THR-beta modulators, alone or in combination with GLP-1r\GIPR\GCGR modulators for the treatment of metabolic diseases and alopecia areata diseases
A combination therapy with THR-β and GLP-1R\GIPR\GCGR modulators effectively manages weight, reduces obesity, and treats alopecia areata by regulating thyroid hormone and glucose levels, addressing the inadequacies of current treatments.
Patent Information
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- ASCLETIS PHARMA (CHINA) CO LTD
- Filing Date
- 2025-10-30
- Publication Date
- 2026-05-07
AI Technical Summary
Current treatments for obesity and androgenetic alopecia are inadequate in efficacy and safety, while existing weight management strategies fail to meet clinical needs, and there is a lack of effective therapies for metabolic diseases such as diabetes and obesity.
A combination therapy using THR-β modulators, alone or in combination with GLP-1R\GIPR\GCGR modulators, administered to subjects to address obesity, alopecia areata, and metabolic diseases, utilizing compounds like Resmetirom, Tiratricol, and others, to regulate thyroid hormone and glucose levels.
The therapy effectively manages weight, reduces obesity, and treats alopecia areata by modulating thyroid hormone and glucose regulation, providing robust and long-term safety.
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Figure PCTCN2025131243-FTAPPB-I100001 
Figure PCTCN2025131243-FTAPPB-I100002 
Figure PCTCN2025131243-FTAPPB-I100003
Abstract
Description
THR-BETA MODULATORS, ALONE OR IN COMBINATION WITHGLP-1R\GIPR\GCGR MODULATORS FOR THE TREATMENT OF METABOLIC DISEASES AND ALOPECIA AREATA DISEASES
[0001] CROSS-REFERENCE TO RELATED APPLICATIONS
[0002] The present disclosure claims the benefits of the PCT application No. PCT / CN2024 / 128509 entitled “A compound or a method for the treatment of metabolic diseases and alopecia areata diseases” filed October 30, 2024, the PCT application No. PCT / CN2024 / 130172 entitled “A compound or a method for the treatment of metabolic diseases and alopecia areata diseases” filed November 06, 2024, and the PCT application No. PCT / CN2024 / 139943 entitled “A compound or a method for the treatment of metabolic diseases and alopecia areata diseases” filed December 17, 2024, which are incorporated herein by their entireties.Field
[0003] The present invention is related to a combination therapy or a method for the treatment of metabolic diseases or alopecia areata diseases (AGA) . And the metabolic diseases is including obesity, chronic weight management, weight management and overweight.Background
[0004] Thyroid hormones are critical for normal growth and development and for maintaining metabolic homeostasis (Paul M. Yen Physiological Review, Vol. 81 (3) : pp. 1097-1126 (2001) ) . Circulating levels of thyroid hormones are tightly regulated by feedback mechanisms in the hypothalamus / pituitary / thyroid (HPT) axis. Thyroid dysfunction leading to hypothyroidism or hyperthyroidism clearly demonstrates that thyroid hormones exert profound effects on cardiac function, body weight, metabolism, metabolic rate, body temperature, cholesterol, bone, muscle and behavior. The thyroid hormone receptors are derived from two separate genes, αandβ. These distinct gene products produce multiple forms of their respective receptors through differential RNA processing. The major thyroid receptor isoforms areαl, α2, βl and β2. Thyroid hormone receptorsαl, βl andβ2 bind thyroid hormone. It has been shown that the thyroid hormone receptor subtypes can differ in their contribution to particular biological responses. Recent studies suggest that TRβl plays an important role in regulating TRH (thyrotropin releasing hormone) and on regulating thyroid hormone actions in the liver. TRβ2 plays an important role in the regulation of TSH (thyroid stimulating hormone) . TRβl plays an important role in regulating heart rate.
[0005] GIP (Glucose-Dependent Insulinotropic Polypeptide) , GLP-1 (Glucagon-Like Peptide-1) , and GCGR (Glucagon Receptor) are hormones and receptors closely related to the regulation of blood glucose levels. These three hormones and receptors in the body is crucial for maintaining glucose homeostasis and regulating energy balance. GIP and GLP-1 are typically secreted in increased amounts after meals, working synergistically on pancreaticβ-cells to promote insulin secretion, while GCGR promotes glycogenolysis and gluconeogenesis through the action of glucagon when blood glucose levels are low, to maintain blood glucose levels. Research on these receptors and hormones provides important targets and strategies for the treatment of metabolic diseases such as diabetes and obesity.
[0006] Obesity, chronic weight management, weight management or over weight is a common metabolic disease characterized by excessive accumulation of body fat to the extent that it becomes detrimental to health. Obesity is typically associated with a variety of health issues, including but not limited to: cardiovascular diseases: such as coronary heart disease, hypertension, stroke, etc. Metabolic syndrome: a cluster of symptoms that includes high blood pressure, high blood sugar, abnormal cholesterol levels, and abdominal obesity. Type 2 diabetes: obesity is a significant risk factor for type 2 diabetes. Respiratory problems: such as sleep apnea. Certain cancers: including breast, colon, and endometrial cancers. Musculoskeletal and joint problems: such as osteoarthritis. Psychological impacts: such as depression and anxiety.
[0007] Given the significant health risks associated with obesity, patients with weight imbalance require chronic weight management strategies. Although various methods for weight management exist, they often fail to fully meet clinical needs. This shortfall highlights the necessity for new and effective therapies that can prevent, treat, or ameliorate obesity, chronic weight management, weight management and overweight.
[0008] Androgenetic alopecia, also known male pattern baldness, occurs not only in men but also in women. Current treatments such as minoxidil and finasteride are only efficacious in a small percentage of subjects. Novel mechanisms with robust efficacy and long-term safety are still needed for the treatment of androgenetic alopecia. Thyroid hormone receptor agonists (thyromimetics) are closely associated with hair growth. Topical triiodo-thyronine (T3) stimulates epidermal proliferation, dermal thickening, and hair growth in both mice and rats. Some human subjects given with thyroxine (T4) to treat thyroid hormone deficiency reported hair growth as a side effect. Thyroid hormones are also found to directly alter human hair follicle functions including anagen prolongation and stimulation of both hair matrix keratinocyte proliferation and hair pigmentation.Summary
[0009] One aspect of the present disclosure provides a method for preventing, treating, or ameliorating obesity, overweight or alopecia areata disease, comprising administering to a subject in need thereof an effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0010] Another aspect of the present disclosure provides a method for weight management or chronic weight management, comprising administering to a subject in need thereof a effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0011] Still another aspect of the present disclosure provides use of a THR-βmodulator in the preparation of a medicament for the treatment of obesity, alopecia areata disease, or overweight, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0012] Yet still another aspect of the present disclosure provides use of a THR-βmodulator in the preparation of a medicament for weight management or chronic weight management, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0013] Yet still another aspect of the present disclosure provides a method for preventing, treating, or ameliorating obesity or overweight, comprising administering to a subject in need thereof a effective amount of a GLP-1R\GIPR\GCGR modulator, in combination with a effective amount of a THR-βmodulator, wherein the THR-β modulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0014] Yet still another aspect of the present disclosure provides a method for weight management or chronic weight management, comprising administering to a subject in need thereof an effective amount of a GLP-1R\GIPR\GCGR modulator, in combination with an effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0015] Yet still another aspect of the present disclosure provides use of a GLP-1R\GIPR\GCGR modulator, in combination with a THR-βmodulator in preparation of a medicament for the treatment of obesity or overweight, wherein the THR-β modulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0016] Yet still another aspect of the present disclosure provides use of a GLP-1R\GIPR\GCGR modulator, in combination with a THR-βmodulator in preparation of a medicament for weight management or chronic weight management, wherein the THR-β modulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0017] Yet still another aspect of the present disclosure provides a pharmaceutical composition comprising a GLP-1R\GIPR\GCGR modulator, a THR-βmodulator of the present disclosure, and a pharmaceutically acceptable excipient.Brief Description of Drawings
[0018] Fig. 1 shows in vivo body weight reduction of MGL-3196.
