Classifications

• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J11/00—Normal steroids containing carbon, hydrogen, halogen or oxygen, not substituted in position 3
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
  • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
  • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
  • A61K47/54—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
  • A61K47/542—Carboxylic acids, e.g. a fatty acid or an amino acid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/16—Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/12—Drugs for disorders of the urinary system of the kidneys
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/04—Anorexiants; Antiobesity agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/02—Non-specific cardiovascular stimulants, e.g. drugs for syncope, antihypotensives
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J31/00—Normal steroids containing one or more sulfur atoms not belonging to a hetero ring
  • C07J31/006—Normal steroids containing one or more sulfur atoms not belonging to a hetero ring not covered by C07J31/003
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J9/00—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane
  • C07J9/005—Normal steroids containing carbon, hydrogen, halogen or oxygen substituted in position 17 beta by a chain of more than two carbon atoms, e.g. cholane, cholestane, coprostane containing a carboxylic function directly attached or attached by a chain containing only carbon atoms to the cyclopenta[a]hydrophenanthrene skeleton

Definitions

• non-alcoholic fatty liver disease is a disorder affecting millions of adults in the United States, and refers to conditions where there is an accumulation of excess fat in the liver of people who drink little or no alcohol.
• the most common form of NAFLD is a non-serious condition called hepatic steatosis (fatty liver), in which fat accumulates in the liver cells.
• NAFLD most often presents itself in individuals with a constellation of risk factors called metabolic syndrome, which is characterized by elevated fasting plasma glucose with or without intolerance to post-prandial glucose, being overweight or obese, high blood lipids such as cholesterol and triglycerides and low high-density lipoprotein cholesterol levels, and high blood pressure; but not all patients have all the manifestations of metabolic syndrome.
• Obesity is thought to be the most common cause of NAFLD and some experts estimate that about two-thirds of obese adults and one-half of obese children may have fatty liver.
• NASH non-alcoholic steatohepatitis
• the present invention addresses these needs. Therefore, it is the object of the present invention to provide a novel therapeutic agent to treat liver disorders such as NAFLD and NASH while exhibiting physicochemical, in vitro and/or in vivo ADME (adsorption, distribution, metabolism and excretion) properties superior to known compounds and/or superior pharmacokinetics in vivo.
• ADME adsorption, distribution, metabolism and excretion
• An objective of the present invention is to provide a compound that activates the Farnesoid X receptor (FXR) and is therefore useful to treat FXR related disorders including NAFLD and NASH. Accordingly, the present invention provides Compound 1 :
• the present invention further provides a pharmaceutical composition
• a pharmaceutical composition comprising Compound 1 or a pharmaceutically acceptable salt or amino acid conjugate thereof, and a pharmaceutically acceptable carrier or excipient.
• the present invention also provides a method for treating or preventing a disease or condition activated by FXR, comprising administering to a subject in need thereof an effective amount of Compound 1 or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the present invention also provides for the manufacture of a medicament for treating or preventing a disease or condition activated by FXR, wherein the medicament comprises Compound 1 or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the present invention further provides compositions, including pharmaceutical compositions, for use in treating or preventing a disease or condition activated by FXR, wherein the composition comprises Compound 1 or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• Figure 1 shows the expression levels of FXR Target Gene Panel.
• FXR Farnesoid X receptor
• FXR is a nuclear receptor which acts as a key regulator of cholesterol homeostasis, triglyceride synthesis and lipogenesis (Crawley, Expert Opinion Ther. Patents 2010, 20, 1047-1057). This receptor is expressed in various organs and shown to be involved in many diseases and conditions, including liver diseases, lung diseases, renal diseases, intestinal diseases, and heart diseases, and biological processes, such as glucose metabolism, insulin metabolism, and lipid metabolism.
• Compound 1 or “a compound of the invention” refers to 7 ⁇ ,11 ⁇ - dihydroxy-6a-ethyl-5P-cholan-24-oic acid which has the following chemical structure:
• the invention also comprehends isotopically-labeled Compound 1, or
• isotopes that can be incorporated into the compound of the invention or pharmaceutically acceptable salts or amino acid conjugates thereof include isotopes of hydrogen, carbon, nitrogen, fluorine, such as 3 H, U C, 14 C, and 18 F.
• Tritiated, i.e., 3 H, and carbon-14, i.e., 14 C, isotopes may be used for their ease of preparation and detectability. Further, substitution with heavier isotopes such as deuterium, i.e., 2 H, can afford certain therapeutic advantages resulting from greater metabolic stability, for example increased in vivo half-life or reduced dosage requirements and, hence, may be used in some circumstances.
• Isotopically labeled compounds or pharmaceutically acceptable salts or amino acid conjugates thereof can generally be prepared by carrying out the procedures disclosed in the Scheme and/or in the Examples, by substituting a readily available isotopically labeled reagent for a non-isotopically labeled reagent.
• Compound 1 or pharmaceutically acceptable salts or amino acid conjugates thereof are not isotopically labeled.
• deuterated Compound 1 or pharmaceutically acceptable salts or amino acid conjugates thereof are useful for bioanalytical assays.
• Compound 1 or pharmaceutically acceptable salts or amino acid conjugates thereof are radiolabeled.
• pharmaceutically acceptable salts refer to derivatives of Compound 1 wherein the parent compound is modified by forming a salt of the carboxylic acid moiety.
• pharmaceutically acceptable salts include, but are not limited to, cations such as Na + , K + , Ca 2+ , Mg 2+ , and H4 + are examples of cations present in pharmaceutically acceptable salts.
• Suitable inorganic bases include calcium hydroxide, potassium hydroxide, sodium carbonate and sodium hydroxide. Salts may also be prepared using organic bases, such as salts of primary, secondary and tertiary amines, substituted amines including naturally-occurring substituted amines, and cyclic amines including isopropylamine, trimethylamine,
• phrases "pharmaceutically acceptable carrier” is art-recognized, and includes, for example, pharmaceutically acceptable materials, compositions or vehicles, such as a liquid or solid filler, diluent, excipient, solvent or encapsulating material, involved in carrying or transporting any subject composition from one organ, or portion of the body, to another organ, or portion of the body.
