Nucleoside with anti-hepatitis B virus activity

Details Nucleoside with anti-hepatitis B virus activity Nucleoside with anti-hepatitis B virus activity

1999-11-05

2002-10-01

Richter, Johann (Department: 1623)

Drug, bio-affecting and body treating compositions

Designated organic active ingredient containing

Carbohydrate doai

C514S051000, C536S026800, C536S028520, C536S028200

Reexamination Certificate

active

06458773

ABSTRACT:

This invention is in the area of methods for the treatment of hepatitis B virus (also referred to as “HBV”) that includes administering an effective amount of one or more of a L-2′ or 3′-azido)-2′,3′-dideoxy-5-fluorocytosine to a host in need thereof.
BACKGROUND OF THE INVENTION
HBV is second only to tobacco as a cause of human cancer. The mechanism by which HBV induces cancer is unknown, although it is postulated that it may directly trigger tumor development, or indirectly trigger tumor development through chronic inflammation, cirrhosis, and cell regeneration associated with the infection.
Hepatitis B virus has reached epidemic levels worldwide. After a two to six month incubation period in which the host is unaware of the infection, HBV infection can lead to acute hepatitis and liver damage, that causes abdominal pain, jaundice, and elevated blood levels of certain enzymes. HBV can cause fulminant hepatitis, a rapidly progressive, often fatal form of the disease in which massive sections of the liver are destroyed. Patients typically recover from acute viral hepatitis. In some patients, however, high levels of viral antigen persist in the blood for an extended, or indefinite, period, causing a chronic infection. Chronic infections can lead to chronic persistent hepatitis. Patients infected with chronic persistent HBV are most common in developing countries. By mid-1991, there were approximately 225 million chronic carriers of HBV in Asia alone, and worldwide, almost 300 million carriers. Chronic persistent hepatitis can cause fatigue, cirrhosis of the liver, and hepatocellular carcinoma, a primary liver cancer. In western industrialized countries, high risk groups for HBV infection include those in contact with HBV carriers or their blood samples. The epidemiology of HBV is in fact very similar to that of acquired immunodeficiency syndrome, which accounts for why HBV infection is common among patients with AIDS or HIV-associated infections. However, HBV is more contagious than HIV.
Daily treatments with a-interferon, a genetically engineered protein, has shown promise. A human serum-derived vaccine has also been developed to immunize patients against HBV. Vaccines have been produced through genetic engineering. While the vaccine has been found effective, production of the vaccine is troublesome because the supply of human serum from chronic carriers is limited, and the purification procedure is long and expensive. Further, each batch of vaccine prepared from different serum must be tested in chimpanzees to ensure safety. In addition, the vaccine does not help the patients already infected with the virus.
A number of synthetic nucleosides have been identified which exhibit activity against HBV. The (−)-enantiomer of BCH-189 (2′,3′-dideoxy-3′-thiacytidine), known as 3TC, claimed in U.S. Pat. No. 5,539,116 to Liotta, et al., is currently in clinical trials for the treatment of hepatitis B. See also EPA 0 494 119 A1 filed by BioChem Pharma, Inc.
&bgr;-2-Hydroxymethyl-5-(5-fluorocytosin-1-yl)-1,3-oxathiolane (“FTC”), claimed in U.S. Pat. Nos. 5,814,639 and 5,914,331 to Liotta, et al., exhibits activity against HBV. See Furman, et al., “The Anti-Hepatitis B Virus Activities, Cytotoxicities, and Anabolic Profiles of the (−) and (+) Enantiomers of cis-5-Fluoro-1-[2-(Hydroxymethyl)-1,3-oxathiolane-5-yl]-Cytosine”
Antimicrobial Agents and Chemotherapy,
December 1992, page 2686-2692; and Cheng, et al.,
Journal of Biological Chemistry,
Volume 267(20), 13938-13942 (1992).
U.S. Pat. Nos. 5,565,438, 5,567,688 and 5,587,362 (Chu, et al.) disclose the use of 2′-fluoro-5-methyl-&bgr;-L-arabinofuranolyluridine (L-FMAU) for the treatment of hepatitis B and Epstein Barr virus.
