WO2023056933A1 - 包含衣壳蛋白抑制剂和逆转录酶抑制剂的药物组合 - Google Patents
包含衣壳蛋白抑制剂和逆转录酶抑制剂的药物组合 Download PDFInfo
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- WO2023056933A1 WO2023056933A1 PCT/CN2022/123799 CN2022123799W WO2023056933A1 WO 2023056933 A1 WO2023056933 A1 WO 2023056933A1 CN 2022123799 W CN2022123799 W CN 2022123799W WO 2023056933 A1 WO2023056933 A1 WO 2023056933A1
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- pharmaceutically acceptable
- acceptable salt
- tenofovir
- compound
- entecavir
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Classifications
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- 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
- A61K31/40—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
-
- 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
- A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
-
- 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
- A61K31/66—Phosphorus compounds
- A61K31/675—Phosphorus compounds having nitrogen as a ring hetero atom, e.g. pyridoxal phosphate
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
- A61P31/12—Antivirals
Definitions
- the application belongs to the field of medicinal chemistry and relates to a drug combination comprising a capsid protein inhibitor and a reverse transcriptase inhibitor. Specifically, it relates to a compound of formula I as a capsid protein inhibitor or a pharmaceutically acceptable salt thereof and entecavir or tenofovir, or a pharmaceutically acceptable prodrug thereof, a pharmaceutically acceptable salt thereof or a solvate thereof combination, or its use in the treatment of hepatitis B virus infection.
- HBV hepatitis B virus
- cccDNA a stable covalently closed circular DNA, cccDNA, is formed in the nucleus of the host's liver cells, which serves as a template for the continuous replication of HBV.
- All subgenomic RNAs (sgRNAs) and pregenomic RNAs (pgRNAs) are transcribed from cccDNA. After leaving the nucleus, sgRNA is translated into X protein and three other envelope proteins, and pgRNA is translated into core protein and viral polymerase. Under the action of polymerase, pgRNA and core protein self-assemble to form RNA wrapped in nucleocapsid.
- nucleocapsid In the nucleocapsid, pgRNA is reverse-transcribed into negative-strand DNA, and thus further synthesizes DNA positive-strand to form rcDNA.
- the rcDNA wrapped by the nucleocapsid re-unshells and enters the nucleus to further amplify the cccDNA; on the other hand, it re-combines with the envelope protein and releases the cell through the endoplasmic reticulum to form new HBV.
- the synthesis of nucleocapsid is a key step in the replication process of HBV genome, and the synthesis of viral DNA can only specifically occur inside the nucleocapsid.
- nucleocapsid Assembly of the nucleocapsid is an evolutionarily constrained process that limits HBV diversity and is highly sensitive to even subtle molecular perturbations. Targets acting on the synthesis and degradation of nucleocapsids are very promising for the development of new therapies against different HBV genotypes and drug-resistant strains.
- nucleoside (acid) compounds and interferon.
- Nucleoside (acid) drugs such as entecavir and tenofovir, can inhibit HBV DNA replication.
- the present application provides a pharmaceutical combination, which includes a capsid protein inhibitor or a pharmaceutically acceptable salt thereof and one or more other therapeutic drugs.
- the capsid protein inhibitor or a pharmaceutically acceptable salt thereof in the present application is selected from compounds in WO2019185016, WO2019165374, WO2019241292, WO2021119081, or WO2020156494 or a pharmaceutically acceptable salt thereof.
- the capsid protein inhibitors or pharmaceutically acceptable salts thereof in the present application are selected from specific compounds or pharmaceutically acceptable salts thereof in WO2019185016, WO2019165374, WO2019241292, WO2021119081, or WO2020156494.
- the one or more other therapeutic drugs described in this application are selected from nucleotide compounds or interferon.
- the one or more other therapeutic drugs described in this application are selected from reverse transcriptase inhibitors or interferon.
- One or more other therapeutic drugs described in the application are selected from reverse transcriptase inhibitors (nucleotide compounds) or interferon (such as short-acting interferon or long-acting interferon, specifically such as interferon ⁇ 1b, interferon ⁇ 2a , interferon alpha 2b).
- reverse transcriptase inhibitors nucleotide compounds
- interferon such as short-acting interferon or long-acting interferon, specifically such as interferon ⁇ 1b, interferon ⁇ 2a , interferon alpha 2b.
- One or more other therapeutic drugs described in this application are selected from reverse transcriptase inhibitors (nucleotide compounds).
- the reverse transcriptase inhibitor is selected from the group consisting of entecavir, tenofovir, lamivudine, telbivudine, adefovir, clavudine, CMX157, AGX-1009, zidovudine Dine, didanosin, zalcitabine, stavudine, emtricitabine, abacavir, D-D4FC, alovudine, amdosovir, effitabine, delavirdine, Efavirenz, nevirapine, capravirine, calanolide A, TMC278, BMS-561390, and DPC-083, or their pharmaceutically acceptable prodrugs, their pharmaceutically acceptable salts, or their solvates.
- the reverse transcriptase inhibitor is selected from entecavir or tenofovir, pharmaceutically acceptable prodrugs thereof, pharmaceutically acceptable salts or solvates thereof. In some embodiments, the reverse transcriptase inhibitor is selected from entecavir, a pharmaceutically acceptable salt thereof, or a solvate thereof. In some embodiments, the reverse transcriptase inhibitor is selected from tenofovir, a pharmaceutically acceptable prodrug thereof, a pharmaceutically acceptable salt thereof, or a solvate thereof. In another aspect, the present application provides a pharmaceutical combination, which includes the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof, and,
- the present application also provides the use of the pharmaceutical combination of the present application in the preparation of medicines for treating hepatitis B virus infection.
- the present application also provides a method for treating hepatitis B virus infection, which comprises administering an effective amount of the pharmaceutical combination of the present application to an individual in need.
- the present application also provides a drug combination for treating hepatitis B virus infection.
- the present application also provides the use of the pharmaceutical combination of the present application for treating hepatitis B virus infection.
- the pharmaceutical combination described in the present application includes the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a hydrate thereof. In some embodiments, the pharmaceutical combination described herein includes the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and entecavir or a monohydrate thereof. In some embodiments, the pharmaceutical combination described herein includes the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and entecavir-maleate monohydrate.
- the pharmaceutical combination described in the present application includes the capsid protein inhibitor described in the present application or its pharmaceutically acceptable salt and tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable Salt.
- the drug combination described in the application includes the capsid protein inhibitor described in the application or a pharmaceutically acceptable salt thereof and tenofovir alafenamide or tenofovir disoproxil or its equivalent Medicinal salt.
- the pharmaceutical combination described in the application includes the capsid protein inhibitor described in the application or a pharmaceutically acceptable salt thereof and tenofovir disoproxil fumarate or tenofovir alafenamide Amine fumarate.
- the capsid protein inhibitor of the present application or a pharmaceutically acceptable salt thereof of the pharmaceutical combination can be administered once a day, twice a day, three times a day, or every two days Once, every three days, every four days, every five days, every six days, every week, every two weeks, or every three weeks.
- the capsid protein inhibitor described in the application of the pharmaceutical combination or its pharmaceutically acceptable salt is administered with 10mg-500mg, 10-100mg or 10-50mg specification dose (based on free compound weight) each time. calculate).
- each dose of the capsid protein inhibitor described in the present application of the pharmaceutical combination or a pharmaceutically acceptable salt thereof is 10 mg-500 mg, 10-100 mg or 10-50 mg specification dose (as free calculated by compound weight).
- the capsid protein inhibitor of the present application or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 0.0001 to 20 mg/kg weight (calculated by free compound weight) per administration.
- each dose of the capsid protein inhibitor of the present application or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 0.0001 to 20 mg/kg weight (calculated by free compound weight).
- the capsid protein inhibitor of the application or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is administered at 1-2000 mg, 2-1500 mg, 2-1000 mg, 3-800 mg, 3- 600mg, 4-550mg, 5-500mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg.
- each dose of the capsid protein inhibitor or the pharmaceutically acceptable salt thereof of the application of the pharmaceutical combination is 1-2000mg, 2-1500mg, 2-1000mg, 3-800mg, 3-600mg, 4-550mg, 5-500mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9- 340mg or 10-320mg.
- the capsid protein inhibitor of the present application or the pharmaceutically acceptable salt thereof of the pharmaceutical combination is administered at 1-1500 mg or 10-1000 mg (calculated by free compound weight) each time, and the replacement
- the average daily dose of nofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is 0.05 mg to 500 mg (calculated by weight of tenofovir).
- each dose of the capsid protein inhibitor described in the application or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 1-1500 mg or 10-1000 mg (calculated by free compound weight), so The average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is 0.05 mg to 500 mg (calculated by weight of tenofovir).
- the average daily average daily The dose ratio (based on the weight unit of the corresponding free compound, capsid protein inhibitor compound: tenofovir) is selected from 500:1 to 1:1000.
- the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt and the ratio of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt average daily dosage (with corresponding The weight unit of free compound) is selected from 500:1, 450:1, 400:1, 350:1, 300:1, 250:1, 200:1, 150:1, 100:1, 95:1, 90 :1, 85:1, 80:1, 75:1, 70:1, 65:1, 60:1, 55:1, 50:1, 45:1, 40:1, 39:1, 38:1 , 37:1, 36:1, 35:1, 34:1, 33:1, 32:1, 31:1, 30:1, 29:1, 28:1, 27:1, 26:1, 25 :1, 24:1, 23:1, 22:1, 21:1, 20:1, 19:1, 18:1, 17:1, 16:1, 15:
- the average daily average daily The dose ratio (based on the molar ratio of the free compound) is selected from 100:1 to 1:100.
- the ratio of the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt to tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt average daily dose (in moles of free compound Ratio, capsid protein inhibitor compound: tenofovir) selected from: 100:1, 98:1, 96:1, 94:1, 92:1, 90:1, 88:1, 86:1, 84:1, 82:1, 80:1, 78:1, 76:1, 74:1, 72:1, 70:1, 68:1, 66:1, 64:1, 62:1, 60: 1, 58:1, 56:1, 54:1, 52:1, 50:1, 48:1, 46:1, 44:1, 42:1, 40:1, 38:1, 36:1, 34:1, 32:1, 30:1, 28:1, 26:1, 25:1, 24:1, 23:1, 22:1, 21
- the capsid protein inhibitor or its pharmaceutically acceptable salt (the capsid protein inhibitor compound is calculated as a free compound) and tenofovir disoproxil
- the ratio of the average daily dose of fumarate (in weight units) is selected from 1:300 to 1500:300 or 10:300 to 1000:300.
