AU2007327047A1 - Substituted quinazolines - Google Patents

Description

WO 2008/065444 PCT/GB2007/050697 SUBSTITUTED QUINAZOLINES FIELD OF THE INVENTION This invention relates to the discovery of 3-and 5-substituted analogues of the selective platelet 5 lowering agent anagrelide with reduced potential for cardiovascular side-effects which should lead to improved patient compliance and safety in the treatment of myeloproliferative diseases. More specifically, the present invention relates to certain imidazoquinazoline derivatives which have utility as platelet lowering agents in humans. The compounds of the present invention function by inhibiting megakaryocytopoeisis and hence the formation of blood platelets. 10 BACKGROUND OF THE INVENTION Anagrelide hydrochloride (Agrylin@, Xagrid@) is a novel orally administered imidazoquinazoline which selectively reduces platelet count in humans and is used for such purposes in the treatment of myeloproliferative diseases (MPDs), such as essential 15 thrombocythemia (ET), where an elevated platelet count may put the patient at increased thrombotic risk. The chemical structure of anagrelide, 6,7-dichloro-1,5-dihydroimidazo[2,1-b] quinazolin-2(3H)-one hydrochloride monohydrate is shown as the hydrochloride monohydrate in the following formula: N H O HCI.H 2 0 N C I 20 CI 3 position Preparation of anagrelide hydrochloride was referred to in U.S. Patent Nos. 3,932,407; RE31,617 and 4,146,718. 25 Anagrelide is a unique, highly selective platelet lowering agent. In vitro studies of human megakaryocytopoiesis suggested that, in vivo, its thrombocytopenic activity results primarily from an inhibitory effect on megakaryocyte maturation. Anagrelide inhibited TPO-induced megakaryocytopoiesis in a dose-dependent manner with an estimated IC 50 of -26 nM, showing it 1 WO 2008/065444 PCT/GB2007/050697 to be a highly potent agent. Anagrelide does not affect erythroid or myelomonocytic differentiation stimulated by erythropoietin or granulocyte-macrophage colony-stimulating factor, demonstrating the selectivity of this compound against the megakaryocytic lineage. 5 The drug, which is available in both the U.S. and Europe, has proven to be of considerable clinical value in the treatment of myeloproliferative diseases, such as essential thrombocythemia. Anagrelide was shown to be effective and selective in reducing and maintaining platelet count close to or within the physiological range in patients with thrombocythemia secondary to a myeloproliferative disorder. The time to complete response, defined as a platelet count 10 600x10 9 /L, ranged from 4 to 12 weeks. In the majority of patients, the platelet count can be reduced and maintained at a dose of 1 to 3mg/day. In early volunteer trials, the most frequently reported adverse effects AEs other than headache were palpitations, postural dizziness and nausea. During patient studies, the most frequently 15 reported drug-related AEs were headache, palpitations, oedema/fluid retention, nausea/vomiting, diarrhea, dizziness and abdominal pain. These effects are all likely to arise from the secondary, cardiovascular pharmacology associated with anagrelide resulting from its inhibitory effects on human phosphodiesterase III (PDE III). Anagrelide is a potent PDE III inhibitor with an IC 50 value of -29 nM (cf. milrinone, a classical PDE III inhibitor, IC 50 = 170-350 nM). Inhibition of 20 myocardial PDE III leads to positive inotropy (increasing of the force of contractions of the heart), increased chronotropy (increase in heart rate), and peripheral vasodilatation. Such cardiovascular manifestations of this inhibition are typically seen with the classical positive inotropes, milrinone and enoximone, and exploited in the short-term acute treatment of congestive heart failure. However, in the treatment of a so-called silent disease (i.e., 25 asymptomatic) such as ET, the cardiovascular side-effects of palpitations and tachycardia associated with anagrelide limit its utility and a significant proportion of patients - reportedly between 25 and 50% - fail to tolerate the drug during long term treatment. The PDE III inhibitory properties of anagrelide are quite distinct from its platelet lowering anti 30 megakaryocytic effects. Indeed studies have shown no correlation between potency as a PDE III inhibitor and anti-megakaryocytic effects for anagrelide and its principal pharmacologically 2 WO 2008/065444 PCT/GB2007/050697 active metabolite, 3-hydroxyanagrelide (3-OH anagrelide or 3-HA, formerly known as SPD604 or BCH24426). Surprisingly the latter was found to be over 40-fold more potent than anagrelide as a PDE III inhibitor. With respect to inhibition of megakaryocytopoiesis (and therefore platelet lowering potential) it was however no more potent than the parent drug. Anagrelide's active 5 metabolite, 3-HA, is present in vivo in amounts greatly exceeding those of the parent drug with typical exposures being 2-3 fold greater. Thus by implication 3-OH anagrelide is likely to be a major contributor to the pharmacological actions of the drug. 10 In addition to the unwanted cardiovascular effects associated with PDE III inhibition, the consequent elevation of cAMP can result in an anti-aggregatory effect. While initially this property may appear to be beneficial in essential thrombocythemia patients predisposed to greater thrombotic risk, such anti-platelet effects, in excess, could have haemorrhagic consequences and on balance may not be desirable. Indeed the haemorrhagic events occasionally 15 seen in ET patients treated with anagrelide might be due to a combination of the anti-aggregatory effects contributed largely by 3-OH anagrelide and an overshooting of platelet reduction, compounded by a synergistic interaction with aspirin that is frequently concomitantly administered. (In some ET patients, plasma concentrations of 3-OH anagrelide have been shown likely to exceed the in vitro IC 50 values for inhibition of platelet aggregation by a factor of 3). 20 The PDE III mediated cardiovascular side-effects associated with anagrelide treatment mean that many patients have to be switched to the only significant alternative therapy, namely that with hydroxyurea. However, this drug is a simple chemical anti-metabolite which inhibits 25 ribonucleoside diphosphate reductase (RNR) with resultant profound effects on DNA synthesis. Ribonucleoside diphosphate reductase catalyzes the conversion of ribonucleosides into deoxyribonucleosides, which are the building blocks of DNA synthesis and repair. Inhibition of ribonucleoside diphosphate reductase explains the cytoreductive and - most importantly - the mutagenic effects of this compound as well as its platelet lowering action. Hydroxyurea is thus 30 officially classified as a "presumed human carcinogen." As well as possessing the potential to 3 WO 2008/065444 PCT/GB2007/050697 induce leukemic transformation, hydroxyurea is associated with the induction of difficult-to-treat leg ulcers. Faced with this dilemma in treatment options, there is a clear need for a new agent in the 5 treatment of thrombocythemia which is selective in its effects on megakaryocytopoiesis but with reduced or minimal side effects. While anagrelide offers some selectivity in its mechanism of action, the limitations to its use are those associated with cardiovascular effects resulting from its secondary pharmacology and contributed largely by the active metabolite of anagrelide, 3 hydroxyanagrelide. 10 The metabolism of anagrelide generally proceeds extremely rapidly, resulting in a less than ideal pharmacokinetic profile of the drug.. The typical half-life of anagrelide is just 1.5 hr (2.5 hr for the metabolite) necessitating frequent drug administration (up to 4 times per day). This, combined with the side-effects profile, can lead to poor patient compliance. Furthermore, 15 anagrelide undergoes a large first pass effect (>50%) leading to considerable intersubject variation in achieved exposures and, therefore, potentially variable drug response. Also, exposure to the pharmacologically active metabolite varies dramatically between patients since its formation is dependent on CYP1A, an enzyme whose expression is highly dependent on exposure to inducing agents such as cigarette smoke. Overall, this may result in the need for 20 careful dose titration in patients being treated with anagrelide. US4256748 discloses a number of imidazo[2,1-b]quinazolin-2(3H)-ones which have an analogous structure to anagrelide and which are said to be effective in the treatment of thromboses resulting from their anti-aggregatory effects on blood platelets mediated by PDE III 25 inhibition. However, this disclosure does not appreciate the entirely separate anti megakaryocytic potential (reducing platelet numbers) which could be associated with some analogues. Ideally there is a need for compounds which possess anti-megakaryocytic activity whilst at the 30 same time having a reduced level of PDE III inhibitory activity and therefore unwanted cardiovascular effects. 4 WO 2008/065444 PCT/GB2007/050697 It is an aim of the present invention to overcome various disadvantages of or to improve on the properties of prior art compounds. Thus it is an aim of the invention to provide an anagrelide derivative which has improved activity and / or reduced cardiovascular toxicity relative to prior 5 art compounds in the treatment of diseases for which modulation of megakaryocytopoeisis provides an efficacious treatment. The compounds of the present invention are especially beneficial because they display less inhibitory activity towards phosphodiesterase III (PDE III) and yet surprisingly still retain their anti-megakarycocytic and hence platelet lowering properties. 10 It is also desirable that the compounds of the present invention should have an improved pharmacokinetic profile to aid patient compliance and ensure consistency of therapeutic response. It is thus a further aim to provide compounds with a good duration of action i.e. long half-life in vivo. Additionally it is a further aim to provide compounds that are available via relatively convenient synthetic processes. 15 The compounds described in relation to the present invention satisfy some or all of the above aims. 20 SUMMARY OF THE INVENTION We have found that analogues of anagrelide in which the principal site of metabolism is blocked by an appropriate group are likely not only to have improved pharmacokinetics but also a better side effect profile. This would be expected to lead to better tolerability and improved patient 25 compliance enabling a broader spectrum of patients to be effectively treated. The compounds of the present invention are surprisingly beneficial for two reasons: they have a dramatically lower PDE III inhibitory activity than 3-hydroxyanagrelide, yet still retain potent anti-megakaryocytic activity. Indeed these compounds have therapeutic indices which are likely 30 to be much more favorable than that for anagrelide itself. 5 WO 2008/065444 PCT/GB2007/050697 In one embodiment, the present invention encompasses an anagrelide analogue comprising a 3-, 5-, 3,3- or 5,5-substituted anagrelide compound. Thus, for example, in the 3-substituted derivatives, first pass metabolism to 3-hydroxyanagrelide is effectively blocked. Surprisingly, these compounds still show good antimegakaryocytic activity. Thus one aspect of this invention 5 relates to anagrelide analogues, comprising 3-substituted derivatives, wherein first pass metabolism to the corresponding 3-hydroxyanagrelide is effectively blocked. In the case of the 5-substituted compounds it is expected that a bulky group is more effective than a smaller group. Groups such as t-butyl and other bulky blocking groups are thus expected to be of most utility when substituted at the 5-position. A substituent comprising a large group at the 5-position is 10 expected to sterically hinder access to the 3-position by the metabolising cytochrome's active site. This should inhibit formation of the cardioactive metabolite, 3-hydroxyanagrelide. According to one aspect of the present invention, there is provided a compound of Formula (I) or 15 a pharmaceutically acceptable salt or solvate thereof. R 8 R 9 7 R N N 1 0 6 / N RR4

