Home » Uncategorized (Page 172)
Category Archives: Uncategorized
ALIROCUMAB
ALIROCUMAB
http://www.ama-assn.org/resources/doc/usan/alirocumab.pdf
Immunoglobulin G1, anti-(human neural apoptosis-regulated proteinase 1) (human REGN727 heavy chain), disulfide with human REGN727 κ-chain, dimer
Immunoglobulin G1, anti-(human proprotein convertase subtilisin/kexin type 9
(EC=3.4.21.-, neural apoptosis-regulated convertase 1, proprotein convertase 9,
subtilisin/kexin-like protease PC9)); human monoclonal REGN727 des-448-
lysine(CH3-K107)-1 heavy chain (221-220′)-disulfide with human monoclonal
REGN727 light chain dimer (227-227”:230-230”)-bisdisulfide
Clinical Trials for Compound
| Number of clinical trials registered at clinicaltrials.gov | 30 |
Biological Sequence
| Description | Sequence |
| Alirocumab heavy chain | EVQLVESGGGLVQPGGSLRLSCAASGFTFNNYAMNWVRQAPGKGLDWVSTISGSGGTTNY ADSVKGRFIISRDSSKHTLYLQMNSLRAEDTAVYYCAKDSNWGNFDLWGRGTLVTVSSAS TKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGL YSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPKSCDKTHTCPPCPAPELLGGPS VFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNST YRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGQPREPQVYTLPPSRDELT KNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQ GNVFSCSVMHEALHNHYTQKSLSLSPG |
| Alirocumab light chain | DIVMTQSPDSLAVSLGERATINCKSSQSVLYRSNNRNFLGWYQQKPGQPPNLLIYWASTR ESGVPDRFSGSGSGTDFTLTISSLQAEDVAVYYCQQYYTTPYTFGQGTKLEIKRTVAAPS VFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYS LSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGEC |
1245916-14-6 CAS
C6472H9996N1736O2032S42
Alirocumab is a human monoclonal antibody designed for the treatment of hypercholesterolemia.[1]
This drug was discovered by Regeneron Pharmaceuticals and is being co-developed by Regeron and Sanofi.
When the results from Phase II trials of Sanofi and Regeneron’s proprotein convertase subtilisin kexin 9 (PCSK9) inhibitor alirocumab were presented in March, they stunned even the company representatives working on the trials. “I’m still amazed by the reduction in low-density lipoprotein cholesterol (LDL-C) that we saw with our drug,” says Bill Sasiela, vice president of cardiovascular and metabolic research at Regeneron. The monoclonal antibody (mAb) reduced LDL-C levels by up to 73% in three mid-stage trials, irrespective of baseline LDL-C levels or background treatment, offering hope for millions of patients who can’t hit the recommended cholesterol targets with statins — the standard therapies for lowering LDL-C levels in patients with cardiovascular disease. Spurred on by these results, Sanofi and Regeneron geared up into Phase III trials of the first-in-class alirocumab (also known as REGN727 and SAR236553) over the summer, and initiated the latest and largest trial — an 18,000-patient outcomes study
It is a Proprotein convertase subtilisin/kexin type 9, (also known as PCSK9) inhibitor . Phase III trials showed a 47% reduction in LDL-C. There was a high rate of adverse events with 69% experiencing side effects (most common problem was infection).
About PCSK9 PCSK9 is known to be a determinant of circulating LDL levels, as it binds to LDL receptors resulting in their degradation so that fewer are available on liver cells to remove excess LDL-cholesterol from the blood. Moreover, traditional LDL-lowering therapies such as statins actually stimulate the production of PCSK9, which limits their own ability to lower LDL-cholesterol. Blocking the PCSK9 pathway is therefore a potentially novel mechanism for lowering LDL-cholesterol.
Alirocumab is an investigational, fully-human monoclonal antibody that targets and blocks PCSK9. It is administered via subcutaneous injection. By inhibiting PCSK9, a determinant of circulating LDL-C levels in the blood, alirocumab has been shown in pre-clinical studies to increase the number of LDL receptors on hepatocytes, thereby lowering LDL-C.
The investigational agent described above is currently under clinical development and its safety and efficacy have not been fully evaluated by any regulatory authority
References
- Statement On A Nonproprietary Name Adopted By The USAN Council – Alirocumab, American Medical Association.

