Farnesoid X receptor agonist formulations

Abstract

Disclosed herein are pharmaceutical formulations of the farnesoid X receptor agonist 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate, and methods of using such pharmaceutical formulations in the treatment of conditions, diseases, or disorders associated with farnesoid X receptor activity.

Description

[Technical Field]

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 62 / 991,216, filed March 18, 2020, which is incorporated herein by reference in its entirety.

[0002] Described herein are spray-dried solid dispersions of farnesoid X receptor agonists, pharmaceutical formulations comprising such spray-dried solid dispersions, and methods of using such spray-dried solid dispersions and pharmaceutical formulations in the treatment of conditions, diseases, or disorders associated with farnesoid X receptor activity. [Background technology]

[0003] The farnesoid X receptor (FXR) is a nuclear receptor highly expressed in the liver, intestine, kidney, adrenal gland, and adipose tissue. FXR regulates various target genes involved in the synthesis and transport of bile acids, lipid metabolism, and the control of glucose homeostasis. Activation of FXR is a therapeutic approach for many metabolic disorders, liver diseases or conditions, inflammatory conditions, gastrointestinal disorders, or cell proliferation disorders. Summary of the Invention

[0004] In one embodiment, provided herein is a spray-dried solid dispersion comprising: (a) 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate; and (b) a pharmaceutically acceptable polymer, wherein 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is dispersed in a polymer matrix formed from the pharmaceutically acceptable polymer. In some embodiments, the pharmaceutically acceptable polymer is PVP / VA 64, PVP 30, HPMCAS-L, HPMCAS-M, HPMCAS-H, Eudragit (registered trademark) L100-55, Eudragit (registered trademark) L100, Eudragit (registered trademark) EPO, HPMC E15, HPMC E3, HPMC E5, HPMCP-HP55 and Soluplus (registered trademark)In some embodiments, the pharmaceutically acceptable polymer is selected from PVP / VA 64 and HPMCAS-M. In some embodiments, the pharmaceutically acceptable polymer is PVP / VA 64. In some embodiments, the pharmaceutically acceptable polymer is HPMCAS-M. In some embodiments, the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is 9:1 to 1:9. In some embodiments, the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is 3:1 to 1:3. In some embodiments, the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 2:1. In some embodiments, the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 1.5:1.In some embodiments, the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 1:1. In some embodiments, the spray-dried solid dispersion further comprises a non-aqueous solvent. In some embodiments, the non-aqueous solvent is selected from the group consisting of tert-butanol, n-propanol, n-butanol, isopropanol, ethanol, methanol, acetone, ethyl acetate, dimethyl carbonate, acetonitrile, dichloromethane, methyl ethyl ketone, methyl isobutyl ketone, 1-pentanol, methyl acetate, carbon tetrachloride, dimethyl sulfoxide, hexafluoroacetone, chlorobutanol, dimethyl sulfone, acetic acid, cyclohexane, and mixtures thereof. In some embodiments, the non-aqueous solvent is selected from the group consisting of ethanol, methanol, propanol, butanol, isopropanol, tert-butanol, dichloromethane, and mixtures thereof. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol. In some embodiments of the spray-dried solid dispersion, 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is substantially amorphous. In some embodiments of the spray-dried solid dispersion, 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is substantially crystalline.

[0005] In another aspect, provided herein is a pharmaceutical formulation comprising the spray-dried solid dispersion described herein, further comprising one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more binders, one or more lubricants, one or more glidants, and one or more surfactants. In some embodiments, the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, mannitol, crospovidone, and sodium stearyl fumarate. In some embodiments, the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, and colloidal silicon dioxide. In some embodiments, the pharmaceutical formulation is in the form of a tablet. In some embodiments, the tablet comprises about 1% to about 30% by weight of the spray-dried solid dispersion. In some embodiments, the tablet comprises about 5% to about 25% by weight of the spray-dried solid dispersion. In some embodiments, the tablet contains about 1% to about 20% by weight of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate. In some embodiments, the tablet contains about 1 mg, about 5 mg, about 12 mg, or about 25 mg of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate. In some embodiments, the pharmaceutical formulation is in capsule form.

[0006] In another aspect, provided herein are methods for treating or preventing a liver disease or condition in a mammal, comprising administering a therapeutically effective amount of a spray-dried solid dispersion or pharmaceutical formulation described herein to a mammal in need thereof. In some embodiments, the disease or condition is a metabolic condition. In some embodiments, the disease or condition is a hepatic condition.

[0007] In some embodiments, the spray-dried solid dispersions described herein are administered to a mammal by intravenous, subcutaneous, oral, inhalation, nasal, dermal, or ocular administration. In some embodiments, the pharmaceutical formulations described herein are administered to a mammal by intravenous, subcutaneous, oral, inhalation, nasal, dermal, or ocular administration.

[0008] In another aspect, described herein is a method for treating or preventing any one of the diseases or conditions described herein, comprising administering a therapeutically effective amount of the spray-dried solid dispersion or pharmaceutical formulation described herein to a mammal in need thereof.

[0009] In another aspect, the present specification describes a method for treating or preventing a metabolic or hepatic condition in a mammal, the method comprising administering a spray-dried solid dispersion or pharmaceutical formulation described herein to a mammal in need thereof. In other embodiments, the metabolic or hepatic condition is susceptible to treatment with an FXR agonist. In some embodiments, the method further comprises administering a second therapeutic agent to the mammal in addition to the spray-dried solid dispersion described herein or a pharmaceutically acceptable salt or solvate thereof.

[0010] In another aspect, described herein are methods for treating or preventing a liver disease or condition in a mammal, comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the liver disease or condition is alcoholic or non-alcoholic liver disease. In some embodiments, the liver disease or condition is primary biliary cirrhosis, primary sclerosing cholangitis, cholestasis, non-alcoholic steatohepatitis (NASH), or non-alcoholic fatty liver disease (NAFLD). In some embodiments, the alcoholic liver disease or condition is fatty liver (steatosis), cirrhosis, or alcoholic hepatitis. In some embodiments, the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH) or non-alcoholic fatty liver disease (NAFLD). In some embodiments, the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH). In some embodiments, the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH) and is accompanied by liver fibrosis. In some embodiments, non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH) without liver fibrosis.In some embodiments, non-alcoholic liver disease or condition is intrahepatic cholestasis or extrahepatic cholestasis.In some embodiments, liver disease or condition is steatohepatitis, cholangitis, fatty liver disease, cholestasis, cirrhosis, fibrotic liver disease, hepatitis, primary biliary cholangitis, biliary atresia, Alagille syndrome, IFALD (intestinal failure-associated liver disease), parenteral nutrition-associated liver disease (PNALD), hepatitis, hepatocellular carcinoma, cholangiocarcinoma, or combinations thereof.

[0011] In another aspect, the present specification describes a method for treating or preventing liver fibrosis in a mammal, comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein.In some embodiments, the mammal has been diagnosed with hepatitis C virus (HCV), non-alcoholic steatohepatitis (NASH), primary sclerosing cholangitis (PSC), cirrhosis, Wilson's disease, hepatitis B virus (HBV), HIV-associated steatohepatitis and cirrhosis, chronic viral hepatitis, non-alcoholic fatty liver disease (NAFLD), alcoholic steatohepatitis (ASH), primary biliary cirrhosis (PBC), or biliary cirrhosis.In some embodiments, the mammal has been diagnosed with non-alcoholic steatohepatitis (NASH).

[0012] In another aspect, described herein is a method for treating or preventing hepatitis in a mammal, comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the mammal has been diagnosed with hepatitis C virus (HCV), non-alcoholic steatohepatitis (NASH), primary sclerosing cholangitis (PSC), cirrhosis, Wilson's disease, hepatitis B virus (HBV), HIV-associated steatohepatitis and cirrhosis, chronic viral hepatitis, non-alcoholic fatty liver disease (NAFLD), alcoholic steatohepatitis (ASH), primary biliary cirrhosis (PBC), or biliary cirrhosis. In some embodiments, the mammal has been diagnosed with non-alcoholic steatohepatitis (NASH). In some embodiments, the hepatitis is associated with inflammation of the gastrointestinal tract. In some embodiments, the mammal has been diagnosed with inflammatory bowel disease.

[0013] In another aspect, the present disclosure provides a method for treating or preventing a gastrointestinal disease or condition in a mammal, comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the gastrointestinal disease or condition is necrotizing enterocolitis, gastritis, ulcerative colitis, Crohn's disease, inflammatory bowel disease, irritable bowel syndrome, gastroenteritis, radiation-induced enterocolitis, pseudomembranous colitis, chemotherapy-induced enterocolitis, gastroesophageal reflux disease (GERD), peptic ulcer, non-ulcer dyspepsia (NUD), celiac disease, intestinal celiac disease, postoperative inflammation, gastric carcinogenesis, graft-versus-host disease, or any combination thereof. In some embodiments, the gastrointestinal disease is irritable bowel syndrome (IBS), irritable bowel syndrome with diarrhea (IBS-D), irritable bowel syndrome with constipation (IBS-C), mixed IBS (IBS-M), unclassifiable IBS (IBS-U), or bile acid diarrhea (BAD).

[0014] In another aspect, described herein are methods for treating or preventing a renal disease or condition in a mammal, the methods comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the renal disease or condition is renal fibrosis, acute kidney injury, chronic kidney injury, ischemic nephropathy, diabetic nephropathy, tubulointerstitial nephritis / nephropathy, glomerulonephritis / nephropathy, or a combination thereof.

[0015] In another aspect, described herein are methods for treating or preventing a metabolic inflammation-mediated disease or disorder in a mammal, the methods comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the metabolic inflammation-mediated disease or disorder is diabetes.

[0016] In another aspect, described herein are methods for treating or preventing a lipid disease or disorder in a mammal, comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the lipid disease or disorder in the mammal is dyslipidemia.

[0017] In another aspect, described herein are methods for treating or preventing cancer in a mammal, comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the cancer is prostate cancer, colon cancer, or hepatocellular carcinoma.

[0018] In another aspect, described herein are methods for treating or preventing a disease or condition in a mammal that may benefit from treatment with an FXR agonist, the methods comprising administering to the mammal a spray-dried solid dispersion or pharmaceutical formulation described herein. In some embodiments, the methods described herein further comprise administering at least one additional therapeutic agent in addition to the spray-dried solid dispersion or pharmaceutical formulation described herein.

[0019] (Incorporated by reference) All publications and patent applications mentioned herein are incorporated by reference, to the extent applicable and relevant. [Brief explanation of the drawings]

[0020] [Figure 1] FIG. 1 shows the pharmacokinetic profiles of Compound 1 tablets A and C in monkeys. [Figure 2] FIG. 1 shows the release profiles of 12 mg tablets of Compound 1 containing 5% and 10% croscarmellose sodium. DETAILED DESCRIPTION OF THE INVENTION

[0021] The nuclear hormone receptor farnesoid X receptor (FXR, also known as nuclear receptor subfamily 1, group H, member 4 (NR1H4)) (OMIM: 603826) functions as a modulator of bile acid metabolism. FXR is a ligand-activated transcriptional receptor expressed in diverse tissues, including the adrenal gland, kidney, stomach, duodenum, jejunum, ileum, colon, gallbladder, liver, macrophages, and white and brown adipose tissue. FXR is highly expressed in tissues involved in bile acid metabolism, such as the liver, intestine, and kidney. Bile acids function as endogenous ligands for FXR, and their intestinal and systemic release induces FXR-directed changes in gene expression networks. Bile acids are the major oxidation products of cholesterol, and in some cases, when secreted into the intestine, they become modulators of cholesterol absorption. The rate-limiting step in the conversion of cholesterol to bile acids is catalyzed by the cytochrome p450 enzyme cholesterol 7-α-hydroxylase (CYP7A1) and occurs in the liver. The cytochrome p450 enzyme sterol 12-β-hydroxylase (CYP8B1) mediates the production of cholic acid and determines the relative amounts of the two major bile acids, cholic acid and chenodeoxycholic acid. FXR activation can suppress the transcription of CYP7A1 and CYP8B1 by increasing the expression levels of small heterodimer partner (SHP) (also known as nuclear receptor subfamily 0, group B, member 2, or NR0B2) in the liver and the intestinal expression of fibroblast growth factor 15 (FGF15) in mice and fibroblast growth factor 19 (FGF19) in humans. SHP suppresses the transcription factors liver receptor homolog 1 (LRH-1) and hepatocyte nuclear factor 4α (HNFα4), which regulate CYP7A1 and CYP8B1 gene expression. The repression of CYP8B1 by FXR may be species-specific, and activation of FXR may increase CYP8B1 expression in humans in some cases (Sanyal et al., PNAS, 2007, 104, 15665). In some cases, FGF15 / 19 released from the intestine subsequently activates fibroblast growth factor receptor 4 in the liver, leading to activation of the mitogen-activated protein kinase (MAPK) signaling pathway, which suppresses CYP7A1 and CYP8B1.

