WO2024123716A1 - Inhibiteurs de kcnt1 comprenant un noyau cyclique de sulfonamide et procédés d'utilisation - Google Patents

Inhibiteurs de kcnt1 comprenant un noyau cyclique de sulfonamide et procédés d'utilisation Download PDF

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WO2024123716A1
WO2024123716A1 PCT/US2023/082400 US2023082400W WO2024123716A1 WO 2024123716 A1 WO2024123716 A1 WO 2024123716A1 US 2023082400 W US2023082400 W US 2023082400W WO 2024123716 A1 WO2024123716 A1 WO 2024123716A1
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disorder
compound
disorder associated
kcnt1
gain
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Ricardo Lira
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Praxis Precision Medicines Inc
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Praxis Precision Medicines Inc
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D513/00—Heterocyclic compounds containing in the condensed system at least one hetero ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for in groups C07D463/00, C07D477/00 or C07D499/00 - C07D507/00
    • C07D513/02—Heterocyclic compounds containing in the condensed system at least one hetero ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for in groups C07D463/00, C07D477/00 or C07D499/00 - C07D507/00 in which the condensed system contains two hetero rings
    • C07D513/04—Ortho-condensed systems
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D275/00—Heterocyclic compounds containing 1,2-thiazole or hydrogenated 1,2-thiazole rings
    • C07D275/04—Heterocyclic compounds containing 1,2-thiazole or hydrogenated 1,2-thiazole rings condensed with carbocyclic rings or ring systems
    • C07D275/06—Heterocyclic compounds containing 1,2-thiazole or hydrogenated 1,2-thiazole rings condensed with carbocyclic rings or ring systems with hetero atoms directly attached to the ring sulfur atom
    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D279/00—Heterocyclic compounds containing six-membered rings having one nitrogen atom and one sulfur atom as the only ring hetero atoms
    • C07D279/02—1,2-Thiazines; Hydrogenated 1,2-thiazines

Definitions

  • the present disclosure is generally directed to KCNT1 inhibitors comprising a sulfonamide core, as well as pharmaceutical compositions and methods of treatment involving the use of such compounds.
  • KCNT1 Potassium sodium-activated channel subfamily T member 1
  • Slack sodium -activated potassium channels known as Slack (Sequence like a calcium- activated K + channel). These channels are found in neurons throughout the brain and can mediate a sodium-activated potassium current /KNa. This delayed outward current can regulate neuronal excitability and the rate of adaption in response to maintained stimulation. Abnormal Slack activity has been associated with development of early-onset epilepsies and intellectual impairment.
  • pharmaceutical compounds that selectively regulate sodium-activated potassium channels e.g., abnormal KCNT1 or abnormal /KNa
  • KCNT1 or abnormal /KNa are useful in treating a neurological disease or disorder or a disease or condition related to excessive neuronal excitability and/or KCNT1 gain-of- function mutations.
  • Described herein are compounds and compositions useful for preventing and/or treating a disease, disorder, or condition, e.g., a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation in a gene, for example, KCNT1.
  • a disease, disorder, or condition e.g., a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation in a gene, for example, KCNT1.
  • X is chosen from -C- or -N-;
  • Ri is chosen from -H or an alkyl
  • R2 is chosen from -H, an alkyl, an alkoxy, or a halogen
  • R3 is chosen from -H, an alkyl, or a halogen; and n is 1 or 2.
  • X is -C-, and in certain embodiments, X is -N-.
  • Ri is -H, and in certain embodiments, Ri is -CH3.
  • X is -C-, n is 2 and Ri is -H, such that Formula (III) forms a benzothiazine dioxide.
  • R2 is chosen from -H, - OCH3, or -F.
  • R3 is -Cl.
  • X is chosen from -C- or -N-; Ri is chosen from -H or an alkyl; R2 is chosen from -H, an alkoxy, or a halogen; R3 is a halogen; n is 1 or 2.
  • the compound of Formula (III) having a sulfonamide core is chosen from:
  • composition comprising any of the compounds described herein, or a pharmaceutically acceptable salt thereof, and at least one pharmaceutically acceptable excipient.
  • a method of treating a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation of a gene comprising administering to a subject in need thereof an effective amount of any of the compounds described herein or a pharmaceutically acceptable salt thereof, or pharmaceutical compositions described herein comprising such compounds or a pharmaceutically acceptable salt thereof.
  • the method provided involves treating a disorder associated with a gain-of-function mutation of KCNT1.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is epilepsy, an epilepsy syndrome, or an encephalopathy.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is a genetic or pediatric epilepsy or a genetic or pediatric epilepsy syndrome.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is a cardiac dysfunction.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is chosen from epilepsy or other encephalopathies (e.g., malignant migrating focal seizures of infancy (MMFSI) or epilepsy of infancy with migrating focal seizures (EIMFS), autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE), West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, Lennox-Gastaut syndrome, seizures (e.g., Generalized tonic clonic seizures, Asymmetric Tonic Seizures), leukodystrophy, leukoencephalopathy, intellectual disability, Multifocal Epilepsy, Drug resistant epilepsy, Temporal lobe epilepsy, or cerebellar ataxia).
  • epilepsy or other encephalopathies e.g., malignant migrating focal
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is chosen from cardiac arrhythmia, Brugada syndrome, or myocardial infarction.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is selected from pain and related conditions (e.g., neuropathic pain, acute/chronic pain, migraine).
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is a muscle disorder (e.g., myotonia, neuromyotonia, cramp muscle spasms, spasticity).
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is selected from itch and pruritis, ataxia, or cerebellar ataxias.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is a psychiatric disorder (e.g., major depression, anxiety, bipolar disorder, schizophrenia).
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation in a gene is chosen from a learning disorder, Fragile X, neuronal plasticity, or an autism spectrum disorder.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation of a gene is chosen from epileptic encephalopathy with SCN1A, SCN2A, and/or SCN8A mutations, early infantile epileptic encephalopathy, Dravet syndrome, Dravet syndrome with SCN1A mutation, generalized epilepsy with febrile seizures, intractable childhood epilepsy with generalized tonic- clonic seizures, infantile spasms, benign familial neonatal-infantile seizures, SCN2A epileptic encephalopathy, focal epilepsy with SCN3A mutation, cryptogenic pediatric partial epilepsy with SCN3A mutation, SCN8A epileptic encephalopathy, Rasmussen encephalitis, malignant migrating partial seizures of infancy, autosomal dominant nocturnal frontal lobe epilepsy, KCNQ2 epileptic ence
  • compositions useful for preventing and/or treating a disease, disorder, or condition described herein e.g., a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of- function mutation in a gene (e.g., KCNT1).
  • a disease, disorder, or condition described herein e.g., a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of- function mutation in a gene (e.g., KCNT1).
  • Exemplary diseases, disorders, or conditions include epilepsy and other encephalopathies (e g., MMFSI or EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, Lennox-Gastaut syndrome, seizures, leukodystrophy, leukoencephalopathy, Intellectual disability, Multifocal Epilepsy, Generalized tonic clonic seizures, Drug resistant epilepsy, Temporal lobe epilepsy, cerebellar ataxia, Asymmetric Tonic Seizures); cardiac dysfunctions (e.g., cardiac arrhythmia, Brugada syndrome, or myocardial infarction); pain and related conditions (e.g., neuropathic pain, acute/chronic pain, migraine, etc.), muscle disorders (e.g., myotonia, neuromyotonia, cramp muscle spasms, spasticity); itch and pruritis; ataxia and cere
  • ranges excluding either or both of those included limits are also included in the disclosure.
  • two opposing and open-ended ranges are provided for a feature, and in such description it is envisioned that combinations of those two ranges are provided herein.
  • a feature is greater than about 10 units, and it is described (such as in another sentence) that the feature is less than about 20 units, and thus, the range of about 10 units to about 20 units is described herein.
  • analogue means one analogue or more than one analogue.
