MITAPIVAT

MITAPIVAT

CAS 1260075-17-9

MF C24H26N4O3S MW 450.55

UPDATE…. FDA APPROVE 2/17/2022 To treat hemolytic anemia in pyruvate kinase deficiency, Pyrukynd

8-Quinolinesulfonamide, N-[4-[[4-(cyclopropylmethyl)-1-piperazinyl]carbonyl]phenyl]-

N-[4-[[4-(Cyclopropylmethyl)-1-piperazinyl]carbonyl]phenyl]-8-quinolinesulfonamide

• Originator Agios Pharmaceuticals
• Class Antianaemics; Piperazines; Quinolines; Small molecules; Sulfonamides
• Mechanism of Action Pyruvate kinase stimulants

• Orphan Drug Status Yes – Inborn error metabolic disorders
• New Molecular Entity Yes

• Phase III Inborn error metabolic disorders
• Phase II  Thalassaemia

• 27 Feb 2019 Agios Pharmaceuticals plans a phase III trial for Inborn error metabolic disorders (Pyruvate kinase deficiency) (Treatment-experienced) in the US, Brazil, Canada, Czech Republic, Denmark, France, Germany, Ireland, Italy, Japan, South Korea, Netherlands, Portugal, Spain, Switzerland, Thailand, Turkey and United Kingdom in March 2019 (NCT03853798) (EudraCT2018-003459-39)
• 11 Dec 2018 Phase-II clinical trials in Thalassaemia in Canada (PO) (NCT03692052)
• 29 Aug 2018 Chemical structure information added

Product Ingredients

INGREDIENT	UNII	CAS	INCHI KEY
Mitapivat sulfate	N4JTA67V3O	Not Available	Not applicable

Mitapivat sulfate CAS#: 2151847-10-6 (sulfate hydrate) Chemical Formula: C48H60N8O13S3 Exact Mass: 1052.3442 Molecular Weight: 1053.23 Elemental Analysis: C, 54.74; H, 5.74; N, 10.64; O, 19.75; S, 9.13  N-(4-(4-(cyclopropylmethyl)piperazine-1-carbonyl)phenyl)quinoline-8-sulfonamide hemisulfate trihydrate Related CAS #: 2151847-10-6 (sulfate hydrate)   1260075-17-9 (free)   2329710-91-8 (sulfate) Mitapivat, sold under the brand name Pyrukynd, is a medication used to treat hemolytic anemia.^[1] It is taken as the sulfate hydrate salt by mouth.^[1] Mitapivat is a pyruvate kinase activator.^[1] Mitapivat was approved for medical use in the United States in February 2022.^[1][2][3]

Activator of pyruvate kinase isoenzyme M2 (PKM2), an enzyme involved in glycolysis. Since all tumor cells exclusively express the embryonic M2 isoform of PK, it is hypothesized that PKM2 is a potential target for cancer therapy. Modulation of PKM2 might also be effective in the treatment of obesity, diabetes, autoimmune conditions, and antiproliferation-dependent diseases.