[0019] Fig. 2 shows in vivo body weight reduction of ALG-055009.Detailed Description
[0020] Definition
[0021] Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art.
[0022] “GLP-1R\GIPR dual agonist” refers to a compound with activity at each of the GLP-1R and GIPR, especially a compound having a balanced and sufficient activity at each receptor to provide the benefits of agonism of that receptor while avoiding unwanted side effects associated with too much activity of that receptor.
[0023] “GLP-1R\GCGR dual agonist” refers to a compound with activity at each of the GLP-1R and GCGR, especially a compound having a balanced and sufficient activity at each receptor to provide the benefits of agonism of that receptor while avoiding unwanted side effects associated with too much activity of that receptor.
[0024] “GLP-1R\GIPR dual antagonist” refers to a compound with activity at each of the GLP-1R and GIPR, especially a compound having a balanced and sufficient activity at each receptor to provide the benefits of antagonist of that receptor while avoiding unwanted side effects associated with too much activity of that receptor.
[0025] “GLP-1R\GCGR dual antagonist” refers to a compound with activity at each of the GLP-1R and GCGR, especially a compound having a balanced and sufficient activity at each receptor to provide the benefits of antagonist of that receptor while avoiding unwanted side effects associated with too much activity of that receptor.
[0026] “GLP-1R\GIPR\GCGR tripe agonist” refers to a compound with activity at each of the GLP-1R, GIPR and GCGR, especially a compound having a balanced and sufficient activity at each receptor to provide the benefits of agonism of that receptor while avoiding unwanted side effects associated with too much activity of that receptor.
[0027] “GLP-1R\GIPR\GCGR tripe antagonist” refers to a compound with activity at each of the GLP-1R, GIPR and GCGR, especially a compound having a balanced and sufficient activity at each receptor to provide the benefits of antagonist of that receptor while avoiding unwanted side effects associated with too much activity of that receptor.
[0028] "GLP-1R agonist / GIPR antagonist" refers to a compound that has activity at both the GLP-1R and GIPR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R agonism and GIPR antagonism.
[0029] “GLP-1R agonist\GCGR antagonist” refers to a compound that has activity at both the GLP-1R and GCGR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R agonism and GCGR antagonism.
[0030] “GLP-1R antagonist\GCGR agonist” refers to a compound that has activity at both the GLP-1R and GCGR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R antagonism and GCGR agonism.
[0031] GLP-1R antagonist\GIPR agonist refers to a compound that has activity at both the GLP-1R and GIPR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R antagonism and GIPR agonism.
[0032] “GLP-1R antagonist\GIPR antagonist” refers to a compound that has activity at both the GLP-1R and GIPR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R antagonism and GIPR antagonism.
[0033] “GLP-1R antagonist\GCGR antagonist” refers to a compound that has activity at both the GLP-1R and GCGR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R antagonism and GCGR antagonism.
[0034] “GLP-1R agonist\GIPR antagonist\GCGR agonist” refers to a compound that has activity at the GLP-1R, GIPR and GCGR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R agonism, GIPR antagonism and GCGR agonism.
[0035] “GLP-1R agonist\GIPR antagonist\GCGR antagonist” refers to a compound that has activity at the GLP-1R, GIPR and GCGR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R agonism, GIPR antagonism and GCGR antagonism.
[0036] “GLP-1R agonist\GIPR agonist\GCGR antagonist” refers to a compound that has activity at the GLP-1R, GIPR and GCGR receptors, particularly a compound that possesses a balanced and adequate level of activity at each receptor to provide the benefits of GLP-1R agonism, GIPR agonism and GCGR antagonism.
[0037] The phrase "effective amount" means an amount of a compound or a combination of compounds that ameliorates, attenuates or eliminates one or more of the symptoms of a particular disease or condition or prevents, modifies, or delays the onset of one or more of the symptoms of a particular disease or condition, or has the effect of weight management or chronic weight management.
[0038] The term "pharmaceutically acceptable salt" includes salts of compounds of Formula I and its prodrugs derived from the combination of a compound of this invention and an organic or inorganic acid or base. Suitable acids include acetic acid, adipic acid, benzenesulfonic acid, (+) -7, 7-dimethyl-2-oxobicyclo [2.2.1] heptane-l-methanesulfonic acid, citric acid, 1, 2-ethanedisulfonic acid, dodecyl sulfonic acid, fumaric acid, glucoheptonic acid, gluconic acid, glucuronic acid, hippuric acid, hydrochloride hemiethanolic acid, HBr, HCl, HI, 2-hydroxyethanesulfonic acid, lactic acid, lactobionic acid, maleic acid, methanesulfonic acid, methylbromide acid, methyl sulfuric acid, 2-naphthalenesulfonic acid, nitric acid, oleic acid, 4, 4'-methylenebis [3-hydroxy-2-naphthalenecarboxylic acid] , phosphoric acid, polygalacturonic acid, stearic acid, succinic acid, sulfuric acid, sulfosalicylic acid, tannic acid, tartaric acid, terphthalic acid, andj9-toluenesulfonic acid.
[0039] The term "subject" means an animal.
[0040] The term "animal" includes birds and mammals. In one embodiment a mammal includes a dog, cat, cow, horse, goat, sheep, pig or human. In one embodiment the animal is a human. In another embodiment the animal is a male. In another embodiment the animal is a female.
[0041] The term "prodrug" as used herein refers to any compound that when administered to a biological system generates a biologically active compound as a result of spontaneous chemical reaction (s) , enzyme catalyzed chemical reaction (s) , and / or metabolic chemical reaction (s) , or a combination of each. Standard prodrugs are formed using groups attached to functionality, e.g., HO-, HS-, HOOC-, R2N-, associated with the drug, that cleave in vivo. Standard prodrugs include but are not limited to carboxylate esters where the group is alkyl, aryl, aralkyl, acyloxyalkyl, alkoxycarbonyloxyalkyl as well as esters of hydroxyl, thiol and amines where the group attached is an acyl group, an alkoxycarbonyl, aminocarbonyl, phosphate or sulfate. The groups illustrated are exemplary, not exhaustive, and one skilled in the art could prepare other known varieties of prodrugs. Such prodrugs of the compounds of the present invention fall within this scope. Prodrugs must undergo some form of a chemical transformation to produce the compound that is biologically active or is a precursor of the biologically active compound. In some cases, the prodrug is biologically active, usually less than the drug itself, and serves to improve drug efficacy or safety through improved oral bioavailability, and / or pharmacodynamic half-life, etc. Prodrug forms of compounds may be utilized, for example, to improve bioavailability, improve subject acceptability such as by masking or reducing unpleasant characteristics such as bitter taste or gastrointestinal irritability, alter solubility such as for intravenous use, provide for prolonged or sustained release or delivery, improve ease of formulation, or provide site-specific delivery of the compound. Prodrugs are described in The Organic Chemistry of Drug Design and Drug Action, by Richard B. Silverman, Academic Press, San Diego, 1992. Chapter 8: "Prodrugs and Drug delivery Systems" pp. 352-401; Design of Prodrugs, edited by H. Bundgaard, Elsevier Science, Amsterdam, 1985; Design of Biopharmaceutical Properties through Prodrugs and Analogs, Ed. by E.B. Roche, American Pharmaceutical Association, Washington, 1977; and Drug Delivery Systems, ed. by R.L. Juliano, Oxford Univ. Press, Oxford, 1980.
[0042] The terms "treating" or "treatment" of a disease includes a slowing of the progress or development of a disease after onset or actually reversing some or all of the disease effects. Treatment also includes palliative treatment.
[0043] The term "preventing" includes a slowing of the progress or development of a disease before onset or precluding onset of a disease.
