SOLID FORMS OF N-(4-FLUORO-3-(6-(3-METHYLPYRIDIN-2-YL)-[1,2,4]TRIAZOLO[1,5-A]PYRIMIDIN-2-YL)PHENYL)-2,4-DIMETHYLOXAZOLE-5-CARBOXAMIDE
20220041604 · 2022-02-10
Inventors
- Yudong Cao (Changshu, CN)
- Siyi JIANG (Shanghai, CN)
- Hongyong Kim (Changshu, CN)
- Andreas Kordikowski (Binningen, CH)
- Irene Xia (Pudong, CN)
- Bo Yu (Changshu, CN)
- Jing Zhang (Changshu, CN)
- Yi Zhao (Changshu, CN)
Cpc classification
A61K31/519
HUMAN NECESSITIES
A61K9/0053
HUMAN NECESSITIES
A61K45/06
HUMAN NECESSITIES
A61P33/02
HUMAN NECESSITIES
Y02A50/30
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
International classification
A61K31/519
HUMAN NECESSITIES
A61K45/06
HUMAN NECESSITIES
Abstract
The application relates to N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide (Compound I) fumaric acid co-crystals and X-ray amorphous complexes of Compound (I) and fumaric acid. The application also provides methods of making the same; pharmaceutical compositions comprising them; and their use in treating, preventing, inhibiting, ameliorating, or eradicating the pathology and/or symptomology of a disease caused by a kinetoplastid parasite, such as leishmaniasis, human African trypanosomiasis and Chagas disease.
##STR00001##
Claims
1-29. (canceled)
30. A co-crystal comprising N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide and an aliphatic C.sub.4 di-carboxylic acid.
31. The co-crystal according to claim 30, wherein said C.sub.4 di-carboxylic acid is fumaric acid, succinic acid, tartaric acid or maleic acid.
32. The co-crystal according to claim 30, comprising N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide and fumaric acid.
33. The co-crystal of claim 32, wherein said co-crystal is characterized by: (i) an X-ray powder diffraction pattern comprising three or more 20 peaks selected from 25.8°±0.2° (2θ), 9.40±0.2°, 14.2°±0.2° and 11.0°±0.2°; (ii) an X-ray powder diffraction pattern comprising three or more 20 peaks selected from 24.7°±0.2°, 23.9°±0.2°, 16.0°±0.2° (2θ) and 13.4°±0.2° (2θ); (iii) an X-ray powder diffraction pattern comprising three or more three or more 20 peaks selected from 27.6°±0.2° 14.8°±0.2° 9.8° 0.2°, 11.3°±0.2° 24.6°±0.2° 25.0°±0.2° and 26.5°±0.2° (2θ); or (iv) an X-ray powder diffraction pattern comprising three or more 20 peaks selected from 13.5°±0.2°, 3.8°±0.2°, 17.2°±0.2° and 26.6°±0.2 (2θ); when measured with a CuKα radiation at a wavelength of 0.15 nm at room temperature.
34. The co-crystal of claim 32, which is characterized by one of more selected from: (a) an X-ray powder diffraction pattern that is substantially as shown in
35. The co-crystal of claim 32, having an X-ray powder diffraction pattern comprising 20 peaks at 24.7°±0.2°, 23.9°±0.2° and 16.0±0.2.
36. The co-crystal of claim 32, which is characterized by one of more selected from: (a) an X-ray powder diffraction pattern that is substantially as shown in
37. The co-crystal of claim 32, having an X-ray powder diffraction pattern comprising 20 peaks at 27.6°±0.2°, 14.8°±0.2°, and 9.8°±0.2° (2θ).
38. The co-crystal of claim 32, which is characterized by one of more selected from: (a) an X-ray powder diffraction pattern that is substantially as shown in
39. The co-crystal of claim 32, having an X-ray powder diffraction pattern comprising 20 peaks at 13.5°±0.2, 3.8°±0.2° and 17.2°±0.2° (2θ).
40. The co-crystal according to claim 32, which is characterized by one of more selected from: (a) an X-ray powder diffraction pattern that is substantially as shown in
41. The co-crystal according to claim 32, comprising at least 90% by weight of said co-crystal based on the weight of the composition.
42. The co-crystal according to claim 32, comprising at least 80% by weight of said co-crystal based on the weight of the composition.
43. A pharmaceutical composition comprising a co-crystal according to claim 30, and a pharmaceutically acceptable carrier.
44. A combination comprising a co-crystal according to claim 30, and one or more therapeutically active agents.
45. A method for treating a disease caused by a parasite, comprising administering to a subject a therapeutically effective amount of a pharmaceutical composition comprising a co-crystal according to claim 30 and at least one pharmaceutically acceptable carrier, and optionally in combination with a second agent, wherein the disease is selected from leishmaniasis, human African trypanosomiasis and Chagas disease.
46. The method according to claim 45, comprising administering said pharmaceutical composition at a dose of about 10 mg to about 500 mg.
47. A process for preparing a co-crystal according to claim 30, comprising (1) adding fumaric acid to a first solvent to form a fumaric acid solution; (2) adding N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide to a second solvent to form a N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide solution; and (3) adding said N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide solution to said fumaric acid solution under suitable conditions to form said N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide fumaric acid co-crystal.
48. A process for preparing a co-crystal according to claim 30, comprising (1) adding fumaric acid to a first solvent to form a fumaric acid solution; (2) adding N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide to a second solvent to form a N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide solution; and (3) adding said fumaric acid solution to said N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide solution to form said N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide fumaric acid co-crystal.
