TRIAZINEONE COMPOUNDS FOR TREATING DISEASES DUE TO SARCOSYSTIS, NEOSPORA AND TOXOPLASMA

Abstract: Disclosed herein are methods of treating therapeutically, or metaphylactically infected animals susceptible to, or infected animal suffering from parasitic neurologic or abortigenic diseases due to Sarcocystis, Neospora or Toxoplasma that are treatable with triazineone compounds by administering thereto a pharmaceutically effective amount of the compound, including a single high dose therapeutic treatment.

Description: TRIAZINEONE COMPOUNDS FOR TREATING DISEASES DUE TO SARCOSYSTIS. NEOSPORA AND TOXOPLASMA BACKGROUND OF THE INVENTION Field of the Invention: The present invention relates to triazineone compounds for treating animals infected with parasites that cause abortigenic or neurologic diseases. More specifically, the present invention relates the triazineone compounds that are useful in treating parasitic protozoa such as coccidia that cause abortigenic or neurologic diseases. Brief Description of the Prior Art: Triazineone compounds such as triazinediones, e.g., diclazuril compounds, and triazinetriones, e.g., toltrazuril compounds have been used in treating and protecting various mammals, insects and fish from diseases caused by a broad range of protozoa. See U.S. Patents; 4,933,341 ; 4,935,423; 5,114,938; 5,141 ,938; 5,188,832, 5,196,562, 5,256,631 and 5,464,837. Protozoa sensitive to these compounds infect birds, mammals and insects and manifest as diarrhea, wasting, nausea and vomiting. Generally, the mode of action of the triazineones is to attack the intermediate parasite stages found in the gut and intestinal wall cells, causing the endoplasmic reticulum, the pe nuciear space and the mitochondria of the parasite to swell. This purportedly disturbs the ability for nuclear divisions causing the shizonts and microgamonts to remain small forming only a few merozoites and microgametes respectively. The end result is reported to be the loss of the ability of these latter stages of the parasites to penetrate new mammalian cells, effectively halting the replication of the parasite in the host. Of particular concern here are certain protozoa suspected of causing neurologic and/or abortigenic diseases of animals since the 1970's. Successful isolation and in vitro cultivation of some of these protozoa proved to be difficult. For example successful isolation from the brain or cerebral spinal fluid were not accomplished until the late 1980s Once it was determined that neurologic diseases could be produced by certain parasites infecting the brain and abortigenic diseases could be produced by certain parasites infecting the fetus, the need for effective anti-parasite drugs which could cross the blood-brain and the placental barrier without producing deleterious side effects became imperative Many of the art-known drugs that can to cross the blood-brain barrier and/or the placental barrier to effectively treat parasitic infections of the brain have detrimental side effects such that they cannot be used without great risk As such, there have been no effective drugs approved to date which provide an effective treatment for such neurologic or abortigenic diseases The following is a brief description of the parasitic diseases Equine Protozal Myoencephalitis (EPM) is a neurologic disease of horses, with a predilection for young horses undergoing stress (e g , thoroughbred race horses and purebred performance horses), and is thus a disease with significant monetary impact for the horse industry EPM, first recognized as a disease in the 1970's, was cultured from a horse with EPM and given the name Sarcocystis neurona until 1991 In 1997, a Neospora spp , now named Neospora hugesi, was isolated from the brain of a horse with EPM Accordingly, it is now proposed that EPM may be caused by this newly recognized organism alone, by Sarcocystis neurona alone or the combination of the two EPM most often results in asymmetric incoordination (ataxia), weakness, and spasticity The disease can mimic almost any neurologic condition It can occur as a peracute or chronic condition The chronic form is often insidious at onset, difficult to diagnose until late in the course of the disease, and can result in death In the mildest cases the only clinical sign may be ill-defined pelvic limb lameness or a minor respiratory noise In the most severe cases, horses are unable to swallow or stand It is now known that in the most severe cases, the parasite, e g , S neurona infects the brain and produces significant damage therein The clinical signs of EPM are caused by direct neuronal (brain and spinal cord) damage by the parasites as well as brain damage resulting from infiltration of inflammatory cells, edema, and neuronal death associated with merozoites and meronts in the central nervous system (CNS) Currently there is no approved effective treatment or prophylaxis for the control of EPM The human drug tπmethopπm-sulfonamide combination has been used However, treatment is expensive and requires an extensive number of repeated doses Another coccidian parasite, Toxoplasma gondn, has been known for some time and was first isolated from the intestines and muscle tissue of cats The definitive host for this parasite is the cat that can harbor the organism for long periods of time spreading oocysts to other animals including bovines, ovines swine and humans Infection of sheep, cattle and humans has been associated with abortion and congenitally acquired disorders, which primarily affect the central nervous system It has also recently been associated with abortion and malformation in kittens born to infected queens that had been seronegative