Classifications

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  • C07D491/00—Heterocyclic compounds containing in the condensed ring system both one or more rings having oxygen atoms as the only ring hetero atoms and one or more rings having nitrogen atoms as the only ring hetero atoms, not provided for by groups C07D451/00 - C07D459/00, C07D463/00, C07D477/00 or C07D489/00
  • C07D491/02—Heterocyclic compounds containing in the condensed ring system both one or more rings having oxygen atoms as the only ring hetero atoms and one or more rings having nitrogen atoms as the only ring hetero atoms, not provided for by groups C07D451/00 - C07D459/00, C07D463/00, C07D477/00 or C07D489/00 in which the condensed system contains two hetero rings
  • C07D491/10—Spiro-condensed systems
  • C07D491/113—Spiro-condensed systems with two or more oxygen atoms as ring hetero atoms in the oxygen-containing ring
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  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
  • A61K31/4025—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil not condensed and containing further heterocyclic rings, e.g. cromakalim
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
  • A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
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  • C07D207/00—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom
  • C07D207/02—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D207/04—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members
  • C07D207/08—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members with hydrocarbon radicals, substituted by hetero atoms, attached to ring carbon atoms
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  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D207/00—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom
  • C07D207/02—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D207/04—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members
  • C07D207/10—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
  • C07D207/16—Carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals
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  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D333/00—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom
  • C07D333/02—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom not condensed with other rings
  • C07D333/04—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom not condensed with other rings not substituted on the ring sulphur atom
  • C07D333/26—Heterocyclic compounds containing five-membered rings having one sulfur atom as the only ring hetero atom not condensed with other rings not substituted on the ring sulphur atom with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
  • C07D333/38—Carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals
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  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D409/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms
  • C07D409/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms containing two hetero rings
  • C07D409/12—Heterocyclic compounds containing two or more hetero rings, at least one ring having sulfur atoms as the only ring hetero atoms containing two hetero rings linked by a chain containing hetero atoms as chain links
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D417/00—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00
  • C07D417/02—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings
  • C07D417/12—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings linked by a chain containing hetero atoms as chain links
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D471/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00
  • C07D471/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, at least one ring being a six-membered ring with one nitrogen atom, not provided for by groups C07D451/00 - C07D463/00 in which the condensed system contains two hetero rings
  • C07D471/08—Bridged systems
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D491/00—Heterocyclic compounds containing in the condensed ring system both one or more rings having oxygen atoms as the only ring hetero atoms and one or more rings having nitrogen atoms as the only ring hetero atoms, not provided for by groups C07D451/00 - C07D459/00, C07D463/00, C07D477/00 or C07D489/00
  • C07D491/02—Heterocyclic compounds containing in the condensed ring system both one or more rings having oxygen atoms as the only ring hetero atoms and one or more rings having nitrogen atoms as the only ring hetero atoms, not provided for by groups C07D451/00 - C07D459/00, C07D463/00, C07D477/00 or C07D489/00 in which the condensed system contains two hetero rings
  • C07D491/10—Spiro-condensed systems
  • C07D491/107—Spiro-condensed systems with only one oxygen atom as ring hetero atom in the oxygen-containing ring
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D519/00—Heterocyclic compounds containing more than one system of two or more relevant hetero rings condensed among themselves or condensed with a common carbocyclic ring system not provided for in groups C07D453/00 or C07D455/00
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07F—ACYCLIC, CARBOCYCLIC OR HETEROCYCLIC COMPOUNDS CONTAINING ELEMENTS OTHER THAN CARBON, HYDROGEN, HALOGEN, OXYGEN, NITROGEN, SULFUR, SELENIUM OR TELLURIUM
  • C07F7/00—Compounds containing elements of Groups 4 or 14 of the Periodic Table
  • C07F7/02—Silicon compounds
  • C07F7/08—Compounds having one or more C—Si linkages
  • C07F7/0803—Compounds with Si-C or Si-Si linkages
  • C07F7/081—Compounds with Si-C or Si-Si linkages comprising at least one atom selected from the elements N, O, halogen, S, Se or Te
  • C07F7/0812—Compounds with Si-C or Si-Si linkages comprising at least one atom selected from the elements N, O, halogen, S, Se or Te comprising a heterocyclic ring
  • C07F7/0816—Compounds with Si-C or Si-Si linkages comprising at least one atom selected from the elements N, O, halogen, S, Se or Te comprising a heterocyclic ring said ring comprising Si as a ring atom

Definitions

• the complement system is a part of the innate immune system which does not adapt to changes over the course of the host’ s life, but is recruited and used by the adaptive immune system. For example, it assists, or complements, the ability of antibodies and phagocytic cells to clear pathogens.
• This sophisticated regulatory pathway allows rapid reaction to pathogenic organisms while protecting host cells from destruction.
• Over thirty proteins and protein fragments make up the complement system. These proteins act through opsonization (enhancing phagocytosis of antigens), chemotaxis (attracting macrophages and neutrophils), cell lysis (rupturing membranes of foreign cells), and agglutination (clustering and binding of pathogens together).
• the complement system has three pathways: classical, alternative, and lectin.
• the classical pathway is triggered by antibody-antigen complexes with the antibody isotypes IgG and IgM.
• the antibody-antigen complex binds to Cl and this initiates the cleavage of C4 and C2 to generate C3 convertase that then splits C3 into C3a and C3b.
• C3a interacts with its C3a receptor to recruit leukocytes
• C3b binds to C3 convertase to form C5 convertase.
• C5 convertase cleaves C5 into C5a and C5b.
• C5a interacts with its C5a receptor to recruit leukocytes
• C5b interacts with C6, C7, C8, and C8 and together these proteins form the cylindrical membrane attack complex (MAC) that causes the cell to swell and burst.
• MAC cylindrical membrane attack complex
• This disclosure includes a compound of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• the compound or its salt or composition, as described herein is used to treat a medical disorder which is an inflammatory or immune condition, a disorder mediated by the complement cascade (including a dysfunctional cascade), a disorder or abnormality of a cell that adversely affects the ability of the cell to engage in or respond to normal complement activity including for example, the classical complement pathway, or an undesired complement-mediated response to a medical treatment, such as surgery or other medical procedure or a pharmaceutical or biopharmaceutical drug administration, a blood transfusion, or other allogenic tissue or fluid administration.
• a medical disorder which is an inflammatory or immune condition, a disorder mediated by the complement cascade (including a dysfunctional cascade), a disorder or abnormality of a cell that adversely affects the ability of the cell to engage in or respond to normal complement activity including for example, the classical complement pathway, or an undesired complement-mediated response to a medical treatment, such as surgery or other medical procedure or a pharmaceutical or biopharmaceutical drug administration, a blood transfusion, or other all
• a method for the treatment of a disorder mediated by complement activity includes the administration of an effective amount of a compound of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition, as described in more detail below.
• the disorder is associated with the complement classical pathway and the compound inhibits the classical pathway.
• the disorder is associated with the alternative complement cascade pathway.
• the disorder is associated with the complement lectin pathway.
• the active compound or its salt or prodrug may act through a different mechanism of action than the complement cascade to treat a disorder described herein.
• the active compound, and/or its salt or prodrug inhibits a combination of these pathways.
• a method for treating a host, typically a human, with a disorder mediated by the complement system, that includes administration of a prophylactic antibiotic or vaccine to reduce the possibility of a bacterial infection during the treatment using one of the compounds described herein.
• the host typically a human
• the host is given a prophylactic vaccine prior to, during or after treatment with one of the compounds described herein.
• the host typically a human
• the infection is a meningococcal infection (e.g., septicemia and/or meningitis), an Aspergillus infection, or an infection due to an encapsulated organism, for example, Streptococcus pneumoniae or Haemophilus influenza type b (Hib), especially in children.
• the vaccine or antibiotic is administered to the patient after contracting an infection due to, or concommitent with, inhibition of the complement system.
• each n is independently 1, 2, or 3;
• each m is independently 0, 1, 2, or 3; is either a single or a double bond;
• Z is CH 2, C(CH 2 ), or C(O);
• X 1 is selected from S, O, and N(R 30 );
• X 2 is selected from bond, N(R 30 ), and -0-N(R 30 )-;
• X 3 is selected from N and C(R 17 );
• X 4 is selected from N and C(R 18 );
• X 5 is C or Si
• X 7 is selected from O, S, N(R 30 ), and CR 5 R 6 ;
• R 1 and R 2 are independently selected from hydrogen, halogen, C1-C6 alkyl, C2-O, alkenyl, C2-C6 alkynyl, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 1 and R 2 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from C1-C6 alkyl, C 2 -C6 alkenyl, C 2 -C6 alkynyl, halogen, C1-C6 haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2
• R 3 and R 4 are independently selected from hydrogen, C(0)R 31 , -SR 30 , and -OR 30 ;
• R 3 and R 4 are independently selected from hydrogen, CN, C(0)R 31 , -SR 30 , and -OR 30 ; or R 3 and R 4 are instead combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and oxo, for
• Ci-Ce alkyl Ci-Ce alkenyl, Ci-Ce alkynyl, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 ,
• R 7 and R 8 may be taken together with the carbon to which they are attached to form carbonyl
• R 9 and R 10 may be taken together with the atom to which they are attached to form a 3- to 6-membered carbocyclic spiro ring or a 4- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 11 and R 12 may be taken together with the carbon to which they are attached to form carbonyl;
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2
• each R 13 is independently selected from hydrogen or C1-C6 alkyl
• R 14 , R 15 , and R 16 are independently selected from hydrogen, halogen,
• R 14 , R 15 , and R 16 are independently selected from hydrogen, halogen,
• SFs Ci-Ce alkyl, C 2 -C 6 alkenyl, C 2 -C 6 alkynyl, Ci-Ce haloalkyl, -Ci-Ce alkyl-aryl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro each of which R 14 , R 15 , and R 16 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from SF5, C1-C6 alkyl, C2- Ce alkenyl, C 2 -Ce alkynyl, halogen, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31
• R 17 and R 18 are independently selected from hydrogen, halogen, C1-C 6 alkyl, Ci-Ce haloalkyl, -OR 30 , and -N(R 30 ) 2 ;
• R 17 and R 18 are taken together with the carbons to which they are attached to form a double bond
• R 19 and R 20 are independently selected from hydrogen, Ci-C6alkyl, C5-C1 0 bicyclic carbocycle, C4-C6 heterocycle, halogen, C1-C 6 haloalkyl, -OR 30 , -N(R 30 ) 2 , -(CH 2 ) n -R 33 , and
• R 21 is selected from C1-C 6 alkyl and -O-C1-C 6 alkyl
• R 21 is selected from C1-C 6 haloalkyl, -O-C1-C 6 haloalkyl, C1-C 6 alkyl, -O-C1-C 6 alkyl, aryl, -O-aryl, heteroaryl, or -O-heteroaryl, each of which R 21 group is optionally substituted with 1, 2, 3, or 4 substituents independently selected from SF5, C1-C 6 alkyl, C 2 -C6 alkenyl, C 2 - Ce alkynyl, halogen, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro;
• each R 30 is independently selected from hydrogen, C1-C 6 alkyl, C1-C 6 haloalkyl, aryl, heteroaryl, heterocycle, and C(0)R 31 ;
• each R 31 is independently selected from hydrogen, C1-C 6 alkyl, C1-C 6 haloalkyl, -OR 32 , -SR 32 , -N(R 32 ) 2 , heterocycle, aryl, and heteroaryl;
• each R 32 is independently selected from hydrogen, C1-C 6 alkyl, and C1-C 6 haloalkyl; each R 33 is independently selected from hydrogen, guanidine, heteroaryl, aryl, -C 6 H5-OR 30 ; -OR 30 , -SR 30 , -SeR 30 , -N(R 30 ) 2 , and -C(0)R 31 ,
• X 3 is C(R 17 ) and X 4 is C(R 18 );
• R 17 is selected from halogen, C1-C 6 alkyl, C1-C 6 haloalkyl, -OR 30 , and -N(R 30 )2;
• X 5 is Si
• Z is C(CH 2 );
• e. Z is CH 2 ; f. R 7 and R 8 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 10 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 11 and R 12 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 or R 12 is not hydrogen;
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 8 or R 10 is not hydrogen;
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• X 6 is selected from
• R 3 and R 4 are CN, -SR 30 or C(0)R 31 ; or
• R 3 and R 4 are combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and oxo.
• the compound of Formula IX is:
• the compound of Formula IX is:
• the compound of the present disclosure is of Formula X, XI, or XII:
• R 22 is selected from -C1-C6 alkyl-R 23 , -C2-C 6alkenyl-R 23 , -C2-C6 alkynyl-R 23 and bicyclic cycloalkyl-R 23 , each of which R 22 is optionally substituted with 1, 2, 3, or 4 substituents independently selected from C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, halogen, C1-C6 haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro;
• R 23 is selected from hydrogen, sugar, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , and -S(0) 2 R 31 ;
• X 3 is C(R 17 ) and X 4 is C(R 18 );
• R 17 is selected from halogen, C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and -N(R 30 )2;
• X 5 is Si
• Z is C(CH 2 );
• e. Z is CH2; f. R 7 and R 8 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 10 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 is not hydrogen; i. R 11 and R 12 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 is not hydrogen; k. R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• R 22 is substituted with at least three OR 30 groups
• R 23 is a sugar
• R 3 and R 4 are CN, -SR 30 , or C(0)R 31 ; or
• R 3 and R 4 are combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and oxo.
• R 23 is selected from hydrogen, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , and -S(0) 2 R 31 .
