CA2012852A1 - Method of inhibiting vasospasm and platelet aggregation resulting from angioplasty using thromboxane a receptor antagonists - Google Patents
Method of inhibiting vasospasm and platelet aggregation resulting from angioplasty using thromboxane a receptor antagonistsInfo
- Publication number
- CA2012852A1 CA2012852A1 CA002012852A CA2012852A CA2012852A1 CA 2012852 A1 CA2012852 A1 CA 2012852A1 CA 002012852 A CA002012852 A CA 002012852A CA 2012852 A CA2012852 A CA 2012852A CA 2012852 A1 CA2012852 A1 CA 2012852A1
- Authority
- CA
- Canada
- Prior art keywords
- thromboxane
- lower alkyl
- alpha
- receptor antagonist
- amino
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 238000002399 angioplasty Methods 0.000 title claims abstract description 28
- 238000000034 method Methods 0.000 title claims abstract description 26
- 206010047163 Vasospasm Diseases 0.000 title claims abstract description 23
- 208000010110 spontaneous platelet aggregation Diseases 0.000 title claims abstract description 18
- 230000002401 inhibitory effect Effects 0.000 title claims abstract description 14
- 239000002464 receptor antagonist Substances 0.000 title abstract description 12
- 229940044551 receptor antagonist Drugs 0.000 title abstract description 12
- RZWIIPASKMUIAC-VQTJNVASSA-N thromboxane Chemical compound CCCCCCCC[C@H]1OCCC[C@@H]1CCCCCCC RZWIIPASKMUIAC-VQTJNVASSA-N 0.000 title description 3
- -1 7-oxabicycloheptane prostaglandin Chemical class 0.000 claims abstract description 29
- 239000003769 thromboxane A2 receptor blocking agent Substances 0.000 claims abstract description 27
- 229940123987 Thromboxane A2 receptor antagonist Drugs 0.000 claims abstract description 24
- 125000000217 alkyl group Chemical group 0.000 claims description 32
- 125000002924 primary amino group Chemical group [H]N([H])* 0.000 claims description 15
- 125000003118 aryl group Chemical group 0.000 claims description 14
- DYWAPFDKPAHSED-UHFFFAOYSA-N 2-cycloheptyloxepane Chemical group C1CCCCCC1C1OCCCCC1 DYWAPFDKPAHSED-UHFFFAOYSA-N 0.000 claims description 11
- 125000003545 alkoxy group Chemical group 0.000 claims description 10
- 125000002496 methyl group Chemical group [H]C([H])([H])* 0.000 claims description 9
- 125000000218 acetic acid group Chemical group C(C)(=O)* 0.000 claims description 7
- 125000003710 aryl alkyl group Chemical group 0.000 claims description 7
- 125000003342 alkenyl group Chemical group 0.000 claims description 4
- 125000003282 alkyl amino group Chemical group 0.000 claims description 4
- 125000000304 alkynyl group Chemical group 0.000 claims description 4
- 125000001691 aryl alkyl amino group Chemical group 0.000 claims description 4
- 125000001769 aryl amino group Chemical group 0.000 claims description 4
- 125000004104 aryloxy group Chemical group 0.000 claims description 4
- 125000001316 cycloalkyl alkyl group Chemical group 0.000 claims description 4
- 125000004356 hydroxy functional group Chemical group O* 0.000 claims description 4
- 125000004076 pyridyl group Chemical group 0.000 claims description 4
- 125000001544 thienyl group Chemical group 0.000 claims description 4
- 125000002915 carbonyl group Chemical group [*:2]C([*:1])=O 0.000 claims description 3
- 125000000717 hydrazino group Chemical group [H]N([*])N([H])[H] 0.000 claims description 3
- 229910052783 alkali metal Inorganic materials 0.000 claims description 2
- 125000004183 alkoxy alkyl group Chemical group 0.000 claims description 2
- 125000000278 alkyl amino alkyl group Chemical group 0.000 claims description 2
- 125000005127 aryl alkoxy alkyl group Chemical group 0.000 claims description 2
- 125000002102 aryl alkyloxo group Chemical group 0.000 claims description 2
- 125000005128 aryl amino alkyl group Chemical group 0.000 claims description 2
- 125000005160 aryl oxy alkyl group Chemical group 0.000 claims description 2
- 125000003178 carboxy group Chemical group [H]OC(*)=O 0.000 claims description 2
- 125000000753 cycloalkyl group Chemical group 0.000 claims description 2
- 229910052739 hydrogen Inorganic materials 0.000 claims description 2
- HRDXJKGNWSUIBT-UHFFFAOYSA-N methoxybenzene Chemical group [CH2]OC1=CC=CC=C1 HRDXJKGNWSUIBT-UHFFFAOYSA-N 0.000 claims description 2
- 150000003839 salts Chemical class 0.000 claims description 2
- 125000000547 substituted alkyl group Chemical group 0.000 claims description 2
- 150000003536 tetrazoles Chemical class 0.000 claims description 2
- 229940122202 Thromboxane receptor antagonist Drugs 0.000 claims 1
- 239000002396 thromboxane receptor blocking agent Substances 0.000 claims 1
- 102000003938 Thromboxane Receptors Human genes 0.000 abstract description 12
- 108090000300 Thromboxane Receptors Proteins 0.000 abstract description 12
- 210000001367 artery Anatomy 0.000 description 9
- 208000037803 restenosis Diseases 0.000 description 7
- 239000003795 chemical substances by application Substances 0.000 description 6
- 230000007246 mechanism Effects 0.000 description 6
- 230000008021 deposition Effects 0.000 description 5
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 4
- 239000005557 antagonist Substances 0.000 description 4
- HQKMJHAJHXVSDF-UHFFFAOYSA-L magnesium stearate Chemical compound [Mg+2].CCCCCCCCCCCCCCCCCC([O-])=O.CCCCCCCCCCCCCCCCCC([O-])=O HQKMJHAJHXVSDF-UHFFFAOYSA-L 0.000 description 4
- 208000007536 Thrombosis Diseases 0.000 description 3
- 239000002552 dosage form Substances 0.000 description 3
- 239000000203 mixture Substances 0.000 description 3
- 230000001732 thrombotic effect Effects 0.000 description 3
- DSNBHJFQCNUKMA-SCKDECHMSA-N thromboxane A2 Chemical compound OC(=O)CCC\C=C/C[C@@H]1[C@@H](/C=C/[C@@H](O)CCCCC)O[C@@H]2O[C@H]1C2 DSNBHJFQCNUKMA-SCKDECHMSA-N 0.000 description 3
- CIWBSHSKHKDKBQ-JLAZNSOCSA-N Ascorbic acid Chemical compound OC[C@H](O)[C@H]1OC(=O)C(O)=C1O CIWBSHSKHKDKBQ-JLAZNSOCSA-N 0.000 description 2
- 229940127291 Calcium channel antagonist Drugs 0.000 description 2
- 229920002261 Corn starch Polymers 0.000 description 2
- 208000027418 Wounds and injury Diseases 0.000 description 2
- 239000004480 active ingredient Substances 0.000 description 2
- 230000001154 acute effect Effects 0.000 description 2
- 230000002776 aggregation Effects 0.000 description 2
- 238000004220 aggregation Methods 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 239000000480 calcium channel blocker Substances 0.000 description 2
- 150000001875 compounds Chemical class 0.000 description 2
- 239000008120 corn starch Substances 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 239000003814 drug Substances 0.000 description 2
- 210000003038 endothelium Anatomy 0.000 description 2
- 238000009472 formulation Methods 0.000 description 2
- 229920000159 gelatin Polymers 0.000 description 2
- 235000019322 gelatine Nutrition 0.000 description 2
- 230000005764 inhibitory process Effects 0.000 description 2
- 229940102223 injectable solution Drugs 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 235000019359 magnesium stearate Nutrition 0.000 description 2
- LXCFILQKKLGQFO-UHFFFAOYSA-N methylparaben Chemical compound COC(=O)C1=CC=C(O)C=C1 LXCFILQKKLGQFO-UHFFFAOYSA-N 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000037361 pathway Effects 0.000 description 2
- 230000002265 prevention Effects 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- QELSKZZBTMNZEB-UHFFFAOYSA-N propylparaben Chemical compound CCCOC(=O)C1=CC=C(O)C=C1 QELSKZZBTMNZEB-UHFFFAOYSA-N 0.000 description 2
