WO2016144706A2 - Autotaxin inhibitor compounds and uses thereof - Google Patents

Autotaxin inhibitor compounds and uses thereof Download PDF

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Publication number
WO2016144706A2
WO2016144706A2 PCT/US2016/020737 US2016020737W WO2016144706A2 WO 2016144706 A2 WO2016144706 A2 WO 2016144706A2 US 2016020737 W US2016020737 W US 2016020737W WO 2016144706 A2 WO2016144706 A2 WO 2016144706A2
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compound
pharmaceutically acceptable
acceptable salt
solvate
cancer
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PCT/US2016/020737
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French (fr)
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WO2016144706A3 (en
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John Howard Hutchinson
David Lonergan
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Pharmakea, Inc.
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Publication of WO2016144706A3 publication Critical patent/WO2016144706A3/en

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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D495/00—Heterocyclic compounds containing in the condensed system at least one hetero ring having sulfur atoms as the only ring hetero atoms
    • C07D495/02—Heterocyclic compounds containing in the condensed system at least one hetero ring having sulfur atoms as the only ring hetero atoms in which the condensed system contains two hetero rings
    • C07D495/04—Ortho-condensed systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D209/00—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom
    • C07D209/02—Heterocyclic compounds containing five-membered rings, condensed with other rings, with one nitrogen atom as the only ring hetero atom condensed with one carbocyclic ring
    • C07D209/04—Indoles; Hydrogenated indoles
    • C07D209/10—Indoles; Hydrogenated indoles with substituted hydrocarbon radicals attached to carbon atoms of the hetero ring
    • C07D209/18—Radicals substituted by carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals
    • C07D209/22—Radicals substituted by carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals with an aralkyl radical attached to the ring nitrogen atom
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D231/00—Heterocyclic compounds containing 1,2-diazole or hydrogenated 1,2-diazole rings
    • C07D231/54—Heterocyclic compounds containing 1,2-diazole or hydrogenated 1,2-diazole rings condensed with carbocyclic rings or ring systems
    • C07D231/56—Benzopyrazoles; Hydrogenated benzopyrazoles
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/04—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings directly linked by a ring-member-to-ring-member bond
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/06—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a carbon chain containing only aliphatic carbon atoms
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D401/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom
    • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
    • C07D401/12—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D403/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00
    • C07D403/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing two hetero rings
    • C07D403/04—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing two hetero rings directly linked by a ring-member-to-ring-member bond
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D403/00—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00
    • C07D403/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing two hetero rings
    • C07D403/06—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing two hetero rings linked by a carbon chain containing only aliphatic carbon atoms
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D413/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms
    • C07D413/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings
    • C07D413/04—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings directly linked by a ring-member-to-ring-member bond
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D417/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00
    • C07D417/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings
    • C07D417/04—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings directly linked by a ring-member-to-ring-member bond
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D417/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00
    • C07D417/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings
    • C07D417/12—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings linked by a chain containing hetero atoms as chain links
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D471/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00
    • C07D471/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00 in which the condensed system contains two hetero rings
    • C07D471/04—Ortho-condensed systems

Definitions

  • Described herein are compounds that are autotaxin inhibitors, methods of making such compounds, pharmaceutical compositions and medicaments comprising such compounds, and methods of using such compounds in the treatment of conditions, diseases, or disorders associated with autotaxin activity.
  • Lysophosphatidic acid is a lipid mediator that functions, for example, as a mitogen, chemoattractant, and survival factor for many cell types.
  • LPA signaling is implicated in, for example, cancer, angiogenesis, chronic inflammation, autoimmune diseases, fibrotic diseases, neurodegenerative diseases, reperfusion injury post stroke or myocardial ischemia, reproduction and tumor progression.
  • compositions described herein are autotaxin (ATX) inhibitors.
  • ATX autotaxin
  • the autotaxin inhibitors described herein are useful as agents for the treatment or prevention of diseases or conditions in which ATX and/or LPA participates, is involved in the etiology or pathology of the disease, or is otherwise associated with at least one symptom of the disease.
  • Inhibition of the physiological activity of ATX and/or LPA is useful in a variety of diseases or conditions.
  • the ATX-LPA signaling pathway has been implicated in fibrotic diseases, cancer, pruritus, angiogenesis, inflammation, autoimmune diseases, reproduction and tumor progression.
  • Compounds of Formula (I) are used in the treatment of diseases or conditions in which autotaxin activity contributes to the symptomology or progression of the disease, disorder or condition. These diseases, disorders, or conditions may arise from one or more of a genetic, iatrogenic, immunological, infectious, metabolic, oncological, toxic, surgical, and/or traumatic etiology.
  • diseases, disorders, or conditions may arise from one or more of a genetic, iatrogenic, immunological, infectious, metabolic, oncological, toxic, surgical, and/or traumatic etiology.
  • medicaments described herein comprise autotaxin inhibitors.
  • the compounds of Formula (I) are useful for the treatment of diseases or conditions such as, but not limited to, fibrosis, cell proliferative disease, inflammatory disease, autoimmune diseases, reproductive diseases, abnormal angiogenesis-associated diseases, scleroderma, brain or heart reperfusion injury, neurodegenerative diseases, neuropathic pain, peripheral neuropathy, ocular disease, diabetic retinopathy, proliferative vitreoretinopathy, cicatricial pemphigoid, and glaucoma.
  • diseases or conditions such as, but not limited to, fibrosis, cell proliferative disease, inflammatory disease, autoimmune diseases, reproductive diseases, abnormal angiogenesis-associated diseases, scleroderma, brain or heart reperfusion injury, neurodegenerative diseases, neuropathic pain, peripheral neuropathy, ocular disease, diabetic retinopathy, proliferative vitreoretinopathy, cicatricial pemphigoid, and glaucoma.
  • R 3 is H, halogen, -CN, -OH, Ci-C 4 alkyl, Ci-C 4 fluoroalkyl, Ci-C 4 deuteroalkyl, C
  • n 0, 1, or 2;
  • L 1 is absent, Ci-C 6 alkylene, Ci-C 6 fluoroalkylene, C 3 -C 6 cycloalkylene, (Ci-C 6 alkylene) p C 3 -C 6 cycloalkylene-(Ci-C 6 alkylene) q , or -(Ci-C 6 alkylene) p -X 1 -(Ci-C 6 alkylene) q ;
  • p is 0 or 1;
  • q is 0 or 1
  • Y is H, unsubstituted or unsubstituted Ci-C 6 alkyl, CF 3 , halogen, or CN;
  • C 6 fluoroalkyl Ci-C 6 deuteroalkyl, C 3 -C 6 cycloalkyl, a substituted or unsubstituted phenyl, a substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl;
  • each R 10 is independently selected from the group consisting of H, Ci-C 6 alkyl, Ci- C 6 fluoroalkyl, Ci-C 6 deuteroalkyl, C 3 -C 6 cycloalkyl, a substituted or unsubstituted phenyl, and a substituted or unsubstituted monocyclic heteroaryl; or
  • substituents are selected from among a subset of the listed alternatives.
  • Q is -C0 2 H, or - C0 2 (Ci-C 6 alkyl).
  • Q is -C0 2 H.
  • L 2 is -Ci-C 6 alkylene-.
  • L 2 is -CH 2 -, -CH 2 CH 2 -, -CH 2 CH 2 CH 2 -, -C(CH 3 ) 2 -, or -CH(CH 3 )-
  • Ring A is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms;
  • Ring B is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
  • Ring A is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl; Ring B is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
  • Ring A is phenyl or pyridinyl
  • Ring B is phenyl or pyridinyl
  • the compound of Formula (I) has the following structure of Formula (II), Formula (III), Formula (IV), Formula (V), Formula (VI), or Formula (VII):
  • X is CH or N
  • X is CH. In some embodiments, X is N.
  • Y is H, -CH 3 , CF 3 , F, CI, Br, or CN;
  • R 1 is H, F, CI, -CN, -CH 3 , - CF 3 , or -CD 3 .
  • Y is H, -CH 3 , CF 3 , F, CI, Br, or CN. In some embodiments, Y is
  • Y is CN
  • L 1 is absent, -CH 2 -, -CH 2 CH 2 -, -CH 2 CH 2 CH 2 -, -CH(CH 3 ) -, - CH(CH 2 CH 3 )-, -C(CH 3 ) 2 -, -C(CH 2 CH 3 ) 2 -, cyclopropyl-l,l-diyl, cyclobutyl-l,l-diyl, cyclopentyl-
  • I 1-diyl or cyclohexyl-l, l-diyl
  • each R A is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH 3 , -CF 3 , -OCH 3 , -OCH 2 CH 3 , -OCF 3 , or -OCH 2 CF 3 ;
  • each R B is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH 3 , -CF 3 , -OCH 3 , -OCH 2 CH 3 , -OCF 3 , or -OCH 2 CF 3 .
  • R 2 is H, halogen, -CN, -OH, d-C 4 alkyl, Ci-C 4 fluoroalkyl, C C 4 deuteroalkyl, Ci-C 4 alkoxy, or Ci-C 4 fluoroalkoxy.
  • R 2 is H, F, CI, Br, I, -CN, -OH, -CH 3 , -CF 3 , -CD 3 , -OCH 3 , -
  • R 2 is H or CI.
  • R 3 is H, halogen, -CN, -OH, Ci-C 4 alkyl, Ci-C 4 fluoroalkyl, Ci- C 4 deuteroalkyl, Ci-C 4 alkoxy, or Ci-C 4 fluoroalkoxy.
  • R 3 is H, F, CI, Br, I, -CN, -OH, -CH 3 , -CF 3 , -CD 3 , -OCH 3 , -
  • R 3 is H, F, or CI.
  • L 1 is absent, -CH 2 -, -CH 2 CH 2 -, or -CH 2 CH 2 CH 2 -;
  • Q is -C0 2 H, or -C0 2 (Ci-C 6 alkyl).
  • a pharmaceutical composition comprising a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, and at least one pharmaceutically acceptable excipient.
  • the pharmaceutical composition is formulated for administration to a mammal by intravenous administration, subcutaneous administration, oral administration, inhalation, nasal administration, dermal administration, or ophthalmic administration.
  • the pharmaceutical composition is in the form of a tablet, a pill, a capsule, a liquid, a suspension, a gel, a dispersion, a solution, an emulsion, an ointment, or a lotion.
  • the pharmaceutical composition further comprises one or more additional therapeutically active agents in addition to the compound of Formula (I).
  • Additional therapeutic agents include, but are not limited to, immunosuppressants, ant-fibrotic agents, analgesics, anti-cancer agents, and anti-inflammatories.
  • such agents include, but are not limited to, corticosteroids, immunosuppressants, analgesics, anti-cancer agents, anti-inflammatories, non-steroidal anti-inflammatories, TNF-alpha blockers, kinase inhibitors, chemokine receptor antagonists, bronchodilators, leukotriene receptor antagonists, leukotriene formation inhibitors, prostaglandin receptor antagonists, prostaglandin formation inhibitors, monoacylglycerol kinase inhibitors, phospholipase Ai inhibitors, phospholipase A 2 inhibitors, lysophospholipase D (lysoPLD) inhibitors, autotaxin inhibitors, and LP A receptor antagonists.
  • corticosteroids include, but are not limited to, corticosteroids, immunosuppressants, analgesics, anti-cancer agents, anti-inflammatories, non-steroidal anti-inflammatories, TNF-alpha blockers,
  • described herein is a method of treating or preventing any one of the diseases or conditions described herein comprising administering a therapeutically effective amount of a compound described herein (e.g. Formula (I)), or a pharmaceutically acceptable salt, or solvate thereof, to a mammal in need thereof.
  • a compound described herein e.g. Formula (I)
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof in the treatment or prevention of a disease or condition in which the activity of autotaxin and/or at least one LPA receptor contributes to the pathology and/or symptoms of the disease or condition.
  • the disease or condition is any of the diseases or conditions described herein.
  • a method for treating or preventing cancer, fibrosis, pruritis, an inflammatory disease or condition, an airway disease or condition, an autoimmune disease or condition, obesity, intraocular pressure, neuropathic pain, or combinations thereof in a mammal comprising administering a therapeutically effective amount of a compound of Formual (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
  • the cancer is a solid tumor.
  • the cancer is bladder cancer, colon cancer, brain cancer, breast cancer, endometrial cancer, heart cancer, kidney cancer, lung cancer, liver cancer, uterine cancer, blood and lymphatic cancer, ovarian cancer, pancreatic cancer, prostate cancer, thyroid cancer, or skin cancer.
  • the cancer is a sarcoma, carcinoma, or lymphoma.
  • the cancer is amendable to treatment with an autotaxin inhibitor.
  • the method further comprises administering a second therapeutic agent to the mammal in addition to the compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof.
  • a method for the treatment or prevention of fibrosis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
  • the fibrosis comprises lung fibrosis, liver fibrosis, kidney fibrosis or cutaneous fibrosis.
  • the fibrosis is amendable to treatment with an autotaxin inhibitor.
  • the method further comprises administering a second therapeutic agent to the mammal in addition to the compound of Formula (I), or a
  • reducing or inhibiting angiogenesis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
  • reducing or inhibiting angiogenesis in the mammal treats atherosclerosis, hypertension, tumor growth, inflammation, rheumatoid arthritis, wet-form macular degeneration, choroidal neovascularization, retinal neovascularization, or diabetic retinopathy.
  • described herein is a method of treating or preventing an inflammatory disease or condition in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
  • the inflammatory disease or condition is psoriasis, rheumatoid arthritis, vasculitis, inflammatory bowel disease, dermatitis, osteoarthritis, asthma, inflammatory muscle disease, allergic rhinitis, vaginitis, interstitial cystitis, scleroderma, eczema, lupus erythematosus, dermatomyositis, Sjogren's syndrome, thyroiditis, myasthenia gravis, autoimmune hemolytic anemia, multiple sclerosis, cystic fibrosis, chronic relapsing hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, allergic conjunctivitis or atopic dermatitis.
  • a method for treating or preventing pruritis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
  • the pruiritus is associated with dermatitis herpetiformis, dermatomyositis, pemphigoid, Sjogren's syndrome, Darier's disease, Hailey-Hailey disease, Ichthyoses, Sjogren- Larsson syndrome, dermatophytosis, folliculitis, impetigo and other bacterial infections, insect bites, pediculosis, ccabies, viral infection, histosis, atopic eczema, contact dermatitis, drug reaction, lichen planus, lichen simplex chronicus, mastocytosis (urticaria pigmentosa), miliaria, psoriasis, scar(s), urticaria, cutaneous T-cell lymphoma or mycosis fungoides, cutaneous B-cell lymphoma, leukemia cutis, pemphigoid gestationis, polymorphic eruption of pregnancy or prurigo gestationis.
  • a method for treating or preventing cholestatic pruritis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
  • the effective amount of the compound of Formula (I), or a pharmaceutically acceptable salt thereof is: (a) systemically administered to the mammal; and/or (b) administered orally to the mammal; and/or (c) intravenously administered to the mammal; and/or (d) administered by inhalation; and/or (e) administered by nasal administration; or and/or (f) administered by injection to the mammal; and/or (g) administered topically to the mammal; and/or (h) administered by ophthalmic administration; and/or (i) administered rectally to the mammal; and/or (j) adminstered non- systemically or locally to the mammal.
  • any of the aforementioned aspects are further embodiments comprising single administrations of the effective amount of the compound, including further embodiments in which the compound is administered once a day to the mammal or the compound is administered to the mammal multiple times over the span of one day. In some embodiments, the compound is administered on a continuous dosing schedule. In some embodiments, the compound is administered on a continuous daily dosing schedule. [0050] In any of the aforementioned aspects involving the treatment of ATX dependent diseases or conditions are further embodiments comprising administering at least one additional agent in addition to the administration of a compound having the structure of Formula (I), or a pharmaceutically acceptable salt thereof. In various embodiments, each agent is administered in any order, including simultaneously.
  • the mammal is a human.
  • compounds provided herein are administered to a human.
  • compounds provided herein are orally administered.
  • Articles of manufacture which include packaging material, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, within the packaging material, and a label that indicates that the compound or composition, or pharmaceutically acceptable salt, tautomers, pharmaceutically acceptable N-oxide, pharmaceutically active metabolite, pharmaceutically acceptable prodrug, or pharmaceutically acceptable solvate thereof, is used for inhibiting the activity of autotaxin, or for the treatment, prevention or amelioration of one or more symptoms of a disease or condition that would benefit from inhibition of the activity of autotaxin, are provided.
  • Autotaxin (ATX, PP2, or E- PP2), an approximately 120 kDa glycoprotein, is a secreted nucleotide pyrophosphatase/phosphodiesterase (NPP) with lysophospholipase D activity that converts extracellular lysophosphatidylcholine (LPC) and other lysophospholipids to lysophosphatidic acid (LPA).
  • NPP nucleotide pyrophosphatase/phosphodiesterase
  • LPC lysophospholipase D activity that converts extracellular lysophosphatidylcholine
  • LPA lysophospholipids to lysophosphatidic acid
  • LPA acts through sets of specific G protein-coupled receptors (GPCRs), such as LPA1, LPA2, LP A3, LPA4, LPA5, LPA6, LPA7, LPA8, in an autocrine and paracrine fashion to produce a variety of biological responses.
  • GPCRs G protein-coupled receptors
  • GPCRs G protein-coupled receptors
  • LPA lysophosphatidic acid
  • ATX and LPA have been detected in various biological fluids such as serum, plasma, cerebrospinal fluid, seminal fluid, urine, and saliva, both in animals and humans, suggesting that they are potential biomarkers to predict certain diseases.
  • serum ATX concentration and activity is elevated in patients with chronic liver diseases and in pregnant women.
  • ATX concentration has been found to be lower in postoperative cancer patients as a result of postoperative damage or poor nutritional state.
  • ATX is known to be essential for normal development.
  • ATX-deficient mice die at embryonic day 9.5 with profound vascular defects in both the yolk sac and the embryo.
  • embryonic day 8.5 ATX-deficient embryos were found to have malformed allantois, neural tube defects, and asymmetric headfolds.
  • ATX has been demonstrated to increase cell motility, neovascularization, proliferation and aggressiveness of tumors. It is upregulated in numerous tumor lineages, such as breast, renal, liver, glioblastoma, ovarian and prostate cancer.
  • disclosed herein are methods of treating cancer with a compound disclosed herein.
  • ATX is a prometastatic enzyme initially isolated from the conditioned medium of human melanoma cells.
  • ATX overexpression is frequently observed in malignant tumor tissues such as breast cancer, renal cancer, Hodgkin lymphoma, hepatocellular carcinoma, pancreatic cancer and glioblastoma.
  • LPA also contributes to tumorigenesis by increasing motility and invasiveness of cells.
  • cancer refers to an abnormal growth of cells that tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread).
  • Types of cancer include, but are not limited to, solid tumors (such as those of the bladder, bowel, brain, breast, endometrium, heart, kidney, lung, liver, uterus, lymphatic tissue (lymphoma), ovary, pancreas or other endocrine organ (thyroid), prostate, skin (melanoma or basal cell cancer) or hematological tumors (such as the leukemias and lymphomas) at any stage of the disease with or without metastases.
  • solid tumors such as those of the bladder, bowel, brain, breast, endometrium, heart, kidney, lung, liver, uterus, lymphatic tissue (lymphoma), ovary, pancreas or other endocrine organ (thyroid), prostate, skin (melanoma or basal cell cancer) or hematological tumors (such as the leukemias and lymph
  • Non- limiting examples of cancers include, acute lymphoblastic leukemia, acute myeloid leukemia, adrenocortical carcinoma, anal cancer, appendix cancer, astrocytomas, atypical teratoid/rhabdoid tumor, basal cell carcinoma, bile duct cancer, bladder cancer, bone cancer (osteosarcoma and malignant fibrous histiocytoma), brain stem glioma, brain tumors, brain and spinal cord tumors, breast cancer, bronchial tumors, Burkitt lymphoma, cervical cancer, chronic lymphocytic leukemia, chronic myelogenous leukemia, colon cancer, colorectal cancer, craniopharyngioma, cutaneous T-Cell lymphoma, desmoid tumors, embryonal tumors, endometrial cancer, ependymoblastoma, ependymoma, esophageal cancer, ewing sarcoma
  • gastrointestinal carcinoid tumor gastrointestinal stromal tumor (GIST), gastrointestinal stromal cell tumor, germ cell tumor, glioma, hairy cell leukemia, head and neck cancer, hepatocellular (liver) cancer, Hodgkin lymphoma, hypopharyngeal cancer, intraocular melanoma, islet cell tumors (endocrine pancreas), Kaposi sarcoma, kidney cancer, Langerhans cell histiocytosis, laryngeal cancer, leukemia, Acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myelogenous leukemia, hairy cell leukemia, liver cancer, non- small cell lung cancer, small cell lung cancer, Burkitt lymphoma, cutaneous T-cell lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, lymphoma, Waldenstrom macroglobulinemia, medulloblastoma,
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in the treatment of ovarian cancer, prostate cancer, breast cancer, lung cancer, melanoma, head and neck cancer, bowel cancer (colorectal cancer), thyroid cancer, glioblastoma, follicular lymphoma, renal cancer, Hodgkin lymphoma, hepatocellular carcinoma, pancreatic cancer or melanoma.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in the treatment of bone metastases.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in the treatment of oral cancer, prostate cancer, rectal cancer, non-small cell lung cancer, lip and oral cavity cancer, liver cancer, lung cancer, anal cancer, kidney cancer, vulvar cancer, breast cancer, oropharyngeal cancer, nasal cavity and paranasal sinus cancer, nasopharyngeal cancer, urethra cancer, small intestine cancer, bile duct cancer, bladder cancer, ovarian cancer, laryngeal cancer, hypopharyngeal cancer, gallbladder cancer, colon cancer, colorectal cancer, head and neck cancer, parathyroid cancer, penile cancer, vaginal cancer, thyroid cancer, pancreatic cancer, esophageal cancer, Hodgkin's lymphoma, leukemia-related disorders, my
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in the treatment of non-small cell lung cancer, pancreatic cancer, breast cancer, ovarian cancer, colorectal cancer, or head and neck cancer.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in the treatment of a carcinoma, a tumor, a neoplasm, a lymphoma, a melanoma, a glioma, a sarcoma, or a blastoma.
  • the carcinoma is selected from the group consisting of:
  • carcinoma adenocarcinoma, adenoid cystic carcinoma, adenosquamous carcinoma,
  • adrenocortical carcinoma well differentiated carcinoma, squamous cell carcinoma, serous carcinoma, small cell carcinoma, invasive squamous cell carcinoma, large cell carcinoma, islet cell carcinoma, oat cell carcinoma, squamous carcinoma, undifferentiatied carcinoma, verrucous carcinoma, renal cell carcinoma, papillary serous adenocarcinoma, merkel cell carcinoma, hepatocellular carcinoma, soft tissue carcinomas, bronchial gland carcinomas, capillary carcinoma, bartholin gland carcinoma, basal cell carcinoma, carcinosarcoma,
  • papilloma/carcinoma clear cell carcinoma, endometrioid adenocarcinoma, mesothelial, metastatic carcinoma, mucoepidermoid carcinoma, cholangiocarcinoma, actinic keratoses, cystadenoma, and hepatic adenomatosis.
  • the tumor is selected from the group consisting of: astrocytic tumors, malignant mesothelial tumors, ovarian germ cell tumor, supratentorial primitive neuroectodermal tumors, Wilm's tumor, pituitary tumors, extragonadal germ cell tumor, gastrinoma, germ cell tumors, gestational trophoblastic tumor, brain tumors, pineal and supratentorial primitive neuroectodermal tumors, pituitary tumor, somatostatin-secreting tumor, endodermal sinus tumor, carcinoids, central cerebral astrocytoma, glucagonoma, hepatic adenoma, insulinoma, medulloepithelioma, plasmacytoma, vipoma, and pheochromocytoma.
  • astrocytic tumors malignant mesothelial tumors, ovarian germ cell tumor, supratentorial primitive neuroectodermal tumors, Wilm's tumor, pituitary tumors, extra
  • the neoplasm is selected from the group consisting of:
  • intaepithelial neoplasia multiple myeloma/plasma cell neoplasm, plasma cell neoplasm, interepithelial squamous cell neoplasia, endometrial hyperplasia, focal nodular hyperplasia, hemangioendothelioma, lymphangioleio myomatosis and malignant thymoma.
  • the lymphoma is selected from the group consisting of: nervous system lymphoma, AIDS-related lymphoma, cutaneous T-cell lymphoma, non-Hodgkin's lymphoma, mantle cell lymphoma, follicular lymphoma and Waldenstrom's macroglobulinemia.
  • the melanoma is selected from the group consisting of: acral lentiginous melanoma, superficial spreading melanoma, uveal melanoma, lentigo maligna melanomas, melanoma, intraocular melanoma, adenocarcinoma nodular melanoma, and hemangioma.
  • the sarcoma is selected from the group consisting of: adenomas, adenosarcoma, chondosarcoma, endometrial stromal sarcoma, Ewing's sarcoma, Kaposi's sarcoma, leiomyosarcoma, rhabdomyosarcoma, sarcoma, uterine sarcoma, osteosarcoma, and pseudosarcoma.
  • the glioma is selected from the group consisting of: glioma, brain stem glioma, and hypothalamic and visual pathway glioma.
  • the blastoma is selected from the group consisting of: pulmonary blastoma, pleuropulmonary blastoma, retinoblastoma, neuroblastoma, medulloblastoma, glioblastoma, and hemangiblastomas.
  • disclosed herein are methods of treating fibrosis with a compound disclosed herein.
  • Fibrosis refers to the accumulation of extracellular matrix
  • tissue fibrosis include, but are not limited to, pulmonary fibrosis, renal fibrosis, cardiac fibrosis, cirrhosis and fibrosis of the liver, skin scars and keloids, adhesions, fibromatosis, atherosclerosis, and amyloidosis.
  • a method of reducing fibrosis in a tissue comprising contacting a fibrotic cell or tissue with a compound disclosed herein, in an amount sufficient to decrease or inhibit the fibrosis.
  • the fibrosis includes a fibrotic condition.
  • reducing fibrosis, or treatment of a fibrotic condition includes reducing or inhibiting one or more of: formation or deposition of extracellular matrix proteins; the number of pro-fibrotic cell types (e.g., fibroblast or immune cell numbers); cellular collagen or hydroxyproline content within a fibrotic lesion; expression or activity of a fibrogenic protein; or reducing fibrosis associated with an inflammatory response.
  • the fibrotic condition is primary fibrosis.
  • the fibrotic condition is idiopathic.
  • the fibrotic condition is associated with (e.g., is secondary to) a disease (e.g., an infectious disease, an inflammatory disease, an autoimmune disease, a malignant or cancerous disease, and/or a connective disease); a toxin; an insult (e.g., an environmental hazard (e.g., asbestos, coal dust, polycyclic aromatic
  • hydrocarbons hydrocarbons
  • cigarette smoking a wound
  • a medical treatment e.g., surgical incision, chemotherapy or radiation
  • the fibrotic condition is a fibrotic condition of the lung, a fibrotic condition of the liver, a fibrotic condition of the heart or vasculature, a fibrotic condition of the kidney, a fibrotic condition of the skin, a fibrotic condition of the gastrointestinal tract, a fibrotic condition of the bone marrow or a hematopoietic tissue, a fibrotic condition of the nervous system, or a combination thereof.
  • the fibrotic condition affects a tissue chosen from one or more of muscle, tendon, cartilage, skin (e.g., skin epidermis or endodermis), cardiac tissue, vascular tissue (e.g., artery, vein), pancreatic tissue, lung tissue, liver tissue, kidney tissue, uterine tissue, ovarian tissue, neural tissue, testicular tissue, peritoneal tissue, colon, small intestine, biliary tract, gut, bone marrow, or hematopoietic tissue.
  • skin e.g., skin epidermis or endodermis
  • cardiac tissue e.g., vascular tissue (e.g., artery, vein)
  • pancreatic tissue e.g., lung tissue, liver tissue, kidney tissue, uterine tissue, ovarian tissue
  • neural tissue e.g., testicular tissue, peritoneal tissue, colon, small intestine, biliary tract, gut, bone marrow, or hematopoietic tissue.
  • the fibrotic condition is a fibrotic condition of the lung.
  • the fibrotic condition of the lung is chosen from one or more of: pulmonary fibrosis, idiopathic pulmonary fibrosis (IPF), usual interstitial pneumonitis (UIP), interstitial lung disease, cryptogenic fibrosing alveolitis (CFA), bronchiolitis obliterans, or bronchiectasis.
  • the fibrosis of the lung is secondary to a disease, a toxin, an insult, a medical treatment, or a combination thereof.
  • fibrosis of the lung is associated with one or more of: a disease process such as asbestosis and silicosis; an occupational hazard; an environmental pollutant; cigarette smoking; an autoimmune connective tissue disorders (e.g., rheumatoid arthritis, scleroderma and systemic lupus erythematosus (SLE)); a connective tissue disorder such as sarcoidosis; an infectious disease, e.g., infection, particularly chronic infection; a medical treatment, including but not limited to, radiation therapy, and drug therapy, e.g., chemotherapy (e.g., treatment with as bleomycin, methotrexate, amiodarone, busulfan, and/or nitrofurantoin).
  • the fibrotic condition of the lung treated with the methods of the invention is associated with (e.g., secondary to) a cancer treatment, e.g., treatment of a cancer (e.g. squamous cell carcinoma, testicular cancer, Hodgkin's disease with bleomycin).
  • a cancer e.g. squamous cell carcinoma, testicular cancer, Hodgkin's disease with bleomycin.
  • the fibrotic condition is a fibrotic condition of the liver.
  • the fibrotic condition of the liver is chosen from one or more of: fatty liver disease, steatosis (e.g., nonalcoholic steatohepatitis (NASH), cholestatic liver disease (e.g., primary biliary cirrhosis (PBC), cirrhosis, alcohol-induced liver fibrosis, biliary duct injury, biliary fibrosis, cholestasis or cholangiopathies.
  • fatty liver disease e.g., nonalcoholic steatohepatitis (NASH)
  • cholestatic liver disease e.g., primary biliary cirrhosis (PBC), cirrhosis, alcohol-induced liver fibrosis, biliary duct injury, biliary fibrosis, cholestasis or cholangiopathies.
  • hepatic or liver fibrosis includes, but is not limited to, hepatic fibrosis associated with alcoholism, viral infection, e.g., hepatitis (e.g., hepatitis C, B or D), autoimmune hepatitis, non-alcoholic fatty liver disease (NAFLD), progressive massive fibrosis, exposure to toxins or irritants (e.g., alcohol,
  • the fibrotic condition is a fibrotic condition of the heart.
  • the fibrotic condition of the heart is myocardial fibrosis (e.g., myocardial fibrosis associated with radiation myocarditis, a surgical procedure complication (e.g., myocardial post-operative fibrosis), infectious diseases (e.g., Chagas disease, bacterial, trichinosis or fungal myocarditis)); granulomatous, metabolic storage disorders (e.g.,
  • cardiomyopathy hemochromatosis
  • developmental disorders e.g., endocardial fibroelastosis
  • arteriosclerotic or exposure to toxins or irritants (e.g., drug induced cardiomyopathy, drug induced cardiotoxicity, alcoholic cardiomyopathy, cobalt poisoning or exposure).
  • toxins or irritants e.g., drug induced cardiomyopathy, drug induced cardiotoxicity, alcoholic cardiomyopathy, cobalt poisoning or exposure.
  • the myocardial fibrosis is associated with an inflammatory disorder of cardiac tissue (e.g., myocardial sarcoidosis).
  • the fibrotic condition is a fibrotic condition of the kidney.
  • the fibrotic condition of the kidney is chosen from one or more of: renal fibrosis (e.g., chronic kidney fibrosis), nephropathies associated with injury/fibrosis (e.g., chronic nephropathies associated with diabetes (e.g., diabetic nephropathy)), lupus, scleroderma of the kidney, glomerular nephritis, focal segmental glomerular sclerosis, IgA nephropathyrenal fibrosis associated with human chronic kidney disease (CKD), chronic progressive nephropathy (CPN), tubulointerstitial fibrosis, ureteral obstruction, chronic uremia, chronic interstitial nephritis, radiation nephropathy, glomerulosclerosis, progressive glomerulonephrosis (PGN),
  • renal fibrosis e.g., chronic kidney fibrosis
  • endothelial/thrombotic microangiopathy injury HIV-associated nephropathy, or fibrosis associated with exposure to a toxin, an irritant, or a chemotherapeutic agent.
  • the fibrotic condition is a fibrotic condition of the skin.
  • the fibrotic condition of the skin is chosen from one or more of: skin fibrosis, scleroderma, nephrogenic systemic fibrosis (e.g., resulting after exposure to gadolinium which is frequently used as a contrast substance for MRIs in patients with severe kidney failure), scarring and keloid.
  • the fibrotic condition is a fibrotic condition of the
  • the fibrotic condition is chosen from one or more of fibrosis associated with scleroderma; radiation induced gut fibrosis; fibrosis associated with a foregut inflammatory disorder such as Barrett's esophagus and chronic gastritis, and/or fibrosis associated with a hindgut inflammatory disorder, such as inflammatory bowel disease (IBD), ulcerative colitis and Crohn's disease.
  • IBD inflammatory bowel disease
  • ulcerative colitis Crohn's disease
  • the fibrotic condition is adhesions.
  • the adhesions are chosen from one or more of: abdominal adhesions, peritoneal adhesions, pelvic adhesions, pericardial adhesions, peridural adhesions, peritendinous or adhesive capsulitis.
  • the fibrotic condition is a fibrotic condition of the eye.
  • the fibrotic condition of the eye involves diseases of the anterior segment of the eye such as glaucoma and corneal opacification; in some embodiments, the fibrotic condition of the eye involves disease of the posterior segment of the eye such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity and neovascular glaucoma; in some embodiments, the fibrotic condition of the eye results from fibrosis following ocular surgery.
  • the fibrotic condition is a fibrotic condition of the bone marrow or a hematopoietic tissue.
  • the fibrotic condition of the bone marrow is an intrinsic feature of a chronic myeloproliferative neoplasm of the bone marrow, such as primary myelofibrosis (also referred to herein as agnogenic myeloid metaplasia or chronic idiopathic myelofibrosis).
  • the bone marrow fibrosis is associated with (e.g., is secondary to) a malignant condition or a condition caused by a clonal proliferative disease.
  • the bone marrow fibrosis is associated with a hematologic disorder (e.g., a hematologic disorder chosen from one or more of polycythemia vera, essential thrombocythemia, myelodysplasia, hairy cell leukemia, lymphoma (e.g., Hodgkin or non-Hodgkin lymphoma), multiple myeloma or chronic myelogeneous leukemia (CML)).
  • a hematologic disorder e.g., a hematologic disorder chosen from one or more of polycythemia vera, essential thrombocythemia, myelodysplasia, hairy cell leukemia, lymphoma (e.g., Hodgkin or non-Hodgkin lymphoma), multiple myeloma or chronic myelogeneous leukemia (CML)).
  • a hematologic disorder e.g., a hematologic disorder chosen from
  • the bone marrow fibrosis is associated with (e.g., secondary to) a non-hematologic disorder (e.g., a non- hematologic disorder chosen from solid tumor metastasis to bone marrow, an autoimmune disorder (e.g., systemic lupus erythematosus, scleroderma, mixed connective tissue disorder, or polymyositis), an infection (e.g., tuberculosis), or secondary hyperparathyroidism associated with vitamin D deficiency.
  • a non-hematologic disorder e.g., a non- hematologic disorder chosen from solid tumor metastasis to bone marrow, an autoimmune disorder (e.g., systemic lupus erythematosus, scleroderma, mixed connective tissue disorder, or polymyositis), an infection (e.g., tuberculosis), or secondary hyperparathyroidism associated with vitamin D deficiency.
  • disclosed herein are methods of treating pruritis with a compound disclosed herein.
  • Pruritus is a condition involving localized or general itching that is a common and distressing symptom in a variety of diseases. Although usually occurring in the skin, pruritus can also occur in non-cutaneous sites such as mucous membranes. Pruritus is a frequent
  • ⁇ manifestation of localized skin disorders caused by hypersensitivity reactions such as allergic reactions to insect bites or to environmental allergens, urticaria, dermatoses of fungal and bacterial origins, ectoparasite infections, and hemorrhoids.
  • method of treating pruritus caused by systemic diseases including, for example, hypothyroidism, thyrotoxicosis, mucocandiasis in diabetes mellitus, and Hodgkin's disease.
  • methods of treating bouts of persistent or recurrent pruritus associated with many systemic diseases and skin disorders are provided.
  • Hepatic diseases leading to pruritus include primary biliary cirrhosis, B and C viral hepatitis, primary sclerosing cholangitis, carcinoma of bile ducts, alcoholic cirrhosis, autoimmune hepatitis and others.
  • xerosis skin conditions (such as psoriasis, eczema, sunburn, athlete's foot), insect bites, poisonous plants (such as poison ivy, poison oak, poison sumac), Hodgkin's disease, jaundice, polycythemia, scabies, lice, worms, thyroid illness, diabetes mellitus, dandruff, iron deficiency anemia, parasitic infections, medications, cholestasis, pruritus related to pregnancy, HIV infection or other causes of itching or pruritus.
  • causes such as xerosis, skin conditions (such as psoriasis, eczema, sunburn, athlete's foot), insect bites, poisonous plants (such as poison ivy, poison oak, poison sumac), Hodgkin's disease, jaundice, polycythemia, scabies, lice, worms, thyroid illness, diabetes mellitus, dandruff, iron defic
  • disclosed herein are methods of treating an inflammatory condition, disease, or disorder with a compound disclosed herein.
  • inflammation refers to the well known localized response to various types of injury or infection, which is characterized by redness, heat, swelling, and pain, and often also including dysfunction or reduced mobility.
  • Inflammatory conditions, diseases, and disorders, which can be treated with a compound disclosed herein, include airway diseases comprising pulmonary inflammation, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, and asthma.
  • COPD chronic obstructive pulmonary disease
  • COPD cystic fibrosis
  • asthma chronic obstructive pulmonary disease
  • COPD is comprised primarily of two related diseases: chronic bronchitis and emphysema. In both diseases, there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and progressive over time
  • Asthma is a chronic disease of the airways of the lungs, characterized by inflammation and paradoxical narrowing of the bronchi.
  • Asthma includes asthmatic conditions mediated via T- cell action, including extrinsic asthma (allergic asthma), intrinsic asthma (non-allergic asthma), mixed asthma (extrinsic and intrinsic asthma), occupational asthma induced by agents such as toluene diisocyanate, polyvinyl chloride, phthalic anhydride, trimellitic anhydride, plicatic acid (Western Red Cedar trees) or metal salts such as platinum or nickel), drug-induced asthma (including aspirin-induced asthma or asthma induced by non-steroidal anti-inflammatory drugs (NSAIDs)), exercise-induced asthma, and cough variant asthma.
  • the asthma is an allergic or non-allergic asthmatic condition mediated by T-cell function.
  • a method of treating asthma with a compound disclosed herein is a method of treating asthma with a compound disclosed herein.
  • the release of normal repair mediators, including LPA is exaggerated or the actions of the repair mediators are inappropriately prolonged leading to inappropriate airway remodeling.
  • Major structural features of the remodeled airway observed in asthma include a thickened lamina reticularis (the basement membrane-like structure just beneath the airway epithelial cells), increased numbers and activation of myofibroblasts, thickening of the smooth muscle layer, increased numbers of mucus glands and mucus secretions, and alterations in the connective tissue and capillary bed throughout the airway wall.
  • ATX and/or LPA contribute to these structural changes in the airway.
  • ATX and/or LPA are involved in acute airway hyperresponsiveness in asthma.
  • the lumen of the remodeled asthmatic airway is narrower due to the thickening of the airway wall, thus decreasing airflow.
  • LPA contributes to the long-term structural remodeling and the acute hyperresponsiveness of the asthmatic airway.
  • LPA contributes to the hyper-responsiveness that is a primary feature of acute exacerbations of asthma.
  • COPD chronic obstructive pulmonary disease
  • COPD chronic bronchitis, emphysema and obliterative bronchiolitis. The most common of these diseases are chronic bronchitis and emphysema.
  • emphysema usually results from damage to the lungs caused by environmental insult, usually as a result of long-term smoking, emphysema may also be caused by congenital absence of al -antitrypsin in the lungs; this type of emphysema is usually inherited.
  • CB chronic bronchitis
  • bronchitis inflammation of one or more bronchi, usually secondary to infection, and is characterized by excessive production of mucus in the bronchi, accompanied by a recurrent cough which persists for at least three months of the year during at least two successive years.
  • CB is the major non-asthmatic disease of the lung.
  • Pathological changes in the lung include: (1) hypertrophy and hyperplasia of mucus- secreting glands in the bronchi, (2) increase in goblet cells, (3) disappearance or damage of cilia, and (4) chronic inflammatory changes and narrowing of small airways.
  • Emphysema is a lung condition which results from damage to the alveolar sacs in the lungs, usually caused by long-term smoking. This damage leads to a pathological accumulation of air in the tissues.
  • LPA in vivo induces airway hyperresponsiveness, itch-scratch responses, infiltration and activation of eosinophils and neutrophils, vascular remodeling, and nociceptive flexor responses.
  • LPA also induces histamine release from mouse and rat mast cells.
  • histamine induces various responses, such as contraction of smooth muscle, plasma exudation, and mucus production.
  • Plasma exudation is important in the airway, because the leakage and subsequent airway-wall edema contribute to the development of airway hyperresponsiveness.
  • disclosed herein is a method of reducing plasma exudation due to an acute allergic reaction with a compound disclosed herein.
  • the methods described herein include methods for the treatment, reduction of risk, and delaying of onset of an autoimmune disease or disorder with a compound disclosed herein.
