USE OF OXAZOLIDINONE DERIVATIVES FOR TREATING PSORIASIS, ARTHRITIS AND REDUCING THE TOXICITY OF CANCER CHEMOTHERAPY

Abstract: The present invention is a method of treating a person who has psoriasis or arthritis or reducing the toxicity of cancer chemotherapy which comprises administering to the patient an anti-psoriasis effective amount of an oxazolidinone, preferably (S)-N-[[3-[3-fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5-oxazolidinyl]methyl]acetamide.

Description: USE OF OXAZOLIDINONE DERIVATIVES FOR TREATING PSORIASIS, ARTHRITIS AND REDUCING THE TOXICITY OF CANCER CHEMOTHERAPY 1. Field of the Invention The present .invention is the use of known o.xazo.lidLnones to treat psoriasis, ai-ώritis and to reduce the tojάcity of cancer chemotherapy. 2. Description of the R . elated .Art US Patents 5,164,510, 5,231,188, 5,565,571, 5,652,238 and 5,688,792 all disclose various oxazohtϋnone antibiotics which are well .known to those sl Ued in. the art. Psoriasis is a we.ll .known condition, a pro.liferative disease of the slάn of urd∑nown etiology. It is not laiown, or beUeved, to have a microbiologic cause. Problem. s e.xperienced by those suffer. ing with psoriasis .include intense itctung .and discomfort, unsightly sldn ble.mishes and chrome scratching resulting skin .ύifections. At present there are no cures, only methods of deahng with the cU <^l symptoms e.xperienced by the patients. These methods of treatment .include avoidaing d.rying of the sldn and * uτitation of sldn, use of topical steroid cremes and ointments, use of crude coal tar (1-5% in .an ointment base) applied topically, ultraviolet light therapy, topical vitamin D (calcipitriol), oral methotrexate for severe cases (a drawback to this therapy is that methotrexate causes severe hver damage if not careM), use of etretrinate (a synthetic retinoid) for severe cases (however a drawback to this therapy i .s that it is .associated with severe deformities m fetuses if a female patient is pregnant). There is no cure for psoriasis, but rather treatments which may induce a remission for a period of time. Since the pathogenesis of psoriasis is unlmown, the reason why the various treatments do not .fully succeed is not known but it is .likely that present treatments are not treating the root cause of psoriasis. WMle there are number of phaπnaceutical agents available for treating psoriaSais, none treat the condition/disease as weU as psoriasis sufferers or physicians would .Hke. Arthritis, inflammation of the joint tissues, has numerous causes including bacterial ."infection (septic artliritis), degeneration of .articular surfaces (osteoartliritis), immunologic reaction against joint tissues (rheumatoid arthritis), crystal induced .artliritis (gouty arthritis, pseudogout) and other misceU.aneous causes (.Reite.r's syndrome, etc). One common thread all of these is inflammation in and around the joint. Present day therapeutics for art-hritis are not curative unless the arthritis is infectious and the underlying pathogen is eliminated by an antibiotic. For other types of arth. ritis medications can reduce pain or inflammation but do not cure the disease. The OXAZOL.LD.INO.NEs can be used to treat the inflammation and pain caused by arthritis, including those types of arthritis which are not caused by infection. This is important since all of the medications presently available to treat arthritis have severe side effects. Steroidal medications (glucocorticoids like prednisone and cortisol) give stomach ulcere, cataracts, reduced resistance to infection, weight gain and thinning of sldn. Non-steroidal anti-inflammatory drugs (NS.AIDS such as indomethacin or ibuprofen among other's) can cause stomach ulcers, reduced kidney function .and bone marrow effects. Chemotherapeutic agents (like methotrexate) can have severe adverse effects on bone maιτow and liver function. The OX- AZOL.IDL. NO.NEs provide the oppor. tunity for relief of symptoms of inflammation for patients intolerant of other types of arthritis medications. Patients who have cancer and need to undergo anti-cancer chemotherapy have the problem that the dose .limiting factor in their treatment is the suppression of bone marrow. The present invention prevents and reduces the amount of suppression of bone marrow and injury to intestinal crypt cells (the cells that produce new intestinal cells). By preventing damage to the hematopoietic ceUs in gene.ral and the bone marrow cells in particular, physicians can prevent or