阅读说明：本技术 用于治疗原发性胆汁性胆管炎的化合物和方法 (For treating the Compounds and methods for of primary biliary cholangitis ) 是由 C·G·拉森 M·R·琼斯 Q·刘 R·J·克里斯托弗 于 2018-02-16 设计创作，主要内容包括：本发明尤其涉及可用于治疗原发性胆汁性胆管炎(PBC)的(R)-2-(7-(4-环戊基-3-(三氟甲基)苄氧基)-1,2,3,4-四氢环戊二烯并[b]吲哚-3-基)乙酸(化合物1)的治疗方法和组合。在一些实施例中,所述方法还包含施用化合物1或其药学上的盐、溶剂化物或水合物,以及选自由以下组成的组的化合物：抗组胺药(苯海拉明)、消胆胺(questran、prevalite)、利福平、阿片类拮抗剂(纳洛酮)、毛果芸香碱(isopto carpine、salagen)、西维美林(evoxac)、钙和/或维生素D补充剂,以及维生素A、D、E和/或K补充剂。其它实施例涉及滴定包装,其使得能够遵守在一段时间内改变药物剂量的方案来治疗原发性胆汁性胆管炎(PBC)。(The invention particularly relates to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1 that can be used for treating primary biliary cholangitis (PBC), 2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) treatment method and combination.In some embodiments, the method further includes application compound 1 or its salt, solvate or hydrates pharmaceutically, and the compound selected from the group being made up of: antihistamine (diphenhydramine), cholestyramine (questran, prevalite), rifampin, opioid antagonist (naloxone), pilocarpinum (isopto carpine, salagen), cevimeline (evoxac), calcium and/or Vitamin D supplements and vitamin A. D. E and/or K replenishers.Other embodiments are related to titration packaging, make it possible to abide by the scheme of change drug dose whithin a period of time to treat primary biliary cholangitis (PBC).)

1. a kind of method for treating the primary biliary cholangitis (PBC) in individual in need, it includes application treatments to have (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indoles -3- of effect amount Base) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

2. one kind (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] Yin Diindyl -3- base) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically in manufacture for treating the original in individual Purposes in the drug of the biliar cholangitis (PBC) of hair property.

3. the method according to claim 11 or purposes according to claim 2, wherein the individual is previously with treatment A effective amount of ursodesoxycholic acid (UDCA) treatment.

4. method according to claim 1 or 3 or purposes according to claim 1 or 2, wherein the individual is at present It is treated with the ursodesoxycholic acid (UDCA) of therapeutically effective amount.

5. the method according to claim 3 or 4 or purposes, wherein the therapeutically effective amount of UDCA is at least three moon Amount basically the same.

6. the method according to claim 11 or purposes according to claim 2, wherein the individual was previously gone with bear Oxycholic acid (UDCA) treatment, and the individual has insufficient reaction to UDCA.

7. according to the method for claim 6 or purposes such as passes through wherein the individual has insufficient reaction to UDCA The individual > alkaline phosphate (ALP) of 1.67x Upper Limit of Normal Value (ULN) determines.

8. the method according to claim 11 or purposes, wherein the individual with UDCA after being treated 6 months with insufficient Reaction.

9. the method according to claim 11 or purposes, wherein the individual with UDCA after being treated 6 months with insufficient Reaction and the > alkaline phosphate (ALP) of 1.67x Upper Limit of Normal Value (ULN).

10. according to claim 1 with method described in any one of 3 to 9；Or according to any one of claim 2 to 9 Purposes, wherein there is the individual at least one to be selected from the primary biliary bile duct inflammation diagnostic criteria for the group being made up of:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5 x ULN continues at least six moon；And

Liver biopsy result is consistent with PBC.

11. according to claim 1 with method described in any one of 3 to 9；Or according to any one of claim 2 to 9 Purposes, wherein the individual has at least two primary biliary bile duct inflammation diagnostic criterias selected from the group being made up of:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5 x ULN continues at least six moon；And

Liver biopsy result is consistent with PBC.

12. according to claim 1 with method described in any one of 3 to 9；Or according to any one of claim 2 to 9 Purposes, wherein there is the individual at least one to be selected from the standard for the group being made up of:

The x of ALP>1.67 ULN but<10 x ULN；

The x of ALT and AST < 5 ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2 x ULN；And

Serum creatinine < 1.5mg/dL (133 μm of ol/L).

13. according to claim 1 with method described in any one of 3 to 9；Or according to any one of claim 2 to 9 Purposes, wherein there is the individual at least one to be selected from the standard for the group being made up of:

The x of ALP>1.67 ULN but<10 x ULN；

The x of ALT and AST < 5 ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2 x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；And

(Transient elastography) < 10kPa.

14. according to claim 1 with method described in any one of 3 to 13；Or according to any one of claim 2 to 13 Purposes, wherein the individual suffers from least one other patient's condition selected from the group being made up of: itch, fatigue, sclerotin are thin Pine, vitamin-deficiency, eyes and/or xerostomia, portal hypertension, pain, jaundice, xanthelasma and vitiligoidea.

15. according to claim 1 with method described in any one of 3 to 14；Or according to any one of claim 2 to 14 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt of the therapeutically effective amount, hydrate or solvate are oral.

16. according to claim 1 with method described in any one of 3 to 15；Or according to any one of claim 2 to 15 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate be formulated into be suitable for it is oral Capsule or tablet.

17. according to claim 1 with method described in any one of 3 to 16；Or according to any one of claim 2 to 16 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate of the therapeutically effective amount are in amount It is equal to the compound 1 of about 1.0mg to about 5mg.

18. according to claim 1 with method described in any one of 3 to 17；Or according to any one of claim 2 to 17 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate of the therapeutically effective amount are in amount It is equal to about 1mg to about 2mg.

19. according to claim 1 with method described in any one of 3 to 18；Or according to any one of claim 2 to 18 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate of the therapeutically effective amount are in amount It is equal to the compound 1 of about 1mg, about 1.25mg, about 1.5mg, about 1.75mg or about 2mg.

20. according to claim 1 with method described in any one of 3 to 18；Or according to any one of claim 2 to 18 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate of the therapeutically effective amount are in amount It is equal to the compound 1 of about 1mg.

21. according to claim 1 with method described in any one of 3 to 18；Or according to any one of claim 2 to 18 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate of the therapeutically effective amount are in amount It is equal to the compound 1 of about 2mg.

22. according to claim 1 with method described in any one of 3 to 21；Or according to any one of claim 2 to 21 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt of the therapeutically effective amount, hydrate or solvate daily one It applies secondaryly.

23. according to claim 1 with method described in any one of 3 to 22；Or according to any one of claim 2 to 22 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are the L- essence ammonia of compound 1 Hydrochlorate.

24. according to claim 1 with method described in any one of 3 to 22；Or according to any one of claim 2 to 22 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are the L- of compound 1 The anhydrous unsolvated crystal form of arginine salt.

25. according to claim 1 with method described in any one of 3 to 22；Or according to any one of claim 2 to 22 Purposes, wherein the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are the described non-of compound 1 The free lath habit of the crystallization of solvation L-arginine salt.

26. according to claim 1 with method described in any one of 3 to 25；Or according to any one of claim 2 to 25 Purposes, also include the choosing for applying compound 1 or its salt, solvate or hydrate and therapeutically effective amount pharmaceutically The compound of free group consisting of: antihistamine, cholestyramine, rifampin, opioid antagonist, pilocarpinum, west dimension Merrill Lynch, calcium and/or Vitamin D supplements and vitamin A. D. E and/or K replenishers.

27. according to claim 1 with method described in any one of 3 to 26；Or according to any one of claim 2 to 26 Purposes, wherein compound 1 is applied in the case where no food.

28. a kind of use (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] Indol-3-yl) acetic acid (compound 1) method for the treatment of individual in need, it includes:

(a) at least one obtained before being treated with compound 1 for analyzing one or more samples from the individual is raw The first level of object marker；

(b) to the individual application compound 1；

(c) at least one of one or more samples from the individual obtained after being treated with compound 1 is analyzed The second of biomarker is horizontal；And

If described second of at least one biomarker (d) in (i) step (c) is horizontal to be Less than or equal to about step (a) the corresponding first level of at least one biomarker in, then continuing to apply compound 1；Or

(ii) if the described second horizontal institute being higher than in step (a) of at least one biomarker in step (c) The corresponding first level of at least one biomarker is stated, then interrupting application compound 1；

Wherein at least one biomarker is selected from the group being made up of: (i) anti-gp210；(ii) anti-sp100； (iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)； (vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)； (viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；And (xii) IgM.

29. according to the method for claim 28, wherein the individual suffers from primary biliary cholangitis (PBC).

30. the method according to claim 28 or 29, wherein the individual is with fatigue, itch, eye is done and/or Xiu Gelian Cotard (Syndrome, SS).

31. a kind of fatigue of individual for the treatment of with primary biliary cholangitis (PBC), itch, eye is done and/or Xiu Gelianshi The method of syndrome (SS), it includes (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxies of application therapeutically effective amount Base) -1,2,3,4- tetrahydro cyclopentyl diene simultaneouslies [b] indol-3-yl) acetic acid (compound 1) or its salt, solvate pharmaceutically Or hydrate.

32. a kind of use (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] Indol-3-yl) acetic acid (compound 1) method for the treatment of individual in need, it includes:

(a) at least one obtained before being treated with compound 1 for analyzing one or more samples from the individual is raw The level of object marker；With

(d) change the application of compound 1,

Wherein at least one biomarker is selected from the group being made up of: (i) anti-gp210；(ii) anti-sp100； (iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)； (vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)； (viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；And (xii) IgM.

33. according to the method for claim 32, wherein the application for changing compound 1 includes to increase the amount of compound 1.

34. according to the method for claim 32, wherein the application for changing compound 1 includes to reduce the amount of compound 1.

35. the method according to any one of claim 32 to 34, wherein the individual has been applied before changing application With compound 1.

36. the method according to any one of claim 3 to 27；Or according to any one of claim 4 to 27 Purposes, wherein the amount of UDCA is about 13mg to about 15mg/kg/ days.

37. the method according to claim 11 or purposes, wherein the UDCA is applied with two to four divided doses.

38. the method according to any one of claim 3 to 27；Or according to any one of claim 4 to 27 Purposes, wherein the amount of UDCA is about 250mg or about 500mg.

39. the method according to any one of claim 3 to 27；Or according to any one of claim 4 to 27 Purposes, wherein the amount or frequency of the application of UDCA reduce when applying together with compound 1.

40. the method according to any one of claim 3 to 27；Or according to any one of claim 4 to 27 Purposes, wherein the amount or frequency of the application of compound 1 reduce when applying together with UDCA.

Technical field

The invention particularly relates to (R) -2- (7- (the 4- cyclopenta-that can be used for treating primary biliary cholangitis (PBC) 3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) treatment side Method and combination.In some embodiments, the method further includes application compound 1 or its salt, solvate or water pharmaceutically Close object, and the compound selected from the group being made up of: antihistamine (diphenhydramine), cholestyramine (questran, Prevalite), rifampin, opioid antagonist (naloxone), pilocarpinum (isopto carpine, salagen), west Tie up Merrill Lynch (evoxac), calcium and/or Vitamin D supplements and vitamin A. D. E and/or K replenishers.Other embodiments are related to Titration packaging makes it possible to abide by the scheme of change drug dose whithin a period of time to treat primary biliary cholangitis (PBC)。

Background technique

C18-Sphingosine 1-phosphate (S1P) receptor 1-5 constitutes the g protein coupled receptor family with seven transmembrane domains. These receptors are known as S1P₁To S1P₅(it was referred to as endothelial differentiation gene (EDG) receptor -1, -5, -3, -6 and -8 in the past；Chun etc. People, " pharmacological review (Pharmacological Reviews) ", 54:265-269,2002), by by sphingosine-1-phosphate Salt (its by sphingosine kinase enzymatic phosphorylation generate) in conjunction with and activate.S1P₁、S1P₄And S1P₅Receptor activation GI rather than Gq, And S1P₂And S1P₃Receptor activation Gi and Gq two.S1P₃Receptor rather than S1P₁Receptor plays the increased agonist of intracellular Ca2+ anti- It answers.

Compound (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) is strong (EC₅₀CAMP, 0.093nM (mankind)) and selective (EC₅₀β-suppression Albumen processed, 6.10nM (S1P₁), > 10,000nM (S1P₂), > 10,000nM, (S1P₃), 147nM (S1P₄) and 24.4nM (S1P₅)), it takes orally available for S1P₁The research drug candidates of receptor.

