Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/435—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
  • A61K31/4353—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems
  • A61K31/437—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom ortho- or peri-condensed with heterocyclic ring systems the heterocyclic ring system containing a five-membered ring having nitrogen as a ring hetero atom, e.g. indolizine, beta-carboline
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/04—Anorexiants; Antiobesity agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/06—Antihyperlipidemics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P3/00—Drugs for disorders of the metabolism
  • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
  • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P5/00—Drugs for disorders of the endocrine system
  • A61P5/48—Drugs for disorders of the endocrine system of the pancreatic hormones
  • A61P5/50—Drugs for disorders of the endocrine system of the pancreatic hormones for increasing or potentiating the activity of insulin
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system

Definitions

• the invention relates to the use of inhibitors of microsomal triglyceride transfer protein (MTP) for lowering the postprandial triglyceride-rich lipoprotein particles (ppTRL) or for lowering their breakdown products
• MTP microsomal triglyceride transfer protein
• ppTRL Small cholesterol-rich "small remnant particle”
• VLDL very low density lipoprotein
• ApoE is also involved in the regulation of the immune system, the regeneration of nerve cells and the differentiation of muscles (Masliah E, Mallory M, Ge N, Alford M, Neinbergs I, Roses AD ⁇ eurodegeneration in the central nervous system of apoE-deficient mice. Exp. Neurol.
• the pathological effects of a disturbed lipoprotein or lipid metabolism are therefore not only limited to atherosclerosis.
• Mouse is therefore suitable as an animal model to investigate the effects of medicinal products on the lipoprotein or lipid metabolism, atherosclerosis and damage to the nervous system in a multi-factorial manner with the aim of intervening in these complex pathological processes.
• ppTRL and its breakdown products in particular play an important role in diabetes (Howard, BN; Insulin resistance and lipid metabolism; Am. J. Cardiol., 1999; 84 (1A): pp. 28J- 32J; Mero, ⁇ ., Malmstrom, R., Steiner, G., Taskinen, M., Syvanne, M .; Postprandial metabolism of apolipoprotein B-48- and B-100-containing particles in type 2 diabetes mellitus: relations to angiographically verified severity of coronary artery disease. Atherosclerosis, 2000; 150 (1): pp. 167-177). It is therefore of great importance to find ways to lower the ppTRL level in the blood plasma.
• the invention therefore relates to the use of MTP inhibitors for reducing or lowering the ppTRL in the plasma.
• Lowering ppTRL by inhibiting MTP has a beneficial impact on morbidity and mortality, particularly with regard to neurodegenerative and cardiovascular diseases.
• MTP inhibitors are therefore suitable for favorably influencing these disease courses.
• liver-derived LDL particles which are only ApoB-100-associated lipoprotein particles in humans, are largely unaffected.
• Sober plasma values means that measurements must not be taken in postprandial plasma or serum, ie after ingestion of food containing lipids, but in sober plasma or serum, which is obtained about 12 hours after the last ingestion of food.
• the MTP inhibitors can also be used to inhibit or reduce intestinal cholesterol absorption.
• the targeted lowering of the plasma ppTRL with a low dose of an MTP inhibitor is already sufficient to prolong patient survival. Since a disturbed lipoprotein or lipid metabolism, as explained above, can lead to complex degenerative diseases, lowering the ppTRL makes an important therapeutic contribution to the treatment of such complex clinical pictures.