49. An X-ray amorphous complex of N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide and fumaric acid; wherein the molar ratio of N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide and fumaric acid is 2:(0.1-5); and optionally substantially free of crystalline forms.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0062]
[0063]
[0064]
[0065]
[0066]
[0067]
[0068]
[0069]
[0070]
[0071]
[0072]
[0073]
[0074]
[0075]
[0076]
[0077]
[0078]
[0079]
DETAILED DESCRIPTION OF THE INVENTION
[0080] In one aspect, the invention provides N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide (Compound I) fumaric acid co-crystals, and methods of making the same; pharmaceutical compositions comprising thereof, and methods of treatment using such compositions. The co-crystals of the present invention possess one or more improved physicochemical properties selected from dissolution rate, solubility, chemical stability, physical stability, hygroscopicity, melting point, morphology, flowability, bulk density, and compressibility, as compared to the free form. As a result, a pharmaceutical composition comprising at least one co-crystal of the present invention may have improved pharmacokinetic and/or pharmacodynamic effects in animals, such as humans, as compared to a pharmaceutical composition comprising the free form. As another result, a pharmaceutical composition comprising at least one co-crystal of the present invention may possess one or more improved drug product attributes selected from oral dosage form size, compatibility with one or more desirable pharmaceutically acceptable carriers, storage life, and storage conditions, as compared to the free form.
[0081] In another aspect, the invention provides an X-ray amorphous complex of N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide and fumaric acid; wherein the molar ratio of N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide and fumaric acid is about 1:1 or 2:1; and optionally substantially free of crystalline forms.
Definitions
[0082] As used herein, the term “co-crystal(s)” refers to single phase crystalline materials comprising two or more components in a specific stoichiometric ratio, where the arrangement in the crystal lattice is not based on ionic bonds (as with salts) and at least two of the components are solids at room temperature.
[0083] As used herein, the term “aliphatic C.sub.2-8 dicarboxylic acid” refers to a straight-chained or branched, saturated or unsaturated, substituted or unsubstituted dicarboxylic acid having from 2-8 carbon atoms, preferably from 4-6 carbon atoms, including but not limited to fumaric acid, succinic acid, maleic acid, and tartaric acid.
[0084] As used herein, the term “Compound I fumaric acid co-crystal (1:1)” refer to N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide (Compound I) fumaric acid co-crystals having a Compound I: fumaric acid stoichiometric ratio of about 1:1; for example, 1:(0.7-1.3), 1:(0.8-1.2) or 1:(0.9-1.1) or 1:1.
[0085] As used herein, the term “Compound I fumaric acid co-crystal (2:1)” refer to N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide (Compound I) fumaric acid co-crystals having a Compound I: fumaric acid stoichiometric ratio of about 2:1; for example, 2:(0.7-1.3), 2:(0.8-1.2), 2:(0.9-1.1) or 2:1.
[0086] As used herein, the terms “Form A”, “Form B”, “Form C”, etc. used to characterize specific co-crystal embodiments are mere identifiers that should be interpreted according to the characterization information presented herein; and should not be considered limiting with respect to any other substance possessing similar or identical physical and chemical characteristics.
[0087] As used herein, the term “amorphous” refers to a solid form of a molecule, atom, and/or ion that is not crystalline. An amorphous solid does not display a definitive X-ray diffraction pattern.
[0088] As used herein, the term “amorphous Compound I fumaric acid (1:1)” refer to an X-ray amorphous complex of N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide (Compound I) and fumaric acid having a Compound I: fumaric acid stoichiometric ratio of about 1:1, for example, 1:(0.7-1.3), 1:(0.8-1.2), 1:(0.9-1.1) or 1:1; and wherein the complex may comprise co-crystal, salt and solid dispersion forms.
[0089] As used herein, the term “amorphous Compound I fumaric acid (2:1)” refer to an X-ray amorphous complex of N-(4-fluoro-3-(6-(3-methylpyridin-2-yl)-[1,2,4]triazolo[1,5-a]pyrimidin-2-yl)phenyl)-2,4-dimethyloxazole-5-carboxamide (Compound I) and fumaric acid having a Compound I: fumaric acid stoichiometric ratio of about 2:1, for example, 2:(0.7-1.3), 2:(0.8-1.2), 2:(0.9-1.1) or 2:1; and wherein the complex may comprise co-crystal, salt and solid dispersion forms.
[0090] As used herein, the term “substantially pure” in reference to the co-crystals of the invention, means a co-crystal form having a purity greater than 80 weight %, including greater than 85, 90, 95, 96, 97, 98, and 99 weight %, and also including equal to about 100 weight % of co-crystal, based on the weight of the composition. The remaining material comprises other co-crystalline form(s), reaction impurities, and/or processing impurities arising from its preparation.
[0091] For example, a co-crystalline Form A may be deemed substantially pure in that it has a purity greater than 90 weight %, as measured by means known and generally accepted in the art, where the remaining less than 10 weight % of material comprises other co-crystalline form(s), reaction impurities, and/or processing impurities. The presence of reaction impurities and/or processing impurities may be determined by analytical techniques known in the art, such as, for example, chromatography, nuclear magnetic resonance spectroscopy, mass spectrometry, or infrared spectroscopy.
[0092] As used herein, the term “room temperature” (RT) refers to a temperature in the range of from 20° C. to 30° C. as measured under standard conditions. Typically, standard conditions can additionally mean a measurement under 20-50% relative humidity. In one embodiment, “room temperature” refers to a temperature of about 22° C.-25° C.
[0093] As used herein, the term “about” means within a statistically meaningful range of a value. Such a range can be within an order of magnitude, typically within 10%, more typically within 5%, even more typically within 1%, and most typically within 0.1% of the indicated value or range. Sometimes, such a range can lie within experimental error, typical of standard methods used for the measurement and/or determination of a given value or range.
