FR2861301A1 - Use of pyrazole derivative as cannabinoid CB1 receptor antagonist, for treatment and prevention of metabolic syndrome, particularly cardiovascular risks and dyslipidemia associated with obesity - Google Patents

Abstract

Use of a pyrazole compound (I) which is an antagonist of the CB1 cannabinoid receptor, to prepare a composition for treatment and prevention of metabolic syndrome. An independent claim is also included for a composition containing (I) and a second active agent (II). ACTIVITY : Antilipemic; Anorectic; Antidiabetic; Cardiant; Hypotensive; Antiarteriosclerotic; Antianginal; Anticoagulant; Cerebroprotective; Ophthalmological. MECHANISM OF ACTION : CB1 cannabinoid receptor antagonist.

Description

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 USE OF A PYRAZOLE DERIVATIVE FOR THE PREPARATION OF MEDICAMENTS USEFUL IN THE PREVENTION AND TREATMENT OF METABOLIC SYNDROME.

 The present invention relates to the use of a pyrazole-derived cannabinoid CB1 receptor antagonist compound for the preparation of medicaments useful in the prevention and treatment of dyslipidemias, metabolic syndrome, cardiovascular risks associated with obesity and associated with dyslipidemia.

 Obesity is now recognized as one of the major public health problems. Correlated with a large number of cardiovascular diseases, diabetes, cancers, respiratory disorders, it is associated with an increase in the mortality rate. The annual costs of somatic complications of obesity are estimated by the World Health Organization (WHO) at one-third of the global health budget.

 Dyslipidemia (elevated triglycerides, LDL-c (Low Density Lipoprotein Cholesterol), low concentration of HDL-c (English High Density Lipoprotein Cholesterol), presence of small particles of LDL) associated or not with obesity is also recognized as an atherogenic profile.

 Metabolic syndrome refers to a set of risk factors including dyslipidemia, increased abdominal circumference / obesity, but also insulin resistance, and hypertension. It affects millions of people around the world, putting them at increased risk of developing diabetes with complications of kidney failure and retinopathy, or causing cardiovascular disease, such as coronary artery disease, coronary heart disease, atherosclerosis, arteriosclerosis, accident cerebrovascular disease, myocardial infarction, angina, thrombosis, atherothrombosis or glaucoma. By improving each parameter of the metabolic syndrome, particularly by preventing and treating dyslipidemia and obesity, the prevention and treatment of the metabolic syndrome of at-risk patients can help to reduce the occurrence of cardiovascular disease and type 2 diabetes.

 The definition of the metabolic syndrome is not universally unified, that given by the National Cholesterol Education Program (NCEP), within the framework of an expert group ATP III (of the English Adult Treatment Panel III) retains the listed criteria in the following table. Patients have a metabolic syndrome when they

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 meet at least 3 of the listed criteria: increase in abdominal circumference / obesity, dyslipidemia, hypertension, hyperglycemia.

TABLE 1

<Tb>
<tb> ATP <SEP> III <SEP>
<tb> Circumference <SEP><SEP> Round of <SEP> size <SEP>: <SEP>
<tb> abdominal <SEP> Men <SEP>><SEP> 102 <SEP> cm
<tb> Women <SEP>><SEP> 88 <SEP> cm
<tb> Lipids <SEP> Triglycerides <SEP> (TG) <SEP>: <SEP>
<tb>#<SEP> 150 <SEP> mg / dl
<tb> HDL-c <SEP> (from <SEP> English <SEP> High <SEP> Density <SEP> Lipoprotein
<tb> cholesterol)
<tb> Men <SEP><<SEP> 40 <SEP> mg / dl
<tb> Women <SEP><<SEP> 50 <SEP> mg / dl
<tb><SEP> blood pressure <SEP>#<SEP> 130 / 85mm <SEP> Hg <SEP>
<tb> Blood Glucose <SEP> to <SEP> Fast <SEP>#<SEP> 110 <SEP> mg / dl
<Tb>

Cannabinoid CB1 receptor antagonist compounds derived from pyrazole are described in several patents or patent applications such as WO 03/007887, WO 01/70700, EP 656354, EP 576357, EP 1150961.

