Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
  • A61K31/7042—Compounds having saccharide radicals and heterocyclic rings
  • A61K31/7052—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
  • A61K31/706—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
  • A61K31/7064—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
  • A61K31/7068—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid
  • A61K31/7072—Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines having oxo groups directly attached to the pyrimidine ring, e.g. cytidine, cytidylic acid having two oxo groups directly attached to the pyrimidine ring, e.g. uridine, uridylic acid, thymidine, zidovudine
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/12—Antivirals
  • A61P31/14—Antivirals for RNA viruses
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
  • C07H19/00—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/06—Pyrimidine radicals
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07H—SUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
  • C07H19/00—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
  • C07H19/02—Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
  • C07H19/04—Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
  • C07H19/06—Pyrimidine radicals
  • C07H19/10—Pyrimidine radicals with the saccharide radical esterified by phosphoric or polyphosphoric acids

Definitions

• the present invention relates to compounds effective in inhibiting replication of Hepatitis C virus ("HCV").
• HCV Hepatitis C virus
• the present invention also relates to compositions comprising these compounds and methods of using these compounds to treat HCV infection.
• the HCV is an RNA virus belonging to the Hepacivirus genus in the Flaviviridae family.
• the enveloped HCV virion contains a positive stranded RNA genome encoding all known virus-specific proteins in a single, uninterrupted, open reading frame.
• the open reading frame comprises approximately 9500 nucleotides and encodes a single large polyprotein of about 3000 amino acids.
• the polyprotein comprises a core protein, envelope proteins El and E2, a membrane bound protein p7, and the nonstructural proteins NS2, NS3, NS4A, NS4B, NS5A and NS5B.
• Chronic HCV infection is associated with progressive liver pathology, including cirrhosis and hepatocellular carcinoma.
• Chronic hepatitis C may be treated with peginterferon-alpha in combination with ribavirin.
• Substantial limitations to efficacy and tolerability remain as many users suffer from side effects, and viral elimination from the body is often incomplete. Therefore, there is a need for new therapies to treat HCV infection.
• the present invention features compounds having Formula I, and pharmaceutically acceptable salts thereof,
• each compound number in Table 1 can represent compounds of different formulas but with the same X, R 1; R 2 , R3, R4 and R5 moieties.
• the present invention features compounds having Formula II, and pharmaceutically acceptable salts thereof, as well as prodrugs thereof,
• the present invention features compounds having Formula III, and pharmaceutically acceptable salts thereof, as well as prodrugs thereof,
• the present invention features phosphoramidate prodrugs of compounds having Formula ⁇ ,
• the present invention features compounds having Formula V,
• the present invention features compounds having Formula VI, and pharmaceutically acceptable salts thereof,
• the present invention features compounds having Formula VI', and pharmaceutically acceptable salts thereof,
• the present invention features compounds having Formula VI", and pharmaceutically acceptable salts thereof,
• the present invention features compounds having Formula VII, and pharmaceutically acceptable salts thereof,
• the present invention features compounds having Formula IX, and pharmaceutically acceptable salts
• the present invention features compounds having Formula A, and pharmaceutically acceptable salts
• X, R 1; R 2 , R3, R t and R5 are as defined in Table 1.
• the present invention also features compounds with any formula described herein, wherein X, Ri, R 2 , R3, Rt and R5 moieties are as defined in Table 1, except that one CI at R 1; R 2 , R3, Rt or R 5 is replaced with Br, or preferably one CI at Ri or R 2 is replaced with Br.
• the present invention also features compounds with any formula described herein, wherein X, Ri, R 2 , R3, Rt and R5 moieties are as defined in Table 1, except that two CI at R 1; R 2 , R3, Rt or R 5 are replaced with Br, or preferably two CI at Ri or R 2 are replaced with Br.
• the present invention also features compounds with any formula described herein, wherein X, Ri, R 2 , R3, Rt and R5 moieties are as defined in Table 1, except that one F at R 1; R 2 , R3, Rt or R 5 is replaced with Br, or preferably one F at Ri or R 2 is replaced with Br.
• the present invention also features compounds with any formula described herein, wherein X, Ri, R 2 , R3, Rt and R5 moieties are as defined in Table 1, except that two F at R 1; R 2 , R3, Rt or R 5 are replaced with Br, or preferably two F at Ri or R 2 are replaced with Br.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula I.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula II.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula III.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula ⁇ .
