WO2012116349A2

WO2012116349A2 - Novel cocrystals of ezetimibe

Info

Publication number: WO2012116349A2
Application number: PCT/US2012/026658
Authority: WO
Inventors: Scott L. Childs; Nathan BARISHANSKY; Shreenivas Reddy LINGIREDDY
Original assignee: Amplio Pharma, Llc
Priority date: 2011-02-26
Filing date: 2012-02-24
Publication date: 2012-08-30
Also published as: WO2012116349A3

Abstract

The invention relates to a novel L-proline cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4- fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone. The invention further relates to a novel imidazole cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)- 3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone. The preparation and characterization of the novel cocrystals according to various embodiments of the invention are described. The invention also relates to pharmaceutical compositions containing the novel L- proline and/or novel imidazole cocrystal, and the therapeutic use of the novel cocrystals to treat and/or prevent various disorders and/or conditions, including primary hypercholesterolemia, mixed hyperlipidemia and homozygous familial sitosterolemia.

Description

NOVEL COCRYSTALS OF EZETIMIBE

Technical Field

[0001] The invention relates to a novel L-proline cocrystal of l-(4-fluorophenyl)- 3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone, and a novel imidazole cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]- 4(S ) - (4-hydroxyphenyl) -2-azetidinone .

[0002] The invention also relates to processes of preparing each of those novel cocrystals, pharmaceutical compositions comprising those novel cocrystals, and methods of treating and/or preventing various conditions by administering those novel cocrystals.

Background

[0003] The compound l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)- hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone (shown below), referred to by its common name "ezetimibe," is a known active pharmaceutical ingredient ("API") having beneficial therapeutic activity, for example as a hypocholesterolemic agent in the treatment and/or prevention of atherosclerosis, or in the reduction of plasma cholesterol levels.:

Ezetimibe is a white, crystalline solid, having a melting range of about 163-166 °C. The preparation and pharmacologic activity of ezetimibe are described, for example, in U.S. Patent Nos. 5,631,365 and 5,767,115.

[0004] Ezetimibe is a lipid-lowering chemical that inhibits the absorption of dietary cholesterol and related compounds from the small intestine. Ezetimibe is useful in treating and/or preventing various conditions such as, for example, primary hypercholesterolemia. As disclosed in International Application No. PCT/EP2009/062575 and U.S. Publication No.

2007/0275052, ezetimibe selectively inhibits the intestinal absorption of cholesterol and related phytosterols, resulting in reduced blood cholesterol levels. As disclosed in U.S. Publication No. 2007/0275052 and International Publication Number WO 2005/062897 A2, ezetimibe is indicated in patients with primary hypercholesterolemia, and may be administered alone or in combination with compounds such as atorvastatin, simvastatin, pravastatin, and lovastatin (statins).

[0005] Ezetimibe administered alone is indicated as adjunctive therapy to diet for the reduction of elevated total-C, LDL-C, and Apo B in patients with primary (heterozygous familial and non-familial) hypercholesterolemia. Ezetimibe administered in combination with an HMG- CoA reductase inhibitor is similarly indicated as adjunctive therapy to diet for the reduction of elevated total-C, LDL-C, and Apo B in patients with primary (heterozygous familial and non- familial) hypercholesterolemia. The combination of ezetimibe with atorvastatin or simvastatin is indicated for the reduction of elevated total-C and LDL-C levels in patients with HoFH, as an adjunct to other lipid-lowering treatments (e.g., LDL apheresis), or in place of such treatments if such treatments are unavailable. Ezetimibe is indicated as adjunctive therapy to diet for the reduction of elevated sitosterol and campesterol levels in patients with homozygous familial sitosterolemia. Ezetimibe administered in combination with fenofibrate is indicated for mixed hyperlipidemia.

[0006] Although therapeutic efficacy is a primary concern for a therapeutic agent, such as ezetimibe, the salt and/or solid-state form (e.g., crystalline or amorphous forms) of a drug candidate can be important to its pharmacological properties and to its development as a viable API. For example, each salt or each solid form of a drug candidate can have different solid state (physical and chemical) properties. The differences in physical properties exhibited by a particular solid form of an API, such as a cocrystal, salt, or polymorph of the original compound, can affect pharmaceutical parameters of the API. For example, storage stability, compressibility and density, all of which can be important in formulation and product manufacturing, and solubility and dissolution rates, which may be important factors in determining bioavailability, may be affected. Because these physical properties are often influenced by the solid state form of the API, they can significantly impact a number of factors, including, by way of example only, the selection of a compound as an API, the ultimate pharmaceutical dosage form, the optimization of manufacturing processes, and absorption in the body. Moreover, finding the most adequate form for further drug development can reduce the time and the cost of that development.

[0007] Obtaining pure forms, then, is extremely useful in drug development. It may permit better characterization of the drug candidate's chemical and physical properties. For example, crystalline forms often have better chemical and physical properties than amorphous forms. As a further example, a crystalline form may possess more favorable pharmacology than an amorphous form, or may be easier to process. It may also have better storage stability. [0008] One such physical property of a pharmaceutical compound that may be important is its dissolution rate in aqueous fluid. The rate of dissolution of an active ingredient in a patient's stomach fluid may have therapeutic consequences because it can impact the rate at which an orally administered active ingredient may reach the patient's bloodstream.