[0022] In some embodiments, elevated bile acid concentrations are associated with insulin resistance. For example, insulin resistance can lead to decreased glucose uptake from the blood and increased de novo glucose production in the liver. In some cases, intestinal sequestration of bile acids has been shown to improve insulin resistance by promoting the secretion of glucagon-like peptide-1 (GLP1) from intestinal L-cells. GLP-1 is an incretin derived from the transcription product of the proglucagon gene. It is released in response to food intake, regulates appetite and gastrointestinal function, and promotes insulin secretion from the pancreas. Biologically active forms of GLP-1 include GLP-1-(7-37) and GLP-1-(7-36)NH2, which result from selective cleavage of the proglucagon molecule. In such cases, activation of FXR, leading to decreased bile acid production, is associated with reduced insulin resistance.

[0023] In some embodiments, the activation of FXR is also associated with the secretion of pancreatic polypeptide folding, such as peptide YY (PYY or PYY3-36).In some cases, peptide YY is a gut hormone peptide that regulates neuronal activity in the hypothalamus and brainstem, which are brain regions involved in reward processing.In some cases, reduced PYY concentration is associated with increased appetite and weight gain.

[0024] In some cases, activation of FXR indirectly leads to a decrease in plasma triglycerides. Clearance of triglycerides from the bloodstream is via lipoprotein lipase (LPL). LPL activity is enhanced by induction of its activator, apolipoprotein CII, and suppression of its inhibitor, apolipoprotein CIII, in the liver occurs upon FXR activation.

[0025] In some cases, activation of FXR further regulates energy expenditure, such as the differentiation and function of adipocytes. Adipose tissue contains adipocytes or fat cells. In some cases, adipocytes further differentiate into brown adipose tissue (BAT) or white adipose tissue (WAT). The function of BAT is to generate body heat, while WAT functions as a fat storage tissue.

[0026] In some cases, FXR is widely expressed in the intestine. In some instances, activation of FXR has been shown to induce the expression and secretion of FGF19 (or FGF15 in mice) in the intestine. FGF19 is a hormone that regulates bile acid synthesis and influences glucose metabolism, lipid metabolism, and energy expenditure. In some cases, FGF19 has also been observed to regulate adipocyte function and differentiation. Indeed, one study showed that administration of FGF19 to mice fed a high-fat diet increased energy expenditure, regulated adipocyte differentiation and function, reversed weight gain, and improved insulin resistance (see Fu et al., “Fibroblast growth factor 19 increases metabolic rate and reverses dietary and leptin-deficient diabetes,” Endocrinology 145:2594-2603 (2004)).

[0027] In some cases, intestinal FXR activity has been shown to be involved in reducing microbiome overgrowth, such as during feeding (Li et al., NatCommun 4:2384, 2013). For example, one study showed that FXR activation was associated with increased expression of several genes in the ileum, including Ang2, iNos, and Il18, which have established antibacterial properties (Inagaki et al., Proc Natl Acad Sci USA 103:3920-3925, 2006).

[0028] In some instances, FXR is involved in intestinal barrier function and immune regulation. FXR regulates the transcription of genes involved in the synthesis, transport, and metabolism of bile salts in the liver and intestine, which in some instances has been shown to improve intestinal inflammation and prevent bacterial translocation into the intestinal tract (Gadaleta et al., Gut., April 2011, 60(4):463-72).

[0029] In some cases, overproduction of bile acids or inadequate transport and recycling of bile acids can lead to diarrhea. FXR regulates the transcription of genes involved in bile salt synthesis, transport, and metabolism in the liver and intestine, leading to improvement of diarrhea in some cases (Camilleri, Gut Liver. 2015 May, 9(3):332-339).

[0030] G protein-coupled bile acid receptor 1 (GPBAR2, GPCR19, also known as membrane-type bile acid receptor or M-BAR, or TGR5) is a cell surface receptor for bile acids. Upon activation by bile acids, TGR5 induces intracellular cAMP production, which activates the deiodinase enzyme DIO2 in BAT, resulting in an increase in triiodothyronine, which in turn increases energy expenditure.

[0031] Thus, in some embodiments, the regulation of metabolic processes such as bile acid synthesis, bile acid cycling, glucose metabolism, lipid metabolism, or insulin sensitivity is regulated by activation of FXR. Furthermore, in some embodiments, dysregulation of metabolic processes such as bile acid synthesis, bile acid cycling, glucose metabolism, lipid metabolism, or insulin sensitivity results in metabolic diseases such as diabetes or diabetes-related conditions or disorders, alcoholic or non-alcoholic liver diseases or conditions, intestinal inflammation, or cell proliferative disorders.

[0032] Disclosed herein, in certain embodiments, are compounds that have activity as FXR agonists. In some embodiments, the FXR agonists described herein are structurally distinct from bile acids, other synthetic FXR ligands, and other natural FXR ligands.

[0033] Also disclosed herein, in some embodiments, are methods for treating or preventing metabolic disorders such as diabetes, obesity, impaired glucose tolerance, dyslipidemia, or insulin resistance by administering a therapeutically effective amount of an FXR agonist. In some instances, the compound is administered to the gastrointestinal tract of a subject.

[0034] In a further embodiment, disclosed herein is a method for treating or preventing an alcoholic or non-alcoholic liver disease or condition (e.g., cholestasis, primary biliary cirrhosis, steatosis, cirrhosis, alcoholic hepatitis, non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), primary sclerosing cholangitis (PSC), or elevated liver enzymes) by administering a therapeutically effective amount of an FXR agonist to a subject in need thereof (e.g., via the gastrointestinal tract). In a further embodiment, disclosed herein is a method for treating or preventing cholestasis, cirrhosis, primary biliary cirrhosis, non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), or primary sclerosing cholangitis (PSC) by administering a therapeutically effective amount of an FXR agonist to a subject in need thereof. In some embodiments, what is disclosed herein includes a method for treating or preventing cholestasis by administering a therapeutically effective amount of an FXR agonist to a subject in need thereof. In some embodiments, what is disclosed herein includes a method for treating or preventing primary biliary cirrhosis by administering a therapeutically effective amount of an FXR agonist to a subject in need thereof. In some embodiments, what is disclosed herein includes a method for treating or preventing NASH by administering a therapeutically effective amount of an FXR agonist to a subject in need thereof. In some embodiments, what is disclosed herein includes a method for treating or preventing NAFLD by administering a therapeutically effective amount of an FXR agonist to a subject in need thereof.

[0035] In further embodiments, what is disclosed herein includes a method of treating or preventing inflammation in the intestine and / or cell proliferative disorders such as cancer by administering (e.g., via the gastrointestinal tract) a therapeutically effective amount of an FXR agonist to a subject in need thereof.

[0036] In further embodiments, the present disclosure includes FXR agonists that modulate one or more proteins or genes associated with metabolic processes such as bile acid synthesis, glucose metabolism, lipid metabolism, or insulin sensitivity, e.g., increasing the activity of FGF19 (FGF15 in mice), increasing the secretion of GLP-1, or increasing the secretion of PYY.

[0037] 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate (Compound 1) Described herein is the FXR agonist compound 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate (Compound 1). "Compound 1" or "4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate" refers to a compound having the following structure:

[0038] [ka]

[0039] In some embodiments, Compound 1 is in the form of a pharmaceutically acceptable salt. In some embodiments, Compound 1 is a free base. Additionally, Compound 1 can exist in unsolvated forms and solvated forms with pharmaceutically acceptable solvents such as water, ethanol, and the like. The solvated forms of Compound 1 presented herein are also considered to be disclosed herein. In some embodiments, Compound 1 is solvated. In some embodiments, Compound 1 is unsolvated. In some embodiments, Compound 1 is crystalline. In some embodiments, Compound 1 is amorphous.

[0040] Compound 1 has a non-bile acidic chemical structure. In some embodiments, Compound 1 has sustained exposure when administered to a mammal. In some embodiments, Compound 1 has continuous target engagement with FXR. In some embodiments, Compound 1 is suitable for once-daily oral administration.

[0041] Obeticholic acid (OCA) is an FXR agonist that contains the chemical structure of a bile acid. Published clinical studies have demonstrated clinical efficacy of OCA as an FXR agonist, but it is associated with adverse side effects at high doses, including itching, increased LDL cholesterol, and liver toxicity. In some embodiments, Compound 1 exhibited at least 30-fold greater potency than OCA in a suitable in vitro assay assessing the binding of FXR agonists to FXR. In some embodiments, the increased potency of Compound 1 indicates a broader potential therapeutic window compared to OCA.

[0042] In some embodiments, Compound 1 has demonstrated sustained FXR engagement in preclinical animal models based on pharmacokinetic and pharmacodynamic markers. In some embodiments, Compound 1 demonstrates sustained FXR engagement, allowing for once-daily administration of Compound 1.

[0043] As used herein, "pharmaceutically acceptable" refers to a material, such as a carrier or diluent, that does not abrogate the biological activity or properties of the compound and that is relatively non-toxic, i.e., the material may be administered to an individual without causing undesired biological effects or interacting in a deleterious manner with any of the components of the composition in which it is contained.

[0044] The term "pharmaceutically acceptable salt" refers to a form of a therapeutically active agent that consists of the cationic form of the therapeutically active agent combined with a suitable anion, or in another embodiment, the anionic form of the therapeutically active agent combined with a suitable cation. Handbook of Pharmaceutical Salts: Properties, Selection and Use. International Union of Pure and Applied Chemistry, Wiley-VCH 2002. S.M. Berge, L.D.Bighley, D.C. Monkhouse, J.Pharm.Sci. 1977, 66, 1-19. P.H. Stahl and C.G. Wermuth, Handbook of Pharmaceutical Salts: Properties, Selection and Use, Weinheim / Zuerich: Wiley-VCH / VHCA, 2002. Pharmaceutical salts are typically more soluble and rapidly dissolving in gastric and intestinal fluids than non-ionic species, making them useful in solid dosage forms. Furthermore, their solubility is often a function of pH, allowing for selective dissolution in one part of the gastrointestinal tract or another, an ability that can be manipulated as an aspect of delayed- and sustained-release behavior. Also, salt-forming molecules can be in equilibrium with their neutral forms, allowing for tailored passage through biological membranes.

[0045] It should be understood that a reference to a pharmaceutically acceptable salt includes solvent addition forms. In some embodiments, solvates contain either stoichiometric or non-stoichiometric amounts of solvent, and are formed during the process of isolating or purifying a compound using a pharmaceutically acceptable solvent such as water, ethanol, etc. When the solvent is water, a hydrate is formed, and when the solvent is alcohol, an alcoholate is formed. Solvates of the compounds described herein can be conveniently prepared or formed during the process described herein. Furthermore, the compounds provided herein can optionally exist in unsolvated and solvated forms.

[0046] Specific Terms Unless otherwise stated, the following terms used in this application have the definitions set forth below. The use of the term "including" and other forms such as "include," "includes," "included," etc. is not limiting. The term "about," when referring to a number or numerical range, means that the referenced number or numerical range is approximate within experimental variation (or within statistical experimental error), and thus the number or numerical range may vary from 1% to 15% of the specified number or numerical range. The section headings used herein are for organizational purposes only and should not be construed as limiting the subject matter described.

[0047] The term "acceptable" as used herein with respect to a formulation, composition, or ingredient means having no lasting adverse effects on the general health of the subject being treated.

[0048] The term "modulate," as used herein, means to interact with a target directly or indirectly so as to alter the activity of the target, and includes, by way of example only, enhancing the activity of the target, inhibiting the activity of the target, limiting the activity of the target, or enhancing the activity of the target.

[0049] The term "modulator," as used herein, refers to a molecule that interacts directly or indirectly with a target. Interactions include, but are not limited to, those of an agonist, partial agonist, inverse agonist, antagonist, degrader, or combinations thereof. In some embodiments, the modulator is an agonist.

[0050] As used herein, the terms "administer," "administering," "administration," and the like refer to methods that can be used to deliver a compound or composition to a desired site of biological action. These methods include, but are not limited to, oral routes, intraduodenal routes, parenteral injection (including intravenous, subcutaneous, intraperitoneal, intramuscular, intravascular, or infusion), topical, and rectal administration. Those skilled in the art are familiar with the administration techniques that can be used with the compounds and methods described herein. In some embodiments, the compounds and compositions described herein are administered orally.