In preclinical study, compound 1, which is shown below the lymphocyte calculated in four kinds of different plant species, reduces IC₅₀ Value: 0.101 μM (mouse), 0.051 μM (rat), 0.058 μM (dog) and 0.098 μM (monkey).It is worth noting that, the leaching calculated Bar cell reduces IC₅₀Value reflects total plasma concentration that wherein 1 height protein of compound combines, and (97.8% people, 98.0% is big Mouse).It is effective that compound 1, which is shown in mouse experimental autoimmune encephalomyelitis (EAE) model of simulation multiple sclerosis, 's.Prophylactically, compound 1 is relative to mediator until the breaking-out and serious journey of the 25th day (interruption of the administration at this time) prevention disease Degree.It is serious disease that all treatment groups, which all continue development,.The therapeutic administration of compound 1 is also checked for.Treatment starts from the 18 days, all animals were suffering from serious disease at this time.Day application compound 1 from the 18th day to the 37th, and show relative to matchmaker Agent reverse disease and be analogous to fingomode (that is,Being approved for treatment in September, 2010 has The individual of the recurrent form of multiple sclerosis) the effect of observing.Similarly, compound 1 is in Collagen-Induced Arthritis It (CIA) is effective in model.Preventative take orally the 17th day after every daily oral dose of Female Lewis rats causes ankle straight Diameter substantially reduces, and similar with what is observed in the rat of fingomode or methotrexate for treatment.CIA rat is also observed Knee and ankle Histological parameter improvement, show with compound 1 treat inhibit lymphocyte enter arthritis knuckle containment CIA in rodent.In addition details can be found in the following: PCT application, sequence number PCT/US2009/004265 (submission on July 22nd, 2009) (international publication number WO2010/011316)；PCT application, sequence number PCT/US2011/000153, Submission on January 27 (international publication number WO2011/094008) in 2011；With Buzard:D.J. et al., ACS Med.Chem.Lett.2014,5,1313-1317；It is incorporated herein by reference in its entirety.

S1P is signal sphingolipid needed for lymphocyte leaves lymphoid tissue and enter blood flow by chemotactic gradient.S1P1 by Body is a kind of Physiological Medium, has been demonstrated the lymphocyte recirculation between adjustable lymphoid tissue and blood.S1P1 receptor Combination and internalization can lead to the lymphocyte in lymphoid tissue reservation, then reduce periphery lymphocyte count and lymphocyte Raise the availability of inflammation part.The expression of S1P1 receptor surface is that the lymphocyte that S1P gradient mediates is migrated from lymphoid tissue To (2010 November of Brinkmann V., Nat Rev Drug Discov needed for circulation；9(11):883-97).

Primary biliary cholangitis is a kind of chronic cholestatic hepatopathy that reason is unknown.From portal vein and Men Jing Arteries and veins week, the progressive bile duct injury of inflammation can lead to progressive fibrosis and final cirrhosis.The portal vein and door of PBC patient The immunohistochemical staining of T lymphocyte shows the CD4 positive and CD8 positive T cell (known T cell group in vein week region It is interacted and is adjusted by S1P1).In addition to T cell, natural killer cells seems also to work in PBC.Tranquillization and activation NK cell expresses S1P1, S1P4 and S1P5 receptor.It is reported that S1P5 receptor participate in NK cell chemotaxis (Jenne et al., 2009).Allende et al. proves effect of the S1P4 in neutrophil leucocyte transport, because of S1P lyases deficient mice (Sgpl1-/- GrS1pr1) is in terms of the serum-concentration of the blood level and proinflammatory cytokine of lymphocyte and neutrophil leucocyte It is not significantly different with single mutation Sgpl1-/- mouse.On the contrary, lacking S1P lyases and S1P4 (Sgpl1-/- S1pr4-/-) Mouse and single mutation Sgp11-/- mouse (Allende et al., 2011), which are compared, has significant lower blood neutrophil meter Several and serum proinflammatory cytokine.These statistics indicate that S1P4 receptor participate in neutrophil leucocyte transport, this may be it is relevant, because To have been reported that the effect (Sun et al., 2014) for showing IL-33 in enhancing PBC progress in the migration of neutrophil leucocyte.Due to report Connection in the cholangiocarcinoma (CCA) in road between S1P2 adjusting avoids S1P2 interaction from being important, and S1P2 adjusting may be by gallbladder The congugated bile acids of S1P2 receptor adjust driving (Liu et al. people 2014) on solencyte.Have shown that S1P1 rather than S1P2 receptor Inhibition reduce rat hepatocytes in bile salt (glycochenodeoxycholate) induction Apoptosis, show the potential treatment of PBC Benefit (Karimian et al., " Acta Biochimica et Biophysica Sinica (Biochim Biophys Acta.) " in December, 2013； 1832 (12): 1922-9).Furthermore, it was reported that S1P1 may participate in promoting the process of liver fibrosis, show to block S1P1 approach can It can help to mitigate liver fibrosis (Yang L et al., " hepatology magazine (J Hepatol.) " in July, 2013；59 (1): 114-23).Therefore, the adjusting of S1P1, S1P4 and S1P5 receptor represents the distribution of the target for treating PBC.

However it is reported that liver turns after many S1P regulators currently on the market or in clinical development show chronic administration The raised evidence of adnosine deaminase.For example has it been observed that GILENYA (fingomode), Xi Punimode (siponimod), Ni Xi The liver enzyme of Mo De (ponesimod), GSK2018682 and ozanimod increase (Gergely et al., " Britain's pharmacology magazine (British J of Pharm)"2012；167:1035-1047；D ' Ambrosio et al., " the treatment development in chronic disease (Therapeutic Advances in Chronic Disease)"2016；7(1):18-33；Cohen et al., " ECTRIMS The 32nd conference (32^ndCongress of ECTRIMS) " 14-17 of in September, 2016；Xu et al., Am College of Clinical Pharm 2014；3(3):170-178).In fact, the Product labelling of GILENYA (fingomode) contain about The warning and precautionary measures of liver effect.It is reduced additionally, there are drug metabolic enzyme activity in PBC patient and general liver is by harm Pathophysiologic evidence (as liver transaminase raising proves) (Reshetnyak, " world magazine (World of gastroenterology J of Gastroenterology) " July 7 in 2015；21(25):7683-7708).Therefore, S1P regulator liver function by Safety in the PATIENT POPULATION of damage is unknown.

This document describes Proof of Concept clinical tests, wherein assessing compound 1 in the patient with PBC.Compound 1 is aobvious A possibility that showing the global selectivity activation of S1P1, S1P4 and S1P5 and the personal safety being damaged with liver applied, therefore Represent the in demand selection of individual of the treatment with PBC.

Summary of the invention

In their various embodiments, the invention particularly relates to the primary biliary cholangitis treated in individual in need (PBC) method, it includes application therapeutically effective amount (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2, 3,4- tetrahydro cyclopentyl diene simultaneouslies [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, solvate or Hydrate.In some embodiments, primary biliary cholangitis (PBC) is primary biliary cirrhosis.

In other embodiments, the present invention relates to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2, 3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, solvate or water It closes object and is manufacturing the purposes in the drug for treating primary biliary cholangitis (PBC).

In some embodiments, individual is previously treated with the ursodesoxycholic acid (UDCA) of therapeutically effective amount.

In some embodiments, individual is treated with the ursodesoxycholic acid (UDCA) of therapeutically effective amount at present.

In some embodiments, the UDCA of therapeutically effective amount amount (stabilizer basically the same at least six moon Amount).

In some embodiments, the UDCA of therapeutically effective amount amount (stabilizer basically the same at least three moon Amount).

In some embodiments, individual previously with ursodesoxycholic acid (UDCA) treat, and individual to UDCA have do not fill The reaction divided.

In some embodiments, individual has insufficient reaction to UDCA, as by for individual > 1.67x is normal The alkaline phosphate (ALP) of the value upper limit (ULN) determines.

In some embodiments, individual has insufficient reaction after being treated 6 months with UDCA.

In some embodiments, individual is controlled with the alkaline phosphate (ALP) of UDCA and > 1.67x Upper Limit of Normal Value (ULN) There is insufficient reaction after treating 6 months.

In some embodiments, the therapeutic dose of UDCA is at least 13mg/kg/ days.

In some embodiments, individual has at least one primary biliary cholangitis selected from the group being made up of Diagnostic criteria:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5x ULN continues at least six moon；With

Liver biopsy result is consistent with PBC.

In some embodiments, individual has at least two primary biliary cholangitis selected from the group being made up of Diagnostic criteria:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5x ULN continues at least six moon；With

Liver biopsy result is consistent with PBC.

In some embodiments, individual has at least one standard selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；With

Serum creatinine < 1.5mg/dL (133 μm of ol/L).

In some embodiments, individual has at least one standard selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；With

Serum creatinine < 1.5mg/dL (133 μm of ol/L).

In some embodiments, individual suffers from least one other patient's condition selected from the group being made up of: itch, tired Labor, osteoporosis, vitamin-deficiency, eyes and/or xerostomia, portal hypertension, pain.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is oral.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are formulated into suitable In oral capsule or tablet.

In some embodiments, before the compound 1 of application therapeutically effective amount, the chemical combination of titration dosage is applied to individual Object 1, wherein titration dosage is less than the compound 1 of therapeutically effective amount.

In some embodiments, titration dosage is less than the about 2mg of compound 1.

In some embodiments, titration dosage is maintained until the vital sign and/or EKG of individual do not have significant changes.

In some embodiments, maintain titration dosage until individual in pulse frequency >=55bpm, systolic pressure (SBP) >=90, and And diastolic pressure (DBP) >=55mmHg.

In some embodiments, before the compound 1 of application therapeutically effective amount, titration dose maintenance is no more than 14 It.

In some embodiments, titration dosage includes the first titration dosage and the second titration dosage, wherein the first titrant Amount is less than the second titration dosage, and each titration dosage is less than the compound 1 of therapeutically effective amount.

In some embodiments, the first titration dosage is equal to the compound 1 of about 1mg in amount.

In some embodiments, the second titration dosage is equal to the compound 1 of about 1.5mg in amount.

In some embodiments, the first titration dosage is equal to the compound 1 of about 1mg, and the second titrant in amount Amount is equal to the compound 1 of about 1.5mg in amount.

In some embodiments, before application second titrates dosage, the first titration dose maintenance is no more than 7 days.

In some embodiments, before the compound 1 of application therapeutically effective amount, the second titration dose maintenance is no more than 7 days.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to the compound 1 of about 1.0mg to about 5mg in amount.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to the compound 1 of about 2mg in amount.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are selected from: chemical combination The L-arginine salt of object 1, the calcium salt of compound 1 and compound 1.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 L-arginine salt.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 L-arginine salt anhydrous unsolvated crystal form.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 Non-solvated L-arginine salt crystallization dissociate lath habit.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 Anhydrous unsolvated crystal form.

In some embodiments, method also includes to apply compound 1 or its salt, solvate or hydrate pharmaceutically, And the compound selected from the group being made up of of therapeutically effective amount: antihistamine (diphenhydramine), cholestyramine (questran, prevalite), rifampin, opioid antagonist (naloxone), pilocarpinum (isopto carpine, Salagen), cevimeline (evoxac), calcium and/or Vitamin D supplements and vitamin A. D. E and/or K replenishers.

Some embodiments of the present invention be related to titration packaging, make it possible to abide by change drug dose whithin a period of time Scheme treat primary biliary cholangitis (PBC), wherein drug is (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) Benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneouslies [b] indol-3-yl) acetic acid (compound 1) or its is pharmaceutically acceptable Salt, solvate or hydrate, described to include:

The doctor of compound 1 or its pharmaceutically acceptable salt, hydrate or solvate comprising one or more dosage The day unit of first quantity of drug composition, wherein each dosage is equal to about 1.5mg or less compound 1 in amount, and

The medicinal combination of compound 1 or its pharmaceutically acceptable salt, hydrate or solvate comprising standard dose The day unit of second quantity of object is equal to about 1.0 to about 2.5mg compound 1 in amount.

In some embodiments, the first quantity day unit dosage be equal to the compound 1 of about 1mg in amount.

In some embodiments, the first quantity day unit dosage be equal to the compound 1 of about 1.5mg in amount.

In some embodiments, the second quantity day unit dosage be equal to the compound 1 of about 2mg in amount.

In some embodiments, the first quantity day unit dosage be equal to the compound of about 1mg or 1.5mg in amount 1, and the second quantity day unit dosage be equal to the compound 1 of about 2mg in amount.

Some embodiments are related to kit, and it includes packed and indicated to apply drug according to the titration of any previous embodiment With the specification to the individual for needing to treat primary biliary cholangitis (PBC).

With the progress of patent disclosure, the these and other aspects of present invention disclosed herein will be described in greater detail.

Detailed description of the invention

Fig. 1 shows the PXRD map combining figure of the L-arginine salt of compound 1, and which show lath of the instruction compared with spherocrystal The higher lath of crystallinity and spherocrystal between peak intensity difference.Also show the lower sample background context scattering of lath (that is, lower amorphous dizzy contribution).However, observing that lath and spherocrystal show identical crystal phase.

Fig. 2 shows the journey of the screening period of individual relevant to clinical research described in example 2, treatment phase and follow-up period The timetable of sequence and interview.

Fig. 3 shows the program of the screening period of individual relevant to clinical research described in example 2 and the time of interview Table.

Fig. 4 shows the program and interview of the treatment phase (part 1) of individual relevant to clinical research described in example 2 Timetable.

Fig. 5 shows the program and interview of the treatment phase (part 2) of individual relevant to clinical research described in example 2 Timetable.