- the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt (capsid protein inhibitor compound is calculated as free compound) and tenofovir disoproxil fumarate in the drug combination
- the ratio of the average daily dose (in weight units) is selected from 10:300, 20:300, 30:300, 40:300, 50:300, 60:300, 70:300, 80:300, 90:300, 100 :300, 110:300, 120:300, 130:300, 140:300, 150:300, 160:300, 170:300, 180:300, 190:300, 200:300, 210:300, 220:300 ,230:300,240:300,250:300,260:300,270:300,280:300,290:300,300:300,310:300,320:300,330:300,340:300,350 :300, 360:300, 370:300, 380:300, 390:300, 400:300, 410:300, 420:300, 430:300, 440:300,
- the capsid protein inhibitor or its pharmaceutically acceptable salt (the capsid protein inhibitor compound is calculated as a free compound) and tenofovir alafenamide
- the ratio of the average daily dose is selected from 1:25 to 1500:25 or 10:25 to 1000:25.
- the capsid protein inhibitor or its pharmaceutically acceptable salt (the capsid protein inhibitor compound is calculated as free compound) and the average daily dose of tenofovir alafenamide ( In weight units) the ratio is selected from 10:25, 20:25, 30:25, 40:25, 50:25, 60:25, 70:25, 80:25, 90:25, 100:25, 110 :25, 120:25, 130:25, 140:25, 150:25, 160:25, 170:25, 180:25, 190:25, 200:25, 210:25, 220:25, 230:25 , 240:25, 250:25, 260:25, 270:25, 280:25, 290:25, 300:25, 310:25, 320:25, 330:25, 340:25, 350:25, 360 :25, 370:25, 380:25, 390:25, 400:25, 410:25, 420:25, 430:25
- the capsid protein inhibitor or its pharmaceutically acceptable salt (the capsid protein inhibitor compound is calculated as a free compound) and tenofovir alafenamide
- the ratio of the average daily dose of fumarate is selected from 1:28 to 1500:28 or 10:28 to 1000:28.
- the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt (capsid protein inhibitor compound is calculated as free compound) and tenofovir alafenamide fumarate in the drug combination
- the ratio of the average daily dose (in weight units) is selected from 10:28, 20:28, 30:28, 40:28, 50:28, 60:28, 70:28, 80:28, 90:28, 100 :28, 110:28, 120:28, 130:28, 140:28, 150:28, 160:28, 170:28, 180:28, 190:28, 200:28, 210:28, 220:28 , 230:28, 240:28, 280:28, 260:28, 270:28, 280:28, 290:28, 300:28, 310:28, 320:28, 330:28, 340:28, 350 :28, 360:28, 370:28, 380:28, 390:28, 400:28, 410:28, 420
- the capsid protein inhibitor or the pharmaceutically acceptable salt thereof and tenofovir or the pharmaceutically acceptable prodrug or the pharmaceutically acceptable salt thereof in the drug combination are respectively Administration in single or multiple dose forms.
- the capsid protein inhibitor of the application or the pharmaceutically acceptable salt thereof of the pharmaceutical combination is administered 1-1500 mg, 2-1000 mg, 3-800 mg, 3-600 mg, 4- 550mg, 5-500mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg,
- the average daily dose of Entecavir or its pharmaceutically acceptable salt or its solvate is 0.005 mg to 10.0 mg.
- each dose of the capsid protein inhibitor described in the application or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 1-1500 mg, 2-1000 mg, 3-800 mg, 3-600 mg, 4-550mg, 5-500mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-
- the average daily dose of entecavir or its pharmaceutically acceptable salt or its solvate is 0.005 mg to 10.0 mg.
- the ratio of the average daily dose of the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt to entecavir or its pharmaceutically acceptable salt or its solvate in the pharmaceutical combination is selected from 1000:1 to 1:1000.
- the ratio of the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt to the average daily dose of entecavir or its pharmaceutically acceptable salt or its solvate selected from 1000:1, 950:1, 900:1, 850:1, 800:1, 750:1, 700:1, 650:1, 640:1, 630:1, 620: 1, 610:1, 600:1, 550:1, 500:1, 450:1, 400:1, 350:1, 300:1, 250:1, 200:1, 150:1, 100:1, 90:1, 80:1, 70:1, 60:1, 50:1, 40:1, 30:1, 20:1, 10:1, 1:0.01, 1:0.02, 1:0.03, 1: 0.04, 1:0.05, 1:0.06, 1:0.07, 1:0.08, 1:0.09, 1:0.1, 1:0.5, 1:0.6, 1:0.7, 1:0.8, 1:0.9, 1:1, 1:10, 1:20, 1:30, 1:40,
- the ratio of the average daily dose of the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt to entecavir or its pharmaceutically acceptable salt or its solvate in the pharmaceutical combination is selected from 300:1 to 1:100.
- the ratio of the capsid protein inhibitor described in the application or its pharmaceutically acceptable salt to the average daily dose of entecavir or its pharmaceutically acceptable salt or its solvate (based on the molar ratio of the free compound, capsid protein Inhibitor compound: Entecavir) selected from: 300:1, 290:1, 280:1, 270:1, 260:1, 250:1, 240:1, 235:1, 230:1, 225:1, 220 :1, 215:1, 210:1, 205:1, 200:1, 190:1, 180:1, 170:1, 160:1, 150:1, 140:1, 130:1, 120:1 , 110:1, 100:1, 98:1, 96:1, 94:1, 92:1, 90:1, 88:1, 86:1, 84:1, 82:1, 80:1, 78 :1, 76:1, 74:1, 72:1, 70:1, 68:1, 66:1, 64:1, 62:1, 60:1, 58:1, 56:1, 54:1 , 52
- the capsid protein inhibitor described in the present application or its pharmaceutically acceptable salt is calculated as a free compound
- the average daily dose of entecavir monohydrate ( (in weight units) ratio is selected from 1:0.5 to 1500:0.5 or 10:0.5 to 1000:0.5.
- the capsid protein inhibitor or pharmaceutically acceptable salt thereof is calculated as a free compound
- the average daily dose of entecavir monohydrate (in weight units) in the drug combination ) ratio is selected from 10:0.5, 20:0.5, 30:0.5, 40:0.5, 50:0.5, 60:0.5, 70:0.5, 80:0.5, 90:0.5, 100:0.5, 110:0.5, 120 :0.5, 130:0.5, 140:0.5, 150:0.5, 160:0.5, 170:0.5, 180:0.5, 190:0.5, 200:0.5, 210:0.5, 220:0.5, 230:0.5, 240:0.5 ,250:0.5,260:0.5,270:0.5,280:0.5,290:0.5,300:0.5,310:0.5,320:0.5,330:0.5,340:0.5,350:0.5,360:0.5,370 :0.5, 380:0.5, 390:0.5, 400:0.5, 410:0.5, 420:0.5, 430:0.5, 440:0.5, 450:0.5,
- the capsid protein inhibitor or the pharmaceutically acceptable salt thereof and one or more other therapeutic drugs in the pharmaceutical combination are administered in a single dose or multiple doses, respectively.
- the capsid protein inhibitor or its pharmaceutically acceptable salt described in the present application and entecavir or its pharmaceutically acceptable salt or its solvate in the said pharmaceutical combination are in single dose or multi-dose form respectively medication.
- the drug combination is a fixed combination.
- the fixed combination is in the form of a solid pharmaceutical composition.
- the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and one or more other therapeutic drugs in the fixed combination are present in the same solid pharmaceutical composition.
- the capsid protein inhibitor or pharmaceutically acceptable salt thereof and tenofovir or its pharmaceutically acceptable prodrug or pharmaceutically acceptable salt thereof in the fixed combination are present in the same solid pharmaceutical composition.
- the capsid protein inhibitor or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof in the fixed combination are present in the same solid pharmaceutical composition.
- the drug combination is a non-fixed combination.
- the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or solvate thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition.
- the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof in the non-fixed combination are each in a solid form Pharmaceutical composition form.
- the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof in the non-fixed combination are each in a solid form Pharmaceutical composition form, and the solid pharmaceutical composition of capsid protein inhibitor or its pharmaceutically acceptable salt described in the application and the solid pharmaceutical composition of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt present in the same pouch.
- the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof in the non-fixed combination are each in a solid form Pharmaceutical composition form, and the solid pharmaceutical composition of capsid protein inhibitor or its pharmaceutically acceptable salt described in the application and tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt solid pharmaceutical composition are not present in the same pouch.
- the capsid protein inhibitor or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition, and
- the capsid protein inhibitor or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition, and
- the solid pharmaceutical composition of the capsid protein inhibitor or its pharmaceutically acceptable salt and the solid pharmaceutical composition of entecavir or its pharmaceutically acceptable salt or its solvate described in this application do not exist in the same medicine bag.
- the solid pharmaceutical composition is selected from tablets or capsules.
- the present application also provides the use of the pharmaceutical combination of the present application in the preparation of medicines for treating hepatitis B virus infection.
- the drug combination is as described above.
- the present application also provides a method for treating hepatitis B virus infection, which comprises administering an effective amount of the pharmaceutical combination of the present application to an individual in need.
- the drug combination is as described above.
- the present application also provides the pharmaceutical combination of the present application for treating hepatitis B virus infection.
- the drug combination is as described above.
- the application also provides the use of the drug combination of the application for treating hepatitis B virus infection.
- the drug combination is as described above.
- the present application also provides a kit for treating hepatitis B virus infection, comprising: (a) containing the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof as the active and (b) a second pharmaceutical composition comprising a reverse transcriptase inhibitor or a pharmaceutically acceptable prodrug thereof, a pharmaceutically acceptable salt thereof, or a solvate thereof as an active ingredient; and Optional (c) Description of the joint use of the capsid protein inhibitor or its pharmaceutically acceptable salt and reverse transcriptase inhibitor or its pharmaceutically acceptable prodrug, its pharmaceutically acceptable salt or its solvate described in this application .
- the reverse transcriptase inhibitor or its pharmaceutically acceptable prodrug, its pharmaceutically acceptable salt or its solvate is as described above.
- the present application provides a capsid protein inhibitor comprising the present application or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug thereof or a pharmaceutically acceptable salt thereof Application as an active ingredient in the preparation of a drug for the treatment of hepatitis B virus infection, wherein the capsid protein inhibitor or its pharmaceutically acceptable salt and tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable The salts are prepared into pharmaceutical compositions respectively.
- the present application also provides a kit for treating hepatitis B virus infection, comprising: (a) containing the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof as the active A first pharmaceutical composition of ingredients; and (b) a second pharmaceutical composition containing tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof as an active ingredient; and optionally (c) Description of the combined use of the capsid protein inhibitor or its pharmaceutically acceptable salt and tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt described in the application.