• MTP inhibitors are described, for example, in the following documents: Wetterau et al. Science 282, 751 (1998), J Lipid Res 37, 1468 (1996), Bristol-Myers-
• MTP inhibitors Some examples of the MTP inhibitors described there are listed below:
• Preferred MTP inhibitors which can be used according to the invention are: Compounds of the general formula (AI)
• R denotes hydrogen or straight-chain or branched alkyl having up to 4 carbon atoms
• R3 and R ⁇ together with the double bond connecting them form a phenyl ring or a 4- to 8-membered cycloalkene or oxocycloalkene radical,
• D represents hydrogen, cycloalkyl having 4 to 12 carbon atoms or straight-chain or branched alkyl having up to 12 carbon atoms,
• E represents the -CO or -CS group
• L represents an oxygen or sulfur atom or represents a group of the formula -NR 9 ,
• R 9 is hydrogen or straight-chain or branched alkyl with up to 6 Carbon atoms, which is optionally substituted by hydroxy or phenyl,
• R ⁇ represents phenyl or a 5- to 7-membered saturated or unsaturated heterocycle with up to 3 heteroatoms from the series S, N and or O,
• cycles are optionally up to 3 times the same or different by nitro, carboxy, halogen, cyano or by straight-chain or branched alkenyl or alkoxycarbonyl each having up to 6 carbon atoms or by straight-chain or branched alkyl having up to 6 carbon atoms, which are optionally substituted is substituted by hydroxy, carboxy or by straight-chain or branched alkoxy or alkoxycarbonyl each having up to 6 carbon atoms, and / or the cycles are optionally substituted by a group of the formula -OR "or - RHR12,
• RIO is hydrogen or straight-chain or branched alkyl or alkenyl each having up to 6 carbon atoms
• RU or Rl2 are the same or different and are phenyl, hydrogen or straight-chain or branched alkyl having up to 6 carbon atoms
• Rl3 and Rl4 are identical or different and are hydrogen or straight-chain or branched acyl having up to 8 carbon atoms
• R6 represents hydrogen, carboxy or straight-chain or branched alkoxycarbonyl having up to 5 carbon atoms
• R 1 denotes phenyl which is optionally substituted up to 3 times identically or differently by halogen, hydroxyl or by straight-chain or branched alkyl having up to 5 carbon atoms,
• R * 6 denotes hydrogen, benzyl, triphenylmethyl or straight-chain or branched acyl with up to 6 carbon atoms,
• R represents hydrogen or
• Q represents a nitrogen atom or the -CH group
• T represents a group of the formula -SO2 or -CO or an oxygen or sulfur atom
• V represents an oxygen or sulfur atom
• R5, R6, R7 and R8 are the same or different and
• R 9 trifluoromethyl, benzyl or a 5- to 7-membered, optionally benzocondensed heterocycle with up to 3 heter atoms from the
• Row S, N and / or O means, which is optionally substituted up to 3 times identically or differently by halogen, phenyl, hydroxy or by straight-chain or branched alkyl or alkoxy each having up to 4 carbon atoms, or a group of the formula -S (O) a -R ⁇ means
• a represents a number 0, 1 or 2
• IO means straight-chain or branched alkyl or alkenyl each having up to 8 carbon atoms, which may be replaced by straight-chain or branched acyl having up to 6 carbon atoms.
• D and E are the same or different and represent hydrogen, halogen, trifluoromethyl, hydroxyl, carboxyl or straight-chain or branched alkyl, alkoxy or alkoxycarbonyl each having up to 6 carbon atoms,
• Z represents an oxygen or sulfur atom
• Rl stands for cycloalkyl with 3 to 10 carbon atoms or for straight-chain or branched alkyl with 1 to 10 carbon atoms, or stands for phenyl which may optionally be identical or different up to 2 times through halogen, nitro, cyano, hydroxy, straight-chain or branched alkyl or Alkoxy is each substituted with up to 4 carbon atoms,
• R ⁇ represents hydrogen or straight-chain or branched alkyl with up to 3