[0051] As used herein, the term "co-administration" and the like is meant to encompass the administration of selected therapeutic agents to a single patient and is intended to include therapeutic regimens in which the agents are administered by the same or different routes of administration or at the same or different times.

[0052] As used herein, the term "effective amount" or "therapeutically effective amount" refers to a sufficient quantity of an administered drug or compound to relieve to some extent one or more of the symptoms of the disease or condition being treated. The results include reduction and / or alleviation of the signs, symptoms, or causes of the disease, or other desired alteration of a biological system. For example, an "effective amount" for therapeutic use is the amount of a composition comprising a compound disclosed herein required to provide a clinically significant reduction in disease symptoms. An appropriate "effective" amount in any individual case is optionally determined using techniques such as a dose escalation study.

[0053] The terms "enhance" or "enhancing," as used herein, means to increase or prolong either in potency or duration a desired effect. Thus, in regard to enhancing the effect of therapeutic agents, the term "enhancing" refers to the ability to increase or prolong, either in potency or duration, the effect of other therapeutic agents on a system. An "enhancing-effective amount," as used herein, refers to an amount sufficient to enhance the effect of another therapeutic agent in a desired system.

[0054] As used herein, the term "pharmaceutical combination" refers to a product resulting from the mixing or combination of multiple active ingredients, including both fixed and non-fixed combinations of active ingredients. The term "fixed combination" means that both active ingredients, such as Compound 1 or a pharmaceutically acceptable salt thereof, and co-agents are administered to a patient simultaneously in the form of a single entity or dosage. The term "unfixed combination" means that the active ingredients, such as Compound 1 or a pharmaceutically acceptable salt thereof, and co-agents are administered to a patient simultaneously, in parallel, or sequentially without a specific intervening time, as separate entities, such that such administration provides effective levels of the two compounds in the patient's body. The latter also applies to cocktail therapy, such as the administration of three or more active ingredients.

[0055] The terms "kit" and "article of manufacture" are used synonymously.

[0056] The term "subject" or "patient" encompasses mammals. Examples of mammals include, but are not limited to, any member of the mammalian class: humans, non-human primates such as chimpanzees and other ape and monkey species, livestock such as cows, horses, sheep, goats, pigs, domestic animals such as rabbits, dogs, cats, laboratory animals including rodents such as rats, mice, guinea pigs, etc. In one embodiment, the mammal is a human.

[0057] As used herein, the terms "treat," "treating," or "treatment" include alleviating, reducing, or ameliorating at least one symptom of a disease or condition, preventing additional symptoms, inhibiting a disease or condition, e.g., halting the progression of a disease or condition, relieving a disease or condition, causing regression of a disease or condition, alleviating conditions caused by a disease or condition, or arresting the symptoms of a disease or condition prophylactically and / or therapeutically.

[0058] Pharmaceutical Composition In some embodiments, the spray-dried solid dispersion of Compound 1 described herein is formulated into a pharmaceutical composition. Pharmaceutical compositions are formulated in a conventional manner using one or more pharmaceutically acceptable inactive ingredients that facilitate the processing of the active compound into a pharmaceutical preparation. Suitable formulations depend on the selected route of administration. Summaries of pharmaceutical compositions described herein can be found, for example, in Remington: The Science and Practice of Pharmacy, 19th Edition (Easton, Pa.: Mack Publishing Company, 1995), Hoover, John E., Remington's Pharmaceutical Sciences (Mack Publishing Co., Easton, Pennsylvania 1975), Liberman, HA and Lachman, L., Pharmaceutical Dosage Forms (Marcel Decker, New York, NY, 1980), and Pharmaceutical Dosage Forms and Drug Delivery Systems, 7th Edition (Lippincott Williams & Wilkins, 1999), which are incorporated herein by reference for their disclosure.

[0059] In some embodiments, the spray-dried solid dispersion of Compound 1 described herein is administered alone or in combination with a pharmaceutically acceptable carrier, excipient, or diluent in a pharmaceutical composition. The administration of the spray-dried solid dispersion of Compound 1 described herein and pharmaceutical compositions thereof can be effected by any method that allows delivery of the compound to the site of action. These methods include, but are not limited to, oral administration.

[0060] In some embodiments, pharmaceutical compositions of Compound 1 suitable for oral administration are presented as discrete units such as capsules, cachets or tablets, each containing a predetermined amount of the active ingredient as a powder or granules.

[0061] Orally usable pharmaceutical compositions include tablets, push-fit capsules made of gelatin, and soft, sealed capsules made of gelatin and a plasticizer such as glycerol or sorbitol. Tablets can be made by compression or molding, optionally with one or more accessory ingredients. Compressed tablets can be prepared by compressing in a suitable machine the active ingredient in a free-flowing form, such as a powder or granules, optionally mixed with a binder, inert diluent, or lubricant, surfactant, or dispersant. Molded tablets can be made by molding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. In some embodiments, tablets are coated or scored to provide slow or controlled release of the active ingredient therein. All formulations intended for oral administration should be in dosages suitable for such administration. Push-fit capsules can contain the active ingredient mixed with a filler such as lactose, a binder such as starch, and / or a lubricant such as talc or magnesium stearate, and optionally, stabilizers. In soft capsules, the active compound can be dissolved or suspended in a suitable liquid, such as fatty oils, liquid paraffin, or liquid polyethylene glycol. In some embodiments, stabilizers are added. The dragee cores are coated with a suitable coating. For this purpose, gum arabic, talc, polyvinylpyrrolidone, carbopol gel, polyethylene glycol, and / or titanium dioxide, lacquer solutions, and concentrated sugar solutions, which may optionally contain suitable organic solvents or solvent mixtures, can be used. Dyes or pigments can be added to tablets or dragee coatings to identify or characterize different combinations of active compound doses.

[0062] Conventional techniques for producing solid oral dosage forms include, but are not limited to, one or a combination of the following methods: (1) dry blending, (2) direct compression, (3) milling, (4) dry or non-aqueous granulation, or (5) wet granulation. See, e.g., Lachman et al., *The Theory and Practice of Industrial Pharmacy* (1986). Other methods include, for example, spray drying, pan coating, melt granulation, granulation, fluidized bed spray drying or coating (e.g., Wurster coating), tangential coating, top spray, tabletting, extrusion, etc.

[0063] It will be understood that in addition to the ingredients particularly mentioned above, the compounds and compositions described herein may include other agents conventional in the art having regard to the type of formulation in question, e.g., those suitable for oral administration may include flavoring agents.

[0064] Provided is a tablet comprising Compound 1 or a pharmaceutically acceptable salt thereof. In some embodiments, the tablet comprises Compound 1 dispersed in a polymer matrix formed from a pharmaceutically acceptable polymer, one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more lubricants, one or more glidants, and optionally one or more film coatings.

[0065] In some embodiments, described herein are spray-dried solid dispersions comprising (a) Compound 1 and (b) a pharmaceutically acceptable polymer, wherein Compound 1 is dispersed in a polymer matrix formed from the pharmaceutically acceptable polymer.

[0066] Described herein, in some embodiments, are tablets prepared using the spray-dried solid dispersions described herein.

[0067] Compound 1: Spray-dried solid dispersion formulation In some embodiments described herein, the pharmaceutical composition of Compound 1 is a spray-dried solid dispersion formulation. In some embodiments, provided herein is a spray-dried solid dispersion comprising (a) 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate and (b) a pharmaceutically acceptable polymer, wherein 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is dispersed in a polymer matrix formed from the pharmaceutically acceptable polymer. In some embodiments, the pharmaceutically acceptable polymer is PVP / VA 64, PVP 30, HPMCAS-L, HPMCAS-M, HPMCAS-H, Eudragit (registered trademark) L100-55, Eudragit (registered trademark) L100, Eudragit (registered trademark) EPO, HPMC E15, HPMC E3, HPMC E5, HPMCP-HP55, and SolPlus (registered trademark) In some embodiments, the pharmaceutically acceptable polymer is selected from PVP / VA 64 and HPMCAS-M. In some embodiments, the pharmaceutically acceptable polymer is PVP / VA 64. In some embodiments, the pharmaceutically acceptable polymer is HPMC-AS-M. In some embodiments, the pharmaceutically acceptable polymer is PVP 30. In some embodiments, the pharmaceutically acceptable polymer is HPMC-AS-L. In some embodiments, the pharmaceutically acceptable polymer is HPMC-AS-H. In some embodiments, the pharmaceutically acceptable polymer is Eudragit (registered trademark)In some embodiments, the pharmaceutically acceptable polymer is Eudragit L100-55. (registered trademark) In some embodiments, the pharmaceutically acceptable polymer is Eudragit L100. (registered trademark) In some embodiments, the pharmaceutically acceptable polymer is HPMC E15. In some embodiments, the pharmaceutically acceptable polymer is HPMC E3. In some embodiments, the pharmaceutically acceptable polymer is HPMC E5. In some embodiments, the pharmaceutically acceptable polymer is HPMCP-HP55. In some embodiments, the pharmaceutically acceptable polymer is Soluplus (registered trademark)In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 9:1 to 1:9. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 7:1 to 1:7. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 5:1 to 1:5. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 4:1 to 1:4. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 3:1 to 1:3. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 2:1 to 1:2. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 4:1. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 3:1. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 2:1. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 1.5:1. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 1:1. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 1:1.5. In some embodiments, the weight ratio of Compound 1 to the pharmaceutically acceptable polymer is 1:2. In some embodiments, the spray-dried solid dispersion further comprises a non-aqueous solvent. In some embodiments, the non-aqueous solvent is selected from tert-butanol, n-propanol, n-butanol, isopropanol, ethanol, methanol, acetone, ethyl acetate, dimethyl carbonate, acetonitrile, dichloromethane, methyl ethyl ketone, methyl isobutyl ketone, 1-pentanol, methyl acetate, carbon tetrachloride, dimethyl sulfoxide, hexafluoroacetone, chlorobutanol, dimethyl sulfone, acetic acid, cyclohexane, and mixtures thereof. In some embodiments, the non-aqueous solvent is selected from the group consisting of ethanol, methanol, propanol, butanol, isopropanol, tert-butanol, dichloromethane, and mixtures thereof.In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 15 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 14 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 13 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 12 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 11 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 10 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 9 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 8 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 7 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 6 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 5 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 4 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 3 / 1.In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 2 / 1. In some embodiments, the non-aqueous solvent is a mixture of dichloromethane and methanol, wherein the weight ratio of dichloromethane to methanol is about 1 / 1. In some embodiments of the spray-dried solid dispersion, Compound 1 is substantially amorphous.

[0068] In another aspect, provided herein is a pharmaceutical formulation comprising the spray-dried solid dispersion described herein, further comprising one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more binders, one or more lubricants, one or more glidants, and one or more surfactants. In some embodiments, the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, mannitol, crospovidone, and sodium stearyl fumarate. In some embodiments, the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, and colloidal silicon dioxide. In some embodiments, the pharmaceutical formulation is in the form of a tablet. In some embodiments, the pharmaceutical formulation is in the form of a capsule.

[0069] In one embodiment, described herein is a tablet comprising Compound 1 or a pharmaceutically acceptable salt thereof dispersed in a polymeric matrix formed from a pharmaceutically acceptable polymer, one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more lubricants, one or more glidants, and optionally one or more film coatings.

[0070] In some embodiments, Compound 1 or a pharmaceutically acceptable salt thereof dispersed in a polymer matrix formed from a pharmaceutically acceptable polymer is a spray-dried solid dispersion described herein.

[0071] In some embodiments, the tablet comprises about 1% to about 15% by weight of Compound 1. In some embodiments, the tablet comprises about 1% to about 20% by weight of a polymer matrix formed from a pharmaceutically acceptable polymer.

[0072] In some embodiments, the tablet comprises about 1% to about 15% by weight of Compound 1 dispersed in about 0.5% to about 10% by weight of a polymer matrix formed from a pharmaceutically acceptable polymer.

[0073] In some embodiments, the tablet comprises about 1% to about 15% by weight of Compound 1 dispersed in about 0.5% to about 10% by weight of a polymer matrix formed from a pharmaceutically acceptable polymer, about 70% to about 99% by weight of one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more lubricants, one or more glidants, and optionally less than about 2% by weight of one or more film coating agents.

[0074] In some embodiments, the tablet comprises about 1% to about 30% by weight of the spray-dried solid dispersion. In some embodiments, the tablet comprises about 5% to about 25% by weight of the spray-dried solid dispersion. In some embodiments, the tablet comprises about 5% to about 20% by weight of the spray-dried solid dispersion. In some embodiments, the tablet comprises about 5% to about 15% by weight of the spray-dried solid dispersion. In some embodiments, the tablet comprises about 5% to about 10% by weight of the spray-dried solid dispersion.

