EP3558316A1 - Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sind - Google Patents
Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sindInfo
- Publication number
- EP3558316A1 EP3558316A1 EP17818103.8A EP17818103A EP3558316A1 EP 3558316 A1 EP3558316 A1 EP 3558316A1 EP 17818103 A EP17818103 A EP 17818103A EP 3558316 A1 EP3558316 A1 EP 3558316A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- hydrogen
- alkyl
- fluorine
- endometriosis
- trifluoromethyl
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 201000009273 Endometriosis Diseases 0.000 title claims abstract description 147
- 238000011282 treatment Methods 0.000 title claims abstract description 97
- 206010016654 Fibrosis Diseases 0.000 title claims abstract description 78
- 230000004761 fibrosis Effects 0.000 title claims abstract description 63
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 title claims abstract description 51
- 230000002980 postoperative effect Effects 0.000 title claims abstract description 25
- 201000010099 disease Diseases 0.000 title abstract description 24
- 230000015572 biosynthetic process Effects 0.000 title abstract description 16
- 239000003601 chymase inhibitor Substances 0.000 title description 6
- 208000002193 Pain Diseases 0.000 claims abstract description 37
- 230000036407 pain Effects 0.000 claims abstract description 37
- 208000005641 Adenomyosis Diseases 0.000 claims abstract description 31
- 201000009274 endometriosis of uterus Diseases 0.000 claims abstract description 30
- 238000011321 prophylaxis Methods 0.000 claims abstract description 18
- 229910052739 hydrogen Inorganic materials 0.000 claims description 137
- 239000001257 hydrogen Substances 0.000 claims description 137
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- PXGOKWXKJXAPGV-UHFFFAOYSA-N Fluorine Chemical compound FF PXGOKWXKJXAPGV-UHFFFAOYSA-N 0.000 claims description 69
- 125000002023 trifluoromethyl group Chemical group FC(F)(F)* 0.000 claims description 68
- 150000002431 hydrogen Chemical group 0.000 claims description 66
- 150000001875 compounds Chemical class 0.000 claims description 65
- UFHFLCQGNIYNRP-UHFFFAOYSA-N Hydrogen Chemical compound [H][H] UFHFLCQGNIYNRP-UHFFFAOYSA-N 0.000 claims description 63
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- 125000004178 (C1-C4) alkyl group Chemical group 0.000 claims description 53
- 125000002496 methyl group Chemical group [H]C([H])([H])* 0.000 claims description 50
- 125000006272 (C3-C7) cycloalkyl group Chemical group 0.000 claims description 45
- -1 hydroxy, methoxy, ethoxy, azetidinyl Chemical group 0.000 claims description 34
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- 125000001424 substituent group Chemical group 0.000 claims description 31
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- 229910052799 carbon Inorganic materials 0.000 claims description 24
- 125000002887 hydroxy group Chemical group [H]O* 0.000 claims description 22
- 125000003566 oxetanyl group Chemical group 0.000 claims description 22
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- 125000003718 tetrahydrofuranyl group Chemical group 0.000 claims description 21
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- 125000001495 ethyl group Chemical group [H]C([H])([H])C([H])([H])* 0.000 claims description 18
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- 229920001223 polyethylene glycol Polymers 0.000 description 1
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- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 1
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- 201000009395 primary hyperaldosteronism Diseases 0.000 description 1
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- 230000002685 pulmonary effect Effects 0.000 description 1
- 125000003373 pyrazinyl group Chemical group 0.000 description 1
- 125000003072 pyrazolidinyl group Chemical group 0.000 description 1
- 125000002098 pyridazinyl group Chemical group 0.000 description 1
- 125000004076 pyridyl group Chemical group 0.000 description 1
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- 125000003548 sec-pentyl group Chemical group [H]C([H])([H])C([H])([H])C([H])([H])C([H])(*)C([H])([H])[H] 0.000 description 1
- 210000004739 secretory vesicle Anatomy 0.000 description 1
- 230000008313 sensitization Effects 0.000 description 1
- 208000022925 sleep disturbance Diseases 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
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- 239000007921 spray Substances 0.000 description 1
- 239000003381 stabilizer Substances 0.000 description 1
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- 238000003786 synthesis reaction Methods 0.000 description 1
- 229920001059 synthetic polymer Polymers 0.000 description 1
- 125000006253 t-butylcarbonyl group Chemical group [H]C([H])([H])C(C(*)=O)(C([H])([H])[H])C([H])([H])[H] 0.000 description 1
- 125000000999 tert-butyl group Chemical group [H]C([H])([H])C(*)(C([H])([H])[H])C([H])([H])[H] 0.000 description 1
- ZRKFYGHZFMAOKI-QMGMOQQFSA-N tgfbeta Chemical compound C([C@H](NC(=O)[C@H](C(C)C)NC(=O)CNC(=O)[C@H](CCC(O)=O)NC(=O)[C@H](CCCNC(N)=N)NC(=O)[C@H](CC(N)=O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CCC(O)=O)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](CC(C)C)NC(=O)CNC(=O)[C@H](C)NC(=O)[C@H](CO)NC(=O)[C@H](CCC(N)=O)NC(=O)[C@@H](NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@@H](NC(=O)[C@H](CC(C)C)NC(=O)[C@@H](N)CCSC)C(C)C)[C@@H](C)CC)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](C)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](C)C(=O)N[C@@H](CC=1C=CC=CC=1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](C)C(=O)N[C@@H](CC(C)C)C(=O)N1[C@@H](CCC1)C(=O)N1[C@@H](CCC1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CO)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC(C)C)C(O)=O)C1=CC=C(O)C=C1 ZRKFYGHZFMAOKI-QMGMOQQFSA-N 0.000 description 1
- 125000001113 thiadiazolyl group Chemical group 0.000 description 1
- 230000008719 thickening Effects 0.000 description 1
- 125000001544 thienyl group Chemical group 0.000 description 1
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- LENZDBCJOHFCAS-UHFFFAOYSA-N tris Chemical compound OCC(N)(CO)CO LENZDBCJOHFCAS-UHFFFAOYSA-N 0.000 description 1
- 239000000080 wetting agent Substances 0.000 description 1
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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
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
-
- 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
- A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
- A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
- A61K31/506—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
-
- 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
- A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
- A61K31/536—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines ortho- or peri-condensed with carbocyclic ring systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P15/00—Drugs for genital or sexual disorders; Contraceptives
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P15/00—Drugs for genital or sexual disorders; Contraceptives
- A61P15/02—Drugs for genital or sexual disorders; Contraceptives for disorders of the vagina
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P41/00—Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
-
- 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
- A61P5/24—Drugs for disorders of the endocrine system of the sex hormones
- A61P5/30—Oestrogens
Definitions
- the present application relates to the use of bicyclic-substituted uracil derivatives, alone or in combination with other active substances for the treatment and / or prophylaxis of diseases, in particular for the treatment and / or prophylaxis of inflammatory and fibrotic diseases, for the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, as well as postoperative peritoneal fibrosis and adhesion formation.