• the compound of Formula X is selected from:
• the compound of Formula X, XI, or XII is selected from
• the compound of Formula XII is N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N-(2-aminoethyl)-2-aminoethyl-N
• the compound of the present disclosure is of Formula XIII:
• X 7 is selected from O, S, N(R 30 ), and CR 5 R 6 ;
• o 0, 1, or 2;
• each R 25 is independently selected from hydrogen, halogen, C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 25 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from C1-C6 alkyl, C2-C6 alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroary
• each R 25 is independently selected from hydrogen, SF5, halogen, C1-C6 alkyl, C2- Ce alkenyl, C2-C6 alkynyl, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 25 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from
• Ci-Cealkyl C2-C 6 alkenyl, C2-C 6 alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro;
• X 11 is selected from N and CR 1 ;
• X 12 is selected from N and CR 2 ;
• X 1 is O or N(R 30 );
• R 14 is not hydrogen
• R 1 is not hydrogen
• R 2 is not hydrogen
• R 3 is not hydrogen
• R 4 is not hydrogen.
• the compound of the present disclosure is of Formula XV:
• each X 8 and X 9 is independently selected from O, S, NR 30 , CR 9 R 10 , CR 5 R 6 . and CFh; wherein X 8 and X 9 cannot both be the same group; and all other variables are as defined herein.
• X 8 and X 9 cannot both be the same group; and all other variables are as defined herein.
• the compound of the present disclosure is of Formula XVI, XVII, or
• X 10 is selected from R 35 is selected from C3-Cioalkyl or C3-Ciohaloalkyl;
• the compound of the present disclosure is of Formula XIX or Formula
• R 29 is selected from halogen, Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, Ci-C6haloalkyl, - OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, and heteroaryl, each of which R 29 groups other than hydrogen and halogen are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; and
• R 29 is hydrogen.
• Pharmaceutical compositions comprising a compound or salt of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, together with a pharmaceutically acceptable carrier are also disclosed.
• the present disclosure thus includes at least the following features:
• a a compound of the present disclosure or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition;
• NASH nonalcoholic steatohepatitis
• liver inflammation e.g., cirrhosis, liver failure
• dermatomyositis e.g., amyotrophic lateral sclerosis
• cytokine or inflammatory reactions in response to biotherapeutics e.g.
• CAR T-cell therapy hereditary angioedema (HAE), chronic immune thrombocytopenia (ITP), cold agglutinin disease, cold agglutinin syndrome, warm autoimmune hemolytic anemia, cryoglobulinemia, bullous pemphigoid, common variable immunodeficiency, endotoxemia, sepsis, multiple organ dysfunction syndrome, hemolytic uremic syndrome (HUS), atypical hemolytic uremic syndrome (aHUS), acute kidney injury, kidney transplantation, graft rejection, antibody -mediated rejection, delayed graft function, end-stage renal disease, myasthenia gravis, systemic lupus erythema (SLE), paroxysmal nocturnal hemoglobinuria (PNH), rheumatoid arthritis, multiple sclerosis, age-related macular degeneration (AMD), retinal degeneration, other ophthalmic diseases (e.g., geographic atrophy), a respiratory disease or a cardiovascular disease; a disorder of the central
• a compound of the present disclosure as described herein, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition, in the manufacture of a medicament for treating or preventing a disorder, including but not limited to the development of fatty liver and conditions stemming from fatty liver, such as nonalcoholic steatohepatitis (NASH), liver inflammation, cirrhosis, liver failure; dermatomyositis; amyotrophic lateral sclerosis; cytokine or inflammatory reactions in response to biotherapeutics (e.g.
• NASH nonalcoholic steatohepatitis
• liver inflammation e.g., cirrhosis, liver failure
• dermatomyositis e.g., amyotrophic lateral sclerosis
• cytokine or inflammatory reactions in response to biotherapeutics e.g.
• CAR T-cell therapy hereditary angioedema (HAE), chronic immune thrombocytopenia (ITP), cold agglutinin disease, cold agglutinin syndrome, warm autoimmune hemolytic anemia, cryoglobulinemia, bullous pemphigoid, common variable immunodeficiency, endotoxemia, sepsis, multiple organ dysfunction syndrome, hemolytic uremic syndrome (HUS), atypical hemolytic uremic syndrome (aHUS), acute kidney injury, kidney transplantation, graft rejection, antibody -mediated rejection, delayed graft function, end-stage renal disease, myasthenia gravis, systemic lupus erythema (SLE), paroxysmal nocturnal hemoglobinuria (PNH), rheumatoid arthritis, multiple sclerosis, age-related macular degeneration (AMD), retinal degeneration, other ophthalmic diseases (e.g., geographic atrophy), a respiratory disease or a cardiovascular disease; a disorder of the central
• a process for manufacturing a medicament intended for the therapeutic use for treating or preventing a disorder, or generally for treating or preventing disorders mediated by the classical complement pathway characterized in that a compound of the present disclosure or an embodiment of the active compound is used in the manufacture; g. a compound of the present disclosure or a salt thereof as described herein in substantially pure form (e.g., at least 90 or 95%);
• a medical disorder which is an inflammatory or immune condition, a disorder mediated by the complement cascade (including a dysfunctional cascade), a disorder or abnormality of a cell that adversely affects the ability of the cell to engage in or respond to normal complement activity, or an undesired complement-mediated response to a medical treatment, such as
• the compounds in any of the Formulas described herein include enantiomers, mixtures of enantiomers, diastereomers, tautomers, racemates and other isomers, such as rotamers, as if each is specifically described, unless otherwise indicated or otherwise excluded by context.
• the present disclosure includes compounds of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, with at least one desired isotopic substitution of an atom, at an amount above the natural abundance of the isotope, i.e., enriched.
• isotopes examples include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorous, fluorine, and chlorine, such as 2 H, 3 H, U C, 13 C, 14 C, 15 N, 17 0, 18 0, 18 F 31 P, 32 P, 35 S, 36 CI, and 125 I respectively.
• isotopically labelled compounds can be used in metabolic studies (with 14 C), reaction kinetic studies (with, for example 2 H or 3 H), detection or imaging techniques, such as positron emission tomography (PET) or single-photon emission computed tomography (SPECT) including drug or substrate tissue distribution assays, or in radioactive treatment of patients.
• PET positron emission tomography
• SPECT single-photon emission computed tomography
• an 18 F labeled compound may be particularly desirable for PET or SPECT studies.
• Isotopically labeled compounds of this disclosure and prodrugs thereof can generally be prepared by carrying out the procedures disclosed in the schemes or in the examples and preparations described below by substituting a readily available isotopically labeled reagent for a non-isotopically labeled reagent.
• isotopes of hydrogen for example, deuterium ( 2 H) and tritium ( 3 H) may optionally be used anywhere in described structures that achieves the desired result.
• isotopes of carbon e.g., 13 C and 14 C, may be used.
• the isotopic substitution is replacing hydrogen with a deuterium at one or more locations on the molecule to improve the performance of the drug, for example, the pharmacodynamics, pharmacokinetics, biodistribution, half-life, stability, AUC, Tmax, Cmax, etc.
• the deuterium can be bound to carbon in a location of bond breakage during metabolism (an a-deuterium kinetic isotope effect) or next to or near the site of bond breakage (a b-deuterium kinetic isotope effect).
• Isotopic substitutions for example deuterium substitutions, can be partial or complete. Partial deuterium substitution means that at least one hydrogen is substituted with deuterium.
• the isotope is 80, 85, 90, 95 or 99% or more enriched in an isotope at any location of interest.
• deuterium is 80, 85, 90, 95 or 99% enriched at a desired location. Unless otherwise stated, the enrichment at any point is above natural abundance, and in an embodiment is enough to alter a detectable property of the drug in a human.
• the substitution of a hydrogen atom for a deuterium atom can be provided in any formula of the present disclosure. In one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs within any R group. In one embodiment, the R group is selected from any of R 1 , R 2 , R 3 , R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11 , R 12 , R 13 , R 14 , R 15 , R 16 , R 17 , R 18 , R 19 , R 20 , R 21 , R 22 , R 23 , R 25 , R 26 , R 27 , R 29 , R 30 , R 31 , R 32 , R 33 , R 200 , and R 201 .
• the alkyl residue may be deuterated (in non-limiting embodiments, CD3, CH2CD3, CD2CD3, CDFh, CD2H, CD3, CHDCH2D, CH2CD3, CHDCHD2, OCDH2, OCD2H, or OCD3 etc ).
• an R group has a“ '“ or an“a” designation, which in one embodiment can be deuterated.
• the unsubstituted methylene carbon may be deuterated.
• the compound of the present disclosure may form a solvate with solvents (including water). Therefore, in one embodiment, the disclosure includes a solvated form of the active compound.
• solvate refers to a molecular complex of a compound of the present disclosure (including a salt thereof) with one or more solvent molecules.
• solvents are water, ethanol, dimethyl sulfoxide, acetone and other common organic solvents.
• hydrate refers to a molecular complex comprising a compound of the disclosure and water.
• Pharmaceutically acceptable solvates in accordance with the disclosure include those wherein the solvent of crystallization may be isotopically substituted, e.g. D2O, d6-acetone, d6- DMSO.
• a solvate can be in a liquid or solid form.
• a dash (“-") that is not between two letters or symbols is used to indicate a point of attachment for a substituent.
• substituted means that any one or more hydrogens on the designated atom or group is replaced with a moiety selected from the indicated group, provided that the designated atom's normal valence is not exceeded and the resulting compound is stable.
• a pyridyl group substituted by oxo is a pyridone.
• a stable active compound refers to a compound that can be isolated and can be formulated into a dosage form with a shelf life of at least one month.
• a stable manufacturing intermediate or precursor to an active compound is stable if it does not degrade within the period needed for reaction or other use.
• a stable moiety or substituent group is one that does not degrade, react or fall apart within the period necessary for use.
• Non-limiting examples of unstable moieties are those that combine heteroatoms in an unstable arrangement, as typically known and identifiable to those of skill in the art.
• Any suitable group may be present on a“substituted” or“optionally substituted” position that forms a stable molecule and meets the desired purpose of the disclosure and includes, but is not limited to, e.g., halogen (which can independently be F, Cl, Br or I); cyano; hydroxyl; nitro; azido; alkanoyl (such as a C2-C6 alkanoyl group); carboxamide; alkyl, cycloalkyl, alkenyl, alkynyl, alkoxy, aryloxy such as phenoxy; thioalkyl, including those having one or more thioether linkages; alkyl sulfinyl; alkylsulfonyl groups, including those having one or more sulfonyl linkages; aryl (e.g., phenyl, biphenyl, naphthyl, or the like, each ring either substituted or unsubstituted); arylalkyl having
• Such groups may be further substituted, e.g. with hydroxy, alkyl, alkoxy, halogen and amino.
• “optionally substituted” includes one or more substituents independently selected from halogen, hydroxyl, amino, cyano, -CHO, -COOH, - CONH2, alkyl including Ci-C6alkyl, alkenyl including C2-C6alkenyl, alkynyl including C2- Cealkynyl, -Ci-C6alkoxy, alkanoyl including C2-C6alkanoyl, (mono- and di-Ci-C6alkylamino)Co- C2alkyl, haloalkyl including Ci-C6haloalkyl, hydoxyCi-Cealkyl, ester, carbamate, urea, sulfonamide, -Ci-C6alkyl(heterocyclo), Ci-C6alkyl(heteroaryl), -
• Alkyl is a branched or straight chain saturated hydrocarbon group. In one embodiment, the alkyl contains from 1 to about 12 carbon atoms, more generally from 1 to about 6 carbon atoms or from 1 to about 4 carbon atoms. In one embodiment, the alkyl contains from 1 to about 8 carbon atoms. In certain embodiments, the alkyl is C1-C2, C1-C 3 , C1-C4, C1-C5 or C1-C 6. The specified ranges as used herein indicate an alkyl group having each member of the range described as an independent species.
• C1-C 6 alkyl indicates a straight or branched alkyl group having from 1, 2, 3, 4, 5, or 6 carbon atoms and is intended to mean that each of these is described as an independent species.
• Ci-C4alkyl indicates a straight or branched alkyl group having from 1, 2, 3, or 4 carbon atoms and is intended to mean that each of these is described as an independent species.
• Co-Cn alkyl is used herein in conjunction with another group, for example, (C3-C7cycloalkyl)Co-C4 alkyl, or -Co-C4alkyl(C3- C7cycloalkyl)
• the indicated group in this case cycloalkyl, is either directly bound by a single covalent bond (Coalkyl), or attached by an alkyl chain in this case 1, 2, 3, or 4 carbon atoms.
• Alkyl groups can also be attached via other groups such as heteroatoms as in -0-Co-C4alkyl(C3- C7cycloalkyl).
• alkyl examples include, but are not limited to, methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, t-butyl, n-pentyl, isopentyl, tert- pentyl, neopentyl, n-hexyl, 2- methylpentane, 3-methylpentane, 2,2-dimethylbutane, 2,3-dimethylbutane, and hexyl.
• Alkyl groups can be optionally substituted independently with one or more substituents described herein.
• alkyl alkenyl, alkynyl, alkoxy, alkanoyl, alkenloxy, haloalkyl, etc.
• alkyl alkenyl, alkynyl, alkoxy, alkanoyl, alkenloxy, haloalkyl, etc.
• Alkenyl is a branched or straight chain aliphatic hydrocarbon group having one or more carbon-carbon double bonds that may occur at a stable point along the chain. Non-limiting examples are C2-Csalkenyl, C2-C7alkenyl, C2-C6alkenyl, C2-Csalkenyl and C2-C4alkenyl.