reduce the toxicity of the chemotherapeutic agents and therefore can treat cancer patients longer and/or with higher doses and with reduced risks of complications. .All this means a more successful outcome for the patient. At present there is no product on the market that prevents damage to hematopoietic and/or intestinal cells from exposure to anti-cancer chemotherapeutic .agents. There are products which .are given after anti-cancer chemotherapy to try and help the patient recover, but this is not the same as the preventive method of the present i .nvention. These agents include bone marrow colony stimulating factors such as GM-CSF. There are protective agents known, but not in clinical use, for dealing with radiation therapy such as glutatliione derivatives, but these do not prevent the problems associated with anti-cancer chemotherapy. SUMM^Y OF INVENTION Disclosed is a method of treating a person who has psoriasis which comp.rises administeiing to the patient an anti-psoriasis effective amount of an oxazolidinone selected from the group consisting of: (S)-N-[[3-[3-fluoro-4-[4-(hydro3cyacetyl)-l-piper^inyl]-phenyl]-2-oxo-5- ox. azoHd yl]methyl]acetamide, (S)-N-[[3-[3-fluoro-4^(4-mo.rpholinyl)phenyl]-2-oxo-5- αxazOalidinyUmethyljacetamide, [4(S)-cis]-(-)-N-[[3-[3-Fluoro-4-(tetrahydro-l-oxido-2H-thiopyran-4-yl)phenyl]-2- oxo-5-oxazohdinyl]methyl]acetamide, N-((5S)-3-(3-fluoro-4-(4-(2-fluoroethyl)-3-oxopiperazin-l-yl)phenyl)-2- oxooxazolidin-5-ylmethyl)acetamide, (S)-N-[[3-[5-(3-pyridyl)thiophen-2-yl]-2-oxo-5-oxazoHdinyl]methyl]acetemide and (5)-N-[[3-[5-(4-pyridyl)pyrid-2-yl]-2-oxo-5-ox. azolidinyl]methyl]acetømide and pharmaceutically acceptable salts thereof. Also disclosed is a method of treating a pe * rson who has art.hritis which compiises administering to the patient an anti-arthritis effective .amount of an oxazolidainone selected from the group consisting of the six oxazolidinones set forth above. Further disclosed is a method of reducing damage to hematopoietic ceUs and intestinal ceUs in a person beώg treated with one or more anti-cancer chemotherapeutic agents which compiises administering to the human an anti- cytotoxic effective amount of an oxazolidinone selected from the group consisting of the sxi oxazolidinones set forth above. DETAILED DESCRIPTION OF THE INVENTION The oxazolidinones of the present invention are .known, see E.XAMP.LES 1 thru 6 (OXAZOLIDINONEs) and pharmaceutically acceptable salts thereof. Suitable pharmaceutical acceptable salts include the acid addition salts from the both inorganic and organic acids including hydrochloric, hydrobromic, sulfiiric, phosphoric, sulfonic acids, methanesulfonic, ghiconic, galacturonic, citratic, ox. ylatic and acetic. It is preferred that the person being treated for psoriasis or arthritis or with cancer chemotherapy agents with OXAZOLIDINONEs does not have a gram positive bacterial infection at the time of be g treated. In treating psoriasis, the OXAZOLIDINONEs can either be used individually or in combination with each other or combination with non-OXAZOL.LDLNONEs. In treating psoriasis, the OX. AZOLIDL. NONEs .are administered orally, parenterally (TV), topically or rectally. When administered orally, the OXAZOLLDINONEs can be administered in tablet, capsule or liquid (suspension, syrup or solution) dosage form. Regardless of the dosage form, an anti-psoriasis effective amount of the OX ^ZOLI. DINONEs is from about 50 mg to about 1,200 mg/day. It is preferred that the OXa AZOLIDINONEs be given in two or more divided doses, more preferably in two divided doses. When administered parenterally, the OXAZOLTOINONEs should be admiiύstered IV. The IV infusion should be adjusted such that the flow rate delivera an anti-psoriasis effective amount of from about 50 mg to about 1,200 mg day. (S)-N-[[3-[3-Fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5- ox. azolidinyl]methyl]acetaιmde is vύ ually 100% bioavailable. Therefore, the patient will acMeve approx. imately the same blood levels with the same dose regardless of whether it is given orally of parenterally. When applied topically, the OX. AZOL. JDI. NON. ES can be applied in many different phairmaceutical dosage forms all well known to those skilled in the art. These include as a solution, cream, ointment, gel, lotion, suspension or emulsion, etc. Regardless of the topical pharmaceutical dosage form selected, the concentration of the O.XAZOLIDINO.NES should be from about 0.01% to about 10% (wt/wt). .Regardless of the