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WO 2013/074910 Al 23 May 2013 (23.05.2013) W P O P C T

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WO 2013/074910 Al 23 May 2013 (23.05.2013) W P O P C T (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2013/074910 Al 23 May 2013 (23.05.2013) W P O P C T (51) International Patent Classification: AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY, A61K 38/26 (2006.01) A61K 31/56 (2006.01) BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, A61K 38/00 (2006.01) DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, (21) International Application Number: KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, PCT/US20 12/065492 ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (22) International Filing Date: NO, NZ, OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, 16 November 2012 (16.1 1.2012) RW, SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, (25) Filing Language: English ZM, ZW. (26) Publication Language: English (84) Designated States (unless otherwise indicated, for every (30) Priority Data: kind of regional protection available): ARIPO (BW, GH, 61/561,094 17 November 201 1 (17. 11.201 1) US GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ, (71) Applicant: INDIANA UNIVERSITY RESEARCH AND TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK, TECHNOLOGY CORPORATION [US/US]; 35 1 West EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV, 10th Street, Indianapolis, Indiana 46202 (US). MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, SM, TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW, (72) Inventors: DIMARCHI, Richard D.; 10890 Wilmington ML, MR, NE, SN, TD, TG). Drive, Camel, Indiana 46033 (US). YANG, Bin; 2869 E. Creeks Edge Drive, Bloomington, Indiana 47401 (US). Published: (74) Agent: BREEN, John P.; Barnes & Thornburg Lip, 11 — with international search report (Art. 21(3)) South Meridian Street, Indianapolis, Indiana 46204 (US). — with sequence listing part of description (Rule 5.2(a)) (81) Designated States (unless otherwise indicated, for every kind of national protection available): AE, AG, AL, AM, © © o- (54) Title: GLUCAGON SUPERFAMILY PEPTIDES EXHIBITING GLUCOCORTICOID RECEPTOR ACTIVITY (57) Abstract: Provided herein are glucagon superfamily peptides conjugated with GR ligands that are capable of acting at a gluco - corticoid receptor. Also provided herein are pharmaceutical compositions and kits of the conjugates of the invention. Further ¾ provided herein are methods of treating a disease, e.g., a metabolic disorder, such as diabetes and obesity, comprising administering the conjugates of the invention. 32993-223357 -1- GLUCAGON SUPERFAMILY PEPTIDES EXHIBITING GLUCOCORTICOID RECEPTOR ACTIVITY INCORPORATION BY REFERENCE OF MATERIAL SUBMITTED ELECTRONICALLY [0001] Incorporated by reference in its entirety is a computer-readable amino acid sequence listing submitted concurrently herewith and identified as follows: One 894,620 byte ASCII (Text) file named "46628A_SeqListing.txt," created on November 8, 2012. CROSS REFERENCE TO RELATED APPLICATIONS [0002] This application claims priority to U. S. Provisional Patent Application No. 61/561,094, filed on November 17, 201 1, which is incorporated by reference in its entirety. BACKGROUND OF THE INVENTION Field of the Disclosure [0003] This invention provides glucagon superfamily peptides conjugated to glucocorticoid receptor ligands that are capable of acting at glucocorticoid receptors. Brief Description of Related Technology [0004] Nuclear hormone receptor proteins form a class of ligand activated proteins that, when bound to specific sequences of DNA, serve as on-off switches for transcription within the cell nucleus. These switches control the development and differentiation of skin, bone and behavioral centers in the brain, as well as the continual regulation of reproductive tissues. [0005] Nuclear hormone receptor ligands such as steroids, sterols, retinoids, thyroid hormones, and vitamin D function to activate nuclear hormone receptors. The interaction of the hormone and receptor triggers a conformational change in the receptor, which results in the up- regulation of gene expression. The level of cellular signal transduction activated by the interaction of a ligand and a nuclear hormone receptor is determined by the number of ligands and receptors available for binding, and by the binding affinity between the ligand and the receptor. Many ligands and corresponding analogs that bind to nuclear hormone receptors are used as medication to treat, for example, Parkinson's disease (NURRl), sleep disorders (RZRP), arthritis and cerebellar ataxia (RORa), central nervous system disorders (NOR-1, Rev-ErbAp, Tlx, NGFI-Ββ, HZF-2a, COUP-TFa, COUP-TFP, COUR-TFy, NUR77), hypercholesterolemia 