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Wo 2010/075090 A2 (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 1 July 2010 (01.07.2010) WO 2010/075090 A2 (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every C07D 409/14 (2006.01) A61K 31/7028 (2006.01) kind of national protection available): AE, AG, AL, AM, C07D 409/12 (2006.01) A61P 11/06 (2006.01) AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, (21) International Application Number: DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, PCT/US2009/068073 HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, (22) International Filing Date: KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, 15 December 2009 (15.12.2009) ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (25) Filing Language: English SE, SG, SK, SL, SM, ST, SV, SY, TJ, TM, TN, TR, TT, (26) Publication Language: English TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 61/122,478 15 December 2008 (15.12.2008) US kind of regional protection available): ARIPO (BW, GH, GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, (71) Applicant (for all designated States except US): AUS- ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, PEX PHARMACEUTICALS, INC. [US/US]; 1261 TM), European (AT, BE, BG, CH, CY, CZ, DE, DK, EE, Liberty Way, Suite C, Vista, CA 9208 1 (US). ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV, MC, MK, MT, NL, NO, PL, PT, RO, SE, SI, SK, SM, (72) Inventor; and TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW, (75) Inventor/Applicant (for US only): GANT, Thomas, G. ML, MR, NE, SN, TD, TG). [US/US]; 1261 Liberty Way, Suite C, Vista, CA 92081 (US). Published: (74) Agent: BENNETT, Dennis, A.; Global Patent Group, — without international search report and to be republished LLC, 104 11 Clayton Road, Suite 304, St. Louis, MO upon receipt of that report (Rule 48.2(g)) 63 13 1 (US). (54) Title: SCOPINE MODULATORS OF MUSCARINIC ACETYLCHOLINE RECEPTOR (57) Abstract: The present invention relates to new scopine modulators of muscarinic acetylcholine receptors, pharmaceutical compositions thereof, and methods of use thereof. (I) Formula I SCOPINE MODULATORS OF MUSCARINIC ACETYLCHOLINE RECEPTOR [0001] This application claims the benefit of priority of United States provisional application No. 61/122,478, filed December 15, 2008, the disclosure of which is hereby incorporated by reference as if written herein in its entirety. [0002] Disclosed herein are new tropine compounds and compositions and their application as pharmaceuticals for the treatment of disorders. Methods of modulation of muscarinic acetylcholine receptor activity in a subject are also provided for the treatment of disorders such as chronic obstructive pulmonary disorder and asthma. [0003] Tiotropium bromide (Ba-679, Ba-679 Br, Ba-679-BR, Spiriva®, CAS # 136310-93-5), (l α,2β,4β,7β)-7-[(hydroxidi-2-thienylacetyl)oxy]-9,9-dimethyl-3- oxa-9-azoniatricyclo[3.3.1.02,4]nonane, is a muscarinic acetylcholine receptor antagonist. Tiotropium bromide is commonly prescribed for the treatment of chronic obstructive pulmonary disorder (Drug Report for Tiotropium Bromide, Thompson Investigational Drug Database (Sept. 15, 2008); Van Noord et al., Eur. Resp. J. 2002, 19(4), 639-644; Mundy et al., Nature Rev. Drug Disc. 2004, 3(8), 643-644; Koumis et al. Clin. Ther., 2005, 27(4), 377-392; Joos et al., Int. J. Clin. Pract. 2003, 57(10), 906-909; Hvizdos et al., Drugs 2002, 62(8), 1195-1203; and Barnes, Chest 2000, 117(2, Suppl.), 63S-66S. Tiotropium bromide has also shown promise in treating asthma (Drug Report for Tiotropium Bromide, Thompson Investigational Drug Database (Sept. 15, 2008); and Koumis et al., Clin. Ther. 2005, 27(4), 377-392). Tiotropium bromide [0004] Tiotropium bromide is subject to CYP3A4 and CYP2D6-mediated oxidative metabolism (Koumis et al., Clin. Ther. 2005, 27(4), 377-392). Adverse effects associated with tiotropium bromide administration include: dry mouth, chest pain, fatigue, headache, dizziness, hypoesthesia, abdominal pain, constipation, diarrhea, cough, pharyngitis, sinusitis, influenza-like symptoms, upper respiratory tract infection, and pneumonia. Deuterium Kinetic Isotope Effect [0005] In order to eliminate foreign substances such as therapeutic agents, the animal body expresses various enzymes, such as the cytochrome P450 enzymes (CYPs), esterases, proteases, reductases, dehydrogenases, and monoamine oxidases, to react with and convert these foreign substances to more polar intermediates or metabolites for renal excretion. Such metabolic reactions frequently involve the oxidation of a carbon-hydrogen (C-H) bond to either a carbon-oxygen (C-O) or a carbon-carbon (C-C) π-bond. The resultant metabolites may be