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Title:
COMPOSITIONS AND METHODS FOR THE TREATMENT OF CYSTIC FIBROSIS
Document Type and Number:
WIPO Patent Application WO/1999/040883
Kind Code:
A2
Abstract:
The invention is directed to novel pharmaceutical compositions comprising chemical agents that are useful in the treatment and prevention of cystic fibrosis and the prevention of signs and symptoms of this disease. These pharmaceutical compositions are surprisingly successful in the treatment of disorders related to cystic fibrosis including disorders of blood production. Many of these compositions of the invention are even more effective when administered to a patient in pulses. Pulse therapy is not a form of discontinuous administration of the same amount of a composition over time, but comprises administration of the same dose of the composition at a reduced frequency or administration of reduced doses.

Inventors:
FALLER DOUGLAS V (US)
PERRINE SUSAN P (US)
STAMATOYANNOPOULOS GEORGE (US)
Application Number:
PCT/US1999/003014
Publication Date:
August 19, 1999
Filing Date:
February 11, 1999
Export Citation:
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Assignee:
FALLER DOUGLAS V (US)
PERRINE SUSAN P (US)
STAMATOYANNOPOULOS GEORGE (US)
International Classes:
A61K9/22; A61K31/00; A61K31/165; A61K31/191; A61K31/192; A61K31/194; A61K31/195; A61K31/216; A61K31/22; (IPC1-7): A61K/
Domestic Patent References:
WO1998040078A11998-09-17
WO1998056370A21998-12-17
WO1994004671A11994-03-03
WO1998004290A21998-02-05
WO1996027369A21996-09-12
Foreign References:
US4704402A1987-11-03
Other References:
RUBENSTEIN, RONALD C. (1) ET AL: "A pilot clinical trial of oral sodium 4- phenylbutyrate (Buphenyl) in DELTAF508-homozygous cystic fibrosis patients: Partial restoration of nasal epithelial CFTR function." AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, (FEB., 1998) VOL. 157, NO. 2, PP. 484-490. , XP000949440
WALSH S M ET AL: "COMBINATION OF DRUG AND GENE DELIVERY BY GELATIN NANOSPHERES FOR THE TREATMENT OF CYSTIC FIBROSIS" PROCEEDINGS OF THE INTERNATIONAL SYMPOSIUM ON CONTROLLED RELEASE OF BIOACTIVE MATERIALS,US,DEERFIELD, IL., CONTROLLED RELEASE SOC, vol. SYMP. 24, 15 June 1997 (1997-06-15), pages 75-76, XP002052415 ISSN: 1022-0178
RUBENSTEIN ET AL: "In vitro pharmacologic restoration of CFTR-mediated chloride transport with sodium 4-phenylbutyrate in cystic fibrosis epithelial cells containing delta.F508-CFTR" JOURNAL OF CLINICAL INVESTIGATION,US,NEW YORK, NY, vol. 10, no. 100, 15 November 1997 (1997-11-15), pages 2457-2465, XP002076381 ISSN: 0021-9738 cited in the application
KONSTAN, MICHAEL W. (1) ET AL: "Effect of High -Dose Ibuprofen In Patients With Cystic Fibrosis." NEW ENGLAND JOURNAL OF MEDICINE, (1995) VOL. 332, NO. 13, PP. 848-854. , XP000951543
Attorney, Agent or Firm:
Remenick, James (L.L.P. The Warner 1299 Pennsylvania Avenue N.W. Washington, DC, US)
Dean, John Paul (Withers & Rogers Goldings House 2 Hays Lane London SE1 2HW, GB)
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Claims:
We Claim:
1. A composition formulated for use in the treatment or prevention of cystic fibrosis comprising the administration of a composition comprising a physiologically effective amount of one or more agents selected from the group consisting of butyric acid ethyl ester, 2,2dimethyl butyric acid, 2,2diethyl butyric acid, 3,3dimethyl butyric acid, 3,3diethyl butyric acid, 2,3dimethyl succinic acid, methoxy acetic acid, phenoxyacetic acid, 2and 3thiophenoxy propionic acid, 2and 3phenoxy propionic acid, 2and 3phenyl propionic acid, 4chlorophenoxy2propionic acid, methoxy acetic acid, or 2thiophenoxy acetic acid, or a chemical compound of the structure phenyl R9RIO wherein R9 is CHX, CO, NHX, OHX, SHx, or a branched or linear aryl chain; R, o is CHX, CO, HX, NHX, OHX, SHX, CONHX, COOH, COSHx, COOR", COR", CO or OR,,; and R, l is CHX, CO, Hx, NHX, OHx, SHx or a branched or linear alkyl chain; wherein x is or 3.
