Anti-HIV Pyrimidine Nucleosides

Abstract: Certain 3′-fluoro pyrimidine and purine nucleosides have been found to have potent antiviral activity particularly against Human Immunodeficiency Virus (HIV).

Description: The present invention relates to a 3'-fluoro-2',3'-dideoxynuceoside, pharmaceutically acceptable derivatives thereof, and its use in therapy, particularly for the treatment or prophylaxis of certain viral infections. In the field of antiviral chemotherapy, few drugs exist which effectively combat the virus per se , owing to the difficulty of attacking the virus while leaving uninfected host cells unimpaired. It has recently been established that certain stages in the virus life-cycle, which vary from species to species, are specified by the virus itself. These stages may prove susceptible to attack where they differ sufficiently from any corresponding host-cell function. However, owing to great similarity between viral and host functions, effective treatments have proven very difficult to identify. One group of viruses which has recently assumed a particular importance are the retroviruses. Retroviruses form a sub-group of RNA viruses which, in order to replicate, must first 'reverse transcribe' the RNA of their genome into DNA ('transcription' conventionally describes the synthesis of RNA from DNA). Once in the form of DNA, the viral genome is incorporated into the host cell genome, allowing it to take full advantage of the host cell's transcription/translation machinery for the purposes of replication. Once incorporated, the viral DNA is virtually indistinguishable from the host's DNA and, in this state, the virus may persist for as long as the cell lives. As it is believed to be invulnerable to attack in this form, any treatment must be directed at another stage of the virus life cycle and would, have to be continued until all virus-infected cells have died. A species of retrovirus has also been reproducibly isolated from patients with AIDS and is now named as human immunodeficiency virus (HIV) and is also known as human T-cell lymphotropic virus III (HTLV III), AIDS associated retrovirus (ARV), or lymphadenopathy associated virus (LAV). This virus has been shown preferentially to infect and destroy T-cells bearing the OKT⁴ surface marker and is now generally accepted as the aetiologic agent of AIDS. The patient progressively loses this set of T-cells, upsetting the overall balance of the immune system, reducing his ability to combat other infections, and predisposing him to opportunistic infections which frequently prove fatal. Thus, the usual cause of death in AIDS victims is by opportunistic infection, such as pneumonia or virally induced cancers, and not as a direct result of HIV infection. Recently, HIV has also been recovered from other tissue types, including B- cells expressing the T⁴ marker, macrophages and non-blood associated tissue in the central nervous system. This infection of the central nervous system has been discovered in patients expressing classical AIDS symptoms and is associated with progressive demyelination, leading to wasting and such symptoms as encephalopathy, progressive dysarthria, ataxia and disorientation. Further conditions associated with HIV infection are the asymptomatic carrier state, progressive generalised lymphadenopathy (PGL) and AIDS-related complex (ARC). Herdewijn et al (J. Med. Chem., 1987, 30, 1270-1278) reported the in vitro anti-HIV activity of the compounds 3'-fluoro-2',3'-dideoxythymidine (compound 3a) and 1-(3-fluoro-2,3-dideoxy-β-D-erythro-pentofuranosyl)cytosine (compound 3b). Also disclosed is the synthesis of compound 1-(3-fluoro-2,3-dideoxy-β-D-erythro-pentofuranosyl)-5-ethyluridine (compound 3g). This compound was shown to have an IC₅₀ against HIV of >500µm. We have now discovered that certain 3'-fluoro-2',3,-dideoxynucleosides, as referred to below, are useful for the treatment or prophylaxis of viral infections, particularly retroviral infections and especially HIV infections such as AIDS, ARC, PGL and carriers of HIV. The present invention, therefore provides the use of a 3'-fluoro-2',3'-dideoxynucleoside having the following formula (I): wherein B represents a group of formula: in which R¹ represents a chlorine atom, or a pharmaceutically acceptable derivative thereof, in the manufacture of a medicament for the treatment or prophylaxis of a human immunodeficiency virus infection, AIDS, AIDS-related complex or an asymptomatic patient having a human