AU2007221967A1 - Inorganic ion receptor-active compounds - Google Patents

Inorganic ion receptor-active compounds Download PDF

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AU2007221967A1
AU2007221967A1 AU2007221967A AU2007221967A AU2007221967A1 AU 2007221967 A1 AU2007221967 A1 AU 2007221967A1 AU 2007221967 A AU2007221967 A AU 2007221967A AU 2007221967 A AU2007221967 A AU 2007221967A AU 2007221967 A1 AU2007221967 A1 AU 2007221967A1
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Prior art keywords
compound
hydrogen
alkyl
group
disease
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AU2007221967A
Inventor
Manuel F Balandrin
Eric G Delmar
Scott T Moe
Richard Trovato
Bradford C Van Wagenen
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Shire NPS Pharmaceuticals Inc
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NPS Pharmaceuticals Inc
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Priority claimed from AU2004202208A external-priority patent/AU2004202208B2/en
Application filed by NPS Pharmaceuticals Inc filed Critical NPS Pharmaceuticals Inc
Priority to AU2007221967A priority Critical patent/AU2007221967A1/en
Publication of AU2007221967A1 publication Critical patent/AU2007221967A1/en
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S&FRef: 441381D3
AUSTRALIA
PATENTS ACT 1990 COMPLETE SPECIFICATION FOR A STANDARD PATENT Name and Address of Applicant: Actual Inventor(s): Address for Service: Invention Title: NPS Pharmaceuticals, Inc., of Suite 240 420 Chipeta Way, Salt Lake City, Utah, 84108-1256, United States of America Manuel F Balandrin Eric G Delmar Scott T Moe Richard Trovato Bradford C van Wagenen Spruson Ferguson St Martins Tower Level 31 Market Street Sydney NSW 2000 (CCN 3710000177) Inorganic ion receptor-active compounds The following statement is a full description of this invention, including the best method of performing it known to me/us:- 5845c(986403_1)
DESCRIPTION
Inorganic Ion Receptor-Active Compounds 0 FIELD OF THE INVENTION This invention relates to compounds able to modulate one or more inorganic ion receptor activities.
SBACKGROUND OF THE INVENTION The references provided herein are not admitted to be prior art to the claimed invention.
Certain cells in the body respond not only to chemical signals, but also to ions such as extracellular calcium ions (Ca 2 Extracellular Ca 2 is under tight homeostatic control and regulates various processes such as blood clotting, nerve and muscle excitability, and proper bone formation.
Calcium receptor proteins enable certain specialized cells to respond to changes in extracellular Ca 2 concentration. For example, extracellular Ca 2 inhibits the secretion of parathyroid hormone (PTH) from parathyroid cells, inhibits bone resorption by osteoclasts, and stimulates secretion of calcitonin from C-cells.
PTH is the principal endocrine factor regulating Ca 2 homeostasis in the blood and extracellular fluids. PTH, by acting on bone and kidney cells, increases the level of Ca 2 in the blood. This increase in extracellular Ca 2 then acts as a negative feedback signal, depressing PTH secretion. The reciprocal relationship between extracellular Ca 24 and PTH secretion forms an important mechanism maintaining bodily Ca 2 homeostasis.
Extracellular Ca' acts directly on parathyroid cells to regulate PTH secretion. The existence of a parathyroid cell surface protein which detects changes in extracellular Ca 2 has been confirmed. (Brown et al., Nature 366:574, 1993.) 0 In parathyroid cells, this protein, the calcium receptor, eC acts as a receptor for extracellular Ca 2 detects changes in o the ion concentration of extracellular Ca 2 and initiates a O functional cellular response, PTH secretion.
Extracellular Ca 2 can exert effects on different cell functions, reviewed in Nemeth et al., Cell Calcium 11:319, 1990. The role of extracellular Ca 2 in parafollicular (C-
NO
Scells) and parathyroid cells is discussed in Nemeth, Cell C Calcium 11:323, 1990. These cells were shown to express similar calcium receptors. (See Brown et al., Nature 366:574, 1993; Mithal et al., J. Bone Miner. Res. 9, Suppl.
1, s282, 1994; Rogers et al., J. Bone Miner. Res. 9, Suppl, 1, s409, 1994; Garrett et al., Endocrinology 136:5202-5211, 1995.) The ability of various molecules to mimic extracellular Ca 2 in vitro is discussed in references such as Nemeth et al., in "Calcium-Binding Proteins in Health and Disease," 1987, Academic Press, Inc., pp. 33-35; Brown et al., Endocrinology 128:3047, 1991; Chen et al., J. Bone Miner.
Res. 5:581, 1990; and Zaidi et al., Biochem. Biophys. Res.
Commun. 167:807, 1990.
Nemeth et al., PCT/US92/07175, International Publication Number WO 93/04373, Nemeth et al., PCT/US93/01642, International Publication Number WO 94/18959, and Nemeth et al., PCT/US94/12117, International Publication Number WO 95/11211, describe various compounds which can modulate the effect of an inorganic ion receptor.
SUMMARY OF THE INVENTION The present invention features compounds able to modulate one or more activities of an inorganic ion receptor and methods for treating diseases or disorders using such 0 compounds. Preferred compounds can mimic or block the effect c_ of extracellular calcium on a cell surface calcium receptor.
O Inorganic ion receptor activities are those processes yC brought about as a result of inorganic ion receptor activation. Such processes include the production of molecules which can act as intracellular or extracellular messengers.
SInorganic ion receptor-modulating compounds include ionomimetics, ionolytics, calcimimetics, and calcilytics.
lonomimetics are compounds which mimic evoke or Cl potentiate) the effects of an inorganic ion at an inorganic ion receptor. Preferably, the compound affects one or more calcium receptor activities. Calcimimetics are ionomimetics which affect one or more calcium receptor activities.
Ionolytics are compounds which block inhibit or diminish) one or more activities caused by an inorganic ion at an inorganic ion receptor. Preferably, the compound affects one or more calcium receptor activities. Calcilytics are ionolytics which block one or more calcium receptor activities evoked by extracellular calcium.
Ionomimetics and ionolytics may bind at the same receptor site as the native inorganic ion ligand binds or can bind at a different site an allosteric site). For example, NPS R-467 binding to a calcium receptor results in calcium receptor activity and, thus, NPS R-467 is classified as a calcimimetic. However, NPS R-467 binds to the calcium receptor at a different site an allosteric site) than extracellular calcium.
A measure of the effectiveness of a compound to modulate receptor activity can be determined by calculating the EC, 0 or ICs, for that compound. The EC, 0 is the concentration of a compound which causes a half-maximal mimicking effect. The O IC,, is the concentration of a compound which causes a halfmaximal blocking effect. EC, and ICso values for compounds at o a calcium receptor can be determined by assaying one or more (N of the activities of extracellular calcium at a calcium receptor. Examples of assays for measuring EC, 5 and IC,, values are described Nemeth et al., PCT/US93/01642,
\O
International Publication Number WO 94/18959, and Nemeth et al., PCT/US92/07175, International Publication Number WO 93/04373, (both of these publications are hereby incorporated by reference here) and below. Such assays include oocyte expression assays and measuring increases in intracellular calcium ion concentration ([Ca 2 due to calcium receptor activity. Preferably, such assays measure the release or inhibition of a particular hormone associated with activity of a calcium receptor.
An inorganic ion receptor-modulating compound preferably selectively targets inorganic ion receptor activity in a particular cell. For example, selective targeting of a calcium receptor activity is achieved by a compound exerting a greater effect on a calcium receptor activity in one cell type than at another cell type for a given concentration of compound. Preferably, the differential effect is 10-fold or greater as measured in vivo or in vitro. More preferably, the differential effect is measured in vivo and the compound concentration is measured as the plasma concentration or extracellular fluid concentration and the measured effect is the production of extracellular messengers such as plasma calcitonin, parathyroid hormone, or plasma calcium. For example, in a preferred embodiment, the compound selectively targets PTH secretion over calcitonin secretion.
Preferably, the compound is either a calcimimetic or calcilytic having an EC, 5 or an ICs, at a calcium receptor of less than or equal to 5 pM, and even more preferably less o than or equal to 1 pM, 100 nmolar, 10 nmolar, or 1 nmolar cI using one of the assays described below. More preferably, the assay measures intracellular Ca 2 in HEK 293 cells 5 transformed with nucleic acid expressing the human
\O
N parathyroid calcium receptor and loaded with fura-2. Lower SECs, or IC,, values are advantageous since they allow lower concentrations of compounds to be used in vivo or in vitro.
O The discovery of compounds with low EC, 0 and ICs, values S 10 enables the design and synthesis of additional compounds having similar or improved potency, effectiveness, and/or selectivity.
Thus, a first aspect the invention features an inorganic ion receptor-modulating compound having the formula: STRUCTURE I
H
Ar N Ar 2 R2 R3 wherein Ar, is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, where up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2 OH, CONH 2
CN,
acetoxy, N(alkyl) 2 phenyl, phenoxy, benzyl, benzyloxy, a,adimethylbenzyl, NO,, CHO, CH3CH(OH), acetyl, OCH,COOH, and ethylene dioxy; Ar, is either optionally substituted naphthyl,-e optionally substituted phenylor an optionally substituted 6 heterocyclic aryl, where up to 5 substituents may be present 0 and each substituent is independently selected from the group Cl consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH,OH, CONH,, CN,
OCH
2 COOH, ethylene dioxy, and acetoxy;
\O
N q is 0, 1, 2, or 3; C, R, is either H or alkyl; and
R
2 and R, are each independently either hydrogen, alkyl, or together cycloalkyl or cycloalkenyl; and pharmaceutically acceptable salts and complexes thereof.
Preferably, the compound is an ionomimetic which modulates one or more inorganic ion receptor activities, more preferably the compound is a calcimimetic.
"Alkenyl" refers to a hydrocarbon chain having 2-6 carbons and at least one double-bond which may be a straight chain, branched, or non-aromatic cyclic. Preferably, the alkenyl has 2-4 carbon atoms.
"Alkyl" refers to a saturated hydrocarbon having 1-6 carbons which may be a straight chain, branched, or cyclic.
Preferably, the alkyl has 1-4 carbon atoms.
"Alkoxy" refers to "O-alkyl," where is an oxygen joined to an alkyl.
"Cycloalkenyl" refers to a non-aromatic cyclic hydrocarbon chain having 3-12 carbons and at least one double-bond, and includes multiple ring structures.
Preferably, the cycloalkenyl has 3 to 6 carbon atoms.
"Cycloalkyl" refers to a saturated cyclic hydrocarbon chain having 3-12 carbons, and includes multiple ring structures. Preferably, the cycloalkyl has 3 to 6 carbon atoms.
7 c_ "Thioalkyl" refers to "S-alkyl," where is.a sulfur o joined to an alkyl.
C< "Haloalkyl" refers to an alkyl substituted with at least one halogen. Preferably, only the terminal carbon of the haloalkyl is substituted with a halogen and 1 to 3 halogens
\O
are present. More preferably, the haloalkyl contains 1 carbon. Preferably, the halogen substitutions are either Cl or F.
"Haloalkoxy" refers to "O-haloalkyl," where is an C 10 oxygen joined to a haloalkyl.
"Heterocyclic aryl" refers to an aryl ring system having i to 3 heteroatoms as ring atoms in a heteroaromatic ring system and the remainder of the ring atoms are carbon atoms.
Suitable heteroatoms include oxygen, sulfur, and nitrogen.
Preferably, the heterocyclic ring system is mono- or bicyclic. More preferably, the heterocyclic aryl is either furanyl, thiofuranyl (also known as "thienyl"), benzofuranyl or benzothiofuranyl (also known as "benzothienyl").
Another aspect of the present invention features an inorganic ion receptor-modulating compound having the formula: STRUCTURE II R8
H
Ar, N Ar 2
R
7 R9 2 R3 Where Arl, Ar 2 R, and R, are as described for Structure I compounds; R, is either hydrogen, alkyl or phenyl; Re is either hydrogen, or alkyl; O R 9 is either hydrogen, alkyl or phenyl; Sand pharmaceutically acceptable salts and complexes thereof.
O Preferably, the compound is an ionomimetic modulating one or more inorganic ion receptor activities, more preferably the compound is a calcimimetic.