• a pharmaceutically acceptable carrier is non-pyrogenic.
• materials which may serve as pharmaceutically acceptable carriers include: sugars, such as lactose, glucose and sucrose; starches, such as corn starch and potato starch; cellulose, and its derivatives, such as sodium carboxymethyl cellulose, ethyl cellulose and cellulose acetate; powdered tragacanth; malt; gelatin; talc; excipients, such as cocoa butter and suppository waxes; oils, such as peanut oil, cottonseed oil, sunflower oil, sesame oil, olive oil, corn oil and soybean oil; glycols, such as propylene glycol; polyols, such as glycerin, sorbitol, mannitol and polyethylene glycol; esters, such as ethyl oleate and ethyl laurate; agar; buffering agents, such as magnesium hydroxide and aluminum hydroxide; alginic acid; pyrogen-free water; isotonic saline; Ringer' s solution;
• compositions or “pharmaceutical composition” is a formulation containing a compound of the invention or a salt or amino acid conjugate thereof.
• the pharmaceutical composition is in bulk or in unit dosage form.
• the unit dosage form is any of a variety of forms, including, for example, a capsule, an IV bag, a tablet, a single pump on an aerosol inhaler, or a vial.
• the quantity of active ingredient (e.g., a formulation of a compound of the invention or salts thereof) in a unit dose of composition is an effective amount and is varied according to the particular treatment involved.
• active ingredient e.g., a formulation of a compound of the invention or salts thereof
• the dosage will also depend on the route of administration.
• routes including oral, ocular, ophthalmic, pulmonary, rectal, parenteral, transdermal, subcutaneous, intravenous, intramuscular, intraperitoneal, intranasal, and the like.
• Dosage forms for the topical or transdermal administration of a compound of the invention include powders, sprays, ointments, pastes, creams, lotions, gels, solutions, patches and inhalants.
• Compound 1 is mixed under sterile conditions with a pharmaceutically acceptable carrier, and with any preservatives, buffers, or propellants that are required.
• treating refers to relieving, lessening, reducing, eliminating, modulating, or ameliorating, i.e., causing regression of the disease state or condition.
• preventing refers to completely or almost completely stop a disease state or condition, from occurring in a patient or subject, especially when the patient or subject is predisposed to such or at risk of contracting a disease state or condition.
• Preventing can also include inhibiting, i.e., arresting the development, of a disease state or condition, and relieving or ameliorating, i.e., causing regression of the disease state or condition, for example when the disease state or condition may already be present.
• reducing the risk of refers to lowering the likelihood or probability of a central nervous system disease, inflammatory disease and/or metabolic disease from occurring in a patient, especially when the subject is predisposed to such occurrence.
• “Combination therapy” refers to the administration of a compound of the invention and at least a second agent as part of a specific treatment regimen intended to provide the beneficial effect from the co-action of these therapeutic agents ⁇ i.e., the compound of the invention and at least a second agent).
• the beneficial effect of the combination includes, but is not limited to, pharmacokinetic or pharmacodynamic co-action resulting from the combination of therapeutic agents.
• Administration of these therapeutic agents in combination typically is carried out over a defined time period (usually minutes, hours, days or weeks depending upon the combination selected).
• “Combination therapy” may, but generally is not, intended to encompass the administration of two or more of these therapeutic agents as part of separate monotherapy regimens that incidentally and arbitrarily result in the combinations of the present application.
• Combination therapy is intended to embrace administration of this therapeutic agent in a sequential manner, that is, wherein the therapeutic agent is administered at a different time, as well as administration of this therapeutic agent, or at least two therapeutic agents, in a substantially simultaneous manner.
• Substantially simultaneous administration can be accomplished, for example, by administering to the subject a single capsule having a fixed ratio of a therapeutic agent or in multiple, single capsules for each of the therapeutic agents.
• Sequential or substantially simultaneous administration of each therapeutic agent can be effected by any appropriate route including, but not limited to, oral routes, intravenous routes, intramuscular routes, and direct absorption through mucous membrane tissues.
• the therapeutic agent can be administered by the same route or by different routes.
• a first therapeutic agent of the combination selected may be administered by intravenous injection while the other therapeutic agents of the combination may be administered orally.
• all therapeutic agents may be administered orally or all therapeutic agents may be administered by intravenous injection.
• the sequence in which the therapeutic agents are administered is not narrowly critical.
• Combination therapy also embraces the administration of the therapeutic agent as described above in further combination with other biologically active ingredients and non- drug therapies (e.g., surgery or mechanical treatments).
• the combination therapy further comprises a non-drug treatment
• the non-drug treatment may be conducted at any suitable time so long as a beneficial effect from the co-action of the combination of the therapeutic agents and non-drug treatment is achieved. For example, in appropriate cases, the beneficial effect is still achieved when the non-drug treatment is temporally removed from the administration of the therapeutic agents, perhaps by days or even weeks.
• an "effective amount" of a compound of the invention is an amount (quantity or concentration) of the compound to produce the desired pharmacological effect. In one embodiment, when an effective amount of a compound is administered to a subject in need of treatment symptoms arising from the disease are ameliorated immediately or after
• the amount of the compound to be administered to a subject will depend on the particular disorder, the mode of administration, co-administered compounds, if any, and the characteristics of the subject, such as general health, other diseases, age, sex, genotype, body weight, and tolerance to drugs. The skilled artisan will be able to determine appropriate dosages depending on these and other factors.
• prophylactically effective amount means an amount (quantity or concentration) of a compound of the present invention, or a combination of compounds, that is administered to prevent or reduce the risk of a disease - in other words, an amount needed to provide a preventative or prophylactic effect.
