ZA200301684B - Purine ribosides as antiarrhythmics. - Google Patents
Purine ribosides as antiarrhythmics. Download PDFInfo
- Publication number
- ZA200301684B ZA200301684B ZA200301684A ZA200301684A ZA200301684B ZA 200301684 B ZA200301684 B ZA 200301684B ZA 200301684 A ZA200301684 A ZA 200301684A ZA 200301684 A ZA200301684 A ZA 200301684A ZA 200301684 B ZA200301684 B ZA 200301684B
- Authority
- ZA
- South Africa
- Prior art keywords
- adenosine
- tetrahydrofuranyl
- cvt
- substituted
- alkyl
- Prior art date
Links
- -1 Purine ribosides Chemical class 0.000 title claims description 31
- 239000003416 antiarrhythmic agent Substances 0.000 title description 5
- KDCGOANMDULRCW-UHFFFAOYSA-N Purine Natural products N1=CNC2=NC=NC2=C1 KDCGOANMDULRCW-UHFFFAOYSA-N 0.000 title description 4
- 230000003288 anthiarrhythmic effect Effects 0.000 title description 3
- OIRDTQYFTABQOQ-KQYNXXCUSA-N adenosine Chemical compound C1=NC=2C(N)=NC=NC=2N1[C@@H]1O[C@H](CO)[C@@H](O)[C@H]1O OIRDTQYFTABQOQ-KQYNXXCUSA-N 0.000 claims description 48
- 239000002126 C01EB10 - Adenosine Substances 0.000 claims description 24
- 229960005305 adenosine Drugs 0.000 claims description 24
- 206010003119 arrhythmia Diseases 0.000 claims description 13
- 230000006793 arrhythmia Effects 0.000 claims description 12
- 125000000623 heterocyclic group Chemical group 0.000 claims description 12
- 241000124008 Mammalia Species 0.000 claims description 6
- FWMUBGAYBMDTGP-RUQIKYNFSA-N (3r)-2-(7h-purin-6-yl)oxolan-3-amine Chemical compound N[C@@H]1CCOC1C1=NC=NC2=C1NC=N2 FWMUBGAYBMDTGP-RUQIKYNFSA-N 0.000 claims description 4
- 206010003658 Atrial Fibrillation Diseases 0.000 claims description 4
- 229940044601 receptor agonist Drugs 0.000 claims description 4
- 239000000018 receptor agonist Substances 0.000 claims description 4
- 206010003662 Atrial flutter Diseases 0.000 claims description 3
- 206010003668 atrial tachycardia Diseases 0.000 claims description 3
- 238000010253 intravenous injection Methods 0.000 claims 1
- 230000000694 effects Effects 0.000 description 25
- OESBDSFYJMDRJY-BAYCTPFLSA-N (2r,3s,4r,5r)-2-(hydroxymethyl)-5-[6-[[(3r)-oxolan-3-yl]amino]purin-9-yl]oxolane-3,4-diol Chemical compound O[C@@H]1[C@H](O)[C@@H](CO)O[C@H]1N1C2=NC=NC(N[C@H]3COCC3)=C2N=C1 OESBDSFYJMDRJY-BAYCTPFLSA-N 0.000 description 24
- 150000001875 compounds Chemical class 0.000 description 22
- 125000000217 alkyl group Chemical group 0.000 description 17
- 125000003118 aryl group Chemical group 0.000 description 14
- 125000001072 heteroaryl group Chemical group 0.000 description 13
- 239000000203 mixture Substances 0.000 description 9
- 102000005962 receptors Human genes 0.000 description 9
- 108020003175 receptors Proteins 0.000 description 9
- 238000000034 method Methods 0.000 description 8
- 125000003545 alkoxy group Chemical group 0.000 description 7
- 125000000753 cycloalkyl group Chemical group 0.000 description 7
- 229910052736 halogen Inorganic materials 0.000 description 7
- 150000002367 halogens Chemical class 0.000 description 7
- 125000002887 hydroxy group Chemical group [H]O* 0.000 description 7
- OKKJLVBELUTLKV-UHFFFAOYSA-N Methanol Chemical compound OC OKKJLVBELUTLKV-UHFFFAOYSA-N 0.000 description 6
- 125000004104 aryloxy group Chemical group 0.000 description 6
- 230000036772 blood pressure Effects 0.000 description 6
- 125000004432 carbon atom Chemical group C* 0.000 description 6
- 125000003178 carboxy group Chemical group [H]OC(*)=O 0.000 description 6
- 125000004093 cyano group Chemical group *C#N 0.000 description 6
- 238000002360 preparation method Methods 0.000 description 6
- 125000002924 primary amino group Chemical group [H]N([H])* 0.000 description 6
- 235000002639 sodium chloride Nutrition 0.000 description 6
- 239000007787 solid Substances 0.000 description 6
- 206010003130 Arrhythmia supraventricular Diseases 0.000 description 5
- 230000033764 rhythmic process Effects 0.000 description 5
- 150000003839 salts Chemical class 0.000 description 5
- 150000003573 thiols Chemical class 0.000 description 5
- IJGRMHOSHXDMSA-UHFFFAOYSA-N Atomic nitrogen Chemical compound N#N IJGRMHOSHXDMSA-UHFFFAOYSA-N 0.000 description 4
- 206010003677 Atrioventricular block second degree Diseases 0.000 description 4
- XEKOWRVHYACXOJ-UHFFFAOYSA-N Ethyl acetate Chemical compound CCOC(C)=O XEKOWRVHYACXOJ-UHFFFAOYSA-N 0.000 description 4
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 4
- 125000002252 acyl group Chemical group 0.000 description 4
- 125000004414 alkyl thio group Chemical group 0.000 description 4
- 210000001992 atrioventricular node Anatomy 0.000 description 4
- 239000007788 liquid Substances 0.000 description 4
- 125000000449 nitro group Chemical group [O-][N+](*)=O 0.000 description 4
- 125000001424 substituent group Chemical group 0.000 description 4
- 125000003107 substituted aryl group Chemical group 0.000 description 4
- 230000002861 ventricular Effects 0.000 description 4
- MIPHRQMEIYLZFZ-BYPYZUCNSA-N (3s)-oxolan-3-amine Chemical compound N[C@H]1CCOC1 MIPHRQMEIYLZFZ-BYPYZUCNSA-N 0.000 description 3
- CSCPPACGZOOCGX-UHFFFAOYSA-N Acetone Chemical compound CC(C)=O CSCPPACGZOOCGX-UHFFFAOYSA-N 0.000 description 3
- 102000009346 Adenosine receptors Human genes 0.000 description 3
- 108050000203 Adenosine receptors Proteins 0.000 description 3
- 208000001953 Hypotension Diseases 0.000 description 3
- ZMANZCXQSJIPKH-UHFFFAOYSA-N Triethylamine Chemical compound CCN(CC)CC ZMANZCXQSJIPKH-UHFFFAOYSA-N 0.000 description 3
- 239000002253 acid Substances 0.000 description 3
- 125000003368 amide group Chemical group 0.000 description 3
- 239000000969 carrier Substances 0.000 description 3
- 150000001768 cations Chemical class 0.000 description 3
- 239000003814 drug Substances 0.000 description 3
- 125000005842 heteroatom Chemical group 0.000 description 3
- 229910052739 hydrogen Inorganic materials 0.000 description 3
- 239000001257 hydrogen Substances 0.000 description 3
- 230000036543 hypotension Effects 0.000 description 3
- 230000001404 mediated effect Effects 0.000 description 3
- 239000000243 solution Substances 0.000 description 3
- 239000006188 syrup Substances 0.000 description 3
- 235000020357 syrup Nutrition 0.000 description 3