• R 3 represents hydrogen or straight-chain or branched alkyl having up to 5 carbon atoms, or cycloalkyl having 3 to 7 carbon atoms, or phenyl or a 5- to 7-membered aromatic heterocycle up to 3 heteroatoms from the series S, N and / or O, which are optionally substituted up to 3 times identically or differently by halogen, nitro, phenyl, hydroxyl or by straight-chain or branched alkyl or alkoxy having up to 6 carbon atoms,
• R4 represents hydrogen or a group of the formula -CH2-OH or CH2O-CO- R 11 ,
• U is hydrogen, straight-chain or branched alkyl having up to 8 carbon atoms or phenyl, which is optionally substituted up to 3 times identically or differently by halogen, hydroxy, cyano or straight-chain or branched alkyl or alkoxy each having up to 4 carbon atoms,
• R6, R7, R10 and R11 are the same or different and
• R8 and R 9 are the same or different and
• R ⁇ can also mean benzyl
• E and L are the same or different and represent hydrogen, halogen, trifluoromethyl, hydroxyl, carboxyl or straight-chain or branched alkyl, alkoxy or alkoxycarbonyl each having up to 6 carbon atoms,
• Rl stands for cycloalkyl with 3 to 10 carbon atoms or for straight-chain or branched alkyl with 1 to 10 carbon atoms, or for phenyl, which may optionally be identical or different up to 2 times through halogen, cyano, hydroxy, straight-chain or branched alkyl or alkoxy up to 4 carbon atoms is substituted,
• R ⁇ represents hydrogen or straight-chain or branched alkyl with up to 3
• R3 represents hydrogen or straight-chain or branched alkyl having up to 5 carbon atoms, or cycloalkyl having 3 to 7 carbon atoms, or phenyl or a 5- to 7-membered aromatic heterocycle having up to 3 heteroatoms from the series S, N and / or O, which are optionally substituted up to 3 times identically or differently by halogen, nitro, phenyl, hydroxyl or by straight-chain or branched alkyl or alkoxy having up to 6 carbon atoms,
• R4 represents hydrogen or a group of the formula -CH2-OH or CH2O-CO- R 12 ,
• Rl2 is hydrogen, straight-chain or branched alkyl having up to 8 carbon atoms or phenyl, which is optionally substituted up to 3 times identically or differently by halogen, hydroxy, cyano or straight-chain or branched alkyl or alkoxy each having up to 4 carbon atoms,
• R 3 , R4 5 R6 and R ⁇ are the same or different and
• T, V, X and Y are the same or different and represent an oxygen or sulfur atom
• R5 and R8 are the same or different and
• Hydrogen, halogen, cycloalkyl having 3 to 8 carbon atoms or straight-chain or branched alkyl or alkenyl each having up to 8 carbon atoms, which are optionally by cycloalkyl having 3 to 8 carbon atoms, or by a 5- to 6-membered, aromatic, optionally benzo-condensed heterocycle are substituted by up to 3 heteroatoms from the series S, N and / or O, or by aryl having 6 to 10 carbon atoms, the cycles in turn being identical or different up to 3 times by a 5- to 6-membered aromatic heterocycle up to 3 heteroatoms from the series S, N and / or O, or by phenyl, benzyl, halogen, hydroxy, carboxyl or by straight-chain or branched alkyl, alkoxy or alkoxycarbonyl, each having up to 6 carbon atoms, can be substituted, or
• a number means 0 or 1
• R 9 and RIO are the same or different and
• D and E are the same or different and represent hydrogen, halogen, trifluoromethyl, hydroxyl, carboxyl or straight-chain or branched alkyl, alkoxy or alkoxycarbonyl each having up to 6 carbon atoms,
• Rl represents hydrogen or cycloalkyl having 3 to 8 carbon atoms, or represents straight-chain or branched alkyl or alkenyl each having up to 8 carbon atoms, which may be by cycloalkyl having 3 to 6
• Carbon atoms, phenyl or by a 5- to 6-membered aromatic Heterocycle are substituted with up to 3 heteroatoms from the series S, N and / or O, or represents phenyl or a 5- to 6-membered aromatic heterocycle with up to 3 heteroatoms from the series S, N and / or O, where the ring systems optionally up to 3 times the same or different by halogen,
• Phenyl trifluoromethyl or straight-chain or branched alkyl or alkoxy each having up to 5 carbon atoms, hydroxyl or substituted by a group of the formula -NRl 1R 2,
• Rl 1 and Rl2 have the meaning given above of R 9 and RIO and are the same or different with this,