- KAQKFAOMNZTLHT-OZUDYXHBSA-N prostaglandin I2 Chemical compound O1\C(=C/CCCC(O)=O)C[C@@H]2[C@@H](/C=C/[C@@H](O)CCCCC)[C@H](O)C[C@@H]21 KAQKFAOMNZTLHT-OZUDYXHBSA-N 0.000 description 2
- 230000009467 reduction Effects 0.000 description 2
- 239000011780 sodium chloride Substances 0.000 description 2
- 239000000243 solution Substances 0.000 description 2
- 230000009885 systemic effect Effects 0.000 description 2
- 239000007916 tablet composition Substances 0.000 description 2
- 239000003768 thromboxane synthase inhibitor Substances 0.000 description 2
- 208000019553 vascular disease Diseases 0.000 description 2
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Chemical compound O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 2
- 239000008215 water for injection Substances 0.000 description 2
- 125000004178 (C1-C4) alkyl group Chemical group 0.000 description 1
- SGTNSNPWRIOYBX-UHFFFAOYSA-N 2-(3,4-dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl](methyl)amino}-2-(propan-2-yl)pentanenitrile Chemical compound C1=C(OC)C(OC)=CC=C1CCN(C)CCCC(C#N)(C(C)C)C1=CC=C(OC)C(OC)=C1 SGTNSNPWRIOYBX-UHFFFAOYSA-N 0.000 description 1
- HVAUUPRFYPCOCA-AREMUKBSSA-N 2-O-acetyl-1-O-hexadecyl-sn-glycero-3-phosphocholine Chemical compound CCCCCCCCCCCCCCCCOC[C@@H](OC(C)=O)COP([O-])(=O)OCC[N+](C)(C)C HVAUUPRFYPCOCA-AREMUKBSSA-N 0.000 description 1
- XTWYTFMLZFPYCI-KQYNXXCUSA-N 5'-adenylphosphoric acid Chemical compound C1=NC=2C(N)=NC=NC=2N1[C@@H]1O[C@H](COP(O)(=O)OP(O)(O)=O)[C@@H](O)[C@H]1O XTWYTFMLZFPYCI-KQYNXXCUSA-N 0.000 description 1
- XTWYTFMLZFPYCI-UHFFFAOYSA-N Adenosine diphosphate Natural products C1=NC=2C(N)=NC=NC=2N1C1OC(COP(O)(=O)OP(O)(O)=O)C(O)C1O XTWYTFMLZFPYCI-UHFFFAOYSA-N 0.000 description 1
- 206010067484 Adverse reaction Diseases 0.000 description 1
- 206010002383 Angina Pectoris Diseases 0.000 description 1
- 200000000007 Arterial disease Diseases 0.000 description 1
- BSYNRYMUTXBXSQ-UHFFFAOYSA-N Aspirin Chemical compound CC(=O)OC1=CC=CC=C1C(O)=O BSYNRYMUTXBXSQ-UHFFFAOYSA-N 0.000 description 1
- 241000282472 Canis lupus familiaris Species 0.000 description 1
- 241000282693 Cercopithecidae Species 0.000 description 1
- 101000862089 Clarkia lewisii Glucose-6-phosphate isomerase, cytosolic 1A Proteins 0.000 description 1
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 1
- 241000282326 Felis catus Species 0.000 description 1
- 108010010803 Gelatin Proteins 0.000 description 1
- 239000001828 Gelatine Substances 0.000 description 1
- 208000032843 Hemorrhage Diseases 0.000 description 1
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 description 1
- 241000282412 Homo Species 0.000 description 1
- HEFNNWSXXWATRW-UHFFFAOYSA-N Ibuprofen Chemical compound CC(C)CC1=CC=C(C(C)C(O)=O)C=C1 HEFNNWSXXWATRW-UHFFFAOYSA-N 0.000 description 1
- 229930195725 Mannitol Natural products 0.000 description 1
- 229920000168 Microcrystalline cellulose Polymers 0.000 description 1
- SNIOPGDIGTZGOP-UHFFFAOYSA-N Nitroglycerin Chemical compound [O-][N+](=O)OCC(O[N+]([O-])=O)CO[N+]([O-])=O SNIOPGDIGTZGOP-UHFFFAOYSA-N 0.000 description 1
- 239000000006 Nitroglycerin Substances 0.000 description 1
- 208000031481 Pathologic Constriction Diseases 0.000 description 1
- 108010003541 Platelet Activating Factor Proteins 0.000 description 1
- 208000035965 Postoperative Complications Diseases 0.000 description 1
- 241000700159 Rattus Species 0.000 description 1
- DWAQJAXMDSEUJJ-UHFFFAOYSA-M Sodium bisulfite Chemical compound [Na+].OS([O-])=O DWAQJAXMDSEUJJ-UHFFFAOYSA-M 0.000 description 1
- 208000007271 Substance Withdrawal Syndrome Diseases 0.000 description 1
- 229940099508 TP receptor antagonist Drugs 0.000 description 1
- 229940111979 Thromboxane synthase inhibitor Drugs 0.000 description 1
- 206010053648 Vascular occlusion Diseases 0.000 description 1
- 206010047139 Vasoconstriction Diseases 0.000 description 1
- 229960001138 acetylsalicylic acid Drugs 0.000 description 1
- 230000006838 adverse reaction Effects 0.000 description 1
- 239000000556 agonist Substances 0.000 description 1
- 125000002947 alkylene group Chemical group 0.000 description 1
- 125000003277 amino group Chemical group 0.000 description 1
- 230000000844 anti-bacterial effect Effects 0.000 description 1
- 239000003963 antioxidant agent Substances 0.000 description 1
- 235000006708 antioxidants Nutrition 0.000 description 1
- 239000007864 aqueous solution Substances 0.000 description 1
- 235000010323 ascorbic acid Nutrition 0.000 description 1
- 229960005070 ascorbic acid Drugs 0.000 description 1
- 239000011668 ascorbic acid Substances 0.000 description 1
- 230000023555 blood coagulation Effects 0.000 description 1
- 239000000872 buffer Substances 0.000 description 1
- 239000004067 bulking agent Substances 0.000 description 1
- 239000002775 capsule Substances 0.000 description 1
- 239000012876 carrier material Substances 0.000 description 1
- 238000007887 coronary angioplasty Methods 0.000 description 1
- 125000001511 cyclopentyl group Chemical group [H]C1([H])C([H])([H])C([H])([H])C([H])(*)C1([H])[H] 0.000 description 1
- XQGZSYKGWHUSDH-UHFFFAOYSA-N dazoxiben Chemical compound C1=CC(C(=O)O)=CC=C1OCCN1C=NC=C1 XQGZSYKGWHUSDH-UHFFFAOYSA-N 0.000 description 1
- 229950008000 dazoxiben Drugs 0.000 description 1
- IZEKFCXSFNUWAM-UHFFFAOYSA-N dipyridamole Chemical compound C=12N=C(N(CCO)CCO)N=C(N3CCCCC3)C2=NC(N(CCO)CCO)=NC=1N1CCCCC1 IZEKFCXSFNUWAM-UHFFFAOYSA-N 0.000 description 1
- 229960002768 dipyridamole Drugs 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 230000000001 effect on platelet aggregation Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 230000003511 endothelial effect Effects 0.000 description 1
- 229960001123 epoprostenol Drugs 0.000 description 1
- 239000008273 gelatin Substances 0.000 description 1
- 235000011852 gelatine desserts Nutrition 0.000 description 1
- 229960003711 glyceryl trinitrate Drugs 0.000 description 1
- 238000005469 granulation Methods 0.000 description 1
- 230000003179 granulation Effects 0.000 description 1
- 229960002897 heparin Drugs 0.000 description 1
- 229920000669 heparin Polymers 0.000 description 1
- 125000000623 heterocyclic group Chemical group 0.000 description 1
- 125000004435 hydrogen atom Chemical group [H]* 0.000 description 1
- 229960001680 ibuprofen Drugs 0.000 description 1
- 239000004615 ingredient Substances 0.000 description 1
- 239000003112 inhibitor Substances 0.000 description 1
- 238000001990 intravenous administration Methods 0.000 description 1
- 239000000314 lubricant Substances 0.000 description 1
- 239000000594 mannitol Substances 0.000 description 1
- 235000010355 mannitol Nutrition 0.000 description 1
- 235000010270 methyl p-hydroxybenzoate Nutrition 0.000 description 1
- 239000004292 methyl p-hydroxybenzoate Substances 0.000 description 1
- 229960002216 methylparaben Drugs 0.000 description 1
- 235000019813 microcrystalline cellulose Nutrition 0.000 description 1
- 239000008108 microcrystalline cellulose Substances 0.000 description 1
- 229940016286 microcrystalline cellulose Drugs 0.000 description 1
- 230000001114 myogenic effect Effects 0.000 description 1
- 229910052757 nitrogen Inorganic materials 0.000 description 1
- 125000004433 nitrogen atom Chemical group N* 0.000 description 1
