CA2247946C - Anticachectic composition - Google Patents

Abstract

A medicinal composition for the prophylaxis and treatment of cachexia which comprises a compound of formula (I) wherein R
represents a hydrocarbon group that may be substituted or a heterocyclic group that may be substituted; Y represents a group of the formula -CO-, -CH(OH)-, or -NR3- (R3 represents an alkyl group that may be substituted); m is 0 or 1; n is 0, 1 or 2; X represents CH or N; A
represents a bond or a bivalent aliphatic hydrocarbon group having 1 to 7 carbon atoms; Q represents oxygen or sulphur; R1 represents hydrogen or an alkyl group; ring E may have further 1 to 4 substituents, which may form a ring in combination with R1; L and M
respectively represent hydrogen or may be combined with each other to form a bond, provided that when m and n are O, X represents CH, A represents a bond, Q represents sulfur, R1, L and M respectively represent hydrogen, and ring E does not have further substituents, R
does not represent dihydrobenzopyranyl; or a salt thereof.

Description

WO 97!37656 PCT/JP97/01148 DESCRIPTION
ANTICACHECTIC COMPOSITION
TECHNICAL FIELD
The present invention relates to a medicinal com-position for the prophylaxis and treatment of cachexia which develops in chronic diseases such as malignant tumor, tuberculosis, diabetes, blood dyscrasia, endocrine disease, infectious disease, or acquired immunodeficiency syndrome.
BACKGROiJND ART
Cachexia is a systemic syndrome with progressive loss of body weight, anemia, edema, and anorexia as cardinal symptoms which develops in chronic diseases such as malignant tumor, tuberculosis, diabetes, blood dyscrasia, endocrine disease, infectious disease, and acquired immunodeficiency syndrome [e. g. Kern et al., Cancer Cachexia, J. Parenteral and Enteral Nutrition, 286-298 (1988) and American Journal of Medicine, ,$~, 289-291 (1988)].
In cachexia, therapeutic nutrition and endocrine therapy are generally administered but a satisfactory anticachectic modality remains to be established. Par-ticularly where cachexia is caused by a malignant tumor, the available anticancer chemotherapy cannot be administered when cachexia is progressing, with the result that the treatment encounters a serious setback.
Moreover, any therapeutic nutrition for relief of cachectic symptoms may rather exacerbate the malignant tumor and detract from the life expectancy of the patient. While cachexia is frequently caused by the malignant tumors, administration of an antitumor agent in such settings may result in control of the tumors but generally side effects of the drug develop in superimposition, the net result being no improvement in cachexia [Nelson et al., Journal of Clinical Oncology, Z ~. ....

~, 213-225 (1994)).
In the above state of the art, there is a standing need for an anticachectic composition that should ameliorate or inhibit progression of cachectic symptoms such as loss of body weight.
DISCLOSURE OF INVFN'~ION
The present invention relates toga medicinal com position for the prophylaxis and treatment of cachexia which comprises a compound of the formula:
~_ ~y~~ ~~g2~n_ A E~ C---C-0 ( ~
A Cl~
Q~,.NH
wherein R represents a hydrocarbon group that may be substituted or a heterocyclic group that may be substi-tuted; Y represents a group of the formula -CO-, -CH(OH)-, or -NR3- (R3 represents an alkyl group that may be substituted); m is 0 or 1; n is 0, 1 or 2; X
represents CH o.r N; A represents a bond or a bivalent aliphatic hydrocarbon group having 1 to 7 carbon atoms;
Q represents oxygen or sulfur; Ri represents hydrogen or an alkyl group; ring E may have further 1 to 4 substituents, which may form a ring in combination with R1; L and M each represent hydrogen or are combined with each other to form a bond; provided that when m and n are 0, X represents CH, A represents a bond, Q represents sulfur, R1, L and M each represent hydrogen, and ring E does not have further substituents, R does not represent dihydrobenzopyranyl;
or a salt thereof (hereinafter referred to simply as Compound (I)).
Referring to the hydrocarbon group that may be substituted for R, the hydrocarbon group includes aliphatic, alicyclic, alicyclic-aliphatic, aromatic-aliphatic, and aromatic hydrocarbon groups. The preferred number of carbon atoms constituting such hydrocarbon groups is 1 to 14.
The aliphatic hydrocarbon group is preferably a Ci_8 aliphatic hydrocarbon group. The aliphatic hydrocarbon group includes saturated C1_8 aliphatic hydrocarbon groups (e. g. alkyl groups) such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, t-butyl, pentyl, isopentyl, neopentyl, t-pentyi, hexyl, isohexyl, heptyl, and octyl; and unsaturated Cz_8 aliphatic hydrocarbon groups (e. g. alkenyl, alkadienyl, alkynyl, and alkadiynyl groups) such as ethenyl, 1-propenyl, 2-propenyl, 1-butenyl, 2-butenyl, 3-butenyl, 2-methyl-1-propenyl, 1-pentenyl, 2-pentenyl, 3-pentenyl, 4-pentenyl, 3-methyl-2-butenyl, 1-hexenyl, 3-hexenyl, 2,4-hexadienyl, 5-hexenyl, i-heptenyl, 1-octenyl, ethynyl, 1-propynyl, 2-propynyl, 1-butynyl, 2-butynyl, 3-butynyl, 1-pentynyl, 2-pentynyl, 3-pentynyl, 4-pentynyl, 1-hexynyl, 3-hexynyl, 2,4-hexadiynyl, 5-hexynyl, 1-heptynyl, and 1-octynyl.
The alicyclic hydrocarbon group is preferably a C3_~ alicyclic hydrocarbon group. The alicyclic hydrocarbon group includes saturated C3_~ alicyclic hydrocarbon groups (e.g. cycloalkyl groups) such as cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, etc. and unsaturated CS_~ alicyclic hydrocarbon groups (e.g. cycloalkenyl and cycloalkadienyl groups) such as 1-cyclopentenyl, 2-cyclopentenyl, 3-cyclopentenyl, 1-cyclohexenyl, 2-cyclohexenyl, 3-cyclohexenyl, 1-cycloheptenyl, 2-cycloheptenyl, 3-cycloheptenyl, and 2,4-cyclo-heptadienyl.
The alicyclic-aliphatic hydrocarbon group is a group consisting of the above-described alicyclic hydrocarbon group and aliphatic hydrocarbon group (e. g.
cycloalkyl-alkyl and cycloalkenyl-alkyl groups) and is preferably a C4_9 alicyclic-aliphatic hydrocarbon group.
Specifically, the alicyclic-aliphatic hydrocarbon group includes cyclopropylmethyl, cyclopropylethyl, cyclobutylmethyl, cyclopentylmethyl, 2-cyclopentenylmethyl, 3-cyclopentenylmethyl, cyclohexylmethyl, 2-cyclohexenylmethyl, 3-cyclo-hexenylmethyl, cyclohexylethyl, cyclohexylpropyl, cycloheptylmethyl, cycloheptylethyl, etc.
The aromatic-aliphatic hydrocarbon group is preferably a C~_13 aromatic-aliphatic hydrocarbon group (e. g. aralkyl and arylalkenyl groups). The aromatic-aliphatic hydrocarbon group includes C~-9 phenylalkyl such as benzyl, phenethyl, 1-phenylethyl, 3-phenylpropyl, 2-phenylpropyl and 1-phenylpropyl; C11-is naphthylalkyl such as a-naphthylmethyl, a,-naphthylethyl, j3-naphthylmethyl, and J3-naphthylethyl;
C8_lo phenylalkenyl such as styryl and 4-phenyl-1,3-butadienyl; and Clz-13 naphthylalkenyl such as 2-(2-naphthyl)vinyl.
The aromatic hydrocarbon group is preferably a C6_ 14 aromatic hydrocarbon group (e.g. aryl groups ). The aromatic hydrocarbon group includes phenyl and naphthyl {a-naphthyl, ~3-naphthyl).
Referring to the formula (I), the heterocyclic group in a heterocyclic group that may be substituted for R is a 5- to 7-membered monocyclic heterocyclic group containing 1 to 4 hetero-atoms selected from oxygen, sulfur, and nitrogen in addition to carbon as ring members or a condensed heterocyclic ring group.
The condensed heterocyclic ring may for example be one consisting of such a 5- to 7-membered monocyclic heterocyclic group and a S-membered ring containing 1 or 2 nitrogen atoms, a benzene ring, or a 5-membered WO 97/37656 PCT/JP97/Og148 ring containing one sulfur atom.