pharmaceutical dosage form, the topical formulation should be apphed one to four times dafly. When administered rectally, the O.XAZOLIDINONEs should be administered as a suppository which delivers an anti-psoriasis effective amount of from about 50 mg to about 1,200 mg day. When administered systemically, whether orally, parenterally or rectally the OaXAZOLIDINONEs should be ad.ministered either continuously or m cyclic courses of 7-28 days every 1 to 12 months. When administered topically, the O.XAZOLID.INO.NES should be applied either daily for 7 to 28 days every 1 - 12 months. In treating artliritis, the OXAZOLIDINONEs can either be used individually or in combination with each other or in combination with non-O.XAZOI DINONEs. In treating artiiritis, the OXAZOL-LDINONEs are administered orally, parenterally (TV), topically or rectally. When administered orally, the O.X^OLIDINONEs can be administered in t-ablet, capsule or liquid (suspension, syrup or solution) dosage form. .Regardless of the dosage form, .an anti-artliritis effective .amount of the OXAZOL.IDINONEs is from about 50 mg to about 1,200 mg day. It is prefeired that the OXa AZOLIDINONEs be given in two or more divided doses, more preferably in two divided doses. When administered parenterally, the OXi-iZOL.IDINO.NEs should be administered IV. The IV infusion should be adjusted such that the flow rate delivere an anti-arthritis effective amount of from about 50 mg to about 1,200 mg/day. This can be done by a continuous infusion, or as divided doses given as short term infusions of 30-90 minutes, preferably twice a day. When applied topically, the OXAZO.LIDINO.NEs can be applied in many different pharmaceutical dosage forms all well .known to those sltiUed in the art. These include a solution, cream, ointment, gel, lotion, suspension or emulsion. Regardless of the pharmaceutical dosage form selected, the concentration of the O.XAZOLIDINONEs should be from about 0.01% to about 10% (wt wt). Regardless of the pharmaceutical dosage form, the topical formulation should be applied one to four times daily. When administered rectally, the OXAZOLffilNONEs should be adniiiiistered as a suppository wliich delivers an anti-arthritis effective amount of from about 50 mg to about 1,200 mg/day. When administered systemically, whether orally, parenter.ally or rectally the QXAZOL.LDINO.NEs should be administered either continuously or in cyclic courses of 7-28 days every 1 to 12 months. When administered topically, the O.XAZOLIDINONEs should be applied either daily for 7 to 28 days every 1 - 12 months. The exact dosage and frequency of admimstration depends on the particular OaXt-vZOLIDINONE used, the severity of the condition being treated, the age, weight, general physical condition of the particular patient, other medication the individual may be taking as is weU known to those skilled in the art and can be more accurately determined by measuring the blood level or concentration of the OXAZOLaLDINONE in the patient's blood and/or the patient's response to the parti-mlar condition being treated. .Individuals who have cancer and are treated with anti-cancer chemotherapeutic agents e-Eperience damage to their hematopoietic and mtestin^ cells. There are three types of hematopoietic cells. These are bone marrow cells, spleen cells and liver cells. It is prefeired that the hematopoietic cells be bone marrow ceUs. The present method also prevents reduces damage to intestinal crypt cells. These are the cells located in the intestinal area that produce new intestinal cells. By preventing damage to the hematopoietic cells in general and the bone marrow cells in particular, physicians can prevent or reduce the toxicity of the chemotherapeutic agents and therefore can treat cancer patients longer and or with higher doses and with reduced ήsks of complications. .All this means a more succesSaful outcome for the patient. In preventing/reducing the damage to hematopoietic ce.Us and intestinal cells from ejφosure to anti-cancer chemotherapeutic agents, the OXAZOLIDINONEs can either be used individually or in combination with each other or in combination with non-OXAZOLIDINONEs. In some cases the present method will prevent the damage from occurring and in other cases it will reduce the damage that would have occurred if the patient had not been treated with the OXAZO.LIDINO.NEs. As used here, reduction is a fo.rm of prevention; prevention is the ultimate reduction. The present method is practiced by