- 230000000414 obstructive effect Effects 0.000 description 1
- 239000006186 oral dosage form Substances 0.000 description 1
- 230000008506 pathogenesis Effects 0.000 description 1
- 239000000546 pharmaceutical excipient Substances 0.000 description 1
- 230000000144 pharmacologic effect Effects 0.000 description 1
- 239000000843 powder Substances 0.000 description 1
- 239000003755 preservative agent Substances 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 235000010232 propyl p-hydroxybenzoate Nutrition 0.000 description 1
- 239000004405 propyl p-hydroxybenzoate Substances 0.000 description 1
- 229960003415 propylparaben Drugs 0.000 description 1
- 150000003180 prostaglandins Chemical class 0.000 description 1
- 238000011555 rabbit model Methods 0.000 description 1
- 230000011514 reflex Effects 0.000 description 1
- 230000002040 relaxant effect Effects 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 238000012552 review Methods 0.000 description 1
- 235000010267 sodium hydrogen sulphite Nutrition 0.000 description 1
- 241000894007 species Species 0.000 description 1
- 208000037804 stenosis Diseases 0.000 description 1
- 230000036262 stenosis Effects 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 230000003827 upregulation Effects 0.000 description 1
- 208000021331 vascular occlusion disease Diseases 0.000 description 1
- 230000025033 vasoconstriction Effects 0.000 description 1
- 239000005526 vasoconstrictor agent Substances 0.000 description 1
- 230000000304 vasodilatating effect Effects 0.000 description 1
- 229940124549 vasodilator Drugs 0.000 description 1
- 239000003071 vasodilator agent Substances 0.000 description 1
- 229960001722 verapamil Drugs 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/557—Eicosanoids, e.g. leukotrienes or prostaglandins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P7/00—Drugs for disorders of the blood or the extracellular fluid
- A61P7/02—Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors
Landscapes
- Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- Epidemiology (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Diabetes (AREA)
- Hematology (AREA)
- Chemical Kinetics & Catalysis (AREA)
- General Chemical & Material Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Organic Chemistry (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Heterocyclic Carbon Compounds Containing A Hetero Ring Having Oxygen Or Sulfur (AREA)
- Pyrrole Compounds (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
Abstract
HA491 METHOD OF INHIBITING VASOSPASM AND PLATELET AGGREGATION RESULTING FROM ANGIOPLASTY USING THROMBOXANE A2 RECEPTOR ANTAGONISTS Abstract A method is provided for inhibiting vasospasm and platelet aggregation resulting from angioplasty by administering a thromboxane A2 receptor antagonist before, during and/or after the angioplasty procedure, which thromboxane A2 receptor antagonist is a 7-oxabicycloheptane prostaglandin analog.
Description
METHOD OF INHIBITING VASOSPASM AND PLATELET
AGGREGATION RESULTING FROM ANGIOPLASTY USING
~H.OM~L~O~y~ L_ ~CEPTOR ANTAGONISTS
S : :
The present invention relates to a method for inhibiting vasospasm and platelet aggregation resulting from angioplasty using thromboxane A2 receptor antagonist~, and is more particularly concerned with such a method using 7-oxabicyclo-prostaglandin analogs.
Percutaneous transluminal coronary angiopla~ty, or balloon catheter coronary angioplasty, (both referred to hereinafter as angioplasty) is a procedure for mechanically reshaping an artery so as to alleviate obstructive -~ lesions. Simply stated, the procedure involves introducing a catheter having a deflated balloon incorporated therein into an occluded artery and inflating the balloon in order to "reopen" the artery. ~his procedure has proven to be very successful in recent years and in many cases offers significant cost and safety advantages compared to alternative medical and surgical methods of treating occluded arteries.
European Patent Application 0,256,~05 discloses thromboxane receptor antagonists of the general formula 201Z8SZ~
oR2 ( CH2 ) nXWCOOR
<~
O Y
wherein W is straight or branched C1 7 alkylene;
X is cis or ~rans -CH=CH- or -CH2CH2-; and, Y is a saturated heterocyclic amino group (attached to the cyclopentane ring via the nitrogen atom) which has 5-8 ring members and (a) optionally contains in the ring -O-, -S-, -SO2-, or -NR3 (where R3 is a hydrogen atom, C1 7 alkyl or aralkyl having a C1 4 alkyl portion); and/or (b) is optionally substituted by one or more C1 4 alkyl groups;
which are said to be useful, either singly or in combination with thromboxane synthase inhibitors, for the treatment of occlusive vascular diseases. Included in the series of vascular disorders listed is the use for peri- and post-operative complications following angioplasty.
Complications often associated with angioplasty are restenosis and acute thrombotic occlusion of the artery which has been opened.
This reduction in inside diameter of the artery and blockage thereof appear, in turn, to result from increased platelet aggregation and vasospasm. There are numerous theories attempting to explain the mechanism for platelet aggregation and vasospasm following angioplasty, and since the mechanisms are not completely understood, neither is the choice of suitable treatment.
Chesebro et al., in a paper entitled Restenosis After Arterial Angio~lasty: A
Hemorrheologic Res~onse to Injury~ Am. J. C~rdiol.
AGGREGATION RESULTING FROM ANGIOPLASTY USING
~H.OM~L~O~y~ L_ ~CEPTOR ANTAGONISTS
S : :
The present invention relates to a method for inhibiting vasospasm and platelet aggregation resulting from angioplasty using thromboxane A2 receptor antagonist~, and is more particularly concerned with such a method using 7-oxabicyclo-prostaglandin analogs.
Percutaneous transluminal coronary angiopla~ty, or balloon catheter coronary angioplasty, (both referred to hereinafter as angioplasty) is a procedure for mechanically reshaping an artery so as to alleviate obstructive -~ lesions. Simply stated, the procedure involves introducing a catheter having a deflated balloon incorporated therein into an occluded artery and inflating the balloon in order to "reopen" the artery. ~his procedure has proven to be very successful in recent years and in many cases offers significant cost and safety advantages compared to alternative medical and surgical methods of treating occluded arteries.
European Patent Application 0,256,~05 discloses thromboxane receptor antagonists of the general formula 201Z8SZ~
oR2 ( CH2 ) nXWCOOR
<~
O Y
wherein W is straight or branched C1 7 alkylene;
X is cis or ~rans -CH=CH- or -CH2CH2-; and, Y is a saturated heterocyclic amino group (attached to the cyclopentane ring via the nitrogen atom) which has 5-8 ring members and (a) optionally contains in the ring -O-, -S-, -SO2-, or -NR3 (where R3 is a hydrogen atom, C1 7 alkyl or aralkyl having a C1 4 alkyl portion); and/or (b) is optionally substituted by one or more C1 4 alkyl groups;
which are said to be useful, either singly or in combination with thromboxane synthase inhibitors, for the treatment of occlusive vascular diseases. Included in the series of vascular disorders listed is the use for peri- and post-operative complications following angioplasty.