  • CM alkyl is intended to encompass, Ch, C2, C3, C4, C5, Ch, C1-6, Ci-
  • Alkyl refers to a radical of a straight-chain or branched saturated hydrocarbon group, e.g., having 1 to 20 carbon atoms (“C1-20 alkyl”). In some embodiments, an alkyl group has 1 to 10 carbon atoms (“C1-10 alkyl”). In some embodiments, an alkyl group has 1 to. 9 carbon atoms (“C1.9 alkyl”). In some embodiments, an alkyl group has 1 to 8 carbon atoms (“Ci-s alkyl”). In some embodiments, an alkyl group has 1 to 7 carbon atoms (“C1-7 alkyl”). In some embodiments, an alkyl group has 1 to 6 carbon atoms (“C1-6 alkyl”).
  • an alkyl group has 1 to 5 carbon atoms (“C1-5 alkyl”). In some embodiments, an alkyl group has 1 to 4 carbon atoms alkyl”). In some embodiments, an alkyl group has 1 to 3 carbon atoms (“C1-3 alkyl”). In some embodiments, an alkyl group has 1 to 2 carbon atoms (“C1-2 alkyl”). In some embodiments, an alkyl group has 1 carbon atom (“Ci alkyl”). Examples of C1-6 alkyl groups include methyl, ethyl, propyl, isopropyl, butyl, isobutyl, pentyl, hexyl, and the like.
  • alkenyl refers to a radical of a straight-chain or branched hydrocarbon group having from 2 to 20 carbon atoms, one or more carbon-carbon double bonds (e.g., 1, 2, 3, or 4 carbon-carbon double bonds), and optionally one or more carbon-carbon triple bonds (e.g., 1, 2, 3, or 4 carboncarbon triple bonds) (“C2-20 alkenyl”). In certain embodiments, alkenyl does not contain any triple bonds. In some embodiments, an alkenyl group has 2 to 10 carbon atoms (“C2-10 alkenyl”). In some embodiments, an alkenyl group has 2 to 9 carbon atoms (“C2-9 alkenyl”).
  • an alkenyl group has 2 to 8 carbon atoms (“C2-8 alkenyl”). In some embodiments, an alkenyl group has 2 to 7 carbon atoms (“C2-7 alkenyl”). In some embodiments, an alkenyl group has 2 to 6 carbon atoms (“C2-6 alkenyl”). In some embodiments, an alkenyl group has 2 to 5 carbon atoms (“C2-5 alkenyl”). In some embodiments, an alkenyl group has 2 to 4 carbon atoms (“C2-4 alkenyl”). In some embodiments, an alkenyl group has 2 to 3 carbon atoms (“C2-3 alkenyl”). In some embodiments, an alkenyl group has 2 carbon atoms (“C2 alkenyl”).
  • the one or more carbon-carbon double bonds can be internal (such as in 2-butenyl) or terminal (such as in 1-butenyl).
  • C2-4 alkenyl groups include ethenyl (C2), 1-propenyl (C3), 2-propenyl (C3), 1-butenyl (C4), 2-butenyl (C4), butadienyl (C4), and the like.
  • C2-6 alkenyl groups include the aforementioned C2-4 alkenyl groups as well as pentenyl (Ci), pentadienyl (C5), hexenyl (Ce), and the like.
  • Additional examples of alkenyl include heptenyl (C7), octenyl (Cs), octatrienyl (Cs), and the like.
  • Alkoxy refers to a radical of a straight-chain or branched hydrocarbon group, e.g., having 1 to 20 carbon atoms, having a single bond to oxygen. In some embodiments, an alkoxy has 1-2 carbon atoms, such as -OCH3 or -OCH2CH3.
  • Alkynyl refers to a radical of a straight-chain or branched hydrocarbon group having from 2 to 20 carbon atoms, one or more carbon-carbon triple bonds (e.g., 1, 2, 3, or 4 carbon-carbon triple bonds), and optionally one or more carbon-carbon double bonds (e.g., 1, 2, 3, or 4 carboncarbon double bonds) (“C2-20 alkynyl”). In certain embodiments, alkynyl does not contain any double bonds. In some embodiments, an alkynyl group has 2 to 10 carbon atoms (“C2-10 alkynyl”). In some embodiments, an alkynyl group has 2 to 9 carbon atoms (“C2-9 alkynyl”).
  • an alkynyl group has 2 to 8 carbon atoms (“C2-8 alkynyl”). In some embodiments, an alkynyl group has 2 to 7 carbon atoms (“C2-7 alkynyl”). In some embodiments, an alkynyl group has 2 to 6 carbon atoms (“C2-6 alkynyl”). In some embodiments, an alkynyl group has 2 to 5 carbon atoms (“C2-5 alkynyl”). In some embodiments, an alkynyl group has 2 to 4 carbon atoms (“C2-4 alkynyl”). In some embodiments, an alkynyl group has 2 to 3 carbon atoms (“C2-3 alkynyl”).
  • an alkynyl group has 2 carbon atoms (“C2 alkynyl”).
  • the one or more carbon-carbon triple bonds can be internal (such as in 2-butynyl) or terminal (such as in 1-butynyl).
  • Examples of C2-4 alkynyl groups include, without limitation, ethynyl (C2), 1-propynyl (C3), 2-propynyl (C3), 1-butynyl (C4), 2-butynyl (C4), and the like.
  • Examples of C2-6 alkenyl groups include the aforementioned C2-4 alkynyl groups as well as pentynyl (C5), hexynyl (Ce), and the like. Additional examples of alkynyl include heptynyl (C7), octynyl (Cs), and the like.
  • Aryl refers to a radical of a monocyclic or polycyclic (e.g., bicyclic or tricyclic) 4n+2 aromatic ring system (e.g., having 6, 10, or 1471 electrons shared in a cyclic array) having 6-14 ring carbon atoms and zero heteroatoms provided in the aromatic ring system (“Ce-14 aryl”).
  • an aryl group has six ring carbon atoms (“Ce aryl”; e.g., phenyl).
  • an aryl group has ten ring carbon atoms (“C10 aryl”; e.g., naphthyl such as 1-naphthyl and 2-naphthyl). In some embodiments, an aryl group has fourteen ring carbon atoms (“C14 aryl”; e.g., anthracyl). “Aryl” also includes ring systems wherein the aryl ring, as defined above, is fused with one or more carbocyclyl or heterocyclyl groups wherein the radical or point of attachment is on the aryl ring, and in such instances, the number of carbon atoms continue to designate the number of carbon atoms in the aryl ring system.
  • Typical aryl groups include, but are not limited to, groups derived from aceanthrylene, acenaphthylene, acephenanthrylene, anthracene, azulene, benzene, chrysene, coronene, fluoranthene, fluorene, hexacene, hexaphene, hexalene, as-indacene, s-indacene, indane, indene, naphthalene, octacene, octaphene, octalene, ovalene, penta-2,4-diene, pentacene, pentalene, pentaphene, perylene, phenalene, phenanthrene, picene, pleiadene, pyrene, pyranthrene, rubicene, triphenylene, and trinaphthalene.
  • Particularly aryl groups include pheny
  • Hetero when used to describe a compound or a group present on a compound means that one or more carbon atoms in the compound or group have been replaced by a nitrogen, oxygen, or sulfur heteroatom. Hetero may be applied to any of the alkyl groups described above such as alkyl, e.g., heteroalkyl; alkenyl, e.g., heteroalkenyl; alkynyl, e.g., heteroal kynyl; carbocyclyl, e.g., heterocyclyl; aryl, e.g., heteroaryl, and the like having from 1 to 5, and particularly from 1 to 3 heteroatoms.
  • alkyl e.g., heteroalkyl
  • alkenyl e.g., heteroalkenyl
  • alkynyl e.g., heteroal kynyl
  • carbocyclyl e.g., heterocyclyl
  • aryl e.g., heteroaryl, and the like
  • Heteroaryl refers to a radical of a 5-10 membered monocyclic or bicyclic 4n+2 aromatic ring system (e.g., having 6 or 10 7i electrons shared in a cyclic array) having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen and sulfur (“5-10 membered heteroaryl”).
