WO2022256301A1 - Méthodes et composés pour traiter des sujets atteints d'une maladie de stargardt - Google Patents

Méthodes et composés pour traiter des sujets atteints d'une maladie de stargardt Download PDF

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Publication number
WO2022256301A1
WO2022256301A1 PCT/US2022/031552 US2022031552W WO2022256301A1 WO 2022256301 A1 WO2022256301 A1 WO 2022256301A1 US 2022031552 W US2022031552 W US 2022031552W WO 2022256301 A1 WO2022256301 A1 WO 2022256301A1
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WIPO (PCT)
Prior art keywords
compound
rbp4
formula
administered
inhibitor
Prior art date
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PCT/US2022/031552
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English (en)
Inventor
Gary Jay STERNBERG
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Stargazer Pharmaceuticals, Inc.
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Publication of WO2022256301A1 publication Critical patent/WO2022256301A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents
    • 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
    • A61K31/41—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/415—1,2-Diazoles
    • 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
    • A61K31/4418—Non condensed pyridines; Hydrogenated derivatives thereof having a carbocyclic group directly attached to the heterocyclic ring, e.g. cyproheptadine
    • 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
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim

Definitions

  • This invention relates to methods and compositions useful in treating subjects with Stargardt disease, comprising administration of a therapeutically-effective amount of an RBP4 inhibitor compound.
  • Stargardt disease is an inherited retinal degenerative disease which leads to gradual visual loss and blindness. It is the leading cause of childhood blindness and the prevalence rate is estimated to be 50,000-80,000 patients in the US and the European Union Five (France, Germany, Italy, Spain, United Kingdom) combined. There is no approved treatment available. Patients typically exhibit severe depression among other serious comorbidities. Typical onset of disease is at 10-20 years of age.
  • ABCA4 Autosomal Recessive Mutation in ATP Binding Cassette Subfamily A Member 4
  • aspects of the present invention relate to methods of treating Stargardt disease.
  • aspects of the present invention relate to methods of treating a subject with
  • aspects of the present invention relate to methods of reducing plasma concentrations of Retinol Binding Protein 4 (RBP4) and Vitamin A (retinol).
  • RBP4 Retinol Binding Protein 4
  • Vitamin A Vitamin A
  • These methods of the present invention comprise administering to the subject an RBP4 inhibitor compound.
  • a 20 mg dose of the RBP4 inhibitor compound can be administered orally to the subject at least once a day.
  • a 25 mg dose of the RBP4 inhibitor compound can be administered orally to the subject at least once a day.
  • a 30 mg dose of the RBP4 inhibitor compound can be administered orally to the subject at least once a day.
  • Figure 1 A illustrates a plot depicting the pharmacokinetics for 20 mg of the RBP4 inhibitor compound.
  • Figure IB illustrates a plot depicting the pharmacokinetics for 30 mg of the RBP4 inhibitor compound.
  • Figure 1C illustrates a plot depicting the pharmacokinetics for both 20 mg and 30 mg of the RBP4 inhibitor compound.
  • Figure 2A illustrates a plot depicting AUCtau for 20 mg and 30 mg of the RBP4 inhibitor compound.
  • Figure 2B illustrates a plot depicting Cmax for 20 mg and 30 mg of the RBP4 inhibitor compound.
  • Figure 2C illustrates a plot comparing pre-dose and 24-hour post dose concentrations for 20 mg and 30 mg on days 14 and 28.
  • Figure 3A illustrates a plot depicting AUCtau in Stargardt subjects vs. healthy subjects on day 1.
  • Figure 3B illustrates a plot depicting Cmax in Stargardt subjects vs. healthy subjects on day 1.
  • Figure 4A illustrates a plot depicting Cmax in Stargardt subjects vs. healthy subjects for a 20 mg dose of the RBP4 inhibitor compound on day 1.
  • Figure 4B illustrates a plot depicting AUCtau in Stargardt subjects vs. healthy subjects for a 20 mg dose of the RBP4 inhibitor compound on day 1.
  • Figure 5 illustrates a graph depicting the RBP4 data for a 20 mg dose and a 30 mg dose of the RBP4 inhibitor compound.
  • Figure 6 illustrates a graph depicting the Vitamin A/retinol data for a 20 mg dose and a 30 mg dose of the RBP4 inhibitor compound.
  • Figure 7A illustrates a graph depicting the RBP4 change from baseline (spaghetti plots).
  • Figure 7B illustrates a graph depicting the retinol change from baseline (spaghehi plots).