Agios Pharmaceuticals is developing AG-348 (in phase 3 , in June 2019), an oral small-molecule allosteric activator of the red blood cell-specific form of pyruvate kinase (PK-R), for treating PK deficiency and non-transfusion-dependent thalassemia. Mitapivat is a novel, first-in-class pyruvate kinase activator. It works to increase the activity of erythrocyte pyruvate kinase, a key enzyme involved in the survival of red blood cells. Defects in the pyruvate kinase enzyme in various red blood cells disorders lead to the lack of energy production for red blood cells, leading to lifelong premature destruction of red blood cells or chronic hemolytic anemia.¹ On February 17, 2022, the FDA approved mitapivat as the first disease-modifying treatment for hemolytic anemia in adults with pyruvate kinase (PK) deficiency, a rare, inherited disorder leading to lifelong hemolytic anemia.⁶ Mitapivat has also been investigated in other hereditary red blood cell disorders associated with hemolytic anemia, such as sickle cell disease and alpha- and beta-thalassemia.¹ SYN WO 20100331307 CAS 59878-57-8 TO CAS 57184-25-5 Eisai Co., Ltd., EP1508570,  Lithium aluminium hydride (770 mg, 20.3 mmol) was suspended in tetrahydrofuran (150 mL), 1-(cyclopropylcarbonyl)piperazine (1.56 g, 10.1 mmol) was gradually added thereto, and the reaction mixture was heated under reflux for 30 minutes. The reaction mixture was cooled to room temperature, and 0.8 mL of water, 0.8 mL of a 15percent aqueous solution of sodium hydroxide and 2.3 mL of water were seque ntially gradually added thereto. The precipitated insoluble matter was removed by filtration through Celite, and the filtrate was evaporated to give the title compound (1.40g) as a colorless oil. The product was used for the synthesis of (8E,12E,14E)-7-((4-cyclopropylmethylpiperazin-1-yl)carbonyl)oxy-3,6,16,21-tetrahydroxy-6,10,12,16,20-pentamethyl-18,19-epoxytricosa-8,12,14-trien-11-olide (the co mpound of Example 27) without further purification.1H-NMR Spectrum (CDCl3,400MHz) delta(ppm): 0.09-0.15(2H,m), 0.48-0.56(2H,m),0.82-0.93(1H,m),2.25(2H,d,J=7.2Hz) 2.48-2.65(4H,m),2.90-2.99(4H,m). CAS 91-22-5 TO CAD 18704-37-5 NMR US2010/331307 dimethylsulfoxide-d6, 1H ¹H NMR (400 MHz, DMSO-d₆) δ: 1.2 (t, 2H), 1.3 (t, 2H), 1.31-1.35 (m, 1H), 2.40 (s, 2H), 3.68 (br s, 4H), 3.4-3.6 (m, 4H), 7.06 (m, 6H), 7.25-7.42 (m, 3H), 9.18 (s, 1H) 10.4 (s, 1H) ¹H NMR (400 MHz, DMSO-d₆) δ: 0.04-0.45 (m, 2H), 0.61-0.66 (m, 2H), 1.4-1.6 (m, 1H), 2.21-2.38 (m, 4H), 2.61 (d, 2H), 3.31-3.61 (br s, 4H), 6.94-7.06 (m, 4H), 7.40 (d, 2H), 7.56-7.63 (m, 2H), 8.28 (d, 1H), 9.18 (s, 1H), 10.4 (s, 1H) SYN J. Med. Chem. 2024, 67, 4376−4418 Mitapivat (Pyrukynd). Mitapivat (9), developed by Agios Pharmaceuticals, Inc., was approved in the EU and US as an oral treatment of hemolytic anemia and pyruvate kinase deficiency (PKD), a rare, inherited condition associated with chronic hemolytic anemia. 