CERTAIN (2S)-N-[(1S)-1-CYANO-2-PHENYLETHYL]-1,4-OXAZEPANE-2-CARBOXAMIDES FOR TREATING BRONCHIECTASIS
The present disclosure relates to methods for treating bronchiectasis, for example, non-cystic fibrosis bronchiectasis with compositions comprising an effective amount of certain (2S)—N-[(1S)-1-cyano-2-phenylethyl]-1,4-oxazepane-2-carboxamide compounds of Formula (I), including pharmaceutically acceptable salts thereof, that inhibit dipeptidyl peptidase 1 (DPP1) activity. Methods provided herein are useful for prophylaxis, increasing the lung function in a patient, and/or and/or decreasing the rate of pulmonary exacerbation in a patient. In one embodiment, the compound of Formula (I) is (2S)—N-{(1S)-1-cyano-2-[4-(3-methyl-2-oxo-2,3-dihydro-1,3-benzoxazol-5-yl)phenyl]ethyl}-1,4-oxazepane-2-carboxamide.
1 . A method for treating non-cystic fibrosis (CF) bronchiectasis in a patient in need of treatment, comprising, administering to the patient once daily via oral administration a pharmaceutical composition comprising 10 mg to 50 mg of a compound of formula (I), or a pharmaceutically acceptable salt thereof,
wherein,
R 1 is
R 2 is hydrogen, F, Cl, Br, OSO 2 C 1-3 alkyl, or C 1-3 alkyl;
R 3 is hydrogen, F, Cl, Br, CN, CF 3 , SO 2 C 1-3 alkyl, CONH 2 or SO 2 NR 4 R 5 , wherein R 4 and R 5 together with the nitrogen atom to which they are attached form an azetidine, pyrrolidine or piperidine ring;
R 6 is C 1-3 alkyl, optionally substituted by 1, 2 or 3 F and/or optionally by OH, OC 1-3 alkyl, N(C 1-3 alkyl) 2 , cyclopropyl, or tetrahydropyran;
R 7 is hydrogen, F, Cl or CH 3 ;
X is O, S or CF 2 ;
Y is O or S; and
Q is CH or N.
2 . The method of claim 1 , wherein, R 1 is
3 . The method of claim 2 , wherein, X is O; R 6 is C 1-3 alkyl; and R 7 is hydrogen.
4 . (canceled)
5 . The method of claim 1 , wherein the compound of Formula (I) is (2S)—N-{(1S)-1-cyano-2-[4-(3-methyl-2-oxo-2,3-dihydro-1,3-benzoxazol-5-yl)phenyl]ethyl}-1,4-oxazepane-2-carboxamide:
or a pharmaceutically acceptable salt thereof.
6 . The method of claim 1 , wherein the compound of Formula (I) is (2S)—N-{(1S)-1-cyano-2-[4-(3-methyl-2-oxo-2,3-dihydro-1,3-benzoxazol-5-yl)phenyl]ethyl}-1,4-oxazepane-2-carboxamide.
7 . The method of claim 1 , wherein the composition comprises a pharmaceutically acceptable adjuvant, diluent or carrier.
8 - 12 . (canceled)
13 . The method of claim 1 , wherein the treating comprises increasing the length of time to first pulmonary exacerbation, as compared to an untreated non-CF bronchiectasis patient, wherein the pulmonary exacerbation is characterized by three or more of the following symptoms exhibited for at least 48 hours by the patient: (1) increased cough: (2) increased sputum volume or change in sputum consistency: (3) increased sputum purulence; (4) increased breathlessness and/or decreased exercise tolerance; (5) fatigue and/or malaise: (6) hemoptysis.
14 . (canceled)
15 . The method of claim 13 , wherein the increasing comprises increasing of about 20 days to about 100 days, or from about 30 days to about 100 days, or from about 20 days to about 75 days, or from about 20 days to about 50 days, or from about 20 days to about 40 days.
16 . The method of claim 1 , wherein treating comprises reducing the rate of pulmonary exacerbation in the patient, as compared to the rate of pulmonary exacerbation experienced by the patient prior to treatment, or compared to an untreated non-CF bronchiectasis patient, wherein the pulmonary exacerbation is characterized by three or more of the following symptoms exhibited for at least 48 hours by the patient: (1) increased cough: (2) increased sputum volume or change in sputum consistency: (3) increased sputum purulence: (4) increased breathlessness and/or decreased exercise tolerance; (5) fatigue and/or malaise; (6) hemoptysis.
17 . (canceled)
18 . The method of claim 16 , wherein the rate of pulmonary exacerbation in the patient is reduced by about 5%, by about 10%, by about 15%, by about 20%, by about 25%, by about 30%, by about 35%, by about 40% or by about 50%, as compared to the rate of pulmonary exacerbation experienced by the patient prior to treatment, or compared to an untreated non-CF bronchiectasis patient.
19 . The method of claim 16 , wherein the rate of pulmonary exacerbations in the patient is reduced by at least about 20%, as compared to the rate of pulmonary exacerbation experienced by the patient prior to treatment, or compared to an untreated non-CF bronchiectasis patient.
20 - 38 . (canceled)
39 . The method of claim 19 , wherein treating comprises decreasing active neutrophil elastase (NE) sputum concentration in the patient, as compared to the active NE sputum concentration prior to treatment.
40 - 41 . (canceled)
42 . The method of claim 19 , wherein treating comprises lightening the patient's sputum color as compared to the patient's sputum color prior to treatment, as measured by the sputum color chart of Murray.
43 . The method of claim 42 , wherein lightening the patient's sputum color comprises lightening the patient's sputum color by a single gradation.
44 - 59 . (canceled)
60 . The method of claim 1 , wherein the patient is administered 10 mg of the compound of Formula (I) once daily.
61 . The method of claim 1 , wherein the patient is administered 25 mg of the compound of Formula (I) once daily.