U.S. patent application number 12/898297 was filed with the patent office on 2011-04-07 for metabolically inert antifolates for treating disorders of abnormal cellular proliferation and inflammation.
This patent application is currently assigned to Chelsea Therapeutics, Inc.. Invention is credited to Simon Pedder, Michael J. Roberts.
Application Number | 20110081338 12/898297 |
Document ID | / |
Family ID | 36037042 |
Filed Date | 2011-04-07 |
United States Patent
Application |
20110081338 |
Kind Code |
A1 |
Roberts; Michael J. ; et
al. |
April 7, 2011 |
METABOLICALLY INERT ANTIFOLATES FOR TREATING DISORDERS OF ABNORMAL
CELLULAR PROLIFERATION AND INFLAMMATION
Abstract
The present invention provides compositions and methods for the
treatment of disorders of abnormal cell proliferation and/or
inflammation, such as psoriasis and inflammatory bowel disease, in
a human or other host animals.
Inventors: |
Roberts; Michael J.;
(Charlotte, NC) ; Pedder; Simon; (Fort Mill,
SC) |
Assignee: |
Chelsea Therapeutics, Inc.
|
Family ID: |
36037042 |
Appl. No.: |
12/898297 |
Filed: |
October 5, 2010 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
11223433 |
Sep 8, 2005 |
7829708 |
|
|
12898297 |
|
|
|
|
60607883 |
Sep 8, 2004 |
|
|
|
60611482 |
Sep 20, 2004 |
|
|
|
Current U.S.
Class: |
424/133.1 ;
424/142.1; 514/1.1; 514/171; 514/249 |
Current CPC
Class: |
A61P 15/02 20180101;
C07D 239/95 20130101; A61P 3/10 20180101; A61P 13/00 20180101; A61P
17/00 20180101; A61P 1/00 20180101; A61P 3/00 20180101; A61P 31/04
20180101; A61P 19/02 20180101; A61P 37/02 20180101; A61P 25/00
20180101; A61P 11/06 20180101; A61P 17/18 20180101; A61P 7/00
20180101; A61P 11/00 20180101; A61P 11/16 20180101; A61P 35/00
20180101; A61P 43/00 20180101; A61P 29/00 20180101; A61P 9/12
20180101; A61P 37/08 20180101; A61P 9/00 20180101; A61P 25/16
20180101; A61P 17/06 20180101; A61P 13/12 20180101; A61P 17/02
20180101; A61P 25/28 20180101; A61P 25/18 20180101; A61P 27/02
20180101; A61P 9/08 20180101; A61P 37/00 20180101; A61P 9/10
20180101; A61P 15/00 20180101 |
Class at
Publication: |
424/133.1 ;
514/249; 514/171; 514/1.1; 424/142.1 |
International
Class: |
A61K 39/395 20060101
A61K039/395; A61K 31/517 20060101 A61K031/517; A61K 31/573 20060101
A61K031/573; A61K 38/16 20060101 A61K038/16; A61P 35/00 20060101
A61P035/00; A61P 19/02 20060101 A61P019/02; A61P 29/00 20060101
A61P029/00; A61P 3/00 20060101 A61P003/00; A61P 25/28 20060101
A61P025/28; A61P 11/06 20060101 A61P011/06; A61P 25/16 20060101
A61P025/16 |
Claims
1. A method for treating a condition responsive to inhibition of
one or more of dihydrofolate reductase (DHFR), thymidylate synthase
(TS), folylpolyglutamyl synthase (FPGS), glycinamide ribonucleotide
transformylase (GAR), and aminoimidazole carboxamide ribonucleotide
transformylase (AICAR), the method comprising administering to a
patient in need of treatment for the condition an effective amount
of a compound of the formula: ##STR00030## or its pharmaceutically
acceptable salt, wherein: if Y.sup.1 and Y.sup.2 are both oxygen,
and V.sup.1 and V.sup.2 are both oxygen, then at least two of
R.sup.1, R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6 and R.sup.7
are not H; X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH,
NCH.sub.3, or NR.sup.7; R.sup.1, R.sup.2, R.sup.3, R.sup.4, and
R.sup.7 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, acyl,
--C(O)-(alkyl), --C(O)-(alkenyl), --C(O)-(alkynyl),
--C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue, or an amino acid acyl
residue; R.sup.5 and R.sup.6 are independently selected from H,
optionally substituted alkyl, optionally substituted alkenyl or
alkynyl, lipid, phospholipid, carbohydrate, peptide, cholesterol,
an amino acid residue, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; each Y.sup.1,
Y.sup.2, and Y.sup.3 independently is O, S, or NJ.sup.1; each
V.sup.1 and V.sup.2 independently is O, S, or NJ.sup.1; each
V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1, NH.sub.2,
NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; each J.sup.1
and J.sup.2 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and each R.sup.101,
R.sup.102, and R.sup.103 are independently hydrogen, alkyl,
alkenyl, alkynyl, aryl, acyl, heteroaryl, heteroalkyl, hydroxyl,
alkoxy, cyano, azido, halogen, nitro, SO.sub.2, SO.sub.3,
thioalkyl, or amino.
2. The method of claim 1, wherein the condition is a condition of
abnormal cellular proliferation, inflammation, or both abnormal
cellular proliferation and inflammation.
3. The method of claim 2, wherein the condition is a condition of
abnormal cellular proliferation.
4. The method of claim 3, wherein the condition is a non-neoplastic
abnormal cellular proliferation disorder.
5. The method of claim 4, wherein the condition is psoriasis.
6. The method of claim 4, wherein the condition is psoriatic
arthritis.
7. The method of claim 4, wherein the condition is
atherosclerosis.
8. The method of claim 3, wherein the condition is a neoplastic
abnormal cellular proliferation disorder.
9. The method of claim 8, wherein the condition is cancer.
10. The method of claim 9, wherein the cancer is selected from the
group consisting of breast cancer, skin cancer, bone cancer,
prostate cancer, liver cancer, lung cancer, brain cancer, larynx
cancer, gallbladder cancer, pancreatic cancer, rectal cancer,
parathyroid cancer, thyroid cancer, adrenal cancer, neural tissue
cancer, colon cancer, stomach cancer, bronchial cancer, renal
cancer, basal cell carcinoma, squamous cell carcinoma, metastatic
skin carcinoma, osteo sarcoma, Ewing's sarcoma, myeloma, giant cell
tumor, small-cell lung tumor, islet cell tumor, primary brain
tumor, acute and chronic lymphocytic and granulocytic tumors,
hairy-cell tumor, adenoma, hyperplasia, medullary carcinoma,
mucosal neuronas, intestinal ganglioneuromas, hyperplastic corneal
nerve tumor, Wilm's tumor, seminoma, ovarian tumor, neuroblastoma,
retinoblastoma, soft tissue sarcoma, malignant carcinoid, topical
skin lesion, Kaposi's sarcoma, malignant hypercalcemia, renal cell
tumor, polycythemia vera, adenocarcinoma, glioblastoma multiforma,
leukemia, lymphoma, malignant melanoma, and epidermoid
carcinoma.
11. The method of claim 2, wherein the condition is a condition of
inflammation.
12. The method of claim 11, wherein the condition is selected from
the group consisting of inflammatory bowel disease (IBD), chronic
obstructive pulmonary disease (COPD), sarcoidosis, asthma,
arthritis, osteoarthritis, cardiovascular disease, multiple
sclerosis, Parkinson's disease, and Alzheimer's disease.
13. The method of claim 12, wherein the condition is Crohn's
disease.
14. The method of claim 12, wherein the condition is ulcerative
colitis.
15. The method of claim 12, wherein the condition is rheumatoid
arthritis.
16. The method of claim 12, wherein the condition is systemic lupus
erythematosus.
17. The method of claim 1, further comprising administering a
second therapeutic agent.
18. The method of claim 17, wherein the second therapeutic agent is
an anti-neoplastic agent.
19. The method of claim 17, wherein the second therapeutic agent is
selected from the group consisting of anti-angiogenic agents,
alkylating agents, anti-metabolites, cytotoxic agents, and
anti-rheumatoid arthritis agents.
20. The method of claim 17, wherein the second therapeutic agent is
selected from the group consisting of non-steroidal
anti-inflammatory agents, analgesics, corticosteroids, and
disease-modifying anti-rheumatic agents.
21. The method of claim 20, wherein the disease-modifying
anti-rheumatic agent is a TNF blocker.
22. The method of claim 21, wherein the TNF blocker is selected
from the group consisting of etanercept, infliximab, adalimumab,
and CDP-870.
23. The method of claim 17, wherein the second therapeutic agent is
an anti-autoimmune disease agent.
24. The method of claim 17, wherein the second therapeutic agent is
selected from the group consisting of rituximab, abatacept,
actemra, leflunomide, and methotrexate.
25. The method of claim 17, wherein the second therapeutic agent
and the compound of said formula are administered separately.
26. The method of claim 17, wherein the second therapeutic agent
and the compound of said formula are administered in an effective
ratio of dosages.
27. The method of claim 1, wherein the compound of said formula is
in the form of a pharmaceutically acceptable salt.
28. The method of claim 27, wherein the salt is an alkali metal
salt.
29. The method of claim 28, wherein the alkali metal is sodium or
potassium.
Description
[0001] The present application is a division of U.S. patent
application Ser. No. 11/223,433, filed Sep. 8, 2005, which claims
priority to U.S. Prov. App. No. 60/607,883, filed Sep. 8, 2004, and
U.S. Prov. App. No. 60/611,482, filed Sep. 20, 2004, the
disclosures of which are incorporated herein by reference in their
entireties.
FIELD OF THE INVENTION
[0002] The invention is in the area of pharmaceutical chemistry,
and is in particular, metabolically inert etiolate compounds for
the prevention and treatment of disorders of abnormal cell
proliferation and/or inflammation, such as psoriasis and Crohn's
disease.
BACKGROUND OF THE INVENTION
[0003] Disorders of abnormal cell proliferation are characterized
by inappropriate growth or multiplication of one or more cell
types. They include malignant (i.e., cancer) as well as
non-malignant disorders. Many of these diseases also include an
inflammatory component. Psoriasis represents one type of
non-malignant disorder of abnormal cell proliferation. The disorder
is characterized by psoriatic skin plaques representing highly
localized sites of deregulated growth and inflammation. While the
cause of psoriasis is poorly understood, it is thought to involve
both a genetic and environmental component. Moderate-to-severe
psoriasis has traditionally been treated with systemic therapies
such as cyclosporine, methotrexate, retinoids, and phototherapy
(i.e., ultraviolet B, psoralen plus ultraviolet A). Traditional
treatments, however, suffer limitations including significant side
effects, lack of durable efficacy, and inconvenient administration
schedules.
[0004] Uncontrolled or inappropriate chronic inflammatory responses
are characteristic of a variety of diseases and disorders.
Inflammatory bowel disease (IBD), including both Crohn's disease
and ulcerative colitis, provides one example of an inflammatory
disorder. IBD affects the quality of life of more than one million
Americans. At present, aminosalicylates (5-ASA), corticosteroids,
immune modifiers and antibiotics are used to treat Crohn's disease.
Current therapies, however, are ineffective in many patients and
present significant side effects including slow onset of action and
toxicity.
[0005] Antifolates are compounds that interfere with various stages
of foliate metabolism. An intact foliate enzyme pathway is
important to maintain de novo synthesis of the building blocks of
DNA, as well as of the important amino acids. Antifolate targets
include the various enzymes involved in foliate metabolism,
including (i) dihydrofolate reductase (DHFR); (ii) thymidylate
synthase (TS); (iii) folylpolyglutamyl synthase; and (iv)
glycinamide ribonucleotide (GAR) and aminoimidazole carboxamide
ribonucleotide (AICAR) transformylases.
[0006] Antifolates are folate acid analogs. For a general review of
antifolates, see Montgomery J A and Piper Jr. Design and Synthesis
of Folate Analogs as Antimetabolites. In Folate Antagonists as
Therapeutic Agents. Volume 1: Biochemistry, Molecular Actions and
Synthetic Design. Eds. Sirotnak F M, Burchall J J, Ensminger W D
and Montgomery J A. Academic Press. pp 219-261, 1984; Thomas W.
Current Oncology Reports (2003) 5:114-125; Graffner N M. Approaches
to Soft Drug Analogues of Dihydrofolate Reductase Inhibitors, in
Comprehensive Summaries of Uppsala Dissertations from the Faculty
of Pharmacy 252 (2001); Beale, P., and Clarke, S. Tomudex. Clinical
development. In: A. L. Jackman (ed.), Antifolate Drugs in Cancer
Therapy, pp. 167-191. Allegra C J: Antifolates, in Chabner B A,
Collins J M (eds): Cancer Chemotherapy: Principles & Practice,
pp 110-153. Philadelphia, Lippincott, 1990.
[0007] Folic acid contains a pteridine ring, para-aminobenzoic acid
and a glutamate residue.
##STR00001##
[0008] Methotrexate, a DHFR inhibitor, is among the earliest
antifolates. It is a classical antifolate, meaning it is
characterized by a p-aminobenzogylglutamic acid side chain, and
closely resembles the folic acid molecule. MTX differs from folic
acid by the substitution of an amino group for a hydroxyl at the
4-position of the pterdine ring and by the methylation of the amine
of the para-aminobenzoic moeity. The substitution of an amino group
for a hydroxyl at the 4-position of the pterdine ring changes the
enzyme substrate into a tight binding inhibitor of DHFR.
##STR00002##
[0009] Both MTX and naturally occurring folate compounds undergo
intracellular metabolism to polyglutamate derivatives. This
polyglutamylation is catalyzed by the enzyme folylpolyglutamyl
synthase (FPGS), which attaches up to six glutamate residues to the
molecule, which helps to trap it within the cell. Polyglutamylation
of MTX occurs more slowly compared to naturally occurring
antifolates, but the resulting methotrexate polyglutamylates have
extremely long intracellular half-lives, and can be detected in
some tissues more than several months after a single drug
administration (Takimoto C H et al. Oncology (1995) 9(7):
649-656).
[0010] The most common use of MTX is as an anti-cancer drug. MTX is
curative of choriocarcinoma and Burkett's lymphoma. It has also
widely used as a single agent or in combination with other drugs
for the treatment of various forms of human cancer. More recently,
MTX has been shown to have anti-inflammatory and immunosuppressive
properties with accompanying activity against autoimmune disorders.
MTX is now widely prescribed as an immunosuppressive agent in the
treatment of autoimmune diseases, including rheumatoid arthritis
(Weinblatt M E et al. N. Engl. J. Med. (1985) 312:818; Wilke W S
(Ed). Methotrexate Therapy in Rheumatic Disease. Marcel Dekker,
Inc. (1989). Intrinsic and acquired resistance to MTX and other
antifolate analogues limits their clinical effectiveness, however.
Apart from resistance, major limitations of MTX treatment include
bone marrow toxicity, gastrointestinal ulceration and liver and
kidney damage.
[0011] A number of antifolates have been designed to overcome these
limitations. Rational design has focused, for example, on the
development of antifolates with greater lipid solubility and/or
improved transport characteristics relative to methotrexate
(Takimoto C H et al. Oncology (1995) 9(7); 649-656). Representative
non-classical agents include trimetrexate and piritrexim (Kamen B A
et al. J. Biochem. Pharmacol. (1984) 33: 1697-1984; Duch D S et al.
Cancer Res. (1982) 42: 3987-3994). Unlike classical antifolates,
non-classical antifolates lack the glutamate moiety, and therefore
do not require carrier-mediated cellular uptake. These lipophilic
antifolates are used against opportunistic infections (e.g.,
Pneumocystic carinii pneumonia, PCP) in individuals with AIDS and
other disorders of the immune system and have undergone extensive
clinical testing as anticancer agents.
##STR00003##
[0012] Inhibitors of glycinamide ribotide formyltransferase (GARFT)
have also been developed. Lometrexol ((5,10-dideazatetrahydrofolate
[DDATHF]) is a specific GARFT inhibitor that has shown anti-tumor
properties (Habeck L L et al. Cancer Res. (1994) 54: 1021-1026).
Early clinical trials, however, were confounded by cumulative
myelosuppression that prevented repetitive administration (Roberts
J D. Cancer Chemother Pharmacol. (2000) 45(2):103-10). LY309887
(6R-2',5'-thienyl-5,10-dideazatetrahydrofolic acid) is a thiophene
analogue of lometrexol, is a second generation GARFT inhibitor
(Mendelsohn L G. Investig. New Drugs (1996) 14: 287-294).
##STR00004##
[0013] In 1991, Nair et al. demonstrated that contrary to the
widely accepted notion, polyglutamylation of classical antifolates
is not essential for anti-tumor activity and further, that this
metabolic transformation is actually undesirable because it may
cause the loss of pharmacological control and target specificity of
the drug (Nair M G et al.
##STR00005##
[0014] Other antifolates in clinical development specifically
target folate-dependent enzymes such as TS or GARFT, thereby
directly affecting pools of nucleotides available for DNA synthesis
(Takemura Y. et al. Anti-Cancer Drugs (1997) 8: 3-16; Habeck L L et
al. Cancer Res (1994) 54: 1021-1026). Direct and specific TS
inhibitors have been studied as potential anticancer drugs (Stout T
J et al. Biochemistry (1999) 38: 1607-1617). Of these, Tomudex
(raltitrexed; ZD1649),
[N-{5-[N-(3-,4-dihydro-2-methyl-4-oxoquinazoline-6-yl-methyl)-N-methylami-
ne]-2-theroyl}-L-glutei acid], is one of the most extensively
evaluated and has been approved for treatment in Europe (Van Custom
Euro. J. Cancer, (1999) 35(Suppl. 1): 1-2; Jack man A L. Invest.
New Drugs, (1996) 14: 305-316). Comdex undergoes substantial
polyglutamylation within the cell. Comdex and its polyglutamates do
not appear to inhibit DHFR, GAR or AICAR transformylase, suggesting
that the drug is a pure TS inhibitor. J. Med. Chem (1991) 34:
222-227). This new finding let to the discovery of a number of
nonpolyglutamylatable classical antifolates (Nair M G et al. Proc.
Amer. Assoc. Cancer. Research. (1998) 39:431).
[0015] U.S. Pat. No. 5,073,554 (Nair) describes
methylene-1-deazaminopterine (MDAM), a nonpolyglutamylatable
antifolate compound. MDAM has been developed as an experimental
anticancer drug for the treatment of human solid tumors (Cao S. et
al. Clinical Cancer Research (1996) 2(4): 707-712); Johansen M et
al. Cancer Chemother Pharmacol. (2004) 53(5):370-6). U.S. Pat. No.
5,550,128 (Nair et al) describes the active enantiomer of MDAM as
the one possessing the L-configuration.
##STR00006##
[0016] Further investigation by Nair et al. of the metabolic
disposition of certain non-polyglutamylatable antifolates led to
the unexpected finding that the presence of the
4-methyleneglutamate moiety modulates the binding of such compounds
to the liver enzyme aldehyde oxidase, which mediates their
oxidative deactivation to the corresponding 7-hydroxy derivatives
(Cellular. Pharmacology (1996) 3: 29). U.S. Pat. No. 5,912,251
(Nair) describes metabolically inert classical antifolates,
including 4-Amino-4-deoxy-5,8,10-trideazapteroyl-4'-methylene
glutamic acid, which are non-polyglutamylatable and
non-hydroxylatable. They are said to be useful in the treatment of
neoplastic disease (leukemia, ascetic and solid tumors), asthma and
related anti-inflammatory disease, and for the treatment of
rheumatoid arthritis and other autoimmune diseases.
##STR00007##
wherein X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, or
NCH.sub.3.
##STR00008##
wherein X is CH.sub.2.
MTREX
[0017] U.S. Pat. No. 5,912,251 to Nair discloses certain antifolate
compounds for the treatment of neoplastic diseases, asthma, and/or
rheumatoid arthritis.
[0018] There remains a strong need to provide effective agents to
treat diseases and disorders of abnormal cell proliferation and/or
inflammation.
[0019] It is therefore an object of the present invention to
provide compositions and methods for the treatment of diseases and
disorders characterized by abnormal cell proliferation, such as
psoriasis.
[0020] It is a further object of the present invention to provide
compositions and methods for the treatment of diseases and
disorders characterized by inflammation, including inflammatory
bowel disease.
SUMMARY OF THE INVENTION
[0021] The present invention provides metabolically inert
antifolate compounds, or pharmaceutically acceptable formulations
containing these compounds, for use in the prevention and treatment
of disorders characterized by abnormal cell proliferation and/or
inflammation, such as psoriasis and Crohn's disease.
[0022] A method for the treatment of disorders characterized by
abnormal cell proliferation and/or inflammation is also disclosed
that includes administering an effective amount of the
metabolically inert antifolate compound of the present invention,
administered alone or in combination with another
anti-proliferation or anti-inflammation agent, optionally in a
pharmaceutically acceptable carrier.
[0023] In one embodiment, the compound of Formula (I) is provided
as well as a method for the treatment of a host with a disease or
disorder characterized by non-neoplastic abnormal cell
proliferation, non-asthmatic inflammation including, but not
limited to, inflammatory bowel disease (e.g., Crohn's disease)
and/or chronic obstructive pulmonary disease (COPD), and/or
non-rheumatoid arthritic auto-immune disease including, but not
limited to, psoriasis, osteoarthritis, and/or multiple sclerosis
(MS), comprising administering an effective treatment amount of
compound of Formula (I):
##STR00009##
or its pharmaceutically acceptable salt, ester, salt of an ester,
amide, salt or an amide, prodrug, salt of a prodrug, or a
steroisomeric, tautomeric or polymorphic form thereof; wherein
[0024] X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH,
NCH.sub.3, or NR.sup.7 [0025] R.sup.1, R.sup.2, R.sup.3, R.sup.4,
and R.sup.7 are independently selected from H, optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, an amino acid acyl residue or
derivative or other pharmaceutically acceptable leaving group that
is capable of providing a free amine when administered in vivo;
[0026] R.sup.5 and R.sup.6 are independently selected from H,
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0027] each Y.sup.1, Y.sup.2, and Y.sup.3
independently is O, S or NJ.sup.1; [0028] each V.sup.1 and V.sup.2
independently is O, S or NJ.sup.1 each V.sup.3 independently is OH,
OJ.sup.1, SH, SJ.sup.1, NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2,
CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102, or
CR.sup.101R.sup.102R.sup.103; [0029] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0030] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0031] In one embodiment of the present invention, a method for the
treatment of a host with a disease or disorder characterized by
non-neoplastic abnormal cell proliferation is provided. Diseases or
disorders characterized by non-neoplastic abnormal cell
proliferation include, but are not limited to, (i) skin disorders
including, without limitation, psoriasis (all types), eczema, acne,
acne vulgaris, acne inverse, rosacea, common warts, anogenital
(venereal) warts, lupus associated skin lesions, dermatitides
(e.g., such as atopic dermatitis, contact dermatitis, seborrheic
dermatitis and solar dermatitis), keratoses (e.g., seborrheic
keratosis, keratosis follicularis, senile keratosis, actinic
keratosis, photo-induced keratosis), skin ageing (e.g.,
photo-induced skin aging), keloids, eukoplakia, lichen planus,
keratitis, urticaria, pruritus, hidradenitis, pemphigus vulgaris;
(ii) bowel disorders; (iii) blood vessel disorders including,
without limitation, ischemic-reperfusion related brain edema and
injury, cortical ischemia, ovarian hyperplasia and
hypervascularity, (polycystic ovary syndrome), endometriosis,
psoriasis, diabetic retinopaphy, and other ocular angiogenic
diseases such as retinopathy of prematurity (retrolental
fibroplastic), macular degeneration, corneal graft rejection,
neuroscular glaucoma and Oster Webber syndrome; (iv) cardiovascular
disorders including, for example, hypertension, vasculo-occlusive
diseases (e.g., atherosclerosis, thrombosis and restenosis after
angioplasty), acute coronary syndromes (e.g., unstable angina,
myocardial infarction, ischemic and non-ischemic cardiomyopathies,
post-MI cardiomyopathy and myocardial fibrosis, and
substance-induced cardiomyopathy), ischemic heart disease; (v)
fibrotic disorders including, without limitation, fibrosis and
other medical complications of fibrosis which result in whole or in
part from the proliferation of fibroblasts, and hepatic cirrhosis;
(vi) mesangial disorders including, without limitation, human renal
diseases such as glomerulonephritis, diabetic nephropathy,
malignant nephrosclerosis, thrombotic microangiopathy syndromes,
transplant rejection, and glomerulopathies; (vii) graft-versus-host
rejection; (viii) urogenital disorders including, without
limitation, endometriosis, benign prostatic hyperplasia, eiomyoma,
polycystic kidney disease, and diabetic nephropathy; (ix) disorders
of the tissue and joints including, without limitation Raynaud's
phenomenon/disease, Sjogren's Syndrome systemic sclerosis, systemic
lupus erythematosus, vasculitides, ankylosing spondylitis,
osteoarthritis, reactive arthritis, psoriatic arthritis,
fibromyalgia; (x) degenerative neurological disorders such as
Parkinson's disease and Alzheimer's disease; (xi) virus-induced
hyperproliferative diseases including, for example, human papilloma
virus-induced disease (e.g., lesions caused by human papilloma
virus infection), Epstein-Barr virus-induced disease, acquired
immune deficiency syndrome (AIDS)-induced disease, scar formation,
genital warts, cutaneous warts, and the like; (xii) pulmonary
disorders including, without limitation, chronic obstructive
pulmonary disease (COPD), reactive airway disease, pulmonary
fibrosis, acute respiratory distress syndrome (ARDS) pulmonary
hypertension; (xiii) other diseases and disorders including
Behcet's syndrome, Fibrocystic breast disease, fibroadenoma,
chronic fatigue syndrome, post-dialysis syndrome, vasculitis, lipid
histiocytosis, septic shock, and familial intestinal polyposes such
as Gardner syndrome. The compound of Formula (I) can be
administered either alone or in combination with one or more other
anti-proliferative agent, optionally in a pharmaceutically
acceptable carrier to treat a disease or disorder characterized by
non-neoplastic abnormal cell proliferation.