Fig. 6 shows the program of the follow-up period of individual relevant to clinical research described in example 2 and the time of interview Table.

Fig. 7, which is shown, prepares (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl two Alkene simultaneously [b] indol-3-yl) acetic acid (compound 1) L-arginine salt core tablet flow chart.

The footnote in Fig. 2 to 6 and abbreviation is provided below:

AE: adverse events；ALP: alkaline phosphatase；C4:7 Alpha-hydroxy -4- cholestene -3- ketone；ECG: electrocardiogram；EOS: it grinds Study carefully end；EOT: treatment end；EWD: it exits in advance；FU: follow-up；HBsAg: hepatitis B surface antibody；HCV: hepatitis C Virus；HIV: human immunodeficiency virus；PK: pharmacokinetics；PML: progressive multifocal leukoencephalopathy；PSS: primary is stopped Lattice connect Cotard；TB: tuberculosis.

^aFor the patient of the dosage escalation of the available PK tolerance 1mg dosage level based on the 1st day and the 2nd week, and safety Property data；Interview only is carried out to the patient of these dosage escalations within 14th week.

¹Only interim/simple physical examination.

²At most 45 minutes before administration, upon administration 2,4,6 and 8 hours on day 1 with the 2nd week, optionally upon administration 12 And/or the blood sample of PK was collected within 24 hours at the 2nd week.12nd week: if patient does not have dosage raising, before taking administration Sample.If patient dose is gradually increased to daily 2mg dosage, before collecting administration, 6 hours and 8 hours samples after administration Product.14th week: if the daily 2mg dosage of patient, will collect before administration and 2,4,6,8 hours and 12 hours optional after administration And/or 24 hours samples.24th week: all patients will be during interview in the 24th week about 24 hours after its last time dosage PK sample is collected, wherein 2 optional time points are after its last time dosage between 72 hours to 1 week.1st day and the 2nd week Data by tetrabromo when being the 12nd week not moral Potential dose be incremented by guidance is provided.

³Vital sign and 12 lead ECG will before on day 1/baseline and administration in the 2nd week acquisition per hour it is primary, Zhi Daolin At least 8 hours after bed administration.Life entity will be carried out per hour for those of dosage escalation patient the 12nd week and the 14th week The ECG that seeks peace monitoring, until at least 8 hours after clinical administration.At the 12nd week, for those of no dosage escalation patient, In ECG monitoring is carried out before administration.For remaining clinical interview (the 4th, 8,16,20 week and the 24th week), capture is given birth to before administration Order sign and 12 lead ECG.After 24 hr Ambulatory EKG Monitoring monitors will be administered for 24 hours and the 1st day and the 12nd week before administration Progress in 24 hours (in case of dosage escalation).Typically, other than the pretreatment ECG obtained on day 1, all safety ECG will be obtained as single mark, this is to record in triplicate.

⁴For all female patients, need to carry out within the 1st day Urine test paper pregnancy tests, and for all other specified Interview need to carry out serum hCG test.

⁵For 12 weeks before dose titration, if tolerance, few patients will receive 1mg q.d., then connect at the 12nd week By 2mg q.d..During remaining research, dosage should be maintained at 2mg q.d.

⁶FSH- only confirms postmenopausal state in women.

⁷For the patient of screening results exception.

⁸If in follow-up in 2 weeks, absolute periphery lymphocyte counting did not returned at least the 80% of baseline value, or reached Normal range (NR), then patient must come back for weekly CBC test, until absolute periphery lymphocyte count back at least these Value.AE: adverse events；ALP: alkaline phosphatase；C4:7 Alpha-hydroxy -4- cholestene -3- ketone；ECG: electrocardiogram；EOS: research knot Beam；EOT: treatment end；EWD: it exits in advance；FU: follow-up；HBsAg: hepatitis B surface antibody；HCV: Hepatitis C Virus； HIV: human immunodeficiency virus；PK: pharmacokinetics；PML: progressive multifocal leukoencephalopathy；PSS: primary Xiu Gelian Cotard；TB: tuberculosis.

Specific embodiment

The disclosure particularly provides the method for treating the primary biliary cholangitis (PBC) in individual in need, (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl two comprising applying therapeutically effective amount Alkene simultaneously [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, solvate or hydrate.

In other embodiments, the present invention relates to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2, 3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, solvate or water It closes object and is manufacturing the purposes in the drug for treating the primary biliary cholangitis (PBC) in individual.

In other embodiments, the present invention relates to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2, 3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, hydrate or solvent Compound, for treating primary biliary cholangitis (PBC).

In other embodiments, the present invention relates to be related to titration packaging, make it possible to abide by change whithin a period of time The scheme of drug dose treats primary biliary cholangitis (PBC), and wherein drug is (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneouslies [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically Acceptable salt, solvate or hydrate, described to include:

The doctor of compound 1 or its pharmaceutically acceptable salt, hydrate or solvate comprising one or more dosage The day unit of first quantity of drug composition, wherein each dosage is equal to about 1.5mg or less compound 1 in amount, and

The medicinal combination of compound 1 or its pharmaceutically acceptable salt, hydrate or solvate comprising standard dose The day unit of second quantity of object is equal to about 1.0 to about 2.5mg compound 1 in amount.

Certain methods of the L-arginine salt of prepare compound 1 and compound 1 are previously described；Referring to WO2010/ 011316 and WO2011/094008.In addition, the new crystallization lath habit of the L-arginine salt of compound 1 is previously described, And referred to herein as " the free lath habit of the crystallization of the non-solvated L-arginine salt of compound 1 "；Referring to WO2016/ 209809。

In some embodiments, method provided herein has developed into the primary of primary biliary cirrhosis for treating The biliar cholangitis of property.In some embodiments, method provided herein is for preventing primary biliary cirrhosis.Some In embodiment, method provided herein progresses to primary biliary cirrhosis for postponing.

It is abbreviated list below: ACS (acute coronary syndrome)；ADL (daily routines)；AE (adverse events)；ALP (alkaline phosphatase)；ALT (alanine aminotransferase (SGPT))；AMA (anti-mitochondrial antibody)；ANA (antinuclear antibodies)；AST (asparagus fern Propylhomoserin transaminase (SGOT))；AV (chamber)；Bpm (beating/minute)；CBC (whole blood count)；CFR (federal regulations)；CI (confidence interval)；CRF (case report form)；CRP (C reactive protein)；CRO (Contract Research Organization)；D (day)；DILI (drug Property hepatic injury)；ECG (electrocardiogram)；ED50 (half maximal dose)；EGFR (estimation glomerular filtration rate)；ELISA is (enzyme-linked to exempt from Epidemic disease determining adsorption)；EOS (research terminates)；EOT (treatment end)；FDA (Food and Drug Administration)；FEV1 (forced expiration Amount)；FU (follow-up)；FVC (Force Vital Capacity)；GCP (good clinical practice)；GGT (γ glutamyl transferase)；HBsAg is (B-mode Hepatitis surface antigen)；HCG (human chorionic gonadotropin)；HCV (Hepatitis C Virus)；HREC (human research Ethics Committee (AUS))；HIV (human immunodeficiency virus)；HR (heart rate)；ICH (international coordination meeting)；ICF (informed consent form)；IEC (independent Ethics Committee)；IND (research new drug)；IRB (institutional review board)；INR (International Standardization Ratio)；Hormone Release system)；IUD (intrauterine device)；IUS (in utero hormone release system)；Kg (kilogram)；LDH (lactic dehydrogenase)；L (liter)；MCH (mean corpuscular hemoglobin)；MCV (mean corpuscular volume (MCV))；MedDRA (supervision activity Medical Dictionary)；mg (milligram)；MI (myocardial infarction)；NK (natural kill)；NOAEL (does not observe adverse reaction level)；OTC (over-the-counter trading)； PBC (the biliar cholangitis in periphery)；PBL (peripheral blood lymphocytes)；PD (pharmacodynamics)；PFT (pulmonary function test)；PGA (doctor Net assessment)；PI (chief researcher)；PK (pharmacokinetics)；P.o. (oral (oral))；PRO (patient reports result)； PSS (primary Xiu Gelian Cotard)；PVG (pharmacovigilance)；Q.d. (daily (once a day))；SAP (statistical analysis meter It draws)；S1P (sphingol 1- phosphate)；SAE (serious adverse events)；SBP (systolic pressure)；SD (standard deviation)；Sec (second)；SOP (S.O.P.)；T1/2 (eliminates half-life period)；Tmax (median time for reaching maximal plasma concentration)；(tear film is broken by TBUT Split the time)；TIA (transient ischemic attack)；UDCA (ursodesoxycholic acid)；ULN (Upper Limit of Normal Value)；VS (vital sign)； VZV (varicellazoster virus)；WBC (leucocyte)；WHO (World Health Organization)；With WHODRUG (World Health Organization's medicine Object dictionary).

The crystallization L-arginine salt of compound 1

Crystallizing free lath habit or form and process can be used for preparing (the R) -2- being described in WO2016/209809 The L- of (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid The free lath habit of the crystallization of arginine salt.Lath is found from new synthetic method, and is shown as thin hexagon shape lath, Two opposite sides of the lath are longer than the other side (i.e. elongated hexagon lath).However, seldom being seen due to the thin feature of lath To complete unbroken lath.On the contrary, what is be generally observed is the big to small fracture of thin hexagon shape lath.Art technology Personnel should be understood that microexamination is to discriminate between one of two kinds of crystal habits or more useful technology of form.When two or more When form is related with the identical or essentially identical crystal phase of the L-arginine salt of compound 1, this is particularly useful.Compare previously The PXRD figure of the lath habit of the habit (i.e. WO2011/094008) and the preparation as described in WO2016/209809 of preparation (is shown in Fig. 1, PXRD is covered between spherocrystal and lath), observe that two kinds of PXRD figures are identical or essentially identical, therefore two kinds of habits represent phase Same crystal phase.

Although two habits show identical or substantially the same PXRD figure, lath habit is observed higher Crystallinity, such as by substantially higher peak intensity and lower sample background context scattering (that is, lower amorphous dizzy contribution) Indicated.Since sample size and sample preparation can influence peak intensity and the relevant backscatter of sample, and due to two Kind habit shares identical crystal phase, and PXRD may not be considered as the most suitable test method for distinguishing two kinds of habits.However, PXRD allows to determine two kinds of habits crystal phase whether having the same or different crystal phases really.In order to determine different habits, show Micro mirror inspection is more useful one of method.Thus, those skilled in the art can check the microphoto of crystal habit, and hold Easily determine crystal habit.

Other than art-recognized technology, specific surface area can also be used for characterization habit, such as free lath.Therefore, originally Specific surface area value disclosed in invention is integrated by the specific surface based on BET (Brunauer, Emmett and Teller) theory What analysis technology obtained, the theory is known in the art to calculate solid to the physical absorption of gas molecule by measurement solid Surface area it is generally acknowledged theoretical (see Brunauer, S.；Emmett,P.H.；And Teller, E.；" U.S. chemical institute magazine (J.Am.Chem.Soc.) ", 1938,60,309).Specifically, the specific surface area value measured in the present invention is via BET surface area Figure calculates, and the BET surface area figure at 77.3K by measuring in 0.05-0.3 (P/P₀) different relative pressures in range (P/P₀) under by solid weighted volumes adsorb nitrogen molecule amount and obtain.By with feature described in following example 3 Micromeritics^TMThe measurement of TriStar II BET surface analyzer progress gas molecule absorption.That is, nitrogen is for adsorbing Measurement.The sample of each analysis deaerates 960 minutes at vacuum (i.e. 100mm/Hg) at 25 DEG C.At 77.3K, fully dispersed 11 relative pressure (P/P in about 0.05 to about 0.30 range₀) (i.e. within the scope of about 738mmHg to about 743mmHg Ten one absolute pressures of the saturation pressure within the scope of about 36mm Hg to about 223mm Hg when relative to measurement) under measure nitrogen The determination of absorption.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy as described herein Base) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid L-arginine salt new crystallization plates crystalline form state.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- four Hydrogen cyclopenta [b] indol-3-yl) acetic acid L-arginine salt crystallization dissociate lath habit.

In some embodiments, to crystallize free lath habit have x-ray diffractogram of powder, it includes for 2 θ Peak at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± 0.2 °.In some embodiments, crystallizing free lath habit has X-ray diffractogram of powder, it includes the peaks at 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 ° for 2 θ. In some embodiments, to crystallize free lath habit have x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± Peak at 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 °.In some embodiments, free lath is crystallized to practise Property there is x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, Peak at 24.6 ° ± 0.2 ° and 28.8 ° ± 0.2 °.In some embodiments, free lath habit is crystallized to spread out with X-ray powder Penetrate figure, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± Peak at 0.2 ° and 37.3 ° ± 0.2 °.

