JP2021508326A - sGC刺激薬 - Google Patents
sGC刺激薬 Download PDFInfo
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- JP2021508326A JP2021508326A JP2020534495A JP2020534495A JP2021508326A JP 2021508326 A JP2021508326 A JP 2021508326A JP 2020534495 A JP2020534495 A JP 2020534495A JP 2020534495 A JP2020534495 A JP 2020534495A JP 2021508326 A JP2021508326 A JP 2021508326A
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- RYMZZMVNJRMUDD-HGQWONQESA-N simvastatin Chemical compound C([C@H]1[C@@H](C)C=CC2=C[C@H](C)C[C@@H]([C@H]12)OC(=O)C(C)(C)CC)C[C@@H]1C[C@@H](O)CC(=O)O1 RYMZZMVNJRMUDD-HGQWONQESA-N 0.000 description 1
- 229960002578 sitaxentan Drugs 0.000 description 1
- 235000010413 sodium alginate Nutrition 0.000 description 1
- 239000000661 sodium alginate Substances 0.000 description 1
- 229940005550 sodium alginate Drugs 0.000 description 1
- 235000019812 sodium carboxymethyl cellulose Nutrition 0.000 description 1
- 229920001027 sodium carboxymethylcellulose Polymers 0.000 description 1
- 229940125794 sodium channel blocker Drugs 0.000 description 1
- 239000003195 sodium channel blocking agent Substances 0.000 description 1
- 239000001509 sodium citrate Substances 0.000 description 1
- NLJMYIDDQXHKNR-UHFFFAOYSA-K sodium citrate Chemical compound O.O.[Na+].[Na+].[Na+].[O-]C(=O)CC(O)(CC([O-])=O)C([O-])=O NLJMYIDDQXHKNR-UHFFFAOYSA-K 0.000 description 1
- 229940083618 sodium nitroprusside Drugs 0.000 description 1
- XMVONEAAOPAGAO-UHFFFAOYSA-N sodium tungstate Chemical compound [Na+].[Na+].[O-][W]([O-])(=O)=O XMVONEAAOPAGAO-UHFFFAOYSA-N 0.000 description 1
- AEQFSUDEHCCHBT-UHFFFAOYSA-M sodium valproate Chemical compound [Na+].CCCC(C([O-])=O)CCC AEQFSUDEHCCHBT-UHFFFAOYSA-M 0.000 description 1
- MDTNUYUCUYPIHE-UHFFFAOYSA-N sodium;(4-chloro-3-methyl-1,2-oxazol-5-yl)-[2-[2-(6-methyl-1,3-benzodioxol-5-yl)acetyl]thiophen-3-yl]sulfonylazanide Chemical compound [Na+].CC1=NOC([N-]S(=O)(=O)C2=C(SC=C2)C(=O)CC=2C(=CC=3OCOC=3C=2)C)=C1Cl MDTNUYUCUYPIHE-UHFFFAOYSA-N 0.000 description 1
- 239000007901 soft capsule Substances 0.000 description 1
- 239000012265 solid product Substances 0.000 description 1
- 238000000638 solvent extraction Methods 0.000 description 1
- 229960004532 somatropin Drugs 0.000 description 1
- 235000011069 sorbitan monooleate Nutrition 0.000 description 1
- 239000001593 sorbitan monooleate Substances 0.000 description 1
- 229940035049 sorbitan monooleate Drugs 0.000 description 1
- 235000011076 sorbitan monostearate Nutrition 0.000 description 1
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- 229960002909 spirapril Drugs 0.000 description 1
- 108700035424 spirapril Proteins 0.000 description 1
- 238000012453 sprague-dawley rat model Methods 0.000 description 1
- 239000007858 starting material Substances 0.000 description 1
- SFVFIFLLYFPGHH-UHFFFAOYSA-M stearalkonium chloride Chemical compound [Cl-].CCCCCCCCCCCCCCCCCC[N+](C)(C)CC1=CC=CC=C1 SFVFIFLLYFPGHH-UHFFFAOYSA-M 0.000 description 1
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- KDYFGRWQOYBRFD-UHFFFAOYSA-L succinate(2-) Chemical compound [O-]C(=O)CCC([O-])=O KDYFGRWQOYBRFD-UHFFFAOYSA-L 0.000 description 1
- 235000000346 sugar Nutrition 0.000 description 1
- 150000005846 sugar alcohols Polymers 0.000 description 1
- 150000008163 sugars Chemical class 0.000 description 1
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- NCEXYHBECQHGNR-QZQOTICOSA-N sulfasalazine Chemical compound C1=C(O)C(C(=O)O)=CC(\N=N\C=2C=CC(=CC=2)S(=O)(=O)NC=2N=CC=CC=2)=C1 NCEXYHBECQHGNR-QZQOTICOSA-N 0.000 description 1
- NCEXYHBECQHGNR-UHFFFAOYSA-N sulfasalazine Natural products C1=C(O)C(C(=O)O)=CC(N=NC=2C=CC(=CC=2)S(=O)(=O)NC=2N=CC=CC=2)=C1 NCEXYHBECQHGNR-UHFFFAOYSA-N 0.000 description 1
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- IEHKWSGCTWLXFU-IIBYNOLFSA-N tadalafil Chemical compound C1=C2OCOC2=CC([C@@H]2C3=C([C]4C=CC=CC4=N3)C[C@H]3N2C(=O)CN(C3=O)C)=C1 IEHKWSGCTWLXFU-IIBYNOLFSA-N 0.000 description 1
- WOXKDUGGOYFFRN-IIBYNOLFSA-N tadalafil Chemical compound C1=C2OCOC2=CC([C@@H]2C3=C(C4=CC=CC=C4N3)C[C@H]3N2C(=O)CN(C3=O)C)=C1 WOXKDUGGOYFFRN-IIBYNOLFSA-N 0.000 description 1
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- 239000011975 tartaric acid Substances 0.000 description 1
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- FIQOFIRCTOWDOW-BJLQDIEVSA-N temocapril Chemical compound C([C@@H](C(=O)OCC)N[C@@H]1C(N(CC(O)=O)C[C@H](SC1)C=1SC=CC=1)=O)CC1=CC=CC=C1 FIQOFIRCTOWDOW-BJLQDIEVSA-N 0.000 description 1
- VCKUSRYTPJJLNI-UHFFFAOYSA-N terazosin Chemical compound N=1C(N)=C2C=C(OC)C(OC)=CC2=NC=1N(CC1)CCN1C(=O)C1CCCO1 VCKUSRYTPJJLNI-UHFFFAOYSA-N 0.000 description 1
- 229960001693 terazosin Drugs 0.000 description 1
- 150000003512 tertiary amines Chemical class 0.000 description 1
- 229960001874 tesamorelin Drugs 0.000 description 1
- 108700002800 tesamorelin Proteins 0.000 description 1
- 229960005333 tetrabenazine Drugs 0.000 description 1
- BSYVTEYKTMYBMK-UHFFFAOYSA-N tetrahydrofurfuryl alcohol Chemical compound OCC1CCCO1 BSYVTEYKTMYBMK-UHFFFAOYSA-N 0.000 description 1
- OULAJFUGPPVRBK-UHFFFAOYSA-N tetratriacontyl alcohol Natural products CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCO OULAJFUGPPVRBK-UHFFFAOYSA-N 0.000 description 1
- 125000003831 tetrazolyl group Chemical group 0.000 description 1
- 229960004559 theobromine Drugs 0.000 description 1
- 239000003451 thiazide diuretic agent Substances 0.000 description 1
- 239000002562 thickening agent Substances 0.000 description 1
- 125000003396 thiol group Chemical group [H]S* 0.000 description 1
- 239000003868 thrombin inhibitor Substances 0.000 description 1
- 229960004605 timolol Drugs 0.000 description 1
- LERNTVKEWCAPOY-DZZGSBJMSA-N tiotropium Chemical compound O([C@H]1C[C@@H]2[N+]([C@H](C1)[C@@H]1[C@H]2O1)(C)C)C(=O)C(O)(C=1SC=CC=1)C1=CC=CS1 LERNTVKEWCAPOY-DZZGSBJMSA-N 0.000 description 1
- 229940110309 tiotropium Drugs 0.000 description 1
- 229950006150 tioxaprofen Drugs 0.000 description 1
- 229960000984 tocofersolan Drugs 0.000 description 1
- 229940041597 tofranil Drugs 0.000 description 1
- 229960005371 tolbutamide Drugs 0.000 description 1
- 229960002905 tolfenamic acid Drugs 0.000 description 1
- YEZNLOUZAIOMLT-UHFFFAOYSA-N tolfenamic acid Chemical compound CC1=C(Cl)C=CC=C1NC1=CC=CC=C1C(O)=O YEZNLOUZAIOMLT-UHFFFAOYSA-N 0.000 description 1
- 229960001256 tolvaptan Drugs 0.000 description 1
- GYHCTFXIZSNGJT-UHFFFAOYSA-N tolvaptan Chemical compound CC1=CC=CC=C1C(=O)NC(C=C1C)=CC=C1C(=O)N1C2=CC=C(Cl)C=C2C(O)CCC1 GYHCTFXIZSNGJT-UHFFFAOYSA-N 0.000 description 1
- 230000001256 tonic effect Effects 0.000 description 1
- 229940100611 topical cream Drugs 0.000 description 1
- 229940100615 topical ointment Drugs 0.000 description 1
- 229940118436 tracleer Drugs 0.000 description 1
- 229960002051 trandolapril Drugs 0.000 description 1
- 238000013518 transcription Methods 0.000 description 1
- 230000035897 transcription Effects 0.000 description 1
- 230000026683 transduction Effects 0.000 description 1
- 238000010361 transduction Methods 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 229960003991 trazodone Drugs 0.000 description 1
- 229960005032 treprostinil Drugs 0.000 description 1
- PAJMKGZZBBTTOY-ZFORQUDYSA-N treprostinil Chemical compound C1=CC=C(OCC(O)=O)C2=C1C[C@@H]1[C@@H](CC[C@@H](O)CCCCC)[C@H](O)C[C@@H]1C2 PAJMKGZZBBTTOY-ZFORQUDYSA-N 0.000 description 1
- 229960005294 triamcinolone Drugs 0.000 description 1
- GFNANZIMVAIWHM-OBYCQNJPSA-N triamcinolone Chemical compound O=C1C=C[C@]2(C)[C@@]3(F)[C@@H](O)C[C@](C)([C@@]([C@H](O)C4)(O)C(=O)CO)[C@@H]4[C@@H]3CCC2=C1 GFNANZIMVAIWHM-OBYCQNJPSA-N 0.000 description 1
- 229960001288 triamterene Drugs 0.000 description 1
- 125000001425 triazolyl group Chemical group 0.000 description 1
- 239000003029 tricyclic antidepressant agent Substances 0.000 description 1
- LEIMLDGFXIOXMT-UHFFFAOYSA-N trimethylsilyl cyanide Chemical compound C[Si](C)(C)C#N LEIMLDGFXIOXMT-UHFFFAOYSA-N 0.000 description 1
- LENZDBCJOHFCAS-UHFFFAOYSA-N tris Chemical compound OCC(N)(CO)CO LENZDBCJOHFCAS-UHFFFAOYSA-N 0.000 description 1
- GXPHKUHSUJUWKP-UHFFFAOYSA-N troglitazone Chemical compound C1CC=2C(C)=C(O)C(C)=C(C)C=2OC1(C)COC(C=C1)=CC=C1CC1SC(=O)NC1=O GXPHKUHSUJUWKP-UHFFFAOYSA-N 0.000 description 1