66 Previous clinical management of PKD has been limited to only supportive therapies associated with short- and long-term risks, including red cell transfusions and splenectomy. 67 Mitapivat is a first-in-class activator of erythrocyte pyruvate kinase and has been shown to increase hemoglobin levels in patients who were not receiving regular red cell transfusions. In addition to its approved treatment of PKD, it is also currently in clinical studies for the treatment of sickle cell disease and thalassemia. 66 68 As compared to the linear medicinal chemistry route utilized for analog synthesis, Agios Pharmaceuticals, Inc. developed a convergent, high-yielding route to mitapivat depicted in Scheme 17 and Scheme 18. 69 Piperazine 9.3 was synthesized in two steps from tert-butyl piperazine-1-carboxylate (9.1) in 92% yield (Scheme 17) beginning with a reductive amination in the presence of excess cyclopropanecarbaldehyde (9.2) to give the desired tertiary amine. This was carried forward as a solution into the N-Boc deprotection, precipitating the piperazine as bis-HCl salt 9.3. The second module of mitapivat, sulfonamide 9.7, was prepared in two steps beginning with the reaction of sulfonyl chloride 9.4 with aniline 9.5 to afford ester 9.6 in 99% yield (Scheme 18). Saponification of ester 9.6 under basic conditions provided carboxylic acid 9.7 in 91% yield. Efficient coupling was demonstrated on the kilogram scale by activation of carboxylic acid 9.7 with CDI, followed by addition of piperazine 9.3. Finally, addition of water to the reaction mixture induced crystallization of the product, providing mitapivat in 90% isolated yield. (66) Pilo, F.; Angelucci, E. Mitapivat for sickle cell disease and thalassemia. Drugs Today (Barc) 2023, 59, 125−134. (67) Al-Samkari, H.; Galacteros, F.; Glenthoej, A.; Rothman, J. A.; Andres, O.; Grace, R. F.; Morado-Arias, M.; Layton, D. M.; Onodera, K.; Verhovsek, M.; et al. Mitapivat versus placebo for pyruvate kinase deficiency. N. Engl. J. Med. 2022, 386, 1432−1442. (68) Salituro, F. G.; Saunders, J. O.; Yan, S. Preparation of aroylpiperazines and related compounds as pyruvate kinase M2 modulators useful in treatment of cancer. U.S. Patent US 20100331307, 2010. (69) Sizemore, J. P.; Guo, L.; Mirmehrabi, M.; Su, Y. Preparation of amorphous and crystalline forms of N-(4-(4-(cyclopropylmethyl) piperazine-1-carbonyl)phenyl)quinoline-8-sulfonamide useful for treatment of pyruvate kinase associated disorders. WO 2019104134, 2019.

