Prostacyclin compounds, compositions and methods of use thereof
Patent Information
- Application Number
- JP2024216284
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2014-08-26
- Filing Date
- 2024-12-11
- Publication Date
- 2025-02-28
- Estimated Expiration
- 2034-10-24
AI Technical Summary
【0034】
別の実施形態では、PH(例えば、PAH)またはPPH治療を必要とする患者に投与されるプロスタサイクリン化合物は、トレプロスチニルを患者に投与した場合のトレプロスチニルの平均肺または血漿曲線下面積(AUC0~t)と比較して、プロスタサイクリン化合物および/またはその代謝産物トレプロスチニルの、より大きい平均肺または血漿曲線下面積(AUC0~t)を提供する。さらに別の実施形態では、それを必要とする患者に投与されるプロスタサイクリン化合物は、トレプロスチニルを患者に投与した場合のトレプロスチニルの肺または血漿ピーク濃度までの時間(tmax)と比較して、プロスタサイクリン化合物および/またはその代謝産物トレプロスチニルの、より長い肺または血漿ピーク濃度までの時間(tmax)を提供する。
本発明は、例えば、以下の項目を提供する。
(項目1)
式(I):
【化】
(式中、R1はNH、OまたはSであり;
R2は、直鎖状C5~C18アルキル、分枝状C5~C18アルキル、直鎖状C2~C18アルケニル、分枝状C3~C18アルケニル、アリール、アリール-C1~C18アルキル;アミノ酸またはペプチドであり;
R3は、H、OH、任意選択で置換された直鎖状もしくは分枝状C1~C15アルコキシ、O-任意選択で置換された直鎖状もしくは分枝状C2~C15アルケニル、O(C=O)-任意選択で置換された直鎖状もしくは分枝状C1~C15アルキルまたはO(C=O)-任意選択で置換された直鎖状もしくは分枝状C2~C15アルケニルであり;
R4は、任意選択で置換された直鎖状もしくは分枝状C1~C15アルキルまたは任意選択で置換された直鎖状もしくは分枝状C2~C15アルケニルであり;
nは0~5の整数である)
のプロスタサイクリン化合物。
(項目2)
式(II):
【化】
(式中、R1はNH、OまたはSであり;
R2は、直鎖状C5~C18アルキル、分枝状C5~C18アルキル、直鎖状C2~C18アルケニル、分枝状C3~C18アルケニル、アリール、アリール-C1~C18アルキル;アミノ酸またはペプチドであり;
nは0~5の整数である)
のプロスタサイクリン化合物。
(項目3)
R2が、直鎖状C5~C18アルキルまたは分枝状C5~C18アルキル、直鎖状C2~C18アルケニル、分枝状C3~C18アルケニルであり、nが0または1である、項目1または2に記載のプロスタサイクリン化合物。
(項目4)
R2が、アミノ酸、または2~10個のアミノ酸を含むペプチドである、項目1または2に記載のプロスタサイクリン化合物。
(項目5)
R1がNである、項目1~4のいずれか一項に記載のプロスタサイクリン化合物。
(項目6)
R1がOである、項目1~4のいずれか一項に記載のプロスタサイクリン化合物。
(項目7)
R1がSである、項目1~4のいずれか一項に記載のプロスタサイクリン化合物。
(項目8)
nが0である、項目1~7のいずれか一項に記載のプロスタサイクリン化合物。
(項目9)
nが1である、項目1~7のいずれか一項に記載のプロスタサイクリン化合物。
(項目10)
R2が直鎖状C5~C18アルキルである、項目1~3および5~9のいずれか一項に記載のプロスタサイクリン化合物。
(項目11)
R2が直鎖状C5~C18アルケニルである、項目1~3および5~9のいずれか一項に記載のプロスタサイクリン化合物。
(項目12)
R2が分枝状C5~C18アルキルである、項目1~3および5~9のいずれか一項に記載のプロスタサイクリン化合物。
(項目13)
R2が、分枝状C5~C18アルケニルである、項目1~3および5~9のいずれか一項に記載のプロスタサイクリン化合物。
(項目14)
R2が、アリールまたはアリール-C1~C18アルキルである、項目1~3および5~9のいずれか一項に記載のプロスタサイクリン化合物。
(項目15)
R2がアリールである、項目14に記載のプロスタサイクリン化合物。
(項目16)
前記アリールがC5~C10アリールである、項目15に記載のプロスタサイクリン化合物。
(項目17)
前記アリールがフェニル、ナフチル、チエニル、インドリルまたはアントラセニルである、項目16に記載のプロスタサイクリン化合物。
(項目18)
アリール基が縮合環構造を含む、項目15または16に記載のプロスタサイクリン化合物。
(項目19)
R2がアリール-C1~C18アルキルである、項目14に記載のプロスタサイクリン化合物。
(項目20)
R2がアリール-C5~C18である、項目19に記載のプロスタサイクリン化合物。(項目21)
前記アリール-C1~C18アルキルがC5~C10アリールを含む、項目19または20に記載のプロスタサイクリン化合物。
(項目22)
R2がペンチルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目23)
R2がヘキシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目24)
R2がヘプチルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目25)
R2がオクチルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目26)
R2がノニルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目27)
R2がデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目28)
R2がウンデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目29)
R2がドデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目30)
R2がトリデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目31)
R2がテトラデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目32)
R2がペンタデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目33)
R2がヘキサデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目34)
R2がヘプタデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目35)
R2がオクタデシルである、項目1~3および5~10のいずれか一項に記載のプロスタサイクリン化合物。
(項目36)
R2が、直鎖状C5アルケニル、直鎖状C6アルケニル、直鎖状C8アルケニル、直鎖状C10アルケニル、直鎖状C12アルケニル、直鎖状C14アルケニル、直鎖状C16アルケニルまたは直鎖状C18アルケニルである、項目1~3、5~9および11のいずれか一項に記載のプロスタサイクリン化合物。
(項目37)
R3がOHである、項目1および3~36のいずれか一項に記載のプロスタサイクリン化合物。
(項目38)
R3がHである、項目1および3~36のいずれか一項に記載のプロスタサイクリン化合物。
(項目39)
R4がO-アルキルである、項目1および3~36のいずれか一項に記載のプロスタサイクリン化合物。
(項目40)
nが1であり、R1がOであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目41)
nが1であり、R1がSであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目42)
nが1であり、R1がNであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目43)
nが0であり、R1がNであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目44)
R2が、直鎖状C5アルキル、直鎖状C6アルキル、直鎖状C8アルキル、直鎖状C10アルキル、直鎖状C12アルキル、直鎖状C14アルキル、直鎖状C16アルキルまたは直鎖状C18アルキルである、項目40~43のいずれか一項に記載のプロスタサイクリン化合物。
(項目45)
nが1であり、R1がOであり、R2が直鎖状C10~C18アルキルであり、R3がOHであり、R4がヒドロキシル置換C1~C15アルキルである、項目1に記載のプロスタサイクリン化合物。
(項目46)
nが1であり、R1がSであり、R2が直鎖状C5~C18アルキルであり、R3がOHであり、R4がヒドロキシル置換C1~C15アルキルである、項目1に記載のプロスタサイクリン化合物。
(項目47)
nが1であり、R1がNであり、R2が直鎖状C5~C18アルキルであり、R3がOHであり、R4がヒドロキシル置換C1~C15アルキルである、項目1に記載のプロスタサイクリン化合物。
(項目48)
nが0であり、R1がNであり、R2が直鎖状C5~C18アルキルであり、R3がOHであり、R4がヒドロキシル置換C1~C15アルキルである、項目1に記載のプロスタサイクリン化合物。
(項目49)
R4がヒドロキシル置換C5~C10アルキルであり、前記ヒドロキシルがR4基のC2位に存在する、項目45~48のいずれか一項に記載のプロスタサイクリン化合物。
(項目50)
nが1であり、R1がOであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目51)
nが1であり、R1がSであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目52)
nが1であり、R1がNであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目53)
nが0であり、R1がNであり、R2が直鎖状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目54)
R2が、直鎖状C5アルキル、直鎖状C6アルキル、直鎖状C8アルキル、直鎖状C10アルキル、直鎖状C12アルキル、直鎖状C14アルキル、直鎖状C16アルキルまたは直鎖状C18アルキルである、項目50~53のいずれか一項に記載のプロスタサイクリン化合物。
(項目55)
nが1であり、R1がOであり、R2が直鎖状または分枝状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目56)
nが1であり、R1がSであり、R2が直鎖状または分枝状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目57)
nが1であり、R1がNであり、R2が直鎖状または分枝状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目58)
nが0であり、R1がNであり、R2が直鎖状または分枝状C5~C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目59)
R2が、直鎖状もしくは分枝状C5アルキル、直鎖状C6アルキル、直鎖状C8アルキル、直鎖状もしくは分枝状C10アルキル、直鎖状もしくは分枝状C12アルキル、直鎖状もしくは分枝状C14アルキル、直鎖状もしくは分枝状C16アルキルまたは直鎖状もしくは分枝状C18アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目60)
nが1であり、R1がOであり、R2が直鎖状または分枝状C5~C18アルケニルである、項目1または2に記載のプロスタサイクリン化合物。
(項目61)
nが1であり、R1がSであり、R2が直鎖状または分枝状C5~C18アルケニルである、項目1または2に記載のプロスタサイクリン化合物。
(項目62)
nが1であり、R1がNであり、R2が直鎖状または分枝状C5~C18アルケニルである、項目1または2に記載のプロスタサイクリン化合物。
(項目63)
nが0であり、R1がNであり、R2が直鎖状または分枝状C5~C18アルケニルである、項目1または2に記載のプロスタサイクリン化合物。
(項目64)
R2が、直鎖状もしくは分枝状C5アルケニル、直鎖状C6アルケニル、直鎖状C8アルケニル、直鎖状もしくは分枝状C10アルケニル、直鎖状もしくは分枝状C12アルケニル、直鎖状もしくは分枝状C14アルケニル、直鎖状もしくは分枝状C16アルケニルまたは直鎖状もしくは分枝状C18アルケニルである、項目1~3および5~9のいずれか一項に記載のプロスタサイクリン化合物。
(項目65)
1個または複数の水素原子が重水素原子で置き換えられている、項目1または2に記載のプロスタサイクリン化合物。
(項目66)
R1がOであり、R2が対称性分枝状アルキルまたは非対称性分枝状アルキルである、項目1または2に記載のプロスタサイクリン化合物。
(項目67)
5-ノナニル-トレプロスチニル(5C9-TR)である、項目66に記載のプロスタサイクリン化合物。
(項目68)
R2部分がR異性体とS異性体の混合物である、項目1または2に記載のプロスタサイクリン化合物。
(項目69)
R2部分がR異性体またはS異性体である、項目1または2に記載のプロスタサイクリン化合物。
(項目70)
R2が
【化】
である、項目1または2に記載のプロスタサイクリン化合物。
(項目71)
式(II)
【化】
(式中、nは1であり、R1はNH、OまたはSであり、R2は
【化】
【化】
である)
のプロスタサイクリン化合物。
(項目72)
R1がOであり、前記化合物が以下の構造:
【化】
を有する、項目163に記載のプロスタサイクリン化合物。
(項目73)
nが1であり、R1がNH、OまたはSであり、R2が5-ノナニル、4-ヘプチル、4-オクチル、3-オクチル、2-ジメチル-1-プロピル、3,3-ジメチル-1-ブチル、2-エチル-1-ブチルおよび3-ペンチルからなる群から選択される、項目2に記載のプロスタサイクリン化合物。
(項目74)
R1がOであり、R2が5-ノナニルである、項目73に記載のプロスタサイクリン化合物。
(項目75)
R1がOであり、R2が4-ヘプチルである、項目73に記載のプロスタサイクリン化合物。
(項目76)
R1がOであり、R2が4-オクチルである、項目73に記載のプロスタサイクリン化合物。
(項目77)
R1がOであり、R2が3-オクチルである、項目73に記載のプロスタサイクリン化合物。
(項目78)
R1がOであり、R2が2-ジメチル-1-プロピルである、項目73に記載のプロスタサイクリン化合物。
(項目79)
R1がOであり、R2が3,3-ジメチル-1-ブチルである、項目73に記載のプロスタサイクリン化合物。
(項目80)
R1がOであり、R2が2-エチル-1-ブチルである、項目73に記載のプロスタサイクリン化合物。
(項目81)
R1がOであり、R2が3-ペンチルである、項目73に記載のプロスタサイクリン化合物。
(項目82)
式(Ia’’)、(Ib’’)、(Ic’’)または(Id’’)
【化】
(式中、R3はOHであり;R2はH、
【化】
【化】
【化】
および直鎖状C6~C16アルキルからなる群から選択される)
によるプロスタサイクリン化合物。
(項目83)
式(III)
【化】
(式中、
R1はNH、OまたはSであり;
R2は、直鎖状C5~C18アルキル、分枝状C5~C18アルキル、直鎖状C2~C18アルケニル、分枝状C3~C18アルケニル、アリール、アリール-C1~C18アルキル;アミノ酸またはペプチドであり;
R5およびR6は独立に、H、任意選択で置換された直鎖状もしくは分枝状C1~C15アルキル、任意選択で置換された直鎖状もしくは分枝状C2~C15アルケニル、(C=O)-任意選択で置換された直鎖状もしくは分枝状C1~C15アルキルまたは(C=O)-任意選択で置換された直鎖状もしくは分枝状C2~C15アルケニルから選択される)
のプロスタサイクリン化合物であって、ただし、トレプロスチニルではない式(III)のプロスタサイクリン化合物。
(項目84)
R1がNHであり、R2が直鎖状C5~C18アルキルであり、R5がHであり、R6がHである、項目83に記載のプロスタサイクリン化合物。
(項目85)
R1がOであり、R2が直鎖状C5~C18アルキルであり、R5がHであり、R6がHである、項目83に記載のプロスタサイクリン化合物。
(項目86)
R2が直鎖状C6~C12アルキルである、項目84に記載のプロスタサイクリン化合物。
(項目87)
R2が直鎖状C10~C18アルキルである、項目85に記載のプロスタサイクリン化合物。
(項目88)
R2が直鎖状C6~C10アルキルである、項目86に記載のプロスタサイクリン化合物。
(項目89)
R1がSであり、R2が直鎖状C6~C18アルキルであり、R5がHであり、R6がHである、項目83に記載のプロスタサイクリン化合物。
(項目90)
項目1~89のいずれか一項に記載のプロスタサイクリン化合物の薬学的に許容される塩。
(項目91)
項目1~90のいずれか一項に記載のプロスタサイクリン化合物またはその薬学的に許容される塩、および両親媒性物質を含む組成物。
(項目92)
前記両親媒性物質が、ペグ化された脂質、界面活性剤、脂肪酸またはブロックコポリマーである、項目91に記載の組成物。
(項目93)
前記両親媒性物質が界面活性剤である、項目92に記載の組成物。
(項目94)
前記界面活性剤が非イオン性である、項目93に記載の組成物。
(項目95)
前記両親媒性物質が脂肪酸である、項目91に記載の組成物。
(項目96)
前記ブロックコポリマーが、PEO-PPO-PEOまたはPEO-ポリ(イソプレン)-PEOである、項目92に記載の組成物。
(項目97)
前記両親媒性物質がペグ化された脂質である、項目92に記載の組成物。
(項目98)
前記ペグ化された脂質が、PEG400、PEG500、PEG1000、PEG2000、PEG3000、PEG4000またはPEG5000を含む、項目97に記載の組成物。
(項目99)
前記ペグ化された脂質がPEG1000を含む、項目98に記載の組成物。
(項目100)
前記ペグ化された脂質がPEG2000を含む、項目98に記載の組成物。
(項目101)
前記脂質がコレステロールである、項目97~100のいずれか一項に記載の組成物。(項目102)
前記脂質がリン脂質である、項目97~100のいずれか一項に記載の組成物。
(項目103)
前記脂質がジステアロイルホスファチジルエタノールアミン(DSPE)である、項目97~100のいずれか一項に記載の組成物。
(項目104)
前記脂質がジミリストイルホスホエタノールアミン(DMPE)である、項目97~100のいずれか一項に記載の組成物。
(項目105)
前記脂質がジステアロイルグリセロール(DSG)である、項目97~100のいずれか一項に記載の組成物。
(項目106)
前記ペグ化された脂質がコレステロール-PEG2000、DSPE-PEG1000またはDSG-PEG2000である、項目97に記載の組成物。
(項目107)
疎水性添加剤をさらに含む、項目91~106のいずれか一項に記載の組成物。
(項目108)
前記疎水性添加剤が、炭化水素、テルペンまたは疎水性脂質、アルキルエステル、コレステリルエステル、モノ、ジ、トリアルキル-グリセリドである、項目107に記載の組成物。
(項目109)
前記疎水性添加剤が炭化水素である、項目107または108に記載の組成物。
(項目110)
前記疎水性添加剤がテルペンである、項目107または108に記載の組成物。
(項目111)
前記疎水性添加剤が疎水性脂質である、項目107または108に記載の組成物。
(項目112)
前記テルペンがスクアランである、項目110に記載の組成物。
(項目113)
水性媒体中のナノ粒子懸濁液を含む、項目91~112のいずれか一項に記載の組成物。
(項目114)
乾燥粉末として処方された、項目91~112のいずれか一項に記載の組成物。
(項目115)
項目1~89のいずれか一項に記載のプロスタサイクリン化合物またはその薬学的に許容される塩を含む乾燥粉末組成物。
(項目116)
項目1~89のいずれか一項に記載のプロスタサイクリン化合物またはその薬学的に許容される塩および噴霧剤を含む組成物。
(項目117)
前記噴霧剤がヒドロフルオロアルカンである、項目90に記載の組成物。
(項目118)
肺高血圧症(PH)の治療を必要とする患者における肺高血圧症(PH)を治療する方法であって、前記患者に、有効量の項目1~89のいずれか一項に記載のプロスタサイクリン化合物もしくはその薬学的に許容される塩、または項目91~117のいずれか一項に記載のプロスタサイクリン組成物を投与するステップを含む方法。
(項目119)
前記患者がWHOの第I群のPH患者である、項目118に記載の方法。
(項目120)
前記患者がWHOの第II群のPH患者である、項目118に記載の方法。
(項目121)
前記患者がWHOの第III群のPH患者である、項目118に記載の方法。
(項目122)
前記患者がWHOの第IV群のPH患者である、項目118に記載の方法。
(項目123)
前記患者がWHOの第V群のPH患者である、項目118に記載の方法。
(項目124)
前記有効量のプロスタサイクリン化合物を前記患者の肺に投与する、項目118に記載の方法。
(項目125)
前記有効量のプロスタサイクリン化合物またはプロスタサイクリン組成物を、前記患者に、経口、経鼻、静脈内または皮下で投与する、項目118~123のいずれか一項に記載の方法。
(項目126)
前記有効量のプロスタサイクリン化合物を、定量式吸入器によって前記患者の肺に投与する、項目118~124のいずれか一項に記載の方法。
(項目127)
前記有効量のプロスタサイクリン化合物を、乾燥粉末吸入器によって前記患者の肺に投与する、項目124に記載の方法。
(項目128)
前記有効量のプロスタサイクリン化合物またはプロスタサイクリン組成物を、噴霧器によって前記患者の肺に投与する、項目118~124のいずれか一項に記載の方法。
(項目129)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩の投与が、トレプロスチニルまたはイロプロストを投与した場合に前記患者によって経験される副作用の数または副作用の重症度と比較して、前記患者によって経験される副作用の数の減少または前記患者によって経験される副作用の重症度の低下をもたらす、項目118~124および126~128のいずれか一項に記載の方法。
(項目130)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩の投与が、トレプロスチニルまたはイロプロストを投与した場合に前記患者によって経験される副作用の数または副作用の重症度と比較して、前記患者によって経験される副作用の数の減少または前記患者によって経験される副作用の重症度の低下をもたらす、項目125に記載の方法。
(項目131)
前記副作用の重症度の低下が、咳嗽応答の頻度または重症度の低下である、項目129に記載の方法。
(項目132)
前記有効量のプロスタサイクリン化合物を1日1回投与する、項目118~131のいずれか一項に記載の方法。
(項目133)
前記有効量のプロスタサイクリン化合物を1日2回投与する、項目118~131のいずれか一項に記載の方法。
(項目134)
前記有効量のプロスタサイクリン化合物を、1日3回またはそれ超投与する、項目118~131のいずれか一項に記載の方法。
(項目135)
前記噴霧器が振動メッシュ噴霧器である、項目128に記載の方法。
(項目136)
肺動脈高血圧症(PAH)の治療を必要とする患者における肺動脈高血圧症(PAH)を治療する方法であって、前記患者に、有効量の項目1~89のいずれか一項に記載のプロスタサイクリン化合物またはその薬学的に許容される塩を投与するステップを含む方法。
(項目137)
肺動脈高血圧症(PAH)の治療を必要とする患者における肺動脈高血圧症(PAH)を治療する方法であって、前記患者に、有効量の項目91~117のいずれか一項に記載のプロスタサイクリン組成物を投与するステップを含む方法。
(項目138)
前記患者が、ニューヨーク心臓協会(NYHA)によって分類されているクラスIのPAH患者である、項目136または137に記載の方法。
(項目139)
前記患者が、ニューヨーク心臓協会(NYHA)によって分類されているクラスIIのPAH患者である、項目136または137に記載の方法。
(項目140)
前記患者が、ニューヨーク心臓協会(NYHA)によって分類されているクラスIIIのPAH患者である、項目136または137に記載の方法。
(項目141)
前記患者が、ニューヨーク心臓協会(NYHA)によって分類されているクラスIVのPAH患者である、項目136または137に記載の方法。
(項目142)
前記有効量のプロスタサイクリン化合物を前記患者の肺に投与する、項目136または137に記載の方法。
(項目143)
前記有効量のプロスタサイクリン化合物またはプロスタサイクリン組成物を、前記患者に、経口、経鼻、静脈内または皮下で投与する、項目136~142のいずれか一項に記載の方法。
(項目144)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を、定量式吸入器によって前記患者の肺に投与する、項目136に記載の方法。
(項目145)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を、乾燥粉末吸入器によって前記患者の肺に投与する、項目136に記載の方法。
(項目146)
前記有効量のプロスタサイクリン組成物を、噴霧器によって前記患者の肺に投与する、項目137に記載の方法。
(項目147)
前記有効量のプロスタサイクリン化合物、その薬学的に許容される塩またはプロスタサイクリン組成物を、噴霧器によって前記患者の肺に投与する、項目136~142のいずれか一項に記載の方法。
(項目148)
前記有効量のプロスタサイクリン化合物、その薬学的に許容される塩またはプロスタサイクリン組成物の投与が、トレプロスチニルまたはイロプロストを投与した場合に前記患者によって経験される副作用の数または副作用の重症度と比較して、前記患者によって経験される副作用の数の減少または前記患者によって経験される副作用の重症度の低下をもたらす、項目136~147のいずれか一項に記載の方法。
(項目149)
前記副作用の重症度の低下が咳嗽応答の重症度の低下である、項目148に記載の方法。
(項目150)
前記有効量のプロスタサイクリン化合物を1日1回投与する、項目136~149のいずれか一項に記載の方法。
(項目151)
前記有効量のプロスタサイクリン化合物を1日2回投与する、項目136~149のいずれか一項に記載の方法。
(項目152)
前記有効量のプロスタサイクリン化合物を、1日3回またはそれ超投与する、項目136~149のいずれか一項に記載の方法。
(項目153)
前記噴霧器が振動メッシュ噴霧器である、項目147に記載の方法。
(項目154)
慢性血栓塞栓性肺高血圧症の治療を必要とする患者における慢性血栓塞栓性肺高血圧症を治療する方法であって、前記患者に、有効量の項目1~89のいずれか一項に記載のプロスタサイクリン化合物もしくはその薬学的に許容される塩または項目91~117のいずれか一項に記載のプロスタサイクリン組成物を投与するステップを含む方法。
(項目155)
門脈肺高血圧症(PPH)の治療を必要とする患者における門脈肺高血圧症(PPH)を治療する方法であって、前記患者に、有効量の項目1~89のいずれか一項に記載のプロスタサイクリン化合物またはその薬学的に許容される塩を投与するステップを含む方法。
(項目156)
門脈肺高血圧症(PPH)の治療を必要とする患者における門脈肺高血圧症(PPH)を治療する方法であって、前記患者に、有効量の項目91~117のいずれか一項に記載のプロスタサイクリン組成物を投与するステップを含む方法。
(項目157)
前記有効量のプロスタサイクリン化合物、その薬学的に許容される塩または組成物を前記患者の肺に投与する、項目154~156のいずれか一項に記載の方法。
(項目158)
前記有効量のプロスタサイクリン化合物、その薬学的に許容される塩、またはプロスタサイクリン組成物を前記患者に経口、経鼻、静脈内または皮下で投与する、項目154~156のいずれか一項に記載の方法。
(項目159)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を、定量式吸入器によって前記患者の肺に投与する、項目154または155に記載の方法。
(項目160)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を、乾燥粉末吸入器によって前記患者の肺に投与する、項目154または155に記載の方法。
(項目161)
前記有効量のプロスタサイクリン組成物を、噴霧器によって前記患者の肺に投与する、項目154~156のいずれか一項に記載の方法。
(項目162)
前記有効量のプロスタサイクリン化合物、その薬学的に許容される塩またはプロスタサイクリン組成物を、噴霧器によって前記患者の肺に投与する、項目154~156のいずれか一項に記載の方法。
(項目163)
前記有効量のプロスタサイクリン化合物、その薬学的に許容される塩またはプロスタサイクリン組成物の投与が、トレプロスチニルまたはイロプロストを投与した場合に前記患者によって経験される副作用の数または副作用の重症度と比較して、前記患者によって経験される副作用の数の減少または前記患者によって経験される副作用の重症度の低下をもたらす、項目154~162のいずれか一項に記載の方法。
(項目164)
前記副作用の重症度の低下が咳嗽応答の重症度の低下である、項目163に記載の方法。
(項目165)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を1日1回投与する、項目154~164のいずれか一項に記載の方法。
(項目166)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を1日2回投与する、項目154~164のいずれか一項に記載の方法。
(項目167)
前記有効量のプロスタサイクリン化合物またはその薬学的に許容される塩を1日3回投与する、項目154~164のいずれか一項に記載の方法。
(項目168)
前記噴霧器が振動メッシュ噴霧器である、項目162に記載の方法。
(項目169)
前記プロスタサイクリン化合物またはその薬学的に許容される塩のそれを必要とする前記患者への投与が、トレプロスチニルを前記患者に投与した場合のトレプロスチニルの平均肺曲線下面積AUC0~tまたは血漿曲線下面積AUC0~tと比較して、前記プロスタサイクリン化合物および/またはトレプロスチニルのより大きい平均肺曲線下面積(AUC0~t)または血漿曲線下面積(AUC0~t)をもたらす、項目118~168のいずれか一項に記載の方法。
(項目170)
前記プロスタサイクリン化合物またはその薬学的に許容される塩のそれを必要とする患者への投与が、トレプロスチニルを前記患者に投与した場合のトレプロスチニルの肺ピーク濃度または血漿ピーク濃度までの時間tmaxと比較して、前記プロスタサイクリン化合物および/またはトレプロスチニルのより大きい肺ピーク濃度または血漿ピーク濃度までの時間(tmax)をもたらす、項目118~168のいずれか一項に記載の方法。
(項目171)
前記プロスタサイクリン化合物またはその薬学的に許容される塩のそれを必要とする患者への投与が、トレプロスチニルの肺排出半減期t1/2と比較して、前記プロスタサイクリン化合物および/またはトレプロスチニルのより長い肺排出半減期(t1/2)をもたらす、項目118~168のいずれか一項に記載の方法。
(項目172)
エアゾール化された形態の項目91~117のいずれか一項に記載の組成物。
(項目173)
エアゾール粒子のMMADが、アンダーソンカスケードインパクタ(ACI)または次世代インパクタ(NGI)で測定して、約1μm~約5μm、または約1μm~約4μm、または約1μm~約3μmまたは約1μm~約2μmである、項目172に記載の組成物。
(項目174)
エアゾール粒子のMMADが、カスケードインパクションで、例えばACIまたはNGIで測定して、約5μmもしくはそれ未満、約4μmもしくはそれ未満、約3μmもしくはそれ未満、約2μmもしくはそれ未満または約1μmもしくはそれ未満である、項目172に記載の組成物。
(項目175)
エアゾール粒子のFPFが、ACIまたはNGIで測定して約50%より大きいまたはそれに等しい、ACIまたはNGIで測定して約60%より大きいまたはそれに等しい、あるいはACIまたはNGIで測定して約70%より大きいまたはそれに等しい、項目172~174のいずれか一項に記載の組成物。
(項目176)
エアゾール粒子のFPFが、NGIまたはACIで測定して、約50%~約80%、約50%~約70%または約50%~約60%である、項目172~174のいずれか一項に記載の組成物。
(項目177)
噴霧化組成物のMMADが、ACIまたはNGIで測定して、約1μm~約5μm、または約1μm~約4μm、または約1μm~約3μmまたは約1μm~約2μmである、項目128、147および162のいずれか一項に記載の方法。
(項目178)
噴霧化組成物のFPFが、ACIまたはNGIで測定して約50%より大きいまたはそれに等しい、ACIまたはNGIで測定して約60%より大きいまたはそれに等しい、あるいはACIまたはNGIで測定して約70%より大きいまたはそれに等しい、項目128、147および162のいずれか一項に記載の方法。
(項目179)
投与された乾燥粉末組成物のMMADが、NGIまたはACIで測定して、約1μm~約10μm、または約1μm~約9μm、または約1μm~約8μm、または約1μm~約7μm、または約1μm~約6μm、または約1μm~約5μm、または約1μm~約4μm、または約1μm~約3μmまたは約1μm~約2μmの直径である、項目127、145、146および160のいずれか一項に記載の方法。
(項目180)
投与された乾燥粉末のFPFが、ACIまたはNGIで測定して、約40%~約80%、約40%~約70%、約40%~約60%または約40%~約50%である、項目127、145、146および160~161のいずれか一項に記載の方法。
Smart Images

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Abstract
Description
[Technical field]
[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Provisional Application No. 62 / 042,123, filed August 26, 2014; U.S. Provisional Application No. 62 / 028,758, filed July 24, 2014; U.S. Provisional Application No. 61 / 950,967, filed March 11, 2014; U.S. Provisional Application No. 61 / 910,703, filed December 2, 2013; and U.S. Provisional Application No. 61 / 895,680, filed October 25, 2013, each of which is incorporated by reference in its entirety for all purposes. [Background technology]
[0002] Pulmonary hypertension (PH) is characterized by abnormally high blood pressure in the pulmonary vascular system. It is a progressive, fatal disease that leads to heart failure and can occur in the pulmonary arteries, pulmonary veins, or pulmonary capillaries. Symptomatically, patients experience shortness of breath, dizziness, fainting, and other symptoms, all of which are worsened by exercise. There are many causes, which may be idiopathic with an unknown origin, and may lead to hypertension in other systems, for example portopulmonary hypertension, where a patient has both portal and pulmonary hypertension.