[0094] As used herein, the term “endothermic peak” refers to the melting peak in a differential scanning calorimetry (DSC) thermogram.
[0095] As used herein, the term “pharmaceutically acceptable carrier” refers to a substance useful in the preparation or use of a pharmaceutical composition and includes, for example, suitable diluents, solvents, dispersion media, surfactants, antioxidants, preservatives, isotonic agents, buffering agents, emulsifiers, absorption delaying agents, salts, drug stabilizers, binders, excipients, disintegration agents, lubricants, wetting agents, sweetening agents, flavoring agents, dyes, and combinations thereof, as would be known to those skilled in the art (see, for example, Remington The Science and Practice of Pharmacy, 22.sup.nd Ed. Pharmaceutical Press, 2013, pp. 1049-1070).
[0096] As used herein, the term “inhibit”, “inhibition” or “inhibiting” refers to the reduction or suppression of a given condition, symptom, or disorder, or disease, or a significant decrease in the baseline activity of a biological activity or process.
[0097] As used herein, the term “treat”, “treating” or “treatment” of any disease or disorder refers to alleviating or ameliorating the disease or disorder (i.e., slowing or arresting the development of the disease or at least one of the clinical symptoms thereof); or alleviating or ameliorating at least one physical parameter or biomarker associated with the disease or disorder, including those which may not be discernible to the patient.
[0098] As used herein, the term “prevent”, “preventing” or “prevention” of any disease or disorder refers to the prophylactic treatment of the disease or disorder; or delaying the onset or progression of the disease or disorder.
[0099] As used herein, the term “a therapeutically effective amount” of a compound of the present invention refers to an amount of the compound of the present invention that will elicit the biological or medical response of a subject, for example, reduction or inhibition of an enzyme or a protein activity, or ameliorate symptoms, alleviate conditions, slow or delay disease progression, or prevent a disease, etc. In a non-limiting embodiment, the term “a therapeutically effective amount” refers to the amount of the compound of the present invention that, when administered to a subject, is effective to (1) at least partially alleviate, inhibit, prevent and/or ameliorate a condition, or a disorder or a disease caused by the proliferation of a kinetoplastid parasite; or (2) reduce or inhibit the proliferation of a kinetoplastid parasite.
[0100] As used herein, the term “subject” refers to primates (e.g., humans (male or female), dogs, rabbits, guinea pigs, pigs, rats and mice). In certain embodiments, the subject is a primate. In yet other embodiments, the subject is a human.
[0101] As used herein, the term “a,” “an,” “the” and similar terms used in the context of the present invention (especially in the context of the claims) are to be construed to cover both the singular and plural unless otherwise indicated herein or clearly contradicted by the context.
Aspects of the Invention
[0102] In one aspect, the invention provides Compound I fumaric acid co-crystals. In one embodiment, the invention provides Compound I fumaric acid co-crystal (1:1) Form A, Form B or Form C; or Compound I fumaric acid co-crystals (2:1). In another embodiment, the invention provides substantially pure Compound I fumaric acid co-crystal (1:1) Form A, Form B or Form C; or substantially pure Compound I fumaric acid co-crystal (2:1). In yet another embodiment, the invention provides a composition consisting essentially of Compound I fumaric acid co-crystal (1:1) Form A, Form B or Form C; or a composition consisting essentially of Compound I fumaric acid co-crystal (2:1).
[0103] The co-crystals of the invention may be characterized as having an X-ray powder diffraction pattern, differential scanning calorimetry (DSC) thermogram, or thermogravimetric analysis (TGA) diagram that is “substantially as shown in” a figure (e.g.,
[0104] Preferably, the crystalline form has substantially pure phase homogeneity as indicated by less than 10%, preferably less than 5%, and more preferably less than 2% of the total peak area in the experimentally measured XRPD pattern arising from the extra peaks that are absent from the simulated XRPD pattern. Most preferred is a crystalline form having substantially pure phase homogeneity with less than 1% of the total peak area in the experimentally measured XRPD pattern arising from the extra peaks that are absent from the simulated XRPD pattern.
[0105] In another aspect, the invention provides X-ray amorphous complexes of Compound I and fumaric acid; wherein the molar ratio of Compound I is about 1:1 or 2:1; and optionally, substantially free of crystalline forms. In one embodiment, the invention provides substantially pure X-ray amorphous complexes of Compound I and fumaric acid as described herein. In yet another embodiment, the invention provides a composition consisting essentially of an X-ray amorphous complex of Compound I and fumaric acid, wherein the molar ratio of Compound I and fumaric acid is about 1:1 or 2:1.
Pharmaceutical Compositions, Dosage and Administration
[0106] In yet another aspect, the invention provides a pharmaceutical composition comprising Compound I fumaric acid co-crystals and/or amorphous Compound I fumaric acid, and a pharmaceutically acceptable carrier.
[0107] In one embodiment, the invention provides a pharmaceutical composition comprising at least one of Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); and a pharmaceutically acceptable carrier. The pharmaceutically acceptable carrier can readily be selected by one of ordinary skill in the art according to the desired mode of administration. Illustrative examples of suitable modes of administration include oral, nasal, parenteral, topical, transdermal, and rectal.
[0108] The compositions of the invention may take any pharmaceutical form recognizable to the skilled artisan as being suitable. Suitable pharmaceutical forms include solid, semisolid, liquid, or lyophilized formulations, such as tablets, powders, capsules, suppositories, suspensions, liposomes, and aerosols. In one embodiment, the invention provides a pharmaceutical composition comprising Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); for oral or parenteral administration.