• amount of the present compound to be administered to a subject will depend on the particular disorder, the mode of administration, co-administered compounds, if any, and the characteristics of the subject, such as general health, other diseases, age, sex, genotype, body weight, and tolerance to drugs. The skilled artisan will be able to determine appropriate dosages depending on these and other factors.
• a "subject” includes mammals, e.g., humans, companion animals (e.g., dogs, cats, birds, and the like), farm animals (e.g., cows, sheep, pigs, horses, and the like), and laboratory animals (e.g., rats, mice, guinea pigs, and the like). Typically, the subject is human.
• companion animals e.g., dogs, cats, birds, and the like
• farm animals e.g., cows, sheep, pigs, horses, and the like
• laboratory animals e.g., rats, mice, guinea pigs, and the like.
• the subject is human.
• a “pharmaceutical composition” is a formulation containing a compound of the invention in a form suitable for administration to a subject.
• the pharmaceutical composition is in bulk or in unit dosage form. It can be advantageous to formulate compositions in dosage unit form for ease of administration and uniformity of dosage.
• Dosage unit form as used herein refers to physically discrete units suited as unitary dosages for the subject to be treated; each unit containing a predetermined quantity of active reagent calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier.
• the specification for the dosage unit forms are dictated by and directly dependent on the unique characteristics of the active reagent and the particular therapeutic effect to be achieved, and the limitations inherent in the art of compounding such an active agent for the treatment of individuals.
• Possible formulations include those suitable for oral, sublingual, buccal, parenteral (e.g., subcutaneous, intramuscular, or intravenous), rectal, topical including transdermal, intranasal and inhalation administration. Most suitable means of administration for a particular patient will depend on the nature and severity of the disease being treated or the nature of the therapy being used and on the nature of the active compound, but where possible, oral administration may be used for the prevention and treatment of FXR activated diseases and conditions.
• Formulations suitable for oral administration may be provided as discrete units, such as tablets, capsules, cachets, lozenges, each containing a predetermined amount of the active compound; as powders or granules; as solutions or suspensions in aqueous or non-aqueous liquids; or as oil-in-water or water-in-oil emulsions.
• Formulations suitable for sublingual or buccal administration include lozenges comprising the active compound and, typically a flavored base, such as sugar and acacia or tragacanth and pastilles comprising the active compound in an inert base, such as gelatin and glycerin or sucrose acacia.
• Formulations suitable for parenteral administration typically comprise sterile aqueous solutions containing a predetermined concentration of the active compound; the solution may be isotonic with the blood of the intended recipient. Additional formulations suitable for parenteral administration include formulations containing physiologically suitable co-solvents and/or complexing agents such as surfactants and cyclodextrins. Oil-in-water emulsions are also suitable formulations for parenteral formulations. Although such solutions may be administered intravenously, they may also be administered by subcutaneous or intramuscular injection.
• Formulations suitable for rectal administration may be provided as unit-dose suppositories comprising the active ingredient in one or more solid carriers forming the suppository base, for example, cocoa butter.
• Formulations suitable for topical or intranasal application include ointments, creams, lotions, pastes, gels, sprays, aerosols, and oils.
• Suitable carriers for such formulations include petroleum jelly, lanolin, polyethyleneglycols, alcohols, and combinations thereof.
• Formulations of the invention may be prepared by any suitable method, typically by uniformly and intimately admixing the active compound with liquids or finely divided solid carriers or both, in the required proportions and then, if necessary, shaping the resulting mixture into the desired shape.
• a tablet may be prepared by compressing an intimate mixture comprising a powder or granules of the active ingredient and one or more optional ingredients, such as a binder, lubricant, inert diluent, or surface active dispersing agent, or by molding an intimate mixture of powdered active ingredient and inert liquid diluent.
• Suitable formulations for administration by inhalation include fine particle dusts or mists which may be generated by means of various types of metered dose pressurized aerosols, nebulizers, or insufflators.
• the particle size of the powder or droplets is typically in the range of 0.5-10 ⁇ , or may be about 1-5 ⁇ , to ensure delivery into the bronchial tree.
• a particle size in the range of 10-500 ⁇ may be used to ensure retention in the nasal cavity.
• Metered dose inhalers are pressurized aerosol dispensers, typically containing a suspension or solution formulation of the active ingredient in a liquefied propellant. During use, these devices discharge the formulation through a valve adapted to deliver a metered volume, typically from 10 to 150 ⁇ , to produce a fine particle spray containing the active ingredient.
• Suitable propellants include certain chlorofluorocarbon compounds, for example, dichlorodifluoromethane, trichlorofluoromethane, dichlorotetrafluoroethane, and mixtures thereof.
• the formulation may additionally contain one or more co-solvents, for example, ethanol surfactants, such as oleic acid or sorbitan trioleate, anti-oxidants and suitable flavoring agents.
• Nebulizers are commercially available devices that transform solutions or suspensions of the active ingredient into a therapeutic aerosol mist either by means of acceleration of a compressed gas typically air or oxygen, through a narrow venturi orifice, or by means of ultrasonic agitation.
• Suitable formulations for use in nebulizers consist of the active ingredient in a liquid carrier and comprise up to 40% w/w of the formulation, preferably less than 20% w/w.
• the carrier is typically water or a dilute aqueous alcoholic solution, preferably made isotonic with body fluids by the addition of, for example, sodium chloride.
• Optional additives include preservatives if the formulation is not prepared sterile, for example, methyl hydroxy-benzoate, anti-oxidants, flavoring agents, volatile oils, buffering agents, and surfactants.
• Suitable formulations for administration by insufflation include finely comminuted powders which may be delivered by means of an insufflator or taken into the nasal cavity in the manner of a snuff.
• the powder is contained in capsules or cartridges, typically made of gelatin or plastic, which are either pierced or opened in situ and the powder delivered by air drawn through the device upon inhalation or by means of a manually- operated pump.
• the powder employed in the insufflator consists either solely of the active ingredient or of a powder blend comprising the active ingredient, a suitable powder diluent, such as lactose, and an optional surfactant.