  • autoimmune diseases include, but are not limited to, Alopecia Areata, Lupus, Ankylosing Spondylitis, Meniere's Disease, Antiphospholipid
  • IPP Thrombocytopenia Purpura
  • the methods described herein include methods for the treatment, reduction of risk, and delaying onset of other inflammatory conditions or diseases with a compound disclosed herein, such as (a Ocular inflammation associated with corneal ulcers, giant papillary conjunctivitis, blepharitis, chelazion, uveitis, dry eye, post-surgical inflammation, and contact lens associated inflammation; (b) allergic diseases such as hay fever, rhinitis, seasonal allergic conjunctivitis, vernal conjunctivitis and other eosinophil-mediated conditions; (c) skin diseases such as psoriasis, contact dermatitis, eczema, infectious skin ulcers, open wounds, and cellulitis; (d) infectious diseases including sepsis, septic shock, encephalitis, infectious arthritis, endotoxic shock, gram negative shock, Jarisch-Herxheimer reaction, shingles, toxic shock, cerebral malaria, bacterial meningitis, acute respiratory distress syndrome (
  • ischemia/reperfusion injury vasospasm following subarachnoid hemorrhage, vasospasm following cerebrovascular accident, pleuritis, pericarditis, and the cardiovascular complications of diabetes;
  • dialysis including pericarditis, due to peritoneal dialysis;
  • gout and
  • chemical or thermal -induced inflammation due to burns, acid, alkali and the like.
  • disclosed herein are methods of treating obesity and/or diabetes with a compound disclosed herein.
  • ATX is responsible for the lysoPLD activity released by adipocytes and exerts a paracrine control on preadipocyte growth via an LPA-dependent mechanism.
  • ATX is up-regulated during adipocyte differentiation and in genetic obesity.
  • ATX mRNA is up-regulated in adipocytes from db/db mice suggesting that the up-regulation of ATX is related to the severe type 2 diabetes phenotype and adipocyte insulin resistance.
  • up-regulation of ATX in adipocytes is associated with type 2 diabetes.
  • Olesity refers to a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to increased health problems.
  • “obesity” refers to a weight increase, which is at least 5% of the total body weight.
  • disclosed herein is a method of treating
  • disclosed herein are methods of treating elevated intraocular pressure associated with glaucoma.
  • Glaucoma is one of the leading causes of blindness and is characterized by elevated intraocular pressure (IOP).
  • IOP intraocular pressure
  • Ocular hypotensive therapy is the mainstay of glaucoma treatment. Elevated IOP results from diminished aqueous humor (AH) drainage through the trabecular pathway and autotaxin activity is an abundant protein in human AH. Autotaxin is secreted by human trabecular meshwork cells and ATX activity is significantly elevated from glaucoma patients. Inhibition of autotaxin activity in AH by topical and intracameral delivery of a small molecule inhibitor leads to decreased IOP in rabbits.
  • AH aqueous humor
  • disclosed herein are methods of treating neuropathic pain with a compound disclosed herein.
  • LP A induces neuropathic pain as well as demyelination and pain-related protein expression changes via LPAl .
  • ATX heterozygous knockout mice show about 50% recovery of nerve injury- induced neuropathic pain compared to wild type mice.
  • Lysophosphatidylcholine is known to induce neuropathic pain.
  • LPC- induced neuropathic pain is partially reduced in ATX heterozygous knockout mice.
  • Neuropathic pain results from injury to a nerve. In contrast to immediate pain caused by tissue injury, in some embodiments, neuropathic pain develops days or months after a traumatic injury. In addition, neuropathic pain frequently is long-lasting or chronic and can occur spontaneously or as a result of stimulation that normally is not painful.
  • Compounds of Formula (I), including pharmaceutically acceptable salts, prodrugs, active metabolites and pharmaceutically acceptable solvates thereof, are autotaxin inhibitors.
  • R 3 is H, halogen, -CN, -OH, Ci-C 4 alkyl, Ci-C 4 fluoroalkyl, Ci-C 4 deuteroalkyl, C
  • n 0, 1, or 2;
  • L 1 is absent, Ci-C 6 alkylene, Ci-Cefluoroalkylene, C3-C 6 cycloalkylene, (Ci-C 6 alkylene) p - C 3 -C 6 cycloalkylene-(Ci-C 6 alkylene) q , or -(Ci-C 6 alkylene) p -X 1 -(Ci-C 6 alkylene) q ;
  • p is 0 or 1;
  • q is 0 or 1
  • Y is H, unsubstituted or unsubstituted Ci-C 6 alkyl, CF 3 , halogen, or CN;
  • n 0, 1, or 2;
  • each R 9 is independently selected from the group consisting of Ci-C 6 alkyl, Ci-
  • each R is independently selected from the group consisting of H, Ci-C 6 alkyl, Ci- C 6 fluoroalkyl, Ci-C 6 deuteroalkyl, C 3 -C 6 cycloalkyl, a substituted or unsubstituted phenyl, a substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl; each R is independently selected from the group consisting of H, Ci-C 6 alkyl, Ci- C 6 fluoroalkyl, Ci-C 6 deuteroalkyl, C 3 -C 6 cycloalkyl, a substituted or unsubstituted phenyl, and a substituted or unsubstituted monocyclic heteroaryl; or
  • substituents are selected from among a subset of the listed alternatives.
  • Q is -C0 2 H, or - C0 2 (Ci-C 6 alkyl).
  • Q is -C0 2 H.
  • L 2 is -Ci-C 6 alkylene-. In some embodiments, L 2 is -CH 2 -, - CH2CH2-, -CH2CH2CH2-, -C(CH 3 ) 2 -, or -CH(CH 3 )-. In some embodiments, L 2 is -CH 2 -.
  • Ring A is phenyl, naphthyl, monocyclic heteroaryl containing 1- 4 N atoms and 0 or 1 O or S atoms, monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms, bicyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or bicyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
  • Ring A is phenyl, naphthyl, indanyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, triazinyl, quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl,
  • Ring A is phenyl, naphthyl, or indanyl. In some embodiments, Ring A is phenyl or naphthyl. In some embodiments, Ring A is phenyl. In some embodiments, Ring A is indanyl. In some embodiments, Ring A is phenyl, or indanyl.
  • Ring A is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
  • Ring A is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, or thiadiazolyl. In some embodiments, Ring A is thiazolyl.
  • Ring A is pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl. In some embodiments, Ring A is pyridinyl or pyrimidinyl. In some embodiments, Ring A is pyridinyl. In some embodiments, Ring A is pyrimidinyl.
  • Ring A is quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridinyl, pyridopyrimidinyl, pyrazolopyrimidinyl, or azaindolyl.
  • each R A is independently selected from the group consisting of
  • each R is H.
  • Ring A is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms;
  • Ring B is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
  • Ring B is phenyl, naphthyl, monocyclic heteroaryl containing 1- 4 N atoms and 0 or 1 O or S atoms, monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms, bicyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or bicyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
  • Ring B is phenyl, naphthyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, triazinyl, quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridin
  • Ring B is phenyl, or pyridinyl.
  • Ring B is phenyl or naphthyl. In some embodiments, Ring B is phenyl.
  • Ring B is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
  • Ring B is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, or thiadiazolyl. In some embodiments, Ring B is thiazolyl.
  • Ring B is pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl. In some embodiments, Ring B is pyridinyl.
  • Ring B is quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridinyl, pyridopyrimidinyl, pyrazolopyrimidinyl, or azaindolyl.
  • Ring A is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl; Ring B is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
  • Ring A is phenyl or pyridinyl
  • Ring B is phenyl or pyridinyl
  • the compound of Formula (I) has the following structure of Formula (II):
  • X is CH or N
  • the compound of Formula (I) has the following structure of Formula (III):
  • X is CH or ;
  • the compound of Formula (I) has the following structure of Formula (IV):
  • X is CH or N
  • the compound of Formula (I) has the following structure of Formula Formula (V):
  • X is CH or N
  • the compound of Formula (I) has the following structure of Formula (VI):
  • X is CH or N
  • the compound of Formula (I) has the following structure of Formula Formula (VII):
  • X is CH or N
  • X is CH. In some embodiments, X is N.
  • Y is H, -CH 3 , CF 3 , F, CI, Br, or CN;
  • R 1 is H, F, CI, -CN, -CH 3 , - CF 3 , or -CD 3 .
  • Y is H, -CH 3 , CF 3 , F, CI, Br, or CN. In some embodiments, Y is H, or CN. In some embodiments, Y is CN.
  • L 1 is absent, Ci-C 6 alkylene, C 3 -C 6 cycloalkylene, or (Ci- C6alkylene)p-C 3 -C6cycloalkylene-(Ci-C6alkylene) q . In some embodiments, L 1 is absent, Ci- C 6 alkylene, or C 3 -C 6 cycloalkylene.
  • L 1 is absent, -CH 2 -, -CH 2 CH 2 -, - CH 2 CH 2 CH 2 -, -CH(CH 3 ) -, -CH(CH 2 CH 3 )-, -C(CH 3 ) 2 -, -C(CH 2 CH 3 ) 2 -, cyclopropyl-l,l-diyl, cyclobutyl-l, l-diyl, cyclopentyl-l, l-diyl or cyclohexyl-l,l-diyl.
  • L 1 is absent, -CH 2 -, -CH(CH 3 ) -, -C(CH 3 ) 2 -, or cyclopropyl-l,l-diyl. In some embodiments, L 1 is absent or -CH 2 -. In some embodiments, L 1 is absent.
  • L 1 is absent, -CH 2 -, -CH 2 CH 2 -, -CH 2 CH 2 CH 2 -, -CH(CH 3 ) -, - CH(CH 2 CH 3 )-, -C(CH 3 ) 2 -, -C(CH 2 CH 3 ) 2 -, cyclopropyl-l,l-diyl, cyclobutyl-l,l-diyl, cyclopentyl- 1, 1-diyl or cyclohexyl-l, l-diyl;
  • each R A is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH 3 , -CF 3 , -OCH 3 , -OCH 2 CH 3 , -OCF 3 , or -OCH 2 CF 3 ;
  • each R B is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH 3 , -CF 3 , -OCH 3 , -OCH 2 CH 3 , -OCF 3 , or -OCH 2 CF 3 .
  • R 2 is H, halogen, -CN, -OH, d-C 4 alkyl, Ci-C 4 fluoroalkyl, C C 4 deuteroalkyl, Ci-C 4 alkoxy, or Ci-C 4 fiuoroalkoxy.
  • R 2 is H, F, CI, Br, I, -CN, -OH, -CH 3 , -CF 3 , -CD 3 , -OCH 3 , -
  • R 2 is H or CI.
  • R 3 is H, halogen, -CN, -OH, Ci-C 4 alkyl, Ci-C 4 fluoroalkyl, Ci- C 4 deuteroalkyl, Ci-C 4 alkoxy, or Ci-C 4 fluoroalkoxy.
  • R 3 is H, F, CI, Br, I, -CN, -OH, -CH 3 , -CF 3 , -CD 3 , -OCH 3 , -
  • R 3 is H, F, or CI.
  • L 1 is absent, -CH 2 -, -CH 2 CH 2 -, or -CH 2 CH 2 CH 2 -;
  • Q is -C0 2 H, or -C0 2 (Ci-C 6 alkyl).
  • each R B is independently selected from the group consisting of H, halogen, -CN, -OH, -OR 9 , Ci-C 6 alkyl, and Ci-C 6 fluoroalkyl. In some embodiments, each R B is independently selected from the group consisting of H, F, CI, -CN, -OH, -OCH 3 , -OCH 2 CH 3 , - OCH 2 CH 2 CH 3 , -CH 3 , -CH 2 CH 3 , -CF 3 , and -CH 2 CF 3 .
  • each R B is independently selected from the group consisting of H, F, CI, -OCH 3 , -CH 3 , and -CF 3 . In some embodiments, each R B is independently selected from the group consisting of H, F, and CI. In some embodiments, n is 0 or 1. In some embodiments, n is 1.
  • Ring B is phenyl, or pyridinyl; each R B is independently selected from the group consisting of H, halogen, -CN, -OH, -OR 9 , Ci-C 6 alkyl, and Ci-C 6 fluoroalkyl; n is 0 or 1.
  • Ring B is phenyl, or pyridinyl; each R B is independently selected from the group consisting of H, F, CI, -OCH 3 , -CH 3 , and -CF 3 ; n is 0 or 1.
  • L 1 is absent, -CH 2 -, -CH 2 CH 2 -, or -CH 2 CH 2 CH 2 -; and Q is - C0 2 H, or -C0 2 (Ci-C 6 alkyl). In some embodiments, L 1 is absent, or -CH 2 -; and Q is -C0 2 H.
  • Exemplary compounds of Formula (I) include the compounds described in the following Tables:
  • Table 1 3 , 5, 6, 7, or 8 is replaced with a group as defined in Table 2 or Table
  • compounds described herein are in the form of pharmaceutically acceptable salts.
  • active metabolites of these compounds having the same type of activity are included in the scope of the present disclosure.
  • the compounds described herein can exist in unsolvated as well as solvated forms with pharmaceutically acceptable solvents such as water, ethanol, and the like.
  • the solvated forms of the compounds presented herein are also considered to be disclosed herein.
  • “Pharmaceutically acceptable,” as used herein, refers a material, such as a carrier or diluent, which does not abrogate the biological activity or properties of the compound, and is relatively nontoxic, i.e., the material is administered to an individual without causing undesirable biological effects or interacting in a deleterious manner with any of the components of the composition in which it is contained.
  • pharmaceutically acceptable salt refers to a form of a therapeutically active agent that consists of a cationic form of the therapeutically active agent in combination with a suitable anion, or in alternative embodiments, an anionic form of the therapeutically active agent in combination with a suitable cation.
  • Handbook of Pharmaceutical Salts Properties, Selection and Use. International Union of Pure and Applied Chemistry, Wiley-VCH 2002. S.M. Berge, L.D. Bighley, D.C. Monkhouse, J. Pharm. Sci. 1977, 66, 1-19. P. H. Stahl and C. G. Wermuth, editors, Handbook of Pharmaceutical Salts: Properties, Selection and Use,
  • salts typically are more soluble and more rapidly soluble in stomach and intestinal juices than non-ionic species and so are useful in solid dosage forms. Furthermore, because their solubility often is a function of pH, selective dissolution in one or another part of the digestive tract is possible and this capability can be manipulated as one aspect of delayed and sustained release behaviours. Also, because the salt- forming molecule can be in equilibrium with a neutral form, passage through biological membranes can be adjusted.
  • pharmaceutically acceptable salts are obtained by reacting a compound of Formula (I) with an acid.
  • the compound of Formula (I) i.e. free base form
  • Inorganic acids include, but are not limited to, hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid, and metaphosphoric acid.
  • Organic acids include, but are not limited to, 1- hydroxy-2-naphthoic acid; 2,2-dichloroacetic acid; 2-hydroxyethanesulfonic acid; 2-oxoglutaric acid; 4-acetamidobenzoic acid; 4-aminosalicylic acid; acetic acid; adipic acid; ascorbic acid (L); aspartic acid (L); benzenesulfonic acid; benzoic acid; camphoric acid (+); camphor- 10-sulfonic acid (+); capric acid (decanoic acid); caproic acid (hexanoic acid); caprylic acid (octanoic acid); carbonic acid; cinnamic acid; citric acid; cyclamic acid; dodecylsulfuric acid; ethane-1,2- disulfonic acid; ethanesulfonic acid; formic acid; fumaric acid; galactaric acid; gentisic acid; glucoheptonic acid (D); glu
  • methanesulfonic acid naphthalene- 1,5-disulfonic acid; naphthalene-2-sulfonic acid; nicotinic acid; oleic acid; oxalic acid; palmitic acid; pamoic acid; phosphoric acid; proprionic acid;
  • pyroglutamic acid (- L); salicylic acid; sebacic acid; stearic acid; succinic acid; sulfuric acid; tartaric acid (+ L); thiocyanic acid; toluenesulfonic acid (p) and undecylenic acid.
  • a compound of Formula (I) is prepared as a chloride salt, sulfate salt, bromide salt, mesylate salt, maleate salt, citrate salt or phosphate salt. In some embodiments, a compound of Formula (I) is prepared as a hydrochloride salt.
  • pharmaceutically acceptable salts are obtained by reacting a compound of Formula (I) with a base.
  • the compound of Formula (I) is acidic and is reacted with a base.
  • an acidic proton of the compound of Formula (I) is replaced by a metal ion, e.g., lithium, sodium, potassium, magnesium, calcium, or an aluminum ion.
  • compounds described herein coordinate with an organic base, such as, but not limited to, ethanolamine, diethanolamine, triethanolamine, tromethamine, meglumine, N-methylglucamine, dicyclohexylamine, tris(hydroxymethyl)methylamine.
  • compounds described herein form salts with amino acids such as, but not limited to, arginine, lysine, and the like.
  • Acceptable inorganic bases used to form salts with compounds that include an acidic proton include, but are not limited to, aluminum hydroxide, calcium hydroxide, potassium hydroxide, sodium carbonate, potassium carbonate, sodium hydroxide, lithium hydroxide, and the like.
  • the compounds provided herein are prepared as a sodium salt, calcium salt, potassium salt, magnesium salt, meglumine salt, N-methylglucamine salt or ammonium salt.
  • the compounds provided herein are prepared as a sodium salt.
  • solvates contain either stoichiometric or non- stoichiometric amounts of a solvent, and are formed during the process of crystallization with pharmaceutically acceptable solvents such as water, ethanol, and the like. Hydrates are formed when the solvent is water, or alcoholates are formed when the solvent is alcohol. Solvates of compounds described herein are conveniently prepared or formed during the processes described herein. In addition, the compounds provided herein optionally exist in unsolvated as well as solvated forms.
  • N-oxides if appropriate
  • crystalline forms also known as polymorphs
  • pharmaceutically acceptable salts of compounds having the structure of Formula (I) as well as active metabolites of these compounds having the same type of activity.
  • sites on the organic radicals (e.g. alkyl groups, aromatic rings) of compounds of Formula (I) are susceptible to various metabolic reactions. Incorporation of appropriate substituents on the organic radicals will reduce, minimize or eliminate this metabolic pathway.
  • the appropriate substituent to decrease or eliminate the susceptibility of the aromatic ring to metabolic reactions is, by way of example only, a halogen, deuterium, an alkyl group, a haloalkyl group, or a deuteroalkyl group.
  • the compounds described herein are labeled isotopically (e.g. with a radioisotope) or by another other means, including, but not limited to, the use of chromophores or fluorescent moieties, bioluminescent labels, or chemiluminescent labels.
  • Compounds described herein include isotopically-labeled compounds, which are identical to those recited in the various formulae and structures presented herein, but for the fact that one or more atoms 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 the present compounds include isotopes of hydrogen, carbon, nitrogen, oxygen, sulfur, fluorine and chlorine, such as, for example, 2 H, 3 H, 13 C, 14 C, 15 N, 18 0, 17 0, 35 S, 18 F, 36 C1.
  • isotopically-labeled compounds described herein for example those into which radioactive isotopes such as 3 H and 14 C are incorporated, are useful in drug and/or substrate tissue distribution assays.
  • substitution with isotopes such as deuterium affords certain therapeutic advantages resulting from greater metabolic stability, such as, for example, increased in vivo half-life or reduced dosage requirements.
  • the compounds of Formula (I) possess one or more stereocenters and each stereocenter exists independently in either the R or S configuration.
  • the compounds presented herein include all diastereomeric, enantiomeric, atropisomers, and epimeric forms as well as the appropriate mixtures thereof.
  • the compounds and methods provided herein include all cis, trans, syn, anti,
  • E
  • Z
  • isomers as well as the appropriate mixtures thereof.
  • stereoisomers are obtained, if desired, by methods such as, stereoselective synthesis and/or the separation of stereoisomers by chiral chromatographic columns.
  • compounds of Formula (I) are prepared as their individual stereoisomers by reacting a racemic mixture of the compound with an optically active resolving agent to form a pair of diastereoisomeric compounds/salts, separating the diastereomers and recovering the optically pure enantiomers.
  • resolution of enantiomers is carried out using covalent diastereomeric derivatives of the compounds described herein.
  • diastereomers are separated by separation/resolution techniques based upon differences in solubility.
  • separation of steroisomers is performed by chromatography or by the forming diastereomeric salts and separation by recrystallization, or chromatography, or any combination thereof.
  • stereoisomers are obtained by stereoselective synthesis.
  • compounds described herein are prepared as prodrugs.
  • a "prodrug” refers to an agent that is converted into the parent drug in vivo. Prodrugs are often useful because, in some situations, they are easier to administer than the parent drug. They are, for instance, bioavailable by oral administration whereas the parent is not. Further or
  • the prodrug also has improved solubility in pharmaceutical compositions over the parent drug.
  • the design of a prodrug increases the effective water solubility.
  • a prodrug is a compound described herein, which is administered as an ester (the "prodrug") but then is metabolically hydrolyzed to provide the active entity.
  • a further example of a prodrug is a short peptide (polyaminoacid) bonded to an acid group where the peptide is metabolized to reveal the active moiety.
  • a prodrug upon in vivo administration, a prodrug is chemically converted to the biologically,
  • a prodrug is enzymatically metabolized by one or more steps or processes to the biologically, pharmaceutically or therapeutically active form of the compound.
  • Prodrugs of the compounds described herein include, but are not limited to, esters, ethers, carbonates, thiocarbonates, N-acyl derivatives, N-acyloxy alkyl derivatives, quaternary derivatives of tertiary amines, N-Mannich bases, Schiff bases, amino acid conjugates, phosphate esters, and sulfonate esters. See for example Design of Prodrugs, Bundgaard, A. Ed., Elseview, 1985 and Method in Enzymology, Widder, K. et al, Ed.; Academic, 1985, vol. 42, p. 309-396; Bundgaard, H.
  • a hydroxyl group in the compounds disclosed herein is used to form a prodrug, wherein the hydroxyl group is incorporated into an acyloxyalkyl ester, alkoxycarbonyloxyalkyl ester, alkyl ester, aryl ester, phosphate ester, sugar ester, ether, and the like.
  • a hydroxyl group in the compounds disclosed herein is a prodrug wherein the hydroxyl is then metabolized in vivo to provide a carboxylic acid group.
  • a carboxyl group is used to provide an ester or amide (i.e. the prodrug), which is then metabolized in vivo to provide a carboxylic acid group.
  • compounds described herein are prepared as alkyl ester prodrugs.
  • Prodrug forms of the herein described compounds, wherein the prodrug is metabolized in vivo to produce a compound of Formula (I) as set forth herein are included within the scope of the claims. In some cases, some of the herein-described compounds is a prodrug for another derivative or active compound.
  • the compounds described herein are metabolized upon administration to an organism in need to produce a metabolite that is then used to produce a desired effect, including a desired therapeutic effect.
  • a "metabolite” of a compound disclosed herein is a derivative of that compound that is formed when the compound is metabolized.
  • active metabolite refers to a biologically active derivative of a compound that is formed when the compound is metabolized.
  • metabolism refers to the sum of the processes (including, but not limited to, hydrolysis reactions and reactions catalyzed by enzymes) by which a particular substance is changed by an organism. Thus, enzymes may produce specific structural alterations to a compound.
  • cytochrome P450 catalyzes a variety of oxidative and reductive reactions while uridine diphosphate glucuronyltransferases catalyze the transfer of an activated glucuronic-acid molecule to aromatic alcohols, aliphatic alcohols, carboxylic acids, amines and free sulphydryl groups.
  • Metabolites of the compounds disclosed herein are optionally identified either by administration of compounds to a host and analysis of tissue samples from the host, or by incubation of compounds with hepatic cells in vitro and analysis of the resulting compounds.
  • Indazoles are readily prepared by chemical synthesis using commercially available indazoles as starting materials. Compounds are prepared using standard organic chemistry techniques such as those described in, for example, March's Advanced Organic Chemistry, 6 th Edition, John Wiley and Sons, Inc. Alternative reaction conditions for the synthetic
  • transformations described herein may be employed such as variation of solvent, reaction temperature, reaction time, as well as different chemical reagents and other reaction conditions.
  • Indole containing compounds of general structure 1-7 are prepared in a variety of ways.
  • indoles of general structure I 7 are prepared as outlined in Scheme I.
  • a hydrazine of general structure -l is N- alkylated using standard conditions to afford the hydrazine 1-2.
  • a Fisher-indole condensation then affords the indole i -4 with cyclization favoring the C-3 unsubstituted indole (see Illy and Funderburk, J. Org. Chem., 1968, 33, 4283-4285). Reversing the order of reactions (Fisher-indolization to yield 1-3 then N- alkylation) provides an alternate way to synthesize 1-4.
  • R 1 is an ester (e.g.
  • R 1 -C0 2 Me
  • a suitable base for hydrolysis includes but is not limited to aqueous LiOH in MeOH.
  • functionalization at C-3 of the indole J-4 is carried out to generate the 3-formyl derivative J-5 (using POCl 3 in DMF) or the 3-iodo derivative 1-6 (using NIS in TUF).
  • the aldehyde of 1 -5 is converted into the alkene containing compound 1-7 using a suitable method, such as an aldol reaction or a Wittig reaction.
  • alkene containing compounds such as 1-7 are prepared from the iodo compound 1-6 by a metal -catalyzed cross coupling reaction with the appropriately substituted alkene or cross-coupling with the appropriate alkyne followed by reduction to the alkene.
  • hydrazines of general structure ⁇ -1 (or 1-2) are reacted with the appropriate ketones to generate indoles of structure 1-7 directly by utilizing the Fisher-indole reaction.
  • lH-indole-3-carbaldehydes are prepared as outlined in Scheme II.
  • the Larock indole synthesis is adapted to yield indoles II-4 containing both 2-H and 3-formyl substituents.
  • 2-iodo aniline II- 1 a palladium-catalyzed reaction using the bis-TES-propargyl alcohol A yields the indole II- 2. Removal of the silicon protecting groups then affords II-3 and further oxidation results in the formation of II-4.
  • indoles are prepared as outlined in Scheme III.
  • Boc-protected 2-iodoanilines (III-l) are treated with TMS -acetylene using Sonogashira cross-coupling conditions to generate the alkyne III-2 which, upon treatment with a suitable base then cyclizes to afford indoles of general structure III-3.
  • indoles are prepared as outlined in Scheme IV using the Leimgruber-Batcho indole synthesis.
  • substituted O-nitrotoluene IV- 1 is reacted with dimethylformamide dimethyl acetal (DMFDMA) to provide the vinyl intermediate IV-2.
  • DMFDMA dimethylformamide dimethyl acetal
  • Reductive cyclization using the appropriate reagents yields the indole of general structure IV-3.
  • Suitable reagents for reductive cyclization include but are not limited to nickel boride and hydrazine.
  • indoles are prepared as outlined in Scheme IV using the Bartoli indole synthesis.
  • N-H Indoles of general structure VI- 1 are further modified as shown in Scheme VI.
  • an appropriate base such as NaH
  • an electrophile for example BrCH 2 CONR'R" or BrCH 2 CH 2 C0 2 tBu
  • subsequent chemical modifications are made to the indole N-substituent using standard chemical transformations.
  • direct arylation or heteroarylation is achieved using Ullman-type conditions to generate VI-3.
  • Deprotonation of VI-1 with a suitable base by treatment with a variety of suitable electrophiles affords a series of N-functionalized compounds of general structures VI-4 to VI-7.
  • An example of a suitable base includes but is not limited to NaH.
  • a variety of suitable electrophiles includes but is not limited to R 3 S0 2 C1; R 3 COCl, and R 3 OCOCl.
  • indazoles are prepared as outlined in Scheme VII.
  • substituted indoles of general structure VII- 1 are treated with aqueous NaN0 2 under acidic conditions (pH 1-2) to afford the corresponding 3-indazole carboxaldehyde VII-2.
  • Oxidation of VII-2 using an appropriate oxidizing agent, such as NaC10 2 then affords the 3-carboxylic acid VII-3.
  • an anion such as a Grignard reagent or an organolithium species, results in the secondary alcohol VII-4, where R is an organic radical.
  • a suitable reducing agent includes but is not limited to NaBH. Reaction of the aldehyde with a Wittig reagent or under condensation conditions then results in unsaturated derivatives of general structure VII-5.
  • acid VII-3 is transformed into a variety of derivatives.
  • VII-4 is dehydrated by reaction with mesyl chloride or tosyl chloride and then subjected to conditions for elimination of the leaving group to afford compounds such as VII-5.
  • 2-nitrobenzaldehydes of general structure VIII- 1 are treated with malonic acid and ammonium formate in EtOH followed by reductive cyclization with N 2 H 4 , Ra-Ni in aqueous NaOH to provide the indazole VIII-2.
  • indazoles are prepared as shown in Scheme IX.
  • Scheme IX describes the synthesis of 3-aminoindazoles IX-2 by treatment of 2- fluorobenzonitriles IX-1 with N 2 H 4 in EtOH at elevated temperature.
  • indazoles are prepared from 2-fluorobenzaldehydes as shown in Scheme X.
  • 2-fluorobenzaldehydes (X-1) are treated with N 2 H 4 in a suitable solvent, such as DMSO, with heat to generate the indazole X-2.
  • a suitable solvent such as DMSO
  • Formylation using POCl 3 in DMF yields the aldehyde X-4.
  • Iodination at C-3 is achieved using I 2 , NaOH in DMF to yield X-3 then metal catalyzed cross-coupling reactions are used to install a variety of different R groups as in X-5.
  • Phenylketones of general structure XI- 1 upon treatment with a hydrazine H 2 N HR 1 in a suitable solvent, such as MeOH ,with an appropriate acid catalyst, such as HO Ac, will form the hydrazone XI-2.
  • An intramolecular C-H amination reaction then converts XI-2 into the indazole XI-3.
  • Suitable reagents for this transformation include but are not limited to FeBr 3 and 0 2 in toluene at elevated temperature (Zhang and Bao, J. Org. Chem., 2013 in press) or alternatively using Pb(OAc) 4 in DCM followed by BF 3 .Et 2 0 (Lien et al, J. Med. Chem., 2002, 45, 4947- 4949).
  • N-H indazoles are N-substituted as described in Scheme XII.
  • indazoles of general structure XII- 1 are N-substituted by treatment with a suitable strong base (e.g.NaH) in a suitable organic solvent (such as, but not limited to, THF or DMF) followed by reaction with an electrophile (such as, but not limited to, a bromide (R ⁇ -Br)).
  • a suitable strong base e.g.NaH
  • a suitable organic solvent such as, but not limited to, THF or DMF
  • an electrophile such as, but not limited to, a bromide (R ⁇ -Br)
  • the resulting indazole is further reacted using standard conditions to generate indazole-containing products.
  • Substituted 7-azaindoles XIII-A, B, C and D; pyrimidine pyrroles XIII-E and F; thienopyrroles with the 6H-thieno[2,3-b]pyrrole XIII-G core or 4H-thieno[3,2-b]pyrrole XIII-H and pyrazolopyridines XIII-I, J, K andj ⁇ cores are commercially available and are used as starting materials for the preparation of compounds described herein in some embodiments. Functionalization of compounds containing core structures XIII-A to L is achieved using similar chemistry as described above in some embodiments.
  • 6H-thieno[2,3-b]pyrrole containing compounds are prepared as outlined in Scheme XIV.
  • 6H-thieno[2,3-b]pyrrole containing compounds are prepared starting from the appropriate thiophene-3-carboxaldehyde XIV-1 (c.f Venable J. Med. Chem, 2005, 48, p8289). Condensation of XIV-1 and ethyl azidoacetate yields the thiophene XIV-2, which then undergoes a Hemetsburger reaction to generate the thienopyrrole XIV-3. In some embodiments, further substitution of the thienopyrrole ring is performed. For an example, chlorination of XIV-4 using NCS in AcOH provides XIV-5.
  • the ester XIV-5 is hydrolyzed to the acid using a suitable aqueous base (e.g. LiOH) with an appropriate organic solvent, such as MeOH, and the resulting acid is decarboxylated using, for example Cu in quinoline at reflux, to generate the 2-H derivative XIV-6.
  • a suitable aqueous base e.g. LiOH
  • MeOH an appropriate organic solvent
  • the resulting acid is decarboxylated using, for example Cu in quinoline at reflux, to generate the 2-H derivative XIV-6.
  • the 4H-thieno[3,2-b]pyrrole containing compounds are prepared according to Scheme XV following a similar reaction sequence.
  • the double bond to which the nitrile and heteroaryl group (such as a 3-substituted indole in compound XVI-1) may be reduced using, for example, NaBH 4 in an organic solvent such as THF or MeOH to afford the saturated derivative XVI-2 (Scheme XVI).
  • An alternate method of reducing the double bond employs hydrogen gas in the presence of a catalyst such as Pd on carbon in a solvent such as acetone.
  • Ci-C x includes C 1 -C 2 , C 1 -C3 . . . Ci-C x .
  • a group designated as "C 1 -C 4 " indicates that there are one to four carbon atoms in the moiety, i.e. groups containing 1 carbon atom, 2 carbon atoms, 3 carbon atoms or 4 carbon atoms.
  • C 1 -C4 alkyl indicates that there are one to four carbon atoms in the alkyl group, i.e., the alkyl group is selected from among methyl, ethyl, propyl, z ' so-propyl, /7-butyl, /so-butyl, sec-butyl, and t-butyl.
  • an "alkyl” group refers to an aliphatic hydrocarbon group.
  • the alkyl group is branched or straight chain.
  • the "alkyl” group has 1 to 10 carbon atoms, i.e. a Ci- C 10 alkyl.
  • a numerical range such as “1 to 10” refers to each integer in the given range; e.g., " 1 to 10 carbon atoms” means that the alkyl group consist of 1 carbon atom, 2 carbon atoms, 3 carbon atoms, etc., up to and including 10 carbon atoms, although the present definition also covers the occurrence of the term "alkyl” where no numerical range is designated.
  • an alkyl is a Ci-C 6 alkyl.
  • the alkyl is methyl, ethyl, propyl, iso-propyl, n-butyl, iso-butyl, sec-butyl, or t-butyl.
  • Typical alkyl groups include, but are in no way limited to, methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, tertiary butyl, pentyl, neopentyl, or hexyl.
  • alkyl ene group refers refers to a divalent alkyl radical. Any of the above mentioned monovalent alkyl groups may be an alkylene by abstraction of a second hydrogen atom from the alkyl. In some embodiments, an alkelene is a Ci-C 6 alkylene. In other words,
  • an alkylene is a Ci-C 4 alkylene.
  • Typical alkylene groups include, but are not limited to, -CH 2 -, -CH(CH 3 )-, -C(CH 3 ) 2 -, -CH 2 CH 2 -, -CH 2 CH(CH 3 )-, -CH 2 C(CH 3 ) 2 -, - CH 2 CH 2 CH 2 -, -CH 2 CH 2 CH 2 CH 2 -, and the like.
  • Deuteroalkyl refers to an alkyl group where 1 or more hydrogen atoms of an alkyl are replaced with deuterium.
  • alkenyl refers to a type of alkyl group in which at least one carbon-carbon double bond is present.
  • R is H or an alkyl.
  • alkynyl refers to a type of alkyl group in which at least one carbon-carbon triple bond is present.
  • an alkenyl group has the formula -C ⁇ C-R, wherein R refers to the remaining portions of the alkynyl group.
  • R is H or an alkyl.
  • Non-limiting examples of an alkynyl group include -C ⁇ CH, -C ⁇ CCH 3 -C ⁇ CCH 2 CH 3 , - CH 2 C ⁇ CH.
  • alkoxy refers to a (alkyl)O- group, where alkyl is as defined herein.
  • alkylamine refers to the -N(alkyl) x H y group, where x is 0 and y is 2, or where x is 1 and y is 1, or where x is 2 and y is 0.
  • aromatic refers to a planar ring having a delocalized ⁇ -electron system containing 4n+2 ⁇ electrons, where n is an integer.
  • aromatic includes both carbocyclic aryl ("aryl”, e.g., phenyl) and heterocyclic aryl (or “heteroaryl” or “heteroaromatic”) groups (e.g., pyridine).
  • aryl e.g., phenyl
  • heterocyclic aryl or “heteroaryl” or “heteroaromatic” groups
  • pyridine e.g., pyridine
  • the term includes monocyclic or fused-ring polycyclic (i.e., rings which share adjacent pairs of carbon atoms) groups.
  • carbocyclic or “carbocycle” refers to a ring or ring system where the atoms forming the backbone of the ring are all carbon atoms. The term thus distinguishes carbocyclic from “heterocyclic” rings or “heterocycles” in which the ring backbone contains at least one atom which is different from carbon. In some embodiments, at least one of the two rings of a bicyclic carbocycle is aromatic. In some embodiments, both rings of a bicyclic carbocycle are aromatic. [00236] As used herein, the term “aryl” refers to an aromatic ring wherein each of the atoms forming the ring is a carbon atom.
  • aryl is phenyl or a naphthyl. In some embodiments, an aryl is a phenyl. In some embodiments, an aryl is a phenyl, naphthyl, indanyl, indenyl, or tetrahyodronaphthyl. In some embodiments, an aryl is a C 6 -Cioaryl. Depending on the structure, an aryl group is a monoradical or a diradical (i.e., an arylene group).
  • cycloalkyl refers to a monocyclic or polycyclic aliphatic, non-aromatic radical, wherein each of the atoms forming the ring (i.e. skeletal atoms) is a carbon atom.
  • cycloalkyls are spirocyclic or bridged compounds.
  • cycloalkyls are optionally fused with an aromatic ring, and the point of attachment is at a carbon that is not an aromatic ring carbon atom.
  • Cycloalkyl groups include groups having from 3 to 10 ring atoms.
  • cycloalkyl groups are selected from among cyclopropyl, cyclobutyl, cyclopentyl, cyclopentenyl, cyclohexyl, cyclohexenyl, cycloheptyl, cyclooctyl, spiro[2.2]pentyl, norbornyl and bicycle[l . l . l]pentyl.
  • a cycloalkyl is a C 3 - C 6 cycloalkyl.
  • halo or, alternatively, "halogen” or “halide” means fluoro, chloro, bromo or iodo. In some embodiments, halo is fluoro, chloro, or bromo.
  • fluoroalkyl refers to an alkyl in which one or more hydrogen atoms are replaced by a fluorine atom.
  • a fluoralkyl is a Ci-C 6 fluoroalkyl.
  • heteroalkyl refers to an alkyl group in which one or more skeletal atoms of the alkyl are selected from an atom other than carbon, e.g., oxygen, nitrogen (e.g. - H-, - N(alkyl)-, sulfur, or combinations thereof.
  • a heteroalkyl is attached to the rest of the molecule at a carbon atom of the heteroalkyl.
  • a heteroalkyl is a Ci-C 6 heteroalkyl.
  • heterocycle refers to heteroaromatic rings (also known as heteroaryls) and heterocycloalkyl rings (also known as heteroalicyclic groups) containing one to four heteroatoms in the ring(s), where each heteroatom in the ring(s) is selected from O, S and N, wherein each heterocyclic group has from 3 to 10 atoms in its ring system, and with the proviso that any ring does not contain two adjacent O or S atoms.
  • Non-aromatic heterocyclic groups also known as heterocycloalkyls
  • aromatic heterocyclic groups include rings having 5 to 10 atoms in its ring system.
  • heterocyclic groups include benzo-fused ring systems.
  • non-aromatic heterocyclic groups are pyrrolidinyl, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothienyl, oxazolidinonyl, tetrahydropyranyl, dihydropyranyl, tetrahydrothiopyranyl, piperidinyl, morpholinyl,
  • aromatic heterocyclic groups are pyridinyl, imidazolyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, furyl, thienyl, isoxazolyl, thiazolyl, oxazolyl, isothiazolyl, pyrrolyl, quinolinyl, isoquinolinyl, indolyl, benzimidazolyl, benzofuranyl, cinnolinyl, indazolyl, indolizinyl, phthalazinyl, pyridazinyl, triazinyl, isoindolyl, pteridinyl, purinyl, oxadiazolyl, thiadiazolyl, furazanyl, benzofurazanyl, benzothiophenyl, benzothiazolyl, benzoxazolyl, quinazolinyl, quinox
  • the foregoing groups are either C-attached (or C-linked) or TV-attached where such is possible.
  • a group derived from pyrrole includes both pyrrol-l-yl (TV-attached) or pyrrol-3-yl (C-attached).
  • a group derived from imidazole includes imidazol-l-yl or imidazol-3-yl (both TV- attached) or imidazol-2-yl, imidazol-4-yl or imidazol-5-yl (all C-attached).
  • the heterocyclic groups include benzo-fused ring systems.
  • at least one of the two rings of a bicyclic heterocycle is aromatic.
  • both rings of a bicyclic heterocycle are aromatic.
  • heteroaryl or, alternatively, “heteroaromatic” refers to an aryl group that includes one or more ring heteroatoms selected from nitrogen, oxygen and sulfur.
  • heteroaryl groups include monocyclic heteroaryls and bicyclcic heteroaryls.
  • Monocyclic heteroaryls include pyridinyl, imidazolyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, furyl, thienyl, isoxazolyl, thiazolyl, oxazolyl, isothiazolyl, pyrrolyl, pyridazinyl, triazinyl, oxadiazolyl, thiadiazolyl, and furazanyl.
  • Monocyclic heteroaryls include indolizine, indole, benzofuran, benzothiophene, indazole, benzimidazole, purine, quinolizine, quinoline, isoquinoline, cinnoline, phthalazine, quinazoline, quinoxaline, 1,8-naphthyridine, and pteridine.
  • a heteroaryl contains 0-4 N atoms in the ring.
  • a heteroaryl contains 1-4 N atoms in the ring.
  • a heteroaryl contains 0-4 N atoms, 0-1 O atoms, and 0-1 S atoms in the ring.
  • a heteroaryl contains 1-4 N atoms, 0-1 O atoms, and 0-1 S atoms in the ring.
  • heteroaryl is a Ci-C 9 heteroaryl.
  • monocyclic heteroaryl is a Ci-C 5 heteroaryl.
  • monocyclic heteroaryl is a 5-membered or 6-membered heteroaryl.
  • bicyclic heteroaryl is a C 6 -C 9 heteroaryl.