Disclosed herein is a compound having the formula: R8 Arl N Ar 2 SR 7
R
9
R
2 R3 Swherein Art is either optionally substituted naphthyl, optionally substituted Ci phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, to alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH,
CONH
2 CN, acetoxy, benzyl, benzyloxy, ca,a-dimethylbenzyl, NO 2 CHO, CH 3
CH(OH),
N(alkyl) 2 acetyl, OCH 2 COOH, and ethylene dixoy; Ar 2 is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2
OH,
CONH
2 CN, OCH 2 COOH, ethylene dioxy, and acetoxy;
R
2 and R 3 are each independently either hydrogen, alkyl or alkenyl or together cycloalkyl or cycloalkenyl;
R
7 is either hydrogen, alkyl or phenyl;
R
8 is either hydrogen, or alkyl;
R
9 is either hydrogen, alkyl or phenyl; and pharmaceutically acceptable salts or complexes thereof.
Preferably, the compound is an ionomimetic which modulates one or more inorganic ion receptor activities, more preferably the compound is a calcimimetic.
"Alkenyl" refers to a hydrocarbon chain having 2-6 carbons and at least one doublebond which may be a straight chain, branched, or non-aromatic cyclic. Preferably, the alkenyl has 2-4 carbon atoms.
"Alkyl" refers to a saturated hydrocarbon having 1-6 carbons which may be a straight chain, branched, or cyclic. Preferably, the alkyl has 1-4 carbon atoms.
"Alkoxy" refers to "O-alkyl," where is an oxygen joined to an alkyl.
[R\LIBZZ]441381D2speci doc gym 0 "Cycloalkenyl" refers to a non-aromatic cyclic hydrocarbon chain having 3-12 Scarbons and at least one double-bond, and includes multiple ring structures. Preferably, O the cycloalkenyl has 3 to 6 carbon atoms.
S"Cycloalkyl" refers to a saturated cyclic hydrocarbon chain having 3-12 carbons, and includes multiple ring structures. Preferably, the cycloalkyl has 3 to 6 carbon atoms.
"Thioalkyl" refers to "S-alkyl," where is a sulfur joined to an alkyl.
ID
"Haloalkyl" refers to an alkyl substituted with at least one halogen. Preferably, Conly the terminal carbon of the haloalkyl is substituted with a halogen and 1 to 3 halogens are present. More preferably, the haloalkyl contains 1 carbon. Preferably, the halogen substitutions are either Cl or F.
"Haloalkoxy" refers to "O-haloalkyl," where is an oxygen joined to a haloalkyl.
"Heterocyclic aryl" refers to an aryl ring system having 1 to 3 heteroatoms as ring atoms in a heteroaromatic ring system and the remainder of the ring atoms are carbon atoms. Suitable heteroatoms include oxygen, sulfur, and nitrogen. Preferably, the heterocyclic ring system is mono- or bicyclic. More preferably, the heterocyclic aryl is either furanyl, thiofuranyl (also known as "thienyl"), benzofuranyl or benzothiofuranyl (also known as "benzothienyl").
Another aspect of the present invention features a pharmaceutical composition X made up of an inorganic ion receptor-modulating compound described herein and a physiologically acceptable carrier. A "pharmacological composition" refers to a composition in a form suitable for administration into a mammal, preferably a human.
Preferably, the pharmaceutical composition contains a sufficient amount of a calcium receptor-modulating compound in a proper pharmaceutical form to exert a therapeutic effect on a human.
Considerations concerning forms suitable for administration are known in the art and include toxic effects, solubility, route of administration, and maintaining activity. For example, pharmacological compositions injected into the blood stream should be soluble.
Pharmaceutical compositions can also be formulated as pharmaceutically acceptable salts acid addition salts) and complexes thereof. The preparation of such salts can facilitate the pharmacological use of a compound by altering its physical characteristics without preventing it from exerting a physiological effect.
Another aspect the present invention features a method for treating a patient by using inorganic ion receptor-modulating compounds described herein. The method [R:\LIBZZ]441381D2spcci docgym O involves administering to the patient a pharmaceutical composition containing a Stherapeutically effective amount of an inorganic ion receptor-modulating compound. In a O preferred embodiment R 9 is either hydrogen, alkyl or phenyl and pharmaceutically C acceptable salts and complexes thereof.
Another aspect of the present invention features a pharmaceutical composition r made up of an inorganic ion receptor-modulating compound described herein and a physiologically acceptable carrier. A "pharmacological composition" refers to a Ccomposition in a form suitable for administration into a mammal, preferably a human.
Preferably, the pharmaceutical composition contains a sufficient amount of a calcium 0io receptor-modulating compound in a proper pharmaceutical form to exert a therapeutic effect on a human.
Considerations concerning forms suitable for administration are known in the art and include toxic effects, solubility, route of administration, and maintaining activity. For example, pharmacological compositions injected into the blood stream should be soluble.
Pharmaceutical compositions can also be formulated as pharmaceutically acceptable salts acid addition salts) and complexes thereof. The preparation of such salts can facilitate the pharmacological use of a compound by altering its physical characteristics without preventing it from exerting a physiological effect.
Another aspect of the present invention features a method for treating a patient by using inorganic ion receptor-modulating compounds described herein. The method involves administering to the patient a pharmaceutical composition containing a therapeutically effective amount of an inorganic ion receptor-modulating compound. In a preferred embodiment, [R:\LIBZZ]441381D2spccidoc:gym SD the disease or disorder is treated by administering to the c- patient a therapeutically effective amount of a calcium o 0 receptor-modulating compound.
C Inorganic ion receptor-modulating compounds, and compositions containing such compounds, can be used to treat different types of patients. A "patient" refers to a mammal
\O
in which compounds able to modulate inorganic ion receptor activity will have a beneficial effect including a beneficial prophylactic effect. Suitable patients can be diagnosed using standard techniques known to those in the medical profession.
Preferably, a patient is a human having a disease or disorder characterized by one more of the following: (1) abnormal inorganic ion homeostasis, more preferably abnormal calcium homeostasis; an abnormal level of a messenger whose production or secretion is affected by inorganic ion receptor activity, more preferably affected by calcium receptor activity; and an abnormal level or activity of a messenger whose function is affected by inorganic ion receptor activity, more preferably affected by calcium receptor activity.
Diseases characterized by abnormal calcium homeostasis include hyperparathyroidism, osteoporosis and other bone and mineral-related disorders, and the like (as described, e.g., in standard medical text books, such as "Harrison's Principles of Internal Medicine"). Such diseases are treated using calcium receptor-modulating compounds which mimic or block one or more of the effects of extracellular Ca 2 on a calcium receptor.
By "therapeutically effective amount" is meant an amount of a compound which relieves to some extent one or more symptoms of a disease or disorder in the patient; or returns 0 to normal either partially or completely one or more physiological or biochemical parameters associated with or O causative of the disease or disorder. Thus, a C1 therapeutically effective amount can be an amount effective to prophylactically decrease the likelihood of the onset of a disease or disorder.
IO
0 In a preferred embodiment, the patient has a disease or C. disorder characterized by an abnormal level of one or more N calcium receptor-regulated components and the compound is active on a calcium receptor of a cell selected from the group consisting of: parathyroid cell, bone osteoclast, juxtaglomerular kidney cell, proximal tubule kidney cell, distal tubule kidney cell, central nervous system cell, peripheral nervous system cell, cell of the thick ascending limb of Henle's loop and/or collecting duct, keratinocyte in the epidermis, parafollicular cell in the thyroid (C-cell), intestinal cell, platelet, vascular smooth muscle cell, cardiac atrial cell, gastrin-secreting cell, glucagonsecreting cell, kidney mesangial cell, mammary cell, beta cell, fat/adipose cell, immune cell, GI tract cell, skin cell, adrenal cell, pituitary cell, hypothalamic cell, and cell of the subfornical organ.
More preferably, the cells are chosen from the group consisting of: parathyroid cell, central nervous system cell, peripheral nervous system cell, cell of the thick ascending limb of Henle's loop and/or collecting duct in the kidney, parafollicular cell in the thyroid (C-cell), intestinal cell, GI tract cell, pituitary cell, hypothalamic cell, and cell of the subfornical organ.
In a preferred embodiment, the compound reduces the level of parathyroid hormone in the serum of the patient.
More preferably, the level is reduced to a degree sufficient
.I
O to cause a decrease in plasma Ca 2 Most preferably, the c- parathyroid hormone level is reduced to that present in a O normal individual.
C1 Patients in need of treatment using the compounds described by the present invention can be diagnosed by standard medical techniques, such as blood or urine analysis.
SExamples of such medical techniques include detecting a C, deficiency of protein whose production or secretion is affected by changes in inorganic ion concentrations, and by detecting abnormal levels of inorganic ions or hormones which effect inorganic ion homeostasis.
Various examples are used throughout the application.
These examples are not intended in any way to limit the claimed invention.
Other features and advantages of the invention will be apparent from the following figures, detailed description of the invention, examples, and the claims.
BRIEF DESCRIPTION OF THE DRAWING Figure 1 provides the chemical structures of different ionomimetic compounds.
Figure 2 provides the chemical structures of different ionomimetic compounds.
Figure 3 provides the chemical structures of different ionomimetic compounds.
Figure 4 provides the chemical structures of different ionomimetic compounds.
DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention features compounds able to modulate one or more inorganic ion receptor activities.
Preferably, the compounds can mimic or block an effect of an 0 12 extracellular ion on a cell having an inorganic ion receptor, Smore preferably, the extracellular ion is Ca 2 and the effect is on a cell having a calcium receptor. Most preferably, the compounds can mimic the effect of extracellular Ca 2 on a cell S 5 having a calcium receptor.
C While the compounds described herein are believed to be Cr able to act at an inorganic ion receptor, preferably a calcium receptor, unless otherwise explicitly stated in the O claims that a compound exerts an effect by acting at a receptor, there is no intention to limit the claimed methods to those requiring modulation of receptor activity. Rather, the compounds are characterized by their ability to modulate inorganic ion receptor activity in vivo or in vitro.
I. CALCIUM RECEPTORS Calcium receptors are present in different cells. The pharmacological effects of the following cells, in response to extracellular Ca 2 is consistent with the presence of a calcium receptor: parathyroid cell, bone osteoclast, juxtaglomerular kidney cell, proximal tubule kidney cell, distal tubule kidney cell, central nervous system cell, peripheral nervous system cell, cell of the thick ascending limb of Henle's loop and/or collecting duct, keratinocyte in the epidermis, parafollicular cell in the thyroid (C-cell), intestinal cell, trophoblast in the placenta, platelet, vascular smooth muscle cell, cardiac atrial cell, gastrinsecreting cell, glucagon-secreting cell, kidney mesangial cell, mammary cell, endocrine and exocrine cells in the pancreas, fat/adipose cell, immune cell, GI tract cell, skin cell, adrenal cell, pituitary cell, hypothalamic cell, and cell of the subfornical organ.
13
(N
The presence of a calcium receptor on the following 0 cells have been confirmed using physical data, such as (1 hybridization with nucleic acid encoding a calcium receptor: parathyroid cell, central nervous system cell, peripheral 5 nervous system cell, cell of the thick ascending limb of IN Henle's loop and/or collecting duct in the kidney, parafollicular cell in the thyroid (C-cell), intestinal cell, GI tract cell, pituitary cell, hypothalamic cell, cell of the Q subfornical organ, and endocrine and exocrine cells in the pancreas.
The calcium receptor on these different cell types may be different. It is also possible that a cell can have more than one type of calcium receptor. Comparison of calcium receptor activities and amino acid sequences from different cells indicate that distinct calcium receptor types exist.
For example, calcium receptors can respond to a variety of di- and trivalent cations. The parathyroid cell calcium receptor responds to calcium and Gd 3 while osteoclasts respond to divalent cations such as calcium, but do not respond to Gd 3 Thus, the parathyroid cell calcium receptor is pharmacologically distinct from the calcium receptor on the osteoclast.
On the other hand, the nucleic acid sequences encoding calcium-receptors present in parathyroid cells and C-cells indicate that these receptors have a very similar amino acid structure. Nevertheless, calcimimetic compounds exhibit differential pharmacology and regulate different activities at parathyroid cells and C-cells. Thus, pharmacological properties of calcium receptors may vary significantly depending upon the cell type or organ in which they are expressed even though the calcium receptors may have similar or even identical structures.