PARIS and TARRYTOWN, N.Y., Oct. 16, 2013 /PRNewswire via COMTEX/ — Sanofi and Regeneron Pharmaceuticals, Inc. REGN -1.73% today announced that the Phase 3 ODYSSEY MONO trial with alirocumab, an investigational monoclonal antibody targeting PCSK9 (proprotein convertase subtilisin/kexin type 9), met its primary efficacy endpoint. The mean low-density lipoprotein-cholesterol (LDL-C, or “bad” cholesterol) reduction from baseline to week 24, the primary efficacy endpoint of the study, was significantly greater in patients randomized to alirocumab, as compared to patients randomized to ezetimibe (47.2% vs. 15.6%, p<0.0001). In the trial, which employed a dose increase (up-titration) for patients who did not achieve an LDL-C level of 70 milligrams/deciliter (mg/dL), the majority of patients remained on the initial low dose of alirocumab of 75 milligrams (mg). read at
Pipeline of selected PCSK9 inhibitors
| Drug name | Companies | Modality | Clinical phase |
|---|---|---|---|
| Alirocumab (also known as REGN727 and SAR236553) | Regeneron/Sanofi | Monoclonal antibody | III |
| AMG145 | Amgen | Monoclonal antibody | II |
| LGT209 | Novartis | Monoclonal antibody | II |
| RG7652 | Roche/Genentech | Monoclonal antibody | II |
| RN316 | Pfizer | Monoclonal antibody | II |
| BMS-962476 | Bristol-Myers Squibb | Adnectin | I |
| ALN-PCS | Alnylam | RNA interference | I |
| ISIS-405879/BMS-844421 | Isis/Bristol-Myers Squibb | Antisense | Discontinued |
| PCSK9, proprotein convertase subtilisin kexin 9. | |||

FINASTERIDE
![]()
(5α, 17β)-N-(1 ,1-dimethylethyl)-3-oxo-4-aza-androst-1-ene-17-carboxamide, finasteride, a 4-aza-steroid compound 5 which exhibits pharmaceutical activity as an inhibitor of the enzyme testosterone 5-α-reductase, and is useful in the treatment of prostate cancer
Finasteride;YM-152;MK-906;Prodel;Propecia;
Chibro-Proscar;Finastid;Prostide;Andozac;Proscar
Finasteride (brand names Proscar and Propecia by Merck, among other generic names) is a synthetic drug for the treatment of benign prostatic hyperplasia (BPH) and male pattern baldness (MPB). It is a type II 5α-reductase inhibitor. 5α-reductase is an enzymethat converts testosterone to dihydrotestosterone (DHT).

Figure . Conversion of testosterone to dihydrotestosterone.
Chemical synthesis
Propecia 1 mg & Finpecia 1 mg tablets
Finasteride is synthesized fromprogesterone:
![]()
History
In 1974, Julianne Imperato-McGinley of Cornell Medical College in New York attended a conference on birth defects. She reported on a group of intersex children in the Caribbean who appeared sexually ambiguous at birth, and were initially raised as girls, but then grew external male genitalia and other masculine characteristic post-onset of puberty. Her research group found that these children shared agenetic mutation, causing deficiency of the 5α-reductase enzyme and male hormone dihydrotestosterone (DHT), which was found to have been the etiology behind abnormalities in male sexual development. Upon maturation, these individuals were observed to have smaller prostates which were underdeveloped, and were also observed to lack incidence of male pattern baldness.
In 1975, copies of Imperato-McGinley’s presentation were seen by P. Roy Vagelos, who was then serving as Merck’s basic-research chief. He was intrigued by the notion that decreased levels of DHT led to the development of smaller prostates. Dr. Vagelos then sought to create a drug which could mimic the condition found in these children in order to treat older men who were suffering from benign prostatic hyperplasia.
In 1992, finasteride (5 mg) was approved by the U.S. Food and Drug Administration (FDA) for treatment of benign prostatic hyperplasia(BPH), which Merck marketed under the brand name Proscar.
In 1997, Merck was successful in obtaining FDA approval for a second indication of finasteride (1 mg) for treatment of male pattern baldness (MPB), which was marketed under the brand name Propecia.
CHEMISTRY
Formerly known as MK-906, finasteride (Figure 1) ([5-
, 17-
-N-(1,1-dimethylethyl) -3-oxo-4-azaandrost- 1-ene-17-carboxamide) belongs to the 4-azasteroid structural class of compounds. (Click on the structure to the right to view a Chime rotatable structure.) Its synthesis, shown in Scheme 1, was published by Rasmusson et al. in 1986.[2] Briefly, beginning with a previously synthesized intermediate, the A-ring of the steroid skeleton was converted from its 3- keto precursor (1) to the required 4-aza system (3) through an open analog (2). Saturation of the B-ring using catalytic hydrogenation gave intermediate 4. Use of the 2-pyridyl thio ester (5) gave a reactive substrate to form the tertiary butyl carboxamide (6). The final step in the synthesis, dehydration of the A-ring with benzeneselenic anhydride, gave the final product, finasteride (7).