• L represents an oxygen or sulfur atom
• R 2 for mercapto, hydroxy, straight-chain or branched alkoxy having up to 8 carbon atoms or for the group of the formula
• Rl-3 denotes hydrogen or straight-chain or branched alkyl having up to 4 carbon atoms
• R 14 denotes hydrogen, phenyl or a 5- to 6-membered aromatic heterocycle with up to 3 heteroatoms from the series S, N and / or O
• R15 is hydrogen or straight-chain or branched alkyl having up to 8 carbon atoms, which is optionally substituted by hydroxy
• A, D, E, G, L and M are the same or different and represent hydrogen, halogen, trifluoromethyl, carboxy, hydroxy, straight-chain or branched alkoxy or alkoxycarbonyl each having up to 6 carbon atoms or straight-chain or branched alkyl having up to 6 carbon atoms which in turn can be substituted by hydroxyl or by straight-chain or branched alkoxy having up to 4 carbon atoms,
• Rl and R 2 are the same or different and represent hydrogen, cycloalkyl having 3 to 8 carbon atoms or straight-chain or branched alkyl having up to 10 carbon atoms, which is optionally substituted by cycloalkyl having 3 to 6 carbon atoms, or represent phenyl, which is optionally substituted by Halogen or trifluoromethyl is substituted, or l and R 2 together with the carbon atom form a 4-8 membered cycloalkyl ring
• R 3 represents phenyl, which is optionally up to 3 times identical or different by nitro, carboxy, halogen, cyano or by straight-chain or branched alkenyl or alkoxycarbonyl each having up to 6 carbon atoms or by straight-chain or branched alkyl having up to 6 carbon atoms.
• lenstoffatomen is substituted, which is optionally substituted by hydroxy, carboxy or by straight-chain or branched alkoxy or alkoxycarbonyl each having up to 6 carbon atoms, and or is optionally substituted by a group of the formula -OR 4 or - R ⁇ R ⁇ ,
• R 4 denotes hydrogen or straight-chain or branched alkyl or alkenyl each having up to 6 carbon atoms
• R5 or R6 are identical or different and represent phenyl, hydrogen or straight-chain or branched alkyl having up to 6 carbon atoms, or mean straight-chain or branched acyl having up to 8 carbon atoms, which is optionally replaced by a group of the formula -
• NR 7 R 8 is substituted
• R 7 and R8 are the same or different and
• Hydrogen or straight-chain or branched acyl with up to 8 carbon atoms mean
• A, D, E, G, L and M are the same or different and represent hydrogen, halogen, trifluoromethyl, carboxy, hydroxy, straight-chain or branched alkoxy or alkoxycarbonyl each having up to 6 carbon atoms or straight-chain or branched alkyl having up to 6 carbon atoms which in turn can be substituted by hydroxyl or by straight-chain or branched alkoxy having up to 4 carbon atoms,
• R * and R 2 are identical or different and represent hydrogen, cycloalkyl having 3 to 8 carbon atoms or straight-chain or branched alkyl having up to 10 carbon atoms, which is optionally substituted by cycloalkyl having 3 to 6 carbon atoms, or represent phenyl, which is optionally is substituted by halogen or trifluoromethyl, or
• Rl and R 2 together with the carbon atom form a 4-8 membered cycloalkyl ring and
• R 3 represents phenyl, which is optionally up to 3 times identical or different by nitro, carboxy, halogen, cyano or by straight-chain or branched alkenyl or alkoxycarbonyl each having up to 6 carbon atoms or by straight-chain or branched alkyl having up to 6 Carbon atoms, which is optionally substituted by hydroxy, carboxy or by straight-chain or branched alkoxy or alkoxycarbonyl each having up to 6 carbon atoms, and / or is optionally substituted by a group of the formula -OR 4 or -NR ⁇ RO,
• R 4 denotes hydrogen or straight-chain or branched alkyl or alkenyl each having up to 6 carbon atoms
• R5 or R6 are the same or different and represent phenyl, hydrogen or straight-chain or branched alkyl having up to 6 carbon atoms, or mean straight-chain or branched acyl having up to 8 carbon atoms, which is optionally substituted by a group of the formula - NR 7 R 8 .