In some embodiments, crystallizing free lath habit has differential scanning calorimetry trace, and it includes at 10 DEG C/minute There is the heat absorption of 205.0 DEG C to 208.5 DEG C of temperature of the extrapolated onset under the sweep speed of clock.In some embodiments, crystallization trip From lath habit have differential scanning calorimetry trace, it includes under 10 DEG C/min of sweep speed have 205.0 DEG C extremely The heat absorption of 208.1 DEG C of temperature of the extrapolated onset.In some embodiments, crystallizing free lath habit has differential scanning calorimetry Trace, it includes the heat absorptions of the temperature of the extrapolated onset under 10 DEG C/min of sweep speed with 205.5 DEG C to 208.5 DEG C.In In some embodiments, crystallizing free lath habit has differential scanning calorimetry trace, and it includes the scanning at 10 DEG C/min is fast There is the heat absorption of 206.0 DEG C to 208.5 DEG C of temperature of the extrapolated onset under rate.In some embodiments, free lath habit is crystallized With differential scanning calorimetry trace, outside under 10 DEG C/min of sweep speed with 206.5 DEG C to 208.5 DEG C Push away the heat absorption of initial temperature.In some embodiments, crystallizing free lath habit has differential scanning calorimetry trace, it includes There is the heat absorption of 205.5 DEG C to 208.1 DEG C of temperature of the extrapolated onset under 10 DEG C/min of sweep speed.In some embodiments In, crystallizing free lath habit has differential scanning calorimetry trace, and it includes have under 10 DEG C/min of sweep speed The heat absorption of 206.5 DEG C to 208.1 DEG C of temperature of the extrapolated onset.In some embodiments, crystallizing free lath habit has differential Scanning calorimetry trace, it includes the extrapolations under 10 DEG C/min of sweep speed with 207.0 DEG C to 208.1 DEG C to originate temperature The heat absorption of degree.

In some embodiments, it crystallizes free lath habit to be distributed with dynamic moisture absorption (DMS), absorption is mutually 30%RH To 90%RH, wherein crystallize free lath habit increases about 0.3 weight % or less at 90%RH.In some embodiments, It crystallizes free lath habit to be distributed with dynamic moisture absorption (DMS), absorption is mutually 30%RH to 90%RH, wherein crystallizing free plate Brilliant habit increases about 0.2 weight % or less at 90%RH.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- four Hydrogen cyclopenta [b] indol-3-yl) crystallization of L-arginine salt of acetic acid dissociates lath habit, and it is described to crystallize free lath Habit has BET specific surface area below: about 0.05m²/ g, about 0.1m²/ g, about 0.15m²/ g, about 0.2m²/ g, about 0.25m²/g、 About 0.3m²/ g, about 0.35m²/ g, about 0.4m²/ g, about 0.45m²/ g, about 0.5m²/ g, about 0.55m²/ g, about 0.6m²/ g, about 0.65m²/ g, or about 0.7m²/ g to about 2.0m²/ g, about 2.5m²/ g, about 3.0m²/ g, about 3.5m²/ g, about 4.0m²/ g, about 4.5m²/ G, about 5.0m²/ g, about 5.5m²/ g, about 6.0m²/ g, about 6.5m²/ g, about 7.0m²/ g, about 7.5m²/ g, about 8.0m²/ g, about 8.5m²/ G, about 9.0m²/ g, or about 9.5m²/g。

In some embodiments, crystallizing free lath habit has about 0.1m²/ g to about 5.0m²The BET specific surface area of/g. In some embodiments, crystallizing free lath habit has about 0.1m²/ g to about 4.0m²The BET specific surface area of/g.In some realities It applies in example, crystallizing free lath habit has about 0.3m²/ g to about 4.0m²The BET specific surface area of/g.In some embodiments, it ties The free lath habit of crystalline substance has about 0.5m²/ g to about 4.0m²The BET specific surface area of/g.In some embodiments, free plate is crystallized Brilliant habit has about 0.6m²/ g to about 4.0m²The BET specific surface area of/g.In some embodiments, free lath habit tool is crystallized There is about 0.3m²/ g to about 3.0m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has about 0.4m²/ g to about 2.0m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has about 0.5m²/ g is extremely About 1.8m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has about 0.6m²/ g to about 1.6m²/g BET specific surface area.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° and 37.3 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.0 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.3 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 ° and 24.6 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 206.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.3 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± Peak at 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.2 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± Peak at 0.2 °；

2) differential scanning calorimetry trace, it includes have 207.1 DEG C to 208.1 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.2 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) differential scanning calorimetry trace, it includes have 205.0 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

2) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.3 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) differential scanning calorimetry trace, it includes have 206.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

2) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.3 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) differential scanning calorimetry trace, it includes have 205.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

2) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.2 weight % or less under 90%RH.

In in some implementations, crystallizes free lath habit and include

1) differential scanning calorimetry trace, it includes have 207.1 DEG C to 208.1 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；And/or

2) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, is existed wherein crystallizing free lath habit Increase about 0.2 weight % or less under 90%RH.In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± Peak at 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.0 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.3 weight % or less at 90%RH；And/or

4) about 0.1m²/ g to about 5.0m²The BET specific surface area of/g.In in some implementations, free lath habit tool is crystallized Have:

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± Peak at 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.3 weight % or less at 90%RH；And/or

4) about 0.1m²/ g to about 4.0m²The BET specific surface area of/g.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± Peak at 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.3 weight % or less at 90%RH；And/or

4) about 0.3m²/ g to about 3.0m²The BET specific surface area of/g.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 ° and 24.6 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.3 weight % or less at 90%RH；And/or

4) about 0.6m²/ g to about 4.0m²The BET specific surface area of/g.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 ° and 24.6 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 206.5 DEG C to 208.5 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.3 weight % or less at 90%RH；And/or

4) about 0.4m²/ g to about 2.0m²The BET specific surface area of/g.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 °, 24.6 ° ± 0.2 ° and 28.8 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 206.5 DEG C to 208.1 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.2 weight % or less at 90%RH；And/or

4) about 0.5m²/ g to about 1.8m²The BET specific surface area of/g.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° and 37.3 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 205.5 DEG C to 208.1 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.2 weight % or less at 90%RH；And/or

4) BET specific surface area of about 0.6m2/g to about 4.0m2/g.

In in some implementations, crystallizes free lath habit and include

1) x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± Peak at 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° and 37.3 ° ± 0.2 °；

2) differential scanning calorimetry trace, it includes have 207.1 DEG C to 208.1 under 10 DEG C/min of sweep speed DEG C temperature of the extrapolated onset heat absorption；

3) dynamic moisture absorption (DMS) is distributed, and absorption is mutually 30%RH to 90%RH, wherein described crystallize free lath habit Increase about 0.2 weight % or less at 90%RH；And/or

4) about 0.6m²/ g to about 1.6m²The BET specific surface area of/g.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- four Hydrogen cyclopenta [b] indol-3-yl) crystallization of L-arginine salt of acetic acid dissociates lath habit, and it is described to crystallize free lath Habit have x-ray diffractogram of powder, it includes for 2 θ at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± 0.2 ° The peak at place.In some embodiments, to crystallize free lath habit have x-ray diffractogram of powder, it includes for 2 θ Peak at 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 °.In some embodiments, crystallizing free lath habit has X-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± Peak at 0.2 °.In some embodiments, crystallizing free lath habit has x-ray diffractogram of powder, and it includes for 2 θ The peak at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 ° and 28.8 ° ± 0.2 °.Some In embodiment, crystallizing free lath habit has x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, Peak at 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° and 37.3 ° ± 0.2 °.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- four Hydrogen cyclopenta [b] indol-3-yl) crystallization of L-arginine salt of acetic acid dissociates lath habit, and it is described to crystallize free lath Habit have differential scanning calorimetry trace, it includes when under 10 DEG C/min scan when with 205.0 DEG C to 208.5 DEG C The heat absorption of temperature of the extrapolated onset.In some embodiments, crystallizing free lath habit has differential scanning calorimetry trace, packet It is contained in the heat absorption under 10 DEG C/min of sweep speed with 205.0 DEG C to 208.1 DEG C of temperature of the extrapolated onset.In some implementations In example, crystallizing free lath habit has differential scanning calorimetry trace, and it includes have under 10 DEG C/min of sweep speed The heat absorption of 205.5 DEG C to 208.5 DEG C of temperature of the extrapolated onset.In some embodiments, crystallizing free lath habit has differential Scanning calorimetry trace, it includes the extrapolations under 10 DEG C/min of sweep speed with 205.5 DEG C to 208.1 DEG C to originate temperature The heat absorption of degree.In some embodiments, crystallizing free lath habit has differential scanning calorimetry trace, it includes 10 DEG C/ There is the heat absorption of 206.0 DEG C to 208.5 DEG C of temperature of the extrapolated onset under the sweep speed of minute.In some embodiments, it crystallizes Free lath habit has differential scanning calorimetry trace, it includes have under 10 DEG C/min of sweep speed 206.5 DEG C extremely The heat absorption of 208.5 DEG C of temperature of the extrapolated onset.In some embodiments, crystallizing free lath habit has differential scanning calorimetry Trace, it includes the heat absorptions of the temperature of the extrapolated onset under 10 DEG C/min of sweep speed with 206.5 DEG C to 208.1 DEG C.In In some embodiments, crystallizing free lath habit has differential scanning calorimetry trace, and it includes the scanning at 10 DEG C/min is fast There is the heat absorption of 207.0 DEG C to 208.1 DEG C of temperature of the extrapolated onset under rate.In some embodiments, free lath habit is crystallized With x-ray diffractogram of powder, it includes for 2 θ at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± 0.2 ° Peak.In some embodiments, crystallizing free lath habit has x-ray diffractogram of powder, it includes for 2 θ at 8.2 ° Peak at ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 °.In some embodiments, crystallizing free lath habit has powder X-ray diffractogram, it includes for 2 θ at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 ° The peak at place.In some embodiments, to crystallize free lath habit have x-ray diffractogram of powder, it includes for 2 θ Peak at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 ° and 28.8 ° ± 0.2 °.In some implementations In example, crystallizing free lath habit has x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± Peak at 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° and 37.3 ° ± 0.2 °.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- four Hydrogen cyclopenta [b] indol-3-yl) crystallization of L-arginine salt of acetic acid dissociates lath habit, and it is described to crystallize free lath Habit is distributed with dynamic moisture absorption (DMS), and absorption is mutually 30%RH to 90%RH, wherein crystallizing free lath habit 90% Increase about 0.3 weight % or less under RH.In some embodiments, free lath habit is crystallized with dynamic moisture absorption (DMS) point Cloth, absorption are mutually 30%RH to 90%RH, wherein crystallize free lath habit increases about 0.2 weight % or more at 90%RH It is few.In some embodiments, crystallizing free lath habit has x-ray diffractogram of powder, it includes for 2 θ at 8.2 ° Peak at ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± 0.2 °.In some embodiments, crystallizing free lath habit has powder X-ray diffractogram, it includes the peaks at 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 ° for 2 θ.One In a little embodiments, crystallizing free lath habit has x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, Peak at 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 °.In some embodiments, free lath habit tool is crystallized Have x-ray diffractogram of powder, it includes for 2 θ at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° Peak at ± 0.2 ° and 28.8 ° ± 0.2 °.In some embodiments, crystallizing free lath habit has x-ray diffractogram of powder, It includes for 2 θ at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° With the peak at 37.3 ° ± 0.2 °.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- four Hydrogen cyclopenta [b] indol-3-yl) crystallization of L-arginine salt of acetic acid dissociates lath habit, and it is described to crystallize free lath Habit has about 0.1m²/ g to about 5.0m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has About 0.1m²/ g to about 4.0m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has about 0.3m²/g To about 4.0m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has about 0.5m²/ g is to about 4.0m²The BET specific surface area of/g.In some embodiments, crystallizing free lath habit has about 0.6m²/ g to about 4.0m²/ g's BET specific surface area.In some embodiments, crystallizing free lath habit has about 0.3m²/ g to about 3.0m²The BET specific surface of/g Product.In some embodiments, crystallizing free lath habit has about 0.4m²/ g to about 2.0m²The BET specific surface area of/g.Some In embodiment, crystallizing free lath habit has about 0.5m²/ g to about 1.8m²The BET specific surface area of/g.In some embodiments, Crystallizing free lath habit has about 0.6m²/ g to about 1.6m²The BET specific surface area of/g.In some embodiments, crystallization is free Lath habit has x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 ° and 20.5 ° ± Peak at 0.2 °.In some embodiments, crystallizing free lath habit has x-ray diffractogram of powder, and it includes for 2 θ The peak at 8.2 ° ± 0.2 °, 20.5 ° ± 0.2 ° and 24.6 ° ± 0.2 °.In some embodiments, free lath habit is crystallized With x-ray diffractogram of powder, it includes for 2 θ at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 ° and Peak at 24.6 ° ± 0.2 °.In some embodiments, crystallizing free lath habit has x-ray diffractogram of powder, and it includes just The peak at 8.2 ° ± 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 ° and 28.8 ° ± 0.2 ° for 2 θ. In some embodiments, to crystallize free lath habit have x-ray diffractogram of powder, it includes for 2 θ 8.2 ° ± Peak at 0.2 °, 16.4 ° ± 0.2 °, 20.5 ° ± 0.2 °, 24.6 ° ± 0.2 °, 28.8 ° ± 0.2 ° and 37.3 ° ± 0.2 °.