[0009] Another solid state property of a pharmaceutical compound that may be important is its thermal behavior, including its melting point. The melting point of the solid form of a drug is optionally high enough to avoid melting or plastic deformation during standard processing operations, as well as concretion of the drug by plastic deformation on storage (See, e.g., Gould, P. L. Int. J. Pharmaceutics 1986 33 201-217). It may be desirable in some cases for a solid form to melt above about 100 °C. For example, melting point categories used by one pharmaceutical company are, in order of preference, + (mp > 120 °C), 0 (mp 80-120 °C), and - (mp < 80 °C) (Balbach, S.; Korn, C. Int. J. Pharmaceutics 2004 275 1-12).

[0010] Active drug molecules may be made into pharmaceutically acceptable salts for therapeutic administration to the patient. Crystalline salts of a drug may offer advantages over the free form of the compound, such as improved solubility, stability, processing improvements, etc., and different crystalline salt forms may offer greater or lesser advantages over one another. However, crystalline salt formation is not predictable, and in fact is not always possible.

Moreover, there is no way to predict the properties of a particular crystalline salt of a compound until it is formed. As such, finding the right conditions to obtain a particular crystalline salt form of a compound, with pharmaceutically acceptable properties, can take significant time and effort.

[0011] It is also possible to achieve desired properties of a particular API by forming a cocrystal of the API itself, or of a salt of the API. Cocrystals are crystals that contain two or more non-identical molecules. Examples of cocrystals may be found in the Cambridge Structural Database. Examples of cocrystals may also be found at Etter, M.C., and Adsmond, D.A., J. Chem. Soc, Chem. Commun. 1990 589-591; Etter, M. C, MacDonald, J.C., and Bernstein, J., Acta Crystallogr., Sect. B, Struct. Sci. 1990 B46 256-262; and Etter, M.C., Urbanczyk-Lipkowska, Z., Zia-Ebrahimi, M., and Panunto, T.W., J. Am. Chem. Soc. 1990 112 8415-8426, which are incorporated herein by reference in their entireties. The following articles are also incorporated herein by reference in their entireties: Gorbotz C.H., and Hersleth, H.P. Acta Cryst. 2000 B56 625-534; and Senthil Kumar, V.S., Nangia, A., Katz, A.K., and Carrell, H.L., Crystal Growth & Design, 2002 2 313-318.

[0012] By cocrystallizing an API or a salt of an API with a coformer (the other component of the cocrystal), one creates a new solid state form of the API which has unique properties relative to existing solid forms of the API or its salt. For example, a cocrystal may have different dissolution and/or solubility properties than the active agent itself or its salt. As an example, if a particular cocrystal form of an API has improved solubility relative to the known forms of the compound, it may be preferred since improved solubility may lead to increased concentration in solution, which may, in turn, lead to increased levels of the compound or its metabolites in the blood. Cocrystals containing APIs can, therefore, be used to deliver APIs therapeutically. New drug formulations comprising cocrystals of APIs with

pharmaceutically acceptable coformers may, in some cases, have superior properties over existing drug formulations. However, cocrystal formation is also not predictable, and likewise not always possible. Moreover, there is no way to predict the properties of a particular cocrystal of a compound until it is formed. As such, finding the right conditions to obtain a particular cocrystal of a compound, with pharmaceutically acceptable properties, can also take significant time, effort, and resources. [0013] A crystalline form of a compound, a crystalline salt of the compound, or a cocrystal containing the compound or its salt form generally possesses distinct crystallographic, thermal and spectroscopic properties when compared to other crystalline forms having the same chemical composition. Crystallographic and spectroscopic properties of a particular form may be measured by XRPD, single crystal X-ray crystallography, solid state NMR spectroscopy, e.g.

13 C CP/MAS NMR, and/or Raman spectrometry, among other techniques. A particular crystalline form of a compound, of its salt, or of a cocrystal, often also exhibits distinct thermal behavior. Thermal behavior can be measured in the laboratory by such techniques as, for example, capillary melting point, TGA, and DSC.

[0014] In the following description, various aspects and embodiments of the invention will become evident. In its broadest sense, the invention could be practiced without having one or more features of these aspects and embodiments. Further, these aspects and embodiments are exemplary and explanatory only. Additional objects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practicing the invention. The objects and advantages of the invention will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.

Summary

[0015] In accordance with various embodiments of the invention and after extensive experimentation, the inventors have discovered a novel L-proline cocrystal of ezetimibe, L- proline ezetimibe, and a novel imidazole cocrystal of ezetimibe, imidazole ezetimibe.

[0016] The invention in various embodiments also relates to processes of preparing these novel cocrystals of ezetimibe, pharmaceutical compositions containing these novel cocrystals of ezetimibe, and their use in the treatment and/or prevention of various conditions such as, for example, primary hypercholesterolemia, mixed hyperlipidemia, and/or homozygous familial sitosterolemia.

[0017] As used herein, the term "XRPD" refers to x-ray powder diffraction. The XRPD data disclosed herein were obtained using a Scintag XI powder diffractometer equipped with a peltier cooled solid state detector. Data were collected using Cu-K radiation and the tube voltage and amperage were set to 45 kV and 40 mA, respectively. Samples were prepared for analysis by pressing a thin layer of the sample onto a metal sample holder. Instrument calibration was performed using a quartz reference standard.