R

5 R4 R 3 R2 (I) wherein: 20 1 2 34 R, R, R and R4 independently represent hydrogen or a blocking group which functions to directly or indirectly prevent metabolic reaction at the 3- position of substitution; 1 2 3 4 or wherein R and R , and/or R and R together with the carbon to which they are attached form 25 a blocking group which functions to directly or indirectly prevent metabolic reaction at either the 3-position of substitution, the remainder of groups R to R 4 being hydrogen; 6 WO 2008/065444 PCT/GB2007/050697

R

5 is selected from the group comprising: fluoro, chloro, bromo and iodo;

R

6 is selected from the group comprising: fluoro, chloro, bromo and iodo; 5 R and R are independently selected from the group comprising: H; halo; cyano; C1_6 alkyl, C1_6 haloalkyl, C1_6 alkoxy, and C1_ 6 haloalkoxy; and

R

9 is H, C1_6 alkyl, or a Group I metal ion; 10 provided always that R , R 2, R3 and R4 are not all hydrogen, or that when one of R and R2 is methyl and R3 and R4 are hydrogen then other of R1 and R2 is not hydrogen. In an embodiment: 15 R 1 and R 2 are independently selected from the group comprising: H; cyano; C1_ 6 alkyl, SC1_ 6 alkyl, C 2

_

6 alkenyl, C 2

_

6 alkynyl, C 3

_

8 cycloalkyl wherein said alkyl, alkenyl, alkynyl or cycloalkyl groups may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C1_ 4 alkylsulphonyl and COOH; C1_6 hydroxyalkyl; C1_6 carboxyalkyl; and sulphide; 20 or R and R 2 together with the carbon to which they are attached form a C 3