- 229960001641 troglitazone Drugs 0.000 description 1
- GXPHKUHSUJUWKP-NTKDMRAZSA-N troglitazone Natural products C([C@@]1(OC=2C(C)=C(C(=C(C)C=2CC1)O)C)C)OC(C=C1)=CC=C1C[C@H]1SC(=O)NC1=O GXPHKUHSUJUWKP-NTKDMRAZSA-N 0.000 description 1
- 229960000281 trometamol Drugs 0.000 description 1
- 229960000438 udenafil Drugs 0.000 description 1
- IYFNEFQTYQPVOC-UHFFFAOYSA-N udenafil Chemical compound C1=C(C=2NC=3C(CCC)=NN(C)C=3C(=O)N=2)C(OCCC)=CC=C1S(=O)(=O)NCCC1CCCN1C IYFNEFQTYQPVOC-UHFFFAOYSA-N 0.000 description 1
- 229960001130 urapidil Drugs 0.000 description 1
- 239000006213 vaginal ring Substances 0.000 description 1
- 239000006216 vaginal suppository Substances 0.000 description 1
- 239000000003 vaginal tablet Substances 0.000 description 1
- 229960002004 valdecoxib Drugs 0.000 description 1
- LNPDTQAFDNKSHK-UHFFFAOYSA-N valdecoxib Chemical compound CC=1ON=C(C=2C=CC=CC=2)C=1C1=CC=C(S(N)(=O)=O)C=C1 LNPDTQAFDNKSHK-UHFFFAOYSA-N 0.000 description 1
- 229940102566 valproate Drugs 0.000 description 1
- 229960004699 valsartan Drugs 0.000 description 1
- SJSNUMAYCRRIOM-QFIPXVFZSA-N valsartan Chemical compound C1=CC(CN(C(=O)CCCC)[C@@H](C(C)C)C(O)=O)=CC=C1C1=CC=CC=C1C1=NN=N[N]1 SJSNUMAYCRRIOM-QFIPXVFZSA-N 0.000 description 1
- 108010015385 valyl-prolyl-proline Proteins 0.000 description 1
- 229960002381 vardenafil Drugs 0.000 description 1
- 230000024883 vasodilation Effects 0.000 description 1
- 239000003038 vasopressin antagonist Substances 0.000 description 1
- 229940099270 vasotec Drugs 0.000 description 1
- 235000015112 vegetable and seed oil Nutrition 0.000 description 1
- 239000008158 vegetable oil Substances 0.000 description 1
- 229960004688 venlafaxine Drugs 0.000 description 1
- PNVNVHUZROJLTJ-UHFFFAOYSA-N venlafaxine Chemical compound C1=CC(OC)=CC=C1C(CN(C)C)C1(O)CCCCC1 PNVNVHUZROJLTJ-UHFFFAOYSA-N 0.000 description 1
- 229940105295 ventavis Drugs 0.000 description 1
- 229940070384 ventolin Drugs 0.000 description 1
- 229960001722 verapamil Drugs 0.000 description 1
- 229950005577 vesnarinone Drugs 0.000 description 1
- 229940094720 viagra Drugs 0.000 description 1
- 229940087652 vioxx Drugs 0.000 description 1
- 235000019154 vitamin C Nutrition 0.000 description 1
- 239000011718 vitamin C Substances 0.000 description 1
- 235000019165 vitamin E Nutrition 0.000 description 1
- 229940046009 vitamin E Drugs 0.000 description 1
- 239000011709 vitamin E Substances 0.000 description 1
- 235000019143 vitamin K2 Nutrition 0.000 description 1
- 239000011728 vitamin K2 Substances 0.000 description 1
- 229940019333 vitamin k antagonists Drugs 0.000 description 1
- 229960002263 vortioxetine Drugs 0.000 description 1
- YQNWZWMKLDQSAC-UHFFFAOYSA-N vortioxetine Chemical compound CC1=CC(C)=CC=C1SC1=CC=CC=C1N1CCNCC1 YQNWZWMKLDQSAC-UHFFFAOYSA-N 0.000 description 1
- 229960005080 warfarin Drugs 0.000 description 1
- 238000009736 wetting Methods 0.000 description 1
- 239000003871 white petrolatum Substances 0.000 description 1
- 229960001522 ximelagatran Drugs 0.000 description 1
- 229950000339 xinafoate Drugs 0.000 description 1
- 229960000537 xipamide Drugs 0.000 description 1
- MTZBBNMLMNBNJL-UHFFFAOYSA-N xipamide Chemical compound CC1=CC=CC(C)=C1NC(=O)C1=CC(S(N)(=O)=O)=C(Cl)C=C1O MTZBBNMLMNBNJL-UHFFFAOYSA-N 0.000 description 1
- 229960001600 xylazine Drugs 0.000 description 1
- BPICBUSOMSTKRF-UHFFFAOYSA-N xylazine Chemical compound CC1=CC=CC(C)=C1NC1=NCCCS1 BPICBUSOMSTKRF-UHFFFAOYSA-N 0.000 description 1
- 229940072252 zestril Drugs 0.000 description 1
- 229960000607 ziprasidone Drugs 0.000 description 1
- 229940020965 zoloft Drugs 0.000 description 1
- WFPIAZLQTJBIFN-DVZOWYKESA-N zuclopenthixol Chemical compound C1CN(CCO)CCN1CC\C=C\1C2=CC(Cl)=CC=C2SC2=CC=CC=C2/1 WFPIAZLQTJBIFN-DVZOWYKESA-N 0.000 description 1
- 229940039925 zyprexa Drugs 0.000 description 1
- 239000002076 α-tocopherol Substances 0.000 description 1
- 235000004835 α-tocopherol Nutrition 0.000 description 1
Classifications
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07D—HETEROCYCLIC COMPOUNDS
- C07D487/00—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00
- C07D487/02—Heterocyclic compounds containing nitrogen atoms as the only ring hetero atoms in the condensed system, not provided for by groups C07D451/00 - C07D477/00 in which the condensed system contains two hetero rings
- C07D487/04—Ortho-condensed systems
-
- 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
-
- C—CHEMISTRY; METALLURGY
- C07—ORGANIC CHEMISTRY
- C07F—ACYCLIC, CARBOCYCLIC OR HETEROCYCLIC COMPOUNDS CONTAINING ELEMENTS OTHER THAN CARBON, HYDROGEN, HALOGEN, OXYGEN, NITROGEN, SULFUR, SELENIUM OR TELLURIUM
- C07F9/00—Compounds containing elements of Groups 5 or 15 of the Periodic System
- C07F9/02—Phosphorus compounds
- C07F9/06—Phosphorus compounds without P—C bonds
- C07F9/08—Esters of oxyacids of phosphorus
- C07F9/09—Esters of phosphoric acids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
- A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
Landscapes
- Chemical & Material Sciences (AREA)
- Organic Chemistry (AREA)
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Biochemistry (AREA)
- Molecular Biology (AREA)
- Pharmacology & Pharmacy (AREA)
- Medicinal Chemistry (AREA)
- Epidemiology (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
- Nitrogen Condensed Heterocyclic Rings (AREA)
Abstract
Description
[0001]本出願は、35 U.S.C.§119(e)に基づき、2017年12月19日出願の米国仮特許出願第62/607619号の出願日の利益を主張するものである。上記出願の内容全体を、本明細書中で参考として援用する。
Yは、独立して、NまたはCであり;
環Bは、フェニル、またはN、OもしくはSから独立して選択される1もしくは2個の環ヘテロ原子を含有する5もしくは6員ヘテロアリール環であり;
nは、0〜3から選択される整数であり;各JBは、独立して、ハロゲン、−CN、C1−6脂肪族基、−ORBまたはC3−8脂環式環であり;
これに関し、C1−6脂肪族基である各JBおよびC3−8脂環式環である各JBは、独立して、最大3つの事例のR3で置換されていてもよく;
各RBは、独立して、水素、C1−6脂肪族基またはC3−8脂環式環であり;前記RBは、独立して、最大3つの事例のR3aで置換されていてもよく;
各R3およびR3aは、各事例において、独立して、ハロゲン、−CN、C1−4アルキル、C1−4ハロアルキル、−O(C1−4アルキル)または−O(C1−4ハロアルキル)であり;
Zは、水素、−P(O)(OH)2、−P(O)(OH)O−M+、−P(O)(O−)2(M+)2、−P(O)(O−)2D2+および−P(O)(O−ベンジル)2からなる群より選択され;これに関し、M+は、医薬的に許容しうる一価のカチオンであり、D2+は、医薬的に許容しうる二価のカチオンであり;
mは0または1であり;
R1は、C1−4アルキル、C1−4フルオロアルキル、−C(O)NH2または水素であり;そして
R2は、C1−4アルキル、C1−4フルオロアルキルまたは水素であり;
R4の両方の事例は同時に水素であるか、R4の両方の事例は、それらが付着している炭素原子と一緒になって、カルボニル基を形成し;
JDは、水素、ハロゲン、メトキシまたは−CNであり
pは、1、2または3であり;そして
各JCは、独立して、水素、ハロゲン、C1−4脂肪族基、C1−4アルコキシまたは−CNであり;これに関し、各前記C1−4脂肪族基および各前記C1−4アルコキシは、独立して、C1−4アルコキシ、C1−4ハロアルコキシ、−OHまたはハロゲンの最大3つの事例によって置換されていてもよい]。
定義および一般的専門用語
[0009]本開示の目的に関し、化学元素は、元素の周期表、CASバージョン、およびHandbook of Chemistry and Physics,第75版、1994年に従って識別される。これに加えて、有機化学の一般的原理は、“Organic Chemistry”,Thomas Sorrell,University Science Books,Sausalito:1999年、および“March’s Advanced Organic Chemistry”,第5版,Smith,M.B.およびMarch,J.,編集,John Wiley & Sons,New York:2001年に記載されており、これらを全体として本明細書中で参考として援用する。
[002]“融合”環系は、2つの隣接する環原子を共有する2つの環を含む。
[003] “スピロ”環系は、1つの隣接する環原子を共有する2つの環を含む。
[0025]“置換可能な環原子”は、少なくとも1つの水素原子に結合している環炭素または窒素原子である。水素は、所望により適した置換基で置き換えられることができる。“置換可能な環原子”は環炭素または窒素原子を包含せず、その構造は、環炭素または窒素原子が水素以外の1以上の部分または置換基に既に付着していて、置換に利用可能な水素がないことを表す。特定の環が所望により置換されている場合、それは、許容される置換基の数に応じて、置換可能な環原子の1つまたはいくつかまたは全てが置換されていてもよいことが理解されるであろう。
[0030]“ハロアルキル”、“ハロアルケニル”、“ハロ脂肪族”および“ハロアルコキシ”という用語は、場合によっては1以上のハロゲン原子で置換されているアルキル、アルケニル、脂肪族またはアルコキシを意味する。例えば、C1−3ハロアルキルは例えば−CFHCH2CHF2であることができ、C1−2ハロアルコキシは例えば−OC(Br)HCHF2であることができる。
[0034]本明細書中で用いる場合、“アミノ”基は−NH2をさす。
[0036]本明細書中で用いる場合、単独または他の基と関連して用いられる“カルボニル”は、−C(O)−をさす。
[0039]Zが水素ではない場合、式Iの化合物は式IIの化合物のリン酸エステルプロドラッグおよび医薬的に許容しうるその塩であり、sGC刺激薬として有用である。式IIに関し、すべての可変要素の定義は、式Iについて提示されたものと同じである。
[0041]“プロドラッグ”という用語は、投与および吸収後に何らかの代謝過程、酵素過程、加水分解過程または急速化学変換過程を介してin vivoで薬物を放出する薬物前駆体である化合物をさす。一般に、プロドラッグは、親薬物への開裂前は、標的に対し単独で親化合物より低い生物学的活性を持つ。プロドラッグは親薬物の物理的特性を改善することができ、ならびに/または、例えば薬物の吸収、血中濃度、代謝的分布および細胞取り込みを制御することによって薬物の毒性および望ましくない副作用を低減することにより、全体的薬効を改善することができる。プロドラッグは、in vivoでの薬物動態学的な被験対象間のばらつきを減少させることもできる。プロドラッグはまた、より望ましい医薬的特性を示すことができ、したがって、プロドラッグはまた、薬物の製剤化能(formulability)を改善し、または特定の投与モードに関し薬物の製剤化能を促進することができる。
化合物の態様
[0045]第1の態様において、本発明の化合物は、式Iまたは医薬的に許容しうるその塩によって表される。式Iの可変要素の定義は、上記のとおりである。特定の態様において、式Iの化合物に関し、環Bは、フェニル、またはNおよびSから選択される1もしくは2個の環ヘテロ原子を含有する5もしくは6員ヘテロアリール環であり;残りの可変要素の定義は、式Iについて上記したとおりである。他の特定の態様において、式Iの化合物に関し、環Bは、フェニル、または1もしくは2個の環窒素原子を含有する5もしくは6員ヘテロアリール環である。