Specifically the heterocyclic group includes 2-pyridyl, 3-pyridyl, 4-pyridyl, 2-pyrimidinyl, 4-pyrimidinyl, 5-pyrimidinyl, 6-pyrimidinyl, 3-5 pyridazinyl, 4-pyridazinyl, 2-pyrazinyl, 2-pyrrolyl, 3-pyrrolyl, 2-imidazolyl, 4-imidazolyl, 5-imidazolyl, 3-pyrazolyl, 4-pyrazolyl, isothiazolyl, isoxazolyl, 2-thiazolyl, 4-thiazolyl, 5-thiazolyl, 2-oxazolyl, 4-oxazolyl, 5-oxazolyl, 1,2,4-oxadiazol-5-yl, 1,2,4-triazol-3-yl, 1,2,3-triazol-4-yl, tetrazol-5-yl, benzimidazol-2-yl, indol-3-yl, 1H-indazol-3-yl, 1H-pyrrolo[2,3-b]pyrazin-2-yl, 1H-pyrrolo[2,3-b]pyridin-6-yl, 1H-imidazo[4,5-b]pyridin-2-yl, IH-imidazo[4,5-c]pyridin-2-yl, 1H-imidazo[4,5-b]pyrazin-2-yl, and benzopyranyl. The preferred heterocyclic group is pyridyl, oxazolyl, or thiazolyl.

Referring to the formula (I), the hydrocarbon group and heterocyclic group for R may respectively have 1 to 5, preferably 1 to 3 substituents at substitutable positions. Such substituents include for example aliphatic hydrocarbon groups, alicyclic hydrocarbon groups, aryl groups, aromatic heterocyclic groups, nonaromatic heterocyclic groups, halogen, nitro, amino group that may be substituted, aryl groups that may be substituted, hydroxy group that may be substituted, thiol that may be substituted, and carboxyl group that may be esterified.
The aliphatic hydrocarbon group includes straight chain or branched aliphatic hydrocarbon groups having 1 to~l5 carbon atoms, such as alkyl, alkenyl, and alkynyl groups.
The preferred alkyl group is a C1_lo alkyl group, such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, t-butyl, pentyl, isopentyl, neo-pentyl, t-pentyl, 1-ethylpropyl, hexyl, isohexyl, l,I-dimethylbutyl, 2,2-dimethylbutyl, 3,3-dimethylbutyl, 2-WO 97!37656 PCT/JP97/01148 ethylbutyl, hexyl, pentyl, octyl, nonyl, and decyl.
The preferred alkenyl group is a CZ_lo alkenyl group, such as vinyl, ally!, isopropenyl, 1-propenyl, ' 2-methyl-1-propenyl, 1-butenyl, 2-butenyl, 3-butenyl, 2-ethyl-1-butenyl, 3-methyl-2-butenyl, 1-pentenyl, 2-pentenyl, 3-pentenyl, 4-pentenyl, 4-methyl-3-pentenyl, 1-hexenyl, 2-hexenyl, 3-hexenyl, 4-hexenyl, and 5-hexenyl.
The preferred alkynyl group is a Cz_lo alkynyl group, such as ethynyl, 1-propynyl, 2-propynyl, 1 butynyl, 2-butynyl, 3-butynyl, 1-pentynyl, 2-pentynyl, 3-pentynyl, 4-pentynyl, 1-hexynyl, 2-hexynyl, 3-hexynyl, 4-hexynyl, and 5-hexynyl.
The alicyclic hydrocarbon group includes saturated and unsaturated alicyclic hydrocarbon groups having 3 to 12 carbon atoms, such as cycloalkyl, cycloalkenyl, and cycloalkadienyl groups.
The preferred cycloalkyl group is a C3_lo cycloalkyl group, such as cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, bicyclo[2.2.1]heptyl, bicyclo[2.2.2]octyl, bicyclo[3.2.I]octyl, bicyclo[3.2.2]nonyl, bicyclo[3.3.1]nonyl, bicyclo[4.2.1]nonyl, and bicyclo[4.3.I]decyl.
The preferred cycloalkenyl group is a C3_lo cycloalkenyl group, such as 2-cyclopenten-1-yl, 3-cyclopenten-1-yl, 2-cyclohexen-1-yl, 3-cyclohexen-1-yl.
The preferred cycloalkadienyl group is a C4_lo cycloalkadienyl group, such as 2,4-cyclopentadien-1-yl, 2,4-cyclohexadien-1-yl, 2,5-cyclohexadien-1-yl.
The term "aryl group" means a monocyclic or condensed polycyclic aromatic hydrocarbon group. As preferred examples, C6_14 aryl groups such as phenyl, a naphthyl, anthryl, phenanthryl, acenaphthylenyl can be mentioned. Particularly preferred are phenyl, 1-naphthyl, and 2-naphthyl.

