# Patent

## Title
Anti-viral pyrimidine nucleoside derivatives

## Abstract

A compound for use in the treatment or prophylaxis of viral infections such, for example as chicken pox or shingles caused by the Varicella Zoster virus, said compound having the general formula (II): wherein X is O, S, NH or CH2, Y is O, S or NH, Z is O, S or CH2, R1 is C1-6 alkyl, preferably n-alkyl, e.g., n-pentyl or n-hexyl, and one of R2 and R3 is OH, and the other of R3 and R2 is a neutral, non-polar amino acid moiety, or a pharmaceutically acceptable salt or hydrate thereof. Said neutral, non-polar amino acid moiety R2 or R3 may be (IV): in which R4, R5, R6 and R7 are each independently H or C1-2 alkyl. In preferred embodiments, one of R2 or R3 is valine, leucine, isoleucine or alanine, particularly valine.

## Background
RELATED APPLICATIONS
This is a continuation of U.S. patent application Ser. No. 12/226,044, filed Dec. 21, 2009, which is a national stage application, filed under 35 U.S.C. 371, of International Application No. PCT/GB2007/001677, filed on May 9, 2007, which claims the benefit of GB Serial No. 0609178.9, filed May 9, 2006.


The present invention relates to ester derivatives of certain nucleoside analogues having therapeutic use in the prophylaxis and treatment of viral infections such, for example, as those caused by the Varicella Zoster virus (VZV). Varicella Zoster virus is the aetiological agent in chickenpox and shingles, which can cause considerable human illness and suffering. The invention also provides a pharmaceutical composition comprising such an ester derivative, and a method of treatment or prophylaxis of viral infection by administering such a derivative.
WO 01/83501 A1, the contents of which are incorporated herein by reference, describes certain nucleoside analogues with potent activity against Varicella Zoster virus (VZV), said nucleoside analogues having general formula (I):




wherein:
Ar is an optionally substituted, aromatic ring system, the aromatic ring system comprising one six-membered aromatic ring or two fused six-membered aromatic rings;
R8 and R9 are each independently selected from the group comprising hydrogen, alkyl, cycloalkyl, halogens, amino, alkylamino, dialkylamino, nitro, cyan, alkyoxy, aryloxy, thiol, alkylthiol, arythiol, aryl;
Q is selected from the group comprising O, S and CY2, where Y may be the same or different and is selected from H, alkyl and halogens;
X is selected from the group comprising O, NH, S, N-alkyl, (CH2), where m is 1 to 10, and CY2 where Y may be the same or different and is selected from hydrogen, alkyl and halogens;
Z is selected from the group comprising O, S, NH, and N-alkyl;
U′′ is H and U′ is selected from H and CH2T, or U′ and U′′ are joined so as to form a ring moiety including Q wherein U′-U′′ together is respectively selected from the group comprising CTH-CT′T′′ and CT′=CT′ , so as to provide ring moieties selected from the group comprising:




wherein T is selected from the group comprising OH, H, halogens, O-alkyl, O-acyl, O-aryl, CN, NH2, and N3:
T′ is selected from the group comprising H and halogens and, where more than one T′ is present, they may be the same or different;
T′′ is selected from the group comprising H and halogens; and
W is selected from the group comprising H, a phosphate group and a pharmacologically acceptable salt, derivative or pro-drug thereof:
with the proviso that when T is OAc and T′ and T′′ are present and are H, Ar is not 4-(2-benzoxazolyl)phenyl.
Compounds 1 and 2 below are particularly preferred compounds according to WO 01/83501 A1:




An object of the present invention is to provide novel compounds for the treatment or prophylaxis of viral infections, especially those caused or exacerbated by the Varicella Zoster virus (VZV).
Another object of the present invention is to provide compounds for the treatment of such viral infections, said compounds having improved bioavailabilities.
Yet another object of the present invention is to provide such compounds which have advantageous pharmacokinetic properties.
A different object of the present invention is to provide a method of making such compounds.
According to one aspect of the present invention therefore there is provided a compound of general formula (II):




wherein X is O, S, NH or CH2,
Y is O, S or NH,
Z is O, S or CH2,
R1 is C1-6 alkyl, preferably n-alkyl, e.g., n-pentyl or n-hexyl, and
one of R2 and R3 is OH, and the other of R3 and R2 is a neutral, non-polar amino acid moiety,
or a pharmaceutically acceptable salt or hydrate thereof.
Preferably said neutral, non-polar amino acid moiety R2 or R3 is:




in which R4, R5, R6 and R7 are each independently H or C1-2 alkyl.
R6 and R7 are preferably both H.
In some embodiments, one of R2 or R3 may be valine, leucine, isoleucine or alanine. Preferably R2 or R3 is valine.
It is to be understood that the valine ester of the present invention may be either L-valine, D-valine or D,L-valine.
Further, X, Y and Z are preferably all O.
Particularly preferred compounds according to the present invention are




It will be appreciated that Compounds 3 and 5 are the valine esters of the 3′- and 5′-hydroxy groups respectively of Compound 1.
According to a different aspect of the present invention there is provided a method of synthesising a compound of the invention, said method comprising esterifying a compound of formula (III):




with a protected neutral, non-polar amino acid, wherein R1, X, Y and Z are as defined above.
Preferably, said amino acid has the formula (IV):




wherein R4, R5, R6 and R7 are as defined above.
The α-amino group is suitably protected during the esterification reaction. In some embodiments, where R6 and R7 are both H, said amino acid may be protected using a 3.9-fluorenylmethoxycarbonyl (Fmoc) protecting group. Other suitable protecting groups are known and available to those skilled in the art.




The Fmoc group may be introduced under Schotten-Baumen conditions. It is exceptionally stable towards acid. The cleavage of this group may be base catalysed (ammonia, piperidine, morpholine, DBU) undergoing an E1 β-elimination mechanism.
The esterification is preferably carried out under Mitsunobu conditions1: 1 Mitsunobu, Synthesis, January 1981: 1-28




The hydrochloride salt may be prepared by treatment of the ester (V) with a solution of HCl in THF.
Preferably, R1 is n-pentyl, X, Y and Z are all O, and R4 and R5 are both methyl.
It has been found that the compounds of the present invention, and their hydrochloride salts, e.g., Compound 6 (see below), have advantageous pharmacokinetic (PK) properties and improved bioavailability as compared to Compound 1 of WO 01/83501 A1.