[0064]本明細書中に記載する化合物の“医薬的に許容しうる塩”は、無機または有機の酸または塩基と混合したときに前記化合物から誘導されるものを包含する。いくつかの態様において、塩は、化合物の最終的な単離および精製中にその場で調製することができる。他の態様において、塩は、別個の合成段階において遊離形態の化合物から調製することができる。上記医薬的に許容しうる塩および他の典型的な医薬的に許容しうる塩の調製法は、Berg et al.,“Pharmaceutical Salts,”J.Pharm.Sci.,1977:66:1-19に十分に記載されており、これを全体として本明細書中で参考として援用する。
医薬組成物および投与方法。
[0070]典型的な製剤は、式Iの化合物または医薬的に許容しうるその塩と、キャリヤー、希釈剤または賦形剤を混合することにより調製する。適したキャリヤー、希釈剤および賦形剤は当業者に周知であり、炭水化物、ワックス、水溶性および/もしくは水膨潤性ポリマー、親水性もしくは疎水性材料、ゼラチン、油、溶媒、水などのような材料を包含する。用いられる特定のキャリヤー、希釈剤または賦形剤は、式Iの化合物を配合する手段および目的に依存する。溶媒は、一般に、哺乳類に投与するのに安全(GRAS−一般に安全とみなされる(Generally Regarded as Safe))であると当業者に認められている溶媒に基づき選択する。一般に、安全な溶媒は、非毒性水性溶媒、例えば、水、および水中で可溶性または混和性を示す他の非毒性溶媒である。適した水性溶媒としては、水、エタノール、プロピレングリコール、ポリエチレングリコール(例えば、PEG400、PEG300)など、およびそれらの混合物が挙げられる。製剤はまた、見栄えの良い薬物(すなわち、式Iの化合物またはその医薬組成物)を提供するために、または医薬製品(すなわち医薬品)の製造を補助するために、他のタイプの賦形剤、例えば、1以上の緩衝剤、安定剤、付着防止剤、界面活性剤、湿潤剤、潤滑剤、乳化剤、バインダー、懸濁化剤、崩壊剤、充填剤、収着剤、コーティング(例えば、腸溶性または徐放性)、防腐剤、酸化防止剤、不透明化剤(opaquing agent)、流動促進剤(glidant)、加工助剤、着色剤、甘味剤、芳香剤、香味剤および他の公知の添加剤を包含することができる。
[0076]固体剤形では、活性化合物を、少なくとも1つの不活性な医薬的に許容しうる賦形剤またはキャリヤー、例えば、クエン酸ナトリウムまたはリン酸二カルシウム、および/またはa)充填剤または増量剤、例えば、デンプン、ラクトース、スクロース、グルコース、マンニトール、およびケイ酸、b)バインダー、例えば、カルボキシメチルセルロース、アルギネート、ゼラチン、ポリビニルピロリドン、スクロース、およびアカシアなど、c)グリセロールなどの保湿剤、d)崩壊剤、例えば、寒天、炭酸カルシウム、ジャガイモまたはタピオカデンプン、アルギン酸、特定のシリケート、および炭酸ナトリウム、e)パラフィンなどの溶液抑制剤、f)第四級アンモニウム化合物などの吸収促進剤、g)湿潤剤、例えば、セチルアルコールおよびモノステアリン酸グリセロールなど、h)吸収剤、例えば、カオリンおよびベントナイト粘土、ならびにi)潤滑剤、例えば、タルク、ステアリン酸カルシウム、ステアリン酸マグネシウム、固体ポリエチレングリコール、ラウリル硫酸ナトリウム、およびそれらの混合物、と混合する。錠剤は、コーティングされていなくてもよく、あるいは、不快な味を隠すため、または胃腸管での崩壊および吸収を遅らせて、これにより長期間にわたる持続作用をもたらすために、マイクロカプセル化を含む公知の技術によりコーティングされていてもよい。例えば、モノステアリン酸グリセリルまたはジステアリン酸グリセリルなどの遅延材料を、単独またはワックスと一緒に採用することができる。水溶性味質マスキング剤、例えば、ヒドロキシプロピル−メチルセルロースまたはヒドロキシプロピル−セルロースを採用してもよい。
治療法
[0089]他の観点において、本発明はまた、疾患の処置を必要とする被験対象における疾患の処置方法であって、治療的有効量の式Iの化合物、または医薬的に許容しうるその塩を、単独または併用療法で被験対象に投与することを含む方法を提供する;これに関し、疾患は、sGCの刺激、またはNOもしくはcGMPもしくは両方の濃度上昇、またはNO経路のアップレギュレーションから恩恵を受けるものである。本発明はまた、疾患の処置を必要とする被験対象における疾患の処置方法であって、式Iの化合物もしくは医薬的に許容しうるその塩を含む医薬組成物、または該医薬組成物を含む剤形を、単独または併用療法で被験対象に投与することを含む方法を提供する;これに関し、疾患は、sGCの刺激、またはNOもしくはcGMPもしくは両方の濃度上昇、またはNO経路のアップレギュレーションから恩恵を受けるものである。
[0093]無ベータリポタンパク血症、アカラシア(例えば、食道アカラシア)、急性呼吸窮迫症候群(ARDS)、癒着性関節包炎、加齢性学習および記憶障害、加齢性記憶喪失、アルコール依存症、脱毛症または抜け毛、高山病、アルツハイマー病(アルツハイマー病前、軽度から中等度のアルツハイマー病および中等度から重度のアルツハイマー病を含む)、筋萎縮性側索硬化症(ALSまたはルー・ゲーリック病)、肛門裂肛、動脈瘤、狭心症(例えば、安定または不安定狭心症、異型狭心症、プリンツメタル狭心症、微小血管狭心症)、不安または不安障害、アルギノコハク酸尿症、動脈および静脈血栓症、関節炎、アスペルガー症候群、喘息および喘息性疾患 運動失調、毛細血管拡張症(telangliectasia)、アテローム性動脈硬化(例えば、内皮損傷、血小板および単球の付着および凝集、平滑筋増殖または遊走に付随するアテローム性動脈硬化症)、萎縮性腟炎、注意欠陥障害(ADD)および注意欠陥多動性障害(ADHD)、自閉症および自閉症スペクトラムにおける障害、良性前立腺過形成(BPH)または前立腺肥大または前立腺拡大、双極性障害、膀胱出口閉塞、膀胱痛症候群(BPS)、眼瞼炎、骨および炭水化物代謝障害、骨治癒(例えば、破骨細胞性骨リモデリング、破骨細胞性骨吸収、骨新生に続く骨治癒)、脳動脈瘤、脳低酸素症、がん転移、脳アミロイド血管症(CAA)またはコンゴレッド親和性(congophilic)血管障害、皮質下梗塞および白質脳症を伴う常染色体優性脳動脈症(CADASILまたはCADASIL症候群)、脳潅流、脳小血管疾患、脳血管痙攣、ケモブレイン、小児期崩壊性障害、慢性気管支炎、慢性疲労、慢性外傷性脳症(CTE)、繊毛病、硬変症(例えば、肝硬変、慢性肝疾患に付随する肝硬変、原発性胆汁性肝硬変)、CNS疾患に関連する性的機能不全、CNS疾患に関連する睡眠障害、ハンチントン病に付随する認知障害、認知機能不全 認知障害(例えば、血管性認知障害、軽度認知障害、糖尿病に付随する認知障害、多発性硬化症に付随する認知障害、閉塞性睡眠時無呼吸に付随する認知障害、統合失調症(CIAS)に付随する認知障害、鎌状赤血球症に付随する認知障害、震とう症、先天性筋無力症候群、結合組織病、脳梗塞(脳卒中)の予後、外傷患者における代用血液の保存、CREST症候群、クローン病、嚢胞性線維症(CF)、妄想性障害、認知症(例えば、血管性認知症、脳卒中後認知症、レビー小体型認知症、前頭葉変性症を伴う認知症、前頭側頭葉変性症を伴う認知症、大脳皮質基底核変性症を伴う認知症、クロイツフェルト−ヤコブ認知症、HIV認知症、多発梗塞性認知症、術後認知症 戦略的部位の単発梗塞による認知症、HIV関連認知症(無症候性神経認知障害(ANI)、軽度神経認知障害(MND)、HIV関連認知症(HAD、AIDS認知症症候群(AIDS dementia complex)[ADC]またはHIV脳症ともよばれる)、初老期認知症(軽度認知障害、MCI)、混合型認知症、ビンスワンガー型認知症(皮質下動脈硬化性脳症)、パーキンソン認知症)、脱髄、うつ病、抑うつ性障害、皮膚筋炎、糖尿病性血管症、糖尿病性黄斑浮腫、糖尿病性微小血管症、糖尿病性潰瘍または創傷(例えば、糖尿病性足潰瘍(diabetic food ulcer))、メタボリックシンドロームに付随または関連する疾患(例えば、肥満、糖尿病、インスリン抵抗性、空腹時グルコースの上昇、空腹時インスリンの上昇、脂質の上昇)、ダウンレギュレートされた神経伝達物質が関与する疾患、脳血流の障害が関与する疾患、神経変性の障害が関与する疾患、シナプス機能の障害が関与する疾患、神経炎症が関与する疾患、神経毒性が関与する疾患、男性および女性の泌尿生殖器系の臓器の疾患(良性および悪性)、学習および記憶障害を伴う小児の集中力障害、ダウン症、薬物依存症、薬物誘発性精神病、ドライアイ症候群、デュシェンヌ型筋ジストロフィー、デュプイトラン拘縮、ジスキネジー(例えば、急性ジスキネジー、慢性または遅発性ジスキネジー、非運動性ジスキネジー、レボドパ誘発性ジスキネジー(LID))、月経困難症(dysmenhorrea)(例えば、原発性月経困難症、続発性月経困難症)、性交疼痛症(dyspaneuria)、嚥下困難、ジストニア(例えば、全身性ジストニア、限局性ジストニア、分節性ジストニア、性的ジストニア、中間型ジストニア、急性ジストニア反応、遺伝性または原発性ジストニア)、浮腫、電解質(elecrolyte)障害(例えば、高カルシウム血症(herkalemia)、低ナトリウム血症)、気腫、子宮内膜症、内皮機能不全または損傷および内皮機能不全に付随する疾患、勃起障害、食道アカラシア、ファブリー病、女性の性的機能障害(例えば、女性の性的興奮機能障害)、線維筋痛、線維症(例えば、心内膜心筋線維症、心房性線維症、心間質線維症、心線維症、肺線維症、眼線維症、皮膚線維症、腸線維症、腎性または腎線維症、間質性腎線維症、肺線維症、特発性肺線維症、肺の進行性塊状線維症、肝線維症、縦隔線維症、後腹膜線維症、関節線維症、骨髄線維症、骨髄線維化、骨骨髄線維症(osteomyelofibrosis)、放射線誘発性線維症、膵線維症)、脆弱X、機能性消化不良、胃不全麻痺、ゴーシェ病、一般的集中力障害、一般的精神病、緑内障、グリア芽種、糸球体症(例えば、糸球体腎炎、急性糸球体腎炎、糸球体硬化症、巣状分節状糸球体硬化症)、肉芽腫、頭部外傷、聴覚障害(例えば、部分的聴力損失、全聴力損失、部分的聴覚消失、全聴覚消失、騒音性聴力損失)、心疾患(例えば、左心室心筋リモデリング、左心室収縮機能不全、虚血性心筋症、拡張型心筋症、アルコール性心筋症、貯蔵心筋症、先天性心欠陥、冠血流低下、拡張期または収縮期機能不全、冠血流不全、急性冠血流不全症候群、冠動脈疾患、不整脈、心室前負荷の軽減、心肥大、右心肥大、心房および心室の調律障害および心伝導障害、I〜III度の房室ブロック(AVB I〜III)、上室性頻拍性不整脈、心室性早期収縮、心房細動、心房粗動、心室細動、心室粗動、心室性頻拍性不整脈、トルサード・ド・ポアント頻拍、心房および心室の期外収縮、房室接合部期外収縮、洞不全症候群、房室結節リエントリー性頻拍、Wolff−Parkinson−White症候群、心筋不全、慢性、急性またはウイルス性心筋炎、心原性ショック、心臓リモデリング)、心不全(HF;例えば:駆出率が保持されている心不全(HFPEF)、駆出率が低下した心不全(HFREF)、急性心不全、慢性心不全、既存の慢性心不全の急性期(HFの悪化)、一過性心不全、急性後(post-acute)心不全、収縮期心不全、拡張期心不全、うっ血性心不全、急性非代償性心不全、右心室不全、全心不全、高拍出性心不全、弁膜欠損を伴う心不全、糖尿病性心不全、心不全/心腎症候群、右心不全)、高濃度のプラスミノーゲン活性化因子阻害薬1(PA−1)、高レベルのフィブリノーゲンおよび低密度DLD、ヒスチオサイトーシスX、ハンチントン病または舞踏病(HD)、高アンモニア血症および関連するもの、高血圧(例えば、動脈性高血圧、抵抗性高血圧、糖尿病性高血圧、特発性高血圧、本態性高血圧、二次性高血圧、妊娠性高血圧、門脈圧亢進症、全身性高血圧、子癇前症、急性および慢性の冠血流圧上昇)、筋緊張亢進、肥厚性瘢痕、性的興奮低下障害、低潅流、インポテンス、炎症性腸疾患(例えば、クローン病、潰瘍性大腸炎)、脳マラリアに起因する炎症、感染性疾患に起因する炎症、周術期(perioprative)ケアにおける炎症反応、血小板凝集、知的障害、間欠性跛行、間質性膀胱炎(IC)、透析中の低血圧、虚血(例えば、脳虚血、心筋虚血、血栓塞栓性虚血、重篤な四肢虚血)、ケロイド、腎疾患(例えば、慢性腎疾患、急性および慢性腎機能不全、急性および慢性腎不全、腎不全の後遺症、肺水腫に関連する腎不全、HFに関連する腎不全、尿毒症または貧血症に関連する腎不全、原発性腎疾患、先天性腎疾患、多嚢胞腎疾患の進行、腎移植片拒絶反応、免疫複合体誘発性腎疾患、クレアチニンおよび/または水分排泄の異常な減少、尿素、窒素、カリウムおよび/またはクレアチニンの血中濃度の異常な上昇、腎酵素(例えば、グルタミルシンテターゼ)の活性変化、尿の容積モル浸透圧濃度および尿量の変化、微量アルブミン尿の増加、マクロアルブミン尿、糸球体および細動脈の病変、尿細管拡張、高リン酸血症、血管性腎疾患、腎嚢胞、HFによる腎浮腫)、コルサコフ精神病、白血球活性化、レボドパ誘発性の常習的挙動、硬化性苔癬、脂質関連障害(例えば、過剰な脂肪蓄積、過剰な皮下脂肪、高脂血症、脂質異常症、高コレステロール血症、高密度リポタンパク質コレステロール(HDL−コレステロール)の低下、低密度リポタンパク質コレステロール(LDL−コレステロール)レベルの中程度の上昇、高トリグリセリド血症、高グリセリド血症、低リポタンパク血症(hypolipoproteinanemias)、シトステロール血症、脂肪肝疾患、肝脂肪変性または肝臓における異常な脂質蓄積、心臓、腎臓または筋肉の脂肪変性、シトステロール血症、黄色腫症、タンジール病)、肝疾患(例えば、血管性肝疾患、肝星細胞活性化、肝線維性コラーゲンおよび全コラーゲン蓄積、壊死炎症性および/または免疫性の肝疾患、肉芽腫性肝疾患に付随する胆汁うっ滞性肝疾患、肝悪性腫瘍に付随する胆汁うっ滞性肝疾患、妊娠の肝内胆汁うっ滞に付随する胆汁うっ滞性肝疾患、肝炎に付随する胆汁うっ滞性肝疾患、敗血症に付随する胆汁うっ滞性肝疾患、薬物または毒素に付随する胆汁うっ滞性肝疾患、移植片対宿主病に付随する胆汁うっ滞性肝疾患、肝移植後に付随する胆汁うっ滞性肝疾患、総胆管結石症に付随する胆汁うっ滞性肝疾患、胆管腫瘍に付随する胆汁うっ滞性肝疾患、膵癌に付随する胆汁うっ滞性肝疾患、ミリッチ症候群に付随する胆汁うっ滞性肝疾患、AIDSに付随する胆汁うっ滞性肝疾患、胆管症、寄生虫に付随する胆汁うっ滞性肝疾患、住血吸虫症に付随する胆汁うっ滞性肝疾患、肝炎 非アルコール性脂肪肝炎(NASH)、非アルコール性脂肪肝疾患(NAFLD)、肝血管閉塞性疾患(hepatic vaso-occlusive disease)(VOD)、肝類洞閉塞症候群(SOS)、肝性脳症、限局性血栓症、下部尿路症候群(LUTS)、腰部脊柱管狭窄症、ループス腎炎、エリテマトーデスまたは全身性エリテマトーデス、微量アルブミン尿症、微小循環異常、片頭痛、軽度の神経認知障害(MND)、限局性強皮症、モヤモヤ病、多発性ラクナ梗塞、多臓器不全症候群(MODS)、多臓器障害(MOF)、多発性硬化症(MS、臨床的に単独の症候群(clinically isolated syndrome)(CIS)、再発寛解型MS(RRMS)、一次進行型MS(SPMS)、二次進行型MS(SPMS)を含む)、多系統萎縮症(MSA)、心筋梗塞または心臓発作(例えば、ST上昇型心筋梗塞、非ST上昇型心筋梗塞、陳旧性心筋梗塞)、近視性脈絡膜新血管形成、母斑、麻薬依存症、腎症(例えば、糖尿病性腎症、非糖尿病性腎炎、腎炎、毒素誘発性腎症、造影剤誘発性腎症、糖尿病性または非糖尿病性腎硬化症、ネフローゼ症候群、腎盂腎炎、腎性線維症)、神経変性疾患、神経因性膀胱および失禁、神経炎症、一酸化窒素産生の低減に付随する神経障害、神経筋疾患(例えば、デュシェンヌ型筋ジストロフィー(DMD)、ベッカー型筋ジストロフィー(BMD)、肢帯型筋ジストロフィー、末梢性ミオパシー、I型およびII型筋強直性ジストロフィー、顔面−肩甲−腓骨筋ジストロフィー、常染色体性およびX連鎖性のエメリ・ドレフュス型筋ジストロフィー、眼球咽頭型筋ジストロフィー、筋萎縮性側索硬化症、棘筋萎縮症(SMA))、視神経脊髄炎、神経障害(例えば、末梢神経障害、自律神経障害、中枢神経系神経障害、化学療法誘発性神経障害、糖尿病性神経障害、有痛性神経障害、神経障害痛、非有痛性神経障害、有痛性糖尿病性神経障害、非有痛性糖尿病性神経障害、CNS疾患(例えば、多発性硬化症、MS)に付随する神経障害、放射線誘発性神経障害)、帯状疱疹に付随する神経障害痛、脊椎手術に付随する神経障害痛)強迫性障害(OCD)、閉塞性血栓血管炎、閉塞性尿路疾患、好酸球性(oesinophilic)筋膜炎、
