ANTITHROMBOTI CONNECTIONS
The invention relates to new antithrombotic agents, a process for their preparation, pharmaceutical compositions containing the compounds as active ingredients, as well as the use of said compounds for the manufacture of medicaments. Serine proteases are enzymes which play an important role in the blood coagulation cascade. Members of this group of proteases are for example thrombin, trypsin, factors VIIa, IXa, Xa, XIa, XIIa, and protein C. Thrombin is the final serine protease enzyme in the coagulation cascade. The prime function of thrombin is the cleavage of fibrinogen to generate fibrin monomers, which are cross-linked to form an insoluble gel. In addition, thrombin regulates its own production by activation of factors V and VIII earlier in the cascade. It also has important actions at cellular level, where it acts on specific receptors to cause platelet aggregation, endothelial cell activation and fibroblast proliferation. Thus thrombin has a central regulatory role in haemostasis and thrombus formation. Since inhibitors of thrombin may have a wide range of therapeutical applications, extensive research is done in this area. Another important serine protease, factor Xa, catalyzes the conversion of prothrombin into thrombin. In the development of synthetic inhibitors of serine proteases, and more specifically of thrombin, the benzamidine moiety is one of the key structures. It mimics the protonated side-chain of the basic amino acids Arg and Lys of its natural substrates. Compounds with this moiety have been studied extensively and repeatedly. A very potent representative of this type of thrombin inhibitors is the amino acid derivative Nα-(2-naphthylsulfonyl)-glycyl-4-amidinophenylalanin-piperidide (NAPAP) ( It has now been found that compounds of the formula (I) wherein R1 is phenyl, naphthyl, 1,2,3,4-tetrahydronaphthyl, (iso)quinolinyl, tetrahydro(iso)quinolinyl, 3,4-dihydro-1H-isoquinolinyl, chromanyl or the camphor group, which groups may optionally be substituted with one or more substituents selected from (1-8C)alkyl or (1-8C)alkoxy; R2 and R3 are independently H or (1-8C)alkyl; R4 is (1-8C)alkyl or (3-8C)cycloalkyl; or R3 and R4 together with the nitrogen atom to which they are bonded are a nonaromatic (4-8)membered ring optionally containing another heteroatom, the ring optionally being substituted with (1-8C)alkyl or SO2-(1-8C)alkyl;Q is a spacer having a chain length of 10 to 70 atoms; andZ is a negatively charged oligosaccharide residue comprising two to six monosaccharide units, the charge being compensated by positively charged counterions; or a pharmaceutically acceptable salt thereof or a prodrug thereof are potent and highly versatile antithrombotics. The compounds of the invention have anti-thrombin activity, but also the structure of the compounds may be selectively modified so that they have a tuneable mixed profile of both non-mediated, direct anti-thrombin (factor IIa) activity and anti-thrombin III (AT-III) mediated anti-Xa activity. The compounds of the invention thus are dual inhibitors. Compounds of the invention have a long plasma half-life and, as a result, they possess prolonged anti-thrombin activity compared to NAPAP or its above reported derivatives. Further, compounds of the invention may escape the neutralizing action of platelet factor 4 (PF4). Low toxicity is also an advantageous aspect of compounds of this invention. Another type of dual inhibitors is disclosed in The compounds of the present invention are useful for treating and preventing thrombin-mediated and thrombin-associated diseases. This includes a number of thrombotic and prothrombotic states in which the coagulation cascade is activated which include, but are not limited to, deep vein thrombosis, pulmonary embolism, thrombophlebitis, arterial occlusion from thrombosis or embolism, arterial