Bioavailability is often a key factor in the practical application of a drug as a therapeutic agent and compounds that demonstrate enhanced PK and/or solubility generally have improved potency in vivo over compounds with less favorable PK properties even though their in vitro potency may be similar. Such compounds, i.e., derivatives of known in vitro active compounds, are often referred to as prodrugs. Novel Compound 5 and its hydrochloride salt Compound 6, are examples of two such prodrugs.
Compounds 5 and 6 were tested for antiviral activity as described below and found to be active. In addition, a comparative study of the pharmacokinetic behaviour of Compounds 1 and 5 was conducted in a mouse model, demonstrating the improved bioavailability of Compound 5 compared to Compound 1.
According to another aspect of the present invention therefore there is provided a compound according to the present invention for use in a method of treatment, particularly the prophylaxis or treatment of a viral infection. In some embodiments, said compound may be provided for use in the treatment or prophylaxis of an infection with the Varicella Zoster virus.
According to a yet another aspect of the present invention there is provided use of a compound according to the present invention in the manufacture of a medicament for the prophylaxis or treatment of viral infection, especially a viral infection caused by the Varicella Zoster virus, e.g., chicken pox or shingles.
According to yet another aspect of the present invention there is provided a method of prophylaxis or treatment of viral infection, said method comprising administration to a human or non-human animal patient in need of such treatment an effective dose of a compound according to the present invention.
According to a further aspect of the present invention there is provided a pharmaceutical composition comprising a compound of the present invention in combination with a pharmaceutically acceptable excipient. Medicaments embodying the present invention can be administered by oral, enteral or parenteral routes, including intravenous, intramuscular, intraperitoneal, subcutaneous, transdermal, airway (aerosol), rectal, vaginal and topical (including buccal and sublingual) administration.
For oral administration, compounds embodying the present invention will generally be provided in the form of tablets or capsules, as a powder or granules, or as an aqueous solution or suspension.
Tablets for oral use may include the active ingredient mixed with pharmaceutically acceptable excipients such as inert diluents, disintegrating agents, binding agents, lubricating agents, sweetening agents, flavouring agents, colouring agents and preservatives. Suitable inert diluents include sodium and calcium carbonate, sodium and calcium phosphate, and lactose, while corn starch and alginic acid are suitable disintegrating agents. Binding agents may include starch and gelatin, while the lubricating agent, if present, will generally be magnesium stearate, stearic acid or talc. If desired, the tablets may be coated with a material such as glyceryl monostearate or glyceryl distearate, to delay absorption in the gastrointestinal tract.
Capsules for oral use include hard gelatin capsules in which the active ingredient is mixed with a solid diluent, and soft gelatin capsules wherein the active ingredient is mixed with water or an oil such as peanut oil, liquid paraffin or olive oil.
Formulations for rectal administration may be presented as a suppository with a suitable base comprising for example cocoa butter or a salicylate.
Formulations suitable for vaginal administration may be presented as pessaries, tampons, creams, gels, pastes, foams or spray formulations containing in addition to the active ingredient such carriers as are known in the art to be appropriate.
For intramuscular, intraperitoneal, subcutaneous and intravenous use, compounds embodying the present invention will generally be provided in sterile aqueous solutions or suspensions, buffered to an appropriate pH and isotonicity. Suitable aqueous vehicles include Ringer's solution and isotonic sodium chloride. Aqueous suspensions embodying the invention may include suspending agents such as cellulose derivatives, sodium alginate, polyvinyl-pyrrolidone and gum tragacanth, and a wetting agent such as lecithin. Suitable preservatives for aqueous suspensions include ethyl and n-propyl p-hydroxybenzoate.
Compounds embodying the present invention can be presented as liposome formulations.
In general, a suitable dose will be in the range of 0.001 to 300 mg per kilogram body weight of the recipient per day, preferably in the range of 0.01 to 25 mg per kilogram body weight per day and most preferably in the range 0.05 to 10 mg per kilogram body weight per day. The desired dose is preferably presented as two, three, four, five or six or more sub-doses administered at appropriate intervals throughout the day. These sub-doses may be administered in unit dosage forms, for example, containing 0.1 to 1500 mg, preferably 0.2 to 1000 mg, and most preferably 0.5 to 700 mg of active ingredient per unit dosage form.
Following are various examples of the invention with reference to the accompanying drawings, from which examples further advantages and effects of the compounds of the invention will be apparent.



BRIEF DESCRIPTION OF DRAWINGS
FIG. 1 shows plasma concentration of Compound 1 was much higher in mice receiving Compound 5 compared to mice receiving Compound 1.
In the drawings the single FIGURE is a graph of Mean±SD Plasma Compound 1 (shown as relative peak area) in Female Mice After a Single Oral Gavage Dose of Compound 1 (25 mg/kg) or Compound 5 (31.25 mg/kg, equivalent to 25 mg/kg of Compound 1)



EXPERIMENTAL PROCEDURES AND BIOLOGICAL RESULTS
Preparation of Compounds
Example 1
Preparation of Compound 5; Formation of Valine Ester