[0018] As used herein, the term "DSC" refers to differential scanning calorimetry. DSC data disclosed herein were obtained using a TA Instruments differential scanning calorimeter 2920. The sample was placed into an aluminum DSC pan, and the weight accurately recorded. The pan was crimped and the contents heated under nitrogen under the conditions given in the figures. Indium metal was used as the calibration standard.

[0019] As used herein, the term "¹H-NMR" refers to proton nuclear magnetic resonance spectroscopy. Solution 1H NMR data discussed herein were acquired on a Varian ™^/Γ7ΙΝθνΑ-400 spectrometer.

[0020] As used herein, the term "TGA" refers to thermo gravimetric analysis. TGA data disclosed herein were obtained using a TA Instruments 2950 thermogravimetric analyzer. Each sample was placed in an aluminum sample pan and inserted into the TG furnace. Nickel and Alumel™ were used as the calibration standards. Reported temperatures are at the transition maxima. [0021] As used herein, the term "Raman" refers to Raman spectroscopy. Raman spectra were acquired on a Chromex Sentinel dispersive Raman unit equipped with a 785nm, 70mW excitation laser and a TE cooled CCD. Each spectrum is a result of twenty co-added 20- second scans. The unit has continuous automatic calibration using an internal standard. The data was collected by SentinelSoft data acquisition software and processed in GRAMS AI.

[0022] As shown below (Example 5), powder dissolution data were also collected. Dissolution media were prepared by dissolving 1.74 g of NaOH, 19.77 g of NaH₂P0₄.H₂0 or 17.19 g of anhydrous NaH₂P0₄, and 30.93 g of NaCl in 5 L of purified water. The pH was adjusted to approximately 6.5 by adding a solution of NaOH or HC1 as necessary. Tween-80 was added to form a 1.3% by weight Tween-80 solution. Sodium dodecyl sulfate (SDS) was added to form a 0.2% by weight SDS solution. The samples used in the dissolution experiments were passed through a 106 micron sieve prior to charging the dissolution vessel with the solid. 1.5 g of the sieved formulated sample was charged to an empty 1 liter USP dissolution flask. 500 mL of dissolution media were added and the stirring rate was set at 70 RPM. The temperature of the dissolution bath was maintained between 20°C and 21°C. Approximately 1 mL samples were withdrawn at 0.5, 1, 1.5, 2, 3, 5, 10, 15, 30, 60, and 120 minutes. Samples were immediately filtered and diluted with an equal volume of methanol. The concentration of ezetimibe in each sample was determined by HPLC.

[0023] As used herein with respect to the various analytical techniques described herein and data generated therefrom, the term "substantially" the same as or similar to is meant to convey that a particular set of analytical data is, within acceptable scientific limits, sufficiently similar to that disclosed herein such that one of skill in the art would appreciate that the form of the compound is the same as that of the present invention. One of skill in the art would appreciate that certain analytical techniques, such as, for example, XRPD, Raman spectroscopy, 1H-NMR, TGA and DSC, will not produce exactly the same results every time due to, for example, instrumental variation, sample preparation, scientific error, etc. By way of example only, XRPD results (i.e. peak locations, intensities, and/or presence) may vary slightly from sample to sample, despite the fact that the samples are, within accepted scientific principles, the same form, and this may be due to, for example, preferred orientation, varying degree of crystallinity, or varying solvent or water content. It is well within the ability of those skilled in the art, looking at the data as a whole, to appreciate whether such differences indicate a different form, and thus determine whether analytical data being compared to those disclosed herein are substantially the same as or similar.

[0024] In this regard, and as is commonly practiced within the scientific community, it is not intended that the exemplary analytical data of the novel forms of L-proline ezetimibe and imidazole ezetimibe disclosed herein be met literally in order to determine whether comparative data represent the same form as that disclosed and claimed herein, such as, for example, whether each and every peak of the exemplary XRPD pattern disclosed herein is present in the comparative data, in the same location, and/or of the same intensity. Rather, as discussed above, it is intended that those of skill in the art, using accepted scientific principles, will make a determination based on the data as a whole regarding whether comparative analytical data represent the same or a different form of the novel L-proline ezetimibe or imidazole ezetimibe disclosed herein.

[0025] Further, it should be noted that varying degrees of crystallinity of a cocrystal of a compound, such as the novel cocrystals disclosed herein, may be achieved. The degree of crystallinity achieved may, for example, depend on the conditions under which a sample is prepared. Accordingly, one of skill in the art will appreciate that a particular set of analytical data may reflect a greater or lesser degree of crystallinity than the exemplary analytical data shown in the Figures herein, but appreciate that the form of the compound is, indeed, the same as that disclosed and claimed herein. By way of example only, an XRPD pattern may reflect broader and less defined peaks than those found in FIG. 1A disclosed herein, indicating a lesser degree of crystallinity of a sample of L-proline cocrystal of ezetimibe, such as found in FIG. IB. However, one skilled in the art of interpreting XRPD patterns of solid forms of a compound will be able to determine whether an XRPD does, indeed, represent the same cocrystal of L-proline ezetimibe disclosed and claimed herein. It is, therefore, the intent of the inventors to include forms of the cocrystals disclosed and claimed herein having any and all degrees of crystallinity, so long as they are, indeed, the L-proline and imidazole cocrystals of ezetimibe disclosed and claimed herein.