[0032] In another embodiment of the present invention, a method for
the treatment of a host with a disease or disorder characterized by
non-asthmatic inflammation is provided. Disorders characterized by
non-asthmatic inflammatory diseases associated with abnormal cell
proliferation include, but are not limited to, inflammatory bowel
disease (IBD) (e.g., Crohn's disease (CD) and ulcerative colitis
(UC)), chronic obstructive pulmonary disease (COD), sarcidosis,
non-rheumatoid arthritis (e.g., fibromyalgia, fibrositis, myofascil
pain, humeral epicondyltitis, frozen shoulder, Tietze's syndrome,
fascitis, tendonitis, tenosynovitis, bursitis, juvenile chronic
arthristis, spondyloarthropaties, hyperuricemia, and arthristis
associated with acute gout, chronic gout and systemic lupus
erthematosus, osteoarthristis), multiple sclerosis (MS),
proliferative glomerulonephritis, lupus erythematosus, scleroderma,
temporal arteritis, thromboangiitis obliterans, mucocutaneous lymph
node syndrome, host versus graft, thyroiditis, Grave's disease,
antigen-induced airway hyperactivity, pulmonary eosinophilia,
Guillain-Barre syndrome, allergic rhinitis, myasthenia gravis,
human T-lymphotrophic virus type 1-associated myelopathy, herpes
simplex encephalitis, inflammatory myopathies, Goodpasture's
syndrome, poststreptococcal and autoimmune renal failure, septic
shock, systemic inflammatory response syndrome (SIRS), adult
respiratory distress syndrome (ARDS), envenomation, Hashimoto's
thyroiditis, autoimmune hemolytic anemias, insulin dependent
diabetes mellitus, rheumatic fever, pelvic inflammatory disease
(PID), conjunctivitis, dermatitis, bronchitis, rhinitis, and
cardiovascular diseases, including restenosis, atherosclerosis,
atherosclerotic complications resulting from plaque rupture, severe
tissue ischemia, and heart failure. The compound of Formula (I) can
be administered either alone or in combination with one or more
other anti-proliferative agent, optionally in a pharmaceutically
acceptable carrier to treat a non-asthmatic inflammation
disorder.
[0033] In one embodiment, a method for the treatment of psoriasis
in a host, including a human, is disclosed that involves
administering an effective amount of the compound of Formula (I),
administered either alone or in combination with one or more other
anti-psoriasis agents, optionally in a pharmaceutically acceptable
carrier.
[0034] In another embodiment, a method for the treatment of
inflammatory bowel disease in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (I), administered either alone or in
combination with one or more other anti-inflammatory bowel disease
agents, optionally in a pharmaceutically acceptable carrier. In one
embodiment, the inflammatory bowel disease is Crohn's disease. In
another embodiment, the inflammatory bowel disease is ulcerative
colitis.
[0035] In another embodiment, a method for the treatment of
osteoarthritis in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (I), administered either alone or in combination with one
or more other anti-osteoarthritis agents, optionally in a
pharmaceutically acceptable carrier.
[0036] In yet another embodiment, a method for the treatment of
chronic obstructive pulmonary disease (COPD) in a host, including a
human, is disclosed that involves administering an effective amount
of the compound of Formula (I), administered either alone or in
combination with one, or more other anti-COPD agents, optionally in
a pharmaceutically acceptable carrier.
[0037] In another preferred embodiment, a method for the treatment
of multiple sclerosis (MS) in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (I), administered either alone or in
combination with one or more other anti-MS agent, optionally in a
pharmaceutically acceptable carrier.
[0038] In an alternative embodiment, the compound of Formula (II)
is provided as well as a method for the treatment of a host with a
disorder characterized by abnormal cell proliferation,
inflammation, and/or auto-immune disease, comprising administering
an effective treatment amount of a compound of Formula (II):
##STR00010##
or its pharmaceutically acceptable salt, ester, salt of an ester,
amide, salt or an amide, prodrug, salt of a prodrug, or a
steroisomeric, tautomeric or polymorphic form thereof; wherein
[0039] X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH,
NCH.sub.3, or NR.sup.7 [0040] R.sup.1, R.sup.2, R.sup.3, R.sup.4,
and R.sup.7 are independently selected from H, optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, an amino acid acyl residue or
derivative or other pharmaceutically acceptable leaving group that
is capable of providing a free amine when administered in vivo;
[0041] R.sup.5 and R.sup.6 are independently selected from H,
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0042] each Y.sup.1, Y.sup.2, and Y.sup.3
independently is O, S or NJ.sup.1; [0043] each V.sup.1 and V.sup.2
independently is O, S or NJ.sup.1 [0044] each V.sup.3 independently
is OH, OJ.sup.1, SH, SJ.sup.1, NH.sub.2, NHJ.sup.1,
NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102,
CR.sup.101R.sup.102R.sup.103; [0045] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0046] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino; [0047] such that, if
Y.sup.1 and Y.sup.2 are both oxygen, and V.sup.1 and V.sup.2 are
both oxygen, then at least one of R.sup.1, R.sup.2, R.sup.3,
R.sup.4, R.sup.5, R.sup.6, and R.sup.7 is not H.
[0048] In one embodiment, a method for the treatment of abnormal
cell proliferation in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination with one
or more other anti-abnormal cell proliferation agents, optionally
in a pharmaceutically acceptable carrier.
[0049] In one embodiment, a method for the treatment of an
autoimmune disorder in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination with one
or more other agents effective in the treatment of an autoimmune
disorder.
[0050] In another embodiment, a method for the treatment of an
inflammatory disease in a host, including a human, is disclosed
that involves administering an effective amount of a of the
compound of Formula (II), administered either alone or in
combination with one or more other anti-inflammatory agents,
optionally in a pharmaceutically acceptable carrier, optionally in
a pharmaceutically acceptable carrier.
[0051] In another embodiment, a method for the treatment of
psoriasis in a host, including a human, is disclosed that involves
administering an effective amount of the compound of Formula (II),
administered either alone or in combination with one or more other
anti-psoriasis agents, optionally in a pharmaceutically acceptable
carrier.
[0052] In another embodiment, a method for the treatment of
inflammatory bowel disease in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (II), administered either alone or in
combination with one or more other anti-inflammatory bowel disease
agents, optionally in a pharmaceutically acceptable carrier. In one
embodiment, the inflammatory bowel disease is Crohn's disease. In
another embodiment, the inflammatory bowel disease is ulcerative
colitis.
[0053] In another embodiment, a method for the treatment of
osteoarthritis in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination with one
or more other anti-osteoarthritis agents, optionally in a
pharmaceutically acceptable carrier.
[0054] In yet another embodiment, a method for the treatment of
chronic obstructive pulmonary disease (COPD) in a host, including a
human, is disclosed that involves administering an effective amount
of the compound of Formula (II), administered either alone or in
combination with one or more other anti-COPD agents, optionally in
a pharmaceutically acceptable carrier.
[0055] In another embodiment, a method for the treatment of
multiple sclerosis (MS) in a host, including a human, is disclosed
that involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination with one
or more other anti-MS agents, optionally in a pharmaceutically
acceptable carrier.
[0056] The compounds of the present invention can be administered,
for example, by parenteral, intraperitoneal, intravenous,
intradermal, epidural, intraspinal, infrasternal, intra-articular,
infra-synovial, intrathecal, intra-arterial, intracardiac,
intramuscular, intranasal, subcutaneous, intraorbital,
intracapsular, topical, transdermal patch, via rectal, vaginal or
urethral administration including via suppository, percutaneous,
nasal spray, surgical implant, internal surgical paint, infusion
pump administration or via catheter, stent, balloon or other
delivery device. In one embodiment, the agent and carrier can be
administered in a controlled release formulation such as a
monolithic matrix device. In another embodiment, the compounds and
compositions described herein can be administered as
microcrystalline cellulose tablets. In one particular embodiment,
the compounds and compositions described herein can be administered
intravenously. In one particular embodiment of the present
invention, the compounds and/or compositions described herein can
be administered topically. In one embodiment, the compounds and
compositions can be administered topically to treat an abnormal
cell proliferation disorder, for example, psoriasis. In another
particular embodiment, the compounds and/or compositions described
herein can be administered topically, for example, as a cream, for
the treatment of psoriasis.
DESCRIPTION OF THE FIGURES
[0057] FIG. 1 provides an illustration of the metabolically inert
characteristics of the compound of Formula I, as described further
below.
[0058] FIG. 2 provides an illustration of the synthesis of a
sub-embodiment of the compound of Formula I, as described further
below.
DETAILED DESCRIPTION OF THE INVENTION
[0059] Disclosed herein is a compound, method and composition for
the treatment of abnormal cell proliferation and/or inflammation in
a human and other host animals. The method includes administration
of an effective anti-proliferative or anti-inflammatory amount of
the compounds described herein. The compounds of this invention
either posses anti-proliferative and/or anti-inflammatory activity,
or are metabolized to a compound that exhibits such activity. In
one embodiment of the present invention, the composition and method
are used to treat psoriasis. In an alternative embodiment, the
composition and method are used to treat inflammatory bowel
disease, such as Crohn's disease.
I. Compounds
[0060] The compositions of the present invention are metabolically
inert antifolates. The term "metabolically inert antifolate" is
intended to include compounds that are (i) folic acid analogs
capable of disrupting folate metabolism; (ii)
non-polyglutamylatable; and (iii) non-hydroxylatable. A
representation of the metabolically inert characteristics of the
compounds of the present invention, as illustrated for a particular
sub embodiment, is provided in FIG. 1.
[0061] Antifolates are compounds that interfere with various stages
of foliate metabolism. An intact foliate enzyme pathway is
important to maintain de novo synthesis of the building blocks of
DNA, as well as of the important amino acids. Antifolate targets
include the various enzymes involved in foliate metabolism,
including (i) dihydrofolate reductase (DHFR); thymidylate synthase
(TS); (iii) folylpolyglutamyl synthase; and (iv) glycinamide
ribonucleotide (GAR) and aminoimidazole carboxamide ribonucleotide
(AICAR) transformylases.
[0062] Antifolates are folate acid analogs. For a general review of
antifolates, see Montgomery J A and Piper Jr. Design and Synthesis
of Folate Analogs as Antimetabolites. In Folate Antagonists as
Therapeutic Agents. Volume 1: Biochemistry, Molecular Actions and
Synthetic Design. Eds. Sirotnak F M, Burchall J J, Ensminger W D
and Montgomery J A. Academic Press. pp 219-261, 1984; Thomas W.
Current Oncology Reports (2003) 5:114-125; Graffner N M. Approaches
to Soft Drug Analogues of Dihydrofolate Reductase Inhibitors, in
Comprehensive Summaries of Uppsala Dissertations from the Faculty
of Pharmacy 252 (2001); Beale, P., and Clarke, S. Tomudex. Clinical
development. In: A. L. Jackman (ed.), Antifolate Drugs in Cancer
Therapy, pp. 167-191. Allegra C J: Antifolates, in Chabner B A,
Collins J M (eds): Cancer Chemotherapy: Principles & Practice,
pp 110-153. Philadelphia, Lippincott, 1990.
[0063] Folic acid contains a pteridine ring, para-aminobenzoic acid
and a glutamate residue.
##STR00011##
[0064] Methotrexate, a DHFR inhibitor, is among the earliest
antifolates. It is a classical antifolate, meaning it is
characterized by a p-aminobenzogylglutamic acid side chain, and
closely resembles the folic acid molecule. MTX differs from folic
acid by the substitution of an amino group for a hydroxyl at the
4-position of the pterdine ring and by the methylation of the amine
of the para-aminobenzoic moeity. The substitution of an amino group
for a hydroxyl at the 4-position of the pterdine ring changes the
enzyme substrate into a tight binding inhibitor of DHFR.
##STR00012##
[0065] Both MTX and naturally occurring folate compounds undergo
intracellular metabolism to polyglutamate derivatives. This
polyglutamylation is catalyzed by the enzyme folylpolyglutamyl
synthase (FPGS), which attaches up to six glutamate residues to the
molecule, which helps to trap it within the cell. Polyglutamylation
of MTX occurs more slowly compared to naturally occurring
antifolates, but the resulting methotrexate polyglutamylates have
extremely long intracellular half-lives, and can be detected in
some tissues more than several months after a single drug
administration (Takimoto C H et al. Oncology (1995) 9(7):
649-656).
[0066] The most common use of MIX is as an anti-cancer drug. MIX is
curative of choriocarcinoma and Burkett's lymphoma. It has also
widely used as a single agent or in combination with other drugs
for the treatment of various forms of human cancer. More recently,
MIX has been shown to have anti-inflammatory and immunosuppressive
properties with accompanying activity against autoimmune disorders.
MTX is now widely prescribed as an immunosuppressive agent in the
treatment of autoimmune diseases, including rheumatoid arthritis
(Weinblatt M E et al. N. Engl. J. Med. (1985) 312:818; Wilke W S
(Ed). Methotrexate Therapy in Rheumatic Disease. Marcel Dekker,
Inc. (1989). Intrinsic and acquired resistance to MTX and other
antifolate analogues limits their clinical effectiveness, however.
Apart from resistance, major limitations of MTX treatment include
bone marrow toxicity, gastrointestinal ulceration and liver and
kidney damage.
[0067] A number of antifolates have been designed to overcome these
limitations. Rational design has focused, for example, on the
development of antifolates with greater lipid solubility and/or
improved transport characteristics relative to methotrexate
(Takimoto C H et al. Oncology (1995) 9(7); 649-656). Representative
non-classical agents include trimetrexate and piritrexim (Kamen B A
et al. J. Biochem. Pharmacol. (1984) 33: 1697-1984; Duch D S et al.
Cancer Res. (1982) 42: 3987-3994). Unlike classical antifolates,
non-classical antifolates lack the glutamate moiety, and therefore
do not require carrier-mediated cellular uptake. These lipophilic
antifolates are used against opportunistic infections (e.g.,
Pneumocystic carinii pneumonia, PCP) in individuals with AIDS and
other disorders of the immune system and have undergone extensive
clinical testing as anticancer agents.
##STR00013##
[0068] Other antifolates in clinical development specifically
target folate-dependent enzymes such as TS or GARFT, thereby
directly affecting pools of nucleotides available for DNA synthesis
(Takemura Y. et al. Anti-Cancer Drugs (1997) .delta.: 3-16; Habeck
L L et al. Cancer Res (1994) 54: 1021-1026). Direct and specific TS
inhibitors have been studied as potential anticancer drugs (Stout T
J et al. Biochemistry (1999) 38: 1607-1617). Of these, Tomudex
(raltitrexed; ZD1649),
[N-{5-[N-(3-,4-dihydro-2-methyl-4-oxoquinazoline-6-yl-methyl)-N-methylami-
ne]-2-theroyl}-L-glutei acid], is one of the most extensively
evaluated and has been approved for treatment in Europe (Van Custom
Euro. J. Cancer, (1999) 35(Suppl. 1): 1-2; Jack man A L. Invest.
New Drugs, (1996) 14: 305-316). Comdex undergoes substantial
polyglutamylation within the cell. Comdex and its polyglutamates do
not appear to inhibit DHFR, GAR or AICAR transformylase, suggesting
that the drug is a pure TS inhibitor.
##STR00014##
[0069] Inhibitors of glycinamide ribotide formyltransferase (GARFT)
have also been developed. Lometrexol ((5,10-dideazatetrahydrofolate
[DDATHF]) is a specific GARFT inhibitor that has shown anti-tumor
properties (Habeck L L et al. Cancer Res. (1994) 54: 1021-1026).
Early clinical trials, however, were confounded by cumulative
myelosuppression that prevented repetitive administration (Roberts
J D. Cancer Chemother Pharmacol. (2000) 45(2): 103-10). LY309887
(6R-2',5'-thienyl-5,10-dideazatetrahydrofolic acid) is a thiophene
analogue of lometrexol, is a second generation GARFT inhibitor
(Mendelsohn L G. Investig. New Drugs (1996) 14: 287-294).
##STR00015##
[0070] In 1991, Nair et al. demonstrated that contrary to the
widely accepted notion, polyglutamylation of classical antifolates
is not essential for anti-tumor activity and further, that this
metabolic transformation is actually undesirable because it may
cause the loss of pharmacological control and target specificity of
the drug (Nair M G et al. J. Med. Chem (1991) 34: 222-227). This
new finding let to the discovery of a number of
nonpolyglutamylatable classical antifolates (Nair M G et al. Proc.
Amer. Assoc. Cancer. Research. (1998) 39:431).
[0071] U.S. Pat. No. 5,073,554 (Nair) describes
methylene-1-deazaminopterine (MDAM), a nonpolyglutamylatable
antifolate compound. MDAM has been developed as an experimental
anticancer drug for the treatment of human solid tumors (Cao S. et
al. Clinical Cancer Research (1996) 2(4): 707-712); Johansen M et
al. Cancer Chemother Pharmacol. (2004) 53(5):370-6). U.S. Pat. No.
5,550,128 (Nair et al) describes the active enantiomer of MDAM as
the one possessing the L-configuration.
##STR00016##
[0072] Further investigation by Nair et al. of the metabolic
disposition of certain non-polyglutamylatable antifolates led to
the unexpected finding that the presence of the
4-methyleneglutamate moiety modulates the binding of such compounds
to the liver enzyme aldehyde oxidase, which mediates their
oxidative deactivation to the corresponding 7-hydroxy derivatives
(Cellular. Pharmacology (1996) 3: 29). U.S. Pat. No. 5,912,251
(Nair) describes metabolically inert classical antifolates,
including 4-Amino-4-deoxy-5,8,10-trideazapteroyl-4'-methylene
glutamic acid, which are non-polyglutamylatable and
non-hydroxylatable. They are said to be useful in the treatment of
neoplastic disease (leukemia, ascetic and solid tumors), asthma and
related anti-inflammatory disease, and for the treatment of
rheumatoid arthritis and other autoimmune diseases.
##STR00017##
wherein X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, or
NCH.sub.3.
##STR00018##
wherein X is CH.sub.2.
MTREX
[0073] In one embodiment, the compound of Formula (I) is provided
as well as a method for the treatment of a host with a disorder
characterized by non-neoplastic abnormal cell proliferation,
non-asthmatic inflammation including, but not limited to,
inflammatory bowel disease (e.g., Crohn's disease) and/or chronic
obstructive pulmonary disease (COPD), and/or non-rheumatoid
arthritic auto-immune disease including, but not limited to,
psoriasis, osteoarthritis, and/or multiple sclerosis (MS),
comprising administering an effective treatment amount of compound
of Formula (I):
##STR00019##
or its pharmaceutically acceptable salt, ester, salt of an ester,
amide, salt or an amide, prodrug, salt of a prodrug, or a
steroisomeric, tautomeric or polymorphic form thereof; wherein
[0074] X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH,
NCH.sub.3, or NR.sup.7 [0075] R.sup.1, R.sup.2, R.sup.3, R.sup.4,
and R.sup.7 are independently selected from H, optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, an amino acid acyl residue or
derivative or other pharmaceutically acceptable leaving group that
is capable of providing a free amine when administered in vivo;
[0076] R.sup.5 and R.sup.6 are independently selected from H,
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0077] each Y.sup.1, Y.sup.2, and Y.sup.3
independently is O, S or NJ.sup.1; [0078] each V.sup.1 and V.sup.2
independently is O, S or NJ.sup.1 [0079] each V.sup.3 independently
is OH, OJ.sup.1, SH, SJ.sup.1, NH.sub.2, NHJ.sup.1,
NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102,
CR.sup.101R.sup.102R.sup.103; [0080] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0081] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0082] In another embodiment, a method for the treatment of
psoriasis in a host, including a human, is disclosed that involves
administering an effective amount of the compound of Formula (I),
administered either alone or in combination and/or alternation with
one or more other anti-psoriasis agent, optionally in a
pharmaceutically acceptable carrier.
[0083] In another embodiment, a method for the treatment of
inflammatory bowel disease in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (I), administered either alone or in
combination and/or alternation with one or more other
anti-inflammatory bowel disease agent, optionally in a
pharmaceutically acceptable carrier. In one embodiment, the
inflammatory bowel disease is Crohn's disease.
[0084] In another preferred embodiment, a method for the treatment
of osteoarthritis in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (I), administered either alone or in combination and/or
alternation with one or more other anti-osteoarthritis agent,
optionally in a pharmaceutically acceptable carrier.
[0085] In yet another preferred embodiment, a method for the
treatment of chronic obstructive pulmonary disease (COPD) in a
host, including a human, is disclosed that involves administering
an effective amount of the compound of Formula (I), administered
either alone or in combination and/or alternation with one or more
other anti-COPD agent, optionally in a pharmaceutically acceptable
carrier.
[0086] In another preferred embodiment, a method for the treatment
of multiple sclerosis (MS) in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (I), administered either alone or in
combination and/or alternation with one or more other anti-MS
agent, optionally in a pharmaceutically acceptable carrier.
[0087] In an alternative embodiment, the compound of Formula (II)
is provided as well as a method for the treatment of a host with a
disorder characterized by abnormal cell proliferation,
inflammation, and/or auto-immune disease, comprising administering
an effective treatment amount of a compound of Formula (II):
##STR00020##
or its pharmaceutically acceptable salt, ester, salt of an ester,
amide, salt or an amide, prodrug, salt of a prodrug, or a
steroisomeric, tautomeric or polymorphic form thereof; wherein
[0088] X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH,
NCH.sub.3, or NR.sup.7 [0089] R.sup.1, R.sup.2, R.sup.3, R.sup.4,
and R.sup.7 are independently selected from H, optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, an amino acid acyl residue or
derivative or other pharmaceutically acceptable leaving group that
is capable of providing a free amine when administered in vivo;
[0090] R.sup.5 and R.sup.6 are independently selected from H,
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0091] each Y.sup.1, Y.sup.2, and Y.sup.3
independently is O, S or NJ.sup.1; [0092] each V.sup.1 and V.sup.2
independently is O, S or NJ.sup.1 [0093] each V.sup.3 independently
is OH, OJ.sup.1, SH, SJ.sup.1, NH.sub.2, NHJ.sup.1,
NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102,
or CR.sup.101R.sup.102R.sup.103; [0094] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0095] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino; [0096] such that, if
Y.sup.1 and Y.sup.2 are both oxygen, and V.sup.1 and V.sup.2 are
both oxygen, then at least one of R.sup.1, R.sup.2, R.sup.3,
R.sup.4, R.sup.5, R.sup.6, and R.sup.7 is not H.