 As a cannabinoid receptor antagonist derived from pyrazole, mention may in particular be made of N-piperidino-5- (4-chlorophenyl) -1- (2,4-dichlorophenyl) -4-methylpyrazole-3-carboxamide, whose international nonproprietary name is rimonabant described in European Patent 656354 and N-piperidino-5- (4-bromophenyl) -1- (2,4-dichlorophenyl) -4-ethylpyrazole-3-carboxamide described in European Patent 1150961.

 Clinical studies with rimonabant have shown that it acts on quantitative and qualitative food intake and reduces the body weight of obese patients (G. Le Fur, 2003,35, First European Workshop on Cannabinoid Research, Madrid, Spain, April 4-5, 2003, and Heshmati HM et al., Obesity Research, 2001, 9 (Suppl 3), 70.

 It has now been found that cannabinoid CB1 receptor antagonists derived from pyrazole have lipid-lowering properties which can

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 to help decrease the metabolic syndrome in patients with this syndrome, and reduce the risk of cardiovascular disease associated with obesity and dyslipidemia. Thus, according to the present invention, a cannabinoid CB1 receptor antagonist compound, derived from pyrazole, can be used for the preparation of medicaments useful for preventing and treating dyslipidemia and metabolic syndrome, more particularly a cannabinoid CB1 receptor antagonist compound. can be used to treat and prevent the risk of cardiovascular disease associated with obesity and dyslipidemia.

 Cardiovascular risks associated with dyslipidemia and obesity include cardiovascular diseases such as: coronary artery disease, coronary insufficiency, atherosclerosis, arteriosclerosis, stroke, myocardial infarction, angina, thrombosis, atherothrombosis or glaucoma.

 The pharmaceutical compositions according to the present invention contain an effective dose of a cannabinoid CB1 receptor antagonist compound derived from pyrazole, as well as at least one pharmaceutically acceptable excipient.

 Said excipients are chosen according to the pharmaceutical form and the desired mode of administration, from the usual excipients which are known to those skilled in the art.

 In the pharmaceutical compositions of the present invention for oral, sublingual, subcutaneous, intramuscular, intravenous, topical, local, intratracheal, intranasal, transdermal or rectal administration, the active ingredient may be administered in unit dosage form. , in admixture with conventional pharmaceutical excipients, to animals and humans for the prevention or treatment of the above disorders or diseases.

 Suitable unit dosage forms include oral forms such as tablets, soft or hard capsules, powders, granules and oral solutions or suspensions, sublingual, oral, intratracheal, intraocular, intranasal forms of administration. by inhalation, topical, transdermal, subcutaneous, intramuscular or intravenous administration forms, rectal administration forms and implants. For topical application, the compounds according to the invention can be used in creams, gels, ointments or lotions.

 For the use according to the present invention, a cannabinoid receptor antagonist, derived from pyrazole, may be combined with another active principle chosen from one of the following therapeutic classes: an angiotensin II AT1 receptor antagonist, alone or in combination with a diuretic;

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 an inhibitor of the conversion enzyme, alone or in combination with a diuretic or a calcium antagonist; a calcium antagonist; a beta-blocker alone or in combination with a diuretic or a calcium antagonist; an antihyperlipidemic agent or an antihypercholesterolemic agent; - an antidiabetic; a PPAR receptor agonist (of the English peroxisome proliferator-activated receptor); an anti-obesity agent.