• R 7 and R 8 are the same or different and
• the compounds of the general formula (AI) are of great interest as MTP inhibitors; the compounds of Examples 1 to 119 below are also of particular importance, in particular the compounds of Examples 92 to 119, very particularly the compounds of Examples 48 and 80 , (2S) -2-Cyclopentyl-2- [4- (2,4-dimethyl-pyrido [2,3-b] indol-9-ylmethyl) phenyl] -N- (2- (IR) -hydroxy- l- ⁇ henyl-ethyl) -acetamide (Example 48) and (2S) -2-cyclo ⁇ entyl-2- [4- (2,4-dimethyl-pyrimido [l, 2-a] indol-10-ylmethyl) - ⁇ henyl] -N- (2- (IR) -hydroxy-1-phenyl-ethyl) -acetamide (Example 80).
• physiologically acceptable salts of the MTP inhibitors listed above are also claimed.
• Physiologically acceptable salts of the compounds according to the invention are e.g. Salts of the substances according to the invention with mineral acids, carboxylic acids or sulfonic acids.
• Physiologically acceptable salts of the MTP inhibitors listed above can also be metal or ammonium salts of the compounds according to the invention which have a free carboxyl group.
• metal or ammonium salts of the compounds according to the invention which have a free carboxyl group.
• Sodium, potassium, magnesium or calcium salts and also ammonium salts derived from ammonia, or organic amines, such as ethylamine, di- or triethylamine, ethanolamine, di- or triethanolamine, dicyclohexylamine, dimethylaminoethanol, arginine, lysine, Ethylenediamine or 2-phenylethylamine.
• the MTP inhibitors according to the invention can be in stereoisomeric forms, which are either like image and mirror image (enantiomers), or which are not like image and
• the invention relates to both Enantiomers as well as diastereomers or their respective mixtures. These mixtures of the enantiomers and diastereomers can be separated into the stereoisomerically uniform constituents in a known manner.
• MTP inhibitors are used for the prophylaxis and treatment of diseases that are associated with increased plasma levels of ppTRL and its remnants.
• diseases of the cardiovascular system such as As atherosclerosis or myocardial infarction, further such diseases that can be attributed to neuronal degeneration and are associated with disorders in the metabolism of lipoproteins or lipids, z.
• B. dementia or Alzheimer's disease Disorders of carbohydrate metabolism, such as Diabetes or IGT (impaired glucose tolerance), associated with elevated and prolonged ppTRL levels. Therefore, these diseases can also be treated with MTP inhibitors.
• the lowering of the ppTRL also leads to a reduced formation of its degradation products, the remnants. Since the ppTRL and the remnants are associated with ApoB-48, the MTP inhibitors not only lower the ppTRL but also the remnants and ApoB-48 or ApoB-48-associated lipoproteins.
• Preferred MTP inhibitors are the compounds listed in the following table:
• MTP inhibitors are the compounds listed in the table below.
• the MTP inhibitors can be used, for example, for the treatment and / or prophylaxis of diseases which are particularly associated with disorders of the postprandial lipoprotein or lipid metabolism.
• diseases which are particularly associated with disorders of the postprandial lipoprotein or lipid metabolism.
• disorders are to be understood here: accumulation and / or prolonged residence time of ppTRL, chylomicrons and cholesterol are sufficient remnants in the plasma as well as increased or prolonged postprandial plasma lipid levels.
• Neurodegeneration such as Alzheimer's disease, progressive brain atrophy, morphological changes in the brain during normal aging (presenile dementia), cortical cholinergic system disorders, memory disorders, orientation disorders, aphasia, word finding disorders, agnosia, apraxia, euphoria, depression, Binswanger disease, pick Niemann disease
• cardiovascular diseases which are associated with disorders of the postprandial lipoprotein or lipid metabolism are: arteriosclerosis, stroke, angina, diseases of the coronary arteries, in particular the arterial coronary arteries, heart failure, primary and secondary myocardial infarction, pathological changes in the vascular wall, disorders of blood circulation and microcirculation.
• carbohydrate metabolism disorders are associated with elevated and prolonged ppTRL levels, such as Insulin resistance, IGT (impaired glucose tolerance), diabetes, especially type 11 diabetes, metabolic syndrome. Therefore, these diseases can also be treated with MTP inhibitors.