[0075] In some embodiments, the additional excipients in the tablet, in addition to the spray-dried solid dispersion, include one or more diluents, one or more disintegrants, one or more lubricants, one or more glidants, or any combination thereof. In some embodiments, the additional excipients in the tablet, in addition to the spray-dried solid dispersion, include microcrystalline cellulose, mannitol, crospovidone, colloidal silicon dioxide, and magnesium stearate.

[0076] In some embodiments, the tablet comprises one or more fillers / binders / diluents selected from celluloses (e.g., microcrystalline cellulose, carboxymethylcellulose, ethylcellulose, and methylcellulose), starch, gelatin, sugars (e.g., sucrose, glucose, dextrose, mannitol, and lactose), natural and synthetic gums (e.g., acacia, sodium alginate, breadwort gum, and ghatti gum), polyvinylpyrrolidinone, polyethylene glycol, waxes, and any combination thereof. In some embodiments, the tablet comprises microcrystalline cellulose and lactose monohydrate.

[0077] In some embodiments, one or more fillers / binders / diluents in a tablet described herein comprise about 40% to about 95% by weight of the total tablet weight. In some embodiments, one or more fillers / binders / diluents in a tablet described herein comprise about 60% to about 95% by weight of the total tablet weight. In some embodiments, one or more fillers / binders / diluents in a tablet described herein comprise about 65% to about 95% by weight of the total tablet weight. In some embodiments, one or more fillers / binders / diluents in a tablet described herein comprise about 75% to about 95% by weight of the total tablet weight. In some embodiments, one or more fillers / binders / diluents in a tablet described herein comprise about 50%, about 55%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, or about 95% by weight of the total tablet weight. In some embodiments, the one or more fillers / binders / diluents in the tablets described herein comprise about 58% by weight of the total tablet weight, hi some embodiments, less than 95%, less than 85%, less than 75%, less than 65%, or less than 60% by weight of the total tablet weight comprises one or more fillers / binders / diluents.

[0078] In some embodiments, the tablet comprises one or more disintegrants selected from croscarmellose sodium, crospovidone, sodium starch glycolate, Veegum HV, methylcellulose, agar, bentonite, cellulose, carboxymethylcellulose, and any combination thereof. In some embodiments, the tablet comprises croscarmellose sodium.

[0079] In some embodiments, one or more disintegrants in a tablet described herein comprise about 2% to about 20% by weight of the total tablet weight. In some embodiments, one or more disintegrants in a tablet described herein comprise about 5% to about 10% by weight of the total tablet weight. In some embodiments, one or more disintegrants in a tablet described herein comprise about 5%, about 6%, about 7%, about 8%, about 9%, about 10%, about 11%, about 12%, about 13%, about 14%, about 15%, about 16%, about 17%, about 18%, about 19%, or about 20% by weight of the total tablet weight. In some embodiments, one or more disintegrants in a tablet described herein comprise about 5% by weight of the total tablet weight. In some embodiments, one or more disintegrants in a tablet described herein comprise about 10% by weight of the total tablet weight. In some embodiments, less than 20% by weight of the tablet's total weight comprises one or more disintegrants.

[0080] In some embodiments, the tablet comprises one or more lubricants selected from talc, magnesium stearate, calcium stearate, stearic acid, sodium stearyl fumarate, glyceryl behenate, hydrogenated vegetable oil, polyethylene glycol, and any combination thereof. In some embodiments, the tablet comprises magnesium stearate.

[0081] In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1% to about 5% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1% to about 2% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1% to about 1% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1%, about 0.2%, about 0.3%, about 0.4%, about 0.5%, about 0.6%, about 0.7%, about 0.8%, about 0.9%, or about 1% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 1% by weight of the total tablet weight. In some embodiments, less than 2% by weight of the total tablet weight comprises one or more lubricants.

[0082] In some embodiments, the tablet contains one or more glidants. Glidants are substances added to powders to improve flowability. Examples of glidants include magnesium stearate, colloidal silicon dioxide, starch, and talc. In some embodiments, the tablet contains colloidal silicon dioxide.

[0083] In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1% to about 5% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1% to about 2% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 0.5% to about 1.5% by weight of the total tablet weight. In some embodiments, one or more lubricants in a tablet described herein comprise about 0.1%, about 0.2%, about 0.3%, about 0.4%, about 0.5%, about 0.6%, about 0.7%, about 0.8%, about 0.9%, about 1%, about 1.1%, about 1.2%, about 1.3%, about 1.4%, about 1.5%, about 1.6%, about 1.7%, about 1.8%, about 1.9%, or about 2% by weight of the total tablet weight. In some embodiments, the one or more lubricants in the tablets described herein comprise about 1% by weight of the total tablet weight, hi some embodiments, less than 2% by weight of the total tablet weight comprises one or more lubricants.

[0084] Additional excipients In some embodiments, the tablets described herein contain additional excipients, including but not limited to buffers, glidants, preservatives, and colorants. Additional excipients such as bulking agents, tonicity agents, and chelating agents are within the scope of the embodiments.

[0085] Non-limiting examples of buffering agents include, but are not limited to, sodium bicarbonate, potassium bicarbonate, magnesium hydroxide, magnesium lactate, magnesium gluconate, aluminum hydroxide, aluminum hydroxide / sodium bicarbonate coprecipitate, mixtures of amino acids and buffers, mixtures of aluminum glycinate and buffers, mixtures of acid salts of amino acids and buffers, and mixtures of alkali salts of amino acids and buffers. Additional buffering agents include sodium citrate, sodium tartrate, sodium acetate, sodium carbonate, sodium polyphosphate, potassium polyphosphate, sodium pyrophosphate, potassium pyrophosphate, disodium hydrogen phosphate, dipotassium hydrogen phosphate, trisodium phosphate, tripotassium phosphate, sodium acetate, potassium metaphosphate, magnesium oxide, hydroxides including magnesium carbonate, magnesium silicate, calcium acetate, calcium glycerophosphate, calcium chloride, calcium hydroxide, calcium lactate, calcium carbonate, calcium bicarbonate, and other calcium salts.

[0086] In some embodiments, the tablets described herein contain a preservative. Preservatives include antibacterial agents, antioxidants, and agents that enhance sterility. Examples of preservatives include ascorbic acid, ascorbyl palmitate, BHA, BHT, citric acid, erythorbic acid, fumaric acid, malic acid, propyl gallate, sodium ascorbate, sodium bisulfate, sodium metabisulfite, sodium sulfite, parabens (methyl-, ethyl-, butyl-), benzoic acid, potassium sorbate, vanillin, etc.

[0087] In some embodiments, the tablets described herein contain a coloring agent for identification of the resulting liquid form and / or for aesthetic purposes. Suitable coloring agents include, for example, FD&C Red No. 3, FD&C Red No. 20, FD&C Red No. 40, FD&C Yellow No. 6, FD&C Blue No. 2, D&C Green No. 5, D&C Orange No. 5, caramel, iron oxide, and mixtures thereof.

[0088] In tablet embodiments, additional excipients are contemplated. These additional excipients are selected based on their function and compatibility with the tablet compositions described herein and can be found, for example, in Remington: The Science and Practice of Pharmacy, 19th Edition (Easton, PA: Mack Publishing Company, 1995), Hoover, John E., Remington's Pharmaceutical Sciences (Easton, PA: Mack Publishing Co 1975), Liberman, HA and Lachman, L., Pharmaceutical Dosage Forms (New York, NY: Marcel Decker 1980), and Pharmaceutical Dosage Forms and Drug Delivery Systems, 7th Edition (Lippincott Williams & Wilkins 1999), which are incorporated herein by reference in their entirety.

[0089] In a further embodiment, the tablets described herein are coated tablets, such as enteric coated tablets, sugar coated tablets, or film coated tablets.

[0090] In one embodiment, the individual unit doses also include a film coating that disintegrates upon oral ingestion or contact with diluent. In one embodiment, these formulations are manufactured by conventional techniques.

[0091] Compressed tablets are solid dosage forms prepared by compressing the bulk blend formulation described above. In various embodiments, compressed tablets designed to dissolve in the mouth contain one or more flavoring agents. In other embodiments, compressed tablets contain a film surrounding the final compressed tablet. In some embodiments, the film coating aids patient compliance (e.g., Opadry® coating or sugar coating). Film coatings, including Opadry®, typically range from about 1% to about 5% of the tablet weight. In other embodiments, compressed tablets contain one or more excipients.

[0092] Provided herein are film-coated tablet forms that include an active ingredient (e.g., Compound 1 or a pharmaceutically acceptable salt thereof) in combination with one or more tableting excipients to form a tablet core and subsequently coat the core. The tablet core is manufactured using conventional tableting processes, followed by compression and coating.

[0093] An enteric coating is a coating that resists the action of stomach acid but dissolves or disintegrates in the intestine.

[0094] In one embodiment, the oral solid dosage form disclosed herein comprises an enteric coating.The enteric coating comprises one or more of cellulose acetate phthalate, methyl acrylate-methacrylic acid copolymer, cellulose acetate succinate, hydroxypropyl methylcellulose phthalate, hydroxypropyl methylcellulose acetate succinate (hypromellose acetate succinate), polyvinyl acetate phthalate (PVAP), methyl methacrylate-methacrylic acid copolymer, methacrylic acid copolymer, cellulose acetate (and its succinic and phthalic acid versions), styrene maleic acid copolymer, polymethacrylic acid / acrylic acid copolymer, hydroxyethyl ethylcellulose phthalate, hydroxypropyl methylcellulose acetate succinate, cellulose acetate tetrahydrophthalate, acrylic resin, and shellac.

[0095] An enteric coating is a coating applied to tablets, pills, capsules, pellets, beads, granules, particles, etc. to prevent them from dissolving until they reach the small intestine.

[0096] Sugar-coated tablets are compressed tablets that have been coated with sugar to mask any unpleasant tastes or odors and to help protect the tablets from oxidation.

[0097] Film-coated tablets are compressed tablets covered with a thin layer or film of a water-soluble substance. Film coatings include, but are not limited to, hydroxyethylcellulose, sodium carboxymethylcellulose, polyethylene glycol 4000, and cellulose acetate phthalate. Film coatings impart the same general properties as sugar coatings. Multiple-compressed tablets are compressed tablets produced by multiple compression cycles, including layered tablets and press-coated or dry-coated tablets. In some embodiments, tablets are coated with a water-soluble, pH-independent film coating that allows for immediate disintegration for rapid active release (e.g., Opadry products).

[0098] Tablet dosage In some embodiments, the amount of Compound 1 in the tablet is between about 1 mg and about 25 mg. In some embodiments, the amount of Compound 1 in the tablet is about 1 mg. In some embodiments, the amount of Compound 1 in the tablet is about 5 mg. In some embodiments, the amount of Compound 1 in the tablet is about 12 mg. In some embodiments, the amount of Compound 1 in the tablet is about 25 mg.

[0099] Administration Methods and Treatment Regimen In one embodiment, Compound 1 described herein, or a pharmaceutically acceptable salt thereof, is used in the preparation of a medicament for treating a disease or condition in a mammal that can benefit from the administration of an FXR agonist. A method of treating any of the diseases or conditions described herein in a mammal in need of such treatment comprises administering to the mammal a therapeutically effective amount of a pharmaceutical composition (i.e., formulation) comprising Compound 1 described herein, or a pharmaceutically acceptable salt, active metabolite, prodrug, or pharmaceutically acceptable solvate thereof.

[0100] Disclosed herein are methods for administering an FXR agonist in combination with an additional therapeutic agent. In some embodiments, the additional therapeutic agent comprises a therapeutic agent for treating diabetes or a diabetes-related disorder or condition, alcoholic or non-alcoholic liver disease, an inflammation-related intestinal condition, or a cell proliferative disorder.

[0101] In certain embodiments, compositions containing the compounds described herein are administered for prophylactic and / or therapeutic treatment.In certain therapeutic applications, the compositions are administered to patients already suffering from a disease or condition in an amount sufficient to cure or at least partially prevent at least one of the symptoms of the disease or condition.The amount effective for this use will vary depending on the severity and course of the disease or condition, previous treatments, the patient's health, weight, and response to drugs, and the judgment of the attending physician.The therapeutically effective amount is optionally determined by methods including, but not limited to, dose escalation and / or dose ranging clinical trials.

[0102] In prophylactic applications, compositions containing the compounds described herein are administered to patients susceptible to or otherwise at risk of a particular disease, disorder, or condition. Such an amount is defined as a "prophylactically effective amount or dose." In this use, the precise amount also depends on the patient's health, weight, etc. When used in patients, the amount effective for this use will vary depending on the severity and course of the disease, disorder, or condition, previous treatments, the patient's health status and response to the drugs, and the judgment of the treating physician. In one embodiment, prophylactic treatment involves administering a pharmaceutical composition containing Compound 1 or a pharmaceutically acceptable salt thereof to a mammal that has previously experienced at least one symptom of the disease being treated and is now in remission, to prevent the recurrence of symptoms of the disease or condition.