immunodeficiency virus infection. The above compound of formula (I) namely 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil and its pharmaceutically acceptable derivatives are hereinafter referred to as the compounds according to the invention. The compounds according to the invention have particularly good activity against HIV (HTLV-III); The invention accordingly provides the compounds according to the invention for use in the treatment or prophylaxis of the above infection. The compounds according to the invention are also useful for the treatment or prophylaxis of other clinical conditions associated with retroviral infections, for example, Kaposi's sarcoma, thrombocytopenia purpura, AIDS-related complex, and patients carrying AIDS-antibodies or who are seropositive to the AIDS virus, as well as chronic neurological conditions such as multiple sclerosis or tropical spastic paraparesis. The compounds according to the invention are also useful for the treatment or prophylaxis of HTLV-I, HTLV-II, HTLV-IV and HIV-2 infections as well as other human retrovirus infections associated with AIDS or immunodeficiency, and also psoriasis. The invention accordingly provides the compounds according to the invention for use in the treatment or prophylaxis of any of the above infections or conditions. By "a pharmaceutically acceptable derivative" is meant any pharmaceutically acceptable salt, 5'-ester, 5'-secondary ether (e.g. isopropyl ether) or salt of such ester or ether of a compound of formula (I), or any other compound which, upon administration to the recipient, is capable of providing (directly or indirectly) such a compound or an antivirally active metabolite or residue thereof. Preferred esters of the compound of formula (I) include carboxylic acid esters in which the non-carbonyl moiety of the ester grouping is selected from straight or branched chain alkyl, alkoxyalkyl (e.g. methoxymethyl), aralkyl (e.g. benzyl), aryloxyalkyl (e.g. phenoxymethyl), aryl (e.g. phenyl optionally substituted by halogen, C₁₋₄ alkyl or C₁₋₄ alkoxy); sulphonate esters such as alkyl- or aralkylsulphonyl (e.g. methanesulphonyl); amino acid esters; and mono-, di- or tri-phosphate esters. With regard to the above-described esters, unless otherwise specified, any alkyl moiety present advantageously contains 1 to 18 carbon atoms, particularly 1 to 5 carbon atoms. Any aryl moiety present in such esters advantageously comprises a phenyl group. Any reference to any of the above compounds also includes a reference to a pharmaceutically acceptable salt thereof. Examples of pharmaceutically acceptable salts of the compound of formula (I) and pharmaceutically acceptable derivatives thereof include base salts, eg derived from an appropriate base, such as alkali metal (e.g. sodium), alkaline earth metal (e.g. magnesium) salts, ammonium and NX + / 4 (wherein X is C₁₋₄ alkyl). Physiologically acceptable salts of an hydrogen atom or an amino group include salts of organic carboxylic acids such as acetic, lactic, tartaric, malic, isethionic, lactobionic and succinic acids; organic sulfonic acids such as methanesulfonic, ethanesulfonic, benzenesulfonic and p-tolunesulfonic acids and inorganic acids such as hydrochloric, sulfuric, phosphoric and sulfamic acids. Physiologically acceptable salts of a compound of an hydroxy group include the anion of said compound in combination with a suitable cation such as Na⁺, NH₄⁺, and NX₄⁺ (wherein X is a C₁₋₄ alkyl group). The compounds according to the invention, also referred to herein as the active ingredient, may be administered for therapy by any suitable route including oral, rectal, nasal, topical (including buccal and sublingual), vaginal and parenteral (including subcutaneous, intramuscular, intravenous and intradermal). It will be appreciated that the preferred route will vary with the condition and age of the recipient, the nature of the infection and the chosen active ingredient. In general a suitable dose will be in the range of 0.1 to 120 mg per kilogram body weight of the recipient per day, preferably in the range of 0.5 to 40 mg per kilogram body weight per day and most preferably in the range 1 to 15 mg per kilogram body weight per day. The desired dose is preferably presented as two, three, four, five, six or or more sub-doses administered at appropriate intervals throughout the day. These sub-doses may be administered in unit dosage forms, for example, containing 10 to 1500 mg, preferably 20 to 1000 mg, and