Some embodiments

In their various embodiments, the invention particularly relates to the primary biliary cholangitis treated in individual in need (PBC) method, it includes application therapeutically effective amount (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2, 3,4- tetrahydro cyclopentyl diene simultaneouslies [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, solvate or Hydrate.

In other embodiments, the present invention relates to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2, 3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) or its pharmaceutically acceptable salt, solvate or water It closes object and is manufacturing the purposes in the drug for treating the primary biliary cholangitis (PBC) in individual.

In some embodiments, individual is previously treated with the ursodesoxycholic acid (UDCA) of therapeutically effective amount.

In some embodiments, individual is treated with the ursodesoxycholic acid (UDCA) of therapeutically effective amount at present.

In some embodiments, the UDCA of therapeutically effective amount is about 10-20mg/kg/ days.In some embodiments, it treats A effective amount of UDCA is about 13-15mg/kg/ days.

In some embodiments, when applying together with compound 1, the UDCA of therapeutically effective amount is reduced.In some implementations In example, the UDCA of therapeutically effective amount is decreased below 15mg/kg/ days.In some embodiments, the UDCA of therapeutically effective amount is reduced To less than 13mg/kg/ days.In some embodiments, the UDCA of therapeutically effective amount decreases below 500mg.In some embodiments In, the UDCA of therapeutically effective amount, which is reduced to each application, is less than 500mg.In some embodiments, the UDCA of therapeutically effective amount subtracts As little as it is less than 250mg.In some embodiments, the UDCA of therapeutically effective amount, which is reduced to each application, is less than 250mg.In some realities It applies in example, the frequency of administration of UDCA reduces.In some embodiments, the application of UDCA is reduced to four divided doses.In some realities It applies in example, the application of UDCA is reduced to three divided doses.In some embodiments, the application of UDCA is reduced to two divided doses. In some embodiments, UDCA is applied four times daily.In some embodiments, UDCA is applied three times daily.In some embodiments In, UDCA is applied twice daily.

In some embodiments, when applying together with UDCA, the compound 1 of therapeutically effective amount is reduced.In some implementations In example, the compound 1 of therapeutically effective amount is reduced to less than 2mg.In some embodiments, the compound 1 of therapeutically effective amount is reduced To less than 1.5mg.In some embodiments, the compound 1 of therapeutically effective amount is reduced to less than 1mg.In some embodiments, change The frequency of administration for closing object 1 reduces.In some embodiments, compound 1 is administered once a day.In some embodiments, compound 1 Every other day apply.

In some embodiments, the UDCA of therapeutically effective amount is about 100mg to about 1000mg.In some embodiments, it controls Treating a effective amount of UDCA is about 250mg to about 500mg.In some embodiments, the UDCA of therapeutically effective amount be about 100mg, 125mg、150mg、175mg、200mg、225mg、250mg、275mg、300mg、325mg、350mg、375mg、400mg、 425mg、450mg、475mg、500mg、525mg、550mg、575mg、600mg、625mg、650mg、675mg、700mg、 725mg, 750mg, 775mg, 800mg, 825mg, 850mg, 875mg, 900mg, 925mg, 950mg, 975mg or 1000mg.In In some embodiments, the UDCA of therapeutically effective amount is about 250mg.In some embodiments, the UDCA of therapeutically effective amount is about 500mg。

In some embodiments, the UDCA of therapeutically effective amount is applied with two to ten divided doses.In some embodiments, it controls A effective amount of UDCA is treated to apply with two to four divided doses.In some embodiments, the UDCA of therapeutically effective amount is with two points of agent Amount application.In some embodiments, the UDCA of therapeutically effective amount is applied with three divided doses.In some embodiments, treatment has The UDCA of effect amount is applied with four divided doses.In some embodiments, the UDCA of therapeutically effective amount is applied with five divided doses.In In some embodiments, UDCA is applied four times daily.In some embodiments, UDCA is applied three times daily.In some embodiments, UDCA is applied twice daily.

In some embodiments, the UDCA of therapeutically effective amount amount (stabilizer basically the same at least six moon Amount).

In some embodiments, individual previously with ursodesoxycholic acid (UDCA) treat, and individual to UDCA have do not fill The reaction divided.

In some embodiments, individual has insufficient reaction to UDCA, as by for individual > 1.67x is normal The alkaline phosphate (ALP) of the value upper limit (ULN) determines.

In some embodiments, individual has insufficient reaction after being treated 6 months with UDCA.

In some embodiments, individual is controlled with the alkaline phosphate (ALP) of UDCA and > 1.67x Upper Limit of Normal Value (ULN) There is insufficient reaction after treating 6 months.

In some embodiments, the therapeutic dose of UDCA is at least 13mg/kg/ days.

In some embodiments, individual has at least one primary biliary cholangitis selected from the group being made up of Diagnostic criteria:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5x ULN continues at least six moon；With

Liver biopsy result is consistent with PBC.

In some embodiments, individual has at least two primary biliary cholangitis selected from the group being made up of Diagnostic criteria:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5x ULN continues at least six moon；With

Liver biopsy result is consistent with PBC.

In some embodiments, individual has at least one standard selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；With

Serum creatinine < 1.5mg/dL (133 μm of ol/L).

In some embodiments, individual has at least one standard selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；With

Serum creatinine < 1.5mg/dL (133 μm of ol/L).

In some embodiments, individual has at least one standard selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least one standard selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

(Transient elastography) < 10kPa.

In some embodiments, individual has at least two standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least two standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least three kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least three kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least four standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least four standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least five kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least five kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least six kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least six kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least seven kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least seven kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least eight kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has at least eight kinds standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has all standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < 1.5x ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.4g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual has all standards selected from the group being made up of:

ALP>1.67x ULN but<10x ULN；

ALT and AST < 5x ULN；

Total bilirubin < ULN；

International Standardization Ratio (INR) < 1.2x ULN；

Platelet count > 150,000/mm³；

Seralbumin > 3.0g/dL；

Serum creatinine < 1.5mg/dL (133 μm of ol/L)；

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation；With

Fibroscan (Transient elastography) < 10kPa.

In some embodiments, individual suffers from least one other patient's condition selected from the group being made up of: itch, tired Labor, osteoporosis, vitamin-deficiency, eyes and/or xerostomia, portal hypertension, pain.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is oral.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are formulated into suitable In oral capsule or tablet.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are formulated into suitable In oral tablet.

In some embodiments, before the compound 1 of application therapeutically effective amount, the chemical combination of titration dosage is applied to individual Object 1, wherein titration dosage is less than the compound 1 of therapeutically effective amount.

In some embodiments, titration dosage is less than the about 2mg of compound 1.

In some embodiments, titration dosage is maintained until the vital sign and/or EKG of individual do not have significant changes.

In some embodiments, maintain titration dosage until individual in pulse frequency >=55bpm, systolic pressure (SBP) >=90, and And diastolic pressure (DBP) >=55mmHg.

In some embodiments, before the compound 1 of application therapeutically effective amount, titration dose maintenance is no more than 14 It.

In some embodiments, titration dosage includes the first titration dosage and the second titration dosage, wherein the first titrant Amount is less than the second titration dosage, and each titration dosage is less than the compound 1 of therapeutically effective amount.

In some embodiments, the first titration dosage is equal to the compound 1 of about 1mg in amount.

In some embodiments, the second titration dosage is equal to the compound 1 of about 1.5mg in amount.

In some embodiments, the first titration dosage is equal to the compound 1 of about 1mg, and the second titrant in amount Amount is equal to the compound 1 of about 1.5mg in amount.

In some embodiments, before application second titrates dosage, the first titration dose maintenance is no more than 7 days.

In some embodiments, before the compound 1 of application therapeutically effective amount, the second titration dose maintenance is no more than 7 days.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to the compound 1 of about 1.0mg to about 5mg in amount.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to about 1mg to about 2mg in amount.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to about 1mg, about 1.25mg, about 1.5mg, about 1.75 or about 2mg in amount.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to about 1mg or about 2mg in amount.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to the compound 1 of about 1mg in amount.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to the change of 1.1mg, 1.2mg, 1.3mg, 1.4mg, 1.5mg, 1.6mg, 1.7mg, 1.8mg, 1.9mg or 2mg in amount Close object 1.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal in amount >=compound 1 of 1mg.In some embodiments, the compound 1 of therapeutically effective amount or its can pharmaceutically connect Salt, hydrate or the solvate received be equal in amount >=compound 1 of 1.5mg.In some embodiments, therapeutically effective amount Compound 1 or its pharmaceutically acceptable salt, hydrate or solvate be equal to the≤compound 1 of 1mg in amount.One In a little embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvate of therapeutically effective amount are equivalent in amount In the compound 1 of≤1.5mg.In some embodiments, the compound 1 or its pharmaceutically acceptable salt, water of therapeutically effective amount It closes object or solvate and is equal to≤the compound 1 of 2mg in amount.In some embodiments, compound 1 or its can pharmaceutically connect The therapeutically effective amount of salt, hydrate or the solvate received is no more than the compound 1 of 1mg, 1.5mg, 2mg or 5mg.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, water of therapeutically effective amount are applied once a day Close object or solvate.

In some embodiments, the compound 1 or its pharmaceutically acceptable salt, hydrate or solvation of therapeutically effective amount Object is equal to the compound 1 of about 2mg in amount.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are selected from: chemical combination The L-arginine salt of object 1, the calcium salt of compound 1 and compound 1.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 L-arginine salt.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 L-arginine salt anhydrous unsolvated crystal form.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 Non-solvated L-arginine salt crystallization dissociate lath habit.

In some embodiments, compound 1 or its pharmaceutically acceptable salt, hydrate or solvate are compounds 1 Anhydrous unsolvated crystal form.

In some embodiments, method also includes to apply compound 1 or its salt, solvate or hydrate pharmaceutically, And the compound selected from the group being made up of of therapeutically effective amount: antihistamine (diphenhydramine), cholestyramine (questran, prevalite), rifampin, opioid antagonist (naloxone), pilocarpinum (isopto carpine, Salagen), cevimeline (evoxac), calcium and/or Vitamin D supplements and vitamin A. D. E and/or K replenishers.

Some embodiments of the present invention be related to titration packaging, make it possible to abide by change drug dose whithin a period of time Scheme treat primary biliary cholangitis (PBC), wherein drug is (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) Benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneouslies [b] indol-3-yl) acetic acid (compound 1) or its is pharmaceutically acceptable Salt, solvate or hydrate, described to include:

The doctor of compound 1 or its pharmaceutically acceptable salt, hydrate or solvate comprising one or more dosage The day unit of first quantity of drug composition, wherein each dosage is equal to about 1.5mg or less compound 1 in amount, and

The medicinal combination of compound 1 or its pharmaceutically acceptable salt, hydrate or solvate comprising standard dose The day unit of second quantity of object is equal to about 1.0 to about 2.5mg compound 1 in amount.

In some embodiments, the first quantity day unit dosage be equal to the compound 1 of about 1mg in amount.

In some embodiments, the first quantity day unit dosage be equal to the compound 1 of about 1.5mg in amount.

In some embodiments, the second quantity day unit dosage be equal to the compound 1 of about 2mg in amount.

In some embodiments, the first quantity day unit dosage be equal to the compound of about 1mg or 1.5mg in amount 1, and the second quantity day unit dosage be equal to the compound 1 of about 2mg in amount.

Some embodiments are related to kit, and it includes packed and indicated to apply drug according to the titration of any previous embodiment With the specification to the individual for needing to treat primary biliary cholangitis (PBC).

In some embodiments, once a day to the compound 1 of individual application therapeutically effective amount.

In some embodiments, twice daily to the compound 1 of individual application therapeutically effective amount.

In some embodiments, three times a day to the compound 1 of individual application therapeutically effective amount.

In some embodiments, every other day to the compound 1 of individual application therapeutically effective amount.

In some embodiments, compound 1 is applied in the case where no food.

In some embodiments, identified that individual has liver function damage before application titrates dosage.

Some embodiments are related to method, also include:

Identify the liver function of individual；With

If individual liver function damage, applies and titrates dosage at least once, or

If individual does not have liver function damage, titration dosage is not applied.

Some embodiments are related to method, wherein by least one marker selected from the following carry out liver functional test come Determine the liver function damage of individual: bilirubin, albumin, total protein, transaminase (ALT), aspartate transaminase (AST), flesh Acid anhydride kinases (CK), gamma glutamyltransferase (GGT) or alkaline phosphatase (ALP).

