WO2022140646A1 - Dosing regimen for oteseconazole - Google Patents
Dosing regimen for oteseconazole Download PDFInfo
- Publication number
- WO2022140646A1 WO2022140646A1 PCT/US2021/065036 US2021065036W WO2022140646A1 WO 2022140646 A1 WO2022140646 A1 WO 2022140646A1 US 2021065036 W US2021065036 W US 2021065036W WO 2022140646 A1 WO2022140646 A1 WO 2022140646A1
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- WIPO (PCT)
- Prior art keywords
- oteseconazole
- days
- administered
- dose period
- period
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- 235000010199 sorbic acid Nutrition 0.000 description 1
- 239000004334 sorbic acid Substances 0.000 description 1
- 229940075582 sorbic acid Drugs 0.000 description 1
- 239000003381 stabilizer Substances 0.000 description 1
- 235000019698 starch Nutrition 0.000 description 1
- 125000001424 substituent group Chemical group 0.000 description 1
- 239000005720 sucrose Substances 0.000 description 1
- 239000000375 suspending agent Substances 0.000 description 1
- 239000000725 suspension Substances 0.000 description 1
- 239000003765 sweetening agent Substances 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000004797 therapeutic response Effects 0.000 description 1
- 208000014001 urinary system disease Diseases 0.000 description 1
- 239000003981 vehicle Substances 0.000 description 1
- 235000019154 vitamin C Nutrition 0.000 description 1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
- A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
- A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
- A61K31/4439—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a five-membered ring with nitrogen as a ring hetero atom, e.g. omeprazole
Definitions
- the present application relates to dosing regimen dosing regimen of compound 1.
- the present application seeks to provide a method for treating or preventing vulvovaginal candidiasis using compound 1.
- Oteseconazole has been developed as an oral fungal inhibitor to treat a range of multi-drug resistant fungal pathogens.
- Oteseconazole is being developed as treatment for recurrent vulvovaginal candidiasis (RVVC), a debilitating chronic condition that affects millions of women worldwide.
- RVVC recurrent vulvovaginal candidiasis
- oral administration is the most preferred and patient friendly route for administration
- oral delivery of Oteseconazole at a regimen that is effective to treat acute VVC episodes in women with RVVC remains a challenge. Accordingly, research continues into the development of Oteseconazole oral delivery dosing regimens that can provide for practical unit oral dosage forms for the treatment of RVVC.
- the present application relates to such dosing regimens suitable for the treatment of RVVC.
- the present application is directed to a suitable dosing regimen of compound 1 (also known as Oteseconazole and VT-1161), or a pharmaceutically acceptable salt thereof:
- the present application is also related to a method of treating or preventing RVVC comprising administering to a subject in need thereof a suitable dosing regimen of Oteseconazole.
- Oteseconazole is administered in an oral dosage form as a solid or liquid formulation.
- suitable liquid oral dosage forms of Oteseconazole include syrups, solutions, ampoules, dispersions, semi-solids, softgels, etc.
- Suitable solid dosage forms of Oteseconazole include tablets, capsules, sachets, powders, granules, orally dispersible films, etc. It would be understood that Oteseconazole can be administered in an encapsulated liquid formulation such that while the dosage form is a solid form, the active is in a liquid form. Regardless of the form of administration, it is contemplated that any immediate release formulation of Oteseconazole may be suitable in the dosage regimens described herein.
- a method of providing maintenance phase or period for a subject in need of RVVC treatment wherein the maintenance phase or period follows at least one previous loading dose phase or period followed by a non-dosing phase or period, wherein the maintenance and the loading dose phases comprise administering a suitable amount of Oteseconazole to a subject in need of.
- phase and “period” are used interchangeably.
- the loading dose period lasts about 2 days where the subject is administered a suitable dose of Oteseconazole in day 1 followed by a suitable dose of Oteseconazole on day 2.
- the loading dose period may be about 18 hours, about 24 hours, about 36 hours, about 48 hours or about 54 hours.
- the term “about” means ⁇ 6 hours such that the loading dose period can be as short as 12 hours and as long as 60 hours.
- the loading dose period may be about 2 days where Oteseconazole is administered to the patient once a day wherein the two doses in the loading dose phase may be the same or different.
- a higher first dose on day 1 follows a lower second dose on day 2 in the 2-day loading dose period.
- between about 400 mg and about 800 mg of Oteseconazole may be administered on day 1 of the loading dose phase.
- about 400 mg, about 480 mg, about 560 mg, about 640 mg, about 720 mg, or about 800 mg of Oteseconazole may be administered on day 1 of the loading dose phase.
- about 600 mg of Oteseconazole may be administered on day 1 of the loading dose phase.
- between about 300 mg and about 600 mg of Oteseconazole may be administered on day 2 of the loading dose phase.
- about 300 mg, about 360 mg, about 420 mg, about 480 mg, about 540 mg, or about 600 mg of Oteseconazole may be administered on day 2 of the loading dose phase.
- about 450 mg of Oteseconazole may be administered on day 2 of the loading dose phase.
- the loading dose period may last up to two weeks of daily or near daily administration.
- the term “near daily” as used here means that two administrations of the drug may be separated by about 18 hours to about 30 hours.
- the loading dose phase may last about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, or about 10 days. In some aspects, the loading dose phase lasts about 6 days, about 7 days or about 8 days. In particular aspects, the loading dose phase lasts about 7 days.
- the subject may receive daily administration of about 100 to about 200 mg Oteseconazole.
- the subject may be administered with about 100 mg, about 120 mg, about 140 mg, about 160 mg, about 180 mg, or about 200 mg of Oteseconazole daily during the loading dose period.
- the subject may be administered with about 120 mg, about 140 mg, about 160 mg, or about 180 mg of Oteseconazole daily during the loading dose period.
- the subject may be administered with about 140 mg, about 150 mg, or 160 mg of Oteseconazole daily during the loading dose period.
- the subject may be administered with about 150 mg of Oteseconazole daily during the loading dose period.
- a non-dosing period of between about 5 days and about 20 days may be used.
- the non-dosing period may be about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, about 10 days, about 11 days, about 12 days, about 13 days, about 14 days, about 15 days, about 16 days, about 17 days, about 18 days, about 19 days, about 20 days, or about 21 days.
- the non-dosing period may be between about 10 and about 14 days.
- the non-dosing period is between about 11 and about 13 days. In particular aspects, the non-dosing period is about 12 days.
- the non-dosing period may be up to about two weeks.
- the non-dosing period may be about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, or about 10 days.
- the non-dosing period may be about 5 days, about 6 day, about 7 days, or about 8 days such that the maintenance period begins on day 13, day 14, day 15, or day 16 of the dosing regimen.
- the non-dosing period is about one week .
- the maintenance dose period Oteseconazole is typically administered once a week.