 Thus, the subject of the present invention is also pharmaceutical compositions containing in combination a cannabinoid CB1 receptor antagonist, derived from pyrazole, and another active ingredient chosen from one of the following therapeutic classes: an AT 1 receptor antagonist; angiotensin II alone or in combination with a diuretic or a calcium antagonist; an inhibitor of the conversion enzyme, alone or in combination with a diuretic; a calcium antagonist; a beta-blocker alone or in combination with a diuretic or a calcium antagonist; an antihyperlipidemic agent or an antihypercholesterolemic agent; - an antidiabetic; a PPAR receptor agonist (of the English peroxisome proliferator-activated receptor) of the class [alpha] or y; an anti-obesity agent.

 According to the present invention, the pharmaceutical compositions containing, in combination, rimonabant and another active principle chosen from one of the following therapeutic classes are preferred: an angiotensin II AT1 receptor antagonist, alone or in combination with a diuretic or a calcium antagonist; an inhibitor of the conversion enzyme, alone or in combination with a diuretic; a calcium antagonist; a beta-blocker alone or in combination with a diuretic or a calcium antagonist; an antihyperlipidemic agent or an antihypercholesterolemic agent; - an antidiabetic; a PPAR receptor agonist (of the English peroxisome proliferator-activated receptor); an anti-obesity agent.

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 By angiotensin II AT1 receptor antagonist is meant a compound such as candesartan cilexitil, eprosartan, irbesartan, losartan potassium, olmesartan medoxomil, telmisartan, valsartan, each of these compounds being able to be itself associated with a diuretic such as hydrochlorothiazide.

 By inhibitor of the conversion enzyme is meant a compound such as alacepril, benazepril, captopril, cilazapril, enalapril, enalaprilat, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril, ramipril, spirapril, temocapril, trandolapril, zofenopril, each such compounds may itself be associated with a diuretic such as hydrochlorothiazide or indapamide or a calcium antagonist such as amlodipine, diltiazem, felodipine or verapamil.

 By calcium antagonist is meant a compound such as amlodipine, aranidipine, benidipine, bepridil, cilnidipine, diltiazem, efonidipine hydrochloride ethanol, fasudil, felodipine, isradipine, lacidipine, lercanidipine hydrochloride, manidipine, mibefradil hydrochloride, nicardipine, nifedipine, nilvadipine, nimodipine, Nisoldipine, Nitrendipine, Terodiline, Verapamil.

 By beta-blocker is meant a compound such as acebutolol, alprenolol, amosulalol, arotinolol, atenolol, befunolol, betaxolol, bevololol, bisoprolol, bopindolol, bucumolol, bufetolol, bunitrolol, butofilolol, carazolol, cardolol, carvedilol, cloranolol, epanolol, esmolol. , indenolol, labetalol, landiolol, levobunolol, levomoprolol, mepindolol, metiprolol, metoprolol, nadolol, nebivolol, nifenalol, nipradilol, oxprenolol, penbutolol, pindolol, propanolol, salmeterol, sotalol, talinolol, tertatolol, tilisolol, timolol, xamoterol, xibenolol.

 By antihyperlipemic or antihypercholesterolemic, is meant a compound selected from fibrates such as alufibrate, beclobrate, ciprofibrate, clinofibrate, clofibrate, etofibrate, fenofibrate; statins (HMG-CoA reductase inhibitors), such as atorvastatin, fluvastatin sodium, lovastatin, pravastatin, rosuvastatin, simvastatin, or a compound such as acipimox, aluminum nicotinate, azacosterol, cholestyramine, dextrothyroxine, meglutol, niceritrol, nicoclonate, nicotinic acid, beta-sitosterin, tiadenol.

 By antidiabetic means a compound such as acarbose, acetohexamide, carbutamide, chlorpropamide, glibenclamide, glibomuride, gliclazide, glimepiride, glipizide, gliquidone, glisoxepide, glybuzole, glymidine, metahexamide, metformin, miglitol, nateglinide, pioglitazone, repaglinide, rosiglitazone, tolazamide , tolbutamide, vogliose.