Penciclovir (2-amino-1,9-dihydro-9-[4-hydroxy-3-(hydroxymethyl)butyl]-6H-purin-6-one; PCV) has established activity against hepatitis B. See U.S. Pat. Nos. 5,075,445 and 5,684,153.
Adefovir (9-[2-(phosphonomethoxy)ethyl]adenine, also referred to as PMEA or [[2-(6-amino-9H-purin-9-yl)ethoxy]methylphosphonic acid), also has established activity against hepatitis B. See for example U.S. Pat. Nos. 5,641,763 and 5,142,051.
Yale University and The University of Georgia Research Foundation, Inc. disclose the use of L-FDDC (5-fluoro-3′-thia-2′,3′-dideoxycytidine) for the treatment of hepatitis B virus in WO 92/18517.
Other drugs explored for the treatment of HBV include adenosine arabinoside, thymosin, acyclovir, phosphonoformate, zidovudine, (+)-cyanidanol, quinacrine, and 2′-fluoroarabinosyl-5-iodouracil.
U.S. Pat. Nos. 5,444,063 and 5,684,010 to Emory University disclose the use of enantiomerically pure &bgr;-D-1,3-dioxolane purine nucleosides to treat hepatitis B.
WO 96/40164 filed by Emory University, UAB Research Foundation, and the Centre National de la Recherche Scientifique discloses a number of &bgr;-L-2′,3′-dideoxynucleosides for the treatment of hepatitis B.
WO 95/07287 also filed by Emory University, UAB Research Foundation, and the Centre National de la Recherche Scientifique discloses 2′ or 3′ deoxy and 2′,3′-dideoxy-&bgr;-L-pentofuranosyl nucleosides for the treatment of HIV infection.
WO96/13512 filed by Genencor International, Inc., and Lipitek, Inc., discloses the preparation of L-ribofuranosyl nucleosides as antitumor agents and virucides.
WO95/32984 discloses lipid esters of nucleoside monophosphates as immunosuppresive drugs.
DE4224737 discloses cytosine nucleosides and their pharmaceutical uses.
Tsai, et al., in Biochem. Pharmacol. 48(7), pages 1477-81, 1994 disclose the effect of the anti-HIV agent 2′-&bgr;-D-F-2′,3′-dideoxynucleoside analogs on the cellular content of mitochondrial DNA and lactate production.
Galvez, J. Chem. Inf. Comput. Sci. (1994), 35(5), 1198-203 describes molecular computation of &bgr;-D-3&bgr;-azido-2′,3′-dideoxy-5-fluorocytidine.
Mahmoudian, Pharm. Research 8(1), 43-6 (1991) discloses quantitative structure-activity relationship analyses of HIV agents such as &bgr;-D-3′-azido-2′,3′-dideoxy-5-fluorocytidine.
U.S. Pat. No. 5,703,058 discloses (5-carboximido or 5-fluoro)-(2′,3′-unsaturated or 3′-modified) pyrimidine nucleosides for the treatment of HIV or HBV.
Lin, et al., discloses the synthesis and antiviral activity of various 3′-azido analogues of &bgr;-D-nucleosides in J. Med. Chem. 31(2), 336-340 (1988).
An essential step in the mode of action of purine and pyrimidine nucleosides against viral diseases, and in particular, HBV and HIV, is their metabolic activation by cellular and viral kinases, to yield the mono-, di-, and triphosphate derivatives. The biologically active species of many nucleosides is the triphosphate form, which inhibits DNA polymerase or reverse transcriptase, or causes chain termination. The nucleoside derivatives that have been developed for the treatment of HBV and HIV to date have been presented for administration, to the host in unphosphorylated form, notwithstanding the fact that the nucleoside must be phosphorylated in the cell prior to exhibiting its antiviral effect, because the triphosphate form has typically either been dephosphorylated prior to reaching the cell or is poorly absorbed by the cell. Nucleotides in general cross cell membranes very inefficiently and are generally not very not very potent in vitro. Attempts at modifying nucleotides to increase the absorption and potency of nucleotides have been described by R. Jones and N. Bischofberger,
Antiviral Research,
27 (1995) 1-17, the contents of which are incorporated herein by reference.
In light of the fact that hepatitis B virus has reached epidemic levels worldwide, and has severe and often tragic effects on the infected patient, there remains a strong need to provide new effective pharmaceutical agents to, treat humans infected with the virus that have low toxicity to the host.
Therefore, it is an object of the present invention to provi

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