[0003] Pulmonary hypertension is classified into five groups by the World Health Organization (WHO). Group I is referred to as pulmonary arterial hypertension (PAH), which includes PAH with no known cause (idiopathic), hereditary PAH (i.e., familial PAH or FPAH), PAH caused by drugs or toxins, and PAH caused by conditions such as connective tissue disease, HIV infection, liver disease, and congenital heart disease. Group II pulmonary hypertension is characterized by pulmonary hypertension associated with left heart disease. Group III pulmonary hypertension is characterized by PH associated with lung disease, such as chronic obstructive pulmonary disease and interstitial lung disease, and PH associated with sleep-related breathing disorders (e.g., sleep apnea). Group IV PH is PH caused by chronic thrombotic and / or embolic disease, such as PH caused by blood clots or blood clotting disorders in the lungs. Group V includes PH caused by other disorders or conditions, such as blood disorders (e.g., polycythemia vera, essential thrombocythemia), systemic disorders (e.g., sarcoidosis, vasculitis), metabolic disorders (e.g., thyroid disease, glycogen storage diseases).
[0004] Pulmonary arterial hypertension (PAH) afflicts approximately 200,000 people worldwide, with approximately 30,000-40,000 of these patients in the United States. PAH patients experience narrowing of the pulmonary arteries, which results in high pulmonary artery pressure and makes it difficult for the heart to pump blood to the lungs. Patients suffer from shortness of breath and fatigue, which often significantly limits their ability to perform physical activities.
[0005] The New York Heart Association (NYHA) classifies PAH patients into four functional classes that are used to grade the severity of their disease. NYHA Class I PAH patients have no limitations in physical activity because ordinary physical activity does not cause undue dyspnea or fatigue, chest pain, or near-fainting. Class I PAH patients do not require treatment. NYHA Class II PAH patients have mild limitations in physical activity. These patients are comfortable at rest, but ordinary physical activity causes undue dyspnea or fatigue, chest pain, or near-fainting. NYHA Class III PAH patients have severe limitations in physical activity. Although comfortable at rest, Class III PAH patients experience undue dyspnea or fatigue, chest pain, or near-fainting as a result of less than ordinary physical activity. NYHA Class IV PAH patients are unable to perform any physical activity without symptoms. Patients with class IV PAH may experience dyspnea and / or fatigue at rest, with physical activity increasing discomfort. Patients with class IV PAH often have signs of right heart failure.
[0006] Patients with PAH are treated with endothelin receptor antagonists (ERAs), phosphodiesterase type 5 (PDE-5) inhibitors, guanylate cyclase stimulators, prostanoids (e.g., prostacyclin), or combinations thereof. ERAs include ambrisentan (abrisentan) (Letairis®), sitaxsentan, bosentan (Tracleer®), and macitentan (Opsumit®). PDE-5 inhibitors indicated for the treatment of PAH include sildenafil (Revatio®), tadalafil (Adcirca®). Prostanoids indicated for the treatment of PAH include iloprost, epoprostenol, and treprostinil (Remodulin®, Tyvaso®). One approved guanylate cyclase stimulator is riociguat (Adempas®). Additionally, patients are often treated with combinations of the above compounds.
[0007] Portopulmonary hypertension is defined by the coexistence of portal hypertension and pulmonary hypertension and is a severe complication of liver disease. The diagnosis of portopulmonary hypertension is based on hemodynamic criteria: (1) portal hypertension and / or liver disease (clinical diagnosis - ascites / varices / splenomegaly), (2) mean pulmonary artery pressure >25 mmHg at rest, (3) >240 dynes / cm 5 PPH is based on a pulmonary vascular resistance of 0.01 mmHg, (4) a pulmonary artery occlusion pressure of <15 mmHg, or a transpulmonary gradient of >12 mmHg. PPH is a serious complication of liver disease and is present in 0.25-4% of patients suffering from cirrhosis. Today, PPH is a comorbidity in 4-6% of liver transplant referrals. Summary of the Invention [Problem to be solved by the invention]
[0008] Although there are treatments for PAH and PPH, current prostacyclin therapy is associated with significant toxicity and tolerability problems and the need for inconvenient dosing schedules. The present invention overcomes addresses these factors by providing compounds and treatment schedules that offer less toxicity, better tolerability and a more convenient dosing schedule. [Means for solving the problem]
[0009] In one aspect of the invention, a compound of formula (I): [ka] (Wherein, R1 is NH, O or S; R2 is H, linear C5-C 18 Alkyl, branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 Alkenyl, aryl; aryl-C1-C 18 alkyl; amino acid or peptide; R3 is H, OH, O-alkyl or O-alkenyl; R4 is an optionally substituted linear or branched C1-C 15 Alkyl or optionally substituted linear or branched C2-C 15 alkenyl; n is an integer from 0 to 5. or a pharma- ceutically acceptable salt thereof, with the proviso that the prostacyclin compound is not treprostinil.
[0010] In another aspect of the present invention, a compound of formula (II): [ka] (Wherein, R1 is NH, O or S; R2 is a linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl or branched C3-C18 Alkenyl, aryl, aryl-C1-C 18 alkyl, amino acid, or peptide; n is an integer from 0 to 5. or a pharma- ceutically acceptable salt thereof.
[0011] In one embodiment, compounds of formula (I) and / or (II) are provided in which one or more hydrogen atoms are replaced by deuterium. Thus, in one embodiment, the present invention relates to isotopic species of formula (I) and / or (II) in which one or more deuterium atoms are replaced. The isotopic species of formula (I) and / or (II) can be used to accurately determine the concentration of compounds of formula (I) and / or (II) in biological fluids and to determine the metabolic patterns of compounds of formula (I) and / or (II) and their isotopic species. The present invention further provides compositions comprising these deuterium isotopic species and methods of treating diseases and conditions as described herein.
[0012] In one embodiment of the present invention, there is provided a compound of formula (I) or (II) or a pharma- ceutically acceptable salt thereof, wherein R1 is N and n is 1. In another embodiment, R2 is a linear C5-C 18 Alkyl or branched C5-C 18 In another embodiment, R2 is a linear C-C alkyl. 12 Alkyl or branched C6-C 12 It is an alkyl.
[0013] Another embodiment of the invention provides compounds of formula (I) or (II) where R1 is O and n is 1. In another embodiment, compounds of formula (I) or (II) are provided where R1 is S and n is 1. In yet another embodiment of the invention, compounds of formula (I) or (II) are provided where R1 is N and n is 0.
[0014] Another embodiment of the present invention is a linear C5-C 18Prostacyclin compounds of formula (I) or (II) are provided, wherein n is an alkyl group. In other embodiments, n is 0 or 1. In yet other embodiments, R1 is N or O. In yet other embodiments, R2 is a linear C6-C 16 In yet another embodiment, R1 is N and R2 is a linear C-C alkyl. 18 In yet another embodiment, R2 is a linear C6, C8, C 10 , C 12 or C 14 It is an alkyl.
[0015] Another embodiment of the present invention is where R2 is a branched C5-C 18 Provided herein is a prostacyclin compound of formula (I) or (II) or a pharma- ceutically acceptable salt thereof, wherein n is alkyl. In another embodiment, n is 0 or 1. In yet another embodiment, R1 is N or O. In yet another embodiment, the branched alkyl is hexyl, octyl, decyl, dodecyl, tetradecyl, hexadecyl or octadecyl.
[0016] In yet another embodiment, R2 is a linear C5-C 18 Prostacyclin compounds of formula (I) or (II) or pharma- ceutically acceptable salts are provided which are alkenyl. In other embodiments, n is 0 or 1. In still other embodiments, R1 is N or O. In still other embodiments, branched alkyl is hexyl, octyl, decyl, dodecyl, tetradecyl, hexadecyl or octadecyl.
[0017] In yet another embodiment, R2 is a branched C5-C 18Prostacyclin compounds of formula (I) or (II) or pharma- ceutically acceptable salts are provided which are alkenyl. In other embodiments, n is 0 or 1. In still other embodiments, R1 is N or O. In still other embodiments, the branched alkenyl is pentenyl, hexenyl, heptenyl, octenyl, nonenyl, decenyl, undecenyl, dodecenyl, tridecenyl, tetradecenyl, pentadecenyl, hexadecenyl, heptadecenyl or octadecenyl.
[0018] In one embodiment, there is provided a prostacyclin compound of formula (I) or (II) or a pharma- ceutically acceptable salt thereof, wherein R2 is a branched alkyl, which is a symmetrical branched alkyl or an asymmetrical branched alkyl. In one embodiment of formula (I) or (II), R1 is O or N, and R2 is [ka] where m1 and m2 are independently integers selected from 1-9, and R' at each occurrence is independently H, linear or branched C1-C8 alkyl, or linear or branched C1-C8 alkenyl. When m1 and / or m2 are integers from 2 to 9, m1 / m2 at the end of the carbon chain is CH3, and the remaining m1 / m2 groups are CH2. In other embodiments, n is 0 or 1. In yet other embodiments, n is 1, R1 is O, and R2 is [ka] and the following compound: [ka] or a pharma- ceutically acceptable salt thereof. In one embodiment, m1 and m2 are both 4. In another embodiment, m1 is 3 and m2 is 4. In yet another embodiment, n is 1.
[0019] In one embodiment, a compound of formula (I) or (II) is provided, wherein R1 is O and R2 is [ka] In yet another embodiment of formula (I) or (II), R1 is O and R2 is [ka] It is.
[0020] In one embodiment, a compound of formula (I) or (II) is provided, wherein R1 is N and R2 is [ka] In yet another embodiment of formula (I) or (II), R1 is N and R2 is [ka] It is.
[0021] In other embodiments, n is 1 and the compound: [ka] (referred to herein as 5-nonanyl-treprostinil or 5C9-TR) is provided.
[0022] In one embodiment, prostacyclin compounds of the formulas provided herein having a branched alkyl or alkenyl at the R2 position (e.g., R2 of the formulas provided herein is 5-nonanyl, 3-heptyl, 4-heptyl, 4-octyl, 3-octyl, 2-octyl, 2-dimethyl-1-propyl, 3,3-dimethyl-1-butyl, 2-ethyl-1-butyl, 3-pentyl) exhibit a slower conversion rate than prostacyclin compounds having a linear alcohol chain at the R2 position, and have the additional advantage of high solubility.
[0023] Yet another embodiment of the present invention is a compound of formula (III): [ka] (wherein R1 and R2 are as defined above; R5 and R6 are independently H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15 Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15 Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 alkenyl) or a pharma- ceutically acceptable salt thereof, with the proviso that the prostacyclin compound of formula (III) is not Treprostinil.
[0024] Another aspect of the present invention relates to a prostacyclin composition comprising a prostacyclin compound of formula (I), (II) or (III). In one embodiment, the prostacyclin composition comprises a prostacyclin compound of formula (I), (II) or (III) and a hydrophobic additive. In another embodiment, the hydrophobic additive is a hydrocarbon, a terpene or a hydrophobic lipid. In another embodiment, the hydrophobic additive is cholesteryl acetate, ethyl stearate, palmitate, myristate, palmityl palmitate, tocopherol acetate, monoglyceride, diglyceride, triglyceride, such as palmitate, myristate, dodecanoate, decanoate, octanoate or squalane. In yet another embodiment, the hydrophobic additive is squalane.
[0025] In another aspect of the present invention, a composition is provided that includes a prostacyclin compound of formula (I), (II) or (III) and an amphiphilic substance. In one embodiment, the amphiphilic substance is a PEGylated lipid, surfactant or block copolymer. In another embodiment, the prostacyclin composition includes a prostacyclin compound of formula (I), (II) or (III) and a PEGylated lipid. In another embodiment, the PEGylated lipid includes PEG400, PEG500, PEG1000, PEG2000, PEG3000, PEG4000 or PEG5000. In other embodiments, the lipid component of the PEGylated lipid is selected from the group consisting of dimyristoylphosphatidylethanolamine (DMPE), dipalmitoylphosphoethanolamine (DPPE), distearoylphosphatidylethanolamine (DSPE), dimyristoylglycerol (DMG), diphosphatidylglycerol (DPG), distearoylglycerol (DSG), and the like. Contains covalently bound PEG.
[0026] In another embodiment of the present invention, a composition is provided that comprises a prostacyclin compound of formula (I), (II) or (III), a hydrophobic additive and an amphiphilic substance.In one embodiment, the amphiphilic substance is a PEGylated lipid, a surfactant or a block copolymer.In another embodiment, the hydrophobic additive is squalane.In another embodiment, the PEGylated lipid is present in the composition and comprises PEG400, PEG500, PEG1000, PEG2000, PEG3000, PEG4000 or PEG5000.
[0027] In another aspect of the present invention, a method for treating pulmonary hypertension (PH) is provided. The method for treating includes treating PH of group I (PAH), group II, group III, group IV or group V. In one embodiment, the method for treating PH includes treating pulmonary arterial hypertension (PAH) in a patient in need thereof. In one embodiment, the method for treating PAH includes administering to a patient in need thereof a prostacyclin compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof or a composition comprising a prostacyclin compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof. In other embodiments, administration is by subcutaneous, oral, nasal, intravenous or pulmonary route of administration. For pulmonary administration, the compound of formula (I), (II) or (III) or a composition comprising a prostacyclin compound of formula (I), (II) or (III) is administered to the patient by a nebulizer, dry powder inhaler or metered dose inhaler.
[0028] In another aspect of the present invention, a method for treating portopulmonary hypertension (PPH) in a patient in need thereof is provided. In one embodiment, the method for treating PPH comprises administering to a patient in need of treatment a prostacyclin compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof or a composition comprising a prostacyclin compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof. In other embodiments, administration is by subcutaneous, oral, nasal, intravenous or pulmonary route of administration. For pulmonary administration, the compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof or a composition comprising a prostacyclin compound of formula (I), (II) or (III) is administered to the patient by a nebulizer, dry powder inhaler or metered dose inhaler.
[0029] In one embodiment of the present invention, a method for treating PH, PAH or PPH in a patient in need thereof is provided, comprising administering a prostacyclin compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof to the lungs of the patient by a metered dose inhaler containing a propellant. In another embodiment, the propellant is a fluorocarbon. In one embodiment, the compound of formula (I), (II) or (III) or a pharma- ceutically acceptable salt thereof is administered to the lungs of a patient in need of PH, PAH or PPH treatment by a metered dose inhaler, and the administration is once, twice or three times a day. In an embodiment in which the compound of formula (I), (II) or (III) or a composition comprising a compound of formula (I), (II) or (III) is administered orally, nasally, subcutaneously, intravenously or to the lungs (e.g., by nebulization, dry powder inhaler or metered dose inhaler), the administration to the patient is once or twice a day. In one embodiment, a compound of Formula (I), (II) or (III) or a composition comprising a compound of Formula (I), (II) or (III) is administered once daily to a patient in need of treatment, either subcutaneously, intravenously, orally, intranasally, or to the lungs by aerosolization using a nebulizer, dry powder inhaler, or metered dose inhaler.
[0030] In one embodiment, a patient treated for PH, PAH or PPH with the compounds, compositions and methods described herein experiences a reduced number of side effects or a reduced severity of side effects compared to the number of side effects or the severity of the side effects experienced by the patient when administered treprostinil. In one embodiment, the side effect is the patient's cough response, and the frequency and / or severity is reduced compared to the frequency and / or severity of the cough response experienced by the patient when administered treprostinil.
[0031] In another embodiment, the prostacyclin compound administered to a patient in need thereof by the pulmonary route by the methods of treating PH, PAH or PPH described herein is selected from the group consisting of a prostacyclin compound having a pulmonary elimination half-life (t 1 / 2 ) compared with the longer pulmonary elimination half-life (t 1 / 2 ) is provided.
[0032] In another embodiment, the prostacyclin compound administered to a patient in need thereof by the methods of treating PH, PAH or PPH described herein has a systemic elimination half-life (t 1 / 2 ) compared to the longer systemic half-life (t 1 / 2 In other embodiments, administration of the prostacyclin compound and treprostinil comprises subcutaneous or intravenous administration.
[0033] In another embodiment, the prostacyclin compound administered to a patient in need of PH, PAH, or PPH treatment has a respective lung or plasma C of treprostinil when administered to the patient. max Higher mean lung C for treprostinil compared with max and / or lower plasma C max is provided to patients.
[0034] In another embodiment, the prostacyclin compound administered to a patient in need of PH (e.g., PAH) or PPH treatment is a prostacyclin compound that is more effective than the mean lung or plasma area under the curve (AUC) of treprostinil when administered to the patient. 0~t ) compared with a larger mean lung or plasma area under the curve (AUC 0~t In yet another embodiment, the prostacyclin compound administered to a patient in need thereof provides a time to peak lung or plasma concentration (t max ) compared to longer times to peak lung or plasma concentrations (t max ) is provided. The present invention provides, for example, the following items. (Item 1) Formula (I): [ka] (Wherein, R1 is NH, O or S; R2 is a linear C5-C 18 Alkyl, branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 alkyl; an amino acid or a peptide; R3 is H, OH, optionally substituted linear or branched C1-C 15 Alkoxy, O-optionally substituted linear or branched C2-C 15 Alkenyl, O(C=O)-optionally substituted straight or branched C1-C 15 Alkyl or O(C=O)-Optionally substituted linear or branched C2-C 15 alkenyl; R4 is an optionally substituted linear or branched C1-C 15 Alkyl or optionally substituted linear or branched C2-C 15 alkenyl; n is an integer from 0 to 5. of prostacyclin compounds. (Item 2) Formula (II): [ka] (Wherein, R1 is NH, O or S; R2 is a linear C5-C 18 Alkyl, branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 alkyl; an amino acid or a peptide; n is an integer from 0 to 5. of prostacyclin compounds. (Item 3) R2 is a linear C5-C 18 Alkyl or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 3. The prostacyclin compound according to item 1 or 2, wherein n is alkenyl and n is 0 or 1. (Item 4) 3. The prostacyclin compound according to item 1 or 2, wherein R2 is an amino acid or a peptide containing 2 to 10 amino acids. (Item 5) 5. The prostacyclin compound according to any one of items 1 to 4, wherein R1 is N. (Item 6) 5. The prostacyclin compound according to any one of items 1 to 4, wherein R1 is O. (Item 7) 5. The prostacyclin compound according to any one of items 1 to 4, wherein R1 is S. (Item 8) 8. The prostacyclin compound according to any one of items 1 to 7, wherein n is 0. (Item 9) 8. The prostacyclin compound according to any one of items 1 to 7, wherein n is 1. (Item 10) R2 is linear C5~C 18 10. The prostacyclin compound according to any one of items 1 to 3 and 5 to 9, wherein the prostacyclin compound is alkyl. (Item 11) R2 is linear C5~C 18 The prostacyclin compound according to any one of items 1 to 3 and 5 to 9, which is alkenyl. (Item 12) R2 is branched C5~C 18 10. The prostacyclin compound according to any one of items 1 to 3 and 5 to 9, wherein the prostacyclin compound is alkyl. (Item 13) R2 is branched C5~C 18 10. The prostacyclin compound according to any one of items 1 to 3 and 5 to 9, which is alkenyl. (Item 14) R2 is aryl or aryl-C1-C 18 10. The prostacyclin compound according to any one of items 1 to 3 and 5 to 9, wherein the prostacyclin compound is alkyl. (Item 15) 15. The prostacyclin compound according to item 14, wherein R2 is aryl. (Item 16) The aryl is C5-C 10 16. The prostacyclin compound according to item 15, which is aryl. (Item 17) 17. The prostacyclin compound of claim 16, wherein said aryl is phenyl, naphthyl, thienyl, indolyl or anthracenyl. (Item 18) 17. The prostacyclin compound according to item 15 or 16, wherein the aryl group comprises a fused ring structure. (Item 19) R2 is aryl-C1~C 1815. The prostacyclin compound according to item 14, which is alkyl. (Item 20) R2 is aryl-C5~C 18 (Item 21) The prostacyclin compound according to item 19, The aryl-C1 to C 18 Alkyl is C5-C 10 21. The prostacyclin compound according to item 19 or 20, which comprises an aryl. (Item 22) The prostacyclin compound according to any one of items 1-3 and 5-10, wherein R2 is pentyl. (Item 23) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is hexyl. (Item 24) The prostacyclin compound according to any one of items 1-3 and 5-10, wherein R2 is heptyl. (Item 25) The prostacyclin compound according to any one of items 1-3 and 5-10, wherein R2 is octyl. (Item 26) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is nonyl. (Item 27) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is decyl. (Item 28) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is undecyl. (Item 29) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is dodecyl. (Item 30) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is tridecyl. (Item 31) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is tetradecyl. (Item 32) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is pentadecyl. (Item 33) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is hexadecyl. (Item 34) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is heptadecyl. (Item 35) The prostacyclin compound according to any one of items 1 to 3 and 5 to 10, wherein R2 is octadecyl. (Item 36) R2 is linear C5 alkenyl, linear C6 alkenyl, linear C8 alkenyl, linear C 10 Alkenyl, Linear C 12 Alkenyl, Linear C 14 Alkenyl, Linear C 16 Alkenyl or linear C 18 12. The prostacyclin compound according to any one of items 1 to 3, 5 to 9 and 11, which is alkenyl. (Item 37) 37. The prostacyclin compound according to any one of items 1 and 3-36, wherein R3 is OH. (Item 38) 37. The prostacyclin compound according to any one of items 1 and 3-36, wherein R3 is H. (Item 39) 37. The prostacyclin compound according to any one of items 1 and 3-36, wherein R4 is O-alkyl. (Item 40) n is 1, R1 is O, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 41) n is 1, R1 is S, and R2 is a linear C5-C 183. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 42) n is 1, R1 is N, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 43) n is 0, R1 is N, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 44) R2 is a linear C5 alkyl, a linear C6 alkyl, a linear C8 alkyl, a linear C 10 Alkyl, linear C 12 Alkyl, linear C 14 Alkyl, linear C 16 Alkyl or linear C 18 44. The prostacyclin compound according to any one of items 40 to 43, which is alkyl. (Item 45) n is 1, R1 is O, and R2 is linear C 10 ~C 18 alkyl, R3 is OH, and R4 is hydroxyl-substituted C1-C 15 2. The prostacyclin compound according to claim 1, wherein the prostacyclin compound is alkyl. (Item 46) n is 1, R1 is S, and R2 is a linear C5-C 18 alkyl, R3 is OH, and R4 is hydroxyl-substituted C1-C 15 2. The prostacyclin compound according to claim 1, wherein the prostacyclin compound is alkyl. (Item 47) n is 1, R1 is N, and R2 is a linear C5-C 18 alkyl, R3 is OH, and R4 is hydroxyl-substituted C1-C 15 2. The prostacyclin compound according to claim 1, wherein the prostacyclin compound is alkyl. (Item 48) n is 0, R1 is N, and R2 is a linear C5-C 18 alkyl, R3 is OH, and R4 is hydroxyl-substituted C1-C15 2. The prostacyclin compound according to claim 1, wherein the prostacyclin compound is alkyl. (Item 49) R4 is hydroxyl substituted C5-C 10 49. The prostacyclin compound according to any one of items 45 to 48, wherein R is alkyl and said hydroxyl is at the C2 position of the R4 group. (Item 50) n is 1, R1 is O, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 51) n is 1, R1 is S, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 52) n is 1, R1 is N, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 53) n is 0, R1 is N, and R2 is a linear C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 54) R2 is a linear C5 alkyl, a linear C6 alkyl, a linear C8 alkyl, a linear C 10 Alkyl, linear C 12 Alkyl, linear C 14 Alkyl, linear C 16 Alkyl or linear C 18 54. The prostacyclin compound according to any one of items 50 to 53, which is alkyl. (Item 55) n is 1, R1 is O, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 56) n is 1, R1 is S, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 57) n is 1, R1 is N, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 58) n is 0, R1 is N, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 59) R2 is a linear or branched C5 alkyl, a linear C6 alkyl, a linear C8 alkyl, a linear or branched C 10 Alkyl, linear or branched C 12 Alkyl, linear or branched C 14 Alkyl, linear or branched C 16 Alkyl or linear or branched C 18 3. The prostacyclin compound according to item 1 or 2, which is alkyl. (Item 60) n is 1, R1 is O, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkenyl. (Item 61) n is 1, R1 is S, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkenyl. (Item 62) n is 1, R1 is N, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkenyl. (Item 63) n is 0, R1 is N, and R2 is a linear or branched C5-C 18 3. The prostacyclin compound according to item 1 or 2, which is alkenyl. (Item 64) R2 is a linear or branched C5 alkenyl, a linear C6 alkenyl, a linear C8 alkenyl, a linear or branched C 10Alkenyl, linear or branched C 12 Alkenyl, linear or branched C 14 Alkenyl, linear or branched C 16 Alkenyl or linear or branched C 18 The prostacyclin compound according to any one of items 1 to 3 and 5 to 9, which is alkenyl. (Item 65) 3. The prostacyclin compound according to item 1 or 2, wherein one or more hydrogen atoms are replaced with deuterium atoms. (Item 66) 3. The prostacyclin compound according to item 1 or 2, wherein R1 is O and R2 is symmetrical branched alkyl or asymmetrical branched alkyl. (Item 67) 67. The prostacyclin compound according to item 66, which is 5-nonanyl-treprostinil (5C9-TR). (Item 68) 3. The prostacyclin compound according to item 1 or 2, wherein the R2 moiety is a mixture of R and S isomers. (Item 69) 3. The prostacyclin compound according to item 1 or 2, wherein the R2 moiety is an R or S isomer. (Item 70) R2 [ka] 3. The prostacyclin compound according to item 1 or 2, (Item 71) Formula (II) [ka] (wherein n is 1, R1 is NH, O or S, and R2 is [ka] [ka] is) of prostacyclin compounds. (Item 72) R1 is O and the compound has the following structure: [ka] 164. The prostacyclin compound according to item 163, having the formula: (Item 73) 3. The prostacyclin compound according to item 2, wherein n is 1, R1 is NH, O or S, and R2 is selected from the group consisting of 5-nonanyl, 4-heptyl, 4-octyl, 3-octyl, 2-dimethyl-1-propyl, 3,3-dimethyl-1-butyl, 2-ethyl-1-butyl and 3-pentyl. (Item 74) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 5-nonanyl. (Item 75) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 4-heptyl. (Item 76) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 4-octyl. (Item 77) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 3-octyl. (Item 78) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 2-dimethyl-1-propyl. (Item 79) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 3,3-dimethyl-1-butyl. (Item 80) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 2-ethyl-1-butyl. (Item 81) 74. The prostacyclin compound according to item 73, wherein R1 is O and R2 is 3-pentyl. (Item 82) Formula (Ia″), (Ib″), (Ic″) or (Id″) [ka] wherein R3 is OH; R2 is H, [ka] [ka] [ka] and linear C6-C 16 alkyl) Prostacyclin compound by. (Item 83) Formula (III) [ka] (In the formula, R1 is NH, O or S; R2 is a linear C5-C 18 Alkyl, branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 alkyl; an amino acid or a peptide; R5 and R6 are independently H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15 Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 alkenyl) A prostacyclin compound of formula (III) with the proviso that it is not treprostinil. (Item 84) R1 is NH and R2 is a linear C5-C 18 84. The prostacyclin compound according to item 83, wherein R is alkyl, R5 is H, and R6 is H. (Item 85) R1 is O and R2 is a linear C5-C 18 84. The prostacyclin compound according to item 83, wherein R is alkyl, R5 is H, and R6 is H. (Item 86) R2 is linear C6~C 12 85. The prostacyclin compound according to item 84, which is alkyl. (Item 87) R2 is linear C 10 ~C 18 86. The prostacyclin compound according to item 85, which is alkyl. (Item 88) R2 is linear C6~C 10 87. The prostacyclin compound according to item 86, which is alkyl. (Item 89) R1 is S and R2 is linear C6-C 18 84. The prostacyclin compound according to item 83, wherein R is alkyl, R5 is H, and R6 is H. (Item 90) 90. A pharma- ceutically acceptable salt of the prostacyclin compound according to any one of items 1 to 89. (Item 91) 91. A composition comprising the prostacyclin compound or a pharma- ceutically acceptable salt thereof according to any one of items 1 to 90, and an amphiphilic substance. (Item 92) 92. The composition of claim 91, wherein the amphiphilic substance is a pegylated lipid, surfactant, fatty acid or block copolymer. (Item 93) 93. The composition of claim 92, wherein the amphiphilic agent is a surfactant. (Item 94) 94. The composition of claim 93, wherein the surfactant is non-ionic. (Item 95) 92. The composition of claim 91, wherein the amphiphilic substance is a fatty acid. (Item 96) 93. The composition of claim 92, wherein the block copolymer is PEO-PPO-PEO or PEO-poly(isoprene)-PEO. (Item 97) 93. The composition of claim 92, wherein the amphiphile is a pegylated lipid. (Item 98) 98. The composition of claim 97, wherein the pegylated lipid comprises PEG400, PEG500, PEG1000, PEG2000, PEG3000, PEG4000 or PEG5000. (Item 99) 99. The composition of claim 98, wherein the pegylated lipid comprises PEG1000. (Item 100) 99. The composition of claim 