• the present invention features Compound No. 1 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula IV .
• the present invention features Compound No. 1 according to Table wherein the compound has Formula IV" .
• the present invention features Compound No. 1 according to Table wherein the compound has Formula V.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula VI.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula VII.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula VIII. [0033] In another aspect, the present invention features Compound No. 1 according to Table wherein the compound has Formula IX.
• the present invention features Compound No. 1 according to Table wherein the compound has Formula A.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula I.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula II.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula III.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula ⁇ .
• the present invention features Compound No. 157 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula IV" .
• the present invention features Compound No. 157 according to Table wherein the compound has Formula V.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula VI.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula VII.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula VIII.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula IX.
• the present invention features Compound No. 157 according to Table wherein the compound has Formula A.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula I.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula II. [0050] In another aspect, the present invention features Compound No. 34 according to Table wherein the compound has Formula III.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula ⁇ .
• the present invention features Compound No. 34 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula IV" .
• the present invention features Compound No. 34 according to Table wherein the compound has Formula V.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula VI.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula VII.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula VIII.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula IX.
• the present invention features Compound No. 34 according to Table wherein the compound has Formula A.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula I.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula II.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula III.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula ⁇ .
• the present invention features Compound No. 43 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula IV. [0067] In another aspect, the present invention features Compound No. 43 according to Table wherein the compound has Formula IV" .
• the present invention features Compound No. 43 according to Table wherein the compound has Formula V.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula VI.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula VII.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula VIII.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula IX.
• the present invention features Compound No. 43 according to Table wherein the compound has Formula A.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula I.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula II.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula III.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula ⁇ .
• the present invention features Compound No. 46 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula IV.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula IV" .
• the present invention features Compound No. 46 according to Table wherein the compound has Formula V.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula VI.
• the present invention features Compound No. 46 according to Table wherein the compound has Formula VII. [0084] In another aspect, the present invention features Compound No. 46 according to Table 1, wherein the compound has Formula VIII.
• the present invention features Compound No. 46 according to Table 1, wherein the compound has Formula IX.
• the present invention features Compound No. 46 according to Table 1, wherein the compound has Formula A.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula I.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula II.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula III.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula ⁇ .
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula IV.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula IV.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula IV" .
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula V.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula VI.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula VII.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula VIII.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula IX.
• the present invention features Compound No. 37 according to Table 1, wherein the compound has Formula A.
• the present invention features Compound No. 67 according to Table 1, wherein the compound has Formula I, II, III, ⁇ , IV, IV, IV", V, VI,. VII, VIII, IX, or A.
• the present invention features Compound No. 109 according to Table 1, wherein the compound has Formula I, II, III, ⁇ , IV, IV, IV", V, VI,. VII, VIII, IX, or A.
• the present invention features Compound No. 1 18 according to Table 1, wherein the compound has Formula I, II, III, ⁇ , IV, IV, IV", V, VI,. VII, VIII, IX, or A.
• the present invention features Compound No. 1 19 according to Table 1, wherein the compound has Formula I, II, III, ⁇ , IV, IV, IV", V, VI,. VII, VIII, IX, or A.
• the present invention features Compound No. 120 according to Table 1, wherein the compound has Formula I, II, III, ⁇ , IV, IV, IV", V, VI,. VII, VIII, IX, or A.
• a suitable prodrug has chemically or metabolically cleavable group(s) and becomes, by solvolysis or under physiological conditions, a compound that is pharmaceutically active in vivo.
• a prodrug can be formed in a conventional manner by reaction of a functional group of the compound (such as an amino, hydroxy or carboxy group).
• Prodrugs often offer advantages of better metabolism, potency, solubility, tissue compatibility, or delayed release in mammals.
• Prodrugs include acid derivatives well known to practitioners of the art, such as, for example, esters prepared by reaction of the parent acidic compound with a suitable alcohol, or amides prepared by reaction of the parent acid compound with a suitable amine.
• prodrugs include, but are not limited to, acetate, formate, benzoate or other acylated derivatives of alcohol or amine functional groups within the compounds of the invention.
• prodrugs can be aliphatic or aromatic esters derived from acidic groups on a compound of the invention.