prior to infection during pregnancy Non-feline hosts such as bovines, ovines swine and humans do not produce oocysts but develop and may suffer from invasion of muscle and brain by tachyzoites and bradyzoites which produce the clinical signs of disease - neurological symptoms and abortion with fetal defects It has been reported that 60% of cats are serologically positive to T gondu Once again, there is no approved treatment or prophylactic for toxoplasmosis Yet another coccidia parasite, Neospora caninum, produces both a neurologic and abortigenic disease in animals It was first isolated from dogs in 1988, and was previously confused with Toxoplasma gondn The disease caused by this parasite occurs most severely in transplacentally infected puppies and is characterized by progressive ascending paralysis in the puppies, particularly of the hind limbs, polymyositis and hepatitis may also occur This disease has more recently been recognized as a major cause of abortion and neurologically-associated limb defects in newborn calves Microscopic lesions of non-suppurative encephalitis and myocarditis in aborted fetuses may be seen in the brain, spinal cord and heart A definitive host for Neospora caninum has recently been identified to be the dog At this time there is no approved treatment or prophylaxis for either Neospora caninum of dogs or bovines or Neospora hugesi of horses Art-known references, including the above-cited references do not suggest or teach the use of triazineone compounds such as Toltrazunl or Toltrazunl Sulfone (recently renamed "Ponazunl") in treating animals infected with coccidia or, more specifically, of the family Sarcocystidae causing abortigenic or neurologic diseases without causing intolerable side effects There is, therefore, a need for an improved and safe treatment for animals afflicted with parasitic diseases manifesting as neurologic or abortigenic diseases. SUMMARY OF THE INVENTION In accordance with the foregoing, the present invention encompasses a method of therapeutically treating a diseased animal suffering from a parasitic neurologic or abortigenic disease that is susceptible to being treated with a triazineone compound with the proviso that when the disease is Sarcocystis neurona the compound is not diciazuril or toltrazuril. The method comprises administering to the animal, a pharmaceutically effective amount of the compound The term "pharmaceutically-effective amount" as used herein means that the amount of triazineone being administered is high enough to inhibit the in vivo or in vitro growth of the parasitic protozoa, typically coccidia that produce neurological disease and/or abortions The pharmaceuticallly- effective amount controls the parasites in the infected tissues and consequently lead to an improvement in the animal s health Further, the present invention encompasses a method of metaphylactically treating an animal infected with a parasite that can cause a neurologic or abortigenic disease, that is susceptible to being treated with a triazineone compound The metapyiactic treatment comprises administering to the animal, the triazineone compound using a metaphylactically-effective regimen By the term metaphylactically- effective regimen is meant administering scheduled intermittent doses of triazineone compounds for a prolonged period until said animal overcomes the invading parasites by, say, developing a protective immune response or otherwise clearing the parasite Typically, the regimen is such as would effectively control the parasites and prevent clinical signs of disease The metaphylactically-effective dose can also be administered for a prolonged period up to five years or the lifetime of the animal especially in an instance when the parasite is difficult to control For the metaphylactic treatment, the preferred triazineone compounds are tnazinetriones, which include but are not limited to Toltrazunl, and Ponazruil Also, the present invention encompasses a single high dose treatment of the animals This method comprises administering to the animals a single high dose of a pharmaceutically effective amount of the triazineone compound to a diseased animal suffering from a parasitic neurologic or abortigenic disease that is susceptible to being treated with a triazineone By the term "single high dose" is meant an amount that is administered only once This amount is significantly higher than the dose amount employed in the therapeutic or metapylactic treatment, is effective in controlling the disease-causing parasites, and as such would not result in detrimental effects such as toxicity The single high dose of triazineone is accordingly greater than 10 mg/Kg This and other aspects of the invention are described more fully hereunder DETAILED DESCRIPTION OF THE INVENTION As set forth above, the present invention relates to a method of treating a infected or diseased animal suffering from a parasitic disease that manifests as neurologic or abortigenic disease that is susceptible to being treated with a triazineone compound, comprising administering thereto a pharmaceutically effective amount of said compound Illustrative but non-limiting examples of the animals can be equines bovines felines, canines, swine ovines, birds, insects and humans The parasites infecting or causing disease are coccidia of the Family Sarcocystidae that can manifest as neurologic or abortigenic diseases Illustrative but non- miting examples thereof can be selected from the group consisting of Sarcocystis spp , Neospora spp and Toxoplasma spp The Sarcocystidae are typically selected from the group consisting of S neurona, N hugesi, N caninum and T gondn The protozoan infections