most preferably 50 to 700 mg of active ingredient per unit dosage form. Ideally, the active ingredient should be administered to achieve peak plasma concentrations of the active compound of from about 1 to about 75 µm preferably about 2 to 50 µM, most preferably about 3 to about 30 µM This may be achieved, for example, by the intravenous injection of a 0.1 to 5% solution of the active ingredient, optionally in saline, or orally administered as a bolus containing about 1 to about 100 mg/kg of the active ingredient. Desirable blood levels may be maintained by a continuous infusion to provide about 0.01 to about 5.0 mg/kg/hour or by intermittent infusions containing about 0.4 to about 15 mg/kg of the active ingredient. While it is possible for the active ingredient to be administered alone it is preferable to present it as a pharmaceutical formulation. The formulations of the present invention comprise at least one active ingredient, as above defined, together with one or more acceptable carriers therefor and optionally other therapeutic agents. Each carrier must be "acceptable" in the sense of being compatible with the other ingredients of the formulation and not injurious to the patient. Formulations include those suitable for oral, rectal, nasal, topical (including buccal and sublingual), vaginal or parenteral (including subcutaneous, intramuscular, intravenous and intradermal) administration. The formulations may conveniently be presented in unit dosage form and may be prepared by any methods well known in the art of pharmacy. Such methods include the step of bringing into association the active ingredient with the carrier which constitutes one or more accessory ingredients. In general, the formulations are prepared by uniformly and intimately bringing into association the active ingredient with liquid carriers or finely divided solid carriers or both, and then if necessary shaping the product. Formulations of the present invention suitable for oral administration may be presented as discrete units such as capsules, cachets or tablets each containing a predetermined amount of the active ingredient; as a powder or granules; as a solution or a suspension in an aqueous or non-aqueous liquid; or as an oil-in-water liquid emulsion or a water-in-oil liquid emulsion. The active ingredient may also be presented as a bolus, electuary or paste. A tablet may be made by compression or moulding, optionally with one or more accessory ingredients. Compressed tablets may be prepared by compressing in a suitable machine the active ingredient in a free-flowing form such as a powder or granules, optionally mixed with a binder (e.g. povidone, gelatin, hydroxypropylmethyl cellulose), lubricant, inert diluent, preservative, disintegrant (e.g. sodium starch glycollate, cross-linked povidone, cross-linked sodium carboxymethyl cellulose) surface-active or dispersing agent. Moulded tablets may be made by moulding in a suitable machine a mixture of the powdered compound moistened with an inert liquid diluent. The tablets may optionally be coated or scored and may be formulated so as to provide slow or controlled release of the active ingredient therein using, for example, hydroxypropylmethyl cellulose in varying proportions to provide the desired release profile. Tablets may optionally be provided with an enteric coating, to provide release in parts of the gut other than the stomach. Formulations suitable for topical administration in the mouth include lozenges comprising the active ingredient in a flavoured basis, usually sucrose and acacia or tragacanth; pastilles comprising the active ingredient in an inert basis such as gelatin and glycerin, or sucrose and acacia; and mouthwashes comprising the active ingredient in a suitable liquid carrier. 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. Formulations suitable for parenteral administration include aqueous and non- aqueous isotonic sterile injection solutions which may contain anti-oxidants, buffers, bacteriostats and solutes which render the formulation isotonic with the blood of the intended recipient; and aqueous and non-aqueous sterile suspensions which may include suspending agents and thickening agents. The formulations may be presented in unit-dose or multi-dose sealed containers, for example, ampoules and vials, and may be stored in a freeze-dried (lyophilized) condition requiring only the addition of the sterile liquid carrier, for example water for injections, immediately prior to