14
(N
Calcium receptors, in general, have a low affinity O for extracellular Ca 2 (apparent Kd generally greater than Sabout 0.5 mM). Calcium receptors may include a free or bound effector mechanism as defined by Cooper, Bloom and Roth, "The Biochemical Basis of Neuropharmacology", Ch. 4, and are thus C distinct from intracellular calcium receptors, e.g., C calmodulin and the troponins.
Calcium receptors respond to changes in extracellular Q calcium levels. The exact changes depend on the particular receptor and cell line containing the receptor. For example, the in vitro effect of calcium on the calcium receptor in a parathyroid cell includes the following: 1. An increase in internal calcium. The increase is due to the influx of external calcium and/or to mobilization of internal calcium. Characteristics of the increase in internal calcium include the following: A rapid (time to peak 5 seconds) and transient increase in [Ca 2 that is refractory to inhibition by 1 uM La 3 or 1 pM Gd 3 and is abolished by pretreatment with ionomycin (in the absence of extracellular Ca'); The increase is not inhibited by dihydropyridines; The transient increase is abolished by pretreatment for 10 minutes with 10 mM sodium fluoride; The transient increase is diminished by pretreatment with an activator of protein kinase C (PKC), such as phorbol myristate acetate (PMA), mezerein or indolactam V. The overall effect of the protein kinase C activator is to shift the concentration-response curve of calcium to the right without affecting the maximal response; and r- I 0 Pretreatment with pertussis toxin (100 0 ng/ml for 4 hours) does not affect the increase.
2. A rapid 30 seconds) increase in the formation of inositol-1,4,5-triphosphate or diacylglycerol.
Pretreatment with pertussis toxin (100 ng/ml for 4 hours) does not affect this increase; C 3. The inhibition of dopamine- and isoproterenol-stimulated cyclic AMP formation. This effect is Q blocked by pretreatment with pertussis toxin (100 ng/ml for 4 hours); and 4. The inhibition of PTH secretion.
Pretreatment with pertussis toxin (100 ng/ml for 4 hours) does not affect the inhibition in PTH secretion.
Using techniques known in the art, the effect of calcium on other calcium receptors in different cells can be readily determined. Such effects may be similar in regard to the increase in internal calcium observed in parathyroid cells.
However, the effect is expected to differ in other aspects, such as causing or inhibiting the release of a hormone other than parathyroid hormone.
II. INORGANIC ION RECEPTOR-MODULATING
COMPOUNDS
Inorganic ion receptor-modulating compounds modulate one or more-inorganic ion receptor activities. Preferred inorganic ion receptor-modulating compounds are calcimimetics or calcilytics. Inorganic ion receptor-modulating compounds can be identified by screening compounds which are modeled after a compound shown to have a particular activity a lead compound).
A preferred method of measuring calcium receptor activity is to measure changes in (Ca 2 Changes in [Ca2-], can be measured using different techniques such as by using 16 HEK 293 cells transduced with nucleic acid expressing the o human parathyroid calcium receptor and loaded with fura-2; and by measuring an increase in Cl- current in a Xenopus oocyte injected with nucleic acid coding for a calcium receptor. (See Nemeth et al., PCT/US93/01642, International
\O
SPublication Number WO 94/18959.) For example, poly(A)* mRNA Scan be obtained from cells expressing a calcium receptor, such as a parathyroid cell, bone osteoclast, juxtaglomerular 0 kidney cell, proximal tubule kidney cell, distal tubule kidney cell, cell of the thick ascending limb of Henle's loop and/or collecting duct, keratinocyte in .the epidermis, parafollicular cell in the thyroid (C-cell), intestinal cell, central nervous cell, peripheral nervous system cell, platelet, vascular smooth muscle cell, cardiac atrial cell, gastrin-secreting cell, glucagon-secreting cell, kidney mesangial cell, mammary cell, beta cell, fat/adipose cell, immune cell, and GI tract cell. Preferably, the nucleic acid is from a parathyroid cell, C-cell, or osteoclast. More preferably, the nucleic acid encodes a calcium receptor and is present on a plasmid or vector.
In a preferred embodiment, the compound has an EC, 5 or IC,, less than or equal to 5 yM at one or more, but not all cells chosen from the group consisting of: parathyroid cell, bone osteoclast, juxtaglomerular kidney cell, proximal tubule kidney cell, distal tubule kidney cell, central nervous system cell, peripheral nervous system cell, cell of the thick ascending limb of Henle's loop and/or collecting duct, keratinocyte in the epidermis, parafollicular cell in the thyroid (C-cell), intestinal cell, platelet, vascular smooth muscle cell, cardiac atrial cell, gastrin-secreting cell, glucagon-secreting cell, kidney mesangial cell, mammary cell, beta cell, fat/adipose cell, immune cell, GI tract cell, skin 0 17 cell, adrenal cell, pituitary cell, hypothalamic cell, and O cell of the subfornical organ. More preferably, the cells C are chosen from the group consisting of parathyroid cell, central nervous system cell, peripheral nervous system cell, 5 cell of the thick ascending limb of Henle's loop and/or I collecting duct in the kidney, parafollicular cell in the thyroid (C-cell), intestinal cell, GI tract cell, pituitary Scell, hypothalamic cell, and cell of the subfornical organ.
O The presence of a calcium receptor in this group of cells has been confirmed by physical data such as in situ hybridization and antibody staining.
Preferably, inorganic ion receptor-modulating compounds mimic or block the effects of an extracellular ion on a cell having an inorganic ion receptor, such that the compounds achieve a therapeutic effect. Inorganic ion receptormodulating compounds may have the same, or different, effects on cells having different types of inorganic ion receptor morphology such as cells having normal inorganic ion receptors, a normal number of inorganic ion receptors, an abnormal inorganic ion receptor, and an abnormal number of inorganic ion receptors) Calcium receptor-modulating compounds preferably mimic or block all of the effects of extracellular ion in a cell having a-calcium receptor. However, calcimimetics need not possess all the biological activities of extracellular Ca 2 Similarly, calcilytics need not block all of the activities caused by extracellular calcium. Additionally, different calcimimetics and different calcilytics do not need to bind to the same site on the calcium receptor as does extracellular Ca 2 to exert their effects.
Inorganic receptor-modulating compounds need not effect inorganic receptor activity to the same extent or in exactly 18 the same manner as the natural ligand. For example, a O calcimimetic may affect calcium receptor activity to a different extent, to a different duration, by binding to a different binding site, or by having a different affinity, compared to calcium acting at a calcium receptor.
NO
C A Ionomimetics C Different compound are described by Nemeth et al., 0 PCT/US92/07175, International Publication Number WO 93/04373, Nemeth et al., PCT/US93/01642, International Publication Number WO 94/18959, Nemeth et al., PCT/US94/12117, International Publication Number WO 95/11211, and Van Wagenen et al. PCT/US95/13704 (each of these references are hereby incorporated by reference herein). Different generic groups are described herein, preferably, these groups exclude each of the specific compounds described in these prior international applications the specific compounds described in PCT/US92/07175, PCT/US93/01642, PCT/US94/12117, and PCT/US95/13704, are preferably excluded from the different generic and subgeneric formula provided herein).
Structure I Compounds Structure I compounds able to modulate calcium receptor activity-have the following formula: 19 o STRUCTURE I 0
H
N Ar 2 ArC q
SR
1 R2 R 3
IND
q Where Ar, is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, where up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2 OH, CONH 2
CN,
acetoxy, N(alkyl),, phenyl, phenoxy, benzyl, benzyloxy, c,adimethylbenzyl, NO,, CHO, CH 3 CH(OH), acetyl, OCHCOOH, and ethylene dioxy. In one embodiment of the present invention Ar, is either an optionally substituted naphthyl, or a substituted phenyl, having 1 to 4 substituents, more preferably Ar, is either an unsubstituted naphthyl or a substituted phenyl; more preferably, Ar, is a substituted phenyl; preferably each Ar, substituent is independently selected from the group consisting of: isopropyl, CH,O, CF 3
CH
3 S, CFO, Br, I, Cl, F, and CH 3 In another embodiment of the present invention Ar, is an optionally substituted heterocyclic aryl. Preferred heterocyclic aryl substituents are independently selected from the group consisting of: isopropyl, CH,O, CF, CH,S, CFO, Br, I, Cl, F, and CH.
Preferred heterocyclic aryls are either furanyl, thiofuranyl, benzofuranyl, or benzothiophenyl; Ar, is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, where up to 5 substituents may be present and each substituent is independently selected from the group 0 o consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, O methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2 OH, CONH 2
CN,
OCH
2 COOH, ethylene dioxy, and acetoxy; In one embodiment Ar, is preferably either an optionally substituted naphthyl, or a substituted phenyl having 1 to 4 substituents, more preferably Ar, is either an unsubstituted naphthyl or a substituted phenyl; more preferably, Ar, is a substituted phenyl with a substituent in the meta position, even more O preferably, Ar, is mono substituted with a substituent in the meta position; preferably each Ar, substituent is independently selected from the group consisting of: isopropyl, CH,O, CH 3 S, CFO, Br, I, Cl, F, CF,, and CH,, more preferably a CH,O is located in the meta position. In another embodiment of the present invention Ar, is an optionally substituted heterocyclic aryl. Preferred heterocyclic aryl substituents are independently selected from the group consisting of: isopropyl, CH 3 O, CF 3 CH3S, CF30, Br, I, Cl, F, and CH. Preferred heterocyclic aryls are either furanyl, thiofuranyl, benzofuranyl, or benzothiophenyl; q is 0, 1, 2, or 3; in alternative embodiments q is 0 or 2; RI is either H or alkyl; when Ri is alkyl in alternative embodiments the alkyl is methyl, or the alkyl has more than one carbon atom, preferably 2 to 4 carbon atoms; R, and R, are each independently either hydrogen, alkyl, or together cycloalkyl or cycloalkenyl; preferably, R, and R 3 are each independently either hydrogen or alkyl, provided that at least one of R 2 and R, is not hydrogen, preferably, R, is alkyl, more preferably R 2 is methyl; and pharmaceutically acceptable salts and complexes thereof.
0 21 SIn a more preferred embodiment the compound has 0 following formula: STRUCTURE IA
IND
SH
Ar8 N Ar 2 D R1 R2 R 3 Where Ar,, Ar 2
R
2 and R, are as--described above for Structure I compounds, including preferred embodiments.
In another more preferred embodiment the compound has the formula: Structure IB Xn H z Arl N R2 R3 Where Ar,, R 2 and R 3 is as described above for Structure I compounds including preferred embodiments; each X and Z is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CHOH, CONH 2
CN,
OCHCOOH, ethylene dioxy, and acetoxy; more preferably each X and Z is independently selected from the group consisting of: isopropyl, CH,O, CH,S, CF3O, Br, I, Cl, P, CF 3 and CH; 22 n and m are each independently 0, 1, 2, or 3, provided 0 that n and m together are no more than 5; preferably n and m are each independently 0 or 1, more preferably, 0.
2- Structure II Compounds Structure II compounds have the formula: STRUCTURE II
R
8
H
Arl N Ar 2 H7 R 9
R
2
R
3 Where Ar, Ar 2
R
3 and R4 are as described above for Structure I compounds, including preferred embodiments; is either hydrogen, alkyl or phenyl; preferably hydrogen;
R
0 is either hydrogen, or alkyl; preferably hydrogen;
R
9 is either hydrogen, alkyl or phenyl; preferably hydrogen or alkyl, when R, is alkyl in alternative embodiments the alkyl is methyl, or the alkyl.has more than one carbon atom, preferably 2 to 4 carbon atoms; and pharmaceutically acceptable salts and complexes thereof.
3. Calcimimetic Acti- y The ability of compounds to lic the activity of Ca 2 at calcium receptors can be determine using procedures known in the art such as those described by Nemeth et al., PCT/US93/01642, International Publication Number WO 94/18959.