- Fibrosis refers to a diseased growth of connective tissue in human and animal tissues and organs, the main component of which is collagen fibers.
- the formation of fibrosis when it involves two different tissues or organs connecting them together leads to adhesions that can restrict the function of the organs.
- the chymase inhibitors described here are suitable since they prevent a decisive mast cell pathomechanism.
- mast cells are key cells of induction and regulation of inflammatory processes. All mast cells share characteristic features independent of species and localization:
- Human mast cells can be divided into tryptase- and / or chymase-positive populations.
- Activated mast cells play an important role in wound healing and in inflammatory processes, such as the formation of fibrosis on wounds, angiogenesis and cardiac remodeling (Miyazaki et al., Pharmacol. Ther., 12 (2006), 668-676, Shiota et al., J. Hypertens. 21 (2003), 1823-1825).
- Chymase positive Mast cells may also play an important role in the vascular remodeling of the respiratory tract in asthma. An increased number of mast cells has been found in endobronchial biopsies of asthmatic patients (Zanini et al., J. Allergy Clin Immunol 120 (2007), 329-333).
- Chymase is a chymotrypsin-like serine protease that is stored as a macromolecular complex with heparin proteoglycans in secretory vesicles of mast cells. As a protease chymase cleaves a number of substrates.
- Chymase is involved in various physiological processes (activation of proinflammatory cytokines, recruitment of immune cells, fibrosis, and adhesion formation (Pejler et al., 95, 2007, Adv Immunol, 167-255), all of which have pathological implications, including in the Endometriosis and postoperative fibrosis formation.
- Chymase degrades extracellular matrix proteins, such as fibronectin, procollagen, and vitronectin, and tears off focal adhesions. It causes the activation and release of transforming growth factor beta (TGFß) from its latent form, which plays an important role in the development of peritoneal adhesions and fibrosis after surgery and also in endometriosis.
- TGFß transforming growth factor beta
- the action of chymase results in release and activation of the cytokine interleukin 1 beta (IL-1 ⁇ ), which is a major mediator of proinflammatory responses (Lopez-Castejon et al., Cytokine Growth Factor Rev. 22 (201 1) 189-95 ).
- IL-1 ⁇ cytokine interleukin 1 beta
- interleukin 1 beta leads to a sensitization of nerve cells and thus to the development of sensation of pain.
- Other proinflammatory cytokines are also activated by the action of chymase. This leads to a recruitment of other immune cells, which increase the inflammation locally in the tissue. Chymase is thus an enhancement of inflammation, the development of pain, the recruitment of immune cells and the formation of adhesions involved. Chymase is described as a potential pharmacological target for the treatment of inflammatory diseases (Heuston et al., Br. J. Pharmacol. 167 (2012) 732-740). The ability to use chymase inhibitors for the treatment of various diseases has been demonstrated in numerous animal studies.
- Beta-ketophosphonate a chymase inhibitor, blocks IL-1 ⁇ generation and prevents immigration of infammatory cells in a peritonitis model (Garavilla et al., J Biol Chem 280 (2005) 18001 -7).
- Endometriosis is an inflammatory disease (Lousse JC et al., Front Biosci. 4 (2012) 23-40), caused by the growth of endometrial tissue (lesions) outside the cavum uteri in the abdominal cavity and the presence of peripheral nerve endings in the vicinity lesions (McKinnon et al., Trends Endocrinol & Metab. 26 (2015) 1-10).
- Characteristic of endometriosis is the formation of an inflammatory environment in the abdominal cavity, which is often associated with fibrosis and the resulting formation of adhesions. The main symptoms of this disease are pain.
- Inflammation is seen as a possible important pathomechanism of endometriosis and as a cause of endometriosis-associated pain (Laux-Biehlmann et al., Trends in Pharmacol Sci. 36 (2015) 270-276).
- Endometriosis is treated by standard hormone and / or pain therapy.
- As a non-drug therapy surgical removal of endometriotic lesions and fibrosis is available.
- Hormonal therapies reduce estrogen levels, which are considered to be a major factor in the development and maintenance of endometriosis.
- the most important active ingredients in hormonal therapy of endometriosis are: • progestagens such as medroxyprogesterone acetate, levonorgestrel, dydrogesterone and dienogest.
- Administration can be either oral (e.g., dienogest in Visanne®) or local (e.g., levonorgestrel in an intrauterine system).
- GnRH Gonadotropin releasing hormone
- Complaints such as hot flashes, sleep disorders, dry vagina, bone loss and mood swings.
- Hormonal contraceptives prill
- intrauterine levonorgestrel-releasing systems intrauterine device
- hormonal therapies lead to a recurrence of symptoms after weaning and should therefore be carried out over a very long period of time, which is not possible at all.
- some hormonal therapies such as GnRH analogues have a transient state as in menopause with the accompanying side effects.
- patients suffer from hot flashes, sleep disturbances, mood swings, loss of libido and bone loss (osteoporosis), which makes therapy lasting more than 6 months difficult.
- analgesics such as acetylsalicylic acid, ibuprofen or diclofenac may be used. Due to the side effects on the kidneys and the stomach, but also the cardiovascular system, pain therapy can only be used for a short time and in close consultation with the doctor.
- an operative therapy for example, with electric current, laser or scalpel is trying to remove the endometrial implants as completely as possible. The procedure is mainly performed in the context of a laparoscopy, sometimes a belly cut is necessary. In severe cases sometimes parts of the ovary or fallopian tube have to be removed. After an operative removal of endometriosis, the disease often appears in the longer term.
- mast cells and in particular chymase from mast cells are involved in the pathophysiology: a comparison of endometriotic lesions with the endometrium shows a greatly increased number of activated mast cells in endometriotic lesions (Sugamata et al., J. Reprod., Immunol ) 120-125); Fujiwara et al, J. of Reprod. Immunol. 51 (2004) 341-344).
- a large increase in the number of activated and chymase-expressing mast cells is described in the vicinity of peritoneal nerves and in deeply infiltrating lesions in endometriosis (Anaf et al., Fertil. Sterile 86 (2006) 1336-1343).
- An increase of mast cells is also shown in peritoneal adhesions (Xu et al., Ann Surg 236 (2001) 593-601).
- Mast cells are ascribed an important pathophysiological role in endometriosis (Kirchhoff et al., Expert Opin Ther Targets, 16 (2012) 237-241; Hart, Int J Inflam. 26 (2015) 1-10).
- mast cells in endometriotic lesions are chymase positive (Anaf et al., Fertil. Sterile 86, 2006, 1336-1343).