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Development Overview

WO2011002817 Mitapivat, also known as PKM2 activator 1020, is an activator of a pyruvate kinase PKM2, an enzyme involved in glycolysis. It was disclosed in a patent publication WO 2011002817 A1 as compound 78. WO2019099651 , PATENT WO-2019104134 Novel crystalline and amorphous forms of N-(4-(4-(cyclopropylmethyl)piperazine-1-carbonyl)phenyl)quinoline-8-sulfonamide (also known as mitapivat ) and their hemi-sulfate, solvates, hydrates, sesquihydrate, anhydrous and ethanol solvate (designated as Form A-J), processes for their preparation and compositions comprising them are claimed. Also claims are their use for treating pyruvate kinase deficiency, such as sickle cell disease, thalassemia and hemolytic anemia. Pyruvate kinase deficiency (PKD) is a disease of the red blood cells caused by a deficiency of the pyruvate kinase R (PKR) enzyme due to recessive mutations of PKLR gene (Wijk et al. Human Mutation, 2008, 30 (3) 446-453). PKR activators can be beneficial to treat PKD, thalassemia (e.g., beta-thalessemia), abetalipoproteinemia or Bassen-Kornzweig syndrome, sickle cell disease, paroxysmal nocturnal hemoglobinuria, anemia (e.g., congenital anemias (e.g., enzymopathies), hemolytic anemia (e.g. hereditary and/or congenital hemolytic anemia, acquired hemolytic anemia, chronic hemolytic anemia caused by phosphoglycerate kinase deficiency, anemia of chronic diseases, non- spherocytic hemolytic anemia or hereditary spherocytosis). Treatment of PKD is supportive, including blood transfusions, splenectomy, chelation therapy to address iron overload, and/or interventions for other disease-related morbidity. Currently, however, there is no approved medicine that treats the underlying cause of PKD, and thus the etiology of life-long hemolytic anemia. [0003] N-(4-(4-(cyclopropylmethyl)piperazine-l-carbonyl)phenyl)quinoline-8-sulfonamide, herein referred to as Compound 1, is an allosteric activator of red cell isoform of pyruvate kinase (PKR). See e.g., WO 2011/002817 and WO 2016/201227, the contents of which are incorporated herein by reference. (Compound 1) [0004] Compound 1 was developed to treat PKD and is currently being investigated in phase 2 clinical trials. See e.g., U.S. clinical trials identifier NCT02476916. Given its therapeutic benefits, there is a need to develo Compound 1, i.e., the non-crystalline free base, can be prepared following the procedures described below. Preparation of ethyl -4-(quinoline-8-sulfonamido) benzoate EtO TV  [00170] A solution containing ethyl-4-aminobenzoate (16. Og, 97mmol) and pyridine (l4.0g, l77mmol) in acetonitrile (55mL) was added over 1.2 hours to a stirred suspension of quinoline- 8 -sulfonyl chloride (20.0g, 88mmol) in anhydrous acetonitrile (100 mL) at 65°C. The mixture was stirred for 3.5 hours at 65 °C, cooled to 20°C over 1.5 hours and held until water (140 mL) was added over 1 hour. Solids were recovered by filtration, washed 2 times (lOOmL each) with acetonitrile/water (40/60 wt./wt.) and dried to constant weight in a vacuum oven at 85°C. Analyses of the white solid (30.8g, 87mmol) found (A) HPLC purity = 99.4% ethyl -4-(quinoline-8-sulfonamido) benzoate, (B) LC-MS consistent with structure, (M+l)= 357 (C18 column eluting 95-5, CH3CN/water, modified with formic acid, over 2 minutes), and (C) 1H NMR consistent with structure (400 MHz, DMSO-i ₆) = d 10.71 (s, 1H), 9.09 (dd, 7 = 4.3, 1.6 Hz, 1H), 8.46 (ddt, 7 = 15.1, 7.3, 1.5 Hz, 2H), 8.26 (dd, 7 = 8.3, 1.4 Hz, 1H), 7.84 – 7.54 (m, 4H), 7.18 (dd, 7 = 8.6, 1.3 Hz, 2H), 4.26 – 4.07 (m, 2H), 1.19 (td, 7 = 7.1, 1.2 