- the maintenance dose period lasts from about 7 weeks to 25 weeks, or longer. It is understood that any maintenance dose period lasting any specific period between 7 weeks and 25 weeks would be considered to be within the scope of the disclosed dosing regimens despite the fact that time is a continuum and an infinite number of “time periods” may be defined within a time window.
- the maintenance dose period may last about 8 weeks, about 9 weeks, about 10 weeks, about 11 weeks, about 12 weeks, about 13 weeks, about 14 weeks, about 15 weeks, about 16 weeks, about 17 weeks, about 18, weeks, about 19 weeks, about 20 weeks, about 21 weeks, about 22 weeks, about 23 weeks, about 24 weeks, or about 25 weeks, or any fraction thereof.
- the maintenance dose period lasts about 9 weeks, about 10 weeks, about 11 weeks, about 12 weeks, or about 13 weeks.
- the maintenance dose period may last about 10, about 11 weeks, or about 12 weeks.
- the maintenance phase may last about 11 weeks.
- between about 100 mg and about 200 mg of Oteseconazole may be administered once a week during the maintenance dose period. In some embodiments, about 100 mg, about 120 mg, about 140 mg, about 180 mg, or about 200 mg of Oteseconazole may be administered once a week during the maintenance dose period. In some embodiments, about 120 mg, about 140 mg, or about 180 mg of Oteseconazole may be administered once a week during the maintenance dose period. In particular embodiments, about 150 mg of Oteseconazole may be administered once a week during the maintenance dose period.
- the loading dose and non-dosing periods together last about 12, about 13, about 14, or about 15 days and the maintenance period begins on day 13, 14, 15, or 16 of the dosing regimen. In certain embodiments, the loading dose and non-dosing periods together last about 12, about 13, or about 14 days and the maintenance dose period begins on day 13, 14, or 15 of the dosing regimen. In particular embodiments, the maintenance dose period begins on day 14 of the dosing regimen.
- subject in need thereof means a subject in need of treatment because the subject has been exposed to or infected with vulvovaginal candidiasis or because of the subject’s prior history of vulvovaginal candidiasis infections.
- administering means providing a formulation to a subject.
- the term “about” means that the stated number can vary from that value by ⁇ 10% or, in the case of time, ⁇ 6 hours.
- quantity such as weight
- the term means the quantity can vary by ⁇ 10%.
- about 100 mg means between 80 and 120 mg.
- time can vary by ⁇ 6 hrs.
- about one day means between 18 hours and 30 hrs.
- about 2 days means between 42 hours and 54 hours.
- the present application provides a pharmaceutical composition comprising a compound of any formulae herein and a pharmaceutically acceptable carrier.
- the present application provides a pharmaceutical composition further comprising an additional therapeutic agent.
- the additional therapeutic agent is an anti-cancer agent, antifungal agent, cardiovascular agent, antiinflammatory agent, chemotherapeutic agent, an anti-angiogenesis agent, cytotoxic agent, an anti-proliferation agent, metabolic disease agent, ophthalmologic disease agent, central nervous system (CNS) disease agent, urologic disease agent, or gastrointestinal disease agent.
- the present application provides a kit comprising an effective amount of a compound of any formulae herein, in unit dosage form, together with instructions for administering the compound to a subject suffering from or susceptible to vulvovaginal candidiasis or RVVC.
- pharmaceutically acceptable salt or “pharmaceutically acceptable carrier” is meant to include salts of the active compounds, which are prepared with relatively nontoxic acids or bases, depending on the particular substituents found on the compounds described herein.
- base addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired base, either neat or in a suitable inert solvent.
- pharmaceutically acceptable base addition salts include sodium, potassium, calcium, ammonium, organic amino, or magnesium salt, or a similar salt.
- acid addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired acid, either neat or in a suitable inert solvent.
- Examples of pharmaceutically acceptable acid addition salts include those derived from inorganic acids like hydrochloric, hydrobromic, nitric, carbonic, monohydrogencarbonic, phosphoric, monohydrogenphosphoric, dihydrogenphosphoric, sulfuric, monohydrogensulfuric, hydroiodic, or phosphorous acids and the like, as well as the salts derived from relatively nontoxic organic acids like acetic, propionic, isobutyric, maleic, malonic, benzoic, succinic, suberic, fumaric, lactic, mandelic, phthalic, benzenesulfonic, p-tolylsulfonic, citric, tartaric, methanesulfonic, and the like.
- inorganic acids like hydrochloric, hydrobromic, nitric, carbonic, monohydrogencarbonic, phosphoric, monohydrogenphosphoric, dihydrogenphosphoric, sulfuric, monohydrogensulfuric, hydroiodic, or phosphorous acids and the like
- salts of amino acids such as arginate and the like, and salts of organic acids like glucuronic or galactunoric acids and the like (see e.g., Berge et al., Journal of Pharmaceutical Science 66:1-19 (1977)).
- Certain specific compounds of the present application contain both basic and acidic functionalities that allow the compounds to be converted into either base or acid addition salts.
- Other pharmaceutically acceptable carriers known to those of skill in the art are suitable for the present application.
- the neutral forms of the compounds may be regenerated by contacting the salt with a base or acid and isolating the parent compound in the conventional manner.
- the parent form of the compound differs from the various salt forms in certain physical properties, such as solubility in polar solvents, but otherwise the salts are equivalent to the parent form of the compound for the purposes of the present application.
- Oteseconazole and its pharmaceutically acceptable salts can exist in a variety of polymorphic solids, including unsolvated forms as well as solvated forms, including hydrated forms. In general, the solvated forms are equivalent to unsolvated forms and both forms are intended to be encompassed within the scope of the present application. Oteseconazole may exist in multiple crystalline or amorphous forms. In general, all physical forms are equivalent for the uses contemplated by the present application and are intended to be within the scope of the present application.
- the present application also provides a pharmaceutical composition, comprising an effective amount of Oteseconazole and a pharmaceutically acceptable carrier.
- a pharmaceutical composition comprising an effective amount of Oteseconazole and a pharmaceutically acceptable carrier.
- Actual dosage levels and time course of administration of Oteseconazole in the pharmaceutical compositions of the present application may be varied so as to obtain an amount of the active ingredient which is effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration, without being toxic (or unacceptably toxic) to the patient.
- pharmaceutically effective amount as used herein is meant an amount of Oteseconazole high enough to significantly positively modify the condition to be treated but low enough to avoid serious side effects (at a reasonable benefit/risk ratio), within the scope of sound medical judgment.
- a pharmaceutically effective amount of Oteseconazole for treating vulvovaginal candidiasis or RVVC will vary with the particular goal to be achieved, the age and physical condition of the patient being treated, the severity of the underlying disease, the duration of treatment, the nature of concurrent therapy and the specific dosage employed. For example, a therapeutically effective amount of Oteseconazole administered to a child or a neonate will be reduced proportionately in accordance with sound medical judgment. The effective amount of Oteseconazole will thus be the minimum amount, which will provide the desired effect.
- the compound may be administered as a dispersion.