  • a "heterocycloalkyl” or “heteroalicyclic” group refers to a cycloalkyl group that includes at least one heteroatom selected from nitrogen, oxygen and sulfur.
  • a heterocycloalkyl is fused with an aryl or heteroaryl.
  • the heterocycloalkyl is oxazolidinonyl, pyrrolidinyl, tetrahydrofuranyl, tetrahydrothienyl,
  • tetrahydropyranyl tetrahydrothiopyranyl
  • piperidinyl morpholinyl, thiomorpholinyl, piperazinyl, piperidin-2-onyl, pyrrolidine-2,5-dithionyl, pyrrolidine-2,5-dionyl, pyrrolidinonyl,
  • heteroalicyclic also includes all ring forms of the carbohydrates, including but not limited to the monosaccharides, the disaccharides and the oligosaccharides.
  • a heterocycloalkyl is a C 2 - Cioheterocycloalkyl.
  • a heterocycloalkyl is a C 4 -Ci 0 heterocycloalkyl.
  • a heterocycloalkyl contains 0-2 N atoms in the ring.
  • a heterocycloalkyl contains 0-2 N atoms, 0-2 O atoms and 0-1 S atoms in the ring.
  • bond refers to a chemical bond between two atoms, or two moieties when the atoms joined by the bond are considered to be part of larger substructure.
  • bond when a group described herein is a bond, the referenced group is absent thereby allowing a bond to be formed between the remaining identified groups.
  • moiety refers to a specific segment or functional group of a molecule.
  • Chemical moieties are often recognized chemical entities embedded in or appended to a molecule.
  • optional substituents are independently selected from halogen, -CN, -NH 2 , -OH, -NH(CH 3 ), -N(CH 3 ) 2 , -CH 3 , - CH 2 CH 3 , -CF 3 , -OCH 3 , and -OCF 3 .
  • substituted groups are substituted with one or two of the preceding groups.
  • carboxylic acid bioisostere refers to a functional group or moiety that exhibits similar physical, biological and/or chemical properties as a carboxylic acid moiety.
  • Examples of carboxylic acid bioisosteres include, but are not limited to,
  • module means to interact with a target either directly or indirectly so as to alter the activity of the target, including, by way of example only, to enhance the activity of the target, to inhibit the activity of the target, to limit the activity of the target, or to extend the activity of the target.
  • modulator refers to a molecule that interacts with a target either directly or indirectly.
  • the interactions include, but are not limited to, the interactions of an agonist, partial agonist, an inverse agonist, antagonist, degrader, or combinations thereof.
  • a modulator is an antagonist.
  • a modulator is a degrader.
  • administer refers to the methods that may be used to enable delivery of compounds or compositions to the desired site of biological action. These methods include, but are not limited to oral routes, intraduodenal routes, parenteral injection (including intravenous, subcutaneous, intraperitoneal, intramuscular, intravascular or infusion), topical and rectal administration. Those of skill in the art are familiar with administration techniques that can be employed with the compounds and methods described herein. In some embodiments, the compounds and compositions described herein are administered orally.
  • co-administration or the like, as used herein, are meant to encompass administration of the selected therapeutic agents to a single patient, and are intended to include treatment regimens in which the agents are administered by the same or different route of administration or at the same or different time.
  • an “effective amount” or “therapeutically effective amount,” as used herein, refer to a sufficient amount of an agent or a compound being administered, which will relieve to some extent one or more of the symptoms of the disease or condition being treated. The result includes reduction and/or alleviation of the signs, symptoms, or causes of a disease, or any other desired alteration of a biological system.
  • an “effective amount” for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms.
  • An appropriate “effective” amount in any individual case is optionally determined using techniques, such as a dose escalation study.
  • the terms “enhance” or “enhancing,” as used herein, means to increase or prolong either in potency or duration a desired effect.
  • the term “enhancing” refers to the ability to increase or prolong, either in potency or duration, the effect of other therapeutic agents on a system.
  • An “enhancing-effective amount,” as used herein, refers to an amount adequate to enhance the effect of another therapeutic agent in a desired system.
  • pharmaceutical combination means a product that results from the mixing or combining of more than one active ingredient and includes both fixed and non-fixed combinations of the active ingredients.
  • fixed combination means that the active ingredients, e.g. a compound of Formula (I), or a pharmaceutically acceptable salt thereof, and a co-agent, are both administered to a patient simultaneously in the form of a single entity or dosage.
  • non-fixed combination means that the active ingredients, e.g.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof, and a co-agent are administered to a patient as separate entities either simultaneously, concurrently or sequentially with no specific intervening time limits, wherein such administration provides effective levels of the two compounds in the body of the patient.
  • cocktail therapy e.g. the administration of three or more active ingredients.
  • the term "subject” or “patient” encompasses mammals.
  • mammals include, but are not limited to, any member of the Mammalian class: humans, non-human primates such as chimpanzees, and other apes and monkey species; farm animals such as cattle, horses, sheep, goats, swine; domestic animals such as rabbits, dogs, and cats; laboratory animals including rodents, such as rats, mice and guinea pigs, and the like.
  • the mammal is a human.
  • treat include alleviating, abating or ameliorating at least one symptom of a disease or condition, preventing additional symptoms, inhibiting the disease or condition, e.g., arresting the development of the disease or condition, relieving the disease or condition, causing regression of the disease or condition, relieving a condition caused by the disease or condition, or stopping the symptoms of the disease or condition either prophylactically and/or therapeutically.
  • Pharmaceutical compositions include alleviating, abating or ameliorating at least one symptom of a disease or condition, preventing additional symptoms, inhibiting the disease or condition, e.g., arresting the development of the disease or condition, relieving the disease or condition, causing regression of the disease or condition, relieving a condition caused by the disease or condition, or stopping the symptoms of the disease or condition either prophylactically and/or therapeutically.
  • the compounds described herein are formulated into
  • compositions are formulated in a conventional manner using one or more pharmaceutically acceptable inactive ingredients that facilitate processing of the active compounds into preparations that are used pharmaceutically. Proper formulation is dependent upon the route of administration chosen.
  • a summary of pharmaceutical compositions described herein is found, for example, in Remington: The Science and Practice of Pharmacy, Nineteenth Ed (Easton, Pa. : Mack Publishing Company, 1995); Hoover, John E., Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pennsylvania 1975;
  • the compounds described herein are administered either alone or in combination with pharmaceutically acceptable carriers, excipients or diluents, in a
  • Administration of the compounds and compositions described herein can be effected by any method that enables delivery of the compounds to the site of action. These methods include, though are not limited to delivery via enteral routes (including oral, gastric or duodenal feeding tube, rectal suppository and rectal enema), parenteral routes
  • injection or infusion including intraarterial, intracardiac, intradermal, intraduodenal,
  • compounds described herein can be administered locally to the area in need of treatment, by for example, local infusion during surgery, topical application such as creams or ointments, injection, catheter, or implant.
  • the administration can also be by direct injection at the site of a diseased tissue or organ.
  • compositions suitable for oral administration are presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion.
  • the active ingredient is presented as a bolus, electuary or paste.
  • Pharmaceutical compositions which can be used orally include tablets, push-fit capsules made of gelatin, as well as soft, sealed capsules made of gelatin and a plasticizer, such as glycerol or sorbitol.
  • Tablets may be made by compression or molding, optionally with one or more accessory ingredients.
  • Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with binders, inert diluents, or lubricating, surface active or dispersing agents. Molded tablets may be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. In some embodiments, the tablets are coated or scored and are formulated so as to provide slow or controlled release of the active ingredient therein. All formulations for oral administration should be in dosages suitable for such administration.
  • the push-fit capsules can contain the active ingredients in admixture with filler such as lactose, binders such as starches, and/or lubricants such as talc or magnesium stearate and, optionally, stabilizers.
  • the active compounds may be dissolved or suspended in suitable liquids, such as fatty oils, liquid paraffin, or liquid polyethylene glycols.
  • stabilizers are added.
  • Dragee cores are provided with suitable coatings.
  • suitable coatings for this purpose, concentrated sugar solutions may be used, which may optionally contain gum arabic, talc, polyvinyl pyrrolidone, carbopol gel, polyethylene glycol, and/or titanium dioxide, lacquer solutions, and suitable organic solvents or solvent mixtures.
  • Dyestuffs or pigments may be added to the tablets or Dragee coatings for identification or to characterize different combinations of active compound doses.
  • compositions are formulated for parenteral administration by injection, e.g., by bolus injection or continuous infusion.
  • Formulations for injection may be presented in unit dosage form, e.g., in ampoules or in multi-dose containers, with an added preservative.
  • the compositions may take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents.
  • compositions may be presented in unit-dose or multi- dose containers, for example sealed ampoules and vials, and may be stored in powder form or in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example, saline or sterile pyrogen-free water, immediately prior to use.
  • sterile liquid carrier for example, saline or sterile pyrogen-free water
  • Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described.
  • compositions for parenteral administration include aqueous and nonaqueous (oily) sterile injection solutions of the active compounds which may contain
  • aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents.
  • Suitable lipophilic solvents or vehicles include fatty oils such as sesame oil, or synthetic fatty acid esters, such as ethyl oleate or triglycerides, or liposomes.
  • Aqueous injection suspensions may contain substances which increase the viscosity of the suspension, such as sodium carboxymethyl cellulose, sorbitol, or dextran.
  • the suspension may also contain suitable stabilizers or agents which increase the solubility of the compounds to allow for the preparation of highly concentrated solutions.
  • compositions may also be formulated as a depot preparation. Such long acting formulations may be administered by implantation (for example subcutaneously or intramuscularly) or by intramuscular injection.
  • the compounds may be formulated with suitable polymeric or hydrophobic materials (for example, as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.
  • compositions may take the form of tablets, lozenges, pastilles, or gels formulated in conventional manner.
  • Such compositions may comprise the active ingredient in a flavored basis such as sucrose and acacia or tragacanth.
  • compositions may also be formulated in rectal compositions such as suppositories or retention enemas, e.g., containing conventional suppository bases such as cocoa butter, polyethylene glycol, or other glycerides.
  • compositions may be administered topically, that is by non-systemic administration.
  • non-systemic administration includes the application of a compound of the present invention externally to the epidermis or the buccal cavity and the instillation of such a compound into the ear, eye and nose, such that the compound does not significantly enter the blood stream.
  • systemic administration refers to oral, intravenous, intraperitoneal and intramuscular administration.
  • compositions suitable for topical administration include liquid or semi- liquid preparations suitable for penetration through the skin to the site of inflammation such as gels, liniments, lotions, creams, ointments or pastes, and drops suitable for administration to the eye, ear or nose.
  • the active ingredient may comprise, for topical administration, from 0.001% to 10%) w/w, for instance from 1%> to 2% by weight of the formulation.
  • compositions for administration by inhalation are conveniently delivered from an insufflator, nebulizer pressurized packs or other convenient means of delivering an aerosol spray.
  • Pressurized packs may comprise a suitable propellant such as dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas.
  • the dosage unit may be determined by providing a valve to deliver a metered amount.
  • pharmaceutical preparations may take the form of a dry powder composition, for example a powder mix of the compound and a suitable powder base such as lactose or starch.
  • the powder composition may be presented in unit dosage form, in for example, capsules, cartridges, gelatin or blister packs from which the powder may be administered with the aid of an inhalator or insufflator.
  • compositions described herein may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavoring agents.
  • the compounds of Formula (I), or a pharmaceutically acceptable salt thereof are used in the preparation of medicaments for the treatment of diseases or conditions in a mammal that would benefit from inhibition or reduction of autotaxin activity.
  • Methods for treating any of the diseases or conditions described herein in a mammal in need of such treatment involves administration of pharmaceutical compositions that include at least one compound of Formula (I) or a pharmaceutically acceptable salt, active metabolite, prodrug, or pharmaceutically acceptable solvate thereof, in therapeutically effective amounts to said mammal.
  • compositions containing the compound(s) described herein are administered for prophylactic and/or therapeutic treatments.
  • therapeutic agents in certain embodiments, are administered for prophylactic and/or therapeutic treatments.
  • compositions are administered to a patient already suffering from a disease or condition, in an amount sufficient to cure or at least partially arrest at least one of the symptoms of the disease or condition.
  • Amounts effective for this use depend on the severity and course of the disease or condition, previous therapy, the patient's health status, weight, and response to the drugs, and the judgment of the treating physician.
  • Therapeutically effective amounts are optionally determined by methods including, but not limited to, a dose escalation and/or dose ranging clinical trial.
  • compositions containing the compounds described herein are administered to a patient susceptible to or otherwise at risk of a particular disease, disorder or condition. Such an amount is defined to be a "prophylactically effective amount or dose.”
  • prophylactically effective amount or dose the precise amounts also depend on the patient's state of health, weight, and the like. When used in patients, effective amounts for this use will depend on the severity and course of the disease, disorder or condition, previous therapy, the patient's health status and response to the drugs, and the judgment of the treating physician.
  • prophylactic treatments include administering to a mammal, who previously experienced at least one symptom of the disease being treated and is currently in remission, a pharmaceutical composition comprising a compound of Formula (I), or a pharmaceutically acceptable salt thereof, in order to prevent a return of the symptoms of the disease or condition.
  • the administration of the compounds are administered chronically, that is, for an extended period of time, including throughout the duration of the patient's life in order to ameliorate or otherwise control or limit the symptoms of the patient's disease or condition.
  • the dose of drug being administered is temporarily reduced or temporarily suspended for a certain length of time (i.e., a "drug holiday").
  • the length of the drug holiday is between 2 days and 1 year, including by way of example only, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 10 days, 12 days, 15 days, 20 days, 28 days, or more than 28 days.
  • the dose reduction during a drug holiday is, by way of example only, by 10%-100%, including by way of example only 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, and 100%.
  • a maintenance dose is administered if necessary. Subsequently, in specific embodiments, the dosage or the frequency of administration, or both, is reduced, as a function of the symptoms, to a level at which the improved disease, disorder or condition is retained. In certain embodiments, however, the patient requires intermittent treatment on a long-term basis upon any recurrence of symptoms.
  • the amount of a given agent that corresponds to such an amount varies depending upon factors such as the particular compound, disease condition and its severity, the identity (e.g., weight, sex) of the subject or host in need of treatment, but nevertheless is determined according to the particular circumstances surrounding the case, including, e.g., the specific agent being administered, the route of administration, the condition being treated, and the subject or host being treated.
  • doses employed for adult human treatment are typically in the range of 0.01 mg-5000 mg per day. In one aspect, doses employed for adult human treatment are from about 1 mg to about 1000 mg per day. In one embodiment, the desired dose is conveniently presented in a single dose or in divided doses administered simultaneously or at appropriate intervals, for example as two, three, four or more sub-doses per day.
  • the daily dosages appropriate for the compound of Formula (I), or a pharmaceutically acceptable salt thereof, described herein are from about 0.01 to about 50 mg/kg per body weight.
  • the daily dosage or the amount of active in the dosage form are lower or higher than the ranges indicated herein, based on a number of variables in regard to an individual treatment regime.
  • the daily and unit dosages are altered depending on a number of variables including, but not limited to, the activity of the compound used, the disease or condition to be treated, the mode of administration, the requirements of the individual subject, the severity of the disease or condition being treated, and the judgment of the practitioner.
  • Toxicity and therapeutic efficacy of such therapeutic regimens are determined by standard pharmaceutical procedures in cell cultures or experimental animals, including, but not limited to, the determination of the LD 50 and the ED 50 .
  • the dose ratio between the toxic and therapeutic effects is the therapeutic index and it is expressed as the ratio between LD 50 and ED 50 .
  • the data obtained from cell culture assays and animal studies are used in formulating the therapeutically effective daily dosage range and/or the therapeutically effective unit dosage amount for use in mammals, including humans.
  • the daily dosage amount of the compounds described herein lies within a range of circulating concentrations that include the ED 50 with minimal toxicity.
  • the daily dosage range and/or the unit dosage amount varies within this range depending upon the dosage form employed and the route of administration utilized.
  • the effective amount of the compound of Formula (I), or a pharmaceutically acceptable salt thereof is: (a) systemically administered to the mammal; and/or (b) administered orally to the mammal; and/or (c) intravenously administered to the mammal; and/or (d) administered by injection to the mammal; and/or (e) administered topically to the mammal; and/or (f) administered non- systemically or locally to the mammal.
  • any of the aforementioned aspects are further embodiments comprising single administrations of the effective amount of the compound, including further embodiments in which (i) the compound is administered once a day; or (ii) the compound is administered to the mammal multiple times over the span of one day.
  • any of the aforementioned aspects are further embodiments comprising multiple administrations of the effective amount of the compound, including further embodiments in which (i) the compound is administered continuously or intermittently: as in a single dose; (ii) the time between multiple administrations is every 6 hours; (iii) the compound is administered to the mammal every 8 hours; (iv) the compound is administered to the mammal every 12 hours; (v) the compound is administered to the mammal every 24 hours.
  • the compound is administered continuously or intermittently: as in a single dose; (ii) the time between multiple administrations is every 6 hours; (iii) the compound is administered to the mammal every 8 hours; (iv) the compound is administered to the mammal every 12 hours; (v) the compound is administered to the mammal every 24 hours.
  • the method comprises a drug holiday, wherein the administration of the compound is temporarily suspended or the dose of the compound being administered is temporarily reduced; at the end of the drug holiday, dosing of the compound is resumed.
  • the length of the drug holiday varies from 2 days to 1 year.
  • the pharmaceutical composition further comprises one or more anti-cancer agents.
  • the therapeutic effectiveness of one of the compounds described herein is enhanced by administration of an adjuvant (i.e., by itself the adjuvant has minimal therapeutic benefit, but in combination with another therapeutic agent, the overall therapeutic benefit to the patient is enhanced).
  • an adjuvant i.e., by itself the adjuvant has minimal therapeutic benefit, but in combination with another therapeutic agent, the overall therapeutic benefit to the patient is enhanced.
  • the benefit experienced by a patient is increased by administering one of the compounds described herein with another agent (which also includes a therapeutic regimen) that also has therapeutic benefit.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is co-administered with a second therapeutic agent, wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, and the second therapeutic agent modulate different aspects of the disease, disorder or condition being treated, thereby providing a greater overall benefit than administration of either therapeutic agent alone.
  • different therapeutically-effective dosages of the compounds disclosed herein will be utilized in formulating pharmaceutical composition and/or in treatment regimens when the compounds disclosed herein are administered in combination with one or more additional agent, such as an additional therapeutically effective drug, an adjuvant or the like.
  • additional agent such as an additional therapeutically effective drug, an adjuvant or the like.
  • Therapeutically-effective dosages of drugs and other agents for use in combination treatment regimens is optionally determined by means similar to those set forth hereinabove for the actives themselves.
  • the methods of prevention/treatment described herein encompasses the use of metronomic dosing, i.e., providing more frequent, lower doses in order to minimize toxic side effects.
  • a combination treatment regimen i.e., providing more frequent, lower doses in order to minimize toxic side effects.
  • Treatment regimens in which administration of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is initiated prior to, during, or after treatment with a second agent described herein, and continues until any time during treatment with the second agent or after termination of treatment with the second agent. It also includes treatments in which a compound of Formula (I), or a pharmaceutically acceptable salt thereof, and the second agent being used in combination are administered simultaneously or at different times and/or at decreasing or increasing intervals during the treatment period. Combination treatment further includes periodic treatments that start and stop at various times to assist with the clinical management of the patient.
  • the dosage regimen to treat, prevent, or ameliorate the condition(s) for which relief is sought is modified in accordance with a variety of factors (e.g. the disease, disorder or condition from which the subject suffers; the age, weight, sex, diet, and medical condition of the subject).
  • factors e.g. the disease, disorder or condition from which the subject suffers; the age, weight, sex, diet, and medical condition of the subject.
  • the dosage regimen actually employed varies and, in some embodiments, deviates from the dosage regimens set forth herein.
  • dosages of the co-administered compounds vary depending on the type of co-drug employed, on the specific drug employed, on the disease or condition being treated and so forth.
  • the compound provided herein when co-administered with one or more other therapeutic agents, is administered either simultaneously with the one or more other therapeutic agents, or sequentially.
  • the multiple therapeutic agents are administered in any order or even simultaneously. If administration is simultaneous, the multiple therapeutic agents are, by way of example only, provided in a single, unified form, or in multiple forms (e.g., as a single pill or as two separate pills).
  • the compounds of Formula (I), or a pharmaceutically acceptable salt thereof, as well as combination therapies are administered before, during or after the occurrence of a disease or condition, and the timing of administering the composition containing a compound varies.
  • the compounds described herein are used as a prophylactic and are administered continuously to subjects with a propensity to develop conditions or diseases in order to prevent the occurrence of the disease or condition.
  • the compounds and compositions are administered to a subject during or as soon as possible after the onset of the symptoms.
  • a compound described herein is administered as soon as is practicable after the onset of a disease or condition is detected or suspected, and for a length of time necessary for the treatment of the disease.
  • the length required for treatment varies, and the treatment length is adjusted to suit the specific needs of each subject.
  • a compound described herein or a formulation containing the compound is administered for at least 2 weeks, about 1 month to about 5 years.
  • Hormone blocking therapy includes the use of agents that block the production of estrogens or block the estrogen receptors.
  • hormone blocking therapy includes the use of estrogen receptor modulators and/ aromatase inhibitors.
  • Estrogen receptor modulators include triphenyl ethylene derivatives (e.g.
  • Aromatase inhibitors include steroidal aromatase inhibitors and non-steroidal aromatase inhibitors. Steroidal aromatase inhibitors include, but are not limited to, such exemestane. Non-steroidal aromatase inhibitors include, but are not limited to, as anastrozole, and letrozole.
  • Chemotherapy includes the use of anti-cancer agents.
  • anti-cancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof include one or more of the following: abiraterone; abarelix; abraxane, adriamycin; actinomycin; acivicin; aclarubicin; acodazole hydrochloride; acronine; adozelesin; aldesleukin; alemtuzumab; allopurinol; alitretinoin;
  • amsacrine amsacrine; anastrozole; anthramycin; aprepitant; arsenic trioxide; asparaginase; asperlin;
  • azacitidine azetepa; azotomycin; batimastat; bendamustine hydrochloride; benzodepa;
  • bevacizumab bexarotene; bicalutamide; bisantrene hydrochloride; bisnafide dimesylate;
  • bizelesin bleomycin; bleomycin sulfate; bortezomib; brequinar sodium; bropirimine; busulfan; cactinomycin; calusterone; caracemide; carbetimer; carboplatin; carmustine; carubicin hydrochloride; carzelesin; capecitabine; cedefingol; cetuximab; chlorambucil; cirolemycin;
  • cisplatin cladribine; clofarabine; crisnatol mesylate; cyclophosphamide; cytarabine; dacarbazine; dasatinib; daunorubicin hydrochloride; dactinomycin; darbepoetin alfa; decitabine; degarelix; denileukin diftitox; dexormaplatin; dexrazoxane hydrochloride; dezaguanine; dezaguanine mesylate; diaziquone; docetaxel; doxorubicin; doxorubicin hydrochloride; droloxifene;
  • hydrochloride elsamitrucin; eltrombopag olamine; enloplatin; enpromate; epipropidine;
  • epirubicin hydrochloride epoetin alfa; erbulozole; erlotinib hydrochloride; esorubicin
  • estramustine estramustine phosphate sodium; etanidazole; etoposide; etoposide phosphate; etoprine; everolimus; exemestane; fadrozole hydrochloride; trasrabine; fenretinide; filgrastim; floxuridine; fludarabine phosphate; fiuorouracil; flurocitabine; fosquidone; fostriecin sodium; fulvestrant; gefitinib; gemcitabine; gemcitabine hydrochloride; gemcitabine -cisplatin; gemtuzumab ozogamicin; goserelin acetate; histrelin acetate; hydroxyurea; idarubicin hydrochloride; ifosfamide; iimofosine; ibritumomab tiuxetan; idarubicin; ifosfamide; imatinib mesy
  • peliomycin pentamustine; peplomycin sulfate; perfosfamide; pipobroman; piposulfan;
  • piroxantrone hydrochloride piroxantrone hydrochloride; plicamycin; plomestane; pomalidomide, porfimer sodium;
  • porfiromycin prednimustine; procarbazine hydrochloride; puromycin; puromycin hydrochloride; pyrazofurin; quinacrine; raloxifene hydrochloride; rasburicase; recombinant HPV bivalent vaccine; recombinant HPV quadrivalent vaccine; riboprine; rogletimide; rituximab; romidepsin; romiplostim; safingol; safingol hydrochloride; sargramostim; semustine; pumprazene; sipuleucel- T; sorafenib; sparfosate sodium; sparsomycin; spirogermanium hydrochloride; spiromustine; spiroplatin; streptonigrin; streptozocin; sulofenur; sunitinib malate; talisomycin; tamoxifen citrate; tecogalan sodium; t
  • temsirolimus teniposide; teroxirone; testolactone; thalidomide; thiamiprine; thioguanine;
  • thiotepa tiazofurin; tirapazamine; topotecan hydrochloride; toremifene; tositumomab and 1 131 Iodine tositumomab; trastuzumab; trestolone acetate; tretinoin; triciribine phosphate;
  • trimetrexate trimetrexate glucuronate; triptorelin; tubulozole hydrochloride; uracil mustard; uredepa; valrubicin; vapreotide; verteporfin; vinblastine; vinblastine sulfate; vincristine sulfate; vindesine; vindesine sulfate; vinepidine sulfate; vinglycinate sulfate; vinleurosine sulfate;
  • vinorelbine tartrate vinrosidine sulfate; vinzolidine sulfate; vorinostat; vorozole; zeniplatin; zinostatin; zoledronic acid; and zorubicin hydrochloride.
  • Monoclonal antibodies include, but are not limited to, trastuzumab (Herceptin) and rituximab (Rituxan).
  • At least one additional chemotherapeutic agent is selected from, by way of example only, alemtuzumab, arsenic trioxide, asparaginase (pegylated or non-), bevacizumab, cetuximab, platinum-based compounds such as cisplatin, cladribine, daunorubicin/doxorubicin/idarubicin, irinotecan, fludarabine, 5-fluorouracil, gemtuzumab, methotrexate, taxol, temozolomide, thioguanine, or classes of drugs including hormones (an antiestrogen, an antiandrogen, or gonadotropin releasing hormone analogues, interferons such as alpha interferon, nitrogen mustards such as busulfan or melphalan or mechlorethamine, retinoids such as tretinoin, topoisomerase inhibitors such as irinotecan or to
  • the compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered or formulated in combination with one or more anti -cancer agents.
  • one or more of the anti-cancer agents are proapoptotic agents.
  • anti-cancer agents include, but are not limited to, any of the following: gossypol, genasense, polyphenol E, Chlorofusin, all trans-retinoic acid (ATRA), bryostatin, tumor necrosis factor- related apoptosis-inducing ligand (TRAIL), 5-aza-2'-deoxycytidine, all trans retinoic acid, doxorubicin, vincristine, etoposide, gemcitabine, imatinib, geldanamycin, 17-N-Allylamino-17- Demethoxygeldanamycin (17-AAG), flavopiridol, LY294002, bortezomib, carfilzomib, trastuzumab, BAY 11-7082, PKC412, or PD184352, paclitaxel, and analogs of paclitaxel.
  • gossypol genasense
  • polyphenol E Chlorofusin
  • TRA
  • anti-cancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof include inhibitors of mitogen-activated protein kinase signaling, e.g., U0126, PD98059, PD184352, PD0325901, ARRY-142886, SB239063, SP600125, BAY 43-9006, wortmannin, or LY294002; Syk inhibitors; mTOR inhibitors; activin inhibitors, PKM2 inhibitors, c-fms inhibitors and histone deacetylase inhibitors.
  • anti-cancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof include aromatase inhibitors.
  • Aromatase inhibitors include steroidal aromatase inhibitors and non-steroidal aromatase inhibitors.
  • Steroidal aromatase inhibitors include, but are not limited to, exemestane.
  • Nonsteroidal aromatase inhibitors include, but are not limited to, anastrozole, and letrozole.
  • anticancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include alkylating agents, antimetabolites, natural products, or hormones, e.g., nitrogen mustards (e.g., mechloroethamine, cyclophosphamide, chlorambucil, etc.), alkyl sulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine, lomusitne, ete.), or triazenes (decarbazine, etc.).
  • nitrogen mustards e.g., mechloroethamine, cyclophosphamide, chlorambucil, etc.
  • alkyl sulfonates e.g., busulfan
  • nitrosoureas e.g., carmustine, lomusitne, ete.
  • triazenes decarbazine, etc.
  • antimetabolites include but are not limited to folic acid analog (e.g., methotrexate), or pyrimidine analogs (e.g., Cytarabine), purine analogs (e.g., mercaptopurine, thioguanine, pentostatin).
  • folic acid analog e.g., methotrexate
  • pyrimidine analogs e.g., Cytarabine
  • purine analogs e.g., mercaptopurine, thioguanine, pentostatin.
  • Examples of natural products for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof include but are not limited to vinca alkaloids (e.g., vinblastin, vincristine), epipodophyllotoxins (e.g., etoposide), antibiotics (e.g., daunorubicin, doxorubicin, bleomycin), enzymes (e.g., L-asparaginase), or biological response modifiers (e.g., interferon alpha).
  • vinca alkaloids e.g., vinblastin, vincristine
  • epipodophyllotoxins e.g., etoposide
  • antibiotics e.g., daunorubicin, doxorubicin, bleomycin
  • enzymes e.g., L-asparaginase
  • biological response modifiers e.g., interferon alpha
  • alkylating agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include, but are not limited to, nitrogen mustards (e.g., mechloroethamine, cyclophosphamide, chlorambucil, meiphalan, etc.), ethylenimine and methylmelamines (e.g., hexamethlymelamine, thiotepa), alkyl sulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine, lomusitne, semustine, streptozocin, etc.), or triazenes
  • nitrogen mustards e.g., mechloroethamine, cyclophosphamide, chlorambucil, meiphalan, etc.
  • ethylenimine and methylmelamines e.g., hexamethlymelamine, thiotepa
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used to treat cancer in combination with: an antiestrogen (e.g., tamoxifen), an antiandrogen (e.g., bicalutamide, flutamide), a gonadotropin releasing hormone analog (e.g., leuprolide).
  • an antiestrogen e.g., tamoxifen
  • an antiandrogen e.g., bicalutamide, flutamide
  • a gonadotropin releasing hormone analog e.g., leuprolide
  • platinum coordination complexes e.g., cisplatin, carboblatin
  • anthracenedione e.g., mitoxantrone
  • substituted urea e.g., hydroxyurea
  • methyl hydrazine derivative e.g., procarbazine
  • adrenocortical suppressant e.g., mitotane, aminoglutethimide
  • anti -cancer agents which act by arresting cells in the G2-M phases due to stabilized microtubules include without limitation the following marketed drugs and drugs in development: Erbulozole, Dolastatin 10, Mivobulin isethionate, Vincristine, NSC-639829, Discodermolide, ABT-751, Altorhyrtins (such as Altorhyrtin A and Altorhyrtin C), Spongistatins (such as Spongistatin 1, Spongistatin 2, Spongistatin 3, Spongistatin 4, Spongistatin 5,
  • Epothilones such as Epothilone A, Epothilone B, Epothilone C, Epothilone D, Epothilone E, Epothilone F, Epothilone B N-oxide, Epothilone A N-oxide, 16-aza-epothilone B, 21- aminoepothilone B, 21 -hydroxy epothilone D, 26-fluoroepothilone, Auristatin PE, Soblidotin, Vincristine sulfate, Cryptophycin 52, Vitilevuamide, Tubulysin A, Canadensol, Centaureidin, Oncocidin Al Fijianolide B, Laulimalide, Narcosine, Nascapine, Hemiasterlin, Vanadocene acetyl acetonate, In
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is co-administered with thrombolytic agents (e.g., alteplase anistreplase, streptokinase, urokinase, or tissue plasminogen activator), heparin, tinzaparin, warfarin, dabigatran (e.g., dabigatran etexilate), factor Xa inhibitors (e.g., fondaparinux, draparinux, rivaroxaban, DX-9065a, otamixaban, LY517717, or YM150), ticlopidine, clopidogrel, CS-747 (prasugrel, LY640315), ximelagatran, or BIBR 1048.
  • thrombolytic agents e.g., alteplase anistreplase, streptokinase, urokinase, or tissue plasmin
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in combination with anti-emetic agents to treat nausea or emesis, which result from the use of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, anticancer agent(s) and/or radiation therapy.
  • Anti-emetic agents include, but are not limited to: neurokinin-1 receptor antagonists, 5HT3 receptor antagonists (such as ondansetron, granisetron, tropisetron, palonosetron, and zatisetron), GABA B receptor agonists (such as baclofen), corticosteroids (such as
  • prochlorperazine, metoclopramide antihistamines (HI histamine receptor antagonists, such as but not limited to, cyclizine, diphenhydramine, dimenhydrinate, meclizine, promethazine, hydroxyzine), cannabinoids (such as but not limited to, cannabis, marinol, dronabinol), and others (such as, but not limited to, trimethobenzamide; ginger, emetrol, propofol).
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in combination with an agent useful in the treatment of anemia.
  • an agent useful in the treatment of anemia is, for example, a continuous eythropoiesis receptor activator (such as epoetin-a).
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in combination with an agent useful in the treatment of neutropenia.
  • agents useful in the treatment of neutropenia include, but are not limited to, a hematopoietic growth factor which regulates the production and function of neutrophils such as a human granulocyte colony stimulating factor, (G-CSF).
  • G-CSF human granulocyte colony stimulating factor
  • examples of a G-CSF include filgrastim.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered in combination with one or more immunosuppressants.
  • Immunosuppressive therapy is clinically used to treat or prevent the rejection of transplanted organs and tissues (e.g. bone marrow, heart, kidney, liver); treatment of autoimmune diseases or diseases that are most likely of autoimmune origin (e.g. rheumatoid arthritis, myasthenia gravis, systemic lupus erythematosus, Crohn's disease, and ulcerative colitis); and treatment of some other non- autoimmune inflammatory diseases (e.g. long term allergic asthma control), and in the treatment of fibrotic conditions.
  • organs and tissues e.g. bone marrow, heart, kidney, liver
  • autoimmune diseases or diseases that are most likely of autoimmune origin e.g. rheumatoid arthritis, myasthenia gravis, systemic lupus erythematosus, Crohn's disease, and ulcerative colitis
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered with a corticosteroid.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered with an a therapeutic agent selected from among: Calcineurin inhibitors (such as, but not limited to, cyclosporin, tacrolimus); mTOR inhibitors (such as, but not limited to, sirolimus, everolimus); anti-proliferatives (such as, but not limited to, azathioprine, mycophenolic acid); corticosteroids (such as, but not limited to, prednisone, cortisone acetate, prednisolone, methylprednisolone, dexamethasone, betamethasone, triamcinolone, beclometasone, fludrocortisone acetate, deoxycorticosterone acetate, aldosterone, hydrocortisone); antibodies (
  • Other therapeutic agents include, but are not limited to: cyclophosphamide,
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered in combination with Cyclosporin A (CsA) or tacrolimus (FK506).
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered to a mammal in combination with an anti-inflammatory agent including, but not limited to, non-steroidal anti-inflammatory drugs (NSAIDs), phosphodiesterase-4 inhibitors. JNK kinase inhibitors and corticosteroids (glucocorticoids).
  • NSAIDs non-steroidal anti-inflammatory drugs
  • JNK kinase inhibitors and corticosteroids (glucocorticoids).
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered with corticosteroids.
  • Corticosteroids include, but are not limited to: betamethasone, prednisone, alclometasone, aldosterone, amcinonide, beclometasone,
  • desoxycortone dexamethasone, diflorasone, diflucortolone, difluprednate, fluclorolone, fludrocortisone, fludroxycortide, flumetasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin, fluocortolone, fluorometholone, fluperolone, fluprednidene, fluticasone, formocortal, halcinonide, halometasone, hydrocortisone/cortisol, hydrocortisone aceponate, hydrocortisone buteprate, hydrocortisone butyrate, loteprednol, medrysone, meprednisone, methylprednisolone, methylprednisolone aceponate, mometasone furoate, paramethasone, prednicarbate,
  • prednisone/prednisolone rimexolone
  • tixocortol triamcinolone
  • ulobetasol a product that has been modified by the following agents: prednisone/prednisolone, rimexolone, tixocortol, triamcinolone, and ulobetasol.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is administered to a mammal in combination with a non-steroidal anti-inflammatory drug (NSAID).
  • NSAIDs include, but are not limited to: aspirin, salicylic acid, gentisic acid, choline magnesium salicylate, choline salicylate, choline magnesium salicylate, choline salicylate, magnesium salicylate, sodium salicylate, diflunisal, carprofen, fenoprofen, fenoprofen calcium, flurobiprofen, ibuprofen, ketoprofen, nabutone, ketolorac, ketorolac tromethamine, naproxen, oxaprozin, diclofenac, etodolac, indomethacin, sulindac, tolmetin, meclofenamate,
  • COX-2 specific inhibitors such as, but not limited to, celecoxib, rofecoxib, valdecoxib, parecoxib, etoricoxib, lumiracoxib, CS- 502, JTE-522, L-745,337 and NS398).
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is co-administered with an analgesic.
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is used in combination with radiation therapy (or radiotherapy).
  • Radiation therapy is the treatment of cancer and other diseases with ionizing radiation.
  • Radiation therapy is optionally used to treat localized solid tumors, such as cancers of the skin, tongue, larynx, brain, breast, prostate, colon, liver, uterus and/or cervix. It is also optionally used to treat leukemia and lymphoma (cancers of the blood-forming cells and lymphatic system, respectively).
  • a technique for delivering radiation to cancer cells is to place radioactive implants directly in a tumor or body cavity.
  • This is called internal radiotherapy (brachytherapy, interstitial irradiation, and intracavitary irradiation are types of internal radiotherapy.)
  • internal radiotherapy brachytherapy, interstitial irradiation, and intracavitary irradiation are types of internal radiotherapy.
  • the radiation dose is concentrated in a small area, and the patient stays in the hospital for a few days.
  • Internal radiotherapy is frequently used for cancers of the tongue, uterus, prostate, colon, and cervix.
  • radiotherapy or “ionizing radiation” include all forms of radiation, including but not limited to ⁇ , ⁇ , and ⁇ radiation and ultraviolet light.
  • Example A-l Parenteral Pharmaceutical Composition
  • a parenteral pharmaceutical composition suitable for administration by injection (subcutaneous, intravenous)
  • 1-100 mg of a water-soluble salt of a compound Formula (I), or a pharmaceutically acceptable salt or solvate thereof, is dissolved in sterile water and then mixed with 10 mL of 0.9% sterile saline.
  • a suitable buffer is optionally added as well as optional acid or base to adjust the pH.
  • the mixture is incorporated into a dosage unit form suitable for administration by injection
  • a sufficient amount of a compound of Formula (I), or a pharmaceutically acceptable salt thereof is added to water (with optional solubilizer(s),optional buffer(s) and taste masking excipients) to provide a 20 mg/mL solution.
  • a tablet is prepared by mixing 20-50%) by weight of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, 20-50%> by weight of microcrystalline cellulose, 1-10%> by weight of low-substituted hydroxypropyl cellulose, and 1-10%> by weight of magnesium stearate or other appropriate excipients. Tablets are prepared by direct compression. The total weight of the compressed tablets is maintained at 100 -500 mg.
  • a pharmaceutical composition for oral delivery 10-500 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is mixed with starch or other suitable powder blend. The mixture is incorporated into an oral dosage unit such as a hard gelatin capsule, which is suitable for oral administration.
  • Example A-5 Topical Gel Composition
  • a compound of Formula (I), or a pharmaceutically acceptable salt thereof is mixed with hydroxypropyl celluose, propylene glycol, isopropyl myristate and purified alcohol USP.
  • the resulting gel mixture is then incorporated into containers, such as tubes, which are suitable for topical administration.
  • Example A-6 Human Autotaxin Assay
  • ATX activity is assayed in concentrated conditioned media from Hep3B human hepatocellular carcinoma cells by measuring the amount of choline released from the substrate, lysophosphatidylcholine (LPC) as it is cleaved to LPA.
  • Conditioned media is collected from confluent Hep3B cells and concentrated 20-fold using Centriprep-30 filter devices (Millipore).
  • 10-20 ⁇ ⁇ of the concentrated conditioned media is incubated with 2.5 ⁇ . of a test compound in DMSO and 72.5-82.5 ⁇ .
  • lyso-PLD buffer 100 mM Tris pH 9, 500 mM NaCl, 5 mM MgCl 2 , 5 mM CaCl 2 , 0.05% Triton X-100 in the presence or absence of 0.2% fatty-acid-free human serum albumin
  • 5 ul of 2 mM LPC 14:0; Avanti Polar Lipids Cat# 855575C
  • lyso-PLD buffer is added for a final concentration of 100 uM and the incubation continues for 1.5-3 hours at 37 °C.
  • Example A-7 Human Whole Blood Autotaxin Assay
  • Inhibition of ATX activity in human whole blood is assayed by measuring the concentration of 20:4 LPA in plasma after a prolonged incubation at 37 °C.
  • Blood is drawn from consenting human volunteers into heparin vacutainer tubes and 200 ⁇ aliquots are added to 2 ⁇ test compound in DMSO or DMSO alone. Several of the vehicle tubes are centrifuged
  • Plasma is processed for LCMS as follows: 40 ul plasma is removed and 5 volumes of methanol containing 125 ng/ml 17:0 LPA as an internal standard are added and the mixture incubated at -20 °C for 10 min before centrifuging at 4000 x g for 10 minutes at 4 °C.
  • LPA 20:4 and the internal standard (LPA 17:0) were analyzed on a quadrupole mass spectrometer (ABI Sciex 4000QTrap) in the negative ion mode (ESI) by multiple reaction monitoring (MRM).
  • the mobile phases contain 0.1% ammonium hydroxide in 90%) water/10%) acetonitrile (solvent A) and 0.1%> ammonium hydroxide in 90% acetonitrile/ 10%> water (solvent B).
