NZ725538B2 - Compositions and methods for modulating apolipoprotein (a) expression - Google Patents
Compositions and methods for modulating apolipoprotein (a) expression Download PDFInfo
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- NZ725538B2 NZ725538B2 NZ725538A NZ72553814A NZ725538B2 NZ 725538 B2 NZ725538 B2 NZ 725538B2 NZ 725538 A NZ725538 A NZ 725538A NZ 72553814 A NZ72553814 A NZ 72553814A NZ 725538 B2 NZ725538 B2 NZ 725538B2
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- C12N2320/00—Applications; Uses
- C12N2320/30—Special therapeutic applications
- C12N2320/32—Special delivery means, e.g. tissue-specific
-
- C—CHEMISTRY; METALLURGY
- C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
- C12Y—ENZYMES
- C12Y301/00—Hydrolases acting on ester bonds (3.1)
- C12Y301/03—Phosphoric monoester hydrolases (3.1.3)
- C12Y301/03048—Protein-tyrosine-phosphatase (3.1.3.48)
Abstract
Discloses a compound comprising a modified oligonucleotide and a conjugate group, wherein the modified oligonucleotide consists of 12-30 contiguous nucleobases comprising a portion of at least 8 contiguous nucleosides complementary to an equal length portion of nucleobases of SEQ ID NO: 1, wherein the nucleobase sequence of the modified oligonucleotide complementary to SEQ ID NO: 1; and wherein the conjugate group and sequences are as defined in the complete specification. he nucleobase sequence of the modified oligonucleotide complementary to SEQ ID NO: 1; and wherein the conjugate group and sequences are as defined in the complete specification.
Description
COMPOSITIONS AND METHODS FOR MODULATING APOLIPOPROTEIN (a) EXPRESSION
SEQUENCE LISTING
The present ation is being filed along with a Sequence Listing in electronic format. The
ce Listing is provided as a file entitled BIOLOZSOWOSEQ_ST25.txt, created on May 1, 2014, which
is 432 Kb in size. The ation in the electronic format of the sequence listing is incorporated herein by
reference in its entirety.
BACKGROUND OF THE INVENTION
The principle behind antisense technology is that an antisense compound hybridizes to a target
nucleic acid and modulates the amount, activity, and/or function of the target nucleic acid. For example in
certain instances, antisense compounds result in d transcription or translation of a . Such
modulation of expression can be achieved by, for example, target mRNA degradation or occupancy-based
inhibition. An e of modulation of RNA target function by degradation is RNase H-based degradation
of the target RNA upon hybridization with a DNA-like antisense nd. Another e of modulation
of gene expression by target degradation is RNA interference (RNAi). RNAi refers to antisense-mediated
gene silencing through a mechanism that utilizes the RNA-induced siliencing complex . An additional
e of tion of RNA target function is by an occupancy-based mechanism such as is employed
naturally by microRNA. MicroRNAs are small non-coding RNAs that regulate the expression of protein-
coding RNAs. The binding of an antisense compound to a microRNA prevents that NA from binding
to its messenger RNA targets, and thus interferes with the function of the microRNA. MicroRNA mimics
can e native microRNA function. Certain antisense compounds alter splicing of pre-mRNA.
Regardless of the specific mechanism, ce-specificity makes antisense compounds attractive as tools for
target validation and gene functionalization, as well as therapeutics to selectively te the expression of
genes involved in the pathogenesis of diseases.
nse technology is an effective means for modulating the expression of one or more specific
gene products and can therefore prove to be uniquely useful in a number of therapeutic, diagnostic, and
research applications. Chemically modified nucleosides may be incorporated into nse compounds to
enhance one or more properties, such as nuclease resistance, pharmacokinetics or affinity for a target nucleic
acid. In 1998, the antisense compound, Vitravene® (fomivirsen; developed by Isis Pharmaceuticals Inc.,
Carlsbad, CA) was the first antisense drug to achieve marketing clearance from the US. Food and Drug
Administration (FDA), and is currently a treatment of cytomegalovirus (CMV)-induced retinitis in AIDS
patients.
New chemical modifications have improved the potency and efficacy of antisense nds,
uncovering the potential for oral delivery as well as enhancing subcutaneous administration, decreasing
potential for side s, and g to improvements in patient convenience. Chemical modifications
increasing potency of antisense compounds allow administration of lower doses, which reduces the potential
for toxicity, as well as decreasing overall cost of therapy. Modifications increasing the resistance to
ation result in slower clearance from the body, allowing for less nt dosing. Different types of
chemical modifications can be combined in one compound to further optimize the compounds y.
oteins are globular, e-like particles that consist of a non-polar core of acylglycerols and
cholesteryl esters surrounded by an amphiphilic coating of n, phospholipid and cholesterol.
Lipoproteins have been classified into five broad categories on the basis of their fimctional and physical
properties: chylomicrons, very low density lipoproteins (VLDL), intermediate density lipoproteins (IDL), low
density lipoproteins (LDL), and high density lipoproteins (HDL). Chylomicrons transport dietary lipids from
intestine to tissues. VLDLs, IDLs and LDLs all transport lglycerols and terol from the liver to
tissues. HDLs transport endogenous cholesterol from tissues to the liver
Lipoprotein particles undergo continuous metabolic processing and have variable properties and
compositions. Lipoprotein ies increase without increasing le diameter because the density of their
outer coatings is less than that of the inner core. The protein components of lipoproteins are known as
apolipoproteins. At least nine apolipoproteins are distributed in significant amounts among the various human
lipoproteins.
The lipoprotein(a) [Lp(a)] particle was identified nearly 50 years ago and is comprised of a highly
unique LDL particle in which one apolipoprotein B (apoB) protein is linked via a disulfide bond to a single
apolipoprotein(a) [apo(a)] protein. The apo(a) protein shares a high degree of homology with plasminogen
particularly within the kringle IV type 2 repetitive domain. Levels of ating Lp(a) are inversely
proportional to the number of kringle IV type 2 variable repeats present in the molecule and, as both s
are co-expressed within individuals, can display heterozygous plasma isoform profiles (Kraft et al., Eur J
Hum Genet, 1996; 4(2): 74-87). It is t that this kringle repeat domain in apo(a) may be responsible for
its pro-thrombotic and anti-fibrinolytic properties, potentially enhancing atherosclerotic progression.
Apo(a) is transcriptionally regulated by IL-6 and in studies in rheumatoid arthritis patients d
with an IL-6 inhibitor (tocilizumab), plasma levels were reduced by 30% after 3 month treatment (Schultz et
al., PLoS One 2010; 5:el4328).
Apo(a) has been shown to preferentially bind oxidized phospholipids and potentiate ar
inflammation (Bergmark et al., J Lipid Res 2008; 49:2230—2239; Tsimikas et al., Circulation. 2009;
ll9(l3):l7l 1—1719).
Further, studies suggest that the Lp(a) particle may also stimulate endothelial permeability, induce
plasminogen activator inhibitor type-l expression and activate macrophage interleukin-8 secretion
insky and Marcovina, Curr Opin Lipidol 2004; 15:167—174). Importantly, recent genetic association
studies revealed that Lp(a) was an independent risk factor for myocardial infarction, , eral
vascular e and abdominal aortic aneurysm (Rifai et al., Clin Chem 2004; 50:1364—71; Erqou et al.,
JAMA 2009;302:412–23; Kamstrup et al., Circulation 2008;117:176–84). Further, in the recent Precocious
Coronary Artery Disease (PROCARDIS) study, Clarke et al. (Clarke et al., NEJM (2009)361; 2518-2528)
described robust and independent associations between coronary heart disease and plasma Lp(a)
trations. Additionally, Solfrizzi et al., suggested that increased serum Lp(a) may be linked to an
increased risk for mer’s Disease (AD) (Solfrizzi et al., J Neurol urg Psychiatry 2002, 72:732-
736. Currently, in the clinic setting, examples of indirect apo(a) inhibitors for treating cardiovascular disease
include aspirin, Niaspan, Mipomersen, Anacetrapib, Epirotirome and Lomitapide which reduce plasma Lp(a)
levels by 18%, 39%, 32%, 36%, 43% and 17%, tively. Additionally, Lp(a) apheresis has been used in
the clinic to reduce apo(a) containing Lp(a) particles.
To date, therapeutic strategies to treat cardiovascular disease by directly ing apo(a) levels have
been limited. Ribozyme oligonucleotides (U.S. Patent 5,877,022) and nse ucleotides (WO
00201; ; WO2013/177468; US20040242516; U.S. Patent Nos. 8,138,328, 8,673,632
and 7,259,150; Merki et al., J Am Coll Cardiol 2011; 57:1611–1621; each publication incorporated by
reference in its entiretly) have been developed but none have been approved for commercial use.
Thus, there remains a clear unmet l need for novel agents which can potently and selectively
reduce apo(a) levels in patients at enhanced risk for cardiovascular events due to chronically elevated plasma
Lp(a) levels.
SUMMARY OF THE INVENTION
The present application is a divisional application out of NZ . NZ 740338 is in turn a
divisional of the present application. The complete description of the inventions of NZ 631512, the present
application and NZ 740338 are retained herein for clarity and completeness.
Provided herein are compositions and methods for modulating sion of apo(a) mRNA and
protein. In n embodiments, the apo(a) specific inhibitor decreases expression of apo(a) mRNA and
protein. Provided herein are compositions and methods for ting expression of Lp(a) levels. In a
particular aspect, the present invention provides a compound comprising a modified oligonucleotide and a
conjugate group, wherein the ed ucleotide consists of 12 to 30 linked nucleosides and comprises
a nucleobase sequence comprising a portion of at least 8 contiguous nucleobases complementary to an equal
length portion of SEQ ID NO: 1; wherein the conjugate group comprises:
[FOLLOWED BY PAGE 3a]
HOOH O
O O N
HO 4 H
AcHN O
HOOH O O O
O O N O
N N
HO 4 O 4 H H H
AcHN O
HOOH
O O N
HO O
AcHN ,
and wherein the compound is not:
a compound sing a ed oligonucleotide and a conjugate group, wherein the modified
oligonucleotide consists of 20 contiguous nucleobases complementary to an equal length portion of
nucleobases 3901 to 3920 of SEQ ID NO: 1, wherein the base sequence of the modified
oligonucleotide is at least 80% complementary to SEQ ID NO: 1; and wherein the conjugate group
comprises:
HOOH O
O O N
HO 4 H
AcHN O
HOOH O O O
O O N O
N N
HO H H 4 O 4 H
AcHN O
HOOH
O O N
HO O
AcHN .
In n embodiments, the composition is an apo(a) specific inhibitior. In certain ments, the
apo(a) specific inhibitor is a nucleic acid, protein, or small molecule. In certain ments, the apo(a)
specific inhibitor is an antisense oligonucleotide targeting apo(a) with a conjugate. In certain embodiments,
the apo(a) specific inhibitor is a modified oligonucleotide and a conjugate, wherein the modified
oligonucleotide consists of 12 to 30 linked nucleosides and comprises a nucleobase sequence comprising a
n of at least 8 contiguous nucleobases complementary to an equal length portion of nucleobases 3901 to
3920 of SEQ ID NO: 1, wherein the nucleobase sequence of the modified oligonucleotide is at least 80%
[FOLLOWED BY PAGE 3b]
complementary to SEQ ID NO: 1. In certain embodiments, the apo(a) specific inhibitor is a modified
oligonucleotide and a conjugate, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides
and has a base sequence sing at least 8, least 9, least 10, least 11, at least 12, least 13, at least
14, at least 15, at least 16, least 17, least 18, least 19, or 20 contiguous nucleobases of the nucleobase
sequence of SEQ ID NO: 1-130, 133, 134. In certain embodiments, the apo(a) specific inhibitor is a modified
oligonucleotide and a ate, wherein the modified oligonucleotide consists of 20 linked nucleosides and
[FOLLOWED BY PAGE 4]
has a base sequence comprising at least 8 contiguous nucleobases of any of SEQ ID NO: 5 8, wherein
the modified oligonucleotide comprises: (a) a gap segment consisting of ten linked deoxynucleosides; (b) a 5’
wing segment consisting of five linked nucleosides; (c) a 3’ wing segment consisting of five linked
nucleosides; and wherein the gap segment is positioned between the 5’ wing segment and the 3’ wing
segment, wherein each nucleoside of each wing segment comprises a 2’-O-methoxyethyl sugar, wherein at
least one intemucleoside linkage is a phosphorothioate linkage and wherein each cytosine residue is a 5-
methylcytosine.
Certain embodiments provide a composition comprising a ated antisense compound bed
herein, or a salt thereof, and a pharmaceutically acceptable r or diluent.
In certain embodiments, the modulation of apo(a) expression occurs in a cell or tissue. In certain
embodiments, the tions occur in a cell or tissue in an animal. In certain embodiments, the animal is a
human. In certain embodiments, the modulation is a reduction in apo(a) mRNA level. In certain
embodiments, the modulation is a reduction in apo(a) protein level. In certain embodiments, both apo(a)
mRNA and protein levels are reduced. In certain embodiments, the modulation is a reduction in Lp(a) level.
Such reduction may occur in a time-dependent or in a dose-dependent manner.
Certain embodiments provide conjugated antisense compositions and methods for use in therapy.
Certain embodiments provide compositions and methods for preventing, ng, delaying, slowing the
progression and/or ameliorating apo(a) related diseases, disorders, and conditions. Certain ments
provide compositions and s for preventing, treating, delaying, slowing the progression and/or
rating Lp(a) related diseases, disorders, and conditions. In certain embodiments, such diseases,
disorders, and conditions are inflammatory, cardiovascular and/or lic diseases, disorders, and
conditions. In certain embodiments, the compositions and methods for therapy include administering an
apo(a) specific inhibitor to an individual in need thereof. In certain embodiments, the apo(a) specific
inhibitor is a nucleic acid. In n embodiments, the nucleic acid is an antisense nd. In certain
embodiments, the antisense nd is a modified oligonucleotide. In certain embodiments, the nse
compound is a modified oligonucleotide with a conjugate.
In certain embodiments, the present disclosure provides conjugated antisense compounds. In certain
embodiments, the t disclosure provides ated antisense compounds comprising an antisense
oligonucleotide complementary to a nucleic acid transcript. In certain embodiments, the present disclosure
provides methods comprising contacting a cell with a conjugated antisense compound comprising an
antisense oligonucleotide complementary to a nucleic acid ript. In certain embodiments, the present
disclosure provides methods comprising ting a cell with a conjugated antisense compound comprising
an antisense oligonucleotide and reducing the amount or activity of a nucleic acid transcript in a cell.
The asialoglycoprotein receptor (ASGP-R) has been described previously. See e. g., Park et al.,
PNAS vol. 102, No. 47, pp 17129 (2005). Such receptors are sed on liver cells, particularly
hepatocytes. Further, it has been shown that compounds comprising clusters of three N-
acetylgalactosamine (GalNAc) ligands are capable of binding to the ASGP-R, resulting in uptake of the
nd into the cell. See e.g., Khorev et al., Bioorganic and Medicinal Chemistry, 16, 9, pp 5216-5231
(May 2008). ingly, conjugates comprising such GalNAc clusters have been used to facilitate uptake
of certain compounds into liver cells, specifically hepatocytes. For example it has been shown that certain
GalNAc-containing conjugates increase activity of duplex siRNA nds in liver cells in vivo. In such
ces, the GalNAc-containing conjugate is typically attached to the sense strand of the siRNA duplex.
Since the sense strand is ded before the antisense strand ultimately hybridizes with the target nucleic
acid, there is little concern that the conjugate will interfere with activity. Typically, the conjugate is attached
to the 3’ end of the sense strand of the siRNA. See e.g., U.S. Patent 8,106,022. Certain conjugate groups
described herein are more active and/or easier to synthesize than conjugate groups previously described.
In certain embodiments of the present invention, conjugates are attached to single-stranded nse
compounds, including, but not limited to RNase H based antisense compounds and antisense compounds that
alter splicing of a pre-mRNA target nucleic acid. In such embodiments, the conjugate should remain attached
to the antisense compound long enough to provide benefit (improved uptake into cells) but then should either
be cleaved, or otherwise not interfere with the subsequent steps necessary for activity, such as hybridization
to a target nucleic acid and ction with RNase H or enzymes associated with splicing or splice
tion. This balance of ties is more important in the g of single-stranded antisense
compounds than in siRNA nds, where the conjugate may simply be attached to the sense strand.
Disclosed herein are ated single-stranded antisense compounds having improved potency in liver cells
in vivo compared with the same antisense compound lacking the conjugate. Given the ed balance of
properties for these compounds such improved potency is surprising.
In certain ments, conjugate groups herein comprise a cleavable moiety. As noted, without
wishing to be bound by ism, it is logical that the conjugate should remain on the compound long
enough to provide enhancement in uptake, but after that, it is desirable for some portion or, ideally, all of the
conjugate to be cleaved, releasing the parent compound (e. g., antisense compound) in its most active form. In
certain ments, the cleavable moiety is a cleavable nucleoside. Such embodiments take age of
endogenous ses in the cell by attaching the rest of the conjugate (the cluster) to the antisense
oligonucleotide through a nucleoside via one or more cleavable bonds, such as those of a phosphodiester
linkage. In certain embodiments, the cluster is bound to the cleavable nucleoside through a phosphodiester
linkage. In certain embodiments, the cleavable nucleoside is attached to the antisense oligonucleotide
(antisense compound) by a phosphodiester linkage. In certain embodiments, the conjugate group may
comprise two or three cleavable nucleosides. In such ments, such cleavable sides are linked to
one another, to the antisense compound and/or to the cluster via cleavable bonds (such as those of a
phosphodiester linkage). Certain conjugates herein do not comprise a cleavable nucleoside and instead
comprise a cleavable bond. It is shown that that sufficient cleavage of the conjugate from the oligonucleotide
is provided by at least one bond that is vulnerable to cleavage in the cell (a cleavable bond).
In certain embodiments, conjugated antisense compounds are prodrugs. Such prodrugs are
administered to an animal and are ultimately metabolized to a more active form. For example, conjugated
nse compounds are cleaved to remove all or part of the conjugate resulting in the active (or more active)
form of the antisense compound lacking all or some of the conjugate.
In certain embodiments, conjugates are attached at the 5’ end of an oligonucleotide. Certain such 5’-
conjugates are cleaved more efficiently than counterparts having a similar conjugate group attached at the 3’
end. In certain embodiments, improved activity may correlate with ed cleavage. In certain
embodiments, oligonucleotides comprising a conjugate at the 5’ end have greater efficacy than
oligonucleotides sing a conjugate at the 3’ end (see, for example, Examples 56, 81, 83, and 84).
r, 5’-attachment allows r oligonucleotide synthesis. Typically, oligonucleotides are synthesized
on a solid support in the 3’ to 5’ direction. To make a 3’-conjugated oligonucleotide, typically one attaches a
pre—conjugated 3’ nucleoside to the solid t and then builds the oligonucleotide as usual. However,
attaching that conjugated nucleoside to the solid t adds complication to the synthesis. Further, using
that approach, the conjugate is then present throughout the synthesis of the oligonucleotide and can become
degraded during subsequent steps or may limit the sorts of reactions and reagents that can be used. Using the
structures and techniques described herein for jugated oligonucleotides, one can synthesize the
oligonucleotide using standard automated techniques and uce the conjugate with the final (5 ’-most)
nucleoside or after the oligonucleotide has been cleaved from the solid support.
In view of the art and the present disclosure, one of ordinary skill can easily make any of the
conjugates and ated oligonucleotides herein. er, synthesis of certain such ates and
conjugated oligonucleotides disclosed herein is easier and/or requires few steps, and is therefore less
expensive than that of conjugates previously disclosed, providing advantages in manufacturing. For example,
the synthesis of certain conjugate groups ts of fewer synthetic steps, resulting in increased yield,
relative to conjugate groups previously described. Conjugate groups such as GalNAc3-10 in e 46 and
GalNAc3-7 in Example 48 are much simpler than previously bed conjugates such as those described in
US. 8,106,022 or US. 7,262,177 that require assembly of more chemical intermediates . Accordingly, these
and other conjugates described herein have ages over previously described compounds for use with
any oligonucleotide, ing single-stranded oligonucleotides and either strand of -stranded
oligonucleotides (e. g., siRNA).
Similarly, sed herein are conjugate groups having only one or two GalNAc ligands. As shown,
such conjugates groups improve activity of nse compounds. Such compounds are much easier to
prepare than conjugates comprising three GalNAc ligands. Conjugate groups comprising one or two GalNAc
ligands may be attached to any antisense compounds, including single-stranded oligonucleotides and either
strand of double-stranded oligonucleotides (e. g., siRNA).
In certain embodiments, the conjugates herein do not substantially alter certain measures of
bility. For example, it is shown herein that conjugated antisense compounds are not more immunogenic
than unconjugated parent compounds. Since potency is improved, embodiments in which tolerability remains
the same (or indeed even if tolerability worsens only slightly compared to the gains in potency) have
improved properties for y.
In certain embodiments, conjugation allows one to alter nse compounds in ways that have less
attractive consequences in the absence of conjugation. For example, in certain embodiments, replacing one
or more phosphorothioate linkages of a fully phosphorothioate antisense compound with phosphodiester
es results in improvement in some measures of tolerability. For example, in certain instances, such
antisense compounds having one or more odiester are less immunogenic than the same compound in
which each linkage is a phosphorothioate. However, in certain instances, as shown in Example 26, that same
replacement of one or more phosphorothioate es with phosphodiester es also results in reduced
cellular uptake and/or loss in potency. In certain embodiments, conjugated antisense compounds described
herein tolerate such change in linkages with little or no loss in uptake and potency when compared to the
conjugated hosphorothioate rpart. In fact, in certain embodiments, for example, in Examples 44,
57, 59, and 86, oligonucleotides sing a ate and at least one phosphodiester internucleoside
linkage actually exhibit increased potency in vivo even relative to a full phosphorothioate counterpart also
comprising the same conjugate. Moreover, since conjugation results in ntial increases in
uptake/potency a small loss in that substantial gain may be acceptable to achieve improved tolerability.
Accordingly, in certain ments, conjugated antisense compounds comprise at least one phosphodiester
linkage.
In certain embodiments, conjugation of antisense compounds herein results in increased delivery,
uptake and activity in hepatocytes. Thus, more compound is delivered to liver tissue. However, in certain
embodiments, that sed delivery alone does not explain the entire increase in activity. In certain such
embodiments, more compound enters cytes. In certain ments, even that increased hepatocyte
uptake does not explain the entire increase in activity. In such embodiments, productive uptake of the
conjugated compound is increased. For example, as shown in Example 102, certain ments of
GalNAc-containing conjugates increase enrichment of antisense oligonucleotides in cytes versus non-
parenchymal cells. This ment is beneficial for oligonucleotides that target genes that are expressed in
hepatocytes.
In certain embodiments, conjugated antisense compounds herein result in reduced kidney exposure.
For example, as shown in Example 20, the concentrations of antisense oligonucleotides comprising n
embodiments of GalNAc-containing conjugates are lower in the kidney than that of antisense
oligonucleotides lacking a GalNAc-containing conjugate. This has several beneficial therapeutic
implications. For therapeutic indications where activity in the kidney is not sought, exposure to kidney risks
kidney toxicity without corresponding benefit. Moreover, high concentration in kidney typically results in
loss of compound to the urine resulting in faster clearance. Accordingly for non-kidney targets, kidney
accumulation is undesired.
In certain embodiments, the present disclosure provides conjugated antisense compounds ented
by the formula:
A—B—C—D—eE—F)
Wherein
A is the antisense oligonucleotide;
B is the cleavable moiety
C is the conjugate linker
D is the ing group
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In the above diagram and in similar diagrams herein, the branching group “D” branches as many
times as is necessary to accommodate the number of (E-F) groups as indicated by q” Thus, Where q = l,
the formula is:
A—B—C—D—E—F
Where q = 2, the formula is:
Where q = 3, the a is:
Where q = 4, the formula is:
Where q = 5, the formula is:
A—B—C—D
In certain ments, conjugated antisense compounds are provided having the structure:
Targeting moiety
/—/%
HO OH
wwflwfi O:P70H NH2
0 N
VJ”0 «fr/" NHAc
HO0H 0 o
Mfl£0%,“ C?
NHAc
ice—1 Cleavable moiety
Ligand Tether
:eeww Branching group
NHAc
In certain embodiments, conjugated antisense compounds are provided having the structure:
Cell targeting moiety
HO /\ "
/P\ Cleavable m01ety'
ACHN | 0
>| NH
N 2
HOOH
O o
O H (H) 0 (1:117%
OH “
ACHN 0 Q
Tether
Ligand 0—on
o \
HO OH ii
0 O\/\/\/\0/ A80
NHAC Branching group
PCT/USZOl4/036460
In certain embodiments, conjugated antisense compounds are provided having the structure:
ASO Cleavable moiety
Cell targeting moiety I—(gl—I—l
HO OW\/\ (H)
04.30 OH
ACHN 0 j 0
HO OH 0 (<2; Conjugate
o 9 | linker
HO /P\ 0—1320
0 do 0 I
ACHN 0 OH
Tether I—l
HO 0“ (ii
0 O\/\/\/\O (5-0
NHAC Branching group
In certain ments, ated antisense compounds are provided having the structure:
Ligand
Cl bl _ (I)
Tether eava e m01ety
HO—P=O
HOOH
HO%/O H l
O N 0
4 2 O
HOOH o
Hog Vlir/O H ( )
O N 3
2 O
ACHN O
Conjugate
HOOH
HO¥/ WV linker
O H
O N
2 O
ACHN O
Branching group
%/—J
Cell targeting moiety
The present disclosure provides the following non-limiting numbered embodiments:
In embodiments having more than one of a particular variable (e.g., more than one “m” or “n”),
unless otherwise indicated, each such particular variable is selected independently. Thus, for a structure
having more than one n, each n is selected independently, so they may or may not be the same as one another.
In certain embodiments, the present disclosure provides conjugated antisense compounds ented
by the following structure. In certain embodiments, the nse compound comprises modified
oligonucleotide ISIS 494372 with a 5’-X, wherein X is a conjugate group comprising GalNAc. In certain
embodiments, the antisense compound consists of d oligonucleotide ISIS 494372 with a 5’-X,
wherein X is a conjugate group comprising GalNAc.
WO 79625
In n embodiments, the present disclosure provides conjugated antisense compounds ented
by the following structure. In certain embodiments, the antisense compound comprises the conjugated
modified ucleotide ISIS 681251. In certain embodiments, the antisense compound consists of the
conjugated modified oligonucleotide ISIS 681251.
HO&W WHO HN O
‘5 N O
O N
WNH /
N O
In certain embodiments, the present disclosure provides conjugated nse compounds ented
by the following structure. In certain embodiments, the antisense compound ses the conjugated
modified oligonucleotide ISIS 681257. In certain embodiments, the antisense compound consists of the
conjugated modified oligonucleotide ISIS 681257.
2014/036460
In n embodiments, the present disclosure provides conjugated antisense compounds represented
by the ing structure. In certain embodiments, the antisense compound comprises a modified
oligonucleotide With SEQ ID NO: 58 With a NAc With variability in the sugar mods of the Wings. In
certain embodiments, the antisense compound consists of a modified oligonucleotide With SEQ ID NO: 58
with a 5’-GalNAc with variability in the sugar mods of the Wings.
Wherein either R1 is —OCH2CHZOCH3 (MOE)and R2 is H; or R1 and R2 together form a bridge,
wherein R1 is —O- and R2 is —CH2-, -CH(CH3)-, or -CH2CH2-, and R1 and R2 are directly connected such that
the resulting bridge is selected from: -O-CH2-, -O-CH(CH3)-, and —O-CH2CH2-;
And for each pair of R3 and R4 on the same ring, independently for each ring: either R3 is selected
from H and -OCH2CH20CH3 and R4 is H; or R3 and R4 er form a , wherein R3 is —O-, and R4 is —
CH2-, -CH(CH3)-, or -CH2CH2-and R3 and R4 are directly connected such that the resulting bridge is selected
from: -O-CH2-, -O-CH(CH3)-, and —O-CH2CH2-;
And R5 is selected from H and —CH3;
And Z is selected from S' and O'.
The present sure provides the following non-limiting ed embodiments:
DETAILED DESCRIPTION
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 disclosure. Herein, the use of
the singular includes the plural unless specifically stated otherwise. As used herein, the use of “or” means
r” unless stated otherwise. rmore, the use of the term “including” as well as other forms, such as
“includes” and “included”, is not limiting. Also, terms such as “element” or “component” encompass both
elements and components comprising one unit and elements and ents that comprise more than one
subunit, unless specifically stated otherwise.
The section headings used herein are for zational purposes only and are not to be construed as
limiting the subject matter described. All documents, or portions of documents, cited in this application,
including, but not limited to, patents, patent applications, articles, books, and treatises, are hereby expressly
incorporated by reference in their entirety for any purpose.
A. Definitions
Unless specific definitions are provided, the lature used in connection with, and the
procedures and ques of, analytical chemistry, synthetic c chemistry, and medicinal and
pharmaceutical chemistry described herein are those well known and commonly used in the art. Standard
techniques may be used for chemical synthesis, and chemical analysis. Certain such ques and
procedures may be found for example in “Carbohydrate Modifications in Antisense Research” Edited by
Sangvi and Cook, American Chemical Society Pharmaceutical
, Washington DC, 1994; ”Remington's
Sciences,” Mack hing Co., Easton, Pa., 21St edition, 2005; and “Antisense Drug Technology, Principles,
Strategies, and ations” Edited by Stanley T. Crooke, CRC Press, Boca Raton, Florida; and Sambrook
et al., “Molecular Cloning, A laboratory Manual,” 2“1 Edition, Cold Spring Harbor Laboratory Press, 1989,
which are hereby incorporated by reference for any purpose. Where permitted, all patents, applications,
published ations and other publications and other data referred to throughout in the disclosure are
incorporated by reference herein in their entirety.
Unless otherwise indicated, the following terms have the following meanings:
As used herein, “nucleoside” means a compound comprising a nucleobase moiety and a sugar
moiety. Nucleosides include, but are not limited to, lly occurring nucleosides (as found in DNA and
RNA) and modified nucleosides. Nucleosides may be linked to a phosphate moiety.
As used herein, “chemical modification” means a chemical difference in a compound when compared
to a naturally occurring counterpart. Chemical modifications of oligonucleotides include nucleoside
modifications (including sugar moiety modifications and nucleobase modifications) and intemucleoside
linkage modifications. In reference to an ucleotide, chemical modification does not include differences
only in nucleobase sequence.
As used herein, “furanosyl” means a structure comprising a 5-membered ring comprising four carbon
atoms and one oxygen atom.
As used herein, “naturally occurring sugar moiety” means a ribofuranosyl as found in naturally
occurring RNA or a deoxyribofuranosyl as found in lly occurring DNA.
As used herein, “sugar moiety” means a naturally occurring sugar moiety or a modified sugar moiety
of a nucleoside.
As used herein, “modif1ed sugar moiety” means a substituted sugar moiety or a sugar ate.
As used herein, “substituted sugar moiety” means a furanosyl that is not a naturally occurring sugar
moiety. tuted sugar moieties include, but are not d to furanosyls sing substituents at the
2’-position, the 3’-position, the 5’-position and/or the 4’-position. Certain substituted sugar es are
bicyclic sugar moieties.
As used herein, “2’-substituted sugar moiety” means a furanosyl comprising a substituent at the 2’-
position other than H or OH. Unless otherwise indicated, a stituted sugar moiety is not a bicyclic sugar
moiety (i.e., the 2’-substituent of a 2’-substituted sugar moiety does not form a bridge to another atom of the
furanosyl ring.
As used , “MOE” means -OCH2CH20CH3.
As used herein, “2’-F nucleoside” refers to a nucleoside comprising a sugar comprising fluorine at
the 2’ position. Unless otherwise indicated, the fluorine in a 2’-F nucleoside is in the ribo position (replacing
the OH of a natural ribose).
As used herein the term ”sugar surrogate” means a structure that does not comprise a furanosyl and
that is capable of replacing the naturally occurring sugar moiety of a nucleoside, such that the ing
nucleoside sub-units are capable of linking together and/or linking to other nucleosides to form an oligomeric
nd which is capable of hybridizing to a complementary oligomeric compound. Such structures
e rings sing a different number of atoms than furanosyl (e.g., 4, 6, or 7-membered rings);
replacement of the oxygen of a furanosyl with a non-oxygen atom (e. g., carbon, sulfur, or nitrogen); or both a
change in the number of atoms and a ement of the oxygen. Such structures may also comprise
substitutions corresponding to those described for substituted sugar moieties (e. g., 6-membered carbocyclic
ic sugar surrogates optionally comprising additional substituents). Sugar surrogates also include more
complex sugar replacements (e.g., the non-ring s of peptide nucleic acid). Sugar surrogates include
Without limitation morpholinos, cyclohexenyls and eXitols.
As used , “bicyclic sugar moiety” means a modified sugar moiety comprising a 4 to 7
membered ring (including but not limited to a furanosyl) comprising a bridge connecting two atoms of the 4
to 7 membered ring to form a second ring, resulting in a bicyclic structure. In certain embodiments, the 4 to 7
membered ring is a sugar ring. In certain embodiments the 4 to 7 membered ring is a furanosyl. In certain
such embodiments, the bridge connects the 2’-carbon and the 4’-carbon of the furanosyl.
As used herein, “nucleic acid” refers to molecules composed of monomeric nucleotides. A nucleic
acid es ribonucleic acids (RNA), deoxyribonucleic acids (DNA), -stranded nucleic acids
(ssDNA), double-stranded nucleic acids (dsDNA), small interfering ribonucleic acids (siRNA), and
microRNAs (miRNA). A nucleic acid may also comprise any combination of these elements in a single
molecule.
As used herein, “nucleotide” means a side further comprising a phosphate linking group. As
used herein, “linked sides” may or may not be linked by phosphate linkages and thus includes, but is
not limited to “linked nucleotides.” As used herein, “linked sides” are nucleosides that are connected
in a continuous sequence (i.e. no additional sides are t between those that are linked).
As used herein, ”nucleobase” means a group of atoms that can be linked to a sugar moiety to create a
nucleoside that is capable of incorporation into an oligonucleotide, and Wherein the group of atoms is e
of bonding With a complementary naturally occurring nucleobase of r oligonucleotide or nucleic acid.
Nucleobases may be naturally occurring or may be modified. As used herein, ”nucleobase sequence” means
the order of contiguous nucleobases independent of any sugar, linkage, or nucleobase ation.
As used herein the terms, ”unmodified nucleobase” or ”naturally ing nucleobase” means the
naturally occurring heterocyclic nucleobases of RNA or DNA: the purine bases adenine (A) and guanine (G),
and the pyrimidine bases thymine (T), cytosine (C) ding 5-methyl C), and uracil (U).
As used herein, “modified base” means any nucleobase that is not a naturally occurring
nucleobase.
As used herein, “modified nucleoside” means a nucleoside comprising at least one chemical
modification compared to naturally occurring RNA or DNA nucleosides. Modified nucleosides comprise a
modified sugar moiety and/or a modified nucleobase.
As used herein, “bicyclic nucleoside” or “BNA” means a nucleoside comprising a bicyclic sugar
moiety.
As used herein, rained ethyl side” or “cEt” means a nucleoside comprising a bicyclic
sugar moiety comprising a 4’-CH(CH3)-O-2’bridge.
As used herein, “locked nucleic acid nucleoside” or “LNA” means a nucleoside comprising a bicyclic
sugar moiety comprising a 4’-CH2-O-2’bridge.
As used herein, “2’-substituted nucleoside” means a nucleoside sing a substituent at the 2’-
position other than H or OH. Unless otherwise indicated, a 2’-substituted nucleoside is not a bicyclic
nucleoside.
As used , “deoxynucleoside” means a nucleoside sing 2’-H furanosyl sugar moiety, as
found in naturally ing deoxyribonucleosides (DNA). In certain embodiments, a 2’-deoxynucleoside
may comprise a modified nucleobase or may comprise an RNA nucleobase (e. g., uracil).
As used herein, ”oligonucleotide” means a compound comprising a plurality of linked nucleosides.
In certain embodiments, an oligonucleotide comprises one or more unmodified ribonucleosides (RNA) and/or
unmodified deoxyribonucleosides (DNA) and/or one or more d nucleosides.
As used herein nucleoside” means an oligonucleotide in which none of the intemucleoside
linkages contains a phosphorus atom. As used herein, oligonucleotides include oligonucleosides.
As used herein, “modified ucleotide” means an ucleotide sing at least one
modif1ed nucleoside and/or at least one modif1ed intemucleoside linkage.
As used herein, “linkage” or “linking group” means a group of atoms that link together two or more
other groups of atoms.
As used herein “intemucleoside linkage” means a covalent linkage n adjacent nucleosides in
an oligonucleotide.
As used herein “naturally ing internucleoside linkage” means a 3' to 5' phosphodiester linkage.
As used , “modified cleoside linkage” means any intemucleoside linkage other than a
naturally occurring intemucleoside linkage.
As used herein, “terminal internucleoside linkage” means the linkage between the last two
nucleosides of an oligonucleotide or defined region thereof.
As used herein, “phosphorus linking group” means a linking group comprising a phosphorus atom.
Phosphorus linking groups include without limitation groups haVing the formula:
Rb:1:)_Rc
wherein:
R2, and Rd are each, independently, O, S, CH2, NH, or NJ 1 wherein J1 is C1-C6 alkyl or tuted C1-
C6 alkyl;
Rb is O or S;
RC is OH, SH, C1-C6 alkyl, substituted C1-C6 alkyl, C1-C6 alkoxy, substituted C1-C6 alkoxy, amino or
substituted amino; and
J1 is Rb is O or S.
Phosphorus linking groups include without limitation, phosphodiester, phosphorothioate, phosphorodithioate,
phosphonate, phosphoramidate, orothioamidate, thionoalkylphosphonate, phosphotriesters,
thionoalkylphosphotriester and boranophosphate.
As used herein, “internucleoside phosphorus linking group” means a phosphorus linking group that
directly links two nucleosides.
As used herein, “non-internucleoside phosphorus g group” means a phosphorus linking group
that does not directly link two nucleosides. In n embodiments, a non-internucleoside phosphorus
linking group links a nucleoside to a group other than a nucleoside. In n embodiments, a non-
intemucleoside phosphorus linking group links two groups, neither of which is a nucleoside.
As used herein, ”neutral linking group” means a linking group that is not charged. Neutral linking
groups include without limitation phosphotriesters, phosphonates, MMI (-CHg-N(CH3)-O-), amide-3 (-
CH2-C(=O)-N(H)-), amide-4 (-CHz-N(H)-C(=O)-), formacetal (-O-CH2), and thioformacetal (-S-CH2).
Further neutral g groups include nonionic linkages comprising siloxane (dialkylsiloxane), carboxylate
ester, carboxamide, sulfide, sulfonate ester and amides (See for example: ydrate Modifications in
Antisense Research; Y.S. SanghVi and PD. Cook Eds. ACS ium Series 580; Chapters 3 and 4, (pp.
40-65)). Further neutral linking groups include nonionic es comprising mixed N, O, S and CH2
component parts.
As used herein, “internucleoside neutral g group” means a neutral linking group that directly
links two nucleosides.
As used herein, nternucleoside neutral linking group” means a neutral linking group that does
not directly link two nucleosides. In certain embodiments, a non-internucleoside neutral linking group links a
nucleoside to a group other than a nucleoside. In certain embodiments, a non-internucleoside neutral linking
group links two groups, neither of which is a nucleoside.
As used herein, ”oligomeric compound” means a polymeric structure comprising two or more sub-
structures. In n embodiments, an eric compound comprises an oligonucleotide. In certain
embodiments, an oligomeric compound comprises one or more conjugate groups and/or terminal groups. In
certain embodiments, an oligomeric nd consists of an oligonucleotide. Oligomeric compounds also
include naturally occurring nucleic acids. In certain embodiments, an oligomeric compound comprises a
backbone of one or more linked ric subunits where each linked monomeric subunit is directly or
indirectly attached to a heterocyclic base moiety. In certain embodiments, oligomeric compounds may also
include monomeric subunits that are not linked to a heterocyclic base moiety, y providing abasic sites.
In certain embodiments, the linkages joining the monomeric subunits, the sugar moieties or surrogates and
the heterocyclic base moieties can be independently modified. In certain ments, the linkage-sugar
unit, which may or may not include a heterocyclic base, may be substituted with a mimetic such as the
rs in peptide nucleic acids.
As used herein, “terminal group” means one or more atom attached to , or both, the 3’ end or
the 5’ end of an oligonucleotide. In certain embodiments a terminal group is a conjugate group. In certain
WO 79625
ments, a terminal group comprises one or more terminal group nucleosides.
As used herein, “conjugate” or “conjugate group” means an atom or group of atoms bound to an
oligonucleotide or oligomeric compound. In general, conjugate groups modify one or more properties of the
compound to which they are attached, including, but not limited to pharmacodynamic, pharmacokinetic,
binding, tion, cellular distribution, cellular uptake, charge and/or clearance properties.
As used herein, “conjugate linker” or “linker” in the context of a conjugate group means a portion of
a conjugate group comprising any atom or group of atoms and which covalently link (1) an oligonucleotide
to another portion of the conjugate group or (2) two or more portions of the ate group.
Conjugate groups are shown herein as radicals, providing a bond for forming covalent attachment to
an oligomeric compound such as an antisense oligonucleotide. In certain embodiments, the point of
attachment on the oligomeric compound is the 3'-oxygen atom of the 3'-hydroxyl group of the 3’ terminal
nucleoside of the oligomeric compound. In certain embodiments the point of attachment on the oligomeric
compound is the 5'-oxygen atom of the 5'-hydroxyl group of the 5’ terminal nucleoside of the oligomeric
compound. In n embodiments, the bond for forming attachment to the oligomeric compound is a
ble bond. In certain such embodiments, such cleavable bond constitutes all or part of a cleavable
moiety.
In n embodiments, conjugate groups comprise a cleavable moiety (e.g., a cleavable bond or
cleavable nucleoside) and a carbohydrate cluster portion, such as a GalNAc cluster portion. Such
carbohydrate cluster portion comprises: a ing moiety and, optionally, a conjugate linker. In certain
embodiments, the carbohydrate cluster portion is identified by the number and identity of the ligand. For
e, in certain embodiments, the carbohydrate cluster portion ses 3 GalNAc groups and is
ated “GalNAc3”. In certain embodiments, the carbohydrate cluster portion comprises 4 GalNAc
groups and is designated “GalNAc4”. Specific carbohydrate cluster portions (having specific tether, branching
and conjugate linker groups) are described herein and designated by Roman numeral followed by subscript
“a”. Accordingly “GalNac3-la” refers to a specific carbohydrate cluster portion of a conjugate group having
3 GalNac groups and specifically identified tether, branching and linking groups. Such carbohydrate cluster
fragment is attached to an oligomeric compound via a cleavable moiety, such as a cleavable bond or
cleavable side.
As used herein, able moiety” means a bond or group that is capable of being split under
physiological conditions. In certain embodiments, a ble moiety is d inside a cell or sub-cellular
compartments, such as a lysosome. In n embodiments, a cleavable moiety is cleaved by endogenous
enzymes, such as nucleases. In certain embodiments, a cleavable moiety ses a group of atoms having
one, two, three, four, or more than four ble bonds.
As used herein, “cleavable bond” means any chemical bond capable of being split. In certain
embodiments, a cleavable bond is ed from among: an amide, a polyamide, an ester, an ether, one or
both esters of a phosphodiester, a phosphate ester, a ate, a di-sulfide, or a peptide.
As used herein, ”carbohydrate cluster” means a compound having one or more carbohydrate residues
attached to a scaffold or linker group. (see, e.g., Maier et al., “Synthesis of Antisense Oligonucleotides
Conjugated to a alent Carbohydrate Cluster for Cellular Targeting,” Bioconjugate try, 2003,
(14): 18-29, which is incorporated herein by reference in its entirety, or Rensen et al., “Design and Synthesis
of Novel N—Acetylgalactosamine-Terminated Glycolipids for Targeting of Lipoproteins to the Hepatic
Asiaglycoprotein or,” J. Med. Chem. 2004, (47): 5798-5808, for examples of carbohydrate conjugate
clusters).
As used herein, “modif1ed carbohydrate” means any carbohydrate having one or more chemical
modifications relative to naturally occurring carbohydrates.
As used herein, “carbohydrate derivative” means any compound which may be synthesized using a
ydrate as a starting material or intermediate.
As used herein, hydrate” means a naturally ing carbohydrate, a d carbohydrate,
or a carbohydrate derivative.
As used herein cting group” means any compound or protecting group known to those having
skill in the art. Non-limiting examples of protecting groups may be found in ”Protective Groups in Organic
Chemistry”, T. W. Greene, P. G. M. Wuts, ISBN 062301-6, John Wiley & Sons, Inc, New York, which
is incorporated herein by reference in its entirety.
As used , “single-stranded” means an oligomeric compound that is not hybridized to its
complement and which lacks sufficient self-complementarity to form a stable self-duplex.
As used , “double stranded” means a pair of oligomeric compounds that are hybridized to one
another or a single self-complementary oligomeric compound that forms a hairpin structure. In certain
embodiments, a double-stranded oligomeric compound ses a first and a second oligomeric compound.
As used herein, “antisense compound” means a compound comprising or consisting of an
oligonucleotide at least a portion of which is complementary to a target nucleic acid to which it is capable of
hybridizing, resulting in at least one antisense activity.
As used , “antisense activity” means any detectable and/or measurable change attributable to
the hybridization of an antisense compound to its target nucleic acid. In certain embodiments, antisense
activity includes modulation of the amount or activity of a target nucleic acid transcript (e. g. mRNA). In
certain ments, antisense activity includes modulation of the splicing of pre-mRNA.
As used herein, “RNase H based antisense compound” means an antisense compound wherein at
least some of the antisense activity of the nse compound is utable to hybridization of the nse
compound to a target nucleic acid and subsequent cleavage of the target nucleic acid by RNase H.
As used herein, “RISC based nse compound” means an antisense compound wherein at least
some of the antisense activity of the antisense compound is attributable to the RNA Induced Silencing
Complex (RISC).
As used herein, “detecting” or “measuring” means that a test or assay for detecting or measuring is
med. Such detection and/or ing may result in a value of zero. Thus, if a test for detection or
measuring results in a finding of no activity (activity of zero), the step of ing or measuring the activity
has nevertheless been med.
As used herein, “detectable and/or measureable activity” means a statistically significant activity that
is not zero.
As used herein, “essentially unchanged” means little or no change in a particular parameter,
particularly relative to another parameter which changes much more. In n embodiments, a parameter is
essentially unchanged when it changes less than 5%. In certain embodiments, a parameter is essentially
unchanged if it changes less than two-fold while another parameter changes at least ten-fold. For example, in
certain embodiments, an antisense activity is a change in the amount of a target c acid. In certain such
embodiments, the amount of a non-target nucleic acid is essentially unchanged if it changes much less than
the target nucleic acid does, but the change need not be zero.
As used herein, “expression” means the process by which a gene ultimately results in a n.
Expression includes, but is not limited to, transcription, ranscriptional modification (e. g., splicing,
polyadenlyation, addition of 5’-cap), and translation.
As used herein, ”target nucleic acid” means a nucleic acid molecule to which an antisense compound
is intended to hybridize to result in a desired antisense activity. Antisense oligonucleotides have sufficient
complementarity to their target nucleic acids to allow ization under physiological conditions.
As used herein, “nucleobase mentarity” or ementarity” when in reference to
nucleobases means a nucleobase that is e of base pairing with another nucleobase. For example, in
DNA, adenine (A) is complementary to thymine (T). For example, in RNA, adenine (A) is complementary to
uracil (U). In certain embodiments, mentary nucleobase means a nucleobase of an antisense
compound that is capable of base pairing with a nucleobase of its target nucleic acid. For example, if a
nucleobase at a certain position of an antisense compound is capable of hydrogen bonding with a nucleobase
at a certain position of a target nucleic acid, then the position of hydrogen bonding between the
oligonucleotide and the target nucleic acid is considered to be complementary at that base pair.
Nucleobases comprising certain modifications may maintain the ability to pair with a counterpart nucleobase
and thus, are still e of nucleobase complementarity.
As used herein, “non-complementary” in reference to nucleobases means a pair of nucleobases that
do not form hydrogen bonds with one r.
As used herein, “complementary” in reference to oligomeric compounds (e.g., linked nucleosides,
ucleotides, or nucleic acids) means the capacity of such oligomeric compounds or regions thereof to
hybridize to another oligomeric compound or region thereof through nucleobase complementarity.
Complementary oligomeric compounds need not have nucleobase complementarity at each nucleoside.
Rather, some ches are tolerated. In n embodiments, complementary oligomeric compounds or
regions are complementary at 70% of the nucleobases (70% mentary). In certain embodiments,
complementary oligomeric compounds or regions are 80% complementary. In certain embodiments,
complementary oligomeric compounds or regions are 90% complementary. In certain embodiments,
complementary oligomeric compounds or regions are 95% complementary. In certain embodiments,
complementary oligomeric compounds or regions are 100% mentary.
As used herein, “mismatch” means a nucleobase of a first oligomeric compound that is not capable of
pairing with a nucleobase at a corresponding position of a second oligomeric compound, When the first and
second oligomeric compound are aligned. Either or both of the first and second eric compounds may
be oligonucleotides.
As used herein, ”hybridization” means the pairing of complementary oligomeric compounds (e. g., an
antisense compound and its target nucleic acid). While not limited to a particular mechanism, the most
common mechanism of pairing involves en bonding, which may be Watson-Crick, Hoogsteen or
reversed Hoogsteen en bonding, between complementary nucleobases.
As used herein, “specifically izes” means the ability of an oligomeric compound to hybridize
to one nucleic acid site With greater affinity than it hybridizes to r nucleic acid site.
As used , “fully complementary” in nce to an oligonucleotide or portion thereof means
that each nucleobase of the oligonucleotide or portion thereof is capable of pairing With a nucleobase of a
complementary nucleic acid or contiguous portion thereof. Thus, a fully mentary region comprises no
mismatches or unhybridized nucleobases in either strand.
As used herein, “percent complementarity” means the percentage of nucleobases of an oligomeric
compound that are complementary to an equal-length portion of a target nucleic acid. t
mentarity is calculated by dividing the number of nucleobases of the oligomeric compound that are
complementary to nucleobases at corresponding positions in the target nucleic acid by the total length of the
oligomeric compound.
As used , “percent identity” means the number of nucleobases in a first nucleic acid that are the
same type (independent of chemical modification) as nucleobases at corresponding positions in a second
nucleic acid, divided by the total number of nucleobases in the first nucleic acid.
As used herein, ”modulation” means a change of amount or quality of a molecule, function, or
activity When ed to the amount or quality of a molecule, function, or activity prior to modulation. For
example, modulation includes the change, either an increase (stimulation or induction) or a decrease
(inhibition or ion) in gene sion. As a r example, modulation of expression can include a
change in splice site ion of pre-mRNA processing, resulting in a change in the te or relative
amount of a particular splice-variant compared to the amount in the absence of modulation.
As used herein, “chemical motif” means a pattern of chemical modifications in an oligonucleotide or
a region f. Motifs may be defined by modifications at certain nucleosides and/or at certain linking
groups of an oligonucleotide.
As used herein, “nucleoside motif” means a pattern of nucleoside modifications in an oligonucleotide
or a region thereof. The linkages of such an oligonucleotide may be modified or unmodified. Unless
otherwise indicated, motifs herein describing only nucleosides are intended to be nucleoside motifs. Thus, in
such instances, the linkages are not limited.
As used herein, “sugar motif” means a pattern of sugar modifications in an oligonucleotide or a
region thereof.
As used , ge motif” means a pattern of linkage modifications in an oligonucleotide or
region thereof. The nucleosides of such an oligonucleotide may be d or fied. Unless
otherwise indicated, motifs herein describing only linkages are intended to be linkage motifs. Thus, in such
instances, the nucleosides are not limited.
As used herein, “nucleobase modification motif” means a pattern of modifications to nucleobases
along an oligonucleotide. Unless otherwise indicated, a nucleobase modification motif is independent of the
nucleobase ce.
As used herein, nce motif” means a pattern of bases ed along an oligonucleotide
or portion thereof. Unless otherwise indicated, a sequence motif is independent of chemical ations
and thus may have any combination of al modifications, including no al modifications.
As used herein, “type of modification” in reference to a nucleoside or a nucleoside of a “type” means
the chemical ation of a nucleoside and includes modified and unmodified nucleosides. Accordingly,
unless otherwise indicated, a “nucleoside having a modification of a first type” may be an unmodified
nucleoside.
As used herein, “differently modified” mean chemical modifications or chemical substituents that are
different from one another, including absence of modifications. Thus, for example, a MOE nucleoside and an
unmodified DNA nucleoside are “differently modified,” even though the DNA nucleoside is unmodified.
Likewise, DNA and RNA are “differently modified,” even though both are naturally-occurring unmodified
nucleosides. Nucleosides that are the same but for comprising different nucleobases are not differently
modified. For example, a nucleoside comprising a 2’-OMe modified sugar and an unmodified adenine
nucleobase and a nucleoside comprising a 2’-OMe modified sugar and an unmodified thymine nucleobase are
not differently modified.
As used herein, “the same type of modifications” refers to modifications that are the same as one
r, including absence of modifications. Thus, for e, two unmodified DNA nucleosides have
“the same type of modification,” even though the DNA side is unmodified. Such nucleosides having
the same type modification may comprise different nucleobases.
As used herein, ate regions” means portions of an ucleotide wherein the chemical
modifications or the motif of al modifications of any neighboring portions e at least one
difference to allow the separate regions to be distinguished from one another.
As used herein, “pharmaceutically acceptable carrier or diluent” means any substance suitable for use
in administering to an animal. In certain embodiments, a pharmaceutically acceptable carrier or diluent is
sterile saline. In certain embodiments, such sterile saline is pharmaceutical grade saline.
As used herein the term “metabolic disorder” means a disease or condition principally characterized
by ulation of metabolism — the complex set of al reactions associated with breakdown of food
to produce energy.
As used herein, the term “cardiovascular er” means a e or condition principally
characterized by impaired function of the heart or blood vessels.
As used herein the term ”mono or polycyclic ring system” is meant to include all ring systems
selected from single or polycyclic radical ring systems wherein the rings are fused or linked and is meant to
be inclusive of single and mixed ring systems individually ed from aliphatic, alicyclic, aryl, aryl,
aralkyl, kyl, cyclic, heteroaryl, heteroaromatic and heteroarylalkyl. Such mono and poly cyclic
structures can contain rings that each have the same level of saturation or each, independently, have varying
degrees of saturation ing fully saturated, partially saturated or fully unsaturated. Each ring can
comprise ring atoms selected from C, N, O and S to give rise to heterocyclic rings as well as rings comprising
only C ring atoms which can be present in a mixed motif such as for example benzimidazole wherein one
ring has only carbon ring atoms and the fused ring has two nitrogen atoms. The mono or polycyclic ring
system can be further tuted with substituent groups such as for example imide which has two =0
groups attached to one of the rings. Mono or polycyclic ring s can be attached to parent molecules
using various strategies such as directly through a ring atom, fused through multiple ring atoms, through a
substituent group or through a bifunctional linking moiety.
As used herein, “prodrug” means an ve or less active form of a compound which, when
administered to a subject, is metabolized to form the active, or more active, compound (e. g., drug).
As used herein, ”substituen ” and ”substituent group,” means an atom or group that replaces the atom
or group of a named parent compound. For example a substituent of a modified nucleoside is any atom or
group that differs from the atom or group found in a naturally occurring nucleoside (e. g., a modified 2’-
substuent is any atom or group at the 2’-position of a nucleoside other than H or OH). Substituent groups can
be protected or unprotected. In certain embodiments, compounds of the t disclosure have substituents
at one or at more than one position of the parent compound. Substituents may also be further substituted with
other substituent groups and may be attached directly or via a linking group such as an alkyl or hydrocarbyl
group to a parent compound.
Likewise, as used herein, “substituent” in reference to a al functional group means an atom or
group of atoms that differs from the atom or a group of atoms ly present in the named functional
group. In certain embodiments, a substituent es a hydrogen atom of the functional group (e. g., in
certain embodiments, the substituent of a substituted methyl group is an atom or group other than hydrogen
which replaces one of the hydrogen atoms of an unsubstituted methyl group). Unless otherwise indicated,
groups le for use as substituents include without limitation, halogen, yl, alkyl, alkenyl, alkynyl,
2014/036460
acyl (-C(O)Raa), carboxyl (-C(O)O-Raa), aliphatic groups, alicyclic groups, alkoxy, substituted oxy (-O-Raa),
aryl, aralkyl, heterocyclic radical, heteroaryl, heteroarylalkyl, amino (-N(Rbb)(RCC)), imino(=NRbb), amido
(-C(O)N(Rbb)(RCC) or -N(Rbb)C(O)Raa), azido (-N3), nitro (-N02), cyano (-CN), carbamido
(-OC(O)N(Rbb)(RCC) or -N(Rbb)C(O)ORaa), ureido (-N(Rbb)C(O)N(Rbb)(Rcc)), thioureido (-N(Rbb)C(S)N(Rbb)-
(Rcc)), guanidinyl (-N(Rbb)C(=NRbb)N(Rbb)(RCC)), amidinyl (-C(=NRbb)N(Rbb)(RCC) or -N(Rbb)C(=NRbb)(Raa)),
thiol (-SRbb), yl (-S(O)Rbb), sulfonyl (-S(O)2Rbb) and amidyl (-S(O)2N(Rbb)(RCC) or -N(Rbb)S-
(0)2Rbb). n each Raa, Rbb and RCC is, independently, H, an optionally linked chemical functional group
or a further substituent group with a preferred list including t limitation, alkyl, alkenyl, alkynyl,
aliphatic, alkoxy, acyl, aryl, l, heteroaryl, alicyclic, cyclic and heteroarylalkyl. Selected
substituents within the compounds described herein are present to a recursive .
As used , ”alkyl,” as used herein, means a saturated straight or branched hydrocarbon radical
containing up to twenty four carbon atoms. Examples of alkyl groups include without limitation, methyl,
ethyl, propyl, butyl, isopropyl, l, octyl, decyl, dodecyl and the like. Alkyl groups typically include
from 1 to about 24 carbon atoms, more typically from 1 to about 12 carbon atoms (Cl-Cu alkyl) with from 1
to about 6 carbon atoms being more preferred.
As used , ”alkenyl,” means a straight or branched hydrocarbon chain radical containing up to
twenty four carbon atoms and having at least one carbon-carbon double bond. Examples of alkenyl groups
include without limitation, ethenyl, propenyl, butenyl, l-methylbuten—l-yl, dienes such as l,3-butadiene
and the like. Alkenyl groups typically include from 2 to about 24 carbon atoms, more typically from 2 to
about 12 carbon atoms with from 2 to about 6 carbon atoms being more preferred. Alkenyl groups as used
herein may optionally include one or more further substituent groups.
As used herein, "alkynyl," means a straight or branched hydrocarbon radical containing up to twenty
four carbon atoms and haVing at least one carbon-carbon triple bond. Examples of alkynyl groups e,
without limitation, ethynyl, l-propynyl, l-butynyl, and the like. Alkynyl groups typically include from 2 to
about 24 carbon atoms, more typically from 2 to about 12 carbon atoms with from 2 to about 6 carbon atoms
being more preferred. Alkynyl groups as used herein may optionally include one or more further substituent
groups.
As used herein, ”acyl," means a radical formed by removal of a hydroxyl group from an organic acid
and has the general a X where X is typically aliphatic, alicyclic or aromatic. Examples include
aliphatic carbonyls, aromatic carbonyls, tic sulfonyls, aromatic sulf1nyls, tic sulf1nyls, aromatic
phosphates, aliphatic phosphates and the like. Acyl groups as used herein may optionally include further
tuent groups.
As used herein, ”alicyclic” means a cyclic ring system wherein the ring is aliphatic. The ring system
can comprise one or more rings wherein at least one ring is tic. Preferred alicyclics include rings
haVing from about 5 to about 9 carbon atoms in the ring. Alicyclic as used herein may optionally include
further substituent groups.
2014/036460
As used herein, ”aliphatic” means a straight or branched arbon radical containing up to twenty
four carbon atoms wherein the tion between any two carbon atoms is a single, double or triple bond.
An aliphatic group preferably contains from 1 to about 24 carbon atoms, more typically from 1 to about 12
carbon atoms with from 1 to about 6 carbon atoms being more preferred. The straight or branched chain of
an aliphatic group may be interrupted with one or more heteroatoms that include nitrogen, oxygen, sulfur and
phosphorus. Such aliphatic groups interrupted by heteroatoms e without limitation, polyalkoxys, such
as polyalkylene glycols, polyamines, and polyimines. Aliphatic groups as used herein may optionally include
further substituent groups.
As used herein, ”alkoxy” means a radical formed between an alkyl group and an oxygen atom
wherein the oxygen atom is used to attach the alkoxy group to a parent le. Examples of alkoxy groups
include without limitation, methoxy, ethoxy, propoxy, isopropoxy, n-butoxy, sec-butoxy, tert—butoxy, n-
pentoxy, neopentoxy, n-hexoxy and the like. Alkoxy groups as used herein may optionally include further
tuent groups.
As used herein, ”aminoalkyl” means an amino tuted C1-C12 alkyl radical. The alkyl portion of
the radical forms a covalent bond with a parent molecule. The amino group can be located at any position
and the aminoalkyl group can be substituted with a further substituent group at the alkyl and/or amino
portions.
As used herein, ”aralkyl” and ”arylalkyl” mean an aromatic group that is covalently linked to a C1-C12
alkyl radical. The alkyl radical portion of the ing aralkyl (or arylalkyl) group forms a covalent bond
with a parent molecule. Examples include without limitation, benzyl, phenethyl and the like. Aralkyl groups
as used herein may optionally include further substituent groups attached to the alkyl, the aryl or both groups
that form the radical group.
As used herein, ”aryl” and ”aromatic” mean a mono- or polycyclic carbocyclic ring system ls
haVing one or more aromatic rings. es of aryl groups include without limitation, phenyl, naphthyl,
tetrahydronaphthyl, indanyl, idenyl and the like. red aryl ring systems have from about 5 to about 20
carbon atoms in one or more rings. Aryl groups as used herein may optionally include further substituent
groups.
As used herein, ”halo” and ”halogen,” mean an atom selected from fluorine, chlorine, bromine and
iodine.
As used herein, ”heteroaryl,” and ”heteroaromatic,” mean a radical comprising a mono- or poly-
cyclic aromatic ring, ring system or fused ring system wherein at least one of the rings is ic and
es one or more heteroatoms. Heteroaryl is also meant to include fused ring systems including systems
where one or more of the fused rings contain no heteroatoms. Heteroaryl groups typically include one ring
atom selected from sulfur, en or oxygen. Examples of heteroaryl groups include without limitation,
pyridinyl, pyrazinyl, pyrimidinyl, pyrrolyl, pyrazolyl, olyl, thiazolyl, oxazolyl, isooxazolyl,
thiadiazolyl, oxadiazolyl, thiophenyl, furanyl, quinolinyl, isoquinolinyl, benzimidazolyl, benzooxazolyl,
WO 79625
quinoxalinyl and the like. Heteroaryl radicals can be attached to a parent molecule directly or through a
linking moiety such as an aliphatic group or hetero atom. Heteroaryl groups as used herein may optionally
include further substituent groups.
As used herein, “conjugate compound” means any atoms, group of atoms, or group of linked atoms
le for use as a conjugate group. In certain embodiments, conjugate compounds may possess or impart
one or more properties, including, but not limited to codynamic, pharmacokinetic, binding,
absorption, cellular distribution, cellular uptake, charge and/or clearance properties.
As used herein, unless otherwise indicated or modified, the term “double-stranded” refers to two
separate oligomeric compounds that are hybridized to one another. Such double stranded compounds may
have one or more or bridizing nucleosides at one or both ends of one or both s (overhangs)
and/or one or more internal non-hybridizing nucleosides (mismatches) provided there is sufficient
complementarity to in hybridization under physiologically relevant conditions.
As used herein, “5’ target site” refers to the tide of a target nucleic acid which is
complementary to the 5’-most nucleotide of a particular antisense compound.
As used herein, “About” means within 210% of a value. For example, if it is stated, “a marker may
be increased by about 50%”, it is implied that the marker may be increased between 45%-55%.
As used herein, “administered itantly” refers to the co-administration of two agents in any
manner in which the pharmacological s of both are manifest in the patient at the same time.
Concomitant administration does not require that both agents be administered in a single pharmaceutical
composition, in the same dosage form, or by the same route of administration. The effects of both agents
need not manifest themselves at the same time. The effects need only be overlapping for a period of time and
need not be nsive.
As used herein, “administering” or “administration” means providing a pharmaceutical agent to an
individual, and includes, but is not limited to, stering by a medical professional and self-administering.
Administration of a pharmaceutical agent to an individual can be continuous, chronic, short or intermittent.
Administration can parenteral or non-parenteral.
As used herein, “agent” means an active substance that can provide a eutic benefit when
administered to an animal. “First agent” means a therapeutic compound of the ion. For example, a first
agent can be an antisense oligonucleotide targeting apo(a). “Second agent” means a second therapeutic
compound of the invention (e.g. a second nse oligonucleotide targeting apo(a)) and/or a non-apo(a)
therapeutic compound.
As used herein, “amelioration” or “ameliorate” or “ameliorating” refers to a lessening of at least one
indicator, sign, or symptom of an associated disease, disorder, or condition. The severity of tors can be
ined by subjective or objective measures, which are known to those skilled in the art.
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As used herein, “animal” refers to a human or non-human animal, including, but not limited to, mice,
rats, rabbits, dogs, cats, pigs, and non-human primates, including, but not limited to, monkeys and
nzees.
As used herein, )” means any nucleic acid or protein sequence encoding apo(a). For example,
in n embodiments, apo(a) includes a DNA sequence encoding apo(a), a RNA sequence transcribed from
DNA encoding apo(a) (including genomic DNA sing introns and exons), a mRNA sequence encoding
apo(a), or a peptide sequence encoding apo(a).
As used herein, “apo(a) nucleic acid” means any nucleic acid encoding apo(a). For example, in
certain embodiments, an apo(a) nucleic acid includes a DNA sequence encoding apo(a), a RNA sequence
transcribed from DNA encoding apo(a) (including genomic DNA comprising introns and exons), and a
mRNA sequence encoding apo(a).
As used , “apo(a) mRN ”
means a mRNA encoding an apo(a) protein.
As used herein, “apo(a) protein” means any protein sequence encoding Apo(a).
As used herein, “apo(a) specific inhibitor” refers to any agent capable of specifically inhibiting the
expression of an apo(a) nucleic acid and/or apo(a) protein. For example, apo(a) specific inhibitors include
nucleic acids ding antisense nds), es, antibodies, small molecules, and other agents
capable of inhibiting the expression of apo(a) nucleic acid and/or apo(a) protein. In certain ments, by
specifically ting apo(a) nucleic acid expression and/or apo(a) protein expression, apo(a) specific
inhibitors can affect other components of the lipid transport system including downstream components.
rly, in certain embodiments, apo(a) specific inhibitors can affect other molecular processes in an
animal.
As used herein, “atherosclerosis” means a hardening of the arteries affecting large and medium-sized
arteries and is characterized by the presence of fatty deposits. The fatty deposits are called ”atheromas” or
“plaques,” which consist mainly of cholesterol and other fats, calcium and scar tissue, and damage the lining
of arteries.
As used herein, ary heart disease (CHD)” means a narrowing of the small blood s that
supply blood and oxygen to the heart, which is often a result of atherosclerosis.
As used , “diabetes mellitus” or “diabetes” is a syndrome terized by disordered
lism and abnormally high blood sugar (hyperglycemia) resulting from insufficient levels of insulin or
reduced insulin sensitivity. The characteristic ms are excessive urine production (polyuria) due to high
blood glucose levels, excessive thirst and increased fluid intake (polydipsia) attempting to compensate for
increased urination, blurred vision due to high blood glucose effects on the eye's optics, unexplained weight
loss, and lethargy.
As used herein, “diabetic dyslipidemia” or “type 2 diabetes with idemia” means a condition
characterized by Type 2 diabetes, reduced HDL-C, ed triglycerides (TG), and elevated small, dense
LDL particles.
As used herein, “diluent” means an ingredient in a composition that lacks pharmacological activity,
but is pharmaceutically necessary or desirable. For e, the t in an injected composition can be a
liquid, e. g. saline solution.
As used herein, “dyslipidemia” refers to a disorder of lipid and/or lipoprotein metabolism, ing
lipid and/or lipoprotein overproduction or deficiency. Dyslipidemias can be manifested by elevation of lipids
such as chylomicron, terol and triglycerides as well as lipoproteins such as low-density lipoprotein
(LDL) cholesterol.
As used herein, “dosage unit” means a form in which a pharmaceutical agent is provided, e.g. pill,
tablet, or other dosage unit known in the art. In certain embodiments, a dosage unit is a Vial containing
lyophilized nse oligonucleotide. In certain embodiments, a dosage unit is a Vial containing reconstituted
nse ucleotide.
As used herein, “dose” means a specified quantity of a pharmaceutical agent provided in a single
administration, or in a specified time period. In certain embodiments, a dose can be administered in one, two,
or more boluses, tablets, or injections. For example, in n ments where subcutaneous
administration is desired, the desired dose requires a volume not easily accommodated by a single injection,
therefore, two or more injections can be used to achieve the desired dose. In certain embodiments, the
pharmaceutical agent is administered by infusion over an extended period of time or continuously. Doses can
be stated as the amount of pharmaceutical agent per hour, day, week, or month. Doses can also be stated as
mg/kg or g/kg.
As used herein, “effective amount” or “therapeutically effective amount” means the amount of active
pharmaceutical agent sufficient to effectuate a desired physiological outcome in an indiVidual in need of the
agent. The effective amount can vary among individuals depending on the health and physical condition of
the individual to be treated, the taxonomic group of the individuals to be treated, the formulation of the
composition, assessment of the individual’s medical condition, and other nt factors.
As used herein, “fully complementary” or “100% complementary” means each nucleobase of a
nucleobase ce of a first nucleic acid has a complementary nucleobase in a second nucleobase sequence
of a second nucleic acid. In certain ments, a first nucleic acid is an antisense compound and a second
nucleic acid is a target nucleic acid.
As used herein, “glucose” is a monosaccharide used by cells as a source of energy and inflammatory
intermediate. “Plasma glucose” refers to e present in the plasma.
As used , “high density lipoprotein-C” or “HDL-C” means cholesterol associated with high
y lipoprotein particles. Concentration of HDL-C in serum (or plasma) is typically fied in mg/dL or
nmol/L. “Serum HDL-C” and “plasma HDL-C” mean HDL-C in serum and , respectively.
As used , “HMG-CoA reductase inhibitor” means an agent that acts through the inhibition of
the enzyme HMG-CoA reductase, such as atorvastatin, rosuvastatin, fluvastatin, lovastatin, pravastatin, and
simvastatin.
2014/036460
As used herein, “hypercholesterolemia” means a condition characterized by elevated cholesterol or
circulating (plasma) cholesterol, LDL-cholesterol and VLDL-cholesterol, as per the guidelines of the Expert
Panel Report of the al Cholesterol Educational Program (NCEP) of Detection, Evaluation of Treatment
of high cholesterol in adults (see, Arch. Int. Med. (1988) 148, .
As used herein, “hyperlipidemia” or “hyperlipemia” is a ion characterized by ed serum
lipids or circulating (plasma) lipids. This condition manifests an abnormally high concentration of fats. The
lipid fractions in the circulating blood are cholesterol, low density oteins, very low density lipoproteins,
chylomicrons and triglycerides. The Fredrickson fication of hyperlipidemias is based on the pattern of
TG and cholesterol-rich lipoprotein les, as measured by electrophoresis or ultracentrifugation and is
commonly used to characterize primary causes of hyperlipidemias such as hypertriglyceridemia (Fredrickson
and Lee, Circulation, 1965, 31 :321-327; ckson et al., New Eng J Med, 1967, 276 (1): 34—42).
As used herein, triglyceridemia” means a condition characterized by elevated triglyceride
levels. Its etiology includes primary (i.e. genetic causes) and secondary (other underlying causes such as
diabetes, metabolic syndrome/insulin resistance, obesity, physical inactivity, cigarette smoking, excess
alcohol and a diet very high in carbohydrates) s or, most often, a combination of both (Yuan et al.
CMAJ, 2007,176:1113-1120).
As used herein, “identifying” or “selecting an animal with metabolic or cardiovascular disease”
means identifying or ing a subject prone to or having been diagnosed with a metabolic disease, a
cardiovascular disease, or a lic syndrome; or, identifying or selecting a subject having any symptom of
a metabolic disease, cardiovascular disease, or metabolic syndrome including, but not limited to,
hypercholesterolemia, hyperglycemia, hyperlipidemia, hypertriglyceridemia, hypertension sed insulin
resistance, decreased insulin sensitivity, above normal body weight, and/or above normal body fat content or
any combination thereof Such identification can be accomplished by any method, including but not limited
to, standard clinical tests or assessments, such as measuring serum or circulating (plasma) cholesterol,
ing serum or circulating (plasma) glucose, measuring serum or circulating (plasma)
triglycerides, measuring blood-pressure, measuring body fat content, measuring body weight, and the like.
As used herein, “improved cardiovascular outcome” means a reduction in the ence of adverse
cardiovascular events, or the risk thereof. Examples of adverse cardiovascular events include, without
limitation, death, reinfarction, stroke, cardiogenic shock, pulmonary edema, cardiac arrest, and atrial
dysrhythmia.
As used herein, iately adjacent” means there are no intervening elements between the
immediately nt elements, for e, between regions, segments, nucleotides and/or nucleosides.
As used herein, “increasing HDL” or “raising HDL” means increasing the level of HDL in an animal
after administration of at least one compound of the invention, compared to the HDL level in an animal not
administered any compound.
As used herein, idual” or “subject” or “animal” means a human or non-human animal selected
for treatment or therapy.
As used herein, “individual in need thereof” refers to a human or non-human animal selected for
treatment or y that is in need of such treatment or therapy.
As used herein, “induce”, “inhibit”, “potentiate”, “elevate”, “increase”, “decrease”, “reduce” or the
like denote quantitative differences between two states. For example, “an amount ive to inhibit the
ty or expression of apo(a)” means that the level of activity or sion of apo(a) in a treated sample
will differ from the level of apo(a) activity or expression in an untreated sample. Such terms are d to,
for example, levels of expression, and levels of activity.
As used herein, “inflammatory condition” refers to a e, disease state, syndrome, or other
condition resulting in inflammation. For example, rheumatoid arthritis and liver fibrosis are inflammatory
conditions. Other examples of inflammatory conditions include sepsis, myocardial ischemia/reperfusion
injury, adult respiratory distress syndrome, nephritis, graft rejection, inflammatory bowel disease, multiple
sclerosis, arteriosclerosis, atherosclerosis and vasculitis.
As used herein, “inhibiting the sion or activity” refers to a reduction or blockade of the
expression or activity of a RNA or protein and does not necessarily te a total elimination of expression
or activity.
As used herein, “insulin resistance” is defined as the condition in which normal amounts of insulin are
inadequate to produce a normal insulin response from fat, muscle and liver cells. Insulin resistance in fat cells
results in hydrolysis of stored triglycerides, which elevates free fatty acids in the blood plasma. Insulin
resistance in muscle reduces glucose uptake whereas insulin resistance in liver reduces glucose e, with
both effects serving to elevate blood glucose. High plasma levels of insulin and glucose due to insulin
resistance often leads to metabolic syndrome and type 2 es.
As used herein, “insulin sensitivity” is a measure of how effectively an individual ses glucose.
An individual having high insulin sensitivity effectively processes glucose whereas an individual with low
insulin sensitivity does not effectively process glucose.
As used herein, “lipid-lowering” means a reduction in one or more lipids (e. g., LDL, VLDL) in a
subject. “Lipid-raising” means an increase in a lipid (e. g., HDL) in a subject. Lipid-lowering or lipid-raising
can occur with one or more doses over time.
As used , “lipid-lowering therapy” or “lipid lowering agent” means a therapeutic regimen
provided to a subject to reduce one or more lipids in a t. In certain embodiments, a lipid-lowering
therapy is provided to reduce one or more of apo(a), CETP, apoB, total cholesterol, LDL-C, VLDL-C, IDL-
C, non-HDL-C, triglycerides, small dense LDL particles, and Lp(a) in a subject. Examples of lipid-lowering
therapy include, but are not limited to, apoB inhibitors, statins, fibrates and MTP inhibitors.
As used , rotein”, such as VLDL, LDL and HDL, refers to a group of proteins found in
the serum, plasma and lymph and are ant for lipid ort. The chemical composition of each
lipoprotein differs, for example, in that the HDL has a higher proportion of n versus lipid, whereas the
VLDL has a lower proportion of protein versus lipid.
As used herein, “Lp(a)” comprises apo(a) and a LDL like particle containing apoB. The apo(a) is
linked to the apoB by a disulfide bond.
As used herein, “low density lipoprotein-cholesterol (LDL-C)” means cholesterol carried in low
density otein particles. Concentration of LDL-C in serum (or plasma) is typically quantified in mg/dL
or . “Serum LDL-C” and a LDL-C” mean LDL-C in the serum and plasma, respectively.
As used herein, “major risk factors” refers to factors that bute to a high risk for a particular
disease or condition. In certain embodiments, major risk factors for coronary heart disease e, without
limitation, cigarette smoking, hypertension, high LDL, low HDL-C, family history of coronary heart disease,
age, and other s disclosed .
As used herein, “metabolic disorder” or “metabolic disease” refers to a condition characterized by an
alteration or disturbance in metabolic function. “Metabolic” and “metabolism” are terms well known in the
art and generally include the whole range of biochemical processes that occur within a living sm.
Metabolic disorders include, but are not limited to, hyperglycemia, prediabetes, diabetes (type 1 and type 2),
y, insulin resistance, metabolic syndrome and dyslipidemia due to type 2 diabetes.
As used herein, “metabolic syndrome” means a condition characterized by a clustering of lipid and
non-lipid cardiovascular risk factors of metabolic origin. In certain embodiments, metabolic syndrome is
identified by the presence of any 3 of the following factors: waist circumference of greater than 102 cm in
men or greater than 88 cm in women; serum triglyceride of at least 150 mg/dL; HDL-C less than 40 mg/dL in
men or less than 50 mg/dL in women; blood pressure of at least 130/85 mmHg; and fasting e of at least
110 mg/dL. These determinants can be readily ed in clinical practice (JAMA, 2001, 285: 2486-2497).
teral administration” means administration through injection or infusion. Parenteral
administration includes subcutaneous stration, intravenous administration, intramuscular
administration, intraarterial administration, intraperitoneal administration, or intracranial administration, e. g.
intrathecal or intracerebroventricular administration. Administration can be continuous, chronic, short or
intermittent.
As used herein, “peptide” means a molecule formed by g at least two amino acids by amide
bonds. Peptide refers to ptides and proteins.
As used herein, “pharmaceutical agent” means a substance that provides a therapeutic benefit when
administered to an individual. For example, in certain embodiments, an antisense oligonucleotide targeted to
apo(a) is a pharmaceutical agent.
As used herein, “pharmaceutical composition” or “composition” means a e of substances
suitable for administering to an dual. For example, a pharmaceutical composition can comprise one or
more active agents and a pharmaceutical carrier e. g., a sterile aqueous solution.
As used herein, “pharmaceutically acceptable derivative” encompasses derivatives of the compounds
described herein such as solvates, hydrates, esters, prodrugs, polymorphs, isomers, isotopically labelled
variants, pharmaceutically acceptable salts and other derivatives known in the art.
As used herein, “pharmaceutically acceptable salts” means physiologically and pharmaceutically
acceptable salts of nse nds, i.e., salts that retain the desired ical activity of the parent
compound and do not impart undesired toxicological effects thereto. The term aceutically acceptable
salt” or “salt” es a salt prepared from pharmaceutically acceptable non-toxic acids or bases, including
inorganic or organic acids and bases. “Pharmaceutically acceptable salts” of the compounds described herein
may be prepared by methods well-known in the art. For a review of pharmaceutically acceptable salts, see
Stahl and Wermuth, Handbook of Pharmaceutical Salts: Properties, ion and Use -VCH,
Weinheim, Germany, 2002). Sodium salts of antisense oligonucleotides are useful and are well accepted for
therapeutic administration to . Accordingly, in one embodiment the compounds described herein are
in the form of a sodium salt.
As used herein, “portion” means a defined number of contiguous (i.e. linked) nucleobases of a
nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of a target
nucleic acid. In certain embodiments, a portion is a defined number of contiguous nucleobases of an
antisense compound.
As used herein, “prevent”or ”preventing” refers to delaying or forestalling the onset or development
of a disease, disorder, or condition for a period of time from minutes to indefinitely. Prevent also means
reducing risk of developing a disease, disorder, or ion.
As used herein, “raise” means to increase in amount. For example, to raise plasma HDL levels means
to increase the amount of HDL in the .
As used , “reduce” means to bring down to a smaller extent, size, amount, or number. For
example, to reduce plasma triglyceride levels means to bring down the amount of triglyceride in the plasma.
As used herein, “region” or “target region” is defined as a portion of the target nucleic acid having at
least one identifiable structure, function, or characteristic. For example, a target region may encompass a 3’
UTR, a 5’ UTR, an exon, an intron, an exon/intron junction, a coding region, a translation initiation region,
translation ation region, or other defined nucleic acid . The structurally defined regions for
apo(a) can be obtained by accession number from ce databases such as NCBI and such information is
incorporated herein by reference. In certain ments, a target region may encompass the sequence from
a 5’ target site of one target segment within the target region to a 3’ target site of another target segment
within the target .
As used herein, “second agent” or “second eutic agent” means an agent that can be used in
combination with a “first agent”. A second therapeutic agent can include, but is not limited to, antisense
oligonucleotides targeting apo(a) or apoB. A second agent can also include anti- apo(a) antibodies, apo(a)
peptide inhibitors, cholesterol lowering agents, lipid lowering agents, glucose lowering agents and anti-
inflammatory agents.
As used , “segments” are d as smaller, sub-portions of regions within a nucleic acid. For
example, a “target segment” means the sequence of nucleotides of a target nucleic acid to which one or more
antisense compounds is targeted. “5’ target site” refers to the t nucleotide of a target segment. “3’
target site” refers to the 3’-most tide of a target segment. Alternatively, a “start site” can refer to the 5’
most nucleotide of a target segment and a “stop site” refers to the 3’-most nucleotide of a target segment. A
target t can also begin at the “start site” of one sequence and end at the “stop site” of another
sequence.
As used herein, “statin” means an agent that inhibits the activity of HMG-CoA reductase.
As used herein, taneous administration” means administration just below the skin.
As used herein, “subject” means a human or non-human animal selected for treatment or therapy.
As used herein, “symptom of cardiovascular disease or disorder” means a phenomenon that arises
from and accompanies the cardiovascular disease or disorder and serves as an indication of it. For example,
angina; chest pain; shortness of breath; palpitations; weakness; dizziness; nausea; sweating; tachycardia;
bradycardia; arrhythmia; atrial fibrillation; swelling in the lower extremities; cyanosis; fatigue; fainting;
numbness of the face; numbness of the limbs; claudication or cramping of muscles; bloating of the abdomen;
or fever are ms of cardiovascular e or disorder.
As used herein, “targeting” or “targeted” means the process of design and selection of an antisense
compound that will specifically ize to a target nucleic acid and induce a desired effect.
As used herein, peutically effective amount” means an amount of a pharmaceutical agent that
provides a therapeutic benefit to an individual.
As used herein, peutic lifestyle change” means y and lifestyle changes intended to lower
fat/adipose tissue mass and/or cholesterol. Such change can reduce the risk of developing heart disease, and
may includes recommendations for dietary intake of total daily calories, total fat, saturated fat,
polyunsaturated fat, saturated fat, carbohydrate, protein, cholesterol, insoluble fiber, as well as
recommendations for physical actiVity.
As used herein, “treat” or “treating” refers to administering a compound described herein to effect an
alteration or improvement of a disease, disorder, or condition.
As used , “triglyceride” or “TG” means a lipid or neutral fat consisting of ol combined
with three fatty acid molecules.
As used herein, “type 2 diabetes,” (also known as “type 2 diabetes mellitus”, “diabetes mellitus, type
2”, “non-insulin-dependent diabetes”, “NIDDM”, “obesity related diabetes”, or “adult-onset diabetes”) is a
lic disorder that is ily characterized by insulin resistance, relative insulin deficiency, and
hyperglycemia.
Certain Embodiments
In certain embodiments, a compound comprises a siRNA or antisense oligonucleotide targeted to
apolipoprotein(a) (apo(a)) known in the art and a conjugate group described herein. Examples of antisense
oligonucleotides targeted to apo(a) suitable for conjugation include but are not d to those disclosed in
; US 8,673,632; US 7,259,150; and US Patent Application Publication No. US
2004/0242516; which are incorporated by reference in their entireties herein. In certain embodiments, a
compound comprises an antisense oligonucleotide having a nucleobase sequence of any of SEQ ID NOs 12-
130, 133, 134 disclosed in WC 2013/177468 and a conjugate group described . In certain
embodiments, a compound comprises an nse oligonucleotide having a nucleobase sequence of any of
SEQ ID NOs 11-45 and 85-96 disclosed in US 8,673,632 and a conjugate group described . In certain
embodiments, a compound comprises an antisense oligonucleotide having a nucleobase sequence of any of
SEQ ID NOs 11-45 disclosed in US 7,259,150 and a conjugate group described herein. In certain
embodiments, a compound comprises an antisense oligonucleotide having a nucleobase sequence of any of
SEQ ID NOs 7-41 disclosed in US Patent Application Publication No. US 2004/0242516 and a ate
group described herein. The nucleobase sequences of all of the aforementioned referenced SEQ ID NOs are
incorporated by reference herein.
Certain embodiments provide a compounds and methods for decreasing apo(a) mRNA and protein
expression. In certain embodiments, the compound is an apo(a) specific inhibitor for treating, preventing, or
ameliorating an apo(a) associated disease. In certain embodiments, the compound is an antisense
oligonucleotide targeting apo(a). In certain embodiments, the compound is an nse oligonucleotide
targeting apo(a) and a conjugate group.
Certain embodiments provide a compounds and methods for sing Lp(a) levels. In n
embodiments, the compound is an apo(a) specific inhibitor for treating, preventing, or ameliorating an Lp(a)
associated e. In certain embodiments, the compound is an antisense ucleotide ing apo(a). In
certain ments, the compound is an antisense ucleotide targeting apo(a) and a conjugate group.