- Dispersions can also be prepared, for example, in glycerol, liquid polyethylene glycols, and mixtures thereof, and in oils.
- substances which can serve as pharmaceutical carriers are sugars, such as lactose, glucose and sucrose; starches such as corn starch and potato starch; cellulose and its derivatives such as sodium carboxymethycellulose, ethylcellulose and cellulose acetates; powdered tragancanth; malt; gelatin; talc; stearic acids; magnesium stearate; calcium sulfate; vegetable oils, such as peanut oils, cotton seed oil, sesame oil, olive oil, corn oil and oil of theobroma; polyols such as propylene glycol, glycerin, sorbitol, mannitol, and polyethylene glycol; agar; alginic acids; pyrogen-free water; isotonic saline; and phosphate buffer solution; skim milk powder; as well as other non-toxic compatible substances used in pharmaceutical formulations such as Vitamin C, estrogen and echinacea, for example.
- sugars such as lactose, glucose and sucrose
- wetting agents and lubricants such as sodium lauryl sulfate, as well as coloring agents, flavoring agents, lubricants, excipients, tableting agents, stabilizers, anti-oxidants and preservatives, can also be present.
- Solubilizing agents including for example, cremaphore and beta-cyclodextrins can also used in the pharmaceutical compositions herein.
- compositions comprising Oteseconazole can be manufactured by means of conventional mixing, dissolving, granulating, dragee-making levigating, emulsifying, encapsulating, entrapping or lyophilization processes.
- the compositions can be formulated in conventional manner using one or more physiologically acceptable carriers, diluents, excipients or auxiliaries which facilitate processing of the active compounds into preparations which can be used pharmaceutically.
- the pharmaceutical compositions can take the form of, for example, lozenges, tablets or capsules prepared by conventional means with pharmaceutically acceptable excipients such as binding agents (e.g., pregelatinized maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose); fillers (e.g., lactose, microcrystalline cellulose or calcium hydrogen phosphate); lubricants (e.g., magnesium stearate, talc or silica); disintegrants (e.g., potato starch or sodium starch glycolate); or wetting agents (e.g., sodium lauryl sulfate).
- binding agents e.g., pregelatinized maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose
- fillers e.g., lactose, microcrystalline cellulose or calcium hydrogen phosphate
- lubricants e.g., magnesium stearate, talc or silica
- disintegrants e.g
- Liquid preparations for oral administration can take the form of, for example, elixirs, solutions, syrups or suspensions, or they can be presented as a dry product for constitution with water or other suitable vehicle before use.
- Such liquid preparations can be prepared by conventional means with pharmaceutically acceptable additives such as suspending agents (e.g., sorbitol syrup, cellulose derivatives or hydrogenated edible fats); emulsifying agents (e.g., lecithin or acacia); non aqueous vehicles (e.g., almond oil, oily esters, ethyl alcohol or fractionated vegetable oils); and preservatives (e.g., methyl or propyl p-hydroxybenzoates or sorbic acid).
- the preparations also can contain buffer salts, preservatives, flavoring, coloring and sweetening agents as appropriate.
- the dosage regimens may comprise Oteseconazole, a pharmaceutically acceptable salt or a prodrug thereof.
- prodrug includes compounds with moieties which can be metabolized in vivo. Generally, the prodrugs are metabolized in vivo by esterases or by other mechanisms to active drugs. Examples of prodrugs and their uses are well known in the art (See, e.g., Berge et al. (1977) "Pharmaceutical Salts", J. Pharm. Sci. 66:1-19).
- the prodrugs can be prepared in situ during the final isolation and purification of the compounds, or by separately reacting the purified compound in its free acid form or hydroxyl with a suitable esterifying agent. Hydroxyl groups can be converted into esters via treatment with a carboxylic acid.
- prodrug moieties include substituted and unsubstituted, branch or unbranched lower alkyl ester moieties, (e.g., propionic acid esters), lower alkenyl esters, di-lower alkyl-amino lower-alkyl esters (e.g., dimethylaminoethyl ester), acylamino lower alkyl esters (e.g., acetyloxymethyl ester), acyloxy lower alkyl esters (e.g., pivaloyloxymethyl ester), aryl esters (phenyl ester), aryl-lower alkyl esters (e.g., benzyl ester), substituted (e.g., with methyl, halo, or methoxy substituents) aryl and aryl- lower alkyl esters, amides, lower-alkyl amides, di-lower alkyl amides, and hydroxy amides.
- prodrug moieties are propionoic acid esters and acyl esters.
- Prodrugs which are converted to active forms through other mechanisms in vivo are also included.
- the compounds of the invention are prodrugs of any of the formulae herein.
- Particular prodrugs of Oteseconazole suitable for the dosage regimens of the present application include phosphate esters of the compound.
- a phosphate ester of Oteseconazole the OH group of the active is replaced by the following group: , wherein Z may be an alkyl group (for mono-hydrogen phosphate esters) or H (for di -hydrogen phosphate ester).
- compositions can, if desired, be presented in a pack or dispenser device which can contain one or more unit dosage forms containing the active compound(s).
- the pack can, for example, comprise metal or plastic foil, such as a blister pack.
- the pack or dispenser device can be accompanied by instructions for administration.
- the pharmaceutically active component of the presently disclosed subject matter, or compositions thereof, will generally be used in an amount effective to treat or prevent vulvovaginal candidiasis or RVVC.
- the compound can be administered therapeutically to achieve therapeutic benefit or prophylactically to achieve prophylactic benefit.
- therapeutic benefit is meant eradication or amelioration of vulvovaginal candidiasis or RVVC and/or eradication or amelioration of one or more of the symptoms associated with vulvovaginal candidiasis or RVVC such that the patient reports an improvement in feeling or condition, notwithstanding that the patient can still be afflicted with the underlying disorder.
- the compound can be administered to a patient at risk of infection of vulvovaginal candidiasis or developing RVVC.
- a patient at risk of developing a disease can be a patient having characteristics placing the patient in a designated group of at risk patients, as defined by an appropriate medical professional or group.
- a patient at risk may also be a patient that is commonly or routinely in a setting where development of the underlying disease that may be treated by administration of Oteseconazole could occur.
- the at risk patient is one who is commonly or routinely exposed to vulvovaginal candidiasis or may be acutely exposed for a limited time.
- prophylactic administration can be applied to avoid the onset of symptoms in a patient diagnosed with the underlying disorder.
- the amount of compound administered will depend upon a variety of factors, including, for example, the particular indication being treated, whether the desired benefit is prophylactic or therapeutic, the severity of the indication being treated and the age and weight of the patient, and the like. Determination of an effective dosage is well within the capabilities of those skilled in the art.
- Effective dosages can be estimated initially from in vitro assays.
- an initial dosage for use in animals can be formulated to achieve a circulating blood or serum concentration of active compound that is at or above an IC50 of the particular compound as measured in as in vitro assay, such as the in vitro fungal MIC or MFC and other in vitro assays described in the Examples section.