• prodrugs can be aliphatic or aromatic esters of hydroxyl or amino groups on a compound of the invention.
• Phosphate prodrugs of hydroxyl groups are preferred prodrugs.
• prodrugs used herein are phosphoramidate prodrugs.
• any compound, salt or prodrug according to any aspect, embodiment, example and preference described herein can be isotopically substituted.
• Preferred isotopic substitutions include substitutions with stable or nonradioactive isotopes such as deuterium, 13 C, 15 N or 18 0.
• Incorporation of a heavy atom, such as substitution of deuterium for hydrogen can give rise to an isotope effect that could alter the pharmacokinetics of the drug.
• at least 5 mol % (e.g., at least 10 mol %) of hydrogen in a compound of the present invention is substituted with deuterium.
• at least 25 mole % of hydrogen in a compound of the present invention is substituted with deuterium.
• the present invention features methods of using any compound/salt/prodrug according to any aspect, embodiment, example and preference described herein to treat HCV infection.
• a compound, salt or prodrug has inhibitory activity against HCV polymerase.
• the method comprises administering an effective amount of such a compound, salt or prodrug to an HCV patient in need thereof.
• the patient is infected with HCV genotype 1.
• the patient is infected with HCV genotype 2.
• the patient is infected with HCV genotype 3.
• the patient is infected with HCV genotype 4.
• the patient is infected with HCV genotype 5.
• the patient is infected with HCV genotype 6.
• different compounds of the invention may have different anti-viral activities and/or toxicity/safety profiles. Compounds with less antiviral activities can be dosed more frequently and/or with greater amounts. Compounds with higher antiviral activities can be dosed less frequently and/or with lesser amounts. Moreover, a compound that does not have a commercially desired toxicity/safety profile does not prevent its utility under patent law as an anti-viral agent, despite the fact that the US FDA might not approve it for human treatment due to the agency's benefit-cost analyses and/or other non-patent related concerns.
• the present invention features methods for treating HCV infection in a subject in need of such treatment.
• the methods comprise administering at least two direct acting antiviral agents (DAAs) to the subject for a duration of no more than 12 weeks, or for another duration as set forth herein.
• DAAs direct acting antiviral agents
• Said at least two DAAs comprise (1) a compound/salt/prodrug according to any aspect, embodiment, example and preference described herein, and (2) another DAA.
• the other DAA can be, for example, selected from an HCV protease inhibitor, an HCV polymerase inhibitor, an HCV NS5A inhibitor, or a cyclophilin inhibitor.
• the other DAA is an HCV protease inhibitor, an HCV polymerase inhibitor, or an HCV NS5A inhibitor. More preferably, the other DAA is an HCV NS5A inhibitor, such as those described in US Patent Application Publication Nos. 2010/0317568 and 2012/0004196, both of which are incorporated herein by reference in their entireties. Highly preferably, the other DAA is the compound of Example 35 of US Patent Application Publication No. 2010/0317568. Also, highly preferably, the other DAA is the compound of Example 3.52 of US Patent Application Publication No. 2012/0004196. In one example, the duration of the treatment is 12 weeks. The duration of the treatment can also be, for example, no more than 8 weeks.
• the two or more DAAs are administered in amounts effective to provide a sustained virological response (SVR) or achieve another desired measure of effectiveness in the subject.
• SVR sustained virological response
• the subject is not administered ribavirin during the treatment regimen.
• the subject is also not administered interferon during the treatment regimen.
• the methods exclude the administration of interferon or ribavirin to the subject, thereby avoiding the side effects associated with interferon and ribavirin.
• the present invention features methods for treating a population of subjects having HCV infection.
• the methods comprise administering at least two DAAs to the subjects for a duration of no more than 12 weeks.
• Said at least two DAAs comprise (1) a compound/salt/prodrug according to any aspect, embodiment, example and preference described herein, and (2) another DAA.
• the other DAA can be, for example, selected from an HCV protease inhibitor, an HCV polymerase inhibitor, an HCV NS5A inhibitor, or a cyclophilin inhibitor.
• the other DAA is an HCV protease inhibitor, an HCV polymerase inhibitor, or an HCV NS5A inhibitor.
• the other DAA is an HCV NS5A inhibitor, such as those described in US Patent Application Publication Nos. 2010/0317568 and 2012/0004196, both of which are incorporated herein by reference in their entireties.