Certain embodiments provide a nd comprising a modified oligonucleotide ing apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides. In
certain embodiments, the modified ucleotide with the conjugate group ts of 15 to 30, 18 to 24, 19
to 22, 13 to 25, 14 to 25, 15 to 25 linked nucleosides. In n embodiments, the modified oligonucleotide
with the ate group comprises at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at
least 18, at least 19, at least 20, at least 21, at least 22, at least 23, at least 24, at least 25, at least 26, at least
27, at least 28, at least 29 or 30 linked nucleosides. In certain embodiments, the modified oligonucleotide
with the conjugate group consists of 20 linked nucleosides.
Certain ments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide comprises at least 8, at least 9, at least 10, at
least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20
contiguous nucleobases complementary to an equal length portion of any of SEQ ID NOs: 1-4.
Certain embodiments provide a nd comprising a modified oligonucleotide targeting an apo(a)
segment and a conjugate group, wherein the modified ucleotide comprises at least 8, at least 9, at least
, at least 11, at least 12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, or
contiguous bases complementary to an equal length portion of any of the target segments shown in,
for example, Examples 114 and 117. In the tables, the “Start Site” refers to the 5’-most nucleotide of a target
segment and “Stop Site” refers to the 3’-most nucleotide of a target segment. A target segment can range
from the start site to the stop site of each sequence listed in the tables. Alternatively, the target segment can
range from the start site of one sequence and end at the stop site of another sequence. For example, as shown
in Table 125, a target segment can range from 3901-3920, the start site to the stop site of SEQ ID NO: 58. In
r example, as shown in Table 125, a target segment can range from 3900-3923, the start site of SEQ ID
NO: 57 to the stop site of SEQ ID NO: 61.
Certain embodiments provide a nd comprising a d oligonucleotide targeting apo(a)
and a conjugate group, wherein the nucleobase sequence of the modified oligonucleotide is at least 80%, at
least 85%, at least 90%, at least 95%, or 100% complementary to any of SEQ ID NOs: 1-4. Certain
embodiments provide a compound comprising a modified oligonucleotide targeting apo(a) and a conjugate
group, n the nucleobase sequence of the modified oligonucleotide is at least 80%, at least 85%, at least
90%, at least 95%, or 100% complementary to any of the target segments shown in, for example, Examples
1 14 and 1 17.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and
comprises a nucleobase sequence comprising a portion of at least 8, at least 9, at least 10, at least 11, at least
12, at least 13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous
nucleobases mentary to an equal length portion of nucleobases 3901 to 3920 of SEQ ID NO: 1,
wherein the base sequence of the d oligonucleotide is at least 80% complementary to SEQ ID
NO: 1.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and
comprises a nucleobase sequence sing at least 8, at least 9, at least 10, at least 11, at least 12, at least
13, at least 14, at least 15, at least 16, at least 17, at least 18, at least 19, at least 20, at least 21, at least 22, at
least 23, at least 24, at least 25, at least 26, at least 27, at least 28, at least 29 or 30 contiguous nucleobases
complementary to an equal length portion of bases 3900 to 3923 of SEQ ID NO: 1, wherein the
nucleobase sequence of the d oligonucleotide is at least 80% complementary to SEQ ID NO: 1.
Certain embodiments provide a compound comprising a modified ucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
2014/036460
a base sequence sing at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: 12-130, 133, 134. In certain embodiments, the modified
oligonucleotide has a nucleobase sequence sing at least 8 contiguous nucleobases of any one of the
nucleobase sequences of SEQ ID NOs: 12-130, 133, 134. In certain embodiments, the nd consists of
any one of SEQ ID NOs: , 133, 134 and a conjugate group.
Certain embodiments provide a compound sing a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a base sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: 12-20, 22-33, 35-44, 47-50, 51, 53, 57-62, 65-66, 68, 70-79, 81, 85-
86, 89-90, 92-94, 97, 105-110, 103-104, 133-134. In certain embodiments, the nd consists of any of
the nucleobase sequences of SEQ ID NOs: 12-20, 22-33, 35-44, 47-50, 51, 53, 57-62, 65-66, 68, 70-79, 81,
85-86, 89-90, 92-94, 97, 105-110, 103-104, 133-134 and a conjugate group.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: 12-19, 26-30, 32, 35, 38-44, 46-47, 50, 57-58, 61, 64-66, 68, 72-74,
76-77, 92-94, 103-110. In certain embodiments, the compound consists of any of the base sequences of
SEQ ID NOs: 12-19, 26-30, 32, 35, 38-44, 46-47, 50, 57-58, 61, 64-66, 68, 72-74, 76-77, 92-94, 0 and
a conjugate group.
Certain embodiments provide a compound comprising a modified ucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
base ces of SEQ ID NOs: 111, 114-121, 123-129. In certain embodiments, the compound
consists of any of the nucleobase sequences of SEQ ID NOs: 111, 114-121, 123-129 and a conjugate group.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: l4, l7, 18, 26-28, 39, 71, 106-107. In certain embodiments, the
compound ts of any ofthe nucleobase sequences of SEQ ID NOs: l4, l7, 18, 26-28, 39, 71, 106-107
and a conjugate group.
2014/036460
Certain embodiments e a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, n the modified oligonucleotide ts of 12 to 30 linked sides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: 14, 26-29, 39-40, 82. In certain ments, the compound consists
of any of the nucleobase sequences of SEQ ID NOs: 14, 26-29, 39-40, 82 and a conjugate group.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: 14, 16-18. In certain ments, the compound consists of any of
the nucleobase sequences of SEQ ID NOs: 14, 16-18 and a ate group.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase ce comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
base sequences of SEQ ID NOs: 26-27, 107. In certain embodiments, the compound consists of any of
the nucleobase sequences of SEQ ID NOs: 26-27, 107 and a conjugate group.
Certain embodiments e a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
base sequences of SEQ ID NOs: 28-29, 39-40, 47. In certain embodiments, the compound consists of
any of the nucleobase sequences of SEQ ID NOs: : 28-29, 39-40, 47 and a conjugate group.
Certain embodiments provide a compound comprising a modified oligonucleotide ing apo(a)
and a conjugate group, wherein the modified ucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of any of the
nucleobase sequences of SEQ ID NOs: 28, 93, 104, 134. In certain embodiments, the compound consists of
any of the nucleobase sequences of SEQ ID NOs: 28, 93, 104, 134 and a conjugate group.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and has
a nucleobase sequence comprising at least 8, at least 9, at least 10, at least 11, at least 12, at least 13, at least
14, at least 15, at least 16, at least 17, at least 18, at least 19, or 20 contiguous nucleobases of the nucleobase
sequence of SEQ ID NO: 58. In certain embodiments, the modified oligonucleotide with the conjugate group
has a base sequence comprising at least 8 uous nucleobases of the nucleobase sequence of SEQ
ID NO: 5 8. In certain embodiments, the compound consists of SEQ ID NO: 5 8 and a conjugate group.
In certain embodiments, the present disclosure es conjugated antisense compounds represented
by the following structure. In certain embodiments, the antisense compound comprises the modified
oligonucleotide ISIS 494372 with a 5’-X, wherein X is a conjugate group comprising . In certain
embodiments, the antisense compound consists of the modified oligonucleotide ISIS 494372 with a 5’-X,
wherein X is a conjugate group comprising GalNAc.
In certain embodiments, the present disclosure es conjugated antisense compounds represented
by the following structure. In certain embodiments, the nse nd comprises the conjugated
modified oligonucleotide ISIS 681251. In certain embodiments, the antisense compound consists of the
conjugated modified oligonucleotide ISIS 681251.
HO&W WHO HN O
‘5 N O
O N
WNH /
N O
In certain embodiments, the present disclosure provides conjugated nse nds represented
by the following structure. In certain embodiments, the antisense compound comprises the conjugated
d oligonucleotide ISIS 681257. In certain embodiments, the antisense compound consists of the
conjugated modified oligonucleotide ISIS 681257.
In certain embodiments, the present disclosure provides conjugated antisense compounds represented
by the following structure. In certain embodiments, the antisense compound comprises a d
oligonucleotide with the nucleobase sequence of SEQ ID NO: 58 with a 5’-GalNAc with variability in the
sugar mods of the wings. In certain ments, the antisense compound consists of a d
oligonucleotide with the nucleobase seuquence of SEQ ID NO: 58 with a 5’-GalNAc with variability in the
sugar mods of the wings.
HOOH o
Hofiowflflll O wNH O
HOOH O
HomOWHk/o
IoNH 0
HOOH
Infiwofibmo fi
IoNH
Wherein either R1 is —OCH2CHZOCH3 (MOE) and R2 is H; or R1 and R2 er form a bridge,
wherein R1 is —O- and R2 is —CH2-, -CH(CH3)-, or -CH2CH2-, and R1 and R2 are directly ted such that
the resulting bridge is selected from: -O-CH2-, -O-CH(CH3)-, and —O-CH2CH2-;
And for each pair of R3 and R4 on the same ring, independently for each ring: either R3 is ed
from H and -OCH2CH20CH3 and R4 is H; or R3 and R4 together form a bridge, wherein R3 is —O-, and R4 is —
CH2-, -CH(CH3)-, or -CH2CH2-and R3 and R4 are ly connected such that the resulting bridge is selected
from: -O-CH2-, -O-CH(CH3)-, and —O-CH2CH2-;
And R5 is ed from H and —CH3;
And Z is selected from S' and 0'.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a ate group, wherein the d oligonucleotide is single-stranded.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein at least one intemucleoside linkage is a modified intemucleoside linkage. In
certain embodiments, the modified intemucleoside linkage is a orothioate intemucleoside linkage. In
certain embodiments, at least 1, at least 2, at least 3, at least 4, at least 5, at least 6, at least 7, at least 8, at
least 9 or at least 10 internucleoside linkages of said modified oligonucleotide are phosphorothioate
intemucleoside linkages. In certain ments, each intemucleoside linkage is a phosphorothioate
intemucleoside linkage. In certain embodiments, the modified oligonucleotide comprises at least 1, at least 2,
at least 3, at least 4, at least 5, at least 6, at least 7, at least 8, at least 9 or at least 10 phosphodiester
intemucleoside linkages. In certain embodiments, each intemucleoside linkage of the modified
oligonucleotide is selected from a phosphodiester internucleoside linkage and a orothioate
intemucleoside linkage.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein at least one nucleoside ses a modified nucleobase. In certain
embodiments, the modified nucleobase is a 5-methylcytosine.
Certain embodiments provide a nd comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide comprises at least one modified sugar. In certain
embodiments, the modified sugar is a bicyclic sugar. In certain embodiments, the d sugar comprises a
2’-O-methoxyethyl, a ained ethyl, a ro-HNA or a 4’- (CH2)n-O-2’ bridge, wherein n is l or 2.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified ucleotide consists of 12 to 30 linked nucleosides and
comprises: (a) a gap segment consisting of linked deoxynucleosides; (b) a 5’ wing segment ting of
linked nucleosides; (c) a 3’ wing segment consisting of linked nucleosides; and wherein the gap segment is
positioned between the 5’ wing segment and the 3’ wing t and wherein each side of each wing
segment ses a modified sugar.
Certain embodiments provide a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, n the modified oligonucleotide consists of 20 linked nucleosides and
comprises: (a) a gap segment consisting of ten linked deoxynucleosides; (b) a 5’ wing segment consisting of
five linked nucleosides; (c) a 3’ wing segment consisting of five linked nucleosides; and wherein the gap
segment is oned between the 5’ wing segment and the 3’ wing segment, wherein each nucleoside of
each wing segment comprises a ethoxyethyl sugar, wherein at least one intemucleoside linkage is a
phosphorothioate linkage and wherein each ne residue is a 5-methylcytosine.
Certain embodiments e a compound comprising a modified oligonucleotide targeting apo(a)
and a conjugate group, wherein the modified oligonucleotide consists of 20 linked nucleosides and has a
nucleobase sequence comprising at least 8 contiguous bases of any of SEQ ID NOs: 12-130, 133, 134,
wherein the modified oligonucleotide ses: (a) a gap segment consisting of ten linked
deoxynucleosides; (b) a 5’ wing segment consisting of five linked nucleosides; (c) a 3’ wing segment
consisting of five linked nucleosides; and wherein the gap segment is positioned between the 5’ wing
segment and the 3’ wing segment, wherein each nucleoside of each wing segment comprises a 2’-O-
methoxyethyl sugar, wherein at least one internucleoside linkage is a phosphorothioate linkage and wherein
each cytosine residue is a 5-methylcytosine.
Certain embodiments provide a compound comprising a d oligonucleotide targeting apo(a)
and a conjugate group, wherein the d oligonucleotide consists of 20 linked nucleosides and has a
nucleobase ce comprising at least 8 contiguous nucleobases of SEQ ID NO: 58, wherein the modified
ucleotide comprises: (a) a gap segment consisting of ten linked deoxynucleosides; (b) a 5’ wing
segment consisting of five linked nucleosides; (c) a 3’ wing segment consisting of five linked nucleosides;
and wherein the gap segment is positioned between the 5’ wing segment and the 3’ wing segment, wherein
each nucleoside of each wing segment comprises a 2’-O-methoxyethyl sugar, wherein at least one
intemucleoside linkage is a phosphorothioate linkage and wherein each ne residue is a 5 -
methylcytosine.
Certain embodiments provide a d oligonucleotide ing apo(a) and a ate group,
wherein the modified oligonucleotide consists of 20 linked nucleosides with the nucleobase ce of SEQ
ID NO: 58, wherein the modified ucleotide comprises: (a) a gap segment consisting of ten linked
deoxynucleosides; (b) a 5’ wing segment consisting of five linked nucleosides; (c) a 3’ wing segment
consisting of five linked nucleosides; and wherein the gap segment is positioned between the 5’ wing
segment and the 3’ wing segment, wherein each nucleoside of each wing segment comprises a 2’-O-
methoxyethyl sugar, wherein at least one internucleoside linkage is a phosphorothioate linkage and wherein
each cytosine residue is a 5-methylcytosine.
In certain embodiments, the conjugate group is linked to the modified oligonucleotide at the 5’ end of
the modified oligonucleotide. In certain embodiments, the conjugate group is linked to the modified
oligonucleotide at the 3’ end of the modified oligonucleotide.
In certain embodiments, the conjugate group comprises one or more s. In certain embodiments,
the conjugate group comprises two or more ligands. In certain ments, the conjugate group comprises
three or more ligands. In certain ments, the conjugate group comprises three ligands. In certain
embodiments, each ligand is selected from among: a polysaccharide, modified polysaccharide, mannose,
galactose, a mannose derivative, a ose derivative, D-mannopyranose, L-Mannopyranose, D-Arabinose,
L-Galactose, D-Xylofuranose, L-XlefUI‘aIIOSC, D-glucose, L-glucose, D-Galactose, L-Galactose, nnofuranose
, B-D-Mannofuranose, (x-D-Mannopyranose, B-D-Mannopyranose, (x-D-Glucopyranose, B-D-
yranose, (x-D-GlucofiJranose, B-D-GlucofiJranose, (x-D-fructofiJranose, (x-D-fructopyranose, lactopyranose
, B -D-Galactopyranose, (x-D-Galactofuranose, B -D-Galactofuranose, glucosamine, sialic
acid, (x-D-galactosamine, N—Acetylgalactosamine, 2-Amino0-[(R)-l-carboxyethyl]—2-deoxy-B-D-
glucopyranose, 2-Deoxymethylamino-L-glucopyranose, deoxyformamido-2,3-di- O-methyl-D-
mannopyranose, 2-Deoxysulfoamino-D-glucopyranose, N—Glycoloyl-(x-neuraminic acid, 5-thio-B-D-
glucopyranose, methyl 2,3,4-tri- O-acetyl-l-thioO-trityl-(x-D-glucopyranoside, 4-Thio-B-D-
galactopyranose, ethyl 3,4,6,7-tetraacetyldeoxy-l ,5-dithio-0t-D-gluc0-heptopyranoside, 2,5-Anhydro-
D-allononitrile, ribose, D-ribose, Dthioribose, L-ribose, Lthioribose. In certain embodiments, each
ligand is N—acetyl galactosamine.
In certain embodiments, each ligand is N—acetyl galactosamine.
In certain embodiments, the conjugate group comprises:
HO OH
In certain embodiments, the conjugate group comprises:
2014/036460
In certain embodiments, the conjugate group comprises:
WO 79625
HoOH '
O (3ng
HO 3
O O
AcHN |
HOOH
o N
OW o
AcHN l
o=P-OH
HoOH "
o N
HO 3
o [20 E
AcHN
In certain embodiments, the conjugate group comprises at least one phosphorus linking group or neutral
linking group.
In certain embodiments, the conjugate group comprises a structure selected from among:
OH OH
E—o—E—o eke o—E—o—g é—o—E—o 0&0 o
5H V3 “rt \
(5H 5H m “”2 e”
o o
t‘ mgr-HII 5 E
s ”M
H OH 0
o and
wherein n is from 1 to 12; and
wherein m is from 1 to 12.
In certain embodiments, the ate group has a tether having a structure selected from among:
0 Z1
6’5 L 5'3. {95% )W/L E
n L is either a phosphorus linking group or a neutral linking group;
Z1 is C(=O)O-R2;
Z2 is H, C1-C6 alkyl or substituted C1-C6 alky;
R2 is H, C1-C6 alkyl or tuted C1-C6 alky; and
each ml is, independently, from O to 20 wherein at least one ml is greater than 0 for each tether.
In certain embodiments, conjugate group has a tether having a structure selected from among:
(3 3L 0 COOH 9H 5,1
o—P—o and
“‘21‘ m1 (5H m1 fiwN/K(o—fi—o—Qm1m1 H O
wherein Z2 is H or CH3; and
each ml is, independently, from O to 20 wherein at least one ml is greater than 0 for each tether.
In certain embodiments, the conjugate group has tether having a structure selected from among:
Walden/$71 ; EMHJLN o
wherein n is from 1 to 12; and
wherein m is from 1 to 12.
In n embodiments, the conjugate group is covalently attached to the modified oligonucleotide.
In certain embodiments, the compound has a structure represented by the formula:
A—B—C—D+E—F)
wherein
A is the modified oligonucleotide;
B is the cleavable moiety
C is the conjugate linker
D is the branching group
each E is a tether;
each F is a ligand; and
q is an integer n 1 and 5.
In certain embodiments, the compound has a structure represented by the formula:
A—éBfiCfiDfiE_F>Cl
wherein:
A is the modified oligonucleotide;
B is the cleavable moiety
C is the conjugate linker
D is the branching group
each E is a tether;
each F is a ligand;
each n is independently O or 1; and
q is an integer n 1 and 5.
In n embodiments, the compound has a ure represented by the formula:
A—B—c+E—F>
wherein
A is the modified oligonucleotide;
B is the cleavable moiety;
C is the conjugate linker;
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain ments, the compound has a structure represented by the formula:
A—C_D_6E—F)
A is the modified oligonucleotide;
C is the conjugate linker;
D is the branching group;
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, the compound has a structure represented by the formula:
A—c+E—F>
wherein
A is the ed ucleotide;
C is the conjugate linker;
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, the compound has a structure represented by the formula:
A—B—D+E—F>
wherein
A is the modified ucleotide;
B is the cleavable moiety;
D is the branching group;
each E is a tether;
each F is a ; and
q is an integer between 1 and 5.
In certain embodiments, the compound has a structure represented by the formula:
Awe—a
wherein
A is the modified oligonucleotide;
B is the ble moiety;
each E is a ;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, the compound has a structure represented by the formula:
A nee—F)
wherein
A is the modified oligonucleotide;
D is the branching group;
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, the conjugate linker has a structure ed from among:
0 O
A .fiifrpfiks
Wherein each L is, independently, a phosphorus linking group or a neutral linking group; and
each n is, independently, from 1 to 20.
In certain embodiments, the conjugate linker has a ure selected from among:
0 O O O
EkNMN/YH a H
/‘14,. JV“
. EkNW” ;"77_ W;;
O HO’ 0
O O
N\/\></\/\f‘H H
r‘;W H
0 0 ’ H
s’ N\/\ NY,
0 o W o o
O O
\n/\/ \915’ W \/\O O 5’5
2014/036460
In certain embodiments, the conjugate linker has the followingstructure:
Ova/”‘1
In certain ments, the conjugate linker has a structure selected from among:
{a\o/\/\e_‘s; éf\O/\/\O/\/\éé ;and £\O/\/\O/\/\O/\/\€‘s _
In certain embodiments, the conjugate linker has a structure selected from among:
OH OH
$030 0&0_ _ _ 030;_ _ _ and $030_ _ _ 04/0 0
5H W3 \ 5H V3 “Pg 5H V3 9"
In certain embodiments, the ate linker has a structure ed from among:
0 o
3’ o—P—o—§ e3
_ 3 NH/\(\/)/631,
3 ”M6 (IDH ’ and
E
2 ”M
In certain embodiments, the conjugate linker comprises a pyrrolidine. In certain ments, the
conjugate linker does not comprise a pyrrolidine. In certain embodiments, the conjugate linker comprises
PEG. In certain embodiments, the ate linker comprises an amide. In certain embodiments, the
ate linker comprises at least two amides. In certain embodiments, the conjugate linker does not
comprise an amide. In certain embodiments, the conjugate linker comprises a ide. In certain
embodiments, the conjugate linker comprises an amine. In certain embodiments, the conjugate linker
comprises one or more disulfide bonds. In certain embodiments, the conjugate linker comprises a protein
binding moiety. In certain embodiments, the protein binding moiety comprises a lipid.
In certain embodiments, the n binding moiety is selected from among: cholesterol, cholic acid,
adamantane acetic acid, l-pyrene butyric acid, dihydrotestosterone, l,3-Bis-O(hexadecyl)glycerol,
geranyloxyhexyl group, hexadecylglycerol, l, menthol, 1,3-propanediol, heptadecyl group, ic
acid, myristic acid, O3-(oleoyl)lithocholic acid, eoyl)cholenic acid, dimethoxytrityl, or phenoxazine), a
Vitamin (e.g., folate, Vitamin A, Vitamin E, biotin, pyridoxal), a peptide, a carbohydrate (e.g.,
monosaccharide, disaccharide, trisaccharide, tetrasaccharide, oligosaccharide, polysaccharide), an
endosomolytic component, a d (e.g., uvaol, hecigenin, diosgenin), a terpene (e.g., triterpene, e.g.,
sarsasapogenin, friedelin, epifriedelanol derivatized lithocholic acid), or a cationic lipid.
In n embodiments, the protein binding moiety is selected from among: a C16 to C22 long chain
saturated or unsaturated fatty acid, cholesterol, cholic acid, Vitamin E, adamantane or l-pentafluoropropyl.
In certain embodiments, the conjugate linker has a structure selected from among:
H H w E—NH
N N |
'31/ W 0”; 9
0 R023 [1V0 O—P—OH
N |
N 0
\‘f ”luv
' H
\ i N
N ” O 3r flfigo ; ( "
m ( )n
é;\o ”Tu Ill Cl)
ii 0,, OH ,
’ O
p "'1 1H. n
”r“ “I”
0 'NW 04
04..
if ‘H’ ‘M’ Mn MAN *0}; H
n n
n W ,
’ .LLL/N\/\S/S n O
"”4.
J\/|VV
JWV O
o o WO‘CK /,0 \..... o\ ,p 5 N 0’? OH
OH o
N _ ,P
O I n W \l....
w o\ d n 0 Q
E—s H
n o
N ,and. :1 N
HNfl/g
”W n
Ili/ n 0
wherein each n is, independently, is from 1 to 20; and p is from 1 to 6.
In certain embodiments, the conjugate linker has a structure selected from among:
”CO 0,,
)5. 0V0)"
O o N
O N
H H SN
NNo ; I777- S O
I111 n n n i
n O
ITIH o O
H N
W gulf/WN
n HMN O ’
”\J “
$3 n O
; and
wherein each n is, independently, from 1 to 20.
In certain embodiments, the conjugate linker has a structure ed from among:
“i“ Q
”T” ('3
O!» W
I o \..... o\ ,o
O. 5 ,P OH
O\ O I
H is 0V0 S_S/\/\( O\HI X!
”LLL/ N\/\
,s o N \g‘. N
s d
3 o , M ,an
E H
E 10 0 \NW 5 o
In certain embodiments, the conjugate linker has a structure selected from among:
14:“ ”S,
9w 0 like}:
3W0 and EWO
wherein n is from 1 to 20.
In certain embodiments, the ate linker has a structure selected from among:
5W“,AM?EHO——E 3L
and EWfi/W
In certain ments, the conjugate linker has a structure selected from among:
szAM:—EHo——E
and EWMW‘
wherein each n is independently, O, l, 2, 3, 4, 5, 6, or 7.
In certain embodiments, the ate linker has the following structure:
0 O
In certain embodiments, the branching group has one of the following structures:
wherein each Al is independently, O, S, C=O or NH; and
each n is, independently, from 1 to 20.
In certain embodiments, the branching group has one of the following structures:
wherein each Al is independently, O, S, C=O or NH; and
each n is, independently, from 1 to 20.
In certain embodiments, the branching group has the following structure:
/O\a—/"Ha,
In certain embodiments, the branching group has the following ure:
O N
/ #O/E
In n embodiments, the branching group has the following structure:
M/;LN}5‘
“In,” '
In certain embodiments, the ing group has the following structure:
,1”,
55‘“
In certain embodiments, the branching group comprises an ether.
In certain embodiments, the branching group has the following structure:
each n is, independently, from 1 to 20; and
m is from 2 to 6.
In certain ments, the branching group has the following structure:
“at 0 EL
o 0
KW“! “a .
’ HJ~rfit/\NjV\/\AN)‘
H O Kfo O
’ NH;rr
"’w" 0
o O
o o
E—NH )2 O
. EANNNflf
o , o ; AN 21 e“
;and 'gZ/NH
m o
In certain embodiments, the branching group has the following structure:
O O
In certain ments, the branching group comprises:
O o
EWNH EWNH
)n )n
O AM O
H H 1’1
on (n
NH EMNH
‘5 0r o
, ;
wherein each j is an integer from 1 to 3; and
wherein each n is an integer from 1 to 20.
In n embodiments, the branching group comprises:
HN}L 0
EWLNH
In certain embodiments, each tether is selected from among:
0 Z1
6’5 L .771. £19k Jfi/L 1%.
Wherein L is selected from a phosphorus linking group and a neutral linking group;
Z1 is C(=O)O-R2;
Z2 is H, C1-C6 alkyl or tuted Cl-C6 alky;
R2 is H, C1-C6 alkyl or substituted Cl-C6 alky; and
each ml is, independently, from O to 20 wherein at least one ml is greater than 0 for each tether.
In certain embodiments, each tether is selected from among:
0 3L 0 COOH OH
0—3—0 I
“L “”2 6H “”2 ng/Kfl—fi—O‘Mfi:m2H O
Wherein Z2 is H or CH3; and
each m2 is, independently, from O to 20 Wherein at least one m2 is greater than 0 for each tether.
In certain embodiments, each tether is selected from among:
/$71 ; EMHJLN o
“(WK/NJ}?
n n is from 1 to 12; and
Wherein m is from 1 to 12.
In certain embodiments, at least one tether comprises ethylene glycol. In certain embodiments, at least
one tether comprises an amide. In n embodiments, at least one tether comprises a polyamide. In certain
embodiments, at least one tether comprises an amine. In certain embodiments, at least two tethers are
different from one another. In certain embodiments, all of the s are the same as one another. In certain
embodiments, each tether is selected from among:
O H 1%.
EMNWOVhOAH/Ei ; Lat/NW2 ; aw J EWOW'T; ;
gWONM;o a ,4;”WW5; mew;H g H H E
_N\<H:imwii ;£MOfiOk/)nn\g §_H n DWI/“WE
; ;
2 p E—H o o
O O
EWMWK)‘; w; WW
wherein each n is, independently, from 1 to 20; and
each p is from 1 to about 6.
In certain embodiments, each tether is selected from among:
“ta/\AN/VOwO/VLL‘I ; gl/HWE ; HHV\/\[('15- ;
ELMO/ff ; ”JR/\ONOVRL ; zl/Nmegmnd Emoaéy
In certain embodiments, each tether has the following ure:
,6 NH 3,
wherein each n is, ndently, from 1 to 20.
In n embodiments, each tether has the following structure:
0 O
2014/036460
In certain embodiments, the tether has a structure selected from among:
0 O
Wmfifi or ”mi:
, ; wherein each n is independently, O, l, 2, 3, 4, 5, 6, or 7.
In certain embodiments, the tether has a structure selected from among:
«r.
In certain embodiments, the ligand is galactose. In certain embodiments, the ligand is mannose
phosphate.
In certain embodiments, each ligand is selected from among:
Hofio OH HO O
0 Ho OH
HO 0—; R
R1 and 1
wherein each R1 is ed from OH and NHCOOH.
In certain embodiments, each ligand is selected from among:
HOOH OH HO HO
HO&/ \ HOFE;§::;§x/O OH OH
O O -O
O '0
HO O HO
”s ; #5 . \ HO ,
NHAC OH HO
: HE
HOOH
”kw \t’ Wm“HO N HO OH HOOH
mom 0“ OH
HO \ - /*2:
, HO
HO OH
OH .0
In certain embodiments, each ligand has the following structure:
HOOH
In certain ments, each ligand has the following structure:
HOOH
Ho&cofi
NHAC _
In certain embodiments, the conjugate group comprises a cell-targeting moiety.
In n embodiments, the conjugate group comprises a cell-targeting moiety having the following
structure:
HOOH
HO O A?
ACHN O5}?
HOOH \<\\ ) n
“0% WHITE/Hm)o 0
O H o
ACHN OH
HOOH
Hofiw Wo O
(‘1)5 Al)
| \O n
NHAC
wherein each n is, independently, from 1 to 20.
In certain embodiments, the argeting moiety has the following structure:
HOOH
HO O\/\/\/\ 9
ACHN O/EEIOK
HOOH
HOmOWO/fiO/moo o
ACHN OH O
NHAC
In certain embodiments, the cell-targeting moiety has the following structure:
2014/036460
HO OH
NHAc 0
Ho HN
H o
o N
NHAc 0
wherein each n is, independently, from 1 to 20.
In certain embodiments, the cell-targeting moiety has the following structure:
HO OH
H o
O HN\/\/N
NHAc
HO OH o
O H H
O N_|H
HO N\/\/N\H/\/o
NHAc o
HO HN
H o
o N
HO WY
NHAc
In certain embodiments, the cell-targeting moiety comprises:
HO OH
0 o
AcHN WY
HO OH H
o HN 5
HO M o
AcHN 0
HO OH
Hog/OM0 NH
AcHN o
In certain embodiments, the cell-targeting moiety ses:
HoOH '
O N
O o
AcHN |
OZT-OH
HoOH
O N
HO 0%
O o
AcHN |
O=Fl>—OH
HoOH
HOWO N
AcHN _§
In certain embodiments, the cell-targeting moiety comprises:
HOOH
O o N o
HO W
AcHN
HOOH O
HOW WHO o N /‘7‘
AcHN
HoOH
o N o
HO /Wfi:_H
AcHN
In certain embodiments, the cell-targeting moiety comprises:
HO OH
O NH
AcHN
HO OH
sew N o
ACHN I2 2
SgtwHOOH ZI NH
AcHN 0
HO OH
@WNACHN
In certain embodiments, the cell-targeting moiety comprises:
OH OH
H0 00 O
AcHN WNH
0th in
mfiw O
AcHN W E
N/\/\N N
o FWH
“06090OHH0
NHAC
In certain embodiments, the cell-targeting moiety comprises:
H o
OH ”NH
0 0
NHAc
In certain embodiments, the cell-targeting moiety comprises:
HoOH O
O o N
H0 10 H
AcHN o
HoOH O
0 )
o N N:3
H0 10 H H
AcHN o
HoOH
O Ii
O N
HO O
H
NHAc
In certain embodiments, the cell-targeting moiety comprises:
HOOH
HOWOVWNQ/ “PK0,15;
AcHN o o
HoOH O’BRMOaVOYo
mow,”o 0/ O o
AcHN 0
0 638
HO OH ,O/
HO 0
NHAc
In certain embodiments, the cell-targeting moiety comprises:
14/179625
HOEE:%A/o o/W7kN N
4 HA$E\H
AcHN
HoOH o N
H0%Q/o Ngk
o N H
4 HWZ/ O
AcHN
HoOH O
o/\(V>JLN 0
Ho 4 HAM?”
AcHN
HoOH o
Hog/OWNMN3 o
H H
AcHN
HoOH o N A
o N»\// M
3 H O
AcHN
HoOH O
O N/\/\ O
Ho 3 H N
AcHN
HoOH O o
o N
HO 4 H N
AcHN H
HoOH o N .a
N”\// N
O o H
HO 4 H o
AcHN
HoOH O
O o NMN O
HO 4 H H
AcHN
In certain embodiments, the cell-targeting moiety comprises:
HOOH '
HO 0mN
0 o
ACHN O—FI’ OH
HOOH
O DAWN
HO 3
o o
ACHN O—FI’ OH
HOOH
O OWN
HO 3
0 _§
AcHN
HOOH H O
O OWNWNQ
HO O O
ACHN O—|=|’-OH
HOOH
o 0%“MN
HO O O
AcHN O‘I-OH
HOOH
O o”$§\fHMN3
HO O 0—;
AcHN
In n embodiments, the cell-targeting moiety comprises:
HOOH //\OH
WWW 1O0 N
AcHN I
AcHN I
HOOH
O OWN
HO 3
O 0—;
AcHN
In certain embodiments, the cell-targeting moiety comprises:
HoOH H O /_/
Hog/W0 o
3 lo
In certain embodiments, the cell-targeting moiety comprises:
OH OH
:50» O
Ho OWOL
ACHN NH
OH OH
HOflOWNAcHN HY
In n embodiments, the cell-targeting moiety comprises:
OH OH
HO O
AcHN
In certain ments, the cell-targeting moiety comprises:
\/\/\/O\P\/OHO
AcHN 0' Y
0‘ 2
’0 O Y
O~p\
I OH fl0’ Y
I"QAcHN
wherein each Y is selected from O, S, a substituted or unsubstituted Cl-CIO alkyl, amino, substituted
amino, azido, alkenyl or alkynyl.
In certain embodiments, the conjugate group comprises:
HO$&/O\/\/\/O\P/OHO
AcHN O" \ O“ I
Y O\P’O\/\O’P\‘fs\
o O” Y
O~p\
I OH fl0’ Y
H9AcHN
wherein each Y is selected from O, S, a substituted or unsubstituted Cl-CIO alkyl, amino, substituted
amino, azido, alkenyl or alkynyl.
In certain embodiments, the ate group comprises:
HO$g/O\/\/\/O\p/EHO
ACHN o" ‘Y
wherein each Y is selected from O, S, a substituted or unsubstituted Cl-CIO alkyl, amino, substituted
amino, azido, alkenyl or alkynyl.
In certain embodiments, the conjugate group comprises:
o 71.
O O\/\/\/u\ .mO
ACHN
In n embodiments, the conjugate group comprises:
OVV\/U\ .mOH
ACHN
In certain embodiments, the conjugate group comprises:
0 _\\o—§
ACHN NWH
In certain embodiments, the conjugate group comprises:
O ,,\OH
Ho OWNH/\/\/\n/N
ACHN
O 0—?
In certain embodiments, the ate group comprises a cleavable moiety selected from among: a
phosphodiester, an amide, or an ester.
In certain embodiments, the conjugate group comprises a phosphodiester cleavable moiety.
In certain ments,the conjugate group does not comprise a cleavable moiety, and wherein the
conjugate group comprises a phosphorothioate linkage between the conjugate group and the oligonucleotide.
In certain embodiments, the conjugate group comprises an amide cleavable moiety. In certain ments,
the conjugate group comprises an ester cleavable .
In certain embodiments, the compound has the following structure:
HOOH
HO 0 4(3)
ACHN OéHo )
HOOH \<\\“
o 0
O " o O
|| 0 BX
ACHN OH OH
O 0'“ Q13
HOOH 9. JJ) HO-I"=O
0 OW/P\o
n I
11 OH A
NHAC
wherein each n is, independently, from 1 to 20;
Q13 is H or O(CH2)2-OCH3;
A is the modified oligonucleotide; and
Bx is a heterocyclic base moiety.
In certain ments, the compound has the following structure:
HOOH
Ho OW\/\ 1‘5?
ACHN O/|\O
OH K
HO OH O
O 9 i)? o O BX
OW\/\
x \ o_ —
HO O 1|) 0M0 (5H «(J
ACHN OH O o Q13
wherein each n is, independently, from 1 to 20;
Q13 is H or O(CH2)2-OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base .
In certain embodiments, the compound has the following structure:
HO-l|3=O
('3‘ Q13
HO OH (61
HO O (I?
WO’RM
A HN E o
0 OH ) 0 \Z
HO O“ n
o 0 o
0 || o
ACHN OH O 5H
“0 O” 9
0 O 0’1|)\Oii)n
HO H OH
NHAC
wherein each n is, independently, from 1 to 20;
Q13 is H or O(CH2)2-OCH3;
A is the modified oligonucleotide;
Z is H or a linked solid support; and
BX is a heterocyclic base moiety.
In certain embodiments, the compound has the following structure:
HO-l|3=O
OWBX
65 QB
HO—I|’=O
HO OH 0
HO O\/A\/“»/”\ / \%
0 (5H0 §—\b
ACHN 0 \z
( )3
HO OH 0
O 9 0—3-0
HO /\o’1|)‘o/\/\O/}V I—
ACHN 0H 0
NHAC
wherein each n is, independently, from 1 to 20;
Q13 is H or O(CH2)2-OCH3;
A is the modified oligonucleotide;
Z is H or a linked solid support; and
BX is a heterocyclic base moiety.
2014/036460
In certain embodiments, the compound has the ing structure:
OH OH
ACHN
Ol'bH in
“0%0 O K
AcHN WNMM
N M
H “fig H‘H/O\
6 HO—llazo
0 Fr
flNH O Q13
“0%on Ho—1||>=o
HO A
NHAC
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotidegand
Bx is a heterocyclic base moiety.
In certain embodiments, the compound has the ing structure:
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotidegand
Bx is a heterocyclic base moiety.
In certain embodiments, the compound has the following structure:
HOOH O
Hog/ WHJIO o N
AcHN o
HOOH O O O
AcHN o HO"?=O
wherein Q13 is H or O(CH2)2-OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the compound has the following structure:
HOOH
mkmfi043‘“I
HoOH
o &::f/ o
o HOdfO
HO r o 0
AcHN 0
§\ _‘\i_lr1k
HO OH (:1/063 9f
HO _
O O\/\/\“/N _I'D—O
HO O A
NHAc
wherein Q13 is H or 2-OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the compound has the following structure:
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the compound has the following structure:
HOOH O O
O OAHJLNMN
HO 3 H H
ACHN H O O
HOOH O N JJ\/\/u\
N N
O OAHJLNV H HW?
HO 3 H O =0
ACHN
HOOH O
O M /\/\ 0 Owa
HO¥Q/O $.-
3 M M ('3‘
ACHN HO—1ID20
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the compound has the ing structure:
HoOH O o
O OWNMN
4 H H
ACHN H O O
HOOH O W
N N
O OWN/V H HWO\
4 H O HO—1":-O
ACHN O
HOOH O
O Owa
O N/\/\ O \5'
HO Q13
4 H M 9
ACHN HO—TZO
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the compound has the following structure:
HoOH
0 CW”?
HO 3
O O
ACHN O—FI’ OH
HoOHO
HOWOW”QC
A HNC
O:—F:’—OH
O HOA::O
HOOH
HOfiwoAH/WN Q13\QBX
ACHN
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a cyclic base moiety.
In certain embodiments, the compound has the following structure:
2014/036460
HoOH O
HOEEZiA/Iflfijgo O NMNQH 3
AcHN
CIT-OH
HoOH H O
H0§Q/m 3 O
AcHN
O=T—OH
p A
HoOH HNV”§%_£;:O HOfiTO
O o/Tii§ o O
HO 3
0 _\(;ZBX
AcHN \\\\\\\\c§ Q13
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the nd has the following structure:
AcHN I
O=P-OH
HoOH F‘/3 Ho—rqa
o ()
HQ¥Q/ BX
o o”IfirwrN ‘q
3 0 L0 0‘“ 13
AcHN \\\\\\i-o
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In n embodiments, the compound has the following structure:
HoOH H o /—/
HO mvaLN3 10
AcHN I
o=FI>—OH
HoOH H O
HO mNx/WLN3 10
AcHN
OH1|%
o Ho—1|>=o
HoOH H O 7/ O O BX
HO mNVWLN \q..
3 LO 08 Q13
AcHN l
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base .
In certain embodiments, the conjugate group comprises:
HO OH
NHAC
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the conjugate group comprises:
wherein Q13 is H or O(CH2)2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, the conjugate group comprises:
wherein Q13 is H or 2—OCH3;
A is the modified oligonucleotide; and
BX is a heterocyclic base moiety.
In certain embodiments, BX is selected from among from adenine, guanine, thymine, uracil, or
cytosine, or 5-methyl ne. In certain embodiments, BX is e. In certain embodiments, BX is
thymine. In certain ments, Q13 is O(CH2)2-OCH3. In certain embodiments, Q13 is H.
In certain embodiments, the compound is in a salt form. In further embodiments, the nd
r comprises of a pharmaceutically acceptable carrier or diluent. In certain embodiments, the compound
comprises a modified oligonucleotide targeting apo(a) and a conjugate group, or a salt thereof, and a
pharmaceutically acceptable carrier or diluent.
Certain embodiments provide a composition comprising a conjugated antisense compound as
described herein, wherein the viscosity level of the compound is less than 40 centipoise (cP). In certain
embodiments, the conjugated antisense compounds as described herein are efficacious by virtue of having a
viscosity of less than 40 CF, less than 35 CF, less than 30 CF, less than 25 CF, less than 20 cP or less than 15
cP when measured by the parameters as described in Example 125.
Certain embodiments provide compositions and methods comprising administering to an animal a
conjugated antisense compound or composition disclosed herein. In certain embodiments, administering the
conjugated antisense compound prevents, treats, rates, or slows ssion of a cardiovascular,
metabolic and/or inflammatory disease
Certain embodiments provide compositions and s for use in therapy to treat an apo(a) related
disease, disorder or condition. Certain embodiments provide compositions and methods for use in therapy to
treat an Lp(a) related disease, disorder or condition. In certain embodiments, apo(a) and/or Lp(a) levels are
elevated in an animal. In certain embodiments, the composition is a compound sing an apo(a) specific
inhibitor. In certain ments, the apo(a) specific tor is a nucleic acid. In certain embodiments, the
nucleic acid is an antisense compound. In certain embodiments, the antisense nd is a modified
oligonucleotide targeting apo(a). In certain embodiments, the antisense compound is a modified
oligonucleotide targeting apo(a) and a conjugate group. In certain embodiments, the modified oligonucleotide
targeting apo(a) with the conjugate group, is used in treating, preventing, slowing progression, ameliorating a
cardiovascular and/or metabolic disease, disorder or condition. In certain embodiments, the compositions and
methods for therapy include administering an apo(a) specific tor to an individual in need thereof.
Certain embodiments provide compositions and methods for ng apo(a) levels. Certain
ments provide itions and methods for reducing Lp(a) levels. In certain embodiments, reducing
apo(a) levels in a tissue, organ or subject es the ratio of LDL to HDL or the ratio of TG to HDL.
Certain embodiments provide compositions and methods to reduce apo(a) mRNA or protein expression in an
animal sing administering to the animal a conjugated nse compound or composition disclosed
herein to reduce apo(a) mRNA or protein expression in the animal. Certain embodiments provide
compositions and methods to reduce Lp(a) levels in an animal comprising administering to the animal a
conjugated antisense compound or composition disclosed herein to reduce apo(a) mRNA or protein
expression in the animal.
Certain embodiments provide compositions and methods for preventing, treating, delaying, slowing
the progression and/or rating apo(a) related diseases, disorders, and conditions in a subject in need
thereof. Certain embodiments e itions and methods for ting, treating, delaying, slowing
the progression and/or ameliorating Lp(a) related diseases, ers, and conditions in a subject in need
thereof. In certain ments, such diseases, ers, and ions include inflammatory,
cardiovascular and/or metabolic diseases, disorders, and conditions. n such cardiovascular diseases,
disorders or conditions include, but are not limited to, aortic stenosis, aneurysm (e.g., abdominal aortic
aneurysm), , arrhythmia, atherosclerosis, cerebrovascular disease, coronary artery disease, coronary
heart disease, dyslipidemia, hypercholesterolemia, hyperlipidemia, hypertension, hypertriglyceridemia,
myocardial infarction, peripheral vascular disease (e.g., peripheral artery disease, eral artery occlusive
disease), retinal vascular occlusion, or stroke. Certain such metabolic diseases, disorders or conditions
include, but are not limited to, hyperglycemia, prediabetes, diabetes (type I and type II), obesity, insulin
resistance, metabolic syndrome and diabetic dyslipidemia. Certain such inflammatory diseases, ers or
conditions include, but are not limited to, aortic stenosis, coronary artey disease (CAD), Alzheimer’s Disease
and thromboembolic diseases, disorder or conditions. n thromboembolic diseases, disorders or
conditions include, but are not limited to, stroke, thrombosis (e.g., venous thromboembolism), myocardial
infarction and peripheral vascular disease. n embodiments provide itions and methods for
ting, treating, delaying, slowing the ssion and/or ameliorating aortic stenosis.
Certain embodiments e a method of ng at least one symptom of a cardiovascular disease,
disorder or condition. In n embodiments, the ms e, but are not limited to, angina, chest
pain, shortness of breath, palpitations, weakness, dizziness, nausea, sweating, tachycardia, bradycardia,
arrhythmia, atrial fibrillation, swelling in the lower extremities, cyanosis, fatigue, fainting, numbness of the
face, numbness of the limbs, claudication or cramping of muscles, bloating of the abdomen, and fever.
Certain embodiments provide a method of reducing at least one symptom of aortic stenosis.
In certain embodiments, the modulation of apo(a) or Lp(a) expression occurs in a cell, tissue or
organ. In certain embodiments, the modulations occur in a cell, tissue or organ in an animal. In n
embodiments, the modulation is a reduction in apo(a) mRNA level. In certain embodiments, the modulation
is a reduction in apo(a) protein level. In certain embodiments, both apo(a) mRNA and n levels are
reduced. In certain ments, the modulation is a reduction in Lp(a) level. Such reduction may occur in a
ependent or in a dose-dependent manner.
In certain embodiments, the subject or animal is human.
In certain embodiments, the conjugated nse compound is parenterally administered. In further
embodiments, the parenteral administration is subcutaneous.
In certain embodiments, the conjugated antisense compound or composition is co-administered with
a second agent or therapy. In certain embodiments, the conjugated antisense compound or composition and
the second agent are administered concomitantly.
In certain ments, the second agent is a e-lowering agent. In certain embodiments, the
second agent is a LDL, TG or cholesterol lowering agent. In certain embodiments, the second agent is an
anti-inflammatory agent. In certain embodiments, the second agent is an Alzheimer e drug. In certain
embodiments, the second agent can be, but is not limited to, a non-steroidal anti-inflammatory drug (NSAID
e. g., aspirin), niacin (e. g., Niaspan), nicotinic acid, an apoB inhibitor (e. g., Mipomersen), a CETP inhibitor
(e. g., Anacetrapib), an apo(a) tor, a thyroid hormone analog (e. g., Eprotirome), a HMG-CoA reductase
inhibitor (e. g., a statin), a fibrate (e.g., Gemflbrozil) and an microsomal triglyceride transfer protein inhibitor
(e. g., Lomitapide). The therapy can be, but is not limited to, Lp(a) apheresis. Agents or therapies can be co-
administered or administered concomitantly. Agents or therapies can be sequentially or subsequently
stered.
Certain embodiments provide use of a conjugated antisense compound targeted to apo(a) for
decreasing apo(a) levels in an animal. Certain embodiments provide use of a conjugated nse compound
targeted to apo(a) for decreasing Lp(a) levels in an animal. Certain embodiments provide use of a conjugated
nse compounds targeted to apo(a) for the treatment, prevention, or amelioration of a disease, er,
or condition associated with apo(a). Certain embodiments provide use of a conjugated antisense nds
ed to apo(a) for the treatment, prevention, or amelioration of a disease, disorder, or condition ated
With Lp(a).
Certain embodiments provide use of a conjugated antisense compound targeted to apo(a) in the
ation of a medicament for decreasing apo(a) levels in an . Certain embodiments provide use of a
conjugated antisense compound targeted to apo(a) in the preparation of a medicament for decreasing Lp(a)
levels in an . n embodiments provide use of a conjugated antisense compound for the preparation
of a medicament for the treatment, prevention, or amelioration of a disease, er, or condition ated
With apo(a). Certain ments provide use of a conjugated antisense compound for the preparation of a
medicament for the treatment, prevention, or amelioration of a disease, disorder, or condition associated With
Lp(a).
Certain embodiments provide the use of a conjugated antisense compound as described herein in the
manufacture of a medicament for ng, ameliorating, delaying or preventing one or more of a disease
related to apo(a) and/or Lp(a).
Certain embodiments provide a kit for treating, preventing, or ameliorating a disease, disorder or
condition as described herein Wherein the kit comprises: (i) an apo(a) specific inhibitor as described herein;
and optionally (ii) a second agent or therapy as described herein.
A kit of the t invention can further include instructions for using the kit to treat, prevent, or
ameliorate a disease, disorder or condition as described herein by combination therapy as bed herein.
B. Certain Compounds
In certain embodiments, the ion provides conjugated antisense compounds comprising
antisense oligonucleoitdes and a conjugate.
a. n Antisense Oligonucleotides
In certain embodiments, the invention provides antisense oligonucleotides. Such antisense
oligonucleotides comprise linked nucleosides, each nucleoside comprising a sugar moiety and a nucleobase.
The structure of such antisense oligonucleotides may be ered in terms of chemical features (e.g.,
modifications and patterns of modifications) and nucleobase sequence (e.g., sequence of antisense
oligonucleotide, idenity and sequence of target nucleic acid).
i. Certain Chemistry Features
In n embodiments, antisense oligonucleotide comprise one or more ation. In certain
such embodiments, antisense oligonucleotides comprise one or more modified nucleosides and/or modified
internucleoside linkages. In certain embodiments, modified nucleosides comprise a d sugar moirty
and/or modifed base.
1. Certain Sugar Moieties
In n embodiments, compounds of the disclosure comprise one or more modifed nucleosides
comprising a modifed sugar moiety. Such compounds comprising one or more sugar-modified nucleosides
may have desirable properties, such as enhanced se stability or increased binding affinity with a target
nucleic acid relative to an ucleotide comprising only nucleosides comprising naturally occurring sugar
moieties. In certain embodiments, modified sugar moieties are substitued sugar moieties. In certain
embodiments, modified sugar es are sugar surrogates. Such sugar surrogates may comprise one or
more substitutions corresponding to those of substituted sugar moieties.
In certain ments, modified sugar moieties are substituted sugar moieties comprising one or
more non-bridging sugar substituent, including but not d to substituents at the 2’ and/or 5’ positions.
Examples of sugar substituents suitable for the 2’-position, include, but are not limited to: 2’-F, 2'-OCH3
(“OMe” or “O-methyl”), and 2'-O(CH2)20CH3 ). In certain ments, sugar substituents at the 2’
position is selected from allyl, amino, azido, thio, O-allyl, O-Cl-Clo alkyl, O-Cl-Clo substituted alkyl, OCF3,
O(CH2)ZSCH3, O(CH2)2-O-N(Rm)(Rn), and O-CH2-C(=O)-N(Rm)(Rn), Where each Rm and Rn is,
ndently, H or substituted or unsubstituted C1-C10 alkyl. Examples of sugar tuents at the 5’-
position, include, but are not limited to:, 5’-methyl (R or S); 5'-Vinyl, and 5’-methoxy. In certain
embodiments, substituted sugars comprise more than one non-bridging sugar substituent, for example, 2'-F-
5'-methyl sugar moieties (see,e.g., PCT International Application WO 01 157, for additional 5', 2'-bis
substituted sugar moieties and nucleosides).
Nucleosides comprising 2’-substituted sugar moieties are referred to as 2’-substituted nucleosides. In
certain embodiments, a 2’- substituted nucleoside comprises a 2'-substituent group selected from halo, allyl,
amino, azido, SH, CN, OCN, CF3, OCF3, O, S, or N(Rm)-alkyl; O, S, or N(Rm)-alkenyl; O, S or N(Rm)-
alkynyl, lenyl-O-alkyl, alkynyl, alkaryl, aralkyl, O-alkaryl, O-aralkyl, 2SCH3, O-(CH2)2-O-
N(Rm)(Rn) or O-CH2-C(=O)-N(Rm)(Rn), Where each RIn and RI1 is, independently, H, an amino protecting
group or substituted or unsubstituted C1-C10 alkyl. These stituent groups can be further substituted With
one or more substituent groups independently selected from hydroxyl, amino, alkoxy, carboxy, benzyl,
phenyl, nitro (N02), thiol, thioalkoxy (S-alkyl), halogen, alkyl, aryl, alkenyl and alkynyl.
In certain embodiments, a 2’- substituted nucleoside comprises a 2’-substituent group selected from
F, NHg, N3, OCF3, O-CHg, 0(CH2)3NH2, CHg-CHZCHz, O'CHQ'CHZCHZ, QOCHg, O(CH2)2$CH3,
)2-O-N(Rm)(Rn), O(CH2)20(CH2)2N(CH3)2, and tituted acetamide (O-CHg-C(=O)-N(Rm)(Rn)
Where each RIn and R11 is, ndently, H, an amino protecting group or substituted or tituted C1-C10
alkyl.
In certain embodiments, a 2’- substituted nucleoside comprises a sugar moiety comprising a 2’-
substituent group ed from F, OCFg, O-CH3, OCHQCHQOCH3, O(CH2)2SCH3, O-(CH2)2-ON
(CH3)2, -O(CH2)20(CH2)2N(CH3)2, and O-CHg-C(=O)-N(H)CH3.
In certain embodiments, a 2’- substituted side ses a sugar moiety comprising a 2’-
substituent group selected from F, O-CH3, and OCHQCHQOCH3.
Certain modifed sugar moieties comprise a bridging sugar substituent that forms a second ring
resulting in a bicyclic sugar moiety. In certain such embodiments, the bicyclic sugar moiety comprises a
bridge between the 4' and the 2' furanose ring atoms. Examples of such 4’ to 2’ sugar substituents, include,
but are not limited to: '[C(Ra)(Rb)]n-, '[C(Ra)(Rb)]n'O', -C(RaRb)-N(R)-O- or, —C(RaRb)-O-N(R)-; 4'-CH2-2',
4'-(CH2)2-2', 4'-(CH2)3-2',. 4'-(CH2)-O-2' (LNA); 4'-(CH2)-S-2'; 4'-(CH2)2-O-2' (ENA); 4'-CH(CH3)-O-2'
(cEt) and 4'-CH(CH20CH3)-O-2',and analogs thereof (see, e.g., US. Patent 7,399,845, issued on July 15,
2008); 4'-C(CH3)(CH3)-O-2'and analogs thereof, (see, e.g., WO2009/006478, published January 8, 2009); 4'-
CHZ-N(OCH3)-2' and analogs thereof (see, e.g., /150729, published December 11, 2008); 4'-CH2-O-
-2' (see, e.g., US2004/0171570, hed September 2, 2004 ); 4'-CH2-O-N(R)-2', and 4'-CH2-N(R)-
O-2'-, Wherein each Ris, independently, H, a protecting group, or C1-C12 alkyl; 4'-CH2-N(R)-O-2', Wherein R
is H, C1-C12 alkyl, or a protecting group (see, US. Patent 7,427,672, issued on September 23, 2008); 4'-CH2-
C(H)(CH3)-2' (see, e.g., Chattopadhyaya, et al., J. Org. Chem.,2009, 74, 118-134); and 4'-CH2-C(=CH2)-2'
and analogs thereof (see, published PCT International Application WC 2008/154401, published on December
8, 2008).
In certain embodiments, such 4’ to 2’ bridges independently comprise from 1 to 4 linked groups
independently ed from -[C(Ra)(Rb)]n-, -C(Ra)=C(Rb)-, -C(Ra)=N-, -C(=NRa)-, -C(=O)-, -C(=S)-, -O-, -
Si(Ra)2-, -S(=0)x-, and 'N(Ra)';
Wherein:
X is 0, l, or 2;
nis l, 2, 3, or4;
each R2, and Rb is, independently, H, a protecting group, yl, C1-C12 alkyl, substituted C1-C12
alkyl, C2-C12 alkenyl, substituted C2-C12 alkenyl, C2-C12 alkynyl, substituted C2-C12 alkynyl, C5-C20 aryl,
substituted C5-C20 aryl, heterocycle radical, substituted heterocycle radical, heteroaryl, substituted heteroaryl,
C5-C7 alicyclic radical, substituted C5-C7 alicyclic radical, halogen, OJ 1, NJ1J2, SJ 1, N3, COOJ1, acyl -
H), substituted acyl, CN, sulfonyl (S(=O)2-J1), or yl (S(=O)-J1); and
each J1 and J2 is, independently, H, C1-C12 alkyl, substituted C1-C12 alkyl, C2-C12 alkenyl, substituted
C2-C12 l, C2-C12 alkynyl, substituted C2-C12 l, C5-C20 aryl, substituted C5-C20 aryl, acyl (C(=O)-
H), substituted acyl, a heterocycle radical, a substituted heterocycle radical, C1-C12 aminoalkyl, substituted
2014/036460
C1-C12 aminoalkyl, or a protecting group.
Nucleosides comprising ic sugar moieties are referred to as bicyclic nucleosides or BNAs.
Bicyclic nucleosides include, but are not limited to, (A) (x-L-Methyleneoxy (4’-CH2-O-2’) BNA , (B) B-D-
Methyleneoxy (4’-CH2-O-2’) BNA (also referred to as locked nucleic acid or LNA) , (C) Ethyleneoxy (4’-
(CH2)2-O-2’) BNA , (D) Aminooxy (4’-CH2-O-N(R)-2’) BNA, (E) Oxyamino (4’-CH2-N(R)-O-2’) BNA, (F)
Methyl(methyleneoxy) (4’-CH(CH3)-O-2’) BNA (also referred to as ained ethyl or cEt), (G)
methylene-thio (4’-CH2-S-2’) BNA, (H) methylene-amino (4’-CH2-N(R)-2’) BNA, (1) methyl carbocyclic
(4’-CH2-CH(CH3)-2’) BNA, and (J) ene yclic (4’-(CH2)3-2’) BNA as depicted below.
wherein BX is a nucleobase moiety and R is, independently, H, a protecting group, or C1-C12 alkyl.
Additional ic sugar es are known in the art, for example: Singh et al., Chem. Commun,
1998, 4, 455-456; Koshkin et al., Tetrahedron, 1998, 54, 3607-3630; Wahlestedt et al., Proc. Natl. Acad. Sci.
U. S. A., 2000, 97, 5633-5638; Kumar et al., Bioorg. Med. Chem. Lett., 1998, 8, 2219-2222; Singh et al., J.
Org. Chem., 1998, 63, 10035-10039; Srivastava et al., J. Am. Chem. Soc., 129(26) 8362-8379 (Jul. 4, 2007);
Elayadi et al., Curr. Opinion Invens. Drugs, 2001, 2, 558-561; Braasch et al., Chem. Biol, 2001, 8, 1-7;
Orum et al., Curr. Opinion Mo]. Ther., 2001, 3, 239-243; US. Patent Nos. 7,053,207, 6,268,490, 6,770,748,
6,794,499, 7,034,133, 6,525,191, 6,670,461, and 7,399,845; WO 06356, WO 1994/14226, WO
2005/021570, and ; US. Patent Publication Nos. US2004/0171570, US2007/0287831, and
US2008/0039618; US. Patent Serial Nos. 12/129,154, ,574, 61/026,995, 61/026,998, 61/056,564,
61/086,231, 61/097,787, and 61/099,844; and PCT International Applications Nos. ,
, and .
In certain embodiments, ic sugar moieties and nucleosides incorporating such bicyclic sugar
moieties are further defined by ic configuration. For example, a nucleoside comprising a 4’-2’
ene-oxy bridge, may be in the (x-L configuration or in the B-D configuration. usly, (x-L-
methyleneoxy (4’-CH2-O-2’) bicyclic nucleosides have been incorporated into antisense oligonucleotides that
showed antisense activity (Frieden et al., c Acids Research, 2003, 21, 6365-6372).
In certain embodiments, substituted sugar moieties comprise one or more non-bridging sugar
substituent and one or more bridging sugar tuent (e. g., 5’-substituted and 4’-2’ bridged sugars). (see,
PCT International ation , published on 11/22/07, wherein LNA is substituted with,
for example, a 5'-methyl or a 5'-Vinyl group).
In certain embodiments, modified sugar moieties are sugar surrogates. In certain such embodiments,
the oxygen atom of the naturally occuring sugar is substituted, e. g., with a , carbon or nitrogen atom. In
certain such embodiments, such modified sugar moiety also comprises bridging and/or non-bridging
substituents as described above. For example, certain sugar surrogates se a 4’-sulfer atom and a
substitution at the 2'-position (see,e.g., hed US. Patent Application /0130923, published on
June 16, 2005) and/or the 5’ position. By way of onal example, yclic bicyclic nucleosides having
a 4'-2' bridge have been described (see, e. g., Freier et al., Nucleic Acids Research, 1997, 25(22), 4429-4443
and Albaek et al., J. Org. Chem., 2006, 71, 7731-7740).
In certain embodiments, sugar surrogates comprise rings haVing other than 5-atoms. For e, in
certain embodiments, a sugar surrogate ses a morphlino. Morpholino compounds and their use in
oligomeric compounds has been reported in numerous patents and published articles (see for example:
Braasch et al., Biochemistry, 2002, 41, 4503-4510; and US. Patents 5,698,685; 5,166,315; 5,185,444; and
5,034,506). As used here, the term “morpholino” means a sugar surrogate having the following structure:
ijiBx
In certain embodiments, morpholinos may be modified, for example by adding or altering various substituent
groups from the above morpholino structure. Such sugar surrogates are d to herein as “modifed
morpholinos.”
For another example, in certain embodiments, a sugar surrogate comprises a six-membered
tetrahydropyran. Such tetrahydropyrans may be further modified or substituted. Nucleosides comprising
such modified tetrahydropyrans include, but are not limited to, hexitol nucleic acid (HNA), anitol nucleic
acid (ANA), manitol nucleic acid (MNA) (see Leumann, CJ. . & Med. Chem. (2002) 10:841-854),
fluoro HNA (F-HNA), and those compounds having Formula VI:
q1 q2
T3_0 q3
q7 C14
C16 BX
/ R1 q5
wherein independently for each of said at least one tetrahydropyran nucleoside analog of a VI:
BX is a nucleobase moiety;
T3 and T4 are each, independently, an ucleoside linking group linking the tetrahydropyran
nucleoside analog to the antisense compound or one of T3 and T4 is an internucleoside linking group linking
the tetrahydropyran nucleoside analog to the antisense nd and the other of T3 and T4 is H, a hydroxyl
protecting group, a linked conjugate group, or a 5' or 3'—terminal group;
q, (12, q3, q4, q5, q6 and q7 are each, independently, H, C1-C6 alkyl, substituted C1-C6 alkyl, C2-C6 alkenyl,
substituted C2-C6 alkenyl, C2-C6 alkynyl, or substituted C2-C6 alkynyl, and
each of R1 and R2 is independently ed from among: en, halogen, substituted or
tituted alkoxy, NJ1J2, SJ1, N3, OC(=X)J1, OC(=X)NJ1J2, NJ3C(=X)NJ1J2, and CN, wherein X is O, S or
NJ1, and each J1, J2, and J3 is, independently, H or C1-C6 alkyl.
In certain embodiments, the modified THP nucleosides of Formula VI are provided wherein ql, C12,
q3, q4, q5, q6 and q7 are each H. In certain embodiments, at least one of ql, C12, q3, q4, q5, q6 and q7 is other than
H. In certain embodiments, at least one of ql, C12, q3, q4, q5, q6 and q7 is methyl. In certain embodiments, THP
nucleosides of Formula VI are provided wherein one of R1 and R2 is F. In certain embodiments, R1 is fluoro
and R2 is H, R1 is methoxy and R2 is H, and R1 is methoxyethoxy and R2 is H.
Many other bicyclo and tricyclo sugar surrogate ring systems are also known in the art that can be
used to modify nucleosides for incorporation into antisense compounds (see, e. g., review article: Leumann, J.
C, Bioorganic & Medicinal Chemistry, 2002, 10, 4).
Combinations of modifications are also provided without limitation, such as 2'-F-5'-methyl
substituted sides (see PCT International Application 157 Published on 8/21/08 for other
disclosed 5', 2'-bis substituted nucleosides) and replacement of the ribosyl ring oxygen atom with S and
further substitution at the 2'-position (see published US. Patent Application US2005-0130923, published on
June 16, 2005) or alternatively 5'-substitution of a bicyclic nucleic acid (see PCT International Application
, published on 11/22/07 n a 4'—CH2-O-2' bicyclic nucleoside is fiirther substituted at
the 5' position with a hyl or a 5'-vinyl . The synthesis and preparation of carbocyclic bicyclic
nucleosides along with their oligomerization and biochemical studies have also been described (see, e. g.,
Srivastava et al., J. Am. Chem. Soc. 2007, 129(26), 8362-8379).
In certain embodiments, the present disclosure provides oligonucleotides comprising modified nucleosides.
Those modified nucleotides may include modified sugars, modified nucleobases, and/or modified es.
The specific modifications are selected such that the resulting oligonucleotides possess desireable
teristics. In n embodmiments, oligonucleotides comprise one or more RNA-like nucleosides. In
certain embodiments, ucleotides comprise one or more DNA-like nucleotides.
2. Certain Nucleobase Modifications
In certain embodiments, nucleosides of the present disclosure comprise one or more unmodified
nucleobases. In certain embodiments, nucleosides of the present sure comprise one or more modifed
nucleobases.
In certain ments, modified nucleobases are selected from: universal bases, hydrophobic bases,
promiscuous bases, xpanded bases, and fiuorinated bases as defined . 5-substituted pyrimidines,
6-azapyrimidines and N—2, N—6 and 0-6 substituted purines, including opropyladenine, 5-
propynyluracil; 5-propynylcytosine; oxymethyl cytosine, xanthine, nthine, 2-aminoadenine, 6-
methyl and other alkyl derivatives of adenine and guanine, 2-propyl and other alkyl derivatives of adenine
and guanine, 2-thiouracil, 2-thiothymine and 2-thiocytosine, 5-halouracil and cytosine, 5-propynyl (-CEC-
CH3) uracil and cytosine and other alkynyl tives of pyrimidine bases, 6-azo uracil, cytosine and
thymine, 5-uracil (pseudouracil), 4-thiouracil, 8-halo, 8-amino, 8-thiol, 8-thioa1kyl, 8-hydroxyl and other 8-
tuted adenines and guanines, 5-halo particularly 5-bromo, 5-trifluoromethyl and other 5-substituted
uracils and cytosines, 7-methylguanine and 7-methyladenine, 2-F-adenine, 2-amino-adenine, 8-azaguanine
and 8-azaadenine, aguanine and 7-deazaadenine, aguanine and 3-deazaadenine, universal bases,
hydrophobic bases, promiscuous bases, xpanded bases, and fiuorinated bases as defined herein. Further
modified nucleobases include tricyclic pyrimidines such as phenoxazine cytidine( [5,4-b][1,4]benzoxazin—
2(3H)-one), phenothiazine cytidine (1H-pyrimido[5,4-b][1,4]benzothiazin-2(3H)-one), G-clamps such as a
substituted phenoxazine cytidine (e. g. 9-(2-aminoethoxy)-H-pyrimido[5,4-b][1,4]benzoxazin—2(3H)-one),
carbazole cytidine (2H-pyrimido[4,5-b]indolone), pyridoindole cytidine (H-pyrido[3',2':4,5]pyrrolo[2,3-
d]pyrimidin—2-one). Modified nucleobases may also include those in Which the purine or dine base is
replaced With other heterocycles, for example 7-deaza-adenine, 7-deazaguanosine, 2-aminopyridine and 2-
pyridone. Further nucleobases include those disclosed in United States Patent No. 3,687,808, those disclosed
in The Concise Encyclopedia Of Polymer Science And Engineering, WitZ, J.I., Ed., John Wiley &
Sons, 1990, 85 8-859; those disclosed by Englisch et al., Angewandte Chemie, International Edition, 1991, 30,
613; and those disclosed by Sanghvi, Y.S., Chapter 15, Antisense Research and Applications, Crooke, S.T.
and Lebleu, B., Eds., CRC Press, 1993, 273-288.
Representative United States patents that teach the preparation of certain of the above noted modified
nucleobases as well as other modified nucleobases include Without limitation, US. 3,687,808; 4,845,205;
,130,302; 5,134,066; 5,175,273; 5,367,066; 5,432,272; 5,457,187; 5,459,255; 5,484,908; 5,502,177;
,525,711; 5,552,540; 5,587,469; 5,594,121; 5,596,091; 5,614,617; 5,645,985; 5,681,941; 5,750,692;
,763,588; 5,830,653 and 6,005,096, certain of which are ly owned with the instant application, and
each of which is herein incorporated by reference in its entirety.
3. Certain Internucleoside Linkages
In certain embodiments, the t disclosure provides oligonucleotides comprising linked
sides. In such embodiments, nucleosides may be linked together using any intemucleoside linkage.
The two main s of internucleoside linking groups are defined by the presence or absence of a
phosphorus atom. entative phosphorus containing intemucleoside linkages include, but are not limited
to, phosphodiesters (PO), phosphotriesters, methylphosphonates, phosphoramidate, and phosphorothioates
(PS). Representative non-phosphorus containing internucleoside linking groups include, but are not limited
to, methylenemethylimino (-CH2-N(CH3)-O-CH2-), thiodiester (-O-C(O)-S-), thionocarbamate (-OC
(O)(NH)-S-); siloxane (-O-Si(H)2-O-); and N,N'-dimethylhydrazine N(CH3)-N(CH3)-). ed
linkages, compared to l phosphodiester linkages, can be used to alter, typically increase, nuclease
resistance of the ucleotide. In certain embodiments, internucleoside linkages having a chiral atom can
be ed as a racemic mixture, or as separate enantiomers. Representative chiral linkages e, but are
not limited to, alkylphosphonates and phosphorothioates. s of preparation of phosphorous-containing
and non-phosphorous-containing internucleoside es are well known to those skilled in the art.
The oligonucleotides described herein contain one or more asymmetric centers and thus give rise to
enantiomers, reomers, and other stereoisomeric configurations that may be defined, in terms of absolute
stereochemistry, as (R) or (S), a or b such as for sugar anomers, or as (D) or (L) such as for amino acids etc.
Included in the antisense compounds provided herein are all such le isomers, as well as their racemic
and optically pure forms.
Neutral internucleoside linkages include without limitation, phosphotriesters, methylphosphonates,
MMI 2-N(CH3)-O-5'), amide-3 (3'-CH2-C(=O)-N(H)-5'), amide-4 (3'-CH2-N(H)-C(=O)-5'), formacetal
(3'-O-CH2-O-5'), and thioformacetal (3'-S-CH2-O-5'). Further neutral ucleoside linkages include
nonionic linkages comprising siloxane (dialkylsiloxane), carboxylate ester, carboxamide, sulfide, sulfonate
ester and amides (See for example: Carbohydrate Modifications in Antisense Research; Y.S. Sanghvi and
PD. Cook, Eds., ACS ium Series 580; Chapters 3 and 4, . Further neutral intemucleoside
linkages include nonionic linkages comprising mixed N, O, S and CH2 component parts.
4. Certain Motifs
In certain embodiments, nse oligonucleotides comprise one or more modified side (e.g.,
nucleoside comprising a modified sugar and/or modified nucleobase) and/or one or more modified
internucleoside linkage. The pattern of such modifications on an oligonucleotide is referred to herein as a
motif. In certain embodiments, sugar, nucleobase, and linkage motifs are independent of one another.
a. Certain sugar motifs
In certain embodiments, oligonucleotides comprise one or more type of ed sugar moieties
and/or naturally occurring sugar moieties arranged along an oligonucleotide or region thereof in a defined
pattern or sugar modif1cation motif. Such motifs may include any of the sugar modifications discussed herein
and/or other known sugar modifications.
In certain embodiments, the ucleotides comprise or consist of a region haVing a gapmer sugar
motif, which comprises two external s or “wings” and a central or internal region or “gap.” The three
regions of a gapmer sugar motif (the 5’-wing, the gap, and the 3’-wing) form a contiguous sequence of
nucleosides wherein at least some of the sugar moieties of the sides of each of the wings differ from at
least some of the sugar moieties of the nucleosides of the gap. Specifically, at least the sugar moieties of the
nucleosides of each wing that are closest to the gap (the 3’-most nucleoside of the 5’-wing and the 5’-most
nucleoside of the 3’-wing) differ from the sugar moiety of the neighboring gap nucleosides, thus defining the
ry n the wings and the gap. In n embodiments, the sugar moieties within the gap are the
same as one another. In certain embodiments, the gap includes one or more nucleoside having a sugar moiety
that differs from the sugar moiety of one or more other nucleosides of the gap. In n embodiments, the
sugar motifs of the two wings are the same as one another (symmetric sugar gapmer). In certain
embodiments, the sugar motifs of the 5'-wing differs from the sugar motif of the g (asymmetric sugar
gapmer).
i. Certain 5’-wings
In certain embodiments, the 5’- wing of a gapmer consists of l to 8 linked nucleosides. In certain
embodiments, the 5’- wing of a gapmer consists of l to 7 linked nucleosides. In certain embodiments, the 5’-
wing of a gapmer consists of l to 6 linked nucleosides. In certain embodiments, the 5’- wing of a gapmer
ts of l to 5 linked nucleosides. In certain embodiments, the 5’- wing of a gapmer consists of 2 to 5
linked nucleosides. In certain ments, the 5’- wing of a gapmer consists of 3 to 5 linked nucleosides.
In n embodiments, the 5’- wing of a gapmer consists of 4 or 5 linked nucleosides. In certain
embodiments, the 5’- wing of a gapmer consists of 1 to 4 linked nucleosides. In certain embodiments, the 5’-
wing of a gapmer consists of l to 3 linked nucleosides. In certain embodiments, the 5’- wing of a gapmer
consists of l or 2 linked nucleosides. In certain embodiments, the 5’- wing of a gapmer consists of 2 to 4
linked nucleosides. In certain embodiments, the 5’- wing of a gapmer consists of 2 or 3 linked nucleosides.
In certain embodiments, the 5’- wing of a gapmer consists of 3 or 4 linked nucleosides. In certain
ments, the 5’- wing of a gapmer consists of l nucleoside. In certain ments, the 5’- wing of a
gapmer consists of 2 linked nucleosides. In certain embodiments, the 5’- wing of a gapmer consists of 3
linked nucleosides. In certain embodiments, the 5’- wing of a gapmer consists of 4 linked nucleosides. In
certain embodiments, the 5’- wing of a gapmer consists of 5 linked nucleosides. In certain embodiments, the
’- wing of a gapmer consists of 6 linked nucleosides.
In certain embodiments, the 5’- wing of a gapmer comprises at least one bicyclic nucleoside. In
certain ments, the 5’- wing of a gapmer comprises at least two bicyclic nucleosides. In certain
embodiments, the 5’- Wing of a gapmer ses at least three bicyclic nucleosides. In certain
embodiments, the 5’- Wing of a gapmer comprises at least four bicyclic nucleosides. In certain embodiments,
the 5’- Wing of a gapmer comprises at least one constrained ethyl nucleoside. In certain ments, the 5’-
Wing of a gapmer comprises at least one LNA nucleoside. In certain embodiments, each nucleoside of the 5’-
Wing of a gapmer is a bicyclic nucleoside. In certain embodiments, each nucleoside of the 5’- Wing of a
gapmer is a constrained ethyl nucleoside. In certain embodiments, each nucleoside of the 5’- Wing of a
gapmer is a LNA nucleoside.
In certain ments, the 5’- Wing of a gapmer comprises at least one non-bicyclic modified
nucleoside. In n embodiments, the 5’- Wing of a gapmer comprises at least one 2’-substituted
nucleoside. In certain embodiments, the 5’- Wing of a gapmer comprises at least one 2’-MOE side. In
certain embodiments, the 5’- Wing of a gapmer comprises at least one 2’-OMe nucleoside. In certain
embodiments, each nucleoside of the 5’- Wing of a gapmer is a non-bicyclic modified nucleoside. In certain
embodiments, each nucleoside of the 5’- Wing of a gapmer is a 2’-substituted side. In certain
embodiments, each nucleoside of the 5’- Wing of a gapmer is a 2’-MOE nucleoside. In certain embodiments,
each nucleoside of the 5’- Wing of a gapmer is a 2’-OMe nucleoside.
In certain embodiments, the 5’- Wing of a gapmer comprises at least one 2’-deoxynucleoside. In
certain embodiments, each nucleoside of the 5’- Wing of a gapmer is a 2’-deoxynucleoside. In a certain
embodiments, the 5’- Wing of a gapmer comprises at least one ribonucleoside. In n embodiments, each
nucleoside of the 5’- Wing of a gapmer is a ribonucleoside. In certain embodiments, one, more than one, or
each of the nucleosides of the 5’- Wing is an RNA-like nucleoside.
In certain embodiments, the 5’-Wing of a gapmer comprises at least one ic nucleoside and at
least one non-bicyclic modified nucleoside. In certain embodiments, the 5’-Wing of a gapmer ses at
least one bicyclic side and at least one 2’-substituted nucleoside. In certain embodiments, the 5’-Wing
of a gapmer comprises at least one bicyclic nucleoside and at least one 2’-MOE nucleoside. In certain
embodiments, the 5’-Wing of a gapmer ses at least one bicyclic nucleoside and at least one 2’-OMe
nucleoside. In certain embodiments, the 5’-Wing of a gapmer comprises at least one bicyclic nucleoside and
at least one xynucleoside.
In certain embodiments, the 5’-Wing of a gapmer comprises at least one constrained ethyl nucleoside
and at least one non-bicyclic d nucleoside. In certain embodiments, the 5’-Wing of a gapmer
ses at least one constrained ethyl nucleoside and at least one 2’-substituted nucleoside. In certain
embodiments, the 5’-Wing of a gapmer comprises at least one constrained ethyl nucleoside and at least one
2’-MOE nucleoside. In certain embodiments, the 5’-Wing of a gapmer comprises at least one constrained
ethyl nucleoside and at least one 2’-OMe nucleoside. In certain embodiments, the 5’-Wing of a gapmer
comprises at least one ained ethyl side and at least one 2’-deoxynucleoside.
ii. Certain 3’-wings
In certain embodiments, the 3’- wing of a gapmer ts of l to 8 linked nucleosides. In certain
embodiments, the 3’- wing of a gapmer consists of l to 7 linked nucleosides. In certain embodiments, the 3’-
wing of a gapmer consists of l to 6 linked nucleosides. In certain embodiments, the 3’- wing of a gapmer
consists of l to 5 linked nucleosides. In certain embodiments, the 3’- wing of a gapmer consists of 2 to 5
linked nucleosides. In certain embodiments, the 3’- wing of a gapmer consists of 3 to 5 linked nucleosides.
In n embodiments, the 3’- wing of a gapmer consists of 4 or 5 linked nucleosides. In certain
embodiments, the 3’- wing of a gapmer ts of 1 to 4 linked nucleosides. In certain ments, the 3’-
wing of a gapmer consists of l to 3 linked nucleosides. In n embodiments, the 3’- wing of a gapmer
consists of l or 2 linked nucleosides. In certain embodiments, the 3’- wing of a gapmer consists of 2 to 4
linked nucleosides. In certain embodiments, the 3’- wing of a gapmer consists of 2 or 3 linked nucleosides.
In certain ments, the 3’- wing of a gapmer consists of 3 or 4 linked nucleosides. In certain
embodiments, the 3’- wing of a gapmer consists of l side. In certain embodiments, the 3’- wing of a
gapmer consists of 2 linked nucleosides. In certain embodiments, the 3’- wing of a gapmer ts of
31inked nucleosides. In certain embodiments, the 3’- wing of a gapmer consists of 4 linked nucleosides. In
certain embodiments, the 3’- wing of a gapmer ts of 5 linked nucleosides. In certain embodiments, the
3’- wing of a gapmer consists of 6 linked nucleosides.
In n ments, the 3’- wing of a gapmer comprises at least one bicyclic nucleoside. In
certain embodiments, the 3’- wing of a gapmer comprises at least one constrained ethyl nucleoside. In certain
embodiments, the 3’- wing of a gapmer comprises at least one LNA nucleoside. In certain embodiments,
each nucleoside of the 3’- wing of a gapmer is a ic nucleoside. In certain ments, each
nucleoside of the 3’- wing of a gapmer is a constrained ethyl nucleoside. In certain embodiments, each
nucleoside of the 3’- wing of a gapmer is a LNA nucleoside.
In n embodiments, the 3’- wing of a gapmer comprises at least one non-bicyclic modified
nucleoside. In certain embodiments, the 3’- wing of a gapmer comprises at least two non-bicyclic modified
nucleosides. In certain embodiments, the 3’- wing of a gapmer comprises at least three non-bicyclic modified
nucleosides. In certain embodiments, the 3’- wing of a gapmer comprises at least four non-bicyclic modified
nucleosides. In certain embodiments, the 3’- wing of a gapmer comprises at least one 2’-substituted
nucleoside. In certain embodiments, the 3’- wing of a gapmer comprises at least one 2’-MOE nucleoside. In
certain embodiments, the 3’- wing of a gapmer comprises at least one 2’-OMe nucleoside. In certain
embodiments, each nucleoside of the 3’- wing of a gapmer is a non-bicyclic modified nucleoside. In n
embodiments, each nucleoside of the 3’- wing of a gapmer is a 2’-substituted nucleoside. In certain
embodiments, each nucleoside of the 3’- wing of a gapmer is a 2’-MOE nucleoside. In certain embodiments,
each nucleoside of the 3’- wing of a gapmer is a 2’-OMe nucleoside.
In certain embodiments, the 3’- wing of a gapmer ses at least one 2’-deoxynucleoside. In
n embodiments, each nucleoside of the 3’- wing of a gapmer is a 2’-deoxynucleoside. In a certain
embodiments, the 3’- wing of a gapmer comprises at least one ribonucleoside. In certain embodiments, each
nucleoside of the 3’- Wing of a gapmer is a ribonucleoside. In certain ments, one, more than one, or
each of the nucleosides of the 5’- Wing is an RNA-like nucleoside.
In certain embodiments, the 3’-Wing of a gapmer ses at least one bicyclic nucleoside and at
least one non-bicyclic modified nucleoside. In certain embodiments, the 3’-Wing of a gapmer comprises at
least one bicyclic nucleoside and at least one 2’-substituted nucleoside. In certain embodiments, the 3’-Wing
of a gapmer comprises at least one bicyclic nucleoside and at least one 2’-MOE nucleoside. In certain
embodiments, the 3’-Wing of a gapmer comprises at least one bicyclic nucleoside and at least one 2’-OMe
side. In n embodiments, the 3’-Wing of a gapmer comprises at least one bicyclic nucleoside and
at least one 2’-deoxynucleoside.
In certain embodiments, the 3’-Wing of a gapmer comprises at least one constrained ethyl nucleoside
and at least one non-bicyclic modified nucleoside. In certain embodiments, the 3’-Wing of a gapmer
comprises at least one constrained ethyl nucleoside and at least one 2’-substituted nucleoside. In certain
embodiments, the 3’-Wing of a gapmer comprises at least one constrained ethyl nucleoside and at least one
2’-MOE nucleoside. In certain embodiments, the 3’-Wing of a gapmer comprises at least one ained
ethyl nucleoside and at least one 2’-OMe nucleoside. In certain embodiments, the 3’-Wing of a gapmer
comprises at least one constrained ethyl nucleoside and at least one 2’-deoxynucleoside.
In n embodiments, the 3’-Wing of a gapmer ses at least one LNA nucleoside and at least
one non-bicyclic modified nucleoside. In certain embodiments, the 3’-wing of a gapmer comprises at least
one LNA nucleoside and at least one 2’-substituted nucleoside. In certain ments, the 3’-Wing of a
gapmer comprises at least one LNA nucleoside and at least one 2’-MOE nucleoside. In certain ments,
the 3’-Wing of a gapmer ses at least one LNA nucleoside and at least one 2’-OMe nucleoside. In
certain embodiments, the 3’-Wing of a gapmer comprises at least one LNA nucleoside and at least one 2’-
deoxynucleoside.
In certain embodiments, the 3’-Wing of a gapmer comprises at least one bicyclic nucleoside, at least
one non-bicyclic modified nucleoside, and at least one 2’-deoxynucleoside. In certain ments, the 3’-
Wing of a gapmer ses at least one constrained ethyl nucleoside, at least one cyclic modified
nucleoside, and at least one 2’-deoxynucleoside. In certain embodiments, the 3’-wing of a gapmer comprises
at least one LNA side, at least one cyclic modified nucleoside, and at least one 2’-
deoxynucleoside.
In certain embodiments, the 3’-Wing of a gapmer comprises at least one bicyclic nucleoside, at least
one 2’-substituted nucleoside, and at least one 2’-deoxynucleoside. In certain embodiments, the 3’-Wing of a
gapmer comprises at least one constrained ethyl nucleoside, at least one 2’-substituted nucleoside, and at least
one 2’-deoxynucleoside. In certain embodiments, the 3’-Wing of a gapmer comprises at least one LNA
nucleoside, at least one 2’-substituted nucleoside, and at least one 2’-deoxynucleoside.
In certain embodiments, the 3’-Wing of a gapmer ses at least one bicyclic nucleoside, at least
one 2’-MOE nucleoside, and at least one 2’-deoxynucleoside. In certain embodiments, the 3’-Wing of a
gapmer comprises at least one constrained ethyl nucleoside, at least one 2’-MOE nucleoside, and at least one
2’-deoxynucleoside. In certain embodiments, the 3’-Wing of a gapmer ses at least one LNA
nucleoside, at least one 2’-MOE nucleoside, and at least one 2’-deoxynucleoside.