- the mast cell-specific chymase expression in endometriotic lesions is greatly increased in comparison to the mast cell-specific expression of chymase in the endometrium (Paula et al., J Mol Histol.46 (2015) 33-43).
- peritoneal operations such as laparoscopy or laparotomies. These operations often result in tissue damage to organs and resulting local sources of inflammation. These local inflammations lead in the peritoneum to the formation of fibrosis and the connection of organs by fibrotic tissue ie Adhesions. Adhesions of organs in the abdominal cavity can impair the function of the organs, leading among other things to subfertility, intestinal obstruction and chronic abdominal pain.
- the chymase formed by mast cells is of particular importance for pathophysiology.
- the formation of peritoneal adhesions in a hamster model could be reduced (Okamoto et al., J. Surg. Res., 107 (2002) 219-222 and Fertil and Sterile 77 (2002) 1044-1048).
- the object of the present invention is to provide possibilities for the treatment and prevention of inflammatory diseases and chronic pelvic pain diseases, such as e.g. Endometriosis and / or secondary dysmenorrhea and / or postoperative fibrosis and adhesions to provide.
- the new treatment options are distinguished from the methods known from the prior art in that they can be used in a chronic treatment without thereby exerting an influence on the woman's hormonal cycle or susceptibility to infection.
- the present invention relates to the use of compounds of general formula (I)
- R 1 is hydrogen or (C 1 -C 4 ) -alkyl
- R 2 is a group of the formula
- A is -CH 2 -, -CH 2 -CH 2 -, -O-CH 2 - ## or oxygen
- n is a number 0, 1 or 2
- R 4 is halogen, difluoromethyl, trifluoromethyl, (C 1 -C 4 ) -alkyl, difluoromethoxy, trifluoromethoxy or (C 1 -C 4 ) -alkoxy,
- R 5A is hydrogen or deuterium
- R 5B is hydrogen, deuterium or (C 1 -C 4 ) -alkyl
- R 6 is hydrogen or fluorine
- R 7 is hydrogen or fluorine
- R 8 is halogen, difluoromethyl, trifluoromethyl, (C 1 -C 4 ) -alkyl or nitro,
- R 9 represents hydrogen, halogen, difluoromethyl, trifluoromethyl, (C 1 -C 4 ) -alkyl, nitro or (C 1 -C 4 ) -alkylthio,
- the ring Q is 5- to 7-membered heterocyclyl or 5- or 6-membered heteroaryl
- R 24 is halogen, (C 1 -C 4 ) -alkyl or (C 1 -C 4 ) -alkoxy,
- n stands for a number 0, 1, 2 or 3
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis, and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses Endometriosis-associated symptoms such as dysmenorrhoea, dyspareunia, dysuria or dyscheza and endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- alkyl is a linear or branched alkyl radical having in each case the number of carbon atoms specified. Examples which may be mentioned are: methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, 1-methylpropyl, tert-butyl, n-pentyl, isopentyl, 1-ethylpropyl, 1-methylbutyl, 2 Methylbutyl, 3-methylbutyl, n-hexyl, 1-methylpentyl, 2-methylpentyl, 3-methylpentyl, 4-methylpentyl, 3,3-dimethylbutyl, 1-ethylbutyl, 2-ethylbutyl, 1, 4-dimethylpentyl, 4.4 Dimethylpentyl and 1,4,4-trimethylpentyl.
- Cycloalkyl in the context of the invention is a monocyclic, saturated alkyl radical having 3 to 7 carbon atoms. Examples which may be mentioned by way of example include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl and cycloheptyl.
- Alkylcarbonyl in the context of the invention is a linear or branched alkyl radical having 1 to 4 carbon atoms and a carbonyl group attached in position 1.
- Alkoxy in the context of the invention represents a linear or branched alkoxy radical of 1 to 4 carbon atoms.
- alkoxy radical of 1 to 4 carbon atoms.
- Alkoxycarbonyl in the context of the invention are a linear or branched alkoxy radical having 1 to 4 carbon atoms and one attached to the oxygen Carbonyl group.
- alkoxycarbonyl in the context of the invention are a linear or branched alkoxy radical having 1 to 4 carbon atoms and one attached to the oxygen Carbonyl group.
- Alkylthio in the context of the invention is a linear or branched alkyl radical having 1 to 4 carbon atoms which is bonded via a sulfur atom.
- Preferred examples which may be mentioned are: methylthio, ethylthio, n-propylthio, isopropylthio, 1 - methylpropylthio, n-butylthio, / 'so-butylthio, and the IU / f.-butylthio.
- Alkylsulfonyl in the context of the invention is a linear or branched alkyl radical having 1 to 4 carbon atoms, which is bonded via a sulfonyl group.
- a sulfonyl group By way of example and preferably its name: methylsulfonyl, ethylsulfonyl, n-propylsulfonyl, iso-propylsulfonyl, n-butylsulfonyl and tert-butylsulfonyl.
- 4- to 7-membered heterocyclyl is in the context of the invention for a monocyclic, saturated heterocycle having a total of 4 to 7 ring atoms, which contains one or two ring heteroatoms from the series N, O, S, SO and / or SO2 and via a Ring carbon atom or optionally a ring nitrogen atom is linked.
- Examples which may be mentioned are: azetidinyl, oxetanyl, pyrrolidinyl, pyrazolidinyl, tetrahydrofuranyl, piperidinyl, piperazinyl, tetrahydropyranyl, morpholinyl, thiomorpholinyl.
- 5- to 7-membered heterocyclyl in the context of the invention represents a partially unsaturated heterocycle having a total of 5 to 7 ring atoms which contains 1 to 3 ring heteroatoms from the series N, O, S and / or SO 2 and to the phenyl ring in R 3 is annealed.
- Examples which may be mentioned are: dihydropyrrolyl, dihydroimidazolyl, dihydrothiazole dioxide, dihydrooxazolyl, dihydropyridyl, tetrahydropyrazinyl and dihydrooxazinyl.
- Heteroaryl is in the context of the invention for a monocyclic aromatic heterocycle (heteroaromatic) with a total of 5 or 6 ring atoms containing up to three identical or different ring heteroatoms from the series N, O and / or S and anneals to the phenyl ring in R 3 is.
- Examples which may be mentioned are: furyl, pyrrolyl, thienyl, pyrazolyl, imidazolyl, thiazolyl, oxazolyl, isoxazolyl, isothiazolyl, triazolyl, oxadiazolyl, thiadiazolyl, pyridyl, pyrimidinyl, pyridazinyl, pyrazinyl and triazinyl.
- furyl pyrrolyl, thienyl, pyrazolyl, imidazolyl, thiazolyl, oxazolyl, isoxazolyl, isothiazolyl, triazolyl, oxadiazolyl, thiadiazolyl, pyridyl, pyrimidinyl, pyridazinyl, pyrazinyl and triazinyl.
- pyrazolyl imidazolyl, thiazolyl and triazolyl.