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- Tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) method for the treatment of individual in need, it includes:

(a) at least one obtained before being treated with compound 1 of one or more samples from the individual is analyzed The level of kind biomarker；With

(b) before therapeutic compounds 1, the predeterminated level based at least one biomarker applies compound to individual 1 or do not apply compound 1；

Wherein at least one biomarker is selected from the group being made up of: (i) anti-gp210；(ii) anti- sp100；(iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)；(vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)；(viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；(xii) IgM.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- Tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) method for the treatment of individual in need, it includes:

(a) compound 1 is applied to individual；

(b) at least one biology of one or more samples from individual obtained after being treated with compound 1 is analyzed The level of marker；With

If (c) (i) at least one biomarker before therapeutic compounds 1 is less than or equal at least one biology mark The predeterminated level of will object then continues to apply compound 1；Or

(ii) if at least one biomarker is greater than at least one biomarker before the treatment of compound 1 Predeterminated level then interrupts application compound 1；

Wherein at least one biomarker is selected from the group being made up of: (i) anti-gp210；(ii) anti- sp100；(iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)；(vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)；(viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；(xii) IgM.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- Tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) method for the treatment of individual in need, it includes:

(a) at least one obtained before being treated with compound 1 for analyzing one or more samples from individual is raw The first level of object marker；

(b) compound 1 is applied to individual；

(c) at least one biology of one or more samples from individual obtained after being treated with compound 1 is analyzed The second of marker is horizontal；With

If (d) the second of at least one of (i) step (c) biomarker is horizontal is Less than or equal to about step (a) At least one of biomarker corresponding first level, then continue apply compound 1；Or

(ii) if the second horizontal at least one be higher than in step (a) of at least one of step (c) biomarker The corresponding first level of kind biomarker then interrupts application compound 1；

Wherein at least one biomarker is selected from the group being made up of: (i) anti-gp210；(ii) anti- sp100；(iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)；(vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)；(viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；(xii) IgM.

In some embodiments, individual suffers from primary biliary cholangitis (PBC).

In some embodiments, individual with fatigue, itch, eye do and/or Xiu Gelian Cotard (SS).

In some embodiments, individual is with fatigue.

In some embodiments, individual suffers from itch.

In some embodiments, individual is dry with eye.

In some embodiments, individual suffers from Xiu Gelian Cotard (SS).

In some embodiments, the second of at least one of step (c) biomarker it is horizontal than in step (a) at least A kind of corresponding first level of biomarker is low 2%, 5%, 10%, 12%, 15%, 17%, 20%, 22%, 25%, 30%, 35%, 40%, 45%, 50% or > 50%.

In some embodiments, at least one biomarker is two kinds, three kinds, four selected from the group being made up of Kind, five kinds, six kinds, seven kinds, eight kinds, nine kinds, ten kinds, a kind of ten or 12 kinds of biomarkers: (i) anti-gp210；(ii) anti- sp100；(iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)；(vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)；(viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；(xii) IgM.

In some embodiments, at least one of step (c) biomarker is two selected from the group being made up of Kind, three kinds, four kinds, five kinds, six kinds, seven kinds, eight kinds, nine kinds, ten kinds, a kind of ten or 12 kinds of biomarkers: (i) is anti- gp210；(ii) anti-sp100；(iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) day Aspartic acid transaminase (AST)；(vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) Gao Er Matrix protein 73 (GP73)；(viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；(xii) IgM.

One aspect of the present invention is related to the method for treating the fatigue in individual in need, and it includes application treatment is effective (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indoles -3- of amount Base) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

One aspect of the present invention is related to the side of the fatigue of individual of the treatment with primary biliary cholangitis (PBC) Method, it includes (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3, the 4- tetrahydros of application therapeutically effective amount Cyclopenta [b] indol-3-yl) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

One aspect of the present invention is related to the method for treating the itch in individual in need, and it includes application treatment is effective (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indoles -3- of amount Base) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

One aspect of the present invention is related to the side of the itch of individual of the treatment with primary biliary cholangitis (PBC) Method, it includes (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3, the 4- tetrahydros of application therapeutically effective amount Cyclopenta [b] indol-3-yl) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

One aspect of the present invention is related to treating the dry method of the eye in individual in need, and it includes application treatment is effective (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indoles -3- of amount Base) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

One aspect of the present invention is related to the side that the eye of individual of the treatment with primary biliary cholangitis (PBC) is done Method, it includes (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3, the 4- tetrahydros of application therapeutically effective amount Cyclopenta [b] indol-3-yl) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

One aspect of the present invention is related to treating Xiu Gelian Cotard (SS) method in individual in need, it includes Apply (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously of therapeutically effective amount [b] indol-3-yl) acetic acid (compound 1) or its salt, solvate or hydrate pharmaceutically.

The Xiu Gelianshi that one aspect of the present invention is related to individual of the treatment with primary biliary cholangitis (PBC) is comprehensive The method of simulator sickness (SS), it includes (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy)-of application therapeutically effective amount 1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) or its salt, solvate or water pharmaceutically Close object.

One aspect of the present invention is related to (R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- Tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid (compound 1) method for the treatment of individual in need, it includes:

(a) at least one obtained before being treated with compound 1 of one or more samples from the individual is analyzed The level of kind biomarker；With

(d) change the application of compound 1,

Wherein at least one biomarker is selected from the group being made up of: (i) anti-gp210；(ii) anti- sp100；(iii) Serum High Sensitivity C reactive protein (hsCRP)；(iv) alanine aminotransferase (ALT)；(v) aspartate transaminase (AST)；(vi) gamma glutamyltransferase (GGT)；(vii) anti-mitochondrial antibody (AMA)；(viii) golgi protein 73 (GP73)；(viii) bile acid；(x) recruitment factor 4 (C4)；(xi)IgG；(xii) IgM.

In some embodiments, change amount of the application of compound 1 comprising increasing compound 1.

In some embodiments, change amount of the application of compound 1 comprising reducing compound 1.

In some embodiments, individual has applied compound 1 before changing application.

In some embodiments, the amount of UDCA is about 13mg to about 15mg/kg/ days.

In some embodiments, UDCA is applied with two to four divided doses.

In some embodiments, the amount of UDCA is about 250mg or about 500mg.

In some embodiments, when applying together with compound 1, the amount or frequency of the application of UDCA are reduced.

In some embodiments, when applying together with UDCA, the amount or frequency of the application of compound 1 are reduced.

Pharmaceutical composition

Another aspect of the present invention relates to medical compositions, and it includes one or more compounds as described herein and one Kind or a variety of pharmaceutically acceptable carriers.Some embodiments are related to comprising the compounds of this invention and pharmaceutically acceptable carrier Medical composition.

Some embodiments of the present invention include the method for producing medical composition, and the method includes by least one basis The compound of any compound embodiment disclosed herein is mixed with pharmaceutically acceptable carrier.

Formulation can be prepared by any suitable method, usually by by reactive compound and liquid or fine crushing consolidating Body carrier or both uniformly mixing in a desired proportion, and then, if it is desired, gained mixture is formed to required shape Shape.

Conventional excipient, as bonding agent, filler, acceptable wetting agent, tableting lubricant and disintegrating agent can be used In oral tablet and capsule.Oral liquid preparation can be the shape of solution, lotion, aqueous or oily suspensions and syrup Formula.Alternatively, oral preparation can be dry powder form, can be reconstructed using preceding with water or the suitable liquid vehicle of another kind. Other additive can be added into liquid preparation, such as suspension or emulsifier, non-aqueous vehicle (including edible oil), preservative With flavoring agent and colorant.Parenteral dosage forms can be by the way that the compound of the present invention to be dissolved in suitable liquid vehicle and mistake Filter sterilization solution is then filled into suitable bottle or ampoule and seals to prepare.These are only use well-known in the art In several examples of many appropriate methods of preparation dosage form.

Technology well known to the skilled person can be used, the compounds of this invention is configured to medical composition.It removes Those of be mentioned herein, suitable pharmaceutically acceptable carrier is known in the art；For example, with reference to " Remington: pharmacy Science with practice (Remington, The Science and Practice of Pharmacy) ", the 20th edition, 2000, benefit Ping Kete WILLIAMS-DARLING Ton and Wei Erjinsi publishing house (Lippincott Williams&Wilkins), (editor: Gennaro etc. People).

Although it is possible that the compound of the present invention can be used as original in substitution use in order to for preventing or treating Material or pure chemicals application, but preferably match using compound or active constituent as the medicine for also including pharmaceutically acceptable carrier Object or composition processed are presented.

Therefore, the present invention also provides medical formulation, it includes the compounds of this invention or its pharmaceutically acceptable salt, Solvate, hydrate or derivative and its one or more pharmaceutically acceptable carrier and/or prevention ingredient.With match Other ingredients of object processed it is compatible and to its recipient it is harmless in the sense that, carrier must be " acceptable ".

Medical formulation includes being suitble to oral, rectum, nose, part (including cheek and sublingual), vagina or parenteral (including flesh It is interior, subcutaneous and intravenous) application those of or fit through sucking, be blown into or transdermal patch apply form.Transdermal patch is logical It crosses to have the effective means of minimum drug degradation to present the drug for absorption with controlled rate-allocation drug.In general, thoroughly Skin patch includes impermeable back sheet, single contact adhesive and the removable protective layer with release liner.This field Ordinarily skilled artisan will understand that being suitable for the technology for needing to manufacture desired effective transdermal patch based on technical staff with understanding.

Therefore, the compound of the present invention can be put into medical formulation and its together with standard adjuvant, carrier or diluent In the form of unit dose, and may be used as the solid for being used to be administered orally in this form, such as tablet or filling capsule, Or liquid, such as solution, suspension, lotion, elixir, gel or the capsule for filling it；Rectal administration is used in the form of suppository；Or It is used in the form of sterile injectable solution for parenteral (including subcutaneous).This medical composition and its unit dosage forms can wrap Conventional ingredient containing conventional ratio, is with or without other reactive compound or principle, and this unit dosage forms can containing with Will the comparable any appropriate effective amount of expection daily dosage range active constituent.

For oral, medical composition be can be, for example, the form of tablet, capsule, suspension or liquid.Medicinal combination Object is made preferably in the form of the dosage unit containing specific quantity active constituent.The example of this dosage unit be capsule, tablet, Powder, particle or suspension, with conventional additives such as lactose, mannitol, cornstarch or potato starch；With adhesive Such as avicel cellulose, cellulose derivative, gum arabic, cornstarch or gelatin；With disintegrating agent such as cornstarch, potato Starch or sodium carboxymethylcellulose；And there is lubricant such as talcum or magnesium stearate.Active constituent can also be used as composition It is applied by injection, wherein for example salt water, dextrose or water may be used as suitable pharmaceutically acceptable carrier.

The compound of the present invention or its salt, solvate, hydrate or physiological functional derivative can be used as medical group The active constituent in object is closed, S1P1 receptor modulators are especially used as.The term defined in the background of " medical composition " is " living Property ingredient " refer to the component of the medical composition of main pharmacological effect be provided, and be typically considered to not provide pharmaceutical benefit " non-active ingredient " is opposite.

Dosage when using the compound of the present invention can change, and by convention and known to doctor, every The individual patient's condition is adjusted in one individual case.For example, its property for depending on treated disease and severity, individual The patient's condition or whether treat acute or chronic morbid state or carry out prevention or in addition to the compounds of the invention whether Also apply other reactive compounds.Representative dosage of the invention includes but is not limited to about 1mg to about 5mg, about 0.5mg, about 0.75mg, about 1mg, about 1.25mg, about 1.5mg, about 1.75mg, about 2mg, about 2.25mg, about 2.5mg, about 2.75mg, about 3mg, About 3.25mg, about 3.5mg, about 3.75mg, about 4mg, about 4.25mg, about 4.5mg, about 4,75mg and about 5mg.It can be in one day Multi-dose is applied, especially when thinking to need relatively large amount, such as 2,3 or 4 dosage.Depending on doctor individual and such as individual Teacher or care-giver think suitable, it may be necessary to deviate upward or downward from dosage as described herein.

It not only will be with using the amount of required active constituent or its active salt, solvate or hydrate derivative for treating Selected salt and change, and also by with the property of administration method, the patient's condition being treated and individual age and The patient's condition and change, and will finally be determined by doctor or clinician.Represent sexual factor include individual type, the age, weight, Gender, diet and medical condition, the severity of disease, administration method, pharmacological considerations, such as specific compound used Activity, effect, pharmacokinetics and Toxicological Characterization, if use drug delivery system, if treating acute or chronic Morbid state prevent or whether applies other reactive compounds in addition to the compounds of the invention and as medicine group A part of conjunction.With the dosage of the compound of the present invention and/or the composition therapeuticing disease patient's condition according to including those described above Various factors inside is selected.Therefore, used actual dose scheme can be widely varied, and therefore can deviate Preferred dosage, and those skilled in the art will appreciate that the dosage except these typical ranges and agent can be tested Amount scheme, and can be used in method of the invention in appropriate circumstances.

Desired dosage is presented in which can be convenient with single dose or with the divided dose of appropriate intervals application, such as according to Daily 2,3,4 or more sub-doses.Subdose itself can be further separated into for example multiple discrete loose intervals Application.Daily dose can be divided into several parts of such as 2,3 or 4 parts of applications, when especially applying relatively large amount when being deemed appropriate.Such as Fruit is suitable, depends on individual behavior, it may be necessary to deviate upward or downward from the daily dose of instruction.

