Crystalline(2S,4R)-5-(5′-chloro-2′-fluoro-[1,1′-bipheny]-4-yl)-2-(ethoxymethyl)-4-(3-hydroxyisoxazole-5-carboxamido)-2-methylpentanoic acid and uses thereof
In one aspect, the invention relates to a crystalline form of the structure: or a pharmaceutically acceptable salt thereof, having neprilysin inhibition activity. In another aspect, the invention relates to pharmaceutical compositions comprising this crystalline form; methods of using this crystalline form and its soluble form (I); and processes for preparing soluble (I) and crystalline (I′) forms.
1. A method for treating hypertension, heart failure, or renal disease in a patient in need thereof, the method comprising administering a crystalline free acid form of (2S,4R)-5-(5′-chloro-2′-fluoro-[1,1′-biphenyl]-4-yl)-2-(ethoxymethyl)-4-(3-hydroxyisoxazole-5-carboxamido)-2-methylpentanoic acid (Compound I′) to the patient.
2. The method of claim 1 , wherein the hypertension is primary hypertension, pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension, or hypertension with renal artery stenosis.
3. The method of claim 1 , wherein the renal disease is diabetic nephropathy, chronic kidney disease, proteinuria, acute kidney injury, nephrotic syndrome, focal segmental glomerulosclerosis or polycystic kidney disease.
4. A method of treating hypertension, heart failure, or renal disease in a renally-impaired patient, the method comprising administering a therapeutically effective amount of a crystalline free acid form of (2S,4R)-5-(5′-chloro-2′-fluoro-[1,1′-biphenyl ]-4-yl)-2-(ethoxymethyl)-4-(3-hydroxyisoxazole-5-carboxamido)-2-methylpentanoic acid (Compound I′) to the patient.
5. The method of claim 4 , wherein the renally-impaired patient has chronic kidney disease with an estimated glomerular filtration rate (eGFR) between 60 mL/min/1.73 m 2 and 15 mL/min/1.73 m 2 .
6. A method of increasing atrial natriuretic peptide (ANP) or cyclic guanosine monophosphate (cGMP) levels in a human for at least 24 hours, the method comprising administering to the human an ANP or cGMP-increasing amount of a crystalline free acid form of (2S,4R)-5-(5′-chloro-2′-fluoro-[1,1′-biphenyl]-4-yl)-2-(ethoxymethyl)-4-(3-hydroxyisoxazole-5-carboxamido)-2-methylpentanoic acid (Compound I′).
7. The method of claim 6 , wherein levels of ANP and cGMP are measured in either urine or plasma or both in the human.
8. The method of claim 1 , 4 or 6 , wherein Compound I′ is administered parenterally.
9. The method of claim 1 , 4 or 6 , wherein the crystalline form is characterized by a powder x-ray diffraction pattern comprising diffraction peaks at 2θ values of 6.51±0.20, 11.62±0.20, 13.05±0.20, 15.07±0.20, and 23.28±0.20.
10. The method of claim 1 , 4 or 6 , wherein the crystalline form is characterized by a powder x-ray diffraction pattern comprising diffraction peaks at 2θ values of 6.51±0.20, 11.62±0.20, 13.05±0.20, 15.07±0.20, 17.12±0.20, 23.28±0.20, and 26.19±0.20.
11. The method of claim 1 , 4 , or 6 , wherein the crystalline form is characterized by a powder x-ray diffraction pattern comprising one or more diffraction peaks at 2θ values selected from 6.51±0.20, 11.62±0.20, 13.05±0.20, 15.07±0.20, 15.72±0.20, 17.12±0.20, 20.79±0.20, 21.10±0.20, 23.28±0.20, 24.48±0.20, 25.81±0.20, and 26.19±0.20.
12. The method of claim 1 , 4 or 6 , wherein the crystalline form is characterized by a powder x-ray diffraction pattern in which the peak positions are substantially in accordance with the peak positions of the pattern shown in FIG. 1 .
13. The method of claim 1 , 4 or 6 , wherein the crystalline form is characterized by a differential scanning calorimetry trace recorded at a heating rate of 10° C. per minute which shows a maximum in endothermic heat flow at a temperature between about 214° C. and about 218° C.
14. The method of claim 1 , 4 or 6 , wherein the crystalline form is characterized by a different scanning calorimetry trace substantially in accordance with that shown in FIG. 2 .
15. The method of claim 1 , 4 or 6 , wherein Compound I′ is administered once-daily.