Search

EP-4736946-A2 - AMYLIN ANALOGUES

EP4736946A2EP 4736946 A2EP4736946 A2EP 4736946A2EP-4736946-A2

Abstract

The present invention relates to amylin analogues and to their use in the treatment or prevention of a variety of diseases, conditions or disorders, including obesity, excess food intake and associated metabolic diseases such as diabetes. The analogues have good physical and chemical stability, good solubility, and a long duration of action, and are well suited for use in the form of a liquid formulation.

Inventors

  • MATHIESEN, Jesper Mosolff
  • VILLASDEN, Jesper Skodborg
  • GIEHM, Lise
  • MUNCH, Henrik Kofoed
  • HAMPRECHT, DIETER WOLFGANG
  • HEIM-RIETHER, ALEXANDER
  • FOSSATI, Giacomo

Assignees

  • Zealand Pharma A/S

Dates

Publication Date
20260506
Application Date
20170911

Claims (10)

  1. An amylin analogue which is a compound having the formula: [19CD]-isoGlu-RD()GTATK()ATERLA-Aad-FLQRSSF-Gly(Me)-A-Ile(Me)-LSSTEVGSNT- Hyp-NH 2 (Compound 35) wherein an intramolecular lactam bridge is formed between the side chains of residues indicated by parentheses "()"; and wherein [19CD]-isoGlu is a 19-carboxynonadecanoyl group covalently attached to the alpha amino group of an iso-glutamic acid linker; or a pharmaceutically acceptable salt thereof.
  2. A pharmaceutical composition comprising the amylin analogue according to claim 1 in combination with a pharmaceutically acceptable carrier, excipient or vehicle.
  3. The pharmaceutical composition according to claim 2, wherein the pharmaceutical composition is in unit dosage form.
  4. The pharmaceutical composition according to claim 3, wherein the pharmaceutical composition is in a single-dose injectable form.
  5. The pharmaceutical composition according to claim 4, wherein the single-dose injectable form is in the form of a pen device containing a liquid-phase pharmaceutical composition.
  6. The pharmaceutical composition according any one of claims 2 to 4, wherein the pharmaceutical composition is suitable for subcutaneous, intramuscular, intravenous, intradermal or transdermal administration.
  7. An amylin analogue according to claim 1 or a pharmaceutical composition according to any one of claims 2 to 6 for use in a method of medical treatment.
  8. The amylin analogue or pharmaceutical composition for use according to claim 7, wherein the amylin analogue or pharmaceutical composition is for use in a method of treating obesity, morbid obesity, obesity prior to surgery, obesity-linked inflammation, obesity-linked gallbladder disease and obesity-induced sleep apnea and respiratory problems, degeneration of cartilage, osteoarthritis, or reproductive health complications of obesity or overweight.
  9. The amylin analogue or pharmaceutical composition for use according to claim 7, wherein the amylin analogue or pharmaceutical composition or device is for use in a method of prevention or treatment of Alzheimer's disease, diabetes, type 1 diabetes, type 2 diabetes, pre-diabetes, insulin resistance syndrome, impaired glucose tolerance (IGT), disease states associated with elevated blood glucose levels, metabolic disease including metabolic syndrome, hyperglycemia, hypertension, atherogenic dyslipidemia, hepatic steatosis ("fatty liver"; including non-alcoholic fatty liver disease (NAFLD), which itself includes non-alcoholic steatohepatitis (NASH)), kidney failure, arteriosclerosis (e.g. atherosclerosis), macrovascular disease, microvascular disease, diabetic heart disease (including diabetic cardiomyopathy and heart failure as a diabetic complication), coronary heart disease, peripheral artery disease or stroke, and combinations thereof.
  10. The amylin analogue or pharmaceutical composition for use according to claim 7, wherein the amylin analogue or pharmaceutical composition is for use in a method of lowering circulating LDL levels and/or increasing HDL/LDL ratio.