preferably pre-treating the patient for about 2 to about 20 days prior to the patient being treated with an anti-cancer chemotherapeutic agent. It is more preferable that the pretreatment be from about 5 to about 7 days prior to the patient being treated with an anti-cancer chemotherapeutic agent. .Alternatively, the OXAZOLIDINONEs can be administered concurrently with the anti-cancer chemotherapeutic agent. .Anti-cancer chemotherapeutic agents which are included in the method of reducing damage according to the present invention .are selected from four d.ifferent types of chemotherapeutic agents. These are: (1) DNA-.interactive agents (including alkylating agents, DNA strand- breakage agents, DNA topoisomerase I and II inhibitors, DNA minor groove binders) such as chlorambucil, cyclophosphamide, thiotepa, busulfan, carmustine, cisplatin, carboplatin, mitomycin, procarbazine, bleomycin, amsacrine, dauno.rubicin, doxorubicin, etoposide, plicamycin, campothecin and ironotecan; (2) .antimetabo.lites (including folate .antagonists, purine antagonists, pyriinidine antagonists) such as methotrexate, mercaptopurine, elojαiridine and fluorouracil; (3) tubulin-interactive agents such as vinblastine, vincristine and paclitaxel; (4) hoπnonal agents such as dienestrol, diethylstilbestrol, estradiol, tamo-αfon and fluOaXymesterone. It is prefe.rred that the anti-cancer chemotherapeutic agent be selected from the group consisting of chlorambucil, cyclophosphamide, thiotepa, busnlfam, carmustine, cisplatin, carboplatin, mitomycin, procarbazine, bleomycin, amsacrine, daunorubicin, doxorubicin, etoposide, plicamycin, camptothecin, ironotecan, methotrβa ate, mercaptopurine, elαxuridine, fluorouracil, vinblastin, vincristine, pacHtaxel, dienestrol, diethylstilbestrol, estradiol, tamo.xifon and fluo.xymesterone. It is more preferred that the anti-cancer chemotherapeutic agent be selected from the group consisting of etoposide, irinotecan, fluorouricil and paclitaxel. In preventin^reducing the damage to hematopoietic cells and intestinal cells from exposure to anti-cancer chemotherapeutic agents, the OXAZOL.ID.INONEs are administered orally, parenterally (TV) or rectaUy. It is prefeιτed that the OX. AZO.HDI, NONEs be administered orally or by TV, more preferably orally. When administered orally, the OXAZOLIDLNQNEs can be administered in soHd (tablet or capsule) or .liquid (suspension, syrup or solution) dosage form. Regardless of the dosage form, a cytostatic or an anti-cytotoxic effective amount of the OXAZOLIDINONEs is from about 50 mg to about 1,200 mg/day. It is preferred that the OXAZOL.LD.INONEs be given in two or more divided doses, more preferably in two divided doses. When administered parenterally, the O.XAZOLID.LNO.NEs should be administered IV. The TV infasion should be adjusted such that the flow rate delivers an anti-cytotoxic effective amount of from about 50 mg to about 1,200 mg/day. This can be done by a continuous infusion, or .as divided doses given as short term infusions of 30-90 minutes, preferably twice a day. When administered rectally, the O.XAZOL.ID.INONES should be administered as a suppository which dehvers an anti-cytotoxic effective amount of from about 50 mg to about 1,200 mg day. When administered systemically, whether orally, parenterally or rectally the should be administered either continuously or in cyclic courses of 7-28 days ever. y 1 to 12 months. The exact dosage and frequency of administration depends on the particular OXAZOL.IDINONE used, the particular anti-cancer chemotherapeutic agent used, the dose of the anti-cancer chemotherapeutic agent, the severity of the condition being treated, the age, weight, general physical condition of the particular patient, other medication the individual may be taking as is well .known to those skilled in the art and can be more accurately dete * rmined by measuring the blood level or concentration of the OXAZOLIDINO.NE in the patient's blood and/or the patient's response to the particular condition being treated. DEFalNITIONS A3STD CONVENTIONS The defi. nitions and e.xplanations below are for the terms as used throughout this entire document including both the specification and the claims. DEFINITIONS Pharmaceutically acceptable refera to those properties and/or substances which are acceptable to the patient from a pharmacological/to.xicological point of view and to the manufacturing pharmaceutical chemist from a physical chemical point of view regarding composition, formulation, stability, patient