- the present application provides a preparation comprising the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt thereof or a solvate thereof for the treatment of hepatitis B virus infection
- a preparation comprising the capsid protein inhibitor described herein or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt thereof or a solvate thereof for the treatment of hepatitis B virus infection
- the present application also provides a kit for treating hepatitis B virus infection, comprising: (a) containing the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof as the active and (b) the second pharmaceutical composition containing entecavir or its pharmaceutically acceptable salt or its solvate as an active ingredient; and optionally (c) the shell described in the present application
- a kit for treating hepatitis B virus infection comprising: (a) containing the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof as the active and (b) the second pharmaceutical composition containing entecavir or its pharmaceutically acceptable salt or its solvate as an active ingredient; and optionally (c) the shell described in the present application
- a protein inhibitor or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof comprising: (a) containing the capsid protein inhibitor described in the present application or a pharmaceutically acceptable salt thereof as the active and (b) the second pharmaceutical composition containing
- the capsid protein inhibitor described in the present application or its pharmaceutically acceptable salt is selected from the compound of formula I or its pharmaceutically acceptable salt
- the application provides a pharmaceutical combination, which includes a compound of formula I or a pharmaceutically acceptable salt thereof and a reverse transcriptase inhibitor or a pharmaceutically acceptable prodrug thereof, or a pharmaceutically acceptable salt or a solvate thereof,
- the reverse transcriptase inhibitor or a pharmaceutically acceptable prodrug thereof, or a pharmaceutically acceptable salt or a solvate thereof is selected from entecavir or a pharmaceutically acceptable salt or a solvate thereof, or an alternative Nofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt.
- the present application provides a pharmaceutical combination, which comprises a compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof.
- the present application provides a pharmaceutical combination comprising a compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof.
- the present application also provides the use of the pharmaceutical combination of the present application in the preparation of medicines for treating hepatitis B virus infection.
- the present application also provides a method for treating hepatitis B virus infection, which comprises administering an effective amount of the pharmaceutical combination of the present application to an individual in need.
- the present application also provides a drug combination for treating hepatitis B virus infection.
- the present application also provides the use of the pharmaceutical combination of the present application for treating hepatitis B virus infection.
- the entecavir solvate is selected from entecavir hydrate.
- the Entecavir hydrate is selected from Entecavir 0.5-2 hydrate.
- the entecavir hydrate is selected from entecavir monohydrate.
- the pharmaceutically acceptable salt of entecavir is selected from maleate. In some embodiments of the present application, the pharmaceutically acceptable salt of entecavir is selected from monomaleate.
- entecavir or its pharmaceutically acceptable salt or its solvate is selected from entecavir-maleate, entecavir monohydrate, or entecavir-maleate monohydrate.
- the pharmaceutical combination described in the present application includes the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a hydrate thereof.
- the pharmaceutical combination described herein includes the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a monohydrate thereof.
- the pharmaceutical combination described in this application comprises the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir monomaleate monohydrate.
- the pharmaceutically acceptable prodrug of tenofovir includes tenofovir disoproxil, tenofovir alafenamide or amitenofovir.
- the pharmaceutically acceptable salt of tenofovir or its pharmaceutically acceptable prodrug is selected from fumarate, orotate, disulfonate, phosphate, succinic acid or aspartate. In some embodiments of the present application, the pharmaceutically acceptable salt of tenofovir or its pharmaceutically acceptable prodrug is selected from fumarate.
- tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is selected from tenofovir, tenofovir alafenamide fumarate, tenofovir Tenofovir disoproxil fumarate, tenofovir disoproxil orotate, tenofovir disoproxil hemidisulfonate, tenofovir disoproxil phosphate, tenofovir disoproxil Fovir disoproxil succinate, tenofovir disoproxil aspartate, or amitenofovir disoproxil fumarate.
- the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is selected from tenofovir disoproxil fumarate or tenofovir aira Phenylamine fumarate. In some embodiments of the present application, tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is selected from tenofovir disoproxil fumarate.
- tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is selected from the following structures:
- the pharmaceutical combination described in the present application includes the compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof.
- the pharmaceutical combination described in this application includes the compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir alafenamide or tenofovir disoproxil or a pharmaceutically acceptable salt thereof.
- the pharmaceutical combination described in the present application includes the compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir disoproxil fumarate or tenofovir alafenamide fumarate.
- the compound of formula I or a pharmaceutically acceptable salt thereof of the pharmaceutical combination can be administered once a day, twice a day, three times a day, once every two days, or every three days Once, every four days, every five days, every six days, every week, every two weeks, or every three weeks.
- the compound of formula I or a pharmaceutically acceptable salt thereof in the pharmaceutical combination is administered at a standard dose of 10 mg or 50 mg (calculated by the weight of the compound of formula I) each time.
- the compound of formula I or a pharmaceutically acceptable salt thereof in the pharmaceutical combination is selected from a standard dose of 10 mg or 50 mg (calculated by the weight of the compound of formula I).
- the compound of formula I or a pharmaceutically acceptable salt thereof in the pharmaceutical combination is 0.0001 to 20 mg/kg weight (calculated by the weight of the compound of formula I) per administration.
- the dose of the compound of formula I or a pharmaceutically acceptable salt thereof in the pharmaceutical combination is 0.0001 to 20 mg/kg weight (calculated by the weight of the compound of formula I) each time.
- the compound of formula I or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 1-1500 mg, 2-1000 mg, 3-800 mg, 3-600 mg, 4-550 mg, 5-500 mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg.
- the dosage of the compound of formula I or a pharmaceutically acceptable salt thereof in the pharmaceutical combination is 1-1500 mg, 2-1000 mg, 3-800 mg, 3-600 mg, 4-550 mg, 5- 500mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg.
- tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of said pharmaceutical combination can be administered once a day, administered twice a day, or administered once every two days, or The administration is once every three days, or once every four days, or once every five days, or once every six days, or once every seven days.
- tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof of the pharmaceutical combination may be administered once a day.
- tenofovir disoproxil fumarate is 300 mg per administration. In some embodiments of the present application, tenofovir alafenamide 25 mg or tenofovir alafenamide fumarate 28 mg per administration.
- the dose of tenofovir disoproxil fumarate is 300 mg each time. In some embodiments of the present application, the dose of tenofovir alafenamide is 25 mg each time or the dose of tenofovir alafenamide fumarate is 28 mg each time.
- the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 0.05 mg to 500 mg (calculated by weight of tenofovir). In some embodiments of the present application, the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 0.1 mg to 400 mg (calculated by weight of tenofovir). In some embodiments of the present application, the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 1 mg to 300 mg (calculated by weight of tenofovir).
- the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 5 mg to 200 mg (calculated by weight of tenofovir). In some embodiments of the present application, the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 8 mg to 190 mg (calculated by weight of tenofovir). In some embodiments of the present application, the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 10 mg to 185 mg (calculated by weight of tenofovir). In some embodiments of the present application, the average daily dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt of the pharmaceutical combination is 14 mg to 140 mg (calculated by weight of tenofovir).
- the entecavir or a pharmaceutically acceptable salt or a solvate thereof of the pharmaceutical combination can be administered once a day, twice a day, or once every two days.
- the Entecavir or its pharmaceutically acceptable salt or its solvate of the pharmaceutical combination is administered at a standard dose of 0.5 mg or 1.0 mg (calculated by the weight of Entecavir) each time.
- the dose of entecavir or its pharmaceutically acceptable salt or its solvate of the pharmaceutical combination is 0.5 mg or 1.0 mg standard dose (calculated by weight of entecavir) each time.
- the average daily dose of entecavir or a pharmaceutically acceptable salt or solvate thereof of the pharmaceutical combination is 0.005 mg to 10.0 mg. In some embodiments of the present application, the average daily dose of entecavir or a pharmaceutically acceptable salt or solvate thereof of the pharmaceutical combination is 0.05 mg to 5.0 mg. In some embodiments of the present application, the average daily dose of entecavir or a pharmaceutically acceptable salt or solvate thereof of the pharmaceutical combination is 0.10 mg to 2.0 mg. In some embodiments of the present application, the average daily dose of entecavir or a pharmaceutically acceptable salt or solvate thereof of the pharmaceutical combination is 0.25 mg to 2.0 mg. In some embodiments of the present application, the average daily dose of entecavir or a pharmaceutically acceptable salt or solvate thereof of the pharmaceutical combination is 0.5 mg to 1.0 mg.
- the compound of formula I or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 1-1500 mg or 10-1000 mg (calculated by the weight of the compound of formula I) for each administration, and the tenofovir or its The average daily dose of the pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is 0.05 mg to 500 mg (calculated by weight of tenofovir).
- the dose of the compound of formula I or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 1-1500 mg or 10-1000 mg (calculated by the weight of the compound of formula I) each time, and the tenofovir
- the average daily dose of its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is 0.05 mg to 500 mg (calculated by weight of tenofovir).
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt in the pharmaceutical combination is selected from 500:1 to 1:1000.
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is selected from 500:1, 450:1, 400:1, 350:1, 300:1, 250:1, 200:1, 150:1, 100:1, 95: 1, 90:1, 85:1, 80:1, 75:1, 70:1, 65:1, 60:1, 55:1, 50:1, 45:1, 40:1, 39:1, 38:1, 37:1, 36:1, 35:1, 34:1, 33:1, 32:1, 31:1, 30:1, 29:1, 28:1, 27:1, 26: 1, 25:1, 24:1, 23:1, 22:1, 21:1, 20:1, 19:1, 18:1, 17:1, 16:1, 15:1, 10:1, 5:1, 4:1, 3:1, 2:1, 1:1, 1:2, 1:3, 1:4, 1:5, 1:6, 1:7, 1:8, 1: 9, 1:10, 1:11, 1:12, 1:1
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt in the pharmaceutical combination selected from 100:1 to 1:100.
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt selected from: 100:1, 98:1, 96:1, 94:1, 92:1, 90:1, 88:1, 86:1, 84:1, 82:1 , 80:1, 78:1, 76:1, 74:1, 72:1, 70:1, 68:1, 66:1, 64:1, 62:1, 60:1, 58:1, 56 :1, 54:1, 52:1, 50:1, 48:1, 46:1, 44:1, 42:1, 40:1, 38:1, 36:1, 34:1, 32:1 , 30:1, 28:1, 26:1, 25:1, 24:1, 23:1, 22:1, 21:1, 20:1, 19:1, 18:1, 17:1, 16 :1, 15:1, 14:1, 13:1, 12:1, 11:1, 10:1, 9:1,
- the compound of formula I or its pharmaceutically acceptable salt (compound of formula I is calculated as free compound) and tenofovir disoproxil fumarate average daily dose (by weight) in the pharmaceutical combination Unit) The ratio is selected from 1:300 ⁇ 1500:300 or 10:300 ⁇ 1000:300.