• MTP inhibitors may be advantageous to use in combination with other suitable active ingredients.
• suitable active ingredients include acetylcholinesterase Inhibitors, for example metrifonate, tacrine and donepezil, substances which inhibit the abnormal cleavage of the amyloid precursor protein, estrogens such as for example estradiol, synthetic estrogen receptor agonists, nitamine E,
• the targeted reduction in plasma ppTRL levels also leads to an improved tolerance of the MTP inhibitors. Especially through lower ones
• Dosages avoid side effects that can occur at high dosages. Furthermore, no or only minor mechanism-related effects in the liver are to be expected at low doses; consequently, no mechanism-related side effects can be induced in the liver.
• the MTP inhibitors are preferably used in human medicine, but are also suitable for veterinary medicine, especially for the treatment of mammals.
• the combinations according to the invention can be administered parenterally or, preferably, orally.
• the MTP inhibitors can be converted into the customary formulations in a known manner, which can be liquid or preferably solid formulations. Examples are tablets, dragees, pills, capsules, granules, aerosols, syrups, emulsions, suspensions, juices.
• the MTP inhibitors are preferably used in doses of 0.01 to 20 mg / kg, in particular 0.1 to 5 mg of active ingredient per kg of body weight of the patient.
• the solid oral dosage forms listed here are manufactured according to the general standard procedures.
• Ingredients are those that are pharmaceutically accepted and are physiologically harmless, for example: as fillers cellulose derivatives (e.g. microcrystalline cellulose), sugar (e.g. lactose), sugar alcohols (e.g. mannitol, sorbitol), inorganic fillers (e.g. calcium phosphates), binders ( eg polyvinylpyrrolidone, gelatin, starch and cellulose derivatives), as well as all other auxiliaries which are required for the preparation of pharmaceutical formulations of the desired properties, for example Lubricants (magnesium stearate), e.g. Disintegrants (e.g.
• cross-linked polyvinyl pyrrolidone, sodium carboxymethyl cellulose e.g. Wetting agents (e.g. sodium lauryl sulfate) e.g. Retardants (e.g. cellulose derivatives, polyacrylic acid derivatives), e.g. Stabilizers, e.g. Flavors, e.g. Color pigments.
• Wetting agents e.g. sodium lauryl sulfate
• Retardants e.g. cellulose derivatives, polyacrylic acid derivatives
• Stabilizers e.g. Flavors, e.g. Color pigments.
• Liquid formulations are also produced by standard methods with pharmaceutically customary auxiliaries and contain the active ingredient or the two active ingredients either dissolved or suspended. Typical application volumes of these pharmaceutical preparations are 1 to 10 ml.
• auxiliaries in these liquid formulations are: solvents (e.g. water, alcohol, natural and synthetic oils, e.g. medium-chain triglcerides), solubilizers (e.g. glycerol, glycol derivatives), wetting agents (e.g. polysorbate, sodium lauryl sulfate) ), as well as other auxiliary substances that are required for the production of pharmaceutical formulations with the desired properties, eg viscosity increasing agents, e.g. pH corrections, e.g. Sweeteners and flavors, e.g. Antioxidants, e.g. Stabilizers, e.g. Preservative.
• solvents e.g. water, alcohol, natural and synthetic oils, e.g. medium-chain triglcerides
• the main components of the capsule formulations are, for example, gelatin or hydroxypropylethylcellulose.
• Pharmaceutical auxiliaries as are known to the person skilled in the art, are also described, for example, in the following manual: "Handbook of Pharmaceutical Excipients", Wade, A. & Weller, PJ, American Pharmaceutical Association, Washington, 2nd edition 1994.
• ApoE knockout mice were on a fatty diet (0.15% cholesterol,
• the treated group was administered the compound according to Example 48 with the feed in a proportion of 5 ppm, while the control group received the feed without active ingredient. After 13 months, over half of the untreated mice were dead during 23 out of 25 animals were still alive in the treated group.

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