The preferred aromatic heterocyclic group includes 5- to 7-membered monocyclic aromatic heterocyclic groups containing 1 to 4 hetero-atoms selected from oxygen, sulfur, and nitrogen in addition to carbon as ring members, such as furyl, thienyl, pyrrolyl, oxazolyl, isoxazolyl, thiazolyl, isothiazolyl, imidazolyl, pyrazolyl, 1,2,3-oxadiazolyl, 1,2,4-oxadiazolyl, 1,3,4-oxadiazolyl, furazanyl, 1,2,3-thiadiazolyl, 1,2,4-thiadiazolyl, 1,3,4-thiadiazolyl, 1,2,3-triazolyl, 1,2,4-triazolyl, tetrazolyl, pyridyl, pyridazinyl, pyrimidinyl, pyrazinyl, and triazinyl; and dicyclic or tricyclic condensed aromatic heterocyclic groups containing 1 to 5 hetero-atoms selected from oxygen, sulfur, and nitrogen in addition to carbon as ring members, such as benzofuranyl, isobenzofuranyl, benzo[b]thienyl, indolyl, isoindolyl, 1H-indazolyl, benzimidazolyl, benzoxazolyl, 1,2-benzisoxazolyl, benzothiazolyl, 1,2-benzisothiazolyl, 1H-benzotriazolyl, quinolyl, isoquinolyl, cinnolinyl, quinazolinyl, quinoxalinyl, phthalazinyl, naphthyridinyl, purinyl, pteridinyl, carbazolyl, oc-carbolinyl, j3-carbolinyl, y-carbolinyl, acridinyl, phenoxazinyl, phenothiazinyl, phenazinyl, phenoxathiinyl, thianthrenyl, phenanthridinyl, phenanthrolinyl, indolizinyl, pyrrolo[1,2-b]pyridazinyl, pyrazolo[1,5-a]pyridyl, imidazo[1,2-a]pyridyl, imidazo[1,5-a]pyridyl, imidazo[1,2-b]pyridazinyl, imidazo[1,2-a]pyrimidinyl, 1,2,4-triazolo[4,3-a]pyridyl, and 1,2,4-triazolo[4,3-b]pyridazinyl.

The preferred nonaromatic heterocyclic group includes oxiranyl, azetidinyl, oxetanyl, thietanyl, . pyrrolidinyl, tetrahydrofuryl, thiolanyl, piperidyl, tetrahydropyranyl, morpholinyl, thiomorpholinyl, piperazinyl, pyrrolidino, piperidino, and morpholino.

The halogen includes fluorine, chlorine, bromide, and iodine, and is preferably fluorine or chlorine.
The amino group that may be substituted includes amino (-NHz) that may be mono- or di-substituted by, for example, C1_lo alkyl groups, C3_lo cycloalkyl groups, Cz_io alkenyl groups, C3_lo cycloalkenyl groups, C1_13 acyl groups (e.g. Cz_io alkanoyl groups, C~_13 arylcarbonyl groups), or C6_iz aromatic groups. As examples of the substituted amino group, there can be mentioned methyl-amino, dimethylamino, ethylamino, diethylamino, dibutylamino, diallylamino, cyclohexylamino, acetylamino, propionylamino, benzoylamino, phenylamino, and N-methyl-N-phenylamino.
The acyl group in the acyl groups that may be substituted includes C1_13 acyl groups. For example, formyl and groups formed between carbonyl and C1_io alkyl, C3_lo cycloalkyl, Cz_lo alkenyl, C3_~o cycloalkenyl, Cs-iz aryl, or aromatic heterocyclic groups {e. g.
thienyl, furyl, pyridyl). The preferred acyl group includes acetyl, propionyl, butyryl, isobutyryl, valeryl, isovaleryl, pivaloyl, hexanoyl, heptanoyl, octanoyl, cyclobutanecarbonyl, cyclopentanecarbonyl, cyclohexanecarbonyl, cycloheptanecarbonyl, crotonyl, 2-cyclohexenecarbonyl, benzoyl, nicotinoyl. The substi-tutent in the substituted acyl groups includes C1_3 alkyl, C1_3 alkoxy groups, halogen (e. g. chlorine, fluorine, bromine, etc.), nitro, hydroxy, and amino.
Referring to the hydroxy group that may be substituted, the substituted hydroxy includes alkoxy, alkenyloxy, aralkyloxy, acyloxy, and aryloxy groups.
The preferred alkoxy group includes C1_lo alkoxy groups, such as methoxy, ethoxy, propoxy, isopropoxy, butoxy, isobutoxy, sec-butoxy, t-butoxy, pentyloxy, isopentyloxy, neopentyloxy, hexyloxy, heptyloxy, nonyloxy, cyclobutoxy, cyclopentyloxy, and cyclohexyloxy.

WO 97!37656 PCT/JP97/Oll148 The preferred alkenyloxy group includes CZ_io alkenyloxy groups, such as allyloxy, crotyloxy, 2-pentenyloxy, 3-hexenyloxy, 2-cyclopentenylmethoxy, and 2-cyciohexenylmethoxy.
The preferred aralkyloxy group includes C7_lo aralkyloxy groups, such as phenyl-C1_4 alkyloxy (e. g.
benzyloxy, phenethyloxy, etc.).
The preferred acyloxy group includes CZ_13 acyloxy groups, more preferably Cz_4 alkanoyloxy (e. g.
acetyloxy, propionyloxy, butyryloxy, isobutyryloxy, etc.).
The preferred aryloxy group includes C6_~4 aryloxy groups, such as phenoxy, and naphthyloxy. This aryloxy group may have 1 or 2 substituents such as halogen (e.g. chlorine, fluorine, bromine, etc.). The substituted aryloxy group includes 4-chlorophenoxy.
Referring to the thiol group that may be substituted, the substituted thiol group includes alkylthio, cycloalkylthio, aralkylthio, and acylthio groups.
The preferred alkylthio group includes C1_io alkylthio groups, such as methylthio, ethylthio, propylthios, isopropylthio, butylthio, isobutylthio, sec-butylthio, t-butylthio, pentylthio, isopentylthio, neopentylthio, hexylthio, heptylthio, and nonylthio.
The preferred cycloalkylthio group includes C3_io cycloalkylthio groups such as cyclobutylthio, cyclopentylthio, and cyclohexylthio.
The preferred aralkylthio group includes C~_io aralkylthio groups, such as phenyl-C1_4 alkylthio (e. g.
benzylthio, phenethylthio, etc.).
The acylthio group is preferably a Cz_13 acylthio group, more preferably a Cz_4 alkanoylthio group (e. g.
acetylthio, propionylthio, butyrylthio, isobutyrylthio, etc.).

