Compositions comprising pgi2-receptor agonists and processes for the preparation thereof

A method for the treatment of pulmonary arterial hypertension (PAH) in an individual, comprising:

• administering to the individual in need thereof a dose of Compound 1 sufficient to achieve in the individual a blood plasma concentration of Compound 1 of at least about 2.5 ng/mL.

A method for the treatment of a PGI2 receptor mediated disorder in an individual, comprising:

• administering to the individual in need thereof a dose of Compound 1 or a pharmaceutically acceptable salt, solvate, or hydrate thereof sufficient to achieve in the individual a blood plasma concentration of Compound 1 of at least about 5 ng/mL.

A method for the treatment of pulmonary arterial hypertension (PAH) in an individual, comprising:

• administering to the individual in need thereof a dose of Compound 1 sufficient to achieve in the individual a blood plasma concentration of Compound 1 of at least about 5 ng/mL.

A method for selecting a dose of Compound 1 for an individual with pulmonary arterial hypertension (PAH), comprising:

• determining the blood plasma level of Compound 1 in the individual;
• and
• increasing the dose of Compound 1 to the individual until a threshold blood plasma level is reached.

A method for selecting a dose of Compound 1 for an individual with pulmonary arterial hypertension (PAH), comprising:

• determining the blood plasma level of Compound 1 in the individual;
• and
• maintaining the dose of Compound 1 to the individual if a threshold blood plasma level has been reached.

A method for selecting a dose of Compound 1 for an individual with pulmonary arterial hypertension (PAH), comprising:

• determining the blood plasma level of Compound 1 in the individual;
• and
• decreasing the dose of Compound 1 to the individual if a threshold blood plasma level has been exceeded.

The method of any one of the preceding claims, wherein the blood plasma concentration of Compound 1 is at least, or at least about, 3.0, 3.1, 3.2, 3.25, 3.3, 3.4, 3.5, 3.6, 3.7, 3.75, 3.8, 3.9, 4.0, 4.1, 4.2, 4.25, 4.3, 4.4, 4.5, 4.6, 4.7, 4.75, 4.8, 4.9, 5.0, 5.1, 5.2, 5.25, 5.3, 5.4, 5.5, 5.6, 5.7, 5.75, 5.8, 5.9, 6.0, 6.1, 6.2, 6.25, 6.3, 6.4, 6.5, 6.6, 6.7, 6.75, 6.8, 6.9, 7.0, 7.1, 7.2, 7.25, 7.3, 7.4, 7.5, 7.6, 7.7, 7.75, 7.8, 7.9, 8.0, 8.1, 8.2, 8.25, 8.3, 8.4, 8.5, 8.6, 8.7, 8.75, 8.8, 8.9, 9.0, 9.1, 9.2, 9.25, 9.3, 9.4, 9.5, 9.6, 9.7, 9.75, 9.8, 9.9, or 10 ng/mL.

The method of any one of the preceding claims, wherein the blood plasma concentration of Compound 1 is, or is about 3.0, 3.1, 3.2, 3.25, 3.3, 3.4, 3.5, 3.6, 3.7, 3.75, 3.8, 3.9, 4.0, 4.1, 4.2, 4.25, 4.3, 4.4, 4.5, 4.6, 4.7, 4.75, 4.8, 4.9, or 5.0 ng/mL.

The method of any one of the preceding claims, wherein the threshold blood plasma level of Compound 1 is selected from, or from about:

• 1, 1.1, 1.2, 1.25, 1.3, 1.4, 1.5, 1.6, 1.7, 1.75, 1.8, 1.9, 2, 2.1, 2.2, 2.25, 2.3, 2.4, 2.5, 2.6, 2.7, 2.75, 2.8, 2.9, 3, 3.1, 3.2, 3.25, 3.3, 3.4, 3.5, 3.6, 3.7, 3.75, 3.8, 3.9, 4, 4.1, 4.2, 4.25, 4.3, 4.4, 4.5, 4.6, 4.7, 4.75, 4.8, 4.9, 5, 5.1, 5.2, 5.25, 5.3, 5.4, 5.5, 5.6, 5.7, 5.75, 5.8, 5.9, 6, 6.25, 6.5, 6.75, 7, 7.25, 7.5, 7.75, 8, 8.25, 8.5, 8.75, 9, 9.25, 9.5, 9.75, and 10 ng/ml.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is selected from, or from about, 0.01 mg, 0.02 mg, 0.025 mg, 0.03 mg, 0.04 mg, 0.05 mg, 0.06 mg, 0.065 mg, 0.07 mg, 0.075 mg, 0.08 mg, 0.09 mg, 0.1 mg, 0.12 mg, 0.15 mg, 0.16 mg, 0.2 mg, 0.25 mg, 0.3 mg, 0.35 mg, 0.4 mg, 0.45 mg, 0.5 mg, 0.55 mg, 0.6 mg, 0.65 mg, 0.7 mg, 0.75 mg, 0.8 mg, 0.85 mg, 0.9 mg, 0.95 mg, 1.0 mg, 1.05 mg, 1.1 mg, 1.15 mg, 1.2 mg, 1.25 mg, 1.3 mg, 1.35 mg, 1.4 mg, 1.45, and 1.5 mg daily.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is a starting dose selected from, or from about, 0.01, 0.02, 0.025, 0.03, 0.04, 0.05, 0.06, 0.07, 0.075, 0.08, 0.09, and 0.1 mg daily.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is a highest tolerated dose selected from, or from about, 0.4 mg, 0.45 mg, 0.5 mg, 0.55 mg, 0.6 mg, 0.65 mg, 0.7 mg, 0.75 mg, 0.8 mg, 0.85 mg, 0.9 mg, 0.95 mg, 1.0 mg, and 1.05 mg, 1.1 mg, 1.15 mg, 1.2 mg, 1.25 mg, 1.3 mg, 1.35 mg, 1.4 mg, 1.45, and 1.5 mg daily.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is a maximum dose selected from, or from about, 0.4 mg, 0.45 mg, 0.5 mg, 0.55 mg, 0.6 mg, 0.65 mg, 0.7 mg, 0.75 mg, 0.8 mg, 0.85 mg, 0.9 mg, 0.95 mg, 1.0 mg, 1.05 mg, 1.1 mg, 1.15 mg, 1.2 mg, 1.25 mg, 1.3 mg, 1.35 mg, 1.4 mg, 1.45, and 1.5 mg daily.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is a maximum tolerated dose selected from, or from about, 0.4 mg, 0.45 mg, 0.5 mg, 0.55 mg, 0.6 mg, 0.65 mg, 0.7 mg, 0.75 mg, 0.8 mg, 0.85 mg, 0.9 mg, 0.95 mg, 1.0 mg 1.05 mg, 1.1 mg, 1.15 mg, 1.2 mg, 1.25 mg, 1.3 mg, 1.35 mg, 1.4 mg, 1.45, and 1.5 mg daily.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is a maintenance dose selected from, or from about, 0.01 mg, 0.02 mg, 0.025 mg, 0.03 mg, 0.04 mg, 0.05 mg, 0.06 mg, 0.065 mg, 0.07 mg, 0.075 mg, 0.08 mg, 0.09 mg, 0.1 mg, 0.12 mg, 0.15 mg, 0.16 mg, 0.2 mg, 0.25 mg, 0.3 mg, 0.35 mg, 0.4 mg, 0.45 mg, 0.5 mg, 0.55 mg, 0.6 mg, 0.65 mg, 0.7 mg, 0.75 mg, 0.8 mg, 0.85 mg, 0.9 mg, 0.95 mg, 1.0 mg, 1.05 mg, 1.1 mg, 1.15 mg, 1.2 mg, 1.25 mg, 1.3 mg, 1.35 mg, 1.4 mg, 1.45, and 1.5 mg daily.

The method of any one of the preceding claims, wherein the threshold blood plasma level is a peak blood plasma level.

The method of any one of the preceding claims, wherein the threshold blood plasma level is a trough blood plasma level.

The method of any one of the preceding claims, wherein the threshold blood plasma level is a peak blood plasma level and a trough blood plasma level.