Complications often associated with angioplasty are restenosis and acute thrombotic occlusion of the artery which has been opened.
This reduction in inside diameter of the artery and blockage thereof appear, in turn, to result from increased platelet aggregation and vasospasm. There are numerous theories attempting to explain the mechanism for platelet aggregation and vasospasm following angioplasty, and since the mechanisms are not completely understood, neither is the choice of suitable treatment.
Chesebro et al., in a paper entitled Restenosis After Arterial Angio~lasty: A
Hemorrheologic Res~onse to Injury~ Am. J. C~rdiol.
2(~1285:2 1987; 60:10B-16B, state that the region of the artery which has been dilated typically undergoes denudation of the endothelium resulting in immediate platelet growth and aggregation.
Chesebro et al. further disclose that vasoconstriction which occurs in the artery is directly related to the platelet deposition in that area. Chesebro et al. have found agents such as heparin, dipyridamole, aspirin, nitroglycerin and ibuprofen to be effective in reducing platelet-thrombus deposition. Several other agents, e.g. calcium channel blockers and thromboxane A2 receptor antagonists, were found to reduce vasospasm but had no effect on platelet aggregation at the dosages tested. Chesebro et al. additionally postulate that it is not clear that all platelet inhibition therapies will successfully alleviate angioplasty-induced restenosis.
Harker, in his article, Role of Platelets and Thrombosis in Mechanisms of Acute Occlusion and Restenosis After AngioPlastv, Am. J. Cardio 7 .
19~7; 60:20B-28B, reviews the numerous pathways responsible for mediating platelet deposition/
aggregation. Indeed, platelet aggregation probably involves thromboxane A2, adenosine diphosphate and platelet-activating factor pathways. Harker acknowledges that while reduction in vascular occlusion in a number of arterial disorders has been demonstrated by known pharmacologic modification of platelet behavior, the indication for the use of agents that inhibit platelet function for reducing restenosis after angioplasty is not clear. This seems to be so because of the lack of definitive knowledge of the pathogenesis of the restenosis process, and because of the theory that lesion formation resulting from mechanical injury, i.e. after angioplasty, may not be governed by the same mechanisms responsible for other stenosis occurrences.
The occurrence of vasospasm, i.e.
constriction of the artery, from angioplasty is similarly believed to be the result of a number of possible factors. For example, LeVeen et al. in AnqioPlastv-Induced VasosDasm in Rabbit Model, Mechanisms and Treatment, Investigative Radiol ogy 1985; 20:938-944, disclose that the causes of angioplasty-induced vasospasm are likely selected from 1) myogenic response, i.e. reflex arterial constriction from the str~tch of the arterial wall; 2) depletion of two otherwise-present vasodilating substances, prostacyclin (PGI2) and endothelial derived relaxing factor (EDRF), resulting from`the denudation of the endothelium by the catheter; 3) deposition of platelets which are known to release patent vasoconstrictors; and 4~ deposition of platelets which can cause thrombosis which may itself induce vasospasm.
LeVeen et al. found verapamil, a calcium channel blocker, to reverse established vasospasm but to be ineffective in prevention. Similarly, dazoxiben, a thromboxane synthase inhibitor, was found to reduce vasospasm, but not eliminate it or prevent it.
Although, the above-mentioned European Patent Application 0,256,805 discloses specific thromboxane receptor antagonists which are stated to be suitable for use with angioplasty, all 2(~Z85~
_5_ thromboxane receptor antagonists may not prove useful in this area of treatment. For example, to the extent thromboxane receptor antagonists inhibit blood coagulation, intramural hemorrhage in the treated vessel may be a possible adverse reaction. Further, use of thromboxane receptor antagonists could result in up regulation of platelet thromboxane receptors possibly leading to a thrombotic risk for the treated vessel following drug withdrawal. Also, it is believed that some thromboxane receptor antagonists may have significant agonist activity. In one published example, Throm. Res., 58:181, 1987, patients treated with BM 13,177 did develop angina and the drug had to be withdrawn from further study.
While platelet behavior modification agents (e.g., thromboxane receptor antagonists), vasodilators and the like may appear to be obvious choices for the treatment/prevention of restenosis and thrombotic occlusion resuIting from angioplasty, the plethera of possible mechanisms and unsuccessful trials as outlined above are hardly considered predictive o the success or failure of any given agent or class of agents.
Therefore, medicaments useful in inhibiting vasospasm and platelet aggregation resulting from angiopl~sty would be a useful addition to the medical art.
:~OlZ85~
In accordance with the present invention, a method is provided for inhibiting vasospasm and platelet aggregation resulting from angioplasty wherein a therapeutically effective amount of a thromboxane A2 receptor antagonist is systemically administered, such as orally or parenterally.
The term "thromboxane A2 receptor antagonist" as employed herein includes compounds which are so-called thromboxane A2 receptor antagonists, thromboxane A2 antagonists, thromboxane A2/prostaglandin endoperoxide antagonists, TP-receptor antagonists, or thromboxane antagonists except insofar as the compound is solely an inhibitor of thromboxane synthesis.
The thromboxane A2 receptor antagonist employed herein will be a 7-oxabicycloheptane prostaglandin analog and will include 7-oxabicyclo-heptane substi~uted diamide prostaglandin analogs as disclosed in U.S. Patent No. 4,663,336, 7-oxa-bicycloheptane substituted amino prostaglandin _7_ HA491 analogs as disclosed in U.S. Patent No. 4,416,896 and 7-oxabicycloheptane prostaglandin analogs as disclosed in U.S. Patent No. 4,537,981.
The 7-oxabicycloheptane substituted diamide prostaglandin analogs suitable for use herein, as disclosed in U.S. Patent No. 4,663,336, have the formula (CH2)m~A~(CH2)n Q
10 ~
(CH2)p-I--~-(CH2)q~I--lCI-R
including all stereoisomers thereof, wherein m is O
: to 4; A is -CH=CH- or -CH2-CH2-; n is 1 to 5; Q is -CH=CH-, -CH2~
OH Halo Halo /Halo -CH-, -CH-, -C-or a single bond; R is CO2H, CO2alkyl, CO2 alkali metal, CO2polyhydroxyamine salt, -CH2OH, N- N
~ N - N or -CNR4R5 H
wherein R4 and R5 are the same or different and are H, lower alkyl, hydroxy, lower alkoxy or aryl at least one of R4 and R5 being other than hydroxy and lower alkoxy; p is 1 to 4; Rl is H or lower 201Z85~
alkyl; q is 1 to 12; R2 is H or lower alkyl; and R3 is H, lower alkyl, lower alkenyl, lower alkynyl, aryl, arylalkyl, lower alkoxy, arylalkyloxy, aryloxy, amino, alkylamino, arylalkylamino, arylamino, (1l)n~ (~I)n' (1l) lower alkyl-S-, aryl-S-, arylalkyl-S-, (1l)n~ (1l)n~ (1l)n~
aryl-S-alkyl-, alkyl-S-alkyl-, arylalkyl-S-alkyl (wherein n' is 0, 1 or 2), alkylaminoalkyl, arylaminoalkyl, arylalkylaminoalkyl, alkoxyalkyl, aryloxyalkyl or arylalkoxyalkyl.