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 By PPAR receptor agonist is meant a compound such as doconexent, docosahexaenoic acid, ciprofibrate, fenofibrate, clofibrate, pioglitazone, rosiglitazone, bex arotene.

 By anti-obesity agent is meant a compound such as amfepramone, benfluorex, benzphetamine, indanorex, mazindole, mefenorex, methamphetamine, nodeeudoephedrine, voglibose.

 In particular, the subject of the present invention is a pharmaceutical composition containing in combination a cannabinoid CB1 receptor antagonist derived from pyrazole, in particular rimonabant and an angiotensin II AT1 receptor antagonist, in particular irbesartan. More particularly, the present invention relates to a pharmaceutical composition containing in combination rimonabant, irbesartan and hydrochlorothiazide.

 According to another aspect of the invention, the cannabinoid receptor antagonist derived from pyrazole and the other associated active ingredient can be administered simultaneously, separately or spread over time.

 By "simultaneous use" is meant the administration of the compounds of the composition according to the invention included in one and the same pharmaceutical form.

 By "separate use" is meant the administration, at the same time, of the two compounds of the composition according to the invention, each comprised in a separate pharmaceutical form.

 "Extended use over time" is understood to mean the sequential administration of the first compound of the composition according to the invention, included in a pharmaceutical form, then, of the second compound of the composition according to the invention, included in a form pharmaceutical industry.

 In the case of this "use spread over time", the lapse of time elapsed between the administration of the first compound of the composition according to the invention and the administration of the second compound of the same composition according to the invention does not exceed usually not 24 hours, it may be higher if either compound is presented in a pharmaceutical formulation allowing, for example, a weekly administration.

 The pharmaceutical forms, comprising either one of the constituent compounds of the composition according to the invention or the combination of the two compounds, which may be used in the various types of use described above, may for example be appropriate. oral, nasal, parenteral or transdermal administration.

 Also, in the case of "separate use" and "spread use over time", two different pharmaceutical forms may be destined for the same route

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 administered or to a different route of administration (oral and transdermal or oral and nasal or parenteral and transdermal etc.).

 The invention thus also relates to a kit containing a cannabinoid CB1 receptor antagonist derived from pyrazole and another active ingredient in which said cannabinoid CB1 receptor antagonist derived from pyrazole and said active ingredient are in separate compartments and in similar or different packages, and are intended to be administered simultaneously, separately or spread over time.

 EXAMPLE 1: Rimonabant on serum lipid levels in obese mice.

 The effect of long-term (2 months) treatment with rimonabant was studied in mice with established obesity.

 The study was conducted in mice receiving either a normal diet or a fatty diet. Obesity developed in mice on a fat diet and stabilized after 5 months. The mice were then divided into 3 groups: group 1: fat diet and oral treatment for 2 months with rimonabant 10 mg / kg / day, in water with 0.1% Tween 80; group 2: maintenance of the fat diet and administration of the vehicle (Tween 80); group 3: return to a normal diet and administration of the vehicle (Tween 80); group 4 consists of mice receiving from the beginning a normal diet and the vehicle.

 After 5 months of fat diet, the mice showed a weight gain of 46% and a marked increase in serum levels of leptin, insulin, glucose and total cholesterol.

 The HDLc (high density lipoprotein cholesterol) and LDLc (low density lipid cholesterol) levels were measured for these obese mice, and there was an increase in these levels, accompanied by a decrease in HDLc / LDLc ratio.

 After 2 months of treatment with rimonabant, the weight of the group 1 mice decreased by 34.5 ~ 0.8 g, ie in the same proportions as that of the group 3 mice brought back to a normal diet (33.7 ~ 0.6 g).

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 Similarly, after 2 months of treatment, group 1 mice showed a reduction in serum levels of leptin, insulin and glucose; similarly, these levels were reduced for group 3 mice.