• the other DAA is the compound of Example 35 of US Patent Application Publication No. 2010/0317568.
• the other DAA is the compound of Example 3.52 of US Patent Application Publication No. 2012/0004196.
• said at least two DAAs are administered to the subjects in amounts effective to result in SVR or another measure of effectiveness in at least about 70% of the population, preferably at least about 80% of the population, or more preferably at least about 90% of the population.
• the subjects are not administered ribavirin during the treatment regimen.
• the subjects are also not administered interferon during the treatment regimen.
• the methods exclude the administration of interferon or ribavirin to the subject, thereby avoiding the side effects associated with interferon and ribavirin.
• Non-limiting examples of the other DAAs include PSI-7977 (sofosbuvir), PSI-938, BMS- 790052 (daclatasvir), BMS-650032 (asunaprevir), BMS-791325, GS-5885 (ledipasvir), GS-9451 (tegobuvir), GS-9190, GS-9256, BI-201335, BI-27127, telaprevir, VX-222, TMC-435 (simepravir), MK- 5172, MK-7009 (vaniprevir ), danoprevir, paritaprevir, ombitasvir, ABT-493, and R7128 (mericitabine).
• the DAAs can be administered in any effective dosing schemes and/or frequencies; for example, they can each be administered daily.
• Each DAA can be administered either separately or in combination, and each DAA can be administered once a day, twice a day, or three times a day.
• the DAAs employed herein are administered once daily.
• the present invention features a combination of a compound/salt/prodrug according to any aspect, embodiment, example and preference described herein, and another DAA, for use to treat HCV infection.
• the other DAA can be, for example, selected from an HCV protease inhibitor, an HCV polymerase inhibitor, an HCV NS5A inhibitor, or a cyclophilin inhibitor.
• the other DAA is an HCV protease inhibitor, an HCV polymerase inhibitor, or an HCV NS5A inhibitor. More preferably, the other DAA is an HCV NS5A inhibitor, such as those described in US Patent Application Publication Nos.
• the treatment comprises administering the DAAs to a subject infected with HCV.
• the duration of the treatment regimen is no more than twelve weeks (e.g., the duration being 12 weeks; or the duration being 11, 10, 9, 8, 7, 6, 5, 4, or 3 weeks). Preferably, the duration of the treatment regimen is twelve weeks.
• the duration of the treatment can also last, for example, no more than eight weeks (e.g., the duration being 8 weeks; or the duration being 7, 6, 5, 4, or 3 weeks).
• the treatment does not include administering interferon or ribavirin.
• the DAAs can be administered concurrently or sequentially. Preferably, the DAAs are administered once daily.
• the patient being treated is infected with HCV genotype 1, such as genotype la or lb.
• the patient is infected with HCV genotype 2.
• the patient is infected with HCV genotype 3.
• the patient is infected with HCV genotype 4.
• the patient is infected with HCV genotype 5.
• the patient is infected with HCV genotype 6.
• the patient is a HCV -treatment naive patient, a HCV-treatment experienced patient, an interferon non-responder (e.g., a null responder), or not a candidate for interferon treatment.
• the interferon non-responder patients include partial interferon responders and interferon rebound patients.
• the treatment lasts for 12 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In another example, the treatment lasts for 11 weeks, and the subject being treated is a naive patient infected with HCV genotype 1.
• the treatment lasts for 10 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 9 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 8 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 7 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 6 weeks, and the subject being treated is a naive patient infected with HCV genotype 1.
• the treatment lasts for 5 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 4 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 3 weeks, and the subject being treated is a naive patient infected with HCV genotype 1. In yet another example, the treatment lasts for 12 weeks, and the subject being treated is a naive patient infected with HCV genotype. In another example, the treatment lasts for 11 weeks, and the subject being treated is a naive patient infected with HCV selected from genotypes 2, 3, 4, 5 or 6.
• the treatment lasts for 10 weeks, and the subject being treated is a naive patient infected with HCV selected from genotypes 2, 3, 4, 5 or 6. In yet another example, the treatment lasts for 9 weeks, and the subject being treated is a naive patient infected with HCV selected from genotypes 2, 3, 4, 5 or 6. In yet another example, the treatment lasts for 8 weeks, and the subject being treated is a naive patient infected with selected from genotypes 2, 3, 4, 5 or 6. In yet another example, the treatment lasts for 7 weeks, and the subject being treated is a naive patient infected with selected from genotypes 2, 3, 4, 5 or 6.