_

8 carbocyclic ring which may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C1_ 4 haloalkyl, C1_ 4 alkylsulphonyl and COOH; 25 or R and R 2 together represent a C 2

_

6 alkenyl or C 2

_

6 alkynyl group bound through a double bond to the ring to which it is attached and which may be optionally substituted by one to three groups independently selected from the group comprising: halo, hydroxyl, cyano, C 1

_

4 haloalkyl and COOH. 30 In a preferred set of compounds, R is an optionally substituted C1_ 4 alkyl or C 3

_

8 cycloalkyl group. 7 WO 2008/065444 PCT/GB2007/050697 In a preferred set of compounds, R2 is an optionally substituted C1_4 alkyl group or C 3

_

8 cycloalkyl. 5 In another preferred set of compounds, R and R2 together form an optionally substituted C 3

_

8 cycloalkyl group. Most preferably this is a cyclopropyl group Other preferred compounds are those in which at least one of R and R2 is -C(H)(F)m or C(H)n(F)m-C(H)p(F)q, where m = 2 or 3, and n = (3-m); and p = 2 or 3, and q = ( 3 -p). 10 More preferably at least one of R and R 2 is CF 3 or CHF 2 . Most preferably, at least one of R and R2 is CF 3 . In an embodiment, R 1 is preferably methyl, cyclopropyl, CF 3 or CHF 2 . More preferably, R 1 is methyl or cyclopropyl. Most preferably, R 1 is methyl. In an embodiment, R2 is preferably 15 methyl, cyclopropyl, CF 3 or CHF 2 . More preferably R2 is methyl or cyclopropyl. Most preferably R2 is methyl. In an embodiment: 20 R 3 and R 4 are independently selected from the group comprising: H; cyano; C1_ 6 alkyl, SC1_ 6 alkyl, C 2

_

6 alkenyl, C 2

_

6 alkynyl, C 3

_

8 cycloalkyl wherein said alkyl, alkenyl, alkynyl or cycloalkyl groups may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C1_ 4 alkylsulphonyl and COOH; C1_6 hydroxyalkyl; C1_6 carboxyalkyl; and sulphide; 25 or R 3 and R 4 together with the carbon to which they are attached form a C 3

_

8 carbocyclic ring which may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C1_ 4 haloalkyl, C1_ 4 alkylsulphonyl and COOH; 30 or R 3 and R 4 together represent a C 2

_

6 alkenyl or C 2

_

6 alkynyl group bound through a double bond to the ring to which it is attached and which may be optionally substituted by one to three groups 8 WO 2008/065444 PCT/GB2007/050697 independently selected from the group comprising: halo, hydroxyl, cyano, C1_4 haloalkyl and COOH. In an embodiment, R 3 is H or C1_6 alkyl. Preferably, R 3 is H. 5 In an embodiment, R 4 is H or C1_6 alkyl. Preferably, R 4 is H. In an embodiment, R 5 is preferably chloro. 10 In an embodiment, R 6 is preferably chloro. In an embodiment R 7 is H. In an embodiment R 8 is H. 15 In an embodiment R 9 is H. In an alternative embodiment, R 9 is C1_ 6 alkyl and, in this case, the PDE III inhibiting activity is effectively eliminated. Me represents a particularly preferred alkyl substituent. In another alternative embodiment, R 9 is a Group I metal ion and, in this case the compounds show significantly improved water solubility. Sodium represents a particularly 20 preferred Group I metal. In a further embodiment: R and R2 are independently selected from the group comprising: H; cyano; C1_6 alkyl, C2-6 25 alkenyl, C2_6 alkynyl, C 3

_

8 cycloalkyl wherein said alkyl, alkenyl, alkynyl or cycloalkyl groups may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C1_ 4 alkylsulphonyl and COOH; C 1

_

6 hydroxyalkyl; C 1

_

6 carboxyalkyl; and sulphide; 9 WO 2008/065444 PCT/GB2007/050697 or RI and R 2 together with the carbon to which they are attached form a C 3

_

8 carbocyclic ring may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C1_4 haloalkyl, C1_4 alkylsulphonyl and COOH; 5 or R and R 2 together with the carbon to which they are attached represent a C 2

_

6 alkenyl or C2-6 alkynyl group bound through a double bond to the ring to which it is attached and being optionally substituted by one to three groups independently selected from the group comprising: halo, hydroxyl, cyano, C1_ 4 haloalkyl and COOH; 10 provided always that R and R2 are not both hydrogen, or that when one of R and R2 is methyl the other is not hydrogen;

R

3 and R 4 are hydrogen; 15 R 5 is selected from the group comprising: fluoro, chloro, bromo and iodo;

R

6 is selected from the group comprising: fluoro, chloro, bromo and iodo; and 7 8 9 R , R and R are hydrogen. 20 Another preferred group of compounds is those in which neither R nor R2 is hydrogen. Amongst these, it is preferred when RI and R 2 are both independently selected from the group comprising: cyano, C1_ 6 alkyl, C 2

_

6 alkenyl, C 2

_

6 alkynyl, in which the alkyl, alkenyl, and alkynyl groups may be optionally substituted; 25 or wherein R and R 2 together with the carbon to which they are attached form an optionally substituted C 3

_

8 carbocyclic ring or wherein RI and R 2 together represent an optionally substituted C 2