  • the point of attachment can be a carbon or nitrogen atom, as valency permits.
  • Heteroaryl bicyclic ring systems can include one or more heteroatoms in one or both rings.
  • Heteroaryl includes ring systems wherein the heteroaryl ring, as defined above, is fused with one or more carbocyclyl or heterocyclyl groups wherein the point of attachment is on the heteroaryl ring, and in such instances, the number of ring members continue to designate the number of ring members in the heteroaryl ring system. “Heteroaryl” also includes ring systems wherein the heteroaryl ring, as defined above, is fused with one or more aryl groups wherein the point of attachment is either on the aryl or heteroaryl ring, and in such instances, the number of ring members designates the number of ring members in the fused (aryl/heteroaryl) ring system.
  • Bicyclic heteroaryl groups wherein one ring does not contain a heteroatom e.g., indolyl, quinolinyl, carbazolyl, and the like
  • the point of attachment can be on either ring, i.e., either the ring bearing a heteroatom (e g., 2-indolyl) or the ring that does not contain a heteroatom (e.g., 5-indolyl).
  • a heteroaryl group is a 5-10 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-10 membered heteroaryl”).
  • a heteroaryl group is a 5-8 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-8 membered heteroaryl”).
  • a heteroaryl group is a 5-6 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-6 membered heteroaryl”).
  • the 5-6 membered heteroaryl has 1-3 ring heteroatoms selected from nitrogen, oxygen, and sulfur.
  • the 5-6 membered heteroaryl has 1-2 ring heteroatoms selected from nitrogen, oxygen, and sulfur.
  • the 5-6 membered heteroaryl has 1 ring heteroatom selected from nitrogen, oxygen, and sulfur.
  • Carbocyclyl or “carbocyclic” refers to a radical of a non-aromatic cyclic hydrocarbon group having from 3 to 10 ring carbon atoms (“C3-10 carbocyclyl”) and zero heteroatoms in the non-aromatic ring system.
  • a carbocyclyl group has 3 to 8 ring carbon atoms (“C3-8 carbocyclyl”).
  • a carbocyclyl group has 3 to 6 ring carbon atoms (“C3-6 carbocyclyl”).
  • a carbocyclyl group has 3 to 6 ring carbon atoms (“C3-6 carbocyclyl”).
  • a carbocyclyl group has 5 to 10 ring carbon atoms (“C5-10 carbocyclyl”).
  • C5-10 carbocyclyl ring carbon atoms
  • Exemplary C3-6 carbocyclyl groups include, without limitation, cyclopropyl (C3), cyclopropenyl (C3), cyclobutyl (C4), cyclobutenyl (C4), cyclopentyl (C5), cyclopentenyl (C5), cyclohexyl (Ce), cyclohexenyl (Ce), cyclohexadienyl (Ce), and the like.
  • Exemplary C3-5 carbocyclyl groups include, without limitation, the aforementioned C3-6 carbocyclyl groups as well as cycloheptyl (C7), cycloheptenyl (C7), cycloheptadienyl (C7), cycloheptatrienyl (C7), cyclooctyl (Cs), cyclooctenyl (Cs), bicyclo[2.2.1]heptanyl (C7), bicyclo[2.2.2]octanyl (Cs), and the like.
  • Exemplary C3-10 carbocyclyl groups include, without limitation, the aforementioned C3-8 carbocyclyl groups as well as cyclononyl (C9), cyclononenyl (C9), cyclodecyl (C10), cyclodecenyl (C10), octahydro-lH-indenyl (C9), decahydronaphthalenyl (Cio), spiro[4.5]decanyl (Cio), and the like.
  • the carbocyclyl group is either monocyclic (“monocyclic carbocyclyl”) or contain a fused, bridged or spiro ring system such as a bicyclic system (“bicyclic carbocyclyl”) and can be saturated or can be partially unsaturated.
  • “Carbocyclyl” also includes ring systems wherein the carbocyclyl ring, as defined above, is fused with one or more aryl or heteroaryl groups wherein the point of attachment is on the carbocyclyl ring, and in such instances, the number of carbons continue to designate the number of carbons in the carbocyclic ring system.
  • Heterocyclyl or “heterocyclic” refers to a radical of a 3- to 10-membered non-aromatic ring system having ring carbon atoms and 1 to 4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, sulfur, boron, phosphorus, and silicon (“3-10 membered heterocyclyl”).
  • the point of attachment can be a carbon or nitrogen atom, as valency permits.
  • a heterocyclyl group can either be monocyclic (“monocyclic heterocyclyl”) or a fused, bridged or spire ring system such as a bicyclic system (“bicyclic heterocyclyl”), and can be saturated or can be partially unsaturated.
  • Heterocyclyl bicyclic ring systems can include one or more heteroatoms in one or both rings.
  • Heterocyclyl also includes ring systems wherein the heterocyclyl ring, as defined above, is fused with one or more carbocyclyl groups wherein the point of attachment is either on the carbocyclyl or heterocyclyl ring, or ring systems wherein the heterocyclyl ring, as defined above, is fused with one or more aryl or heteroaryl groups, wherein the point of attachment is on the heterocyclyl ring, and in such instances, the number of ring members continue to designate the number of ring members in the heterocyclyl ring system.
  • a heterocyclyl group is a 5-10 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, sulfur, boron, phosphorus, and silicon (“5-10 membered heterocyclyl”).
  • a heterocyclyl group is a 5-8 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-8 membered heterocyclyl”).
  • a heterocyclyl group is a 5-6 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-6 membered heterocyclyl”).
  • the 5-6 membered heterocyclyl has 1- 3 ring heteroatoms selected from nitrogen, oxygen, and sulfur.
  • the 5-6 membered heterocyclyl has 1-2 ring heteroatoms selected from nitrogen, oxygen, and sulfur.
  • the 5-6 membered heterocyclyl has one ring heteroatom selected from nitrogen, oxygen, and sulfur.
  • Exemplary 3-membered heterocyclyl groups containing one heteroatom include, without limitation, azirdinyl, oxiranyl, thiorenyl.
  • Exemplary 4-membered heterocyclyl groups containing one heteroatom include, without limitation, azetidinyl, oxetanyl and thietanyl.
  • Exemplary 5-membered heterocyclyl groups containing one heteroatom include, without limitation, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl, dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl and pyrrolyl-2, 5-dione.
  • Exemplary 5-membered heterocyclyl groups containing two heteroatoms include, without limitation, dioxolanyl, oxasulfuranyl, disulfuranyl, and oxazolidin-2- one.
  • Exemplary 5-membered heterocyclyl groups containing three heteroatoms include, without limitation, triazolinyl, oxadiazolinyl, and thiadiazolinyl.
  • Exemplary 6-membered heterocyclyl groups containing one heteroatom include, without limitation, piperidinyl, tetrahydropyranyl, dihydropyridinyl, and thianyl.
  • Exemplary 6-membered heterocyclyl groups containing two heteroatoms include, without limitation, piperazinyl, morpholinyl, dithianyl, dioxanyl.
  • Exemplary 6- membered heterocyclyl groups containing three heteroatoms include, without limitation, triazinanyl.
  • Exemplary 7-membered heterocyclyl groups containing one heteroatom include, without limitation, azepanyl, oxepanyl and thiepanyl.
  • Exemplary 8-membered heterocyclyl groups containing one heteroatom include, without limitation, azocanyl, oxecanyl and thiocanyl.
  • Exemplary 5-membered heterocyclyl groups fused to a C>, aryl ring include, without limitation, indolinyl, isoindolinyl, dihydrobenzofuranyl, dihydrobenzothienyl, benzoxazolinonyl, and the like.
  • Exemplary 6-membered heterocyclyl groups fused to an aryl ring include, without limitation, tetrahydroquinolinyl, tetrahydroisoquinolinyl, and the like.
  • Halo or halogen refers to a fluorine atom (i.e., fluoro or -F), a chlorine atom (i.e., chloro or -Cl), a bromine atom (i.e., bromo or -Br), and an iodine atom (i.e., iodo or -I).
