GANAXOLONE DERIVATIVES FOR TREATMENT OF CENTRAL NERVOUS SYSTEMS DISORDERS

Abstract

The present invention is directed to Ganaxolone prodrugs with increased aqueous solubility and oral bioavailability relative to Ganaxolone and that enable development of stable extended release formulations which offer a significant therapeutic advantage and improved patience compliance by enabling treatments with lower doses over prolonged periods of time.

Claims

1. A compound of Formula ##STR00009## Wherein X.sup.1 is selected from the group consisting of (CO)R.sup.1, (CO)(CH.sub.2).sub.nCO.sub.2.sup.M.sup.+, (CO)(CH.sub.2).sub.nCO.sub.2R, (CO)(CH.sub.2).sub.mO(CO)R, (CO)(CH.sub.2).sub.nOR, (CO)CHCHCO.sub.2R, (CO)CHCHCO.sub.2.sup.M.sup.+, (CO)(CH.sub.2).sub.nN(R).sub.2, (CO)(CH.sub.2).sub.n(CO)N(R).sub.2, (CO)(CH.sub.2).sub.mN(CO)R, (CO)(CHR.sup.4)N(R).sub.2, (PO)(O.sup.M.sup.+).sub.2, (PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, (CO)N(CH.sub.2CO.sub.2R).sub.2, (CO)O(C(R.sup.2).sub.2).sub.mO(CO)R, C(R.sup.2).sub.2O(CO)R.sup.1, C(R.sup.2).sub.2O(CO)OR.sup.1, C(R.sup.2).sub.2O(PO)(O.sup.M.sup.+).sub.2, C(R.sup.2).sub.2O(PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, C(R.sup.2).sub.2O(CO)(CHR)N(R).sub.2, C(R.sup.2).sub.2O(CO)N(R).sub.2, C(R.sup.2).sub.2O(CO)N(CH.sub.2CO.sub.2R).sub.2, ##STR00010## R is H, alkyl or arylalkyl; R.sup.1 is alkyl, cycloalkyl, aryl, heterocyclic or heteroaryl; R.sup.2 is hydrogen or methyl; R.sup.3 is methyl, isopropyl or t-butyl; R.sup.4 is an amino acid; R.sup.5 is alkyl or alkyl-OH M.sup.+ is Hydrogen, Na+, K+, Ca++, Mg++, R.sub.4N+, R.sup.5NH.sub.3+, (R.sup.5).sub.2NH.sub.2+, (R.sup.5).sub.3NH+, or (R.sup.5).sub.4N+; Y is O, NH, or CH.sub.2; n is an integer from 0-6; m is an integer from 1-6; and p is an integer from 2-6; or a pharmaceutically acceptable salt thereof.

2-23. (canceled)

24. A compound of Formulae ##STR00011## Wherein X.sup.2 is selected from the group consisting of: (CO)OC(R.sup.2).sub.2O(CO)R.sup.1, (CO)OC(R.sup.2).sub.2O(CO)OR.sup.1, (CO)OC(R.sup.2).sub.2O(PO)(O.sup.M.sup.+).sub.2, (CO)OC(R.sup.2).sub.2O(PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, (CO)OC(R.sup.2).sub.2O(CO)CHRN(R).sub.2, (CO)OC(R.sup.2).sub.2O(CO)N(R).sub.2, (CO)OC(R.sup.2).sub.2O(CO)N(CH.sub.2CO.sub.2R).sub.2, (CO)R.sup.1, (CO)(CH.sub.2).sub.nCO.sub.2.sup.M.sup.+, (CO)(CH.sub.2).sub.nCO.sub.2R, (CO)(CH.sub.2).sub.mO(CO)R, (CO)(CH.sub.2).sub.nOR, (CO)CHCHCO.sub.2R, (CO)CHCHCO.sub.2.sup.M.sup.+, (CO)(CH.sub.2).sub.nN(R).sub.2, (CO)(CH.sub.2).sub.n(CO)N(R).sub.2, (CO)(CH.sub.2).sub.pN(CO)R, (CO)(CHR.sup.4)N(R).sub.2, (CO)(CH.sub.2).sub.nN(R).sub.3.sup.+A.sup., (CO)OR.sup.1, (PO)(O.sup.M.sup.+).sub.2, (PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, (CO)N(CH.sub.2CO.sub.2R).sub.2, C(R.sup.2).sub.2O(CO)R.sup.1, C(R.sup.2).sub.2O(CO)OR.sup.1, C(R.sup.2).sub.2O(PO)(O.sup.M.sup.+).sub.2, C(R.sup.2).sub.2O(PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, C(R.sup.2).sub.2O(CO)(CHR)N(R).sub.2, C(R.sup.2).sub.2O(CO)N(R).sub.2, C(R.sup.2).sub.2O(CO)N(CH.sub.2CO.sub.2R).sub.2, ##STR00012## R is H, alkyl, arylalkyl; R.sup.1 is alkyl, cycloalkyl, aryl or heteroaryl; R.sup.2 is Hydrogen or methyl; R.sup.3 is methyl, isopropyl or t-butyl; R.sup.4 is an amino acid; R.sup.5 is alkyl or alkyl-OH; R.sup.6 is OH, OCH.sub.3, OBenzyl, or OX.sup.2; M.sup.+ is Hydrogen, Na+, K+, Ca++, Mg++, R.sub.4N+, R.sup.5NH.sub.3+, (R.sup.5).sub.2NH.sub.2+, (R.sup.5).sub.3NH+, or (R.sup.5).sub.4N+; Y is O, NH, or CH.sub.2; n is an integer from 0-6; m is an integer from 0-6; and p is an integer from 0-6 or a pharmaceutically acceptable salt thereof.

