Lipid prodrugs of mycophenolic acid and uses thereof

1. A method of treating an autoimmune disease, disorder, or condition, organ transplant rejection, graft-versus-host disease, or implant rejection in a patient in need thereof, comprising administering to the patient an effective amount of a compound of Formula VI:

or a pharmaceutically acceptable salt thereof, wherein:

R 1 and R 2 are each independently hydrogen, an acid-labile group, a lipid, or —C(O)R 3 ;

each R 3 is independently a saturated or unsaturated, straight or branched, optionally substituted C 1-37 hydrocarbon chain;

X is —O—, —NR—, —S—, —O(C 1-6 aliphatic)—O—, —O(C 1-6 aliphatic)—S—, —O(C 1-6 aliphatic)—NR—, —S(C 1-6 aliphatic)—O—, —S(C 1-6 aliphatic)—S—, —S(C 1-6 aliphatic)—NR—, —NR(C 1-6 aliphatic)—O—, —NR(C 1-6 aliphatic)—S—, or —NR(C 1-6 aliphatic)—NR—, wherein 0-2 methylene units of the C 1-6 aliphatic group are independently and optionally replaced with —O—, —NR—, or —S— and the C 1-6 aliphatic group is independently and optionally substituted with 1, 2, or 3 deuterium or halogen atoms;

each R is independently hydrogen or an optionally substituted group selected from C 1-6 aliphatic, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur;

Y is absent or is —C(O)—, —C(NR)—, or —C(S)—;

L is a covalent bond or a saturated or unsaturated, straight or branched, optionally substituted bivalent C 1-30 hydrocarbon chain, wherein 0-8 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O) 2 —, —C(S)—, —NRS(O) 2 —, —S(O) 2 NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid; and wherein 1 methylene unit of L is optionally replaced with -M-; or L is

wherein either the right-hand side or left-hand side of L is attached to A;

each -Cy- is independently an optionally substituted 3-6 membered bivalent saturated, partially unsaturated, or aromatic ring having 0-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur;

each R 4 and R 5 is independently hydrogen, deuterium, halogen, —CN, —OR, —NR 2 , —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C 1-6 aliphatic group optionally substituted with —CN, —OR, —NR 2 , —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C 1-6 aliphatic is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or

two instances of R 4 or R 5 attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur;

-M- is a self-immolative group;

n is 0-18;

each m is independently 0-6;

A is a therapeutic agent selected from mycophenolic acid or a derivative, analogue, or prodrug thereof;

the autoimmune disease, disorder, or condition is Behcet's disease, pemphigus vulgaris, refractory incomplete systemic lupus erythematosus, retroperitoneal fibrosis, idiopathic thrombocytopenic purpura (ITP), scleroderma (systemic sclerosis or SSc), pemphigus vulgaris, granulomatosis with polyangiitis, immunoglobulin A nephropathy, small vessel vasculitis, retroperitoneal fibrosis, or psoriasis; and

the organ transplant is selected from a skin, liver, heart, kidney, pancreas, thymus, small intestine, large intestine, uterus, a vascularized composite allograft (VCA), bone marrow, allogenic blood and marrow transplant (BMT), cornea, or lung transplant.

2. The method according to claim 1 , wherein R 1 and R 2 are —C(O)R 3 and each R 3 is independently a saturated or unsaturated, unbranched C 2-37 hydrocarbon chain.

3. The method according to claim 1 , wherein X is —O— and Y is —C(O)—.

4. The method according to claim 1 , wherein L is a covalent bond or a saturated or unsaturated, straight or branched, optionally substituted bivalent C 6-20 hydrocarbon chain, wherein 0-8 methylene units of L are independently replaced by -Cy-, —O—, —NR—, —S—, —OC(O)—, —C(O)O—, —C(O)—, —S(O)—, —S(O) 2 —, —C(S)—, —NRS(O) 2 —, —S(O) 2 NR—, —NRC(O)—, —C(O)NR—, —OC(O)NR—, —NRC(O)O—, or an amino acid selected from

and wherein 1 methylene unit of L is optionally replaced with -M-; or L is

wherein either the right-hand side or left-hand side of L is attached to A.

5. The method according to claim 1 , wherein L is a saturated bivalent C 3-25 hydrocarbon chain optionally substituted with 1, 2, 3, or 4 groups selected from deuterium, halogen, —CN, a 3-6 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, a 4-6 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C 1-6 aliphatic group optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; wherein 0-4 methylene units of L are independently replaced by —O—, —OC(O)—, —C(O)O—, or —C(O)—; and 1 methylene unit of L is optionally replaced with -M-.