WO 97!37G56 PCTI3P97/01148 The carboxyl group that may be esterified includes alkoxycarbonyl, aralkyloxycarbonyl, and aryloxycarbonyl groups. ' The preferred alkoxycarbonyl group includes CZ_s 5 alkoxycarbonyl groups, such as methoxycarbonyl, ethoxycarbonyl, propoxycarbonyl, and butoxycarbonyl.
The preferred aralkyloxycarbonyl group includes C8_lo aralkyloxycarbonyl groups, such as benzyloxy-carbonyl.

10 The preferred aryloxycarbonyl group includes C~_ls aryloxycarbonyl groups, such as phenoxycarbonyl, and p-tolyloxycarbonyl.
The preferred substituent on the hydrocarbon or heterocyclic group for R includes C1_lo alkyl groups, aromatic heterocyclic groups, and C6_14 aryl groups.
Particularly preferred is C1_3 alkyl, furyl, thienyl, phenyl, or naphthyl.
Referring to the formula (I), when the substituent on the hydrocarbon or heterocyclic group for R is an alicyclic hydrocarbon group, an aryl group, an aromatic heterocyclic group, or a nonaromatic heterocyclic group, this substituent may be further substituted by one or more, preferably 1 to 3 suitable substituents.
As such substituents, there can be mentioned C1_6 alkyl groups, C~_6 alkenyl groups, C~_6 alkynyl groups, C3_~
cycloalkyl groups, C6_14 aryl groups (e. g. phenyl, naphthyl, etc.), aromatic heterocyclic groups (e. g.
thienyl, furyl, pyridyl, oxazolyl, thiazolyl, etc.), nonaromatic heterocyclic groups (e. g. tetrahydrofuryl, morpholino, thiomorpholino, piperidino, pyrrolidino, piperazino, etc.), C7_9 aralkyl groups, amino, N-mono(Ci_ -4 ) alkylamino groups , N, N-di ( C1_4 ) alkylamino groups , C2_$
acylamino groups (e. g. acetylamino, propionylamino, benzoylamino, etc . ) , amidino, CZ_8 acyl groups ( a . g . CZ_$
alkanoyl groups, etc.), carbamoyl, N-mono(C1_ WO 97/37656 PCT/.TP97/01148 4)alkylcarbamoyl groups, N,N-di(C1_4)alkylcarbamoyl groups, sulfamoyl, N-mono(C1_4)alkyisulfamoyl groups, N, N-di ( C1_4 ) alkylsulfamoyl groups , carboxyl , C2_$

alkoxycarbonyl groups , hydroxy, Cl_4 alkoxy groups , C2_s ' 5 alkenyloxy groups, C3_~ cycloalkyloxy groups, C~_9 aralkyloxy groups, C6_i4 aryloxy groups (e. g. phenyloxy, naphthyloxy, etc.), mercapto, C1_4 alkylthio groups, C~_9 aralkylthio groups, C6_14 arylthio groups (e. g. phenyl-thio, naphthylthio, etc.), sulfo, cyano, azido, nitro, nitroso, and halogen (e. g. fluorine, chlorine, bromine, iodine).

In the formula (I), R is preferably a heterocyclic group that may be substituted. More preferably, R is pyridyl, oxazolyl, or thiazolyl group, which may have 1 Z5 to 3 substituents selected from C1_3 alkyl, furyl, thienyl, phenyl, and naphthyl.

Referring to the formula (I), Y represents -CO-, -CH(OH)-, or -NR3-. Y is preferably -CH(OH}- or -NR3-and more preferably -CH(OH)-. Referring to an alkyl group that may be substituted for R3, the alkyl group includes C1_4 alkyl groups, such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, and t-butyl. The substituent includes halogen (e. g.

fluorine, chlorine, bromine, iodine}, C1_~ alkoxy groups (e. g. methoxy, ethoxy, propoxy, butoxy, isobutoxy, sec-butoxy, t-butoxy), hydroxy, nitro, and Ci_4 acyl groups (e.g formyl, acetyl, propionyl, etc.).

The symbol n represents 0, 1 or 2 and is preferably 0 or 1.