- Halogen in the context of the invention includes fluorine, chlorine, bromine and iodine. Preference is given to chlorine or fluorine.
- An oxo group in the context of the invention represents an oxygen atom which is bonded via a double bond to a carbon or sulfur atom.
- radicals in the compounds of the general formula (I) When radicals in the compounds of the general formula (I) are substituted, the radicals may, unless otherwise specified, be monosubstituted or polysubstituted. In the context of the present invention, the meaning is independent of each other for all radicals which occur repeatedly. Substitution with one or two identical or different substituents is preferred. Very particular preference is given to the substitution with a substituent.
- endometriosis is understood as meaning an inflammatory disease (Lousse JC et al., Front Biosci 4 (2012) 23-40], which is characterized by the growth of endometrial tissue (lesions) outside the cavity of the uterus in the abdominal cavity.
- fibrosis is understood as a pathological regeneration of connective tissue fibers. Basically, all tissues and organs can be affected.
- an adhesion means a physical connection between organs which are not directly connected to one another in healthy humans. Basically, all tissues and organs can be affected.
- postoperative adhesion is understood to mean the physical connection between organs which is not directly linked to one another in healthy humans by physical intervention in the peritoneum, such as a laparoscopy or laparotomy, for example in the context of endometriosis treatment or tube ligation. Basically, all tissues and organs can be affected.
- adenomyosis (adenomyosis uteri) is understood to mean a disease in which endometriotic cells implant in the uterine musculature (myometrium) and thus settle in the middle layer of the uterine wall.
- the migrated Endometriosezellen are thus in addition to the cells of the inner uterine lining in the overlying uterine muscles. This can lead to enlargement and thickening of the uterus. These enlargements of the uterus may occur at a single site or throughout the entire muscular system of the uterus.
- secondary dysmenorrhoea is the secondary regulatory pain caused by organic changes or diseases such as e.g. Endometriosis or adhesions, understood.
- treatment includes inhibiting, delaying, arresting, alleviating, attenuating, restraining, reducing, suppressing, restraining or curing a disease, a disease, a disease, an injury or a medical condition , the unfolding, the course or progression of such conditions and / or the symptoms of such conditions.
- therapy is understood to be synonymous with the term “treatment”.
- prevention means the avoidance or reduction of the risk, a disease, a disease, a disease, an injury or a health disorder, a development or a
- the treatment or prevention of a disease, a disease, a disease, an injury, or a medical condition may be partial or total.
- R 1 is hydrogen, methyl or ethyl
- R 2 is a group of the formula
- A is -CH 2 - or oxygen
- R 4A is hydrogen, fluorine, chlorine, trifluoromethyl or methyl
- R 4B is hydrogen, fluorine, chlorine, trifluoromethyl or methyl
- R 5A is hydrogen
- R 5B is hydrogen
- R 6 is hydrogen
- R 7 is hydrogen
- R 8 is fluorine, chlorine, difluoromethyl, trifluoromethyl or methyl
- R 9 is fluorine, chlorine, difluoromethyl, trifluoromethyl or methyl
- # represents the point of attachment to the uracil nitrogen atom, stands for CR 11 or N,
- R 11 is hydrogen, (C 1 -C 4 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or aminocarbonyl,
- R 12 is hydrogen, (C 1 -C 4 ) -alkyl or (C 3 -C 7 ) -cycloalkyl,
- R 16A is hydrogen, fluorine, (C 1 -C 4 ) -alkyl or hydroxyl
- R 16B is hydrogen, fluorine, chlorine, (Ci-C 4 ) alkyl or trifluoromethyl, or
- R 16A and R 16B together with the carbon atom to which they are attached form a 3- to 6-membered carbocycle
- R 17 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkoxycarbonyl,
- R 18A is hydrogen, fluorine, (C 1 -C 4 ) -alkyl or hydroxyl
- R 18B is hydrogen, fluorine, chlorine, (Ci-C 4 ) -alkyl or trifluoromethyl, or
- R 18A and R 18B together with the carbon atom to which they are attached form a 3- to 6-membered carbocycle
- R 19 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkoxycarbonyl,
- K 1 is CH 2 or O
- K 2 is CH 2 or O
- D 1 , D 2 , D 3 and D 4 independently of one another represent CR 23 or N,
- R 23 is hydrogen, halogen, (C 1 -C 6 ) -alkyl or (C 3 -C 7 ) -cycloalkyl, with the proviso that at most 2 of the groups D 1 , D 2 , D 3 and D 4 are N .
- R 24 is fluorine or methyl
- n is a number 0 or 1
- R 10 is (C 1 -C 4 ) -alkyl or (C 3 -C 7 ) -cycloalkyl
- (C 1 -C 4 ) -alkyl having 1 or 2 substituents independently of one another selected from the group of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl may be substituted,
- R 13 is hydrogen, (C 1 -C 4 ) -alkyl or (C 3 -C 7 ) -cycloalkyl,
- R 15 is hydrogen, (C 1 -C 6 ) -alkyl or (C 3 -C 7 ) -cycloalkyl,
- (C 1 -C 6) -alkyl may be substituted by 1 or 2 substituents independently selected from the group consisting of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl,
- R 20 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkylcarbonyl,
- (C 1 -C 6) -alkyl may be substituted by 1 or 2 substituents independently selected from the group consisting of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl,
- R 21 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkylsulfonyl,
- R 22A is hydrogen or (C 1 -C 4 ) -alkyl
- R 22B is hydrogen or (C 1 -C 4 ) -alkyl
- R 22A and R 22B together with the carbon atom to which they are attached form a carbonyl group, and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis disease, and the treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- R 1 is hydrogen, methyl or ethyl
- R 2 is a group of the formula
- A is -CH 2 -, -CH 2 -CH 2 -, -O-CH 2 - ## or oxygen
- R 4A is hydrogen, fluorine, chlorine, trifluoromethyl or methyl
- R 4B is hydrogen, fluorine, chlorine, trifluoromethyl or methyl
- R 5A is hydrogen
- R 5B is hydrogen
- R 6 is hydrogen
- R 7 is hydrogen
- R 8 is fluorine, chlorine, difluoromethyl, trifluoromethyl or methyl
- R 9 is fluorine, chlorine, difluoromethyl, trifluoromethyl or methyl
- E 1 is CR 11 or N
- R 11 is hydrogen, (C 1 -C 4 ) -alkyl, (C 3 -C 7 ) -cycloalkyl aminocarbonyl,
- E 2 is CR 12 or N
- R 12 is hydrogen, (C 1 -C 4 ) -alkyl or (C 3 -C 7 ) -cycloalkyl,
- E 3 is NR 14 or S
- G 2 is CR 16A R 16B , NR 17 , O or S,
- R 16A is hydrogen, fluorine, (C 1 -C 4 ) -alkyl or hydroxyl
- R 16B is hydrogen, fluorine, chlorine, (Ci-C 4 ) alkyl or trifluoromethyl, or