  • Figure 8 illustrates a plot depicting a comparison of the PK/PD of healthy subjects and Stargardt subjects.
  • the present invention relates to methods and compositions useful for subjects with Stargardt disease.
  • the methods comprise administering an RBP4 inhibitor compound to the subjects in need thereof.
  • the compound is heterocyclic compound.
  • the compound is administered orally as a 20 mg dose, a 25 mg dose, and a 30 mg dose.
  • the present invention relates to methods and compositions useful for subjects with Stargardt disease.
  • the methods comprise administering an RBP4 inhibitor compound to the subjects in need thereof.
  • the RBP4 inhibitor compound can be represented by the formula (I):
  • ring A is a pyrazole ring, a pyridine ring, or a pyrimidine ring;
  • X is CH2 or O
  • R is a hydrogen atom or a Ci-6 alkyl group, or a salt thereof.
  • the RBP4 inhibitor compound is ((2-(3,5 bis(Trifluoromethyl)phenyl)pyrimidin-5-yl)oxy)acetic acid or a salt thereof.
  • the RBP4 inhibitor compound is ((6-(3,5- bis(Trifluoromethyl)phenyl)pyridin-3-yl)oxy)acetic acid or a salt thereof.
  • the RBP4 inhibitor compound is 3-(3-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-l-yl)propanoic acid or a salt thereof, having the structure OH
  • the RBP4 inhibitor compound is ((l-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-3-yl)oxy)acetic acid or a salt thereof, having the structure
  • compound (I) is a salt
  • examples thereof include metal salts, ammonium salts, salts with organic bases, salts with inorganic acids, salts with organic acids, salts with basic or acidic amino acids.
  • metal salt alkali metal salts such as sodium salt, potassium salt and the like; alkaline earth metal salts such as calcium salt, magnesium salt, barium salt and the like; aluminum salt can be mentioned.
  • salts with organic bases salts with trimethylamine, triethylamine, pyridine, picoline, 2,6-lutidine, ethanolamine, diethanolamine, triethanolamine, cyclohexylamine, dicyclohexylamine, N,N’- dibenzylethylenediamine and the like can be mentioned.
  • salts with inorganic acids salts with hydrochloric acid, hydrobromic acid, nitric acid, sulfuric acid, phosphoric acid and the like can be mentioned.
  • salts with organic acids salts with formic acid, acetic acid, trifluoroacetic acid, phthalic acid, fumaric acid, oxalic acid, tartaric acid, maleic acid, citric acid, succinic acid, malic acid, methanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid and the like can be mentioned.
  • salts with basic amino acids salts with arginine, lysine, ornithine and the like can be mentioned.
  • salts with acidic amino acids salts with aspartic acid, glutamic acid and the like can be mentioned.
  • salts are preferable.
  • inorganic salts such as alkali metal salts (e.g., sodium salt, potassium salt and the like), alkaline earth metal salts (e.g., calcium salt, magnesium salt, and the like) and the like, ammonium salt and the like can be mentioned.
  • salts with inorganic acids such as hydrochloric acid, hydrobromic acid, nitric acid, sulfuric acid, phosphoric acid and the like
  • salts with organic acids such as acetic acid, phthalic acid, fumaric acid, oxalic acid, tartaric acid, maleic acid, citric acid, succinic acid, methanesulfonic acid, benzenesulfonic acid, p- toluenesulfonic acid and the like can be mentioned.
  • compound (I), crystal of compound (I), prodrug of compound (I) and the like are sometimes collectively abbreviated as “the compound of the present invention”.
  • compound (I) contains optical isomer, stereoisomer, positional isomer, or rotamer, these are also encompassed in compound (I), and can be obtained as a single product by synthesis methods and separation methods (e.g., concentration, solvent extraction, column chromatography, recrystallization etc.) known per se.
  • compound (I) contains an optical isomer
  • an optical isomer resolved from the compound is also encompassed in compound (I).
  • Compound (I) may be a crystal.
  • the crystal of compound (I) obtained by the above-mentioned production method has high purity, high quality, and low hygroscopicity, is not denatured even after preservation under general conditions for a long term, and is extremely superior in stability. It is also superior in biological properties (e.g., pharmacokinetics (absorption, distribution, metabolism, excretion), efficacy expression), and thus is extremely useful as a medicament.
  • a prodrug of compound (I) means a compound which is converted to the compound (I) with a reaction due to an enzyme, an gastric acid, etc. under the physiological condition in the living body, that is, a compound which is converted to the compound (I) with oxidation, reduction, hydrolysis, etc. according to an enzyme; a compound which is converted to the compound (I) by hydrolysis etc. due to gastric acid, etc.