In certain embodiments, the g of a gapmer comprises at least one bicyclic nucleoside, at least
one 2’-OMe nucleoside, and at least one 2’-deoxynucleoside. In certain embodiments, the 3’-Wing of a
gapmer comprises at least one constrained ethyl nucleoside, at least one 2’-OMe nucleoside, and at least one
2’-deoxynucleoside. In n embodiments, the g of a gapmer comprises at least one LNA
nucleoside, at least one 2’-OMe nucleoside, and at least one 2’-deoxynucleoside.
iii. Certain Central Regions (gaps)
In certain embodiments, the gap of a gapmer consists of 6 to 20 linked nucleosides. In certain
embodiments, the gap of a gapmer consists of 6 to 15 linked nucleosides. In certain embodiments, the gap of
a gapmer consists of 6 to 12 linked nucleosides. In certain embodiments, the gap of a gapmer consists of 6 to
linked nucleosides. In n embodiments, the gap of a gapmer consists of 6 to 9 linked nucleosides. In
certain ments, the gap of a gapmer consists of 6 to 8 linked sides. In certain embodiments, the
gap of a gapmer consists of 6 or 7 linked nucleosides. In certain embodiments, the gap of a gapmer consists
of 7 to 10 linked nucleosides. In certain embodiments, the gap of a gapmer consists of 7 to 9 linked
nucleosides. In certain ments, the gap of a gapmer consists of 7 or 8 linked nucleosides. In certain
embodiments, the gap of a gapmer consists of 8 to 10 linked nucleosides. In n embodiments, the gap of
a gapmer consists of 8 or 9 linked nucleosides. In certain embodiments, the gap of a gapmer ts of 6
linked nucleosides. In certain embodiments, the gap of a gapmer consists of 7 linked nucleosides. In certain
embodiments, the gap of a gapmer consists of 8 linked nucleosides. In certain embodiments, the gap of a
gapmer consists of 9 linked nucleosides. In certain embodiments, the gap of a gapmer consists of 10 linked
nucleosides. In certain ments, the gap of a gapmer ts of 11 linked nucleosides. In certain
embodiments, the gap of a gapmer consists of 12 linked nucleosides.
In certain embodiments, each nucleoside of the gap of a gapmer is a 2’-deoxynucleoside. In certain
ments, the gap ses one or more d nucleosides. In certain embodiments, each nucleoside
of the gap of a gapmer is a 2’-deoxynucleoside or is a modified nucleoside that is “DNA-like.” In such
embodiments, “DNA-like” means that the nucleoside has similar characteristics to DNA, such that a duplex
comprising the gapmer and an RNA molecule is capable of ting RNase H. For example, under certain
conditions, 2’-(ara)-F have been shown to support RNase H activation, and thus is DNA-like. In certain
embodiments, one or more nucleosides of the gap of a gapmer is not a 2’-deoxynucleoside and is not DNA-
like. In certain such embodiments, the gapmer nonetheless supports RNase H activation (e.g., by Virtue of
the number or placement of the non-DNA nucleosides).
In certain embodiments, gaps comprise a stretch of unmodified 2’-deoxynucleoside interrupted by
one or more modified nucleosides, thus resulting in three sub-regions (two stretches of one or more 2’-
deoxynucleosides and a stretch of one or more interrupting modified nucleosides). In certain embodiments,
no stretch of unmodified 2’-deoxynucleosides is longer than 5, 6, or 7 nucleosides. In certain embodiments,
such short stretches is achieved by using short gap regions. In certain embodiments, short stretches are
achieved by interrupting a longer gap region.
In certain embodiments, the gap comprises one or more modified nucleosides. In certain
embodiments, the gap ses one or more modified nucleosides selected from among cEt, FHNA, LNA,
and 2-thio-thymidine. In certain embodiments, the gap comprises one modified nucleoside. In certain
embodiments, the gap comprises a 5’-substituted sugar moiety selected from among 5’-Me, and 5’-(R)-Me.
In n embodiments, the gap comprises two modified nucleosides. In certain embodiments, the gap
comprises three modified nucleosides. In certain embodiments, the gap comprises four modified nucleosides.
In certain embodiments, the gap comprises two or more modified nucleosides and each modified nucleoside
is the same. In certain embodiments, the gap comprises two or more modified nucleosides and each modified
nucleoside is different.
In certain embodiments, the gap comprises one or more d linkages. In certain embodiments,
the gap comprises one or more methyl phosphonate linkages. In certain ments the gap comprises two
or more modified linkages. In certain embodiments, the gap comprises one or more modified linkages and
one or more modified nucleosides. In certain embodiments, the gap comprises one modified linkage and one
modified nucleoside. In certain embodiments, the gap comprises two modified linkages and two or more
modified nucleosides.
b. Certain Internucleoside Linkage Motifs
In certain embodiments, oligonucleotides comprise modified internucleoside linkages arranged along
the oligonucleotide or region thereof in a defined pattern or modified internucleoside linkage motif In
certain embodiments, oligonucleotides comprise a region having an alternating internucleoside linkage motif
In n embodiments, ucleotides of the present sure comprise a region of uniformly d
internucleoside linkages. In certain such embodiments, the oligonucleotide comprises a region that is
uniformly linked by phosphorothioate internucleoside linkages. In n embodiments, the oligonucleotide
is uniformly linked by phosphorothioate internucleoside es. In certain embodiments, each
internucleoside linkage of the oligonucleotide is selected from phosphodiester and orothioate. In
certain ments, each internucleoside linkage of the oligonucleotide is selected from odiester and
phosphorothioate and at least one ucleoside linkage is phosphorothioate.
In certain embodiments, the oligonucleotide comprises at least 6 phosphorothioate internucleoside
linkages. In certain embodiments, the oligonucleotide comprises at least 7 phosphorothioate internucleoside
es. In certain embodiments, the oligonucleotide comprises at least 8 phosphorothioate internucleoside
linkages. In certain embodiments, the ucleotide comprises at least 9 orothioate internucleoside
linkages. In certain embodiments, the oligonucleotide comprises at least 10 phosphorothioate internucleoside
linkages. In certain embodiments, the oligonucleotide comprises at least 11 phosphorothioate internucleoside
linkages. In certain embodiments, the oligonucleotide comprises at least 12 phosphorothioate internucleoside
linkages. In certain embodiments, the oligonucleotide comprises at least 13 phosphorothioate internucleoside
es. In certain embodiments, the oligonucleotide comprises at least 14 phosphorothioate internucleoside
linkages.
In certain embodiments, the ucleotide comprises at least one block of at least 6 utive
orothioate ucleoside linkages. In certain embodiments, the oligonucleotide comprises at least
one block of at least 7 consecutive phosphorothioate internucleoside linkages. In certain embodiments, the
oligonucleotide comprises at least one block of at least 8 consecutive phosphorothioate internucleoside
linkages. In certain embodiments, the oligonucleotide comprises at least one block of at least 9 consecutive
phosphorothioate internucleoside linkages. In certain embodiments, the oligonucleotide comprises at least
one block of at least 10 consecutive orothioate internucleoside linkages. In certain ments, the
oligonucleotide comprises at least block of at least one 12 consecutive phosphorothioate internucleoside
linkages. In certain such embodiments, at least one such block is located at the 3’ end of the oligonucleotide.
In certain such embodiments, at least one such block is d Within 3 nucleosides of the 3’ end of the
oligonucleotide.In certain embodiments, the oligonucleotide ses less than 15 phosphorothioate
internucleoside linkages. In n ments, the ucleotide comprises less than 14 phosphoro-
thioate internucleoside linkages. In certain embodiments, the ucleotide comprises less than 13
phosphorothioate internucleoside linkages. In certain embodiments, the oligonucleotide comprises less than
12 phosphorothioate internucleoside es. In n embodiments, the oligonucleotide comprises less
than 11 phosphorothioate internucleoside linkages. In certain ments, the oligonucleotide comprises
less than 10 phosphorothioate internucleoside linkages. In certain embodiments, the oligonucleotide
comprises less than 9 phosphorothioate internucleoside linkages. In certain embodiments, the oligonucleotide
comprises less than 8 phosphorothioate internucleoside linkages. In certain ments, the oligonucleotide
comprises less than 7 phosphorothioate internucleoside linkages. In certain embodiments, the oligonucleotide
comprises less than 6 phosphorothioate internucleoside linkages. In certain embodiments, the oligonucleotide
comprises less than 5 phosphorothioate internucleoside es.
c. Certain Nucleobase Modification Motifs
In certain embodiments, oligonucleotides comprise chemical modifications to nucleobases arranged
along the oligonucleotide or region thereof in a defined pattern or nucleobases modification motif. In certain
such embodiments, base modifications are arranged in a gapped motif. In certain embodiments,
nucleobase modifications are arranged in an alternating motif. In certain ments, each nucleobase is
modified. In n embodiments, none of the nucleobases is chemically modified.
In certain embodiments, oligonucleotides comprise a block of modified nucleobases. In certain such
embodiments, the block is at the 3’-end of the oligonucleotide. In certain embodiments the block is Within 3
nucleotides of the 3’-end of the oligonucleotide. In certain such embodiments, the block is at the 5’-end of
the oligonucleotide. In certain embodiments the block is Within 3 nucleotides of the 5’-end of the
oligonucleotide.
In certain embodiments, nucleobase modifications are a on of the natural base at a particular
position of an oligonucleotide. For example, in certain embodiments each purine or each pyrimidine in an
oligonucleotide is modified. In certain embodiments, each e is modified. In certain ments,
each guanine is modified. In n embodiments, each thymine is modified. In certain embodiments, each
cytosine is modified. In certain embodiments, each uracil is modified.
In certain embodiments, some, all, or none of the ne moieties in an oligonucleotide are 5-
methyl ne moieties. Herein, 5-methyl cytosine is not a “modified nucleobase. :9 Accordingly, unless
otherwise indicated, unmodified nucleobases include both cytosine residues having a 5-methyl and those
lacking a 5 methyl. In certain ments, the ation state of all or some cytosine nucleobases is
specified.
In certain embodiments, chemical ations to nucleobases comprise attachment of certain
conjugate groups to nucleobases. In certain embodiments, each purine or each pyrimidine in an
oligonucleotide may be optionally modified to comprise a conjugate group.
d. Certain Overall Lengths
In certain embodiments, the present disclosure provides oligonucleotides of any of a variety of ranges
of lengths. In certain ments, oligonucleotides t ofX to Y linked nucleosides, Where X
represents the fewest number of nucleosides in the range and Y represents the largest number of nucleosides
in the range. In certain such embodiments, X and Y are each independently selected from 8, 9, 10, 11, 12, 13,
14,15,16,17,18,19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42,
43, 44, 45, 46, 47, 48, 49, and 50; provided that XSY. For example, in certain embodiments, the
oligonucleotide may consist of8 to 9, 8 to 10, 8 toll, 8 to 12, 8 to 13, 8 to 14, 8 to 15, 8 to 16, 8 to 17, 8 to
18, 8 to 19, 8 to 20, 8 to 21, 8 to 22, 8 to 23, 8 to 24, 8 to 25, 8 to 26, 8 to 27, 8 to 28, 8 to 29, 8 to 30, 9 to 10,
9to 11, 9to 12, 9to 13, 9to 14, 9t015, 9to 16, 9to 17, 9to 18, 9to 19, 9to20, 9to21, 9to22, 9to23, 9
to 24, 9 to 25, 9 to 26, 9 to 27, 9 to 28, 9 to 29, 9 to 30,10 toll, 10 to 12, 10 to 13, 10 to 14, 10 to 15, 10 to
16,10 to 17, 10 to 18, 10 to 19, 10 to 20,10 to 21,10 to 22,10 to 23,10 to 24,10 to 25,10 to 26,10 to 27,
to 28, 10to 29, 10to 30, 11 to 12, 11 to 13, 11 to 14, 11 to 15, 11 to 16, 11 to 17, 11 to 18, 11 to 19, 11 to
,11to21,11to22,11to23,11to24,11to25,11to26,11to27,11to28,11to29,11to 30, 12 to 13,
12 to 14, 12 to 15, 12 to 16, 12 to 17, 12 to 18, 12 to 19, 12 to 20,12 to 21,12 to 22,12 to 23,12 to 24,12 to
,12 to 26,12 to 27,12 to 28,12 to 29,12 to 30,13 to 14, 13 to 15, 13 to 16, 13 to 17, 13 to 18, 13 to 19,
13 to 20,13 to 21,13 to 22,13 to 23,13 to 24,13 to 25,13 to 26,13 to 27,13 to 28,13 to 29,13 to 30,14 to
,14 to 16, 14 to 17, 14 to 18, 14 to 19, 14 to 20,14 to 21,14 to 22,14 to 23,14 to 24,14 to 25,14 to 26,
14 to 27,14 to 28,14 to 29,14 to 30,15 to 16, 15 to 17, 15 to 18, 15 to 19, 15 to 20,15 to 21,15 to 22,15 to
23,15 to 24,15 to 25,15 to 26,15 to 27,15 to 28,15 to 29,15 to 30,16 to 17, 16 to 18, 16 to 19, 16 to 20,
16 to 21,16 to 22,16 to 23,16 to 24,16 to 25,16 to 26,16 to 27,16 to 28,16 to 29,16 to 30,17 to 18, 17 to
19,17 to 20,17 to 21,17 to 22,17 to 23,17 to 24,17 to 25,17 to 26,17 to 27,17 to 28,17 to 29,17 to 30,
18 to 19, 18 to 20,18 to 21,18 to 22,18 to 23,18 to 24,18 to 25,18 to 26,18 to 27,18 to 28,18 to 29,18 to
,19 to 20,19 to 21,19 to 22,19 to 23,19 to 24,19 to 25,19 to 26,19 to 29,19 to 28,19 to 29,19 to 30,
to 21, 20 to 22, 20 to 23, 20 to 24, 20 to 25, 20 to 26, 20 to 27, 20 to 28, 20 to 29, 20 to 30, 21 to 22, 21 to
23, 21 to 24, 21 to 25, 21 to 26, 21 to 27, 21 to 28, 21 to 29, 21 to 30, 22 to 23, 22 to 24, 22 to 25, 22 to 26,
22 to 27, 22 to 28, 22 to 29, 22 to 30, 23 to 24, 23 to 25, 23 to 26, 23 to 27, 23 to 28, 23 to 29, 23 to 30, 24 to
, 24 to 26, 24 to 27, 24 to 28, 24 to 29, 24 to 30, 25 to 26, 25 to 27, 25 to 28, 25 to 29, 25 to 30, 26 to 27,
26 to 28, 26 to 29, 26 to 30, 27 to 28, 27 to 29, 27 to 30, 28 to 29, 28 to 30, or 29 to 30 linked nucleosides. In
embodiments Where the number of sides of an oligonucleotide of a compound is limited, Whether to a
range or to a specific number, the compound may, nonetheless further comprise additional other substituents.
For example, an ucleotide sing 8-30 sides excludes oligonucleotides having 31
nucleosides, but, unless otherwise indicated, such an ucleotide may further comprise, for example one
or more ate groups, terminal groups, or other substituents.
r, Where an oligonucleotide is described by an overall length range and by regions having
specified lengths, and Where the sum of specified s of the regions is less than the upper limit of the
overall length range, the oligonucleotide may have additional nucleosides, beyond those of the specified
regions, provided that the total number of nucleosides does not exceed the upper limit of the overall length
range.
. Certain Antisense Oligonucleotide Chemistry Motifs
In certain embodiments, the chemical ural features of antisense oligonucleotides are
characterized by their sugar motif, internucleoside linkage motif, nucleobase modification motif and overall
length. In certain embodiments, such parameters are each independent of one another. Thus, each
internucleoside linkage of an ucleotide having a gapmer sugar motif may be modified or unmodified
and may or may not follow the gapmer modification pattern of the sugar modifications. Thus, the
internucleoside linkages Within the Wing regions of a sugar-gapmer may be the same or different from one
another and may be the same or different from the internucleoside linkages of the gap region. Likewise, such
sugar-gapmer oligonucleotides may comprise one or more modified nucleobase independent of the gapmer
pattern of the sugar modifications. One of skill in the art Will appreciate that such motifs may be combined to
create a variety of oligonucleotides.
In certain embodiments, the selection of internucleoside e and nucleoside ation are not
independent of one another.
i. Certain Sequences and Targets
In certain embodiments, the invention provides antisense oligonucleotides having a sequence
mentary to a target nucleic acid. Such antisense compounds are capable of izing to a target
nucleic acid, resulting in at least one antisense activity. In certain embodiments, antisense compounds
2014/036460
specifically ize to one or more target nucleic acid. In certain embodiments, a specifically hybridizing
antisense compound has a nucleobase sequence comprising a region having sufficient complementarity to a
target nucleic acid to allow hybridization and result in antisense activity and insufficient complementarity to
any non-target so as to avoid or reduce non-specific hybridization to non-target nucleic acid sequences under
conditions in which specific ization is desired (e.g., under physiological conditions for in vivo or
therapeutic uses, and under conditions in which assays are performed in the case of in vitro ). In
n embodiments, oligonucleotides are selective between a target and non-target, even though both target
and non-target comprise the target sequence. In such embodiments, selectivity may result from relative
accessibility of the target region of one nucleic acid molecule compared to the other.
In certain embodiments, the present sure provides antisense compounds comprising
oligonucleotides that are fully complementary to the target nucleic acid over the entire length of the
ucleotide. In certain embodiments, ucleotides are 99% complementary to the target nucleic acid.
In certain embodiments, oligonucleotides are 95% complementary to the target nucleic acid. In certain
embodiments, such ucleotides are 90% complementary to the target nucleic acid.
In certain ments, such ucleotides are 85% complementary to the target nucleic acid. In
certain embodiments, such oligonucleotides are 80% complementary to the target nucleic acid. In certain
embodiments, an antisense compound comprises a region that is fully complementary to a target nucleic acid
and is at least 80% complementary to the target nucleic acid over the entire length of the oligonucleotide. In
certain such embodiments, the region of full complementarity is from 6 to 14 nucleobases in length.
In certain embodiments, ucleotides comprise a hybridizing region and a terminal region. In
certain such ments, the hybridizing region consists of 12-30 linked nucleosides and is fully
complementary to the target nucleic acid. In certain embodiments, the hybridizing region includes one
mismatch relative to the target nucleic acid. In certain embodiments, the hybridizing region includes two
mismatches relative to the target nucleic acid. In certain embodiments, the hybridizing region includes three
mismatches ve to the target nucleic acid. In certain embodiments, the terminal region ts of 1-4
terminal nucleosides. In certain embodiments, the terminal nucleosides are at the 3’ end. In certain
embodiments, one or more of the terminal nucleosides are not complementary to the target nucleic acid.
Antisense mechanisms e any mechanism involving the hybridization of an oligonucleotide with
target nucleic acid, wherein the hybridization results in a ical effect. In certain embodiments, such
hybridization results in either target nucleic acid degradation or occupancy with concomitant inhibition or
stimulation of the cellular machinery involving, for example, translation, transcription, or ng of the
target nucleic acid.
One type of antisense mechanism involving degradation of target RNA is RNase H mediated
antisense. RNase H is a ar endonuclease which cleaves the RNA strand of an RNA:DNA duplex. It is
known in the art that single-stranded antisense compounds which are “DNA-like” elicit RNase H activity in
mammalian cells. Activation of RNase H, therefore, results in cleavage of the RNA , thereby greatly
enhancing the ency of DNA-like oligonucleotide-mediated inhibition of gene expression.
In certain embodiments, a conjugate group comprises a cleavable moiety. In certain embodiments,
a conjugate group comprises one or more ble bond. In certain embodiments, a conjugate group
comprises a linker. In n embodiments, a linker comprises a protein binding moiety. In certain
embodiments, a conjugate group comprises a cell-targeting moiety (also ed to as a cell-targeting group).
In certain embodiments a cell-targeting moiety comprises a branching group. In certain ments, a cell-
targeting moiety comprises one or more tethers. In certain embodiments, a cell-targeting moiety comprises a
carbohydrate or carbohydrate cluster.
ii. Certain ble Moieties
In certain ments, a cleavable moiety is a cleavable bond. In certain embodiments, a
cleavable moiety comprises a cleavable bond. In certain embodiments, the ate group comprises a
cleavable moiety. In certain such embodiments, the cleavable moiety attaches to the antisense
oligonucleotide. In certain such embodiments, the ble moiety attaches ly to the cell-targeting
moiety. In certain such embodiments, the cleavable moiety attaches to the conjugate linker. In certain
ments, the ble moiety comprises a phosphate or phosphodiester. In certain embodiments, the
cleavable moiety is a ble nucleoside or side analog. In n embodiments, the nucleoside or
nucleoside analog comprises an optionally protected heterocyclic base selected from a purine, substituted
purine, pyrimidine or substituted pyrimidine. In certain embodiments, the cleavable moiety is a side
comprising an ally protected heterocyclic base selected from uracil, thymine, cytosine, 4-N-
benzoylcytosine, 5-methylcytosine, 4-N-benzoylmethylcytosine, adenine, 6-N-benzoyladenine, guanine
and 2-N—isobutyrylguanine. In certain embodiments, the cleavable moiety is 2'-deoxy nucleoside that is
attached to the 3' position of the antisense oligonucleotide by a phosphodiester linkage and is attached to the
linker by a phosphodiester or phosphorothioate linkage. In certain embodiments, the cleavable moiety is 2'-
deoxy adenosine that is attached to the 3' position of the nse oligonucleotide by a phosphodiester
linkage and is attached to the linker by a phosphodiester or phosphorothioate linkage. In certain
embodiments, the cleavable moiety is 2'-deoxy adenosine that is attached to the 3' position of the antisense
oligonucleotide by a odiester linkage and is attached to the linker by a phosphodiester linkage.
In certain embodiments, the cleavable moiety is attached to the 3' position of the antisense
oligonucleotide. In certain embodiments, the cleavable moiety is attached to the 5' position of the antisense
oligonucleotide. In certain embodiments, the cleavable moiety is ed to a 2' position of the antisense
oligonucleotide. In n embodiments, the cleavable moiety is attached to the antisense oligonucleotide by
a phosphodiester linkage. In certain embodiments, the cleavable moiety is attached to the linker by either a
phosphodiester or a phosphorothioate linkage. In certain embodiments, the cleavable moiety is attached to
the linker by a phosphodiester linkage. In certain embodiments, the conjugate group does not include a
cleavable moiety.
In certain embodiments, the cleavable moiety is cleaved after the complex has been administered to
an animal only after being internalized by a targeted cell. Inside the cell the cleavable moiety is cleaved
thereby releasing the active antisense ucleotide. While not g to be bound by theory it is believed
that the cleavable moiety is d by one or more ses within the cell. In certain embodiments, the
one or more nucleases cleave the odiester linkage between the ble moiety and the . In
certain embodiments, the cleavable moiety has a structure selected from among the following:
O=Fl’-OH
l s5
O=Fl’-OH O=F|’-OH
O O
O BX1 O BX2
‘ d o
O 2 OH: — O=F:’-OH |
O=F|’-OH
O O
O Bx O BX2 O BX3
; and
C? C? C?
O: -OH O=P-OH O: -OH
wherein each of BX, BX1, BXQ, and BX3 is independently a heterocyclic base moiety. In certain embodiments,
the cleavable moiety has a structure selected from among the following:
O N
<’ 1‘“
O N NJ
(.5:
0: -OH
iii. Certain Linkers
In certain embodiments, the conjugate groups comprise a linker. In certain such embodiments, the
linker is covalently bound to the cleavable moiety. In certain such embodiments, the linker is covalently
bound to the antisense oligonucleotide. In certain embodiments, the linker is covalently bound to a cell-
ing moiety. In n embodiments, the linker further comprises a covalent attachment to a solid
support. In certain embodiments, the linker further comprises a covalent attachment to a protein binding
moiety. In certain embodiments, the linker r ses a covalent ment to a solid t and
further ses a covalent attachment to a protein binding moiety. In certain embodiments, the linker
es multiple positions for ment of tethered ligands. In certain embodiments, the linker includes
multiple positions for attachment of tethered ligands and is not attached to a branching group. In certain
embodiments, the linker further comprises one or more cleavable bond. In certain embodiments, the
conjugate group does not e a linker.
In certain embodiments, the linker includes at least a linear group comprising groups selected from
alkyl, amide, 1de, hylene , ether, thioether (-S-) and hydroxylamino (-O-N(H)-) . In
certain embodiments, the linear group comprises groups selected from alkyl, amide and ether groups. In
certain ments, the linear group ses groups selected from alkyl and ether groups. In certain
embodiments, the linear group comprises at least one phosphorus linking group. In certain embodiments, the
linear group comprises at least one phosphodiester group. In certain embodiments, the linear group includes
at least one neutral linking group. In certain embodiments, the linear group is covalently attached to the cell-
targeting moiety and the cleavable moiety. In certain ments, the linear group is covalently ed to
the cell-targeting moiety and the antisense oligonucleotide. In certain embodiments, the linear group is
covalently attached to the cell-targeting moiety, the cleavable moiety and a solid support. In certain
embodiments, the linear group is covalently attached to the cell-targeting moiety, the cleavable moiety, a
solid support and a protein binding moiety. In certain embodiments, the linear group includes one or more
cleavable bond.
In certain embodiments, the linker includes the linear group covalently attached to a scaffold group.
In certain embodiments, the scaffold includes a branched aliphatic group comprising groups selected from
alkyl, amide, disulf1de, polyethylene glycol, ether, thioether and hydroxylamino groups. In certain
embodiments, the scaffold includes a branched aliphatic group comprising groups selected from alkyl, amide
and ether groups. In certain ments, the scaffold includes at least one mono or polycyclic ring .
In certain embodiments, the ld includes at least two mono or clic ring systems. In certain
embodiments, the linear group is covalently attached to the scaffold group and the ld group is
covalently attached to the cleavable moiety and the linker. In certain embodiments, the linear group is
covalently attached to the scaffold group and the scaffold group is covalently attached to the cleavable
moiety, the linker and a solid support. In certain embodiments, the linear group is covalently attached to the
scaffold group and the scaffold group is covalently attached to the cleavable moiety, the linker and a protein
binding moiety. In certain embodiments, the linear group is covalently attached to the scaffold group and the
scaffold group is covalently attached to the cleavable moiety, the linker, a protein binding moiety and a solid
support. In certain embodiments, the scaffold group includes one or more cleavable bond.
In certain embodiments, the linker includes a protein binding . In certain embodiments, the
protein binding moiety is a lipid such as for example including but not limited to cholesterol, cholic acid,
adamantane acetic acid, l-pyrene butyric acid, dihydrotestosterone, l,3-Bis-O(hexadecyl)glycerol,
geranyloxyhexyl group, hexadecylglycerol, borneol, l, 1,3-propanediol, heptadecyl group, palmitic
acid, myristic acid, O3-(oleoyl)lithocholic acid, O3-(oleoyl)cholenic acid, dimethoxytrityl, or phenoxazine), a
Vitamin (e.g., folate, Vitamin A, Vitamin E, biotin, pyridoxal), a e, a carbohydrate (e.g.,
monosaccharide, disaccharide, trisaccharide, tetrasaccharide, oligosaccharide, polysaccharide), an
endosomolytic component, a steroid (e.g., uvaol, hecigenin, diosgenin), a e (e.g., triterpene, e.g.,
sarsasapogenin, friedelin, epifriedelanol tized lithocholic acid), or a cationic lipid. In certain
ments, the protein binding moiety is a C16 to C22 long chain saturated or unsaturated fatty acid,
cholesterol, cholic acid, n E, adamantane or l-pentafluoropropyl.
In certain embodiments, a linker has a structure selected from among:
WO 79625
H H «vw E—NH
N N |
21/ W 0/, (I?
0 R02 o—P—OH
N [k0 N |
N O
\3 "'W
- H
\ 1 N ;
( )n
W o
le
<5\ I
0 N |
ii O,,_ mO—Ifi-OH ;
OH - ;
’ aMo
p T
”l“ ”T”
o w 0,
H H H H H [ko\
E/WnflnwnN N N N NMJL \o N 5“
n :3 H
kHz/$S/S ’
1 no O
"'4,
JVI'W
wherein each n is, independently, from 1 to 20; and p is from 1 to 6.
In certain embodiments, a linker has a structure ed from among:
“<0 0
O o N
O N
H H
1'7-
"LLL NMO ’
n W8SNOn i
n O
Q» ”a O/ is
O Q,
n H
o o
00 0A
NkflAN/31 O
NJ: V n H NWN/E
o, I“? n
’4 9 q
Uvo-so . UV ‘I’
,NM 0 OH
E n O
IILLWn O ,and
o N H
s‘ H
\N o SHN‘En
wherein each n is, independently, from 1 to 20.
In n embodiments, a linker has a structure selected from among:
wherein n is from 1 to 20.
In certain embodiments, a linker has a structure selected from among:
Wherein each L is, independently, a phosphorus linking group or a neutral linking group; and
each n is, ndently, from 1 to 20.
In certain embodiments, a linker has a structure selected from among:
WO 79625
EL/NfiLHWNvflg/KOH H
WO 79625
JVIW
In n embodiments, a linker has a structure selected from among:
0 O O O
H H
EkNMM/EKE; EkNWM/E ;“51)J\/N\gWKFJH ;
O O
2014/036460
In certain embodiments, a linker has a structure selected from among:
0 O O O
O H
EkNWM/f;H a EkNll/WHEH / )va
[771. M; ;
OH m,
o o
H A
N HN o
o W f
“QB, ;
3;” ,
, WE
2014/036460
In certain embodiments, a linker has a structure selected from among:
w; “i”
UV0A moat
N 0 N
1W0 and 3W0
n n is from 1 to 20.
In certain embodiments, a linker has a structure selected from among:
\/\‘g; 5\O/\/\O/\/\‘g ;and €9\O/\/\O/\/\O/\/\€é .
In certain embodiments, a linker has a structure selected from among:
OH OH
OH 3 OH 3
In certain embodiments, a linker has a structure selected from among:
O 0
E‘WMNS EH0_II_ _E e; 1%
and WNW
In certain embodiments, the conjugate linker has the structure:
In certain embodiments, the conjugate linker has the structure:
0 O
In certain embodiments, a linker has a structure selected from among:
EHO——E “a
and fiWfi/M
In certain embodiments, a linker has a structure selected from among:
szAMS‘'P—o——: WNWOH g‘ “a
and 0
wherein each n is ndently, O, l, 2, 3, 4, 5, 6, or 7.
iv. Certain Cell-Targeting Moieties
In certain embodiments, conjugate groups comprise cell-targeting moieties. Certain such
cell-targeting es increase cellular uptake of antisense compounds. In certain embodiments, cell-
targeting moieties comprise a branching group, one or more tether, and one or more ligand. In certain
embodiments, cell-targeting moieties comprise a branching group, one or more tether, one or more ligand and
one or more cleavable bond.
1. Certain Branching Groups
In certain embodiments, the conjugate groups comprise a targeting moiety comprising a branching
group and at least two tethered ligands. In certain embodiments, the branching group attaches the conjugate
linker. In certain embodiments, the branching group attaches the ble moiety. In n embodiments,
the ing group attaches the antisense oligonucleotide. In certain embodiments, the branching group is
covalently attached to the linker and each of the tethered ligands. In certain embodiments, the branching
group comprises a branched tic group comprising groups ed from alkyl, amide, disulfide,
polyethylene glycol, ether, thioether and hydroxylamino groups. In certain embodiments, the branching
group comprises groups selected from alkyl, amide and ether groups. In certain embodiments, the branching
group comprises groups selected from alkyl and ether groups. In certain ments, the branching group
comprises a mono or polycyclic ring . In certain ments, the branching group comprises one or
more cleavable bond. In certain embodiments, the conjugate group does not include a branching group.
In certain embodiments, a ing group has a structure selected from among:
WO 79625
o (
E/NH
3L NH
O n
H 11W,“
N )9. ' and H H
N ’
( L( n
E/NH 0
wherein each n is, independently, from 1 to 20;
j is from 1 t0 3; and
m is from 2 t0 6.
In certain embodiments, a branching group has a structure selected from among:
bLLI— ml
0 o 0% |
NH ('3' O o O
“51W” 11
. HO O—P—O E _ EANWNMJK; ;
wherein each n is, independently, from 1 to 20; and
m is from 2 to 6.
In certain ments, a branching group has a structure selected from among:
3L 0 “a
EWMi/Y‘iO E
O O #5 I/m E
; N O
. o
ITJH Tl?) o ’ NH ra‘
W W
’ijjo ’;\N 377. E/NH Hf
HN/ii O
E £51“ J:
HM};
WE/MNH itWkNH
H J\
EWLN H
N593 ; and
at M
H o
o if
9" NH
2”“ WW
In certain embodiments, a branching group has a structure selected from among:
\ |
A1 A1
‘7‘," (
/A1 A1
.111“ ) nE TAN—E §_A1 ( n n
A A
1 1
/ and |
WO 79625
wherein each A1 is independently, O, S, C=O or NH; and
each n is, ndently, from 1 to 20.
In certain embodiments, a branching group has a structure selected from among:
WIW ”Iw ”IV"
A A1 A1
AF; )n AF; )n AF;
’ n n
—A1 §_A1
A1 nA1 and §_A1 n( )n
wherein each A1 is independently, O, S, C=O or NH; and
each n is, independently, from 1 to 20.
In certain embodiments, a branching group has a structure selected from among:
wherein A1 is O, S, C=O or NH; and
each n is, independently, from 1 to 20.
In certain embodiments, a branching group has a structure selected from among:
0 "m
o Nl-I
In n embodiments, a branching group has a structure selected from among:
/O\g—/“m
In certain embodiments, a branching group has a structure ed from among:
2. Certain Tethers
In certain embodiments, conjugate groups comprise one or more tethers covalently attached to the
branching group. In certain embodiments, ate groups comprise one or more tethers covalently
attached to the linking group. In certain embodiments, each tether is a linear aliphatic group comprising one
or more groups selected from alkyl, ether, thioether, disulfide, amide and polyethylene glycol groups in any
combination. In certain embodiments, each tether is a linear tic group comprising one or more groups
selected from alkyl, substituted alkyl, ether, thioether, disulfide, amide, phosphodiester and polyethylene
glycol groups in any combination. In certain embodiments, each tether is a linear aliphatic group comprising
one or more groups selected from alkyl, ether and amide groups in any combination. In certain ments,
each tether is a linear aliphatic group comprising one or more groups selected from alkyl, substituted alkyl,
phosphodiester, ether and amide groups in any combination. In n ments, each tether is a linear
aliphatic group comprising one or more groups selected from alkyl and phosphodiester in any combination.
In certain embodiments, each tether comprises at least one phosphorus linking group or neutral g group.
In certain embodiments, the tether includes one or more cleavable bond. In certain embodiments,
the tether is attached to the branching group through either an amide or an ether group. In certain
embodiments, the tether is attached to the branching group h a phosphodiester group. In certain
embodiments, the tether is attached to the branching group through a phosphorus linking group or neutral
linking group. In certain embodiments, the tether is attached to the branching group through an ether group.
In n ments, the tether is attached to the ligand h either an amide or an ether group. In
n embodiments, the tether is attached to the ligand through an ether group. In certain embodiments, the
tether is attached to the ligand through either an amide or an ether group. In certain embodiments, the tether
is attached to the ligand through an ether group.
In certain embodiments, each tether comprises from about 8 to about 20 atoms in chain length
between the ligand and the branching group. In certain embodiments, each tether group comprises from
about 10 to about 18 atoms in chain length between the ligand and the branching group. In certain
embodiments, each tether group comprises about 13 atoms in chain length.
In certain embodiments, a tether has a structure selected from among:
0 H 3L
EMNWOVhOAH/i ; “3/wa ; 1W ; “H‘Mfoflfi ;
fimo/Yoflh re: WNW; E H H 1%
n n ’
p N “O n J W W1W ,
WWmWE “WWW?O H
; ”OWHWH‘ ;
2 p H O O
;M ”Wok - mgM and E “M3
n n ’ ’
n v65 n Y
wherein each n is, independently, from 1 to 20; and
each p is from 1 to about 6.
In certain embodiments, a tether has a ure selected from among:
“gt/\AMNOWOA/R— - - NW w: -
, HL/ 9:" , WYE ,
EMOAEF ; ‘JJJV\O/\/OVBLLL ; E/Nwmfsfilnd _
H‘:\/\O/\5ré
In certain ments, a tether has a structure ed from among:
,6 NH 1
wherein each n is, independently, from 1 to 20.
In certain ments, a tether has a structure ed from among:
0 21
.a‘ L 1, 2.
d 39L JYLN
wherein L is either a phosphorus linking group or a neutral linking group;
21 is C(=O)O-R2;
Zg is H, C1-C6 alkyl or substituted C1-C6 alky;
R2 is H, C1-C6 alkyl or substituted C1-C6 alky; and
each m1 is, ndently, from O to 20 wherein at least one m1 is greater than 0 for each
tether.
In certain embodiments, a tether has a structure selected from among:
In certain embodiments, a tether has a structure selected from among:
0 ~91 fWkNJfi,o—fi—o—(—9fi::‘0 COOH OH
0—5—0 I
“a m1<5H m1 m1H O
wherein Zg is H or CH3; and
each m1 is, independently, from O to 20 wherein at least one m1 is greater than 0 for each
tether.
In certain embodiments, a tether has a structure selected from among:
0 0
”mior “mi:
, ; wherein each n is independently, O, l, 2, 3, 4, 5, 6, or 7.
In certain embodiments, a tether comprises a phosphorus linking group. In certain
ments, a tether does not comprise any amide bonds. In n embodiments, a tether
comprises a phosphorus linking group and does not comprise any amide bonds.
3. Certain Ligands
In n embodiments, the present disclosure provides ligands wherein each ligand is covalently
attached to a tether. In certain embodiments, each ligand is selected to have an affinity for at least one type of
receptor on a target cell. In certain embodiments, ligands are selected that have an affinity for at least one
type of receptor on the surface of a mammalian liver cell. In certain embodiments, ligands are selected that
have an affinity for the hepatic asialoglycoprotein receptor (ASGP-R). In certain embodiments, each ligand
is a carbohydrate. In certain embodiments, each ligand is, ndently ed from galactose, N—acetyl
galactoseamine, mannose, glucose, glucosamone and fucose. In certain embodiments, each ligand is N—acetyl
galactoseamine (GalNAc). In certain embodiments, the ing moiety comprises 2 to 6 ligands. In certain
embodiments, the targeting moiety comprises 3 ligands. In n embodiments, the ing moiety
comprises 3 N—acetyl oseamine ligands.
In certain embodiments, the ligand is a carbohydrate, carbohydrate derivative, d
carbohydrate, multivalent carbohydrate cluster, polysaccharide, d polysaccharide, or polysaccharide
derivative. In certain embodiments, the ligand is an amino sugar or a thio sugar. For e, amino sugars
may be selected from any number of compounds known in the art, for example glucosamine, sialic acid, (1-D-
galactosamine, N—Acetylgalactosamine, 2-acetamidodeoxy—D-galactopyranose (GalNAc), 2-Amino0-
[(R)-l-carboxyethyl]deoxy—B-D-glucopyranose (B-muramic acid), 2-Deoxy—2-methylamino-L-
glucopyranose, 4,6-Dideoxy—4-formamido-2,3-dimethyl-D-mannopyranose, ysulfoamino-D-
glucopyranose and N—sulfo-D-glucosamine, and N—Glycoloyl-(x-neuraminic acid. For example, thio sugars
may be ed from the group consisting of 5-Thio-B-D-glucopyranose, Methyl 2,3,4-triacetyl-l-thio
O-trityl-(x-D-glucopyranoside, 4-Thio-B-D-galactopyranose, and ethyl 3,4,6,7-tetraacetyldeoxy—l,5-
dithio-(x-D-gluco-heptopyranoside.
In certain embodiments, “GalNac” or “Gal-NAc” refers to 2-(Acetylamino)deoxy—D-
galactopyranose, commonly referred to in the literature as N—acetyl galactosamine. In certain ments,
“N—acetyl galactosamine” refers to tylamino)deoxy-D-galactopyranose. In certain embodiments,
“GalNac” or “Gal-NAc” refers to 2-(Acetylamino)deoxy-D-galactopyranose. In certain embodiments,
“GalNac” or Ac” refers to 2-(Acetylamino)deoxy—D-galactopyranose, which includes both the B-
form: 2-(Acetylamino)deoxy-B-D-galactopyranose and (x-form: 2-(Acetylamino)deoxy—D-
galactopyranose. In certain embodiments, both the B-form: 2-(Acetylamino)deoxy-B-D-galactopyranose
and (x-form: 2-(Acetylamino)deoxy—D-galactopyranose may be used interchangeably. Accordingly, in
structures in which one form is depicted, these structures are intended to include the other form as well. For
example, where the structure for an (x-form: 2-(Acetylamino)deoxy—D-galactopyranose is shown, this
structure is intended to include the other form as well. In certain embodiments, In certain preferred
embodiments, the B-form 2-(Acetylamino)-2—deoxy—D-galactopyranose is the preferred embodiment.
o OH
HO J‘M o
””1 k
HO N
2-(Acetylamino)deoxy-D-galactopyranose
HO 0—;
NHAC
2-(Acetylamino)deoxy-B-D-galactopyranose
NHAC
2-(Acetylamino)deoxy-(x-D-galactopyranose
In certain ments one or more ligand has a structure selected from among:
HO O
H$4/
0—; HO
R1 ‘%
R1 and
R1 O O
wherein each R1 is selected from OH and NHCOOH.
In certain embodiments one or more ligand has a structure selected from among:
HOOH HO
HO&S/ \ OH
o 0H0
O HO,/1§;:::/O '0 '
HO HO o HO
NHAcrrrr ; “f . \ HO ,
OH HO
: 5;
HOOH
“0%HO N HO OH HOOH
\H“ ’ Wom“
\ Mm 0“ OH
HO -
HO \%?:é73 /a HO *5 , 0 ,and
OH OH
HO OH
OH -O
In certain ments one or more ligand has a structure selected from among:
HOOH
HO&£w\HH
NHAC
In certain embodiments one or more ligand has a structure selected from among:
HOOH
Home}:
NHAC _
i. Certain Conjugates
In n embodiments, conjugate groups comprise the structural features above. In certain such
embodiments, conjugate groups have the following structure:
HO OH
wherein each n is, independently, from 1 to 20.
In certain such embodiments, conjugate groups have the following structure:
HO OH
O H O
O HN\/\/
NHAc O
HO OH o
O H H H
0 NWN 0 N_|
NHAc WY o
HO HN
H\/\/ o
o N
NHAc
In certain such embodiments, conjugate groups have the following structure:
HO OH _
O H H o OH
N N
o 9H 6
NHAc W\9:
” = 0
HO 0H 0
H H ‘
N N
o O qN 0I
HO \9/ n o—P=X
“ n ”
NHAc (IDH
o o
o HW/HN o
HO n
NHAc
wherein each n is, independently, from 1 to 20;
Z is H or a linked solid support;
Q is an antisense compound;
X is O or S; and
BX is a heterocyclic base moiety.
In certain such embodiments, conjugate groups have the following structure:
HO OH _
O H H O
o OH O=Fl’—OH
HO \/ :
HO OV\H/ \/ O—FI’ZX
NHAc OH
o 0
0 H HN
O N\/
NHAC
O
2014/036460
In certain such embodiments, conjugate groups have the following structure:
HO OH _
O H O 0 2 OH: — N N
oWM 9H N
Ho <
NHAc = O N
NHAc o
H0 W 3 NHAc
HOOH
HO O i?
“ 0 (5H0
ACHN )
HOOH n
mm Wakomoo 0
0 ll o
ACHN OH
HOOH Q
O 0%’3‘04") 11
H0 11 OH
NHAC
In certain such embodiments, conjugate groups have the following structure:
NHAC
In certain such ments, conjugate groups have the following structure:
HOOH
HO O i?
ACHN O/|\O
OH )
HOOH 11 NHZ
HOW Wolomo \
O 0 O 0
0 "
newH O N
/P\ JAN
_ _ be
ACHN OH OH
O 0‘
HOOH
o 0 SP). fl) Ho—r}=o
We}? “
HO 9
NHAC
In certain such embodiments, conjugate groups have the following structure:
HOOH
HO OV\/\/\ i?
O’ |\O
ACHN
OH k
HO OH
O 0
0 (II) o {If
HO O\/\/\/\ /l3l\ /\/\ O—P—OW N’J
O | O 0 (5H \
ACHN 0H 0
Ho—13=o
HO 0“ 15L ('3
O DMD/('31? —
NHAC
In certain such embodiments, conjugate groups have the following structure:
o (3 o
HO WO/flKO/egh ('3
O O
ACHN OH
HOOH O
Hofig/ W0 0
/ fl)
O | O n
NHAC
In certain such embodiments, conjugate groups have the following structure:
HO—I|’=O
HOOH 0
HO OW\/\ (H) /P\ OH
AcHN I O
OH 0
HO OH O
O 9 0 (13—0 _
HO O\/\/\/\O/II)\O/\/\O/a\/ I
AcHN 0H OH
In n embodiments, conjugates do not comprise a pyrrolidine.
In certain such embodiments, conjugate groups have the following structure:
I N
O- W
HOOH .-
o H H
o ('3‘
HO :VYNWNf O=P-O'
ACHN o
HOOH
\/\/\n/N\/\/N\H/\/OO N
AcHN
H O
HO O\/\/\n/N\/\/
ACHN
In certain such embodiments, conjugate groups have the ing structure:
ACHN O Q
o /JKJ O:I_O
HO OH it W
O O\/\/\/\O (5.0
NHAC
In certain such embodiments, conjugate groups have the following ure:
HO OH
NHAC
In certain such embodiments, conjugate groups have the following structure:
HoOH o
o N
Ho 4 Hkk
AcHN
Hog/o o :
O N ”W0 s
H M ‘
AcHN o
HoOH
o /£’J
o N
Ho O
4 H
AcHN
In certain such embodiments, conjugate groups have the following structure:
HO OH H
O o N O
HO W
ACHN
HOOH O
o o
O o N
HO WH QWQWO 5
ACHN
HOOH
HO 4
ACHN
In certain such embodiments, conjugate groups have the following structure:
HO OH H
O o N O
HO W
ACHN
HOOH O
o o
O OAmi}N O
HO ”WMWO_P_§
AcHN
HOOH
O O
HO Ami—H
ACHN
In certain such embodiments, conjugate groups have the ing structure:
ACHN
OHOH
HO O O H O H O
OWN N NWN‘9; §
AcHN H O H O
OH “NH
O O
NHAC
OHOH
O O H O H O?
ACHN H O H O
O O
NHAC
In certain such embodiments, conjugate groups have the following structure:
HOOH '
o N
HO 0%
O O
ACHN O—FI’ OH
HOOH
o N
OW O
ACHN O‘FI’ OH
HOOH
o N
HO 0%20
o E
AcHN
In certain such ments, conjugate groups have the following structure:
HoOH '
Home;Q0o N
ACHN |
OZT-OH
HOOH
o N
HO O/*%:?; o
ACHN |
O=T—OH
HOOH
o N
ACHN ('3
In certain embodiments, the cell-targeting moiety of the ate group has the following structure:
HoOH
HO O\\X
AcHN \\
HoOH
Hog/OO i —X 0 /3‘
ACHN
HOOH X/
o o//
ACHN
wherein X is a substituted or unsubstituted tether of six to eleven utively bonded atoms.
In certain embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HoOH
HO O\\X
AcHN \\
HoOH
Hog/Oo _#_X___0 ”’3‘
AcHN
HOOH X/
o o//
AcHN
wherein X is a substituted or unsubstituted tether of ten consecutively bonded atoms.
In n embodiments, the cell-targeting moiety of the conjugate group has the ing structure:
HoOH
HO O\\X
AcHN \\
HoOH
Hog/Oo _#_X___0 ”’3‘
AcHN
HOOH X/
o o//
AcHN
wherein X is a substituted or unsubstituted tether of four to eleven consecutively bonded atoms and wherein
the tether comprises exactly one amide bond.
In certain embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HoOH
HO O\Y
AcHN ‘jz
\N 2/0
HoOH O
Hog/Oo __Y\N/u\Z,O ,%
AcHN H z\
HOOH O
Y/ \W
O O/ o
AcHN
wherein Y and Z are independently selected from a C1-C12 substituted or unsubstituted alkyl, alkenyl, or
l group, or a group comprising an ether, a ketone, an amide, an ester, a carbamate, an amine, a
piperidine, a phosphate, a odiester, a phosphorothioate, a triazole, a pyrrolidine, a disulfide, or a
thioether.
In certain such embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HOOH
Hoj§:%~L/O\YO
AcHN ‘jz
\N 2/0
HoOH O
Hoj§:%~X/Oo _YkNJLZ,O )5
AcHN H z\
HOOH Y/‘WV O
O O/ o
ACHN
wherein Y and Z are independently selected from a C1-C12 substituted or unsubstituted alkyl group, or a
group comprising exactly one ether or exactly two ethers, an amide, an amine, a piperidine, a ate, a
phosphodiester, or a phosphorothioate.
In certain such embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HOOH
Hoj§:%~L/O\YO
AcHN ‘jz
\N 2/0
HoOH O
Hoj§:%~X/Oo Z,O )5
AcHN H z\
HOOH Y/‘WV O
O O/ o
ACHN
wherein Y and Z are independently selected from a C1-C12 substituted or unsubstituted alkyl group.
In certain such embodiments, the cell-targeting moiety of the conjugate group has the ing structure:
HoOH O
HomoflmN/UffoH
AcHN O “
wherein m and n are independently selected from 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, and 12.
In certain such embodiments, the cell-targeting moiety of the ate group has the following structure:
HOOH O
Homo/amN/UT’IOo H n
HOOH W0 )1
mo N m " IZ
AcHN
wherein m is 4, 5, 6, 7, or 8, and n is l, 2, 3, or 4.
In certain ments, the cell-targeting moiety of the conjugate group has the following structure:
H00H
HO O\
HOOH X
AcHN
o X
HO 3%
AcHN I2
Howe/X
AcHN
wherein X is a substituted or unsubstituted tether of four to thirteen consecutively bonded atoms, and wherein
X does not comprise an ether group.
In certain embodiments, the argeting moiety of the conjugate group has the following structure:
wherein X is a substituted or unsubstituted tether of eight utively bonded atoms, and wherein X does
not comprise an ether group.
In certain embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HOOH
HQOH HO \X
AcHN
O X
HO NE
AcHN H
OHOH
HOJE%:i/O//x
AcHN
wherein X is a substituted or unsubstituted tether of four to thirteen consecutively bonded atoms, and wherein
the tether ses y one amide bond, and wherein X does not comprise an ether group.
In certain ments, the cell-targeting moiety of the conjugate group has the following structure:
AcHN
wherein X is a substituted or unsubstituted tether of four to thirteen consecutively bonded atoms and wherein
the tether consists of an amide bond and a substituted or unsubstituted C2-C11 alkyl group.
In certain embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HOOH H
O O—Y’N O
AcHN
HoOH O
O /Y\
o N 2
HO H ”
AcHN
HoOH
O O—Y/M O
AcHN
wherein Y is selected from a C1-C12 substituted or unsubstituted alkyl, alkenyl, or alkynyl group, or a group
comprising an ether, a ketone, an amide, an ester, a ate, an amine, a piperidine, a phosphate, a
phosphodiester, a phosphorothioate, a triazole, a pyrrolidine, a ide, or a thioether.
In certain such embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HOOH H
O 0—y—N O
AcHN
HoOH O
O /Y\
o N 2
HO H ”
AcHN
HoOH
C) o——Y/’N O
AcHN
wherein Y is selected from a C1-C12 substituted or unsubstituted alkyl group, or a group comprising an ether,
an amine, a piperidine, a ate, a phosphodiester, or a phosphorothioate.
In certain such embodiments, the cell-targeting moiety of the ate group has the following structure:
HOOH H
O O—Y’N O
AcHN
HoOH O
O /Y\
o N 2
HO H ”
AcHN
HoOH
O O-—Y’/H O
AcHN
wherein Y is selected from a C1-C12 substituted or unsubstituted alkyl group.
In certain such embodiments, the cell-targeting moiety of the conjugate group has the ing structure:
HOOH H
O o N O
HO fin
AcHN
HoOH O
Hofifi/ flEHo o N A
AcHN
HoOH
O O‘49\n N O
HO H
AcHN
WMmmnmLL&&i@Z&%lQHmHZ
In certain such embodiments, the cell-targeting moiety of the conjugate group has the following structure:
HOOH H
OoNfan O
AcHN
HoOH o
O oIfw Ni
HO H
AcHN
HoOH
HO H
AcHN
wherein n is 4, 5, 6, 7, or 8.
b.Certain c0n°u ated antisense com ounds
In certain embodiments, the conjugates are bound to a nucleoside of the antisense oligonucleotide
at the 2’, 3’, of 5’ on of the nucleoside. In certain ments, a conjugated antisense compound has
the following structure:
A———B———C———D——6E-—-a
wherein
A is the antisense oligonucleotide;
B is the cleavable moiety
C is the conjugate linker
D is the branching group
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, a conjugated antisense nd has the following structure:
§E_F)
wherein
A is the antisense oligonucleotide;
C is the conjugate linker
D is the branching group
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain such embodiments, the ate linker comprises at least one cleavable bond.
In certain such embodiments, the branching group comprises at least one cleavable bond.
In n embodiments each tether comprises at least one cleavable bond.
In n embodiments, the conjugates are bound to a side of the nse oligonucleotide at the 2’,
3’, of 5’ position of the nucleoside.
In certain embodiments, a conjugated antisense compound has the following structure:
A—B—c+E—F>
wherein
A is the antisense oligonucleotide;
B is the cleavable moiety
C is the conjugate linker
each E is a ;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, the conjugates are bound to a nucleoside of the antisense oligonucleotide at the 2’,
3’, of 5’ position of the nucleoside. In certain embodiments, a conjugated antisense compound has the
following structure:
A—C+E—F>
wherein
A is the antisense oligonucleotide;
C is the conjugate linker
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, a conjugated antisense nd has the ing structure:
A—B—D+E—F>
wherein
A is the nse oligonucleotide;
B is the cleavable moiety
D is the branching group
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain embodiments, a conjugated antisense nd has the following structure:
A owe—F)
wherein
A is the antisense oligonucleotide;
D is the branching group
each E is a tether;
each F is a ligand; and
q is an integer between 1 and 5.
In certain such embodiments, the conjugate linker comprises at least one cleavable bond.
In certain embodiments each tether comprises at least one ble bond.
In certain embodiments, a conjugated antisense compound has a structure selected from among the
following:
Targeting moiety
HO OH
WWW";
HOOHM iJfll PO
Ligand Tether WU Cleavable moiety
$wa Branching group
In certain embodiments, a conjugated nse compound has a structure selected from among the
following:
Cell targeting moiety
Branching group
In certain embodiments, a conjugated antisense compound has a structure ed from among the
following:
2014/036460
Cleavable m01ety
Cell targeting moiety |
HO OH
0’ : OH
ACHN ((2:01 0
HOOH O 233 Conjugate
O—lID—O linker
ACHN O OH
Tether I—l
Ligand ZOE—lO
O O
NHAC Branching group
In certain embodiments, the conjugated antisense compound has the following structure:
Representative United States patents, United States patent ation ations, and international
patent application publications that teach the ation of certain of the above noted conjugates, conjugated
antisense compounds, tethers, linkers, branching groups, ligands, cleavable moieties as well as other
modifications include Without limitation, US 5,994,517, US 319, US 6,660,720, US 6,906,182, US
7,262,177, US 7,491,805, US 8,106,022, US 7,723,509, US 2006/0148740, US 2011/0123520, WO
2013/033230 and , each of Which is incorporated by reference herein in its entirety.
Representative ations that teach the preparation of certain of the above noted conjugates,
conjugated antisense compounds, tethers, linkers, branching groups, ligands, cleavable moieties as well as
other modifications include without limitation, BIESSEN et al., ”The Cholesterol Derivative of a
Triantennary Galactoside with High Affinity for the Hepatic Asialoglycoprotein Receptor: a Potent
Cholesterol ng Agent” J. Med. Chem. (1995) 38:1846-1852, BIESSEN et al., ”Synthesis of Cluster
Galactosides with High Affinity for the c Asialoglycoprotein Receptor” J. Med. Chem. (1995)
38:1538-1546, LEE et al., ”New and more efficient multivalent ligands for asialoglycoprotein receptor
of mammalian cytes” Bioorganic & Medicinal Chemistry (2011) 19:2494-2500, RENSEN et al.,
”Determination of the Upper Size Limit for Uptake and Processing of Ligands by the Asialoglycoprotein
or on Hepatocytes in Vitro and in Vivo” J. Biol. Chem. (2001) 276(40):37577-37584, RENSEN et al.,
”Design and sis of Novel N—Acetylgalactosamine-Terminated Glycolipids for Targeting of
Lipoproteins to the Hepatic Asialoglycoprotein Receptor” J. Med. Chem. (2004) 47:5798-5 808, SLIEDREGT
et al., ”Design and Synthesis of Novel Amphiphilic Dendritic osides for ive Targeting of
Liposomes to the Hepatic Asialoglycoprotein or” J. Med. Chem. (1999) 42:609-618, and Valentijn et
al., “Solid-phase synthesis of lysine-based cluster galactosides with high affinity for the Asialoglycoprotein
Receptor” Tetrahedron, 1997, 53(2), 759-770, each of which is incorporated by nce herein in its
entirety.
In certain embodiments, conjugated antisense compounds comprise an RNase H based
oligonucleotide (such as a gapmer) or a splice modulating oligonucleotide (such as a fully modified
oligonucleotide) and any conjugate group comprising at least one, two, or three GalNAc groups. In certain
ments a conjugated antisense compound comprises any conjugate group found in any of the following
references: Lee, Carbohydr Res, 1978, 67, 509-514; Connolly et al., J Biol Chem, 1982, 257, 939-945; Pavia
et al., IntJPep Protein Res, 1983, 22, 539-548; Lee et al., Biochem, 1984, 23, 261; Lee et al.,
Glycoconjugate J, 1987, 4, 317-328; Toyokuni et al., Tetrahedron Lett, 1990, 31, 2673-2676; Biessen et al., J
Med Chem, 1995, 38, 1538-1546; Valentijn et al., Tetrahedron, 1997, 53, 759-770; Kim et al., Tetrahedron
Lett, 1997, 38, 3487-3490; Lee et al., Bioconjug Chem, 1997, 8, 762-765; Kato et al., Glycobiol, 2001, 11,
821-829; Rensen et al., JBiol Chem, 2001, 276, 37577-37584; Lee et al., Methods Enzymol, 2003, 362, 38-
43; lind et al., Glycoconj J, 2004, 21, 227-241; Lee et al., Bioorg Med Chem Lett, 2006, 16(19), 5132-
5135; Maierhofer et al., Bioorg Med Chem, 2007, 15, 7661-7676; Khorev et al., Bioorg Med Chem, 2008, 16,
5216-5231; Lee et al., Bioorg Med Chem, 2011, 19, 2494-2500; Kornilova et al., Analyt Biochem, 2012, 425,
43-46; Pujol et al., Angew Chemie Int Ed Engl, 2012, 51, 448; Biessen et al., JMed Chem, 1995, 38,
1846-1852; egt et al., JMed Chem, 1999, 42, 609-618; Rensen et al., JMed Chem, 2004, 47, 5798-
808; Rensen et al., Arterioscler Thromb Vasc Biol, 2006, 26, 169-175; van Rossenberg et al., Gene Ther,
2004, 11, 457-464; Sato et al., JAm Chem Soc, 2004, 126, 14013-14022; Lee et al., JOrg Chem, 2012, 77,
7564-7571; Biessen et al., FASEB J, 2000, 14, 1784-1792; Rajur et al., Bioconjug Chem, 1997, 8, 935-940;
Duff et al., Methods Enzymol, 2000, 313, 1; Maier et al., Bioconjug Chem, 2003, 14, 18-29;
Jayaprakash et al., Org Lett, 2010, 12, 5410-5413; Manoharan, Antisense Nucleic Acid Drug Dev, 2002, 12,
103-128; MerWin et al., Bioconjug Chem, 1994, 5, 612-620; Tomiya et al., Bioorg Med Chem, 2013, 21,
5275-5281; International applications WOl998/013381; WO2011/038356; /046098;
WO2008/098788; WO2004/101619; WO2012/037254; WO2011/120053; WO2011/100131;
WO2011/163121; WO2012/177947; WO2013/033230; WO2013/075035; WO2012/083185;
WO2012/083046; WO2009/082607; WO2009/134487; WO2010/144740; /148013;
WOl997/020563; WO2010/088537; WO2002/043771; WO2010/129709; /068187;
WO2009/126933; WO2004/024757; WO2010/054406; WO2012/089352; WO2012/089602;
WO2013/166121; WO2013/165816; US. Patents 4,751,219; 8,552,163; 6,908,903; 177; 5,994,517;
6,300,319; 022; 7,491,805; 805; 7,582,744; 8,137,695; 6,383,812; 6,525,031; 720;
7,723,509; 8,541,548; 125; 772; 8,349,308; 467; 8,501,930; 601; 7,262,177;
6,906,182; 916; 8,435,491; 8,404,862; 7,851,615; Published US. Patent Application Publications
US2011/0097264; US2011/0097265; US2013/0004427; /0164235; US2006/0148740;
US2008/0281044; US2010/0240730; US2003/0119724; US2006/0183886; /0206869;
US2011/0269814; US2009/0286973; US2011/0207799; US2012/0136042; US2012/0165393;
US2008/0281041; US2009/0203135; US2012/0035115; US2012/0095075; US2012/0101148;
US2012/0128760; US2012/0157509; US2012/0230938; US2013/0109817; US2013/0121954;
US2013/0178512; US2013/0236968; US2011/0123520; US2003/0077829; US2008/0108801; and
US2009/0203132; each of Which is incorporated by reference in its entirety.
C. Certain Uses and Features
In certain embodiments, conjugated antisense compounds exhibit potent target RNA reduction in
vivo. In certain embodiments, unconjugated antisense compounds accumulate in the kidney. In certain
embodiments, conjugated antisense compounds accumulate in the liver. In certain embodiments, ated
antisense compounds are well tolerated. Such properties render conjugated nse compounds particularly
useful for inhibition of many target RNAs, including, but not limited to those involved in metabolic,
cardiovascular and other diseases, disorders or conditions. Thus, provided herein are methods of treating
such diseases, disorders or conditions by contacting liver tissues With the conjugated antisense compounds
targeted to RNAs associated With such diseases, disorders or conditions. Thus, also provided are methods for
ameliorating any of a variety of metabolic, cardiovascular and other es, disorders or conditions With the
conjugated antisense compounds of the present invention.
In certain embodiments, conjugated antisense compounds are more potent than unconjugated
counterpart at a particular tissue concentration. Without g to be bound by any theory or mechanism, in
certain embodiemtns, the conjugate may allow the conjugated antisense compound to enter the cell more
efficiently or to enter the cell more productively. For example, in certain embodiments conjugated antisense
compounds may exhibit greater target reduction as compared to its unconjugated counterpart Wherein both
the conjugated antisense compound and its unconjugated counterpart are present in the tissue at the same
concentrations. For example, in certain embodiments conjugated antisense compounds may exhibit greater
target reduction as compared to its ugated counterpart wherein both the conjugated antisense
compound and its unconjugated rpart are present in the liver at the same concentrations.
Productive and oductive uptake of oligonucleotides has beed discussed previously (See e. g.
Geary, R. S., E. Wancewicz, et al. (2009). t of Dose and Plasma Concentration on Liver Uptake and
Pharmacologic ty of a 2'-MethoxyethylModif1ed Chimeric Antisense Oligonucleotide Targeting
PTEN.” Biochem. Pharmacol. 78(3): ; & Koller, E., T. M. Vincent, et al. (2011). ”Mechanisms of
single-stranded phosphorothioate modified antisense oligonucleotide accumulation in hepatocytes.” Nucleic
Acids Res. 39(11): 4795-807). Conjugate groups bed herein may improve productive uptake.
In n embodiments, the conjugate groups described herein may further improve potency by
increasing the affinity of the conjugated antisense compound for a particular type of cell or tissue. In certain
embodiments, the conjugate groups described herein may further improve potency by increasing recognition
of the conjugated antisense compound by one or more cell-surface receptors. . In certain ments, the
conjugate groups described herein may further improve potency by facilitating endocytosis of the ated
antisense compound.
In certain embodiments, the cleavable moiety may further improve potency by allowing the
conjugate to be cleaved from the nse oligonucleotide after the conjugated nse compound has
entered the cell. Accordingly, in certain embodiments, ated antisense compounds can be administed at
doses lower than would be necessary for unconjugated antisense oligonucleotides.
Phosphorothioate es have been incorporated into antisense oligonucleotides previously. Such
phosphorothioate linkages are resistant to nucleases and so improve ity of the oligonucleotide. Further,
phosphorothioate linkages also bind certain proteins, which results in accumulation of antisense
oligonucleotide in the liver. Oligonucleotides with fewer phosphorothioate linkages accumulate less in the
liver and more in the kidney (see, for example, Geary, R., “Pharmacokinetic Properties of 2’-O-(2-
Methoxyethyl)-Modif1ed Oligonucleotide Analogs in Rats,” Journal ofPharmacology and Experimental
Therapeutics, Vol. 296, No. 3, 890-897; & cological Properties of2 ’Methoxyethyl Modified
Oligonucleotides in Antisense a Drug logy, Chapter 10, Crooke, S.T., ed., 2008) In certain
ments, oligonucleotides with fewer phosphorothioate intemculeoside linkages and more
phosphodiester internucleoside es accumulate less in the liver and more in the kidney. When treating
diseases in the liver, this is undesibable for several reasons (1) less drug is getting to the site of desired action
(liver); (2) drug is escaping into the urine; and (3) the kidney is exposed to relatively high concentration of
drug which can result in toxicities in the . Thus, for liver diseases, phosphorothioate linkages provide
important benefits.
In certain embodiments, however, administration of oligonucleotides uniformly linked by oro-
thioate intemucleoside linkages induces one or more proinflammatory reactions. (see for example: J Lab
Clin Med. 1996 Sep; l28(3):329-3 8. “Amplification of antibody production by phosphorothioate
oligodeoxynucleotides”. Branda et al.; and see also for e: logic Properties in Antisense a Drug
Technology, Chapter 12, pages 342-351, Crooke, S.T., ed., 2008). In certain embodiments, administration of
oligonucleotides n most of the internucleoside linkages comprise phosphorothioate intemucleoside
linkages induces one or more proinflammatory reactions.
In certain embodiments, the degree of proinflammatory effect may depend on several variables (e. g.
backbone modification, off-target effects, nucleobase modifications, and/or nucleoside modifications) see for
example: Toxicologic Properties in nse a Drug Technology, Chapter 12, pages 342-351, , S.T.,
ed., 2008). In certain embodiments, the degree of proinflammatory effect may be mitigated by adjusting one
or more variables. For example the degree of proinflammatory effect of a given oligonucleotide may be
mitigated by replacing any number of phosphorothioate intemucleoside linkages with phosphodiester
intemucleoside linkages and thereby reducing the total number of phosphorothioate internucleoside es.
In certain embodiments, it would be desirable to reduce the number of phosphorothioate linkages, if
doing so could be done without losing stability and without shifting the distribution from liver to kidney. For
example, in certain embodiments, the number of phosphorothioate linkages may be reduced by replacing
phosphorothioate linkages with odiester linkages. In such an embodiment, the antisense compound
having fewer phosphorothioate linkages and more phosphodiester linkages may induce less proinflammatory
reactions or no proinflammatory reaction. Although the the nse compound having fewer phosphoro-
thioate linkages and more phosphodiester linkages may induce fewer proinflammatory reactions, the
antisense compound having fewer phosphorothioate linkages and more phosphodiester linkages may not
accumulate in the liver and may be less efficacious at the same or similar dose as ed to an antisense
compound having more phosphorothioate linkages. In certain embodiments, it is ore desirable to
design an antisense compound that has a ity of phosphodiester bonds and a plurality of
orothioate bonds but which also possesses stability and good distribution to the liver.
In certain embodiments, conjugated antisense compounds accumulate more in the liver and less in
the kidney than ugated counterparts, even when some of the phosporothioate linkages are replaced
with less ammatory odiester intemucleoside linkages. In certain embodiments, conjugated
nse compounds accumulate more in the liver and are not excreted as much in the urine compared to its
unonjugated counterparts, even when some of the phosporothioate linkages are replaced with less
proinflammatory phosphodiester intemucleoside linkages. In certain embodiments, the use of a conjugate
allows one to design more potent and better tolerated antisense drugs. Indeed, in certain emobidments,
conjugated antisense compounds have larger therapeutic indexes than unconjugated rparts. This
allows the conjugated antisense nd to be administered at a higher te dose, because there is less
risk of proinflammatory response and less risk of kidney toxicity. This higher dose, allows one to dose less
frequently, since the clearance (metabolism) is expected to be similar. Further, because the compound is
more potent, as described above, one can allow the concentration to go lower before the next dose without
losing therapeutic activity, allowing for even longer periods between dosing.
In n embodiments, the inclusion of some orothioate linkages remains desirable. For
example, the terminal linkages are vulnerable to exonucleoases and so in certain embodiments, those linkages
are phosphorothioate or other modified linkage. Intemucleoside linkages linking two deoxynucleosides are
vulnerable to endonucleases and so in certain ments those those linkages are phosphorothioate or
other modif1ed linkage. Intemucleoside linkages between a modified nucleoside and a deoxynucleoside
where the deoxynucleoside is on the 5’ side of the linkage deoxynucleosides are vulnerable to endonucleases
and so in certain embodiments those those linkages are phosphorothioate or other modif1ed e.
Internucleoside es between two modified nucleosides of certain types and n a deoxynucleoside
and a modified nucleoside of certain typ where the modified nucleoside is at the 5’ side of the linkage are
sufficiently resistant to nuclease digestion, that the linkage can be phosphodiester.
In certain embodiments, the antisense oligonucleotide of a conjugated antisense compound
comprises fewer than 16 phosphorthioate linkages. In certain ments, the antisense oligonucleotide of
a conjugated antisense compound comprises fewer than 15 phosphorthioate linkages. In certain
embodiments, the antisense oligonucleotide of a conjugated antisense compound comprises fewer than 14
phosphorthioate linkages. In certain embodiments, the nse oligonucleotide of a conjugated antisense
compound comprises fewer than 13 phosphorthioate linkages. In certain embodiments, the antisense
ucleotide of a conjugated antisense compound comprises fewer than 12 phosphorthioate linkages. In
certain embodiments, the antisense oligonucleotide of a conjugated antisense nd comprises fewer
than 11 phosphorthioate linkages. In certain embodiments, the antisense ucleotide of a ated
antisense nd comprises fewer than 10 phosphorthioate linkages. In certain embodiments, the
antisense oligonucleotide of a conjugated antisense compound ses fewer than 9 phosphorthioate
linkages. In certain embodiments, the nse oligonucleotide of a conjugated antisense compound
comprises fewer than 8 phosphorthioate linkages.
In certain ments, antisense nds comprsing one or more conjugae group bed
herein has increased ty and/or potency and/or tolerability compared to a parent antisense nd
lacking such one or more conjugate group. Accordingly, in certain embodiments, attachment of such
conjugate groups to an oligonucleotide is desirable. Such conjugate groups may be attached at the 5’-, and/or
3’- end of an oligonucleotide. In certain instances, attachment at the 5’-end is synthetically desireable.
Typically, oligonucleietides are synthesized by attachment of the 3’ terminal nucleoside to a solid support
and sequential coupling of nucleosides from 3’ to 5’ using techniques that are well known in the art.
ingly if a conjugate group is desred at the 3’-terminus, one may (I) attach the conjugate group to the
3’-terminal nucleoside and attach that conjugated nucleoside to the solid support for subsequent preparation
of the ucleotide or (2) attach the ate group to the 3’-terminal nucleoside of a completed
oligonucleotide after synthesis. Niether of these approaches is very nt and thus both are costly. In
particular, attachment of the conjugated nucleoside to the solid support, while trated in the Examples
herein, is an inefficient process. In certain embodiments, attaching a conjugate group to the 5’-terminal
nucleoside is tically easier than attachment at the 3’-end. One may attach a non-conjugated 3’ terminal
nucleoside to the solid support and prepare the ucleotide using standard and well characterized
reastions. One then needs only to attach a 5’nucleoside having a conjugate group at the final coupling step.
In certain embodiments, this is more efficient than attaching a conjugated nucleoside ly to the solid
support as is typically done to prepare a 3’-conjugated oligonucleotide. The Examples herein demonstrate
attachment at the 5’-end. In on, certain conjugate groups have synthetic advantages. For Example,
certain conjugate groups comprising phosphorus linkage groups are synthetically r and more
efficiently ed than other conjugate , including conjugate groups reported previously (e.g.,
WO/2012/037254).
In certain embodiments, conjugated antisense compounds are administered to a subject. In such
embodiments, antisense compounds comprsing one or more ae group described herein has increased
activity and/or potency and/or tolerability compared to a parent antisense compound lacking such one or
more conjugate group. Without being bound by mechanism, it is believed that the conjugate group helps with
distribution, ry, and/or uptake into a target cell or tissue. In n embodiments, once inside the target
cell or tissue, it is desirable that all or part of the conjugate group to be d to releas the active
oligonucleitde. In n embodiments, it is not necessary that the entire conjugate group be cleaved from
the oligonucleotide. For example, in Example 20 a conjugated oligonucleotide was administered to mice and
a number of different chemical s, each comprising a different portion of the conjugate group remaining
on the oligonucleotide, were detected (Table 23a). Thisconjugated antisense compound demonstrated good
potency (Table 23). Thus, in certain embodiments, such metabolite profile of multiple partial cleavage of the
conjugate group does not interfere with activity/potency. Nevertheless, in certain embodiments it is desirable
that a prodrug (conjugated oligonucleotide) yield a single active compound. In certain instances, if multiple
forms of the active nd are found, it may be necessary to determine relative amounts and activities for
each one. In certain embodiments where regulatory review is required (e.g., USFDA or counterpart) it is
desirable to have a single (or predominantly single) active species. In certain such embodiments, it is
desirable that such single active species be the antisense oligonucleotide lacking any portion of the conjugate
group. In certain embodiments, conjugate groups at the 5’-end are more likely to result in complete
metabolism of the conjugate group. Without being bound by mechanism it may be that nous enzymes
responsible for metabolism at the 5’ end (e.g., 5’ nucleases) are more active/efficient than the 3’ counterparts.
In certain embodiments, the specific conjugate groups are more le to metabolism to a single active
species. In certain embodiments, certain conjugate groups are more amenable to lism to the
oligonucleotide.
D. Antisense
In certain embodiments, oligomeric compounds of the t invention are antisense compounds.
In such embodiments, the oligomeric compound is complementary to a target nucleic acid. In certain
embodiments, a target nucleic acid is an RNA. In n embodiments, a target nucleic acid is a non-coding
RNA. In certain ments, a target nucleic acid encodes a protein. In certain embodiments, a target
nucleic acid is selected from a mRNA, a pre-mRNA, a microRNA, a ding RNA, including small non-
coding RNA, and a promoter-directed RNA. In certain embodiments, oligomeric compounds are at least
partially complementary to more than one target nucleic acid. For example, oligomeric compounds of the
present invention may be microRNA mimics, Which typically bind to multiple targets.
In n embodiments, antisense compounds comprise a portion having a nucleobase sequence at
least 70% complementary to the nucleobase ce of a target c acid. In certain embodiments,
antisense compounds comprise a portion having a nucleobase sequence at least 80% complementary to the
nucleobase sequence of a target nucleic acid. In certain embodiments, antisense compounds comprise a
portion having a base sequence at least 90% complementary to the nucleobase sequence of a target
nucleic acid. In certain embodiments, nse nds comprise a portion having a nucleobase
sequence at least 95% complementary to the nucleobase sequence of a target nucleic acid. In n
embodiments, nse compounds comprise a portion having a nucleobase sequence at least 98%
mentary to the nucleobase ce of a target nucleic acid. In certain embodiments, antisense
compounds comprise a portion having a nucleobase sequence that is 100% complementary to the nucleobase
ce of a target nucleic acid. In certain embodiments, antisense compounds are at least 70%, 80%, 90%,
95%, 98%, or 100% complementary to the nucleobase sequence of a target nucleic acid over the entire
length of the antisense compound.
Antisense mechanisms include any mechanism involving the hybridization of an oligomeric
compound With target nucleic acid, Wherein the hybridization results in a biological effect. In certain
embodiments, such hybridization results in either target nucleic acid degradation or occupancy With
concomitant inhibition or stimulation of the cellular machinery involving, for example, ation,
transcription, or polyadenylation of the target nucleic acid or of a nucleic acid With Which the target nucleic
acid may otherwise interact.
One type of nse mechanism ing degradation of target RNA is RNase H mediated
antisense. RNase H is a cellular endonuclease Which cleaves the RNA strand of an RNA:DNA duplex. It is
known in the art that single-stranded antisense compounds Which are “DNA-like” elicit RNase H activity in
mammalian cells. Activation of RNase H, ore, results in cleavage of the RNA target, thereby greatly
enhancing the efficiency of ke oligonucleotide-mediated inhibition of gene expression.
Antisense mechanisms also include, without limitation RNAi mechanisms, which utilize the RISC
pathway. Such RNAi isms include, without limitation siRNA, ssRNA and NA mechanisms.
Such isms include creation of a microRNA mimic and/or an anti-microRNA.
Antisense mechanisms also include, without limitation, mechanisms that hybridize or mimic non-
coding RNA other than NA or mRNA. Such non-coding RNA includes, but is not limited to
promoter-directed RNA and short and long RNA that effects transcription or translation of one or more
nucleic acids.
In certain embodiments, ucleotides comprising ates described herein are RNAi
compounds. In certain embodiments, oligomeric ucleotides comprising conjugates described herein
are ssRNA compounds. In certain embodiments, oligonucleotides comprising conjugates described herein
are paired with a second oligomeric compound to form an siRNA. In certain such embodiments, the second
oligomeric compound also comprises a conjugate. In certain embodiments, the second oligomeric compound
is any modified or f1ed nucleic acid. In certain embodiments, the oligonucleotides comprising
conjugates described herein is the antisense strand in an siRNA compound. In certain embodiments, the
oligonucleotides comprising conjugates described herein is the sense strand in an siRNA compound. In
embodiments in which the conjugated oligomeric compound is double-stranded siRnA, the conjugate may be
on the sense strand, the antisense strand or both the sense strand and the antisense strand.
C. Apolipoprotein 1a) gapog an
In certain embodiments, conjugated antisense compounds target any apo(a) nucleic acid. In certain
embodiments, the target nucleic acid encodes an apo(a) target protein that is ally nt. In such
embodiments, tion of the target nucleic acid results in clinical benefit.
The targeting process usually includes determination of at least one target region, segment, or site
within the target nucleic acid for the nse interaction to occur such that the desired effect will result.
In certain ments, a target region is a structurally def1ned region of the nucleic acid. For
example, in certain such embodiments, a target region may encompass a 3’ UTR, a 5’ UTR, an exon, an
intron, a coding region, a translation initiation region, translation termination region, or other def1ned nucleic
acid region or target segment.
In certain embodiments, a target segment is at least about an 8-nucleobase portion of a target region
to which a conjugated antisense compound is targeted. Target segments can e DNA or RNA sequences
that comprise at least 8 consecutive nucleobases from the 5'-terminus of one of the target segments (the
remaining nucleobases being a consecutive stretch of the same DNA or RNA beginning immediately
upstream of the 5'-terminus of the target segment and continuing until the DNA or RNA comprises about 8 to
about 30 nucleobases). Target segments are also ented by DNA or RNA sequences that comprise at
least 8 consecutive nucleobases from the 3'-terminus of one of the target segments (the remaining
nucleobases being a consecutive h of the same DNA or RNA beginning immediately downstream of the
3'-terminus of the target segment and continuing until the DNA or RNA comprises about 8 to about 30
nucleobases). Target ts can also be represented by DNA or RNA sequences that comprise at least 8
consecutive nucleobases from an internal portion of the sequence of a target t, and may extend in
either or both directions until the conjugated nse compound comprises about 8 to about 30 nucleobases.
In certain embodiments, antisense compounds targeted to an apo(a) nucleic acid can be modified as
described herein. In certain embodiments, the antisense compounds can have a modified sugar moiety, an
unmodified sugar moiety or a mixture of modified and unmodified sugar moieties as described herein. In
certain embodiments, the antisense compounds can have a modified intemucleoside linkage, an unmodified
cleoside linkage or a mixture of modified and unmodified intemucleoside linkages as described
herein. In certain embodiments, the antisense compounds can have a modified nucleobase, an unmodified
nucleobase or a mixture of modified and unmodified nucleobases as described herein. In certain
embodiments, the antisense compounds can have a motif as described herein.
In certain ments, antisense compounds targeted to apo(a) nucleic acids can be conjugated as
described herein.
One apo(a) protein is linked via a de bond to a single apolipoprotein B (apoB) protein to form
a lipoprotein(a) (Lp(a)) le. The apo(a) n shares a high degree of homology with plasminogen
particularly within the kringle IV type 2 repetitive domain. It is thought that the kringle repeat domain in
apo(a) may be responsible for its rombotic and brinolytic properties, potentially enhancing
atherosclerotic ssion. Apo(a) is transcriptionally regulated by IL-6 and in studies in rheumatoid
arthritis ts treated with an IL-6 inhibitor izumab), plasma levels were reduced by 30% after 3
month treatment. Apo(a) has been shown to preferentially bind ed phospholipids and potentiate
vascular inflammation. Further, studies suggest that the Lp(a) particle may also stimulate endothelial
permeability, induce plasminogen activator inhibitor type-l sion and activate hage interleukin-8
secretion. Importantly, recent genetic association s ed that Lp(a) was an independent risk factor
for myocardial infarction, stroke, peripheral vascular disease and abdominal aortic aneurysm. Further, in the
Precocious Coronary Artery Disease (PROCARDIS) study, Clarke et al. described robust and independent
associations n coronary heart disease and plasma Lp(a) concentrations. Additionally, Solfrizzi et al.,
suggested that increased serum Lp(a) may be linked to an increased risk for Alzheimer’s Disease (AD).
Antisense compounds targeting apo(a) have been previously disclosed in WOZOOS/OOOZOl and US2010-
WO 79625
0331390, herein incorporated by reference in its entirety. An antisense oligonucleobase targeting Apo(a),
ISIS-APOARX, was assessed in a Phase I clinical trial to study it’s safety profile.
Certain Conjugated Antisense Compounds Targeted to an Apo(a) Nucleic Acid
In certain ments, conjugated antisense compounds are targeted to an Apo(a) nucleic acid
having the sequence of GENBANK® Accession No. NM_005577.2, incorporated herein as SEQ ID NO: 1;
GENBANK Accession No. NT_007422. 12 truncated from nucleotides 3230000 to 3380000, incorporated
herein as SEQ ID NO: 2; GENBANK ion No. NT_025741.15 truncated from nucleotides 65120000 to
65258000, designated herein as SEQ ID NO: 3; and GENBANK Accession No. NM_005577.1, incorporated
herein as SEQ ID NO: 4. In certain such ments, a conjugated antisense compound is at least 90%, at
least 95%, or 100% complementary to any of the nucleobase ces of SEQ ID NOs: 1-4.
In certain embodiments, a conjugated antisense compound targeted to any of the nucleobase
ces of SEQ ID NOs: 1-4 comprises an at least 8 consecutive nucleobase sequence selected from the
nucleobase sequence of any of SEQ ID NOs: 12-130, 133, 134. In certain ments, a conjugated
antisense compound targeted to any of SEQ ID NOs: 1-4 ses a nucleobase sequence selected from the
nucleobase sequence of any of SEQ ID NOs: 12-130, 133, 134.
Table A: Antisense Compounds targeted to Ap0(a) SEQ ID NO: 1
Target Start ,_ , . SEQ ID
ISIS N0 Sequence (5 3 ) Motlf
Site NO
494372 3901 TGCTCCGTTGGTGCTTGTTC eeeeeddddddddddeeeee 58
494283 1323 TCTTCCTGTGACAGTGGTGG eeeeeddddddddddeeeee 26
2294
3320
85
494284 —13;; TTCTTCCTGTGACAGTGGTG eeeeeddddddddddeeeee 27
3321
87
494286 1613 GGTTCTTCCTGTGACAGTGG dddddddddeeeee 29
1955
2297
494301 T CGACTATGCGAGTGTGGTGT eeeeeddddddddddeeeee 3 8
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1312
1654
1996
2338
2680
3022
1313
494302 —133: CCGACTATGCGAGTGTGGTG eeeeeddddddddddeeeee 39
2339
2681
3023
Ap0(a) Therapeutic Indications
In certain embodiments, the invention provides methods for using a conjugated antisense compound
targeted to an apo(a) nucleic acid for modulating the expression of apo(a) in a subject. In n
embodiments, the expression of apo(a) is reduced.
In certain ments, provided herein are methods of treating a subject comprising administering
one or more pharmaceutical itions as described herein. In certain embodiments, the invention
provides s for using a conjugated antisense compound ed to an apo(a) nucleic acid in a
pharmaceutical ition for treating a subject. In certain embodiments, the individual has an apo(a)
related disease. In certain embodiments, the individual has an Lp(a) related disease. In certain embodiments,
the individual has an inflammatory, cardiovascular and/or a metabolic disease, disorder or condition.
In n embodiments, the subject has an inflammatory, cardiovascular and/or metabolic disease,
disorder or condition.
In certain ments, the cardiovascular diseases, disorders or conditions include, but are not
limited to, aortic stenosis, aneurysm (e. g., abdominal aortic aneurysm), , arrhythmia, atherosclerosis,
cerebrovascular disease, coronary artery disease, coronary heart e, dyslipidemia, hypercholesterolemia,
hyperlipidemia, hypertension, hypertriglyceridemia, myocardial infarction, peripheral vascular disease (e. g.,
peripheral artery disease), stroke and the like.
In certain embodiments, the compounds targeted to apo(a) bed herein modulate physiological
markers or phenotypes of the cardiovascular e, disorder or condition. For example, administration of
the compounds to animals can decrease LDL and cholesterol levels in those animals compared to untreated
animals. In certain embodiments, the modulation of the physiological markers or phenotypes can be
associated with tion of apo(a) by the compounds.
In certain embodiments, the physiological markers of the cardiovascular disease, disorder or
condition can be quantifiable. For example, LDL or cholesterol levels can be measured and quantified by, for
2014/036460
example, standard lipid tests. For such markers, in n embodiments, the marker can be decreased by
about 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 99%, or arange defined by any
two of these values.