[0044] The term "thyroid hormone receptors" (TR or THR) refers to intracellular proteins located in cell nuclei that, following the binding of thyroid hormone, stimulate transcription of specific genes by binding to DNA sequences called thyroid hormone response elements (TREs) . In this manner TR regulates the expression of a wide variety of genes involved in metabolic processes (e.g., cholesterol homeostasis and fatty acid oxidation) and growth and development in many tissues, including liver, muscle and heart. There are at least two forms of TR; TR alpha (on chromosome 17) and TR beta (on chromosome 3) . Each of these isoforms also has two main isoforms: TR alpha-1 and TR alpha-2; and TR beta-1 and TR beta-2, respectively. TRs are high affinity receptors for thyroid hormones, especially triiodothyronine.
[0045] Provided are pharmaceutical compositions a compound useful in the present invention. Also provided are pharmaceutical compositions of the present invention having an oral bioavailability of least 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%or at least 80%.
[0046] “Pharmaceutically acceptable excipient” includes without limitation any adjuvant, carrier, excipient, glidant, sweetening agent, diluent, preservative, dye / colorant, flavor enhancer, surfactant, wetting agent, dispersing agent, suspending agent, stabilizer, isotonic agent, solvent, or emulsifier which has been approved by the United States Food and Drug Administration as being acceptable for use in humans or domestic animals.
[0047] “Co-administration” as used herein refers to administration of unit dosages of the compounds disclosed herein before or after administration of unit dosages of one or more additional therapeutic agents, for example, administration of the compound disclosed herein within seconds, minutes, or hours of the administration of one or more additional therapeutic agents. For example, in some embodiments, a unit dose of a compound of the present disclosure is administered first, followed within seconds or minutes by administration of a unit dose of one or more additional therapeutic agents. Alternatively, in other embodiments, a unit dose of one or more additional therapeutic agents is administered first, followed by administration of a unit dose of a compound of the present disclosure within seconds or minutes. In some embodiments, a unit dose of a compound of the present disclosure is administered first, followed, after a period of hours (e.g., 1-12 hours) , by administration of a unit dose of one or more additional therapeutic agents. In other embodiments, a unit dose of one or more additional therapeutic agents is administered first, followed, after a period of hours (e.g., 1-12 hours) , by administration of a unit dose of a compound of the present disclosure. Co-administration of a compound disclosed herein with one or more additional therapeutic agents generally refers to simultaneous or sequential administration of a compound disclosed herein and one or more additional therapeutic agents, such that therapeutically effective amounts of each agent are present in the body of the subject.
[0048] Provided are also pharmaceutically acceptable salts, hydrates, solvates, tautomeric forms, polymorphs, and prodrugs of the compounds described herein.
[0049] “Pharmaceutically acceptable” refers to compounds, salts, compositions, dosage forms and other materials which are useful in preparing a pharmaceutical composition that is suitable for veterinary or human pharmaceutical use.
[0050] The compounds described herein may be prepared and / or formulated as pharmaceutically acceptable salts or when appropriate as a free base. Pharmaceutically acceptable salts are non-toxic salts of a free base form of a compound that possesses the desired pharmacological activity of the free base. These salts may be derived from inorganic or organic acids or bases. For example, a compound that contains a basic nitrogen may be prepared as a pharmaceutically acceptable salt by contacting the compound with an inorganic or organic acid. Non-limiting examples of pharmaceutically acceptable salts include sulfates, pyrosulfates, bisulfates, sulfites, bisulfites, phosphates, monohydrogen-phosphates, dihydrogenphosphates, metaphosphates, pyrophosphates, chlorides, bromides, iodides, acetates, propionates, decanoates, caprylates, acrylates, formates, isobutyrates, caproates, heptanoates, propiolates, oxalates, malonates, succinates, suberates, sebacates, fumarates, maleates, butyne-1, 4-dioates, hexyne-1, 6-dioates, benzoates, chlorobenzoates, methylbenzoates, dinitrobenzoates, hydroxybenzoates, methoxybenzoates, phthalates, sulfonates, methylsulfonates, propylsulfonates, besylates, xylenesulfonates, naphthalene-1-sulfonates, naphthalene-2-sulfonates, phenylacetates, phenylpropionates, phenylbutyrates, citrates, lactates, γ-hydroxybutyrates, glycolates, tartrates, and mandelates. Lists of other suitable pharmaceutically acceptable salts are found in Remington: The Science and Practice of Pharmacy, 21st Edition, Lippincott Wiliams and Wilkins, Philadelphia, Pa., 2006.
[0051] Examples of “pharmaceutically acceptable salts” of the compounds disclosed herein also include salts derived from an appropriate base, such as an alkali metal (for example, sodium, potassium) , an alkaline earth metal (for example, magnesium) , ammonium and N (C1-C4 alkyl)4+. Also included are base addition salts, such as sodium or potassium salts.
[0052] The disclosure also provides pharmaceutical compositions comprising a therapeutically effective amount of a compound or a pharmaceutically acceptable salt thereof, and one or more pharmaceutically acceptable carriers or excipients. A composition can optionally contain an additional therapeutic agent. Pharmaceutically acceptable excipients and carriers include pharmaceutically acceptable substances, materials and vehicles. Non-limiting examples of types of excipients include liquid and solid fillers, diluents, binders, lubricants, glidants, surfactants, dispersing agents, disintegration agents, emulsifying agents, wetting agents, suspending agents, thickeners, solvents, isotonic agents, buffers, pH adjusters, absorption-delaying agents, stabilizers, antioxidants, preservatives, antimicrobial agents, antibacterial agents, antifungal agents, chelating agents, adjuvants, sweetening agents, flavoring agents, coloring agents, encapsulating materials and coating materials. The use of such excipients in pharmaceutical formulations is known in the art. For example, conventional vehicles and carriers include without limitation oils (e.g., vegetable oils such as olive oil and sesame oil) , aqueous solvents (e.g., saline, buffered saline (e.g., phosphate-buffered saline [PBS] ) and isotonic solutions (e.g., Ringer's solution)) , and organic solvents (e.g., dimethyl sulfoxide and alcohols [e.g., ethanol, glycerol and propylene glycol] ) . Except insofar as any conventional excipient or carrier is incompatible with a peptide product, the disclosure encompasses the use of conventional excipients and carriers in formulations containing a peptide product. See, e.g., Remington: The Science and Practice of Pharmacy, 21st Ed., Lippincott Williams &Wilkins (Philadelphia, Pennsylvania) (2005) ; Handbook of Pharmaceutical Excipients, 5th Ed., Rowe et ah, Eds., The Pharmaceutical Press and the American Pharmaceutical Association (2005) ; Handbook of Pharmaceutical Additives, 3rd Ed., Ash and Ash, Eds., Gower Publishing Co. (2007) ; and Pharmaceutical Pre-formulation and Formulation, Gibson, Ed., CRC Press (Boca Raton, Florida) (2004) .
[0053] An appropriate or suitable formulation can depend on various factors, such as the route of administration chosen. Potential routes of administration of a pharmaceutical composition include without limitation oral, parenteral (including intradermal, subcutaneous, intramuscular, intravascular, intravenous, intra-arterial, intraperitoneal, intracavitary and topical) , and topical (including transdermal, transmucosal, intranasal (e.g., by nasal spray or drop) , ocular (e.g., by eye drop) , pulmonary (e.g., by oral or nasal inhalation) , buccal, sublingual, rectal (e.g., by suppository) , and vaginal (e.g., by suppository) . In certain embodiments, a present modified peptide product is administered parenterally (e.g., subcutaneously, intravenously or intramuscularly) . In other embodiments, a peptide product is administered by oral inhalation or nasal inhalation or insufflation. In some embodiments, the carrier is an aqueous-based carrier, such as in a parenteral (e.g., subcutaneous, intravenous or intramuscular) formulation. In other embodiments, the carrier is a nonaqueous-based carrier. In certain embodiments, the nonaqueous-based carrier is a hydrofluoroalkane (HFA) or HFA-like solvent that may comprise sub-micron anhydrous a-lactose or / and other excipients, such as in a formulation for administration by oral inhalation or nasal inhalation or insufflation.