use. Extemporaneous injection solutions and suspensions may be prepared from sterile powders, granules and tablets of the kind previously described. Preferred unit dosage formulations are those containing a daily dose or unit, daily sub-dose, as herein above recited, or an appropriate fraction thereof, of an active ingredient. The above compounds of the present invention and their pharmaceutically acceptable derivatives may be employed in combination with other therapeutic agents for the treatment or prophylaxis of the above infections or conditions. Examples of such further therapeutic agents include agents that are effective for the treatment or prophylaxis of HIV infections or associated conditions, such as 3'azido-3'deoxythymidine (zidovudine), compounds that complement, enhance or potentiate the activity of the compounds according to the invention such as 2',3'-dideoxynucleosides such as 2',3'-dideoxy-cytidine, -adenosine or -inosine,carbocyclic nucleoside analogues such as carbovir, acyclic nucleosides (eg acyclovir), interferons such as α-interferon, renal excretion inhibitors such as probenicid or nucleoside transport inhibitors such as dipyridamole, as well as immunomodulators such as interleukin II and granulocyte macrophage colony stimulating factors. It should be understood that in addition to the ingredients particularly mentioned above the formulations of this invention may include other agents conventional in the art having regard to the type of formulation in question, for example, those suitable for oral administration may include such further agents as sweeteners, thickeners and flavouring agents. The present invention further includes a process for the preparation of a compound of formula (I) and pharmaceutically acceptable derivatives thereof which comprises either: (A) reacting a compound of formula: wherein B is as hereinbefore defined, and R a represents a precursor group for the hydroxy group, or for a pharmaceutically acceptable derivative group thereof, with an agent or under conditions serving to convert the said precursor group into the corresponding desired group; or (B) reacting a pyrimidine base of formula B - H (III) (wherein B is as hereinbefore defined). or a functional equivalent thereof, with a compound serving to introduce the desired ribofuranosyl ring at the 1-position of the purine or pyrimidine base of formula (III); and thereafter, or simultaneously therewith, effecting one or more of the following optional conversions:- (i) when a compound of formula (I) is formed, converting it into a pharmaceutically acceptable derivative thereof; (ii) when a pharmaceutically acceptable derivative of a compound of formula (I) is formed, converting the said derivative into a compound of formula (I), or a different derivative thereof; (iii) converting the resulting compound of formula (I)) or a pharmaceutically acceptable derivative thereof into a different pharmaceutically acceptable derivative thereof. In the above-described process according to the invention, it will be appreciated that the precursor compounds of formula (II) as well as the above-mentioned agents and conditions, will be selected from those that are known in the art of nucleoside synthetic chemistry. Examples of such conversion procedures are described hereinafter for guidance and it will be understood that they can be modified in conventional manner depending on the desired compound of formula (I). In particular, where a conversion is described which would otherwise result in the undesired reaction of labile groups then such groups may be protected in conventional manner, with subsequent removal of the protecting groups after completion of the conversion. With regard to process (A), R a may represent a protected hydroxy group e.g. an ester grouping particularly acetoxy or methoxycarbonyl, or an ether group such as a trialkylsilyloxy group, e.g. t-butyldimethylsilyloxy or an aralkoxy group e.g. triphenylmethoxy. Such groups may be converted for example by hydrolysis to the desired hydroxy group or, by transesterification, to an alternative ester group. With regard to process (B), this may be effected for example by treating an appropriate pyrimidine base of formula (III) or a salt or protected derivative thereof, with a 2',3'-dideoxythymidine for example in the presence of the appropriate pentosyl transferring enzyme. 