Also, ed herein are methods for preventing, treating or ameliorating a symptom ated with
the cardiovascular disease, disorder or condition in a subject in need thereof. In certain embodiments,
provided is a method for reducing the rate of onset of a symptom associated with the cardiovascular disease,
disorder or condition. In certain embodiments, provided is a method for reducing the severity of a symptom
associated with the cardiovascular disease, disorder or condition. In such embodiments, the s
comprise stering a therapeutically effective amount of a compound targeted to an apo(a) nucleic acid
to an individual in need thereof
The cardiovascular disease, er or condition can be characterized by numerous physical
symptoms. Any symptom known to one of skill in the art to be associated with the cardiovascular disease,
disorder or condition can be prevented, treated, ameliorated or otherwise modulated with the compounds and
methods described herein. In certain embodiments, the symptom can be any of, but not limited to, angina,
chest pain, ess of breath, palpitations, weakness, dizziness, , sweating, ardia, bradycardia,
arrhythmia, atrial fibrillation, swelling in the lower extremities, cyanosis, fatigue, fainting, numbness of the
face, numbness of the limbs, claudication or cramping of muscles, bloating of the n or fever.
In certain embodiments, the metabolic es, disorders or conditions include, but are not d
to, hyperglycemia, betes, diabetes (type I and type II), obesity, insulin resistance, metabolic syndrome
and diabetic dyslipidemia.
In certain embodiments, compounds targeted to apo(a) as described herein modulate physiological
markers or phenotypes of the metabolic e, disorder or condition. For example, administrion of the
compounds to animals can decrease glucose and insulin resistance levels in those animals compared to
ted animals. In certain embodiments, the modulation of the physiological s or phenotypes can be
associated with inhibition of apo(a) by the compounds.
In certain embodiments, physiological markers of the metabolic disease, disorder or condition can be
quantifiable. For example, glucose levels or insulin resistance can be measured and quantified by standard
tests known in the art. For such markers, in certain embodiments, the marker can be decreased by about 5, 10,
, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 99%, or a range defined by any two ofthese
values. In another example, n sensitivity can be measured and quantified by rd tests known in the
art. For such markers, in certain embodiments, the marker can be increase by about 5, 10, 15, 20, 25, 30, 35,
40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 95 or 99%, or a range defined by any two ofthese values.
Also, provided herein are methods for preventing, treating or ameliorating a symptom associated with
the metabolic disease, disorder or condition in a subject in need f In certain embodiments, provided is
a method for reducing the rate of onset of a symptom associated with the lic disease, disorder or
condition. In certain embodiments, provided is a method for reducing the severity of a symptom associated
with the metabolic disease, disorder or condition. In such embodiments, the methods comprise administering
a therapeutically ive amount of a nd targeted to an apo(a) nucleic acid to an individual in need
thereof.
The metabolic disease, disorder or condition can be characterized by numerous physical symptoms.
Any m known to one of skill in the art to be associated with the metabolic disease, disorder or
condition can be prevented, treated, ameliorated or otherwise modulated with the compounds and methods
described . In certain embodiments, the symptom can be any of, but not limited to, excessive urine
production (polyuria), excessive thirst and increased fluid intake (polydipsia), blurred vision, unexplained
weight loss and lethargy.
In certain ments, the inflammatory diseases, disorders or conditions include, but are not
limited to, aortic stenosis, ry artey disease (CAD), Alzheimer’s Disease and thromboembolic diseases,
disorder or conditions. n thromboembolic es, disorders or conditions include, but are not limited
to, , thrombosis, myocardial infarction and peripheral vascular disease.
In n embodiments, the compounds targeted to apo(a) described herein modulate physiological
markers or phenotypes of the inflammatory disease, disorder or condition. For example, administration of the
compounds to animals can decrease inflammatory cytokine or other atory markers levels in those
animals ed to untreated animals. In certain ments, the modulation of the physiological markers
or phenotypes can be associated with inhibition of apo(a) by the compounds.
In certain embodiments, the physiological s of the inflammatory disease, disorder or condition
can be quantifiable. For example, cytokine levels can be measured and quantified by standard tests known in
the art. For such markers, in certain embodiments, the marker can be decreased by at least about 5%, 10%,
%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95% or 99%, or
a range defined by any two of these values.
Also, provided herein are methods for preventing, treating or ameliorating a symptom associated with
the inflammatory disease, disorder or condition in a subject in need thereof In certain embodiments, ed
is a method for reducing the rate of onset of a symptom associated with the inflammatory disease, disorder or
condition. In certain ments, provided is a method for reducing the severity of a m ated
with the inflammatory disease, disorder or condition. In such embodiments, the methods comprise
administering a therapeutically effective amount of a compound targeted to an apo(a) nucleic acid to an
dual in need thereof.
In certain embodiments, provided are methods of treating an individual with an apo(a) related
disease, disorder or condition comprising administering a therapeutically effective amount of one or more
pharmaceutical compositions as described herein. In certain embodiments, the individual has elevated apo(a)
levels. In certain embodiments, provided are methods of treating an individual with an Lp(a) related disease,
disorder or condition comprising administering a therapeutically effective amount of one or more
pharmaceutical itions as described herein. In certain embodiments, the individual has elevated Lp(a)
2014/036460
levels. In certain ments, the individual has an inflammatory, cardiovascular and/or metabolic disease,
disorder or condition. In n ments, administration of a therapeutically effective amount of an
antisense compound targeted to an apo(a) c acid is accompanied by monitoring of apo(a) or Lp(a)
levels. In certain embodiments, administration of a eutically effective amount of an antisense
compound targeted to an apo(a) nucleic acid is accompanied by monitoring of markers of inflammatory,
cardiovascular and/or metabolic disease, or other disease process ated With the expression of apo(a), to
determine an dual’s response to the antisense compound. An individual’s response to administration of
the antisense compound targeting apo(a) can be used by a physician to determine the amount and duration of
eutic intervention with the compound.
In certain embodiments, administration of an antisense compound targeted to an apo(a) nucleic acid
results in reduction of apo(a) expression by at least about 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%,
60%, 65%, 70%, 75%, 80%, 85%, 90%, 95% or 99%, or a range defined by any two of these values. In
certain embodiments, apo(a) sion is reduced to at least S 100 mg/dL, S 90 mg/dL, S 80 mg/dL, S
70 mg/dL, S 60 mg/dL, S 50 mg/dL, S 40 mg/dL, S 30 mg/dL, S20 mg/dL or S 10 mg/dL.
In certain ments, administration of an antisense compound targeted to an apo(a) c acid
results in reduction of Lp(a) expression by at least about 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%,
60%, 65%, 70%, 75%, 80%, 85%, 90%, 95% or 99%, or a range defined by any two of these values. In
certain embodiments, Lp(a) expression is reduced to at least S 200 mg/dL, S 190 mg/dL, S 180 mg/dL, S 175
mg/dL, S 170 mg/dL, S 160 mg/dL, S 150 mg/dL, S 140 mg/dL, S 130 mg/dL, S 120 mg/dL, S 110 mg/dL, S
100 mg/dL, S 90 mg/dL, S 80 mg/dL, S 70 mg/dL, S 60 mg/dL, S 55 mg/dL, S 50 mg/dL, S 45 mg/dL, S 40
mg/dL, S 35 mg/dL, S 30 mg/dL, S 25 mg/dL, S 20 mg/dL, S 15 mg/dL, or S 10 mg/dL.
In certain embodiments, the ion provides methods for using a conjugated nse compound
targeted to an apo(a) nucleic acid in the preparation of a medicament. In certain embodiments,
pharmaceutical compositions comprising a conjugated antisense compound targeted to apo(a) are used for the
preparation of a medicament for treating a patient suffering or susceptible to an inflammatory, cardiovascular
and/or a metabolic disease, disorder or condition.
Ap0(a) Treatment tions
Certain subjects with high Lp(a) levels are at a significant risk of various diseases (Lippi et al.,
Clinica Chimica Acta, 2011, 412:797-801; Solfrizz et al.). In many subjects with high Lp(a) levels, current
ents cannot reduce their Lp(a) levels to safe levels. Apo(a) plays an important role in the formation of
Lp(a), hence reducing apo(a) can reduce Lp(a) and prevent, treat or ameliorate a disease associated with
Lp(a).
In certain embodiments, treatment with the compounds and methods disclosed herein is indicated for
a human animal with elevated apo(a) levels and/or Lp(a) levels. In certain embodiments, the human has
apo(a) levels 2 10 mg/dL, Z 20 mg/dL, Z 30 mg/dL, Z 40 mg/dL, Z 50 mg/dL, Z 60 mg/dL, Z 70 mg/dL, Z
80 mg/dL, Z 90 mg/dL or Z 100 mg/dL. In certain embodiments, the human has Lp(a) levels 2 10 mg/dL, Z
mg/dL, Z 20 mg/dL, Z 25 mg/dL, Z 30 mg/dL, Z 35 mg/dL, Z 40 mg/dL, Z 50 mg/dL, Z 60 mg/dL, Z 70
mg/dL, Z 80 mg/dL, Z 90 mg/dL, Z 100 mg/dL, Z 110 mg/dL, Z 120 mg/dL, Z 130 mg/dL, Z 140 mg/dL,
Z 150 mg/dL, Z 160 mg/dL, Z 170 mg/dL, Z 175 mg/dL, Z 180 mg/dL, Z 190 mg/dL, Z 200 mg/dL.
D. Certain Pharmaceutical itions
In certain embodiments, the present disclosure provides pharmaceutical compositions comprising one
or more nse compound. In certain embodiments, such pharmaceutical composition comprises a suitable
pharmaceutically acceptable diluent or carrier. In certain ments, a pharmaceutical ition
comprises a sterile saline on and one or more antisense compound. In certain embodiments, such
pharmaceutical composition consists of a sterile saline solution and one or more antisense compound. In
certain embodiments, the sterile saline is pharmaceutical grade saline. In certain embodiments, a
pharmaceutical composition comprises one or more antisense compound and sterile water. In certain
embodiments, a pharmaceutical composition ts of one or more antisense compound and sterile water.
In certain embodiments, the sterile saline is ceutical grade water. In n embodiments, a
ceutical composition comprises one or more antisense compound and phosphate-buffered saline
(PBS). In certain embodiments, a pharmaceutical composition ts of one or more antisense compound
and sterile phosphate-buffered saline (PBS). In n embodiments, the sterile saline is pharmaceutical
grade PBS.
In certain embodiments, antisense compounds may be admixed With pharmaceutically acceptable
active and/or inert substances for the preparation of pharmaceutical compositions or formulations.
Compositions and methods for the formulation of pharmaceutical compositions depend on a number of
ia, including, but not limited to, route of administration, extent of disease, or dose to be administered.
Pharmaceutical compositions comprising antisense compounds ass any pharmaceutically
acceptable salts, , or salts of such esters. In certain embodiments, pharmaceutical compositions
comprising antisense compounds comprise one or more oligonucleotide which, upon administration to an
animal, including a human, is capable of providing (directly or indirectly) the biologically active metabolite
or residue thereof. Accordingly, for example, the disclosure is also drawn to pharmaceutically acceptable
salts of antisense compounds, prodrugs, pharmaceutically acceptable salts of such prodrugs, and other
ivalents. Suitable pharmaceutically acceptable salts include, but are not limited to, sodium and
potassium salts.
A g can include the incorporation of additional nucleosides at one or both ends of an
oligonucleotide Which are cleaved by endogenous nucleases Within the body, to form the active antisense
oligonucleotide.
Lipid moieties have been used in nucleic acid therapies in a variety of methods. In certain such
methods, the c acid is introduced into preformed liposomes or lipoplexes made of mixtures of cationic
lipids and neutral lipids. In certain methods, DNA xes With mono- or poly-cationic lipids are formed
Without the presence of a neutral lipid. In certain embodiments, a lipid moiety is selected to increase
bution of a pharmaceutical agent to a particular cell or tissue. In certain embodiments, a lipid moiety is
selected to increase distribution of a pharmaceutical agent to fat tissue. In certain embodiments, a lipid
moiety is selected to increase distribution of a pharmaceutical agent to muscle tissue.
In certain embodiments, pharmaceutical compositions ed herein se one or more
modified oligonucleotides and one or more ents. In certain such embodiments, excipients are selected
from water, salt solutions, alcohol, polyethylene glycols, n, lactose, amylase, magnesium stearate, talc,
silicic acid, s paraffin, hydroxymethylcellulose and polyvinylpyrrolidone.
In certain embodiments, a pharmaceutical composition provided herein comprises a delivery system.
Examples of delivery s include, but are not limited to, liposomes and ons. Certain delivery
systems are useful for preparing certain pharmaceutical itions including those comprising
hydrophobic compounds. In certain embodiments, certain organic ts such as dimethylsulfoxide are
used.
In certain embodiments, a pharmaceutical composition provided herein comprises one or more tissue-
specific delivery les designed to deliver the one or more pharmaceutical agents of the present
sure to specific tissues or cell types. For example, in certain embodiments, pharmaceutical
compositions include liposomes coated With a tissue-specific antibody.
In certain embodiments, a pharmaceutical composition provided herein comprises a co-solvent
system. Certain of such co-solvent s comprise, for example, benzyl alcohol, a nonpolar surfactant, a
water-miscible organic polymer, and an aqueous phase. In certain embodiments, such co-solvent systems are
used for hydrophobic compounds. A non-limiting example of such a co-solvent system is the VPD co-solvent
system, Which is a solution of absolute ethanol comprising 3% W/V benzyl alcohol, 8% W/V of the nonpolar
surfactant Polysorbate 80““ and 65% W/V polyethylene glycol 300. The proportions of such vent
systems may be varied considerably Without significantly altering their solubility and toxicity characteristics.
Furthermore, the identity of co-solvent components may be varied: for example, other surfactants may be
used instead of Polysorbate 80““; the fraction size of hylene glycol may be varied; other biocompatible
polymers may replace polyethylene , e. g., polyvinyl pyrrolidone; and other sugars or ccharides
may substitute for dextrose.
In certain embodiments, a pharmaceutical composition provided herein is ed for oral
administration. In certain embodiments, pharmaceutical compositions are prepared for buccal administration.
In certain embodiments, a pharmaceutical composition is prepared for administration by ion
(e.g., intravenous, subcutaneous, intramuscular, etc.). In certain of such embodiments, a pharmaceutical
composition comprises a carrier and is formulated in aqueous solution, such as water or physiologically
compatible buffers such as Hanks's on, Ringer's solution, or physiological saline buffer. In certain
ments, other ingredients are included (e.g., ingredients that aid in solubility or serve as preservatives).
In certain embodiments, injectable suspensions are prepared using appropriate liquid carriers, suspending
agents and the like. Certain pharmaceutical compositions for injection are presented in unit dosage form, e.g.,
in ampoules or in multi-dose containers. Certain ceutical compositions for injection are suspensions,
solutions or emulsions in oily or aqueous vehicles, and may contain formulatory agents such as ding,
stabilizing and/or sing agents. Certain solvents suitable for use in pharmaceutical compositions for
injection include, but are not limited to, lipophilic solvents and fatty oils, such as sesame oil, synthetic fatty
acid esters, such as ethyl oleate or triglycerides, and liposomes. Aqueous injection suspensions may contain
substances that increase the viscosity of the sion, such as sodium carboxymethyl cellulose, sorbitol, or
dextran. Optionally, such sions may also contain suitable stabilizers or agents that increase the
solubility of the pharmaceutical agents to allow for the preparation of highly concentrated ons.
In certain embodiments, a pharmaceutical composition is prepared for transmucosal administration.
In certain of such embodiments penetrants appropriate to the barrier to be ted are used in the
formulation. Such ants are generally known in the art.
In certain embodiments, a pharmaceutical composition ed herein comprises an oligonucleotide
in a therapeutically effective amount. In certain embodiments, the eutically effective amount is
sufficient to prevent, alleviate or ameliorate symptoms of a disease or to g the survival of the subject
being treated. Determination of a therapeutically effective amount is well within the capability of those
skilled in the art.
In certain embodiments, one or more ed oligonucleotide provided herein is formulated as a
prodrug. In certain embodiments, upon in viva administration, a prodrug is chemically converted to the
biologically, pharmaceutically or therapeutically more active form of an oligonucleotide. In certain
embodiments, gs are useful because they are easier to administer than the corresponding active form.
For example, in certain instances, a g may be more bioavailable (e.g., through oral administration) than
is the corresponding active form. In n instances, a prodrug may have improved lity compared to
the corresponding active form. In n embodiments, prodrugs are less water soluble than the
corresponding active form. In certain instances, such prodrugs possess superior transmittal across cell
membranes, where water solubility is detrimental to mobility. In certain embodiments, a g is an ester.
In certain such embodiments, the ester is metabolically hydrolyzed to carboxylic acid upon administration. In
certain ces the carboxylic acid containing compound is the corresponding active form. In n
embodiments, a prodrug comprises a short peptide (polyaminoacid) bound to an acid group. In certain of
such embodiments, the peptide is cleaved upon administration to form the corresponding active form.
In certain embodiments, the present disclosure provides compositions and methods for reducing the
amount or activity of a target nucleic acid in a cell. In certain embodiments, the cell is in an animal. In
certain embodiments, the animal is a mammal. In certain embodiments, the animal is a rodent. In certain
embodiments, the animal is a primate. In certain embodiments, the animal is a non-human primate. In
certain embodiments, the animal is a human.
In certain embodiments, the present disclosure provides methods of administering a pharmaceutical
ition comprising an oligonucleotide of the present disclosure to an animal. Suitable administration
routes include, but are not limited to, oral, rectal, transmucosal, intestinal, enteral, topical, suppository,
through inhalation, intrathecal, intracerebroventricular, intraperitoneal, intranasal, intraocular, intratumoral,
and parenteral (e. g., intravenous, intramuscular, intramedullary, and subcutaneous). In certain embodiments,
pharmaceutical intrathecals are stered to achieve local rather than systemic exposures. For example,
pharmaceutical compositions may be injected directly in the area of desired effect (e.g., into the liver).
Nonlimiting disclosure and incorporation by reference
While certain compounds, compositions and methods described herein have been described with
specificity in accordance with certain ments, the following examples serve only to illustrate the
compounds described herein and are not intended to limit the same. Each of the nces, GenBank
accession numbers, and the like recited in the present application is incorporated herein by reference in its
entirety.
gh the sequence listing accompanying this filing identifies each sequence as either “RNA” or
“DNA” as required, in reality, those sequences may be modified with any combination of al
modifications. One of skill in the art will readily appreciate that such designation as “RNA” or “DNA” to
describe modified oligonucleotides is, in n instances, arbitrary. For example, an oligonucleotide
comprising a nucleoside comprising a 2’-OH sugar moiety and a thymine base could be described as a DNA
having a modified sugar (2’-OH for the natural 2’-H of DNA) or as an RNA having a modified base (thymine
(methylated ) for l uracil of RNA).
Accordingly, nucleic acid ces provided herein, including, but not limited to those in the
ce listing, are intended to ass nucleic acids containing any combination of natural or modified
RNA and/or DNA, including, but not limited to such nucleic acids having modified nucleobases. By way of
further example and without limitation, an oligonucleotide having the nucleobase sequence TCG”
encompasses any oligonucleotides having such nucleobase ce, whether modified or unmodified,
including, but not limited to, such nds comprising RNA bases, such as those having sequence
“AUCGAUCG” and those having some DNA bases and some RNA bases such as “AUCGATCG” and
oligonucleotides having other modified bases, such as GAUCG,” wherein meC indicates a cytosine
base comprising a methyl group at the 5-position.
EXAMPLES
The ing examples illustrate certain embodiments of the present disclosure and are not limiting.
Moreover, where specific embodiments are provided, the ors have contemplated generic application of
those c ments. For example, disclosure of an oligonucleotide having a particular motif
provides reasonable support for additional oligonucleotides having the same or similar motif. And, for
example, where a particular ffinity modification appears at a ular position, other high-affinity
modifications at the same position are considered suitable, unless otherwise indicated.
Example 1: General Method for the Preparation of Phosphoramidites, Compounds 1, 1a and 2
O O BX
’BX DMTOWBx Q’
\c S "1 /\/OMG H3C S; \:
o O
| o o o
x P\ Px
1 l a 2
Bx is a heterocyclic base;
Compounds 1, 1a and 2 were prepared as per the procedures well known in the art as described in the
specification herein (see Seth et al., Bioorg. Med. Chem., 2011, 21(4), 1122-1125, J. Org. Chem., 2010,
75(5), 1569-1581, Nucleic Acids Symposium Series, 2008, 52(1), 553-554); and also see published PCT
International Applications (, , WO2010/036698, /143369, WO
2009/006478, and ), and US patent 7,569,686).
Example 2: Preparation of Compound 7
AcOOAc
AcOOAc O 0
AC0 WK
0 HO
TMSOTf, 50 °C O/\© 5
AC0 OAc —» o
CICHzCHzCI N\
AcHN TMSOTf, DCE
3 (93%)
4 (66%)
AcOOAc
AcOOAc
ACO¥/ \/\/\”/ VG O
O H2/Pd O OH
0 o —» ACO¥/ V\/\”/
MeOH
A HNC 0
AcHN o (95%)
6 7
Compounds 3 (2-acetamido-l,3,4,6-tetraacetyldeoxy-B-Dgalactopyranose or galactosamine
pentaacetate) is commercially available. Compound 5 was prepared according to published procedures
(Weber et al., J. Med. Chem, 1991, 34, 2692).
2014/036460
Example 3: Preparation of Compound 11
EtO\n/\\
NC/\\
HOHO O EtO
/\/CN 9 HCI, EtOH
NH —>2 NC/\/O NH —>2
aq. KOH Reflux, rt, WEI/DQ7W20 EtO
HO 1 4-dioxane, O (56%)
8 (40%) NC\) 10 ON 11
Compounds 8 and 9 are commercially available.
Example 4: Preparation of Compound 18
EtO EtO
W n O O O benzylchloroformate,
EtO NAG LIOH, H20_
o NH Dioxane, Na2C03 O
2 —> BOW/V Dioxane
O (86")
EtO O 030 ( 910/0)
ON N 12 11
H H
N N
HO >(FE“ WO
F V}Ho
OAQ HBTU DIEA DMF
HO o
(69%)
N + iN/\/\0'quo
O 13
AcOOAc
H2N H O
\/\/N o OH
\n/\\ A00¥/W 17
H o o AcHN o
H 2 \/\/N\n/\/O\%7HJOK
GAE: HBTU,D|EA, HOBt
95% O O DMF
16 (64%)
HQNMH O
AcOOAc
O H H
ACHN
AcOOAc OMNWNfiO
0 OVVYHWHYVO
A00 NAG
AcHN do
O O O
AcOOAc H HN’CO
0 Nfl
ACO O\/\/\n/
AcHN 18
2014/036460
Compound 11 was prepared as per the procedures illustrated in Example 3. Compound 14 is
commercially available. Compound 17 was prepared using similar procedures reported by Rensen et al., J.
Med. Chem, 2004, 47, 5798-5808.
Example 5: Preparation of Compound 23
O O
o H3co)L(‘/):LOH 21
oj/ b
1TBDMScI TBDMSO |EA
N DMF, ImIdazode, rt (95 %)
DMF, rt (65%)
HO —>
2. Pd/C, H2, MeOH, rt
2. TEA.3HF TEA THF
-,,OH 87% OTBDMS (7é%)
DMTO
HO 0 o
1 DMTCI pyr rt (7)5%
N OCH3 —>
2. LiOH, Dioxane
(97%)
a 22
Compounds 19 and 21 are commercially available.
2014/036460
Example 6: Preparation of Compound 24
ACOOAC
1. H2, Pd/C, MeOH (93%)
AcowovaHWHWI/Vog’hlko 2. HBTU, DIEA, DMF (76%)
/«T:j O O /ODMT
H HOJ%afi\ f
W4 ”9 23
O 18
AnI—IN
Compounds 18 and 23 were prepared as per the procedures illustrated in Examples 4 and 5.
2014/036460
Example 7: Preparation of Compound 25
AcOOAc
O H H
ACO \/\/\n/N\/\/N\EO
ACHN O
AcOOAc
O /ODMT
H O O =_
1. Succinic anhydride,DMAP, DCE
ACO $:ro OWNWHTVogimwNQ
ACHN O O O 2. DMF, HBTU, EtN(iPr)2, PS-SS
AcOOAc HN”:
AcOmOMNflH O
AcHN
AcOOAc
O H
o H 0
A00 \/\/\n/N\/\/ K
ACHN o
ODMT
AcOOAc o
O O ’
o H H
AcO W \/\/N\n/\/ %H0 NWa N NH
AcHN o o o
( o
AcOOAc HN
AcHN
Compound 24 was prepared as per the procedures illustrated in Example 6.
Example 8: Preparation of Compound 26
AcOOAc
O H
o H 0
A00 \/\/\n/N\/\/ K
ACHN O
AcOOAc
o /ODMT
H O
O OWYNWNYVQgiuwNQH
O :__
AcO Phosphitylation
ACHN O O O
AcOOAc H HN’CO
o N\/\/
A00 O\/\/\n/
AcHN
AcOOAc
O H
o H 0
A00 \/\/\n/N\/\/ K
ACHN O
AcOOAc
O /ODMT
Agog/O H
o H o O
0%NWNQ=__ WYN\/\/N\g/V H s
ACHN O O
< O
HN “Owe/P‘NaPr»
HN\/\/ O
0 OR
Compound 24 is prepared as per the ures illustrated in Example 6.
Example 9: General preparation of conjugated ASOs comprising 3-1 at the 3’ terminus,
Compound 29
ACOOAC
O H
o H o
ACO \/\/\n/N\/\/ K
ACHN O
ACOOA
0 .5
ACO VVT \/\/NY» %H0 NWa N NH
ACHN o o o
1. DCA, DCM
ACOOAC HN’:
H\/\/ O 2. DCI,N1\/H, ACN
O O\/\/\n/N Phosphoramidite DNA/RNA
ACO building block 1 automated synthesizer
ACHN 3. Capping
4. t-BuOOH DMTOAfi,
ACOOAC
O H
o H ('3 CN
ACO /VENo 0=P—o/\’
ACHN O
ACOOA
H\/\/
ACHN O 0QOHN
1. DCA, DCM
2. DCI, N1VH, ACN
ACOOAC H O Phosphoramidite DNA/RNA
O Ole/Nx/V building bIOCk 1a automated synthesizer
AcO 3- Capping
27 4. t-BuOOH
ACHN
DMTOWBX
('3‘. beMe
\/CN
ACOOAC
o H H o (I)
ACHN O
ACOOACO o P
O O :
ACO OW\H/N\/\/N M’lLNQ NH
H a
ACHN \CIDI/V O
1. DCA, DCM
AcOOAc H\/\/ o 2. DCI, NMI, ACN
O Phosphoramidite DNA/RNA
ACO O\/\/\n/N
automated synthesize
O ng bIOCkS
28 3. Capping
4. xanthane hydride or t-BuOOH
. Et3N/CH3CN (1:1)
6. Aqueous NH? (cleavage)
(IDH
OLIGO
X=P\-O
o o BX
BX — Heterocycllc base._ VfOMe0
X=OorS |
O=|={—o
HOOH
o H H o ('3
HO WY \/\/ K OzF|>-O
ACHN O
HOOH
o ,0
H O O ’
O H
HO WY WNYvogiMMNQ
ACHN O O O
HOOH H HN’CO
HO OWY
ACHN
Wherein the protected GalNAc3-1 has the structure:
E—Ff—o 0 «JANN Na
HOOH
o H H o 9
HO W\n/ \/\/ K O=F|"O'
ACHN O
HOOH o ,0
O O
o H H 2'
HO W WNYVOgiuwNQ
ACHN o o o
HOOH H HN’CO
HO O\/\/\n/
ACHN
The GalNAc3 cluster n of the conjugate group 3-1 (GalNAc3-1a) can be combined With
any cleavable moiety to provide a variety of conjugate groups. Wherein GalNAc3-1a has the formula:
HOOH
O H
o H o
HO WYNW T; ”in,
ACHN O
HOOH
HNW“ o o _,O
HO WY 0 NW
\n/V H 8 Na
AcHN o o )3 OH
The solid support bound protected GalNAc3-1, Compound 25, was prepared as per the procedures
illustrated in Example 7. Oligomeric Compound 29 comprising GalNAc3-1 at the 3’ terminus was prepared
using standard procedures in ted DNA/RNA synthesis (see Dupouy et al., Angew. Chem. Int. Ed.,
2006, 45, 3623-3627). Phosphoramidite building blocks, Compounds 1 and la were prepared as per the
procedures illustrated in Example 1. The phosphoramidites illustrated are meant to be entative and not
intended to be limiting as other phosphoramidite building blocks can be used to prepare oligomeric
compounds haVing a ermined sequence and composition. The order and quantity of phosphoramidites
added to the solid support can be adjusted to prepare gapped oligomeric compounds as described herein.
Such gapped oligomeric compounds can have ermined ition and base sequence as dictated by
any given target.
e 10: General preparation conjugated ASOs comprising GalNAc3-1 at the 5’ terminus,
Compound 34
ODMT 1. Capping (Ac20,NMprr)
1. DCA,DCM OLIGO g géislgrcfiuOOHi
:= UNL—ODMT ,
2. DCI, NMI, ACN O
Phosphoramidite | 4. DCI, NMI, ACN
Q\E UNL O-P~ /\/CN Phosphoramidite~ ~
_ O 1
building blocks
DNARNA
DNA/RNA
31 automated synthes1zer.
automated synthesizer
1. g (A020, NMI, pyr). DMTO/\<:7’BX
2. t-BuOOH
NC Q
3. DCA, DCM \/\o—1l>
4. DCI, NMI, ACN
Phosphoramidite 26 OLIGO
DNA/RNA
X = O, or S automated synthesizer (I)
BX = Heterocylic base Q UNL—O—R‘O/VCN
AcOOAc
O H
o H o
ACO \/\/\n/N\/\/ K
AcHN 0
A00 OAC O /ODMT
$0 H O o
H 1"
w\/\/N 0 NW
wah N
AcHN O O O
NC\/\O/ROWE);
AcOOAc Hfl” 0
0 CM 0‘“
NC\/\ I
AcO O —
O I'D—O
AcHN
OLIGO
1. Capping (A020, NMI, pyr) (I)
2. H
_ _| /\/CN
3. Et3N:CH3CN (1:1 v/v) Q UNL O FPO
4. DCA, DCM
. NH4, rt (cleavage)
HOOH
O H
o H o
HO \/\/\n/N\/\/ K
AcHN O
HoOH o xOH
O O
o H H
HO WT WN 0 NW
\H/V 8 N
AcHN o o o
- |
O‘R O BX
O Nfl
0 Q
H0 [31/ 'O-ll3=O
AcHN 34
The UnylinkerTM 30 is commercially available. Oligomeric Compound 34 comprising a GalNAc3-1
cluster at the 5’ us is prepared using standard procedures in automated DNA/RNA synthesis (see
Dupouy et al., Angew. Chem. Int. Ed., 2006, 45, 3623-3627). Phosphoramidite building blocks, Compounds
l and la were prepared as per the procedures illustrated in e 1. The phosphoramidites rated are
meant to be representative and not intended to be limiting as other phosphoramidite building blocks can be
used to prepare an oligomeric compound having a predetermined sequence and composition. The order and
quantity of phosphoramidites added to the solid t can be adjusted to prepare gapped oligomeric
compounds as described herein. Such gapped oligomeric compounds can have predetermined composition
and base sequence as dictated by any given target.
Example 11: Preparation of Compound 39
A OOAc°
1. HoWfiko/D AcOOAc
AC0 35
TMSOTf,DCE
o NH2o 8
Ni‘ 2. H2/Pd, MeOH AcHN 36
A60 OAc
AcO 1. H2,Pd/C,MeOH
HBTU, DMF, EtN(iPr)2 o
Compound 13 AcHN W”
2. HBTU DIEA DMF
:ZVMWHOAc
mo Compound 23
w9%“?
NHAc
AcHN
0 ODMT
E Phosphitylation
NHAc o O
AGO p
o 38
A00 OWNH
ACHN
ACO OAc
A00 /ODMT
WHWN AcHN 8 OMNqo
Acogx/ACO OWN\H/\O/figiNH
NC\/\O’Fl’NUP02
NHAc
AcO p
o NH 39
A00 w
AcHN
Compounds 4, 13 and 23 were prepared as per the procedures rated in Examples 2, 4, and 5.
Compound 35 is prepared using similar procedures published in Rouchaud et al., Eur. J. Org. Chem, 2011,
12, 2346-2353.
Example 12: Preparation of Compound 40
A00 OAc
o /ODMT
AcHN WHW
0A M“QOH
Ac$53M“wW?“
NHAC
1. Succinic anhydride, DMAP, DCE
A00 p -
0 NH 2. DMF,HBTU, EtN(iPr)2, PS-SS
ACO WV8
AcHN
ACO OAc
0 ODMT
NHAc o 0
A00 W 40
o NH
ACO w
AcHN
Compound 38 is ed as per the procedures illustrated in Example 11.
Example 13: Preparation of Compound 44
ACOOAC HBTU, DMF, EtN(iPr)2
o NH2
AcHN
36 V }NLo
HOWfO 41
ACO OAc
AcHN WWHN8
O O
}N>=0H 1. H2, Pd/C,MeOH
2. HBTU,D|EA,DMF
Op Compound 23
OAC 0
Acow WV8ACO O
O NH
ACHN
ACO OAc
AcHN 8 jZI\n/\\::NNMNam-I Phosphitylation
O 43
o p
A00 OVHWNH
ACHN
ACO OAc
MHVo /ODMT
AcHN 8 5
AcomowpNHOAcACO 44
ACHN
Compounds 23 and 36 are prepared as per the procedures illustrated in es 5 and 11.
Compound 41 is prepared using similar procedures published in WO 2009082607.
Example 14: Preparation of Compound 45
A00 OAc
Acog/OMHo {ODMT
AcHN 8 o :
O 43
A00 W
1. Succinic anhydride, DMAP, DCE
AcO i?) OMNH
AcHN 2. DMF, HBTU, EtN(iPr)2, Ps-ss
ACO OAc
AcOk/OMHo {ODMT
AcHN 8 o :
0A0 45
A00 OWN“
ACHN
Compound 43 is ed as per the ures illustrated in Example 13.
Example 15: Preparation of Compound 47
O DMTO
HO >_ / o < >
N 1. DMTCI, pyr
2. Pd/C, H2, MeOH
HO: 46
Compound 46 is commercially available.
2014/036460
Example 16: Preparation of Compound 53
HBTU, EtN(iPr)2’ DMF
H3COWNHZ
O / H3COWNO
49 BZ/NH
,CBz
H3COW\NO mN/CBZ .
1. TFA H 1.LIOH,MeOH
2- HBTU EtN(I'Pr)2 DMF 2. HBTU, EtN(iPr)2’DMF
/CzB Compound 47
O \CBz
,CBz
DMTO HN
1. H2,Pd/C
[082 2_ tN(iPr)2,DMF
Compound 17
How. N—mN NH N
O H
HN‘CBz
OACOAc
AcO 0/\/\)'|\NH
NHAc
$§%%oMN “N OHMNPIH‘OH
p:(§:&,OMN“ ODMT
NHAc
Compounds 48 and 49 are commercially available. Compounds 17 and 47 are prepared as per the
procedures illustrated in Examples 4 and 15.
Example 17: Preparation of Compound 54
NHAC
A:E§::SL__O/A\v/“\v/fi\N 0
HM ...\OH N
HN N
NHAC O
Ego“NH ODMT
NHAC
Phosphitylation
OACOAc
A00 /\/\)j\
0 NH
NHAC
OAC 0 \/\
0 HM ....0' CN
0 W N
HN N
A00 7
NHAC O
OACOAC o ODMT
A00 0
NHAC
Compound 53 is prepared as per the procedures illustrated in Example 16.
Example 18: Preparation of Compound 55
0 Wk
0 NH
NHAC
OWJ\HN N
HN N
NHACO O
A::C§ACO:83 O/\/\/uo—NH ODMT
NHACO
1. ic anhydride, DMAP, DCE
2. DMF, HBTU, EtN(iPr)2, PS-SS
0 Wk
0 NH
NHAC
SSQLMW‘LH
NHAC O
AfigoI O/\/\/UO—NH ODMT
NHACO
Compound 53 is prepared as per the procedures illustrated in Example 16.
Example 19: General method for the preparation of conjugated ASOs comprising GalNAc3-1 at the 3’
position via solid phase techniques (preparation of ISIS 647535, 647536 and )
Unless otherwise stated, all reagents and solutions used for the synthesis of oligomeric compounds
are purchased from commercial sources. Standard phosphoramidite building blocks and solid support are
used for incorporation nucleoside residues which include for example T, A, G, and InC residues. A 0.1 M
solution of phosphoramidite in anhydrous acetonitrile was used for B-D-Z’-de0xyrib0nucle0side and 2’-
MOE.
The ASO syntheses were performed on ABI 394 synthesizer (1-2 umol scale) or on GE Healthcare
Bioscience AKTA oligopilot sizer (40-200 umol scale) by the phosphoramidite coupling method on an
GalNAc3-1 loaded VIMAD solid t (110 umol/g, GuzaeV et al., 2003) packed in the column. For the
2014/036460
coupling step, the phosphoramidites were red 4 fold excess over the g on the solid support and
phosphoramidite condensation was carried out for 10 min. All other steps followed standard protocols
supplied by the manufacturer. A solution of 6% dichloroacetic acid in toluene was used for removing
oxytrityl (DMT) group from 5 ’-hydroxyl group of the nucleotide. 4,5-Dicyanoimidazole (0.7 M) in
anhydrous CH3CN was used as activator during coupling step. Phosphorothioate linkages were introduced by
sulfurization with 0.1 M solution of xanthane hydride in 1:1 pyridine/CH3CN for a contact time of 3 minutes.
A solution of 20% tert—butylhydroperoxide in CH3CN containing 6% water was used as an oxidizing agent to
provide phosphodiester intemucleoside linkages with a contact time of 12 s.
After the desired sequence was assembled, the cyanoethyl phosphate protecting groups were
deprotected using a 1:1 (v/v) e of ylamine and itrile with a contact time of 45 minutes. The
solid-support bound ASOs were suspended in aqueous ammonia (28-30 wt %) and heated at 55 0C for 6 h.
The unbound ASOs were then filtered and the ammonia was boiled off The residue was purified by
high pressure liquid chromatography on a strong anion exchange column (GE Healthcare Bioscience, Source
30Q, 30 um, 2.54 x 8 cm, A = 100 mM ammonium acetate in 30% aqueous CH3CN, B = 1.5 M NaBr in A, 0-
40% of B in 60 min, flow 14 mL min-1, k = 260 nm). The residue was desalted by HPLC on a reverse phase
column to yield the desired ASOs in an isolated yield of 15-30% based on the initial loading on the solid
support. The ASOs were characterized by ion-pair-HPLC coupled MS analysis with Agilent 1100 MSD
system.
Antisense ucleotides not comprising a conjugate were synthesized using standard
oligonucleotide synthesis procedures well known in the art.
Using these methods, three separate antisense compounds targeting ApoC III were prepared. As
summarized in Table 17, below, each of the three antisense compounds targeting ApoC III had the same
nucleobase sequence; ISIS 304801 is a 55 MOE gapmer having all phosphorothioate linkages; ISIS
647535 is the same as ISIS 304801, except that it had a GalNAc3-1 conjugated at its 3’end; and ISIS 647536
is the same as ISIS 647535 except that certain intemucleoside linkages of that compound are phosphodiester
linkages. As further summarized in Table 17, two separate antisense compounds targeting SRB-l were
synthesized. ISIS 440762 was a 22 cEt gapmer with all orothioate ucleoside es; ISIS
651900 is the same as ISIS 440762, except that it included a GalNAc3-1 at its 3’-end.
Table 17
Modified ASO targeting ApoC III and SRB-l
CalCd Observed
, ,
AesGesmCesTesTesmCdsTdsTdsGdsTdsmCdsmCdsAdsGdsmCds TesTesTesAesTe
3 (£31880 1 Afi‘l’c 7165.4 7164.4
ISIS mCesTesTesmCdsTdsTdsGdsTdsmCdsmCdsAdsGdsmCdsTesTesTesAesTeoAdo" APOC
647535 3_la -9239.5 9237.8 136
ISIS AesGeomCeoTeoTeomCdsTdsTdsGdsTdsmCdsmCdsAdsGdsmCdsTeoTeoTesAesTeoAdo" APOC
647536 GalNAC3_la -9142.9 9140.8 136
44017862 TkskasAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTkska 46470 46464 -
ISIS SR1}
TkskasAdsGdsTdsmCdsAd5TdsGdsAdsmCdsTdsTkskaoAdoa-GalNAc3-la 672 1. 1 67 19.4 1 38
651900
Subscripts: “e” indicates 2’-MOE modified side; “d” indicates B-D-2’-deoxyribonucleoside; “k”
indicates 6’-(S)-CH3 bicyclic nucleoside (e. g. cEt); “s” indicates phosphorothioate internucleoside linkages
(PS); “0” indicates odiester intemucleoside linkages (PO); and “o’” indicates -O-P(=O)(OH)-.
Superscriptm1ndicates66m” ' 5-methylcytosines. “GalNAc3-1” indicates a conjugate group having the structure
shown previously in Example 9. Note that GalNAc3-1 comprises a cleavable adenosine which links the ASO
to der of the conjugate, which is designated c3-1a.” This nomenclature is used in the above
table to show the full nucleobase sequence, including the ine, which is part of the conjugate. Thus, in
the above table, the sequences could also be listed as ending with “GalNAc3-1” with the “Ado” omitted. This
convention of using the subscript 66a” to indicate the portion of a conjugate group lacking a cleavable
nucleoside or cleavable moiety is used hout these Examples. This portion of a conjugate group lacking
the cleavable moiety is referred to herein as a “cluster” or “conjugate cluster” or “GalNAc3 cluster.” In
certain instances it is convenient to describe a conjugate group by separately providing its r and its
cleavable moiety.
e 20: Dose-dependent antisense inhibition of human ApoC III in huApoC III transgenic mice
ISIS 304801 and ISIS 647535, each targeting human ApoC III and described above, were separately
tested and evaluated in a dose-dependent study for their ability to inhibit human ApoC III in human ApoC III
transgenic mice.
Treatment
Human ApoCIII transgenic mice were maintained on a 12-hour light/dark cycle and fed ad libitum
Teklad lab chow. Animals were acclimated for at least 7 days in the ch facility before initiation of the
experiment. ASOs were prepared in PBS and sterilized by filtering through a 0.2 micron filter. ASOs were
dissolved in 0.9% PBS for ion.
Human ApoC III transgenic mice were ed intraperitoneally once a week for two weeks with
ISIS 304801 or 647535 at 0.08, 0.25. 0.75, 2.25 or 6.75 umol/kg or with PBS as a l. Each ent
group consisted of 4 animals. Forty-eight hours after the administration of the last dose, blood was drawn
from each mouse and the mice were sacrificed and tissues were collected.
ApoC [[1 mRNA is
ApoC III mRNA levels in the mice’s livers were determined using real-time PCR and
RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc. Eugene, OR) according to standard
protocols. ApoC III mRNA levels were determined relative to total RNA (using Ribogreen), prior to
normalization to PBS-treated control. The results below are presented as the average percent of ApoC III
mRNA levels for each treatment group, normalized to PBS-treated control and are denoted as “% PBS”. The
half maximal effective dosage (ED 50) of each ASO is also presented in Table 18, below.
As illustrated, both antisense nds reduced ApoC III RNA relative to the PBS control.
Further, the antisense nd conjugated to GalNAc3-1 (ISIS 647535) was substantially more potent than
the antisense compound lacking the GalNAc3-1 ate (ISIS 304801).
Table 18
Effect ofASO treatment on ApoC III mRI\A levels in human ApoC III transgenic mice
($331.) (£353., 3’ 13:21:35; SE18.
PBS 0 100 -- - --
0.08 95
:31% 0.77 None PS/20 135
0.08 50
0.75 15
ISIS
0.074 GalNAc3-1 PS/20 136
647535W
6.75 8
ApoC [[1 Protein Analysis (Turbidometric Assay)
Plasma ApoC III protein analysis was determined using procedures reported by Graham et al,
ation ch, published online before print March 29, 2013.
Approximately 100 pl of plasma isolated from mice was ed without dilution using an Olympus
al Analyzer and a commercially available turbidometric ApoC III assay (Kamiya, Cat# KAI-006,
Kamiya Biomedical, Seattle, WA). The assay protocol was performed as described by the vendor.
As shown in the Table 19 below, both antisense nds reduced ApoC III protein relative to the
PBS control. Further, the antisense compound conjugated to GalNAc3-1 (ISIS 647535) was substantially
more potent than the antisense compound lacking the 3-1 conjugate (ISIS 304801).
Table 19
Effect ofASO treatment on ApoC III plasma protein levels in human ApoC III transgenic mice
Dose % EDSO Internucleoside
AS0 3, C , SEQ ID
on uJ gate (umol/kg) PBS (umol/kg) Linkage/Length N0-
---———_
ISIS 0.08
ISIS ——
019 GalNAc 1 PS/20 136
Plasma triglycerides and cholesterol were extracted by the method of Bligh and Dyer (Bligh, E.G.
and Dyer, W.J. Can. J. Biochem. Physiol. 37: 7, 1959)(Bligh, E and Dyer, W, Can JBiochem Physiol,
37, 911-917, 1959)(Bligh, E and Dyer, W, Can JBiochem Physiol, 37, 911-917, 1959) and measured by
using a Beckmann Coulter clinical er and commercially ble reagents.
The triglyceride levels were measured relative to PBS ed mice and are denoted as “%
PBS”. Results are presented in Table 20. As illustrated, both antisense compounds lowered triglyceride
levels. Further, the nse compound conjugated to GalNAc3-1 (ISIS 647535) was substantially more
potent than the antisense compound lacking the GalNAc3-1 conjugate (ISIS 304801).
Table 20
Effect ofASO treatment on triglyceride levels in transgenic mice
Dose % EDSO 3’ ucleoside SEQ ID
(”“30ng) PBS kg) Conjugate Linkage/Length No.
PBS 0 100 -- -- __
0.08 87
ISIS 0.75 46
0.63 None PS/20 135
304801 2.25 21
6.75 12
0.08 65
ISIS 0.75 9
0.13 GalNAc3-1 PS/20 136
647535 2.25 8
6.75 9
Plasma samples were analyzed by HPLC to determine the amount of total cholesterol and of different
ons of cholesterol (HDL and LDL). Results are presented in Tables 21 and 22. As rated, both
antisense compounds lowered total cholesterol levels; both lowered LDL; and both raised HDL. Further, the
antisense compound conjugated to GalNAc3-1 (ISIS 647535) was substantially more potent than the
antisense compound lacking the GalNAc3-1 conjugate (ISIS 304801). An increase in HDL and a decrease in
LDL levels is a cardiovascular beneficial effect of antisense inhibition of ApoC III.
Table 21
Effect ofASO ent on total cholesterol levels in transgenic mice
Dose Total Cholesterol Internucleoside
AS0 3’ SEQ
(umol/kg) (mg/dL) Conjugate Linkage/Length ID No.
PBS 0 257 __ __
0.08 226
35213801H None PS/20 135
6.75 82
0.08 230
64131525 2:: :: GalNAc3-1 PS/20 136
6.75 99
Table 22
Effect ofASO treatment on HDL and LDL cholesterol levels in transgenic mice
Dose HDL LDL 3 ’ Intemucleoside SEQ
(umol/kg) (mg/dL) (mg/dL) Conjugate Llnkage/Length ID No.
PBS 0 17 28 -- --
0.08 17 23
35213801# None PS/20 135
6.75 45 2
0.08 21 21
1515W
GalNAc3-1 PS/20 136
647535W
6.75 58 2
Pharmacokinetics Analysis (PK)
The PK of the ASOs was also evaluated. Liver and kidney samples were minced and extracted using
standard protocols. Samples were ed on MSD1 utilizing C-MS. The tissue level (pg/g) of
full-length ISIS 304801 and 647535 was measured and the results are provided in Table 23. As illustrated,
liver concentrations of total full-length antisense nds were similar for the two antisense compounds.
Thus, even though the GalNAc3-1 -conjugated nse compound is more active in the liver (as
demonstrated by the RNA and protein data above), it is not present at substantially higher concentration in
the liver. Indeed, the calculated ECSO (provided in Table 23) confirms that the observed increase in potency
of the ated compound cannot be entirely attributed to increased accumulation. This result suggests that
the conjugate improved y by a mechanism other than liver accumulation alone, possibly by improving
the productive uptake of the antisense compound into cells.
The results also show that the concentration of GalNAc3-1 conjugated antisense compound in the
kidney is lower than that of antisense compound lacking the GalNAc conjugate. This has several beneficial
therapeutic implications. For therapeutic indications where activity in the kidney is not sought, exposure to
kidney risks kidney toxicity without corresponding benefit. Moreover, high tration in kidney typically
results in loss of compound to the urine resulting in faster clearance. Accordingly, for non-kidney targets,
kidney accumulation is red. These data suggest that 3-1 conjugation s kidney
accumulation.
Table 23
PK is of ASO treatment in transgenic mice
Internucleoside
Dose L'1VeI‘ K'd1 1’1ey L'1Ve ECI‘ .3 ’ 5° SEQ
ASO Linkage/Length
(umol/kg) (jig/g) (jig/g) (jig/g) ate ID NO.
0.1 5.2 2.1
ISIS 0.8 62.8 119.6
—53 None PS/20 135
304801 2.3 142.3 191.5
6.8 202.3 337.7
0.1 3.8 0.7
ISIS 0'8 72'7 34'3
—3 8. G lNAa c3-1 PS/20 136
647535 2.3 106.8 111.4
6.8 237.2 179.3
Metabolites of ISIS 647535 were also identified and their masses were confirmed by high resolution
mass spectrometry analysis. The cleavage sites and structures of the observed metabolites are shown below.
The relative % of full length ASO was calculated using standard procedures and the results are presented in
Table 23a. The major lite of ISIS 647535 was full-length ASO lacking the entire conjugate (i.e. ISIS
), which results from cleavage at cleavage site A, shown below. Further, additional metabolites
resulting from other cleavage sites were also observed. These results suggest that introducing other cleabable
bonds such as esters, peptides, disulfides, phosphoramidates or acyl-hydrazones between the 3-1
sugar and the ASO, which can be cleaved by enzymes inside the cell, or which may cleave in the reductive
environment of the cytosol, or which are labile to the acidic pH inside endosomes and lyzosomes, can also be
Table 23a
Observed full length metabolites of ISIS 647535
Metabolite ASO Cleavage site Relative %
2 ISIS 304801 + dA B 10.5
3 ISIS 647535 minus [3 GalNAc] C 16.1
ISIS 647535 minus
4 D 17 6
[3 GalNAc -- 1 5-hydroxy-pentan0ic acid tether] '
ISIS 647535 minus
D 9 9
[2 GalNAc -- 2 oxy-pentan0ic acid tether] '
ISIS 647535 minus D
6 [3 GalNAc -- 3 5-hydroxy-pentan0ic acid tether] 9-8
ASO 304801
Cleavage Sites
Cleavage site A
HO OH Cleavage siteC O:F"OH
ge site D o
OH (N
NHAC
CleavagesiteCOQ01—Cleavage site B
\0 \“WWo if0
NHAC WCleavage site D O
HO HN/:OON
site C
NHAc Cleavage
ASO 304801
O:P*OH NH2
ASO 304801 ‘
_ . /N
Metabohte 1 ] Metabohte 2
OH OWN/I?”
2014/036460
I‘ASO 304801
O:P*OH NH2
H 0 /
OH 1
o O C
n H L
HOWWW0 H o 3:0
Metabohte 3
HN A50 304801
HOWNWH 0
O o:F‘fOH NH2
H o
HZNWN (5H (NfN
K0,,“ ’N/J
o 0 d
n n ‘7
HOW \/\/ W0 H 0 3:0
Metabohte 4
HN ASO 304801
HOWH/N c‘)
o:FfOH NH2
H 0 OH
HZNWN E KOgN(“‘ng’ g g N
O o o5
H \
H2N\/\/NWO m O F":0
Metabohte 5.
H“ Aso304801
HOWH/NWH o
O:P*OH NH2
H o / N
HZNWN (gm 0 <N 1NJ
o o o‘:
H \
”NW\H/V0 u o 1:0
Metabolite 6
Example 21: Antisense inhibition of human ApoC III in human ApoC III enic mice in single
administration study
ISIS 304801, 647535 and 647536 each targeting human ApoC III and described in Table 17, were
further evaluated in a single administration study for their ability to inhibit human ApoC III in human ApoC
III transgenic mice.
Treatment
Human ApoCIII transgenic mice were maintained on a 12-hour light/dark cycle and fed ad libitum
Teklad lab chow. Animals were ated for at least 7 days in the research facility before initiation of the
experiment. ASOs were prepared in PBS and sterilized by ng through a 0.2 micron filter. ASOs were
dissolved in 0.9% PBS for ion.
Human ApoC III transgenic mice were injected intraperitoneally once at the dosage shown below
with ISIS , 647535 or 647536 (described above) or with PBS treated control. The treatment group
consisted of 3 animals and the control group consisted of 4 animals. Prior to the treatment as well as after the
last dose, blood was drawn from each mouse and plasma samples were analyzed. The mice were ced
72 hours following the last administration .
Samples were collected and analyzed to determine the ApoC III mRNA and n levels in the
liver; plasma triglycerides; and cholesterol, including HDL and LDL fractions were assessed as bed
above (Example 20). Data from those analyses are presented in Tables 24-28, below. Liver transaminase
levels, alanine ransferase (ALT) and aspartate aminotransferase (AST), in serum were ed
relative to saline injected mice using standard protocols. The ALT and AST levels showed that the antisense
compounds were well tolerated at all administered doses.
These results show improvement in potency for antisense compounds comprising a GalNAc3-1
conjugate at the 3’ terminus (ISIS 647535 and 647536) compared to the antisense compound lacking a
GalNAc3-1 conjugate (ISIS 304801). Further, ISIS 647536, which comprises a GalNAc3-1 conjugate and
some odiester linkages was as potent as ISIS 647535, which comprises the same conjugate and all
internucleoside linkages within the ASO are phosphorothioate.
Table 24
Effect ofASO treatment on ApoC III mRNA levels in human ApoC III transgenic mice
Dose
0 ED50 3’ Internucleoside SEQ ID
ASO A) PBS
(mg/kg) (mg/kg) ate linkage/Length No.
PBS 0 99 -- - --
1 104
ISIS 3 92
13.2 None PS/20 135
304801W
40
ISIS Oi3 :3 1 9' GalNAc —1
647535 3 PS/20 136
WO 79625
647536
Table 25
Effect ofASO treatment on ApoC III plasma protein levels in human ApoC III transgenic mice
Dose
0 EDso 3’ Intemucleoside SEQ ID
ASO APBS
(mg/kg) (mg/kg) Conjugate Linkage/Length N0,
PBS 0 99 -- -- __
A23.2
ISIS 3 92
N‘me 135/20 135
40
0.3 98 2.1
ISIS 1 70
GalNAc3-1 PS/2O 136
647535fl
20
M1.8
ISIS 1 60
GalNAc3-1 PS/PO/2O 136
647536E
21
Table 26
Effect ofASO treatment on triglyceride levels in transgenic mice
Dose
0 EDso Intemucleoside SEQ ID
ASO APBS 3 , Conjugate-
(mg/kg) (mg/kg) Linkage/Length No.
PBS 0 98 -- -- __
ISIS 3 92
29-1 None PS/20 135
304801W
47
ISIS 1 70
2-2 GalNAc3-1 PS/20 136
23
ISIS 1 66
1-9 Gama-1 PS/PO/ZO 136
647536E
23
Table 27
Effect ofASO treatment on total cholesterol levels in transgenic mice
PBS 0 96 —— __
ISIS 3 96
None PS/20 135
304801W
72
ISIS 1 85
GalNAc3-1 PS/20 136
647535 3 61
53
0.3 115
ISIS 1 79
3-1 20 136
647536fi
54
Table 28
Effect ofASO treatment on HDL and LDL cholesterol levels in transgenic mice
Dose HDL LDL 3’ Internucleoside SEQ ID
(mg/kg) % PBS % PBS ate Linkage/Length No.
PBS 0 131 90 —- __
1 130 72
ISIS 3 186 79
None PS/20 135
304801 10 226 63
240 46
ISIS 1 214 67
GalNAc3-1 PS/20 136
218 35
1818 1 187 56
GalNAc3-1 PS/PO/20 136
647536W
221 34
These results confirm that the GalNAc3-1 conjugate improves potency of an antisense compound.
The results also show equal potency of a GalNAc3-1 conjugated nse compounds where the antisense
oligonucleotides have mixed linkages (ISIS 647536 which has six phosphodiester linkages) and a full
phosphorothioate version of the same antisense compound (ISIS 647535).
Phosphorothioate linkages provide several properties to antisense nds. For example, they
resist nuclease digestion and they bind proteins resulting in accumulation of compound in the liver, rather
than in the kidney/urine. These are desirable properties, particularly when treating an indication in the liver.
However, phosphorothioate linkages have also been associated with an inflammatory response. Accordingly,
ng the number of phosphorothioate linkages in a compound is expected to reduce the risk of
inflammation, but also lower tration of the compound in liver, increase concentration in the kidney and
urine, decrease stability in the presence of nucleases, and lower l potency. The present results show
that a 3-1 conjugated antisense compound where certain phosphorothioate linkages have been
replaced with phosphodiester linkages is as potent against a target in the liver as a counterpart having full
phosphorothioate linkages. Such compounds are expected to be less proinflammatory (See Example 24
describing an ment showing reduction of PS results in reduced atory effect).
Example 22: Effect of GalNAc3-1 conjugated modified ASO targeting SRB-l in vivo
ISIS 440762 and 651900, each targeting SRB-l and described in Table 17, were evaluated in a dose-
dependent study for their ability to t SRB-l in Balb/c mice.
Treatment
Six week old male Balb/c mice (Jackson Laboratory, Bar Harbor, ME) were injected subcutaneously
once at the dosage shown below with ISIS 440762, 651900 or with PBS treated l. Each treatment
group consisted of 4 s. The mice were sacrificed 48 hours following the final administration to
determine the SRB-l mRNA levels in liver using real-time PCR and RIBOGREEN® RNA quantification
reagent (Molecular Probes, Inc. Eugene, OR) according to standard ols. SRB-l mRNA levels were
determined relative to total RNA (using Ribogreen), prior to normalization to PBS-treated control. The
results below are ted as the average t of SRB-l mRNA levels for each treatment group,
normalized to PBS-treated control and is denoted as “% PBS”.
As illustrated in Table 29, both antisense compounds lowered SRB-l mRNA levels. Further, the
antisense nd comprising the GalNAc3-1 conjugate (ISIS 651900) was substantially more potent than
the antisense compound lacking the GalNAc3-1 conjugate (ISIS 440762). These results demonstrate that the
potency benefit of GalNAc3-1 conjugates are observed using antisense oligonucleotides complementary to a
different target and having different chemically modified nucleosides, in this ce modified nucleosides
comprise constrained ethyl sugar moieties (a bicyclic sugar moiety).
Table 29
Effect ofASO ent on SRB-l mRNA levels in Balb/c mice
Internucleosid
Dose Liver ED50 , . e
ASO 3 conlugate
(mg/kg) %PBS (mg/kg) linkage/Lengt
_-___———_
IsIs ——
W PS“
440762E:
WO 79625
1s1s
0.3 GalNAc3-1 PS/14 138
651900
Example 23: Human Peripheral Blood Mononuclear Cells (hPBMC) Assay Protocol
The hPBMC assay was performed using BD Vautainer CPT tube method. A sample of whole blood
from volunteered donors with informed consent at US HealthWorks clinic (Faraday & El Camino Real,
Carlsbad) was obtained and collected in 4-15 BD Vacutainer CPT 8 ml tubes (VWR Cat.# BD362753). The
imate starting total whole blood volume in the CPT tubes for each donor was recorded using the
PBMC assay data sheet.
The blood sample was remixed immediately prior to centrifugation by gently inverting tubes 8-10
times. CPT tubes were centrifuged at rt (18-25 0C) in a horizontal (swing-out) rotor for 30 min. at 1500-1800
RCF with brake off (2700 RPM Beckman Allegra 6R). The cells were ved from the buffy coat interface
(between Ficoll and polymer gel layers); transferred to a sterile 50 m1 conical tube and pooled up to 5 CPT
tubes/50 m1 l onor. The cells were then washed twice with PBS (Ca++, Mg++ free; GIBCO). The
tubes were topped up to 50 ml and mixed by inverting several times. The sample was then centrifuged at 330
x g for 15 minutes at rt (1215 RPM in Beckman Allegra 6R) and aspirated as much supernatant as possible
t disturbing pellet. The cell pellet was dislodged by gently swirling tube and resuspended cells in
RPMI+10% FBS+pen/strep (~1 ml / 10 ml starting whole blood volume). A 60 ul sample was pipette into a
sample vial (Beckman Coulter) with 600 pl VersaLyse reagent (Beckman Coulter Cat# A09777) and was
gently vortexed for 10-15 sec. The sample was allowed to incubate for 10 min. at rt and being mixed again
before counting. The cell sion was d on Vicell XR cell viability analyzer (Beckman Coulter)
using PBMC cell type (dilution factor of 1:11 was stored with other parameters). The live cell/ml and
viability were ed. The cell suspension was d to 1 x 107 live PBMC/ml in RPMI+ 10%
FBS+pen/strep.
The cells were plated at 5 x 105 in 50 ul/well of 96-well tissue e plate (Falcon Microtest). 50
ul/well of 2x concentration oligos/controls diluted in RPMI+10% FBS+pen/strep. was added ing to
experiment template (100 ul/well total). Plates were placed on the shaker and allowed to mix for approx. 1
min. After being incubated for 24 hrs at 37 0C; 5% C02, the plates were centrifuged at 400 x g for 10
minutes before removing the supernatant for MSD cytokine assay (i.e. human lL-6, lL-10, lL-8 and MCP-l).
Example 24: Evaluation of Proinflammatory Effects in hPBMC Assay for GalNAc3-1 conjugated ASOs
The antisense oligonucleotides (ASOs) listed in Table 30 were evaluated for proinflammatory effect
in hPBMC assay using the protocol described in Example 23. ISIS 353512 is an internal standard known to
be a high responder for lL-6 release in the assay. The hPBMCs were isolated from fresh, volunteered donors
and were treated with ASOs at 0, , 0.064, 0.32, 1.6, 8, 40 and 200 uM concentrations. After a 24 hr
ent, the cytokine levels were measured.
The levels of IL-6 were used as the primary t. The ECSO and Emax was calculated using
standard procedures. Results are expressed as the average ratio of Emax/ECSO from two donors and is denoted
as “EmaX/ECSO.” The lower ratio indicates a relative se in the proinflammatory response and the higher
ratio tes a relative increase in the proinflammatory response.
With regard to the test compounds, the least proinflammatory compound was the PS/PO linked ASO
(ISIS 616468). The GalNAc3-1 conjugated ASO, ISIS 647535 was slightly less proinflammatory than its
non-conjugated counterpart ISIS 304801. These results indicate that incorporation of some PO linkages
reduces proinflammatory reaction and addition of a GalNAc3-1 conjugate does not make a compound more
proinflammatory and may reduce proinflammatory response. Accordingly, one would expect that an
antisense compound comprising both mixed PS/PO linkages and a GalNAc3-1 conjugate would produce
lower proinflammatory responses relative to full PS linked antisense nd with or without a GalNAc3-1
conjugate. These results show that GalNAc3_1 conjugated antisense compounds, particularly those having
reduced PS content are less proinflammatory.
Together, these results suggest that a GalNAc3-1 conjugated compound, particularly one with
reduced PS content, can be administered at a higher dose than a rpart full PS antisense compound
lacking a GalNAc3-1 conjugate. Since half-life is not expected to be ntially different for these
compounds, such higher administration would result in less frequent dosing. Indeed such administration
could be even less frequent, because the GalNAc3-1 conjugated compounds are more potent (See Examples
-22) and ing is necessary once the concentration of a compound has dropped below a d level,
where such desired level is based on potency.
Table 30
Modified ASOS
ASO Sequence (5’ to 3’) Target SEIEJD
ISIS GesmCesTesGesAesTdsTdsAdsGdSAdsGds
TNFoc 139
104838 AdsGdsAdsGdsGesTesmCeSmCeSmCe
ISIS Tes Ces Ces TdSTdSTdS CdsAdsGdS
CRP 140
3 5 3 5 12 GdsAdsGdsAdsmCdsmCdsTesGesGe
ISIS AeSGeSmCeSTesTeSmCdSTdSTdSGdSTdS
ApoC III 135
304801 mCdSmCdsAdSGdsmCds TeSAeSTe
ISIS AeSGeSmCeSTesTeSmCdSTdSTdSGdSTdS
ApoC III 136
64753 5 mCdsmCdSAdsGdsmCdSTesTesTesAesTeoAdoa-GalNAC3-1 a
ISIS AesGeomCeoTeoTeomCdsTdsTdsGdsTds
ApoC III 135
616468 dsAdsGdsmCdSTaoTaoTesAesTe
Subscripts: cc :9
e indicates 2’-MOE modified nucleoside; “d” indicates B-D-2’-
deoxyribonucleoside; “k” indicates 6’-(S)-CH3 bicyclic nucleoside (e. g. cEt); “s” indicates phosphorothioate
2014/036460
intemucleoside linkages (PS); “0” indicates phosphodiester internucleoside linkages (PO); and “0’” indicates
O)(OH)-. Superscript “m” indicates 5-methylcytosines. “AdOs-GalNAc3-1a” indicates a conjugate
having the structure GalNAc3-l shown in Example 9 attached to the 3’-end of the antisense oligonucleotide,
as indicated.
Table 31
Proinflammatory Effect of ASOs targeting ApoC III in hPBMC assay
EC50 Emax 3’ cleoside SEQ ID
ASO EmaX/ECSO
(uM) (uM) Conjugate Linkage/Length No.
ISIS 353512
0.01 265.9 None PS/20 140
, 26,590
(high responder)
ISIS 304801 0.07 106.55 1,522 None PS/20 135
ISIS 647535 0.12 138 1,150 GalNAc3-1 PS/20 136
ISIS 616468 0.32 71.52 224 None PS/PO/20 135
Example 25: Effect of 3-1 conjugated modified ASO targeting human ApoC III in vitro
ISIS 304801 and 647535 described above were tested in vitro. Primary hepatocyte cells from
transgenic mice at a density of 25,000 cells per well were treated with 003,008, 0.24, 0.74, 2.22, 6.67 and 20
uM concentrations of modified oligonucleotides. After a ent period of approximately 16 hours, RNA
was isolated from the cells and mRNA levels were measured by quantitative real-time PCR and the hApoC
III mRNA levels were adjusted according to total RNA content, as measured by RIBOGREEN.
The IC50 was calculated using the standard methods and the results are presented in Table 32. As
illustrated, comparable potency was observed in cells treated with ISIS 647535 as compared to the control,
ISIS 304801.
Table 32
Modified ASO ing human ApoC III in primary hepatocytes
, . Intemucleoside SEQ
ASO IO” (”M) 3 conlugate
linkage/Length ID No.
rsrs
0.44 None PS/20 135
304801
rsrs
0.31 GalNAc3-1 PS/20 136
647535
In this experiment, the large potency benefits of GalNAc3-1 conjugation that are ed in vivo
were not observed in vitro. uent free uptake experiments in primary hepatocytes in vitro did show
increased potency of oligonucleotides comprising various GalNAc conjugates relative to oligonucleotides
that lacking the GalNAc conjugate.(see Examples 60, 82, and 92)
Example 26: Effect of PO/PS linkages 0n ApoC 111 A80 ty
Human ApoC III transgenic mice were injected intraperitoneally once at 25 mg/kg of ISIS 304801,
or ISIS 616468 (both described above) or with PBS treated control once per week for two weeks. The
treatment group consisted of 3 animals and the control group consisted of 4 s. Prior to the treatment as
well as after the last dose, blood was drawn from each mouse and plasma samples were analyzed. The mice
were sacrificed 72 hours ing the last stration.
Samples were collected and analyzed to determine the ApoC III protein levels in the liver as
described above (Example 20). Data from those es are presented in Table 33, below.
These results show reduction in potency for antisense compounds with PO/PS (ISIS 616468) in the
wings relative to full PS (ISIS 304801).
Table 33
Effect ofASO treatment on ApoC III protein levels in human ApoC III transgenic mice
Dose 3’ Internucleoside
0 SEQ ID
ASO A) PBS
(mg/kg) Conjugate linkage/Length No.
PBS 0 99 - --
1s1s
mg/kg/wk 24 None Full PS 135
304801
for 2 wks
1s1s
mg/kg/wk 40 None 14 PS/6 PO 135
616468
for 2 wks
Example 27: Compound 56
Compound 56 is cially available from Glen Research or may be prepared according to
published procedures reported by Shchepinov et al., Nucleic Acids Research, 1997, 25(22), 4447-4454.
Example 28: Preparation of Compound 60
AcO OAc
AcO OAc
WOBH 57 O
ACO H0
AGO OvW\ —>H2/Pd
—’ OBH MeOH
o TMSOTf, DCE 58
N\ AcHN (quant)
(71%)
AcO OAc N(iPr)2)PC1, AcO OAc
N(£02
EDIP O | CN
0 A00 OWO/P\O/\/
AcO \/\/\/\OH CHZCIZ
AcHN 59 (80%) ACHN 60
Compound 4 was prepared as per the procedures illustrated in Example 2. nd 57 is
commercially available. Compound 60 was confirmed by structural is.
Compound 57 is meant to be representative and not intended to be limiting as other monoprotected
substituted or unsubstituted alkyl diols including but not limited to those ted in the specification herein
can be used to prepare phosphoramidites having a predetermined ition.
Example 29: Preparation of Compound 63
ODMT
1. BnCl OH 1. DMTC1,pyr
0 %
HO >—CH3 2. KOH DMSO 2. Pd/C H
’ BnO —2»
OH 033/0 ODMT
OO 3. HCl, MeOH 3. Phosphitylatlon I
ODMT
4. Ncho3 NOPUZ
62 63
Compounds 61 and 62 are prepared using procedures similar to those reported by Tober et al., Eur. J.
Org. Chem, 2013, 3, 7; and Jiang et al., edron, 2007, 63(19), 3982-3988.
Alternatively, Compound 63 is prepared using procedures similar to those reported in scientific and
patent literature by Kim et al., Synlett, 2003, [2, 1838-1840; and Kim et al., published PCT International
Application, WO 2004063208.Example 30: Preparation of nd 63b
OH ODMT
/_/ CN
0 S O
TPDBSOon/VOH 1. DMTCl, pyr
2. TBAF
3. Phosphitylatlon. . O\P/O\/E\O/\/ODMT
O I
N(iPr)2
63a OH ODMT
Compound 63a is prepared using procedures similar to those reported by Hanessian et al., Canadian
Journal ofChemistry, 1996, 74(9), 1731-1737.
Example 31: Preparation of Compound 63d
O N(iPr)2
l. DMTCl, pyr
DMTO O P
HOWO O/\/\OBn 2. Pd/C,H2 \/\/ o/\/\o/ \o/\/CN
O Phosphitylation O
—/_/ 63c f 63d
DMTO
nd 63c is prepared using procedures similar to those reported by Chen et al., Chinese
Chemical Letters, 1998, 9(5), 451-453.
Example 32: Preparation of nd 67
COZBn
AcO OAc
ACOSL €~§O/OMOH AcO 0A0
H N/WOTBDMS CO Bn
2 2
OWLN/K(OTBDMS
—>ACO%O
ACHN
HBTU, DIEA AcHN
R : H or CH3
A 00AC C
1. TEA.3HF, THF O COZBn
A O OWL O\ /O\/\
2. Phosphitylation C E P CN
ACHN R N(iPr)2
Compound 64 was prepared as per the procedures illustrated in Example 2. Compound 65 is
prepared using procedures similar to those reported by Or et al., published PCT International Application,
WO 2009003009. The protecting groups used for nd 65 are meant to be representative and not
intended to be limiting as other protecting groups including but not limited to those presented in the
specification herein can be used.
e 33: Preparation of Compound 70
H N/\(0Bn2
AcO OAc 68
MOW 0 AcO OAc
O M CH3
OH HBTU DIEA
AcO 35/130,OWLN
ACHN C4 N/YOBH
AcHN CH3
A 00AC C
1. 2
OM O\/\
2. Phosphitylation m%o N/YOP CN
AcHN CH3 N(iPr)2
Compound 64 was prepared as per the ures illustrated in Example 2. Compound 68 is
commercially available. The protecting group used for nd 68 is meant to be representative and not
intended to be limiting as other protecting groups including but not limited to those presented in the
specification herein can be used.
Example 34: Preparation of Compound 75a
O CF3
1. TBDMSCI, pyr Y
2. Pd/C,H2 N('Pr)1 2
/\/O HNWO I
NC 3. CF3C02Et,MeOH H /P\ /\/CN
NC/\/O OH FgchWO 0 0
NC\/\O 4. TEA.3HF, THF O
. Phosphitylatlon 0
75 A 75a
0 CF3
Compound 75 is prepared according to published procedures reported by Shchepinov et al., c
Acids Research, 1997, 25(22), 4447-4454.
Example 35: Preparation of Compound 79
DMTOWO HOWO
1- BnCl NaH DCL NMI, ACN
\/O ’
OH , HO\/\/O OBn Phosphoramidite 60
DMTOMO 2. DCA, CH2C12 HOMO
76 77
AcO OAC NC
0 I
AGO OW\/\ (I)
o/P\O
AcHN
ch K 1. HZ/Pd, MeOH
ACO OAC
O \/\/\/\O/P\O/\/\O/a\/OBH(I) 2. Phosphitylation
AcHN o
ACO 1‘3\
0 O 0/ 0
NHAC
ACO OAC NC
0 1
Aco OW/ \1?
O 0
AcHN
ACO OAC \LO
ACO%/ P\O/V\O/3\/O\P/ \/\CN|0O I
ACHN O
N(iPr)2
NHAC
Compound 76 was prepared according to published procedures ed by Shchepinov et al.,
Nucleic Acids Research, 1997, 25(22), 4447-4454.
Example 36: Preparation of Compound 79a
HOWO\3/\OBIIHOWO 1. FmocCl, pyr FmocOWo 171(1'Pr)2
2. Pd/C, H2 FmOCO\/\/O\g/\O/P\O/\/CN
HOMO 3. Phosphitylation FmocO/\/\O
77 79a
Compound 77 is prepared as per the ures illustrated in Example 35.
Example 37: General method for the preparation of ated oligomeric compound 82 comprising a
phosphodiester linked GalNAc3-2 conjugate at 5’ terminus via solid support (Method 1)
ODMT
O\/\/
o O/\/\ODMT
DMT0’\<_7’BX O/\/\ODMT
e o
0- NC 1|)\ 0 BX
NC\/\ _._ \/\o’ o
0 13-0 1.DCA,DCM ’\(_7’
0 2. DCI, NMI, ACN o‘
NC\/\0_15=0
Phosphoramidite 56
OLIGO |
DNA/RNA 0
O automated synthesizer
OLIGO
. I
:2 o—rlko/VCN
79b (I)
Q VIMAD—O-l’l~O/\/CN
X = S' or O' X
BX = Heterocylic base 80
1. Capping (Ac20, NMI, pyr)
2. t-BuOOH
3. DCA, DCM
4. DCI, NMI, ACN
AC0 OAC NC\\\ Phosphoramidite 60
OW\/\/ \I"
AcHN 0
NC 7}
AcOOAC 1 o of
O 0I | O BX
OW\/\O/P\O/\/\O O_ —O
ACO (:1; W
AcHN O O
NC~\\O _ll)_0
NHAC (I)
Q: VIMAD—O-l’l\0/\/CN
1. Capping (AczO, NMI, pyr) 81
2. t-BuOOH
3. 20% Et2NH inToluene (V/V)
4. NH4, 55 0C,
NHAC 32
wherein GalNAc3-2 has the structure:
HOOH
HO O\/\/\/\ (I;
AcHN ('3- OK
HoOH O
O O BX
oW ‘ —
,('1)?\ o (I; o
AcHN O Q
o f O:IILO
HO OH it NW
NHAc
The GalNAc3 r portion of the conjugate group GalNAc3-2 (GalNAcg-Za) can be combined With
any cleavable moiety to provide a variety of conjugate groups. n GalNAc3-2a has the formula:
AcHN o
HO OH (1)5 f
NHAC
The VlMAD-bound oligomeric compound 79b was prepared using standard procedures for
automated DNA/RNA synthesis (see Dupouy et al., Angew. Chem. Int. Ed., 2006, 45, 3623-3627). The
phosphoramidite Compounds 56 and 60 were prepared as per the procedures illustrated in Examples 27 and
28, respectively. The phosphoramidites illustrated are meant to be representative and not intended to be
ng as other phosphoramidite building blocks ing but not limited those presented in the
specification herein can be used to prepare an oligomeric compound haVing a phosphodiester linked
conjugate group at the 5’ terminus. The order and quantity of phosphoramidites added to the solid t
can be adjusted to e the oligomeric compounds as described herein haVing any predetermined sequence
and composition.
Example 38: Alternative method for the preparation of oligomeric compound 82 sing a
phosphodiester linked 3-2 conjugate at 5’ terminus (Method 11)
o‘ 1. DCA, DCM
.' 2. DCI, NMI, ACN
Phosphoramidite 79
OLIGO DNA/RNA
ted synthes1zer-
VIMAD—O-llko/VCN X = S' or O'
BX = Heterocyclic base
NHAC
l. Capping
2. t-BuOOH
3. Et3NzCH3CN(1:1V/V) 83
4. NH4, 55 °C
Oligomeric Compound 82
The VlMAD-bound oligomeric compound 79b was prepared using standard procedures for
automated DNA/RNA synthesis (see Dupouy et al., Angew. Chem. Int. Ed., 2006, 45, 3623-3627). The
GalNA03-2 cluster oramidite, Compound 79 was prepared as per the procedures illustrated in Example
. This alternative method allows a one-step installation of the phosphodiester linked GalNAc3-2 conjugate
to the oligomeric compound at the final step of the synthesis. The oramidites illustrated are meant to
be representative and not intended to be limiting, as other phosphoramidite building blocks including but not
limited to those presented in the specification herein can be used to prepare oligomeric compounds having a
phosphodiester conjugate at the 5’ us. The order and ty of phosphoramidites added to the solid
support can be adjusted to prepare the oligomeric compounds as described herein having any predetermined
sequence and composition.
2014/036460
Example 39: General method for the preparation of oligomeric compound 83h comprising a GalNAc3-
3 Conjugate at the 5’ Terminus (GalNAc3-1 modified for 5' end attachment) via Solid t
AcO o
H 1. H2, Pd/C, MeOH (93%)
I? o BnO OH
H o OgiNJLOAQ 2_ M
0 O
O O O
HBTU, DIEA, DMF, 76%
NHAc HNMN 3. H2,Pd/C,MeOH
H 0
o OAc
o AcO
AcO AcO o H
NHAc
N H
AcHN WNW o o
F I? O O
F o N H \/\/ O OH
\COCF3 OAC M
AGO T» 5L“
83b 0
o O o
F ACO
‘F— NHAc HNMN 830
Pyridine, DMF
NHAc
AcO 836
o H 3' 5,
N H fi
AcHN W WNW F
F OLIGO
o o O_F|, O_(CH2)6_NH2
H O O N
N F —>H
OAc M W If»0 NH O Borate buffer, DMSO, pH 8.5, rt
A oc
o 0
0 O
F F
NHAc HNMN
H O
Aco\gof/AcO o
NHAc
ACO OAC
AcO o
Aqueous ammonia
HO OH
HO o H H
“W“ 0 NH )6—o—fi-o—-
H0 O
mgry0H0 OW o
HN/\/\N
Compound 18 was prepared as per the procedures illustrated in Example 4. Compounds 83a and 83b
are commercially available. eric Compound 83e comprising a odiester linked mine was
prepared using standard oligonucleotide synthesis procedures. Treatment of the protected oligomeric
compound With aqueous ammonia provided the 5'-GalNAc3-3 conjugated oligomeric compound (83h).
Wherein GalNAc3-3 has the structure:
HO OH
NHAC
The GalNAc3 cluster portion of the conjugate group GalNAc3-3 (GalNAc3-3a) can be combined With
any cleavable moiety to provide a variety of conjugate groups. Wherein GalNAc3-3a has the formula:
WO 79625
HO OH
2014/036460
Example 40: General method for the preparation of oligomeric compound 89 comprising a
phosphodiester linked GalNAc3-4 conjugate at the 3’ terminus via solid support
ODMT
0\/\/
l. DCA A\
$2 UNL—ODMT 0 O/\/\0Fmoc
2. DCI, NMI, ACN
, |
CN
F N(z'Pr)2 .E UNL—O—lfi‘o/V
mocOWO | O
/P\ /\/CN 85
DMTOWO O O
3. Capping ODMT CN
OFmoc
4. t-BuOOH O\/\/ I /_/_
O O OFmoc
1. 2%P1per1d1ne,. . .
’1') /—/—
2% DBU, 96% DMF 0 0M0 0 JO_/0Fmoc
3. DCI,NMI,ACN O
Phosphoramidite 79a
DNA/RNA 1. Capping
automated s thesizer g. til/31119012.0 1per1 me,
AcO OAC 2% DBU, 96% DMF
A00 4. DCI, NMl, ACN
O Phosphoramidite 60
AcHN O DNA/RNA
automated s thes1zer.
Z 5. Capping.
AcO OAc O
O’P\
O\/\/ P20
O | 87
.”? t-BuOOHDCAOligo sis (DNA/RNA automated synthesizer)CappingOxidationEt3NzCH3CN (1:1, V/V)
A00 OAc
AcHN 0
0O/\O\/\/OO7P' 13:0
9 f0
AGO \/\/\/\Or \ _O o o 0
oPOMO
AGO DMT /\/CN
NHAC 5OL—Go3 Q UNL—0—P—ON
NH 55°C
HO 4’
Ho\‘\\7L\LOAcHN
HO OH OOLLH
wk*0 0P7\,,0
O\/\/\/\ 0- o
A HN0 159 ' 89
00/-\0\/\/ O 1|3=Q
HO \
o o\/\/\/\O’
HO O/\/\0
NHAc /
OLIGO
5V 3‘
Wherein GalNAc3-4 has the structure:
HO OH
ACHN O
HO OH IO
0—1)
HO o / \
O O- O\/\/
ACHN \/\/\/\ p o-
O O\ /
HO \O \ $0 0-
HO APO
NHAC g -/0
Wherein CM is a cleavable moiety. In certain embodiments, cleavable moiety is:
The GalNAc3 cluster portion of the conjugate group GalNAc3-4 (GalNAc3-4a) can be combined With
any cleavable moiety to provide a y of conjugate groups. Wherein GalNAc3-4a has the formula:
HO OH
AcHN O
HO OH IO
HO 0 0—5/
0 o o
\/\/\/\ W0
AcHN o 0-
0 O\/
9 f 0W0
W0 /O/\/\o OH
HO "”“b
The protected Unylinker functionalized solid support Compound 30 is cially available.
Compound 84 is prepared using procedures similar to those reported in the literature (see Shchepinov et al.,
Nucleic Acids Research, 1997, 25(22), 4447-4454; Shchepinov et al., Nucleic Acids Research, 1999, 27,
3035-3041; and Hornet et al., Nucleic Acids Research, 1997, 25, 4842-4849).
The oramidite ng , Compounds 60 and 79a are prepared as per the procedures
illustrated in Examples 28 and 36. The phosphoramidites illustrated are meant to be representative and not
intended to be ng as other phosphoramidite building blocks can be used to prepare an oligomeric
compound having a phosphodiester linked conjugate at the 3’ terminus With a predetermined sequence and
composition. The order and quantity of phosphoramidites added to the solid support can be adjusted to
prepare the oligomeric compounds as described herein having any predetermined sequence and composition.
Example 41: General method for the preparation of ASOs comprising a phosphodiester linked
GalNAc3-2 (see Example 37, Bx is adenine) conjugate at the 5’ position via solid phase ques
(preparation of ISIS 661134)
Unless ise stated, all reagents and solutions used for the synthesis of oligomeric nds
are purchased from commercial s. Standard phosphoramidite building blocks and solid t are
used for incorporation nucleoside residues Which include for example T, A, G, and InC residues.
Phosphoramidite compounds 56 and 60 were used to synthesize the phosphodiester linked GalNAc3-2
2014/036460
conjugate at the 5’ terminus. A 0.1 M solution of phosphoramidite in anhydrous itrile was used for B-
D-2’-deoxyribonucleoside and .
The ASO syntheses were performed on ABI 394 synthesizer (1-2 umol scale) or on GE Healthcare
Bioscience AKTA oligopilot synthesizer 0 umol scale) by the phosphoramidite coupling method on
VIMAD solid support (110 umol/g, Guzaev et al., 2003) packed in the column. For the coupling step, the
phosphoramidites were delivered at a 4 fold excess over the l loading of the solid support and
phosphoramidite coupling was carried out for 10 min. All other steps followed rd protocols supplied
by the manufacturer. A solution of 6% dichloroacetic acid in toluene was used for removing the
dimethoxytrityl (DMT) groups from roxyl groups of the nucleotide. 4,5-Dicyanoimidazole (0.7 M) in
anhydrous CH3CN was used as tor during the coupling step. Phosphorothioate linkages were
introduced by sulfurization with 0.1 M solution of xanthane hydride in 1:1 pyridine/CH3CN for a contact time
of 3 minutes. A solution of 20% tert—butylhydroperoxide in CH3CN containing 6% water was used as an
oxidizing agent to e phosphodiester internucleoside linkages with a contact time of 12 minutes.
After the desired sequence was assembled, the cyanoethyl phosphate protecting groups were
deprotected using a 20% diethylamine in toluene (v/v) with a contact time of 45 minutes. The solid-support
bound ASOs were suspended in aqueous ammonia (28-30 wt %) and heated at 55 0C for 6 h.
The unbound ASOs were then filtered and the ammonia was boiled off The residue was purified by high
pressure liquid chromatography on a strong anion ge column (GE Healthcare Bioscience, Source 30Q,
um, 2.54 x 8 cm, A = 100 mM ammonium acetate in 30% aqueous CH3CN, B = 1.5 M NaBr in A, 0-40%
of B in 60 min, flow 14 mL min-1, k = 260 nm). The residue was desalted by HPLC on a reverse phase
column to yield the desired ASOs in an isolated yield of 15-30% based on the initial g on the solid
support. The ASOs were characterized by ion-pair-HPLC coupled MS analysis with Agilent 1100 MSD
system.