骨粗鬆症、過活動膀胱、疼痛(例えば、急性疼痛、中枢性疼痛症候群、炎症性疼痛、術後疼痛、持続性疼痛、内臓痛、跛行痛、オーファン性疼痛(orphan pain)の適応(例えば、アセタゾラミド応答性ミオトニー、自己赤血球感作症候群、常染色体優性シャルコー・マリー・トゥース病 タイプ2V、神経障害痛を伴う常染色体優性中間型シャルコー・マリー・トゥース病、常染色体劣性肢帯筋ジストロフィー タイプ2A、チャネロパチーが関連する先天性無痛症、髄腔内無痛を要する慢性疼痛、複合性局所疼痛症候群、複合性局所疼痛症候群タイプ1、複合性局所疼痛症候群タイプ2、発汗過多を伴う先天性無痛症、重度の知的障害を伴う先天性無痛症、先天性無痛症−発汗減少症候群、有痛性のひび割れを伴うびまん性掌蹠角皮症、家族性偶発性疼痛症候群、主に下肢が関与する家族性偶発性疼痛症候群、主に上半身が関与する家族性偶発性疼痛症候群、遺伝性有痛性胼胝、遺伝性の感覚性および自律性神経障害 タイプ4、遺伝性の感覚性および自律性神経障害 タイプ5、遺伝性の感覚性および自律性神経障害 タイプ7、間質性膀胱炎、有痛性の眼窩および全身性神経線維腫−マルファン様体質症候群、発作性激痛性障害、持続性特発性顔面痛、カルパインの質的または量的欠乏、トローザ・ハント症候群))、膵炎、パニック障害、パーキンソン病、パーキンソニズム・プラス、パーキンソン嚥下障害、病的摂食障害、骨盤痛、末梢血管疾患(例えば、末梢動脈疾患、末梢動脈閉塞性疾患、末梢塞栓症、末梢血流障害)、腹膜炎、広汎性発達障害、ペイロニー病、ピック症候群、多発性軟骨炎、多発性筋炎、ヘルペス後神経痛、外傷後頭部損傷、外傷後ストレス障害(PTSD)、早漏、進行性核麻痺、前立腺肥大、肺疾患(例えば、多因性肺動脈症、気管支収縮または肺気管支収縮、肺の血管疾患、慢性閉塞性肺疾患(COPD)、肺毛細血管腫症、リンパ管腫症および圧迫された肺血管(例えば、アデノパシー、腫瘍または線維化性縦隔炎による)、肺血管リモデリング、肺筋緊張亢進)、肺高血圧(PH、例えば、肺動脈高血圧(PAH)、原発性PH、続発性PH、芽胞性(sporatid)PH、前毛細血管性(pre-capically)PH、特発性PH、左心室疾患に付随するPH、HIVに付随するPH、SCDに付随するPH、血栓塞栓症(thromoboembolism)に付随するPH(慢性血栓塞栓性PHまたはCTEPH)、サルコイドーシスに付随するPH、慢性閉塞性肺疾患に付随するPH、急性呼吸窮迫症候群(ARDS)に付随するPH、急性肺傷害に付随するPH、アルファ−1−アンチトリプシン欠乏症(AATD)に付随するPH、肺気腫に付随するPH(例えば、喫煙誘発性気腫)、肺疾患に付随するPH、低酸素血症に付随するPH、強皮症に付随するPH、嚢胞性線維症(CF)に付随するPH、左心室機能不全に付随するPH、低酸素血症に付随するPH、PH(WHO群I、II、III、IVおよびV)、僧帽弁疾患に付随するPH、心膜炎に付随するPH、収縮性心膜炎に付随するPH、大動脈弁狭窄症に付随するPH、拡張型心筋症に付随するPH、肥大型(hyperthrophic)心筋症に付随するPH、拘束型心筋症に付随するPH、縦隔線維症に付随するPH、肺線維症に付随するPH、異常な肺静脈ドレナージに付随するPH、肺静脈閉塞性疾患に付随するPH、肺血管炎に付随するPH、膠原血管病に付随するPH、先天性心疾患に付随するPH、肺静脈高血圧に付随するPH、間質性肺疾患に付随するPH、睡眠呼吸障害に付随するPH、慢性気流閉塞に付随するPH、閉塞型睡眠時無呼吸に付随するPH、中枢性睡眠時無呼吸に付随するPH、混合型睡眠時無呼吸に付随するPH、肺胞低換気障害に付随するPH、慢性的高地暴露に付随するPH、新生児肺疾患に付随するPH、肺胞毛細血管異形成に付随するPH、鎌状赤血球症に付随するPH、他の凝固障害に付随するPH、慢性血栓塞栓症に付随するPH)、神経根障害、レイノー病、レイノー症候群(原発性また二次性)、難治性てんかん、レンペニング症候群、再潅流傷害(例えば、虚血−再潅流損傷、臓器移植に付随する虚血−再潅流)、再狭窄(例えば、血栓溶解療法後、経皮経腔的血管形成術(PTA)後、経腔的冠動脈血管形成術(PTCA)後、心移植後、またはバイパス手術後に発現する再狭窄)、網膜症(例えば、糖尿病性網膜症、非糖尿病性網膜症、非増殖性糖尿病性網膜症、増殖性硝子体網膜症、末梢網膜変性、網膜静脈閉塞症)、レット障害、リウマチ様またはリウマチ性疾患(例えば、関節炎、関節リウマチ)、サルコイドーシス、サルコイド、住血吸虫症、統合失調感情障害、統合失調症、認知症を伴う統合失調症、強皮症(例えば、局在性強皮症または限局性強皮症、全身性強皮症)、硬化症(例えば、腎硬化症、進行性硬化症、肝硬化症、原発性硬化性胆管炎、胃腸管の硬化症、海馬硬化症、巣状硬化症、原発性側索硬化症、骨硬化症、耳硬化症、アテローム性動脈硬化症、結節性硬化症、全身性硬化症)、敗血症または敗血症性ショックまたはアナフィラキシーショック、鎌状赤血球貧血、鎌状赤血球病、シェーグレン症候群、睡眠覚醒障害、スネドン症候群、痙攣(例えば、冠動脈痙攣、血管痙攣、末梢動脈の痙攣)、脊髄損傷、脊髄性筋萎縮症、脊髄亜脱臼、脊髄小脳性運動失調、スティール・リチャードソン・オルゼウスキー疾患(進行性核上性麻痺)、脳卒中、くも膜下出血、皮質下動脈硬化性脳症、失神、タウオパチー、緊張、視床変性、血栓塞栓性または血栓形成性障害、一過性脳虚血発作(TIA)、外傷性脳損傷、尿細管間質性疾患、潰瘍、子宮筋腫、腟萎縮、弁欠損(例えば、僧帽弁狭窄、僧帽弁の逆流、閉鎖不全または機能不全、大動脈弁狭窄、大動脈弁閉鎖不全、三尖弁閉鎖不全、肺動脈弁狭窄、肺動脈弁閉鎖不全、連合弁欠損)、脳の血管疾患 心臓および腎臓の合併症に起因する血管障害、血管の漏出または透過性、血管炎(例えば、血栓性血管炎、閉塞性血栓性血管炎、川崎病、動脈炎、大動脈炎)、血管閉塞性クリーゼ、静脈グラフト不全、湿性加齢性黄斑変性およびウィリアムズ症候群。
併用療法
[00101]本明細書中で用いる場合、“併用で”(“併用療法で”という語句においてのように)または“同時投与”という用語は、1より多くの治療(例えば、1以上の治療薬)の使用をさすために互換的に用いることができる。該用語の使用は、治療(例えば、治療薬)を被験対象に投与する順序を限定するわけではない。
(1)内皮由来の放出因子(EDRF)。
(2)NO供与体、例えば、ニトロソチオール、ニトリット、シドノンイミン、NONOエート、N−ニトロソアミン、N−ヒドロキシルニトロソアミン、ニトロソイミン(nitrosimine)、ニトロチロシン、ジアゼチンジオキシド(diazetine dioxide)、オキサトリアゾール5−イミン、オキシム、ヒドロキシルアミン、N−ヒドロキシグアニジン、ヒドロキシ尿素またはフロキサン。これらのタイプの化合物のいくつかの例としては、以下が挙げられる:三硝酸グリセリン(GTN、ニトログリセリン(nitroglycerin)、ニトログリセリン(nitroglycerine)およびトリニトログリセリンとしても知られる)、グリセロールの硝酸エステル;酸化窒素分子が金属鉄に配位して正方形両錐錯体(square bipyramidal complex)を形成している、ニトロプルシドナトリウム(SNP);モルホリンとシドノンイミンの組み合わせによって形成される両性イオン性化合物である、3−モルホリノシドノンイミン(SIN−1);ニトロソチオール官能基を有するN−アセチル化アミノ酸誘導体である、S−ニトロソ−N−アセチルペニシラミン(SNAP);ジエチレントリアミンに共有結合している酸化窒素化合物である、ジエチレントリアミン/NO(DETA/NO);アセチルサリチル酸のm−ニトロキシメチルフェニルエステル。これらのクラスのNO供与体のいくつかのより詳細な例としては、以下が挙げられる:標準的なニトロ血管拡張薬、例えば、有機硝酸エステルおよび亜硝酸エステル、例えば、ニトログリセリン、亜硝酸アミル、二硝酸イソソルビド、5−一硝酸イソソルビド、およびニコランジル;イソソルビド(Dilatrate(登録商標)−SR、Imdur(登録商標)、Ismo(登録商標)、Isordil(登録商標)、Isordil(登録商標)、Titradose(登録商標)、Monoket(登録商標))、3−モルホリノシドノンイミン;リンシドミンクロロ水和物(“SIN−1”);S−ニトロソ−N−アセチルペニシラミン(“SNAP”);S−ニトロソグルタチオン(GSNO)、ニトロプルシドナトリウム、S−ニトロソグルタチオン モノエチルエステル(GSNO−エステル)、6−(2−ヒドロキシ−1−メチル−ニトロソヒドラジノ)−N−メチル−1−ヘキサンアミンまたはジエチルアミンNONOエート。
(3)cGMP濃度を上昇させる他の物質、例えば、プロトポルフィリンIX、アラキドン酸およびフェニルヒドラジン誘導体。
(4)一酸化窒素シンターゼ基質:例えば、L−アルギニン、n−ヒドロキシグアニジンに基づく類似体、例えば、N[G]−ヒドロキシ−L−アルギニン(NOHA)、1−(3,4−ジメトキシ−2−クロロベンジリデンアミノ)−3−ヒドロキシグアニジン、およびPR5(1−(3,4−ジメトキシ−2−クロロベンジリデンアミノ)−3−ヒドロキシグアニジン);L−アルギニン誘導体(例えば、ホモ−Arg、ホモ−NOHA、N−tert−ブチルオキシ−およびN−(3−メチル−2−ブテニル)オキシ−L−アルギニン、カナバニン、イプシロングアニジン−カルポン酸(carpoic acid)、アグマチン、ヒドロキシル−アグマチン、およびL−チロシル−L−アルギニン);N−アルキル−N’−ヒドロキシグアニジン(N−シクロプロピル−N’−ヒドロキシグアニジンおよびN−ブチル−N’−ヒドロキシグアニジンなど)、N−アリール−N’−ヒドロキシグアニジン(N−フェニル−N’−ヒドロキシグアニジン、およびそれぞれ−F、−Cl、−メチル、−OH置換基を持つそのパラ置換誘導体など);3−(トリフルオロメチル)プロピルグアニジンなどのグアニジン誘導体。
(5)eNOS転写を増強する化合物。
(6)NO非依存性ヘム非依存性sGC活性化薬、例えば、限定されるものではないが:BAY58−2667(特許公報DE19943635に記載);HMR−1766(アタシグアトナトリウム、特許公報WO2000002851に記載);S3448(2−(4−クロロ−フェニルスルホニルアミノ)−4,5−ジメトキシ−N−(4−(チオモルホリン−4−スルホニル)−フェニル)−ベンズアミド(特許公報DE19830430およびWO2000002851に記載);およびHMR−1069(Sanofi−Aventis)。
(7)ヘム依存性NO非依存性sGC刺激薬、例えば、限定されるものではないが:
YC−1(特許公報EP667345およびDE19744026参照);リオシグアト(BAY63−2521、Adempas、DE19834044に記載);ネリシグアト(BAY60−4552WO2003095451に記載);ベリシグアト(BAY1021189);BAY41−2272(DE19834047およびDE19942809に記載);BAY41−8543(DE19834044に記載);エトリシグアト(WO2003086407に記載);CFM−1571(特許公報WO2000027394に記載);A−344905、そのアクリルアミド類似体A−350619およびアミノピリミジン類似体A−778935;
および、公報:米国特許出願公開第20090209556号、米国特許公報第8455638号、米国特許出願公開第20110118282号(WO2009032249)、米国特許出願公開第20100292192号、米国特許出願公開第20110201621号、米国特許公報第7947664号、米国特許公報第8053455号(WO2009094242)、米国特許出願公開第20100216764号、米国特許公報第8507512号、(WO2010099054)米国特許出願公開第20110218202号(WO2010065275)、米国特許出願公開第20130012511号(WO2011119518)、米国特許出願公開第20130072492号(WO2011149921)、米国特許出願公開第20130210798号(WO2012058132)、およびTetrahedron Letters(2003),44(48):8661−8663の1つに記載されている他の化合物;ならびにIW−1973およびIW1701。
(8)cGMPおよび/またはcAMPの分解を阻害する化合物、例えば:
PDE1阻害薬、PDE2阻害薬、PDE−3阻害薬、例えば、アムリノン、ミルリノン、エノキシモン、ベスナリノン、ピモベンダンおよびオルプリノンなど、PDE4阻害薬、例えばロルミラストなど、PDE5阻害薬、例えば、シルデナフィル(Viagra(登録商標))および関連薬剤、例えば、アバナフィル、ロデナフィル、ミロデナフィル、クエン酸シルデナフィル(Revatio(登録商標))、タダラフィル(Cialis(登録商標)またはAdcirca(登録商標))、バルデナフィル(Levitra(登録商標))およびウデナフィル;アルプロスタジル;ジピリダモールおよびPF−00489791など;PDE6阻害薬、PDE9阻害薬、例えばPF−04447943など、PDE10阻害薬、例えばPF−02545920(PF−10)など、およびPDE11阻害薬。
(9)以下のタイプのカルシウムチャネル遮断薬:
ジヒドロピリジンカルシウムチャネル遮断薬、例えば、アムロジピン(Norvasc(登録商標))、アラニジピン(Sapresta(登録商標))、アゼルニジピン(Calblock(登録商標))、バルニジピン(HypoCa(登録商標))、ベニジピン(Coniel(登録商標))、シルニジピン(Atelec(登録商標)、Cinalong(登録商標)、Siscard(登録商標))、クレビジピン(Cleviprex(登録商標))、ジルチアゼム、エホニジピン(Landel(登録商標))、フェロジピン(Plendil(登録商標))、ラシジピン(Motens(登録商標)、Lacipil(登録商標))、レルカニジピン(Zanidip(登録商標))、マニジピン(Calslot(登録商標)、Madipine(登録商標))、ニカルジピン(Cardene(登録商標)、Carden SR(登録商標))、ニフェジピン(Procardia(登録商標)、Adalat(登録商標))、ニルバジピン(Nivadil(登録商標))、ニモジピン(Nimotop(登録商標))、ニソルジピン(Baymycard(登録商標)、Sular(登録商標)、Syscor(登録商標))、ニトレンジピン(Cardif(登録商標)、Nitrepin(登録商標)、Baylotensin(登録商標))、プラニジピン(Acalas(登録商標))、およびイスラジピン(Lomir(登録商標));
フェニルアルキルアミンカルシウムチャネル遮断薬、例えば、ベラパミル(Calan(登録商標)、Isoptin(登録商標));およびガロパミル(Procorum(登録商標)、D600);
ベンゾチアゼピン、例えば、ジルチアゼム(Cardizem(登録商標));および
非選択性カルシウムチャネル遮断薬、例えば、ミベフラジル、ベプリジル、フルスピリレンおよびフェンジリン。
(10)エンドセリン受容体類似体(ERA)、例えば、二重(ETAおよびETB)エンドセリン受容体アンタゴニストのボセンタン(Tracleer(登録商標)、シタキセンタン(Thelin(登録商標))またはアンブリセンタン(Letairis(登録商標))。
(11)プロスタサイクリン誘導体または類似体、例えば、プロスタサイクリン(プロスタグランジンI2)、エポプロステノール(合成プロスタサイクリン、Flolan(登録商標))、トレプロスチニル(Remodulin(登録商標))、イロプロスト(Ilomedin(登録商標))、イロプロスト(Ventavis(登録商標));ならびに開発中のRemodulin(登録商標)の経口および吸入形態。
(12)以下のタイプのような抗脂質異常薬:
コレスチラミン、コレスチポール、コレスチラン、コレセベラムまたはセベラマーのような胆汁酸金属イオン封鎖剤;
アトルバスタチン、シンバスタチン、ロバスタチン、フルバスタチン、ピタバスタチン、ロスバスタチンおよびプラバスタチンのようなスタチン;
エゼチミブなどのコレステロール吸収阻害薬;
他の脂質低下薬、例えば、イコサペントエチルエステル、オメガ−3−酸エチルエステル、レデュコール(Reducol);
フィブリン酸誘導体、例えば、クロフィブラート、ベザフィブラート、クリノフィブラート、ゲムフィブロジル、ロニフィブラート、ビニフィブラート、フェノフィラート、シプロフィブラート、コリンフェノフィブラート;
ニコチン酸誘導体、例えば、アシピモックスおよびナイアシン;
スタチン、ナイアシンおよび腸コレステロール吸収阻害サプリメント(エゼチミブなど)およびフィブラートの組み合わせ;ならびに
重硫酸クロピドグレルなどの抗血小板療法。
(13)以下のタイプのような抗凝固薬:
クマリン(ビタミンKアンタゴニスト)、例えば、ワルファリン(Coumadin(登録商標))、セノクマロール、フェンプロクモンおよびフェニンジオン;
ヘパリンおよび誘導体、例えば、低分子量ヘパリン、フォンダパリヌクスおよびイドラパリヌクス;
直接トロンビン阻害薬、例えば、アルガトロバン、レピルジン、ビバリルジン、ダビガトラン、およびキシメラガトラン(Exanta(登録商標));および
血餅を溶解し、動脈の遮断を取り除くために用いられる組織プラスミノーゲン活性化薬、例えば、アルテプラーゼ。
(14)抗血小板薬、例えば、トピドグレル、チクロピリジン、ジピリダモールおよびアスピリンなど。
(15)ACE阻害薬、例えば以下のタイプ:
スルフヒドリル含有薬剤、例えば、カプトプリル(Capoten(登録商標))およびゾフェノプリル;
ジカルボキシレート含有薬剤、例えば、エナラプリル(Vasotec/Renitec(登録商標))、ラミプリル(Altace(登録商標)/Tritace(登録商標)/Ramace(登録商標)/Ramiwin(登録商標))、キナプリル(Accupril(登録商標))、ペリンドプリル(Coversyl(登録商標)/Aceon(登録商標))、リシノプリル(Lisodur(登録商標)/Lopril(登録商標)/Novatec(登録商標)/Prinivil(登録商標)/Zestril(登録商標))およびベナゼプリル(Lotensin(登録商標));
ホスホネート含有薬剤、例えばフォシノプリル;
天然由来のACE阻害薬、例えば、:乳製品、特に発酵乳の摂取後に自然に生じるカゼインおよび乳清の分解産物である、カソキニンおよびラクトキニン;
プロバイオティックLactobacillus helveticusによって産生されるか、カゼインから誘導される、ラクトトリペプチドVal−Pro−ProおよびIle−Pro−Proも、ACE阻害作用および抗高血圧作用を有する;
他のACE阻害薬、例えば、アラセプリル、デラプリル、シラザプリル、イミダプリル、トランドラプリル、テモカプリル、モエキシプリルおよびスピラプリル。
(16)酸素補給療法。
(17)以下のタイプのようなベータ遮断薬:
非選択性薬剤、例えば、アルプレノロール、ブシンドロール、カルテオロール、カルベジロール、ラベタロール、ナドロール、ペンブトロール、ピンドロール、オクスプレノロール(oxprenonol)、アセブトロール、ソタロール、メピンドロール、セリプロロール、アロチノロール、テルタトロール、アモスラロール、ニプラジロール、プロプラノロールおよびチモロール;
β1選択性薬剤、例えば、セブトロール、アテノロール、ベタキソロール、ビソプロロール、セリプロロール、塩酸ドブタミン、マレイン酸イルソグラジン、イソグラジンマレイン酸塩、カルベジロール、タリノロール、エスモロール、メトプロロールおよびネビボロール;
およびブタキサミンなどのβ2−選択剤。
(18)以下のタイプのような抗不整脈薬:
タイプI(ナトリウムチャネル遮断薬)、例えば、キニジン、リドカイン、フェニトイン、プロパフェノン;
タイプIII(カリウムチャネル遮断薬)、例えば、アミオダロン、ドフェチリドおよびソタロール;ならびに
タイプV、例えば、アデノシンおよびジゴキシン。