_

6 alkenyl or C 2

_

6 alkynyl 30 group. 10 WO 2008/065444 PCT/GB2007/050697 Particularly preferred individual compounds of the invention include: 3-methyleneanagrelide 3,3,spiro-cyclopropyl-anagrelide 3,3-dimethylanagrelide 5 (R)-3-(hydroxymethyl)anagrelide (S)-3-(hydroxymethyl)anagrelide Particularly preferred compounds include 3,3-dimethylanagrelide, and spiro[anagrelide-3,1' cyclopropane]} . These compounds are generally prepared as the HBr addition salts. 10 It has also been found that the individual enantiomers of 3-substituted derivatives show efficacy. The present invention therefore also relates to both the resolved optical isomers of such compounds as well as mixtures of enantiomers. For the purposes of comparison of the compounds of the present invention with anagrelide, the correct comparison is that made with 15 the PDE III inhibitory activity of the 3-hydroxy metabolite of anagrelide since this is the predominant component in plasma after anagrelide treatment. Regarding the use of the compounds of the invention in humans, there is provided: 20 a pharmaceutical composition comprising a compound of formula (I), or a pharmaceutically acceptable salt or solvate thereof, together with a pharmaceutically acceptable diluent or carrier, which may be adapted for oral, parenteral or topical administration; 25 a compound of formula (I), or a pharmaceutically acceptable salt or solvate thereof, or a pharmaceutical composition containing any of the foregoing, for use as a medicament; the use of a compound of formula (I), or a pharmaceutically acceptable salt or solvate thereof in the manufacture of a medicament for the treatment of a disease selected from: myeloprolific 30 diseases and/or generalised thrombotic diseases. 11 WO 2008/065444 PCT/GB2007/050697 a method of treating a disease selected from: myeloproliferative diseases and/or generalised thrombotic diseases in a human, which comprises treating said human with an effective amount of a compound of formula (I), or a pharmaceutically acceptable salt or solvate thereof, or with a 5 pharmaceutical composition containing any of the foregoing. The present invention also encompasses a method of treating a patient having essential thrombocythemia or high blood platelet count, which method comprises administering to the patient a therapeutically effective amount of a compound of the present invention. 10 Another embodiment of the present invention includes a method of reducing blood platelet count within a patient, which method comprises administering to the patient a therapeutically effective amount of a compound of the present invention. 15 The present invention encompasses providing the compounds of the present invention for the methods listed above, among others, wherein cardiotoxicity is reduced compared to using anagrelide. 20 Separately, we have found that individually both (R)-3-methyl anagrelide and (S)-3-methyl anagrelide show good anti-megakaryocytic activity whilst showing significantly reduced PDE III inhibition relative to 3-OH anagrelide. We thus expect that 3-methyl anagrelide will have utility in treating myeloproliferative diseases. 25 Accordingly, the invention also includes the use of 3-methyl anagrelide, or a pharmaceutically acceptable salt or solvate thereof in the manufacture of a medicament for the treatment of myeloprolific diseases. The invention thus also extends to a method of treating myeloproliferative diseases in a human, 30 which comprises treating said human with an effective amount of 3-methyl anagrelide, or a 12 WO 2008/065444 PCT/GB2007/050697 pharmaceutically acceptable salt or solvate thereof, or with a pharmaceutical composition containing any of the foregoing. The present invention also encompasses pharmaceutical compositions comprising a compound or 5 pharmaceutically acceptable salt of a compound of the present invention and a pharmaceutically acceptable carrier. DETAILED DESCRIPTION OF THE INVENTION 10 The present invention is directed to new 3 or 5-substituted analogues of the established platelet lowering agent anagrelide. Substitution at the 3 or the adjacent 5-position of the anagrelide molecule would be expected to block or hinder the principal site of metabolism and potentially preclude the formation of the highly potent PDE III inhibitor 3-OH anagrelide while 15 substitution at the 1-position has surprisingly been found to abolish PDE III inhibition. The compounds of the present invention retain the anti-megakaryocytic properties (hence platelet lowering activity) of the parent drug molecule but have reduced PDE III inhibitory properties and hence lower potential for unwanted cardiovascular and anti-aggregatory side-effects. They also have the potential for improved pharmacokinetic characteristics as the result of inhibition of 20 metabolism. These improved cardiovascular and pharmacokinetic properties were demonstrated by studies in the dog. A comparison of the in vivo cardiovascular effects of anagrelide, its active metabolite and a representative example of an improved analogue shown in the table below: 25 Comparative activity of anagrelide, its metabolite 3-hydroxy anagrelide and a representative 3 alkyl substituted analogue of the drug Compound In vitro |C50 for In vivo ED50 for In vivo ED20 for In vitro |C50 for PDE III inhibition effects on dog effects on dog anti (human enzyme) heart rate heart rate megakaryocytic effects (human cell-line) Anagrelide 29nM 986 pg/kg 376 pg/kg 26nM 13 WO 2008/065444 PCT/GB2007/050697 3-hydroxy anagrelide (active 0.7nM 11.72ug/kg 7.1 pg/kg 44nM metabolite) 3,3 dimethyl anagelide 164nM 3,557ug/kg 2,512 pg/kg 166nM The most meaningful comparison of the data cited in the table above is between 3-hydroxy anagrelide - as the drug's active metabolite - and the 3-alkyl substituted analogue since the former is the predominant species present in the plasma of patients treated with the drug. On this 5 basis the therapeutic benefit to potential for CV side