[0026] As used herein, the terms "L-proline ezetimibe" and "L-proline cocrystal of ezetimibe," including variations which use the chemical name "l-(4-fluorophenyl)-3(R)-[3-(4- fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone" in place of the common name "ezetimibe," are used interchangeably to refer to the novel L-proline cocrystal of ezetimibe described herein.

[0027] As used herein, the terms "imidazole ezetimibe" and "imidazole cocrystal of ezetimibe," including variations which use the chemical name "l-(4-fluorophenyl)-3(R)-[3-(4- fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone" in place of the common name "ezetimibe," are used interchangeably to refer to the novel imidazole cocrystal described herein. [0028] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.

Brief Description of the Figures

[0029] FIGS. 1A and IB are exemplary XRPD patterns of the L-proline cocrystal of ezetimibe, according to embodiments of the invention;

[0030] FIG. 2 is an exemplary Raman spectrum of the L-proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0031] FIG. 3 is an exemplary DSC thermogram of the L-proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0032] FIG. 4 is an exemplary TGA profile of the L-proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0033] FIG. 5A is an exemplary full 1H NMR spectrum of the L-proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0034] FIG. 5B is an exemplary 1H NMR spectrum from 8 ppm to 6 ppm of the L- proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0035] FIG. 5C is an exemplary 1H NMR spectrum from 5 ppm to 2.75 ppm of the L- proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0036] FIG. 5D is an exemplary 1H NMR spectrum from 2.75 ppm to 1 ppm of the L- proline cocrystal of ezetimibe, according to an embodiment of the invention;

[0037] FIG. 6 is an exemplary XRPD pattern of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention; [0038] FIG. 7 is an exemplary Raman spectrum of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention;

[0039] FIG. 8 is an exemplary DSC thermogram of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention; and

[0040] FIG. 9 is an exemplary TGA profile of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention;

[0041] FIG. 10A is an exemplary full 1H NMR spectrum of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention;

[0042] FIG. 10B is an exemplary 1H NMR spectrum from 8.5 ppm to 6 ppm of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention;

[0043] FIG. IOC is an exemplary 1H NMR spectrum from 5.75 ppm to 3.25 ppm of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention;

[0044] FIG. 10D is an exemplary 1H NMR spectrum from 3.25 ppm to 1 ppm of the imidazole cocrystal of ezetimibe, according to an embodiment of the invention;

[0045] FIG. 11 shows solubility data for L-proline cocrystals of ezetimibe, according to an embodiment of the invention.

Description of Exemplary Embodiments

[0046] The invention relates to a novel L-proline cocrystal of ezetimibe and a novel imidazole cocrystal of ezetimibe. Specifically, the novel cocrystals that have been discovered are an anhydrous L-proline cocrystal of ezetimibe containing ezetimibe and L-proline, and an anhydrous imidazole cocrystal of ezetimibe having approximately one mole of ezetimibe and approximately one mole of imidazole. At least one exemplary method of preparation of each of the novel L-proline cocrystal of ezetimibe and the novel imidazole cocrystal of ezetimibe according to the invention is described below in the examples.

[0047] The novel cocrystal of L-proline ezetimibe is obtained in a crystalline solid form, as seen by the high degree of crystallinity depicted in the XRPD pattern provided in FIGS. 1A and IB. The cocrystal is shown to have distinct physicochemical properties. The L-proline cocrystal of ezetimibe described herein is particularly suitable for the preparation of stable pharmaceutical preparations.

[0048] The novel L-proline cocrystal of ezetimibe is characterized by an XRPD pattern substantially as shown in FIGS. 1A and IB, a Raman spectrum substantially as shown in FIG. 2, a DSC thermogram substantially as shown in FIG. 3, a TGA profile substantially as shown in FIG. 4, an 1H NMR spectrum substantially as shown in FIGS. 5A, 5B, 5C and 5D, and a solubility profile substantially as shown in FIG. 11. An exemplary listing of representative XRPD peaks of the novel L-proline cocrystal of ezetimibe according to an embodiment of the invention can be found in Table 1. An exemplary listing of representative Raman peaks of the novel L-proline cocrystal of ezetimibe according to an embodiment of the invention can be found in Table 2.

TABLE 1: Exemplary listing of XRPD peaks of L-proline cocrystal of ezetimibe

'2Θ (j-space (A) Intensity ( )

9.4 ± 0.2 9.4 0.20 51

11.0 ± 0.2 8.0 0.15 44 12.8 ± 0.2 6.9 0.11 28 14.1 ± 0.2 6.3 0.09 17 15.3 ± 0.2 5.8 0.07 20 16.2 ± 0.2 5.5 0.07 100 19.2 ± 0.2 4.6 0.05 90 22.4 ± 0.2 4.0 0.03 74 24.6 ± 0.2 3.6 0.03 44 TABLE 2: Exemplary listing of Raman peaks of L-proline cocrystal of ezetimibe

Peak No. Raman Shift (cm-1) Intensity % (l/lo)

