Compounds for Preventing Ototoxicity
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(19) TZZ ¥ _T (11) EP 2 982 382 A1 (12) EUROPEAN PATENT APPLICATION (43) Date of publication: (51) Int Cl.: 10.02.2016 Bulletin 2016/06 A61K 45/06 (2006.01) A61K 31/4174 (2006.01) A61K 31/4178 (2006.01) A61K 31/4196 (2006.01) (2006.01) (2006.01) (21) Application number: 14179771.2 A61K 31/427 A61P 27/16 (22) Date of filing: 04.08.2014 (84) Designated Contracting States: (72) Inventor: Gaboyard-Niay, Sophie AL AT BE BG CH CY CZ DE DK EE ES FI FR GB 34770 Gigean (FR) GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR (74) Representative: Icosa Designated Extension States: 83 avenue Denfert-Rochereau BA ME 75014 Paris (FR) (71) Applicant: Sensorion 34000 Montpellier (FR) (54) Compounds for preventing ototoxicity (57) The present invention relates to a compound for use for preventing ototoxicity in a subject in need thereof. The present invention also relates to a composition, a pharmaceutical composition or a medicament comprising the compound of the invention. EP 2 982 382 A1 Printed by Jouve, 75001 PARIS (FR) EP 2 982 382 A1 Description FIELD OF INVENTION 5 [0001] The present invention relates to methods for preventing ototoxicity. More specifically, the present invention relates to compounds for preventing ototoxicity, such as, for example, drug-induced ototoxicity. BACKGROUND OF INVENTION 10 [0002] There are several causes to ototoxicity: exposure to loud noise, head and neck radiation, but ototoxicity is more frequently caused by drug reactions. Ototoxic drugs include aminoglycoside antibiotics such as gentamicin, platinum- based chemotherapy agents such as cisplatin, excitatory neurotoxins such as glutamate, loop-diuretics, contaminants in food or medicaments or environmental and industrial pollutants. Symptoms of ototoxicity include partial or profound hearing loss, vertigo, tinnitus, and dizziness. If the ototoxic drug is used at high doses and/or for a prolonged time, the 15 impairments can become persistent and irreversible. [0003] Methods for treating ototoxicity were described in the art. For example, WO 2012/112810 and US 2011/0046156 describe the administration of multiparticulate corticosteroids and redox-active therapeutics respectively, for treating or reducing the severity of ototoxicity. However, the two of them only describe the treatment of a symptom of ototoxicity but do not prevent ototoxicity. 20 [0004] Some ototoxicity preventing agents are known, such as cimetidine, thiourea, pantoprazole or sodium thiosulfate. Cimetidine is an approved drug for the treatment of heartburn and peptic ulcers, but also has potential as a clinical antidote against cisplatin-induced nephrotoxicity. According to preclinical data, cimetidine also seems to have potential as a clinical antidote against cisplatin-induced ototoxicity. Unfortunately, this agent can lead to side effects because of the high therapeutically effective dose necessary to observe an effect. Besides WO 03061574 describes thiourea as an 25 ototoxic preventing agent. Moreover, as regards sodium thiosulfate, preliminary results from phase 3 studies seem to show a lower survival of administered patients (Freyer DR, "The effects of sodium thiosulfate (STS) on cisplatin-induced hearing loss: A report from the Children’s Oncology Group.", Abstract 10017. 2014 ASCO Annual Meeting). [0005] Therefore, to the Applicant knowledge, there is no clinically validated molecule for preventing ototoxicity, what- ever the cause thereof. Accordingly, there is still a need for means to prevent ototoxicity, i.e. an agent preventing the 30 appearance of ototoxicity or the worsening of ototoxicity. [0006] Antifungal agents are known to treat and prevent mycoses. Some of them were previously described to be non-ototoxic (Lawrence, The Laryngoscope, 2000; Munguia & Daniel, Int J Pediatr Otorhinolaryngol., 2008), and may therefore be used for treating otomycosis (i.e. mycosis of the ear). However, no direct effect of antifungal agents on ototoxicity was previously disclosed in the art. Surprisingly, the inventors showed that the administration of antifungal 35 agents allows preventing ototoxicity. [0007] The present invention thus provides compounds to prevent ototoxicity. SUMMARY 40 [0008] The present invention thus relates to a compound for use for preventing ototoxicity in a subject in need thereof, wherein said compound is an antifungal agent. [0009] In one embodiment, said compound is a compound of general formula I: 45 50 55 or a salt or solvate thereof, wherein 2 EP 2 982 382 A1 - X represents C or N atom; - Y represents nothing, O or S atom; - V represents nothing or an imino group; - V’ represents nothing or an imino group; 5 - n is 0, 1 or 2; - m is 0, 1 or 2; and - optionally, Z represents at least