25. A compound according to claim 24, wherein X.sup.2 is selected from the group consisting of: (CO)OC(R.sup.2).sub.2O(CO)R.sup.1, (CO)OC(R.sup.2).sub.2O(CO)OR.sup.1, (CO)OC(R.sup.2).sub.2O(PO)(O.sup.M.sup.+).sub.2, (CO)OC(R.sup.2).sub.2O(PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, (CO)OC(R.sup.2).sub.2O(CO)(CHR)N(R).sub.2, (CO)OC(R.sup.2).sub.2O(CO)N(R).sub.2, and (CO)OC(R.sup.2).sub.2O(CO)N(CH.sub.2CO.sub.2R).sub.2.

26. A compound according to claim 24, wherein X.sup.2 is selected from the group consisting of: (CO)R.sup.1, (CO)(CH.sub.2).sub.nCO.sub.2.sup.M.sup.+, (CO)(CH.sub.2).sub.nCO.sub.2R, (CO)(CH.sub.2).sub.mO(CO)R, (CO)(CH.sub.2).sub.nOR, (CO)CHCHCO.sub.2R, (CO)CHCHCO.sub.2.sup.M.sup.+, (CO)(CH.sub.2).sub.nN(R).sub.2, (CO)(CH.sub.2).sub.n(CO)N(R).sub.2, (CO)(CH.sub.2).sub.pN(CO)R, (CO)(CHR.sup.4)N(R).sub.2, (CO)(CH.sub.2)NR.sub.3.sup.+A.sup., (CO)OR.sup.1, (PO)(O.sup.M.sup.+).sub.2, (PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, and (CO)N(CH.sub.2CO.sub.2R).sub.2.

27. A compound according to claim 24, wherein X.sup.2 is selected from the group consisting of: C(R.sup.2).sub.2O(CO)R.sup.1, C(R.sup.2).sub.2O(CO)OR.sup.1, C(R.sup.2).sub.2O(PO)(O.sup.M.sup.+).sub.2, C(R.sup.2).sub.2O(PO)(OC(R.sup.2).sub.2O(CO)YR.sup.1).sub.2, C(R.sup.2).sub.2O(CO)(CHR)N(R).sub.2, C(R.sup.2).sub.2O(CO)N(R).sub.2, and C(R.sup.2).sub.2O(CO)N(CH.sub.2CO.sub.2R).sub.2.

28. A compound according to claim 24 wherein R is hydrogen.

29. A compound according to claim 24 wherein R is methyl.

30. (canceled)

31. A compound according to claim 24 wherein R.sup.1 is alkyl.

32. (canceled)

33. (canceled)

34. (canceled)

35. A compound according to claim 24 wherein R.sup.2 is hydrogen

36. A compound according to claim 24 wherein R.sup.2 is methyl.

37. (canceled)

38. A compound according to claim 24 wherein M.sup.+ is hydrogen.

39. A compound according to claim 24 wherein M.sup.+ is Na+ or K+.

40. A compound according to claim 24 wherein M.sup.+ is Ca++ or Mg++.

41. A compound according to claim 24 wherein M.sup.+ is R.sub.4N+.

42. A compound according to claim 24 wherein M.sup.+ is R.sup.5NH.sub.3+, (R.sup.5).sub.2NH.sub.2+, (R.sup.5).sub.3NH+, or (R.sup.5).sub.4N+.

43. A compound according to claim 24 wherein M.sup.+ is HOCH.sub.2CH.sub.2NH.sub.3+.

44. A compound according to claim 24 wherein Y is O.

45. A compound according to claim 24 wherein n is an integer from 0-3; m is an integer from 1-3; and p is an integer from 2-3.

46. A method of treating epilepsy in a human patient in need of such therapy comprising administering an effective amount of a prodrug of Formulae Ia, Ib, Ic or Id.

47. A pharmaceutical composition comprising a pharmacologically effective amount of a prodrug of Formulae Ia, Ib, Ic or Id.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0166] Compounds of the Formulae Ia, Ib, Ic or Id, may be prepared according to the following reaction Schemes and accompanying discussion. Unless otherwise indicated, R, R.sup.1, R.sup.2, R.sup.3, R.sup.4, R.sup.5, R.sup.6 and X, and structural Formulae Ia, Ib, Ic or Id, are as defined above in the reaction schemes and discussion that follow. In general the compounds of this invention may be made by processes which include processes analogous to those known in the chemical arts, particularly in light of the description contained herein. Certain processes for the manufacture of the compounds of this invention are provided as further features of the invention and are illustrated by the following reaction schemes. Other processes may be described in the experimental section.