• the treatment lasts for 6 weeks, and the subject being treated is a naive patient infected with selected from genotypes 2, 3, 4, 5 or 6. In yet another example, the treatment lasts for 5 weeks, and the subject being treated is a naive patient infected with selected from genotypes 2, 3, 4, 5 or 6. In yet another example, the treatment lasts for 4 weeks, and the subject being treated is a naive patient infected with selected from genotypes 2, 3, 4, 5 or 6. In yet another example, the treatment lasts for 3 weeks, and the subject being treated is a naive patient infected with selected from genotypes 2, 3, 4, 5 or 6.
• the treatment lasts for 12 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 11 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 10 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 9 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 8 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 7 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 6 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 5 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 4 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 3 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV genotype 1.
• the treatment lasts for 12 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 1 1 weeks, and the subject being treated is a non- responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 10 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 9 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 8 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 7 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 6 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 5 weeks, and the subject being treated is a non- responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 4 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• the treatment lasts for 3 weeks, and the subject being treated is a non-responder (e.g., a null responder) infected with HCV selected from genotype 2, 3, 4, 5 or 6.
• a treatment regimen of the present invention generally constitutes a complete treatment regimen, i.e., no subsequent interferon-containing regimen is intended.
• a treatment or use described herein generally does not include any subsequent interferon-containing treatment.
• a treatment or use described herein does not include any subsequent ribavirin-containing treatment.
• the methods of the present invention can provide effective treatment of HCV infection without the use of interferon or ribavirin and for a shorter period of time, for example and without limitation, a treatment duration of no more than twelve weeks, alternatively no more than eleven weeks, alternatively no more than ten weeks, alternatively no more than nine weeks, alternatively no more than eight weeks, alternatively no more than seven weeks, alternatively no more than six weeks, alternatively no more than five weeks, alternatively no more than four weeks, or alternatively, no more than three weeks.
• the present invention features methods for treating HCV infection in a subject comprising administering at least two DAAs, in the absence of interferon and ribavirin, to the subject for a duration of no more than twelve weeks, alternatively no more than eight weeks. Put another way, the methods exclude interferon and ribavirin.
• Said at least two DAAs comprise a compound/salt/prodrug according to any aspect, embodiment, example and preference described herein, and another DAA, which can be co-administered, or administered separately or independently, with the same or different dosing frequencies.
• said at least two DAAs are administered once a day. They can also be administered, for example, twice a day or three times a day.
• the other DAA can be, for example, selected from an HCV protease inhibitor, an HCV polymerase inhibitor, an HCV NS5A inhibitor, or a cyclophilin inhibitor.
• the other DAA is an HCV protease inhibitor, an HCV polymerase inhibitor, or an HCV NS5A inhibitor.
• the other DAA is an HCV NS5A inhibitor, such as those described in US Patent Application Publication Nos. 2010/0317568 and 2012/0004196.
• the other DAA is the compound of Example 35 of US Patent Application Publication No. 2010/0317568.
• the other DAA is the compound of Example 3.52 of US Patent Application Publication No. 2012/0004196.
• SVR which, as used herein, means that the virus is undetectable at the end of therapy and for at least 8 weeks after the end of therapy (SVR8); preferably, the virus is undetectable at the end of therapy and for at least 12 weeks after the end of therapy (SVR12); more preferably, the virus is undetectable at the end of therapy and for at least 16 weeks after the end of therapy (SVR16); and highly preferably, the virus is undetectable at the end of therapy and for at least 24 weeks after the end of therapy (SVR24).
• SVR24 is often considered as a functional definition of cure; and a high rate of SVR at less than 24 week post-treatment (e.g., SVR8 or SVR12) can be predictive of a high rate of SVR24.
• a treatment regimen of the invention comprises treating a population of subjects having HCV infection (e.g. treatment naive subjects), and the regimen comprises administering at least two DAAs to the subjects for a duration of no more than 12 weeks, or for another duration disclosed herein, wherein said at least two DAAs comprise a compound/salt/prodrug according to any aspect, embodiment, example and preference described herein, and another DAA, and are administered to the subjects in amounts effective to provide an SVR (e.g., SVR12 or SVR24) in at least about 70% of the population, alternatively at least about 75% of the population, alternatively at least about 80% of the population, alternatively at least about 85% of the population, alternatively at least about 90% of the population, alternatively at least about 95% of the population, alternatively about 100% of the population.