[0054] “administering" includes any mode of administration, such as oral, subcutaneous, sublingual, transmucosal, parenteral, intravenous, intra-arterial, buccal, sublingual, topical, vaginal, rectal, ophthalmic, otic, nasal, inhaled, intramuscular, intraosseous, intrathecal, and transdermal, or a combination thereof. "Administering" can also include providing a different compound that when ingested or delivered as above will necessarily transform into the compound that is desired to be administered, this type of “different compound” is often being referred to as a “prodrug” . "Administering" can also include prescribing or filling a prescription for a dosage form comprising a particular compound. "Administering" can also include providing directions to carry out a method involving a particular compound or a dosage form comprising the compound or compounds.
[0055] “subject in need thereof’ means a mammal, such as a human, with a condition, disease, disorder or symptom requiring treatment or therapy, including for example, those listed herein. In particular, the preferred individual to be treated is a human.
[0056] “Treatment” or “treat” or “treating” or “ameliorating” as used herein refers to an approach for obtaining beneficial or desired results. For purposes of the present disclosure, beneficial or desired results include, but are not limited to, alleviation of a symptom and / or diminishment of the extent of a symptom and / or preventing a worsening of a symptom associated with a disease or condition. In one embodiment, “treatment” or “treating” includes one or more of the following: a) inhibiting the disease or condition (e.g., decreasing one or more symptoms resulting from the disease or condition, and / or diminishing the extent of the disease or condition) ; b) slowing or arresting the development of one or more symptoms associated with the disease or condition (e.g., stabilizing the disease or condition, delaying the worsening or progression of the disease or condition) ; and c) relieving the disease or condition, e.g., causing the regression of clinical symptoms, ameliorating the disease state, delaying the progression of the disease, increasing the quality of life, and / or prolonging survival. “Obesity” is a medical condition characterized by an excessive amount of body fat. It is typically defined by a body mass index (BMI) of 30 or greater for adults. BMI is calculated by dividing a person's weight in kilograms by the square of their height in meters (kg / m2) .
[0057] “obesity” means, with regard to an individual, one having a BMI≥30 kg / m2.
[0058] “Overweight” refers to a person's weight exceeding the healthy weight range, and having a 27 kg / m2≤BMI<30 kg / m2.
[0059] “Chronic weight management” refers to the long-term and continuous control and management of weight for subject who are overweight or obese, in order to reduce health risks associated with obesity and to improve the quality of life. And when the subject is mice, the “long-term” refers to a period of six weeks; when the subject is human, the “long-term” refers to a period ranging from 52 weeks to 104 weeks.
[0060] “Weight management” refers to the intentional regulation and control of a subject weight to maintain a healthy weight range. It allows subject to keep their weight within the optional range for their health, reduce the risk of diseases, and improve overall quality of life, when the subject is human, the duration for weight management ranging from 26 weeks to 51 weeks.
[0061] Alopecia areata diseases (AGA) is a hereditary hair loss condition associated with changes in androgen levels. It is a progressive type of hair loss that typically begins in adolescence or just after puberty. AGA is known as male pattern baldness in men and female pattern hair loss in women. This type of hair loss is characterized by a gradual miniaturization of the hair follicles, leading to finer hairs and eventual shedding.
[0062] “synergistic effect” refers to the situation where the combined use of two or more agents results in an effect that is greater than the sum of their individual effects when used alone.
[0063] Methods of treatment
[0064] One aspect of the present disclosure provides a method for preventing, treating, or ameliorating obesity, overweight or alopecia areata disease, comprising administering to a subject in need thereof an effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0065] Another aspect of the present disclosure provides a method for weight management or chronic weight management, comprising administering to a subject in need thereof an effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0066] Still another aspect of the present disclosure provides use of a THR-βmodulator in the preparation of a medicament for the treatment of obesity, alopecia areata disease, or overweight, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0067] Yet still another aspect of the present disclosure provides use of a THR-βmodulator in the preparation of a medicament for weight management or chronic weight management, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0068] Yet still another aspect of the present disclosure provides a method for preventing, treating, or ameliorating obesity or overweight, comprising administering to a subject in need thereof an effective amount of a GLP-1R\GIPR\GCGR modulator, in combination with an effective amount of a THR-βmodulator, wherein the THR-β modulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0069] Yet still another aspect of the present disclosure provides a method for weight management or chronic weight management, comprising administering to a subject in need thereof an effective amount of a GLP-1R\GIPR\GCGR modulator, in combination with an effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0070] Yet still another aspect of the present disclosure provides use of a GLP-1R\GIPR\GCGR modulator, in combination with a THR-βmodulator in preparation of a medicament for the treatment of obesity or overweight, wherein the THR-β modulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0071] Yet still another aspect of the present disclosure provides use of a GLP-1R\GIPR\GCGR modulator, in combination with a THR-βmodulator in preparation of a medicament for weight management or chronic weight management, wherein the THR-β modulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0072] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator and THR-βmodulator are co-formulated into a pharmaceutical composition comprising a GLP-1R\GIPR\GCGR modulator, a THR-βmodulator, and a pharmaceutically acceptable excipient.
[0073] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is formulated into a pharmaceutical composition comprising a GLP-1R\GIPR\GCGR modulator and a pharmaceutically acceptable excipient, the THR-βmodulator is formulated into a pharmaceutical composition comprising a THR-βmodulator and a pharmaceutically acceptable excipient.
[0074] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is one to three modulators selected from three groups consisting of
[0075] (1) a GLP-1R agonist,
[0076] (2) a GLP-1R antagonist,
[0077] (3) a GIPR agonist,
[0078] (4) a GIPR antagonist,
[0079] (5) a GCGR agonist,
[0080] (6) a GCGR antagonist,
[0081] (7) a GLP-1\GIPR dual agonist,
[0082] (8) a GLP-1R\GCGR dual agonist
[0083] (9) a GLP-1R\GIPR dual antagonist,
[0084] (10) a GLP-1R\GCGR dual antagonist,
[0085] (11) a GLP-1R\GIPR\GCGR tripe agonist,
[0086] (12) a GLP-1R\GIPR\GCGR tripe antagonist,
[0087] (13) a GLP-1R agonist\GIPR antagonist,
[0088] (14) a GLP-1R agonist\GCGR antagonist,
[0089] (15) a GLP-1R antagonist\GCGR agonist,
[0090] (16) a GLP-1R antagonist\GIPR agonist,
[0091] (17) GLP-1R antagonist\GIPR antagonist,
[0092] (18) GLP-1R antagonist\GCGR antagonist,
[0093] (19) a GLP-1R agonist\GIPR antagonist\GCGR agonist,
[0094] (20) a GLP-1R agonist\GIPR antagonist\GCGR antagonist, and
[0095] (21) a GLP-1R agonist\GIPR agonist\GCGR antagonist.
[0096] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of a GLP-1R agonist, a GIPR agonist, a GIPR antagonist, a GLP-1R\GIPR dual agonist, a GLP-1R\GCGR dual agonist, a GLP-1R agonist\GIPR antagonist, a GLP-1R agonist\GCGR antagonist, a GLP-1R\GIPR\GCGR tripe agonist, a GLP-1R agonist\GIPR antagonist\GCGR agonist, a GLP-1R agonist\GIPR antagonist\GCGR antagonist, and a GLP-1R agonist\GIPR agonist\GCGR antagonist.
[0097] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, Orforglipron, Danuglipron, Lotiglipron, HRS-7535, CagriSema, Exendin-4, HRS-9531, NA-931, RGT-075, NN-9541, GMA106, HDM1002, Efocipegtrutide, ROSE-010, Noiiglutide, Cotadutide, Froniglutide, Amycretin, RAY1225, ZT002, SAL0112, CT-388, Efinopegdutide, Dapiglutide, Pemvidutide, Bofanglutide, Olatorepatide, VK2735, AMG133, CT-868, Aleniglipron, AZD-9550, AZD5004, PB-718, HM-15275, HDM-1005, NN-6177, LY3493269, RAY002, XW-014, XW-015, Utreglutide, PF-06954522, BI3006337, Bamadutide, DR10627, KN056, TERN-601, CT-996, GS-4571, ID110521156, LY3437943, HS-10501 (From Jiangsu Hansoh Pharmaceutical Co. Ltd. ) , and LY-3537031, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0098] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, Semaglutide, Liraglutide, Dulaglutide, VK2735, AMG133 and Retatrutide, Orforglipron, Aleniglipron, AZD5004, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0099] In some embodiments, wherein the THR-βmodulator is selected from the group consisting of
[0100] Resmetirom (MGL-3196)
[0101] or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof..