- Calculating dosages to achieve such circulating blood or serum concentrations taking into account the bioavailability of the particular compound is well within the capabilities of skilled artisans. For guidance, see Fingl & Woodbury, “General Principles,” In: Goodman and Gilman’s The Pharmaceutical Basis of Therapeutics, Chapter 1, pp. 1-46, latest edition, Pagamonon Press, and the references cited therein, which are incorporated herein by reference.
- Initial dosages also can be estimated from in vivo data, such as animal models. Animal models useful for testing the efficacy of compounds to treat or prevent the various diseases described above are well-known in the art.
- Oteseconazole is being studied to compare the efficacy of oral Oteseconazole with that of fluconazole in the treatment of acute VVC episodes in RVVC subjects.
- the dosing regimens described herein incorporate an loading dose phase to treat the initial acute infection with either fluconazole or Oteseconazole.
- Fluconazole dosing regimen to be employed in the Eoading dose Phase is in alignment with the recommendation proposed by the Infectious Disease Society of America (IDS A) for the treatment of vulvovaginal candidiasis, in which fluconazole, 150 mg, is given every 72 hours for a total of 3 doses. This recommendation is strongly supported by IDSA and for which high-quality evidence is available to support its clinical effectiveness.
- Oteseconazole has previously been evaluated in a Phase 2a multi-center, randomized, double-blind, active-controlled, parallel-group, dose-ranging study in patients with moderate-to- severe acute VVC.
- a total of 55 subjects with moderate-to-severe acute VVC (severity score >6 and a positive fungal KOH test) participated in the study across 4 dose groups: 1) Oteseconazole 300 mg qd for 3 days; 2) 600 mg qd for 3 days; 3) 600 mg bid for 3 days; or 4) a single dose of fluconazole 150 mg followed by matching placebo.
- Oteseconazole was shown to be safe and well tolerated when administered for 3 days. There were no serious adverse events (AEs) reported and no treatment emergent adverse events (TEAEs) led to study discontinuation. No safety signals of clinical concern were observed from the safety assessments.
- AEs adverse events
- TEAEs treatment emergent adverse events
- Oteseconazole in the treatment of moderate-to-severe acute VVC was evaluated at the TOC visit in the Per Protocol population at the Day 28 test of cure (TOC) visit was, 87%, 86%, 86%, and 75% of subjects receiving the low , mid-, or high-dose Oteseconazole or comparator arm of fluconazole, respectively, achieved an effective therapeutic cure (defined as having a total clinical signs and symptoms severity score of ⁇ 1 and a negative culture for Candida species) in the Per Protocol population
- a oral loading dose of about 600 mg of Oteseconazole on Day 1 and about 450 mg of Oteseconazole on Day 2 will provide for clinically effective plasma levels (approximately 2 pg/mL) to treat the presenting acute Candida spp. Infection and may have efficacy comparable to that of fluconazole in the treatment of an acute VVC episode in subjects with RVVC.
- This dosing regimen and targeted Oteseconazole plasma concentrations is also expected to effectively treat Candida spp. that are generally resistant to fluconazole, including but not limited to C. glabrata, C. parapsilosis, C. krusei, C. tropicalis and fluconazole resistant C. albicans.
- Oteseconazole dosing regimens will also incorporate a 150 mg once weekly maintenance dose phase for 11 weeks. Based on the PK results from the Phase 2b study, it is expected that a mean plasma concentration of approximately 2.5 pg/mL at the end of the dosing period (Week 14) will be obtained.
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Abstract
The present application relates to dosing regimen of compound 1 and their use to treat RVVC.
Description
DOSING REGIMEN FOR OTESECONAZOLE
TECHNICAL FIELD
The present application relates to dosing regimen dosing regimen of compound 1. In particular, the present application seeks to provide a method for treating or preventing vulvovaginal candidiasis using compound 1.
BACKGROUND
Oteseconazole has been developed as an oral fungal inhibitor to treat a range of multi-drug resistant fungal pathogens. For example, Oteseconazole is being developed as treatment for recurrent vulvovaginal candidiasis (RVVC), a debilitating chronic condition that affects millions of women worldwide. While oral administration is the most preferred and patient friendly route for administration, oral delivery of Oteseconazole at a regimen that is effective to treat acute VVC episodes in women with RVVC remains a challenge. Accordingly, research continues into the development of Oteseconazole oral delivery dosing regimens that can provide for practical unit oral dosage forms for the treatment of RVVC. The present application relates to such dosing regimens suitable for the treatment of RVVC.
BRIEF SUMMARY
The present application is directed to a suitable dosing regimen of compound 1 (also known as Oteseconazole and VT-1161), or a pharmaceutically acceptable salt thereof:
The present application is also related to a method of treating or preventing RVVC comprising administering to a subject in need thereof a suitable dosing regimen of Oteseconazole.
In some aspects, Oteseconazole is administered in an oral dosage form as a solid or liquid formulation. Suitable liquid oral dosage forms of Oteseconazole include syrups, solutions, ampoules, dispersions, semi-solids, softgels, etc. Suitable solid dosage forms of Oteseconazole include tablets, capsules, sachets, powders, granules, orally dispersible films, etc. It would be understood that Oteseconazole can be administered in an encapsulated liquid formulation such that
while the dosage form is a solid form, the active is in a liquid form. Regardless of the form of administration, it is contemplated that any immediate release formulation of Oteseconazole may be suitable in the dosage regimens described herein.
In some embodiments, provided herein is a method of providing maintenance phase or period for a subject in need of RVVC treatment, wherein the maintenance phase or period follows at least one previous loading dose phase or period followed by a non-dosing phase or period, wherein the maintenance and the loading dose phases comprise administering a suitable amount of Oteseconazole to a subject in need of. As used herein, the terms “phase” and “period” are used interchangeably.
In one aspect, the loading dose period lasts about 2 days where the subject is administered a suitable dose of Oteseconazole in day 1 followed by a suitable dose of Oteseconazole on day 2. In another aspect, the loading dose period may be about 18 hours, about 24 hours, about 36 hours, about 48 hours or about 54 hours. As used in this paragraph, the term “about” means ±6 hours such that the loading dose period can be as short as 12 hours and as long as 60 hours.
In one aspect, the loading dose period may be about 2 days where Oteseconazole is administered to the patient once a day wherein the two doses in the loading dose phase may be the same or different. In certain embodiment, a higher first dose on day 1 follows a lower second dose on day 2 in the 2-day loading dose period.
In some aspects, between about 400 mg and about 800 mg of Oteseconazole may be administered on day 1 of the loading dose phase. In other embodiments, about 400 mg, about 480 mg, about 560 mg, about 640 mg, about 720 mg, or about 800 mg of Oteseconazole may be administered on day 1 of the loading dose phase. In particular embodiments, about 600 mg of Oteseconazole may be administered on day 1 of the loading dose phase.