The 7-oxabicycloheptane substituted amino prostaglandin analogs suitable for use herein, as disclosed in U.S. Patent No. 4,416,896, have the formula * CH2-A-(CH2)ml~ CRa < i*
\~
~\ I ( CH2 )nl NH Ra : 25 and including all stereoisomers thereof, wherein A is CH=CH or (CH2)2; m1 is 1 to 8; n1 is 0 to 5, Ra is H or lower alkyl; and Ra is lower alkyl, aryl, aralkyl, lower alkoxy, aralkoxy or G
-NH-C-Ra 2~)~Z85Z
wherein R2 is lower alkyl, aryl, aralkyl, alkoxy, aryloxy, aralkoxy, alkylamino, arylamino or aralkylamino.
The 7-oxabicycloheptane prostaglandin S analogs suitable for use herein, as disclosed in U.S. Patent No. 4,537,981, have the formula CH2-A-(CH2)m -X
< I l*
B-CH-Y
O OH
and including all stereoisomers thereof, wherein A
and B may be the same or different and A is CH=CH or (CH2)2; B is CH=CH, C_C or (CH2)2; m1 is 1 to 8;
,X is OEI;
,N - N
-C~
\ N - N
CO2Ra wherein Ra is H or lower alkyl; or O
CNH-~
wherein Z is H, lower alkyl, aryl, SO2-Q
(with Q1 being lower alkyl or aryl), o C-Q1, or ORb wherein ~ is H, and Y is alkyl, substituted alkyl; aryl-lower alkyl; alkenyl;
alkynyl, aryl; pyridyl; substituted pyridyl;
2~Z~S~
pyridyl-lower alkyl; thienyl, substituted thienyl;
thienyl-lower alkyl; cycloalkyl; cycloalkylalkyl;
substituted cycloalkylalkyl; or phenoxymethyl.
Preferred examples of thromboxane A2 receptor antagonists which may be employed herein include the 7-oxabicycloheptane compounds disclosed in U.S. Patent No. 4,537,981, especially, [lS-[la,2a(Z),3a(1E,3S*,4R*),4a]]-7-[3-(3-hydroxy-4-phenyl-1-pentenyl)-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid; the 7-oxabi-cycloheptane substituted amino-prostaglandin analogs disclosed in U.S. Patent No. 4,416,896, especially, [lS-[la,2a,(Z),3a,4a]]-7-[3-[[2-(phenylamino)carbonyl]hydrazino]methyl]-7-oxa-bicyclo[2.2.1]hept-2-yl]-5-heptenoic acid; the 7-oxabicycloheptane substituted diamide prostaglandin analogs disclosed in U.S. Patent No.
4,663,336, especially, [lS-[la,2a(Z),3a,4a]~-7-[3-[[[[(1-oxoheptyl)amino~acetyl]amino]methyl]-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid and the corresponding tetrazole, and [lS-[la,2a(Z),3a,4a]]-7-~3-[[[[(4-cyclohexyl-l-oxobutyl)amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid.
The disclosures of the above-mentioned patents are incorporated herein by reference.
In carrying out the method of the present invention, the thromboxane A2 receptor antagonist may be administered systemically, such as orally or parenterally, to mammalian species, such as monkeys, dogs, cats, rats, humans, etc., prior to, during and/or after the angioplasty process.
2~)1285Z
The thromboxane A2 receptor antagonist may be incorporated in a conventional dosage form, such as a tablet, capsule, elixir or injectable.
The above dosage forms will also include the necessary carrier material, excipient, lubricant, buffer, antibacterial, bulking agent (such as mannitol), anti-oxidants (ascorbic acid or sodium bisulfite) or the like. oral dosage forms are preferred, although parenteral forms are quite satisfactory as well.
With regard to such systemic formulations, single or divided doses of from about 0.1 to about 2500 mg, preferably from about 5 to 200 mg/one to four times daily, may be administered in systemic dosage forms as described above for a prolonged period, that is, four weeks to six months, or longer, beginning at the time of the angioplasty procedure-.
2~)~285~
The following Examples represent preferred embodiments of the present invention:
Example 1 An injectable solution of thromboxane A2 receptor antagonist for intravenous use in the inhibition of vasospasm and platelet aggregation resulting from angioplasty is produced as follows:
[lS-[1~,2~(Z),3~,4~]]-7-[3-[[2-(phenylamino)carbonyl]hydrazino]-methyl]-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 29,548)2500 mg Methyl paraben 5 mg 15 Propyl paraben 1 mg Sodium chloride 25 g Water for injection qs. 5 1.
The thromboxane A2 receptor antagonist, preservatives and sodium chloride are dissolved in 3 liters of water for injection and then the volume is brought up to 5 liters. The solution is filtered through a sterile filter and aseptically filled into presterilized vials which are then closed with presterilized rubber closures. Each vial contains a concentration of 75 mg of active ingredient per 150 mg of solution.
Example 2 An injectable for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 1 except that the thromboxane A2 receptor antagonist employed is [lS-[la,2a(Z),3a(1E,3S*,4R*),4a]]-7-[3-(3-hydroxy-4-phenyl-1-pentenyl)-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 28,668).
Example 3 An injectable solution of thromboxane A2 receptor antagonist for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty containing [lS-[la,2a(Z),3a,4a]]-7-[3-[[[[(1-oxo-heptyl)-amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]-hept-2-yl]-5-heptenoic acid (SQ 30,741) as the thromboxane A2 receptor antagonist is prepared as described in Example 1.
Example 4 An injectable for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 1 except that the thromboxane A2 receptor antagonist employed is [lS-[la,2a(Z),3a,4a]]-7-[3-[[[[(4-cyclohexyl-l-oxo-butyl)amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 31,491).
2~)~285:;~
ExamPle 5 A thromboxane A2 antagonist formulation suitable for oral administration for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is set out below.
1000 tablets each containing 400 mg of thromboxane A2 receptor antagonist are produced from the following ingredients.
[ls-[la~2a(z)~3a~4a]]-7-[3-t[[[( Oxoheptyl)amino]acetyl]amino]methyl]~
7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 30,741) 400 g Corn starch 50 g 15 Gelatine 7.5 g Avicel (microcrystalline cellulose) 25 g Magnesium stearate 2.5 g The thromboxane A2 receptor antagonist and corn starch are admixed with an aqueous solution of the gelatin. The mixture is dried and ground to a find powder. The Avicel and then the magnesium stearate are admixed with the granulation. This is then compressed in a tablet to form 1000 tablets each containing 400 mg of active ingredient.
2~)1Z8SZ
Exam~le 6 A thromboxane A2 antagonist tablet formulation for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 5 except that SQ 29,548 is employed as the thromboxane A2 receptor antagonist in place of SQ 30,741.
Exam~le 7 10 A thromboxane A2 antagonist tablet formulation for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 5 except that SQ 28,668 is employed in place of SQ 30,741.
Chesebro et al. further disclose that vasoconstriction which occurs in the artery is directly related to the platelet deposition in that area. Chesebro et al. have found agents such as heparin, dipyridamole, aspirin, nitroglycerin and ibuprofen to be effective in reducing platelet-thrombus deposition. Several other agents, e.g. calcium channel blockers and thromboxane A2 receptor antagonists, were found to reduce vasospasm but had no effect on platelet aggregation at the dosages tested. Chesebro et al. additionally postulate that it is not clear that all platelet inhibition therapies will successfully alleviate angioplasty-induced restenosis.
Harker, in his article, Role of Platelets and Thrombosis in Mechanisms of Acute Occlusion and Restenosis After AngioPlastv, Am. J. Cardio 7 .
19~7; 60:20B-28B, reviews the numerous pathways responsible for mediating platelet deposition/
aggregation. Indeed, platelet aggregation probably involves thromboxane A2, adenosine diphosphate and platelet-activating factor pathways. Harker acknowledges that while reduction in vascular occlusion in a number of arterial disorders has been demonstrated by known pharmacologic modification of platelet behavior, the indication for the use of agents that inhibit platelet function for reducing restenosis after angioplasty is not clear. This seems to be so because of the lack of definitive knowledge of the pathogenesis of the restenosis process, and because of the theory that lesion formation resulting from mechanical injury, i.e. after angioplasty, may not be governed by the same mechanisms responsible for other stenosis occurrences.