[0167] As an initial note, in the preparation of the Formulae Ia, Ib, Ic or Id compounds it is noted that some of the preparation methods useful for the preparation of the compounds described herein may require protection of remote functionality. The need for such protection will vary depending on the nature of the remote functionality and the conditions of the preparation methods. The need for such protection is readily determined by one skilled in the art. The use of such protection/deprotection methods is also within the skill in the art. For a general description of protecting groups and their use, see T. W. Greene, Protective Groups in Organic Synthesis, John Wiley & Sons, New York, 1991. For example, certain compounds contain primary amines or carboxylic acid functionalities which may interfere with reactions at other sites of the molecule if left unprotected. Accordingly, such functionalities may be protected by an appropriate protecting group which may be removed in a subsequent step. Suitable protecting groups for amine and carboxylic acid protection include those protecting groups commonly used in peptide synthesis (such as N-t-butoxycarbonyl, benzyloxycarbonyl, and 9-fluorenylmethylenoxycarbonyl for amines and lower alkyl or benzyl esters for carboxylic acids) which are generally not chemically reactive under the reaction conditions described and can typically be removed without chemically altering other functionality in the Formulae Ia, Ib, Ic or Id, compounds.

##STR00007##

[0168] Compounds of Formula Ia may be prepared by methods analogous to those described below In Example 1, or well known to those skilled in the art.

[0169] Compounds of Formula Ib may be prepared from a mixture of ganaxolone and p-toluenesulfonic acid in acetic anhydride (200 mL) was heated at 150 C. in an oil bath while the solvent was slowly distilled through a short path column over 5 hr. The remaining solvent was removed at reduced pressure. The residue was partitioned between cold ether and cold saturated NaHCO.sub.3 solution. The layers were separated and the aqueous layer was extracted with Et.sub.2O (2). The Et.sub.2O layers were washed with H.sub.2, brine, combined and dried over sodium sulfate. Evaporation of the solvent gave enol acetate 1b. See Djerassi, Carl et al. Journal of the American Chemical Society, 77, 3826-9; 1955

[0170] Synthesis of 1c: A mixture of ganaxolone and p-toluenesulfonic acid in isopropenyl acetate was heated to afford 1c in addition to 1b. See: By Moffett, Robert Bruce and Weisblat, D. I. Journal of the American Chemical Society, 74, 2183-5; 1952.

[0171] Synthesis of 1d: A stirred solution of ganaxolone in dry pyridine (5 mL) was treated with hydroxylamine hydrochloride (2 equiv) and Et3N. The mixture was refluxed for 6 h. Finally, the reaction mixture was quenched with ice-H2O, and a white precipitate was formed. The precipitate was collected and taken into EtOAc, dried over MgSO4, and evaporated. See: Hamilton, Niall M. et al Journal of Medicinal Chemistry, 55(9), 4431-4445; 2012.

[0172] Compounds of Formulae Ia, Ib, Ic or Id, that have chiral centers may exist as stereoisomers, such as racemates, enantiomers, or diastereomers. Conventional techniques for the preparation/isolation of individual enantiomers include chiral synthesis from a suitable optically pure precursor or resolution of the racemate using, for example, chiral high pressure liquid chromatography (HPLC). Alternatively, the racemate (or a racemic precursor) may be reacted with a suitable optically active compound, for example, an alcohol, or, in the case where the compound contains an acidic or basic moiety, an acid or base such as tartaric acid or 1-phenylethylamine. The resulting diastereomeric mixture may be separated by chromatography and/or fractional crystallization and one or both of the diastereoisomers converted to the corresponding pure enantiomer(s) by means well known to one skilled in the art. Chiral compounds of Formulae Ia, Ib, Ic or Id, (and chiral precursors thereof) may be obtained in enantiomerically-enriched form using chromatography, typically HPLC, on an asymmetric resin with a mobile phase consisting of a hydrocarbon, typically heptane or hexane, containing from 0 to 50% isopropanol, typically from 2 to 20%, and from 0 to 5% of an alkylamine, typically 0.1% diethylamine. Concentration of the eluate affords the enriched mixture. Stereoisomeric conglomerates may be separated by conventional techniques known to those skilled in the art. See, e.g. Stereochemistry of Organic Compounds by E. L. Eliel (Wiley, New York, 1994), the disclosure of which is incorporated herein by reference in its entirety.

[0173] Where a compound of Formulae Ia, Ib, Ic or Id, contains an alkenyl or alkenylene group, geometric cis/trans (or Z/E) isomers are possible. Cis/trans isomers may be separated by conventional techniques well known to those skilled in the art, for example, chromatography and fractional crystallization. Salts of the present invention can be prepared according to methods known to those of skill in the art.

[0174] Polymorphs can be prepared according to techniques well-known to those skilled in the art.