effects ratio is clearly much improved for this 3-alkyl derivative. A comparison of the pharmacokinetic profile in the dog of anagrelide and a representative 3 substituted analogue is shown below: 14 WO 2008/065444 PCT/GB2007/050697 Comparative pharmacokinetics of anagrelide, its resultant active metabolite and a representative 3 substituted analogue follow Img/kg iv in the conscious dog model Compound Cm. AUC(o-t) T1/2 CL* Vss* F(AUCO-t))* (ng/mL) (ng.h/mL) (h) (mL/h/kg) (mL/kg) Anagrelide 48.1± 21 101± 15 1.37 ±20 1156 ±4.56 1011 ±3.8 11.8± 14.4 3-hydroxy anagrelide (arising 60.1±14 179 ±14 1.57 ±24 NA NA from anagrelide treatment) 3,3 167 ±33 1903 ±47 9.39 ±21 178 ±45.9 1967 ±24 39 25 dimethyl anagelide 5 Results represent geometric means and % CV * After 1mg/kg iv The data in the above table clearly show a much longer half-life for the 3-alkyl substituted analogue compared to anagrelide itself (9.39 vs 1.37h) which, if reflected in man, should enable 10 much less frequent drug administration and improved patient compliance compared to that seen with anagrelide. This comparatively longer half-life for 3,3 dimethyl anagrelide observed in the dog was mirrored in an in vitro metabolic stability study in which it was clearly much more metabolically stable than anagrelide (see table below). Hepatic metabolism is known to be the principal mechanism of clearance of anagrelide in both animals and in man. Furthermore, and 15 most importantly, this much greater metabolic stability for the 3-substituted analogue was also observed in human hepatocytes suggesting the likelihood of improved pharmacokinetics in man. 20 15 WO 2008/065444 PCT/GB2007/050697 Comparative metabolic stability of anagrelide and a representative analogue in dog and human hepatocytes Compound In vitro "half-life" in In vitro "half-life" in dog hepatocytes human hepatocytes Anagrelide 1.25h 6.62h 3,3 dimethyl anagrelide No apparent degradation over 22.8h time course of study 5 The pharmaceutically acceptable acid addition salts of certain of the compounds of formula (I) may also be prepared in a conventional manner. For example, a solution of the free base is treated with the appropriate acid, either neat or in a suitable solvent, and the resulting salt isolated either by filtration or by evaporation under reduced pressure of the reaction solvent. For a review on suitable salts, see "Handbook of Pharmaceutical Salts: Properties, Selection, and 10 Use" by Stahl and Wermuth (Wiley-VCH, Weinheim, Germany, 2002). Definition of terms: Halo means a group selected from: fluoro, chloro, bromo or iodo. The term "alkyl" as used herein as a group or a part of a group refers to a straight or branched 15 hydrocarbon chain containing the specified number of carbon atoms. For example, CI- 10 alkyl means a straight or branched alkyl containing at least 1 and at most 10 carbon atoms. Examples of "alkyl" as used herein include, but are not limited to, methyl, ethyl, n-propyl, n-butyl, n pentyl, isobutyl, isopropyl, t-butyl, hexyl, heptyl, octyl, nonyl and decyl. A C 1 4 alkyl group is one embodiment, for example methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl or t-butyl. 20 The term "cycloalkyl" as used herein refers to a non-aromatic monocyclic hydrocarbon ring of 3 to 8 carbon atoms such as, for example, but not limited to, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl or cycloheptyl. 16 WO 2008/065444 PCT/GB2007/050697 The term "spirocyclic" as used herein refers to a ring system joined to a second ring system at one carbon atom. The term "alkoxy" as used herein refers to a straight or branched hydrocarbon chain group 5 containing oxygen and the specified number of carbon atoms. For example, C 1 6 alkoxy means a straight or branched alkoxy containing at least 1 and at most 6 carbon atoms. Examples of "alkoxy" as used herein include, but are not limited to, methoxy, ethoxy, propoxy, prop-2-oxy, butoxy, but-2-oxy, 2-methylprop-1-oxy, 2-methylprop-2-oxy, pentoxy and hexyloxy. A C 1-4 alkoxy group is one embodiment, for example methoxy, ethoxy, propoxy, prop-2-oxy, butoxy, 10 but-2-oxy or 2-methylprop-2-oxy. The term "hydroxyalkyl" as used herein as a group refers to a straight or branched hydrocarbon chain containing the specified number of carbon atoms, which is substituted by 1-3 hydroxyl groups. For example, C 1 4 hydroxyalkyl means a straight or branched alkyl chain containing from 15 1 to 4 carbon atoms and at least one hydroxyl group; examples of such group include hydroxymethyl, hydroxyethyl, hydroxypropyl, hydroxyisopropyl, hydroxybutyl and the like. The term "alkenyl" as used herein as a group or a part of a group refers to a straight or branched hydrocarbon chain containing the specified number of carbon atoms and containing at least one 20 double bond. For example, the term "C2- 6 alkenyl" means a straight or branched alkenyl containing at least 2 and at most 6 carbon atoms and containing at least one double bond. Examples of "alkenyl" as used herein include, but are not limited to, ethenyl, 2-propenyl, 3 butenyl, 2-butenyl, 2-pentenyl, 3-pentenyl, 3-methyl-2-butenyl, 3-methylbut-2-enyl, 3-hexenyl and 1,1-dimethylbut-2-enyl. It will be appreciated that in groups of the form -0-C2- 6 alkenyl, the 25 double bond is preferably not adjacent to the oxygen. The term "alkynyl" as used herein as a group or a part of a group refers to a straight or branched hydrocarbon chain containing the specified number of carbon atoms and containing at least one triple bond. For example, the term "C2- 6 alkynyl" means a straight or branched alkynyl 30 containing at least 2 and at most 6 carbon atoms and containing at least one triple bond. 17 WO 2008/065444 PCT/GB2007/050697 Examples of "alkynyl" as used herein include, but are not limited to, ethynyl, 2-propynyl, 3 butynyl, 2-butynyl, 2-pentynyl, 3-pentynyl, 3-methyl-2-butynyl, 3-methylbut-2-ynyl, 3 hexynyl and 1,1-dimethylbut-2-ynyl. It will be appreciated that in groups of the form

