COMPOUNDS AND METHODS FOR INHIBITING NHE-MEDIATED ANTIPORT IN THE TREATMENT OF DISORDERS ASSOCIATED WITH FLUID RETENTION OR SALT OVERLOAD AND GASTROINTESTINAL TRACT DISORDERS
申请人:Ardelyx, Inc.
公开号:EP3351248A1
公开(公告)日:2018-07-25
The present disclosure is directed to compounds and methods for the treatment of disorders associated with fluid retention or salt overload, such as heart failure (in particular, congestive heart failure), chronic kidney disease, end-stage renal disease, liver disease, and peroxisome proliferator-activated receptor (PPAR) gamma agonist-induced fluid retention. The present disclosure is also directed to compounds and methods for the treatment of hypertension. The present disclosure is also directed to compounds and methods for the treatment of gastrointestinal tract disorders, including the treatment or reduction of pain associated with gastrointestinal tract disorders. The methods generally comprise administering to a mammal in need thereof a pharmaceutically effective amount of a compound, or a pharmaceutical composition comprising such a compound, that is designed to be substantially active in the gastrointestinal (GI) tract to inhibit NHE-mediated antiport of sodium ions and hydrogen ions therein. More particularly, the method comprises administering to a mammal in need thereof a pharmaceutically effective amount of a compound, or a pharmaceutical composition comprising such a compound, that inhibits NHE-3, -2 and/or -8 mediated antiport of sodium and/or hydrogen ions in the GI tract and is designed to be substantially impermeable to the layer of epithelial cells, or more specifically the epithelium of the GI tract. As a result of the compound being substantially impermeable, it is not absorbed and is thus essentially systemically non-bioavailable, so as to limit the exposure of other internal organs (e.g., liver, heart, brain, etc.) thereto. The present disclosure is still further directed to a method wherein a mammal is administered such a compound with a fluid-absorbing polymer, such that the combination acts as described above and further provides the ability to sequester fluid and/or salt present in the GI tract
本公开内容涉及用于治疗与体液潴留或盐负荷过重相关的疾病的化合物和方法,如心力衰竭(尤其是充血性心力衰竭)、慢性肾病、终末期肾病、肝病和过氧化物酶体增殖激活受体(PPAR)γ激动剂诱导的体液潴留。本公开还涉及治疗高血压的化合物和方法。本公开还涉及治疗胃肠道疾病的化合物和方法,包括治疗或减轻与胃肠道疾病相关的疼痛。这些方法一般包括向有需要的哺乳动物施用药学上有效量的化合物或包含这种化合物的药物组合物,这种化合物在胃肠道中基本具有活性,可抑制其中钠离子和氢离子的NHE介导的反转运。更具体地说,该方法包括向有需要的哺乳动物施用药学上有效量的化合物或包含该化合物的药物组合物,该化合物可抑制胃肠道中NHE-3、-2和/或-8介导的钠离子和/或氢离子的反转运,且设计成基本上不渗透上皮细胞层,或更具体地说不渗透胃肠道上皮细胞。由于该化合物基本上不渗透,因此不会被吸收,从而基本上不会被全身生物利用,从而限制了其他内脏器官(如肝脏、心脏、大脑等)对该化合物的接触。本公开内容还进一步涉及一种方法,在这种方法中,哺乳动物与吸液聚合物一起服用这种化合物,从而使这种组合起到如上所述的作用,并进一步提供封存存在于消化道中的液体和/或盐的能力。