• the specified ranges as used herein indicate an alkenyl group having each member of the range described as an independent species, as described above for the alkyl moiety. Examples of alkenyl include, but are not limited to, ethenyl and propenyl. Alkenyl groups can be optionally substituted independently with one or more substituents described herein.
• Alkynyl is a branched or straight chain aliphatic hydrocarbon group having one or more carbon-carbon triple bonds that may occur at any stable point along the chain, for example, C2- Csalkynyl or C2-C6alkynyl.
• the specified ranges as used herein indicate an alkynyl group having each member of the range described as an independent species, as described above for the alkyl moiety.
• alkynyl examples include, but are not limited to, ethynyl, propynyl, 1-butynyl, 2- butynyl, 3-butynyl, 1-pentynyl, 2-pentynyl, 3-pentynyl, 4-pentynyl, 1-hexynyl, 2-hexynyl, 3- hexynyl, 4-hexynyl and 5-hexynyl.
• Alkynyl groups can be optionally substituted independently with one or more substituents described herein.
• Haloalkyl indicates both branched and straight-chain alkyl groups substituted with 1 or more halogen atoms, up to the maximum allowable number of halogen atoms.
• haloalkyl include, but are not limited to, trifluoromethyl, monofluoromethyl, difluoromethyl, 2- fluoroethyl, and penta-fluoroethyl.
• Haloalkyl groups can be optionally substituted independently with one or more substituents described herein.
• Aryl indicates an aromatic group containing only carbon in the aromatic ring or rings.
• the aryl group contains 1 to 3 separate or fused rings and is 6 to 14 or 18 ring atoms, without heteroatoms as ring members.
• such aryl groups may be further substituted with carbon or non-carbon atoms or groups. Such substitution may include fusion to a 4 to 7 or a 5 to 7-membered saturated or partially unsaturated cyclic group that optionally contains 1, 2 or 3 heteroatoms independently selected from N, O, B, P, Si and S, to form, for example, a 3,4-methylenedioxyphenyl group.
• Aryl groups include, for example, phenyl and naphthyl, including 1 -naphthyl and 2-naphthyl. In one embodiment, aryl groups are pendant. An example of a pendant ring is a phenyl group substituted with a phenyl group. Aryl groups can be optionally substituted independently with one or more substituents described herein.
• heterocycle refers to saturated and partially saturated heteroatom-containing ring radicals, where the heteroatoms may be selected from N, S, and O.
• heterocycle includes monocyclic 3-12 membered rings, as well as bicyclic 5-16 membered ring systems (which can include fused, bridged, or spiro, bicyclic ring systems). It does not include rings containing -0-0-. -0-S-, or -S-S- portions.
• saturated heterocycle groups include saturated 4- to 7-membered monocyclic groups containing 1 to 4 nitrogen atoms [e.g., pyrrolidinyl, imidazolidinyl, piperidinyl, pyrrolinyl, azetidinyl, piperazinyl, and pyrazolidinyl]; saturated 4 to 6-membered monocyclic groups containing 1 to 2 oxygen atoms and 1 to 3 nitrogen atoms [e.g., morpholinyl]; saturated 3 to 6-membered heteromonocyclic group containing 1 to 2 sulfur atoms and 1 to 3 nitrogen atoms [e.g., thiazolidinyl].
• nitrogen atoms e.g., pyrrolidinyl, imidazolidinyl, piperidinyl, pyrrolinyl, azetidinyl, piperazinyl, and pyrazolidinyl
• partially saturated heterocycle radicals include but are not limited to, dihydrothienyl, dihydropyranyl, dihydrofuryl, and dihydrothiazolyl.
• partially saturated and saturated heterocycle groups include, but are not limited to, pyrrolidinyl, imidazolidinyl, piperidinyl, pyrrolinyl, pyrazolidinyl, piperazinyl, morpholinyl, tetrahydropyranyl, thiazolidinyl, dihydrothienyl, 2,3-dihydro-benzo[l,4]dioxanyl, indolinyl, isoindolinyl, dihydrobenzothienyl, dihydrobenzofuryl, isochromanyl, chromanyl, 1,2- dihydroquinolyl, 1,2, 3, 4- tetrahydro-isoquinolyl, 1 ,2,3,4-tetrahydro-quinolyl, 2, 3, 4, 4a, 9,9
• “Bicyclic heterocycle” includes groups wherein the heterocyclic radical is fused with an aryl radical wherein the point of attachment is the heterocycle ring. “Bicyclic heterocycle” also includes heterocyclic radicals that are fused with a carbocycle radical. For example, partially unsaturated condensed heterocyclic group containing 1 to 5 nitrogen atoms, for example, indoline, isoindoline, partially unsaturated condensed heterocyclic group containing 1 to 2 oxygen atoms and 1 to 3 nitrogen atoms, partially unsaturated condensed heterocyclic group containing 1 to 2 sulfur atoms and 1 to 3 nitrogen atoms, and saturated condensed heterocyclic group containing 1 to 2 oxygen or sulfur atoms are all encompassed. Heterocycle groups can be optionally substituted independently with one or more substituents described herein.
• bicyclic heterocycles include:
• bicyclic heterocycle includes cis and trans diastereomers.
• Non-limiting examples of chiral bicyclic heterocycles include:
• Heteroaryl refers to a stable monocyclic, bicyclic, or multicyclic aromatic ring which contains from 1 to 3, or in some embodiments from 1, 2, or 3 heteroatoms selected from N, O, S, B, and P (and typically selected from N, O, and S) with remaining ring atoms being carbon, or a stable bicyclic or tricyclic system containing at least one 5, 6, or 7 membered aromatic ring which contains from 1 to 3, or in some embodiments from 1 to 2, heteroatoms selected from N, O, S, B or P with remaining ring atoms being carbon.
• the only heteroatom is nitrogen.
• the only heteroatom is oxygen.
• the only heteroatom is sulfur.
• Monocyclic heteroaryl groups typically have from 5 or 6 ring atoms.
• bicyclic heteroaryl groups are 8- to 10-membered heteroaryl groups, that is, groups containing 8 or 10 ring atoms in which one 5, 6, or 7 member aromatic ring is fused to a second aromatic or non-aromatic ring wherein the point of attachment is the aromatic ring.
• the total number of S and O atoms in the heteroaryl group exceeds 1, these heteroatoms are not adjacent to one another.
• the total number of S and O atoms in the heteroaryl group is not more than 2.
• the total number of S and O atoms in the aromatic heterocycle is not more than 1.
• heteroaryl groups include, but are not limited to, pyridinyl (including, for example, 2-hydroxypyridinyl), imidazolyl, imidazopyridinyl, pyrimidinyl (including, for example, 4-hydroxypyrimidinyl), pyrazolyl, triazolyl, pyrazinyl, furyl, thienyl, isoxazolyl, thiazolyl, oxadiazolyl, oxazolyl, isothiazolyl, pyrrolyl, quinolinyl, isoquinolinyl, tetrahydroisoquinolinyl, indolyl, benzimidazolyl, benzofuranyl, cinnolinyl, indazolyl, indolizinyl, phthalazinyl, pyridazinyl, triazinyl, isoindolyl, pteridinyl, purinyl, oxadiazoly
• A“dosage form” means a unit of administration of an active agent.
• dosage forms include tablets, capsules, injections, suspensions, liquids, emulsions, implants, particles, spheres, creams, ointments, suppositories, inhalable forms, transdermal forms, buccal, sublingual, topical, gel, mucosal, and the like.
• A“dosage form” can also include an implant, for example an optical implant.
• “Pharmaceutical compositions” are compositions comprising at least one active agent, and at least one other substance, such as a pharmaceutically acceptable carrier. “Pharmaceutical combinations” are combinations of at least two active agents which may be combined in a single dosage form or provided together in separate dosage forms with instructions that the active agents are to be used together to treat any disorder described herein.
• A“pharmaceutically acceptable salt” is a derivative of the disclosed compound in which the parent compound is modified by making inorganic and organic, pharmaceutically acceptable, acid or base addition salts thereof.
• the salts of the present compounds can be synthesized from a parent compound that contains a basic or acidic moiety by conventional chemical methods. Generally, such salts can be prepared by reacting free acid forms of these compounds with a stoichiometric amount of the appropriate base (such as Na, Ca, Mg, or K hydroxide, carbonate, bicarbonate, or the like), or by reacting free base forms of these compounds with a stoichiometric amount of the appropriate acid. Such reactions are typically carried out in water or in an organic solvent, or in a mixture of the two.
• salts of the present compounds further include solvates of the compounds and of the compound salts.
• Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like.
• the pharmaceutically acceptable salts include salts which are acceptable for human consumptionand the quaternary ammonium salts of the parent compound formed, for example, from inorganic or organic acids.
• salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, mesylic, esylic, besylic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, HOOC-(CH2)I-4- COOH, and the like, or using a different acid that produces the same counterion.
• inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phospho
• carrier applied to pharmaceutical compositions/combinations according to the disclosure refers to a diluent, excipient, or vehicle with which an active compound is provided.
• A“pharmaceutically acceptable excipient” or“pharmaceutically acceptable carrier” may be used interchangeably and mean an excipient that is useful in preparing a pharmaceutical composition/combination that is generally safe, acceptable for human consumption, and neither biologically nor otherwise inappropriate for administration to a host, typically a human.
• an excipient is used that is acceptable for veterinary use.
• an excipient is used that is acceptable for mammalian, particularly human, use.
• A“patient” or“host” or“subject” is a human or non-human animal in need of treatment or prevention of any of the disorders as specifically described herein, including but not limited to by modulation of the the classical complement pathway or with a condition that is treatable with one of the compounds described herein.
• the host is a human.
• A“patient” or“host” or “subject” also refers to for example, a mammal, primate (e.g., human), cows, sheep, goat, horse, dog, cat, rabbit, rat, mice, bird and the like.
• A“prodrug” as used herein means a compound which when administered to a host in vivo is converted into a parent drug.
• the term "parent drug” means any of the presently described chemical compounds herein.
• Prodrugs can be used to achieve any desired effect, including to enhance properties of the parent drug or to improve the pharmaceutic or pharmacokinetic properties of the parent, including to increase the half-life of the drug in vivo.
• Prodrug strategies provide choices in modulating the conditions for in vivo generation of the parent drug.
• Non-limiting examples of prodrug strategies include covalent attachment of removable groups, or removable portions of groups, for example, but not limited to acylation, phosphorylation, phosphonylation, phosphoramidate derivatives, amidation, reduction, oxidation, esterification, alkylation, other carboxy derivatives, sulfoxy or sulfone derivatives, carbonylation or anhydride, among others.
• “Providing a compound with at least one additional active agent,” for example, in one embodiment can mean that the compound and the additional active agent(s) are provided simultaneously in a single dosage form, provided concomitantly in separate dosage forms, or provided in separate dosage forms for administration.
• A“therapeutically effective amount” of a pharmaceutical composition/combination of this disclosure means an amount effective, when administered to a host, to provide a therapeutic benefit, such as an amelioration of symptoms or reduction or dimunition of the disease itself.
• a therapeutically effective amount is an amount sufficient to prevent a significant increase, or will significantly reduce, the detectable level of hemolysis in the patient’s blood, serum, or tissues.
• any of the active compounds can be provided in its N-oxide form to a patient in need thereof.
• an N-oxide of an active compound or a precursor of the active compound is used in a manufacturing scheme.
• the N- oxide is a metabolite of administration of one of the active compounds herein, and may have independent activity.
• the N-oxide can be formed by treating the compound of interest with an oxidizing agent, for example, a suitable peroxyacid or peroxide, to generate an N-oxide compound.
• any of the active compounds with a sulfur can be provided in its sulfoxide or sulfone form to a patient in need thereof.
• a sulfoxide or sulfone of one of the active compounds or a precursor of the active compound is used in a manufacturing scheme.
• a sulfur atom in a selected compound as described herein can be
• TAPC l,3,5-triazo-2,4,6-triphosphorine-2,2,4,4,6,6-tetrachloride
• Oxidation of sulfides with 30% hydrogen peroxide catalyzed by tantalum carbide provides sulfoxides in high yields, see Kirihara, A., et al.,“Tantalum Carbide or Niobium Carbide Catalyzed Oxidation of Sulfides with Hydrogen Peroxide: Highly Efficient and Chemoselective Syntheses of Sulfoxides and Sulfones”, Synlett , 1557-1561 (2010).
• alkyl is a Ci-Cioalkyl, Ci-C9alkyl, Ci-Csalkyl, Ci-C7alkyl, Ci-Cealkyl, Ci-Csalkyl, Ci-C 4 alkyl, Ci-Csalkyl, or Ci-C 2 alkyl.
• “alkyl” has one carbon.
• “alkyl” has two carbons. In one embodiment“alkyl” has three carbons.
• “alkyl” has five carbons.
• “alkyl” has six carbons.
• Non-limiting examples of“alkyl” include: methyl, ethyl, propyl, butyl, pentyl, and hexyl.
• “alkyl” examples include: isopropyl, isobutyl, isopentyl, and isohexyl.
• alkyl examples include: sec-butyl, sec-pentyl, and sec-hexyl.
• alkyl include: neopentyl, 3-pentyl, and active pentyl.
• haloalkyl is a Ci-Ciohaloalkyl, Ci-C9haloalkyl, Ci-Cshaloalkyl, Ci- C7haloalkyl, Ci-C6haloalkyl, Ci-Cshaloalkyl, Ci-C4haloalkyl, Ci-C3haloalkyl, and Ci- C2haloalkyl.
• “haloalkyl” has one carbon.
• “haloalkyl” has one carbon and one halogen.
• “haloalkyl” has one carbon and two halogens.