[0109] The pharmaceutical compositions of the invention can be in unit dosage of about 1-1000 mg of active ingredient for a subject of about 50-70 kg; or about 1-600 mg; or about 1-400 mg; or about 1-300 mg; or about 1-150 mg; or about 1-50 mg of active ingredient. The therapeutically effective dosage of the composition is dependent on the species of the subject, the body weight, age and individual condition, the disorder or disease or the severity thereof being treated. A physician, clinician or veterinarian of ordinary skill can readily determine the effective amount of each of the active ingredients necessary to prevent, treat or inhibit the progress of the disorder or disease.
[0110] The above-cited dosage properties are demonstrable in vitro and in vivo tests using advantageously mammals, e.g., mice, rats, dogs, monkeys or isolated organs, tissues and preparations thereof. The compositions of the invention can be applied in vitro in the form of solutions, e.g., aqueous solutions, and in vivo either enterally, parenterally, advantageously intravenously, e.g., as a suspension or in aqueous solution. The dosage in vitro may range between about 10-3 molar and 10-9 molar concentrations.
[0111] The invention further provides therapeutic regimens for treating, preventing, inhibiting, ameliorating, or eradicating the pathology and/or symptomology of a disease caused by a kinetoplastid parasite. In one embodiment, the invention provides methods for treating, a disease caused by a kinetoplastid parasite, comprising administering a composition comprising Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); to a subject in need thereof; at a dose in a range of about 10 mg to about 400 mg; about 30 mg to about 300 mg; about 100 mg to about 300 mg; or about 100 mg to about 150 mg. In some embodiments, the composition is administered at a dose of about 10 mg, about 30 mg, about 50 mg, about 100 mg, about 150 mg, about 300 mg, about 400 mg, or about 600 mg. Such doses may be for oral administration; and may be for daily administration (e.g. once or twice daily administration).
[0112] The pharmaceutical compositions of the present invention may be administered either simultaneously with, or before or after, one or more other therapeutic agent. The compositions of the present invention may be administered separately, by the same or different route of administration, or together in the same pharmaceutical composition as the other agents. A therapeutic agent is, for example, a chemical compound, peptide, antibody, antibody fragment or nucleic acid, which is therapeutically active or enhances the therapeutic activity when administered to a patient in combination with a compound of the invention.
[0113] In one embodiment, the invention provides a product comprising Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); and at least one other therapeutic agent as a combined preparation for simultaneous, separate or sequential use in therapy. Products provided as a combined preparation include a composition comprising Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); and the other therapeutic agent(s), together in the same pharmaceutical composition or in separate form, e.g. in the form of a kit. Optionally, the pharmaceutical composition may comprise a pharmaceutically acceptable carrier, as described above.
[0114] In one embodiment, the invention provides a kit comprising two or more separate pharmaceutical compositions, at least one of which contains Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1). In one embodiment, the kit comprises means for separately retaining said compositions, such as a container, divided bottle, or divided foil packet. An example of such a kit is a blister pack, as typically used for the packaging of tablets, capsules and the like.
[0115] The kit of the invention may be used for administering different dosage forms, for example, oral and parenteral, for administering the separate compositions at different dosage intervals, or for titrating the separate compositions against one another. To assist compliance, the kit of the invention typically comprises directions for administration.
[0116] In the combination therapies of the invention, the compound of the invention and the other therapeutic agent may be manufactured and/or formulated by the same or different manufacturers. Moreover, the compound of the invention and the other therapeutic may be brought together into a combination therapy: (i) prior to release of the combination product to physicians (e.g. in the case of a kit comprising the compound of the invention and the other therapeutic agent); (ii) by the physician themselves (or under the guidance of the physician) shortly before administration; (iii) in the patient themselves, e.g. during sequential administration of the compound of the invention and the other therapeutic agent.
[0117] Accordingly, the invention provides the use of a composition comprising Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); for treating a disease or condition caused by the growth and proliferation of a kinetoplastid parasite, wherein the medicament is prepared for administration with another therapeutic agent. The invention also provides the use of another therapeutic agent for treating a disease or condition caused by the growth and proliferation of a kinetoplastid parasite, wherein the medicament is administered with Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1).
[0118] The invention also provides the use of a composition comprising Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1); for treating a disease or condition caused by the growth and proliferation of a kinetoplastid parasite, wherein the patient has previously (e.g. within 24 hours) been treated with another therapeutic agent. The invention also provides the use of another therapeutic agent for treating a disease or condition caused by the growth and proliferation of a kinetoplastid parasite, wherein the patient has previously (e.g. within 24 hours) been treated with Compound I fumaric acid co-crystals (1:1) Form A, Form B or Form C, Compound I fumaric acid co-crystal (2:1), amorphous Compound 1 fumaric acid (1:1), or amorphous Compound I fumaric acid (2:1).
[0119] In one embodiment, the other therapeutic agent is selected from stibogluconate, meglumine antimoniate, amphotericin, miltefosine and paromomycin or a combination thereof, for the treatment of Leishmaniasis. In another embodiment, the other therapeutic agent is selected from benznidazole, nifurtimox and amphotericin or a combination thereof, for the treatment of Chagas disease. In yet another, the other therapeutic agent is selected from pentamidine, suramin, melarsoprol, eflornithine, and nifurtimox or a combination thereof, for treatment of human African trypanosomiasis. Where the pharmaceutical compositions of the invention are administered in conjunction with other therapies, dosages of the co-administered compounds will of course vary depending on the type of co-drug employed, on the specific drug employed, on the condition being treated and so forth.