  • a prodrug for compound (I) may be a compound obtained by subjecting an amino group in compound (I) to an acylation, alkylation or phosphorylation (e.g., a compound obtained by subjecting an amino group in compound (I) to an eicosanoylation, alanylation, pentylaminocarbonylation, (5-methyl-2-oxo-l,3-dioxolen- 4-yl)methoxycarbonylation, tetrahydrofuranylation, pyrrolidylmethylation, pivaloyloxymethylation and tert-butylation, etc.); a compound obtained by subjecting a hydroxy group in compound (I) to an acylation, alkylation, phosphorylation or boration [e.g., a compound obtained by subjecting an hydroxy group in compound (I) to an acetylation, palmitoylation, propanoylation, pivaloylation, succinylation, fumarylation, alanylation, di
  • a prodrug for compound (I) may also be one which is converted to compound (I) under physiological conditions, such as those described in “Development of Pharmaceutical Product”, Vol. 7, Design of Molecules, p.163-198, Published by HIROKAWA SHOTEN (1990).
  • Compound (I) may be any of a hydrate, a non-hydrate, a solvate and a non-solvate. [0044] Compound (I) also encompasses a compound labeled with an isotope (e.g., 3 H, 14 C,
  • Compound (I) also encompasses a deuterium conversion form wherein 'H is converted to 2 H(D).
  • Compound (I) also encompasses a tautomer.
  • Compound (I) may be a pharmaceutically acceptable cocrystal or cocrystal salt.
  • the cocrystal or cocrystal salt means a crystalline substance consisting of two or more particular substances which are solids at room temperature, each having different physical properties (e.g., structure, melting point, heat of melting, hygroscopicity, solubility, stability etc.).
  • the cocrystal and cocrystal salt can be produced by cocry stallizati on method known per se.
  • the compound of the present invention can be directly used as the medicament of the present invention, or as a pharmaceutical composition formed by mixing with a pharmacologically acceptable carrier by a means known per se, which is generally used for a production method of a pharmaceutical preparation.
  • the medicament of the present invention can be safely administered orally or parenterally to mammals (e.g., human, monkey, bovine, horse, swine, mouse, rat, hamster, rabbit, cat, dog, sheep, goat etc.).
  • mammals e.g., human, monkey, bovine, horse, swine, mouse, rat, hamster, rabbit, cat, dog, sheep, goat etc.
  • the medicament may be administered by tablet.
  • the medicament may be administered by capsule.
  • the representative content of the compound of the present invention in the medicament of the present invention is about 0.01 wt% to about 100 wt%, of the whole medicament.
  • a single dose is generally about 0.01 to 100 mg, preferably 10 to 30 mg, more preferably 20 to 30 mg, for oral administration to Stargardt patients, and the dose is desirably administered in 1 to 3 times per day, more preferably once a day (QD).
  • the pharmaceutical composition is formulated for oral administration.
  • the present invention relates to methods of treating a subject with Stargardt disease, comprising administering to the subject an RBP4 inhibitor compound as described herein.
  • a 20 mg dose of 3-(3-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-l-yl)propanoic acid or a salt thereof can be administered orally.
  • a 25 mg dose of 3-(3-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-l-yl)propanoic acid or a salt thereof can be administered orally.
  • a 30 mg dose of 3-(3-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-l-yl)propanoic acid or a salt thereof can be administered orally.
  • the RPB4 inhibitor can be administered at least once a day (QD).
  • the present invention relates to the RBP4 inhibitor compound as described herein for use in treating a subject with Stargardt disease. Such uses are performed in accordance with the methods of the present invention described herein. [0059] In some embodiments, the present invention relates to uses of the RBP4 inhibitor compound as described herein to treat a subject with Stargardt disease. Such uses are performed in accordance with the methods of the present invention described herein.
  • the present invention relates to the use of the RBP4 inhibitor compound in the manufacture of a medicament for treating a subject with Stargardt disease. These uses of the medicament are performed in accordance with the methods of the present invention described herein.
