature then purified by silicagel chromatography using a solvent gradient of 100% dichloromethane 96% dichloromethane / 4% methanol to provide [[(2E,5R,6R,7S)-6- hydroxy-5-methyl-7-(methylamino)-oct-2-enedioic acid] methyl ester] 1 [methylene-Sar] 3 cyclosporin A (Intermediate 7) as an off-white solid.
• dichloromethane 95% dichloromethane / 5% methanol to provide [(5R,6R,7S)-6- hydroxy-5-methyl-7-(methylamino)-octanedioic acid] 1 [(R)-methyl-Sar] 3 cyclosporin A (Intermediate 9) as a white solid.
• reaction mixture was stirred at room temperature for 17 hours, then additional dry acetone (2mL) and bis(acetonitrile)dichloropalladium (II) (lmg, 0.004mmol) were added and the reaction mixture was stirred for a further 3 days.
• the reaction mixture was filtrered through celite using diethyl ether and methanol as solvents. The solvents were evaporated and the residue obtained was purified by silica gel chromatography using a solvent gradient of 100% dichloromethane to 95% dichloromethane 1 5% methanol to provide
• reaction mixture was filtered through celite then concentrated in vacuo to provide the dihydro version of intermediate 1 1 [[(5R,6R,7S)-6-(t-butyldimethylsilanyloxy)-5-methyl-7-(methylamino)- octanedioic acid ] 1 [(R)-methyl-Sar]3 cyclosporin A (Intermediate 56) as a white solid.
• Intermediate 53 was prepared by reduction of the aldehyde, Intermediate 4, using sodium borohydride in a solvent such as methanol, as described in US 2004/0110666. Specifically, Intermediate 4 (0.17g, 0.13mmoles) was dissolved in methanol
• Step 1 Intermediate 26 is prepared according to the procedure used to prepare
• Step 2 in Scheme VIII above was carried out in an identical manner as described in step 2 Scheme 1 to give intermediate 16.
• Intermediate 16 may be substituted for
• Alternative compounds of Formula I may be produced according to Scheme VIII through the use of alternative heterocycles or amines at Step 3 in Scheme VIII.
• Exemplary compounds that may be used in place of morpholine at step 3 in scheme VIII to produce compounds of the present invention include but are not limited to 2 methyloctahydropyrrolo[3,4c]pyrrole, piperidine, N-methyl piperazine, homomorpholine, and pyrrolidine.
• H-cube is a continuous flow reactor for carrying out hydrogenation under pressure.
• the hydrogenation is carried out using palladium on carbon catalyst at a hydrogen pressure of 30 atmospheres.
• Intermediate 18 is a structural variant of cyclosporin A having an -OCH 3 at the position 3 a-carbon. Intermediate 18 can be used in place of cyclosporin A according to any of the schemes shown herein to produce compounds of Formula I (e.g., amines and amides of Formula I) in which R 1 is -OCH 3 . Intermediate 18 can be prepared as described in Example 1 ((3 -methoxy cyclosporin) of US 2010/0167996. The chemical structure of Intermediate 18 is shown below.
• Compound B can be prepared from Intermediate 18 as shown below
• Intermediate 23 is a structural variant of cyclosporine A having a -CH 2 OCH 3 at the position 3 a-carbon. Intermediate 23 can be used in place of Cyclosporin A according to any of the schemes shown herein to produce compounds of Formula I (e.g., amines and amides of Formula I) in which R 1 is -CH 2 OCH 3 .
• Compound D can be prepared from Intermediate 23 and similarly Compounds V, S and AD can be prepared from [(D)-Serine] 3 cyclosporin A as shown below.
• Scheme X describes the acylation of Intermediate 1 (Step 1) and bromination of
• Step 2 N-bromosuccinimide azobisisobutyrylnitrile in carbon tetrachloride
• Step 3 and 4 are carried out as described in Steps 2 and 3 in Scheme II.
• Intermediate 1 is obtained as described in Scheme I.
• Step 5 is carried out by stirring Intermediate 32 in a solution of potassium carbonate in a mixture of methanol and water as described for Example 8 in US 2003/0212249.
• Scheme Xa describes the use of Wittig chemistry on Intermediate 4 (Step 1).
• Intermediate 4 is obtained as described in Scheme I.
• Deprotection of Intermediate 35 and hydrogenation of Intermediate 36 are carried out as described in Steps 5 and 3, respectively, in Scheme I.
• Exemplary syntheses according to Scheme Xa are described below for the preparation of Compounds KF and KG.

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