reocclusion during or after angioplasty or thrombolysis, restenosis following arterial injury or invasive cardiological procedures, postoperative venous thrombosis or embolism, acute or chronic atherosclerosis, stroke, myocardial infarction, cancer and metastasis, and neurodegenerative diseases. The compounds of the invention may also be used as anticoagulants in extracorporeal blood circuits, as necessary in dialysis and surgery. The compounds of the invention may also be used as The mixed profile of the compounds of the invention may be tuned by varying the nature of the oligosaccharide residue Z and the length of the spacer Q. A range of profiles is thereby available. Any negatively charged oligosaccharide residue of 2 to 6 saccharide units is useable in the compounds of the present invention. Suitable compounds of the invention are compounds wherein Z is a sulfated or phosphorylated oligosaccharide residue. Preferably, the oligosaccharide residue Z is derived from an oligosaccharide which has Further preferred compounds of the invention are compounds of formula I, wherein R1 is phenyl, 4-methoxy-2,3,6-trimethylphenyl or naphthyl. In preferred compounds, NR3R4 represents the piperidinyl group. Preferably, R2 is H. The chemical structure of the spacer is of minor or no importance for the anti-thrombotic activity of the compounds of the invention, it may however not be completely rigid. Highly flexible spacers are more suitable than others. Further, for synthetic reasons some spacers are more appropriate than others. Suitable spacers that can easily be used have for example the formula (III): -[(CH2)2O]m-[(CH2)n-NR3-C(O)]p-W-(CH2)s- (III), whereinW is -[1,4-phenylene-NR3-C(O)]q-(CH2)r-S- or -(CH2)t-S-(CH2)u-[O(CH2)2]v-O-(CH2)w-C(O)-NR3-; and R3 is independently H or (1-8C)alkyl; m = 1-12; n =1-8; p = 0-4; q = 0 or 1; r = 1-8; s = 1-8; t = 1-8; u = 1-8; v = 1-12; w = 1 - 8; the total number of atoms is 10 - 70; and the moiety -[(CH2)2O]m- is the end with which Q is attached to Z. Preferred spacers are the following: In the description of the compounds of formula (I) the following definitions are used. The term (1-8C)alkyl means a branched or unbranched alkyl group having 1-8 carbon atoms, for example methyl, ethyl, propyl, isopropyl, butyl, sec-butyl, tert-butyl, hexyl and octyl. Methyl and ethyl are preferred alkyl groups. The term (1-8C)alkoxy means an alkoxy group having 1-8 carbon atoms, the alkyl moiety having the meaning as previously defined. Methoxy is a preferred alkoxy group. The term (3-8C)cycloakyl means a cycloalkyl group having 3-8 carbon atoms, being cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl or cyclo-octyl. Cyclopentyl and cyclohexyl are preferred cycloalkyl groups. The spacer length is the number of atoms of the spacer, counted along the shortest chain between Z and the peptide part of the molecule, not counting the oxygen atom of the oligosaccharide Z which is connected to the spacer. The term "prodrug" means a compound of the invention in which the amino group of the amidino-moiety is protected, e.g. by hydroxy or a (1-6C)alkoxycarbonyl group. The compounds of the present invention are prepared by derivatizing NAPAP (or a NAPAP-analogue) at the glycine position with cysteine or lysine using methods generally known in the art, which compound subsequently (a) is coupled to a oligosaccharide-spacer residue or (b) is coupled to a spacer, which then is derivatized with a thiol group and subsequently is coupled to an oligosaccharide residue. Any suitable oligosaccharide may be used for this purpose, for example oligosaccharides known in literature (e.g. from The peptide coupling, a procedural step in the above described method to prepare the compounds of the invention, can be carried out by methods commonly known in the art for the coupling - or condensation - of peptide