or diseases include but are not limited to EPM, Neosporosis, and Toxoplasmosis In the practice of the invention, treatment of the parasitic infections or diseases caused by the protozoa described herein results in the alleviation of the symptoms of the neurologic and abortigenic diseases Generally, the symptoms include lameness, ataxia, paralysis, abortion, weak newboms and other related disorders For therapeutic treatment, the regimen can be once a day, two or more times a day, once every other day or even once per week, depending on factors such as the severity of the disease and the type of disease-producing parasite In some cases, however, the treatment regimen can last indefinitely, sometimes for the remaining life of the animal For example, in the case of infection of an animal with a more resistant strain of parasite, the treatment can be extended for longer periods of time until the signs of disease are eliminated Typically the duration of treatment is from about 28 days to 90 days and preferably from about 28 to 60 days The most preferred treatment is once, daily for about 28 days For the metaphylactic treatment, infected animals are treated to protect them against clinical manifestation of diseases This treatment eventually results in the animals acquisition of the ability to control the parasite, say, by the establishing an effective immune response to impart protection against future infections without a need for further administration of triazineone compounds The metaphylactic activity, in accordance with the invention, refers to the use of the triazineone compounds on a scheduled intermittent treatment regimen (metaphylactically-effective regimen) to control the protozoa, which may have infected the animal, since the previous treatment Accordingly, the metaphylactically-effective regimen is administered to reduce the ability of the parasites to cause disease by, say, killing them or reducing them in number In essence, the metaphylactically effective regimen can be administered two or more times, typically from about once per month, up to over the lifetime of the animal or until an inherent clearance mechanism, e g , an effective immune response develops within the animal to protect it from future infections The latter can occur within 5 years or less As would be realized, the metaphylactic treatment is based on the recognition that when animals are infected with the protozoa described herein, they do not demonstrate clinical signs such as neurological signs or abortion until a significant time has passed (e g., 2-6 months post infection) In contrast, the enteric protozoan infections manifest themselves shortly after infection In accordance with this invention, the metaphylactic treatment prevents the parasite from establishing itself and causing a clinical disease The treatment regimen is on an intermittent schedule of about once per month, once per two months or once per two weeks For the therapeutic and metaphylactic treatments one can employ a dose equivalent of about between 1 0 and 100 mg/Kg, preferably about 1 0 to 25mg/Kg and more preferably about 2 5 to 10mg/Kg The high range would be required in particularly resistant cases (e g when an animal is infected with a resistant strain) The required dose level and duration of treatment are within the purview of one of ordinary skill in the art A preferred treatment regimen for horses with EPM or bovines with Neosporosis is about 1 0 to 25 mg/Kg, and a more preferred range is about 2.5 to 10 mg/Kg of triazinetπone every 28 days For the single high dose treatment the triazineone is administered in pharmaceutically effective amounts that are greater than 10 mg/Kg and up to about 100 mg/Kg It is a distinct feature of the invention the compounds of this invention can be non-toxic, thus they can be administrated at high dose levels The advantage of the high dose administration resides in the fact repeated doses are not required For the single high dose treatment, Ponazunl has been found to be both safe and effective at doses as high as 100 mg/Kg body weight Unlike art-related compounds, the triazineone compounds which are equivalent to Ponazunl are preferred in that they do not cause detrimental side effects if administered at very high dose levels Without being bound to any particular theory of the invention, it believed that the unexpected success of the treatments described herein results from the ability of the triazineone compounds to cross the blood- brain barrier or placental barrier It is believed that the compounds of this invention easily cross the blood-brain barrier and, also, are able to penetrate the placenta and kill the protozoa in situ in the brain and cerebral spinal fluid/spinal cord It has been a further been found that the compounds of this class are non-toxic and non-mutagenic even at the high doses necessary for the single high dose treatment regimen described herein Heretofore, no cost-effective, easily administered drugs have been available for effectively treating and protecting against these diseases without producing unacceptable side effects such as toxicity or mutagenicity in animals The following is a description of the triazineone compounds with particularity but without limitation to Toltrazunl compounds This disclosure and the claimed invention also encompass other triazineone compounds that are useful in the manner of the Toltrazunl compounds The Toltrazunl compounds useful herein are of formula (1 ) in which R 1 represents halogenoalkylthio. halogenoalkyl-sulphinyl or halogenoalkylsulphonyl, R 2 represents hydrogen, alkyl, alkoxy, alkoxyalkyl, alkylmercapto, halogen, halogenoalkyl or an optionally substituted sulphamoyl, such as dialkyl sulphamoyl, radical, R 3 and R 4 can be identical or different and represent hydrogen, alkyl, alkenyl or alkinyl and X is 0 or S, and their physiologically acceptable salts. Furthermore, it as been found that, in particular, the following compounds of the formula la and their physiologically acceptable salts have, can be useful herein: in which R' represents halogenoalkyl(C 1 -C 4 )-thιo, halogenoalkyl(C 1 -C 4 )-sulphιnyl or halogenoalkyl(C C 4 )-sulphonyl, R" represents hydrogen, alkyl (C r C 4 ), alkoxy (C,-C 4 ), halogen, alkoxy(C 1 -C 4 )alkyl(C 1 -C 4 ), alkyl (C 1 -C 4 )-mercapto, dialkyl (C.