In other aspects, between about 300 mg and about 600 mg of Oteseconazole may be administered on day 2 of the loading dose phase. In some embodiments, about 300 mg, about 360 mg, about 420 mg, about 480 mg, about 540 mg, or about 600 mg of Oteseconazole may be administered on day 2 of the loading dose phase. In particular embodiments, about 450 mg of Oteseconazole may be administered on day 2 of the loading dose phase.
In some aspects, the loading dose period may last up to two weeks of daily or near daily administration. The term “near daily” as used here means that two administrations of the drug may be separated by about 18 hours to about 30 hours. The loading dose phase may last about 5 days,
about 6 days, about 7 days, about 8 days, about 9 days, or about 10 days. In some aspects, the loading dose phase lasts about 6 days, about 7 days or about 8 days. In particular aspects, the loading dose phase lasts about 7 days.
When the loading dose period is prolonged to more than about 2 days, the subject may receive daily administration of about 100 to about 200 mg Oteseconazole. For example, the subject may be administered with about 100 mg, about 120 mg, about 140 mg, about 160 mg, about 180 mg, or about 200 mg of Oteseconazole daily during the loading dose period. In some aspects, the subject may be administered with about 120 mg, about 140 mg, about 160 mg, or about 180 mg of Oteseconazole daily during the loading dose period. In other aspects, the subject may be administered with about 140 mg, about 150 mg, or 160 mg of Oteseconazole daily during the loading dose period. In a particular aspect, the subject may be administered with about 150 mg of Oteseconazole daily during the loading dose period.
In one aspect, a non-dosing period of between about 5 days and about 20 days may be used. In some embodiments, the non-dosing period may be about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, about 10 days, about 11 days, about 12 days, about 13 days, about 14 days, about 15 days, about 16 days, about 17 days, about 18 days, about 19 days, about 20 days, or about 21 days. In other embodiments, the non-dosing period may be between about 10 and about 14 days. In other aspects, the non-dosing period is between about 11 and about 13 days. In particular aspects, the non-dosing period is about 12 days.
When the loading dose period is prolonged to more than about 2 days with the concomitant reduced dosage of Oteseconazole during the loading dose period, the non-dosing period may be up to about two weeks. For example, the non-dosing period may be about 5 days, about 6 days, about 7 days, about 8 days, about 9 days, or about 10 days. In this dosage regimen, the non-dosing period may be about 5 days, about 6 day, about 7 days, or about 8 days such that the maintenance period begins on day 13, day 14, day 15, or day 16 of the dosing regimen. In some aspects, the non-dosing period is about one week .
During the maintenance dose period, Oteseconazole is typically administered once a week. In some aspects, the maintenance dose period lasts from about 7 weeks to 25 weeks, or longer. It is understood that any maintenance dose period lasting any specific period between 7 weeks and 25 weeks would be considered to be within the scope of the disclosed dosing regimens despite the fact that time is a continuum and an infinite number of “time periods” may be defined
within a time window. For example, the maintenance dose period may last about 8 weeks, about 9 weeks, about 10 weeks, about 11 weeks, about 12 weeks, about 13 weeks, about 14 weeks, about 15 weeks, about 16 weeks, about 17 weeks, about 18, weeks, about 19 weeks, about 20 weeks, about 21 weeks, about 22 weeks, about 23 weeks, about 24 weeks, or about 25 weeks, or any fraction thereof. In some aspects, the maintenance dose period lasts about 9 weeks, about 10 weeks, about 11 weeks, about 12 weeks, or about 13 weeks. The maintenance dose period may last about 10, about 11 weeks, or about 12 weeks. In a particular embodiment, the maintenance phase may last about 11 weeks.
In some aspects, between about 100 mg and about 200 mg of Oteseconazole may be administered once a week during the maintenance dose period. In some embodiments, about 100 mg, about 120 mg, about 140 mg, about 180 mg, or about 200 mg of Oteseconazole may be administered once a week during the maintenance dose period. In some embodiments, about 120 mg, about 140 mg, or about 180 mg of Oteseconazole may be administered once a week during the maintenance dose period. In particular embodiments, about 150 mg of Oteseconazole may be administered once a week during the maintenance dose period.
In some embodiments, the loading dose and non-dosing periods together last about 12, about 13, about 14, or about 15 days and the maintenance period begins on day 13, 14, 15, or 16 of the dosing regimen. In certain embodiments, the loading dose and non-dosing periods together last about 12, about 13, or about 14 days and the maintenance dose period begins on day 13, 14, or 15 of the dosing regimen. In particular embodiments, the maintenance dose period begins on day 14 of the dosing regimen.
The synthesis and the characterization of Oteseconazole has been described in U.S. Patent Nos. 8,236,962; 8,754,227; 9,414,596; 9,840,492; 10,221,160; 10,370,353; 10,414,751; 10,464,921; 10,526,312; and 10,676,459, each of which is incorporated herein by reference.
As used herein, “subject in need thereof’ means a subject in need of treatment because the subject has been exposed to or infected with vulvovaginal candidiasis or because of the subject’s prior history of vulvovaginal candidiasis infections.
As used herein, “administering” means providing a formulation to a subject.
As used here, the term “about” means that the stated number can vary from that value by ±10% or, in the case of time, ±6 hours. Where the term defines quantity (such as weight), the term means the quantity can vary by ±10%. For example, about 100 mg means between 80 and 120 mg.
Where the term “about” defines time expressed in days, the stated time can vary by ±6 hrs. For example, about one day means between 18 hours and 30 hrs. Further, “about 2 days” means between 42 hours and 54 hours.
Where the term “about” defines time expressed in weeks, the stated time can vary by ±2 days. Thus, “about two weeks” means from one week and five days to two weeks and two days. About one week means between five and nine days.
When introducing elements of the present disclosure or the exemplary embodiment(s) thereof, the articles "a," "an," "the" and "said" are intended to mean that there are one or more of the elements. The terms "comprising," "including" and "having" are intended to be inclusive and mean that there may be additional elements other than the listed elements. Although the present application has been described with respect to specific embodiments, the details of these embodiments are not to be construed as limitations.
Pharmaceutical Compositions
In one aspect, the present application provides a pharmaceutical composition comprising a compound of any formulae herein and a pharmaceutically acceptable carrier.
In another embodiment, the present application provides a pharmaceutical composition further comprising an additional therapeutic agent. In a further embodiment, the additional therapeutic agent is an anti-cancer agent, antifungal agent, cardiovascular agent, antiinflammatory agent, chemotherapeutic agent, an anti-angiogenesis agent, cytotoxic agent, an anti-proliferation agent, metabolic disease agent, ophthalmologic disease agent, central nervous system (CNS) disease agent, urologic disease agent, or gastrointestinal disease agent.
In one aspect, the present application provides a kit comprising an effective amount of a compound of any formulae herein, in unit dosage form, together with instructions for administering the compound to a subject suffering from or susceptible to vulvovaginal candidiasis or RVVC.