In order to prepare medical composition from the compound of the present invention, suitable pharmaceutically acceptable carrier can be solid The mixture of body, liquid or both.Solid form preparations include powder, tablet, pill, capsule, cachet, suppository and can be dispersed Particle.Solid carrier can be one or more substances, can also act as diluent, flavoring agent, solubilizer, lubricant, hangs Floating agent, adhesive, preservative, tablet disintegrant or encapsulating material.

In the powder, carrier is solid fine crushing, in the mixture with active component fine crushing.

In tablets, active component is mixed in proper proportions with having the carrier of necessary binding ability, and be pressed into Required shapes and sizes.

The reactive compound of powder and tablet containing different weight percentage amount.Representative amount in powder or tablet can be The 0.5 of reactive compound is to about 90%.But technical staff will know when to need the quantity beyond this range.For powder Suitable carrier with tablet include magnesium carbonate, magnesium stearate, talcum, sugar, lactose, pectin, dextrin, starch, gelatin, bassora gum, Methylcellulose, sodium carboxymethylcellulose, low melt wax, cocoa butter etc..Term " preparation " is intended to include the packet for being used as carrier Closure material prepares reactive compound, provides the wherein active component with or without carrier and is surrounded by carrier, therefore joins with it The capsule of conjunction.Equally, including cachet and pastille.Tablet, powder, capsule, pill, cachet and pastille may be used as being suitable for mouth The solid form of clothes.

In order to prepare suppository, melting low melt wax first, such as fatty glyceride or the mixture of cocoa butter, and will be active Component is uniformly dispersed therein (such as passing through stirring).Then size mold appropriate is poured the molten homogeneous mixture into In, it is allowed to cool, to solidify.

Formulation suitable for vaginal application can be used as vaginal suppository, tampon, emulsifiable paste, gel, paste, foam or be in by spraying It is existing, also contain suitable carrier as known in the art in addition to the active ingredient (s.

Liquid form preparation includes solution, suspension and lotion, such as water or water-propylene glycol solution.For example, parenteral is infused Solution in polyethylene glycol solution can be configured to by penetrating liquid preparation.Suitable dispersion or wetting agent and suspension can be used Agent prepares injectable formulation according to known technology, for example, sterile injection is aqueous or oily suspensions.Sterile injectable preparation is also It can be sterile injectable solution or suspension in the nontoxic acceptable diluent of parenteral or solvent, such as 1,3- Solution in butanediol.The acceptable mediator and solvent that can be used are water, Ringer's solution and isotonic sodium chlorrde solution.Separately Outside, sterile non-volatile oil is typically used as solvent or suspension media.For this purpose, any mild fixedness can be used Oil, monoglyceride or diglyceride including synthesis.In addition, fatty acid such as oleic acid can be used for preparing injectable agent.

Therefore, compound according to the present invention can be formulated for parenteral administration (for example, by injection, such as quickly Injection or continuous infusion), and can be in ampoule, pre-filled syringe, small size infusion or in the multi-dose for being added with preservative It is presented in container with unit dosage forms.Medical composition can be taken such as suspension, solution or the lotion in oiliness or aqueous vehicles Form, and preparaton can be contained, such as suspending agent, stabilizer and/or dispersing agent.Alternatively, active constituent can be powder Last form is obtained by sterile separation sterile solid or by being lyophilized from solution, for using preceding suitable mediator (example Such as aseptic apirogen water) it restores.

Aqueous formulations suitable for being administered orally can be by dissolving or suspending active component in water simultaneously as needed Suitable colorant, flavoring agent, stabilizer and thickener are added to prepare.

It can be by such as natural by active component and cohesive material fine crushing or close suitable for the aqueous suspension that is administered orally It is dispersed in water at natural gum, resin, methylcellulose, sodium carboxymethylcellulose or other well-known suspending agents to prepare.

Further include the preparation of solid form, is intended to be converted into shortly before use for oral liquid form preparation. These liquid forms include solution, suspension and lotion.In addition to active component, these preparations can also containing colorant, flavoring agent, Stabilizer, buffer, artificial and natural sweetener, dispersing agent, thickener, solubilizer etc..

Local application for epidermis, compound according to the present invention can be configured to ointment, emulsifiable paste or lotion or conduct Transdermal patch.

Ointment and emulsifiable paste can be for example with aqueous or oiliness substrate the case where adding suitable thickener and/or gelling agent Lower preparation.Lotion can be prepared with aqueous or oiliness substrate, and usually also contained one or more emulsifying agents, stabilizer, divided Powder, suspending agent, thickener or colorant.

Formulation suitable for local application in the oral cavity includes pastille, and it includes in substrate (the usually sucrose through seasoning With Arabic gum or bassora gum) in activating agent；Tablet, it includes inert substrate (such as gelatin and glycerol or sucrose and I Primary glue) in active constituent；And mouthwash, it includes the active constituents in suitable liquid-carrier.

Solution or suspension are directly applied into nasal cavity by conventional means, such as with dropper, pipette or sprayer.Match Object processed can be provided with single dose or multi-form.Under the latter situation of dropper or pipette, this can be applied by individual The solution or suspension of predetermined volume appropriate is realized.In the case where sprayer, this can for example pass through metering atomising spray Mist pump is realized.

Administration of respiratory tract can also realize that wherein active constituent is with suitable propellants by aerosol formulations The form of compression package provides.If the compound of the present invention or comprising its medical composition as aerosol-applied (such as nose Aerosol passes through sucking), this can be with, for example, using sprayer, atomizer, pump atomizer, inhalation device, metered dose inhaler or Diskus carries out.Pharmaceutical forms for applying the compound of the present invention as aerosol can pass through those skilled in the art The well-known method preparation of member.For example, the compound of the present invention or its pharmaceutically acceptable salt, solvate, hydrate Or solution or dispersion of the derivative in water, water/alcohol mixture or suitable saline solution can be used conventional additives and adopts With (such as benzyl alcohol or other suitable preservatives), the absorption enhancer for increasing biological usability, solubilizer, dispersing agent Deng, and if applicable, conventional propellant (such as carbon dioxide, CFC such as dicholorodifluoromethane, trichlorine can also be used Fluoromethane or dichlorotetra-fluoroethane etc.).Aerosol is convenient to also contain surfactant, such as lecithin.Offer can be provided Metering valve controls drug dose.

In the formulation (including intranasal formulation) for being intended to administration of respiratory tract, compound usually has small partial size, example Such as from about 10 microns or smaller.This partial size can be obtained by methods known in the art, such as pass through micronization.It, can when needing To use the formulation for being suitable for sustained release activity ingredient.

Alternatively, active constituent can be provided in the form of dry powder (for example, powder of the compound in suitable powder base Last mixture, the powder base such as lactose, starch, starch derivatives such as hydroxypropyl methyl cellulose and polyvinylpyrrolidone (PVP)).Easily, dust carrier will form gel in nasal cavity.Powder composition can be for gelatin or blister package Unit dosage forms (such as capsule, cylindrantherae) exist, and powder can be applied by inhalator from it.

Pharmaceutical preparation is preferably in unit dosage forms.In this form, preparation is subdivided into the list containing appropriate active component Position dosage.Unit dosage forms can be the preparation of packaging, the preparation of the packaging containing discrete magnitude, such as the packaging in bottle or ampoule Tablet, capsule and powder.In addition, unit dosage forms can be capsule, tablet, cachet or pastille itself or it can be packet Dress form it is any of these in right quantity.

In some embodiments, composition is tablet for oral administration or capsule.

In some embodiments, composition is the liquid for intravenously applying.

Compound according to the present invention optionally exists as pharmaceutically acceptable salt, including by pharmaceutically may be used The pharmaceutically acceptable acid-addition salts of non-toxic acid (including the inorganic acid and organic acid) preparation of receiving.Representative acid includes But it is not limited to acetic acid, benzene sulfonic acid, benzoic acid, camphorsulfonic acid, citric acid, vinyl sulfonic acid, dichloroacetic acid, formic acid, fumaric acid, grape Saccharic acid, hippuric acid, hydrobromic acid, hydrochloric acid, isethionic acid, lactic acid, maleic acid, malic acid, mandelic acid, methanesulfonic acid, glues glutamic acid Liquid acid, nitric acid, oxalic acid, pamoic acid, pantothenic acid, phosphoric acid, succinic acid, sulfuric acid, tartaric acid, oxalic acid, p-methyl benzenesulfonic acid etc., such as Berge et al., " medical science periodical (Journal of Pharmaceutical Sciences) ", 66:1-19 (1977) column Those of out pharmaceutically acceptable salt, which is incorporated herein by reference in its entirety.

The direct product that acid-addition salts can be used as compound synthesis obtains.It, can be by free alkali soluble in alternative solution Solution separates salt in the suitable solvent containing appropriate acid, and by evaporating solvent or in other ways separation salt and solvent.This Method known to those skilled in the art and standard low molecular weight solvent can be used to form solvate for the compound of invention.

The compound of the present invention can be converted into " prodrug ".Term " prodrug " refers to specified chemical base known in the art The compound of group's modification, and when applying individual, undergo bioconversion to obtain parent compound.Therefore, prodrug is visual For the compound of the present invention, containing one or more special nontoxic blocking groups used with transient fashion, to change or Eliminate the property of compound.In a general aspect, " prodrug " method is for promoting oral absorption.In T.Higuchi and V.Stella, " prodrug (Pro-drugs as Novel Delivery Systems) as novel delivery system " are " Americanized Learn proceeding (A.C.S.Symposium Series) " volume 14；And " the bio-reversible carrier in drug design (Bioreversible Carriers in Drug Design) ", Edward B.Roche is compiled, American Pharmaceutical Association and Pergamon Press has carried out thorough discussion in 1987, with complete The mode of text reference is incorporated herein.

Some embodiments of the present invention include method of the preparation for the medical composition of " combination treatment ", the method packet Containing at least one compound according to any compound embodiment disclosed herein and at least one is known as described herein Medicament and pharmaceutically acceptable carrier mixing.

As it will be realized, the step of method of the invention, does not need to carry out any specific times or with any particular order It carries out.After refering to following Examples, other purposes, advantage and novel feature of the invention will become aobvious to those skilled in the art And be clear to, these examples are intended to be illustrative and be not restrictive.

Example

Example 1: the preparation of compound

The preparation of compound 1 (certain crystalline forms including compound 1) is described in following: with international publication WO2010/ International Patent Application No. PCT/US2009/004265 of No. 011316 announcement；And with international publication WO2011/094008 Number announce International Patent Application No. PCT/US2011/000153；Entire contents are incorporated herein in entirety by reference In.

The crystalline form of the non-solvated L-arginine salt of compound 1 and the preparation for crystallizing free lath habit are described in the world International Patent Application No. PCT/US2016/038506 for announcing No. WO2016/209809 announcement, entire contents are with complete The mode of text reference is incorporated herein.

Example 2: the clinical test of primary biliary cholangitis (PBC) is treated with compound 1

I/II phase, open-label, single armed, Proof of Concept research are carried out to assess compound 1 with primary biliary Safety, tolerance and effect in the individual of cholangitis (PBC).Research in the individual of 18 to 80 years old (including endpoint) into Row, the individual reacts insufficient with PBC and to ursodesoxycholic acid (UDCA), and consistent dose is in front of screening UDCA at least six moon.Test includes that preliminary test is studied, to assess up to ten individual pharmacokinetics and tolerance.

Main target includes the effect of compound 1 in PBC individual in 24 weekly treatment periods (that is, ALP is horizontally relative to base The variation of line), safety and tolerance.

Exploratory target includes following assessment: 1) pharmacokinetics (PK) in the individual with PBC point of compound 1 Cloth；2) drug effect of the antinuclear antibodies (ANA) (anti-gp210 and anti-sp100) of 24 weekly treatment periods and other exploratory biomarkers It learns (PD) reaction (lymphocyte count and its subgroup) and changes；；3) the Serum High Sensitivity C reactive protein between 24 weekly treatment periods (hsCRP), alanine aminotransferase (ALT), aspartate transaminase (AST), gamma glutamyltransferase (GGT), resist mitochondria are anti- Body (AMA), golgi protein 73 (GP73), complement factor 4 (C4), bile acid, total IgG, total IgM；4) whole blood count (CBC)；5) incidence of the quality of life (QoL) between 24 weekly treatment periods and itch and/or fatigue；6) compound 1 is in 12 periods Between safety, tolerance and effect；7) liver hardness is checked using Transient elastography during treatment in 24 weeks；8) screening knot The abnormal individual of fruit eye in 24 weekly treatment periods is dry, Xi Ermo (Schirmer) is tested and tears rupture time (TBUT) test Variation.