Hz, 3H). Preparation of 4-(quinoline-8-sulfonamide) benzoic acid Step 2 [00171] A NaOH solution (16.2g, l22mmol) was added over 30 minutes to a stirred suspension of ethyl -4-(quinoline-8-sulfonamido) benzoate (20. Og, 56.2mmol) in water (125 mL) at 75°C. The mixture was stirred at 75°-80°C for 3 hours, cooled 20°C and held until THF (150 mL) was added. Hydrochloric acid (11% HCL, 8lmL, l32mmol) was added over >1 hour to the pH of 3.0. The solids were recovered by filtration at 5°C, washed with water (2X lOOmL) and dried to constant weight in a vacuum oven at 85°C. Analysis of the white solid (16.7g, 51 mmol) found (A) HPLC puurity = >99.9% 4-(quinoline-8-sulfonamide)benzoic acid, LC-MS consistent with structure (M+l) = 329 (Cl 8 column eluting 95-5 CH3CN/water, modified with formic acid, over 2 minutes.) and 1H NMR consistent with structure (400 MHz, DMSO-7₆) = d 12.60 (s, 1H), 10.67 (s, 1H), 9.09 (dd, 7 = 4.2, 1.7 Hz, 1H), 8.46 (ddt, 7 = 13.1, 7.3, 1.5 Hz, 2H), 8.26 (dd, 7 = 8.2, 1.5 Hz, 1H), 7.77 -7.62 (m, 3H), 7.64 (d, 7 = 1.3 Hz, 1H), 7.16 (dd, 7 = 8.7, 1.4 Hz, 2H). Preparation of l-(cyclopropylmethyl)piperazine dihydrochloride (4) 1 ) NaBH(OAc)₃ 2 3 acetone 4 [00172] To a 1 L reactor under N₂ was charged tert-butyl piperazine- l-carboxylate (2) (100.0 g, 536.9 mmol), cyclopropanecarbaldehyde (3) (41.4 g, 590.7 mmol ), toluene (500.0 mL) and 2-propanol (50.0 mL). To the obtained solution was added NaBH(OAc)₃ (136.6 g, 644.5 mmol) in portions at 25-35 °C and the mixture was stirred at 25 °C for 2 h. Water (300.0 mL) was added followed by NaOH solution (30%, 225.0 mL) to the pH of 12. The layers were separated and the organic layer was washed with water (100.0 mLx2). To the organic layer was added hydrochloric acid (37%, 135.0 mL, 1.62 mol) and the mixture was stirred at 25 °C for 6 h. The layers were separated and the aqueous layer was added to acetone (2.0 L) at 25 °C in lh. The resulted suspension was cooled to 0 °C. The solid was filtered at 0 °C, washed with acetone (100.0 mLx2) and dried to afford 4 (105.0 g) in 92% isolated yield. LC-MS (C18 column eluting 90-10 CH₃CN/water over 2 minutes) found (M+l) =141. 1H NMR (400 MHz, DMSO-7₆) d 11.93 (br.s, 1H), 10.08 (br., 2H), 3.65 (br.s, 2H), 3.46 (br.s, 6H), 3.04 (d, / = 7.3 Hz, 2H), 1.14 – 1.04 (m, 1H), 0.65 – 0.54 (m, 2H), 0.45 – 0.34 (m, 2H) ppm. Preparation of N-(4-(4-(cyclopropylmethyl)piperazine-l-carbonyl)phenyl)quinoline-8- sulfonamide (1) [00173] To a 2 L reactor under N₂ was charged 4-(quinoline-8-sulfonamido) benzoic acid (5) (100.0 g, 304.5 mmol) and DMA (500.0 mL). To the resulted suspension was added CDI (74.0 g, 456.4 mmol) in portions at 25 °C and the mixture was stirred at 25 °C for 2 h. To the resulted suspension was added l-(cyclopropylmethyl)piperazine dihydrochloride (4) (97.4 g, 457.0 mmol) in one portion at 25 °C and the mixture was stirred at 25 °C for 4 h. Water (1.0 L) was added in 2 h. The solid was filtered at 25 °C, washed with water and dried under vacuum at 65 °C to afford 1 (124.0 g) in 90 % isolated yield. LC-MS (C18 column eluting 90-10 CH₃CN/water over 2 minutes) found (M+l) =451. 1H NMR (400 MHz, DMSO-7₆) d 10.40 (br.s, 1H), 9.11 (dd, 7 = 4.3, 1.6 Hz, 1H), 8.48 (dd, / = 8.4, 1.7 Hz, 1H), 8.40 (dt, / 7.4, 1.1 Hz, 1H), 8.25 (dd, 7 = 8.3, 1.3 Hz, 1H), 7.76 – 7.63 (m, 2H), 7.17 – 7.05 (m, 4H), 3.57 – 3.06 (m, 4H), 2.44 – 2.23 (m, 4H), 2.13 (d, J = 6.6 Hz, 2H), 0.79 – 0.72 (m, 1H), 0.45 – 0.34 (m, 2H), 0.07 – 0.01 (m, 2H) ppm. [00174] Two impurities are also identified from this step of synthesis. The first impurity is Compound IM- 1 (about 0.11% area percent based on representative HPLC) with the following structure: Compound IM-l) Compound IM-l was generated due to the presence of N-methyl piperazine, an impurity in compound 2, and was carried along to react with compound 5. LC-MS found (M+l) =411.2; (M-l)= 409.2. 