-C 4 )amιnosulphonyl or halogenoalkyl (C.-C 4 ) and R'" and R ιv can be identical or different and represent hydrogen, alkyl (C C 4 ) or alkenyl (C .-C) and X is O or S. and X is 0 or S Finally, it has been found that (a) 1-(4-phenoxy-phenyl)-1 ,3,5-trιazιnes of the formula I are obtained when compounds of the formula II ( II ) in which R\ R 2 , R 3 and X have the meaning indicated above, are reacted with a substituted carbonyl isocyanate of the formula III (HI) R -C— N=C=O II O in which R 5 represents a halogen atom, an alkoxy group or an aryloxy group, and the substituted 1 ,3,5-trιazιne derivatives, formed during this procedure, of the formula IV in which R\ R 2 , R 3 and X have the meaning indicated above, are optionally isolated and optionally reacted with a compound of the formula V A — Z (V) wherein A represents alkyl, alkenyl or alkinyl and Z represents halogen; or that (b) 1 -(4-phenoxy-phenyl)-1 ,3,5-trιazιne derivatives of the general formula I are obtained when compounds of the formula II, in which R 1 , R 2 , R 3 and X have the meaning indicated above, are reacted with bis- (chlorocarbonyl)-amιnes of the formula VI (VI) COCl R 6 — N 0Cl in which R 6 represents alkyl, optionally in the presence of acid acceptors or that (c) in order to obtain compounds of the formula I in which the substituents R 2 , R 3 and R 4 as well as X have the meaning indicated above and R 1 represents halogenoalkylsulphinyl or halogenoalkylsulphonyl, compounds of the formula in which R 2 , R 3 and R 4 have, the meaning indicated above and R 1 represents halogenalkylthio, are reacted with the appropriate amount of a suitable oxidizing agent.. If N-[3-chloro-4-(4'-trifluoromethylthio-phenoxy)-phenyl]-N'- methyl-urea and chlorocarbonyl isocyanate are used in process variant (a), the course of the reaction can be represented by the following equation: If N-[3-ethoxy-4-(4'-trifluoromethylthio-phenoxy)-phenyl]-thiourea and N-methyl-bis-(chlorocarbonyl) amine are used as the starting materials in process variant (b), the course of the reaction can be represented by the following equation: The compounds of the general formula I, obtained according to process variant (a) or (b), in which R,=halogenoalkylthio and X=0 can be oxidized according to process variant (c) to the corresponding halogenoalkylsulphinyl or halogenoalkylsulphonyl derivatives. If hydrogen peroxide is used as the oxidizing agent, the course of the reaction can be represented by the following equation: In the formulae I, II, IV, V, VI and VII, alkyl as defined in R 2 , R 3 , R 4 , R 6 or A is straight-chain or branched alkyl with preferably 1 to 6, in particular 1 to 4, carbon atoms Examples that may be mentioned are optionally substituted methyl, ethyl, n- and i-propyl and n-, i- and t-butyl In the formulae I, II, IV, V and VII, alkenyl as defined in R 3 , R 4 or A is straight-chain or branched alkenyl with preferably 2 to 6, in particular 2 to 4, carbon atoms Examples, which may be mentioned, are optionally substituted ethenyl, propen-1 -yl, propen-2-yl and buten-3-yl In the formulae I, II, IV, V and VII, alkinyl as defined in R 3 , R 4 or A is straight-chain or branched alkinyl with preferably 2 to 6, in particular 2 to 4, carbon atoms Examples which may be mentioned are optionally sub- stituted ethinyl, propen-1 -yl, propιn-2-yl and butιn-3-yl In the formulae I, II, III, IV and VII, alkoxy as defined in R 2 or R 5 is straight-chain or branched alkoxy with preferably 1 to 6, in particular 1 to 4, carbon atoms Examples which may be mentioned are optionally substituted methoxy, ethoxy, n- and i-propoxy and n- and i-butoxy In the formulae I, II, III, IV, V and VII, halogen as defined in R 2 , R 5 or Z is preferably fluorine, chlorine, bromine and iodine, especially chlorine and bromine In the formulae I, II, IV and VII, halogenoalkylthio as defined in R 1 is halogenoalkylthio preferably 1 to 4, in particular 1 or 2, carbon atoms preferably 1 to 5, in particular 1 to 3, identical or different halogen atoms, halogen atoms preferably being fluorine, chlorine and bromine, especially fluorine and chlorine Examples which may be mentioned are tπfluoro- methylthio, chloro-di-fluoromethylthio, bromomethylthio, 2,2,2-trι- fluoroethylthio and pentafluoroethylthio In the formulae I, II and IV, halogenoalkylsulphinyl as defined in R 1 is halogenoalkylsulphinyl with preferably 1 to 4, in particular 1 or 2, carbon atoms and preferably 1 to 5, in particular 1 to 3, identical or different halogen atoms, halogen atoms preferably being fluorine, chlorine and bromine, especially fluorine and chlorine Examples which may be mentioned are tnfluoromethylsulphuryl, chloro-di-fluoromethylsulphuryl, bromomethylsulphinyl, 2,2,2-trιfluoroethylsulphιnyl and pentafluoroethyl- sulphinyl In the formulae I, II and IV, halogenoalkylsulphonyl as defined in R 1 is halogenoalkylsulphonyl with preferably 1 to 4, in particular 1 or 2, carbon atoms and preferably 1 to 5, in particular 1 to 3, identical or different halogen atoms, halogen atoms preferably being