[0175] Cis/trans isomers may be separated by conventional techniques well known to those skilled in the art, for example, chromatography and fractional crystallisation.

[0176] Conventional techniques for the preparation/isolation of individual enantiomers include chiral synthesis from a suitable optically pure precursor or resolution of the racemate (or the racemate of a salt or derivative) using, for example, chiral high pressure liquid chromatography (HPLC).

[0177] Alternatively, the racemate (or a racemic precursor) may be reacted with a suitable optically active compound, for example, an alcohol, or, in the case where the compound of Formulae Ia, Ib, Ic or Id, contains an acidic or basic moiety, a base or acid such as 1-phenylethylamine or tartaric acid. The resulting diastereomeric mixture may be separated by chromatography and/or fractional crystallization and one or both of the diastereoisomers converted to the corresponding pure enantiomer(s) by means well known to a skilled person.

[0178] Chiral compounds of the invention (and chiral precursors thereof) may be obtained in enantiomerically-enriched form using chromatography, typically HPLC, on an asymmetric resin with a mobile phase consisting of a hydrocarbon, typically heptane or hexane, containing from 0 to 50% by volume of isopropanol, typically from 2% to 20%, and from 0 to 5% by volume of an alkylamine, typically 0.1% diethylamine. Concentration of the eluate affords the enriched mixture.

[0179] When any racemate crystallises, crystals of two different types are possible. The first type is the racemic compound (true racemate) referred to above wherein one homogeneous form of crystal is produced containing both enantiomers in equimolar amounts. The second type is the racemic mixture or conglomerate wherein two forms of crystal are produced in equimolar amounts each comprising a single enantiomer.

[0180] While both of the crystal forms present in a racemic mixture have identical physical properties, they may have different physical properties compared to the true racemate. Racemic mixtures may be separated by conventional techniques known to those skilled in the artsee, for example, Stereochemistry of Organic Compounds by E. L. Eliel and S. H. Wilen (Wiley, 1994).

[0181] The invention also includes isotopically-labeled compounds of Formulae Ia, Ib, Ic or Id, wherein one or more atoms is replaced by an atom having the same atomic number, but an atomic mass or mass number different from the atomic mass or mass number usually found in nature. Isotopically-labeled compounds of Formulae Ia, Ib, Ic or Id, can generally be prepared by conventional techniques known to those skilled in the art or by processes analogous to those described herein, using an appropriate isotopically-labeled reagent in place of the non-labeled reagent otherwise employed.

[0182] Compounds of Formulae Ia, Ib, Ic or Id are prodrugs of ganaxolone. Prodrugs are compounds that undergo biotransformation before exhibiting their pharmacological effects. They can enhance how the intended drug is absorbed, distributed, metabolized and excreted (so-called ADME properties). Prodrugs often improve oral bioavailability in cases such as the present where ganaxolone is poorly absorbed through the gastrointestinal tract. Prodrugs may also be used to improve how selectively the intended drug interacts with cells or processes that are not its intended target. This reduces the adverse or unintended effects of the intended drug, especially important in treatments like chemotherapy, which can have severe unintended and undesirable side effects.

[0183] The compounds of Formulae Ia, Ib, Ic or Id, should be assessed for their biopharmaceutical properties, such as solubility and solution stability (across pH), permeability, bioconversion, etc., in order to select the most appropriate dosage form and route of administration for treatment of the proposed indication.

[0184] Compounds of the invention intended for pharmaceutical use may be administered as crystalline or amorphous products. They may be obtained, for example, as solid plugs, powders, or films by methods such as precipitation, crystallization, freeze drying, spray drying, or evaporative drying. Microwave or radio frequency drying may be used for this purpose.

[0185] They may be administered alone or in combination with one or more other compounds of the invention or in combination with one or more other drugs (or as any combination thereof). Generally, they will be administered as a formulation in association with one or more pharmaceutically acceptable excipients. The term excipient is used herein to describe any ingredient other than the compound(s) of the invention. The choice of excipient will to a large extent depend on factors such as the particular mode of administration, the effect of the excipient on solubility and stability, and the nature of the dosage form.

[0186] Pharmaceutical compositions suitable for the delivery of compounds of the present invention and methods for their preparation will be readily apparent to those skilled in the art. Such compositions and methods for their preparation may be found, for example, in Remington's Pharmaceutical Sciences, 19th Edition (Mack Publishing Company, 1995).

[0187] The compounds of the invention may be administered orally. Oral administration may involve swallowing, so that the compound enters the gastrointestinal tract, and/or buccal, lingual, or sublingual administration by which the compound enters the blood stream directly from the mouth.

[0188] Formulations suitable for oral administration include solid, semi-solid and liquid systems such as tablets; soft or hard capsules containing multi- or nano-particulates, liquids, or powders; lozenges (including liquid-filled); chews; gels; fast dispersing dosage forms; films; ovules; sprays; and buccal/mucoadhesive patches.