Description

PRIORITY This application claims priority from European patent application no. 16188024.0, filed 9 September 2016, the disclosure of which is hereby incorporated by reference in its entirety. FIELD OF THE INVENTION The present invention relates to amylin analogues that are amylin receptor agonists, and to their medical use in the treatment and/or prevention of a variety of diseases, conditions or disorders, including treatment and/or prevention of excess food intake, obesity and excess body weight, metabolic diseases, and other conditions and disorders described herein. In particular, the present invention relates to stable amylin analogues that have a long duration of action and are well suited for use in the form of a liquid formulation. BACKGROUND OF THE INVENTION Amylin is one of a family of peptide hormones that includes amylin, calcitonin, calcitonin gene-related peptide, adrenomedullin and intermedin (intermedin also being known as AFP-6), and has been implicated in various metabolic diseases and disorders. Human amylin was first isolated, purified and characterized as the major component of amyloid deposits in the islets of pancreases from type 2 diabetes patients. Native human amylin is a 37-amino acid peptide having the formula         H-KC()NTATC()ATQRLANFLVHSSNNFGAILSSTNVGSNTY-NH2 wherein H- at the N-terminus designates a hydrogen atom, corresponding to the presence of a free amino group on the N-terminal amino acid residue [i.e. the lysine (K) residue at sequence position number 1 in the sequence shown above]; wherein -NH2 at the C-terminus indicates that the C-terminal carboxyl group is in the amide form; and wherein the parentheses () associated with the two cysteine (C, Cys) residues at sequence positions 2 and 7 indicate the presence of an intramolecular disulfide bridge between the two Cys residues in question. Amylin may be beneficial in treating metabolic disorders such as diabetes and/or obesity. Amylin is believed to regulate gastric emptying, and to suppress glucagon secretion and food intake, thereby regulating the rate of glucose release to the circulation. Amylin appears to complement the actions of insulin. Compared to healthy adults, type 1 diabetes patients have no circulating amylin, and type 2 diabetes patients exhibit reduced postprandial amylin concentrations. In human trials an amylin analogue known as pramlintide, described in WO 93/10146 and having the sequence Lys-Cys-Asn-Thr-Ala-Thr-Cys-Ala-Thr-Gln-Arg-Leu-Ala-Asn-Phe-Leu-Val-His-Ser-Ser-Asn-Asn-Phe-Gly-Pro-Ile-Leu-Pro-Pro-Thr-Asn-Val-Gly-Ser-Asn-Thr-Tyr, which also possesses a disulphide bridge between the Cys residues at positions 2 and 7, has been shown to reduce body weight or reduce weight gain. An alternative amylin analogue incorporating N-methylated residues and having a reduced tendency to fibrillation, designated IAPP-GI, has been described by Yan et al. (PNAS, 103(7), 2046-2051, 2006; Angew. Chem. Int. Ed. 2013, 52, 10378-10383; WO2006/042745). IAPP-GI appears to have lower activity than native amylin, however. WO91/07978 describes analogues of hypocalcemic peptides, including amylin, in which internal disulphide bridges are replaced with alternative cyclisations. The effect of these alternative structures on the activity of amylin analogues is not disclosed. WO99/34764 presents data showing that 2,7cyclo-[2Asp,7Lys]-h-amylin has considerably lower potency than certain other amylin analogues, and human amylin itself. Further analogues of amylin or pramlintide are described in WO2013/156594, WO2012/168430, WO2012/168431 and WO2012/168432, as well as WO2015/040182. Obesity is believed to be a major causal factor in development of type 2 diabetes, which constitutes a growing and worldwide major health problem. Diseases or disorders that may develop as a consequence of untreated diabetes include cardiovascular and peripheral artery disease, micro- and macrovascular complications, stroke, and certain forms of cancer, particularly hematopoietic cancers. There is a need in the art for further amylin analogues. For example, amylin analogues that show a reduced tendency for fibrillation and/or high chemical stability at or around pH 7 might allow for a formulation at or near physiological pH. Amylin analogues having appropriately long plasma elimination half-lives, may also enable longer intervals between dosing than is currently possible (e.g. once weekly, or even less frequently) and hence improve patient compliance. High levels of agonist activity at the amylin receptor may also be desirable. SUMMARY OF THE INVENTION The present invention relates to compounds which are analogues of human amylin. In a first aspect, the invention provides an amylin analogue which is a compound having the formula:         R1-Z-R2 wherein R1 is hydrogen, C1-4 acyl, benzoyl or C1-4 alkyl, or a half-life extending moiety M, wherein M is optionally linked to Z via a linker moiety L;R2 is OH or NHR3, wherein R3 is hydrogen or C1-3-alky