1 241.4 61%

2 278.1 53%

3 295.9 56%

4 334.0 58%

5 383.8 56%

6 397.7 57%

7 635.5 77%

8 800.8 60%

9 827.0 73%

10 845.1 87%

11 913.3 57%

12 960.1 51%

13 1056.6 54%

14 1097.2 52%

15 1155.6 77%

16 1166.8 68%

17 1223.3 63%

18 1291.0 60%

19 1390.6 93%

20 1512.0 68%

21 1611.8 100%

22 1737.7 58%

[0049] It should be noted that FIG. 1A and FIG. IB both show XRPD patterns for the L-proline cocrystal of ezetimibe disclosed herein. FIG. 1A, a more crystalline sample isolated from the final bulk material, shows a peak just above 18° 2Θ, which can be attributed to a small amount of excess L-proline present in the isolated bulk material. FIG. IB was obtained from a sample of the material from the same reaction as that used to produce FIG. 1A, but obtained at a different point during the reaction. FIG. IB does not show the peak just above 18° 2Θ, and thus, confirms that this peak is not attributable to the L-proline cocrystal of ezetimibe. [0050] The novel cocrystal of imidazole ezetimibe is also obtained in a crystalline solid form, as seen by the high degree of crystallinity depicted in the XRPD pattern provided in FIG.6. The cocrystal is shown to have distinct physicochemical properties. The imidazole cocrystal of ezetimibe described herein is also particularly suitable for the preparation of stable pharmaceutical preparations.

[0051] The novel imidazole cocrystal of ezetimibe is characterized by an XRPD pattern substantially as shown in FIG. 6, a Raman spectrum substantially as shown in FIG. 7, a DSC thermogram substantially as shown in FIG. 8, a TGA profile substantially as shown in FIG. 9, and a, ¹H NMR spectrum substantially as shown in FIGS. 10A, 10B, IOC and 10D. An exemplary listing of representative XRPD peaks of the novel imidazole cocrystal of ezetimibe according to an embodiment of the invention can be found in Table 3. An exemplary listing of representative Raman peaks of the novel imidazole cocrystal of ezetimibe according to an embodiment of the invention can be found in Table 4.

TABLE 3: Exemplary listing of XRPD peaks of imidazole cocrystal of ezetimibe

°2Θ i/-space (A) Intensity ( )

11.2 ± 0.2 7.9 ± 0.14 5

11.7 ± 0.2 7.6 ± 0.11 9

13.7 ± 0.2 6.4 ± 0.09 9

16.5 ± 0.2 5.4 ± 0.07 11

19.2 ± 0.2 4.6 ± 0.05 100

20.6 ± 0.2 4.3 ± 0.05 11

21.8 ± 0.2 4.1 ± 0.04 57

23.0 ± 0.2 3.9 ± 0.04 24

23.8 ± 0.2 3.7 ± 0.03 6 TABLE 4: Exemplary listing of Raman peaks of imidazole cocrystal of ezetimibe

Peak No. Raman Shift (cm-1) Intensity % (l/lo)

1 238.0 51%

2 301.3 49%

3 368.9 47%

4 396.2 44%

5 637.0 67%

6 824.4 100%

7 918.1 33%

8 1028.1 39%

9 1098.9 35%

10 1134.1 37%

11 1158.2 59%

12 1172.6 42%

13 1203.8 50%

14 1260.9 47%

15 1332.8 44%

16 1371.1 36%

17 1394.2 74%

18 1506.3 45%

19 1600.5 59%

20 1613.6 81%

21 1712.6 35%

Pharmaceutical Compositions and Methods of Treatment and/or Prevention

[0052] The novel L-proline ezetimibe cocrystal and novel imidazole ezetimibe cocrystal described herein possess the same general pharmacological activity as the free ezetimibe form, and are useful for decreasing the absorption of cholesterol, and thereby treating, alleviating, and/or preventing primary hypercholesterolemia, mixed hyperlipidemia, and/or homozygous familial sitosterolemia, as discussed above. By use of the term "treating" or "alleviating," it is meant decreasing the symptoms, markers, or any negative effects of a condition in any appreciable degree in a patient who currently has the condition, and by

"preventing" it is meant preventing entirely or preventing to some extent, such as, for example, by delaying the onset or lessening the degree to which a patient develops the condition. [0053] Accordingly, various embodiments of the invention include methods for preventing, treating, and/or alleviating primary hypercholesterolemia, mixed hyperlipidemia, and/or homozygous familial sitosterolemia in a mammal, comprising administering to said mammal an effective amount of ezetimibe comprising the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein, including, for example, an effective amount of the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein. Various embodiments of the invention also include methods for treating, alleviating, and/or preventing primary hypercholesterolemia, mixed hyperlipidemia and/or homozygous familial sitosterolemia in a mammal, comprising administering to said mammal a pharmaceutical composition comprising any amount of the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal and a pharmaceutically acceptable vehicle, carrier, and/or diluent. In exemplary methods, said mammal may be suffering from primary

hypercholesterolemia, mixed hyperlipidemia, and/or homozygous familial sitosterolemia, or may be at risk of suffering from any of these diseases or conditions. As used herein, "mammal" is intended to include humans.

[0054] Various embodiments of the invention include methods of inhibiting the intestinal absorption of cholesterol and related phytosterols in a mammal in need of inhibition of the intestinal absorption of cholesterol and related phytosterols comprising administering a cholesterol-absorption-inhibiting amount of ezetimibe comprising the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein. Various embodiments of the invention also include methods of inhibiting the intestinal absorption of cholesterol and related phytosterols in a mammal in need of inhibition of intestinal absorption of cholesterol and related phytosterols, comprising administering a pharmaceutical composition comprising the novel L- proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein, and a pharmaceutically acceptable vehicle, carrier, and/or diluent.