The occurrence of vasospasm, i.e.
constriction of the artery, from angioplasty is similarly believed to be the result of a number of possible factors. For example, LeVeen et al. in AnqioPlastv-Induced VasosDasm in Rabbit Model, Mechanisms and Treatment, Investigative Radiol ogy 1985; 20:938-944, disclose that the causes of angioplasty-induced vasospasm are likely selected from 1) myogenic response, i.e. reflex arterial constriction from the str~tch of the arterial wall; 2) depletion of two otherwise-present vasodilating substances, prostacyclin (PGI2) and endothelial derived relaxing factor (EDRF), resulting from`the denudation of the endothelium by the catheter; 3) deposition of platelets which are known to release patent vasoconstrictors; and 4~ deposition of platelets which can cause thrombosis which may itself induce vasospasm.
LeVeen et al. found verapamil, a calcium channel blocker, to reverse established vasospasm but to be ineffective in prevention. Similarly, dazoxiben, a thromboxane synthase inhibitor, was found to reduce vasospasm, but not eliminate it or prevent it.
Although, the above-mentioned European Patent Application 0,256,805 discloses specific thromboxane receptor antagonists which are stated to be suitable for use with angioplasty, all 2(~Z85~
_5_ thromboxane receptor antagonists may not prove useful in this area of treatment. For example, to the extent thromboxane receptor antagonists inhibit blood coagulation, intramural hemorrhage in the treated vessel may be a possible adverse reaction. Further, use of thromboxane receptor antagonists could result in up regulation of platelet thromboxane receptors possibly leading to a thrombotic risk for the treated vessel following drug withdrawal. Also, it is believed that some thromboxane receptor antagonists may have significant agonist activity. In one published example, Throm. Res., 58:181, 1987, patients treated with BM 13,177 did develop angina and the drug had to be withdrawn from further study.
While platelet behavior modification agents (e.g., thromboxane receptor antagonists), vasodilators and the like may appear to be obvious choices for the treatment/prevention of restenosis and thrombotic occlusion resuIting from angioplasty, the plethera of possible mechanisms and unsuccessful trials as outlined above are hardly considered predictive o the success or failure of any given agent or class of agents.
Therefore, medicaments useful in inhibiting vasospasm and platelet aggregation resulting from angiopl~sty would be a useful addition to the medical art.
:~OlZ85~
In accordance with the present invention, a method is provided for inhibiting vasospasm and platelet aggregation resulting from angioplasty wherein a therapeutically effective amount of a thromboxane A2 receptor antagonist is systemically administered, such as orally or parenterally.
The term "thromboxane A2 receptor antagonist" as employed herein includes compounds which are so-called thromboxane A2 receptor antagonists, thromboxane A2 antagonists, thromboxane A2/prostaglandin endoperoxide antagonists, TP-receptor antagonists, or thromboxane antagonists except insofar as the compound is solely an inhibitor of thromboxane synthesis.
The thromboxane A2 receptor antagonist employed herein will be a 7-oxabicycloheptane prostaglandin analog and will include 7-oxabicyclo-heptane substi~uted diamide prostaglandin analogs as disclosed in U.S. Patent No. 4,663,336, 7-oxa-bicycloheptane substituted amino prostaglandin _7_ HA491 analogs as disclosed in U.S. Patent No. 4,416,896 and 7-oxabicycloheptane prostaglandin analogs as disclosed in U.S. Patent No. 4,537,981.
The 7-oxabicycloheptane substituted diamide prostaglandin analogs suitable for use herein, as disclosed in U.S. Patent No. 4,663,336, have the formula (CH2)m~A~(CH2)n Q
10 ~
(CH2)p-I--~-(CH2)q~I--lCI-R
including all stereoisomers thereof, wherein m is O
: to 4; A is -CH=CH- or -CH2-CH2-; n is 1 to 5; Q is -CH=CH-, -CH2~
OH Halo Halo /Halo -CH-, -CH-, -C-or a single bond; R is CO2H, CO2alkyl, CO2 alkali metal, CO2polyhydroxyamine salt, -CH2OH, N- N
~ N - N or -CNR4R5 H
wherein R4 and R5 are the same or different and are H, lower alkyl, hydroxy, lower alkoxy or aryl at least one of R4 and R5 being other than hydroxy and lower alkoxy; p is 1 to 4; Rl is H or lower 201Z85~
alkyl; q is 1 to 12; R2 is H or lower alkyl; and R3 is H, lower alkyl, lower alkenyl, lower alkynyl, aryl, arylalkyl, lower alkoxy, arylalkyloxy, aryloxy, amino, alkylamino, arylalkylamino, arylamino, (1l)n~ (~I)n' (1l) lower alkyl-S-, aryl-S-, arylalkyl-S-, (1l)n~ (1l)n~ (1l)n~
aryl-S-alkyl-, alkyl-S-alkyl-, arylalkyl-S-alkyl (wherein n' is 0, 1 or 2), alkylaminoalkyl, arylaminoalkyl, arylalkylaminoalkyl, alkoxyalkyl, aryloxyalkyl or arylalkoxyalkyl.
The 7-oxabicycloheptane substituted amino prostaglandin analogs suitable for use herein, as disclosed in U.S. Patent No. 4,416,896, have the formula * CH2-A-(CH2)ml~ CRa < i*
\~
~\ I ( CH2 )nl NH Ra : 25 and including all stereoisomers thereof, wherein A is CH=CH or (CH2)2; m1 is 1 to 8; n1 is 0 to 5, Ra is H or lower alkyl; and Ra is lower alkyl, aryl, aralkyl, lower alkoxy, aralkoxy or G
-NH-C-Ra 2~)~Z85Z
wherein R2 is lower alkyl, aryl, aralkyl, alkoxy, aryloxy, aralkoxy, alkylamino, arylamino or aralkylamino.
The 7-oxabicycloheptane prostaglandin S analogs suitable for use herein, as disclosed in U.S. Patent No. 4,537,981, have the formula CH2-A-(CH2)m -X
< I l*
B-CH-Y
O OH
and including all stereoisomers thereof, wherein A
and B may be the same or different and A is CH=CH or (CH2)2; B is CH=CH, C_C or (CH2)2; m1 is 1 to 8;
,X is OEI;
,N - N
-C~
\ N - N
CO2Ra wherein Ra is H or lower alkyl; or O
CNH-~
wherein Z is H, lower alkyl, aryl, SO2-Q
(with Q1 being lower alkyl or aryl), o C-Q1, or ORb wherein ~ is H, and Y is alkyl, substituted alkyl; aryl-lower alkyl; alkenyl;
alkynyl, aryl; pyridyl; substituted pyridyl;
2~Z~S~
pyridyl-lower alkyl; thienyl, substituted thienyl;
thienyl-lower alkyl; cycloalkyl; cycloalkylalkyl;
substituted cycloalkylalkyl; or phenoxymethyl.
Preferred examples of thromboxane A2 receptor antagonists which may be employed herein include the 7-oxabicycloheptane compounds disclosed in U.S. Patent No. 4,537,981, especially, [lS-[la,2a(Z),3a(1E,3S*,4R*),4a]]-7-[3-(3-hydroxy-4-phenyl-1-pentenyl)-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid; the 7-oxabi-cycloheptane substituted amino-prostaglandin analogs disclosed in U.S. Patent No. 4,416,896, especially, [lS-[la,2a,(Z),3a,4a]]-7-[3-[[2-(phenylamino)carbonyl]hydrazino]methyl]-7-oxa-bicyclo[2.2.1]hept-2-yl]-5-heptenoic acid; the 7-oxabicycloheptane substituted diamide prostaglandin analogs disclosed in U.S. Patent No.
4,663,336, especially, [lS-[la,2a(Z),3a,4a]~-7-[3-[[[[(1-oxoheptyl)amino~acetyl]amino]methyl]-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid and the corresponding tetrazole, and [lS-[la,2a(Z),3a,4a]]-7-~3-[[[[(4-cyclohexyl-l-oxobutyl)amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid.