Screening up to surrounding is carried out to individual, then continuous 24 weeks 1 or 2mg of application compounds 1.It is assessed during screening Safety laboratory parameters, vital sign, physical examination and concomitant drugs, and Child-Pugh score can be calculated.It is as follows It is tested:

1) before carrying out remaining clinical test, the experimental study of surrounding is carried out to assess up to 10 individual safety Property and tolerance, including PK and maximum tolerated dose.Allow individual to enter clinic on day 1 and stops to the 3rd day.During this period Monitoring vital sign and EKG variation extensively.0.5,1,2,4,6,8 and the 12 of 1st day after individual (baseline) before administration and administration 6 hours of 2nd and 3 day places shorten PK and sample at hour and after administration.Individual received 1mg compound 1 at the 1st, 2 and 3 day (PO, QD).If 1 well-tolerated of 1mg compound and vital sign and EKG are without clinically significant variation, 1mg dosage level is maintained And make individual discharge on day 3.If not tolerating 1mg, if carrying out any of following discovery during treatment, stop Only treat:

● certain ECG change (that is, if observe and confirming the interval QTc >=500msec, carry out it is extended monitor until It was found that having solved and having stopped being administered)；

● ALT/AST > 3x baseline level and > ULN；Or

● total bilirubin > 2x baseline level and > 1.5mg/dL.

Based on the safety and PK data of individual, 1mg dosage level can increase to 2mg at the 4th week.In the 4th weekly dose There is incremental individual other PK to sample, and every 30 minutes progresss vital signs and ECG monitoring are at least 6 small after being administered When.If it is possible, dose maintenance in 2mg QD, but if feeling the need to, can be back to 1mg QD.

2) above-mentioned experimental study data are based on, subsequent individual starts into clinic and on day 1 to treat (1mg on day 1 QD).PK sampling place's progress in 0.5,1,2,4,6 and 8 hour of the 1st day after at most 45 minutes and administration before administration.Monitoring closely Vital sign and EKG variation collected other PK sample at the 1st, 2,4,8,12,16,20 and 24 week before administration., be based on The safety and PK data of individual, 1mg dosage level can increase to 2mg at the 4th week.If not being resistant to 1mg, institute as above State stopping treatment.In the individual that the 4th weekly dose is incremented by there is other PK to sample, and every 30 minutes progresss vital signs with ECG monitoring is at least 6 hours after administration.If it is possible, dose maintenance in 2mg QD, but if feeling the need to, can be returned It is back to 1mg QD.Safety and tolerance are assessed by monitoring adverse events and vital sign, ECG and blood testing.It is personal It is checked the 1st, 2,4,8,12,16,20 and 24 week return study site, such as program and interview timetable (Fig. 2 to 6) institute It states.

The final dose of compound 1 terminates the previous day application in 24 weekly treatment periods.

Two weeks after 24 weeks treatment ends, individual returns to research position and carries out last interview, and according to program and visit Depending on timetable carry out last program (Fig. 2 to 6).

ALP, GGT, ALT/AST, bilirubin (total and direct), PT/INR, albumin, lipid are measured during research Group and total serum IgG/IgM and PBC-40 questionnaire and 5-D itch scale/VAS.

Individual has to comply with following selected and exclusion criterias for participating in research.

Inclusion criteria:

1. individual must be the sex for being 18 to 80 years old (including endpoint) at the age in screening, and according to following three At least two in a standard determine PBC diagnosis:

Anti-mitochondrial antibody (AMA) titre > 1:40；

Alkaline phosphate (ALP) > 1.5x ULN continues at least six moon；With

Liver biopsy result is consistent with PBC.

2. the reaction of couple UDCA is insufficient, as by after minimum dose is 13mg/kg/ days UDCA 6 months > 1.67x The alkaline phosphate (ALP) of ULN is defined.

3. UDCA at least three moon of individual necessary consistent dose before screening.

4. take for itch or fatigue drug individual must on day 1 before under the consistent dose of these drugs Continue at least two weeks.

5. individual must have following laboratory parameters in screening:

ALP>1.67x ULN but<10x ULN

ALT and AST < 5x ULN

Total bilirubin < ULN

International Standardization Ratio (INR) < 1.2x ULN

Platelet count > 150,000/mm³(>150x 10⁹/L)

Seralbumin > 3.0g/dL (> 30g/L)

Serum creatinine < 1.5mg/dL (133 μm of ol/L)

Estimate glomerular filtration rate (eGFR) >=60mL/min/1.73m²

TSH < 5.0mU/L, free T3 and T4 level are without clinically significant variation

·(Transient elastography) < 10kPa

6. individual, which is considered to be in, to be stablized in health, such as by identified below in researcher:

A) clinically significant abnormal screening physical examination not unrelated with PBC.

B) vital sign when screening: pulse frequency >=55bpm, systolic pressure (SBP) >=90, and diastolic pressure (DBP) >= 55mmHg。

C) researcher thinks not to be noted clinical abnormal (referring also to exclusion criteria #22 in 12 lead electrocardiogram (ECG) And #23).

D) there is no macula lutea water in the ophthalmologic assessment (being carried out by eye doctor) supported with optical coherence tomography (OCT) Swollen evidence, wherein can get in screening or before screening earlier than three months and (depend on site ability).

Exclusion criteria:

1. the chronic liver disease of the non-PBC cause of disease.However, having money with the PBC patient of primary Xiu Gelian Cotard (pSS) Lattice are participated in.

2. the clinically history or evidence of significant liver decompensation:

A) portal hypertension, cirrhosis and cirrhosis/portal hypertension complication (such as variceal bleeding, Encephalopathy or ascites).

B) liver transfer operation medical history, be placed on liver transfer operation list at present or at present Model for end-stage liver disease (MELD) score >= 12。

C) cirrhosis is with complication, including medical history below or presence: spontaneous bacterial peritonitis, and hepatocellular carcinoma is high Bilirubinemia > 1.5x ULN.

D) hepatorenal syndrome (I type or II type).

E) splenomegaly.

3. the increased medical condition of the non-liver of ALP (such as Paget disease) can be caused.

4. there is no the evidence of deterioration of liver function during screening.

5. any blood or the patient with significant blood loss are contributed in 30 days before screening.

6. by researcher's judgement, clinically significantly infection (such as pneumonia, pyelonephritis), treatment start (the 1st day) The preceding Close Date is less than 6 weeks.It needs to be hospitalized or intravenous antimicrobial therapy or in the case where opportunistic infections in infection, these Infection must terminate at least 8 weeks before on day 1.

7. whenever infecting Hepatitis C Virus in the past；Infection activity hepatitis type B virus is confirmed in screening.

8. current active or latent tuberculosis (TB) or TB medical history are not yet by successful treatment.In the past success that document is recorded Treatment andIn the case where the current positive of test, medical monitoring instrument is can be used sick one by one in this standard It is assessed on the basis of example.

9. positive diagnosis TB test definition when screening is the positiveIt tests or 2 continuous uncertainTest.

10. the medicament for any patient's condition listed in 30 days exclusion participation standards before treating the 1st day.

11. being exposed to B cell or T cell targeted therapies in 30 days before on day 1, (such as natalizumab, benefit are appropriate Former times monoclonal antibody, Abatace, excellent spy gram monoclonal antibody).

12. imuran, colchicin or methotrexate (MTX) before on day 1 in 30 days.

13. being treated in 30 days before on day 1 with cholic acid (OCA) or fibrates (including Bezafibrate).

14. other immunosuppressor, immunomodulator or antitumor agent on day 1 before (or be unsatisfactory for such as institute in 30 days The stabilization period of the concomitant drugs of permission).However, being used as the drug for the complementary therapy that PBC is combined with UDCA (as itch And fatigue) should on day 1 before 30 days in be in consistent dose.These drugs can be adjusted during studying treatment, still All adjustment must be recorded in concomitant drugs source document and eCRF.

UDCA prescription information do not allow using drug: arranged in participation standard for being excluded in 30 days before treating the 1st day The medicament of any patient's condition out；B cell or T cell targeted therapies are exposed to (such as in 30 days before on day 1 and during research Natalizumab, Rituximab, A Batapu, excellent spy gram monoclonal antibody)；Sulphur azoles before on day 1 in 30 days and during research Purine, colchicin or methotrexate (MTX)；Fibrates (including Bezafibrate) before on day 1 in 30 days and during research；In It is treated in 30 days and during research with OCA before 1st day；Due to the potential impact to ALP, immunosuppressor, immunomodulator Such as 5-ASA, imuran, colchicin or methotrexate (MTX)；The moderate of CYP2C9 to strong suppression is used before on day 1 in 30 days Preparation (such as amiodarone, Fei Er amine ester, Fluconazole, Miconazole, piperine, Barosmin, disulfiram, Fluvastatin, fluorine volt are husky Bright, voriconazole)；(and at least six moon after the final dose of research drug) receives live vaccine 30 days before on day 1； Before on day 1, receiving any investigational agent in 30 days or 5 half-life period (whichsoever longer), (including S1P is adjusted Agent)；On day 1 before 30 days and research during, the investigational agent in addition to compound 1；And it receives researcher and thinks to prevent Patient safety participates in any other drug of research.

15. before on day 1 in 30 days using the moderate of CYP2C9 to strong inhibition agent (such as amiodarone, Fei Er amine ester, Fluconazole, Miconazole, piperine, Barosmin, disulfiram, Fluvastatin, Fluvoxamine, voriconazole).

16. do not record positive varicellazoster virus (VZV) IgG- antibody state patient or on day 1 before 6 Do not have to complete the patient of VZV inoculation in week.

Receive epidemic disease living 17. before on day 1 in 30 days (and after the final dose of research drug at least six moon) Seedling.

18. before on day 1, receiving any investigational agent (packet in 30 days or 5 half-life period (whichsoever longer) Include S1P regulator).

19. receiving researcher thinks any other drug for preventing patient safety from participating in research.

20. when abnormal forced expiratory volume (FEV1) or forced vital capacity (FVC), i.e. screening predicted value < 80%.

21. congenital or acquired immunodeficiency many known medical histories are (for example, common variable immunodeficiency, the mankind Immunodeficiency virus [HIV] infects [ELISA and Western blotting] test result, organ transplant).

22. cardiovascular and cerebrovascular diseases, acute coronary syndrome (ACS), myocardial infarction (MI), cardiomyopathy, heart failure, no Stable angina cordis, cerebrovascular accident, the nearest medical history including transient ischemic attack (TIA) is (at 6 months of screening interview It is interior).

23. arrhythmia cordis, conducting system disease (including AV ties dysfunction, 2 or 3 degree of cardiac blocks and diseased sinus node Syndrome) medical history or presence or the use of Ia class or Group III antiarrhymic or baseline QTc >=500msec.

24. it is any required on day 1 before the surgical operation of general anesthesia or plan to carry out greatly during research in 30 days Operation.

25. the medical history or presence of macular edema.

26. passing through the medical history or sign of PML inspection table assessment progressive multifocal leukoencephalopathy (PML) and disease in screening Shape.PML is suffered from if suspected, stops being administered and with reference to neurologist；If it is confirmed that then permanent discontinuation is administered.

27. shingles zoster breaking-out is more than once or the medical history of any breaking-out of disseminated herpes zoster.

28. lymphoproliferative disorders, lymthoma, leukaemia, the medical history of myeloproliferative disease or Huppert's disease.

29. oligoleukocythemia or lymphocyte are reduced when screening.

30. the medical history of malignant tumour in addition to the basal cell skin cancer and cervix or uterus sufficiently treated carcinoma in situ with Outside, excision has those of the sharp edge being documented completely.

31. severe allergy or anaphylactoid medical history need medical attention.

32. the medical history of uncontrolled hypothyroidism.

33. the current or recent history that alcohol dependence or illicit drug use (in 1 year before on day 1).

34. researcher thinks, active mental disease may will affect the compliance to search procedure.

35. any other history with clinically important medical condition will prevent patient safety in researcher Participate in research.

36. all researchs can not be participated in visit interview or abide by search procedure.

Example 3:BET (Brunauer, Emmett and Teller) specific surface area method (lath habit)

In general, the specific surface area of the free lath habit of the crystallization of the non-solvated L-arginine salt of compound 1 is by making With the recognized technology based on Brunauer, Emmett and Telle theory by nitrogen physisorption on the surface from every batch of sample On determine.

Use Micromeritics^TMTriStar II BET surface area analyzer (MicroActive for TriStar IIPlus 2.02 Software^TM), pass through particle medical service (Micromeritics Pharmaceutical Services the BET surface area of sample) is measured.Sample is deaerated 960 minutes at vacuum (i.e. 100mm/Hg) at 25 DEG C.In 77.3K lower N₂The determination of absorption is measured using 11 point methods of BET surface area, wherein the relative pressure of each sample to weigh In about 0.05 to about 0.3 (P/P₀) in range, referring to the following table 1.It is analyzed according to ISO9277.

Table 1

Example 4:(R) -2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid L-arginine salt formulation

Core tablet is manufactured using formulation described in table 2 and using with method essentially identical described in Fig. 7.(R)- 2- (7- (4- cyclopenta -3- (trifluoromethyl) benzyloxy) -1,2,3,4- tetrahydro cyclopentyl diene simultaneously [b] indol-3-yl) acetic acid L-arginine salt is 72.42% free acid (compound 1) 27.58%L- arginine (the i.e. L-arginine salt of compound 1 1.381mg corresponds to activity/free acid of 1mg).

Table 2

It would be recognized by those skilled in the art that without departing from the spirit of the invention, it can be to as described herein Illustrative example carry out various modifications, adds, replaces and changes, and therefore it is deemed within the scope of the present invention.