2',3'-dideoxy-3'-fluorouridine may be prepared as described for example by G. Kowollik et al, J. Prakt. Chem. 1973, 315(5), 895-900. The compound of formula (I) may be prepared for example by halogenating the corresponding uracil compound of formula (I) in which B represents the desired unsubstituted base and in which the 5'-hydroxy group is blocked, for example by an acyl group such a p-toluoyl group. Chlorination may be effected using a chlorine complex of iodobenzene, e.g. in glacial acetic acid. The above toluoyl derivative may be prepared by treating the compound of formula (I) with for example p-toluoyl chloride, eg in pyridine. After halogenation as described above, the p-toluoyl protecting group may be removed for example by sodium methoxide in methanol. A compound of formula (I) may be converted into a pharmaceutically acceptable ester by reaction with an appropriate esterifying agent, e.g. an acid halide or anhydride. The compound of formula (I), including esters thereof, may be converted into pharmaceutically acceptable salts thereof in conventional manner, e.g. by treatment with an appropriate base. An ester or salt of a compound of formula (I) may be converted into the parent compound, e.g. by hydrolysis. The following Examples are intended for illustration only and are not intended to limit the scope of the invention in any way. The term 'active ingredient' as used in the Examples means a compound of formula (I) or a pharmaceutically acceptable derivative thereof. Example 1 : Tablet Formulations The following formulations A and B are prepared by wet granulation of the ingredients with a solution of povidone, followed by addition of magnesium stearate and compression. Formulation A mg/tablet mg/tablet (a) Active ingredient 250 250 (b) Lactose B.P. 210 26 (c) Povidone B.P. 15 9 (d) Sodium Starch Glycollate 20 12 (e) Magnesium Stearate 5 3 500 300 Formulation B mg/tablet mg/tablet (a) Active ingredient 250 250 (b) Lactose 150 - (c) Avicel PH 101 60 26 (d) Povidone B.P. 15 9 (e) Sodium Starch Glycollate 20 12 (f) Magnesium Stearate 5 3 500 300 Formulation C . mg/tablet Active ingredient 100 Lactose 200 Starch 50 Povidone 5 Magnesium stearate 4 359 The following formulations, D and E, are prepared by direct compression of the admixed ingredients. The lactose used in formulation E is of the direct compression type (Dairy Crest - "Zeparox"). Formulation D mg/capsule Active Ingredient 250 Pregelatinised Starch NF15 150 400 Formulation E mg/capsule Active Ingredient 250 Lactose 150 Avicel 100 500 Formulation F (Controlled Release Formulation) The formulation is prepared by wet granulation of the ingredients (below) with a solution of povidone followed by the addition of magnesium stearate and compression. mg/tablet (a) Active Ingredient 500 (b) Hydroxypropylmethylcellulose (Methocel K4M Premium) 112 (c) Lactose B.P. 53 (d) Povidone B.P.C. 28 (e) Magnesium Stearate 7 700 Drug release takes place over a period of about 6-8 hours and is complete after 12 hours. Example 2: Capsule Formulations Formulation A A capsule formulation is prepared by admixing the ingredients of Formulation D in Example 1 above and filling into a two-part hard gelatin capsule. Formulation B ( infra ) is prepared in a similar manner. Formulation B mg/capsule (a) Active ingredient 250 (b) Lactose B.P. 143 (c) Sodium Starch Glycollate 25 (d) Magnesium Stearate 2 420 Formulation C mg/capsule (a) Active ingredient 250 (b) Macrogol 4000 BP 350 600 Capsules are prepared by melting the Macrogol 4000 BP, dispersing the active ingredient in the melt and filling the melt into a two-part hard gelatin capsule. Formulation D mg/capsule Active ingredient 250 Lecithin 100 Arachis Oil 100 450 Capsules are prepared by dispersing the active ingredient in the lecithin and arachis oil and filling the dispersion into soft, elastic gelatin capsules. Formulation E (Controlled Release Capsule) The following controlled release capsule formulation is prepared by extruding ingredients a, b and c using an extruder, followed by spheronisation of the extrudate and drying. The dried pellets are then coated with release- controlling membrane (d) and filled into a two-piece, hard gelatin capsule. mg/capsule (a) Active Ingredient 250 (b) Microcrystalline Cellulose 125 (c) Lactose BP 125 (d) Ethyl Cellulose 13 513 Example 3 : Injectable Formulation Formulation A . Active ingredient 0.200g Hydrochloric acid solution, 0.1M q.s. to pH 4.0 to 7.0 Sodium hydroxide solution, 0.1M q.s. to pH 4.0 to 7.0 Sterile water q.s. to 10ml The active ingredient is dissolved in most of the water (35°-40°C) and the pH