- R 16A and R 16B together with the carbon atom to which they are attached form a 3- to 6-membered carbocycle
- R 17 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkoxycarbonyl,
- (C 1 -C 6) -alkyl having 1 to 3 substituents independently of one another is selected from the group consisting of fluorine, trifluoromethyl, cyano, (C 3 -C 7) -cycloalkyl, hydroxy, trifluoromethoxy, (C 1 -C 4 ) -alkoxy, azetidinyl, Oxetanyl, tetrahydrofuranyl and pyrrolidinyl may be substituted,
- G 3 is CR 18A R 18B , NR 19 , O or S,
- R 18A is hydrogen, fluorine, (C 1 -C 4 ) -alkyl or hydroxyl
- R 18B is hydrogen, fluorine, chlorine, (Ci-C 4 ) -alkyl or trifluoromethyl, or
- R 18A and R 18B together with the carbon atom to which they are attached form a 3- to 6-membered carbocycle
- R 19 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkoxycarbonyl,
- (C 1 -C 6) -alkyl having 1 to 3 substituents independently of one another is selected from the group consisting of fluorine, trifluoromethyl, cyano, (C 3 -C 7) -cycloalkyl, hydroxy, trifluoromethoxy, (C 1 -C 4 ) -alkoxy, azetidinyl, Oxetanyl, tetrahydrofuranyl and pyrrolidinyl may be substituted,
- K 1 is CH 2 or O
- K 2 is CH 2 or O
- D 1 , D 2 , D 3 and D 4 independently of one another represent CR 23 or N,
- R 23 is hydrogen, halogen, (C 1 -C 6 ) -alkyl or (C 3 -C 7 ) -cycloalkyl, with the proviso that at most 2 of the groups D 1 , D 2 , D 3 and D 4 are N , R 24 is fluorine or methyl, n is a number 0 or 1,
- R 10 is (C 1 -C 4 ) -alkyl or (C 3 -C 7 ) -cycloalkyl
- (C 1 -C 4 ) -alkyl having 1 or 2 substituents independently of one another selected from the group of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl may be substituted,
- R 13 is hydrogen, (C 1 -C 4 ) -alkyl or (C 3 -C 7 ) -cycloalkyl,
- R 15 is hydrogen, (C 1 -C 6 ) -alkyl or (C 3 -C 7 ) -cycloalkyl,
- (C 1 -C 6) -alkyl may be substituted by 1 or 2 substituents independently selected from the group consisting of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl,
- R 20 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkylcarbonyl,
- (C 1 -C 6) -alkyl may be substituted by 1 or 2 substituents independently selected from the group consisting of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl,
- R 21 is hydrogen, (C 1 -C 6 ) -alkyl, (C 3 -C 7 ) -cycloalkyl or (C 1 -C 4 ) -alkylsulfonyl,
- R 22A is hydrogen or (C 1 -C 4 ) -alkyl
- R 22B is hydrogen or (C 1 -C 4 ) -alkyl
- R 22A and R 22B together with the carbon atom to which they are attached form a carbonyl group and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis disease and the treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- R 1 is hydrogen
- R 2 is a group of the formula
- A stands for -CH2-
- R 4A is chlorine or trifluoromethyl
- R 4B is hydrogen
- E 1 stands for CR 11 ,
- R 11 is hydrogen
- R 16A is hydrogen, fluorine, methyl or hydroxy
- R 16B is hydrogen, fluorine, methyl or trifluoromethyl
- R 16A and R 16B together with the carbon atom to which they are attached form a cyclopropyl ring
- R 17 is hydrogen, (Ci-C 4 ) -alkyl or (C 3 -C 5 ) -cycloalkyl, wherein (Ci-C 4 ) -alkyl having 1 to 3 substituents independently selected from the group fluorine, trifluoromethyl, cyano , Cyclopropyl, cyclobutyl, hydroxy, trifluoromethoxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl, is hydrogen or fluorine,
- methyl and ethyl may be substituted with 1 substituent selected from the group consisting of fluorine, trifluoromethyl and cyclopropyl, and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, endometriosis-associated Pain and the treatment and prevention of postoperative fibrosis and adhesions.
- 1 substituent selected from the group consisting of fluorine, trifluoromethyl and cyclopropyl, and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, endometriosis-associated Pain and the treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue disorder of the Palms) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue disorder of the Palms
- R 1 is hydrogen
- R 2 is a group of the formula
- R 5A is hydrogen
- R 5B is hydrogen
- R 6 is hydrogen
- R 7 is hydrogen
- R 8 is fluorine, chlorine or trifluoromethyl
- R 9 is fluorine, chlorine, trifluoromethyl or methyl
- R 11 is hydrogen
- R 16A is hydrogen, fluorine, methyl or hydroxy
- R 16B is hydrogen, fluorine, methyl or trifluoromethyl
- R 16A and R 16B together with the carbon atom to which they are attached form a cyclopropyl ring
- R 17 is hydrogen, (Ci-C 4 ) -alkyl or (C 3 -C 5 ) -cycloalkyl, wherein (Ci-C 4 ) -alkyl having 1 to 3 substituents independently selected from the group fluorine, trifluoromethyl, cyano , Cyclopropyl, cyclobutyl, hydroxy, trifluoromethoxy, methoxy, ethoxy, azetidinyl, oxetanyl, tetrahydrofuranyl and pyrrolidinyl, is hydrogen or fluorine,
- methyl and ethyl may be substituted with 1 substituent selected from the group consisting of fluorine, trifluoromethyl and cyclopropyl, and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, endometriosis-associated Pain and the treatment and prevention of postoperative fibrosis and adhesions.
- 1 substituent selected from the group consisting of fluorine, trifluoromethyl and cyclopropyl, and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, endometriosis-associated Pain and the treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- prophylaxis of chronic pelvic pain preference is also given to the use of compounds of the formula (I) in which
- R 1 is hydrogen, methyl or ethyl
- R 2 stands for a formula of the formula
- A stands for -CH2-
- R 4A is chlorine or trifluoromethyl
- R 4B is hydrogen, and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis disease, and the treatment and prevention of postoperative fibroses and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- prophylaxis of chronic pelvic pain preference is also given to the use of compounds of the formula (I) in which
- R 3 is a group of the formula
- E 1 is CR 11 or N
- R 11 is hydrogen, methyl, ethyl or aminocarbonyl
- E 2 is CR 12 or N
- R 12 is hydrogen
- G 2 is CR 16A R 16B , NR 17 , O or S,
- R 16A is hydrogen, fluorine, methyl or hydroxy
- R 16B is hydrogen, fluorine, chlorine, methyl or trifluoromethyl, or
- R 16A and R 16B together with the carbon atom to which they are attached form a cyclopropyl ring
- R 17 is hydrogen, (C 1 -C 4 ) -alkyl, cyclopropyl or cyclobutyl, wherein (C 1 -C 4) -alkyl having 1 or 2 substituents independently of one another selected from the group of fluorine, trifluoromethyl, cyclopropyl, cyclobutyl, hydroxy, azetidinyl and oxetanyl may be substituted, represents CR 18A R 18B ,
- R 18A is hydrogen, fluorine, methyl or hydroxy
- R 18B is hydrogen, fluorine, methyl or trifluoromethyl
- K 1 is CH 2 or O
- K 2 is CH 2 .