The term “pharmaceutically acceptable salt” or “pharmaceutically acceptable carrier” is meant to include salts of the active compounds, which are prepared with relatively nontoxic acids or bases, depending on the particular substituents found on the compounds described herein. When compounds of the present application contain relatively acidic functionalities, base addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired base, either neat or in a suitable inert solvent. Examples of pharmaceutically acceptable
base addition salts include sodium, potassium, calcium, ammonium, organic amino, or magnesium salt, or a similar salt. When compounds of the present application contain relatively basic functionalities, acid addition salts can be obtained by contacting the neutral form of such compounds with a sufficient amount of the desired acid, either neat or in a suitable inert solvent. Examples of pharmaceutically acceptable acid addition salts include those derived from inorganic acids like hydrochloric, hydrobromic, nitric, carbonic, monohydrogencarbonic, phosphoric, monohydrogenphosphoric, dihydrogenphosphoric, sulfuric, monohydrogensulfuric, hydroiodic, or phosphorous acids and the like, as well as the salts derived from relatively nontoxic organic acids like acetic, propionic, isobutyric, maleic, malonic, benzoic, succinic, suberic, fumaric, lactic, mandelic, phthalic, benzenesulfonic, p-tolylsulfonic, citric, tartaric, methanesulfonic, and the like. Also included are salts of amino acids such as arginate and the like, and salts of organic acids like glucuronic or galactunoric acids and the like (see e.g., Berge et al., Journal of Pharmaceutical Science 66:1-19 (1977)). Certain specific compounds of the present application contain both basic and acidic functionalities that allow the compounds to be converted into either base or acid addition salts. Other pharmaceutically acceptable carriers known to those of skill in the art are suitable for the present application.
The neutral forms of the compounds may be regenerated by contacting the salt with a base or acid and isolating the parent compound in the conventional manner. The parent form of the compound differs from the various salt forms in certain physical properties, such as solubility in polar solvents, but otherwise the salts are equivalent to the parent form of the compound for the purposes of the present application.
Oteseconazole and its pharmaceutically acceptable salts can exist in a variety of polymorphic solids, including unsolvated forms as well as solvated forms, including hydrated forms. In general, the solvated forms are equivalent to unsolvated forms and both forms are intended to be encompassed within the scope of the present application. Oteseconazole may exist in multiple crystalline or amorphous forms. In general, all physical forms are equivalent for the uses contemplated by the present application and are intended to be within the scope of the present application.
The present application also provides a pharmaceutical composition, comprising an effective amount of Oteseconazole and a pharmaceutically acceptable carrier. Actual dosage levels and time course of administration of Oteseconazole in the pharmaceutical compositions of
the present application may be varied so as to obtain an amount of the active ingredient which is effective to achieve the desired therapeutic response for a particular patient, composition, and mode of administration, without being toxic (or unacceptably toxic) to the patient.
By “pharmaceutically effective amount” as used herein is meant an amount of Oteseconazole high enough to significantly positively modify the condition to be treated but low enough to avoid serious side effects (at a reasonable benefit/risk ratio), within the scope of sound medical judgment. A pharmaceutically effective amount of Oteseconazole for treating vulvovaginal candidiasis or RVVC will vary with the particular goal to be achieved, the age and physical condition of the patient being treated, the severity of the underlying disease, the duration of treatment, the nature of concurrent therapy and the specific dosage employed. For example, a therapeutically effective amount of Oteseconazole administered to a child or a neonate will be reduced proportionately in accordance with sound medical judgment. The effective amount of Oteseconazole will thus be the minimum amount, which will provide the desired effect.
The compound may be administered as a dispersion. Dispersions can also be prepared, for example, in glycerol, liquid polyethylene glycols, and mixtures thereof, and in oils.
Some examples of substances which can serve as pharmaceutical carriers are sugars, such as lactose, glucose and sucrose; starches such as corn starch and potato starch; cellulose and its derivatives such as sodium carboxymethycellulose, ethylcellulose and cellulose acetates; powdered tragancanth; malt; gelatin; talc; stearic acids; magnesium stearate; calcium sulfate; vegetable oils, such as peanut oils, cotton seed oil, sesame oil, olive oil, corn oil and oil of theobroma; polyols such as propylene glycol, glycerin, sorbitol, mannitol, and polyethylene glycol; agar; alginic acids; pyrogen-free water; isotonic saline; and phosphate buffer solution; skim milk powder; as well as other non-toxic compatible substances used in pharmaceutical formulations such as Vitamin C, estrogen and echinacea, for example. Wetting agents and lubricants such as sodium lauryl sulfate, as well as coloring agents, flavoring agents, lubricants, excipients, tableting agents, stabilizers, anti-oxidants and preservatives, can also be present. Solubilizing agents, including for example, cremaphore and beta-cyclodextrins can also used in the pharmaceutical compositions herein.
Pharmaceutical compositions comprising Oteseconazole can be manufactured by means of conventional mixing, dissolving, granulating, dragee-making levigating, emulsifying, encapsulating, entrapping or lyophilization processes. The compositions can be formulated in
conventional manner using one or more physiologically acceptable carriers, diluents, excipients or auxiliaries which facilitate processing of the active compounds into preparations which can be used pharmaceutically.
The pharmaceutical compositions can take the form of, for example, lozenges, tablets or capsules prepared by conventional means with pharmaceutically acceptable excipients such as binding agents (e.g., pregelatinized maize starch, polyvinylpyrrolidone or hydroxypropyl methylcellulose); fillers (e.g., lactose, microcrystalline cellulose or calcium hydrogen phosphate); lubricants (e.g., magnesium stearate, talc or silica); disintegrants (e.g., potato starch or sodium starch glycolate); or wetting agents (e.g., sodium lauryl sulfate). The tablets can be coated by methods well known in the art with, for example, sugars or enteric coatings.
Liquid preparations for oral administration can take the form of, for example, elixirs, solutions, syrups or suspensions, or they can be presented as a dry product for constitution with water or other suitable vehicle before use. Such liquid preparations can be prepared by conventional means with pharmaceutically acceptable additives such as suspending agents (e.g., sorbitol syrup, cellulose derivatives or hydrogenated edible fats); emulsifying agents (e.g., lecithin or acacia); non aqueous vehicles (e.g., almond oil, oily esters, ethyl alcohol or fractionated vegetable oils); and preservatives (e.g., methyl or propyl p-hydroxybenzoates or sorbic acid). The preparations also can contain buffer salts, preservatives, flavoring, coloring and sweetening agents as appropriate.
The dosage regimens may comprise Oteseconazole, a pharmaceutically acceptable salt or a prodrug thereof.