• SVR e.g., SVR12 or SVR24
• the other DAA can be, for example, selected from an HCV protease inhibitor, an HCV polymerase inhibitor, an HCV NS5A inhibitor, or a cyclophilin inhibitor.
• the other DAA is an HCV protease inhibitor, an HCV polymerase inhibitor, or an HCV NS5A inhibitor.
• the other DAA is an HCV NS5A inhibitor, such as those described in US Patent Application Publication Nos. 2010/0317568 and 2012/0004196.
• the other DAA is the compound of Example 35 of US Patent Application Publication No. 2010/0317568.
• the other DAA is the compound of Example 3.52 of US Patent Application Publication No. 2012/0004196.
• a treatment regimen of the invention comprises treating a population of IFN experienced subjects (e.g., interferon non-responders) having HCV infection, and the method comprises administering at least two DAAs to the subjects for a duration of no more than 12 weeks, or for another duration disclosed herein, wherein said at least two DAAs comprise (1) a compound/salt/prodrug according to any aspect, embodiment, example and preference described herein (hereinafter "Compound 1"), and another DAA (hereinafter “Compound 2”), and are administered to the subjects in amounts effective to provide an SVR (e.g., SVR12 or SVR24) in at least about 50% of the population, alternatively at least about 55% of the population, alternatively at least about 60% of the population, alternatively at least about 65% of the population, alternatively at least about 70% of the population, alternatively at least about 75% of the population, alternatively at least about 80% of the population, alternatively at least about 85% of the population, alternatively at least about 90%
• SVR e.g
• Compound 2 can be, for example, selected from an HCV protease inhibitor, an HCV polymerase inhibitor, an HCV NS5A inhibitor, or a cyclophilin inhibitor.
• Compound 2 is an HCV protease inhibitor, an HCV polymerase inhibitor, or an HCV NS5A inhibitor.
• Compound 2 is an HCV NS5A inhibitor, such as those described in US Patent Application Publication Nos. 2010/0317568 and 2012/0004196.
• Compound 2 is the compound of Example 35 of US Patent Application Publication No. 2010/0317568.
• Compound 2 is the compound of Example 3.52 of US Patent Application Publication No. 2012/0004196.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 8 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 7 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 6 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 5 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 4 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 3 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 24 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 13 to 23 weeks (e.g., the duration of the treatment is selected from 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 or 23 weeks) and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 12 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• a HCV polymerase inhibitor can be a nucleoside polymerase inhibitor, a nucleotide polymerase inhibitor, a non-nucleoside polymerase inhibitor, or a non-nucleotide polymerase inhibitor.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 1 1 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 10 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• the present invention features a method of treating HCV infection, comprising administering to a patient in need thereof an effective amount of a combination of at least two DAAs, wherein said at least two DAAs comprise Compound 1 and Compound 2.
• the treatment lasts 9 weeks and does not include administration of any interferon or ribavirin.
• the DAAs can be administered at the same or different dosing frequencies.
• the patient being treated can be a treatment naive patient; a treatment experienced patient, including, but not limited to, a relapser, an interferon partial responder, an interferon non-re sponder, or a null responder; or a patient unable to take interferon.
• the patient may be infected with, for example and without limitation, HCV genotype 1, such as HCV genotype la or HCV genotype lb; or HCV genotype 2 or 3; or HCV genotype 4, 5 or 6.
• HCV genotype 1 such as HCV genotype la or HCV genotype lb
• HCV genotype 2 or 3 such as HCV genotype 4 or 6.
• the treatment according to this aspect of the technology may also be effective against other HCV genotypes.
• the DAAs can be administered around the same time or at different times.
• said at least two DAAs can also include one or more additional DAAs selected from, for example, HCV protease inhibitors, HCV polymerase inhibitors, or HCV NS5A inhibitors.
• Non-limiting examples of such additional DAAs include PSI-7977, PSI-938, TMC-435, BMS-790052, BMS-650032, GS-5885, GS- 9190, GS-9451, BI-201335, BI-207127, telaprevir, VX-222, mericitabine, and danoprevir.