• the active ingredient typically comprises from 0.1 to 100 % w/w of the formulation.
• the present invention provides a pharmaceutical composition
• a pharmaceutical composition comprising, as active ingredient, a compound of the invention together, and/or in admixture, with at least one pharmaceutical carrier or diluent.
• These pharmaceutical compositions may be used in the prevention or treatment of the foregoing diseases or conditions.
• the carrier is pharmaceutically acceptable and must be compatible with, i.e. not have a deleterious effect upon, the other ingredients in the composition.
• the carrier may be a solid or liquid and is preferably formulated as a unit dose formulation, for example, a tablet which may contain from 0.05 to 95% by weight of the active ingredient. If desired, other physiologically active ingredients may also be incorporated in the pharmaceutical
• compositions of the invention are provided.
• formulations of the present invention may include other agents known to those skilled in the art of pharmacy, having regard for the type of formulation in issue.
• formulations suitable for oral administration may include flavoring agents and formulations suitable for intranasal administration may include perfumes.
• the compound of the invention is useful for therapy in subjects such as mammals, including humans.
• the compound of the invention is useful in a method of treating or preventing a disease or condition in a subject comprising administering to the subject in need thereof an effective amount of a compound of the invention or a
• the disease or condition is activated by FXR-activation ⁇ e.g., FXR plays a role in the initiation or progress of the disease or condition).
• FXR plays a role in the initiation or progress of the disease or condition.
• the disease or condition is selected from cardiovascular disease, chronic liver disease, lipid disorder, gastrointestinal disease, renal disease, metabolic disease, cancer, and neurological disease.
• the invention relates to a method of treating or preventing cardiovascular disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• cardiovascular disease selected from atherosclerosis, arteriosclerosis, dyslipidemia, hypercholesteremia, hyperlipidemia, hyperlipoproteinemia, and hypertriglyceridemia.
• hyperlipidemia refers to the presence of an abnormally elevated level of lipids in the blood. Hyperlipidemia can appear in at least three forms: hypercholesterolemia, i.e., an elevated cholesterol level; hypertriglyceridemia, i.e., an elevated triglyceride level; and combined hyperlipidemia, i.e., a combination of hypercholesterolemia and
• dislipidemia refers to abnormal levels of lipoproteins in blood plasma including both depressed and/or elevated levels of lipoproteins ⁇ e.g., elevated levels of LDL, VLDL and depressed levels of HDL).
• the invention relates to a method selected from reducing cholesterol levels or modulating cholesterol metabolism, catabolism, absorption of dietary cholesterol, and reverse cholesterol transport in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a
• the invention in another embodiment, relates to a method of treating or preventing a disease affecting cholesterol, triglyceride, or bile acid levels in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of lowering triglycerides in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating or preventing a disease state associated with an elevated cholesterol level in a subject, comprising
• the invention relates to a method of treating a disease state associated with an elevated cholesterol level in a subject. In one embodiment, the invention relates to a method of preventing a disease state associated with an elevated cholesterol level in a subject.
• the disease state is selected from coronary artery disease, angina pectoris, carotid artery disease, strokes, cerebral arteriosclerosis, and xanthoma.
• the invention relates to a method of treating or preventing a lipid disorder in a subject, comprising administering to the subject in need thereof an effective amount of Compound 1 or a pharmaceutically acceptable salt or amino acid conjugate thereof. In one embodiment, the invention relates to a method of treating a lipid disorder. In one embodiment, the invention relates to a method of preventing a lipid disorder.
• Lipid disorders are the term for abnormalities of cholesterol and triglycerides. Lipid abnormalities are associated with an increased risk for vascular disease, and especially heart attacks and strokes. Abnormalities in lipid disorders are a combination of genetic
• lipid disorders are associated with being overweight. Lipid disorders may also be associated with other diseases including diabetes, the metabolic syndrome (sometimes called the insulin resistance syndrome), underactive thyroid or the result of certain medications (such as those used for anti -rejection regimens in people who have had transplants).
• diabetes sometimes called the insulin resistance syndrome
• underactive thyroid or the result of certain medications (such as those used for anti -rejection regimens in people who have had transplants).
• the invention relates to a method of treating or preventing one or more symptoms of disease affecting lipid metabolism (i.e., lipodystrophy) in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating one or more symptoms of a disease affecting lipid metabolism.
• the invention relates to a method of preventing one or more symptoms of a disease affecting lipid metabolism.
• the invention relates to a method of decreasing lipid accumulation in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating or preventing chronic liver disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof. In one embodiment, the invention relates to a method of treating chronic liver disease. In one embodiment, the invention relates to a method of preventing chronic liver disease.
• the chronic liver disease is selected from primary biliary cirrhosis (PBC) (also known as primary biliary cholangitis (PBC)), cerebrotendinous xanthomatosis (CTX), primary sclerosing cholangitis (PSC), drug induced cholestasis, intrahepatic cholestasis of pregnancy, parenteral nutrition associated cholestasis (PNAC), bacterial overgrowth or sepsis associated cholestasis, autoimmune hepatitis, chronic viral hepatitis, alcoholic liver disease, nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), liver transplant associated graft versus host disease, living donor transplant liver regeneration, congenital hepatic fibrosis, choledocholithiasis, granulomatous liver disease, intra- or extrahepatic malignancy, Sjogren's syndrome, Sarcoidosis, Wilson's disease, Gaucher's
• the invention relates to a method of treating or preventing one or more symptoms of cholestasis, including complications of cholestasis in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating one or more symptoms of cholestasis.
• the invention relates to preventing one or more symptoms of cholestasis.
• Intrahepatic cholestasis is typically caused by factors within the liver (intrahepatic) or outside the liver (extrahepatic) and leads to the accumulation of bile salts, bile pigment bilirubin, and lipids in the blood stream instead of being eliminated normally.
• Intrahepatic cholestasis is characterized by widespread blockage of small ducts or by disorders, such as hepatitis, that impair the body's ability to eliminate bile.