Scheme 1. Key intermediates in the synthesis of finasteride by Rasmusson et al. Reagents: a, KMnO4-NaIO4, t-BuOH, reflux; b, NH3, heat; c, H2, Pt, ArOH; d, 2,2′-dipyridyl disulfide, triphenylphosphine, toluene; e, t-butyl amine, THF; f, benzeneselenic anhydride, chlorobenzene.
The preparation of finasteride is described and claimed in U.S. Patent 4.377.584 and further described in U.S. Patent 4.760.071. Other patents which pertain to the preparation of finasteride include Canadian patent application 2.029.859: U.S. patents 5.084.574 and 5.116.983: and Canadian patent applications 2.049.882 and 2.049.881. All these teach the conversion of a final intermediate tofinasteride, which is purified and isolated as a crystalline solid. Althoughfinasteride polymorphs are not mentioned specifically in these items of prior art, the finasteride obtained using them, as a crystalline solid, must be in one or other of the known polymorphic forms, or a mixture of both of them.
Aforementioned Canadian Patent Application 2.103.107 Dolling et a published May 20, 1994, describes preparations of finasteride and the specific polymorphic Form I and Form II thereof. In particular, it teaches that polymorphic Form I can be prepared by crystallization from a mixture of finasteride in an organic solvent and optionally water, such that the amount of organic solvent and water in the mixture is sufficient to cause the solubility of the non-solvated form of finasteride(Form I) to be exceeded and the non- solvated form of finasteride to be less soluble than any other form of finasteride in the mixture. It also teaches that the polymorphic Form I of finasteride can be prepared by heating the polymorphic Form II of finasteride to at least 25°C in water or an organic solvent for a sufficient period of time to effect the conversion. The same reference teaches that polymorphic Form II finasteride can be prepared by crystallization from a mixture of finasteride in an organic solvent and water, such that the amount of organic solvent and water in the mixture is sufficient to cause the solubility of the solvated form of finasteride to be exceeded and the solvated form of finasteride to be less soluble than any other form of finasteride in the mixture, followed by recovery of the solid and removal of the solvent therefrom; or by heating polymorphic Form I finasteride to at least to about 150°C for sufficient time to complete the conversion.
MORE INFO
-
Finasteride, marketed under the tradename of PROSCAR®, by Merck & Co., Inc is 17β-(N-tert-butyl carbamoyl)-4-aza-5α-androst-1-en-3-one and is a 5α-reductase inhibitor for use in treating acne, female hirsutism, and particularly benign prostatic hyperplasia. See US Patent 4,760,071 (1988), the entire disclosure of which is incorporated herein by reference..
-
[0002]The synthesis of finasteride in US Patent 4,760,071 involves reacting the 17β-(2-pyridylthio) carboxylate of 4-aza-5α-androst-1-ene-3-one with t-butylamine. A further synthesis of finasteride is described in Synthetic Communications, 30 (17), p. 2683-2690 (1990). including the reacting of the 17-acylimidazole of 4-aza-5α-androst-1-en-3-one with t-butylamine.
-
[0003]However, both of these reactions require the use of heterocyclic aromatic amines which are expensive and give rise to environmental safety and toxicity considerations. Both of these intermediates are prepared from the 17β-carboxylic acid.
-
[0004]The Bodroux reaction, described by F. Bodroux in the references, Bull. Soc. Chim. France 33, 831 ( 1905); 35, 519 (1906); 1, 912 (1907); Compt. Rend. 138, 1427 (1904); 140, 1108 (1905); 142, 401 (1906) discloses the reaction of the magnesium halide salts of amines with esters. However, there is no description or teaching that the reaction can be applied to the reaction of a sterically hindered amine, e.g. t-butyl amine, with a sterically hindered ester such as 1.