[0097] In one particular embodiment of the present invention, the
compound of Formula (II) is provided as well as a method for the
treatment of a host with a disorder characterized by abnormal cell
proliferation, inflammation, and/or auto-immune disease, comprising
administering an effective treatment amount of the compound of
Formula (II) wherein: [0098] X is NR.sup.7; [0099] R.sup.1,
R.sup.2, R.sup.3, and R.sup.4 are independently selected from H,
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower
alkyl), --C(O)-(alkenyl), --C(O)-(alkynyl),
--C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, an amino
acid acyl residue or derivative or other pharmaceutically
acceptable leaving group that is capable of providing a free amine
when administered in vivo; [0100] R.sup.7 is independently selected
from an optionally substituted alkyl including lower alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)(lower alkyl), --C(O)-(alkenyl), --C(O)-(alkynyl),
--C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, an amino
acid acyl residue or derivative or other pharmaceutically
acceptable leaving group that is capable of providing a free amine
when administered in vivo; [0101] R.sup.5 and R.sup.6 are
independently selected from H, optionally substituted alkyl
including lower alkyl, optionally substituted alkenyl or alkynyl,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, or other pharmaceutically acceptable
leaving group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0102] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0103] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0104] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0105] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0106] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0107] In another particular embodiment of the present invention,
the compound of Formula (II) is provided as well as a method for
the treatment of a host with a disorder characterized by abnormal
cell proliferation, inflammation, and/or auto-immune disease,
comprising administering an effective treatment amount of the
compound of Formula (II) wherein: [0108] X is NR.sup.7 [0109]
R.sup.1, R.sup.2, R.sup.3, R.sup.4 are H, optionally substituted
alkyl including lower alkyl, optionally substituted alkenyl or
alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, an amino acid acyl residue or
derivative or other pharmaceutically acceptable leaving group that
is capable of providing a free amine when administered in vivo;
[0110] R.sup.7 is independently selected from an optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or derivative, an amino acid acyl residue or
derivative or other pharmaceutically acceptable leaving group that
is capable of providing a free amine when administered in vivo;
[0111] R.sup.5 and R.sup.6 are independently selected from H,
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0112] each Y.sup.1 and Y.sup.2 are O [0113]
each Y.sup.3 independently is O, S or NJ.sup.1; [0114] each V.sup.1
and V.sup.2 independently is O; [0115] each V.sup.3 independently
is OH, OJ.sup.1, SH, SJ.sup.1, NH.sub.2, NHJ.sup.1,
NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102,
or CR.sup.101R.sup.102R.sup.103; [0116] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0117] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0118] In another particular embodiment of the present invention,
the compound of Formula (II) is provided as well as a method for
the treatment of a host with a disorder characterized by abnormal
cell proliferation, inflammation, and/or auto-immune disease,
comprising administering an effective treatment amount of the
compound of Formula (II) wherein: [0119] X is CH.sub.2, CHCH.sub.3,
CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or NR.sup.7 [0120] R.sup.1,
R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are independently selected
from H, optionally substituted alkyl including lower alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)(lower alkyl), --C(O)-(alkenyl), --C(O)-(alkynyl),
--C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, an amino
acid acyl residue or derivative or other pharmaceutically
acceptable leaving group that is capable of providing a free amine
when administered in vivo; [0121] wherein at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, and R.sup.7 is not H; [0122] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl including lower alkyl, optionally substituted alkenyl or
alkynyl, lipid, phospholipid, carbohydrate, peptide, cholesterol,
an amino acid residue or derivative, or other pharmaceutically
acceptable leaving group that is capable of providing a
--C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when administered in
vivo; [0123] each Y.sup.1, Y.sup.2, and Y.sup.3 independently is O,
S or NJ.sup.1; [0124] each V.sup.1 and V.sup.2 independently is O,
S or NJ.sup.1 [0125] each V.sup.3 independently is OH, OJ.sup.1,
SH, SJ.sup.1, NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3,
CH.sub.2R.sup.101, CHR.sup.101R.sup.102, or
CR.sup.101R.sup.102R.sup.103; [0126] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0127] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0128] In yet another particular embodiment of the present
invention, the compound of Formula (II) is provided as well as a
method for the treatment of a host with a disorder characterized by
abnormal cell proliferation, inflammation, and/or auto-immune
disease, comprising administering an effective treatment amount of
the compound of Formula (II) wherein: [0129] X is CH.sub.2,
CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or NR.sup.7 [0130]
R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are independently
selected from H, optionally substituted alkyl including lower
alkyl, optionally substituted alkenyl or alkynyl, acyl,
--C(O)-(alkyl), --C(O)(lower alkyl), --C(O)-(alkenyl),
--C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid,
carbohydrate, peptide, cholesterol, an amino acid residue or
derivative, an amino acid acyl residue or derivative or other
pharmaceutically acceptable leaving group that is capable of
providing a free amine when administered in vivo; [0131] R.sup.5
and R.sup.6 are independently selected from H, optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, lipid, phospholipid, carbohydrate, peptide,
cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0132] each Y.sup.1, Y.sup.2, and Y.sup.3
independently is O, S or NJ.sup.1; [0133] each V.sup.1 and V.sup.2
independently is O, S or NJ.sup.1; [0134] wherein at least one of
Y.sup.1, Y.sup.2, V.sup.1 and V.sup.2 is not 0; [0135] each V.sup.3
independently is OH, OJ.sup.1, SH, NH.sub.2, NHJ.sup.1,
NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102,
or CR.sup.101R.sup.102R.sup.103; [0136] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0137] each R.sup.100,
R.sup.101, R.sup.102, and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0138] In yet another particular embodiment of the present
invention, the compound of Formula (II) is provided as well as a
method for the treatment of a host with a disorder characterized by
abnormal cell proliferation, inflammation, and/or auto-immune
disease, comprising administering an effective treatment amount of
the compound of Formula (II) wherein: [0139] X is CH.sub.2,
CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or NR.sup.7 [0140]
R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are independently
selected from H, optionally substituted alkyl including lower
alkyl, optionally substituted alkenyl or alkynyl, acyl,
--C(O)-(alkyl), --C(O)(lower alkyl), --C(O)-(alkenyl),
--C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid,
carbohydrate, peptide, cholesterol, an amino acid residue or
derivative, an amino acid acyl residue or derivative or other
pharmaceutically acceptable leaving group that is capable of
providing a free amine when administered in vivo; [0141] R.sup.5
and R.sup.6 are independently selected from H, optionally
substituted alkyl including lower alkyl, optionally substituted
alkenyl or alkynyl, lipid, phospholipid, carbohydrate, peptide,
cholesterol, an amino acid residue or derivative, or other
pharmaceutically acceptable leaving group that is capable of
providing a --C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when
administered in vivo; [0142] wherein at least one of R.sup.5 and
R.sup.6 is not H; [0143] each Y.sup.1, Y.sup.2, and Y.sup.3
independently is O, S or NJ.sup.1; [0144] each V.sup.1 and V.sup.2
independently is O, S or NJ.sup.1 [0145] each V.sup.3 independently
is OH, OJ.sup.1, SH, SJ.sup.1, NH.sub.2, NHJ.sup.1,
NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101, CHR.sup.101R.sup.102,
or CR.sup.101R.sup.102R.sup.103; [0146] each J.sup.1, J.sup.2 and
J.sup.3 independently are hydrogen, alkyl, alkenyl, alkynyl,
alkaryl, cycloalkyl, aryl, cycloaryl, heteroalkyl, heterocycle,
heteroaryl, hydroxyl, alkoxy, or amine; and [0147] each R.sup.100,
R.sup.101; R.sup.102; and R.sup.103 are independently hydrogen,
alkyl, alkenyl, alkynyl, aryl, acyl, heteroaromatic, heteroaryl,
heteroalkyl, hydroxyl, alkoxy, cyano, azido, halogen, nitro,
SO.sub.2, SO.sub.3, thioalkyl, or amino; [0148] such that, if
Y.sup.1 and Y.sup.2 are both oxygen, and V.sup.1 and V.sup.2 are
both oxygen, then at least one of R.sup.1, R.sup.2, R.sup.3,
R.sup.4, R.sup.5, R.sup.6, and R.sup.7 is not H.
[0149] In yet another particular embodiment of the present
invention, the compound of Formula (II) is provided as well as a
method for the treatment of a host with a disorder characterized by
abnormal cell proliferation, inflammation, and/or auto-immune
disease, comprising administering an effective treatment amount of
the compound of Formula (II) wherein: [0150] at least one of
R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 is selected from an
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower
alkyl), --C(O)-(alkenyl), --C(O)-(alkynyl),
--C(.dbd.Y.sup.3)V.sup.3, lipid, phospholipid, carbohydrate,
peptide, cholesterol, an amino acid residue or derivative, an amino
acid acyl residue or derivative or other pharmaceutically
acceptable leaving group that is capable of providing a free amine
when administered in vivo; [0151] each Y.sup.i and Y.sup.2 is O;
and [0152] each V.sup.1 and V.sup.2 is O.
[0153] In another particular embodiment of the present invention,
the compound of Formula (II) is provided as well as a method for
the treatment of a host with a disorder characterized by abnormal
cell proliferation, inflammation, and/or auto-immune disease,
comprising administering an effective treatment amount of the
compound of Formula (II) wherein: [0154] at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, and R.sup.7 is selected from an
optionally substituted alkyl including lower alkyl, optionally
substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl), --C(O)(lower
alkyl), --C(O)-(alkenyl), --C(O)-(alkynyl),
--C(.dbd.Y.sup.3)V.sup.3, an amino acid residue or derivative, or
an amino acid acyl residue or derivative; [0155] each Y.sup.1 and
Y.sup.2 is O; and [0156] each V.sup.1 and V.sup.2 is O.
[0157] In another particular embodiment of the present invention,
the compound of Formula (II) is provided as well as a method for
the treatment of a host with a disorder characterized by abnormal
cell proliferation, inflammation, and/or auto-immune disease,
comprising administering an effective treatment amount of the
compound of Formula (II) wherein: [0158] at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, and R.sup.7 is selected from an
optionally acyl, --C(O)-(alkyl), --C(O)(lower alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3, or an
amino acid acyl residue or derivative; [0159] each Y.sup.1 and
Y.sup.2 is O; and [0160] each V.sup.1 and V.sup.2 is O.
[0161] In yet another particular embodiment of the present
invention, the compound of Formula (II) is provided as well as a
method for the treatment of a host with a disorder characterized by
abnormal cell proliferation, inflammation, and/or auto-immune
disease, comprising administering an effective treatment amount of
the compound of Formula (II) wherein: [0162] at least one of
R.sup.5 and R.sup.6 is selected from an optionally substituted
alkyl including lower alkyl, optionally substituted alkenyl or
alkynyl, lipid, phospholipid, carbohydrate, peptide, cholesterol,
an amino acid residue or derivative, or other pharmaceutically
acceptable leaving group that is capable of providing a
--C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when administered in
vivo; [0163] each Y.sup.1 and Y.sup.2 is O; and [0164] each V.sup.1
and V.sup.2 is O.
[0165] In another particular embodiment of the present invention,
the compound of Formula (II) is provided as well as a method for
the treatment of a host with a disorder characterized by abnormal
cell proliferation, inflammation, and/or auto-immune disease,
comprising administering an effective treatment amount of the
compound of Formula (II) wherein: [0166] at least one of R.sup.5
and R.sup.6 is selected from an optionally substituted alkyl
including lower alkyl, optionally substituted alkenyl or alkynyl,
an amino acid residue or derivative, or other pharmaceutically
acceptable leaving group that is capable of providing a
--C(.dbd.Y)V.sup.- or --C(.dbd.Y)VH moiety when administered in
vivo; [0167] each Y.sup.1 and Y.sup.2 is O; and [0168] each V.sup.1
and V.sup.2 is O.
[0169] In another particular embodiment of the present invention,
the compound of Formula (II) is provided as well as a method for
the treatment of a host with a disorder characterized by abnormal
cell proliferation, inflammation, and/or auto-immune disease,
comprising administering an effective treatment amount of the
compound of Formula (II) wherein: [0170] at least one of R.sup.5
and R.sup.6 is selected from an optionally substituted alkyl
including lower alkyl, optionally substituted alkenyl or alkynyl,
or an amino acid residue or derivative; [0171] each Y.sup.1 and
Y.sup.2 is O; and [0172] each V.sup.1 and V.sup.2 is O.
[0173] In one embodiment, a method for the treatment of abnormal
cell proliferation in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination and/or
alternation with one or more other anti-abnormal cell proliferation
agent, optionally in a pharmaceutically acceptable carrier.
[0174] In one embodiment, a method for the treatment of abnormal
cell proliferation in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination and/or
alternation with one or more other agent effective in the treatment
of an autoimmue disorder.
[0175] In another embodiment, a method for the treatment of an
inflammatory disease in a host, including a human, is disclosed
that involves administering an effective amount of a of the
compound of Formula (II), administered either alone or in
combination and/or alternation with one or more other
anti-inflammatory agent, optionally in a pharmaceutically
acceptable carrier, optionally in a pharmaceutically acceptable
carrier.
[0176] In another embodiment, a method for the treatment of
psoriasis in a host, including a human, is disclosed that involves
administering an effective amount of the compound of Formula (II),
administered either alone or in combination and/or alternation with
one or more other anti-psoriasis agent, optionally in a
pharmaceutically acceptable carrier.
[0177] In another embodiment, a method for the treatment of
inflammatory bowel disease in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (II), administered either alone or in
combination and/or alternation with one or more other
anti-inflammatory bowel disease agent, optionally in a
pharmaceutically acceptable carrier. In one embodiment, the
inflammatory bowel disease is Crohn's disease.
[0178] In another preferred embodiment, a method for the treatment
of osteoarthritis in a host, including a human, is disclosed that
involves administering an effective amount of the compound of
Formula (II), administered either alone or in combination and/or
alternation with one or more other anti-osteoarthritis agent,
optionally in a pharmaceutically acceptable carrier.
[0179] In yet another preferred embodiment, a method for the
treatment of chronic obstructive pulmonary disease (COPD) in a
host, including a human, is disclosed that involves administering
an effective amount of the compound of Formula (II), administered
either alone or in combination and/or alternation with one or more
other anti-COPD agent, optionally in a pharmaceutically acceptable
carrier.
[0180] In another preferred embodiment, a method for the treatment
of multiple sclerosis (MS) in a host, including a human, is
disclosed that involves administering an effective amount of the
compound of Formula (II), administered either alone or in
combination and/or alternation with one or more other anti-MS
agent, optionally in a pharmaceutically acceptable carrier.
[0181] Other particular embodiments include:
[0182] A compound of the formula:
##STR00021##
or its pharmaceutically acceptable salt, wherein [0183] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0184] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0185] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0186] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0187] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0188] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NH.sub.2, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0189] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0190] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0191] such that, if Y.sup.1 and Y.sup.2 are both oxygen, and
V.sup.1 and V.sup.2 are both oxygen, then at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6 and R.sup.7 is not
H.
[0192] A method for the treatment of abnormal cell proliferation,
comprising administering an effective amount of a compound of the
formula below in combination with an anti-neoplastic agent:
##STR00022##
or its pharmaceutically acceptable salt, wherein [0193] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0194] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0195] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0196] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0197] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0198] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0199] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0200] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0201] A method to treat a disease or disorder characterized by
abnormal cell proliferation in a host, comprising administering an
effective amount of the compound of Formula (II).
##STR00023##
or its pharmaceutically acceptable salt; wherein [0202] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0203] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0204] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0205] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0206] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0207] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0208] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0209] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0210] such that, when the disorder is a tumor, if Y.sup.1 and
Y.sup.2 are both oxygen, and V.sup.1 and V.sup.2 are both oxygen,
then at least one of R.sup.1, R.sup.2, R.sup.3, R.sup.4, R.sup.5,
R.sup.6, and R.sup.7 is not H.
[0211] A method to treat an inflammatory disease or disorder in a
host, comprising administering an effective amount of the compound
of Formula (II).
##STR00024##
or its pharmaceutically acceptable salt; wherein [0212] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0213] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0214] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0215] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0216] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0217] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0218] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0219] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0220] such that, if Y.sup.1 and Y.sup.2 are both oxygen, and
V.sup.1 and V.sup.2 are both oxygen, then at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6, and R.sup.7 is not
H.
[0221] A method to treat an autoimmune disease or disorder in a
host, comprising administering an effective amount of the compound
of Formula (II)
##STR00025##
or its pharmaceutically acceptable salt; wherein [0222] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0223] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0224] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0225] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0226] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0227] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0228] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0229] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0230] such that, if Y.sup.1 and Y.sup.2 are both oxygen, and
V.sup.1 and V.sup.2 are both oxygen, then at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6, and R.sup.7 is not
H.
[0231] A method of treating psoriasis, comprising administering an
effective amount of the compound of Formula (I):
##STR00026##
or its pharmaceutically acceptable salt; wherein [0232] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0233] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0234] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0235] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0236] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0237] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0238] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0239] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino.
[0240] A method of treating inflammatory bowel disease, comprising
administering an effective amount of the compound of Formula
(I):
##STR00027##
or its pharmaceutically acceptable salt; wherein [0241] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0242] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0243] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0244] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0245] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0246] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0247] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0248] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0249] A method of treating multiple sclerosis in a host,
comprising administering an effective amount of the compound of
Formula (I):
##STR00028##
or its pharmaceutically acceptable salt; wherein [0250] X is
CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, NCH.sub.3, or
NR.sup.7 [0251] R.sup.1, R.sup.2, R.sup.3, R.sup.4, and R.sup.7 are
independently selected from H, optionally substituted alkyl,
optionally substituted alkenyl or alkynyl, acyl, --C(O)-(alkyl),
--C(O)-(alkenyl), --C(O)-(alkynyl), --C(.dbd.Y.sup.3)V.sup.3,
lipid, phospholipid, carbohydrate, peptide, cholesterol, an amino
acid residue or an amino acid acyl residue; [0252] R.sup.5 and
R.sup.6 are independently selected from H, optionally substituted
alkyl, optionally substituted alkenyl or alkynyl, lipid,
phospholipid, carbohydrate, peptide, cholesterol, an amino acid
residue or derivative, or other pharmaceutically acceptable leaving
group that is capable of providing a --C(.dbd.Y)V.sup.- or
--C(.dbd.Y)VH moiety when administered in vivo; [0253] each
Y.sup.1, Y.sup.2, and Y.sup.3 independently is O, S or NJ.sup.1;
[0254] each V.sup.1 and V.sup.2 independently is O, S or NJ.sup.1
[0255] each V.sup.3 independently is OH, OJ.sup.1, SH, SJ.sup.1,
NH.sub.2, NHJ.sup.1, NJ.sup.1J.sup.2, CH.sub.3, CH.sub.2R.sup.101,
CHR.sup.101R.sup.102, or CR.sup.101R.sup.102R.sup.103; [0256] each
J.sup.1, J.sup.2 and J.sup.3 independently are hydrogen, alkyl,
alkenyl, alkynyl, alkaryl, cycloalkyl, aryl, cycloaryl,
heteroalkyl, heterocycle, heteroaryl, hydroxyl, alkoxy, or amine;
and [0257] each R.sup.100, R.sup.101, R.sup.102, and R.sup.103 are
independently hydrogen, alkyl, alkenyl, alkynyl, aryl, acyl,
heteroaromatic, heteroaryl, heteroalkyl, hydroxyl, alkoxy, cyano,
azido, halogen, nitro, SO.sub.2, SO.sub.3, thioalkyl, or amino;
[0258] such that, if Y.sup.1 and Y.sup.2 are both oxygen, and
V.sup.1 and V.sup.2 are both oxygen, then at least one of R.sup.1,
R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6, and R.sup.7 is not
H.
[0259] A pharmaceutically acceptable salt of a compound of the
formula:
##STR00029##
wherein X is CH.sub.2, CHCH.sub.3, CH(CH.sub.2CH.sub.3), NH, or
NCH.sub.3.
II. Definitions
[0260] The term "alkyl" as used herein, unless otherwise specified,
refers to a saturated straight, branched, or cyclic, primary,
secondary, or tertiary hydrocarbon of, for example, C.sub.1 to
C.sub.10, and specifically includes methyl, trifluoromethyl, ethyl,
propyl, isopropyl, cyclopropyl, butyl, isobutyl, t-butyl, pentyl,
cyclopentyl, isopentyl, neopentyl, hexyl, isohexyl, cyclohexyl,
cyclohexylmethyl, 3-methylpentyl, 2,2-dimethylbutyl, and
2,3-dimethylbutyl. The term includes both substituted and
unsubstantiated alkyl groups. Moieties with which the alkyl group
can be substituted with one or more substituents are selected from
the group consisting of halo, including Cl, F, Br and I so as to
form, for e.g., CF.sub.3, 2-Br-ethyl, CH.sub.2F, CH.sub.2Cl,
CH.sub.2CF.sub.3, or CF.sub.2CF.sub.3; hydroxyl, for e.g.
CH.sub.2OH; amino, for eg., CH.sub.2NH.sub.2, CH.sub.2NHCH.sub.3,
or CH.sub.2N(CH.sub.3).sub.2; carboxylate; carboxamido; alkylamino;
arylamino; alkoxy; aryloxy; nitro; azido, for eg., CH.sub.2N.sub.3;
cyano, for eg., CH.sub.2CN; thio; sulfonic acid; sulfate;
phosphonic acid; phosphate; and phosphonate, either unprotected or
protected as necessary, known to those skilled in the art, for eg.,
as taught in Greene et al., Protective Groups in Organic Synthesis,
John Wiley and Sons, Second Edition (1991), incorporated herein by
reference.
[0261] The term "lower alkyl", as used herein, and unless otherwise
specified, refers to a C.sub.1 to C.sub.6 saturated straight,
branched, or if appropriate, a cyclic (for example, cyclopropyl)
alkyl group, including both substituted and unsubstituted forms.
Unless otherwise specifically stated in this application, when
alkyl is a suitable moiety, lower alkyl is preferred. Similarly,
when alkyl or lower alkyl is a suitable moiety, unsubstituted alkyl
or lower alkyl is preferred.
[0262] The terms alkenyl and alkynyl refer to alkyl moieties
wherein at least one saturated C--C bond is replaced by a double or
triple bond. Thus, (C.sub.2-C.sub.6)alkenyl can be vinyl, allyl,
1-propenyl, 2-propenyl, 1-butenyl, 2-butenyl, 3-butenyl,
1-pentenyl, 2-pentenyl, 3-pentenyl, 4-pentenyl, 1-hexenyl,
2-hexenyl, 3-hexenyl, 4-hexenyl, or 5-hexenyl. Similarly,
(C.sub.2-C.sub.6)alkynyl can be ethynyl, 1-propynyl, 2-propynyl,
1-butynyl, 2-butynyl, 3-butynyl, 1-pentynyl, 2-pentynyl,
3-pentynyl, 4-pentynyl, 1-hexynyl, 2-hexynyl, 3-hexynyl, 4-hexynyl,
or 5-hexynyl.
[0263] As used herein, with exceptions as noted, "aryl" is intended
to mean any stable monocyclic, bicyclic or tricyclic carbon ring of
up to 8 members in each ring, wherein at least one ring is aromatic
as defined by the Huckel 4n+2 rule. Examples of aryl ring systems
include phenyl, naphthyl, tetrahydronaphthyl, and biphenyl. The
aryl group can be substituted with one or more moieties selected
from the group consisting of hydroxyl, amino, alkylamino,
arylamino, alkoxy, aryloxy, nitro, cyano, sulfonic acid, sulfate,
phosphonic acid, phosphate, or phosphonate, either unprotected, or
protected as necessary, as known to those skilled in the art, for
example, as taught in Greene, et al., Protective Groups in Organic
Synthesis, John Wiley and Sons, Second Edition, 1991.
[0264] The terms "aralkyl" and "arylalkyl", as used herein, and
unless otherwise specified, refers to an aryl group as defined
above linked to the molecule through an alkyl group as defined
above.
[0265] The term "alkaryl" and "alkylaryl", as used herein, and
unless otherwise specified, refers to an alkyl group as defined
above linked to the molecule through an aryl group as defined
above.
[0266] The term alkoxy, as used herein, and unless otherwise
specified, refers to a moiety of the structure --O-alkyl, wherein
alkyl is as defined above.
[0267] The term "halo" as used herein includes bromo, chloro, iodo
and fluoro.
[0268] The term "acyl" refers to a carboxylic acid ester in which
the non-carbonyl moiety of the ester group is selected from
straight, branched, or cyclic alkyl or lower alkyl; alkoxyalkyl
including methoxymethyl; aralkyl including benzyl; aryloxyalkyl
such as phenoxymethyl; aryl including phenyl optionally substituted
with halogen; C.sub.1-C.sub.6 alkyl or C.sub.1-C.sub.6 alkoxy;
sulfonate esters such as alkyl or aralkyl sulphonyl including
methanesulfonyl; the mono-, di- or triphosphate ester; trityl or
monomethoxytrityl; substituted benzyl; trialkylsilyl as, for e.g.,
dimethyl-t-butylsilyl or diphenylmethylsilyl. Aryl groups in the
esters optimally comprise a phenyl group.
[0269] The term "lower acyl" refers to an acyl group in which the
non-carbonyl moiety is lower alkyl.
[0270] The term amino, as used herein, refers to a moiety
represented by the structure --NR.sub.2, and includes primary
amines, and secondary, and tertiary amines substituted by alkyl
(i.e. alkylamino). Thus, R.sub.2 may represent two hydrogens, two
alkyl moieties, or one hydrogen and one alkyl moiety.
[0271] The terms "alkylamino" and "arylamino" refer to an amino
group that has one or two alkyl or aryl substituents,
respectively.
[0272] The term "protected" as used herein and, unless otherwise
defined, refers to a group that is added to an oxygen, nitrogen or
phosphorus atom to prevent its further reaction or for other
purposes. Numerous oxygen and nitrogen protecting groups are known
to those skilled in the art of organic synthesis.
[0273] The term amido, as used herein, refers to a moiety
represented by the structure --C(O)NR.sub.2, wherein R.sub.2 is as
defined for amino.
[0274] As used herein, an "amino acid" is a natural amino acid
residue (e.g. Ala, Arg, Asn, Asp, Cys, Glu, Gln, Gly, His, Hyl,
Hyp, Ile, Leu Lys, Met, Phe, Pro, Ser, Thr, Trp, Tyr, and Val) in D
or L form, or an unnatural amino acid (e.g. phosphoserine;
phosphothreonine; phosphotyrosine; gamma-carboxyglutamate; hippuric
acid; octahydroindole-2-carboxylic acid; statine;
1,2,3,4,-tetrahydroisoquinoline-3-carboxylic acid; penicillamine;
ornithine; citrulline; .alpha.-methyl-alanine;
para-benzoylphenylalanine; phenylglycine; propargyl-glycine;
sarcosine; and tert-butylglycine) residue having one or more open
valences. Other unnatural amino acids include those represented by
the formula NH.sub.2 (CH.sub.2).sub.yCOOH, wherein y=2-20, and
preferably 2-12, and include the aminoalkanoic acids such as
.epsilon.-amino caproic acid
(H.sub.2N--(CH.sub.2).sub.5--COOH).