- R 24 is hydrogen, fluorine or methyl
- R 10 is methyl or ethyl
- R 15 is methyl or ethyl
- R20 is hydrogen, methyl, ethyl or methylcarbonyl
- R 21 is methyl or ethyl
- R 22B together with the carbon atom to which they are attached form a carbonyl group and their salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis disease and the treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- prophylaxis of chronic pelvic pain preference is also given to the use of compounds of the formula (I) in which
- R 2 stands for a formula of the formula
- A stands for -CH2-
- R 4A is chlorine or trifluoromethyl
- R 4B is hydrogen
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue connective tissue disorder
- prophylaxis of chronic pelvic pain preference is also given to the use of compounds of the formula (I) in which
- R 2 stands for a formula of the formula
- A stands for -CH2-
- R 4A is hydrogen, fluorine, chlorine, trifluoromethyl or methyl
- R 4B is hydrogen, fluorine, chlorine, trifluoromethyl or methyl
- the carbon atom attached to the uracil nitrogen has an R configuration, and its salts, solvates and solvates of the salts for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis disease, and the like Treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyschezie, as well as endometriosis-associated subfertility.
- the compounds are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- the compounds are useful in the treatment of Dupuytren's disease (a connective tissue disorder of the Palms) and in the treatment and / or prophylaxis of chronic pelvic pain.
- Dupuytren's disease a connective tissue disorder of the Palms
- the compounds of the general formula (I) can be used alone or as needed in combination with other active ingredients.
- the invention therefore also provides a use of the chymase inhibitors of the general formula (I) and their salts, solvates and solvates of the salts in combination with other active substances for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis and the treatment and prevention of postoperative fibrosis and adhesions.
- the compounds are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhoea, Dyspareunia, dysuria or dyscheza, as well as endometriosis-associated subfertility.
- the compounds of general formula (I) and their salts, solvates and solvates of the salts in combination with other active substances are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-induced subfertility.
- the compounds of the general formula (I) and their salts, solvates and solvates of the salts in combination with other active substances are suitable for the treatment of Dupuytren's disease (a disorder of the connective tissue of the palms) and in the treatment and / or Prophylaxis of chronic pelvic pain.
- Suitable active ingredients that can be used in combination with the chymase inhibitors according to general formula (I) are given below by way of example and not by way of limitation: known hormonal agents such as progestins, eg. B. Norethynodrel, norethindrone, norethindrone acetate, ethynodiol acetate, norgestrel, levonorgestrel, norgestimate, desogestrel, gestodene, drospirenone, dienogest or nomegestrol acetate, alone or together with estrogens, e.g.
- known hormonal agents such as progestins, eg. B. Norethynodrel, norethindrone, norethindrone acetate, ethynodiol acetate, norgestrel, levonorgestrel, norgestimate, desogestrel, gestodene, drospiren
- estradiol or Estradiolester such as estradiol valerate
- hormonal contraceptives can be administered either orally, subcutaneously, transdermally, intrauterine or intravaginally.
- Suitable preparations for this are combined oral contraceptives (COC), progestin-only pill (POP), which contains only one progestin, or hormone-containing devices such as implants, patches or intravaginal rings.
- COC oral contraceptives
- POP progestin-only pill
- hormone-containing devices such as implants, patches or intravaginal rings.
- COCs include a combination of an estrogen (estradiol) and a progestin (progestin).
- the estrogenic component in most COCs is ethinylestradiol.
- Some COCs contain estradiol or estradiol valerate.
- the following progestins are used in COCs: norethynodrel, norethindrone, norethindrone acetate, ethynodiol acetate, norgestrel, levonorgestrel, norgestimate, desogestrel, gestodene, drospirenone, dienogest or nomegestrol acetate.
- Another embodiment of the present invention is therefore a combination of COC with the present compounds of the general formula (I), for example, combinations of the compounds of general formula (I) with ethinyl estradiol and drospirenone (Yasmin ® and Yaz ®), (with ethinyl estradiol and levonorgestrel Microgynon ® and Miranova ®), with ethinyl estradiol and desogestrel (Marvelon ®), with ethinyl estradiol and dienogest (Valette ®) or ethinyl estradiol with chlormadinone acetate (Belara ® and Enriqa ®).
- a further embodiment of the present invention is a combination of compounds of general formula (I) with for example estradiol and Normegestrol (Zoely ®) or estradiol valerate and dienogest (Qlaira ®).
- Another embodiment is the administration of compounds of general formula (I) in combination with synthetic progestins without estrogen component.
- This variant can be realized, for example, with so-called POPs (progestin-only pills) as contraceptives.
- POPs are also known as mini pills. Examples of POPs are Cerazette ® with the progestin desogestrel, Microlut ® with levonorgestrel or norethindrone Micronor ® with.
- Another embodiment of the present invention involves a combination of the compounds of general formula (I) with non-oral progestin-only forms as intrauterine systems (LUDS), for example, Mirena ®, ® or Jaydess Kyleena ® each with levonorgestrel, or as injectable forms, such as Depo-Provera ® progesteronacetat with medroxyprogesterone acetate, or as implants such as Implanon with etonogestrel.
- LUDS intrauterine systems
- vaginal rings like NuvaRing ® with ethinyl estradiol and etonogestrel or vaginal rings containing an aromatase inhibitor such as anastrozole, and a progestin, or transdermal Systems such as contraceptive patches, eg Ortho-Evra with ethinylestradiol and norelgestromin or Apleek (Lisvy) with ethinyl estradiol and gestodene.
- vaginal rings like NuvaRing ® with ethinyl estradiol and etonogestrel or vaginal rings containing an aromatase inhibitor such as anastrozole, and a progestin, or transdermal Systems
- contraceptive patches eg Ortho-Evra with ethinylestradiol and norelgestromin or Apleek (Lisvy) with ethinyl estradiol and gestodene.
- the compounds of the general formula (I) can be used in combination with the following active substances for the purposes of the present invention: combination with inhibitors of the P2X-purine receptors (P2X3, P2X4), with inhibitors of IRAK4 (interleukin-1 receptor-associated kinase 4) , PTGES (prostaglandin synthase) and antagonists of the prostaglandin receptor EP4 (prostaglandin E2 receptor 4). Further combinations are with AKR1 C3 inhibitors (aldoketoreductase 1 C3) and with functionally blocking antibodies of the prolactin receptor.