98, wherein the pegylated lipid comprises PEG2000. (Item 101) The composition according to any one of items 97 to 100, wherein the lipid is cholesterol. (Item 102) 101. The composition according to any one of items 97 to 100, wherein the lipid is a phospholipid. (Item 103) 101. The composition according to any one of items 97 to 100, wherein the lipid is distearoylphosphatidylethanolamine (DSPE). (Item 104) 101. The composition according to any one of items 97 to 100, wherein the lipid is dimyristoylphosphoethanolamine (DMPE). (Item 105) The composition according to any one of items 97 to 100, wherein the lipid is distearoylglycerol (DSG). (Item 106) 98. The composition of claim 97, wherein the pegylated lipid is cholesterol-PEG2000, DSPE-PEG1000 or DSG-PEG2000. (Item 107) 107. The composition according to any one of items 91 to 106, further comprising a hydrophobic additive. (Item 108) Item 108. The composition according to item 107, wherein the hydrophobic additive is a hydrocarbon, a terpene or a hydrophobic lipid, an alkyl ester, a cholesteryl ester, a mono-, di-, tri-alkyl-glyceride. (Item 109) 109. The composition according to claim 107 or 108, wherein the hydrophobic additive is a hydrocarbon. (Item 110) Item 109. The composition according to item 107 or 108, wherein the hydrophobic additive is a terpene. (Item 111) Item 109. The composition according to item 107 or 108, wherein the hydrophobic additive is a hydrophobic lipid. (Item 112) Item 111. The composition according to item 110, wherein the terpene is squalane. (Item 113) 113. The composition according to any one of items 91 to 112, comprising a suspension of nanoparticles in an aqueous medium. (Item 114) 113. The composition according to any one of items 91 to 112, formulated as a dry powder. (Item 115) 90. A dry powder composition comprising the prostacyclin compound or a pharma- ceutically acceptable salt thereof according to any one of items 1 to 89. (Item 116) 90. A composition comprising the prostacyclin compound or a pharma- ceutically acceptable salt thereof according to any one of items 1 to 89 and a propellant. (Item 117) 91. The composition of claim 90, wherein the propellant is a hydrofluoroalkane. (Item 118) A method for treating pulmonary hypertension (PH) in a patient in need of such treatment, comprising administering to the patient an effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof according to any one of items 1 to 89, or a prostacyclin composition according to any one of items 91 to 117. (Item 119) 19. The method according to item 118, wherein the patient is a WHO group I PH patient. (Item 120) 19. The method according to item 118, wherein the patient is a WHO group II PH patient. (Item 121) 19. The method according to item 118, wherein the patient is a WHO group III PH patient. (Item 122) 19. The method of item 118, wherein the patient is a WHO group IV PH patient. (Item 123) 19. The method according to item 118, wherein the patient is a WHO group V PH patient. (Item 124) 19. The method of claim 118, wherein the effective amount of a prostacyclin compound is administered to the lungs of the patient. (Item 125) 124. The method according to any one of items 118 to 123, wherein the effective amount of the prostacyclin compound or prostacyclin composition is administered to the patient orally, intranasally, intravenously or subcutaneously. (Item 126) 125. The method of any one of items 118 to 124, wherein the effective amount of the prostacyclin compound is administered to the lungs of the patient by a metered dose inhaler. (Item 127) 125. The method of claim 124, wherein the effective amount of the prostacyclin compound is administered to the patient's lungs by a dry powder inhaler. (Item 128) 125. The method according to any one of items 118 to 124, wherein the effective amount of a prostacyclin compound or a prostacyclin composition is administered to the lungs of the patient by a nebulizer. (Item 129) The method according to any one of items 118-124 and 126-128, wherein administration of the effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof results in a decrease in the number of side effects experienced by the patient or a decrease in the severity of side effects experienced by the patient compared to the number of side effects or the severity of side effects experienced by the patient when administered treprostinil or iloprost. (Item 130) Item 126. The method of item 125, wherein administration of the effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof results in a reduction in the number of side effects experienced by the patient or a reduction in the severity of side effects experienced by the patient compared to the number of side effects or the severity of side effects experienced by the patient when administered treprostinil or iloprost. (Item 131) 130. The method of claim 129, wherein the reduction in severity of a side effect is a reduction in the frequency or severity of a cough response. (Item 132) 132. The method according to any one of items 118 to 131, wherein the effective amount of the prostacyclin compound is administered once a day. (Item 133) 132. The method according to any one of items 118 to 131, wherein the effective amount of the prostacyclin compound is administered twice a day. (Item 134) 132. The method of any one of items 118-131, wherein the effective amount of the prostacyclin compound is administered three or more times a day. (Item 135) Item 129. The method of item 128, wherein the nebulizer is a vibrating mesh nebulizer. (Item 136) 90. A method for treating pulmonary arterial hypertension (PAH) in a patient in need of such treatment, comprising administering to the patient an effective amount of a prostacyclin compound described in any one of items 1 to 89, or a pharma- ceutically acceptable salt thereof. (Item 137) A method for treating pulmonary arterial hypertension (PAH) in a patient in need of such treatment, comprising administering to the patient an effective amount of a prostacyclin composition described in any one of items 91 to 117. (Item 138) 138. The method according to item 136 or 137, wherein the patient is a PAH patient of class I as classified by the New York Heart Association (NYHA). (Item 139) 138. The method according to item 136 or 137, wherein the patient is a class II PAH patient as classified by the New York Heart Association (NYHA). (Item 140) 138. The method according to item 136 or 137, wherein the patient is a PAH patient of class III as classified by the New York Heart Association (NYHA). (Item 141) 138. The method according to item 136 or 137, wherein the patient is a class IV PAH patient as classified by the New York Heart Association (NYHA). (Item 142) 138. The method of claim 136 or 137, wherein the effective amount of a prostacyclin compound is administered to the lungs of the patient. (Item 143) 143. The method according to any one of items 136 to 142, wherein the effective amount of the prostacyclin compound or prostacyclin composition is administered to the patient orally, intranasally, intravenously or subcutaneously. (Item 144) 137. The method of claim 136, wherein the effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered to the patient's lungs by means of a metered dose inhaler. (Item 145) 137. The method of claim 136, wherein the effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered to the patient's lungs by a dry powder inhaler. (Item 146) 138. The method of claim 137, wherein the effective amount of the prostacyclin composition is administered to the patient's lungs by a nebulizer. (Item 147) 143. The method according to any one of items 136 to 142, wherein the effective amount of a prostacyclin compound, its pharma- ceutically acceptable salt or a prostacyclin composition is administered to the lungs of the patient by a nebulizer. (Item 148) 148. The method of any one of items 136 to 147, wherein administration of the effective amount of a prostacyclin compound, a pharma- ceutically acceptable salt thereof, or a prostacyclin composition results in a decrease in the number of side effects experienced by the patient or a decrease in the severity of side effects experienced by the patient compared to the number of side effects or the severity of side effects experienced by the patient when administered treprostinil or iloprost. (Item 149) 149. The method of claim 148, wherein the reduction in severity of a side effect is a reduction in the severity of a cough response. (Item 150) 150. The method according to any one of items 136 to 149, wherein the effective amount of the prostacyclin compound is administered once a day. (Item 151) 150. The method according to any one of items 136 to 149, wherein the effective amount of the prostacyclin compound is administered twice a day. (Item 152) 150. The method of any one of items 136-149, wherein the effective amount of the prostacyclin compound is administered three or more times a day. (Item 153) Item 148. The method of item 147, wherein the nebulizer is a vibrating mesh nebulizer. (Item 154) A method for treating chronic thromboembolic pulmonary hypertension in a patient in need of such treatment, comprising administering to said patient an effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof according to any one of items 1 to 89, or a prostacyclin composition according to any one of items 91 to 117. (Item 155) 90. A method for treating portal pulmonary hypertension (PPH) in a patient in need of such treatment, comprising administering to said patient an effective amount of a prostacyclin compound according to any one of items 1 to 89, or a pharma- ceutically acceptable salt thereof. (Item 156) 13. A method for treating portal pulmonary hypertension (PPH) in a patient in need of such treatment, comprising administering to said patient an effective amount of a prostacyclin composition according to any one of claims 91 to 117. (Item 157) 157. The method according to any one of items 154 to 156, wherein the effective amount of a prostacyclin compound, a pharma- ceutically acceptable salt thereof or a composition thereof is administered to the lungs of the patient. (Item 158) 157. The method according to any one of items 154 to 156, wherein the effective amount of a prostacyclin compound, a pharma- ceutically acceptable salt thereof, or a prostacyclin composition is administered to the patient orally, intranasally, intravenously, or subcutaneously. (Item 159) 156. The method of claim 154 or 155, wherein the effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered to the patient's lungs by means of a metered dose inhaler. (Item 160) 156. The method according to item 154 or 155, wherein the effective amount of a prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered to the lungs of the patient by means of a dry powder inhaler. (Item 161) 157. The method according to any one of items 154 to 156, wherein the effective amount of the prostacyclin composition is administered to the lungs of the patient by means of a nebulizer. (Item 162) 157. The method according to any one of items 154 to 156, wherein the effective amount of a prostacyclin compound, a pharma- ceutically acceptable salt thereof or a prostacyclin composition is administered to the lungs of the patient by a nebulizer. (Item 163) 163. The method of any one of items 154 to 162, wherein administration of the effective amount of a prostacyclin compound, a pharma- ceutically acceptable salt thereof, or a prostacyclin composition results in a decrease in the number of side effects experienced by the patient or a decrease in the severity of side effects experienced by the patient compared to the number of side effects or the severity of side effects experienced by the patient when administered treprostinil or iloprost. (Item 164) 164. The method of claim 163, wherein the reduction in severity of a side effect is a reduction in the severity of a cough response. (Item 165) 165. The method according to any one of items 154 to 164, wherein the effective amount of the prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered once a day. (Item 166) 165. The method according to any one of items 154 to 164, wherein the effective amount of the prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered twice a day. (Item 167) 165. The method according to any one of items 154 to 164, wherein the effective amount of the prostacyclin compound or a pharma- ceutically acceptable salt thereof is administered three times a day. (Item 168) Item 163. The method of item 162, wherein the nebulizer is a vibrating mesh nebulizer. (Item 169) administering said prostacyclin compound or a pharma- ceutical acceptable salt thereof to said patient in need thereof reduces the mean lung area under the curve (AUC) of treprostinil when treprostinil is administered to said patient. 0~t or area under the plasma curve, AUC 0~t A greater mean pulmonary area under the curve (AUC 0~t) or area under the plasma curve (AUC 0~t 169. The method according to any one of items 118 to 168, wherein (Item 170) Administration of the prostacyclin compound or a pharma- ceutical acceptable salt thereof to a patient in need thereof reduces the time to peak lung or plasma concentration of treprostinil when treprostinil is administered to the patient, t max a greater lung peak concentration or time to plasma peak concentration (t max 169. The method according to any one of items 118 to 168, wherein (Item 171) Administration of the prostacyclin compound or a pharma- ceutical acceptable salt thereof to a patient in need thereof reduces the pulmonary elimination half-life, t 1 / 2 A longer pulmonary elimination half-life (t 1 / 2 169. The method according to any one of items 118 to 168, wherein (Item 172) The composition according to any one of items 91 to 117 in an aerosolized form. (Item 173) Item 173. The composition according to item 172, wherein the MMAD of the aerosol particles is from about 1 μm to about 5 μm, or from about 1 μm to about 4 μm, or from about 1 μm to about 3 μm, or from about 1 μm to about 2 μm, as measured by an Anderson Cascade Impactor (ACI) or a Next Generation Impactor (NGI). (Item 174) Item 173. The composition of item 172, wherein the MMAD of the aerosol particles is about 5 μm or less, about 4 μm or less, about 3 μm or less, about 2 μm or less, or about 1 μm or less, as measured by cascade impaction, e.g., ACI or NGI. (Item 175) 175. The composition according to any one of items 172 to 174, wherein the FPF of the aerosol particles is greater than or equal to about 50% as measured by ACI or NGI, greater than or equal to about 60% as measured by ACI or NGI, or greater than or equal to about 70% as measured by ACI or NGI. (Item 176) 175. The composition according to any one of items 172 to 174, wherein the FPF of the aerosol particles is from about 50% to about 80%, from about 50% to about 70%, or from about 50% to about 60%, as measured by NGI or ACI. (Item 177) 163. The method of any one of items 128, 147 and 162, wherein the MMAD of the nebulized composition is from about 1 μm to about 5 μm, or from about 1 μm to about 4 μm, or from about 1 μm to about 3 μm, or from about 1 μm to about 2 μm, as measured by ACI or NGI. (Item 178) 163. The method of any one of items 128, 147 and 162, wherein the FPF of the nebulized composition is greater than or equal to about 50% as measured by ACI or NGI, greater than or equal to about 60% as measured by ACI or NGI, or greater than or equal to about 70% as measured by ACI or NGI. (Item 179) 161. The method of any one of items 127, 145, 146 and 160, wherein the MMAD of the administered dry powder composition is from about 1 μm to about 10 μm, or from about 1 μm to about 9 μm, or from about 1 μm to about 8 μm, or from about 1 μm to about 7 μm, or from about 1 μm to about 6 μm, or from about 1 μm to about 5 μm, or from about 1 μm to about 4 μm, or from about 1 μm to about 3 μm, or from about 1 μm to about 2 μm in diameter, as measured by NGI or ACI. (Item 180) The method of any one of items 127, 145, 146 and 160-161, wherein the FPF of the administered dry powder is about 40% to about 80%, about 40% to about 70%, about 40% to about 60%, or about 40% to about 50%, as measured by ACI or NGI. [Brief description of the drawings]
[0035] [Figure 1A] FIG 1A is a graph showing the rate of spontaneous hydrolysis vs. time for treprostinil compounds (C3: propyl ester, C4: butyl ester, C5: pentyl ester, C6: hexyl ester, C8: octyl ester, and C10: decyl ester).
[0036] [Figure 1B] FIG. 1B is a graph showing the rate of esterase-mediated hydrolysis of the alkyl chain at various time points (15 min, 30 min, 60 min) of a treprostinil compound dissolved in aqueous buffer and a treprostinil composition comprising a PEGylated lipid.
[0037] [Diagram 2] Figure 2 is a graph of the mean particle size for various treprostinil alkyl esters in formulations containing PEGylated lipids as a function of alkyl ester chain length. The alkyl chain is present on the carboxylic acid moiety of treprostinil. PD is polydispersity.
[0038] [Figure 3A] Figures 3A, 3B, and 3C are graphs of the relative cAMP response vs. time of CHO-K1-P4 cells (2.5 x 104 cells / well) in response to 10 μM (Figure 3A), 1 μM (Figure 3B), or 0.1 μM (Figure 3C) treprostinil and treprostinil alkyl ester compositions (C6: hexyl ester, C8: octyl ester, C10: decyl ester). [Figure 3B] Figures 3A, 3B, and 3C are graphs of the relative cAMP response vs. time of CHO-K1-P4 cells (2.5 x 104 cells / well) in response to 10 μM (Figure 3A), 1 μM (Figure 3B), or 0.1 μM (Figure 3C) treprostinil and treprostinil alkyl ester compositions (C6: hexyl ester, C8: octyl ester, C10: decyl ester). [Figure 3C]Figures 3A, 3B, and 3C are graphs of the relative cAMP response vs. time of CHO-K1-P4 cells (2.5 x 104 cells / well) in response to 10 μM (Figure 3A), 1 μM (Figure 3B), or 0.1 μM (Figure 3C) treprostinil and treprostinil alkyl ester compositions (C6: hexyl ester, C8: octyl ester, C10: decyl ester).
[0039] [Figure 4] 4 is a graph of the relative cAMP response vs. time of CHO-K1-P4 cells (2.5×104 cells / well) in response to 5 μM treprostinil and treprostinil alkyl ester compositions. (C6: hexyl ester, C8: octyl ester, C10: decyl ester, C12: dodecyl ester).
[0040] [Diagram 5] FIG. 5 is a graph of the relative cAMP response vs. time of CHO-K1-P4 cells (2.5×10 4 cells / well) in response to challenge with treprostinil at 5 μM and various treprostinil alkyl ester compounds.
[0041] [Figure 6] 6 is a graph of relative cAMP activity vs. time in CHO-K1-P4 cells (2.5×104 cells / well) in response to challenge with treprostinil and nebulized and non-nebulized treprostinil alkyl ester compositions as measured by a modified GloSensor assay. "(N)" indicates nebulized composition.
[0042] [Figure 7] FIG. 7 is a graph of the relative cAMP response vs. free treprostinil in CHO-K1-P4 cells (2.5×10 4 cells / well) at various doses and time points.
[0043] [Figure 8]FIG. 8 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) versus T554 (C2-TR) treprostinil alkyl ester composition challenge at various dosages and time points.
[0044] [Figure 9] FIG. 9 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) versus T568 (C12-TR) treprostinil alkyl ester composition challenge at various dosages and time points.
[0045] [Figure 10] FIG. 10 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) versus T631 (C14-TR) treprostinil alkyl ester composition challenge at various dosages and time points.
[0046] [Figure 11] FIG. 11 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) vs. T623 (C16-TR) treprostinil alkyl ester composition challenge at various dosages and time points.
[0047] [Figure 12] FIG. 12 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) vs. treprostinil ethyl ester (C2) compound challenge at various dosages and time points.
[0048] [Figure 13] FIG. 13 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) versus treprostinil ethyl ester (C12) compound challenge at various dosages and time points.
[0049] [Figure 14]FIG. 14 is a graph of the relative cAMP response of CHO-K1-P4 cells (2.5×10 4 cells / well) vs. treprostinil ethyl ester (C2) compositions at various dosages and time points.
[0050] [Figure 15A] Figure 15A is a graph of pulmonary artery pressure (expressed as a percent of starting hypoxic values) versus time in response to animal challenge with phosphate buffered saline (PBS), treprostinil and prostacyclin compositions (T554 (C2) and T-568 (C12)). The target dose for treprostinil and prostacyclin alkyl ester was 76.8 nmol / kg; the deposited dose achieved could be 5x lower than these targets.
[0051] [Figure 15B] Figure 15B is a dot plot showing the effect of treprostinil and C2, C8, C10 and C12 treprostinil alkyl ester compositions on PAP (expressed as a percentage of starting hypoxic values) in an acutely hypoxic rat model of PAH in vivo. Doses are target values; actual lung doses achieved may be approximately 5x lower.
[0052] [Figure 16] FIG. 16 is a graph of systemic arterial pressure (expressed as a percent of starting hypoxic values) versus time in response to animal challenge with PBS, treprostinil and treprostinil alkyl ester compositions (T554 (C2-TR) and T-568 (C12-TR)) in an acutely hypoxic rat model of PAH in vivo. The vertical dotted lines represent time increment change on the x-axis. The target dose for treprostinil and prostacyclin alkyl ester was 76.8 nmol / kg; achieved adherence doses could be 5× lower than these targets.
[0053] [Figure 17]FIG. 17 is a graph of in vivo heart rate (expressed as a percent of starting hypoxic values) versus time in response to animal challenge with PBS, treprostinil and treprostinil alkyl ester compositions (T554(C2) and T-568(C12)) in an in vivo acute hypoxic rat model of PAH. The vertical dotted lines represent the time increment change on the x-axis. The target dose for treprostinil and prostacyclin alkyl ester was 76.8 nmol / kg; the achieved adherence dose could be 5× lower than these targets.
[0054] [Figure 18] The top panel of Figure 18 is a graph of the relative cAMP response of CHO-K1 cells as a function of 5C9-TR (a 5-nonanyl-treprostinil alkyl ester composition) challenge at various doses and time points. The bottom panel of Figure 18 shows the EC50 of 5C9-TR over time, calculated from the cAMP response of CHO-K1 cells vs. 5C9-TR.
[0055] [Figure 19] The top panel of Figure 19 is a graph of the relative cAMP response of CHO-K1 cells vs. C14-TR (a C14 treprostinil alkyl ester composition) challenge at various doses and time points. The bottom panel of Figure 19 shows the EC50 of C14-TR over time, calculated from the cAMP response of CHO-K1 cells vs. C14-TR.
[0056] [Figure 20] The top panel of Figure 20 is a graph of the relative cAMP response of CHO-K1 cells vs. C16-TR (a C16 treprostinil alkyl ester composition) challenge at various doses and time points. The bottom panel of Figure 20 shows the EC50 of C16-TR over time, calculated from the cAMP response of CHO-K1 cells vs. C16-TR.
[0057] [Figure 21]FIG. 21 is a graph of the relative cAMP response vs. time of CHO-K1 cells in response to challenge with C12-TR, C14-TR, C16-TR, or 5-nonanyl-TR (5C9-TR) at 10 μM (top panel) or 5 μM (bottom panel).
[0058] [Figure 22] Figure 22 (top panel) is a graph of the relative cAMP response of CHO-K1 cells vs. T679 (C14-TR 45 mol%, squalane 45 mol%, chol-PEG2k 10%) treprostinil alkyl ester composition challenge at various dosages and time points. Figure 22 (bottom panel) shows the EC50 of T679 over time calculated from the cAMP response of CHO-K1 cells vs. T679.
[0059] [Figure 23] FIG. 23 is a graph of the relative cAMP response vs. time of CHO-K1 cells in response to challenge with treprostinil at 10 μM (top panel) or 5 μM (bottom panel), T631 (C14-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%) or T679 (C14-TR 45 mol%, squalane 45 mol%, chol-PEG2k 10 mol%).
[0060] [Figure 24] The top panel of Figure 24 is a graph of the relative cAMP response of CHO-K1 cells vs. T647 (C14-TR 90 mol%, chol-PEG2k 10 mol%) treprostinil alkyl ester composition challenge at various dosages and time points. The bottom panel of Figure 24 shows the EC50 of T647 over time calculated from the cAMP response of CHO-K1 cells vs. T647-TR.
[0061] [Diagram 25]FIG. 25 is a graph of the relative cAMP response vs. time of CHO-K1 cells in response to challenge with treprostinil at 10 μM (top panel) or 5 μM (bottom panel), T631 (C14-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%) or T647 (C14-TR 90 mol%, chol-PEG2k 10 mol%).
[0062] [Figure 26] The top panel of Figure 26 is a graph of the relative cAMP response of CHO-K1 cells vs. T637 (C18-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%) treprostinil alkyl ester lipid nanoparticle composition challenge at various dosages and time points. The bottom panel of Figure 26 shows the EC50 of T637 over time calculated from the cAMP response of CHO-K1 cells vs. T637-TR.
[0063] [Figure 27] Figure 27 shows the results of the analysis of treprostinil, T555 (C8-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%), T556 (C10-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%), T568 (C12-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%), T631 (C14-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%), T623 (C16-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%), and T623 (C16-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%) at 10 μM (upper panel) or 5 μM (lower panel). 10 mol%) or T637 (C18-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%).
[0064] [Figure 28] FIG. 28 is a graph of the conversion rate (% of total) over time (hours) for linear (C8TR) versus branched (2-dimethyl-1-propanyl-TR, 3,3-dimethyl-1-butanyl-TR, 2-ethyl-1-butanyl-TR, 5-nonanyl-TR or 3-pentanyl-TR) prostacyclin compounds.
[0065] [Figure 29] 29 is a graph showing the conversion of treprostinil compounds derivatized with an octyl moiety (R2=C8) versus various linear alkyl chains. Conversions were measured after 1 hour of incubation with esterase.
[0066] [Diagram 30] 30 is a graph showing the conversion of treprostinil compounds derivatized with an octyl moiety (R2=C8) versus the conversion of treprostinil compounds derivatized with various branched alkyl chains. Conversions were measured after 1 hour of incubation with esterase.
[0067] [Diagram 31] FIG. 31 is a schematic diagram of the Jaeger-NYU nose-only directed-flow inhalation exposure system (CH Technologies, Westwood, NJ, www.onares.org) used for the 24-hour pharmacokinetic studies.
[0068] [Diagram 32] The left side of Figure 32 is a graph of treprostinil plasma levels (ng / mL) as a function of time for treprostinil and various inhaled treprostinil alkyl ester formulations. The right side of Figure 32 is a graph of treprostinil plasma levels (ng / mL) as a function of time for treprostinil and various inhaled treprostinil alkyl ester micelle formulations.
[0069] [Diagram 33] Figure 33 is a graph of treprostinil and treprostinil alkyl ester concentrations in the lungs after administration of nebulized treprostinil solution or formulated treprostinil alkyl ester suspension. Lungs were harvested 6 hours after administration. Treprostinil alkyl ester concentrations are presented as treprostinil equivalents on a molar basis.
[0070] [Diagram 34] The top part of Figure 34 is a graph of treprostinil plasma levels (ng / mL) as a function of time in rats after nose-only inhalation of a nebulized treprostinil alkyl ester formulation. The bottom part of Figure 34 is a graph of treprostinil and treprostinil alkyl ester plasma levels (ng / mL) as a function of time in rats after nose-only inhalation of a nebulized treprostinil alkyl ester formulation.
[0071] [Diagram 35] The top of Figure 35 is a graph of treprostinil plasma levels (ng / mL) as a function of time after nebulization (nose-only administration) of various concentrations of C16-TR formulations. The bottom of Figure 35 is a graph of treprostinil and C16-TR plasma levels (ng / mL) as a function of time after nebulization (nose-only administration) of various concentrations of C16-TR formulations.
[0072] [Diagram 36] FIG. 36 is a graph of the plasma concentration of treprostinil (ng / mL) in intubated dogs as a function of time following administration of treprostinil or a T623 lipid nanoparticle formulation (C16-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%).
[0073] [Figure 37]Figure 37, left, is a graph of the conversion of treprostinil alkyl esters to treprostinil as a function of time for various treprostinil alkyl esters exposed to rat lung tissue homogenates. Figure 37, right, is a graph of the conversion of C12-treprostinil to treprostinil as a function of time in rat, dog, and monkey lung tissue homogenates.
[0074] [Figure 38] FIG. 38 is a graph of mean pulmonary artery pressure (mPAP) as a function of time in rats treated with PBS, treprostinil, T568 (C12-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%) or T623 (C16-TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, DOPC 10 mol%).
[0075] [Figure 39] Figure 39, top, is a graph of mean systemic arterial pressure (mSAP) as a function of time in rats treated with PBS, treprostinil, T568 or T623. Figure 39, bottom, is a graph of heart rate as a function of time in rats treated with PBS, treprostinil, T568 or T623.
[0076] [Diagram 40] FIG. 40 is a graph of treprostinil plasma levels (ng / mL) as a function of time in rats following administration of free treprostinil, T568, or T623.
[0077] [Diagram 41] FIG. 41 is a graph of treprostinil plasma levels (ng / mL) as a function of time in rats following administration of Composition T763i. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0078] The term "alkyl" as used herein refers to both linear alkyls, where the alkyl chain length is designated by a numerical range, and branched alkyls, where there are branch points in the chain and the total number of carbon atoms in the chain is designated by a numerical range. In exemplary embodiments, "alkyl" refers to an alkyl chain, as defined above, containing 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 carbons (i.e., C6-C 16 Alkyl).
[0079] The term "alkenyl," as used herein, refers to a carbon chain that contains one or more carbon-carbon double bonds.
[0080] As used herein, the term "aryl" refers to a cyclic hydrocarbon in which the ring is characterized by delocalized pi electrons (aromaticity) shared between the ring members and the number of ring atoms is designated by a numerical range. In an exemplary embodiment, "aryl" refers to a cyclic hydrocarbon as described above containing 6, 7, 8, 9 or 10 ring atoms (i.e., C6-C 10 Examples of aryl groups include, but are not limited to, benzene, naphthalene, tetralin, indene, and indane.
[0081] The term "alkoxy" as used herein refers to -O-(alkyl), where "alkyl" is defined above.
[0082] As used herein, the term "substituted" in the context of a moiety means that refers to another substituent attached to the moiety at any permitted position on the moiety. Unless otherwise specified, the moiety can be attached through a carbon, nitrogen, oxygen, sulfur, or any other permitted atom.