acceptance and bioavailability. When the solubility of a solid in a solvent is used the ratio of the solid to the solvent is weightvolume (wt v). When the % active ingredient of a pharmaceutical fo.rmulation is set forth, it is the ratio of the active ingredient of the entire pharmaceutteal formulation and is expressed as weight weight (wt wt). Alcohol refere to ethyl alcohol. IV refers to parenteral administration by the intravenous route. OXAZO.LJDINONES refers to the compounds of EaXAJMPLES 1 thru 6. Anti-cytotoxic refers to reducing and/or preventing normal ceU death. EXAMPLES Without further elaboration, it is believed that one sltilled in the art can, using the preceding description, practice the present invention to its fullest extent. The following detailed examples describe how to prepare the vstrious compounds and/or perform the various processes of the invention .and are to be construed as merely illustrative, and not limitations of the preceding disclosure in any way whatsoever. Those slriUed in the art will promptly recognize appropriate variations from the procedures both as to reactants and as to reaction conditions and techniques. EXAMPLE 1 (S)-N-[[3-[3-Muoro-4-[4-(hydrox. yacetyl)- l-piperazinyl]-phenyl]-2- oxo-5-oxazoHdinyl]methyl]acetamide (S)-N-[[3-[3-Fluoro-4-[4-(hydro^acetyl)-l-piperazinyl]-phenyl]-2-oxo-5- oxazolidinyl]methyl]acetamide is known, see US Patent 5,652,238, EX. AMPLE 1. .EXAMP.LE 2 (S)-N-[[3-[3-Fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5- ox. azoUdi.nyl]methyl]acetamide (S)-N-[[3-[3-πuoro-4-(4-moιpholinyl)phenyl]-2-oxo-5- oxazolidinyl]methyl]acetamide is k . nown, see US Patent 5,688,792, EXAMP.LE 5. EXAMPLE 3 [4(S)-cis3-(-)-N-[[3-[3-Fluoro-4-(tetrahydro-l-o3ddo-2H-thiopyran- 4-yl)phenyl]-2-oxo-5-oxazolidinyl]methyl]acetamide A mixture of (S)-(-)-N-[[3-[3-fluoro-4-(3,6-dihydro-2H-thiopyran-4-yl)phenyl]-2- oxo-5-oxazolidinyl]methyl]acetamide S-oade (International Publication No. WO 97/09328, 4.50 g) and platinum o-dde (697 mg) in methanol (164 ml) is shaken on the Paιτ apparatus under a hydrogen atmosphere at 40 psi for 18 hours. The catalyst is then removed by filtration through Celite, and the filtrate is concentrated under reduced pressure and the residue chromatographed on silica gel (230 - 400 mesh, 350 g), eluting with a gradient of methsuiol/methylene chloride (3/97 - 7/93). The appropriate fractions (those fractions with an Rf = 0.44 by TLC; methanol/cMoroform, 10/90) are pooled and concentrated to give the title compound, mp 203 - 204°. EXAMP.LE 4 N-((5S)-3-(3-Fluoro-4-(4-(2-fluoroethyl)-3-oxopiper.azin-l- yl)phenyl)-2-oxooxazolidin-5-ylmethyl)acetamide N-((5S)-3-(3-Fluoro-4-(4-(2-fluoroethyl)-3-oxopiperazin-l-yl)phenyl)-2- oxooχ.azoHdin-5-ylmethyl)acetamide is known, see International .Pub.lication WO97/27188 (Example 4). l^Buto.xycarbonyl-3-oxopiperazine (21.6 g) is dissolved in dry DMF (500 ml) and potassium t-butαxide (24.2 g) is added. The mixture is stirred at 20-25° for 30 πnnutes, then l-(4-methylphenylsulfonylox. y)-2-fluoroethane (J. Med. Chem., 23(9), 985-90 (1980), 25.9 g) is added and stirring continued at the same temperature for 24 hours. The solvent is removed and the residue partitioned between ethyl acetate and water. The organic phase is washed with water and concentrated. The residue is dissolved in isopropanol and diluted with iso-hexane forming a precipitate which is removed by filtration. The mixture is chromato.graphed (silica; eluting with a gradient increasing in polarity from 0 to 50% isopropanol in iso-hexane) to give 1-t- butoxycarbonyl-4-(2-fluoroethyl)-3-oxopiperaz.ine. l-^ButoaXycarbonyl-4-(2-fluoroethyl)-3-oxopiperazine (6.65 g) is dissolved in dichloromethane (500 ml), cooled in an ice-bath and tiifluoroacetic acid (150 ml) added. The mixture is stirred at the same temperature for 2 hours. The solvent is removed to give a crude product which is dissolved in the minim"™ volume of ethyl acetate. Slow addition of ether causes precipitation of l-(2-fluoroethyl)-2- oxopiperaz.ine as the mono tiifluoroacetic acid salt. l-(2-Fluoroethyl)-2-oxopiperazine trifluoroacetate (6.1 g) is dissolved in acetonitrile (100 ml). N,N-Dϋsopropylethyl.amine (13 ml) is added to the mixture, followed by 3,4-difluoronitrobenzene (3.39 g) and the mixture heated to reflux for 18 hours. The solvent is removed and the residue chromatographed (s.ilica; eluting with a gradient increasing in polarity from 0 to 4% methanol in dichloromethane) to give 3-fluoro-4-(4-{2-fluoroethyl}-3-oxopiperazin-l-yl)nitrobenzene. 