[0102] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, VK2735, AMG133, Orforglipron, Aleniglipron, AZD5004, Danuglipron, Lotiglipron, CT-996 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof, and the THR-βmodulator which is Resmetirom (MGL-3196) or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0103] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, VK2735, AMG133, Orforglipron, Aleniglipron, AZD5004, Danuglipron, Lotiglipron, CT-996 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof, and the THR-βmodulator which is ALG-055009, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0104] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, VK2735, AMG133, Orforglipron, Aleniglipron, AZD5004, Danuglipron, Lotiglipron, CT-996 and or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof, and the THR-βmodulator which is or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0105] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of:
[0106] and the THR-βmodulator is
[0107] ALG-055009 or those listed in Table 2, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0108] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator and the THR-βmodulator are administered together, simultaneously, sequentially, or alternately.
[0109] In some embodiments, wherein the subject is suffering from obesity.
[0110] In some embodiments, wherein the subject need chronic weight management.
[0111] In some embodiments, wherein the subject need weight management.
[0112] In some embodiments, wherein the subject is overweight.
[0113] In some embodiments, wherein the THR-βmodulator is administered once daily, twice daily, once weekly, once monthly, once every three months, once every six months, or once annually.
[0114] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is administered once daily, twice daily, once weekly, once monthly, once every three months, once every six months, or once annually.
[0115] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is administered once daily or once weekly, and the THR-βmodulator is administered once weekly.
[0116] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is administered subcutaneously, intravenously, intramuscularly, intraperitoneally, orally, or via inhalation.
[0117] In some embodiments, wherein the THR-β modulator is administered subcutaneously, intravenously, intramuscularly, intraperitoneally, orally, or via inhalation.
[0118] In some embodiments, wherein the THR-β modulator is administered subcutaneously, and the GLP-1R\GIPR\GCGR modulator is administered subcutaneously.
[0119] In some embodiments, wherein the subject is human.
[0120] In some embodiments, the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009 (From the patent: US11091467B2) , ABX-002 (From the patent: US20190210950A1) , HSK31679 (CN111801324B) , TERN-501 (From the patent: WO2021050945A1, US11034676B2, US11084802B2, WO2021041237A1, WO2020041741A1) , CS-060380 (From the company: Kaisi Kaidi (Shanghai) Pharmaceutical Technology Co., Ltd. ) , Kylo-0603 (From the company: Kylonova (Xiamen) Biopharma Co., Ltd) , ECC-4703 (From the patent: WO2021244582A1) , CS-060304 (From the company: Kaisi Kaidi (Shanghai) Pharmaceutical Technology Co., Ltd. ) , HPG-7233 (From the company: Hepagene Therapeutics (Sahnghai) Co. Ltd) , HP-515 (From the company: WO2019242766A1, CN112409340A) , CS-27109 (From the company: Kaisi Kaidi (Shanghai) Pharmaceutical Technology Co., Ltd. ) , Sobetirome and KY-41111 (WO2021104288A1, CN113278013A, WO2022143574A1, CN116178368A, CN118146217A) , or a pharmaceutically acceptable salt thereof.
[0121] In some embodiments, the GLP-1R\GIPR\GCGR modulator is selected from those listed in Table 1 below, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0122] Table 1
[0123] In some embodiments, the subject has one or more conditions selected from the group consisting of obesity, overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes or high cholesterol) , unhealthy behaviors, stress, medications, genes, and people’s environment.
[0124] In some embodiments, the THR-βmodulator is a compound derived from disclosed patents and literature.
[0125] In some embodiments, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of:
[0126] or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof;
[0127] and the THR-βmodulator is
[0128] ALG-055009 or those listed in Table 2, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0129] In some embodiments, the THR-βmodulator is selected from the disclosed patents including but not limit to, WO2007009913A1, WO2009037172A1, WO2023154842A1, CN111646979A, WO2019242766A1, CN112409340A, WO2019240938A1, CN114057701A, CN110938094A, CN113549058A, WO2020041741A1, WO2020077123A1, WO2021041237A1, WO2020123827A1, WO2021050945A1, WO2021231646A1, WO2022187403A1, WO2023086561, WO2020073974A1, CN111484481A, CN111592528A, CN112707892A, WO2020169069A1, WO2020227549A1, WO2022011120A1, WO2022099060A2, WO2022099049A1, WO2022099066A1, WO2022099044A1, CN111909137A, CN112300133A, WO2022242743A1, WO2020239076A1, WO2022194287A1, WO2022194278A1, CN112442013A, WO2021057791A1, CN113045551A, CN114195764A, CN114621207A, CN113045551B, WO2021104288A1, CN113278013A, WO2022143574A1, CN116178368A, CN118146217A, WO2021121210A1, CN113698388B, WO2022068915A1, WO2021143706A1, WO2021244582A1, CN114075173A, CN114591300A, CN112645936A, WO2022184177A1, WO2023023474A1, CN116063296A, CN113979963A, CN116836158A, CN117624069A, CN115650928A, WO2024169357A1, WO2023125716A1, WO2024141076A1, WO2024141104A1, CN117843621A, CN117327057A, CN112300211A, WO2021032218A1, WO2021129827A, WO2023280152A1, WO2023280150A1, WO2024141076A1, WO2024167961A2 CN114763363A, CN114907401A, CN116199717A, CN115974925A and CN118290483A.
[0130] In some embodiments, the THR-βmodulator is selected from those listed in Table 2 below, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.
[0131] Table 2
[0132] In some embodiments, the effective amount of a GLP-1R\GIPR\GCGR modulator is administered at a dose of about 0.1 mg to about 3 g, or about 1 mg to about 50 mg, or about 50 to about 250 mg, or about 150 to about 500 mg, or about 150 to about 250 mg, or about 250 mg to about 1 g, or about 100 mg to about 2 g, or about 500 mg to about 2 g, or about 500 mg to about 1 g, or about 100 mg to about 300 mg, about 5 mg to about 25 mg, about 20 mg to about 100 mg, about 5 mg to about 100 mg, about 5 mg to about 500 mg, about 50 mg to about 300 mg, about 100 mg to about 200 mg, about 100 mg to about 500 mg, or about 5 mg to about 50 mg;
[0133] In some embodiments, the effective amount of a THR-βmodulator is administered at a dose of about 0.1 mg to about 3 g, or about 1 mg to about 50 mg, or about 50 to about 250 mg, or about 150 to about 500 mg, or about 150 to about 250 mg, or about 250 mg to about 1 g, or about 100 mg to about 2 g, or about 500 mg to about 2 g, or about 500 mg to about 1 g, or about 100 mg to about 300 mg, about 5 mg to about 25 mg, about 20 mg to about 100 mg, about 5 mg to about 100 mg, about 5 mg to about 500 mg, about 50 mg to about 300 mg, about 100 mg to about 200 mg, about 100 mg to about 500 mg, or about 5 mg to about 50 mg;
[0134] Pharmaceutical composition
[0135] Yet still another aspect of the present disclosure provides a pharmaceutical composition comprising the GLP-1R\GIPR\GCGR modulator, the THR-βmodulator of the present disclosure, and a pharmaceutically acceptable excipient.
[0136] In some embodiments, the pharmaceutical composition comprising the compound, the stereoisomer, the pharmaceutically acceptable salt, or the deuterated compound thereof of the present disclosure may be prepared with one or more pharmaceutically acceptable excipients, the excipients may be selected in accordance with conventional practice. Tablets may contain excipients, including flow aids, fillers, binders, and the like. Aqueous compositions may be prepared in a sterile form and may generally be isotonic when intended to be delivered by means other than oral administration.