Table 34
A80 comprising a phosphodiester linked 3-2 conjugate at the 5’ position ing SRB-l
Observed SEQ ID
ISIS No. Sequence (5 to 3 ) CalCd Mass
Mass No.
GalNAc3'2a'o'AdoTkskasAdsGdsTdsmCdsAdsTds
661134 6482.2 6481.6 141
GdsAdsmCdsTdsTkska
Subscripts: cc :9
e indicates 2’-MOE modified nucleoside; “(1” indicates B-D-2’-
deoxyribonucleoside; “k” indicates 6’-(S)-CH3 bicyclic nucleoside (e. g. cEt); “s” indicates phosphorothioate
internucleoside linkages (PS); “0” indicates phosphodiester internucleoside linkages (PO); and “0’” indicates
-O-P(=O)(OH)-. Superscript “m” indicates 5-methylcytosines. The ure of GalNAc3-2a is shown in
Example 37.
WO 79625
e 42: General method for the preparation of ASOs comprising a GalNAc3-3 conjugate at the 5’
position via solid phase techniques (preparation of ISIS 661166)
The synthesis for ISIS 661166 was performed using similar procedures as illustrated in Examples 39
and 41.
ISIS 661166 is a 55 MOE gapmer, wherein the 5’ position ses a GalNA03-3 conjugate.
The ASO was characterized by ion-pair-HPLC d MS analysis with Agilent 1100 MSD system.
Table 34a
ASO comprising a GalNAc3-3 conjugate at the 5’ position via a hexylamino
phosphodiester linkage targeting Malat—l
INSIS Conjugate Calcd Observed
--3GalNAC3a-o’mCesGesGesTesGes
661 166 mCdsAdsAdsGdSGdSmCdsTdSTdsAdsGds 5’-GalNAc3-3 8992.16 8990. 51
GesAesAes TesTe
Subscripts: “e” indicates 2’-MOE modified nucleoside; “(1” indicates B-D-Z’-deoxyribonucleoside;
66 S” indicates phosphorothioate internucleoside linkages (PS); 66 039'1ndicates phosphodiester ucleoside
linkages (PO); and “o”’ indicates -O-P(=O)(OH)-. Superscript “m” indicates 5-methylcytosines. The
structure of “5’-Ga1NA03-3a” is shown in Example 39.
Example 43: Dose-dependent study of phosphodiester linked GalNAc3-2 (see examples 37 and 41, Bx is
adenine) at the 5’ terminus targeting SRB-l in vivo
ISIS 661134 (see Example 41) comprising a phosphodiester linked GalNAc3-2 conjugate at the 5’
terminus was tested in a dose-dependent study for nse tion of SRB-l in mice. Unconjugated ISIS
440762 and 651900 (GalNA03-1 ate at 3’ us, see Example 9) were included in the study for
comparison and are described previously in Table 17.
Treatment
Six week old male Balb/c mice (Jackson tory, Bar Harbor, ME) were injected subcutaneously
once at the dosage shown below with ISIS , 651900, 661134 or with PBS treated control. Each
ent group consisted of 4 animals. The mice were sacrificed 72 hours following the final administration
to determine the liver SRB-1 mRNA levels using real-time PCR and RIBOGREEN® RNA quantification
reagent (Molecular Probes, Inc. Eugene, OR) according to standard protocols. SRB-l mRNA levels were
determined relative to total RNA (using Ribogreen), prior to normalization to PBS-treated control. The
results below are presented as the average percent of SRB-l mRNA levels for each treatment group,
normalized to PBS-treated control and is denoted as “% PBS”. The EDsos were measured using similar
s as described usly and are presented below.
As illustrated in Table 35, treatment with antisense ucleotides lowered SRB-l mRNA levels in
a dose-dependent manner. Indeed, the antisense oligonucleotides comprising the phosphodiester linked
GalNAc3-2 conjugate at the 5’ terminus (ISIS 661134) or the GalNAc3-1 conjugate linked at the 3’ us
(ISIS ) showed substantial improvement in potency compared to the unconjugated antisense
ucleotide (ISIS 440762). Further, ISIS 661134, which comprises the phosphodiester linked GalNAc3-2
conjugate at the 5’ terminus was equipotent compared to ISIS 651900, which ses the GalNAc3-1
conjugate at the 3’ terminus.
Table 35
ASOs containing GalNAc3-1 0r GalNAc3-2 targeting SRB-l
ISIS Dosage SRB-l mRNA EDSO Conjugate
SEQ ID NO'
No. (mg/kg) levels (% PBS) (mg/kg)
PBS 0 100 -- --
0.2 116
0.7 91
440762 2 69 2.58 No conjugate 137
7 22
5
0.07 95
0.2 77
651900 0.7 28 0.26 3’ GalNAc3-1 138
2 11
7 8
0.07 107
0.2 86
661134 0.7 28 0.25 5’ GalNAc3-2 141
2 10
7 6
ures for 3’ GalNAc3-1 and 5’ GalNAc3-2 were described previously in Examples 9 and 37.
Pharmacokinetics Analysis (PK)
The PK of the ASOs from the high dose group (7 mg/kg) was examined and evaluated in the same
manner as illustrated in Example 20. Liver sample was minced and extracted using rd protocols. The
full length metabolites of 661134 (5’ GalNAc3-2) and ISIS 651900 (3’ GalNAc3-1) were identified and their
masses were confirmed by high resolution mass spectrometry analysis. The results showed that the major
metabolite detected for the ASO comprising a odiester linked GalNAc3-2 conjugate at the 5’ terminus
(ISIS 661134) was ISIS 440762 (data not shown). No additional metabolites, at a detectable level, were
ed. Unlike its counterpart, additional metabolites similar to those reported usly in Table 23a
were observed for the ASO having the GalNAc3-1 conjugate at the 3’ terminus (ISIS 651900). These results
t that having the phosphodiester linked GalNAc3-1 or GalNAc3-2 conjugate may improve the PK
profile of ASOs without compromising their potency.
Example 44: Effect of PO/PS linkages on antisense inhibition of ASOs sing GalNAc3-1
conjugate (see Example 9) at the 3’ terminus targeting SRB-l
ISIS 655861 and 655862 comprising a GalNA03-l conjugate at the 3’ terminus each targeting SRB-l
were tested in a single administration study for their ability to inhibit SRB-l in mice. The parent
unconjugated compound, ISIS 353382 was included in the study for comparison.
The ASOs are 55 MOE gapmers, wherein the gap region comprises ten 2’-deoxyribonucleosides
and each wing region comprises five 2’-MOE modified nucleosides. The ASOs were prepared using similar
methods as illustrated usly in Example 19 and are described Table 36, below.
Table 36
Modified ASOs comprising GalNAc3-1 conjugate at the 3’ terminus targeting SRB-l
Chemistry SEQ
ISIS No. Sequence (5’ to 3’) ID
353382 GesmCesTCSTesmCesAdsGdsTdsmCdSAdSTdSGdSAdS Full PS no conjugate 143
(parent) InCdSTdSTeSmCeSmCeSTeSTe
sTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds Full PS Wlth 144
655 861
mCdsTdsTesmCesmCesTesTeoAd0"GalNAC3-1 a GalNAC3-1 conjugate
GesmCeoTeoTeomCeoAdsGdsTdsmCdsAdsTdsGdsAds Mixed PS/PO With 144
655 862
InC:dsTdsTeomC:eomC:esTesTeoAdowc;alNAc3'1 a GalNAc3-1 conjugate
Subscripts: “e” indicates 2’-MOE modified nucleoside; “d” indicates -deoxyribonucleoside;
“s” indicates phosphorothioate internucleoside linkages (PS); “0” indicates phosphodiester internucleoside
linkages (PO); and “0’” indicates -O-P(=O)(OH)-. Superscript “m” indicates ylcytosines. The
structure of “GalNAc3-l” is shown in e 9.
Treatment
Six week old male Balb/c mice (Jackson Laboratory, Bar Harbor, ME) were injected subcutaneously
once at the dosage shown below with ISIS 353382, , 655862 or with PBS treated control. Each
treatment group consisted of 4 animals. Prior to the treatment as well as after the last dose, blood was drawn
from each mouse and plasma samples were ed. The mice were sacrificed 72 hours following the final
administration to ine the liver SRB-l mRNA levels using real-time PCR and RIBOGREEN® RNA
quantification reagent (Molecular Probes, Inc. Eugene, OR) according to standard protocols. SRB-l mRNA
levels were determined relative to total RNA (using Ribogreen), prior to ization to PBS-treated
control. The results below are presented as the average percent of SRB-l mRNA levels for each treatment
group, ized to PBS-treated control and is denoted as “% PBS”. The EDsos were measured using
similar methods as bed previously and are reported below.
As illustrated in Table 37, treatment with nse oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent manner compared to PBS treated control. Indeed, the antisense oligonucleotides
comprising the GalNAc3-1 conjugate at the 3’ terminus (ISIS 655861 and 655862) showed substantial
improvement in y comparing to the ugated antisense oligonucleotide (ISIS 353382). Further,
ISIS 655862 with mixed PS/PO linkages showed an improvement in potency relative to full PS (ISIS
655861).
Table 37
Effect of PO/PS linkages 0n antisense inhibition of ASOs
comprising GalNAc3-1 conjugate at 3’ terminus targeting SRB-l
ISIS Dosage SRB-l mRNA EDSO
Chemlsu'y. SEQ ID NO'
No. (mg/kg) levels (% PBS) )
PBS 0 100 -- --
3 76.65
:?) 10 52.40 10.4 Full PS without conjugate 143
24.95
0'5 8122
Fu11 PS 'th G lNA 1
1.5 63.51 W. a 03'
—5 2.2 conjugate 144
24.61
14.80
0.5 69.57
1.5 45.78 Mixed PS/PO with
655862 1'3 144
19.70 GalNA03-1 conjugate
12.90
Liver transaminase , alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were measured relative to saline injected mice using standard protocols. Organ weights were also
evaluated. The results demonstrated that no elevation in transaminase levels (Table 38) or organ weights
(data not shown) were observed in mice treated with ASOs compared to PBS control. Further, the ASO with
mixed PS/PO linkages (ISIS 655 862) showed similar transaminase levels compared to full PS (ISIS 655 861).
Table 38
Effect of PO/PS linkages 0n transaminase levels of ASOs
comprising GalNAc3-1 conjugate at 3’ terminus targeting SRB-l
ISIS Dosage ALT AST
Chemlstry_ SEQ ID No,
No. (mg/kg) (U/L) (U/L)
PBS 0 28.5 65 __
3 50.25 89
.31233)W “flag?“. 143
p J g
27.3 97
0528—55-7
1-5 30 78 Full PS with
655861 144
#GalNAc3—1
28.8 67.8
0.5 50 75.5 , .
29.3 69
____——
Example 45: Preparation of PFP Ester, Compound 110a
n OAC OAc , 2
OAc oOAC EtOAC’ MeOH
103a; ":1 O o/VHWN
3 —>
AcO 103k); n= 7 A00
—>AcHN
N 104a; n=1
7/0 104b; n= 7
4 0A0
AcHN o 0
OAc OAc 0Ac
AcOfi/O OAc Wm
0 WNH PFPTFA o
n —>AcO
AcHN
DMF, pyr AcHN OWNHn N02
105a; n=1 Compound 90 0
A00 0 O
AcHN
106a; n=1
106b; n= 7
0AACO%O0A0CAcHN OVWN o
Ra-Ni H2 O0Ac H
HBTU, DIEA, DMF
—’> ACO WNH —>
MeOH, EtOAc ACHNACONgQ/On
0A0 0A0
0 Wm ’8n
AcHN 99
107a;n 1
107b; n 7
AcHN 0
AcO ‘ngOAc OVWNH NH
AcHN NH
ACONgA/On 0
0A0 0A0
o WHN
AcHN
108a; n=1 0
108b; n= 7 I
/\H/V\0A0 Pd/C, H2, WACHSA
108a; n=1 EtOAc, MeOH
108b; n= 7 AcO
ACHNfi/CWnWNH
Acofi/OWOACW
ACHN
109a; n= 1
109b; n= 7
AcHN
PFPTFA,DMF, o
0A0 0A0
—> O
A00 0/\/\/\/HN O
109a
AcHN
110a o F
F F
F F
Compound 4 (9.5g, 28.8 mmoles) was d with compound 103a or 103b (38 moles),
individually, and TMSOTf (0.5 eq.) and molecular sieves in dichloromethane (200 mL), and d for 16
hours at room temperature. At that time, the c layer was filtered thru celite, then washed with sodium
bicarbonate, water and brine. The organic layer was then separated and dried over sodium sulfate, filtered
and reduced under reduced pressure. The resultant oil was purified by silica gel chromatography (2%-->10%
methanol/dichloromethane) to give compounds 104a and 104b in >80% yield. LCMS and proton NMR was
consistent with the structure.
Compounds 104a and 104b were treated to the same conditions as for compounds 100a-d (Example
47), to give compounds 105a and 105b in >90% yield. LCMS and proton NMR was consistent with the
structure.
Compounds 105a and 105b were treated, dually, with compound 90 under the same conditions
as for compounds 901a-d, to give compounds 106a (80%) and 106b (20%). LCMS and proton NMR was
consistent with the structure.
Compounds 106a and 106b were treated to the same conditions as for compounds 96a-d (Example
47), to give 107a (60%) and 107b (20%). LCMS and proton NMR was consistent with the structure.
Compounds 107a and 107b were treated to the same conditions as for compounds 97a-d (Example
47), to give compounds 108a and 108b in 40-60% yield. LCMS and proton NMR was consistent with the
structure.
Compounds 108a (60%) and 108b (40%) were treated to the same ions as for compounds 100a-
d le 47), to give compounds 109a and 10% in >80% yields. LCMS and proton NMR was consistent
with the structure.
Compound 109a was treated to the same conditions as for compounds 101a-d (Example 47), to give
Compound 110a in 30-60% yield. LCMS and proton NMR was consistent with the structure. Alternatively,
Compound 110b can be prepared in a similar manner starting with Compound 10%.
Example 46: General Procedure for Conjugation with PFP Esters nucleotide 111); Preparation
of ISIS 666881 (GalNAc3-10)
A 5’-hexylamino modified oligonucleotide was synthesized and purified using standard solid-phase
oligonucleotide procedures. The 5’-hexylamino modified oligonucleotide was dissolved in 0.1 M sodium
tetraborate, pH 8.5 (200 uL) and 3 equivalents of a selected PFP fied GalNAc3 r dissolved in
DMSO (50 uL) was added. If the PFP ester precipitated upon addition to the A80 solution DMSO was
added until all PFP ester was in solution. The reaction was complete after about 16 h of mixing at room
temperature. The ing solution was diluted with water to 12 mL and then spun down at 3000 rpm in a
spin filter with a mass cut off of 3000 Da. This process was ed twice to remove small molecule
impurities. The solution was then lyophilized to s and redissolved in concentrated aqueous a
and mixed at room temperature for 2.5 h followed by concentration in vacuo to remove most of the ammonia.
The conjugated oligonucleotide was purified and desalted by RP-HPLC and lyophilized to e the
GalNAc3 conjugated oligonucleotide.
HO1%OH
o 83e
3 . 5. | AcHN o o
OLIGO O-F|’-O-(CH2)6-NH2 OH OH \/\/\/\H
110a +> NH
1. Borate buffer, DMSO, pH 8.5, rt AcHN
2. NH3 (aq) rt
, O
OH OH
HOfi/OO /\/\/\/HN O
OLIGO o 4
Oligonucleotide 111 is conjugated with GalNAc3-10. The GalNAc3 cluster portion of the conjugate
group 3-10 c3-10a) can be combined with any cleavable moiety to provide a y of
conjugate groups. In n embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)- as shown in
the oligonucleotide (ISIS 666881) synthesized with GalNAc3-10 below. The structure of GalNAc3-10
(GalNAc3-10a-CM-) is shown below:
Homwflffi NWNAMAO A.”
Following this l procedure ISIS 666881 was ed. 5’-hexylamino modified
oligonucleotide, ISIS 660254, was synthesized and purified using standard solid-phase oligonucleotide
procedures. ISIS 660254 (40 mg, 5.2 umol) was dissolved in 0.1 M sodium tetraborate, pH 8.5 (200 uL) and
3 equivalents PFP ester (Compound 110a) dissolved in DMSO (50 uL) was added. The PFP ester
precipitated upon addition to the ASO solution requiring additional DMSO (600 uL) to fully dissolve the PFP
ester. The reaction was complete after 16 h of mixing at room temperature. The solution was diluted with
water to 12 mL total volume and spun down at 3000 rpm in a spin filter with a mass cut off of 3000 Da. This
process was repeated twice to remove small molecule impurities. The solution was lyophilized to dryness
and redissolved in concentrated aqueous ammonia with mixing at room temperature for 2.5 h followed by
concentration in vacuo to remove most of the ammonia. The ated oligonucleotide was purified and
desalted by C and lyophilized to give ISIS 666881 in 90% yield by weight (42 mg, 4.7 umol).
GalNAc3-10 conjugated oligonucleotide
NH2(CH2)6'oAdoGesmCesTesTesmCesAdsGdsTds
ISIS 660254 Hexylamlne- 145
InC:dslAdsTdsC}d31AdsmC:dsTdsTesmC:esmC:esTesTe
GalNAC3-10a'o’Ad0GesmCesTesTesmCesAdsGdsTds
ISIS 6668 81 GalNAC3-10
InC:dslAdsTdsC}d31AdsmC:dsTdsTesmC:esmC:esTesTe
Capital letters indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “d” indicates a B-D-Z’-deoxyribonucleoside; “s”
indicates a phosphorothioate internucleoside linkage (PS); “0” tes a phosphodiester internucleoside
linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
Example 47: Preparation of Oligonucleotide 102 Comprising GalNAc3-8
HZNMNHBOC HANn O
91a; n= 1
91b n—2 BocHNMNH N02 M,
PFPTFA DIPEA DMF
BocHNVWHN o
92a; n=1
92b, n=2
HZNAHANH OAC OAc
N02 ; O TMSOTf, DCM
AcO OAc —>
AcHN
HZNV®VHN o
93a; n=1
93b, n=2
94a; m=1
94b, m=2 O
OAC OAC
O HOW0,Bn O0Ac
m A OC
A oC %
—> AcHN OMOHm
Pd/C. H2 64, m=2
AmwgmOWN
”W 0 OAc
—938(93b) ACOfi/OAWNMNH Ra-Ni, H2
HBTU, DIPEA, DMF ACACHN N02
AcOfi/OOAcOMNWHN o
AcHN n
96a; n=1, m=1
96b; n=1, m=2
960; n=2, m=1
96d: n=2. m=2
2014/036460
mow/*0 0
AcHN o N O
m H N
n HBTU,D|EA,DMF
0A0 0A0 O H
Acofi/OWH0 a9“NHn NH2
AcHN O ODMTr
0Ac 0
OAc HO
AGO OWNWHN 0 ’7
AcHN n N
O -,
97a; n=1, m=1
97b; n=1, m=2
97c; n=2, m=1
97d; n=2, m=2
ACO\%DAWAcHN O N 0
OAc H
OOAC 0
/\H/\ H O ODMTr
AcO OWN NH
n N
AcHN )
0A0 O
0A0 7
H N
O KMWGVHN
Aco o "0H
AcHN n
98a; n=1, m=1
98b; n=1, m=2
980; n=2, m=1
98d' n=2 m=2
WO 79625
AchK/WVLV o HBTU, DIEA, DMF
97a; n=1,m=1OOAc O
97b; n=1, m=2 —>
97c; n=2, m=1 AcO N/WNH MN
O 0
97d, n—2, m=2
HOzC/flifio’ ”
AcHNO ‘Bn
B 760%»)OWNWHN0A0 o
99 m
AcHN '1
100a; n=1, m=1
100b; n=1, m=2
100c; n=2, m=1
100d; n=2, m=2
Pd(OH) 2/c, o 0
H2, EtOAc, OOAC , DMF,
_MeQH_. AC0 d?NI-In MS OH pyr
AcHN
Acofi/o0A0 OAc
0 101a; n=1, m=1
AcHN OMNWHNn 101b; n=1, m=2
O 101c; n=2, m=1
101d; n=2, m=2
(QACJK:WW,“
(DAG/W
OAc OAc
AcO 0M 102a; n=1, m=1
AcHN 102b; n=1, m=2
102c; n=2, m=1
102d; n=2, m=2
The triacid 90 (4 g, 14.43 mmol) was dissolved in DMF (120 mL) and N,N—Diisopropylethylamine
(12.35 mL, 72 moles). Pentafluorophenyl trifluoroacetate (8.9 mL, 52 moles) was added dropwise, under
argon, and the reaction was allowed to stir at room temperature for 30 minutes. Boc-diamine 91a or 91b
(68.87 mmol) was added, along with N,N—Diisopropylethylamine (12.35 mL, 72 moles), and the reaction
was allowed to stir at room temperature for 16 hours. At that time, the DMF was reduced by >75% under
reduced pressure, and then the mixture was dissolved in dichloromethane. The organic layer was washed
with sodium bicarbonate, water and brine. The organic layer was then separated and dried over sodium
sulfate, filtered and reduced to an oil under reduced pressure. The resultant oil was d by silica gel
chromatography (2%-->10% methanol/dichloromethane) to give nds 92a and 92b in an approximate
80% yield. LCMS and proton NMR were consistent with the structure.
Compound 92a or 92b (6.7 ) was treated with 20 mL of dichloromethane and 20 mL of
trifluoroacetic acid at room temperature for 16 hours. The resultant solution was evaporated and then
ved in ol and treated with DOWEX-OH resin for 30 minutes. The resultant on was filtered
and reduced to an oil under reduced pressure to give 85-90% yield of compounds 93a and 93b.
Compounds 7 or 64 (9.6 mmoles) were treated with HBTU (3.7g, 9.6 mmoles) and N,N—
Diisopropylethylamine (5 mL) in DMF (20 mL) for 15 minutes. To this was added either compounds 93a or
93b (3 moles), and d to stir at room temperature for 16 hours. At that time, the DMF was reduced by
>75% under d pressure, and then the mixture was dissolved in dichloromethane. The organic layer
was washed with sodium bicarbonate, water and brine. The organic layer was then separated and dried over
sodium sulfate, filtered and d to an oil under reduced pressure. The resultant oil was purified by silica
gel chromatography (5%-->20% methanol/dichloromethane) to give compounds 96a-d in 20-40% yield.
LCMS and proton NMR was consistent with the structure.
Compounds 96a-d (0.75 mmoles), individually, were enated over Raney Nickel for 3 hours in
Ethanol (75 mL). At that time, the catalyst was removed by filtration thru celite, and the ethanol removed
under reduced pressure to give nds 97a-d in 80-90% yield. LCMS and proton NMR were consistent
with the ure.
Compound 23 (0.32g, 0.53 mmoles) was treated with HBTU (0.2g, 0.53 ) and N,N—
Diisopropylethylamine (0.19 mL, 1.14 mmoles) in DMF (30mL) for 15 minutes. To this was added
compounds 97a-d (0.38 mmoles), individually, and allowed to stir at room temperature for 16 hours. At that
time, the DMF was reduced by >75% under reduced re, and then the mixture was dissolved in
dichloromethane. The organic layer was washed with sodium bicarbonate, water and brine. The organic
layer was then separated and dried over sodium sulfate, filtered and reduced to an oil under reduced pressure.
The resultant oil was purified by silica gel chromatography 20% methanol/dichloromethane) to give
compounds 98a-d in 30-40% yield. LCMS and proton NMR was consistent with the structure.
Compound 99 (0.17g, 0.76 mmoles) was treated with HBTU (0.29 g, 0.76 mmoles) and N,N—
Diisopropylethylamine (0.35 mL, 2.0 mmoles) in DMF (50mL) for 15 minutes. To this was added
compounds 97a-d (0.51 mmoles), individually, and allowed to stir at room temperature for 16 hours. At that
time, the DMF was reduced by >75% under reduced pressure, and then the mixture was dissolved in
dichloromethane. The organic layer was washed with sodium bicarbonate, water and brine. The organic
layer was then separated and dried over sodium sulfate, filtered and reduced to an oil under reduced pressure.
The resultant oil was purified by silica gel chromatography (5%-->20% methanol/ dichloromethane) to give
compounds 100a-d in 40-60% yield. LCMS and proton NMR was tent with the structure.
Compounds 100a-d (0.16 mmoles), dually, were enated over 10% Pd(OH)2/C for 3
hours in methanol/ethyl acetate (1 :1, 50 mL). At that time, the catalyst was removed by filtration thru celite,
and the organics removed under reduced pressure to give compounds 101a-d in 80-90% yield. LCMS and
proton NMR was consistent with the structure.
Compounds 101a-d (0.15 mmoles), individually, were dissolved in DMF (15 mL) and pyridine
(0.016 mL, 0.2 mmoles). uorophenyl trifluoroacetate (0.034 mL, 0.2 mmoles) was added dropwise,
under argon, and the reaction was allowed to stir at room temperature for 30 minutes. At that time, the DMF
was reduced by >75% under reduced re, and then the mixture was dissolved in dichloromethane. The
organic layer was washed with sodium bicarbonate, water and brine. The organic layer was then separated
and dried over sodium sulfate, filtered and reduced to an oil under reduced pressure. The resultant oil was
purified by silica gel chromatography 5% methanol/dichloromethane) to give compounds lOZa-d in an
approximate 80% yield. LCMS and proton NMR were consistent with the ure.
3' 5' ('3'
-o-F|>-o-(CH2)6NH2
Borate buffer, DMSO, pH 8.5, rt
102d —>
2. aq. ammonia, rt
HoOH o o
Ho%O o’fka 4 HM?”
AcHN o o
HOOH O O
HO¥Q/ W
o O”Tka N Wm
N H 4
4 HwH
AcHN
HoOH o
Hog/O O/TTKN”r¥\N O
4 H 2 H 102
AcHN
eric Compound 102, comprising a GalNAc3-8 conjugate group, was prepared using the
general procedures illustrated in Example 46. The GalNAc3 cluster portion of the ate group GalNAc3-
8 (GalNAc3-8a) can be combined with any cleavable moiety to provide a variety of conjugate groups. In a
preferred embodiment, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.
The structure of GalNAc3-8 (GalNAc3-8a-CM-) is shown below:
Example 48: Preparation of ucleotide 119 Comprising GalNAc3-7
ACOOAC ACO OAC
0 0
A00 TMSOT“! DOE A00 OWNHCBZ Pd(OH)2/C
—> 4 —>
Ni? HO/VHg/NHCBZ AcHN H2, MeOH, EtOAc
4 35b 112
HO\H/\\
HBTU, DIEA
$0: 0 NHCBZ —,
OWNH HO
A00 2 + %
AcHN o
105a p
A00 OAC
ACO%Q/o\/H\/NHo o
AcHN
A00 OAc
o H 0
A00 o
AcHN \/H4\/N\n/\/o\%NHCBZ
o 0
A00 OAc p
ACO%Q/O\/H4\/NHO
AcHN
ACO OAC
O oWH O
A HNC
ACO OAc
Pd/C, H2, 0
114 CHsOH AGO%Q/O\/H4\/NH\n/\/O%NH2ACHN
O 0
A00 OAC p
ACO%O\/H4\/NHO
ACHN
A00 OAC
O\/H\/NHO O
HBTU, DIEA, DMF A HNC
O O
ACO OAC
—>ACO%O\/H4\/NH\”/VO\%NHOO WOBn
ACHN
O O
HO 0Q
\n/V\n/ O
ACO OAC
O O 0 H
A00 O\/H4\/NH
ACHN
Compound 112 was sized following the procedure described in the literature (J. Med. Chem.
2004, 47, 5798-5808).
Compound 112 (5 g, 8.6 mmol) was dissolved in 1:1 methanol/ethyl acetate (22 mL/22 mL).
Palladium hydroxide on carbon (0.5 g) was added. The reaction mixture was stirred at room temperature
under hydrogen for 12 h. The reaction mixture was filtered through a pad of celite and washed the pad with
1:1 ol/ethyl acetate. The filtrate and the washings were combined and concentrated to dryness to yield
nd 105a (quantitative). The structure was confirmed by LCMS.
Compound 113 (1.25 g, 2.7 mmol), HBTU (3.2 g, 8.4 mmol) and DIEA (2.8 mL, 16.2 mmol) were
dissolved in anhydrous DMF (17 mL) and the reaction mixture was d at room temperature for 5 min. To
this a solution of Compound 105a (3.77 g, 8.4 mmol) in anhydrous DMF (20 mL) was added. The reaction
was stirred at room temperature for 6 h. Solvent was removed under reduced pressure to get an oil. The
residue was dissolved in CHgClg (100 mL) and washed with aqueous saturated NaHC03 on (100 mL)
and brine (100 mL). The organic phase was separated, dried (Na2S04), filtered and evaporated. The residue
was purified by silica gel column chromatography and eluted with 10 to 20 % MeOH in romethane to
yield Compound 114 (1.45 g, 30%). The structure was confirmed by LCMS and 1H NMR analysis.
Compound 114 (1.43 g, 0.8 mmol) was dissolved in 1:1 ol/ethyl acetate (4 mL/4 mL).
Palladium on carbon (wet, 0.14 g) was added. The reaction mixture was flushed with hydrogen and stirred at
room ature under en for 12 h. The reaction mixture was filtered through a pad of celite. The
celite pad was washed with methanol/ethyl acetate (1:1). The filtrate and the washings were combined
together and evaporated under reduced pressure to yield Compound 115 (quantitative). The structure was
confirmed by LCMS and 1H NMR analysis.
Compound 83a (0.17 g, 0.75 mmol), HBTU (0.31 g, 0.83 mmol) and DIEA (0.26 mL, 1.5 mmol)
were ved in anhydrous DMF (5 mL) and the reaction mixture was stirred at room temperature for 5
min. To this a solution of Compound 115 (1.22 g, 0.75 mmol) in anhydrous DMF was added and the reaction
was stirred at room temperature for 6 h. The t was removed under reduced pressure and the e
was dissolved in CHgClg. The organic layer was washed aqueous ted NaHC03 solution and brine and
dried over anhydrous Na2S04 and filtered. The organic layer was concentrated to dryness and the residue
obtained was purified by silica gel column chromatography and eluted with 3 to 15 % MeOH in
dichloromethane to yield Compound 116 (0.84 g, 61%). The structure was confirmed by LC MS and 1H
NMR analysis.
ACO OAC
ACHN
Pd/C, H2, ACO OAC
116 EtOAC, MeOH 0 OH
—,Aco§wovswknmo()0ng:
ACHN
ACO OAC H
ACO%Q/O\/H4\/NHO 117
ACHN
ACO OAC
ACOE “ago /O\/H\/NH O F
4 F
ACHN
PFPTFA DMF
, v Pyr ACO OAC KO MOI:
AGO0%OVHYNH 0%NH F
ACHN \n/V F
ACO OAC (p
Inflow/OWNH 118
ACHN
Compound 116 (0.74 g, 0.4 mmol) was dissolved in 1:1 methanol/ethyl acetate (5 mL/S mL).
Palladium on carbon (wet, 0.074 g) was added. The on mixture was flushed with hydrogen and stirred
at room temperature under hydrogen for 12 h. The on e was filtered through a pad of celite. The
celite pad was washed with methanol/ethyl acetate (1:1). The filtrate and the washings were combined
together and evaporated under reduced pressure to yield compound 117 (0.73 g, 98%). The structure was
confirmed by LCMS and 1H NMR analysis.
Compound 117 (0.63 g, 0.36 mmol) was dissolved in anhydrous DMF (3 mL). To this solution N,N—
Diisopropylethylamine (70 uL, 0.4 mmol) and uorophenyl trifluoroacetate (72 uL, 0.42 mmol) were
added. The reaction mixture was stirred at room temperature for 12 h and poured into a aqueous saturated
NaHC03 solution. The mixture was extracted with dichloromethane, washed with brine and dried over
anhydrous Na2SO4. The romethane solution was concentrated to dryness and purified with silica gel
column chromatography and eluted with 5 to 10 % MeOH in dichloromethane to yield nd 118 (0.51
g, 79%). The structure was confirmed by LCMS and 1H and 1H and 19F NMR.
3- 5' |
OLIGO O-T-O-(Csz'NHz
1. Borate buffer, DMSO, pH 8.5, rt
118 —>
2. aq. a, rt
HO%HOOH
ACHN
HW/flAJk/‘gwfiocm oueo
oWHN O 119
Oligomeric Compound 119, comprising a GalNAc3-7 conjugate group, was prepared using the
general procedures illustrated in Example 46. The GalNAc3 cluster portion of the conjugate group GalNAc3-
7 (GalNAc3-7a) can be combined with any ble moiety to provide a variety of conjugate groups. In
certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.
The structure of GalNAc3-7 (GalNAc3-7a-CM-) is shown below:
HoOH o
o N
Ho 4 Hkk
AcHN
Hog/o o :
O N s
4 H M ”W0 ‘
AcHN o
HoOH
o t
o N
Ho O
4 H
AcHN
Example 49: Preparation of Oligonucleotide 132 Comprising GalNAc3-5
Er HN’BOC
Boc\Eh 80:15YN OH
Boc\N H
HBTU TEA L'OH H20
DMF MeOH, THF HN\
120 122
78% 123
Compound 120 (14.01 g, 40 mmol) and HBTU (14.06 g, 37 mmol) were dissolved in ous
DMF (80 mL). Triethylamine (11.2 mL, 80.35 mmol) was added and stirred for 5 min. The reaction mixture
was cooled in an ice bath and a solution of compound 121 (10 g, mol) in anhydrous DMF (20 mL) was
added. Additional triethylamine (4.5 mL, 32.28 mmol) was added and the reaction mixture was stirred for 18
h under an argon atmosphere. The reaction was red by TLC (ethyl acetate:hexane; 1:1; Rf = 0.47).
The t was removed under reduced pressure. The residue was taken up in EtOAc (300 mL) and washed
with 1M NaHSO4 ( 3 X 150 mL), aqueous saturated NaHC03 solution (3 X 150 mL) and brine (2 X 100 mL).
Organic layer was dried with . Drying agent was removed by filtration and organic layer was
concentrated by rotary evaporation. Crude mixture was purified by silica gel column chromatography and
eluted by using 35 — 50% EtOAc in hexane to yield a compound 122 (15.50 g, ). The structure was
confirmed by LCMS and 1H NMR analysis. Mass m/z 589.3 [M + H]+.
A solution of LiOH (92.15 mmol) in water (20 mL) and THF (10 mL) was added to a cooled solution
of Compound 122 (7.75 g,13.16 mmol) dissolved in methanol (15 mL). The reaction mixture was stirred at
room temperature for 45 min. and monitored by TLC :hexane; 1:1). The reaction mixture was
concentrated to half the volume under reduced pressure. The remaining solution was cooled an ice bath and
neutralized by adding concentrated HCl. The reaction mixture was diluted, extracted with EtOAc (120 mL)
and washed with brine (100 mL). An emulsion formed and cleared upon ng overnight. The c
layer was separated dried (NaZSO4), filtered and evaporated to yield Compound 123 (8.42 g). Residual salt is
the likely cause of excess mass. LCMS is consistent with structure. Product was used without any r
purification. M.W.cal:574.36; M.W.fd:575.3 [M + H]+.
S? e O
o @S-OH - H20 '4stij
HZNMOH || 0
+ HO O ' —> (I? /\©
Toluene, Reflux ('5
124 125 126
99.6%
Compound 126 was synthesized following the procedure described in the literature (J. Am. Chem.
Soc. 2011, 133, 958-963).
2014/036460
HOBt DIEA CI"20'2
PyBop, Bop, DMF
CF3COO
AcO OAC
O OH
3W0 AcHN 7 o
CF3COO'@H3N —>
HATU, HOAt, DIEA, DMF
CF3COO' @NH3 128
A00 OAc
AcHN W0
Acog/ O
AcHN
A00 OAC
AcHN o
AcO OAc
o o
AcHN WY
Pd/C H M OH e
129 ’ 2’ o
A 0 OAcC H or
HN N
AcHN
A00 OAC
0 NH
AcHN 130
AcO OAc o
A00 0
AcHN W0
PFPTFA, DMF, Pyr
AcO OAC
Acog/0O:k5\(NO MW:
AcHN
AcO OAC
AcO CW
AcHN o
Compound 123 (7.419 g, 12.91 mmol), HOBt (3.49 g, 25.82 mmol) and compound 126 (6.33 g,
16.14 mmol) were dissolved in and DMF (40 mL) and the resulting reaction mixture was cooled in an ice
bath. To this N,N—Diisopropylethylamine (4.42 mL, 25.82 mmol), PyBop (8.7 g, 16.7 mmol) followed by
Bop coupling reagent (1.17 g, 2.66 mmol) were added under an argon atmosphere. The ice bath was
removed and the solution was allowed to warm to room temperature. The reaction was completed after 1 h as
determined by TLC (DCM:MeOH:AA; 89:10:1). The reaction mixture was concentrated under d
pressure. The residue was dissolved in EtOAc (200 mL) and washed with 1 M NaHSO4 (3X100 mL),
s saturated NaHC03 (3X100 mL) and brine (2X100 mL). The c phase separated dried (Na2S04),
filtered and concentrated. The residue was purified by silica gel column chromatography with a gradient of
50% hexanes/EtOAC to 100% EtOAc to yield Compound 127 (9.4 g) as a white foam. LCMS and 1H NMR
were consistent with ure. Mass m/z 778.4 [M + H] +.
Trifluoroacetic acid (12 mL) was added to a solution of compound 127 (1.57 g, 2.02 mmol) in
dichloromethane (12 mL) and stirred at room temperature for 1 h. The reaction mixture was co-evaporated
with e (30 mL) under reduced pressure to dryness. The residue obtained was porated twice with
acetonitrile (30 mL) and toluene (40 mL) to yield Compound 128 (1.67 g) as trifluoro acetate salt and used
for next step t further purification. LCMS and 1H NMR were consistent with structure. Mass m/z
478.2 [M + H] i
Compound 7 (0.43 g, 0.963 mmol), HATU (0.35 g, 0.91 mmol), and HOAt (0.035 g, 0.26 mmol)
were combined er and dried for 4 h over P205 under reduced pressure in a round bottom flask and then
dissolved in anhydrous DMF (1 mL) and stirred for 5 min. To this a solution of compound 128 (0.20 g, 0.26
mmol) in anhydrous DMF (0.2 mL) and N,N—Diisopropylethylamine (0.2 mL) was added. The on
mixture was stirred at room temperature under an argon atmosphere. The reaction was complete after 30 min
as determined by LCMS and TLC (7% MeOH/DCM). The on mixture was concentrated under reduced
pressure. The residue was dissolved in DCM (30 mL) and washed with 1 M NaHSO4 (3x20 mL), aqueous
saturated NaHC03 (3 x 20 mL) and brine (3x20 mL). The organic phase was separated, dried over Na2SO4,
filtered and concentrated. The residue was purified by silica gel column chromatography using 5-15%
MeOH in dichloromethane to yield Compound 129 (96.6 mg). LC MS and 1H NMR are consistent with
structure. Mass m/z 883.4 [M + 2H]+.
Compound 129 (0.09 g, 0.051 mmol) was dissolved in ol (5 mL) in 20 mL scintillation vial.
To this was added a small amount of 10% Pd/C (0.015 mg) and the reaction vessel was flushed with H2 gas.
The reaction mixture was stirred at room temperature under H2 atmosphere for 18 h. The reaction mixture
was filtered through a pad of Celite and the Celite pad was washed with methanol. The filtrate washings
were pooled together and concentrated under reduced pressure to yield Compound 130 (0.08 g). LCMS and
1H NMR were consistent with structure. The product was used without r purification. Mass m/z 838.3
[M + 2H]+.
To a 10 mL d round bottom flask were added compound 130 (75.8 mg, 0.046 mmol), 0.37 M
ne/DMF (200 uL) and a stir bar. To this solution was added 0.7 M pentafluorophenyl
trifluoroacetate/DMF (100 uL) drop wise with stirring. The reaction was completed after 1 h as determined
by LC MS. The solvent was removed under reduced pressure and the residue was dissolved in CHC13 (N 10
mL). The organic layer was partitioned against NaHSO4 (1 M, 10 mL) saturated NaHC03 (10 mL)
, aqueous
and brine (10 mL) three times each. The organic phase separated and dried over Na2SO4, filtered and
trated to yield Compound 131 (77.7 mg). LCMS is consistent with structure. Used without further
purification. Mass m/z 921.3 [M + 2H]+.
HO OH
0 HO
3' 5' I AcHN W0 -O-F|’-o-(CH2>6-NH2
1. Borate buffer, DMSO, pH 8.5, rt
131—>
2. aq. ammonia, rt HO OHE
HO%/O
ACHN
HO OH
HO Memo—r-
AcHN
Oligomeric Compound 132, comprising a GalNAc3-5 conjugate group, was prepared using the
l procedures rated in Example 46. The GalNAc3 cluster portion of the conjugate group 3-
(GalNAc3-5a) can be combined with any cleavable moiety to provide a variety of conjugate groups. In
certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.
The structure of GalNAc3-5 (GalNAc3-5a-CM-) is shown below:
HO OH
AcHN WYO
HO OH N
“N NH
HO OM O
AcHN
HO OH
o NH
HO VVY O NAM/\o—I—E
H 4
AcHN o
Example 50: Preparation of Oligonucleotide 144 Comprising GalNAc4-11
DMTO Fmoc 1. TBTU, DIEA DMTO Fmoc
KC)? .
ACN, VIMAD Resin K617 pipiDBU1DMF
—> —>
O O 2. A020 Capping (222296)
2,OGOH .3
Kaiser: Negetive O
HN’FmOC
DMTO
KG Fmoc\N/W\n/OH“
o O
DMTr\
136 O
b . N
HBTU, DIEA, DMF
135 ’O
NH-Fmoc
DMTr|
1. pip-:DBUzDMi:_ 1. 2% hydrazine/DMF
: Posmve —> kHCH Kaiser. Positive
2. Dde-Lys(Fmoc)—OH (138)
. 2. Fmoc—Lys(Fmoc)—OH (140)
HATU, DIEA, DMF 0: ”0101—,
HATU DIEA DMF
Kaiser: Negative Kaiser. ve
O /Fmoc
N \Fmoc
l_|N\Fmoc
AcO OAC
AcHN OWNH
AcO OAC
AcO OW}N N
ACHN
1. pip:DBU:DMF O H
Kalser: Posmve
2. 7, HATU, DIEA, AcO OAc
K ' alser: N ega Ivet'
AcO OWN
AcHN
O o
AcO OAC
AcHN OWNH
Synthesis of Compound 134. To a Merrifield flask was added aminomethyl VIMAD resin (2.5 g,
450 umol/g) that was washed with acetonitrile, dimethylformamide, dichloromethane and acetonitrile. The
resin was swelled in acetonitrile (4 mL). Compound 133 was pre-activated in a 100 mL round bottom flask
by adding 20 (1.0 mmol, 0.747 g), TBTU (1.0 mmol, 0.321 g), itrile (5 mL) and DIEA (3.0 mmol, 0.5
mL). This solution was allowed to stir for 5 min and was then added to the Merrifield flask with shaking.
The suspension was allowed to shake for 3 h. The reaction mixture was drained and the resin was washed
with acetonitrile, DMF and DCM. New resin loading was quantitated by measuring the ance of the
DMT cation at 500 nm (extinction coefficient = 76000) in DCM and determined to be 238 umol/g. The resin
was capped by suspending in an acetic anhydride solution for ten s three times.
The solid support bound nd 141 was synthesized using iterative Fmoc-based solid phase
peptide synthesis methods. A small amount of solid support was withdrawn and ded in aqueous
ammonia (28-30 wt%) for 6 h. The cleaved compound was analyzed by LC-MS and the observed mass was
consistent with structure. Mass m/z 1063.8 [M + 2H]+.
The solid support bound compound 142 was synthesized using solid phase peptide synthesis
methods.
AcO OAC
ACHN OW>\NH
A00 OAC
AcO OVV>\ O
AcHN
o H
DNA syntesizer O H
142—> 3
A00 OAC
AcO OWN
AcHN
o 0
A00 OAC
AGO$¢OWNHO 143
ACHN
HO OH
ACHN O\/\/>\NH
HO OH
Hog/OW}O H o
N N
AcHN
o H pH
aqueous NH3 0 H
—> 3 N
HO OH o
Hog/O O
H NH |
AcHN
o o
HO OH
ACHN WNH
The solid support bound nd 143 was synthesized using standard solid phase synthesis on a
DNA synthesizer.
The solid support bound compound 143 was ded in aqueous ammonia (28-30 wt%) and heated
at 55 0C for 16 h. The solution was cooled and the solid support was filtered. The e was concentrated
and the residue dissolved in water and purified by HPLC on a strong anion exchange column. The fractions
containing full length compound 144 were pooled together and desalted. The resulting GalNAc4-11
WO 79625
conjugated eric compound was analyzed by LC-MS and the observed mass was tent with
structure.
The GalNAc4 cluster portion of the conjugate group GalNAc4-ll c4-lla) can be combined
with any cleavable moiety to provide a variety of conjugate groups. In certain embodiments, the cleavable
moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.
The structure of GalNAc4-ll (GalNAc4-l la-CM) is shown below:
HO OH
EEWWMACHN
HO OH
EtwACHN
ET“:
AcHN o
HO OH
HO$Q/ WNHO O
ACHN
Example 51: Preparation of Oligonucleotide 155 Comprising GalNAc3-6
Q 0
H BrQL Q o o
O N NH2 OTNWIVEOHH ‘5 OH
O OH 0
2M NaOH o OH
Compound 146 was synthesized as described in the literature (Analytical Biochemistry 1995, 229, 54-
60).
O AcO OAC
H O
35b O
4 p A00 J\O
TMS—OTf, 4 A molecular sieves, CHZCIZ, rt H
AcHN
Q 0 H
A00 OAC O\n/N\)J\OH
H2, Pd(OH)2 /C O O 147
—>ACO W\/\NH2
EtOAc/MeOH AcHN
105a HBTU, DIEA, DMF, rt
AcO OAC
Agog/OWNJK/ \n/O\/© —>HO H
0 H2, Pd(OH)2/C, EtOAc/MeOH
AcHN
148 0
A00 OAC
O O\/\/\/\N)l\/
AcHN
Compound 4 (15 g, 45.55 mmol) and compound 35b (14.3 grams, 57 mmol) were dissolved in
CHgClg (200 ml). Activated molecular sieves (4 A. 2 g, powdered) were added, and the reaction was allowed
to stir for 30 minutes under en atmosphere. TMS-OTf was added (4.1 ml, 22.77 mmol) and the
reaction was allowed to stir at room temp overnight. Upon completion, the reaction was quenched by
pouring into solution of saturated aqueous NaHC03 (500 ml) and crushed ice (N 150 g). The c layer
was separated, washed with brine, dried over MgSO4, filtered, and was concentrated to an orange oil under
reduced pressure. The crude material was purified by silica gel column chromatography and eluted with 2-10
% MeOH in CHgClg to yield Compound 112 (16.53 g, 63 %). LCMS and 1H NMR were consistent with the
expected compound.
Compound 112 (4.27 g, 7.35 mmol) was dissolved in 1:1 MeOH/EtOAc (40 ml). The reaction
mixture was purged by ng a stream of argon through the on for 15 minutes. Pearlman’s catalyst
(palladium ide on carbon, 400 mg) was added, and hydrogen gas was bubbled through the solution for
s. Upon completion (TLC 10% MeOH in CHgClg, and LCMS), the catalyst was removed by
filtration h a pad of celite. The filtrate was concentrated by rotary evaporation, and was dried briefly
under high vacuum to yield Compound 105a (3.28 g). LCMS and 1H NMR were consistent with desired
product.
Compound 147 (2.31 g, 11 mmol) was dissolved in anhydrous DMF (100 mL). N,N—
Diisopropylethylamine (DIEA, 3.9 mL, 22 mmol) was added, followed by HBTU (4 g, 10.5 mmol). The
reaction mixture was allowed to stir for N 15 minutes under nitrogen. To this a solution of compound 105a
(3.3 g, 7.4 mmol) in dry DMF was added and stirred for 2 h under nitrogen atmosphere. The reaction was
diluted with EtOAc and washed with saturated aqueous NaHC03 and brine. The organics phase was
separated, dried ), filtered, and concentrated to an orange syrup. The crude material was purified by
column chromatography 2-5 % MeOH in CH2C12 to yield Compound 148 (3.44 g, 73 %). LCMS and 1H
NMR were consistent with the expected product.
Compound 148 (3.3 g, 5.2 mmol) was dissolved in 1:1 MeOH/EtOAc (75 ml). The reaction mixture
was purged by bubbling a stream of argon through the solution for 15 minutes. Pearlman’s st
(palladium hydroxide on ) was added (350 mg). Hydrogen gas was bubbled through the solution for
30 s. Upon completion (TLC 10% MeOH in DCM, and LCMS), the catalyst was removed by
filtration through a pad of celite. The filtrate was concentrated by rotary evaporation, and was dried briefly
under high vacuum to yield Compound 149 (2.6 g). LCMS was consistent with d product. The residue
was dissolved in dry DMF (10 ml) was used immediately in the next step.
ACO \/\(\/)/\NAJ\/ N
ACHN 3 H O
146 —> AcO OAc o
HBTU, DIEA,DMF o OWN/[V
ACO 3 H
NHAC
ACO OAC
o o
AGO OWNJK/H O
AC0 OAC
Pd(OH)2/C,H2 ACHN 3
’ Acog/ WNX/ \ll/\No £1
O N ji/mNH2
MeOH,EtOAc
ACHN 3 H O
ACO OAC o
O OWN/kw
3 H
NHAC
Compound 146 (0.68 g, 1.73 mmol) was dissolved in dry DMF (20 ml). To this DIEA (450 uL, 2.6
mmol, 1.5 eq.) and HBTU (1.96 g, 0.5.2 mmol) were added. The on mixture was d to stir for 15
minutes at room temperature under nitrogen. A solution of compound 149 (2.6 g) in anhydrous DMF (10
mL) was added. The pH of the reaction was adjusted to pH = 9-10 by addition of DIEA (if ary). The
reaction was allowed to stir at room temperature under nitrogen for 2 h. Upon completion the reaction was
diluted with EtOAc (100 mL), and washed with aqueous ted aqueous NaHC03, followed by brine. The
organic phase was ted dried over MgSO4, filtered, and concentrated. The residue was purified by
silica gel column chromatography and eluted with 2-10 % MeOH in CHgClg to yield Compound 150 (0.62 g,
%). LCMS and 1H NMR were consistent with the desired product.
Compound 150 (0.62 g) was dissolved in 1:1 MeOH/ EtOAc (5 L). The reaction mixture was purged
by bubbling a stream of argon h the solution for 15 minutes. Pearlman’s catalyst (palladium hydroxide
on carbon) was added (60 mg). Hydrogen gas was bubbled through the solution for 30 minutes. Upon
completion (TLC 10% MeOH in DCM, and LCMS), the catalyst was removed by filtration ge-tip
Teflon filter, 0.45 um). The filtrate was concentrated by rotary evaporation, and was dried briefly under high
vacuum to yield Compound 151 (0.57 g). The LCMS was consistent with the desired product. The product
was dissolved in 4 mL dry DMF and was used immediately in the next step.
WO 79625
)J\/\/U\ o H
O N
BnO 0H Acog/ WNJK/ \ll/\N M
3 H OBn
83a O
151 —, H
AcHN 3 o
PFP-TFA DIEA DMF
’ ’
AcO 0A0 0
O OWN/[V
A00 3 H
NHAc
A00 OAC
o o
o H
AcO \/\M/\ N
A00 AcHN 3 H O O
o H
Pd(OH)2/C, H2 0
N M —> Acog/OVWNJK/ \“/\N
3 H OH
MeOH, EtOAc AcHN 3 H 0
AcO 0A0 0 L70
A00 0A0 AcHN 3 H m o o F
PFP-TFA, DIEA N
—>AC 3
3 H O
DMF AcHN Lfo F
AcO 0A0 0
O OWN/[V
3 H
NHAc
Compound 83a (0.11 g, 0.33 mmol) was dissolved in anhydrous DMF (5 mL) and N,N—
Diisopropylethylamine (75 uL, 1 mmol) and PFP-TFA (90 uL, 0.76 mmol) were added. The reaction
mixture turned a upon t, and gradually turned orange over the next 30 minutes. Progress of
reaction was monitored by TLC and LCMS. Upon completion tion of the PFP ester), a solution of
compound 151 (0.57 g, 0.33 mmol) in DMF was added. The pH of the reaction was adjusted to pH = 9-10 by
addition of isopropylethylamine (if necessary). The reaction mixture was stirred under nitrogen for N
min. Upon completion, the majority of the solvent was removed under reduced pressure. The residue was
diluted with CHgClg and washed with aqueous saturated NaHC03, followed by brine. The organic phase
separated, dried over MgSO4, filtered, and concentrated to an orange syrup. The residue was purified by
silica gel column chromatography (2-10 % MeOH in CHgClg) to yield nd 152 (0.35 g, 55 %). LCMS
and 1H NMR were consistent with the desired product.
Compound 152 (0.35 g, 0.182 mmol) was dissolved in 1:1 MeOH/EtOAc (10 mL). The reaction
mixture was purged by bubbling a stream of argon thru the solution for 15 minutes. Pearlman’s catalyst
(palladium hydroxide on carbon) was added (35 mg). Hydrogen gas was bubbled thru the solution for 30
minutes. Upon tion (TLC 10% MeOH in DCM, and LCMS), the catalyst was removed by filtration
(syringe-tip Teflon filter, 0.45 um). The filtrate was concentrated by rotary evaporation, and was dried
briefly under high vacuum to yield Compound 153 (0.33 g, quantitative). The LCMS was consistent with
desired product.
nd 153 (0.33 g, 0.18 mmol) was dissolved in anhydrous DMF (5 mL) with stirring under
nitrogen. To this N,N—Diisopropylethylamine (65 uL, 0.37 mmol) and A (35 uL, 0.28 mmol) were
added. The reaction mixture was stirred under nitrogen for N 30 min. The reaction mixture turned magenta
upon t, and gradually turned orange. The pH of the reaction mixture was maintained at pH = 9-10 by
adding more N,-Diisopropylethylamine. The progress of the reaction was monitored by TLC and LCMS.
Upon tion, the majority of the solvent was removed under reduced pressure. The residue was diluted
with CH2C12 (50 mL), and washed with saturated aqueous NaHC03, followed by brine. The organic layer
was dried over MgSO4, filtered, and concentrated to an orange syrup. The e was purified by column
chromatography and eluted with 2-10 % MeOH in CHgClg to yield Compound 154 (0.29 g, 79 %). LCMS
and 1H NMR were consistent with the desired product.
3' 5' || HOOH O
-O-P-O-(CH2)6NH2 O
OH 0%”
AcHN HN
HOOH o
1. Borate buffer, DMSO, o
154 pHssn—’
0 H
' JV“ H
Ho mm rm MNWO
2. aq. ammonia, 5
rt 0 4
AcHN O O
HoOH £0] 0
HO oAHfHN O
AcHN
eric nd 155, comprising a 3-6 conjugate group, was prepared using the
general procedures illustrated in Example 46. The GalNAc3 r portion of the conjugate group GalNAcg-
6 (GalNAc3-6a) can be combined with any cleavable moiety to provide a variety of conjugate groups. In
certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.
The structure of GalNAc3-6 (GalNAc3-6a-CM-) is shown below:
HoOH o
WNJHo
AcHN HN
AcHN
Example 52: Preparation of Oligonucleotide 160 Comprising GalNAc3-9
AcOOAC AcOOAcO
Meow TMSOTf 50 °C
/\M%OA©
AcHN CICHZCHZCI rt 93% 4\i TMSOTf DCE 66%
AcO OAC AcO OAc
“0&0WW H2, Pd/C
MeOH, 95A:0 “0&0W0“
AcHN AcHN
156 157
HBTU, DMF, EtN(iPr)2
Phosphitylation
DMTO AcOOAc 81%
AcHN ODMT
H0: 47 NC
Ooj_P/
\N(iPr)2
ACOWWNAcOOAC
AcHN ODMT
Compound 156 was synthesized ing the procedure described in the literature (J. Med. Chem.
2004, 47, 5798-5808).
Compound 156, (18.60 g, 29.28 mmol) was dissolved in methanol (200 mL). Palladium on carbon
(6.15 g, 10 wt%, loading (dry basis), matrix carbon powder, wet) was added. The reaction mixture was
stirred at room temperature under hydrogen for 18 h. The reaction e was filtered through a pad of
celite and the celite pad was washed thoroughly with methanol. The combined e was washed and
concentrated to dryness. The residue was purified by silica gel column chromatography and eluted with 5-10
% methanol in dichloromethane to yield Compound 157 (14.26 g, 89%). Mass m/z 544.1 [M-H]'.
Compound 157 (5 g, 9.17 mmol) was dissolved in anhydrous DMF (30 mL). HBTU (3.65 g, 9.61
mmol) and N,N—Diisopropylethylamine (13.73 mL, 78.81 mmol) were added and the reaction e was
stirred at room ature for 5 s. To this a solution of compound 47 (2.96 g, 7.04 mmol) was added.
The reaction was stirred at room temperature for 8 h. The reaction mixture was poured into a saturated
NaHC03 aqueous solution. The mixture was extracted with ethyl acetate and the organic layer was washed
with brine and dried (Na2S04), filtered and evaporated. The residue obtained was purified by silica gel
column chromatography and eluted with 50% ethyl acetate in hexane to yield compound 158 (8.25g, 73.3%).
The structure was confirmed by MS and 1H NMR analysis.
Compound 158 (7.2 g, 7.61 mmol) was dried over P205 under reduced pressure. The dried
compound was dissolved in anhydrous DMF (50 mL). To this razole (0.43 g, 6.09 mmol) and N-
methylimidazole (0.3 mL, 3.81 mmol) and 2-cyanoethyl-N,N,N’,N’-tetraisopropyl phosphorodiamidite (3.65
mL, 11.50 mmol) were added. The on mixture was stirred t under an argon atmosphere for 4 h. The
on mixture was diluted with ethyl acetate (200 mL). The reaction mixture was washed with saturated
NaHC03 and brine. The organic phase was separated, dried (Na2S04), filtered and evaporated. The residue
was purified by silica gel column chromatography and eluted with 50-90 % ethyl acetate in hexane to yield
Compound 159 (7.82 g, 80.5%). The structure was confirmed by LCMS and “P NMR analysis.
HOOH '
O 0%“
HO 9
o o
ACHN O—Fl> OH
HOoH '
1.DNAsynthesizer
159 0 MN
2. aq. NH4OH HO
o o
ACHN o-F'> OH
HoOH
O OWNED
Oligomeric Compound 160, comprising a GalNAc3-9 conjugate group, was prepared using standard
oligonucleotide synthesis procedures. Three units of compound 159 were coupled to the solid support,
followed by nucleotide phosphoramidites. Treatment of the protected oligomeric compound with aqueous
a yielded compound 160. The 3 cluster portion of the ate group GalNAc3-9 (GalNAcg-
9a) can be combined With any cleavable moiety to provide a variety of conjugate groups. In certain
embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The ure of GalNAc3-9 (GalNAc3-
9a-CM) is shown below:
HoOH '
Hog/OmOo N
ACHN 0—; OH
HoOH
o N
HO o”$§j§ o
ACHN 0-; OH
HoOH
ififiLg/O”*£\Wo N
0 s
AcHN
Example 53: Alternate procedure for preparation of Compound 18 (GalNAc3-1a and GalNAc3-3a)
/\/\
H2N NHR H TMSOTf
R = H or Cbz HO\/\/\n/N\/\/NHR OAC
o OAC
161 = 0
CszI, Et3N E E: g’bgefiaezb AGO
4 Ny/O
PFPO
OAc h
OAc O O
0 —>
A00 o\/\/\n/N\/\/NHR +
NHAc PFPOWOQ‘NHCBZ
o o O O
R = Cbz, 163a
Pol/C, H2 l— PFPOM
A00 (3%ng H
NHAC
OAc WNW/j
ACO%/O‘§’)%l—NWNYVO%OAC O O
O H H
NHCBZ
NHAC
o O O
Lactone 161 was reacted with diamino propane (3-5 eq) 0r Mono-B00 protected diamino propane (1
eq) to provide alcohol 162a 0r 162b. When unprotected propanediamine was used for the above reaction, the
excess diamine was removed by evaporation under high vacuum and the free amino group in 162a was
protected using CszI to provide 162b as a white solid after purification by column chromatography.
Alcohol 162b was further d with compound 4 in the presence of TMSOTf to e 163a which was
converted to 163b by removal of the Cbz group using catalytic hydrogenation. The uorophenyl (PFP)
ester 164 was prepared by reacting d 113 (see Example 48) with PFPTFA (3.5 eq) and ne (3.5 eq)
in DMF (0.1 to 0.5 M). The triester 164 was directly reacted with the amine 163b (3—4 eq) and DIPEA (3—4
eq) to provide Compound 18. The above method greatly facilitates purification of intermediates and
minimizes the formation of byproducts which are formed using the procedure bed in Example 4.
Example 54: ate procedure for preparation of nd 18 c3-1a and GalNAc3-3a)
HOZC/\\ PFPTFA PFPO
O DMF, pyr O
/\/O NHCBZ O NHCBZ
PFPO
H020 W
o o O
HOZCJ
113 H 164
BocHN\/\/N7]/\\O
1. HCI or TFA
—.BocHN H NHCBZ —»
W Wl/V0%
DIPEA
/\/\ M
BOCHN H ACO0%OWk
OPFF
165 NHAC
OACOOACQ: 166
O 1. 1 6-hexanediol
AcO 0% H ’
4 HN N or 1,5-pentane-dlol
NHAc W 77/\\ TMSOTf + compound 4
2. TEMPO
O O
3. PFPTFA, pyr
H H o NHCBZ
\/\/ (V
NHAc
o o 0
OACOAc
HNWNW
O H
A00 0%
NHAc
The triPFP ester 164 was prepared from acid 113 using the ure outlined in example 53 above
and reacted with mono-Boc protected diamine to provide 165 in essentially quantitative yield. The Boc
groups were removed with hydrochloric acid or trifluoroacetic acid to provide the triamine which was reacted
with the PFP activated acid 166 in the presence of a suitable base such as DIPEA to provide Compound 18.
The PFP protected Gal-NAG acid 166 was prepared from the corresponding acid by treatment with
PFPTFA (l-l.2 eq) and pyridine (l-l.2 eq) in DMF. The precursor acid in turn was prepared from the
corresponding alcohol by oxidation using TEMPO (0.2 eq) and BAIB in acetonitrile and water. The
precursor alcohol was prepared from sugar intermediate 4 by on with 1,6-hexanediol (or 1,5-pentanediol
or other diol for other n values) (2-4 eq) and TMSOTf using conditions described previously in example 47.
Example 55: Dose-dependent study of oligonucleotides comprising either a 3' or 5'-conjugate group
rison of GalNAc3-1, 3, 8 and 9) targeting SRB-l in vivo
The ucleotides listed below were tested in a dose-dependent study for antisense inhibition of
SRB-l in mice. Unconjugated ISIS 353382 was included as a rd. Each of the various GalNA03
conjugate groups was attached at either the 3' or 5' us of the respective ucleotide by a
phosphodiester linked 2'-deoxyadenosine nucleoside (cleavable moiety).
Table 39
d ASO targeting SRB-l
ASO Sequence (5’ to 3’) Motif Conjugate
ID NO.
ISIS 3533 82 GCSmCCSTCSTCSmCCSACSGCSTCSmCCSACSTCSGCSACS
/ 1 0/5 none 143
(parent) mCdsTdsTesmCesmCesTesTe
GCSmCCSTCSTCSmCCSACSGCSTCSmCCSACSTCSGCSACS
ISIS 655 861 5/ 1 0/5 GalNAc3-1 144
sTesmCesmCesTesTeoAdo"GalNAc3' a
GCS CCSTCSTCS CCSACSGCSTCS CCSACSTCSGCSACS
ISIS 664078 5/10/5 GalNAC3-9 144
mCdsTdSTesmCesmCesTesTeoAdoa-GalNAC3- a
GalNAc3-3a-0sAd0
ISIS 661 161 GesmCesTesTesmCesAcchsTcschsAcsTcchsAcs 5/ l 0/5 GalNAc3-3 145
InC:dsTdsTesmC:esmC:esTesTe
GalNAc3-8a-0sAd0
ISIS 665001 GesmCesTesTesmCesAcchsTcschsAcsTcchsAcs 5/ l 0/5 GalNAc3-8 145
InCdSTdSTesmCesmCesTesTe
Capital letters indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “(1” indicates a B-D-2’-deoxyribonucleoside; “s”
indicates a phosphorothioate ucleoside linkage (PS); “0” indicates a odiester internucleoside
linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
The structure of GalNAC3-la was shown previously in Example 9. The structure of GalNA03-9 was
shown previously in Example 52. The structure of GalNA03-3 was shown previously in Example 39. The
structure of 3-8 was shown previously in Example 47.
Treatment
Six week old male Balb/c mice (Jackson Laboratory, Bar Harbor, ME) were injected subcutaneously
once at the dosage shown below with ISIS 353382, , 664078, 661161, 665001 or with saline. Each
treatment group consisted of 4 animals. The mice were sacrificed 72 hours following the final administration
to determine the liver SRB-l mRNA levels using real-time PCR and RIBOGREEN® RNA quantification
reagent (Molecular Probes, Inc. Eugene, OR) according to standard protocols. The results below are
presented as the average percent of SRB-l mRNA levels for each treatment group, normalized to the saline
control.
As illustrated in Table 40, treatment with antisense oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent manner. Indeed, the antisense oligonucleotides comprising the odiester linked
GalNAc3-1 and GalNAc3-9 conjugates at the 3’ terminus (ISIS 655861 and ISIS 664078) and the 3-3
and GalNAc3-8 conjugates linked at the 5’ terminus (ISIS 661161 and ISIS 665001) showed substantial
improvement in potency compared to the unconjugated antisense oligonucleotide (ISIS 353382).
rmore, ISIS 664078, comprising a GalNAc3-9 conjugate at the 3' us was ially equipotent
ed to ISIS 655861, which comprises a GalNAc3-1 conjugate at the 3’ terminus. The 5' conjugated
antisense oligonucleotides, ISIS 661161 and ISIS , comprising a GalNAc3-3 or GalNAc3-9,
respectively, had increased potency compared to the 3' conjugated antisense oligonucleotides (ISIS 655861
and ISIS 664078).
Table 40
ASOs containing GalNAc3-1, 3, 8 0r 9 targeting SRB-l
Dosage SRB-l mRNA
ISIS N0. Conjugate.
(m /k ) (% Saline)
Saline n/a 100
3 88
353382 10 68 none
36
0.5 98
1'5 76
655861 GalNac3 -1 (3')
31
20
0.5 88
1.5 85
664078 GalNac3-9 (3 ),
46
20
0.5 92
1.5 59
661161 GalNac3-3 (5),
19
11
0.5 100
1.5 73
665001 GalNac3-8 (5 ),
29
13
Liver transaminase levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were measured relative to saline injected mice using standard protocols. Total bilirubin and BUN were
also evaluated. The change in body weights was evaluated with no significant change from the saline group.
ALTs, ASTs, total bilirubin and BUN values are shown in the table below.
Table 41
Dosage Total
ISIS N0. ALT AST BUN Conjugate.
mg/kg Bilirubin
Saline 24 59 0.1 37.52
3 21 66 0.2 34.65
353382 10 22 54 0.2 34.2 none
22 49 0.2 33.72
0.5 25 62 0.2 30.65
1.5 23 48 0.2 30.97
655861 —5GalNac3-1 (3),
28 49 0.1 32.92
40 97 0.1 31.62
0.5 40 74 0.1 35.3
1.5 47 104 0.1 32.75
664078 —5GalNac3-9 (3 ),
43 0.1 30.62
38 92 0.1 26.2
0.5 101 162 0.1 34.17
1.5 g 42 100 0.1 33.37
661161 GalNac3-3 (5),
g 23 99 0.1 34.97
53 83 0.1 34.8
0.5 28 54 0.1 31.32
1.5 42 75 0.1 32.32
665001 —5GalNac3-8 (5 ),
24 42 0.1 31.85
32 67 0.1 31.
Example 56: Dose-dependent study of oligonucleotides comprising either a 3' 0r 5'-c0njugate group
rison of GalNAc3-1, 2, 3, 5, 6, 7 and 10) targeting SRB-l in vivo
The ucleotides listed below were tested in a dose-dependent study for antisense inhibition of
SRB-l in mice. Unconjugated ISIS 353382 was included as a standard. Each of the various GalNA03
conjugate groups was attached at the 5 ' terminus of the respective oligonucleotide by a phosphodiester linked
2'-deoxyadenosine nucleoside (cleavable moiety) except for ISIS 655861 which had the GalNA03 conjugate
group attached at the 3’ terminus.
Table 42
Modified ASO targeting SRB-l
ASO ce (5 ’ to 3 ’) Motif Conjugate
ID NO.
ISIS 3 53 3 82 GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds
/ 1 0/5 ‘
no conjugate 143
(parent) mCdsTdsTesmCesmCesTesTe
GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds
ISIS 655 861 mCdsTdsTesmCesmCesTesTeoAdo"GalNAc3-1a 5/ 1 O/5 3-1 144
GalNAc3'2a'o’AdoGesmCesTesTesmCesAdsGdsTds
ISIS 664507 5/ 1 O/5 GalNAc3-2 145
mCdsAdsTdsGdsAdsmCdsTdsTesmCesmCesTesTe
GalNAc3-3a-0sAd0
ISIS 661 161 GesmCesTesTesmCesAdSGdSTdSmCdSAdSTdSGdSAdS 5/ 1 O/5 GalNAc3-3 145
mCdsTdsTesmCesmCesTesTe
ISIS 666224 GalNAc3-5a-oaAdoGesmCesTesTesmCesAdsGdsTdS 5/ 1 O/5 GalNAc3-5 145
2014/036460
InCdslAdsTdsCIdsIAdsmCdsTdsTesmCesmCesTesTe
GalNAc3'6a'0’Ad0GesmCesTesTesmCesAdsGdsTds
ISIS 666961 5/10/5 GalNAc3-6 145
InCdslAdsTdsCIdsIAdsmCdsTdsTesmCesmCesTesTe
GalNAc3'7a'0’Ad0GesmCesTesTesmCesAdsGdsTds
ISIS 666981 5/10/5 GalNAc3-7 145
InCdslAdsTdsCIdsIAdsmCdsTdsTesmCesmCesTesTe
3-10a'0’AdoGesmCesTesTesmCesAdsGdsTds
ISIS 666881 5/10/5 GalNAc3-10 145
InCdslAdsTdsCIdsIAdsmCdsTdsTesmCesmCesTesTe
Capital letters indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine.
Subscripts: “e” tes a 2’-MOE modified nucleoside; “d” indicates a -deoxyribonucleoside; “s”
indicates a phosphorothioate intemucleoside e (PS); “0” indicates a phosphodiester intemucleoside
linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
The structure of GalNAc3-1a was shown usly in Example 9. The ure of GalNAc3-2a was
shown usly in Example 37. The structure of GalNAc3-3a was shown previously in Example 39. The
ure of GalNAc3-5a was shown previously in Example 49. The structure of GalNAc3-6a was shown
previously in Example 51. The structure of GalNAc3-7a was shown previously in Example 48. The structure
of GalNAc3-10a was shown previously in Example 46.
Treatment
Six week old male Balb/c mice (Jackson Laboratory, Bar Harbor, ME) were injected aneously
once at the dosage shown below with ISIS , 655861, 664507, 661161, 666224, 666961, 666981,
666881 or with saline. Each treatment group consisted of 4 animals. The mice were sacrificed 72 hours
following the final administration to determine the liver SRB-l mRNA levels using real-time PCR and
RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc. Eugene, OR) according to standard
protocols. The results below are presented as the e percent of SRB-l mRNA levels for each treatment
group, normalized to the saline control.
As illustrated in Table 43, treatment with antisense oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent manner. Indeed, the conjugated nse oligonucleotides showed substantial
improvement in potency compared to the unconjugated antisense oligonucleotide (ISIS 353382). The 5'
conjugated antisense oligonucleotides showed a slight increase in potency compared to the 3' conjugated
antisense oligonucleotide.
Table 43
Dosage SRB-l mRNA
ISIS N0. Conjugate.
(mg/kg) (% Saline)
Saline n/a 100.0
—-E_
353382 none
655861 GalNaC3-1 (3')
1.5 81.2
33.9
15.2
0.5 102.0
1.5 73.2
664507 —5 GalNac3-2 (5 ),
31-3
10.8
0.5 90.7
1.5 67.6
661161 —5 GalNac3-3 (5),
24.3
11.5
0.5 96.1
1.5 61.6
666224 GalNac3-5 (5),
25.6
11.7
0.5 85.5
1.5 56.3
666961
—534-2 GalNAc3-6 (5),
13.1
0.5 84.7
1.5 59.9
666981
—524.9 GalNAc3-7 (5),
8.5
0.5 100.0
1.5 65.8
666881 —5 GalNAc3-10 (5 ),
26.0
13.0
Liver transaminase levels, alanine aminotransferase (ALT) and ate aminotransferase (AST), in
serum were measured relative to saline injected mice using standard protocols. Total bin and BUN were
also evaluated. The change in body weights was evaluated with no significant change from the saline group.
ALTs, ASTs, total bilirubin and BUN values are shown in Table 44 below.
Table 44
Dosage Total
ISIS N0. ALT AST BUN Conjugate.
mg/kg Bilirubin
Saline 26 57 0-2 27
3 25 92 0.2 27
353382 10 23 40 0.2 25 none
29 54 0.1 28
0.5 25 71 0.2 34
1.5 28 60 0.2 26
655861 ,
—526 GalNac3-1 (3)
63 0‘2 28
25 61 0.2 28
0.5 25 62 0.2 25
1.5 24 49 0.2 26
664507 —5GalNac3-2 (5 ),
21 50 0.2 26
59 84 0.1 22
0.5 20 42 0.2 29
1.5 g 37 74 0.2 25
661161 GalNac3-3 (5),
g 28 61 0.2 29
21 41 0.2 25
0.5 34 48 0.2 21
1.5 23 46 0.2 26
666224 —5GalNac3-5 (5),
24 47 0.2 23
32 49 0.1 26
0.5 17 63 0.2 26
1.5 23 68 0.2 26
666961 —5GalNAc3-6 (5 ),
66 0.2 26
29 107 0.2 28
0.5 24 48 0.2 26
1.5 30 55 0.2 24
666981 —5GalNAc3-7 (5),
46 74 0.1 24
29 58 0.1 26
0.5 20 65 0.2 27
1.5 23 59 0.2 24
666881 GalNAc3-10 (5 ),
45 70 0‘2 26
21 57 0.2 24
Example 57: Duration of action study of oligonucleotides comprising a 3'-conjugate group targeting
ApoC III in vivo
Mice were injected once with the doses indicated below and monitored over the course of 42 days for
ApoC-III and plasma triglycerides (Plasma TG) . The study was med using 3 transgenic mice
that express human APOC-III in each group.
Table 45
Modified ASO targeting ApoC III
Sequence (5’ to 3’) SEIEJD
ISIS AesGesmCesTesTesmCdsTdsTdsGdsTds PS 13 5
304801 mC:dslAdstdsmChsTesTesTeslAesTe
64753 5 AdsGdSmCdSTesTesTesAesTeoAdos-GalNAc3-1 a
AesGeomCeoTeoTeomCdsTdsTdsGdsTdsmCdsmCds
64753 6 AdSGdSmCdSTeoTeoTesAesTeoAdoa-GalNAc3-1 a
Capital letters indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “(1” indicates a B-D-2’-deoxyribonucleoside; “s”
indicates a phosphorothioate internucleoside linkage (PS); “0” indicates a phosphodiester internucleoside
linkage (PO); and “0’” indicates O)(OH)-. ate groups are in bold.
The structure of 3-la was shown previously in Example 9.
Table 46
ApoC III mRNA (% Saline on Day 1) and Plasma TG Levels (% Saline on Day 1)
ASO Dose Target Day 3 Day 7 Day 14 Day 35 Day 42
Saline 0 mg/kg II 98 100 100 95 116
ISIS 304801 30 mg/kg ApoC-III 28 30 41 65 74
ISIS 647535 10 mg/kg ApoC-III 16 19 25 74 94
ISIS 647536 10 mg/kg ApoC-III 18 16 17 35 51
Saline 0 mg/kg Plasma TG 121 130 123 105 109
ISIS 304801 30 mg/kg Plasma TG 34 37 50 69 69
ISIS 647535 10 mg/kg Plasma TG 18 14 24 18 71
ISIS 647536 10 mg/kg Plasma TG 21 19 15 32 35
As can be seen in the table above the duration of action increased with addition of the 3'-conjugate
group compared to the unconjugated oligonucleotide. There was a further increase in the duration of action
for the conjugated mixed PO/PS oligonucleotide 647536 as compared to the conjugated full PS
oligonucleotide 647535.
Example 58: Dose-dependent study of oligonucleotides comprising a 3'-conjugate group (comparison of
GalNAc3-1 and 4-11) targeting SRB-l in vivo
The oligonucleotides listed below were tested in a dose-dependent study for antisense tion of
SRB-l in mice. Unconjugated ISIS 440762 was included as an unconjugated standard. Each of the
conjugate groups were attached at the 3' terminus of the respective oligonucleotide by a phosphodiester
linked 2'-deoxyadenosine nucleoside cleavable moiety.
The structure of GalNAc3-1a was shown previously in e 9. The structure of GalNAc3-11a was
shown previously in e 50.
Treatment
Six week old male Balb/c mice (Jackson Laboratory, Bar Harbor, ME) were injected subcutaneously
once at the dosage shown below with ISIS 440762, 651900, 663748 or with saline. Each treatment group
consisted of 4 animals. The mice were sacrificed 72 hours following the final administration to determine the
liver SRB-l mRNA levels using real-time PCR and EEN® RNA quantification t (Molecular
Probes, Inc. Eugene, OR) according to standard protocols. The results below are presented as the e
percent of SRB-l mRNA levels for each treatment group, normalized to the saline control.
As illustrated in Table 47, treatment with antisense oligonucleotides d SRB-l mRNA levels in
a dose-dependent manner. The antisense oligonucleotides comprising the phosphodiester linked GalNAc3-1
and GalNAc4-11 conjugates at the 3’ terminus (ISIS 651900 and ISIS 663748) showed substantial
improvement in potency compared to the unconjugated nse ucleotide (ISIS 440762). The two
conjugated oligonucleotides, GalNAc3-1 and GalNAc4-11, were equipotent.
Table 47
Modified ASO targeting SRB-l
9 9 % Saline SEQ ID
ASO Sequence (5 to 3 ) Dose mg/kg
control No.
Saline 100
0.6 73.45
m m
rsrs 440762 Egg ghfidfii‘g“ CdSAdSTdSGdSAdS 2 59.66 137
ds ds ks k
6 2350
0.2 62.75
TkskasAdsGdsTdSmCdSAdSTdSGdSAdS 0.6 29.14
ISIS 651900 13 8
mCdsTdSTkskaoAdol-GalNAC3-1a 2 8.61
6 5.62
0.2 63.99
TkskasAdsGdsTdsmCdsAdsTdsGdsAds 0-6 33-53
ISIS 663748 138
InCdSTdsTksmclmAdo.-GalNAc4-11a 2 7.58
6 5.52
Capital letters indicate the nucleobase for each side and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “k” indicates 6’-(S)-CH3 bicyclic nucleoside; “d”
indicates a B-D-2’-deoxyribonucleoside; “s” indicates a phosphorothioate internucleoside linkage (PS); “0”
indicates a phosphodiester internucleoside linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate
groups are in bold.
Liver transaminase levels, e aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were measured relative to saline injected mice using standard protocols. Total bilirubin and BUN were
also evaluated. The change in body weights was ted with no significant change from the saline group.
ALTs, ASTs, total bin and BUN values are shown in Table 48 below.
Table 48
Dosage Total
ISIS N0. ALT AST BUN Conjugate.
mg/kg Bilirubin
Saline 30 76 0-2 40
0.60 32 70 0.1 35
440762 2 26 57 0.1 35 none
6 31 48 0.1 39
0.2 32 115 0.2 39
0.6 33 61 0.1 35
651900 GalNac3-1 (3),
2 30 50 0‘1 37
6 34 52 0.1 36
0.2 28 56 0.2 36
663748 0.6 34 60 0.1 35 GalNac4-11 (3')
2 44 62 0.1 36
6 38 71 0.1 33
Example 59: Effects of 3-1 conjugated ASOs targeting FXI in vivo
The oligonucleotides listed below were tested in a multiple dose study for antisense inhibition of FXI
in mice. ISIS 404071 was included as an unconjugated standard. Each of the conjugate groups was attached
at the 3' terminus of the respective oligonucleotide by a phosphodiester linked 2'-de0xyaden0sine nucleoside
cleavable .
Table 49
Modified ASOs targeting FXI
SEQ ID
AS0 Sequence (5’ t0 3’) Linkages
404071 TdsTdsTdsmCdsAesGesAesGesGe
656172 TdSTdSTdSmCdSAesGesAesGesGeoAdo’-GalNAc3-1 a
ISIS TesCleocjeoTeolAeolAdsTdsmC:dsmC:dslAdsmChs
PO/PS
656173 TdsTdsTdsmcdsAeoGeersGesGeoAdos-Ga1NAc3-1a
Capital letters indicate the nucleobase for each side and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “(1” indicates a B-D-Z’-de0xyrib0nucleoside; “s”
indicates a phosphorothioate internucleoside linkage (PS); “0” indicates a phosphodiester ucleoside
linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
The structure of GalNA03-1a was shown previously in Example 9.
Treatment
Six week old male Balb/c mice (Jackson Laboratory, Bar Harbor, ME) were injected subcutaneously
twice a week for 3 weeks at the dosage shown below with ISIS 404071, 656172, 656173 or with PBS treated
control. Each treatment group consisted of 4 s. The mice were sacrificed 72 hours following the final
administration to determine the liver FXI mRNA levels using real-time PCR and RIBOGREEN® RNA
quantification reagent ular Probes, Inc. Eugene, OR) according to standard protocols. Plasma FXI
n levels were also ed using ELISA. FXI mRNA levels were ined relative to total RNA
(using RIBOGREEN®), prior to normalization to PBS-treated control. The results below are presented as the
average percent of FXI mRNA levels for each treatment group. The data was ized to PBS-treated
control and is denoted as “% PBS”. The EDsos were measured using similar methods as described previously
and are presented below.
Table 50
Factor XI mRNA (% Saline)
Dose
ASO % Control Conjugate Linkages
mg/kg
WO 79625
Saline 100 none
3 92
$148071 10 40 none PS
15
0.7 74
ISIS
2 33 GalNAc3-1 PS
656172
6 9
0.7 49
ISIS
656173 2 i2 GalNAc3-1 PO/PS
As illustrated in Table 50, treatment with nse oligonucleotides lowered FXI le\A levels in a
dose-dependent manner. The oligonucleotides comprising a 3'-GalNAc3-1 conjugate group showed
substantial improvement in y compared to the ugated antisense oligonucleotide (ISIS 404071).
Between the two conjugated oligonucleotides an improvement in potency was further provided by
substituting some of the PS linkages with P0 (ISIS 656173).
As illustrated in Table 50a, treatment with antisense oligonucleotides lowered FXI protein levels in a
ependent manner. The oligonucleotides comprising a 3'-GalNAc3-1 conjugate group showed
substantial improvement in potency compared to the unconjugated antisense oligonucleotide (ISIS 404071).
Between the two conjugated oligonucleotides an improvement in potency was r provided by
substituting some of the PS linkages with P0 (ISIS 656173).
Table 50a
Factor XI n (% Saline)
A80 1131;; 1232:3321) (%
Conjugate Linkages
Saline 100 none
$1.807. To PS
3
1s1s
GalNAc3-1 PS
656172 2 23
6 1
1s1s
GalNAc3-1 PO/PS
656173 2 6
6 0
Liver transaminase levels, alanine aminotransferase (ALT) and aspartate ransferase (AST), in
serum were measured relative to saline injected mice using standard ols. Total bilirubin, total albumin,
CRE and BUN were also evaluated. The change in body weights was evaluated with no significant change
from the saline group. ALTs, ASTs, total bilirubin and BUN values are shown in the table below.
Table 51
Dosage Total Total
ISIS No. ALT AST CRE BUN Conjugate.
m /k Albumin Bilirubin
Saline 71.8 84.0 3.1 0.2 0.2 22.9
3 152.8 176.0 3.1 0.3 0.2 23.0
404071 10 73.3 121.5 3.0 0.2 0.2 21.4 none
82.5 92.3 3.0 0.2 0.2 23.0
0.7 62.5 111.5 3.1 0.2 0.2 23.8
656172 2 33.0 51.8 2.9 0.2 0.2 22.0 GalNac3-1 (3')
6 65.0 71.5 3.2 0.2 0.2 23.9
0.7 54.8 90.5 3.0 0.2 0.2 24.9
656173 2 85.8 71.5 3.2 0.2 0.2 21.0 GalNac3-1 (3')
6 114.0 101.8 3.3 0.2 0.2 22.7
e 60: Effects of conjugated ASOs targeting SRB-l in vitro
The oligonucleotides listed below were tested in a multiple dose study for antisense inhibition of
SRB-l in primary mouse hepatocytes. ISIS 353382 was ed as an unconjugated standard. Each of the
conjugate groups were attached at the 3' 0r 5' terminus of the respective ucleotide by a odiester
linked 2'-de0xyaden0sine nucleoside cleavable moiety.
Table 52
Modified ASO targeting SRB-l
ASO Sequence (5’ to 3’) Motif Conjugate fggo.