3-Fluoro-4-(4-{2-fluoroethyl}-3-oxopiperazin-l-yl)nitrobenzene (4.35 g) is dissolved in a mixture of ethyl acetate (250 ml) and D.MF (5 ml), and the solution flushed with argon. Palladium (10% on carbon, 200 mg) is added and the πώrture hydrogenated under ambient pressure. .After gas uptake had ceased, the mixture is .filtered through celite and solvent removed. The residue is taken up in ethyl acetate, washed twice with water, dried over magnesium sulfate and the solvent is removed to give 5-amino-2-[4-(2-fluoroethyl)-3-oxopiperazin-l-yl]fluorobenzene wMch is used without f . urther purification. 5-Amino-2-(4-[2-fluoroethyl]-3-oxopiperazin-l-yl)fluorobenzene (2.6 g) is dissolved in diy dichloromethane (50 ml) under argon. P . yridine (1.03 ml) is added, and the mixture cooled to -20°. Benzyl chloroformate (1.6 ml) is added and the mixture stirred for 10 minutes at -20°, before allowing the temperature to rise to 20- 25° over 1.5 hours. The solvents are removed and the residue is di.ssolved in dichloromethane and washed with sodium bicarbonate solution. After drying over magnesium sulfate and removal of the solvent, the residue is chromatographed (silica, eluting with a gradient increasing in polarity from 0 to 5% methanol in dichloromethane) to give 5-benzylox. ycarbonylamino-2-(4-[2-fluoroethyl]-3- oxopiperazin- l-yl)fluorobenzene. A solution of lithium is prepared by addition of n-butyllithium (1.6 M in hexane, 2.9 ml) to a stirred solution of t-butanol (0.43 g) in anhydrous THF (10 ml) at -10° under argon. After cooling to -70°, a solution of 5- benzyloxycarbonylamino-2-(4-[2-fluoroethyl]-3-oxopiperazin-l-yl)fluorobenzene (1.5 g) in dry THF (15 ml) is added. After 10 minutes, (R)-glycidylbutyrate (0.67 g) in dry THF (15 ml) is added to the resulting mixture, and stirring continued at -70° for 15 minutes, before aUowing the temperature to rise to 20-25° over 16 hours. Methanol (10 ml) is added, followed by saturated sodium bicarbonate solution (20 ml) and water (10 ml). The organic phase is separated and ejctracted into ethyl acetate (3 x 25 ml), washed with saline and dried over magnesium sulfate. The solvent is removed and the residue purified by chrαmatography (silica; eluting with a gradient increasing in polarity from 0 to 3% methanol in dichloromethane) to give (5R)-3-(3- fluoro-4-[4-(2-fluoroethyl)-3-oxopiperazin-l-yl]phenyl)-5-hydro3cymethylox. £izolidin-2- one. (5R)-3-(3-Fluoro-4-[4-(2-fluoroethyl)-3-oxopiperøin-l-yl]phenyl)-5- hydrox. ymethyloxazolidin-2-one (0.8 g) is dissolved in pyridine (15 ml) and the mixture cooled to 0°. Triethylamine (0.38 ml) .and methanesulfonyl chloride (0.19 ml) are added to the mixture, and stirring continued at 20-25° for 2 hours. The solvent is removed and the residue dissolved in dichloromethane, washed with water, saline, dried over magnesium sulfate and concentrated. The resulting residue is triturated with ether to give (5R)-3-(3-fluoro-4-[4-(2-fluoroethyl)-3-oxopiperazm-l- yl]phenyl)-5-(meth.anesulfonyloxymethyl)oxazohdin-2-one (0.76 g) which is used without further purification. (5R)-3-(3-Muoro-4-[4-(2-fluoroethyl)-3-oxopiperazin-l-yl]-5- (methanesulfonyloxymethyl)oxazolidin-2-one (719 mg) is dissolved in dry D.MF (15 ml) .and sodium azide (647 mg) is added to the mixture. The mixture is heated at 80° for 6 hrs and then concentrated to dryness. The resulting residue is dissolved in ethyl acetate, washed twice with water, and dried over magnesium sulfate. R . emoval of the solvent gives (5R)-5-azidomethyl-3-(3-fluoro-4-(4-(2-fluoroethyl)-3-oxopiper.azin- (413 mg) wliich is used without further purification. (5R)-5-Azidomethyl-3-(3-fluoro-4-[4-(2-fluoroethyl)-3-oxopiper£izin-l- yl]phenyl)oxazolidin-2-one (360 mg) is dissolved in dry D.MF (20 ml) and the mixture purged with .argon. Palladium (10% on carbon, 72 mg) is added, followed by acetic anhydride (0J7 ml) and the mύrture stirred at 20-25° under hydrogen confined in a balloon for 3 hr. The mixture is .filtered through cehte, concentrated to dryness and partitioned between ethyl acetate and water. The organic e.xtract is washed with sa e, dried over magnesium sulfate and concentrated. The residue is chromatographed (silica gel; eluting with a gradient increasing in polarity from 0 to 2.5% methanol/diCahloromethane). The appropriate fractions are pooled and concentrated to give the title compound. .13X.AMPLE 5 (S)-N-[[3-[5-(3-Pyridyl)thiophen-2-yl]-2-oxo-5- ox.azohdinyl]methyl3acetamide (5)-N-[[3-[5-(3-Eyridyl)thiophen-2-yl]-2-oxo-5-ox^olidinyl3methyl]acetamide is .known, see US Patent 5,698,574 (Example 124). EXAMPLE 6 (S)-N-[[3-[5-(4-Pyridyl)pyrid-2-yl]-2-oxo-5- oxazolidinyl]methyl]acetamide hydrochloride (S)-N-[[3-[5-(4-Pyridyl)pyrid-2-yl]-2-oxo-5-oxazolidinyl]methyl]acetamide hydrochloride is prepared following the general procedure of US Patent 5,627,181 EXAMPLa Es 36 and 52 and making non-critical variations but using a 4-pyridinyl adduct. EXAJMPLE A 47 Year Old White Male - Psoriasis A 47 year old white male had a history of psoriasis since age 32. He had chronic psoriatic lesions of both elbows, groin, left leg, right leg, and lower back. The lesions were treated in the past with coal tar and topical steroids but not UV light. He was alle.rgic to the excipients in the steroidal topical preparations. He was treated with 625 mg of (S)-N-[[3-[3-fluoro-4-(4-moιτ)holinyl)phenyl]-2- oxo-5-oxazolidinyl]methyl]acetamide IV twice daily for five days and then with 625 mg of the same pharmaceutical orally twice daily for nine days. Hence, the patient was given 625 mg of (S)-N-[[3-[3-fluoiO-4-(4-morpholinyl)phenyl]-2-oxo-5- o.xazolidinyl]methyl]acetamide twice daily for fourteen days and noticed an immediate improvement in his psoriasis as soon as he started taking the medication. He had a complete clearing of the psoriasis from the time he took the medication until three months later when it gradually began to return. .After six months it had returned to the pretreatment state. .During the time he took the oxazolidinone he did not use any other psoriasis treatment. EXAMPLE B 50 Year Old White Male - Arthritis A 50 year old white male (Subject No 19.12) who had a histoi of chronic obstructive pulmonary disease (i.e. he was a smoker), hypertension, coronary artery disease and arthritis of the "legs, arms and shoulders" for which he took non ste.roid.al antiinflammatory agents including aspirin, developed community acquired pneumonia with Streptococcus pneumoniae as evidenced by an abnormal chest X-ray. He is treated with 625 mg of (S)-N-[[3-[3-fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5- oxazolidinyl]methyl]acetamide twice d-rily intravenously for 3 days followed by 8 days of oral (S)-N-[[3-[3-fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5- αxazo.lidinyl]methyl]acetaιnide at the same dose. At long term follow up the patient stated that his arthritis was gone and he was taking no medications. CHART A EXAMPLE 1 15 EXAMPLE 2 20 25 EXAMPLE 3 30 CHART A - continued EXAMPLE 4 10 15 EXAMPLE 5 20 EXAMPLE 6 30

Claims: CLAIMS 1. Use of an oxazolidinone selected from: (S)-N-[[3-[3-fluoro-4-[4-(hydro * xyacetyl)-l-piperazinyl]-phenyl]-2-oxo-5- oxazolidinyl]methyl]acetamide, (S)-N-[[3-[3-fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5- oxaaolidinyl]methyl]acetamide, [4(S)-cis]-(-)-N-[[3-[3-fluoro-4-(tetrahydro-l-oxido-2H-thiopyran-4-yl)phenyl]-2- oxo-5-oxazolidinyl]methyl]acetamide, N-((5S)-3-(3-fluoro-4-(4-(2-fluoroethyl)-3-oxopiper.azin-l-yl)phenyl)-2- oxooχ.azolidin-5-yhnethyl)acetamde, (S)-N-[[3-[5-(3-pyridyl)thiophen-2-yl]-2-oxo-5-oxazolidinyl]methyl]acetamide and (S)-N-[[3-[5-(4-pyridyl)pyrid-2-yl]-2-oxo-5-oxazolidinyl]methyl]acetamide and pharmaceutically acceptable salts thereof for the manufacture of a medicament for use in treating psoriasis where the human to be treated does not have a gram positive bacterial infection. 2. Use of an oxazolidinone according to claim 1 where the medicament is administered oraUy. 3. Use of an oxazolidinone according to claim 2 where the d.aily dose of the Oa saαlidianone .is from about 50 to about 1,200 mg day. 4. Use of an o.xazolid.inone according to claim 1 where the medicament .is administered topically as a solution, cream, ointment, gel, lotion, suspension or emulsion. 5. Use of an oxazolidinone according to claim 1 where the amount to be administered topically is from about 0.01% to about 10%. 6. Use of an o.xazolidinone according to claim 1 where the medicament is administered TV. 7. A method of treating a person who has psoriasis accor-chng to claim 7 where the amount to be administered IV is from about 50 to about 1,200 mg day. 8. Use of an oxazolidinone according to claim 1 where the oxazolidinone is (S)-N-[[3- [3-fluoro-4-(4-morpholinyl)phenyl]-2-oxc)-5-ox-«oUdinyl]methyl]acetamide. 