EXAMPLES
[0120] The following Examples are merely illustrative, and do not limit the scope of the invention otherwise claimed. The purity of reagents is analytical reagent grade or HPLC grade.
Abbreviations
[0121] XRPD X-ray powder diffraction
DSC Differential scanning calorimetry
TGA Thermogravimetric analysis
DVS Dynamic Vapor Sorption
[0122] RT room temperature
RH Relative humidity
THF Tetrahydrofuran
UPLC Ultra Performance Liquid Chromatography
FaSSIF Fasted State Simulated Intestinal Fluid
FeSSIF Fed State Simulated Intestinal Fluid
DVS Dynamic Vapor Sorption (DVS)
Instrumentation
[0123]
TABLE-US-00001 TGA-method Instrument TA Discovery TGA Q5000 Temperature range 30° C.-300° C. Scan rate 10 K/min Nitrogen flow 25 mL/min DSC-method Instrument TA Discovery DSC Temperature range 30° C.-300° C. Scan rate 10 K/min Nitrogen flow 50 mL/min XRPD-method Instrument Bruker D8 Advance Detector LYNXEYE (1D mode), open angle: 1.996° Radiation CuKα (0.15 nm) Monochromator Nickel filter X-ray generator power 40 kV, 40 mA Step size, resolution 0.041 degree Scan range 2° to 45° (2 theta value) Scan time 1209 seconds Source slit Primary: fixed illuminated sample size 5 mm, secondary slit: 5 mm, axial soller: 2.5° DVS Instrument Intrinsic Sample weight About 5 mg Temperature 25° C. dm/dt 0.002%/min
Example 1
Preparation of Compound I Fumaric Acid Co-Crystal (1:1) Form A
[0124] Ethyl acetate (1 mL) was added to Compound I (50 mg) at 55° C. and stirred at 500 rpm for 2 hrs, to which was added fumaric acid (1 eq., 13.1 mg). The reaction mixture was stirred at 55° C. for 5 hrs, cooled to RT over a 4 hr period, and stirred for another 12 hrs. The resulting solids were filtered and dried at 55° C. under vacuum for 6 hrs to give Compound I fumaric acid co-crystal (1:1) Form A (“Form A”).
[0125] Form A is characterized by one or more of the following parameters: (a) an X-ray powder diffraction pattern that is substantially as shown in
TABLE-US-00002 TABLE 1 Intensity Angle °2θ d value Å Rel. description 4.6 19.28 3.2% weak 5.0 17.53 17.3% weak 9.4 9.38 48.7% medium 10.1 8.73 5.1% weak 11.0 8.06 27.6% medium 13.4 6.59 15.0% weak 13.5 6.58 15.9% weak 14.2 6.21 28.2% medium 15.2 5.82 6.0% weak 17.1 5.19 8.7% weak 18.6 4.76 17.6% weak 19.0 4.68 8.5% weak 19.3 4.60 7.9% weak 19.7 4.49 11.3% weak 19.8 4.49 9.3% weak 22.0 4.04 6.6% weak 23.0 3.86 11.1% weak 23.4 3.80 7.7% weak 24.2 3.67 11.2% weak 24.8 3.59 10.5% weak 25.8 3.45 100% strong 28.8 3.10 13.6% weak
Example 2A
Preparation of Compound I Fumaric Acid Co-Crystal (1:1) Form B by Form a Seeding
[0126] Ethyl acetate (60 mL) was added to Compound I (3 g) at 55° C. and stirred at 500 r.p.m. for 2 hours, to which was added fumaric acid (1 eq, 796 mg). The reaction mixture was stirred at 55° C. for 6 hours, to which was added a small amount of Form A prepared in Example 1 (20 mg). The reaction mixture seeded with Form A was stirred at 55° C. for 16 hours, cooled to RT over a 2 hour period, and stirred for 8 hours. The resulting solids were filtered, washed with ethyl acetate (5 mL), and dried at 55° C. under vacuum for 12 hours to give Compound I fumaric acid co-crystal (1:1) Form B (“Form B”).
Example 2B
Preparation of Compound I Fumaric Acid Co-Crystal (1:1) Form B Seeds
[0127] THF (200 mL) was added to Compound I (20 g, 45.1 mmol, 1 eq) at RT to form a Compound I/THF suspension. Fumaric acid (5.8 g, 49.6 mmol, 1.1 eq) was added to isopropyl alcohol (160 mL) at RT, and the resulting fumaric acid solution was added to the Compound I/THF suspension over a 1 hr period. The reaction mixture was stirred at RT for 20 hrs, filtered, and the filter cake was washed with isopropyl alcohol (40 mL). The collected solids were dried at 50° C. under vacuum for 20 hrs, and equilibrated in ethyl acetate (100 mL) at 50° C. for 30 hrs. The solids were filtered and dried under vacuum at 50° C. for 16 h to give Form B, which was used as fumarate seed crystals.
Example 2C
Preparation of Compound I Fumaric Acid Co-Crystal (1:1) Form B by Form B Seeding
[0128] Fumaric acid (6.0 g, 51.9 mmol, 1.15 eq) was added to isopropyl alcohol (130 mL). The resulting solution was heated to 52° C., and filtered to obtain a clear fumaric acid solution. The fumaric acid solution was maintained at 50° C., to which was added a small amount of Form B prepared in Example 2B (10 mg) to give a fumaric acid solution seeded with Form B.