  • the flow rate was maintained at 0.8 mL/min and the total run time was 3 min.
  • Analytes were separated using a linear gradient as follows: 1) mobile phase was held for 0.5 min at 10% B; 2) B was increased from 10% to 90% over the next 1 min; 3) B was held constant for 0.5 min at 90%; and 4) B was returned to the initial gradient conditions.
  • LP A and ATX activity are induced by carrageenan injection into a mouse air pouch.
  • a mouse air pouch assay was utilized to determine pharmacodynamic activity of autotaxin inhibitors in reducing carrageenan-induced ATX activity and LPA biosynthesis.
  • An air pouch was formed in female balb/c mice by instilling 5 ml of 0.2 ⁇ filtered air into the subcutaneous space in the scapular region on Day 1. On Day 3, 3 ml of air was instilled into the pouch and on Day 6, another 3 ml air was instilled into the pouch. On Day 7, test compounds were
  • Example A-9 MDA-MB-435 Melanoma Cell Migration Assay
  • Cells from the MDA-MB-435S human melanoma line are maintained in subconfluent culture in media containing FBS and penicillin/streptomycin. The day before the assay, cells are serum-starved overnight in media containing 0.1-0.2%) fatty-acid-free BSA. On the day of the assay, the conditioned media is removed from the cells and set aside. The cells are then harvested by scraping, counted, and pelleted by centrifugation. The cells are resuspended at 1.05X the final desired density in the conditioned media. The assays are performed in duplicate using the Neuroprobe 96-well chemotaxis system with 8 ⁇ pore size and fibronectin-coated filters.
  • 152 ⁇ cells are added to 8 ⁇ test compound and incubated for 15 min at 37°C.
  • the lower chamber is loaded with 2-10 ⁇ LPC and then 50 ⁇ of the cell/test compound suspension is added to the top of each filter well site.
  • the filters are incubated at 37°C for 1-24 hours and non-migrated cells removed from the top of the filter by rinsing with PBS and scraping.
  • the filter is air dried then stained before reading the absorbance at 580 nm.
  • a syngeneic mouse model is used to test efficacy of compounds in inhibiting tumor metastases.
  • 4T1 cells are in injected into the #1 mammary fat pad of female Balb/c mice while the mice are anesthetized. The primary tumors are measured by caliper twice weekly until they are resected under isofluorane anesthesia (between days 10-14). Test compound is administered orally daily at various times after the injection of the 4T1 cells. At 8-11 weeks after the 4T1 injection, lymph nodes, lungs, liver and any other organs suspected of harboring metastases are collected for histological analysis.
  • An experimental lung metastasis model is used to test efficacy of compounds in reducing the number of metastases of injected B16-F 10 mouse melanoma cells to the lung. Briefly, female C57BL/6J mice, female (BALB/cByJ x C57BL/6J)Fi, mice (CByB6Fi/J), athymic nude female and male CByB6Fi/J mice (nu/nu), and control littermates (nu/nu) are used at ages 7-18 weeks, when they weighed between 18 and 28 g. A single-cell suspension of B16F10 cells, harvested in log phase (approx.
  • mice 5-10 x 10 4 cells
  • Hanks' balanced salt solution 5-10 x 10 4 cells
  • Test compound or vehicle is delivered daily.
  • the mice are sacrificed, and the lungs are removed. Lungs are fixed in 10% buffered formalin overnight and weighed, and tumor colonies at the surface are scored with the aid of a dissecting microscope.
  • Example A-12 Mouse Carbon Tetrachloride (CC -induced Liver Fibrosis Model
  • mice Female balb/c mice receive CC1 4 (1.0 ml/kg body weight) diluted in olive oil via intraperitoneal injection twice a week for 8 weeks. (Higazi, A. A. et al, Clin Exp Immunol. 2008 Apr;152(l): 163-73). Control mice receive an equivalent volume of olive oil only. Test compound or vehicle is delivered orally daily. At the end of the study (8 weeks after first i.p. injection of CC1 4 ), mice are sacrificed using inhaled isoflurane and blood is drawn via cardiac puncture for subsequent analysis of ALT/AST levels.
  • liver fibrosis The liver is harvested and frozen at -80 0 C for the biochemical analysis of liver fibrosis or fixed in 10% neutral buffered formalin for histological assessment of liver fibrosis.
  • liver tissue homogenates are analyzed for collagen concentration using a hydroxyproline assay.
  • liver fibrosis fixed liver tissue is Masson's trichrome stained and liver fibrosis is determined by quantitative, computer-assisted densitometry using light microscopy.
  • Example A-13 Rat Diethylnitrosamine (DEN)-induced Liver Fibrosis and Hepatocellular Carcinoma
  • DEN diethylnitrosamine
  • PBS phosphate-buffered saline
  • HCC hepatocellular carcinoma
  • Control rats receive weekly injections of an equivalent volume of PBS.
  • Test compound or vehicle is delivered orally daily.
  • rats are sacrificed using inhaled isoflurane and blood is drawn via cardiac puncture for subsequent analysis of ALT/AST levels and drug concentrations.
  • the liver is harvested and frozen at -80 0 C for biochemical analysis of fibrosis or fixed in 10% neutral buffered formalin for histological assessment of liver fibrosis.
  • liver tissue homogenates are analyzed for collagen concentration using a hydroxyproline assay.
  • histological assessment of liver fibrosis and HCC fixed liver tissue is hematoxylin and eosin stained and Masson's trichrome stained and liver fibrosis and HCC is determined by quantitative, computer-assisted densitometry using light microscopy.
  • Intervention Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
  • Secondary Outcome Measures Number of Acute Exacerbations of IPF; health related quality of life; P0 2 at rest and at exercise from baseline; P(A-a)0 2 at rest and at exercise from baseline; Predicted FEV1 from baseline; forced expiratory volume in one second (FEV1) to FVC from baseline; plethysmographic lung volumes from baseline; diffusion capacity for carbon monoxide (DLco) from baseline; Six-Minute Walk test, from baseline: resting and 6 minute Sp02, presence or absence of desaturation to 88% or lower at the end of the six minute walk, walked distance; Pre and post modified Borg dyspnea scores; scoring of extent of lung fibrosis on HRCT, according to two independent chest radiologists, form baseline; number and severity of adverse effects.
  • Eligibility Male and female subjects that are 40 years to 80 years.
  • Inclusion Criteria Clinical symptoms of IPF for at least 3 months; forced vital capacity (FVC) between 50 to 90% of the predicted value; DLco at least 35% of the predicted value; Pa02 > 55 mm Hg while breathing ambient air at rest; High -resolution computed tomography (HRCT) showing definite or probable criteria of IPF.
  • FVC forced vital capacity
  • HRCT High -resolution computed tomography
  • Exclusion Criteria Clinically significant exposure to known fibrogenic agents (birds, molds, asbestos, radiation and drugs known to cause pulmonary fibrosis (amiodarone, nitrofurantoin, bleomicin, etc)); history of neurofibromatosis, Hermansky-Pudlak syndrome, metabolic storage disorders, etc.; history of fever, weight loss, myalgias, arthralgias, skin rash, arthritis; active infection within one week before enrollment; alternative cause of interstitial lung disease; ratio of the forced expiratory volume in one second (VEFl) to FVC of less than 0.6 after the use of a bronchodilator; residual volume more than 120% of the predicted value (when available); more than 20% of lymphocytes or eosinophils in bronchoalveolar lavage (BAL) (when available); granulomas, infection or malignancy in the transbronchial or surgical biopsy (when available); previous therapy with azathioprine, prednisol
  • Example A-15 Clinical Trial for Liver Fibrosis
  • liver fibrosis clinical trial in humans is described below.
  • liver biopsy Liver enzymes (ALT, AST, ALP), liver biopsy
  • Pharmacodynamic markers may include: Tissue PD markers through mRNA expression, ATX, LOXL2, LOX, Other LOXL proteins, aSMA, Collagen 1A1, F-KB1, Caspase 1, SMAD, and NOD; Serum and plasma PD markers include: AST-to-platelet ratio index (APRI), ATX activity, LOXL2, Osteopontin, Hyaluronic Acid, CXCL 9, 10 and 11, MMPl, MMP3, MMP9, TFMP1, CD40L, TGF- ⁇ , ET-1, VEGF, GAL3, IL- 6 / IL-8 / TNFa / ⁇ , a2-macroglobulin, Apolipoprotein Al, PINP, PIIINP, PVCP-1230, PDGF; Assessing the effects of chronic dosing on liver structure (using, for example, ultrasound and/or MRI) and fibrotic markers; incidence of adverse events resulting from the administration of
  • Eligibility Male and female subjects that are 18 to 60 years old.
  • Inclusion Criteria Stage 1-3 fibrosis by Metavir score on a liver biopsy; Body mass index ⁇ 36 kg/m2.
  • Exclusion Criteria Any evidence of hepatic decompensation past or present; subjects currently abusing amphetamines, cocaine, opiates, or alcohol; clinically significant cardiac disease; history of cancer, other than non-melanomatous skin cancer, within 5 years prior to screening; systemic fungal, bacterial, viral, or other infection that is not controlled; use of systemic immunosuppressants within 28 days of the Pre-treatment Phase; use of approved therapy for hepatitis C or hepatitis B virus within 28 days of the Pre-treatment Phase; pregnant or lactating; history of bleeding diathesis within the last 6 months of study Day 1.
  • Eligibility Male and female subjects that are 21 to 80 years old.
  • Inclusion Criteria Patients with pruritus as a result of a cholestatic disorder.
  • Intervention Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
  • Eligibility Male and female subjects that are 21 to 80 years old with advanced pancreatic cancer.
  • Inclusion Criteria Radiographic or clinical evidence of measurable advanced pancreatic carcinoma (Stage II, III, IV). Subjects must have measurable disease at least 2 cm in diameter. ECOG performance status of 0 or 1.
  • Negative pregnancy test Fertile patients must use effective contraception during and for > 3 months after completion of study treatment; Able to swallow oral medication; No other malignancy within the past 5 years except for in situ cancers or basal cell or squamous cell carcinoma of the skin; No hypersensitivity or intolerance to statins; no other non-malignant systemic disease that would preclude rosuvastatin administration or prolonged follow-up.
  • Example A-18 Clinical Trial for Hepatocellular Carcinoma (HCC)
  • Intervention Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
  • Eligibility Male and female subjects that are 21 to 80 years old.
  • Inclusion Criteria Patients with histopathologically or clinically confirmed diagnosis of hepatocellular carcinoma; unresponsive to standard therapy or for whom standard therapy is intolerable, or for whom there is no appropriate therapy; ECOG performance status score of 0-2.
  • Exclusion Criteria Patients with a primary malignant tumor; history of liver transplant; brain metastases; psychiatric disorder that might cause difficulty in obtaining informed consent or in conducting the trial; Not pregnant or nursing; Fertile patients must use effective
  • liver function tests liver function tests, tumor biomarkers, liver imaging (Ultrasound, MRI, PET).
  • Example A-19 Clinical Trial for Fatty Liver Disease /Steatosis (NAFLD, NASH)
  • Intervention Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
  • Eligibility Male and female subjects that are 21 to 80 years old.
  • Inclusion Criteria Patients with clinically confirmed diagnosis of non-alcohol fatty liver disease or non-alcohol steatohepatitis; histologic evidence of definite or probable nonalcoholic steatohepatitis (NASH) based upon a liver biopsy obtained no more than 90 days prior to randomization and a nonalcoholic fatty liver disease activity score (NAS) of 4 or greater.
  • NASH nonalcoholic steatohepatitis
  • NAFLD nonalcoholic fatty liver disease
  • methotrexate systemic glucocorticoids, tetracyclines, tamoxifen, estrogens at doses greater than those used for hormone replacement, anabolic steroids, valproic acid, and other known hepatotoxins
  • bariatric surgery eg, gastroplasty, roux-en-Y gastric bypass
  • uncontrolled diabetes defined as Hemoglobin Ale 9.5% or higher within 60 days prior to enrollment, presence of cirrhosis on liver biopsy, platelet count below 100,000/mm3
  • Clinical evidence of hepatic decompensation as defined by the presence of any of the following abnormalities: serum albumin less than 3.2 grams/deciliter (g/dL), INR(international normalized ratio) greater than 1.3, direct bilirubin greater than 1.3 milligrams per deciliter (mg/dL), history of esophageal varices, ascites or hepatic encephalopathy;
  • fibrotic biomarkers fibrotic biomarkers, liver imaging (ultrasound, MRI), insulin resistance as measure by HOMA-IR, lipid panel, glucose homeostasis (OGTT).
  • MRI ultrasound, MRI
  • OGTT glucose homeostasis

Abstract

Described herein are compounds that are autotaxin inhibitors, methods of making such compounds, pharmaceutical compositions and medicaments comprising such compounds, and methods of using such compounds in the treatment of conditions, diseases, or disorders associated with autotaxin activity.

Description

AUTOTAXIN INHIBITOR COMPOUNDS AND USES THEREOF
RELATED APPLICATIONS
[0001] This application claims the benefit of U.S. Provisional Patent Application No.
62/131,721 entitled "AUTOTAXIN INHIBITOR COMPOUNDS AND USES THEREOF" filed on March 11, 2015, which is herein incoporated by reference in its entirety.
FIELD OF THE INVENTION
[0002] Described herein are compounds that are autotaxin inhibitors, methods of making such compounds, pharmaceutical compositions and medicaments comprising such compounds, and methods of using such compounds in the treatment of conditions, diseases, or disorders associated with autotaxin activity.
BACKGROUND OF THE INVENTION
[0003] Lysophosphatidic acid (LP A) is a lipid mediator that functions, for example, as a mitogen, chemoattractant, and survival factor for many cell types. LPA signaling is implicated in, for example, cancer, angiogenesis, chronic inflammation, autoimmune diseases, fibrotic diseases, neurodegenerative diseases, reperfusion injury post stroke or myocardial ischemia, reproduction and tumor progression.
SUMMARY OF THE INVENTION
[0004] Compounds described herein are autotaxin (ATX) inhibitors. In some embodiments, the autotaxin inhibitors described herein are useful as agents for the treatment or prevention of diseases or conditions in which ATX and/or LPA participates, is involved in the etiology or pathology of the disease, or is otherwise associated with at least one symptom of the disease. Inhibition of the physiological activity of ATX and/or LPA is useful in a variety of diseases or conditions. The ATX-LPA signaling pathway has been implicated in fibrotic diseases, cancer, pruritus, angiogenesis, inflammation, autoimmune diseases, reproduction and tumor progression.
[0005] Compounds of Formula (I) are used in the treatment of diseases or conditions in which autotaxin activity contributes to the symptomology or progression of the disease, disorder or condition. These diseases, disorders, or conditions may arise from one or more of a genetic, iatrogenic, immunological, infectious, metabolic, oncological, toxic, surgical, and/or traumatic etiology. In one aspect, the methods, compounds, pharmaceutical compositions, and
medicaments described herein comprise autotaxin inhibitors.
[0006] In one aspect, the compounds of Formula (I) are useful for the treatment of diseases or conditions such as, but not limited to, fibrosis, cell proliferative disease, inflammatory disease, autoimmune diseases, reproductive diseases, abnormal angiogenesis-associated diseases, scleroderma, brain or heart reperfusion injury, neurodegenerative diseases, neuropathic pain, peripheral neuropathy, ocular disease, diabetic retinopathy, proliferative vitreoretinopathy, cicatricial pemphigoid, and glaucoma.
[0007] In one aspect, described herein is a compound of Formula (I), or a pharmaceutically acceptable salt, pharmaceutically acceptable solvate, or prodrug thereof:
Figure imgf000003_0001
R1 is H, D, halogen, -CN, -C(=0)H, Ci-C4alkyl, Ci-C4fluoroalkyl, C3-C6cycloalkyl or Ci- C4deuteroalkyl;
R2 is H, halogen, -CN, -OH, N02, NH2, N(R10)2, -OC(=O)N(R10)2 , -C(=O)N(R10)2 , - NHC(=0)R9, -NHC(=0)OR9, substituted or unsubstituted d-C4alkyl, C
C4fluoroalkyl, Ci-C4deuteroalkyl, substituted or unsubstituted Ci-C4alkoxy, Ci- C4fluoroalkoxy, -S-Ci-C4alkyl, -S(=0)-Ci-C4alkyl, -S(=0)2-Ci-C4alkyl, Ci- C hydroxyalkyl, substituted or unsubstituted phenyl, or substituted or unsubstituted monocyclic heteroaryl;
R3 is H, halogen, -CN, -OH, Ci-C4alkyl, Ci-C4fluoroalkyl, Ci-C4deuteroalkyl, C
C4alkoxy, Ci-C4fluoroalkoxy, -S-Ci-C4alkyl, -S(=0)-Ci-C4alkyl, -S(=0)2-Ci-C4alkyl, or Ci-C4hydroxyalkyl; Ring A is a monocyclic aryl, bicyclic aryl, monocyclic heteroaryl or bicyclic heteroaryl; each RA is independently selected from the group consisting of H, halogen, -CN, - N02, -OH, -OR9, -SR9, -S(=0)R9, -S(=0)2R9, -S(=O)2N(R10)2, - R10S(=O)2R9, - C(=0)R9, -OC(=0)R9, -C02R10, -OC02R9, -N(R10)2, -C(=O)N(R10)2, - OC(=O)N(R10)2, - HC(=0)R9, - HC(=0)OR9, Ci-C6alkyl, Ci-C6fluoroalkyl, C C6deuteroalkyl, Ci-C6heteroalkyl, substituted or unsubstituted C3-Ci0cycloalkyl, substituted or unsubstituted C2-Ci0heterocycloalkyl, substituted or unsubstituted phenyl, and substituted or unsubstituted monocyclic heteroaryl;
m is 0, 1, or 2;
L1 is absent, Ci-C6alkylene, Ci-C6fluoroalkylene, C3-C6cycloalkylene, (Ci-C6alkylene)p C3-C6cycloalkylene-(Ci-C6alkylene)q, or -(Ci-C6alkylene)p-X1-(Ci-C6alkylene)q; X1 is O, S, S(=0), S(=0)2, C(=0) H, HC(=0), NH, OC(=0)NH, NHC(=0)0, or NHC(=0)0;
p is 0 or 1;
q is 0 or 1;
Q is -C02H, -C02(Ci-C6alkyl), -OH, -CN, -B(OH)2, -C(=0)NHS02R9, -C(=O)N(R10)2 -S02NHC(=0)R9, -CN, tetrazolyl, -OP(=0)(OH)2, -P(=0)(OH)2 or carboxylic acid bioisostere;
L2 is -Ci-C6alkylene-, -C3-C6cycloalkylene-, -C(=0)-, -C(=0)-Ci-C6alkylene- , -
C(=0)NH-, -C(=0)NH-Ci-C6alkylene-, -C(=0)0-, -C(=0)0-Ci-C6alkylene-, -Ci- C6alkylene-C(=0)-, -Ci-C6alkylene-C(=0)NH-, -Ci-C6alkylene-NHC(=0)-, -Ci- C6alkylene-C(=0)0-, -Ci-C6alkylene-OC(=0)-, -Ci-C6alkylene-OC(=0)NH-, -C C6alkylene-NHC(=0)NH-, or absent;
Y is H, unsubstituted or unsubstituted Ci-C6alkyl, CF3, halogen, or CN;
Ring B is a monocyclic aryl, bicyclic aryl, monocyclic heteroaryl or bicyclic heteroaryl; each RB is independently selected from the group consisting of H, halogen, -CN, - N02, -OH, -OR9, -SR9, -S(=0)R9, -S(=0)2R9, -S(=O)2N(R10)2, -NR10S(=O)2R9, - C(=0)R9, -OC(=0)R9, -C02R10, -OC02R9, -N(R10)2, -C(=O)N(R10)2, - OC(=O)N(R10)2, -NHC(=0)R9, -NHC(=0)OR9, Ci-C6alkyl, Ci-C6fluoroalkyl, C C6deuteroalkyl, Ci-C6heteroalkyl, substituted or unsubstituted C3-Ciocycloalkyl, substituted or unsubstituted C2-Ci0heterocycloalkyl, substituted or unsubstituted phenyl, substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl;
n is 0, 1, or 2; each R9 is independently selected from the group consisting of Ci-C6alkyl, Ci-
C6fluoroalkyl, Ci-C6deuteroalkyl, C3-C6cycloalkyl, a substituted or unsubstituted phenyl, a substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl;
each R10 is independently selected from the group consisting of H, Ci-C6alkyl, Ci- C6fluoroalkyl, Ci-C6deuteroalkyl, C3-C6cycloalkyl, a substituted or unsubstituted phenyl, and a substituted or unsubstituted monocyclic heteroaryl; or
two R10 groups attached to the same N atom are taken together with the N atom to which they are attached to form a substituted or unsubstituted heterocycle.
[0008] For any and all of the embodiments, substituents are selected from among a subset of the listed alternatives. For example, in some embodiments, Q is -C02H, -C02(Ci-C6alkyl),- C(=0) HS02R9, tetrazolyl, or carboxylic acid bioisostere. In other embodiments, Q is -C02H, - C02(Ci-C6alkyl) ,-C(=0) HS02R9, or tetrazolyl. In some other embodiments, Q is -C02H, or - C02(Ci-C6alkyl). In yet some other embodiments, Q is -C02H.
[0009] In some embodiment
[0010] In some embodiment
[0011] In some embodiment
[0012] In some embodiment
[0013] In some embodiment
[0014] In some embodiment
Figure imgf000005_0001
[0015] In some embodiments,
[0016] In some embodiments,
[0017] In some embodiments,
Figure imgf000006_0001
[0018] In some embodiments, L2 is -Ci-C6alkylene-.
[0019] In some embodiments, L2 is -CH2-, -CH2CH2-, -CH2CH2CH2-, -C(CH3)2-, or -CH(CH3)-
[0020] In some embodiments, Ring A is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms; Ring B is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
[0021] In some embodiments, Ring A is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl; Ring B is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
[0022] In some embodiments, Ring A is phenyl or pyridinyl; Ring B is phenyl or pyridinyl.
[0023] In some embodiments, the compound of Formula (I) has the following structure of Formula (II), Formula (III), Formula (IV), Formula (V), Formula (VI), or Formula (VII):
Figure imgf000006_0002
Formula (II) Formula (III) Formula (IV)
Figure imgf000007_0001
Formula (V) Formula (VI) Formula (VII) wherein,
X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
[0024] In some embodiments, X is CH. In some embodiments, X is N.
[0025] In some embodiments, Y is H, -CH3, CF3, F, CI, Br, or CN; R1 is H, F, CI, -CN, -CH3, - CF3, or -CD3.
[0026] In some embodiments, Y is H, -CH3, CF3, F, CI, Br, or CN. In some embodiments, Y is
H, or CN. In some embodiments, Y is CN.
[0027] In some embodiments, L1 is absent, -CH2-, -CH2CH2-, -CH2CH2CH2-, -CH(CH3) -, - CH(CH2CH3)-, -C(CH3)2-, -C(CH2CH3)2-, cyclopropyl-l,l-diyl, cyclobutyl-l,l-diyl, cyclopentyl-
I, 1-diyl or cyclohexyl-l, l-diyl; Q is -C02H, -C02(Ci-C6alkyl), -C(=0)NHS02R9 or tetrazolyl.
[0028] In some embodiments, each RA is independently selected from the group consisting of H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci-Cefiuoroalkyl; each RB is independently selected from the group consisting of H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci- C6fluoroalkyl.
[0029] In some embodiments, each RA is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH3, -CF3, -OCH3, -OCH2CH3, -OCF3, or -OCH2CF3; each RB is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH3, -CF3, -OCH3, -OCH2CH3, -OCF3, or -OCH2CF3.
[0030] In some embodiments, R2 is H, halogen, -CN, -OH, d-C4alkyl, Ci-C4fluoroalkyl, C C4deuteroalkyl, Ci-C4alkoxy, or Ci-C4fluoroalkoxy.
[0031] In some embodiments, R2 is H, F, CI, Br, I, -CN, -OH, -CH3, -CF3, -CD3, -OCH3, -
OCH2CH3, -OCF3, or -OCH2CF3.
[0032] In some embodiments, R2 is H or CI.
[0033] In some embodiments, R3 is H, halogen, -CN, -OH, Ci-C4alkyl, Ci-C4fluoroalkyl, Ci- C4deuteroalkyl, Ci-C4alkoxy, or Ci-C4fluoroalkoxy. [0034] In some embodiments, R3 is H, F, CI, Br, I, -CN, -OH, -CH3, -CF3, -CD3, -OCH3, -
OCH2CH3, -OCF3, or -OCH2CF3.
[0035] In some embodiments, R3 is H, F, or CI.
[0036] In some embodiments, L1 is absent, -CH2-, -CH2CH2-, or -CH2CH2CH2-; Q is -C02H, or -C02(Ci-C6alkyl).
[0037] Any combination of the groups described above for the various variables is
contemplated herein. Throughout the specification, groups and substituents thereof are chosen by one skilled in the field to provide stable moieties and compounds.
[0038] In one aspect, described herein is a pharmaceutical composition comprising a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, and at least one pharmaceutically acceptable excipient. In some embodiments, the pharmaceutical composition is formulated for administration to a mammal by intravenous administration, subcutaneous administration, oral administration, inhalation, nasal administration, dermal administration, or ophthalmic administration. In some embodiments, the pharmaceutical composition is in the form of a tablet, a pill, a capsule, a liquid, a suspension, a gel, a dispersion, a solution, an emulsion, an ointment, or a lotion. In some embodiments, the pharmaceutical composition further comprises one or more additional therapeutically active agents in addition to the compound of Formula (I). Additional therapeutic agents include, but are not limited to, immunosuppressants, ant-fibrotic agents, analgesics, anti-cancer agents, and anti-inflammatories. For example, such agents include, but are not limited to, corticosteroids, immunosuppressants, analgesics, anti-cancer agents, anti-inflammatories, non-steroidal anti-inflammatories, TNF-alpha blockers, kinase inhibitors, chemokine receptor antagonists, bronchodilators, leukotriene receptor antagonists, leukotriene formation inhibitors, prostaglandin receptor antagonists, prostaglandin formation inhibitors, monoacylglycerol kinase inhibitors, phospholipase Ai inhibitors, phospholipase A2 inhibitors, lysophospholipase D (lysoPLD) inhibitors, autotaxin inhibitors, and LP A receptor antagonists.
[0039] In one aspect, described herein is a method of treating or preventing any one of the diseases or conditions described herein comprising administering a therapeutically effective amount of a compound described herein (e.g. Formula (I)), or a pharmaceutically acceptable salt, or solvate thereof, to a mammal in need thereof.
[0040] In another aspect is the use of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, in the treatment or prevention of a disease or condition in which the activity of autotaxin and/or at least one LPA receptor contributes to the pathology and/or symptoms of the disease or condition. In one aspect, the disease or condition is any of the diseases or conditions described herein. [0041] In one aspect, described is a method for treating or preventing cancer, fibrosis, pruritis, an inflammatory disease or condition, an airway disease or condition, an autoimmune disease or condition, obesity, intraocular pressure, neuropathic pain, or combinations thereof in a mammal comprising administering a therapeutically effective amount of a compound of Formual (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
[0042] In another aspect, described is a method for treating or preventing cancer in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof. In some embodiments, the cancer is a solid tumor. In some embodiments, the cancer is bladder cancer, colon cancer, brain cancer, breast cancer, endometrial cancer, heart cancer, kidney cancer, lung cancer, liver cancer, uterine cancer, blood and lymphatic cancer, ovarian cancer, pancreatic cancer, prostate cancer, thyroid cancer, or skin cancer. In yet other embodiments, the cancer is a sarcoma, carcinoma, or lymphoma. In some embodiments, the cancer is amendable to treatment with an autotaxin inhibitor. In some embodiments, the method further comprises administering a second therapeutic agent to the mammal in addition to the compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof.
[0043] In one aspect, described herein is a method for the treatment or prevention of fibrosis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof. In some embodiments, the fibrosis comprises lung fibrosis, liver fibrosis, kidney fibrosis or cutaneous fibrosis. In some embodiments, the fibrosis is amendable to treatment with an autotaxin inhibitor. In some embodiments, the method further comprises administering a second therapeutic agent to the mammal in addition to the compound of Formula (I), or a
pharmaceutically acceptable salt, or solvate thereof.
[0044] In one aspect, described herein is a method of reducing or inhibiting angiogenesis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof. In some embodiments, reducing or inhibiting angiogenesis in the mammal treats atherosclerosis, hypertension, tumor growth, inflammation, rheumatoid arthritis, wet-form macular degeneration, choroidal neovascularization, retinal neovascularization, or diabetic retinopathy.
[0045] In one aspect, described herein is a method of treating or preventing an inflammatory disease or condition in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof. In some embodiments, the inflammatory disease or condition is psoriasis, rheumatoid arthritis, vasculitis, inflammatory bowel disease, dermatitis, osteoarthritis, asthma, inflammatory muscle disease, allergic rhinitis, vaginitis, interstitial cystitis, scleroderma, eczema, lupus erythematosus, dermatomyositis, Sjogren's syndrome, thyroiditis, myasthenia gravis, autoimmune hemolytic anemia, multiple sclerosis, cystic fibrosis, chronic relapsing hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, allergic conjunctivitis or atopic dermatitis.
[0046] In one aspect, described herein is a method for treating or preventing pruritis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof. In some embodiments, the pruiritus is associated with dermatitis herpetiformis, dermatomyositis, pemphigoid, Sjogren's syndrome, Darier's disease, Hailey-Hailey disease, Ichthyoses, Sjogren- Larsson syndrome, dermatophytosis, folliculitis, impetigo and other bacterial infections, insect bites, pediculosis, ccabies, viral infection, asteatosis, atopic eczema, contact dermatitis, drug reaction, lichen planus, lichen simplex chronicus, mastocytosis (urticaria pigmentosa), miliaria, psoriasis, scar(s), urticaria, cutaneous T-cell lymphoma or mycosis fungoides, cutaneous B-cell lymphoma, leukemia cutis, pemphigoid gestationis, polymorphic eruption of pregnancy or prurigo gestationis.
[0047] In one aspect, described herein is a method for treating or preventing cholestatic pruritis in a mammal comprising administering a therapeutically effective amount of a compound of Formula (I), or a pharmaceutically acceptable salt, or solvate thereof, to the mammal in need thereof.
[0048] In any of the aforementioned aspects are further embodiments in which the effective amount of the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is: (a) systemically administered to the mammal; and/or (b) administered orally to the mammal; and/or (c) intravenously administered to the mammal; and/or (d) administered by inhalation; and/or (e) administered by nasal administration; or and/or (f) administered by injection to the mammal; and/or (g) administered topically to the mammal; and/or (h) administered by ophthalmic administration; and/or (i) administered rectally to the mammal; and/or (j) adminstered non- systemically or locally to the mammal.
[0049] In any of the aforementioned aspects are further embodiments comprising single administrations of the effective amount of the compound, including further embodiments in which the compound is administered once a day to the mammal or the compound is administered to the mammal multiple times over the span of one day. In some embodiments, the compound is administered on a continuous dosing schedule. In some embodiments, the compound is administered on a continuous daily dosing schedule. [0050] In any of the aforementioned aspects involving the treatment of ATX dependent diseases or conditions are further embodiments comprising administering at least one additional agent in addition to the administration of a compound having the structure of Formula (I), or a pharmaceutically acceptable salt thereof. In various embodiments, each agent is administered in any order, including simultaneously.
[0051] In any of the embodiments disclosed herein, the mammal is a human.
[0052] In some embodiments, compounds provided herein are administered to a human.
[0053] In some embodiments, compounds provided herein are orally administered.
[0054] Articles of manufacture, which include packaging material, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, within the packaging material, and a label that indicates that the compound or composition, or pharmaceutically acceptable salt, tautomers, pharmaceutically acceptable N-oxide, pharmaceutically active metabolite, pharmaceutically acceptable prodrug, or pharmaceutically acceptable solvate thereof, is used for inhibiting the activity of autotaxin, or for the treatment, prevention or amelioration of one or more symptoms of a disease or condition that would benefit from inhibition of the activity of autotaxin, are provided.
[0055] Other objects, features and advantages of the compounds, methods and compositions described herein will become apparent from the following detailed description. It should be understood, however, that the detailed description and the specific examples, while indicating specific embodiments, are given by way of illustration only, since various changes and modifications within the spirit and scope of the instant disclosure will become apparent to those skilled in the art from this detailed description.
DETAILED DESCRIPTION OF THE INVENTION
Autotaxin and LPA
[0056] Autotaxin (ATX, PP2, or E- PP2), an approximately 120 kDa glycoprotein, is a secreted nucleotide pyrophosphatase/phosphodiesterase (NPP) with lysophospholipase D activity that converts extracellular lysophosphatidylcholine (LPC) and other lysophospholipids to lysophosphatidic acid (LPA). ATX is considered to be responsible for the majority of circulating LPA production.
[0057] LPA acts through sets of specific G protein-coupled receptors (GPCRs), such as LPA1, LPA2, LP A3, LPA4, LPA5, LPA6, LPA7, LPA8, in an autocrine and paracrine fashion to produce a variety of biological responses. For example, lysophospholipids, such as
lysophosphatidic acid (LPA), are known to affect such biological functions as cellular proliferation, differentiation, survival, migration, adhesion, invasion, and morphogenesis. In addition, LPA is known to play a role in such processes as platelet activation, smooth muscle contraction, actin stress fiber formation, and cell migration.
[0058] ATX and LPA have been detected in various biological fluids such as serum, plasma, cerebrospinal fluid, seminal fluid, urine, and saliva, both in animals and humans, suggesting that they are potential biomarkers to predict certain diseases. For example, serum ATX concentration and activity is elevated in patients with chronic liver diseases and in pregnant women. In addition, ATX concentration has been found to be lower in postoperative cancer patients as a result of postoperative damage or poor nutritional state. In addition, ATX is known to be essential for normal development. For example, ATX-deficient mice die at embryonic day 9.5 with profound vascular defects in both the yolk sac and the embryo. Furthermore, at embryonic day 8.5 ATX-deficient embryos were found to have malformed allantois, neural tube defects, and asymmetric headfolds.
Cancer
[0059] ATX has been demonstrated to increase cell motility, neovascularization, proliferation and aggressiveness of tumors. It is upregulated in numerous tumor lineages, such as breast, renal, liver, glioblastoma, ovarian and prostate cancer.
[0060] In some embodiments, disclosed herein are methods of treating cancer with a compound disclosed herein.
[0061] ATX is a prometastatic enzyme initially isolated from the conditioned medium of human melanoma cells. In addition, ATX overexpression is frequently observed in malignant tumor tissues such as breast cancer, renal cancer, Hodgkin lymphoma, hepatocellular carcinoma, pancreatic cancer and glioblastoma. LPA also contributes to tumorigenesis by increasing motility and invasiveness of cells.
[0062] The term "cancer" as used herein, refers to an abnormal growth of cells that tend to proliferate in an uncontrolled way and, in some cases, to metastasize (spread). Types of cancer include, but are not limited to, solid tumors (such as those of the bladder, bowel, brain, breast, endometrium, heart, kidney, lung, liver, uterus, lymphatic tissue (lymphoma), ovary, pancreas or other endocrine organ (thyroid), prostate, skin (melanoma or basal cell cancer) or hematological tumors (such as the leukemias and lymphomas) at any stage of the disease with or without metastases.
[0063] Non- limiting examples of cancers include, acute lymphoblastic leukemia, acute myeloid leukemia, adrenocortical carcinoma, anal cancer, appendix cancer, astrocytomas, atypical teratoid/rhabdoid tumor, basal cell carcinoma, bile duct cancer, bladder cancer, bone cancer (osteosarcoma and malignant fibrous histiocytoma), brain stem glioma, brain tumors, brain and spinal cord tumors, breast cancer, bronchial tumors, Burkitt lymphoma, cervical cancer, chronic lymphocytic leukemia, chronic myelogenous leukemia, colon cancer, colorectal cancer, craniopharyngioma, cutaneous T-Cell lymphoma, desmoid tumors, embryonal tumors, endometrial cancer, ependymoblastoma, ependymoma, esophageal cancer, ewing sarcoma family of tumors, eye cancer, retinoblastoma, gallbladder cancer, gastric (stomach) cancer,
gastrointestinal carcinoid tumor, gastrointestinal stromal tumor (GIST), gastrointestinal stromal cell tumor, germ cell tumor, glioma, hairy cell leukemia, head and neck cancer, hepatocellular (liver) cancer, Hodgkin lymphoma, hypopharyngeal cancer, intraocular melanoma, islet cell tumors (endocrine pancreas), Kaposi sarcoma, kidney cancer, Langerhans cell histiocytosis, laryngeal cancer, leukemia, Acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myelogenous leukemia, hairy cell leukemia, liver cancer, non- small cell lung cancer, small cell lung cancer, Burkitt lymphoma, cutaneous T-cell lymphoma, Hodgkin lymphoma, non-Hodgkin lymphoma, lymphoma, Waldenstrom macroglobulinemia, medulloblastoma, medulloepithelioma, melanoma, mesothelioma, mouth cancer, chronic myelogenous leukemia, myeloid leukemia, multiple myeloma, nasopharyngeal cancer, neuroblastoma, non-Hodgkin lymphoma, non-small cell lung cancer, oral cancer, oropharyngeal cancer, osteosarcoma, malignant fibrous histiocytoma of bone, ovarian cancer, ovarian epithelial cancer, ovarian germ cell tumor, ovarian low malignant potential tumor, pancreatic cancer, papillomatosis, parathyroid cancer, penile cancer, pharyngeal cancer, pineal parenchymal tumors of intermediate differentiation, pineoblastoma and supratentorial primitive neuroectodermal tumors, pituitary tumor, plasma cell neoplasm/multiple myeloma, pleuropulmonary blastoma, primary central nervous system lymphoma, prostate cancer, rectal cancer, renal cell (kidney) cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, sarcoma, Sezary syndrome, skin cancer, small cell lung cancer, small intestine cancer, soft tissue sarcoma, squamous cell carcinoma, stomach (gastric) cancer, supratentorial primitive neuroectodermal tumors, T-cell lymphoma, testicular cancer, throat cancer, thymoma and thymic carcinoma, thyroid cancer, urethral cancer, uterine cancer, uterine sarcoma, vaginal cancer, vulvar cancer, Waldenstrom macroglobulinemia, and Wilms tumor.
[0064] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in the treatment of ovarian cancer, prostate cancer, breast cancer, lung cancer, melanoma, head and neck cancer, bowel cancer (colorectal cancer), thyroid cancer, glioblastoma, follicular lymphoma, renal cancer, Hodgkin lymphoma, hepatocellular carcinoma, pancreatic cancer or melanoma.
[0065] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in the treatment of bone metastases. [0066] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in the treatment of oral cancer, prostate cancer, rectal cancer, non-small cell lung cancer, lip and oral cavity cancer, liver cancer, lung cancer, anal cancer, kidney cancer, vulvar cancer, breast cancer, oropharyngeal cancer, nasal cavity and paranasal sinus cancer, nasopharyngeal cancer, urethra cancer, small intestine cancer, bile duct cancer, bladder cancer, ovarian cancer, laryngeal cancer, hypopharyngeal cancer, gallbladder cancer, colon cancer, colorectal cancer, head and neck cancer, parathyroid cancer, penile cancer, vaginal cancer, thyroid cancer, pancreatic cancer, esophageal cancer, Hodgkin's lymphoma, leukemia-related disorders, mycosis fungoides, or myelodysplastic syndrome.
[0067] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in the treatment of non-small cell lung cancer, pancreatic cancer, breast cancer, ovarian cancer, colorectal cancer, or head and neck cancer.
[0068] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in the treatment of a carcinoma, a tumor, a neoplasm, a lymphoma, a melanoma, a glioma, a sarcoma, or a blastoma.
[0069] In some embodiments, the carcinoma is selected from the group consisting of:
carcinoma, adenocarcinoma, adenoid cystic carcinoma, adenosquamous carcinoma,
adrenocortical carcinoma, well differentiated carcinoma, squamous cell carcinoma, serous carcinoma, small cell carcinoma, invasive squamous cell carcinoma, large cell carcinoma, islet cell carcinoma, oat cell carcinoma, squamous carcinoma, undifferentiatied carcinoma, verrucous carcinoma, renal cell carcinoma, papillary serous adenocarcinoma, merkel cell carcinoma, hepatocellular carcinoma, soft tissue carcinomas, bronchial gland carcinomas, capillary carcinoma, bartholin gland carcinoma, basal cell carcinoma, carcinosarcoma,
papilloma/carcinoma, clear cell carcinoma, endometrioid adenocarcinoma, mesothelial, metastatic carcinoma, mucoepidermoid carcinoma, cholangiocarcinoma, actinic keratoses, cystadenoma, and hepatic adenomatosis.
[0070] In some embodiments, the tumor is selected from the group consisting of: astrocytic tumors, malignant mesothelial tumors, ovarian germ cell tumor, supratentorial primitive neuroectodermal tumors, Wilm's tumor, pituitary tumors, extragonadal germ cell tumor, gastrinoma, germ cell tumors, gestational trophoblastic tumor, brain tumors, pineal and supratentorial primitive neuroectodermal tumors, pituitary tumor, somatostatin-secreting tumor, endodermal sinus tumor, carcinoids, central cerebral astrocytoma, glucagonoma, hepatic adenoma, insulinoma, medulloepithelioma, plasmacytoma, vipoma, and pheochromocytoma.
[0071] In some embodiments, the neoplasm is selected from the group consisting of:
intaepithelial neoplasia, multiple myeloma/plasma cell neoplasm, plasma cell neoplasm, interepithelial squamous cell neoplasia, endometrial hyperplasia, focal nodular hyperplasia, hemangioendothelioma, lymphangioleio myomatosis and malignant thymoma.