6. The method according to claim 1 , wherein -M- is:

wherein each R 6 is independently selected from hydrogen, deuterium, C 1-10 aliphatic, halogen, or —CN;

each R 7 is independently selected from hydrogen, deuterium, halogen, —CN, —OR, —NR 2 , —NO 2 , —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or a C 1-6 aliphatic group optionally substituted with —CN, —OR, —NR 2 , —SR, a 3-8 membered saturated or partially unsaturated monocyclic carbocyclic ring, phenyl, an 8-10 membered bicyclic aromatic carbocyclic ring, a 4-8 membered saturated or partially unsaturated monocyclic heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur, a 5-6 membered monocyclic heteroaromatic ring having 1-4 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or an 8-10 membered bicyclic heteroaromatic ring having 1-5 heteroatoms independently selected from nitrogen, oxygen, or sulfur, or the C 1-6 aliphatic is optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms;

each Z 1 is independently selected from —O—, —NR—, or —S—;

each Z 2 is independently selected from —O—, —NR—, —S—, —OC(O)—, —NRC(O)O—, or —OC(O)NR—

each Z 3 is independently selected from ═N— or ═C(R 7 )—; and

each Z 4 is independently selected from —O—, —NR—, —S—, —C(R 6 ) 2 —, or a covalent bond.

7. The method according to claim 6 , wherein -M- is selected from

8. The method according to claim 6 , wherein -M- is selected from

9. The method according to claim 1 , wherein each R 4 is independently hydrogen, deuterium, halogen, —CN, or C 1-4 aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R 4 attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

10. The method according to claim 1 , wherein each R 5 is independently hydrogen, deuterium, halogen, —CN, or C 1-4 aliphatic optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms; or two instances of R 5 attached to the same carbon atom, taken together with the carbon atom to which they are attached, form a 3-6 membered saturated monocyclic carbocyclic ring or 3-6 membered saturated heterocyclic ring having 1-2 heteroatoms independently selected from nitrogen, oxygen, or sulfur.

11. The method according to claim 1 , wherein each R 4 and R 5 is independently hydrogen or C 1-4 alkyl optionally substituted with 1, 2, 3, 4, 5, or 6 deuterium or halogen atoms.

12. The method according to claim 1 , wherein the compound is of Formula VI-a or VI-b:

or a pharmaceutically acceptable salt thereof.

13. The method according to claim 1 , wherein said compound is of Formula VIII-a or VIII-b:

or a pharmaceutically acceptable salt thereof, wherein A is

14. The method according to claim 13 , wherein A is

and R is C 1-6 aliphatic or phenyl.

15. The method according to claim 1 , wherein the compound is of Formula XI-d:

or a pharmaceutically acceptable salt thereof.

16. The method according to claim 1 , further comprising the step of administering an additional therapeutic agent.

17. The method according to claim 1 , wherein the compound or pharmaceutically acceptable salt thereof is delivered selectively to B or T lymphocytes or modulates the activity of B or T lymphocytes.

18. The method according to claim 1 , wherein the compound or pharmaceutically acceptable salt thereof modulates the activity of one or more of B cells, dendritic cells, granulocytes, innate lymphoid cells (ILCs), megakaryocytes, monocytes/macrophages, myeloid-derived suppressor cells (MDSC), natural killer (NK) cells, platelets, red blood cells (RBCs), T cells, or thymocytes.

19. The method according to claim 1 , wherein the compound or pharmaceutically acceptable salt thereof exhibits increased delivery at a given dose, or more selective delivery at a given dose, to B or T lymphocytes as compared with a corresponding dose of a non-lipid prodrug form of mycophenolic acid, or a derivative, analogue, or prodrug thereof.

20. The method according to claim 1 , wherein a given dose of the compound or pharmaceutically acceptable salt thereof more effectively modulates the activity of one or more of B cells, dendritic cells, granulocytes, innate lymphoid cells (TLCs), megakaryocytes, monocytes/macrophages, myeloid-derived suppressor cells (MDSC), natural killer (NK) cells, platelets, red blood cells (RBCs), T cells, or thymocytes, as compared with a corresponding dose of a non-lipid prodrug form of mycophenolic acid, or a derivative, analogue, or prodrug thereof.