[0189] Liquid formulations include suspensions, solutions, syrups and elixirs. Such formulations may be employed as fillers in soft or hard capsules (made, for example, from gelatin or hydroxypropylmethylcellulose) and typically comprise a carrier, for example, water, ethanol, polyethylene glycol, propylene glycol, methylcellulose, or a suitable oil, and one or more emulsifying agents and/or suspending agents. Liquid formulations may also be prepared by the reconstitution of a solid, for example, from a sachet.

[0190] The compounds of the invention may also be used in fast-dissolving, fast-disintegrating dosage forms such as those described in Expert Opinion in Therapeutic Patents, 11(6), 981-986, by Liang and Chen (2001).

[0191] For tablet dosage forms, depending on dose, the drug may make up from 1 weight % to 80 weight % of the dosage form, more typically from 5 weight % to 60 weight % of the dosage form. In addition to the drug, tablets generally contain a disintegrant. Examples of disintegrants include sodium starch glycolate, sodium carboxymethyl cellulose, calcium carboxymethyl cellulose, croscarmellose sodium, crospovidone, polyvinylpyrrolidone, methyl cellulose, microcrystalline cellulose, lower alkyl-substituted hydroxypropyl cellulose, starch, pregelatinised starch and sodium alginate. Generally, the disintegrant will comprise from 1 weight % to 25 weight %, preferably from 5 weight % to 20 weight % of the dosage form.

[0192] Binders are generally used to impart cohesive qualities to a tablet formulation. Suitable binders include microcrystalline cellulose, gelatin, sugars, polyethylene glycol, natural and synthetic gums, polyvinylpyrrolidone, pregelatinised starch, hydroxypropyl cellulose and hydroxypropyl methylcellulose. Tablets may also contain diluents, such as lactose (monohydrate, spray-dried monohydrate, anhydrous and the like), mannitol, xylitol, dextrose, sucrose, sorbitol, microcrystalline cellulose, starch and dibasic calcium phosphate dihydrate.

[0193] Tablets may also optionally comprise surface active agents, such as sodium lauryl sulfate and polysorbate 80, and glidants such as silicon dioxide and talc. When present, surface active agents may comprise from 0.2 weight % to 5 weight % of the tablet, and glidants may comprise from 0.2 weight % to 1 weight % of the tablet. Tablets also generally contain lubricants such as magnesium stearate, calcium stearate, zinc stearate, sodium stearyl fumarate, and mixtures of magnesium stearate with sodium lauryl sulphate. Lubricants generally comprise from 0.25 weight % to 10 weight %, preferably from 0.5 weight % to 3 weight % of the tablet.

[0194] Other possible ingredients include anti-oxidants, colourants, flavouring agents, preservatives and taste-masking agents.

[0195] Exemplary tablets contain up to about 80% drug, from about 10 weight % to about 90 weight % binder, from about 0 weight % to about 85 weight % diluent, from about 2 weight % to about 10 weight % disintegrant, and from about 0.25 weight % to about 10 weight % lubricant.

[0196] Tablet blends may be compressed directly or by roller to form tablets. Tablet blends or portions of blends may alternatively be wet-, dry-, or melt-granulated, melt congealed, or extruded before tabletting. The final formulation may comprise one or more layers and may be coated or uncoated; it may even be encapsulated.

[0197] The formulation of tablets is discussed in Pharmaceutical Dosage Forms: Tablets, Vol. 1, by H. Lieberman and L. Lachman (Marcel Dekker, New York, 1980).

[0198] Consumable oral films for human or veterinary use are typically pliable water-soluble or water-swellable thin film dosage forms which may be rapidly dissolving or mucoadhesive and typically comprise a compound of Formulae Ia, Ib, Ic or Id, a film-forming polymer, a binder, a solvent, a humectant, a plasticiser, a stabiliser or emulsifier, a viscosity-modifying agent and a solvent. Some components of the formulation may perform more than one function.

[0199] The compound of Formulae Ia, Ib, Ic or Id, may be water-soluble or insoluble. A water-soluble compound typically comprises from 1 weight % to 80 weight %, more typically from 20 weight % to 50 weight %, of the solutes. Less soluble compounds may comprise a greater proportion of the composition, typically up to 88 weight % of the solutes. Alternatively, the compound of Formulae Ia, Ib, Ic or Id, may be in the form of multiparticulate beads.

[0200] The film-forming polymer may be selected from natural polysaccharides, proteins, or synthetic hydrocolloids and is typically present in the range 0.01 to 99 weight %, more typically in the range 30 to 80 weight %.

[0201] Other possible ingredients include anti-oxidants, colorants, flavourings and flavour enhancers, preservatives, salivary stimulating agents, cooling agents, co-solvents (including oils), emollients, bulking agents, anti-foaming agents, surfactants and taste-masking agents.

[0202] Films in accordance with the invention are typically prepared by evaporative drying of thin aqueous films coated onto a peelable backing support or paper. This may be done in a drying oven or tunnel, typically a combined coater dryer, or by freeze-drying or vacuuming.