• Intrahepatic cholestasis may also be caused by alcoholic liver disease, primary biliary cirrhosis, cancer that has spread (metastasized) from another part of the body, primary sclerosing cholangitis, gallstones, biliary colic, and acute cholecystitis. It can also occur as a complication of surgery, serious injury, cystic fibrosis, infection, or intravenous feeding or be drug induced. Cholestasis may also occur as a complication of pregnancy and often develops during the second and third trimesters.
• Extrahepatic cholestasis is most often caused by choledocholithiasis (Bile Duct Stones), benign biliary strictures (non-cancerous narrowing of the common duct), cholangiocarcinoma (ductal carcinoma), and pancreatic carcinoma. Extrahepatic cholestasis can occur as a side effect of many medications.
• a compound of the invention may be used for treating or preventing one or more symptoms of intrahepatic or extrahepatic cholestasis, including without limitation, biliary atresia, obstetric cholestasis, neonatal cholestasis, drug induced cholestasis, cholestasis arising from Hepatitis C infection, chronic cholestatic liver disease such as primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC).
• PBC primary biliary cirrhosis
• PSC primary sclerosing cholangitis
• the invention relates to a method of enhancing liver regeneration in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the method is enhancing liver regeneration for liver
• the invention relates to a method of treating or preventing fibrosis in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof. In one embodiment, the invention relates to a method of treating fibrosis. In one embodiment, the invention relates to a method of preventing fibrosis.
• fibrosis refers to all recognized fibrotic disorders, including fibrosis due to pathological conditions or diseases, fibrosis due to physical trauma (“traumatic fibrosis”), fibrosis due to radiation damage, and fibrosis due to exposure to chemotherapeutics.
• organ fibrosis includes but is not limited to liver fibrosis, fibrosis of the kidneys, fibrosis of lung, and fibrosis of the intestine.
• Traumatic fibrosis includes but is not limited to fibrosis secondary to surgery (surgical scarring), accidental physical trauma, burns, and hypertrophic scarring.
• liver fibrosis includes liver fibrosis due to any cause, including but not limited to virally-induced liver fibrosis such as that due to hepatitis B or C virus;
• alcohol alcoholic liver disease
• certain pharmaceutical compounds including but not limited to methotrexate, some chemotherapeutic agents, and chronic ingestion of arsenicals or vitamin A in megadoses, oxidative stress, cancer radiation therapy or certain industrial chemicals including but not limited to carbon tetrachloride and
• dimethylnitrosamine dimethylnitrosamine
• diseases such as primary biliary cirrhosis, primary sclerosing cholangitis, fatty liver, obesity, non-alcoholic steatohepatitis, cystic fibrosis,
• liver fibrosis hemochromatosis, auto-immune hepatitis, and steatohepatitis.
• Current therapy in liver fibrosis is primarily directed at removing the causal agent, e.g., removing excess iron (e.g., in the case of hemochromatosis), decreasing viral load (e.g., in the case of chronic viral hepatitis), or eliminating or decreasing exposure to toxins (e.g., in the case of alcoholic liver disease).
• Anti-inflammatory drugs such as corticosteroids and colchicine are also known for use in treating inflammation that can lead to liver fibrosis.
• liver fibrosis may be clinically classified into five stages of severity (SO, S I, S2, S3, and S4), usually based on histological examination of a biopsy specimen. SO indicates no fibrosis, whereas S4 indicates cirrhosis. While various criteria for staging the severity of liver fibrosis exist, in general early stages of fibrosis are identified by discrete, localized areas of scarring in one portal (zone) of the liver, whereas later stages of fibrosis are identified by bridging fibrosis (scarring that crosses zones of the liver).
• the invention relates to a method of treating or preventing organ fibrosis in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the fibrosis is liver fibrosis.
• the invention relates to a method of treating or preventing gastrointestinal disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating gastrointestinal disease.
• the invention relates to a method of preventing gastrointestinal disease.
• the gastrointestinal disease is selected from inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), bacterial overgrowth, malabsorption, post-radiation colitis, and microscopic colitis.
• the inflammatory bowel disease is selected from Crohn's disease and ulcerative colitis.
• the invention relates to a method of treating or preventing renal disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating renal disease.
• the invention relates to a method of preventing renal disease.
• the renal disease is selected from diabetic nephropathy, focal segmental glomerulosclerosis (FSGS), hypertensive nephrosclerosis, chronic glomerulonephritis, chronic transplant glomerulopathy, chronic interstitial nephritis, and polycystic kidney disease.
• FSGS focal segmental glomerulosclerosis
• hypertensive nephrosclerosis chronic glomerulonephritis
• chronic transplant glomerulopathy chronic interstitial nephritis
• chronic interstitial nephritis chronic interstitial nephritis
• polycystic kidney disease polycystic kidney disease
• the invention relates to a method of treating or preventing metabolic disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating renal disease.
• the invention relates to a method of preventing renal disease.
• the metabolic disease is selected from insulin resistance, hyperglycemia, diabetes mellitus, diabesity, and obesity.
• the diabetes mellitus is type I diabetes.
• the diabetes mellitus is type II diabetes.
• Diabetes mellitus commonly called diabetes, refers to a disease or condition that is generally characterized by metabolic defects in production and utilization of glucose which result in the failure to maintain appropriate blood sugar levels in the body.
• type II diabetes the disease is characterized by insulin resistance, in which insulin loses its ability to exert its biological effects across a broad range of insulin resistance, in which insulin loses its ability to exert its biological effects across a broad range of insulin resistance, in which insulin loses its ability to exert its biological effects across a broad range of insulin resistance, in which insulin loses its ability to exert its biological effects across a broad range of insulin resistance, in which insulin loses its ability to exert its biological effects across a broad range of
• hyperglycemia is associated with increased and premature mortality due to an increased risk for microvascular and macrovascular diseases, including retinopathy (the impairment or loss of vision due to blood vessel damage in the eyes); neuropathy (nerve damage and foot problems due to blood vessel damage to the nervous system); and nephropathy (kidney disease due to blood vessel damage in the kidneys), hypertension, cerebrovascular disease, and coronary heart disease. Therefore, control of glucose homeostasis is a critically important approach for the treatment of diabetes.