The method of any one of the preceding claims, wherein the threshold blood plasma level is:

• a peak blood plasma level of, of about, of at least, or of at least about, 3.0, 3.1, 3.2, 3.25, 3.3, 3.4, 3.5, 3.6, 3.7, 3.75, 3.8, 3.9, 4.0, 4.1, 4.2, 4.25, 4.3, 4.4, 4.5, 4.6, 4.7, 4.75, 4.8, 4.9, 5.0, 5.1, 5.2, 5.25, 5.3, 5.4, 5.5, 5.6, 5.7, 5.75, 5.8, 5.9, 6.0, 6.1, 6.2, 6.25, 6.3, 6.4, 6.5, 6.6, 6.7, 6.75, 6.8, 6.9, 7.0, 7.1, 7.2, 7.25, 7.3, 7.4, 7.5, 7.6, 7.7, 7.75, 7.8, 7.9, 8.0, 8.1, 8.2, 8.25, 8.3, 8.4, 8.5, 8.6, 8.7, 8.75, 8.8, 8.9, 9.0, 9.1, 9.2, 9.25, 9.3, 9.4, 9.5, 9.6, 9.7, 9.75, 9.8, 9.9, or 10 ng/mL;
• and
• a trough blood plasma level of, of about, of at least, or of at least about, 2.0, 2.1, 2.2, 2.25, 2.3, 2.4, 2.5, 2.6, 2.7, 2.75, 2.8, 2.9, 3.0, 3.1, 3.2, 3.25, 3.3, 3.4, 3.5, 3.6, 3.7, 3.75, 3.8, 3.9, 4.0, 4.1, 4.2, 4.25, 4.3, 4.4, 4.5, 4.6, 4.7, 4.75, 4.8, 4.9, 5.0, 5.1, 5.2, 5.25, 5.3, 5.4, 5.5, 5.6, 5.7, 5.75, 5.8, 5.9, 6.0, 6.1, 6.2, 6.25, 6.3, 6.4, 6.5, 6.6, 6.7, 6.75, 6.8, 6.9, 7.0, 7.1, 7.2, 7.25, 7.3, 7.4, 7.5, 7.6, 7.7, 7.75, 7.8, 7.9, 8.0, 8.1, 8.2, 8.25, 8.3, 8.4, 8.5, 8.6, 8.7, 8.75, 8.8, 8.9, 9.0, 9.1, 9.2, 9.25, 9.3, 9.4, 9.5, 9.6, 9.7, 9.75, 9.8, 9.9, or 10 ng/mL.

The method of any one of the preceding claims, wherein the threshold blood plasma level is:

• a peak blood plasma level of, of about, or of at least about, 2.5 ng/mL;
• and
• a trough blood plasma level of, of about, or of at least of about, 2.5 ng/mL.

The method of any one of the preceding claims, wherein the threshold blood plasma level is:

• a peak blood plasma level of, of about, or of at least about, 5 ng/mL;
• and
• a trough blood plasma level of, of about, or of at least of about, 2.5 ng/mL.

The method of any one of the preceding claims, wherein the threshold blood plasma level is:

• a peak blood plasma level of, or of about, 5 ng/mL;
• and
• a trough blood plasma level of, or of about, 2.5 ng/mL.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises a first excipient and a second excipient, wherein the first excipient comprises hydroxypropyl methylcellulose having a viscosity of about 2300 mPA seconds to about 3800 mPA seconds when present in an amount of about 2% in water at 20° C. and the second excipient comprises hydroxypropyl methylcellulose having a viscosity of about 75 mPA seconds to about 120 mPA seconds when present in an amount of about 2% in water at 20° C.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises a first excipient and a second excipient, wherein the first excipient comprises a release modifier having a viscosity of about 2300 mPA seconds to about 3800 mPA seconds when present in an amount of about 2% in water at 20° C. and the second excipient comprises a release modifier having a viscosity of about 75 mPA seconds to about 120 mPA seconds when present in an amount of about 2% in water at 20° C.

The method of any one of the preceding claims, wherein the first excipient is present in an amount equal to about 5% to about 45% by weight and the second excipient is present in an amount equal to about 5% to about 45% by weight.