fragments such as by the azide method, mixed anhydride method, activated ester method, or, preferably, by the carbodiimide method, especially with the addition of catalytic and racemisation suppressing compounds like N-hydroxysuccinimide and N-hydroxybenzotriazole. An overview is given in Amine functions present in the compounds may be protected during the synthetic procedure by an N-protecting group, which means a group commonly used in peptide chemistry for the protection of an α-amino group, like the The compounds of the invention, which can occur in the form of a free base, may be isolated from the reaction mixture in the form of a pharmaceutically acceptable salt. The pharmaceutically acceptable salts may also be obtained by treating the free base of formula (I) with an organic or inorganic acid such as HCl, HBr, HI, H2SO4, H3PO4, acetic acid, propionic acid, glycolic acid, maleic acid, malonic acid, methanesulphonic acid, fumaric acid, succinic acid, tartaric acid, citric acid, benzoic acid, ascorbic acid and the like. The compounds of this invention possess chiral carbon atoms, and may therefore be obtained as a pure enantiomer, or as a mixture of enantiomers, or as a mixture containing diastereomers. Methods for obtaining the pure enantiomers are well known in the art, e.g. crystallization of salts which are obtained from optically active acids and the racemic mixture, or chromatography using chiral columns. For diastereomers straight phase or reversed phase columns may be used. The compounds of the invention may be administered enterally or parenterally. The exact dose and regimen of these compounds and compositions thereof will neccessarily be dependent upon the needs of the individual subject to whom the medicament is being administered, the degree of affliction or need and the judgment of the medical practitioner. In general parenteral administration requires lower dosages than other methods of administration which are more dependent upon absorption. However, the daily dosages are for humans preferably 0.001-100 mg per kg body weight, more preferably 0.01-10 mg per kg body weight. The medicament manufactured with the compounds of this invention may also be used as adjuvant in acute anticoagulant therapy. In such a case, the medicament is administered with other compounds useful in treating such disease states. Mixed with pharmaceutically suitable auxiliaries, e.g. as described in the standard reference, The invention is further illustrated by the following examples. Abbreviations used : The numbers of the compounds refer to the compounds on the formula sheets. To a stirred solution of maltotriose (1) (2.0 g, 4.0 mmol) in pyridine (100 mL) was added acetic anhydride (6.2 mL, 65 mmol) and a catalytic amount of DMAP (0.79 g, 6.5 mmol). After 5 h the reaction mixture was poured into aqueous sodium hydrogencarbonate (1M, 250 mL) and extracted three times with ethyl acetate (200 mL). The combined organic layers were dried on magnesium sulfate and concentrated A solution of donor 4 (0.69 g, 0.76 mmol) and acceptor 5 (0.31 g, 0.76 mmol) in dichloromethane (1.5 mL) was stirred for 1 h under a flow of argon in the presence of activated molecular sieves 4Å (250 mg). The solution was cooled to -20 °C and a solution of trimethylsilyl trifluoromethanesulfonate (15 µL) in dichloromethane (0.6 mL) was added dropwise to the reaction mixture. After 10 min, TLC analysis (5% methanol in dichloromethane) showed the presence of one product. Solid sodium hydrogencarbonate (0.3 g) was added to the reaction mixture, which was stirred for 10 min and then filtrated. The filtrate was diluted with dichloromethane (50 mL), subsequently washed with aqueous sodium hydrogencarbonate (1 M, 2 x 25 mL), dried (magnesium sulfate), and concentrated Compound 6 (0.57 g, 0.43 mmol) was treated with a solution of potassium A solution of 1 