• “haloalkyl” has one carbon and three halogens.
• “haloalkyl” has two carbons.
• “haloalkyl” has three carbons.
• “haloalkyl” has four carbons.
• “haloalkyl” has five carbons.
• “haloalkyl” has six carbons.
• Non-limiting examples of“haloalkyl” include: , Additional non-limiting examples of “haloalkyl” include:
• haloalkyl include: C H , and
• haloalkyl include: Cl , Cl , and Cl
• aryl is a 6 carbon aromatic group (phenyl)
• aryl is a 10 carbon aromatic group (napthyl)
• aryl is“substituted aryl”.
• heteroaryl is a 5 membered aromatic group containing 1, 2, or 3, nitrogen atoms.
• Non-limiting examples of 5 membered “heteroaryl” groups include pyrrole, furan, thiophene, pyrazole, imidazole, triazole, isoxazole, oxazole, oxadiazole, oxatriazole, isothiazole, thiazole, thiadiazole, and thiatriazole.
• 5 membered“heteroaryl” groups include:
• “heteroaryl” is a 6 membered aromatic group containing 1, 2, or 3 nitrogen atoms (i.e. pyridinyl, pyridazinyl, triazinyl, pyrimidinyl, and pyrazinyl).
• Non-limiting examples of 6-membered“heteroaryl” groups with 1 or 2 nitrogen atoms include: and l IN J .
• “heteroaryl” is a 9 membered bicyclic aromatic group containing 1 or 2 atoms selected from nitrogen, oxygen, and sulfur.
• Non-limiting examples of“heteroaryl” groups that are bicyclic include indole, benzofuran, isoindole, indazole, benzimidazole, azaindole, azaindazole, purine, isobenzofuran, benzothiophene, benzoisoxazole, benzoisothiazole, benzooxazole, and benzothi azole.
• heteroaryl is a 10 membered bicyclic aromatic group containing 1 or 2 atoms selected from nitrogen, oxygen, and sulfur.
• heteroaryl groups that are bicyclic include quinoline, isoquinoline, quinoxaline, phthalazine, quinazoline, cinnoline, and naphthyridine.
• heteroaryl is tetrazole.
• “cycloalkyl” is a Cs-Cscycloalkyl, C3-C7cycloalkyl, C 3 -C 6 cycloalkyl, C 3 -C5cycloalkyl, C 3 -C4cycloalkyl, C4-C8cycloalkyl, Cs-Cscycloalkyl, or C6-Cscycloalkyl.
• “cycloalkyl” has three carbons.
• “cycloalkyl” has four carbons.
• “cycloalkyl” has five carbons.
• “cycloalkyl” has six carbons.
• “cycloalkyl” has seven carbons.
• “cycloalkyl” has eight carbons.
• “cycloalkyl” has nine carbons.
• “cycloalkyl” has ten carbons.
• cycloalkyl include: cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, and cyclodecyl.
• heterocycle refers to a cyclic ring with one nitrogen and 3, 4, 5, 6, 7, or 8 carbon atoms.
• heterocycle refers to a cyclic ring with one nitrogen and one oxygen and 3, 4, 5, 6, 7, or 8 carbon atoms.
• heterocycle refers to a cyclic ring with two nitrogens and 3, 4, 5, 6, 7, or 8 carbon atoms.
• heterocycle refers to a cyclic ring with one oxygen and 3, 4, 5, 6, 7, or 8 carbon atoms.
• heterocycle refers to a cyclic ring with one sulfur and 3, 4, 5, 6, 7, or 8 carbon atoms.
• Non-limiting examples of“heterocycle” include aziridine, oxirane, thiirane, azetidine, 1,3- diazetidine, oxetane, and thietane. Additional non-limiting examples of“heterocycle” include pyrrolidine, 3-pyrroline, 2- pyrroline, pyrazolidine, and imidazolidine.
• heterocycle examples include tetrahydrofuran, 1,3-dioxolane, tetrahydrothiophene, 1,2-oxathiolane, and 1,3-oxathiolane.
• heterocycle examples include piperidine, piperazine, tetrahydropyran, 1,4-dioxane, thiane, 1,3-dithiane, 1,4-dithiane, morpholine, and thiomorpholine.
• Non-limiting examples of“heterocycle” also include:
• Non-limiting examples of“heterocycle” also include:
• Non-limiting examples of“heterocycle” also include:
• Additional non-limiting examples of“heterocycle” include: Additional non-limiting examples of“heterocycle” include:
• “sugar” refers to a compound of formula C3H5O3, C4H7O4, C5H9O5,
• Non-limiting examples of sugar include
• In one embodiment is selected from: ?
• R 22 is selected from
• R 22 is selected from , ?
• R 26 is selected from
• R 27 is selected from ,
• R 21 is selected from:
• a compound of Formula I selected from:
• a compound of Formula I selected from: In one aspect, a compound of Formula I is provided selected from:
• the compound of the present disclosure is selected from: In one aspect, a compound of Formula I is provided selected from:
• a compound of Formula I selected from: In one aspect, a compound of Formula I is provided selected from:
• a compound of Formula I selected from:
• a compound of Formula IV selected from:
• a compound of Formula V selected from:
• the compound of Formula I is selected from:
• the compound of Formula I is selected from:
• the compound of Formula I is selected from:
• R 200 is selected from halogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and -N(R 30 ); and all other variables are as defined herein.
• the compound of Formula I is selected from:
• — is selected from a 3- to 6-membered carbocyclic ring and a 4- to 6-membered heterocyclic ring containing 1 or 2 heteroatoms independently chosen from N, O, and S; for
• the compound of Formula I is selected from:
• R 8 and R 10 are not hydrogen;
• the compound of Formula I is selected from:
• R 10 and R 12 is not hydrogen; and all other variables are as defined herein.
• the compound of the present disclosure is selected from:
• the compound of Formula X is selected from:
• i selected from a 3- to 6-membered carbocyclic ring and a 4- to 6-membered heterocyclic ring containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• ⁇ is optionally substituted with 1, 2, 3, or 4 substituents independently selected from halogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and - N(R 30 ) 2 ;
• the compound of Formula X is selected from:
• R 8 and R 10 are not hydrogen;
• the compound of Formula X is selected from:
• ⁇ is a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; for example, in one embodiment
• R 10 and R 12 are not hydrogen;
• a 3- to 8-membered carbocycle is a 4- to 8-membered carbocycle. In another embodiment a 3- to 8-membered carbocycle is a 4- to 8-membered carbocycle.
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 4- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 4- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• ⁇ is a 4- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• the compound of Formula XIV is selected from:
• the compound of Formula XIV is selected from:
• R 201 is selected from halogen, Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, Ci-C6haloalkyl, - OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, and heteroaryl, each of which R 201 groups other than halogen are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, CCealkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, - OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; and
• R 9 and R 11 are taken together with the atoms to which they are attached to form a cyclopropane.
• the compound of the present disclosure is selected from:
• the compound of the present disclosure is selected from:
• the compound of the present disclosure is selected from:
• the compound of the present disclosure is selected from:
• each R 40 is independently selected from: SFs, Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• the compound of the present disclosure is selected from:
• the compound of the present disclosure is selected from:
• the compound of the present disclosure is selected from:
• each n is independently 1, 2, or 3;
• each m is independently 0, 1, 2, or 3;
• o 0, 1, or 2;
• & « is either a single or a double bond
• Z is CH 2, C(CH 2 ), or C(O);
• X 1 is selected from S, O, and N(R 30 );
• X 2 is selected from bond, N(R 30 ), and -0-N(R 30 )-;
• X 3 is selected from N and C(R 17 );
• X 4 is selected from N and C(R 18 );
• X 5 is C or Si
• X 7 is selected from O, S, N(R 30 ), and CR 5 R 6 ;
• each X 8 and X 9 is independently selected from O, S, NR 30 , CR 9 R 10 , CR 5 R 6 . and CH2; wherein X 8 and X 9 cannot both be the same group;
• X 10 is selected from
• X 11 is selected from N and CR 1 ;
• X 12 is selected from N and CR 2 ;
• R 1 and R 2 are independently selected from hydrogen, halogen, Ci-C6alkyl, C2-C6alkenyl, Ci-Cealkynyl, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 1 and R 2 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl,
• R 3 and R 4 are independently selected from hydrogen, CN, C(0)R 31 , -SR 30 , and -OR 30 ; or R 3 and R 4 are instead combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and oxo;
• each R 5 and R 6 are independently selected from hydrogen, halogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and -N(R 30 )2, wherein when on carbons adjacent to each other a R 5 and a R 6 group may optionally be replaced by a carbon-carbon double bond;
• R 7 , R 8 , R 9 , R 10 , R 11 , and R 12 are independently selected from hydrogen, halogen, Ci-Cealkyl, C2-C 6 alkenyl, C2-C 6 alkynyl, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 ,
• R 7 and R 8 may be taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring or a 4- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 7 and R 8 may be taken together with the carbon to which they are attached to form carbonyl
• R 9 and R 10 may be taken together with the atom to which they are attached to form a 3- to 6-membered carbocyclic spiro ring or a 4- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 9 and R 10 may be taken together with the atom to which they are attached to form carbonyl;
• R 11 and R 12 may be taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring or a 4- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 11 and R 12 may be taken together with the carbon to which they are attached to form
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• each R 13 is independently selected from hydrogen or Ci-C6alkyl;
• R 14 , R 15 , and R 16 are independently selected from hydrogen, halogen,
• SFs Ci-Cealkyl, Ci-Cealkenyl, Ci-Cealkynyl, Ci-Cehaloalkyl, -Ci-Cealkyl-aryl.
• R 17 and R 18 are independently selected from hydrogen, halogen, Ci-C6alkyl, Ci-Cehaloalkyl, -OR 30 , and -N(R 30 ) 2 ;
• R 17 and R 18 are taken together with the carbons to which they are attached to form a double bond
• R 19 and R 20 are independently selected from hydrogen, Ci-C6alkyl, C5-C10 bicyclic carbocycle, C4-C6heterocycle, halogen, Ci-C6haloalkyl, -OR 30 , -N(R 30 )2, -(CH2)n-R 33 , and
• R 21 is selected from Ci-C6haloalkyl, -0-Ci-C6haloalkyl, Ci-C6alkyl, -0-Ci-C6alkyl, aryl, -O-aryl, heteroaryl, or -O-heteroaryl, each of which R 21 group is optionally substituted with 1, 2, 3, or 4 substituents independently selected from SFs, Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro;
• R 22 is selected from -Ci-C6alkyl-R 23 , -C2-C6alkenyl-R 23 , -C2-C6alkynyl-R 23 and bicyclic cycloalkyl-R 23 , each of which R 22 is optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro;
• R 23 is selected from hydrogen, sugar, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , and -S(0) 2 R 31 ;
• each R 25 is independently selected from hydrogen, SF5, halogen, Ci-C6alkyl, C2-C6alkenyl, Ci-Cealkynyl, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 25 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-Cealkyl, Ci-Cealkenyl, Ci-Cealkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl,
• R 29 is selected from halogen, Ci-C6alkyl, C2-C6alkenyl, C 2 -C6alkynyl, Ci-C6haloalkyl, - OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, and heteroaryl, each of which R 29 groups other than hydrogen and halogen are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C 2 -C6alkenyl, C 2 -C6alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• each R 30 is independently selected from hydrogen, Ci-C6alkyl, Ci-C6haloalkyl, aryl, heteroaryl, heterocycle, and C(0)R 31 ;
• each R 31 is independently selected from hydrogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 32 , -SR 32 , -N(R 32 ) 2 , heterocycle, aryl, and heteroaryl;
• each R 32 is independently selected from hydrogen, Ci-C6alkyl, and Ci-C6haloalkyl;
• each R 33 is independently selected from hydrogen, guanidine, heteroaryl, aryl, -C6H5-OR 30 ; -OR 30 , -SR 30 , -SeR 30 , -N(R 30 ) 2 , and -C(0)R 31 ;
• R 35 is selected from C3-Cioalkyl or C3-Ciohaloalkyl; wherein for compounds of Formula I and Formula II at least one of the following is satisfied: a.
• X 3 is C(R 17 ) and X 4 is C(R 18 );
• R 17 is selected from halogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and -N(R 30 )2;
• X 5 is Si
• Z is C(CH 2 );
• R 7 and R 8 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 11 and R 12 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 8 or R 10 is not hydrogen;
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 or R 12 is not hydrogen;
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• X 6 is selected from
• R 3 and R 4 are combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and oxo; wherein for compounds of Formula X and Formula XI at least one of the following is satisfied: a. X 3 is C(R 17 ) and X 4 is C(R 18 );
• R 17 is selected from halogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and -N(R 30 )2;
• X 5 is Si
• Z is C(CH 2 );
• R 7 and R 8 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 10 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 is not hydrogen; i. R 11 and R 12 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 3- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 is not hydrogen;
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• R 22 is substituted with at least three OR 30 groups; m. R 23 is a sugar;
• R 3 and R 4 are CN, -SR 30 , or C(0)R 31 ; or
• R 3 and R 4 are combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and oxo; wherein for compounds of Formula XIV at least one of the following is satisfied:
• X 1 is O or N(R 30 );
• R 14 is not hydrogen
• R 1 is not hydrogen
• R 2 is not hydrogen
• R 3 is not hydrogen
• R 4 is not hydrogen.