The data measured in cholesterol triglyceride and lipoprotein assays are reported in the tables below:
TABLE 2
Distribution of triglycerides and cholesterol in obese mice after 2 months of treatment or return to a normal diet.

<Tb>
<Tb>

Group <SEP> n <SEP> Triglycerides <SEP> mmol / L <SEP> Cholesterol <SEP> total
<tb> g / L
<tb> 1 <SEP> 28 <SEP> 0.74 <SEP> 0.04 <SEP> 1.73 <SEP> 0.07 <SEP>#
<tb> 2 <SEP> 74 <SEP> 0.93 <SEP> 0.03 <SEP> * <SEP> 2.04 <SEP> 0.04 <SEP> *
<tb> 3 <SEP> 9 <SEP> 0.72 <SEP> 0.03 <SEP> 1.21 <SEP> 0.05 <SEP>
<tb> 4 <SEP> 31 <SEP> 0.78 <SEP> 0.03 <SEP> 1.15 <SEP> 0.02
<tb> * <SEP>: <SEP> p <SEP><<SEP> 0.001 <SEP> screw <SEP> to <SEP> screw <SEP> other <SEP> * <SEP>: <SEP><<SEP> 0.001 <SEP> screws <SEP> to <SEP> screws <SEP> other <SEP> groups
<tb> groups <SEP>#<SEP>:<SEP> p <SEP><<SEP> 0,01 <SEP> screws <SEP> to <SEP> screws <SEP> groups <SEP> 3 <SEP> and <SEP> 4
<Tb>

TABLE 3 Distribution of cholesterol fractions in obese mice after
2 months of treatment or return to a normal diet.

<Tb>
<tb> Group <SEP> n <SEP> HDLc <SEP> mg / dL <SEP> LDLc <SEP> mg / dL <SEP> HDLc / <SEP> cholesterol <SEP> LDLc / <SEP> HDLc / <SEP> LDLc <SEP>
<tb> total <SEP> cholesterol <SEP> total <SEP>%
<tb>% <SEP>% <SEP>
<Tb>

1 28 107,8 4,5* 9,3 0,5 62,2 0,5# 5,5 0,3* 12,40,8#

1 28 107.8 4.5 * 9.3 0.5 62.2 0.5 # 5.5 0.3 * 12.40.8 #

<Tb>
<tb> 2 <SEP> 74 <SEP> 115.7 <SEP> + <SEP> 2.0 * <SEP> 16.2 <SEP> + <SEP> 0.8 <SEP> 57.1 <SEP> + <SEP> 0.4 * <SEP> 7.7 <SEP> ~ <SEP> 0.2 <SEP> 7.9 <SEP> ~ <SEP> 0.2 <SEP> *
<Tb>

3 9 78,2 + 4,5 7,3 0,6 64,3 2,0# 6,1 0,6* 11,5 1,3

3 9 78.2 + 4.5 7.3 0.6 64.3 2.0 # 6.1 0.6 * 11.5 1.3

<Tb>
<tb> 4 <SEP> 31 <SEP> 77.7 <SEP> ~ <SEP> 1.8 <SEP> 8.1 <SEP> ~ <SEP> 0.4 <SEP> 67.5 <SEP> ~ <SEP> 0.8 <SEP> 7.1 + 0.3 <SEP> 10.3 <SEP> 0.6 <SEP>
<tb> * <SEP>: <SEP> p <SEP><<SEP> 0.001 <SEP> * <SEP>: <SEP> p <SEP><<SEP> 0.001 <SEP> screws <SEP> to <SEP > * <SEP>: <SEP> p <SEP><<SEP> 0.001 <SEP> screw <SEP> to <SEP> * <SEP>: <SEP> p <SEP><<SEP> 0.05 <SEP > screw <SEP> to <SEP> * <SEP>: <SEP> p <SEP><<SEP> 0.001
<tb> screws <SEP> to <SEP> screws <SEP> screws <SEP> other <SEP> groups <SEP> screws <SEP> other <SEP> groups <SEP> screws <SEP> group <SEP> 2 <SEP > screws <SEP> to <SEP> screws <SEP> others
<tb> groups <SEP> 3 <SEP> and <SEP> 4 <SEP>#<SEP>:<SEP> p <SEP><<SEP> 0.05 <SEP> screws <SEP> to <SEP> screws <SEP> groups
<tb> group <SEP> 4 <SEP>#<SEP>:<SEP> p <SEP><<SEP> 0,05 <SEP> screws
<tb> to <SEP> screws <SEP> group <SEP> 4
<Tb>
n: number of animals.