[0203] Solid formulations for oral administration may be formulated to be immediate and/or modified release. Modified release formulations include delayed-, sustained-, pulsed-, controlled-, targeted and programmed release.

[0204] Suitable modified release formulations for the purposes of the invention are described in U.S. Pat. No. 6,106,864. Details of other suitable release technologies such as high energy dispersions and osmotic and coated particles are to be found in Pharmaceutical Technology On-line, 25(2), 1-14, by Verma et al (2001). The use of chewing gum to achieve controlled release is described in WO 00/35298.

[0205] The compounds of the invention may also be administered directly into the blood stream, into muscle, or into an internal organ. Suitable means for parenteral administration include intravenous, intraarterial, intraperitoneal, intrathecal, intraventricular, intraurethral, intrasternal, intracranial, intramuscular, intrasynovial and subcutaneous. Suitable devices for parenteral administration include needle (including microneedle) injectors, needle-free injectors and infusion techniques.

[0206] Parenteral formulations are typically aqueous solutions which may contain excipients such as salts, carbohydrates and buffering agents (preferably to a pH of from 3 to 9), but, for some applications, they may be more suitably formulated as a sterile non-aqueous solution or as a dried form to be used in conjunction with a suitable vehicle such as sterile, pyrogen-free water.

[0207] The preparation of parenteral formulations under sterile conditions, for example, by lyophilisation, may readily be accomplished using standard pharmaceutical techniques well known to those skilled in the art.

[0208] The solubility of compounds of Formulae Ia, Ib, Ic or Id, used in the preparation of parenteral solutions may be increased by the use of appropriate formulation techniques, such as the incorporation of solubility-enhancing agents.

[0209] Formulations for parenteral administration may be formulated to be immediate and/or modified release. Modified release formulations include delayed-, sustained-, pulsed-, controlled-, targeted and programmed release. Thus compounds of the invention may be formulated as a suspension or as a solid, semi-solid, or thixotropic liquid for administration as an implanted depot providing modified release of the active compound. Examples of such formulations include drug-coated stents and semi-solids and suspensions comprising drug-loaded poly(dl-lactic-coglycolic)acid (PGLA) microspheres.

[0210] The compounds of the invention may also be administered topically, (intra)dermally, or transdermally to the skin or mucosa. Typical formulations for this purpose include gels, hydrogels, lotions, solutions, creams, ointments, dusting powders, dressings, foams, films, skin patches, wafers, implants, sponges, fibres, bandages and microemulsions. Liposomes may also be used. Typical carriers include alcohol, water, mineral oil, liquid petrolatum, white petrolatum, glycerin, polyethylene glycol and propylene glycol. Penetration enhancers may be incorporatedsee, for example, J Pharm Sci, 88 (10), 955-958, by Finnin and Morgan (October 1999).

[0211] Other means of topical administration include delivery by electroporation, iontophoresis, phonophoresis, sonophoresis and microneedle or needle-free (e.g. Powderject, Bioject, etc.) injection.

[0212] Formulations for topical administration may be formulated to be immediate and/or modified release. Modified release formulations include delayed-, sustained-, pulsed-, controlled-, targeted and programmed release.

[0213] The compounds of the invention can also be administered intranasally or by inhalation, typically in the form of a dry powder (either alone, as a mixture, for example, in a dry blend with lactose, or as a mixed component particle, for example, mixed with phospholipids, such as phosphatidylcholine) from a dry powder inhaler, as an aerosol spray from a pressurised container, pump, spray, atomiser (preferably an atomiser using electrohydrodynamics to produce a fine mist), or nebuliser, with or without the use of a suitable propellant, such as 1,1,1,2-tetrafluoroethane or 1,1,1,2,3,3,3-heptafluoropropane, or as nasal drops. For intranasal use, the powder may comprise a bioadhesive agent, for example, chitosan or cyclodextrin.

[0214] The pressurized container, pump, spray, atomizer, or nebuliser contains a solution or suspension of the compound(s) of the invention comprising, for example, ethanol, aqueous ethanol, or a suitable alternative agent for dispersing, solubilising, or extending release of the active, a propellant(s) as solvent and an optional surfactant, such as sorbitan trioleate, oleic acid, or an oligolactic acid.

[0215] Prior to use in a dry powder or suspension formulation, the drug product is micronised to a size suitable for delivery by inhalation (typically less than 5 microns). This may be achieved by any appropriate comminuting method, such as spiral jet milling, fluid bed jet milling, supercritical fluid processing to form nanoparticles, high pressure homogenisation, or spray drying.

[0216] Capsules (made, for example, from gelatin or hydroxypropylmethylcellulose), blisters and cartridges for use in an inhaler or insufflator may be formulated to contain a powder mix of the compound of the invention, a suitable powder base such as lactose or starch and a performance modifier such as l-leucine, mannitol, or magnesium stearate. The lactose may be anhydrous or in the form of the monohydrate, preferably the latter. Other suitable excipients include dextran, glucose, maltose, sorbitol, xylitol, fructose, sucrose and trehalose.