-O-C

2

-

6 alkynyl, the triple bond is preferably not adjacent to the oxygen. The term "halo" 5 refers to halogens such as fluorine, chlorine, bromine or iodine atoms. The term "sulfide" refers to a radical of Ra-S-Rb, wherein a sulfur atom is covalently attached to two hydrocarbon chains, Ra and Rb, wherein the two hydrocarbon chains may be, for example, but not limited to, any discussed above. 10 The compounds of the invention, i.e. those of formula (I), possess antimegakaryocytic activity in humans. They may be particularly useful in the treatment of myeloprolific diseases. The compounds may also find utility in the treatment of generalised thrombotic diseases. 15 It is to be appreciated that references to treatment include prophylaxis as well as the alleviation of established symptoms of a condition. "Treating" or "treatment" of a state, disorder or condition includes: (1) preventing or delaying the appearance of clinical symptoms of the state, disorder or condition developing in a human that may be afflicted with or predisposed to the state, disorder or condition but does not yet experience or display clinical or subclinical 20 symptoms of the state, disorder or condition, (2) inhibiting the state, disorder or condition, i.e., arresting, reducing or delaying the development of the disease or a relapse thereof (in case of maintenance treatment) or at least one clinical or subclinical symptom thereof, or (3) relieving or attenuating the disease, i.e., causing regression of the state, disorder or condition or at least one of its clinical or subclinical symptoms. 25 Myeloproliferative diseases which may be treatable with the compounds of the present invention include: essential thrombocythemia, polycythema vera, chronic idiopathic myelofibrosis, chronic myeloid leukaemia with residual thrombocytosis, reactive thrombocytosis immediately preceding a surgical procedures, as an immediate or post operative preventative measures to 30 minimise the risk of thrombus formation during or post surgery. 18 WO 2008/065444 PCT/GB2007/050697 Thrombotic cardiovascular diseases (TCVD) (i.e. patients at increased generalised thrombotic risk) which may also be treatable with the compounds of the present invention include: myocardial infarct (heart attack) thrombotic stroke, patients having undergone coronary stent 5 placement. The compounds of the present invention may find utility for the reduction of atherothrombotic events as follows: recent MI, recent stroke or established peripheral arterial disease, acute coronary syndrome (unstable angina/non-Qwave MI), cardiovascular death, MI, stroke, and 10 refractory ischemia. It is to be understood that compounds of formula (I) may contain one or more asymmetric carbon atoms, thus compounds of the invention can exist as two or more stereoisomers. 15 Included within the scope of the present invention are all stereoisomers such as enantiomers and diastereomers, all geometric isomers and tautomeric forms of the compounds of formula (I), including compounds exhibiting more than one type of isomerism, and mixtures of one or more thereof. 20 Solubility studies were carried out on a number of anagrelide derivatives according to the present invention in various test media. The test media were: a) singly distilled water (pH 5.0) - note no attempt was made to remove dissolved CO 2 . b) 50 mM ammonium formate (pH 7.9) c) 0.1 M hydrochloric acid (pH 0.6) 25 Calibration plots of HPLC peak area vs. concentration were obtained in MeOH or MeOH / DMSO over the range 1000 - 1 p g / ml for each substance at a temperature 20 - 22 'C. The HPLC method used a reverse phase C 18 column with a water (0.6% formic acid) and acetonitrile gradient. For the solubility studies, saturated solutions were prepared by dissolving in the desired 30 medium with the aid of an ultrasonic bath for 20 minutes and the excess solid removed by 19 WO 2008/065444 PCT/GB2007/050697 centrifugation. The concentration of the substance in the supernatant liquid was determined from the measured peak area. Unexpectedly it was found that stable metal salts could be prepared following deprotonation at 5 the 1-position of the quinazoline ring structure. The value of such salts is seen in their relatively much greater aqueous solubility than the corresponding HBr salts. This is likely to facilitate the rapid dissolution and quantitative absorption of these generally poorly water soluble compounds and so represent a major clinical advantage. These salts are Group I metal salts and most usually are sodium or potassium salts. Table 1 shows the results of the solubility measurements. 10 Table 1 Solubilities of Anagrelide and Anagrelide Derivatives (pg mL 1 at ca. 20 "C) Compound Ammonium formate Water Hydrochloric acid (50 mM, pH 7.9) (pH 5.0) (0.1 M, pH 0.6) Anagrelide 10 11 169 hydrochloride 3,3- 6 409 212 Dimethylanagrelide sodium salt 3,3- 4 20 215 Dimethylanagrelide hydrobromide 3,3,Spiro- 1 542 28 Cyclopropyl anagrelide sodium salt 3,3-spiro- 1 2 35 Cyclopropyl anagrelide hydrobromide 20 WO 2008/065444 PCT/GB2007/050697 3- 5 9 43 Methyleneanagrelide 3- 39 1830 189 Methyleneanagrelide Na salt Geometric isomers may be separated by conventional techniques well known to those skilled in the art, for example, by chromatography and fractional crystallisation. 5 Stereoisomers may be separated by conventional techniques known to those skilled in the art see, for example, "Stereochemistry of Organic Compounds" by E L Eliel (Wiley, New York, 1994). 10 The compounds of formula I can be prepared using literature techniques and in an analogous manner to those described in Formula Scheme I and Formula Scheme II in US 4256748. The synthesis of 3-ethyl anagrelide is described by way of example to show how individual isomers of the invention can be prepared. Analogous procedures can be used to prepare the other compounds of the invention by using appropriate a.-haloesters 15 The formation of 3-ethyl anagrelide (compound (4a)) is shown in Scheme A below. 1-amino-2, 3-dichloro nitrobenzene (la) undergoes nucleophilic substitution with the u-haloester R-ethyl-2 bromobutanoate to afford compound (2a). The nitro group is then reduced to an amine group using tin chloride in ethanol to afford the diamine compound (3a). Compound (3a) is then 20 cyclised with cyanogen bromide in toluene to yield the 3-ethyl anagrelide (4a). Scheme A: Formation of 3-ethylanagrelide. 21 WO 2008/065444 PCT/GB2007/050697 Br R CO 2 Et

NO

2 NO 2 Et H CI

NH

2 C / N sCO 2 Et CI (1a) CI (2a) Et H NH, 2 N SnCl 2 H CNBr N / NS CO2Et N / EtOH CI Toluene CI S CI (3a) Et CI (4a) Et 5 The formation of certain derivatives is accomplished in an analogous manner to the synthesis shown in Scheme A above or by reversing the positions of the NH 2 group and the Br groups in the starting materials, as appropriate to the chemistry involved. In this case, an u-aminoester and a halobenzyl derivative are used as the starting materials. The reaction can be generically presented as shown in Scheme B below in relation to the 3-substituted compound. 10 Scheme B: Formation of 3-substituted anagrelides. B CO 2 Et