  • the halo group is fluoro or chloro.
  • Haloalkyl refers to an alkyl group substituted with one or more halogen atoms.
  • substituted means that at least one hydrogen present on a group (e.g., a carbon or nitrogen atom) is replaced with a permissible substituent, e.g., a substituent which upon substitution results in a stable compound, e.g , a compound which does not spontaneously undergo transformation such as by rearrangement, cyclization, elimination, or other reaction.
  • a “substituted” group has a substituent at one or more substitutable positions of the group, and when more than one position in any given structure is substituted, the substituent is either the same or different at each position.
  • pharmaceutically acceptable salt refers to those salts which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of humans and lower animals without undue toxicity, irritation, allergic response and the like, and are commensurate with a reasonable benefit/risk ratio.
  • the general concept of pharmaceutically acceptable salts has been discussed in the art, including, for example, Berge et al., which describes pharmaceutically acceptable salts in detail in J Pharmaceutical Sciences (1977) 66: 1-19.
  • Pharmaceutically acceptable salts of the compounds described herein include those derived from suitable inorganic and organic acids and bases.
  • Examples of pharmaceutically acceptable, nontoxic acid addition salts are salts of an amino group formed with inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid or with organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • inorganic acids such as hydrochloric acid, hydrobromic acid, phosphoric acid, sulfuric acid and perchloric acid
  • organic acids such as acetic acid, oxalic acid, maleic acid, tartaric acid, citric acid, succinic acid or malonic acid or by using other methods used in the art such as ion exchange.
  • salts include adipate, alginate, ascorbate, aspartate, benzenesulfonate, benzoate, bisulfate, borate, butyrate, camphorate, camphorsulfonate, citrate, cyclopentanepropionate, digluconate, dodecyl sulfate, ethanesulfonate, formate, fumarate, glucoheptonate, glycerophosphate, gluconate, hemisulfate, heptanoate, hexanoate, hydroiodide, 2- hydroxy-ethanesulfonate, lactobionate, lactate, laurate, lauryl sulfate, malate, maleate, malonate, methanesulfonate, 2-naphthalenesulfonate, nicotinate, nitrate, oleate, oxalate, palmitate, pamoate, pect
  • Pharmaceutically acceptable salts derived from appropriate bases include alkali metal, alkaline earth metal, ammonium and N + (Ci-4alkyl)4 salts.
  • Representative alkali or alkaline earth metal salts include sodium, lithium, potassium, calcium, magnesium, and the like.
  • Further pharmaceutically acceptable salts include, when appropriate, nontoxic ammonium, quaternary ammonium, and amine cations formed using counterions such as halide, hydroxide, carboxylate, sulfate, phosphate, nitrate, lower alkyl sulfonate, and aryl sulfonate.
  • modified-release polymer refers to a polymer that is used in a formulation (e.g., tablets and capsules) to modify the release rate of the drug upon administration to a subject.
  • a modified-release polymer is used to dissolve a drug over time in order to be released slower and steadier into the bloodstream.
  • a modified-release polymer is a controlled- release polymer.
  • a modified-release polymer or a controlled-release polymer is an HPMC polymer.
  • a modified-release polymer may include hydrophilic matrix polymers (e.g., hypromellose, hydroxyl -propyl methylcellulose (HPMC)), hydrophobic matrix polymers (e.g., ethyl cellulose, ethocel), or polyacrylate polymers (e.g., Eudragit® RL100, Eudragit® RS100).
  • hydrophilic matrix polymers e.g., hypromellose, hydroxyl -propyl methylcellulose (HPMC)
  • hydrophobic matrix polymers e.g., ethyl cellulose, ethocel
  • polyacrylate polymers e.g., Eudragit® RL100, Eudragit® RS100.
  • diluent refers to an excipient used to increase weight and improve content uniformity.
  • diluents include cellulose derivatives (e.g., microcrystalline cellulose), starches (e.g., hydrolyzed starches, and partially pregelatinized starches), anhydrous lactose, lactose monohydrate, di-calcium phosphate (DCP), sugar alcohols (e.g., sorbitol, xylitol and mannitol)).
  • glidant refers to an excipient used to promote powder flow by reducing interparticle friction and cohesion.
  • glidants include fumed silica (e.g., colloidal silicon dioxide), talc, and magnesium carbonate.
  • lubricant refers to an excipient used to prevent ingredients from clumping together and from sticking to the tablet punches or capsule filling machine. Lubricants are also used to ensure that tablet formation and ejection can occur with low friction between the solid and die wall.
  • lubricants include magnesium stearate, calcium stearate, stearic acid, talc, silica, and fats (e.g., vegetable stearin).
  • coating refers to an excipient to protect tablet ingredients from deterioration by moisture in the air and make large or unpleasant-tasting tablets easier to swallow.
  • embodiments disclosed herein are not intended to be limited in any manner by the above exemplary listing of chemical groups and substituents. Those skilled in the art will recognize that several embodiments are possible within the scope and spirit of the present disclosure. The following description illustrates the disclosure and, of course, should not be construed in any way as limiting the scope of the inventions described herein.
  • X is chosen from -C- or -N-;
  • Ri is chosen from -H or an alkyl
  • R2 is chosen from -H, an alkyl, an alkoxy, or a halogen
  • R3 is chosen from -H, an alkyl, or a halogen; and n is 1 or 2.
  • X is -C-, and in some embodiments, X is -N-.
  • Ri is -H, and in certain embodiments, Ri is -CH3.
  • X is -C-, n is 2 and Ri is -H, such that Formula (III) forms a benzothiazine dioxide.
  • R2 is chosen from -H, -OCH3, or -F.
  • R3 is -Cl.
  • n is 1 or 2, such that Formula (III) contains a 5- or 6-membered heteroaryl, respectively.
  • X is chosen from -C- or -N-; Ri is chosen from -H or an alkyl; R2 is chosen from -H, an alkoxy, or a halogen; R3 is a halogen; and n is 1 or 2.
  • the compound is an optically active compound.
  • the compound is a single enantiomer.
  • the compound is the (R)- enantiomer.
  • the compound is the (S)-enantiomer.
  • Compounds described herein can comprise one or more asymmetric centers, and thus can exist in various isomeric forms, e.g., enantiomers and/or diastereomers.
  • the compounds described herein can be in the form of an individual enantiomer, diastereomer or geometric isomer, or can be in the form of a mixture of stereoisomers, including racemic mixtures and mixtures enriched in one or more stereoisomer.
  • Isomers can be isolated from mixtures by methods known to those skilled in the art, including chiral high pressure liquid chromatography (HPLC) and the formation and crystallization of chiral salts; preferred isomers can be prepared by asymmetric syntheses.
  • HPLC high pressure liquid chromatography
  • a pure enantiomeric compound is substantially free from other enantiomers or stereoisomers of the compound i.e., in enantiomeric excess).
  • an “S” form of the compound is substantially free from the “R” form of the compound and is, thus, in enantiomeric excess of the “R” form.
  • enantiomerically pure or “pure enantiomer” denotes that the compound comprises more than 75% by weight, such as more than 80% by weight, more than 85% by weight, more than 90% by weight, more than 91% by weight, more than 92% by weight, more than 93% by weight, more than 94% by weight, more than 95% by weight, more than 96% by weight, more than 97% by weight, more than 98% by weight, more than 98.5% by weight, more than 99% by weight, more than 99.2% by weight, more than 99.5% by weight, more than 99.6% by weight, more than 99.7% by weight, more than 99.8% by weight, or more than 99.9% by weight, of the enantiomer.
  • the weights are based upon total weight of all enantiomers or stereoisomers of the compound.
  • compositions comprising the compounds described herein.
  • an enantiomerically pure compound can be present in the compositions with other active or inactive ingredients.
  • a pharmaceutical composition comprising enantiomerically pure R-compound can comprise, for example, about 90% excipient and about 10% enantiomerically pure R-compound.
  • the enantiomerically pure R-compound in such compositions can, for example, comprise at least about 95% by weight R-compound and at most about 5% by weight S-compound, by total weight of the compound.