- the average daily dose of tenofovir disoproxil fumarate (in weight units) between the compound of formula I or a pharmaceutically acceptable salt thereof (compound of formula I is calculated as a free compound) in the pharmaceutical combination
- the ratio is selected from 10:300, 20:300, 30:300, 40:300, 50:300, 60:300, 70:300, 80:300, 90:300, 100:300, 110:300, 120:300 ,130:300,140:300,150:300,160:300,170:300,180:300,190:300,200:300,210:300,220:300,230:300,240:300,250 :300, 260:300, 270:300, 280:300, 290:300, 300:300, 310:300, 320:300, 330:300, 340:300, 350:300, 360:300, 370:300 ,380:300,390:300,400:300,410:300,420:300,430:300,440:300,450:
- the compound of formula I or its pharmaceutically acceptable salt in the pharmaceutical combination, is calculated as a free compound and the average daily dose of tenofovir alafenamide (in weight units) The ratio is selected from 1:25 to 1500:25 or 10:25 to 1000:25. In some schemes, the ratio of the compound of formula I or its pharmaceutically acceptable salt (compound of formula I is calculated as free compound) to the average daily dose of tenofovir alafenamide (in units of weight) is selected from 10 in the pharmaceutical combination.
- the compound of formula I or its pharmaceutically acceptable salt is calculated as free compound
- the average daily dose of tenofovir alafenamide fumarate by weight) in the pharmaceutical combination Unit
- the ratio is selected from 1:28 ⁇ 1500:28 or 10:28 ⁇ 1000:28.
- the compound of formula I or a pharmaceutically acceptable salt thereof is calculated as a free compound
- the average daily dose of tenofovir alafenamide fumarate (in units of weight) in the drug combination The ratio is selected from 10:28, 20:28, 30:28, 40:28, 50:28, 60:28, 70:28, 80:28, 90:28, 100:28, 110:28, 120:28 , 130:28, 140:28, 150:28, 160:28, 170:28, 180:28, 190:28, 200:28, 210:28, 220:28, 230:28, 240:28, 280 :28, 260:28, 270:28, 280:28, 290:28, 300:28, 310:28, 320:28, 330:28, 340:28, 350:28, 360:28, 370:28 , 380:28, 390:28, 400:28, 410:28, 420:28
- the compound of formula I or its pharmaceutically acceptable salt and tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt in the pharmaceutical combination are administered in single dose or multiple doses respectively medicine.
- the compound of formula I or a pharmaceutically acceptable salt thereof of the pharmaceutical combination is 1-1500 mg, 2-1000 mg, 3-800 mg, 3-600 mg, 4-550 mg, 5-500 mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg, the entecavir or its
- the average daily dose of the pharmaceutically acceptable salt or its solvate is 0.005 mg to 10.0 mg.
- the dosage of the compound of formula I or a pharmaceutically acceptable salt thereof in the pharmaceutical combination is 1-1500 mg, 2-1000 mg, 3-800 mg, 3-600 mg, 4-550 mg, 5- 500mg, 5-450mg, 5-400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg, the entecavir or
- the average daily dose of its pharmaceutically acceptable salt or its solvate is 0.005 mg to 10.0 mg.
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to entecavir or its pharmaceutically acceptable salt or its solvate (in the weight unit of the free compound) in the pharmaceutical combination is selected from From 1000:1 to 1:1000.
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to entecavir or its pharmaceutically acceptable salt or its solvate is selected from From 1000:1, 950:1, 900:1, 850:1, 800:1, 750:1, 700:1, 650:1, 640:1, 630:1, 620:1, 610:1, 600 :1, 550:1, 500:1, 450:1, 400:1, 350:1, 300:1, 250:1, 200:1, 150:1, 100:1, 90:1, 80:1 , 70:1, 60:1, 50:1, 40:1, 30:1, 20:1, 10:1, 1:0.01, 1:0.02, 1:0.03, 1:0.04, 1:0.05, 1 :0.06, 1:0.07, 1:0.08, 1:0.09, 1:0.1, 1:0.5, 1:0.6, 1:0.7, 1:0.8, 1:0.9, 1:1, 1:10, 1:20 , 1:30, 1:40, 1
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to entecavir or its pharmaceutically acceptable salt or its solvate (based on the molar ratio of the free compound) in the pharmaceutical combination is selected from From 300:1 to 1:100.
- the ratio of the average daily dose of the compound of formula I or its pharmaceutically acceptable salt to entecavir or its pharmaceutically acceptable salt or its solvate is selected from From: 300:1, 290:1, 280:1, 270:1, 260:1, 250:1, 240:1, 235:1, 230:1, 225:1, 220:1, 215:1, 210:1, 205:1, 200:1, 190:1, 180:1, 170:1, 160:1, 150:1, 140:1, 130:1, 120:1, 110:1, 100: 1, 98:1, 96:1, 94:1, 92:1, 90:1, 88:1, 86:1, 84:1, 82:1, 80:1, 78:1, 76:1, 74:1, 72:1, 70:1, 68:1, 66:1, 64:1, 62:1, 60:1, 58:1, 56:1, 54:1, 52:1, 50: 1, 48:1, 46:1, 44:1, 42
- the ratio of the compound of formula I or its pharmaceutically acceptable salt (calculated as free compound) to the average daily dose of entecavir monohydrate (in units of weight) in the pharmaceutical combination is selected from 1 :0.5 ⁇ 1500:0.5 or 10:0.5 ⁇ 1000:0.5.
- the ratio of the compound of formula I or its pharmaceutically acceptable salt (the compound of formula I is calculated as free compound) and the average daily dose of entecavir monohydrate (in units of weight) in the pharmaceutical combination is selected from 10:0.5, 20 :0.5, 30:0.5, 40:0.5, 50:0.5, 60:0.5, 70:0.5, 80:0.5, 90:0.5, 100:0.5, 110:0.5, 120:0.5, 130:0.5, 140:0.5 , 150:0.5, 160:0.5, 170:0.5, 180:0.5, 190:0.5, 200:0.5, 210:0.5, 220:0.5, 230:0.5, 240:0.5, 250:0.5, 260:0.5, 270 :0.5, 280:0.5, 290:0.5, 300:0.5, 310:0.5, 320:0.5, 330:0.5, 340:0.5, 350:0.5, 360:0.5, 370:0.5, 380:0.5, 390:0.5 ,400:0.5,410:0.5,420:0.5,430:0.5,440:0.5,450:0.5
- the compound of formula I or its pharmaceutically acceptable salt and entecavir or its pharmaceutically acceptable salt or its solvate in the pharmaceutical combination are administered in a single dose or multiple doses respectively.
- the drug combination is a fixed combination.
- the fixed combination is in the form of a solid pharmaceutical composition.
- the compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof in the fixed combination are present in the same solid pharmaceutical composition.
- the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof in the fixed combination are present in the same solid pharmaceutical composition.
- the drug combination is a non-fixed combination.
- the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or solvate thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition.
- the compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition, and
- the solid pharmaceutical composition of the compound of formula I or its pharmaceutically acceptable salt and the solid pharmaceutical composition of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt exist in the same medicine bag.
- the compound of formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition, and
- the solid pharmaceutical composition of the compound of formula I or its pharmaceutically acceptable salt and the solid pharmaceutical composition of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt do not exist in the same medicine bag.
- the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt thereof or a solvate thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition, and the compound of formula I or a pharmaceutically acceptable salt thereof
- the solid pharmaceutical composition of pharmaceutically acceptable salt and the solid pharmaceutical composition of entecavir or its pharmaceutically acceptable salt or its solvate exist in the same medicine bag.
- the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt thereof or a solvate thereof in the non-fixed combination are each in the form of a solid pharmaceutical composition, and the compound of formula I or a pharmaceutically acceptable salt thereof
- the solid pharmaceutical composition of pharmaceutically acceptable salt and the solid pharmaceutical composition of entecavir or its pharmaceutically acceptable salt or its solvate do not exist in the same medicine bag.
- the solid pharmaceutical composition is selected from tablets or capsules.
- the present application also provides the use of the pharmaceutical combination of the present application in the preparation of medicines for treating hepatitis B virus infection.
- the drug combination is as described above.
- the present application also provides a method for treating hepatitis B virus infection, which comprises administering an effective amount of the pharmaceutical combination of the present application to an individual in need.
- the drug combination is as described above.
- the present application also provides the pharmaceutical combination of the present application for treating hepatitis B virus infection.
- the drug combination is as described above.
- the application also provides the use of the drug combination of the application for treating hepatitis B virus infection.
- the drug combination is as described above.
- the present application also provides a kit for the treatment of hepatitis B virus infection, comprising: (a) the first medicament containing a compound of formula I or a pharmaceutically acceptable salt thereof as an active ingredient composition; and (b) a second pharmaceutical composition comprising a reverse transcriptase inhibitor or a pharmaceutically acceptable prodrug thereof, a pharmaceutically acceptable salt thereof, or a solvate thereof as an active ingredient; and optionally (c) Description of the combined use of a compound of formula I or a pharmaceutically acceptable salt thereof and a reverse transcriptase inhibitor or a pharmaceutically acceptable prodrug thereof, a pharmaceutically acceptable salt or a solvate thereof.
- the reverse transcriptase inhibitor or its pharmaceutically acceptable prodrug, its pharmaceutically acceptable salt or its solvate is as described above.
- the present application provides a compound comprising formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof as active ingredients in the preparation of therapeutic
- a compound comprising formula I or a pharmaceutically acceptable salt thereof and tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof as active ingredients in the preparation of therapeutic
- the application in medicine for hepatitis B virus infection, wherein the compound of formula I or its pharmaceutically acceptable salt and tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt are prepared into pharmaceutical composition respectively.
- the present application also provides a kit for the treatment of hepatitis B virus infection, comprising: (a) the first medicament containing a compound of formula I or a pharmaceutically acceptable salt thereof as an active ingredient composition; and (b) the second pharmaceutical composition containing tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt as an active ingredient; and optionally (c) a compound of formula I or its Instructions for the combined use of pharmaceutically acceptable salts and tenofovir or its pharmaceutically acceptable prodrugs or pharmaceutically acceptable salts thereof.
- the present application provides the use of a compound of formula I or its pharmaceutically acceptable salt and entecavir or its pharmaceutically acceptable salt or its solvate in the preparation of a medicament for treating hepatitis B virus infection, wherein the compound of formula I or its pharmaceutically acceptable salt and entecavir or its pharmaceutically acceptable salt or its solvate are respectively prepared into a pharmaceutical composition.