[0055] As discussed, additional embodiments of the invention relate to

pharmaceutical compositions comprising any amount of the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein, and a pharmaceutically acceptable carrier and/or excipient. The novel L-proline ezetimibe cocrystal and novel imidazole ezetimibe cocrystal according to the invention have the same or similar pharmaceutical activity as previously reported for the free ezetimibe form. Thus, pharmaceutical compositions for the treatment and/or prevention of the conditions and/or disorders described herein may contain some amount, for example a therapeutically effective amount, of the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal described herein, as appropriate, e.g. for treatment of a patient with the particular condition or disorder. As a further example, the amount of the cocrystal in the pharmaceutical compositions may likewise be lower than a therapeutically effective amount, and may, for example, be in the composition in conjunction with another compound or form of ezetimibe, which, when combined, are present in a therapeutically effective amount for treating, alleviating, and/or preventing the particular condition or disorder.

[0056] A "therapeutically effective amount" as described herein refers to an amount of a therapeutic agent sufficient to treat, alleviate, and/or prevent a condition or disorder treatable and/or preventable by administration of a composition of the invention, in any degree. That amount can be an amount sufficient to exhibit a detectable therapeutic or preventative or ameliorative effect, and can be determined by routine experimentation by those of skill in the art. The effect may include, for example, treatment, alleviation, and/or prevention of one or more of the conditions and/or disorders listed herein. The actual amount required, e.g., for treatment of any particular patient, will depend upon a variety of factors, including the condition/disorder being treated and/or prevented; its severity; the specific pharmaceutical composition employed; the age, body weight, general health, gender, and diet of the patient; the mode of administration; the time of administration; the route of administration; the rate of excretion of ezetimibe; the duration of the treatment; any drugs used in combination or coincidental with the specific compound employed; and other such factors well known in the medical arts. These factors are discussed in, for example, Goodman and Gilman's "The Pharmacological Basis of

Therapeutics", Tenth Edition, A. Gilman, J.Hardman and L. Limbird, eds., McGraw-Hill Press, 155-173, 2001.

[0057] A pharmaceutical composition according to various embodiments of the invention may be any pharmaceutical form which contains a novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein. Depending on the type of

pharmaceutical composition, the pharmaceutically acceptable carrier may be chosen from any one or a combination of carriers known in the art. The choice of the pharmaceutically acceptable carrier depends upon the pharmaceutical form and the desired method of administration to be used. For a pharmaceutical composition according to various embodiments of the invention, that is, one having a novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein, a carrier may optionally be chosen that maintains the cocrystal form. In other words, the carrier, in at least some embodiments, will not substantially alter the cocrystal form of ezetimibe as described herein. In additional embodiments, the carrier will likewise not be otherwise incompatible with ezetimibe itself, such as by producing any undesirable biological effect or otherwise interacting in a deleterious manner with any other component(s) of the pharmaceutical composition. [0058] The pharmaceutical compositions according to various embodiments of the invention are optionally formulated in unit dosage form for ease of administration and uniformity of dosage. A "unit dosage form" refers to a physically discrete unit of therapeutic agent appropriate for the patient to be treated. It will be understood, however, that the total daily dosage of a novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal described herein and pharmaceutical compositions thereof will be decided by the attending physician within the scope of sound medical judgment using known methods.

[0059] Because the novel L-proline ezetimibe cocrystal and novel imidazole ezetimibe cocrystal as described herein are more easily maintained during preparation, solid dosage forms are, at least in certain embodiments, a preferred form for the pharmaceutical composition of the invention. Solid dosage forms for oral administration may include, for example, capsules, tablets, pills, powders, and granules. In one exemplary embodiment, the solid dosage form is a tablet. The active ingredient may be contained in a solid dosage form formulation that provides quick release, sustained release, or delayed release after administration to the patient. In such solid dosage forms, the active compound may be mixed with at least one inert, pharmaceutically acceptable carrier, such as, for example, sodium citrate or dicalcium phosphate. The solid dosage form may also include one or more of various additional ingredients, including, for example: a) fillers or extenders such as, for example, starches, lactose, sucrose, glucose, mannitol, and silicic acid; b) binders such as, for example,

carboxymethylcellulose, alginates, gelatin, polyvinylpyrrolidinone, sucrose, and acacia; c) humectants such as, for example, glycerol; d) disintegrating agents such as, for example, agar, calcium carbonate, potato or tapioca starch, alginic acid, certain silicates, and sodium carbonate; e) dissolution retarding agents such as, for example, paraffin; f) absorption accelerators such as, for example, quaternary ammonium compounds; g) wetting agents such as, for example, cetyl alcohol and glycerol monostearate; h) absorbents such as, for example, kaolin and bentonite clay; and i) lubricants such as, for example, talc, calcium stearate, magnesium stearate, solid polyethylene glycols, and sodium lauryl sulfate. The solid dosage forms may also comprise buffering agents. They may optionally contain opacifying agents and can also be of a

composition that they release the active ingredient(s) only, or preferentially, in a certain part of the intestinal tract, optionally, in a delayed manner. Remington's Pharmaceutical Sciences, Sixteenth Edition, E. W. Martin (Mack Publishing Co., Easton, Pa., 1980) discloses various carriers used in formulating pharmaceutical compositions and known techniques for the preparation thereof. Solid dosage forms of pharmaceutical compositions according to various embodiments of the invention can also be prepared with coatings and shells such as enteric coatings and other coatings well known in the pharmaceutical formulating art.

