# Patent

## Title
Inhibitors of 11-beta-hydroxysteroid dehydrogenase 1

## Abstract

The present invention discloses novel compounds of Formula I: (I) possessing 11β-HSD type 1 antagonist activity, as well as methods for preparing such compounds. In another embodiment, the invention discloses pharmaceutical compositions comprising compounds of Formula I, as well as methods of using the compounds and compositions to treat diabetes, hyperglycemia, obesity, hypertension, hyperlipidemia, metabolic syndrome, cognitive disorders, and other conditions associated with 11β-HSD type 1 activity.

## Background
This is the national phase application, under 35 USC 371, for PCT/US2007/067353, filed Apr. 25, 2007, which claims the benefit, under 35 USC 119(e), of U.S. provisional application 60/745,565 filed Apr. 25, 2006.


This invention relates to compounds that are inhibitors of 11-β-hydroxysteroid dehydrogenase type 1 (“11-β-HSD1”), and to pharmaceutical compositions thereof, and the uses of these compounds and compositions in the treatment of the human or animal body, and to novel intermediates useful in preparation of the inhibitors. The present compounds show potent and selective inhibition of 11-β-HSD1, and as such are useful in the treatment of disorders responsive to the modulation of 11-β-HSD1, such as diabetes, metabolic syndrome, cognitive disorders, and the like.
Glucocorticoids acting in the liver, adipose tissue, and muscle, are important regulators of glucose, lipid, and protein metabolism. Chronic glucocorticoid excess is associated with insulin resistance, visceral obesity, hypertension, and dyslipidemia, which also represent the classical hallmarks of metabolic syndrome. 11-β-HSD1 catalyses the conversion of inactive cortisone to active cortisol, and has been implicated in the development of metabolic syndrome. Evidence in rodents and humans links 11-β-HSD1 to metabolic syndrome. Evidence suggests that a drug which specifically inhibits 11-β-HSD1 in type 2 diabetic patients will lower blood glucose by reducing hepatic gluconeogenesis, reduce central obesity, improve atherogenic lipoprotein phenotypes, lower blood pressure, and reduce insulin resistance. Insulin effects in muscle will be enhanced, and insulin secretion from the beta cells of the islet may also be increased. Evidence from animal and human studies also indicates that an excess of glucocorticoids impair cognitive function. Recent results indicate that inactivation of 11-β-HSD1 enhances memory function in both men and mice. The 11-β-HSD inhibitor carbenoxolone was shown to improve cognitive function in healthy elderly men and type 2 diabetics, and inactivation of the 11-β-HSD1 gene prevented aging-induced impairment in mice. Selective inhibition of 11-β-HSD1 with a pharmaceutical agent has recently been shown to improve memory retention in mice.
A number of publications have appeared in recent years reporting agents that inhibit 11-β-HSD1. See International Application WO2004/056744 which discloses adamantyl acetamides as inhibitors of 11-β-HSD, International Application WO2005/108360 which discloses pyrrolidin-2-one and piperidin-2-one derivatives as inhibitors of 11-β-HSD, and International Application WO2005/108361 which discloses adamantyl pyrrolidin-2-one derivatives as inhibitors of 11-β-HSD. In spite of the number of treatments for diseases that involve 11-β-HSD1, the current therapies suffer from one or more inadequacies, including poor or incomplete efficacy, unacceptable side effects, and contraindications for certain patient populations. Thus, there remains a need for an improved treatment using alternative or improved pharmaceutical agents that inhibit 11-β-HSD1 and treat the diseases that could benefit from 11-β-HSD1 inhibition. The present invention provides such a contribution to the art based on the finding that a novel class of compounds has a potent and selective inhibitory activity on 11-β-HSD1. The present invention is distinct in the particular structures and their activities. There is a continuing need for new methods of treating diabetes, metabolic syndrome, and cognitive disorders, and it is an object of this invention to meet these and other needs.
The present invention provides a compound structurally represented by formula I:




or a pharmaceutically acceptable salt thereof, wherein

R1 is —H or -halogen;

R2 is

    
    
        —H, -halogen, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R3 is

        —H, -halogen, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R4 is —H or -halogen;

R5 is

    
    






    
    
        wherein the dashed line represents the point of attachment to the R5 position in formula I;
        wherein n is 0, 1, or 2, and wherein when n is 0, then “(CH2) n” is a bond;
        wherein m is 1 or 2;

R6 is

        —H, —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), —(C1-C3)alkyl-O—R20, —(C1-C3)alkyl-pyrrolidinyl, phenyl, -HET1, -HET2, —CH2-phenyl, —CH2-HET1, —CH2-HET2, —(C1-C3)alkyl-N(R20)(R20), —(C1-C3)alkyl-N+(O−)(CH3)2, —(C1-C3)alkyl-C(O)N(R41)(R41), —CH(C(O)OH)(CH2OR20), —CH(C(O)OH)(CH2N(R20)(R20)), —(C1-C3)alkyl-C(O)O—R20,
    
    






    
    
         wherein the dashed line indicates the point of attachment to the position indicated by R6;

HET1 is

    
    






wherein the dashed line indicates the point of attachment to the position indicated by HET1;

HET2 is





wherein the dashed line indicates the point of attachment to the position indicated by HET2;

R7 is

    
    
        —H, —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —(C1-C3)alkyl-O—R20;

R8 is

        —H, —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)—(C3-C8)cycloalkyl, —(C1-C3)alkyl-O—R20, —C(O)O—(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), —S(O2)—(C3-C8)cycloalkyl, —S(O2)—(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)—N(R20)(R20);

R9 is

        —H, -halogen, —OH, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R10 is independently at each occurrence —H, or -halogen;

R20 is independently at each occurrence —H, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R21 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R22 is independently at each occurrence —H, or —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens);

R23 is independently at each occurrence —H, —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)O—(C1-C4)alkyl;

R24 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R31 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl; and

R41 is independently at each occurrence —H, or —CH3.

    
    


The present invention provides compounds of formula I that are useful as potent and selective inhibition of 11-β-HSD1. The present invention further provides a pharmaceutical composition which comprises a compound of Formula I, or a pharmaceutical salt thereof, and a pharmaceutically acceptable carrier, diluent, or excipient. In addition, the present invention provides a method for the treatment of metabolic syndrome, and related disorders, which comprise administering to a patient in need thereof an effective amount of a compound of formula I or a pharmaceutically acceptable salt thereof.
In one embodiment, the present invention provides compounds of Formula I or a pharmaceutically acceptable salt thereof as described in detail above. While all of the compounds of the present invention are useful, certain of the compounds are particularly interesting and are preferred. The following listings set out several groups of preferred compounds.
In another embodiment the invention provides a compound structurally represented by formula I, or a pharmaceutically acceptable salt thereof, wherein
R1 is —H; R2 is -halogen; R3 is -halogen; R4 is —H or -halogen;
R5 is







wherein the dashed line represents the point of attachment to the R5 position in formula I;

R6 is

    
    
        —H, —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), —(C1-C3)alkyl-O—R20, —(C1-C3)alkyl-pyrrolidinyl, —(C1-C3)alkyl-N(R20)(R20), —(C1-C3)alkyl-N+(O−)(CH3)2, —(C1-C3)alkyl-C(O)N(R41)(R41), —CH(C(O)OH)(CH2OR20), —CH(C(O)OH)(CH2N(R20)(R20)), —(C1-C3)alkyl-C(O)O—R20,
    
    






    
    
         wherein the dashed line indicates the point of attachment to the position indicated by R6;

R7 is

        —H, —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —(C1-C3)alkyl-O—R20;

R8 is

        —H, —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)—(C3-C8)cycloalkyl, —(C1-C3)alkyl-O—R20, —C(O)O—(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), —S(O2)—(C3-C8)cycloalkyl, —S(O2)—(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)—N(R20)(R20);

R9 is

        —H, —OH, -halogen, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R10 is independently at each occurrence —H or -halogen;

R20 is independently at each occurrence —H or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R21 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R22 is independently at each occurrence —H, or —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens);

R23 is independently at each occurrence —H, —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)O—(C1-C4)alkyl;

R24 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens); and

R41 is independently at each occurrence —H or —CH3.

    
    


In another embodiment the invention provides a compound structurally represented by formula I, or a pharmaceutically acceptable salt thereof, wherein
R1 is —H; R2 is -fluorine, -chlorine, or -bromine; R3 is -fluorine, -chlorine, or -bromine;
R4 is —H or -halogen;
R5 is




wherein the dashed line represents the point of attachment to the R5 position in formula I;

R6 is

    
    
        —H, —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), —(C1-C3)alkyl-O—R20, —(C1-C3)alkyl-pyrrolidinyl, —(C1-C3)alkyl-N(R20)(R20), —(C1-C3)alkyl-N+(O−)(CH3)2, —(C1-C3)alkyl-C(O)N(R41)(R41), —CH(C(O)OH)(CH2OR20), —CH(C(O)OH)(CH2N(R20)(R20)), —(C1-C3)alkyl-C(O)O—R20,
    
    






    
    
         wherein the dashed line indicates the point of attachment to the position indicated by R6;

R7 is

        —H, —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —(C1-C3)alkyl-O—R20;

R8 is

        —H, —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)—(C3-C8)cycloalkyl, —(C1-C3)alkyl-O—R20, —C(O)O—(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), —S(O2)—(C3-C8)cycloalkyl, —S(O2)—(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)—N(R20)(R20);

R9 is

        —H, -halogen, —OH, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R10 is independently at each occurrence —H or -halogen;

R20 is independently at each occurrence —H or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R21 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R22 is independently at each occurrence —H or —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens);

R23 is independently at each occurrence —H, —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)O—(C1-C4)alkyl;

R24 is independently at each occurrence —H; and

R41 is independently at each occurrence —H.