2. The composition of claim 1 wherein the chemical compound of the structure phenylR9R, o is selected from the group consisting of acids, amines and amides of cinnamic acid, hydrocinnamic acid, dihydrocinnamic acid, amethyl hydrocinnamic acid, dihydro cinnamic acid, 2,3dimethyl hydrocinnamic, dihydrocinnamic acid, phenyl acetate ethyl ester, 2phenoxypropionic acid, phenoxy acetic acid, or 3phenyl butyric acid.
3. The composition of claim 1 wherein the one or more agents is substituted with one or more halogens.
4. The composition of claim 3 wherein the halogen is selected from the group consisting of chlorine, fluorine, iodine, bromine or mixtures or combinations thereof.
5. The composition of claim 1 wherein administration is pulsed administration or timedrelease administration.
6. The composition of claim 5 wherein the pulsed administration comprises a plurality of individual pulses delivered to a patient continuously over a period of 2 hours, 4 hours, 6 hours, 8 hours, 10 hours, 12 hours, 14 hours, 16 hours, 2 days, 3 days, 4 days, 5 days, 6 days, 7 days, two weeks, three weeks or four weeks.
7. The composition of claim 5 wherein the pulsed administration comprises a plurality of individual pulses delivered at regular intervals measuring from between 3 to 9 hours.
8. The composition of claim 1 which further comprises a pharmaceutically acceptable carrier.
9. The composition of claim 1 which further comprises a compound that positively affects expression of a CFTR molecule.
10. The composition of claim 9 wherein the compound that positively affects expression of the CFTR molecule, increases the extent or magnitude of CFTR function, increases the expression of the CFTR molecule, increases transport of the CFTR molecule to the cell surface, increases halflife of the CFTR molecule, increases expression from a CFTR gene, increases CFTR transcript levels, increases post transcriptional processes which increase CFTR transcript levels in the cell, or increases translation posttranslational processing of a CFTR gene product.
11. The composition of claim 1 wherein the agent treats defective chloride ion transport.
12. A composition formulated for use in the therapy of cystic fibrosis comprising administering to a patient a quantity of an agent, or pharmaceutically acceptable derivatives thereof, effective for said therapy, said agent selected from the group consisting of butyric acid ethyl ester, 2,2dimethyl butyric acid, 2,2diethyl butyric acid, 3,3dimethyl butyric acid, 3,3diethyl butyric acid, 2,3dimethyl succinic acid, methoxy acetic acid, phenoxyacetic acid, 2and 3thiophenoxy propionic acid, 2 and 3phenoxy propionic acid, 2and 3phenyl propionic acid, 4chlorophenoxy2propionic acid, methoxy acetic acid, 2thiophenoxy acetic acid, or a chemical compound of the structure phenylR9R, o wherein R9 is CHX, CO, NHX, OHX, SHX, or a branched or linear aryl chain; Rlois CHX, CO, Hx, NHX, OH » SH » CONHX, COOH, COSHX, COOR", COR", CO or OR"; and R"is CHX, CO, Hx, NHx, OHX, SHx or a branched or linear alkyl chain; wherein x is or 3.
13. The composition of claim 12 wherein the chemical compound of the structure phenylR9Rio is selected from the group consisting of acids, amines and amides of cinnamic acid, hydrocinnamic acid, dihydrocinnamic acid, amethyl hydrocinnamic acid, dihydro cinnamic acid, 2,3dimethyl hydrocinnamic, dihydrocinnamic acid, phenyl acetate ethyl ester, 2phenoxypropionic acid, phenoxy acetic acid, and 3phenyl butyric acid.
14. A composition formulated for use in enhancing expression of CFTR comprising the administration of a physiologically effective amount of one or more agents or pharmaceutically acceptable derivatives thereof, said agents selected from the group consisting of butyric acid ethyl ester, 2,2dimethyl butyric acid, 2,2diethyl butyric acid, 3,3dimethyl butyric acid, 3,3diethyl butyric acid, 2,3dimethyl succinic acid, methoxy acetic acid, phenoxyacetic acid, 2and 3thiophenoxy propionic acid, 2 and 3phenoxy propionic acid, 2and 3phenyl propionic acid, 4chlorophenoxy2propionic acid, methoxy acetic acid, 2thiophenoxy acetic acid, and chemical compounds of the structure phenylR9R, o wherein R9 is CHX, CO, NHX, OHX, SHX, or a branched or linear aryl chain; Rlo is CHx, CO, Hx, NHX, OHX, SHx, CONHX, COOH, COSHX, COOR", COR", CO or OR"; and R"is CHX, CO, Hx, NHX, OHX, SHX or a branched or linear alkyl chain; wherein x is 0,1,2 or 3.