[0275] The term also comprises natural and unnatural amino acids
bearing amino protecting groups such as acetyl, acyl,
trifluoroacetyl, and benzyloxycarbonyl), as well as natural and
unnatural amino acids protected at carboxy with protecting groups
such as a C.sub.1-C.sub.6 alkyl, phenyl or benzyl ester and amide.
Other suitable amino and carboxy protecting groups are known to
those skilled in the art. See for example, T. W. Greene, Protecting
Groups in Organic Synthesis; Wiley: New York, 1981; D. Voet,
Biochemistry, Wiley: New York, 1990; L. Stryer, Biochemistry,
(3.sup.rd Ed), W. H. Freeman and Co.: New York, 1975; J. March,
Advanced Organic Chemistry, Reactions, Mechanisms and Structure,
(2.sup.nd Ed.), McGraw Hill: New York, 1977; F. Carey and R.
Sundberg, Advanced Organic Chemistry, Part B: Reactions and
Synthesis, (2.sup.nd Ed.), Plenum: New York, 1977; and references
cited therein.
[0276] The term heteroalkyl refers to an alkyl group that contains
a heteroatom in the alkyl chain, including O, S, N, or P, and
wherein the heteroatom can be attached to other substituents to
complete the valence. Non-limiting examples of heteralkyl moieties
include polyoxyalkylene, and when divalent, --(CH.sub.2O).sub.n--
wherein n is an integer of from 0 to 20.
[0277] The term heterocycle or heterocyclic, as used herein except
where noted represents a stable 5- to 7-membered monocyclic or
stable 8- to 11-membered bicyclic heterocyclic ring which is either
saturated or unsaturated, and which consists of carbon atoms and
from one to three heteroatoms selected from the group consisting of
N, O and S; and wherein the nitrogen and sulfur heteroatoms may
optionally be oxidized, and the nitrogen heteroatom may optionally
be quaternized, and including any bicyclic group in which any of
the above-defined heterocyclic rings is fused to a benzene ring.
The heterocyclic ring may be attached at any heteroatom or carbon
atom which results in the creation of a stable structure.
[0278] The term heteroaryl or heteroaromatic, as used herein,
refers to an aromatic moiety that includes at least one sulfur,
oxygen, nitrogen or phosphorus in the aromatic ring. The term
heterocyclic refers to a nonaromatic cyclic group wherein there is
at least one heteroatom, such as oxygen, sulfur, nitrogen, or
phosphorus in the ring. Non-limiting examples of heteroaryl and
heterocyclic groups include furyl, furanyl, pyridyl, pyrimidyl,
thienyl, isothiazolyl, imidazolyl, tetrazolyl, pyrazinyl,
benzofuranyl, benzothiophenyl, quinolyl, isoquinolyl, benzothienyl,
isobenzofuryl, pyrazolyl, indolyl, isoindolyl, benzimidazolyl,
purinyl, carbazolyl, oxazolyl, thiazolyl, isothiazolyl,
1,2,4-thiadiazolyl, isooxazolyl, pyrrolyl, quinazolinyl,
cinnolinyl, phthalazinyl, xanthinyl, hypoxanthinyl, thiophene,
furan, pyrrole, isopyrrole, pyrazole, imidazole, 1,2,3-triazole,
1,2,4-triazole, oxazole, isoxazole, thiazole, isothiazole,
pyrimidine or pyridazine, and pteridinyl, aziridines, thiazole,
isothiazole, 1,2,3-oxadiazole, thiazine, pyridine, pyrazine,
piperazine, pyrrolidine, oxaziranes, phenazine, phenothiazine,
morpholinyl, pyrazolyl, pyridazinyl, pyrazinyl, quinoxalinyl,
xanthinyl, hypoxanthinyl, pteridinyl, 5-azacytidinyl,
5-azauracilyl, triazolopyridinyl, imidazolopyridinyl,
pyrrolopyrimidinyl, pyrazolopyrimidinyl, adenine,
N.sup.6-alkylpurines, N.sup.6-benzylpurine, N.sup.6-halopurine,
N.sup.6-vinypurine, N.sup.6-acetylenic purine, N.sup.6-acyl purine,
N.sup.6-hydroxyalkyl purine, N.sup.6-thioalkyl purine, thymine,
cytosine, 6-azapyrimidine, 2-mercaptopyrmidine, uracil,
N.sup.5-alkyl-pyrimidines, N.sup.5-benzylpyrimidines,
N.sup.5-halopyrimidines, N.sup.5-vinyl-pyrimidine,
N.sup.5-acetylenic pyrimidine, N.sup.5-acyl pyrimidine,
N.sup.5-hydroxyalkyl purine, and N.sup.6-thioalkyl purine, and
isoxazolyl. The heteroaromatic and heterocyclic moieties can be
optionally substituted as described above for aryl, including
substituted with one or more substituent selected from halogen,
haloalkyl, alkyl, alkoxy, hydroxy, carboxyl derivatives, amido,
amino, alkylamino, dialkylamino. The heteroaromatic can be
partially or totally hydrogenated as desired. As a nonlimiting
example, dihydropyridine can be used in place of pyridine.
Functional oxygen and nitrogen groups on the heteroaryl group can
be protected as necessary or desired. Suitable protecting groups
are well known to those skilled in the art, and include
trimethylsilyl, dimethylhexylsilyl, t-butyldi-methylsilyl, and
t-butyldiphenylsilyl, trityl or substituted trityl, alkyl groups,
acyl groups such as acetyl and propionyl, methanesulfonyl, and
p-toluenesulfonyl.
[0279] As used herein, the terms "substantially free of" and
"substantially in the absence of" refer to a composition that
includes at least 85-90% by weight, preferably 95%-98% by weight,
and even more preferably 99%-100% by weight, of the designated
enantiomer of that compound. In a preferred embodiment, the
compounds listed in the methods and compounds of this invention are
substantially free of enantiomers other than for the one
designated.
[0280] Similarly, the term "isolated" refers to a composition that
includes at least 85%-90% by weight, preferably 95%-98% by weight,
and even more preferably 99%-100% by weight, of the compound, the
remainder comprising other chemical species or enantiomers.
[0281] The term "independently" is used herein to indicate that a
variable is applied in any one instance without regard to the
presence or absence of a variable having that same or a different
definition within the same compound. Thus, in a compound in which
R'' appears twice and is defined as "independently carbon or
nitrogen", both R''s can be carbon, both R''s can be nitrogen, or
one R'' can be carbon and the other nitrogen.
[0282] The term "host", as used herein, refers to unicellular or
multicellular organism in which abnormal cellular proliferation can
be mimicked. The term host specifically refers to cells that
abnormally proliferate, either from natural or unnatural causes
(for example, from genetic mutation or genetic engineering,
respectively), and animals, in particular, primates (including
chimpanzees) and humans. In most animal applications of the present
invention, the host is a human patient. Veterinary applications, in
certain indications, however, are clearly anticipated by the
present invention.
III. Prodrugs and Derivatives
[0283] The active compound can be administered as any salt or
prodrug that upon administration to the recipient is capable of
providing directly or indirectly the parent compound, or that
exhibits activity itself.
A. Pharmaceutically Acceptable Salts
[0284] In cases where compounds are sufficiently basic or acidic to
form stable nontoxic acid or base salts, administration of the
compound as a pharmaceutically acceptable salt may be
appropriate.
[0285] The term "pharmaceutically acceptable salt" refers to a salt
or complex of the active compound in which the compound carries a
counterion that is pharmaceutically acceptable and retains the
desired biological activity of the parent compound and exhibits
minimal, if any, undesired toxicological effects. Any salt that
retains the desired biological activity of the compounds contained
herein and that exhibits minimal or no undesired or toxicological
effects is intended for inclusion here.
[0286] Pharmaceutically acceptable salts may be obtained using
standard procedures well known in the art, for example by reacting
a sufficiently basic compound such as an amine with a suitable acid
affording a physiologically acceptable anion. Alkali metal (for
example, sodium, potassium or lithium) or alkaline earth metal (for
example calcium) salts of carboxylic acids can also be made.
[0287] Nonlimiting examples of such salts are (a) acid addition
salts formed with inorganic acids (for example, hydrochloric acid,
hydrobromic acid, sulfuric acid, phosphoric acid, nitric acid,
bicarbonic acid, carbonic acid and the like), and salts formed with
organic acids such as acetic acid, oxalic acid, formic acid,
fumaric acid, propionic acid, glycolic acid, lactic acid, pyruvic
acid, maleic acid, salicylic acid, tartaric acid, succinic acid,
malic acid, ascorbic acid, benzoic acid, tannic acid, palmoic acid,
alginic acid, polyglutamic acid, tosic acid, methanesulphonic acid,
citric acid, malonic acid, .alpha.-ketoglutaric acid,
.alpha.-glycerophosphonic acid, naphthalenesulfonic acids,
naphthalene-disulfonic acids, and polygalacturonic acid; (b) base
addition salts formed with cations such as sodium, potassium,
lithium, zinc, calcium, bismuth, barium, magnesium, aluminum,
copper, cobalt, nickel, cadmium, and the like, or with an organic
cation, for example, formed from an amine, such as ammonium,
N,N-dibenzyl-ethylenediamine, D-glucosamine, tetraethylammonium, or
ethylenediamine; or (c) combinations of (a) and (b), e.g., a zinc
tannate salt or the like.
B. Prodrugs
[0288] Any of the compounds described herein can be administered as
a prodrug to increase the activity, bioavailability, stability or
otherwise alter the properties of the compound. A pharmaceutically
acceptable prodrug refers to a compound that is metabolized (i.e.,
hydrolyzed or oxidized, for example) in the host to form a compound
of the present invention. Typical examples of prodrugs include
compounds that have biologically labile protecting groups on a
functional moiety of the active compound. Prodrugs include
compounds that can be oxidized, reduced, aminated, deaminated,
hydroxylated, dehydroxylated, hydrolyzed, dehydrolyzed, alkylated,
dealkylated, acylated, deacylated, phosphorylated, and/or
dephosphorylated to produce the active compound. The compounds of
this invention possess anti-proliferative activity against
abnormally proliferating cells, or are metabolized to a compound
that exhibits such activity.
[0289] A number of prodrug ligands are known. In general,
alkylation, acylation or other lipophilic modification of one or
more heteroatoms of the compound, such as a free amine or
carboxylic acid residue, reduces polarity and allows passage into
cells. Examples of substituent groups that can replace one or more
hydrogens on the free amine and/or carboxylic acid moiety are
alkyl, aryl, steroids, carbohydrates, including sugars,
1,2-diacylglycerol, alcohols, acyl (including lower acyl); alkyl
(including lower alkyl); sulfonate ester including alkyl or
arylalkyl sulfonyl including methanesulfonyl and benzyl, wherein
the phenyl group is optionally substituted with one or more
substituents as provided in the definition of an aryl given herein;
optionally substituted arylsulfonyl; a lipid, including a
phospholipid; phosphotidylcholine, phosphocholine, an amino acid
residue or derivative; an amino acid acyl residue or derivative; a
carbohydrate; a peptide; cholesterol; or other pharmaceutically
acceptable leaving group which, when administered in vivo, provides
the free amine and/or carboxylic acid moiety. Any of these can be
used in combination with the disclosed compounds to achieve a
desired effect.
C. Stereochemistry
[0290] It is to be understood that the compounds disclosed herein
may contain chiral centers. Such chiral centers may be of either
the (R) or (S) configuration, or may be a mixture thereof. Thus,
the compounds provided herein may be enantiomeric ally pure, or be
stereoisomeric or diastereomeric mixtures. It is understood that
the disclosure of a compound herein encompasses any racemic,
optically active, polymorphic, or steroisomeric form, or mixtures
thereof, which preferably possesses the useful properties described
herein, it being well known in the art how to prepare optically
active forms and how to determine activity using the standard tests
described herein, or using other similar tests which are will known
in the art. Examples of methods that can be used to obtain optical
isomers of the compounds include the following:
[0291] i) physical separation of crystals--a technique whereby
macroscopic crystals of the individual enantiomers are manually
separated. This technique can be used if crystals of the separate
enantiomers exist, i.e., the material is a conglomerate, and the
crystals are visually distinct;
[0292] ii) simultaneous crystallization--a technique whereby the
individual enantiomers are separately crystallized from a solution
of the racemate, possible only if the latter is a conglomerate in
the solid state;
[0293] iii) enzymatic resolutions--a technique whereby partial or
complete separation of a racemate by virtue of differing rates of
reaction for the enantiomers with an enzyme
[0294] iv) enzymatic asymmetric synthesis, a synthetic technique
whereby at least one step of the synthesis uses an enzymatic
reaction to obtain an enantiomerically pure or enriched synthetic
precursor of the desired enantiomer;
[0295] v) chemical asymmetric synthesis--a synthetic technique
whereby the desired enantiomer is synthesized from an achiral
precursor under conditions that produce asymetry (i.e., chirality)
in the product, which may be achieved using chiral catalysts or
chiral auxiliaries;
[0296] vi) diastereomer separations--a technique whereby a racemic
compound is reacted with an enantiomerically pure reagent (the
chiral auxiliary) that converts the individual enantiomers to
diastereomers. The resulting diastereomers are then separated by
chromatography or crystallization by virtue of their now more
distinct structural differences and the chiral auxiliary later
removed to obtain the desired enantiomer;
[0297] vii) first- and second-order asymmetric transformations a
technique whereby diastereomers from the racemate equilibrate to
yield a preponderance in solution of the diastereomer from the
desired enantiomer or where preferential crystallization of the
diastereomer from the desired enantiomer perturbs the equilibrium
such that eventually in principle all the material is converted to
the crystalline diastereomer from the desired enantiomer. The
desired enantiomer is then released from the diastereomer,
[0298] viii) kinetic resolutions--this technique refers to the
achievement of partial or complete resolution of a racemate (or of
a further resolution of a partially resolved compound) by virtue of
unequal reaction rates of the enantiomers with a chiral,
non-racemic reagent or catalyst under kinetic conditions;
[0299] ix) enantiospecific synthesis from non-racemic precursors--a
synthetic technique whereby the desired enantiomer is obtained from
non-chiral starting materials and where the stereochemical
integrity is not or is only minimally compromised over the course
of the synthesis;
[0300] x) chiral liquid chromatography, a technique whereby the
enantiomers of a racemate are separated in a liquid mobile phase by
virtue of their differing interactions with a stationary phase. The
stationary phase can be made of chiral material or the mobile phase
can contain an additional chiral material to provoke the differing
interactions;
[0301] xi) chiral gas chromatography, a technique whereby the
racemate is volatilized and enantiomers are separated by virtue of
their differing interactions in the gaseous mobile phase with a
column containing a fixed non-racemic chiral adsorbent phase;
[0302] xii) extraction with chiral solvents--a technique whereby
the enantiomers are separated by virtue of preferential dissolution
of one enantiomer into a particular chiral solvent; and
[0303] xiii) transport across chiral membranes--a technique whereby
a racemate is placed in contact with a thin membrane barrier. The
barrier typically separates two miscible fluids, one containing the
racemate, and a driving force such as concentration or pressure
differential causes preferential transport across the membrane
barrier. Separation occurs as a result of the non-racemic chiral
nature of the membrane which allows only one enantiomer of the
racemate to pass through.
[0304] The compound optionally may be provided in a composition
that is enantiomerically enriched, e.g., a mixture of enantiomers
in which one enantiomer is present in excess, e.g., to the extent
of 95% or more, or 98% or more, including 100%.
IV. Synthesis
[0305] As depicted in FIG. 2, the process of the invention for the
synthesis of a sub-embodiment of the compound of Formula (I) starts
with the conversion of commercially available
5-methyl-2-nitrobenzoic acid to the corresponding amide (2) and its
subsequent transformation to 5-methyl-2-nitrobenzonitrile (3) by
standard procedures. Reaction of (3) in DMF under nitrogen with
p-formylmethylbenzoate in the presence of an organic base such as
diazabicylo octane for several hours gave the olefin (4) after work
up as a mixture of geometric isomers. Olefin (4) can also be
prepared by reacting (3) with p-formylmethylbenzoate in methanol
using sodium methoxide as a base. In general, this reaction can be
performed in any appropriate organic solvent using commonly used
organic or inorganic bases. Reduction of (4) with a reducing agent,
such as sodium dithionite, gave the aminonitrile (5), which was
cyclized with guanidine to the corresponding pteroate analogue (6),
which after catalytic hydrogenation and hydrolysis gave
4-amino-4-deoxy-5,8,10-trideazapteroic acid (7). Coupling of (7)
with diethyl-4-methyleneglutamate by the isobutylchlorformate
method previously described by Nair and Baugh [Biochemistry (1973)
12: 3923-3927] followed by mild hydrolysis of the resultant diester
gave crude (1) which was purified by reverse phase chromatography
on C-18 silica gel using 12% acetonitrile in water as the eluting
solvent [Scheme-1].
[0306] An alternate procedure for the preparation of olefine (4) is
allylic bromination of (3) to the corresponding benzyl bromide
(3b), and its subsequent reaction with triphenylphosphine to the
Wittig salt. Treatment of this Wittig salt with
p-formylmethylbenzoate in an organic solvent (e.g., DMF) using an
organic base in a typical Wittig reaction gave (4) in moderate
yield. Any convenient organic solvent and an organic or inorganic
base compatible with the solvent can be used for this reaction.
[0307] Substitution of p-formyl methylbenzoate with
p-carbomethoxyacetophenone in the above reaction with (3) gives the
corresponding methyl substituted olefin which after dithionite
reduction, guanidine cyclization, hydrogenation, hydrolysis,
diethyl-4-methyleneglutamate coupling followed by hydrolysis yields
the 10-methyl derivative (1a). Likewise, substitution of p-formyl
methylbenzoate with p-carbomethoxy-propiophenone in the reaction
with (3) and workup as above should yield the 10-ethyl derivative
(1b).
[0308] Benzylic bromination of (3) gave the corresponding
bromomethyl derivative (3b) that on reaction with
p-methylaminomethybenzoate an dmethyl-p-methylaminobenzoate gave
the corresponding aminonitriles which after dithionite reduction,
guanidine cyclization and hydrolysis gave the pteroate analogs (3)
and (9). 4-Methyleneglutamate coupling described as above and
hydrolysis gave the 10-nor-methylamino and 10-nor-amino derivatives
(1c) and (1d), respectively.
V. Pharmaceutical Compositions and Administration
[0309] Any host organism, including a patient, mammal, and
specifically a human, suffering from any of the above-described
conditions can be treated by the administration of a composition
comprising an effective amount of the compound of formula (I) or
formula (II) or a pharmaceutically acceptable salt, prodrug or
ester thereof, optionally in a pharmaceutically acceptable carrier.
The term "carrier" includes but is not limited to diluents,
binders, lubricants, disintegrators, fillers, and coating
compositions.
[0310] An effective dose for any of the herein described conditions
can be readily determined by the use of conventional techniques and
by observing results obtained under analogous circumstances. In
determining the effective dose, a number of factors are considered
including, but not limited to: the species of patient; its size,
age, and general health; the specific disease involved; the degree
of involvement or the severity of the disease; the response of the
individual patient; the particular compound administered; the mode
of administration; the bioavailability characteristics of the
preparation administered; the dose regimen selected; and the use of
concomitant medication. The compound is administered for a
sufficient time period to alleviate the undesired symptoms and the
clinical signs associated with the condition being treated.
[0311] The active compound is included in the pharmaceutically
acceptable carrier or diluent in an amount sufficient to deliver to
a patient a therapeutic amount of compound in vivo in the absence
of serious toxic effects. The concentration of active compound in
the drug composition will depend on absorption, inactivation, and
excretion rates of the drug as well as other factors known to those
of skill in the art. It is to be noted that dosage values will also
vary with the severity of the condition to be alleviated. It is to
be further understood that for any particular subject, specific
dosage regimens should be adjusted over time according to the
individual need and the professional judgment of the person
administering or supervising the administration of the
compositions, and that the dosage ranges set forth herein are
exemplary only and are not intended to limit the scope or practice
of the claimed composition. The active ingredient may be
administered at once, or may be divided into a number of smaller
doses to be administered at varying intervals of time.
[0312] The compound can also be mixed with other active materials
that do not impair the desired action, or with materials that
supplement the desired action. For a detailed description, see, for
example, Section VII, "Combination Therapies."
[0313] The formulations of the pharmaceutical compositions
described herein may be prepared by any method known or hereafter
developed in the art of pharmacology. In general, such preparatory
methods include the step of bringing the therapeutic compound into
association with a carrier or one or more other accessory
ingredients, and then, if necessary or desirable, shaping or
packaging the product into a desired single- or multi-dose
unit.
[0314] In one embodiment, compound may be administered orally in
combination with a pharmaceutically acceptable vehicle such as an
inert diluent or an edible carrier. Oral compositions may be
enclosed in hard or soft shell gelatin capsules, may be compressed
into tablets or may be incorporated directly with the food of the
patient's diet. For the purpose of oral therapeutic administration,
the compound can be incorporated with one or more excipients and
used in the form of tablets, buccal tablets, troches, capsules,
elixirs, suspensions, syrups, wafers and the like. The percentage
of the composition and preparations may be varied, and may
conveniently be between from about 2% to about 60% of the weight of
a given unit dosage form. The amount of substance in such
therapeutically useful compositions is such that an effective
dosage level will be obtained.
[0315] The tablets, pills, capsules, troches and the like can
contain any of the following ingredients, or compounds of a similar
nature: a binder such as microcrystalline cellulose, gum tragacanth
or gelatin; an excipient such as starch or lactose, a
disintegrating agent such as alginic acid, Primogel, or corn
starch; a lubricant such as magnesium stearate or Sterotes; a
glidant such as colloidal silicon dioxide; a sweetening agent such
as sucrose or saccharin; or a flavoring agent such as peppermint,
methyl salicylate, or orange flavoring. In one particular
embodiment, the compounds and compositions disclosed herein can be
formulated as microcrystalline cellulose tablets.
[0316] Hard capsules containing the compound may be made using a
physiologically degradable composition, such as gelatin. Such hard
capsules comprise the compound, and may further comprise additional
ingredients including, for example, an inert solid diluent such as
calcium carbonate, calcium phosphate, or kaolin. Soft gelatin
capsules containing the compound may be made using a
physiologically degradable composition, such as gelatin. Such soft
capsules comprise the compound, which may be mixed with water or an
oil medium such as peanut oil, liquid paraffin, or olive oil.
[0317] Sublingual tablets are designed to dissolve very rapidly.
Examples of such formulations include ergotamine tartrate,
isosorbide dinitrate, isoproterenol HCL. The formulations of these
tablets contain, in addition to the drug, a limited number of
soluble excipients, usually lactose and powdered sucrose, but
sometimes dextrose and mannitol.
[0318] The solid dosage forms of the present invention may
optionally be coated. Examples of suitable coating materials
include, but are not limited to, cellulose polymers such as
cellulose acetate phthalate, hydroxypropyl cellulose, hydroxypropyl
methylcellulose, hydroxypropyl methylcellulose phthalate and
hydroxypropyl methylcellulose acetate succinate; polyvinyl acetate
phthalate, acrylic acid polymers and copolymers, and methacrylic
resins that are commercially available under the trade name
Eudragit.RTM. (Roth Pharma, Westerstadt, Germany), Zein, shellac,
and polysaccharides.
[0319] Powdered and granular formulations of a pharmaceutical
preparation of the invention may be prepared using known methods.
Such formulations may be administered directly to a patient used,
for example, to form tablets, to fill capsules, or to prepare an
aqueous or oily suspension or solution by addition of an aqueous or
oily vehicle thereto. Each of these formulations may further
comprise one or more of dispersing or wetting agent, a suspending
agent, and a preservative. Additional excipients (e.g., fillers and
sweetening, flavoring, or coloring agents) may also be included in
these formulations.
[0320] Liquid formulations of the pharmaceutical composition of the
invention which are suitable for oral administration may be
prepared, packaged, and sold either in liquid form or in the form
of a dry product intended for reconstitution with water or another
suitable vehicle prior to use.
[0321] Liquid suspensions may be prepared using conventional
methods to achieve suspension of the compound and an aqueous or
oily vehicle. Aqueous vehicles include, for example, water and
isotonic saline. Oily vehicles include, for example, almond oil,
oily esters, ethyl alcohol, vegetable oils such as arachis, olive,
sesame, or coconut oil, fractionated vegetable oils, and mineral
oils such as liquid paraffin. Liquid suspensions may also contain
one or more additional ingredients including, but not limited to,
suspending agents, dispersing or wetting agents, emulsifying
agents, demulcents, preservatives, buffers, salts, flavorings,
coloring agents, and sweetening agents. Oily suspensions may
further comprise a thickening agent. Suspending agents may include,
for example, sorbitol syrup, hydrogenated edible fats, sodium
alginate, polyvinylpyrrolidone, gum tragacanth, gum acacia, and
cellulose derivatives such as sodium carboxymethylcellulose,
methylcellulose, hydroxypropylmethylcellulose. Dispersing or
wetting agents may include, for example, naturally-occurring
phosphatides such as lecithin, condensation products of an alkylene
oxide with a fatty acid, with a long chain aliphatic alcohol, with
a partial ester derived from a fatty acid and a hexitol, or with a
partial ester derived from a fatty acid and a hexitol anhydride
(e.g., polyoxyethylene stearate, heptadecaethyleneoxycetanol,
polyoxyethylene sorbitol monooleate, and polyoxyethylene sorbitan
monooleate, respectively). Emulsifying agents include, but are not
limited to, lecithin and acacia. Preservatives may include, for
example, methyl, ethyl, or n-propyl-para-hydroxybenzoates, ascorbic
acid, and sorbic acid. Sweetening agents include, for example,
glycerol, propylene glycol, sorbitol, sucrose, and saccharin.