- FWMUBGAYBMDTGP-NTFOPCPOSA-N (3s)-2-(7h-purin-6-yl)oxolan-3-amine Chemical compound N[C@H]1CCOC1C1=NC=NC2=C1NC=N2 FWMUBGAYBMDTGP-NTFOPCPOSA-N 0.000 description 2
- MIOPJNTWMNEORI-GMSGAONNSA-M (S)-camphorsulfonate Chemical compound C1C[C@@]2(CS([O-])(=O)=O)C(=O)C[C@@H]1C2(C)C MIOPJNTWMNEORI-GMSGAONNSA-M 0.000 description 2
- VBICKXHEKHSIBG-UHFFFAOYSA-N 1-monostearoylglycerol Chemical compound CCCCCCCCCCCCCCCCCC(=O)OCC(O)CO VBICKXHEKHSIBG-UHFFFAOYSA-N 0.000 description 2
- 229940127291 Calcium channel antagonist Drugs 0.000 description 2
- LTMHDMANZUZIPE-AMTYYWEZSA-N Digoxin Natural products O([C@H]1[C@H](C)O[C@H](O[C@@H]2C[C@@H]3[C@@](C)([C@@H]4[C@H]([C@]5(O)[C@](C)([C@H](O)C4)[C@H](C4=CC(=O)OC4)CC5)CC3)CC2)C[C@@H]1O)[C@H]1O[C@H](C)[C@@H](O[C@H]2O[C@@H](C)[C@H](O)[C@@H](O)C2)[C@@H](O)C1 LTMHDMANZUZIPE-AMTYYWEZSA-N 0.000 description 2
- 108010010803 Gelatin Proteins 0.000 description 2
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 2
- NTYJJOPFIAHURM-UHFFFAOYSA-N Histamine Chemical compound NCCC1=CN=CN1 NTYJJOPFIAHURM-UHFFFAOYSA-N 0.000 description 2
- 238000012313 Kruskal-Wallis test Methods 0.000 description 2
- 235000010643 Leucaena leucocephala Nutrition 0.000 description 2
- 240000007472 Leucaena leucocephala Species 0.000 description 2
- IMNFDUFMRHMDMM-UHFFFAOYSA-N N-Heptane Chemical compound CCCCCCC IMNFDUFMRHMDMM-UHFFFAOYSA-N 0.000 description 2
- JUJWROOIHBZHMG-UHFFFAOYSA-N Pyridine Chemical compound C1=CC=NC=C1 JUJWROOIHBZHMG-UHFFFAOYSA-N 0.000 description 2
- UIIMBOGNXHQVGW-UHFFFAOYSA-M Sodium bicarbonate Chemical compound [Na+].OC([O-])=O UIIMBOGNXHQVGW-UHFFFAOYSA-M 0.000 description 2
- NINIDFKCEFEMDL-UHFFFAOYSA-N Sulfur Chemical compound [S] NINIDFKCEFEMDL-UHFFFAOYSA-N 0.000 description 2
- WYURNTSHIVDZCO-UHFFFAOYSA-N Tetrahydrofuran Chemical compound C1CCOC1 WYURNTSHIVDZCO-UHFFFAOYSA-N 0.000 description 2
- 125000004442 acylamino group Chemical group 0.000 description 2
- 125000004423 acyloxy group Chemical group 0.000 description 2
- 239000000556 agonist Substances 0.000 description 2
- 238000000540 analysis of variance Methods 0.000 description 2
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 2
- 230000001746 atrial effect Effects 0.000 description 2
- 239000000480 calcium channel blocker Substances 0.000 description 2
- 125000004181 carboxyalkyl group Chemical group 0.000 description 2
- 239000000460 chlorine Substances 0.000 description 2
- 238000007796 conventional method Methods 0.000 description 2
- LTMHDMANZUZIPE-PUGKRICDSA-N digoxin Chemical compound C1[C@H](O)[C@H](O)[C@@H](C)O[C@H]1O[C@@H]1[C@@H](C)O[C@@H](O[C@@H]2[C@H](O[C@@H](O[C@@H]3C[C@@H]4[C@]([C@@H]5[C@H]([C@]6(CC[C@@H]([C@@]6(C)[C@H](O)C5)C=5COC(=O)C=5)O)CC4)(C)CC3)C[C@@H]2O)C)C[C@@H]1O LTMHDMANZUZIPE-PUGKRICDSA-N 0.000 description 2
- 229960005156 digoxin Drugs 0.000 description 2
- LTMHDMANZUZIPE-UHFFFAOYSA-N digoxine Natural products C1C(O)C(O)C(C)OC1OC1C(C)OC(OC2C(OC(OC3CC4C(C5C(C6(CCC(C6(C)C(O)C5)C=5COC(=O)C=5)O)CC4)(C)CC3)CC2O)C)CC1O LTMHDMANZUZIPE-UHFFFAOYSA-N 0.000 description 2
- 239000003085 diluting agent Substances 0.000 description 2
- ZUOUZKKEUPVFJK-UHFFFAOYSA-N diphenyl Chemical compound C1=CC=CC=C1C1=CC=CC=C1 ZUOUZKKEUPVFJK-UHFFFAOYSA-N 0.000 description 2
- 239000003937 drug carrier Substances 0.000 description 2
- 239000000839 emulsion Substances 0.000 description 2
- 235000019439 ethyl acetate Nutrition 0.000 description 2
- 125000001495 ethyl group Chemical group [H]C([H])([H])C([H])([H])* 0.000 description 2
- 239000008273 gelatin Substances 0.000 description 2
- 229920000159 gelatin Polymers 0.000 description 2
- 239000007903 gelatin capsule Substances 0.000 description 2
- 235000019322 gelatine Nutrition 0.000 description 2
- 235000011852 gelatine desserts Nutrition 0.000 description 2
- 210000003630 histaminocyte Anatomy 0.000 description 2
- 150000002430 hydrocarbons Chemical group 0.000 description 2
- 125000004435 hydrogen atom Chemical group [H]* 0.000 description 2
- 230000003993 interaction Effects 0.000 description 2
- 125000000959 isobutyl group Chemical group [H]C([H])([H])C([H])(C([H])([H])[H])C([H])([H])* 0.000 description 2
- 125000001449 isopropyl group Chemical group [H]C([H])([H])C([H])(*)C([H])([H])[H] 0.000 description 2
- 239000012669 liquid formulation Substances 0.000 description 2
- HQKMJHAJHXVSDF-UHFFFAOYSA-L magnesium stearate Chemical compound [Mg+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O HQKMJHAJHXVSDF-UHFFFAOYSA-L 0.000 description 2
- 125000002496 methyl group Chemical group [H]C([H])([H])* 0.000 description 2
- 238000003801 milling Methods 0.000 description 2
- 238000002156 mixing Methods 0.000 description 2
- 125000004108 n-butyl group Chemical group [H]C([H])([H])C([H])([H])C([H])([H])C([H])([H])* 0.000 description 2
- 125000001280 n-hexyl group Chemical group C(CCCCC)* 0.000 description 2
- 125000004123 n-propyl group Chemical group [H]C([H])([H])C([H])([H])C([H])([H])* 0.000 description 2
- 229910052757 nitrogen Inorganic materials 0.000 description 2
- 229910052760 oxygen Inorganic materials 0.000 description 2
- 239000001301 oxygen Substances 0.000 description 2
- 238000007911 parenteral administration Methods 0.000 description 2
- 239000008194 pharmaceutical composition Substances 0.000 description 2
- 239000000546 pharmaceutical excipient Substances 0.000 description 2
- 150000008223 ribosides Chemical class 0.000 description 2
- 229930195734 saturated hydrocarbon Natural products 0.000 description 2
- 239000011780 sodium chloride Substances 0.000 description 2
- 125000005346 substituted cycloalkyl group Chemical group 0.000 description 2
- 229910052717 sulfur Inorganic materials 0.000 description 2
- 239000011593 sulfur Substances 0.000 description 2
- 125000000999 tert-butyl group Chemical group [H]C([H])([H])C(*)(C([H])([H])[H])C([H])([H])[H] 0.000 description 2
- 229940124597 therapeutic agent Drugs 0.000 description 2
- 230000001225 therapeutic effect Effects 0.000 description 2
- 125000005323 thioketone group Chemical group 0.000 description 2
- 125000002023 trifluoromethyl group Chemical group FC(F)(F)* 0.000 description 2
- 230000024883 vasodilation Effects 0.000 description 2
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- XHRJGHCQQPETRH-KQYNXXCUSA-N (2r,3r,4s,5r)-2-(6-chloropurin-9-yl)-5-(hydroxymethyl)oxolane-3,4-diol Chemical compound O[C@@H]1[C@H](O)[C@@H](CO)O[C@H]1N1C2=NC=NC(Cl)=C2N=C1 XHRJGHCQQPETRH-KQYNXXCUSA-N 0.000 description 1