[0083] The term "amino acid" refers to both natural (genetically encoded) and non-natural (non-genetically encoded) amino acids and moieties thereof. Of the 20 natural amino acids, 19 have the general structure: [ka] where R is an amino acid side chain. The 20th amino acid, proline, is also within the scope of the invention and has the following structure: [ka] Of the 20 naturally occurring amino acids, all except glycine are chiral, and both D- and L-amino acid isomers, as well as mixtures thereof, are acceptable for use in the prostacyclin compounds described herein. It is also noted that amino acid moieties are encompassed by the term "amino acid". For example, the amino acid moiety [ka] are encompassed by the term "amino acid".
[0084] Examples of unnatural amino acids that are acceptable for use in the present invention include β-alanine (β-Ala); 2,3-diaminopropionic acid (Dpr); nipecotic acid (Nip); pipecolic acid (Pip); ornithine (Om); citrulline (Cit); t-butylalanine (t-BuA); 2-t-butylglycine (t-BuG); N-methylisoleucine (MeIle); phenylglycine (PhG); cyclohexylalanine (ChA); norleucine (Nle); naphthylalanine (Nal); 4-chlorophenylalanine (Phe(4-Cl)); 2-fluorophenylalanine (Phe(2-F)); 3-fluorophenylalanine (Phe(3-F)); 4-fluorophenylalanine (Phe(4-Cl)); These include homoylalanine (Phe(4-F)); penicillamine (Pen); 1,2,3,4-tetrahydroisoquinoline-3-carboxylic acid (Tic); β-2-thienylalanine (Thi); methionine sulfoxide (MSO); homoarginine (hArg); N-acetyl-lysine (AcLys); 2,4-diaminobutyric acid (Dbu); 2,3-diaminobutyric acid (Dab); p-aminophenylalanine (Phe(pNH2)); N-methylvaline (MeVal); homocysteine (hCys), homophenylalanine (hPhe); homoserine (hSer); hydroxyproline (Hyp); homoproline (hPro); and the corresponding D-enantiomers of each of the above. Other non-genetically encoded amino acid residues include 3-aminopropionic acid; 4-aminobutyric acid; isonipecotic acid (Inp); aza-pipecolic acid (azPip); aza-proline (azPro); α-aminoisobutyric acid (Aib); ε-aminohexanoic acid (Aha); δ-aminovaleric acid (Ava); and N-methylglycine (MeGly).
[0085] A "peptide" is a polymer of amino acids (or portion thereof) linked by peptide bonds. Peptides for use in the present invention contain from about 2 to about 15 amino acids, for example, 2, 3, 4, 5, 6, 7, 8, 9, or 10 amino acids (or portion thereof).
[0086] The term "salt" or "salts" as used herein includes pharma- ceutically acceptable salts that are commonly used to form alkali metal salts of free acids and to form addition salts of free bases. The nature of the salt is not critical, so long as it is pharma- ceutically acceptable. Suitable pharma-ceutically acceptable acid addition salts can be prepared from inorganic or organic acids. Exemplary pharmaceutical salts are disclosed in Stahl, PH, Wermuth, CG (eds.), Handbook of Pharmaceutical Salts: Properties, Selection and Use; Verlag Helvetica Chimica Acta / Wiley-VCH: Zurich, 2002, the contents of which are incorporated herein by reference in their entirety. Specific non-limiting examples of inorganic acids are hydrochloric acid, hydrobromic acid, hydroiodic acid, nitric acid, carbonic acid, sulfuric acid, and phosphoric acid. Suitable organic acids include, but are not limited to, fatty acids, cyclic fatty acids, aromatic acids, aryl fatty acids, and carboxylic and sulfonic acids, such as formic acid, acetic acid, propionic acid, succinic acid, glycolic acid, gluconic acid, lactic acid, malic acid, tartaric acid, citric acid, ascorbic acid, glucuronic acid, maleic acid, fumaric acid, pyruvic acid, aspartic acid, glutamic acid, benzoic acid, anthranilic acid, mesylic acid, stearic acid, salicylic acid, p-hydroxybenzoic acid, phenylacetic acid, mandelic acid, embonic acid (pamoic acid), methanesulfonic acid, ethanesulfonic acid, benzenesulfonic acid, pantothenic acid, toluenesulfonic acid, 2-hydroxyethanesulfonic acid, sulfanilic acid, cyclohexylaminosulfonic acid, algenic acid, 3-hydroxybutyric acid, galactaric acid, or the like. or heterocyclyls containing galacturonic acid. Suitable pharma- ceutically acceptable salts of the free acid-containing compounds disclosed herein include, but are not limited to, metallic salts and organic salts. Exemplary metallic salts include, but are not limited to, suitable alkali metal (group Ia) salts, alkaline earth metal (group IIa) salts and other physiologically acceptable metals. Such salts can be made from aluminum, calcium, lithium, magnesium, potassium, sodium and zinc. Exemplary organic salts can be made from primary amines, secondary amines, tertiary amines and quaternary ammonium salts, such as tromethamine, diethylamine, tetra-N-methylammonium, N,N'-dibenzylethylenediamine, chloroprocaine, choline, diethanolamine, ethylenediamine, meglumine (N-methylglucamine) and procaine.
[0087] In one aspect, the present invention provides a prostacyclin compound, such as a treprostinil derivative, or a composition comprising the same, which is effective when used in a once-daily, twice-daily, or three-times-daily dosing regimen, for example, for the treatment of pulmonary arterial hypertension or portopulmonary hypertension in a patient in need thereof. In one embodiment, the prostacyclin compound provided herein can be administered less frequently than treprostinil with comparable or greater efficacy. Furthermore, in one embodiment, the side effect profile of the compound provided herein is less adverse than that resulting from treprostinil administration. In one embodiment, these advantages allow for greater patient compliance. In one embodiment, the treatment is performed by pulmonary administration of one of the compounds provided herein, for example, by a nebulizer, dry powder inhaler, or metered dose inhaler. In some embodiments, a composition comprising one of the compounds provided herein is administered to a patient in need of PH treatment by a nebulizer. In some embodiments, the compound described herein is suspended in a propellant and delivered to the patient by a metered dose inhaler.
[0088] In one aspect of the invention described herein, a compound of formula (I): [ka] (Wherein, R1 is NH, O or S; R2 is H, linear C5-C 18 Alkyl, branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 alkyl; an amino acid or a peptide; R3 is H, OH, optionally substituted linear or branched C1-C 15 Alkoxy, O-optionally substituted linear or branched C2-C 15 Alkenyl , O-(C=O)-optionally substituted linear or branched C1-C 15 Alkyl or O-(C=O)-optionally substituted linear or branched C2-C 15 alkenyl; R4 is an optionally substituted linear or branched C1-C 15 Alkyl or optionally substituted linear or branched C2-C 15 alkenyl; n is an integer from 0 to 5. or a pharma- ceutically acceptable salt thereof, with the proviso that the prostacyclin compound of formula (I) is not treprostinil.
[0089] In another embodiment, there is provided a prostacyclin compound of formula (I) where R3 is OH and n is 0 or 1. In yet another embodiment, R4 is an optionally substituted linear or branched C1-C 15 In yet other embodiments, R is NH or O.
[0090] In one embodiment, R1 is NH, O or S; R2 is a linear C5-C 18 Alkyl, branched C5-C18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 alkenyl; R3 is H, OH or O-alkyl; R4 is an optionally substituted linear or branched C1-C 15 Alkyl or optionally substituted linear or branched C2-C 15 alkenyl; and n is an integer from 0 to 5. In yet another embodiment, R1 is NH or O and R2 is a linear C5-C 18 Alkyl or branched C5-C 18 It is an alkyl.
[0091] In one embodiment, R2 is aryl or aryl-C1-C 18 R is OH and n is 0 or 1. In yet other embodiments, R is an optionally substituted linear or branched C-C alkyl group. 15 It is an alkyl.
[0092] In one embodiment, the present invention relates to a compound of formula (Ia), (Ib), (Ic) or (Id): [ka] (Wherein, R2 is H, a linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl or branched C3-C 18 alkenyl; R3 is H, OH, optionally substituted linear or branched C1-C 15 Alkoxy, O-optionally substituted linear or branched C2-C 15 Alkenyl, -O(C=O)-optionally substituted straight or branched C1-C 15 Alkyl or -O(C=O)- optionally substituted linear or branched C2-C 15 alkenyl; R4 is [ka] , optionally substituted linear or branched C1-C 15 Alkyl or optionally substituted linear or branched C2-C 15 alkenyl, R5 is H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15 Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15 Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 alkenyl) or a pharma- ceutically acceptable salt thereof. In another embodiment, R4 is [ka] with the proviso that the compound is not treprostinil, i.e., R2 and R5 cannot both be H.
[0093] In one embodiment of formula (Ia), formula (Ib), formula (Ic) and formula (Id), R2 is a linear or branched C5-C 18 In yet another embodiment, R2 is alkyl. [ka] or [ka] wherein m1 and m2 are each independently an integer selected from 1 to 9, and R' at each occurrence is independently H, a linear or branched C1-C8 alkyl, or a linear or branched C1-C8 alkenyl. In yet another embodiment, R2 is [ka] and m1 and m2 are both 4. In another embodiment, R2 is [ka] and m1 is 3 and m2 is 4, or m1 is 2 and m2 is 3.
[0094] When m1 and / or m2 are integers from 2 to 9, m1 / m2 at the ends of the carbon chains are CH3 and the remaining m1 / m2 groups are CH2.
[0095] In one embodiment of formula (Ia), formula (Ib), formula (Ic) and formula (Id), R2 is [ka] [ka] In another embodiment, R3 is OH and R4 is [ka] R5 is H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15 Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15 Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 It is alkenyl.
[0096] In one embodiment of formula (Ia), (Ib), (Ic) or (Id), R2 is H, R3 is OH and R4 is [ka] and R5 is [ka] or [ka] where m1 and m2 are each independently an integer selected from 1 to 9, and R' at each occurrence is independently H, linear or branched C1-C8 alkyl, or linear or branched C1-C8 alkenyl. When m1 and / or m2 are integers from 2 to 9, m1 / m2 at the carbon chain termini are CH3, and the remaining m1 / m2 groups are CH2.
[0097] In another embodiment, the compound of formula (Ia'), (Ib'), (Ic') or (Id'): [ka] (Wherein, R2 is H, a linear or branched C5-C 18 Alkyl or linear or branched C5-C 18 alkenyl; R4 is [ka] , optionally substituted linear or branched C1-C 15 Alkyl or optionally substituted linear or branched C2-C 15 alkenyl, R5 is H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15 Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 alkenyl, with the proviso that R2 and R5 cannot both be H. In one embodiment of formula (Ia'), formula (Ib'), formula (Ic') and formula (Id'), R4 is [ka] and R2 is [ka] or R5 is [ka] or [ka] wherein m1 and m2 are each independently an integer selected from 1 to 9, and R' at each occurrence is independently H, a linear or branched C1-C8 alkyl, or a linear or branched C1-C8 alkenyl. In yet another embodiment, R2 is [ka] [ka] It is.
[0098] Yet another embodiment of the present invention is a compound of formula (Ia″), (Ib″), (Ic″) or (Id″): [ka] (In the formula, R2 is H, linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl, branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 alkyl; an amino acid or a peptide; R3 is H, OH, optionally substituted linear or branched C1-C 15 Alkoxy, O-optionally substituted linear or branched C2-C 15 Alkenyl, O-(C=O)-optionally substituted straight or branched C1-C 15 Alkyl or O-(C=O)-optionally substituted linear or branched C2-C 15 alkenyl; R5 is H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15 Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15 Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 alkenyl, with the proviso that R2 and R5 cannot both be H. or a pharma- ceutically acceptable salt thereof. In another embodiment, R3 is OH, and R2 is 5-nonanyl, 4-heptyl, 4-octyl, 3-octyl, 2-dimethyl-1-propyl, 3,3-dimethyl-1-butyl, 2-ethyl-1-butyl, 3-pentyl, pentyl, hexyl, heptyl, octyl, nonyl, decyl, undecyl, dodecyl, tridecyl, tetradecyl, pentadecyl, hexadecyl, heptadecyl or octadecyl. In yet another embodiment, R2 is decyl, undecyl, dodecyl, tridecyl, tetradecyl, pentadecyl, hexadecyl, heptadecyl or octadecyl. In yet another embodiment, R2 is linear alkyl.
[0099] One embodiment of the present invention is directed to compounds of formula (Ic), (Ic') and (Ic''). In another embodiment, R2 is a linear C5-C 18 Alkyl or branched C5-C 18 In yet another embodiment, R2 is a linear C-C alkyl. 18 Alkyl or branched C6-C 18 In yet another embodiment, R2 is a linear C-C alkyl. 14 Alkyl, e.g., linear C6 alkyl, C8 alkyl, C 10 Alkyl, C 12 Alkyl or C 14 It is an alkyl.
[0100] In one embodiment, R2 is a linear C5-C 18 R is OH and R is H. In another embodiment, compounds of formula (Ic'') are provided in which R is a linear C6-C 18 Compounds of formula (Ic'') are provided in which R2 is a linear C6-C alkyl, R3 is OH and R5 is H. In further embodiments, R2 is a linear C6-C 16 R is OH and R is H. In yet another embodiment, compounds of formula (Ic'') are provided in which R is a linear C8-C 14Compounds of formula (Ic'') are provided wherein R is alkyl; R3 is OH and R5 is OH.
[0101] In one embodiment, R2 is a linear C5-C 18 R is an alkyl group; R is OH and R is H. In another embodiment, compounds of formula (Ic'') are provided where R is a branched C6-C 18 R is an alkyl group; R is OH and R is H. In a further embodiment, compounds of formula (Ic'') are provided where R is a branched C-C 16 R is an alkyl group; R is OH and R is H. In yet another embodiment, compounds of formula (Ic'') are provided in which R is a branched C8-C 14 R3 is OH and R5 is H. Compounds of formula (Ic'') are provided wherein R3 is OH and R5 is H.
[0102] In yet other embodiments, the compounds of Formulae (Ic), (Ic') and (Ic'') are administered to patients in need of PH treatment via a metered dose inhaler.
[0103] In yet another embodiment of formula (Ia″), (Ib″), (Ic″) or (Id″), R3 is OH, R5 is H and R2 is [ka] and m1 and m2 are each independently an integer selected from 1 to 9. In yet another embodiment, R2 is [ka] [ka] It is.
[0104] In yet another embodiment of formula (Ia″), (Ib″), (Ic″) or (Id″), R2 is H, R3 is OH and R5 is [ka] and m1 and m2 are each independently an integer selected from 1 to 9. In yet another embodiment, R2 is [ka] [ka] It is.
[0105] In one embodiment, R2 is a linear or branched C5-C 18 Prostacyclin compounds of formula (I), (Ia), (Ib), (Ic) or (Id) are provided, wherein R2 is alkyl.In other embodiments, R2 is 5-nonanyl, 4-heptanyl, 4-octanyl, 3-octanyl, 2-dimethyl-1-propanyl, 3,3-dimethyl-1-butanyl, 2-ethyl-1-butanyl, 3-pentanyl, pentyl, hexyl, heptyl, octyl, nonyl, decyl, undecyl, dodecyl, tridecyl, tetradecyl, pentadecyl, hexadecyl, heptadecyl or octadecyl.
[0106] In one embodiment, R2 is a linear or branched C5-C 18 In yet another embodiment, R2 is a linear C5-C alkyl group. 18 In another embodiment, R2 is [ka] wherein m1 and m2 are each independently an integer selected from 1 to 9, and R' at each occurrence is independently H, a linear or branched C1-C8 alkyl, or a linear or branched C1-C8 alkenyl. In yet another embodiment, R2 is [ka] [ka] It is.
[0107] In another embodiment, R2 is a branched C5-C 18 Prostacyclin compounds of formula (I), (Ia), (Ib), (Ic) or (Id) are provided, wherein R2 is alkyl.In other embodiments, R2 is 5-nonanyl, 4-heptyl, 4-octyl, 3-octyl, 2-dimethyl-1-propyl, 3,3-dimethyl-1-butyl, 2-ethyl-1-butyl, 3-pentyl, pentyl, hexyl, heptyl, octyl, nonyl, decyl, undecyl, dodecyl, tridecyl, tetradecyl, pentadecyl, hexadecyl, heptadecyl or octadecyl.
[0108] In one embodiment of the present invention, the prostacyclin compound of the present invention has the following structure: [ka] (wherein R1 is NH, O or S). has.
[0109] For example, R1 is O or N and the following compounds (5-nonanyl treprostinil (alkyl ester, 5C9-TR) or 5-nonanyl treprostinil (amide bonded; 5C9-TR-A): [ka] One of the following will be provided.
[0110] In one embodiment, R2 is [ka] wherein m1 and m2 are each independently an integer selected from 1 to 9, and R', for each occurrence, is independently H, straight chain or branched C1-C8 alkyl, or straight chain or branched C1-C8 alkenyl.
[0111] When m1 and / or m2 are integers from 2 to 9, m1 / m2 at the ends of the carbon chains are CH3 and the remaining m1 / m2 groups are CH2.
[0112] In yet another embodiment, a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic'') or (Id'') is provided, wherein R2 is [ka] [ka] It is.
[0113] The compounds provided herein can include symmetrically branched or asymmetrically branched alkyl as the R2 moiety. For example, R2 can be [ka] When m1 and m2 are different, R2 is an asymmetrical branched alkyl.
[0114] In another embodiment, a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic'') or (Id'') is provided, wherein R2 is [ka] wherein m1 is 2 and m2 is 3; m1 and m2 are each independently 4; or m1 and m2 are each independently 3.
[0115] In another embodiment, the prostacyclin compound includes an asymmetric branched alkyl at the R2 position, such as 3-hexanyl (3C6), 2-heptanyl (2C7), 3-heptanyl (3C7), 2-octanyl (2C8), 3-octanyl (3C8) or 4-octanyl (4C8).
[0116] In another embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id), wherein R2 is a branched alkyl selected from 2,2-diethyl-1-pentyl, 3-pentyl, 4-octyl, 5-nonanyl, 2-ethyl-1-butyl, 2-propyl-1-pentyl, 12-butyl-1-octyl, 2-dimethyl-1-propyl and 3,3-dimethyl-1-butyl.
[0117] In another embodiment, R2 is a linear or branched C5-C 18Prostacyclin compounds of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic') or (Id') are provided, which are alkenyl. For example, in one embodiment, R2 is a linear C5-C aryl selected from pentenyl, hexenyl, heptenyl, octenyl, nonenyl, decenyl, undecenyl, tridecenyl, tetradecenyl, pentadecenyl, hexadecenyl, heptadecenyl or octadecenyl. 18 In another embodiment, R3 is OH. In another embodiment, R2 is a branched C5-C aryl selected from pentenyl, hexenyl, heptenyl, octenyl, nonenyl, decenyl, undecenyl, tridecenyl, tetradecenyl, pentadecenyl, hexadecenyl, heptadecenyl, or octadecenyl. 18 In another embodiment, R3 is OH.
[0118] In one embodiment, a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) is provided, wherein R4 is [ka] In other embodiments, R4 is [ka] It is.
[0119] In one embodiment, a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) is provided, wherein R2 is a linear C5-C 18 alkyl, R3 is OH, and R4 is [ka] In other embodiments, R2 is 5-nonanyl, 4-heptyl, 4-octanyl, 3-octanyl, 2-dimethyl-1-propyl, 3,3-dimethyl-1-butyl, 2-ethyl-1-butyl, 3-pentyl, pentyl, hexyl, heptyl, octyl, nonyl, decyl, undecyl, dodecyl, tridecyl, tetradecyl, pentadecyl, hexadecyl, heptadecyl, or octadecyl.
[0120] In one embodiment, a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) is provided, wherein R2 is hexyl, dodecyl, tetradecyl, hexadecyl, 5-nonanyl, 4-heptanyl, 4-octanyl, 3-octanyl, 2-dimethyl-1-propyl, 3,3-dimethyl-1-butyl, 2-ethyl-1-butyl, 3-pentyl, R3 is OH, and R4 is [ka] It is.
[0121] In one embodiment, a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) is provided, wherein R2 is hexyl, R3 is OH and R4 is [ka] It is.
[0122] In one embodiment, a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) is provided, wherein R2 is hexyl, R3 is OH and R4 is [ka] It is.
[0123] In another embodiment, a prostacyclin compound of formula (Ia″), (Ib″), (Ic″) or (Id″) is provided, wherein R2 is hexyl, R3 is OH, and R4 is H. In another embodiment, the compound is a compound of formula (Ic″). In yet another embodiment, a prostacyclin compound of formula (Ia″), (Ib″), (Ic″) or (Id″) is provided, wherein R2 is dodecyl, tetradecyl, pentadecyl, or hexadecyl, R3 is OH, and R4 is H. In another embodiment, the compound is a compound of formula (Ia″). In yet another embodiment, the compound is present in a lipid nanoparticle formulation, as described in more detail below.
[0124] In one embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is heptyl, R3 is OH and R4 is [ka] It is.
[0125] In one embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is octyl, R3 is OH and R4 is [ka] It is.
[0126] In one embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is nonyl, R3 is OH, and R4 is [ka] It is.
[0127] In another embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is decyl, R3 is OH and R4 is [ka] It is.
[0128] In yet another embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is undecyl, R3 is OH and R4 is [ka] It is.
[0129] In yet another embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is dodecyl, R3 is OH and R4 is [ka] It is.
[0130] In one embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is tridecyl, R3 is OH, and R4 is [ka] It is.
[0131] In another embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is tetradecyl, R3 is OH and R4 is [ka] It is.
[0132] In yet another embodiment, there is provided a prostacyclin compound of formula (I), (Ia), (Ib), (Ic) or (Id) or a pharma- ceutically acceptable salt thereof, wherein R2 is pentadecyl, R3 is OH and R4 is [ka] It is.
[0133] Another embodiment of the present invention is a compound in which R2 is hexadecyl, R3 is OH, and R4 is [ka] or a pharma- ceutically acceptable salt thereof.
[0134] Yet another embodiment of the present invention is a compound wherein R2 is heptadecyl, R3 is OH, and R4 is [ka] or a pharma- ceutically acceptable salt thereof.
[0135] Yet another embodiment of the present invention is a compound in which R2 is octadecyl, R3 is OH, and R4 is [ka] or a pharma- ceutically acceptable salt thereof.
[0136] In one embodiment, compounds of formula (I), (Ia), (Ib), (Ic) or (Id) or pharma- ceutically acceptable salts are provided in which one or more hydrogen atoms are replaced by deuterium. Thus, in one embodiment, the present invention relates to isotopic species of formula (I), (Ia), (Ib), (Ic) or (Id) in which one or more deuterium atoms are replaced. The isotopic species of formula (I), (Ia), (Ib), (Ic) or (Id) can be used to accurately determine the concentration of compounds of formula (I), (Ia), (Ib), (Ic) or (Id) in biological fluids and to determine the metabolic patterns of compounds of formula (I), (Ia), (Ib), (Ic) or (Id) and their isotopic species. The present invention further provides compositions comprising these deuterium isotopic species and methods of treating diseases and conditions as described herein.
[0137] In another embodiment of the present invention, there is provided a prostacyclin compound of formula (II) or a pharma- ceutically acceptable salt thereof: [ka] (Wherein, R1 is NH, O or S; R2 is a linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl or branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 is an alkyl, amino acid or peptide; n is an integer from 0 to 5. is provided.
[0138] In one embodiment, R1 is NH, O or S; R2 is a linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl or branched C3-C 18 Prostacyclin compounds of formula (II) or pharma- ceutically acceptable salts thereof are provided, wherein R is alkenyl; n is an integer from 0 to 5. In other embodiments, n is 1 and R is NH or O.
[0139] In one embodiment, the present invention relates to a compound of formula (IIa), (IIb), (IIc) or (IId): [ka] [ka] (Wherein, R2 is a linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl or branched C3-C 18 Alkenyl, aryl, aryl-C1-C 18 alkyl, amino acid or peptide) or a pharma- ceutically acceptable salt thereof. In another embodiment, R2 is a linear or branched C5-C 18 Alkyl, linear C2-C 18 Alkenyl or branched C3-C 18Compounds of formula (IIa), (IIb), (IIc) or (IId) are provided which are alkenyl. In one embodiment, compounds of formula (II), (IIa), (IIb), (IIc) or (IId) are provided in which one or more hydrogen atoms are replaced by deuterium. Thus, in one embodiment, the present invention relates to isotopic species of formula (II), (IIa), (IIb), (IIc) or (IId) in which one or more deuterium atoms are replaced. The isotopic species of formula (II), (IIa), (IIb), (IIc) or (IId) can be used to accurately determine the concentration of compounds of formula (II), (IIa), (IIb), (IIc) or (IId) in biological fluids and to determine the metabolic pattern of compounds of formula (II), (IIa), (IIb), (IIc) or (IId) and their isotopic species. The present invention further provides compositions comprising these deuterium isotope species and methods of treating diseases and conditions as provided herein.
[0140] In one embodiment, the prostacyclin derivative is a compound of formula (IIc). In another embodiment, R2 is a linear C5-C 18 Alkyl or branched C5-C 18 For example, in one embodiment, R2 is a linear C-C alkyl. 18 In another embodiment of formula (IIc), R2 is a linear C-C alkyl. 10 In yet other embodiments of Formula (IIc), R2 is hexyl, heptyl or octyl.
[0141] Compounds of formula (IIa) and formula (IId) are shown in Tables A and B below. [Table A] [Table B]
[0142] Yet another embodiment of the present invention is a compound of formula (III): [ka] wherein R1 and R2 are defined as provided for formulas (I) and (II), and R5 and R6 are independently H, optionally substituted linear or branched C1-C 15 Alkyl, optionally substituted linear or branched C-C 15 Alkenyl, (C=O)-optionally substituted straight or branched C1-C 15 Alkyl or (C=O)-optionally substituted linear or branched C2-C 15 alkenyl) or a pharma- ceutically acceptable salt thereof, with the proviso that the prostacyclin compound of formula (III) is not Treprostinil.
[0143] In one embodiment, the branched chain prostacyclin compounds provided herein exhibit both higher solubility and slower enzymatic conversion to treprostinil relative to linear derivatized prostacyclin compounds. In one embodiment, asymmetric branched chain prostacyclin compounds are provided that are more stable than the corresponding symmetric branched chain prostacyclin compounds.
[0144] In one embodiment, the present invention provides a prostacyclin compound that comprises a chiral moiety at one or more of the R2, R5 and / or R6 positions. For example, in one embodiment, the moiety at the R2 position is a chiral moiety and comprises an R isomer, an S isomer or a mixture thereof. The optical isomers at the R2, R5 and / or R6 positions can also be classified by D / L nomenclature. For example, when R2 is an amino acid or amino acid moiety, the amino acid or amino acid moiety can be a D isomer, an L isomer or a mixture thereof.
[0145] In one embodiment, one or more of the R2, R5 and / or R6 moieties are R or S isomers. In another embodiment, one or more of the R2, R5 and / or R6 moieties provided herein comprise a mixture of R and S moieties. As used herein, "R isomer" or "S isomer" refers to an enantiomerically pure isomer. An "enantiomerically pure isomer" has at least 90%, at least 95%, at least 96%, at least 97%, at least 98% or at least 99% purity of the R- or S-isomer, or, when the D / L nomenclature is used, the D- or L-isomer. A racemate is a compound having a mixture of equal amounts of both enantiomers.
[0146] In another aspect of the present invention, the prostacyclin compounds described herein are provided in compositions for delivery to patients, for example, to treat pulmonary hypertension (PH). The compositions can include the compounds, pharma- ceutically acceptable salts of the compounds, or combinations thereof. In one embodiment, the PH is pulmonary arterial hypertension (PAH). Prostacyclin compositions (so-called "lipid nanoparticle compositions") and formulations comprising prostacyclin, cationic compounds, and surfactants are described in PCT Publication No. WO2014 / 085813, the disclosure of which is incorporated herein by reference in its entirety for all purposes. The compositions described in WO2014 / 085813 are acceptable for use with the prostacyclin derivative compounds provided herein.
[0147] In one embodiment, the composition comprises one of the prostacyclin compounds described herein, i.e., a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), and an amphiphile. In one embodiment, when formulated together, the prostacyclin compound and the amphiphile form micro- or nanoparticles. In one embodiment, the amphiphile is a pegylated lipid, surfactant or block copolymer. In another embodiment, the prostacyclin composition provided herein comprises two or more of the prostacyclin compounds described herein (e.g., compounds of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) comprising deuterated compounds) and an amphiphilic agent (e.g., a pegylated lipid, lipid, surfactant or block copolymer). In one embodiment, when formulated together, the prostacyclin composition comprising a prostacyclin compound component and an amphiphilic agent comprises a plurality of nanoparticles. In other embodiments, the average diameter of the plurality of nanoparticles is from about 20 nm to about 700 nm, e.g., from about 50 nm to about 500 nm, from about 100 nm to about 600 nm, or from about 100 nm to about 500 nm. When the amphiphile comprises a lipid, e.g., a pegylated lipid, e.g., cholesterol-PEG or distearoylphosphatidylethanolamine-PEG (DSPE-PEG), the composition is described as comprising lipid nanoparticles.