- said combinations are suitable for use in the treatment of inflammatory and distinct fibrotic disorders, in particular for the treatment and prevention of endometriosis, endometriosis-associated fibrosis, adenomyosis, pain associated with endometriosis disease and the treatment and prevention of postoperative fibroses and adhesions .
- said combinations are suitable for use in the treatment of endometriosis, endometriosis-associated fibrosis, adenomyosis and pain associated with endometriosis disease, endometriosis-associated adhesions and fibroses, endometriosis-associated symptoms such as dysmenorrhea , Dyspareunia, dysuria or dyschez, and endometriosis-associated subfertility.
- said combinations are suitable for use in the treatment and prevention of postoperative adhesions in the abdominal cavity and for the prevention of adhesion-related subfertility.
- said combinations are suitable for the treatment of Dupuytren's disease (a connective tissue connective tissue disorder) and in the treatment and / or prophylaxis of chronic pelvic pain.
- the compounds of the general formula (I) can act systemically and / or locally.
- they may be applied in a suitable manner, e.g. oral, parenteral, pulmonary, nasal, sublingual, lingual, buccal, rectal, dermal, transdermal, conjunctival, otic or as an implant or stent.
- the compounds of the general formula (I) can be administered in suitable administration forms.
- the compounds of the invention rapidly and / or modified donating application forms containing the compounds of the invention in crystalline and / or amorphized and / or dissolved form, such.
- Tablets uncoated or coated tablets, for example with enteric or delayed-release or insoluble coatings which control the release of the compound of the invention
- tablets or films / wafers rapidly breaking down in the oral cavity, films / lyophilisates
- capsules e.g. Soft gelatin capsules
- dragees granules, pellets, powders, emulsions, suspensions, aerosols or solutions.
- Parenteral administration may be by circumvention of an absorption step (e.g., intravenous, intraarterial, intracardiac, intraspinal, or intralumbar) or by absorption (e.g., inhalation, intramuscular, subcutaneous, intracutaneous, percutaneous, or intraperitoneal).
- absorption step e.g., intravenous, intraarterial, intracardiac, intraspinal, or intralumbar
- absorption e.g., inhalation, intramuscular, subcutaneous, intracutaneous, percutaneous, or intraperitoneal.
- parenteral administration are suitable as application forms u.a. Injection and infusion preparations in the form of solutions, suspensions, emulsions, lyophilisates or sterile powders.
- Inhalation medicaments including powder inhalers, nebulizers, aerosols
- nasal drops solutions or sprays
- lingual, sublingual or buccal tablets films / wafers or capsules
- suppositories ear or ophthalmic preparations
- vaginal capsules aqueous suspensions (lotions, shake mixtures)
- lipophilic suspensions ointments
- creams transdermal therapeutic systems (eg plasters)
- transdermal therapeutic systems eg plasters
- milk pastes, foams, powdered powders, implants or stents.
- the compounds of the general formula (I) can be converted into the stated administration forms. This can be done in a conventional manner by mixing with inert, non-toxic, pharmaceutically suitable excipients.
- excipients include, but are not limited to, excipients (e.g., microcrystalline cellulose, lactose, mannitol), solvents (eg, liquid polyethylene glycols), emulsifiers and dispersing or wetting agents (e.g., sodium dodecyl sulfate, polyoxysorbitanoleate), binders (e.g., polyvinylpyrrolidone), synthetic and natural polymers (e.g. Albumin), stabilizers (eg antioxidants such as ascorbic acid), dyes (eg inorganic pigments such as iron oxides) and flavor and / or odoriferous agents.
- excipients e.g., microcrystalline cellulose, lactose, mannitol
- solvents eg, liquid polyethylene glycols
- emulsifiers and dispersing or wetting agents e.g., sodium dodecyl sulfate, polyoxysorbitanoleate
- the dosage is about 0.01 to 100 mg / kg, preferably about 0.01 to 20 mg / kg and most preferably 0.1 to 10 mg / kg of body weight.
- the enzyme source used is recombinant human chymase (expressed in HEK293 cells) or chymase purified from hamster tongues.
- assay 1 ⁇ of a 50-fold concentrated solution of test substance in DMSO, 24 ⁇ enzyme solution (dilution 1: 80,000 human or 1: 4,000 hamsters) and 25 ⁇ substrate solution (final concentration 10 ⁇ ) in assay buffer (Tris 50 mM (pH 7.5), sodium chloride 150 mM, BSA 0.10%, chaps 0.10%, glutathione 1 mM, EDTA 1 mM) in a white 384-well microtiter plate (Greiner Bio-One, Frickenhausen, Germany). The reaction is incubated for 60 min at 32 degrees and the fluorescence emission at 465 nm after excitation at 340 nm is measured in a fluorescence reader, eg Tecan Ultra (Tecan, Switzerland).
- fluorescence reader eg Tecan Ultra (Tecan, Switzerland).
- test compound is tested on the same microtiter plate in 10 different concentrations from 30 ⁇ to 1 nM in duplicate.
- Compounds according to the invention which were tested in this assay inhibited the chymase activity with an IC50 value less than 10 ⁇ .
- female Syrian hamsters (about 150 g) are used at the age of 3-4 months.
- the cycle of animals is determined via a vaginal swab needle.
- the oestrus is defined in the animals by the outflow of a pus-like secretion from the vagina.
- the operation is performed to induce rectovaginal endometriosis and the generation of associated adhesions, fibroses and fistulas.
- a rectovaginal endometriosis is induced in the animals as follows: One day after estrus, the animals are anesthetized with isoflurane and the abdominal wall is opened.
- the animals are treated daily with the test substance for a period of 21 days.
- Disease severity is determined based on adhesions and fistula development after sectioning the animals on day 21 using the following scoring system:
- Figure 1 clearly shows a reduction by the test substance Example compound 189 of the fibrosis-related adhesions, which were caused by an induced endometriosis.
- Hamster adhesion model
- the abdominal wall is closed by setting a suture.
- the animals are treated daily for 7 days with the test substance.
- killing is by decapitation or deep isoflurane anesthesia and then autopsy.
- the number of adhesions per ischemic nodule, as well as their size and nature are determined before the tissue is harvested for histological and molecular biological analysis.
- tissue from the surrounding peritoneum is preserved as a control tissue.