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 According to Tables 2 and 3, rimonabant treatment, as administered to group 1 animals, corrects the mild hypertriglyceridemia observed in animals fed a fat diet.

 From Tables 2 and 3 it can be seen that treatment with rimonabant can lower total cholesterol but not normalize it; this same treatment makes it possible to normalize the level of LDLc with the consequence of increasing the HDLc / LDLc ratio.

 It can be concluded that treatment with rimonabant produces favorable changes in the plasma lipid profile, even though the mice are kept on a fatty diet: indeed, although the reduction in total cholesterol is modest, the treatment normalizes the level of triglycerides and LDLc while maintaining a high level of the "protective" level of HDLc, thus the HDLc / LDLc ratio is greater in animals that have been treated with rimonabant than in animals treated by the vehicle alone, whether they have been on a fat or normal diet.

EXAMPLE 2 Action of rimonabant on lipid parameters in clinic.

 A clinical trial was conducted for 4 weeks on 287 obese patients whose body mass index (BMI) was between 30 and 40. The patients were randomized to receive doses of 5, 10 or 20 mg / day of rimonabant or placebo, after receiving placebo for 2 weeks.

 A control visit was performed 4 weeks after the end of treatment.

 During the course of the study, patients were asked to follow a low-calorie diet (deficit of 500 kcal / day).

The results observed at the end of the treatment are reported in the following table:
TABLE 4

<Tb>
<tb> Group <SEP> Loss <SEP> of <SEP> Decrease <SEP> Increase <SEP> Blood Glucose <SEP> Improvement
<tb> treatment <SEP> weight <SEP> (kg) <SEP> of <SEP> of <SEP> HDLc <SEP> mMol / L <SEP> of <SEP> syndrome
<tb> triglycerides <SEP>><SEP> 10 <SEP>% <SEP> metabolic
<tb>> 10%
<tb> Placebo <SEP> 1.1 <SEP> 34 <SEP>% <SEP> 34 <SEP>% <SEP> + <SEP> 0.26 <SEP> 19%
<tb> 5 <SEP> mg / d <SEP> 3,4 <SEP> * <SEP> 36 <SEP>% <SEP> 43 <SEP>% <SEP> - <SEP> 0,09 <SEP> * * <SEP> 42 <SEP>% <SEP>
<tb> 10 <SEP> mglj <SEP> 3.7 <SEP> * <SEP> 34 <SEP>% <SEP> 45 <SEP>% <SEP> - <SEP> 0.02 <SEP> *** <SEP> 39 <SEP>%
<tb> 20 <SEP> mg / d <SEP> 4.5 <SEP> 51% <SEP> 44% <SEP> + <SEP> 0.03 <SEP> 21%
<Tb>
* p <0.005 versus the placebo group.

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 ** p <0.01 versus the placebo group.

 *** p <0.05 versus the placebo group.

 It has been found that weight loss in subjects treated with rimonabant is accompanied by a tendency to lower triglycerides and increase HDLc. At the same time, patients' blood glucose levels remained stable or decreased discreetly for patients in rimonabant-treated groups, while blood glucose levels in placebo patients increased.

 In obese patients, the influence of rimonabant treatment on various biological parameters was considered in the evaluation of the metabolic syndrome as defined by ATP III. This results in a tendency to improve the metabolic syndrome in patients treated with rimonabant.