[0072] In some embodiments, the lymphoma is selected from the group consisting of: nervous system lymphoma, AIDS-related lymphoma, cutaneous T-cell lymphoma, non-Hodgkin's lymphoma, mantle cell lymphoma, follicular lymphoma and Waldenstrom's macroglobulinemia.
[0073] In some embodiments, the melanoma is selected from the group consisting of: acral lentiginous melanoma, superficial spreading melanoma, uveal melanoma, lentigo maligna melanomas, melanoma, intraocular melanoma, adenocarcinoma nodular melanoma, and hemangioma.
[0074] In some embodiments, the sarcoma is selected from the group consisting of: adenomas, adenosarcoma, chondosarcoma, endometrial stromal sarcoma, Ewing's sarcoma, Kaposi's sarcoma, leiomyosarcoma, rhabdomyosarcoma, sarcoma, uterine sarcoma, osteosarcoma, and pseudosarcoma.
[0075] In some embodiments, the glioma is selected from the group consisting of: glioma, brain stem glioma, and hypothalamic and visual pathway glioma.
[0076] In some embodiments, the blastoma is selected from the group consisting of: pulmonary blastoma, pleuropulmonary blastoma, retinoblastoma, neuroblastoma, medulloblastoma, glioblastoma, and hemangiblastomas.
Fibrosis
[0077] In some embodiments, disclosed herein are methods of treating fibrosis with a compound disclosed herein.
[0078] "Fibrosis," as used herein, refers to the accumulation of extracellular matrix
constituents that occurs following trauma, inflammation, tissue repair, immunological reactions, cellular hyperplasia, and neoplasia. Examples of tissue fibrosis include, but are not limited to, pulmonary fibrosis, renal fibrosis, cardiac fibrosis, cirrhosis and fibrosis of the liver, skin scars and keloids, adhesions, fibromatosis, atherosclerosis, and amyloidosis.
[0079] In some embodiments, disclosed herein is a method of reducing fibrosis in a tissue comprising contacting a fibrotic cell or tissue with a compound disclosed herein, in an amount sufficient to decrease or inhibit the fibrosis. In some embodiments, the fibrosis includes a fibrotic condition.
[0080] In some embodiments, reducing fibrosis, or treatment of a fibrotic condition, includes reducing or inhibiting one or more of: formation or deposition of extracellular matrix proteins; the number of pro-fibrotic cell types (e.g., fibroblast or immune cell numbers); cellular collagen or hydroxyproline content within a fibrotic lesion; expression or activity of a fibrogenic protein; or reducing fibrosis associated with an inflammatory response. [0081] In some embodiments, the fibrotic condition is primary fibrosis. In some embodiments, the fibrotic condition is idiopathic. In some embodiments, the fibrotic condition is associated with (e.g., is secondary to) a disease (e.g., an infectious disease, an inflammatory disease, an autoimmune disease, a malignant or cancerous disease, and/or a connective disease); a toxin; an insult (e.g., an environmental hazard (e.g., asbestos, coal dust, polycyclic aromatic
hydrocarbons), cigarette smoking, a wound); a medical treatment (e.g., surgical incision, chemotherapy or radiation), or a combination thereof.
[0082] In some embodiments, the fibrotic condition is a fibrotic condition of the lung, a fibrotic condition of the liver, a fibrotic condition of the heart or vasculature, a fibrotic condition of the kidney, a fibrotic condition of the skin, a fibrotic condition of the gastrointestinal tract, a fibrotic condition of the bone marrow or a hematopoietic tissue, a fibrotic condition of the nervous system, or a combination thereof.
[0083] In some embodiments, the fibrotic condition affects a tissue chosen from one or more of muscle, tendon, cartilage, skin (e.g., skin epidermis or endodermis), cardiac tissue, vascular tissue (e.g., artery, vein), pancreatic tissue, lung tissue, liver tissue, kidney tissue, uterine tissue, ovarian tissue, neural tissue, testicular tissue, peritoneal tissue, colon, small intestine, biliary tract, gut, bone marrow, or hematopoietic tissue.
[0084] In some embodiments, the fibrotic condition is a fibrotic condition of the lung. In some embodiments, the fibrotic condition of the lung is chosen from one or more of: pulmonary fibrosis, idiopathic pulmonary fibrosis (IPF), usual interstitial pneumonitis (UIP), interstitial lung disease, cryptogenic fibrosing alveolitis (CFA), bronchiolitis obliterans, or bronchiectasis. In some embodiments, the fibrosis of the lung is secondary to a disease, a toxin, an insult, a medical treatment, or a combination thereof. In some embodiments, fibrosis of the lung is associated with one or more of: a disease process such as asbestosis and silicosis; an occupational hazard; an environmental pollutant; cigarette smoking; an autoimmune connective tissue disorders (e.g., rheumatoid arthritis, scleroderma and systemic lupus erythematosus (SLE)); a connective tissue disorder such as sarcoidosis; an infectious disease, e.g., infection, particularly chronic infection; a medical treatment, including but not limited to, radiation therapy, and drug therapy, e.g., chemotherapy (e.g., treatment with as bleomycin, methotrexate, amiodarone, busulfan, and/or nitrofurantoin). In some embodiments, the fibrotic condition of the lung treated with the methods of the invention is associated with (e.g., secondary to) a cancer treatment, e.g., treatment of a cancer (e.g. squamous cell carcinoma, testicular cancer, Hodgkin's disease with bleomycin).
[0085] In some embodiments, the fibrotic condition is a fibrotic condition of the liver. In certain embodiments, the fibrotic condition of the liver is chosen from one or more of: fatty liver disease, steatosis (e.g., nonalcoholic steatohepatitis (NASH), cholestatic liver disease (e.g., primary biliary cirrhosis (PBC), cirrhosis, alcohol-induced liver fibrosis, biliary duct injury, biliary fibrosis, cholestasis or cholangiopathies. In some embodiments, hepatic or liver fibrosis includes, but is not limited to, hepatic fibrosis associated with alcoholism, viral infection, e.g., hepatitis (e.g., hepatitis C, B or D), autoimmune hepatitis, non-alcoholic fatty liver disease (NAFLD), progressive massive fibrosis, exposure to toxins or irritants (e.g., alcohol,
pharmaceutical drugs and environmental toxins).
[0086] In some embodiments, the fibrotic condition is a fibrotic condition of the heart. In certain embodiments, the fibrotic condition of the heart is myocardial fibrosis (e.g., myocardial fibrosis associated with radiation myocarditis, a surgical procedure complication (e.g., myocardial post-operative fibrosis), infectious diseases (e.g., Chagas disease, bacterial, trichinosis or fungal myocarditis)); granulomatous, metabolic storage disorders (e.g.,
cardiomyopathy, hemochromatosis); developmental disorders (e.g., endocardial fibroelastosis); arteriosclerotic, or exposure to toxins or irritants (e.g., drug induced cardiomyopathy, drug induced cardiotoxicity, alcoholic cardiomyopathy, cobalt poisoning or exposure). In some embodiments, the myocardial fibrosis is associated with an inflammatory disorder of cardiac tissue (e.g., myocardial sarcoidosis).
[0087] In some embodiments, the fibrotic condition is a fibrotic condition of the kidney. In some embodiments, the fibrotic condition of the kidney is chosen from one or more of: renal fibrosis (e.g., chronic kidney fibrosis), nephropathies associated with injury/fibrosis (e.g., chronic nephropathies associated with diabetes (e.g., diabetic nephropathy)), lupus, scleroderma of the kidney, glomerular nephritis, focal segmental glomerular sclerosis, IgA nephropathyrenal fibrosis associated with human chronic kidney disease (CKD), chronic progressive nephropathy (CPN), tubulointerstitial fibrosis, ureteral obstruction, chronic uremia, chronic interstitial nephritis, radiation nephropathy, glomerulosclerosis, progressive glomerulonephrosis (PGN),
endothelial/thrombotic microangiopathy injury, HIV-associated nephropathy, or fibrosis associated with exposure to a toxin, an irritant, or a chemotherapeutic agent.
[0088] In some embodiments, the fibrotic condition is a fibrotic condition of the skin. In some embodiments, the fibrotic condition of the skin is chosen from one or more of: skin fibrosis, scleroderma, nephrogenic systemic fibrosis (e.g., resulting after exposure to gadolinium which is frequently used as a contrast substance for MRIs in patients with severe kidney failure), scarring and keloid.
[0089] In some embodiments, the fibrotic condition is a fibrotic condition of the
gastrointestinal tract. In some embodiments, the fibrotic condition is chosen from one or more of fibrosis associated with scleroderma; radiation induced gut fibrosis; fibrosis associated with a foregut inflammatory disorder such as Barrett's esophagus and chronic gastritis, and/or fibrosis associated with a hindgut inflammatory disorder, such as inflammatory bowel disease (IBD), ulcerative colitis and Crohn's disease.
[0090] In some embodiments, the fibrotic condition is adhesions. In some embodiments, the adhesions are chosen from one or more of: abdominal adhesions, peritoneal adhesions, pelvic adhesions, pericardial adhesions, peridural adhesions, peritendinous or adhesive capsulitis.
[0091] In some embodiments, the fibrotic condition is a fibrotic condition of the eye. In some embodiments, the fibrotic condition of the eye involves diseases of the anterior segment of the eye such as glaucoma and corneal opacification; in some embodiments, the fibrotic condition of the eye involves disease of the posterior segment of the eye such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity and neovascular glaucoma; in some embodiments, the fibrotic condition of the eye results from fibrosis following ocular surgery.
[0092] In some embodiments, the fibrotic condition is a fibrotic condition of the bone marrow or a hematopoietic tissue. In some embodiments, the fibrotic condition of the bone marrow is an intrinsic feature of a chronic myeloproliferative neoplasm of the bone marrow, such as primary myelofibrosis (also referred to herein as agnogenic myeloid metaplasia or chronic idiopathic myelofibrosis). In some embodiments, the bone marrow fibrosis is associated with (e.g., is secondary to) a malignant condition or a condition caused by a clonal proliferative disease. In some embodiments, the bone marrow fibrosis is associated with a hematologic disorder (e.g., a hematologic disorder chosen from one or more of polycythemia vera, essential thrombocythemia, myelodysplasia, hairy cell leukemia, lymphoma (e.g., Hodgkin or non-Hodgkin lymphoma), multiple myeloma or chronic myelogeneous leukemia (CML)). In some embodiments, the bone marrow fibrosis is associated with (e.g., secondary to) a non-hematologic disorder (e.g., a non- hematologic disorder chosen from solid tumor metastasis to bone marrow, an autoimmune disorder (e.g., systemic lupus erythematosus, scleroderma, mixed connective tissue disorder, or polymyositis), an infection (e.g., tuberculosis), or secondary hyperparathyroidism associated with vitamin D deficiency.
Pruritis
[0093] In some embodiments, disclosed herein are methods of treating pruritis with a compound disclosed herein.
[0094] Pruritus is a condition involving localized or general itching that is a common and distressing symptom in a variety of diseases. Although usually occurring in the skin, pruritus can also occur in non-cutaneous sites such as mucous membranes. Pruritus is a frequent
manifestation of localized skin disorders caused by hypersensitivity reactions such as allergic reactions to insect bites or to environmental allergens, urticaria, dermatoses of fungal and bacterial origins, ectoparasite infections, and hemorrhoids. In some embodiments, disclosed herein are method of treating pruritus caused by systemic diseases, including, for example, hypothyroidism, thyrotoxicosis, mucocandiasis in diabetes mellitus, and Hodgkin's disease. In some embodiments, disclosed herein are methods of treating bouts of persistent or recurrent pruritus associated with many systemic diseases and skin disorders.
[0095] In some embodiments, disclosed herein are methods of treating pruritus associated with liver diseases and intrahepatic or posthepatic cholestasis. Hepatic diseases leading to pruritus include primary biliary cirrhosis, B and C viral hepatitis, primary sclerosing cholangitis, carcinoma of bile ducts, alcoholic cirrhosis, autoimmune hepatitis and others.
[0096] In some embodiments, disclosed herein are method of treating pruritus arising from a variety of causes such as xerosis, skin conditions (such as psoriasis, eczema, sunburn, athlete's foot), insect bites, poisonous plants (such as poison ivy, poison oak, poison sumac), Hodgkin's disease, jaundice, polycythemia, scabies, lice, worms, thyroid illness, diabetes mellitus, dandruff, iron deficiency anemia, parasitic infections, medications, cholestasis, pruritus related to pregnancy, HIV infection or other causes of itching or pruritus.
Inflammation
[0097] In some embodiments, disclosed herein are methods of treating an inflammatory condition, disease, or disorder with a compound disclosed herein.
[0098] As used in the present disclosure, "inflammation" refers to the well known localized response to various types of injury or infection, which is characterized by redness, heat, swelling, and pain, and often also including dysfunction or reduced mobility.
Airway diseases
[0099] Inflammatory conditions, diseases, and disorders, which can be treated with a compound disclosed herein, include airway diseases comprising pulmonary inflammation, such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, and asthma. COPD is comprised primarily of two related diseases: chronic bronchitis and emphysema. In both diseases, there is chronic obstruction of the flow of air through the airways and out of the lungs, and the obstruction generally is permanent and progressive over time
[00100] Asthma is a chronic disease of the airways of the lungs, characterized by inflammation and paradoxical narrowing of the bronchi. Asthma includes asthmatic conditions mediated via T- cell action, including extrinsic asthma (allergic asthma), intrinsic asthma (non-allergic asthma), mixed asthma (extrinsic and intrinsic asthma), occupational asthma induced by agents such as toluene diisocyanate, polyvinyl chloride, phthalic anhydride, trimellitic anhydride, plicatic acid (Western Red Cedar trees) or metal salts such as platinum or nickel), drug-induced asthma (including aspirin-induced asthma or asthma induced by non-steroidal anti-inflammatory drugs (NSAIDs)), exercise-induced asthma, and cough variant asthma. In some embodiments, the asthma is an allergic or non-allergic asthmatic condition mediated by T-cell function.
[00101] In some embodiments, disclosed herein is a method of treating asthma with a compound disclosed herein. In an asthmatic individual, the release of normal repair mediators, including LPA, is exaggerated or the actions of the repair mediators are inappropriately prolonged leading to inappropriate airway remodeling. Major structural features of the remodeled airway observed in asthma include a thickened lamina reticularis (the basement membrane-like structure just beneath the airway epithelial cells), increased numbers and activation of myofibroblasts, thickening of the smooth muscle layer, increased numbers of mucus glands and mucus secretions, and alterations in the connective tissue and capillary bed throughout the airway wall. In some embodiments, ATX and/or LPA contribute to these structural changes in the airway. In some embodiments, ATX and/or LPA are involved in acute airway hyperresponsiveness in asthma. The lumen of the remodeled asthmatic airway is narrower due to the thickening of the airway wall, thus decreasing airflow. In some embodiments, LPA contributes to the long-term structural remodeling and the acute hyperresponsiveness of the asthmatic airway. In some embodiments, LPA contributes to the hyper-responsiveness that is a primary feature of acute exacerbations of asthma.
[00102] In some embodiments, disclosed herein is a method of treating or preventing COPD with a compound disclosed herein. The term "chronic obstructive pulmonary disease (COPD)" refers to a group of lung diseases, including chronic bronchitis, emphysema and obliterative bronchiolitis. The most common of these diseases are chronic bronchitis and emphysema.
Although a person with COPD may have either chronic bronchitis or emphysema, he or she will often have a mixture of the symptoms of these two conditions. Although emphysema usually results from damage to the lungs caused by environmental insult, usually as a result of long-term smoking, emphysema may also be caused by congenital absence of al -antitrypsin in the lungs; this type of emphysema is usually inherited.
[00103] In some embodiments, disclosed herein is a method of treating chronic bronchitis with a compound disclosed herein. Chronic bronchitis (CB) is inflammation of one or more bronchi, usually secondary to infection, and is characterized by excessive production of mucus in the bronchi, accompanied by a recurrent cough which persists for at least three months of the year during at least two successive years. CB is the major non-asthmatic disease of the lung. Many different factors initiate CB, including cigarette smoking, environmental pollution, chronic infections and various genetic abnormalities. Of these factors, cigarette smoking is the most prevalent. Pathological changes in the lung include: (1) hypertrophy and hyperplasia of mucus- secreting glands in the bronchi, (2) increase in goblet cells, (3) disappearance or damage of cilia, and (4) chronic inflammatory changes and narrowing of small airways.
[00104] In some embodiments, disclosed herein is a method of treating emphysema with a compound disclosed herein. Emphysema is a lung condition which results from damage to the alveolar sacs in the lungs, usually caused by long-term smoking. This damage leads to a pathological accumulation of air in the tissues.
[00105] Administration of LPA in vivo induces airway hyperresponsiveness, itch-scratch responses, infiltration and activation of eosinophils and neutrophils, vascular remodeling, and nociceptive flexor responses. LPA also induces histamine release from mouse and rat mast cells. In an acute allergic reaction, histamine induces various responses, such as contraction of smooth muscle, plasma exudation, and mucus production. Plasma exudation is important in the airway, because the leakage and subsequent airway-wall edema contribute to the development of airway hyperresponsiveness. In some embodiments, disclosed herein is a method of reducing plasma exudation due to an acute allergic reaction with a compound disclosed herein.
Autoimmune Diseases
[00106] The methods described herein, in some embodiments, include methods for the treatment, reduction of risk, and delaying of onset of an autoimmune disease or disorder with a compound disclosed herein. Examples of autoimmune diseases include, but are not limited to, Alopecia Areata, Lupus, Ankylosing Spondylitis, Meniere's Disease, Antiphospholipid
Syndrome, Mixed Connective Tissue Disease, Autoimmune Addison's Disease, Autoimmune Hemolytic Anemia, Myasthenia Gravis, Autoimmune Hepatitis, Pemphigus Vulgaris, Behcet's Disease, Pernicious Anemia, Bullous Pemphigoid, Polyarthritis Nodosa, Cardiomyopathy, Polychondritis, Celiac Sprue-Dermatitis, Polyglandular Syndromes, Chronic Fatigue Syndrome (CFIDS), Polymyalgia Rheumatica, Chronic Inflammatory Demyelinating, Polymyositis and Dermatomyositis, Chronic Inflammatory Polyneuropathy, Primary Agammaglobulinemia, Churg-Strauss Syndrome, Primary Biliary Cirrhosis, Cicatricial Pemphigoid, Psoriasis, CREST Syndrome, Raynaud's Phenomenon, Cold Agglutinin Disease, Reiter's Syndrome, Crohn's Disease, Rheumatic Fever, Discoid Lupus, Rheumatoid Arthritis, Essential Mixed,
Cryoglobulinemia Sarcoidosis, Fibromyalgia, Scleroderma, Grave's Disease, Sjogren's
Syndrome, Guillain-Barre, Stiff-Man Syndrome, Hashimoto's Thyroiditis, Takayasu Arteritis, Idiopathic Pulmonary Fibrosis, Temporal Arteritis/Giant Cell Arteritis, Idiopathic
Thrombocytopenia Purpura (ITP), Ulcerative Colitis, IgA Nephropathy, Uveitis, Insulin
Dependent Diabetes (Type I), Diabetes (Type II), Vasculitis, Lichen Planus, and Vitiligo. Other Inflammatory Disorders
[00107] The methods described herein, in some embodiments, include methods for the treatment, reduction of risk, and delaying onset of other inflammatory conditions or diseases with a compound disclosed herein, such as (a Ocular inflammation associated with corneal ulcers, giant papillary conjunctivitis, blepharitis, chelazion, uveitis, dry eye, post-surgical inflammation, and contact lens associated inflammation; (b) allergic diseases such as hay fever, rhinitis, seasonal allergic conjunctivitis, vernal conjunctivitis and other eosinophil-mediated conditions; (c) skin diseases such as psoriasis, contact dermatitis, eczema, infectious skin ulcers, open wounds, and cellulitis; (d) infectious diseases including sepsis, septic shock, encephalitis, infectious arthritis, endotoxic shock, gram negative shock, Jarisch-Herxheimer reaction, shingles, toxic shock, cerebral malaria, bacterial meningitis, acute respiratory distress syndrome (ARDS), lyme disease, and HIV infection, (e) wasting diseases such as cachexia secondary to cancer and HIV; (f) inflammation due to organ, tissue or cell transplantation (e.g., bone marrow, cornea, kidney, lung, liver, heart, skin, pancreatic islets) including transplant rejection, and graft versus host disease; (g) adverse effects from drug therapy, including adverse effects from amphotericin B treatment, adverse effects from immunosuppressive therapy, e.g., interleukin-2 treatment, adverse effects from OKT3 treatment, adverse effects from GM-CSF treatment, adverse effects of cyclosporine treatment, and adverse effects of aminoglycoside treatment, stomatitis, and mucositis due to immunosuppression; (h) cardiovascular conditions including circulatory diseases induced or exasperated by an inflammatory response, such as ischemia, atherosclerosis, peripheral vascular disease, restenosis following angioplasty, inflammatory aortic aneurysm, vasculitis, stroke, spinal cord injury, congestive heart failure, hemorrhagic shock,
ischemia/reperfusion injury, vasospasm following subarachnoid hemorrhage, vasospasm following cerebrovascular accident, pleuritis, pericarditis, and the cardiovascular complications of diabetes; (i) dialysis, including pericarditis, due to peritoneal dialysis; (j) gout; and (k) chemical or thermal -induced inflammation due to burns, acid, alkali and the like.
Obesity
[00108] In some embodiments, disclosed herein are methods of treating obesity and/or diabetes with a compound disclosed herein.
[00109] ATX is responsible for the lysoPLD activity released by adipocytes and exerts a paracrine control on preadipocyte growth via an LPA-dependent mechanism. In addition, ATX is up-regulated during adipocyte differentiation and in genetic obesity. In certain instances, ATX mRNA is up-regulated in adipocytes from db/db mice suggesting that the up-regulation of ATX is related to the severe type 2 diabetes phenotype and adipocyte insulin resistance. In some instances, up-regulation of ATX in adipocytes is associated with type 2 diabetes. [00110] "Obesity," as used herein, refers to a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to increased health problems. In some embodiments, "obesity" refers to a weight increase, which is at least 5% of the total body weight. In some embodiments, disclosed herein is a method of treating
postmenopausal obesity and/or visceral obesity with a compound disclosed herein.
Intraocular Pressure
[00111] In some embodiments, disclosed herein are methods of treating elevated intraocular pressure associated with glaucoma.
[00112] Glaucoma is one of the leading causes of blindness and is characterized by elevated intraocular pressure (IOP). IOP is a primary risk factor for developing glaucoma and the risk of developing glaucoma decreases when IOP is reduced. Ocular hypotensive therapy is the mainstay of glaucoma treatment. Elevated IOP results from diminished aqueous humor (AH) drainage through the trabecular pathway and autotaxin activity is an abundant protein in human AH. Autotaxin is secreted by human trabecular meshwork cells and ATX activity is significantly elevated from glaucoma patients. Inhibition of autotaxin activity in AH by topical and intracameral delivery of a small molecule inhibitor leads to decreased IOP in rabbits.
Neuropathic Pain
[00113] In some embodiments, disclosed herein are methods of treating neuropathic pain with a compound disclosed herein.
[00114] LP A induces neuropathic pain as well as demyelination and pain-related protein expression changes via LPAl . In some instances, ATX heterozygous knockout mice show about 50% recovery of nerve injury- induced neuropathic pain compared to wild type mice.
Lysophosphatidylcholine (LPC), is known to induce neuropathic pain. In certain instances, LPC- induced neuropathic pain is partially reduced in ATX heterozygous knockout mice.
[00115] Neuropathic pain results from injury to a nerve. In contrast to immediate pain caused by tissue injury, in some embodiments, neuropathic pain develops days or months after a traumatic injury. In addition, neuropathic pain frequently is long-lasting or chronic and can occur spontaneously or as a result of stimulation that normally is not painful.
Compounds
[00116] Compounds of Formula (I), including pharmaceutically acceptable salts, prodrugs, active metabolites and pharmaceutically acceptable solvates thereof, are autotaxin inhibitors. In one aspect, provided herein is a compound of Formula (I), or a pharmaceutically acceptable salt, solvate, metabolite or prodrug thereof:
Figure imgf000024_0001
Figure imgf000024_0002
R1 is H, D, halogen, -CN, -C(=0)H, d-C4alkyl, Ci-C4fluoroalkyl, C3-C6cycloalkyl or C C4deuteroalkyl;
R2 is H, halogen, -CN, -OH, N02, NH2, N(R10)2, -OC(=O)N(R10)2 , -C(=O)N(R10)2 , - NHC(=0)R9, -NHC(=0)OR9, substituted or unsubstituted Ci-C4alkyl, C
C fluoroalkyl, Ci-C deuteroalkyl, substituted or unsubstituted Ci-C alkoxy, Ci- C4fluoroalkoxy, -S-Ci-C4alkyl, -S(=0)-Ci-C4alkyl, -S(=0)2-Ci-C4alkyl, Ci- C4hydroxyalkyl, substituted or unsubstituted phenyl, or substituted or unsubstituted monocyclic heteroaryl;
R3 is H, halogen, -CN, -OH, Ci-C4alkyl, Ci-C4fluoroalkyl, Ci-C4deuteroalkyl, C
C4alkoxy, Ci-C4fluoroalkoxy, -S-Ci-C4alkyl, -S(=0)-Ci-C4alkyl, -S(=0)2-Ci-C4alkyl, or Ci-C4hydroxyalkyl;
Ring A is a monocyclic aryl, bicyclic aryl, monocyclic heteroaryl or bicyclic heteroaryl; each RA is independently selected from the group consisting of H, halogen, -CN, - N02, -OH, -OR9, -SR9, -S(=0)R9, -S(=0)2R9, -S(=O)2N(R10)2, -NR10S(=O)2R9, - C(=0)R9, -OC(=0)R9, -C02R10, -OC02R9, -N(R10)2, -C(=O)N(R10)2, - OC(=O)N(R10)2, -NHC(=0)R9, -NHC(=0)OR9, Ci-C6alkyl, Ci-C6fluoroalkyl, Ci- C6deuteroalkyl, Ci-C6heteroalkyl, substituted or unsubstituted C3-Ciocycloalkyl, substituted or unsubstituted C2-Ci0heterocycloalkyl, substituted or unsubstituted phenyl, and substituted or unsubstituted monocyclic heteroaryl;
m is 0, 1, or 2;
L1 is absent, Ci-C6alkylene, Ci-Cefluoroalkylene, C3-C6cycloalkylene, (Ci-C6alkylene)p- C3-C6cycloalkylene-(Ci-C6alkylene)q, or -(Ci-C6alkylene)p-X1-(Ci-C6alkylene)q; X1 is O, S, S(=0), S(=0)2, C(=0) H, HC(=0), NH, OC(=0)NH, NHC(=0)0, or NHC(=0)0;
p is 0 or 1;
q is 0 or 1;
Q is -C02H, -C02(Ci-C6alkyl), -OH, -CN, -B(OH)2, -C(=0)NHS02R9, -C(=O)N(R10)2, -S02NHC(=0)R9, -CN, tetrazolyl, -OP(=0)(OH)2, -P(=0)(OH)2 or carboxylic acid bioisostere;
L2 is -Ci-C6alkylene-, -C3-C6cycloalkylene-, -C(=0)-, -C(=0)-Ci-C6alkylene- , - C(=0)NH-, -C(=0)NH-Ci-C6alkylene-, -C(=0)0-, -C(=0)0-Ci-C6alkylene-, -C C6alkylene-C(=0)-, -Ci-C6alkylene-C(=0)NH-, -Ci-C6alkylene-NHC(=0)-, -Ci- C6alkylene-C(=0)0-, -Ci-C6alkylene-OC(=0)-, -Ci-C6alkylene-OC(=0)NH-, -Ci- C6alkylene-NHC(=0)NH-, or absent;
Y is H, unsubstituted or unsubstituted Ci-C6alkyl, CF3, halogen, or CN;
Ring B is a monocyclic aryl, bicyclic aryl, monocyclic heteroaryl or bicyclic heteroaryl; each RB is independently selected from the group consisting of H, halogen, -CN, - N02, -OH, -OR9, -SR9, -S(=0)R9, -S(=0)2R9, -S(=O)2N(R10)2, -NR10S(=O)2R9, - C(=0)R9, -OC(=0)R9, -C02R10, -OC02R9, -N(R10)2, -C(=O)N(R10)2, - OC(=O)N(R10)2, -NHC(=0)R9, -NHC(=0)OR9, Ci-C6alkyl, Ci-C6fluoroalkyl, Ci- C6deuteroalkyl, Ci-C6heteroalkyl, substituted or unsubstituted C3-Ciocycloalkyl, substituted or unsubstituted C2-Ci0heterocycloalkyl, substituted or unsubstituted phenyl, substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl;
n is 0, 1, or 2;
each R9 is independently selected from the group consisting of Ci-C6alkyl, Ci-
C6fluoroalkyl, Ci-C6deuteroalkyl, C3-C6cycloalkyl, a substituted or unsubstituted phenyl, a substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl; each R is independently selected from the group consisting of H, Ci-C6alkyl, Ci- C6fluoroalkyl, Ci-C6deuteroalkyl, C3-C6cycloalkyl, a substituted or unsubstituted phenyl, and a substituted or unsubstituted monocyclic heteroaryl; or
two R10 groups attached to the same N atom are taken together with the N atom to which they are attached to form a substituted or unsubstituted heterocycle.
[00117] For any and all of the embodiments, substituents are selected from among a subset of the listed alternatives. For example, in some embodiments, Q is -C02H, -C02(Ci-C6alkyl),- C(=0) HS02R9, tetrazolyl, or carboxylic acid bioisostere. In other embodiments, Q is -C02H, - C02(Ci-C6alkyl) ,-C(=0) HS02R9, or tetrazolyl. In some other embodiments, Q is -C02H, or - C02(Ci-C6alkyl). In yet some other embodiments, Q is -C02H.
[00118] In some embodiment
[00119] In some embodiment
[00120] In some embodiment
[00121] In some embodiment
[00122] In some embodiment
[00123] In some embodiment
[00124] In some embodiment
Figure imgf000026_0001
[00125] In some embodiments,
[00126] In some embodiments,
Figure imgf000027_0001
[00127] In some embodiments, L2 is -Ci-C6alkylene-. In some embodiments, L2 is -CH2-, - CH2CH2-, -CH2CH2CH2-, -C(CH3)2-, or -CH(CH3)-. In some embodiments, L2 is -CH2-.
[00128] In some embodiments, Ring A is phenyl, naphthyl, monocyclic heteroaryl containing 1- 4 N atoms and 0 or 1 O or S atoms, monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms, bicyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or bicyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
[00129] In some embodiments, Ring A is phenyl, naphthyl, indanyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, triazinyl, quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridinyl, pyridopyrimidinyl, pyrazolopyrimidinyl, or azaindolyl.
[00130] In some embodiments, Ring A is phenyl, naphthyl, or indanyl. In some embodiments, Ring A is phenyl or naphthyl. In some embodiments, Ring A is phenyl. In some embodiments, Ring A is indanyl. In some embodiments, Ring A is phenyl, or indanyl.
[00131] In some embodiments, Ring A is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
[00132] In some embodiments, Ring A is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, or thiadiazolyl. In some embodiments, Ring A is thiazolyl.
[00133] In some embodiments, Ring A is pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl. In some embodiments, Ring A is pyridinyl or pyrimidinyl. In some embodiments, Ring A is pyridinyl. In some embodiments, Ring A is pyrimidinyl.
[00134] In some embodiments, Ring A is quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridinyl, pyridopyrimidinyl, pyrazolopyrimidinyl, or azaindolyl. [00135] In some embodiments, each RA is independently selected from the group consisting of
H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci-C6fluoroalkyl. In some embodiments, each R is H.
[00136] In some embodiments,
Figure imgf000028_0001
is a substituted or unsubstituted benzoic acid.
Figure imgf000028_0002
[00137] In some embodiments, Ring A is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms; Ring B is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
[00138] In some embodiments, Ring B is phenyl, naphthyl, monocyclic heteroaryl containing 1- 4 N atoms and 0 or 1 O or S atoms, monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms, bicyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or bicyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
[00139] In some embodiments, Ring B is phenyl, naphthyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, triazinyl, quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridinyl, pyridopyrimidinyl, pyrazolopyrimidinyl, or azaindolyl.
[00140] In some embodiments, Ring B is phenyl, or pyridinyl.
[00141] In some embodiments, Ring B is phenyl or naphthyl. In some embodiments, Ring B is phenyl.
[00142] In some embodiments, Ring B is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
[00143] In some embodiments, Ring B is furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, or thiadiazolyl. In some embodiments, Ring B is thiazolyl.
[00144] In some embodiments, Ring B is pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl. In some embodiments, Ring B is pyridinyl. [00145] In some embodiments, Ring B is quinolinyl, isoquinolinyl, quinazolinyl, quinoxalinyl, naphthyridinyl, indolyl, indazolyl, benzoxazolyl, benzisoxazolyl, benzofuranyl, benzothienyl, benzothiazolyl, benzimidazolyl, purinyl, cinnolinyl, phthalazinyl, pteridinyl, pyridopyrimidinyl, pyrazolopyrimidinyl, or azaindolyl.
[00146] In some embodiments, Ring A is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl; Ring B is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl.
[00147] In some embodiments, Ring A is phenyl or pyridinyl; Ring B is phenyl or pyridinyl.
[00148] In some embodiments, the compound of Formula (I) has the following structure of Formula (II):
Figure imgf000029_0001
Formula (II)
wherein,
X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
[00149] In some embodiments, the compound of Formula (I) has the following structure of Formula (III):
Figure imgf000029_0002
Formula (III) wherein,
X is CH or ;
or is a pharmaceutically acceptable salt, or solvate thereof.
[00150] In some embodiments, the compound of Formula (I) has the following structure of Formula (IV):
Figure imgf000030_0001
Formula (IV)
wherein,
X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
[00151] In some embodiments, the compound of Formula (I) has the following structure of Formula Formula (V):
Figure imgf000030_0002
Formula (V)
wherein,
X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
[00152] In some embodiments, the compound of Formula (I) has the following structure of Formula (VI):
Figure imgf000031_0001
Formula (VI)
wherein,
X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
[00153] In some embodiments, the compound of Formula (I) has the following structure of Formula Formula (VII):
Figure imgf000031_0002
Formula (VII)
wherein,
X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
[00154] In some embodiments, X is CH. In some embodiments, X is N.
[00155] In some embodiments, Y is H, -CH3, CF3, F, CI, Br, or CN; R1 is H, F, CI, -CN, -CH3, - CF3, or -CD3.
[00156] In some embodiments, Y is H, -CH3, CF3, F, CI, Br, or CN. In some embodiments, Y is H, or CN. In some embodiments, Y is CN.
[00157] In some embodiments, L1 is absent, Ci-C6alkylene, C3-C6cycloalkylene, or (Ci- C6alkylene)p-C3-C6cycloalkylene-(Ci-C6alkylene)q. In some embodiments, L1 is absent, Ci- C6alkylene, or C3-C6cycloalkylene. In some embodiments, L1 is absent, -CH2-, -CH2CH2-, - CH2CH2CH2-, -CH(CH3) -, -CH(CH2CH3)-, -C(CH3)2-, -C(CH2CH3)2-, cyclopropyl-l,l-diyl, cyclobutyl-l, l-diyl, cyclopentyl-l, l-diyl or cyclohexyl-l,l-diyl. In some embodiments, L1 is absent, -CH2-, -CH(CH3) -, -C(CH3)2-, or cyclopropyl-l,l-diyl. In some embodiments, L1 is absent or -CH2-. In some embodiments, L1 is absent.
[00158] In some embodiments, L1 is absent, -CH2-, -CH2CH2-, -CH2CH2CH2-, -CH(CH3) -, - CH(CH2CH3)-, -C(CH3)2-, -C(CH2CH3)2-, cyclopropyl-l,l-diyl, cyclobutyl-l,l-diyl, cyclopentyl- 1, 1-diyl or cyclohexyl-l, l-diyl; Q is -C02H, -C02(Ci-C6alkyl), -C(=0)NHS02R9 or tetrazolyl.
[00159] In some embodiments, each RA is independently selected from the group consisting of H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci-Cefluoroalkyl; each RB is independently selected from the group consisting of H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci- C6fluoroalkyl.
[00160] In some embodiments, each RA is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH3, -CF3, -OCH3, -OCH2CH3, -OCF3, or -OCH2CF3; each RB is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -CH3, -CF3, -OCH3, -OCH2CH3, -OCF3, or -OCH2CF3.
[00161] In some embodiments, R2 is H, halogen, -CN, -OH, d-C4alkyl, Ci-C4fluoroalkyl, C C4deuteroalkyl, Ci-C4alkoxy, or Ci-C4fiuoroalkoxy.
[00162] In some embodiments, R2 is H, F, CI, Br, I, -CN, -OH, -CH3, -CF3, -CD3, -OCH3, -
OCH2CH3, -OCF3, or -OCH2CF3.
[00163] In some embodiments, R2 is H or CI.
[00164] In some embodiments, R3 is H, halogen, -CN, -OH, Ci-C4alkyl, Ci-C4fluoroalkyl, Ci- C4deuteroalkyl, Ci-C4alkoxy, or Ci-C4fluoroalkoxy.
[00165] In some embodiments, R3 is H, F, CI, Br, I, -CN, -OH, -CH3, -CF3, -CD3, -OCH3, -
OCH2CH3, -OCF3, or -OCH2CF3.
[00166] In some embodiments, R3 is H, F, or CI.
[00167] In some embodiments, L1 is absent, -CH2-, -CH2CH2-, or -CH2CH2CH2-; Q is -C02H, or -C02(Ci-C6alkyl).
[00168] In some embodiments, R1 is H, halogen, -CN, -C(=0)H, Ci-C4alkyl, Ci-C4fluoroalkyl, or Ci-C4deuteroalkyl. In other embodiments, R1 is H, halogen, -CN, -C(=0)H, Ci-C4alkyl, or Ci-C4fluoroalkyl. In yet other embodiments, R1 is H, halogen, -CN, -C(=0)H, or Ci-C4alkyl. In yet other embodiments, R1 is H, or Ci-C4alkyl. In some embodiments, R1 is H, F, CI, -CN, - C(=0)H, -CH3, -CF3, or -CD3. In some embodiments, R1 is H, F, CI, -CN, -CH3, -CF3, or -CD3. In some embodiments, R1 is H or -CH3. In some embodiments, R1 is H. In some embodiments, R1 is -CH3.
[00169] In some embodiments, each RB is independently selected from the group consisting of H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci-C6fluoroalkyl. In some embodiments, each RB is independently selected from the group consisting of H, F, CI, -CN, -OH, -OCH3, -OCH2CH3, - OCH2CH2CH3, -CH3, -CH2CH3, -CF3, and -CH2CF3. In some embodiments, each RB is independently selected from the group consisting of H, F, CI, -OCH3, -CH3, and -CF3. In some embodiments, each RB is independently selected from the group consisting of H, F, and CI. In some embodiments, n is 0 or 1. In some embodiments, n is 1.
[00170] In some embodiments, Ring B is phenyl, or pyridinyl; each RB is independently selected from the group consisting of H, halogen, -CN, -OH, -OR9, Ci-C6alkyl, and Ci-C6fluoroalkyl; n is 0 or 1. In some embodiments, Ring B is phenyl, or pyridinyl; each RB is independently selected from the group consisting of H, F, CI, -OCH3, -CH3, and -CF3; n is 0 or 1.
[00171] In In
Figure imgf000033_0001
some embo I .S 2-methoxypyridin-5 -yl .
[00172] In some embodiments, L1 is absent, -CH2-, -CH2CH2-, or -CH2CH2CH2-; and Q is - C02H, or -C02(Ci-C6alkyl). In some embodiments, L1 is absent, or -CH2-; and Q is -C02H.
[00173] Any combination of the groups described above for the various variables is
contemplated herein. Throughout the specification, groups and substituents thereof are chosen by one skilled in the field to provide stable moieties and compounds.