- the present application also provides a kit for the treatment of hepatitis B virus infection, comprising: (a) the first medicament containing a compound of formula I or a pharmaceutically acceptable salt thereof as an active ingredient composition; and (b) the second pharmaceutical composition containing entecavir or a pharmaceutically acceptable salt thereof or a solvate thereof as an active ingredient; and optionally (c) a compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or Instructions for the combined use of its pharmaceutically acceptable salts or solvates thereof.
- the compound of formula I belongs to the prior art, and its chemical name is (S)-N-(3-cyano-4-fluorophenyl)-1,2,4-trimethyl-5-(2-oxo -2-((1,1,1-trifluoroprop-2-yl)amino)acetyl)-1H-pyrrole-3-carboxamide, which has the following structural formula:
- the pharmaceutical composition of the compound of formula I or a pharmaceutically acceptable salt thereof is selected from solid pharmaceutical compositions, preferably from tablets or capsules.
- the compound of formula I or a pharmaceutically acceptable salt thereof is in the form of a pharmaceutical composition
- the single dose of the pharmaceutical composition is a pharmaceutical composition of 1 mg to 1000 mg, preferably a single dose of a pharmaceutical composition of 1 mg to 400 mg , preferably from a single dose of 1 mg, 2 mg, 3 mg, 4 mg, 5 mg, 6 mg, 7 mg, 8 mg, 9 mg, 10 mg, 11 mg, 12 mg, 13 mg, 14 mg, 15 mg, 16 mg, 17 mg, 18 mg, 19 mg, 20 mg, 21 mg, 22 mg, 23mg, 24mg, 25mg, 26mg, 27mg, 28mg, 29mg, 30mg, 31mg, 32mg, 33mg, 34mg, 35mg, 36mg, 37mg, 38mg, 39mg, 40mg, 41mg, 42mg, 43mg, 44mg, 45mg, 46mg, 47mg, 48mg, 49mg, 50mg, 51mg
- the entecavir chemical name is 2-amino-9-[(1S,3R,4S)-4-hydroxy-3-hydroxymethyl-2-methylenecyclopentyl]-1,9- Dihydro-6H-purin-6-one, which has the following structural formula:
- the entecavir used may be its pharmaceutically acceptable salt, and the pharmaceutically acceptable salt is selected from maleate. In some schemes, the pharmaceutically acceptable salt of Entecavir is selected from monomaleate.
- the entecavir used may be a solvate thereof, and the solvate is selected from entecavir hydrate.
- the Entecavir hydrate is selected from Entecavir 0.5-2 hydrate.
- the entecavir hydrate is selected from entecavir monohydrate.
- the entecavir is selected from entecavir-maleate, entecavir monohydrate, or entecavir-maleate monohydrate.
- entecavir or a pharmaceutically acceptable salt or solvate thereof is in the form of a pharmaceutical composition.
- the pharmaceutical composition is selected from solid pharmaceutical compositions.
- the solid pharmaceutical composition is preferably selected from tablets or capsules.
- the pharmaceutical composition of Entecavir or its pharmaceutically acceptable salt or its solvate is selected from pharmaceutical compositions with a single dose of 0.01 mg to 5 mg, preferably from a single dose of 0.01 mg, 0.02 mg, and 0.05 mg. , 0.08mg, 0.1mg, 0.2mg, 0.3mg, 0.4mg, 0.5mg, 0.6mg, 0.7mg, 0.8mg, 0.9mg, 1.0mg, 1.1mg, 1.2mg, 1.3mg, 1.4mg, 1.5mg, 1.6 mg, 1.7mg, 1.8mg, 1.9mg, 2.0mg, 2.1mg, 2.2mg, 2.3mg, 2.4mg, 2.5mg, 2.6mg, 2.7mg, 2.8mg, 2.9mg, 3.0mg, 3.1mg, 3.2mg, 3.3mg, 3.4mg, 3.5mg, 3.6mg, 3.7mg, 3.8mg,
- the entecavir or its pharmaceutically acceptable salt or its solvate, or its pharmaceutical composition can be selected from commercially available products (such as entecavir dispersible tablets: ).
- Tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt described in this application or its pharmaceutical composition comprises tenofovir free compound, or its prodrug, or pharmaceutically acceptable salt, or its pharmaceutical composition.
- the tenofovir chemical name is R-9-(2-methoxypropyl phosphate) adenine, which has the following structural formula:
- the tenofovir used may be its prodrug.
- the pharmaceutically acceptable prodrug of tenofovir is selected from tenofovir alafenamide, tenofovir disoproxil or amitenofovir.
- the tenofovir used may be its free compound or a pharmaceutically acceptable salt of a prodrug.
- the pharmaceutically acceptable salt of the tenofovir free compound or prodrug comprises fumarate, orotate, disulfonate, phosphate, succinate or aspartate.
- the tenofovir used may be a pharmaceutically acceptable salt of its prodrug.
- the pharmaceutically acceptable salt of tenofovir prodrug is selected from tenofovir disoproxil fumarate, tenofovir alafenamide fumarate or amitenofovir Wei fumarate.
- the pharmaceutically acceptable salt of the tenofovir prodrug is selected from tenofovir alafenamide fumarate.
- the number ratio of tenofovir alafenamide to fumaric acid molecules in the pharmaceutically acceptable salt of the tenofovir prodrug is 2:1.
- the tenofovir alafenamide fumarate is selected from the following structures
- the pharmaceutically acceptable salt of the tenofovir prodrug is selected from tenofovir disoproxil fumarate.
- the number ratio of tenofovir disoproxil to fumaric acid molecules in the pharmaceutically acceptable salt of the tenofovir prodrug is 1:1.
- the tenofovir disoproxil fumarate is selected from the following structures
- the pharmaceutically acceptable salt of the prodrug of tenofovir is selected from ami tenofovir fumarate.
- the number ratio of tenofovir to fumaric acid molecules in the pharmaceutically acceptable salt of the tenofovir prodrug is 1:1.
- the ami tenofovir fumarate is selected from the following structures
- the pharmaceutically acceptable salt of the tenofovir prodrug is selected from tenofovir disoproxil orotate.
- the number ratio of tenofovir disoproxil to orotic acid molecules in the pharmaceutically acceptable salt of the tenofovir prodrug is 1:1.
- the tenofovir disoproxil orotate is selected from the following structures
- the pharmaceutically acceptable salt of the tenofovir prodrug is selected from tenofovir disoproxil succinate.
- the number ratio of tenofovir disoproxil to succinic acid molecules in the pharmaceutically acceptable salt of the tenofovir prodrug is 1:1.
- the tenofovir disoproxil succinate is selected from the following structures
- tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof is in the form of a pharmaceutical composition.
- the pharmaceutical composition is selected from solid pharmaceutical compositions.
- the solid pharmaceutical composition is preferably selected from tablets or capsules.
- the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is selected from the pharmaceutical composition with a single dose of 0.05 mg to 500 mg (calculated as tenofovir free compound), preferably From a single dose of 0.1mg, 0.5mg, 1mg, 2mg, 3mg, 4mg, 5mg, 6mg, 7mg, 8mg, 9mg, 10mg, 11mg, 12mg, 13mg, 14mg, 15mg, 16mg, 17mg, 18mg, 19mg, 20mg, 21mg, 22mg, 23mg, 24mg, 25mg, 26mg, 27mg, 28mg, 29mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 60mg, 65mg, 70mg, 75mg, 80mg, 85mg, 90mg, 95mg, 100mg, 105mg, 110
- the pharmaceutical composition of tenofovir disoproxil fumarate is selected from pharmaceutical compositions with a single dose of 300 mg.
- the pharmaceutical composition of tenofovir alafenamide is selected from pharmaceutical compositions with a single dose of 25 mg.
- the pharmaceutical composition of tenofovir alafenamide fumarate is selected from pharmaceutical compositions with a single dose of 28 mg.
- the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt can be selected from commercially available products (such as tenofovir disoproxil fumarate tablets: Tenofovir alafenamide fumarate: ).
- the individual is selected from a previously treated individual or a previously untreated individual.
- the subject is selected from subjects previously treated with entecavir or a pharmaceutically acceptable salt or solvate thereof, or tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof.
- the individual is selected from previously treatment-na ⁇ ve individuals. In some embodiments, the individual is selected from previously treated individuals.
- the individual is selected from serum virology criteria: serum HBsAg positive for more than 6 months or evidence of chronic hepatitis B for 6 months, 1000IU/ml ⁇ HbsAg quantitative ⁇ 40000IU/ml.
- the individual is selected from individuals who have received treatment before, and the following conditions need to be met:
- HBV DNA suppression in medical history records 6 months before enrollment ⁇ the lower limit of normal detection, and HBV DNA suppression during the screening period was defined as ⁇ LLOQ;
- the individual is selected from a previously untreated individual subject to the following conditions:
- HBeAg-positive chronic hepatitis B patients HBV DNA>10 5 copies/mL (or>20,000IU/mL); or HBeAg-negative patients, HBV DNA>10 4 copies/mL (or>2,000IU/mL);
- the compound of formula I includes its non-salt form (for example, free acid or free base), and also includes its pharmaceutically acceptable salt, and the non-salt or salt are all included in the protection scope of this application.
- the entecavir includes its non-solvate form and its solvate form, and the non-solvate or solvate are all included in the protection scope of the present application.
- the ratio of the amount of the compound to the solvent can be selected from 1:0.5, 1:1, 1:1.5, 1:2 or the range formed by any endpoint, such as 1:0.5 ⁇ 1:2 , 1:0.5 ⁇ 1:1.5, or 1:1 ⁇ 1:1.5.
- the entecavir is in unsolvated form.
- the entecavir is in the form of a hydrate.
- the entecavir is in the form of a monohydrate.
- the tenofovir includes its prodrug form, and also includes its prodrug salt form, and the tenofovir, its prodrug or its salt are all included in the protection scope of this application.
- by weight refers to the weight of the free form of the compound of formula I, entecavir or tenofovir.
- administering means physically introducing a composition comprising a therapeutic agent into a subject using any of a variety of methods and delivery systems known to those skilled in the art.
- treatment generally refers to obtaining a desired pharmacological and/or physiological effect.
- the effect may be therapeutic in terms of partial or complete stabilization or cure of the disease and/or side effects due to the disease.
- treatment encompasses any treatment of a disease in a patient, including: (a) inhibiting the symptoms of the disease, ie arresting its development; or (b) relieving the symptoms of the disease, ie causing regression of the disease or symptoms.
- the term "effective amount” means (i) treating or preventing a particular disease, condition or disorder, (ii) alleviating, ameliorating or eliminating one or more symptoms of a particular disease, condition or disorder, or (iii) preventing or delaying the The amount of a compound of the application for the onset of one or more symptoms of a particular disease, condition or disorder described in .