fluorine, chlorine and bromine, especially fluorine and chlorine Examples which may be mentioned are trifluoromethylsulphonyl, chloro-di-fluoromethylsulphonyl, bromomethyl-sulphonyl, 2,2,2-trιfluoroethylsulphonyl and pentafluoro- ethylsulphonyl In the formulae I, II, and IV, optionally substituted sulphamoyl as defined in R2 is preferably one of the following radicals SO.NH ,, S0 NH — CH,, SO,N(CH,) 2 , S0 NH — C 2 H 5 , SO, — N(C 2 H 5 ) 2 , In the formulae III, aryloxy as defined in R 5 is preferably monocyclic carbocyclic aryloxy or bicyc c carbocyclic aryloxy, particularly phenoxy In the formulae III, aryloxy R 5 is preferably phenoxy Most of the substituted ureas or thioureas of the formula II which are used as starting materials have not been known hitherto, but they can be easily prepared by methods which are in themselves known by (a) either reacting substituted 4-amιnodιphenyl ethers with the corresponding substituted isocyanates or isothiocyanates in an inert solvent at temperatures between 0°C and 100°C , or, reversing the sequence, (b) reacting ammonia or substituted amines and the corresponding substituted isocyanato or 4-ιsothιocyanato-dιphenyl ethers with one another under the same conditions, or by (c) subjecting substituted 4-hydroxyphenyl-ureas or -thioureas to a condensation reaction with activated halogenoaromatic compounds in aprotic solvents, such as dimethylsulphoxide, dirnethylform-arnide or hexamethylphosphonc acid tπamide, in the presence of bases, such as sodium hydride, potassium hydroxide, potassium carbonate z a m , at temperatures between 20°C and 150°C When the amount of solvent is appropriately chosen, the reaction products generally crystallize out on cooling the solution Literature for the alternate preparation of ureas from amines and isocyanates is Methoden der Org Chemie (Methods of Organic Chemistry) (Houbeπ-Weyl), IVth edition, Volume VIII, page 157-158 Some of the bιs-(chlorocarbonyl)-amιnes of the general formula VI which can be used according to the invention in process (b) are already known (compare the article in Synthesis 1970, page 542-543) and, if they are not yet known, they can be prepared in an analogous manner from cyclic diacyldisulphides and chlo nation in inert organic solvents, preferably in carbon tetrachlo de Possible diluents for the reaction of the ureas or thioureas of the formula II both with carbonyl isocyanates of the formula III (process variant a) and with bιs(chlorocarbonyl)-amιnes of the formula VI (process variant b) as well as for the reaction of the 1 ,3,5-trιazιne derivatives of the formula IV with compounds of the formula A-Z are all the organic solvents which are inert in these reactions These include, in addition to the pyndine, preferably, aromatic hydrocarbons, such as benzene, toluene and xylene, halogenated aromatic hydrocarbons, such as chlorobenzene and dichlorobenzene, and ethers, such as tetrahydrofurane and dioxane The hydrochloric acid which may form during the reaction escapes as a gas or can be bonded by organic or inorganic acid acceptors The acid acceptors include, preferably, tertiary organic bases, such as tnalkyla- mines, for example, triethylamine, N-hetero mono- or bi-cyclic aromatic amines, such as pyndine aza-cyclo alkyl amines which are mono- or bi- cyclic, such as diazabicyclononene, diazabicycloundecene and many others, or inorganic bases, such as alkali metal carbonates, oxides or hydroxides or alkaline earth metal carbonates, oxides or hydroxides The reaction temperatures for the above-mentioned reaction stages can be varied within a wide range In general, the reaction is carried out between about 0°C and about 150°C , preferably between about 20°C and about 100°C In the above-mentioned reaction stages, the reaction can be carried out under normal pressure or under elevated pressure In general, the reaction is carried out under normal pressure. Possible oxidizing agents for the conversion, according to process variant (c) of the trifluoromethylthio compounds of the general formula 1 , in which Y represents oxygen, into the corresponding sulphinyl or sul- phonyl compounds are, appropriately H 2 0 2 /glacιal acetic acid; H 2 0 2 /acetic anhydride; H 2 0 2 /methanol; peracids, such as, for example, m-chloroper- benzoic acid, and chromic acid; potassium permanganate, sodium penodate, cerise ammonium nitrate; and nitric acid. A resulting compound can be converted into a corresponding addition salt, for example by reacting it with an inorganic or organic base. In the practice of the invention, the triazineone compound can be formulated in any convenient manner into compositions or formulations for administration to animals. Formulations suitable for oral administration, which is preferred herein, can be suspensions, tablets, capsules, gels, pastes, boluses, or preparations in the form of powders, granules, or pellets. The preferred orally administered formulation is in the form of a paste or a feed additive. Other modes of administration that can be employed include parenteral, topical, intramuscular, and intramucosal or by other routes known to those skilled in the art. Topical administration in the form of a pour-on is also preferred. Typically, pharmaceutically acceptable carriers and auxiliaries are employed in the formulations. Examples thereof can be a thickening agents selected from the group consisting of: Carbopol, inorganic thickeners such as silicates, bentonites or colloidal silica and organic thickeners such as fatty alcohols or fatty acid esters and the wetting agent is selected from the group consisting of polyethylene glycol and sodium lauryl sulfate with Carbopols, more specifically, Carbopol 