15. The composition of claim 14 wherein the chemical compounds of the structure phenylR9R, o are selected from the group consisting of acids, amines and amides of cinnamic acid, hydrocinnamic acid, dihydrocinnamic acid, amethyl hydrocinnamic acid, dihydro cinnamic acid, 2,3dimethyl hydrocinnamic, dihydrocinnamic acid, phenyl acetate ethyl ester, 2phenoxypropionic acid, phenoxy acetic acid, and 3phenyl butyric acid.
16. The composition of claim 14 wherein administration is pulsed administration.
17. The composition of claim 14 wherein enhancement of the expression of CFTR comprises increasing the expression of CFTR genes, increasing the number of CFTRexpressing cells or increasing the function or activity of CFTR.
18. The composition of claim 14 wherein CFTR expression is enhanced greater than about 30%.
19. The composition of claim 14 wherein CFTR expression is enhanced greater than about 100%.
20. The composition of claim 14 wherein CFTR expression is enhanced greater than about 200%.
Description:
INTERNATIONAL SEARCH REPORT natlonal Application No eCT/US 99/03014 C. (Continuation) DOCUMENTS CONSIDERED TO BE RELEVANT Category Citation of document, with indication, where appropriate, of the relevant passages Relevant to claim No. X RUBENSTEIN, RONALD C. (1) ET AL:"A pilot 1,5-8, clinical trial of oral sodium 4-11,12, phenylbutyrate (Buphenyl) in 14,16-20 DELTAF508-homozygous cystic fibrosis patients: Partial restoration of nasal epithelial CFTR function." AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, (FEB., 1998) VOL. 157, NO. 2, PP. 484-490., XP000949440 the whole document X WALSH S M ET AL:"COMBINATION OF DRUG AND 1,5-8, GENE DELIVERY BY GELATIN NANOSPHERES FOR 11,12, THE TREATMENT OF CYSTIC FIBROSIS"14,16-20 PROCEEDINGS OF THE INTERNATIONAL SYMPOSIUM ON CONTROLLED RELEASE OF BIOACTIVE MATERIALS, US, DEERFIELD, IL., CONTROLLED RELEASE SOC, vol. SYMP. 24,15 June 1997 (1997-06-15), pages 75-76, XP002052415 ISSN: 1022-0178 the whole document X RUBENSTEIN ET AL:"In vitro pharmacologic 1,5-8, restoration of CFTR-mediated chloride 11,12, transport with sodium 4-phenylbutyrate in 14,16-20 cystic fibrosis epithelial cells containing delta. F508-CFTR" JOURNAL OF CLINICAL INVESTIGATION, US, NEW YORK, NY, vol. 10, no. 100, 15 November 1997 (1997-11-15), pages 2457-2465, XP002076381 ISSN: 0021-9738 cited in the application the whole document X KONSTAN, MICHAEL W. (1) ET AL:"Effect of 1,5-8, High-Dose Ibuprofen In Patients With 11,12, CysticFibrosis."14,16-20 NEW ENGLAND JOURNAL OF MEDICINE, (1995) VOL. 332, NO. 13, PP. 848-854., XP000951543 the whole document A WO 94 04671 A (UNIV IOWA RES FOUND 1-20 ; GENZYME CORP (US)) 3 March 1994 (1994-03-03) the whole document 1 INTERNATIONAL SEARCH REPORT I-natlonal Appllcatlon No rCT/US99/03014 C. (Continuatlon) DOCUMENTS CONSIDERED TO BE RELEVANT Category Citation of document, with indication, where appropriate, of the relevant passages Relevant to claim No. X WO 98 04290 A (WHITE BRIAN F; PERRINE 1-20 SUSAN P (US); FALLER DOUGLAS V (US)) 5 February 1998 (1998-02-05) abstract page 21, line 15-page 27, line 13 page 30, line 12-page 31, line 22; claims X WO 96 27369 A (UNIV BOSTON) 1-20 12 September 1996 (1996-09-12) abstract page 22, line 10-page 25, line 23 page 29, line 1-line 14; claims X US 4 704 402 A (ABRAHAM DONALD J ET AL) 1-8, 3 November 1987 (1987-11-03) 11-20 cited in the application the whole document 1 iternational application No. INTERNATIONAL SEARCH REPORT PCT/US 99/03014 Box I Observatlons where certain claims were found unsearchable (Continuation of Item 1 of first sheet) This International Search Report has not been established in respect of certain claims under Article 17 (2) (a) for the following reasons: 1. nj Claims Nos.: because they relate to subject matter not required to be searched by this Authority, namely: 2. Claims Nos. : because they relate to parts of the International Application that do not comply with the prescribed requirements to such an extent that no meaningful International Search can be carried out, specifically : see FURTHER INFORMATION sheet PCT/ISA/210 3. Claims Nos.: because they are dependent claims and are not drafted in accordance with the second and third sentences of Rule 6.4 (a). Box 11 Observations where unity of invention Is lacking (Continuation of Item 2 of first sheet) This International Searching Authority found multiple inventions in this international application, as follows: 1. As all required additional search fees were timely paid by the applicant, this International Search Report covers all 1claims. 