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EP-4736881-A2 - CONTROLLED-RELEASE CNP AGONISTS WITH INCREASED NEP STABILITY

EP4736881A2EP 4736881 A2EP4736881 A2EP 4736881A2EP-4736881-A2

Abstract

The present invention relates to controlled-release CNP agonists having an at least 5-fold longer degradation half-life in an in vitro NEP degradation assay than the corresponding released CNP agonist, to pharmaceutical compositions comprising said controlled-release CNP agonist, their use and to methods of treatment.

Inventors

  • Sprogøe, Kennett
  • RAU, HARALD
  • BERNHARD, Ana
  • HERSEL, ULRICH
  • CLEEMANN, FELIX
  • WEGGE, THOMAS

Assignees

  • Ascendis Pharma Growth Disorders A/S

Dates

Publication Date
20260506
Application Date
20170105

Claims (14)

  1. A controlled-release CNP agonist, wherein the controlled-release CNP agonist releases one or more CNP, wherein the controlled-release CNP agonist has an at least 5-fold longer degradation half-life in an in vitro NEP degradation assay than the corresponding released CNP and wherein the controlled-release CNP agonist is a CNP agonist of formula (Ia) or (Ib): wherein -D is a CNP moiety; -L 1 - is a reversible prodrug linker moiety of formula (III): wherein the dashed line indicates attachment to a primary or secondary amine or hydroxyl of -D which is a CNP moiety by forming an amide or ester linkage, respectively; -R 1 , -R 1a , -R 2 , -R 2a , -R 3 and -R 3a are independently of each other selected from the group consisting of -H, -C(R 8 R 8a R 8b ), -C(=O)R 8 , -C=N, -C(=NR 8 )R 8a , -CR 8 (=CR 8a R 8b ), -C≡CR 8 and -T; -R 4 , -R 5 and -R 5a are independently of each other selected from the group consisting of -H, -C(R 9 R 9a R 9b ) and -T; al and a2 are independently of each other 0 or 1; each -R 6 , -R 6a , -R 7 , -R 7a , -R 8 , -R 8a , -R 8b , -R 9 , -R 9a , -R 9b are independently of each other selected from the group consisting of -H, halogen, -CN, -COOR 10 , -OR 10 , -C(O)R 10 , -C(O)N(R 10 R 10a ), -S(O) 2 N(R 10 R 10a ), -S(O)N(R 10 R 10a ), -S(O) 2 R 10 , -S(O)R 10 , -N(R 10 )S(O) 2 N(R 10a R 10b ), -SR 10 , -N(R 10 R 10a ), -NO 2 , -OC(O)R 10 , -N(R 10 )C(O)R 10a , -N(R 10 )S(O) 2 R 10a , -N(R 10 )S(O)R 10a , -N(R 10 )C(O)OR 10a , -N(R 10 )C(O)N(R 10a R 10b ), -OC(O)N(R 10 R 10a ), -T, C 1-20 alkyl, C 2-20 alkenyl, and C 2-20 alkynyl; wherein -T, C 1-20 alkyl, C 2-20 alkenyl, and C 2-20 alkynyl are optionally substituted with one or more -R 11 , which are the same or different and wherein C 1-20 alkyl, C 2-20 alkenyl, and C 2-20 alkynyl are optionally interrupted by one or more groups selected from the group consisting of -T-, -C(O)O-, -O-, -C(O)-, -C(O)N(R 12 )-, -S(O) 2 N(R 12 )-, -S(O)N(R 12 )-, -S(O) 2 -, -S(O)-, -N(R 12 )S(O) 2 N(R 12a )-, -S-, -N(R 12 )-, -OC(OR 12 )(R 12a )-, -N(R 12 )C(O)N(R 12a )-, and -OC(O)N(R 12 )-; each -R 10 , -R 10a , -R 10b is independently selected from the group consisting of -H, -T, C 1-20 alkyl, C 2-20 alkenyl, and C 2-20 alkynyl; wherein -T, C 1-20 alkyl, C 2-20 alkenyl, and C 2-20 alkynyl are optionally substituted with one or more -R 11 , which are the same or different and wherein C 1-20 alkyl, C 2-20 alkenyl, and C 2-20 alkynyl are optionally interrupted by one or more groups selected from the group consisting of -T-, -C(O)O-, -O-, -C(O)-, -C(O)N(R 12 )-, -S(O) 2 