- MHOVLDXJDIEEMJ-WCCKRBBISA-N (3s)-oxolan-3-amine;hydrochloride Chemical compound Cl.N[C@H]1CCOC1 MHOVLDXJDIEEMJ-WCCKRBBISA-N 0.000 description 1
- BGABKEVTHIJBIW-UHFFFAOYSA-N (7,7-dimethyl-3-oxo-4-bicyclo[2.2.1]heptanyl)methanesulfonyl chloride Chemical compound C1CC2(CS(Cl)(=O)=O)C(=O)CC1C2(C)C BGABKEVTHIJBIW-UHFFFAOYSA-N 0.000 description 1
- 238000005160 1H NMR spectroscopy Methods 0.000 description 1
- ZCYVEMRRCGMTRW-UHFFFAOYSA-N 7553-56-2 Chemical group [I] ZCYVEMRRCGMTRW-UHFFFAOYSA-N 0.000 description 1
- HBAQYPYDRFILMT-UHFFFAOYSA-N 8-[3-(1-cyclopropylpyrazol-4-yl)-1H-pyrazolo[4,3-d]pyrimidin-5-yl]-3-methyl-3,8-diazabicyclo[3.2.1]octan-2-one Chemical class C1(CC1)N1N=CC(=C1)C1=NNC2=C1N=C(N=C2)N1C2C(N(CC1CC2)C)=O HBAQYPYDRFILMT-UHFFFAOYSA-N 0.000 description 1
- 229940122614 Adenosine receptor agonist Drugs 0.000 description 1
- 229920001817 Agar Polymers 0.000 description 1
- GUBGYTABKSRVRQ-XLOQQCSPSA-N Alpha-Lactose Chemical compound O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@H]1O[C@@H]1[C@@H](CO)O[C@H](O)[C@H](O)[C@H]1O GUBGYTABKSRVRQ-XLOQQCSPSA-N 0.000 description 1
- USFZMSVCRYTOJT-UHFFFAOYSA-N Ammonium acetate Chemical compound N.CC(O)=O USFZMSVCRYTOJT-UHFFFAOYSA-N 0.000 description 1
- 239000005695 Ammonium acetate Substances 0.000 description 1
- WKBOTKDWSSQWDR-UHFFFAOYSA-N Bromine atom Chemical compound [Br] WKBOTKDWSSQWDR-UHFFFAOYSA-N 0.000 description 1
- COVZYZSDYWQREU-UHFFFAOYSA-N Busulfan Chemical compound CS(=O)(=O)OCCCCOS(C)(=O)=O COVZYZSDYWQREU-UHFFFAOYSA-N 0.000 description 1
- BVKZGUZCCUSVTD-UHFFFAOYSA-L Carbonate Chemical compound [O-]C([O-])=O BVKZGUZCCUSVTD-UHFFFAOYSA-L 0.000 description 1
- 206010007559 Cardiac failure congestive Diseases 0.000 description 1
- VEXZGXHMUGYJMC-UHFFFAOYSA-M Chloride anion Chemical compound [Cl-] VEXZGXHMUGYJMC-UHFFFAOYSA-M 0.000 description 1
- ZAMOUSCENKQFHK-UHFFFAOYSA-N Chlorine atom Chemical compound [Cl] ZAMOUSCENKQFHK-UHFFFAOYSA-N 0.000 description 1
- 208000017667 Chronic Disease Diseases 0.000 description 1
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 1
- PXGOKWXKJXAPGV-UHFFFAOYSA-N Fluorine Chemical compound FF PXGOKWXKJXAPGV-UHFFFAOYSA-N 0.000 description 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- VEXZGXHMUGYJMC-UHFFFAOYSA-N Hydrochloric acid Chemical compound Cl VEXZGXHMUGYJMC-UHFFFAOYSA-N 0.000 description 1
- UFHFLCQGNIYNRP-UHFFFAOYSA-N Hydrogen Chemical compound [H][H] UFHFLCQGNIYNRP-UHFFFAOYSA-N 0.000 description 1
- DGAQECJNVWCQMB-PUAWFVPOSA-M Ilexoside XXIX Chemical compound C[C@@H]1CC[C@@]2(CC[C@@]3(C(=CC[C@H]4[C@]3(CC[C@@H]5[C@@]4(CC[C@@H](C5(C)C)OS(=O)(=O)[O-])C)C)[C@@H]2[C@]1(C)O)C)C(=O)O[C@H]6[C@@H]([C@H]([C@@H]([C@H](O6)CO)O)O)O.[Na+] DGAQECJNVWCQMB-PUAWFVPOSA-M 0.000 description 1
- 229930194542 Keto Natural products 0.000 description 1
- GUBGYTABKSRVRQ-QKKXKWKRSA-N Lactose Natural products OC[C@H]1O[C@@H](O[C@H]2[C@H](O)[C@@H](O)C(O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@H]1O GUBGYTABKSRVRQ-QKKXKWKRSA-N 0.000 description 1
- 206010049694 Left Ventricular Dysfunction Diseases 0.000 description 1
- 229930195725 Mannitol Natural products 0.000 description 1
- 235000019483 Peanut oil Nutrition 0.000 description 1
- OAICVXFJPJFONN-UHFFFAOYSA-N Phosphorus Chemical compound [P] OAICVXFJPJFONN-UHFFFAOYSA-N 0.000 description 1
- 239000002202 Polyethylene glycol Substances 0.000 description 1
- VYPSYNLAJGMNEJ-UHFFFAOYSA-N Silicium dioxide Chemical compound O=[Si]=O VYPSYNLAJGMNEJ-UHFFFAOYSA-N 0.000 description 1
- 229920002472 Starch Polymers 0.000 description 1
- 235000021355 Stearic acid Nutrition 0.000 description 1
- 208000001871 Tachycardia Diseases 0.000 description 1
- 206010049761 Ventricular pre-excitation Diseases 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000005856 abnormality Effects 0.000 description 1
- 230000002378 acidificating effect Effects 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 239000008272 agar Substances 0.000 description 1
- 235000010419 agar Nutrition 0.000 description 1
- 150000001298 alcohols Chemical class 0.000 description 1
- 150000004703 alkoxides Chemical class 0.000 description 1
- 125000000033 alkoxyamino group Chemical group 0.000 description 1
- 125000005741 alkyl alkenyl group Chemical group 0.000 description 1
- 125000005119 alkyl cycloalkyl group Chemical group 0.000 description 1
- 235000019257 ammonium acetate Nutrition 0.000 description 1
- 229940043376 ammonium acetate Drugs 0.000 description 1
- 230000033115 angiogenesis Effects 0.000 description 1
- 125000005428 anthryl group Chemical group [H]C1=C([H])C([H])=C2C([H])=C3C(*)=C([H])C([H])=C([H])C3=C([H])C2=C1[H] 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 239000007900 aqueous suspension Substances 0.000 description 1
- 230000004872 arterial blood pressure Effects 0.000 description 1
- 125000003710 aryl alkyl group Chemical group 0.000 description 1
- 208000006673 asthma Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 239000002876 beta blocker Substances 0.000 description 1
- 229940097320 beta blocking agent Drugs 0.000 description 1
- 239000004305 biphenyl Substances 0.000 description 1
- 235000010290 biphenyl Nutrition 0.000 description 1
- 239000012267 brine Substances 0.000 description 1
- GDTBXPJZTBHREO-UHFFFAOYSA-N bromine Substances BrBr GDTBXPJZTBHREO-UHFFFAOYSA-N 0.000 description 1
- 229910052794 bromium Inorganic materials 0.000 description 1
- 210000004375 bundle of his Anatomy 0.000 description 1
- 239000011575 calcium Substances 0.000 description 1
- PASHVRUKOFIRIK-UHFFFAOYSA-L calcium sulfate dihydrate Chemical compound O.O.[Ca+2].[O-]S([O-])(=O)=O PASHVRUKOFIRIK-UHFFFAOYSA-L 0.000 description 1
- 125000002837 carbocyclic group Chemical group 0.000 description 1
- 229910052799 carbon Inorganic materials 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 230000015556 catabolic process Effects 0.000 description 1
- 125000002091 cationic group Chemical group 0.000 description 1
- 230000004663 cell proliferation Effects 0.000 description 1
- 239000001913 cellulose Substances 0.000 description 1
- 229920002678 cellulose Polymers 0.000 description 1
- 238000006243 chemical reaction Methods 0.000 description 1