• R 21 is selected from Ci-C6alkyl and -0-Ci-C6alkyl
• each R 25 is independently selected from hydrogen, halogen, Ci-C6alkyl, C2-C6alkenyl, Ci-Cealkynyl, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 1 and R 2 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C 2 -C6alkenyl, C 2 -C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle,
• R 14 , R 15 , and R 16 are independently selected from hydrogen, halogen, Ci-C6alkyl, C 2 - Cealkenyl, C 2 -C6alkynyl, Ci-C6haloalkyl, -Ci-C6alkyl-aryl.
• the compound of the present disclosure is selected from:
• each n is independently 1, 2, or 3;
• each m is independently 0, 1, 2, or 3;
• o 0, 1, or 2; is either a single or a double bond;
• Z is CH 2 , C(CH 2 ), or C(O);
• X 1 is selected from S, O, and N(R 30 );
• X 2 is selected from bond, N(R 30 ), and -0-N(R 30 )-;
• X 3 is selected from N and C(R 17 );
• X 4 is selected from N and C(R 18 );
• X 5 is C or Si
• X 7 is selected from O, S, N(R 30 ), and CR 5 R 6 ;
• each X 8 and X 9 is independently selected from O, S, NR 30 , CR 9 R 10 , CR 5 R 6 . and CH2; wherein X 8 and X 9 cannot both be the same group
• X 11 is selected from N and CR 1 ;
• X 12 is selected from N and CR 2 ;
• R 1 and R 2 are independently selected from hydrogen, halogen, Ci-C6alkyl, C2-C6alkenyl, C2-C 6 alkynyl, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 1 and R 2 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl,
• R 3 and R 4 are independently selected from hydrogen, C(0)R 31 , -SR 30 , and -OR 30 ;
• R 3 and R 4 are instead combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and oxo;
• each R 5 and R 6 are independently selected from hydrogen, halogen, Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and -N(R 30 )2, wherein when on carbons adjacent to each other a R 5 and a R 6 group may optionally be replaced by a carbon-carbon double bond;
• R 9 and R 10 may be taken together with the atom to which they are attached to form carbonyl;
• R 11 and R 12 may be taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring or a 4- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, and S;
• R 11 and R 12 may be taken together with the carbon to which they are attached to form carbonyl;
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 4- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; or R 7 and R 1 1 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• each R 13 is independently selected from hydrogen or Ci-C6alkyl
• R 14 , R 15 , and R 16 are independently selected from hydrogen, halogen,
• R 17 and R 18 are independently selected from hydrogen, halogen, Ci-C6alkyl, Ci-Cehaloalkyl, -OR 30 , and -N(R 30 ) 2 ;
• R 17 and R 18 are taken together with the carbons to which they are attached to form a double bond
• R 19 and R 20 are independently selected from hydrogen, Ci-C6alkyl, C5-C10 bicyclic carbocycle, C4-C6heterocycle, halogen, Ci-C6haloalkyl, -OR 30 , -N(R 30 )2, -(CH2)n-R 33 , and
• R 21 is selected from C1-C6 alkyl and -O-C1-C6 alkyl
• R 22 is selected from -C1-C6 alkyl-R 23 , -C2-C6 alkenyl-R 23 , -C2-C6 alkynyl-R 23 and bicyclic cycloalkyl-R 23 , each of which R 22 is optionally substituted with 1, 2, 3, or 4 substituents independently selected from C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, halogen, C1-C6 haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro;
• R 23 is selected from hydrogen, sugar, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , and -S(0) 2 R 31 ;
• each R 25 is independently selected from hydrogen, halogen, C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, Ci-Ce haloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro; each of which R 1 and R 2 groups other than hydrogen, halogen, cyano, and nitro are optionally substituted with 1, 2, 3, or 4 substituents independently selected from C1-C6 alkyl, C2-C6 alkenyl, C2-C6 alkynyl, halogen, C1-C6 haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle,
• each R 30 is independently selected from hydrogen, C1-C6 alkyl, C1-C6 haloalkyl, aryl, heteroaryl, heterocycle, and C(0)R 31 ;
• each R 31 is independently selected from hydrogen, C1-C6 alkyl, C1-C6 haloalkyl, -OR 32 , -SR 32 , -N(R 32 )2, heterocycle, aryl, and heteroaryl;
• each R 32 is independently selected from hydrogen, C1-C6 alkyl, and C1-C6 haloalkyl; each R 33 is independently selected from hydrogen, guanidine, heteroaryl, aryl, -C6H5-OR 30 ; -OR 30 , -SR 30 , -SeR 30 , -N(R 30 ) 2 , -C(0)R 31 ,
• X 3 is C(R 17 ) and X 4 is C(R 18 );
• R 17 is selected from halogen, C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and -N(R 30 )2;
• X 5 is Si
• Z is C(CH 2 );
• e. Z is CH2;
• R 7 and R 8 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 10 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 11 and R 12 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• X 6 is selected from
• R 3 and R 4 are -SR 30 or C(0)R 31 ; or
• R 3 and R 4 are combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and oxo; wherein for compounds of Formula X and Formula XI at least one of the following is satisfied: a. X 3 is C(R 17 ) and X 4 is C(R 18 );
• R 17 is selected from halogen, C1-C6 alkyl, C1-C6 haloalkyl, -OR 30 , and -N(R 30 )2;
• X 5 is Si
• Z is C(CH 2 );
• R 7 and R 8 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 10 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 9 and R 11 are taken together with the atoms to which they are attached to form a 4- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 is not hydrogen; i. R 11 and R 12 are taken together with the carbon to which they are attached to form a 3- to 6-membered carbocyclic spiro ring; a 4- to 6-membered heterocyclic spiro ring containing
• R 7 and R 9 are taken together with the atoms to which they are attached to form a 4- to 8-membered carbocycle or a 4- to 8-membered heterocycle containing 1 or 2 heteroatoms independently chosen from N, O, and S; and R 10 is not hydrogen;
• R 7 and R 11 are taken together with the atoms to which they are attached to form a 1 or 2 carbon bridge;
• R 22 is substituted with at least three OR 30 groups
• R 23 is a sugar
• At least one of R 3 and R 4 is -SR 30 or C(0)R 31 ; or
• R 3 and R 4 are combined to form an oxadiazole optionally substituted with 1, 2, or 3 substituents independently selected from Ci-C6alkyl, Ci-C6haloalkyl, -OR 30 , and oxo; wherein for compounds of Formula XIV at least one of the following is satisfied:
• X 1 is O or N(R 30 );
• R 14 is not hydrogen
• R 1 is not hydrogen
• R 2 is not hydrogen
• R 3 is not hydrogen
• R 4 is not hydrogen.
• R 1 and R 2 are independently selected from hydrogen, halogen, -OR 30 , -SR 30 , -N(R 30 )2, and Ci-C6alkyl.
• R 10 is selected from halogen, Ci-Cealkyl, Ci-Cealkenyl, Ci-Cealkynyl, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , and -S(0) 2 R 31 .
• R 10 is selected from aryl and heteroaryl each of which is optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C 2 -C6alkenyl, C 2 -C6alkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , -C(0)R 31 , -S(0)R 31 , -S(0) 2 R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• R 19 is selected from Ci- Cealkyl, C5-C10 bicyclic carbocycle, C4-C 6 heterocycle, halogen, Ci-C6haloalkyl, -
• R 20 is selected from Ci- Cealkyl, C5-C10 bicyclic carbocycle, C4-C 6 heterocycle, halogen, Ci-C6haloalkyl, -
• R 21 is phenyl, optionally substituted with 1, 2, 3, or 4 substituents independently selected from SF5, Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, - C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• substituents independently selected from SF5, Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, - C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• R 21 is heteroaryl, optionally substituted with 1, 2, 3, or 4 substituents independently selected from SFs, Ci-C6alkyl, Ci-Cealkenyl, Ci-Cealkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , - C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• substituents independently selected from SFs, Ci-C6alkyl, Ci-Cealkenyl, Ci-Cealkynyl, halogen, Ci-Cehaloalkyl, -OR 30 , -SR 30 , -N(R 30 ) 2 , - C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro
• R 22 is -Ci-C6alkyl-R 23 optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• R 22 is -C3-C 6 alkyl-R 23 optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci- Cealkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• R 22 is bicyclic cycloalkyl - R 23 optionally substituted with 1, 2, 3, or 4 substituents independently selected from Ci-C6alkyl, C2-C6alkenyl, C2-C6alkynyl, halogen, Ci-C6haloalkyl, -OR 30 , -SR 30 , -N(R 30 )2, -C(0)R 31 , -S(0)R 31 , -S(0)2R 31 , heterocycle, aryl, heteroaryl, cyano, and nitro.
• R 33 is independently selected from hydrogen, guanidine, heteroaryl, aryl, -C6H5-OR 30 ; -OR 30 , -SR 30 , -SeR 30 , -N(R 30 )2, and -C(0)R 31 .
• R 33 is independently selected from hydrogen, guanidine, heteroaryl, aryl, -C6H5-OR 30 ; -OR 30 , -SR 30 , -SeR 30 , -N(R 30 )2, and -C(0)R 31 .
• the compound of the present is selected from:
• the compound of the present disclosure is selected from:
• a pharmaceutical composition comprising a compound of any one of embodiments 1-147 and a pharmaceutically acceptable carrier is provided.
• a method of treating a complement mediated disorder comprising administering to a subj ect in need thereof a therapeutically effective amount of a compound or pharmaceutical composition thereof according to any one of embodiments 1-148, or a pharmaceutically acceptable salt thereof, is provided.
• any one of embodiments 149-151, wherein the disorder is selected from hereditary angioedema type 1, hereditary angioedema type 2, trauma, inflammation, sepsis, multiple organ dysfunction syndrome, endotoxemia, end stage renal disease, kidney failure, delayed graft function, ischemic reperfusion injury, neuromyelitis optica, common variable immunodeficiency, antibody-mediated rejection, graft rejection, asthma, allergic asthma, angioneurotic edema, acute ACE- induced angioedema, kidney transplantation, and acute kidney injury.
• the disorder is selected from hereditary angioedema type 1, hereditary angioedema type 2, trauma, inflammation, sepsis, multiple organ dysfunction syndrome, endotoxemia, end stage renal disease, kidney failure, delayed graft function, ischemic reperfusion injury, neuromyelitis optica, common variable immunodeficiency, antibody-mediated rejection, graft rejection, asthma, allergic asthma, angioneurotic edema, acute ACE-
• a compound of pharmaceutically acceptable salt thereof according to any one of embodiments 1-147 or a pharmaceutical composition of embodiment 148 for use in the treatment of a complement mediated disorder is provided.
• ATD age-related macular degeneration
• any one of embodiments 164-166 wherein the disorder is selected from hereditary angioedema type 1, hereditary angioedema type 2, trauma, inflammation, sepsis, multiple organ dysfunction syndrome, endotoxemia, end stage renal disease, kidney failure, delayed graft function, ischemic reperfusion injury, neuromyelitis optica, common variable immunodeficiency, antibody-mediated rejection, graft rejection, asthma, allergic asthma, angioneurotic edema, acute ACE-induced angioedema, kidney transplantation, and acute kidney injury.
• the disorder is selected from hereditary angioedema type 1, hereditary angioedema type 2, trauma, inflammation, sepsis, multiple organ dysfunction syndrome, endotoxemia, end stage renal disease, kidney failure, delayed graft function, ischemic reperfusion injury, neuromyelitis optica, common variable immunodeficiency, antibody-mediated rejection, graft rejection, asthma, allergic asthma, angioneurotic edema, acute ACE-induced angio
• a use of a compound of any one of embodiments 1-147 or its pharmaceutically acceptable salt in the manufacture of a medicament for the treatment of a complement mediated disorder is provided.
• embodiment 179 wherein the subject is a human.
• any one of embodiments 179-181, wherein the disorder is selected from hereditary angioedema type 1, hereditary angioedema type 2, trauma, inflammation, sepsis, multiple organ dysfunction syndrome, endotoxemia, end stage renal disease, kidney failure, delayed graft function, ischemic reperfusion injury, neuromyelitis optica, common variable immunodeficiency, antibody-mediated rejection, graft rejection, asthma, allergic asthma, angioneurotic edema, acute ACE-induced angioedema, kidney transplantation, and acute kidney injury.
• the disorder is selected from hereditary angioedema type 1, hereditary angioedema type 2, trauma, inflammation, sepsis, multiple organ dysfunction syndrome, endotoxemia, end stage renal disease, kidney failure, delayed graft function, ischemic reperfusion injury, neuromyelitis optica, common variable immunodeficiency, antibody-mediated rejection, graft rejection, asthma, allergic asthma, angioneurotic edema, acute ACE-induced angio
• Active compounds described herein can be administered to a host in need thereof as the neat chemical, but are more typically administered as a pharmaceutical composition that includes an effective amount for a host, typically a human, in need of such treatment of an active compound as described herein or its pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof.
• the disclosure provides pharmaceutical compositions comprising an effective amount of compound or pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof together with at least one pharmaceutically acceptable carrier for any of the uses described herein.
• the pharmaceutical composition may contain a compound or salt as the only active agent, or, in an alternative embodiment, the compound and at least one additional active agent.
• an effective amount of an active compound as described herein, or the active compound described herein in combination or alternation with, or preceded by, concomitant with or followed by another active agent can be used in an amount sufficient to (a) inhibit the progression of a disorder mediated by the complement pathway, including an inflammatory, immune, including an autoimmune, disorder or complement related disorder; (b) cause a regression of an inflammatory, immune, including an autoimmune, disorder or complement related disorder; (c) cause a cure of an inflammatory, immune, including an autoimmune, disorder or complement related disorder; or inhibit or prevent the development of an inflammatory, immune, including an autoimmune, disorder or complement related disorder. Accordingly, an effective amount of an active compound or its salt or composition described herein will provide a sufficient amount of the active agent when administered to a patient to provide a clinical benefit.