N(R 12 )-, -S(O)N(R 12 )-, -S(O) 2 -, -S(O)-, -N(R 12 )S(O) 2 N(R 12a )-, -S-, -N(R 12 )-, -OC(OR 12 )(R 12a )-, -N(R 12 )C(O)N(R 12a )-, and -OC(O)N(R 12 )-; each T is independently of each other selected from the group consisting of phenyl, naphthyl, indenyl, indanyl, tetralinyl, C 3-10 cycloalkyl, 3- to 10-membered heterocyclyl, and 8- to 11-membered heterobicyclyl; wherein each T is independently optionally substituted with one or more -R 11 , which are the same or different; each -R 11 is independently of each other selected from halogen, -CN, oxo (=O), -COOR 13 , -OR 13 , -C(O)R 13 , -C(O)N(R 13 R 13a ), -S(O) 2 N(R 13 R 13a ), -S(O)N(R 13 R 13a ), -S(O) 2 R 13 , -S(O)R 13 , -N(R 13 )S(O) 2 N(R 13a R 13b ), -SR 13 , -N(R 13 R 13a ), -NO 2 , -OC(O)R 13 , -N(R 13 )C(O)R 13a , -N(R 13 )S(O) 2 R 13a , -N(R 13 )S(O)R 13a , -N(R 13 )C(O)OR 13a , -N(R 13 )C(O)N(R 13a R 13b ), -OC(O)N(R 13 R 13a ), and C 1-6 alkyl; wherein C 1-6 alkyl is optionally substituted with one or more halogen, which are the same or different; each -R 12 , -R 12a , -R 13 , -R 13a , -R 13b is independently selected from the group consisting of -H, and C 1-6 alkyl; wherein C 1-6 alkyl is optionally substituted with one or more halogen, which are the same or different; optionally, one or more of the pairs -R 1 /-R 1a , -R 2 /-R 2a , -R 3 /-R 3a , -R 6 /-R 6a , -R 7 /-R 7a are joined together with the atom to which they are attached to form a C 3-10 cycloalkyl or a 3- to 10-membered heterocyclyl; optionally, one or more of the pairs -R 1 /-R 2 , -R 1 /-R 3 , -R 1 /-R 4 , -R 1 /-R 5 , -R 1 /-R 6 , -R 1 /-R 7 , -R 2 /-R 3 , -R 2 /-R 4 , -R 2 /-R 5 , -R 2 /-R 6 , -R 2 /-R 7 , -R 3 /-R 4 , -R 3 /-R 5 , -R 3 /-R 6 , -R 3 /-R 7 , -R 4 /-R 5 , -R 4 /-R 6 , -R 4 /-R 7 , -R 5 /-R 6 , -R 5 /-R 7 , -R 6 /-R 7 are joined together with the atoms to which they are attached to form a ring A; A is selected from the group consisting of phenyl; naphthyl; indenyl; indanyl; tetralinyl; C 3-10 cycloalkyl; 3- to 10-membered heterocyclyl; and 8- to 11-membered heterobicyclyl; wherein -L 1 - is substituted with -L 2 -Z and -L 1 - is optionally further substituted; -L 2 - is a single chemical bond or a spacer moiety; -Z comprises: i) a fatty acid derivative; or ii) a C 8-24 alkyl moiety, wherein each hydrogen atom of the C 8-24 carbon may optionally be replaced by a substituent, wherein the one or more optional substituents are independently of each other selected from the group consisting of halogen, -CN, -COOR x1 , -OR x1 , -C(O)R x1 , -C(O)N(R x1 R x1a ), -S(O) 2 N(R x1 R x1a ), -S(O)N(R x1 R x1a ), -S(O) 2 R x1 , -S(O)R x1 , -N(R x1 )S(O) 2 N(R x1a R x1b ), -SR x1 , -N(R x1 R x1a ), -NO 2 , -OC(O)R x1 , -N(R x1 )C(O)R x1a , -N(R x1 )S(O) 2 R x1a , -N(R x1 )S(O)R x1a , -N(R x1 )C(O)OR x1a , -N(R x1 )C(O)N(R x1a R x1b ), -OC(O)N(R x1 R x1a ), -T 0 , C 1-6 alkyl, C 2-6 alkenyl, and C 2-6 alkynyl; wherein -T 0 , C 1-6 alkyl, C 2-6 alkenyl, and C 2-6 alkynyl are optionally substituted with one or more -R x2 , which are the same or different and wherein C 1-6 alkyl, C 2-6 alkenyl, and C 2-6 alkynyl are optionally interrupted by one or more groups selected from the group consisting of -T 0 -, -C(O)O-, -O-, -C(O)-, -C(O)N(R x3 )-, -S(O) 2 N(R x3 )-, -S(O)N(R x3 )-, -S(O) 2 -, -S(O)-, -N(R x3 )S(O) 2 N(R x3a )-, -S-, -N(R x3 )-, -OC(OR x3 )(R