- 239000003153 chemical reaction reagent Substances 0.000 description 1
- 229910052801 chlorine Inorganic materials 0.000 description 1
- 125000006165 cyclic alkyl group Chemical group 0.000 description 1
- 125000004122 cyclic group Chemical group 0.000 description 1
- 125000001995 cyclobutyl group Chemical group [H]C1([H])C([H])([H])C([H])(*)C1([H])[H] 0.000 description 1
- 125000000640 cyclooctyl group Chemical group [H]C1([H])C([H])([H])C([H])([H])C([H])([H])C([H])(*)C([H])([H])C([H])([H])C1([H])[H] 0.000 description 1
- 125000001511 cyclopentyl group Chemical group [H]C1([H])C([H])([H])C([H])([H])C([H])(*)C1([H])[H] 0.000 description 1
- 125000001559 cyclopropyl group Chemical group [H]C1([H])C([H])([H])C1([H])* 0.000 description 1
- 238000006731 degradation reaction Methods 0.000 description 1
- 230000003111 delayed effect Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 230000000881 depressing effect Effects 0.000 description 1
- 238000013461 design Methods 0.000 description 1
- 239000008121 dextrose Substances 0.000 description 1
- 230000003205 diastolic effect Effects 0.000 description 1
- 229940057307 dihydrate calcium sulfate Drugs 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 208000035475 disorder Diseases 0.000 description 1
- 231100000673 dose–response relationship Toxicity 0.000 description 1
- 230000001091 dromotropic effect Effects 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 238000002651 drug therapy Methods 0.000 description 1
- 230000007831 electrophysiology Effects 0.000 description 1
- 238000002001 electrophysiology Methods 0.000 description 1
- 210000002615 epidermis Anatomy 0.000 description 1
- 235000019441 ethanol Nutrition 0.000 description 1
- 230000007717 exclusion Effects 0.000 description 1
- 239000011737 fluorine Substances 0.000 description 1
- 229910052731 fluorine Inorganic materials 0.000 description 1
- 125000000524 functional group Chemical group 0.000 description 1
- YQEMORVAKMFKLG-UHFFFAOYSA-N glycerine monostearate Natural products CCCCCCCCCCCCCCCCCC(=O)OC(CO)CO YQEMORVAKMFKLG-UHFFFAOYSA-N 0.000 description 1
- 235000011187 glycerol Nutrition 0.000 description 1
- UHUSDOQQWJGJQS-UHFFFAOYSA-N glycerol 1,2-dioctadecanoate Chemical compound CCCCCCCCCCCCCCCCCC(=O)OCC(CO)OC(=O)CCCCCCCCCCCCCCCCC UHUSDOQQWJGJQS-UHFFFAOYSA-N 0.000 description 1
- SVUQHVRAGMNPLW-UHFFFAOYSA-N glycerol monostearate Natural products CCCCCCCCCCCCCCCCC(=O)OCC(O)CO SVUQHVRAGMNPLW-UHFFFAOYSA-N 0.000 description 1
- 238000005469 granulation Methods 0.000 description 1
- 230000003179 granulation Effects 0.000 description 1
- 125000004475 heteroaralkyl group Chemical group 0.000 description 1
- 125000005553 heteroaryloxy group Chemical group 0.000 description 1
- 125000004470 heterocyclooxy group Chemical group 0.000 description 1
- 229960001340 histamine Drugs 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-M hydroxide Chemical compound [OH-] XLYOFNOQVPJJNP-UHFFFAOYSA-M 0.000 description 1
- 125000002349 hydroxyamino group Chemical group [H]ON([H])[*] 0.000 description 1
- 238000001802 infusion Methods 0.000 description 1
- 230000000297 inotrophic effect Effects 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 125000000468 ketone group Chemical group 0.000 description 1
- 239000008101 lactose Substances 0.000 description 1
- 239000008176 lyophilized powder Substances 0.000 description 1
- 235000019359 magnesium stearate Nutrition 0.000 description 1
- 239000000594 mannitol Substances 0.000 description 1
- 235000010355 mannitol Nutrition 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 230000000116 mitigating effect Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- VYQNWZOUAUKGHI-UHFFFAOYSA-N monobenzone Chemical compound C1=CC(O)=CC=C1OCC1=CC=CC=C1 VYQNWZOUAUKGHI-UHFFFAOYSA-N 0.000 description 1
- 125000002950 monocyclic group Chemical group 0.000 description 1
- 125000001421 myristyl group Chemical group [H]C([*])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])C([H])([H])[H] 0.000 description 1
- 125000001624 naphthyl group Chemical group 0.000 description 1
- 238000001422 normality test Methods 0.000 description 1
- QIQXTHQIDYTFRH-UHFFFAOYSA-N octadecanoic acid Chemical compound CCCCCCCCCCCCCCCCCC(O)=O QIQXTHQIDYTFRH-UHFFFAOYSA-N 0.000 description 1
- OQCDKBAXFALNLD-UHFFFAOYSA-N octadecanoic acid Natural products CCCCCCCC(C)CCCCCCCCC(O)=O OQCDKBAXFALNLD-UHFFFAOYSA-N 0.000 description 1
- 239000003921 oil Substances 0.000 description 1
- 235000019198 oils Nutrition 0.000 description 1
- 239000004006 olive oil Substances 0.000 description 1
- 235000008390 olive oil Nutrition 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 239000012044 organic layer Substances 0.000 description 1
- 125000004043 oxo group Chemical group O=* 0.000 description 1
- MHOVLDXJDIEEMJ-UHFFFAOYSA-N oxolan-3-amine;hydrochloride Chemical compound Cl.NC1CCOC1 MHOVLDXJDIEEMJ-UHFFFAOYSA-N 0.000 description 1
- 238000007427 paired t-test Methods 0.000 description 1
- 239000000312 peanut oil Substances 0.000 description 1
- 239000001814 pectin Substances 0.000 description 1
- 235000010987 pectin Nutrition 0.000 description 1
- 229920001277 pectin Polymers 0.000 description 1
- 125000005561 phenanthryl group Chemical group 0.000 description 1
- 125000001997 phenyl group Chemical group [H]C1=C([H])C([H])=C(*)C([H])=C1[H] 0.000 description 1
- 229910052698 phosphorus Inorganic materials 0.000 description 1
- 239000011574 phosphorus Substances 0.000 description 1
- 230000001766 physiological effect Effects 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 239000000843 powder Substances 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 239000003379 purinergic P1 receptor agonist Substances 0.000 description 1
- 125000004309 pyranyl group Chemical group O1C(C=CC=C1)* 0.000 description 1
- UMJSCPRVCHMLSP-UHFFFAOYSA-N pyridine Natural products COC1=CC=CN=C1 UMJSCPRVCHMLSP-UHFFFAOYSA-N 0.000 description 1
- 239000002464 receptor antagonist Substances 0.000 description 1
- 229940044551 receptor antagonist Drugs 0.000 description 1
- 230000000284 resting effect Effects 0.000 description 1
- 210000005245 right atrium Anatomy 0.000 description 1
- 229920006395 saturated elastomer Polymers 0.000 description 1