Compound 9 (311 mg, 87 µmol) was dissolved in To a stirred mixture of commercially available A solution of trifluoroacetic acid and triisopropylsilane in dichloromethane (1/1/18, v/v/v) was added to compound 12 (0.44 g, 0.76 mmol). After stirring for 20 min, the mixture was poured into water and extracted with dichloromethane (2 x 50 mL). The combined organic layers were dried on magnesium sulfate and concentrated To a solution of To a solution of maltotriose-decaphosphate 18 (21 mg, 9.8 µmol) in 0.1 M Na2HPO4 buffer (1.0 mL, pH 7.5) was added a solution of Diastereoisomer I-a:1H NMR (D2O, 600 MHz, HH-COSY): Diastereoisomer I-b:1H NMR (D2O, 600 MHz, HH-COSY): Spacer 20 (0.75, 2.4 mmol) ( Prepared as described for 12, using 23 and benzenesulfonyl chloride as starting materials. (0.86 g, 75% yield). Compound 24 (0.86 g, 2.2 mmol) was treated with 3 N hydrogen chloride in ethyl acetate. After 15 min the reaction mixture was concentrated Prepared as described for 16, using 26 and 15 as starting materials. (87 mg, 70% yield). Prepared as described for I, using 18 and 27 as starting materials. Purification of the crude II was effected by semi-preparative HPLC (LiChrospher® RP-18 column). Subsequent desalting by gel filtration (Sephadex G-25 DNA-grade Superfine), transformation into the Na+-form using Dowex 50 WX4-Na+ ion exchange resin and lyophilization afforded pure II as a white fluffy solid (8.5 mg, 23% yield from 18).1H NMR (D2O, 600 MHz, HH-COSY): Known pentasaccharide 29 (53 mg, 49 µmol) ( Compound 30 (54 mg, 45 µmol) was dissolved in dimethylformamide (1 mL). Triethylamine sulfurtrioxide complex (0.51 g, 5 equiv for each hydroxyl group) was added and the mixture was stirred under a nitrogen atmosphere at 55 °C for 16 h. The mixture was subsequently cooled to 0 °C and aqueous sodium hydrogen carbonate was added (5 equiv for each eq. of triethylamine sulfurtrioxide complex). The mixture was stirred for 1 h, concentrated to a small volume and applied onto a Sephadex G-25 column, which was eluted with 10 % acetonitril in water. The appropriate fractions were pooled and concentrated to a small volume, which was subsequently passed through a column of Dowex 50 WX4 (Na+ form) eluted with water. The eluate was concentrated and redissolved in 0.2 N hydrogen chloride (1 mL) and allowed to stand for 16 h at 4 °C. The reaction mixture was neutralized with 0.1 N sodium hydroxide and desalted on a Sephadex G-25 column and eluted with 10 % acetonitril in water to afford homogeneous 31. Compound 31 was dissolved in Pentasaccharide 32 (15 mg, 6.5 µmol) was dissolved in 0.1 M NaH2PO4 buffer (2 mL, pH 7.5) and to this solution was added Using similar methods, the following compounds are prepared: The biological activities of the compounds of the present invention were determined by the following test methods. Trombin (Factor IIa) is a factor in the coagulation cascade. The anti-thrombin activity of compounds of the present invention was assessed by measuring spectrophotometrically the rate of hydrolysis of the chromogenic substrate s-2238 exterted by thrombin. This assay for anti-thrombin activity in a buffer system was used to assess the IC50-value of a test compound. For each final concentration the maximum absorbance was calculated from the assay plot. The IC50-value (final concentration, expressed in µmol·1-1, causing 50% inhibition of the maximum absorbance of the blank) was calculated using the logit transformation analysis according to Activated Factor X (Xa) is a factor in the coagulation cascade. The anti-Xa activity of compounds of the present invention was assessed by measuring spectrophotometrically the rate of hydrolysis of the chromogenic substrate s-2222 exterted by Xa. This assay for anti-Xa activity in a buffer system was used to assess the IC50-value of the test compound. In general the followed procedure and