• Insulin resistance has been hypothesized to unify the clustering of hypertension, glucose intolerance, hyperinsulinemia, increased levels of triglyceride and decreased HDL cholesterol, and central and overall obesity.
• the association of insulin resistance with glucose intolerance, an increase in plasma triglyceride and a decrease in high-density lipoprotein cholesterol concentrations, hypertension, hyperuricemia, smaller denser low- density lipoprotein particles, and higher circulating levels of plasminogen activator inhibitor-1 has been referred to as "Syndrome X".
• methods of treating or preventing any disorders related to insulin resistance including the cluster of disease states, conditions or disorders that make up "Syndrome X" are provided.
• the invention relates to a method of treating or preventing metabolic syndrome in a subject, comprising
• the invention relates to a method of treating metabolic syndrome. In another embodiment, the invention relates to a method of preventing metabolic syndrome.
• the invention relates to a method of treating or preventing cancer in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating cancer.
• the invention relates to a method of preventing cancer.
• the cancer is selected from hepatocellular carcinoma, colorectal cancer, gastric cancer, renal cancer, prostate cancer, adrenal cancer, pancreatic cancer, breast cancer, bladder cancer, salivary gland cancer, ovarian cancer, uterine body cancer, and lung cancer.
• the cancer is hepatocellular carcinoma.
• the cancer is colorectal cancer.
• the cancer is gastric cancer. In one embodiment, the cancer is renal cancer. In one embodiment, the cancer is prostate cancer. In one embodiment, the cancer is adrenal cancer. In one embodiment, the cancer is pancreatic cancer. In one embodiment, the cancer is breast cancer. In one embodiment, the cancer is bladder cancer. In one embodiment, the cancer is salivary gland cancer. In one embodiment, the cancer is ovarian cancer. In one embodiment, the cancer is uterine body cancer. In one embodiment, the cancer is lung cancer.
• At least one of an agent selected from Sorafenib, Sunitinib, Erlotinib, or Imatinib is co-administered with the compound of the invention to treat cancer.
• Appropriate treatment for cancers depends on the type of cell from which the tumor derived, the stage and severity of the malignancy, and the genetic abnormality that contributes to the tumor.
• Cancer staging systems describe the extent of cancer progression. In general, the staging systems describe how far the tumor has spread and puts patients with similar prognosis and treatment in the same staging group. In general, there are poorer prognoses for tumors that have become invasive or metastasized.
• stage I cancers are often localized and are usually curable.
• Stage II and IIIA cancers are usually more advanced and may have invaded the surrounding tissues and spread to lymph nodes.
• Stage IV cancers include metastatic cancers that have spread to sites outside of lymph nodes.
• TNM staging which stands for the categories: Tumor,
• T classifies the extent of a primary tumor from 0 to 0
• N classifies the extent of lymph node involvement with 0 representing a malignancy with no lymph node involvement and 4 representing a malignancy with extensive lymph node involvement.
• M classifies the extent of metastasis from 0 to 1 with 0 representing a malignancy with no metastases and 1 representing a malignancy with metastases.
• the invention relates to a method of treating or preventing gallstones in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof. In one embodiment, the invention relates to a method of treating gallstones. In one embodiment, the invention relates to a method of preventing gallstones.
• a gallstone is a crystalline concretion formed within the gallbladder by accretion of bile components. These calculi are formed in the gallbladder but may distally pass into other parts of the biliary tract such as the cystic duct, common bile duct, pancreatic duct, or the ampulla of Vater. Rarely, in cases of severe inflammation, gallstones may erode through the gallbladder into adherent bowel potentially causing an obstruction termed gallstone ileus.
• Presence of gallstones in the gallbladder may lead to acute cholecystitis, an inflammatory condition characterized by retention of bile in the gallbladder and often secondary infection by intestinal microorganisms, predominantly Escherichia coli, and Bacteroides species.
• the invention relates to a method of treating or preventing cholesterol gallstone disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating cholesterol gallstone disease.
• the invention relates to a method of preventing cholesterol gallstone disease.
• the invention relates to a method of treating or preventing neurological disease in a subject, comprising administering to the subject in need thereof an effective amount of a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention relates to a method of treating neurological disease.
• the invention relates to a method of preventing neurological disease.
• the neurological disease is stroke.
• the invention relates to a method as described herein and further wherein, the compound is administered by a route selected from oral, parenteral,
• the route is oral.
• the compound utilized in one or more of the methods described herein is an FXR agonist.
• the compound is a selective FXR agonist.
• the compound does not activate TGR5.
• the compound does not activate other nuclear receptors involved in metabolic pathways (e.g., as measured by an AlphaScreen assay).
• such other nuclear receptors involved in metabolic pathways are selected from LXRp, PXR, CAR, PPARa, PPAR6, PPARv, RAR, RARa, VDR, TR, PR, RXR, GR, and ER.
• the compound induces apoptosis.
• the invention relates to a method of regulating the expression level of one or more genes involved in bile acid homeostasis.
• the invention relates to a method of down regulating the expression level of one or more genes selected from CYP7od and SREBP-IC in a cell by administering to the cell a compound of the invention. In one embodiment, the invention relates to a method of up regulating the expression level of one or more genes selected from
• OSTa OSTa
• OSTp BSEP
• SHP UGT2B4
• MRP2 FGF-19
• PPARy PPARy
• PLTP PLTP
• APOCII PEPCK
• the invention also relates to the manufacture of a medicament for treating or preventing a disease or condition (e.g., a disease or condition activated by FXR), wherein the medicament comprises a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• a disease or condition e.g., a disease or condition activated by FXR
• the invention relates to the manufacture of a medicament for treating or preventing any one of the diseases or conditions described herein above, wherein the medicament comprises a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the invention also relates to a composition for use in a method for treating or preventing a disease or condition (e.g., a disease or condition activated by FXR), wherein the composition comprises a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• a disease or condition e.g., a disease or condition activated by FXR
• the invention relates to a composition for use in a method for treating or preventing any one of the diseases or conditions described herein above, wherein the composition comprises a compound of the invention or a pharmaceutically acceptable salt or amino acid conjugate thereof.