[0217] A suitable solution formulation for use in an atomiser using electrohydrodynamics to produce a fine mist may contain from 1 g to 20 mg of the compound of the invention per actuation and the actuation volume may vary from 1 l to 100 l. A typical formulation may comprise a compound of formula I, propylene glycol, sterile water, ethanol and sodium chloride. Alternative solvents which may be used instead of propylene glycol include glycerol and polyethylene glycol.

[0218] Suitable flavours, such as menthol and levomenthol, or sweeteners, such as saccharin or saccharin sodium, may be added to those formulations of the invention intended for inhaled/intranasal administration.

[0219] Formulations for inhaled/intranasal administration may be formulated to be immediate and/or modified release using, for example, PGLA. Modified release formulations include delayed-, sustained-, pulsed-, controlled-, targeted and programmed release.

[0220] The compounds of the invention may be administered rectally or vaginally, for example, in the form of a suppository, pessary, or enema. Cocoa butter is a traditional suppository base, but various alternatives may be used as appropriate.

[0221] Formulations for rectal/vaginal administration may be formulated to be immediate and/or modified release. Modified release formulations include delayed-, sustained-, pulsed-, controlled-, targeted and programmed release.

[0222] The compounds of the invention may also be administered directly to the eye or ear, typically in the form of drops of a micronised suspension or solution in isotonic, pH-adjusted, sterile saline. Other formulations suitable for ocular and aural administration include ointments, gels, biodegradable (e.g. absorbable gel sponges, collagen) and non-biodegradable (e.g. silicone) implants, wafers, lenses and particulate or vesicular systems, such as niosomes or liposomes. A polymer such as crossed-linked polyacrylic acid, polyvinylalcohol, hyaluronic acid, a cellulosic polymer, for example, hydroxypropylmethylcellulose, hydroxyethylcellulose, or methyl cellulose, or a heteropolysaccharide polymer, for example, gelan gum, may be incorporated together with a preservative, such as benzalkonium chloride. Such formulations may also be delivered by iontophoresis.

[0223] Formulations for ocular/aural administration may be formulated to be immediate and/or modified release. Modified release formulations include delayed-, sustained-, pulsed-, controlled-, targeted, or programmed release.

[0224] The compounds of the invention may be combined with soluble macromolecular entities, such as cyclodextrin and suitable derivatives thereof or polyethylene glycol-containing polymers, in order to improve their solubility, dissolution rate, taste-masking, bioavailability and/or stability for use in any of the aforementioned modes of administration.

[0225] Drug-cyclodextrin complexes, for example, are found to be generally useful for most dosage forms and administration routes. Both inclusion and non-inclusion complexes may be used. As an alternative to direct complexation with the drug, the cyclodextrin may be used as an auxiliary additive, i.e. as a carrier, diluent, or solubiliser. Most commonly used for these purposes are alpha-, beta- and gamma-cyclodextrins, examples of which may be found in International Patent Applications Nos. WO 91/11172, WO 94/02518 and WO 98/55148.

[0226] Since the present invention has an aspect that relates to the treatment of the disease/conditions described herein with a combination of active ingredients which may be administered separately, the invention also relates to combining separate pharmaceutical compositions in kit form. The kit comprises two separate pharmaceutical compositions: a compound of Formulae Ia, Ib, Ic or Id, and a second compound as described above. The kit comprises means for containing the separate compositions such as a container, a divided bottle or a divided foil packet. Typically the kit comprises directions for the administration of the separate components. The kit form is particularly advantageous when the separate components are preferably administered in different dosage forms (e.g., oral and parenteral), are administered at different dosage intervals, or when titration of the individual components of the combination is desired by the prescribing physician.

[0227] An example of such a kit is a so-called blister pack. Blister packs are well known in the packaging industry and are being widely used for the packaging of pharmaceutical unit dosage forms (tablets, capsules, and the like). Blister packs generally consist of a sheet of relatively stiff material covered with a foil of a preferably transparent plastic material. During the packaging process recesses are formed in the plastic foil. The recesses have the size and shape of the tablets or capsules to be packed. Next, the tablets or capsules are placed in the recesses and the sheet of relatively stiff material is sealed against the plastic foil at the face of the foil which is opposite from the direction in which the recesses were formed. As a result, the tablets or capsules are sealed in the recesses between the plastic foil and the sheet. Preferably the strength of the sheet is such that the tablets or capsules can be removed from the blister pack by manually applying pressure on the recesses whereby an opening is formed in the sheet at the place of the recess. The tablet or capsule can then be removed via said opening.

[0228] It may be desirable to provide a memory aid on the kit, e.g., in the form of numbers next to the tablets or capsules whereby the numbers correspond with the days of the regimen which the tablets or capsules so specified should be ingested. Another example of such a memory aid is a calendar printed on the card, e.g., as follows First Week, Monday, Tuesday, etc. . . . Second Week, Monday, Tuesday, . . . etc. Other variations of memory aids will be readily apparent. A daily dose can be a single tablet or capsule or several pills or capsules to be taken on a given day. Also, a daily dose of Formulae Ia, Ib, Ic or Id, compound can consist of one tablet or capsule while a daily dose of the second compound can consist of several tablets or capsules and vice versa. The memory aid should reflect this.