one halo, aryl, thiobenzyl or benzyl mercaptan group; preferably Z represents at least one halo group; more preferably Z represents at least one chloro or fluoro group; - R1 or R2 may be identical or different and each is independently selected from the group of H, hydroxyl, alkyl, 10 heteroalkyl, aryl, heteroaryl, alkylaryl, heteroalkylaryl, cycloether, oxolanyl, dioxolanyl or W1 group: 15 20 wherein, 25 + Y’ represents nothing, O or S atom; + n’ is 0, 1 or 2; + and optionally, Z’ represents at least one halo, aryl or benzyl mercaptan group; + Ra, Rb or Rc may be identical or different and each independently is selected from the group of H, aryl, hydroxyl, oxo, nitro, amido, carboxy, amino, cyano, alkoxy, alkyl, alkene, alkyne, cycloalkyl, cycloalkene, heteroalkyl, heter- 30 oaryl, heterocycloalkyl or halo group; preferably Ra, Rb or Rc is at least one halo group; more preferably is a chloro group; + Rb and Rc may represent one fused substituent selected from the group of aryl, heteroaryl, cycloalkyl, cycloalkane or heterocycloalkyl; optionally substituted by at least one group selected from halo, aryl, hydroxyl, oxo, nitro, amido, carboxy, amino, cyano, alkoxy, alkyl, alkene, alkyne, cycloalkyl, cycloalkene, heteroalkyl or heterocycloalkyl group; 35 preferably Rb and Rc represent an aryl group substituted by at least one chloro group; preferably R1 or R2 may be identical or different and each is independently a benzyl, phenyl, alkyltriazolo, triazolo, thiazolo, pyrimidinyl or quinazolinone group; optionally substituted by at least one group selected from halo, aryl, hydroxyl, oxo, nitro, amido, carboxy, amino, cyano, alkoxy, alkoxyaryl, alkyl, alkene, alkyne, cycloalkyl, cycloalkene, heteroalkyl, 40 heteroaryl, heteroalkylaryl, alkyletheraryl or heterocycloalkyl group; preferably a benzyl, phenyl, alkyltriazolo, triazolo, thiazolo, pyrimidinyl or quinazolinone group; said groups optionally substituted by at least one group selected from aryl, cycloalkyl, alkylaryl, alkylcycloalkyl, heteroaryl arylcycloalkyl, heterocycloalkyl, amidocycloalkyl or alkylamidocycloalkyl group; preferably benzyl, phenyl, alkyltriazolone, piperazinyl, arylpiperazinyl, alkylpiperazinyl, amidopiperazinyl or alky- lamidopiperazinyl group; optionally substituted by alkyl, nitrile, alkyltriazolone, hydroxylalkyltriazolone, piperazinyl, ami- 45 dopiperazinyl or alkylamidopiperazinyl; R2 is a nothing when V or V’ is an imido group or R1 is a cycloether, oxolanyl, dioxolanyl group; ----- refers to a single or a double bond, or said compound is thiabendazole, luliconazole or omoconazole. [0010] In one embodiment, said compound is a compound of general formula II: 50 55 3 EP 2 982 382 A1 5 10 15 or a salt or solvate thereof, wherein 20 - X is C or N atom; - V’ represents nothing or an imino group; - Y" represents nothing, O or S atom; - R1 is selected from the aryl group; preferably a phenyl or triazolo group optionally substituted by at least one halo 25 group, preferably by at least one chloro or fluoro group; - R2 is H, OH or nothing when V’ is an imino group; - Z represents at least one halo group, preferably at least one chloro or fluoro group; more preferably two chloro or fluoro groups; 30 ---- refers to a single or a double bond, preferably, the compound of formula II is selected from the list comprising miconazole, econazole, fluconazole, sulco- nazole and oxiconazole. [0011] In one embodiment, said compound is a compound of general formula III: 35 40 45 50 or a salt or solvate thereof, wherein 55 - X is C or N atom; - V’ represents nothing or an imino group; - Y" represents nothing, O or S atom; - R1 is selected from the aryl group; preferably a phenyl or triazolo group optionally substituted by at least one halo 4 EP 2 982 382 A1 group, preferably by at least one chloro or fluoro group; - R2 is H, OH or nothing when V’ is an imino group; - R3 and R4 are both chloro or fluoro group; 5 ---- refers to a single or a double bond, preferably, the compound of formula III is selected from the list comprising miconazole, econazole, fluconazole, sulco- nazole and oxiconazole. [0012] In one embodiment, said compound is a compound of general formula IV: 10 15 20 25 or a salt or solvate thereof, wherein R1 is a phenyl group optionally substituted by one or more chloro group, 30 preferably, the compound of formula IV is selected from the list comprising miconazole and econazole. [0013] In one embodiment, ototoxicity is induced: - by chemotherapeutic drugs, preferably selected from vincristine or platinum based chemotherapeutic agent, more 35 preferably cisplatin, carboplatin, oxiplatin or bis-platinate; - by antibiotic agents, preferably selected from aminoglycoside antibiotic or macrolide antibiotic; - by a diuretic; or - by salicylate. 40 [0014] In one embodiment, said ototoxicity