[0060] The novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal described herein can be, in one exemplary embodiment, administered in a solid microencapsulated form with one or more carriers as discussed above. Microencapsulated forms may also be used in soft and hard-filled gelatin capsules with carriers such as lactose or milk sugar as well as high molecular weight polyethylene glycols and the like.

[0061] The novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein may also be used in the preparation of non-solid formulations, such as, for example, injectables and patches, of ezetimibe. Such non-solid formulations are known in the art. In a non- solid formulation, the cocrystal form may, in certain exemplary embodiments, not be maintained. For example, the cocrystal may be dissolved in a liquid carrier. In this case, the novel cocrystals of ezetimibe described herein may represent intermediate forms of ezetimibe used in the preparation of the non-solid formulation. The novel L-proline ezetimibe cocrystal and/or novel imidazole ezetimibe cocrystal described herein may provide advantages of handling stability and/or purity to the process of making such formulations.

[0062] In various exemplary embodiments, the novel L-proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal according to the invention may be administered at dosage levels ranging from about 0.001 mg/kg to about 50 mg/kg, from about 0.01 mg/kg to about 25 mg/kg, or from about 0.1 mg/kg to about 10 mg/kg of subject body weight per day, one or more times a day, to obtain the desired therapeutic effect. It will also be appreciated that dosages smaller than about 0.001 mg/kg or greater than about 50 mg/kg (for example, ranging from about 50 mg/kg to about 100 mg/kg) can also be administered to a subject in certain embodiments of the invention. As discussed above, the amount required for a particular patient will depend upon a variety of factors including the disorder being treated and/or prevented; its severity; the specific pharmaceutical composition employed; the age, body weight, general health, gender, and diet of the patient; the mode of administration; the time of administration; the route of administration; the rate of excretion of ezetimibe; the duration of the treatment; any drugs used in combination or coincidental with the specific compound employed; and other such factors well known in the medical arts. And, as also discussed, the pharmaceutical compositions comprising a novel L- proline ezetimibe cocrystal and/or imidazole ezetimibe cocrystal as described herein may be administered as a unit dosage form.

[0063] Although the present invention herein has been described with reference to various exemplary embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. Those having skill in the art would recognize that a variety of modifications to the exemplary embodiments may be made, without departing from the scope of the invention.

[0064] Moreover, it should be understood that various features and/or characteristics of differing embodiments herein may be combined with one another. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the scope of the invention.

[0065] Furthermore, other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a scope and spirit being indicated by the claims.

EXAMPLES

[0066] Example 1 - Preparation of an L-proline Cocrystal of Ezetimibe

[0067] A 7 mL glass vial was charged with 101.7 mg of ezetimibe and 28 mg of L- proline. 3 mL of an ethyl acetate:heptane: 2,2,2-trifluoro ethanol (1:3:0.5, vohvol) solvent mixture was added to form a slurry. The reaction was stirred, and after 12 hours, 3 mL of heptanes was added. The reaction was allowed to stir for a total of 72 hours, at which time the solids present were isolated by vacuum filtration and air dried at room temperature to yield 110 mg of L-proline ezetimibe cocrystal. The isolated solid was analyzed by XRPD, Raman spectroscopy, DSC, TGA and ¹H-NMR. The XRPD pattern is shown in FIG. 1A, and the Raman spectrum is shown in FIG. 2. The DSC thermogram is substantially the same as that shown in FIG. 3. The TGA profile is substantially the same as that shown in FIG. 4. The 1H-NMR spectrum is shown in FIGS. 5A, 5B, 5C, and 5D. [0068] Example 2 - Preparation of an L-proline Cocrystal of Ezetimibe

[0069] 407 mg of ezetimibe and 150 mg of L-proline were dissolved in 10 mL of methyl ethyl ketone:2,2,2-trifluoro ethanohisooctane (1:0.5:2, vohvol) in a 20 mL vial to form a slurry at ambient temperature. An additional 10 mL of methyl ethyl ketone:2,2,2-trifluoro ethanohisooctane (1:0.5:2 vohvol) was added, and the reaction was stirred at ambient temperature for 48 hours, at which time 100 mg of additional L-proline was added. After a total of 54 hours of stirring, the solids were isolated by vacuum filtration and air dried. The amount of solids isolated was approximately 600 mg. The isolated solid was analyzed by XRPD, Raman spectroscopy, DSC, TGA and 1H-NMR. The XRPD pattern is substantially the same as that shown in FIG. 1A, and the Raman spectrum is substantially the same as that shown in FIG. 2. The DSC thermogram is shown in FIG. 3. The TGA profile is shown in FIG. 4. The 1H-NMR spectrum is substantially the same as that shown in FIGS. 5A, 5B, 5C, and 5D.