• the methods of the invention comprise the step of administering an effective amount of a compound of the invention.
• an "effective amount" refers to an amount of a compound of the invention which is sufficient to achieve the stated effect.
• an effective amount of a compound of the invention used in a method for the prevention or treatment of FXR activated diseases or conditions will be an amount sufficient to prevent or treat the FXR activated disease or condition.
• an effective amount of a compound of the invention for use in a method for the prevention or treatment of a cholestatic liver disease or increasing bile flow will be an amount sufficient to increase bile flow to the intestine.
• a typical daily dose for the treatment of a FXR activated disease and condition may be expected to lie in the range of from about 0.01 mg/kg to about 100 mg/kg.
• This dose may be administered as a single unit dose or as several separate unit doses or as a continuous infusion. Similar dosages would be applicable for the treatment of other diseases, conditions and therapies including the prevention and treatment of cholestatic liver diseases.
• Compound 1 was prepared according to the procedures described in Scheme 1 and from 7a,l ip-dihydroxy-6a-ethyl-5P-cholan-24-oic acid (Al) as the starting material.
• Al was prepared by methods known in the art. For example, Al can be prepared by the procedures described in PCT Publication No. WO 2014/184271.
• Reagents and conditions a) MeOH, ?-TSA; b) Fetizon's Reagent, dry toluene, reflux; c) NaOH, MeOH; d) KOH, ⁇ 2 ⁇ 2 ⁇ 2 0, ethylene glycol, reflux.
• Methyl 7a,lip-dihydroxy-6a-ethyl-3-oxo-5p-cholan-24-oate (A2): A solution of Al (0.46 mmol) and p-TS (0.046 mmol) in MeOH (5 mL) was reacted overnight. The solvent was removed under reduced pressure, the residue was dissolved in ethyl acetate (10 mL) and washed with a saturated solution of NaHC0 3 up to neutral pH. The aqueous phase was extracted with EtOAc and the combined organic layers washed with brine, dried over anhydrous Na 2 S0 4 and concentrated under vacuum.
• Methyl 7a, l ip-dihydroxy-6a-ethyl-3-oxo-5P-cholan-24-oate (A2) (150 mg) was stirred with a methanolic solution of NaOH overnight. The solvent was evaporated under reduced pressure and the residual dissolved in water and washed with Et 2 0. The aqueous phase was acidified with HCl 3 N up to pH 1, extracted with CHCh and the collected organic layers washed with H 2 0, brine, dried over anhydrous Na 2 S0 4 and concentrated under vacuum. The crude was purified by flash chromatography on silica gel using a mixture of petroleum ether and ethyl acetate as eluting solvent system.
• the crude was purified by reverse phase CI 8 flash chromatography using H 2 0-MeOH as eluting solvent system thus obtaining 7a, 11 ⁇ - dihydroxy-6a-ethyl-5P-cholan-24-oic acid (1) as a white solid.
• the prospect of a compound as a drug candidate may be evaluated using various assays known in the art.
• FXR its activity and selectivity can be evaluated using AlphaScreen (biochemical assay); gene expression can be evaluated using RT-PCR (FXR target gene); and cytotoxicity (e.g., HepG2) can be evaluated using ATP content, LDH release, and Caspase-3 activation.
• TGR5 cell- based assay
• gene expression can be evaluated using RT-PCR (TGR5 target gene (i.e., cFOS)); and cytotoxicity (e.g., HepG2) can be evaluated using ATP content, LDH release, and Caspase-3 activation.
• cFOS RT-PCR
• cytotoxicity e.g., HepG2
• ECDCA 6-alpha-ethyl chenodeoxycholic acid, or 6a-ethyl-3a,7a-dihydroxy-5 -cholan-24- oic acid.
• Compound B is , which is also known as INT-767 or 6a-ethyl-
• Compound F is , which is also known as 3 ⁇ ,7 ⁇ , 1 ip-dihydroxy-6a- ethyl-5P-cholan-24-oic acid.
• ligand-bound nuclear receptors modulate initiation of transcription by directly interacting with the basal transcriptional machinery or by contacting bridging factors called coactivators (Onate, et al, Science, 1995, 270, 1354-1357; Wang, et al, J Biol Chem, 1998, 273, 30847-30850; and Zhu, et al, Gene Expr, 1996, 6, 185-195).
• AF-2 activation function 2
• NR box nuclear receptor boxes
• AlphaScreen was used with the aim of identifying novel modulators by taking advantage of the bimolecular interaction prevailing between FXR and the LXXLL motif present in the NR box of the steroid receptor coactivator 1 (SRC-1).
• Human FXR-LBD-GST was incubated with increasing concentrations of the indicated ligands in the presence of biotinylated LXXLL SRC-1 peptide.
• the AlphaScreen signal increases when the complex receptor-coactivator is formed.
• the compound of this invention is a potent FXR agonists. Data are provided in Table 1.
• Bile acids modulate not only several nuclear hormone receptors, but are also agonists for the G protein-coupled receptor (GPCR) TGR5 (Makishima, et al, Science, 1999, 284, 1362-1365; Parks, et al, Science, 1999, 284, 1365-1368; Maruyama, et al, Biochem Biophys Res Commun, 2002, 298, 714-719; and Kawamata, et al, J Biol Chem, 2003, 278, 9435-9440). Signaling via FXR and TGR5 modulates several metabolic pathways, regulating not only BA synthesis and enterohepatic recirculation, but also triglyceride, cholesterol, glucose, and energy homeostasis.