test conditions were analogous to those of the anti-thrombin assay as described above. Differences are indicated below. The present invention relates to compounds of formula (I), wherein R1 is phenyl, naphthyl, 1,2,3,4-tetrahydronaphthyl, (iso)quinolinyl, tetrahydro(iso)quinolinyl, 3,4-dihydro-1H-isoquinolinyl, chromanyl or the camphor group, which groups may optionally be substituted with one or more substitutents selected from (1-8C)alkyl or (1-8C)alkoxy; R2 and R3 are independently H or (1-8C)alkyl; R4 is (1-8C)alkyl or (3-8C)cycloalkyl; or R3 and R4 together with the nitrogen atom to which they are bonded are a nonaromatic (4-8)membered ring optionally containing another heteroatom, the ring optionally being substituted with (1-8C)alkyl or SO2-(1-8C)alkyl; Q is a spacer having a chain length of 10 to 70 atoms; and Z is a negatively charged oligosaccharide residue comprising two to six monosaccharide units, the charge being compensated by positively charged counterions; or a pharmaceutically acceptable salt thereof or a prodrug thereof. The compounds of the invention have antithrombotic activity an can be used in treating or preventing thrombin-related diseases. A compound of the formula (I)
wherein R1 is phenyl, naphthyl, 1,2,3,4-tetrahydronaphthyl, (iso)quinolinyl, tetrahydro(iso)quinolinyl, 3,4-dihydro-1H-isoquinolinyl, chromanyl or the camphor group, which groups may optionally be substituted with one or more substituents selected from (1-8C)alkyl or (1-8C)alkoxy;
R2 and R3 are independently H or (1-8C)alkyl;
R4 is (1-8C)alkyl or (3-8C)cycloalkyl;
or R3 and R4 together with the nitrogen atom to which they are bonded are a nonaromatic (4-8)membered ring optionally containing another heteroatom, the ring optionally being substituted with (1-8C)alkyl or SO2-(1-8C)alkyl;Q is a spacer having a chain length of 10 to 70 atoms; andZ is a negatively charged oligosaccharide residue comprising two to six monosaccharide units, the charge being compensated by positively charged counterions;
or a pharmaceutically acceptable salt thereof or a derivative thereof in which the amino group of the amidino-moiety is protected, e.g. by hydroxy or a (1-6C)-alkoxycarbonyl group. The compound of claim 1, wherein Z is derived from an oligosaccharide which has per se AT-III mediated anti-Xa activity. The compound of claim 2, wherein Z is a pentasaccharide residue. The compound of claim 3, wherein Z has the formula (II)
wherein R5 is independently OSO3- or (1-8C)alkoxy. The compound of any one of claims 1 to 4, wherein R1 is phenyl, 4-methoxy-2,3,6-trimethylphenyl or naphthyl; R2 is H;
and NR3R4 represents the piperidinyl group. The compound of any one of claims 1 to 5, wherein Q has the formula (III)
-[(CH2)2O]m-[(CH2)m-NR3-C(O)]p-W-(CH2)s- (III),
whereinW is -[1,4-phenylene-NR3-C(O)]q-(CH2)r-S-
or
-(CH2)t-S-(CH2)u-[O(CH2)2]v-O-(CH2)w-C(O)-NR3-;
and R3 is independently H or (1-8C)alkyl;
m= 1-12; n= 1-8; p= 0-4; q = 0 or 1; r= 1-8; s= 1-8; t= 1-8; u= 1-8; v= 1-12; w = 1 - 8; the total number of atoms is 10 - 70; and the moiety -[(CH2)2O]m- is the end with which Q is attached to Z. The compound of claim 6, wherein Q is selected from
- [(CH2)2O]5-(CH2)2-NH-C(O)-CH2-S-CH2-;- [(CH2)2O]5-(CH2)2-NH-C(O)-CH2-S-(CH2)2-[O(CH2)2]3-O-CH2-C(O)-NH-(CH2)4-; and- [(CH2)2O]3-(CH2)2-NH-C(O)-1,4-phenylene-NH-C(O)-CH2-S-CH2-. A pharmaceutical composition comprising the compound of any one of claims 1 to 7 and pharmaceutically suitable auxiliaries. The compound of any one of claims 1 to 7 for use in therapy. Use of the compound of any one of claims 1 to 7 for the manufacture of a medicament for treating or preventing thrombosis or other thrombin-related diseases.EXAMPLES
4-
1-Aminohexaethylene glycol 4-
Condensation coupling of maltotriose-decaphosphate 18 with peptide 16
N
Condensation coupling of maltotriose-decaphosphate 18 with peptide 27 (II)