[0070] Example 3 - Preparation of an Imidazole Cocrystal of Ezetimibe

[0071] A PEEK grinding jar was charged with 81.0 mg of ezetimibe and 13.3 mg of imidazole. 150 uL of 1:3 (vohvol) ethyl acetate: heptane were added along with two stainless steel grinding balls. The grinding jar was shaken at 80% power on a Retsch MM2 grinding apparatus for two 10 minute periods. The solvent was then evaporated, and the dry powder was isolated to yield 75 mg (80%) of the ezetimibe: imidazole molecular complex. The solid was analyzed by XRPD, Raman spectroscopy, DSC, TGA and ¹H-NMR. The XRPD pattern is shown in FIG. 6. The Raman spectrum is shown in FIG. 7. The DSC thermogram was substantially the same as that shown in FIG. 8. The TGA profile was substantially the same as that shown in FIG. 9. The 1H-NMR spectrum is shown in FIGS. 10A, 10B, IOC, and 10D.

[0072] Example 4 - Preparation of an Imidazole Cocrystal of Ezetimibe

[0073] 10 mg of imidazole was dissolved in 2 mL of methyl tert-butyl ether to form a clear solution. 60 mg of ezetimibe was added to this solution to form a clear solution. 3 mL of isooctane were added in six portions to form a slurry. The slurry was stirred for approximately 24 hours, at which time approximately 3 to 10 mg of the solid present was isolated by vacuum filtration and air dried. XRPD data from this solid sample was examined and compared to XRPD data from known solid phases of imidazole and ezetimibe in order to determine if, in addition to the cocrystal, excess imidazole or ezetimibe was present in the solid isolated from the reaction. Additional imidazole or ezetimibe was added in 1 to 10 mg amounts to drive the product towards pure cocrystal. The process of isolating a 3 to 10 mg sample, obtaining and analyzing the XRPD data, and adding additional imidazole or ezetimibe in 1 to 10 mg amounts and stirring for approximately 24 hours was repeated until the product obtained was only cocrystal based on XRPD data. The amount of ezetimibe: imidazole cocrystal isolated was approximately 120mg. The solid was analyzed by XRPD, Raman spectroscopy, DSC, TGA and 1H-NMR. The XRPD pattern was substantially the same as that shown in FIG. 6. The Raman spectrum was substantially the same as that shown in FIG. 7. The DSC thermogram is shown in FIG. 8. The TGA profile is shown in FIG. 9. The 1H-NMR spectrum is substantially the same as that shown in FIGS. 10A, 10B, IOC, and 10D. [0074] Example 5 - Powder Dissolution Data of Formulated L-proline Exetimibe

[0075] Formulated samples of L-proline ezetimibe cocrystal and ezetimibe having the compositions set forth in Table 5 below were acquired. Two ezetimibe and three L-proline ezetimibe cocrystal dissolution experiments were performed, and the averaged data is shown in FIG. 11.

TABLE 5

[0076] The dissolution data in FIG. 11 demonstrates that the L-proline cocrystal of ezetimibe has improved solubility in solution relative to the known forms of ezetimibe, leading to a higher concentration of ezetimibe in solution. [0077] Example 6 -Stability Testing of L-proline Ezetimibe

[0078] Samples of L-proline Ezetimibe Cocrystals obtained in Examples 1 and 2 were stored in an RH environment of approximately 75% relative humidity (saturated NaCl) at 40°C for 31 days. The solids were analyzed by XRPD. The XRPD patterns were substantially the same as that of FIG. 1 A, indicating no substantial change in the solid form of the sample during the course of the experiment.

Claims

WHAT IS CLAIMED IS:

1. An L-proline cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)- hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone.

2. An L-proline cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)- hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone having substantially the same XRPD pattern as in FIG. 1A.

3. A pharmaceutical composition comprising the L-proline cocrystal of l-(4- fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 1.

4. A pharmaceutical composition comprising the L-proline cocrystal of l-(4- fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 2.

5. A method of treating and/or preventing any of the following conditions comprising administering a pharmaceutical composition comprising the L-proline cocrystal of 1- (4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 1 : primary hypercholesterolemia, mixed hyperlipidemia, and homozygous familial sitosterolemia.

6. A method of treating and/or preventing any of the following conditions comprising administering a pharmaceutical composition comprising the L-proline cocrystal of 1- (4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 2: primary hypercholesterolemia, mixed hyperlipidemia and homozygous familial sitosterolemia.

7. An imidazole cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)- hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone.

8. An imidazole cocrystal of l-(4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)- hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2-azetidinone having substantially the same XRPD pattern as in FIG. 6.

9. A pharmaceutical composition comprising the imidazole cocrystal of l-(4- fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 7.

10. A pharmaceutical composition comprising the imidazole cocrystal of l-(4- fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 8.

11. A method of treating and/or preventing any of the following conditions comprising administering a pharmaceutical composition comprising the imidazole cocrystal of 1- (4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 7: primary hypercholesterolemia, mixed hyperlipidemia and homozygous familial sitosterolemia.

12. A method of treating and/or preventing any of the following conditions comprising administering a pharmaceutical composition comprising the imidazole cocrystal of 1- (4-fluorophenyl)-3(R)-[3-(4-fluorophenyl)-3(S)-hydroxypropyl]-4(S)-(4-hydroxyphenyl)-2- azetidinone according to claim 8: primary hypercholesterolemia, mixed hyperlipidemia and homozygous familial sitosterolemia.