- the amount of a compound of the present application that constitutes a “therapeutically effective amount” will vary depending on the compound, the disease state and its severity, the mode of administration, and the age of the mammal to be treated, but can be routinely determined by a person skilled in the art according to its own knowledge and this disclosure.
- the term "individual” or “subject” includes mammals. In some embodiments, the “individual” or subject is a mouse. In some embodiments, the “individual” or subject is a human.
- the compound of formula I or a pharmaceutically acceptable salt thereof may be administered by any suitable route and method, such as orally or parenterally (eg, intravenously).
- a therapeutically effective amount of a compound of formula I or a pharmaceutically acceptable salt thereof includes, but is not limited to, from about 0.0001 to 20 mg/kg weight/day, such as from 0.001 to 10 mg/kg weight/day.
- the dosage frequency of the compound of formula I or a pharmaceutically acceptable salt thereof is determined by the needs of the individual patient, including severity, response of the disease, any treatment-related toxicity, age and health status of the patient, for example once or twice a day, or once a day more times.
- Dosing may be intermittent, for example, wherein the subject receives a daily dose of a compound of formula I, or a pharmaceutically acceptable salt thereof, over a period of several days, followed by a period of several or more days in which the patient does not receive the compound of formula I Daily dosage of Compound I or a pharmaceutically acceptable salt thereof.
- Entecavir or its pharmaceutically acceptable salts or solvates thereof can be administered by various routes including but not limited to oral, parenteral, intraperitoneal, intravenous, intraarterial, transdermal, sublingual, intramuscular, rectal , buccal, intranasal, by inhalation, vaginal, intraocular, topical, subcutaneous, intrafat, intra-articular, intraperitoneal and intrathecal.
- the administration is orally.
- the amount of entecavir administered can be determined according to the severity of the disease, the response of the disease, any toxicity associated with the treatment, the age and state of health of the patient. For example, entecavir may be administered at a daily dose of 0.005 mg to 10.0 mg.
- Entecavir can be administered one or more times daily. In some embodiments, entecavir is administered once daily as an oral solid formulation.
- Tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof can be administered by a variety of routes including, but not limited to, oral, parenteral, intraperitoneal, intravenous, intraarterial, transdermal, lingual Subcutaneously, intramuscularly, rectally, transbuccally, intranasally, by inhalation, vaginally, intraocularly, topically, subcutaneously, intrafatally, intraarticularly, intraperitoneally, and intrathecally. In some specific embodiments, the administration is orally.
- the amount of tenofovir or a pharmaceutically acceptable prodrug or pharmaceutically acceptable salt thereof to be administered can be determined according to the severity of the disease, the response of the disease, any treatment-related toxicity, the age and state of health of the patient.
- the daily dosage of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt can be administered from 0.05 mg to 500 mg.
- Tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof may be administered one or more times daily.
- tenofovir or a pharmaceutically acceptable prodrug thereof or a pharmaceutically acceptable salt thereof is administered once daily in an oral solid formulation.
- pharmaceutical combination refers to the simultaneous, parallel or sequential use of two or more active ingredients.
- fixed combination means that the active ingredients (such as a compound of formula I or entecavir or tenofovir) are administered to a subject simultaneously in a fixed total dose or dose ratio, or in the form of a single entity, pharmaceutical composition or formulation. In some embodiments, for example, in the same tablet or the same capsule or the same sachet.
- non-fixed combination refers to the simultaneous, concurrent or sequential administration of two or more active ingredients to an individual as separate entities (e.g. pharmaceutical composition, pharmaceutical preparation) without specific time limitation, wherein the active ingredients administered to the individual achieve therapeutically effective level.
- examples that may be cited of non-fixed combinations are cocktail therapy, eg administration of 2, 3 or more active ingredients.
- the individual active ingredients may be packaged, sold or administered as entirely separate pharmaceutical compositions.
- the "non-fixed combination” also includes the combined use of "fixed combinations” or "fixed combinations” with any one or more independent entities of active components.
- pharmaceutical composition refers to a mixture of one or more compounds of the present application or a pharmaceutical combination or salt thereof and pharmaceutically acceptable auxiliary materials.
- the purpose of the pharmaceutical composition is to facilitate administration of a compound of the present application, or a pharmaceutical combination thereof, to a subject.
- pharmaceutically acceptable excipients refers to those excipients that have no obvious stimulating effect on the organism and will not impair the biological activity and performance of the active compound. Suitable excipients are well known to those skilled in the art, such as carbohydrates, waxes, water-soluble and/or water-swellable polymers, hydrophilic or hydrophobic materials, gelatin, oils, solvents, water and the like.
- the pharmaceutical composition of the present application can be prepared by combining the compound of the present application with suitable pharmaceutically acceptable excipients, for example, it can be formulated into solid preparations such as tablets, pills, capsules and the like.
- the pharmaceutical composition of the present application can be produced by methods well known in the art, such as conventional mixing methods, dissolving methods, granulating methods, dragee-making methods, pulverizing methods, emulsifying methods, freeze-drying methods and the like.
- pharmaceutically acceptable refers to those compounds, materials, compositions and/or dosage forms which, within the scope of sound medical judgment, are suitable for use in contact with human and animal tissues without excessive Toxicity, irritation, allergic reaction or other problems or complications, commensurate with a reasonable benefit/risk ratio.
- Solid oral compositions can be prepared by conventional methods of mixing, filling or tabletting. It can be obtained, for example, by mixing the active compound with solid excipients, optionally milling the resulting mixture, adding other suitable excipients if desired, and processing the mixture into granules to obtain tablets Or the core of the sugar coating.
- Suitable auxiliary materials include but are not limited to: binders, diluents, disintegrants, lubricants, glidants, sweeteners or flavoring agents, etc.
- pharmaceutically acceptable salt or “pharmaceutically acceptable salt” refers to a salt of a compound of the present application that falls within the definition of "pharmaceutically acceptable”.
- single dose refers to the smallest packaging unit containing a certain amount of medicine.
- a box of medicine has seven capsules, and each capsule is a single dose; or each bottle of injection is a single dose.
- multiple dose consists of a number of single doses.
- free compound means that the compound of the present application exists in a free state, specifically means and
- solvate refers to a substance formed by combining a compound of the present application with a pharmaceutically acceptable solvent.
- Pharmaceutically acceptable solvents include water, alcohols and the like. Solvates include stoichiometric solvates and non-stoichiometric solvates.
- prodrug is intended to include any covalently bound carrier which, when administered to a mammalian subject, releases the active parent drug of the invention in vivo.
- the prodrugs of the present invention are prepared by modifying functional groups present on the compounds in such a way that the modifications are cleaved to the parent compound during routine manipulation or in vivo.
- nucleoside (acid) analogue or “nucleoside (acid) drug” (nucleos(t)ide analogue, NA) can be used to treat hepatitis B.
- NA includes, but is not limited to, entecavir, tenofovir, lamivudine, adefovir, telbivudine, and the like.
- the active components in the pharmaceutical combination of the present application can be formulated separately, or part or all of them can be formulated together.
- the pharmaceutical combination of the present application can be formulated as a pharmaceutical composition suitable for single or multiple administrations.
- the active components in the pharmaceutical combination of the present application can be administered alone, or part or all of them can be administered together.
- the components in the pharmaceutical combination of the present application may not be administered substantially at the same time, or some or all of them may be administered substantially at the same time.
- the active ingredients in the pharmaceutical combination of the present application can be administered independently, or some or all of them can be administered together by suitable various routes, including but not limited to oral or parenteral (by intravenous, intramuscular, topical or subcutaneous routes) ).
- the active components of the pharmaceutical combination of the present application can be administered independently, or some or all of them can be administered orally or by injection, such as intravenous injection or intraperitoneal injection.
- the active components in the pharmaceutical combination of the present application can be each independently, or some or all of them can be suitable dosage forms together, including but not limited to: tablets, buccal tablets, pills, capsules (such as hard capsules, soft capsules, Enteric-coated capsules, microcapsules), elixirs, granules, syrups, injections (intramuscular, intravenous, intraperitoneal), powders, emulsions, suspensions, solutions, dispersions and for oral or parenteral administration The dosage form of sustained-release preparations.
- the active components in the pharmaceutical combination of the present application may each independently, or part or all of them jointly contain pharmaceutically acceptable carriers and/or excipients.
- the pharmaceutical combinations of the present application may also contain additional therapeutic agents.
- the additional therapeutic agent may be a therapeutic agent known in the art to treat hepatitis B virus infection.
- effective doses of the compound of formula I of the present application or its pharmaceutically acceptable salt and entecavir or its pharmaceutically acceptable salt or its solvate can be administered to individuals in need simultaneously, sequentially or at intervals.
- an effective amount of the compound of formula I or a pharmaceutically acceptable salt thereof and entecavir or a pharmaceutically acceptable salt or a solvate thereof may be administered to an individual in need in the same or different dosage regimens.
- the compound of formula I or a pharmaceutically acceptable salt thereof is administered three times a day, twice a day, once a day, once every two days, once every three days, once every four days, Administration is once every five days, every six days, every week, every two weeks, or every three weeks.
- the compound of formula I or its pharmaceutically acceptable salt is administered 1-1500mg, 2-1000mg, 3-800mg, 3-600mg, 4-550mg, 5-500mg, 5-450mg, 5-400mg each time , 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg dosage, preferably 1mg, 2mg, 3mg, 4mg, 5mg, 6mg, 7mg, 8mg, 9mg, 10mg, 11mg, 12mg, 13mg, 14mg, 15mg, 16mg, 17mg, 18mg, 19mg, 20mg, 21mg, 22mg, 23mg, 24mg, 25mg, 26mg, 27mg, 28mg, 29mg, 30mg, 31mg, 32mg, 33mg, 34mg, 35mg, 36mg, 30m
- the dosage of the compound of formula I or its pharmaceutically acceptable salt is 1-1500mg, 2-1000mg, 3-800mg, 3-600mg, 4-550mg, 5-500mg, 5-450mg, 5 - a dose of 400mg, 5-480mg, 5-460mg, 5-450mg, 5-430mg, 6-400mg, 7-380mg, 8-360mg, 9-340mg or 10-320mg, preferably 1mg, 2mg, 3mg, 4mg, 5mg, 6mg, 7mg, 8mg, 9mg, 10mg, 11mg, 12mg, 13mg, 14mg, 15mg, 16mg, 17mg, 18mg, 19mg, 20mg, 21mg, 22mg, 23mg, 24mg, 25mg, 26mg, 27mg, 28mg, 29mg, 30mg, 31mg, 32mg, 33mg, 34mg, 35mg, 30m
- the compound of formula I or a pharmaceutically acceptable salt thereof is administered once a day, and each administration is 1 to 320 mg.