For example, calcimimetics possess one or more and preferably 23 all of the following activities when tested on parathyroid O cells in vitro: 1. The compound causes a rapid (time to peak seconds) and transient increase in intracellular calcium concentration that is refractory to inhibition by 1 uM La 3 or 0D 1 uM Gdl'. The increase in [Ca 2 persists in the absence of -q extracellular Ca 2 but is abolished by pretreatment with ionomycin (in the absence of extracellular Ca 2 Q 2. The compound potentiates increases in [Ca 2 elicited by submaximal concentrations of extracellular Ca 2 3. The increase in [Ca 2 elicited by extracellular Ca 2 is not inhibited by dihydropyridines; 4. The transient increase in [Ca 2 caused by the compound is abolished by pretreatment for 10 minutes with 10 mM sodium fluoride; The transient increase in [Ca 2 caused by the compound is diminished by pretreatment with an activator of protein kinase C (PKC), such as phorbol myristate acetate (PMA), mezerein or (-)-indolactam V. The overall effect of the protein kinase C activator is to shift the concentrationresponse curve of the compound to the right without affecting the maximal response; 6. The compound causes a rapid 30 seconds) increase in the formation of inositol-1,4,5-triphosphate and/or diacylglycerol; 7. The compound inhibits dopamine- or isoproterenol-stimulated cyclic AMP formation; 8. The compound inhibits PTH secretion; 9. Pretreatment with pertussis toxin (100 ng/ml for 4 hours) blocks the inhibitory effect of the compound on cyclic AMP formation, but does not effect increases in 24 o [Ca2']i, inositol-1,4,5-triphosphate, or diacylglycerol, nor O decreases in PTH secretion; The compound elicits increases in Cl- current in Xenopus oocytes injected with poly(A)'-enriched mRNA from bovine or human parathyroid cells, but is without effect in
NO
Xenopus oocytes injected with water, or liver mRNA; and 11. Similarly, using a cloned calcium receptor from a parathyroid cell, the compound will elicit a response O in Xenopus oocytes injected with the specific cDNA or mRNA encoding the receptor.
Different calcium activities can be measured using available techniques. Parallel definitions of compounds mimicking Ca 2 activity on other calcium responsive cell, preferably at a calcium receptor, are evident from the examples provided herein and Nemeth et al., PCT/US93/01642, International Publication Number WO 94/18959.
Preferably, the compound as measured by the bioassays described herein, or by Nemeth et al., PCT/US93/01642, International Publication Number WO 94/18959, has one or more, more preferably all of the following activities: evokes a transient increase in internal calcium, having a duration of less that 30 seconds (preferably by mobilizing internal calcium); evokes a rapid increase in [Ca 2 .ccurring within thirty seconds; evokes a sustained increase (greater than thirty seconds) in [Ca 2 (preferably by causing an influx of external calcium); evokes an increase in inositol-1,4,5triphosphate or diacylglycerol levels, preferably within less than 60 seconds; and inhibits dopamine- or isoproterenolstimulated cyclic AMP formation.
The transient increase in [Ca 2 1 ]i is preferably abolished by pretreatment of the cell for ten minutes with 10 mM sodium fluoride, or the transient increase is diminished by brief o pretreatment (not more than ten minutes) of the cell with an 0 activator of protein kinase C, preferably, phorbol myristate Sacetate (PMA), mezerein or indolactam V.
B. Calcilytics SThe ability of a compound to block the activity of r' extracellular calcium at a calcium receptor can be determined using standard techniques based on the present disclosure.
0 (See, also Nemeth et al., PCT/US93/01642, International Publication Number WO 94/18959.) For example, compounds which block the effect of extracellular calcium, when used in reference to a parathyroid cell, possess one or more, and preferably all of the following characteristics when tested on parathyroid cells in vitro: 1. The compound blocks, either partially or completely, the ability of increased concentrations of extracellular Ca 2 to: increase [Ca 2 mobilize intracellular Ca 2 increase the formation of inositol-1,4,5triphosphate, decrease dopamine- or isoproterenolstimulated cyclic AMP formation, and inhibit PTH secretion; 2. The compound blocks increases in Cl- current in Xenopus oocytes injected with poly(A)'-mRNA from bovine or human parathyroid cells elicited by extracellular Ca 2 or calcimimetic compounds, but not in Xenopus oocytes injected with water or liver mRNA; 3. Similarly, using a cloned calcium receptor from a parathyroid cell, the compound will block a response in Xenopus oocytes injected with the specific cDNA, mRNA or 26 cRNA encoding the calcium receptor, elicited by extracellular O Ca 2 or a calcimimetic compound.
Parallel definitions of compounds blocking Ca 2 activity on a calcium responsive cell, preferably at a calcium receptor, are evident from the examples provided herein and 0 Nemeth et al., PCT/US93/01642, International Publication C Number WO 94/18959.
0 III. TREATMENT OF DISEASES OR DISORDERS Diseases or disorders which can be treated using compounds able to modulate inorganic ion receptor activity include one or more of the following types: those characterized by abnormal inorganic ion homeostasis, preferably calcium homeostasis; those characterized by an abnormal amount of an extracellular or intracellular messenger whose production can be affected by inorganic ion receptor activity, preferably calcium receptor activity; (3) those characterized by an abnormal effect a different effect in kind or magnitude) of an intracellular or extracellular messenger which can itself be ameliorated by inorganic ion receptor activity, preferably calcium receptor activity; and other diseases or disorders in which modulation of inorganic ion receptor activity, preferably calcium receptor activity, will exert a beneficial effect, for example, in diseases or disorders where the production of an intracellular or extracellular messenger stimulated by receptor activity compensates for an abnormal amount of a different messenger. Examples of extracellular messengers whose secretion and/or effect can be affected by modulating inorganic ion receptor activity include inorganic ions, hormones, neurotransmitters, growth factors, and chemokines.
27 Examples of intracellular messengers include cAMP, cGMP, IP,° O and diacylglycerol.
CI In a preferred embodiment, the compound is used to treat a disease or disorder characterized by abnormal bone and mineral homeostasis, more preferably calcium homeostasis.
\O
Extracellular Ca 2 is under tight homeostatic control and controls various processes such as blood clotting, nerve and muscle excitability, and proper bone formation. Abnormal calcium homeostasis is characterized by one or more of the following activities: an abnormal increase or decrease in serum calcium; an abnormal increase or decrease in urinary excretion of calcium; an abnormal increase or decrease in bone calcium levels, for example, as assessed by bone mineral density measurements; an abnormal absorption of dietary calcium; an abnormal increase or decrease in the production and/or release of messengers which affect serum calcium levels such as parathyroid hormone and calcitonin; and an abnormal change in the response elicited by messengers which affect serum calcium levels.
The abnormal increase or decrease in these different aspects of calcium homeostasis is relative to that occurring in the general population and is generally associated with a disease or disorder.
Diseases and disorders characterized by abnormal calcium homeostasis can be due to different cellular defects such as a defective calcium receptor activity, a defective number of calcium receptors, or a defective intracellular protein acted on by a calcium receptor. For example, in parathyroid cells, the calcium receptor is coupled to the G i protein which in turn inhibits cyclic AMP production. Defects in G i protein can affect its ability to inhibit cyclic AMP production.
0 28 Diseases or disorders which can be treated by modulating 0 calcium receptor activity are known in the art. For example, diseases or disorders which can be treated by modulating calcium receptor activity can be identified based on the functional responses of cells regulated by calcium receptor IN activity.
C- Functional responses of cells regulated by calcium receptor are know in the art, including PTH secretion by Q parathyroid cells, calcitonin secretion by C-cells, and bone resorption by osteoclasts. Such functional responses are associated with different diseases or disorders. For example, hyperparathyroidism results in elevated levels of PTH in the plasma. Decreasing the plasma levels of PTH offers an effective means of treating hyperparathyroidism.
Likewise, increasing plasma levels of calcitonin is associated with an inhibition of bone resorption. Inhibiting bone resorption is an effective treatment for osteoporosis.
Thus, modulation of calcium receptor activity can be used to treat diseases such as hyperparathyroidism, and osteoporosis.
Those compounds modulating inorganic ion receptor activity, preferably calcium receptor activity, can be used to confer beneficial effects to patients suffering from a variety of diseases or disorders. For example, osteoporosis is an age-related disorder characterized by loss of bone mass and increased risk of bone fracture. Compounds can be used to block osteoclastic bone resorption either directly an osteoclast ionomimetic compound) or indirectly by increasing endogenous calcitonin levels a C-cell calcimimetic). Alternatively, a calcilytic active on the parathyroid cell calcium receptor will increase circulating levels of parathyroid hormone, stimulating bone formation.
29 All three of these approaches will result in beneficial o effects to patients suffering from osteoporosis.
In addition, it is known that intermittent low dosing with PTH results in an anabolic effect on bone mass and appropriate bone remodeling. Thus, compounds and dosing 0 regimens evoking transient increases in parathyroid hormone intermittent dosing with a parathyroid cell ionolytic) can increase bone mass in patients suffering from 0 osteoporosis.
Additional diseases or disorders can be identified by identifying additional cellular functional responses, associated with a disease or disorder, which are regulated by calcium receptor activity. Diseases or disorder which can be treated by modulating other inorganic ion receptors can be identified in an analogous manner.
Different diseases can be treated by the present invention by targeting cells having a calcium receptor. For example, primary hyperparathyroidism (HPT) is characterized by hypercalcemia and abnormal elevated levels of circulating PTH. A defect associated with the major type of HPT is a diminished sensitivity of parathyroid cells to negative feedback regulation by extracellular Thus, in tissue from patients with primary HPT, the "set-point" for extracellular Ca 2 is shifted to the right so that higher than normal concentrations of extracellular Ca 2 are required to depress PTH secretion. Moreover, in primary HPT, even high concentrations of extracellular Ca 2 often depress PTH secretion only partially. In secondary (uremic) HPT, a similar increase in the set-point for extracellular Ca 2 is observed even though the degree to which Ca 2 suppresses
PTH
secretion is normal. The changes in PTH secretion are paralleled by changes in [Ca 2 the set-point for
P
030 o extracellular Ca 2 '-induced increases in [Ca 2 is shifted to o the right and the magnitude of such increases is reduced.
Patients suffering from secondary HPT may also have renal osteodystrophy. Calcimimetics appear to be useful for treating both abnormal PTH secretion and renal osteodystrophy O in such patients.
Compounds that mimic the action of extracellular Ca 2 are beneficial in the long-term management of both primary and secondary HPT. Such compounds provide the added impetus required to suppress PTH secretion which the hypercalcemic condition alone cannot achieve and, thereby, help to relieve the hypercalcemic condition. Compounds with greater efficacy than extracellular Ca 2 may overcome the apparent nonsuppressible component of PTH secretion which is particularly troublesome in the major form of primary HPT caused by adenoma of the parathyroid gland. Alternatively, or additionally, such compounds can depress synthesis of PTH, as prolonged hypercalcemia has been shown to depress the levels of preproPTH mRNA in bovine and human adenomatous parathyroid tissue. Prolonged hypercalcemia also depresses parathyroid cell proliferation in vitro, so calcimimetics can also be effective in limiting the parathyroid cell hyperplasia characteristic of secondary HPT.
Cells other than parathyroid cells can respond directly to physiological changes in the concentration of extracellular Ca 2 For example, calcitonin secretion from parafollicular cells in the thyroid (C-cells) is regulated by changes in the concentration of extracellular Ca 2 Isolated osteoclasts respond to increases in the concentration of extracellular Ca 2 with corresponding increases in [Ca 2 that arise partly from the mobilization of intracellular Ca 2 Increases in [Ca 2 in osteoclasts are 31 associated with the inhibition of bone resorption. Release o of alkaline phosphatase from bone-forming osteoblasts is directly stimulated by calcium.
Renin secretion from juxtaglomerular cells in the 5 kidney, like PTH secretion, is depressed by increased 0" concentrations of extracellular Ca 2 Extracellular Ca 2 C\ causes the mobilization of intracellular Ca 2 in these cells.
Other kidney cells respond to calcium as follows: elevated O Ca 2 inhibits formation of 1,25(OH) 2 -vitamin D by proximal tubule cells, stimulates production of calcium-binding protein in distal tubule cells, and inhibits tubular reabsorption of Ca 2 and Mg 2 and the action of vasopressin on the thick ascending limb of Henle's loop (MTAL), reduces vasopressin action in the cortical collecting duct cells, and affects vascular smooth muscle cells in blood vessels of the renal glomerulus.
Calcium also promotes the differentiation of intestinal goblet cells, mammary cells, and skin cells; inhibits atrial natriuretic peptide secretion from cardiac atria; reduces cAMP accumulation in platelets; alters gastrin and glucagon secretion; acts on vascular smooth muscle cells to modify cell secretion of vasoactive factors; and affects cells of the central nervous system and peripheral nervous system.