The term “prodrug” includes compounds with moieties which can be metabolized in vivo. Generally, the prodrugs are metabolized in vivo by esterases or by other mechanisms to active drugs. Examples of prodrugs and their uses are well known in the art (See, e.g., Berge et al. (1977) "Pharmaceutical Salts", J. Pharm. Sci. 66:1-19). The prodrugs can be prepared in situ during the final isolation and purification of the compounds, or by separately reacting the purified compound in its free acid form or hydroxyl with a suitable esterifying agent. Hydroxyl groups can be converted into esters via treatment with a carboxylic acid. Examples of prodrug moieties include substituted and unsubstituted, branch or unbranched lower alkyl ester moieties, (e.g., propionic acid esters), lower alkenyl esters, di-lower alkyl-amino lower-alkyl esters (e.g., dimethylaminoethyl ester), acylamino lower alkyl esters (e.g., acetyloxymethyl ester), acyloxy
lower alkyl esters (e.g., pivaloyloxymethyl ester), aryl esters (phenyl ester), aryl-lower alkyl esters (e.g., benzyl ester), substituted (e.g., with methyl, halo, or methoxy substituents) aryl and aryl- lower alkyl esters, amides, lower-alkyl amides, di-lower alkyl amides, and hydroxy amides. Preferred prodrug moieties are propionoic acid esters and acyl esters. Prodrugs which are converted to active forms through other mechanisms in vivo are also included. In aspects, the compounds of the invention are prodrugs of any of the formulae herein.
Particular prodrugs of Oteseconazole suitable for the dosage regimens of the present application include phosphate esters of the compound. In a phosphate ester of Oteseconazole, the OH group of the active is replaced by the following group:
, wherein Z may be an alkyl group (for mono-hydrogen phosphate esters) or H (for di -hydrogen phosphate ester).
The pharmaceutical compositions can, if desired, be presented in a pack or dispenser device which can contain one or more unit dosage forms containing the active compound(s). The pack can, for example, comprise metal or plastic foil, such as a blister pack. The pack or dispenser device can be accompanied by instructions for administration.
The pharmaceutically active component of the presently disclosed subject matter, or compositions thereof, will generally be used in an amount effective to treat or prevent vulvovaginal candidiasis or RVVC. The compound can be administered therapeutically to achieve therapeutic benefit or prophylactically to achieve prophylactic benefit. By therapeutic benefit is meant eradication or amelioration of vulvovaginal candidiasis or RVVC and/or eradication or amelioration of one or more of the symptoms associated with vulvovaginal candidiasis or RVVC such that the patient reports an improvement in feeling or condition, notwithstanding that the patient can still be afflicted with the underlying disorder.
For prophylactic administration, the compound can be administered to a patient at risk of infection of vulvovaginal candidiasis or developing RVVC. A patient at risk of developing a disease can be a patient having characteristics placing the patient in a designated group of at risk patients, as defined by an appropriate medical professional or group. A patient at risk may also be a patient that is commonly or routinely in a setting where development of the underlying disease
that may be treated by administration of Oteseconazole could occur. In other words, the at risk patient is one who is commonly or routinely exposed to vulvovaginal candidiasis or may be acutely exposed for a limited time. Alternatively, prophylactic administration can be applied to avoid the onset of symptoms in a patient diagnosed with the underlying disorder.
The amount of compound administered will depend upon a variety of factors, including, for example, the particular indication being treated, whether the desired benefit is prophylactic or therapeutic, the severity of the indication being treated and the age and weight of the patient, and the like. Determination of an effective dosage is well within the capabilities of those skilled in the art.
Effective dosages can be estimated initially from in vitro assays. For example, an initial dosage for use in animals can be formulated to achieve a circulating blood or serum concentration of active compound that is at or above an IC50 of the particular compound as measured in as in vitro assay, such as the in vitro fungal MIC or MFC and other in vitro assays described in the Examples section. Calculating dosages to achieve such circulating blood or serum concentrations taking into account the bioavailability of the particular compound is well within the capabilities of skilled artisans. For guidance, see Fingl & Woodbury, “General Principles,” In: Goodman and Gilman’s The Pharmaceutical Basis of Therapeutics, Chapter 1, pp. 1-46, latest edition, Pagamonon Press, and the references cited therein, which are incorporated herein by reference.
Initial dosages also can be estimated from in vivo data, such as animal models. Animal models useful for testing the efficacy of compounds to treat or prevent the various diseases described above are well-known in the art.
Study Design
Oteseconazole is being studied to compare the efficacy of oral Oteseconazole with that of fluconazole in the treatment of acute VVC episodes in RVVC subjects. The dosing regimens described herein incorporate an loading dose phase to treat the initial acute infection with either fluconazole or Oteseconazole. Fluconazole dosing regimen to be employed in the Eoading dose Phase is in alignment with the recommendation proposed by the Infectious Disease Society of America (IDS A) for the treatment of vulvovaginal candidiasis, in which fluconazole, 150 mg, is given every 72 hours for a total of 3 doses. This recommendation is strongly supported by IDSA and for which high-quality evidence is available to support its clinical effectiveness.
Oteseconazole has previously been evaluated in a Phase 2a multi-center, randomized, double-blind, active-controlled, parallel-group, dose-ranging study in patients with moderate-to- severe acute VVC. A total of 55 subjects with moderate-to-severe acute VVC (severity score >6 and a positive fungal KOH test) participated in the study across 4 dose groups: 1) Oteseconazole 300 mg qd for 3 days; 2) 600 mg qd for 3 days; 3) 600 mg bid for 3 days; or 4) a single dose of fluconazole 150 mg followed by matching placebo. Oteseconazole was shown to be safe and well tolerated when administered for 3 days. There were no serious adverse events (AEs) reported and no treatment emergent adverse events (TEAEs) led to study discontinuation. No safety signals of clinical concern were observed from the safety assessments.
The efficacy of Oteseconazole in the treatment of moderate-to-severe acute VVC was evaluated at the TOC visit in the Per Protocol population at the Day 28 test of cure (TOC) visit was, 87%, 86%, 86%, and 75% of subjects receiving the low , mid-, or high-dose Oteseconazole or comparator arm of fluconazole, respectively, achieved an effective therapeutic cure (defined as having a total clinical signs and symptoms severity score of <1 and a negative culture for Candida species) in the Per Protocol population
It is expected that a oral loading dose of about 600 mg of Oteseconazole on Day 1 and about 450 mg of Oteseconazole on Day 2 will provide for clinically effective plasma levels (approximately 2 pg/mL) to treat the presenting acute Candida spp. Infection and may have efficacy comparable to that of fluconazole in the treatment of an acute VVC episode in subjects with RVVC. This dosing regimen and targeted Oteseconazole plasma concentrations is also expected to effectively treat Candida spp. that are generally resistant to fluconazole, including but not limited to C. glabrata, C. parapsilosis, C. krusei, C. tropicalis and fluconazole resistant C. albicans.
Oteseconazole dosing regimens will also incorporate a 150 mg once weekly maintenance dose phase for 11 weeks. Based on the PK results from the Phase 2b study, it is expected that a mean plasma concentration of approximately 2.5 pg/mL at the end of the dosing period (Week 14) will be obtained.