974P being the most preferred thickening agent for the paste formulation preferred herein. Also employed herein can be preservatives selected from the group consisting of parabens, alcohols and aldehydes. These may be liquid, solid, or gaseous materials, which are otherwise inert or medically acceptable and are compatible with the active ingredients Surprisingly, the pastes of the present invention are effective in delivering the tπazineones, particularly Toltrazunl, and Ponazunl to cross the blood-brain or placenta barrier and attack the parasites which have already invaded the brain or infected the fetus of a pregnant animals As a matter convenience, there is provided herein a description of a specific embodiment of the preferred pastes and how it is prepared A preferred paste, according to the present invention contains a micronized suspension of the tnazinetrione (e g , Ponazunl), propylene glycol, a thickening agent such as Carbopol, preservatives such as Methylparaben and Propylparaben, and water It can be made by combining water, typically, purified water and Propylene Glycol, heating the combination to about 70°C , and adding the preservatives, at this temperature The resulting mixture is cooled to room temperature after which Carbopol, preferably in the form of Carbopol 974P, is added Finally the tnazinetrione is added. After complete mixing, the pH is adjusted to approximately 6.0 with sodium hydroxide The most preferable paste includes 15% w/w Ponazunl, 20% w/w Propylene Glycol, 0 5% w/w Carbopol 974P, 0 14% w/w Methylparaben, 0 02%w/w Propylparaben, 0 1 %w/w sodium hydroxide with the remainder being purified water Sweeteners including dextrose, sucrose, lactose, fructose, sorbitol, xylitol, artificial sweeteners and molasses may be added to improve palatability Additionally, yeast or liver flavoring may be added for the same purpose The invention is further described by following illustrative but non- limiting examples EXAMPLES EXAMPLE 1 A pharmacokinetic study was conducted in horses comparing blood levels of Toltrazunl, Ponazunl and Toltrazunl Sulfoxide at various times post a single dose of Toltrazunl All horses received a single dose of 10 mg/kg, which was administered orally as a suspension Blood samples were drawn at the time of treatment (0) and at 0 25, 0 5, 1 , 2, 4, 6, 12, 24, 48 and 72 hours post treatment Results of the sampling are listed in Table 1 It was surprising to note that horses receiving Toltrazunl demonstrated relatively high levels of Ponazunl in their serum Additionally, significant levels of Toltrazunl sulfoxide were found in the bloodstream This was an indication that Ponazunl. alone, would produce acceptable blood levels that are envisioned to pass the blood-brain barrier, a characteristic required to treat neurological diseases such as those caused by Sarcocystis neurona, Toxoplasma gondn, Neospora caninum and Neospora heugesi CΛ c 03 CΛ H H C H PI CΛ EPI I H 5c0 rI CΛ C cα CΛ H H C H PI CΛ X P- PI H cr PI ) ©\ EXAMPLE 2 Ponazunl 1 -methyl-3-[4-p-[tnfluoromethyl)sulfonylphenoxy]-m-tolyl]- s-trιazιne-2,4,6 (1 H,3H,5H)-trιone, a representative Tnazinetrione, was formulated into a paste for administration to horses The components listed in Table 2 were used in preparing formulations as follows Table 2 Components of Ponazuril Horse Paste The formulations were prepared using process (A) and (B) as follows The first process (A) comprised 1 ) Mixing a portion of the water with the Propylene Glycol, 2) adding the preservatives (Methylparaben and Propylparaben, 3) slowly adding the Carbopol 974P until an even suspension was prepared 4) adding the Ponazuril in a micronized form, 5) adding the Sodium Hydroxide to bring the suspension to a pH of approximately 6 0, and 6) adding the remainder of the water to QS to volume The final suspension was in the form of a paste, which can be delivered orally to a horse The second process (B) comprised 1 ) Mixing a portion of the water with the Propylene Glycol, 2) heating to 70°C, 3) adding the preservatives (Methylparaben and Propylparaben while holding the solution at 70°C, 4) cooling the solution to room temperature 5) slowly adding the Carbopol 974P until an even suspension was prepared, 6) adding the Ponazunl in a micronized form, 7) adding the Sodium Hydroxide to bring the suspension to a pH of approximately 6 0 and 8) adding the remainder of the water to QS to volume The final suspension was also in the form of a paste, which can be delivered orally to a horse The resulting pastes were administered to horses and found to be palatable and well accepted EXAMPLE 3 Ponazuril, 1 -methyl-3-[4-p-[trιfluoromethyl)sulfonylphenoxy]-m-tolyl]- s-trιazιne-2 4,6 (1 H,3H,5H)-trιone, a representative Tnazinetrione, was tested for its ability to treat horses already demonstrating signs of Equine Protozoal Myoencephalitis (EPM) The compound was formulated into a paste using Ponazuril as a 15% active ingredient (a i ) as described in EXAMPLE 1 It was administered to horses already diagnosed with EPM once a day for 28 days at a dose rate between 2 5 mg/Kg and 10mg/Kg Naturally occurring clinical cases of EPM were well characterized by signalment and laboratory diagnosis The diagnosis used for incorporation of EPM-positive horses into this trial was as follows Confirmed asymmetrical neurological deficit as determined by a standardized neurological examination, to include radiography, indicative of EPM, Positive Western Blot for Sarcocystis neurona IgG, Red Blood Cell count below 500 cells/mL, CSF indices - Total Protein <90, IgG index >0 3 AQ quotient <2 2 Additional requirements were that the horses were not suffering from diseases