x3a )-, -N(R x3 )C(O)N(R x3a )-, and -OC(O)N(R x3 )-; each -R x1 , -R x1a , -R x1b , -R x2 , -R x3 , -R x3a is independently selected from the group consisting of -H, halogen, C 1-6 alkyl, C 2-6 alkenyl, and C 2-6 alkynyl; each T 0 is independently selected from the group consisting of phenyl, naphthyl, indenyl, indanyl, tetralinyl, C 3-10 cycloalkyl, 3- to 10-membered heterocyclyl, and 8- to 11-membered heterobicyclyl; wherein each T 0 is independently optionally substituted with one or more -R x2 , which are the same or different; x is an integer selected from the group consisting of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 or 16; and y is an integer selected from the group consisting of 1, 2, 3, 4 and 5.
  2. The controlled-release CNP agonist of claim 1, wherein the controlled-release CNP agonist is water-soluble.
  3. The controlled-release CNP agonist of claim 1 or 2, wherein the controlled-release CNP agonist is of formula (Ia) with x being 1.
  4. The controlled-release CNP agonist of any one of claims 1 to 3, wherein -D is connected to -L 1 - through a primary or secondary amine of -D.
  5. The controlled-release CNP agonist of any one of claims 1 to 4, wherein -D comprises a ring moiety of SEQ ID NO:96.
  6. The controlled-release CNP agonist of any one of claims 1 to 5, wherein -D has the sequence of SEQ ID NO:24, SEQ ID NO:25 or SEQ ID NO:30.
  7. The controlled-release CNP agonist of any one of claims 1 to 6, wherein -D has the sequence of SEQ ID NO:30.
  8. The controlled-release CNP agonist of any one of claims 1 to 7, wherein -L 2 - is selected from the group consisting of -T-, -C(O)O-, -O-, -C(O)-, -C(O)N(R y1 )-, -S(O) 2 N(R y1 )-, -S(O)N(R y1 )-, -S(O) 2 -, -S(O)-, -N(R y1 )S(O) 2 N(R y1a )-, -S-, -N(R y1 ), -OC(OR y1 )(R y1a )-, -N(R y1 )C(O)N(R y1a )-, -OC(O)N(R y1 )-, C 1-50 alkyl, C 2-50 alkenyl, and C 2-50 alkynyl; wherein -T-, C 1-50 alkyl, C 2-50 alkenyl, and C 2-50 alkynyl are optionally substituted with one or more -R y2 , which are the same or different and wherein C 1-50 alkyl, C 2-50 alkenyl, and C 2-50 alkynyl are optionally interrupted by one or more groups selected from the group consisting of -T-, -C(O)O-, -O-, -C(O)-, -C(O)N(R y3 )-, -S(O) 2 N(R y3 )-, -S(O)N(R y3 )-, -S(O) 2 -, -S(O)-, -N(R y3 )S(O) 2 N(R y3a )-, -S-, -N(R y3 )-, -OC(OR y3 )(R y3a )-, -N(R y3 )C(O)N(R y3a )-, and -OC(O)N(R y3 )-; -R y1 and -R y1a are independently of each other selected from the group consisting of -H, -T, C 1-50 alkyl, C 2-50 alkenyl, and C 2-50 alkynyl; wherein -T, C 1-50 alkyl, C 2-50 alkenyl, and C 2-50 alkynyl are optionally substituted with one or more -R y2 , which are the same or different, and wherein C 1-50 alkyl, C 2-50 alkenyl, and C 2-50 alkynyl are optionally interrupted by one or more groups selected from the group consisting of -T-, -C(O)O-, -O-, -C(O)-, -C(O)N(R y4 )-, -S(O) 2 N(R y4 )-, -S(O)N(R y4 )-, -S(O) 2 -, -S(O)-, -N(R y4 )S(O) 2 N(R y4a )-, -S-, -N(R y4 )-, -OC(OR y4 )(R y4a )-, -N(R y4 )C(O)N(R y4a )-, and -OC(O)N(R y4 )-; each T is independently selected from the group consisting of phenyl, naphthyl, indenyl, indanyl, tetralinyl, C 3-10 cycloalkyl, 3- to 10-membered heterocyclyl, 8- to 11-membered heterobicyclyl, 8- to 30-membered carbopolycyclyl, and 8- to 30-membered heteropolycyclyl; wherein each T is independently