    
    


In another embodiment the invention provides a compound structurally represented by formula I, or a pharmaceutically acceptable salt thereof, wherein
R1 is —H; R2 is -fluorine, -chlorine, or -bromine; R3 is -fluorine, -chlorine, or -bromine;
R4 is —H;
R5 is




    
    
        wherein the dashed line represents the point of attachment to the R5 position in formula I;

R8 is

        —H, —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)(C1-C6)alkyl(optionally substituted with 1 to 3 halogens), —C(O)—(C3-C8)cycloalkyl, —(C1-C3)alkyl-O—R20, —C(O)O—(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), —S(O2)—(C3-C8)cycloalkyl, —S(O2)—(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)—N(R20)(R20);

R9 is

        —H, -halogen, —OH, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R10 is independently at each occurrence —H or -halogen;

R20 is independently at each occurrence —H, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R21 is independently at each occurrence —H, -halogen, or —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens);

R22 is independently at each occurrence —H or —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens); and

R23 is independently at each occurrence —H, —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), or —C(O)O—(C1-C4)alkyl.

    
    


Other embodiments of the invention are provided wherein each of the embodiments described herein above is further narrowed as described in the following preferences. Specifically, each of the preferences below is independently combined with each of the embodiments above, and the particular combination provides another embodiment in which the variable indicated in the preference is narrowed according to the preference.
Preferably embodiments of the invention are structurally represented by the formula:




wherein R1 is -fluorine, -chlorine, -bromine. Preferably R1 is —H. Preferably R2 is -halogen, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens). Preferably R2 is -halogen. Preferably R2 is —CH3 (optionally substituted with 1 to 3 halogens). Preferably R2 is —O—CH3 (optionally substituted with 1 to 3 halogens). Preferably R2 is -chlorine, -fluorine, or -bromine. Preferably R2 is chlorine. Preferably R3 is -halogen, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens). Preferably R3 is -halogen. Preferably R3 is —CH3 (optionally substituted with 1 to 3 halogens). Preferably R3 is —O—CH3 (optionally substituted with 1 to 3 halogens). Preferably R3 is -chlorine, -fluorine, or -bromine. Preferably R3 is chlorine. Preferably R3 is -fluorine. Preferably R2 is -chlorine, -fluorine, or -bromine, and R3 is chlorine, -fluorine, or -bromine. Preferably R4 is —H. Preferably R4 is -halogen. Preferably R4 is -fluorine or chlorine. Preferably R1 is —H; R2 is chlorine; R3 is -chlorine; and R4 is —H. Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R5 is





wherein R8 is —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens); R9 is —H, -halogen, —CH3 (optionally substituted with 1 to 3 halogens; and R10 is independently at each occurrence

—H or -halogen. Preferably R5 is





wherein R8 is —(C1-C3)alkyl (optionally substituted with 1 to 3 halogens). Preferably R5 is





Preferably R5 is





Preferably R5 is





Preferably R6 is —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), —(C1-C3)alkyl-O—R20, —(C1-C3)alkyl-pyrrolidinyl, phenyl, -HET1, -HET2, —CH2-phenyl, —CH2-HET1, —CH2-HET2, —(C1-C3)alkyl-N(R20)(R20), —(C1-C3)alkyl-N+(O−)(CH3)2, —(C1-C3)alkyl-C(O)N(R41)(R41), —CH(C(O)OH)(CH2OR20), —CH(C(O)OH)(CH2N(R20)(R20)), —(C1-C3)alkyl-C(O)O—R20,





Preferably R6 is —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens), —(C1-C3)alkyl-O—R20, —(C1-C3)alkyl-pyrrolidinyl, —(C1-C3)alkyl-N(R20)(R20), —(C1-C3)alkyl-N+(O−)(CH3)2, —(C1-C3)alkyl-C(O)N(R41)(R41), —CH(C(O)OH)(CH2OR20), —CH(C(O)OH)(CH2N(R20)(R20)), —(C1-C3)alkyl-C(O)O—R20,





Preferably R7 is —H. Preferably R7 is —(C1-C3)alkyl(optionally substituted with 1 to 3 halogens). Preferably R7 is —(C2-C3)alkyl-O—R20.