NO

2 NO 2 R | H A J:IN ",CO 2Et CICICOE CI CI R H IN

NH

2 IN N SnC I H CNBr - N CO 2 Et - /- N EtOH CI Toluene CI CI R CI R where A is NH2 or Br, and B is the other of NH or Br 22 WO 2008/065444 PCT/GB2007/050697 The formation of (R)-3-ethyl anagrelide can be accomplished in an analogus manner to the synthesis shown in Scheme A above. In this case an u-haloester of the opposite stereochemistry to that used in Scheme A is employed in the nucleophilic substitution step i.e. S-ethyl-2 bromobutanonate. This procedure is generally applicable. 5 If single enantiomers are not required then a racemic u-haloester can be employed in the first stage of the synthesis. A person skilled in the art will be aware of variations of, and alternatives to, the processes 10 referred to above and to those in US 4256748 which allow the individual compounds defined by formula (I) to be obtained. It will also be appreciated by a person skilled in the art that the compounds of the invention could be made by adaptation of the methods herein described and/or adaptation of methods 15 known in the art, for example the art described herein, or using standard textbooks such as "Comprehensive Organic Transformations - A Guide to Functional Group Transformations", RC Larock, Wiley-VCH (1999 or later editions), "March's Advanced Organic Chemistry - Reactions, Mechanisms and Structure", MB Smith, J. March, Wiley, (5th edition or later) "Advanced Organic Chemistry, Part B, Reactions and Synthesis", FA Carey, RJ Sundberg, Kluwer 20 Academic/Plenum Publications, (2001 or later editions), "Organic Synthesis - The Disconnection Approach", S Warren (Wiley), (1982 or later editions), "Designing Organic Syntheses" S Warren (Wiley) (1983 or later editions), "Guidebook To Organic Synthesis" RK Mackie and DM Smith (Longman) (1982 or later editions), etc.,and the references therein as a guide. 25 It will also be apparent to a person skilled in the art that sensitive functional groups may need to be protected and deprotected during synthesis of a compound of the invention. This may be achieved by conventional methods, for example as described in "Protective Groups in Organic Synthesis" by TW Greene and PGM Wuts, John Wiley & Sons Inc (1999), and references therein. 30 23 WO 2008/065444 PCT/GB2007/050697 Compounds of the invention intended for pharmaceutical use may be administered as crystalline or amorphous products. They may be obtained, for example, as solid plugs, powders, or films by methods such as precipitation, crystallization, freeze drying, or spray drying, or evaporative drying. Microwave or radio frequency drying may be used for this purpose. 5 They may be administered alone or in combination with one or more other compounds of the invention or in combination with one or more other drugs. Generally, they will be administered as a formulation in association with one or more pharmaceutically acceptable excipients. Pharmaceutically acceptable excipients include one or more of: anti-oxidants, colourants, 10 flavouring agents, preservatives and taste-masking agents. Pharmaceutical compositions suitable for the delivery of compounds of the present invention and methods for their preparation will be readily apparent to those skilled in the art. Such compositions and methods for their preparation may be found, for example, in 'Remington's 15 Pharmaceutical Sciences', 19th Edition (Mack Publishing Company, 1995). The formulation of tablets is discussed in "Pharmaceutical Dosage Forms: Tablets, Vol. 1", by H. Lieberman and L. Lachman, Marcel Dekker, N.Y., N.Y., 1980 (ISBN 0-8247-6918-X). The methods by which the compounds may be administered include oral administration by 20 capsule, bolus, tablet, powders, lozenges, chews, multi and nanoparticulates, gels, solid solution, films, sprays, or liquid formulation. Liquid forms include suspensions, solutions, and syrups. Such formulations may be employed as fillers in soft or hard capsules and typically comprise a carrier, for example, water, ethanol, polyethylene glycol, propylene glycol, methylcellulose, or a suitable oil, and one or more emulsifying agents and/or suspending agents. Liquid formulations 25 may also be prepared by the reconstitution of a solid preparation, for example, from a sachet. The compounds may also be administered topically to the skin or mucosa, that is dermally or transdermally. Typical formulations for this purpose include pour-on solutions, sprays, powder formulations, gels, hydrogels, lotions, creams, ointments, films and patches, and implants. 30 24 WO 2008/065444 PCT/GB2007/050697 The compounds can also be administered parenterally, or by injection directly into the blood stream, muscle or into an internal organ. Suitable means for parenteral administration include intravenous, intraarterial, intraperitoneal, intrathecal, intraventricular, intraurethral, intrasternal, intracranial, intramuscular and subcutaneous. Suitable devices for parenteral administration 5 include needle (including microneedle) injectors, needle-free injectors and infusion techniques. Formulations may be immediate and/or modified controlled release. Controlled release formulations include Modified release formulations include: delayed-, sustained-, and pulsed release. 10 Dosages Typically, a physician will determine the actual dosage which will be most suitable for an individual subject. The specific dose level and frequency of dosage for any particular individual 15 may be varied and will depend upon a variety of factors including the activity of the specific compound employed, the metabolic stability and length of action of that compound, the age, body weight, general health, sex, diet, mode and time of administration, rate of excretion, drug combination, the severity of the particular condition, and the individual undergoing therapy. 20 In general however a suitable dose will be in the range of from about 0.001 to about 50 mg/kg of body weight per day, in a further embodiment, of from about 0.001 to about 5 mg/kg of body weight per day; in a further embodiment of from about 0.001 to about 0.5 mg/kg of body weight per day and in yet a further embodiment of from about 0.001 to about 0.1mg/kg of body weight per day. In further embodiments, the ranges can be of from about 0.1 to about 750 mg/kg of body 25 weight per day, in the range of 0.5 to 60 mg/kg/day, and in the range of 1 to 20 mg/kg/day. The desired dose may conveniently be presented in a single dose or as divided doses administered at appropriate intervals, for example as one, two, three, four or more doses per day. If the compounds are administered transdermally or in extended release form, the compounds 30 could be dosed once a day or less. 25 WO 2008/065444 PCT/GB2007/050697 The compound is conveniently administered in unit dosage form; for example containing 0.1 to 50 mg, conveniently 0.1 to 5 mg, most conveniently 0.1 to 5 mg of active ingredient per unit dosage form. In yet a further embodiment, the compound can conveniently administered in unit 5 dosage form; for example containing 10 to 1500 mg, 20 to 1000 mg, or 50 to 700 mg of active ingredient per unit dosage form. Compounds of the present invention and their activities are exemplified below. 10 Example 1 Comparative IC 5 o data on anagrelide and some 3-alkyl substituted analogues as PDE III inhibitors and anti-megakaryocytic agents The table below shows the comparative activity of anagrelide and its analogues with respect to 15 their effects on megakaryocytopoeisis (the process giving rise to blood platelets) and PDE III (inhibition of which leads to adverse cardiovascular responses). 26 WO 2008/065444 PCT/GB2007/050697 Comparative in vitro assessment of potential therapeutic and adverse effects of anagrelide and its analogues Compound IC 50 for anti- IC 50 for PDE III Benefit ratio megakaryocytic inhibition (therapeutic to (platelet lowering) (cardiovascular adverse effects) activity effects) Anagrelide 27nM 32nM *0.024: 1 3-hydroxy 44nM 0.7nM 0.016 : 1 anagrelide 3,3 dimethyl 164nM 166nM 1: 1 anagrelide 3-spirocyclo 547nM 797nM 1.45 : 1 propyl anagrelide * Pharmacokinetically adjusted value based on three-fold greater systemic exposure to active 5 metabolite (3-hydroxy anagrelide) than to the drug itself in man. Assessment of the in vitro anti-megakaryocytic activity - and potentially therefore the platelet lowering capability - of the 3-substituted analogues of anagrelide was conducted using a well established model of megakaryocytopoiesis (Cohen-Solal et al., Thromb. Haemost. 1997, 78:37 10 41 and Cramer et al., Blood, 1997, 89:2336-46). It can be readily seen that with anagrelide the benefit ratio (therapeutic to adverse effects) was comparatively low at 0.024:1 (after accounting for the predominant exposure to the cardioactive metabolite in vivo). By contrast 3 spirocyclopropyl and 3,3 dimethyl anagrelide both demonstrated a relatively much better benefit ratio in these studies. 15 27