- 230000035945 sensitivity Effects 0.000 description 1
- 239000000741 silica gel Substances 0.000 description 1
- 229910002027 silica gel Inorganic materials 0.000 description 1
- 210000001013 sinoatrial node Anatomy 0.000 description 1
- 239000011734 sodium Substances 0.000 description 1
- 229910052708 sodium Inorganic materials 0.000 description 1
- 239000001632 sodium acetate Substances 0.000 description 1
- 235000017281 sodium acetate Nutrition 0.000 description 1
- 235000017557 sodium bicarbonate Nutrition 0.000 description 1
- 229910000030 sodium bicarbonate Inorganic materials 0.000 description 1
- 239000001509 sodium citrate Substances 0.000 description 1
- NLJMYIDDQXHKNR-UHFFFAOYSA-K sodium citrate Chemical compound O.O.[Na+].[Na+].[Na+].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O NLJMYIDDQXHKNR-UHFFFAOYSA-K 0.000 description 1
- HPALAKNZSZLMCH-UHFFFAOYSA-M sodium;chloride;hydrate Chemical compound O.[Na+].[Cl-] HPALAKNZSZLMCH-UHFFFAOYSA-M 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 239000008107 starch Substances 0.000 description 1
- 235000019698 starch Nutrition 0.000 description 1
- 239000008117 stearic acid Substances 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
- 230000000638 stimulation Effects 0.000 description 1
- 238000013268 sustained release Methods 0.000 description 1
- 239000012730 sustained-release form Substances 0.000 description 1
- 230000009885 systemic effect Effects 0.000 description 1
- 230000006794 tachycardia Effects 0.000 description 1
- 239000000454 talc Substances 0.000 description 1
- 235000012222 talc Nutrition 0.000 description 1
- 229910052623 talc Inorganic materials 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- YLQBMQCUIZJEEH-UHFFFAOYSA-N tetrahydrofuran Natural products C=1C=COC=1 YLQBMQCUIZJEEH-UHFFFAOYSA-N 0.000 description 1
- 125000005309 thioalkoxy group Chemical group 0.000 description 1
Description
PURINE RIBOSIDES AS ANTIARRHYTHMICS
This invention relates to a method of treating atrial arrhythmias that minimizes undesirable side effects, comprising administration of an adenosine A; receptor agonist in low doses.
Background Information
Atrial arrhythmias, such as primary atrial fibrillation, atrial flutter, and paroxysmal atrial tachycardia (PSVT), are abnormal heart rhythms that are due to a variety of factors.
Arrhythmias can range from incidental, asymptomatic clinical findings to life-threatening abnormalities. Arrythmias account for a significant percentage of the causes of death in human. Thus, it is desirable to develop methods of mitigating the effects of arrhythmia.
A variety of anti-arrhythmic drug therapies are presently available. These compounds, however, have significant limitations. Digoxin, for example, has a delayed onset of action (about 30 min) and its peak effects are not observed for 3 to 4 hours after administration.
Other examples are B-blockers and calcium-channel blockers, which widely used to treat arrhythmias, can cause hypotension and have negative inotropic effects. :
Adenosine is a naturally occurring compound that is highly effective in ameliorating arrhythmia. However, adenosine has a wide variety of physiological effects. The multiple activities of adenosine are mediated by its interactions with a family of adenosine receptors, known as the adenosine Ay, Aza, Asg, and A; receptors, each of which regulates distinct biological activites. For example, adenosine binds to adenosine A, receptors in heart resulting in a dromotrophic effect while the binding of adenosine to A, results in coronary vasodilation. Likewise adenosine binds to adenosine Agp receptors thus affecting a wide array of activities including angiogenesis, cellular proliferation, and apopotosis, to name a few. On the other hand, adenosine binds toA, receptors on mast cells thereby stimulating degranulation and the release of histamine,
The anti-arrhythmic effects of adenosine are due exclusively to its interaction with the adenosine A; receptor subtype. However, contemporaneous binding of adenosine to the subtypes, Aza, Azs, and Aj results in undesirable side effects, such as vasodilation, changes in the heart rate and mast cell degradation. Thus, the lack of selectivity of adenosine for the A; receptor subtype makes adenosine unsuitable for the treatment of arrhythmias. Additionally, adenosine has a short half-life (~10 sec) making it ineffective in any condition that requires prolonged drug action.
Thus, there is a need for a method of treating arrhythmias with therapeutic agents that are selective for the adenosine A, receptor, have sufficiently long half-lives, and have few side effects. Preferred compounds would be active at very low doses, since lower doses provide less opportunity for side effects.
New classes of agonists that bind to adenosine A, receptors and that are useful in treating arrhythmias are disclosed in US Patent No. 5,789,416, the entire disclosure of which is hereby incorporated by reference. These compounds have a high specificity for the adenosine A; receptor subtypes, but like all therapeutic compounds, can potentially cause side effects.
The effective dose of the compounds of ‘416 is disclosed to be in the range of 0.01- 100 mg/kg. Surprisingly, we have discovered that the compounds are active at much lower doses (0.0003-0.009 mg/kg) than those disclosed as effective in ‘416. Accordingly, a novel and effective method of treating arrhythmias is provided that restores sinus rhythm without slowing the sinus rate and is virtually free of undesirable side effects, such as changes in mean arterial pressure, blood pressure, heart rate, or other adverse effects. "SUMMARY OF THE INVENTION
Tt is an object of this invention to provide an effective method of treating atrial arrhythmias in a mammal while minimizing undesirable side effects. Accordingly, in a first aspect, the invention relates to a method of treating atrial arrhythmias in a mammal comprising administration of a therapeutically minimal dose of an adenosine A; receptor agonist of Formula I to a mammal in need thereof:
NHR' 0
LA
OH o y
HO
: Formula I
Wherein:
R; is an optionally substituted heterocyclic group, preferably monocyclic; and said minimal dose is in the range of 0.0003-0.009 mg/kg.