other than EPM Therefore, they had to meet the following criteria Negative CSF (<1 4) for EHV-1 Normal serum values for Vitamin E ( 2 0 μg/mL), Lack of seizure disorders, Lack of behavior disorders Diagnosed horses were randomly assigned to groups Group 1 horses received the paste formulation daily at a dose rate of 5mg/Kg whereas Group 2 horses received the paste formulation daily at a dose rate of 10mg/Kg The treatment dose was based on body weight The horses were evaluated for a period of 90 days (approximately 60 days after discontinuation of treatment) in order to determine that treatment was indeed effective The response to treatment was scored using the following system' 1 ) 0 = complete success-chnically normal with a negative CSF; 2) 1 = Deficit just detected at a normal gait; 3) 2 = Deficit easily detected and exaggerated by backing, turning, swaying, jaw loin pressure and neck extension; 4) 3 = Deficit very prominent on walking, Facial turning, loin pressure or neck extension; 5) 4 = Stumbling, tripping and falling down spontaneously; 6) 5 = Recumbent, unable to rise. An improvement of one (1 ) unit in the score was considered a significant improvement. Results of this study are shown in Table 3. All (100%) of the horses in the 10 mg/Kg group which were treated for 28 days showed a significant improvement in clinical score by day 90 post start of treatment with Ponazuril (day 0) Eight of nine (88.9%) horses treated with the 5mg/Kg dose demonstrated acceptable improvement When adding all of the scores for each group for each treatment day, a total score is obtained. The improvement in total scores demonstrated by both Group 1 and Group 2 horses is approximately equivalent. It is thus concluded that Ponazuril at either a 5mg/Kg or 10mg/Kg is effective for the active treatment of EPM in horses. TABLE 3 Response of EPM-lnfected Horses to Treatment with Toltrazunl Sulfone EXAMPLE 4 In order to determine the scope of protection provided by Ponazuril, in vitro testing was conducted The following strains of parasites were evaluated for their sensitivity to this compound Strain SN3 of Sarcocystis neurona, strain SF1 of Sarcocystis falcatula, strain RH of Toxoplasma gondn, and the NC-1 strain of Neospora caninum Ponazunl was tested at 2 concentrations (1 μg/mL and 10 ug/mL) Bovine turbinate (BT) cells were used for all in vitro studies Cells were grown to confluency in 25 cm 2 flasks in RMPI 1640 media supplemented with 10% v/v fetal bovine serum (FBS), 100 Units penicillin (G/mL), 100 mg streptomycin/mL and 5 X 10 2 mM 2-mercpatoethanol After cell confluence was obtained, cells were maintained in the same media with reduced FBS (2% v/v) Cell cultures were incubated at 37°C in a humidified atmosphere containing 5% carbon dioxide and 95% air For growth of parasites, BT cell monolayers were infected with parasites and examined with an inverted microscope for the development of lesions (cytopathic effect, "CPE") or the presence of many extracellular merozoites Once lesions were observed, or many extracellular parasites were present, the monolayer was scraped with the tip of a 5 mL pipette and 1 to 3 drops of the merozoite-containing fluid was transferred to two flasks of fresh BT cells Merozoites of S neurona and S falcatula were passaged in this manner every 5 to 10 days while the tachyzoites of T gondn and N caninum were passaged every 3 to 4 days The assay used to determine the effectiveness of Ponazunl was the Microtiter Monolayer Disruption Assay (MMDA) This assay was used to determine if the parasites or compound were toxic for BT cells Flat bottomed 96-well microtiter plates were inoculated with BT cells and the resulting monolayers were used to determine the effects of Toltrazunl and Ponazuril on merozoite production as measured by CPE (plaque formation) Monolayers were inoculated with parasites (S neurona or S falcatula at a count of 50,000/well, T gondn at a level of 10,000/well, and N caninum at 20,000/well All wells were inoculated with the test compound 2 hours after infection Untreated and uninfected monolayer wells served as parasite controls and uninfected agent treated BT cells served as toxicity controls Each treatment was examined in replicates of 6 Each well was visually monitored daily and the assay was stopped when 90-100% of the untreated merozoite infected cells had lysed (90- 100% CPE) All wells of the plates were rinsed in Phosphate Buffered Saline (PBS) and fixed in 100% methanol for 5 minutes after which they were stained in crystal violet solution Areas of merozoite induced destruction or BT cell death due to toxicity do not take up the crystal violet An ELISA plate reader was used to quantitate the crystal violet incorporation and these data were used to determine the concentration of Ponazunl that inhibits destruction by 50% (Inhibitory Concentratιon 50 or IC 50 ) The data demonstrating inhibition are presented in Table 4 It is noted that as little as 1μg/mL of Ponazunl provided 100% inhibition of cell destruction produced by N caninum, T gondn and S falcatula whereas 10μg/mL of Ponazuril was required to produce 100% inhibition of cell destruction by S neurona This indicates that tnazineones such as Toltrazunl and Ponazuril would be efficacious for treatment of diseases caused by the Coccidia known to associated with neurological and abortigenic disease syndromes including diseases caused by S neurona, N caninum, N hugesi and T gondn Additionally, Ponazunl was not toxic to the BT cells TABLE 4: In vitro Data on Ponazuril EXAMPLE 5: This experiment was conducted in order to determine whether triazineones such as Toltrazuril can pass the blood-brain barrier. Normal horses