  • a pharmaceutical composition comprising enantiomerically pure S-compound can comprise, for example, about 90% excipient and about 10% enantiomerically pure S-compound.
  • the enantiomerically pure S-compound in such compositions can, for example, comprise at least about 95% by weight S-compound and at most about 5% by weight R-compound, by total weight of the compound.
  • the active ingredient can be formulated with little or no excipient or carrier.
  • H may be in any isotopic form, including 1 H, 2 H (D or deuterium), and 3 H (T or tritium); C may be in any isotopic form, including 12 C, 13 C, and 14 C. 0 may be in any isotopic form, including 16 O and 18 O, and F may be in any isotopic form, including 18 F and 19 F.
  • the compounds and compositions described above and herein can be used to treat a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation in a gene (e.g., KCNT1).
  • a neurological disorder e.g., KCNT1
  • a disorder associated with excessive neuronal excitability e.g., KCNT1
  • a disorder associated with a gain-of-function mutation in a gene e.g., KCNT1
  • a neurological disorder a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation of a gene
  • methods of treating a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation of a gene comprising administering to a subject in need thereof an effective amount of any of the compounds described herein or a pharmaceutically acceptable salt thereof, or pharmaceutical compositions comprising such compounds or a pharmaceutically acceptable salt thereof.
  • Exemplary diseases, disorders, or conditions include epilepsy and other encephalopathies (e.g., MMFSI or EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, developmental and epileptic encephalopathy (DEE), early infantile epileptic encephalopathy (EIEE), generalized epilepsy, focal epilepsy, multifocal epilepsy, temporal lobe epilepsy, Ohtahara syndrome, early myoclonic encephalopathy, Lennox-Gastaut syndrome, drug resistant epilepsy, seizures (e.g., frontal lobe seizures, generalized tonic clonic seizures, asymmetric tonic seizures, focal seizures), leukodystrophy, hypomyelinating leukodystrophy, and leukoencephalopathy), cardiac dysfunctions (e.g., cardiac arrhythmia, Brugada syndrome, myocardial infarction), pulmonary vasculopathy/hemorrhage, pain and related conditions (
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation in a gene is selected from EIMFS, ADNFLE, or West syndrome.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of-function mutation in a gene is selected from infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, or Lennox-Gastaut syndrome.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, or the disorder associated with a gain-of- function mutation in a gene is seizure.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, and/or the disorder associated with a gain-of-function mutation in a gene is selected from cardiac arrhythmia, Brugada syndrome, or myocardial infarction.
  • the neurological disorder, the disorder associated with excessive neuronal excitability, and/or the disorder associated with a gain-of-function mutation in a gene is selected from a learning disorder, Fragile X, intellectual function, neuronal plasticity, a psychiatric disorder, or an autism spectrum disorder.
  • the compounds, pharmaceutically acceptable salts thereof, and compositions disclosed herein can be administered to a subject with a neurological disorder, a disorder associated with excessive neuronal excitability, or a disorder associated with a gain-of-function mutation in a gene such as KCNT1 (e.g., EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, Lennox-Gastaut syndrome, seizures, cardiac arrhythmia, Brugada syndrome, and myocardial infarction).
  • KCNT1 e.g., EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, Lennox-Gastaut syndrome, seizures, cardiac arrhythmia, Brugada syndrome, and myocardial infarction.
  • EIMFS is a rare and debilitating genetic condition characterized by an early onset (before 6 months of age) of almost continuous heterogeneous focal seizures, where seizures appear to migrate from one brain region and hemisphere to another.
  • Patients with EIMFS are generally intellectually impaired, non-verbal, and non-ambulatory. While several genes have been implicated to date, the gene that is most commonly associated with EIMFS is KCNT1.
  • ADNFLE has a later onset than EIMFS, generally in mid-childhood, and is generally a less severe condition. It is characterized by nocturnal frontal lobe seizures and can result in psychiatric, behavioral, and cognitive disabilities in patients with the condition. While ADNFLE is associated with genes encoding several neuronal nicotinic acetylcholine receptor subunits, mutations in the KCNT1 gene have been implicated in more severe cases of the disease (Heron et al. (2012) Nat Genet. 44: 1188-1190).
  • West syndrome is a severe form of epilepsy composed of a triad of infantile spasms, an interictal electroencephalogram (EEG) pattern termed hypsarrhythmia, and mental retardation, although a diagnosis can be made when one of these elements is missing.
  • EEG interictal electroencephalogram
  • Mutations in KCNT1, including G652V and R474H, have been associated with West syndrome (Fukuoka et al. (2017) Brain Dev 39:80-83 and Ohba et al. (2015) Epilepsia 56:el21-el28). Treatment targeting the KCNT1 channel suggests that these mutations are gain-of-function mutations (Fukuoka et al. (2017) Brain Dev 39: SO- 83).
  • KCNT1 for example, epilepsy and other encephalopathies (e.g., MMFSI or EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, DEE, Lennox-Gastaut syndrome, seizures, leukodystrophy, leukoencephalopathy, intellectual disability, Multifocal Epilepsy, Generalized tonic clonic seizures, Drug resistant epilepsy, Temporal lobe epilepsy, cerebellar ataxia, Asymmetric Tonic Seizures), cardiac dysfunctions (e.g., cardiac arrhythmia, Brugada syndrome, myocardial infarction), pain and related conditions (e.g., neuropathic pain, acute/chronic pain, migraine, etc.), muscle disorders (e.g., epilepsy and other encephalopathies (e.g., MMFSI or EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephal
  • psychiatric disorders e.g., major depression, anxiety, bipolar disorder, schizophrenia
  • learning disorders e.g., Fragile X, neuronal plasticity, and autism spectrum disorders
  • administering to a subject in need thereof a compound disclosed herein or a pharmaceutically acceptable salt thereof or a pharmaceutical composition disclosed herein.
  • the subject presenting with a disorder that may be associated with a gain-of-function mutation in KCNT1 is genotyped to confirm the presence of a known gain-of- function mutation in KCNT1 prior to administration of the compounds or a pharmaceutically acceptable salt thereof or compositions disclosed herein.
  • whole exome sequencing can be performed on the subject.
  • Gain-of-function mutations associated with EIMFS may include, but are not limited to, V271F, G288S, R428Q, R474Q, R474H, R474C, I760M, A934T, P924L, G243S, H257D, A259D, R262Q, Q270E, L274I, F346L, C377S, R398Q, P409S, A477T, F502V, M516V, Q550del, K629E, K629N, I760F, E893K, M896K, R933G, R950Q, and K1154Q.
  • Gain-of-function mutations associated with ADNFLE may include, but are not limited to, M896I, R398Q, Y796H, R928C, and G288S.
  • Gain-of-function mutations associated with West syndrome may include, but are not limited to, G652V and R474H.
  • Gain-of-function mutations associated with temporal lobe epilepsy may include, but are not limited to, R133H and R565H.
  • Gain-of-function mutations associated with Lennox-Gastaut may include, but are not limited to, R209C.
  • Gain-of-function mutations associated with seizures may include, but are not limited to, A259D, G288S, R474C, and R474H.
  • Gain-of- function mutations associated with leukodystrophy may include, but are not limited to, G288S and Q906H.
  • Gain-of-function mutations associated with Multifocal Epilepsy may include, but are not limited to, V340M.
  • Gain-of-function mutations associated with early-onset epilepsy may include, but are not limited to, F346L and A934T.
  • Gain-of-function mutations associated with Early- onset epileptic encephalopathies (EOEE) may include, but are not limited to, R428Q.
  • Gain-of- function mutations associated with developmental and epileptic encephalopathies may include, but are not limited to, F346L, R474H, and A934T.
  • Gain-of-function mutations associated with epileptic encephalopathies may include, but are not limited to, L437F, Y796H, P924L, and R961H.
  • Gain-of-function mutations associated with Early Infantile Epileptic Encephalopathy (EIEE) may include, but are not limited to, M896K.