ISIS 353382 S§:¥::$:Eg:gg:fif¥fdSmCdSAdsTdsGdsAds 5/10/5 none 143
ISIS 655861 SC;EECmECAgfingcag‘kigdlAd 5/10/5 GalNAc3-1 144
ISIS 655862 SC;Egcmgc‘ififidfidmcégghf‘i‘id 5/10/5 GalNAc3-1 144
ISIS 661161 gaileXdidadchmInchTZTTm?méd(T}dT 5/10/5 3-3 145
ISIS 665001 $32233::ajigmccdfii:;E::%:$:Te 5/10/5 GalNAc3-8 145
ISIS 664078 SC;EECmECAgfingcég‘kiggAd 5/10/5 GalNAc3-9 144
ISIS 666961 $33?!ngGfdAfmZSTETTmZCm‘édng 5/10/5 GalNAc3-6 145
ISIS 664507 Egflfiaédlgdmgflfgmgmgf‘fdgfld 5/10/5 GalNAc3-2 145
ISIS 666881 SaifiifidlcgwfigcfrjfiEchZCTA‘iGde 5/10/5 GalNAc3-10 145
ISIS 666224 Eé‘jififiédfigflffém2???“ 5/10/5 GalNAc3-5 145
ISIS 666981 Egjifidédsdmgdifgmg:23)??de 5/10/5 GalNAc3-7 145
Capital s indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “d” indicates a B-D-2’-deoxyribonucleoside; “s”
tes a phosphorothioate intemucleoside linkage (PS); “0” indicates a phosphodiester intemucleoside
linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
The structure of GalNAc3-la was shown usly in Example 9. The structure of GalNAc3-3a was
shown previously in Example 39. The structure of GalNAc3-8a was shown previously in e 47. The
ure of GalNAc3-9a was shown previously in e 52. The structure of GalNAc3-6a was shown
usly in Example 51. The structure of GalNAc3-2a was shown previously in Example 37. The structure
of GalNAc3-10a was shown usly in Example 46. The structure of GalNAc3-5a was shown previously
in Example 49. The ure of GalNAc3-7a was shown previously in Example 48.
Treatment
The oligonucleotides listed above were tested in vitro in primary mouse hepatocyte cells plated at a
density of 25,000 cells per well and treated with 0.03, 0.08, 0.24, 0.74, 2.22, 6.67 or 20 nM modified
oligonucleotide. After a treatment period of imately 16 hours, RNA was isolated from the cells and
mRNA levels were measured by quantitative real-time PCR and the SRB-l mRNA levels were adjusted
according to total RNA content, as ed by RIBOGREEN®.
The IC50 was calculated using standard methods and the results are presented in Table 53. The results
show that, under free uptake conditions in which no reagents or electroporation techniques are used to
artificially e entry of the oligonucleotides into cells, the oligonucleotides comprising a GalNAc
conjugate were significantly more potent in hepatocytes than the parent oligonucleotide (ISIS 353382) that
does not comprise a GalNAc conjugate.
Table 53
Internucleoside SEQ ID
ASO ICso (nM) Conjugate
linkages N0.
ISIS 353382 19021 PS none 143
ISIS 655861 11a PS GalNAc3-1 144
ISIS 655862 3 PO/PS GalNAc3-1 144
ISIS 661161 15a PS GalNAc3-3 145
ISIS 665001 20 PS GalNAc3-8 145
ISIS 664078 55 PS GalNAc3-9 144
ISIS 666961 22a PS GalNAc3-6 145
ISIS 664507 30 PS GalNAc3-2 145
ISIS 666881 30 PS GalNAc3-10 145
ISIS 666224 3021 PS GalNAc3-5 145
ISIS 666981 40 PS GalNAc3-7 145
21Average of multiple runs.
Example 61: Preparation of oligomeric compound 175 comprising GalNAc3-12
2014/036460
AcO B \ 00 ”MNHZ
O 0A0
pprJKAA/o 0 o A Oc
OAC 91a 0A0
—> \ /\/\ O
HN N N O
Ac H H OAc
166 HN
167 \AC
HOOC
/N N
A00 CBZ
0 ¥COOH
TFA 169 COOH
_. HZNMN —
H OAC
DCM HN\AC HBTU DIEA DMF
A00 OAc
©\/O\n/NH (LNW
O A O0
N\ O OAc
/\/\ W0 0
O N N OAc
o HN H H
HN AcO
o o
170 HN
A0 A00 OAc
M0O OAC
Pd(0H)2/C,H2 HN
o H ”MAC
MeOH/EtOAc
—> RLNJV
O AcO
H2N N 0
W0:[ OAc
A”MHWO0
HN AcO
o 0
171 ”N
2014/036460
benzyl (perfluorophenyl) glutarate
AcO OAc
MO0 OAc
HN HN\
o o N N
o HN H H
HN AcO
O 0
1 72
AcO OAc
JOK/VVO 0 OAc
HN HN\
Pd(OH)2/C,H2 “\J/\J Ac
172 ——————————>
H |/»/
OAC O A“)
HOWT/\v/\WVN N o OAc
O 0 WI ANMNWOQQOA‘
o HN H H
HN AcO
o 0
173 HN\
AcO OAc
PFPIFA
—> o o
DEA DMF )LV/~\/“\/O OAc
“N HN
o H ‘Ac
O A oc
174 HN\
3' 5' ||
OLIGO O-(CH2)e—NH2
1. Borate
174 buffer, DMSO, pH 8.5, rt
2. aq. ammonia, rt
HO O
ACHN M
O O
NHAC
nd 169 is commercially available. Compound 172 was prepared by addition of benzyl
(perfluorophenyl) glutarate to compound 171. The benzyl (perfluorophenyl) ate was prepared by adding
PFP-TFA and DIEA to 5-(benzyloxy)oxopentanoic acid in DMF. Oligomeric compound 175, comprising
a GalNAc3-12 conjugate group, was prepared from compound 174 using the general procedures illustrated in
Example 46. The GalNAc3 cluster portion of the conjugate group GalNAc3-12 (GalNAc3-12a) can be
combined with any cleavable moiety to provide a variety of conjugate groups. In a certain embodiments, the
ble moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNAc3-12 (GalNAc3-12a-CM-) is shown
below:
WO 79625
OH OH
HofiowvokACHN
Ol'bH in
HO%O O
O j:O/\/\ o
H H H ‘H/ a
H 5
Fr 0
OH JJJ’NH
HO o 0
H056
NHAC
Example 62: Preparation of oligomeric compound 180 comprising GalNAc3-13
2014/036460
OOAc
AcHN OMOH 0M0 HATU, HOAt
DIEA, DMF
0A0 0A0
A00 0M
AcHN
OOAc H2, Pd/C
AcO OWN —>
AcHN (DH/MO
0A0 0A0
O 177
A00 OW
AcHN 0
0A0 0A0
A00 o\/\/\/U\
AcHN
“0&0OAco\/\/\/ICJ:N PFPTFA TEA
AcHN OH/VWOH
OAC OAC 178
ACHN O
0A0 0A0
A00 0M
AcHN NH
OAC OAC
ACOfiOWOk O F
Ojku/m/EI/ D?FH O F
AcHN H
0A0 0A0
ACHN O
3' 5' ||
-O-F|’—O-<CH2>6‘NH2
1. Borate , DMSO, pH 8.5, rt
2. aq. ammonia, rt
OH OH
Hofi/OMOO
AcHN NH
OH OH
E45: 0 O
AcHN N HM W0 OLIGO
o o
ACHN
Compound 176 was prepared using the general procedure shown in Example 2. Oligomeric compound 180,
comprising a GalNAc3-l3 conjugate group, was prepared from compound 177 using the general procedures
illustrated in Example 49. The GalNAc3 cluster portion of the conjugate group GalNAc3-l3 c3-l3a)
can be combined with any cleavable moiety to provide a variety of conjugate groups. In a
certainembodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNAc3-13
(GalNAc3-13a-CM-) is shown below:
OHOH
HOW \/\/\)OJ\0 NH
AcHN
OHOH
HO 0 O H O H o
O\/\/\)LN N NWN‘6; a
AcHN H O H O
OH “NH
o o
Example 63: Preparation of oligomeric compound 188 sing GalNAc3-14
1816 N N
NHCB O
HOW/V0%NHCBZ Ho(/\);5 3’ Z
4 7/
HBTU DIEA
Op DMF
HO (3);)
HO VZH
13 182
OAc OAc
A00 A00
ONGNWO Acofl/ONGWHN AcO
OAc NHAC AOOAC NHAC O 0
A00 CNN C
NHCBZ Pd/C, H2
AcO \fl/VO A00 OWle/VO\%NH26
o o
NHAC :N’<—/O NchAC
AGO W
OAc OWN AGO 0H6 0 A00 6H
AcO NHAC
Op “3%?m“AcO ON
1. Pd/C, H2
HO\n/\/\n/
OAC NHAC 03%NZ’LO—>
2 PFP.TFA
AcO IDYr,
—> ACO
HBTU, NHACAAC
DIEA, AcO
DMF 0
A00 GHW
NHAC
ACOAcofl/ONGH
\H/\\O F
A:O&/Of\%/
2:9ng F
NHAc
NHAC
83e HO
3' 5' II
OLIGO O-F|’-O-(CH2)6-NH2 %oNHN
HOHSH 6 EDI/\b m
NHAc H
CH O N O
1. Borate buffer, DMSO, pH 8.5, rt HO\é 0% TI/VN H H“ OLIGO
—, NHAc O o 0
2. aq. ammonia, rt HO H
o N
HO 6'" 188
NHAc
Compounds 181 and 185 are commercially available. Oligomeric compound 188, comprising a 3-14
conjugate group, was prepared from compound 187 using the general procedures illustrated in Example 46.
The GalNAc3 cluster portion of the conjugate group GalNAc3-14 c3-14a) can be combined with any
cleavable moiety to provide a variety of conjugate groups. In certain embodiments, the cleavable moiety
is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of 3-14 (GalNAc3-14a-CM-) is shown below:
HOOH O
O o N
AcHN o
HOOH O O O
H0%O O
NJK/‘O JJ\/\/u\ é
H M ”W0 <
AcHN o
HoOH
O t
o N O
H0 10 H
AcHN
Example 64: Preparation of oligomeric nd 197 comprising GalNAc3-15
AcO 0A0 OTBS OTBS
“0%” K] A00 OAC O
A HNC N
H ”gem”
HBTU, DIEA ACHN
7 N NH3/MeOH
8220, DMAP
HO OH
HO O
ACHN
OTBS
ACHN
AcHN
Phosphitylation B::OOB%/o Q?
AcHN
DMTO /
O O—P
\/\/O
DMTO 5'
DMTO 3.
/\/\O
DMTO
88, DNA sizer 196
1. 194, DNA synthesizer AcHN
—> O /O
N \P/
2. Aq NH355 O0, 18h
o |\OH
O O
// \/\/O
HO OH O\
O U . W HO aw“
/ OH
/\/\O
NHAC O
OH 0
Compound 189 is commercially available. Compound 195 was prepared using the general procedure shown
in Example 31. Oligomeric compound 197, comprising a GalNAc3-15 conjugate group, was prepared from
compounds 194 and 195 using standard oligonucleotide synthesis procedures. The GalNAc3 r portion
of the conjugate group GalNAc3-15 (GalNAc3-15a) can be combined with any cleavable moiety to e a
variety of conjugate groups. In certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.
The structure of GalNAc3-15 (GalNAc3-15a-CM-) is shown below:
HOOH
kWU0,15:“PkAcHN
O’P‘OIQMO/aVO-\m—E
NHAC
Example 65: Dose-dependent study of oligonucleotides comprising a 5’-conjugate group (comparison of
GalNAc3-3, 12, 13, 14, and 15) targeting SRB-l in vivo
The oligonucleotides listed below were tested in a dose-dependent study for antisense inhibition of
SRB-l in mice. Unconjugated ISIS 353382 was included as a standard. Each of the GalNA03 conjugate
groups was attached at the 5' terminus of the respective oligonucleotide by a phosphodiester linked 2'-
denosine nucleoside (cleavable moiety).
Table 54
Modified ASOs targeting SRB-l
ISIS Sequences (5’ to 3’) Conjugate SEQ
N0. ID
—N°-
3 5 3 3 82 GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAdsmIEdsTdsTesmCesmCesTesTe none 143
661161 GalNAc30aAd0GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAdsmCdSTdS Gal\ACa-3 145
Te:nCe:nCesTesTe
671144 GalNAc3-12a-OaAd0GesmCesTeSTesmCesAdsGulsTdSmC,1,AdsT,1,GulsAdsmCdsTdS Gamma-12 145
smCCSTCST
670061 GalNAc30aAd0GesmCesTesTesmCesAdsGdsTdSmCdsAdsTdsGdsAdsmCdSTdS Gal\ACa-13 145
TesmcesmCCSTCST
671261 GalNAc3-14a-OaAd0GesmCesTeSTesmCesAdsGulsTdSmC,1,AdsT,1,GulsAdsmCdsTdS Gal\ACa-14 145
Te:nCe:nCesTesTe
671262 GalNAc3-15a-oaAdoGesmCCSTesTesmCesAdsGdsTdSmCdsAdsTdsGdsAdsmCdsTds Gal\ACa-15 145
Tes Ces Te
Capital letters indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine. Subscripts:
‘6 633 indicates a 2’-MOE d nucleoside; “(1” indicates a B-D-2’-deoxyribonucleoside; 66 S33'1ndicates
phosphorothioate ucleoside linkage (PS); 66 033'1ndicates a phosphodiester ucleoside e (PO);
and “0 indicates -O-P(=O)(OH)-. Conjugate groups are in bold-
The structure of GalNAc3-3a was shown previously in Example 39. The structure of GalNAc3-12a
was shown previously in Example 61. The structure of GalNAc3-13a was shown previously in Example 62.
The structure of GalNAc3-14a was shown previously in Example 63. The structure of GalNAc3-15a was
shown previously in Example 64.
Treatment
Six to eight week old C57bl6 mice (Jackson Laboratory, Bar , ME) were injected
subcutaneously once or twice at the dosage shown below with ISIS 353382, 661161, 671144, ,
671261, 671262, or with saline. Mice that were dosed twice received the second dose three days after the
first dose. Each ent group consisted of 4 animals. The mice were sacrificed 72 hours following the
final administration to determine the liver SRB-l mRNA levels using real-time PCR and RIBOGREEN®
RNA fication reagent (Molecular Probes, Inc. Eugene, OR) ing to standard protocols. The
results below are presented as the average percent of SRB-l mRNA levels for each treatment group,
normalized to the saline control.
As rated in Table 55, treatment with antisense oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent manner. No significant differences in target knockdown were observed between s
that ed a single dose and animals that received two doses (see ISIS 353382 s 30 and 2 x 15
mg/kg; and ISIS 661161 dosages 5 and 2 x 2.5 . The antisense oligonucleotides comprising the
phosphodiester linked GalNAc3-3, 12, 13, 14, and 15 conjugates showed substantial improvement in potency
compared to the unconjugated antisense oligonucleotide (ISIS 335382).
Table 55
SRB-l mRNA (% Saline)
ISIS No. Dosage (mg/kg) SRB-l mRNA (% ED50 (mg/kg) Conjugate
Saline)
Saline n/a 100.0 n/a n/a
3 85.0
69.2
353382 22.4
—3034-2 none
2 x 15 36.0
0.5 87.4
1.5 59.0
661161 5 25.6 2.2 GalNAc3-3
2 x 2.5 27.5
17.4
0.5 101.2
671144 —;'533(1) 3.4 GalNAc3-12
17.6
0.5 94.8
670061 1.5 57.8 2.1 GalNAc3-13
20.7
13.3
0.5 110.7
1.5 81.9
671261 4.1 GalNAcg-l4
39.8
14.1
671262 GalNAc3- 1 5
Liver transaminase levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were measured relative to saline injected mice using standard protocols. Total bilirubin and BUN were
also evaluated. The changes in body weights were ted with no significant differences from the saline
group (data not shown). ALTs, ASTs, total bilirubin and BU\I values are shown in Table 56 below.
Table 56
Total
Dosage ALT . . . BUN
ISIS No. AST (U/L) B111rub1n Conjugate.
(mg/kg) (U/L) )
(mg/(1L)
Saline n/a 28 60 0.1 39 n/a
3 30 77 0.2 36
25 78 0.2 36
353382 “one
28 62 0.2 35
2 x 15 22 59 0.2 33
0.5 39 72 0.2 34
1.5 26 50 0.2 33
661161 5 41 80 0.2 32 GalNAc3-3
2 x 2.5 24 72 0.2 28
32 69 0.2 36
0.5 25 39 0.2 34
1.5 26 55 0.2 28
671144 GalNAc3-12
48 82 0.2 34
23 46 0.2 32
0.5 27 53 0.2 33
1.5 24 45 0.2 35
670061 3-13
23 58 0.1 34
24 72 0.1 31
0.5 69 99 0.1 33
1.5 34 62 0.1 33
671261 GalNAc3-14
43 73 0.1 32
32 53 0.2 30
0.5 24 51 0.2 29
1.5 32 62 0.1 31
671262 GalNAc3-15
30 76 0'2 32
31 64 0.1 32
Example 66: Effect of various cleavable moieties on antisense inhibition in vivo by oligonucleotides
targeting SRB-l comprising a NAc3 cluster
WO 79625
The oligonucleotides listed below were tested in a dose-dependent study for antisense inhibition of
SRB-l in mice. Each of the GalNAc3 conjugate groups was attached at the 5' terminus of the respective
oligonucleotide by a phosphodiester linked nucleoside (cleavable moiety (CM)).
Table 57
Modified ASOs ing SRB-l
Mew—(WW
No. Cluster ID No.
661161 GalNAc3-3a-0:AdoGeSmCCSTCSTCSmCCSAdSGdSTdSmCdSAdSTu1S Gal\ACa-3a Ad 145
GCSACSmccsrcsresmcesmcesresre
670699 GalNAc303TdoGeSmCeOTCOTCOmCeoAdSGdSTdSmCdSAdSTdS Gal\ACa-3a Ta 148
GCSACSmccsrcsreomceomcesresre
670700 GalNAc30:AeoGeSmCCOTeoTeomCeoAdSGdSTdSmCdSAdSTdS Gal\ACa-3a Ac 145
GCSACSmccsrcsreomceomcesresre
670701 GalNAc30aTeoGesmCeOTCOTeomCeoAdSGdSTdsmCdsAdSTds a-3a Te 148
GCSACSmccsrcsreomceomcesresre
671165 GalNAc30sAdOGesmCeoTeoTeomCeoAdsGdsTdsmCdSAdSTdS Gal\AC3-13a Ad 145
GCSACSmccsrcsreomceomcesresre
Capital s indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine. Subscripts:
“e” indicates a 2’-MOE modified nucleoside; “d” indicates a B-D-Z’-deoxyribonucleoside; “s” tes a
phosphorothioate intemucleoside linkage (PS); “0” indicates a phosphodiester intemucleoside linkage (PO);
and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
The structure of GalNAc3-3a was shown usly in Example 39. The structure of GalNAc3-13a
was shown previously in Example 62.
Treatment
Six to eight week old C57bl6 mice (Jackson Laboratory, Bar , ME) were injected
aneously once at the dosage shown below with ISIS 661161, 670699, 670700, 670701, 671165, or with
saline. Each treatment group consisted of 4 animals. The mice were sacrificed 72 hours following the final
administration to determine the liver SRB-l mRNA levels using real-time PCR and RIBOGREEN® RNA
quantification reagent (Molecular Probes, Inc. Eugene, OR) according to standard protocols. The s
below are presented as the average percent of SRB-l mRNA levels for each treatment group, normalized to
the saline control.
As illustrated in Table 5 8, treatment with antisense oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent . The antisense oligonucleotides comprising various cleavable moieties all showed
r potencies.
Table 58
SRB-l n1RNA(% Saline)
ISIS No. Dosage (mg/kg) SRB-l mRNA GalNAc3 CM
(% Saline) Cluster
Saline n/a 100.0 n/a n/a
0.5 87.8
1.5 61.3
661161 GalNAc3-3a Ad
33.8
14.0
0.5 89.4
1.5 59.4
670699 GalNAc3-3a Td
313
17.1
0.5 79.0
1.5 63.3
670700 GalNAc3-3a AC
32.8
17.9
0.5 79.1
1.5 59.2
670701 3-3a Te
35.8
17.7
0.5 76.4
1.5 43.2
671165 GalNAc3-13a Ad
22.6
10.0
Liver transaminase levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were measured relative to saline ed mice using standard protocols. Total bilirubin and BUN were
also evaluated. The s in body weights were evaluated with no significant differences from the saline
group (data not shown). ALTs, ASTs, total bilirubin and BUN values are shown in Table 56 below.
Table 59
Dosage ALT AST BUN GalNAc3
ISIS No ' B{gain
(mg/kg) (U/L) (U/L) ) Cluster
(mg/(1L)
Saline n/a 24 64 0.2 31 n/a n/a
0.5 25 64 0.2 31
1.5 24 50 0.2 32
27 52 0.2 31
0.5 42 83 0.2 31
1.5 33 58 0.2 32
670699 GalNAc3-3a Td
26 70 0.2 29
25 67 0.2 29
0.5 40 74 0.2 27
1.5 23 62 0.2 27
670700 —5GalNAc3-3a AC
24 49 0‘2 29
25 87 0.1 25
0.5 30 77 0.2 27
670701 —15 GalNAc3-3a Te
22 55 0.2 30
WO 79625
81 101 0.2 25
3 1 82 O 2. 24 -
671165 GalNAC _13a3 Ad
e 67: Preparation of oligomeric compound 199 comprising GalNAc3-16
0::ASFTK:WNN/NAN
OOAC /\M/2\NH /ODMTr
Aco OWN
AcHN
o AcOOCfi/OOWNWW0 OH4<:;>)LN{O1. Succinic anhydride,DMAP DCE 0A0 2. DMF, HBTU, DIEA,
PS-SS
AcHN
AcOOAc
O H H
AGO OMNMVN o 2 2
AHN o
C OD'V'T
AcOOAc
o H "-
H '
o N N
1.DNA Synthesizer
AcO WW NM N —>
H 8 Z 2.aq.NH3
AcHN o O
AcOOAc
H o
0 OMWN
A0o 2
AcHN 198
HOOH
O H H
HO OMNMVN O
HOOH AcHN O m
o /O
o —.
o H H
0 N N
Ho WW N
H 8 Q
AcHN o O
HOOH
H o
0 OMWN
Ho 2
AcHN
eric compound 199, comprising a GalNA03-l6 conjugate group, is prepared using the general
procedures illustrated in Examples 7 and 9. The GalNA03 cluster portion of the conjugate group GalNA03-l6
03-l6a) can be combined with any cleavable moiety to provide a variety of conjugate . In
certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-.The structure of GalNA03-l6
(GalNA03-l6a-CM-) is shown below:
OHOH O o
HogomOWN/fl“/\H/\N4 H 2 H /-—E
HAcHN H o o ’0
O N
“WNW
OAcHN 4 H 2 o NWNQ
HO%HoOH o
o/\(\/))LN O
4 H/WM
AcHN
Example 68: Preparation of oligomeric nd 200 comprising GalNAc3-17
A00 OOAC O
3' 5' (Ijl
AcHN o N/\/\N o F OLIGO
H O-F|>-O-(CH2)6-NH2
OAC F
OAc o H O O F OH
0 OWNMNH 1.Borate buffer, DMSO, pH 8.5,rt
A00 NMO F
A HN H H —>
0A0 F
0A0 O 2. aq. ammonia, rt
0 N
A00 0 WHN o
AcHN W
102a
HoOH O o
o N
HO /\(V)JL /\/\3 H H
AcHN o 0
HoOH o o
O NWNWO OLIGO
o N/\/\N H H
HO 3 H H
AcHN
HoOH o
HOWO o/\(V)JL /\/\N 0
3 H H
AcHN
Oligomeric compound 200, comprising a GalNA03-l7 conjugate group, was prepared using the l
procedures illustrated in Example 46. The GalNA03 cluster portion of the conjugate group GalNA03-l7
03-l7a) can be combined with any cleavable moiety to e a variety of conjugate groups. In
certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNA03-l7
(GalNA03-l7a-CM-) is shown below:
WO 79625
HoOH o o
o N/\/\N
3 H H
ACHN H
HO 0 N m
N/\// N N”$¢A\ 3
o H H O_III__
3 H o
AcHN
HoOH o
O N/\/\N O
3 H H
AcHN
ACO GAO O
0 83e
AcHN o’Aij§\/kN’\\/\N O F 3 5' 3
GAO oOAC o F F OLKBO o—Twowcsz—NHZ
H o
AcHN Oo/$¢\VE~N/\/“NH N/J\/\/Kb F
1. Borate buffer, DMSO, pH 8.5, rt
OAC OOAC 0
2. aq. ammonia, rt
A00 0 H\/\/HN O
AcHN MN
102b
O N/\/\
4 H H
AcHN O O
HOOH O O
Home JJ\/\/u\
NMN H ”W0 OLIGo
4 H H
AcHN
O N/\/\ O
4 H H
AcHN
Oligomeric compound 201, comprising a 3-l8 conjugate group, was prepared using the general
procedures illustrated in Example 46. The GalNAc3 cluster portion of the conjugate group GalNAc3-l8
(GalNAc3-18a) can be combined with any cleavable moiety to provide a variety of conjugate groups. In
n embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNAc3-l8
(GalNAc3-18a-CM-) is shown below:
HoOH o o
m::$\\/O )LN/\/\N N
4 HH H
Oo/liiNV N N
H I-1/\iv)‘7\‘3—III—_E
ACHN
HOoOH
AcHN
e 70: ation of oligomeric compound 204 comprising GalNAc3-19
AcO OAc AcOOAc
O O
0 ON 0 0M
HBTU DMF DIEA
AcO '—>A00
OH N .....OH
AcHN DMTO AcHN
64 NH 202
DMTO
' 47
AcOOAc
PhosphityIation \/\)J\ , N NC 1. DNA synthesizer
A HN .....0\ C O —’
p/ \J
l 2. aq. NH3
DMTO (iPr)2N
HOOH
How 0
AcHN OOZT—OH|
HOOH
HowAWN?0
AcHN |
OZT—OH
HOOH
HowAMEN/Q0 .cm -OL|GO
AcHN
Oligomeric compound 204, comprising a GalNA03-l9 conjugate group, was prepared from compound 64
using the general ures illustrated in Example 52. The GalNA03 cluster portion of the conjugate group
GalNA03-l9 (GalNA03-l9a) can be combined with any cleavable moiety to provide a variety of conjugate
groups. In certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of
GalNA03-l9 (GalNA03-l9a-CM-) is shown below:
2014/036460
AcHN 9
OZT—OH
HoOH
HO o/*%§:§N
AcHN 9
O=T—OH
HoOH
o N
HO 0%
Example 71: Preparation of oligomeric nd 210 comprising GalNAc3-20
F F H
EtN(iPr)2, CH3CN N
FfiNNM: F? MN ""'OH
DMTO 0
206 DMTO
AcOOAc
0 A00 E: \/\/\)J\
K2co3/Methanol HZNMN AcHN 166
””OH
DMTO
ACOOAC
O Phosphitylation
O OM 3 N ""'OH —>
AcO NH
AcHN
DMTO
1. DNA syntheSIzer. AcO OAC
0 0M 3 N ""‘O NO —’
AcO NH \P/OV 2. aq. NH3
AcHN l
DMTO (iPr)2N
OH .
Ho HVHjL o N
HO 3
o o
AcHN |
CIT—OH
OH 0 ~‘
o “MN
HO 3
o o
AcHN |
O=F|>—0H
OH 0
Compound 205 was prepared by adding PFP-TFA and DIEA to 6-(2,2,2-trifluoroacetamido)hexanoic acid in
acetonitrile ,which was ed by adding triflic anhydride to 6-aminohexanoic acid. The reaction e
was heated to 80 0C, then lowered to rt. Oligomeric compound 210, comprising a GalNAc3-20 conjugate
group, was prepared from compound 208 using the general procedures rated in Example 52. The
GalNAc3 cluster portion of the conjugate group GalNAc3-20 (GalNAc3-20a) can be combined with any
cleavable moiety to provide a variety of conjugate . In certain embodiments, the cleavable moiety
is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNAc3-20 (GalNAc3-20a-CM-) is shown below:
OH _.
HO o
Hog/OWHO NMN
AcHN (I)
o:F|>—OH
0 50
HO ‘
HO OW 3
AcHN (I)
O=F|>—OH
0 50
e 72: Preparation of oligomeric compound 215 comprising GalNAc3-21
1 AcOOAc
O OH
N H O
R Acog/OM AcOOAcO
AcHN 176 OWJKNH
BOP, EtN(iPr)2, 1 2,-dichloroethane ACHN \\\OH
ODMT
AcOOAc
DMTCI, Pyridine, rt 0 OWJ\Nr/
Phosphitylation
—>A00 —>
AcHN 10”
r/ P\ 1. DNA synthesizer
ACOOAC
ACO¥/0 o N(IPr)2 —>
0 M 2. aq . NH3
AcHN \\\
ODMT
AcHN |
o:F|>—0H
0 N
Ho 0W L
AcHN Cl)
O—T—OH
0 N
HO 0W LO
AcHN OLIGO
Compound 21] is commercially available. Oligomeric compound 215, comprising a GalNAc3-2l conjugate
group, was prepared from compound 213 using the general procedures illustrated in Example 52. The
GalNAc3 cluster portion of the conjugate group GalNAc3-2l (GalNAc3-2la) can be combined with any
cleavable moiety to provide a variety of ate . In n embodiments, the cleavable moiety
is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNAc3-21 (GalNAc3-2la-CM-) is shown below:
HO H
O N
AcHN ('3
OZT—OH
HO H
O N
Ho ow L
AcHN (I)
O=F|’—OH
“kO N
Ho WL
o I E
Example 73: Preparation of oligomeric compound 221 sing GalNAc3-22
O O
H H\ /\/OH H
o F F R 211 o
OH R
205 F F 216 OH
DIEA ACN
O K2003
DMT'C' —FacTNMNNODMTr —»
R MEOH / H20
pyridine O
217 OH
HZNM /\/ODMTr 0A0 F
N o F
3 O 0W
218 NHAc F F
OH 166
OAc H
A00goe/O/VVYNWLN/\/ODMTr
Phosphitylation
A00 0 —>
NHAc
OAc H
O O/W\n/NMN/VODMTI‘
A00 0
NHAc
NC ,P\ .
220 \/\0 NW»
OH H
OHQ‘MWWNMWc
HO 0
NHAc
1. DNA Synthesizer
OH “\NJK I ,O
OH O’P\OH
2. Aq. NH3 N/\/
HOgoe/OWW0
NHAc %
goe/OWWHWJ
OH O/P<OH
HO O
NHAc %
221 m
Compound 220 was prepared from nd 219 using diisopropylammonium tetrazolide. Oligomeric
compound 221, comprising a GalNAc3-2l conjugate group, is prepared from compound 220 using the general
procedure illustrated in Example 52. The GalNAc3 cluster portion of the conjugate group GalNAc3-22
(GalNAc3-22a) can be combined with any cleavable moiety to provide a variety of conjugate groups. In
certain embodiments, the cleavable moiety is -P(=O)(OH)-Ad-P(=O)(OH)-. The structure of GalNAc3-22
c3-22a-CM-) is shown below:
NMH OH990W NWOH
HO o
NHAc
OH “Mi |,’o
OHEzgjic/O/N\/”\V/\Tr O’P\OH
N/\\/
HO O
NHAc Lj
Mi OIP<OH
N/\/
HO 0
NHAc Lj
O E
Example 74: Effect of various cleavable es on antisense inhibition in vivo by ucleotides
targeting SRB-l comprising a 5’-GalNAc3 conjugate
The oligonucleotides listed below were tested in a ependent study for antisense inhibition of
SRB-l in mice. Each of the GalNAc3 conjugate groups was attached at the 5' terminus of the respective
oligonucleotide.
Table 60
Modified ASOs targeting SRB-l
ISIS
Sequences (5 ,
GalNAc3 SEQ
to 3 , ) CM
No. Cluster ID No.
CAGTmCA TGAmCTT
353382 es es es es es dsIn ds rriis ds ds ds ds ds ds ds es n/a n/a 143
Ces CesTesTe
GalNAcaA GmC T TmCA G T mc AT3 30
661161 domes es esmes Ines ds ds ds ds ds ds GalNA03—3a Ad 145
GdsAds CdsTdsTes Ces CesTesTe
GalNAc3G mc T T me A G T me A T3 a”
666904 3: es es 3: 2: ds ds ds ds ds ds 3-3a PO 143
GdsAds CdsTdsTes Ces Te
GalNAcsA G mc T T mc A G T mc A T3 30
67544] din es es eIsn esIn es ds ds ds ds ds ds GalNA03—l7a Ad 145
GdsAds CdsTdsTes Ces CesTesTe
GalNAc3A G mc T T mc A G T mc A T3 30
675442 din es es eIsn esIn es ds ds ds ds ds ds GalNA03—l8a Ad 145
GdsAds CdsTdsTes Ces CesTesTe
In all , capital letters indicate the nucleobase for each nucleoside and InC indicates a 5-methyl cytosine.
Subscripts: “e” indicates a 2’-MOE modified nucleoside; “(1” indicates a B-D-Z’-deoxyribonucleoside; “s”
indicates a phosphorothioate cleoside linkage (PS); “0” indicates a phosphodiester intemucleoside
linkage (PO); and “0’” indicates -O-P(=O)(OH)-. Conjugate groups are in bold.
The structure of GalNAc3-3a was shown previously in Example 39. The structure of GalNAc3-l7a
was shown previously in Example 68, and the ure of GalNAc3-l 8a was shown in Example 69.
Treatment
Six to eight week old C57BL/6 mice on Laboratory, Bar Harbor, ME) were injected
subcutaneously once at the dosage shown below with an oligonucleotide listed in Table 60 or with saline.
Each treatment group consisted of 4 animals. The mice were sacrificed 72 hours following the final
stration to determine the SRB-l mRNA levels using real-time PCR and RIBOGREEN® RNA
quantification reagent (Molecular Probes, Inc. Eugene, OR) according to standard protocols. The results
below are presented as the average percent of SRB-l mRNA levels for each ent group, normalized to
the saline control.
As illustrated in Table 61, treatment with antisense oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent manner. The antisense oligonucleotides comprising a GalNAc conjugate showed similar
ies and were significantly more potent than the parent oligonucleotide lacking a GalNAc conjugate.
Table 61
SRB-l mRNA (% Saline)
ISIS No. Dosage (mg/kg) SRB-l mRNA GalNAc3 CM
(% Saline) Cluster
100-0
3 79.38
353382 10 68.67 n/a n/a
40.70
0.5 79.18
1.5 75.96
661161 —5 GalNAc3-3a Ad
.53
12.52
0.5 91.30
1.5 57.88
666904 —5 GalNAc3-3a P0
21.22
16.49
0.5 76.71
1.5 63.63
675441 GalNAc3-17a Ad
29.57
13.49
0.5 95.03
1.5 60.06
675442
—531.04 GalNAc3-18a Ad
19.40
Liver transarninase levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were measured relative to saline injected mice using standard protocols. Total bilirubin and BUN were
also ted. The change in body weights was evaluated with no significant change from the saline group
(data not shown). ALTs, ASTs, total bin and BUN values are shown in Table 62 below.
Table62
Dosage ALT AST 311133151111 BUN GalNAc3
ISIS N0 '
(mg/kg) (U/L) (U/L) ) Cluster
(mg/dL)
Saline n/a 26 59 0.16 42 n/a n/a
3 23 58 0.18 39
353382 10 28 58 0.16 43 n/a n/a
20 48 0.12 34
0.5 30 47 0.13 35
1.5 23 53 0.14 37
661161 —5GalNAc3-3a Ad
26 48 0.15 39
32 57 0.15 42
0.5 24 73 0.13 36
1.5 21 48 0.12 32
666904 —5GalNAc3-3a P0
19 49 0.14 33
20 52 0.15 26
0.5 42 148 0.21 36
1.5 60 95 0.16 34
675441 —5GalNAc3-17a Ad
27 75 0.14 37
24 61 0.14 36
0.5 26 65 0.15 37
1.5 25 64 0.15 43
675442 —5GalNAc3-18a Ad
27 69 0.15 37
30 84 0.14 37
Example 75: Pharmacokinetic analysis of oligonucleotides comprising a 5’-conjugate group
The PK of the ASOs in Tables 54, 57 and 60 above was evaluated using liver samples that were
obtained following the ent procedures described in Examples 65, 66, and 74. The liver samples were
minced and extracted using standard ols and analyzed by IP-HPLC-MS ide an internal standard.
The combined tissue level (ug/g) of all metabolites was measured by integrating the appropriate UV peaks,
and the tissue level of the full-length ASO missing the conjugate (“parent,” which is Isis No. 353382 in this
case) was ed using the appropriate extracted ion tograms (EIC).
Table 63
PK Analysis in Liver
ISIS N0. Dosage Total Tissue Level Parent ASO Tissue GalNA03 CM
(mg/kg) by UV (Hg/g) Level by EIC (ug/g) Cluster
353382 3 8.9 8.6
22.4 21.0 n/a n/a
54.2 44.2
661161 5 32.4 20.7
Gal\AC3-3a Ad
632 441
671144 5 20.5 19.2
Gal\A03-12a Ad
486 41.5
670061 5 31.6 28.0
Gal\AC3-l3a Ad
67.6 555
Gal\A03-l4a Ad
64.7 49.1
Gal\AC3-15a Ad
52.3 24.2
670699 5 16.4 10.4
Gal\Acg-3a T01
31.5 225
Gal\Acg-3a Ae
38.1 200
670701 5 21.8 8.8
Gal\AC3-3a Te
352 161
671165 5 27.1 26.5
Gal\ACg-13a Ad
48.3 44.3
666904 5 30.8 24.0
Gal\Ac3-3a PO
52.6 37.6
675441 5 25.4 19.0
Gal\A03-17a Ad
542 42-1
675442 5 22.2 20.7
Gal\AC3-183 Ad
39.6 290
The results in Table 63 above show that there were greater liver tissue levels of the oligonucleotides
comprising a GalNA03 conjugate group than of the parent ucleotide that does not comprise a 3
conjugate group (ISIS 353382) 72 hours following oligonucleotide administration, particularly when taking
into consideration the differences in dosing between the ucleotides with and without a GalNA03
conjugate group. Furthermore, by 72 hours, 40-98% of each oligonucleotide comprising a GalNA03 conjugate
group was metabolized to the parent compound, indicating that the GalNAc3 conjugate groups were cleaved
from the oligonucleotides.
Example 76: Preparation of eric compound 230 comprising GalNAc3-23
ToSCI NaN3
HO/\/O\/\O/\/OH —> HO/\/ /OTSO
222 223
4 TMSOTf
HO/\/ \/\O/\/O N OAC
O O/\/O\/\O/\/N3
NHAC
Pd(OH)2 OAcOAC ACN
—’ o NH —,
O 2
H2, EtOAc,MeOH o/\/ \/\o/\/
F F
NHAC
F F
F O
C—No2
OAC H
OAc N 0
OAc NHAc H N02 1) Reduce
O\/\ /\/ 2) Couple Diacid
0 ON 0
OAc 3) Pd/C
o o
OAC 4) PFPTFA
NHAC OAC
O O/\/O\/\O/\/NH
NHAc
OAc H o
OACOAC NHAc H NH 0 F
O O/\/O\/\O/\/ M
OAC O O
O o F F
NHAc OAC F
0 O/\/O\/\O/\/
3' 5' H
-‘O_F|"O‘(CH2)6'NH2
1. Borate buffer, DMSO, pH 8.5, rt
2. aq. ammonia, rt
N O
O O/\/O\/\O/\/
OHOH NHAC H NH
N MHvHx/O
4 .-CM
o OMAN
0. O O
O O
NHAC OH
O o/\/O\/\O/\/NH
NHAC 230
Compound 222 is commercially available. 44.48 ml (0.33 mol) of compound 222 was treated with
tosyl chloride (25.39 g, 0.13 mol) in pyridine (500mL) for 16 hours. The reaction was then evaporated to an
oil, dissolved in EtOAc and washed with water, sat. NaHC03, brine, and dried over Na2S04. The ethyl
acetate was concentrated to s and purified by column chromatography, eluted with EtOAc/hexanes
(1 :1) followed by 10% methanol in CHZCIZ to give compound 223 as a colorless oil. LCMS and NMR were
tent with the structure. 10 g (32.86 mmol) of 1-Tosyltriethylene glycol (compound 223) was treated
with sodium azide (10.68 g, 164.28 mmol) in DMSO ) at room temperature for 17 hours. The
reaction mixture was then poured onto water, and extracted with EtOAc. The c layer was washed with
water three times and dried over Na2S04. The organic layer was concentrated to dryness to give 5.3g of
compound 224 (92%). LCMS and NMR were consistent with the structure. 1-Azidotriethylene glycol
(compound 224, 5.53 g, 23.69 mmol) and compound 4 (6 g, 18.22 mmol) were d with 4A molecular
sieves (5g), and TMSOTf (1.65 ml, 9.11 mmol) in dichloromethane (100mL) under an inert atmosphere.
After 14 hours, the reaction was filtered to remove the sieves, and the organic layer was washed with sat.
NaHC03, water, brine, and dried over . The organic layer was concentrated to dryness and purified
by column chromatography, eluted with a gradient of 2 to 4% ol in dichloromethane to give
compound 225. LCMS and NMR were tent with the structure. Compound 225 (11.9 g, 23.59 mmol)
was hydrogenated in EtOAc/Methanol (4:1, 250mL) over Pearlman's catalyst. After 8 hours, the catalyst was
removed by filtration and the solvents removed to dryness to give nd 226. LCMS and NMR were
consistent with the structure.
In order to generate compound 227, a solution of nitromethanetrispropionic acid (4.17 g, 15.04
mmol) and Hunig’s base (10.3 ml, 60.17 mmol) in DMF (100mL) were treated dropwise with
pentaflourotrifiuoro acetate (9.05 ml, 52.65 mmol). After 30 minutes, the on was poured onto ice water
and extracted with EtOAc. The organic layer was washed with water, brine, and dried over Na2S04. The
organic layer was trated to dryness and then recrystallized from heptane to give compound 227 as a
white solid. LCMS and NMR were consistent with the structure. Compound 227 (1.5 g, 1.93 mmol) and
compound 226 (3.7 g, 7.74 mmol) were stirred at room temperature in acetonitrile (15 mL) for 2 hours. The
on was then evaporated to dryness and d by column chromatography, eluting with a gradient of 2
t010% ol in dichloromethane to give compound 228. LCMS and NMR were consistent with the
structure. Compound 228 (1.7 g, 1.02 mmol) was d with Raney Nickel (about 2g wet) in ethanol
(100mL) in an atmosphere of hydrogen. After 12 hours, the catalyst was removed by filtration and the
organic layer was evaporated to a solid that was used directly in the next step. LCMS and NMR were
consistent with the structure. This solid (0.87 g, 0.53 mmol) was treated with benzylglutaric acid (0.18 g, 0.8
mmol), HBTU (0.3 g, 0.8 mmol) and DIEA (273.7 ul, 1.6 mmol) in DMF (5mL). After 16 hours, the DMF
was removed under reduced pressure at 65°C to an oil, and the oil was dissolved in dichloromethane. The
organic layer was washed with sat. NaHC03, brine, and dried over Na2SO4. After evaporation of the organic
layer, the compound was purified by column tography and eluted with a gradient of 2 to 20%
methanol in dichloromethane to give the coupled product. LCMS and NMR were consistent with the
ure. The benzyl ester was deprotected with Pearlman’s catalyst under a hydrogen atmosphere for 1
hour. The catalyst was them d by filtration and the solvents removed to dryness to give the acid.
LCMS and NMR were consistent with the structure. The acid (486 mg, 0.27 mmol) was dissolved in dry
DMF (3 mL). Pyridine (53.61 ul, 0.66 mmol) was added and the reaction was purged with argon.
Pentaflourotrifiouro acetate (46.39 ul, 0.4 mmol) was slowly added to the reaction mixture. The color of the
on changed from pale yellow to burgundy, and gave off a light smoke which was blown away with a
stream of argon. The reaction was allowed to stir at room temperature for one hour (completion of reaction
was confirmed by LCMS). The solvent was removed under reduced re (rotovap) at 70 OC. The
residue was diluted with DCM and washed with 1N NaHSO4, brine, saturated sodium bicarbonate and brine
again. The organics were dried over Na2S04, filtered, and were concentrated to dryness to give 225 mg of
nd 229 as a brittle yellow foam. LCMS and NMR were consistent with the ure.
Oligomeric compound 230, comprising a GalNAc3-23 conjugate group, was prepared from
compound 229 using the l procedure illustrated in Example 46. The GalNAc3 cluster portion of the
3-23 conjugate group (GalNAc3-23a) can be combined with any cleavable moiety to provide a variety
of conjugate groups. The structure of GalNAc3-23 (GalNAc3-23a-CM) is shown below:
N O
O O/\/O\/\O/\/
0H0“ NHAC H NH “We
0 o/\/O\/\o/\/ M 4.;
OH O O
O O
NHAC OH
O O/\/O\/\O/\/NH
NHAC
Example 77: Antisense inhibition in vivo by oligonucleotides targeting SRB-l comprising a GalNAc3
conjugate
The oligonucleotides listed below were tested in a dose-dependent study for antisense inhibition of
SRB-l in mice.
Table 64
d ASOs targeting SRB-l
ISIS
Sequences (5 ,
GalNA03 SEQ
t0 3 , ) CM
N0. Cluster ID No.
GalNAcaA GmC T TmCA G T mc AT3 30
661161 domes es es es es ds ds ds ds ds ds GalNA03—3a Ad 145
GcsAcs CcsTcsTesmCesmCesTesTe
GalNAc3G mc T T mc A G T mc A T3 30
666904 613: es es es es ds ds ds ds ds ds 3—3a PO 143
GcsAcs CcsTcSTesmCesmCesTesTe
GalNAcsA G mc T T mc A G T mc A T3 30
673502 dom es e0 epn e0In e0 ds ds ds ds ds ds GalNA03-10a Ac 145
GcsAcs CcsTcsTeo Ceo CesTesTe
GalNAcaA GmC T T mc A G T mc A T3 30
677844 domes es esmes Ines ds ds ds ds ds ds GalNA03—9a Ac 145
GcsAcs CcsTcsTes Ces Te
GalNAc3-23a-03Ad0G C T T mc A G T mc A T
677843 es es eIsn esIn es ds ds ds ds ds ds
In GalNA03—23a Ac 145
CS CS CTSTCSCC CTTCS C S CS CS 6
GemCTTmCAGTmCATGAmCTTmC
655861 3 es es es Hes cs ds ds ds ds ds ds ds ds ds es es GalNA03—la Ac 144
CesTesTe do"GalNAc3'1a
GmCTTmCAGTmCATGAmCTTmC
677841 es es es es Ines cs ds ds ds ds ds ds ds ds ds es es GalNA03—l9a Ac 144
CesTesTe do"GalNAc3'19a
GmCTTmCAGTmCAT GAmCTTmC
677842 es es es es es ds ds ds ds ds ds ds ds ds ds es es GalNA03—20a Ac 144
CesTesTe lNAc3-20a
The ure of 3-la was shown previously in Example 9, GalNA03-3a was shown in
Example 39, GalNA03-9a was shown in Example 52, GalNA03-10a was shown in Example 46, GalNA03-19a
was shown in Example 70, GalNA03-20a was shown in Example 71, and GalNA03-23a was shown in Example
Treatment
Six to eight week old C57BL/6 mice (Jackson Laboratory, Bar Harbor, ME) were each injected
subcutaneously once at a dosage shown below with an oligonucleotide listed in Table 64 or with saline. Each
treatment group consisted of 4 animals. The mice were sacrificed 72 hours following the final administration
to determine the SRB-l mRNA levels using real-time PCR and RIBOGREEN® RNA quantification reagent
ular Probes, Inc. Eugene, OR) according to rd protocols. The results below are presented as the
average percent of SRB-l mRNA levels for each treatment group, ized to the saline control.
As illustrated in Table 65, ent with antisense oligonucleotides lowered SRB-l mRNA levels in
a dose-dependent manner.
Table 65
SRB-l mRNA (% Saline)
ISIS No. Dosage (mg/kg) SRB-l mRNA GalNAc3 CM
(% Saline) Cluster
Saline n/a 100.0 n/a n/a
0.5 89.18
1.5 77.02
661161 GalNAc3-3a Ad
29-10
12.64
0.5 93.11
1.5 55.85
666904 —5 GalNAc3-3a P0
2129
13.43
0.5 77.75
1.5 41.05
673502 —5 GalNAc3-10a Ad
19-27
14.41
0.5 87.65
1.5 93.04
677844 GalNAc3-9a Ad
40-77
16.95
0.5 102.28
1.5 70.51
677843
—530.68 GalNAc3-23a Ad
13.26
0.5 79.72
1.5 55.48
655861
—526.99 3-1a Ad
17.58
0.5 67.43
1.5 45.13
677841 —5 GalNAc3-19a Ad
27-02
12.41
0.5 64.13
1.5 53.56
677842 —5 GalNAc3-20a Ad
-47
10.23
Liver transaminase , alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
serum were also measured using standard protocols. Total bilirubin and BUN were also evaluated. Changes
in body weights were evaluated, with no significant change from the saline group (data not shown). ALTs,
ASTs, total bilirubin and BUN values are shown in Table 66 below.
Table66
Dosage ALT AST Bgfiflm BUN GalNAc3
ISIS N0 '
(mg/kg) (U/L) (U/L) (mg/dL) Cluster
(mg/(1L)
Saline n/a 21 45 0.13 34 n/a n/a
0.5 28 51 0.14 39
1.5 23 42 0.13 39
661161 GalNAc3-3a Ad
22 59 0.13 37
21 56 0.15 35
0.5 24 56 0.14 37
1.5 26 68 0.15 35
666904
—523 GalNAc3-3a P0
77 0.14 34
24 60 0.13 35
0.5 24 59 0.16 34
1.5 20 46 0.17 32
673502
—524 GalNAc3-10a Ad
45 0.12 31
24 47 0.13 34
0.5 25 61 0.14 37
1.5 23 64 0.17 33
677844 —5GalNAc3-9a Ad
58 0.13 35
22 65 0.14 34
0.5 53 53 0.13 35
1.5 25 54 0.13 34
677843 —5GalNAc3-23a Ad
21 60 0.15 34
22 43 0.12 38
0.5 21 48 0.15 33
1.5 28 54 0.12 35
655861 —5GalNAc3-1a Ad
22 60 0.13 36
21 55 0.17 30
0.5 32 54 0.13 34
1.5 24 56 0.14 34
677841 Ac3-19a Ad
23 92 0.18 31
24 58 0.15 31
0.5 23 61 0.15 35
1.5 24 57 0.14 34
677842 GalNAc3-20a Ad
41 62 0.15 35
24 37 0.14 32
Example 78: nse tion in vivo by oligonucleotides targeting Angiotensinogen comprising a
GalNAc3 conjugate
The oligonucleotides listed below were tested in a dose-dependent study for antisense inhibition of
Angiotensinogen (AGT) in normotensive Sprague Dawley rats.
Table 67
Modified ASOs targeting AGT
1s1s , , GalNAc3 SEQ
InC:eslkesmC:esTesC}eSIAdsTdsTdsTds'TdsTdsChsmC:dsmCdsmCdsAesGes
552668
esTe
InC:es14esmC:esTesC}eSIAdsTdsTdsTds'TdsTdsChsmC:dsmCdsmCdsAesGes
669509
GesAesTeoAdoa-GalNAc3-1a
The structure of GalNAc3-la was shown previously in Example 9.
Treatment
Six week old, male Sprague Dawley rats were each injected subcutaneously once per week at a
dosage shown below, for a total of three doses, with an oligonucleotide listed in Table 67 or with PBS. Each
treatment group consisted of 4 animals. The rats were sacrificed 72 hours following the final dose. AGT liver
mRNA levels were measured using ime PCR and RIBOGREEN® RNA quantification reagent
(Molecular Probes, Inc. Eugene, OR) according to standard protocols. AGT plasma n levels were
measured using the Total Angiotensinogen ELISA (Catalog # 2, IBL International, Toronto, ON) with
plasma diluted 120,000. The s below are presented as the average percent of AGT mRNA levels in
liver or AGT protein levels in plasma for each treatment group, normalized to the PBS control.
As illustrated in Table 68, treatment with antisense oligonucleotides d AGT liver mRNA and
plasma protein levels in a dose-dependent manner, and the oligonucleotide comprising a GalNAc conjugate
was significantly more potent than the parent oligonucleotide lacking a GalNAc conjugate.
Table 68
AGT liver mRNA and plasma protein levels
ISIS Dosage (mg/kg) AGT liver AGT plasma GalNAc3 Cluster CM
No. mRNA (% PBS) n (% PBS)
PBS n/a 100 100 n/a n/a
3 95 122
85 97
552668 n/a n/a
46 79
90 8 11
0.3 95 70
l 95 129
669509 GalNAc3-la Ad
3 62 97
9 23
Liver transaminase levels, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), in
plasma and body s were also measured at time of sacrifice using standard protocols. The results are
shown in Table 69 below.
Table 69
Liver transaminase levels and rat body weights
Body CM
ISIS No. (figs/1g: ALT (U/L) AST (U/L) Weight (%
g (Egg?
of baseline)
PBS n/a 51 81 186 n/a n/a
3 54 93 183
51 93 194
552668 n/a n/a
59 99 182
90 56 78 170
0.3 53 90 190
1 51 93 192
669509 GalNAc3-1a Ad
3 48 85 189
56 95 189
Example 79: Duration of action in vivo of oligonucleotides targeting APOC-III comprising a GalNAc3
The oligonucleotides listed in Table 70 below were tested in a single dose study for duration of action
in mice.
Table 70
Modified ASOs targeting APOC-III
ISIS , , GalNAc3 SEQ
sequences (5 t0 3 ) CM
No. Cluster ID No.
AesGes CesTesTes CdsTdsTdsGdsTds Cds CdsAdsGds Tes
304801 n/a n/a 135
TesAesTe
AesGesmCesTesTesmCdsTdsTdsGdsTdsmCdsmCdsAdsGdsmCdsTesTes
647535 G lNAa C3 -1 a Ad 136
TesAesTeoAdoa-GalNAa-la
GalNAc3'3a'o’Ad0AesGesmCesTesTesmCdsTdsTdsGdsTdsmCds
663083 G lNAa C3 -3 a Ad 151
InC:dslAdsCldsmC:dsTesTes TesAesTe
TdsGdsTds Cds
674449 93-7211);AdolAesC-le:n CesTesTes GalNA03—7a Ad 151
CdsAdsGds CdsTesTes TesAesTe
GalNAC3-1oago’AdersG: CesTesTes CdsTdsTdsGdsTds Cds
674450 GalNA03—1Oa Ad 151
CdsAdsGds Tes TesAesTe
GalNAc3'13a'o’AdoAesGesmCesTesTesmCdsTdsTdsGdsTdsmCds
674451 G lNAa C3-13 a Ad 151
lAdsCldsmC:dsTesTes TesAesTe
The structure of GalNAc3-1a was shown previously in Example 9, GalNAc3-3a was shown in Example 39,
GalNAc3-7a was shown in Example 48, GalNAc3-10a was shown in Example 46, and GalNAc3-13a was
shown in Example 62.
WO 79625
Treatment
Six to eight week old transgenic mice that express human APOC-III were each injected
subcutaneously once with an oligonucleotide listed in Table 70 or with PBS. Each treatment group consisted
of 3 animals. Blood was drawn before dosing to determine baseline and at 72 hours, 1 week, 2 weeks, 3
weeks, 4 weeks, 5 weeks, and 6 weeks following the dose. Plasma triglyceride and APOC-III protein levels
were measured as described in Example 20. The results below are presented as the average percent of plasma
triglyceride and APOC-III levels for each ent group, normalized to baseline levels, showing that the
oligonucleotides comprising a GalNAc conjugate group exhibited a longer duration of action than the parent
oligonucleotide without a conjugate group (ISIS 304801) even though the dosage of the parent was three
times the dosage of the oligonucleotides comprising a GalNAc conjugate group.
Table 71
Plasma ceride and II protein levels in enic mice
T1me pomt
ISIS Dosage Triglycerides AFDC-IE GalNAc3 CM
(days p05“ prom (A
No' (mg/kg) (% baseline) Cluster
dose) baseline)
3 97 102
7 101 98
14 108 98
PBS n/a 21 107 107 n/a n/a
28 94 91
88 90
42 91 105
3 40 34
7 41 37
14 50 57
304801 30 21 50 50 n/a n/a
28 57 73
68 70
42 75 93
3 36 37
7 39 47
14 40 45
647535 10 21 41 41 GalNAc3-1a Ad
28 42 62
69 69
42 85 102
3 24 18
7 28 23
14 25 27
663083 10 21 28 28 GalNAc3-3a Ad
28 37 44
55 57
42 60 78
674449 10 g g: g? GalNAc3-7a Ad
14 38 41
21 44 44
28 53 63
69 77
42 78 99
3 33 3O
7 35 34
14 31 34
674450 10 21 44 44 GaDiAcyloa Ad
28 56 61
68 7O
42 83 95
3 35 33
7 24 32
14 4O 34
674451 10 21 48 48 GaDiAcy13a Ad
28 54 67
65 75
42 74 97
Example 80: Antisense inhibition in vivo by oligonucleotides targeting Alpha-1 Antitrypsin (AlAT)
comprising a GalNAc3 Conjugate
The oligonucleotides listed in Table 72 below were tested in a study for ependent inhibition of
AlAT in mice.
Table 72
Modified ASOs targeting AlAT
ISIS
ces (5 , , GalNAc3 SEQ ID
t0 3 ) CM
No. Cluster No.
Aes Ces Ces CesAesAdsTdsTds CdsAdsGdsAdsAdsGdsGdsAesAes
476366 n/a n/a 152
GesGesAe
AesmCesmCesmCesAesAdsTdsTdsmCdsAdsGdsAdsAdsGdsGdsAesAes
656326 G lNAc -1a 3 a Ac 153
GesGesAeoAdos-GalNAa-la
GalNAc3'3a'o’AdoAesmCesmCesmCesAesAdsTdsTdsmCdsAdsGdsAds
678381 G lNAa C3 -3 a Ac 154
AdsGdsGdsAesAes GesGesAe
3'7a'o’AdoAesmCesmCesmCesAesAdsTdsTdsmCdsAdsGdsAds
678382 G DQAa C3 -7a A{ 154
AdsGdsGdsAesAes GesGesAe
GalNAC3-10a'o’AdersmCesmCesmCesAesAdsTdsTdsmCdsAdsGds
678383 G lNAa C3-10a Ac 154
GdsGdsAesAes GesGesAe
GalNAc3'13a'o’Aders Ces Ces CesAesAdsTdsTds CdsAdsGds
678384 GalNA03—13a Ac 154
AdsAdsGdsGdsAesAes GesGesAe
The structure of GalNAc3-1a was shown previously in Example 9, Gall\Ac3-3a was shown in Example 39,
GalNAc3-7a was shown in Example 48, GalNAc3-10a was shown in Example 46, and Gal\IAc3-13a was
shown in Example 62.
Treatment
Six week old, male C57BL/6 mice (Jackson tory, Bar Harbor, ME) were each injected
subcutaneously once per week at a dosage shown below, for a total of three doses, with an oligonucleotide
listed in Table 72 or with PBS. Each treatment group ted of 4 animals. The mice were sacrificed 72
hours following the final administration. A1AT liver mRNA levels were ined using real-time PCR and
RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc. Eugene, OR) according to standard
protocols. A1AT plasma protein levels were determined using the Mouse Alpha 1-Antitrypsin ELISA
(catalog # 41-A1AMS-E01, Alpco, Salem, NH). The results below are presented as the e percent of
A1AT liver mRNA and plasma protein levels for each treatment group, normalized to the PBS control.
As illustrated in Table 73, treatment with antisense oligonucleotides lowered A1AT liver mRNA and
A1AT plasma protein levels in a dose-dependent manner. The oligonucleotides comprising a GalNAc
conjugate were significantly more potent than the parent (ISIS 476366).
Table 73
AlAT liver mRNA and plasma protein levels
ISIS Dosage (mg/kg) A1AT liver A1AT plasma GalNAc3 Cluster CM
No. mRNA (% PBS) protein (% PBS)
PBS n/a 100 100 n/a n/a
86 78
476366
73 61 n/a n/a
45 30 38
0.6 99 90
2 61 70
656326 GalNAc3-1a Ad
6 15 30
18 6 10
0.6 105 90
678381 2 53 60
GalNAc3-3a Ad
6 16 20
18 7 13
0.6 90 79
2 49 57
678382 GalNAc3-7a Ad
6 21 27
18 8 11
0.6 94 84
2 44 53
678383 GalNAc3-10a Ad
6 13 24
18 6 10
0.6 106 91
2 65 59
678384 GalNAc3-13a Ad
6 26 31
18 11 15
Liver minase and BUN levels in plasma were ed at time of sacrifice using standard
protocols. Body weights and organ weights were also ed. The results are shown in Table 74 below.
Body weight is shown as % relative to baseline. Organ weights are shown as % of body weight relative to
the PBS control group.
Table 74
ISIS Dosage ALT AST BUN BOdy .Lwer Kldney Spleen
we1ght (% we1ght (Rel we1ght (Rel we1ght (Rel
No‘ (mg/kg) (U/L) (U/L) (mg/dL)
ne) % BW) % BW) % BW)
PBS n/a 25 51 37 119 100 100 100
34 68 35 116 91 98 106
476366 15 37 74 30 122 92 101 128
45 30 47 31 118 99 108 123
0.6 29 57 40 123 100 103 119
2 36 75 39 114 98 111 106
656326
6 32 67 39 125 99 97 122
18 46 77 36 116 102 109 101
0.6 26 57 32 117 93 109 110
2 26 52 33 121 96 106 125
678381
6 40 78 32 124 92 106 126
18 31 54 28 118 94 103 120
0.6 26 42 35 114 100 103 103
2 25 50 31 117 91 104 117
678382
6 30 79 29 117 89 102 107
18 65 112 31 120 89 104 113
0.6 30 67 38 121 91 100 123
2 33 53 33 118 98 102 121
678383
6 32 63 32 117 97 105 105
18 36 68 31 118 99 103 108
0.6 36 63 31 118 98 103 98
2 32 61 32 119 93 102 114
678384
6 34 69 34 122 100 100 96
18 28 54 30 117 98 101 104
Example 81: Duration of action in vivo of oligonucleotides targeting AlAT comprising a 3
cluster
The oligonucleotides listed in Table 72 were tested in a single dose study for on of action in
mice.
Six week old, male C57BL/6 mice were each injected subcutaneously once with an oligonucleotide
listed in Table 72 or with PBS. Each treatment group consisted of 4 s. Blood was drawn the day
before dosing to determine baseline and at 5, 12, 19, and 25 days following the dose. Plasma AlAT protein
levels were measured via ELISA (see Example 80). The results below are presented as the average percent of
plasma AlAT protein levels for each treatment group, normalized to baseline levels. The results show that
the oligonucleotides comprising a GalNAc conjugate were more potent and had longer duration of action than
the parent lacking a GalNAc conjugate (ISIS 476366). Furthermore, the oligonucleotides comprising a 5 ’-
GalNAc conjugate (ISIS , 678382, 678383, and 678384) were lly even more potent with even
longer duration of action than the oligonucleotide comprising a 3’-GalNAc conjugate (ISIS 656326).
Table 75
Plasma AlAT n levels in mice
ISIS Dosage Time point AlAT (% GalNAc3 CM
No. (mg/kg) (days post- baseline) Cluster
dose)
93
12 93
PBS n/a n/a n/a
—19 90
97
38
12 46
476366 100 n/a n/a
—1962
77
33
12 36
656326 18 —19GalNAcg-la Ad
72
21
12 21
678381 18 —19GalNAc3-3a Ad
48
21
12 21
678382 18 GalNAc3-7a Ad
19 39
60
24
12 21
678383 18 —19GalNAc3-10a Ad
73
29
12 34
678384 18 —19GalNAc3-13a Ad
76
Example 82: Antisense inhibition in vitro by oligonucleotides targeting SRB-l comprising a GalNAc3
conjugate
Primary mouse liver hepatocytes were seeded in 96 well plates at 15,000 cells/well 2 hours prior to
treatment. The oligonucleotides listed in Table 76 were added at 2, 10, 50, or 250 nM in Williams E medium
and cells were incubated overnight at 37 0C in 5% C02. Cells were lysed 16 hours following oligonucleotide
addition, and total RNA was purified using RNease 3000 BioRobot (Qiagen). SRB-l mRNA levels were
determined using real-time PCR and RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc.
Eugene, OR) ing to standard protocols. IC50 values were ined using Prism 4 software
(GraphPad). The results show that oligonucleotides comprising a variety of different GalNAc conjugate
groups and a variety of different cleavable moieties are significantly more potent in an in vitro free uptake
experiment than the parent ucleotides lacking a GalNAc conjugate group (ISIS 353382 and 666841).
Table 76
Inhibition of SRB-l expression in vitro
ISIS , , . GalNAc 1C50 SEQ
Sequence (5 to 3 ) Llnkages CM
No. cluster (nM) ID No.
3 53 3 82 CesTesges CesAdfdsTnds CdsAdsTdsGdsAds
PS n/a n/a 250 143
CdsTdsTes Ces CesTesTe
GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds Ga1\AC3
655861 PS AC 40 144
InC:dsTdsTesmC:esmC:esTesTeoAdo’'(;alNAc3'1a ' 1
Gal\AC3
661 161 GEINAC3'3a'0’Adognes CesTesTIfis CgsAdsGdsTds PS AC 40 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe '33.
661 162 3-3a-03Adocifs CCOTCOTIEO CIEOAdSGdSTdS Ga1\AC3
PO/PS Ac 8 145
CdsAdsTdsGdsAds CdsTds Teo Ceo CesTesTe '33.
GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds Ga1\AC3
664078 PS AC 20 144
InC:dsTdsTesmC:esmC:esTesTeoAdo’'GalNAc3'9a '93.
GalNAc3'8a'o’AdoGesmCesTesTesmCesAdsGdsTds Ga1\AC3
665001 PS AC 70 145
lAdsTdsC}d31AdsmC:dsTdsTesmC:esmC:esTesTe ' 83.
GalNAc3'5a'o’AdoGesmCesTesTesmCesAdsGdsTds Ga1\AC3
666224 PS AC 8O 145
InC:dslAdsTdsC}d31AdsmC:dsTdsTesmC:esmC:esTesTe '53.
666841 C6°T6°HTC6° 3?:ngan fiSédsTdsGdsAds PO/PS n/a n/a >250 143
ds ds e0 e0 es es e
GalNAc3-10a'o’Ad0GesmCesTesTesmCesAdsGdsTds Gal\AC3
6668 81 PS Ad 3 O 145
InC:dslAdsTdsC}d31AdsmC:dsTdsTesmC:esmC:esTesTe "103.
666904 GalNAC3-3a-03Gein TesmCesfideGdsTds Cds Gal\Ac3
PS PO 9 143
GdsAds CdsTds Tes Ces CesTesTe '33.
666924 GSINAC3-3a-0’Tdogrfs CCSTCSTIES CIisAdsGdsTds Gal\Ac3
PS Tc 15 148
CdsAdsTdchsAcs CcsTds Tes Ces CesTesTe '33.
GalNAc3'6a'0’AdoGesmCesTesTesmCesAdsGdsTds Ga1\AC3
666961 PS AC 150 145
InC:dSIAdsTdsC}c SACschsTdsTesmCesmCesTesTe '63.
GalNAc3'7a'0’AdoGesmCesTesTesmCesAdsGdsTds Ga1\AC3
666981 PS AC 20 145
InC:dSIAdsTdsC}c SACschsTdsTesmCesmCesTesTe '73.
670061 GilNAc3'13a'0’Adoges CesTesEles gesAdsGdsTds Gal\AC3
PS Ac 3 O 145
CdsAdsTdchsAcs CcsTds Tes Ces CesTesTe "133.
GalNAc -3a-0,T 0G mc T T me A G T3 ‘3
6° 6° 66 66 ‘6 G31\AC3
670699 m if H66 51" PO/PS Tc 15 148
CdsAdsTds GcsAcs Cc sTdsTeo Ceo CesTesTe '33.
GalNAc -3a-0sAe0G mc T T me A G T3
‘6 Gal\AC°
670700 6° 6° 66 66
m 6; 6: 6;: PO/PS AC 30 145
Tds GdsAds CdsTdsTeo Ceo sT '33.
GalNAc -3a-0aTe0G mc T T me A G T3
670701 65 6° 6° 51" if 66 66 ‘6 Gal\AC°
m PO/PS Te 25 148
CdsAdsTds GdsAds CdsTdsTeo Ceo CesTesTe '33.
GilNAcfa'lZa'o’Adog-les CesTesEles gesAdsGdsTds Gal\AC3
671 144 PS Ad 40 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe _123'
GalNAc -13,-0,A 0G mc T T me A G T3 d Gal\AC3
671165 6° 6° H?" ‘15 d5 ‘15
m H? n?" PO/PS A, 8 145
CdsAdsTds GdsAds CdsTdsTeo Ceo CesTesT '13a
671261 GigNAcfa'l‘I'a'o’Adoges CeSTeSTneS geSAdSGdSTdS Ga1\AC3
PS Ac >250 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe '14a
671262 GilgNAc3-1 Sa'o’Adoges CeSTeSTneS geSAdSGdSTdS 3
PS Ac >250 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe '15a
673501 GilNAc3'7a'0’Ad0Cigs CCOTCO'TIifO sGdsTds 3
PO/PS Ac 3 O 145
CdsAdsTdsGdsAds CdsTdsTeo Ceo Te '7a
GiinlNAcfa-loa-O’Adoges CeoTeoTneO geoAdsGdsTds Ga1\AC3
673502 PO/PS Ac 8 145
TdsGdsAds CdsTds Teo Ceo CesTesTe _10a
675441 GigNAch7a'0’Ad0ges CesTesTnes gesAdsGdsTds Gal\AC3
PS Ac 3 O 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe '17a
675442 GigNAcfa'lsa'o’Adog-les CesTesTnes GdsTds Gal\AC3
PS Ac 20 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe _1 8a
GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds 3
677841 PS A“ 40 144
mcdsTdsTesmCesmCesTesTeoAdoa-Ga1NAc3-19a -19a
GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds Gal\AC3
677842 PS A“ 30 144
mcdsTdsTesmCesmCesTesTeoAdoa-Ga1NAc3-20a -2oa
677843 GigNAc3'23a'o’Adog-les CesTesTnes gesAdsGdsTds Gal\AC3
PS AC 40 145
CdsAdsTdsGdsAds CdsTds Tes Ces CesTesTe '23a
The ure of GalNAcg-la was shown previously in Example 9, GalNAc3-3a was shown in Example 39,
GalNAc3-5a was shown in Example 49, GalNAc3-6a was shown in Example 51, GalNAc3-7a was shown in
Example 48, GalNAc3-8a was shown in Example 47, GalNAc3-9a was shown in e 52, GalNAcg-lOa
was shown in Example 46, GalNAc3-12a was shown in Example 61, GalNAc3-13a was shown in Example 62,
GalNAc3-14a was shown in Example 63, GalNAc3-15a was shown in Example 64, GalNAc3-17a was shown in
Example 68, GalNAc3-18a was shown in Example 69, GalNAc3-19a was shown in Example 70, GalNAcg-ZOa
was shown in Example 71, and GalNAc3-23a was shown in Example 76.
Example 83: Antisense inhibition in vivo by oligonucleotides ing Factor XI sing a GalNAc3
cluster
The oligonucleotides listed in Table 77 below were tested in a study for dose-dependent inhibition of
Factor X1 in mice.
Table 77
Modified oligonucleotides targeting Factor XI
1s1s GalNAc
, , SEQ
WW6 to”
TesGesGesTesAesAdsTds C: (giséds CdsTdsTdsTds CdsAesGes
404071
TesCleoCleoTeolAeolAdsTdsmcdsmcdsAdsmCdsTdsTdsTdsmCdsAeoGeo
663086 GalNAc3-3a-oaAdoTesGeoGeoTeeroAdsTdsmCdsmCdsAdsmCdsTdS GalNAc3-3a
TdsTdsmCdslAeoC}eolAesC-lesC}e
3'7a'0’Ad0TesGeoGeoTeeroAdsTdsmCdsmCdsAdsmCdsTds
678347 GalNAC3'7a Ad 155
TdsTdsmCdsAeoGeersGesGe
GalNAc3-10a'0’AdoTesGeoGeoTeeroAdsTdsmCdsmCdsAdsmCds
678348 GalNAC3_10a
TdsTdsTdsmCdslAeoCleOIAesC-lescje
GalNAc3-13a'o’Ad0TesCleoCleoTeolAeOIAdsTdsmCdsmCdslAdsmCds
678349 3_13a
TdsmCdslAeoCleOIAesC-lescje
The structure of GalNAc3-1a was shown previously in Example 9, GalNAc3-3a was shown in Example 39,
GalNAc3-7a was shown in Example 48, GalNAc3-10a was shown in Example 46, and GalNAc3-13a was
shown in Example 62.
Six to eight week old mice were each injected subcutaneously once per week at a dosage shown
below, for a total of three doses, with an oligonucleotide listed below or with PBS. Each treatment group
consisted of 4 animals. The mice were sacrificed 72 hours following the final dose. Factor XI liver mRNA
levels were measured using real-time PCR and normalized to cyclophilin according to standard protocols.
Liver transaminases, BUN, and bilirubin were also measured. The results below are presented as the average
percent for each treatment group, normalized to the PBS control.
As illustrated in Table 78, treatment with antisense oligonucleotides lowered Factor XI liver mRNA
in a dose-dependent manner. The results show that the oligonucleotides comprising a GalNAc conjugate were
more potent than the parent lacking a GalNAc conjugate (ISIS 404071). Furthermore, the oligonucleotides
comprising a 5 ’-GalNAc conjugate (ISIS 663086, 678347, 678348, and 678349) were even more potent than
the ucleotide comprising a 3’-GalNAc conjugate (ISIS ).
Table 78
Factor XI liver mRNA, liver minase, BUN, and bilirubin levels
ISIS Dosage Factor XI ALT AST BUN Bilirubin GalNAc3 SEQ
No. (mg/kg) mRNA (% PBS) (U/L) (U/L) (mg/dL) ) Cluster ID No.
PBS n/a 100 63 70 21 0.18 n/a n/a
3 65 41 58 21 0.15
404071
33 49 53 23 0.15 n/a 146
17 43 57 22 0.14
0.7 43 90 89 21 0.16
656173 2 9 36 58 26 0.17 GalNAcg-la 147
6 3 50 63 25 0.15
0.7 33 91 169 25 0.16
663086
2 7 38 55 21 0.16 GalNAc3-3a 155
6 1 34 40 23 0.14
0.7 35 28 49 20 0.14
678347 2 10 180 149 21 0.18 GalNAc3-7a 155
6 1 44 76 19 0.15
0.7 39 43 54 21 0.16
678348
—25 GalNAc3-10a 155
38 55 22 0.17
6 2 25 38 20 0.14
0.7 34 39 46 20 0.16
umGalNA03-13a
_—-__
Example 84: Duration of action in vivo of oligonucleotides targeting Factor XI comprising a GalNAc3
Conjugate
The oligonucleotides listed in Table 77 were tested in a single dose study for duration of action in
mice.
Treatment
Six to eight week old mice were each injected subcutaneously once with an oligonucleotide listed in
Table 77 or with PBS. Each treatment group consisted of 4 animals. Blood was drawn by tail bleeds the day
before dosing to determine baseline and at 3, 10, and 17 days following the dose. Plasma Factor XI protein
levels were measured by ELISA using Factor XI capture and biotinylated detection antibodies from R & D
Systems, Minneapolis, MN (catalog # AF2460 and # BAF2460, respectively) and the OptEIA Reagent Set B
(Catalog # 550534, BD ences, San Jose, CA). The results below are ted as the e percent
of plasma Factor XI protein levels for each treatment group, normalized to baseline levels. The s show
that the oligonucleotides comprising a GalNAc conjugate were more potent with longer duration of action
than the parent lacking a GalNAc conjugate (ISIS 404071). rmore, the oligonucleotides comprising a
’-GalNAc conjugate (ISIS 663086, , 678348, and 678349) were even more potent with an even
longer duration of action than the oligonucleotide comprising a 3’-GalNAc ate (ISIS 656173).
Table 79
Plasma Factor XI protein levels in mice
ISIS (mg/kgg)Dosa e TimepolsDt-dos(e) yoint da s Factor XI %baseline) CM SE ID
GalNA03 Cluster
No. 130.
3 123
PBS n/a 10 56 n/a n/a n/a
17 100
3 11
404071 30 10 47 n/a n/a 146
17 52
3 1
656173 6 10 3 GalNA03-1a Ad 147
17 21
3 1
663086 6 10 2 GalNA03-3a Ad 155
17 9
3 1
678347 6 10 1 GalNA03-7a Ad 155
17 8
WO 79625
678348 10 1 GalNAcg-10a Ad 155
678349-== GalNAC3-13a
Example 85: Antisense inhibition in vivo by oligonucleotides targeting SRB-l comprising a GalNAc3
Conjugate
Oligonucleotides listed in Table 76 were tested in a dose-dependent study for antisense inhibition of
SRB-l in mice.
Treatment
Six to eight week old C57BL/6 mice were each injected subcutaneously once per week at a dosage
shown below, for a total of three doses, with an oligonucleotide listed in Table 76 or with saline. Each
ent group consisted of 4 animals. The mice were sacrificed 48 hours following the final administration
to determine the SRB-l mRNA levels using real-time PCR and RIBOGREEN® RNA quantification reagent
(Molecular Probes, Inc. Eugene, OR) according to standard protocols. The results below are presented as the
average percent of liver SRB—l mRNA levels for each treatment group, normalized to the saline control.
As rated in Tables 80 and 81, treatment with antisense oligonucleotides lowered SRB-l mRNA
levels in a ependent manner.
Table 80
SRB-l mRNA in liver
ISIS No. Dosage (mg/kg) SRB-l mRNA (% GalNA03 r CM
Saline)
Saline n/a 100 n/a n/a
0.1 94
655861 %GalNAcg-la Ad
3 32
0.1 120
661161 (1)3 £7 GalNAcg-3a Ad
3 26
0.1 107
666881 cg-10a Ad
3 27
0.1 120
666981 %GalNAcg-7a Ad
3 21
0.1 118
670061
WGalNAcg-13a Ad
3 18 -
677842 GalNAC3'ZOa Ad
Table 81
SRB-l mRNA in liver
ISIS No. Dosage (mg/kg) SRB-l mRNA (% GalNA03 r CM
Saline)
0.1 107
661161 (1)3 2: GalNAcg-3a Ad
3 18
0.1 110
677841 (1)3 :3 g-19a Ad
3 25
Liver transarninase levels, total bilirubin, BUN, and body weights were also ed using standard
protocols. Average values for each treatment group are shown in Table 82 below.
Table 82
ISIS Dosage ALT AST Bilirubin BUN Body Weight GalNA03 CM
No. (mg/kg) (U/L) (U/L) (mg/dL) (mg/dL) (% baseline) Cluster
Saline n/a 19 39 0.17 26 118 n/a n/a
0.1 25 47 0.17 27 114
0.3 29 56 0.15 27 118
655861 GalNAcg-la Ad
1 20 32 0.14 24 112
3 27 54 0.14 24 115
0.1 35 83 0.13 24 113
0.3 42 61 0.15 23 117
661161 GalNAcg-3a Ad
1 34 60 0.18 22 116
3 29 52 0.13 25 117
0.1 30 51 0.15 23 118
0.3 49 82 0.16 25 119
666881 GalNAcg-10a Ad
1 23 45 0‘14 24 117
3 20 38 0.15 21 112
0.1 21 41 0.14 22 113
0.3 29 49 0.16 24 112
666981 GalNAcg-7a Ad
1 19 34 0.15 22 111
3 77 78 0.18 25 115
0.1 20 63 0.18 24 111
0.3 20 57 0.15 21 115
670061 GalNAcg-13a Ad
1 20 35 0.14 20 115
3 27 42 0.12 20 116
0.1 20 38 0.17 24 114
677842 0.3 31 46 0.17 21 117 GalNAcg-20a Ad
1 22 34 0.15 21 119
3 41 57 0.14 23 118
Example 86: Antisense inhibition in vivo by oligonucleotides targeting TTR comprising a GalNAc3
cluster
Oligonucleotides listed in Table 83 below were tested in a dose-dependent study for antisense
inhibition of human transthyretin (TTR) in transgenic mice that express the human TTR gene.
Treatment
Eight week old TTR transgenic mice were each ed subcutaneously once per week for three
weeks, for a total of three doses, with an ucleotide and dosage listed in the tables below or with PBS.
Each treatment group consisted of 4 animals. The mice were sacrificed 72 hours following the final
administration. Tail bleeds were performed at s time points throughout the experiment, and plasma
TTR protein, ALT, and AST levels were measured and reported in Tables 85-87. After the animals were
sacrificed, plasma ALT, AST, and human TTR levels were measured, as were body weights, organ weights,
and liver human TTR mRNA levels. TTR protein levels were measured using a clinical analyzer (AU480,
Beckman Coulter, CA). ime PCR and RIBOGREEN® RNA quantification reagent (Molecular Probes,
Inc. , OR) were used according to standard protocols to determine liver human TTR mRNA levels.
The results ted in Tables 84-87 are the average values for each treatment group. The mRNA levels are
the average values relative to the average for the PBS group. Plasma protein levels are the e values
relative to the average value for the PBS group at baseline. Body weights are the e percent weight
change from baseline until sacrifice for each individual treatment group. Organ weights shown are
normalized to the animal’s body , and the average normalized organ weight for each treatment group is
then presented relative to the average normalized organ weight for the PBS group.
In Tables 84-87, “BL” indicates baseline, measurements that were taken just prior to the first dose.
As illustrated in Tables 84 and 85, treatment with antisense oligonucleotides lowered TTR expression levels
in a dose-dependent manner. The oligonucleotides comprising a GalNAc conjugate were more potent than the
parent g a GalNAc conjugate (ISIS 420915). Furthermore, the ucleotides comprising a GalNAc
conjugate and mixed PS/PO internucleoside linkages were even more potent than the oligonucleotide
comprising a GalNAc conjugate and full PS linkages.
Table 83
ucleotides targeting human TTR
GalNAc SEQ
151s No.. Sequence 5 , , .
to 3 L1nkages
cluster ID No.
TesmCesTesTesGesGdsTdsTdsAdsmCdsAdsTdsGdsAdsAds
420915
AesTesmCesmCesmCe
TesmCesTesTesGesGdsTdsTdsAdsmCdsAdsTdsGdsAdsAds
682883 GalNAc3-3HaTesmCeoTeoTeoGeoGdSTdsTdsAdsmCdSAdS PS/PO GalNAc3-3a m-
TdsGdsAdsAdsAeoTeomCesmCesmCe
GalNAc3'7a-0’TesmCeoTeoTeoGeoGdsTdsTdsAdsmCdsAds
682884 PS/PO GalNAcg-7a PO
TdsGdsAdsAdsAeoTeomCesmCesmCe
GalNAc3-10a-o’TesmCeoTeoTeoGeoGdsTdsTdsAdsmCds
682885 PS/PO GalNAcg- 10a “-
AdsTdsGdsAdsAdsAeoTeomCesmCesmCe
GalNAc3-13a—o’TesmCeoTeoTeoCleoCldsTdsTdSIAdsmCds
682886 PS/PO 3-13a fl-
AdsTdsGdsAdsAdsAeoTeomCesmCesmCe
TesmCeoTeoTeoCleoCldsTdsTdsIAdsmCdslAdsTdsChslAdslAds
684057 PS/PO GalNAc3-19a
AeoTeomCesmCesmCeoAdo"GalNAc3'19a
The legend for Table 85 can be found in Example 74. The structure of GalNAc3-1 was shown in Example 9.
The structure of 3-3a was shown in Example 39. The structure of GalNAc3-7a was shown in Example
48. The structure of GalNAc3-10a was shown in Example 46. The structure of GalNAc3-13a was shown in
Example 62. The structure of GalNAc3-19a was shown in Example 70.
Table 84
Antisense tion of human TTR in vivo
. Dosage TTR mRNA (% Plasma TTR protein SEQ
1s1s No. GalNAc cluster CM
(mg/kg) PBS) (% PBS) ID No.
PBS n/a 100 100 n/a n/a
6 99 95
420915 20 48 65 n/a n/a 156
60 18 28
0.6 113 87
2 4O 56
660261 GalNAcg-la Ad 157
6 20 27
9 11
Table 85
Antisense inhibition of human TTR in vivo
Plasma TTR prote1n (A) PBS at BL)' TTR 0 SEQ
. Dosage GalNAc
1s1s No. mRNA Day 17 CM 1D
(mg/kg) BL Day 3 Da 10
(% PBS) y cluster
(After sac) No.
PBS n/a 100 100 96 90 114 n/a n/a
6 74 106 86 76 83
420915 20 43 102 66 61 58 n/a n/a 156
60 24 92 43 29 32
0.6 60 88 73 63 68
682883 2 18 75 38 23 23 Gallglfcg- 156
6 10 80 35 11 9
0.6 56 88 78 63 67
682884 2 19 76 44 25 23 Gal??? PO
6 15 82 35 21 24
0.6 60 92 77 68 76
682885 2 22 93 58 32 32 @3130? 156
6 17 85 37 25 20
682886 0.6 57 91 70 64 69 GalNAc3- PO 156
2 21 89 50 31
mfimm—Zi102
GalNAC3_
684057_____—
“____—
Table 86
Transaminase levels, body weight changes, and ve organ weights
2;): ALT (U/L) AST (U/L)
Body Liver Spleen Kidne SEQ
1515 NO-
(mg Day Day Day Day Day Day (% (% (% y (% ID
BL BL
3 10
/kg) 17 3 10 17 BL) PBS) PBS) PBS) N0.
PBS n/a 33 34 33 24 58 62 67 52 105 100 100 100 n/a
6 34 33 27 21 64 59 73 47 115 99 89 91
420915 20 34 30 28 19 64 54 56 42 111 97 83 89 156
60 34 35 31 24 61 58 71 58 113 102 98 95
0.6 33 38 28 26 70 71 63 59 111 96 99 92
2 29 32 31 34 61 60 68 61 118 100 92 90
660261 157
6 29 29 28 34 58 59 70 90 114 99 97 95
33 32 28 33 64 54 68 95 114 101 106 92
Table 87
Transaminase levels, body weight changes, and relative organ weights
2;): ALT (U/L) AST (U/L)
Body Liver Spleen Kidne SEQ
1515 NO- (% (% (% y (% ID
(mg Day Day Day Day Day Day
BL BL
3 10 17 3 10 17 BL) PBS) PBS) PBS) N0.