• a method of the present invention can be used to treat a naive patient or a treatment experienced patient. Treatment experienced patients include interferon non-responders (e.g., null responders), partial responders, and relapsers. A method of the present invention can also be used to treat patients who are not candidates for interferon treatment.
• Patients who are not candidates for interferon treatment include, but are not limited to, one or more of the following groups: patients intolerant to interferon, patients who refuse to take interferon treatment, patients with medical conditions which preclude them from taking interferon, and patients who have an increased risk of side effects or infection by taking interferon.
• one or more additional DAAs can be optionally used in the treatment regimen in addition to Compound 1 and Compound 2.
• additional DAAs can be HCV protease inhibitors, HCV nucleoside or nucleotide polymerase inhibitors, HCV non-nucleoside polymerase inhibitors, HCV NS3B inhibitors, HCV NS4A inhibitors, HCV NS5A inhibitors, HCV NS5B inhibitors, HCV entry inhibitors, cyclophilin inhibitors, or combinations thereof.
• HCV protease inhibitors for this purpose include, but are not limited to, telaprevir (Vertex), boceprevir (Merck), BI-201335 (Boehringer Ingelheim), GS-9451 (Gilead), and BMS-650032 (BMS).
• protease inhibitors include, but are not limited to, ACH-1095 (Achillion), ACH- 1625 (Achillion), ACH-2684 (Achillion), AVL-181 (Avila), AVL-192 (Avila), BMS-650032 (BMS), danoprevir (RG7227/ITMN-191, Roche), GS-9132 (Gilead), GS-9256 (Gilead), IDX- 136 (Idenix), IDX- 316 (Idenix), IDX-320 (Idenix), MK-5172 (Merck), narlaprevir (Schering-Plough Corp), PHX- 1766 (Phenomix), TMC-435 (Tibotec), vaniprevir (MK-7009, Merck), VBY708 (Virobay), VX-500 (Vertex), VX-813 (Vertex), VX-985 (Vertex), or a combination thereof
• Preferred non-nucleoside HCV polymerase inhibitors for use in the present invention include, but are not limited to, GS-9190 (Gilead), BI-207127 (Boehringer Ingelheim), and VX-222 (VCH-222) (Vertex & ViraChem).
• Preferred nucleotide HCV polymerase inhibitors include, but are not limited to, PSI-7977 (Gilead), and PSI-938 (Gilead).
• HCV polymerase inhibitors include ANA-598 (Anadys), BI-207127 (Boehringer Ingelheim), BILB-1941 (Boehringer Ingelheim), BMS-791325 (BMS), filibuvir, GL59728 (Glaxo), GL60667 (Glaxo), GS-9669 (Gilead), IDX-375 (Idenix), MK-3281 (Merck), tegobuvir, TMC-647055 (Tibotec), VCH-759 (Vertex & ViraChem), VCH-916 (ViraChem), VX-759 (Vertex), GS-6620 (Gilead), IDX- 102 (Idenix), IDX- 184 (Idenix), INX-189 (Inhibitex), MK-0608 (Merck), RG7128 (Roche), TMC64912 (Medivir), GSK625433 (GlaxoSmithKline), BC
• a polymerase inhibitor may be a nucleoside or nucleotide polymerase inhibitor, such as GS-6620 (Gilead), IDX- 102 (Idenix), IDX-184 (Idenix), INX- 189 (Inhibitex), MK-0608 (Merck), PSI-7977 (Gilead), PSI-938 (Gilead), RG7128 (Roche), TMC64912 (Medivir), ALS-2200 (Alios BioPharma/Vertex), ALS-2158 (Alios BioPharma/Vertex), or a combination therefore.
• GS-6620 Gilead
• IDX- 102 Idenix
• IDX-184 Idenix
• INX- 189 Inhibitex
• MK-0608 Merck
• PSI-7977 Gilead
• PSI-938 Gilead
• RG7128 RG7128
• TMC64912 Medivir
• ALS-2200 Alios
• a polymerase inhibitor may also be a non-nucleoside polymerase inhibitor, such as PF- 00868554 (Pfizer), ANA-598 (Anadys), BI-207127 (Boehringer Ingelheim), BILB-1941 (Boehringer Ingelheim), BMS-791325 (BMS), filibuvir, GL59728 (Glaxo), GL60667 (Glaxo), GS-9669 (Gilead), IDX-375 (Idenix), MK-3281 (Merck), tegobuvir (Gilead),, TMC-647055 (Tibotec), VCH-759 (Vertex & ViraChem), VCH-916 (ViraChem), VX-222 (VCH-222) (Vertex & ViraChem), VX-759 (Vertex), or a combination thereof.