32993-223357 -2- (LXRa, COR), obesity (Rev-ErbAa), diabetes (HNF4a), immune disorders (TOR), metabolic disorders (MB67a, SHP, FXR, SF-1, LXR ), and infertility and contraception (GCNF, TR2- Ι ΐ α,β, TR4, ERa , ERRa , ). [0006] Pre-proglucagon is a 158 amino acid precursor polypeptide that is processed in different tissues to form a number of different proglucagon-derived peptides, including glucagon, glucagon-like peptide- 1 (GLP-1), glucagon-like peptide-2 (GLP-2) and oxyntomodulin (OXM), that are involved in a wide variety of physiological functions, including glucose homeostasis, insulin secretion, gastric emptying, and intestinal growth, as well as the regulation of food intake. Glucagon is a 29-amino acid peptide that corresponds to amino acids 33 through 6 1 of pre- proglucagon, while GLP-1 is produced as a 37-amino acid peptide that corresponds to amino acids 72 through 108 of pre-proglucagon. GLP-l(7-36) amide or GLP-l(7-37) acid are biologically potent forms of GLP-1, that demonstrate essentially equivalent activity at the GLP-1 receptor. [0007] Glucagon is used in the acute treatment of severe hypoglycemia. Oxyntomodulin has been reported to have pharmacological ability to suppress appetite and lower body weight. GLP- 1 and GLP-1 receptor agonists are used as treatment for Type II diabetes. Exendin-4 is a peptide present in the saliva of the Gila monster that resembles GLP-1 in structure, and like glucagon and GLP-1, increases insulin release. [0008] Gastric inhibitory polypeptide (GIP) is also known as a glucose-dependent insulinotropic peptide, and is a member of the secretin family of hormones. GIP is derived from a 153-amino acid proprotein encoded by the GIP gene and circulates as a biologically active 42- amino acid peptide. The GIP gene is expressed in the small intestine as well as the salivary glands and is a weak inhibitor of gastric acid secretion. In addition to its inhibitory effects in the stomach, in the presence of glucose, GIP enhances insulin release by pancreatic beta islet cells when administered in physiological doses. GIP is believed to function as an enteric factor that stimulates the release of pancreatic insulin and that may play a physiological role in maintaining glucose homeostasis. [0009] Osteocalcin is a noncollagenous protein found in bone and dentin. It is secreted by osteoblasts and thought to play a role in mineralization and calcium ion homeostasis. Osteocalcin has also been reported to function as a hormone in the body, causing beta cells in the 32993-223357 -3- pancreas to release more insulin, and at the same time directing fat cells to release the hormone adiponectin, which increases sensitivity to insulin. SUMMARY OF THE INVENTION [0010] Provided herein are glucagon superfamily peptides conjugated to ligands that activate nuclear glucocorticoid receptors ("GR ligands"). These conjugates with plural activities are useful for the treatment of a variety of diseases. [001 1] The glucagon superfamily peptide conjugates of the invention can be represented by the following formula: Q-L-Y wherein Q is a glucagon superfamily peptide, Y is a GR ligand, and L is a linking group or a bond. For example, the GR ligand is conjugated to Q or L at position 3 or 17 of the GR ligand. [0012] The glucagon superfamily peptide (Q) in some embodiments can be a glucagon related peptide that exhibits agonist activity at the glucagon receptor, agonist activity at the GLP-1 receptor, agonist activity at the GIP receptor, co-agonist activity at the glucagon and GLP-1 receptors, co-agonist activity at the glucagon and GIP receptors, co-agonist activity at the GLP-1 and GIP receptors, or tri-agonist activity at the glucagon, GIP, and GLP-1 receptors. In some embodiments, the glucagon related peptide exhibits antagonist activity at the glucagon, GLP-1 or GIP receptor. The activity of the glucagon related peptide at the glucagon receptor, at the GLP-1 receptor, or at the GIP receptor can be in accordance with any of the teachings set forth herein. In some specific embodiments, the glucagon related peptide exhibits at least 0.1% activity of native glucagon at the glucagon receptor, at least 0.1% activity of native GLP-1 at the GLP-1 receptor, or at least 0.1% activity of native GIP at the GIP receptor. [0013] The GR ligand (Y) is wholly or partly non-peptidic and acts at a glucocorticoid receptor with an activity in accordance with any of the teachings set forth herein. In some µΜ embodiments the GR ligand has an EC 50 or IC 50 of about 1 mM or less, or 100 or less, or 10 µΜ or less, or 1 µΜ or less. In some embodiments, the GR ligand has a molecular weight of up to about 5000 daltons, or up to about 2000 daltons, or up to about 1000 daltons, or up to about 32993-223357 -4- 500 daltons.
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