Thickening agents for oily suspensions include, for example,
beeswax, hard paraffin, and acetyl alcohol.
[0322] Liquid solutions of the active ingredient in aqueous or oily
solvents may be prepared in substantially the same manner as liquid
suspensions, wherein the active ingredient is dissolved, rather
than suspended in the solvent. Liquid solutions of the
pharmaceutical composition of the invention may contain each of the
components described above for liquid suspensions, other than
suspending agents, which are unnecessary. Aqueous solvents include,
for example, water and isotonic saline. Oily solvents include, for
example, almond oil, oily esters, ethyl alcohol, vegetable oils
such as arachis, olive, sesame, or coconut oil, fractionated
vegetable oils, and mineral oils such as liquid paraffin.
[0323] Administration
[0324] The compositions can be administered in any desired manner,
including, but not limited to, oral, topical, parenteral,
intravenous, intradermal, intra-articular, intra-synovial,
intrathecal, intra-arterial, intracardiac, intramuscular,
subcutaneous, intraorbital, intracapsular, intraspinal,
intrasternal, topical, transdermal patch, via rectal, vaginal or
urethral suppository, peritoneal, percutaneous, nasal spray,
surgical implant, internal surgical paint, infusion pump, or via
catheter, stent, balloon or other delivery device.
[0325] Parenteral administration of the pharmaceutical composition
includes any route of administration characterized by physical
breaching of a tissue of a subject and administration of the
pharmaceutical composition through the breach in the tissue, such
as administration of the pharmaceutical composition by injection of
the composition, by application of the composition through a
surgical incision, by application of the composition through a
tissue-penetrating non-surgical wound, and the like.
[0326] Formulations of a pharmaceutical composition suitable for
parenteral administration comprise the compound combined with a
pharmaceutically acceptable carrier, such as sterile water or
sterile isotonic saline. Formulations suitable for parenteral
administration include, for example, suspensions, solutions,
emulsions in oily or aqueous vehicles. Such formulations may
further comprise one or more additional ingredients including, but
not limited to, suspending, stabilizing, or dispersing agents. In
one embodiment of a formulation for parenteral administration, the
compound is provided in dry (i.e., powder or granular) form for
reconstitution with a suitable vehicle (e.g., sterile pyrogen-free
water) prior to parenteral administration of the reconstituted
composition.
[0327] In one embodiment, the compound administered intravenously
or intraperitoneally by infusion or injection. The pharmaceutical
dosage forms suitable for infusion or injection can include sterile
aqueous solutions or dispersions or sterile powders containing the
substance which are adapted for the extemporaneous preparation of
sterile injectable or infusible solutions or dispersions,
optionally encapsulated in liposomes. In all cases, the ultimate
dosage form must be sterile, fluid and stable under the conditions
of storage or manufacture. The liquid carrier or vehicle can be a
solvent or liquid dispersion medium comprising, for example, water,
normal saline, ethanol, a polyol (e.g.; glycerol, propylene glycol,
liquid polyethylene glycol and the like), vegetable oils, nontoxic
glyceryl esters, and suitable mixtures thereof. The proper fluidity
can be maintained, for example, by the formation of liposomes, by
the maintenance of the required particle size in the case of
dispersions or by the use of surfactants. The prevention of the
action of microorganisms can be brought about by various
antibacterial and antifungal agents, for example, parabens,
chlorobutanol, phenol, benzyl alcohol, sorbic acid, thimerosal, and
the like. In many cases, it will be preferable to include isotonic
agents, for example, sugars, buffers or sodium chloride. Prolonged
absorption of the injectable compositions can be brought about by
the use in the compositions of agents delaying absorption, for
example, aluminum monostearate and gelatin.
[0328] Sterile injectable solutions are prepared by incorporating
the substance in the required amount in the appropriate solvent
with various of the other ingredients enumerated above, as
required, followed by filter sterilization. In the case of sterile
powders for the preparation of sterile injectable solutions, the
preferred methods of preparation are vacuum drying and the freeze
drying techniques, which yield a powder of the active ingredient
plus any additional desired ingredient present in the previously
sterile-filtered solutions.
[0329] Injectable solutions are particularly advantageous for local
administration of the therapeutic composition. In particular,
parenchymal injection can be used to deliver the therapeutic
composition directly to a tumorous growth. Intra-articular
injection is a preferred alternative in cases of arthritis where
the practitioner wishes to treat one or only a few (such as 2-6)
joints. Additionally, the therapeutic compounds are injected
directly into lesions (intra-lesion administration) in appropriate
cases. Intradermal administration is an alternative for dermal
lesions.
[0330] The compounds of the present invention are optionally
administered topically. Formulations suitable for topical
administration include, for example, liniments, lotions,
oil-in-water or water-in-oil emulsions such as creams, ointments or
pastes, and solutions or suspensions. Ointments are semisolid
preparations which are typically based on petrolatum or other
petroleum derivatives. Creams containing the compound are typically
viscous liquid or semisolid emulsions, often either oil-in-water or
water-in-oil, Cream bases are typically water-washable, and contain
an oil phase, an emulsifier and an aqueous phase. The oil phase,
also sometimes called the "internal" phase, is generally comprised
of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol;
the aqueous phase usually, although not necessarily, exceeds the
oil phase in volume, and generally contains a humectant. The
emulsifier in a cream formulation is generally a nonionic, anionic,
cationic or amphoteric surfactant. The specific ointment or cream
base to be used, as will be appreciated by those skilled in the
art, is one that will provide for optimum drug delivery. As with
other carriers or vehicles, an ointment base should be inert,
stable, nonirritating and nonsensitizing. Formulations for topical
administration may further comprise one or more of the additional
ingredients described herein.
[0331] In one embodiment, the compound is delivered through the
skin using transdermal drug delivery system. In a specific
embodiment, the active ingredient is contained within a laminated
structure that serves as a drug delivery device to be affixed to
the skin--e.g. a patch. In such a structure, the drug composition
is typically contained in a layer, or "reservoir," underlying an
upper backing layer. The patch may contain a single reservoir, or
it may contain multiple reservoirs.
[0332] In one particular embodiment of the present invention, the
compounds and/or compositions described herein can be administered
topically for the treatment of a abnormal cell proliferation
disorder. In one embodiment, the disorder can be psoriasis. In
another particular embodiment, the compounds and/or compositions
described herein can be administered topically, for example, as a
cream, for the treatment of psoriasis.
[0333] For pulmonary delivery, the compound may be administered to
the lungs of a subject by any suitable means, but are preferably
administered by administering an aerosol suspension of respirable
particles comprised of the active compound, which the subject
inhales. The respirable particles may be liquid or solid. The
active compound can be aerosolized in a variety of forms, such as,
but not limited to, dry powder inhalants, metered dose inhalants,
or liquid/liquid suspensions.
[0334] In one embodiment, the formulation may contain the compound
in the form of dry particles. Such compositions are conveniently in
the form of dry powders for administration using a device
comprising a dry powder reservoir to which a stream of propellant
may be directed to disperse the powder or using a self-propelling
solvent/powder-dispensing container such as a device comprising the
compound dissolved or suspended in a low-boiling propellant in a
sealed container. Dry powder compositions preferably include a
solid fine powder diluent such as sugar and are conveniently
provided in a unit dose form.
[0335] In one embodiment, the formulation for pulmonary delivery
provides the compound in the form of droplets of a solution or
suspension. Such formulations may be prepared, packaged, or sold as
aqueous or dilute alcoholic solutions or suspensions, optionally
sterile, comprising the active ingredient, and may conveniently be
administered using any nebulization or atomization device. Such
formulations may further comprise one or more additional
ingredients including, for example, a flavoring agent such as
saccharin sodium, a volatile oil, a buffering agent, a surface
active agent, or a preservative such as methylhydroxybenzoate.
[0336] Aerosols of solid particles containing the active compound
may be produced with any solid particulate medicament aerosol
generator. Aerosol generators suitable for administering solid
particulate medicaments to a subject produce particles which are
respirable and generate a volume of aerosol containing a
predetermined metered dose of a medicament at a rate suitable for
human administration. A representative solid particulate aerosol
generator is an insufflator. Suitable formulations for
administration by insufflation include finely comminuted powders
which may be delivered by means of an insufflator or taken into the
nasal cavity in the manner of a snuff. In the insufflator, the
powder (e.g., a metered dose thereof effective to carry out the
treatments described herein) is contained in capsules or
cartridges, typically made of gelatin or plastic, which are either
pierced or opened in situ and the powder delivered by air drawn
through the device upon inhalation or by means of a
manually-operated pump. The powder employed in the insufflator
consists either solely of the active ingredient or of a powder
blend comprising the active ingredient, a suitable powder diluent,
such as lactose, and an optional surfactant. The active ingredient
typically comprises from 0.1 to 100 w/w of the formulation.
[0337] The metered dose inhaler provides a second example of a
solid particulate aerosol generator. Metered dose inhalers are
pressurized aerosol dispensers, which typically contain a
suspension or solution formulation of the active ingredient in a
liquified propellant. During use these devices discharge the
formulation through a valve adapted to deliver a metered volume,
typically from 10 to 200 .mu.L, to produce a fine particle spray
containing the active ingredient. Suitable propellants include, for
example, chlorofluorocarbon compounds (e.g.,
dichlorodifluoromethane, trichlorofluoromethane,
dichlorotetrafluoroethane and mixtures thereof). The formulation
may additionally contain one or more co-solvents, for example,
ethanol, surfactants, such as oleic acid or sorbitan trioleate,
antioxidants and suitable flavoring agents.
[0338] Aerosols of liquid particles comprising the active compound
may be produced by any suitable means, such as with a
pressure-driven jet aerosol nebulizer or an ultrasonic nebulizer.
See, e.g., U.S. Pat. No. 4,501,729. Nebulizers transform solutions
or suspensions of the active ingredient into a therapeutic aerosol
mist either by means of acceleration of compressed gas, typically
air or oxygen, through a narrow venturi orifice or by means of
ultrasonic agitation. Suitable formulations for use in nebulizers
consist of the active ingredient in a liquid carrier, the active
ingredient comprising up to 40% w/w of the formulation, but
preferably less than 20% w/w.
[0339] Solid or liquid particulate pharmaceutical formulations
should include particles sizes should be within a range suitable
for depositing a therapeutically effective amount in the lungs or
in the airways, e.g., about 1-10 microns, to treat the lung
condition of a patient in need of such treatment. Particles greater
in size which are included in the aerosol tend to be deposited in
the throat and swallowed, and the quantity of non-respirable
particles in the aerosol is preferably minimized.
[0340] The formulations described herein as being useful for
pulmonary delivery are also useful for intranasal delivery of a
pharmaceutical composition of the invention. For nasal
administration, a particle size in the range of 10-500 microns is
preferred to ensure retention in the nasal cavity.
[0341] For ophthalmic applications, the therapeutic compound is
formulated into solutions, suspensions, and ointments appropriate
for use in the eye. For opthalmic formulations, see Mitra (ed.),
Ophthalmic Drug Delivery Systems, Marcel Dekker, Inc., New York,
N.Y. (1993), and also Havener, W. H., Ocular Pharmacology, C. V.
Mosby Co., St. Louis (1983).
[0342] In one embodiment of the present invention, the compounds
are prepared with carriers that will protect the compound against
rapid elimination from the body, such as controlled release
formulations. Controlled release formulations include, for example,
delayed release or extended release formulations. The
controlled-release of the compound can be controlled in any way
suitable for achieving the desired result. Books describing methods
of controlled delivery that are appropriate for the delivery of
4-PBA include: Robert S. Langer, Donald L. Wise, editors; Medical
applications of controlled release (Volumes 1 and 2); Boca Raton,
Fla.: CRC Press, 1984; and William J. M. Hrushesky, Robert Langer
and Felix Theeuwes, editors; Temporal control of drug delivery
(series); New York: New York Academy of Sciences, 1991.
Representative, non-limiting systems suitable for use in the
present invention include diffusion controlled, solvent controlled
and chemically controlled systems.
[0343] Diffusion controlled systems suitable for use in the present
invention include systems involving (i) diffusion through a
membrane; and (ii) diffusion through a bulk polymer. In a membrane
system, otherwise known as a reservoir device, diffusion of water
through the polymer membrane is the rate determining step.
Reservoir devices include oral, implantable or transdermal systems,
for example. In one embodiment of the present invention, the active
ingredient is encapsulated within a polymer film or coat.
Representative, non-limiting polymers include cellulose ester,
cellulose ether, an acrylic polymer, or a mixture of polymers.
[0344] In one embodiment of the present invention, sustained
release of the compound is achieved through microencapsulation.
Microcapsules are defined as microparticles having an outer polymer
shell surrounding a core of another material, in this case, the
compound of the present invention. The size of a microcapsule can
vary from just a few microns to several millimeters. The
microencapsulation drug delivery system may utilize any of a number
of protective wall or covering materials, including proteins,
polysaccharides, starches, waxes, fats, polymers and resins.
[0345] In one embodiment of the present invention, controlled
release of the compound is achieved using a monolithic (matrix)
device. Release is by continuous leaching of the drug from the
polymer matrix core. Monolithic device may be formed, for example,
by the compression of the polymer/drug mixture or by dissolution or
melting. One type of matrix formulation is a matrix tablet, which
is a matrix formulation in tablet form. The rate of release through
the bulk polymer depends upon the amount of drug present at a
particular time, and is therefore time dependent.
[0346] The three major types of materials suitable for use in the
preparation of matrix devices include (i) insoluble plastics; (ii)
hydrophilic polymers; and (iii) fatty compounds. Plastic matrixes
are chemically inert and have a good drug embedding ability.
Examples of suitable thermoplastic polymers are those having
formulas incorporating monomeric units such as lactides,
glycolides, caprolactones, anhydrides, amides, urethanes,
esteramides, orthoesters, dioxanones, acetals, ketals, carbonates,
phosphazenes, hydroxybutyrates, hydroxyvalerates, alkylene
oxalates, alkylene succinates, and amino acids. Copolymers of any
combination of lactide, caprolactone, and glycolide monomeric units
are preferred.
[0347] Representative hydrophilic polymers suitable for use in a
polymer matrix include cellulose derivatives, noncellulose
polysaccharides, polyethylene oxide, polyvinyl alcohols and acrylic
acid copolymers. Representative, non-limiting examples of cellulose
derivatives include methylcellulose, hydroxypropyl methylcellulose
(HPMC), hydroxyethyl cellulose, hydroxypropyl cellulose,
carboxymethylcellulose, hydroxomethylcellulose, hemicellulose, and
methylcellulose.
[0348] Fatty compounds include, but are not limited to, fatty
excipients including glycerides (e.g., mono-, di- or triglycerides
such as stearin, paInitin, laurin, myristin, hydrogenated castor or
cottonseed oils, precirol), fatty acids and alcohols (e.g.,
stearic, palmitic or lauric acids; stearyl, cetyl or cetostearyl
alcohols), fatty acid esters (e.g., monostearates of propylene
glycol and of sucrose, sucrose distearate) and waxes (e.g., white
wax, cachalot wax).
[0349] The matrix may include a single polymer type or multiple
polymer types (i.e., a polymer blend). Representative U.S. patent
disclosing polymer blends include U.S. Pat. No. 5,128,143 (Baichwal
et al.) entitled "Sustained Release Excipient and Tablet
Formation"; U.S. Pat. No. 4,842,866 (Horder et al) entitled "Slow
Release Solid Preparation"; U.S. Pat. No. 5,811,126 (Krishnamurthy)
entitled "Controlled Release Matrix for Pharmaceuticals"; U.S. Pat.
No. 3,965,256 (Leslie) entitled "Slow Release Pharmaceutical
Composition"; and U.S. Pat. No. 4,235,870 (Leslie) entitled "Slow
Release Pharmaceutical Compositions." In a polymer blend, the ratio
of the two polymer types may be equal or different. A
representative, non-limiting example of a hydrophilic polymer blend
is a polyvinyl alcohol (PVA) and polyvinyl pyrrolidone (PVP)-based
matrix.
[0350] The devices with different drug release mechanisms described
above could be combined in a final dosage form comprising single or
multiple units. Examples of multiple units include multilayer
tablets, capsules containing tablets, beads, granules, etc.
[0351] Osmotically controlled systems are also suitable for use in
the present invention. The osmotic pump is one such system. It is
similar to a reservoir device but contains an osmotic agent (e.g.,
the active agent in salt form) which acts to imbibe water from the
surrounding medium via a semi-permeable membrane. See Theeuwes F.,
Elementary Osmotic Pump., J. Pharm. Sci., 64 (12), 1987-1991,
1975.
[0352] Chemically controlled systems are also suitable for use in
the present invention. Chemically controlled systems include (i)
erosion based systems; and (ii) pendant systems (i.e., combination
of hydrolysis of pendant group and diffusion from bulk polymer).
One type of erosion based system is a biodegradable polymer-based
system. Representative, non-limiting examples of biodegradable
polymers include naturally occurring biodegradable polymers such as
alginate, dextrin, cellulose, collagen, chitosan; chemically or
enzymatrically modified naturally occurring biodegradable polymers;
and synthetic biodegradable polymers, such as polyanhydrides,
polyesters, polyacrylic acids polyurethanes, polyphosphoesters and
polyphosphazenes and poly(methyl methacrylates.
[0353] Non-limiting examples of U.S. patents that describe
controlled release formulations are: U.S. Pat. No. 5,356,630 to
Laurencin et al. (Delivery System for Controlled Release of
Bioactive Factors); U.S. Pat. No. 5,797,898 to Santini, Jr. et al.
(Microchip Drug Delivery Devices); U.S. Pat. No. 5,874,064 to
Edwards et al. (Aerodynamically Light Particles for Pulmonary Drug
Delivery); U.S. Pat. No. 5,548,035 to Kim et al. (Biodegradable
Copolymer as Drug Delivery Matrix Comprising Polyethyleneoxide and
Aliphatic Polyester Blocks); U.S. Pat. No. 5,532,287 to Savage et
al. (Radiation Cured Drug Release Controlling Membrane); U.S. Pat.
No. 5,284,831 to Kahl et al. (Drug Delivery Porphyrin Composition
and Methods); U.S. Pat. No. 5,741,329 to Agrawal et al. (Methods of
Controlling the pH in the Vicinity of Biodegradable Implants); U.S.
Pat. No. 5,820,883 to Tice et al. (Methods for Delivering Bioactive
Agents into and Through the Mucosally-Associated Lymphoid Tissues
and Controlling Their Release);U.S. Pat. No. 5,955,068 to Gouin et
al. (Biodegradable polyanhydrides Derived from Dimers of Bile Acids
and Use Thereof as Controlled Drug Release Systems); U.S. Pat. No.
6,001,395 to Coombes et al. (Polymeric Lamellar Substrate Particles
for Drug Delivery); U.S. Pat. No. 6,013,853 to Athanasiou et al.
(Continuous Release Polymeric Implant Carriers); U.S. Pat. No.
6,060,582 to Hubbell et al. (Photopolymerizable Biodegradable
Hydrogels as Tissue Contacting Materials and Controlled Release
Carriers); U.S. Pat. No. 6,113,943 to Okada et al.
(Sustained-Release Preparation Capable of Releasing a
Physiologically Active Substance); and PCT Publication No. WO
99/59548 to Oh et al. (Controlled Drug Delivery System Using the
Conjugation of Drug to Biodegradable Polyester); U.S. Pat. No.
6,123,861 (Fabrication of Microchip Drug Delivery Devices); U.S.
Pat. No. 6,060,082 (Polymerized Liposomes Targeted to M cells and
Useful for Oral or Mucosal Drug Delivery); U.S. Pat. No. 6,041,253
(Effect of Electric Field and Ultrasound for Transdermal Drug
Delivery); U.S. Pat. No. 6,018,678 (Transdermal protein delivery or
measurement using low-frequency sonophoresis); U.S. Pat. No.
6,007,845 Nanoparticles And Microparticles Of Non-Linear
Hydrophilic-Hydrophobic Multiblock Copolymers; U.S. Pat. No.
6,004,534 Targeted Polymerized Liposomes For Improved Drug
Delivery; U.S. Pat. No. 6,002,961 Transdermal Protein Delivery
Using Low-Frequency Sonophoresis; U.S. Pat. No. 5,985,309
Preparation Of Particles For Inhalation; U.S. Pat. No. 5,947,921
Chemical And Physical Enhancers And Ultrasound For Transdermal Drug
Delivery; U.S. Pat. No. 5,912,017 Multiwall Polymeric Microspheres;
U.S. Pat. No. 5,911,223 Introduction Of Modifying Agents Into Skin
By Electroporation; U.S. Pat. No. 5,874,064 Aerodynamically Light
Particles For Pulmonary Drug Delivery; U.S. Pat. No. 5,855,913
Particles Incorporating Surfactants For Pulmonary Drug Delivery;
U.S. Pat. No. 5,846,565 Controlled Local Delivery Of
Chemotherapeutic Agents For Treating Solid Tumors; U.S. Pat. No.
5,837,752 Semi-Interpenetrating Polymer Networks; U.S. Pat. No.
5,814,599 Transdermal Delivery Of Encapsulated Drugs; U.S. Pat. No.
5,804,178 Implantation Of Cell-Matrix Structure Adjacent Mesentery,
Omentum Or Peritoneum Tissue; U.S. Pat. No. 5,797,898 Microchip
Drug Delivery Devices; U.S. Pat. No. 5,770,417 Three-Dimensional
Fibrous Scaffold Containing Attached Cells For Producing
Vascularized Tissue In vivo; U.S. Pat. No. 5,770,193 Preparation Of
Three-Dimensional Fibrous Scaffold For Attaching Cells To Produce
Vascularized Tissue In vivo; U.S. Pat. No. 5,762,904 Oral Delivery
Of Vaccines Using Polymerized Liposomes; U.S. Pat. No. 5,759,830
Three-Dimensional Fibrous Scaffold Containing Attached Cells For
Producing Vascularized Tissue In vivo; U.S. Pat. No. 5,749,847
Delivery Of Nucleotides Into Organisms By Electroporation; U.S.
Pat. No. 5,736,372 Biodegradable Synthetic Polymeric Fibrous Matrix
Containing Chondrocyte For In vivo Production Of A Cartilaginous
Structure; U.S. Pat. No. 5,718,921 Microspheres Comprising Polymer
And Drug Dispersed There Within; U.S. Pat. No. 5,696,175
Preparation Of Bonded Fiber Structures For Cell Implantation; U.S.
Pat. No. 5,667,491 Method For Rapid Temporal Control Of Molecular
Transport Across Tissue; U.S. Pat. No. 5,654,381 Functionalized
Polyester Graft Copolymers; U.S. Pat. No. 5,651,986 Controlled
Local Delivery Of Chemotherapeutic Agents For Treating Solid
Tumors; U.S. Pat. No. 5,629,009 Delivery System For Controlled
Release Of Bioactive Factors; U.S. Pat. No. 5,626,862 Controlled
Local Delivery Of Chemotherapeutic Agents For Treating Solid
Tumors; U.S. Pat. No. 5,593,974 Localized Oligonucleotide Therapy;
U.S. Pat. No. 5,578,325 Nanoparticles And Microparticles Of
Non-Linear Hydrophilic-Hydrophobic Multiblock Copolymers; U.S. Pat.
No. 5,562,099 Polymeric Microparticles Containing Agents For
Imaging; U.S. Pat. No. 5,545,409 Delivery System For Controlled
Release Of Bioactive Factors; U.S. Pat. No. 5,543,158 Biodegradable
Injectable Nanoparticles; U.S. Pat. No. 5,514,378 Biocompatible
Polymer Membranes And Methods Of Preparation Of Three Dimensional
Membrane Structures; U.S. Pat. No. 5,512,600 Preparation Of Bonded
Fiber Structures For Cell Implantation; U.S. Pat. No. 5,500,161
Method For Making Hydrophobic Polymeric Microparticles; U.S. Pat.
No. 5,487,390 Gas-filled polymeric microbubbles for ultrasound
imaging; U.S. Pat. No. 5,399,665 Biodegradable polymers for cell
transplantation; U.S. Pat. No. 5,356,630 Delivery system for
controlled release of bioactive factors; U.S. Pat. No. 5,330,768
Controlled drug delivery using polymer/pluronic blends; U.S. Pat.
No. 5,286,763 Bioerodible polymers for drug delivery in bone; U.S.
Pat. No. 5,149,543 Tonically cross-linked polymeric microcapsules;
U.S. Pat. No. 5,128,420 Method of making hydroxamic acid polymers
from primary amide polymers; U.S. Pat. No. 5,122,367 Polyanhydride
bioerodible controlled release implants for administration of
stabilized growth hormone; U.S. Pat. No. 5,100,668 Controlled
release systems containing heparin and growth factors; U.S. Pat.
No. 5,019,379 Unsaturated polyanhydrides; U.S. Pat. No. 5,010,167
Poly(amide- and imide-co-anhydride) for biological application;
U.S. Pat. No. 4,948,587 Ultrasound enhancement of transbuccal drug
delivery; U.S. Pat. No. 4,946,929 Bioerodible articles useful as
implants and prostheses having predictable degradation rates; U.S.