• the exact amount of the active compound or pharmaceutical composition described herein to be delivered to the host, typically a human, in need thereof, will be determined by the health care provider to achieve the desired clinical benefit.
• the pharmaceutical composition is in a dosage form that contains from about 0.1 mg to about 2000 mg, from about 10 mg to about 1000 mg, from about 100 mg to about 800 mg, or from about 200 mg to about 600 mg of the active compound and optionally from about 0.1 mg to about 2000 mg, from about 10 mg to about 1000 mg, from about 100 mg to about 800 mg, or from about 200 mg to about 600 mg of an additional active agent in a unit dosage form.
• Examples are dosage forms with at least about 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 10, 15, 20, 25, 50, 75, 100, 150, 200, 250, 300, 350, 400, 450, 500, 550, 600, 650, 700, 750, 800, 900, 1000, 1100, 1200, 1250, 1300, 1400, 1500, or 1600 mg of active compound, or its salt, N-oxide, isotopic analog, or prodrug.
• the dosage form has at least about lmg, 5 mg, 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, 200 mg, 400 mg, 500 mg, 600 mg, lOOOmg, 1200 mg, or 1600 mg of active compound, N-oxide, isotopic analog, prodrug, or its salt.
• the amount of active compound in the dosage form is calculated without reference to the salt.
• the dosage form can be administered, for example, once a day (q.d.), twice a day (b.i.d.), three times a day (t.i.d.), four times a day (q.i.d.), once every other day (Q2d), once every third day (Q3d), as needed, or any dosage schedule that provides treatment of a disorder described herein.
• Compounds disclosed herein or used as described herein may be administered orally, topically, parenterally, by inhalation or spray, sublingually, via implant, including ocular implant, transdermally, via buccal administration, rectally, as an ophthalmic solution, injection, including ocular injection, intravenous, intra-aortal, intracranial, subdermal, intraperitoneal, subcutaneous, transnasal, sublingual, intrathecal, or rectal or by other means, in dosage unit formulations containing conventional pharmaceutically acceptable carriers.
• the compound can be administered, as desired, for example, as a solution, suspension, or other formulation via intravitreal, intrastromal, intracameral, sub-tenon, sub-retinal, retro-bulbar, peribulbar, suprachorodial, subchorodial, chorodial, conjunctival, subconjunctival, episcleral, periocular, transscleral, retrobulbar, posterior juxtascleral, circumcorneal, or tear duct injections, or through a mucus, mucin, or a mucosal barrier, in an immediate or controlled release fashion or via an ocular device, injection, or topically administered formulation, for example, a solution or suspension provided as an eye drop.
• the pharmaceutical composition may be formulated as any pharmaceutically useful form, e.g., as an aerosol, a cream, a gel, a gel cap, a pill, a microparticle, a nanoparticle, an injection or infusion solution, a capsule, a tablet, a syrup, a transdermal patch, a subcutaneous patch, a dry powder, an inhalation formulation, in a medical device, suppository, buccal, or sublingual formulation, parenteral formulation, or an ophthalmic solution or suspension.
• Some dosage forms, such as tablets and capsules are subdivided into suitably sized unit doses containing appropriate quantities of the active components, e.g., an effective amount to achieve the desired purpose.
• compositions, and methods of manufacturing such compositions, suitable for administration as contemplated herein are known in the art.
• known techniques include, for example, US Patent Nos. 4,983,593; 5,013,557; 5,456,923; 5,576,025; 5,723,269; 5,858,411; 6,254,889; 6,303, 148; 6,395,302; 6,497,903; 7,060,296; 7,078,057; 7,404,828; 8,202,912; 8,257,741; 8,263, 128; 8,337,899; 8,431, 159; 9,028,870; 9,060,938; 9,211,261; 9,265,731; 9,358,478; and 9,387,252; incorporated by reference herein.
• compositions contemplated here can optionally include a carrier.
• Carriers must be of sufficiently high purity and sufficiently low toxicity to render them suitable for administration to the patient being treated.
• the carrier can be inert or it can possess pharmaceutical benefits of its own.
• the amount of carrier employed in conjunction with the compound is sufficient to provide a practical quantity of material for administration per unit dose of the compound.
• Classes of carriers include, but are not limited to binders, buffering agents, coloring agents, diluents, disintegrants, emulsifiers, fillers, flavorants, glidents, lubricants, pH modifiers, preservatives, stabilizers, surfactants, solubilizers, tableting agents, and wetting agents.
• Some carriers may be listed in more than one class, for example vegetable oil may be used as a lubricant in some formulations and a diluent in others.
• Exemplary pharmaceutically acceptable carriers include sugars, starches, celluloses, powdered tragacanth, malt, gelatin; talc, and vegetable oils.
• examples of other matrix materials, fillers, or diluents include lactose, mannitol, xylitol, microcrystalline cellulose, calcium diphosphate, and starch.
• surface active agents include sodium lauryl sulfate and polysorbate 80.
• disintegrants examples include sodium starch gycolate, sodium alginate, carboxymethyl cellulose sodium, methyl cellulose, colloidal silicon dioxide, and croscarmellose sodium.
• binders examples include methyl cellulose, microcrystalline cellulose, starch, and gums such as guar gum, and tragacanth.
• lubricants examples include magnesium stearate and calcium stearate.
• pH modifiers include acids such as citric acid, acetic acid, ascorbic acid, lactic acid, aspartic acid, succinic acid, phosphoric acid, and the like; bases such as sodium acetate, potassium acetate, calcium oxide, magnesium oxide, trisodium phosphate, sodium hydroxide, calcium hydroxide, aluminum hydroxide, and the like, and buffers generally comprising mixtures of acids and the salts of said acids.
• bases such as sodium acetate, potassium acetate, calcium oxide, magnesium oxide, trisodium phosphate, sodium hydroxide, calcium hydroxide, aluminum hydroxide, and the like, and buffers generally comprising mixtures of acids and the salts of said acids.
• buffers generally comprising mixtures of acids and the salts of said acids.
• optionalal other active agents may be included in a pharmaceutical composition, which do not substantially interfere with the activity of the compound of the present disclosure.
• the pharmaceutical preparation may include polymers for controlled delivery of the described compounds, including, but not limited to pluronic polymers, polyesters (e.g., polylactic acid, poly(lactic-co-glycolic acid), polycaprolactone, polyvalerolactone, poly(l,3- dioxan-2one)); polyanhydrides (e.g., poly(sebacic anhydride)); polyethers (e.g., polyethylene glycol); polyurethanes; polymethacrylates; polyacrylates; and polycyanoacrylates.
• polymers may be modified with polyethylene glycol (PEG), with a carbohydrate, and/or with acyclic polyacetals derived from polysaccharides. See , e.g., Papisov, 2001, ACS Symposium Series , 786:301, incorporated by reference herein.
• the compounds of the present disclosure can be formulated as particles.
• the particles are, or include, microparticles.
• the particles are or include nanoparticles.
• common techniques for preparing particles include, but are not limited to, solvent evaporation, solvent removal, spray drying, phase inversion, coacervation, and low temperature casting. Suitable methods of particle formulation are briefly described herein. Pharmaceutically acceptable excipients, including pH modifying agents, disintegrants, preservatives, and antioxidants, can optionally be incorporated into the particles during particle formation.
• the particles are derived through a solvent evaporation method.
• a compound described herein or polymer matrix and one or more compounds described herein
• a volatile organic solvent such as methylene chloride.
• the organic solution containing a compound described herein is then suspended in an aqueous solution that contains a surface active agent such as poly(vinyl alcohol).
• the resulting emulsion is stirred until most of the organic solvent evaporated, leaving solid nanoparticles or microparticles.
• the resulting nanoparticles or microparticles are washed with water and dried overnight in a lyophilizer (under vacuum, with or without heat). Nanoparticles with different sizes and morphologies can be obtained by this method.
• compositions which contain labile polymers may degrade during the fabrication process due to the presence of water.
• labile polymers such as certain polyanhydrides
• methods which are performed in completely or substantially anhydrous organic solvents can be used to make the particles.
• Solvent removal can also be used to prepare particles from a compound that is hydrolytically unstable.
• the compound or polymer matrix and one or more compounds
• a volatile organic solvent such as methylene chloride.
• This mixture is then suspended by stirring in an organic oil (such as silicon oil) to form an emulsion.
• Solid particles form from the emulsion, which can subsequently be isolated from the supernatant.
• the external morphology of spheres produced with this technique is highly dependent on the identity of the drug.
• an active compound as described herein is administered to a patient in need thereof as particles formed by solvent removal.
• the present disclosure provides particles formed by solvent removal comprising a compound of the present disclosure and one or more pharmaceutically acceptable excipients as defined herein.
• the particles formed by solvent removal comprise a compound of the present disclosure and an additional therapeutic agent.
• the particles formed by solvent removal comprise a compound of the present disclosure, an additional therapeutic agent, and one or more pharmaceutically acceptable excipients.
• any of the described particles formed by solvent removal can be formulated into a tablet, and then coated to form a coated tablet.
• the particles formed by solvent removal are formulated into a tablet but the tablet is uncoated.
• the particles are derived by spray drying.
• a compound or polymer matrix and one or more compounds
• an organic solvent such as methylene chloride.
• the solution is pumped through a micronizing nozzle driven by a flow of compressed gas, and the resulting aerosol is suspended in a heated cyclone of air, allowing the solvent to evaporate from the micro droplets, forming particles.
• Microparticles and nanoparticles can be obtained using this method.
• an active compound as described herein is administered to a patient in need thereof as a spray dried dispersion (SDD).
• the present disclosure provides a spray dried dispersion (SDD) comprising a compound of the present disclosure and one or more pharmaceutically acceptable excipients as defined herein.
• the SDD comprises a compound of the present disclosure and an additional therapeutic agent.
• the SDD comprises a compound of the present disclosure, an additional therapeutic agent, and one or more pharmaceutically acceptable excipients.
• any of the described spray dried dispersions can be coated to form a coated tablet.
• the spray dried dispersion is formulated into a tablet but the tablet is uncoated.
• an active compound as described herein is administered to a patient in need thereof as particles formed by phase inversion.
• the present disclosure provides particles formed by phase inversion comprising a compound of the present disclosure and one or more pharmaceutically acceptable excipients as defined herein.
• the particles formed by phase inversion comprise a compound of the present disclosure and an additional therapeutic agent.
• the particles formed by phase inversion comprise a compound of the present disclosure, an additional therapeutic agent, and one or more pharmaceutically acceptable excipients.
• any of the described particles formed by phase inversion can be formulated into a tablet and then coated to form a coated tablet.
• the particles formed by phase inversion are formulated into a tablet, but the tablet is uncoated.
• Coacervation involves the separation of a compound (or polymer matrix and one or more compounds) solution into two immiscible liquid phases.
• One phase is a dense coacervate phase, which contains a high concentration of the compound, while the second phase contains a low concentration of the compound.
• the compound forms nanoscale or microscale droplets, which harden into particles.
• Coacervation may be induced by a temperature change, addition of a non-solvent or addition of a micro-salt (simple coacervation), or by the addition of another polymer thereby forming an interpolymer complex (complex coacervation).
• an active compound as described herein is administered to a patient in need thereof as particles formed by coacervation.
• the present disclosure provides particles formed by coacervation comprising a compound of the present disclosure and one or more pharmaceutically acceptable excipients as defined herein.
• the particles formed by coacervation comprise a compound of the present disclosure and an additional therapeutic agent.
• the particles formed by coacervation comprise a compound of the present disclosure, an additional therapeutic agent, and one or more pharmaceutically acceptable excipients.
• any of the described particles formed by coacervation can be formulated into a tablet and then coated to form a coated tablet.
• the particles formed by coacervation are formulated into a tablet, but the tablet is uncoated.
• a compound of the present disclosure is administered to a patient in need thereof as particles formed by low temperature casting.
• the present disclosure provides particles formed by low temperature casting comprising a compound of the present disclosure and one or more pharmaceutically acceptable excipients as defined herein.
• the particles formed by low temperature casting comprise a compound of the present disclosure and an additional therapeutic agent.
• the particles formed by low temperature casting comprise a compound of the present disclosure, an additional therapeutic agent, and one or more pharmaceutically acceptable excipients.
• any of the described particles formed by low temperature casting can be formulated into a tablet and then coated to form a coated tablet.
• the particles formed by low temperature casting are formulated into a tablet, but the tablet is uncoated.
• an effective amount of an active compound as described herein is incorporated into a nanoparticle, e.g ., for convenience of delivery and/or extended release delivery.
• a nanoparticle e.g ., for convenience of delivery and/or extended release delivery.
• the use of materials in nanoscale provides one the ability to modify fundamental physical properties such as solubility, diffusivity, blood circulation half-life, drug release characteristics, and/or immunogenicity.
• a number of nanoparticle-based therapeutic and diagnostic agents have been developed for the treatment of cancer, diabetes, pain, asthma, allergy, and infections. These nanoscale agents may provide more effective and/or more convenient routes of administration, lower therapeutic toxicity, extend the product life cycle, and ultimately reduce health-care costs.
• nanoparticles can allow targeted delivery and controlled release.
• nanoparticle-based compound delivery can be used to release compounds at a sustained rate and thus lower the frequency of administration, deliver drugs in a targeted manner to minimize systemic side effects, or deliver two or more drugs simultaneously for combination therapy to generate a synergistic effect and suppress drug resistance.
• a number of nanotechnology-based therapeutic products have been approved for clinical use. Among these products, liposomal drugs and polymer-based conjugates account for a large proportion of the products. See Zhang, L., et al., Nanoparticles in Medicine: Therapeutic Applications and Developments, Clin. Pharm. and Ther ., 83(5):761-769, 2008.