- the entecavir or its pharmaceutically acceptable salt or its solvate is administered three times a day, twice a day, once a day, once every two days, once every three days, once every four days Administration is once, every five days, every six days, every week, every two weeks, or every three weeks.
- the entecavir or its pharmaceutically acceptable salt or its solvate is administered at a dose of 0.005 mg to 5.0 mg each time, preferably 0.01 mg, 0.05 mg, 0.1 mg, 0.2 mg, 0.3 mg, 0.4 mg, 0.5 mg, 0.6mg, 0.7mg, 0.8mg, 0.9mg, 1.0mg, 1.1mg, 1.2mg, 1.3mg, 1.4mg, 1.5mg, 1.6mg, 1.7mg, 1.8mg, 1.9mg, 2.0mg, 2.1mg, 2.2mg, 2.3mg, 2.4mg, 2.5mg, 2.6mg, 2.7mg, 2.8mg, 2.9mg, 3.0mg, 3.1mg, 3.2mg, 3.3mg, 3.4mg, 3.5mg, 3.6mg, 3.7mg, 3.8mg , 3.9mg, 4.0mg, 4.1mg, 4.2mg, 4.3mg
- the dose of Entecavir or its pharmaceutically acceptable salt or its solvate is 0.005 mg to 5.0 mg per dose, preferably 0.01 mg, 0.05 mg, 0.1 mg, 0.2 mg, 0.3 mg, 0.4 mg , 0.5mg, 0.6mg, 0.7mg, 0.8mg, 0.9mg, 1.0mg, 1.1mg, 1.2mg, 1.3mg, 1.4mg, 1.5mg, 1.6mg, 1.7mg, 1.8mg, 1.9mg, 2.0mg, 2.1 mg, 2.2mg, 2.3mg, 2.4mg, 2.5mg, 2.6mg, 2.7mg, 2.8mg, 2.9mg, 3.0mg, 3.1mg, 3.2mg, 3.3mg, 3.4mg, 3.5mg, 3.6mg, 3.7mg, 3.8mg, 3.9mg, 4.0mg, 4.1mg, 4.2mg, 4.3mg, 4.4m
- the entecavir or its pharmaceutically acceptable salt or its solvate is administered once a day, with a dose of 0.10 mg to 2.0 mg per administration.
- the entecavir or its pharmaceutically acceptable salt or its solvate can be administered once a day, with a dose of 0.5 mg each time.
- the compound of formula I is administered once a day, with a dose of 1 mg to 100 mg each time; the entecavir or its pharmaceutically acceptable salt or its solvate is administered once a day, with 0.10 mg to 2.0 mg each time. mg dose.
- the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is administered once a day, twice a day, or once every two days, or once every three days, or once every three days. It is administered once every four days, or once every five days, or once every six days, or once every seven days. In some embodiments of the present application, tenofovir or a pharmaceutically acceptable prodrug or a pharmaceutically acceptable salt thereof of the pharmaceutical combination may be administered once a day.
- the dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is administered every time from 0.05mg to 500mg, preferably 0.1mg, 0.5mg, 1mg, 2mg, 3mg, 4mg, 5mg, 6mg, 7mg, 8mg, 9mg, 10mg, 11mg, 12mg, 13mg, 14mg, 15mg, 16mg, 17mg, 18mg, 19mg, 20mg, 21mg, 22mg, 23mg, 24mg, 25mg, 26mg, 27mg, 28mg, 29mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 56mg, 57mg, 58mg, 59mg, 60mg, 65mg, 66mg, 67mg, 68mg, 70mg, 71mg, 72mg, 73mg, 74m
- the dose of tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is 0.05 mg to 500 mg per administration, preferably 0.1 mg, 0.5 mg, 1 mg, 2 mg, 3 mg . , 29mg, 30mg, 35mg, 40mg, 45mg, 50mg, 55mg, 56mg, 57mg, 58mg, 59mg, 60mg, 65mg, 66mg, 67mg, 68mg, 70mg, 71mg, 72mg, 73mg, 74mg, 75mg, 80mg, 85mg, 90mg , 91mg, 92mg, 93mg, 94mg, 95mg, 100mg, 101mg, 102mg, 103mg, 104mg, 105mg, 110mg, 111mg, 112mg, 113mg, 114mg, 115mg, 120mg, 125
- the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is administered once a day, with a dose of 10 mg to 150 mg per administration. In some regimens, the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt can be administered once a day, with a dose of 15 mg or 135.5 mg per administration.
- tenofovir disoproxil fumarate was administered once a day, 300 mg per administration.
- tenofovir alafenamide is administered once daily, 25 mg per administration.
- tenofovir alafenamide fumarate is administered once daily, 28 mg per administration.
- the compound of formula I is administered once a day, with a dose of 1 mg to 320 mg each time; the tenofovir or its pharmaceutically acceptable prodrug or its pharmaceutically acceptable salt is administered once a day, each time Doses of 10 mg to 150 mg are administered at a time.
- the drug combination of the present application can significantly reduce the level of HBV DNA or relieve other HBV indicators; and compared with the single drug, the drug combination of the present application shows a strengthening effect and is well tolerated. It shows that the drug combination of the present application has good medicinal value.
- Single-drug administration process dilute the compound with DMSO to 100 times of the highest detection concentration, then dilute 8 points in a 3-fold gradient with DMSO, add 2 ⁇ L of the compound to each well, mix well, discard the old medium and add mix well 100 ⁇ L of complete medium containing compounds.
- a1b1 represents the administration concentration of the compound of formula I (a) in group 1 and the administration concentration of entecavir (b) in group 1 in the compound of formula I combined with entecavir group. Others and so on.
- nucleic acid release agent 5 ⁇ L of nucleic acid release agent to each well of the 8-tube tube, and then add 5 ⁇ L of quality control standard, quantitative standard and drug-treated cell culture supernatant sample for 6 days to each well, pipette and mix 5 times after adding, and store at room temperature Place for 10min;
- PCR mixture 38 ⁇ L PCR reaction solution + 2 ⁇ L enzyme mixture + 0.2 ⁇ L internal standard
- Detection channel FAM channel (sample detection channel, Reportere:: FAM, Quencher:: None), VIC channel (internal standard detection channel, Reportere:: VIC, Quencher:: None), ROX channel (reference detection channel: Passive Reference ::ROX).
- DAS software was used to analyze the experimental data and calculate the joint index. Combination indices for 50%, 75%, 90% and 95% inhibition were calculated, respectively, and the mean combination index (CIwt) was calculated.
- An average combination index of 0.9-1.1 indicates additivity; a combination index of ⁇ 0.9 indicates synergy; a combination index of >1.1 indicates antagonism.
- the average anti-HBV combination index of the compound of formula I combined with entecavir is 0.695, showing a synergistic effect.
- Embodiment 2 AAV/HBV mouse model experiment
- rAAV8-1.3HBV source: Beijing Wujiahe Institute of Molecular Medicine, titer: 1 ⁇ 1012 v.g/ml
- AAV/HBV mouse model serum: male, C57BL/6
- Dissolve the compound of formula I in DMSO add PEG-400 to make a 1 mg/ml clear solution, then gradually dilute to 0.3, 0.1, 0.03 mg/ml with solvent, and store at room temperature after preparation.
- Dissolve entecavir in DMSO to make 1mg/ml then gradually dilute 1000 times to 0.001mg/ml with normal saline (NS), divide into 1ml/tube as stock solution and store in -20°C refrigerator, take 1 tube every day Then it was diluted 10 times with NS to obtain the required concentration of 0.0001 mg/ml for daily administration.
- NS normal saline
- rAAV8-1.3HBV (Type D, ayw) was purchased from Beijing Wujiahe Gene Technology Co., Ltd., with a titer of 1 ⁇ 10 12 vg/mL.
- Hepatitis B virus nucleic acid assay kit (Sunshine Biotechnology), high-speed refrigerated centrifuge (Sorvall Legend), real-time fluorescent quantitative PCR instrument (TL988).
- AAV-HBV mouse model rAAV8-1.3HBV was pre-prepared into a solution with a concentration of 5 ⁇ 10 11 vg/ml in sterile PBS before injection. Each mouse was injected with 200 ⁇ L through the tail vein, that is, each mouse was injected with 1 ⁇ 10 11 vg.
- Blood collection before grouping On the 14th day after virus injection, ⁇ 100 ⁇ L blood was collected from all infected mice through the orbital vein for serum collection. After the whole blood was allowed to stand at room temperature for 30 minutes, it was centrifuged at 3000 rpm at 4°C for 10 minutes to collect serum. Serum was stored at -80°C for detection of HBV DNA, HBeAg and HBsAg.
- mice All mice were intragastrically administered with vehicle or compound.
- the day of the first administration was set as the 0th day of the experiment, and the duration of the administration was from the 0th to the 27th day.
- Entecavir is administered once a day (QD)
- the compound of formula I is administered once a day (QD, and the administration interval is 8hr-16hr).
- the dosing volume was 10 mL/kg.
- Non-endpoint blood collection On days 7, 14, 21, 28, and 35, ⁇ 100 ⁇ l of serum was collected through orbital vein blood collection for HBV DNA detection.
- mice i-iii, v were euthanized on day 28.
- the experimental endpoint for groups iv and vi was at day 42.
- Serum was collected from the mice through cardiac blood collection for HBV DNA detection.
- hepatitis B virus nucleic acid assay kit For the experimental method, refer to the instructions of the hepatitis B virus nucleic acid assay kit. Add 5 ⁇ L of nucleic acid release agent to each PCR reaction tube, then add 5 ⁇ L of serum to be tested, negative control, positive control and quantitative reference, and lyse for 10 minutes; then add 40 ⁇ l of PCR- mix, a total of 50 ⁇ l system. Reaction conditions: 50°C ⁇ 2min, 1 cycle; 94°C ⁇ 5min, 1 cycle; 94°C ⁇ 15s, 57°C ⁇ 30s, 45 cycles; 25°C ⁇ 10s, 1 cycle.
- Compound of formula I prepared as 10 mg and 50 mg capsules.
- Entecavir Entecavir tablet, specification 0.5mg/tablet (such as Chia Tai Tianqing Pharmaceutical Group Co., Ltd. ).
- Placebo A placebo of a compound of formula I.
- Tenofovir tenofovir disoproxil fumarate, specification 300mg/tablet; tenofovir alafenamide fumarate, specification 25mg/tablet.