Pat. No. 4,933,431 One step preparation of poly(amide-anhydride);
U.S. Pat. No. 4,933,185 System for controlled release of
biologically active compounds; U.S. Pat. No. 4,921,757 System for
delayed and pulsed release of biologically active substances; U.S.
Pat. No. 4,916,204 Pure polyanhydride from dicarboxylic acid and
coupling agent; U.S. Pat. No. 4,906,474 Bioerodible polyanhydrides
for controlled drug delivery; U.S. Pat. No. 4,900,556 System for
delayed and pulsed release of biologically active substances; U.S.
Pat. No. 4,898,734 Polymer composite for controlled release or
membrane formation; U.S. Pat. No. 4,891,225 Bioerodible
polyanhydrides for controlled drug delivery; U.S. Pat. No.
4,888,176 Controlled drug delivery high molecular weight
polyanhydrides; U.S. Pat. No. 4,886,870 Bioerodible articles useful
as implants and prostheses having predictable degradation rates;
U.S. Pat. No. 4,863,735 Biodegradable polymeric drug delivery
system with adjuvant activity; U.S. Pat. No. 4,863,611
Extracorporeal reactors containing immobilized species; U.S. Pat.
No. 4,861,627 Preparation of multiwall polymeric microcapsules;
U.S. Pat. No. 4,857,311 Polyanhydrides with improved hydrolytic
degradation properties; U.S. Pat. No. 4,846,786 Bioreactor
containing suspended, immobilized species; U.S. Pat. No. 4,806,621
Biocompatible, bioerodible, hydrophobic, implantable polyimino
carbonate article; U.S. Pat. No. 4,789,724 Preparation of anhydride
copolymers; U.S. Pat. No. 4,780,212 Ultrasound enhancement of
membrane permeability; U.S. Pat. No. 4,779,806 Ultrasonically
modulated polymeric devices for delivering compositions; U.S. Pat.
No. 4,767,402 Ultrasound enhancement of transdermal drug delivery;
U.S. Pat. No. 4,757,128 High molecular weight polyanhydride and
preparation thereof; U.S. Pat. No. 4,657,543 Ultrasonically
modulated polymeric devices for delivering compositions; U.S. Pat.
No. 4,638,045 Non-peptide polyamino acid bioerodible polymers; U.S.
Pat. No. 4,591,496 Process for making systems for the controlled
release of macromolecules.
[0354] Drug Delivery on a Stent, Balloon or Other Device
[0355] The compounds and compositions of the present invention can
be delivered via a medical device. Any insertable or implantable
medical device, including, but not limited to stents, catheters,
balloon catheters, shunts or coils. In one embodiment, the present
invention provides medical devices, such as stents, the surface of
which is coated with a compound or composition as described herein.
The medical device of this invention can be used, for example, in
any application for treating, preventing, or otherwise affecting
the course of a disease or tissue or organ dysfunction, such as the
diseases disclosed herein. A stent can beany tubular structure used
to maintain or support a bodily orifice or cavity. Stent can be a
scaffolding, usually cylindrical in shape, that can be inserted
into a body passageway or a portion of a body passageway, which has
been narrowed, irregularly contured, obstructed, or occluded by a
disease process in order to prevent closure or reclosure of the
passageway. Stents act by physically holding open the walls of the
body passage into which they are inserted. A balloon catheter can
be a tubular instrument with a balloon or multiple balloons that
can be inflated or deflated without removal after insertion into
the body.
[0356] Additional examples of implantable medical devices include,
but are not limited to, stents, stent grafts, stent covers,
catheters, artificial heart valves and heart valve scaffolds,
venous access devices, vena cava filters, peritoneal access
devices, and enteral feeding devices used in percutaneous
endoscopic gastronomy, prosthetic joints and artificial ligaments
and tendons. Stents include, but are not limited to esophageal
stents, vascular stents, biliary stents, pancreatic stents,
ureteric and urethral stents, lacrimal stents, Eustachian tube
stents, fallopian tube stents and tracheal/bronchial stents. Stents
can be coiled or patterned as a braided or woven open network of
fibers or filaments or, for example, as an interconnecting open
network of articulable segments. Such stent designs can be useful
for maintaining the patency of a body lumen such as a coronary
artery. Stents adapted primarily to provide drainage, in contrast
to stents adapted primarily to support a body lumen, can have a
continuous wall structure in contrast to an open network wall
structure.
[0357] Stents can be readily obtained from commercial sources, or
constructed in accordance with well-known techniques.
Representative examples of stents include those described in U.S.
Pat. No. 4,768,523, entitled "Hydrogel Adhesive;" U.S. Pat. No.
4,776,337, entitled "Expandable Intraluminal Graft, and Method and
Apparatus for Implanting and Expandable Intraluminal Graft;" U.S.
Pat. No. 5,041,126 entitled. "Endovascular Stent and Delivery
System;" U.S. Pat. No. 5,052,998 entitled "Indwelling Stent and
Method of Use;" U.S. Pat. No. 5,064,435 entitled "Self-Expanding
Prosthesis Having Stable Axial Length;" U.S. Pat. No. 5,089,606,
entitled "Water-insoluble Polysaccharide Hydrogel Foam for Medical
Applications;" U.S. Pat. No. 5,147,370, entitled "Nitinol Stent for
Hollow Body Conduits;" U.S. Pat. No. 5,176,626, entitled
"Indwelling Stent;" U.S. Pat. No. 5,213,580, entitled
"Biodegradable polymeric Endoluminal Sealing Process;" and U.S.
Pat. No. 5,328,471, entitled "Method and Apparatus for Treatment of
Focal Disease in Hollow Tubular Organs and Other Tissue
Lumens."
[0358] Stents can be coated with the compounds and compositions of
the present invention in a variety of manners known to one skilled
in the art, including, but not limited to: (a) by directly affixing
to the stent an compound or composition described herein (e.g., by
either spraying the stent with a polymer/drug film, or by dipping
the stent into a polymer/drug solution), (b) by coating the stent
with a substance such as a hydrogel which will in turn absorb the
compounds or compositions, (c) by interweaving compounds or
composition coated thread (or the polymer itself formed into a
thread) into the stent structure, (d) by inserting the stent into a
sleeve or mesh which is comprised of or coated with a compounds or
composition of the present invention, or (e) constructing the stent
itself with a compounds or composition described herein. Therefore,
in one embodiment of the present invention, the compounds are
applied, attached, dripped and/or embedded to the stent by known
methods. Within particular embodiments of the invention, the
composition should firmly adhere to the stent during storage and at
the time of insertion, and should not be dislodged from the stent
when the diameter is expanded from its collapsed size to its full
expansion size. The composition should also preferably not degrade
during storage, prior to insertion, or when warmed to body
temperature after expansion inside the body. In addition, it can
coat the stent smoothly and evenly, with a uniform distribution of
the compound, while not changing the stent contour.
[0359] In one embodiment, the stent structure can include a
plurality of holes or, in a separate embodiment, a plurality of
recesses which can act as reservoirs and can be loaded with the
drug. The stent can be designed with particular sites that can
incorporate the drug, or multiple drugs, optionally with a
biodegradable or non-biodegradable matrix. The sites can be holes,
such as laser drilled holes, or recesses in the stent structure
that can be filled with the drug or can be partially filled with
the drug. In one embodiment, a portion of the holes are filled with
other therapeutic agents, or with materials that regulate the
release of the drug or drugs. One advantage of this system is that
the properties of the coating can be optimized for biocompatibility
and adhesion properties, without the addition requirement of being
able to load and release the drug. The size, shape, position, and
number of reservoirs can be used to control the amount of drug, and
therefore the dose delivered.
[0360] Within another aspect of the present invention, methods are
provided for expanding the lumen of a body passageway, comprising
inserting a stent into the passageway, the stent having a generally
tubular structure, the surface of the structure being coated with a
compound or composition of the present invention, such that the
passageway is expanded.
[0361] Generally, stents can be inserted in a similar fashion
regardless of the site or the disease being treated, such as via
techniques known to one skilled in the art. Briefly, a preinsertion
examination, usually a diagnostic imaging procedure, endoscopy, or
direct visualization at the time of surgery, is generally first
performed in order to determine the appropriate positioning for
stent insertion. A guidewire is then advanced through the lesion or
proposed site of insertion, and over this is passed a delivery
catheter which allows a stent in its collapsed form to be inserted.
Typically, stents are capable of being compressed, so that they can
be inserted through tiny cavities via small catheters, and then
expanded to a larger diameter once they are at the desired
location. Once expanded, the stent physically forces the walls of
the passageway apart and holds them open. As such, they are capable
of insertion via a small opening, and yet are still able to hold
open a large diameter cavity or passageway. The stent can be
self-expanding (e.g., the Wallstent and Gianturco stents), balloon
expandable (e.g., the Palmaz stent and Strecker stent), or
implanted by a change in temperature (e.g., the Nitinol stent).
[0362] Stents can be maneuvered into place under radiologic or
direct visual control, taking particular care to place the stent
precisely across the narrowing in the organ being treated. The
delivery catheter is then removed, leaving the stent standing on
its own as a scaffold. A post insertion examination, usually an
x-ray, is often utilized to confirm appropriate positioning.
VI. Therapeutic Uses
[0363] The formulations comprising the compound of the present
invention can be used for a number of therapeutic applications.
Notably, the compounds can be used to treat disorders characterized
by abnormal cell proliferation, inflammation, or both abnormal
proliferation and inflammation.
A. Disorders of Abnormal Cell Proliferation
[0364] The compositions of the present invention are useful in the
treatment or prevention of abnormal cell proliferation. As used
herein, a "abnormal cell proliferation disorder" refers to a
disease or disorder characterized by the inappropriate growth or
multiplication of one or more cell types relative to the growth of
that cell type or types in an individual not suffering from that
disease or disorder. Abnormal cell proliferation has been shown to
be the root of many diseases and disorders, including cancer and
non-cancer disorders which present a serious health threat.
[0365] The term "treatment" refers to methods of killing,
inhibiting or slowing the growth or increase in size of a body or
population of abnormally proliferative cells or tumor or cancerous
growth, reducing the number of cells in the population of
abnormally proliferative cells, or preventing the spread of
abnormally proliferative cells to other anatomic sites, as well as
reducing the size of a growth of abnormally proliferative cells.
The term "treatment" does not necessarily mean to imply a cure or a
complete abolition of the disorder of abnormal cell proliferation.
The term "prevention" refers to methods to which slow, delay,
control or decrease the likelihood of the incidence or onset of
disorders of abnormal cell proliferation, in comparison to that
which would occur in the absence of treatment.
[0366] Abnormal cellular proliferation, notably hyperproliferation,
can occur as a result of a wide variety of factors, including
genetic mutation, infection, exposure to toxins, autoimmune
disorders, and benign or malignant tumor induction.
Hyperproliferative cell disorders include, but are not limited to,
skin disorders, blood vessel disorders, cardiovascular disorders,
fibrotic disorders, mesangial disorders, autoimmune disorders,
graft-versus-host rejection, tumors and cancers.
[0367] Non-Neoplastic Abnormal Cellular Proliferation Disorders
[0368] Skin disorders associated with cellular hyperproliferation,
including, but are not limited to, psoriasis (all types), eczerma,
acne vulgaris, acne, rosacea, common warts, anogenital (venereal)
warts, eczema; lupus associated skin lesions; dermatitides such as
atopic dermatitis, seborrheic dermatitis and solar dermatitis;
keratoses such as seborrheic keratosis, senile keratosis, actinic
keratosis, photo-induced keratosis, skin ageing, including
photo-induced skin aging, keratosis follicularis; keloids,
eukoplakia, lichen planus, keratitis, contact dermatitis,
urticaria, pruritus, hidradenitis, and acne inverse; pemphigus
vulgaris, actinic keratosis, basal cell carcinoma and squamous cell
carcinoma.
[0369] In a particular embodiment, the compounds of the present
invention are useful in the treatment of psoriasis. Psoriasis is an
immune-mediated skin disorder characterized by chronic T-cell
stimulation by antigen-presenting cells (APC) occurs in the skin.
Approximately 2-3% of the global population is afflicted by
psoriasis. While the cause of psoriasis remains poorly understood,
it appears to result from a combination of genetic and
environmental factors. The various types of psoriasis include, for
example, plaque psoriasis (i.e., vulgaris psoriasis), pustular
psoriasis, guttate psoriasis, inverse psoriasis, erythrodermic
psoriasis, psoriatic arthritis, scalp psoriasis and nail psoriasis.
Psoriasis is a lifelong disease characterized by spontaneous
remissions and exacerbations. Common systemic treatments for
psoriasis include methotrexate, cyclosporin and oral retinoids, but
their use is limited by toxicity. Up to 40% of patients with
psoriasis also develop psoriatic arthritis (Kormeili T et al. Br J.
Dermatol. (2004) 151(1):3-15.
[0370] Blood vessel proliferative disorders include vasculogenic
(formation) and angiogenic (spreading) disorders which result in
abnormal proliferation of blood vessels. Other blood vessel
proliferative disorders include arthritis and ocular diseases such
as diabetic retinopathy. Abnormal neovascularization is also
associated with solid tumors. In a particular embodiment, the
compounds of the present invention are useful in the treatment of
diseases associated with uncontrolled angiogenesis Representative,
non-limiting diseases of abnormal angiogenesis include, e.g,
rheumatoid arthritis, ischemic-reperfusion related brain edema and
injury, cortical ischemia, ovarian hyperplasia and
hypervascularity, (polycystic ovary syndrome), endometriosis,
psoriasis, diabetic retinopaphy, and other ocular angiogenic
diseases such as retinopathy of prematurity. (retrolental
fibroplastic), macular degeneration, corneal graft rejection,
neuroscular glaucoma and Oster Webber syndrome. Cancers associated
with abnormal blood cell proliferation include
hemangioendotheliomas, hemangiomas and Kaposi's sarcoma.
[0371] Disorders of the cardiovascular system involving abnormal
cell proliferation include, for example, hypertension,
vasculo-occlusive diseases (e.g., atherosclerosis, thrombosis and
restenosis after angioplasty), acute coronary syndromes such as
unstable angina, myocardial infarction, ischemic and non-ischemic
cardiomyopathies, post-MI cardiomyopathy and myocardial fibrosis,
substance-induced cardiomyopathy.
[0372] Atherosclerosis represents one type of abnormal smooth
muscle cell proliferation. As used herein, atheroscloeris refers to
classical atherosclerosis, accelerated atherosclerosis,
atherosclerotic lesions and any other arteriosclerotic conditions
characterized by undesirable endothelial and/or vascular smooth
muscle cell proliferation, including vascular complications of
diabetes. Classical atheroscloeris is characterized by
proliferation of vascular smooth muscle cells. Growth factors
released from endothelial cells are thought to stimulate the
proliferation of subintimal smooth muscle which, in turn, reduces
the caliber and finally obstructs the artery. The invention is
useful in inhibiting such proliferation, and therefore in delaying
the onset of, inhibiting the progression of, or even stopping the
progression of such proliferation. Accelerated atherosclerosis is
responsible for the failure of many heart transplants that are not
rejected. Here, proliferation is also mediated by growth factors,
and can produce obstruction of the coronary arteries.
[0373] Vascular injury can also result in endothelial and vascular
smooth muscle cell proliferation. The injury can be caused by
traumatic events or interventions (e.g., angioplasty, vascular
graft, anastomosis, organ transplant) (Clowes A et al. A. J. Vasc.
Surg (1991) 13:885). Restenosis (e.g. coronary, carotid, and
cerebral lesions) is the main complication of successful balloon
angioplasty of the coronary arteries. It is believed to be caused
by the release of growth factors as a result of mechanical injury
to the endothelial cells lining the coronary arteries.
[0374] Other atherosclerotic conditions which can be treated or
prevented by means of the present invention include diseases of the
arterial walls that involve proliferation of endothelial and/or
vascular smooth muscle cells, including complications of diabetes,
diabetic glomerulosclerosis and diabetic retinopathy.
[0375] Abnormal cell proliferation disorders associated the
endrocine system include, for example, insulin resistant states
including obesity, diabetes mellitus (types 1 & 2), diabetic
retinopathy, macular degeneration associated with diabetes,
gestational diabetes, impaired glucose tolerance, polycystic
ovarian syndrome; osteoporosis, osteopenia, accelerated aging of
tissues and organs including Werner's syndrome.
[0376] The compositions and methods of the present invention are
also useful for treating inflammatory diseases associated with
abnormal cell proliferation. These include, but are not limited, to
inflammatory bowel disease (IBD), rheumatoid arthritis (RA),
multiple sclerosis (MS), proliferative glomerulonephritis, lupus
erythematosus, scleroderma, temporal arteritis, thromboangiitis
obliterans, mucocutaneous lymph node syndrome, asthma, host versus
graft, thyroiditis, Grave's disease, antigen-induced airway
hyperactivity, pulmonary eosinophilia, Guillain-Barre syndrome,
allergic rhinitis, myasthenia gravis, human T-lymphotrophic virus
type 1-associated myelopathy, herpes simplex encephalitis,
inflammatory myopathies; atherosclerosis, and Goodpasture's
syndrome. These diseases are considered in more detail below, under
"Disorders of Inflammation."
[0377] Abnormal cell proliferation disorders of the urogenital
system can also be treated according to the present invention.
These include, for example, edometriosis, benign prostatic
hyperplasia, eiomyoma, polycystic kidney disease, and diabetic
nephropathy.
[0378] Treatment of fibrotic disorders is contemplated in the
present invention. As used herein, fibrotic disorders refers to
fibrosis and other medical complications of fibrosis which result
in whole or in part from the proliferation of fibroblasts. Medical
conditions involving fibrosis include undesirable tissue adhesion
resulting from surgery or injury. Non-limiting examples of fibrotic
disorders include hepatic cirrhosis and mesangial proliferative
cell disorders.
[0379] Abnormal cell proliferation disorders of the tissues and
joints can be treated according to the present invention including,
for example, Raynaud's phenomenon/disease, Sjogren's Syndrome
systemic sclerosis, systemic lupus erythematosus, vasculitides,
ankylosing spondylitis, osteoarthritis, reactive arthritis,
psoriatic arthritis, fibromyalgia.
[0380] Mesangial disorders are brought about by abnormal
proliferation of mesangial cells. Mesangial hyperproliferative cell
disorders include various human renal diseases, such as
glomerulonephritis, diabetic nephropathy, malignant
nephrosclerosis, thrombotic microangiopathy syndromes, transplant
rejection, and glomerulopathies.
[0381] Abnormal cell proliferation disorders of the pulmonary
system can also be treated according to the present invention
including, for example, asthma, chronic obstructive pulmonary
disease (COPD), reactive airway disease, pulmonary fibrosis,
pulmonary hypertension.
[0382] Other disorders that can include an abnormal cellular
proliferative component include Behcet's syndrome, Fibrocystic
breast disease, fibroadenoma, chronic fatigue syndrome, acute
respiratory distress syndrome (ARDS), ischemic heart disease,
post-dialysis syndrome, leukemia, acquired immune deficiency
syndrome, vasculitis, lipid histiocytosis, septic shock, familial
intestinal polyposes such as Gardner syndrome.
[0383] Also included in the scope of disorders that may be treated
by the compositions and methods of the present invention are
virus-induced hyperproliferative diseases including, for example,
human papilloma virus-induced disease (e.g., lesions caused by
human papilloma virus infection), Epstein-Ban virus-induced
disease, scar formation, genital warts, cutaneous warts, and the
like.
[0384] Neoplastic Abnormal Cellular Proliferation Disorders
[0385] Diseases of abnormal cell proliferation include various
types of cancers such as primary tumors and tumor metastasis. The
term "cancer" includes both tumor-forming or non-tumor forming
cancers. As used herein, the term "tumor" means an abnormal mass of
cells within a multicellular organism. Generally, the growth of the
abnormal cells of the tumor exceeds and is uncoordinated with that
of normal cells. Furthermore, the abnormal growth of tumor cells
generally persists in an abnormal (i.e., excessive) manner after
the cessation of stimuli that originally caused the abnormality in
the growth of the cells. Tumors can be malignant or benign. A
benign tumor is characterized by cells that retain their
differentiated features and do not divide in a completely
uncontrolled manner. A benign tumor is usually localized and
nonmetastatic. Specific types benign tumors that can be treated
using the present invention include hemangiomas, hepatocellular
adenoma, cavernous haemangioma, focal nodular hyperplasia, acoustic
neuromas, neurofibroma, bile duct adenoma, bile duct cystanoma,
fibroma, lipomas, leiomyomas, mesotheliomas, teratomas, myxomas,
nodular regenerative hyperplasia, trachomas and pyogenic
granulomas.
[0386] A malignant tumor (i.e., cancer) is characterized by cells
that are undifferentiated, do not respond to the body's growth
control signals, and multiply in an uncontrolled manner one.
Maligant tumors are invasive and capable of metastasis.
Representative, non-limiting cancers include breast cancer, skin
cancer, bone cancer, prostate cancer, liver cancer, lung cancer,
brain cancer, cancer of the larynx, gallbladder, pancreas, rectum,
parathyroid, thyroid, adrenal, neural tissue, head and neck, colon,
stomach, bronchi, kidneys, basal cell carcinoma, squamous cell
carcinoma of both ulcerating and papillary type, metastatic skin
carcinoma, osteo sarcoma, Ewing's sarcoma, veticulum cell sarcoma,
myeloma, giant cell tumor, small-cell lung tumor, gallstones, islet
cell tumor, primary brain tumor, acute and chronic lymphocytic and
granulocytic tumors, hairy-cell tumor, adenoma, hyperplasia,
medullary carcinoma, pheochromocytoma, mucosal neuronms, intestinal
ganglloneuromas, hyperplastic corneal nerve tumor, marfanoid
habitus tumor, Wilm's tumor, seminoma, ovarian tumor, leiomyomater
tumor, cervical dysplasia and in situ carcinoma, neuroblastoma,
retinoblastoma, soft tissue sarcoma, malignant carcinoid, topical
skin lesion, mycosis fungoide, rhabdomyosarcoma, Kaposi's sarcoma,
osteogenic and other sarcoma, malignant hypercalcemia, renal cell
tumor, polycythermia vera, adenocarcinoma, glioblastoma multiforma,
leukemias, lymphomas, malignant melanomas, epidermoid carcinomas,
and other carcinomas and sarcomas.
[0387] The compounds of the present invention are also useful in
preventing or treating proliferative responses associated with
organ transplantation which contribute to rejections or other
complications. For example, proliferative responses may occur
during transplantation of the heart, lung, liver, kidney, and other
body organs or organ systems.
B. Inflammation Disorders
[0388] The compounds of the present invention are also useful in
the treatment of diseases characterized by inflammation. Diseases
and disorders which have significant inflammatory components are
ubiquitous and include, for example, skin disorders, bowel
disorders, certain degenerative neurological disorders, arthritis,
autoimmune diseases and a variety of other illnesses. Some of these
diseases have both an inflammatory and proliferative component, as
described above under "Abnormal Cell Proliferation."
[0389] (i) Inflammatory Bowel Disease
[0390] Inflammatory bowel diseases (IBD) includes several chronic
inflammatory conditions, including Crohn's disease (CD) and
ulcerative colitis (UC). Collectively, these diseases afflict
between one and two million Americans and produce symptoms that
impair quality of life and ability to function. Both CD and UC are
considered "idiopathic" because their etiology is unknown. While
the Crohn's disease and ulcerative colitis share many symptoms
(e.g., diarrhea, abdominal pain, fever, fatigue), ulcerative
colitis is limited to the colon whereas Crohn's disease can involve
any segment of the gastrointestinal tract. Both diseases may
involve extraintestinal manifestations, including arthritis,
diseases of the eye (e.g., episcleritis and iritis), skin diseases
(e.g., erythema nodosum and pyoderma gangrenosum), urinary
complications, gallstones and anemia. Strokes, retinal thrombi, and
pulmonary emboli are not uncommon, because many patients are in a
hypercoagulable state.
[0391] While the etiology of IBD is unclear, a combination of
environmental, infectious, genetic, autoimmune, and host factors
have been suspected. Interactions among these factors may be more
important. From a genetic standpoint, IBD is thought to involve
genetically determined, deregulated immune responses to otherwise
innocuous luminal antigens (Rev Lim W C. Gastroenterol Disord.
(2004) 4(2):66-85). Bacterial organisms that can produce IBD
include, for example, Shigella, Salmonella, Campylobacter, H.
pylori, and some E. coli. Bacteria are a common cause of acute
self-limited colitis--active IBD without chronic changes. Recently,
a clear association between complicated courses of ulcerative
colitis and the presence of cytomegalovirus (CMV) has been
established (Hommes D W. Inflamm Bowel Dis. (2004)
10(3):245-50).
[0392] In a particular embodiment, the compounds of the present
invention, including pharmaceutically acceptable salts, prodrugs
and esters thereof, are useful in the treatment of inflammatory
bowel disease. In a preferred embodiment, the inflammatory bowel
disease is Crohn's disease.