  • Gain-of-function mutations associated with drug-resistant epilepsy and generalized tonic-clonic seizure may include, but are not limited to, F346L.
  • Gain-of-function mutations associated with migrating partial seizures of infancy may include, but are not limited to, R428Q.
  • Gain-of-function mutations associated with Leukoencephalopathy may include, but are not limited to, F932I.
  • Gain-of-function mutations associated with NFLE may include, but are not limited to, A934T and R950Q.
  • Gain-of-function mutations associated with Ohtahara syndrome may include, but are not limited to, A966T.
  • Gain-of-function mutations associated with infantile spasms may include, but are not limited to, P924L.
  • Gain-of-function mutations associated with Brugada Syndrome may include, but are not limited to, R1106Q.
  • Gain-of-function mutations associated with Brugada Syndrome may include, but are not limited to, R474H.
  • the subject is first genotyped to identify the presence of a mutation in KCNT1, and this mutation is then confirmed to be a gain-of-function mutation using standard in vitro assays, such as those described in Milligan et al. (2015) Ann Neurol. 75(4): 581-590.
  • the presence of a gain-of-function mutation is confirmed when the expression of the mutated KCNT1 allele results in an increase in whole cell current compared to the whole cell current resulting from expression of wild-type KCNT1, as may be assessed using whole-cell electrophysiology (such as described in Milligan et al. (2015) Ann Neurol. 75(4): 581-590; Barcia et al. (2012) Nat Genet.
  • This increase of whole cell current can be, for example, an increase of at least or about 50%, 100%, 150%, 200%, 250%, 300%, 350%, 400%, or more.
  • the subject can then be confirmed to have a disease or condition associated with a gain-of-function mutation in KCNT1.
  • the subject is confirmed as having a KCNT1 allele containing a gain-of-function mutation (e.g., V271F, G288S, R398Q, R428Q, R474Q, R474H, R474C, G652V, I760M, Y796H, M896I, P924L, R928C, or A934T).
  • a gain-of-function mutation e.g., V271F, G288S, R398Q, R428Q, R474Q, R474H, R474C, G652V, I760M, Y796H, M896I, P924L, R928C, or A934T.
  • the compounds or pharmaceutically acceptable salts thereof disclosed herein or the pharmaceutical composition disclosed herein can also be used therapeutically for conditions associated with excessive neuronal excitability where the excessive neuronal excitability is not necessarily the result of a gain- of-function mutation in KCNT1. Even in instances where the disease is not the result of increased KCNT1 expression and/or activity, inhibition of KCNT1 expression and/or activity can nonetheless result in a reduction in neuronal excitability, thereby providing a therapeutic effect.
  • the compounds or pharmaceutically acceptable salts thereof disclosed herein or the pharmaceutical compositions disclosed herein can be used to treat a subject with conditions associated with excessive neuronal excitability, for example, epilepsy and other encephalopathies (e.g., EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, and Lennox-Gastaut syndrome, seizures) or cardiac dysfunctions (e.g., cardiac arrhythmia, Brugada syndrome, myocardial infarction), regardless of whether or not the disorder is associated with a gain-of-function mutation in KCNT1.
  • epilepsy and other encephalopathies e.g., EIMFS, ADNFLE, West syndrome, infantile spasms, epileptic encephalopathy, focal epilepsy, Ohtahara syndrome, developmental and epileptic encephalopathy, and Lennox-Gastaut syndrome, seizures
  • cardiac dysfunctions
  • a “subject” to which administration is contemplated includes, but is not limited to, humans (i.e., a male or female of any age group, e.g., a pediatric subject (e.g., an infant, child, adolescent) or an adult subject (e.g., a young adult, middle-aged adult, or senior adult)) and/or a non-human animal, e.g., a mammal such as primates (e g., cynomolgus monkeys, rhesus monkeys), cattle, pigs, horses, sheep, goats, rodents, cats, and/or dogs.
  • the subject is a human.
  • the subject is a non-human animal.
  • treating contemplate an action that occurs while a subject is suffering from the specified disease, disorder or condition, which reduces the severity of the disease, disorder or condition, or retards or slows the progression of the disease, disorder or condition (also “therapeutic treatment”).
  • treating refers to a method or procedure for obtaining beneficial or desired results — for example, clinical results.
  • Beneficial or desired results may include: (1) alleviating one or more symptoms caused by or associated with a disease, disorder, or condition; (2) reducing the extent of the disease, disorder, or condition; (3) slowing or stopping the development or progression of one or more symptoms caused by or associated with the disease, disorder, or condition (for example, stabilizing the disease, disorder, or condition); and (4) relieving the disease, for example, by causing the regression of one or more clinical symptoms (e.g., ameliorating the disease state, enhancing the effect of another medication, delaying or stopping the progression of the disease, increasing the quality of life, and/or prolonging survival rates).
  • an “effective amount” of a compound or pharmaceutically acceptable salt thereof refers to an amount sufficient to elicit the desired biological response.
  • the effective amount of a compound or pharmaceutically acceptable salt thereof may vary depending on such factors as the desired biological endpoint, the pharmacokinetics of the compound or pharmaceutically acceptable salt thereof, the disease being treated, the mode of administration, and the age, weight, health, and condition of the subject.
  • a therapeutically effective amount of the compound or pharmaceutically acceptable salt thereof disclosed herein is administered to the subject (e.g., a human).
  • a “therapeutically effective amount” of a compound or pharmaceutically acceptable salt thereof is an amount sufficient to provide a therapeutic benefit in the treatment of a disease, disorder or condition, or to delay or minimize one or more symptoms associated with the disease, disorder or condition.
  • a therapeutically effective amount of a compound or pharmaceutically acceptable salt thereof means an amount of therapeutic agent, alone or in combination with other therapies, which provides a therapeutic benefit in the treatment of the disease, disorder or condition.
  • the term “therapeutically effective amount” can encompass an amount that improves overall therapy, reduces or avoids symptoms or causes of the disease or condition, or enhances the therapeutic efficacy of another therapeutic agent.
  • the method provided involves treating a disorder associated with a gain-of-function mutation of KCNT1.
  • a “disorder associated with a gain-of- function mutation in KCNT1” refers to a disorder that is associated with, is partially or completely caused by, or has one or more symptoms that are partially or completely caused by, a mutation in KCNT1 that results in a gain-of-function phenotype, i.e., an increase in activity of the potassium channel encoded by KCNT1 resulting in an increase in whole cell current.
  • a “gain- of-function mutation of KCNT1” is a mutation in KCNT1 that results in an increase in activity of the potassium channel encoded by KCNT1.
  • Activity can be assessed by, for example, ion flux assay or electrophysiology (e.g., using the whole cell patch clamp technique).
  • a gain-of-function mutation results in an increase of at least or about 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 125%, 150%, 175%, 200%, 225%, 250%, 275%, 300%, 325%, 350%, 375%, 400%, or more compared to the activity of a potassium channel encoded by a wild-type KCNT1.
  • compositions that contain, as the active ingredient, one or more of the compounds described, or a pharmaceutically acceptable salt or ester thereof, and one or more of pharmaceutically acceptable excipients, carriers, including inert solid diluents and fillers, diluents, including sterile aqueous solution and various organic solvents, permeation enhancers, solubilizers, and adjuvants.
  • the pharmaceutical compositions may be administered alone or in combination with other therapeutic agents.
  • compositions may be prepared in a manner disclosed in the pharmaceutical art, including, for example, in Remington’s Pharmaceutical Sciences, Mace Publishing Co., Philadelphia, Pa. 17th Ed. (1985) and Modern Pharmaceutics, Marcel Dekker, Inc. 3rd Ed. (G. S. Banker & C. T. Rhodes, Eds.).
  • compositions may be administered in either single or multiple doses by any of the accepted modes of administration of agents having similar utilities, for example as described in those patents and patent applications incorporated by reference, including rectal, buccal, intranasal, and transdermal routes, by intra-arterial injection, intravenously, intraperitoneally, parenterally, intramuscularly, subcutaneously, orally, topically, as an inhalant, or via an impregnated or coated device such as a stent, for example, or an artery -inserted cylindrical polymer.