The method of any one of the preceding claims, wherein the first excipient is present in an amount equal to about 5% to about 45% by weight and the second excipient is present in an amount equal to about 5% to about 45% by weight.

The method of any one of the preceding claims, wherein the first excipient is present in an amount equal to about 10% to about 40% by weight and the second excipient is present in an amount equal to about 10% to about 40% by weight.

The method of any one of the preceding claims, wherein the first excipient is present in an amount equal to about 12.5% to about 37.5% by weight and the second excipient is present in an amount equal to about 12.5% to about 37.5% by weight.

The method of any one of the preceding claims, wherein the first excipient is present in an amount equal to about 25% by weight and the second excipient is present in an amount equal to about 25% by weight.

The method of any one of the preceding claims, wherein the release rate is the release rate measured with USP Apparatus 1 (baskets) at 100 rpm in 500 mL of an aqueous medium at a pH of 6.8 at a temperature of 37° C.±0.5° C.

The method of any one of the preceding claims, wherein the aqueous medium comprises sodium phosphate at a concentration of 0.05 M.

The method of any one of the preceding claims, wherein the release rate is the release rate measured with USP Apparatus 2 (paddle) at 50 rpm in 500 mL of an aqueous medium at a pH of 6.8 at a temperature of 37° C.±0.5° C.

The method of any one of the preceding claims, wherein the aqueous medium comprises sodium phosphate at a concentration of 0.05 M.

The method of any one of the preceding claims, wherein the pharmaceutical composition is a tablet comprising a core and a coating.

The method of any one of the preceding claims, wherein the core comprises hydroxypropyl methylcellulose.

The method of any one of the preceding claims, wherein the coating does not comprise hydroxypropyl methylcellulose.

The method of any one of the preceding claims, wherein the therapeutically effective amount of Compound 1 is suitable for administration to an individual once daily.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises about 0.05% by weight of Compound 1;

• about 25% by weight of hydroxypropyl methylcellulose having a viscosity of about 2300 mPA seconds to about 3800 mPA seconds when present in an amount of about 2% in water at 20° C.;
• and about 25% by weight of hydroxypropyl methylcellulose having a viscosity of about 75 mPA seconds to about 120 mPA seconds when present in an amount of about 2% in water at 20° C.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises about 0.05 mg of Compound 1;

• about 25 mg of hydroxypropyl methylcellulose having a viscosity of about 2300 mPA seconds to about 3800 mPA seconds when present in an amount of about 2% in water at 20° C.;
• and about 25 mg of hydroxypropyl methylcellulose having a viscosity of about 75 mPA seconds to about 120 mPA seconds when present in an amount of about 2% in water at 20° C.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises about 0.01 mg to about 0.8 mg of Compound 1;

• about 5 mg to about 45 mg of hydroxypropyl methylcellulose having a viscosity of about 2300 mPA seconds to about 3800 mPA seconds when present in an amount of about 2% in water at 20° C.;
• and about 5 mg to about 45 mg of hydroxypropyl methylcellulose having a viscosity of about 75 mPA seconds to about 120 mPA seconds when present in an amount of about 2% in water at 20° C.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises about 0.01 mg to about 0.8 mg of Compound 1;

• about 25 mg of hydroxypropyl methylcellulose having a viscosity of about 2300 mPA seconds to about 3800 mPA seconds when present in an amount of about 2% in water at 20° C.;
• and about 25 mg of hydroxypropyl methylcellulose having a viscosity of about 75 mPA seconds to about 120 mPA seconds when present in an amount of about 2% in water at 20° C.

The method of any one of the preceding claims, wherein the pharmaceutical composition is storage-stable.

The method of any one of the preceding claims, wherein the pharmaceutical composition is a tablet.

The method of any one of the preceding claims, wherein the tablet contains 0.05 mg, 0.25 mg, or 0.4 mg of Compound 1.

The method of any one of the preceding claims, wherein the pharmaceutical composition is a capsule.