~ The symbol X represents CH or N and is preferably CH.
Referring to the formula (I), A represents a bond ' or a bivalent aliphatic hydrocarbon group having 1 to 7 carbon atoms. This aliphatic hydrocarbon group may be straight-chain or branched and may further be saturated or unsaturated. Thus, for example, -CHz-, -CH(CH~)-, -(CHz)z-. -CH(CZHS)-, -{CHz)~-~ -(CH2)4w -{CHz)s-- ( CHz ) s-. - ( CHz ) ~-, etc . can be mentioned for the saturated bivalent aliphatic hydrocarbon group, while -CH=CH-, -C { CH3 ) =CH-, -CH=CH-CHz-, -C ( C2H5 ) =CH-, -CHz- , CH= CH-CHz-, -CHz-CHz-CH=CH-CHz-, -CH=CH-CH=CH-CHz-, -CH=CH-CH=CH-CH=CH-CHz-, etc. can be mentioned for the unsaturated bivalent aliphatic hydrocarbon group. The symbol A preferably represents a bond or a bivalent aliphatic hydrocarbon group having 1 to 4 carbon atoms, which is preferably a saturated group. More preferably, A represents a bond, -CHz- or -{CHz)z-Still more preferably, A represents a bond or -(CHz}z--The alkyl group for R1 includes C1_4 alkyl groups such as methyl, ethyl, propyl, isopropyl, butyl, isobutyl, sec-butyl, and t-butyl. Preferably, R1 represents hydrogen.
Referring to the formula (I), the partial structural formula:
/~ /
E~ is preferably the formula:
wherein each symbols has the same meanings as defined above.
Furthermore, ring E may optionally have I to 4 substituents at substitutable positions. Such substituents include an alkyl group, a hydroxy group that may be substituted, halogen, an acyl group that may be substituted, nitro, and an amino group that may be substituted. These substituents may be the same as the substituents mentioned for the hydrocarbon or heterocyclic group for R.
Ring E, the partial structural formula:
SUBSTITUTE SHEET (RULE 26) E~ is preferably the formulao X
' S wherein R2 represents hydrogen, an alkyl group, a hydroxy group that may be substituted, halogen, an acyl group that may be substituted, nitro, or an amino group that may be substituted.
The alkyl group, hydroxy group that may be substituted, halogen, acyl group that may be substituted, and amino group that may be substituted, for RZ, may each be the same as that mentioned for the hydrocarbon or heterocyclic group for R. Preferably, RZ is hydrogen, hydroxy group that may be substituted, or halogen. More preferably, RZ is hydrogen or hydroxy group that may be substituted. Particularly preferred is hydrogen or a C1_4 alkoxy group .
L and M respectively represent hydrogen or may be combined with each other to form a bond, and preferably they are hydrogen.
Referring to the formula (I}, the compound in which L and M are combined with each other to form a bond:
R' ~
R- (y)~- (CHZ)n- ~ H E~A-CHy=0 \X~ Q~NH C I - A 1 ) wherein each symbols has the same meanings as defined above, may exist as (E)- and (Z)- isomers, owing to the double bond at 5-position of the azolidinedione ring.
The compound in which L and M respectively repre-sent hydrogen:
SUBSTITUTE SHEET (RULE 26) i4 R~
A-CY)~-CCH2)n- ~H E~'A'OHZyH-C=0 ~X Q~iNH < I - A 2 ) a wherein each symbols has the meanings as defined above, may exist as optical isomers, i.e. (R}- and (S)-forms, with respect to the asymmetric carbon at 5-position of the azolidinedione ring. This compound includes those optically active compounds, i.e. (R)- and (S)-forms, as well as the racemic form.
Referring to the formula (I) of the present invention, when m and n are 0; X represents CH; A
represents a bond; Q represents sulfur; R1, L, and M
respectively represent hydrogen; and ring E does not have further substituents, R is not dihydrobenzo-pyranyl.
The preferred compound of the formula (I) is the compound in which R represents pyridyl, oxazolyl, or thiazolyl group, optionally having 1 to 3 substituents selected from the group consisting of C1_3 alkyl, furyl, thienyl, phenyl, and naphthyl; Y represents -CH(OH)-; n is 0 or 1; X represents CH; A represents a bond or -(CHZ)Z-; RI represents hydrogen; ring E, namely the partial structural formula:
/ ~2 is the /
formula: W
X
RZ is hydrogen or a C~_4 alkoxy group; and L and M .
respectively represent hydrogen.
As preferred species of the compound of the .
formula (I), the following compounds {1) to (7) are mentioned.
(1) 5-[4-[2-(5-ethyl-2-pyridyl)ethoxyjbenzylj-2,4-_ SUBSTITUTE SHEET (RULE 26j thiazolidinedione, (2) 5-[4-[2-hydroxy-2-{5-methyl-2-phenyl-4-oxazolyl)-ethoxy]benzyl]-2,4-thiazolidinedione, (3) (R)-(+)-5-[3-[4-[2-(2-furyl)-5-methyl-4-oxazolyl-Y
5 methoxy]-3-methoxyphenyl]propyl]-2,4-oxazolidinedione, (4) (S)-(-)-5-[3-[4-[2-(2-furyl)-5-methyl-4-oxazolyl-methoxy]-3-methoxyphenyl]propyl]-2,4-oxazolidinedione, (5) 5-[3-[3-fluoro-4-(5-methyl-2-phenyl-4-oxazolyl-methoxy)phenyl]propyl]-2,4-oxazolidinedione, 10 (6) 5-[5-[3-methoxy-4-(5-methyl-2-phenyl-4-oxazolyl-methoxy)phenyl]pentyl]-2,4-oxazolidinedione, (7) 5-[3-[3,5-dimethoxy-4-[2-[(E)-styryl]-4-oxazolyl-methoxy)phenyl]propyl]-2,4-oxazolidinedione (hereafter, these compounds are sometimes simply referred to as 15 compound (1), compound (2), and the like).
Among the above compounds, compounds (1) to {3), (5), and (6) are preferred, and compounds (1) to (3) are particularly preferred.
The salt of compound (I) of the present invention is preferably a pharmacologically acceptable salt, which includes salts with inorganic bases, salts with organic bases, salts with inorganic acids, salts with organic acids, and salts with basic or acidic amino acids.
The preferred salt with an inorganic base includes alkali metal salts such as sodium salt, potassium salt, etc.; alkaline earth metal salts such as calcium salt, magnesium salt, etc.; aluminum salt, and ammonium salts.
~ The preferred salt with an organic base includes salts with trimethylamine, triethylamine, pyridine, picoline, ethanolamine, diethanolamine, triethanolamine, dicyclohexylamine, N,N'-dibenzylethylenediamine, etc.
The preferred salt with an inorganic acid includes salts with hydrochloric acid, hydrobromic acid, nitric acid, sulfuric acid, phosphoric acid, etc.
The preferred salt with an organic acid includes salts with formic acid, acetic acid, trifluoroacetic acid, fumaric acid, oxalic acid, tartaric acid, malefic acid, citric acid, succinic acid, malic acid, methanesulfonic acid, benzenesulfonic acid, p-toluenesulfonic acid, etc.
The preferred salt with a basic amino acid includes salts with arginine, lysine, ornithine, etc.
The preferred salt with an acidic amino acid includes salts with aspartic acid, glutamic acid, etc.
The most preferred of all the above-mentioned salts is sodium salt or potassium salt.
Compound (I} or a salt thereof of the present invention can be produced in accordance with methods described in JP-A 555(1980)-22636 (EP-A-8203), JP-A
560(1985)-208980 (EP-A-155845), JP-A S61(1986)-286376 (EP-A-208420), JP-A 561(1986)-085372 (EP-A-177353), JP-A 561(1986)-267580 (EP-A-193256), JP-A H5(1993}-86057 (WO-A-9218501), JP-A H7(1995)-82269 (EP-A-605228), JP-A
H7(1995)-101945 (EP-A-612743), EP-A-643050, EP-A-710659 (JP Application H7(1995)-284106), etc, or methods analogous thereto.
Compound (I) or a salt thereof of the present invention (hereinafter referred to as compound of the present invention) have anticachectic activity, that is the activity to relieve the systemic syndrome featuring progressive loss of body weight (inclusive of weight loss due to lipolysis and weight loss due to myolysis), anemia, edema, and anorexia in chronic diseases such as malignant tumor, tuberculosis, diabetes, blood dyscrasia, endocrine disease, infectious disease, and acquired immunodeficiency syndrome. In addition, the , toxic potential of the compound of the present invention is low.
The composition for prophylaxis and treatment of the present invention can be used as an agent for prophylaxis and treatment of cachexia or an agent for treatment of malnutrition in mammals (e.g man, mouse, rat, rabbit, dog, cat, bovine, equine, swine, monkey, ' 5 etc.).
The cachexia is, for example, cancer cachexia, tuberculosis cachexia, diabetic cachexia, hemodyscrasia-related cachexia, endocrine disease-associated cachexia, infectious disease-associated cachexia, or acquired immunodeficiency syndrome-associated cachexia.
The composition for prophylaxis and treatment of the present invention can be used preferably in cachexia associated with malignant tumor, especially a carcinoma.
The composition for prophylaxis and treatment of the present invention includes the compound of the invention as such. Usually, the composition is provided in a pharmaceutical dosage form by formulating the compound of the invention with per se known pharmaceutically acceptable carriers.
As the pharmaceutically acceptable carrier a variety of organic and inorganic carriers in common use as raw materials for pharmaceutical preparations are employed. Thus, the carrier includes the excipient, lubricant, binder, and disintegrator for a solid dosage form; and the solvent, solubilizer, suspending agent, isotonizing agent, buffering agent and local analgesic for a liquid dosage form. Where necessary, pharmaceutical additives such as the preservative, antioxidant, coloring agent, sweetener, etc. can also be used.
The preferred excipient includes lactose, sucrose, D-mannitol, starch, crystalline cellulose, light silicic anhydride, etc.
The preferred lubricant includes magnesium stearate, calcium stearate, talc, colloidal silica, WO 97/37656 PCT/JP97lO1I48 etc.
The preferred binder includes crystalline cellulose, sucrose, D-mannitol, trehalose, dextrin, hydroxypropylcellulose, hydroxypropylmethylceilulose, polyvinylpyrrolidone, etc.
The preferred disintegrator includes starch, carboxymethylcellulose, carboxymethylcellulose calcium, croscarmellose sodium, carboxymethylstarch sodium, etc.
The preferred solvent includes water for injection, alcohol, propylene glycol, macrogol, sesame oil, corn oil, tricaprylin, etc.
The preferred solubilizer includes polyethylene glycol, propylene glycol, D-mannitol, trehalose, benzyl benzoate, ethanol, trisaminomethane, cholesterol, tri-ethanolamine, sodium carbonate, sodium citrate, etc.
The preferred suspending agent includes surfactants such as stearyltriethanolamine, sodium lauryl sulfate, laurylaminopropionic acid, lecithin, benzalkonium chloride, benzethonium chloride, glyceryl monostearate, etc. and hydrophilic polymers such as polyvinyl alcohol, polyvinylpyrrolidone, carboxymethyl-cellulose sodium, methylcellulose, hydroxymethylcellulose, hydroxyethylcellulose, and hydroxypropylcellulose.
The preferred isotonizing agent includes sodium chloride, glycerin, D-mannitol, etc.
The preferred buffering agent includes buffer solutions such as phosphate, acetate, carbonate, citrate.
~ The preferred local anesthetic includes benzyl alcohol.
The preferred antiseptic includes p-hydroxybenzoic esters, chlorobutanol, benzyl alcohol, phenethyl , alcohol, dehydroacetic acid, sorbic acid, etc.
The preferred antioxidant includes salts of sulfurous acid, ascorbic acid, etc.