[0148] In another embodiment, the prostacyclin composition comprises a prostacyclin compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) and a PEGylated lipid as an amphiphilic agent. In another embodiment, the PEGylated lipid is The PEGylated lipid comprises PEG400 to PEG5000. For example, in one embodiment, the PEGylated lipid comprises PEG400, PEG500, PEG1000, PEG2000, PEG3000, PEG4000, or PEG5000. In other embodiments, the lipid component of the PEGylated lipid comprises cholesterol, dimyristoylphosphatidylethanolamine (DMPE), dipalmitoylphosphoethanolamine (DPPE), distearoylphosphatidylethanolamine (DSPE), dimyristoylglycerol glycerol (DMG), diphosphatidylglycerol (DPG), or distearoylglycerol (DSG). In yet other embodiments, the PEGylated lipid is cholesterol-PEG2000 or DSPE-PEG2000.
[0149] Depending on its molecular weight (MW), PEG is also referred to in the art as polyethylene oxide (PEO) or polyoxyethylene (POE). PEGylated lipids can contain branched or unbranched PEG molecules and are not limited by a particular PEG MW.
[0150] For example, in one embodiment, the pegylated lipid comprises a PEG molecule having a molecular weight of 300 g / mol, 400 g / mol, 500 g / mol, 1000 g / mol, 1500 g / mol, 2000 g / mol, 2500 g / mol, 3000 g / mol, 3500 g / mol, 4000 g / mol, 4500 g / mol, 5000 g / mol or 10,000 g / mol. In one embodiment, the PEG has a MW of 1000 g / mol or 2000 g / mol.
[0151] The lipid component of the PEGylated lipid may have a net charge (e.g., cationic or anionic) or may be net neutral. The lipids used in the PEGylated lipid component of the present invention may be synthetic, semi-synthetic or naturally derived lipids, including phospholipids, sphingolipids, glycolipids, ceramides, tocopherols, sterols, fatty acids or glycoproteins, such as albumin. In one embodiment, the lipid is a sterol. In another embodiment, the sterol is cholesterol. In another embodiment, the lipid is a phospholipid. Phospholipids include, but are not limited to, phosphatidylcholine (PC), phosphatidylglycerol (PG), phosphatidylinositol (PI), phosphatidylserine (PS), phosphatidylethanolamine (PE) and phosphatidic acid (PA). In one embodiment, the phospholipid is egg phospholipid, soybean phospholipid or hydrogenated egg and soybean phospholipid. In one embodiment, the PEGylated lipid comprises a phospholipid. In other embodiments, the phospholipids contain ester bonds of fatty acids containing chains of 12 to 26 carbon atoms at the 2nd and 3rd positions of the glycerol, and different head groups at the 1st position of the glycerol, including choline, glycerol, inositol, serine, ethanolamine and the corresponding phosphatidic acids. The chains on these fatty acids can be saturated or unsaturated, and the phospholipids can be made of fatty acids of different chain lengths and different degrees of unsaturation. In particular, in one embodiment, the PEGylated lipids of the prostacyclin compositions provided herein include distearoylphosphoethanolamine (DSPE), dipalmitoylphosphatidylcholine (DPPC), dioleoylphosphatidylcholine (DOPC) dimyristoylphosphatidylethanolamine (DMPE), dipalmitoylphosphoethanolamine (DPPE), distearoylphosphatidylethanolamine (DSPE), dimyristoylglycerol (DMG), diphosphatidylglycerol (DPG) or distearoylglycerol (DSG).
[0152] Other examples of lipids for use in the compositions comprising the pegylated lipids disclosed herein include dimyristoyl phosphatidylcholine (DMPC), dimyristoyl phosphatidylglycerol (DMPG), dipalmitoyl phosphatidylcholine (DMPC), dimyristoyl phosphatidylglycerol (DMPG), dipalmitoyl phosphatidylcholine (DMPC), dimyristoyl phosphatidylglycerol (DMPG), dipalmitoyl phosphatidylcholine (DMPC), dimyristoyl phosphatidylcholine (DMPG), dipalmi ... PEGylated lipids include phospholipids such as ammonium salts of fatty acids, phospholipids, glycerides, phospholipids and glycerides, sterols (e.g., cholesterol), phosphatidylglycerol (DPPG), distearoylphosphatidylcholine (DSPC), distearoylphosphatidylglycerol (DSPG), dioleylphosphatidylethanolamine (DOPE), and mixed phospholipids such as palmitoylstearoylphosphatidylcholine (PSPC) and palmitoylstearoylphosphatidylglycerol (PSPG), triacylglycerols, diacylglycerols, ceramides, sphingosines, sphingomyelins, and single acylated phospholipids such as mono-oleoyl-phosphatidylethanolamine (MOPE). In another embodiment, the lipid portion of the PEGylated lipid includes ammonium salts of fatty acids, phospholipids, glycerides, phospholipids and glycerides, sterols (e.g., cholesterol), phosphatidylglycerol (PG), phosphatidic acid (PA), phosphatidylcholine (phosphotidylcholine ) (PC), phosphatidylinositol (PI), phosphatidylserine (PS) or combinations thereof. In one embodiment, the fatty acid comprises a fatty acid with a carbon chain length of 12 to 26 carbon atoms, either saturated or unsaturated. Some specific examples include: myristylamine, palmitylamine, laurylamine and stearylamine, dilauroylethylphosphocholine (DLEP), dimyristoylethylphosphocholine (DMEP), dipalmitoylethylphosphocholine (DPEP) and distearoylethylphosphocholine (DSEP), N-(2,3-di-(9(Z)-octadecenyloxy)-prop-1-yl-N,N,N-trimethylammonium chloride (DOTMA) and 1,2-bis(oleoyloxy)-3,4-diamino-1,2-dimethyl ... -(trimethylammonio)propane (DOTAP).Examples of sterols for use in the compositions provided herein include cholesterol and ergosterol.Examples of PG, PA, PI, PC and PS for use in the compositions provided herein include DMPG, DPPG, DSPG, DMPA, DPPA, DSPA, DMPI, DPPI, DSPI, DMPS, DPPS and DSPS, DSPC, DPPG, DMPC, DOPC, egg PC and soybean PC.
[0153] In one embodiment, the pegylated lipid is cholesterol-PEG2000, DSPE-PEG1000 or DSG-PEG2000.
[0154] In another embodiment, the prostacyclin compositions provided herein comprise a prostacyclin compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) and a hydrophobic additive. In another embodiment, the composition comprises an amphiphilic substance, such as a pegylated lipid as described above.
[0155] In yet another embodiment, two or more of the prostacyclin compounds described herein (e.g., compounds of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III)), an amphiphilic agent (e.g., a pegylated lipid, lipid, surfactant or block copolymer) and a hydrophobic additive are provided in the composition.
[0156] In one embodiment, the prostacyclin composition comprises a prostacyclin compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) and a pegylated lipid. In another embodiment, the prostacyclin composition comprises a prostacyclin compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) and a surfactant. In yet another embodiment, the prostacyclin composition comprises a prostacyclin compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), a hydrophobic additive and an amphiphile. In other embodiments, the amphiphile is a surfactant, a pegylated lipid or a block copolymer. In yet other embodiments, the amphiphile is a pegylated lipid.
[0157] In one embodiment, the prostacyclin compound is present in the composition at 5 mol% to 99 mol%. In another embodiment, the prostacyclin compound is present in the composition at 40 mol% to 95 mol%. In another embodiment, the prostacyclin compound is present in the composition at 40 mol% to 60 mol%. In one embodiment, the prostacyclin compound is present in the composition at about 40 mol% or about 45 mol%.
[0158] When present in the composition, in one embodiment the amphiphile, e.g., the pegylated lipid, is present at 10 mol% to 30 mol%, e.g., 10 mol% to 20 mol% or 15 mol% to 25 mol%, hi yet another embodiment, the pegylated lipid is present in the composition at about 10 mol% or 20 mol%.
[0159] When present in the composition, in one embodiment the hydrophobic additive is present in the composition at 25 mol% to 50 mol%, for example 30 mol% to 50 mol%, 35 mol% to 45 mol%, hi yet another embodiment, the hydrophobic additive is present in the composition at about 40 mol% or about 45 mol%.
[0160] In one embodiment, the prostacyclin composition comprises a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'',), (II), (IIa), (IIb), (IIc), (IId) or (III) or a pharma- ceutically acceptable salt thereof, an amphiphile and a hydrophobic additive as described herein. In one embodiment, the hydrophobic additive (e.g., an additive that is at least partially hydrophobic) is a hydrocarbon, a terpene compound or a hydrophobic lipid (e.g., tocopherol, tocopherol acetate, sterol, sterol ester, alkyl ester, vitamin A acetate, triglyceride, phospholipid). In one embodiment, the composition comprises a prostacyclin compound, e.g., a compound of formula (I) or (II), an amphiphile and a hydrophobic additive. The hydrocarbon may be an aromatic, alkane, alkene, cycloalkane, or alkyne. In one embodiment, the hydrocarbon is an alkane (i.e., a saturated hydrocarbon). In another embodiment, the hydrocarbon is a C 15 ~C 50 In another embodiment, the hydrocarbon is 15 , C 20 , C 25 , C 30 , C 35 , C 40 , C 45 or C 50 In yet another embodiment, the hydrophobic additive is a C 15 ~C 25 Hydrocarbons, C 15 ~C 35 Hydrocarbons, C 15 ~C 45 Hydrocarbons, C 15 ~C 20 Hydrocarbons, C 20 ~C 25 Hydrocarbons, C 25 ~C 30 Hydrocarbons, C 30 ~C 35 Hydrocarbons, C 35 ~C 40 Hydrocarbons, C 40 ~C 45 Hydrocarbon or C 45 ~C50 It is a hydrocarbon.
[0161] In one embodiment, a composition is provided that includes a prostacyclin compound, an amphiphile, and a terpene compound (e.g., a hydrophobic additive). In another embodiment, the composition includes a PEGylated lipid as the amphiphile. However, as noted above, block copolymers as well as surfactants can be used as the amphiphilic component of the composition. In one embodiment, the terpene compound (hydrophobic additive) is a hydrocarbon (e.g., isoprene, squalane, or squalene). In another embodiment, the terpene compound is a hemiterpene (C5H8), a monoterpene (C 10 H 16 ), sesquiterpenes (C 15 H 24 ), diterpenes (C 20 H 32 ) (e.g., cafestol, kahweol, cembrene, taxadiene), sesterterpenes (C 25 H 40 ), triterpenes (C 30 H 48 ), sesquaterpene (C 35 H 56 ), tetraterpenes (C 40 H 64 ), polyterpenes (e.g., polyisoprene with trans double bonds) or norisoprenoids (e.g., 3-oxo-α-ionol, 7,8-dihydroionone derivatives). In another embodiment, the terpene compound is selected from one of the compounds shown in Table 1 below. In one embodiment, the hydrophobic additive is squalane. [Table 1]
[0162] As provided above, in one embodiment, the composition provided herein comprises a prostacyclin compound and one or more PEGylated lipids. In another embodiment, the composition comprises a hydrophobic additive as described above. In one embodiment, the composition provided herein comprises a prostacyclin compound of one of formulas (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), a hydrophobic additive and a PEGylated lipid. In another embodiment, the hydrophobic additive comprises a hydrocarbon, such as a terpene compound.
[0163] In one embodiment, the treprostinil derivative compositions provided herein comprise the ingredients shown in Table C below. [Table C]
[0164] The present invention also provides a method for treating a patient in need thereof with one of the prostacyclin compounds or compositions described herein.It should be understood that the reference to a prostacyclin compound in the treatment method includes the use of pharmaceutically acceptable salts of the compound.Similarly, the administration of a prostacyclin composition comprising a prostacyclin compound includes the use of pharmaceutically acceptable salts in the composition.
[0165] In one aspect, a method of treating pulmonary hypertension (PH) is provided. In one embodiment, the method comprises administering a compound provided herein, its pharma- ceutically acceptable salt or composition to a patient in need thereof. In one embodiment, the administration is pulmonary administration, for example, by using a metered dose inhaler (MDI), a dry powder inhaler (DPI) or a nebulizer. The World Health Organization (WHO) classifies PH into five groups. WHO group I PH includes pulmonary arterial hypertension (PAH), idiopathic pulmonary arterial hypertension (IPAH), familial pulmonary arterial hypertension (FPAH) and pulmonary arterial hypertension associated with other diseases (APAH). For example, pulmonary arterial hypertension associated with collagen vascular disease (e.g., scleroderma), congenital shunt between systemic and pulmonary circulation, portal hypertension and / or HIV infection is included in group I PH. In one embodiment, the method provided herein is provided for treating a WHO Group I PH patient in need thereof, such as a PAH patient, an IPAH patient, an FPAH patient, or an APAH patient. WHO Group II PH includes pulmonary hypertension associated with left heart disease, such as atrial or ventricular disease, or valvular disease (e.g., mitral stenosis). In one embodiment, the method provided herein is provided for treating a WHO Group II patient in need thereof. WHO Group III pulmonary hypertension is characterized by pulmonary hypertension associated with pulmonary disease, such as chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), and / or hypoxemia. In one embodiment, the method provided herein is provided for treating a WHO Group III patient in need thereof. WHO Group IV pulmonary hypertension is pulmonary hypertension resulting from chronic thrombotic and / or embolic disease. Group IV PH is also referred to as chronic thromboembolic pulmonary hypertension. Group IV PH patients experience blockage or narrowing of blood vessels due to blood clots. In one embodiment, the methods provided herein are provided for treating WHO Group IV patients in need thereof. The WHO classifies Group V PH as a "miscellaneous" category, which includes: Included are PH caused by blood disorders (e.g., polycythemia vera, essential thrombocythemia), systemic disorders (e.g., sarcoidosis, vasculitis) and / or metabolic disorders (e.g., thyroid disease, glycogen storage disease). In one embodiment, the methods provided herein are provided for treating a WHO Group V patient in need thereof.
[0166] The methods provided herein can be used to treat patients with WHO Group I (i.e., pulmonary arterial hypertension or PAH), Group II, Group III, Group IV, or Group V PH. In one embodiment of a method for treating PH, a method for treating pulmonary arterial hypertension (PAH) is provided. In another embodiment, a method for treating patients with chronic thromboembolic pulmonary hypertension is provided. In one embodiment, a method for treating PH (e.g., PAH) comprises administering an effective amount of one of the compounds described herein to a patient in need thereof by pulmonary (e.g., inhalation by MDI, nebulizer, or dry powder inhaler), subcutaneous, oral, nasal, or intravenous routes of administration. In one embodiment, administration is by inhalation with an MDI or nebulizer. In one embodiment, when compound delivery is by nebulizer, the compound is provided to the patient as a composition, for example, as a lipid nanoparticle composition as described above.
[0167] In another aspect of the present invention, a method for treating portopulmonary hypertension (PPH) is provided. In one embodiment, the method comprises administering an effective amount of one of the compounds described herein (or a pharma- ceutically acceptable salt thereof) to a patient in need thereof by pulmonary (inhalation), subcutaneous, oral, nasal or intravenous administration route. In one embodiment, administration is by inhalation with an MDI or nebulizer. In one embodiment, when compound delivery is by nebulizer, the compound is provided to the patient as a composition, for example as a lipid nanoparticle composition as described above.
[0168] Methods of administering treprostinil and its analogs for the treatment of pulmonary hypertension are described in U.S. Pat. Nos. 5,153,222, 6,521,212, 7,544,713, and U.S. Patent Application Publication No. 2010 / 0076083, the disclosures of each of which are incorporated by reference in their entirety for all purposes.
[0169] In one embodiment, the method of treating a patient for PH (e.g., PAH) or PPH includes administering to a patient in need thereof one of the prostacyclin compounds or compositions provided herein, e.g., a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId''), (IIa), (IIb), (IIc), (IId'', (IIa), (IIb), (IIc), ... The method includes administering a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia"), (Ib"), (Ic"), (Id"), (II), (IIa), (IIb), (IIc), (IId) or (III), or a pharma- ceutically acceptable salt thereof, or a composition comprising a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia"), (Ib"), (Ic"), (Id"), (II), (IIa), (IIb), (IIc), (IId) or (III), or a pharma- ceutically acceptable salt thereof. In one embodiment, the method of treating PH (e.g., PAH) or PPH includes administering to a patient in need thereof a prostacyclin compound or composition provided herein, e.g., a compound of Formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia"), (Ib"), (Ic"), (Id"), (II), (IIa), (IIb), (IIc), (IId) or (III), or a compound of Formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib' (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III). Routes of administration to the patient include pulmonary (inhalation), subcutaneous, oral, nasal and intravenous.In one embodiment, administration of a compound of Formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) or a pharma- ceutically acceptable salt thereof is by inhalation with an MDI or a nebulizer. In one embodiment, when compound delivery is by a nebulizer, the compound is provided to the patient as a composition, for example, a lipid nanoparticle composition as described above.
[0170] In one embodiment, the method of treating PH, PAH or PPH comprises administering to a patient in need thereof an effective amount of a prostacyclin compound or prostacyclin composition described herein. In other embodiments, the compound, or a pharma- ceutically acceptable salt of the compound, is administered to the patient by pulmonary (inhalation), subcutaneous, oral, nasal or intravenous routes of administration. In other embodiments, administration is by inhalation, and the prostacyclin compound or composition is administered by a nebulizer, dry powder inhaler or MDI. In yet other embodiments, the prostacyclin composition or compositions comprises a prostacyclin compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia"), (Ib"), (Ic"), (Id"), (II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof or a pharma- ceutically acceptable salt of the compound.
[0171] In one embodiment, administration of an effective amount of a prostacyclin compound or composition of the present invention for the treatment of PH, PAH or PPH by inhalation, oral, nasal, subcutaneous or intravenous administration results in a reduced number of side effects or a reduced severity of one or more side effects (also referred to herein as "adverse events") compared to administration of an effective amount of treprostinil when the effective amount of treprostinil is administered by inhalation, oral, nasal, subcutaneous or intravenous administration. For example, in one embodiment, a patient with PH, PAH or PPH, when administered a prostacyclin compound or composition of the present invention by inhalation (e.g., by nebulizer, dry powder inhaler, or metered dose inhaler), receives treprostinil inhaled to the patient. In one embodiment, the subject experiences a decreased severity and / or frequency of cough or a decreased cough response compared to the severity and / or frequency of cough or cough response induced by
[0172] In another embodiment, oral, nasal, intravenous, subcutaneous or inhalation administration of an effective amount of a prostacyclin compound or composition of the invention results in a reduction in the severity of one or more of the following adverse events: headache, throat irritation / sore larynx, nausea, flushing and / or fainting, or a reduction in the occurrence of one or more of the above adverse events, compared to oral, nasal, subcutaneous, intravenous or inhalation administration of treprostinil.
[0173] In another embodiment, oral, nasal, intravenous, subcutaneous or inhaled administration of an effective amount of a prostacyclin compound or composition of the invention for the treatment of PH, PAH or PPH results in a decrease in the severity of systemic adverse events or a decrease in the occurrence of systemic adverse events compared to oral, nasal, subcutaneous, intravenous or inhaled administration of treprostinil.
[0174] Without being bound by theory, this invention is The improved adverse event profile of the disclosed prostacyclin compounds and compositions, compared to treprostinil, is believed to result in improved patient compliance.
[0175] In one embodiment, the prostacyclin compounds and compositions of the present invention are administered on a less frequent basis compared to currently approved therapies for PH, PAH (e.g., Tyvaso®, Remodulin®) or PPH, while still achieving a substantially similar or better therapeutic response. Routes of administration to patients include pulmonary (inhalation), subcutaneous, oral, nasal and intravenous. In one embodiment, the therapeutic response of the patient is a decrease in pulmonary vascular resistance index (PVRI) from pre-treatment values, a decrease in mean pulmonary artery pressure from pre-treatment values, an increase in hypoxemia score from pre-treatment values, a decrease in oxygen saturation index from pre-treatment values, an improvement in right heart function compared to pre-treatment, or an improvement in exercise capacity compared to pre-treatment (e.g., as measured by a 6-minute walk test). In one embodiment, the therapeutic response is an improvement of at least 10%, at least 20%, at least 30%, at least 40% or at least 50% compared to pre-treatment values. In another embodiment, the therapeutic response is about 10% to about 70%, about 10% to about 60%, about 10% to about 50%, about 10% to about 40%, about 10% to about 30%, about 10% to about 20%, about 20% to about 70%, about 20% to about 60%, or about 10% to about 50% improvement compared to pre-treatment levels.
[0176] Without wishing to be bound by theory, the less frequent administration of the compounds and compositions of the present invention allows for improved patient compliance as compared to patient compliance administered different PH, PAH or PPH treatments (e.g., treprostinil-Tyvaso®, Remodulin®).
[0177] In one embodiment, the compositions or compounds of the present invention are administered to a patient in need of PH, PAH or PPH treatment by a metered dose inhaler (MDI). In one embodiment, the compositions or compounds are delivered by an MDI using a propellant, such as a chlorofluorocarbon (CFC) or a fluorocarbon. In one embodiment, when delivery is by MDI, the compound is not formulated as a lipid nanoparticle composition, but instead is directly suspended or dissolved in the propellant solution. In one embodiment, the patient is administered the prostacyclin compound or composition of the present invention once a day, twice a day, or three times a day. In one embodiment, the administration is with food. In one embodiment, each administration includes 1 to 5 doses (puffs) from the MDI, such as 1 dose (1 puff), 2 doses (2 puffs), 3 doses (3 puffs), 4 doses (4 puffs), or 5 doses (5 puffs). In one embodiment, the MDI is small and portable by the patient.
[0178] In another embodiment, the prostacyclin compound or prostacyclin composition is administered to a patient in need of PH, PAH or PPH treatment by nebulizer. In one embodiment, administration is once daily, twice daily, three times daily or every other day.
[0179] In one embodiment, the compositions or compounds of the invention are administered to a patient in need of PH, PAH or PPH treatment via a dry powder inhaler (DPI). In one embodiment, the patient is administered a prostacyclin compound or composition of the invention once daily, twice daily or three times daily. In one embodiment, administration is with food. In one embodiment, each administration includes 1 to 5 doses (puffs) from the DPI, for example 1 dose (1 puff), 2 doses (2 puffs), 3 doses (3 puffs), 4 doses (4 puffs) or 5 doses (5 puffs). In one embodiment, the DPI is small and portable by the patient.
[0180] In another embodiment, the prostacyclin compound administered to a patient in need thereof by the pulmonary route according to the methods of treating PH, PAH or PAH described herein has a pulmonary elimination half-life (t 1 / 2 ) compared with the longer pulmonary elimination half-life (t 1 / 2 ) is provided.
[0181] In another embodiment, the prostacyclin compound administered to a patient in need thereof by the methods of treating PH, PAH or PPH described herein has a systemic elimination half-life (t 1 / 2 ) compared with the longer systemic half-life (t 1 / 2 In other embodiments, administration of the prostacyclin compound and treprostinil comprises oral, intranasal, subcutaneous or intravenous administration.
[0182] In another embodiment, the prostacyclin compound administered to a patient in need of PH, PAH, or PPH treatment has a respective lung or plasma C of treprostinil when administered to the patient. max Higher mean lung C for treprostinil compared with max and / or lower plasma C max In another embodiment, the administration of the prostacyclin compound and treprostinil comprises intravenous administration.
[0183] In another embodiment, the prostacyclin compound administered to a patient in need of PH, PAH or PPH treatment is selected from the group consisting of a prostacyclin compound that is effective to reduce the mean lung or plasma area under the curve (AUC) of treprostinil when administered to the patient. 0~t) of prostacyclin compounds or their treprostinil metabolites, compared with 0~t In yet another embodiment, the prostacyclin compound administered to a patient in need thereof provides a prostacyclin compound that is more potent than the time to peak lung or plasma concentration (t max ) compared with the longer time to peak lung or plasma concentration (t max ) is provided.
[0184] In another aspect of the present invention, a method for treating diseases, disorders or conditions other than PH, PAH or PPH is provided.US Patent No. 5,153,222, the entirety of which is incorporated herein by reference, describes the use of treprostinil for the treatment of pulmonary hypertension.Treprostinil is approved for intravenous and subcutaneous routes, the latter avoiding the possibility of septic events associated with continuous intravenous catheters.US Patent No. 6,521,212 and US Patent No. 6,756,033, the entirety of which is incorporated herein by reference, respectively, describe the administration of treprostinil by inhalation for the treatment of pulmonary hypertension, peripheral vascular disease and other diseases and conditions.US Patent No. 6,803,386, the entirety of which is incorporated herein by reference, discloses the administration of treprostinil for the treatment of cancers, such as lung, liver, brain, pancreas, kidney, prostate, breast, colon and head and neck cancer. U.S. Patent Application Publication No. 2005 / 0165111, the entirety of which is incorporated herein by reference, discloses treprostinil treatment of ischemic lesions. U.S. Patent Application No. 7,199,157, the entirety of which is incorporated herein by reference, discloses that treprostinil treatment improves renal function. U.S. Patent Application Publication No. 7,879,909, the entirety of which is incorporated herein by reference, discloses treprostinil treatment of neuropathic foot ulcers. U.S. Patent Application Publication No. 2008 / 0280986, the entirety of which is incorporated herein by reference, discloses treprostinil treatment of pulmonary fibrosis, interstitial lung disease and asthma. U.S. Patent Application No. 6,054,486, the entirety of which is incorporated herein by reference, discloses the treatment of peripheral vascular disease with treprostinil. U.S. Patent Application Publication No. 2009 / 0036465, the entirety of which is incorporated herein by reference, discloses combination therapies including treprostinil. U.S. Patent Application Publication No. 2008 / 0200449 discloses the delivery of treprostinil using a metered dose inhaler.U.S. Patent Nos. 7,417,070, 7,384,978 and 7,544,713, and U.S. Patent Application Publication Nos. 2007 / 0078095, 2005 / 0282901 and 2008 / 0249167, each of which is incorporated herein by reference in its entirety, describe oral formulations of treprostinil and other prostacyclin analogs and their use for treating various conditions.U.S. Patent Application Publication No. 2012 / 0004307, each of which is incorporated herein by reference, discloses the use of treprostinil by oral administration for the treatment of Raynaud's phenomenon, systemic sclerosis and ischemic lesions of the fingers.Each of the above-mentioned indications can be treated with the compounds and compositions provided herein.Routes of administration to patients in need of treatment include pulmonary (inhalation), subcutaneous, oral, nasal and intravenous.
[0185] Additionally, the following references are incorporated by reference in their entirety for all purposes for the practice of embodiments of the present invention: J. Org. Chem. 2004, Vol. 69, pp. 1890-1895. 902 pages, Drug of the Future, 2001, Volume 26 (No. 4), Pages 364-374, U.S. Patent Nos. 5,153,222, 6,054,486, 6,521,212, 6,756,033, 6,803,386 and 7,199,157; U.S. Patent Application Publication Nos. 2005 / 0165111, 2005 / 0282903, 2008 / 0200449, 2008 / 0280986, 2009 / 0036465 and 2012 / 0010159.
[0186] In one embodiment, a method is provided for treating a patient in need thereof for congestive heart failure, peripheral vascular disease, asthma, severe intermittent claudication, immunosuppression, proliferative diseases, cancers such as lung, liver, brain, pancreatic, kidney, prostate, breast, colon and head and neck cancer, ischemic lesions, neuropathic foot ulcers and pulmonary fibrosis, renal function and / or interstitial lung disease. In one embodiment, the method comprises administering an effective amount of one of the prostacyclin compounds or compositions provided herein, e.g., a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia''), (Ib''), (Ic''), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic') The method includes administering to a patient a composition comprising a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'), (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III). In one embodiment, administration is by inhalation (e.g., with a nebulizer or metered dose inhaler), subcutaneously, orally, nasally, or intravenously. In some embodiments, the pharmaceutical formulation can include one or more active ingredients in addition to treprostinil monohydrate.
[0187] In one embodiment, a method is provided for treating and / or preventing interstitial lung disease (e.g., pulmonary fibrosis) or asthma, or a condition associated with interstitial lung disease or asthma, in a patient in need of such treatment. In another embodiment, the method comprises administering to the patient an effective amount of one of the prostacyclin compounds or compositions provided herein, such as a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), The method comprises administering a composition comprising a compound of formula (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III). In one embodiment, the composition or compound is delivered by MDI using a propellant, such as a chlorofluorocarbon (CFC) or a fluorocarbon. In one embodiment, the patient is administered a prostacyclin compound or composition of the present invention once a day, twice a day, or three times a day. In one embodiment, administration is with food. In one embodiment, each administration comprises 1 to 5 doses (puffs) from an MDI, for example 1 dose (1 puff), 2 doses (2 puffs), 3 doses (3 puffs), 4 doses (4 puffs) or 5 doses (5 puffs). In one embodiment, the MDI is small and patient-carryable. In another embodiment, administration is oral, nasal, subcutaneous or intravenous.In another embodiment, oral, nasal, intravenous, subcutaneous or inhalation administration of an effective amount of a prostacyclin compound or composition of the invention for the treatment of interstitial lung disease (e.g., pulmonary fibrosis) or asthma, or a condition associated with interstitial lung disease or asthma, results in a decrease in the severity of systemic adverse events or a decrease in the occurrence of systemic adverse events compared to oral, nasal, subcutaneous, intravenous or inhalation administration of treprostinil.