The disclosures of the above-mentioned patents are incorporated herein by reference.
In carrying out the method of the present invention, the thromboxane A2 receptor antagonist may be administered systemically, such as orally or parenterally, to mammalian species, such as monkeys, dogs, cats, rats, humans, etc., prior to, during and/or after the angioplasty process.
2~)1285Z
The thromboxane A2 receptor antagonist may be incorporated in a conventional dosage form, such as a tablet, capsule, elixir or injectable.
The above dosage forms will also include the necessary carrier material, excipient, lubricant, buffer, antibacterial, bulking agent (such as mannitol), anti-oxidants (ascorbic acid or sodium bisulfite) or the like. oral dosage forms are preferred, although parenteral forms are quite satisfactory as well.
With regard to such systemic formulations, single or divided doses of from about 0.1 to about 2500 mg, preferably from about 5 to 200 mg/one to four times daily, may be administered in systemic dosage forms as described above for a prolonged period, that is, four weeks to six months, or longer, beginning at the time of the angioplasty procedure-.
2~)~285~
The following Examples represent preferred embodiments of the present invention:
Example 1 An injectable solution of thromboxane A2 receptor antagonist for intravenous use in the inhibition of vasospasm and platelet aggregation resulting from angioplasty is produced as follows:
[lS-[1~,2~(Z),3~,4~]]-7-[3-[[2-(phenylamino)carbonyl]hydrazino]-methyl]-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 29,548)2500 mg Methyl paraben 5 mg 15 Propyl paraben 1 mg Sodium chloride 25 g Water for injection qs. 5 1.
The thromboxane A2 receptor antagonist, preservatives and sodium chloride are dissolved in 3 liters of water for injection and then the volume is brought up to 5 liters. The solution is filtered through a sterile filter and aseptically filled into presterilized vials which are then closed with presterilized rubber closures. Each vial contains a concentration of 75 mg of active ingredient per 150 mg of solution.
Example 2 An injectable for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 1 except that the thromboxane A2 receptor antagonist employed is [lS-[la,2a(Z),3a(1E,3S*,4R*),4a]]-7-[3-(3-hydroxy-4-phenyl-1-pentenyl)-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 28,668).
Example 3 An injectable solution of thromboxane A2 receptor antagonist for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty containing [lS-[la,2a(Z),3a,4a]]-7-[3-[[[[(1-oxo-heptyl)-amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]-hept-2-yl]-5-heptenoic acid (SQ 30,741) as the thromboxane A2 receptor antagonist is prepared as described in Example 1.
Example 4 An injectable for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 1 except that the thromboxane A2 receptor antagonist employed is [lS-[la,2a(Z),3a,4a]]-7-[3-[[[[(4-cyclohexyl-l-oxo-butyl)amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 31,491).
2~)~285:;~
ExamPle 5 A thromboxane A2 antagonist formulation suitable for oral administration for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is set out below.
1000 tablets each containing 400 mg of thromboxane A2 receptor antagonist are produced from the following ingredients.
[ls-[la~2a(z)~3a~4a]]-7-[3-t[[[( Oxoheptyl)amino]acetyl]amino]methyl]~
7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid (SQ 30,741) 400 g Corn starch 50 g 15 Gelatine 7.5 g Avicel (microcrystalline cellulose) 25 g Magnesium stearate 2.5 g The thromboxane A2 receptor antagonist and corn starch are admixed with an aqueous solution of the gelatin. The mixture is dried and ground to a find powder. The Avicel and then the magnesium stearate are admixed with the granulation. This is then compressed in a tablet to form 1000 tablets each containing 400 mg of active ingredient.
2~)1Z8SZ
Exam~le 6 A thromboxane A2 antagonist tablet formulation for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 5 except that SQ 29,548 is employed as the thromboxane A2 receptor antagonist in place of SQ 30,741.
Exam~le 7 10 A thromboxane A2 antagonist tablet formulation for use in inhibiting vasospasm and platelet aggregation resulting from angioplasty is prepared as described in Example 5 except that SQ 28,668 is employed in place of SQ 30,741.
Claims (11)
1. A method for inhibiting vasospasm and platelet aggregation resulting from angioplasty in a mammalian species, which comprises adminis-tering to a mammalian species in need of such treatment an effective amount of a thromboxane A2 receptor antagonist, which thromboxane A2 receptor antagonist is a 7-oxabicycloheptane prostaglandin analog.
2. The method as defined in Claim 1 wherein the 7-oxabicycloheptane prostaglandin analog is a 7-oxabicycloheptane substituted diamide prostaglandin analog or a 7-oxabicyclo-heptane substituted amino prostaglandin analog.
3. The method as defined in Claim 1 wherein the 7-oxabicycloheptane prostaglandin analog has the formula and including all stereoisomers thereof, wherein A and B may be the same or different and A
is CH=CH or (CH2)2; B is CH=CH, C?C or (CH2)2; m1 is 1 to 8; X is OH;
CO2Ra wherein Ra is H or lower alkyl; or ?NH-Z
wherein Z is H, lower alkyl, aryl, SO2-Q1 (with Q1 being lower alkyl or aryl), ?-Q1, or OR? wherein R? is H, and Y is alkyl;
substituted alkyl; aryl-lower alkyl; alkenyl;
alkynyl, aryl; pyridyl; substituted pyridyl;
pyridyl-lower alkyl; thienyl, substituted thienyl, thienyl-lower alkyl; cycloalkyl; cycloalkylalkyl;
substituted cycloalkylalkyl; or phenoxymethyl.
is CH=CH or (CH2)2; B is CH=CH, C?C or (CH2)2; m1 is 1 to 8; X is OH;
CO2Ra wherein Ra is H or lower alkyl; or ?NH-Z
wherein Z is H, lower alkyl, aryl, SO2-Q1 (with Q1 being lower alkyl or aryl), ?-Q1, or OR? wherein R? is H, and Y is alkyl;
substituted alkyl; aryl-lower alkyl; alkenyl;
alkynyl, aryl; pyridyl; substituted pyridyl;
pyridyl-lower alkyl; thienyl, substituted thienyl, thienyl-lower alkyl; cycloalkyl; cycloalkylalkyl;
substituted cycloalkylalkyl; or phenoxymethyl.
4. The method as defined in Claim 2 wherein the 7-oxabicycloheptane substituted diamide prostaglandin analog has the formula including all stereoisomers thereof, wherein m is 0 to 4; A is -CH=CH- or -CH2-CH2-; n is 1 to 5; Q
is -CH=CH-, -CH2, or a single hond; R is CO2H, CO2alkyl, CO2 alkali metal, CO2polyhydroxyamine salt, -CH2OH, or -?R4R5 wherein R4 and R5 are the same or different and are H, lower alkyl, hydroxy, lower alkoxy or aryl at least one of R4 and R5 being other than hydroxy and lower alkoxy; p is 1 to 4; R1 is H or lower alkyl q is 1 to 12; R2 is H or lower alkyl; and R3 is H, lower alkyl, lower alkenyl, lower alkynyl, aryl, arylalkyl, lower alkoxy, arylalkyloxy, aryloxy, amino, alkylamino, arylalkylamino, arylamino, lower (wherein n' is 0, 1 or 2), alkylaminoalkyl, arylaminoalkyl, arylalkylaminoalkyl, alkoxyalkyl, aryloxyalkyl or arylalkoxyalkyl.
is -CH=CH-, -CH2, or a single hond; R is CO2H, CO2alkyl, CO2 alkali metal, CO2polyhydroxyamine salt, -CH2OH, or -?R4R5 wherein R4 and R5 are the same or different and are H, lower alkyl, hydroxy, lower alkoxy or aryl at least one of R4 and R5 being other than hydroxy and lower alkoxy; p is 1 to 4; R1 is H or lower alkyl q is 1 to 12; R2 is H or lower alkyl; and R3 is H, lower alkyl, lower alkenyl, lower alkynyl, aryl, arylalkyl, lower alkoxy, arylalkyloxy, aryloxy, amino, alkylamino, arylalkylamino, arylamino, lower (wherein n' is 0, 1 or 2), alkylaminoalkyl, arylaminoalkyl, arylalkylaminoalkyl, alkoxyalkyl, aryloxyalkyl or arylalkoxyalkyl.
