A fused heterocyclic derivative of the formula wherein formula is selected from the formula's A, B, C, D and E: wherein R1 is selected from cyano, alkenyl, alkynyl, alkyl, each optionally substituted with CN or one or more fluoro atoms, cycloalkyl, cycloalkenyl or a bicyclic group, each optionally substituted with halogen or alkyl optionally substituted with one or more fluoro atoms, phenyl, biphenyl, naphthyl, each optionally substituted with one or more substituents independently selected from halogen, cyano, alkyl optionally substituted with one or more fluoro atoms, alkoxy optionally substituted with one or more fluoro atoms, amino, dimethylamino, and cycloalkyl optionally substituted with phenyl which may be substituted with alkyl or halogen, and phenyl substituted with phenoxy, benzyl, benzyloxy, phenylethyl or monocyclic heterocycle, each optionally substituted with alkyl, Z is a linking group -W-(C n -alkylene)-T- wherein W is attached to R1 and selected from a bond, -O-, -CO-, -S-, -SO-, -SO 2 -, -NH-, -CH=CH-, -C(CF 3)=CH-, -C≡C-, -CH 2 -O-, -O-CO-, -CO-O-, -CO-NH-, -NH-CO- and trans-cyclopropylene; n is an integer from 0 to 10; and T is attached to the phenylene moiety and selected from a bond, -O-, -S-, -SO-, -SO 2 -, -NH-, -CO-, -C=C-, -C≡C-, and trans-cyclopropylene; R2 is H or one or more substituents independently selected from cyano, halogen, alkyl optionally substituted with one or more halogen atoms, or alkoxy optionally substituted with one or more halogen atoms; X is selected from C or N; if X is C, R3 is selected from H and alkyl, otherwise R3 is not present; Y is selected from NH, O and S; and R4 is selected from -(CH 2) 2 -OH, -CH 2 -COOH, -(CH 2) 2 -COOH, -(CH 2) 3 -COOH, -CH 2 -CHCH 3 -COOH, -CH 2 -C(CH 3) 2 -COOH, -CHCH 3 -CH 2 -COOH, -CH 2 -CF 2 -COOH, -CO-CH 2 -COOH, 1,3-cyclobutylene-COOH, -(CH 2) 2 -PO 3 H 2, -(CH 2) 3 -PO 3 H 2, -(CH 2) 2 -OPO 3 H 2, -(CH 2) 3 -OPO 3 H 2, -CH 2 -tetrazol-5-yl, -(CH 2) 2 -tetrazol-5-yl and -(CH 2) 3 -tetrazol-5-yl; or a pharmaceutically acceptable salt, a solvate or hydrate thereof or one or more N-oxides thereof. R1 is selected from cyano, alkenyl, alkynyl, alkyl, each optionally substituted with CN or one or more fluoro atoms, cycloalkyl, cycloalkenyl or a bicyclic group, each optionally substituted with halogen or alkyl optionally substituted with one or more fluoro atoms, phenyl, biphenyl, naphthyl, each optionally substituted with one or more substituents independently selected from halogen, cyano, alkyl optionally substituted with one or more fluoro atoms, alkoxy optionally substituted with one or more fluoro atoms, amino, dimethylamino, and cycloalkyl optionally substituted with phenyl which may be substituted with alkyl or halogen, and phenyl substituted with phenoxy, benzyl, benzyloxy, phenylethyl or monocyclic heterocycle, each optionally substituted with alkyl, cyano, alkenyl, alkynyl, alkyl, each optionally substituted with CN or one or more fluoro atoms, cycloalkyl, cycloalkenyl or a bicyclic group, each optionally substituted with halogen or alkyl optionally substituted with one or more fluoro atoms, phenyl, biphenyl, naphthyl, each optionally substituted with one or more substituents independently selected from halogen, cyano, alkyl optionally substituted with one or more fluoro atoms, alkoxy optionally substituted with one or more fluoro atoms, amino, dimethylamino, and cycloalkyl optionally substituted with phenyl which may be substituted with alkyl or halogen, and phenyl substituted with phenoxy, benzyl, benzyloxy, phenylethyl or monocyclic heterocycle, each optionally substituted with alkyl, Z is a linking group -W-(C n -alkylene)-T- wherein W is attached to R1 and selected from a bond, -O-, -CO-, -S-, -SO-, -SO 2 -, -NH-, -CH=CH-, -C(CF 3)=CH-, -C≡C-, -CH 2 -O-, -O-CO-, -CO-O-, -CO-NH-, -NH-CO- and trans-cyclopropylene; n is an integer from 0 to 10; and T is attached to the phenylene moiety and selected from a bond, -O-, -S-, -SO-, -SO 2 -, -NH-, -CO-, -C=C-, -C≡C-, and trans-cyclopropylene; W is attached to R1 and selected from a bond, -O-, -CO-, -S-, -SO-, -SO 2 -, -NH-, -CH=CH-, -C(CF 3)=CH-, -C≡C-, -CH 2 -O-, -O-CO-, -CO-O-, -CO-NH-, -NH-CO- and trans-cyclopropylene; n is an integer from 0 to 10; and T is attached to the phenylene moiety and selected from a bond, -O-, -S-, -SO-, -SO 2 -, -NH-, -CO-, -C=C-, -C≡C-, and trans-cyclopropylene; R2 is H or one or more substituents independently selected from cyano, halogen, alkyl optionally substituted with one or more halogen atoms, or alkoxy optionally substituted with one or more halogen atoms; X is selected from C or N; if X is C, R3 is selected from H and alkyl, otherwise R3 is not present; Y is selected from NH, O and S; and R4 is selected from -(CH 2) 2 -OH, -CH 2 -COOH, -(CH 2) 2 -COOH, -(CH 2) 3 -COOH, -CH 2 -CHCH 3 -COOH, -CH 2 -C(CH 3) 2 -COOH, -CHCH 3 -CH 2 -COOH, -CH 2 -CF 2 -COOH, -CO-CH 2 -COOH, 1,3-cyclobutylene-COOH, -(CH 2) 2 -PO 3 H 2, -(CH 2) 3 -PO 3 H 2, -(CH 2) 2 -OPO 3 H 2, -(CH 2) 3 -OPO 3 H 2, -CH 2 -tetrazol-5-yl, -(CH 2) 2 -tetrazol-5-yl and -(CH 2) 3 -tetrazol-5-yl; or a pharmaceutically acceptable salt, a solvate or hydrate thereof or one or more N-oxides thereof.