optionally substituted with one or more -R y2 , which are the same or different; each -R y2 is independently selected from the group consisting of halogen, -CN, oxo (=O), -COOR y5 , -OR y5 , -C(O)R y5 , -C(O)N(R y5 R y5a ), -S(O) 2 N(R y5 R y5a ), -S(O)N(R y5 R y5a ), -S(O) 2 R y5 , -S(O)R y5 , -N(R y5 )S(O) 2 N(R y5a R y5b ), -SR y5 , -N(R y5 R y5a ), -NO 2 , -OC(O)R y5 , -N(R y5 )C(O)R y5a , -N(R y5 )S(O) 2 R y5a , -N(R y5 )S(O)R y5a , -N(R y5 )C(O)OR y5a , -N(R y5 )C(O)N(R y5a R y5b ), -OC(O)N(R y5 R y5a ), and C 1-6 alkyl; wherein C 1-6 alkyl is optionally substituted with one or more halogen, which are the same or different; and each -R y3 , -R y3a , -R y4 , -R y4a , -R y5 , -R y5a and -R y5b is independently selected from the group consisting of -H, and C 1-6 alkyl, wherein C 1-6 alkyl is optionally substituted with one or more halogen, which are the same or different.
  9. The controlled-release CNP agonist of any one of claims 1 to 8, wherein the fatty acid derivative is the albumin binding moiety described on page 14, line 15 of WO 2005/027978A2.
  10. A pharmaceutical composition comprising the controlled-release CNP agonist of any one of claims 1 to 9 and at least one excipient.
  11. The controlled-release CNP agonist of any one of claims 1 to 9 or the pharmaceutical composition of claim 10 for use as a medicament.
  12. The controlled-release CNP agonist of any one of claims 1 to 9 or the pharmaceutical composition of claim 10 for use in the treatment of a disease which can be treated with CNP.
  13. The controlled-release CNP agonist or the pharmaceutical composition of claim 12, wherein the disease which can be treated with CNP is selected from the group consisting of achondroplasia, hypochondroplasia, short stature, dwarfism, osteochondrodysplasias, thanatophoric dysplasia, osteogenesis imperfecta, achondrogenesis, chondrodysplasia punctata, homozygous achondroplasia, camptomelic dysplasia, congenital lethal hypophosphatasia, perinatal lethal type of osteogenesis imperfecta, short-rib polydactyly syndromes, rhizomelic type of chondrodysplasia punctata, Jansen-type metaphyseal dysplasia, spondyloepiphyseal dysplasia congenita, atelosteogenesis, diastrophic dysplasia, congenital short femur, Langer-type mesomelic dysplasia, Nievergelt-type mesomelic dysplasia, Robinow syndrome, Reinhardt syndrome, acrodysostosis, peripheral dysostosis, Kniest dysplasia, fibrochondrogenesis, Roberts syndrome, acromesomelic dysplasia, micromelia, Morquio syndrome, Kniest syndrome, metatrophic dysplasia, spondyloepimetaphyseal dysplasia, neurofibromatosis, Legius syndrome, LEOPARD syndrome, Noonan syndrome, hereditary gingival fibromatosis, neurofibromatosis type 1, cardiofaciocutaneous syndrome, Costello syndrome, SHOX deficiency, idiopathic short stature, growth hormone deficiency, osteoarthritis, cleidocranial dysostosis, craniosynostosis, dactyly, brachydactyly, camptodactyly, polydactyly, syndactyly, dyssegmental dysplasia, enchondromatosis, fibrous dysplasia, hereditary multiple exostoses, hypophosphatemic rickets, Jaffe-Lichtenstein syndrome, Marfan syndrome, McCune-Albright syndrome, osteopetrosis and osteopoikilosis.
  14. The controlled-release CNP agonist or the pharmaceutical composition of claim 12 or 13, wherein the disease which can be treated with CNP is achondroplasia.