[0137] In some embodiments, the compositions may comprise excipients, such as those set forth in Rowe et al, Handbook of Pharmaceutical Excipients, 6th edition, American Pharmacists Association, 2009. Excipients may include ascorbic acid and other antioxidants, chelating agents such as ethylenediaminetetraacetic acid, carbohydrates such as dextrin, hydroxyalkylcellulose, hydroxyalkylmethylcellulose, stearic acid, and the like. In some embodiments, the compositions are provided in solid dosage forms, including solid oral dosage forms.
[0138] The pharmaceutical composition may be prepared by any of the methods well known in the art of pharmacy, including oral administration. Such methods include the step of bringing into association the active ingredient (e.g., a compound of the present disclosure or a pharmaceutical salt thereof) with one or more pharmaceutically acceptable excipients. In some embodiments, the pharmaceutical compositions are prepared by unifor mly and intimately bringing into association the active ingredient with liquid excipients or finely divided solid excipients or both, and then, if desired, shaping the product. Techniques and formulations generally are found in Remington: The Science and Practice of Pharmacy, 21st Edition, Lippincott Wiliams and Wilkins, Philadelphia, Pa., 2006.
[0139] In some embodiments, the pharmaceutical compositions of the present disclosure are presented in unit dosage form, including but not limited to capsules, sachets, or tablets, each containing a predetermined amount of the active ingredient. In one embodiment, the pharmaceutical composition is a tablet.
[0140] The pharmaceutical composition disclosed herein comprises one or more of the compound, the stereoisomer, the pharmaceutically acceptable salt, or the deuterated compound thereof of the present disclosure, as well as pharmaceutically acceptable excipients and, optionally, other therapeutic agents. The pharmaceutical compositions containing the active ingredient may be in any form suitable for the intended method of administration. When intended for oral use, for example, tablets, lozenges, ingots, aqueous or oil suspensions, dispersible powders or granules, emulsions, hard or soft capsules, syrups, or elixirs may be prepared. Compositions for oral use may be prepared according to any method known in the art for the manufacture of pharmaceutical compositions, and such compositions may contain one or more excipients, including sweeteners, flavoring agents, coloring agents, and preservatives, to provide palatable formulations. Tablets containing the active ingredient with a non-toxic pharmaceutically acceptable excipient are acceptable and said excipient is suitable for the production of tablets. These excipients may be, for example, inert diluents, such as calcium or sodium carbonate, lactose, lactose monohydrate, croscarmellose sodium, povidone, calcium or sodium phosphate; granulating and disintegrating agents, such as maize starch, or alginic acid; binding agents, such as cellulose, microcrystalline cellulose, starch, gelatin or acacia; and lubricating agents, such as magnesium stearate, stearic acid or talc. Tablets may be uncoated or may be coated by known techniques including microencapsulation to delay disintegration and adsorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate alone or with a wax may be employed.
[0141] The amount of active ingredients that may be combined with the inactive ingredients to produce a dosage form may vary depending upon the intended treatment subject and the mode of administration. For example, in some embodiments, a dosage form for oral administration to humans may contain approximately 1 to 1000 mg of active material formulated with an appropriate and convenient amount of a pharmaceutically acceptable excipient. In some embodiments, the pharmaceutically acceptable excipient varies from about 5%to about 95%of the total compositions (weight: weight) .
[0142] In some embodiments, the pharmaceutical composition of the present disclosure does not contain an agent that affects the rate at which the active ingredient is metabolized. Thus, it is understood that pharmaceutical compositions comprising a compound of the present disclosure in one aspect do not comprise an agent that would affect (e.g., slow, hinder or retard) the metabolism of a compound of the present disclosure or any other active ingredient administered separately, sequentially or simultaneously with a compound of the present disclosure. It is also understood that any of the methods, kits, articles of manufacture, and the like detailed herein in one aspect do not comprise an agent that would affect (e.g., slow, hinder or retard) the metabolism of a compound of the present disclosure or any other active ingredient administered separately, sequentially or simultaneously with a compound of the present disclosure.
[0143] In some embodiments, the above-described pharmaceutical compositions are for use in humans or animals.
[0144] The present disclosure also includes compounds of the present disclosure which are administered as a single active ingredient of a pharmaceutically acceptable composition that may be prepared by conventional methods known in the art, for example, by combining the active ingredient to a pharmaceutically acceptable, therapeutically inert organic and / or inorganic carrier or excipient, or by mixing therewith.
[0145] The present disclosure provided herein are uses of the compounds of the present disclosure as a second or other active ingredient, said second or other active ingredient being synergistic with other active ingredients in known drugs, or the compounds of the present disclosure being administered with such drugs.
[0146] The compounds of the present disclosure may also be used in the form of a prodrug or other suitably modified form that releases the active ingredient in vivo.
[0147] Compounds
[0148] The synthesis of some compounds of THR-β modulator refers to the patents: WO2007009913A1, WO2009037172A1, WO2023154842A1, CN111646979A, WO2019242766A1, CN112409340A, WO2019240938A1, CN114057701A, CN110938094A, CN113549058A, WO2020041741A1, WO2020077123A1, WO2021041237A1, WO2020123827A1, WO2021050945A1, WO2021231646A1, WO2022187403A1, WO2023086561, WO2020073974A1, CN111484481A, CN111592528A, CN112707892A, WO2020169069A1, WO2020227549A1, WO2022011120A1, WO2022099060A2, WO2022099049A1, WO2022099066A1, WO2022099044A1, CN111909137A, CN112300133A, WO2022242743A1, WO2020239076A1, WO2022194287A1, WO2022194278A1, CN112442013A, WO2021057791A1, CN113045551A, CN114195764A, CN114621207A, CN113045551B, WO2021104288A1, CN113278013A, WO2022143574A1, CN116178368A, CN118146217A, WO2021121210A1, CN113698388B, WO2022068915A1, WO2021143706A1, WO2021244582A1, CN114075173A, CN114591300A, CN112645936A, WO2022184177A1, WO2023023474A1, CN116063296A, CN113979963A, CN116836158A, CN117624069A, CN115650928A, WO2024169357A1, WO2023125716A1, WO2024141076A1, WO2024141104A1, CN117843621A, and CN117327057A.
[0149] The GLP-1R\GIPR\GCGR modulators can be purchased commercially or synthesized refers to the patents: WO2022017338, US11492365B2, WO2018056453A1, WO2022040600, WO2021242817, WO2022031994, WO2021018023, WO2021154796, WO2021081207, WO2021197464, WO2021254470, WO2022007979 , WO2023141044A1, WO2022199458, WO2025119206, WO2025026270 and WO2025026270.
[0150] Biological Examples
[0151] Example 1:
[0152] Note: s.c. Subcutaneous (ly) ; p.o.: Oral (ly) ; Q2W: Every two weeks / twice a month;
[0153] QD: Once a day; DIO: diet-induced obesity mice; ROA: route of administration;
[0154] The objective of this study was to evaluate the therapeutic efficacy of MGL-3196.
[0155] The NASH model was constructed using HFD diet combined with CCl4 injection. When the mice were fed HFD for 12 weeks, mice were randomly divided into 2 groups according to their body weight, 10 mice in each group. Mice were intraperitoneally injected with 5%CCl4 solution twice a week according to 2.5 mL / kg body weight. The mice in the G2 group were given solvent (100%MCT) as Vehicle, and the G3 mice were given MGL-3196 (3 mg / kg) for 28 days by oral gavage. The body weight of the mice were measured every day.
[0156] Fig. 1 showed there was a significant effect on chronic weight management. The body weight of mice began to reduce at day 2 after taking medication (MGL-3196) and continued to reduce to maximum levels around days 21-23. The reduction of body weight of mice maintained until the end of dosing medication (MGL-3196) at day 28.
[0157] Example 2:
[0158] Mice and modeling:
[0159] Five-week-old male mice (C57BL / 6J) [Gem Pharmatech] were fed a high-fat diet (D12492 [Research Diets, Inc. ] ) with ad libitum fresh water and housed three to four mice per cage in a controlled environment (21-25℃, 30%-70%relative humidity) with a 12-h dark / light cycle. After 16-17 weeks of feeding, the mice had obesity (mean starting weight about 51 g [range 48.3-53.2 g] ) . Mice were grouped according to body weight and body fat percentage before the DIO (diet-induced obesity) studies. All operations and managements were carried out in strict accordance with the SOP institutional guidelines.