The method of any one of the preceding claims, wherein the release rate of Compound 1 after storage of the pharmaceutical composition at 40° C. and 75% RH for at least about one month does not vary at any given dissolution time point equal or greater than 2 hours by more than about 20% of the release rate of the compound prior to storage, wherein the release rate after storage and prior to storage are each measured with USP Apparatus 1 (baskets) at 100 rpm in 500 mL of an aqueous medium at a pH of 6.8 at a temperature of 37° C.±0.5° C. wherein the aqueous medium comprises sodium phosphate at a concentration of 0.05 M.

The method of any one of the preceding claims, wherein the pharmaceutical composition comprises a first excipient and a second excipient, wherein the first excipient comprises a copolymer comprising (a) a first polyoxyethylene chain;

• (b) a poly(propylene oxide) chain bonded to the first polyoxyethylene chain;
• and (c) a second polyoxyethylene chain bonded to the poly(propylene oxide) chain;
• and the second excipient comprises an ester of a polyalcohol and a fatty acid.

The method of any one of the preceding claims, wherein the first excipient comprises Poloxamer 188.

The method of any one of the preceding claims, wherein the second excipient comprises glycerol monostearate and has a monoester content of at least about 90%.

The method of any one of the preceding claims, wherein the second excipient comprises glycerol monostearate and has a monoester content of at least about 95%.

The method of any one of the preceding claims, wherein the pharmaceutical composition is a cured composition.

The method of any one of the preceding claims, wherein the release rate is the release rate measured with USP Apparatus 2 (paddle) at 50 rpm in 500 mL of an aqueous medium at a pH of 6.8 at a temperature of 37° C.±0.5° C.

The method of any one of the preceding claims, wherein the aqueous medium comprises sodium phosphate at a concentration of 0.05 M.

The method of any one of the preceding claims, wherein the compound selected from 2-(((1r,4r)-4-(((4-chlorophenyl)(phenyl)carbamoyloxy)mcthyl)cyclohexyl)methoxy)acetic acid (Compound 1) and pharmaceutically acceptable salts, solvates, and hydrates thereof is 2-(((1r,4r)-4-(((4-chlorophenyl)(phenyl)carbamoyloxy)methyl)cyclohexyl)methoxy)acetic acid (Compound 1).

The method of any one of the preceding claims, wherein the compound is 2-(((1r,4r)-4-(((4-chlorophenyl)(phenyl)carbamoyloxy)methyl)cyclohexyl)methoxy)acetic acid (Compound 1).

The method of any one of the preceding claims, wherein the pharmaceutical composition exhibits peaks in the PXRD spectrum having the following 2θ values:

• 19.7°, 20.2°, 20.7°, 22.6°, 23.1°, and 23.7°.

A method for the treatment of a PGI2 receptor-mediated disorder in an individual, comprising:

• administering to the individual in need thereof a starting dose of Compound 1 wherein the starting dose is an amount equivalent to 0.05 mg of Compound 1 daily for about one week;
• provided that the individual tolerates the starting dose, administering an increased dose for about one week, wherein the increased dose is an amount equivalent to 0.05 mg greater than the starting dose,
• provided that the individual tolerates the increased dose, further increasing the dose.

The method of any one of the preceding claims, further comprising repeating the cycle of administering the increased dose for a period of about one week and then further increasing the dose, so long as the patient tolerates the further increased dose, until an optimized dose is administered.

A method for the treatment of pulmonary arterial hypertension (PAH) in an individual, comprising:

• administering to the individual in need thereof a starting dose of Compound 1 wherein the starting dose is an amount equivalent to 0.05 mg of Compound 1 daily for about one week;
• provided that the individual tolerates the starting dose, administering an increased dose for about one week, wherein the increased dose is an amount equivalent to 0.05 mg greater than the starting dose,
• provided that the individual tolerates the increased dose, further increasing the dose.

The method of any one of the preceding claims, further comprising repeating the cycle of administering the increased dose for a period of about one week and then further increasing the dose, so long as the patient tolerates the further increased dose, until an optimized dose is administered.

The method of any one of the preceding claims, wherein Compound 1 is titrated over about, or at least about, 9 weeks.

The method of any one of the preceding claims, wherein Compound 1 is titrated over about, or at least about, 16 weeks.