Description

The present invention relates to controlled-release CNP agonists having an at least 5-fold longer degradation half-life in an in vitro NEP degradation assay than the corresponding released CNP agonist, to pharmaceutical compositions comprising said controlled-release CNP agonist, their use and to methods of treatment. Achondroplasia (ACH) is caused by a gain-of-function mutation in FGFR3. Binding of CNP to its receptor, natriuretic-peptide receptor B (NPR-B), inhibits FGFR3 downstream signaling and thus triggers endochondral growth and skeletal overgrowth, as observed in both mice and humans overexpressing CNP. Overproduction of CNP in the cartilage or continuous delivery of CNP through intravenous (iv) infusion normalizes the dwarfism of achondroplasic mice, suggesting that administration of CNP at supraphysiological levels is a strategy for treating ACH. However, given its short half-life of CNP-22 (2 min after iv administration) CNP as a therapeutic agent is challenging in a pediatric population because it would require continuous infusion. Furthermore, as CNP is extensively inactivated in the subcutaneous tissue iv infusion is required. Potter (FEBS Journal 278 (2011) 1808-1817) describes the clearance of CNP to occur by two degradation routes: receptor-mediated degradation and degradation by extracellular proteases. CNP is degraded by the action of neutral endopeptidase 24.11 (NEP) and is removed from systemic circulation by natriuretic peptide clearance receptor, NPR-C, that binds to and deposits CNP into lysosomes, where CNP is degraded. Reducing degradation by one or both of these clearance routes would serve to prolong the half-life of CNP. Due to the limited size of its active site cavity, NEP preferably recognizes substrates smaller than about 3 kDa. US 8,377,884 B2 describe variants of CNP which optionally are permanently conjugated to PEG polymer to increases resistance to NEP cleavage. However, addition of PEG, even as small as 0.6 kDa, to wild-type CNP was found to reduce CNP activity, and addition of greater than about 2 or 3 kDa of PEG to CNP or variants thereof reduce CNP functional activity in a size-dependent manner. Therefore, attachment of PEG molecules larger than 2 to 3 kDa to reduce NEP degradation is accompanied by a loss of activity, which may reduce the therapeutic potential of such molecules. In addition to negatively impacting activity of the peptide, conjugation of PEG or another macromolecule to CNP may also prevent effective distribution to the growth plate. Farnum et al. (Anat Rec A Discov Mol Cell Evol Biol. 2006 January; 288(1): 91-103) demonstrated that distribution of molecules from the systemic vasculature to the growth plate was size dependent, and that small molecules (up to 10 kDa) could distribute to the growth plate, whereas a molecular size of 40 kDa and larger prevented entry to the growth plate. A different approach to create a NEP resistant CNP molecule and enable subcutaneous administration was described in The American Journal of Human Genetics 91, 1108-1114. BMN-111 is a modified recombinant human C-type Natriuretic Peptide (CNP) where 17 amino acids have been added to form a 39 amino acid CNP pharmacological analog. BMN-111 mimics CNP pharmacological activity at the growth plate and has an extended half-life as a result of neutral-endopeptidase (NEP) resistance that allows once-daily subcutaneous (SC) administration. As BMN-111 is a non-natural occurring peptide, the risk of inducing an immunological response is increased compared to the native peptide, and as described by Martz in "sFGFR for achondroplasia" (SciBx, Biocentury October 2013), an immunological response to BMN-111 has been observed in animal studies, with the presence of antibodies not affecting the pharmacological activity of the drug. However, BMN-111 only has a half-life of 20 minutes, which when dosed daily is associated with a short duration of exposure to efficacious drug levels. To increase exposure to efficacious drug levels the dose of the drug having CNP activity may be increased. As natriuretic peptides are a family of hormones that may affect blood volume and blood pressure, an increase in dose may be associated with cardiovascular adverse effects. Studies of BMN-111in animals and man have demonstrated that as the dose increases, arterial blood pressure drops and heart rate increases. Doses of BMN-111 up to 15 µg/kg were associated with mild hypotension in healthy volunteers. Therefore increasing the dose of a drug having CNP activity to increase drug exposure, may be associated with unacceptable cardiovascular side effects. Therefore increasing the dose of a drug having CNP activity to increase drug exposure may be associated with unacceptable cardiovascular side effects, such as hypotension. In summary, there is a need for a more efficacious and safer CNP treatment. It is therefore an object of the present invention to at least partially overcome the shortcomings described above