  • agents having similar utilities for example as described in those patents and patent applications incorporated by reference, including rectal, buccal, intranasal, and transdermal routes, by intra-arterial injection, intravenously, intraperitoneally, parenterally, intramuscularly, subcutaneously, orally, topically, as an inhalant, or via an impregnated or coated device such as a stent, for example, or an artery -inserted cylindrical polymer.
  • One mode for administration is parenteral, particularly by injection.
  • the forms in which the novel compositions disclosed herein may be incorporated for administration by injection include aqueous or oil suspensions, or emulsions, with sesame oil, com oil, cottonseed oil, or peanut oil, as well as elixirs, mannitol, dextrose, or a sterile aqueous solution, and similar pharmaceutical vehicles.
  • Aqueous solutions in saline are also conventionally used for injection.
  • Ethanol, glycerol, propylene glycol, liquid polyethylene glycol, and the like (and suitable mixtures thereof), cyclodextrin derivatives, and vegetable oils may also be employed.
  • the proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size in the case of dispersions, and by the use of surfactants.
  • a coating such as lecithin
  • surfactants for example, parabens, chlorobutanol, phenol, sorbic acid, thimerosal, and the like.
  • Sterile inj ectable solutions are prepared by incorporating a compound or pharmaceutically acceptable salt thereof as disclosed herein in the required amount in the appropriate solvent with various other ingredients as enumerated above, as desired, followed by filtered sterilization.
  • dispersions are prepared by incorporating the various sterilized active ingredients into a sterile vehicle which contains the basic dispersion medium and the desired other ingredients from those enumerated above.
  • exemplary methods of preparation include vacuum-drying and freeze-drying techniques which yield a powder of the active ingredient plus any additional desired ingredient from a previously sterile-filtered solution thereof.
  • Oral administration is another route for administration of the compounds or pharmaceutically acceptable salts thereof as disclosed herein. Administration may be via capsule or enteric coated tablets, or the like.
  • the active ingredient may be diluted by an excipient and/or enclosed within such a carrier that can be in the form of a capsule, sachet, paper or other container.
  • the excipient serves as a diluent, it can be in the form of a solid, semi-solid, or liquid material (as above), which acts as a vehicle, carrier or medium for the active ingredient.
  • compositions can be in the form of tablets, pills, powders, lozenges, sachets, cachets, elixirs, suspensions, emulsions, solutions, syrups, aerosols (as a solid or in a liquid medium), ointments containing, for example, up to 10% by weight of the active compound, soft and hard gelatin capsules, sterile injectable solutions, and sterile packaged powders.
  • compositions disclosed herein can additionally include lubricating agents such as talc, magnesium stearate, and mineral oil; wetting agents; emulsifying and suspending agents; preserving agents such as methyl and propylhydroxy-benzoates; sweetening agents; and flavoring agents.
  • compositions disclosed herein can be formulated so as to provide quick, sustained or delayed release of the active ingredient after administration to the patient by employing procedures known in the art.
  • Controlled release drug delivery systems for oral administration include osmotic pump systems and dissolutional systems containing polymer-coated reservoirs or drug-polymer matrix formulations. Examples of controlled release systems are given in U.S. Pat. Nos. 3,845,770; 4,326,525; 4,902,514; and 5,616,345.
  • Another embodiment for use in the methods disclosed herein may employ transdermal delivery devices (“patches”). Such transdermal patches may be used to provide continuous or discontinuous infusion of the compounds or pharmaceutically acceptable salts thereof as disclosed herein in controlled amounts.
  • transdermal patches for the delivery of pharmaceutical agents is described, for example, in U.S. Pat. Nos. 5,023,252, 4,992,445 and 5,001,139. Such patches may be constructed for continuous, pulsatile, or on-demand delivery of pharmaceutical agents.
  • compositions disclosed herein may be formulated in a unit dosage form.
  • unit dosage forms refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical excipient (e g., a tablet, capsule, ampoule).
  • the compounds are generally administered in a pharmaceutically effective amount.
  • each dosage unit contains from about 1 mg to about 2 g of a compound or pharmaceutically acceptable salt thereof as described herein, and for parenteral administration, preferably from about 0.1 mg to about 700 mg of a compound or pharmaceutically acceptable salt thereof as described herein.
  • the amount of the compound or pharmaceutically acceptable salt thereof actually administered usually will be determined by a physician, in the light of the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual compound or pharmaceutically acceptable salt thereof administered and its relative activity, the age, weight, and response of the individual patient, the severity of the patient’s symptoms, and the like.
  • the principal active ingredient may be mixed with a pharmaceutical excipient to form a solid preformulation composition containing a homogeneous mixture of a compound or pharmaceutically acceptable salt thereof as disclosed herein.
  • a pharmaceutical excipient to form a solid preformulation composition containing a homogeneous mixture of a compound or pharmaceutically acceptable salt thereof as disclosed herein.
  • these preformulation compositions as homogeneous, it is meant that the active ingredient is dispersed evenly throughout the composition so that the composition may be readily subdivided into equally effective unit dosage forms such as tablets, pills, and capsules.
  • the tablets or pills disclosed herein may be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action, or to protect from the acid conditions of the stomach.
  • the tablet or pill can comprise an inner dosage and an outer dosage component, the latter being in the form of an envelope over the former.
  • the two components can be separated by an enteric layer that serves to resist disintegration in the stomach and permit the inner component to pass intact into the duodenum or to be delayed in release.
  • enteric layers or coatings such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol, and cellulose acetate.
  • compositions for inhalation or insufflation include solutions and suspensions in pharmaceutically acceptable, aqueous or organic solvents, or mixtures thereof, and powders.
  • the liquid or solid compositions may contain suitable pharmaceutically acceptable excipients as described herein.
  • the compositions are administered by the oral or nasal respiratory route for local or systemic effect.
  • Compositions in pharmaceutically acceptable solvents may be nebulized by use of inert gases. Nebulized solutions may be inhaled directly from the nebulizing device, or the nebulizing device may be attached to a facemask tent or intermittent positive pressure breathing machine. Solution, suspension, or powder compositions may be administered, such as orally or nasally, from devices that deliver the formulation in an appropriate manner.
  • a pharmaceutical composition comprising a compound, or pharmaceutically acceptable salt thereof, as disclosed herein and at least one pharmaceutically acceptable excipient and/or carrier.
  • flash chromatography may either be performed manually or via an automated system.
  • the compounds provided herein may be characterized by known standard procedures, such as nuclear magnetic resonance spectroscopy (NMR) or liquid chromatography mass spectrometry (LCMS). NMR chemical shifts are reported in part per million (ppm) and are generated using methods described in the art.
  • KCNT1 - Patch Clamp Assay Inhibition of KCNT1 (KNal.l, Slack) was evaluated using a tetracycline inducible cell line (HEK-TREX). Currents were recorded using the SyncroPatch 384PE automated, patch clamp system. Pulse generation and data collection were performed with PatchController384 VI.3.0 and DataController384 VI.2.1 (Nanion Technologies). The access resistance and apparent membrane capacitance were estimated using built-in protocols. Current were recorded in perforated patch mode (10 pM escin) from a population of cells. The cells were lifted, triturated, and resuspended at 800,000 cells/ml. The cells were allowed to recover in the cell hotel prior to experimentation.
  • HEK-TREX tetracycline inducible cell line
  • the extracellular solution was used as the wash, reference, and compound delivery solution.
  • the compound was diluted to 1:2 when added to the recording well.
  • the amount of DMSO in the extracellular solution was held constant at the level used for the highest tested concentration.
  • a holding potential of -80 mV with a 100ms step to OmV was used.
  • Mean current was measured during the step to 0 mV.
  • 100 pM Bepridil was used to completely inhibit KCNT1 current to allow for offline subtraction of non-KCNTl current.
  • the average mean current from 3 sweeps was calculated, and the percent inhibition of each compound was calculated.