The first method (International Patent: W0200507M97A) is finasteridedihydro as raw materials, benzeneseleninic anhydride synthesis of finasteride, the reaction is as follows:
Used in this reaction toxic and expensive reagents benzeneseleninic anhydride, yield only about 50%, and the product to column chromatography to separate, while the use of certain toxic chlorobenzene as solvent, the cost is very high , environmental hazards large.
[0005] The second method (U.S. Patent No.: US20070167477A1) is finasteridedihydro as raw materials, the use of DDQ / BSTFA (i.e. 3,3 – dichloro-5 ,6 – dicyano-p-benzoquinone / second (third trimethylsilyl) trifluoroacetamide) Oxidation get finasteride, the reaction is as follows:
The reaction yield about 65%, the resulting fluorine-containing wastewater intractable, quinones great harm to the environment.
[0006] The third method (international patent: W02008101308A) is dihydrofinasteride as raw material, the use of phenyl sulfide oxidation get finasteride, the reaction is as follows:
The method steps and more complicated to operate, the total yield of only 60%, the use of expensive lithium diisopropylamide, lithium bis trimethylsilyl test Qi IJ, the cost is higher.
REF
Rasmusson, G.H.; Reynolds, G.F. (Merck & Co., Inc.); 17beta-Substd.-4-aza-5alpha-androstenones and their use as 5alpha-reductase inhibitors. AU 8539167; EP 0155096; EP 0314199; ES 8702430; JP 1985222497; JP 1989093600; US 4760071 .
Rasmusson, G.H.; Reynolds, G.F. (Merck & Co., Inc.); Treatment of prostatic carcinoma with 17beta-N-monosubstd.-carbamoyl-4-aza-5-alpha-androst-1-en-3-ones. EP 0285383 .
Rasmusson, G.H.; Reynolds, G.F.; Steinberg, N.G.; Walton, E.; Patel, G.F.; Liang, T.; Cascieri, M.A.; Cheung, A.H.; Brooks, J.R.; Berman, C.; Azasteroids: structure-activity relationships for inhibition of 5 alpha-reductase and of androgen receptor binding. J Med Chem 1986, 29, 11, 2298.
Castaner, J.; Prous, J.; Finasteride. Drugs Fut 1991, 16, 11, 996.
The oxidative cleavage of N-tert-butyl-3-oxo-5alpha-androst-4-ene-17beta-carboxamide (I) with NaIO4 and KMnO4 in tert butanol – aqueous Na2CO3 gives the seco-ketoacid (II), which is cyclized with liquid ammonia in ethylene glycol at 180 C to afford the DELTA5-azasteroid (III). Hydrogenation of (III) with H2 over PtO2 in acetic acid yields the corresponding saturated aza-steroid (IV), which is finally dehydrogenated with benzeneseleninic anhydride in refluxing chlorobenzene or with 2,3-dichloro-5,6-dicyanobenzoquinone (DDQ) and bis(trimethylsilyl)trifluoroacetamide (BSTFA) in refluxing dioxane.
NEW DRUG APPROVALS ACHIEVES ONE LAKH VIEWS IN 166 COUNTRIES

DR A .M. CRASTO
THIS BLOG NEW DRUG APPROVALS ACHIEVES ONE LAKH VIEWS IN 166 COUNTRIES …………….16 TH OCT 2013

Boehringer Ingelheim submits lung cancer treatment, Nintedanib, for approval in the EU
October 14 ,2013 | By Márcio Barra

Nintedanib (trade name Vargatef) has been submitted for approval in Europe as a second-line treatment alongside docetaxel (a chemotherapy agent) for the treatment of locally advanced, metastatic or recurrent non-small cell lung cancer (NSCLC) in patients whose tumours are adenocarcinomas – cancer developed from the cells that produce mucus in the lining of the airways – the most common type of lung cancer.
View original post 216 more words
Vitamin B3- Niacin or Nicotinamide
Vitamin B3 is another one of the water-soluble B vitamins. It was first discovered in 1873 by Hugo Weidel during his studies of nicotine. Vitamin B3 is essential in multiple steps in metabolism and is needed for good adrenal gland and nervous system function. It is mostly obtained in the diet from animal sources such as chicken, beef, and fish. Liver and kidney and heart have the highest amounts. The best plant sources include shiitake mushrooms, nuts, whole grains, beans, avocados and dates. The body can also synthesize Vitamin B3 using the amino acid tryptophan. Interestingly vitamin B3 deficiency became epidemic when corn started being adopted by Europeans as a food source after the discovery of the Americas (corn is native to central america and therefore was unknown in Europe until the 1500s). The Mayans and other native americans that ate corn did not have vitamin B3 deficiency. This was because they cooked the corn using a…
View original post 1,291 more words
StemCells, Inc. Receives FDA Authorization to Expand Spinal Cord Injury Trial to the United States
Last week, StemCells, Inc. received FDA authorization to expand its spinal cord injury trial to the United States.
The arrival of this Phase 1/2 study, which is currently ongoing in Switzerland and Canada and involves patients with chronic spinal cord injury, will significantly ease the travel burden for North American patients. Early results from the trial have been promising, showing two patients had gains in sensory function, first seen at 6 months and persisting 12 months after transplantation. No safety issues have been seen.
To date, seven patients from Germany, Norway, Italy, Israel, Canada and the United States have been transplanted at Balgrist University Hospital in Zurich. StemCells is now focused on opening up trial sites in the United States. Information about the clinical trial is available at the ClinicalTrials.gov website of the National Institutes of Health at http://www.clinicaltrials.gov/ct2/show/NCT01321333?lead=StemCells+Inc.&rank=4.
Russo Partners secured coverage of the announcement across industry publications…
View original post 36 more words
Understand UNANI SYSTEM OF MEDICINE
Unani System of Medicine developed in ARAB countries and practiced there. Later it came back to India and flourised in this INDIAN continent.
Unani system of medicine is very near to AYURVEDA.
For convenient to understand basics of the Unani system , see and observe the loaded pages.
DRUG APPROVALS BY DR ANTHONY MELVIN CRASTO
.....




