Preferably R8 is —H. Preferably R8 is —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens), —(C2-C3)alkyl-O—R20, —C(O)—(C1-C4)alkyl, —C(O)O—(C1-C4)alkyl, or —C(O)—N(R20)(R20). Preferably R8 is —(C1-C4)alkyl(optionally substituted with 1 to 3 halogens). Preferably R8 is —(C2-C3)alkyl-O—R20, —C(O)—(C1-C4)alkyl, —C(O)O—(C1-C4)alkyl, or —C(O)—N(R20)(R20). Preferably R8 is —(C2-C3)alkyl-O—R20. Preferably R8 is —C(O)—(C1-C4)alkyl. Preferably R8 is —C(O)O—(C1-C4)alkyl. Preferably R8 is —C(O)—N(R20)(R20).
Preferably R9 is —H. Preferably R9 is -halogen. Preferably R9 is —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens). Preferably R9 is —CF3. Preferably R10 is —H. Preferably R10 is -halogen. Preferably R9 is —H and R10 is —H. Preferably R9 is -halogen and R10 is -halogen.
A preferred embodiment of the invention are compounds of the formula (R)-3-[3,5-Dichloro-4′-(4-trifluoromethyl-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one and (R)-3-[3,5-Dichloro-4′-(4-hydroxy-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one. A further embodiment of the invention are the novel intermediate preparations described herein which are useful for preparing the 11-β-HSD1 inhibitors according to formula I and the embodiments described herein. A further embodiment of the invention are the novel intermediate preparations described herein which are useful for preparing (R)-3-[3,5-Dichloro-4′-(4-trifluoromethyl-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one and (R)-3-[3,5-Dichloro-4′-(4-hydroxy-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one or a pharmaceutically acceptable salt thereof.
Patients with type 2 diabetes often develop “insulin resistance” which results in abnormal glucose homeostasis and hyperglycemia leading to increased morbidity and premature mortality. Abnormal glucose homeostasis is associated with obesity, hypertension, and alterations in lipid, lipoprotein, and apolipoprotein metabolism. Type 2 diabetics are at increased risk of developing cardiovascular complications, e.g., atherosclerosis, coronary heart disease, stroke, peripheral vascular disease, hypertension, nephropathy, neuropathy, and retinopathy. Therefore, therapeutic control of glucose homeostasis, lipid metabolism, obesity, and hypertension are important in the management and treatment of diabetes mellitus. Many patients who have insulin resistance but have not developed type 2 diabetes are also at risk of developing “Syndrome X” or “Metabolic syndrome”. Metabolic syndrome is characterized by insulin resistance along with abdominal obesity, hyperinsulinemia, high blood pressure, low HDL, high VLDL, hypertension, atherosclerosis, coronary heart disease, and chronic renal failure. These patients are at increased risk of developing the cardiovascular complications listed above whether or not they develop overt diabetes mellitus.
Due to their inhibition of 11-β-HSD1, the present compounds are useful in the treatment of a wide range of conditions and disorders in which inhibition of 11-β-HSD1 is beneficial. These disorders and conditions are defined herein as “diabetic disorders” and “metabolic syndrome disorders”. One of skill in the art is able to identify “diabetic disorders” and “metabolic syndrome disorders” by the involvement of 11-β-HSD1 activity either in the pathophysiology of the disorder, or in the homeostatic response to the disorder. Thus, the compounds may find use for example to prevent, treat, or alleviate, diseases or conditions or associated symptoms or sequelae, of “Diabetic disorders” and “metabolic syndrome disorders”.
“Diabetic disorders” and “metabolic syndrome disorders” include, but are not limited to, diabetes, type 1 diabetes, type 2 diabetes, hyperglycemia, hyper insulinemia, beta-cell rest, improved beta-cell function by restoring first phase response, prandial hyperglycemia, preventing apoptosis, impaired fasting glucose (IFG), metabolic syndrome, hypoglycemia, hyper-/hypokalemia, normalizing glucagon levels, improved LDL/HDL ratio, reducing snacking, eating disorders, weight loss, polycystic ovarian syndrome (PCOS), obesity as a consequence of diabetes, latent autoimmune diabetes in adults (LADA), insulitis, islet transplantation, pediatric diabetes, gestational diabetes, diabetic late complications, micro-/macroalbuminuria, nephropathy, retinopathy, neuropathy, diabetic foot ulcers, reduced intestinal motility due to glucagon administration, short bowel syndrome, antidiarrheic, increasing gastric secretion, decreased blood flow, erectile dysfunction, glaucoma, post surgical stress, ameliorating organ tissue injury caused by reperfusion of blood flow after ischemia, ischemic heart damage, heart insufficiency, congestive heart failure, stroke, myocardial infarction, arrhythmia, premature death, anti-apoptosis, wound healing, impaired glucose tolerance (IGT), insulin resistance syndromes, metabolic syndrome, syndrome X, hyperlipidemia, dyslipidemia, hypertriglyceridemia, hyperlipoproteinemia, hypercholesterolemia, arteriosclerosis including atherosclerosis, glucagonomas, acute pancreatitis, cardiovascular diseases, hypertension, cardiac hypertrophy, gastrointestinal disorders, obesity, diabetes as a consequence of obesity, diabetic dyslipidemia, etc. Thus the present invention also provides a method of treatment of “Diabetic disorders” and “metabolic syndrome disorders” while reducing and or eliminating one or more of the unwanted side effects associated with the current treatments.
In addition, the present invention provides a compound of Formula I, or a pharmaceutical salt thereof, or a pharmaceutical composition which comprises a compound of Formula I, or a pharmaceutical salt thereof, and a pharmaceutically acceptable carrier, diluent, or excipient: for use in inhibiting 11-β-HSD1 activity; for use in inhibiting a 11-β-HSD1 activity mediated cellular response in a mammal; for use in reducing the glycemic level in a mammal; for use in treating a disease arising from excessive 11-β-HSD1 activity; for use in treating diabetic and other metabolic syndrome disorders in a mammal; and for use in treating diabetes, metabolic syndrome, obesity, hyperglycemia, atherosclerosis, ischemic heart disease, stroke, neuropathy, and wound healing. Thus, the methods of this invention encompass a prophylactic and therapeutic administration of a compound of Formula I.
The present invention further provides the use of a compound of Formula I, or a pharmaceutical salt thereof for the manufacture of a medicament for inhibiting 11-β-HSD1 activity; for the manufacture of a medicament for inhibiting 11-β-HSD1 activity mediated cellular response in a mammal; for the manufacture of a medicament for reducing the glycemic level in a mammal; for the manufacture of a medicament for treating a disease arising from excessive 11-β-HSD1 activity; for the manufacture of a medicament for treating diabetic and other metabolic syndrome disorders in a mammal; and for the manufacture of a medicament for preventing or treating diabetes, metabolic syndrome, obesity, hyperglycemia, atherosclerosis, ischemic heart disease, stroke, neuropathy, and improper wound healing.
The present invention further provides a method of treating conditions resulting from excessive 11-β-HSD1 activity in a mammal; a method of inhibiting 11-β-HSD1 activity in a mammal; a method of inhibiting a 11-β-HSD1 activity mediated cellular response in a mammal; a method of reducing the glycemic level in a mammal; a method of treating diabetic and other metabolic syndrome disorders in a mammal; a method of preventing or treating diabetes, metabolic syndrome, obesity, hyperglycemia, atherosclerosis, ischemic heart disease, stroke, neuropathy, and improper wound healing; said methods comprising administering to a mammal in need of such treatment a 11-β-HSD1 activity inhibiting amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, or a pharmaceutical composition which comprises a compound of Formula I, or a pharmaceutical salt thereof, and a pharmaceutically acceptable carrier, diluent, or excipient.
In addition, the present invention provides a pharmaceutical composition which comprises a compound of Formula I, or a pharmaceutical salt thereof, and a pharmaceutically acceptable carrier, diluent, or excipient: adapted for use in inhibiting 11-β-HSD1 activity; adapted for use in inhibiting 11-β-HSD1 activity mediated cellular responses; adapted for use in reducing the glycemic level in a mammal; adapted for use in treating diabetic and other metabolic syndrome disorders in a mammal; and adapted for use in preventing or treating diabetes, metabolic syndrome, obesity, hyperglycemia, atherosclerosis, ischemic heart disease, stroke, neuropathy, and wound healing.
In a further aspect of the invention the present compounds are administered in combination with one or more further active substances in any suitable ratios. Such further active substances may for example be selected from antidiabetics, antiobesity agents, antihypertensive agents, agents for the treatment of complications resulting from or associated with diabetes and agents for the treatment of complications and disorders resulting from or associated with obesity. The following listing sets out several groups of combinations. It will be understood that each of the agents named may be combined with other agents named to create additional combinations.
Thus, in a further embodiment of the invention the present compounds may be administered in combination with one or more antidiabetics.
Suitable antidiabetic agents include insulin, insulin analogues and derivatives such as those disclosed in EP 792 290 (Novo Nordisk A/S), for example NεB29-tetradecanoyl des (B30) human insulin, EP 214 826 and EP 705 275 (Novo Nordisk A/S), for example AspB28 human insulin, U.S. Pat. No. 5,504,188 (Eli Lilly), for example LysB28 ProB29 human insulin, EP 368 187 (Aventis), for example Lantus®, GLP-1 and GLP-1 derivatives such as those disclosed in WO 98/08871 (Novo Nordisk A/S), as well as orally active hypoglycemic agents.
The orally active hypoglycemic agents preferably comprise imidazolines, sulphonylureas, biguanides, meglitinides, oxadiazolidinediones, thiazolidinediones, insulin sensitizers, insulin secretagogues, such as glimepiride, α-glucosidase inhibitors, agents acting on the ATP-dependent potassium channel of the β-cells for example potassium channel openers such as those disclosed in WO 97/26265, WO 99/03861 and WO 00/37474 (Novo Nordisk A/S), or mitiglinide, or a potassium channel blocker, such as BTS-67582, nateglinide, glucagon antagonists such as those disclosed in WO 99/01423 and WO 00/39088 (Novo Nordisk A/S and Agouron Pharmaceuticals, Inc.), GLP-1 antagonists, DPP-IV (dipeptidyl peptidase-IV) inhibitors, PTPase (protein tyrosine phosphatase) inhibitors, inhibitors of hepatic enzymes involved in stimulation of gluconeogenesis and/or glycogenolysis, glucose uptake modulators, activators of glucokinase (GK) such as those disclosed in WO 00/58293, WO 01/44216, WO 01/83465, WO 01/83478, WO 01/85706, WO 01/85707, and WO 02/08209 (Hoffman-La Roche) or those disclosed in WO 03/00262, WO 03/00267 and WO 03/15774 (AstraZeneca), GSK-3 (glycogen synthase kinase-3) inhibitors, compounds modifying the lipid metabolism such as antilipidemic agents such as HMG CoA inhibitors (statins), compounds lowering food intake, PPAR (Peroxisome proliferator-activated receptor) ligands including the PPAR-alpha, PPAR-gamma and PPAR-delta subtypes, and RXR (retinoid X receptor) agonists, such as ALRT-268, LG-1268 or LG-1069.
In another embodiment, the present compounds are administered in combination with insulin or an insulin analogue or derivative, such as NεB29-tetradecanoyl des (B30) human insulin, AspB28 human insulin, LysB28 ProB29 human insulin, Lantus®, or a mix-preparation comprising one or more of these.
In a further embodiment of the invention the present compounds are administered in combination with a sulphonylurea such as glibenclamide, glipizide, tolbautamide, chloropamidem, tolazamide, glimepride, glicazide and glyburide.
In another embodiment of the invention the present compounds are administered in combination with a biguanide, for example, metformin.
In yet another embodiment of the invention the present compounds are administered in combination with a meglitinide, for example, repaglinide or nateglinide.
In still another embodiment of the invention the present compounds are administered in combination with a thiazolidinedione insulin sensitizer, for example, troglitazone, ciglitazone, pioglitazone, rosiglitazone, isaglitazone, darglitazone, englitazone, CS-011/CI-1037 or T 174 or the compounds disclosed in WO 97/41097, WO 97/41119, WO 97/41120, WO 00/41121 and WO 98/45292 (Dr. Reddy's Research Foundation).
In still another embodiment of the invention the present compounds may be administered in combination with an insulin sensitizer, for example, such as GI 262570, YM-440, MCC-555, JTT-501, AR-H039242, KRP-297, GW-409544, CRE-16336, AR-H049020, LY510929, MBX-102, CLX-0940, GW-501516 or the compounds disclosed in WO 99/19313, WO 00/50414, WO 00/63191, WO 00/63192, WO 00/63193 such as ragaglitazar (NN 622 or (−)DRF 2725) (Dr. Reddy's Research Foundation) and WO 00/23425, WO 00/23415, WO 00/23451, WO 00/23445, WO 00/23417, WO 00/23416, WO 00/63153, WO 63196, WO 00/63209, WO 00/63190 and WO 00/63189 (Novo Nordisk A/S).
In a further embodiment of the invention the present compounds are administered in combination with an α-glucosidase inhibitor, for example, voglibose, emiglitate, miglitol or acarbose.
In another embodiment of the invention the present compounds are administered in combination with an agent acting on the ATP-dependent potassium channel of the β-cells, for example, tolbutamide, glibenclamide, glipizide, glicazide, BTS-67582 or repaglinide.
In yet another embodiment of the invention the present compounds may be administered in combination with nateglinide.
In still another embodiment of the invention the present compounds are administered in combination with an antilipidemic agent or antihyperlipidemic agent for example cholestyramine, colestipol, clofibrate, gemfibrozil, lovastatin, pravastatin, simvastatin, pitavastatin, rosuvastatin, probucol, dextrothyroxine, fenofibrate or atorvastin.
In still another embodiment of the invention the present compounds are administered in combination with compounds lowering food intake.
In another embodiment of the invention, the present compounds are administered in combination with more than one of the above-mentioned compounds for example in combination with metformin and a sulphonylurea such as glyburide; a sulphonylurea and acarbose; nateglinide and metformin; repaglinide and metformin, acarbose and metformin; a sulfonylurea, metformin and troglitazone; insulin and a sulfonylurea; insulin and metformin; insulin, metformin and a sulfonylurea; insulin and troglitazone; insulin and lovastatin; etc.
General terms used in the description of compounds herein described bear their usual meanings.
As used herein, the terms “(C1-C3)alkyl”, “(C1-C4)alkyl” or “(C1-C6)alkyl” refer to straight-chain or branched-chain saturated aliphatic groups of the indicated number of carbon atoms, such as methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, t-butyl, and the like. The term “(C1-C6)alkoxy” represents a C1-C6 alkyl group attached through an oxygen and include moieties such as, for example, methoxy, ethoxy, n-propoxy, isopropoxy, and the like. The term “halogen” refers to fluoro, chloro, bromo, and iodo. The term “(C3-C8) cycloalkyl” refers to a saturated or partially saturated carbocycle ring of from 3 to 8 carbon atoms, typically 3 to 7 carbon atoms. Examples of (C3-C8) cycloalkyl include but are not limited to cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, and the like.
The term “optionally substituted,” or “optional substituents,” as used herein, means that the groups in question are either unsubstituted or substituted with one or more of the substituents specified. When the groups in question are substituted with more than one substituent, the substituents may be the same or different. Furthermore, when using the terms “independently,” “independently are,” and “independently selected from” mean that the groups in question may be the same or different. Certain of the herein defined terms may occur more than once in the structural formulae, and upon such occurrence each term shall be defined independently of the other.
It is understood that guinea pigs, dogs, cats, rats, mice, hamsters, and primates, including humans, are examples of patients within the scope of the meaning of the term “patient”. Preferred patients include humans. The term “patient” includes livestock animals. Livestock animals are animals raised for food production. Ruminants or “cud-chewing” animals such as cows, bulls, heifers, steers, sheep, buffalo, bison, goats and antelopes are examples of livestock. Other examples of livestock include pigs and avians (poultry) such as chickens, ducks, turkeys and geese. The patient to be treated is preferably a mammal, in particular a human being.
The terms “treatment”, “treating” and “treat”, as used herein, include their generally accepted meanings, i.e., the management and care of a patient for the purpose of preventing, reducing the risk in incurring or developing a given condition or disease, prohibiting, restraining, alleviating, ameliorating, slowing, stopping, delaying, or reversing the progression or severity, and holding in check and/or treating existing characteristics, of a disease, disorder, or pathological condition, described herein, including the alleviation or relief of symptoms or complications, or the cure or elimination of the disease, disorder, or condition. The present method includes both medical therapeutic and/or prophylactic treatment, as appropriate.
As used herein, the term “therapeutically effective amount” means an amount of compound of the present invention that is capable of alleviating the symptoms of the various pathological conditions herein described. The specific dose of a compound administered according to this invention will, of course, be determined by the particular circumstances surrounding the case including, for example, the compound administered, the route of administration, the state of being of the patient, and the pathological condition being treated.
“Composition” means a pharmaceutical composition and is intended to encompass a pharmaceutical product comprising the active ingredient(s) including compound(s) of Formula I, and the inert ingredient(s) that make up the carrier. Accordingly, the pharmaceutical compositions of the present invention encompass any composition made by admixing a compound of the present invention and a pharmaceutically acceptable carrier.
The term “suitable solvent” refers to any solvent, or mixture of solvents, inert to the ongoing reaction that sufficiently solubilizes the reactants to afford a medium within which to effect the desired reaction.
The term “unit dosage form” means physically discrete units suitable as unitary dosages for human subjects and other non-human animals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical carrier.
The compounds of the present invention may have one or more chiral centers and may exist in a variety of stereoisomeric configurations. As a consequence of these chiral centers the compounds of the present invention can occur as racemates, as individual enantiomers or mixtures of enantiomers, as well as diastereomers and mixtures of diastereomers. All such racemates, enantiomers, diastereomers and mixtures are within the scope of the present invention, whether pure, partially purified, or unpurified mixtures. For the examples provided herein, when a molecule which contains a chiral center or centers of known configuration is presented, its stereochemistry is designated in the name and in the structural representation of the molecule. If the stereochemistry is unknown or undefined its stereochemistry is not designated in the name or in the structural representation of the molecule. Embodiments of the invention include the Examples provided herein, and although the Example provided may be of one chiral or conformational form, or a salt thereof, further embodiments of the invention include all other steroisomeric and or conformational forms of the examples described, as well as pharmaceutically acceptable salts thereof. These embodiments include any isolated enantiomers, diastereomers, and or conformers of these structures, as well as any mixtures containing more than one form.
Furthermore, when a double bond or a fully or partially saturated ring system or more than one center of asymmetry or a bond with restricted rotatability is present in the molecule diastereomers may be formed. It is intended that any diastereomers, as separated, pure or partially purified diastereomers or mixtures thereof are included within the scope of the invention. Furthermore, some of the compounds of the present invention may exist in different tautomeric forms and it is intended that any tautomeric forms which the compounds are able to form are included within the scope of the present invention.
The term “enantiomeric enrichment” as used herein refers to the increase in the amount of one enantiomer as compared to the other. A convenient method of expressing the enantiomeric enrichment achieved is the concept of enantiomeric excess, or “ee”, which is found using the following equation:




  ee
  =
  
    
      
        
          E
          1
        
        -
        
          E
          2
        
      
      
        
          E
          1
        
        +
        
          E
          2
        
      
    
    ×
    100
  




wherein E1 is the amount of the first enantiomer and E2 is the amount of the second enantiomer. Thus, if the initial ratio of the two enantiomers is 50:50, such as is present in a racemic mixture, and an enantiomeric enrichment sufficient to produce a final ratio of 70:30 is achieved, the ee with respect to the first enantiomer is 40%. However, if the final ratio is 90:10, the ee with respect to the first enantiomer is 80%. An ee of greater than 90% is preferred, an ee of greater than 95% is most preferred and an ee of greater than 99% is most especially preferred. Enantiomeric enrichment is readily determined by one of ordinary skill in the art using standard techniques and procedures, such as gas or high performance liquid chromatography with a chiral column. Choice of the appropriate chiral column, eluent and conditions necessary to effect separation of the enantiomeric pair is well within the knowledge of one of ordinary skill in the art. In addition, the specific stereoisomers and enantiomers of compounds of formula I can be prepared by one of ordinary skill in the art utilizing well known techniques and processes, such as those disclosed by J. Jacques, et al., “Enantiomers, Racemates, and Resolutions”, John Wiley and Sons, Inc., 1981, and E. L. Eliel and S. H. Wilen, “Stereochemistry of Organic Compounds”, (Wiley-Interscience 1994), and European Patent Application No. EP-A-838448, published Apr. 29, 1998. Examples of resolutions include recrystallization techniques or chiral chromatography.