  • the percent inhibition as a function of the compound concentration was fit with a Hill equation to derive IC50, slope, minimum parameters, and maximum parameters. If KCNT1 inhibition was less than 50% at the highest tested concentration or if an IC50 could not be calculated, then a percent inhibition was reported in place of the IC50.
  • Results from this example are summarized in Table 1.
  • A indicates IC50 of less than or equal to 1 pM
  • B indicates inhibition of between 1 pM to 20 pM
  • C indicates inhibition of greater than or equal to 20 pM
  • Kinetic Solubility Assay The Kinetic solubility assay employed the shake flask method followed by HPLC-UV analysis.
  • test compounds and controls (10 mM in DMSO, 10 pL/vial) into the 50 mM pH 7.4 phosphate buffer (490 pL/well) placed in a Mini-Uniprep filter. 3) Vortex the samples of kinetic solubility for 2 minutes.
  • Log D The Log D assay is a miniaturized 1-octanol/buffer shake flask method followed by LC/MS/MS analysis. It is typically measured by determining the partition of a compound between an organic solvent (1 -octanol) and an aqueous buffer (0.1 M phosphate buffer, pH 7.4; Varied buffer pH can be set). Since logD is pH dependent, the pH of the aqueous phase is always specified and is commonly measured at pH 7.4, the physiological pH of body fluids. The following Log D method was used to calculate the Log D values in Table 8 below:
  • test compounds (10 mM in DMSO; 2 pL/well) and QC samples (10 mM in DMSO; 2 pL/well) from storage tubes to the 96-well polypropylene cluster tubes.
  • NADPH Liver Microsome Metabolic Stability Assay
  • Test compounds were incubated at 37°C with liver microsomes (pooled from multiple donors) at 1.0 pM in the presence of NADPH ( ⁇ 1.0 mM) at 0.5 mg/ml microsomal protein.
  • Positive controls include testosterone (3A4 substrate), propafenone (2D6) and diclofenac (2C9). They are also incubated with microsomes in the presence of NADPH.
  • the mg microsomal protein / g liver weight is 45 for 5 species.
  • the liver weight values will use 40 g/kg, 30 g/kg, 32 g/kg, 20 g/kg and 88 g/kg for rat, monkey, dog, human and mouse, respectively.
  • the liver clearance will be calculated using CLint(mic) with the following equation:
  • Step 2 Synthesis of (/)- ⁇ -(5-chloro-2.3-dihydro-l//-inden-l-yl)-2.3- dihydrobenzo[ ⁇ Z]isothiazole-6-carboxamide 1,1-dioxide (Compound Ill-a)
  • Step 3 Synthesis of 6-bromo-2-(4-methoxybeiizyl)-3-methyl-2,3-dihydrobenzo[ ⁇ Z]isothiazole 1,1-dioxide (4)
  • Step 4 Synthesis of ethyl 2-(4-methoxybenzyl)-3-methyl-2,3-dihydrobenzo[ ⁇ Z
  • Step 6 Synthesis of 3-methyl-2-(2,2,2-trifluoroacetyl)-2,3-dihydro-214-benzo[ ⁇ f]isothiazole-6- carboxylic acid 1,1-dioxide (7)
  • Step 7 Synthesis of ⁇ -( (/?)-5-chloro-2.3-dihydro-l //-inden- 1 -yl)-3-nielhy 1-2.3- dihydrobenzo[ ⁇ /]isothiazole-6-carboxamide 1,1-dioxide (Compound Ill-b)
  • Step 2 Synthesis of 5-bronio- ⁇ -(tert-biityl)-4-niioro-2-niethylbenzenesuironainide (3)
  • Step 3 Synthesis of 5-bromo-2-(bromomethyl)-A-(tert-butyl)-4-fluorobenzenesulfonamide (4)
  • Step 4 Synthesis of 6-bromo-2-(tert-butyl)-5-fluoro-2,3-dihydrobenzo[d]isothiazole 1,1- dioxide (5)
  • Step 5 Synthesis of 6-bromo-2-(tert-butyl)-5-methoxy-2,3-dihydrobenzo[J
  • NaOMe 0.25 g, 4.655 mmol
  • the reaction mixture was stirred at 80 °C for 12 hours.
  • the reaction was cooled to room temperature, diluted with water, and extracted with EtOAc. The combined organic layers were washed with brine, dried over anhydrous Na2SO4, filtered and concentrated under reduced pressure.
  • the crude compound was purified by Combi-Flash chromatography (eluting with 30-45% EtOAc in heptane) to afford the title compound 6 (0.5 g, 1.451 mmol, 93.5% yield) as an off-white solid.
  • Step 6 Synthesis of ethyl 2-(tert-butyl)-5-methoxy-2,3-dihydrobenzo[ ⁇ Z]isothiazole-6- carboxylate 1,1-dioxide (7)
  • Step-7 Synthesis of 2-(tert-butyl)-5-methoxy-2,3-dihydrobenzo[ ]isothiazole-6- carboxylic acid 1,1-dioxide (6)
  • Step 8 Synthesis of (/?)-2-(tert-butyl)- ⁇ -(5-chloro-2.3-dihydro-l//-inden-l-yl)-5- methoxy-2,3-dihydrobenzo[d]isothiazole-6-carboxamide 1,1-dioxide (10)
  • Step 9 Synthesis of (/?)-V-(5-chloro-2.3-dihydro-l//-inden-l-yl)-5-niethoxy-2.3- dihydrobenzo[ ⁇ Z]isothiazole-6-carboxamide 1,1-dioxide (Compound III-c)

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  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

L'invention concerne des composés comprenant un noyau de sulfonamide et des sels pharmaceutiquement acceptables de ceux-ci, ainsi que des compositions utiles pour prévenir et/ou traiter un trouble neurologique, un trouble associé à une excitabilité neuronale excessive, ou un trouble associé à une mutation de gain de fonction dans un gène (par exemple, KCNT1). L'invention concerne également des procédés de traitement d'un trouble neurologique, d'un trouble associé à une excitabilité neuronale excessive, ou d'un trouble associé à une mutation de gain de fonction dans un gène tel que KCNT1.
PCT/US2023/082400 2022-12-05 2023-12-05 Inhibiteurs de kcnt1 comprenant un noyau cyclique de sulfonamide et procédés d'utilisation Ceased WO2024123716A1 (fr)

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Citations (4)

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Publication number Priority date Publication date Assignee Title
US20100183712A1 (en) * 2001-02-13 2010-07-22 Sanofi-Aventis Deutschland Gmbh Acylated indanyl amines and their use as pharmaceuticals
US20160200724A1 (en) * 2014-02-03 2016-07-14 Vitae Pharmaceuticals, Inc. Dihydropyrrolopyridine inhibitors of ror-gamma
US20170044183A1 (en) * 2014-04-22 2017-02-16 Merck Sharp & Dohme Corp. FACTOR XIa INHIBITORS
US20190337935A1 (en) * 2018-05-02 2019-11-07 Enanta Pharmaceuticals, Inc. Apoptosis signal-regulating kinase 1 inhibitors and methods of use thereof

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100183712A1 (en) * 2001-02-13 2010-07-22 Sanofi-Aventis Deutschland Gmbh Acylated indanyl amines and their use as pharmaceuticals
US20160200724A1 (en) * 2014-02-03 2016-07-14 Vitae Pharmaceuticals, Inc. Dihydropyrrolopyridine inhibitors of ror-gamma
US20170044183A1 (en) * 2014-04-22 2017-02-16 Merck Sharp & Dohme Corp. FACTOR XIa INHIBITORS
US20190337935A1 (en) * 2018-05-02 2019-11-07 Enanta Pharmaceuticals, Inc. Apoptosis signal-regulating kinase 1 inhibitors and methods of use thereof

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
DATABASE PUBCHEM COMPOUND 7 October 2017 (2017-10-07), ANONYMOUS: "N-(5-chloro-2-hydroxyphenyl)-1,1dioxo-2,3-dihydro-1,2benzothiazole-6-carboxamide", XP093182575, Database accession no. 130297650 *

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