• polyesters examples include poly(L-lactide-co-L-lysine) (Barrera et al., 1993, J. Am. Chem. Soc ., 115: 11010), poly(serine ester) (Zhou et al., 1990, Macromolecules, 23:3399), poly(4- hydroxy-L-proline ester) (Putnam et al., 1999 , Macromolecules, 32:3658; and Lim et al., 1999, J. Am. Chem.
• the polymeric particle is between about 0.1 nm to about 10000 nm, between about 1 nm to about 1000 nm, between about 10 nm and 1000 nm, between about 1 and 100 nm, between about 1 and 10 nm, between about 1 and 50 nm, between about 100 nm and 800 nm, between about 400 nm and 600 nm, or about 500 nm.
• the micro-particles are no more than about 0.1 nm, 0.5 nm, 1.0 nm, 5.0 nm, 10 nm, 25 nm, 50 nm, 75 nm, 100 nm, 150 nm, 200 nm, 250 nm, 300 nm, 400 nm, 450 nm, 500 nm, 550 nm, 600 nm, 650 nm, 700 nm, 750 nm, 800 nm, 850 nm, 900 nm, 950 nm, 1000 nm, 1250 nm, 1500 nm, 1750 nm, or 2000 nm.
• a compound described herein may be covalently coupled to a polymer used in the nanoparticle, for example a polystyrene particle, PLGA particle, PLA particle, or other nanoparticle.
• compositions according to the disclosure can be formulated for oral administration.
• These compositions can contain any amount of active compound that achieves the desired result, for example, between 0.1 and 99 weight % (wt.%) of the compound, and usually at least about 5 wt.% of the compound.
• Some embodiments contain at least about 10%, 15%, 20%, 25 wt.% to about 50 wt. % or from about 5 wt.% to about 75 wt.% of the compound.
• compositions suitable for rectal administration are typically presented as unit dose suppositories. These may be prepared by admixing the active compound with one or more conventional solid carriers, for example, cocoa butter, and then shaping the resulting mixture.
• conventional solid carriers for example, cocoa butter
• compositions suitable for topical application to the skin preferably take the form of an ointment, cream, lotion, paste, gel, spray, aerosol, or oil.
• Carriers which may be used include petroleum jelly, lanoline, polyethylene glycols, alcohols, transdermal enhancers, and combinations of two or more thereof.
• compositions suitable for transdermal administration may be presented as discrete patches adapted to remain in intimate contact with the epidermis of the recipient for a prolonged period of time.
• Pharmaceutical compositions suitable for transdermal administration may also be delivered by iontophoresis (see, for example, Pharmaceutical Research 3 (6):318 (1986)) and typically take the form of an optionally buffered aqueous solution of the active compound.
• microneedle patches or devices are provided for delivery of drugs across or into biological tissue, particularly the skin. The microneedle patches or devices permit drug delivery at clinically relevant rates across or into skin or other tissue barriers, with minimal or no damage, pain, or irritation to the tissue.
• compositions suitable for administration to the lungs can be delivered by a wide range of passive breath driven and active power driven single/-multiple dose dry powder inhalers (DPI).
• DPI dry powder inhalers
• the devices most commonly used for respiratory delivery include nebulizers, metered-dose inhalers, and dry powder inhalers.
• nebulizers include jet nebulizers, ultrasonic nebulizers, and vibrating mesh nebulizers.
• Selection of a suitable lung delivery device depends on parameters, such as nature of the drug and its formulation, the site of action, and pathophysiology of the lung.
• inhalation drug delivery devices and methods include, for example, US 7,383,837 titled “Inhalation Device” (SmithKline Beecham Corporation); WO/2006/033584 titled “Powder Inhaler” (Glaxo SmithKline Pharmaceuticals SA); WO/2005/044186 titled“Inhalable Pharmaceutical Formulations Employing Desiccating Agents and Methods of Administering the Same” (Glaxo Group Ltd and SmithKline Beecham Corporation); US9,095,670 titled“Inhalation Device and Method of Dispensing Medicament”, US 8,205,611 titled“Dry Powder Inhaler” (Astrazeneca AB); WO/2013/038170 titled“Inhaler” (Astrazeneca AB and Astrazeneca UK Ltd.); US/2014/0352690 titled“Inhalation Device with Feedback System”, US 8,910,625 and US/2015/0165137 titled“Inhalation Device for Use in Aerosol Therapy” (Vectura
• Additional non-limiting examples of methods and devices for drug delivery to the eye include, for example, WO2011/106702 and US 8,889, 193 titled“Sustained delivery of therapeutic agents to an eye compartment”, WO2013/138343 and US 8,962,577 titled“Controlled release formulations for the delivery of HIF-1 inhibitors”, WO/2013/138346 and US2013/0272994 titled “Non-Linear Multiblock Copolymer-Drug Conjugates for the Delivery of Active Agents”, W02005/072710 and US 8,957,034 titled“Drug and Gene Carrier Particles that Rapidly Move Through Mucus Barriers”, W02008/030557, US2010/0215580, US2013/0164343 titled “Compositions and Methods for Enhancing Transport Through Mucous”, W02012/061703, US2012/0121718, and US2013/0236556 titled“Compositions and Methods Relating to Reduced Mucoadhesion”, WO2012/03
• Additional non-limiting examples of drug delivery devices and methods include, for example, US 2009/0203709 titled“Pharmaceutical Dosage Form For Oral Administration Of Tyrosine Kinase Inhibitor” (Abbott Laboratories); US 2005/0009910 titled“Delivery of an active drug to the posterior part of the eye via subconjunctival or periocular delivery of a prodrug”, US 20130071349 titled“Biodegradable polymers for lowering intraocular pressure”, US 8,481,069 titled“Tyrosine kinase microspheres”, US 8,465,778 titled“Method of making tyrosine kinase microspheres”, US 8,409,607 titled“Sustained release intraocular implants containing tyrosine kinase inhibitors and related methods”, US 8,512,738 and US 2014/0031408 titled“Biodegradable intravitreal tyrosine kinase implants”, US 2014/029
• an effective amount of an active compound or its salt or composition as described herein is used to treat a medical disorder which is an inflammatory or immune condition, a disorder mediated by the complement cascade (including a dysfunctional cascade) including a complement-related disorder or alternative complement pathway-related disorder, a disorder or abnormality of a cell that adversely affects the ability of the cell to engage in or respond to normal complement activity, or an undesired complement-mediated response to a medical treatment, such as surgery or other medical procedure or a pharmaceutical or biopharmaceutical drug administration, a blood transfusion, or other allogenic tissue or fluid administration.
• a medical disorder which is an inflammatory or immune condition
• a disorder mediated by the complement cascade including a dysfunctional cascade
• a complement-related disorder or alternative complement pathway-related disorder a disorder or abnormality of a cell that adversely affects the ability of the cell to engage in or respond to normal complement activity, or an undesired complement-mediated response to a medical treatment, such as surgery or other medical procedure or a pharmaceutical or
• a complement-mediated disease or disorder is a disease or disorder in which the amount or activity of complement is such as to cause disease or disorder in an individual.
• the complement-mediated disease or disorder is selected from the group consisting of autoimmune disease, cancer, hematological disease, infectious disease, inflammatory disease, ischemia-reperfusion injury, neurodegenerative disease, neurodegenerative disorder, ocular disease, renal disease, transplant rejection, vascular disease, and vasculitis disease.
• the complement-mediated disease or disorder is an autoimmune disease. In some embodiments, the complement-mediated disease or disorder is cancer.
• the complement-mediated disease or disorder is an infectious disease.
• the complement-mediated disease or disorder is an inflammatory disease.
• the complement-mediated disease or disorder is a hematological disease. In some embodiments, the complement-mediated disease or disorder is an ischemia- reperfusion injury.
• the complement-mediated disease or disorder is ocular disease. In some embodiments, the complement-mediated disease or disorder is a renal disease.
• the complement-mediated disease or disorder is transplant rejection.
• the complement-mediated disease or disorder is antibody-mediated transplant rejection.
• the complement-mediated disease or disorder is a vascular disease.
• the complement-mediated disease or disorder is a vasculitis disorder.
• the complement-mediated disease or disorder is a neurodegenerative disease or disorder.
• the complement-mediated disease is a neurodegenerative disease.
• the complement-mediated disorder is a neurodegenerative disorder. In some embodiments, the complement-mediated disease or disorder is a tauopathy.
• an effective amount of an active compound described herein, or it pharmaceutically acceptable salt is used to treat a medical disorder of the central nervous system (CNS) or peripheral nervous system disorders involving complement activation.
• the CNS disorder is an acquired brain or spinal cord injury, including, but not limited to ischaemic- reperfusion injury or stroke, traumatic brain injury (TBI) and spinal cord injury (SCI).
• the disorder is a neurodegeneration disorder. In embodiments, the disorder is a neuroinflammation disorder.
• an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Alzheimer's disease (AD).
• AD is characterized by two hallmark pathologies; amyloid-b (Ab) plaques and neurofibrillary tangles comprising hyperphosphorylated tau.
• SNPs single nucleotide polymorphisms
• CLU complement proteins Clusterin
• CR1 CR1
• an effective amount of active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat certain forms of frontotemporal dementia including, but not limited to, Pick's disease, sporadic Frontotemporal dementia and Frontotemporal dementia with Parkinsonism linked to chromosome 17, Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD), and Subacute sclerosing panencephalitis.
• frontotemporal dementia including, but not limited to, Pick's disease, sporadic Frontotemporal dementia and Frontotemporal dementia with Parkinsonism linked to chromosome 17, Progressive supranuclear palsy (PSP), Corticobasal degeneration (CBD), and Subacute sclerosing panencephalitis.
• an effective amount of active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat multiple sclerosis (MS).
• MS multiple sclerosis
• C3 has been shown to be deposited in the brains of MS patients.
• T-cell clone (TCC) has been shown to be in association with capillary endothelial cells, predominantly within plaques and adjacent white matter. Localization of C activation to areas of active myelin destruction has also been shown, with TCC deposited exclusively in such areas.
• C3d has been shown to be deposited in association with short segments of disrupted myelin in plaques with low-grade active demyelination and provides evidence for a C contribution to disease progression as well as acute inflammation. See Ingram et ak, Complement in multiple sclerosis: its role in disease and potential as a biomarker. Clin Exp Immunol . 2009 Feb; 155(2): 128-39.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat neuromyelitis optica (NMO).
• NMO neuromyelitis optica
• MS neuromyelitis optica
• IgG NMO-immunoglobulin G
• an effective amount of an active compound as described herein, or a pharmaceutically acceptable salt thereof is used to treat amyotrophic lateral sclerosis (ALS).
• ALS is caused by progressive loss of upper and lower (a) motor neurons resulting in denervation of neuromuscular junctions in the peripheral nervous system, progressive muscle weakness, atrophy, spasticity, respiratory failure, and ultimately paralysis and death.
• Recent studies have shown increased Clq protein in motor cortex and spinal cord of ALS post-mortem tissue; C3 activation fragments and TCC in areas of pathology; C4d and TCC staining of degenerating neurons and glia in ALS motor cortex and spinal cord, and C5aRl upregulation in areas of pathology.
• C3d and C4d have been found on oligodendroglia and degenerating neurites, surrounded by CR4-positive microglia, in spinal cord and motor cortex, and Clq, C3, and TCC have been shown to be present on motor end-plates in intercostal muscles in ALS donors even early in the disease process. See Carpanini et al., Therapeutic Inhibition of the Complement System in Diseases of the Central Nervous System, Front. Immunol ., 04 March 2019.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Parkinson's disease (PD).
• PD is characterized by loss of dopaminergic neurons in the substantia nigra and deposits of the protein a-synuclein that form the pathological hallmarks of the disease, Lewy bodies. Patients present with resting tremor, bradykinesia, and rigidity. Complement activation has been associated with a-synuclein and Lewy bodies in Parkinson's disease; in vitro studies have demonstrated that the disease-associated splice variant a-synuclein 112, but not the full-length protein, cause activation of complement.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Huntington's disease (HD).
• HD is an autosomal dominant, inherited neurodegenerative disease characterized by progressive motor symptoms, psychiatric disturbances, and dementia. It is caused by expansion of a three-base-pair (CAG) repeat (39-121 repeats vs. normal range 8-39 repeats) in exon 1 of the HTT gene that translates into a polyglutamine tract at the N-terminus of the protein. This results in a polyglutamine length-dependent misfolding and accumulation of huntingtin protein in the striatum and cortex (layers 3, 5, and 6) followed by neuronal loss in these areas which spreads to the hippocampus.
• CAG three-base-pair
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat argyrophilic grain dementia, British type amyloid angiopathy, cerebral amyloid angiopathy, Creutzfeldt-Jakob disease, dementia pugilistica, diffuse neurofibrillary tangles with calcification, Down's syndrome, frontotemporal lobar degeneration, Gerstmann-Straussler-Scheinker disease, Hallervorden-Spatz disease, inclusion body myositis, multiple system atrophy (MSA), myotonic dystrophy, Niemann-Pick disease type C, non-Guamanian motor neuron disease with neurofibrillary tangles, postencephalitic parkinsonism, prion protein cerebral amyloid angiopathy, progressive subcortical gliosis, progressive supranuclear palsy, subacute sclerosing panencephalitis, Tangle only dementia, multi-infarct dementia,
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat a hereditary motor and sensory neuropathy (HMSN).
• HMSN hereditary motor and sensory neuropathy
• the hereditary and sensory neuropathy is Charcot-Marie-Tooth (CMT) disease.