[0103] In certain embodiments in which the patient's condition does not improve, Compound 1 is administered chronically, i.e., for an extended period of time, including for the patient's lifetime, to improve or control or limit the symptoms of the patient's disease or condition, at the discretion of the physician.

[0104] In certain embodiments where the patient's condition improves, the administered dose of drug is temporarily reduced or temporarily suspended for a period of time (i.e., a "drug holiday"). In certain embodiments, the length of the drug holiday is between 2 days and 1 year, including, by way of example only, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, 10 days, 12 days, 15 days, 20 days, 28 days, or more than 28 days. The dose reduction during the drug holiday is, by way of example only, 10% to 100%, including, by way of example only, 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95%, and 100%.

[0105] Once the patient's condition has improved, a maintenance dose is administered as needed. In certain embodiments, the dosage or frequency of administration, or both, is then reduced as a function of symptoms to a level at which the improved disease, disorder, or condition is maintained. However, in certain embodiments, the patient requires intermittent treatment on a long-term basis in the event of a recurrence of symptoms.

[0106] The amount of a given agent that corresponds to such an amount will vary depending on factors such as the particular compound, the condition and its severity, the identity of the subject or host requiring treatment (e.g., weight, sex), etc., but will nevertheless be determined according to the particular circumstances surrounding the case, including, for example, the particular agent being administered, the route of administration, the condition being treated, and the subject or host being treated.

[0107] However, in general, the dose used for adult treatment is typically in the range of 0.01 mg to 500 mg per day. In one embodiment, the dose used for adult treatment is about 1 mg to about 500 mg per day. In one embodiment, the desired dose may be administered in a single dose or in divided doses, simultaneously or at appropriate intervals, for example, in subdoses two, three, four or more times per day.

[0108] In one embodiment, a suitable daily dose of Compound 1 or a pharmaceutically acceptable salt thereof described herein is about 0.01 to about 50 mg per kg of body weight. In some embodiments, the daily dosage or amount of active ingredient in a dosage form is lower or higher than the ranges set forth herein, depending on many variables related to the individual treatment plan. In various embodiments, the daily and unit dosage amounts will vary depending on many variables, including, but not limited to, the activity of the compound used, the disease or condition being treated, the mode of administration, the needs of the individual subject, the severity of the disease or condition being treated, and the judgment of the practitioner.

[0109] The toxicity and therapeutic efficacy of such treatment regimens are evaluated by, but not limited to, LD 50 and ED 50 The dose ratio between toxic and therapeutic effects is the therapeutic index, and the LD is the dose-dependent pharmacokinetic (LD) index. 50 and ED 50 In certain embodiments, the data obtained from cell culture assays and animal studies are used in formulating a therapeutically effective daily dose range and / or a therapeutically effective unit dose for use in mammals, including humans. In some embodiments, the daily dosage of the compounds described herein is the ED 50 In certain embodiments, the daily dose range and / or unit dose varies within this range depending upon the dosage form employed and the route of administration utilized.

[0110] In further embodiments of any of the foregoing aspects, an effective amount of Compound 1, or a pharmaceutically acceptable salt thereof, as described herein is (a) administered systemically to a mammal, and / or (b) administered orally to a mammal, and / or (c) administered intravenously to a mammal, and / or (d) administered by injection to a mammal, and / or (e) administered topically to a mammal, and / or (f) administered non-systemically or topically to a mammal.

[0111] Further embodiments of any of the foregoing aspects include a single administration of an effective amount of Compound 1, including further embodiments in which (i) the compound is administered once daily or (ii) the compound is administered to the mammal multiple times daily.

[0112] Further embodiments of any of the foregoing aspects include multiple administrations of an effective amount of Compound 1, including further embodiments in which (i) the compound is administered continuously or intermittently as a single dose, (ii) the multiple doses are administered every 6 hours, (iii) the compound is administered to the mammal every 8 hours, (iv) the compound is administered to the mammal every 12 hours, or (v) the compound is administered to the mammal every 24 hours. In further or alternative embodiments, the method resumes administration of the compound at the end of a drug holiday period, which includes a drug holiday during which administration of the compound is temporarily suspended or the dose of the compound administered is temporarily reduced. In one embodiment, the length of the drug holiday period varies from two days to one year.

[0113] In some cases, it will be appropriate to administer Compound 1, or a pharmaceutically acceptable salt thereof, in combination with one or more other therapeutic agents.

[0114] In one embodiment, the therapeutic effectiveness of Compound 1 is enhanced by the administration of an adjuvant (i.e., the adjuvant itself has minimal therapeutic effect, but when combined with another therapeutic agent, enhances the overall therapeutic effect on the patient). Alternatively, in some embodiments, the benefit experienced by the patient is increased by administering one of the compounds described herein with another agent (including a treatment regimen) that also has a therapeutic benefit.

[0115] In one particular embodiment, Compound 1, or a pharmaceutically acceptable salt thereof, is co-administered with a second therapeutic agent, wherein Compound 1, or a pharmaceutically acceptable salt thereof, and the second therapeutic agent modulate different aspects of the disease, disorder, or condition being treated, thereby providing a greater overall benefit than administering either therapeutic agent alone. [Example]

[0116] List of Abbreviations In the foregoing description, and throughout the description of the present invention, the following abbreviations, unless otherwise indicated, shall be understood to have the following meanings: ACN or MeCN: acetonitrile Bn: Benzyl BOC or Boc: tert-butylcarbamate t-butyl: tert-butyl Cy: Cyclohexyl DCE: dichloroethane (ClCH2CH2Cl) DCM: dichloromethane (CH2Cl2) DIPEA or DIEA: Diisopropylethylamine DMAP: 4-(N,N-dimethylamino)pyridine DMF: dimethylformamide DMA: N,N-dimethylacetamide DMSO: dimethyl sulfoxide equiv: equivalent amount Et: Ethyl Et2O: Diethyl ether EtOH: ethanol EtOAc: ethyl acetate HPLC: High-performance liquid chromatography Me: Methyl MeOH: Methanol MS: Mass spectrometry NMR: nuclear magnetic resonance RP-HPLC: Reversed-phase high-pressure liquid chromatography T3P: 2,4,6-tripropyl-1,3,5,2,4,6-trioxatriphosphorinane-2,4,6-trioxide TBME: Methyl tert-butyl ether TFA: Trifluoroacetic acid THF: tetrahydrofuran TLC: Thin Layer Chromatography

[0117] I. Chemical synthesis Unless otherwise noted, reagents and solvents were used as received from suppliers. Anhydrous solvents and oven-dried glassware were used for moisture- and / or oxygen-sensitive synthetic transformations. Yields were not optimized. Reaction times are approximate and not optimized. Column chromatography and thin-layer chromatography (TLC) were performed on silica gel unless otherwise noted.

[0118] Example 1: Preparation of 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbaldehyde (Intermediate 1)

[0119] [ka]

[0120] Step 1: 8-(4-methoxy-3-methylphenyl)-1,4-dioxaspiro[4.5]decan-8-ol Three batches were run in parallel: n-BuLi (762 mL, 1.90 mol, 2.5 M in n-hexane) was added dropwise to a solution of 4-bromo-1-methoxy-2-methylbenzene (333 g, 1.66 mol) in dry THF (2 L) at −60 °C under N over 1 h. The reaction was stirred at −60 °C for 1 h, and then a solution of 1,4-dioxaspiro[4.5]decan-8-one (284.53 g, 1.82 mol) in dry THF (1 L) was added dropwise over 45 min. The reaction was stirred at −60 °C for 1 h, and then the three batches were poured into saturated aqueous NH4Cl (3 L). The mixture was extracted with EtOAc (5 L × 2). The combined organic layers were washed with brine (5 L), dried over Na2SO4, filtered, concentrated, and then triturated in n-hexane (1.2 L) at room temperature overnight. The mixture was filtered, and the filter cake was washed with cold n-hexane (200 mL × 2) and then dried in vacuo to give 8-(4-methoxy-3-methylphenyl)-1,4-dioxaspiro[4.5]decan-8-ol (1100 g, 82%) as a white solid. 1HNMR (400MHz, CDCl3): δ7.30-7.20(m,2H),6.74(d,1H),4.02-3.87(m,4H),3.78(s,3H) ),2.18(s,3H),2.15-2.00(m,4H),1.82-1.73(m,2H),1.68-1.60(m,2H),1.48(s,4H).

[0121] Step 2: 8-Allyl-8-(4-methoxy-3-methylphenyl)-1,4-dioxaspiro[4.5]decane Four batches were run in parallel: BF3Et2O (376.95 g, 2.65 mol) was added to a solution of 8-(4-methoxy-3-methylphenyl)-1,4-dioxaspiro[4.5]decan-8-ol (275 g, 0.99 mol), allyltrimethylsilane (180.62 g, 1.58 mol), and dry DCM (3 L) under N2 at -65 °C. The reaction mixture was stirred at -65 °C for 1 h, and then the four batches were carefully poured into saturated aqueous NaHCO3 (10 L). This mixture was extracted with DCM (5 L × 3). The combined organic layers were washed with brine (5 L), dried over Na2SO4, filtered, and concentrated to give 8-allyl-8-(4-methoxy-3-methylphenyl)-1,4-dioxaspiro[4.5]decane (1350 g) as a yellow oil. 1 HNMR (400MHz, CDCl3): δ7.17-7.01(m,2H),6.85-6.75(m,1H),5.53-5.37(m,1H),5.01-4.85(m,2H),3.99-3.87(m ,4H),3.82(s,3H),2.37-2.29(m,1H),2.28-2.21(m,5H),2.20-2.10(m,2H),1.82-1.71(m,2H),1.70-1.52(m,3H).

[0122] Step 3: 4-Allyl-4-(4-methoxy-3-methylphenyl)cyclohexanone Three batches were run in parallel: water (450 mL), followed by formic acid (285.95 g, 5.95 mol), was added to a solution of 8-allyl-8-(4-methoxy-3-methylphenyl)-1,4-dioxaspiro[4.5]decane (450 g) in THF (1.8 L) at room temperature. The reaction mixture was refluxed overnight, cooled to room temperature, and then the three batches were poured into saturated aqueous NaHCO3 (3 L). This mixture was extracted with EA (3 L × 3). The combined organic layers were washed with brine (3 L), dried over Na2SO4, filtered, concentrated, and then purified by silica gel chromatography (petroleum ether / EtOAc = 1 / 0 to 50 / 1) to give 4-allyl-4-(4-methoxy-3-methylphenyl)cyclohexanone (800 g, 69.3% over two steps) as a yellow oil. 1 HNMR (400MHz, CDCl3): δ7.16-7.06(m,2H),6.80-6.73(m,1H),5.48-5.30(m,1H),4.9 6-4.79(m,2H),3.77(s,3H),2.48-2.35(m,2H),2.32-2.05(m,9H),1.89-1.77(m,2H).

[0123] Step 4: 4-Allyl-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile Three batches were run in parallel: t-BuOK (299.69 g, 2.67 mol) was added dropwise (internal temperature maintained <5 °C) to a solution of 4-allyl-4-(4-methoxy-3-methylphenyl)cyclohexanone (230 g, 890.25 mmol), Tos-MIC (260.72 g, 1.34 mol), and DME (2 L) at 0 °C under N over 1 h. The mixture was stirred at room temperature for 2 h, and then the three batches were poured into saturated aqueous NH4Cl (5 L). The mixture was extracted with EtOAc (5 L × 2). The combined organic layers were washed with brine (5 L), dried over Na2SO4, filtered, concentrated, and then purified by chromatography on silica gel (petroleum ether / EtOAc = 1 / 0 to 50 / 1) to give 4-allyl-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (508 g, 70.6%) as a yellow oil. 1 HNMR (400MHz, CDCl3): δ7.13-6.99(m,2H),6.83-6.75(m,1H),5.51-5.31(m,1H),5.03-4.85(m,2H),3.8 4(s,3H), 2.58-2.48(m,1H), 2.38-2.02(m,7H), 1.98-1.79(m,2H), 1.78-1.56(m,3H), 1.54-1.40(m,1H).