[00174] Exemplary compounds of Formula (I) include the compounds described in the following Tables:
Table 1
Figure imgf000033_0002
Figure imgf000033_0003
Compound L2 R1 R2 R3 number (RB)n-Q
1-2 -CH2- 4-fluorophenyl H H 4-Cl
1-3 -CH2- 4-fluorophenyl H H 5-Cl
1-4 -CH2- 4-fluorophenyl H CI H
1-5 -CH2- 4-fluorophenyl H H 7-Cl
1-6 -CH2- 4-fluorophenyl H H 5-F
1-7 -CH2- 4-fluorophenyl H F H
1-8 -CH2- 4-fluorophenyl H Br H
1-9 -CH2- 4-fluorophenyl H -CF3 H
1-10 -CH2- 4-fluorophenyl H MeO- H
1-11 -CH2- 4-fluorophenyl H F 4-F
1-12 - 1 -propyl - 1 H-pyrazol -4-y 1 H CI H
1-13 -CH2- phenyl H CI H
1-14 -CH2- pyridin-4-yl H CI H
1-15 -CH2- 2-trifluoromethylthiazol-5-yl H CI H
1-16 -CH2- 2-chloropyridin-5-yll H CI H
1-17 -CH2- 2-ethoxylthiazol-5-yl H CI H
1-18 -CH2- 3 -propyl- 1 ,2,4-oxadiazol-5-yl H CI H
1-19 -CH2- 3 , 5 -di chl orophenyl H CI H
1-20 -CH2- 3 , 5 -ditrifluoromethylphenyl H CI H
1-21 -CH2- 4-trifluoromethylphenyl H CI H
1-22 -CH2CH2- 4-fluorophenyl H CI H
1-23 4-fluorophenyl H CI H
CH2CH2CH2-
1-24 phenyl H CI H
CH2CH2CH2-
1-25 - 1 -methyl- 1 H-pyrazol -4-yl H CI H
1-26 -CH2- 2-methoxypyridin-5-yl H CI H
1-27 -CH2- 2-trifluoromethyl pyridin-5-yl H CI H
1-28 -CH2- 2-fluorophenyl -CH3 H H
1-29 -CH2- 2-methoxypyridin-5-yl H MeO- H
1-30 -CH2- 2-methoxypyridin-5-yl H MeS02- H Compound L2 R1 R2 R3 number (RB)n-Q
1-31 -CH2- 2-methoxypyridin-5-yl H MeS- H
1-32 -CH2- 2-methoxypyridin-5-yl H MeS(=0)- H
1-33 -CH2- 2-methoxypyridin-5-yl H F5S- H
1-34 -CH2- 2-methoxypyridin-5-yl H EtO- H
1-35 -CH2- 2-methoxypyridin-5-yl H H2S02- H
1-36 -CH2- 2-methoxypyridin-5-yl H Ph H
1-36 -CH2- 2-methoxypyridin-5-yl H PhO- H
1-37 -CH2- 2-methoxypyridin-5-yl H BnO- H
1-38 -CH2- 2-methoxypyridin-5-yl H -CF3 H
1-39 -CH2- 2-methoxypyridin-5-yl H CF30- H
1-40 -CH2- 2-methoxypyridin-5-yl H -N02 H
1-41 -CH2- 2-methoxypyridin-5-yl H -NH? H
1-42 -CH2- 2-methoxypyridin-5-yl H Ac H- H
1-43 -CH2- 2-methoxypyridin-5-yl H HC≡C- H
1-44 -CH2- 2-methoxypyridin-5-yl H CN H
1-45 -CH2- 4-trifluoromethoxyphenyl H CI H
1-46 -CH2- 2-trifluoromethyl-4- H CI H fluorophenyl
1-47 -CH2- 2-fluoro-4- H CI H difluoromethoxyphenyl
1-48 -CH2- 2-(2,2,2- H CI H trifluoroethyoxy)pyridin-5-yl
1-49 -CH2- 4-fluorophenyl H CI 7-F
1-50 -CH2- 2-methoxypyridin-5-yl H CI 7-F
1-51 -CH2- phenyl H CI 7-F
1-52 -CH2- pyridin-4-yl H CI 7-F
1-52 -CH2- 2-trifluoromethyl thiazol-5-yl H CI 7-F
1-54 -CH2- 2-chloropyridin-5-yl H CI 7-F
1-55 -CH2- 2-ethoxylthiazol-5-yl H CI 7-F
1-56 -CH2- 2-ethoxypyridin-5-yl H CI 7-F
1-57 -CH2- 4-fluorophenyl H MeO- 7-F Compound L2 R1 R2 R3 number (RB)n-Q
1-58 -CH2- 2-methoxypyridin-5-yl H MeO- 7-F
1-59 -CH2- phenyl H MeO- 7-F
1-60 -CH2- pyridin-4-yl H MeO- 7-F
1-61 -CH2- 2-trifluoromethyl thiazol-5-yl H MeO- 7-F
1-62 -CH2- 2-chloropyridin-5-yl H MeO- 7-F
1-63 -CH2- 2-ethoxylthiazol-5-yl H MeO- 7-F
1-64 -CH2- 2-ethoxypyridin-5-yl H MeO- 7-F
1-65 -CH2- 4-fluorophenyl H EtO- H
1-66 -CH2- 4-fluorophenyl H -N02 H
1-67 -CH2- 4-fluorophenyl H MeS02- H
1-68 -CH2- 4-fluorophenyl H F5S- H
1-69 -CH2- 4-fluorophenyl H Ac H- H
1-70 -CH2- 4-fluorophenyl H Ph H- H
1-71 -CH2- 2-methoxypyridin-5-yl F Cl H
1-72 -CH2- 2-methoxypyridin-5-yl CI CI H
1-73 -CH2- 2-methoxypyridin-5-yl -CN CI H
1-74 -CH2- 2-methoxypyridin-5-yl -CHO CI H
1-75 -CH2- 4-fluorophenyl H OCF3 H
1-76 -CH2- 2-methoxypyridin-5-yl H OCF3 H
1-77 -CH2- 2-trifluoromethyl thiazol-5-yl H OCF3 H
Table 2
Figure imgf000037_0001
Figure imgf000037_0002
Figure imgf000038_0001
Table 3
Figure imgf000039_0001
Figure imgf000039_0002
Figure imgf000040_0001
- - uorop eny e2 -
Table 4
Figure imgf000040_0002
Figure imgf000040_0003
Figure imgf000041_0001
Table 5
Figure imgf000042_0001
Figure imgf000042_0002
Table 6
Figure imgf000043_0001
Figure imgf000043_0002
Table 7
Figure imgf000044_0001
Figure imgf000044_0002
Table 8
Figure imgf000045_0002
[00175] cribed in
Table 1, 3
Figure imgf000045_0001
, 5, 6, 7, or 8 is replaced with a group as defined in Table 2 or Table
[00176] In one aspect, compounds described herein are in the form of pharmaceutically acceptable salts. As well, active metabolites of these compounds having the same type of activity are included in the scope of the present disclosure. In addition, the compounds described herein can exist in unsolvated as well as solvated forms with pharmaceutically acceptable solvents such as water, ethanol, and the like. The solvated forms of the compounds presented herein are also considered to be disclosed herein.
[00177] "Pharmaceutically acceptable," as used herein, refers a material, such as a carrier or diluent, which does not abrogate the biological activity or properties of the compound, and is relatively nontoxic, i.e., the material is administered to an individual without causing undesirable biological effects or interacting in a deleterious manner with any of the components of the composition in which it is contained.
[00178] The term "pharmaceutically acceptable salt" refers to a form of a therapeutically active agent that consists of a cationic form of the therapeutically active agent in combination with a suitable anion, or in alternative embodiments, an anionic form of the therapeutically active agent in combination with a suitable cation. Handbook of Pharmaceutical Salts: Properties, Selection and Use. International Union of Pure and Applied Chemistry, Wiley-VCH 2002. S.M. Berge, L.D. Bighley, D.C. Monkhouse, J. Pharm. Sci. 1977, 66, 1-19. P. H. Stahl and C. G. Wermuth, editors, Handbook of Pharmaceutical Salts: Properties, Selection and Use,
Weinheim/Zurich:Wiley-VCH/VHCA, 2002. Pharmaceutical salts typically are more soluble and more rapidly soluble in stomach and intestinal juices than non-ionic species and so are useful in solid dosage forms. Furthermore, because their solubility often is a function of pH, selective dissolution in one or another part of the digestive tract is possible and this capability can be manipulated as one aspect of delayed and sustained release behaviours. Also, because the salt- forming molecule can be in equilibrium with a neutral form, passage through biological membranes can be adjusted.
[00179] In some embodiments, pharmaceutically acceptable salts are obtained by reacting a compound of Formula (I) with an acid. In some embodiments, the compound of Formula (I) (i.e. free base form) is basic and is reacted with an organic acid or an inorganic acid. Inorganic acids include, but are not limited to, hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid, and metaphosphoric acid. Organic acids include, but are not limited to, 1- hydroxy-2-naphthoic acid; 2,2-dichloroacetic acid; 2-hydroxyethanesulfonic acid; 2-oxoglutaric acid; 4-acetamidobenzoic acid; 4-aminosalicylic acid; acetic acid; adipic acid; ascorbic acid (L); aspartic acid (L); benzenesulfonic acid; benzoic acid; camphoric acid (+); camphor- 10-sulfonic acid (+); capric acid (decanoic acid); caproic acid (hexanoic acid); caprylic acid (octanoic acid); carbonic acid; cinnamic acid; citric acid; cyclamic acid; dodecylsulfuric acid; ethane-1,2- disulfonic acid; ethanesulfonic acid; formic acid; fumaric acid; galactaric acid; gentisic acid; glucoheptonic acid (D); gluconic acid (D); glucuronic acid (D); glutamic acid; glutaric acid; glycerophosphoric acid; glycolic acid; hippuric acid; isobutyric acid; lactic acid (DL); lactobionic acid; lauric acid; maleic acid; malic acid (- L); malonic acid; mandelic acid (DL);
methanesulfonic acid; naphthalene- 1,5-disulfonic acid; naphthalene-2-sulfonic acid; nicotinic acid; oleic acid; oxalic acid; palmitic acid; pamoic acid; phosphoric acid; proprionic acid;
pyroglutamic acid (- L); salicylic acid; sebacic acid; stearic acid; succinic acid; sulfuric acid; tartaric acid (+ L); thiocyanic acid; toluenesulfonic acid (p) and undecylenic acid.
[00180] In some embodiments, a compound of Formula (I) is prepared as a chloride salt, sulfate salt, bromide salt, mesylate salt, maleate salt, citrate salt or phosphate salt. In some embodiments, a compound of Formula (I) is prepared as a hydrochloride salt.
[00181] In some embodiments, pharmaceutically acceptable salts are obtained by reacting a compound of Formula (I) with a base. In some embodiments, the compound of Formula (I) is acidic and is reacted with a base. In such situations, an acidic proton of the compound of Formula (I) is replaced by a metal ion, e.g., lithium, sodium, potassium, magnesium, calcium, or an aluminum ion. In some cases, compounds described herein coordinate with an organic base, such as, but not limited to, ethanolamine, diethanolamine, triethanolamine, tromethamine, meglumine, N-methylglucamine, dicyclohexylamine, tris(hydroxymethyl)methylamine. In other cases, compounds described herein form salts with amino acids such as, but not limited to, arginine, lysine, and the like. Acceptable inorganic bases used to form salts with compounds that include an acidic proton, include, but are not limited to, aluminum hydroxide, calcium hydroxide, potassium hydroxide, sodium carbonate, potassium carbonate, sodium hydroxide, lithium hydroxide, and the like. In some embodiments, the compounds provided herein are prepared as a sodium salt, calcium salt, potassium salt, magnesium salt, meglumine salt, N-methylglucamine salt or ammonium salt. In some embodiments, the compounds provided herein are prepared as a sodium salt.
[00182] It should be understood that a reference to a pharmaceutically acceptable salt includes the solvent addition forms. In some embodiments, solvates contain either stoichiometric or non- stoichiometric amounts of a solvent, and are formed during the process of crystallization with pharmaceutically acceptable solvents such as water, ethanol, and the like. Hydrates are formed when the solvent is water, or alcoholates are formed when the solvent is alcohol. Solvates of compounds described herein are conveniently prepared or formed during the processes described herein. In addition, the compounds provided herein optionally exist in unsolvated as well as solvated forms.
[00183] The methods and formulations described herein include the use of N-oxides (if appropriate), crystalline forms (also known as polymorphs), or pharmaceutically acceptable salts of compounds having the structure of Formula (I), as well as active metabolites of these compounds having the same type of activity.
[00184] In some embodiments, sites on the organic radicals (e.g. alkyl groups, aromatic rings) of compounds of Formula (I) are susceptible to various metabolic reactions. Incorporation of appropriate substituents on the organic radicals will reduce, minimize or eliminate this metabolic pathway. In specific embodiments, the appropriate substituent to decrease or eliminate the susceptibility of the aromatic ring to metabolic reactions is, by way of example only, a halogen, deuterium, an alkyl group, a haloalkyl group, or a deuteroalkyl group.
[00185] In another embodiment, the compounds described herein are labeled isotopically (e.g. with a radioisotope) or by another other means, including, but not limited to, the use of chromophores or fluorescent moieties, bioluminescent labels, or chemiluminescent labels.
[00186] Compounds described herein include isotopically-labeled compounds, which are identical to those recited in the various formulae and structures presented herein, but for the fact that one or more atoms are replaced by an atom having an atomic mass or mass number different from the atomic mass or mass number usually found in nature. Examples of isotopes that can be incorporated into the present compounds include isotopes of hydrogen, carbon, nitrogen, oxygen, sulfur, fluorine and chlorine, such as, for example, 2H, 3H, 13C, 14C, 15N, 180, 170, 35 S, 18F, 36C1. In one aspect, isotopically-labeled compounds described herein, for example those into which radioactive isotopes such as 3H and 14C are incorporated, are useful in drug and/or substrate tissue distribution assays. In one aspect, substitution with isotopes such as deuterium affords certain therapeutic advantages resulting from greater metabolic stability, such as, for example, increased in vivo half-life or reduced dosage requirements.
[00187] In some embodiments, the compounds of Formula (I) possess one or more stereocenters and each stereocenter exists independently in either the R or S configuration. The compounds presented herein include all diastereomeric, enantiomeric, atropisomers, and epimeric forms as well as the appropriate mixtures thereof. The compounds and methods provided herein include all cis, trans, syn, anti, entgegen (E), and zusammen (Z) isomers as well as the appropriate mixtures thereof.
[00188] Individual stereoisomers are obtained, if desired, by methods such as, stereoselective synthesis and/or the separation of stereoisomers by chiral chromatographic columns. In certain embodiments, compounds of Formula (I) are prepared as their individual stereoisomers by reacting a racemic mixture of the compound with an optically active resolving agent to form a pair of diastereoisomeric compounds/salts, separating the diastereomers and recovering the optically pure enantiomers. In some embodiments, resolution of enantiomers is carried out using covalent diastereomeric derivatives of the compounds described herein. In another embodiment, diastereomers are separated by separation/resolution techniques based upon differences in solubility. In other embodiments, separation of steroisomers is performed by chromatography or by the forming diastereomeric salts and separation by recrystallization, or chromatography, or any combination thereof. Jean Jacques, Andre Collet, Samuel H. Wilen, "Enantiomers,
Racemates and Resolutions", John Wiley And Sons, Inc., 1981. In some embodiments, stereoisomers are obtained by stereoselective synthesis.
[00189] In some embodiments, compounds described herein are prepared as prodrugs. A "prodrug" refers to an agent that is converted into the parent drug in vivo. Prodrugs are often useful because, in some situations, they are easier to administer than the parent drug. They are, for instance, bioavailable by oral administration whereas the parent is not. Further or
alternatively, the prodrug also has improved solubility in pharmaceutical compositions over the parent drug. In some embodiments, the design of a prodrug increases the effective water solubility. An example, without limitation, of a prodrug is a compound described herein, which is administered as an ester (the "prodrug") but then is metabolically hydrolyzed to provide the active entity. A further example of a prodrug is a short peptide (polyaminoacid) bonded to an acid group where the peptide is metabolized to reveal the active moiety. In certain embodiments, upon in vivo administration, a prodrug is chemically converted to the biologically,
pharmaceutically or therapeutically active form of the compound. In certain embodiments, a prodrug is enzymatically metabolized by one or more steps or processes to the biologically, pharmaceutically or therapeutically active form of the compound.
[00190] Prodrugs of the compounds described herein include, but are not limited to, esters, ethers, carbonates, thiocarbonates, N-acyl derivatives, N-acyloxy alkyl derivatives, quaternary derivatives of tertiary amines, N-Mannich bases, Schiff bases, amino acid conjugates, phosphate esters, and sulfonate esters. See for example Design of Prodrugs, Bundgaard, A. Ed., Elseview, 1985 and Method in Enzymology, Widder, K. et al, Ed.; Academic, 1985, vol. 42, p. 309-396; Bundgaard, H. "Design and Application of Prodrugs" in A Textbook of Drug Design and Development, Krosgaard-Larsen and H. Bundgaard, Ed., 1991, Chapter 5, p. 113-191; and Bundgaard, H., Advanced Drug Delivery Review, 1992, 8, 1-38, each of which is incorporated herein by reference. In some embodiments, a hydroxyl group in the compounds disclosed herein is used to form a prodrug, wherein the hydroxyl group is incorporated into an acyloxyalkyl ester, alkoxycarbonyloxyalkyl ester, alkyl ester, aryl ester, phosphate ester, sugar ester, ether, and the like. In some embodiments, a hydroxyl group in the compounds disclosed herein is a prodrug wherein the hydroxyl is then metabolized in vivo to provide a carboxylic acid group. In some embodiments, a carboxyl group is used to provide an ester or amide (i.e. the prodrug), which is then metabolized in vivo to provide a carboxylic acid group. In some embodiments, compounds described herein are prepared as alkyl ester prodrugs.
[00191] Prodrug forms of the herein described compounds, wherein the prodrug is metabolized in vivo to produce a compound of Formula (I) as set forth herein are included within the scope of the claims. In some cases, some of the herein-described compounds is a prodrug for another derivative or active compound.
[00192] In additional or further embodiments, the compounds described herein are metabolized upon administration to an organism in need to produce a metabolite that is then used to produce a desired effect, including a desired therapeutic effect.
[00193] A "metabolite" of a compound disclosed herein is a derivative of that compound that is formed when the compound is metabolized. The term "active metabolite" refers to a biologically active derivative of a compound that is formed when the compound is metabolized. The term "metabolized," as used herein, refers to the sum of the processes (including, but not limited to, hydrolysis reactions and reactions catalyzed by enzymes) by which a particular substance is changed by an organism. Thus, enzymes may produce specific structural alterations to a compound. For example, cytochrome P450 catalyzes a variety of oxidative and reductive reactions while uridine diphosphate glucuronyltransferases catalyze the transfer of an activated glucuronic-acid molecule to aromatic alcohols, aliphatic alcohols, carboxylic acids, amines and free sulphydryl groups. Metabolites of the compounds disclosed herein are optionally identified either by administration of compounds to a host and analysis of tissue samples from the host, or by incubation of compounds with hepatic cells in vitro and analysis of the resulting compounds.
Synthesis of Compounds
[00194] Compounds of Formula (I) described herein are synthesized using standard synthetic techniques or using methods known in the art in combination with methods described herein.
[00195] Unless otherwise indicated, conventional methods of mass spectroscopy, MR, UPLC, protein chemistry, biochemistry, recombinant DNA techniques and pharmacology are employed.
[00196] Indazoles are readily prepared by chemical synthesis using commercially available indazoles as starting materials. Compounds are prepared using standard organic chemistry techniques such as those described in, for example, March's Advanced Organic Chemistry, 6th Edition, John Wiley and Sons, Inc. Alternative reaction conditions for the synthetic
transformations described herein may be employed such as variation of solvent, reaction temperature, reaction time, as well as different chemical reagents and other reaction conditions.
[00197] Indole containing compounds of general structure 1-7 are prepared in a variety of ways. In some embodiments, indoles of general structure I 7 are prepared as outlined in Scheme I. Scheme I
Figure imgf000051_0001
[00198] In some embodiments, as shown in Scheme I, a hydrazine of general structure -l is N- alkylated using standard conditions to afford the hydrazine 1-2. Upon reaction with a ketone using the appropriate acidic conditions, a Fisher-indole condensation then affords the indole i -4 with cyclization favoring the C-3 unsubstituted indole (see Illy and Funderburk, J. Org. Chem., 1968, 33, 4283-4285). Reversing the order of reactions (Fisher-indolization to yield 1-3 then N- alkylation) provides an alternate way to synthesize 1-4. In some embodiments wherein R1 is an ester (e.g. -3 or -4, R1 = -C02Me), the ester is hydrolyzed with a suitable base to yield the acid (R1 = C02H) followed by decarboxylation from treatment with Cu power in quinolone at reflux to yield the corresponding compound where R1 = H. An example of a suitable base for hydrolysis includes but is not limited to aqueous LiOH in MeOH. In some embodiments, functionalization at C-3 of the indole J-4 is carried out to generate the 3-formyl derivative J-5 (using POCl3 in DMF) or the 3-iodo derivative 1-6 (using NIS in TUF). In some embodiments, the aldehyde of 1 -5 is converted into the alkene containing compound 1-7 using a suitable method, such as an aldol reaction or a Wittig reaction. In some embodiments, the ester is then hydrolyzed to the corresponding acid 1-7 (R'=H). In some other embodiments, alkene containing compounds such as 1-7 are prepared from the iodo compound 1-6 by a metal -catalyzed cross coupling reaction with the appropriately substituted alkene or cross-coupling with the appropriate alkyne followed by reduction to the alkene. In some embodiments, hydrazines of general structure Ί-1 (or 1-2) are reacted with the appropriate ketones to generate indoles of structure 1-7 directly by utilizing the Fisher-indole reaction.
[00199] In some embodiments, lH-indole-3-carbaldehydes are prepared as outlined in Scheme II.
Scheme II
Figure imgf000052_0001
Figure imgf000052_0002
[00200] In some embodiments, as shown in Scheme II, the Larock indole synthesis is adapted to yield indoles II-4 containing both 2-H and 3-formyl substituents. Starting with the 2-iodo aniline II- 1, a palladium-catalyzed reaction using the bis-TES-propargyl alcohol A yields the indole II- 2. Removal of the silicon protecting groups then affords II-3 and further oxidation results in the formation of II-4.
[00201] In some embodiments, indoles are prepared as outlined in Scheme III.
Scheme III
Figure imgf000052_0003
111-2
[00202] As shown in Scheme III, in some embodiments Boc-protected 2-iodoanilines (III-l) are treated with TMS -acetylene using Sonogashira cross-coupling conditions to generate the alkyne III-2 which, upon treatment with a suitable base then cyclizes to afford indoles of general structure III-3.
[00203] In some embodiments, indoles are prepared as outlined in Scheme IV using the Leimgruber-Batcho indole synthesis.
Scheme IV
Figure imgf000053_0001
In some embodiments, substituted O-nitrotoluene IV- 1 is reacted with dimethylformamide dimethyl acetal (DMFDMA) to provide the vinyl intermediate IV-2. Reductive cyclization using the appropriate reagents yields the indole of general structure IV-3. Suitable reagents for reductive cyclization include but are not limited to nickel boride and hydrazine.
[00204] In some embodiments, indoles are prepared as outlined in Scheme IV using the Bartoli indole synthesis.
Scheme V
Figure imgf000053_0002
V-1 V-2
[00205] The Bartoli indole synthesis is shown in Scheme V and requires an ortho-sub stituted nitrobenzene (V-1). In some embodiments, ttreatment of V-1 with a vinyl magnesium Grignard reagent results in an indole of general structure V-2.
[00206] In some embodiments, N-H Indoles of general structure VI- 1 are further modified as shown in Scheme VI. Scheme VI
Figure imgf000054_0001
[00207] Treatment with an appropriate base, such as NaH, followed by alkylation with an suitable electrophile (for example BrCH2CONR'R" or BrCH2CH2C02tBu) form compounds of general structure VI-2. In some embodiments, subsequent chemical modifications are made to the indole N-substituent using standard chemical transformations. In some embodiments, direct arylation or heteroarylation is achieved using Ullman-type conditions to generate VI-3.
Deprotonation of VI-1 with a suitable base by treatment with a variety of suitable electrophiles affords a series of N-functionalized compounds of general structures VI-4 to VI-7. An example of a suitable base includes but is not limited to NaH. A variety of suitable electrophiles includes but is not limited to R3S02C1; R3COCl, and R3OCOCl.
[00208] In some embodiments, indazoles are prepared as outlined in Scheme VII. Scheme VII
Figure imgf000055_0001
VIM VII-5 VII-6
[00209] In some embodiments, substituted indoles of general structure VII- 1 are treated with aqueous NaN02 under acidic conditions (pH 1-2) to afford the corresponding 3-indazole carboxaldehyde VII-2. Oxidation of VII-2 using an appropriate oxidizing agent, such as NaC102, then affords the 3-carboxylic acid VII-3. Alternatively, addition of an anion such as a Grignard reagent or an organolithium species, results in the secondary alcohol VII-4, where R is an organic radical. Reduction of the aldehyde using a suitable reducing 4 in an organic solvent, such as MeOH, affords the primary alcohol VII-4 in which R = H. An example of a suitable reducing agent includes but is not limited to NaBH. Reaction of the aldehyde with a Wittig reagent or under condensation conditions then results in unsaturated derivatives of general structure VII-5. In some embodiments, acid VII-3 is transformed into a variety of derivatives. For example, in some embodiments VII-3 is coupled with - HMe(OMe) under standard peptide coupling conditions to provide a Weinreb amide and in some embodiments, this amide is treated with an alkyl lithium or Grignard reagent to yield ketones of general structure VII-6 (R = alkyl or aryl radical. In some embodiments, VII-4 is dehydrated by reaction with mesyl chloride or tosyl chloride and then subjected to conditions for elimination of the leaving group to afford compounds such as VII-5.
[00210] An alternative synthesis of indazoles is shown in Scheme VIII.
Scheme VIII
Figure imgf000055_0002
VMM VIII-2
[00211] In some embodiments, 2-nitrobenzaldehydes of general structure VIII- 1 are treated with malonic acid and ammonium formate in EtOH followed by reductive cyclization with N2H4, Ra-Ni in aqueous NaOH to provide the indazole VIII-2. [00212] In yet another embodiment, indazoles are prepared as shown in Scheme IX.
Scheme IX
Figure imgf000056_0001
IX-1 IX-2
[00213] Scheme IX describes the synthesis of 3-aminoindazoles IX-2 by treatment of 2- fluorobenzonitriles IX-1 with N2H4 in EtOH at elevated temperature.
[00214] In some other embodiments, indazoles are prepared from 2-fluorobenzaldehydes as shown in Scheme X.
Scheme X
Figure imgf000056_0002
X-4 X-5
[00215] In some embodiments, 2-fluorobenzaldehydes (X-1) are treated with N2H4 in a suitable solvent, such as DMSO, with heat to generate the indazole X-2. Formylation using POCl3 in DMF yields the aldehyde X-4. Iodination at C-3 is achieved using I2, NaOH in DMF to yield X-3 then metal catalyzed cross-coupling reactions are used to install a variety of different R groups as in X-5. For example, acetylenes allow for R to be -C≡CH-R'; hydroboration of alkynes followed by cross-coupling allows for R to be -CH=CH-R'.
[00216] An alternative method for the synthesis of indazoles is shown in Scheme XI.
Scheme XI
Figure imgf000056_0003
[00217] Phenylketones of general structure XI- 1, upon treatment with a hydrazine H2N HR1 in a suitable solvent, such as MeOH ,with an appropriate acid catalyst, such as HO Ac, will form the hydrazone XI-2. An intramolecular C-H amination reaction then converts XI-2 into the indazole XI-3. Suitable reagents for this transformation include but are not limited to FeBr3 and 02 in toluene at elevated temperature (Zhang and Bao, J. Org. Chem., 2013 in press) or alternatively using Pb(OAc)4 in DCM followed by BF3.Et20 (Lien et al, J. Med. Chem., 2002, 45, 4947- 4949).
[00218] In some embodiments, N-H indazoles are N-substituted as described in Scheme XII.
Scheme XII
Figure imgf000057_0001
[00219] In some embodiments, indazoles of general structure XII- 1 are N-substituted by treatment with a suitable strong base (e.g.NaH) in a suitable organic solvent (such as, but not limited to, THF or DMF) followed by reaction with an electrophile (such as, but not limited to, a bromide (R^-Br)). In some embodiments, the use of Ullmann-type reaction conditions allows for the introduction of aryl/heteroaryl groups on nitrogen (XII-2, R1 = aryl or heteroaryl). In some embodiments, the resulting indazole is further reacted using standard conditions to generate indazole-containing products.
[00220] Substituted 7-azaindoles XIII-A, B, C and D; pyrimidine pyrroles XIII-E and F; thienopyrroles with the 6H-thieno[2,3-b]pyrrole XIII-G core or 4H-thieno[3,2-b]pyrrole XIII-H and pyrazolopyridines XIII-I, J, K andj^ cores are commercially available and are used as starting materials for the preparation of compounds described herein in some embodiments. Functionalization of compounds containing core structures XIII-A to L is achieved using similar chemistry as described above in some embodiments.
1 H-py
Figure imgf000058_0001
rrolo[2,3-6]pyridine 1 H- dine
Xlll-A Xlll-B Xlll-C Xlll-D
Figure imgf000058_0002
5H-pyrrolo[3,2-c/]pyrimidine 7H-pyrrolo[2,3- /]pyrimidine 6H-thieno[2,3-b]pyrrole 4H-thieno[3,2-b]pyrrole
XIM-E Xlll-F Xlll-G Xlll-H
Figure imgf000058_0003
1 H-pyrazolo[3,4-i>]pyridine 1 H-pyrazolo[3,4-c]pyridine 1 H-pyrazolo[4,3-c]pyridine 1 H-pyrazolo[4,3-b]pyridine XMM Xlll-J Xlll-K xm_|_
[00221] In some embodiments, 6H-thieno[2,3-b]pyrrole containing compounds are prepared as outlined in Scheme XIV.
Scheme XIV
Figure imgf000058_0004
XIV-4 XIV-5 I -e
[00222] In some embodiments, 6H-thieno[2,3-b]pyrrole containing compounds are prepared starting from the appropriate thiophene-3-carboxaldehyde XIV-1 (c.f Venable J. Med. Chem, 2005, 48, p8289). Condensation of XIV-1 and ethyl azidoacetate yields the thiophene XIV-2, which then undergoes a Hemetsburger reaction to generate the thienopyrrole XIV-3. In some embodiments, further substitution of the thienopyrrole ring is performed. For an example, chlorination of XIV-4 using NCS in AcOH provides XIV-5. In some embodiments, the ester XIV-5 is hydrolyzed to the acid using a suitable aqueous base (e.g. LiOH) with an appropriate organic solvent, such as MeOH, and the resulting acid is decarboxylated using, for example Cu in quinoline at reflux, to generate the 2-H derivative XIV-6.
[00223] In some embodiments, the 4H-thieno[3,2-b]pyrrole containing compounds are prepared according to Scheme XV following a similar reaction sequence. Scheme XV
Figure imgf000059_0001
[00224] In some embodiments, the double bond to which the nitrile and heteroaryl group (such as a 3-substituted indole in compound XVI-1) may be reduced using, for example, NaBH4 in an organic solvent such as THF or MeOH to afford the saturated derivative XVI-2 (Scheme XVI). An alternate method of reducing the double bond employs hydrogen gas in the presence of a catalyst such as Pd on carbon in a solvent such as acetone.
Scheme XVI
Figure imgf000059_0002
XVI-1 XVI-2
Certain Terminology
[00225] Unless otherwise stated, the following terms used in this application have the definitions given below. The use of the term "including" as well as other forms, such as
"include", "includes," and "included," is not limiting. The section headings used herein are for organizational purposes only and are not to be construed as limiting the subject matter described.
[00226] As used herein, Ci-Cx includes C1-C2, C1-C3 . . . Ci-Cx. By way of example only, a group designated as "C1-C4" indicates that there are one to four carbon atoms in the moiety, i.e. groups containing 1 carbon atom, 2 carbon atoms, 3 carbon atoms or 4 carbon atoms. Thus, by way of example only, "C1-C4 alkyl" indicates that there are one to four carbon atoms in the alkyl group, i.e., the alkyl group is selected from among methyl, ethyl, propyl, z'so-propyl, /7-butyl, /so-butyl, sec-butyl, and t-butyl.
[00227] An "alkyl" group refers to an aliphatic hydrocarbon group. The alkyl group is branched or straight chain. In some embodiments, the "alkyl" group has 1 to 10 carbon atoms, i.e. a Ci- C10alkyl. Whenever it appears herein, a numerical range such as "1 to 10" refers to each integer in the given range; e.g., " 1 to 10 carbon atoms" means that the alkyl group consist of 1 carbon atom, 2 carbon atoms, 3 carbon atoms, etc., up to and including 10 carbon atoms, although the present definition also covers the occurrence of the term "alkyl" where no numerical range is designated. In some embodiments, an alkyl is a Ci-C6alkyl. In one aspect the alkyl is methyl, ethyl, propyl, iso-propyl, n-butyl, iso-butyl, sec-butyl, or t-butyl. Typical alkyl groups include, but are in no way limited to, methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, tertiary butyl, pentyl, neopentyl, or hexyl.
[00228] An "alkyl ene" group refers refers to a divalent alkyl radical. Any of the above mentioned monovalent alkyl groups may be an alkylene by abstraction of a second hydrogen atom from the alkyl. In some embodiments, an alkelene is a Ci-C6alkylene. In other
embodiments, an alkylene is a Ci-C4alkylene. Typical alkylene groups include, but are not limited to, -CH2-, -CH(CH3)-, -C(CH3)2-, -CH2CH2-, -CH2CH(CH3)-, -CH2C(CH3)2-, - CH2CH2CH2-, -CH2CH2CH2CH2-, and the like.
[00229] "Deuteroalkyl" refers to an alkyl group where 1 or more hydrogen atoms of an alkyl are replaced with deuterium.
[00230] The term "alkenyl" refers to a type of alkyl group in which at least one carbon-carbon double bond is present. In one embodiment, an alkenyl group has the formula -C(R)=CR2, wherein R refers to the remaining portions of the alkenyl group, which may be the same or different. In some embodiments, R is H or an alkyl. Non-limiting examples of an alkenyl group include -CH=CH2, -C(CH3)=CH2, -CH=CHCH3, -C(CH3)=CHCH3, and -CH2CH=CH2.
[00231] The term "alkynyl" refers to a type of alkyl group in which at least one carbon-carbon triple bond is present. In one embodiment, an alkenyl group has the formula -C≡C-R, wherein R refers to the remaining portions of the alkynyl group. In some embodiments, R is H or an alkyl. Non-limiting examples of an alkynyl group include -C≡CH, -C≡CCH3 -C≡CCH2CH3, - CH2C≡CH.
[00232] An "alkoxy" group refers to a (alkyl)O- group, where alkyl is as defined herein.
[00233] The term "alkylamine" refers to the -N(alkyl)xHy group, where x is 0 and y is 2, or where x is 1 and y is 1, or where x is 2 and y is 0.
[00234] The term "aromatic" refers to a planar ring having a delocalized π-electron system containing 4n+2 π electrons, where n is an integer. The term "aromatic" includes both carbocyclic aryl ("aryl", e.g., phenyl) and heterocyclic aryl (or "heteroaryl" or "heteroaromatic") groups (e.g., pyridine). The term includes monocyclic or fused-ring polycyclic (i.e., rings which share adjacent pairs of carbon atoms) groups.
[00235] The term "carbocyclic" or "carbocycle" refers to a ring or ring system where the atoms forming the backbone of the ring are all carbon atoms. The term thus distinguishes carbocyclic from "heterocyclic" rings or "heterocycles" in which the ring backbone contains at least one atom which is different from carbon. In some embodiments, at least one of the two rings of a bicyclic carbocycle is aromatic. In some embodiments, both rings of a bicyclic carbocycle are aromatic. [00236] As used herein, the term "aryl" refers to an aromatic ring wherein each of the atoms forming the ring is a carbon atom. In one aspect, aryl is phenyl or a naphthyl. In some embodiments, an aryl is a phenyl. In some embodiments, an aryl is a phenyl, naphthyl, indanyl, indenyl, or tetrahyodronaphthyl. In some embodiments, an aryl is a C6-Cioaryl. Depending on the structure, an aryl group is a monoradical or a diradical (i.e., an arylene group).
[00237] The term "cycloalkyl" refers to a monocyclic or polycyclic aliphatic, non-aromatic radical, wherein each of the atoms forming the ring (i.e. skeletal atoms) is a carbon atom. In some embodiments, cycloalkyls are spirocyclic or bridged compounds. In some embodiments, cycloalkyls are optionally fused with an aromatic ring, and the point of attachment is at a carbon that is not an aromatic ring carbon atom. Cycloalkyl groups include groups having from 3 to 10 ring atoms. In some embodiments, cycloalkyl groups are selected from among cyclopropyl, cyclobutyl, cyclopentyl, cyclopentenyl, cyclohexyl, cyclohexenyl, cycloheptyl, cyclooctyl, spiro[2.2]pentyl, norbornyl and bicycle[l . l . l]pentyl. In some embodiments, a cycloalkyl is a C3- C6cycloalkyl.
[00238] The term "halo" or, alternatively, "halogen" or "halide" means fluoro, chloro, bromo or iodo. In some embodiments, halo is fluoro, chloro, or bromo.
[00239] The term "fluoroalkyl" refers to an alkyl in which one or more hydrogen atoms are replaced by a fluorine atom. In one aspect, a fluoralkyl is a Ci-C6fluoroalkyl.
[00240] The term "heteroalkyl" refers to an alkyl group in which one or more skeletal atoms of the alkyl are selected from an atom other than carbon, e.g., oxygen, nitrogen (e.g. - H-, - N(alkyl)-, sulfur, or combinations thereof. A heteroalkyl is attached to the rest of the molecule at a carbon atom of the heteroalkyl. In one aspect, a heteroalkyl is a Ci-C6heteroalkyl.
[00241] The term "heterocycle" or "heterocyclic" refers to heteroaromatic rings (also known as heteroaryls) and heterocycloalkyl rings (also known as heteroalicyclic groups) containing one to four heteroatoms in the ring(s), where each heteroatom in the ring(s) is selected from O, S and N, wherein each heterocyclic group has from 3 to 10 atoms in its ring system, and with the proviso that any ring does not contain two adjacent O or S atoms. Non-aromatic heterocyclic groups (also known as heterocycloalkyls) include rings having 3 to 10 atoms in its ring system and aromatic heterocyclic groups include rings having 5 to 10 atoms in its ring system. The heterocyclic groups include benzo-fused ring systems. Examples of non-aromatic heterocyclic groups are pyrrolidinyl, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothienyl, oxazolidinonyl, tetrahydropyranyl, dihydropyranyl, tetrahydrothiopyranyl, piperidinyl, morpholinyl,
thiomorpholinyl, thioxanyl, piperazinyl, aziridinyl, azetidinyl, oxetanyl, thietanyl,
homopiperidinyl, oxepanyl, thiepanyl, oxazepinyl, diazepinyl, thiazepinyl, 1,2,3,6- tetrahydropyridinyl, pyrrolin-2-yl, pyrrolin-3-yl, indolinyl, 2H-pyranyl, 4H-pyranyl, dioxanyl, 1.3- dioxolanyl, pyrazolinyl, dithianyl, dithiolanyl, dihydropyranyl, dihydrothienyl, dihydrofuranyl, pyrazolidinyl, imidazolinyl, imidazolidinyl, 3-azabicyclo[3.1.0]hexanyl, 3- azabicyclo[4.1.0]heptanyl, 3H-indolyl, indolin-2-onyl, isoindolin-l-onyl, isoindoline-l,3-dionyl,
3.4- dihydroisoquinolin-l (2H)-onyl, 3,4-dihydroquinolin-2(lH)-onyl, isoindoline-l,3-dithionyl, benzo[d]oxazol-2(3H)-onyl, lH-benzo[d]imidazol-2(3H)-onyl, benzo[d]thiazol-2(3H)-onyl, and quinolizinyl. Examples of aromatic heterocyclic groups are pyridinyl, imidazolyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, furyl, thienyl, isoxazolyl, thiazolyl, oxazolyl, isothiazolyl, pyrrolyl, quinolinyl, isoquinolinyl, indolyl, benzimidazolyl, benzofuranyl, cinnolinyl, indazolyl, indolizinyl, phthalazinyl, pyridazinyl, triazinyl, isoindolyl, pteridinyl, purinyl, oxadiazolyl, thiadiazolyl, furazanyl, benzofurazanyl, benzothiophenyl, benzothiazolyl, benzoxazolyl, quinazolinyl, quinoxalinyl, naphthyridinyl, and furopyridinyl. The foregoing groups are either C-attached (or C-linked) or TV-attached where such is possible. For instance, a group derived from pyrrole includes both pyrrol-l-yl (TV-attached) or pyrrol-3-yl (C-attached). Further, a group derived from imidazole includes imidazol-l-yl or imidazol-3-yl (both TV- attached) or imidazol-2-yl, imidazol-4-yl or imidazol-5-yl (all C-attached). The heterocyclic groups include benzo-fused ring systems. Non-aromatic heterocycles are optionally substituted with one or two oxo (=0) moieties, such as pyrrolidin-2-one. In some embodiments, at least one of the two rings of a bicyclic heterocycle is aromatic. In some embodiments, both rings of a bicyclic heterocycle are aromatic.
[00242] The terms "heteroaryl" or, alternatively, "heteroaromatic" refers to an aryl group that includes one or more ring heteroatoms selected from nitrogen, oxygen and sulfur. Illustrative examples of heteroaryl groups include monocyclic heteroaryls and bicyclcic heteroaryls.
Monocyclic heteroaryls include pyridinyl, imidazolyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, furyl, thienyl, isoxazolyl, thiazolyl, oxazolyl, isothiazolyl, pyrrolyl, pyridazinyl, triazinyl, oxadiazolyl, thiadiazolyl, and furazanyl. Monocyclic heteroaryls include indolizine, indole, benzofuran, benzothiophene, indazole, benzimidazole, purine, quinolizine, quinoline, isoquinoline, cinnoline, phthalazine, quinazoline, quinoxaline, 1,8-naphthyridine, and pteridine. In some embodiments, a heteroaryl contains 0-4 N atoms in the ring. In some embodiments, a heteroaryl contains 1-4 N atoms in the ring. In some embodiments, a heteroaryl contains 0-4 N atoms, 0-1 O atoms, and 0-1 S atoms in the ring. In some embodiments, a heteroaryl contains 1-4 N atoms, 0-1 O atoms, and 0-1 S atoms in the ring. In some
embodiments, heteroaryl is a Ci-C9heteroaryl. In some embodiments, monocyclic heteroaryl is a Ci-C5heteroaryl. In some embodiments, monocyclic heteroaryl is a 5-membered or 6-membered heteroaryl. In some embodiments, bicyclic heteroaryl is a C6-C9heteroaryl. [00243] A "heterocycloalkyl" or "heteroalicyclic" group refers to a cycloalkyl group that includes at least one heteroatom selected from nitrogen, oxygen and sulfur. In some
embodiments, a heterocycloalkyl is fused with an aryl or heteroaryl. In some embodiments, the heterocycloalkyl is oxazolidinonyl, pyrrolidinyl, tetrahydrofuranyl, tetrahydrothienyl,
tetrahydropyranyl, tetrahydrothiopyranyl, piperidinyl, morpholinyl, thiomorpholinyl, piperazinyl, piperidin-2-onyl, pyrrolidine-2,5-dithionyl, pyrrolidine-2,5-dionyl, pyrrolidinonyl,
imidazolidinyl, imidazolidin-2-onyl, or thiazolidin-2-onyl. The term heteroalicyclic also includes all ring forms of the carbohydrates, including but not limited to the monosaccharides, the disaccharides and the oligosaccharides. In one aspect, a heterocycloalkyl is a C2- Cioheterocycloalkyl. In another aspect, a heterocycloalkyl is a C4-Ci0heterocycloalkyl. In some embodiments, a heterocycloalkyl contains 0-2 N atoms in the ring. In some embodiments, a heterocycloalkyl contains 0-2 N atoms, 0-2 O atoms and 0-1 S atoms in the ring.