• CMT Charcot-Marie-Tooth
• the HSMN is Charcot-Marie-Tooth disease type 1 A or type IB.
• the HSMN is Charcot-Marie-Tooth disease type 2.
• the HSMN is Dejerine-Sottas disease (Charcot-Marie-Tooth type).
• the HSMN is Refsum disease. In some embodiments, the HSMN is Charcot-Marie-Tooth with pyramidal features. In some embodiments, the HSMN is Charcot-Marie-Tooth type 6. In some embodiments, the HSMN is HMSN+retinitis pigmentosa.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Churg-Strauss syndrome.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof, is used to treat a peripheral artery disease (PAD).
• PAD peripheral artery disease
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat myasthenia gravis with CNS involvement.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof, is used to treat dementia with Lewy bodies.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat an individual suffering from prion disease.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof, is used to treat Behcet's Disease.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat congenital myasthenia.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat subacute sclerosing panencephalitis (SSPE).
• SSPE subacute sclerosing panencephalitis
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Guillain-Barre syndrome.
• the CNS disorder to be treated is a demyelinating disease, including, but not limited to, demyelinating myelinoclastic diseases and demyelinating leukostrophic disease.
• the disorder to be treated is a demyelinating myelonoclastic disease including, but not limited to, multiple sclerosis, neuromyelitis optica, neuromyelitis optica spectrum of disorders (NMOSD), idiopathic inflammatory demyelinating diseases (HDD), anti- NMDA receptor encephalitis, acute disseminated encephalomyelitis, anti-MOG autoimmune encephalomyelitis, chronic relapsing inflammatory optic neuritis (CRION), acute disseminated encephalomyelitis (ADEM), immune-mediated encephalomyelitis, progressive multifocal leukoencephalopathy (PML); McDonalds-positive multiple sclerosis, acute hemorrhagic leukoencephalitis, Rasmussen's Encephalitis, Marburg multiple sclerosis, pseudotumefactive and tumefactive multiple sclerosis, Balo concentric sclerosis, diffuse myelinoclastic sclerosis, solitary
• the disorder to be treated is a demyelinating leukostrophic disease including, but not limited to, myelitis, central pontine myelinolysis (CPM), extrapontine myelinolysis, tabes dorsalis, progressive multifocal leukoencephalopathy, leukoencephalopathy with vanishing white matter, leukoencephalopathy with neuroaxonal spheroids, reversible posterior leukoencephalopathy syndrome, megalencephalic leukoencephalopathy with subcortical cysts, megalencephalic leukoencephalopathy with subcortical cysts 1, hypertensive leukoencephalopathy, Metachromatic leukodystrophy, Krabbe disease, Canavan disease, X-linked adrenoleukodystrophy, Alexander disease, cerebrotendineous xanthomatosis, Pelizaeus- Merzbacher disease, and Refsum disease.
• myelitis central pontine myelinolysis (CPM),
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Buerger's disease, also known as thromboangiitis obliterans.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof, is used to treat giant cell arteritis.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat Raynaud's disease.
• the disorder to be treated is a demyelinating disease of the peripheral nervous system, including, but not limited to, Guillain-Barre syndrome and its chronic counterpart, chronic inflammatory demyelinating polyneuropathy, anti-MAG peripheral neuropathy, Charcot-Marie-Tooth disease and its counterpart Hereditary neuropathy with liability to pressure palsy, Copper deficiency-associated conditions (peripheral neuropathy, myelopathy, and rarely optic neuropathy), and progressive inflammatory neuropathy.
• demyelinating disease of the peripheral nervous system including, but not limited to, Guillain-Barre syndrome and its chronic counterpart, chronic inflammatory demyelinating polyneuropathy, anti-MAG peripheral neuropathy, Charcot-Marie-Tooth disease and its counterpart Hereditary neuropathy with liability to pressure palsy, Copper deficiency-associated conditions (peripheral neuropathy, myelopathy, and rarely optic neuropathy), and progressive inflammatory neuropathy.
• the disorder to be treated is a neurological inflammatory disorder.
• the disorder to be treated includes, but is not limited to, cranial arteritis; giant cell arteritis; Holmes-Adie syndrome; inclusion body myositis (IBM); meningitis; neurologic paraneoplastic syndrome including, but not limited to, Lambert-Eaton myasthenic syndrome, stiff- person syndrome, encephalomyelitis (inflammation of the brain and spinal cord), myasthenia gravis, cerebellar degeneration, limbic and/or brainstem encephalitis, neuromyotonia, and opsoclonus (involving eye movement) and sensory neuropathy; polymyositis; transverse myelitis; vasculitis including temporal arteritis; arachnoiditis; Kinsbourne syndrome or opsoclonus myoclonus syndrome (OMS); or Saint Vitus Dance or sydenham chorea (SD) disease.
• cranial arteritis giant cell arteritis
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof, is used to treat transverse myelitis.
• the disorder to be treated is a peripheral neuropathy.
• the peripheral neuropathy is a mononeuropathy.
• the neuropathy is a polyneuropathy.
• the polyneuropathy is distal axonopathy, diabetic neuropathy, a demyelinating polyneuropathy, small fiber peripheral neuropathy, mononeuritis multiplex, polyneuritis multiplex, autonomic neuropathy, or neuritis.
• an effective amount of an active compound described herein, or a pharmaceutically acceptable salt thereof is used to treat an autoimmune vascular disease.
• the autoimmune vascular disease is vasculitis.
• the vasculitis includes, but is not limited to, autoimmune inflammatory vasculitis, Cutaneous small-vessel vasculitis, Granulomatosis with polyangiitis , Eosinophilic granulomatosis with polyangiitis, Beliefs disease, Kawasaki disease, Buerger's disease, and "Limited" granulomatosis with polyangiitis vasculitis.
• an active compound or its salt or composition as described herein is used to treat an arteritis.
• the arteritis includes, but is not limited to, giant cell arteritis, Takayasu arteritis, temporal arteritis, and polyarteritis nodosa.
• a method for the treatment of a glomerulonephritis is provided.
• the glomerulonephritis is membranoproliferative glomerulonephritis (MPGN).
• the MPGN is MPGN Type I.
• the MPGN is MPGN Type II.
• the MPGN is MPGN Type III.
• the MPGN is C3 glomerulonephritis (C3G).
• the MPGN is dense deposit disease (DDD).
• the MPGN is a C4 deposition disorder.
• the glomerulonephritis is IC-MPGN. In some embodiments, the glomerulonephritis is a membraneous glomerulonephritis. In some embodiments, the glomerulonephritis is IgA nephropathy. In some embodiments, the glomerulonephritis is Post- infectious glomerulonephritis. In some embodiments, the glomerulonephritis is a rapidly progressive glomerulonephritis, for example Type I (Goodpasture syndrome), Type II, or Type III rapidly progressive glomerulonephritis.
• Type I Goodpasture syndrome
• Type II Type II
• Type III rapidly progressive glomerulonephritis.
• a method for the treatment of paroxysmal nocturnal hemoglobinuria includes the administration of an effective amount of a compound to a host of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• PNH paroxysmal nocturnal hemoglobinuria
• a method for the treatment of hereditary angioedema includes the administration of an effective amount of a compound to a host of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition. Mutations in the SERPING1 gene cause hereditary angioedema type I and type II.
• Hereditary angioedema is a disorder characterized by recurrent episodes of severe swelling (angioedema). The most common areas of the body to develop swelling are the limbs, face, intestinal tract, and airway.
• the SERPING1 gene provides instructions for making the Cl inhibitor protein, which is important for controlling inflammation. Cl inhibitor blocks the activity of certain proteins that promote inflammation. Mutations that cause hereditary angioedema type I lead to reduced levels of Cl inhibitor in the blood, while mutations that cause type II result in the production of a Cl inhibitor that functions abnormally. Without the proper levels of functional Cl inhibitor, excessive amounts of a protein fragment (peptide) called bradykinin are generated. Bradykinin promotes inflammation by increasing the leakage of fluid through the walls of blood vessels into body tissues.
• a protein fragment peptide
• a method for the treatment of cold agglutinin disease includes the administration of an effective amount of a compound to a host of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• CAD is a rare autoimmune hemolytic condition with potentially serious acute and chronic consequences that are driven by Cl activation of the classical complement pathway.
• a method for the treatment of atypical hemolytic uremic syndrome includes the administration of an effective amount of a compound to a host of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• Atypical hemolytic- uremic syndrome is a disease that primarily affects kidney function.
• Atypical hemolytic uremic syndrome which can occur at any age, causes abnormal blood clots (thrombi) to form in small blood vessels in the kidneys. These clots can cause serious medical problems if they restrict or block blood flow.
• Atypical hemolytic-uremic syndrome is characterized by three major features related to abnormal clotting: hemolytic anemia, thrombocytopenia, and kidney failure.
• a method for the treatment of wet or dry age-related macular degeneration (AMD) in a host includes the administration of an effective amount of a compound of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N- oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• ALD age-related macular degeneration
• a method for the treatment of rheumatoid arthritis in a host includes the administration of an effective amount of a compound of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• a method for the treatment of multiple sclerosis in a host includes the administration of an effective amount of a compound of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, or XX, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition.
• the active compounds, or pharmaceutically acceptable salt, prodrug, isotopic analog, N- oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition, as disclosed herein, are also useful for administration in combination (in the same or a different dosage form) or alternation with a second pharmaceutical agent for use in ameliorating or reducing a side effect of the second pharmaceutical agent.
• the active compound may be used in combination with an adoptive cell-transfer therapy to reduce an inflammatory response associated with such therapy, for example, a cytokine mediated response such as cytokine response syndrome.
• an adoptive cell-transfer therapy to reduce an inflammatory response associated with such therapy, for example, a cytokine mediated response such as cytokine response syndrome.
• the adoptive cell-transfer therapy is a chimeric antigen receptor T- Cell (CAR T) or a dendritic cell used to treat a hematologic or solid tumor, for example, a B-cell related hematologic cancer.
• CAR T chimeric antigen receptor T- Cell
• dendritic cell used to treat a hematologic or solid tumor, for example, a B-cell related hematologic cancer.
• the hematologic or solid tumor is acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), non-Hodgkin’s lymphoma, chronic lymphocytic leukemia (CLL), pancreatic cancer, glioblastoma, or a cancer that expresses CD 19.
• ALL acute lymphoblastic leukemia
• AML acute myeloid leukemia
• CLL chronic lymphocytic leukemia
• pancreatic cancer glioblastoma
• glioblastoma or a cancer that expresses CD 19.
• the adoptive cell-transfer therapy is a non-engineered T-cell therapy, wherein the T-cells have been activated and/or expanded to one or more viral or tumor antigens.
• the associated inflammatory response is a cytokine mediated response.
• the second pharmaceutical agent is a cell that has been transformed to express a protein, wherein the protein in the host is mutated or otherwise has impaired function.
• the transformed cell includes a CRISPR gene.
• Another embodiment includes the administration of an effective amount of an active compound, or a pharmaceutically acceptable salt, prodrug, isotopic analog, N-oxide, or isolated isomer thereof, optionally in a pharmaceutically acceptable composition to a host to treat an ocular, pulmonary, gastrointestinal, or other disorder.
• any of the compounds described herein can be administered to the eye in any desired form of administration, including via intravitreal, intrastromal, intracameral, sub-tenon, sub-retinal, retro-bulbar, peribulbar, suprachorodial, choroidal, subchoroidal, conjunctival, subconjunctival, episcleral, posterior juxtascleral, scleral, circumcorneal, and tear duct injections, or through a mucus, mucin, or a mucosal barrier, in an immediate or controlled release fashion.
• intravitreal intrastromal, intracameral, sub-tenon, sub-retinal, retro-bulbar, peribulbar, suprachorodial, choroidal, subchoroidal, conjunctival, subconjunctival, episcleral, posterior juxtascleral, scleral, circumcorneal, and tear duct injections, or through a mucus, mucin, or a mucos
• the active compound includes a lipophilic group, such as a lipophilic acyl group, which is delivered to the eye in a polymeric drug delivery system such as polylactic acid, polylactide-co-glycolide, polyglycolide or other erodible polymer, or a combination thereof, or in another type of lipophilic material for ocular delivery.
• a lipophilic active molecule is more soluble in the polymeric or other form of delivery system than in ocular fluid.
• an active compound provided herein can be used to treat or prevent a disorder in a host mediated by complement.
• the disclosure includes methods to treat or prevent complement associated disorders that are induced by antibody- antigen interactions, a component of an immune or autoimmune disorder or by ischemic injury.
• the disclosure also provides methods to decrease inflammation or an immune response, including an autoimmune response, where mediated or affected by the classical complement pathway.
• the disorder is selected from fatty liver and conditions stemming from fatty liver, such as nonalcoholic steatohepatitis (NASH), liver inflammation, cirrhosis and liver failure.
• NASH nonalcoholic steatohepatitis
• a method is provided for treating fatty liver disease in a host by administering an effective amount of an active compound or its salt or composition as described herein.
• an active compound or its salt or composition as described herein is used to modulate an immune response prior to or during surgery or other medical procedure.
• One non-limiting example is use in connection with acute or chronic graft versus host disease, which is a common complication as a result of organ transplantation, allogeneic tissue transplant, and can also occur as a result of a blood transfusion.
• the present disclosure provides a method of treating or preventing dermatomyositis by administering to a subject in need thereof an effective amount of an active compound or its salt or composition as described herein.
• the present disclosure provides a method of treating or preventing amyotrophic lateral sclerosis by administering to a subject in need thereof an effective amount of an active compound or its salt or composition as described herein.

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