Claims (22)

1. A compound of Formula (I) or a pharmaceutically acceptable salt or solvate thereof R R R N N RG N I R 5 R4 R 3 R 2 5(I wherein: R' and R 2 independently represent a blocking group which functions to prevent metabolic 10 reaction at the position of substitution; RW and R independently represent hydrogen or a blocking group which functions to prevent metabolic reaction at the position of substitution; 15 or wherein R 1 and R2 together with the carbon to which they are attached form a blocking group which functions to prevent metabolic reaction at the 3-position and R? and R 4 are hydrogen; or wherein R' and R 2 , and RW and R 4 , together with the carbons to which they are 20 attached each form a blocking group which functions to directly or indirectly prevent metabolic reaction at the 3-position; R 5 is selected from the group comprising: fluoro, chloro, bromo and iodo; 25 R' is selected from the group comprising: fluoro, chloro, bromo and iodo; 32 WO 2008/065444 PCT/GB2007/050697 R' and R 8 are independently selected from the group comprising: H; halo; cyano; CI. 6 alkyl, C 1 . 6 haloalkyl, CI- 6 alkoxy, and C 1 . 6 haloalkoxy; and R 9 is H, C 1 - alkyl, or a Group I metal ion; 5 provided always that R', R 2 , R? and R are not all hydrogen.

2. A compound according to claim 1, wherein R 1 and R 2 are both independently selected from the group comprising: cyano, CI alkyl, C2. 6 alkenyl, C2. 6 alkynyl, in which the 10 alkyl, alkenyl, and alkynyl groups may be optionally substituted; or wherein R' and R 2 together with the carbon to which they are attached form an optionally substituted C3.s carbocyclic ring 15 or wherein R1 and R 2 together with the carbon to which they are attached represent an optionally substituted C 2 . 6 alkenyl or C 2 6 alkynyl group.

3. A compound according to claim 1 or 2, wherein R 3 and R 4 are independently selected from the group comprising: H; cyano; C 1 . 6 alkyl, SCIs alkyl, C2. 6 alkenyl, C 2 - 6 alkynyl, 20 C 3 - cycloalkyl wherein said alkyl, alkenyl, alkynyl or cycloalkyl groups may be optionally substituted by 1 to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyano, nitro, C 14 alkylsulphonyl and COOH; C 1 . 6 hydroxyalkyl; C1.6 carboxyalkyl; and sulphide; 25 or R 3 and R' together with the carbon to which they are attached form a CM carbocyclic ring may be optionally substituted -by I to 5 groups chosen independently from the group comprising: halo, hydroxyl, cyauo, nitro, C1 haloalkyl, C 14 alkylsulphonyl and COOH; or R 3 and R 4 together represent a C2..6 alkenyl or C246 alkynyl group bound through a 30 double bond to the ring to which it is attached and being optionally substituted by one to 33 WO 2008/065444 PCT/GB2007/050697 three groups independently selected from the group comprising: halo, hydroxyl, cyano, CI4 haloalkyl and COOH.

4. A compound as claimed in claim 1, 2 or 3, wherein R 3 is H or C 1 . 6 alkyl. 5

5. A compound as claimed in claim 1, 2, 3 or 4, wherein R 4 is H or Ca alkyl.

6. A compound as claimed in any preceding claim, wherein RW is chloro. 10

7. A compound as claimed in any preceding claim, wherein R is chloro.

8. A compound as claimed in any preceding claim, wherein R 7 is H.

9. A compound as claimed in any preceding claim, wherein R' is H. 15

10. A compound as claimed in any preceding claim, wherein R 9 is H.

11. A compound as claimed in any of claims I to 9, wherein R 9 is methyl. 20

12. A compound as claimed in any of claims I to 9, wherein R 9 is sodium.

13. A compound as claimed in any preceding claim, wherein R' is an optionally substituted C1.4 alkyl or C3.. cycloalkyl group. 25

14. A compound as claimed in any preceding claim, wherein R 2 is an optionally substituted CI.4 alkyl or Cs 2 s cycloalkyl group.

15. A compound as claimed in any preceding claim, wherein R is methyl, cyclopropyl, CF 3 or CHF 2 . 30 34 WO 2008/065444 PCT/GB2007/050697

16. A compound as claimed in any preceding claim, wherein R 2 is methyl, cyclopropyl, CF3 or CHF 2 .

17. A compound as claimed in any of claims i to 12, wherein RI and R 2 together form an 5 optionally substituted C 34 S cycloalkyl group.

18. A pharmaceutical composition comprising a compound of formula (1) as defined in any of claims 1 to 17, or a pharmaceutically acceptable salt or solvate thereof, together with a pharmaceutically acceptable diluent or carrier, which may be adapted for oral, parenteral 10 or topical administration.

19. A compound of formula (I) as defined in any of claims I to 17, or a pharmaceutically acceptable salt or solvate thereof, or a pharmaceutical composition containing any of the foregoing, for use as a medicament. 15

20. The use of a compound of formula (1) as defined in any of claims 1 to 17, or a pharmaceutically acceptable salt or solvate thereof in the manufacture of a medicament for the treatment of a disease selected from: myeloprolific diseases and generalised thrombotic diseases. 20

21. A method of treating a disease selected from. myeloprolific diseases and generalised thrombotic diseases in a human, which comprises treating said human with an effective amount of a compound of formula (1) as defined in any of claims I to 17, or a pharmaceutically acceptable salt or solvate thereof, or with a pharmaceutical composition 25 containing any of the foregoing.

22. Use of a compound of formula (1) as defined in any of claims 1 to 17 for the reduction of platelet count. 30 35