1H NMR (400 MHz, DMSO-76) d 10.43 (brs, 1H) 9.13-9.12 (m, 1H), 8.52-8.50 (m, 1H), 8.43-8.41 (m, 1H), 8.26 (d, 7=4.0 Hz, 1 H), 7.73-7.70 (m, 2H), 7.15-7.097.69 (m, 4H), 3.60-3.25 (brs, 4H), 2.21 (brs, 4H), 2.13 (s, 3H). [00175] The second impurity is Compound IM-2 (about 0.07% area percent based on the representative HPLC) with the following structure: (Compound IM-2) Compound IM-2 was due to the presence of piperazine, an impurity generated by deprotection of compound 2. The piperazine residue was carried along to react with two molecules of compound 5 to give Compound IM-2. LC-MS found (M+l) =707. 1H NMR (400 MHz, CF₃COOD) d 9.30-9.23 (m, 4H), 8.51 (s, 4H), 8.20-8.00 (m, 4H), 7.38-7.28 (m, 8H), 4.02-3.54 (m, 8H). Solubility Experiments [00176] Solubility measurements were done by gravimetric method in 20 different solvents at two temperatures (23 °C and 50 °C). About 20-30 mg of Form A, the synthesis of which is described below, was weighed and 0.75 mL solvent was added to form a slurry. The slurry was then stirred for two days at the specified temperature. The vial was centrifuged and the supernatant was collected for solubility measurement through gravimetric method. The saturated supernatant was transferred into pre- weighed 2 mL HPLC vials and weighed again (vial + liquid). The uncapped vial was then left on a 50 °C hot plate to slowly evaporate the solvent overnight. The vials were then left in the oven at 50 °C and under vacuum to remove the residual solvent so that only the dissolved solid remained. The vial was then weighed (vial + solid). From these three weights; vial, vial+liquid and vial+solid; the weight of dissolved solid and the solvent were calculated. Then using solvent density the solubility was calculated as mg solid/mL of solvent. Solubility data are summarized in Table 1. Table 1 Optimized Crystalline Form A Hemisulfate Salt Scale-up Procedure [00202] An optimized preparation of Form A as a hemisulfate sesquihydrate salt with and without seeding is provided below. Preparation of l-(cyclopropylmethyl)-4-(4-(quinoline-8-sulfonamido)benzoyl)piperazin- 1-ium sulfate trihydrate (Form A) with seeding [00203] To a 2 L reactor under N₂ was charged N-(4-(4-(cyclopropylmethyl)piperazine-l-carbonyl)phenyl)quinoline-8-sulfonamide (5) (111.0 g, 246.4 mmol), and a pre-mixed process solvent of ethanol (638.6 g), toluene (266.1 g) and water (159.6 g). The suspension was stirred and heated above 60°C to dissolve the solids, and then the resulting solution was cooled to 50°C. To the solution was added an aqueous solution of H₂S0₄ (2.4 M, 14.1 mL, 33.8 mmol), followed by l-(cyclopropylmethyl)-4-(4-(quinoline-8-sulfonamido)benzoyl)piperazin-l-ium sulfate trihydrate (6) (1.1 g, 2.1 mmol). After 1 h stirring, to the suspension was added an aqueous solution of H₂S0₄ (2.4 M, 42.3 mL, 101.5 mmol) over 5 h. The suspension was cooled to 22°C and stirred for 8 h. The solids were filtered at 22°C, washed with fresh process solvent (2 x 175 g) and dried to give the product (121.6 g) in 94% isolated yield. LC-MS (C18 column eluting 90-10 CH₃CN/water over 2 minutes) found (M+l) = 451. 