/kg)
PBS n/a 32 34 37 41 62 78 76 77 104 100 100 100 n/a
6 32 30 34 34 61 71 72 66 102 103 102 105
420915 20 41 34 37 33 80 76 63 54 106 107 135 101 156
60 36 30 32 34 58 81 57 60 106 105 104 99
0.6 32 35 38 40 53 81 74 76 104 101 112 95
682883 2 38 39 42 43 71 84 70 77 107 98 116 99 156
6 35 35 41 38 62 79 103 65 105 103 143 97
0.6 33 32 35 34 70 74 75 67 101 100 130 99
682884 2 31 32 38 38 63 77 66 55 104 103 122 100 156
6 38 32 36 34 65 85 80 62 99 105 129 95
0.6 39 26 37 35 63 63 77 59 100 109 109 112
682885 2 30 26 38 40 54 56 71 72 102 98 111 102 156
6 27 27 34 35 46 52 56 64 102 98 113 96
0.6 30 40 34 36 58 87 54 61 104 99 120 101
682886 2 27 26 34 36 51 55 55 69 103 91 105 92 156
6 40 28 34 37 107 54 61 69 109 100 102 99
0.6 35 26 33 39 56 51 51 69 104 99 110 102
684057 2 33 32 31 40 54 57 56 87 103 100 112 97 157
6 39 33 35 40 67 52 55 92 98 104 121 108
Example 87: on of action in vivo by single doses of oligonucleotides targeting TTR comprising a
GalNAc3 cluster
ISIS numbers 420915 and 660261 (see Table 83) were tested in a single dose study for duration of
action in mice. ISIS numbers 420915, , and 682885 (see Table 83) were also tested in a single dose
study for duration of action in mice.
Treatment
Eight week old, male transgenic mice that express human TTR were each injected subcutaneously
once with 100 mg/kg ISIS No. 420915 or 13.5 mg/kg ISIS No. 660261. Each treatment group consisted of 4
s. Tail bleeds were med before dosing to determine baseline and at days 3, 7, 10, 17, 24, and 39
following the dose. Plasma TTR protein levels were measured as described in Example 86. The results below
are ted as the average percent of plasma TTR levels for each treatment group, normalized to baseline
levels.
Table 88
Plasma TTR protein levels
ISIS Dosage Time point
TTR (A) baselme)0 . GalNAc3 CM
SEQ ID NO'
No. (mg/kg) (days ose) Cluster
3 30
7 23
35
420915 100 —17 n/a n/a 156
24 75
39 100
3 27
7 21
22
660261 13.5 GalNAc3-1a Ad 157
17 36
24 48
39 69
Treatment
Female transgenic mice that express human TTR were each injected subcutaneously once with 100
mg/kg ISIS No. 420915, 10.0 mg/kg ISIS No. 682883, or 10.0 mg/kg 682885. Each treatment group
consisted of 4 animals. Tail bleeds were performed before dosing to ine baseline and at days 3, 7, 10,
17, 24, and 39 following the dose. Plasma TTR protein levels were measured as described in Example 86.
The results below are presented as the average percent of plasma TTR levels for each treatment group,
normalized to baseline levels.
Table 89
Plasma TTR protein levels
ISIS g)Dosa e Time oint . 3 CM
TTR (% baselme) SEQ ID NO'
N0. (days polsDt-dose) Cluster
3 48
7 48
420915 100 10 48 n/a n/a 156
17 66
31 80
3 45
7 37
682883 10.0 10 38 GalNAc3-3a PO 156
17 42
31 65
3 40
7 33
682885 10.0 10 34 GalNAc3-10a PO 156
17 40
31 64
The results in Tables 88 and 89 show that the oligonucleotides comprising a GalNAc conjugate are more
potent with a longer duration of action than the parent ucleotide lacking a ate (ISIS 420915).
Example 88: Splicing modulation in vivo by oligonucleotides targeting SMN comprising a GalNAc3
conjugate
The ucleotides listed in Table 90 were tested for splicing modulation of human survival of
motor neuron (SMN) in mice.
Table 90
Modified ASOs targeting SMN
ISIS , , GalNAc3 SEQ
Sequences (5 t0 3 ) CM
N0. Cluster ID No.
Tes CesAes CesTesTesTes gesAesTesAesAesTesGes CesTesGes
3 87954 n/a n/a 158
GalNAc3'7a'0’AesTesTesmCesAesmCesTesTesTesmCesAesTesAesAes
6998 1 9 G INAa C3 -7a PO 158
TesC}esmcesTesC}esC}e
GalNAc3'73—0’AesTeoTeomCeeromCeoTeoTeoTeomCeeroTeero
699821 G lNAa C3 -7a PO 158
AeoTeoGeomCeoTesGesGe
AesTesTes CesAes CesTesTesTes CesAesTesAesAesTesGes CesTesGes
700000 GalNAc3-1a Ad 157
GeOAdoa-GalNAc3-1 a
703421 X-ATTmCAmCTTTmCATAATGmCTGG n/a n/a 15 8
703422 GalNAc3-7b-X-ATTmCAmCTTTmCATAATGmCTGG GalNAC3-7b n/a 15 8
The structure of GalNAc3-7a was shown previously in Example 48. “X” indicates a 5’ primary amine
generated by Gene Tools (Philomath, OR), and GalNAc3-7b indicates the structure of GalNAc3-7a lacking the
—NH-C6-O portion of the linker as shown below:
HoOH o
O N
Ho 4 Hfl
AcHN
HoOH O O O
O NJK/‘O NW“
HO I“
4 H H
AcHN o
HOOH
O i
O N
HO O
4 H
AcHN
ISIS numbers 703421 and 703422 are morphlino oligonucleotides, wherein each nucleotide of the two
oligonucleotides is a morpholino nucleotide.
Treatment
Six week old transgenic mice that express human SMN were injected subcutaneously once with an
oligonucleotide listed in Table 91 or with saline. Each treatment group consisted of 2 males and 2 s.
The mice were sacrificed 3 days following the dose to determine the liver human SMN mRNA levels both
with and without exon 7 using real-time PCR according to standard protocols. Total RNA was measured
using Ribogreen t. The SMN mRNA levels were normalized to total mRNA, and further normalized to
the averages for the saline treatment group. The ing average ratios of SMN mRNA including exon 7 to
SMN mRNA missing exon 7 are shown in Table 91. The s show that fully modified oligonucleotides
that modulate splicing and comprise a GalNAc conjugate are significantly more potent in ng splicing in
the liver than the parent oligonucleotides lacking a GlaNAc ate. Furthermore, this trend is maintained
for multiple modification chemistries, including 2’-MOE and morpholino modified oligonucleotides.
Table 91
Effect of oligonucleotides targeting human SMN in vivo
113:8 Dose (mg/kg) +Exon 7 / -Exon 7 (31111:? CM 118330.
Saline n/a 1.00 n/a n/a n/a
387954 32 1.65 n/a n/a 158
387954 288 5.00 n/a n/a 158
699819 32 7.84 3-7a PO 158
699821 32 7.22 GalNAc3-7a PO 158
700000 32 6.91 GalNAc3-1a Ad 159
703421 32 1.27 n/a n/a 158
703422 32 4.12 GalNAc3-7b n/a 158
Example 89: Antisense inhibition in vivo by oligonucleotides targeting Apolipoprotein A (Apo(a))
comprising a GalNAc3 conjugate
The oligonucleotides listed in Table 92 below were tested in a study for dose-dependent inhibition of
Apo(a) in transgenic mice.
Table 92
Modified ASOs targeting Apo(a)
-ISIS GalNA03 SEQ ID
Sequences <5 ”3)
TesC}esmC:esTesmC:esmC:dsCidSTdsTdscjdscjdsTds(}dsmC:ds
494372 HI,
c}es'-[‘esTesmC:e
GalNAc3'7a'0’TesGeomCeoTeomCeomCdsGdsTdsTdsGdsGds
68 1257 GalNAc -7a3 P0 58
Tdsc}dsmC:ds TdsTeoC}eoTesTesmC:e
The structure of GalNA03-7a was shown in Example 48.
Treatment
Eight week old, female 6 mice (Jackson Laboratory, Bar Harbor, ME) were each injected
subcutaneously once per week at a dosage shown below, for a total of six doses, with an oligonucleotide
listed in Table 92 or with PBS. Each treatment group consisted of 3-4 s. Tail bleeds were performed
the day before the first dose and weekly following each dose to determine plasma Apo(a) protein levels. The
mice were sacrificed two days following the final administration. Apo(a) liver mRNA levels were determined
using real-time PCR and RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc. Eugene, OR)
according to rd protocols. Apo(a) plasma protein levels were determined using ELISA, and liver
transaminase levels were determined. The mRNA and plasma protein results in Table 93 are presented as the
treatment group average percent relative to the PBS treated group. Plasma n levels were further
normalized to the baseline (BL) value for the PBS group. Average absolute transaminase levels and body
weights (% ve to baseline averages) are ed in Table 94.
As illustrated in Table 93, treatment with the oligonucleotides lowered Apo(a) liver mRNA and
plasma n levels in a dose-dependent manner. Furthermore, the oligonucleotide comprising the GalNAc
conjugate was significantly more potent with a longer duration of action than the parent oligonucleotide
lacking a GalNAc conjugate. As illustrated in Table 94, minase levels and body weights were
unaffected by the oligonucleotides, indicating that the oligonucleotides were well tolerated.
Table 93
Apo(a) liver mRNA and plasma protein levels
ISIS Dosage Apo(a) mRNA Apo(a) plasma protein (% PBS)
N... (mg/kg) <% PBs>
—‘1_-—m—
494372
681257
Table 94
Dosage (mg/kg) ALT (U/L) AST (U/L) Body weight (% baseline)
3 28 68
494372 10 22 55
——__
681257
Example 90: Antisense inhibition in vivo by oligonucleotides targeting TTR comprising a GalNAc3
cluster
Oligonucleotides listed in Table 95 below were tested in a dose-dependent study for antisense
inhibition of human transthyretin (TTR) in transgenic mice that express the human TTR gene.
TTR transgenic mice were each injected subcutaneously once per week for three weeks, for a total of
three doses, with an oligonucleotide and dosage listed in Table 96 or with PBS. Each treatment group
consisted of 4 animals. Prior to the first dose, a tail bleed was performed to determine plasma TTR protein
levels at baseline (BL). The mice were sacrificed 72 hours following the final administration. TTR protein
levels were measured using a clinical analyzer (AU480, Beckman Coulter, CA). Real-time PCR and
RIBOGREEN® RNA quantification reagent ular Probes, Inc. Eugene, OR) were used according to
standard protocols to determine liver human TTR mRNA levels. The results ted in Table 96 are the
average values for each treatment group. The mRNA levels are the average values relative to the average for
the PBS group. Plasma protein levels are the average values ve to the average value for the PBS group at
ne. “BL” tes baseline, measurements that were taken just prior to the first dose. As illustrated in
Table 96, treatment with nse oligonucleotides lowered TTR expression levels in a dose-dependent
manner. The oligonucleotides comprising a GalNAc conjugate were more potent than the parent lacking a
GalNAc conjugate (ISIS 420915), and oligonucleotides comprising a phosphodiester or denosine
cleavable moiety showed significant ements in potency compared to the parent lacking a conjugate
(see ISIS numbers 682883 and 666943 vs 420915 and see Examples 86 and 87).
2014/036460
Table 95
Oligonucleotides targeting human TTR
Isis No. Sequence 5’ to 3’ Linkages (:figgc CM 118330.
420915 T“Inc“TCSTesGei:i:.:E::fig:ggfdsTdsGdSAdSAdS PS n/a n/a 156
682883 GalNAc3gZ;gifgkfifggjgagfifdsmc“Ads PS/PO GalNAc3-3a PO 156
666943 Galfiéfihéfldzg$.EEE‘ETflnEdAd PS/PO GalNAc3-3a Ad 160
682887 Gallfiacgzné‘fldtigmcégEngdAd PS/PO 3-7a Ad 160
682888 Galflégl‘iongjgdeAfTngEEECTdAd PS/PO GalNAc3-10a Ad 160
682889 Galflégl‘iidgjgdxigmgEEECTdAd PS/PO 3-13a Ad 160
The legend for Table 95 can be found in Example 74. The structure of GalNAc3-3a was shown in Example
39. The structure of 3-7a was shown in Example 48. The structure of GalNAc3-10a was shown in
Example 46. The structure of GalNAc3-13a was shown in Example 62.
Table 96
Antisense inhibition of human TTR in vivo
Isis No. Dosage (mg/kg) TTR mRNA (% PBS) TTR protein (% BL) GalNAc cluster CM
PBS n/a 100 124 n/a n/a
6 69 114
420915 20 71 86 n/a n/a
60 21 36
0.6 61 73
682883 2 23 36 GalNAc3-3a PO
6 18 23
0.6 74 93
666943 2 33 57 GalNAc3-3a Ad
6 17 22
0.6 60 97
682887 2 36 49 GalNAc3-7a Ad
6 12 19
0.6 65 92
682888 2 32 46 GalNAc3-10a Ad
6 17 22
0.6 72 74
682889 2 38 45 GalNAc3-13a Ad
6 16 18
Example 91: nse inhibition in vivo by oligonucleotides targeting Factor VII comprising a
GalNAc3 conjugate in non-human primates
Oligonucleotides listed in Table 97 below were tested in a non-terminal, dose escalation study for
antisense tion of Factor VII in monkeys.
Treatment
Non-naive monkeys were each injected subcutaneously on days 0, 15, and 29 with escalating doses
of an oligonucleotide listed in Table 97 or with PBS. Each treatment group consisted of 4 males and 1
female. Prior to the first dose and at various time points thereafter, blood draws were performed to determine
plasma Factor VII n levels. Factor VII protein levels were ed by ELISA. The results presented in
Table 98 are the average values for each treatment group relative to the e value for the PBS group at
baseline (BL), the measurements taken just prior to the first dose. As illustrated in Table 98, treatment with
antisense oligonucleotides d Factor VII expression levels in a dose-dependent manner, and the
oligonucleotide sing the GalNAc conjugate was significantly more potent in monkeys compared to the
oligonucleotide lacking a GalNAc conjugate.
Table 97
Oligonucleotides targeting Factor VII
. , , . GalNAc SEQ
rAesT‘esCIesmC:eslAesT‘ds(his(LETds(EdsIAdST‘dSCLiSInCLiS'Tds
407935
TesmCesTesGesAe —--
GalNAC3-10a-o’AesTesGesmCesAesTdsGdsGdsTdsGds
686892 :-:GalNAC3 10a P0
AdsTdsGdsmCdsTds TesmCesTesGesAe
The legend for Table 97 can be found in Example 74. The structure of GalNA03-10a was shown in Example
Table 98
Factor VII plasma protein levels
ISIS N0. Day Dose (mg/kg) Factor VII (% BL)
0 n/a 100
10 87
22 n/a 92
407935
29 3O 77
36 n/a 46
43 n/a 43
O 3 100
10 56
22 n/a 29
686892
29 3O 19
36 n/a 15
43 n/a 11
Example 92: Antisense inhibition in primary hepatocytes by antisense oligonucleotides ing Apo-
CIII sing a GalNAc3 conjugate
Primary mouse hepatocytes were seeded in 96-well plates at 15,000 cells per well, and the
oligonucleotides listed in Table 99, targeting mouse ApoC-III, were added at 0.46, 1.37, 4.12, or 12.35,
37.04, 111.11, or 333.33 nM or 1.00 uM. After incubation with the oligonucleotides for 24 hours, the cells
were lysed and total RNA was d using RNeasy (Qiagen). I mRNA levels were ined
using real-time PCR and RIBOGREEN® RNA quantification reagent (Molecular Probes, Inc.) according to
standard protocols. ICso values were determined using Prism 4 software (GraphPad). The results show that
regardless of whether the cleavable moiety was a phosphodiester or a phosphodiester-linked deoxyadensoine,
the oligonucleotides comprising a GalNAc conjugate were significantly more potent than the parent
oligonucleotide lacking a conjugate.
Table 99
Inhibition of mouse APOC-III expression in mouse primary cytes
113:8 Sequence (5’ t0 3’) CM (lg/[50) 118330.
440670 mCesAesGesmCeSTeSTdsTdsAdsTdsTdsAdsGdsGdSGdsAdsmCesAesGeSmCesAe n/a 1 3 .20 1 62
661180 mCesA65GeSEfiZEHTCEiiifflffigjfiggfid:GdSAdSmCeS Ad 1.40 163
GalNAc3-3Ha CeSAeSGes
680771 CXCTEZ$E::::STdsTdsAdsGdsGdsGdsAds Ces
PO 0.70 162
680772 GalNAc3-7a_0amCesAssGesmCXCTEZ$E::::STdSTdSAdSGdSGdSGdSAdSmCes PO 1.70 162
GalNAc3-10a_0s CeSAeSGes ’ijfedSTdsTdsAdsGdsGdSGdSAdS Ces
680773 PO 2.00 162
680774 3-13HamCesAesGesmfifi:?sc1::dfldSTdSAdSGdSGdsGdsAdsmCes PO 1‘ 50 162
GalNAc3-3Ha CeSAeOGeo CXCngisgiidSTdSTdSAdSGdSGdSGdSAdS Ceo
681272 PO < 0.46 162
681 273 GalNAc3-3a-oaAdOmCesA,31(25,::IAC;g“e6:13“é::::AdSTdSTdSAdSGdSGdSGdSAdS Ad 1 . 1 0 1 64
683733 CCSACSGCSAEGTmEdX‘Xngglfi‘fi:(1};GdAd C65 Ad 2.50 163
The ure of GalNA03-1a was shown previously in Example 9, GalNA03-3a was shown in Example 39,
GalNA03-7a was shown in Example 48, GalNA03-10a was shown in Example 46, GalNAc3-13a was shown in
Example 62, and GalNA03-19a was shown in Example 70.
Example 93: Antisense inhibition in vivo by oligonucleotides targeting SRB-l comprising mixed wings
and a 5’-GalNAc3 conjugate
The oligonucleotides listed in Table 100 were tested in a dose-dependent study for antisense
inhibition of SRB-l in mice.
Table 100
Modified ASOs targeting SRB-l
ISIS Sequences (5 ’ to 3 ’) Gal\IAc3 CM SEQ
No. Cluster ID No.
449093 TksTkskasAdsGdsTdsmCds AdsTds Gds STdsTkskaska n/a n/a 165
699806 GalNAC3'3a'o’TksTkskasAdsGdsTdsmCds AdsTds GdsAdsmCds Gal\AC3'3a PO
TCSTkSkaSka
6998O7 GalNAC3'7a'0’TksTkskasAdsGdsTdsmCds AdsTds GdsAdsmCds Gal\AC3'73 PO
TCSTkSkaSka
699809 GalNAC3'7a'0’ TksTkskasAdsGdsTdsmCds AdsTds Gds AdsmCds Gal\AC3'7a PO
TcsTeSmCesmCe
69981 1 3'7a'0’TesTesmCesAdsGdsTdsmCds AdsTds GdsAdsmCds Gal\AC3'7a PO
TCSTkSkaSka
699813 GalNAC3'7a'0’TksTdskasAdsGdsTdsmCds AdsTds GdsAdsmCds Gal\AC3'7a PO
TCSTkSmCdSka
699815 GalNAC3'7a-0’TesTkskasAdsGdsTdsmCds AdsTds GdsAdsmCds Gal\AC3'7a PO
TcsFlemC1§sInCe
The ure of 3-3a was shown previously in Example 39, and the structure of GalNAc3-7a was
shown previously in Example 48. Subscripts: “e” indicates 2’-MOE modified nucleoside; “(1” indicates B-D-
2’-deoxyribonucleoside; “k” indicates 6’-(S)-CH3 bicyclic nucleoside (cEt); “s” indicates phosphorothioate
intemucleoside linkages (PS); “0” indicates phosphodiester intemucleoside linkages (PO). Supersript “m”
indicates 5-methylcytosines.
Treatment
Six to eight week old C57BL/6 mice (Jackson Laboratory, Bar Harbor, ME) were injected
subcutaneously once at the dosage shown below with an oligonucleotide listed in Table 100 or with saline.
Each treatment group ted of 4 animals. The mice were sacrificed 72 hours following the final
administration. Liver SRB-l mRNA levels were measured using real-time PCR. SRB-l mRNA levels were
normalized to cyclophilin mRNA levels according to standard protocols. The results are presented as the
average percent of SRB-l mRNA levels for each ent group relative to the saline control group. As
illustrated in Table 10], treatment with antisense oligonucleotides lowered SRB-l mRNA levels in a dose-
ent manner, and the gapmer oligonucleotides sing a GalNAc conjugate and having wings that
were either full cEt or mixed sugar modifications were cantly more potent than the parent
oligonucleotide lacking a conjugate and comprising full cEt modified wings.
Body weights, liver transaminases, total bilirubin, and BUN were also ed, and the average
values for each treatment group are shown in Table 101. Body weight is shown as the average t body
weight relative to the baseline body weight (% BL) ed just prior to the oligonucleotide dose.
Table 101
SRB-l mRNA, ALT, AST, BUN, and total bilirubin levels and body weights
ISIS Dosage SRB-l mRNA ALT AST Body weight
Bil BUN
No. (mg/kg) (% PBS) (U/L) (U/L) (% BL)
PBS n/a 100 31 84 0.15 28 102
1 111 18 48 0.17 31 104
449093 3 94 20 43 0.15 26 103
36 19 50 0.12 29 104
0.1 114 23 58 0.13 26 107
699806 0.3 59 21 45 0.12 27 108
1 25 30 61 0.12 30 104
0.1 121 19 41 0.14 25 100
699807 0.3 73 23 56 0.13 26 105
1 24 22 69 0.14 25 102
0.1 125 23 57 0.14 26 104
699809 0.3 70 20 49 0.10 25 105
1 33 34 62 0.17 25 107
0.1 123 48 77 0.14 24 106
699811 0.3 94 20 45 0.13 25 101
1 66 57 104 0.14 24 107
0.1 95 20 58 0.13 28 104
699813 0.3 98 22 61 0.17 28 105
1 49 19 47 0.11 27 106
0.1 93 30 79 0.17 25 105
699815 0.3 64 30 61 0.12 26 105
1 24 18 41 0.14 25 106
Example 94: Antisense inhibition in vivo by oligonucleotides targeting SRB-l comprising 2’-sugar
modifications and a 5’-GalNAc3 conjugate
The oligonucleotides listed in Table 102 were tested in a dose-dependent study for antisense
inhibition of SRB-l in mice.
Table 102
Modified ASOs targeting SRB-l
ISIS Sequences (5’ to 3 ’) GalNA03 CM SEQ
No. Cluster ID No.
3 5 3 3 82 GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTesmCesmCes n/a n/a
TesTe
700989 GmsCmsUmsUmsCmsAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsUmsCmsCms n/a n/a
1 66
UmsUm
666904 GalNAC3-33'0’GesmCesTesTesmCesAdsGdsTdsmCdsAdsTdsGdsAds GalNAC3_3 a PO
InC:dsTdsTesmC:esmC:esTesTe
700991 GalNAc3'7a'0’GmsCmsUmsUmsCmsAdsGdsTdsmCdsAdsTdsGds GalNAC3_7a PO
1 66
AdsmCdsTdsUmsCmsCmsUmsUm
Subscript “m” indicates a 2’-O-methyl modified side. See Example 74 for te table . The
structure of GalNAC3-3a was shown previously in Example 39, and the structure of GalNA03-7a was shown
usly in Example 48.
Treatment
The study was completed using the protocol described in Example 93. Results are shown in Table
103 below and show that both the 2’-MOE and 2’-OMe modified oligonucleotides comprising a GalNAc
conjugate were significantly more potent than the respective parent oligonucleotides lacking a ate. The
results of the body weights, liver transaminases, total bilirubin, and BUN ements indicated that the
compounds were all well tolerated.
Table 103
SRB-l mRNA
ISIS No. Dosage ) SRB-l mRNA (% PBS)
PBS n/a 100
116
353382 15 58
45 27
120
700989 15 92
45 46
1 98
666904 3 45
17
1 118
700991 3 63
14
Example 95: Antisense inhibition in vivo by oligonucleotides targeting SRB-l comprising bicyclic
nucleosides and a 5’-GalNAc3 conjugate
The oligonucleotides listed in Table 104 were tested in a dose-dependent study for antisense
inhibition of SRB-l in mice.
Table 104
Modified ASOs targeting SRB-l
11338 Sequences (5’ to 3 ’) (Egg? CM $330
440762 TkskasAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTkska n/a n/a 1 3 7
666905 GalNAc3-3a'o’TkskasAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTkska GalNA03'3 a PO 1 3 7
699782 GalNAC3-7a-0’TkskaSAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTkska GalNA03'7a PO 1 3 7
699783 GalNAC3-3a-oaTlsmclsAdsGdsTdsmcdsAdsTdsGdsAdsmCdSTdsTlsmcl 3'3a PO 137
653 621 TlsmclsAdsGdsTdsmcdsAdsTdsGdsAdsmCdSTdsTlsmcloAdO’-GalNAc3-1 a GalNA03' 1 a Ad 1 3 8
439879 TgmchdsGdSTdsmCdsAdsTd GdsAdsmCdsTdSTngg n/a n/a 137
699789 GalNAc3-3a-0aTgsmCgsAdsGdsTdsmCdsAdSTd mCdSTdsTngg 3'3a PO 137
Subscript “g” indicates a fluoro-HNA nucleoside, subscript “1” indicates a locked nucleoside comprising a 2’-
O-CH2-4’ bridge. See the e 74 table legend for other abbreviations. The structure of GalNAc3-1a was
shown previously in Example 9, the structure of GalNAc3-3a was shown usly in Example 39, and the
structure of GalNAc3-7a was shown previously in Example 48.
Treatment
The study was completed using the protocol bed in Example 93. Results are shown in Table
105 below and show that oligonucleotides sing a GalNAc conjugate and various bicyclic nucleoside
modifications were significantly more potent than the parent oligonucleotide lacking a conjugate and
sing bicyclic nucleoside modifications. Furthermore, the oligonucleotide comprising a GalNAc
ate and fluoro-HNA modifications was significantly more potent than the parent lacking a conjugate
and comprising fluoro-HNA ations. The s of the body weights, liver transaminases, total
bilirubin, and BUN measurements indicated that the compounds were all well tolerated.
Table 105
SRB-l mRNA, ALT, AST, BUN, and total bilirubin levels and body weights
ISIS No. Dosage (mg/kg) SRB-l mRNA (% PBS)
PBS n/a 100
1 104
440762 3 65
35
0.1 105
666905 0.3 56
1 18
0.1 93
699782 0.3 63
1 15
0.1 105
699783 0.3 53
1 12
0.1 109
653621 0.3 82
1 27
1 96
439879 3 77
37
0.1 82
699789 0.3 69
1 26
Example 96: Plasma protein binding of antisense oligonucleotides comprising a GalNAc3 conjugate
group
Oligonucleotides listed in Table 70 targeting ApoC-IH and oligonucleotides in Table 106 targeting
Apo(a) were tested in an ultra-filtration assay in order to assess plasma protein binding.
Table 106
d oligonucleotides targeting Apo(a)
ISIS
sequences (5 , to 3 ,
GalNAc3 SEQ
) CM
No. Cluster ID No
Tescjes CesTes Ces
494372 CdsGdsTdf‘TLIiggdsGdsTdsGds CdsTdsTesGesTes
n/a n/a 58
Tescjeo CeoTeo Ceo CdsTdsTeoGeoTes
693401 Tdfs‘TfilsgdsGdsTdsGds n/a n/a 58
GalNAc3'7a'o’TesGes CesTes Ces
681251 CdsidsTdsTdsGdsGdsTdsGds Cds
3—7a P0 58
TdsTescjesTesTes Ce
GalNAc3'7a'o’TesGeo CeoTeo Ceo
681257 CdsgdsTdsTdsGdsGdsTdsGds Cds
GalNAc3—7a P0 58
cjeoTesTes Ce
See the Example 74 for table legend. The structure of GalNAc3-7a was shown previously in Example 48.
Ultrafree-MC ltration units (30,000 NMWL, low-binding regenerated cellulose membrane,
Millipore, Bedford, MA) were pre-conditioned with 300 uL of 0.5% Tween 80 and centrifuged at 2000 g for
minutes, then with 300uL of a 300 ug/mL solution of a control oligonucleotide in H20 and centrifuged at
2000 g for 16 s. In order to assess non-specific binding to the filters of each test oligonucleotide from
Tables 70 and 106 to be used in the studies, 300 uL of a 250 ng/mL solution of oligonucleotide in H20 at pH
7.4 was placed in the pre-conditioned filters and centrifuged at 2000 g for 16 minutes. The unfiltered and
filtered samples were analyzed by an ELISA assay to ine the oligonucleotide concentrations. Three
replicates were used to obtain an average concentration for each sample. The average concentration of the
filtered sample relative to the unfiltered sample is used to determine the percent of oligonucleotide that is
recovered through the filter in the absence of plasma (% recovery).
Frozen whole plasma samples collected in K3-EDTA from , drug-free human volunteers,
cynomolgus monkeys, and CD-1 mice, were purchased from Bioreclamation LLC (Westbury, NY). The test
oligonucleotides were added to 1.2 mL aliquots of plasma at two concentrations (5 and 150 ug/mL). An
aliquot (300 uL) of each spiked plasma sample was placed in a pre-conditioned filter unit and incubated at
37°C for 30 minutes, immediately followed by centrifugation at 2000 g for 16 minutes. Aliquots of filtered
and unfiltered spiked plasma samples were ed by an ELISA to ine the oligonucleotide
concentration in each sample. Three replicates per concentration were used to determine the average
percentage of bound and unbound oligonucleotide in each sample. The average concentration of the filtered
sample relative to the tration of the unfiltered sample is used to determine the percent of
oligonucleotide in the plasma that is not bound to plasma proteins (% unbound). The final unbound
oligonucleotide values are corrected for non-specific binding by dividing the % unbound by the % recovery
for each oligonucleotide. The final % bound oligonucleotide values are determined by cting the final %
unbound values from 100. The results are shown in Table 107 for the two concentrations of oligonucleotide
tested (5 and 150 ug/mL) in each species of plasma. The results show that GalNAc ate groups do not
have a significant impact on plasma n binding. Furthermore, oligonucleotides with filll PS
intemucleoside linkages and mixed PO/PS es both bind plasma ns, and those with full PS
linkages bind plasma ns to a somewhat greater extent than those with mixed PO/PS linkages.
Table 107
Percent of modified oligonucleotide bound to plasma proteins
ISIS Human plasma Monkey plasma Mouse plasma
No. 5 ug/mL 150 ug/mL 5 ug/mL 150 ug/mL 5 ug/mL 150 ug/mL
304801 99.2 98.0 99.8 99.5 98.1 97.2
663083 97.8 90.9 99.3 99.3 96.5 93.0
674450 96.2 97.0 98.6 94.4 94.6 89.3
494372 94.1 89.3 98.9 97.5 97.2 93.6
693401 93.6 89.9 96.7 92.0 94.6 90.2
681251 95.4 93.9 99.1 98.2 97.8 96.1
681257 93.4 90.5 97.6 93.7 95.6 92.7
Example 97: Modified oligonucleotides targeting TTR comprising a GalNAc3 conjugate group
The oligonucleotides shown in Table 108 comprising a GalNAc conjugate were ed to target
TTR.
Table 108
Modified oligonucleotides targeting TTR
ces (5 ,
GalNAc3 SEQ ID
ISIS No. to 3 , ) CM
Cluster No
GalNAc3'3a-0’Ado Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds
666941 GalNAC3_3 Ad 160
Ads Tds Gds Ads Ads Aes Tes InC:es InC:es InC:e
Tes mCeo Te0 Te0 Geo Gds Tds Tds Ads InC:ds Ads Tds Gds Ads Ads
666942 GalNAcg-l Ad 157
A60 T60 mCes mCes mCeo Ado"GalNAc3-3a
GalNAc3'3a-0’Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds Ads Tds
682876 GalNA03—3 PO 156
Gds Ads Ads Aes Tes mCes mCes mCe
GalNAc3'7a-0’Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds Ads Tds
682877 GalNA03-7 PO 156
Gds Ads Ads Aes Tes mCes mCes mCe
GalNAc3'10a-0’Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds Ads
682878 GalNA03—10 PO 156
Tds Gds Ads Ads Aes Tes mCes mCes mCe
GalNAc3'13a-0’Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds Ads
682879 GalNAcg-13 PO 156
Tds Gds Ads Ads Aes Tes mCes mCes mCe
GalNAc3'7a-0’Ado Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds
682880 GalNAC3_7 Ad 160
Ads Tds Gds Ads Ads Aes Tes InC:es InC:es InC:e
3'10a-0’Ado Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds
682881 GalNAC3_10 Ad 160
Ads Tds Gds Ads Ads Aes Tes InC:es InC:es InC:e
GalNAc3'13a-0’Ado Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds
682882 GalNAC3_13 Ad 160
Ads Tds Gds Ads Ads Aes Tes InC:es InC:es InC:e
Tes InC:es Tes Tes Ges Gds Tds Tds Ads InC:ds Ads Tds Gds Ads Ads
684056 GalNA03-19 Ad 157
Aes Tes mCes mCes mCeo Adoa-GalNAc3-19a
The legend for Table 108 can be found in Example 74. The structure of GalNAcg-l was shown in Example 9.
The structure of GalNAC3-3a was shown in Example 39. The structure of GalNAcg-7a was shown in Example
48. The structure of GalNAcg-IOa was shown in Example 46. The structure of g-13a was shown in
Example 62. The structure of GalNAcg-19a was shown in Example 70.
Example 98: Evaluation of pro-inflammatory effects of ucleotides comprising a GalNAc
conjugate in hPMBC assay
The oligonucleotides listed in Table 109 and were tested for pro-inflammatory effects in an hPMBC
assay as described in Examples 23 and 24. (See Tables 30, 83, 95, and 108 for descriptions of the
ucleotides.) ISIS 353512 is a high responder used as a positive control, and the other oligonucleotides
are described in Tables 83, 95, and 108. The results shown in Table 109 were obtained using blood from one
volunteer donor. The results show that the oligonucleotides comprising mixed PO/PS internucleoside
linkages produced significantly lower pro-inflammatory responses compared to the same oligonucleotides
having full PS linkages. Furthermore, the GalNAc conjugate group did not have a significant effect in this
assay.
Table 109
ISIS No. Emax/ECSO GalNA03 cluster Linkages CM
353512 3630 n/a PS n/a
420915 802 n/a PS n/a
682881 1311 GalNA03-10 PS Ad
682888 0.26 GalNA03-10 PO/PS Ad
684057 1.03 GalNA03-19 PO/PS Ad
Example 99: Binding affinities of oligonucleotides comprising a GalNAc ate for the
asialoglycoprotein receptor
The binding affinities of the oligonucleotides listed in Table 110 (see Table 76 for ptions of the
oligonucleotides) for the asialoglycoprotein receptor were tested in a competitive receptor binding assay. The
competitor ligand, (XI-acid glycoprotein (AGP), was incubated in 50 mM sodium acetate buffer (pH 5) with 1
U neuraminidase-agarose for 16 hours at 37°C, and > 90% desialylation was med by either sialic acid
assay or size exclusion chromatography (SEC). Iodine monochloride was used to iodinate the AGP according
to the procedure by Atsma et a1. (see J Lipid Res. 1991 Jan; 32(1):]73-81.) In this method, desialylated or]-
acid glycoprotein (de-AGP) was added to 10 mM iodine de, Na125I, and 1 M glycine in 0.25 M NaOH.
After incubation for 10 minutes at room temperature, 125I ed de-AGP was separated from free 125I by
concentrating the e twice utilizing a 3 KDMWCO spin column. The protein was tested for labeling
efficiency and purity on a HPLC system equipped with an Agilent SEC-3 column (7.8x300mm) and a 13-
RAM r. Competition experiments utilizing 125I -labeled de-AGP and various GalNAc-cluster
containing ASOs were performed as follows. Human HepG2 cells (106 cells/ml) were plated on 6-well plates
in 2 ml of riate grth media. MEM media supplemented with 10% fetal bovine serum (FBS), 2 mM
L-Glutamine and 10mM HEPES was used. Cells were incubated 16-20 hours @ 37°C with 5% and 10% C02
respectively. Cells were washed with media t FBS prior to the experiment. Cells were incubated for 30
min @37°C with 1ml competition mix containing appropriate growth media with 2% FBS, 10'8 M 125 l
d de-AGP and GalNAc-cluster containing ASOs at concentrations ranging from 10'11 to 10'5 M. Non-
specific binding was ined in the presence of 10'2 M GalNAc sugar. Cells were washed twice with
media without FBS to remove unbound 1251 -labeled de-AGP and competitor GalNAc ASO. Cells were lysed
using Qiagen’s RLT buffer containing 1% B-mercaptoethanol. Lysates were transferred to round bottom
assay tubes after a brief 10 min freeze/thaw cycle and assayed on a y-counter. Non-specific binding was
subtracted before dividing 1251 n counts by the value of the lowest GalNAc-ASO concentration counts.
The tion curves were fitted according to a single site competition binding equation using a nonlinear
regression algorithm to ate the binding affinities (KD’s).
The results in Table 110 were obtained from experiments med on five different days. Results
for oligonucleotides marked with superscript “a” are the average of experiments run on two different days.
The results show that the oligonucleotides comprising a GalNAc conjugate group on the 5’-end bound the
asialoglycoprotein receptor on human HepG2 cells with 1.5 to d greater affinity than the
oligonucleotides comprising a GalNAc ate group on the 3’-end.
Table 110
Asialoglycoprotein receptor binding assay results
Oligonucleotide end to
ISIS No. GalNAc conjugate which GalNAc conjugate KD (nM)
is attached
661161a GalNAc3-3 5’ 3.7
666881a GalNAc3-10 5’ 7.6
666981 3-7 5’ 6.0
670061 GalNAc3-13 5’ 7.4
655861a GalNAc3-1 3’ 11.6
677841a GalNAc3-19 3’ 60.8
Example 100: Antisense inhibition in vivo by oligonucleotides comprising a GalNAc conjugate group
targeting Apo(a) in vivo
The oligonucleotides listed in Table 111a below were tested in a single dose study for duration of
action in mice.
Table 111a
Modified ASOs targeting APO(a)
113:8 Sequences (5’ to 3’) (31111:? CM 118330.
681251 GalNA“JEEZSEEZi::G:ejr:Tdfnd§dSTdSGdSGds GalNAc3-7a P0 58
681257 GalNA“3'73;E}:§a§:§:§c}:e°TE§aTdSTdSGdSGdS 3-7a P0 58
The structure of GalNAc3-7a was shown in Example 48.
Treatment
Female transgenic mice that s human Apo(a) were each injected subcutaneously once per
week, for a total of 6 doses, with an oligonucleotide and dosage listed in Table 111b or with PBS. Each
treatment group consisted of 3 animals. Blood was drawn the day before dosing to determine baseline levels
of Apo(a) protein in plasma and at 72 hours, 1 week, and 2 weeks following the first dose. Additional blood
draws will occur at 3 weeks, 4 weeks, 5 weeks, and 6 weeks following the first dose. Plasma Apo(a) protein
levels were measured using an ELISA. The results in Table 111b are presented as the e percent of
plasma Apo(a) protein levels for each treatment group, normalized to baseline levels (% BL), The s
show that the oligonucleotides comprising a GalNAc conjugate group exhibited potent reduction in Apo(a)
expression. This potent effect was ed for the oligonucleotide that comprises full PS internucleoside
linkages and the oligonucleotide that comprises mixed PO and PS linkages.
Table 111b
Ap0(a) plasma protein levels
Apo(a) at 72 hours Apo(a) at 1 week Apo(a) at 3 weeks
ISIS No. Dosage )
(% BL) (% BL) (% BL)
PBS n/a 116 104 107
0.3 97 108 93
1.0 85 77 57
681251
3.0 54 49 11
.0 23 15 4
0.3 114 138 104
1.0 91 98 54
681257
3.0 69 40 6
.0 30 21 4
Example 101: Antisense inhibition by oligonucleotides comprising a GalNAc cluster linked via a stable
moiety
The oligonucleotides listed in Table 112 were tested for tion of mouse APOC-III expression in
vivo. C57Bl/6 mice were each injected subcutaneously once with an oligonucleotide listed in Table 112 or
with PBS. Each treatment group consisted of 4 animals. Each mouse treated with ISIS 440670 received a
dose of 2, 6, 20, or 60 mg/kg. Each mouse d with ISIS 680772 or 696847 received 0.6, 2, 6, or 20
mg/kg. The GalNAc conjugate group of ISIS 696847 is linked via a stable moiety, a phosphorothioate
linkage instead of a readily cleavable phosphodiester containing linkage. The animals were sacrificed 72
hours after the dose. Liver APOC-III mRNA levels were measured using real-time PCR. APOC-III mRNA
levels were normalized to cyclophilin mRNA levels according to standard ols. The results are
presented in Table 112 as the average percent of APOC-III mRNA levels for each treatment group ve to
the saline control group. The results show that the ucleotides comprising a GalNAc conjugate group
were significantly more potent than the oligonucleotide lacking a conjugate group. Furthermore, the
ucleotide comprising a GalNAc conjugate group linked to the oligonucleotide via a cleavable moiety
(ISIS 680772) was even more potent than the oligonucleotide comprising a GalNAc conjugate group linked
to the oligonucleotide via a stable moiety (ISIS ).
Table 1 12
Modified oligonucleotides ing mouse APOC-III
Dosage APOC-III
11:18 SEQ
Sequences (5 ’ to 3 ’) CM (mg/kg) mRNA (%
0. ID No.
PBS)
2 92
InC:es146:3ClesmC:esTesTdsTdslAdsTdsTdslAds 6 86
440670 n/a 162
GdsGdsGdsAdsmCes AesGes InC:eslAe 20 59
60 3 7
0.6 79
GalNAc3'7a-0’mCesAesGesmCesTesTdsTdsAds 2 5 8
680772 PO 162
TdSTdSAdSGdS dsladsmcks AesGesmCesAe 6 3 1
1 3
0 . 6 83
GalNAc3'7a-s’mCesAesGesmCesTesTdsTdsAdsTds 2 73
696847 n/a (PS—) 162
TdsAdsGdsGdsGdsAdsmCes AesGesmCesAe 6 4O
28
The structure of GalNAc3-7a was shown in Example 48.
Example 102: Distribution in liver of antisense oligonucleotides comprising a GalNAc conjugate
The liver distribution of ISIS 353382 (see Table 36) that does not se a GalNAc conjugate and
ISIS 655861 (see Table 36) that does se a GalNAc conjugate was evaluated. Male balb/c mice were
subcutaneously injected once with ISIS 353382 or 655861 at a dosage listed in Table 113. Each treatment
group consisted of 3 s except for the 18 mg/kg group for ISIS 655861, which consisted of 2 animals.
The animals were sacrificed 48 hours following the dose to determine the liver distribution of the
oligonucleotides. In order to measure the number of antisense oligonucleotide molecules per cell, a
Ruthenium (II) tris-bipyridine tag (MSD TAG, Meso Scale Discovery) was conjugated to an oligonucleotide
probe used to detect the antisense oligonucleotides. The results presented in Table 113 are the average
concentrations of oligonucleotide for each ent group in units of millions of oligonucleotide molecules
per cell. The results show that at equivalent doses, the ucleotide comprising a GalNAc conjugate was
present at higher concentrations in the total liver and in hepatocytes than the ucleotide that does not
comprise a GalNAc conjugate. Furthermore, the oligonucleotide comprising a GalNAc conjugate was present
at lower concentrations in non-parenchymal liver cells than the oligonucleotide that does not se a
GalNAc conjugate. And while the concentrations of ISIS 655 861 in hepatocytes and non-parenchymal liver
cells were similar per cell, the liver is approximately 80% hepatocytes by volume. Thus, the majority of the
ISIS 655 861 oligonucleotide that was present in the liver was found in hepatocytes, whereas the majority of
the ISIS 353382 oligonucleotide that was present in the liver was found in non-parenchymal liver cells.
Table 113
ISIS Dosage Concentration in whole Concentration in Concentration in non-
llver (molecules*10A6 hepatocytes parenchymal 11ver cells
No' (mg/kg)
per cell) (molecules*10A6 per cell) (molecules*10A6 per cell)
3 9.7 1.2 37.2
17.3 4.5 34.0
23.6 6.6 65.6
353382
29.1 11.7 80.0
60 73.4 14.8 98.0
90 89.6 18.5 119.9
0.5 2.6 2.9 3.2
1 6.2 7.0 8.8
655861 3 19.1 25.1 28.5
6 44.1 48.7 55.0
18 76.6 82.3 77.1
Example 103: Duration of action in vivo of oligonucleotides targeting APOC-III comprising a GalNAc3
conjugate
The oligonucleotides listed in Table 114 below were tested in a single dose study for duration of
action in mice.
Table 1 14
Modified ASOs targeting APOC-III
ISIS Sequences (5 ’ to 3 ’) GalNAc3 CM SEQ
No. Cluster ID No.
3 04 8 01 AesGesmcesTCSTesmCdSTdSTdsGdSTdSmCdsmCdsAdSGdsmCdsTesTes n/a n/a 13 5
663 O84 GalNAc3-3a-O’AdersGeomCCOTCOTCOmCdSTdSTdSGdSTdSmCdS GalNAC3'3 3 Ad 151
mCdsAdsGdsmCdsTeoTeo TesAesTe
679241 AesGeomCeoTeoTeomCdsTdsTdsGdsTdsmCdsmCdsAdsGdsmCdsTeoTeo GalNAc3-19a Ad 13 6
TesAesTeoAdoa-GalNAc3-19a
The structure of 3-3a was shown in Example 39, and 3-19a was shown in Example 70.
Treatment
Female transgenic mice that express human APOC-HI were each injected subcutaneously once with
an oligonucleotide listed in Table 114 or with PBS. Each treatment group consisted of 3 animals. Blood was
drawn before dosing to determine baseline and at 3, 7, 14, 21, 28, 35, and 42 days following the dose. Plasma
triglyceride and APOC-III protein levels were measured as described in Example 20. The results in Table 115
are ted as the average t of plasma triglyceride and APOC-III levels for each treatment group,
normalized to baseline levels. A comparison of the results in Table 71 of e 79 with the results in Table
115 below show that oligonucleotides comprising a mixture of phosphodiester and phosphorothioate
internucleoside linkages exhibited increased duration of action than equivalent oligonucleotides comprising
only phosphorothioate internucleoside linkages.
Table 115
Plasma triglyceride and APOC-III protein levels in transgenic mice
T1me pomt
ISIS Dosage Triglycerides AFDC-HI 3 CM
(days p05“ prom (%
No' (mg/kg) (% baseline) Cluster
dose) ne)
3 96 101
7 88 98
14 91 103
PBS n/a 21 69 92 n/a n/a
28 83 81
65 86
42 72 88
3 42 46
7 42 51
14 59 69
304801 30 21 67 81 n/a n/a
28 79 76
72 95
42 82 92
3 35 28
7 23 24
14 23 26
663084 10 21 23 29 GalNAc3-3a Ad
28 30 22
32 36
42 37 47
3 38 30
7 31 28
14 30 22
679241 10 21 36 34 Gag“? Ad
28 48 34
50 45
42 72 64
2014/036460
Example 104: Synthesis of ucleotides comprising a 5’-GalNAc2 conjugate
HN'BOC HN’BOC
HBTU, HOBt O
+ H TFA
BomN OH H2N\/\/\)LO —> BomN NMO 4’
H DIEA, DMF H
o o mDOM
120 126 85% 231
0A0 0A0 F
NH\/\/\)OJ\ 0F D'EA
o +
A00 ONgt
o ACHN 0
166 F
0A0 0A0
moi/[4’0 0A0 0A0
55* O
mo 0W
ACHN
ACHN NH
1. H2 Pd/C MeOH
0A0 2 PFPTFA DMF 0A0 0A0 F F
o 0
A00IfA20 OWN ONO/w A00 OW NWI5go
ACHN ACHN N O F
o F
O 83e OH OH
3' 5' H O O
OLIGO 0_ _Fl’ 0_(CH2)6 NH2— Hofiow
ACHN NH
1. Borate buffer, DMSO, pH 8.5, rt OH OH
HOE go o
N\/\/\)L
2. aq. ammonia, rt HAOCHN OWN HMO -m-OLIGO
Compound 120 is commercially available, and the synthesis of compound 126 is described in
Example 49. Compound 120 (1 g, 2.89 mmol), HBTU (0.39 g, 2.89 mmol), and HOBt (1.64 g, 4.33 mmol)
were dissolved in DMF (10 mL. and sopropylethylamine (1.75 mL, 10.1 mmol) were added. After
about 5 min, aminohexanoic acid benzyl ester (1.36 g, 3.46 mmol) was added to the reaction. After 3h, the
reaction mixture was poured into 100 mL of 1 M NaHSO4 and extracted with 2 x 50 mL ethyl acetate.
Organic layers were combined and washed with 3 x 40 mL sat NaHC03 and 2 x brine, dried with Na2S04,
filtered and concentrated. The product was purified by silica gel column chromatography (DCM:EA:Hex
1:1 :1) to yield compound 231. LCMS and NMR were consistent with the structure. Compounds 231 (1.34 g,
2.438 mmol) was dissolved in dichloromethane (10 mL) and racetic acid (10 mL) was added. After
stirring at room ature for 2h, the reaction mixture was concentrated under reduced pressure and c0-
evaporated with toluene ( 3 x 10 mL). The residue was dried under reduced pressure to yield compound 232
as the oracetate salt. The synthesis of compound 166 is described in e 54. Compound 166 (3.39
g, 5.40 mmol) was dissolved in DMF (3 mL). A solution of compound 232 (1.3 g, 2.25 mmol) was dissolved
in DMF (3 mL) and N,N—diisopropylethylamine (1.55 mL) was added. The reaction was stirred at room
temperature for 30 minutes, then poured into water (80 mL) and the aqueous layer was extracted with
EtOAc (2x100 mL). The organic phase was separated and washed with sat. aqueous NaHC03 (3 x 80 mL), 1
WO 79625
M NaHSO4 (3 x 80 mL) and brine (2 x 80 mL), then dried (NaZSO4), filtered, and concentrated. The e
was purified by silica gel column chromatography to yield compound 233. LCMS and NMR were consistent
with the structure. Compound 233 (0.59 g, 0.48 mmol) was dissolved in methanol (2.2 mL) and ethyl acetate
(2.2 mL). Palladium on carbon (10 wt% Pd/C, wet 0.07 g) was added, and the reaction mixture was stirred
under hydrogen atmosphere for 3 h. The reaction mixture was d through a pad of Celite and
concentrated to yield the carboxylic acid. The carboxylic acid (1.32 g, 1.15 mmol, cluster free acid) was
dissolved in DMF (3.2 mL). To this N,N—diisopropylehtylamine (0.3 mL, 1.73 mmol) and PFPTFA (0.30 mL,
1.73 mmol) were added. After 30 min stirring at room ature the reaction mixture was poured into
water (40 mL) and extracted with EtOAc (2 x 50 mL). A standard work-up was completed as described
above to yield compound 234. LCMS and NMR were consistent with the structure. Oligonucleotide 235 was
prepared using the general ure described in Example 46. The GalNAcZ cluster portion (GalNAc2-24a)
of the conjugate group 2-24 can be ed with any cleavable moiety present on the
oligonucleotide to e a variety of conjugate groups. The structure of GalNAc2-24 (GalNAc2-24a-CM) is
shown below:
OH OH
ACHNHAOC%’Ox/\/\)J\;
OHOH
ON\/\/\j\NAM/\OWE
Example 105: Synthesis of oligonucleotides sing a GalNAc1-25 conjugate
O_|O| 83e
—5.OL—GO —o—(CH2)6-NH2
OACOAc |
Rog/owJfl;1. Borate buffer DMSO pH 8.5OH rt
AcHN
2. aq. ammonia, rt
OH OH
0MN14-om
AcHN
The synthesis of compound 166 is described in Example 54. Oligonucleotide 236 was prepared using
the general procedure described in Example 46.
Alternatively, oligonucleotide 236 was synthesized using the scheme shown below, and compound
238 was used to form the oligonucleotide 236 using procedures described in Example 10.
OAC /OH OAc
ACOQVLOWOA H2N 0A
AGO OW
+ PFPTFA
NHAc N/\/\/\/OH NHAc OH
TEA, Acetonltrlle_ _ H
tetrazole, 1-Methylimidazole, DMF
O O
AGO OW Y
N/\/\/\/o N
2-cyanoethyltetraisopropyl phosphorodiamidite NHAc \p’ Y
H |
238 01
OH OH
Oligonucleotide
synthesis HO O
’ O\/\/\)J\ fi
OLIGO
N o
ACHN H 6
The GalNAc1 cluster portion (GalNAc1-25a) of the conjugate group GalNAc1-25 can be combined with any
cleavable moiety present on the oligonucleotide to provide a variety of conjugate groups. The structure of
GalNAc1-25 c1-25a-CM) is shown below:
OH OH
HO 0
OMNAO,- 3
ACHN H 6
Example 106: Antisense inhibition in vivo by oligonucleotides ing SRB-l comprising a 5’-
GalNAcz or a 5’-GalNAc3 conjugate
Oligonucleotides listed in Tables 116 and 117 were tested in dose-dependent studies for nse
inhibition of SRB-l in mice.
Treatment
Six to week old, male C57BL/6 mice (Jackson Laboratory, Bar Harbor, ME) were injected
subcutaneously once with 2, 7, or 20 mg/kg of ISIS No. 440762; or with 0.2, 0.6, 2, 6, or 20 mg/kg of ISIS
No. 686221, 686222, or 708561; or with saline. Each treatment group consisted of 4 animals. The mice were
sacrificed 72 hours following the final administration. Liver SRB-l mRNA levels were measured using real-
time PCR. SRB-l mRNA levels were normalized to hilin mRNA levels according to standard
protocols. The antisense ucleotides lowered SRB-l mRNA levels in a dose-dependent manner, and the
EDSO results are presented in Tables 116 and 117. Although previous studies showed that trivalent GalNAc-
ated ucleotides were significantly more potent than nt GalNAc-conjugated
oligonucleotides, which were in turn significantly more potent than monovalent GalNAc conjugated
oligonucleotides (see, e.g., Khorev et al., Bioorg. & Med. Chem, Vol. 16, 5216-5231 (2008)), treatment with
antisense oligonucleotides comprising monovalent, divalent, and trivalent GalNAc clusters lowered SRB-l
mRNA levels with similar potencies as shown in Tables 116 and 117.
Table 1 1 6
Modified oligonucleotides targeting SRB-l
ISIS , , ED50 SEQ
Sequences (5 to 3 ) GalNAc Cluster
No. (mg/kg) ID No
440762 TkskasAdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTkska n/a 4. 7 l 3 7
686221 GalNAc2-24a-0’Adogks gdsTds CdSAdSTdSGdSAdS
Z'24a O39 141
CdsTdsTks Ck
686222 GalNAc3-13a'0’AdOEks CkSAdsgdsTds CdSAdSTdSGdSAdS
GalNAC3-13a 041 141
CdsTdsTks Ck
See Example 93 for table legend. The structure of GalNAc3-13a was shown in Example 62, and the structure
of GalNAc2-24a was shown in Example 104.
Table 117
d oligonucleotides targeting SRB-l
ISIS
Sequences (5 , to 3 ,
ED50 SEQ
) GalNAc Cluster
No. (mg/kg) ID No
440762 AdsGdsTdsmCdsAdsTdsGdsAdsmCdsTdsTkska 1 3 7
GalNAcl'Zsa'o’TkI: tnsTds CdsAdsTdsGdsAds
708561 GalNAc125a
CdsTdsTks Ck
See Example 93 for table legend. The structure of GalNAc1-25a was shownIn Example 105.
The concentrations of the ucleotides in Tables 116 and 117 in liver were also assessed, using
procedures described in Example 75. The results shown in Tables 117a and 117b below are the average total
antisense oligonucleotide tissues levels for each treatment group, as measured by UV in units of ug
oligonucleotide per gram of liver . The results show that the ucleotides comprising a GalNAc
conjugate group accumulated in the liver at significantly higher levels than the same dose of the
oligonucleotide lacking a GalNAc conjugate group. Furthermore, the antisense oligonucleotides comprising
one, two, or three GalNAc ligands in their respective conjugate groups all accumulated in the liver at similar
levels. This result is surprising in view of the Khorev et al. literature reference cited above and is consistent
with the activity data shown in Tables 116 and 117 above.
Table 1 17a
Liver concentrations of oligonucleotides comprising a GalNAcz or GalNAc3 ate group
[Antisense oligonucleotide] (ug/g) GalNAc cluster
440762 7 13.1 n/a n/a
31.1
0.2 0.9
0.6 2. 7
686221 GalNAc2-24a Ad
2 120
6 26.5
686222 ' ' GalNAcg-13a
Table 117b
Liver concentrations of ucleotides comprising a 1 conjugate group
ISIS N0. fits/1:6) [Antisense oligonucleotide] (ug/g) GalNAc cluster CM
2 2.3
440762 7 8.9 n/a n/a
23.7
0.2 0.4
0.6 1.1
708561 2 5.9 GalNAcl-25a PO
6 23.7
53.9
Example 107: Synthesis of oligonucleotides comprising a GalNAc1-26 or GalNAc1-27 conjugate
Ho? §OH o W
O O\/\/\)J\ ..nO
ACHN
Oligonucleotide 239 is synthesized via coupling of compound 47 (see Example 15) to acid 64 (see
Example 32) using HBTU and DIEA in DMF. The ing amide containing compound is phosphitylated,
then added to the 5’-end of an oligonucleotide using procedures described in Example 10. The GalNA01
cluster portion cl-26a) 0f the conjugate group GalNAcl-26 can be combined With any cleavable
moiety t on the oligonucleotide to provide a variety of conjugate . The structure of GalNAcl-26
(GalNAcl-26a-CM) is shown below:
o -E
Hog/O MO ,IIIO
ACHN
In order to add the GalNAq conjugate group to the 3’-end of an oligonucleotide, the amide formed
from the reaction of compounds 47 and 64 is added to a solid support using procedures described in Example
7. The oligonucleotide sis is then completed using procedures described in Example 9 in order to form
oligonucleotide 240.
O .mOH
AcHN
240 3' 5'
The GalNAc1 cluster portion (GalNAc1-27a) of the conjugate group GalNAc1-27 can be combined with any
cleavable moiety present on the oligonucleotide to provide a variety of ate . The ure of
GalNAc1-27 (GalNAc1-27a-CM) is shown below:
0\/\/\/U\ .-I\OH
ACHN
o 2
Example 108: Antisense inhibition in vivo by oligonucleotides comprising a GalNAc conjugate group
targeting Apo(a) in vivo
The oligonucleotides listed in Table 118 below were tested in a single dose study in mice.
Table 118
Modified ASOs targeting APO(a)
1s1s , , GalNAc3 SEQ
sequences (5 t0 3 ) CM
No. Cluster ID No.
TesCles CesTes Ces
494372 CdsGdsTdsTLIidesGdsTdsGds Cds
n/a n/a 58
TdsTesClesTesTes Ce
CesTes Ces
681251 GalNAc3'7a'o’Tesges CdsglndsTdsTdsGdsGds GalNAc3—7a P0 58
TdsClds CdsTdsTesGes TesTes Ce
681255 GalNAc3'3a'o’Tesgeo CeoTeo Ceo CdsgdsTdsTdsGdsGds GalNAc3—3a P0 58
TdsClds CdsTdsTeoGeo TesTes Ce
681256 GalNAc3'10a'o’TesIE-leo CeoTeo Ceo CdsgdsTdsTdsGdsGds GalNAc3-10a P0 58
TdsClds CdsTdsTeoGeo TesTes Ce
GalNAc3'7a'o’Tesgeo CeoTeo Ceo
681257 CdsgdsTdsTdsGdsGds GalNAc3—7a P0 58
s CdsTdsTeoGeo TesTes Ce
681258 3'13a'o’TesIE-leo CeoTeo Ceo CdsgdsTdsTdsGdsGds GalNAc3— 1 3a P0 58
TdsClds CdsTdsTeoGeo TesTes Ce
TesCleomC:eoTeomC:eomC:dsCldsTdsTdsC}dsC}ds smChSTdsTeoC}eo
681260 G lNAa C3-193 Ad 167
TesTesmCeoAdoa-GalNAQ-l9
The structure of GalNAc3-7a was shown in Example 48.
Treatment
Male transgenic mice that express human Apo(a) were each injected subcutaneously once with an
oligonucleotide and dosage listed in Table 119 or with PBS. Each treatment group consisted of 4 animals.
Blood was drawn the day before dosing to determine baseline levels of Apo(a) n in plasma and at 1
week following the first dose. Additional blood draws will occur weekly for approximately 8 weeks. Plasma
Apo(a) protein levels were measured using an ELISA. The results in Table 119 are presented as the average
percent of plasma Apo(a) protein levels for each treatment group, normalized to baseline levels (% BL), The
results show that the antisense oligonucleotides d Apo(a) protein expression. Furthermore, the
oligonucleotides comprising a GalNAc conjugate group exhibited even more potent reduction in Apo(a)
sion than the oligonucleotide that does not comprise a conjugate group.
Table 119
Ap0(a) plasma protein levels
Apo(a) at 1 week
ISIS No. Dosage (mg/kg)
(% BL)
PBS n/a 143
494372 50 58
681251 10 15
681255 10 14
681256 10 17
681257 10 24
681258 10 22
681260 10 26
Example 109: Synthesis of oligonucleotides sing a GalNAc1-28 0r GalNAc1-29 conjugate
OH 5' 3'
HO 0\-
HO MN N
AcHN HWY
241 OH
Oligonucleotide 241 is synthesized using procedures r to those described in e 71 to
form the phosphoramidite intermediate, followed by procedures described in e 10 to synthesize the
oligonucleotide. The GalNAc1 cluster portion (GalNAc1-28a) of the conjugate group GalNAc1-28 can be
combined with any cleavable moiety present on the oligonucleotide to provide a variety of conjugate groups.
The structure of GalNAc1-28 (GalNAc1-28a-CM) is shown below:
HO “o
H0 W\)‘\ N
ACHN NW
In order to add the 1 conjugate group to the 3’-end of an oligonucleotide, procedures similar
to those described in Example 71 are used to form the hydroxyl intermediate, which is then added to the solid
support using procedures described in Example 7. The oligonucleotide synthesis is then completed using
ures described in Example 9 in order to form ucleotide 242.
HO OH
O .\\
Ho Mo N
ACHN ”WY 3' 5'
242 O_- W
The GalNAc1 cluster portion (GalNAc1-29a) of the conjugate group GalNAc1-29 can be combined with any
cleavable moiety present on the oligonucleotide to provide a variety of conjugate groups. The structure of
GalNAc1-29 (GalNAc1-29a-CM) is shown below:
O _‘\OH
HO M0 N
ACHN ”WY
—&3
Example 110: Synthesis of oligonucleotides comprising a GalNAc1-30 conjugate
OAc OAc
A00 A00
o HO OTBDPS 0
A00 AcO O\/\/\/OTBDPS
TMSOTf
N ACHN
7/0 243
1. NH /MeOH ODMTr
2_ DM§FrC| AcO 1. TBAF
3_ ACZO, pyr O 2. Phosphltllatlon
ACO O\/\/\/OTBDPS —’
ODMTr
1. Couple to 5'-end of A80
A00 O\/\/\/O\P’OCE —>
ACHN
245 '{mpoz 2. ect and purify ASO using
DMT-on ation methods
WO 79625
Ho§fi/O 5' 3'
HO O\/\/\/O\p/o\
ACHN 0/; \Y
Oligonucleotide 246 comprising a GalNAc1-3O conjugate group, wherein Y is selected from O, S, a
tuted or unsubstituted C1-C10 alkyl, amino, substituted amino, azido, alkenyl or alkynyl, is synthesized
as shown above. The 1 cluster portion c1-3Oa) of the conjugate group GalNAc1-3O can be
combined with any cleavable moiety to provide a variety of conjugate groups. In certain embodiments, Y is
part of the cleavable . In certain embodiments, Y is part of a stable moiety, and the cleavable moiety is
present on the oligonucleotide. The structure of GalNAc1-3Oa is shown below:
HO O\/\/\/O\’;
AcHN
Example 111: Synthesis of oligonucleotides comprising a GalNAc2-31 0r GalNAc2-32 conjugate
DMTrO
1. DMTI'CI
OCE Couple to 5'-end of A80
2. Phosphitilation /
O-P\ —>
DMTrO
H0 247 248
1. Remove DMTr groups
DMTrO “(k/é; 2. Couple amidite 245
Ol/P\ 3. Deprotect and purify ASO using
O‘Oligo \ DMT-on
DMTrO purification methods
Ooh/J10?)6V
Oligonucleotide 250 comprising a GalNAc2-3l conjugate group, n Y is selected from O, S, a
substituted or unsubstituted C1-C10 alkyl, amino, substituted amino, azido, l or alkynyl, is synthesized
as shown above. The GalNAcz cluster portion (GalNAc2-3la) of the conjugate group GalNAc2-3l can be
combined with any cleavable moiety to provide a variety of conjugate . In certain embodiments, the Y-
containing group directly adjacent to the 5’-end of the oligonucleotide is part of the cleavable moiety. In
certain embodiments, the Y-containing group directly adjacent to the 5’-end of the oligonucleotide is part of a
stable moiety, and the cleavable moiety is present on the ucleotide. The structure of GalNAcz-31a is
shown below:
HO$g/O\/\/\/O\p/OHO
AcHN o” \Y
O~P\
OH \/\/\/ 6’ Y
HO§OA/oHO
ACHN
The synthesis of an oligonucleotide comprising a GalNAc2-32 conjugate is shown below.
1. DMTrCI
2. Allyl Br
3- 0304, NaIO4 1. Couple to 5'-end of A80
DMTrO
HO 4. NaBH4 2. Remove DMTr groups
. itilatlon__ _
3. Couple amidite 245
OH O—\_
0\ 4. Deprotect and purify ASO using
DMTrO _
HO ,P_N(|Pr)2 DMT-on purification s
247 CEO
OH fl(5’ Y
NHAc
Oligonucleotide 252 sing a GalNAc2-32 conjugate group, wherein Y is selected from O, S, a
substituted or unsubstituted C1-C10 alkyl, amino, substituted amino, azido, l or alkynyl, is synthesized
as shown above. The GalNAcz cluster portion (GalNAc2-32a) of the conjugate group GalNAc2-32 can be
combined with any cleavable moiety to provide a variety of conjugate groups. In certain ments, the Y-
containing group directly adjacent to the 5’-end of the oligonucleotide is part of the cleavable moiety. In
certain embodiments, the Y-containing group directly adjacent to the 5’-end of the oligonucleotide is part of a
stable moiety, and the cleavable moiety is present on the oligonucleotide. The structure of GalNAc2-32a is
shownbelow:
HO$\\/O\/\/\/O\PIOHO O
AcHN OMY Os ,0
/,P\ W0)“
0 O Y
O‘P:
0'I Y
OH fl
NHAc
Example 112: Modified oligonucleotides comprising a GalNAc1 conjugate
The oligonucleotides in Table 120 targeting SRB-l were synthesized with a GalNAc1 conjugate
group in order to further test the potency of oligonucleotides sing conjugate groups that contain one
GalNAc ligand.
Table 120
GalNAc
, , SEQ
ISIS N0. Sequence (5 to 3 ) CM
cluster ID NO.
711461 GalNAcl'ZSa-O’Ado Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds G31\AC '253, Ad 145
Gcs Ads InC:ds Tds Tes InC:es InC:es Tes Te
711462 GalNAcl'ZSa-O’Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds Gds G31\AC "253, PO 143
Acs InC:ds Tds Tes InC:es InC:es Tes Te
711463 Gal.\IAc1-25a_0aGes InCeo T60 T60 InCeo Ads Gds Tds mCds Ads Tds Gal\Ac -25a PO 143
Gcs Ads InC:ds Tds Te0 InC:eo InC:es Tes Te
711465 GalNAcl'26a-0’Ado Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds G31\AC '263, Ad 145
Gcs Ads InC:ds Tds Tes InC:es InC:es Tes Te
711466 GalNAcl'26a-0’Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds Gds G31\AC '26a PO 143
Acs InC:ds Tds Tes InC:es InC:es Tes Te
711467 GalNAc1-26HaGes InCeo T60 T60 InCeo Ads Gds Tds mCdS Ads Tds Gal\Ac -26a PO 143
Gcs Ads InC:ds Tds Te0 InC:eo InC:es Tes Te
711468 l'ZSa-O’Ado Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds G31\AC '283, Ad 145
Gcs Ads InC:ds Tds Tes InC:es InC:es Tes Te
711469 l'ZSa-O’Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds Gds G31\AC '283, PO 143
Acs InC:ds Tds Tes InC:es InC:es Tes Te
71 1470 GalNAcl'ZSa-O’Ges InC:eo Te0 Te0 InC:eo Ads Gds Tds InC:ds Ads Tds G31\AC '28a PO 143
Gcs Ads InC:ds Tds Te0 InC:eo InC:es Tes Te
713844 Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC -27a PO 143
Tes InCes InCes Tes T60s_GalNAc1-27a
713845 Ges InC:eo Te0 Te0 InC:eo Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC -27a PO 143
Teo InCeo InCes Tes T60s_GalNAc1-27a
713846 Ges InC:eo Te0 Te0 InC:eo Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC "273. Ad 144
Teo InCeo InCes Tes T60 Ados_GalNAc1-27a
713847 Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC -29a PO 143
Tes InCes InCes Tes Teoa_GalNAc1-29a
713848 Ges InC:eo Te0 Te0 InC:eo Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC -29a PO 143
Teo InCeo InCes Tes alNAc1-29a
713849 Ges InC:es Tes Tes InC:es Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC '293, Ad 144
Tes InCes InCes TeS Teo Adoa_GalNAc1-29a
713850 Ges InC:eo Te0 Te0 InC:eo Ads Gds Tds InC:ds Ads Tds Gds Ads InC:ds Tds G31\AC "293. Ad 144
Te0 InC:eo InC:es Tes Te0 Ado’-(;alNAcl'2'9a
Example 113: Dose-dependent antisense inhibition of human apolipoprotein (a) (apo(a)) in human
primary hepatocytes
Selected gapmer antisense oligonucleotides from a previous ation (W02005/000201, the
content of which is incorporated by reference in its entirety herein) were tested in a single dose assay in
human primary hepatocytes. Cells were obtained from Tissue ormation Technologies (BD Biosciences,
Franklin Lakes, NJ) and treated with 150 nM of antisense oligonucleotide. After a treatment period of
approximately 16 hours, RNA was isolated from the cells and apo(a) mRNA levels were measured by
quantitative real-time PCR. Human apo(a) primer probe set )3’ (forward sequence
ACAGCAATCAAACGAAGACACTG, designated herein as SEQ ID NO: 5; reverse sequence
AGCTTATACACAAAAATACCAAAAATGC, designated herein as SEQ ID NO: 6; probe sequence
TCCCAGCTACCAGCTATGCCAAACCTT, designated herein as SEQ ID NO: 7) was used to measure
mRNA levels. Additionally, mRNA levels were also ed using human apo(a) primer probe set
hAPO(a)12kB (forward sequence CCACAGTGGCCCCGGT, designated herein as SEQ ID NO: 8; reverse
sequence CTTTTCTCAGGTGGT, designated herein as SEQ ID NO: 9; probe sequence
CCAAGCACAGAGGCTCCTTCTGAACAAG, ated herein as SEQ ID NO: 10). Apo(a) mRNA levels
were normalized to GAPDH mRNA expression. Results are presented in the table below as percent
inhibition of apo(a), relative to untreated control cells.
Table 121
nse inhibition of human apo(a) in human primary hepatocytes
% inhibition % inhibition
ISIS No (hAPO(a)3’ (hAPO(a)12kB
PPset) PPset)
144367 68 77
144368 42 59
144369 43 69
144370 80 75
144371 42 57
144372 87 54
144373 63 49
144374 45 80
144375 33 11
144376 62 82
144377 42 72
144378 0 72
144379 73 46
144380 75 78
144381 63 64
144382 0 58
144383 63 79
144384 38 O
144385 40 94
144386 47 61
144387 38 60
144388 0 57
144389 52 39
144390 12 0
144391 73 57
144392 43 50
144393 83 82
144394 40 76
144395 80 84
144396 53 72
144397 23 64
144398 7 33
144399 43 44
144400 70 75
144401 87 72
Several antisense oligonucleotides were ed for r testing in a dose response assay.
The selected nse oligonucleotides were tested in human primary hepatocytes with 25 nM, 50
nM, 150 nM, or 300 nM trations of antisense oligonucleotide, as specified in the table below. After a
treatment period of approximately 16 hours, RNA was isolated from the cells and apo(a) mRNA levels were
measured by quantitative real-time PCR. Human apo(a) primer probe set hAPO(a)3’ was used to measure
mRNA levels. Apo(a) mRNA levels were normalized to GAPDH mRNA expression. Results are presented
as percent inhibition of apo(a), relative to untreated control cells.
Table 122
Dose-dependent antisense inhibition of human apo(a) in human primary hepatocytes, as measured with
hAPO(a)3 ’
ISIS No 25nM 50nM 150nM 300nM
————n
144395 17 9 8 32
ISIS 1443 67 demonstrated better efficacy and dose-dependency than the other nse
oligonucleotides. Hence, ISIS 144367 was considered the benchmark antisense oligonucleotide to compare
the potency of newly designed antisense oligonucleotides disclosed herein.
Example 114: Antisense inhibition of human apo(a) in transgenic mouse primary hepatocytes
Antisense oligonucleotides were newly designed targeting an apo(a) nucleic acid and were tested for
their effects on apo(a) mRNA in vitro. The antisense oligonucleotides were tested for potency in a series of
parallel ments that had similar culture conditions. Primary hepatocytes from human apo(a) transgenic
mice (Frazer, K.A. et al., Nat. Genet. 1995. 9: 424-431) were used in this study. Hepatocytes at a density of
35,000 cells per well were transfected using electroporation with 1,000 nM antisense oligonucleotide. After a
ent period of approximately 24 hours, RNA was isolated from the cells and apo(a) mRNA levels were
ed by quantitative real-time PCR. Human primer probe set hAPO(a)12kB was used to measure
mRNA levels. Apo(a) mRNA levels were adjusted according to total RNA content, as measured by
RIBOGREEN®. The results for each experiment are presented in separate tables shown below. ISIS 144367
from was used as a benchmark for the new antisense oligonucleotides and also included in the studies.
Results are presented as t inhibition of apo(a), relative to untreated control cells. A total of 1,511
gapmers were tested under these culture ions. Only those antisense oligonucleotides that were selected
for further study are presented in the table below with each table representing a separate experiment.
The newly designed chimeric antisense oligonucleotides were designed as 55 MOE gapmers.
The gapmers are 20 nucleosides in length, wherein the l gap segment comprises of ten 2’-
deoxynucleosides and is flanked by wing segments on the 5’ direction and the 3’ ion comprising five
nucleosides each. Each nucleoside in the 5’ wing segment and each nucleoside in the 3’ wing segment has a
2’-MOE modification. The internucleoside linkages hout each gapmer are phosphorothioate (P=S)
linkages. All cytosine residues throughout each gapmer are 5-methylcytosines.
The apo(a) target sequence contains le Kringle repeat ces, therefore, an antisense
oligonucleotide may target one or more regions of apo(a) depending whether on the oligonucleotide targets a
Kringle sequence or not. “Start site” indicates the 5’-most nucleoside to which the gapmer is ed in the
human ce. “Stop site” indicates the 3’-most nucleoside to which the gapmer is targeted human
sequence. An apo(a) antisense oligonucleotide may have more than one “Start site” or “Stop site” ing
on whether or not it targets a Kringle repeat.
Most gapmers listed in the tables are targeted with 100% complementarity to one or more regions of
either the human apo(a) mRNA, ated herein as SEQ ID NO: 1 (GENBANK Accession No.
NM_005577.2) or the human apo(a) genomic sequence, designated herein as SEQ ID NO: 2 (GENBANK
Accession No. NT_OO7422.12 truncated from nucleotides 3230000 to 3380000), or both. ‘n/a’ indicates that
the antisense oligonucleotide does not target that ular sequence With 100% complementarity.
Table 123
SEQID SEQ SEQ
SEQID SEQ
ISIS DH):1 96 HDNO: HDNO:
DH):1 Sequence ID
1J0 Sunfi inhibition 2 Start 2 Stop
Stop Sfie NO
S1te Site Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 90 21210 21229 11
238 257 21199 21218
580 599 26690 26709
922 941 32237 32256
494157 ACAGTGGTGGAGTA 95 12
1606 1625 43330 43349
1948 1967 48874 48893
2290 2309 54420 54439
3316 3335 72037 72056
239 258 21200 21219
581 600 26691 26710
923 942 32238 32257
494158 1607 1626 TCCTGTGACAGTGGTGGAGT 95 43331 43350 13
1949 1968 48875 48894
2291 2310 54421 54440
3317 3336 72038 72057
241 260 21202 21221
583 602 26693 26712
925 944 32240 32259
1609 1628 43333 43352
494159 1951 1970 CTTCCTGTGACAGTGGTGGA 97 48877 48896 14
2293 2312 54423 54442
3319 3338 72040 72059
4663 4682 94404 94423
5005 5024 115515 115534
242 261 21203 21222
494160 4664 4683 CCTTCCTGTGACAGTGGTGG 97 94405 94424 15
5006 5025 115516 115535
243 262 21204 21223
494161 4665 4684 TCCTTCCTGTGACAGTGGTG 96 94406 94425 16
5007 5026 115517 115536
244 263 21205 21224
3664 3683 77585 77604
494162 GTCCTTCCTGTGACAGTGGT 95 17
4666 4685 94407 94426
5008 5027 115518 115537
494163 245 264 GGTCCTTCCTGTGACAGTGG 96 21206 21225 18
4667 4686 94408 94427
246 265 21207 21226
494164 TTCCTGTGACAGTG 93 19
—46684687 —9440994428
247 266 21208 21227
494165 —4669 CAGGTCCTTCCTGTGACAGT 91
4688 —9441094429 20
494166 248 267 GCAGGTCCTTCCTGTGACAG 89 21209 21228 21
494167 250 269 TGGCAGGTCCTTCCTGTGAC 92 21211 21230 22
494168 251 270 TTGGCAGGTCCTTCCTGTGA 89 21212 21231 23
494169 252 271 CTTGGCAGGTCCTTCCTGTG 92 21213 21232 24
494170 253 272 GCTTGGCAGGTCCTTCCTGT 88 21214 21233 25
Table 124
SEQ ID SEQ
SEQ ID SEQ ID
NO: 1 ID NO: 0A) SEQ
ISIS NO Sequence . . NO: 2 NO: 2
Start 1 Stop 1nh1b1t10n ID NO
. . Start S1te. Stop S1te.
S1te S1te
144367 249 268 TCCTTCCTGTGACA :1 21210 21229 11
584 603 26694 26713
926 945 32241 32260
1610 1629 43334 43353
494283 TCTTCCTGTGACAGTGGTGG 93 26
—19521971 —4887848897
2294 2313 54424 54443
3320 3339 72041 72060
585 604 26695 26714
927 946 32242 32261
1611 1630 43335 43354
494284 —1953 TTCTTCCTGTGACAGTGGTG 95
1972 —4887948898 27
2295 2314 54425 54444
3321 3340 72042 72061
586 605 26696 26715
928 947 32243 32262
1612 1631 43336 43355
494285 —1954 GTTCTTCCTGTGACAGTGGT 95 28
1973 —4888048899
2296 2315 54426 54445
3322 3341 72043 72062
587 606 26697 26716
929 948 32244 32263
494286 1613 1632 GGTTCTTCCTGTGACAGTGG 95 43337 43356 29
1955 1974 48881 48900
2297 2316 54427 54446
588 607 26698 26717
930 949 32245 32264
494287 1614 1633 AGGTTCTTCCTGTGACAGTG 95 43338 43357 30
1956 1975 48882 48901
2298 2317 54428 54447
589 608 26699 26718
494288 931 950 CAGGTTCTTCCTGTGACAGT 91 32246 32265 31
1615 1634 43339 43358
WO 79625
1957 1976 48883 48902
2299 2318 54429 54448
2983 3002 66500 66519
592 611 26702 26721
934 953 32249 32268
1618 1637 43342 43361
494290 TGGCAGGTTCTTCCTGTGAC 90 32
1960 1979 48886 48905
2302 2321 54432 54451
2986 3005 66503 66522
593 612 26703 26722
935 954 32250 32269
1619 1638 43343 43362
494291 TTGGCAGGTTCTTCCTGTGA 89 33
1961 1980 48887 48906
2303 2322 54433 54452
2987 3006 66504 66523
594 613 26704 26723
936 955 32251 32270
1620 1639 43344 43363
494292 CTTGGCAGGTTCTTCCTGTG 94 35
1962 1981 48888 48907
2304 2323 54434 54453
2988 3007 66505 66524
596 615 26706 26725
938 957 32253 32272
1622 1641 43346 43365
494294 AGCTTGGCAGGTTCTTCCTG 90 36
1964 1983 48890 48909
2306 2325 54436 54455
2990 3009 66507 66526
626 645 26736 26755
968 987 32283 32302
1310 1329 37830 37849
1652 1671 43376 43395
494299 ACTATGCGAGTGTGGTGTCA 91 37
1994 2013 48920 48939
2336 2355 54466 54485
2678 2697 60021 60040
3020 3039 66537 66556
627 646 26737 26756
969 988 32284 32303
1311 1330 37831 37850
1653 1672 43377 43396
49800 GACTATGCGAGTGTGGTGTC 93 38
“”5 mn4 4&fl1 4&MO
2337 2356 54467 54486
2679 2698 60022 60041
3021 3040 66538 66557
49501 628 647 CGACTATGCGAGTGTGGTGT 93 26B8 fifl57 39
970 989 32285 32304
1312 1331 37832 37851
1654 1673 43378 43397
1996 2015 48922 48941
2338 2357 54468 54487
2680 2699 60023 60042
3022 3041 66539 66558
629 648 26739 26758
971 990 32286 32305
1313 1332 37833 37852
1655 1674 43379 43398
494302 CCGACTATGCGAGTGTGGTG 94 40
1997 2016 48923 48942
2339 2358 54469 54488
2681 2700 60024 60043
3023 3042 66540 66559
630 649 26740 26759
972 991 32287 32306
1314 1333 37834 37853
1656 1675 43380 43399
494303 TCCGACTATGCGAGTGTGGT 93 41
1998 2017 48924 48943
2340 2359 54470 54489
2682 2701 60025 60044
3024 3043 66541 66560
631 650 26741 26760
973 992 32288 32307
1315 1334 37835 37854
1657 1676 43381 43400
494304 CTATGCGAGTGTGG 94 42
1999 2018 48925 48944
2341 2360 54471 54490
2683 2702 60026 60045
3025 3044 66542 66561
632 651 26742 26761
974 993 32289 32308
1316 1335 37836 37855
1658 1677 43382 43401
494305 GGTCCGACTATGCGAGTGTG 93 43
2000 2019 48926 48945
2342 2361 54472 54491
2684 2703 60027 60046
3026 3045 66543 66562
633 652 26743 26762
975 994 32290 32309
494306 GGGTCCGACTATGCGAGTGT 92 44
1317 1336 37837 37856
1659 1678 43383 43402
2001 2020 48927 48946
2343 2362 54473 54492
2685 2704 60028 60047
3027 3046 66544 66563
494307M CTGCTCAGTCGGTGCTTGTT 91 n/a n/a 45
2558 2577
1212
494310 —1193 CCTCTGCTCAGTCGGTGCTT 90 n/a n/a 46
2561 2580
1213
494311 —1194 GCCTCTGCTCAGTCGGTGCT 88 37733 47
2562 2581 59905 59924
1286
494334 —1267 CTTCCAGTGACAGTGGTGGA 90 —3778737806 48
2635 2654 59978 59997
1269 1288 37789 37808
494336 TTCTTCCAGTGACAGTGGTG 90 49
2637 2656 59980 59999
1270 1289 37790 37809
494337 —2638 GTTCTTCCAGTGACAGTGGT 95 50
2657 —5998160000
1271 1290 37791 37810
494338 —2639 GGTTCTTCCAGTGACAGTGG 91 133
2658 —5998260001
494521 6393 6412 GACCTTAAAAGCTTATACAC 82 140049 140068 51
494525 6397 6416 GTCAGACCTTAAAAGCTTAT 84 140053 140072 52
494530 6402 6421 TGTCAGTCAGACCTTAAAAG 82 140058 140077 53
494535 6407 6426 GAATTTGTCAGTCAGACCTT 85 140063 140082 54
494536 6408 6427 AGAATTTGTCAGTCAGACCT 83 140064 140083 55
494544 6417 6436 CCTTAATACAGAATTTGTCA 82 140073 140092 56
Table 125
SE 1D SE
ISIS SNE8:11D SNE8:11D % N8: 2 ID N?) SEQ
Sequence
NO 1nh1b1t10n. . Start 2 Stop ID NO
Start S1te. Stop S1te.