[0129] Compound I (20 g, 45.1 mmol, 1 eq) was added to THF (500 mL) at RT; and the resulting suspension was heated to 55° C. to obtain a clear solution, which was subsequently filtered. The filtrate was partially concentrated under vacuum, and the residual compound (287 g) was added dropwise to the fumaric acid solution seeded with Form B over a 1 hr period at 50° C. The reaction mixture was maintained at 50° C. for 2 hrs, subsequently cooled to RT over a 5-7 hr period, then concentrated under vacuum at 50° C. Isopropyl alcohol (200 mL*3) was added to the concentrate to further remove residual THF. The resulting suspension was cooled to RT over a 2-4 hr period, filtered and washed with pre-cooled isopropyl alcohol (40 mL). The solid was dried at 60° C. under vacuum for 16 hrs to give Form B as an off-white solid. .sup.1H NMR (400 MHz, DMSO-d.sub.6) δ ppm 2.40 (s, 3H), 6.64 (s, 2H), 7.41-7.45 (m, 1H), 7.82 (br d, J=0.73 Hz, 1H), 7.87-8.00 (m, 1H), 8.59 (dd, J=4.65, 1.10 Hz, 1H), 8.79 (dd, J=6.66, 2.75 Hz, 1H), 9.14 (d, J=2.45 Hz, 1H), 9.75 (d, J=2.32 Hz, 1H), 10.35-10.44 (m, 1H); .sup.13C NMR (101 MHz, DMSO-d.sub.6) δ ppm 13.24, 14.25, 19.78, 117.34, 117.56, 118.34, 118.45, 122.84, 122.86, 124.02, 124.18, 124.70, 124.78, 132.79, 134.42, 135.44, 135.47, 136.76, 139.16, 139.67, 143.45, 147.86, 151.16, 154.70, 155.46, 156.78, 157.18, 157.98, 161.42, 162.38, 162.44, 166.42; MS m/z=444.9 (M+H.sup.+).
[0130] Form B is characterized by one or more of the following parameters: (a) an X-ray powder diffraction pattern that is substantially as shown in
[0131] Form B has a melting point onset at 227.3° C. by DSC and 0.5% weight loss at 180° C. by TGA. Form B is non-hygroscopic and absorbs 0.3% moisture at 90% RH at 25° C. by DVS. Form B shows stability and solubility (24 h) in aqueous media comparable to the free form hydrate.
TABLE-US-00003 TABLE 2 Angle °2θ d value Å Rel. Intensity 8.0 11.10 7.0% weak 9.0 9.86 12.8% weak 9.4 9.44 7.5% weak 9.4 9.43 7.3% weak 9.8 9.06 17.6% weak 12.1 7.32 8.3% weak 12.0 7.37 16.1% weak 13.4 6.60 22.3% medium 16.0 5.65 23.3% medium 16.1 5.52 17.7% weak 16.4 5.41 7.8% weak 16.6 5.33 14.7% weak 18.1 4.91 15.1% weak 19.0 4.67 11.8% weak 20.2 4.39 17.0% weak 20.4 4.34 12.5% weak 21.2 4.19 7.3% weak 22.1 4.02 5.0% weak 22.7 3.91 12.6% weak 22.8 3.90 12.8% weak 23.6 3.77 3.1% weak 23.9 3.72 24.2% medium 24.7 3.60 100.0% strong 25.1 3.55 11.2% weak 26.4 3.37 6.9% weak 32.9 2.72 5.8% weak 34.8 2.57 3.9% weak
Example 3
Preparation of Compound I Fumaric Acid Co-Crystal (1:1) Form C
[0132] Form B (500 mg) was equilibrated in acetone (6 mL) at 50° C. for 72 hrs. The solids were filtered at RT and dried under vacuum at 40° C. for 18 h to give Compound I fumaric acid co-crystal (1:1) Form C (“Form C”).
[0133] Form C is characterized by one or more of the following parameters: (a) an X-ray powder diffraction pattern that is substantially as shown in
[0134] Form C has a melting point onset at 219.2° C. by DSC and 1.3% weight loss at 180° C. by TGA. Form C is slightly hygroscopic and reversibly absorbs approximately 0.6% moisture at 90% RH by DVS.
TABLE-US-00004 TABLE 3 Rel. Angle °2θ d value Å intensity Intensity 5.4 16.47 9.8% weak 9.8 9.04 55.9% medium 11.3 7.79 26.9% medium 14.2 6.25 17.2% weak 14.8 5.97 82.3% strong 16.4 5.41 3.8% weak 17.1 5.19 7.5% weak 19.6 4.53 6.3% weak 20.6 4.31 5.4% weak 22.4 3.97 6.3% weak 23.6 3.78 11.3% weak 23.6 3.76 11.6% weak 24.6 3.61 24.1% medium 25.0 3.56 23.9% medium 26.5 3.358 20.8% medium 27.6 3.23 100.0% strong 29.2 3.06 6.3% weak 30.2 2.96 2.8% weak
Example 4
Preparation of Compound I Fumaric Acid Co-Crystal (2:1) by Form B Seeding
[0135] Compound I (22.5 g, 50.7 mmol, 1 eq) was added to THF (450 mL) at RT; and the resulting suspension was heated to 55° C. to obtain a clear solution, which was subsequently filtered. The filtrate was partially concentrated under vacuum to give a residue comprising Compound I and THF (202.5 g).
[0136] Fumaric acid (6.5 g, 55.8 mmol, 1.1 eq) was added to isopropyl alcohol (225 mL). The resulting solution was heated to 52° C., filtered to obtain a clear fumaric acid solution, and added dropwise into the residue comprising Compound I and THF. After half of the fumaric acid solution was added to the residue comprising Compound I and THF over a 1 hr period, a small amount of Form B prepared in Example 2B (11.3 mg) was added to the remaining fumaric acid solution. The remaining fumaric acid solution was added to the reaction mixture over a 2 hr period.