The compounds of Formula I, can be prepared by one of ordinary skill in the art following a variety of procedures, some of which are illustrated in the procedures and schemes set forth below. The particular order of steps required to produce the compounds of Formula I is dependent upon the particular compound to being synthesized, the starting compound, and the relative lability of the substituted moieties. The reagents or starting materials are readily available to one of skill in the art, and to the extent not commercially available, are readily synthesized by one of ordinary skill in the art following standard procedures commonly employed in the art, along with the various procedures and schemes set forth below.
The following Schemes, Preparations, Examples and Procedures are provided to better elucidate the practice of the present invention and should not be interpreted in any way as to limit the scope of the same. Those skilled in the art will recognize that various modifications may be made while not departing from the spirit and scope of the invention. All publications mentioned in the specification are indicative of the level of those skilled in the art to which this invention pertains.
The optimal time for performing the reactions of the Schemes, Preparations, Examples and Procedures can be determined by monitoring the progress of the reaction via conventional chromatographic techniques. Furthermore, it is preferred to conduct the reactions of the invention under an inert atmosphere, such as, for example, argon, nitrogen. Choice of solvent is generally not critical so long as the solvent employed is inert to the ongoing reaction and sufficiently solubilizes the reactants to effect the desired reaction. The compounds are preferably isolated and purified before their use in subsequent reactions. Some compounds may crystallize out of the reaction solution during their formation and then collected by filtration, or the reaction solvent may be removed by extraction, evaporation, or decantation. The intermediates and final products of Formula I may be further purified, if desired by common techniques such as recrystallization or chromatography over solid supports such as silica gel or alumina.
The skilled artisan will appreciate that not all substituents are compatible with all reaction conditions. These compounds may be protected or modified at a convenient point in the synthesis by methods well known in the art.
The terms and abbreviations used in the instant Schemes, Preparations, Examples and Procedures have their normal meanings unless otherwise designated. For example, as used herein, the following terms have the meanings indicated: “psi” refers to pounds per square inch; “TLC” refers to thin layer chromatography; “HPLC” refers to high performance liquid chromatography; “Rf” refers to retention factor; “Rt” refers to retention time; “δ” refers to part per million down-field from tetramethylsilane; “MS” refers to mass spectrometry, Observed Mass indicates [M+H] unless indicated otherwise. “MS (APCi) refers to atmospheric pressure chemical ionization mass spectrometry, “UV” refers to ultraviolet spectrometry, “1H NMR” refers to proton nuclear magnetic resonance spectrometry. “LCMS” refers to liquid chromatography-mass spectrometry, “GC/MS” refers to gas chromatography/mass spectrometry. “IR” refers to infra red spectrometry, and the absorption maxima listed for the IR spectra are only those of interest and not all of the maxima observed. “RT” refers to room temperature.
“THF” refers to tetrahydrofuran, “LAH” refers to lithium aluminum hydride, “LDA” refers to lithium diisopropylamide, “DMSO” refers to dimethylsulfoxide, “DMF” refers to dimethylforamide, “EtOAc” refers to ethyl acetate, “Pd—C” refers to palladium on carbon, “DCM” refers to dichloromethane, “DMAP” refers to dimethylaminopyridine, “LiHMDS” refers to Lithium Hexamethyldisilisane, “TFA” refers to trifluoroacetic acid, “EDAC” refers to N-Ethyl-N′-(3-dimethylaminopropyl)carbodiimide hydrochloride, “HOBT” refers to 1-Hydroxy benzotriazole, “Bn-9-BBN” refers to Benzyl-9-borabicyclo[3.3.1]nonane, “Pd(dppf)Cl2” refers to [1,1′-Bis(diphenylphosphino)-ferrocene)dichloropalladium(II), “EDCI” refers to N-Ethyl-N′-(3-dimethylaminopropyl)carbodiimide hydrochloride, “DBU” refers to 1,8-Diazabicyclo[5.4.0]undecene-7, “TBSCl” refers to tert-butyl-dimethyl-silanyloxymethyl chloride, “NBS” refers to N-Bromosuccinimide, “TsOH” refers to p-toluenesulfonic acid, “DCE” refers to dichloroethane, “DAST” refers to (Diethylamino) sulfur trifluoride, “EA/H” refers to ethyl acetate/hexanes mixture, “Pd2(dba)3” refers to Bis(dibenzylideneacetone)palladium, “BINAP” refers to 2,2′-Bis(diphenylphospino-1,1′-binaphthalene, “NMP” refers to N-Methylpyrrollidine, “TMSCN” refers to Trimethylsilyl cyanide, “TBAF” refers to Tetrabutylammonium fluoride, “Tf2O” refers to trifluoromethanesulfonic anhydride, “TBSO” refers to tert-butyl-dimethyl-silanyloxy, “OTf” refers to trifluoromethanesulfonate, MeTi(Oi-Pr)3 refers to methyltitanium triisopropoxide, “BBr3” refers to boron tribromide, “PBr3” refers to phosphorous tribromide, “Pd(PPh3)4” refers to tetrakis(triphenylphoshine)palladium (0), “OAc” refers to acetate, “DME” refers to dimethylethane, “Et2O” refers to diethyl ether, “(Ph3P)4Pd” refers to tetrakis(triphenylphoshine)palladium (0), “DMFDMA” refers to N,N-dimethylformamide dimethyl acetal, “Et3N” refers to triethylamine, “tBu” refers to t-butyl, “DIPEA” refers to diisopropylethyl amine, “EDC” refers to -(3-Dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride, “HOAc” refers to acetic acid, “boc” refers to t-butoxycarbonyl. In a structure, “Ph” refers to phenyl, “Me” refers to methyl, “Et” refers to ethyl, “Bn” refers to benzyl, “MeOH” refers to methanol, “OTf” refers to trifluoromethanesulfonate, “TIPSO” refers to triisopropylsilanyloxy, “TBSO” refers to tert-butyl-dimethyl-silanyloxy.
The Examples provided herein are illustrative of the invention claimed herein and are not intended to limit the scope of the claimed invention in any way. The preparations and examples are named using AutoNom 2.2 in ChemDraw Ultra, or AutoNom 2000 in MDL ISIS/Draw version 2.5 SP1 from MDL Information Systems, Inc., or are provided by Chemical Abstracts Services.
A Varian INOVA 400 MHz spectrometer is used to obtain 1H NMR Specta the in the solvent indicated. An Agilent HP1100 instrument equipped with a Mass Spectrometer (Agilent MSD SL) is used to obtain LCMS. A Waters Xterra C18 (2.1×50 mm, 3.5 micron) is used as stationary phase and a standard method is a gradient of 5-100% acetonitrile/methanol (50:50) with 0.2% ammonium formate over 3.5 minutes then held at 100% B for 0.5 minutes at a column temperature of 50° C. and a flow rate of 1.0 mL/min. Another standard method is a gradient of 5-100% acetonitrile/methanol (50:50) with 0.2% ammonium formate over 7.0 minutes then held at 100% B for 1.0 minutes at a column temperature of 50° C. and a flow rate of 1.0 mL/min. Additional MS analysis via Agilent MSD (loop machine) is standard Flow injection Analysis (FIA), no column is present and flow is 0.5 ml/min of 80% MeOH with 6.5 mM Ammonium Acetate for 30 secs run time.




In Scheme A, an optionally substituted phenol (1) is protected (e.g, with TBSCl) to form compound 2, and then compound 2 is converted to the aldehyde (3). Compound 3 is reacted with a compound containing a protecting group (Pg) and leaving group (Lg) to give the ether compound 4. Pg can be —CH3 or —CH2-phenyl and Lg can be mesylate or halo. Preferably, the Lg-Pg compound is I—CH3 or Br—CH2-phenyl. The aldehyde is reduced to form the alcohol (5) and then converted to compound 6. Preferably, compound 5 is halogenated with PBr3 to give the 2-bromo-methyl compound.
Protection and deprotection of the compounds to form compounds of formula I and others are well known to the skilled artisan and are described in the literature. (For example, see: Greene and Wuts, Protective Groups in Organic Synthesis, Third Edition, John Wiley and Sons Inc., 1999).




Scheme B shows the stereo specific synthesis to form the intermediate compound 9. Compound 7 is formed by acylating commercially available (R)-4-benzyl-oxazolidin-2-one with 4-pentenoyl chloride. It is then alkylated with an optionally substituted compound 6 (see Scheme A) to give compound of 8. Compound 8 is oxidized to form the aldehyde intermediate compound 9 using ozone and triphenylphosphine or osmium tetroxide and an oxidant such as sodium metaperiodate.