The above medicinal composition can be manufactured by the established pharmaceutical procedures, for example the procedures described in the Japanese Pharmacopoeia.

The medicinal composition can be provided in a variety of dosage forms, e.g. oral dosage forms such as tablets, capsules (inclusive of soft capsules and microcapsules), powders, granules, and syrups; and non-oral dosage forms such as injections, suppositories, pellets, and drip infusions. These dosage forms can be safely administered either orally or non-orally.

The dosage of the composition for prophylaxis and treatment of the present invention differs depending on the subject, route of administration, clinical condition, etc. For oral administration to an adult patient with cachexia, for instance, the usual unit dose is about 0.1 mg/kg to about 30 mg/kg, preferably about 2 mg/kg to about 20 mg/kg, as the compound of the invention which is an active ingredient, which dose is preferably administered once to 3 times a day.

The composition for prophylaxis and treatment of the present invention can be administered together with other drugs such as chemotherapeutic agents and immunotherapeutic agents to the same subject, either concurrently or at staggered times. The dosage of these drugs can be appropriately selected by referring to the respective recommended clinical dose ranges.

The mixing ratio of the composition for prophylaxis and treatment of the present invention and other drugs can be~appropriately selected according to the subject, age and body weight of the subject, current clinical status, administration time, dosage form, method of administration, and combination of drugs, among other f actors .