[0137] The reaction mixture was maintained at 50° C. for 2 hrs, subsequently cooled to RT over a 5-7 hr period, then concentrated under vacuum at 50° C. Isopropyl alcohol (225 mL*2) was added to the concentrate to further remove residual THF. The resulting suspension was cooled to RT over a 2-4 hr period, filtered and washed with pre-cooled isopropyl alcohol (45 mL). The solid was dried at 60° C. under vacuum for 16 hrs to give Compound I fumaric acid co-crystal (2:1) as an off-white solid. .sup.1H NMR (400 MHz, DMSO-d.sub.6) δ ppm 2.41 (s, 3H), 6.63 (s, 1H), 7.43-7.46 (m, 1H), 7.85 (dd, J=7.70, 0.73 Hz, 1H), 7.91-7.99 (m, 1H), 8.61 (dd, J=4.65, 0.98 Hz, 1H), 8.80 (dd, J=6.66, 2.75 Hz, 1H), 9.15 (d, J=2.45 Hz, 1H), 9.76 (d, J=2.32 Hz, 1H), 10.35-10.48 (m, 1H); .sup.13C NMR (101 MHz, DMSO-d.sub.6) δ ppm 13.26, 14.28, 19.77, 117.38, 117.61, 118.37, 118.48, 122.87, 124.05, 124.22, 124.74, 124.82, 132.83, 134.49, 135.45, 135.48, 136.79, 139.18, 139.70, 143.47, 147.89, 151.19, 154.72, 155.48, 156.82, 157.21, 157.98, 161.46, 162.37, 162.43, 166.50; MS m/z=444.9 (M+H.sup.+).
[0138] Compound I fumaric acid co-crystal (2:1) are characterized by one or more of the following parameters: (a) an X-ray powder diffraction pattern that is substantially as shown in
[0139] Compound I fumaric acid co-crystal (2:1) have a melting point onset at 206.4° C. by DSC and 1.3% weight loss up to 180° C. by TGA. Compound I fumaric acid co-crystal (2:1) are non-hygroscopic and absorb only 0.12% at 90% RH at 25° C. by DVS.
TABLE-US-00005 TABLE 4 Rel. Intensity Angle °2θ d value Å intensity description 3.8 23.48 60.6% strong 11.3 7.80 8.7% weak 12.9 6.85 5.7% weak 13.5 6.55 100.0% strong 15.0 5.91 6.8% weak 15.8 5.62 10.5% weak 16.6 5.32 4.5% weak 17.2 5.14 81.5% strong 18.3 4.85 2.2% weak 18.9 4.69 17.3% weak 19.8 4.49 10.8% weak 20.5 4.32 6.2% weak 21.2 4.20 28.6% medium 21.7 4.09 5.0% weak 22.9 3.88 17.6% weak 23.7 3.74 50.3% medium 24.5 3.63 9.6% weak 25.7 3.46 9.7% weak 26.6 3.35 55.0% medium 27.7 3.22 8.8% weak 28.4 3.14 2.8% weak 29.8 2.99 7.6% weak 30.4 2.95 6.2% weak 31.4 2.84 5.5% weak 31.9 2.80 3.5% weak 33.2 2.70 5.1% weak 34.3 2.61 5.1% weak 35.0 2.56 5.6% weak 36.5 2.46 4.6% weak
Example 5
Preparation of Amorphous Compound I Fumaric Acid (1:1)
[0140] Compound I fumaric acid co-crystal (1:1) Form B seeds (100 mg), prepared following the procedure in Example 2B, was dissolved in 1,4-dioxane (30 mL). The resulting suspension was filtered, and the filtrate was frozen using an acetone dry ice bath. The frozen filtrate was freeze-dried for 3 days at −20° C. to provide amorphous Compound I fumaric acid (1:1).
[0141] The amorphous Compound I fumaric acid (1:1) is characterized by one or more of the following parameters: (a) an X-ray powder diffraction pattern that is substantially as shown in
Example 6
Preparation of Amorphous Compound I Fumaric Acid (2:1)
[0142] Compound I fumaric acid co-crystal (2:1) (100 mg), prepared following the procedure in Example 4, was dissolved in 1,4-dioxane (15 mL). The resulting suspension was filtered, and the filtrate was frozen using an acetone dry ice bath. The frozen filtrate was freeze-dried for 3 days at −20° C. to provide amorphous Compound I fumaric acid (2:1).
[0143] The amorphous Compound I fumaric acid (2:1) is characterized by one or more of the following parameters: (a) an X-ray powder diffraction pattern that is substantially as shown in
Example 7
Stability of Compound I Solid Forms
[0144] Compound I, Compound I fumaric acid co-crystals and amorphous Compound I fumaric acid samples (10 mg) were placed in an open vial at 50° C./75% RH and 80° C./75% RH chamber for one week. A same amount of sample was placed in a closed vial at 50° C. and 80° C. chamber for 1 week. The samples were exposed to 100 k Lux light for 12 h at 25° C.
[0145] Solids were examined by XRPD for physical stability determination and by UPLC for chemical stability determination. The color of the samples was evaluated by visual observation. Table 5 compares the stability of Compound I and its various solid forms.
[0146] At initial purity, the Compound I free form is a hydrate, which changes into a dihydrate when stored at 92% RH and after DVS testing. The free form hydrate converts to an amorphous form after degradation at 160° C. The free form hydrate is chemically stable in bulk at 50° C., 50° C./75& RH, 80° C. and 80° C./75% RH for one week, but form changes were noticed. Upon exposure to 75% RH humidity at both temperatures, a dihydrate was obtained. A mixture of the free form hydrate and anhydrous modification was observed under 50° C./75% RH. The free form is stable upon exposure to 1200 kLuxh light for 12 hrs.