• PF- 00868554 Pfizer
• ANA-598 Anadys
• Preferred NS5A inhibitors include, but are not limited to, BMS-790052 (BMS) and GS-5885 (Gilead).
• suitable NS5A inhibitors include GSK62336805 (GlaxoSmithKline), ACH-2928 (Achillion), AZD2836 (Astra-Zeneca), AZD7295 (Astra-Zeneca), BMS-790052 (BMS), BMS-824393 (BMS), GS-5885 (Gilead), PPI-1301 (Presidio), PPI-461 (Presidio) A-831 (Arrow Therapeutics), A-689 (Arrow Therapeutics) or a combination thereof.
• Non-limiting examples of suitable cyclophilin inhibitors include alisporovir (Novartis & Debiopharm), NM-811 (Novartis), SCY-635 (Scynexis), or a combination thereof.
• HCV entry inhibitors include ITX-4520 (iTherx), ITX- 5061 (iTherx), or a combination thereof.
• the present invention features methods for treating patients infected with HCV genotype 1, such as la or lb.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• the present invention features methods for treating patients with HCV genotype 2 or 3 infection.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• the present invention features methods for treating patients with HCV genotype 2 infection.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• the present invention features methods for treating patients with HCV genotype 3 infection.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• the present invention features methods for treating patients with HCV genotype 4 infection.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• the present invention features methods for treating patients with HCV genotype 5 infection.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• the present invention features methods for treating patients with HCV genotype 6 infection.
• the methods comprise administering to such a patient a combination of at least 2 DAAs for no more than 12 weeks (e.g., the duration being 12 weeks), such as no more than 8 weeks (e.g., the duration being 8 weeks), wherein the treatment does not include administration of either interferon or ribavirin, and said at least 2 DAAs comprise Compound 1 and Compound 2.
• Compound 1 and Compound 2 can be administered in therapeutically effective amounts to provide a SVR (for example, SVR12 or SVR24) after the completion of the treatment.
• the patients may be treatment naive patients or treatment experienced patients.
• the treatment duration can be no more than 12 weeks, including but not limited to, no more than 11 weeks, no more than 10 weeks, no more than 9 weeks, but preferably no more than 8 weeks, no more than 7 weeks, no more than 6 weeks, no more than 5 weeks, no more than 4 weeks, or no more than 3 weeks, e.g., the duration being 12 weeks, or the duration being 8 weeks.
• At least two DAAs comprise Compound 1 and Compound 2
• said at least two DAAs preferably consist of Compound 1 and Compound 2.
• At least two DAAs comprise Compound 1 and Compound 2
• said at least two DAAs preferably consist of Compound 1, Compound 2 and a third DAA.
• the specific dose level for any particular patient will depend upon a variety of factors including the activity of the specific compound employed, the age, body weight, general health, sex, diet, time of administration, route of administration, rate of excretion, drug combination, and the severity of the disease undergoing therapy.
• Compound 1 and Compound 2 may be co-formulated in a single dosage form.
• suitable dosage forms include liquid or solid dosage forms.
• Compound 1 and Compound 2 are formulated in a single solid dosage form in which at least one of the DAAs is in an amorphous form, or highly preferably molecularly dispersed, in a matrix which comprises a pharmaceutically acceptable water-soluble polymer and a pharmaceutically acceptable surfactant.
• the other DAAs can also be in an amorphous form or molecularly dispersed in the matrix, or formulated in different form(s) (e.g., in a crystalline form). More preferably, each of the two DAAs is in an amorphous form, or highly preferably molecularly dispersed, in a matrix which comprises a pharmaceutically acceptable water-soluble polymer and a pharmaceutically acceptable surfactant.
• the patient being treated can be a treatment-naive patient.
• the patient being treated can be an interferon non-responder.
• the patient being treated can be an interferon null-responder.
• the patient being treated can be without cirrhosis.
• the patient being treated can be a cirrhotic patient.
• the patient being treated can be a patient with compensated cirrhosis.

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• 2016
  • 2016-09-02 WO PCT/US2016/050062 patent/WO2017040899A2/fr active Application Filing

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