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Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP16205339.1A EP3338780A1 (de) | 2016-12-20 | 2016-12-20 | Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sind |
PCT/EP2017/082569 WO2018114514A1 (de) | 2016-12-20 | 2017-12-13 | Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sind |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3558316A1 true EP3558316A1 (de) | 2019-10-30 |
Family
ID=57570813
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP16205339.1A Withdrawn EP3338780A1 (de) | 2016-12-20 | 2016-12-20 | Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sind |
EP17818103.8A Withdrawn EP3558316A1 (de) | 2016-12-20 | 2017-12-13 | Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sind |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP16205339.1A Withdrawn EP3338780A1 (de) | 2016-12-20 | 2016-12-20 | Verwendung von chymaseinhibitoren zur behandlung von endometriose, post-operativer fibrose und erkrankungen die durch fibrosebildung gekennzeichnet sind |
Country Status (19)
Country | Link |
---|---|
US (1) | US11266646B2 (de) |
EP (2) | EP3338780A1 (de) |
JP (1) | JP2020502272A (de) |
KR (1) | KR20190098984A (de) |
CN (1) | CN110072527A (de) |
AU (1) | AU2017381324A1 (de) |
BR (1) | BR112019012503A2 (de) |
CA (1) | CA3047448A1 (de) |
CL (1) | CL2019001713A1 (de) |
EA (1) | EA201991292A1 (de) |
IL (1) | IL266823B (de) |
JO (1) | JOP20190149A1 (de) |
MA (1) | MA47067A (de) |
MX (1) | MX2019007377A (de) |
PH (1) | PH12019501409A1 (de) |
SG (1) | SG10202106586TA (de) |
TW (1) | TWI753070B (de) |
UA (1) | UA124848C2 (de) |
WO (1) | WO2018114514A1 (de) |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2021000933A1 (zh) * | 2019-07-03 | 2021-01-07 | 南京明德新药研发有限公司 | 作为糜酶抑制剂的嘧啶酮类化合物及其应用 |
CN114671878B (zh) * | 2020-12-25 | 2023-08-04 | 广东东阳光药业有限公司 | 取代的含氮双环化合物及其用途 |
WO2022135502A1 (zh) * | 2020-12-25 | 2022-06-30 | 广东东阳光药业有限公司 | 多取代的尿嘧啶衍生物及其用途 |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7071220B2 (en) * | 2000-09-18 | 2006-07-04 | Toa Eiyo Ltd. | N-substituted benzothiophenesulfonamide derivatives |
US20040018984A1 (en) * | 2002-07-17 | 2004-01-29 | Mizuo Miyazaki | Methods for preventing adhesion formation using protease inhibitors |
US8193214B2 (en) | 2006-10-06 | 2012-06-05 | Boehringer Ingelheim International Gmbh | Chymase inhibitors |
WO2008147697A1 (en) * | 2007-05-22 | 2008-12-04 | Boehringer Ingelheim International Gmbh | Benzimidazolone chymase inhibitors |
UA112897C2 (uk) * | 2012-05-09 | 2016-11-10 | Байєр Фарма Акцієнгезелльшафт | Біциклічно заміщені урацили та їх застосування для лікування і/або профілактики захворювань |
CN105980381A (zh) | 2013-11-08 | 2016-09-28 | 拜耳医药股份有限公司 | 取代的尿嘧啶及其用途 |
US20160287599A1 (en) | 2013-11-08 | 2016-10-06 | Bayer Pharma Aktiengesellschaft | Substituted 1,2,4-triazine-3,5-diones and the use thereof as chymase inhibitors |
US9695131B2 (en) | 2013-11-08 | 2017-07-04 | Bayer Pharma Aktiengesellschaft | Substituted uracils as chymase inhibitors |
LT3066097T (lt) | 2013-11-08 | 2018-02-12 | Bayer Pharma Aktiengesellschaft | 1-(3-metil-2-okso-2,3-dihidro-1,3-benzoksazol-6-il)-2,4-diokso-3-[(1r)-4-(trifluormetil)-2,3-dihidro-1h-inden-1-il]-1,2,3,4-tetrahidropirimidin-5-karboksirūgšties druskos |
-
2016
- 2016-12-20 EP EP16205339.1A patent/EP3338780A1/de not_active Withdrawn
-
2017
- 2017-06-16 JO JOP/2019/0149A patent/JOP20190149A1/ar unknown
- 2017-12-13 EP EP17818103.8A patent/EP3558316A1/de not_active Withdrawn
- 2017-12-13 MA MA047067A patent/MA47067A/fr unknown
- 2017-12-13 CN CN201780078622.8A patent/CN110072527A/zh active Pending
- 2017-12-13 AU AU2017381324A patent/AU2017381324A1/en not_active Abandoned
- 2017-12-13 CA CA3047448A patent/CA3047448A1/en not_active Abandoned
- 2017-12-13 JP JP2019553638A patent/JP2020502272A/ja active Pending
- 2017-12-13 UA UAA201908579A patent/UA124848C2/uk unknown
- 2017-12-13 WO PCT/EP2017/082569 patent/WO2018114514A1/de unknown
- 2017-12-13 EA EA201991292A patent/EA201991292A1/ru unknown
- 2017-12-13 KR KR1020197018728A patent/KR20190098984A/ko not_active Application Discontinuation
- 2017-12-13 BR BR112019012503A patent/BR112019012503A2/pt not_active IP Right Cessation
- 2017-12-13 US US16/471,928 patent/US11266646B2/en active Active
- 2017-12-13 SG SG10202106586TA patent/SG10202106586TA/en unknown
- 2017-12-13 MX MX2019007377A patent/MX2019007377A/es unknown
- 2017-12-20 TW TW106144698A patent/TWI753070B/zh not_active IP Right Cessation
-
2019
- 2019-05-22 IL IL266823A patent/IL266823B/en unknown
- 2019-06-19 PH PH12019501409A patent/PH12019501409A1/en unknown
- 2019-06-19 CL CL2019001713A patent/CL2019001713A1/es unknown
Also Published As
Publication number | Publication date |
---|---|
KR20190098984A (ko) | 2019-08-23 |
CA3047448A1 (en) | 2018-06-28 |
JOP20190149A1 (ar) | 2019-06-19 |
CN110072527A (zh) | 2019-07-30 |
JP2020502272A (ja) | 2020-01-23 |
AU2017381324A1 (en) | 2019-07-04 |
IL266823A (en) | 2019-07-31 |
US11266646B2 (en) | 2022-03-08 |
PH12019501409A1 (en) | 2020-03-09 |
EP3338780A1 (de) | 2018-06-27 |
MX2019007377A (es) | 2019-09-18 |
TWI753070B (zh) | 2022-01-21 |
BR112019012503A2 (pt) | 2020-04-14 |
TW201827053A (zh) | 2018-08-01 |
IL266823B (en) | 2022-03-01 |
UA124848C2 (uk) | 2021-12-01 |
EA201991292A1 (ru) | 2019-12-30 |
MA47067A (fr) | 2019-10-30 |
SG10202106586TA (en) | 2021-07-29 |
US20190381040A1 (en) | 2019-12-19 |
WO2018114514A1 (de) | 2018-06-28 |
CL2019001713A1 (es) | 2019-11-15 |
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