Claims (19)

 1. Use of a CB1 receptor antagonist compound to cannabinoids derived from pyrazole, for the preparation of drugs useful in the treatment and prevention of metabolic syndrome. The use of claim 1 wherein the cannabinoid CB1 receptor antagonist compound is rimonabant. 3. Use of a compound according to claim 1 for the prevention and treatment of cardiovascular risks associated with obesity. The use of claim 3 wherein the cannabinoid CB1 receptor antagonist compound is rimonabant. 5. Use according to claim 1 for the prevention and treatment of dyslipidemias. The use of claim 5 wherein the cannabinoid CB 1 receptor antagonist compound is rimonabant. 7. A pharmaceutical composition containing in combination a cannabinoid CB1 receptor antagonist compound derived from pyrazole and another active ingredient selected from one of the following therapeutic classes: an AT receptor antagonist; angiotensin II, alone or in combination with a diuretic or a calcium antagonist; an inhibitor of the conversion enzyme, alone or in combination with a diuretic; a calcium antagonist; a beta-blocker alone or in combination with a diuretic or a calcium antagonist; an antihyperlipidemic agent or an antihypercholesterolemic agent; - an antidiabetic; a PPAR receptor agonist (of the English peroxisome proliferator-activated receptor); an anti-obesity agent. The pharmaceutical composition according to claim 7, wherein the cannabinoid CB1 receptor antagonist compound derived from pyrazole is rimonabant. 9. A pharmaceutical composition according to claim 7, comprising in combination a cannabinoid CB1 receptor antagonist compound derived from pyrazole and an angiotensin II AT1 receptor antagonist alone or in combination with a diuretic. <Desc / Clms Page number 12> 10. Pharmaceutical composition according to claim 9, containing in combination rimonabant and irbesartan.  11. Pharmaceutical composition according to claim 9, containing in combination rimonabant, irbesartan and hydrochlorothiazide. 12. Pharmaceutical composition according to claim 7, containing in combination a cannabinoid CB1 receptor antagonist derived from pyrazole and an inhibitor of the conversion enzyme, alone or in combination with a diuretic. 13. A pharmaceutical composition according to claim 7, in association with a cannabinoid CB1 receptor antagonist derived from pyrazole and a calcium antagonist. 14. Pharmaceutical composition according to claim 7, containing in combination a cannabinoid CB1 receptor antagonist derived from pyrazole and a beta-blocker alone or in combination with a diuretic or a calcium antagonist. 15. Pharmaceutical composition according to claim 7, containing in combination a cannabinoid CB1 receptor antagonist derived from pyrazole and an antihyperlipidemic agent or an antihypercholesterolaemic agent. 16. A pharmaceutical composition according to claim 7, in association with a cannabinoid CB1 receptor antagonist derived from pyrazole and an antidiabetic agent. 17. Pharmaceutical composition according to claim 7, in association with a cannabinoid receptor antagonist CB1 to pyrazole derivative, and a PPAR receptor aginist (peroxisome proliferator-activated receptor). 18. Pharmaceutical composition according to claim 7, in association with a cannabinoid-containing CB1 receptor antagonist derived from pyrazole and an anti-obesity agent. 19. A kit containing a cannabinoid CB1al receptor antagonist derived from pyrazole and another active ingredient selected from one of the following therapeutic classes: an angiotensin II AT1 receptor antagonist alone or in combination with a diuretic or a calcium antagonist; an inhibitor of the conversion enzyme, alone or in combination with a diuretic; a calcium antagonist; a beta-blocker alone or in combination with a diuretic or a calcium antagonist; an antihyperlipidemic agent or an antihypercholesterolemic agent; - an antidiabetic; <Desc / Clms Page number 13>  a PPAR receptor agonist (of the English peroxisome proliferator-activated receptor); an anti-obesity agent.