[0393] (ii) Chronic Obstructive Pulmonary Disease
[0394] Chronic Obstructive Pulmonary Disease, or COPD, is
characterized by a not fully reversible airflow limitation which is
progressive and associated with an abnormal inflammatory reaction
of the lungs. It is one of the commonest respiratory conditions of
adults, a major cause of chronic morbidity and mortality, and
represents a substantial economic and social burden worldwide
(Pauwels R A. Lancet. (2004) 364(9434):613-20). In the United
States, COPD is currently the fourth leading cause of death
(Molfino N A. Chest. (2004) 125(5):1929-40). The major risk factors
for the development of COPD are inhaled toxic substances, such as
smoke. Other names for the disorder include, for example, Chronic
Obstructive Airways Disease, (COAD); Chronic Obstructive Lung
Disease, (COLD), Chronic Airflow Limitation, (CAL or CAFL) and
Chronic Airflow Obstruction (COA).
[0395] Chronic obstructive pulmonary disease (COPD) COPD is
characterized by chronic inflammation throughout the airways,
parenchyma, and pulmonary vasculature. The inflammation involves a
multitude of cells, mediators, and inflammatory effects.
[0396] Mediators include, for example, mediators include proteases,
oxidants and toxic peptides. Over time, inflammation damages the
lungs and leads to the pathologic changes characteristic of COPD.
Manifestations of disease includes both chronic bronchitis and
emphysema. Chronic bronchitis is a long-standing inflammation of
the airways that produces a lot of mucus, causing wheezing and
infections. It is considered chronic if a subject has coughing and
mucus on a regular basis for at least three months a year and for
two years in a row. Emphysema is a disease that destroys the
alveolae and/or bronchae, causing the air sacs to become enlarged,
thus making breathing difficult. Most common in COPD patients is
the centrilobular form of emphysema.
[0397] In a particular embodiment, the compounds of the present
invention are useful in the treatment of chronic obstructure
pulmonary disease.
[0398] (iii) Sarcoidois
[0399] Sarcoidois is yet another chronic inflammatory disease with
associated abnormal cell proliferation. Sarcoidois is a multisystem
granulomatous disorder. The granulomas are created by the
angiogenic capillary sprouts providing a constant supply of
inflammatory cells. Psoriasis, also a chronic and recurrent
inflammatory disease, is characterized by papules and plaques of
various sizes. Treatment with the compounds of the present
invention would prevent the formation of new blood vessels
necessary to maintain the characteristic lesions.
[0400] (iv) Asthma
[0401] In recent years, it has become clear that the primary
underlying pathology of asthma is airway tissue inflammation
(Lemanke R F. Pediatrics. (2002)109(2):368-372; Nagayama Y et al.
Pediatr Allergy Immunol. (1995) 6:204-208). Asthma is associated
with a wide range of symptoms and signs, including wheezing, cough,
chest tightness, shortness of breath and sputum production. Airway
inflammation a key feature of asthma pathogenesis and its clinical
manifestations. Inflammatory cells, including mast cells,
eosinophils, and lymphocytes, are present even in the airways of
young patients with mild asthma. Inflammation also plays a role in
wheezing disorders, with or without asthma.
[0402] (v) Arthritis and Osteoarthritis
[0403] Arthritis means joint inflammation. More than 40 million
Americans suffer from arthritis in its various forms, including
includes over 100 kinds of rheumatic diseases (i.e., diseases
affecting joints, muscle, and connective tissue, which makes up or
supports various structures of the body, including tendons,
cartilage, blood vessels, and internal organs). Representative
types of arthritis include rheumatoid (such as soft-tissue
rheumatism and non-articular rheumatism), fibromyalgia, fibrositis,
muscular rheumatism, myofascil pain, humeral epicondylitis, frozen
shoulder, Tietze's syndrome, fascitis, tendinitis, tenosynovitis,
bursitis), juvenile chronic, spondyloarthropaties (ankylosing
spondylitis), osteoarthritis, hyperuricemia and arthritis
associated with acute gout, chronic gout and systemic lupus
erythematosus.
[0404] Hypertrophic arthritis or osteoarthritis is the most common
form of arthritis. It is characterized by the breakdown of the
joint's cartilage. Osteoarthritis is common in people over 65, but
may appear decades earlier. Breakdown of the cartilage causes bones
to rub against each other, causing pain and loss of movement. In
recent years, there has been increasing evidence that inflammation
plays an important role in osteoarthritis. Nearly one-third of
patients ready to undergo joint replacement surgery for
osteoarthritis (OA) had severe inflammation in the synovial fluid
that surrounds and protects the joints.
[0405] In a particular embodiment, the compounds of the present
invention are useful in the treatment of osteoarthritis.
[0406] The second most common form of arthritis is rheumatoid
arthritis. It is an autoimmune disease that can affect the whole
body, causing weakness, fatigue, loss of appetite, and muscle pain.
Typically, the age of onset is much earlier than osteoarthritis,
between ages 20 and 50. Inflammation begins in the synovial lining
and can spread to the entire joint.
[0407] Other forms of arthritis include, for example, gout,
ankylosing spondylitis, juvenile arthritis, psoriatic arthritis,
systemic lupus erythematosus, infectious arthritis, scleroderma,
and fibromyalgia syndrome. Asthma is sometimes classified by the
triggers that may cause an asthma episode (or asthma attack) or the
things that make asthma worse in certain individuals, such as
occupational asthma, exercise induced asthma, nocturnal asthma, or
steroid resistant asthma.
[0408] (vii) Cardiovascular Disease
[0409] As noted above, inflammation also plays an important role in
the pathogenesis of cardiovascular diseases, including restenosis,
atherosclerotic complications resulting from plaque rupture, severe
tissue ischemia, and heart failure. Inflammatory changes in the
arterial wall, for example, are thought to play a major role in the
development of restenosis and atherosclerosis (Ross R. N Engl J
Med. (1999) 340: 115-126). Local inflammation occurs in the
formation the plaques also contributes to the weakening of the
fibrous cap of the advanced plaque, ultimately resulting in plaque
rupture and acute coronary syndromes (Lind L. Atherosclerosis.
(2003) 169(2):203-14. Evidence suggests that mediators such as
adhesion molecules, chemokines and cytokines are involved in the
initiation and progression of atherosclerotic lesions. Dynamic
instability of a coronary atherosclerotic plaque is understood as
the foundation for the development of unstable angina and
myocardial infarction (Smith D. Circulation. (2001)
104(7):746-9.
[0410] (ix) Multiple Sclerosis
[0411] Multiple sclerosis (MS) is a chronic, often debilitating
autoimmune disease that affects the central nervous system. MS is
characterized by inflammation which results when the The body
directs antibodies and white blood cells against proteins in the
myelin sheath, fatty material which insulates the nerves in the
brain and spinal cord. The result may be multiple areas of scarring
(sclerosis), which slows or blocks muscle coordination, visual
sensation and other nerve signals. The severity of the disease may
vary. Most MS patients have a relapsing form of the disease,
involving exacerbations in which symptoms appear suddenly (i.e.,
within 24 hours). Various "triggers" of exacerbation have been
proposed, including bacterial or viral infections that cause T
cells to mistake myelin proteins for these antigens, bacterial
superantigens, physical injury, or stressful life events (Hohlfeld
R. Neurology (1995) 45(6 suppl 6): S33-8).
[0412] In a particular embodiment, the compounds of the present
invention are useful in the treatment of multiple sclerosis.
[0413] (x) Neurological Disease
[0414] Inflammatory have been shown to be associated with the
pathogenesis of neurological disorders, including Parkinson's
disease and Alzheimer's disease (Mirza B. et al. Neuroscience
(2000) 95(2):425-32; Gupta A. Int J Clin Pract. (2003) 57(1):36-9;
Ghatan E. et al. Neurosci Biobehav Rev. (1999) 23(5):615-33).
[0415] (ix) Other Inflammatory Diseases
[0416] The present invention is also useful in the treatment of,
for example, allergic disorders, allergic rhinitis, skin disorders,
transplant rejection, poststreptococcal and autoimmune renal
failure, septic shock, systemic inflammatory response syndrome
(SIRS), adult respiratory distress syndrome (ARDS), envenomation,
lupus erythmatosus, myasthenia gravis, Grave's disease, Hashimoto's
thyroiditis, autoimmune hemolytic anemias, insulin dependent
diabetes mellitus, glomerulonephritis, and rheumatic fever, pelvic
inflammatory disease (PID), conjunctivitis, dermatitis, bronchitis,
and rhinitis.
VII. Combination Therapies
[0417] Any of the compounds disclosed herein can be administered in
combination or alternation with a second, and perhaps third,
biologically active agent to increase its effectiveness against the
target disorder. In combination therapy, effective dosages of two
or more agents are administered together. In alternation therapy,
an effective dosage of each agent is administered serially.
[0418] In general, combination therapy is typically preferred over
alternation therapy because it induces multiple simultaneous
stresses on the condition. Any method of alternation can be used
that provides treatment to the patient. Nonlimiting examples of
alternation patterns include 1-6 weeks of administration of an
effective amount of one agent followed by 1-6 weeks of
administration of an effective amount of a second agent. The
alternation schedule can include periods of no treatment.
Combination therapy generally includes the simultaneous
administration of an effective ratio of dosages of two or more
active agents.
[0419] Illustrative examples of specific agents that can be used in
combination or alternation with the compounds of the present
invention are described below. These agents can alternatively be in
combination with the compounds of the present invention to treat a
host suffering from any of the other disorders listed in Section F
above.
A. Abnormal Cell Proliferation
[0420] The compounds of the present invention can be used in
combination or alternation with antiproliferative agents. As used
herein, an antiproliferative agent is a compound that decreases the
hyperproliferation of cells. Proliferative disorders are currently
treated by a variety of classes of compounds including alkylating
agents, antimetabolites, natural products, enzymes, biological
response modifiers, miscellaneous agents, radiopharmaceuticals (for
example, Y-90 tagged to hormones or antibodies), hormones and
antagonists. Any of the antiproliferative agents listed below or
any other such therapeutic agents and principles as described in,
for example, DeVita, V. T., Jr., Hellmann, S., Rosenberg, S. A.;
In: Cancer: Principles & Practice of Oncology, 5th ed.,
Lippincott-Raven Publishers (1997) can be used in combination with
the compounds of the present invention.
[0421] (i) Anti-Angiogenesis Agents
[0422] Representative, nonlimiting examples of anti-angiogenesis
agents suitable for use in combination with the compounds of the
present invention include, but are not limited to, retinoid acid
and derivatives thereof, 2-methoxyestradiol, Angiostatin.TM.
protein, Endostatin.TM. protein, suramin, squalamine, tissue
inhibitor of metalloproteinase-I, tissue inhibitor of
metalloproteinase-2, plasminogen activator inhibitor-1, plasminogen
activator inhibitor-2, cartilage-derived inhibitor, paclitaxel,
platelet factor 4, protamine sulphate (clupeine), sulphated chitin
derivatives (prepared from queen crab shells), sulphated
polysaccharide peptidoglycan complex (sp-pg), staurosporine,
modulators of matrix metabolism, including for example, proline
analogs ((I-azetidine-2-carboxylic acid (LACA), cishydroxyproline,
d,l-3,4-dehydroproline, thiaproline], .alpha.,.alpha.-dipyridyl,
(3-aminopropionitrile fumarate,
4-propyl-5-(4-pyridinyl)-2(3h)-oxazolone; methotrexate,
mitoxantrone, heparin, interferons, 2 macroglobulin-serum, chimp-3,
chymostatin, .beta.-cyclodextrin tetradecasulfate, eponemycin;
fumagillin, gold sodium thiomalate, d-penicillamine (CDPT),
.beta.-1-anticollagenase-serum, .alpha.-2-antiplasmin, bisantrene,
lobenzarit disodium, n-(2-carboxyphenyl-4-chloroanthronilic acid
disodium or "CCA", thalidomide; angostatic steroid,
cargboxynaminolmidazole; metalloproteinase inhibitors such as BB94.
Other anti-angiogenesis agents include antibodies, preferably
monoclonal antibodies against these angiogenic growth factors:
bFGF, aFGF, FGF-5, VEGF isoforms, VEGF-C, HGF/SF and Ang-1/Ang-2.
Ferrara N. and Alitalo, K. "Clinical application of angiogenic
growth factors and their inhibitors" (1999) Nature Medicine
5:1359-1364.
[0423] (ii) Alkylating Agents
[0424] Representative, nonlimiting examples of alkylating agents
suitable for use in combination with the compounds of the present
invention include, but are not limited to, Nitrogen Mustards, such
as Mechlorethamine (Hodgkin's disease, non-Hodgkin's lymphomas),
Cyclophosphamide, Ifosfamide (acute and chronic lymphocytic
leukemias, Hodgkin's disease, non-Hodgkin's lymphomas, multiple
myeloma, neuroblastoma, breast, ovary, lung, Wilms' tumor, cervix,
testis, soft-tissue sarcomas), Melphalan (L-sarcolysin) (multiple
myeloma, breast, ovary), Chlorambucil (chronic lymphoctic leukemia,
primary macroglobulinemia, Hodgkin's disease, non-Hodgkin's
lymphomas); Ethylenimines and Methylmelamines, such as,
Hexamethylmelamine (ovary), Thiotepa (bladder, breast, ovary);
Alkyl Sulfonates, such as, Busulfan (chronic granuloytic leukemia);
Nitrosoureas, such as, Carmustine (BCNU) (Hodgkin's disease,
non-Hodgkin's lymphomas, primary brain tumors, multiple myeloma,
malignant melanoma), Lomustine (CCNU) (Hodgkin's disease,
non-Hodgkin's lymphomas, primary brain tumors, small-cell lung),
Semustine (methyl-CCNU) (primary brain tumors, stomach, colon),
Streptozocin (STR) (malignant pancreatic insulinoma, malignant
carcinoin); Triazenes, such as, Dacarbazine (DTIC;
dimethyltriazenoimidazole-carboxamide) (malignant melanoma,
Hodgkin's disease, soft-tissue sarcomas).
[0425] (iii) Antimetabolites
[0426] Representative, nonlimiting examples of anti-metabolite
agents suitable for use in combination with the compounds of the
present invention include, but are not limited to, Folic Acid
Analogs, such as, Methotrexate (amethopterin) (acute lymphocytic
leukemia, choriocarcinoma, mycosis fungoides, breast, head and
neck, lung, osteogenic sarcoma); Pyrimidine Analogs: Fluorouracil
(5-fluorouracil; 5-FU) Floxuridine (fluorodeoxyuridine; FUdR)
(breast, colon, stomach, pancreas, ovary, head and neck, urinary
bladder, premalignant skin lesions) (topical), Cytarabine (cytosine
arabinoside) (acute granulocytic and acute lymphocytic leukemias);
Purine Analogs and Related Inhibitors, such as, Mercaptopurine
(6-mercaptopurine; 6-MP) (acute lymphocytic, acute granulocytic and
chronic granulocytic leukemia), Thioguanine (6-thioguanine: TG)
(acute granulocytic, acute lymphocytic and chronic granulocytic
leukemia), Pentostatin (2'-deoxycyoformycin) (hairy cell leukemia,
mycosis fungoides, chronic lymphocytic leukemia); Vinca Alkaloids,
such as, Vinblastine (VLB) (Hodgkin's disease, non-Hodgkin's
lymphomas, breast, testis), Vincristine (acute lymphocytic
leukemia, neuroblastoma, Wilms' tumor, rhabdomyosarcoma, Hodgkin's
disease, non-Hodgkin's lymphomas, small-cell lung);
Epipodophylotoxins, such as Etoposide (testis, small-cell lung and
other lung, breast, Hodgkin's disease, non-Hodgkin's lymphomas,
acute granulocytic leukemia, Kaposi's sarcoma), Teniposide (testis,
small-cell lung and other lung, breast, Hodgkin's disease,
non-Hodgkin's lymphomas, acute granulocytic leukemia, Kaposi's
sarcoma).
[0427] (iv) Cytotoxic Agents
[0428] Representative cytotoxic agents include, but are not limited
to: doxorubicin, carmustine (BCNU), lomustine (CCNU), cytarabine
USP, cyclophosphamide, estramucine phosphate sodium, altretamine,
hydroxyurea, ifosfamide, procarbazine, mitomycin, busulfan,
cyclophosphamide, mitoxantrone, carboplatin, cisplatin, interferon
alfa-2a recombinant, paclitaxel, teniposide, and streptozoci.
Physicians' Desk Reference, 50th Edition, 1996.
[0429] (v) Natural Products
[0430] Representative natural products include, but are not limited
to: Antibiotics, such as, Dactinomycin (actinonmycin D)
(choriocarcinoma, Wilms' tumor rhabdomyosarcoma, testis, Kaposi's
sarcoma), Daunorubicin (daunomycin; rubidomycin) (acute
granulocytic and acute lymphocytic leukemias), Doxorubicin (soft
tissue, osteogenic, and other sarcomas; Hodgkin's disease,
non-Hodgkin's lymphomas, acute leukemias, breast, genitourinary
thyroid, lung, stomach, neuroblastoma), Bleomycin (testis, head and
neck, skin and esophagus lung, and genitourinary tract, Hodgkin's
disease, non-Hodgkin's lymphomas), Plicamycin (mithramycin)
(testis, malignant hypercalcema), Mitomycin (mitomycin C) (stomach,
cervix, colon, breast, pancreas, bladder, head and neck); Enzymes,
such as, L-Asparaginase (acute lymphocytic leukemia); Biological
Response Modifiers, such as, Interferon-alfa (hairy cell leukemia,
Kaposi's sarcoma, melanoma, carcinoid, renal cell, ovary, bladder,
non Hodgkin's lymphomas, mycosis fungoides, multiple myeloma,
chronic granulocytic leukemia).
[0431] (vi) Miscellaneous Agents
[0432] Additional agents that can be used in combination or
alternation with the compounds and compositions disclosed herein
include, but are not limited to: Platinum Coordination Complexes,
such as, Cisplatin (cis-DDP) Carboplatin (testis, ovary, bladder,
head and neck, lung, thyroid, cervix, endometrium, neuroblastoma,
osteogenic sarcoma); Anthracenedione, such as Mixtozantrone (acute
granulocytic leukemia, breast); Substituted Urea, such as,
Hydroxyurea (chronic granulocytic leukemia, polycythemia vera,
essential thrombocytosis, malignant melanoma); Methylhydrazine
Derivatives, such as, Procarbazine (N-methylhydrazine, MIH)
(Hodgkin's disease); Adrenocortical Suppressants, such as, Mitotane
(o,p'-DDD) (adrenal cortex), Aminoglutethimide (breast);
Adrenorticosteriods, such as, Prednisone (acute and chronic
lymphocytic leukemias, non-Hodgkin's lymphomas, Hodgkin's disease,
breast); Progestins, such as, Hydroxprogesterone caproate,
Medroxyprogesterone acetate, Megestrol acetate (endometrium,
breast); Stereoids, such as, include betamethasone sodium phosphate
and betamethasone acetate.
[0433] (vii) Hormones and Antagonists
[0434] Representative, nonlimiting examples of hormones and
antagonists suitable for use in combination with the compounds of
the present invention include, but are not limited to, Estrogens:
Diethylstibestrol Ethinyl estradiol (breast, prostate);
Antiestrogen: Tamoxifen (breast); Androgens: Testosterone
propionate Fluxomyesterone (breast); Antiandrogen: Flutamide
(prostate); Gonadotropin-Releasing Hormone Analog: Leuprolide
(prostate). Other hormones include medroxyprogesterone acetate,
estradiol, megestrol acetate, octreotide acetate,
diethylstilbestrol diphosphate, testolactone, and goserelin
acetate. Physicians' Desk Reference, 50th Edition, 1996.
B. Anti-Psoriasis Agents
[0435] The compounds of the present invention can be used in
combination or alternation with agents used to treat psoriasis
including, but not limited to the following:
[0436] Topical treatments: corticosteroids (cortisone),
calcipotriene (a synthetic form of vitamin D.sub.3); coal tar;
anthralin; topical retinoids (e.g. tazarotene, or Tazorac), LTV
light therapy.
[0437] Systemic drugs: Amevive (alefacept, LFA3TIP), Enbrel
(etanercept), and Raptiva (efalizumab), Remicade (infliximab),
Humira, ABX-IL8, Xanelim, psoralen, methotrexate, Tegison,
Anti-CD4, Anti-IL2R (Simulect.RTM., basiliximab), fusion proteins,
HumaT4, HuMax-CD4, HuMax-IL15, IDEC-114, ISIS 2302, LFA-1
antagonists, methotrexate, MEDI-507 (siplizumab), p38 kindase
inhibitors, Xerecept.RTM. (hCRF), Zenapax.RTM. (anti-CD25,
daclizumab), cyclosporine (Neoral.RTM.), Hydroxyurea (Hydrea.RTM.),
retinoids (e.g., acitretin (Soriatane.RTM.)) and antibiotics.
C. Anti-Inflammatory Bowel Disease (IBD) Agents
[0438] The compounds of the present invention can be used in
combination or alternation with drugs or other agents used to treat
IBD including, for example, aminosalicylates, corticosteroids,
antibiotics and immunomodulators. Representative, non-limiting
anti-IBD agents include:
[0439] Corticosteroids: Prednisone, Medrol.RTM.,
methylprednisolone, hydrocortisone, budesonide (Entocort EC).
[0440] Aminosalicylates: sulfasalazine (Azulfidine), Rowasa,
olsalazine (Dipentum.RTM.), mesalamine (Asacol,.RTM. Pentasa.RTM.),
and balsalazide (Colazal.TM.), Balsalazide (Colazal.TM.).
[0441] Immune System Modulators: azathioprine (Imuran), 6
mercaptopurine (Purinethol); cyclosporine A (Sandimmune.RTM.,
Neoral.RTM.).
[0442] Biological therapy: Infliximab (Remicade)
[0443] Antibiotics: ciprofloxacin (Cipro, metronidazole (Flagyl),
ampicillin, sulfonamide, cephalosporin, tetracycline,
metronidazole, vancomycin, tobramycin.
[0444] Other agents including anti-TNF, interleukin-10 (IL-10),
interferon beta, methotrexate, zinc, tacrolimus (FK506),
mycophenolate mofetil, heparin, essential fatty acids (e.g.,
omega-3 fatty acids (Epanova.TM.), 6-fatty acids), short chain
fatty acids (SCFA) (e.g., butyrate), glutamine,
phosphatidylcholine/phosphatidylinositol (PC/PI), superoxide
dismutase (SOD), rosiglitazone, clotrimazole, Antegren.TM.
(natalizumab), CNI-1493, STA-5326, Adalimumab, G-CSF, melatonin,
estrogen, dehydroepiandrosterone (DHEA), vitamin A, C, E, K,
carotenoids, folic acid, calcium, iron, magnesium, selenium,
metallothionein, copper, fiber, probiotics (e.g., Lactobacilli,
Streptococci, Bifidobacteria, e coli), botanicals and flavinoids
(e.g., ginkgo biloba, boswellia serrata, peumus boldus, plant
sterols and sterolins, bromelain, quercetin, rutin).
D. Anti-Arthritis and Osteoarthritis Agents
[0445] The compounds of the present invention can be used in
combination or alternation with therapeutic agents used to treat
arthritis, including, for example, nonsteroidal anti-inflammatory
drugs (NSAIDs), analgesics, biological response modifiers, cortico
steroids or steroids, disease-modifying antirheumatic drugs
(DMARDs), fibromyalgia medications, osteoporosis medications, and
gout medications.
[0446] NSAIDs: carboxylic acids, propionic acids, fenamates, acetic
acids, pyrazolones, oxicans, alkanones, gold compounds and others
that inhibit prostaglandin synthesis, preferably by selectively
inhibiting cylcooxygenase-2 (COX-2). Some non-limiting examples of
COX-2 inhibitors are Celebrex (celecoxib) and Vioxx (rofacoxib).