• GPCR G protein-coupled receptor
• the selectivity of Compound 1 against the following nuclear receptors involved in the metabolic pathways can be evaluated: LXRa, LXRp, PXR, CAR, PPARa, PPAR6, PPARy, RAR, RARa, VDR, TR, PR, RXRa, GR, and ER.
• Compound 1 to modulate FXR target genes.
• quantitative RT-PCR assays are performed (see Figure 1).
• HepG2 cells are selected as a relevant cell line to determine whether a compound of the invention can regulate the endogenous FXR genetic network.
• the ability of a compound of the invention to induce FXR target genes is assessed by isolating total RNA from cells treated overnight with 1 ⁇ of comparative compounds and a compound of the invention.
• Compound A is established as a potent FXR selective agonist and compound B is established as a dual potent FXR/TGR5 agonist.
• FXR regulates the expression of several target genes involved in BA homeostasis.
• FXR plays a central role in several metabolic pathways, including i.e., lipid metabolism, bile-acids metabolism, and carbohydrate metabolism.
• the genes encoding proteins involved in lipid metabolism include, e.g., APOCII, APOE, APOAI, SREBP-IC, VLDL-R, PLTP, and LPL;
• the genes encoding proteins involved in bile-acids metabolism include, e.g., OSTa/ ⁇ , BSEP, MRP2, SHP, CYP7A1, FGF19, SULT2A1, and UGT2B4;
• the genes encoding proteins involved in carbohydrate metabolism include, e.g., PGC 1-alpha, PEPCK, and GLUT2.
• Adenosine Triphosphate (ATP) nucleotide represents the source of energy at the basic molecular level, as it is a multifunctional molecule that is used in every cell as a coenzyme and is an integral part of the mitochondrial DNA (Kangas, et al., Medical Biology, 1984, 62, 338-343; Crouch, et al., J Immunol. Methods, 1993, 160, 81-88; and Petty, et al., J Biolumin. Chemilumin. 1995, 10, 29-34).
• ATP Adenosine Triphosphate
• Another method to determine the viability of cells is to detect the integrity of the membrane that defines the cellular compartmentalization. Measuring the leakage of components out of the cytoplasm, in damaged cell membranes, indicates loss of membrane integrity, and LDH release is the method used to determine common toxicity in cells. HepG2 cells are treated with a compound of the invention, and serial dilutions are performed. LCA dilutions are added to the plated cells as assay controls together with no-cell and untreated ceils. The assay is performed in triplicate for each test compound concentration. Table 5. Compound 1 in vitro Cytotoxicity
• CYP1A2 CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP3A4
• CYP1A2 CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP3A4
• the compound of the invention is analyzed by its capacity to inhibit (or not) the production of a fluorescent signal, using recombinant CYP450 proteins (baculosomes; Invitrogen), substrates and inhibitors (Bidstrup, et al, Br J Clin. Pharmacol, 2003, 56, 305-14).
• CYP450 proteins baculosomes; Invitrogen
• substrates and inhibitors Bodstrup, et al, Br J Clin. Pharmacol, 2003, 56, 305-14.
• the PredictorTM hERG Fluorescence Polarization assay is employed as it provides an efficient method for an initial determination of the propensity of test compounds to block the hERG channel (Dom, et al. J Biomol. Screen, 2005, 10, 339-347).
• the assay is based on the assumption that the hERG potassium channel activity contributes to the resting membrane potential in permanently transfected cells, and thus a block of hERG channels should result in a depolarization of the cell membrane.
• the assay is designed to identify potential hERG channel blockers by producing data that accurately correlates with patch-clamp electrophysiology studies. Results from the
• PredictorTM assay demonstrate a high correlation with those obtained from patch clamp techniques (Dorn, ei al. J Biomol Screen, 2005, 10, 339-347).
• Membrane preparations from Chinese hamster ovary cells stably transfected with hERG potassium channel are used to evaluate the potential inhibitory effect of a compound of the invention on this channel using the PredictorTM fluorescence polarization assay,
• the assay is performed in triplicate by using a 16-point dose-response of test compound and the positive controls E-4031 and Tamoxifen.
• An assay window more than 100 niP (niiliipolarization) is considered good.
• the non-linear regression curves are obtained by GraphPad Prism (GraphPad Software Inc.) analysis, to calculate the ICso values.
• a Ws water solubility refers to BA as protonated species and therefore not evaluated for Compound B, TCDCA and TUDCA which are highly soluble (hs)
• CMC Critical Micellar Concentration determined in 0.15 M NaCl water solution
• STcmc Surface Tension at CMC in 0.15 M NaCl water solution
• LogPA " 1-octanol -water partition coefficient of the studied bile acids as ionized species
• Aim and Rationale The structural modification of a compound affects its hepatic uptake, hepatic transports, and secretion and intestinal absorption. Therefore, the knowledge of the biliary secretion after either iv or id administration together their metabolism is a key point in the candidate selection for additional studies.
• Compound 1 is administered both intravenously (femoral infusion) and orally (duodenal infusion) at the same dose and its biliary secretion rate is evaluated in the bile fistula rat model. The choleretic effect on bile production is also evaluated.
• AUC area under the curve
• the bile fistula rat model is developed at the University of Bologna Lab facilities.
• Compound 1 is administered at a dose of about 1 ⁇ /kg/min (1 hour infusion) to a rat group via duodenal infusion (id).
• the rats have a bile fistula to collect bile samples at different times before and during the infusion.
• rats 250 ⁇ 10 g
• Bile samples are collected every 15 minutes for four hours.
• 3 control rats are treated with saline solution under the same conditions for times and sampling (duodenal control rats). Choleretic effect - Intravenous infusion
• rats are treated with Compound 1 at about 1 ⁇ /min/kg. Femoral infusion starts after about 75 minutes of steady state and continues for about 60 min. Bile samples are collected about every 15 minutes for four hours. In addition, rats are treated with saline solution under the same conditions for times and sampling

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