Thus, there are sufficient indications to suggest that Ca', in addition to its ubiquitous role as an intracellular signal, also functions as an extracellular signal to regulate the responses of certain specialized cells. Compounds of this invention can be used in the treatment of diseases or disorders associated with disrupted Ca 2 responses in these cells.
Specific diseases and disorders which might be treated or prevented, based upon the affected cells, also include
JF-_
0 32 those of the central nervous system such as seizures, stroke, O head trauma, spinal cord injury, hypoxia-induced nerve cell damage such as in cardiac arrest or neonatal distress, epilepsy, neurodegenerative diseases such as Alzheimer's 5 disease, Huntington's disease and Parkinson's disease, C dementia, muscle tension, depression, anxiety, panic CA disorder, obsessive-compulsive disorder, post-traumatic stress disorder, schizophrenia, neuroleptic malignant O syndrome, and Tourette's syndrome; diseases involving excess water reabsorption by the kidney such as syndrome of inappropriate ADH secretion (SIADH), cirrhosis, congestive heart failure, and nephrosis; hypertension; preventing and/or decreasing renal toxicity from cationic antibiotics aminoglycoside antibiotics); gut motility disorders such as diarrhea, and spastic colon; GI ulcer diseases; GI diseases with excessive calcium absorption such as sarcoidosis; and autoimmune diseases and organ transplant rejection.
While calcium receptor-modulating compounds of the present invention will typically be used in therapy for human patients, they may also be used to treat similar or identical diseases in other warm-blooded animal species such as other primates, farm animals such as swine, cattle, and poultry; and sports animals and pets such as horses, dogs and cats.
IV. ADMINISTRATION The compounds described by the present invention can be formulated for a variety of modes of administration, including systemic and topical or localized administration.
Techniques and formulations generally may be found in Remington's Pharmaceutical Sciences, 1 8 h ed., Mack Publishing Co., Easton, PA, 1990 (hereby incorporated by reference herein).
S33 0 Suitable dosage forms, in part, depend upon the use or O the route of entry, for example, oral, transdermal, transmucosal, or by injection (parenteral). Such dosage forms should allow the compound to reach a target cell whether the 5 target cell is present in a multicellular host or in culture.
For example, pharmacological compounds or compositions injected into the blood stream should be soluble. Other factors are known in the art, and include considerations such 0 as toxicity and dosage forms which retard the compound or composition from exerting its effect.
Compounds can also be formulated as.pharmaceutically acceptable salts and complexes thereof. Pharmaceutically acceptable salts are non-toxic salts in the amounts and concentrations at which they are administered. The preparation of such salts can facilitate the pharmacological use by altering the physical characteristics of the compound without preventing it from exerting its physiological effect.
Useful alterations in physical properties include lowering the melting point to facilitate transmucosal administration and increasing the solubility to facilitate administering higher concentrations of the drug.
The pharmaceutically acceptable salt of the different compounds may be present as a complex. Examples of complexes include an 8-chlorotheophylline complex (analogous to, e.g., dimenhydrinate:diphenhydramine 8 -chlorotheophylline (1:1) complex; Dramamine) and various cyclodextrin inclusion complexes.
Pharmaceutically acceptable salts include acid addition salts such as those containing sulfate, hydrochloride, fumarate, maleate, phosphate, sulfamate, acetate, citrate, lactate, tartrate, methanesulfonate, ethanesulfonate, benzenesulfonate, p-toluenesulfonate, cyclohexylsulfamate and
P
0 34 quinate. Pharmaceutically acceptable salts can be obtained o from acids such as hydrochloric acid, maleic acid, sulfuric acid, phosphoric acid, sulfamic acid, acetic acid, citric acid, lactic acid, tartaric acid, malonic acid, methanesulfonic acid, ethanesulfonic acid, benzenesulfonic IN acid, p-toluenesulfonic acid, cyclohexylsulfamic acid, C-i fumaric acid, and quinic acid.
C Pharmaceutically acceptable salts also include basic 0 addition salts such as those containing benzathine, chloroprocaine, choline, diethanolamine, ethylenediamine, meglumine, procaine, aluminum, calcium, lithium, magnesium, potassium, sodium, ammonium, alkylamine, and zinc, when acidic functional groups, such as carboxylic acid or phenol, are present. For example, see Remington's Pharmaceutical Sciences, 18 th ed., Mack Publishing Co., Easton, PA, p. 1445, 1990. Such salts can be prepared using the appropriate corresponding bases.
Pharmaceutically acceptable salts can be prepared by standard techniques. For example, the free-base form of a compound is dissolved in a suitable solvent, such as an aqueous or aqueous-alcohol in solution containing the appropriate acid and then isolated by evaporating the solution. In another example, a salt is prepared by reacting the free-base and acid in an organic solvent. (See, e.g., PCT/US92/03736, hereby incorporated by reference herein.) Carriers or excipients can also be used to facilitate administration of the compound. Examples of carriers include calcium carbonate, calcium phosphate, various sugars such as lactose, glucose, or sucrose, or types of starch, cellulose derivatives, gelatin, vegetable oils, polyethylene glycols and physiologically compatible solvents. Examples of D physiologically compatible solvents include sterile solutions 0 of water for injection (WFI), saline solution and dextrose.
The compounds can be administered by different routes including intravenous, intraperitoneal, subcutaneous, S 5 intramuscular, oral, topical (transdermal), or transmucosal
\O
Sadministration. For systemic administration, oral CA administration is preferred. For oral administration, for example, the compounds can be formulated into conventional 0 oral dosage forms such as capsules, tablets, and liquid preparations such as syrups, elixirs, and concentrated drops.
Alternatively, injection (parenteral administration) may be used, for example, intramuscular, intravenous, intraperitoneal, and/or subcutaneous administration. For injection, the compounds of the invention are formulated in liquid solutions, preferably, in physiologically compatible buffers or solutions, such as saline solution, Hank's solution, or Ringer's solution. In addition, the compounds may be formulated in solid form and redissolved or suspended immediately prior to use. Lyophilized forms can also be produced.
Systemic administration can also be by transmucosal or transdermal means. For transmucosal or transdermal administration, penetrants appropriate to the barrier to be permeated are used in the formulation. Such penetrants are generally known in the art, and include, for example, for transmucosal administration, bile salts and fusidic acid derivatives. In addition, detergents may be used to facilitate permeation. Transmucosal administration, for example, may be through nasal sprays, buccal or sublingual tablets, rectal suppositories, or vaginal suppositories.
36 For topical administration, the compounds of the 0 invention can be formulated into ointments, salves, gels, or creams, as is generally known in the art.
The amounts of various compounds to be administered can be determined by standard procedures taking into account
\O
factors such as the compound IC 0
EC,,
0 the biological halflife of the compound, the age, size and weight of the patient, and the disease or disorder associated with the patient. The importance of these and other factors to be considered are known to those of ordinary skill in the art.
Generally, it is an amount between about 0.01 and 50 mg/kg, preferably 0.01 and 20 mg/kg of the animal to be treated.
V. EXAMPLES Examples are provided below illustrating different aspects and embodiments of the present invention. These examples are not intended to limit the claimed invention.
Included in these examples are synthesis protocols illustrating techniques which can be used to synthesize different compounds described herein. Other compounds falling within the generic groups described herein can be prepared using standard techniques.
Example I. Assaying Calcium Receptor Activity The ability of different compounds to modulate calcium receptor activity are described in this example. Other methods which can be used to measure calcium receptor activity are known in the art.
Recombinant HEK 293 4.0-7 cells containing a calcium receptor were constructed as described by Rogers et al., J.
Bone Miner. Res. 10 Suppl. 1:S483, 1995 (hereby incorporated by reference herein). The recombinant cells were loaded with 37 fura-2 by incubating the cells in Dulbecco's modified Eagle's medium buffered with 20 mM HEPES containing about 5 pM fluo- 3/AM for one hour at room temperature. Cells were then rinsed with Hank's balanced salt solution buffered with 20 mM HEPES containing 1 mM CaCI 2 and I mM MgCl,. Compounds to be tested were then added to the cells and fluorescence was measured (excitation and emission wavelengths of 340 and 510 nm, respectively). Table I provides results for different compounds.
Table I Compound ECso (nM) 26A 52(1) 6X 286 26B 10900 26C 22000 26D 47 (3) 26E 77 (3) 26F 15(3) 26G 11 (3) 26H 36(1) 261 126(1) 26J 47(1) 27E 12000 27F 230 27G 27H 2750 280 2500 27J 1100 27K 3800 27L >100000
Z/M
27N 270 27P 27Q 27R 1800 960 29 1600 23 2550 210 2900 27S 27T 27U 210
IND
CompoundEC,(M 27V 140 27W 1500 27X 22 27Y 12 27Z 16 28A 28B 2 280 7 280 28 E81 28F60 28G60 28H 281 28J 1100 28K 57 28L 3000 28M 170 8N303 Example 2: Synthesis o2f 26D. R) N_(1 EtylZA4idohenvl) 1- (I-naphthyl)ethylamine hydrochloride The synthesis of the title compound (26D) was accomplished in a one-pot, two-step reaction sequence by reductive amination of the imine formed from the commercially available 41-iodoacetophenone and -naphthyl-1-ethylamine. The reduction of the imine diastereoselectively was conducted under similar conditions as previously reported (Tetrahed-ron Lett.
(1985) 41, 6005-6011.).
A mixture of 4 '-iodoacetophenone (0.25 g, 1.0 mmol), (R)-naphthy1liethylamine (0.17 g, 1.0 mmol), and Ti (i-PrO), (0.38 mL, 1.1 mmol) in abs. EtOH (5 mL) was refluxed for 18 h.
decarboxylate (0.25 g, 1.0 mmol) and Mg(C10 4 2 (0.22 g, 1.0 mmol) were then added to the reaction mixture and the reflux was continued for an additional 18 h. The reaction mixture was then cooled to ap- 39 ambient temperature, H,0 (3 mL) and diethyl ether (10 mL) were 0 added and the mixture was centrifuged (3000 rpm) to remove the Sinorganic salts. The supernatant was decanted away from the pellet and the volatiles were removed under reduced pressure.
S The resulting residue was chromatographed on silica gel (elution C with 1% MeOH/CH,Cl 2 to provide the purified product as its free C-I base. This material was converted to its hydrochloride salt.
0 The salt was recrystallized from CH,Cl,/hexane to provide 0 GC/MS-pure material.
Example 3: Synthesis of 26E. (R.R)-N-(1-Ethyl-4'-ethoxy-3'methylphenvl)-1-(l-naphhth)ethylamine hydrochloride The synthesis of the title compound (26E) was accomplished in a three-step, two-pot reaction sequence. Commercially available 4 -hydroxy-3-methylacetophenone-was O-alkylated with ethyl iodide/K 2 CO,/acetone. This ketone was subsequently reacted with (R)-naphthyl-1-ethylamine in the presence of Ti(i-PrO), to provide the imine. This imine was reduced in high diastereoselective yield by catalytic hydrogenation with Raney-nickel.
A mixture of 4 -ethoxy-3-methylacetophenone (2.0 g, 11.2 mmol), (R)-naphthyl-1-ethylamine (2.0 g, 11.2 mmol), Ti(i-Pro), (4.2 mL, 14.1 mmol), and EtOH (10 mL) were stirred at 60 OC for 18 h. The reaction mixture was then transferred to a Parr hydrogenation flask, Raney-nickel (100 mg; washed with EtOH, 3 x mL) was added, and the mixture was hydrogenated at 50 psig, OC, for 4 h. The reaction mixture was then filtered (Celite/fritted glass), the catalyst was washed (EtOH, 20 mL), and the filtrate was evaporated under reduced pressure to provide the crude product. This material was purified by silica gel chromatography (elution with 2% MeOH/CHCl 2 The free base was converted to its hydrochloride salt to provide 1.1 g (27%) O of a white solid.
Example 4: Synthesis of 26F. (R.R)-N-(l-Propyl-4'-methoxv-31 S 5 methvlphenyl)-1-(1-naphthvl)ethylamine hydrochloride h The synthesis of the title compound (26F) was accomplished C^ in a four-step, three-pot reaction sequence. Commercially available 3-methyl-p-anisaldehyde was reacted with O ethylmagnesium bromide to provide its phenylpropanol derivative.