(19)利尿薬、例えば、チアジド利尿薬、例えば、クロロチアジド、クロルタリドンおよびヒドロクロロチアジド、ベンドロフルメチアジド、シクロペンチアジド、メチクロチアジド、ポリチアジド、キネタゾン、キシパミド、メトラゾン、インダパミド、シクレタニン;ループ利尿薬、例えば、フロセミドおよびトレサミド(toresamide);カリウム保持性利尿薬、例えば、アミロリド、スピロノラクトン、カンレノ酸カリウム、エプレレノンおよびトリアムテレン;これらの薬剤の組み合わせ;他の利尿薬、例えば、アセタゾラミドおよびカルペリチド。
(20)直接作用性血管拡張薬、例えば、塩酸ヒドララジン、ジアゾキシド、ニトロプルシドナトリウム、カドララジン;他の血管拡張薬、例えば、二硝酸イソソルビドおよび5−一硝酸イソソルビド。
(21)外因性血管拡張薬、例えば、Adenocard(登録商標)およびアルファ遮断薬。
(22)アルファ−1−アドレナリン受容体アンタゴニスト、例えば、プラゾシン、インドラミン、ウラピジル、ブナゾシン、テラゾシンおよびドキサゾシン;心房性ナトリウム利尿ペプチド(ANP)、エタノール、ヒスタミン誘発因子、テトラヒドロカンナビノール(THC)およびパパベリン。
(23)以下のタイプの気管支拡張薬:
短時間作用型β2アゴニスト、例えば、サルブタモール(albutamol)またはアルブテロール(Ventolin(登録商標))およびテルブタリン;
長時間作用型β2アゴニスト(LABA)、例えば、サルメテロールおよびホルモテロール;
抗コリン作用薬、例えば、イプラトロピウム(pratropium)およびチオトロピウム;ならびに
気管支拡張薬およびホスホジエステラーゼ阻害薬であるテオフィリン。
(24)コルチコステロイド、例えば、ベクロメタゾン、メチルプレドニゾロン、ベタメタゾン、プレドニゾン、プレドニゾロン、トリアムシノロン、デキサメタゾン、フルチカゾン、フルニソリド、ヒドロコルチゾン、およびコルチコステロイド類似体、例えばブデソニド。
(25)栄養補助食品、例えば、オメガ−3オイル;葉酸、ナイアシン、亜鉛、銅、高麗紅参根、イチョウ、松樹皮、Tribulus terrestris、アルギニン、Avena sativa、ホーニーゴートウィード(horny goat weed)、マカ根、ムイラプアマ、ノコギリヤシ、およびスウェーデンフラワーポーレン(Swedish flower pollen);ビタミンC、ビタミンE、ビタミンK2;テストステロンサプリメント、テストステロン経皮パッチ;ゾラキセル(zoraxel)、ナルトレキソン、ブレメラノチドおよびメラノタンIIなど。
(26)PGD2受容体アンタゴニスト
(27)免疫抑制薬、例えば、シクロスポリン(シクロスポリンA、Sandimmune(登録商標)、Neoral(登録商標))、タクロリムス(FK−506、Prograf(登録商標))、ラパマイシン(Sirolimus(登録商標)、Rapamune(登録商標))および他のFK−506タイプの免疫抑制薬、ミコフェノレート、例えば、ミコフェノール酸モフェチル(CellCept(登録商標))。
(28)非ステロイド性抗喘息薬、例えば、テルブタリン、メタプロテレノール、フェノテロール、イソエタリン、アルブテロール、サルメテロール、ビトルテロールおよびピルブテロールのようなβ2−アゴニスト;β2−アゴニスト−コルチコステロイドの組み合わせ、例えば、サルメテロール−フルチカゾン(Advair(登録商標))、ホルモテロール−ブデソニド(Symbicort(登録商標))、テオフィリン、クロモリン、クロモリンナトリウム、ネドクロミル、アトロピン、イプラトロピウム、臭化イプラトロピウム、およびロイコトリエン生合成阻害薬(ジロートン、BAY1005)。
(29)非ステロイド性抗炎症薬(NSAID)、例えば、プロピオン酸誘導体、例えば、アルミノプロフェン、ベノキサプロフェン、ブクロキシ酸、カルプロフェン、フェンブフェン、フェノプロフェン、フルプロフェン、フルルビプロフェン、イブプロフェン、インドプロフェン、ケトプロフェン、ミロプロフェン、ナプロキセン、オキサプロジン、ピルプロフェン、プラノプロフェン、スプロフェン、チアプロフェン酸およびチオキサプロフェン);酢酸誘導体、例えば、インドメタシン、アセメタシン、アルクロフェナク、クリダナク、ジクロフェナク、フェンクロフェナク、フェンクロジン酸、フェンチアザク、フロフェナク、イブフェナク、イソキセパク、オキシピナク、スリンダク、チオピナク、トルメチン、ジドメタシンおよびゾメピラク;フェナム酸誘導体、例えば、フルフェナム酸、メクロフェナム酸、メフェナム酸、ニフルム酸およびトルフェナム酸;ビフェニルカルボン酸誘導体、例えば、ジフルニサルおよびフルフェニサル;オキシカム、例えば、イソキシカム、ピロキシカム、スドキシカムおよびテノキシカン(tenoxican);サリチラート、例えば、アセチルサリチル酸およびスルファサラジン;および、ピラゾロン、例えば、アパゾン、ベズピペリロン(bezpiperylon)、フェプラゾン、モフェブタゾン、オキシフェンブタゾンおよびフェニルブタゾン。
(30)シクロオキシゲナーゼ−2(COX−2)阻害薬、例えば、セレコキシブ(Celebrex(登録商標))、ロフェコキシブ(Vioxx(登録商標))、バルデコキシブ、エトリコキシブ、パレコキシブおよびルミラコキシブ;オピオイド鎮痛薬、例えば、コデイン、フェンタニル、ヒドロモルホン、レボルファノール、メペリジン、メタドン、モルヒネ、オキシコドン、オキシモルホン、プロポキシフェン、ブプレノルフィン、ブトルファノール、デゾシン、ナルブフィンおよびペンタゾシン;
(31)抗糖尿病薬、例えば、インスリンおよびインスリン模倣薬;スルホニル尿素、例えば、グリブリド、グリベンクラミド、グリピジド、グリクラジド、グリキドン、グリメピリド、メグリナチド(meglinatide)、トルブタミド、クロルプロパミド、アセトヘキサミド、およびトラザミド(olazamide);ビグアニド、例えば、メトホルミン(Glucophage(登録商標));α−グルコシダーゼ阻害薬、例えば、アカルボース、エパルレスタット、ボグリボース、ミグリトール;チアゾリジノン化合物、例えば、ロシグリタゾン(Avandia(登録商標))、トログリタゾン(Rezulin(登録商標))、シグリタゾン、ピオグリタゾン(Actos(登録商標))およびエングリタゾン;インスリン増感薬、例えば、ピオグリタゾンおよびロシグリタゾン;インスリン分泌促進物質、例えば、レパグリニド、ナテグリニドおよびミチグリニド;インクレチン模倣薬、例えば、エキサナチド(exanatide)およびリラグルチド;アミリン類似体、例えば、プラムリンチド;グルコース降下薬、例えば、ピコリン酸クロム、これは、ビオチンと組み合わされていてもよい;ジペプチジルペプチダーゼIV阻害薬、例えば、シタグリプチン、ビルダグリプチン、サクサグリプチン、アログリプチンおよびリナグリプチン。
(32)HDLコレステロール上昇剤、例えば、アナセトラピブおよびダルセトラピブ。
(33)抗肥満薬、例えば、塩酸メタンフェタミン、塩酸アンフェプラモン(Tenuate(登録商標))、フェンテルミン(Ionamin(登録商標))、塩酸ベンズフェタミン(Didrex(登録商標))、酒石酸フェンジメトラジン(Bontril(登録商標)、Prelu−2(登録商標)、Plegine(登録商標))、マジンドール(Sanorex(登録商標))、オルリスタット(Xenical(登録商標))、塩酸シブトラミン一水和物(Meridia(登録商標)、Reductil(登録商標))、リモナバン(Acomplia(登録商標))、アンフェプラモン、ピコリン酸クロム;フェンテルミン/トピラマート、ブプロピオン/ナルトレキソン、シブトラミン/メトホルミン、ブプロピオンSR/ゾニサミドSR、サルメテロール、キシナホエート/プロピオン酸フルチカゾンなどの組み合わせ;塩酸ロルカセリン、フェンテルミン/トピラマート、セチリスタット、エキセナチド、リラグルチド、塩酸メトホルミン、シブトラミン/メトホルミン、ブプロピオンSR/ゾニサミドSR、CORT−108297、カナグリフロジン、ピコリン酸クロム、GSK−1521498、LY−377604、メトレレプチン、オビネピチド(obinepitide)、P−57AS3、PSN−821、キシナホ酸サルメテロール/プロピオン酸フルチカゾン、タングステン酸ナトリウム、ソマトロピン(組み換え型)、テサモレリン、テソフェンシン、ベルネペリト、ゾニサミド、ヘミシュウ酸ベロラニブ(beloranib hemioxalate)、インスリノトロピン、レスベラトロール、ソベチロム、テトラヒドロカンナビバリンおよびベータ−ラパコン。
(34)アンギオテンシン受容体遮断薬、例えば、ロサルタン、バルサルタン、カンデサルタン、シレキセチル、エプロサラン(eprosaran)、イルベサルタン、テルミサルタン、オルメサルトラン(olmesartran)、メドキソミル、アジルサルタンおよびメドキソミル。
(35)レニン阻害薬、例えば、アリスキレンヘミフミレート(aliskiren hemifumirate)。
(36)中枢作用性アルファ−2−アドレナリン受容体アゴニスト、例えば、メチルドパ、クロニジンおよびグアンファシン。
(37)アドレナリン作動性ニューロン遮断薬、例えば、グアネチジンおよびグアナドレル。
(38)イミダゾリンI−1受容体アゴニスト、例えば、リン酸二水素リメニジン(rimenidine)および塩酸モキソニジン水和物。
(39)アルドステロンアンタゴニスト、例えば、スピロノラクトンおよびエプレレノン。
(40)カリウムチャネル活性化薬、例えば、ピナシジル。
(41)ドーパミンD1アゴニスト、例えば、メシル酸フェノルドパム;他のドーパミンアゴニスト、例えば、イボパミン、ドペキサミンおよびドカルパミン。
(42)5−HT2アンタゴニスト、例えばケタンセリン。
(43)バソプレシンアンタゴニスト、例えばトルバプタン。
(44)カルシウムチャネル増感薬、例えば、レボシメンダン、または活性化薬、例えばニコランジル。
(45)アデニル酸シクラーゼ活性化薬、例えば、コルホルシンダプロパート(dapropate)塩酸塩。
(46)陽性変力薬、例えば、ジゴキシンおよびメチルジゴキシン;代謝性強心剤、例えばユビデカレノン;脳性ナトリウム利尿ペプチド、例えばネシリチド。
(47)勃起障害の処置に用いられる薬物、例えば、アルプロスタジル、アビプタジルおよびメシル酸フェントラミン。
(48)肥満の処置に用いられる薬物、例えば、限定されるものではないが、メタンフェタミン塩酸塩(Desoxyn(登録商標))、アンフェプラモン塩酸塩(Tenuate(登録商標))、フェンテルミン(Ionamin(登録商標))、ベンズフェタミン塩酸塩(Didrex(登録商標))、フェンジメトラジン塩酸塩(Bontril(登録商標)、Prelu−2(登録商標)、Plegine(登録商標))、マジンドール(Sanorex(登録商標))およびオルリスタット(Xenical(登録商標))。
(49)アルツハイマー病および認知症の処置に用いられる薬物、例えば、以下のタイプのアセチルコリンエステラーゼ阻害薬、例えば、ガランタミン(Razadyne(登録商標))、リバスチグミン(Exelon(登録商標))、ドネペジル(Aricept(登録商標))およびタクリン(Cognex(登録商標));
NMDA受容体アンタゴニスト、例えば、メマンチン(Namenda(登録商標));および
オキシドレダクターゼ阻害薬、例えば、イデベノン。
(50)以下のタイプような精神医学的投薬:
ジプラシドン(GeodonTM)、リスペリドン(RisperdalTM)、 オランザピン(ZyprexaTM)、バルプロエート;
ドーパミンD4受容体アンタゴニスト、例えばクロザピン;
ドーパミンD2受容体アンタゴニスト、例えばネモナプリド;
混合型ドーパミンD1/D2受容体アンタゴニスト、例えばズクロペンチキソール;
GABA A受容体モジュレーター、例えばカルバマゼピン;
ナトリウムチャネル阻害薬、例えばラモトリギン;および
モノアミンオキシダーゼ阻害薬、例えば、モクロベミドおよびインデロキサジン;ならびに
プリマバンセリン(primavanserin)およびペロスピロン。
(51)以下のタイプのような、運動障害または症状の処置に用いられる薬物:
カテコール−O−メチルトランスフェラーゼ阻害薬、例えばエンタカポン;
モノアミンオキシダーゼB阻害薬、例えばセレギリン;
ドーパミン受容体モジュレーター、例えばレボドーパ;
ドーパミンD3受容体アゴニスト、例えばプラミペキソール;
デカルボキシラーゼ阻害薬、例えばカルビドーパ;
他のドーパミン受容体アゴニスト、例えば、ペルゴリド、ロピニロール、カベルゴリン;リチゴニド(ritigonide)、イストラデフィリン、タリペキソール;ゾニサミドおよびサフィナミド;ならびに
シナプス小胞アミントランスポーター阻害薬、例えばテトラベナジン。
(52)以下のタイプのような、気分的もしくは情動的障害またはOCDの処置に用いられる薬物:
三環系抗うつ薬、例えば、アミトリプチリン(Elavil(登録商標))、デシプラミン(Norpramin(登録商標))、イミプラミン(Tofranil(登録商標))、アモキサピン(Asendin(登録商標))、ノルトリプチリンおよびクロミプラミン;
選択的セロトニン再取り込み阻害薬(SSRI)、例えば、パロキセチン(Paxil(登録商標))、フルオキセチン(Prozac(登録商標))、セルトラリン(Zoloft(登録商標))、およびシトラロプラム(Celexa(登録商標));
ドキセピン(Sinequan(登録商標))、トラゾドン(Desyrel(登録商標))およびアゴメラチン;
選択的ノルエピネフリン再取り込み阻害薬(SNRI)、例えば、ベンラファキシン、レボキセチンおよびアトモキセチン;ドーパミン作動性抗うつ薬、例えば、ブプロピオンおよびアミネプチン。
(53)以下のタイプのようなシナプス可塑性を増強するための薬物:
ニコチン性受容体アンタゴニスト、例えばメカミラミン;および
混合5−HT、ドーパミンおよびノルエピネフリン受容体アゴニスト、例えばルラシドン。
(54)ADHDの処置に用いられる薬物、例えばアンフェタミン;5−HT受容体モジュレーター、例えばボルチオキセチン、およびアルファ−2−アドレナリン受容体アゴニスト、例えばクロニジン。
(55)中性エンドペプチターゼ(NEP)阻害薬、例えば、サクビトリル、オマパトリラート;およびメチレンブルー(MB)。
(56)一酸化窒素シンターゼ補因子、例えば、テトラヒドロビオプテリン、ジヒドロビオプテリン、およびサプロプテリン(Kuvan(登録商標))。
包装およびキット
[00107]使用するための医薬組成物(または製剤)は、薬物の投与に用いられる方法に応じて多様な方法で包装することができる。一般に、分配品は、適した形態の医薬製剤が入っている容器を包含する。適した容器は当業者に周知であり、ボトル(プラスチックおよびガラス)、サシェ、アンプル、プラスチックバッグ、金属シリンダーなどの材料を包含する。容器は、包装の内容物への無分別な接近を防ぐために、不正開封防止機能が付いたセット(assemblage)を包含することもできる。これに加えて、容器の上部には、容器内容物を記載したラベルを付着させておく。ラベルは、適した注意書きも包含することができる。
中間体−1:8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン−6−カルボニトリル(Int−1)
1H NMR (500 MHz, メタノール-d4)δppm 9.09 (s, 1 H), 8.14 (s, 1 H), 7.91 (s, 1 H), 7.35 (t, 1 H), 7.28 (d, 1 H), 7.10 (m, 2 H), 4.60 (s, 2 H).
一般的手順A:中間体−2(Int−2)
[00111]表題化合物を2段階で合成した:
段階1:8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン−6−カルボキシイミドアミドの合成
段階2:5−フルオロ−2−(8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン−6−イル)ピリミジン−4−オール(Int−2)の合成
1H NMR (500 MHz, メタノール-d4)δppm 9.48 (s, 1 H), 8.28 (s, 1 H), 8.09 (d, 1 H), 7.98 (s, 1 H), 7.38 (s, 1 H), 7.29 (d, 1 H), 7.12 (m, 2 H), 4.71 (s, 2 H).
化合物をより大きな規模で作製した場合、それは灰色がかった白色の固体として得られた(57mg、収率33%)。
1H NMR (500 MHz, DMSO-d6)δ(ppm) 12.5 (br s, 1 H), 9.48 (s, 1 H), 8.31 (s, 1 H), 8.18 (m, 1 H), 7.88 (s, 1 H), 7.47 (m, 1 H), 7.27 (q, 1 H), 7.19 (t, 1 H), 7.09 (t, 1 H), 4.59 (s, 2 H).
中間体−3.
6−(4−クロロ−5−フルオロピリミジン−2−イル)−8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン(Int−3)
化合物I−2
1H NMR (500 MHz, DMSO-d6)δppm 9.43 (s, 1 H), 9.22 (s, 1 H), 8.46 (d, 1 H), 8.38 (br. s., 1 H), 8.28 (s, 1 H), 7.84 (s, 1 H), 7.53 (t, 1 H), 7.23 (br. s., 1 H), 7.14 (t, 1 H), 7.04 (t, 1 H), 4.53 (s, 2 H), 4.07 (d, 2 H).
化合物I−1
[00117]表題化合物を2段階で合成した:
段階1:ジベンジル(1,1,3,3,3−ヘキサフルオロ−2−(((5−フルオロ−2−(8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン−6−イル)ピリミジン−4−イル)アミノ)メチル)プロパン−2−イル)ホスフェート(化合物I−4)の合成
1H NMR (500 MHz,酸化重水素)δppm 8.81 9.10 (s, 1 H), 8.12 (d, 1 H), 8.05 (s, 1 H), 7.78 (s, 1 H), 7.31 (m, 2 H), 7.14 (m, 2 H), 4.67 (s, 2H), 4.62 (s, 2 H).