[00244] The term "bond" or "single bond" refers to a chemical bond between two atoms, or two moieties when the atoms joined by the bond are considered to be part of larger substructure. In one aspect, when a group described herein is a bond, the referenced group is absent thereby allowing a bond to be formed between the remaining identified groups.
[00245] The term "moiety" refers to a specific segment or functional group of a molecule.
Chemical moieties are often recognized chemical entities embedded in or appended to a molecule.
[00246] The term "optionally substituted" or "substituted" means that the referenced group is optionally substituted with one or more additional group(s) individually and independently selected from halogen, -CN, - H2, - H(alkyl), -N(alkyl)2, -OH, -C02H, -C02alkyl, -C(=0)NH2, -C(=0) H(alkyl), -C(=0)N(alkyl)2, -S(=0)2 H2, -S(=0)2 H(alkyl), -S(=0)2N(alkyl)2, alkyl, cycloalkyl, fluoroalkyl, heteroalkyl, alkoxy, fluoroalkoxy, heterocycloalkyl, aryl, heteroaryl, aryloxy, alkylthio, arylthio, alkylsulfoxide, arylsulfoxide, alkylsulfone, and arylsulfone. In some other embodiments, optional substituents are independently selected from halogen, -CN, -NH2, - NH(CH3), -N(CH3)2, -OH, -C02H, -C02(Ci-C4alkyl), -C(=0)NH2, -C(=0)NH(Ci-C4alkyl), - C(=0)N(Ci-C4alkyl)2, -S(=0)2NH2, -S(=0)2NH(Ci-C4alkyl), -S(=0)2N(Ci-C4alkyl)2, Ci-C4alkyl, C3-C6cycloalkyl, Ci-C4fluoroalkyl, Ci-C4heteroalkyl, Ci-C4alkoxy, Ci-C4fluoroalkoxy, -SCi- C4alkyl, -S(=0)Ci-C4alkyl, and -S(=0)2Ci-C4alkyl. In some embodiments, optional substituents are independently selected from halogen, -CN, -NH2, -OH, -NH(CH3), -N(CH3)2, -CH3, - CH2CH3, -CF3, -OCH3, and -OCF3. In some embodiments, substituted groups are substituted with one or two of the preceding groups. In some embodiments, an optional substituent on an aliphatic carbon atom (acyclic or cyclic) includes oxo (=0). [00247] The term "carboxylic acid bioisostere" refers to a functional group or moiety that exhibits similar physical, biological and/or chemical properties as a carboxylic acid moiety. Examples of carboxylic acid bioisosteres include, but are not limited to,
Figure imgf000064_0001
like.
[00248] The term "acceptable" with respect to a formulation, composition or ingredient, as used herein, means having no persistent detrimental effect on the general health of the subject being treated.
[00249] The term "modulate" as used herein, means to interact with a target either directly or indirectly so as to alter the activity of the target, including, by way of example only, to enhance the activity of the target, to inhibit the activity of the target, to limit the activity of the target, or to extend the activity of the target.
[00250] The term "modulator" as used herein, refers to a molecule that interacts with a target either directly or indirectly. The interactions include, but are not limited to, the interactions of an agonist, partial agonist, an inverse agonist, antagonist, degrader, or combinations thereof. In some embodiments, a modulator is an antagonist. In some embodiments, a modulator is a degrader.
[00251] The terms "administer," "administering", "administration," and the like, as used herein, refer to the methods that may be used to enable delivery of compounds or compositions to the desired site of biological action. These methods include, but are not limited to oral routes, intraduodenal routes, parenteral injection (including intravenous, subcutaneous, intraperitoneal, intramuscular, intravascular or infusion), topical and rectal administration. Those of skill in the art are familiar with administration techniques that can be employed with the compounds and methods described herein. In some embodiments, the compounds and compositions described herein are administered orally.
[00252] The terms "co-administration" or the like, as used herein, are meant to encompass administration of the selected therapeutic agents to a single patient, and are intended to include treatment regimens in which the agents are administered by the same or different route of administration or at the same or different time.
[00253] The terms "effective amount" or "therapeutically effective amount," as used herein, refer to a sufficient amount of an agent or a compound being administered, which will relieve to some extent one or more of the symptoms of the disease or condition being treated. The result includes reduction and/or alleviation of the signs, symptoms, or causes of a disease, or any other desired alteration of a biological system. For example, an "effective amount" for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms. An appropriate "effective" amount in any individual case is optionally determined using techniques, such as a dose escalation study.
[00254] The terms "enhance" or "enhancing," as used herein, means to increase or prolong either in potency or duration a desired effect. Thus, in regard to enhancing the effect of therapeutic agents, the term "enhancing" refers to the ability to increase or prolong, either in potency or duration, the effect of other therapeutic agents on a system. An "enhancing-effective amount," as used herein, refers to an amount adequate to enhance the effect of another therapeutic agent in a desired system.
[00255] The term "pharmaceutical combination" as used herein, means a product that results from the mixing or combining of more than one active ingredient and includes both fixed and non-fixed combinations of the active ingredients. The term "fixed combination" means that the active ingredients, e.g. a compound of Formula (I), or a pharmaceutically acceptable salt thereof, and a co-agent, are both administered to a patient simultaneously in the form of a single entity or dosage. The term "non-fixed combination" means that the active ingredients, e.g. a compound of Formula (I), or a pharmaceutically acceptable salt thereof, and a co-agent, are administered to a patient as separate entities either simultaneously, concurrently or sequentially with no specific intervening time limits, wherein such administration provides effective levels of the two compounds in the body of the patient. The latter also applies to cocktail therapy, e.g. the administration of three or more active ingredients.
[00256] The terms "kit" and "article of manufacture" are used as synonyms.
[00257] The term "subject" or "patient" encompasses mammals. Examples of mammals include, but are not limited to, any member of the Mammalian class: humans, non-human primates such as chimpanzees, and other apes and monkey species; farm animals such as cattle, horses, sheep, goats, swine; domestic animals such as rabbits, dogs, and cats; laboratory animals including rodents, such as rats, mice and guinea pigs, and the like. In one aspect, the mammal is a human.
[00258] The terms "treat," "treating" or "treatment," as used herein, include alleviating, abating or ameliorating at least one symptom of a disease or condition, preventing additional symptoms, inhibiting the disease or condition, e.g., arresting the development of the disease or condition, relieving the disease or condition, causing regression of the disease or condition, relieving a condition caused by the disease or condition, or stopping the symptoms of the disease or condition either prophylactically and/or therapeutically. Pharmaceutical compositions
[00259] In some embodiments, the compounds described herein are formulated into
pharmaceutical compositions. Pharmaceutical compositions are formulated in a conventional manner using one or more pharmaceutically acceptable inactive ingredients that facilitate processing of the active compounds into preparations that are used pharmaceutically. Proper formulation is dependent upon the route of administration chosen. A summary of pharmaceutical compositions described herein is found, for example, in Remington: The Science and Practice of Pharmacy, Nineteenth Ed (Easton, Pa. : Mack Publishing Company, 1995); Hoover, John E., Remington's Pharmaceutical Sciences, Mack Publishing Co., Easton, Pennsylvania 1975;
Liberman, H.A. and Lachman, L., Eds., Pharmaceutical Dosage Forms, Marcel Decker, New York, N.Y., 1980; and Pharmaceutical Dosage Forms and Drug Delivery Systems, Seventh Ed. (Lippincott Williams & Wilkinsl999), herein incorporated by reference for such disclosure.
[00260] In some embodiments, the compounds described herein are administered either alone or in combination with pharmaceutically acceptable carriers, excipients or diluents, in a
pharmaceutical composition. Administration of the compounds and compositions described herein can be effected by any method that enables delivery of the compounds to the site of action. These methods include, though are not limited to delivery via enteral routes (including oral, gastric or duodenal feeding tube, rectal suppository and rectal enema), parenteral routes
(injection or infusion, including intraarterial, intracardiac, intradermal, intraduodenal,
intramedullary, intramuscular, intraosseous, intraperitoneal, intrathecal, intravascular,
intravenous, intravitreal, epidural and subcutaneous), inhalational, transdermal, transmucosal, sublingual, buccal and topical (including epicutaneous, dermal, enema, eye drops, ear drops, intranasal, vaginal) administration, although the most suitable route may depend upon for example the condition and disorder of the recipient. By way of example only, compounds described herein can be administered locally to the area in need of treatment, by for example, local infusion during surgery, topical application such as creams or ointments, injection, catheter, or implant. The administration can also be by direct injection at the site of a diseased tissue or organ.
[00261] In some embodiments, pharmaceutical compositions suitable for oral administration are presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous liquid or a non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion. In some embodiments, the active ingredient is presented as a bolus, electuary or paste. [00262] Pharmaceutical compositions which can be used orally include tablets, push-fit capsules made of gelatin, as well as soft, sealed capsules made of gelatin and a plasticizer, such as glycerol or sorbitol. Tablets may be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with binders, inert diluents, or lubricating, surface active or dispersing agents. Molded tablets may be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. In some embodiments, the tablets are coated or scored and are formulated so as to provide slow or controlled release of the active ingredient therein. All formulations for oral administration should be in dosages suitable for such administration. The push-fit capsules can contain the active ingredients in admixture with filler such as lactose, binders such as starches, and/or lubricants such as talc or magnesium stearate and, optionally, stabilizers. In soft capsules, the active compounds may be dissolved or suspended in suitable liquids, such as fatty oils, liquid paraffin, or liquid polyethylene glycols. In some embodiments, stabilizers are added. Dragee cores are provided with suitable coatings. For this purpose, concentrated sugar solutions may be used, which may optionally contain gum arabic, talc, polyvinyl pyrrolidone, carbopol gel, polyethylene glycol, and/or titanium dioxide, lacquer solutions, and suitable organic solvents or solvent mixtures. Dyestuffs or pigments may be added to the tablets or Dragee coatings for identification or to characterize different combinations of active compound doses.
[00263] In some embodiments, pharmaceutical compositions are formulated for parenteral administration by injection, e.g., by bolus injection or continuous infusion. Formulations for injection may be presented in unit dosage form, e.g., in ampoules or in multi-dose containers, with an added preservative. The compositions may take such forms as suspensions, solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as suspending, stabilizing and/or dispersing agents. The compositions may be presented in unit-dose or multi- dose containers, for example sealed ampoules and vials, and may be stored in powder form or in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example, saline or sterile pyrogen-free water, immediately prior to use. Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described.
[00264] Pharmaceutical compositions for parenteral administration include aqueous and nonaqueous (oily) sterile injection solutions of the active compounds which may contain
antioxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents. Suitable lipophilic solvents or vehicles include fatty oils such as sesame oil, or synthetic fatty acid esters, such as ethyl oleate or triglycerides, or liposomes. Aqueous injection suspensions may contain substances which increase the viscosity of the suspension, such as sodium carboxymethyl cellulose, sorbitol, or dextran. Optionally, the suspension may also contain suitable stabilizers or agents which increase the solubility of the compounds to allow for the preparation of highly concentrated solutions.
[00265] Pharmaceutical compositions may also be formulated as a depot preparation. Such long acting formulations may be administered by implantation (for example subcutaneously or intramuscularly) or by intramuscular injection. Thus, for example, the compounds may be formulated with suitable polymeric or hydrophobic materials (for example, as an emulsion in an acceptable oil) or ion exchange resins, or as sparingly soluble derivatives, for example, as a sparingly soluble salt.
[00266] For buccal or sublingual administration, the compositions may take the form of tablets, lozenges, pastilles, or gels formulated in conventional manner. Such compositions may comprise the active ingredient in a flavored basis such as sucrose and acacia or tragacanth.
[00267] Pharmaceutical compositions may also be formulated in rectal compositions such as suppositories or retention enemas, e.g., containing conventional suppository bases such as cocoa butter, polyethylene glycol, or other glycerides.
[00268] Pharmaceutical compositions may be administered topically, that is by non-systemic administration. This includes the application of a compound of the present invention externally to the epidermis or the buccal cavity and the instillation of such a compound into the ear, eye and nose, such that the compound does not significantly enter the blood stream. In contrast, systemic administration refers to oral, intravenous, intraperitoneal and intramuscular administration.
[00269] Pharmaceutical compositions suitable for topical administration include liquid or semi- liquid preparations suitable for penetration through the skin to the site of inflammation such as gels, liniments, lotions, creams, ointments or pastes, and drops suitable for administration to the eye, ear or nose. The active ingredient may comprise, for topical administration, from 0.001% to 10%) w/w, for instance from 1%> to 2% by weight of the formulation.
[00270] Pharmaceutical compositions for administration by inhalation are conveniently delivered from an insufflator, nebulizer pressurized packs or other convenient means of delivering an aerosol spray. Pressurized packs may comprise a suitable propellant such as dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, carbon dioxide or other suitable gas. In the case of a pressurized aerosol, the dosage unit may be determined by providing a valve to deliver a metered amount. Alternatively, for administration by inhalation or insufflation, pharmaceutical preparations may take the form of a dry powder composition, for example a powder mix of the compound and a suitable powder base such as lactose or starch. The powder composition may be presented in unit dosage form, in for example, capsules, cartridges, gelatin or blister packs from which the powder may be administered with the aid of an inhalator or insufflator.
[00271] It should be understood that in addition to the ingredients particularly mentioned above, the compounds and compositions described herein may include other agents conventional in the art having regard to the type of formulation in question, for example those suitable for oral administration may include flavoring agents.
Methods of Dosing and Treatment Regimens
[00272] In one embodiment, the compounds of Formula (I), or a pharmaceutically acceptable salt thereof, are used in the preparation of medicaments for the treatment of diseases or conditions in a mammal that would benefit from inhibition or reduction of autotaxin activity. Methods for treating any of the diseases or conditions described herein in a mammal in need of such treatment, involves administration of pharmaceutical compositions that include at least one compound of Formula (I) or a pharmaceutically acceptable salt, active metabolite, prodrug, or pharmaceutically acceptable solvate thereof, in therapeutically effective amounts to said mammal.
[00273] In certain embodiments, the compositions containing the compound(s) described herein are administered for prophylactic and/or therapeutic treatments. In certain therapeutic
applications, the compositions are administered to a patient already suffering from a disease or condition, in an amount sufficient to cure or at least partially arrest at least one of the symptoms of the disease or condition. Amounts effective for this use depend on the severity and course of the disease or condition, previous therapy, the patient's health status, weight, and response to the drugs, and the judgment of the treating physician. Therapeutically effective amounts are optionally determined by methods including, but not limited to, a dose escalation and/or dose ranging clinical trial.
[00274] In prophylactic applications, compositions containing the compounds described herein are administered to a patient susceptible to or otherwise at risk of a particular disease, disorder or condition. Such an amount is defined to be a "prophylactically effective amount or dose." In this use, the precise amounts also depend on the patient's state of health, weight, and the like. When used in patients, effective amounts for this use will depend on the severity and course of the disease, disorder or condition, previous therapy, the patient's health status and response to the drugs, and the judgment of the treating physician. In one aspect, prophylactic treatments include administering to a mammal, who previously experienced at least one symptom of the disease being treated and is currently in remission, a pharmaceutical composition comprising a compound of Formula (I), or a pharmaceutically acceptable salt thereof, in order to prevent a return of the symptoms of the disease or condition.
[00275] In certain embodiments wherein the patient's condition does not improve, upon the doctor's discretion the administration of the compounds are administered chronically, that is, for an extended period of time, including throughout the duration of the patient's life in order to ameliorate or otherwise control or limit the symptoms of the patient's disease or condition.
[00276] In certain embodiments wherein a patient's status does improve, the dose of drug being administered is temporarily reduced or temporarily suspended for a certain length of time (i.e., a "drug holiday"). In specific embodiments, the length of the drug holiday is between 2 days and 1 year, including by way of example only, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 10 days, 12 days, 15 days, 20 days, 28 days, or more than 28 days. The dose reduction during a drug holiday is, by way of example only, by 10%-100%, including by way of example only 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, and 100%.
[00277] Once improvement of the patient's conditions has occurred, a maintenance dose is administered if necessary. Subsequently, in specific embodiments, the dosage or the frequency of administration, or both, is reduced, as a function of the symptoms, to a level at which the improved disease, disorder or condition is retained. In certain embodiments, however, the patient requires intermittent treatment on a long-term basis upon any recurrence of symptoms.
[00278] The amount of a given agent that corresponds to such an amount varies depending upon factors such as the particular compound, disease condition and its severity, the identity (e.g., weight, sex) of the subject or host in need of treatment, but nevertheless is determined according to the particular circumstances surrounding the case, including, e.g., the specific agent being administered, the route of administration, the condition being treated, and the subject or host being treated.
[00279] In general, however, doses employed for adult human treatment are typically in the range of 0.01 mg-5000 mg per day. In one aspect, doses employed for adult human treatment are from about 1 mg to about 1000 mg per day. In one embodiment, the desired dose is conveniently presented in a single dose or in divided doses administered simultaneously or at appropriate intervals, for example as two, three, four or more sub-doses per day.
[00280] In one embodiment, the daily dosages appropriate for the compound of Formula (I), or a pharmaceutically acceptable salt thereof, described herein are from about 0.01 to about 50 mg/kg per body weight. In some embodiments, the daily dosage or the amount of active in the dosage form are lower or higher than the ranges indicated herein, based on a number of variables in regard to an individual treatment regime. In various embodiments, the daily and unit dosages are altered depending on a number of variables including, but not limited to, the activity of the compound used, the disease or condition to be treated, the mode of administration, the requirements of the individual subject, the severity of the disease or condition being treated, and the judgment of the practitioner.
[00281] Toxicity and therapeutic efficacy of such therapeutic regimens are determined by standard pharmaceutical procedures in cell cultures or experimental animals, including, but not limited to, the determination of the LD50 and the ED50. The dose ratio between the toxic and therapeutic effects is the therapeutic index and it is expressed as the ratio between LD50 and ED50. In certain embodiments, the data obtained from cell culture assays and animal studies are used in formulating the therapeutically effective daily dosage range and/or the therapeutically effective unit dosage amount for use in mammals, including humans. In some embodiments, the daily dosage amount of the compounds described herein lies within a range of circulating concentrations that include the ED50 with minimal toxicity. In certain embodiments, the daily dosage range and/or the unit dosage amount varies within this range depending upon the dosage form employed and the route of administration utilized.
[00282] In any of the aforementioned aspects are further embodiments in which the effective amount of the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is: (a) systemically administered to the mammal; and/or (b) administered orally to the mammal; and/or (c) intravenously administered to the mammal; and/or (d) administered by injection to the mammal; and/or (e) administered topically to the mammal; and/or (f) administered non- systemically or locally to the mammal.
[00283] In any of the aforementioned aspects are further embodiments comprising single administrations of the effective amount of the compound, including further embodiments in which (i) the compound is administered once a day; or (ii) the compound is administered to the mammal multiple times over the span of one day.
[00284] In any of the aforementioned aspects are further embodiments comprising multiple administrations of the effective amount of the compound, including further embodiments in which (i) the compound is administered continuously or intermittently: as in a single dose; (ii) the time between multiple administrations is every 6 hours; (iii) the compound is administered to the mammal every 8 hours; (iv) the compound is administered to the mammal every 12 hours; (v) the compound is administered to the mammal every 24 hours. In further or alternative
embodiments, the method comprises a drug holiday, wherein the administration of the compound is temporarily suspended or the dose of the compound being administered is temporarily reduced; at the end of the drug holiday, dosing of the compound is resumed. In one embodiment, the length of the drug holiday varies from 2 days to 1 year. Combination Treatments
[00285] In certain instances, it is appropriate to administer at least one compound of Formula (I), or a pharmaceutically acceptable salt thereof, in combination with one or more other therapeutic agents. In certain embodiments, the pharmaceutical composition further comprises one or more anti-cancer agents.
[00286] In one embodiment, the therapeutic effectiveness of one of the compounds described herein is enhanced by administration of an adjuvant (i.e., by itself the adjuvant has minimal therapeutic benefit, but in combination with another therapeutic agent, the overall therapeutic benefit to the patient is enhanced). Or, in some embodiments, the benefit experienced by a patient is increased by administering one of the compounds described herein with another agent (which also includes a therapeutic regimen) that also has therapeutic benefit.
[00287] In one specific embodiment, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is co-administered with a second therapeutic agent, wherein the compound of Formula (I), or a pharmaceutically acceptable salt thereof, and the second therapeutic agent modulate different aspects of the disease, disorder or condition being treated, thereby providing a greater overall benefit than administration of either therapeutic agent alone.
[00288] In any case, regardless of the disease, disorder or condition being treated, the overall benefit experienced by the patient is simply be additive of the two therapeutic agents or the patient experiences a synergistic benefit.
[00289] In certain embodiments, different therapeutically-effective dosages of the compounds disclosed herein will be utilized in formulating pharmaceutical composition and/or in treatment regimens when the compounds disclosed herein are administered in combination with one or more additional agent, such as an additional therapeutically effective drug, an adjuvant or the like. Therapeutically-effective dosages of drugs and other agents for use in combination treatment regimens is optionally determined by means similar to those set forth hereinabove for the actives themselves. Furthermore, the methods of prevention/treatment described herein encompasses the use of metronomic dosing, i.e., providing more frequent, lower doses in order to minimize toxic side effects. In some embodiments, a combination treatment regimen
encompasses treatment regimens in which administration of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is initiated prior to, during, or after treatment with a second agent described herein, and continues until any time during treatment with the second agent or after termination of treatment with the second agent. It also includes treatments in which a compound of Formula (I), or a pharmaceutically acceptable salt thereof, and the second agent being used in combination are administered simultaneously or at different times and/or at decreasing or increasing intervals during the treatment period. Combination treatment further includes periodic treatments that start and stop at various times to assist with the clinical management of the patient.
[00290] It is understood that the dosage regimen to treat, prevent, or ameliorate the condition(s) for which relief is sought, is modified in accordance with a variety of factors (e.g. the disease, disorder or condition from which the subject suffers; the age, weight, sex, diet, and medical condition of the subject). Thus, in some instances, the dosage regimen actually employed varies and, in some embodiments, deviates from the dosage regimens set forth herein.
[00291] For combination therapies described herein, dosages of the co-administered compounds vary depending on the type of co-drug employed, on the specific drug employed, on the disease or condition being treated and so forth. In additional embodiments, when co-administered with one or more other therapeutic agents, the compound provided herein is administered either simultaneously with the one or more other therapeutic agents, or sequentially.
[00292] In combination therapies, the multiple therapeutic agents (one of which is one of the compounds described herein) are administered in any order or even simultaneously. If administration is simultaneous, the multiple therapeutic agents are, by way of example only, provided in a single, unified form, or in multiple forms (e.g., as a single pill or as two separate pills).
[00293] The compounds of Formula (I), or a pharmaceutically acceptable salt thereof, as well as combination therapies, are administered before, during or after the occurrence of a disease or condition, and the timing of administering the composition containing a compound varies. Thus, in one embodiment, the compounds described herein are used as a prophylactic and are administered continuously to subjects with a propensity to develop conditions or diseases in order to prevent the occurrence of the disease or condition. In another embodiment, the compounds and compositions are administered to a subject during or as soon as possible after the onset of the symptoms. In specific embodiments, a compound described herein is administered as soon as is practicable after the onset of a disease or condition is detected or suspected, and for a length of time necessary for the treatment of the disease. In some embodiments, the length required for treatment varies, and the treatment length is adjusted to suit the specific needs of each subject. For example, in specific embodiments, a compound described herein or a formulation containing the compound is administered for at least 2 weeks, about 1 month to about 5 years.
Exemplary Agent for use in Combination Therapy
[00294] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, in combination with chemotherapy, hormone blocking therapy, radiation therapy, monoclonal antibodies, or combinations thereof. [00295] Hormone blocking therapy includes the use of agents that block the production of estrogens or block the estrogen receptors. In some embodiments, hormone blocking therapy includes the use of estrogen receptor modulators and/ aromatase inhibitors. Estrogen receptor modulators include triphenyl ethylene derivatives (e.g. tamoxifen, toremifene, droloxifene, 3- hydroxytamoxifen, idoxifene, TAT-59 (a phosphorylated derivative of 4- hydroxytamoxifen) and GW5638 (a carboxylic acid derivative of tamoxifen)); non-steroidal estrogen receptor modulators (e.g. raloxifene, LY353381 (SERM3) and LY357489); steroidal estrogen receptor modulators (e.g. ICI-182,780). Aromatase inhibitors include steroidal aromatase inhibitors and non-steroidal aromatase inhibitors. Steroidal aromatase inhibitors include, but are not limited to, such exemestane. Non-steroidal aromatase inhibitors include, but are not limited to, as anastrozole, and letrozole.
[00296] Chemotherapy includes the use of anti-cancer agents.
[00297] In some embodiments, anti-cancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include one or more of the following: abiraterone; abarelix; abraxane, adriamycin; actinomycin; acivicin; aclarubicin; acodazole hydrochloride; acronine; adozelesin; aldesleukin; alemtuzumab; allopurinol; alitretinoin;
altretamine; ametantrone acetate; aminoglutethimide; aminolevulinic acid; amifostine;
amsacrine; anastrozole; anthramycin; aprepitant; arsenic trioxide; asparaginase; asperlin;
azacitidine; azetepa; azotomycin; batimastat; bendamustine hydrochloride; benzodepa;
bevacizumab; bexarotene; bicalutamide; bisantrene hydrochloride; bisnafide dimesylate;
bizelesin; bleomycin; bleomycin sulfate; bortezomib; brequinar sodium; bropirimine; busulfan; cactinomycin; calusterone; caracemide; carbetimer; carboplatin; carmustine; carubicin hydrochloride; carzelesin; capecitabine; cedefingol; cetuximab; chlorambucil; cirolemycin;
cisplatin; cladribine; clofarabine; crisnatol mesylate; cyclophosphamide; cytarabine; dacarbazine; dasatinib; daunorubicin hydrochloride; dactinomycin; darbepoetin alfa; decitabine; degarelix; denileukin diftitox; dexormaplatin; dexrazoxane hydrochloride; dezaguanine; dezaguanine mesylate; diaziquone; docetaxel; doxorubicin; doxorubicin hydrochloride; droloxifene;
droloxifene citrate; dromostanolone propionate; duazomycin; edatrexate; eflornithine
hydrochloride; elsamitrucin; eltrombopag olamine; enloplatin; enpromate; epipropidine;
epirubicin hydrochloride; epoetin alfa; erbulozole; erlotinib hydrochloride; esorubicin
hydrochloride; estramustine; estramustine phosphate sodium; etanidazole; etoposide; etoposide phosphate; etoprine; everolimus; exemestane; fadrozole hydrochloride; fazarabine; fenretinide; filgrastim; floxuridine; fludarabine phosphate; fiuorouracil; flurocitabine; fosquidone; fostriecin sodium; fulvestrant; gefitinib; gemcitabine; gemcitabine hydrochloride; gemcitabine -cisplatin; gemtuzumab ozogamicin; goserelin acetate; histrelin acetate; hydroxyurea; idarubicin hydrochloride; ifosfamide; iimofosine; ibritumomab tiuxetan; idarubicin; ifosfamide; imatinib mesylate; imiquimod; interleukin II (including recombinant interleukin II, or rlL2), interferon alfa-2a; interferon alfa-2b; interferon alfa-nl; interferon alfa-n3; interferon beta-1 a; interferon gamma-1 b; iproplatin; irinotecan hydrochloride; ixabepilone; lanreotide acetate; lapatinib;
lenalidomide; letrozole; leuprolide acetate; leucovorin calcium; leuprolide acetate; levamisole; liposomal cytarabine; liarozole hydrochloride; lometrexol sodium; lomustine; losoxantrone hydrochloride; masoprocol; maytansine; mechlorethamine hydrochloride; megestrol acetate; melengestrol acetate; melphalan; menogaril; mercaptopurine; methotrexate; methotrexate sodium; methoxsalen; metoprine; meturedepa; mitindomide; mitocarcin; mitocromin; mitogillin; mitomalcin; mitomycin C; mitosper; mitotane; mitoxantrone hydrochloride; mycophenolic acid; nandrolone phenpropionate; nelarabine; nilotinib; nocodazoie; nofetumomab; nogalamycin; ofatumumab; oprelvekin; ormaplatin; oxaliplatin;oxisuran; paclitaxel; palifermin; palonosetron hydrochloride; pamidronate; pegfilgrastim; pemetrexed disodium; pentostatin; panitumumab; pazopanib hydrochloride; pemetrexed disodium; plerixafor; pralatrexate; pegaspargase;
peliomycin; pentamustine; peplomycin sulfate; perfosfamide; pipobroman; piposulfan;
piroxantrone hydrochloride; plicamycin; plomestane; pomalidomide, porfimer sodium;
porfiromycin; prednimustine; procarbazine hydrochloride; puromycin; puromycin hydrochloride; pyrazofurin; quinacrine; raloxifene hydrochloride; rasburicase; recombinant HPV bivalent vaccine; recombinant HPV quadrivalent vaccine; riboprine; rogletimide; rituximab; romidepsin; romiplostim; safingol; safingol hydrochloride; sargramostim; semustine; simtrazene; sipuleucel- T; sorafenib; sparfosate sodium; sparsomycin; spirogermanium hydrochloride; spiromustine; spiroplatin; streptonigrin; streptozocin; sulofenur; sunitinib malate; talisomycin; tamoxifen citrate; tecogalan sodium; tegafur; teloxantrone hydrochloride; temozolomide; temoporfin;
temsirolimus; teniposide; teroxirone; testolactone; thalidomide; thiamiprine; thioguanine;
thiotepa; tiazofurin; tirapazamine; topotecan hydrochloride; toremifene; tositumomab and 1 131 Iodine tositumomab; trastuzumab; trestolone acetate; tretinoin; triciribine phosphate;
trimetrexate; trimetrexate glucuronate; triptorelin; tubulozole hydrochloride; uracil mustard; uredepa; valrubicin; vapreotide; verteporfin; vinblastine; vinblastine sulfate; vincristine sulfate; vindesine; vindesine sulfate; vinepidine sulfate; vinglycinate sulfate; vinleurosine sulfate;
vinorelbine tartrate; vinrosidine sulfate; vinzolidine sulfate; vorinostat; vorozole; zeniplatin; zinostatin; zoledronic acid; and zorubicin hydrochloride.
[00298] Monoclonal antibodies include, but are not limited to, trastuzumab (Herceptin) and rituximab (Rituxan).
[00299] In some embodiments, at least one additional chemotherapeutic agent is selected from, by way of example only, alemtuzumab, arsenic trioxide, asparaginase (pegylated or non-), bevacizumab, cetuximab, platinum-based compounds such as cisplatin, cladribine, daunorubicin/doxorubicin/idarubicin, irinotecan, fludarabine, 5-fluorouracil, gemtuzumab, methotrexate, taxol, temozolomide, thioguanine, or classes of drugs including hormones (an antiestrogen, an antiandrogen, or gonadotropin releasing hormone analogues, interferons such as alpha interferon, nitrogen mustards such as busulfan or melphalan or mechlorethamine, retinoids such as tretinoin, topoisomerase inhibitors such as irinotecan or topotecan, tyrosine kinase inhibitors such as gefinitinib or imatinib, or agents to treat signs or symptoms induced by such therapy including allopurinol, filgrastim, granisetron/ondansetron/palonosetron, dronabinol.
[00300] In one aspect, the compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered or formulated in combination with one or more anti -cancer agents. In some embodiments, one or more of the anti-cancer agents are proapoptotic agents. Examples of anti-cancer agents include, but are not limited to, any of the following: gossypol, genasense, polyphenol E, Chlorofusin, all trans-retinoic acid (ATRA), bryostatin, tumor necrosis factor- related apoptosis-inducing ligand (TRAIL), 5-aza-2'-deoxycytidine, all trans retinoic acid, doxorubicin, vincristine, etoposide, gemcitabine, imatinib, geldanamycin, 17-N-Allylamino-17- Demethoxygeldanamycin (17-AAG), flavopiridol, LY294002, bortezomib, carfilzomib, trastuzumab, BAY 11-7082, PKC412, or PD184352, paclitaxel, and analogs of paclitaxel.
Compounds that have the basic taxane skeleton as a common structure feature, have also been shown to have the ability to arrest cells in the G2-M phases due to stabilized microtubules and are optionally useful for treating cancer in combination with the compounds described herein.
[00301] Further examples of anti-cancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include inhibitors of mitogen-activated protein kinase signaling, e.g., U0126, PD98059, PD184352, PD0325901, ARRY-142886, SB239063, SP600125, BAY 43-9006, wortmannin, or LY294002; Syk inhibitors; mTOR inhibitors; activin inhibitors, PKM2 inhibitors, c-fms inhibitors and histone deacetylase inhibitors. Further examples of anti-cancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include aromatase inhibitors.
Aromatase inhibitors include steroidal aromatase inhibitors and non-steroidal aromatase inhibitors. Steroidal aromatase inhibitors include, but are not limited to, exemestane. Nonsteroidal aromatase inhibitors include, but are not limited to, anastrozole, and letrozole.
[00302] Yet other anticancer agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include alkylating agents, antimetabolites, natural products, or hormones, e.g., nitrogen mustards (e.g., mechloroethamine, cyclophosphamide, chlorambucil, etc.), alkyl sulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine, lomusitne, ete.), or triazenes (decarbazine, etc.). Examples of antimetabolites include but are not limited to folic acid analog (e.g., methotrexate), or pyrimidine analogs (e.g., Cytarabine), purine analogs (e.g., mercaptopurine, thioguanine, pentostatin).
[00303] Examples of natural products for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include but are not limited to vinca alkaloids (e.g., vinblastin, vincristine), epipodophyllotoxins (e.g., etoposide), antibiotics (e.g., daunorubicin, doxorubicin, bleomycin), enzymes (e.g., L-asparaginase), or biological response modifiers (e.g., interferon alpha).
[00304] Examples of alkylating agents for use in combination with a compound of Formula (I), or a pharmaceutically acceptable salt thereof, include, but are not limited to, nitrogen mustards (e.g., mechloroethamine, cyclophosphamide, chlorambucil, meiphalan, etc.), ethylenimine and methylmelamines (e.g., hexamethlymelamine, thiotepa), alkyl sulfonates (e.g., busulfan), nitrosoureas (e.g., carmustine, lomusitne, semustine, streptozocin, etc.), or triazenes
(decarbazine, ete.).
[00305] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used to treat cancer in combination with: an antiestrogen (e.g., tamoxifen), an antiandrogen (e.g., bicalutamide, flutamide), a gonadotropin releasing hormone analog (e.g., leuprolide).
[00306] Other agents that are optionally used in the methods and compositions described herein for the treatment or prevention of cancer include platinum coordination complexes (e.g., cisplatin, carboblatin), anthracenedione (e.g., mitoxantrone), substituted urea (e.g., hydroxyurea), methyl hydrazine derivative (e.g., procarbazine), adrenocortical suppressant (e.g., mitotane, aminoglutethimide).
[00307] Examples of anti -cancer agents which act by arresting cells in the G2-M phases due to stabilized microtubules include without limitation the following marketed drugs and drugs in development: Erbulozole, Dolastatin 10, Mivobulin isethionate, Vincristine, NSC-639829, Discodermolide, ABT-751, Altorhyrtins (such as Altorhyrtin A and Altorhyrtin C), Spongistatins (such as Spongistatin 1, Spongistatin 2, Spongistatin 3, Spongistatin 4, Spongistatin 5,
Spongistatin 6, Spongistatin 7, Spongistatin 8, and Spongistatin 9), Cemadotin hydrochloride, Epothilones (such as Epothilone A, Epothilone B, Epothilone C, Epothilone D, Epothilone E, Epothilone F, Epothilone B N-oxide, Epothilone A N-oxide, 16-aza-epothilone B, 21- aminoepothilone B, 21 -hydroxy epothilone D, 26-fluoroepothilone, Auristatin PE, Soblidotin, Vincristine sulfate, Cryptophycin 52, Vitilevuamide, Tubulysin A, Canadensol, Centaureidin, Oncocidin Al Fijianolide B, Laulimalide, Narcosine, Nascapine, Hemiasterlin, Vanadocene acetyl acetonate, Indanocine Eleutherobins (such as Desmethyleleutherobin,
Desaetyleleutherobin, lsoeleutherobin A, and Z-Eleutherobin), Caribaeoside, Caribaeolin, Halichondrin B, Diazonamide A, Taccalonolide A, Diozostatin, (-)-Phenylahistin, Myoseverin B, Resverastatin phosphate sodium.
[00308] In one aspect, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is co-administered with thrombolytic agents (e.g., alteplase anistreplase, streptokinase, urokinase, or tissue plasminogen activator), heparin, tinzaparin, warfarin, dabigatran (e.g., dabigatran etexilate), factor Xa inhibitors (e.g., fondaparinux, draparinux, rivaroxaban, DX-9065a, otamixaban, LY517717, or YM150), ticlopidine, clopidogrel, CS-747 (prasugrel, LY640315), ximelagatran, or BIBR 1048.
[00309] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in combination with anti-emetic agents to treat nausea or emesis, which result from the use of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, anticancer agent(s) and/or radiation therapy.
[00310] Anti-emetic agents include, but are not limited to: neurokinin-1 receptor antagonists, 5HT3 receptor antagonists (such as ondansetron, granisetron, tropisetron, palonosetron, and zatisetron), GABAB receptor agonists (such as baclofen), corticosteroids (such as
dexamethasone, prednisone, prednisolone, or others), dopamine antagonists (such as, but not limited to, domperidone, droperidol, haloperidol, chlorpromazine, promethazine,
prochlorperazine, metoclopramide), antihistamines (HI histamine receptor antagonists, such as but not limited to, cyclizine, diphenhydramine, dimenhydrinate, meclizine, promethazine, hydroxyzine), cannabinoids (such as but not limited to, cannabis, marinol, dronabinol), and others (such as, but not limited to, trimethobenzamide; ginger, emetrol, propofol).
[00311] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in combination with an agent useful in the treatment of anemia. Such an anemia treatment agent is, for example, a continuous eythropoiesis receptor activator (such as epoetin-a).
[00312] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in combination with an agent useful in the treatment of neutropenia.
Examples of agents useful in the treatment of neutropenia include, but are not limited to, a hematopoietic growth factor which regulates the production and function of neutrophils such as a human granulocyte colony stimulating factor, (G-CSF). Examples of a G-CSF include filgrastim.
[00313] In one aspect, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered in combination with one or more immunosuppressants. Immunosuppressive therapy is clinically used to treat or prevent the rejection of transplanted organs and tissues (e.g. bone marrow, heart, kidney, liver); treatment of autoimmune diseases or diseases that are most likely of autoimmune origin (e.g. rheumatoid arthritis, myasthenia gravis, systemic lupus erythematosus, Crohn's disease, and ulcerative colitis); and treatment of some other non- autoimmune inflammatory diseases (e.g. long term allergic asthma control), and in the treatment of fibrotic conditions.
[00314] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered with a corticosteroid. In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered with an a therapeutic agent selected from among: Calcineurin inhibitors (such as, but not limited to, cyclosporin, tacrolimus); mTOR inhibitors (such as, but not limited to, sirolimus, everolimus); anti-proliferatives (such as, but not limited to, azathioprine, mycophenolic acid); corticosteroids (such as, but not limited to, prednisone, cortisone acetate, prednisolone, methylprednisolone, dexamethasone, betamethasone, triamcinolone, beclometasone, fludrocortisone acetate, deoxycorticosterone acetate, aldosterone, hydrocortisone); antibodies (such as, but not limited to, monoclonal anti-IL-2Ra receptor antibodies (basiliximab, daclizumab), polyclonal anti-T-cell antibodies (anti-thymocyte globulin (ATG), anti -lymphocyte globulin (ALG)), B-cell antagonists, rituximab, natalizumab.
[00315] Other therapeutic agents include, but are not limited to: cyclophosphamide,
penicillamine, cyclosporine, nitrosoureas, cisplatin, carboplatin, oxaliplatin, methotrexate, azathioprine, mercaptopurine, pyrimidine analogues, protein synthesis inhibitors, dactinomycin, anthracyclines, mitomycin C, bleomycin, mithramycin, Atgam(R), Thymoglobuline®, OKT3®, basiliximab, daclizumab, cyclosporin, tacrolimus, sirolimus, Interferons (IFN-β, IFN-γ), opioids, T F binding proteins (infliximab, etanercept, adalimumab, golimumab), leflunomide, gold thioglucose, gold thiomalate, aurofin, sulfasalazine, hydroxychloroquinine, minocycline, rapamicin, mycophenolic acid, mycophenolate mofetil, FTY720, as well as those listed in US 7,060,697.
[00316] In one embodiment, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered in combination with Cyclosporin A (CsA) or tacrolimus (FK506). In one embodiment, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered to a mammal in combination with an anti-inflammatory agent including, but not limited to, non-steroidal anti-inflammatory drugs (NSAIDs), phosphodiesterase-4 inhibitors. JNK kinase inhibitors and corticosteroids (glucocorticoids).
[00317] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered with corticosteroids. Corticosteroids, include, but are not limited to: betamethasone, prednisone, alclometasone, aldosterone, amcinonide, beclometasone,
betamethasone, budesonide, ciclesonide, clobetasol, clobetasone, clocortolone, cloprednol, cortisone, cortivazol, deflazacort, deoxycorticosterone, desonide, desoximetasone,
desoxycortone, dexamethasone, diflorasone, diflucortolone, difluprednate, fluclorolone, fludrocortisone, fludroxycortide, flumetasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin, fluocortolone, fluorometholone, fluperolone, fluprednidene, fluticasone, formocortal, halcinonide, halometasone, hydrocortisone/cortisol, hydrocortisone aceponate, hydrocortisone buteprate, hydrocortisone butyrate, loteprednol, medrysone, meprednisone, methylprednisolone, methylprednisolone aceponate, mometasone furoate, paramethasone, prednicarbate,
prednisone/prednisolone, rimexolone, tixocortol, triamcinolone, and ulobetasol.