- Serum virology criteria Serum HBsAg positive for more than 6 months or evidence of chronic hepatitis B for 6 months. 1000IU/ml ⁇ HBsAg quantitative ⁇ 40000IU/ml;
- Subjects must receive the same dose of the same NA treatment (ETV/TAF) for ⁇ 12 months before screening;
- ⁇ Received HBV antiviral drugs (NA) or IFN drugs (not used regularly) within 3 months from the first use of the study drug, or
- NA No HBV antiviral drug
- HBeAg-positive chronic hepatitis B patients HBV DNA>10 5 copies/mL (or>20,000IU/mL); or HBeAg-negative patients, HBV DNA>10 4 copies/mL (or>2,000IU/mL);
- the formula I compound capsule/placebo is administered once a day, administered on an empty stomach (at least 2 hours before or after meals), and the time of each administration should be roughly similar.
- Entecavir administered once a day, Entecavir is administered on an empty stomach (at least 2 hours before or after meals), and the time of each dose should be roughly similar.
- Tenofovir is administered once a day, and tenofovir is administered after a meal (within 1 hour after a meal), and the time of each dose should be roughly similar.
- Indicators include HBV markers (HBsAg, HBsAb, HBeAg, HBeAb, anti-HBc, HBV DNA quantification, HBV RNA and HBcrAg).
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Abstract
Description
Claims (21)
- 药物组合,其包括衣壳蛋白抑制剂或其可药用盐和逆转录酶抑制剂或其可药用的前药、或其可药用盐或其溶剂合物。
- 如权利要求2所述的药物组合,所述逆转录酶抑制剂或其可药用的前药、或其可药用盐或其溶剂合物选自恩替卡韦或其可药用盐或其溶剂合物、或替诺福韦或其可药用的前药或可药用的盐。
- 如权利要求3所述的药物组合,其特征在于,所述恩替卡韦或其可药用盐或其溶剂合物选自恩替卡韦马来酸盐、恩替卡韦一马来酸盐、恩替卡韦水合物、恩替卡韦0.5~2水合物、或恩替卡韦一水合物;任选地,所述恩替卡韦或其可药用盐或其溶剂合物选自恩替卡韦一马来酸盐一水合物。
- 如权利要求3或4所述的药物组合,其特征在于,所述式I化合物或其可药用盐与恩替卡韦或其可药用盐或其溶剂合物的平均日剂量之比以游离化合物的重量计选自1000:1~1:1000;任选地,所述式I化合物或其可药用盐与恩替卡韦或其可药用盐或其溶剂合物的平均日剂量之比以游离化合物的重量计选自1000:1、950:1、900:1、850:1、800:1、750:1、700:1、650:1、640:1、630:1、620:1、610:1、600:1、550:1、500:1、450:1、400:1、350:1、300:1、250:1、200:1、150:1、100:1、90:1、80:1、70:1、60:1、50:1、40:1、30:1、20:1、10:1、1:0.01、1:0.02、1:0.03、1:0.04、1:0.05、1:0.06、1:0.07、1:0.08、1:0.09、1:0.1、1:0.5、1:0.6、1:0.7、1:0.8、1:0.9、1:1、1:10、1:20、1:30、1:40、1:50、1:60、1:70、1:80、1:90、1:100、1:150、1:200、1:250、1:300、1:350、1:400、1:450、1:500、1:550、1:600、1:650、1:700、1:750、1:800、1:850、1:900、1:950、1:1000或任选上述比例形成的范围。
- 如权利要求3-5任一项所述的药物组合,其特征在于,所述恩替卡韦或其可药用盐或其溶剂合物可以每一天施用三次、每一天施用两次、每一天施用一次、每两天施用一次、每三天施用一次、每四天施用一次、每五天施用一次、每六天施用一次、每一周施用一次、每两周施用一次、或每三周施用一次。
- 如权利要求3-6任一项所述的药物组合,其特征在于,所述恩替卡韦或其可药用盐或其溶剂合物每一次施用0.005mg至5.0mg的剂量;任选地,所述恩替卡韦或其可药用盐或其溶剂合物每一次施用0.01mg、0.05mg、0.1mg、0.2mg、0.3mg、0.4mg、0.5mg、0.6mg、0.7mg、0.8mg、0.9mg、1.0mg、1.1mg、1.2mg、1.3mg、1.4mg、1.5mg、1.6mg、1.7mg、1.8mg、1.9mg、2.0mg、2.1mg、2.2mg、2.3mg、2.4mg、2.5mg、2.6mg、2.7mg、2.8mg、2.9mg、3.0mg、3.1mg、3.2mg、3.3mg、3.4mg、3.5mg、3.6mg、3.7mg、3.8mg、3.9mg、4.0mg、4.1mg、4.2mg、4.3mg、4.4mg、4.5mg、4.6mg、4.7mg、4.8mg、4.9mg、5.0mg或上述任意值形成的范围的剂量。
- 如权利要求3所述的药物组合,所述替诺福韦可药用的前药包括替诺福韦二吡呋酯、替诺福韦艾拉酚胺或艾米替诺福韦;任选地,所述替诺福韦或其可药用前药的可药用盐选自富马酸盐、乳清酸盐、二磺酸盐、磷酸盐、琥珀酸或天冬氨酸盐;任选地,所述替诺福韦或其可药用前药或其可药用的盐选自替诺福韦、替诺福韦艾拉酚胺富马酸盐、替诺福韦二吡呋酯富马酸盐、替诺福韦二吡呋酯乳清酸盐、替诺福韦二吡呋酯半二磺酸盐、替诺福韦二吡呋酯磷酸盐、替诺福韦二吡呋酯琥珀酸盐、替诺福韦二吡呋酯天冬氨酸盐或艾米替诺福韦富马酸盐。
- 如权利要求3或8所述的药物组合,所述式I化合物或其可药用盐与替诺福韦或其可药用前药或其可药用的盐平均日剂量之比以对应的游离化合物的重量单位计选自500:1~1:1000;任选地,所述式I化合物或其可药用盐与替诺福韦或其可药用前药或其可药用的盐平均日剂量之比以对应的游离化合物的重量单位计选自500:1、450:1、400:1、350:1、300:1、250:1、200:1、150:1、100:1、95:1、90:1、85:1、80:1、75:1、70:1、65:1、60:1、55:1、50:1、45:1、40:1、39:1、38:1、37:1、36:1、35:1、34:1、33:1、32:1、31:1、30:1、29:1、28:1、27:1、26:1、25:1、24:1、23:1、22:1、21:1、20:1、19:1、18:1、17:1、16:1、15:1、10:1、5:1、4:1、3:1、2:1、1:1、1:2、1:3、1:4、1:5、1:6、1:7、1:8、1:9、1:10、1:11、1:12、1:13、1:14、1:15、1:16、1:17、1:18、1:19、1:20、1:30、1:40、1:50、1:60、1:70、1:80、1:90、1:100、1:150、1:200、1:250、1:300、1:350、1:400、1:450、1:500、1:550、1:600、1:650、1:700、1:750、1:800、1:850、1:900、1:950、1:1000或任选上述比例形成的范围。
- 如权利要求3、8或9任一项所述的药物组合,所述替诺福韦或其可药用前药或其可药用的盐可以每天施用一次、每天施用两次、或每两天施用一次、或每三天施用一次、或每四天施用一次、或每五天施用一次、或每六天施用一次、或每七天施用一次。
- 如权利要求3、8-10任一项所述的药物组合,所述替诺福韦或其可药用前药或其可药用的盐平均日剂量是0.05mg至500mg;或者,所述平均日剂量是0.1mg至400mg;或者,所述平均日剂量是1mg至300mg;或者,所述平均日剂量是5mg至200mg;或者,所述平均日剂量是8mg至190mg;或者,所述平均日剂量是10mg至185mg;或者,所述平均日剂量是14mg至140mg;任选地,每次施用替诺福韦二吡呋酯富马酸盐300mg;或者,每次施用替诺福韦艾拉酚胺25mg;或者,替诺福韦艾拉酚胺富马酸盐28mg。
- 如权利要求1-11任一项所述的药物组合,其特征在于,所述式I化合物或其可药用盐可以每一天施用一次、每一天施用两次、每两天施用一次、每三天施用一次、每四天施用一次、每五天施用一次、每六天施用一次、每一周施用一次、每两周施用一次、或每三周施用一次。
- 如权利要求1-12任一项所述的药物组合,其特征在于,所述式I化合物或其可药用盐每一次施用1-1500mg、2-1000mg、3-800mg、3-600mg、4-550mg、5-500mg、5-450mg、5-400mg、5-480mg、5-460mg、5-450mg、5-430mg、6-400mg、7-380mg、8-360mg、9-340mg或10-320mg的剂量。
- 如权利要求1-13任一项所述的药物组合,其特征在于,所述药物组合是固定组合;任选地所述固定组合呈固体药物组合物形式;任选地,所述固定组合中的式I化合物或其可药用盐和恩替卡韦或其可药用盐或其溶剂合物、或和替诺福韦或其可药用前药或其可药用的盐存在于同一固体药物组合物。
- 如权利要求1-14任一项所述的药物组合,其特征在于,所述药物组合是非固定组合;任选地,所述非固定组合中的式I化合物或其可药用盐和恩替卡韦或其可药用盐或其溶剂合物、或和替诺福韦或其可药用前药或其可药用的盐各自呈固体药物组合物形式;任选地,所述非固定组合中的式I化合物或其可药用盐和恩替卡韦或其可药用盐或其溶剂合物、或和替诺福韦或其可药用前药或其可药用的盐各自呈固体药物组合物形式,且式I化合物或其可药用盐的固体药物组合物和恩替卡韦或其可药用盐或其溶剂合物、或和替诺福韦或其可药用前药或其可药用的盐的固体药物组合物存在于同一个药袋;任选地,所述非固定组合中的式I化合物或其可药用盐和恩替卡韦或其可药用盐或其溶剂合物、或和替诺福韦或其可药用前药或其可药用的盐各自呈固体药物组合物形式,且式I化合物或其可药用盐的固体药物组合物和恩替卡韦或其可药用盐或其溶剂合物、或和替诺福韦或其可药用前药或其可药用的盐的固体药物组合物不存在于同一个药袋。
- 如权利要求1-15任一项所述的药物组合在制备用于治疗乙型肝炎病毒感染的药物中的用途。
- 治疗乙型肝炎病毒感染的方法,其包括向有需要的个体施用有效量的如权利要求1-15任一项所述的药物组合。
- 用于治疗乙型肝炎病毒感染的药物组合,所述药物组合选自权利要求1-15任一项所述的药物组合。
- 权利要求1-15任一项所述的药物组合用于治疗乙型肝炎病毒感染的用途。
- 如权利要求20所述的试剂盒,所述逆转录酶抑制剂或其可药用的前药、其可药用盐或其溶剂合物选自:恩替卡韦或其可药用盐或其溶剂合物;或者替诺福韦或其可药用前药或其可药用的盐。
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