Compositions and methods for treating pulmonary hypertension

Patent metadata

Field	Value
Publication number	US-11497794-B2
Application number	US-202117339606-A
Country	US
Kind code	B2
Filing date	Jun 4, 2021
Priority date	Jul 15, 2016
Publication date	Nov 15, 2022
Grant date	Nov 15, 2022

Abstract

In some aspects, the disclosure relates to GDF/BMP antagonists and methods of using GDF/BMP antagonists to treat, prevent, or reduce the progression rate and/or severity of pulmonary hypertension (PH), particularly treating, preventing or reducing the progression rate and/or severity of one or more PH-associated complications. The disclosure also provides methods of using a GDF/BMP antagonist to treat, prevent, or reduce the progression rate and/or severity of a variety of conditions including, but not limited to, pulmonary vascular remodeling, pulmonary fibrosis, and right ventricular hypertrophy. The disclosure further provides methods of using a GDF/BMP antagonist to reduce right ventricular systolic pressure in a subject in need thereof.

First claim

We claim:

1. A method of treating pulmonary hypertension with left heart disease, comprising administering to a patient in need thereof an effective amount of a fusion protein comprising an ActRII polypeptide, wherein said ActRII polypeptide comprises an amino acid sequence that is at least 90% identical to an amino acid sequence corresponding to residues 30-110 of SEQ ID NO: 9, and wherein the ActRII polypeptide binds to activin and/or GDF11.

2. The method of claim 1 , wherein the ActRII polypeptide is a polypeptide comprising an amino acid sequence that is at least 95% identical to the amino acid sequence corresponding to residues 30-110 of SEQ ID NO: 9.

3. The method of claim 1 , wherein the ActRII polypeptide is a polypeptide comprising an amino acid sequence that is at least 99% identical to the amino acid sequence corresponding to residues 30-110 of SEQ ID NO: 9.

4. The method of claim 1 , wherein the ActRII polypeptide comprises the amino acid sequence corresponding to residues 30-110 of SEQ ID NO: 9.

5. The method of claim 1 , wherein the fusion protein further comprises an Fc domain of an immunoglobulin.

6. The method of claim 5 , wherein the Fc domain of the immunoglobulin is an Fc domain of an IgG1 immunoglobulin.

7. The method of claim 5 , wherein the fusion protein comprises a linker domain positioned between the ActRII polypeptide and the Fc domain of the immunoglobulin.

8. The method of claim 7 , wherein the linker domain comprises TGGG (SEQ ID NO: 23).

9. The method of claim 1 , wherein the ActRII polypeptide comprises an amino acid sequence that is at least 90% identical to the amino acid sequence of SEQ ID NO: 10 .

10. The method of claim 9 , wherein the fusion protein further comprises an Fc domain of an immunoglobulin.

11. The method of claim 10 , wherein the Fc domain of the immunoglobulin is an Fc domain of an IgG1 immunoglobulin.

12. The method of claim 10 , wherein the fusion protein comprises a linker domain positioned between the ActRII polypeptide and the Fc domain of the immunoglobulin.

13. The method of claim 12 , wherein the linker domain comprises TGGG (SEQ ID NO: 23).

14. A method of treating pulmonary hypertension with left heart disease, comprising administering to a patient in need thereof an effective amount of an polypeptide comprising an amino acid sequence that is at least 90% identical to the amino acid sequence of SEQ ID NO: 32.

15. The method of claim 14 , wherein the polypeptide comprises an amino acid sequence that is at least 95% identical to the amino acid sequence of SEQ ID NO: 32.

16. The method of claim 1 , wherein the patient has resting pulmonary arterial pressure (PAP) of at least 25 mm Hg.

17. The method of claim 1 , wherein the patient has Functional Class II or Class III pulmonary hypertension as recognized by the World Health Organization.

18. The method of claim 17 , wherein the method prevents or delays pulmonary hypertension Functional Class progression.

19. The method of claim 1 , wherein the polypeptide is part of a homodimer protein complex.

20. The method of claim 1 , wherein the polypeptide is glycosylated.

21. The method of claim 1 , wherein the polypeptide binds to one or more ligands selected from the group consisting of: activin A, activin B, and GDF11.

22. The method of claim 21 , wherein the polypeptide further binds to one or more ligands selected from the group consisting of: BMP10, GDF8, and BMP6.

23. The method of claim 1 , comprising further administering to the patient an additional active agent and/or supportive therapy for treating pulmonary hypertension.

24. The method of claim 23 , wherein the additional active agent and/or supportive therapy is selected from the group consisting of: prostacyclin and derivatives thereof; prostacyclin receptor agonists; endothelin receptor; calcium channel blockers; anticoagulants; diuretics; oxygen therapy; atrial septostomy; pulmonary thromboendarterectomy; phosphodiesterase type 5 inhibitors; activators of soluble guanylate cyclase; ASK-1 inhibitors; NF-κB antagonists; lung and/or heart transplantation.

25. The method of claim 1 , wherein the patient has been treated with one or more vasodilators.

26. The method of claim 1 , wherein the patient has been treated with one or more agents selected from the group consisting of: phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators, prostacyclin receptor agonist, and endothelin receptor antagonists.

27. The method of claim 26 , wherein the one or more agents is selected from the group consisting of: bosentan, sildenafil, beraprost, macitentan, selexipag, epoprostenol, treprostinil, iloprost, ambrisentan, and tadalafil.

28. The method of claim 1 , wherein the method further comprises administration of one or more vasodilators.

29. The method of claim 1 , wherein the method further comprises administration of one or more agents selected from the group consisting of:
phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators, prostacyclin receptor agonist, and endothelin receptor antagonists.

30. The method of claim 29 , wherein the one or more agents is selected from the group consisting of: bosentan, sildenafil, beraprost, macitentan, selexipag, epoprostenol, treprostinil, iloprost, ambrisentan, and tadalafil.

Assignees

• Acceleron Pharma Inc

Inventors

• Kumar Ravindra
• Knopf John

Classifications

• A61P7/00

  Drugs for disorders of the blood or the extracellular fluid · CPC title

• A61P11/00

  Drugs for disorders of the respiratory system · CPC title

• A61K38/45

  Transferases (2) · CPC title

• A61K38/1709 Primary

  from mammals · CPC title

• C07K2319/30

  Non-immunoglobulin-derived peptide or protein having an immunoglobulin constant or Fc region, or a fragment thereof, attached thereto · CPC title