[0147] The free form hydrate is hygroscopic with 8.9% moisture absorption by DVS at 25° C., along with a form change that is likely a dihydrate. The dihydrate is also obtained after storage of the free form hydrate at 92% RH for 24 hrs. After grinding, compression and wet granulation with water and ethanol, the free form hydrate converted to a different hydrate or a hydrate mixture.
[0148] In contrast, Form B and Compound I fumaric acid co-crystals (2:1) are non-hygroscopic and remains the same form with 0.3% and 0.12% moisture absorption respectively at 90% RH by DVS. Grinding, compression and wet granulation did not alter the crystal form of Form B.
TABLE-US-00006 TABLE 5 Compound I Fumaric Amorphous Amorphous Acid Compound I Compound I Co-crystal Fumaric Fumaric Acid Free Form Form B Form C (2:1) Acid (1:1) (2:1) DP DP DP DP DP DP % CL % CL % CL % CL % CL % CL Initial 99.4 off-white 98.2 off- 98.1 light 98.8 off- 97.4 off- 98.7 white purity (hydrate) powder white yellow white white powder powder powder powder powder Solid state, 1 week 80° C., closed container Bulk 0.6 no 1.7 no 1.8 no 1.2 no 2.6 no 1.7 no (UPLC) change change change change change change Bulk change no change no change no change no change no change (XRPD) Solid state, 1 week 80° C./75% r.h. Bulk 0.6 no 1.7 no 1.8 no 1.2 no 2.7 no 1.6 no (UPLC) change change change change change change Bulk change no change no change no change very weak no change (XRPD) crystallinity Solid state, 1 week 50° C., closed container Bulk 0.6 no 1.8 no 1.8 no 1.2 no ND ND (UPLC) change change change change Bulk no change no change no change no change ND ND (XRPD) Solid state, 1 week 50° C./75% r.h. Bulk 0.6 no 1.7 no 1.7 no 1.2 no ND ND (UPLC) change change change change Bulk change no change no change no change ND ND (XRPD) Xenon light (approx. 1200 kLuxh) Clear vial 0.6 no 1.6 no 1.8 no 1.2 no 4.5 no 10.6 no (HPLC) change change change change change change Clear vial no change no change no change no change very weak crystallized (XRPD) crystallinity Amber vial 0.8 no 1.7 no 1.8 no 1.2 no 2.8 no 1.5 no (HPLC) change change change change change change Amber vial no change no change no change no change very weak crystallized (XRPD) crystallinity *ND (not determined); DP (Degradation Product); CL (color)
Example 8
Solubility of Compound I Solid Forms
[0149] Compound 1, Compound I fumaric acid co-crystals and amorphous Compound I fumaric acid samples (2 mg) in various media (1 mL) were mixed in a glass vial to make a slurry. Each sample was equilibrated at 2500 for 24 hrs, and centrifuged at 13400 r.p.m. for 3 mins with 0.2 μm membrane to separate solids from liquids. The liquid was used to measure solubility by UPLC.
[0150] Table 6 provides solubility data of Compound I and its various solid forms at 25° C. after 24 hours equilibration, with final pH of the sample shown in parentheses. The solubility of Form B in biological fluids such as SGF, FaSSIF and FeSSIF was significantly better compared to the solubility of the free form. The solubility of Compound I fumaric acid co-crystal (2:1) in FeSSIF was also significantly better compared to the solubility of the free form.
TABLE-US-00007 TABLE 6 Compound I Amorphous Amorphous Fumaric Acid Compound Compound Free Co-crystal I Fumaric I Fumaric Form Form B Form C (2:1) Acid (1:1) Acid (2:1) (mg/mL) (mg/mL) (mg/mL) (mg/mL) (mg/mL) (mg/mL) water 0.009 (8.18) 0.004 (2.9) ND (2.9) ND (3.1) 0.0002 (3.0) <0.0001 (3.2) 0.1N HCl 0.232 (1.00) 0.17 (1.0) 0.24 (1.1) 0.16 (0.8) 0.35 (1.1) 0.18 (1.1) pH 1.0 0.01N HCl 0.017 (2.10) 0.021 (2.1) // 0.005 (1.9) 0.036 (2.1) 0.009 (2.0) pH 2.0 acetate buffer 0.002 (4.68) 0.002 (4.6) ND (4.4) ND (4.5) <0.0001 (4.6) <0.0001 (4.7) pH 4.7 phosphate 0.001 (6.65) 0.002 (6.5) ND (6.4) ND (6.6) <0.0001 (6.6) <0.0001 (6.7) buffer pH 6.8 borate buffer 0.002 (8.58) 0.002 (8.1) // ND (9.6) <0.0001 (9.6) <0.0001 (9,7) pH 10.0 SGF 0.029 (1.99) 0.063 (1.9) 0.046 (2.0) 0.03 (1.9) 0.055 (2.2) 0.025 (2.2) pH 2.0 FaSSIF 0.004 (6.31) 0.007 (5.7) ND (5.5) ND (5.9) 0.007 (5.8) 0.003 (6.1) pH 6.5 FeSSIF 0.006 (5.73) 0.016 (5.6) ND (5.5) 0.017 (5.5) 0.018 (5.6) 0.013 (5.7) pH 5.8 *ND (not determined)
[0151] Having fully described the invention, it will be understood by persons of skill in the art that the same can be performed within various modifications without affecting the scope of the invention or any embodiment thereof. All publications, patents, and patent applications cited herein are hereby incorporated by reference for all purposes.