中間体−4(Int−4)
[00120]この中間体は4段階で調製した:
段階1:中間体(15)をシアン化して、2−(ブロモメチル)−3,3,3−トリフルオロ−2−((トリメチルシリル)オキシ)プロパンニトリル(16)を得る
1H-NMR (500 MHz, CDCl3)δ ppm 3.68 (d, J=11.14 Hz, 1 H); 3.57 (d, J=11.14 Hz, 1 H), 0.34 - 0.37 (m, 9 H).
段階2:ニトリル(16)をアミドに変換して、2−(ブロモメチル)−3,3,3−トリフルオロ−2−ヒドロキシプロパンアミド(17)を得る
1H-NMR (500 MHz, CDCl3)δ6.61 - 6.94 (m, 1 H); 5.92 - 6.26 (m, 1 H); 3.93 - 4.00 (m, 1 H); 3.68 (d, J=11.14 Hz, 1 H).
段階3:化合物(17)をN−アルキル化して、2−(アミノメチル)−3,3,3−トリフルオロ−2−ヒドロキシプロパンアミド(14)を得る
1H-NMR (500 MHz, MeOH-d4)δppm 2.94 (d, J= 13.73 Hz, 1H); 3.24 (d, J = 13.58 Hz, 1H).
段階4:(R)−2,2−ジメチル−5−(トリフルオロメチル)オキサゾリジン−5−カルボキサミド(R)−2−ヒドロキシスクシネート(中間体−4、Int−4)としてのアミン(14)のキラル分割
1H-NMR (500 MHz, D2O)δppm 4.33 (br, s, 1H); 3.61 (br, d, J= 13.58 Hz, 1H); 3.40 - 3.47 (m, 1H); 2.76 (br, d, J= 15.87 Hz, 1H); 2.53 - 2.63 (m, 1H); 2.16 (br, s, 4H).
化合物I−3
1H NMR (500 MHz, DMSO-d6)δppm 9.43 (s, 1 H), 8.39 (d, 1 H), 8.32 (br. s., 1 H), 8.27 (s, 1 H), 8.16 (d, 1 H), 7.83 (s, 1 H), 7.78 (br. s., 1 H), 7.60 (br. s., 1 H), 7.52 (t, 1 H), 7.24 (d, 1 H), 7.15 (d, 1 H), 7.06 (t, 1 H), 4.57 (s, 2 H), 4.00 (d, 2 H).
一般式B1の化合物
[00127]化合物I−1、I−2、I−3およびI−4について上記で例示した合成と同様に、以下の式B1の核を有する化合物は、以下のスキームによって合成することができる。
MS ES+ m/z = 271.2 [M+H]+.
[00131]中間体6:6−(4−クロロ−5−フルオロピリミジン−2−イル)−8−(2,5−ジフルオロベンジル)イミダゾ[1,2−a]ピラジン(Int−6)。
MS ES+ m/z 376.3 [M+H]+.
[00133]化合物I−5
1H NMR (500 MHz, CD3OD)δ(ppm): 9.40 (s, 1 H), 8.22 - 8.25 (m, 1 H), 8.18 (s, 1 H), 7.83 (s, 1 H), 7.15 - 7.21 (m, 1 H), 7.06 - 7.10 (m, 1 H), 6.91 - 6.98 (m, 1 H), 4.65 (s, 2 H), 4.26 (d, 1 H), 4.05 (d, 1 H). MS ES+ m/z 512.2 [M+H]+.
[00135]中間体−7:8−(2−フルオロベンジル)−[1,2,4]トリアゾロ[1,5−a]ピラジン−6−カルボニトリル(Int−7)
1H NMR: (500 MHz, DMSO-d6),δ(ppm): 9.46 (s, 1H), 8.74 (s, 1H), 7.39 - 7.42 (m, 1H), 7.30 - 7.34 (m, 1H), 7.14 - 7.21 (m, 2 H), 4.56 (s, 2H). MS ES+m/z = 307.1 [M]+, 309.0 [M+2]+,
[00137]DMA(8mL)中の It‐7b(1.49g、4.85mmol)、シアン化亜鉛(II)(0.684g、5.82mmol)、DPPF(0.538g、0.970mmol)、Pd2(dba)3(0.533g、0.582mmol)、亜鉛(0.162g、2.47mmol)の撹拌混合物を、窒素雰囲気下、120℃で2時間加熱した。完了後、混合物を室温に冷却し、酢酸エチル:ジクロロメタン:メタノール(2:1:1、100mL)の混合物で希釈し、セライトのパッドに通して濾過し、濃縮した。残渣を、ヘキサン中0〜85%酢酸エチルの勾配を利用するシリカゲルクロマトグラフィーによって精製して、中間体Int−7(869mg、71%)を得た。
1H NMR: (500 MHz, MeOH-d4),δ(ppm): 9.52 (s, 1 H), 8.72 (s, 1 H), 7.39 - 7.42 (m, 1 H), 7.28 - 7.32 (m, 1 H), 7.08 - 7.15 (m, 2 H), 4.65 (s, 2 H). MS ES+ m/z 254.1 [M+H]+,
[00138]中間体10:6−(4−クロロ−5−フルオロピリミジン−2−イル)−8−(2−フルオロベンジル)−[1,2,4]トリアゾロ[1,5−a]ピラジン(Int−10)
MS ES+ m/z 271.1 [M+H]+
[00140]無水EtOH(27ml)中の中間体Int−8(1.63g、6.03mmol)の撹拌混合物に、室温で中間体Int−8a(2.82g、18.1mmol)を添加した。混合物を80℃で30分間加熱し、反応の進行をLC−MS分析によってモニタリングした。完了後、HClの水溶液(18.1mL、1M)を添加し、得られた混合物を室温で30分間撹拌して、沈殿物の形成をもたらした。固体を濾過し、減圧乾燥した。30分間放置後、第2の生産物(crop)を濾液から回収した。合わせた固体を高真空下で乾燥して、中間体Int−9(2.01g、98%)を得た。
MS ES+ m/z 341.0 [M+H]+.
[00141]POCl3(1.96mL、21.0mmol)と中間体Int−9(358mg、1.05mmol)の撹拌混合物を、反応の進行をLC−MS分析によってモニタリングしつつ30分間にわたり80℃で加熱した。完了後、POCl3を真空蒸発させ、残渣を飽和重炭酸ナトリウム水溶液(20mL)とジクロロメタン(40mL)に分配した。水層をジクロロメタン(2×40ml)で抽出し、合わせた有機層を乾燥し(MgSO4)、濾過し、濃縮して、粗製残渣を得た。粗生成物を、ヘキサン中0〜50%酢酸エチルの勾配を利用するシリカゲルクロマトグラフィーによって精製して、中間体Int−10(200mg、53.0%)を固体として得た。
1H NMR (500 MHz, DMSO-d6)δppm 9.65 (s, 1H), 9.14 (s, 1H), 8.82 (s, 1H), 7.40 (m, 1H), 7.34 - 7.26 (m, 1H), 7.23 - 7.15 (m, 1H), 7.15 - 7.08 (m, 1H), 4.66 (s, 2H). MS ES+ m/z 359.0 [M+H]+.
[00142]化合物I−6
1H NMR: (500 MHz, DMSO-d6),δ(ppm): 9.57 (s, 1 H), 8.83 (s, 1 H), 8.80 (s, 1 H), 8.49 (d, 1 H), 8.31 (m, 1 H), 7.48 - 7.51 (t, 1 H), 7.26 - 7.30 (m, 1 H), 7.14 - 7.18 (t, 1 H), 7.07 - 7.10 (t, 1 H), 4.60 (s, 2 H), 4.16 (d, 2 H). MS ES+ m/z = 520.3.
[00144]中間体11:3−クロロ−6−(4−クロロ−5−フルオロピリミジン−2−イル)−8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン(Int−11)
MS ES+ m/z 374.2 [M+H]+.
[00146]POCl3(0.836mL、8.97mmol)中の 中間体Int‐2a(47.9mg、0.128mmol)の混合物を60℃で2.5時間撹拌した後、LCMS分析により反応が完了したことが示された。混合物を濃縮乾固した。残留量のPOCl3をトルエン(2×1mL)で追跡し、さらに減圧乾燥することによって除去した。得られたInt−11の粗生成物を精製せずに使用した。
MS ES+ m/z 392.2 [M+H]+.
[00147]化合物I−7
1H NMR: (500 MHz, DMSO-d6),δ(ppm): 8.90 (s, 1 H), 8.28 (d, 1 H), 8.00 (s, 1 H), 7.55 - 7.57 (m, 1 H), 7.44 - 7.47 (m, 1 H), 7.25 - 7.30 (m, 1 H), 7.15 - 7.19 (m, 1 H), 7.09 - 7.12 (m, 1 H), 4.73 (s, 1 H), 4.58 (s, 2 H), 3.49 (d, 2 H), 1.15 (s, 6 H). MS ES+ m/z = 445.2.
[00149]中間体13:6−(4,5−ジクロロピリミジン−2−イル)−8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン(Int−13)
MS ES+ m/z 356.2 [M+H]+
[00151]POCl3(27.0mL、292mmol)中のInt−12(5.20g、14.6mmol)とDMAP(179mg、1.46mmol)の撹拌混合物を、90℃で3時間加熱した。混合物を濃縮し、残留POCl3をトルエン(100mL)と共沸除去した。残渣をジクロロメタン(200mL)に再溶解し、氷浴中で冷却し、NaHCO3の10%水溶液(150mL)で中和した。混合物をDCM(100mL)で希釈し、相を分離した。有機層をH2O(50mL)およびNaHCO3の飽和水液(2×50ml)で洗浄し、Na2SO4で乾燥し、濾過し、濃縮した。残渣を、ヘキサン中20〜80%酢酸エチルの勾配を利用するシリカゲルクロマトグラフィーによって精製して、中間体Int−13(2.50g)を得た。
1H NMR (500 MHz, CDCl3)δ(ppm) 9.18 (s, 1 H), 8.77 (s, 1 H), 7.76 (d, 1 H), 7.69 - 7.73 (m, 1 H), 7.30 (m, 1 H), 7.08-7.12 (m, 1 H), 6.89 - 7.01 (m, 2 H), 4.71 (s, 2 H). MS ES+ m/z 374.1 [M+H]+
[00152]化合物I−8
1H NMR (500 MHz, CD3OD)δ(ppm): 9.35 (s, 1 H), 8.32 (s, 1 H), 8.12 (s, 1 H), 7.80 (s, 1 H), 7.25 - 7.30 (m, 1 H), 7.17 - 7.24 (m, 1 H), 6.99 - 7.02 (m, 1 H), 7.02 - 7.07 (m, 1 H), 4.66 (s, 2 H), 4.33 - 4.41 (m, 1 H), 4.03 (dd, 1 H), 3.76 (dd, 1 H). MS ES+ m/z = 467.2
[00154]中間体15:2−(8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン−6−イル)ピリミジン−4−オール(Int 15)
MS ES+ m/z 322.1 [M+H]+
[00156]中間体Int−14(350mg、1.09mmol)およびPOCl3(2.00mL、21.8mmol)の混合物を90℃で3時間撹拌し、その時点でLCMSは完全な転化を示した。POCl3を減圧除去し、得られた残渣を重炭酸ナトリウム飽和水溶液(25mL)とジクロロメタン(50mL)に分配した。水層をジクロロメタン(2×25mL)で抽出し、合わせた有機抽出物を乾燥し(MgSO4)、濾過し、減圧濃縮して、粗製Int−15(380mg、収率103%)を得た。これを精製せずに次の段階で使用した。
MS ES+ m/z 340.1 [M+H]+
[00157]化合物I−9
1H NMR (500 MHz, CD3OD)δ(ppm) 9.58 (br s, 1 H), 8.26 (s, 2 H), 8.21 (s, 1 H), 7.87 (s, 1 H), 7.18 - 7.30 (m, 2 H), 7.04 - 7.08 (m, 1 H), 7.00 - 7.04 (m, 1 H), 4.67 (s, 2 H), 3.81 (br s, 4 H). MS ES+ m/z 366.1 [M+H]+ (第2のプロトン化が観察された).
[00159]中間体16:8−(3,5−ジフルオロ−4−メチルベンジル)イミダゾ[1,2−a]ピラジン−6−カルボニトリル(Int−16)
MS ES+ m/z = 285.2 [M+H]+.
[00161]中間体−19:6−(4,5−ジクロロピリミジン−2−イル)−8−(3,5−ジフルオロ−4−メチルベンジル)イミダゾ[1,2−a]ピラジン(Int−19)
MS ES+ m/z = 302.2 [M+H]+.
[00163] 中間体Int−19は、8−(2−フルオロベンジル)イミダゾ[1,2−a]ピラジン−6−カルボキシイミドアミドからInt−13を調製する手順に記載した通りに、Int−17から調製した。
1H NMR (500 MHz, CD3OD)δ(ppm): 9.88 (s, 1 H), 8.79-8.90 (m, 1 H), 8.58 (d, 1 H), 8.36 (d, 1 H), 7.06-7.20 (m, 2 H), 4.71 (s, 2 H), 2.15 (s, 3 H). MS ES+ m/z 406.1 [M+H]+
[00164]化合物I−10
1H NMR (500 MHz, CD3OD)δ(ppm): 9.38 (s, 1 H), 8.41 (s, 1 H), 8.14 (s, 1 H), 7.86 (s, 1 H), 7.23 (d, 2 H), 4.49 (s, 2 H), 4.17 (s, 2 H), 2.08 (s, 3 H). MS ES+ m/z 567.2 [M+H]+
[00166]中間体−21:6−(4−クロロ−5−メトキシピリミジン−2−イル)−8−(2−フルオロベンジル)−[1,2,4]トリアゾロ[1,5−a]ピラジン(Int−21)
MS ES+ m/z 174.0 [M+H]+
[00168]無水エタノール(1.5mL)中の中間体Int−8(170mg、0.629mmol)、Int−20a(327mg、1.89mmol)およびDBU(0.285mL、1.89mmol)の溶液を90℃で1時間加熱した後、LC−MS分析は転化が完了したことを示した。室温に冷却した後、反応混合物を、2.5MのHClエタノール溶液でpH2〜3に酸性化して、微細な沈殿物の形成をもたらした。固体を収集し、乾燥して、中間体Int−20(109mg、収率49%)を褐色固体として得た。
1H NMR (500 MHz, DMSO-d6)δ(ppm): 12.30 (br s, 1 H), 9.55 (s, 1 H), 8.82 (s, 1 H), 7.73 (s, 1 H), 7.48 - 7.52 (m, 1 H), 7.26 - 7.34 (m, 1 H), 7.18 - 7.24 (m, 1 H), 7.11 - 7.14 (m, 1 H), 4.63 (s, 2 H), 3.83 (s, 3 H). MS ES+ m/z 353.1 [M+H]+
[00169]POCl3(574μL、6.16mmol)中の中間体Int−20(108.5mg、0.308mmol)の混合物を90℃に1時間加熱し、この時点でLC−MS分析は転化が完了したことを示した。反応混合物を室温に冷却した後、POCl3を減圧除去し、得られた残渣を氷水に懸濁させ、飽和重炭酸ナトリウム溶液で中和した。水性混合物を5:1ジクロロメタン:イソプロパノール(3×20mL)で抽出し、乾燥し(硫酸ナトリウム)、濾過し、濃縮して、中間体Int−21(94.9mg、収率83%)を褐色固体として得た。この材料を精製せずに次の段階で使用した。
MS ES+ m/z 371.1 [M+H]+
[00170]化合物I−11
1H NMR: (500 MHz, CD3OD),δ(ppm): 9.63 (s, 1 H), 8.61 (s, 1 H), 7.74 (s, 1 H), 7.30 - 7.33 (m, 1 H), 7.15 - 7.20 (m, 1 H), 6.97 - 7.01 (m, 2 H, 重複シフト), 4.67 (s, 2 H), 4.28 - 4.32 (m, 1 H), 3.98 - 4.02 (m, 4 H, 重複シフト), 3.86 - 3.91 (m, 1 H). MS ES+ m/z 464.2 [M+H]+
[00172]中間体−23:4−クロロ−2−(8−(2−フルオロベンジル)−[1,2,4]トリアゾロ[1,5−a]ピラジン−6−イル)ピリミジン−5−カルボニトリル(Int−23)
1H NMR (Int-22a): (500 MHz, DMSO-d6),δ(ppm): 13.43 (br. s, 1 H), 9.78 (s, 1 H), 8.88 (s, 1 H), 8.80 (br. s, 1H), 7.44 - 7.53 (br. m, 1 H), 7.28 - 7.32 (m, 1 H), 7.19 - 7.22 (m, 1 H), 7.09 - 7.12 (m, 1 H), 4.64 (s, 2 H). MS ES+m/z 348.1 [M+H]+
[00174]Int‐22aの懸濁液(211mg、0.608mmol)を、POCl3(1.42mL、15.2mmol)中、80℃で加熱した。3時間後、LC−MS分析は転化が完了したことを示した。反応物を濃縮乾固して、粗製Int−23(331mg)を褐色固体として得た。
1H NMR: (500 MHz, DMSO-d6),δ(ppm): 9.84 (s, 1 H), 9.49 (s, 1 H), 8.88 (s, 1H), 7.40 - 7.43 (m, 1 H), 7.28 - 7.33 (m, 1 H), 7.18 - 7.21 (m, 1 H), 7.11 - 7.14 (m, 1 H), 4.67 (s, 2 H). MS ES+ m/z 366.1 [M+H]+
[00175]化合物I−12
1H NMR: (500 MHz, DMSO-d6),δ(ppm): 9.71 (s, 1 H), 8.94 (s, 1 H), 8.85 (s, 1 H), 8.62 (br. s, 1 H), 8.19 (s, 1 H), 7.46 - 7.49 (m, 1 H), 7.26 - 7.30 (m, 1 H), 7.15 - 7.18 (m, 1 H), 7.07 - 7.10 (m, 1 H), 4.61 (s, 2 H), 4.23 - 4.26 (m, 2 H). MS ES-m/z 525.4 [M-H]-
[00177]中間体24:8−(チオフェン−3−イルメチル)イミダゾ[1,2−a]ピラジン−6−カルボニトリル(Int−24)
Int-24a: MS ES+ m/z 295.9 [M+H]+. Int-24: MS ES+ m/z 241.0 [M+H]+.