In a more preferred embodiment, R; is 3-tetrahydrofuranyl, 3-tetrahydrothiofuranyl, 4- pyranyl and 4-thiopyranyl.
The compounds of Formula I exist as a racemic mixture, or as individual isomers. Most . preferred is 6-(3-(R)-aminotetrahydrofuranyl) purine riboside.
The most preferred embodiment of the invention is a method of treating atrial arrhythmias in a mammal comprising administering a therapeutically minimal dose of 0.0003- 0.009 mg/kg of 6-(3-(R)-N-aminotetrahydrofuranyl) purine ribosids, hereafter referred to as
CVT-510.
Figure 1. Time course of the effect of CVT-510 effect on AH interval.
Table 1. The effects of CVT-510 at doses of 0.3, 1.0,3.0,7.5 10, 15 and 30 ng/kg on PSVT
ABBREVIATIONS:
AV: Atrial-ventricular
BP: Blood Pressure
HR: Heart rate
HV: His Ventricular .
WCL: Wenckebach cycle length
SH: Stimulus to His (length of time for conduction of current through AV node)
PSVT Paroxysmal Atrial Tachycardia
As used in the present specification, the following words and phrases are generally s intended to have the meanings as set forth below, except to the extent that the context in which they are used indicates otherwise.
The term “heterocycle” or “heterocyclyl” refers to a monoradical saturated group having a single ring or multiple condensed rings, having from 1 to 40 carbon atoms and from 1 to 10 heteroatoms, preferably 1 to 4 heteroatoms, selected from nitrogen, sulfur, phosphorus, and/or oxygen within the ring. Heterocyclic groups can have a single ring or multiple condensed rings. Preferred heterocyclics include tetrahydrofuran, tetrahydrothiofuranyl, pyranyl, 4-thiopyranyl, morpholino, piperidinyl, and the like.
Unless otherwise constrained by the definition for the heterocyclic substituent, such heterocyclic groups can be optionally substituted with 1 to 5, and preferably 1 to 3 substituents, selected from the group consisting of alkyl, alkoxy, cycloalkyl, acyl, acylamino, acyloxy, amino, substituted amino, cyano, halogen, hydroxyl, oxo, thioketo, carboxyl, carboxylalkyl, thiol, thioalkoxy, aryl, aryloxy, heteroaryl, nitro, -SO-alkyl, -SO-substituted alkyl, -SO-aryl, -SO-heteroaryl, -SO,-alkyl, -SO;-substituted alkyl, -SO,-aryl and -SO,- heteroaryl.
The term "halogen" refers to fluorine, bromine, chlorine, and iodine atoms.
The term “oxo” refers to =O.
The term "hydroxyl" refers to the group -OH.
The term “alkyl” refers to a monoradical branched or unbranched saturated hydrocarbon chain having from 1 to 20 carbon atoms. This term is exemplified by groups such as methyl, ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, t-butyl, n-hexyl, n-decyl, tetradecyl, and the like.
The term “lower alkyl” refers to a monoradical branched or unbranched saturated hydrocarbon chain having from 1 to 6 carbon atoms. This term is exemplified by groups such as methyl, ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, t-butyl, n-hexyl, and the like.
The term "substituted lower alkyl" refers to lower alkyl as defined above substituted by one or more groups chosen from hydroxyl, thiol, alkyithiol, halogen, alkoxy, amino, amido, carboxyl, cycloalkyl, substituted cycloalkyl, heterocycle, cycloheteroalkyl, substituted
Cycloheteroalkyl, acyl, carboxyl, aryl, substituted aryl, aryloxy, hetaryl, substituted hetaryl, aralkyl, heteroaralkyl, alkyl alkenyl, alkyl alkynyl, alkyl cycloalkyl, alkyl cycloheteroalkyl, and cyano. These groups may be attached to any carbon atom of the lower alkyl moiety.
The term “cycloalkyl” refers to cyclic alkyl groups of from 3 to 20 carbon atoms having a single cyclic ring or multiple condensed rings. Such cycloalkyl groups include, by way of example, single ring structures such as cyclopropyl, cyclobutyl, cyclopentyl, cyclooctyl, and the like, or multiple ring structures such as adamantanyl, and bicyclo[2.2. 1]heptane, and the like.
The term “substituted cycloalkyl” refers to cycloalkyl groups having from 1 to 5 substituents, and preferably 1 to 3 substituents, selected from the group consisting of alkoxy, cycloalkyl, acyl, acylamino, acyloxy, amino, substituted amino, cyano, halogen, hydroxyl, keto, thioketo, carboxyl, carboxylalkyl, thiol, thicalkoxy, aryl, aryloxy, heteroaryl, heteroaryloxy, heterocyclyl, heterocyclooxy, hydroxyamino, alkoxyamino, nitro, -SO-alkyl, -
SO-aryl, -SO-heteroaryi, -SO,-alkyl, -SO,-substituted alkyl, -SO,-aryl and -SOz-heteroaryl..
The term "alkoxy" refers to the group -OR, where R is alkyl, lower alkyl or substituted lower alkyl as defined above.
The term "acyl" denotes groups -C (O) R, where R is hydrogen, lower alkyl, substituted . lower alkyl, aryl, substituted aryl, amino, and the like.
The term “amino” refers to the group -NHa. :
The term “substituted amino refers to the group -NRR where each R is independently selected from the group consisting of hydrogen, alkyl, cycloalkyl, aryl, heteroaryl and heterocyclyl, provided that both R’s are not hydrogen. All substituents may be optionally further substituted by alkyl, alkoxy, halogen, CFs, amino, substituted amino, cyano, or —
S(O)R, in which R is alkyl, aryl, or heteroaryl and nis 0, 1 or 2,
The term "aryl" refers to an aromatic carbocyclic group having at least one aromatic ring (e.g., phenyl or biphenyl) or multiple condensed rings in which at least one ring is aromatic, (e.g., 1,2,3 ;4-tetrahydronaphthyl, naphthyl, anthryl, or phenanthryl).
The term “substituted aryl" refers to ary! optionally substituted with one or more functional groups, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, sulfamido, and the like.
The term "aryloxy" denotes groups _OAr, where Ar is aryl, substituted aryl, heteroaryl,
or substituted heteroaryl.
The term “heteroaryl” refers to an aromatic group (i.e., unsaturated) comprising 1 to 15 carbon atoms and 1 to 4 heteroatoms selected from oxygen, nitrogen and sulfur within at least one ring, which may be optionally substituted with halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, or sulfamido.
The compositions of this invention are A, receptor agonists, useful for the treatment of coronary electrical disorders such as arrhythmia, including PSVT atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia. The compositions may be administered orally, intravenously, through the epidermis or by any other means known in the art for administering a therapeutic agent.
The method of treatment comprises the administration of an effective quantity of the chosen compound, preferably dispersed in a pharmaceutical carrier. Dosage units of the active ingredient are selected from the range of 0.0003-0.009 mg/kg, dependent upon the route of administration, and the age and condition of the patient. These dosage units may be administered one to ten times daily for acute or chronic disorders.