adjusted to between 4.0 and 7.0 with the hydrochloric acid or the sodium hydroxide as appropriate. The batch is then made up to volume with the water and filtered through a sterile micropore filter into a sterile 10ml amber glass vial (type 1) and sealed with sterile closures and overseals. Formulation B. Active ingredient 0.125 g Sterile, pyrogen-free, pH 7 phosphate buffer, q.s. to 25 ml Example 4 : Intramuscular injection Active Ingredient 0.20 g Benzyl Alcohol 0.10 g Glycofurol 75 1.45 g Water for Injection q.s. to 3.00 ml The active ingredient is dissolved in the glycofurol. The benzyl alcohol is then added and dissolved, and water added to 3 ml. The mixture is then filtered through a sterile micropore filter and sealed in sterile 3 ml amber glass vials (type 1). Example 5 : Syrup Active ingredient 0.25 g Sorbitol Solution 1.50 g Glycerol 2.00 g Sodium Benzoate 0.005 g Flavour, Peach 17.42.3169 0.0125 ml Purified Water q.s. to 5.00 ml The active ingredient is dissolved in a mixture of the glycerol and most of the purified water. An aqueous solution of the sodium benzoate is then added to the solution, followed by addition of the sorbitol solution and finally the flavour. The volume is made up with purified water and mixed well. Example 6 : Suppository mg/suppository Active Ingredient (63 µm)* 250 Hard Fat, BP (Witepsol H15 - Dynamit NoBel) 1770 2020 *The active ingredient is used as a powder wherein at least 90% of the particles were of 63 µm diameter or less. One-fifth of the Witepsol H15 is melted in a steam-jacketed pan at 45°C maximum. The active ingredient is sifted through a 200 µm sieve and added to the molten base with mixing, using a silverson fitted with a cutting head, until a smooth dispersion is achieved. Maintaining the mixture at 45°C, the remaining Witepsol H15 is added to the suspension and stirred to ensure a homogenous mix. The entire suspension is passed through a 250 lm stainless steel screen and, with continuous stirring, is allowed to cool to 40°C. At a temperature of 38°C to 40°C, 2.02g of the mixture is filled into suitable, 2 ml plastic moulds. The suppositories are allowed to cool to room temperature. Example 7 : Pessaries mg/pessary Active ingredient (63 µm) 250 Anhydrate Dextrose 380 Potato Starch 363 Magnesium Stearate 7 1000 The above ingredients are mixed directly and pessaries prepared by direct compression of the resulting mixture. Example 8 5'-O-toluoyl derivative of 1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil p -Toluoyl chloride (freshly distilled, 325mg, 2.10 mmol) was added to a solution of 1-(2,3-dideoxy-3-fluoro-β- D -erythro-pentofuranosyl)uracil (440mg, 1.91 mmol) in dry pyridine (10ml). The solution was stirred at 50° for 1.5 hour, and then at 25° for 18 hours. The pyridine was evaporated and the residue dissolved in CHCl₃ (25ml). This solution was extracted with 1M H₂SO₄ (5ml), then H₂O (2 x 10 ml), and dried (MgSO₄). Evaporation of CHCl₃ left a colourless glass (0.72g) which was chromatographed on silica gel. Elution with 2% MeOH-CHCl₃ gave the 5'-O-toluoyl derivative as white solid foam (0.66g, 90%); chromatographically homogeneous on TLC plates (silica gel developed with 5% MeOH-CHCl₃); structure confirmed by 'H-NMR. Example 9 5-Chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil The chlorine complex of iodobenzene was freshly prepared as described in the literature (see M.J. Robins, et al., Can. J. Chem . 1982 , 60 , 554) and 246mg (0.895mmol) added to a solution of the 5'-O-toluoyl derivative of 1-(2,3-dideoxy-3-fluoro-B- D - erythro -pentofuranosyl) uracil (260mg, 0.746 mmol), prepared as described in Example 8, in glacial acetic acid (4ml). This solution was maintained at 80° under nitrogen for 20 minutes and evaporated to a white solid foam. Treatment with sodium methoxide in methanol was carried out as in Example 1. Chromatography on 2mm thick silica gel plates (20 x 20cm) developed in CHCl₃: MeOH: NH₄OH/180:20:1 was required to separate 5-chlorouracil (slightly greater R f ) from title compound, isolated as an off-white solid (46mg). Trituration in methanol gave title compound as white needles (34mg); m.p. 183-184°C; Anal . Calcd for C₉H₁₀ClFN₂O₄: C, 40.85; H, 3.81; Cl, 13.40; N, 10.59. Found: C, 40.71; H, 3.85; Cl, 13.31; N, 10.55; UV λ max (H₂O) 275 nM; structure further confirmed by 'H-NMR and mass spectrum. Antiviral Activity The anti-HIV activity of the compounds of Example 9 was assayed in MT4 cells and an IC₅₀ value of 12.4 µM was obtained.