Site Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 84 21210 21229 11
494371 3900 3919 GCTCCGTTGGTGCTTGTTCA 93 n/a n/a 57
494372 3901 3920 TGCTCCGTTGGTGCTTGTTC 93 n/a n/a 5 8
494373 3902 3921 TTGCTCCGTTGGTGCTTGTT 83 n/a n/a 59
494374 3903 3922 TTTGCTCCGTTGGTGCTTGT 89 n/a n/a 60
494375 3904 3923 CTTTGCTCCGTTGGTGCTTG 85 n/a n/a 61
494386 3977 3996 TCCTGTAACAGTGGTGGAGA 86 81985 82004 62
494387 3978 3997 TAACAGTGGTGGAG 82 81986 82005 63
494388 3979 3998 CTTCCTGTAACAGTGGTGGA 86 81987 82006 64
494389 3980 3999 CCTTCCTGTAACAGTGGTGG 92 81988 82007 65
494390 3981 4000 TCCTTCCTGTAACAGTGGTG 92 81989 82008 66
494391 3982 4001 GTCCTTCCTGTAACAGTGGT 84 81990 82009 67
494392 3983 4002 TGTCCTTCCTGTAACAGTGG 81 81991 82010 68
Table 126
WO 79625
SEQ ID SEQ ID SEQ ID SEQ ID
ISIS NO NO: 1 NO: 1 Sequence inhibgfi n SEQ
NO: 2 NO: 2
0 ID NO
Start Site Stop Site Start Site Stop Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 86 21210 21229 11
498369 3203 3222 TGGAGCCAGAATAACATTCG 91 70667 70686 69
498379 3213 3232 CCTCTAGGCTTGGAGCCAGA 85 70677 70696 70
498408 3323 3342 AGTTCTTCCTGTGACAGTGG 86 72044 72063 71
498433 3367 3386 GTCCGACTATGCTGGTGTGG 87 72088 72107 72
498434 3368 3387 GGTCCGACTATGCTGGTGTG 86 72089 72108 73
498435 3369 33 88 GGGTCCGACTATGCTGGTGT 83 72090 72109 74
Table 127
SEQ ID SEQ ID 0 SEQ ID SEQ ID
113%; NO: 1 NO: 1 Sequence ition NO: 2 NO: 2 151313)
Start Site Stop Site Start Site Stop Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 90 21210 21229 11
498229 2871 2890 CCTCTAGGCTTGGAATCGGG 90 65117 65136 75
498238 2883 2902 GTTCAGAAGGAGCCTCTAGG 93 65129 65148 76
498239 2884 2903 TGTTCAGAAGGAGCCTCTAG 94 65130 65149 77
2887 2906
498240 GCTTGTTCAGAAGGAGCCTC 98 n/a n/a 78
4573 4592
2888 2907
498241 TGCTTGTTCAGAAGGAGCCT 94 n/a n/a 79
4574 4593
2889 2908
498242 GTGCTTGTTCAGAAGGAGCC 96 n/a n/a 80
4575 4594
2890 2909
498243 GGTGCTTGTTCAGAAGGAGC 97 n/a n/a 81
4576 4595
2891 2910
498244 TGGTGCTTGTTCAGAAGGAG 92 n/a n/a 82
4577 4596
498251 2898 2917 GCTCAGTTGGTGCTTGTTCA 90 n/a n/a 83
498252 2899 2918 TGCTCAGTTGGTGCTTGTTC 90 n/a n/a 84
Table 128
SEQ ID SEQ ID SEQ ID SEQ ID SEQ
ISIS NO NO: 1 NO: 1 Sequence inhibition NO: 2 NO: 2 ID
Start Site Stop Site Start Site Stop Site NO
1443 67 249 268 GGCAGGTCCTTCCTGTGACA 91 21210 21229 11
498517 3548 3567 GCTTGGATCTGGGACCACCG 89 76233 76252 85
Table 129
SEQ ID SEQ ID
SEQ ID SEQ ID
Sequence NO: 2 NO: 2
inhibition
Start Site Stop Site
Table 130
SEQ ID SEQ ID
ISIS %
Sequence NO: 2 NO: 2
NO tion
Start Site Stop Site
-———————
-——————m
499041 6318 6337 CGTTTGATTGCTGTCTATTA 139974 139993 91
Table 131
SEQID SEQID SEQID SEQID
113138 NO: 1 NO: 1 Sequence inhilfition0 NO: 2 NO: 2 112E130
Start Site Stop Site Start Site Stop Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 91 21210 21229 11
498523 3554 3573 CTCTGTGCTTGGATCTGGGA 94 76239 76258 92
498524 3555 3574 CCTCTGTGCTTGGATCTGGG 96 76240 76259 93
498525 3556 3575 GCCTCTGTGCTTGGATCTGG 94 76241 76260 94
498529 3560 3579 AGAAGCCTCTGTGCTTGGAT 89 76245 76264 95
498535 3566 3585 TTCAGAAGAAGCCTCTGTGC 89 76251 76270 96
498550 3582 3601 GCTCCGTTGGTGCTTCTTCA 90 n/a n/a 97
498553 3585 3604 TTTGCTCCGTTGGTGCTTCT 87 n/a n/a 98
3587 3606
498555 GCTTTGCTCCGTTGGTGCTT 90 n/a n/a 99
3905 3924
3588 3607 77509 77528
498556 GGCTTTGCTCCGTTGGTGCT 89 100
3906 3925 81914 81933
3589 3608 77510 77529
498557 GGGCTTTGC CCGT TTGG GCT 89 1 0 1
3907 3926 81915 81934
498579 3662 3681 CCTTCCTGTGACAGTGGTAG 87 77583 77602 102
498580 3663 3682 TCCTTCCTGTGACAGTGGTA 92 77584 77603 103
3665 3684 77586 77605
498581 TCCTGTGACAGTGG 94 104
5009 5028 115519 115538
Table 132
SEQID SEQID SEQID SEQID
NO: 1 NO: 1 Sequence NO: 2 NO: 2
inhibition
Start Site Stop Site Start Site Stop Site
494230 CCTCTAGGCTTGGAACCGGG 95 105
1503 1522 42020 42039
1845 1864 47564 47583
2187 2206 53110 53129
2529 2548 58662 58681
494 513
836 855
1178 1197
494243 1520 1539 TGCTTGTTCGGAAGGAGCCT 93 n/a n/a 106
1862 1881
2204 2223
2546 2565
495 514
837 856
1179 1198
494244 1521 1540 GTGCTTGTTCGGAAGGAGCC 95 n/a n/a 107
1863 1882
2205 2224
2547 2566
Table 133
SEQ ID SEQ ID SEQ ID SEQ ID
ISIS NO NO: 1 NO: 1 Sequence NO: 2 NO: 2
inhibition
Start Site Stop Site Start Site Stop S1te
————mq494466 4208 4227 AACTGGGACCACCG 95 8513 8 85157
———————&494470 4212 4231 CTGTGCTTGGAACTGGGACC 85142 85161
Example 115: Dose-dependent antisense inhibition of apo(a) in transgenic mouse primary hepatocytes
Gapmers from the studies described above exhibiting significant in vitro inhibition of apo(a) mRNA
were ed and tested at various doses in transgenic mouse primary cytes in a series of parallel
studies with similar culture conditions. Cells were plated at a density of 35,000 per well and transfected
using electroporation with 0.0625 uM, 0.125 uM, 0.25 “M, 0.500 uM, or 1.000 uM concentrations of
antisense ucleotide. After a ent period of approximately 16 hours, RNA was isolated from the
cells and apo(a) mRNA levels were measured by quantitative real-time PCR. Apo(a) primer probe set
hAPO(a)12kB was used to measured mRNA levels. Apo(a) mRNA levels were adjusted according to total
RNA content, as measured by RIBOGREEN®. Results are presented as t inhibition of apo(a), relative
to untreated control cells.
The results of each of the studies are depicted in the tables presented below with each table
representing a separate experiment. The half maximal inhibitory concentration (leo) of each oligonucleotide
is also presented in the tables. Apo(a) mRNA levels were significantly d in a dose-dependent manner
in antisense oligonucleotide d cells. The potency of the newly designed oligos was compared with the
benchmark oligonucleotide ISIS 144367.
Table 134
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 11 27 46 62 80 0.31
494157 11 47 53 76 87 0.23
494158 19 57 75 84 88 0.13
494159 41 65 77 84 92 0.07
494160 44 69 76 85 91 0.06
494161 40 64 74 85 91 0.08
494162 36 63 76 87 88 0.09
494163 20 59 75 85 92 0.13
494164 3 45 62 74 90 0.21
494165 25 39 57 71 75 0.19
494166 17 30 47 59 76 0.31
494167 30 43 55 72 80 0.18
494168 25 36 44 59 75 0.28
494169 19 39 51 61 81 0.25
Table 135
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 23 40 58 76 88 0.19
494170 38 34 60 76 84 0.13
494230 55 71 89 95 97 0.03
494243 47 73 87 92 97 0.05
494244 58 73 86 92 96 0.03
494283 54 70 84 93 94 0.05
494284 45 62 83 92 95 0.07
494285 56 70 84 92 95 0.04
494286 51 70 87 93 95 0.05
494287 32 60 67 87 91 0.11
494288 26 41 61 79 88 0.17
494290 30 43 64 81 87 0.15
494291 29 40 56 75 85 0.18
WO 79625 PCT/USZOl4/036460
Table 136
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 10 38 62 68 84 0.23
494292 17 36 74 85 90 0.17
494294 10 34 53 80 91 0.22
494299 32 29 56 77 88 0.16
494300 34 46 76 86 90 0.12
494301 44 56 72 86 89 0.09
494302 42 59 78 88 89 0.08
494303 37 58 70 86 89 0.10
494304 46 71 78 89 90 0.05
494305 39 58 62 85 87 0.10
494306 31 52 65 79 88 0.13
494307 23 23 39 65 78 0.34
494310 14 29 62 70 88 0.25
Table 137
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 0 29 45 73 92 0.27
494311 28 53 65 85 95 0.13
494334 20 44 66 86 96 0.16
494336 15 38 54 84 97 0.20
494337 28 50 77 90 98 0.12
494338 21 40 68 91 98 0.15
494371 19 0 71 89 97 0.15
494372 33 44 77 91 97 0.12
494373 15 36 65 83 95 0.19
494374 3 17 51 83 90 0.24
494375 1 34 56 80 93 0.23
494386 13 26 46 73 91 0.25
494387 17 27 45 67 88 0.28
Table 138
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 35 42 62 70 91 0.15
494537 19 34 54 79 90 0.21
494544 10 38 73 86 94 0.17
WO 79625
498229 36 58 80 92 97 0.10
498238 41 57 75 91 97 0.09
498239 56 71 79 90 94 0.03
498240 91 94 98 99 100 <0.06
498241 75 84 91 96 98 <0.06
498242 11 27 42 47 63 0.49
498243 91 93 96 98 99 <0.06
498244 4 0 0 13 43 >1.00
498251 30 30 42 73 89 0.26
498252 37 33 58 80 92 0.20
498369 22 22 10 22 34 >100
Table 139
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 15 32 54 75 90 0.22
498379 29 48 71 80 95 0.13
498408 38 57 77 88 96 0.09
498433 29 36 70 88 96 0.15
498434 49 43 50 78 90 0.19
498435 27 39 57 78 93 0.18
498517 64 72 82 93 98 <0.06
498721 77 84 88 96 97 <0.06
498833 73 78 91 95 99 <0.06
498859 7 24 37 62 75 0.36
498868 7 14 39 63 81 0.36
498875 16 21 33 55 81 0.39
499020 7 24 23 55 78 0.36
499041 6 16 33 64 83 0.35
Table 140
0.0625 0.125 0.250 0.500 1.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 14 47 64 79 91 0.14
498523 36 50 80 87 95 0.11
498524 43 79 87 93 97 0.01
498525 32 49 75 86 96 0.12
498529 21 49 57 78 90 0.17
498535 20 34 55 76 86 0.21
498550 12 50 69 84 96 0.11
2014/036460
——————n
Table 141
0.0625 0.125 0.250 0.500 1.000 ICso
ISIS N0 HM HM HM HM HM (HM)
144367 0 9 26 49 77 0.47
494388 0 0 21 33 55 0.89
494389 0 15 22 50 79 0.46
494390 5 20 37 68 81 0.33
494391 7 20 32 54 68 0.46
494392 18 24 40 57 76 0.35
494466 33 45 58 69 82 0.16
494470 45 58 68 79 87 0.08
494472 37 50 60 69 83 0.13
494521 0 0 0 15 54 0.17
494525 0 0 2 28 65 0.85
494530 0 6 27 51 80 0.46
494535 0 7 24 53 74 0.49
494536 0 2 15 42 67 0.63
Table 142
0.0625 0.125 0.250 0.500 1.000 ICso
ISIS N0
HM HM HM HM HM (HM)
144367 0 4 16 26 77 0.65
498379 12 18 27 32 63 0.81
498408 0 11 46 50 77 0.41
498433 22 30 46 60 83 0.27
498434 39 29 25 47 78 0.40
498435 21 28 26 43 73 0.50
498517 44 48 63 70 84 0.11
498721 54 54 66 75 89 <0.06
498833 44 51 58 67 83 0.11
498859 0 29 14 35 66 0.69
498868 0 12 9 26 60 1.07
498875 0 30 31 53 78 0.40
——————n
——————-I
As presented in the tables above, ISIS 494157 (SEQ ID NO: 12), ISIS 494158 (SEQ ID NO:13), ISIS 494159
(SEQ ID NO:14), ISIS 494160 (SEQ ID NO: 15), ISIS 494161 (SEQ ID NO:16), ISIS 494162 (SEQ ID NO:
17), ISIS 494163 (SEQ ID NO: 18), ISIS 494164 (SEQ ID NO: 19), ISIS 494165 (SEQ ID NO: 20), ISIS
494167 (SEQ ID NO: 22), ISIS 494168 (SEQ ID NO: 23), ISIS 494169 (SEQ ID NO: 24), ISIS 494170
(SEQ ID NO: 25), ISIS 494230 (SEQ ID NO: 105), ISIS 494243 (SEQ ID NO: 106), ISIS 494244 (SEQ ID
NO: 107), ISIS 494283 (SEQ ID NO: 26), ISIS 494284 (SEQ ID NO: 27), ISIS 494285 (SEQ ID NO: 28),
ISIS 494286 (SEQ ID NO: 29), ISIS 494287 (SEQ ID NO: 30), ISIS 494288 (SEQ ID NO: 31), ISIS 494290
(SEQ ID NO: 32), ISIS 494291 (SEQ ID NO: 33), ISIS 494292 (SEQ ID NO: 35), ISIS 494294 (SEQ ID
NO: 36), ISIS 494299 (SEQ ID NO: 37), ISIS 494300 (SEQ ID NO: 38), ISIS 494301 (SEQ ID NO: 39),
ISIS 494302 (SEQ ID NO: 40), ISIS 494303 (SEQ ID NO: 41), ISIS 494304 (SEQ ID NO: 42), ISIS 494305
(SEQ ID NO:43), ISIS 494306 (SEQ ID NO: 44), ISIS 494311 (SEQ ID NO: 47), ISIS 494334 (SEQ ID NO:
48), ISIS 494336 (SEQ ID NO: 49), ISIS 494337 (SEQ ID NO: 50), ISIS 494338 (SEQ ID NO: 133), ISIS
494371 (SEQ ID NO: 57), ISIS 494372 (SEQ ID NO: 58), ISIS 494373 (SEQ ID NO: 59), ISIS 494374
(SEQ ID NO: 60), ISIS 494375 (SEQ ID NO: 61), ISIS 494386 (SEQ ID NO: 62), ISIS 494389 (SEQ ID
NO: 65), ISIS 494390 (SEQ ID NO: 66), ISIS 494392 (SEQ ID NO: 68), ISIS 494466 (SEQ ID NO: 108),
ISIS 494470 (SEQ ID NO: 109), ISIS 494472 (SEQ ID NO: 110), ISIS 494521 (SEQ ID NO: 51), ISIS
494530 (SEQ ID NO: 53), ISIS 498229 (SEQ ID NO: 75), ISIS 498238 (SEQ ID NO: 76), ISIS 498239
(SEQ ID NO: 77), ISIS 498240 (SEQ ID NO: 78), ISIS 498241 (SEQ ID NO: 79), ISIS 498243 (SEQ ID
NO: 81), ISIS 498379 (SEQ ID NO: 70), ISIS 498408 (SEQ ID NO: 71), ISIS 498433 (SEQ ID NO: 72),
ISIS 498434 (SEQ ID NO: 73), ISIS 498435 (SEQ ID NO: 74), ISIS 498517 (SEQ ID NO: 85), ISIS 498523
(SEQ ID NO: 92), ISIS 498524 (SEQ ID NO: 93), ISIS 498525 (SEQ ID NO: 94), ISIS 498550 (SEQ ID
NO: 97), ISIS 498580 (SEQ ID NO: 103), ISIS 498581 (SEQ ID NO: 104), ISIS 498721
(ATGCCTCGATAACTCCGTCC; SEQ ID NO: 134), ISIS 498833 (SEQ ID NO: 86), ISIS 498875 (SEQ ID
NO: 89), and ISIS 499020 (SEQ ID NO: 90) were more potent than ISIS 144367 (SEQ ID NO: 11).
Example 116: Dose-dependent nse inhibition of apo(a) in transgenic mouse primary cytes
Potent gapmers from the studies described above were further selected and tested at various doses in
enic mouse primary hepatocytes in a series of studies with similar culture conditions. Cells were plated
at a density of 35,000 per well and transfected using electroporation with 0.049 uM, 0.148 uM, 0.444 uM,
1.333 uM, or 4.000 uM concentrations of antisense oligonucleotide, as specified in tables below. After a
ent period of approximately 16 hours, RNA was isolated from the cells and apo(a) mRNA levels were
measured by quantitative real-time PCR. Apo(a) primer probe set hAPO(a)12kB was used to measured
mRNA . Apo(a) mRNA levels were adjusted according to total RNA content, as measured by
EEN®. Results are presented as percent inhibition of apo(a), relative to untreated control cells.
The results of each of the studies are depicted in the tables presented below with each table
representing a separate experiment. The half maximal inhibitory concentration (IC50) of each oligonucleotide
is also presented in the . Apo(a) mRNA levels were significantly reduced in a dose-dependent manner
in antisense oligonucleotide treated cells. The potency of the newly designed oligos was compared with the
benchmark oligonucleotide, ISIS . As presented in the tables below, ISIS 494157 (SEQ ID NO: 12),
ISIS 494158 (SEQ ID NO:13), ISIS 494159 (SEQ ID NO:14), ISIS 494160 (SEQ ID NO: 15), ISIS 494161
(SEQ ID NO:16), ISIS 494162 (SEQ ID NO: 17), ISIS 494163 (SEQ ID NO: 18), ISIS 494164 (SEQ ID NO:
19), ISIS 494230 (SEQ ID NO: 105), ISIS 494243 (SEQ ID NO: 106), ISIS 494244 (SEQ ID NO: 107), ISIS
494283 (SEQ ID NO: 26), ISIS 494284 (SEQ ID NO: 27), ISIS 494285 (SEQ ID NO: 28), ISIS 494286
(SEQ ID NO: 29), ISIS 494287 (SEQ ID NO: 30), ISIS 494290 (SEQ ID NO: 32), ISIS 494292 (SEQ ID
NO: 35), ISIS 494300 (SEQ ID NO: 38), ISIS 494301 (SEQ ID NO: 39), ISIS 494302 (SEQ ID NO: 40),
ISIS 494303 (SEQ ID NO: 41), ISIS 494304 (SEQ ID NO: 42), ISIS 494305 (SEQ ID NO: 43), ISIS 494306
(SEQ ID NO: 44), ISIS 494310 (SEQ ID NO: 46), ISIS 494311 (SEQ ID NO: 47), ISIS 494337 (SEQ ID
NO: 50), ISIS 494371 (SEQ ID NO: 57), ISIS 494372 (SEQ ID NO: 58), ISIS 494375 (SEQ ID NO: 61),
ISIS 494388 (SEQ ID NO: 64), ISIS 494389 (SEQ ID NO: 65), ISIS 494390 (SEQ ID NO: 66), ISIS 494392
(SEQ ID NO: 68), ISIS 494466 (SEQ ID NO: 108), ISIS 494470 (SEQ ID NO: 109), ISIS 494472 (SEQ ID
NO: 110), ISIS 498238 (SEQ ID NO: 76), ISIS 498239 (SEQ ID NO: 77), ISIS 498433 (SEQ ID NO: 72),
ISIS 498434 (SEQ ID NO: 73), ISIS 498435 (SEQ ID NO: 74), ISIS 498523 (SEQ ID NO: 92), ISIS 498524
(SEQ ID NO: 93), ISIS 498525 (SEQ ID NO: 94), ISIS 498580 (SEQ ID NO: 103), and ISIS 498581 (SEQ
ID NO: 104) were more potent than ISIS 144367 (SEQ ID NO: 11).
Table 143
0.049 0.148 0.444 1.333 4.000 1C50
ISIS N0
HM HM HM HM HM (HM)
144367 0 26 67 89 92 0.32
494157 23 50 83 96 96 0.15
494158 26 62 85 96 96 0.11
494159 42 65 87 95 94 0.07
494160 51 70 88 94 94 <0.05
494161 36 67 87 95 96 0.08
494162 40 69 89 94 95 0.07
494163 41 57 87 95 94 0.08
494164 15 43 75 93 96 0.20
494230 39 77 94 99 99 0.05
494243 39 76 92 98 99 0.06
494244 58 79 91 97 99 0.02
WO 79625
Table 144
0.049 0.148 0.444 1.333 4.000 leo
ISIS N0
HM HM HM HM HM (HM)
144367 21 40 79 94 93 0.18
494285 53 68 90 97 97 <0.05
494286 46 69 89 96 97 0.05
494287 31 38 79 94 95 0.15
494290 22 53 74 93 94 0.16
494292 37 51 81 93 95 0.11
494294 22 40 72 91 94 0.19
494299 15 43 75 93 95 0.20
494300 25 38 79 95 95 0.17
494301 23 48 82 92 95 0.15
494302 26 59 86 93 94 0.12
494303 10 58 84 92 91 0.16
494304 25 62 83 93 93 0.12
Table 145
0.049 0.148 0.444 1.333 4.000 leo
ISIS N0
HM HM HM HM HM (HM)
144367 23 40 70 90 94 0.19
494305 20 48 82 93 95 0.16
494306 26 53 78 91 92 0.14
494310 36 50 79 88 92 0.12
494311 38 50 74 93 95 0.12
494334 20 42 73 90 94 0.19
494336 5 39 74 92 95 0.23
494337 23 51 87 96 96 0.14
494338 12 42 82 93 95 0.19
494371 28 49 82 94 94 0.14
494372 28 54 81 93 88 0.13
494373 21 28 67 86 92 0.25
494375 26 40 77 85 92 0.18
Table 146
WO 79625
0.049 0.148 0.444 1.333 4.000 1C50
1s1s No
HM HM HM HM HM (HM)
144367 5 33 65 78 81 0.32
494388 30 32 60 82 86 0.25
494389 30 45 69 84 84 0.17
494390 32 47 67 83 87 0.16
494392 23 38 54 79 82 0.31
494466 48 67 86 91 95 0.04
494470 74 87 92 96 98 <0.05
494472 69 84 92 96 97 <0.05
494544 5 18 49 74 79 0.48
498238 25 51 76 92 96 0.15
498239 25 62 83 93 97 0.12
498379 5 21 53 71 81 0.55
498408 1 38 63 79 80 0.32
498433 23 43 70 77 79 0.21
Table 147
0.049 0.148 0.444 1.333 4.000 1C50
ISIS N0
HM HM HM HM HM (HM)
498434 32 44 64 78 84 0.20
498435 24 42 64 77 79 0.23
498517 28 23 53 81 85 0.45
498523 50 64 81 90 93 <0.05
498524 53 70 84 93 96 <0.05
498525 38 55 80 92 96 0.09
498550 12 18 62 81 83 0.33
498557 13 33 67 79 83 0.33
498579 6 42 69 80 85 0.31
498580 6 46 76 82 83 0.23
498581 5 40 78 81 84 0.25
498721 40 31 58 78 83 0.35
498833 21 20 58 80 90 0.44
e 117: Antisense inhibition of human apo(a) in transgenic mouse primary hepatocytes
Additional antisense oligonucleotides were newly designed targeting an apo(a) nucleic acid and were
tested for their effects on apo(a) mRNA in vitro. The antisense oligonucleotides were tested in a series of
experiments that had similar culture conditions. Primary hepatocytes from human apo(a) transgenic mice
were used in this study. Hepatocytes at a density of 35,000 cells per well were transfected using
electroporation with 1,000 nM nse oligonucleotide. After a treatment period of imately 24
hours, RNA was ed from the cells and apo(a) mRNA levels were measured by quantitative real-time
PCR. Human primer probe set hAPO(a)12kB was used to measure mRNA levels. Apo(a) mRNA levels were
adjusted according to total RNA content, as measured by RIBOGREEN® The results for each experiment
are presented in separate tables shown below. ISIS 1443 67 was also included in the studies for comparison.
Results are presented as percent inhibition of apo(a), relative to untreated control cells. A total of 231
antisense oligonucleotides were tested under these e ions. Only those antisense oligonucleotides
that were selected for further studies are ted below.
The newly designed chimeric antisense ucleotides were designed as 34 MOE gapmers.
The gapmers are 17 nucleosides in length, wherein the central gap segment comprises of ten 2’-
deoxynucleosides and is flanked by wing segments on the 5’ direction and the 3’ direction comprising three
sides and four sides respectively. Each nucleoside in the 5’ wing segment and each nucleoside
in the 3’ wing segment has a 2’-MOE modification. The ucleoside linkages throughout each gapmer
are phosphorothioate (P=S) linkages. All cytosine residues throughout each gapmer are 5-methylcytosines.
The apo(a) target sequence contains multiple Kringle repeat sequences, therefore, an antisense
oligonucleotide may target one or more regions of apo(a) depending r on the oligonucleotide targets a
Kringle sequence or not. “Start site” indicates the 5’-most nucleoside to which the gapmer is targeted in the
human sequence. “Stop site” indicates the 3 ’-most nucleoside to which the gapmer is targeted human
sequence. An apo(a) antisense oligonucleotide may have more than one “Start site” or “Stop site” depending
on r or not it targets a Kringle repeat.
Most gapmers listed in the tables are targeted with 100% complementarity to multiple regions of
either the human apo(a) mRNA, designated herein as SEQ ID NO: 1 (GENBANK Accession No.
NM_005577.2) or the human apo(a) genomic sequence, designated herein as SEQ ID NO: 2 NK
Accession No. NT_007422. 12 truncated from nucleotides 3230000 to 3380000), or both. ‘n/a’ indicates that
the antisense oligonucleotide does not target that particular sequence with 100% complementarity.
Table 148
SEQ ID SEQ ID SEQ ID SEQ ID
ISIS % SEQ ID
NO: 1 NO: 1 Sequence NO: 2 NO: 2
NO inhibition NO
Start Site Stop Site Start Site Stop Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 64 21210 21229 11
241 257 CCTGTGACAGTGGTGGA 21202 21218
583 599 CCTGTGACAGTGGTGGA 26693 26709
925 941 CCTGTGACAGTGGTGGA 32240 32256
510542 79 111
1609 1625 CCTGTGACAGTGGTGGA 43333 43349
1951 1967 CCTGTGACAGTGGTGGA 48877 48893
2293 2309 CCTGTGACAGTGGTGGA 54423 54439
3319 3 335 CCTGTGACAGTGGTGGA 72040 72056
4&8 M89 CCTGTGACAGTGGTGGA 94404 94420
5005 5021 CCTGTGACAGTGGTGGA 115515 115531
242 258 GACAGTGGTGG 21203 21219
84 600 TCCTGTGACAGTGGTGG 26694 26710
926 942 TCCTGTGACAGTGGTGG 32241 32257
1610 1626 TCCTGTGACAGTGGTGG 43334 43350
510543 1952 1968 TCCTGTGACAGTGGTGG 75 48878 48894 112
2294 2310 TCCTGTGACAGTGGTGG 54424 54440
3320 3336 TCCTGTGACAGTGGTGG 72041 72057
4664 4680 TCCTGTGACAGTGGTGG 94405 94421
5006 5022 TCCTGTGACAGTGGTGG 115516 115532
243 259 TGACAGTGGTG 21204 21220
85 601 TTCCTGTGACAGTGGTG 26695 26711
927 943 TTCCTGTGACAGTGGTG 32242 32258
161 1 1627 TTCCTGTGACAGTGGTG 43335 43351
510544 1953 1969 TTCCTGTGACAGTGGTG 73 48879 48895 113
2295 231 1 TTCCTGTGACAGTGGTG 54425 54441
3321 3337 TTCCTGTGACAGTGGTG 72042 72058
4665 4681 TTCCTGTGACAGTGGTG 94406 94422
5007 5023 TTCCTGTGACAGTGGTG 115517 115533
244 260 CTTCCTGTGACAGTGGT 21205 21221
586 an CTTCCTGTGACAGTGGT 26696 26712
928 944 CTTCCTGTGACAGTGGT 32243 32259
1612 1628 CTTCCTGTGACAGTGGT 43336 43352
1954 1970 CTTCCTGTGACAGTGGT 48880 48896
510545 65 114
2296 2312 CTTCCTGTGACAGTGGT 54426 54442
3322 3338 CTTCCTGTGACAGTGGT 72043 72059
3664 3680 CTTCCTGTGACAGTGGT 77585 77601
M86 M82 CTTCCTGTGACAGTGGT 94407 94423
5008 5024 CTTCCTGTGACAGTGGT 115518 115534
245 261 TGTGACAGTGG 21206 21222
3665 3681 CCTTCCTGTGACAGTGG 77586 77602
510546 74 115
M87 M83 CCTTCCTGTGACAGTGG 94408 94424
5009 5025 CCTTCCTGTGACAGTGG 115519 115535
246 262 TCCTTCCTGTGACAGTG 21207 21223
3666 3682 TCCTTCCTGTGACAGTG 77587 77603
510547 77 116
4&8 46$! CTGTGACAGTG 94409 94425
5010 5026 TCCTTCCTGTGACAGTG 115520 115536
247 263 GTCCTTCCTGTGACAGT 21208 21224
3667 3683 GTCCTTCCTGTGACAGT 77588 77604
510548 73 117
M89 M85 GTCCTTCCTGTGACAGT 94410 94426
501 1 5027 GTCCTTCCTGTGACAGT 115521 115537
W0 2014/179625
248 264 GGTCCTTCCTGTGACAG 21209 21225
510549 67 118
4670 4686 GGTCCTTCCTGTGACAG 9441 1 94427
632 648 CCGACTATGCGAGTGTG 26742 26758
974 990 CCGACTATGCGAGTGTG 32289 32305
1316 1332 ATGCGAGTGTG 37836 37852
1658 1674 CCGACTATGCGAGTGTG 43382 43398
510595 76 119
2000 2016 CCGACTATGCGAGTGTG 48926 48942
2342 2358 CCGACTATGCGAGTGTG 54472 54488
2684 2700 CCGACTATGCGAGTGTG 60027 60043
3026 3042 CCGACTATGCGAGTGTG 66543 66559
634 650 GTCCGACTATGCGAGTG 26744 26760
976 992 GTCCGACTATGCGAGTG 32291 32307
1318 1334 GTCCGACTATGCGAGTG 37838 37854
1660 1676 GTCCGACTATGCGAGTG 43384 43400
510597 70 120
2002 2018 GTCCGACTATGCGAGTG 48928 48944
2344 2360 CTATGCGAGTG 54474 54490
2686 2702 GTCCGACTATGCGAGTG 60029 60045
3028 3044 GTCCGACTATGCGAGTG 66545 66561
635 651 GGTCCGACTATGCGAGT 26745 26761
977 993 GGTCCGACTATGCGAGT 32292 32308
1319 1335 GGTCCGACTATGCGAGT 37839 37855
1661 1677 GGTCCGACTATGCGAGT 43385 43401
510598 70 121
2003 2019 GGTCCGACTATGCGAGT 48929 48945
2345 2361 GGTCCGACTATGCGAGT 54475 54491
2687 2703 GGTCCGACTATGCGAGT 60030 60046
3029 3045 ACTATGCGAGT 66546 66562
Table 149
SEQ ID SEQ ID SEQ ID SEQ ID SEQ
ISIS %
NO: 1 NO: 1 Sequence NO: 2 NO: 2 ID
NO tion
Start S1te Stop Slte Start Site Stop Slte NO
144367 249 268 GGCAGGTCCTTCCTGTGACA 83 21210 21229 1 1
510783 6400 6416 GTCAGACCTTAAAAGCT 75 140056 140072 122
512944 3561 3577 AAGCCTCTGTGCTTGGA 81 76246 76262 123
512947 3560 3576 AGCCTCTGTGCTTGGAT 85 76245 76261 124
512958 3559 3575 GCCTCTGTGCTTGGATC 82 76244 76260 125
512959 3585 3601 GCTCCGTTGGTGCTTCT 77 n/a n/a 126
Table 150
ISIS NO 8158: I1D SE18: 11) Sequence inhiffition 811318212) 811318: I2D 81:??0113
Start Site Stop Site Start Site Stop Site
144367 249 268 GGCAGGTCCTTCCTGTGACA 76 21210 21229 11
510701 4217 4233 CTCTGTGCTTGGAACTG 78 85147 85163 127
219 235 21180 21196
561 577 26671 26687
903 919 32218 32234
1245 1261 37765 37781
510702 1587 1603 TGCCTCGATAACTCTGT 79 43311 43327 128
1929 1945 48855 48871
2271 2287 54401 54417
2613 2629 59956 59972
4299 4315 86472 86488
563 579 26673 26689
905 921 32220 32236
1247 1263 37767 37783
1589 1605 43313 43329
510704 1931 1947 TGTGCCTCGATAACTCT 80 48857 48873 129
2273 2289 54403 54419
2615 2631 59958 59974
4301 4317 86474 86490
4985 5001 115495 115511
510757 4929 4945 GCTCAGTTGGTGCTGCT 74 Ifla tfla 130
Example 118: Dose-dependent antisense inhibition of apo(a) in transgenic mouse primary hepatocytes
Potent s from the s described above were further selected and tested at various doses in
transgenic mouse primary hepatocytes in a series of studies with r culture conditions. Cells were plated
at a density of 35 ,000 per well and transfected using electroporation with 0.156 1.1M, 0.313 MM, 0.625 uM,
1.250 uM, 2.500 HM, or 5.000 uM concentrations of antisense oligonucleotide, as ed in the tables
below. After a treatment period of approximately 16 hours, RNA was isolated from the cells and apo(a)
mRNA levels were measured by quantitative real-time PCR. Apo(a) primer probe set hAPO(a)12kB was
used to measured mRNA levels. Apo(a) mRNA levels were adjusted according to total RNA content, as
measured by RIBOGREEN® Results are presented as percent inhibition of apo(a), relative to untreated
control cells.
The results of each of the s are depicted in the tables presented below with each study
represented in a separate table. The half maximal inhibitory concentration (leo) of each oligonucleotide is
also presented in the tables.
Table 151
0.156 0.312 0.625 1.250 2.500 5.000 1C50
1s1s NO
HM NM NM MM HM MM (MM)
144367 28 55 70 83 90 92 0.31
510542 33 58 75 87 89 90 0.27
WO 79625
510543 33 45 68 78 89 89 0.34
510544 33 50 65 78 88 90 0.33
510545 33 58 76 87 91 90 0.26
510546 39 62 76 87 89 91 0.22
510547 36 66 82 84 86 91 0.22
510548 50 70 82 91 88 90 0.13
510549 32 59 73 85 86 90 0.27
510595 26 57 78 88 90 90 0.29
510597 30 53 76 85 89 89 0.30
Table 152
0.156 0.312 0.625 1.250 2.500 5.000 1C50
ISIS No
HM HM HM HM HM HM (HM)
144367 36 52 78 87 93 94 0.26
510598 48 58 81 88 93 92 0.18
510701 45 59 78 87 95 95 0.18
510702 49 63 75 90 94 95 0.15
510704 55 67 80 93 94 95 <0.16
510757 34 48 68 79 90 93 0.33
510783 21 32 51 58 78 84 0.69
512944 57 72 81 91 96 97 <0.16
512947 64 74 86 92 96 97 <0.16
512958 48 69 83 91 96 97 0.13
512959 39 59 76 84 93 93 0.22
Table 153
0.156 0.312 0.625 1.250 2.500 5.000 1C50
ISIS No
HM HM HM HM HM HM (HM)
144367 41 58 75 81 88 87 0.22
510542 38 54 69 74 85 83 0.27
510545 21 43 73 77 80 78 0.39
510546 37 58 73 81 83 81 0.24
510547 38 58 72 79 84 86 0.24
510548 40 63 77 79 81 84 0.21
510549 37 47 67 77 81 83 0.31
510595 34 66 73 81 80 75 0.23
510597 39 59 74 83 76 77 0.23
Table 154
0.156 0.312 0.625 1.250 2.500 5.000 1C50
ISIS No
HM HM HM HM HM HM (HM)
144367 33 60 72 83 81 81 0.26
510598 47 62 75 75 76 76 0.18
510701 41 67 80 87 92 91 0.19
510702 51 64 77 80 80 83 0.13
510704 54 61 77 84 89 80 0.12
512944 71 74 81 88 92 94 0.02
512947 65 77 86 90 93 95 0.03
512958 63 73 84 92 93 96 0.06
512959 39 62 80 82 86 82 0.22
Apo(a) mRNA levels were significantly reduced in a dose-dependent manner in antisense
oligonucleotide-treated cells. The potency of the newly designed oligonucleotides was compared with the
benchmark oligonucleotide, ISIS 144367. As ted in the tables above, ISIS 510542 (SEQ ID NO: 111),
ISIS 510545 (SEQ ID NO: 114), ISIS 510546 (SEQ ID NO: 115), ISIS 510547 (SEQ ID NO: 116), ISIS
510548 (SEQ ID NO: 117), ISIS 510549 (SEQ ID NO: 118), ISIS 510595 (SEQ ID NO: 119), ISIS 510597
(SEQ ID NO: 120), ISIS 510598 (SEQ ID NO: 121), ISIS 510701 (SEQ ID NO: 127), ISIS 510702 (SEQ ID
NO: 128), ISIS 510704 (SEQ ID NO: 129), ISIS 512944 (SEQ ID NO: 123), ISIS 512947 (SEQ ID NO:
124), ISIS 512958 (SEQ ID NO: 125), and ISIS 512959 (SEQ ID NO: 126) were more potent than ISIS
144367 (SEQ ID NO: 11).
e 119: Effect of in vivo antisense inhibition of human apo(a) in human apo(a) transgenic
mice
Transgenic mice with the human apo(a) gene (Frazer, K.A. et al., Nat. Genet. 1995. 9: 424-431) were
utilized in the studies described below. ISIS antisense ucleotides that demonstrated statistically
significant inhibition of apo(a) mRNA in vitro as described above were ted further in this model.
Study 1
Female human apo(a) transgenic mice were maintained on a 12-hour light/dark cycle and fed ad
libitum normal lab chow. The mice were divided into treatment groups ting of 4 mice each. The groups
received intraperitoneal injections of ISIS 494159, ISIS 494160, ISIS 494161, ISIS 494162, ISIS 494163,
ISIS 494230, ISIS 494243, ISIS 494244, ISIS , ISIS 494284, ISIS 494285, ISIS 494286, ISIS 494301,
ISIS , ISIS 494304, ISIS 494466, ISIS 494470, ISIS 494472, ISIS 498239, ISIS 498408, ISIS 498517,
ISIS 494158, ISIS 494311, ISIS 494337, ISIS 494372, ISIS 498238, ISIS 498523, ISIS 498525, ISIS 510548,
ISIS 512944, ISIS 512947, or ISIS 512958 at a dose of 25 mg/kg twice a week for 2 weeks. One group of
mice received intraperitoneal injections of PBS twice a week for 2 weeks. The PBS group served as the
control group. Two days following the final dose, the mice were euthanized, organs harvested and analyses
done.
Inhibition n apo(a) mRNA
Total RNA was extracted from the livers of some of the treatment groups, and human apo(a) mRNA
was quantitated by RT-PCR. The results are presented in the table below, expressed as t inhibition of
apo(a) mRNA compared to the PBS control.
Table 155
Percent inhibition of human apo(a) mRNA in transgenic mice
ISIS N0 inhilfition
144367 98
494159 100
494160 95
494161 98
494162 100
494163 100
494230 96
494243 99
494244 99
494283 100
494284 100
494285 100
494286 98
494301 99
494302 96
494304 94
494466 97
494470 93
494472 98
498239 72
498408 100
498517 98
The data demonstrates significant inhibition of apo(a) mR\IA by several ISIS oligonucleotides. ISIS
494159 (SEQ ID NO: 14), ISIS 494162 (SEQ ID NO: 17), ISIS 494163 (SEQ ID NO: 18), ISIS 494243
(SEQ ID NO: 106), ISIS 494244 (SEQ ID NO: 107), ISIS 494283 (SEQ ID NO: 26), ISIS 494284 (SEQ ID
NO: 27), ISIS 494285 (SEQ ID NO: 28), ISIS 494301 (SEQ ID NO: 39), and ISIS 498408 (SEQ ID NO: 71)
were more potent than the benchmark ISIS 144367 (SEQ ID NO: 11).
Inhibition ofhuman apo(a) protein
Plasma human apo(a) protein was measured from all ent groups using an Apo(a) ELISA kit
(Mercodia 1001, a, Sweden). The results are presented in the table below, expressed as percent
inhibition of apo(a) mRNA compared to the PBS control.
Table 156
Percent inhibition of human apo(a) protein in transgenic mice
ISIS 96
No inhibition
144367 86
494159 86
494160 0
494161 82
494162 84
494163 82
494230 60
494243 84
494244 87
494283 98
494284 98
494285 89
494286 89
494301 93
494302 88
494304 83
494466 76
494470 73
494472 72
498239 54
498408 84
498517 56
494158 71
494311 83
494337 80
494372 78
498238 58
498523 47
498525 58
510548 74
512944 18
512947 65
512958 72
The data demonstrates significant inhibition of apo(a) mRNA by several ISIS ucleotides.
ISIS 494159 (SEQ ID NO: 14), ISIS 494244 (SEQ ID NO: 82), ISIS 494283 (SEQ ID NO: 26), ISIS 494284
(SEQ ID NO: 27), ISIS 494285 (SEQ ID NO: 28), ISIS 494286 (SEQ ID NO: 29), ISIS 494301 (SEQ ID
NO: 39), and ISIS 494302 (SEQ ID NO: 40) were as potent as or more potent than the benchmark ISIS
144367 (SEQ ID NO: 11)..
Study 2
ISIS 494159, ISIS 494161, ISIS 494162, ISIS 494163, and ISIS 494243 were further evaluated in
this transgenic model. ISIS 144367 was included for comparison.
ent
Female human apo(a) transgenic mice were divided into treatment groups consisting of 4 mice
each. The groups received intraperitoneal injections of ISIS 144367, ISIS 494159, ISIS 494161, ISIS 494162,
ISIS 494163, or ISIS 494243 at doses of 1.5 mg/kg, 5 mg/kg, 15 mg/kg, or 50 mg/kg twice a week for 2
weeks. One group of mice received intraperitoneal injections of PBS twice a week for 2 weeks. The PBS
group served as the control group. Two days following the final dose, the mice were euthanized, organs
harvested and analyses done.
Inhibition n apo(a) mRNA
Total RNA was extracted from the livers of the treatment groups, and human apo(a) mRNA was
quantitated by RT-PCR. The results are presented in the table below, expressed as t inhibition of
apo(a) mRNA compared to the PBS l.
Table 157
Dose-dependent inhibition of human apo(a) mRNA in transgenic mice
Dose %
ISIS N0 ED”
(mg/kg/wk) inhibition
100 71
42
144367— 31
0
3 5
100 91
67
494159— 5
48
3 39
494161 100 82 6
49
61
100 9O
67
494162
5 8
100 83
66
494163
58
100 8O
26
494243 32
The data demonstrates significant inhibition of apo(a) mRNA by several ISIS oligonucleotides. ISIS
494159 (SEQ ID NO: 14), ISIS 494161 (SEQ ID NO: 16), 494162 (SEQ ID NO:17), and ISIS 94163 (SEQ
ID NO: 18) were more ious than the benchmark ISIS 144367 (SEQ ID NO: 11).Reduction ofhuman
apo(a) protein levels
Blood was collected from the ent groups, and human apo(a) protein levels were quantitated by
an Apo(a) ELISA kit (Mercodia 1001, Uppsala, Sweden). The results are presented in the table below,
expressed as percent reduction of apo(a) protein levels compared to the PBS control.
Table 158
Dose-dependent inhibition of human apo(a) protein in enic mice
Dose %
ISIS No ED50
(mg/kg/wk) inhibition
100 73
O
144367 71
6
3 69
100 88
88
494159
85
3 36
100 90
85
494161— 2
73
3 44
100 89
78
494162— 3
76
3 24
100 90
494163M 3
6O
3 37
100 61
494243 —30 174
0
3 0
The data demonstrates significant reduction of apo(a) plasma protein levels by several ISIS
oligonucleotides. ISIS 494159 (SEQ ID NO: 14), ISIS 494161 (SEQ ID NO: 16), ISIS 494162 (SEQ ID NO:
17), and ISIS 494163 (SEQ ID NO: 18) were more efficacious than the benchmark ISIS 144367 (SEQ ID
NO: 11).
Study 3
ISIS 494244, ISIS 494283, and ISIS 494284 were further evaluated in this model. ISIS 144367 was
included for comparison.
Treatment
Female human apo(a) transgenic mice were divided into treatment groups consisting of 4 mice
each. The groups received intraperitoneal injections of ISIS 144367, ISIS 494244, ISIS 494283, or ISIS
494284 at doses of 0.75 mg/kg, 2.5 mg/kg, 7.5 mg/kg, or 25 mg/kg twice a week for 2 weeks. One group of
mice received eritoneal injections of PBS twice a week for 2 weeks. The PBS group served as the
control group. Two days following the final dose, the mice were euthanized, organs harvested and analyses
done.
Inhibition ofhuman apo(a) mRNA
Total RNA was extracted from the livers of the treatment , and human apo(a) mRNA was
tated by RT-PCR. The results are presented in the table below, sed as percent tion of
apo(a) mRNA compared to the PBS control.
Table 159
Dose-dependent inhibition of human apo(a) mRNA in transgenic mice
Dose %
ISIS N0 ED”
(mg/kg/wk) inhibition
50 75
60
144367 22
0
1.5 0
50 73
41
494244W 18
1.5 0
50 74
52
494283 16
24
1.5 0
50 73
494284¥ 16
17
1.5 2
The data demonstrates significant tion of apo(a) le\A by several ISIS oligonucleotides. ISIS
494244 (SEQ ID NO: 107), ISIS 494283 (SEQ ID NO: 26), and ISIS 494284 (SEQ ID NO: 27) were more
efficacious than the benchmark, ISIS 144367 (SEQ ID NO: 11).
Reduction ofhuman apo(a) protein levels
Blood was ted from the treatment groups, and human apo(a) protein levels were quantitated by
an Apo(a) ELISA kit (Mercodia 1001, Uppsala, Sweden). The results are presented in the table below,
expressed as percent reduction of apo(a) protein levels compared to the PBS l.
Table 160
Dose-dependent inhibition of human apo(a) plasma protein in transgenic mice
Dose %
ISIS N0 ED”
/wk) inhibition
50 64
14
144367 16
0
1.5 0
50 67
60
494244 2
—558
1.5 0
494283 50 64 4
=—“64
494284_= 4
The data demonstrates significant reduction of apo(a) plasma protein levels by several ISIS
oligonucleotides. ISIS 494244 (SEQ ID NO: 107), ISIS 494283 (SEQ ID NO: 26), and ISIS 494284 (SEQ ID
NO: 27) were more efficacious than the benchmark, ISIS 144367 (SEQ ID NO: 11).
Study 4
ISIS 494285, ISIS 494286, ISIS 494301, ISIS 494302, and ISIS 494311 were further evaluated in
this model.
Treatment
Male human apo(a) transgenic mice were divided into treatment groups consisting of 4 mice each.
Each such group received intraperitoneal injections of ISIS 494285, ISIS 494286, ISIS 494301, ISIS 494302,
or ISIS 494311 at doses of 5 mg/kg, 15 mg/kg, or 50 mg/kg once a week for 2 weeks. One group of 3 mice
ed intraperitoneal injections of PBS once a week for 2 weeks. The PBS group served as the control
group. Two days following the final dose, the mice were euthanized, organs harvested and analyses done.
tion ofhuman apo(a) mRNA
Total RNA was extracted from the livers of the treatment groups, and human apo(a) mRNA was
tated by RT-PCR. The results are presented in the table below, expressed as percent inhibition of
apo(a) mRNA compared to the PBS control. The data demonstrates significant inhibition of apo(a) mRNA by
ISIS 494285 (SEQ ID NO: 28), ISIS 494286 (SEQ ID NO: 29), ISIS 494301 (SEQ ID NO: 39), ISIS 494302
(SEQ ID NO: 40) and ISIS 494311 (SEQ ID NO: 47).
Table 161
Dose-dependent tion of human Apo(a) mRNA in enic mice
Dose %
(mtg/Wk)
494285 1
4,4286 1
80
50 98
494301 15 96 3
59
50 98
494302 15 88 2
72
50 99
494311 15 96 1
87
Reduction ofhuman apo(a) protein levels
Blood was collected from the ent groups, and human apo(a) protein levels were tated by
an Apo(a) ELISA kit (Mercodia 1001, Uppsala, Sweden). The results are presented in the table below,
expressed as percent reduction of apo(a) protein levels compared to the PBS control. The data demonstrates
significant reduction of apo(a) plasma protein levels by ISIS 494285, ISIS 494286, ISIS 494301, ISIS 494302
and ISIS 494311.
Table 162
Dose-dependent inhibition of human apo(a) protein in transgenic mice
Dose %
ISIS N0 ED”
(mg/kg/wk) inhibition
50 88
494285 15 88 2
72
50 90
494286 15 85 2
75
50 89
494301 15 86 5
38
50 90
494302 15 82 3
61
50 90
494311 15 82 3
69
Study 5
ISIS 494372, ISIS 498524, ISIS , ISIS 498721, and ISIS 498833 were r evaluated in
this model.
Treatment
Female human apo(a) transgenic mice were divided into ent groups consisting of 4 mice
each. The groups received intraperitoneal injections of ISIS 494372, ISIS 498524, ISIS 498581, ISIS 498721,
or ISIS 498833 at doses of 5 mg/kg, 15 mg/kg, or 50 mg/kg once a week for 2 weeks. One group of 3 mice
ed intraperitoneal injections of PBS once a week for 2 weeks. The PBS group served as the control
group. Two days following the final dose, the mice were euthanized, organs harvested and es done.
Inhibition ofhuman apo(a) mRNA
Total RNA was extracted from the livers of the treatment groups, and human apo(a) mRNA was
quantitated by RT-PCR. The s are presented in the table below, expressed as percent inhibition of
apo(a) mRNA compared to the PBS control. The data demonstrates significant inhibition of apo(a) mRNA by
ISIS 494372 (SEQ ID NO: 28), ISIS 498524 (SEQ ID NO: 93), ISIS 498581 (SEQ ID NO: 104), and ISIS
498721 (ATGCCTCGATAACTCCGTCC; SEQ ID NO: 134).
Table 163
Dose-dependent inhibition of human Apo(a) mRNA in transgenic mice
ISIS No (111535731) inhilfition ED”
50 88
494372W 18
0
50 83
498524 15 74 8
34
50 98
498581 15 58 7
48
50 97
498721 15 68 14
0
50 61
498833 15 0 155
17
Reduction ofhuman apo(a) protein levels
Blood was ted from the treatment groups, and human apo(a) protein levels were quantitated by an
Apo(a) ELISA kit (Mercodia 1001, Uppsala, ). The results are presented in the table below,
expressed as percent reduction of apo(a) protein levels compared to the PBS control. The data demonstrates
significant reduction of apo(a) plasma protein levels by ISIS 494372 (SEQ ID NO: 28), ISIS 4985 81 (SEQ
ID NO: 104), and ISIS 498721 (ATGCCTCGATAACTCCGTCC; SEQ ID NO: 134).
Table 164
Dose-dependent inhibition of human apo(a) protein in transgenic mice
Dose %
ISIS N0 ED”
(mg/kg/wk) inhibition
50 68
494372 15 25 32
12
50 38
498524 15 0 118
0
50 79
498581 15 52 9
49
50 81
498721W 10
29
50 15
498833 15 0 738
67
Example 120: Tolerability of antisense oligonucleotides targeting human apo(a) in rodent models
Gapmer antisense oligonucleotides targeting human apo(a) were selected from the studies bed
above for tolerability studies in CD1 mice and in Sprague Dawley rats. Rodents do not express endogenous
apo(a), hence these studies tested the tolerability of each human antisense oligonucleotide in an animal rather
than any phenotypic changes that may be caused by inhibiting apo(a) in the animal.
Tolerability in CD1 mice: Study 1
CD1® mice (Charles River, MA) are a urpose mice model, frequently ed for safety and
efficacy g. The mice were treated with ISIS antisense oligonucleotides selected from studies described
above and ted for changes in the levels of various plasma chemistry markers.
Treatment
Groups of male CD1 mice were injected subcutaneously twice a week for 6 weeks with 50 mg/kg of
ISIS 494159, ISIS 494161, ISIS 494162, ISIS 494244, ISIS 494283, ISIS 494284, ISIS 494285, ISIS 494286,
ISIS 494301, ISIS 494302, ISIS 494311, ISIS 494337, ISIS 494372, and ISIS . One group of six-
week old male CD1 mice was injected subcutaneously twice a week for 6 weeks with PBS. Mice were
euthanized 48 hours after the last dose, and organs and plasma were harvested for further analysis.
Plasma chemistry markers
To evaluate the effect of ISIS oligonucleotides on liver and kidney function, plasma levels of
transaminases, bin, albumin, creatinine, and BUN were measured using an automated clinical try
analyzer (Hitachi Olympus AU400e, Melville, NY). The results are presented in the table below. ISIS
oligonucleotides that caused changes in the levels of any of the liver or kidney function markers outside the
ed range for antisense oligonucleotides were excluded in r s.
Table 165
Plasma chemistry markers of CD1 mice
ALT AST Albumin BUN Creatinine Bilirubin
(IU/L (IU/L) (g/dL) (mg/dL) ) (mg/dL)
PBS 38 71 2.9 25.2 0.16 0.15
ISIS 494159 615 525 2.7 23.9 0.11 0.20
ISIS 494161 961 670 2.6 23.7 0.15 0.14
ISIS 494285 582 436 2.3 25.4 0.16 0.11
ISIS 494286 191 227 2.5 21.1 0.12 0.15
ISIS 494301 119 130 2.7 26.4 0.15 0.12
ISIS 494302 74 96 2.8 24.8 0.14 0.15
ISIS 494311 817 799 2.7 28.7 0.12 0.17
ISIS 494337 722 397 2.5 20.0 0.13 0.11
ISIS 494372 73 164 2.6 28.5 0.16 0.11
ISIS 510548 2819 2245 3.1 26.0 0.15 0.15
Organ weights
Liver, spleen and kidney weights were measured at the end of the study, and are presented in the
table below. ISIS oligonucleotides that caused any changes in organ weights outside the expected range for
antisense oligonucleotides were excluded from further studies.
Table 166
Organ weights of CD1 mice (g)
Kidney Liver Spleen
PBS 0.68 2.0 0.13
ISIS 494159 0.68 3.0 0.21
ISIS 494161 0.62 3.5 0.20
ISIS 494162 0.60 3.3 0.20
ISIS 494283 0.65 2.8 0.24
ISIS 494284 0.69 2.7 0.29
ISIS 494285 0.59 3.2 0.21
ISIS 494286 0.64 2.8 0.25
ISIS 494301 0.72 3.0 0.43
ISIS 494302 0.63 2.3 0.23
ISIS 494311 0.61 3.2 0.19
ISIS 494337 0.56 2.3 0.17
ISIS 494372 0.60 2.5 0.27
ISIS 510548 0.55 3.7 0.20
bility in Sprague Dawley rats
Sprague-Dawley rats are a multipurpose model used for safety and efficacy evaluations. The rats
were treated with ISIS antisense oligonucleotides selected from studies described above and evaluated for
changes in the levels of various plasma try s.
Treatment
Groups of male Sprague Dawley rats were injected aneously twice a week for 8 weeks with 30
mg/kg of ISIS 494159, ISIS 494161, ISIS 494162, ISIS 494244, ISIS 494283, ISIS 494284, ISIS 494285,
ISIS 494286, ISIS 494301, ISIS 494302, ISIS 494311, ISIS 494337, ISIS 494372, and ISIS 510548. One
group of six male e Dawley rats was injected subcutaneously twice a week for 8 weeks with PBS. Rats
were euthanized 48 hours after the last dose, and organs and plasma were harvested for further analysis.
Plasma chemistry markers
To evaluate the effect of ISIS oligonucleotides on liver and kidney function, plasma levels of
transaminases, bilirubin, albumin, creatinine, and BUN were measured using an automated clinical chemistry
analyzer (Hitachi Olympus AU400e, Melville, NY). The s are presented in the table below. ISIS
oligonucleotides that caused changes in the levels of any of the liver or kidney function markers outside the
expected range for antisense oligonucleotides were excluded in further studies.
Table 167
Plasma chemistry markers of Sprague Dawley rats
ALT AST Bilirubin n BUN Creatinine
(IU/L) (IU/L) (mg/dL) (mg/dL) (mg/dL) (mg/dL)
PBS 30 82 0.09 3.2 19 0.28
ISIS 494159 182 208 0.14 3.4 22 0.35
ISIS 494161 36 86 0.13 3.4 23 0.35
ISIS 494162 102 158 0.17 2.6 28 0.32
ISIS 494283 53 156 0.13 2.9 24 0.32
ISIS 494284 34 113 0.08 2.0 28 0.32
ISIS 494285 110 294 0.10 1.4 110 0.52
ISIS 494286 40 83 0.07 1.6 48 0.44
ISIS 494301 38 132 0.08 3.0 18 0.33
ISIS 494302 47 105 0.09 3.2 19 0.34
ISIS 494311 93 185 0.51 2.7 23 0.30
ISIS 494372 54 119 0.12 3.0 19 0.33
ISIS 510548 116 181 0.11 1.7 65 0.66
Kidneyfunction
To evaluate the effect of ISIS oligonucleotides on kidney function, urine levels of total protein and
creatinine were measured using an automated clinical chemistry analyzer (Hitachi s AU400e,
le, NY). Results are presented in the table below, sed in mg/dL.
Table 168
Kidney function markers (mg/dL) in Sprague-Dawley rats
Total
Creatinine
protein
1818 494162 58 925
1818 494284 97 2519
1818 494285 38 2170
1818 494286 51 625
1818 494301 62 280
1818 494302 101 428
1818 494311 48 1160
1818 494372 46 154
1818 510548 55 2119
Organ weights
Liver, spleen and kidney weights were measured at the end of the study, and are presented in the
table below. ISIS oligonucleotides that caused any changes in organ weights outside the expected range for
nse oligonucleotides were excluded from further studies.
Table 169
Organ weights of Sprague Dawley rats (g)
Kidney liver Spleen
PBS 3.5 13.1 0.9
ISIS 494159 3.1 11.7 1.6
ISIS 494161 2.8 12.5 2
ISIS 494162 3.1 14.2 1.6
ISIS 494283 3.3 12.9 2.3
ISIS 494284 4.1 15.8 2.7
ISIS 494285 3.8 13.4 0.8
ISIS 494286 4.2 16.7 2.5
ISIS 494301 3.2 12.1 2.3
ISIS 494302 3.4 13.3 2.4
ISIS 494311 3.5 17.4 3.2
ISIS 494372 3.6 12.9 3.2
ISIS 510548 6.4 21.2 1.5
The finding from the rodent tolerability s showed that in general, taking into consideration all
the tolerability markers screened, ISIS 4943 72 was the best tolerated antisense compound in both the CD1
mouse model and the Sprague Dawley rat model.
Example 121: Pharmacokinetics of antisense oligonucleotide in CD1 mice
CD1 mice were treated with ISIS oligonucleotides and the oligonucleotide concentrations in the liver
and kidney were evaluated.
Treatment
Groups of four CD1 mice each were injected subcutaneously twice per week for 6 weeks with 50
mg/kg of ISIS 494283, ISIS 494284, ISIS 494286, ISIS , ISIS 494302, or ISIS 494372. The mice
were sacrificed 2 days following the final dose. Livers were harvested for analysis.
Measurement ofoligonucleotide concentration
The concentration of the total oligonucleotide tration was measured. The method used is a
modification of usly published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a
phenol-chloroform d-liquid) extraction followed by a solid phase extraction. An al standard (ISIS
355868, a 27-mer 2’-O-methoxyethyl modified phosphorothioate oligonucleotide,
GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 131) was added prior to
extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of
tation (LLOQ) of approximately 1.14 ug/g. Half-lives were then calculated using WinNonlin software
(PHARSIGHT).
The s are presented in the table below, expressed as ug/g liver or kidney tissue. The data
indicates that ISIS 494372 was at an acceptable concentration in the liver and kidneys.
Table 170
Oligonucleotide concentration (ug/g tissue) of ISIS oligonucleotides in CD1 mice
ISIS No Liver Kidney
494288
494284
494288
494894
494892
494872
Example 122: Pharmacokinetics of antisense Oligonucleotide in Sprague Dawley rats
Male Sprague Dawley rats were treated with ISIS oligonucleotides and the oligonucleotide
concentrations in the liver and kidney were evaluated.
Treatment
Groups of four rats each were injected aneously twice per week for 3 weeks with 10 mg/kg of
ISIS 494283, ISIS 494284, ISIS 494286, ISIS 494301, ISIS 494302, or ISIS . The rats were
sacrificed 2 days ing the final dose. Livers were harvested for analysis.
Measurement ofOligonucleotide concentration
The concentration of the total oligonucleotide concentration was measured. The method used is a
modification of previously published methods (Leeds et al., 1996; Geary et al., 1999) which consist of a
phenol-chloroform (liquid-liquid) tion followed by a solid phase extraction. An internal standard (ISIS
355868, a 27-mer 2’-O-methoxyethyl modified phosphorothioate oligonucleotide,
GCGTTTGCTCTTCTTCTTGCGTTTTTT, designated herein as SEQ ID NO: 131) was added prior to
extraction. Tissue sample concentrations were calculated using calibration curves, with a lower limit of
quantitation (LLOQ) of approximately 1.14 ug/g. Half-lives were then calculated using WinNonlin software
(PHARSIGHT).
The results are presented in the table below, expressed as ug/g liver or kidney tissue. The data
indicates that ISIS 494372 was at an able concentration in the liver and s.
Table 171
Oligonucleotide concentration (ug/g tissue) of ISIS oligonucleotides in Sprague Dawley rats
IsIsNo
494301 279 540
494302 205 387
494372 288 663
e 123: Effect of ISIS antisense ucleotides targeting human ap0(a) in cynomolgus monkeys
Cynomolgus monkeys were treated with ISIS antisense oligonucleotides selected from studies
described above. At the time this study was undertaken, the cynomolgus monkey genomic sequence was not
available in the National Center for Biotechnology Information (NCBI) se; therefore, cross-reactivity
with the cynomolgus monkey gene ce could not be confirmed. Instead, the sequences of the ISIS
antisense oligonucleotides used in the cynomolgus s was compared to a rhesus monkey sequence for
homology. It is expected that ISIS ucleotides with homology to the rhesus monkey sequence are fully
cross-reactive with the cynomolgus monkey sequence as well.
The human antisense oligonucleotides tested are also cross-reactive with the rhesus mRNA sequence
(XM_001098061.1; designated herein as SEQ ID NO: 132). The greater the complementarity between the
human oligonucleotide and the rhesus monkey sequence, the more likely the human oligonucleotide can
cross-react with the rhesus monkey sequence. The start and stop sites of each oligonucleotide to SEQ ID NO:
132 is presented in the table below. Each antisense ucleotide targets more than one region in SEQ ID
NO:132 and has multiple start sites. “Start site” indicates the t nucleotide to which the gapmer is
targeted in the rhesus monkey sequence. ‘Mismatches’ indicates the number of nucleotides mismatched
between the human oligonucleotide sequence and the rhesus sequence.
Antisense oligonucleotide bility, as well as their pharmacokinetic profile in the liver and
kidney, was evaluated.
Table 172
Antisense oligonucleotides complementary to SEQ ID NO: 132
ISIS No Start Site Mismatches
278 2
620 2
923 2
1265 2
1607 1
494283
1949 1
2267 1
2609 1
2951 1
3293 1
279 1
621 1
924 1
1266 1
1608 1
494284
1950 1
2268 1
2610 1
2952 1
3294 1
1268
1610
494286
1952
2270
2612
2954
3296
494301 967
1309
1651
494302
1310
1652
1186
494372 1870
2188 t—‘t—‘NNt—‘NNNt—‘NNNNNNNNNt—‘t—‘t—‘H
Treatment
Prior to the study, the monkeys were kept in quarantine for at least a 30-day period, during which the
s were ed daily for general health. The monkeys were 2-4 years old and weighed between 2 and
4 kg. Seven groups of four randomly assigned male cynomolgus monkeys each were injected subcutaneously
with ISIS oligonucleotide or PBS using a stainless steel dosing needle and syringe of appropriate size into the
one of four sites on the back of the monkeys. The ions were given in clock-wise rotation; one site per
dosing. The monkeys were dosed four times a week for the first week (days 1, 3, 5, and 7) as loading doses,
and subsequently once a week for weeks 2-12, with 40 mg/kg of ISIS 494283, ISIS 494284, ISIS 494286,
ISIS 494301, ISIS 494302, or ISIS 494372. A control group of 8 cynomolgus monkeys was injected with
PBS subcutaneously thrice four times a week for the first week (days 1, 3, 5, and 7), and uently once a
week for weeks 2-12.
During the study period, the monkeys were observed at least once daily for signs of s or
distress. Any animal experiencing more than momentary or slight pain or distress due to the treatment, injury
or s was treated by the veterinary staff with approved analgesics or agents to relieve the pain after
consultation with the Study Director. Any animal in poor health or in a possible moribund condition was
identified for further monitoring and possible euthanasia. For ce, one animal in the treatment group of
ISIS 494302 was found moribund on day 56 and was ized. Scheduled euthanasia of the animals was
conducted on days 86 and 87 by uination under deep anesthesia. The protocols described in the
Example were approved by the utional Animal Care and Use Committee (IACUC).
Target Reduction
RNA analysis
On day 86, RNA was extracted from liver tissue for real-time PCR analysis of apo(a) using human
primer probe set ABI Hs009l669l_ml (Applied Biosystems, Carlsbad CA). Results are presented as percent
inhibition of apo(a) mRNA, relative to PBS control. As shown in the table below, treatment with ISIS
antisense oligonucleotides ed in significant reduction of apo(a) mRNA in comparison to the PBS
control.
The mRNA levels of plasminogen, another kringle-containing protein, were also measured.
Treatment with ISIS 4943 72 did not alter the mRNA levels of plasminogen.
Table 173
Percent Inhibition of apo(a) mRNA in the cynomolgus monkey liver relative to the PBS control
ISIS No
494283
494284 “
494286 E-
494301
494302 “
494372 93
Protein analysis
On different days, one mL of blood was collected from the cephalic, saphenous, or femoral vein of
all study monkeys. The blood samples were put into tubes containing A for plasma separation. The
tubes were centrifuged at 3,000 rpm for 10 min at room temperature to obtain plasma. Apo(a) n levels
were analyzed by an Apo(a) ELISA kit (Mercodia 1001, a, Sweden). s are ted as
percentage change of levels from the ne. As shown in the table below, treatment with several ISIS
antisense oligonucleotides resulted in significant reduction of apo(a) protein levels in comparison to the PBS
control. Specif1cally, treatment with ISIS 494372 reduced cynomolgous plasma protein levels of apo(a).
The protein levels of apoB were also measured in the study groups. Antisense inhibition of apo(a)
had no effect on apoB levels.
Table 174
Apo(a) plasma protein levels (% inhibition over baseline values) in the cynomolgus monkey
Day 16 Day 30 Day 44 Day 56 Day 72 Day 86
PBS 0 0 10 0 0 0
ISIS 494283 78 79 81 66 66 70
ISIS 494284 92 95 95 93 93 94
ISIS 494286 92 95 96 94 94 94
ISIS 494301 41 45 52 20 17 29
ISIS 494302 17 0 2 0 0 20
ISIS 494372 67 80 83 79 78 81
Tolerability studies
Body and organ weight ements
To evaluate the effect of ISIS ucleotides on the overall health of the animals, body and organ
weights were measured at day 86. Body weights were measured and are presented in the table below. Organ
weights were measured and the data is presented in the table below. The results indicate that treatment with
ISIS 494372 was well tolerated in terms of the body and organ s of the monkeys.
Table 175
Body weights (g) in the cynomolgus monkey
————--
ISIS 494372 2719 2877 2985 2997 3037 3036
Table 176
Organ weights (% body weight) in the cynomolgus monkey
Spleen Kidneys Liver Heart Lungs
PBS 0.14 0.38 2.2 0.33 0.51
ISIS 494283 0.24 0.95 2.8 0.33 0.49
ISIS 494284 0.19 0.60 2.6 0.36 0.55
ISIS 494286 0.22 0.63 2.7 0.38 0.55
ISIS 494301 0.38 0.81 3.0 0.36 0.61
ISIS 494302 0.17 0.95 2.5 0.39 0.57
ISIS 494372 0.18 1.16 2.6 0.36 0.56
Liverfunction
2014/036460
To evaluate the effect of ISIS oligonucleotides on c on, monkeys were fasted overnight
prior to blood collection. Approximately 1.5 mL of blood was collected from each animal and put into tubes
without anticoagulant for serum separation. The tubes were kept at room temperature for a minimum of 90
min and then centrifuged at 3,000 rpm for 10 min at room temperature to obtain serum. Levels of various
liver function markers were measured using a Toshiba 200FR NEO chemistry analyzer (Toshiba Co., Japan).
Plasma levels of ALT and AST were measured and the results are ted in the table below, expressed in
IU/L. Bilirubin, a liver on marker, was similarly measured and is presented in the table below,
expressed in mg/dL. The results indicate that treatment with ISIS 4943 72 was well tolerated in terms of the
liver function in monkeys.
Table 177
Liver function markers in cynomolgus monkey plasma
ALT AST Bilirubin
(IU/L) (IU/L) (mg/dL)
PBS 33 43 0.20
ISIS 494283 75 73 0.12
ISIS 494284 115 79 0.17
ISIS 494286 67 73 0.13
ISIS 494301 129 90 0.15
ISIS 494302 141 75 0.15
ISIS 494372 46 75 0.17
C—reactive protein level analysis
To evaluate any inflammatory effect of ISIS oligonucleotides in cynomolgus monkeys, blood
samples were taken for analysis. The monkeys were fasted overnight prior to blood collection.
Approximately 1.5 mL of blood was collected from each animal and put into tubes without anticoagulant for
serum separation. The tubes were kept at room temperature for a m of 90 min and then centrifuged at
3,000 rpm for 10 min at room temperature to obtain serum. C-reactive protein (CRP), which is synthesized in
the liver and which serves as a marker of inflammation, was measured using a Toshiba 200FR NEO
chemistry analyzer (Toshiba Co., Japan). The results te that treatment with ISIS 4943 72 did not cause
any inflammation in monkeys.
Table 178
tive protein levels (mg/L) in cynomolgus monkey plasma
2014/036460
PBS 1.4
ISIS 494283 14.7
rsrs 494302
1s1s494372
Complement C3 analysis
To evaluate any effect of ISIS oligonucleotides on the complement pathway in cynomolgus monkeys,
blood samples were taken for analysis on day 84 (pre-dose) and day 85 (24 hours post-dose). Approximately
0.5 mL of blood was collected from each animal and put into tubes without anticoagulant for serum
separation. The tubes were kept at room temperature for a minimum of 90 min and then centrifuged at 3,000
rpm for 10 min at room temperature to obtain serum. C3 was measured using a Toshiba 200FR NEO
try analyzer (Toshiba Co., Japan). The results indicate that ent with ISIS 4943 72 did not cause
any effect on the complement pathway in monkeys.
Table 179
Complement C3 levels (mg/dL) in lgus monkey plasma
Hematology
To evaluate any effect of ISIS ucleotides in cynomolgus monkeys on hematologic parameters,
blood samples of approximately 0.5 mL of blood was collected on day 87 from each of the available study
animals in tubes ning Kg-EDTA. Samples were analyzed for red blood cell (RBC) count, white blood
cells (WBC) count, as well as for platelet count, using an ADVIA120 hematology analyzer (Bayer, USA).
The data is presented in the table below.
The data indicate that treatment with ISIS 494372 was well tolerated in terms of the hematologic
parameters of the monkeys.
Table 180
Blood cell counts in cynomolgus monkeys
WBC RBC et
(x 103/uL) (x 10mm) (x 103/uL)
PBS 15 6.3 329
ISIS 494283 16 5.3 456
ISIS 494284 13 6.3 330
ISIS 494286 14 5.5 304
ISIS 494301 15 6.0 392
ISIS 494302 12 6.3 305
ISIS 494372 11 6.1 447
e 124: Characterization of the pharmacological activity of ISIS 494372 in cynomolgus monkeys
The pharmacological activity of ISIS 4943 72 was characterized by measuring liver apo(a) mRNA
and plasma apo(a) levels in monkeys administered the compound over 13 weeks and allowed to recover for
another 13 weeks.
Treatment
Five groups of 14 randomly assigned male and female cynomolgus monkeys each were injected
subcutaneously with ISIS oligonucleotide or PBS using a ess steel dosing needle and syringe of
appropriate size into the one of four sites on the back (scapular region) of the monkeys. The monkeys were
dosed four times a week for the first week (days 1, 3, 5, and 7) as loading doses, and subsequently once a
week for weeks 2-13 as maintenance doses, as shown in the table below. The loading dose during the first
week is expressed as mg/kg/dose, while the maintenance doses on weeks 2-13 are sed as mg/kg/week.
Table 181
Dosing groups in cynomolgus monkeys
Number of animals for necropsy
Group TeSt M1016 Dose
m Terminal Recovery
1 PBS - 4 6 4
2 4
3 ISIS 8
4 494372 12 4 6 4
4O 4 6 4
Liver samples from animals were taken at the interim, terminal and recovery phases of the study for
the es of apo(a) mRNA. In addition, plasma s were collected on different days to measure
apo(a) protein levels. This non-clinical study was conducted in accordance with the United States Food and
Drug Administration (FDA) Good Laboratory Practice (GLP) Regulations, 21 CFR Part 58.
RNA analysis
Liver samples were collected from monkeys on days 30, 93, and 182, and frozen. Briefly, a piece (0.2
g) of frozen liver was homogenized in 2 mL of RLT solution (Qiagen). The resulting lysate was applied to
Qiagen RNeasy mini columns. After purification and quantification, the tissues were subjected to RT-PCR
analysis. The Perkin-Elmer ABI Prism 7700 Sequence Detection System, which uses real-time fluorescent
RT-PCR detection, was used to quantify apo(a) mRNA. The assay is based on a target-specific probe labeled
with fluorescent reporter and quencher dyes at opposite ends. The probe was yzed through the 5’-
exonuclease activity of Taq DNA polymerase, leading to an increasing fluorescence emission of the er
dye that can be detected during the reaction. A probe set (ABI Rhesus LPA probe set ID Rh02789275_m1,
Applied Biosystems, Carlsbad CA) targeting position 1512 of the rhesus monkey apo(a) mRNA ript
GENBANK Accession No XM_001098061.2 (SEQ ID NO: 132) sequence was used to measure cynomolgus
monkey liver apo(a) mRNA expression levels. Apo(a) expression was normalized using RIBOGREEN®.
Results are presented as percent inhibition of apo(a) mRNA, relative to PBS control.
As shown in the table below, treatment with ISIS 494372 ed in a dose-dependent reduction of
apo(a) mRNA in comparison to the PBS l. At day 30, hepatic apo(a) mRNA expression was reduced in
a ependent manner by 74% and 99% in the 12 week and 40 mg/kg/week dosing cohorts,
respectively. These reductions are tically significant by one-way ANOVA (Dunnett’s multiple
comparison test, P<0.05).
Apo(a) mRNA levels were also measured during the recovery phase. Liver expression levels at day
88 after the last dose were still reduced 49% and 69% in the 12 mg/kg/week and 40 mg/kg/week dosing
cohorts, respectively.
Table 182
Percent inhibition levels of liver apo(a) mRNA in the dosing phase in cynomolgus monkeys treated with ISIS
494372
Dose
Protein analysis
Approximately 20 ul of plasma was analyzed using a commercially ble apo(a) ELISA kit
(Mercodia 1001, Uppsala, Sweden). The assay protocol was med as described by the
manufacturer. The results are presented in the tables below as percentage change from Day 1 pre—dose apo(a)
plasma protein concentrations. Statistically significant differences from Day 1 ne plasma apo(a) using
the Dunnett’s multicomparison test are marked with an sk.
Maximal reduction in plasma apo(a) protein was observed in all dosing cohorts by Day 93. In the
recovery phase, apo(a) plasma protein levels in the 40 mg/kg/week dosing cohort were at 22% and 93% of
the baseline after 4 and 13 weeks (Days 121 and 182) of recovery, respectively. The rate of ry in the 12
mg/kg/week cohort was similar to that seen in the 40 mg/kg/week cohort.
Table 183
Apo(a) plasma protein levels as a percent of Day 1 levels in the dosing phase in cynomolgus monkeys treated
with ISIS 494372
Dose
Day 04’
(mg/kg/wk)
4 93
8 70
12 49
40 15*
4 73
8 56
12 32*
40 11*
WO 79625
Table 184
Apo(a) plasma n levels as a percent of Day 1 levels in the recovery phase in cynomolgus monkeys
treated with ISIS 494372
Dose
Day 04’
(mg/kg/wk)
12 3 8 *
40 22*
12 84
40 93
Example 125: ement of viscosity of ISIS antisense oligonucleotides targeting human Ap0(a)
The viscosity of select antisense oligonucleotides from the studies described above was measured
with the aim of screening out nse oligonucleotides which have a viscosity more than 40 centipoise (cP).
Oligonucleotides having a viscosity greater than 40 cP would have less than optimal viscosity.
ISIS oligonucleotides (32-35 mg) were weighed into a glass vial, 120 uL of water was added and the
antisense oligonucleotide was dissolved into solution by heating the vial at 500C. Part (75 uL) of the pre-
heated sample was pipetted to a micro-viscometer (Cambridge). The temperature of the micro-viscometter
was set to 250C and the viscosity of the sample was measured. Another part (20 uL) of the pre-heated sample
was pipetted into 10 mL of water for UV reading at 260 nM at 850C (Cary UV instrument). The results are
ted in the table below and indicate that most of the antisense oligonucleotides solutions are optimal in
their viscosity under the criterion stated above. Those that were not optimal are marked as ‘viscous’.
Specifically, ISIS 494372 was optimal in its viscosity under the criterion stated above.
Table 185
Viscosity and concentration of ISIS antisense oligonucleotides targeting human Apo(a)
ISIS No Motif Vlizgilty Concentration
494158 55 MOE 9.0 350
494159 55 MOE 11.7 325
494161 55 MOE 12.0 350
494162 55 MOE 25.8 350
494163 55 MOE Viscous 275
494243 55 MOE 28.4 325
494244 55 MOE 19.2 300
2014/036460
494283 34 VIOE 13.4 300
494284 55 VIOE 13.4 350
494285 55 VIOE 23.1 350
494286 55 VIOE 16.5 275
494301 55 VIOE 17.1 325
494302 55 VIOE 24.3 350
494304 55 VIOE 49.3 275
494311 55 VIOE 10.8 325
494337 55 VIOE 29.5 325
494372 55 VIOE 12.5 350
494466 55 VIOE Viscous 275
494470 55 VIOE 16.7 350
494472 55 VIOE 23.6 350
498408 55 VIOE 31.5 300
510548 55 VIOE 9.0 350
512947 34 VIOE 6.8 350
512958 55 VIOE 26.0 350
Claims (40)
1. A compound comprising a modified oligonucleotide and a ate group, wherein the modified oligonucleotide consists of 12 to 30 linked nucleosides and comprises a nucleobase sequence comprising a portion of at least 8 contiguous nucleobases complementary to an equal length portion of SEQ ID NO: 1; wherein the conjugate group comprises: and wherein the compound is not: a compound comprising a modified ucleotide and a conjugate group, wherein the modified ucleotide consists of 20 contiguous nucleobases complementary to an equal length portion of nucleobases 3901 to 3920 of SEQ ID NO: 1, wherein the nucleobase sequence of the modified oligonucleotide is at least 80% complementary to SEQ ID NO: 1; and wherein the ate group comprises:
2. The compound of claim 1, wherein the modified oligonucleotide has a nucleobase sequence comprising at least an 8 nucleobase portion of one of SEQ ID NOs: 11-57, 59-133 and 135.
3. The compound of claim 2, wherein the modified oligonucleotide has a nucleobase sequence comprising at least a 12 nucleobase portion of one of SEQ ID NOs: 11-57, 59-133 and 135.
4. The nd of any of claims 1-3, n the modified ucleotide consists of 15 to 30 linked nucleosides.
5. The compound of claim 4, wherein the modified oligonucleotide consists of 15 to 25 linked nucleosides.
6. The nd of claim 5, wherein the ed oligonucleotide consists of 19 to 22 linked nucleosides.
7. The compound of claim 6, wherein the modified oligonucleotide consists of 20 linked nucleosides.
8. The compound of any of claims 1-7, wherein the nucleobase sequence of said modified oligonucleotide is at least 80% complementary to SEQ ID NO: 1 to an equal portion of SEQ ID NO: 1.
9. The compound of claim 8, wherein the nucleobase sequence of said modified oligonucleotide is at least 85% complementary to SEQ ID NO: 1.
10. The compound of claim 9, wherein the nucleobase sequence of said modified ucleotide is at least 90% complementary to SEQ ID NO: 1.
11. The compound of claim 10, wherein the base sequence of said modified oligonucleotide is at least 95% complementary to SEQ ID NO: 1.
12. The compound of claim 11, wherein the nucleobase sequence of said modified oligonucleotide is 100% mentary to SEQ ID NO: 1.
13. The compound of any of claims 1-12, wherein the modified oligonucleotide comprises at least one modified sugar.
14. The nd of claim 13, wherein at least one modified sugar is a bicyclic sugar.
15. The nd of claim 13, wherein at least one modified sugar comprises a ethoxyethyl, a constrained ethyl, a 3’-fluoro-HNA or a 4’- (CH2)n-O-2’ bridge, wherein n is 1 or 2.
16. The compound of claim 13, wherein at least one modified sugar is 2’-O-methoxyethyl.
17. The compound of any of claims 1-16, wherein at least one nucleoside comprises a modified nucleobase.
18. The compound of claim 17, wherein the modified nucleobase is a 5-methylcytosine.
19. The compound of any of claims 1-18, wherein the conjugate group is linked to the ed oligonucleotide at the 5’ end of the modified ucleotide.
20. The compound of any of claims 1-18, wherein the conjugate group is linked to the modified oligonucleotide at the 3’ end of the modified ucleotide.
21. The compound of any of claims 1-20, wherein each internucleoside linkage of the modified oligonucleotide is selected from a phosphodiester internucleoside linkage and a phosphorothioate internucleoside linkage.
22. The compound of claim 21, wherein the modified oligonucleotide comprises at least 5 phosphodiester internucleoside linkages.
23. The compound of claim 21, wherein the modified oligonucleotide ses at least 2 phosphorothioate internucleoside linkages.
24. The compound of any of claims 1-23, wherein the modified oligonucleotide is single-stranded.
25. The compound of any of claims 1-23, wherein the modified oligonucleotide is double stranded.
26. The compound of any of claims 1-25, wherein the modified oligonucleotide ses: a gap segment consisting of linked deoxynucleosides; a 5’ wing segment consisting of linked nucleosides; a 3’ wing segment consisting of linked nucleosides; wherein the gap segment is positioned between the 5’ wing segment and the 3’ wing segment and wherein each nucleoside of each wing segment comprises a modified sugar.
27. The compound of claim 26, wherein each internucleoside linkage in the gap segment of the modified ucleotide is a phosphorothioate linkage.
28. The nd of claim 27, wherein the modified ucleotide further comprises at least one phosphorothioate internucleoside linkage in each wing segment.
29. The compound of claim 26, wherein the modified oligonucleotide comprises: a gap segment consisting of ten linked deoxynucleosides; a 5’ wing segment ting of five linked nucleosides; a 3’ wing t consisting of five linked nucleosides; wherein the gap segment is oned between the 5’ wing segment and the 3’ wing segment, n each nucleoside of each wing segment comprises a 2’-O-methoxyethyl sugar, and wherein each cytosine residue is a 5-methylcytosine.
30. The compound of claim 29, wherein each internucleoside linkage in the gap segment of the modified oligonucleotide is a phosphorothioate linkage.
31. The compound of claim 30, wherein the modified oligonucleotide further comprises at least one orothioate internucleoside linkage in each wing segment.
32. The compound of claim 30, wherein the internucleoside linkages are phosphorothioate es between nucleosides 1-2, nucleosides 6-16 and sides 17-20 of the modified oligonucleotide, wherein nucleosides 1-20 are positioned 5’ to 3’.
33. The compound of claim 30, wherein the 2nd, 3rd, 4th, and 5th internucleoside linkage from the 5’- end is a phosphodiester internucleoside linkage, n the 3rd and 4th internucleoside linkage from the 3’-end is a phosphodiester internucleoside linkage, and wherein each ing internucleoside linkage is a phosphorothioate internucleoside linkage.
34. The compound of any ing claim, wherein the compound is in a salt form.
35. A pharmaceutical composition comprising a compound of any one of claims 1-34, and a ceutically acceptable diluent or carrier.
36. The pharmaceutical composition of claim 35, n the compound is in a salt form.
37. A method comprising administering to a non-human animal a compound according to any one of claims 1-34, or a composition according to claim 35 or claim 36, wherein administering the compound, or the composition, treats, prevents or slows progression of a disease related to elevated apo(a) and/or elevated Lp(a).
38. Use of a compound according to any one of claims 1-34, or a composition according to claim 35 or claim 36, in the manufacture of a ment for treating, preventing, or g progression of a disease related to elevated apo(a) and/or elevated Lp(a).
39. The method of claim 37, or the use of claim 38, wherein the disease is an inflammatory, cardiovascular or metabolic disease, disorder or condition.
40. The method or the use of claim 39, wherein the cardiovascular e, disorder or condition is aortic stenosis.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| NZ740338A NZ740338A (en) | 2013-05-01 | 2014-05-01 | Compositions and methods for modulating apolipoprotein (a) expression |
Applications Claiming Priority (15)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201361818442P | 2013-05-01 | 2013-05-01 | |
| US61/818,442 | 2013-05-01 | ||
| US201361823826P | 2013-05-15 | 2013-05-15 | |
| US61/823,826 | 2013-05-15 | ||
| US201361843887P | 2013-07-08 | 2013-07-08 | |
| US61/843,887 | 2013-07-08 | ||
| US201361871673P | 2013-08-29 | 2013-08-29 | |
| US61/871,673 | 2013-08-29 | ||
| US201361880790P | 2013-09-20 | 2013-09-20 | |
| US61/880,790 | 2013-09-20 | ||
| US201461976991P | 2014-04-08 | 2014-04-08 | |
| US61/976,991 | 2014-04-08 | ||
| US201461986867P | 2014-04-30 | 2014-04-30 | |
| US61/986,867 | 2014-04-30 | ||
| NZ631512A NZ631512A (en) | 2013-05-01 | 2014-05-01 | Compositions and methods for modulating apolipoprotein (a) expression |
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| Publication Number | Publication Date |
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| NZ725538A NZ725538A (en) | 2021-02-26 |
| NZ725538B2 true NZ725538B2 (en) | 2021-05-27 |
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