This alcohol was then oxidized to the corresponding ketone in the usual manner with PCC. This ketone-was subsequently reacted with (R)-naphthyl-l-ethylamine in the presence of Ti(i-PrO), to provide the imine. This imine was reduced in high diastereoselective yield by catalytic hydrogenation in the presence of Raney-nickel.
In a manner similar to the synthesis of 26E, a mixture of 4 -methoxy-3-methylpropiophenone (5.7 g, 31.7 mmol), (R)-naphthyl-1-ethylamine (5.2 mL, 31.7 mmol), Ti(i-Pro) 4 (11.8 mL, 39.6 mmol), and EtOH (30 mL) were reacted as above to form the imine which was subsequently reduced under catalytic hydrogenation conditions over Raney-nickel. The crude product was purified by silica gel chromatography (elution with 10:1, hexane/EtOAc). The free base was converted to its hydrochloride salt to provide 0.50 g of a white solid.
Example 5: Synthesis of 26G. (R.R)-N-l(-Ethyl-4'-methoxy-3*bromophenyl)-1-(1-naphthyl)ethylamine hydrochloride The synthesis of the title compound (26G) was accomplished in a four-step, three-pot reaction sequence. Commercially available 3 -bromo-4-methoxybenzaldehyde was reacted with methylmagnesium bromide to provide its phenylethanol derivative.
This alcohol was then oxidized to the corresponding ketone in 41 the usual manner with pyridinium chlorochromate (PCC). This o ketone was subsequently reacted with (R)-naphchyl-i-ethylamine in the presence of Ti(i-Pro), to provide the imine. This imine was reduced in high diastereoselective yield using diethyl-1,4-dihydro-2,6-dimethyl.3,5-pyridine decarboxylate.
in a manner similar to the synthesis of 26D, a mixture of 3 -bromo-4-methoxyacetophenone (3.0 g, 13.1 mmol), (R)-naphthyl-1-ethylamine (2.1 mL, 13.1 mmol), and Ti(i-PrO), (4.7 rnL, 15.7 mmol) in abs. EtOH- (100 mL) was reduced with diethyl-l,4-dihydro-2,6..dimethyl.3,5-pyridine decarboxylate in the presence of Mg(C10 4 The resulting crude material was converted to its hydrochloride salt. The salt was purified by precipitation from diethyl ether/hexane to provide GC/MS-pure material (0.6 g, 11i) as a white solid.
1s Examiple 6: -Synthesis of-26H. 261. and 26J. (R)-N-_(3-phenyl- 2 orcenyl) 1- (I-naphthyl) ethyl amine hydrochloride.__(R)-V- (2methyl-3-ohenyl-2-proTnenvl) (1--aohthvl)ethylamine hydrochloride, and 2 meQthoxy--3-ohenvl-2-ropennyl) 1- (1-naohthvl)ethvlamine hydrochloride The syntheses of the title compounds were accomplished in three, two-step, one-pot reaction sequences. Commercially available cmnnamaldehyde, 2-methyl- trans-cinnamaldehyde, and 2 -methox ycinnamaldehyde, respectively, were reacted with (R)-naphthyl-l-ethylamine in the presence of Ti(i-Pro), to provide the corresponding imine. These imines were reduced using sodium cyanoborohydride to provide the title compounds in high overall yields.
xale:PhsclData Table II provides physical data for some of the compounds described herein. Gas chromatographic and mass spectral data 42 c( o were obtained on a Hewlett-Packard 5890 Series II Gas O Chromatograph with a 5971 Series Mass Selective Detector [Ultra-2 Ultra Performance Capillary Column (crosslinked 5% Ph Me silicone); column length, 25 m, column 0.20 mm, film thickness, 0.33 pm; He flow rate, 60 mL/min; injector temp., 250 0_ temp. program, 20 OC/min from 125 to 325 OC for 10 min C1 then held constant at 325 oC for 6 min] STABLE II Compound GC rt m/z 8.32 285 26A 8.75 286 26B 8.51 288 26C 9.60 346 26D 11.08 401 26E 10.71 333 26F 10.56 333 26G 9.09 385 26H 10.95 287 261 10.98 301 26J 11.79 317 Additional Gas chromatographic and mass spectral data were obtained on a Hewlett-Packard 5890 Series II Gas Chromatograph with a 5971 Series Mass Selective Detector (Ultra-2 Ultra Performance Capillary Column (crosslinked 5% phenyl methyl silicone); column length, 25 m, column 0.20 mm; He flow rate, 60 mL/min; injector temp., 250 gradient temperature program, 20 oC/min from 125 to 325 oC for 10 min, then held constant at 325 oC for 6 min].
Compound 26Z, rt 10.22', m/z (rel. int.) 331 316 182 168 156 155 (100), 154 153 43 (18) 152 141 133 (43) 131 129 128 (18), Q 127 (15) 117 115 (13) 115 (13) 105 91 CK1 Compound 27A, rt~ 10.13', mhz (rel. int.) 331 316 182 176 168 167 156 155 (100), 154 153 152 141 134 133 (58) 133 (58) 131 129 (14) 128 (21) 127 (23) 126 119 117 (12) 116 115 (18) 105 (10) 91 (12) -77 Compound 27D, rt 9.41', m/z (rel. int..) 292 171 160 157 147 146 145 143 134 133 132 131 129 119 117 116 (100) 115 115 (14) 105 (10) 103 91 (16) 89 (17) 77 Compound 27E, rt 7.81', m/z (rel. int.) 283 268 (100), 176 150 149 148 135 134 (11), 121 (19) 118 117 115 109 (10) 105 104 103 92 91 79 78 77 77 (21) 65 51 42 41 Compound 27F, rt m/z (rel. int.) 365 231 230 216 215 (59) 214 (17) 190 (15) 174 136 135 (100) 134 129 (13) 128 (15) 127 119 117 114 109 (10) 105 (21) 104 103 (18) 91 (21) 91 (10) 79 (11) ,78 77 (19) 68 (12) 65 42 0 Compound 27G, rt m/z (rel int.) 365 4) 231 230 (49) 216 215 (8G) 213 (27) 190 (23) 187 175 174 (31) 136 (37) 135 (100) 134 130 129 (11) 128 127 120 120 116 115 109 105 103 (13) 92 91 (16) 79 77 (13) 68 0 Compound 27H, rt =10.-44' m/z (rel. int. 317 8) 170 1G2 155 (19) ,154 (28) 153 (14) 152 148 a- 44 o147 (13) 146 (100) 134 129 128 (18) ,127 (21) ,126 0(7) 115 (12) 115 (12) 103 102 89 77 (8) r~lCompound 27J, rt 9.88', m/z (rel. it.) 337 323 (22) 322 (100) ,210 (26) 196 184 (12) 182 (11) 170 (13) 169 (53) 168 167 (14) 165 (10) 154 (22) 153 (41) 152 (32) 150 141 (53) 129 (27) 128 (34) 127 (62), ri ~126 (20) 124 (98) 115 (24) 103 (23) 91 (15) 89 (18) 77 42 41 0 Compound 27K, rt 9.03', m/z (rel. int.) 342 327 (40) 325 (41) 308 (14) 306 (21) 204 (17) 202 (31) 174 (43) 173 (26) 172 (66) 171 (26) 139 (11) 138 (15) 137 127 (33) 124 (100) 117 (10) 115 (12) 111 103 (37) 102 (41) 101 (30) 98 (12) 91 (11) 89 (28) 77 (35) 63 51 0 Compound 27L, rt 8.84', m/z (rel. int.) 264 145 (100) 145 119 (29) 118 (26) 118 (16) 117 116 102 92 91 90 (41) 77 76 75 (14) (14) 65 64 (21) 63 (23) 51 Compound 27M, rt 8.48', m/z (rel. int.) 305 291 290 164 136 (17) 135 (100) 120 111 1ll 105 103 98 92 91 79 77 (12) 65 63 Compound 27N, rt 8.81', m/z (rel. int.) 294 279 (100) 1-87 164 144 136 (16) 135 (75) 135 134 (11) 130 (15) 121 120 117 (11) 116 (36) 115 105 (18) 104 (14) 103 (30) 102 92 91 (19) 89 79 78 77 65 63 Compound 270, rt 9.33', m/z (rel. int.) 347 304 192 156 156 155 (100), 154 153 (22) ,152 150 (24) 149 (16) 148 (23) 135 (28) 129 (9) 128 (14) 127 (15) 115 91 77 Compound 27P, rt 9.23', m/z (rel. int.) 347 304 Q ~(100) 177 156 (12) 155 (87) 154 (12) 153 (15) 152 150 149 (10) 148 (12) 128 127 Compound 27Q, rt 9.64', m/z (rel. int.) 361 304 156 (17) 155 (100) 153 152 151 150 148 135 129 128 127 115 91 c~K1 91 Compound 27R, rt 9.16', m/z (rel. int.) 294 279 (100) 187 164 136 (24) 135 (77) 121 (10) 120 117 116 105 104 103 92 91 (14), 91 89 79 78 77 65 Compound 27S, rt 9.27', m/z (rel. int.) 338 323 322 (38) 164 162 160 (25) 158 (37) 136 136 135 (100) 134 (16) 124 122 120 120 115 105 (19) 104 103 (16) 102 (11) 101 92 91 89 79 78 77 65 63 0 Compound 27U, rt 8.65', m/z (rel. int.) 385 230 230 216 215 214 210 174 156 155 (100), 154 153 152 140 129 (15) 128 (25) 127 (22) 126 115 (12) 109 68 Compound 27V, rt rn/z (rel. int.) 385 230 216 215 214 210 174 156 (23), 155 (100) 154 (25) 153 (26) 152 (11) 130 129 (19) 129 (19) 128 (27) 127 (26) 115 (14) 109 101 77 (5 69 Compound 27W, rt 8.88', m/z (rel. int.) 371 356 (100), 244 184 182 170 169 168 (14), 167 160 159 (46) 154 (11) 153 (24) 153 (24) 152 150 141 133 129 128 127 (19), 126 115 109 46 Compound 27X, rt 10. 61', m/z (rel. int. 419 Q406 404 (20) 403 (100) 402 401 263 250 248 (55) 246 (29) 169 167 156 155 (14) 154 (16) 153 153 152 128 127 Compound 27Y, rt 10.21', m/z (rel. int.) 375 361 3 360 (10 0) 3259 (15) 3258 (78) 279 217 (11) 206 205 204 202 (74) 270 (13) 168 156 (12), 155 (38) 154 153 (37) 152 (21) 141 (11) 129 (16) 128 (37) 127 (41) 126 (21) 123 115 89 77 75 63 0 Compound 27Z, rt 11.10', m/z (rel. int.) 466 451 (60) 450 (13) 449 (61) 311 309 (11) 296 (97) 295 294 (100) 169 (29) 168 167 (24) 156 (20) 155 (56), 154 (74) 153 152 (27) 151 141 (13) 129 (21) 128 127 (61) 126 (18) 115 (18) 89 (43) 77 (13) 75 (14), 74 63 0 Compound 28A, rt 10.73', m/z (rel. int.) 421 408 407 (21) 407 (21) 406 (100), 279 265 252 (22), 251 250 (70) 156 155 (20) 154 (25) 153 (19) 152 (11) 141 129 128 (18) 127 (21) 126 (10) 123 (11), 115 89 (16).
Compound 28B, rt 10. 7S' m/z (rel. int.) 417 3) 274 261 261 (16) 247 246 (100) 156 155 (29), 154 153 152 (11) 141 129 128 127 126 115 105 91 90 (16) 89 77 Compound 28C, rt 8.73', m/z (rel. int.) 317 303 (12) ,302 (62) 282 178 149 (22) 148 +(100) 148 (7) 125 131 127 (16) 124 (46) 119 (12) 117 104 103 102 92 91 (65) 90 (7,89 (18) 78 77 (25) 65 (19) 63 (11).
47 Compound 28D, icc 8.73', m/z (rel. int.) 317 303 Q(14) 302 (71) ,282 178 ,149 (23) 149 (23) ,148 C1(100) 135 ,131 127 (14) ,124 (42) 119 (10) ,117 115 103 (19) 92 91 (56) 90 89 (14) '78 77 65 63 Compound 28E, ict m/z (rel. int.) 338 325 324 (35) 323 (11) ,323 (11) 322 (54) 164 161 159 (23) 136 (30) 135 (100) 121 (15) 120 105 (14) 103 92 91 (11) 79 77 (11).
