Antifolate combinations
The present invention provides combinations of active agents, such combinations comprising one or more antifolate compounds. The particularly can include methotrexate and one or more further antifolate compounds. In specific embodiments, the combinations are useful for treating certain conditions, such as rheumatoid arthritis. The invention also provides articles useful to provide the combinations in desirable dosage forms and combinations. The combinations further may be useful in the treatment of further conditions, including abnormal cell proliferation, inflammatory diseases, asthma, and arthritis.
1. A method for treating a subject suffering from an arthritis related condition, the method comprising administering to the subject a first compound according to a first dosing schedule and a second compound according to a second, different dosing schedule, wherein the first compound is methotrexate or a derivative thereof and the second compound is an antifolate compound according to Formula (6):
wherein:
X is CHR 8 or NR 8 ;
Y 1 , Y 2 , and Y 3 independently are O or S;
V 1 and V 2 independently are O, S, or NZ;
Z is H, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted alkynyl, or alkaryl;
R 1 and R 2 independently are H, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted alkynyl, or alkaryl;
R 3 is H, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted alkynyl, optionally substituted alkoxy, hydroxyl, or halo; and
R 4 , R 5 , R 6 , R 7 , and R 8 independently are H, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted alkynyl, acyl, —C(O)-alkyl, —C(O)-alkenyl, or —C(O)-alkynyl; or a pharmaceutically acceptable ester, amide, salt, solvate, enantiomer, or prodrug thereof; and
wherein the first compound and the second compound are administered in amounts sufficient to provide a synergistic effect in treating the arthritis related condition.
2. The method of claim 1 , wherein the first dosing schedule comprises administering the first compound once per week.
3. The method of claim 1 , wherein the first dosing schedule comprises administering the first compound twice per week.
4. The method of claim 1 , wherein the second dosing schedule comprises administering the second compound at least three times per week.
5. The method of claim 1 , wherein the second dosing schedule comprises administering the second compound at least once per day.
6. The method of claim 4 , wherein the second dosing schedule comprises administering the second compound at least twice per day.
7. The method of claim 1 , wherein the second compound is an antifolate compound according to formula (7):
wherein:
X is CHR 8 or NR 8 ;
R 3 is H, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted alkynyl, optionally substituted alkoxy, hydroxyl, or halo; and
R 4 , R 5 , R 6 , R 7 , and R 8 independently are H, optionally substituted alkyl, optionally substituted alkenyl, optionally substituted alkynyl, acyl, —C(O)-alkyl, —C(O)-alkenyl, or —C(O)-alkynyl; or a pharmaceutically acceptable ester, amide, salt, solvate, enantiomer, or prodrug thereof.
8. The method of claim 1 , wherein the second compound is an antifolate compound according to Formula (9):
or a pharmaceutically acceptable ester, amide, salt, solvate, enantiomer, or prodrug thereof.
9. The method of claim 1 , wherein the second compound is an antifolate compound according to Formula (II):
or an enantiomer thereof, wherein each X + independently is a salt-forming counterion.
10. The method of claim 9 , wherein X + is an alkali metal cation.
11. The method of claim 9 , wherein X + is sodium.
12. The method of claim 9 , wherein X + is potassium.
13. The method of claim 9 , wherein the antifolate compound is a crystalline salt.
14. The method of claim 9 , wherein the antifolate compound is a racemic salt.
15. The method of claim 9 , wherein the second compound is an antifolate compound according to Formula (12):
wherein each X + independently is a salt-forming counterion, and wherein the antifolate compound is in the (S) enantiomeric form.
16. The method of claim 15 , wherein the antifolate compound exhibits an enantiomeric purity for the (S) enantiomer of at least about 90%.
17. The method of claim 15 , wherein the antifolate compound exhibits an enantiomeric purity for the (S) enantiomer of at least about 95%.
18. The method of claim 15 , wherein the antifolate compound exhibits an enantiomeric purity for the (S) enantiomer of at least about 99%.
19. The method of claim 15 , wherein the second compound is an antifolate compound according to Formula (12) that is a crystalline, disodium salt in the (S) enantiomeric form exhibiting an enantiomeric purity for the (S) enantiomer of at least about 99%.
20. The method of claim 15 , wherein the second compound is an antifolate compound according to Formula (12) that is a crystalline, dipotassium salt in the (S) enantiomeric form exhibiting an enantiomeric purity for the (S) enantiomer of at least about 99%.
21. The method of claim 1 , wherein the condition is selected from the group consisting of rheumatoid arthritis, spondyloarthropaties (ankylosing spondylitis), osteoarthritis, arthritis associated with acute gout, arthritis associated with chronic gout, and arthritis associated with systemic lupus erythematosus.
22. The method of claim 21 , wherein the condition is rheumatoid arthritis.