[00179]中間体−26:6−(4−クロロ−5−フルオロピリミジン−2−イル)−8−(チオフェン−3−イルメチル)イミダゾ[1,2−a]ピラジン(Int−26)
Int 25a: MS ES+ m/z 258.0 [M+H]+. Int 25: 1H NMR: (500 MHz, DMSO-d6),δ(ppm): 12.82 (br s, 1 H), 9.46 (br s, 1 H), 8.30 (s, 1 H), 8.22 (br s, 1 H), 7.90 (s, 1 H), 7.43 - 7.46 (m, 2 H, 重複シフト), 7.30 (br s, 1 H), 4.54 (s, 2 H). MS ES+ m/z 328.0 [M+H]+. Int 26: MS ES+m/z 346.0 [M+H]+
[00181]化合物I−13
1H NMR: (500 MHz, DMSO-d6),δ(ppm): 9.57 (s, 1 H), 9.42 (s, 1 H), 8.48 - 8.51 (m, 2 H, 重複シフト), 8.28 (s, 1 H), 7.87 (s, 1 H), 7.42 (br s, 1 H), 7.38 (br s, 1 H), 7.26 - 7.27 (m, 1 H), 4.42 (s, 2 H), 4.08 - 4.09 (m, 2 H). MS ES+m/z 507.1 [M+H]+
[00183]中間体−27:8−((2−メチルピリミジン−5−イル)メチル)イミダゾ[1,2−a]ピラジン−6−カルボニトリル(Int−27)
[00188]化合物I−14
[00190]化合物I−15
[00191]プロドラッグI−1の二ナトリウム塩は、NaOMeを使用し、実験的なJ.Med.Chem.2008,51,1111−1114に記載の手順に従って調製した。
1H NMR (500 MHz, CDCl3)δppm 9.52 (s, 1 H), 8.56 (s, 1 H), 8.26 (s, 1 H), 7.64 (app. t, 1 H), 7.20 - 7.25 (m, 2 H), 7.02 - 7.14 (m, 2 H), 4.77 (s, 2 H), 4.22 - 4.28 (m, 2 H) [CDCl3との交換により2つの酸性プロトンは観察されない]. 化合物 I-16: MS ES+ m/z 495.1 [M+H]+.
実施例2:384ウェル形式のcGMP GloSensor細胞ベースのアッセイによる生物学的活性測定
[00194]GloSensorTM 40F cGMP(品番:CS182801、Promega)を発現するヒト胎児腎細胞(HEK293)細胞を用いて、試験化合物の活性を評価した。これらの細胞に組み込まれた発光性バイオセンサー(人工的ルシフェラーゼ)は、sGC酵素を刺激する化合物によって形成されるcGMPを検出し、ルミネセンスを放出する。
実施例3:Sprague−Dawleyラットにおける血圧変化
[00198]雄ラット(体重250〜350g、Harlan Laboratoriesより供給)をケタミン/キシラジンで麻酔し、ヘパリン化生理食塩水を充填したカテーテルを右大腿動脈に埋め込んだ。カテーテルを肩甲骨の間で体外に出し、キャップをし、動物をそのまま手術後少なくとも7日間回復させてから、任意の化合物の試験を行った。試験前に、動物を、12時間の明暗サイクル下で、飲料水に自由にアクセスさせ、通常の食餌で維持した。
Claims (61)
- 式Iの化合物、または医薬的に許容しうるその塩
Yは、独立して、NまたはCであり;
環Bは、フェニル、またはN、OおよびSから独立して選択される1もしくは2個の環ヘテロ原子を含有する5もしくは6員ヘテロアリール環であり;
nは、0〜3から選択される整数であり;各JBは、独立して、ハロゲン、−CN、C1−6脂肪族基または−ORBであり;
これに関し、C1−6脂肪族基である各JBは、独立して、最大3つの事例のR3で置換されていてもよく;
各RBは、独立して、水素またはC1−6脂肪族基であり;前記RBは、独立して、最大3つの事例のR3aで置換されていてもよく;
各R3およびR3aは、各事例において、独立して、ハロゲン、−CN、C1−4アルキル、C1−4ハロアルキル、−O(C1−4アルキル)または−O(C1−4ハロアルキル)であり;
Zは、水素、−P(O)(OH)2、−P(O)(OH)O−M+、−P(O)(O−)2(M+)2、−P(O)(O−)2D2+および−P(O)(O−ベンジル)2からなる群より選択され;これに関し、M+は、医薬的に許容しうる一価のカチオンであり、D2+は、医薬的に許容しうる二価のカチオンであり;
mは0または1であり;
R1は、C1−4アルキル、C1−4フルオロアルキル、−C(O)NH2または水素であり;そして
R2は、C1−4アルキル、C1−4フルオロアルキルまたは水素であり;
R4の両方の事例は同時に水素であるか、R4の両方の事例は、それらが付着している炭素原子と一緒になって、カルボニル基を形成し;
JDは、水素、ハロゲン、メトキシまたは−CNであり
pは、1または2であり;そして
各JCは、独立して、水素、ハロゲン、C1−4脂肪族基、C1−4アルコキシまたは−CNであり;これに関し、各前記C1−4脂肪族基および各前記C1−4アルコキシは、独立して、C1−4アルコキシ、C1−4ハロアルコキシ、−OHまたはハロゲンの最大3つの事例によって置換されていてもよい]。 - 環Bが、フェニル、または1もしくは2個の環窒素原子を含有する5もしくは6員ヘテロアリール環である、請求項1に記載の化合物。
- JDが、水素、クロロ、フルオロ、メトキシまたは−CNである、請求項1〜7のいずれか一項に記載の化合物。
- JDがメトキシである、請求項8に記載の化合物。
- JDが、水素、クロロ、フルオロまたは−CNである、請求項1〜7のいずれか一項に記載の化合物。
- JDが、水素、クロロまたはフルオロである、請求項10に記載の化合物。
- JDがフルオロまたは水素である、請求項10に記載の化合物。
- JDが水素である、請求項10に記載の化合物。
- JDがフルオロである、請求項10に記載の化合物。
- JDが−CNである、請求項10に記載の化合物。
- JDがクロロである、請求項10に記載の化合物。
- 各JCが、独立して、水素、C1−2アルキル、C1−2アルコキシ、C1−2フルオロアルキル、C1−2フルオロアルコキシ、ハロゲンまたは−CNであり、各前記C1−2アルキルおよびC1−2アルコキシが、独立して、C1−4アルコキシ、C1−4ハロアルコキシ、−OHまたはハロゲンの最大3つの事例によって置換されていてもよい、請求項1〜16のいずれか一項に記載の化合物。
- 各JCが、独立して、水素、C1−2アルキル、C1−2アルコキシ、C1−2フルオロアルキル、C1−2フルオロアルコキシ、ハロゲンまたは−CNである、請求項17に記載の化合物。
- 各JCが、独立して、水素またはハロゲンである、請求項18に記載の化合物。
- JCが水素である、請求項18に記載の化合物。
- 各JCが、独立して、フルオロまたはクロロである、請求項18に記載の化合物。
- 環Bがフェニルである、請求項1〜29のいずれか一項に記載の化合物。
- 環Bが、N、OおよびSから独立して選択される1または2個の環ヘテロ原子を含有する5または6員ヘテロアリール環である、請求項1〜29のいずれか一項に記載の化合物。
- 環Bが、1〜2個の環窒素原子を含有する6員ヘテロアリール環である、請求項31に記載の化合物。
- nが1、2または3であり、各JBが、独立して、ハロゲンまたはC1−6脂肪族基である、請求項1〜32のいずれか一項に記載の化合物。
- nが1または2であり、各JBが、独立して、ハロゲンまたはC1−6脂肪族基である、請求項30に記載の化合物。
- nが1または2であり、各JBがフルオロである、請求項34に記載の化合物。
- nが1であり、JBがフルオロである、請求項35に記載の化合物。
- R1が、C1−2アルキル、C1−2フルオロアルキル、水素または−C(O)NH2である、請求項1〜40のいずれか一項に記載の化合物。
- R1が、C1−2フルオルキルまたは−C(O)NH2である、請求項1〜41のいずれか一項に記載の化合物。
- R2が、C1−2フルオロアルキル、C1−2アルキルまたは水素である、請求項1〜42のいずれか一項に記載の化合物。
- R2がC1−2フルオロアルキルである、請求項1〜42のいずれか一項に記載の化合物。
- R1がトリフルオロメチルまたは−C(O)NH2であり、R2がトリフルオロメチルである、請求項42または請求項44に記載の化合物。
- R1およびR2が両方とも水素またはC1−2アルキルであり;または、R1およびR2の一方が水素であり、他方がC1−2フルオロアルキルである、請求項1〜41のいずれか一項に記載の化合物。
- R1およびR2が両方とも水素である、請求項46に記載の化合物。
- R1およびR2が両方ともメチルである、請求項46に記載の化合物。
- R1およびR2の一方が水素であり、他方がトリフルオロメチルである、請求項46に記載の化合物。
- JDがフルオロである、請求項50に記載の化合物。
- JDがフルオロである、請求項52に記載の化合物。
- Zが−P(O)(OH)2である、請求項1〜53のいずれか一項に記載の化合物。
- Zが−P(O)(OH)O−M+または−P(O)(O−)2(M+)であり;M+が、Na+、K+または有機アミンの一価カチオンである、請求項1〜53のいずれか一項に記載の化合物。
- M+がNa+である、請求項55に記載の化合物。
- Zが−P(O)(O−)2D2+であり;D2+が、Ca2+、Cs2+、Zn2+、Mg2+または有機アミンの二価カチオンである、請求項1〜53のいずれか一項に記載の化合物。
- 表Iに示したものから選択される、請求項1に記載の化合物。
- 請求項1〜58のいずれか一項に記載の化合物と、少なくとも1つの医薬的に許容しうる賦形剤またはキャリヤーとを含む医薬組成物。
- 処置を必要とする被験対象における疾患、健康状態または障害の処置方法であって、治療的有効量の請求項1〜58のいずれか一項に記載の化合物または請求項59に記載の医薬組成物を、処置を必要とする被験対象に投与することを含み、疾患、健康状態または障害が以下から選択される、前記方法:
無ベータリポタンパク血症、アカラシア、食道アカラシア、急性呼吸窮迫症候群(ARDS)、癒着性関節包炎、加齢性学習および記憶障害、加齢性記憶喪失、アルコール依存症、脱毛症または抜け毛、高山病、アルツハイマー病、アルツハイマー病前、軽度から中等度のアルツハイマー病および中等度から重度のアルツハイマー病、筋萎縮性側索硬化症(ALSまたはルー・ゲーリック病)、肛門裂肛、動脈瘤、狭心症、安定または不安定狭心症、異型狭心症、プリンツメタル狭心症、微小血管狭心症、不安または不安障害、アルギノコハク酸尿症、動脈および静脈血栓症、関節炎、アスペルガー症候群、喘息および喘息性疾患 運動失調、毛細血管拡張症、アテローム性動脈硬化、内皮損傷、血小板および単球の付着および凝集、平滑筋増殖または遊走に付随するアテローム性動脈硬化症、萎縮性腟炎、注意欠陥障害(ADD)および注意欠陥多動性障害(ADHD)、自閉症および自閉症スペクトラムにおける障害、良性前立腺過形成(BPH)または前立腺肥大または前立腺拡大、双極性障害、膀胱出口閉塞、膀胱痛症候群(BPS)、眼瞼炎、骨および炭水化物代謝障害、骨治癒、破骨細胞性骨リモデリング、破骨細胞性骨吸収、骨新生に続く骨治癒、脳動脈瘤、脳低酸素症、がん転移、脳アミロイド血管症(CAA)またはコンゴレッド親和性血管障害、皮質下梗塞および白質脳症を伴う常染色体優性脳動脈症(CADASILまたはCADASIL症候群)、脳潅流、脳小血管疾患、脳血管痙攣、ケモブレイン、小児期崩壊性障害、慢性気管支炎、慢性疲労、慢性外傷性脳症(CTE)、硬変症、肝硬変、慢性肝疾患に付随する肝硬変、原発性胆汁性肝硬変、CNS疾患に関連する性的機能不全、CNS疾患に関連する睡眠障害、ハンチントン病に付随する認知障害、認知機能不全、認知障害、血管性認知障害、軽度認知障害、糖尿病に付随する認知障害、多発性硬化症に付随する認知障害、閉塞性睡眠時無呼吸に付随する認知障害、統合失調症(CIAS)に付随する認知障害、鎌状赤血球症に付随する認知障害、震とう症、先天性筋無力症候群、結合組織病、脳梗塞(脳卒中)の予後、外傷患者における代用血液の保存、CREST症候群、クローン病、嚢胞性線維症(CF)、妄想性障害、認知症、血管性認知症、脳卒中後認知症、レビー小体型認知症、前頭葉変性症を伴う認知症、前頭側頭葉変性症を伴う認知症、大脳皮質基底核変性症を伴う認知症、クロイツフェルト−ヤコブ認知症、HIV認知症、多発梗塞性認知症、術後認知症 戦略的部位の単発梗塞による認知症、HIV関連認知症、無症候性神経認知障害(ANI)、軽度神経認知障害(MND)、HIV関連認知症(HAD、AIDS認知症症候群[ADC]またはHIV脳症ともよばれる)、初老期認知症(軽度認知障害、MCI)、混合型認知症、ビンスワンガー型認知症(皮質下動脈硬化性脳症)、パーキンソン認知症、脱髄、うつ病、抑うつ性障害、皮膚筋炎、糖尿病性血管症、糖尿病性黄斑浮腫、糖尿病性微小血管症、糖尿病性潰瘍または創傷、糖尿病性足潰瘍、メタボリックシンドロームに付随または関連する疾患、肥満、糖尿病、インスリン抵抗性、空腹時グルコースの上昇、空腹時インスリンの上昇、脂質の上昇、ダウンレギュレートされた神経伝達物質が関与する疾患、脳血流の障害が関与する疾患、神経変性の障害が関与する疾患、シナプス機能の障害が関与する疾患、神経炎症が関与する疾患、神経毒性が関与する疾患、男性および女性の泌尿生殖器系の臓器の疾患(良性および悪性)、学習および記憶障害を伴う小児の集中力障害、ダウン症、薬物依存症、薬物誘発性精神病、ドライアイ症候群、デュシェンヌ型筋ジストロフィー、デュプイトラン拘縮、ジスキネジー、急性ジスキネジー、慢性または遅発性ジスキネジー、非運動性ジスキネジー、レボドパ誘発性ジスキネジー(LID)、月経困難症、原発性月経困難症、続発性月経困難症、性交疼痛症、嚥下困難、ジストニア、全身性ジストニア、限局性ジストニア、分節性ジストニア、性的ジストニア、中間型ジストニア、急性ジストニア反応、遺伝性または原発性ジストニア、浮腫、電解質障害、高カルシウム血症、低ナトリウム血症、気腫、子宮内膜症、内皮機能不全または損傷および内皮機能不全に付随する疾患、勃起障害、食道アカラシア、ファブリー病、女性の性的機能障害、女性の性的興奮機能障害、線維筋痛、線維症、心内膜心筋線維症、心房性線維症、心間質線維症、心線維症、肺線維症、眼線維症、皮膚線維症、腸線維症、腎性または腎線維症、間質性腎線維症、肺線維症、特発性肺線維症、肺の進行性塊状線維症、肝線維症、縦隔線維症、後腹膜線維症、関節線維症、骨髄線維症、骨髄線維化、骨骨髄線維症、放射線誘発性線維症、膵線維症、脆弱X、機能性消化不良、胃不全麻痺、ゴーシェ病、一般的集中力障害、一般的精神病、緑内障、グリア芽種、糸球体症、糸球体腎炎、急性糸球体腎炎、糸球体硬化症、巣状分節状糸球体硬化症、肉芽腫、頭部外傷、聴覚障害、部分的聴力損失、全聴力損失、部分的聴覚消失、全聴覚消失、騒音性聴力損失、心疾患、左心室心筋リモデリング、左心室収縮機能不全、虚血性心筋症、拡張型心筋症、アルコール性心筋症、貯蔵心筋症、先天性心欠陥、冠血流低下、拡張期または収縮期機能不全、冠血流不全、急性冠血流不全症候群、冠動脈疾患、不整脈、心室前負荷の軽減、心肥大、右心肥大、心房および心室の調律障害および心伝導障害、I〜III度の房室ブロック(AVB I〜III)、上室性頻拍性不整脈、心室性早期収縮、心房細動、心房粗動、心室細動、心室粗動、心室性頻拍性不整脈、トルサード・ド・ポアント頻拍、心房および心室の期外収縮、房室接合部期外収縮、洞不全症候群、房室結節リエントリー性頻拍、Wolff−Parkinson−White症候群、心筋不全、慢性、急性またはウイルス性心筋炎、心原性ショック、心臓リモデリング、