[0124] Step 5: 4-(2,3-dihydroxypropyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile Three batches were run in parallel: NMO (242.66 g, 2.07 mol) and then KOsO·2HO (7.63 g, 20.71 mmol) were added to a solution of 4-allyl-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (1.86 g, 690.47 mmol), acetone (2 L), and HO (2.50 mL) at 0 °C. The reaction was allowed to warm to room temperature and stirred for 2 h. The three batches were poured into saturated aqueous NaSO (4 L), and the mixture was then extracted with EtOAc (3 L × 2). The combined organic layers were washed with brine (3 L), dried over Na2SO4, filtered, concentrated, and then purified by chromatography on silica gel (petroleum ether / EtOAc = 5 / 1 to 1 / 2) to give 4-(2,3-dihydroxypropyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (600 g, 95.4%) as a yellow oil. 1 HNMR (400MHz, CDCl3): δ7.21-7.01(m,2H),6.87-6.74(m,1H),3.83(s,3H),3.65-3.49(m,1H), 3.35-3.17(m,2H),2.60-2.45(m,1H),2.41-2.11(m,5H),2.01-1.81(m,4H),1.79-1.38(m,6H).

[0125] Step 6: 4-(4-methoxy-3-methylphenyl)-4-(2-oxoethyl)cyclohexanecarbonitrile Three batches were run in parallel: NaIO 4( A solution of 4-(2,3-dihydroxypropyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (169.20 g, 791.05 mmol) was added dropwise over 30 min (maintaining an internal temperature of <5 °C) at 0 °C to a solution of 4-(2,3-dihydroxypropyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (200 g, 659.21 mmol), THF (2 L), and HO (1 L). The mixture was stirred at room temperature for 3 h, then poured in three batches into water (2 L). The mixture was extracted with EtOAc (2 L × 2). The combined organic layers were washed with brine (2 L), dried over NaSO, filtered, and concentrated to give 4-(4-methoxy-3-methylphenyl)-4-(2-oxoethyl)cyclohexanecarbonitrile (510 g) as a colorless oil. 1 HNMR(400MHz,CDCl3):δ9.43-9.22(m,1H),7.20-6.99(m,2H),6.87-6.71(m,1H),3.82(s,3H), 2.63-2.48(m,2H), 2.46-2.36(m,1H), 2.33-2.13(m,4H), 2.02-1.71(m,5H), 1.71-1.57(m,2H).

[0126] Step 7: 4-(2-hydroxyethyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile Three batches were run in parallel: NaBH (35.55 g, 939.73 mmol) was added to a solution of 4-(4-methoxy-3-methylphenyl)-4-(2-oxoethyl)cyclohexanecarbonitrile (170 g) in THF (1.7 L) at 0 °C under N. The mixture was stirred at room temperature for 3 h, and then the three batches were poured into ice-cold water (3 L). The mixture was extracted with EtOAc (1.5 L × 2). The combined organic layers were washed with brine (2 L), dried over NaSO, filtered, and concentrated to give 4-(2-hydroxyethyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (495 g) as a colorless oil. 1HNMR (400MHz, CDCl3): δ7.18-6.97(m,2H),6.88-6.71(m,1H),3.85-3.78(m,3H),3.76-3.70(m,1H),3.44-3.33(m,2H),2.71-2.69(m,0.5H), 2.60-2.48(m,0.5H),2.37-2.35(m,0.5H),2.27-2.19(m,3H),2.14-2. 12(m,0.5H),1.96-1.79(m,5H),1.78-1.61(m,3H),1.58-1.45(m,1H).

[0127] Step 8: 4-(2-bromoethyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile Three batches were run in parallel: A solution of PPh3 (316.62 g, 1.21 mol) in DCM (1 L) was added dropwise to a solution of 4-(2-hydroxyethyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (165 g), CBr4 (300.24 g, 905.37 mmol), and DCM (1.5 L) at 0 °C under N2 over 1 h. The mixture was stirred at room temperature for 1.5 h, combined with the other two batches, and concentrated. The crude product was triturated in MTBE (5 L) at room temperature overnight. The solid was filtered off, the cake was washed with MTBE (500 mL × 2), and the filtrate was concentrated and then purified by silica gel chromatography (petroleum ether / EtOAc = 30 / 1) to give 4-(2-bromoethyl)-4-(4-methoxy-3-methylphenyl)cyclohexanecarbonitrile (530 g, 80%) as a white solid. 1 HNMR (400MHz, CDCl3): δ7.11-6.96(m,2H),6.86-6.73(m,1H),3.87-3.73(m,3H),3.09-2.93(m,2H),2.78-2.68(m,0.5H),2.62-2 .50(m,0.5H),2.38-2.34(m,1H),2.28-2.18(m,3H),2.17-2.10(m,2H),2.08-1.99(m,2H),1.99-1.79(m,3H),1.77-1.45(m,3H).

[0128] Step 9: 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbonitrile Three batches were run in parallel: LDA (420 mL, 840 mmol, 2 M in THF) was added to a solution of 4-(2-bromoethyl)-4-(4-methoxy-3-methyl-phenyl)cyclohexanecarbonitrile (143 g, 425.26 mmol), HMPA (381.03 g, 2.13 mol), and THF (1430 mL) at −65° C. under N over 1 h. The mixture was stirred at −65° C. for 3 min, and then the three batches were poured into saturated aqueous NH4Cl (5 L). The mixture was extracted with EtOAc (3 L × 2). The combined organic layers were washed with water (3 L), brine (3 L), dried over Na2SO4, filtered, concentrated, and then triturated in EA:hexane (1:30, 775 mL) at room temperature overnight. The mixture was filtered, and the filter cake was washed with EA:hexane (1:30, 150 mL) and dried under vacuum to give 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbonitrile (240 g, 73%) as a yellow solid. 1 HNMR (400MHz, CDCl3): δ7.13-6.98(m,2H),6.83-6.73(m,1H),3.82(s,3H),2.22(s,3H),2.12-1.98(m,6H),1.94-1.80(m,6H).

[0129] Step 10: 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbaldehyde Three batches were run in parallel: DIBAL-H (1 M PhMe, 830 mL, 830 mmol) was added to a solution of 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbonitrile (106 g, 415.11 mmol) in DCM (1 L) at −65 °C under N 2 . The mixture was stirred at −65 °C for 1 h, and then the three batches were poured into saturated aqueous NaK tartrate (3 L) and diluted with DCM (1.5 L). This mixture was stirred at room temperature for 3 h. The organic layer was separated, and the aqueous phase was extracted with DCM (2 L × 2). The organic layers were combined, washed with brine (3 L), dried over Na 2 SO 4 , filtered, and concentrated to give 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbaldehyde (336 g) as a yellow solid. 1 HNMR(400MHz,DMSO-d6):δ9.50-9.43(m,1H),7.11-7.00(m,2H),6.83-6.79(m,1 H),3.77-3.68(m,3H),2.18-2.02(m,3H),1.82-1.72(m,6H),1.71-1.60(m,6H).

[0130] Step 11: Potassium hydroxy(4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methanesulfonate Six batches were run in parallel: aqueous potassium metabisulfite (2 M, 54 mL, 108 mmol) was added over 10 min to a solution of 4-(4-methoxy-3-methyl-phenyl)bicyclo[2.2.2]octane-1-carbaldehyde (56 g) in THF (300 mL) at 45 °C. The mixture was stirred at 45 °C for 3.5 h, cooled to room temperature, and then stirred at room temperature overnight. The six batches were filtered, and the filter cake was washed with PE (400 mL) and dried under vacuum to give potassium hydroxy(4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methanesulfonate (381 g, 81% over two steps) as a white solid. 1HNMR(400MHz,DMSO-d6):7.12-6.97(m,2H),6.88-6.71(m,1H),4.51(d,1H),3.73(s,3H),3.56(d,1H),2.11(s,3H),1.88-1.56(m,12H).

[0131] Step 12: 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbaldehyde Six batches were run in parallel: Na2CO3 (300 mL) was added to a mixture of potassium hydroxy(4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methanesulfonate (63.5 g, 167.76 mmol) and DCM (300 mL) at room temperature under N2. The mixture was stirred for 1 h, and then the six batches were poured into a mixture of DCM (1500 mL) and HO (1500 mL). The organic layer was separated, and the aqueous phase was extracted with DCM (1500 mL × 3). The combined organic layers were washed with brine (2 L), dried over Na2SO4, filtered, and concentrated to give 4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octane-1-carbaldehyde (240.3 g, 92%) as a white solid. 1 HNMR(400MHz,DMSO-d6):δ9.52-9.41(m,1H),7.14-7.02(m,2H),6.84-7.80(m,1H) ,3.73(s,3H),2.12(s,3H),1.83-1.72(m,6H),1.71-1.56(m,6H),LCMS:259.1[M+H] + .

[0132] Example 2: Preparation of 4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-amine (Intermediate 2)

[0133] [ka]

[0134] 2-Methyltetrahydrofuran (10 mL), Pd(dppf)Cl, followed by aqueous KCO (3 M, 10 mL, 30 mmol) were added to 4-bromopyridin-2-amine (1.87 g, 10.8 mmol) and 1-(tert-butyl)-4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)-1H-pyrazole (2.50 g, 10.0 mmol) in a 40 mL vial. The reaction was degassed with three vacuum / N cycles, heated at 50° C. for 21 hours, and then allowed to cool to room temperature. The layers were separated, and the organic layer was washed with saturated aqueous NaK tartrate (25 mL) and then with brine (25 mL). The aqueous layer was back-extracted with 2-methyltetrahydrofuran (25 mL). The combined organics were dried (MgSO), filtered, concentrated, and then dried under vacuum for 1 h. A suspension of the crude material and MTBE (25 mL) was refluxed for 2 h, cooled to room temperature overnight, and then filtered. The filter cake was washed with MTBE (2 × 3 mL) and then dried under vacuum to give 4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-amine (1.15 g, 53%). 1 HNMR(400MHz,DMSO-d6):δ8.27(s,1H),7.86-7.82(m,2H),6.74(d,1H),6.61(s,1H),5.77(s,2H),1.54(s,9H),LCMS:217.1[M+H] + .

[0135] Example 3: Preparation of trans-4-((tert-butyldimethylsilyl)oxy)cyclohexanecarboxylic acid (Intermediate 3)

[0136] [ka]

[0137] Step 1: trans-tert-butyldimethylsilyl 4-((tert-butyldimethylsilyl)oxy)cyclohexanecarboxylate tert-Butyldimethylsilyl chloride (31.47 g, 208.8 mmol) was added to a mixture of trans-4-hydroxycyclohexanecarboxylic acid (10.03 g, 69.57 mmol), imidazole (18.96 g, 278.5 mmol), and DMF (140 mL) at room temperature under N (the reaction exothermed to 32 °C). The reaction was stirred at room temperature for 2 hours and then diluted with diethyl ether (300 mL). The organic layer was washed (2 × 300 mL of 1 N HCl, then 300 mL of brine), dried (NaSO), filtered, and concentrated to give trans-tert-butyldimethylsilyl 4-((tert-butyldimethylsilyl)oxy)cyclohexanecarboxylate as a clear oil (31.5 g). 1 HNMR(400MHz,DMSO-d6):δ3.61-3.53(m,1H),2.26-2.18(m,1H),2.04-1.96(m,2H),1.92-1.85(m ,2H),1.51-1.39(m,2H),1.39-1.27(m,2H),0.94(s,9H),0.89(s,9H),0.26(s,6H),0.06(s,6H).

[0138] Step 2: trans-4-((tert-butyldimethylsilyl)oxy)cyclohexanecarboxylic acid Potassium carbonate (58.01 g, 419.7 mmol) in HO (300 mL) was added to a mixture of trans-tert-butyldimethylsilyl 4-((tert-butyldimethylsilyl)oxy)cyclohexanecarboxylate (crude 31.5 g, 69.6 mmol), ethanol (1000 mL), and THF (300 mL) at room temperature under N. The reaction was stirred at room temperature for 3 h, concentrated to 300 mL, diluted with brine (600 mL), and then acidified to pH 2-3 with 20% NaHSO (550 mL). The aqueous layer was extracted with diethyl ether (800 mL). The organic layer was washed (800 mL brine), dried (NaSO), filtered, concentrated, and dried under high vacuum (to remove silanol by-products) to give trans-4-((tert-butyldimethylsilyl)oxy)cyclohexanecarboxylic acid (17.3 g, 96% over two steps) as a white solid. 1 HNMR(400MHz,DMSO-d6):δ12.30(brs,1H),3.59-3.51(m,1H),2.15-2.05(m,1H), 1 .88-1.74(m,4H), 1.41-1.29(m,2H),1.28-1.16(m,2H),0.84(s,9H),0.02(s,6H).