Equivalents
Those skilled in the art will recognize, or be able to ascertain using no more than routine experimentation, many equivalents of the specific embodiments of the present application described herein. Such equivalents are intended with be encompassed by the following claims.
Claims
WHAT IS CLAIMED: A method of treating vulvovaginal candidiasis comprising a) administering to a subject in need thereof an effective amount of Oteseconazole during a loading dose period; and b) administering to the subject an effective amount of Oteseconazole during a maintenance dose period, wherein the loading and maintenance dose periods are separated by a nondosing period, wherein the loading dose period is 2 days wherein about 400 mg to about 800 mg of Oteseconazole is administered on day 1 of the loading dose period and about 300 mg to about 600 mg of Oteseconazole is administered on day 2 of the loading dose period; wherein the non-dosing period is between about 5 days and about 20 days; and wherein between about 100 mg and about 200 mg of Oteseconazole is administered during the maintenance dose period, which lasts between 9 weeks and 13 weeks. A method of treating vulvovaginal candidiasis comprising a) administering to a subject in need thereof an effective amount of Oteseconazole during loading dose period; and b) administering to the subject an effective amount of Oteseconazole during a maintenance dose period, wherein the loading and the maintenance dose periods are separated by a non-dosing period,
wherein the loading dose period is between about 5 and about 10 days wherein about 100 mg to about 200 mg of Oteseconazole is administered daily; wherein the non-dosing period is between about 5 days and about 10 days; and wherein between about 100 mg and about 200 mg of Oteseconazole is administered during the maintenance dose period, which lasts between about 9 weeks and about 13 weeks. The method of claim 1 or 2, wherein said vulvovaginal candidiasis is RVVC. The method of claim 1 or 2, wherein the maintenance dose period is about 11 weeks. The method of any of claims 1-4, wherein between about 120 mg and about 180 mg of Oteseconazole is administered during the maintenance dose period. The method of claim 5, wherein between about 140 mg and about 160 mg of Oteseconazole is administered during the maintenance dose period. The method of claim 6, wherein about 150 mg of Oteseconazole is administered during the maintenance dose period. The method of claim 1, wherein said vulvovaginal candidiasis is RVVC; about 480 mg to about 720 mg of Oteseconazole is administered on day 1 of the loading dose period; and about 360 mg to about 540 mg of Oteseconazole is administered on day 2 of the loading dose period. The method of claim 8, wherein about 560 mg to about 660 mg of Oteseconazole is administered on day 1 of the loading dose period and
about 400 mg to about 500 mg of Oteseconazole is administered on day 2 of the loading dose period. The method of claim 9, wherein about 600 mg of Oteseconazole is administered on day 1 of the loading dose period and about 450 mg of Oteseconazole is administered on day 2 of the loading dose period. The method of claims 8-10, wherein the maintenance dose period is 11 weeks. The method of claims 8-11, wherein between about 120 mg and about 180 mg of Oteseconazole is administered weekly during the maintenance dose period. The method of claims 8-12, wherein between about 140 mg and about 160 mg of Oteseconazole is administered weekly during the maintenance dose period. The method of claims 8-13, wherein about 150 mg of Oteseconazole is administered weekly during the maintenance dose period. The method of claim 2, wherein said vulvovaginal candidiasis is RVVC. The method of claim 15, wherein the loading dose period is between about
7 and about 9 days. The method of claim 16, wherein the loading dose period is about 7 days. The method of claim 17, wherein about 120 mg to about 180 mg of
Oteseconazole is administered daily during the loading dose period. The method of claim 18, wherein about 140 mg to about 160 mg of Oteseconazole is administered daily during the loading dose period. The method of claim 19, wherein about 150 mg of Oteseconazole is administered daily during the loading dose period.
15
The method of claims 18-20, wherein the maintenance dose period is about 11 weeks. The method of claims 18-21, wherein between about 120 mg and about 180 mg of Oteseconazole is administered during the maintenance dose period. The method of claims 18-22, wherein between about 140 mg and about 160 mg of Oteseconazole is administered during the maintenance dose period. The method of claims 18-23, wherein about 150 mg of Oteseconazole is administered during the maintenance dose period. The method of claim 1, wherein the loading dose period is two days wherein about 600 mg of Oteseconazole is administered on day 1 of the loading dose period and about 450 mg of Oteseconazole is administered on day 2 of the loading dose period; the non-dosing period is about 12 days; and the maintenance dose period is about 11 weeks wherein about 150 mg of Oteseconazole is administered weekly during the maintenance dose period. The method of claim 2, wherein the loading dose period is about 7 days wherein about 150 mg of Oteseconazole is administered daily during the loading dose period; the non-dosing period is about 7 days and the maintenance dose period is about 11 weeks wherein about 150 mg of Oteseconazole is administered weekly during the maintenance dose period. The method of claim 1, wherein the loading dose period is two days wherein about 600 mg of Oteseconazole is administered on day 1 of the loading dose period and about 450 mg of Oteseconazole is administered on day 2 of the loading dose period; the non-dosing period is about 5 days, about 6 days or about 7 days; and the maintenance dose period is about 11
16
weeks wherein about 150 mg of Oteseconazole is administered weekly during the maintenance dose period. The method of claim 2, wherein the loading dose period is about 7 days wherein about 150 mg of Oteseconazole is administered daily during the loading dose period; the non-dosing period is about 5 days, about 6 days, or about 7 days and the maintenance dose period is about 11 weeks wherein about 150 mg of Oteseconazole is administered weekly during the maintenance dose period.
17
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Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20190076512A1 (en) * | 2016-03-09 | 2019-03-14 | Los Angeles Biomedical Research Institute At Harbor-Ucla Medical Center | Methods and kits for use in preventing and treating vulvovaginal candidiasis |
US20200390751A1 (en) * | 2017-08-04 | 2020-12-17 | Scynexis, Inc. | Antifungal agents with enhanced activity in acidic ph |
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Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20190076512A1 (en) * | 2016-03-09 | 2019-03-14 | Los Angeles Biomedical Research Institute At Harbor-Ucla Medical Center | Methods and kits for use in preventing and treating vulvovaginal candidiasis |
US20200390751A1 (en) * | 2017-08-04 | 2020-12-17 | Scynexis, Inc. | Antifungal agents with enhanced activity in acidic ph |
Non-Patent Citations (2)
Title |
---|
ANONYMOUS: "Oteseconazole - Safety Data Sheet", MEDCHEMEXPRESS, 13 December 2019 (2019-12-13), XP055953440, Retrieved from the Internet <URL:https://file.medchemexpress.com/batch_PDF/HY-17643/Oteseconazole-SDS-MedChemExpress.pdf> [retrieved on 20220822] * |
MYCOVIA PHARMACEUTICALS, INC: "A Phase 3, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of VT-1161 Oral Capsules in the Treatment of Subjects with Recurrent Vulvovaginal Candidiasis", 1 October 2019 (2019-10-01), pages 5,6,11,9 - 10 * |
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