Scheme C shows the formation of the compound of formula Ia starting from the intermediate compound 9.
Preparation 1
2,6-dichloro-4-hydroxy-benzaldehyde
Dissolve 3,5 dichlorophenol (1 kg, 6.13 mol) in 3 L dimethylformamide (DMF) and cool to 0° C. Add imidazole (918.74 g, 6.75 mol), followed by tertbutyldimethylsilyl chloride (1017.13 g, 6.75 mol). Warm the mixture to room temperature and stir for 15 minutes. Pour into water (6 L) and extract with ether (4 L). Wash the organic layer with water 2 times, 10% aqueous lithium chloride solution then brine before drying over sodium sulfate. Filter and concentrate under vacuum to obtain tert-butyl-(3,5-dichloro-phenoxy)-dimethyl-silane (1700 g) as an oil.
Dissolve tert-butyl-(3,5-dichloro-phenoxy)-dimethyl-silane (425 g, 1.5 mol) in 4 L dry tetrahydrofuran and cool to −68° C. Slowly add 1.1 equivalents of sec-butyl lithium (103.1 g, 1.61 mol) at −68° C. ( ̃1.75 hr). After addition is complete stir the reaction at −70° C. for 30 min. Add dimethylformamide (168.5 g, 2.3 mol) and stir the reaction at −70° C. for 1 hr. Add 1 M hydrochloric acid in water (3.5 L) and allow the reaction to warm to room temperature.
Pour the reaction mixture into ether (5 L), wash with water then brine. Dry over sodium sulfate and concentrate under vacuum to an orange solid. Triturate with cold dichloromethane and filter to recover 250 g (80%) pale yellow solid.
Preparation 2
2,6-dichloro-4-methoxy-benzaldehyde
Combine 2,6-dichloro-4-hydroxy-benzaldehyde (120 g, 628.24 mmol) and potassium carbonate (173.65 g, 1256.5 mmol) in 900 mL dimethylformamide and treat with iodomethane (107 g, 753.9 mmol). Stir the reaction at room temperature for 3 hours. Filter off solids and pour into 6 L of water. Filter solids, wash several times with water, air dry and dissolve in ethyl acetate. Wash with water, followed by brine and then dry over sodium sulfate. Filter and concentrate under vacuum to  ̃100 mL volume, at which point, solids start to crash out. Filter then concentrate down the filtrate to yield a second crop. Wash with hexane, combine all solids and vacuum dry to yield 112.3 g of off-white, solid: 1H NMR (400 MHz, CDCl3) δ 10.41 (s, 1H), 6.90 (s, 2H), 3.87 (s, 3H).
Preparation 3
2,6-dichloro-4-benzyloxy-benzaldehyde
Treat a mixture of 2,6-dichloro-4-hydroxy-benzaldehyde (250 g, 1.3 mol) and potassium carbonate (361.8 g, 2.62 mol) in 2 L dimethylformamide with benzyl bromide (268.64 g, 1.57 mol). Stir the reaction at room temperature for 1 hour. Filter off solids and pour into 12 L of water. Filter off solid, wash several times with water, air dry and dissolve in ethyl acetate. Dry over magnesium sulfate, filter and concentrate under vacuum to  ̃1.5 L. Allow to sit overnight then filter. Wash solid with minimal amount of hexane and vacuum dry. Concentrate the filtrate under vacuum and triturate with hexane to yield a second crop of product which when combined with the first crop equals 245 g white crystals. Repeat to obtain a 3rd crop of 80 g as a light-tan powder (88% overall yield): 1H NMR (400 MHz, DMSO-d6) δ 10.26 (s, 1H), 7.43 (m, 5H), 7.28 (s, 2H), 5.25 (s, 2H).
Preparation 4
(2,6-dichloro-4-methoxy-phenyl)-methanol
Suspend 2,6-dichloro-4-methoxy-benzaldehyde (112 g, 546 mmol) in 1500 mL ethanol and cool in an ice bath to 7° C. Add sodium borohydride (20.67, 546 mmol) portionwise to obtain a solution. Remove the ice bath and stir for 2 hours. Carefully add reaction mixture to saturated ammonium chloride solution ( ̃4 L) and stir until fully quenched. Extract with dichloromethane (3×1 L) and dry the combined organic extracts over sodium sulfate. Filter and concentrate under vacuum to yield 113 g of a light-tan solid: 1H NMR (400 MHz, CDCl3) δ 6.86 (s, 2H), 4.86 (s, 2H), 3.78 (s, 3H), 2.07 (s, 1H).
Preparation 5
(2,6-dichloro-4-benzyloxy-phenyl)-methanol
Prepare the title compound essentially as prepared by the method of Preparation 4. NMR (DMSO-d6) δ 7.38 (m, 4H), 7.33 (m, 1H), 7.12 (s, 2H), 5.14 (s, 2H), 5.05 (t, 1H), 4.59 (d, 2H).
Preparation 6
2-bromomethyl-1,3-dichloro-5-methoxy-benzene
Dissolve (2,6-dichloro-4-methoxy-phenyl)-methanol (113 g, 545.76 mmol) in 1200 mL dry THF and cool to 0 deg under nitrogen. Add PBr3 (59.1 g, 218.3 mmol) under nitrogen and stir at 0° C. for 30 minutes. Pour into saturated aqueous NaHCO3 and extract with EtOAc. Dry and concentrate under vacuum to obtain 129.4 g product as an off-white solid. NMR (CDCl3) δ 6.88 (s, 2H), 4.73 (s, 2H), 3.79 (s, 3H).
Preparation 7
2-bromomethyl-1,3-dichloro-5-benzyloxy-benzene
Prepare the title compound essentially as prepared by the method of Preparation 6 in an 89% yield. ES MS (m/z): 347 (M+1).
Preparation 8
(R)-4-benzyl-3-pent-4-enoyl-oxazolidin-2-one
Flush with nitrogen a 12 L 3-neck round bottom flask equipped with a mechanical stirrer, internal temperature probe/N2 inlet, and 1 L addition funnel for 20 min and then add (R)-4-benzyl-2-oxazolidinone (250 g, 1.41 mol). Dilute with tetrahydrofuran (THF) (1.8 L) and cool in a dry ice/acetone bath until the internal temperature is −74° C. Transfer a 1.6M hexanes solution of n-butyllithium (970 mL, 1.552 mol) to the addition funnel via cannula, and add to the oxazolidinone solution at a rate such that the internal temperature does not reach above −65° C. After the addition is complete, allow the reaction to stir in the cooling bath 30 min. Transfer 4-pentenoyl chloride (175 mL, 1.585 mol) to the addition funnel and add dropwise to the anion solution over a 25 min period. Stir the reaction for 45 min in the cooling bath. Remove the cooling bath and stir the reaction 18 hr as it slowly reaches room temperature. Dilute the mixture with 1N aqueous hydrochloric acid (1.5 L) and diethyl ether (1 L). Separate the layers and wash the organic phase with water (2×1 L) then brine (1 L). Extract the combined aqueous washes with ether (1 L). Dry the combined organic phases over anhydrous magnesium sulfate, filter, and concentrate to 390 g of a light tan oil. Purify this material by silica gel chromatography using hexanes:ethyl acetate to obtain 345 g (94.5%) of a clear, yellow oil.
Preparation 9
(R)-4-benzyl-3-[(S)-2-(4-benzyloxy-2,6-dichloro-benzyl)-pent-4-enoyl]-oxazolidin-2-one
Stir a mixture of (R)-4-benzyl-3-pent-4-enoyl-oxazolidin-2-one (345 g, 1.33 mol) and THF (1.8 L) in a 12 L 3-neck round bottom flask, with internal temperature probe/nitrogen inlet and addition funnel, under a nitrogen atmosphere and cool to −75° C. Transfer 1 M LiHMDS (1.6 L) to the addition funnel and add at a rate such that the internal temperature does not reach above −60° C. After the addition is complete, allow the reaction to stir at −25° C. for 30 min then cool to about −60° C. At this point add solid 2-bromomethyl-1,3-dichloro-5-benzyloxy-benzene portionwise over 5 min. After the addition is complete, transfer the reaction vessel to a −10° C. acetone bath and maintain the internal reaction temperature below 10° C. for 1 hr. Cool the mixture to 0° C. then quench with 2 L aqueous 1N hydrochloric acid. Transfer the mixture to a 22 L separatory funnel and dilute with 2.5 L water and 2 L ether. Separate the layers and extract the aqueous layer with ether. Dry the combined organic phase over anhydrous magnesium sulfate, filter and concentrate to 800 g of a thick oil. Purify by silica gel chromatography using hexanes:ethyl acetate to obtain 597 g, (86%) of a colorless oil.
Preparation 10
(R)-4-((R)-4-benzyl-2-oxo-oxazolidin-3-yl)-3-(4-benzyloxy-2,6-dichloro-benzyl)-4-oxo-butyraldehyde
Cool a mixture of (R)-4-benzyl-3-[(S)-2-(4-benzyloxy-2,6-dichloro-benzyl)-pent-4-enoyl]-oxazolidin-2-one (100 g, 190.68 mmol) and dichloromethane (800 mL) to -74° C. Bubble ozone, produced via the A-113 ozone generator at a rate of 75%, through the reaction via carrier air at a rate of 5 CFM until the solution takes on a blue color (approx 3 hr). Add triphenylphosphine (60 g, 228.8 mmol) as a solution in 200 mL dichloromethane and allow the reaction to stir while reaching room temperature over night. Concentrate the solution under vacuum and purify by silica gel chromatography using a gradient of 20-50% ethyl acetate in hexanes to obtain 82.1 g (82%) of the product as a white foam: MS (m/z): 526 (M+).
Alternate procedure for making (R)-4-((R)-4-benzyl-2-oxo-oxazolidin-3-yl)-3-(4-benzyloxy-2,6-dichloro-benzyl)-4-oxo-butyraldehyde
Treat a mixture of (R)-4-benzyl-3-[(S)-2-(4-benzyloxy-2,6-dichloro-benzyl)-pent-4-enoyl]-oxazolidin-2-one (0.96 g, 1.8 mmol), THF (21 mL) and water (7 mL) with 2.5% osmium tetroxide in t-butanol (46 mg, 0.18 mmol). Add sodium periodate (1.17 g, 5.5 mmol) and stir the reaction 4 hr at room temperature. Quench the reaction with water and extract with ethyl acetate. Wash the organic phase with aqueous 1N sodium thiosulfate then brine. Dry the organic layer over magnesium sulfate, filter, and concentrate under vacuum. Purify the crude material by silica gel chromatography using hexanes:ethyl acetate to elute the pure product. Concentrate the fractions containing product under vacuum to afford 0.46 g (48%) of desired product. MS (m/z): 526 (M+).
Preparation 11
(R)-4-benzyl-3-[(S)-2-(4-methoxy-2,6-dichloro-benzyl)-pent-4-enoyl]-oxazolidin-2-one
Stir a mixture of (R)-4-benzyl-3-pent-4-enoyl-oxazolidin-2-one (5.0 g, 19.3 mmol) and tetrahydrofuran (75 mL) in a 250 mL round bottom flask at −75° C. Transfer 2 M LDA (14.5 mL) to the flask via syringe and add at a rate such that the internal temperature does not reach above −60° C. After the addition is complete, allow the reaction to stir at −25° C. for 30 min then cool to about −60° C. At this point, add a solution of 2-bromomethyl-1,3-dichloro-5-methoxy-benzene (7.76 g, 28.96 mmol) in THF (25 mL). After the addition is complete, the reaction vessel is allowed to slowly warm up to 0° C., and maintain the internal reaction temperature at 0° C. for 4 hr. Quench the reaction with 30 mL aqueous 1N hydrochloric acid. Transfer the mixture to a 500 mL separatory funnel and dilute with 100 mL water and 100 mL ether. Separate the layers and extract the aqueous layer with ether. Dry the combined organic phase over anhydrous sodium sulfate, filter and concentrate to give a thick oil. Purify by silica gel chromatography using hexanes:ethyl acetate to obtain 6.65 g, (76%) of a pale yellow oil.
Preparation 12
(R)-4-((R)-4-benzyl-2-oxo-oxazolidin-3-yl)-3-(4-methoxy-2,6-dichloro-benzyl)-4-oxo-butyraldehyde
Treat a mixture of (R)-4-benzyl-3-[(S)-2-(4-methoxy-2,6-dichloro-benzyl)-pent-4-enoyl]-oxazolidin-2-one (6.65 g, 14.87 mmol), tetrahydrofuran (140 mL) and water (45 mL) with 2.5% osmium tetroxide in t-butanol (378 mL, 1.487 mmol). Add sodium periodate (9.55 g, 44.63 mmol) and stir the reaction 4 hr at room temperature. Quench the reaction with water and extract with ethyl acetate. Wash the organic phase with aqueous 1N sodium thiosulfate then brine. Dry the organic layer over magnesium sulfate, filter, and concentrate under vacuum. Purify the crude material by silica gel chromatography using hexanes:ethyl acetate to elute the pure product. Concentrate the fractions containing product under vacuum to afford 3.35 g (49%) of desired product. MS (m/z): 451 (M+).
Preparation 16
(R)-3-(2,6-Dichloro-4-methoxy-benzyl)-1-piperidin-1-yl-pyrrolidin-2-one hydrochloride
Add to a solution of (R)-4-((R)-4-benzyl-3-[2-(4-methoxy-2,6-dichloro-benzyl)-pent-4-enoyl]-oxazolidin-2-one (0.90 g, 2 mmol) in THF (20 mL) at room temperature 1-amino piperidine (0.40 g, 4 mmol) and acetic acid (0.2 mL). Stir the reaction at room temperature for 20 minutes and add sodium triacetoxy borohydride (1.69 g, 8 mmol) and continue stirring at room temperature for 12 h. Partition the mixture between ethyl acetate (20 mL) and water (20 mL). Separate the organic layer, wash three times with water (15 mL each) and then with brine (15 mL). After drying the organic layer over sodium sulfate, filter and concentrate under vacuum. Purify the residue by silica gel chromatography with 2:3 ethyl acetate/hexane to afford the free base of the title compound and then treat with 1 M HCl in ether to afford 0.34 g (43%): MS (m/z): 357 (M+).
Preparation 17
(R)-3-(2,6-Dichloro-4-hydroxy-benzyl)-1-piperidin-1-yl-pyrrolidin-2-one
Cool a solution of 3-(2,6-dichloro-4-methoxy-benzyl)-1-piperidin-1-yl-pyrrolidin-2-one hydrochloride (0.27 g) in dichloroethane (10 mL) to −20° C. and add 1 M solution of boron tribromide in dichloromethane (2.5 mL). Stir the reaction at −20° C. for 1 hour and at room temperature 12 hours. Partition the mixture with dichloromethane (20 mL) and saturated sodium bicarbonate (15 mL). Separate the organic layer. After drying the organic layer over sodium sulfate, filter and concentrate under vacuum to afford 0.18 g (76%) of the title compound. MS (m/z): 343 (M+).
Preparation 13
(R)-Trifluoro-methanesulfonic acid 3,5-dichloro-4-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-phenyl ester
Treat a 0° C. solution of (R)-3-(2,6-dichloro-4-hydroxy-benzyl)-1-piperidin-1-yl-pyrrolidin-2-one (1.02 g, 2.98 mmol) and pyridine (2.4 g, 30 mmol) in CH2Cl2 (20 mL) with trifluoromethanesulfonic anhydride (2.69 g, 9.54 mmol) for 1 hour. Dilute the reaction with CH2Cl2 and wash with 1N HCl and water. Dry the organic layer (Na2SO4), remove the solvent, and purify the residue via silica gel chromatography to afford 0.65 g (46%) of the titled product. MS (m/z): 475 (M+).
Preparation 14
(R)-3′,5′-Dichloro-4′-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-biphenyl-4-carboxylic acid methyl ester
Bring a mixture of (R)-trifluoro-methanesulfonic acid 3,5-dichloro-4-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-phenyl ester (0.236 g, 0.5 mmol), 4-methoxycarbonylphenylboronic acid (0.134 g, 0.75 mmol), sodium carbonate (0.158 g, 1.5 mmol) in THF (20 mL) and water (5 mL) to 60° C. To the mixture at 60° C., add Pd(PPh3)4 (0.029 g, 0.025 mmol), then raise the reaction temperature to 80° C., and stir for 3 hours. Cool the reaction, dilute with ethyl acetate, and wash with water and brine. Dry the organic layer (Na2SO4), remove the solvent in vacuo to afford crude product, and purify on silica gel column with 25% to 50% ethyl acetate in hexanes gradient to afford 0.22 g (95%) of the titled product. MS (m/z): 461 (M+).
Preparation 15
(R)-3′,5′-Dichloro-4′-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-biphenyl-4-carboxylic acid
Treat a solution of (R)-3′,5′-dichloro-4′-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-biphenyl-4-carboxylic acid methyl ester (0.21 g) in THF (10 mL) with 5N NaOH (1 mL) and stir at 60° C. for 12 hours. Partition the mixture between ethyl acetate and water. Dry the organic layer (Na2SO4) and remove the solvent in vacuo to afford 0.19 g (93%) of the title compound. MS (m/z): 447 (M+).