Compound 28F, rt 9.11', m/z (rel. int.) 338 325 324 (39) 323 (11) 322 (59) 164 (10) 161 (19) 161 (19), 159 (2 9) 13 6 (2 7) 13 5 (100), 121 120 115 105 (17) 103 102 101 92 91 89 79 77 65 Compound 28G, icc 7.181, m/z (rel. int.) 251 236 (43) 156 155 154 153 152 152 (18), 151 141 129 (11) 128 (25) 127 (31) 126 (11) 115 (12) 95 (12) 82 81 (100) 77 53 (27) 51 Compound 28H, rc 7.31', m/z (rel. int.) 251 236 (100) 208 170 (10) 168 156 155 (26) 154 (39), 153 152 152 (19) 151 141 129 128 127 (29) 126 (10) 115 94 82 81 (77) 53 (13).
Compound 281, icc 8.20', m/z (rel. int.) 267 252 (36) 156 155 (21) 154 (15) 153 (15) 152 (10) 141 (7) 129 128 (15) 127 (16) 126 115 112 (16) 98 (8) 98 98 96 (100), 53 44 Compound 28J, icc 8.23', m/z (rel. int.) 267 251 (56) 170 (11) 155 (25) ,154 (31) 153 (23) 153 (23) 152 (16) 151 141 129 128 (22) 127 (26) 126 (9) 115 111 110 98 97 96 (100) 85 77 53 44 a 48 c- Compound 28K, rt 9.28', m/z (rel. int.) 315 301 O 300 160 156 155 154 153 (27), S152 146 145 (100), 144 141 129 128 127 127 126 118 117 116 115 91 89 77 0" Compound 28L, rt 7.41', m/z (rel. int.) 319 318 159 147 146 (100), 132 131 130 ps 119 117 115 109 105 104 103 S(11), 91 78 77 42 Compound 28M, rt 10.76', m/z (rel. int.) 372 360 359 358 357 356 169 168 (29), 167 160 158 156 155 (100), 154 153 152 151 141 129 128 127 (28), 126 124 122 115 102 101 89 77 0 Compound 28N, rt 7.40', m/z (rel. int.) 270 136 135 (100), 133 120 120 106 105 (34), 103 103 103 91 91 79 79 78 77 76 64 63 62 Other embodiments are within the following claims.
Thus, while several embodiments have been shown and described, various modifications may be made without departing from the spirit and scope of the present invention.

Claims (95)

  1. 2. The compound of claim 1, wherein Ar, is said optionally substituted heterocyclic aryl. IND \O
  2. 3. The compound of claim 2, wherein said Ar, optionally substituted heterocyclic aryl is selected from the group consisting of: furanyl, thiofuranyl, benzofuranyl, and p- benzothiophenyl.
  3. 4. The compound of claim 3, wherein R, and R, are each independently hydrogen, alkyl, or together either cycloalkyl, provided that at least one of R 2 and R, is not hydrogen; wherein said compound is a calcimimetic modulating one or more calcium receptor activities.
  4. 5. The compound of claim 4, wherein R, is not hydrogen.
  5. 6. The compound of claim 5, wherein R 2 and R 3 are both methyl.
  6. 7. The compound of any of claims 1-5, wherein R 3 is hydrogen.
  7. 8. The compound of any of claims 1-7, wherein R, is alkyl.
  8. 9. The compound of claim 8, wherein said R, alkyl has more than one carbon atoms. 51
  9. 10. The compound of any of claims 1-7, wherein R, is o hydrogen.
  10. 11. The compound of any of claims i-10, wherein Ar, is a substituted phenyl. S 5 12. The compound of claim 11, wherein said Ar, C< substituted phenyl has one to four independently selected substituents, provided that at least one substituent is located eC in the meta position.
  11. 13. The compound of claim 11, wherein said Ar, substituted phenyl has 1 to 4 substituents each independently selected from the group consisting of: isopropyl, CHO, CH 3 S, CFO, Br, I, Cl, F, CF,, and CH 3
  12. 14. The compound of claim 11, wherein said Ar 2 substituted phenyl has 1 to 4 substituents each independently selected from the group consisting of: isopropyl, CH,0, CH 3 S, Br, I, Cl, F, CF,, and CH,, provided that at least one substituent is located in the meta position. The compound of any of claims 1-8, wherein Ar, is said optionally substituted naphthyl.
  13. 16. The compound of claim 15, wherein Ar, is an unsubstituted naphthyl.
  14. 17. The compound of claim 15, wherein Ar, is a substituted naphthyl. 52
  15. 18. The compound of claim 17, wherein said Ar, o substituted naphthyl has 1 to 4 independently selected substituents.
  16. 19. The compound of claim 17, wherein said Ar, substituted naphthyl has 1 to 4 independently selected substituents selected from the group consisting of: isopropyl, P CH30, CHS, CFO, Br, I, Cl, F, CF,, and CH,. C-i
  17. 20. The compound of claim 17, wherein said Ar, substituted naphthyl has 1 substituent selected from the group consisting of: isopropyl, CH 3 O, CH 3 S, CF0O, Br, I, Cl, F, CF, and CH,.
  18. 21. The compound of any of claims 1-20, wherein q is 2.
  19. 22. The compound of any of claims 1-20, wherein q is 0.
  20. 23. An inorganic ion receptor-modulating compound having the formula: R 8 Arl N Ar 2 R7 R 9 2 R 3 wherein Ar, is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH,OH, CONH,, CN, 53 acetoxy, benzyl, benzyloxy, a,a-dimethylbenzyl, NO,, CHO, O CH 3 CH(OH), N(alkyl) 2 acetyl, OCHCOOH, and ethylene dioxy; Ar 2 is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each \O IN substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CHOH, CONH,, CN, OCHCOOH, ethylene dioxy, and acetoxy; R 2 and R 3 are each independently either hydrogen, alkyl, alkenyl or together cycloalkyl or cycloalkenyl; R, is either hydrogen, alkyl or phenyl; Re is either hydrogen, or alkyl; R, is either hydrogen, alkyl or phenyl; and pharmaceutically acceptable salts and complexes thereof; wherein said compound is an ionomimetic modulating one or more inorganic ion receptor activities.
  21. 24. The compound of claim 23, wherein Ar, is said optionally substituted heterocyclic aryl, R 2 and R 3 are each independently hydrogen, alkyl, or together either cycloalkyl, provided that at least one of R 2 and R 3 is not hydrogen; R, is hydrogen; R, is hydrogen; and R, is either hydrogen or lower alkyl; wherein said compound is a calcimimetic modulating one or more calcium receptor activities. The compound of claim 24, wherein R 2 is not hydrogen. 54
  22. 26. The compound of claim 25, wherein R, and R, are both methyl.
  23. 27. hydrogen. The compound of any of claims 23-25, wherein R, is
  24. 28. The compound of any of claims 23-27, wherein R 1 is alkyl.
  25. 29. The compound of claim 28, wherein said R 2 alkyl has more than one carbon atom. hydrogen. The compound of any of claims 23-27, wherein R, is
  26. 31. The compound of any of claims 23-30, wherein Ar, is a substituted phenyl.
  27. 32. The compound of claim 31, wherein said Ar, substituted phenyl has one to four independently selected substituents, provided that at least one substituent is located in the meta position.
  28. 33.- The compound of claim 31, wherein said Ar, substituted phenyl has 1 to 4 substituents each independently selected from the group consisting of: isopropyl, CH30, CH 3 S, CFO, Br, I, Cl, F, CF 3 and CH,.
  29. 34. The compound of claim 31, wherein said Ar, substituted phenyl has 1 to 4 substituents each independently selected from the group consisting of: isopropyl, CH 3 O, CH 3 S, CF,O, Br, I, Cl, F, CF 3 and CH,, provided that at least one substituent is located in the meta position. The compound of any of claims 23-30, wherein Ar 2 is an optionally substituted naphthyl.
  30. 36. The compound of claim 35, wherein Ar, is an unsubstituted naphthyl.
  31. 37. The compound of claim 35, wherein Ar, is a substituted naphthyl.
  32. 38. The compound of claim 37, wherein said Ar 2 substituted naphthyl has 1 to 4 independently selected substituents.
  33. 39. The compound of claim 38, wherein said Ar 2 substituted naphthyl has 1 to 4 independently selected substituents each selected from the group consisting of: isopropyl, CH 3 0, CH 3 S, CF 3 O, Br, I, Cl, F, CF,, and CH,. The compound of claim 30, wherein said Ar, substituted naphthyl has 1 substituent selected from the group consisting of: isopropyl, CH30, CHS, CF 3 O, Br, I, Cl, F, CF 3 and CH,.
  34. 41. A calcium receptor-active compound selected from the group consisting of: 25Z, 26A, 26B, 26C, 26D, 26E, 26F, 26G, 26H, 261, 26J, 26K, 26L, 26M, 26N, 260, 26P, 26Q, 26R, 26S, 26T, 26U, 26V, 26W, 26X, 26Y, 26Z, 27K, 27L, 27M, 27N, 27H, 28K, and pharmaceutically acceptable salts and complexes thereof.
  35. 42. The compound of claim 41, wherein said compound is selected from the group 0 consisting of: 26A, 26D, 26F and 26G. c 43. An inorganic ion receptor-modulating compound, substantially as hereinbefore O described with reference to any one of the Examples. O 5 44. A pharmaceutical composition comprising a compound of any one of claims 1 to S43 and a pharmaceutical acceptable carrier. A method for treating a disease in a patient in need of such treatment comprising the step of administering to said patient a therapeutically effective amount of a compound of Sany one of claims 1 to 43 or of a composition of claim 44.
  36. 46. Use of a compound of any one of claims I to 43 in the manufacture of a NC medicament for treating disease.
  37. 47. A compound of any one of claims 1 to 43 or a composition of claim 44 when Sused to treat disease.
  38. 48. The method, use or compound of any one of claims 45 to 47, wherein said disease is characterised by either, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be affected by calcium receptor activity; and said compound is a calcimimetic.
  39. 49. The method, use or compound of any one of claims 45 to 47, wherein said disease is selected from the group consisting of: primary and secondary hyperparathyroidism, Paget's disease, hypercalcemia malignancy, osteoporosis, hypertension, and renal osteodystrophy. The method, use or compound of claim 49, wherein said disease is selected from the group consisting of primary and secondary hyperparathyroidism.
  40. 51. A method of decreasing serum PTH in a patient comprising the step of administering to said patient an effective amount of a compound of any one of claims 1 to 43 or of a composition of claim 44.
  41. 52. Use of a compound of any one of claims 1 to 43 in the manufacture of a medicament for decreasing serum PTH.
  42. 53. A compound of any one of claims 1 to 43 or a composition of claim 44 when used to decrease serum PTH.
  43. 54. The method, use or compound of any one of claims 51 to 53, wherein serum PTH level is reduced to a degree sufficient to cause a decrease in plasma Ca 2 (/libaa]01414:MEF A compound having the formula: R8 Ar N Ar 2 R7 R 9 R2 R 3 wherein Ar is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each s substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2 0H, CONH 2 CN, acetoxy, benzyl, benzyloxy, a,a-dimethylbenzyl, NO 2 CHO, CH 3 CH(OH), N(alkyl)2, acetyl, OCH 2 COOH, and ethylene dixoy; Ar2 is either optionally substituted naphthyl, optionally substituted phenyl, or an to optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2 0H, CONH 2 CN, OCH 2 COOH, ethylene dioxy, and acetoxy; R2 and R3 are each independently either hydrogen, alkyl or alkenyl or together cycloalkyl or cycloalkenyl; R7 is either hydrogen, alkyl or phenyl; RP is either hydrogen, or alkyl; R 9 is either hydrogen, alkyl or phenyl; and pharmaceutically acceptable salts or complexes thereof.
  44. 56. The compound of claim 55, Wherein Arl is said optionally substituted heterocyclic aryl, R2 and R 3 are each independently hydrogen, alkyl, or together either cycloalkyl, provided that at least one of R 2 and R 3 is not hydrogen; R7 is hydrogen; R 8 is hydrogen; and R 9 is either hydrogen or lower alkyl; wherein said compound is a calcimimetic modulating one or more calcium receptor activities.