Partially protected pentasaccharide 30
Sulfated pentasaccharide 32
Condensation coupling of pentasaccharide 32 with peptide 16
I. Anti-thrombin assay
Test medium: Trommethamine-NaCl-polyethylene glycol 6000 (TNP) buffer Reference compound: I2581 (Kaki) Vehicle: TNP buffer. Solubilisation can be assisted with dimethylsulphoxide, methanol, ethanol, acetonitrile or tert.-butyl alcohol which are without adverse effects in concentrations up to 2.5% in the final reaction mixture. Technique Reagents* 1. Tromethamine-NaCl (TN) buffer Composition of the buffer: Tromethamine (Tris) 6.057 g g (50 mmol) NaCl 5.844 g g (100 mmol) Water to 1 1 The pH of the solution is adjusted to 7.4 at 37°C with HCl (10 mmol·l-1). 2. TNP buffer Polyethylene glycol 6000 is dissolved in TN buffer to give a concentration of 3 g·l-1 3. S-2238 solution One vial S-2238 (25 mg; Kabi Diagnostica, Sweden) is dissolved in 20 ml TN buffer to give a concentration of 1.25 mg·ml-1 (2 mmol·l-1). 4. Thrombin solution Human thrombin (16 000 nKat·vial-1; Centraal Laboratorium voor Bloedtransfusie, Amsterdam, The Netherlands) is dissolved in TNP buffer to give a stock solution of 835 nKat·ml-1. Immediately before use this solution is diluted with TNP buffer to give a concentration of 3.34 nKat·ml-1. * - All ingredients used are of analytical grade - For aqueous solutions ultrapure water (Milli-Q quality) is used. Preparation of test and reference compound solutions The test and reference compounds are dissolved in Milli-Q water to give stock concentrations of 10-2 mol·l-1. Each concentration is stepwise diluted with the vehicle to give concentrations of 10-3, 10-4 and 10-5 mol·l-1. The dilutions, including the stock solution, are used in the assay (final concentrations in the reaction mixture: 3·10-3; 10-3; 3·10-4; 10-4; 3·10-5; 10-5; 3·10-6 and 10-6 mol·l-1 , respectively). Procedure At room temperature 0.075 ml and 0.025 ml test compound or reference compound solutions or vehicle are alternately pipetted into the wells of a microtiter plate and these solutions are diluted with 0.115 ml and 0.0165 ml TNP buffer, respectively. An aliquot of 0.030 ml S-2238 solution is added to each well and the plate is pre-heated and pre-incubated with shaking in an incubator (Amersham) for 10 min. at 37 °C. Following preincubation the hydrolysis of S-2238 is started by addition of 0.030 ml thrombin solution to each well. The plate is incubated (with shaking for 30 s) at 37 °C. Starting after 1 min of incubation, the absorbance of each sample at 405 nm is measured every 2 min. for a period of 90 min. using a kinetic microtiter plate reader (Twinreader plus, Flow Laboratories). All data are collected in an IBM personal computer using LOTUS-MEASURE. For each compound concentration (expressed in mol·l-1 reaction mixture) and for the blank the absorbance is plotted versus the reaction time in min. Evaluation of responses:
Antithrombin activity:
I (one diastereomer) 2 x 10-7 II 8 x 10-6 III 3.5 x 10-7 II. Anti-factor Xa assay
Reference compound: benzamidine Vehicle: TNP buffer. Solubilisation can be assisted with dimethylsulphoxide, methanol, ethanol, acetonitrile or tert.-butyl alcohol which are without adverse effects in concentrations up to 1% (for DMSO) and 2.5% (for the other solvents) in the final reaction mixture. Technique Reagents* 3. S-2222 solution One vial S-2222 (15 mg; Kabi Diagnostica, Sweden) is dissolved in 10 ml water to give a concentration of 1.5 mg·ml-1 (2 mmol·l-1). 4. Xa solution Bovine Factor Xa Human (71 nKat·vial-1; Kabi Diagnostica) is dissolved in 10 ml TNP buffer and then further diluted with 30 ml TNP buffer to give a concentration of 1.77 nKat·ml-1. The dilution has to be freshly prepared. Procedure Instead of the S-2238 solution (in anti-thrombin assay), the above S-2222 solution is added to each well in this assay. Anti-factor Xa activity
III 885