If the final compound of this invention contains a basic group, an acid addition salt may be prepared. Acid addition salts of the compounds are prepared in a standard manner in a suitable solvent from the parent compound and an excess of acid, such as hydrochloric, hydrobromic, sulfuric, phosphoric, acetic, maleic, succinic, or methane sulfonic. The hydrochloric salt form is especially useful. If the final compound contains an acidic group, cationic salts may be prepared. Typically the parent compound is treated with an excess of an alkaline reagent, such as hydroxide, carbonate or alkoxide, containing the appropriate cation.
Cations such as Na", K*, Ca' and NH," are examples of cations present in pharmaceutically acceptable salts. Certain of the compounds form inner salts or zwittcrions which may also be acceptable.
Pharmaceutical compositions including the compounds of this invention, and/or derivatives thereof, may be formulated as solutions or lyophilized powders for parenteral administration. Powders may be reconstituted by addition of a suitable diluent or other pharmaceutically acceptable carrier prior to use. If used in liquid form the compositions of this invention are preferably incorporated into a buffered, isotonic, aqueous solution.
Examples of suitable diluents are normal isotonic saline solution, standard 5% dextrose in
Water and buffered sodium or ammonium acetate solution. Such liquid formulations are suitable for parenteral administration, but may also be used for oral administration. It may be desirable to add excipients such as polyvinylpyrrolidinone, gelatin, hydroxy cellulose, acacia, polyethylene glycol, mannitol, sodium chloride, sodium citrate or any other excipient known to one of skill in the art to pharmaceutical compositions including compounds of this invention. Alternatively, the compounds of Formula I may be encapsulated, tableted or prepared in an emulsion or syrup for oral administration. Pharmaceutically acceptable solid or liquid carriers may be added to enhance or stabilize the composition, or to facilitate preparation of the composition. Liquid carriers include syrup, peanut oil, olive oil, glycerin, saline, alcohols and water. Solid carriers include starch, lactose, calcium sulfate, dihydrate, teffa alba, magnesium stearate or stearic acid, talc, pectin, acacia, agar or gelatin. The carrier may also include a sustained release material such as glycerol monostearate or glycerol distearate, alone or with a wax. The amount of solid carrier varies but, preferably, will be between about 20 mg to about 1 gram per dosage unit. The pharmaceutical dosages are made using conventional techniques such as milling, mixing, granulation, and compressing, when necessary, for tablet forms; or milling, mixing and filling for hard gelatin capsule forms.
When a liquid carrier is used, the preparation will be in the form of a syrup, elixir, emulsion . OF an aqueous or non-aqueous suspension. Such a liquid formulation may be administered directly or filled into a soft gelatin capsule. + The Examples that follow serve to illustrate this invention. The Examples are intended to in no way limit the scope of this invention, but are provided to show how to make and use the compounds of this invention. In the Examples, all temperatures are in degrees
Centigrade. : EXAMPLES
The compounds of Formula I may be prepared by conventional methods, in the manner disclosed in US Patent No. 5,789,416, the entire disclosure of which is hereby -incorporated by reference.
EXAMPLE 1
Al Preparation of (3-(S)-aminotetrahydrofuranyl Jpurine riboside ~ Step 1. Resolution of 3-(S )-aminotetrahydrofuran
A mixture of 3-aminotetrahydrofuran hydrochloride (0.5 GM, 4 mmol) and
(S)(+)-10-camphorsulfonyl chioride (1.1 gm, 4.4 mmol) in pyridine (10 ml) was stirred for 4 hours at room temperature and then concentrated. The residue was dissolved in EtOAc and washed with 0.5N HCL, sodium bicarbonate and brine. The organic layer was dried over
MgSO, filtered, and concentrated to give 1. 17 g of a brown oil (97%) which was chromatographed on silica gel (25% to 70% EtOAc/Hex). The white solid obtained was repeatedly recrystallized from acetone until an enhancement of greater than 90% by 1H NMR was achieved, to yield the (S)-camphorsulfonate of, 3-(S)-aminotetrahydrofuran.
Step 2. Preparation of 3A(S )-aminotetrahydrofuran hydrochloride
The (S)-camphorsulfonate of. 3-(S)-aminotetrahydrofuran (170 mg, 0.56 mmol) was dissolved in conc. HCVACOH (2 mL each), stirred for 20 hours at room temperature, washed three times with CH,Cl, (10 ml) and concentrated to dryness to give 75 mg of 3«(S)- aminotetrahydrofuran, as a white solid.
Step 3. Preparation of 6-(3-( S)-aminotetrahydrofuranyl)purine riboside
A mixture of 6-chloropurine riboside (30 mg, 0.10 mmol), 3-(S)- aminotetrahydrofuran hydrochloride (19 mg, 0.15 mmol) and triethylamine (45 ml, 0.32 mmol) in methanol (0.5 ml) was heated to 80° C for 18 hours. The mixture was cooled, concentrated and chromatographed with 95/5 (CHzCl/MeOH) to give 8 mg (24%) of 6-(3- (S)-aminotetrahydrofuranyl)purine riboside as a white solid.
B. Preparation of ( 3-(R)-aminotetrahydrofuranyl ypurine riboside (CVT-510)
Similarly, following steps 1-3 above, but replacing (S)H(+)-10-camphorsulfonyl chloride with RH) 0-camphorsulfonyl chloride, the following compound was prepared: 6-(3-(R)-aminotetrahydrofuranyl)purine riboside (CVT-510).
Similarly, other enantiomers of the compounds of Formula are prepared.
EXAMPLE 2
The effect of CVT-510 on prolongation of AH interval, a measure of an adenosine A mediated effect of CVT-510, and on the heart rate (sinus rate) of patients with PSVT was tested in patients undergoing a clinically indicated electrophysiology study. In the first study patients volunteers were administered a single bolus of. CVT-510. In the second study PSVT was induced in patients prior to the administration of CVT-510.
All antiarrhythmic agents, including digoxin, beta-blockers and calcium-channel blockers were discontinued for five half lives prior to the study.
Patients were excluded from the study if the PR interval was > 200 ms or resting heart rate was < 60 or >100/min. Other exclusion criteria included evidence of ventricular preexcitation, Class II-IV congestive heart failure or asthma. Patients were also required to have normal baseline electrophysiologic parameters, including a paced AV nodal
Wenckebach cycle length 500 ms, an AH interval between 60 and 125 ms and an HV - interval 35-55 ms. All patients were 18 years of age.
Quadripolar catheters were introduced percutaneously and advanced under fluoroscopic guidance to the high right atrium and across the tricuspid annulus to record the
His bundle potential. Bipolar intracardiac recordings were filtered at 30 to 500 Hz and displayed with surface ECG leads on a digital monitor. Data were stored on optical disk. All patients had continuous ECG and non-invasive blood pressure monitoring throughout the study.
Cardiac stimulation was performed with a programmable stimulator with an isolated constant-current source. Stimuli were delivered as rectangular pulses of 2 ms duration at four . times diastolic threshold. The study design was open-label with dose escalation, with the + latter determined by tolerability. A single intravenous bolus of CVT-510 was administered to -each patient after baseline electrophysiologic measurements were made.
After a bolus dose of CVT-510 was given, blood pressure, heart rate, 12-lead ECG and AH and HV intervals were recorded at 1,5, 10, 15, 20 and 30 min and then every 15 min for up to 1 hour post-bolus or until the parameters returned to baseline. The AH and HV intervals were determined by measuring the last interval during a 15 beat drive at a paced cycle length of 600, 500 and 400 ms (unless precluded by pacing-induced AV nodal Wenckebach).