Compound 1 (200 mg, 0.5 mmol, prepared as described in WO 01/83501 A1, Example 3, page 15) was dissolved in dry DMF (5 mL), followed by the addition of polymer-bound triphenylphosphine [370 mg, 1.1 mmol, (3 mmol p/g resin)] and di-tert-butyl azodicarboxylate (DBAD) (231 mg, 1.0 mmol) to the mixture and stirred for 20 minutes. A solution of Fmoc-Val-OH (340 mg, 1.0 mmol) in DMF (5 mL) was added dropwise over a period of 30 minutes. The reaction mixture was stirred at room temperature under an argon atmosphere until complete disappearance of the starting material (overnight). The resin was filtered off and washed with ethyl acetate. Piperidine (1 mL, 10 mmol) was added to the solution and stirred for 10 minutes. The solvent was removed under reduced pressure without warming over 35° C. and the residue was dissolved in ethyl acetate (20 mL), washed with 10% NaHCO3 (3×20 mL) and brine (2×20 mL). The final residue was purified by column chromatography (gradient CH2Cl2: MeOH 100% 98% 95% 90%), to give 137 mg of Compound 5 (55% yield) as a yellow solid.
1H-NMR (CDCl3) δ: 8.3 (1H, s), 7.55 (2H, d), 7.15 (2H, d), 6.6 (1H, s), 6.25 (1H, t), 4.45-4.30 (4H, m), 3.23 (1H, d), 2.80 (1H, m), 2.53 (2H, t), 2.12 (1H, m), 1.97 (1H, m), 1.60 (2H, m), 1.24 (4H, m), 0.90-0.78 (9H, m).
13C-NMR(CDCl3) δ: 175.16, 171.62, 156.26, 154.89, 145.19, 135.29, 129.02, 125.69, 124.95, 108.60, 96.82, 88.73, 85.08, 70.90, 64.19, 60.19, 41.91, 35.82, 32.32, 31.44, 30.89, 22.50, 19.30, 17.24, 13.99.
Example 2
Preparation of Compound 6; Formation of the HCl Salt




300 mg of Compound 5 were dissolved in 3 mL of THF. Under vigorous stirring 2 mL of HCl 1M were added at 0° C. and the mixture were stirred for 10 minutes. The solvents were dried under reduce pressure to obtain 322 mg (100%) of yellow oil that solidified with addition of ether.
1H-NMR (d6-DMSO) δ: 8.6 (4H, bs), 7.70 (2H, d), 7.30 (2H, d), 7.20 (1H, s), 6.22 (1H, t), 5.60 (1H, bs), 4.48 (2H, m), 4.30 (1H, m), 4.16 (1H, m), 3.98 (1H, m), 2.61 (2H, t), 2.44 (1H, m), 2.25 (1H, m), 2.18 (1H, m), 1.57 (2H, m), 1.32 (4H, m), 1.00-0.83 (9H, m).
13C-NMR (d6-DMSO) δ: 171.13, 168.88, 153.97, 153.70, 144.18, 137.94, 129.04, 125.77, 124.58, 107.22, 98.75, 87.71, 84.13, 69.73, 65.26, 57.35, 40.18, 34.88, 30.88, 30.39, 29.38, 21.91, 18.26, 17.55, 13.90.
Biological and Pharmacokinetic Studies
In order to demonstrate the improved exposure profile of Compound 5, several experiments were run using mouse animal models. Below are representative results
Pilot Comparative Virology Study with Compounds 1 and 5
The objective of this pilot study was to compare the antiviral activity of Compounds 1 and 5 in HEL cells inoculated with the thymidine-kinase deficient Oka VZV strain. Antiviral activity was assessed as the ability of 1 or 5 to reduce viral plaque formation after incubation periods ranging from 3 to 7 days compared to untreated control cultures. Preliminary results of the antiviral efficacy studies showing comparable efficacy between the two compounds are shown in Table 4.2.







TABLE 1







Preliminary Results Comparing Compound 1 and Compound 5 for


Anti-Varicella Zoster Virus Activity in HEL Cells








Compound
EC50 in VZV OKA





1
0.007 μM (2.8 ng/mL)


5
0.016 μM (8.0 ng/mL)





Note:


The molecular weight of Compound 5 is approximately 1.25 times that of Compound 1 due to the valine ester.