The preferred chemotherapeutic agent includes alkylating agents (e. g. cyclophosphamide, ifosfamide), WO 97/37656 PCTIJI'97/01148 antimetabolites (e. g. methotrexate, 5-fluorouracil), antitumor antibiotics (e. g. mitomycin, adriamycin), antitumor plant alkaloids (e. g. vincristine, vindesine, Taxol), cisplastin, carboplatin, and etoposide.
5 Particularly preferred are Flutron and Neo-Flutron, which are 5-fluorouracil derivatives.
The preferred immunotherapeutic agent includes fungal or bacterial cell wall components (e. g. muramyl dipeptide derivatives, picibanil), immunostimulant 10 polysaccharides (e. g. lentinan, schizophyllan, Krestin), recombinant cytokines (e. g. interferons, interleukins (IL)), and colony stimulating factors (e. g. granulocyte colony stimulating. factor, erythropoietin). Particularly preferred are IL-1, IL-15 2, and IL-12.
Furthermore, drugs which are documented as being anticachectic in an animal model or clinically, such as cyclooxygenase inhibitors (e. g. indomethacin) [Cancer Research, 49, 5935-5939, (1989)], progesterone 20 derivatives (e.g. megestrol acetate) [Journal of Clinical Oncology, 1~,, 213-225, 1994], glucocorticoids (e. g. dexamethasone), metoclopramides, tetrahydrocannabinols {the same literature as above), lipid metabolism improving agents (e. g. eicosapentanoic acid) [British Journal of Cancer, ~$, 314-318, 1993], growth hormone, IGF-1, and antibodies to the cachexia-inducing factors TNF-oc, LIF, IL-6, and oncostatin M may also be used together with the composition for prophylaxis and treatment of the present invention.
The compound of the present invention can be used in combination with diuretic. In this case, the administration time of the compound of the present invention and diuretic are not limited, and they can be administered to the same subject, either concurrently or at staggered times. The dosage of the diuretic can be appropriately selected by referring to the recommended clinical dose ranges. The mixing ratio of the compound of the present invention and diuretic can be appropriately selected according to the subject, age and body weight of the subject, current clinical status, administration time, dosage form, method of administration, and combination, among other factors.
For example, when the subject is man, diuretic is used in a proportion of usually about 0.01 to about 100 weight parts, preferably about 0.1 to about 20 weight parts, relative to one weight part of the compound of the present invention.
The diuretic includes xanthine derivative preparations (e. g. theobromine and sodium salicylate, theobromine and calcium salicylate), thiazide preparations (e. g. ethiazide, cyclopenthiazide, trichlormethiazide, hydrochlorothiazide, hydroflumethiazide, benzylhydrochlorothiazide, penflutizide, polythiazide, methyclothiazide), antialdosterone preparations (e. g. spironolactone, triamterene), carbonate dehydratase inhibitors (e. g.
acetazolamide), chiorbenzenesulfonamide preparations (e. g. chlorthalidone, mefruside, indapamide), azosemide, isosorbide, ethacrynic acid, piretanide, bumetanide, and furosemide.
Among the compound of the present invention, especially a compound which has a bivalent aliphatic hydrocarbon group having 1 to 7 carbon atoms for A in the formula (I) or a salt thereof, has an activity to prevent and treat atherosclerosis, and an activity to regulate appetite and food intake in disorders associated with under-eating, such as anorexia nervosa, and disorders associated with over-eating, such as obesity and anorexia bulimia. Therefore, such a compound or a salt thereof can be used, as such or by providing in a pharmaceutic dosage form in the same manner as described above, as an agent for prophylaxis and treatment of atherosclerosis, or medicine for the regulation of appetite and food intake.
The subject, dosage form, and dosage of the agent for prophylaxis and treatment and the medicine are analogous to those in the case of the above-described composition for prophylaxis and treatment of the present invention.
Among the compound of the present invention, a compound or a salt thereof which has a bivalent aliphatic hydrocarbon group having 1 to 7 carbon atoms for A in the formula (I), has an activity to treat impaired glucose tolerance, namely an activity to reduce fasting insulin levels, improve insulin sensitivity, and return glucose tolerance to the normal range. Based on such an activity, the compound or a salt thereof can treat impaired glucose tolerance in order to prevent or delay the onset of noninsulin-dependent diabetes melitus. Such a compound or a salt thereof can be used, as such or by providing in a pharmaceutical dosage form in the same manner as described above, as a treating agent of impaired glucose tolerance.
The subject, dosage form, and dosage of the treating agent are analogous to those in the case of the above-described composition for prophylaxis and treatment of the present invention.
As well known in the art, the medicinal composition may be put in a container for practical use, and the container may be placed in a commercial package for marketing. Such a commercial package includes a written matter describing an indication of the medicinal composition as required by law.

22a BEST MODE FOR CARRYING OUT THE INVENTION
The following examples and test examples are intended to describe the present invention in further detail and should by no means be construed as defining the scope of the invention.
Example 1 (Production of capsules) 1 ) Compound ( 2 ) 10 0 mg 2) Microcrystalline cellulose 30 mg 3) Lactose 37 mg 4) Magnesium stearate 3 mg Total: 170 mg The above components 1), 2), 3) and 4) were mixed and filled in a gelatin capsule.

S Example 2 (Production of soft capsules) 1) Compound (2) 50 mg 2} Corn oil 100 mg Total: 150 mg The components 1) and 2) were mixed and filled in a soft capsule in a conventional manner.

Example 3 (Production of tablets) 1) Compound (2) 100 mg 2} Lactose 34 mg 3) Corn starch 10.6 mg 4) Corn starch (paste) 5 mg 5) Magnesium stearate 0.4 mg 6} Carboxymethylcellulose calcium 20 mg Total: 170 mg The above components 1) to 6) were mixed and compressed with a tableting machine in a conventional manner.

Test Example 1 (Antilipolytic activity) In accordance with the method of Green et al.

[Endocrinology, 134, 2581-2588 (1994)], the antilipolytic activity of the compound of the present invention was evaluated by quantitating the glycerol released from fat cells in rat epididymis adipose tissue.

Thus, the rat epididymis adipose tissue was iso-lated, cut into pieces with a pair of scissors, and digested into fat cells by agitating in collagenase-containing phosphate buffer for 1 hour. To a culture solution containing fat cells was added 10 ng/ml of IL-1(i (manufactured by Pharmingen, PM-19101V). Then, in treatment groups, solutions of compound (2) in N,N-dimethylformamide at graded concentrations were respectively added. After 24 hours, the supernatant was recovered and the glycerol therein was quantitated with an assay kit (manufactured by Sigma, 337-A). The amount of released glycerol in each group treated with compound (2) relative to that in the control group was determined to find the inhibition rate and the 50~
inhibition concentration ICso of the compound was calculated. The antilipolytic concentration IGSO value of compound {2) was 4 nM.
Test Example 2 (Weight loss inhibitory activity in tumor-bearing mice) Using the mouse colon cancer cell line Colon 26 (Tanaka et al., Cancer Research, 50, 4528-4532 (1990)), which is a system known to be high in the reproducibility of cancer cachectic symptoms, the inhibitory effect of the compound of the present invention on lipolysis and body weight loss was evaluated.
Thus, 1x106 Colon 26 cells were transplanted sub-dermaly in 4-week-old CDF1 mice. On day 14 after transplantation, the mice were divided into groups according to tumor size. A 5g (w/v) gum arabic suspension containing compound (2) was administered orally in a dose of 1.0 mg/kg to one group of mice and, as a control, a 5~ (w/v) gum arabic suspension was similarly administered to another group, once daily for 7 days in each case. An additional group of mice was not, transplanted with Colon 26 cells (normal group).
On days 14, 18 and 21 after transplantation, the mice were weighed. On day 22 after transplantation, each mouse was autopsied and the epididymis adipose tissue was isolated and weighed. Changes in mouse body weight and adipose tissue weight are shown in Table 1 and Table 2, respectively.

