| CPC A61K 38/22 (2013.01) [A61K 47/60 (2017.08)] | 10 Claims |
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1. A method of treating, controlling, or delaying a mammalian patient in need of the treatment one or more diseases which can be treated with a C-type natriuretic peptide (CNP), comprising the step of subcutaneously administering to said patient in need thereof a therapeutically effective amount of a controlled-release CNP agonist or a pharmaceutical composition comprising a controlled-release CNP agonist and at least one excipient, wherein the controlled-release CNP agonist is of formula (Ia) or (Ib):
 wherein
-D is a CNP moiety comprising a ring moiety, wherein the ring moiety has the amino acid sequence of SEQ ID NO:96, provided the methionine at position 11 of SEQ ID NO:96 can be substituted with asparagine, the ring moiety being between two cysteine residues forming a disulfide bridge, wherein the CNP moiety has the amino acid sequence of SEQ ID NO:24, SEQ ID NO: 25 or SEQ ID NO:30; is a reversible prodrug linker, which is cleavable in aqueous buffer at pH 7.4 and 37° C. in the absence of enzymes with a half-life of up to six months, and which is covalently and reversibly conjugated to the side chain of an amino acid residue of the ring moiety of -D or to the backbone of the ring moiety of -D;
wherein -L1- has the formula (II):
 wherein the dashed line indicates the attachment to a nitrogen of -D by forming an amide bond;
—X— is —C(R4R4a)—; —N(R4)—; —O—; —C(R4R4a)—C(R5R5a)—; —C(R5R5a)—C(R4R4a)—; —C(R4R4a)—N(R6)—; —N(R6)—C(R4R4a)—; —C(R4R4a)—O—; —O—C(R4R4a)—; or —C(R7R7a)—;
>X1═is >C═; or >S(O)═;
—X2— is —C(R8R8a)—; or —C(R8R8a)—C(R9R9a)—;
═X3 is ═O; ═S; or ═N—CN;
—R1, —R1a, —R2, —R2a, —R4, —R4a, —R5, —R5a, —R6, —R8, —R8a, —R9, —R9a are independently selected from the group consisting of —H; and C1-6 alkyl;
—R3, —R3a are independently selected from the group consisting of —H; and C1-6 alkyl, provided that in case one of —R3, —R3a or both are other than —H they are connected to N to which they are attached through an sp3-hybridized carbon atom;
—R7 is —N(R10R10a); or —NR10—(C═O)—R11;
—R7a, —R10, —R10a, —R11 are independently of each other —H; or C1-6 alkyl;
optionally, one or more of the pairs —R1a/—R4a, —R1a/—R5a, —R1a/—R7a, —R4a/—R5a, —R8a/—R9a form a chemical bond;
optionally, one or more of the pairs —R1/—R1a, —R2/—R2a, —R4/—R4a, —R5/—R5a, —R8/—R8a, —R9/—R9a are joined together with the atom to which they are attached to form a C3-10 cycloalkyl; or 3- to 10-membered heterocyclyl;
optionally, one or more of the pairs —R1/—R4, —R1/—R5, —R1/—R6, —R1/—R7a, —R4/—R5, —R4/—R6, —R8/—R9, —R2/—R3 are joined together with the atoms to which they are attached to form a ring A;
optionally, —R3/—R3a are joined together with the nitrogen atom to which they are attached to form a 3- to 10-membered heterocycle;
A is selected from the group consisting of phenyl; naphthyl; indenyl; indanyl; tetralinyl; C3-10 cycloalkyl; 3- to 10-membered heterocyclyl; and 8- to 11-membered heterobicyclyl; and
wherein —L1— is substituted with —L2—Z provided that the hydrogen marked with the asterisk in formula (II) is not replaced by —L2—Z;
—L2— is a single chemical bond or a spacer moiety;
—Z is a water-soluble carrier moiety comprising a moiety of formula (a):
 wherein
the dashed line indicates attachment to —L2—;
BPa is a branching point selected from the group consisting of —N<, —CR< and >C<;
—R is selected from the group consisting of —H and C1-6 alkyl;
a is 0 if BPa is —N< or —CR< and a is 1 if BPa is <C<;
—Sa—, —Sa′—, —Sa″— and —Sa′″— are independently of each other a chemical bond or are selected from the group consisting of C1-50 alkyl, C2-50 alkenyl, and C2-50 alkynyl;
wherein C1-50 alkyl, C2-50 alkenyl, and C2-50 alkynyl are optionally substituted with one or more —R1, which are the same or different and wherein C1-50 alkyl, C2-50 alkenyl, and C2-50 alkynyl are optionally interrupted by one or more groups selected from the group consisting of —T—, —C(O)O—, —O—,
—C(O)—, —C(O)N(R2)—, —S(O)2N(R2)—, —S(O)N(R2)—,
—S(O)2—, —S(O)—, —N(R2)S(O)2N(R2a)—, —S—, —N(R2)—, —OC(OR2)(R2a)—,
—N(R2)C(O)N(R2a)—, and —OC(O)N(R2)—;
each —T— is independently selected from the group consisting of phenyl, naphthyl, indenyl, indanyl, tetralinyl, C3-10 cycloalkyl, 3- to 10-membered heterocyclyl, 8- to 11-membered heterobicyclyl, 8- to 30-membered carbopolycyclyl, and 8- to 30-membered heteropolycyclyl; wherein each —T—is independently optionally substituted with one or more —R1, which are the same or different;
each —R1 is independently selected from the group consisting of halogen, —CN, oxo (═O),
—COOR3, —OR3, —C(O)R3, —C(O)N(R3R3a), —S(O)2N(R3R3a),
—S(O)N(R3R3a), —S(O)2R3, —S(O)R3, —N(R3)S(O)2N(R3aR3b), —SR3, —N(R3R3a),
—NO2, —OC(O)R3, —N(R3)C(O)R3a, —N(R3)S(O)2R3a, —N(R3)S(O)R3a,
—N(R3)C(O)OR3a, —N(R3)C(O)N(R3aR3b), —OC(O)N(R3R3a), and C1-6 alkyl; wherein C1-6 alkyl is optionally substituted with one or more halogen, which are the same or different;
each —R2, —R2a, —R3, —R3a and —R3b is independently selected from the group consisting of —H, and C1-6 alkyl, wherein C1-6 alkyl is optionally substituted with one or more halogen, which are the same or different; and
—Pa′, —Pa″ and —Pa′″ are independently a polymeric moiety comprising a PEG-based moiety;
x is an integer selected from the group consisting of 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 and 16;
y is an integer selected from the group consisting of 1, 2, 3, 4 and 5; and
wherein D-H is released from the controlled-release CNP agonist by cleavage of the linker with a release half-life of at least 6 hours in aqueous buffer at pH 7.4 and 37° C. in the absence of enzymes and which controlled-release CNP agonist has an EC50 that is at least 20-fold higher than the EC50 of the corresponding D-H, and wherein the one or more diseases which can be treated, controlled, or delayed with CNP is selected from the group consisting of achondroplasia, hypochondroplasia, Noonan syndrome and SHOX deficiency.
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