In conclusion, the results of these comparative pilot in vitro studies showed that Compound 5 has comparable in vitro antiviral activity to Compound 1.
Nonclinical Pharmacokinetic Studies with Compound 5
A pilot study was conducted with Compounds 1 and 5 to compare the relative bioavailability of Compound 1 after oral dosing in mice. Two groups of female mice received equimolar doses of Compound 1 (25 mg/kg) or 5 (31.25 mg/kg; equivalent to 25 mg/kg of Compound 1) as a single oral gavage dose) formulated in 0.5% carboxymethylcellulose. The mice were serially sacrificed at time-points ranging from 0.25 to 3 hours post dosing (3 mice/time-point), and plasma samples were taken and analyzed for Compound 1 concentration using a non-validated HPLC method with fluorescence detection. Results are reported as relative peak areas for Compound 1, which assumes that peak area is directly proportional to concentration over these ranges of concentrations.
The results of this study are shown in the accompanying FIGURE. Plasma concentrations of Compound 1 were much higher in mice receiving Compound 5 compared to mice receiving Compound 1. Note that although these data do not provide absolute plasma concentrations of Compound 1, one can estimate from the peak areas that Compound 5 increases the oral bioavailability of Compound 1 by approximately 8.4 to 10 fold (e.g., the AUC is increased by  ̃840% and the Cmax is increased by  ̃1000%).
In conclusion, this data supports the hypothesis that Compound 5 is a prodrug of Compound 1, and greatly increases the oral bioavailability of Compound 1.

## Claims

1. A method of prophylaxis or treatment of a viral infection caused by the Varicella Zoster virus, the method comprising administering to a human or non-human animal patient in need of such treatment an effective dose of a compound of formula (II):




wherein
X is O, S, NH or CH2,
Y is O, S or NH,
Z is O, S or CH2,
R1 is C1-6 alkyl, and
one of R2 or R3 is H, and the other of R3 or R2 is a neutral, non-polar amino acid moiety, or a pharmaceutically acceptable salt or hydrate thereof.

2. The method of claim 1, wherein said neutral, non-polar amino acid moiety R2 or R3 is:




in which R4, R5, R6 and R7 are each independently H or C1-2 alkyl.

3. The method of claim 2, wherein R6 and R7 are both H.

4. The method of claim 1, wherein one of R2 or R3 is selected from the group consisting of valine, leucine, isoleucine and alanine.

5. The method of claim 1, wherein R2 or R3 is valine.

6. The method of claim 5, wherein said valine is L-valine, D-valine or D,L-valine.

7. The method of claim 1, wherein R1 is n-alkyl.

8. The method of claim 7, wherein R1 is n-pentyl or n-hexyl.

9. The method of claim 1, wherein X, Y and Z are all O.

10. The method of claim 1, wherein the compound is selected from the group consisting of:




the hydrochloride salt of Compound 3 and the hydrochloride salt of Compound 5.

11. The method of claim 1, wherein the compound is:

12. The method of claim 1, wherein the viral infection is selected from chicken pox and shingles.

13. The method of claim 12, wherein said viral infection is chicken pox.

14. The method of claim 12, wherein said viral infection is shingles.

15. The method of claim 1, wherein the patient is a human.

16. The method of claim 1, wherein said compound is administered by an oral, enteral or parenteral route.

17. The method of claim 16, wherein said compound is administered by an intravenous, intramuscular, intraperitoneal, subcutaneous, transdermal, airway, rectal, vaginal, or topical route.

18. The method of claim 1, wherein the compound is administered at a dose of 0.001 to 300 mg per kilogram body weight of the recipient per day.

19. The method of claim 18, wherein the dose is administered as two, three, four, five, or six more sub-doses, wherein said sub-doses are administered at appropriate intervals throughout the day.