  45. 57. The compound of claim 56, wherein R 2 and R 3 are both methyl.
  46. 58. The compound of claim 56, wherein R3 is hydrogen.
  47. 59. The compound of claim 58, wherein Ri is alkyl. The compound of claim 58, wherein R, is hydrogen. R \I .IRVVlO2307sneci.doc:nic
  48. 61. The compound of claim 59 or claim 60, wherein Ar2 is a substituted phenyl.
  49. 62. The compound of claim 61, wherein said Ar2 substituted phenyl has one to four independently selected substituents, provided that at least one substituent is located in the meta position.
  50. 63. The compound of claim 62, wherein said Ar2 substituted phenyl has 1 to 4 substituents each independently selected from the group consisting of: isopropyl, CH 3 0, CH 3 S, CF 3 0, Br, I, CI, F, CF 3 and CH 3
  51. 64. The compound of claim 59 or claim 60, wherein Ar2 is an optionally substituted naphthyl. The compound of claim 64, wherein Ar 2 is an unsubstituted naphthyl. '66. The compound of claim 65, wherein Ar2 is a substituted naphthyl having 1 to 4 independently selected substituents each selected from the group consisting of: isopropyl, CH 3 0, CH 3 S, CF 3 0, Br, I, CI, F, CF 3 and CH 3
  52. 67. A compound selected from the group consisting of: 25Z, 26A, 26B, 26C, 26D, 26E, is 26F, 26G, 26H, 261, 26J, 26K, 26L, 26M, 26N, 260, 26P, 26Q, 26R, 26S, 26T, 26U, 26V, 26W, 26X, 26Y, 26Z, 27K, 27L, 27M, 27N, 27H, 28K, and pharmaceutically acceptable salts and complexes thereof. '68. The compound of claim 67, wherein said compound is selected from the group consisting of: 26A, 26D, 26F, and 26G.
  53. 69. A pharmaceutical composition comprising the compound of any one of claims 55 to 68, and a pharmaceutical acceptable carrier. A method for treating a patient, the method comprising the step of administering to said patient a therapeutically effective amount of the compound of any one of claims 5 to 68 or of a composition of claim 69.
  54. 71. The method of claim 70, wherein said patient has a disease which is characterised by either, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be effected by calcium receptor activity; and said compound is a calcimimetic.
  55. 72. The method of claim 71, wherein said patient has a disease selected from the group consisting of: primary and secondary hyperparathyroidsim, Paget's disease, hypercalcemia malignancy, osteoporosis, hypertension, and renal osteodystrophy. S73. The method of claim 72, wherein said disease is selected from the group consisting of primary and secondary hyperparathyroidism.
  56. 74. Use of a compound of any one of claims 55 to 68 in the manufacture of a medicament to treat disease. [R:\LIBVV102307speci.doc:njc 7. The use of claim 74, wherein said patient has a disease which is characterised by Seither, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be effected by calcium receptor Ci activity; and said compound is a calcimimetic.
  57. 76. The use of claim 75, wherein said patient has a disease selected from the group consisting of: primary and secondary hyperparathyroidsim, Paget's disease, hypercalcemia D malignancy, osteoporosis, hypertension, and renal osteodystrophy.
  58. 77. The use of claim 76, wherein said disease is selected from the group consisting of C primary and secondary hyperparathyroidism. ,o 78. A compound of any one of claims 55 to 68 or a pharmaceutical composition of claim 1 69 when used to treat disease.
  59. 79. The compound or composition of claim 78, wherein the disease is characterised by either, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be effected by calcium receptor activity; and said compound is a calcimimetic. The compound or composition of claim 79, wherein the disease is selected from the group consisting of: primary and secondary hyperparathyroidism, Paget's disease, hypercalcemia malignancy, osteoporosis, hypertension, and renal osteodystrophy.
  60. 81. The compound or composition of claim 80, wherein the disease is selected from the group consisting of primary and secondary hyperparathyroidism.
  61. 82. A method of decreasing serum PTH in a patient, the method comprising the step of administering to said patient an effective amount of a compound of any one of claims 55 to 68 or of a composition of claim 69.
  62. 83. The method of claim 82, wherein serum PTH level is reduced to a degree sufficient to cause a decrease in plasma Ca 2
  63. 84. Use of a compound of any one of claims 55 to 68 in the manufacture of a medicament to decrease serum PTH. The use of claim 84, wherein serum PTH level is reduced to a degree sufficient to cause a decrease in plasma Ca2+.
  64. 86. A compound of any one of claims 55 to 68 or a composition of claim 69 when used to decrease serum PTH. r1 I\ /\ln 7c- i r-*nir
  65. 87. A compound or a composition of claim 86, wherein serum PTH level is reduced to a degree sufficient to cause a decresae in plasma Ca 2 O 88. A compound having the formula: N R8 Ar NH Ar 2 R 7 R9 R 2 R3 S s wherein Art is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CONI 2 CN, acetoxy, benzyl, benzyloxy, c,a-dimethylbenzyl, NO 2 CHO, CH 3 CH(OH), io N(alkyl) 2 acetyl, OCH 2 COOH, and ethylene dixoy; Ar 2 is either optionally substituted naphthyl, optionally substituted phenyl, or an optionally substituted heterocyclic aryl, wherein up to 5 substituents may be present and each substituent is independently selected from the group consisting of: alkyl, alkenyl, halogen, alkoxy, thioalkyl, methylene dioxy, haloalkyl, haloalkoxy, OH, CH 2 OH, CONH 2 CN, OCH 2 COOH, ethylene dioxy, and acetoxy; R 2 and R 3 are each independently either hydrogen, alkyl or alkenyl or together cycloalkyl or cycloalkenyl; R 7 is either hydrogen, alkyl or phenyl; Rg is either hydrogen, or alkyl; R 9 is either hydrogen, alkyl or phenyl; and pharmaceutically acceptable salts or complexes thereof.
  66. 89. The compound of claim 88, wherein Arl is said optionally substituted heterocyclic aryl, R 2 and R 3 are each independently hydrogen, alkyl, or together either cycloalkyl, provided that at least one of R 2 and R 3 is not hydrogen; R 7 is hydrogen; R 8 is hydrogen; and R 9 is either hydrogen or lower alkyl; wherein said compound is a calcimimetic modulating one or more calcium receptor activities. The compound of claim 89, wherein R 2 and R 3 are both methyl. [R:LIBZZ]44131 D2speci docgym J 1. 0 91. The compound of claim 89, wherein R 3 is hydrogen.
  67. 92. The compound of claim 89, wherein R 9 is alkyl, R 2 is methyl and R 3 is O hydrogen. C 93. The compound of claim 89, wherein R 9 is hydrogen, R 2 is methyl and R 3 is hydrogen.
  68. 94. The compound of claim 89, wherein R 9 is alkyl or hydrogen, R 2 is methyl, R 3 N is hydrogen and Ar 2 is a substituted phenyl. The compound of claim 94, wherein said Ar 2 substituted phenyl has one to four independently selected substituents, provided that at least one substituent is located io in the meta position.
  69. 96. The compound of claim 95, wherein said Ar 2 substituted phenyl has I to 4 substituents each independently selected from the group consisting of: isopropyl, CH 3 O, CH 3 S, CF 3 0, Br, I, Cl, F, CF 3 and CH 3
  70. 97. The compound of claim 89, wherein R 9 is alkyl or hydrogen, R 2 is methyl, R 3 is hydrogen and Ar 2 is an optionally substituted naphthyl.
  71. 98. The compound of claim 97, wherein Ar 2 is an unsubstituted naphthyl.
  72. 99. The compound of claim 98, wherein Ar 2 is a substituted naphthyl having 1 to 4 independently selected substituents each selected from the group consisting of: isopropyl, CH30, CH 3 S, CF 3 0, Br, I, Cl, F, CF 3 and CH 3
  73. 100. A compound selected from the group consisting of: 25Z, 26A, 26B, 26C, 26D, 26E, 26F, 26G, 26H, 261, 26J, 26K, 26L, 26M, 26N, 260, 26P, 26Q, 26R, 26S, 26T, 26U, 26V, 26W, 26X, 26Y, 26Z, 27K, 27L, 27M, 27N, 27H, 28K, and pharmaceutically acceptable salts and complexes thereof.
  74. 101. The compound of claim 100, wherein said compound is selected from the group consisting of: 26A, 26D, 26F, and 26G.
  75. 102. A compound of claim 88, substantially as hereinbefore described with reference to any one of the examples.
  76. 103. A process of preparing a compound of claim 88, the process being substantially as hereinbefore described with reference to any one of the examples.
  77. 104. A pharmaceutical composition comprising the compound of any one of claims 88 to 102, and a pharmaceutical acceptable carrier.
  78. 105. A method for treating a patient, the method comprising the step of administering to said patient a therapeutically effective amount of the compound of any one of claims 88 to 102 or of a composition of claim 104. (R:\LIBZZ]441381D2spcci doc:gyin
  79. 106. The method of claim 105, wherein said patient has a disease which is characterised by either, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be effected by calcium receptor activity; and said compound is a calcimimetic.
  80. 107. The method of claim 106, wherein said patient has a disease selected from the group consisting of: primary and secondary hyperparathyroidsim, Paget's disease, hypercalcemia malignancy, osteoporosis, hypertension, and renal osteodystrophy.
  81. 108. The method of claim 107, wherein said disease is selected from the group consisting of primary and secondary hyperparathyroidism.
  82. 109. Use of a compound of any one of claims 88 to 102 in the manufacture of a medicament to treat disease.
  83. 110. The use of claim 109, wherein said disease which is characterised by either, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be effected by calcium receptor activity; and said compound is a calcimimetic.
  84. 111. The use of claim 110, wherein said disease is selected from the group consisting of: primary and secondary hyperparathyroidsim, Paget's disease, hypercalcemia malignancy, osteoporosis, hypertension, and renal osteodystrophy.
  85. 112. The use of claim 111, wherein said disease is selected from the group consisting of primary and secondary hyperparathyroidism.
  86. 113. A compound of any one of claims 88 to 102 or a pharmaceutical composition of claim 104 when used to treat disease.
  87. 114. The compound or composition of claim 113, wherein said disease is characterised by either, or both, of: abnormal calcium homeostasis, and an abnormal amount of an extracellular or intracellular messenger whose production can be effected by calcium receptor activity; and said compound is a calcimimetic.
  88. 115. The compound or composition of claim 114, wherein said disease is selected from the group consisting of: primary and secondary hyperparathyroidism, Paget's disease, hypercalcemia malignancy, osteoporosis, hypertension, and renal osteodystrophy.
  89. 116. The compound or composition of claim 115, wherein the disease is selected from the group consisting of primary and secondary hyperparathyroidism.
  90. 117. A method of decreasing serum PTH in a patient, the method comprising the step of administering to said patient an effective amount of a compound of any one of claims 88 to 102 or of a composition of claim 104. [R\LIBZZ]441381 D2speci docgym
  91. 118. The method of claim 117, wherein serum PTH level is reduced to a degree sufficient to cause a decrease in plasma Ca 2
  92. 119. Use of a compound of any one of claims 88 to 102 in the manufacture of a medicament to decrease serum PTH.
  93. 120. The use of claim 119, wherein serum PTH level is reduced to a degree sufficient to cause a decrease in plasma Ca 2
  94. 121. A compound of any one of claims 88 to 102 or a composition of claim 104 when used to decrease serum PTH.
  95. 122. A compound or a composition of claim 121, wherein serum PTH level is o0 reduced to a degree sufficient to cause a decrease in plasma Ca 2 Dated 12 October, 2007 NPS Pharmaceuticals, Inc. Patent Attorneys for the Applicant/Nominated Person SPRUSON FERGUSON [R\LIBZZ]441381D2speci doc:gym
AU2007221967A 1996-05-01 2007-10-12 Inorganic ion receptor-active compounds Abandoned AU2007221967A1 (en)

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AU2004202208A AU2004202208B2 (en) 1996-05-01 2004-05-21 Inorganic Ion Receptor-active Compounds
AU2007221967A AU2007221967A1 (en) 1996-05-01 2007-10-12 Inorganic ion receptor-active compounds

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