EXAMPLE 1
(R)-3-[3,5-Dichloro-4′-(4-trifluoromethyl-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one




Treat a solution of (R)-3′,5′-dichloro-4′-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-biphenyl-4-carboxylic acid (0.090 g, 0.2 mmol) in CH2Cl2 (10 mL) with 1,1′-carbonyldiimidazole (0.065 g, 0.4 mmol) and stir for 1 hour at room temperature. Treat the reaction with 4-trifluoromethylpiperidine hydrochloride (0.057 g, 0.3 mmol) and diisopropylethylamine (0.039 g, 0.3 mmol) and stir for 12 hours at room temperature. Purify on silica gel column with 25% to 75% ethyl acetate in hexanes to afford 0.065 g (55%) of the title compound. MS (m/z): 582 (M+).
EXAMPLE 2
(R)-3-[3,5-Dichloro-4′-(4-hydroxy-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one




Treat a solution of (R)-3′,5′-dichloro-4′-(2-oxo-1-piperidin-1-yl-pyrrolidin-3-ylmethyl)-biphenyl-4-carboxylic acid (0.102 g, 0.228 mmol) in CH2Cl2 (10 mL) with 1,1′-carbonyldiimidazole (0.074 g, 0.457 mmol) and stir for 1 hour at room temperature. Treat the reaction with 4-hydroxypiperidine (0.065 g, 0.34 mmol) and diisopropylethylamine (0.044 g, 0.34 mmol) and stir for 12 hours at room temperature. Purify the mixture on silica gel column with 100% ethyl acetate and 10% methanol in dichloromethane to afford 0.107 g (89%) of the title compound. MS (m/z): 530 (M+).
In the following section enzyme and functional assays are described which are useful for evaluating the compounds of the invention.
11-β-HSD Type 1 Enzyme Assay
Human 11-β-HSD type 1 activity is measured by assaying NADPH production by fluorescence assay. Solid compounds are dissolved in DMSO to a concentration of 10 mM. Twenty microliters of each are then transferred to a column of a 96-well polypropylene Nunc plate where they are further diluted 50-fold followed by subsequent two-fold titration, ten times across the plate with additional DMSO using a Tecan Genesis 200 automated system. Plates are then transferred to a Tecan Freedom 200 system with an attached Tecan Temo 96-well head and an Ultra 384 plate reader. Reagents are supplied in 96-well polypropylene Nunc plates and are dispensed individually into black 96-well Molecular Devices High Efficiency assay plates (40 μL/well capacity) in the following fashion: 9 μL/well of substrate (2.22 mM NADP, 55.5 μM Cortisol, 10 mM Tris, 0.25% Prionex, 0.1% Triton X100), 3 μL/well of water to compound wells or 3 μL to control and standard wells, 6 μL/well recombinant human 11β-HSD type 1 enzyme, 2 μL/well of compound dilutions. For ultimate calculation of percent inhibition, a series of wells are added that represent assay minimum and maximum: one set containing substrate with 667 μM carbenoxolone (background), and another set containing substrate and enzyme without compound (maximum signal). Final DMSO concentration is 0.5% for all compounds, controls and standards. Plates are then placed on a shaker by the robotic arm of the Tecan for 15 seconds before being covered and stacked for a three hour incubation period at room temperature. Upon completion of this incubation, the Tecan robotic arm removes each plate individually from the stacker and places them in position for addition of 5 μL/well of a 250 μM carbenoxolone solution to stop the enzymatic reaction. Plates are then shaken once more for 15 seconds then placed into an Ultra 384 microplate reader (355EX/460EM) for detection of NADPH fluorescence.
Data for example compounds in the 11-βHSD1 assay are shown below:














Human




11-βHSD1


Example
Structure
IC50 (nM)







2




357









Compounds of the invention can also tested for selectivity against 11-βHSD2 in an assay similar to that described for 11-βHSD1, but using the 11-βHSD2 enzyme. The assay using the 11-βHSD2 enzyme can be carried out by the methods described herein and supplemented by methods known in the art.
Human Aortic Smooth Muscle Cell Assay
Primary human aortic smooth muscle cells (AoSMC) are cultured in 5% FBS growth medium to a passage number of 6, then pelleted by centrifugation and resuspended at a density of 9×104 cells/mL in 0.5% FBS assay medium containing 12 ng/mL hTNFα to induce expression of 11β-HSD1. Cells are seeded into 96-well tissue culture assay plates at 100 μL/well (9×103 cells/well) and incubated for 48 hours at 37° C., 5% CO2. Following induction, cells are incubated for 4 hours at 37° C., 5% CO2 in assay medium containing test compounds then treated with 10 μL/well of 10 μM cortisone solubilized in assay medium, and incubated for 16 hours at 37° C., 5% CO2. Medium from each well is transferred to a plate for subsequent analysis of cortisol using a competitive fluorescence resonance time resolved immunoassay. In solution, an allophycocyanin (APC)-cortisol conjugate and free cortisol analyte compete for binding to a mouse anti-cortisol antibody/Europium (Eu)-anti mouse IgG complex. Higher levels of free cortisol result in diminishing energy transfer from the Europium-IgG to the APC-cortisol complex resulting in less APC fluorescence. Fluorescent intensities for Europium and APC are measured using a LJL Analyst AD. Europium and APC excitation is measured using 360 nm excitation and 615 nm and 650 nm emission filters respectively. Time resolved parameters for Europuium were 1000 μs integration time with a 200 μs delay. APC parameters are set at 150 μs integration time with a 50 μs delay. Fluorescent intensities measured for APC are modified by dividing by the Eu fluorescence (APC/Eu). This ratio is then used to determine the unknown cortisol concentration by interpolation using a cortisol standard curve fitted with a 4-parameter logistic equation. These concentrations are then used to determine compound activity by plotting concentration versus % inhibition, fitting with a 4-parameter curve and reporting the IC50.
Data for the exemplified compounds in the human aortic smooth muscle cell assay are shown below:














IC50


Example
Structure
(nM)







1




16.8


 


2




10.4









Acute In Vivo Cortisone Conversion Assay

In general, compounds are dosed orally into mice, the mice are challenged with a subcutaneous injection of cortisone at a set timepoint after compound injection, and the blood of each animal is collected some time later. Separated serum is then isolated and analyzed for levels of cortisone and cortisol by LC-MS/MS, followed by calculation of mean cortisol and percent inhibition of each dosing group. Specifically, male C57BL/6 mice are obtained from Harlan Sprague Dawley at average weight of 25 grams. Exact weights are taken upon arrival and the mice randomized into groups of similar weights. Compounds are prepared in 1% w-w HEC, 0.25% w-w polysorbate 80, 0.05% w-w Dow Corning antifoam #1510-US at various doses based on assumed average weight of 25 grams. Compounds are dosed orally, 200 μl per animal, followed by a subcutaneous dose, 200 μl per animal, of 30 mg/kg cortisone at 1 to 24 hours post compound dose. At 10 minutes post cortisone challenge, each animal is euthanized for 1 minute in a CO2 chamber, followed by blood collection via cardiac puncture into serum separator tubes. Once fully clotted, tubes are spun at 2500×g, 4° C. for 15 minutes, the serum transferred to wells of 96-well plates (Corning Inc, Costar #4410, cluster tubes, 1.2 ml, polypropylene), and the plates are frozen at −20° C. until analysis by LC-MS/MS. For analysis, serum samples are thawed and the proteins are precipitated by the addition of acetonitrile containing d4-cortisol internal standard. Samples are vortex mixed and centrifuged. The supernatant is removed and dried under a stream of warm nitrogen. Extracts are reconstituted in methanol/water (1:1) and injected onto the LC-MS/MS system. The levels of cortisone and cortisol are assayed by selective reaction monitoring mode following positive ACPI ionization on a triple quadrupole mass spectrophotometer.
Data for example compounds in the acute in vivo cortisone conversion assay are shown below:














% Inhibition after




16 hours




(dose of 10


Example
Structure
(mg/kg))







1




78









Pharmaceutically acceptable salts and common methodology for preparing them are well known in the art. See, e.g., P. Stahl, et al., HANDBOOK OF PHARMACEUTICAL SALTS: PROPERTIES, SELECTION AND USE, (VCHA/Wiley-VCH, 2002); S. M. Berge, et al., “Pharmaceutical Salts,” Journal of Pharmaceutical Sciences, Vol. 66, No. 1, January 1977. The compounds of the present invention are preferably formulated as pharmaceutical compositions administered by a variety of routes. Most preferably, such compositions are for oral administration. Such pharmaceutical compositions and processes for preparing same are well known in the art. See, e.g. REMINGTON: THE SCIENCE AND PRACTICE OF PHARMACY (A. Gennaro, et al., eds., 19th ed., Mack Publishing Co., 1995).
The particular dosage of a compound of formula (I) or a pharmaceutically acceptable salt thereof required to constitute an effective amount according to this invention will depend upon the particular circumstances of the conditions to be treated. Considerations such as dosage, route of administration, and frequency of dosing are best decided by the attending physician. Generally, accepted and effective dose ranges for oral or parenteral administration will be from about 0.1 mg/kg/day to about 10 mg/kg/day which translates into about 6 mg to 600 mg, and more typically between 30 mg and 200 mg for human patients. Such dosages will be administered to a patient in need of treatment from one to three times each day or as often as needed to effectively treat a disease selected from those described herein.
One skilled in the art of preparing formulations can readily select the proper form and mode of administration depending upon the particular characteristics of the compound selected, the disorder or condition to be treated, the stage of the disorder or condition, and other relevant circumstances. (Remington's Pharmaceutical Sciences, 18th Edition, Mack Publishing Co. (1990)). The compounds claimed herein can be administered by a variety of routes. In effecting treatment of a patient afflicted with or at risk of developing the disorders described herein, a compound of formula (I) or a pharmaceutically acceptable salt thereof can be administered in any form or mode that makes the compound bioavailable in an effective amount, including oral and parenteral routes. For example, the active compounds can be administered rectally, orally, by inhalation, or by the subcutaneous, intramuscular, intravenous, transdermal, intranasal, rectal, ocular, topical, sublingual, buccal, or other routes. Oral administration may be preferred for treatment of the disorders described herein. In those instances where oral administration is impossible or not preferred, the composition may be made available in a form suitable for parenteral administration, e.g., intravenous, intraperitoneal or intramuscular.

## Claims

1. A compound structurally represented by the formula:



or a pharmaceutically acceptable salt thereof, wherein
R1 is —H or -halogen;
R2 is
—H or -halogen;

R3 is
—H or -halogen;

R4 is —H or -halogen;
R5 is





; wherein the dashed line represents the point of attachment to the R5 position;
wherein n is 1;

R9 is
—H, —OH, -halogen, —CH3 (optionally substituted with 1 to 3 halogens), or —O—CH3 (optionally substituted with 1 to 3 halogens);

R10 is independently at each occurrence —H, or -halogen;
R22 is independently at each occurrence —H, or —(C1-C6)alkyl(optionally substituted with 1 to 3 halogens).

2. A compound of claim 1 wherein R1 is —H; R2 is -chlorine; R3 is -chlorine; and R4 is —H, or a pharmaceutically acceptable salt thereof.

3. A compound of claim 2 wherein R5 is



R9 is —H, or -halogen; and
R10 is independently at each occurrence —H or -halogen;
or a pharmaceutically acceptable salt thereof.

4. A compound of claim 2 wherein R5 is




or a pharmaceutically acceptable salt thereof.

5. A compound of claim 2 wherein R5 is




or a pharmaceutically acceptable salt thereof.

6. A compound that is (R)-3-[3,5-Dichloro-4′-(4-trifluoromethyl-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one, or a pharmaceutically acceptable salt thereof.

7. A compound that is (R)-3-[3,5-Dichloro-4′-(4-hydroxy-piperidine-1-carbonyl)-biphenyl-4-ylmethyl]-1-piperidin-1-yl-pyrrolidin-2-one, or a pharmaceutically acceptable salt thereof.

8. A pharmaceutical composition which comprises a compound of claim 1, or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.

9. A method for treating type 2 diabetes in a patient in need thereof which comprises administering to said patient an effective amount of a compound of claim 1, or a pharmaceutically acceptable salt thereof.

10. An intermediate for preparing a compound of claim 6 wherein the intermediate is