[0139] Example 4 Preparation of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate (Compound 1)

[0140] [ka]

[0141] Step 1: 4-(1-(tert-butyl)-1H-pyrazol-4-yl)-N-((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)pyridin-2-amine A mixture of Intermediate 1 (1.0 eq) and Intermediate 2 (1.1 eq) in methanol (7.5 vol) and acetic acid (0.33 eq) was heated at 55° C. for at least 3 hours. The reaction mixture was cooled to room temperature, and 2-methylpyridine borane complex (1.0 eq) was added as a solid over at least 20 minutes. The reaction was stirred at room temperature overnight, and water (12.0 vol) was added within at least 60 minutes. The suspension was stirred for at least 2 hours. The solid was collected by filtration, washed with water / methanol (2:1) (2 × 1 vol), TBME (2 × 2 vol), and heptane (2 × 2 vol), and dried on a rotary evaporator at 50° C. to give 4-(1-(tert-butyl)-1H-pyrazol-4-yl)-N-((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)pyridin-2-amine.

[0142] Steps 2 and 3: trans-N-(4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)-4-hydroxy-N-((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)cyclohexanecarboxamide To a mixture of 4-(1-(tert-butyl)-1H-pyrazol-4-yl)-N-((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)pyridin-2-amine (1.0 eq) and Intermediate 3 (1.2 eq) in dichloromethane (7.5 vol) and triethylamine (4.0 eq) at 0° C. was added a solution of T3P in dichloromethane (2.0 eq) over 0.5 h. The reaction mixture was allowed to warm to room temperature and stirred for at least 12 h. The reaction mixture was cooled to 5° C. and quenched by the addition of water in two portions (0.05 vol and 6.0 vol). The mixture was allowed to warm to room temperature and stirred for at least 2 h. The organic layer was collected and washed with water. The dichloromethane solvent was replaced in vacuo with 2-methyltetrahydrofuran (5.4 vol). Methanol (2.4 vol) and water (2 vol) were added to the solution, followed by the addition of aqueous HCl (32%) (1.9 eq). The reaction mixture was stirred at room temperature for at least 2 hours. To the mixture was added 9.5% aqueous NaHCO (4 vol). The organic layer was collected, washed with brine, dried over NaSO, and filtered through Celite. The filtrate was concentrated in vacuo, and TBME (9 vol) was added. The solid was collected by filtration, washed with TBME and heptane, and dried in vacuo at 60° C. to give trans-N-(4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)-4-hydroxy-N-((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)cyclohexanecarboxamide.

[0143] Step 4: 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate (Compound 1) To a solution of trans-N-(4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)-4-hydroxy-N-((4-(4-methoxy)-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)cyclohexanecarboxamide in dichloromethane (8.0 vol) was added 1,1'-carbonyldiimidazole (1.5 eq). The mixture was stirred at room temperature for at least 3.5 hours. 3-Hydroxyazetidine hydrochloride (3.0 eq) was added to this solution at room temperature, followed by iPrNEt (7.0 eq). The reaction mixture was stirred at room temperature for at least 2.5 hours. The reaction was quenched with 4.5% aqueous NaHCO (6.0 vol). The organic layer was collected and the aqueous layer was extracted once with dichloromethane (2.0 vol). Methanol (0.8 vol) was added, and the combined organic layers were washed twice with 20% NH4Cl solution (4.0 vol) and twice with water (4.0 vol). The organic layer was dried (Na2SO4), and the dichloromethane solvent was exchanged for ethyl acetate (4 vol). Heptane was slowly added (4 vol). The crude product was collected by filtration and washed with ethyl acetate:heptane (1:1). The crude product was dried under vacuum at 55°C. The crude product was purified by hot slurry in ethyl acetate (5 vol) and collected by filtration. The product was washed with ethyl acetate and dried under vacuum at 55°C to give 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate (Compound 1).

[0144] II. Compound 1 spray-dried dispersion Example 5: Screening of Compound 1 / Polymer Combinations Polymer-based spray-dried dispersions of compound 1 were developed. Several compound 1 / polymer combinations were screened and evaluated using computational modeling. The polymers evaluated were PVP / VA 64, PVP 30, HPMCAS-L, HPMCAS-M, HPMCAS-H, and Eudragit (registered trademark) L100-55, Eudragit (registered trademark)L100, Eudragit (registered trademark) EPO, HPMC E15, HPMC E3, HPMC E5, HPMCP-HP55, and SolPlus (registered trademark) Compound 1 / polymer combinations were evaluated for the following: 1) Miscibility evaluation—computer simulations to assess phase separation tendency with different stabilizing carriers and drug loadings; 2) API / polymer solubility confirmation—a series of compatible solvent systems were tested for each lead condition; 3) Solvent casting—solvent casting trials with different stabilizing carriers and drug loadings were conducted to further refine formulation changes; and 4) Supersaturation studies—solvent exchange methods were used to evaluate the precipitation suppression of different stabilizing carriers. Based on the screening studies, compound 1 and PVP / VA 64 (60% w / w) and compound 1 and HPMCAS-M (60% w / w) were scaled up.

[0145] Example 6: Lab-scale prototyping of Compound 1 / polymer combination Spray Drying. A laboratory-scale spray dryer (Buchi B-290 spray dryer) was used to dry the feed solution. The unit was equipped with a two-fluid nozzle with a 0.7 mm and 1.5 mm nozzle tip and cap, respectively. The spray drying unit was operated with nitrogen in an open-loop configuration (i.e., no recirculation of dry nitrogen) and the aspirator was blown at 100% capacity.

[0146] Secondary drying: A laboratory-scale vacuum tray dryer was used to reduce the residual solvent content of the wet spray-dried dispersion. Secondary drying was carried out under vacuum with a nitrogen sweep at 50°C for 48 hours.

[0147] Solution Preparation: Solutions for prototype spray-dried dispersions using PVP / VA 64 and HPMCAS-M were prepared according to the following general procedure: Charge the entire amount of polymer to an empty vessel; Add the entire amount of polymer slowly with stirring; Continue stirring until the polymer is completely dissolved; Add the entire amount of Compound 1 slowly with stirring; Continue stirring until Compound 1 is completely dissolved. Representative solutions of Compound 1 and HPMCAS-M, and Compound 1 and PVP / VA 64 were prepared according to the amounts and ratios in Table 1 below (where "C_Feed" = solids in the feed mixture [% w / w], and "C_Compound 1" = Compound 1 content in the feed mixture [% w / w]).

[0148] [Table 1]

[0149] result The main process data and analytical results are summarized in Table 2 below ("T_feed" = temperature of the feed solution [°C], "F_dry" = flow rate of the drying gas in the spray dryer [kg / h], "F_atomization" = atomization gas flow rate [g / min], "T_outlet" = drying gas temperature at the outlet of the drying chamber [°C], "F_feed" = flow rate of the feed solution to the spray dryer [kg / h], "GC" = gas chromatography, "KF" = Karl Fischer, "TFN" = two-fluid nozzle, and "PSD" = particle size distribution).

[0150] [Table 2]

[0151] Both spray-dried dispersions (Compound 1:HPMCAS-M and Compound 1:PVP / VA 64) were amorphous after secondary drying, as indicated by the absence of crystalline peaks (XRPD) and melting endotherms (DSC) characteristic of crystalline material.

[0152] Example 7: Stability Study of Spray-Dried Dispersions of Compound 1 Two spray-dried dispersions of Compound 1 (Compound 1:HPMCAS-M and Compound 1:PVP / VA 64) were stored in capped vials at 40°C / 75% RH for one month. No chemical degradation was observed for either spray-dried dispersion. Furthermore, the amorphous state of each spray-dried dispersion was maintained.

[0153] Example 8: Development of an SDI tablet formulation of Compound 1 First, the compatibility of Compound 1 API (amorphous form) was evaluated with various excipients. These compatibility studies were conducted in sealed containers at 40°C / 75% RH for one month. At the conclusion of the study, no detectable changes in assay, related substances, or appearance were detected. Compound 1 API was determined to be compatible with Avicel (microcrystalline cellulose), Tabletose (lactose monohydrate), Peritol (mannitol), Compitrol (glyceryl behenate), Axdisol (croscarmellose sodium), Polyplasdone XL (crospovidone), magnesium stearate, and Cab-o-sil (colloidal silicon dioxide).

[0154] Four Compound 1 formulation matrices were then prepared using the spray-dried intermediates (SDIs) PVP / VA and HPMCAS, as outlined in Table 3. Tablet formulation blends and tablets were prepared and evaluated for tabletability profile, compressibility profile, disintegration time, friability, and biorelevant dissolution. The only difference between the two formulations tested for each SDI was the disintegrant. The SDI polymer also functions as a binder, so the disintegrant is a critical component of tablets containing SDI. The disintegrant plays an important role in overcoming the binder effect of the SDI polymer to facilitate drug release.

[0155] [Table 3]

[0156] Tableting and compressibility curves were obtained for each of the four formulations. All four formulations produced tablets with high tensile strength (e.g., hardness ≥ 1.7 MPa) using typical compression pressures such as 100-200 MPa. Biorelevant dissolution profiles of the four tablet formulations indicated that all formulations could be compressed into high-quality tablets.

[0157] Two prototype 5 mg tablets were prepared from tablet formulations A and C. These tablets were used in a pharmacokinetic study in monkeys (n=12 per formulation). Compound 1 was well absorbed from both tablet formulations (Figure 1).

[0158] Example 9: Compound 1 SDI Tablet Formulations—5 mg and 25 mg Tablets The ingredients of Formulation A in Example 8 were increased five-fold to produce 25 mg tablets.

[0159] [Table 4]

[0160] Example 10: Compound 1 SDI Tablet Formulation - 1 mg Tablet Because the amount of Compound 1SDI in a 1 mg blend was less than 2%, the blend was prepared by three-step geometric dilution to provide a homogenous mixture. This process involved the following steps: (1) Preblend #1: Sift the required amount of Compound 1SDI for the batch and add twice the amount of microcrystalline cellulose (MCC). Mix Preblend #1. (2) Preblend #2: Add MCC equivalent to twice the weight of Preblend #1 and mix. (3) Preblend #3: Add MCC equivalent to twice the weight of Preblend #2 to the blend and mix. (4) Add the required amount of MCC, lactose monohydrate, croscarmellose sodium, and colloidal silicon dioxide for the remaining batch to the blend and mix. Evaluate this blend for Blend Uniformity Analysis (BUA). (5) Once the BUA meets the requirements, sift half the batch amount of magnesium stearate and add it to the blend from step 4 and mix. (6) The blend from step 5 is granulated by roller compaction. Samples are removed for measuring bulk density (BD), tapped density (TD), and particle size distribution (PSD). The remaining half of the required batch of magnesium stearate is then added and mixed into the dry granulation blend. (7) Compress the blend from step 6 into tablets (round, target weight 100 mg). (8) The compressed tablets are coated in a pan coater. (9) The final coated tablets are sampled for quality testing and stability, and the remaining bulk is bottled and capped.

[0161] [Table 5]

[0162] Example 11: Compound 1 SDI Tablet Formulation - 12 mg Tablets As tablet strength increased beyond 5 mg of Compound 1 and 3.3 mg of PVP / VA per 100 mg tablet, the amount of polymer increased, inhibiting drug release by acting as a binder. Consequently, increasing the amount of croscarmellose sodium from 5% to 10% and decreasing the proportion of microcrystalline cellulose and lactose monohydrate improved the release profile of Compound 1 (Figure 2).

[0163] [Table 6]

[0164] III. Compound 1FXR activity Example 12: In vitro FXR assay (TK)

[0165] sowing CV-1 cells were seeded at a density of 2,000,000 cells in a T175 flask containing DMEM + 10% charcoal-stripped double FBS and incubated at 37°C in 5% CO2 for 18 hours (O / N).

[0166] Transfection After 18 hours of incubation, the medium in the T175 flask was replaced with fresh DMEM + 10% charcoal-stripped serum. In a polypropylene tube, 2500 μL of OptiMEM (Life Technologies, catalog no. 31985-062) was combined with expression plasmids for hFXR, hRXR, TK-ECRE-luc, and pCMX-YFP. The tube was then vortexed briefly and incubated at room temperature for 5 minutes. Transfection reagent (X-tremeGENE HP from Roche, catalog no. 06 366 236 001) was added to the vortexed OptiMEM / plasmid mixture and incubated at room temperature for 20 minutes. After incubation, the transfection reagent / DNA mixture complex was added to the cells in the T175 flask, and the cells were incubated at 37°C in 5% CO2 for 18 hours (O / N).