Administration of CVT-510 started at a dose of 0.3 ug/kg. Dose escalation proceeded with additional groups of patients receiving doses of 1, 3, 7.5, 10, 15 and 30 ug/kg based on tolerability and the absence of AV nodal Wenckebach or 3° AY block during sinus rhythm. :
Data are expressed as mean + SD. Based on the results of the normality test, a paired t-test or a non-parametric signed-rank test (SR) was used to determine the significance of
CVT- 510’s effects on heart rate, blood pressure, ECG and AV nodal conduction times (AH and HV) for each dosing group (e.g., 0.3, 1.0, 3.0, 7.5, 10.0, 15.0 and 30.0 pg/kg). Similarly, analysis of variance (ANOVA) or the Kruskal-Wallis test (KW) was used to compare the AH intervals during sinus rhythm and atrial pacing at all doses. No adjustment for multiple comparisons were made, and a P value < 05 were used to determine the significance of the differences between mean values.
The results are summarized as follows:
Figure 1 shows the timecourse of the effect of various doses of CVT-510 on the AH interval.
The maximal effect of CVT-510 on the AH interval occurred one minute after dosing at a dose of 7.5 pg/kg.
Table 1, below shows the results of treatment of patients with PSVT with doses of CVT-510 ranging between 0.003 pg/kg 0.015 pg/kg, administered as a bolus, at least one minute apart, until the arrhythmia was terminated.. Most patients (75%-100%, mean 98%) converted to sinus rhythm after the first bolus of CVT-510. i after Bolus] | after Bolus 2 | conversion
EE ea me [100 | 0 [100 | canotbedclormined ows eo [eo | os [ __L__
Seed | 75 | 25 [100 | camotbodetermined
Hseeto) | so | 10 | _e0 | o0sé 1 0%
AIL | oss | woos | oes | 008 | 09%
The data shows that CVT-510 slows AV nodal conduction in a dose-dependent manner. The onset of action was rapid (observed by 1 min post-administration) and its effects were mostly eliminated by 20 min. There was also no effect on sinus rate, a finding suggesting a relatively greater sensitivity of the AV node than the sinoatrial node to this A adenosine receptor agonist.
CVT-510 also showed specificity with respect to the A, adenosine receptor, i.c., there was no effect on systemic blood pressure. The effects of CVT-510 on the AV node (but not on coronary conductance) are completely abolished by the selective A, receptor antagonist
CPX. CVT-510 was also shown to have no effect on left ventricular pressure or dPdt" max.
In summary, the data shows that CVT-510 has novel and unique properties that make it a useful antiarrhythmic agent for the treatment of PSVT and for control of ventricular rate during atrial filbrillation/flutter, Its selective A agonist properties allow CVT-510 to have significant negative dromotropic effects on the AV node without causing concomitant ~ hyoptension due to A,— adenosine receptor mediated effects. Its relatively long half-life compared with adenosine, also makes it possible to sustain a beneficial therapeutic effect over a longer duration. - | : :
Also, CVT-510 at low concentrations rapidly terminates PSVT, without causing hypotension, HV prolongation, or depressing sinus or AV nodal conduction after restoring
SR. Selective depression of AV nodal conduction time without hypotension indicates that a constant infusion of CVT-510 may also be useful to control ventricular rate in atrial fibrillation, even in patients with left ventricular dysfunction.
The invention now having been fully described, it will be apparent to one of ordinary skill in the art that many changes and modifications can be made thereto without departing from the spirit or scope of the appended claims.
Claims (13)
1. Use of an adenosine A; receptor agonist of Formula I for treating arrhythmia in a mammal NHR! PH L FN H le] H Formula I wherein: Ris an optionally substituted heterocyclic group; and said minimal dose is in the range of 0.0003-0.009 mg/kg.
2. The use of claim 1, wherein R; is 3-tetrahydrofuranyl, 3-tetrahydrothiofuranyl, 4- pyranyl, or 4-thiopyranyl.
3. The use of claim 2, wherein R| is 3-tetrahydrofuranyl.
4, The use of claim 3, wherein R; is (R)-3-tetrahydrofuranyl, namely 6-(3-(R)- aminotetrahydrofuranyl)purine riboside.
5. The use of claim 4, wherein the administration is by intravenous injection.
6. The use of claim 4, wherein administration is by a single bolus. 12 AMENDED SHECT
7. The use of claim | where the arrhythmias are selected from the group consisting of atrial fibrillation, atrial flutter, and paroxysmal atrial tachycardia.
8. The use of claim 7, wherein R; is 3-tetrahydrofuranyl, 3-tetrahydrothiofuranyl, 4- pyranyl, or 4-thiopyranyl.
9. The use of claim 8, wherein R; is 3-tetrahydrofuranyl.
10. The use of claim 9, wherein R; is (R)-3-tetrahydrofuranyl, namely 6-(3-(R)- aminotetrahydrofuranyl)purine riboside.
11. The use of claim 1 wherein said mammal is a human.
12. The use of claim 1, substantially as herein described and exemplified and/or described with reference to the accompanying figure.
13 AMENDED Shite
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US23101100P | 2000-09-08 | 2000-09-08 |
Publications (1)
Publication Number | Publication Date |
---|---|
ZA200301684B true ZA200301684B (en) | 2004-04-07 |
Family
ID=32849351
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ZA200301684A ZA200301684B (en) | 2000-09-08 | 2003-02-28 | Purine ribosides as antiarrhythmics. |
Country Status (2)
Country | Link |
---|---|
RU (1) | RU2248208C2 (en) |
ZA (1) | ZA200301684B (en) |
-
2001
- 2001-09-07 RU RU2003109941/15A patent/RU2248208C2/en not_active IP Right Cessation
-
2003
- 2003-02-28 ZA ZA200301684A patent/ZA200301684B/en unknown
Also Published As
Publication number | Publication date |
---|---|
RU2248208C2 (en) | 2005-03-20 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
RU2332220C2 (en) | Methods of heartbeat frequency reduction including administration of adenosine a1 receptor agonist together with beta-blocker, calcium canal blocker or cardiac glycoside | |
EP0920438B1 (en) | N6 heterocyclic substituted adenosine derivatives | |
AU2003235466B2 (en) | Method for treating arrhythmias | |
JP3836128B2 (en) | Purine composition and administration method | |
US6368573B1 (en) | Diagnostic uses of 2-substituted adenosine carboxamides | |
EP0774259A1 (en) | New use of organic compounds | |
EP1315508B1 (en) | Purine ribosides as antiarrhythmics | |
AU2001292591A1 (en) | Purine ribosides as antiarrhythmics | |
ZA200301684B (en) | Purine ribosides as antiarrhythmics. | |
KR100518144B1 (en) | Purine ribosides as antiarrhythmics | |
Allan et al. | BW A256C, a chemically novel class 1 antiarrhythmic agent. A comparison of in vitro and in vivo activity with other class 1 antiarrhythmic agents | |
Patterson et al. | Sublingual absorption of the quaternary ammonium antiarrhythmic agent, UM-272 | |
ITo et al. | Effects of Nifekalant Injected into the Pericardial Space on the Transmural Dispersion of Repolarization in Pig | |
MXPA99001509A (en) | N6 | |
CZ13192A3 (en) | the use of 2'-o-alkyladenosine derivatives for the preparation of a medicament suitable for treating neurodegenerative disturbances |