Table 1 Changes in body weight (g) of tumor-bearing mice 5 14th Day after 18th Day after 21st Day after transplantation transplantation transplantation Normal group 28.3 29.4 29.4 Control group 25.4 23.3 21.3 10 Medicated group 26.3 26.3 25.6 15 Table 2 Adipose tissue weights (mg) of tumor-bearing mice 2 2nd Day of ter 20 transplantation Normal group 769 Control group 74 Medicated group 271 It will be apparent from Tables 1 and 2 that the compound of the present invention suppresses lipolysis and weight loss which are cancer cachectic symptoms due to transplantation of mouse colon cancer cell line Colon 26, indicating that it is useful as a treating agent for cachexia.
Comparative Example The antilipolytic activity of indomethacin was evaluated by the same method as in Test Example 1. The antilipolytic concentration ICso value of indomethacin was not less than 30 mM.
Industrial Applicability The composition for prophylaxis and treatment of the present invention is of value as an agent for prophylaxis and treatment of cachexia which develops in chronic diseases such as malignant tumor, tuberculosis, diabetes, blood dyscrasia, endocrine disease, infectious disease, and acquired immunodeficiency syndrome. The composition for prophylaxis and treatment of the present invention is conducive to relief of the systemic syndrome, the cardinal signs of which are progressive loss of body weight (inclusive of weight loss due to lipolysis and weight loss due to ' myolysis), anemia, edema, and anorexia, in said chronic diseases.

Claims (24)

CLAIMS:

1. A medicinal composition for the prophylaxis or treatment of cachexia, which comprises:
(A) a compound of the formula:
wherein:
R represents a hydrocarbon group that may be substituted or a heterocyclic group that may be substituted;
Y represents a group of the formula -CO-, -CH(OH)-, or -NR3- (R3 represents an alkyl group that may be substituted);
m is 0 or 1;
n is 0, 1 or 2;
X represents CH or N;
A represents a bond or a bivalent aliphatic hydrocarbon group having 1 to 7 carbon atoms;
Q represents oxygen or sulfur;
R1 represents hydrogen or an alkyl group;
ring E may have further 1 to 4 substituents, which may form a ring in combination with R1;

L and M each represent hydrogen or are combined with each other to form a bond;
provided that when m and n are each O, X
represents CH, A represents a bond, Q represents sulfur, R1, L and M each represent hydrogen, and ring E does not have further substituents, R does not represent dihydrobenzopyranyl; or a pharmacologically acceptable salt thereof, and (B) a pharmaceutically acceptable carrier.

2. The medicinal composition according to claim 1, wherein the heterocyclic group represented by R is a 5- to 7-membered heterocyclic group containing 1 to 4 hetero-atoms selected from oxygen, sulfur, and nitrogen in addition to carbon as ring members or a condensed ring group.

3. The medicinal composition according to claim 1, wherein R represents a heterocyclic group that may be substituted.

4. The medicinal composition according to claim 3, wherein the heterocyclic group is pyridyl, oxazolyl, or thiazolyl.

5. The medicinal composition according to any one of claims 1 to 4, wherein the partial structural formula is the formula:

6. The medicinal composition according to any one of claims 1 to 5, wherein n is 0 or 1.

7. The medicinal composition according to any one of claims 1 to 6, wherein X represents CH.

8. The medicinal composition according to any one of claims 1 to 7, wherein A represents a bond or a bivalent aliphatic hydrocarbon group having 1 to 4 carbon atoms.

9. The medicinal composition according to any one of claims l to 8, wherein R1 represents hydrogen.

10. The medicinal composition according to any one of claims 1 to 9, wherein L and M each represent hydrogen.

11. The medicinal composition according to claim 1, wherein the compound is 5-[4-[2-(5-ethyl-2-pyridyl)-ethoxy]benzyl]-2,4-thiazolidinedione.

12. The medicinal composition according to claim 1, wherein the compound is 5-[4-[2-hydroxy-2-(5-methyl-2-phenyl-4-oxazolyl)ethoxy]benzyl]-2,4-thiazolidinedione.

13. The medicinal composition according to claim 1, wherein the compound is 5-[3-[3-fluoro-4-(5-methyl-2-phenyl-4-oxazolylmethoxy)phenyl]propyl]-2,4-oxazolidinedione.

14. The medicinal composition according to claim 1, wherein the compound is 5-[5-[3-methoxy-4-(5-methyl-2-phenyl-4-oxazolylmethoxy)phenyl]pentyl]-2,4-oxazolidinedione.

15. The medicinal composition according to claim 1, wherein the compound is (R) - (+) -5- [3- [4- [2- (2-furyl) -5-methyl-4-oxazolylmethoxy]-3-methoxyphenyl]propyl]-2,4-oxazolidinedione.

16. The medicinal composition according to any one of claims 1 to 15, wherein the cachexia is cancer cachexia, tuberculous cachexia, diabetic cachexia, hemodyscrasia-related cachexia, endocrine disease-associated cachexia, infectious disease-associated cachexia, or acquired immunodeficiency syndrome-associated cachexia.

17. The medicinal composition according to any one of claims 1 to 15, wherein the cachexia is diabetic cachexia.

18. The medicinal composition according to any one of claims 1 to 15, wherein the cachexia is cancer cachexia.

19. The medicinal composition according to any one of claims 1 to 18, in a form for oral administration containing the compound or salt at a dose of 2 to 20 mg/kg body weight.

20. A commercial package, which comprises:
(i) a container containing therein the medicinal composition as defined in any one of claims 1 to 15, and (ii) a written matter describing an indication of the medicinal composition for use in the prophylaxis or treatment of cachexia.

21. The commercial package according to claim 20, wherein the cachexia is cancer cachexia, tuberculous cachexia, diabetic cachexia, hemodyscrasia-related cachexia, endocrine disease-associated cachexia, infectious disease-associated cachexia, or acquired immunodeficiency syndrome-associated cachexia.

22. The commercial package according to claim 20, wherein the cachexia is diabetic cachexia.

23. The commercial package according to claim 20, wherein the cachexia is cancer cachexia.

24. Use of the compound as defined in claim 1 or a pharmacologically acceptable salt thereof for the manufacture of a medicinal composition for treating or preventing cachexia.