心不全(HF)、駆出率が保持されている心不全(HFpEF)、駆出率が低下した心不全(HFrEF)、急性心不全、慢性心不全、既存の慢性心不全の急性期(HFの悪化)、一過性心不全、急性後心不全、収縮期心不全、拡張期心不全、うっ血性心不全、急性非代償性心不全、右心室不全、全心不全、高拍出性心不全、弁膜欠損を伴う心不全、糖尿病性心不全、心不全/心腎症候群、右心不全、高濃度のプラスミノーゲン活性化因子阻害薬1(PA−1)、高レベルのフィブリノーゲンおよび低密度DLD、ヒスチオサイトーシスX、ハンチントン病または舞踏病(HD)、高アンモニア血症および関連するもの、高血圧、動脈性高血圧、抵抗性高血圧、糖尿病性高血圧、特発性高血圧、本態性高血圧、二次性高血圧、妊娠性高血圧、門脈圧亢進症、全身性高血圧、子癇前症、急性および慢性の冠血流圧上昇、筋緊張亢進、肥厚性瘢痕、性的興奮低下障害、低潅流、インポテンス、炎症性腸疾患、クローン病、潰瘍性大腸炎、脳マラリアに起因する炎症、感染性疾患に起因する炎症、周術期ケアにおける炎症反応、血小板凝集、知的障害、間欠性跛行、間質性膀胱炎(IC)、透析中の低血圧、虚血、脳虚血、心筋虚血、血栓塞栓性虚血、重篤な四肢虚血、ケロイド、腎疾患、慢性腎疾患、急性および慢性腎機能不全、急性および慢性腎不全、腎不全の後遺症、肺水腫に関連する腎不全、HFに関連する腎不全、尿毒症または貧血症に関連する腎不全、原発性腎疾患、先天性腎疾患、多嚢胞腎疾患の進行、腎移植片拒絶反応、免疫複合体誘発性腎疾患、クレアチニンおよび/または水分排泄の異常な減少、尿素、窒素、カリウムおよび/またはクレアチニンの血中濃度の異常な上昇、腎酵素の活性変化、グルタミルシンテターゼの活性変化、尿の容積モル浸透圧濃度および尿量の変化、微量アルブミン尿の増加、マクロアルブミン尿、糸球体および細動脈の病変、尿細管拡張、高リン酸血症、血管性腎疾患、腎嚢胞、HFによる腎浮腫、コルサコフ精神病、白血球活性化、レボドパ誘発性の常習的挙動、硬化性苔癬、脂質関連障害、過剰な脂肪蓄積、過剰な皮下脂肪、高脂血症、脂質異常症、高コレステロール血症、高密度リポタンパク質コレステロール(HDL−コレステロール)の低下、低密度リポタンパク質コレステロール(LDL−コレステロール)レベルの中程度の上昇、高トリグリセリド血症、高グリセリド血症、低リポタンパク血症、シトステロール血症、脂肪肝疾患、肝脂肪変性または肝臓における異常な脂質蓄積、心臓、腎臓または筋肉の脂肪変性、シトステロール血症、黄色腫症、タンジール病)、肝疾患、血管性肝疾患、肝星細胞活性化、肝線維性コラーゲンおよび全コラーゲン蓄積、壊死炎症性および/または免疫性の肝疾患、肉芽腫性肝疾患に付随する胆汁うっ滞性肝疾患、肝悪性腫瘍に付随する胆汁うっ滞性肝疾患、妊娠の肝内胆汁うっ滞に付随する胆汁うっ滞性肝疾患、肝炎に付随する胆汁うっ滞性肝疾患、敗血症に付随する胆汁うっ滞性肝疾患、薬物または毒素に付随する胆汁うっ滞性肝疾患、移植片対宿主病に付随する胆汁うっ滞性肝疾患、肝移植後に付随する胆汁うっ滞性肝疾患、総胆管結石症に付随する胆汁うっ滞性肝疾患、胆管腫瘍に付随する胆汁うっ滞性肝疾患、膵癌に付随する胆汁うっ滞性肝疾患、ミリッチ症候群に付随する胆汁うっ滞性肝疾患、AIDSに付随する胆汁うっ滞性肝疾患、胆管症、寄生虫に付随する胆汁うっ滞性肝疾患、住血吸虫症に付随する胆汁うっ滞性肝疾患、肝炎 非アルコール性脂肪肝炎(NASH)、非アルコール性脂肪肝疾患(NAFLD)、肝血管閉塞性疾患(VOD)、肝性脳症)、限局性血栓症、下部尿路症候群(LUTS)、腰部脊柱管狭窄症、ループス腎炎、エリテマトーデスまたは全身性エリテマトーデス、微量アルブミン尿症、微小循環異常、片頭痛、軽度の神経認知障害(MND)、限局性強皮症、モヤモヤ病、多発性ラクナ梗塞、多臓器不全症候群(MODS)、多臓器障害(MOF)、多発性硬化症(MS、臨床的に単独の症候群(CIS)、再発寛解型MS(RRMS)、一次進行型MS(SPMS)、二次進行型MS(SPMS)、多系統萎縮症(MSA)、心筋梗塞または心臓発作、ST上昇型心筋梗塞、非ST上昇型心筋梗塞、陳旧性心筋梗塞、近視性脈絡膜新血管形成、母斑、麻薬依存症、腎症、糖尿病性腎症、非糖尿病性腎炎、腎炎、毒素誘発性腎症、造影剤誘発性腎症、糖尿病性または非糖尿病性腎硬化症、ネフローゼ症候群、腎盂腎炎、腎性線維症、神経変性疾患、神経因性膀胱および失禁、神経炎症、一酸化窒素産生の低減に付随する神経障害、神経筋疾患、デュシェンヌ型筋ジストロフィー(DMD)、ベッカー型筋ジストロフィー(BMD)、肢帯型筋ジストロフィー、末梢性ミオパシー、I型およびII型筋強直性ジストロフィー、顔面−肩甲−腓骨筋ジストロフィー、常染色体性およびX連鎖性のエメリ・ドレフュス型筋ジストロフィー、眼球咽頭型筋ジストロフィー、筋萎縮性側索硬化症、棘筋萎縮症(SMA)、視神経脊髄炎、神経障害、末梢神経障害、自律神経障害、中枢神経系神経障害、化学療法誘発性神経障害、糖尿病性神経障害、有痛性神経障害、神経障害痛、非有痛性神経障害、有痛性糖尿病性神経障害、非有痛性糖尿病性神経障害、CNS疾患に付随する神経障害、多発性硬化症(MS)、帯状疱疹に付随する神経障害痛、脊椎手術に付随する神経障害痛、強迫性障害(OCD)、閉塞性血栓血管炎、閉塞性尿路疾患、好酸球性筋膜炎、骨粗鬆症、過活動膀胱、疼痛、急性疼痛、中枢性疼痛症候群、炎症性疼痛、術後疼痛、持続性疼痛、内臓痛、跛行痛、オーファン性疼痛の適応、アセタゾラミド応答性ミオトニー、自己赤血球感作症候群、常染色体優性シャルコー・マリー・トゥース病 タイプ2V、神経障害痛を伴う常染色体優性中間型シャルコー・マリー・トゥース病、常染色体劣性肢帯筋ジストロフィー タイプ2A、チャネロパチーが関連する先天性無痛症、髄腔内無痛を要する慢性疼痛、複合性局所疼痛症候群、複合性局所疼痛症候群タイプ1、複合性局所疼痛症候群タイプ2、発汗過多を伴う先天性無痛症、重度の知的障害を伴う先天性無痛症、先天性無痛症−発汗減少症候群、有痛性のひび割れを伴うびまん性掌蹠角皮症、家族性偶発性疼痛症候群、主に下肢が関与する家族性偶発性疼痛症候群、主に上半身が関与する家族性偶発性疼痛症候群、遺伝性有痛性胼胝、遺伝性の感覚性および自律性神経障害 タイプ4、遺伝性の感覚性および自律性神経障害 タイプ5、遺伝性の感覚性および自律性神経障害 タイプ7、間質性膀胱炎、有痛性の眼窩および全身性神経線維腫−マルファン様体質症候群、発作性激痛性障害、持続性特発性顔面痛、カルパインの質的または量的欠乏、トローザ・ハント症候群、膵炎、パニック障害、パーキンソン病、パーキンソニズム・プラス、パーキンソン嚥下障害、病的摂食障害、骨盤痛、末梢血管疾患、末梢動脈疾患、末梢動脈閉塞性疾患、末梢塞栓症、末梢血流障害、腹膜炎、広汎性発達障害、ペイロニー病、ピック症候群、多発性軟骨炎、多発性筋炎、ヘルペス後神経痛、外傷後頭部損傷、外傷後ストレス障害(PTSD)、早漏、進行性核麻痺、前立腺肥大、肺疾患、多因性肺動脈症、気管支収縮または肺気管支収縮、肺の血管疾患、慢性閉塞性肺疾患(COPD)、肺毛細血管腫症、リンパ管腫症および圧迫された肺血管、これは、アデノパシー、腫瘍または線維化性縦隔炎による、肺血管リモデリング、肺筋緊張亢進)、肺高血圧(PH)、肺動脈高血圧(PAH)、原発性PH、続発性PH、芽胞性PH、前毛細血管性PH、特発性PH、左心室疾患に付随するPH、HIVに付随するPH、SCDに付随するPH、血栓塞栓症に付随するPH(慢性血栓塞栓性PHまたはCTEPH)、サルコイドーシスに付随するPH、慢性閉塞性肺疾患に付随するPH、急性呼吸窮迫症候群(ARDS)に付随するPH、急性肺傷害に付随するPH、アルファ−1−アンチトリプシン欠乏症(AATD)に付随するPH、肺気腫に付随するPH、喫煙誘発性気腫、肺疾患に付随するPH、低酸素血症に付随するPH、強皮症に付随するPH、嚢胞性線維症(CF)に付随するPH、左心室機能不全に付随するPH、低酸素血症に付随するPH、PH(WHO群I、II、III、IVおよびV)、僧帽弁疾患に付随するPH、心膜炎に付随するPH、収縮性心膜炎に付随するPH、大動脈弁狭窄症に付随するPH、拡張型心筋症に付随するPH、肥大型心筋症に付随するPH、拘束型心筋症に付随するPH、縦隔線維症に付随するPH、肺線維症に付随するPH、異常な肺静脈ドレナージに付随するPH、肺静脈閉塞性疾患に付随するPH、肺血管炎に付随するPH、膠原血管病に付随するPH、先天性心疾患に付随するPH、肺静脈高血圧に付随するPH、間質性肺疾患に付随するPH、睡眠呼吸障害に付随するPH、慢性気流閉塞に付随するPH、閉塞型睡眠時無呼吸に付随するPH、中枢性睡眠時無呼吸に付随するPH、混合型睡眠時無呼吸に付随するPH、肺胞低換気障害に付随するPH、慢性的高地暴露に付随するPH、新生児肺疾患に付随するPH、肺胞毛細血管異形成に付随するPH、鎌状赤血球症に付随するPH、他の凝固障害に付随するPH、慢性血栓塞栓症に付随するPH、神経根障害、レイノー病、レイノー症候群(原発性また二次性)、難治性てんかん、レンペニング症候群、再潅流傷害、虚血−再潅流損傷、臓器移植に付随する虚血−再潅流、再狭窄、血栓溶解療法後、経皮経腔的血管形成術(PTA)後、経腔的冠動脈血管形成術(PTCA)後、心移植後、またはバイパス手術後に発現する再狭窄、網膜症、糖尿病性網膜症、非糖尿病性網膜症、非増殖性糖尿病性網膜症、増殖性硝子体網膜症、末梢網膜変性、網膜静脈閉塞症、レット障害、リウマチ様またはリウマチ性疾患、関節炎、関節リウマチ、サルコイドーシス、サルコイド、住血吸虫症、統合失調感情障害、統合失調症、認知症を伴う統合失調症、強皮症、局在性強皮症または限局性強皮症、全身性強皮症、硬化症、腎硬化症、進行性硬化症、肝硬化症、原発性硬化性胆管炎、胃腸管の硬化症、海馬硬化症、巣状硬化症、原発性側索硬化症、骨硬化症、耳硬化症、アテローム性動脈硬化症、結節性硬化症、全身性硬化症、敗血症または敗血症性ショックまたはアナフィラキシーショック、鎌状赤血球貧血、鎌状赤血球病、シェーグレン症候群、睡眠覚醒障害、スネドン症候群、痙攣、冠動脈痙攣、血管痙攣、末梢動脈の痙攣、脊髄損傷、脊髄性筋萎縮症、脊髄亜脱臼、脊髄小脳性運動失調、スティール・リチャードソン・オルゼウスキー疾患(進行性核上性麻痺)、脳卒中、くも膜下出血、皮質下動脈硬化性脳症、失神、タウオパチー、緊張、視床変性、血栓塞栓性または血栓形成性障害、一過性脳虚血発作(TIA)、外傷性脳損傷、尿細管間質性疾患、潰瘍、子宮筋腫、腟萎縮、弁欠損、僧帽弁狭窄、僧帽弁の逆流、閉鎖不全または機能不全、大動脈弁狭窄、大動脈弁閉鎖不全、三尖弁閉鎖不全、肺動脈弁狭窄、肺動脈弁閉鎖不全、連合弁欠損、脳の血管疾患 心臓および腎臓の合併症に起因する血管障害、血管の漏出または透過性、血管炎、血栓性血管炎、閉塞性血栓性血管炎、川崎病、動脈炎、大動脈炎、血管閉塞性クリーゼ、静脈グラフト不全、湿性加齢性黄斑変性およびウィリアムズ症候群。 - さらに、有効量の追加的な適した治療薬を被験対象に投与することを含む、請求項60に記載の方法。
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AU2018388629B2 (en) | 2023-11-16 |
KR20200100696A (ko) | 2020-08-26 |
US20200377508A1 (en) | 2020-12-03 |
CA3086207A1 (en) | 2019-06-27 |
IL275415A (en) | 2020-07-30 |
AU2018388629A1 (en) | 2020-07-30 |
PH12020550956A1 (en) | 2021-03-22 |
MA51305A (fr) | 2020-10-28 |
WO2019126354A1 (en) | 2019-06-27 |
JP7337067B2 (ja) | 2023-09-01 |
SG11202005718PA (en) | 2020-07-29 |
MX2020006433A (es) | 2020-09-17 |
US11897887B2 (en) | 2024-02-13 |
CN111712247A (zh) | 2020-09-25 |
BR112020012629A2 (pt) | 2020-12-01 |
CN111712247B (zh) | 2024-02-09 |
EP3727388A1 (en) | 2020-10-28 |
EA202091502A1 (ru) | 2020-11-12 |
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