[0188] In one embodiment, a method is provided for treating an ischemic disease or condition, such as scleroderma, including systemic sclerosis, or Raynaud's phenomenon, in a patient in need of such treatment. In another embodiment, the method comprises administering an effective amount of one of the prostacyclin compounds or compositions provided herein, such as a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic ... (II), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of Formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) to the patient. In one embodiment, administration is by inhalation (e.g., using a nebulizer or metered dose inhaler), oral, nasal, subcutaneous or intravenous administration. In another embodiment, oral, nasal, intravenous, subcutaneous or inhalation administration of an effective amount of a prostacyclin compound or composition of the present invention for the treatment of an ischemic disease or condition, such as scleroderma, including systemic sclerosis, or Raynaud's phenomenon, results in a decrease in the severity of systemic adverse events or a decrease in the occurrence of systemic adverse events, as compared to oral, nasal, subcutaneous, intravenous or inhalation administration of treprostinil.
[0189] Prostacyclin compounds or compositions provided herein include, for example, a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', Id''), (II), (IIa), (IIb), (IIc), Compositions comprising a compound of (IId) or (III) or deuterated compounds of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', (II), (IIa), (IIb), (IIc), (IId) or (III) are, in one embodiment, used to treat a patient for ischemic digital lesions, such as digital ulcers or necrotic lesions, or to ameliorate symptoms or impairments and / or reduce the number of symptoms and / or impairments associated with ischemic digital lesions. The term "ischemic digital lesion" refers to a lesion on the digits of a subject, such as a human, i.e., on the toes or fingers. In one embodiment, ischemic digital lesions may be caused by or associated with an ischemic disease or condition, such as scleroderma, including systemic sclerosis, or Raynaud's phenomenon. Symptoms that can be improved and / or reduced may be, for example, ischemic ulcers of the finger and / or pain associated with scleroderma. In some embodiments, administering the prostacyclin compound or composition provided herein provides improvement or reduction of one or more functional disorders associated with ischemic lesions of the finger when administered to a patient in need of treatment. For example, in one embodiment, the prostacyclin compound or composition provided herein improves or reduces functional disorders of the hand, i.e., improves the hand function of the patient receiving treatment. In one embodiment, administration is by inhalation (e.g., by nebulizer or metered dose inhaler), oral, nasal, subcutaneous or intravenous administration.In another embodiment, oral, nasal, intravenous, subcutaneous or inhalation administration of an effective amount of a prostacyclin compound or composition of the present invention for the treatment of ischemic lesions of the digital results in a decrease in the severity of systemic adverse events or a decrease in the occurrence of systemic adverse events compared to oral, nasal, subcutaneous, intravenous or inhalation administration of treprostinil.
[0190] In one embodiment, a method is provided for improving renal function or treating renal dysfunction or symptoms associated with renal dysfunction in a patient in need thereof. In another embodiment, the method comprises administering to a patient in need thereof an effective amount of a prostacyclin compound or composition provided herein, such as a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib ... (II), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III). Specific symptoms related to reduced kidney function include, for example, abnormally little urination, high blood levels of creatinine and urea nitrogen, protein leakage in the urine and / or pain. In one embodiment, administration is by inhalation (e.g., with a nebulizer or metered dose inhaler), oral, nasal, subcutaneous, or intravenous administration. In another embodiment, oral, nasal, intravenous, subcutaneous, or inhalation administration of an effective amount of a prostacyclin compound or composition of the present invention for improving renal function or improving symptoms related to renal dysfunction or dysfunction results in a decrease in the severity of systemic adverse events or a decrease in the occurrence of systemic adverse events compared to oral, nasal, intravenous, subcutaneous, or inhalation administration of treprostinil.
[0191] In one embodiment, a method for treating cardiovascular disease, including congestive heart failure, is provided. In one embodiment, the method comprises administering to a patient in need thereof a prostacyclin compound or composition provided herein, such as a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), administering a composition comprising a compound of formula (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III). In one embodiment, administration is by inhalation (e.g., with a nebulizer or metered dose inhaler), subcutaneous, oral, nasal or intravenous administration.
[0192] In one embodiment, a method for treating peripheral vascular disease, including peripheral arterial occlusive disease and intermittent claudication, is provided. In one embodiment, the method includes administering to a patient in need thereof a prostacyclin compound or composition provided herein, such as a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III). In addition to the prostacyclin compounds and compositions provided herein, other pharmacologically active substances known to be useful for treating peripheral vascular disease may be present in the formulations of the present invention. For example, the compounds of the invention may be present together with trental, a substance known to increase red blood cell deformability. In one embodiment, administration is by inhalation (e.g., with a nebulizer or metered dose inhaler), subcutaneous, oral, nasal or intravenous administration.
[0193] In one embodiment, a method for treating and / or preventing neuropathic diabetic foot ulcers is provided. In one embodiment, the method comprises administering to a patient in need thereof a prostacyclin compound or composition provided herein, such as a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id'', II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), administering a composition comprising a compound of formula (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III), or a composition comprising a deuterated compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III). In one embodiment, administration is by inhalation (e.g., with a nebulizer or metered dose inhaler), subcutaneous, oral, nasal or intravenous administration. In addition to the prostacyclin compounds and compositions provided herein, other pharmacologically active substances known to be useful for treating and / or preventing foot ulcers in patients with diabetic neuropathy may be present in the formulations of the present invention.For example, the compounds of the present invention may be present together with analgesics, dressing changes, vasodilator medications and topical or oral antibiotics to treat pain.
[0194] In one embodiment, administration of an effective amount of a prostacyclin compound or composition of the present invention by inhalation, subcutaneous, oral, nasal or intravenous administration for the treatment of various diseases and indications described throughout results in a reduced number of side effects or a reduced severity of one or more side effects (also referred to herein as "adverse events") compared to administration of an effective amount of treprostinil when the effective amount of treprostinil is administered by inhalation, subcutaneous, oral, nasal or intravenous administration. For example, in one embodiment, a patient treated with the methods provided herein experiences a reduced severity and / or frequency of coughing or a reduced coughing response when the prostacyclin compound or composition of the present invention is administered by inhalation (e.g., by nebulizer, dry powder inhaler or metered dose inhaler) compared to the severity and / or frequency of coughing or coughing response induced by inhalation administration of treprostinil to the patient.
[0195] In another embodiment, the prostacyclin compound administered to a patient in need of treatment is selected from the group consisting of a prostacyclin compound that is effective to reduce the respective lung or plasma C of treprostinil when treprostinil is administered to the patient. max Higher mean lung C for treprostinil compared with max and / or lower plasma C max In another embodiment, the administration of the prostacyclin compound and treprostinil comprises intravenous administration.
[0196] In another embodiment, the prostacyclin compound administered to a patient in need of treatment is selected from the group consisting of a prostacyclin compound that is effective to treat a patient having a prostacyclin-related metabolic syndrome (MDS) deficiency associated with increased mean lung or plasma area under the curve (AUC 0~t ) compared with a larger mean lung or plasma area under the curve (AUC 0~t In yet another embodiment, the prostacyclin compound administered to a patient in need thereof provides a time to peak lung or plasma concentration (t max ) compared with longer time to lung or plasma peak concentration of treprostinil (tmax ) is provided.
[0197] In one embodiment, the prostacyclin compound or composition provided herein, for example, a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, or a composition comprising a compound of formula (I), (Ia), (Ib), (Ic), (Id), (Ia'), (Ib'), (Ic'), (Id'), (Ia'', (Ib'', (Ic'', (Id''), (II), (IIa), (IIb), (IIc), (IId) or (III) or a deuterated version thereof, is administered in combination with one or more additional active agents. In some embodiments, such one or more additional active agents can be administered together with the prostacyclin compound or composition provided herein using a metered dose inhaler. In one embodiment, such one or more additional active agents can be administered separately, i.e., prior to or subsequent to the prostacyclin compound or composition provided herein. The specific additional active agent that can be administered in combination with Treprostinil may depend on the specific disease or condition for which Treprostinil is administered to treat or prevent. In some cases, the additional active agent can be a cardiovascular therapeutic agent, such as a COX-2 inhibitor, a RHO kinase inhibitor, a calcium channel blocker, a phosphodiesterase inhibitor, an endothelial antagonist, or an antiplatelet agent.
[0198] As provided above, the prostacyclin compounds and compositions of the present invention can be delivered to patients in need thereof by oral, nasal, pulmonary, intravenous or subcutaneous routes. For pulmonary routes, the prostacyclin compounds and compositions of the present invention can be used in any dosage dispensing device adapted for such administration. In one embodiment, the device is configured to ensure optimal metering accuracy and compatibility of its components, such as containers, valves and actuators, with the formulation, and can be based on mechanical pump systems, such as metered dose nebulizers, dry powder inhalers, soft mist inhalers or nebulizers. For example, pulmonary delivery devices include jet nebulizers, electronic nebulizers, soft mist inhalers and capsule-based dry powder inhalers.
[0199] For example, suitable propellants for MDI delivery can be selected from among gases such as fluorocarbons, chlorofluorocarbons (CFCs), hydrocarbons, hydrofluoroalkane propellants (e.g., HFA-134a and HFA-227), nitrogen and nitrous oxide, or mixtures thereof.
[0200] The inhalation delivery device may be a nebulizer, a dry powder inhaler or a metered dose inhaler (MDI) or any other suitable inhalation delivery device known to those skilled in the art. The device may contain and be used to deliver a single dose of the prostacyclin composition, or the device may contain and be used to deliver multiple doses of the composition of the present invention.
[0201] The nebulizer type inhalation delivery device can contain the composition of the present invention as a solution, usually an aqueous solution or a suspension solution. For example, the prostacyclin compound or composition can be suspended in saline and loaded into the inhalation delivery device. In generating the atomized spray of the composition for inhalation, the nebulizer delivery device can be driven ultrasonically, by compressed air, by other gases, electronically or mechanically (e.g., vibrating mesh or aperture plate). Vibrating mesh nebulizers generate low-velocity aerosols of fine particles and nebulize therapeutic solutions and suspensions at a faster rate than conventional jet or ultrasonic nebulizers. Thus, the duration of treatment can be shortened with vibrating mesh nebulizers compared to jet or ultrasonic nebulizers. Acceptable vibrating mesh nebulizers for use in the methods described herein include Philips Respironics I-Neb®, Omron MicroAir, Nektar Aeroneb® and Pari eFlow®.
[0202] A nebulizer can be designed to be portable and handheld and can be equipped with a self-contained electronic unit. The nebulizer device can include a nozzle with two simultaneous outlet channels of a given opening size through which the liquid formulation can be accelerated. This results in the impaction of the two streams and atomization of the formulation. A nebulizer is a device that uses mechanical action. A actuator can be used to force the liquid formulation through a multi-orifice nozzle of predetermined opening size to create an aerosol of the formulation for inhalation. In single dose nebulizer designs, a blister pack containing a single dose of the formulation can be used.
[0203] In the present invention, a nebulizer can be used to ensure that the sizing of the particles is optimal for placement of the particles within, for example, the lung membrane.
[0204] Once nebulized, the nebulized composition (also referred to as an "aerosolized composition") is in the form of aerosolized particles. An aerosolized composition can be, for example, a "mass median aerodynamic diameter" or "fine particle size" measurement associated with the aerosolized composition. Aerosol particle size can be characterized by measuring the "fine particle fraction." The "mass median aerodynamic diameter" or "MMAD" is normalized with respect to the aerodynamic separation of aqua aerosol droplets and is measured using impactor measurements, e.g., Anderson Cascade Impactor (ACI) or Next Generation Impactor (NEA). In one embodiment, the gas flow rates are 28 liters / minute for the ACI and 15 liters / minute for the NGI.
[0205] "Geometric standard deviation" or "GSD" is a measure of the spread of the aerodynamic particle size distribution. A low GSD is characterized by a narrow droplet size distribution (uniformly sized droplets), which This is advantageous in directing the aerosol towards the respiratory system. In one embodiment, the nebulized compositions provided herein have an average droplet size of less than 5 μm or between about 1 μm and about 5 μm, and a GSD in the range of 1.0 to 2.2, or between about 1.0 to about 2.2, or between 1.5 to 2.2, or between about 1.5 to about 2.2.
[0206] As used herein, "fine particle fraction" or "FPF" refers to the fraction of an aerosol having a particle size less than 5 μm in diameter as measured by cascade impaction. FPF is usually expressed as a percentage.
[0207] In one embodiment, the nebulized composition has a mass median aerodynamic diameter (MMAD) of about 1 μm to about 5 μm, or about 1 μm to about 4 μm, or about 1 μm to about 3 μm, or about 1 μm to about 2 μm, as measured by an Anderson Cascade Impactor (ACI) or Next Generation Impactor (NGI). In another embodiment, the MMAD of the nebulized composition is about 5 μm or less, about 4 μm or less, about 3 μm or less, about 2 μm or less, or about 1 μm or less, as measured by cascade impaction, e.g., by ACI or NGI.
[0208] In one embodiment, the MMAD of an aerosol of the pharmaceutical composition is less than about 4.9 μm, less than about 4.5 μm, less than about 4.3 μm, less than about 4.2 μm, less than about 4.1 μm, less than about 4.0 μm, or less than about 3.5 μm, as measured by cascade impaction.
[0209] In one embodiment, the MMAD of the aerosol of the pharmaceutical composition is about 1.0 μm to about 5.0 μm, about 2.0 μm to about 4.5 μm, about 2.5 μm to about 4.0 μm, about 3.0 μm to about 4.0 μm, or about 3.5 μm to about 4.5 μm, as measured by cascade impaction (e.g., by ACI or NGI).
[0210] In one embodiment, the FPF of the aerosolized composition is greater than or equal to about 50% as measured by ACI or NGI, greater than or equal to about 60% as measured by ACI or NGI, or greater than or equal to about 70% as measured by ACI or NGI. In another embodiment, the FPF of the aerosolized composition is about 50% to about 80%, or about 50% to about 70%, or about 50% to about 60%, as measured by NGI or ACI.
[0211] In one embodiment, a metered dose inhaler (MDI) is used as the inhalation delivery device for the compositions of the present invention. In another embodiment, the prostacyclin compound is suspended in a propellant (e.g., a hydroflourocarbon) prior to loading into the MDI. The basic structure of the MDI includes a metering valve, an actuator and a container. A propellant is used to release the formulation from the device. The composition may consist of particles of a certain size suspended in a pressurized propellant liquid, or the composition may be in a solution or suspension of the pressurized liquid propellant. The propellants used are primarily air-friendly hydrofluorocarbons (HFCs) such as 134a and 227. The device of the inhalation system can deliver a single dose, for example by a blister pack, or it can be designed with multiple doses. The pressurized metered dose inhaler of the inhalation system can be actuated with an exhalation to deliver a precise dose of the lipid-containing formulation. The delivery of the formulation can be programmed with a microprocessor to occur at specific points in the inhalation cycle to ensure accuracy of dosing. The MDI can be portable and handheld.
[0212] In one embodiment, a dry powder inhaler (DPI) is used as the inhalation delivery device for the compositions of the present invention. In one embodiment, the DPI produces particles having an MMAD of about 1 μm to about 10 μm, or about 1 μm to about 9 μm, or about 1 μm to about 8 μm, or about 1 μm to about 7 μm, or about 1 μm to about 6 μm, or about 1 μm to about 5 μm, or about 1 μm to about 4 μm, or about 1 μm to about 3 μm, or about 1 μm to about 2 μm in diameter, as measured by NGI or ACI. In another embodiment, the DPI produces particles having an MMAD of about 1 μm to about 10 μm, or about 2 μm to about 10 μm, or about 3 μm to about 10 μm, or about 4 μm to about 10 μm, or about 5 μm to about 10 μm, or about 6 μm to about 10 μm, or about 7 μm to about 10 μm, or about 8 μm to about 10 μm, or about 9 μm to about 10 μm, as measured by NGI or ACI.
[0213] In one embodiment, the MMAD of particles generated by the DPI is about 1 μm or less, about 9 μm or less, about 8 μm or less, about 7 μm or less, 6 μm or less, 5 μm or less, about 4 μm or less, about 3 μm or less, about 2 μm or less, or about 1 μm or less, as measured by NGI or ACI.
[0214] In one embodiment, the MMAD of particles generated by the DPI is less than about 9.9 μm, less than about 9.5 μm, less than about 9.3 μm, less than about 9.2 μm, less than about 9.1 μm, less than about 9.0 μm, less than about 8.5 μm, less than about 8.3 μm, less than about 8.2 μm, less than about 8.1 μm, less than about 8.0 μm, less than about 7.5 μm, less than about 7.3 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.5 ...5 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.2 μm, less than about 7.5 μm, less than about 7 less than about 7.1 μm, less than about 7.0 μm, less than about 6.5 μm, less than about 6.3 μm, less than about 6.2 μm, less than about 6.1 μm, less than about 6.0 μm, less than about 5.5 μm, less than about 5.3 μm, less than about 5.2 μm, less than about 5.1 μm, less than about 5.0 μm, less than about 4.5 μm, less than about 4.3 μm, less than about 4.2 μm, less than about 4.1 μm, less than about 4.0 μm or less than about 3.5 μm.
[0215] In one embodiment, the MMAD of the particles produced by the DPI is from about 1.0 μm to about 10.0 μm, from about 2.0 μm to about 9.5 μm, from about 2.5 μm to about 9.0 μm, from about 3.0 μm to about 9.0 μm, from about 3.5 μm to about 8.5 μm, or from about 4.0 μm to about 8.0 μm.
[0216] In one embodiment, the FPF of the prostacyclin microparticle composition produced by the DPI is greater than or equal to about 40% as measured by ACI or NGI, greater than or equal to about 50% as measured by ACI or NGI, greater than or equal to about 60% as measured by ACI or NGI, or greater than or equal to about 70% as measured by ACI or NGI. In another embodiment, the FPF of the aerosolized composition is about 40% to about 70%, or about 50% to about 70%, or about 40% to about 60%, as measured by NGI or ACI. EXAMPLES
[0217] The invention will now be further illustrated by reference to the following examples, although, as with the embodiments described above, it should be noted that these examples are illustrative and are in no way to be construed as limiting the scope of the invention. Example 1 Synthesis of Treprostinil Alkyl Esters
[0218] Treprostinil compounds were prepared that were derivatized with alkyl groups at the carboxylic acid moiety. Specifically, treprostinil was derivatized at the C2, C3, C4, C5, C6, C8, C9, C10, C11, C12, C13, C14, C15, C16, C17, C18, C19, C20, C21, C22, C23, C24, C25, C26, C27, C28, C29, C30, C31, C32, C33, C34, C35, C36, C37, C38, C39, C40, C41, C42, C43, C44, C45, C46, C47, C48, C49, C50, C51, C52, C53, C54, C55, C56, C57, C58, C59, C60, C61, C62, C63, C64, C65, C66, C77, C78, C79, C81, C82, C83, C84, C85, C86, C87, C88, C89, C91, C92, C93, C94, C95, C96, C97, C98, C99, C101, C102, C103, C104, C105, C106, C107, C108, C109, C110, C111, C112, C113, C114, C115, C116, C117, C118, C119, C121, C122, C123, C124, C125, C126, C127, C138, C1 10 , C 12 , C 16 and C 18 Alkyl chain (i.e., in the following formula (A), R2 is C2, C3, C4, C5, C6, C8, C 10 , C 12 , C 16 or C 18 Treprostinil was derivatized with 1,2-diamino-1,2-diphenyl ... [ka]
[0219] Scheme 1:
[0220] Treprostinil esterification was catalyzed by the strong acid resin Amberlyst® 15 (Rohm and Haas). Treprostinil acid was dissolved in anhydrous dioxane / alcohol (approximately 4 mL) at a concentration of 10 mg / mL. The alcohol (R2-OH) added was appropriate to create the corresponding chain length at the R2 group. As an example, for the C2 (ethyl ester) compound, the alcohol was ethanol. The molar amount of alcohol in the solvent was 10 times the molar amount of treprostinil.
[0221] Treprostinil in dioxane / alcohol solution was added to wash and dry Amberlyst resin. For each 40 mg of treprostinil, 1 g of resin was added in a glass vial. The mixture was placed on a shaker and incubated at 40° C. overnight. The liquid portion was then removed from the vial and washed twice with 3 mL dioxane. All recovered solvent was then collected. The solvent was dried with a stream of nitrogen until evaporation ceased. The remaining treprostinil alkyl ester and non-volatile alcohol (if a long chain alcohol was used) were dissolved in 2 mL of hexane / ethyl acetate 1:1 and clarified by liquid-liquid extraction against (vs.) an equal volume of phosphate buffer, then with water. The organic layer was then separated, dried with a stream of nitrogen, and further dried under vacuum. If a long chain alcohol was used, an additional purification step was required to separate the alcohol by liquid chromatography. An ACE CN, 5 μm, Ultra-Inert HPLC column, 100×21.2 mm, was used with a mobile phase of hexane / propanol 98:2%.
[0222] Scheme 2:
[0223] To a solution of (1R,2R,3aS,9aS)-[[2,3,3a,4,9,9a-hexahydro-2-hydroxy-1-[(3S)-3-hydroxyoctyl]-1H-benz[f]inden-5-yl]oxy]acetic acid (treprostinil) (78.1 mg, 200 μmol) dissolved in 1,4-dioxane (2.0 mL) was added Amberlyst® 15 resin (2.0 g) and the alcohol R2-OH (2.0 mmol, 10 equiv). The reaction mixture was heated to 40°C and shaken at approximately 100 rpm for 18-196 h. The solvent was removed and the resin was washed with acetonitrile (MeCN) (3×3 mL). The 1,4-dioxane and MeCN extracts were combined and dried using a gentle stream of warm N2 gas and gentle heating to give a thick waxy solid. The crude material was eluted at 20% n It was dissolved in PrOH / hexane and subjected to preparative HPLC purification. The solvent was removed from the purified material using a gentle stream of warm N2 gas and gentle heating to give an off-white waxy solid. For storage, the pure material was suspended in ethyl lactate and subjected to analytical HPLC for concentration determination.
[0224] As an example, the compound of formula (A) below was synthesized by the method of Scheme 2. [Table 1A]
[0225] A general diagram for the synthesis of ethyl esters of Treprostinil is shown below in Scheme 1. An alcohol is substituted with an alkyl ester of the desired chain length (e.g., linear or branched C5-C esters of even or odd chain length). 18 It can be modified based on the alkyl ester. [ka] Example 2 Rates of spontaneous esterase-mediated hydrolysis of treprostinil alkyl esters
[0226] Spontaneous and / or esterase-mediated hydrolysis rates were measured for the prostacyclin alkyl ester compositions shown in Table 2. Cx represents the alkyl chain length at the R2 position of the compound of formula (A) shown above. [Table 2]
[0227] In addition, the spontaneous hydrolysis rate was determined by the following criteria: 10 Alkyl-derivatized treprostinil compounds at 200 μM were measured in 20% ethanol at 40° C. at six time points (0 h, 1 h, 2 h, 4 h, 6 h, 24 h).
[0228] Each sample was prepared as a 200 μM solution in 20% ethanol. At each time point, an aliquot was removed for HPLC analysis and the remaining reactions (C3, C4, C5, C6, C8, C9, C10, C11, C12, C13, C14, C15, C16, C17, C18, C19, C20, C21, C22, C23, C24, C25, C26, 10 ) or their degradation products (Treprostinil). For each sample, the hydrolysis rate was calculated from the measured reactant and product peak areas: % Hydrolysis = (product peak area / (reactant peak area + product peak area) * 100).
[0229] The results of a time course experiment are shown in Figure 1 A. The results indicate that the rate of hydrolysis correlates with the length of the alkyl ester moiety.
[0230] The rate of esterase-mediated hydrolysis of treprostinil compounds and compositions was evaluated by measuring the C2, C4, C6, C8 and C9 carboxylate groups. 10 Compounds derivatized with alkyl groups and compositions containing them were measured. Experiments were carried out at 37°C, and hydrolysis rates were measured at 15 min, 30 min and 1 hour after adding esterase to the compound solution. Reaction mixtures for each sample were prepared in a final volume of 500 μL, containing 200 μM treprostinil compound, 0.05 U esterase, 20% ethanol and PBS. Hydrolysis rates were measured as described above.
[0231] The results of this experiment are shown in Figure 1B. The results show that the rate of degradation of the compounds decreases with increasing alkyl ester chain length.
[0232] The conversion of treprostinil alkyl esters to treprostinil was also measured in the presence of rat, dog and monkey lung tissue homogenates at 37° C., where data was calculated based on an exponential growth fit to a maximum (experiments were performed in duplicate). The results of this study are shown in Table 2A below and in FIG. 37. Specifically, the left side of FIG. 37 shows that the conversion rate to treprostinil depends on the alkyl chain length. In this experiment, treprostinil alkyl esters were prepared in water and incubated for 4 hours at a final concentration of 200 nM in 1 mL of tissue homogenate normalized to 10 mg / mL protein.
[0233] The right side of Figure 37 shows the effect of C in the presence of lung tissue homogenates from rats, dogs, or monkeys. 12 The conversion rate (percentage) of -TR to treprostinil is shown. 12 -TR was prepared in water and incubated for 4 hours at a final concentration of 200 nM in 1 mL of tissue homogenate normalized to 10 mg / mL protein. Both experiments in Figure 37 (left and right graphs) were performed in duplicate. The lines represent nonlinear exponential regression assuming one-phase decay. [Table 2A] Example 3 Particle size characterization of treprostinil compositions
[0234] The compositions in Table 3 were subjected to particle size characterization, where Cx represents the alkyl chain length at the R2 position of formula (A) shown above. [Table 3]
[0235] All particle size measurements were performed using a Wyatt Technology Mobius™ Zeta Potential / Particle Sizing Instrument in quasi-elastic light scattering (QELS) mode. An aliquot of the composition was diluted 10-fold into pre-filtered (0.02 μm pore filter) ultrapure deionized H2O. Light scattering data was collected and converted to particle size and size distribution using Dynamics® v.7.2.4 instrument software. The reported average particle size is based on a cumulative model, which mathematically fits the particle diffusion constant (determined by the raw scattering intensity of the particles in suspension) to obtain the average particle size and the distribution of particle sizes around the average diameter.
[0236] The particle size (average particle size) of the treprostinil composition increases in size in compositions containing C2-C5 alkyl ester derivatized treprostinil and decreases in size in compositions containing C6-C 12 A decrease in size was found in the composition containing alkyl ester derivatized treprostinil. These results are shown in FIG. 2. The largest mean particle size was found for the composition containing treprostinil pentyl ester (i.e., treprostinil derivatized with a C5 alkyl ester) (316 nm). The composition containing treprostinil ethyl ester had a mean particle size of 41 nm. It should be appreciated that by manipulating the processing parameters, the same composition can be produced with different mean diameters and size distributions. Manipulation of the composition in combination with manipulation of the processing parameters can also be used to produce particles of various sizes.
[0237] It was also found that under the conditions utilized herein, treprostinil compounds derivatized with longer chains form more uniform particles than compounds with shorter alkyl ester chains. Particle uniformity was determined using polydispersity (PD%) calculated by software. Polydispersity is defined as the standard deviation of particle size distribution from the mean particle size value. PD% normalizes polydispersity to the mean diameter by dividing by the mean size and multiplying by 100. These parameters indicate whether a particle suspension has one or more size populations of particles (unimodal vs. multimodal). This also provides insight into the width of the particle size distribution around the mean (or degree of particle uniformity) for each particle population.
[0238] When PD%≦15, the Dynamics® polydispersity parameter represents a monodisperse population of particles. Calculated PD%≧57% represents a polydisperse population of particles. For example, the PD% data plotted in FIG. 2 provides information about the uniformity of the particle size population from the treprostinil compounds tested. C8-TR (TR=treprostinil), C 10 -TR,C 12 -TR and C 14 The C-TR alkyl esters yielded near monodisperse particles with PD% of 15 or approximately 15. 16 -TR and C 18 The C8-TR alkyl esters yielded particles with a PD% slightly above 15, suggesting that there is a population of particles. However, these particles were not associated with the C8-TR, C 10 -TR,C 12 -TR and C 14 Compared with C1-TR, C2-TR, C3-TR, C4-TR and C5-TR showed values much larger than 15 PD%, with some showing ≥ 57. These values indicate the presence of multiple populations of particles with a wide particle size distribution. Example 4 Measurement of cyclic adenosine monophosphate (cAMP) levels in CHO-K1 cells in response to treprostinil compositions
[0239] A cell-based Chinese Hamster Ovary-K1 (CHO-K1) assay based on the GloSensor™ cAMP Assay (Promega) was used to characterize the effects of treprostinil alkyl ester compounds on cAMP levels.
[0240] cAMP is a second messenger involved in signal transduction of G-protein coupled receptors (GPCRs) that act through Gα-s and Gα-i proteins. Because the treprostinil receptor is a GPCR, this assay provides an indication of whether the respective prostacyclin compound (or its metabolite) binds to the receptor and activates the GPCR cell signaling cascade.
[0241] The GloSensor™ assay utilizes a genetically engineered form of firefly luciferase into which a cAMP-binding protein moiety has been inserted. Upon cAMP binding, a conformational change is induced, resulting in an increase in light output.