Some non-limiting examples of NSAIDS are aspirin (acetylsalicylic
acid), Dolobid (diflunisal), Disalcid (salsalate,
salicylsalicylate), Trisilate (choline magnesium trisalicylate),
sodium salicylate, Cuprimine (penicillamine), Tolectin (tolmetin),
ibuprofen (Motrin, Advil, Nuprin Rufen), Naprosyn (naproxen,
Anaprox, naproxen sodium), Nalfon (fenoprofen), Orudis
(ketoprofen), Ansaid (flurbiprofen), Daypro (oxaprozin),
meclofenamate (meclofanamic acid, Meclomen), mefenamic acid,
Indocin (indomethacin), Clinoril (sulindac), tolmetin, Voltaren
(diclofenac), Lodine (etodolac), ketorolac, Butazolidin
(phenylbutazone), Tandearil (oxyphenbutazone), piroxicam (Feldene),
Relafen (nabumetone), Myochrysine (gold sodium thiomalate), Ridaura
(auranofin), Solganal (aurothioglucose), acetaminophen, colchicine,
Zyloprim (allopurinol), Benemid (probenecid), Anturane
(sufinpyrizone), Plaquenil (hydroxychloroquine), Aceclofenac,
Acemetacin, Acetanilide, Actarit, Alclofenac, Alminoprofen,
Aloxiprin, Aluminium Aspirin, Amfenac Sodium, Amidopyrine,
Aminopropylone, Ammonium Salicylate, Ampiroxicam, Amyl Salicylate,
Anirolac, Aspirin, Auranofin, Aurothioglucose, Aurotioprol,
Azapropazone, Bendazac (Bendazac Lysine), Benorylate, Benoxaprofen,
Benzpiperylone, Benzydamine, Hydrochloride, Bomyl Salicylate,
Bromfenac Sodium, Bufexamac, Bumadizone Calcium, Butibufen Sodium,
Capsaicin, Carbaspirin Calcium, Carprofen, Chlorthenoxazin, Choline
Magnesium Trisalicylate, Choline Salicylate, Cinmetacin,
Clofexamide, Clofezone, Clometacin, Clonixin, Cloracetadol, Cymene,
Diacerein, Diclofenac (Diclofenac Diethylammonium Salt, Diclofenac
Potassium, Diclofenac Sodium), Diethylamine Salicylate,
Diethylsalicylamide, Difenpiramide, Diflunisal, Dipyrone, Droxicam,
Epirizole, Etenzamide, Etersalate, Ethyl Salicylate, Etodolac,
Etofenamate, Felbinac, Fenbufen, Fenclofenac, Fenoprofen Calcium,
Fentiazac, Fepradinol, Feprazone, Floctafenine, Flufenamic,
Flunoxaprofen, Flurbiprofen (Flurbiprofen Sodium), Fosfosal,
Furprofen, Glafenine, Glucametacin, Glycol Salicylate, Gold
Keratinate, Harpagophytum Procumbens, Ibufenac, Ibuprofen,
Ibuproxam, Imidazole Salicylate, Indomethacin (Indomethacin
Sodium), Indoprofen, Isamifazone, Isonixin, Isoxicam, Kebuzone,
Ketoprofen, Ketorolac Trometamol, Lithium Salicylate, Lonazolac
Calcium, Lomoxicam, Loxoprofen Sodium, Lysine Aspirin, Magnesium
Salicylate, Meclofenamae Sodium, Mefenamic Acid, Meloxicam, Methyl
Butetisalicylate, Methyl Gentisate, Methyl Salicylate, Metiazinic
Acid, Metifenaz one, Mofebutazone, Mofezolac, Morazone
Hydrochloride, Morniflumate, Morpholine Salicylate, Nabumetone,
Naproxen (Naproxen Sodium), Nifenazone, Niflumic Acid, Nimesulide,
Oxametacin, Oxaprozin, Oxindanac, Oxyphenbutazone, Parsalmide,
Phenybutazone, Phenyramidol Hydrochloride, Picenadol Hydrochloride,
Picolamine Salicylate, Piketoprofen, Pirazolac, Piroxicam,
Pirprofen, Pranoprofen, Pranosal, Proglumetacin Maleate,
Proquazone, Protizinic Acid, Ramifenazone, Salacetamide,
Salamidacetic Acid, Salicylamide, Salix, Salol, Salsalate, Sodium
Aurothiomalate, Sodium Gentisate, Sodium Salicylate, Sodium
Thiosalicylate, Sulindac, Superoxide Dismutase (Orgotein,
Pegorgotein, Sudismase), Suprofen, Suxibuzone, Tenidap Sodium,
Tenoxicam, Tetrydamine, Thurfyl Salicylate, Tiaprofenic, Tiaramide
Hydrochloride, Tinoridine Hydrochloride, Tolfenamic Acid, Tometin
Sodium, Triethanolamine Salicylate, Ufenamate, Zaltoprofen,
Zidometacin and Zomepirac Sodium.
[0447] Analgesics: acetaminophen, opioid analgesics, transdermal
fentanyl
[0448] Biological response modifiers: Etanercept (Enbrel),
infliximab (Remicade), adalimumab (Humira), anakinra (Kineret)
[0449] Corticosteroids: glucocorticoids (GC), Aerobid (Aerobid-M,
flunisolide), Azmacort (triamcinolone acetonide), Beclovet
(Vanceril, beclomethasone dipropionate), Flovent (fluticasone),
Pulmicort (budesonide), prednisolone, hydrocortisone, adrenaline,
Alclometasone Dipropionate, Aldosterone, Amcinonide, Beclomethasone
Dipropionate, Bendacort, Betamethasone (Betamethasone Acetate,
Betamethasone Benzoate, Betamethasone Dipropionate, Betamethasone
Sodium Phosphate, Betamethasone Valerate), Budesonide,
Ciclomethasone, Ciprocinonide, Clobetasol Propionate, Clobetasone
Butyrate, Clocortolone Pivalate, Cloprednol, Cortisone Acetate,
Cortivazol, Deflazacort, Deoxycortone Acetate (Deoxycortone
Pivalate), Deprodone, Desonide, Desoxymethasone, Dexamethasone
(Dexamethasone Acetate, Dexamethasone Isonicotinate, Dexamethasone
Phosphate, Dexamethasone Sodium Metasulphobenzoate, Dexamethasone
Sodium Phosphate), Dichlorisone Acetate, Diflorasone Diacetate,
Diflucortolone Valerate, Difluprednate, Domoprednate, Endrysone,
Fluazacort, Fluclorolone Acetonide, Fludrocortisone Acetate,
Flumethasone (Flumethasone Pivalate), Flunisolide, Fluocinolone
Acetonide, Fluocinonide, Fluocortin Butyl, Fluocortolone
(Fluocortolone Hexanoate, Fluocortolone Pivalate), Fluorometholone
(Fluorometholone Acetate), Fluprednidene Acetate, Fluprednisolone,
Flurandrenolone, Fluticasone Propionate, Formocortal, Halcinonide,
Halobetasol Propionate, Halometasone, Hydrocortamate Hydrochloride,
Hydrocortisone (Hydrocortisone Acetate, Hydrocortisone Butyrate,
Hydrocortisone Cypionate, Hydrocortisone Hemisuccinate,
Hydrocortisone Sodium Phosphate, Hydrocortisone Sodium Succinate,
Hydrocortisone Valerate), Medrysone, Meprednisone,
Methylprednisolone (Methylprednisolone Acetate, Methylprednisolone,
Hemisuccinate, Methylprednisolone Sodium Succinate), Mometasone
Furoate, Paramethasone Acetate, Prednicarbate, Prednisolamate
Hydrochloride, Prednisolone (Prednisolone Acetate, Prednisolone
Hemisuccinate, Prednisolone Hexanoate, Prednisolone Pivalate,
Prednisolone Sodium Metasulphobenzoate, Prednisolone Sodium
Phosphate, Prednisolone Sodium Succinate, Prednisolone Steaglate,
Prednisolone Tebutate), Prednisone (Prednisone Acetate),
Prednylidene, Procinonide, Rimexolone, Suprarenal Cortex
[0450] DMARDs: hydroxychloroquine (Plaquenil), cyclosphosphamide
(Cytoxan), chlorambucil (Leukeran), the gold compound auranofin
(Ridaura), sulfasalazine (Azulfidine) and minocycline (Dynacin,
Minocin), cyclosporine (Sandimmune, Neoral), toll-like receptor
agonists and antagonists. Other forms of DMARDs include
immunosuppressants and tumor necrosis factor (TNF) blockers.
Representative, non-limiting TNF blockers include etanercept
(Enbrel), infliximab (Remicade) and adalimumab (Humira).
[0451] Another anti-rheumatic drug suitable for use in combination
with the compound of the present invention is an Interleukin-1
receptor antagonist (IL-1Ra).
[0452] Fibromyalgia medications: amitriptyline (Elavil, Endep) and
fluoxetine (Prozac); cylobenzaprine (Cycloflex, Flexeril), tramadol
(Ultram), gabapentin (Neurontin), and dual-reputake inhibitors.
[0453] Osteoperosis medications: estrogens, parathyroid hormones
(calcitonin) bisphosphonates (alendronate and risedronate sodium),
selective receptor molecules (raloxifene hydrochloride) and bone
formation agents (teriparatide).
[0454] Gout medications: allopurinol (Lopurin, Zyloprim),
probenecid (Benemid, Probalan), losartan (Cozaar, Hyzaar),
fenofibrate (Tricor).
[0455] Agents used to treat osteoarthritis, including but not
limited to:
[0456] Analgesics (e.g., acetaminophen), Paracetamol,
dextropropoxyphene, non-steroidal anti-inflammatory drug (NSAID)
(e.g., Advil, Motrin IB, Aleve, ketoprofen, Ibuprofen and naproxen,
aspirin), corticosteroids, Doxycycline, Kineret, MMP inhibitors,
Hydroxychloroquine (Plaquenil) glucosamine, chondroitin, COX-2
inhibitors (e.g., Vioxx.RTM. (rofecoxib), Celebrex.RTM.
(celecoxib), Bextra.RTM. (valdecoxib), hyaluronans, Hyalgan.RTM.
(hyaluronan), Synvisc.RTM. (hylan G-F20), topical treatments
(non-steroidal anti-inflammatory drugs, capsaicin).
E. Anti-Chronic Obstructive Pulmonary Disease Agents
[0457] The compounds of the present invention can be used in
combination or alternation with therapeutic agents used to treat
chronic obstructive pulmonary disease, including, but not limited
to:
[0458] Bronchiodilator therapy: B2 adrenoreceptor agonists (e.g.,
salbutamol (Ventolin.RTM., Ventodisk.RTM.) and terbutaline sulphate
(Bricanyl), fenoterol hydrobromide (Berotec.RTM.), rimiterol
hydrobromide (Pulmadil.RTM.), pirbuterol (Exirel.RTM.), reproterol
hydrochloride (Bronchodil.RTM.) and tulobuterol hydrochloride
(Brelomax.RTM.)), anticholinergic agents (Ipratropium bromide,
Atrovent.RTM., and Oxitropim bromide, Oxivent.RTM., (Tiotropium
bromide, Ba 679 BR).
[0459] Methylxanthines including theophylline (Theo-Dur.RTM.,
Phyllocontin.RTM., Uniphyllin.RTM.).
[0460] Corticosteriods including beclomethasone dipropionate
(Becotide.RTM., Becloforte.RTM.) and budesonide (Pulmicort.RTM.),
flunisolide inhalation, triamcinolone inhalation, fluticasone
inhalation, beclomethasone inhalation, Prednisone,
methylprednisolone.
[0461] Other agents include, for example, Combivent
(ipratropium/salbutamol), Advair/Seretide (flucatisone/salmeterol),
Symbicort (formoterol/budesonide), Asmanex (mometasone furoate),
Foradil, Ariflo (cilomilast), ONO 6126, talnetant, 842470/AWD
12281, IC 485, CP 671305.
F. Anti-Asmtha Agents
[0462] The compounds of the present invention can be used in
combination or alternation with therapeutic agents used to treat
asmtha, including, for example:
[0463] Anti-allergics: cromolyn sodium (Intal, Lomudal, Nasalcrom,
Novo-Cromolyn, Rynacrom, ketotifen fumarate (ketotifen
fumarate).
[0464] Anti-inflammatories: including both non-steroidal and
steroidal. Non-steroidal anti-inflammatories include, e.g.,
nedocromil (Tilade). Steroidal anti-inflammatories include, e.g.,
beclomethasone dipropionate (Aerobec, Beclovent, Beclodisk,
Becloforte, Becodisk), budesonide (Pulmicort, Rhinocort),
dexamethasone sodium phosophate (Decadron phosphate), flunisolide
(Aerobid, Bronalide, Nasalide), fluticasone propionate,
triamcinolone acetonide (Azmacort, Nasacort).
[0465] Anticholinergics: ipratropium bromide (Atrovent) belladonna
alkaloids, Atrovent (ipratropium bromide), atropine, and oxitropium
bromide.
[0466] Antihistimines: alkylamines, ethanolamines ethylenediamines,
piperazines, piperidines or phenothiazines; Chlortrinmeton
(Teldrin, chlorpheniramine), Atrohist (brompheniramine, Bromarest,
Bromfed, Dimetane), Actidil (triprolidine), Dexchlor (Poladex,
Polaramine, dexchlorpheniramine), Benadryl (diphen-hydramine),
Tavist (clemastine), Dimetabs (dimenhydrinate, Dramamine,
Mainline), PBZ (tripelennamine), pyrilamine, Marezine (cyclizine),
Zyrtec (cetirizine), hydroxyzine, Antivert (meclizine, Bonine),
Allegra (fexofenadine), Hismanal (astemizole), Claritin
(loratadine), Seldane (terfenadine), Periactin (cyproheptadine),
Nolamine (phenindamine, Nolahist), Phenameth (promethazine,
Phenergan), Tacaryl (methdilazine) and Temaril (trimeprazine).
[0467] .beta..sub.2-adrenergic agonists (beta agonists): albuterol
(salbutamol, Proventil, Ventolin), terbutaline, Maxair
(pirbuterol), Serevent (salmeterol), epinephrine, metaproterenol
(Alupent, Metaprel), Brethine (Bricanyl, Brethaire, terbutaline
sulfate), Tornalate (bitolterol), isoprenaline, ipratropium
bromide, bambuterol hydrochloride, bitolterol meslyate, broxaterol,
carbuterol hydrochloride, clenbuterol hydrochloride, clorprenaline
hydrochloride, efirmoterol fumarate, ephedra (source of alkaloids),
ephedrine (ephedrine hydrochloride, ephedrine sulfate), etafedrine
hydrochloride, ethylnoradrenaline hydrochloride, fenoterol
hydrochloride, hexoprenaline hydrochloride, isoetharine
hydrochloride, isoprenaline, mabuterol, methoxyphenamine
hydrochloride, methylephedrine hydrochloride, orciprenaline
sulphate, phenylephrine acid tartrate, phenylpropanolamine
(phenylpropanolamine polistirex, phenylpropanolamine sulphate),
pirbuterol acetate, procaterol hydrochloride, protokylol
hydrochloride, psuedoephedrine (psuedoephedrine polixtirex,
psuedoephedrine tannate, psuedoephedrine hydrochloride,
psuedoephedrine sulphate), reproterol hydrochloride, rimiterol
hydrobromide, ritodrine hydrochloride, salmeterol xinafoate,
terbutaline sulphate, tretoquinol hydrate and tulobuterol
hydrochloride.
[0468] Leukotriene Receptor Antagonists: zafirlukast (Accolate);
zileuton montelukast (Zyflo, Singulair).
[0469] Xanthines (bronchodilators): theophylline (e.g., Aerolate,
Respbid, Slo-bid), dyphylline, oxtriphylline.
[0470] Combination medications: Advair (salmeterol, fluticasone),
Aerocrom (cromolyn sodium, albuterol), Asbron G (theophylline
sodium glycinate, guaifenesin (expectorant), Berodual (ipratropium
HBr, fenoterol HBr), Bronkaid Caplets (ephedrine sulfate,
guaifenesin), Combivent (salbutamol (albuterol), ipratropium
bromide), Congess (guaifenesin, pseudoephedrine), Duo-Medihaler
(isoproterenol hydrochloride, phenylephrine bitartrate), Duovent
(fenoterol hydrobromide, ipratropium bromide), Marax (ephedrine
sulfate, theophylline, Atarax (hydroxyzine HCl)), Primatene Tablets
(theophylline, ephedrine HCl), Quadrinal (theophylline calcium
salicylate, ephedrine HCl, phenobarbital, potassium iodide),
Rynatuss (carbetapentane tannate, chlorpheniramine tannate,
ephedrine tannate, phenylephrine tannate), Tedral (theophylline,
ephedrine HCl, Phenobarbital), Ventolin-Plus (albuterol,
beclomethasone, dipropionate).
[0471] Other anti-asthma agents suitable for use in combination or
alternation with the antifolates of the present invention include
xanthines and methylxanthines, such as Theo-24 (theophylline,
Slo-Phylline, Uniphyllin, Slobid, Theo-Dur), Choledyl
(oxitriphylline), aminophylline; phosphodiesterase inhibitors such
as zardaverine; calcium antagonists such as nifedipine; and
potassium activators such as cromakalim.
[0472] In one embodiment, the compound is administered in
combination or alterantion with one or more prophylactic agent(s).
Examples of prophylactic agents that can be used in alternation or
combination therapy include but are not limited to sodium
cromoglycate, Intal (cromolyn sodium, Nasalcrom, Opticrom, Crolom,
Ophthalmic Crolom), Tilade (nedocromil, nedocromil sodium) and
ketotifen.
G. Anti-Multiple Sclerosis Agents
[0473] The antifolates of the present invention can be used in
combination or alternation with agents used to treat multiple
sclerosis, including for example: ReVia (Naltrexone), Pregabalin,
Copaxone.RTM. (Glatiramer acetate), Provigil (Modafinil), Symmetrel
(Amantadine), Rebif.RTM. (Interferon beta-1a), solu-Medrol (I.V.
Methylprednisolone), Avonex.RTM. (Interferon beta-1a),
Betaseron.RTM. (Interferon beta-1b). Other representative
anti-multiple sclerosis agents for use in combination with the
compounds of the present invention include:
[0474] Chemotherapetuic agents: Mitoxantrone (Novantrone),
Azathioprine (Imuran), Cyclophosphamide (Cytoxan, Neosar),
Cyclosporine (Sandimmune), methotrexate, Cladribine.
[0475] Corticosteroids and ACTH: MethylPrednisolone (Depo-Medrol),
Prednisone (Deltas one), Prednisolone (Delta-Cortef), Dexamethasone
(Medrol, Decadron), Adreno-corticotrophic Hormone (ACTH) and
Corticotropin (Acthar).
[0476] Dysaesthesia agents: Carbamazepine (Tegretol, Epitol,
Atretol, Carbatrol), Gabapentin (Neurotonin), Topiramate (Topamax),
Zonisamide (Zonegran), Phenyloin (Dilantin), Amitriptyline
(Elavil), Imipramine, Imipramine, Doxepin (Sinequan, Adapin,
Triadapin, Zonalon), Protriptyline (Vivactil), Pentoxifylline
(Trental), Ibprofen (Neurofen), aspirin, acetaminophen,
Hydroxyzine.
[0477] Agents used to treat depression and insomnia: Fluoxetine
(Prozac), Sertraline (Zoloft), Venlafaxine, Citalopram (Celexa),
Parocetine (Paxil, Seroxat), Trazodone (Desyrel, Trialodine),
Nortriptyline, Imipramine, Dothiepin, Lofepramine. Tranylcypromine,
Moclobemide, Nefazodone, Mirtazapine, diazepam (Valium),
alprazolam, Buspirone.
[0478] Agents used to treat fatigue: for example, amantadine
(Symmetrel), pemoline (Cylert), and Modafinil.
[0479] Agents used to treat spasticity and muscle tics: Diazepam,
Clonazepam, Baclofen, Dantrolene sodium, Dantrolene sodium,
Clonidine, and Botulinum Toxin.
[0480] Agents used to treat tremors: Clonazepam, Gabapentin,
Primidone, Botulinum toxin, Acetazolamide, Levodopashy, carbidopa,
and Isoniazid.
[0481] Agents used to treat nausea and dizziness: Meclizine,
Dimenhydrinate, Prochlorperazine, Scopolamine, and
Diphenhydramine.
[0482] Antivirals and vaccinations: flu jabs and acyclovir.
[0483] Agents used to treat urinary problems: Oxybutynin, Desmopres
sin, Vasopressin, Tolterodine, carbamazepine, Imipramine, Bethane,
Phenoxybenzamine, Terazosin, Propantheline, Oxybutynin,
Hyoscyamine, Hyoscyamine, Diazepam, Methenamine, Nitrofurantoin,
Phenazopyridine, Ciprofloxacin. Also agents used to treat bowel
problems including, for example, Bisacodyl and Psyllium hydrophilic
mucilloid
[0484] Other agents and therapies include, for example, potassium
channel blockers (e.g., 4-aminopyridine (4-AP and Fampridine), 3,4
Diaminopyridine, alpha-interferon, Alemtuzumab, anti-T-cell
monoclonal antibodies, anti-lymphocyte globulin, IV Immunoglobin,
Eliprodil, oral myelin (Myloral), cladribine (Leustatin, 2-CDA),
cyclophosphamide (Cytoxan), Natalizumab, gamma-interferon,
IL-2-toxin, mitoxantrone, gabapentin, and methylprednisolone,
methotrexate, Pregabalin, Procarin (transdermal histamine),
plasmapheresis (plasma exchange), PUVA (psoralen ultraviolet
light), t-cell receptor therapy, t-cell vaccination, total lymphoid
irradiation, transforming growth factor-beta (TGF), tumor necrosis
factor antagonists, and Ziconotide.
[0485] The present invention is described by way of illustration,
in the following examples. It will be understood that one of
ordinary skill in that art that these examples are in no way
limiting and that variation of detail can be made without departing
from the spirit and scope of the invention.
EXAMPLES
Example 1
Inhibition of Dihydrofolate Reductase and Thymidylate Synthase
[0486] The ability of M-TREX to inhibit recombinant dihydrofolate
reductase (DR) and thymidylate synthase (TS) in vitro studied in
comparison to other antifolate drugs. The results are summarized in
Table 1:
TABLE-US-00001 Compound I.sub.50 (human DHFR) I.sub.50 (Human TS)
MTX 1.7 .times. 10.sup.-8M -- TOMUDEX -- 1.0 .times. 10.sup.-6M
MDAM 4.4 .times. 10.sup.-8M -- MTA (LY-231514) 6.6 .times.
10.sup.-6M 1.1 .times. 10.sup.-5M M-TREX 1.7 .times. 10.sup.-8M 3.8
.times. 10.sup.-6M
[0487] These results establish that M-TREX is a potent inhibitor of
both DHFR and TS.
Example 2
Formulation of MTREX in a Microcrystalline Cellulose Capsule
Materials
[0488] Avicel PH 101 will be used to dilute the drug to the
required dose strengths prior to capsule filling. Additional
materials are listed in Table 1.
TABLE-US-00002 TABLE 1 Material Grade Function Supplier Avicel
PH101 EP Filler/ HONEYWILL & (Microcrystalline Cellulose)
Diluent STEIN White Hard Gelatin Capsules EP Shell CAPSUGEL Size
0
[0489] A Semi-automated capsule filler, such as a Feton Plate and a
blender, such as a Turbula--Drum will be used to formulate the
drug.
Methods
[0490] LOD--Loss On Drying
[0491] The LOD will be measured using Sartorius MA45 infra-red
balance. The program selected for the analysis will be dependant on
the physical properties of the drug. An appropriate sample size
will be weighed out onto the aluminum tray of the LOD balance. Care
will be taken to ensure that sample is leveled and in the middle of
the tray, with no gaps. Using the appropriate method, the loss on
drying analysis will be performed. The LOD value will be recorded
in percentage.
[0492] Carr's Compressibility Index--Bulk/Tap Density
[0493] The sample will be added to a measuring cylinder to an
appropriate volume. The weight and the volume of the sample will be
recorded as W.sub.p, poured weight and V.sub.p, poured volume
respectively. The cylinder will be place upon the jolting volumeter
and oscillated for appropriate number of taps. The final volume of
the sample will be recorded as V.sub.t, tapped volume. The
following calculations will be performed as per equations 1-3.
Poured Density (P.sub.p)=(W.sub.p/V.sub.p) EQUATION 1
Tapped Density (P.sub.t)=(W.sub.p/V.sub.t) EQUATION 2
Cans Compressibility Index
(CCI)=[(P.sub.r-P.sub.p)/P.sub.t].times.100 EQUATION 3
[0494] Semi-Automated Capsule Filling Method
[0495] Probe formulations including placebo (Avicel PH1O1 only)
detailed in Table 3, will be manufactured using a Turbula drum
blender set to an appropriate mixing duration. Each formulation
will undergo an encapsulation process feasibility study using
semi-automated capsule filler--Feton plate. The content uniformity
data, of the powder blend and the filled capsules will be
determined.
[0496] Capsules will be prepared at the highest and lowest dosage
strengths and these will be placed on accelerated stability.
Additional powder blends characterization such as LOD and Can's
index, detailed will also be performed.
TABLE-US-00003 TABLE 3 Materials Function mg/Capsule mg/Capsule
mg/Capsule MTREX Drag 1.0 2.5 5 Avicel PH101 Filler/ -- -- --
(Microcrystalline Diluent Cellulose)
Accelerated Stability Study
[0497] An accelerated stability study as outlined in Table 4, will
be performed. Samples of the formulated drug will be placed at 25
C/60% RH and 40.degree. C./75% RH for up to 8 weeks. Appearance,
assay and degradation testing for active drug MTREX will be
performed at initial, 4 and 8 week time-points. Note, all analysis
will be performed by Quintiles Analytical Development group.
Details of these methods will be covered by separate documents from
this group.
TABLE-US-00004 TABLE 4 Outline of Stress Stability Program
Time-points/(weeks) Conditions 0 4 8 5.degree. C. T S S 25.degree.
C./60% RH n/a T T 40.degree. C./75% RH n/a T T T--denotes test for
Appearance, Assay and Degradation S--Storage only will be tested if
25.degree. C./60% RH fails.
[0498] All of the compositions, methods, and/or processes disclosed
and claimed herein can be made and executed without undue
experimentation in light of the present disclosure. While the
compositions and methods of this invention have been described in
terms of preferred embodiments, it will be apparent to those of
skill in the art that variations may be applied to the
compositions, methods and/or processes and in the steps or in the
sequence of steps of the methods described herein without departing
from the concept and scope of the invention. More specifically, it
will be apparent that certain agents which are both chemically and
physiologically related may be substituted for the agents described
herein while the same or similar results would be achieved. All
such similar substitutes and modifications apparent to those
skilled in the art are deemed to be within the scope and concept of
the invention.
* * * * *