  • the Example corresponds to an open-label, multicenter study in subjects with Stargardt disease, comparing 2 doses of an RBP4 inhibitor compound, e.g., 3-(3-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-l-yl)propanoic acid, with regard to safety, pharmacokinetics and pharmacodynamics.
  • an RBP4 inhibitor compound e.g., 3-(3-(3,5- bis(Trifluoromethyl)phenyl)-lH-pyrazol-l-yl)propanoic acid
  • the study included 10 subjects aged 18 to 55 years (inclusive) with STGD1, genotyped with a minimum of two ABCA4 gene mutations. Treatment course at 20 mg (Cohort 1) or 30 mg (Cohort 2) testing doses will be administered once daily for 28 days. Cohorts were run in parallel. Subjects received their designated dose daily for 28 days and monitored for safety measures during the dosing period and for an additional 28 days after dosing (through
  • RBP4 and retinol are assessed on days 1, 2, 7, 14, 28, 42, and 56.
  • Figure 1 A illustrates a plot depicting the pharmacokinetics for 20 mg QD
  • Figure IB illustrates a plot depicting the pharmacokinetics for 30 mg QD.
  • FIG 1A accumulation is observed from day 1 to day 14, with near steady-state being reached on day 14.
  • Figure IB accumulation is observed from day 1 to day 14 and day 14 to day 28.
  • Figure 1C illustrates a plot depicting the pharmacokinetics for both 20 mg QD and 30 mg QD.
  • Figure 2A illustrates a plot depicting AUCtau for 20 mg QD and 30 mg QD.
  • Figure 2B illustrates a plot depicting Cm ax for 20 mg QD and 30 mg QD. As depicted in these figures, for 20 mg QD, accumulation is observed from day 1 to day 14, with near steady-state being reached by day 14. Further, for 30 mg QD, accumulation is observed from day 1 to day 14 and day 14 to day 28.
  • Figure 2C illustrates a plot comparing pre-dose and 24-hour post dose concentrations on days 14 and 28 for 20 mg QD and 30 mg QD. In this regard, no difference between pre-dose and 24-hour post dose should indicate that steady state has been reached.
  • Figure 3A illustrates a plot depicting AUCtau in Stargardt subjects vs. healthy subjects on day 1.
  • Figure 3B illustrates a plot depicting Cmaxin Stargardt subjects vs. healthy subjects on day 1.
  • AUCtau and Cmax are similar for healthy subjects and subjects with Stargardt disease on day 1.
  • Figure 4A illustrates a plot depicting Cmax in Stargardt subjects vs. healthy subjects for a 20 mg dose on day 1.
  • Figure 4B illustrates a plot depicting AUCtau in Stargardt subjects vs. healthy subjects for a 20 mg dose on day 1.
  • Cmax and AUCtau are similar for healthy subjects and subjects with Stargardt disease on day 1.
  • the 20 mg dose is beher than the 30 mg dose since the 20 mg dose has more predictable pharmacokinetics after day 14 (where the accumulation ratio is ⁇ 3x).
  • the 30 mg dose appears to have not yet reached steady state at day 28 and demonstrated continued non-linearity (where the accumulation ratio was 4.4 x for day 14 and 5.8x for day 28). Further, the 30 mg dose AUC exceeded chronic NOAEL of rat male at day 28 but remained lower than monkey NOAEL. As such, the likelihood of pharmacokinetics-related issues with the 30 mg dose is material Safety
  • Table 2 depicts a summary of the AEs in the study.
  • Table 3 depicts the RBP4 data for a 20 mg dose and a 30 mg dose.
  • Figure 5 illustrates a graph depicting the RBP4 data for a 20 mg dose and a 30 mg dose.
  • Table 4 depicts the Vitamin A/retinol data for a 20 mg dose and a 30 mg dose.
  • Figure 6 illustrates a graph depicting the Vitamin A/retinol data for a 20 mg dose and a 30 mg dose.
  • Figure 7A illustrates a graph depicting the RBP4 change from baseline (spaghetti plots).
  • Figure 7B illustrates a graph depicting the retinol change from baseline (spaghetti plots).
  • Figure 8 illustrates a plot depicting a comparison of the PK/PD of healthy subjects and Stargardt subjects.
  • a comparison of the day 7 healthy subjects and the day 14 Stargardt subjects data indicates that the response in terms of RBP4 reduction is similar in subjects with Stargardt disease and healthy subjects (note: one subject with Stargardt disease is believed to have poor adherence to treatment - this subject appears to be an outlier).
  • 25 mg QD can also be a viable dose.
  • compositions are described as including components or materials, it is contemplated that the compositions can also consist essentially of, or consist of, any combination of the recited components or materials, unless described otherwise.
  • methods are described as including particular steps, it is contemplated that the methods can also consist essentially of, or consist of, any combination of the recited steps, unless described otherwise.
  • the invention illustratively disclosed herein suitably may be practiced in the absence of any element or step which is not specifically disclosed herein.