[0229] In another specific embodiment of the invention, a dispenser designed to dispense the daily doses one at a time in the order of their intended use is provided. Preferably, the dispenser is equipped with a memory-aid, so as to further facilitate compliance with the regimen. An example of such a memory-aid is a mechanical counter which indicates the number of daily doses that has been dispensed. Another example of such a memory-aid is a battery-powered micro-chip memory coupled with a liquid crystal readout, or audible reminder signal which, for example, reads out the date that the last daily dose has been taken and/or reminds one when the next dose is to be taken.

[0230] All publications, including but not limited to, issued patents, patent applications, and journal articles, cited in this application are each herein incorporated by reference in their entirety.

[0231] Although the invention has been described above with reference to the disclosed embodiments, those skilled in the art will readily appreciate that the specific experiments detailed below are only illustrative of the invention. It should be understood that various modifications can be made without departing from the spirit of the invention. Accordingly, the invention is limited only by the claims.

EXAMPLES

[0232] Synthesis of Ganaxolone Phosphate and Salts

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[0233] Synthesis Dibenzylphosphate 1

[0234] A solution of Ganaxolone (1.35 g, 4.07 mmol), 5-methyl-1H-tetrazole (1.5 g, 17.8 mmol), dibenzyl diisopropyl phosphoramidite (4.1 g, 11.8 mmol) in dichloromethane (20 mL) was stirred at ambient temperature under nitrogen for 4 hours. The mixture was then cooled to 10 C., and a solution of m-chloroperoxybenzoic acid (4.3 g, 75% w/w, 18.6 mmol) was added, maintaining the internal temperature below 0 C. The resulting mixture was allowed to warm to ambient temperature for 1 hour. The mixture was then diluted with dichloromethane (30 mL), and washed with cold 10% aqueous sodium metabisulfite (220 mL), 10% sodium bicarbonate (220 mL), cold water (20 mL, and cold brine (20 mL). The solution was dried over MgSO.sub.4, the solvent was removed at ambient temperature. Purification by flash chromatography (EtOAc:hexane 1:4 to 1:2) gave 750 mg (31%) of dibenzylphosphate 2 as a colorless oil. .sup.1H NMR ppm (CDCl.sub.3): 0.58 (s, 3H), 0.70 (s, 3H), 0.58-0.63 (m, 1H), 0.78-0.90 (m, 1H), 1.03-1.75 (m, 18H), 1.50 (s, 3H), 1.95-2.03 (m, 1H), 2.10 (s, 3H), 2.1-2.2 (m, 1H), 2.50 (t, 1H), 4.95-5.05 (m, 4H), 7.25-7.39 (m, 10H).

[0235] Synthesis of Phosphate 2

[0236] To dibenzyl phosphate 1 (800 mg) dissolved in EtOH (10 ml) was added 10% Pd/C (100 mg) and hydrogen (balloon pressure) for 2 hours. The catalyst was removed through Celite filtration. The solvent was removed at ambient temperature, and the resulting material was titrated with hexane, dried to yield phosphate 2 as white solid (300 mg, 55%). .sup.1H NMR ppm (CDCl.sub.3): 0.59 (s, 3H), 0.75 (s, 3H), 0.75-0.83 (m, 1H), 0.90-1.03 (m, 1H), 1.10-1.75 (m, 18H), 1.50 (s, 3H), 1.95-2.03 (m, 1H), 2.10 (s, 3H), 2.1-2.2 (m, 1H), 2.50 (t, 1H), 4.5-5.1 (bs).

[0237] Synthesis of Disodium Salt 3

[0238] A solution of phosphate 2 (16 mg) in methanol (0.2 mL) was added with stirring to a solution of NaOMe (30% in Methanol, 14 mg, 2 eq.) in methanol (0.2 mL) at 0 C. The reaction mixture was stirred at ambient temperature for 1 hour. The solvent was then removed to give a white solid.

[0239] Synthesis of Bisaminoethanol Salt 4

[0240] A solution of phosphate 2 (18.8 mg) in methanol (0.2 mL) was added with stirring to a solution of aminoethanol (5.6 mg, 2 eq.) in methanol (0.2 mL) at 0 C. The reaction mixture was stirred at ambient temperature for 2 hours. The solvent was then removed to give an oil, which was titrated with hexane to yield an off white solid.

[0241] Biological Assays and Data

[0242] Methods for determining the activity of the compounds of the invention are well known to those skilled in the art. Examples for determining the biological activity of the compounds of the invention including pk, pd and bioavailability are described in Monaghan et. al, 1997, Epilepsia, 38(9), 1026-31; Kerrigan et al, 2000, Epilepsy Research 42, 133-9; Pieribone et al, 2007, Epilepsia, 48(10), 1870-74; Ramu et al, 2001, J. Chromatog. B, 751: 49-59; and U.S. Pat. No. 7,858,609.