were divided into three groups of three horses per group. Group 1 horses received Toltrazuril administered orally as a 5% suspension at a dose level of 2.5 mg/Kg. Group 2 horses received Toltrazuril administered orally as a 5% suspension at a dose level of 5.0 mg/Kg. Group 3 horses received Toltrazuril administered orally as a 5% suspension at a dose level of 7.5 mg/Kg. The dosing was repeated daily for 10 days. Blood samples were drawn at 48, 96 and 240 hours and the concentration of Toltrazuril, Toltrazuril sulfoxide and Ponazuril in the serum was measured. Ten days after the start of the treatment (Day 10), a sample of cerebral spinal fluid was removed from each horse and the concentrations of Toltrazuril, Toltrazuril Sulfoxide and Ponazuril were again measured in these samples. The concentrations of Toltrazuril, Toltrazuril Sulfoxide and Ponazuril in the serum and cerebral spinal fluid are reported in TABLES 5a and 5b. Concentration of Ponazuril in the blood and cerebral spinal fluid after treatment of horses with Toltrazuril was significant, in that the concentration of Ponazruil in the cerebral spinal fluid after treatment of horses with Toltrazuril was essentially equivalent to the concentration of Toltrazuril itself. This is evidence that both Toltrazuril and Ponazuril effectively cross the blood-brain barrier and that Ponazuril crosses this barrier more effectively than does Toltrazuril. The data would suggest to one skilled in the art that the triazineones can also effectively cross the placental barrier. TABLE 5a Drug Levels after Repeated Doses of Toltrazuril in Horses Although the invention has been described in detail in the foregoing for the purpose of illustration, it is to be understood that such detail is solely for that purpose and that variations can be made therein by those skilled in the art without departing from the spirit and scope of the invention except as it may be limited by the claims

Claims: WHAT IS CLAIMED IS 1 A method of therapeutically treating a diseased animal suffering from a parasitic neurologic or abortigenic disease that is susceptible to being treated with a triazineone compound, comprising administering to the animal a pharmaceutically effective amount of the compound with the proviso that when the disease is Sarcocystis neurona the compound is not diclazuril or toltrazuril. 2 The method of Claim 1 wherein the parasitic disease is caused by a Coccidia 3 The method of Claim 2 wherein the Coccidia is a member of the Family Sarcocystidae 4 The method of Claim 3 wherein a member of the Family Sarcocystidae is selected from the group consisting of Sarcocystis, Neospora and a Toxoplasma 5 The method of Claim 4 wherein the Sarcocystis is selected from the group consisting of Sarcocystis spp, the Neospora is selected from the group consisting of Neospora spp and the Toxoplasma is selected from the group consisting of Toxoplasma spp 6 The method of Claim 5 wherein the Sarcocystis spp is Sarcocystis neurona, the Neospora spp is Neospora caninum or Neospora hugesi and the Toxoplasma spp is Toxoplasma gondii 7 The method of Claim 4 wherein the Sarcocystis is Sarcocystis neurona causing Equine Protozoal Myeloncephyhtis 8 The method of Claim 4 wherein the Neospora is Neospora caninum causing bovine or canine Neosporosis 9 The method of Claim 4 wherein the Toxoplasma is Toxoplasma gondii 10 A method of metaphylactically treating animals infected with a parasite that is a causative agent for a neurologic or abortagenic disease that is susceptible to being treated with a triazineone compound, comprising administering thereto a metaphylactially-effective regimen of the said triazineone 11. The method of Claim 1 or Claim 10 wherein the triazineone compound is selected from the group consisting of Toltrazuril, Ponazuril and Diclazuril. 12. The method of Claim 1 or Claim 10 wherein the triazineone compound is Ponazuril. 13. The method of Claim 1 or Claim 10 wherein the triazineone compound is administered in two or more repeat doses. 14. The method of Claim 13 wherein the repeat doses are administered in an amount of between 1.0 and 100 mg/Kg. 15. The method of Claim 10 wherein the triazineone compound is administered until the animal has developed protective immunity. 16. The method of Claim 1 or Claim 10 wherein the triazineone is administered in an amount of between 2.5 mg/Kg and 10 mg/Kg. 17. The method of Claim 16 wherein the triazineone is Toltrazuril or Ponazuril. 18. The method of Claim 1 wherein the triazineone compound is administered in a single high dose of greater than 10 mg/Kg. 19. The method of Claim 8 wherein the triazineone compound is administered in a repeated periodic dose regimen until immunological protection is established. 20. The method of Claim 1 wherein the triazineone compound is administered in a regimen of 2.5 mg/Kg to 10 mg/Kg daily for a period of 28 days. 21. A therapeutic composition comprising (a) a triazineone compound in a pharmaceutically effective amount to treat a diseased animal that is susceptible thereto (b) a carrier, and (c) optionally, an auxiliary agent. 22. The composition of Claim 18 which is in the form of a paste. 23. A method of treating equine protozoan myeloencephalitis (EPM) comprising administering to an equine suspected of suffering from EPM a therapeutically effective amount of one or more triazinediones. 24. The method of Claim 23 wherein the triazinedione is diclazuril. 25. The method of Claim 23 wherein the equine is a horse.

Inventors: KENNEDY THOMAS J, KENNEDY, THOMAS, J.
Applicants: BAYER AG, BAYER CORPORATION
Application year: 1999
Main classification: A61K31
IPC codes: A61K31, A61P15, A61P25, A61P33, C07D251