[0242] The EP2 prostanoid receptor was co-transfected with the GloSensor™ plasmid (Promega) into CHO-K1 cells as follows: CHO-K1 cells were harvested when the monolayer was 50-90% confluent. First, the cells were washed with 5 mL of PBS. 2 mL of pre-warmed (37°C) 0.05% trypsin-EDTA (Life Technologies, Catalog No.: 25300054) was added and the cells were dislodged by tapping the side of the flask. Next, 10 mL of antibiotic-free growth medium (Life Tech, Catalog No.: 31765092) containing 10% fetal bovine serum (FBS; Hyclone, Catalog No.: SH30071.03) was added and the cells were centrifuged at 250 x g for 5 min at room temperature. The medium was aspirated and the cell pellet was resuspended in 10 mL of growth medium. Cell counts were determined using a hemocytometer. Add 1 × 10 cells per 100 μL of antibiotic-free growth medium to each well of a culture-treated 96-well flat-bottom plate (Costar, Cat. No. 3917). 4 Cells were incubated overnight at 37° C. and 5% CO2 in a water-jacketed incubator.
[0243] For small-scale transfections of up to 20 wells, the ratio of pGLoSensor-22F cAMP plasmid (Promega, Catalog No. E2301) (2 μg):(EP2) (10 ng) (Origene, Catalog No. SC126558):pGEM-3Zf(+) (10 ng) (Promega, Catalog No. P2271) was diluted to a final concentration of 12.6 ng / μL (total plasmid) in Opti-MEM I Reduced Serum Medium (Life Technologies, Catalog No. 1985062). Then, 6 μL of FuGENE HD Transfection Reagent (Promega, Catalog No. E2311) was added to 160 μL of diluted plasmid and mixed carefully by gentle pipetting. The complex was incubated for 0-10 min at room temperature, then 8 μL of complex was added per well of a 96-well white assay plate (Costar, Cat#: 3917) and mixed gently without disturbing the cell monolayer. The plate was incubated for 20-24 h at 37°C and 5% CO2 in a water-jacketed incubator. Following incubation, the cells were processed and analyzed.
[0244] For larger scale transfections, the above steps were scaled up accordingly and the cells were frozen after the final incubation. To prepare frozen transfected CHO-K1 cells, the medium was aspirated from the culture flask and the cells were rinsed with 5 mL of PBS. As described above, 2 mL of pre-warmed (37°C) 0.05% Trypsin-EDTA (Life Technologies, Catalog No.: 25300054) was added and the cells were dislodged by tapping the side of the flask. Then, 10 mL of antibiotic-free growth medium (Life Technologies, Catalog No.: 31765092) containing 10% FBS (Hyclone, Catalog No.: SH30071.03) was added and the cells were centrifuged at 250 x g for 5 min at room temperature. Cell numbers were determined using a hemocytometer. The medium was aspirated and the cell pellet was collected at 2.5 x 10 6Cells / vial in freezing media (Millipore, Catalog No. S-002-5F ) transfected cells were incubated overnight at -80°C and then transferred to liquid nitrogen for long-term storage. The frozen stock was then thawed one day prior to use in the assay and cells were plated at 2.5 × 10 per well in 100 μL of complete antibiotic-free medium (F12 (Life Technologies, Catalog No.: 31765092) + 10% FBS (Hyclone, Catalog No.: SH30071.03)). 4 After overnight incubation at 37° C. and 5% CO2 in a water-jacketed incubator, the cells were ready for the cAMP response assay.
[0245] In preparation for cAMP measurements, cells were equilibrated with GloSensor cAMP reagent prior to treatment. For equilibration, media was carefully removed from each well. Then, 100 μL of equilibration media (6% v / v Glosensor reagent stock solution (Promega, Cat. No.: E291), 10% FBS (Hyclone, Cat. No.: SH30071.03) and 88% CO2-independent media (Life Technologies, Cat. No.: 18045088)) was added per well of a 96-well plate to the side of each well. The plate was then incubated at room temperature for 2 hours. The first pre-read measurement was performed using a microplate reader (MicroLumat Plus). The plate was incubated for an additional 10 minutes at room temperature, followed by a second pre-read measurement.
[0246] Working solutions of free treprostinil and treprostinil alkyl ester compounds were prepared in 10x concentrated solutions to give a final concentration of 1x when added to cells. Following treatment, each plate was read every 5 min for the duration of the assay using a microplate reader (MicroLumat Plus). To determine the fold change in cAMP relative to the control, transfection efficiency was first determined by dividing the second pre-read measurement by the average of the corresponding pre-read measurements. Normalized relative light units (RLU) of the samples were then calculated by multiplying the plate read measurements by the mean value. The fold change in cAMP relative to the control was then determined by dividing the normalized RLU of the sample by the normalized RLU of the control. Validation of the cAMP assay using free treprostinil
[0247] The cAMP assay was validated using free treprostinil. Treprostinil (10 μM, 1 μM, 0.1 μM, 0.01 μM, 0.001 μM, 0.0001 μM, 0.00001 μM and 0.000001 μM) was added to equilibrated CHO-K1 cells and the cells were then incubated for 30 minutes. Luminescence was then measured at room temperature. Alkyl ester treprostinil compositions
[0248] CHO-K1 cells co-transfected with EP2 receptor and GloSensor™ plasmid were treated with free treprostinil (10 μM, 1 μM, 0.1 μM, 0.01 μM, 0.001 μM, 0.0001 μM, 0.00001 μM, 0.000001 μM) and treprostinil alkyl ester compounds, i.e., C6, C8 or C9 at the R2 position of the compound of formula (A) as shown above. 10 The cells were challenged with compounds having linear alkyl groups.
[0249] The following concentrations of compound were measured: 10 μM, 1 μM, 0.1 μM, 0.01 μM, 0.001 μM, 0.0001 μM, 0.00001 μM, 0.000001 μM. cAMP levels were then measured every 5 minutes over an 8 hour time course. Results from the three highest concentrations are shown in Figure 3A (10 μM), Figure 3B (1 μM) and Figure 3C (0.1 μM). The components of the treprostinil compositions shown in Figures 3A, 3B and 3C are shown in Table 4 below.
[0250] Treprostinil decyl ester (C 10 cAMP levels in response to treprostinil (-TR) (10 μM) were comparable to free treprostinil and were sustained for at least 6 hours. Sustained cAMP levels were not demonstrated in response to free treprostinil.
[0251] CHO-K1 cells co-transfected with the EP2 receptor and GloSensor™ plasmid were treated with free treprostinil (5 μM) and the compounds C2, C6, C8, C9, C10, C11, C12, C13, C14, C15, C16, C17, C18, C19, C20, C21, C22, C23, C24, C25, C26, C28, C29, C30, C31, C32, C33, C34, C35, C36, C37, C38, C39, C40, C41, C42, C43, C44, C45, C46, C47, C48, C49, C50, C51, C52, C53, C54, C55, C56, C57, C60, C61, C62, 10 or C 12 The animals were challenged with a treprostinil composition having either treprostinil derivatized with a linear group (5 μM), or treprostinil derivatized with a linear group (5 μM). The components of the treprostinil composition are shown below in Table 5. cAMP levels were then measured every 5 minutes over an 8 hour time course.
[0252] The results of these experiments using a dose of 5 μM are shown in Figures 4 and 5. 10 The cAMP response to treprostinil alkyl esters (5 μM) was greater than or equal to the response induced by free treprostinil (Figure 4). 10 cAMP levels in response to treprostinil alkyl ester compounds were significantly increased by free treprostinil and C6, C8 and C 12 It lasted significantly longer than the treprostinil derivative. [Table 4] [Table 5] Treprostinil Compounds
[0253] A cell-based (CHO-K1) cAMP assay was also used to characterize the effect of unformulated treprostinil compounds (i.e., compounds without hydrophobic additives and / or amphiphiles, e.g., PEGylated lipids) on cAMP levels.
[0254] CHO-K1 cells co-transfected with EP2 receptor and GloSensor™ plasmids were treated with free treprostinil (5 μM) and C2, C3, C4, C5, C6, C8, C9, C10, C11, C12, C13, C14, C15, C16, C17, C18, C19, C20, C21, C22, C23, C24, C25, C 10 or C 12 Treprostinil derivatives bearing a linear alkyl ester moiety (5 μM) were challenged, and cAMP levels were then measured every 5 min over an 8-h time course.
[0255] The results of these experiments are shown in Figure 5. 10 Treprostinil alkyl esters induced cAMP response levels comparable to those of free treprostinil. 12 The derivatized treprostinil compounds were found to elicit minimal cAMP responses. Nebulized Treprostinil Ester Compositions
[0256] The cell-based (CHO-K1) cAMP assay described above was also used to characterize the effect of nebulization of various treprostinil compositions on cAMP levels.
[0257] CHO-K1 cells co-transfected with the EP2 receptor and GloSensor™ plasmid were treated with 10 μM free treprostinil (control or nebulized) and the compounds of formula (A) shown above with C2, C8, C 10 or C 12The mice were challenged with 10 μM treprostinil compositions (control or nebulized) containing compounds derivatized with either a linear alkyl group.
[0258] The compositions tested in this experiment are shown below in Table 6 (with results in Figure 6). cAMP levels were then measured every 5 minutes over an 8 hour time course.
[0259] A nebulizer Aeroneb Pro (Aerogen) was used to nebulize the treprostinil derivative composition. The desired volume of formulation (usually 3 mL) was loaded onto the mesh head of the nebulizer. The head was directly connected to a glass impinger with an airtight seal. Nebulization was performed using the factory settings until the entire sample was nebulized. After nebulization was completed, the head was removed; the impinger was capped and centrifuged at 600×g for 5 min to settle the aerosol inside the impinger. This procedure resulted in nearly 100% collection of the nebulized sample.
[0260] As shown in FIG. 6, nebulization of the derivatized treprostinil composition did not adversely affect the cAMP response level or duration of the response. [Table 6] Comparison of Treprostinil Compounds and Compositions Containing Same
[0261] Median effective concentration (EC 50 ) was determined using the results from the cAMP assay. Table 7 (below) shows the EC50 values for cAMP response in CHO-K1 cells for the following compositions and compounds: 50 Summarizing the data: T554 (C2-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T612 (C2-TR 10mol%, DMPE-P1K 90mol%), T501 (C5-TR 40mol%, squalane 40mol%, Chol-PEG2k 20 mol%), T601 (C6-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T555 (C8-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T556(C 10 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T568(C 12 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T621(C 12 -TR 10mol%, DPPE-P2K 90mol%), T623(C 16 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T622(C 16 -TR 10mol%, DPPE-P2K 90mol%), C2-TR (100 mol%), C8-TR (100 mol%), C 12 -TR (100 mol%) and Free treprostinil. A subset of dose-response curves for selected treprostinil compounds and compositions are shown in Figures 7-14. For free treprostinil, potency decreases with increasing incubation time (supporting an immediate response), while the various treprostinil compositions all show increasing potency with incubation time (suggesting a delayed release profile). [Table 7] Example 5 Determining the Effects of Treprostinil Compounds on Cell Proliferation
[0262] To determine the effect of treprostinil compounds on cell proliferation, cell-based assays using CHO-K1 cells and rat alveolar cells (NR8383 cells) were performed. CHO-K1 cells
[0263] CHO-K1 cells were harvested when the cell monolayer was 50-90% confluent (using passage numbers 4-11). The medium was aspirated from the flask and the cells were rinsed with 2 mL of F12 medium. Then, 1 mL of pre-warmed (37 °C) 0.25% trypsin-EDTA (Life Technologies, Inc.) was added to the flask. Technologies, Catalog Number: 25300054) was added and the cells were dislodged from the flask by tapping the side of the flask. Complete growth medium (F12 (Life Technologies, Catalog Number: 31765092) + 10% FBS (Hyclone, Catalog Number: SH30071.03) + 1X Pen-Strep (Life Technologies, Catalog Number: 15140-122) was then added to a volume of 10 mL. The cells were centrifuged at 250 x g for 5 minutes at room temperature and the medium was aspirated. The cell pellet was resuspended in 10 mL of complete growth medium. Cell numbers were determined using a hemocytometer. Cells were then seeded at 2000 cells per well of a 96-well plate in 100 μL of complete growth medium. Plates were incubated overnight at 37°C and 5% CO2 in a water-jacketed incubator.
[0264] The next day, 80 μL of fresh complete medium was added to each well and CHO-K1 cells were challenged with treprostinil compounds and composition treatments. Working solutions were prepared at 10× concentration and after 2-fold serial dilution, 20 μL aliquots were added per well to a final 1× concentration. Following 48 hours of incubation at 37° C. and 5% CO2 in a water-jacketed incubator, the inhibitory effect on cell proliferation was determined. Plates were analyzed using 20 μL of Presto Blue reagent (Life Technologies, Catalog No.: A13262) per well. The reagents were mixed and the plates were incubated for 1 hour at 37° C. and 5% CO2 in a water-jacketed incubator. Plates were read using a CytoFluor Series 4000 (PerSeptive BioSystems) or Synergy Neo microplate reader (BioTek) at emission λ: 590 nm and excitation λ: 560 nm. Percent inhibition was determined using the following formula: % inhibition=100%-(treated sample / control x 100%). NR8383 cells
[0265] Rat alveolar NR8383 cells were harvested when the monolayer was 50–90% confluent (using passage numbers 5–11). As NR8383 cells contain both adherent and non-adherent cells, the medium was transferred to a 50 mL Falcon tube. To obtain the cells remaining in the flask, 2 mL of plain media was added and the remaining cells were transferred to a 75 cm 2The flasks were scraped with a cell scraper and added to 50 mL tubes. The cells were centrifuged at 200×g for 5 minutes at room temperature and the medium was aspirated. The cell pellet was resuspended in 10 mL of complete growth medium (F12 (Life Technologies, Catalog No.: 31765092) + 15% FBS-heat inactivated (Hyclone, Catalog No.: SH30071.03) + 1XPen-Strep (Life Technologies, Catalog No.: 15410-122)). Cell numbers were determined using a hemocytometer. The cells were then seeded at 4000 cells per well of a 96-well plate in 100 μL of complete growth medium. The plates were incubated overnight at 37° C. and 5% CO2 in a water-jacketed incubator.
[0266] The next day, 80 μL of fresh complete medium was added to each well and NR8383 cells were challenged with treprostinil compound treatments. Following 72 hours of incubation at 37° C. and 5% CO2 in a water-jacketed incubator, the inhibitory effect on cell proliferation was determined. Measurements and calculations were performed as described above for CHO-K1 cells. Effect of Treprostinil Alkyl Ester Compositions on CHO-K1 Cell Proliferation
[0267] CHO-K1 cells were treated with treprostinil alkyl ester derivatives, at concentrations ranging from 0.55 μM to 125 μM: T554 (C2-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T543 (C6-TR 40mol%, Toco Acet 40mol%, Chol-PEG2k 10mol%), T555 (C8-TR 40mol%, Squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T556(C 10 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T568(C12 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T623(C 16 The cells were challenged with a composition containing 40 mol% treprostinil-TR, 40 mol% squalane, 10 mol% Chol-PEG2k, and 10 mol% DOPC. Following a 48 hour incubation period, the inhibitory effect of the treprostinil derivative composition on cell proliferation was determined.
[0268] Table 8 below summarizes the effect of the above Treprostinil compositions on CHO-K1 cell proliferation. At a maximum concentration of 100 μM, T543 (C6-TR) and T623 (C 16 -TR) showed a significant inhibitory effect on cell proliferation. [Table 8] Effect of Treprostinil Compositions on NR8383 Cell Proliferation
[0269] Rat alveolar NR8383 cells were challenged with the same treprostinil derivative compositions:
[0270] At the same concentration as the CHO-K1 cells above (0.55 μM to 125 μM), T543 (C6-TR 40mol%, Toco Ace 40mol%, Chol-PEG2k 20mol%), T554 (C2-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T555 (C8-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T556(C 10 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%), T568(C 12-TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%) and T623(C 16 -TR 40 mol%, Squalane 40 mol%, Chol-PEG2k 10 mol%, DOPC 10 mol%). Following a 72 hour incubation period, the inhibitory effect of the treprostinil derivative compositions on cell proliferation was determined.
[0271] The effects of the treprostinil compositions on NR8383 cell proliferation are summarized in Table 8. At the maximum dose of 100 μM, all of the treprostinil derivative compositions showed some inhibition of cell proliferation, with T543 (C6-TR) showing the highest inhibitory effect. Effects of Treprostinil Alkyl Ester Compounds on Cell Proliferation
[0272] To determine the effect of the treprostinil derivative compounds (not formulated) on cell proliferation, the cell-based assays described above were performed using CHO-K1 cells and rat alveolar cells (NR8383 cells). CHO-K1 cell proliferation assay
[0273] CHO-K1 cells were treated with treprostinil alkyl esters, i.e., the following R2 groups: C2, C3, C4, C5, C6, C8, C9, C10, C11, C12, C13, C14, C15, C16, C17, C18, C19, C20, C21, C22, C23, C24, C25, C26, C27, C28 10 or C 12 The cells were challenged with TR compounds of formula (A) having linear alkyl chains at dosages ranging from 0.098 μM to 25 μM. Following a 48 hour incubation period, the inhibitory effect on cell proliferation was determined.
[0274] The effects of the above treprostinil alkyl esters on CHO-K1 and NR8383 cell proliferation are summarized below in Table 9. At the highest concentration, only the treprostinil octyl ester compound showed inhibition of cell proliferation. [Table 9] NR8383 cell proliferation assay
[0275] Rat alveolar NR8383 cells were cultured with C2, C3, C4, C5, C6, C8, and C9 at the R2 position of formula (A) at concentrations ranging from 0.195 μM to 25 μM. 10 or C 12 The cells were challenged with treprostinil compounds derivatized with a linear alkyl moiety, and following a 72 hour incubation period, the inhibitory effect on cell proliferation was determined.
[0276] The effects of the treprostinil alkyl esters on NR8383 cell proliferation are summarized in Table 11. Similar to the CHO-K1 cell assay, only the treprostinil octyl ester showed some inhibition of cell proliferation at the highest concentration. Treprostinil Derivative Compositions - Effects on Cell Proliferation
[0277] To determine the effect of the treprostinil derivative compositions on cell proliferation, cell-based assays were performed using CHO-K1 cells and rat alveolar cells (NR8383 cells). Effect of Treprostinil Compositions on CHO Cell Growth
[0278] CHO-K1 cells were cultured with the treprostinil derivative composition: T596(C2-TR 45mol%, DSG-P2K 55mol%), T597(C6-TR 45mol%, DSG-P2K 55mol%), T598(C8-TR 45mol%, DSG-P2K 55mol%), T599(C 10 -TR 45mol%, DSG-P2K 55mol%) and T600(C 12 -TR 45mol%, DSG-P2K 55mol%), T612(C2-TR 10mol%, DMPE-P1K Cells were challenged with T613 (C8-TR 10 mol%, DMPE-P1K 90 mol%) at concentrations ranging from 0.23 μM to 29 μM. Following a 72 hour incubation period, the inhibitory effect on cell proliferation was determined. Following a 48 hour incubation period, the inhibitory effect on cell proliferation was determined.
[0279] The effects of Treprostinil compositions on CHO-K1 cell proliferation are summarized below in Table 10. None of the compositions tested showed a significant inhibitory effect on CHO-K1 cell proliferation. [Table 10]
[0280] Similarly, CHO-K1 cells were challenged with treprostinil compositions T612 (R2=C2), T613 (R2=C8) at concentrations ranging from 1.41 μM to 180 μM. After 48 hours, the inhibitory effect on cell proliferation was determined, with all four treprostinil compositions showing 100% inhibition of cell proliferation at the higher concentrations. Effect of Treprostinil Compositions on NR8383 Cell Proliferation
[0281] Rat alveolar NR8383 cells were treated with the same treprostinil compositions (above) at the same concentrations (0.23 μM to 29 μM) as the CHO-K1 cells, as well as T596 (C2-TR 45 mol%, DSG-P2K 55 mol%), T612 (C2-TR 10 mol%, DMPE-P1K 90 mol%), T597 (C6-TR 45 mol%, DSG-P2K 55 mol%), T598 (C8-TR 45 mol%, DSG-P2K 55 mol%), T613 (C8-TR 10 mol%, DMPE-P1K 90 mol%), T599 (C 10 -TR 45mol%, DSG-P2K 55mol%), T600(C 12 -TR 45 mol%, DSG-P2K 55 mol%). Following a 72 hour incubation period, the inhibitory effect on cell proliferation was determined.
[0282] Table 10 above summarizes the effect of the treprostinil compositions on NR8383 cell proliferation. All of the treprostinil compositions showed some (≦10%) inhibition of NR8383 cell proliferation. Example 6 Treprostinil compounds in vivo
[0283] The effect of treprostinil derivative compounds in vivo was determined using a rat model. Young male Sprague-Dawley rats (Charles River) were used for the study. Rats were anesthetized with ketamine / xylazine, placed on a heating pad, and the trachea was surgically isolated and catheterized, and then mechanically ventilated throughout the study.
[0284] A catheter was placed in the femoral artery to measure systolic (sys) and diastolic (dias) blood pressure. A thoracotomy was performed and a catheter was inserted into the right ventricle and placed in the pulmonary artery to measure pulmonary artery systolic and diastolic blood pressure. Oxygen saturation (SaO2) was measured with a pulse oximeter placed on the foot.
[0285] Cardiovascular measurements were performed under these normoxic conditions in rats ventilated with room air (FIO2 = 0.21). To induce hypoxia, FIO2 was reduced over 30 min until SaO2 had fallen to values between 50 and 60%, and baseline hypoxic values for each of the parameters were determined.
[0286] Groups of four rats were treated with PBS, free treprostinil (1.7 μg / kg and 10 μg / kg), or C2-TR (T554); C8-TR (T555: C8-TR 40 mol%, squalane 40 mol%, Chol-PEG2k 10 mol%, DOPC 10 mol%) (38.6 μg / kg), C 10 -TR(T556:C 10 -TR 40mol%, squalane 40mol%, Chol-PEG2k 10mol%, DOPC 10mol%)(40.8μg / kg)), C12 -TR(T568)-containing composition was administered.
[0287] As shown in Table 11 below, due to differences in molecular weight of the treprostinil derivative compositions, the target doses were slightly varied by weight. The actual lung doses achieved were about 5x lower than those shown in Table 11 (e.g., administration of 10 μg / kg resulted in about 2 μg / kg in the lungs). The various treatments were delivered (by inhalation of nebulized drug into the lungs of rats. Pulmonary artery pressure (PAP), systemic arterial pressure (SAP) and heart rate of the rats were continuously measured for 180 minutes. PAP signals were collected at 200 points per second. [Table 11]
[0288] Normalized variation in mean PAP (mPAP) is shown in Figure 15 as a percentage from the hypoxic baseline value at (T=0). The hypoxic baseline PAP value was 100% and the change in pressure was measured relative to the hypoxic baseline. Normalized variation in mean SAP (mSAP) is shown in Figure 16 as a percentage from the hypoxic baseline value. Heart rate is shown in Figure 17 as a percentage of the hypoxic baseline value over time. Example 7 Measurement of cyclic adenosine monophosphate (cAMP) levels in CHO-K1 cells in response to 5-nonanyl-TR
[0289] A cell-based Chinese Hamster Ovary-K1 (CHO-K1) assay based on the GloSensor™ cAMP Assay (Promega) was used as described above in Example 4 to characterize the effects of the following compounds on cAMP levels: 5-nonanyl-TR, i.e. R2=5-nonanyl [ka] A compound of formula (A) C 12 -TR, i.e. R2=C 12 Alkyl [ka] A compound of formula (A) C 14 -TR, i.e. R2=C 14 Alkyl [ka] A compound of formula (A) C 16 -TR, i.e. R2=C 16 Alkyl [ka] A compound of formula (A)
[0290] CHO-K1 cells co-transfected with the EP2 receptor and GloSensor™ plasmid were treated with 5-nonanyl-treprostinil (branched chain, 5C9-TR) or the above compounds at the R2 position, C 12 , C 14 or C 16 The subjects were challenged with treprostinil alkyl ester compounds with either a linear alkyl group or a linear alkyl group. cAMP levels were then measured every 5 minutes over an 8 hour time course. 14 -TR and C 16 Dose-response curves for -TR at incubation times of 0.5, 1, 2, 3, 4, 5, 6, 7 and 8 hours are shown in Figures 18, 19 and 20, respectively. 14 -TR and C 16 Similar to 5-nonanyl-TR, the potency of 5-nonanyl-TR increased with incubation time, indicating a delayed release profile. 50) was determined using the results from the cAMP assay. 14 -TR and C 16 -EC about TR 50 are shown in Figures 18, 19 and 20, respectively.
[0291] C at 10 μM (upper panel) and 5 μM (lower panel) concentrations 12 -TR,C 14 -TR,C 16 The kinetic profile results from 5-nonanyl-TR or 5-nonanyl-TR are shown in Figure 21. 12 -TR,C 14 cAMP levels in response to treprostinil-TR and 5-nonanyl-TR increased over the first 1 to 1.5 hours and were sustained for at least 8 hours. 12 -TR>C 14 -TR>5-nonanyl-TR>C 16 -TR.
[0292] The results of this study are 12 , C 14 or C 16 Similar to treprostinil alkyl ester compounds with linear alkyl ester groups, 5-nonanyl-TR has been shown to be functional and exhibit sustained cAMP activity. Thus, unlike free treprostinil (see Example 4), 5-nonanyl-TR has a delayed release profile. Example 8 C 14 Comparison of cyclic adenosine monophosphate (cAMP) activation in CHO-K1 cells in response to -TR formulations
[0293] A cell-based Chinese Hamster Ovary-K1 (CHO-K1) assay based on the GloSensor™ cAMP assay (Promega) was used as described above in Example 4 to assess the effect of different Cs on cAMP levels. 14 The effects of the C-TR formulation were characterized. 14-TR formulations are shown below in Table 12. Composition T679 does not contain DOPC; composition T647 does not contain DOPC or squalane. C 14 The structure of -TR is as follows: [ka] [Table 12]
[0294] CHO-K1 cells co-transfected with the EP2 receptor and GloSensor™ plasmid were incubated with 100 mM NaCl at the carboxylic acid position. 14 The animals were challenged with a treprostinil alkyl ester formulation having a linear alkyl ester group and components as shown in Table 12. cAMP levels were then measured every 5 minutes over an 8 hour time course.
[0295] Dose response curves for compound T679 at 0.5, 1, 2, 3, 4, 5, 6, 7 and 8 hour incubation times are shown in Figure 22. The potency of T679 increased over the incubation time, indicating a delayed release profile. Results from the cAMP assay were used to determine the half effective concentration (EC 50 ) was determined, which is also shown in Figure 22.
[0296] A comparative kinetic profile for free treprostinil, T631 and T679 at 10 μM (top panel) and 5 μM (bottom panel) is shown in FIG. 23. Both T631 and T679 were less potent compared to free treprostinil. However, unlike free treprostinil, cAMP activation increased over time in response to both T631 and T679 and was sustained for at least 8 hours. The results of the study showed that C-T631 without DOPC 14 -TR T679 formulation is functional and C 14-TR has been shown to exhibit a delayed release profile similar to that of T631.
[0297] Dose response curves for compound T647 at incubation times of 0.5, 1, 2, 3, 4, 5, 6, 7 and 8 hours are shown in Figure 24. Similar to T679, the potency of T647 increased over the incubation time, indicating a delayed release profile. Results from the cAMP assay were used to determine the half effective concentration (EC 50 ) was determined, which is also shown in Figure 24.
[0298] A comparative kinetic profile for free treprostinil, T631 and T647 at 10 μM (top panel) and 5 μM (bottom panel) is shown in FIG. 25. Both T631 and T647 were less potent compared to free treprostinil. However, unlike free treprostinil, cAMP activation increased over time in response to both T631 and T647 and was sustained for at least 8 hours. The results of the study demonstrated that C-T631, which does not contain DOPC or squalane, is a potent anti-inflammatory agent. 14 -TR T647 formulation is functional and C 14 -TR was shown to exhibit a delayed release profile similar to that of T631. Example 9 Functional cAMP studies on treprostinil alkyl ester nanoparticle formulations
[0299] A cell-based Chinese Hamster Ovary-K1 (CHO-K1) assay based on the GloSensor™ cAMP Assay (Promega) was used to characterize the effect of treprostinil compositions on cAMP levels as described above in Example 4. The cAMP profiles of the following treprostinil compositions were tested in this study (see also Table 13): T555:C8-TR (i.e., R2= [ka] A compound of formula (A) T556:C 10 -TR (i.e., R2 = [ka] A compound of formula (A) T568:C 12 -TR (i.e., R2 = [ka] A compound of formula (A) T631:C 14 -TR (i.e., R2 = [ka] A compound of formula (A) T623:C 16 -TR (i.e., R2 = [ka] A compound of formula (A) T637:C 18 -TR (i.e., R2 = [ka] A compound of formula (A) [Table 13]
[0300] CHO-K1 cells co-transfected with EP2 receptor and GloSensor™ plasmids were challenged with the treprostinil alkyl ester compositions listed above, and cAMP levels were then measured every 5 minutes over an 8 hour time course.
[0301] Composition T637(C 18 Dose response curves for T679 (-TR) at incubation times of 0.5, 1, 2, 3, 4, 5, 6, 7 and 8 hours are shown in Figure 26. The potency of T679 increased over the initial incubation period and then maintained at sustained levels for at least 8 hours, indicating a delayed release profile. Results from the cAMP assay were used to determine the half maximal effective concentration (EC 50 ) was determined, which is also shown in Figure 26.