[0160] Study design
[0161] Base on body weight and fat percentage, animals were randomly divided into 2 groups (N=10 in each group) including DIO model group and ALG-055009 (3 mg / kg, QD*3W, PO) . The details of dosing information were shown as below.
[0162] Note: p.o.: Oral (ly) ; QD: Once a day; DIO: diet-induced obesity mice; ROA: route of administration;
[0163] Body weight
[0164] During the treatment period in DIO studies, animals’ body weight were recorded daily in the morning before afternoon dosing.
[0165] Shown as Fig. 2, the results indicated that ALG-055009 significantly reduced body weight.
[0166] Example 3. In vivo body weight reduction of GLP-1R agonists in group A monotherapy and combined with THR-βmodulator in humanized GLP-1R DIO (Diet-induced-obesity) mice model
[0167] THR-βmodulator: MGL-3196 or ALG-055009:
[0168] GLP-1R agonists in group A:
[0169] Mice and modeling:
[0170] Five-week-old male humanized GLP-1R mice [GemPharmatech] were fed a high-fat diet with ad libitum fresh water and housed three to four mice per cage in a controlled environment (21-25℃, 30%–70%relative humidity) with a 12-h dark / light cycle. After 14-16 weeks of feeding, the mice had obesity. Mice were grouped according to body weight and body composition before the DIO studies. All operations and managements were carried out in strict accordance with the SOP institutional guidelines.
[0171] Study design
[0172] Base on body weight, animals were randomly divided into 10 groups (N=7 in each group) including lean hGLP-1R mice group, hGLP-1R DIO model group and hGLP-1R DIO mice with different treatments. The details of dosing information were shown as below.
[0173] Note:
[0174] 1. DIO: Diet induced obesity;
[0175] 2. ROA: Route of administration;
[0176] 3. SC: subcutaneously; PO: orally;
[0177] 4. QD: Every day;
[0178] Body weight and food intake detection
[0179] During the treatment period (14 days) in DIO studies, animals’ body weight and food intake were recorded daily in the morning.
[0180] Results:
[0181] The results indicated that MGL-3196 when combined with GLP-1R agonists in group A, could significantly reduce body weight, showing a better effect compared to the use of GLP-1R agonists in group A or MGL-3196 alone.
[0182] The results indicated that ALG-055009 when combined with GLP-1R agonists in group A, could significantly reduce body weight, showing a better effect compared to the use of GLP-1R agonists in group A or ALG-055009 alone.
[0183] Example 4. In vivo body weight reduction of GLP-1R agonists in group A monotherapy and combined with THR-βmodulator in humanized GLP-1R DIO (Diet-induced-obesity) mice model
[0184] THR-βmodulator: MGL-3196 or ALG-055009;
[0185] GLP-1R agonists in group A:
[0186] Mice and modeling:
[0187] Five-week-old male humanized GLP-1R mice [GemPharmatech] were fed a high-fat diet with ad libitum fresh water and housed three to four mice per cage in a controlled environment (21-25℃, 30%–70%relative humidity) with a 12-h dark / light cycle. After 14-16 weeks of feeding, the mice had obesity. Mice were grouped according to body weight and body composition before the DIO studies. All operations and managements were carried out in strict accordance with the SOP institutional guidelines.
[0188] Study design
[0189] Base on body weight, animals were randomly divided into 10 groups (N=7 in each group) including lean hGLP-1R mice group, hGLP-1R DIO model group and hGLP-1R DIO mice with different treatments. The details of dosing information were shown as below.
[0190] Note:
[0191] 1. DIO: Diet induced obesity;
[0192] 2. ROA: Route of administration;
[0193] 3. SC: subcutaneously;
[0194] Body weight and food intake detection
[0195] During the treatment period (14 days) in DIO studies, animals’ body weight and food intake were recorded daily in the morning.
[0196] Results:
[0197] The results indicated that MGL-3196 when combined with GLP-1R agonists in group A, could significantly reduce body weight, showing a better effect compared to the use of GLP-1R agonists in group A or MGL-3196 alone.
[0198] The results indicated that ALG-055009 when combined with GLP-1R agonists in group A, could significantly reduce body weight, showing a better effect compared to the use of GLP-1R agonists in group A or ALG-055009 alone.
[0199] Example 5. In vivo body weight reduction of GLP-1R agonists monotherapy and combined with THR-β modulator in humanized GLP-1R DIO (Diet-induced-obesity) mice model
[0200] THR-βmodulator: MGL-3196 or ALG-055009;
[0201] GLP-1R agonists in group B:
[0202] Mice and modeling:
[0203] Five-week-old male humanized GLP-1R mice [GemPharmatech] were fed a high-fat diet with ad libitum fresh water and housed three to four mice per cage in a controlled environment (21-25℃, 30%–70%relative humidity) with a 12-h dark / light cycle. After 14-16 weeks of feeding, the mice had obesity. Mice were grouped according to body weight and body composition before the DIO studies. All operations and managements were carried out in strict accordance with the SOP institutional guidelines.
[0204] Study design
[0205] Base on body weight, animals were randomly divided (N=7 in each group) including lean hGLP-1R mice group, hGLP-1R DIO model group and hGLP-1R DIO mice with different treatments. The details of dosing information were shown as below.
[0206] Note:
[0207] 1. DIO: Diet induced obesity;
[0208] 2. ROA: Route of administration;
[0209] 3. SC: subcutaneously; PO: orally;
[0210] 4. QD: Every day;
[0211] Body weight and food intake detection
[0212] During the treatment period (14 days) in DIO studies, animals’ body weight and food intake were recorded daily in the morning.
[0213] Results:
[0214] The results indicated that MGL-3196 when combined with GLP-1R agonists in group B, could significantly reduce body weight, showing a better effect compared to the use of GLP-1R agonists in group B or MGL-3196 alone.
[0215] The results indicated that ALG-055009 when combined with GLP-1R agonists in group B, could significantly reduce body weight, showing a better effect compared to the use of GLP-1R agonists in group B or ALG-055009 alone.
[0216] Example 6: In vivo metabolic indicators of the THR-β modulator (9 mg / kg, Q2W*4W, s.c) in combination with semaglutide in mice DIO model
[0217] THR-βmodulator: MGL-3196 or ALG-055009.
[0218] Mice and model:
[0219] Five-week-old male mice (C57BL / 6J) [Gem Pharmatech] were fed a high-fat diet (D12492 [Research Diets, Inc. ] ) with ad libitum fresh water and housed three to four mice per cage in a controlled environment (21-25℃, 30%-70%relative humidity) with a 12-h dark / light cycle. After 16-17 weeks of feeding, the mice had obesity (mean starting weight about 49 g [range 44.6-53.1 g] ) . Mice were grouped according to body weight and body fat percentage before the DIO (diet-induced obesity) studies. All operations and managements were carried out in strict accordance with the SOP institutional guidelines.
[0220] Study design
[0221] Base on body weight and fat percentage, animals were randomly divided into 7 groups (N=5-10 in each group) , the details of dosing information were shown as below.
[0222] Note:
[0223] a. ROA: route of administration; s.c.: subcutaneous; Q2W: once every two weeks;
[0224] QD: once daily
[0225] Body weight measurement
[0226] During the treatment period in DIO studies, animals’ body weight were recorded daily in the morning before afternoon dosing.
[0227] Cholesterol and Low-Density Lipoprotein Cholesterol measurement
[0228] On Day 29, 4 weeks after administration, mice were fasted for 5~6h and sacrificed. heart blood were collected and plasma were isolated, Cholesterol (Chol) and Low-Density Lipoprotein Cholesterol (LDL-c) were detected by biochemical analyzer (Hitachi, 3500) .
[0229] Body fat weight and lean body weight measurement.