stable or unstable under physiological conditions, and can have substantially different pharmacokinetic, pharmacodynamic, and acute and long-term toxicity profiles relative to the parent compounds. For most drugs, such oxidations are generally rapid and ultimately lead to administration of multiple or high daily doses. [0006] The relationship between the activation energy and the rate of reaction may be quantified by the Arrhenius equation, k = Ae Eact/RT. The Arrhenius equation states that, at a given temperature, the rate of a chemical reaction depends exponentially on the activation energy (Eact). [0007] The transition state in a reaction is a short lived state along the reaction pathway during which the original bonds have stretched to their limit. By definition, the activation energy E for a reaction is the energy required to reach the transition state of that reaction. Once the transition state is reached, the molecules can either revert to the original reactants, or form new bonds giving rise to reaction products. A catalyst facilitates a reaction process by lowering the activation energy leading to a transition state. Enzymes are examples of biological catalysts. [0008] Carbon-hydrogen bond strength is directly proportional to the absolute value of the ground-state vibrational energy of the bond. This vibrational energy depends on the mass of the atoms that form the bond, and increases as the mass of 9 one or both of the atoms making the bond increases. Since deuterium (D) has twice the mass of protium (1H), a C-D bond is stronger than the corresponding C-1H bond. If a C-1H bond is broken during a rate-determining step in a chemical reaction (i.e. the step with the highest transition state energy), then substituting a deuterium for that protium will cause a decrease in the reaction rate. This phenomenon is known as the Deuterium Kinetic Isotope Effect (DKIE). The magnitude of the DKIE can be expressed as the ratio between the rates of a given reaction in which a C-1H bond is broken, and the same reaction where deuterium is substituted for protium. The DKIE can range from about 1 (no isotope effect) to very large numbers, such as 50 or more. Substitution of tritium for hydrogen results in yet a stronger bond than deuterium and gives numerically larger isotope effects [0009] Deuterium (2H or D) is a stable and non-radioactive isotope of hydrogen which has approximately twice the mass of protium (1H), the most common isotope of hydrogen. Deuterium oxide (D O or "heavy water") looks and tastes like H O, but has different physical properties. [0010] When pure D O is given to rodents, it is readily absorbed. The quantity of deuterium required to induce toxicity is extremely high. When about 0-15% of the body water has been replaced by D2O, animals are healthy but are unable to gain weight as fast as the control (untreated) group. When about 15-20% of the body water has been replaced with D2O, the animals become excitable. When about 20-25% of the body water has been replaced with D2O, the animals become so excitable that they go into frequent convulsions when stimulated. Skin lesions, ulcers on the paws and muzzles, and necrosis of the tails appear. The animals also become very aggressive. When about 30% of the body water has been replaced with D2O, the animals refuse to eat and become comatose. Their body weight drops sharply and their metabolic rates drop far below normal, with death occurring at about 30 to about 35% replacement with D2O. The effects are reversible unless more than thirty percent of the previous body weight has been lost due to D2O. Studies have also shown that the use of D2O can delay the growth of cancer cells and enhance the cytotoxicity of certain antineoplastic agents. [001 1] Deuteration of pharmaceuticals to improve pharmacokinetics (PK), pharmacodynamics (PD), and toxicity profiles has been demonstrated previously with some classes of drugs. For example, the DKIE was used to decrease the hepatotoxicity of halothane, presumably by limiting the production of reactive species such as trifluoroacetyl chloride. However, this method may not be applicable to all drug classes. For example, deuterium incorporation can lead to metabolic switching. Metabolic switching occurs when xenogens, sequestered by Phase I enzymes, bind transiently and re-bind in a variety of conformations prior to the chemical reaction (e.g., oxidation). Metabolic switching is enabled by the relatively vast size of binding pockets in many Phase I enzymes and the promiscuous nature of many metabolic reactions. Metabolic switching can lead to different proportions of known metabolites as well as altogether new metabolites.
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