1H NMR (400 MHz, DMSO-7₆) d 10.45 (s, 1H), 9.11 (dd, J = 4.2, 1.7 Hz, 1H), 8.50 (dd, 7 = 8.4, 1.7 Hz, 1H), 8.41 (dd, 7 = 7.3, 1.5 Hz, 1H), 8.27 (dd, 7 8.2, 1.5 Hz, 1H), 7.79 – 7.60 (m, 2H), 7.17 (d, / = 8.4 Hz, 2H), 7.11 (d, J = 8.4 Hz, 2H), 3.44 (d, J = 8.9 Hz, 5H), 3.03 – 2.50 (m, 6H), 0.88 (p, J = 6.3 Hz, 1H), 0.50 (d, J = 7.6 Hz, 2H), 0.17 (d, 7 = 4.9 Hz, 2H). Preparation of l-(cyclopropylmethyl)-4-(4-(quinoline-8-sulfonamido)benzoyl)piperazin- 1-ium sulfate trihydrate (Form A) without seeding [00204] To a 50 L reactor was charged N-(4-(4-(cyclopropylmethyl)piperazine-l-carbonyl)phenyl)quinoline-8-sulfonamide (5) (1.20 kg, 2.66 mol) and water (23.23 L) at 28°C. While stirring the suspension, an aqueous solution of H2S04 (1.0 M, 261 g) was added dropwise over 2 h. The reaction was stirred at 25 – 30°C for 24 h. The solids were filtered and dried under vacuum below 30°C for 96 h to give the product (1.26 kg) in 90% isolated yield. 11. Reproduction and Preparation of Various Patterns [00205] The patterns observed during the previous experiments were reproduced for characterization. Patterns B, D, E, F were reproducible. Pattern G was reproduced at lower crystallinity. Pattern I was reproduced, although, it was missing a few peaks. Refer to Table 20. Table 20 Crystalline Free Base Form of Compound 1 [00215] The crystalline free-base form of Compound 1 can be prepared via the following method. [00216] 14.8 kg S-l and 120 kg DMAc are charged into a round bottom under N2 protection and the reaction is stirred at 30 °C under N2 protection for 40min, to obtain a clear yellow solution. 7.5 kg CDI (1.02 eq.) is added and the reaction is stirred at 30 °C for 2.5h under N2 protection. 0.6 kg of CDI (0.08 eq.) at 30 °C was added and the mixture was stirred at 30 °C for 2h under N2 protection. The reaction was tested again for material consumption. 11.0 kg (1.14 eq.) l-(cyclopropylmethyl)piperazine chloride was charged in the round bottom at 30 °C and the reaction was stirred under N2 protection for 6h (clear solution). 7.5 X H20 was added dropwise over 2h, some solid formed and the reaction was stirred for lh at 30 °C. 16.8 X H20 was added over 2.5h and the reaction was stirred stir for 2.5h. 3.8 kg (0.25 X) NaOH (30%, w / w, 0.6 eq.) was added and the reaction was stirred for 3h at 30 °C. The reaction was filtered and the wet cake was rinsed with H20 / DMAc=44 kg / 15 kg. 23.35 kg wet cake was obtained (KF: 4%). The sample was re-crystallized by adding 10.0 X DMAc and stirred for lh at 70 °C, clear solution; 4.7 X H20 was added over 2h at 70 °C and the reaction was stirred 2h at 70 °C; 12.8 X H20 was added dropwise over 3h and stirred for 2h at 70 °C; the reaction was adjusted to 30 °C over 5h and stirred for 2h at 30 °C; the reaction was filtered and the wet cake was rinsed with DMAc / H20=l5 kg / 29 kg and 150 kg H20. 19.2 kg wet cake was obtained. The material was recrystallized again as follows. To the wet cake was added 10.0 X DMAc and the reaction was stirred for lh at 70 °C, clear solution. 16.4 X H20 was added dropwise at 70 °C and the reaction was stirred for 2h at 70 °C. The reaction was adjusted to 30 °C over 5.5h and stirred for 2h at 30 °C. The reaction was centrifuged and 21.75 kg wet cake was obtained. The material was dried under vacuum at 70°C for 25h. 16.55 kg of the crystalline free base form of compound 1 was obtained. Purity of 99.6%.

C Kung. Activators of pyruvate kinase M2 and methods of treating disease. PCT Int. Appl. WO 2013056153 A1.

FG Salituro et al. Preparation of aroylpiperazines and related compounds as pyruvate kinase M2 modulators useful in treatment of cancer. U.S. Pat. Appl. US 20100331307 A1.

Drug Properties & Chemical Synopsis ////////////MITAPIVAT, PHASE 3, Orphan Drug Status, Inborn error metabolic disorders, AGIOS, митапиват ,  ميتابيفات , 米他匹伐 ,  O=C(N1CCN(CC2CC2)CC1)C1=CC=C(NS(=O)(=O)C2=CC=CC3=C2N=CC=C3)C=C1