[0230] On Day29, Body fat weight and lean body weight were measured.
[0231] Results:
[0232] The results indicated that MGL-3196 when combined with semaglutide, could significantly reduce body weight, showing a better effect compared to the use of semaglutide or MGL-3196 alone.
[0233] The results indicated that ALG-055009 when combined with semaglutide, could significantly reduce body weight, showing a better effect compared to the use of semaglutide or ALG-055009 alone.
Claims
A method for preventing, treating, or ameliorating obesity, overweight or alopecia areata disease, comprising administering to a subject in need thereof an effective amount of a THR-βmodulator, wherein the THR-βmodulator is selected from the group consisting of Resmetirom (MGL-3196) , Tiratricol, ALG-055009, ABX-002, HSK31679, TERN-501, CS-060380, Kylo-0603, ECC-4703, CS-060304, HPG-7233, HP-515, CS-27109, Sobetirome, KY-41111 andor stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.A method for weight management or chronic weight management, comprising administering to a subject in need thereof an effective amount of a THR-βmodulator of claim 1.Use of a THR-βmodulator of claim 1 in the preparation of a medicament for the treatment of obesity, alopecia areata disease, or overweight.Use of a THR-βmodulator of claim 1 in the preparation of a medicament for weight management or chronic weight management.A method for preventing, treating, or ameliorating obesity or overweight, comprising administering to a subject in need thereof an effective amount of a GLP-1R\GIPR\GCGR modulator, in combination with an effective amount of a THR-βmodulator of claim 1.A method for weight management or chronic weight management, comprising administering to a subject in need thereof an effective amount of a GLP-1R\GIPR\GCGR modulator, in combination with an effective amount of a THR-βmodulator of claim 1.Use of a GLP-1R\GIPR\GCGR modulator, in combination with a THR-βmodulator of claim 1 in preparation of a medicament for the treatment of obesity or overweight.Use of a GLP-1R\GIPR\GCGR modulator, in combination with a THR-βmodulator of claim 1 in preparation of a medicament for weight management or chronic weight management.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator and THR-βmodulator are co-formulated into a pharmaceutical composition comprising a GLP-1R\GIPR\GCGR modulator, a THR-βmodulator, and a pharmaceutically acceptable excipient.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is formulated into a pharmaceutical composition comprising a GLP-1R\GIPR\GCGR modulator and a pharmaceutically acceptable excipient, the THR-βmodulator is formulated into a pharmaceutical composition comprising a THR-β modulator and a pharmaceutically acceptable excipient.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is one to three modulators selected from the group consisting of(1) a GLP-1R agonist,(2) a GLP-1R antagonist,(3) a GIPR agonist,(4) a GIPR antagonist,(5) a GCGR agonist,(6) a GCGR antagonist,(7) a GLP-1\GIPR dual agonist,(8) a GLP-1R\GCGR dual agonist(9) a GLP-1R\GIPR dual antagonist,(10) a GLP-1R\GCGR dual antagonist,(11) a GLP-1R\GIPR\GCGR tripe agonist,(12) a GLP-1R\GIPR\GCGR tripe antagonist,(13) a GLP-1R agonist\GIPR antagonist,(14) a GLP-1R agonist\GCGR antagonist,(15) a GLP-1R antagonist\GCGR agonist,(16) a GLP-1R antagonist\GIPR agonist,(17) GLP-1R antagonist\GIPR antagonist,(18) GLP-1R antagonist\GCGR antagonist,(19) a GLP-1R agonist\GIPR antagonist\GCGR agonist,(20) a GLP-1R agonist\GIPR antagonist\GCGR antagonist, and(21) a GLP-1R agonist\GIPR agonist\GCGR antagonist.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of a GLP-1R agonist, a GIPR agonist, a GIPR antagonist, a GLP-1R\GIPR dual agonist, a GLP-1R\GCGR dual agonist, a GLP-1R agonist\GIPR antagonist, a GLP-1R agonist\GCGR antagonist, a GLP-1R\GIPR\GCGR tripe agonist, a GLP-1R agonist\GIPR antagonist\GCGR agonist, a GLP-1R agonist\GIPR antagonist\GCGR antagonist, and a GLP-1R agonist\GIPR agonist\GCGR antagonist.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, Orforglipron, Danuglipron, Lotiglipron, HRS-7535, CagriSema, Exendin-4, HRS-9531, NA-931, RGT-075, NN-9541, GMA106, HDM1002, Efocipegtrutide, ROSE-010, Noiiglutide, Cotadutide, Froniglutide, Amycretin, RAY1225, ZT002, SAL0112, CT-388, Efinopegdutide, Dapiglutide, Pemvidutide, Bofanglutide, Olatorepatide, VK2735, AMG133, CT-868, Aleniglipron, AZD-9550, AZD5004, PB-718, HM-15275, HDM-1005, NN-6177, LY3493269, RAY002, XW-014, XW-015, Utreglutide, PF-06954522, BI3006337, Bamadutide, DR10627, KN056, TERN-601, CT-996, GS-4571, ID110521156, LY3437943, HS-10501, LY-3537031, andor stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, Semaglutide, Liraglutide, Dulaglutide, VK2735, AMG133 and Retatrutide, Orforglipron, Aleniglipron, AZD5004, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from those listed in Table 1, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the THR-βmodulator is selected from the group consisting ofor stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the THR-βmodulator is selected from those listed in Table 2, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, VK2735, AMG133, Orforglipron, Aleniglipron, AZD5004, Danuglipron, Lotiglipron, CT-996 andor stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof, and the THR-βmodulator is Resmetirom (MGL-3196) or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, VK2735, AMG133, Orforglipron, Aleniglipron, AZD5004, Danuglipron, Lotiglipron, CT-996 andor stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof, and the THR-βmodulator which is ALG-055009, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of Tirzepatide, PEG-Loxenatide, Semaglutide, Beinaglutide, Liraglutide, Dulaglutide, Lixisenatide, Exenatide, Supaglutide, Mazdutide, Albenatide, Visepegenatide, HR-17031, Retatrutide, Ecnoglutide, Survodutide, Efpeglenatide, Glutazumab, VK2735, AMG133, Orforglipron, Aleniglipron, AZD5004, Danuglipron, Lotiglipron, CT-996 andor stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof, and the THR-βmodulator is or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one ofthe preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is selected from the group consisting of:or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof;and the THR-βmodulator isALG-055009 or those listed in Table 2, or stereoisomers thereof, pharmaceutically acceptable salts thereof, deuterium substitutes thereof, isomers thereof, prodrugs thereof, or metabolites thereof.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator and the THR-βmodulator are administered together, simultaneously, sequentially, or alternately.The method or the use of any one of the preceding claims, wherein the subject suffers from obesity.The method or the use of any one of the preceding claims, wherein the subject needs chronic weight management.The method or the use of any one of the preceding claims, wherein the subject needs weight management.The method or the use of any one of the preceding claims, wherein the subject is overweight.The method or the use of any one of the preceding claims, wherein the THR-βmodulator is administered once daily, twice daily, once weekly, once monthly, once every three months, once every six months, or once annually.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is administered once daily, twice daily, once weekly, once monthly, once every three months, once every six months, or once annually.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is administered once daily or once weekly, and the THR-βmodulator is administered once weekly.The method or the use of any one of the preceding claims, wherein the GLP-1R\GIPR\GCGR modulator is administered subcutaneously, intravenously, intramuscularly, intraperitoneally, orally, or via inhalation.The method or the use of any one of the preceding claims, wherein the THR-βmodulator is administered subcutaneously, intravenously, intramuscularly, intraperitoneally, orally, or via inhalation.The method or the use of any one of the preceding claims, wherein the THR-βmodulator is administered subcutaneously, and the GLP-1R\GIPR\GCGR modulator is administered subcutaneously.The method or the use of any one ofthe preceding claims, wherein the subject is human.A pharmaceutical composition comprising the GLP-1R\GIPR\GCGR modulator and the THR-βmodulator of any one of the preceding claims, or a pharmaceutically acceptable excipient thereof.
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