5. The method as defined in Claim 2 wherein the 7-oxabicycloheptane substituted amino prostaglandin analog has the formula and including all stereoisomers thereof, wherein A
is CH=CH or (CH2)2; m1 is 1 to 8; n1 is 0 to 5, Ra is H or lower alkyl; and R? is lower alkyl, aryl, aralkyl, lower alkoxy, aralkoxy or -NH-?-R?
wherein R? is lower alkyl, aryl, aralkyl, alkoxy, aryloxy, aralkoxy, alkylamino, arylamino or aralkylamino.
is CH=CH or (CH2)2; m1 is 1 to 8; n1 is 0 to 5, Ra is H or lower alkyl; and R? is lower alkyl, aryl, aralkyl, lower alkoxy, aralkoxy or -NH-?-R?
wherein R? is lower alkyl, aryl, aralkyl, alkoxy, aryloxy, aralkoxy, alkylamino, arylamino or aralkylamino.
6. The method as defined in Claim 1 wherein the thromboxane A2 receptor antagonist is [1S-[1.alpha.,2.alpha.(Z),3.alpha.(1E,3S*,4R*),4.alpha.]]-7-[3-(3-hydroxy-4-phenyl-1-pentenyl)-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid.
7. The method as defined in Claim 1 wherein the thromboxane A2 receptor antagonist has the name [1S-[1.alpha.,2.alpha.(Z),3.alpha.,4.alpha.]]-7-[3-[[[[(1-oxoheptyl)amino]acetyl]amino]methyl]-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid or the corresponding tetrazole.
8. The method as defined in Claim 1 wherein the thromboxane A2 receptor antagonist has the name [1S-[1.alpha.,2.alpha.(Z),3.alpha.,4.alpha.]]-7-[3-[[[[(4-cyclo-hexyl-1-oxobutyl)amino]acetyl]amino]methyl]-7-oxabicyclo[2.2.1]hept-2-yl]-5-heptenoic acid.
9. The method as defined in Claim 1 wherein the thromboxane A2 receptor antagonist has the name [lS-[la,2a(Z),3a,4a]]-7-[3-[[2-(phenyl-amino)carbonyl]hydrazino]methyl]-7-oxabicyclo-[2.2.1]hept-2-yl]-5-heptenoic acid.
10. The method as defined in Claim 1 wherein the thromboxane A2 receptor antagonist is administered orally or parenterally.
11. The method as defined in Claim 1 wherein the thromboxane receptor antagonist is administered in single or divided doses of from about 0.1 to about 2500 mg/one to four times daily.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US34644789A | 1989-05-01 | 1989-05-01 | |
US346,447 | 1989-05-01 |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2012852A1 true CA2012852A1 (en) | 1990-11-01 |
Family
ID=23359439
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002012852A Abandoned CA2012852A1 (en) | 1989-05-01 | 1990-03-22 | Method of inhibiting vasospasm and platelet aggregation resulting from angioplasty using thromboxane a receptor antagonists |
Country Status (6)
Country | Link |
---|---|
JP (1) | JPH02295922A (en) |
CA (1) | CA2012852A1 (en) |
DE (1) | DE4013680A1 (en) |
FR (1) | FR2646351A1 (en) |
GB (1) | GB2231795A (en) |
IT (1) | IT1240681B (en) |
Families Citing this family (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
AU4687500A (en) * | 1999-04-29 | 2000-11-17 | Allergan Sales, Inc. | Thromboxane ligands without blood clotting side effects |
Family Cites Families (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4537981A (en) * | 1981-11-09 | 1985-08-27 | E. R. Squibb & Sons, Inc. | 7-Oxabicycloheptane and 7-oxabicycloheptene compounds |
US4416896A (en) * | 1982-05-17 | 1983-11-22 | E. R. Squibb & Sons, Inc. | 7-Oxabicyclopheptane substituted amino prostaglandin analogs useful in the treatment of thrombolytic disease |
US4663336A (en) * | 1985-07-01 | 1987-05-05 | E. R. Squibb & Sons, Inc. | 7-oxabicycloheptane substituted diamide and its congener prostaglandin analogs useful in the treatment of thrombotic disease |
-
1990
- 1990-03-22 CA CA002012852A patent/CA2012852A1/en not_active Abandoned
- 1990-04-26 IT IT20136A patent/IT1240681B/en active IP Right Grant
- 1990-04-27 DE DE4013680A patent/DE4013680A1/en not_active Withdrawn
- 1990-04-30 GB GB9009636A patent/GB2231795A/en not_active Withdrawn
- 1990-05-01 JP JP2116704A patent/JPH02295922A/en active Pending
- 1990-05-02 FR FR9005547A patent/FR2646351A1/en not_active Withdrawn
Also Published As
Publication number | Publication date |
---|---|
FR2646351A1 (en) | 1990-11-02 |
DE4013680A1 (en) | 1990-11-08 |
GB9009636D0 (en) | 1990-06-20 |
IT9020136A1 (en) | 1991-10-26 |
JPH02295922A (en) | 1990-12-06 |
IT9020136A0 (en) | 1990-04-26 |
GB2231795A (en) | 1990-11-28 |
IT1240681B (en) | 1993-12-17 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US6610732B2 (en) | Anti-constipation composition | |
US5001154A (en) | Fervescence composition | |
CA1336686C (en) | Method of inhibiting onset of or treating migraine headache using a thromboxane a- receptor antagonist | |
CA2012852A1 (en) | Method of inhibiting vasospasm and platelet aggregation resulting from angioplasty using thromboxane a receptor antagonists | |
EP0309801B1 (en) | Use of thromboxane a2 antagonists for the manufacture of a medicament for improving post-ischemic myocardial dysfunction | |
US5221690A (en) | Increasing the choroidal blood flow | |
HU208493B (en) | Process for producing pharmaceutical composition for treating and preventing vein thrombosis | |
US4975279A (en) | Method of improving post-ischemic myocardial function using a thromboxane A2 antagonist in combination with a thrombolytic agent and combination | |
IE63735B1 (en) | Method of preventing or reducing adverse reactions to protamine using a thromboxane a2 receptor antagonist | |
IE59338B1 (en) | Prostacyclins, their analogues or prostaglandins and thromboxane antagonists for the treatment of thrombotic and thrombo-embolic syndromes | |
US5523321A (en) | Prostacyclins, their analogs or prostaglandins and thromboxane antagonists for treatment of thrombotic and thromboembolic syndromes | |
EP0474438A1 (en) | Method for preventing or treating cerebrovascular disease employing the ACE-inhibitor ceronapril | |
NZ232110A (en) | Pharmaceutical compositions containing a 7-oxa-bicycloheptane prostaglandin analogue as a thrombane a2 receptor antagonist | |
CZ291534B6 (en) | Use of prostane derivatives and combination of these substances with antibiotics for treating bacterial infections | |
CZ288219B6 (en) | Medicament for prophylaxis or therapy of restenosis | |
US3895114A (en) | Cyclic hydroxamic acids as antihypertensive agents | |
JPH0296529A (en) | Intraocular pressure depressing agent | |
NZ226198A (en) | Fervescence (temperature raising) composition comprising 15-keto-pge | |
GB2227664A (en) | Treating hypertension using a thromboxane A2 receptor antagonist | |
EP0342030A2 (en) | Use of a thromboxane receptor antagonist to complement arterial surgery | |
GB2219938A (en) | Use of a thromboxane receptor antagonist in pregnancy-induced hypertension | |
JPH05279253A (en) | Preventing and treating agent for osteoporosis |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
FZDE | Discontinued | ||
FZDE | Discontinued |
Effective date: 19940922 |