[0167] Addition of Compound 1 Compound 1 was serially diluted in DMSO and added to the transfected CV-1 cells. The cells were then incubated for 18 hours. The next day, the cells were lysed and luminescence was measured. Compound 1 TK hFXR:EC 50 ≦0.01 μM. The present invention can provide the following aspects. [1] 1. A spray-dried solid dispersion comprising: (a) 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate; and (b) a pharmaceutically acceptable polymer; A spray-dried solid dispersion in which 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is dispersed in a polymer matrix formed from a pharmaceutically acceptable polymer. [2] The spray-dried solid dispersion according to [1] above, wherein the pharmaceutically acceptable polymer is selected from PVP / VA 64, PVP 30, HPMCAS-L, HPMCAS-M, HPMCAS-H, Eudragit® L100-55, Eudragit® L100, Eudragit® EPO, HPMC E15, HPMC E3, HPMC E5, HPMCP-HP55 and Soluplus®. [3] The spray-dried solid dispersion according to the above [1] or [2], wherein the pharmaceutically acceptable polymer is selected from PVP / VA 64 and HPMCAS-M. [4] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [3], wherein the pharmaceutically acceptable polymer is PVP / VA 64. [5] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [3], wherein the pharmaceutically acceptable polymer is HPMCAS-M. [6] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [5], wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is 9:1 to 1:9. [7] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [6], wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is 3:1 to 1:3. [8] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [7], wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 2:1. [9] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [7], wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 1.5:1.

[10] The spray-dried solid dispersion according to any one of the above-mentioned [1] to [7], wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 1:1.

[11] The spray-dried solid dispersion according to any one of the above [1] to

[10] , further comprising a non-aqueous solvent.

[12] 12. The spray-dried solid dispersion according to

[11] above, wherein the non-aqueous solvent is selected from the group consisting of tert-butanol, n-propanol, n-butanol, isopropanol, ethanol, methanol, acetone, ethyl acetate, dimethyl carbonate, acetonitrile, dichloromethane, methyl ethyl ketone, methyl isobutyl ketone, 1-pentanol, methyl acetate, carbon tetrachloride, dimethyl sulfoxide, hexafluoroacetone, chlorobutanol, dimethyl sulfone, acetic acid, cyclohexane, and mixtures thereof.

[13] The spray-dried solid dispersion according to the above

[11] or

[12] , wherein the non-aqueous solvent is selected from the group consisting of ethanol, methanol, propanol, butanol, isopropanol, tert-butanol, dichloromethane, and mixtures thereof.

[14] The spray-dried solid dispersion according to any one of the above

[11] to

[13] , wherein the non-aqueous solvent is a mixture of dichloromethane and methanol.

[15] The spray-dried solid dispersion according to any one of the above-mentioned [1] to

[14] , wherein 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is substantially amorphous.

[16] The spray-dried solid dispersion according to any one of the above-mentioned [1] to

[14] , wherein 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is crystalline.

[17] A pharmaceutical formulation comprising the spray-dried solid dispersion according to any one of the above [1] to

[16] , and optionally one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more binders, one or more lubricants, one or more glidants, and one or more surfactants.

[18]

[17] The pharmaceutical formulation according to the above

[17] , wherein the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, mannitol, crospovidone, and sodium stearyl fumarate.

[19]

[18] The pharmaceutical formulation according to the above

[18] , wherein the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, and colloidal silicon dioxide.

[20] The pharmaceutical preparation according to any one of the above

[17] to

[19] , which is in the form of a tablet.

[21] The pharmaceutical formulation according to

[20] above, wherein the tablet comprises about 1% by weight to about 30% by weight of the spray-dried solid dispersion.

[22] The pharmaceutical formulation according to

[20] or

[21] above, wherein the tablet comprises about 5% by weight to about 25% by weight of the spray-dried solid dispersion.

[23] The pharmaceutical formulation according to any one of the above

[20] to

[22] , wherein the tablet contains about 1% by weight to about 20% by weight of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate.

[24] The pharmaceutical formulation according to any one of the above-mentioned

[20] to

[22] , wherein the tablet contains about 1 mg, about 5 mg, about 12 mg, or about 25 mg of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate.

[25] The pharmaceutical preparation according to any one of the above

[17] to

[19] , which is in the form of a capsule.

[26] A method for treating or preventing a liver disease or condition in a mammal, the method comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[27] The method according to

[26] above, wherein the liver disease or condition is an alcoholic or non-alcoholic liver disease or condition.

[28] The method according to

[26] above, wherein the liver disease or condition is primary biliary cirrhosis, primary sclerosing cholangitis, cholestasis, non-alcoholic steatohepatitis (NASH), or non-alcoholic fatty liver disease (NAFLD).

[29] The method according to

[27] above, wherein the alcoholic liver disease or condition is fatty liver (steatosis), cirrhosis, or alcoholic hepatitis.

[30] The method according to

[27] above, wherein the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH) or non-alcoholic fatty liver disease (NAFLD).

[31] The method according to

[27] above, wherein the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH).

[32] The method according to

[27] above, wherein the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis (NASH) and is accompanied by liver fibrosis.

[33] The method according to

[27] above, wherein the non-alcoholic liver disease or condition is non-alcoholic steatohepatitis without liver fibrosis (NASH).

[34] The method according to

[27] above, wherein the non-alcoholic liver disease or condition is intrahepatic cholestasis or extrahepatic cholestasis.

[35] 26. The method of claim 25, wherein the liver disease or condition is steatohepatitis, cholangitis, fatty liver disease, cholestasis, cirrhosis, fibrotic liver disease, hepatitis, primary biliary cholangitis, biliary atresia, Alagille syndrome, IFALD (intestinal failure associated liver disease), parenteral nutrition associated liver disease (PNALD), hepatitis, hepatocellular carcinoma, cholangiocarcinoma, or a combination thereof.

[36] A method for treating or preventing liver fibrosis in a mammal, comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[37] 36. The method of claim 36, wherein the mammal has been diagnosed with hepatitis C virus (HCV), non-alcoholic steatohepatitis (NASH), primary sclerosing cholangitis (PSC), cirrhosis, Wilson's disease, hepatitis B virus (HBV), HIV-associated steatohepatitis and cirrhosis, chronic viral hepatitis, non-alcoholic fatty liver disease (NAFLD), alcoholic steatohepatitis (ASH), primary biliary cirrhosis (PBC), or biliary cirrhosis.

[38] The method according to

[36] above, wherein the mammal has been diagnosed with non-alcoholic steatohepatitis (NASH).

[39] A method for treating or preventing hepatitis in a mammal, comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[40] 39. The method of claim 39, wherein the mammal has been diagnosed with hepatitis C virus (HCV), non-alcoholic steatohepatitis (NASH), primary sclerosing cholangitis (PSC), cirrhosis, Wilson's disease, hepatitis B virus (HBV), HIV-associated steatohepatitis and cirrhosis, chronic viral hepatitis, non-alcoholic fatty liver disease (NAFLD), alcoholic steatohepatitis (ASH), primary biliary cirrhosis (PBC), or biliary cirrhosis.

[41] The method according to

[39] above, wherein the mammal has been diagnosed with non-alcoholic steatohepatitis (NASH).

[42] The method according to

[39] above, wherein the hepatitis is associated with inflammation of the gastrointestinal tract.

[43] The method according to

[39] above, wherein the mammal has been diagnosed with inflammatory bowel disease.

[44] A method for treating or preventing a gastrointestinal disease or condition in a mammal, the method comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[45] 44. The method of claim 44, wherein the gastrointestinal disease or condition is necrotizing enterocolitis, gastritis, ulcerative colitis, Crohn's disease, inflammatory bowel disease, irritable bowel syndrome, gastroenteritis, radiation-induced enterocolitis, pseudomembranous colitis, chemotherapy-induced enterocolitis, gastroesophageal reflux disease (GERD), peptic ulcer, non-ulcer dyspepsia (NUD), celiac disease, intestinal celiac disease, postoperative inflammation, gastric carcinogenesis, graft-versus-host disease, or any combination thereof.

[46] The method according to

[44] above, wherein the gastrointestinal disease or condition is irritable bowel syndrome with diarrhea (IBS-D), irritable bowel syndrome with constipation (IBS-C), mixed IBS (IBS-M), unclassifiable IBS (IBS-U), or bile acid diarrhea (BAD).

[47] A method for treating or preventing a renal disease or condition in a mammal, the method comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[48] The method according to

[47] above, wherein the renal disease or condition is renal fibrosis, acute kidney injury, chronic kidney injury, ischemic nephropathy, diabetic nephropathy, tubulointerstitial nephritis / nephropathy, glomerulonephritis / nephropathy, or a combination thereof.

[49] A method for treating or preventing a metabolic inflammation-mediated disease or disorder in a mammal, the method comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[50] The method according to

[49] above, wherein the metabolic inflammation-mediated disease or disorder is diabetes.

[51] A method for treating or preventing a lipid disease or disorder in a mammal, the method comprising administering to the mammal the spray-dried solid dispersion described in any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation described in any one of the above-mentioned

[17] to

[25] .

[52] The method according to

[51] above, wherein the lipid disease or disorder in a mammal is dyslipidemia.

[53] A method for treating or preventing cancer in a mammal, comprising administering to the mammal the spray-dried solid dispersion according to any one of the above-mentioned [1] to

[16] or the pharmaceutical formulation according to any one of the above-mentioned

[17] to

[25] .

[54] The method according to

[53] above, wherein the cancer is prostate cancer, colon cancer, or hepatocellular carcinoma.

[55] A method for treating or preventing a disease or condition in a mammal that can benefit from treatment with an FXR agonist, the method comprising administering to the mammal the spray-dried solid dispersion described in any one of [1] to

[16] above or the pharmaceutical formulation described in any one of

[17] to

[25] above.

[56] The method according to any one of

[26] to

[55] above, further comprising administering at least one additional therapeutic agent in addition to the spray-dried solid dispersion according to any one of [1] to

[16] above.

Claims

1. 1. A spray-dried solid dispersion comprising: (a) 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate; and (b) a pharmaceutically acceptable polymer; A spray-dried solid dispersion in which 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate is dispersed in a polymer matrix formed from the pharmaceutically acceptable polymer.

2. 2. The spray-dried solid dispersion of claim 1, wherein the pharmaceutically acceptable polymer is selected from PVP / VA 64, PVP 30, HPMCAS-L, HPMCAS-M, HPMCAS-H, Eudragit® L100-55, Eudragit® L100, Eudragit® EPO, HPMC E15, HPMC E3, HPMC E5, HPMCP-HP55 and Soluplus®.

3. 3. The spray-dried solid dispersion of claim 2, wherein the pharmaceutically acceptable polymer is PVP / VA 64.

4. 3. The spray-dried solid dispersion of claim 2, wherein the pharmaceutically acceptable polymer is HPMCAS-M.

5. 2. The spray-dried solid dispersion of claim 1, wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is 9:1 to 1:

9.

6. 6. The spray-dried solid dispersion of claim 5, wherein the weight ratio of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate to the pharmaceutically acceptable polymer is about 2:1, about 1.5:1, or about 1:

1.

7. 10. The spray-dried solid dispersion of claim 1, further comprising a non-aqueous solvent selected from the group consisting of ethanol, methanol, propanol, butanol, isopropanol, tert-butanol, dichloromethane, and mixtures thereof.

8. 8. The spray-dried solid dispersion of claim 7, wherein the non-aqueous solvent is a mixture of dichloromethane and methanol.

9. 9. A pharmaceutical formulation comprising the spray-dried solid dispersion of any one of claims 1 to 8, and optionally one or more pharmaceutically acceptable ingredients selected from the group consisting of one or more diluents, one or more disintegrants, one or more binders, one or more lubricants, one or more glidants and one or more surfactants.

10. 10. The pharmaceutical formulation of claim 9, wherein the one or more pharmaceutically acceptable ingredients are selected from the group consisting of microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, colloidal silicon dioxide, mannitol, crospovidone, and sodium stearyl fumarate.

11. 10. The pharmaceutical formulation of claim 9 in the form of a tablet.

12. 12. The pharmaceutical formulation of claim 11, wherein the tablet comprises from about 1% to about 30% by weight of the spray-dried solid dispersion.

13. 13. The pharmaceutical formulation of claim 12, wherein the tablet comprises from about 1% to about 20% by weight of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate.

14. 13. The pharmaceutical formulation of claim 12, wherein the tablet contains about 1 mg, about 5 mg, about 12 mg, or about 25 mg of 4-((4-(1-(tert-butyl)-1H-pyrazol-4-yl)pyridin-2-yl)((4-(4-methoxy-3-methylphenyl)bicyclo[2.2.2]octan-1-yl)methyl)carbamoyl)cyclohexyl 3-hydroxyazetidine-trans-1-carboxylate.

15. 15. Use of the spray-dried solid dispersion of any one of claims 1 to 8 or the pharmaceutical formulation of any one of claims 9 to 14 in the manufacture of a medicament for treating or preventing a gastrointestinal disease or condition in a mammal.

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