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  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Veterinary Medicine (AREA)
  • Medicinal Chemistry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Epidemiology (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Ophthalmology & Optometry (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Engineering & Computer Science (AREA)
  • Organic Chemistry (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

La présente invention concerne des méthodes et des compositions utiles pour des sujets atteints d'une maladie de Stargardt. Les méthodes comprennent le traitement d'un sujet atteint d'une maladie de Stargardt. Ces méthodes impliquent l'administration orale d'un composé inhibiteur de RBP4 aux sujets.
PCT/US2022/031552 2021-06-01 2022-05-31 Méthodes et composés pour traiter des sujets atteints d'une maladie de stargardt WO2022256301A1 (fr)

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US63/195,700 2021-06-01

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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20180237404A1 (en) * 2014-10-24 2018-08-23 Takeda Pharmaceutical Company Limited Heterocyclic compound

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20180237404A1 (en) * 2014-10-24 2018-08-23 Takeda Pharmaceutical Company Limited Heterocyclic compound

Non-Patent Citations (3)

* Cited by examiner, † Cited by third party
Title
"STG-001 RBP4 antagonist", GLIXX LABORATORIES PRODUCTS, pages 1, XP009542806, Retrieved from the Internet <URL:https://web.archive.org/web/20210125141628/http://glixxlabs.com/chemical-products/bioactive-screen-leads-p6/GLXC-23227> [retrieved on 20220720] *
ANONYMOUS: "Recent Developments in Agents for the Treatment of Age-Related Macular Degeneration and Stargardt Disease", TOP MED CHEM, vol. 35, 2020, pages 125 - 160, DOI: 10.1007/7355_2020_105 *
ANONYMOUS: "Study of STG-001 in Subjects With Stargardt Disease ", CLINICALTRIALS.GOV, 27 April 2021 (2021-04-27), XP093009777, Retrieved from the Internet <URL:https://clinicaltrials.gov/ct2/show/NCT04489511> [retrieved on 20221220] *

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