[00318] In one embodiment, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is administered to a mammal in combination with a non-steroidal anti-inflammatory drug (NSAID). NSAIDs include, but are not limited to: aspirin, salicylic acid, gentisic acid, choline magnesium salicylate, choline salicylate, choline magnesium salicylate, choline salicylate, magnesium salicylate, sodium salicylate, diflunisal, carprofen, fenoprofen, fenoprofen calcium, flurobiprofen, ibuprofen, ketoprofen, nabutone, ketolorac, ketorolac tromethamine, naproxen, oxaprozin, diclofenac, etodolac, indomethacin, sulindac, tolmetin, meclofenamate,
meclofenamate sodium, mefenamic acid, piroxicam, meloxicam, COX-2 specific inhibitors (such as, but not limited to, celecoxib, rofecoxib, valdecoxib, parecoxib, etoricoxib, lumiracoxib, CS- 502, JTE-522, L-745,337 and NS398).
[00319] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is co-administered with an analgesic.
[00320] In some embodiments, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is used in combination with radiation therapy (or radiotherapy). Radiation therapy is the treatment of cancer and other diseases with ionizing radiation. Radiation therapy is optionally used to treat localized solid tumors, such as cancers of the skin, tongue, larynx, brain, breast, prostate, colon, liver, uterus and/or cervix. It is also optionally used to treat leukemia and lymphoma (cancers of the blood-forming cells and lymphatic system, respectively).
[00321] A technique for delivering radiation to cancer cells is to place radioactive implants directly in a tumor or body cavity. This is called internal radiotherapy (brachytherapy, interstitial irradiation, and intracavitary irradiation are types of internal radiotherapy.) Using internal radiotherapy, the radiation dose is concentrated in a small area, and the patient stays in the hospital for a few days. Internal radiotherapy is frequently used for cancers of the tongue, uterus, prostate, colon, and cervix.
[00322] The term "radiotherapy" or "ionizing radiation" include all forms of radiation, including but not limited to α, β, and γ radiation and ultraviolet light. EXAMPLES
[00323] The following examples are provided for illustrative purposes only and not to limit the scope of the claims provided herein.
Example A-l: Parenteral Pharmaceutical Composition
[00324] To prepare a parenteral pharmaceutical composition suitable for administration by injection (subcutaneous, intravenous), 1-100 mg of a water-soluble salt of a compound Formula (I), or a pharmaceutically acceptable salt or solvate thereof, is dissolved in sterile water and then mixed with 10 mL of 0.9% sterile saline. A suitable buffer is optionally added as well as optional acid or base to adjust the pH. The mixture is incorporated into a dosage unit form suitable for administration by injection
Example A-2: Oral Solution
[00325] To prepare a pharmaceutical composition for oral delivery, a sufficient amount of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is added to water (with optional solubilizer(s),optional buffer(s) and taste masking excipients) to provide a 20 mg/mL solution.
Example A-3: Oral Tablet
[00326] A tablet is prepared by mixing 20-50%) by weight of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, 20-50%> by weight of microcrystalline cellulose, 1-10%> by weight of low-substituted hydroxypropyl cellulose, and 1-10%> by weight of magnesium stearate or other appropriate excipients. Tablets are prepared by direct compression. The total weight of the compressed tablets is maintained at 100 -500 mg.
Example A-4: Oral Capsule
[0001] To prepare a pharmaceutical composition for oral delivery, 10-500 mg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is mixed with starch or other suitable powder blend. The mixture is incorporated into an oral dosage unit such as a hard gelatin capsule, which is suitable for oral administration.
[00327] In another embodiment, 10-500 mg of a compound of Formula (I), or a
pharmaceutically acceptable salt thereof, is placed into Size 4 capsule, or size 1 capsule
(hypromellose or hard gelatin) and the capsule is closed.
Example A-5: Topical Gel Composition
[00328] To prepare a pharmaceutical topical gel composition, a compound of Formula (I), or a pharmaceutically acceptable salt thereof, is mixed with hydroxypropyl celluose, propylene glycol, isopropyl myristate and purified alcohol USP. The resulting gel mixture is then incorporated into containers, such as tubes, which are suitable for topical administration.
Example A-6: Human Autotaxin Assay
[00329] ATX activity is assayed in concentrated conditioned media from Hep3B human hepatocellular carcinoma cells by measuring the amount of choline released from the substrate, lysophosphatidylcholine (LPC) as it is cleaved to LPA. Conditioned media is collected from confluent Hep3B cells and concentrated 20-fold using Centriprep-30 filter devices (Millipore). To assay for autotaxin inhibition, 10-20 μΐ^ of the concentrated conditioned media is incubated with 2.5 μΐ. of a test compound in DMSO and 72.5-82.5 μΐ. lyso-PLD buffer (100 mM Tris pH 9, 500 mM NaCl, 5 mM MgCl2, 5 mM CaCl2, 0.05% Triton X-100 in the presence or absence of 0.2% fatty-acid-free human serum albumin) for 15 min at 37 °C. After the 15 min incubation, 5 ul of 2 mM LPC (14:0; Avanti Polar Lipids Cat# 855575C) diluted in lyso-PLD buffer is added for a final concentration of 100 uM and the incubation continues for 1.5-3 hours at 37 °C. 100 μΐ of a color mix containing 4.5 mM 4-aminoantipyrine, 2.7 mM N-ethyl-N-(2-hydroxy-3- sulfopropyl)-m-toluidine, 21 units/ml horseradish peroxidase and 3 units/ml choline oxidase in 50 mM Tris, pH 8, 4.5 mM MgCl2 is added and the incubation continued for 15 minutes at room temperature before reading the absorbance at 555 nm.
Example A-7: Human Whole Blood Autotaxin Assay
[00330] Inhibition of ATX activity in human whole blood is assayed by measuring the concentration of 20:4 LPA in plasma after a prolonged incubation at 37 °C. Blood is drawn from consenting human volunteers into heparin vacutainer tubes and 200 μΐ aliquots are added to 2 μΐ test compound in DMSO or DMSO alone. Several of the vehicle tubes are centrifuged
immediately at 800 x g for 10 minutes at 4 °C and the plasma removed for processing to determine the baseline concentration of 20:4 LPA. The remaining blood samples containing vehicle or test compound are incubated at 37 °C for 4 hours before centrifuging at 800 x g for 10 minutes at 4 °C to obtain plasma. Plasma is processed for LCMS as follows: 40 ul plasma is removed and 5 volumes of methanol containing 125 ng/ml 17:0 LPA as an internal standard are added and the mixture incubated at -20 °C for 10 min before centrifuging at 4000 x g for 10 minutes at 4 °C. 150 μΐ of the supernatant is transferred to a 96-well plate and diluted with 100 μΐ of an organic solution (90: 10:0.1 of water/acetonitrile/ammonium hydroxide) for analysis of 20:4 LPA concentrations by LCMS. LPA 20:4 and the internal standard (LPA 17:0) were analyzed on a quadrupole mass spectrometer (ABI Sciex 4000QTrap) in the negative ion mode (ESI) by multiple reaction monitoring (MRM). The mobile phases contain 0.1% ammonium hydroxide in 90%) water/10%) acetonitrile (solvent A) and 0.1%> ammonium hydroxide in 90% acetonitrile/ 10%> water (solvent B). The flow rate was maintained at 0.8 mL/min and the total run time was 3 min. Analytes were separated using a linear gradient as follows: 1) mobile phase was held for 0.5 min at 10% B; 2) B was increased from 10% to 90% over the next 1 min; 3) B was held constant for 0.5 min at 90%; and 4) B was returned to the initial gradient conditions.
Example A-8: Mouse Air Pouch Assay
[00331] LP A and ATX activity are induced by carrageenan injection into a mouse air pouch. A mouse air pouch assay was utilized to determine pharmacodynamic activity of autotaxin inhibitors in reducing carrageenan-induced ATX activity and LPA biosynthesis. An air pouch was formed in female balb/c mice by instilling 5 ml of 0.2 μιη filtered air into the subcutaneous space in the scapular region on Day 1. On Day 3, 3 ml of air was instilled into the pouch and on Day 6, another 3 ml air was instilled into the pouch. On Day 7, test compounds were
administered by oral gavage. At the appropriate time (0-24 hr) after compound administration, carrageenan dissolved in sterile saline was injected into the air pouch. Two hours following carrageenan challenge, mice were sacrificed and blood obtained via cardiac puncture. A 0.5-1 ml bolus of bolus of ice-cold phosphate buffered saline solution was instilled into the air pouch and after 20 seconds of gentle massaging, the pouch was opened and the fluid removed. An aliquot of the air pouch fluid was analyzed for LPA concentrations by LC-MS as described in the Human Whole Blood Autotaxin Assay (Example 20). A separate aliquot of the air pouch fluid was taken, centrifuged (800 x g, 10 min) and assayed for choline content using a TOOS method or for drug concentrations by LCMS. Plasma prepared from blood was assayed for drug concentrations by LCMS. Drug concentrations to achieve 50% inhibition of ATX activity or carrageenan-induced pouch LPA could be calculated by nonlinear regression (Graphpad Prism) of % inhibition versus log drug concentration.
Example A-9: MDA-MB-435 Melanoma Cell Migration Assay
[00332] Cells from the MDA-MB-435S human melanoma line are maintained in subconfluent culture in media containing FBS and penicillin/streptomycin. The day before the assay, cells are serum-starved overnight in media containing 0.1-0.2%) fatty-acid-free BSA. On the day of the assay, the conditioned media is removed from the cells and set aside. The cells are then harvested by scraping, counted, and pelleted by centrifugation. The cells are resuspended at 1.05X the final desired density in the conditioned media. The assays are performed in duplicate using the Neuroprobe 96-well chemotaxis system with 8 μπι pore size and fibronectin-coated filters. 152 μΐ cells are added to 8 μΐ test compound and incubated for 15 min at 37°C. The lower chamber is loaded with 2-10 μΜ LPC and then 50 μΐ of the cell/test compound suspension is added to the top of each filter well site. The filters are incubated at 37°C for 1-24 hours and non-migrated cells removed from the top of the filter by rinsing with PBS and scraping. The filter is air dried then stained before reading the absorbance at 580 nm.
Example A-10: Spontaneous Metastasis Mouse Model
[00333] A syngeneic mouse model is used to test efficacy of compounds in inhibiting tumor metastases. 4T1 cells are in injected into the #1 mammary fat pad of female Balb/c mice while the mice are anesthetized. The primary tumors are measured by caliper twice weekly until they are resected under isofluorane anesthesia (between days 10-14). Test compound is administered orally daily at various times after the injection of the 4T1 cells. At 8-11 weeks after the 4T1 injection, lymph nodes, lungs, liver and any other organs suspected of harboring metastases are collected for histological analysis.
Example A-ll: Lung Metastases Model
[00334] An experimental lung metastasis model is used to test efficacy of compounds in reducing the number of metastases of injected B16-F 10 mouse melanoma cells to the lung. Briefly, female C57BL/6J mice, female (BALB/cByJ x C57BL/6J)Fi, mice (CByB6Fi/J), athymic nude female and male CByB6Fi/J mice (nu/nu), and control littermates (nu/nu) are used at ages 7-18 weeks, when they weighed between 18 and 28 g. A single-cell suspension of B16F10 cells, harvested in log phase (approx. 5-10 x 104 cells) in 0.2 mL of Hanks' balanced salt solution are injected intravenously into the lateral tail vein of the mice. Test compound or vehicle is delivered daily. After 21 days, the mice are sacrificed, and the lungs are removed. Lungs are fixed in 10% buffered formalin overnight and weighed, and tumor colonies at the surface are scored with the aid of a dissecting microscope.
Example A-12: Mouse Carbon Tetrachloride (CC -induced Liver Fibrosis Model
[00335] Female balb/c mice receive CC14 (1.0 ml/kg body weight) diluted in olive oil via intraperitoneal injection twice a week for 8 weeks. (Higazi, A. A. et al, Clin Exp Immunol. 2008 Apr;152(l): 163-73). Control mice receive an equivalent volume of olive oil only. Test compound or vehicle is delivered orally daily. At the end of the study (8 weeks after first i.p. injection of CC14), mice are sacrificed using inhaled isoflurane and blood is drawn via cardiac puncture for subsequent analysis of ALT/AST levels. The liver is harvested and frozen at -80 0 C for the biochemical analysis of liver fibrosis or fixed in 10% neutral buffered formalin for histological assessment of liver fibrosis. For the biochemical assessment of liver fibrosis, liver tissue homogenates are analyzed for collagen concentration using a hydroxyproline assay. For the histological assessment of liver fibrosis, fixed liver tissue is Masson's trichrome stained and liver fibrosis is determined by quantitative, computer-assisted densitometry using light microscopy. Example A-13: Rat Diethylnitrosamine (DEN)-induced Liver Fibrosis and Hepatocellular Carcinoma
[00336] Male Wistar rats receive weekly intraperitoneal injections of 35-100 mg/kg
diethylnitrosamine (DEN) for 5-18 weeks in a total volume of 1.5 ml phosphate-buffered saline (PBS) to induce cirrhosis and hepatocellular carcinoma (HCC). Control rats receive weekly injections of an equivalent volume of PBS. Test compound or vehicle is delivered orally daily. At the end of the study, rats are sacrificed using inhaled isoflurane and blood is drawn via cardiac puncture for subsequent analysis of ALT/AST levels and drug concentrations. The liver is harvested and frozen at -80 0 C for biochemical analysis of fibrosis or fixed in 10% neutral buffered formalin for histological assessment of liver fibrosis. For biochemical assessment of fibrosis, liver tissue homogenates are analyzed for collagen concentration using a hydroxyproline assay. For histological assessment of liver fibrosis and HCC, fixed liver tissue is hematoxylin and eosin stained and Masson's trichrome stained and liver fibrosis and HCC is determined by quantitative, computer-assisted densitometry using light microscopy.
Example A-14: Clinical Trial for Pulmonary Fibrosis
[00337] A non-limiting example of a pulmonary fibrosis clinical trial in humans is described below.
[00338] Purpose: The purposes of this study are to assess the efficacy of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, as single agent or in combination, in the treatment of patients with pulmonary fibrosis, collect information on any side effects the compound may cause as single agent or in combination, and evaluate the pharmacokinetic properties of the compound as single agent or in combination.
[00339] Intervention: Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
[00340] Detailed Description: Patients will be given a compound of Formula (I), or a pharmaceutically acceptable salt thereof, orally once or twice a day as single agent or in combination. Prior to each dosing cycle, a physical exam, blood work and assessment of any side effects will be performed.
[00341] Primary Outcome Measures: Progression-free survival, defined as free of death or a decrease from baseline in the FVC of at least 10%.
[00342] Secondary Outcome Measures: Number of Acute Exacerbations of IPF; health related quality of life; P02 at rest and at exercise from baseline; P(A-a)02 at rest and at exercise from baseline; Predicted FEV1 from baseline; forced expiratory volume in one second (FEV1) to FVC from baseline; plethysmographic lung volumes from baseline; diffusion capacity for carbon monoxide (DLco) from baseline; Six-Minute Walk test, from baseline: resting and 6 minute Sp02, presence or absence of desaturation to 88% or lower at the end of the six minute walk, walked distance; Pre and post modified Borg dyspnea scores; scoring of extent of lung fibrosis on HRCT, according to two independent chest radiologists, form baseline; number and severity of adverse effects.
[00343] Eligibility: Male and female subjects that are 40 years to 80 years.
[00344] Inclusion Criteria: Clinical symptoms of IPF for at least 3 months; forced vital capacity (FVC) between 50 to 90% of the predicted value; DLco at least 35% of the predicted value; Pa02 > 55 mm Hg while breathing ambient air at rest; High -resolution computed tomography (HRCT) showing definite or probable criteria of IPF.
[00345] Exclusion Criteria: Clinically significant exposure to known fibrogenic agents (birds, molds, asbestos, radiation and drugs known to cause pulmonary fibrosis (amiodarone, nitrofurantoin, bleomicin, etc)); history of neurofibromatosis, Hermansky-Pudlak syndrome, metabolic storage disorders, etc.; history of fever, weight loss, myalgias, arthralgias, skin rash, arthritis; active infection within one week before enrollment; alternative cause of interstitial lung disease; ratio of the forced expiratory volume in one second (VEFl) to FVC of less than 0.6 after the use of a bronchodilator; residual volume more than 120% of the predicted value (when available); more than 20% of lymphocytes or eosinophils in bronchoalveolar lavage (BAL) (when available); granulomas, infection or malignancy in the transbronchial or surgical biopsy (when available); previous therapy with azathioprine, prednisolone (>0.5 mg/kg/day or more for at least 3 months), cyclophosphamide or novel biotech drugs; unstable cardiovascular or neurologic disease; uncontrolled diabetes; pregnancy; lactation; likelihood of death, as predicted by the investigator, within the next year; white cell blood count < 4000/mm3; platelet count < 100000/mm3; Hematocrit < 30% or > 59%; liver enzymes more than 3 times the upper limit of the normal range; creatinine level > 1.5 mg/dL; albumin level < 3 g/dL; refusal to sign informed consent by patient or guardian.
Example A-15: Clinical Trial for Liver Fibrosis
[00346] A non-limiting example of a liver fibrosis clinical trial in humans is described below.
[00347] Purpose: The purposes of this study are to assess the efficacy of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, as single agent or in combination, in the treatment of patients with liver fibrosis, collect information on any side effects the compound may cause as single agent or in combination, and evaluate the pharmacokinetic properties of the compound as single agent or in combination. [00348] Intervention: Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
[00349] Detailed Description: Patients will be given a compound of Formula (I), or a pharmaceutically acceptable salt thereof, orally once or twice a day as single agent or in combination. Prior to each dosing cycle, a physical exam, blood work and assessment of any side effects will be performed.
[00350] Primary Outcome Measures: Liver enzymes (ALT, AST, ALP), liver biopsy
[00351] Secondary Outcome Measures: Pharmacodynamic markers may include: Tissue PD markers through mRNA expression, ATX, LOXL2, LOX, Other LOXL proteins, aSMA, Collagen 1A1, F-KB1, Caspase 1, SMAD, and NOD; Serum and plasma PD markers include: AST-to-platelet ratio index (APRI), ATX activity, LOXL2, Osteopontin, Hyaluronic Acid, CXCL 9, 10 and 11, MMPl, MMP3, MMP9, TFMP1, CD40L, TGF-βΙ, ET-1, VEGF, GAL3, IL- 6 / IL-8 / TNFa / ΠΤΝΓγ, a2-macroglobulin, Apolipoprotein Al, PINP, PIIINP, PVCP-1230, PDGF; Assessing the effects of chronic dosing on liver structure (using, for example, ultrasound and/or MRI) and fibrotic markers; incidence of adverse events resulting from the administration of multiple doses of compound.
[00352] Eligibility: Male and female subjects that are 18 to 60 years old.
[00353] Inclusion Criteria: Stage 1-3 fibrosis by Metavir score on a liver biopsy; Body mass index <36 kg/m2.
[00354] Exclusion Criteria: Any evidence of hepatic decompensation past or present; subjects currently abusing amphetamines, cocaine, opiates, or alcohol; clinically significant cardiac disease; history of cancer, other than non-melanomatous skin cancer, within 5 years prior to screening; systemic fungal, bacterial, viral, or other infection that is not controlled; use of systemic immunosuppressants within 28 days of the Pre-treatment Phase; use of approved therapy for hepatitis C or hepatitis B virus within 28 days of the Pre-treatment Phase; pregnant or lactating; history of bleeding diathesis within the last 6 months of study Day 1.
Example A-16: Clinical Trial for Cholestatic Pruritus
[00355] A non-limiting example of a cholestatic pruritus clinical trial in humans is described below.
[00356] Purpose: The purposes of this study are to assess the efficacy of a compound of Formula (I), or a pharmaceutically acceptable salt thereof in the treatment of patients with cholestatic pruritus, collect information on any side effects the compound may cause and evaluate the pharmacokinetic properties of the compound as single agent or in combination. [00357] Intervention: Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day.
[00358] Detailed Description: Patients will be given a compound of Formula (I), or a pharmaceutically acceptable salt thereof, orally once or twice a day. Prior to each dosing cycle, a physical exam, blood work and assessment of any side effects will be performed.
[00359] Eligibility: Male and female subjects that are 21 to 80 years old.
[00360] Inclusion Criteria: Patients with pruritus as a result of a cholestatic disorder.
[00361] Exclusion Criteria: Use of cholestyramine; pregnancy; malignancy/life expectancy <6 months.
[00362] Primary Outcome Measures: Normalization of liver enzymes (ALT, AST, ALP), Reduction of pruritus according to visual analogue scores.
[00363] Secondary Outcome Measures: Improvement in quality of life scores; reduction in pruritus score/scratch lesions.
Example A-17: Clinical Trial for Pancreatic Cancer
[00364] A non-limiting example of a pancreatic cancer clinical trial in humans is described below.
[00365] Purpose: The purposes of this study are to assess the efficacy of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, as single agent or in combination, in the treatment of patients with pancreatic cancer, collect information on any side effects the compound may cause as single agent or in combination, and evaluate the pharmacokinetic properties of the compound as single agent or in combination.
[00366] Intervention: Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
[00367] Detailed Description: Patients will be given a compound of Formula (I), or a pharmaceutically acceptable salt thereof, orally once or twice a day as single agent or in combination. Prior to each dosing cycle, a physical exam, blood work and assessment of any side effects will be performed.
[00368] Eligibility: Male and female subjects that are 21 to 80 years old with advanced pancreatic cancer.
[00369] Inclusion Criteria: Radiographic or clinical evidence of measurable advanced pancreatic carcinoma (Stage II, III, IV). Subjects must have measurable disease at least 2 cm in diameter. ECOG performance status of 0 or 1.
[00370] Exclusion Criteria: Prior history of malignancy (except basal cell or squamous cell carcinoma or carcinoma in situ of the breast) unless the subject has been free of disease for > or = to 1 year. Moderate or severe cardiac disease; Active infection; Not pregnant or nursing;
Negative pregnancy test; Fertile patients must use effective contraception during and for > 3 months after completion of study treatment; Able to swallow oral medication; No other malignancy within the past 5 years except for in situ cancers or basal cell or squamous cell carcinoma of the skin; No hypersensitivity or intolerance to statins; no other non-malignant systemic disease that would preclude rosuvastatin administration or prolonged follow-up.
[00371] Primary Outcome Measures: Progression free survival, overall survival, worsening of pain, onset of pain
[00372] Secondary Outcome Measures: tumor size / response (RECIST)
Example A-18: Clinical Trial for Hepatocellular Carcinoma (HCC)
[00373] A non-limiting example of a hepatocellular carcinoma clinical trial in humans is described below.
[00374] Purpose: The purposes of this study are to assess the efficacy of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, as single agent or in combination, in the treatment of patients with hepatocellular carcinoma, collect information on any side effects the compound may cause as single agent or in combination, and evaluate the pharmacokinetic properties of the compound as single agent or in combination.
[00375] Intervention: Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
[00376] Detailed Description: Patients will be given a compound of Formula (I), or a pharmaceutically acceptable salt thereof, orally once or twice a day as single agent or in combination. Prior to each dosing cycle, a physical exam, blood work and assessment of any side effects will be performed.
[00377] Eligibility: Male and female subjects that are 21 to 80 years old.
[00378] Inclusion Criteria: Patients with histopathologically or clinically confirmed diagnosis of hepatocellular carcinoma; unresponsive to standard therapy or for whom standard therapy is intolerable, or for whom there is no appropriate therapy; ECOG performance status score of 0-2.
[00379] Exclusion Criteria: Patients with a primary malignant tumor; history of liver transplant; brain metastases; psychiatric disorder that might cause difficulty in obtaining informed consent or in conducting the trial; Not pregnant or nursing; Fertile patients must use effective
contraception during and for > 3 months after completion of study treatment; No other malignancy within the past 5 years except for in situ cancers or basal cell or squamous cell carcinoma of the skin; No hypersensitivity or intolerance to statins; no other non-malignant systemic disease that would preclude rosuvastatin administration or prolonged follow-up. [00380] Primary Outcome Measures: time to progression, progression free survival, overall response (RECIST)
[00381] Secondary Outcome Measures: liver function tests, tumor biomarkers, liver imaging (Ultrasound, MRI, PET).
Example A-19: Clinical Trial for Fatty Liver Disease /Steatosis (NAFLD, NASH)
[00382] A non-limiting example of a fatty liver disease/steatosis clinical trial in humans is described below.
[00383] Purpose: The purposes of this study are to assess the efficacy of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, as single agent or in combination, in the treatment of patients with hepatocellular carcinoma, collect information on any side effects the compound may cause as single agent or in combination, and evaluate the pharmacokinetic properties of the compound as single agent or in combination.
[00384] Intervention: Patients are administered 0.1-100 mg/kg of a compound of Formula (I), or a pharmaceutically acceptable salt thereof, per day as single agent or in combination.
[00385] Detailed Description: Patients will be given a compound of Formula (I), or a pharmaceutically acceptable salt thereof, orally once or twice a day as single agent or in combination. Prior to each dosing cycle, a physical exam, blood work and assessment of any side effects will be performed.
[00386] Eligibility: Male and female subjects that are 21 to 80 years old.
[00387] Inclusion Criteria: Patients with clinically confirmed diagnosis of non-alcohol fatty liver disease or non-alcohol steatohepatitis; histologic evidence of definite or probable nonalcoholic steatohepatitis (NASH) based upon a liver biopsy obtained no more than 90 days prior to randomization and a nonalcoholic fatty liver disease activity score (NAS) of 4 or greater.
[00388] Exclusion Criteria: Current or history of significant alcohol consumption, use of drugs historically associated with nonalcoholic fatty liver disease (NAFLD) (amiodarone,
methotrexate, systemic glucocorticoids, tetracyclines, tamoxifen, estrogens at doses greater than those used for hormone replacement, anabolic steroids, valproic acid, and other known hepatotoxins) for more than 2 weeks in the year prior to randomization, prior or planned (during the study period) bariatric surgery (eg, gastroplasty, roux-en-Y gastric bypass), uncontrolled diabetes defined as Hemoglobin Ale 9.5% or higher within 60 days prior to enrollment, presence of cirrhosis on liver biopsy, platelet count below 100,000/mm3; Clinical evidence of hepatic decompensation as defined by the presence of any of the following abnormalities: serum albumin less than 3.2 grams/deciliter (g/dL), INR(international normalized ratio) greater than 1.3, direct bilirubin greater than 1.3 milligrams per deciliter (mg/dL), history of esophageal varices, ascites or hepatic encephalopathy; Evidence of other forms of chronic liver disease: hepatitis B as defined by presence of hepatitis B surface antigen (HBsAg), hepatitis C as defined by presence of hepatitis C virus (HCV) ribonucleic acid (RNA) or positive hepatitis C antibody (anti-HCV), evidence of ongoing autoimmune liver disease as defined by compatible liver histology, primary biliary cirrhosis, primary sclerosing cholangitis, Wilson's disease, Alpha- 1 -antitrypsin (A1AT) deficiency, history of hemochromatosis or iron overload, drug-induced liver disease as defined on the basis of typical exposure and history, known bile duct obstruction, suspected or proven liver cancer, any other type of liver disease other than nonalcoholic steatohepatitis (NASH); serum alanine aminotransferase (ALT) greater than 300 units per liter (U/L); serum creatinine of 2.0 mg/dL or greater; use of ursodeoxycholic acid (Ursodiol, Urso) within 90 days prior to enrollment; inability to safely obtain a liver biopsy, history of biliary diversion, known positivity for Human Immunodeficiency Virus (HIV) infection; pregnancy, planned pregnancy, potential for pregnancy and unwillingness to use effective birth control during the trial, breast feeding
[00389] Primary Outcome Measures: liver function tests, liver biopsy, NAS score
[00390] Secondary Outcome Measures: fibrotic biomarkers, liver imaging (ultrasound, MRI), insulin resistance as measure by HOMA-IR, lipid panel, glucose homeostasis (OGTT).
[00391] The examples and embodiments described herein are for illustrative purposes only and various modifications or changes suggested to persons skilled in the art are to be included within the spirit and purview of this application and scope of the appended claims.

Claims

HAT IS CLAIMED IS:
Figure imgf000092_0001
R1 is H, D, halogen, -CN, -C(=0)H, d-C4alkyl, Ci-C4fluoroalkyl, C3-C6cycloalkyl or C C4deuteroalkyl;
R2 is H, halogen, -CN, -OH, N02, NH2, N(R10)2, -OC(=O)N(R10)2 , -C(=O)N(R10)2 , - NHC(=0)R9, -NHC(=0)OR9, substituted or unsubstituted Ci-C4alkyl, Ci- C4fluoroalkyl, Ci-C4deuteroalkyl, substituted or unsubstituted Ci-C4alkoxy, Ci- C4fluoroalkoxy, -S-Ci-C4alkyl, -S(=0)-Ci-C4alkyl, -S(=0)2-Ci-C4alkyl, C C4hydroxyalkyl, substituted or unsubstituted phenyl, or substituted or unsubstituted monocyclic heteroaryl;
R3 is H, halogen, -CN, -OH, Ci-C4alkyl, Ci-C4fluoroalkyl, Ci-C4deuteroalkyl, C
C4alkoxy, Ci-C4fluoroalkoxy, -S-Ci-C4alkyl, -S(=0)-Ci-C4alkyl, -S(=0)2-Ci-C4alkyl, or Ci-C hydroxyalkyl;
Ring A is a monocyclic aryl, bicyclic aryl, monocyclic heteroaryl or bicyclic heteroaryl; each RA is independently selected from the group consisting of H, halogen, -CN, - N02, -OH, -OR9, -SR9, -S(=0)R9, -S(=0)2R9, -S(=O)2N(R10)2, - R10S(=O)2R9, - C(=0)R9, -OC(=0)R9, -C02R10, -OC02R9, -N(R10)2, -C(=O)N(R10)2, - OC(=O)N(R10)2, - HC(=0)R9, - HC(=0)OR9, Ci-C6alkyl, Ci-C6fluoroalkyl, Ci- C6deuteroalkyl, Ci-C6heteroalkyl, substituted or unsubstituted C3-Ciocycloalkyl, substituted or unsubstituted C2-Ci0heterocycloalkyl, substituted or unsubstituted phenyl, and substituted or unsubstituted monocyclic heteroaryl;
m is 0, 1, or 2;
L1 is absent, Ci-C6alkylene, Ci-Cefluoroalkylene, C3-C6cycloalkylene, (Ci-C6alkylene)p- C3-C6cycloalkylene-(Ci-C6alkylene)q, or -(Ci-C6alkylene)p-X1-(Ci-C6alkylene)q; X1 is O, S, S(=0), S(=0)2, C(=0) H, HC(=0), NH, OC(=0)NH, NHC(=0)0, or NHC(=0)0;
p is 0 or 1;
q is 0 or 1;
Q is -C02H, -C02(Ci-C6alkyl), -OH, -CN, -B(OH)2, -C(=0)NHS02R9, -C(=O)N(R10)2, -S02NHC(=0)R9, -CN, tetrazolyl, -OP(=0)(OH)2, -P(=0)(OH)2 or carboxylic acid bioisostere;
L2 is -Ci-C6alkylene-, -C3-C6cycloalkylene-, -C(=0)-, -C(=0)-Ci-C6alkylene- , - C(=0)NH-, -C(=0)NH-Ci-C6alkylene-, -C(=0)0-, -C(=0)0-Ci-C6alkylene-, -C C6alkylene-C(=0)-, -Ci-C6alkylene-C(=0)NH-, -Ci-C6alkylene-NHC(=0)-, -Ci- C6alkylene-C(=0)0-, -Ci-C6alkylene-OC(=0)-, -Ci-C6alkylene-OC(=0)NH-, -Ci- C6alkylene-NHC(=0)NH-, or absent;
Y is H, unsubstituted or unsubstituted Ci-C6alkyl, CF3, halogen, or CN;
Ring B is a monocyclic aryl, bicyclic aryl, monocyclic heteroaryl or bicyclic heteroaryl; each RB is independently selected from the group consisting of H, halogen, -CN, - N02, -OH, -OR9, -SR9, -S(=0)R9, -S(=0)2R9, -S(=O)2N(R10)2, -NR10S(=O)2R9, - C(=0)R9, -OC(=0)R9, -C02R10, -OC02R9, -N(R10)2, -C(=O)N(R10)2, - OC(=O)N(R10)2, -NHC(=0)R9, -NHC(=0)OR9, Ci-C6alkyl, Ci-C6fluoroalkyl, Ci- C6deuteroalkyl, Ci-C6heteroalkyl, substituted or unsubstituted C3-Ciocycloalkyl, substituted or unsubstituted C2-Cioheterocycloalkyl, substituted or unsubstituted phenyl, substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl;
n is 0, 1, or 2;
each R9 is independently selected from the group consisting of Ci-C6alkyl, Ci-
Cefiuoroalkyl, Ci-C6deuteroalkyl, C3-C6cycloalkyl, a substituted or unsubstituted phenyl, a substituted or unsubstituted monocyclic heteroaryl, and a substituted or unsubstituted bicyclic heteroaryl;
each R10 is independently selected from the group consisting of H, Ci-C6alkyl, Ci-
Cefiuoroalkyl, Ci-C6deuteroalkyl, C3-C6cycloalkyl, a substituted or unsubstituted phenyl, and a substituted or unsubstituted monocyclic heteroaryl; or
two R10 groups attached to the same N atom are taken together with the N atom to which they are attached to form a substituted or unsubstituted heterocycle.
2. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000094_0001
3. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000094_0002
4. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000094_0003
5. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000094_0004
6. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000094_0005
7. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000095_0001
8 The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof,
wherein:
Figure imgf000095_0002
9. The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof,
wherein:
Figure imgf000095_0003
The compound of claim 1, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Figure imgf000095_0004
The compound of any one of claims 1-10, or a pharmaceutically acceptable salt, solvate thereof, wherein:
L2 is -Ci-C6alkylene-.
The compound of any one of claims 1-11, or a pharmaceutically acceptable salt, solvate thereof, wherein:
-CH2-, -CH2CH2-, -CH2CH2CH2-, -C(CH3)2-, or -CH(CH3)-
The compound of any one of claims 1-12, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Ring A is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms;
Ring B is phenyl, monocyclic heteroaryl containing 1-4 N atoms and 0 or 1 O or S atoms, or monocyclic heteroaryl containing 0-4 N atoms and 1 O or S atoms.
14. The compound of any one of claims 1-13, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Ring A is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl;
Ring B is phenyl, furanyl, pyrrolyl, oxazolyl, thiazolyl, imidazolyl, pyrazolyl, triazolyl, tetrazolyl, isoxazolyl, isothiazolyl, oxadiazolyl, thiadiazolyl, pyridinyl, pyrimidinyl, pyrazinyl, pyridazinyl, or triazinyl..
15. The compound of any one of claims 1-14, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Ring A is phenyl or pyridinyl;
Ring B is phenyl or pyridinyl.
16. The compound of claim 1, wherein the compound of Formula (I) has the following structure of Formula (II), Formula (III), Formula (IV), Formula (V), Formula (VI), or Formula (VII):
Figure imgf000096_0001
Formula (II) Formula (III) Formula (IV)
Figure imgf000096_0002
Formula (V) Formula (VI) Formula (VII) wherein, X is CH or N;
or is a pharmaceutically acceptable salt, or solvate thereof.
17. The compound of any one of claims 1-16, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
Y is H, -CH3, CF3, F, CI, Br, or CN;
R1 is H, F, CI, -CN, -CH3, -CF3, or -CD3.
18. The compound of any one of claims 1-17, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
L1 is absent, -CH2-, -CH2CH2-, -CH2CH2CH2-, -CH(CH3) -, -C(CH3)2-, or cyclopropyl- 1, 1-diyl;
Q is -C02H, -C02(Ci-C6alkyl), -C(=0)NHS02R9 or tetrazolyl.
19. The compound of any one of claims 1-18, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
each RA is independently selected from the group consisting of H, halogen, -CN, -OH, -
OR9, Ci-C6alkyl, and Ci-C6fluoroalkyl;
each RB is independently selected from the group consisting of H, halogen, -CN, -OH, -
OR9, Ci-C6alkyl, and Ci-C6fluoroalkyl.
20. The compound of any one of claims 1-18, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
each RA is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -
CH3, -CF3, -OCH3, or -OCF3;
each RB is independently selected from the group consisting of H, F, CI, Br, -CN, -OH, -
CH3, -CF3, -OCH3, or -OCF3.
21. The compound of any one of claims 1-20, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
R2 is H, halogen, -CN, -OH, d-C4alkyl, Ci-C4fluoroalkyl, Ci-C4deuteroalkyl, C
C alkoxy, or Ci-C fluoroalkoxy.
22. The compound of any one of claims 1-21, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
R2 is H, F, CI, Br, I, -CN, -OH, -CH3, -CF3, -CD3, -OCH3, or -OCF3.
23. The compound of any one of claims 1-22, or a pharmaceutically acceptable salt, or solvate thereof, wherein:
R2 is H or CI.
24. The compound of any one of claims 1-23, or a pharmaceutically acceptable salt, or solvate thereof wherein: R3 is H, halogen, -CN, -OH, Ci-C4alkyl, Ci-C4fluoroalkyl, Ci-C4deuteroalkyl, Ci- C4alkoxy, or Ci-C4fluoroalkoxy.
25. The compound of any one of claims 1-24, or a pharmaceutically acceptable salt, or
solvate thereof, wherein:
R3 is H, F, CI, -CH3, -CF3, -CD3, -OCH3, or -OCF3.
26. The compound of any one of claims 1-25, or a pharmaceutically acceptable salt, or
solvate thereof, wherein:
R3 is H, F, or CI.
27. The compound of any one of claims 1-26, or a pharmaceutically acceptable salt, or
solvate thereof, wherein:
L1 is absent, -CH2-, -CH2CH2-, or -CH2CH2CH2-;
Q is -C02H, or -C02(Ci-C6alkyl).
28. A pharmaceutical composition comprising a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, and at least one pharmaceutically acceptable excipient.
29. The pharmaceutical composition of claim 28, wherein the pharmaceutical composition is formulated for administration to a mammal by intravenous administration, subcutaneous administration, oral administration, inhalation, nasal administration, dermal
administration, or ophthalmic administration.
30. The pharmaceutical composition of claim 28, wherein the pharmaceutical composition is in the form of a tablet, a pill, a capsule, a liquid, a suspension, a gel, a dispersion, a solution, an emulsion, an ointment, or a lotion.
31. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment or prevention of cancer, fibrosis, pruritis, an
inflammatory disease or condition, an airway disease or condition, an autoimmune disease or condition, obesity, intraocular pressure, neuropathic pain, demyelinating diseases or combinations thereof, in a mammal.
32. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment or prevention of cancer in a mammal.
33. The use of claim 32, wherein the cancer is bladder cancer, colon cancer, brain cancer, breast cancer, endometrial cancer, heart cancer, kidney cancer, lung cancer, liver cancer, uterine cancer, blood and lymphatic cancer, ovarian cancer, pancreatic cancer, prostate cancer, thyroid cancer, or skin cancer.
34. The use of claim 32, wherein the cancer is a solid tumor.
35. The use of claim 32, wherein the cancer is a sarcoma, carcinoma, or lymphoma.
36. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment or prevention of fibrosis in a mammal.
37. The use of claim 36, wherein the fibrosis comprises lung fibrosis, liver fibrosis, kidney fibrosis, ocular fibrosis, peritoneal fibrosis, intestinal fibrosis, cardiac fibrosisor cutaneous fibrosis.
38. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in reducing or inhibiting angiogenesis in a mammal.
39. The use of claim 38, wherein reducing or inhibiting angiogenesis in the mammal treats atherosclerosis, hypertension, tumor growth, inflammation, rheumatoid arthritis, wet -form macular degeneration, choroidal neovascularization, retinal neovascularization, or diabetic retinopathy.
40. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment or prevention of an inflammatory disease or condition in a mammal.
41. The use of claim 40, wherein the inflammatory disease or condition is psoriasis,
rheumatoid arthritis, vasculitis, inflammatory bowel disease, colitis, Crohn's disease, dermatitis, osteoarthritis, asthma, inflammatory muscle disease, allergic rhinitis, vaginitis, interstitial cystitis, scleroderma, eczema, lupus erythematosus, dermatomyositis, Sjogren's syndrome, thyroiditis, myasthenia gravis, autoimmune hemolytic anemia, multiple sclerosis, cystic fibrosis, chronic relapsing hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, allergic conjunctivitis or atopic dermatitis.
42. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment or prevention of pruritis in a mammal.
43. The use of claim 42, wherein the pruritus is associated with dermatitis herpetiformis, dermatomyositis, pemphigoid, Sjogren's syndrome, Darier's disease, Hailey-Hailey disease, Ichthyoses, Sjogren -Larsson syndrome, dermatophytosis, folliculitis, impetigo and other bacterial infections, insect bites, pediculosis, scabies, viral infection, asteatosis, atopic eczema, contact dermatitis, drug reaction, lichen planus, lichen simplex chronicus, mastocytosis (urticaria pigmentosa), miliaria, psoriasis, scar(s), urticaria, cutaneous T-cell lymphoma or mycosis fungoides, cutaneous B-cell lymphoma, leukemia cutis, pemphigoid gestationis, polymorphic eruption of pregnancy or prurigo gestationis.
44. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment or prevention of cholestatic pruritis in a mammal.
45. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment of a metabolic syndrome in a mammal.
6. Use of a compound of any one of claims 1-27, or a pharmaceutically acceptable salt, or solvate thereof, in the treatment of pain in a mammal.
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