Claims: Claims for the following Contracting States : AT, BE, CH, DE, FR, GB, IT, LI, LU, NL, SE Use of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentoturanosyl)uracil, for the manufacture of a medicament for the treatment or prophylaxis of a human immunodeficiency virus infection. Use of a pharmaceutically acceptable derivative of 5-chlorol-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment or prophylaxis of a human immunodeficiency virus infection. Use of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erthro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment or prophylaxis of an asymptomatic patient having a human immunodeficiency virus infection. Use of a pharmaceutically acceptable derivative of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment of prophylaxis of an asymptomatic patient having a human immunodeficiency virus infection. Use of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment or prophylaxis of AIDS. Use of a pharmaceutically acceptable derivative of 5-chloro-1-(2,3 dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment or proprophylaxis of AIDS. Use of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment or prophylaxis of AIDS - related complex. Use of a pharmaceutically acceptable derivative of 5-chloro-1-(2,3 dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil, for the manufacture of a medicament for the treatment or proprophylaxis of AIDS - related complex. Use according to any one of claims 2, 4, 6 or 8 wherein the pharmaceutically acceptable derivative is a salt. Use according to any one of claims 2, 4, 6 or 8 wherein the pharmaceutically acceptable derivative is a 5'-ester. Use according to any one of claims 1 to 10 wherein the medicament is adapted for oral administration. Use according to claim 11 wherein the medicament is in the form of a tablet or capsule. Use according to any one of claims 1 to 10 wherein the medicament is adapted for parenteral administration. Use according to claim 13 wherein the medicament is adapted for intravenous administration. Use according to any one of claims 1 to 14 wherein the medicament is in a unit dosage form. Use according to claim 15 wherein the unit dosage form contains 10 to 1500mg of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofurnosyl)uracil or a pharmaceutically acceptable derivative thereof. Use according to claim 15 wherein the unit dosage form contains 50 to 700mg of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofurnosyl)uracil or a pharmaceutically acceptable derivative thereof. An anti-human immunodeficiency virus formulation comprising 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl) uracil and a pharmaceutically acceptable carrier. An anti-human immunodeficiency virus formulation comprising a pharmaceutically acceptable derivative of 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil and a pharamaceutically acceptable carrier. Claims for the following Contracting States : ES, GR A process for the preparation of an anti-human immunodeficiency virus pharmaceutical formulation which comprises preparing a compound of formula (I):- wherein B represents a group of formula in which R¹ represents a chlorine atom or a pharmaceutically acceptable derivative thereof, by (A) reacting a compound of formula wherein B is as hereinbefore defined, and Ra represents a precursor group for the hydroxy group, or for a pharmaceutically acceptable derivative group thereof, with an agent or under conditions serving to convert the said precursor group into the corresponding desired group; or (B) reacting a pyrimidine base of formula B-H (III) (wherein B is as hereinbefore defined); or a functional equivalent thereof, with a compound serving to introduce the desired ribofuranosyl ring at the 1-position of the pyrimidine base of formula (III); and thereafter, or simultaneously therewith effecting one or more of the following optional conversions:- (i) when a compound of formula (I) is formed, converting it into a pharmaceutically acceptable derivative thereof; (ii) when a pharmaceutically acceptable derivative of a compound of formula (I) is formed, converting the said derivative into a compound of formula (I), or a different derivative thereof; (iii) converting the resulting compound of formula (I)) or pharmaceutically acceptable derivative thereof into a different pharmaceutically acceptable derivative thereof, and bringing the resulting compound of formula (I) or pharmaceutically acceptable derivative thereof into association with a pharmaceutically acceptable carrier or excipient. A process for the preparation of an anti-human immunodeficiency virus pharmaceutical formulation according to claim 1 wherein the compound of formula (I) is 5-chloro-1-(2,3-dideoxy-3-fluoro-β-D-erythro-pentofuranosyl)uracil. A process for the preparation of an anti-human immunodeficiency virus pharmaceutical formulation according to claims 1 or 2 wherein the pharmaceutical formulation is adapted for oral administration. A process for the preparation of an anti-human immunodeficiency virus pharmaceutical formulation according to any one of claims 1 to 3 wherein the pharmaceutical formulation is adapted for use as a tablet or capsule. A process for the preparation of an anti-human immunodeficiency virus pharmaceutical formulation according to claims 1 or 2 wherein the pharmaceutical formulation is adapted for parenteral administration. A process for the preparation of an anti-human immunodeficiency virus pharmaceutical formulation according to any one of claims 1, 2 or 5, wherein the pharmaceutical formulation is adapted for intravenous administration.

Inventors: BURNS CHARLENE LOUISE, DALUGE SUSAN MARY, KOSZALKA GEORGE WALTER, KRENITSKY THOMAS ANTHONY, TUTTLE JOEL VAN, BURNS, CHARLENE LOUISE, DALUGE, SUSAN MARY, KOSZALKA, GEORGE WALTER, KRENITSKY, THOMAS ANTHONY, TUTTLE, JOEL VAN
Applicants: WELLCOME FOUND, THE WELLCOME FOUNDATION LIMITED
Application year: 1988
Main classification: C07H19
IPC codes: A61P31, A61K31, C07H19