[0302] Kinetic profile comparisons for free treprostinil, T555, T556, T568, T631, T623 and T637 at 10 μM (top panel) and 5 μM (bottom panel) are shown in Figure 27. Each of the treprostinil alkyl ester compounds was less potent than free treprostinil. However, unlike free treprostinil, cAMP activation was increased and then sustained at levels for at least 8 hours in response to each of the treprostinil alkyl ester compounds. This indicates that each of these compounds is functional and exhibits a delayed release profile. The activity ranking for these compounds was in the following order: T555 / T556>T568>T631>T623>T637. Example 10 Kinetics of enzymatic conversion of branched treprostinil compounds.
[0303] A series of studies was performed to determine the conversion kinetics of linear versus various branched treprostinil compounds to treprostinil. 0.4 mM linear C8-TR or branched treprostinil compounds 2-dimethyl-1-propanyl-TR, 3,3-dimethyl-1-butanyl-TR, 2-ethyl-1-butanyl-TR, 5-nonanyl-TR or 3-pentanyl-TR (see below for structures) were incubated with 0.2 U esterase at 37° C. for 1 hour and the conversion (% of total) was calculated for incubation times of 0.25, 0.5, 0.75 or 1 hour. C8-TR (i.e., R2= [ka] A compound of formula (A) 2-Dimethyl-1-propanyl-TR (i.e., R2 = [ka] A compound of formula (A) 3,3-Dimethyl-1-butanyl-TR (i.e., R2 = [ka] A compound of formula (A) 2-Ethyl-1-butanyl-TR (i.e., R2 = [ka] A compound of formula (A) 5-nonanyl-TR (i.e., R2 = [ka] A compound of formula (A) 3-pentanyl-TR (i.e., R2= [ka] A compound of formula (A)
[0304] FIG. 28 shows that 5-nonanyl-TR showed a slower conversion rate than linear C8-TR.
[0305] FIG. 29 shows the esterase-mediated conversion rate to treprostinil of the following treprostinil compounds: C8-TR, C9-TR, C 10 -TR,C 12 -TR,C 14 -TR and C 16 -TR, i.e., R2, is as follows: The conversion is for the C8-TR compound, and the conversion was measured after 1 hour of esterase incubation. C8-TR (i.e., R2= [ka] A compound of formula (A) C9-TR (i.e., R2= [ka] A compound of formula (A) C 10 -TR (i.e., R2 = [ka] A compound of formula (A) C 12 -TR (i.e., R2 = [ka] A compound of formula (A) C14 -TR (i.e., R2 = [ka] A compound of formula (A) C 16 -TR (i.e., R2 = [ka] (a compound of formula (A)
[0306] 30 shows the esterase-mediated conversion of branched treprostinil compounds (below) to treprostinil relative to the esterase-mediated conversion of C8-TR to treprostinil. Conversion rates were measured after 1 hour of esterase incubation. 4C7-TR (i.e., R2= [ka] A compound of formula (A) 4C8-TR (i.e., R2= [ka] A compound of formula (A) 3C8-TR (i.e., R2= [ka] A compound of formula (A) 2C8-TR (i.e., R2= [ka] A compound of formula (A) 5C9-TR (i.e., R2= [ka] A compound of formula (A) 2C9-TR (i.e., R2= [ka] (a compound of formula (A)
[0307] Each of the branched compounds 4C7-TR, 4C8-TR and 5C9-TR showed a slower conversion rate than the linear compound C8-TR. The asymmetric branched compound (4C8-TR) showed a slower conversion rate than the symmetric compounds (4C7-TR and 5C9-TR). Furthermore, there was no significant difference between the conversion rates of the R and S isomers of 2C8-TR ((R)-2C8-TR vs. (S)-2C8-TR). Example 11 Determination of treprostinil pharmacokinetics in rats
[0308] Table 14 shows the treprostinil alkyl ester formulations used in this study. The first three compositions (T568, T631, and T623) are believed to form lipid nanoparticles, while the latter three compositions (T630, T635, and T636) are believed to form micelles. [Table 14]
[0309] T568 and T630:C 12 -TR (i.e., R2 = [ka] (a compound of formula (A)
[0310] T631 and T635:C 14 -TR (i.e., R2 = [ka] (a compound of formula (A)
[0311] T623 and T636:C 16 -TR (i.e., R2 = [ka] (a compound of formula (A)
[0312] Nebulized treprostinil (TRE) solution and treprostinil alkyl ester formulations were administered (15 nmol / kg or 6 mg / kg) by nose-only inhalation (24-hour study) to anesthetized, ventilated (6-hour study) or conscious rats. Blood and lung samples were collected at specific time points. Concentrations of TRE and treprostinil alkyl esters in plasma and lung tissue were measured by HPLC / MS / MS analysis. Anesthetized and ventilated rats
[0313] Male Sprague-Dawley rats were anesthetized and prepared with an endotracheal tube for ventilation. The right femoral vein was cannulated to facilitate blood collection. Distal lung samples were taken for analysis no later than 6 hours after dosing. An Aeroneb® nebulizer and control device (Aerogen, Galway, Ireland) was used to generate aerosols of 2.5 μm to 4 μm median aerodynamic diameter (MMAD) at a rate of 0.1 mL / min to provide an estimated lung dose of 6 μg / kg. A SAR-830 / AP small animal ventilator (CWE Inc., Ardmore, PA) set at a ventilator tidal volume (VT) of 8 mL / kg and a rate of 90 breaths / min was used to deliver a nebulized test article in a volume of 250 μL. Systemic blood pressure (mSAP), heart rate (HR) and arterial oxygen saturation (SaO2). Physiological parameters were measured during normoxia (fraction of inspired oxygen [FrO2] = 0.21, SaO2 ≈ 90%) and during hypoxia (FrO2 = 0.10, SaO2 ≈ 50%) for 2–3 h. Conscious nose-only inhalation
[0314] Male Sprague-Dawley rats were placed in a restraining tube and Exposure to nebulized drugs was provided by an aeger-NYU nose-only directed-flow inhalation exposure system (CH Technologies, Westwood, NJ) (FIG. 31). Test articles (6 mL at a specified concentration) were nebulized using an Aeroneb nebulizer to deliver a predefined estimated lung dose. Blood and lung tissue samples were collected at selected times after drug nebulization and over a 24-hour period.
[0315] Ventilated rats treated with nebulized TRE solution showed the highest plasma concentration (C max ) (3.5 ng / mL), which occurred immediately after dosing (Figure 32, left). Measurable levels of TRE were not seen in plasma for more than 4 hours and in lungs for up to 6 hours. In contrast, ventilated rats treated with nebulized TPD-LNP had lower plasma TRE C levels, ranging from 0.2 ng / mL to 0.6 ng / mL. max values (Table 15, Figure 32 left). At 6 hours, treprostinil alkyl esters remained in the lungs at levels ranging from 100 ng / g to 400 ng / g tissue equivalent of TRE (Figure 33). Treprostinil detected in the lungs was presumably generated by treprostinil alkyl ester hydrolysis during sample preparation. When administered with micellar TPD, plasma levels of TRE were higher than with TPD lipid nanoparticle formulations, indicating that the nanoparticles play an additional role in the delayed release effect (Figure 32, compare left and right graphs). In a 24-hour study in rats administered TPD-lipid nanoparticle formulations (nose-only inhalation), TRE Cmax was higher than in the aerated animals, indicating a near first-order exponential decay. 14 - and C 16 - Plasma concentrations of TRE in rats treated with the treprostinil alkyl ester lipid nanoparticle formulation were maintained above 0.1 ng / mL for up to 24 hours (a level equivalent to activity in acute hypoxia studies) (Figure 34, top). Lung levels of total TRE+TPD were approximately 10 times higher than plasma TRE. 3 The inhaled C-reactive protein concentration was 2-fold higher and also showed an exponential decline in rats administered the treprostinil alkyl ester lipid nanoparticle formulation (Figure 34, bottom). Table 16 further shows the pharmacokinetics of treprostinil in rats after administration via the nose-only system with a nebulized treprostinil alkyl ester lipid nanoparticle formulation at an estimated lung dose of 6 μg / kg. Figure 35 shows the inhaled C-reactive protein concentration in rats after administration of the nebulized treprostinil alkyl ester lipid nanoparticle formulation at an estimated lung dose of 6 μg / kg. 16 It further shows that the release kinetics of treprostinil from -TR formulations over 24 hours is independent of dose (nose-only administration). The times in Figure 35 correspond to the time after the start of nebulization of 6 mL of suspension (nebulization period was 30 min to 60 min). Figure 38 shows that animals treated with T568 and T623 had a survival benefit (survival over 200 min) compared to animals treated with free treprostinil or PBS. Specifically, Figure 38 shows the pulmonary artery pressure in animals treated with various lipid nanoparticle formulations, PBS, and treprostinil. Furthermore, it was shown that treatment with T568 and T623 had little effect on systemic hemodynamics (Figure 39). Finally, it was shown that the treprostinil alkyl ester nanoparticle formulations gradually converted to treprostinil, resulting in consistent plasma levels with low peak values (Figure 40). [Table 15] [Table 16]
[0316] Inhaled TPD has a long-term presence in the lungs and is associated with a slow sustained release of TRE into the blood, and this duration of activity is increased with TPD formulated in lipid nanoparticles. Example 12 C in dogs 16 Pharmacokinetic profile of -TR alkyl ester lipid nanoparticle formulations
[0317] Twelve beagle dogs of either sex were administered different inhaled doses of treprostinil in PBS, both given by nebulizer, or the compound of formula (A) formulated in a lipid nanoparticle formulation suspended in PBS (where R2= [ka] )(C 16 -TR) (T623) (see Table 14). Formulations were nebulized with an Aeroneb nebulizer (MMAD: 2.5-4 μm) and delivered into a 500 ml expansion chamber. Formulations were nebulized for 2 min with ventilator settings of 90 ml / breath, 15 breaths / min (delivered volume = 2.7 L) and collected on a filter. The amount of drug (μg) on the filter was measured by HPLC to calculate the concentration of drug (μg / L) delivered through the ventilator circuit.
[0318] Dosimetry was performed in dogs anesthetized with propofol and nebulized The drug was introduced into a mixing chamber that was inserted onto the inspiratory rim of a canine respirator. Before each experiment, a technical run was performed to measure the concentration of drug delivered for each breath (μg / L). The inhaled drug dose (μg / kg) was calculated using the formula: Inhaled drug dose (μg / kg) = Drug concentration (μg / L) × Minute ventilation (L / min) × Calculations were made using time (min) / body weight (kg). After drug delivery, the dogs were removed from the respirator and blood samples were taken over 72 h to measure treprostinil plasma concentrations by HPLC / MS / MS. Clinical signs were monitored over this 72 h period.
[0319] The use of anesthetized, intubated, and ventilated approach provided reproducibility between dogs and demonstrated the efficacy of treprostinil (5±1 and 16±2 μg / kg) and C 16 Target inhaled doses were achieved for both -TR (7±1, 22±1, 46±1 and 95±1 μg / kg). Treprostinil plasma C for dogs receiving treprostinil (2.7 and 5.9 ng / ml, respectively) at inhaled doses of 5 and 16 μg / kg. max The values are C values for similar inhaled doses (7 and 22 μg / kg) in the T623 formulations (0.2 and 0.3 ng / mL, respectively). 16 The treprostinil levels were 15-20 times higher compared to those achieved with inhaled T623-TR (Figure 36). Furthermore, plasma levels of treprostinil were sustained over 48 hours with inhaled T623 but disappeared within hours after inhalation of treprostinil (Figure 36). Coughing and rapid shallow breathing were absent during delivery of treprostinil to anesthetized, ventilated dogs, but were present during the recovery period. Dogs receiving T623 showed no signs of respiratory irritation at inhaled doses as high as 46 μg / kg. C 16 Alkyl ester lipid nanoparticle treprostinil formulations and C 12 and C 14 Comparison of alkyl ester lipid nanoparticle treprostinil formulations
[0320] Twelve beagle dogs were treated with inhaled treprostinil as well as three treprostinil alkyl ester lipid nanoparticle formulations: T568 (dodecyl-treprostinil, C 12 -TR), T631 (tetradecyl-treprostinil, C 14 -TR) and T623 (hexadecyl-treprostinil, C 16-TR). The components of each formulation are shown in Table 14 above.
[0321] Dosimetry was performed in propofol-anaesthetized, artificially ventilated dogs, with nebulized drug introduced into a mixing chamber interposed over the inspiratory rim of the respirator. Technical trials were performed before each experiment measuring the concentration of drug per breath (μg / L), minute ventilation, and time required to achieve the target lung dose. After recovery from anesthesia, blood samples were collected over 72 h and plasma levels of TRE were measured by HPLC / MS / MS. Clinical signs (coughing, rapid shallow breathing, vomiting, and pale gums) were also monitored.
[0322] At a target lung dose of 18 μg / kg, plasma levels of treprostinil were 1.0–1.2 mg / kg immediately after administration of free treprostinil (C max = 5.9 ± 0.6 ng / ml), but C 12 -TR,C 14 -TR and C 16 -Corresponding C for TR max values were 5-, 13-, and 20-fold lower. Plasma treprostinil was below the level of quantification for up to 4 h after free treprostinil was inhaled, but persisted for 48-72 h after the treprostinil alkyl ester formulation was inhaled.
[0323] C max and AUC were increased in a dose-dependent manner with inhaled C 16 A prolonged presence of treprostinil in plasma was seen with TR (6-90 μg / kg) and up to 72 h at higher doses. 12 - TR had adverse clinical signs, but C 14 -TR and C 16 -TR was not observed. 16 In a dose-response study with -TR, adverse clinical signs were seen in only one dog at a target lung dose of 90 μg / kg.
[0324] Based on PK studies in dogs, the inhaled C 16 -TR results in a sustained presence of treprostinil in the plasma and a lower potential for side effects than inhaled free treprostinil at comparable doses. (Example 13) Lipid Nanoparticles C 16 Characterization of alkyl ester treprostinil formulations
[0325] T748, lipid nanoparticle C with the following components: 16 Alkyl ester treprostinil formulations were characterized. [Table 16A]
[0326] Evaluation of tolerability and pharmacokinetics (PK) of treprostinil in rats administered T748 lipid nanoparticle formulation
[0327] Inhalation C 16 To assess whether repeated dosing with -TR was well tolerated and altered PK, rats were treated with C 16 -TR.
[0328] Five groups of Sprague-Dawley rats (n=4 per group) were treated with either inhaled phosphate-buffered saline (PBS) or four doses of C, administered by nebulization in a nose-only inhalation chamber. 16 Cohorts of rats were exposed to 0.6, 1.8, 6 and 18 μg / kg of C-TR. 16 Treprostinil and C were studied after daily inhalation administration of 1, 7 and 14 days, blood samples were taken at 1, 3, 6 and 24 hours, and lung samples were collected 24 hours after the last administration of drug. 16 -TR concentrations were measured by HPLC / MS / MS. Body weights were recorded daily and organ weights (lungs, heart, liver) were measured 24 h after the last drug administration.
[0329] 14 consecutive days C 16There were no tolerability problems or significant changes in body and organ weights (vs. PBS) after inhalation of C-TR. 16 Increasing the inhaled dose of -TR (0.6 to 18 μg / kg) increased plasma C max and AUC increased, but this was not consistently affected with repeated dosing. There was some variability in AUC between days 1 and 14 among the different dose groups, with two of the four doses (1.8 and 18 μg / kg) showing no difference, and the other two doses (0.6 and 6 μg / kg) showing a 3- to 4-fold increase in AUC by day 14. 16 The presence of -TR was not detected at any dose. However, the presence of relatively high concentrations of C 16 -TR (approximately 1,000-fold higher than plasma treprostinil) was found in the lungs. 16 -TR is the C 16 -induced a dose-dependent increase in the concentration of TR, which was unchanged by repeated dosing for 14 consecutive days.
[0330] Inhalation C 16 -TR (0.6-18 μg / kg) was well tolerated, with no evidence of body or organ weight changes after 14 consecutive days of dosing. C on the cough reflex in guinea pigs 16 Efficacy of alkyl ester lipid nanoparticle treprostinil formulations
[0331] In this study, inhaled treprostinil and the alkyl ester hexadecyl-treprostinil (C 16 The cough suppressant effect of a lipid nanoparticle formulation of acetaminophen (-TR) was studied in guinea pigs.
[0332] Three groups of male Dunkin Hartley guinea pigs were placed in a whole-body The subjects were then subjected to a thysmograph and administered aerosolized phosphate-buffered saline (PBS), TRE (1–300 μg / ml), and C 16-TR lipid nanoparticle formulation T748 (30 μg / ml). T623 has the following components:
[0333] The aerosol was mixed with inspired air delivered at a rate of 2 L / min using the Ultra-Neb Coughs were generated with a Pro nebulizer (nebulizer output 0.36 mL / min). PBS or drug was delivered for 10 min, and the number of coughs was recorded during and 20 min after delivery. Coughs were detected by visual observation, plethysmograph recordings, and cough sounds.
[0334] Exposure to aerosolized PBS did not induce coughing. TRE exposure did not consistently induce coughing in the animals tested until the exposure concentration equaled or exceeded 30 μg / mL. The cough response was characterized by frequent coughing bouts with a lower coughing sound compared to the typical coughing sound induced by citric acid or capsaicin. TRE at a nebulized concentration of 30 μg / mL produced consistent coughing in seven of seven guinea pigs, with one to four coughing bouts and a total cough count averaging 36 ± 9 coughs. In contrast, inhaled CRE at a nebulized concentration of 30 μg / mL did not consistently induce coughing in seven of seven guinea pigs, with one to four coughing bouts and a total cough count averaging 36 ± 9 coughs. 16 The -TR lipid nanoparticle formulation did not induce coughing in 6 of 6 guinea pigs, with no events.
[0335] The results of this study demonstrate that inhaled TRE induces cough in guinea pigs with a profile somewhat similar to that previously described for inhaled prostaglandins in guinea pigs (type II cough) (Maher and Belvisi, 2010). 16 The -TR lipid nanoparticle formulation did not induce coughing, suggesting that this formulation may eliminate some of the local adverse side effects, such as coughing, seen with inhaled TRE therapy in humans. Example 14 Acylation of Treprostinil Derivatives
[0336] Treprostinil or a treprostinil ester derivative (eg, derivatized with an alkyl or alkenyl group in the carboxylic acid moiety as prepared in Example 1) is acylated as follows.
[0337] The compound of Example 1 (0.05 mol) or Treprostinil is dissolved in 10 mL of dichloromethane at 0° C. Dimethylaminopyridine is added (20 mol%), and then a solution of acyl chloride R(CO)Cl (R is R5 or R6 as described herein) (2.1 equivalents) at 0° C. is added to the compound of Example 1 or Treprostinil. The solution is stirred and warmed to 23° C. for 1 hour. The reaction is monitored by thin layer chromatography, and if no further change is observed, the reaction is quenched with NaHCO3(sat) and the quenched mixture is extracted with dichloromethane (3×10 mL). The combined organic extracts are dried over anhydrous sodium sulfate, and the solvent is removed under vacuum to obtain the crude product. Purification is carried out by column chromatography on silica gel with 2% methanol in dichloromethane.
[0338] A general scheme for the synthesis of acylated treprostinil derivatives is shown below (R2 is depicted herein as, for example, H or a straight or branched alkyl group): [ka]
[0339] Other acylation techniques known in the art can be used, including selective acylation of each of the secondary alcohols. Additionally, R2 can be selected such that after acylation of the secondary hydroxyl functionality, the R2 group is selectively removed from the compound of Example 11. Such protecting group strategies are well known to those skilled in the art and are described, for example, in Peter GM Wutes and Theodora W. Greene, Greene's Protective Groups in Organic Synthesis, 4th Edition, Wiley (2002). (2006), which is incorporated herein by reference in its entirety for all purposes. An exemplary scheme of such a process is shown below: [ka]
[0340] C 16 Synthesis of TR-OAc: [ka]
[0341] To a solution of (1R,2R,3aS,9aS)-[[2,3,3a,4,9,9a-hexahydro-2-hydroxy-1-[(3S)-3-hydroxyoctyl]-1H-benz[f]inden-5-yl]oxy]acetic acid (treprostinil) (78.1 mg, 200 μmol) dissolved in 1,4-dioxane (2.0 mL) was added triethylamine (TEA) (98 μL, 700 μmol, 3.5 equiv.), acetic anhydride (166 μL, 1,760 μmol, 8.8 equiv.) and a catalytic amount of dimethylaminopyridine (DMAP). The reaction mixture was shaken at 40° C. for 72 h. The solvent was removed under reduced pressure to give a thick colorless oil. The crude material was dissolved in hexane and washed with a solution of saturated NaHCO3 (3×5 mL). The organic layers were combined and the solvent was removed using a gentle stream of warm N2 gas and gentle heating to give a thick colorless oil. n It was dissolved in PrOH / hexane, passed through a 0.45 μm syringe filter, and subjected to preparative HPLC purification. The solvent was removed from the purified material using a gentle stream of warm N2 gas and gentle heating to give a thick colorless oil. The pure material was suspended in ethyl lactate for storage and subjected to analytical HPLC for concentration determination.
[0342] C 16 -TR-OAc: 73% overall yield. This compound was also characterized by NMR spectroscopy:
[0343] 1H NMR (500 MHz, CDCl3) δ 0.89 (t, J = 7.0 Hz, 6H), 1.17-1.32 (m, 33H), 1.43-1.46 (m, 2H), 1.49-1.66 (m, 8H), 1.89-1.93 (m, 1H), 1.99 (s, 3H), 2.06 (s, 3H), 2.30-2.35 (m, 2h), 2.47 (dのd, J = 14.5 Hz, J = 6.0 Hz, 1H), 2.55 (dのd, J = 15.0 Hz, J = 6.0 Hz, 1H), 2.76 (d, of d, J = 14.5 Hz, J = 6.0 Hz, 1H), 2.90 (dのd, J = 15.0 Hz, J = 6.0 Hz, 1H), 4.19 (t, J = 7.0 Hz, 2H), 4.62 (s, 2H), 4.70-4.74 (m, 1H), 4.87 (p, J = 6.0 Hz, 1H), 6.63 (d, J = 8.0 Hz, 1H), 6.82 (d, J = 8.0 Hz, 1H), 7.08 (t, J = 8.0 Hz, 1H) ppm; 13 C NMR (125 MHz, CDCl3) δ 14.2, 14.3, 21.5 (2), 22.7, 22.9, 25.1, 26.0 (2), 28.3, 28.8, 29.4, 29.6, 29.7, 29.8, 29.9, 31.9, 32.1, 33.6, 33.7, 34.3, 37.8, 40.7, 49.0, 65.6, 66.2, 74.6, 79.0, 109.8, 121.8, 126.4, 127.6, 140.7, 155.1, 169.6, 171.0, 171.1 ppm. (Example 15) Synthesis of トレプロスチニルアミド inducer
[0344] Treprostinil is commercially available and can be synthesized, for example, by the method disclosed in U.S. Patent No. 6,765,117 and U.S. Patent No. 8,497,393. The synthesis of prostaglandin derivatives is described in U.S. Patent No. 4,668,814. The disclosures of U.S. Patent No. 6,765,117, U.S. Patent No. 8,497,393 and U.S. Patent No. 4,668,814 are each incorporated by reference in their entirety for all purposes.
[0345] To a solution of (1R,2R,3aS,9aS)-[[2,3,3a,4,9,9a-hexahydro-2-hydroxy-1-[(3S)-3-hydroxyoctyl]-1H-benz[f]inden-5-yl]oxy]acetic acid (i.e., treprostinil) (78.1 mg, 200 μmol) dissolved in 1,4-dioxane (2.0 mL) was added a solution of triethylamine (TEA) (98 μL, 700 μmol, 3.5 equiv.), alkylamine R1-NH2 (240 μmol, 1.2 equiv.), and PyBOP (364 mg, 700 μmol, 3.5 equiv.) dissolved in 2.0 mL MeCN (acetonitrile).
[0346] The reaction mixture was heated to 40° C. and shaken at approximately 100 rpm overnight. The solvent was removed under reduced pressure to give the crude product as a thick yellow oil. 20% n The product was extracted from the oil by repeated washing with PrOH / hexane (3×3 mL) (1-1 extraction). The solvent was removed from the organic extract using a gentle stream of warm N2 gas and gentle heating to give a thick pale yellow oil. The crude material was concentrated to 20% n It was dissolved in PrOH / hexane, passed through a 0.45 μm syringe filter, and subjected to preparative HPLC purification. The solvent was removed from the purified material using a gentle stream of warm N2 gas and gentle heating to give a thick colorless oil. The pure material was suspended in ethyl lactate for storage and subjected to analytical HPLC for concentration determination.
[0347] The following treprostinil amide derivatives of formula B were prepared according to the synthesis scheme shown above (Table 17), with the % yields shown in parentheses. [ka] [Table 17]
[0348] C6-TR-A and C 12 -TR-A was characterized by NMR spectroscopy. NMR characterization of C6-TR-A 1 H NMR (500 MHz, CDCl3) δ 0.90 (q, J = 7.0 Hz, 6 H), 1.17 (q, J = 12.0 Hz, 1H), 1.30-1.70 (m, 18 H), 1.81-1.83 (m, 1H), 1.80-1.93 (m, 1H), 2.20 (p, J = 6.0 Hz, 1H), 2.22-2.23 (m, 1H), 2.47-2.54 (m, 2H), 2.75-2.82 (m, 2H), 3.16 (sextet, J = 4.0 Hz, 1H), 3.35 (q, J = 7.0 Hz, 2H), 3.63 (s, 1H), 3.70-3.80 (m, 1H), 4.48 (s, 2H), 6.55 (s, 1H), 6.70 (d, J = 7.5 Hz, 1H), 6.85 (d, J = 7.5 Hz, 1H), 7.11 (t, J = 7.5 Hz, 1H) ppm; 13 C NMR (125 MHz, CDCl3) δ 14.2, 14.3, 22.8, 22.9, 25.6, 26.4, 26.7(2), 28.8, 29.7, 31.6, 32.1, 33.0, HRMS (ESI, 2:2:1 MeCN, MeOH, H2O): m / z = 474.35717 ([M+H] + ). NMR characterization of C12-TR-A HRMS (ESI, 2:2:1 MeCN, MeOH, H2O): m / z=558.45099([M+H] + ). (Example 16) Solubility of treprostinilamide derivatives in hydrofluoroalkane propellants.
[0349] Selected treprostinil derivatives were evaluated for use in metered dose inhalers (MDIs). Four ester derivatives, dodecyl-treprostinil (C 12 -TR), tetradecyl-treprostinil (C 14 -TR), hexadecyl-treprostinil (C 16 -TR) and branched-chain nonanyl-treprostinil (5C9-TR) and two amide derivatives, C 16 -TR-A and C 12 -TR-A (see Table 17) was tested for solubility in the hydrofluoroalkane propellants HFA-134a and HFA-227 with the addition of ethanol.
[0350] 5mg of each treprostinil compound was added to a glass bottle. A specific amount of ethanol was added by weight. An MDI valve was crimped onto each bottle, and HFA propellant was added through the valve to a total volume of 5mL. Compounds were allowed to dissolve at room temperature for 24 hours. The formulations were visually evaluated for solubility. The objective was to estimate the minimum ethanol concentration required to solubilize each compound in the propellant.
[0351] Soluble samples were present as clear, colorless solutions. Less soluble samples had thin liquid-vapor rings of various densities visible on the surface of the vial at the liquid-vapor interface. Non-soluble samples had white precipitate or crystals formed. Ethanol was added as a solubilizing aid. As can be seen from the solubility tables below (Tables 18 and 19), compounds that were not soluble in 3% added ethanol became soluble in 10 or 13% added ethanol. [Table 18] [Table 19] (Example 17) In ventilated rats, C 12 Plasma treprostinil pharmacokinetics following inhalation of an amide-linked treprostinil nanoparticle formulation
[0352] Male Sprague-Dawley rats (N=3) were anesthetized and equipped with an endotracheal tube for ventilation. The right femoral vein was cannulated to facilitate blood sampling. The rats were administered the following components: 12 -T763, a lipid nanoparticle formulation having 45 mol% TR-A, 45 mol% squalane, 10 mol% DSPE-PEG2000, was administered.
[0353] An Aeroneb® nebulizer and control unit (Aerogen, Dangan, Galway, Ireland) was used to generate aerosols with mass median aerodynamic diameters (MMAD) of 2.5 μm to 4 μm at a rate of 0.1 mL / min.
[0354] A volume of 300 μL of nebulized test article was delivered using a SAR-830 / AP small animal ventilator (CWE Inc., Ardmore, PA) set at a ventilator tidal volume (VT) of 8 mL / kg and a rate of 90 breaths / min. The target dose was 6 ug / kg treprostinil equivalent.
[0355] C 12 Nanoparticle formulation T568 (C 12 Plasma levels of treprostinil were significantly lower than those obtained with the same dose of -TR 40 mol%, squalane 40 mol%, chol-PEG2k 10 mol%, and DOPC 10 mol%), suggesting that the rate of conversion of the amide prodrug is much slower than that for the ester prodrug of treprostinil.
[0356] While the invention as described has been described with reference to specific embodiments thereof, it should be understood by those skilled in the art that various modifications can be made and equivalents can be substituted without departing from the true spirit and scope of the invention. In addition, many modifications may be made to adapt a particular situation, material, composition of matter, process, process step or steps to the intended spirit and scope of the invention as described. All such modifications are intended to be within the scope of the claims appended hereto.
[0357] All patents, patent applications, patent application publications, journal articles and protocols referenced herein are incorporated by reference in their entirety for all purposes.
Claims
[Claim 1] A composition as described in the specification.