9. Use, of an oxazolidinone selected from: (S)-N-[[3-[3-fluoιrc-4-[4-(hydroxyacetyl)- l-piper.azinyl]-phenyl3-2-oxo-5- oxazohdinyl]methyl]acetamide, (S)-N-[[3-[3-fluoιx)-4-(4-mo^holinyl)phenyl]-2-oxo-5- oχ.azolidinyl]methyl]acetamide, [4(S)- s]-(-)-N-[[3-[3-πuorcv4-(tetrahydro-l-oxido-2H-thiopyran-4-yl)phenyl]-2- oxo-5-o.xazolidinyl]methyl]acetamide, N-((5S)-3-(3-fluoro-4-(4-(2-fluoι )ethyl)-3-oxopiperazin-l-yl)phenyl)-2- oxooxazolidin-5-ylmethyl)acetamide, (5)-N-[[3-[5-(3-pyridyl)thiophen-2-yl]-2-oxc)-5-o.x^oUd-nyl]methyl]acet^-mide and (S)-N-[[3-[5-(4-pyridyl)pyrid-2-yl]-2-oxo-5-oxazoUdinyl]methyl]acetamide and pharmaceutically acceptable salts thereof for the manufacture of a medicament for use in treating arthritis where the human to be treated does not have a gram positive bacterial infection. 10. Use of an oxazolidinone according to claim 9 where the medicament is administered orally. 11. Use of an axazoUdinone according to claim 10 where the daily dose of the o.xazolidinone is from about 50 to about 1,200 mg/day. 12. Use of an oxazolidinone accordmg to claim 9 where the medicament is administered topically as a solution, cream, ointment, gel, lotion, suspension or emulsion. 13. Use of .an ojcazohdinone according to claim 12 where the amount to be administered topically is from about 0.01% to about 10%. 14. Use of an o.xazoUdinone accordmg to claim 9 where the medicament .is administered IV. 15. Use of an oxazolidmone aακ>r. ding to cl.aim 14 where the amount to be administered IV .is from about 50 to about 1,200 mg day. 16. Use of an ox. azo.lidinone according to claim 9 where the oxazolidinone is (S)-N- [[3-t3-fluoιr- 4-(4-moιrpholinyl)phenyl]-2-oxo-5-o.x£izohdinyl]methyl]a∞taumde. 17. Use of an oxazolidinone selected -from: (S)-N-[[3-[3-fluoro-4-[4-(hydroxyacetyl)-l-piperazinyl]-phenyl]-2-oxo-5- oxazolidinyl]methyl]acetamide, (S)-N-[[3-[3-fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5- ox. azolidinyl]methyl]acetamide, [4(S)-cis]-(-)-N-[t3-[3-Muoro-4-(tetrώydro-l-θ3ddo-2H-thiopyran-4-yl)phenyl]-2- oxo-5-oxazo-idinyl]methyl]acetamide, N-((5S)-3-(3-fluoro-4-(4-(2-fluoroethyl)-3-oxopipe-razin-l-yl)phenyl)-2- oxooxazolidin-5-ylmethyl)acetamide, (5)-N-[[3-[5-(3-pyridyl)---hiophen-2-yl]-2-oxo-5-oxazoU-lώyl]methyl]acetamide and (S)-N-[[3-[5-(4-pyridyl)pyrid-2-yl]-2-oxo-5-oxazolidinyl]methyl]acetamide and pharmaceutically acceptable salts thereof for the manufacture of a medicament for reducing damage to hematopoietic cells and intestinal cells in a person being treated with one or more .anti-cancer chemotherapeutic agents where the human to be treated does not have a gram positive bacterial i .nfection. 18. Use of an oxazolidinone according to claim 17 where the hematopoietic cell is a bone marrow ce.ll. 19. Use of .an oxazolidinone according to claim 17 where the hematopoietic cell is a spleen cell. 20. Use of .an oxazolidinone according to claim 17 where the medicament is administered for a period of from about 2 to about 20 days prior to treatment with an anti-cancer chemotherapeutic agent. 21. Use of an oxazolidinone according to claim 20 where the medicament is administered for a period of from about 5 to about 7 days prior to treatment with an anti-cancer chemotherapeutic agent. 22. Use of an oxazolidinone according to claim 17 where the medicament is administered concurrently with the .anti-cancer chemotherapeutic agent. 23. Use of an oxazolidinone according to claim 17 where the anti-cancer chemotherapeutic agent is selected from the group consisting of: chlorambucil, cyclophosphamide, thiotepa, busulfam, carmustine, cisplatin, carboplatin, mitomycin, procarbazine, bleomycin, amsacrine, daunorubiάn, doxoπibicin, etoposide, plicamyάn, camptothecin, ironotecan, methotrexate, mercaptopurine, elo-xuridine, fluorouracil, vinblastin, vincristine, paclitaxel, dienestrol, diethylstilbestrol, estradiol, tamoxifon and fluoxymesterone. 24. Use of an oxazolidinone according to claim 23 where the anti-cancer chemotherapeutic agent is selected from the group consi.sting of etoposide, irinotecan, fluorouricil and paclitaxel. 25. Use of an o.xazolidinone according to claim 17 where the medicament is is administered from about 50 mg to about 1,200 mg day. 26. Use of an oxazolid one accαr-ding to claim 17 where the oxazolidinone is (S)-N- [[3-[3-fluoro-4-(4-morpholinyl)phenyl]-2-oxo-5-oxazoUdinyl]methyl]aceta.amide.

Inventors: BATTS DONALD H, ULRICH ROGER G, BATTS, DONALD, H., ULRICH, ROGER, G.
Applicants: BATTS DONALD H, ULRICH ROGER G, UPJOHN CO, BATTS, DONALD, H., PHARMACIA & UPJOHN COMPANY, ULRICH, ROGER, G.
Application year: 1998
Main classification: A61K31
IPC codes: A61K31, A61P17, A61P19, A61P43