2. as ait searchable claims could be searched without effort justifying an additional fee, this Authority did not invite payment of any additional fee. 3. As only some of the required additional search fees were timely paid by the applicant, this International Search Report covers only those claims for which fees were paid, specifically claims Nos.: 4. No required additional search fees were timely paid by the applicant. Consequently, this International Search Report is restricted to the invention first mentioned in the claims; it is covered by daims Nos.: Remark on Protest The additional search fees were accompanied by the applicant's protest. No protest accompanied accompanied payment payment additional additional search FURTHER INFORMATION CONTINUED FROM PCT/ISA/210 Continuation of Box 1. 2 Present claims 1-20 relate to an extremely large number of possible compounds (see in particular the formula phenyl-R9-R10 and the expression "acids, amines and amides of"). Support within the meaning of Article 6 PCT and disclosure within the meaning of Article 5 PCT is to be found, however, for only a very small proportion of the compounds claimed. In the present case, the claims so lack support, and the application so lacks disclosure, that a meaningful search over the whole of the claimed scope is impossible. Furthermore, present claims 9 and 10 relate to a compound defined by reference to a pharmacological property, namely"compound that positively affects expression of a CFTR molecule". The claims cover all compounds having this property, whereas the application provides support within the meaning of Article 6 PCT and disclosure within the meaning of Article 5 PCT for only a very limited number of such compounds. In the present case, the claims so lack support, and the application so lacks disclosure, that a meaningful search over the whole of the claimed scope is impossible. Independent of the above reasoning, the claims also lack clarity (Article 6 PCT). An attempt is made to define the compound by its pharmacological profile. Again, this lack of clarity in the present case is such as to render a meaningful search over the whole of the claimed scope impossible. Consequently, the search has been carried out for those parts of the claims which appear to be clear, supported and disclosed, namely those parts relating to the compounds specifically mentioned in claims 1,2,12-15 and to the compounds structurally identified on page 13, with due regard to the general idea underlying the present invention. Claims searched incompletely: 1-20 The applicant's attention is drawn to the fact that claims, or parts of claims, relating to inventions in respect of which no international search report has been established need not be the subject of an international preliminary examination (Rule 66.1 (e) PCT). The applicant is advised that the EPO policy when acting as an International Preliminary Examining Authority is normally not to carry out a preliminary examination on matter which has not been searched. This is the case irrespective of whether or not the claims are amended following receipt of the search report or during any Chapter II procedure. INTERNATIONAL SEARCH REPORT national Applicatton No Information on patent famlly members li NCT/US 99/03014, Patent document Publication Patent family Publication cited in search report date member (s) date WO 9840078 A 17-09-1998 US 5939455 A I' AU 6547898 A 29-09-1998 WO 9856370 A 17-12-1998 AU 8062498 A 30-12-1998 EP 0989849 A 05-04-2000 WO 9404671 A 03-03-1994 US 5674898 A 07-10-1997 AU 684049 B 04-12-1997 AU 5092793 A 15-03-1994 CA 2143306 A 03-03-1994 EP 0659211 A 28-06-1995 JP 8500596 T 23-01-1996 US 5750571 A 12-05-1998 WO 9804290 A 05-02-1998 US 5939456 A 17-08-1999 AU 3889197 A 20-02-1998 EP 0969869 A 12-01-2000 WO 9627369 A 12-09-1996 AU 5180596 A 23-09-1996 CA 2214379 A 12-09-1996 EP 0861072 A 02-09-1998 US 6011000 A 04-01-2000 US 4704402 A 03-11-1987 NONE