US20050119274A1 - Indolylmaleimide derivatives - Google Patents
Indolylmaleimide derivatives Download PDFInfo
- Publication number
- US20050119274A1 US20050119274A1 US10/510,027 US51002704A US2005119274A1 US 20050119274 A1 US20050119274 A1 US 20050119274A1 US 51002704 A US51002704 A US 51002704A US 2005119274 A1 US2005119274 A1 US 2005119274A1
- Authority
- US
- United States
- Prior art keywords
- formula
- methyl
- compound
- piperazin
- inflammatory
- 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.)
- Abandoned
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- QFJCIRLUMZQUOT-HPLJOQBZSA-N sirolimus Chemical compound C1C[C@@H](O)[C@H](OC)C[C@@H]1C[C@@H](C)[C@H]1OC(=O)[C@@H]2CCCCN2C(=O)C(=O)[C@](O)(O2)[C@H](C)CC[C@H]2C[C@H](OC)/C(C)=C/C=C/C=C/[C@@H](C)C[C@@H](C)C(=O)[C@H](OC)[C@H](O)/C(C)=C/[C@@H](C)C(=O)C1 QFJCIRLUMZQUOT-HPLJOQBZSA-N 0.000 description 1
- 239000012312 sodium hydride Substances 0.000 description 1
- 229910000104 sodium hydride Inorganic materials 0.000 description 1
- MFRIHAYPQRLWNB-UHFFFAOYSA-N sodium tert-butoxide Chemical compound [Na+].CC(C)(C)[O-] MFRIHAYPQRLWNB-UHFFFAOYSA-N 0.000 description 1
- 239000007790 solid phase Substances 0.000 description 1
- 125000002345 steroid group Chemical group 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
- 230000000638 stimulation Effects 0.000 description 1
- 238000003756 stirring Methods 0.000 description 1
- 125000001424 substituent group Chemical group 0.000 description 1
- YROXIXLRRCOBKF-UHFFFAOYSA-N sulfonylurea Chemical compound OC(=N)N=S(=O)=O YROXIXLRRCOBKF-UHFFFAOYSA-N 0.000 description 1
- 239000006228 supernatant Substances 0.000 description 1
- 239000000829 suppository Substances 0.000 description 1
- 229960004964 temozolomide Drugs 0.000 description 1
- PVLJDNHSECLKTF-UHFFFAOYSA-N tert-butyl 2-(3-chloroisoquinolin-1-yl)acetate Chemical compound C1=CC=C2C(CC(=O)OC(C)(C)C)=NC(Cl)=CC2=C1 PVLJDNHSECLKTF-UHFFFAOYSA-N 0.000 description 1
- DPKBAXPHAYBPRL-UHFFFAOYSA-M tetrabutylazanium;iodide Chemical compound [I-].CCCC[N+](CCCC)(CCCC)CCCC DPKBAXPHAYBPRL-UHFFFAOYSA-M 0.000 description 1
- YLQBMQCUIZJEEH-UHFFFAOYSA-N tetrahydrofuran Natural products C=1C=COC=1 YLQBMQCUIZJEEH-UHFFFAOYSA-N 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 229960002277 tolazamide Drugs 0.000 description 1
- OUDSBRTVNLOZBN-UHFFFAOYSA-N tolazamide Chemical compound C1=CC(C)=CC=C1S(=O)(=O)NC(=O)NN1CCCCCC1 OUDSBRTVNLOZBN-UHFFFAOYSA-N 0.000 description 1
- 229960005371 tolbutamide Drugs 0.000 description 1
- 238000002054 transplantation Methods 0.000 description 1
- LWIHDJKSTIGBAC-UHFFFAOYSA-K tripotassium phosphate Chemical compound [K+].[K+].[K+].[O-]P([O-])([O-])=O LWIHDJKSTIGBAC-UHFFFAOYSA-K 0.000 description 1
- 229910000404 tripotassium phosphate Inorganic materials 0.000 description 1
- LENZDBCJOHFCAS-UHFFFAOYSA-N tris Chemical compound OCC(N)(CO)CO LENZDBCJOHFCAS-UHFFFAOYSA-N 0.000 description 1
- JLEXUIVKURIPFI-UHFFFAOYSA-N tris phosphate Chemical compound OP(O)(O)=O.OCC(N)(CO)CO JLEXUIVKURIPFI-UHFFFAOYSA-N 0.000 description 1
- COIOYMYWGDAQPM-UHFFFAOYSA-N tris(2-methylphenyl)phosphane Chemical compound CC1=CC=CC=C1P(C=1C(=CC=CC=1)C)C1=CC=CC=C1C COIOYMYWGDAQPM-UHFFFAOYSA-N 0.000 description 1
- 210000001631 vena cava inferior Anatomy 0.000 description 1
- SYOKIDBDQMKNDQ-XWTIBIIYSA-N vildagliptin Chemical class C1C(O)(C2)CC(C3)CC1CC32NCC(=O)N1CCC[C@H]1C#N SYOKIDBDQMKNDQ-XWTIBIIYSA-N 0.000 description 1
- 238000005406 washing Methods 0.000 description 1
- CGTADGCBEXYWNE-JUKNQOCSSA-N zotarolimus Chemical compound N1([C@H]2CC[C@@H](C[C@@H](C)[C@H]3OC(=O)[C@@H]4CCCCN4C(=O)C(=O)[C@@]4(O)[C@H](C)CC[C@H](O4)C[C@@H](/C(C)=C/C=C/C=C/[C@@H](C)C[C@@H](C)C(=O)[C@H](OC)[C@H](O)/C(C)=C/[C@@H](C)C(=O)C3)OC)C[C@H]2OC)C=NN=N1 CGTADGCBEXYWNE-JUKNQOCSSA-N 0.000 description 1
- 229950009819 zotarolimus Drugs 0.000 description 1
Classifications
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- C07D403/14—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group C07D401/00 containing three or more hetero rings
Definitions
- the present invention relates to indolylmaleimide derivatives, process for their production and pharmaceutical compositions containing them.
- the compounds of formula I may exist in free form or in salt form, e.g. addition salts with e.g. organic or inorganic acids, for example, hydrochloric acid, acetic acid, trifluoroacetic acid.
- organic or inorganic acids for example, hydrochloric acid, acetic acid, trifluoroacetic acid.
- the compounds of formula I may exist in the form of optical isomers, racemates or diastereoisomers.
- a ring carbon atom bearing a substituent in the position 3 of the piperazinyl residue is asymmetric and may have the R— or S-configuration.
- the present invention embraces all enantiomers and their mixtures. Enantiomers are preferred over racemates. Similar considerations apply in relation to starting materials exhibiting asymmetric carbon atoms as mentioned.
- Alkyl or alkoxy may be straight or branched.
- Phenyl-C 1-4 alkyl is preferably benzyl or phenethyl.
- the alkoxy moiety is preferably methoxy or ethoxy and the alkyl moiety preferably methyl or ethyl; a suitable example is e.g. 2-methoxyethyl.
- Halogen may be F, Cl, Br or I, preferably F, Cl or Br.
- Halogeno-C 1-4 alkyl is alkyl wherein one or more H are replaced by halogen, e.g. Cl or F, e.g. CH 2 Cl, CH 2 F or CF 3 R is preferably a radical of formula (a), (c) or (e), preferably (e).
- R 2 or R 15 is preferably in para to R 1 or R 14 , respectively.
- R 3 is preferably in meta to R 1 .
- R 9 is preferably 4,7-diaza-spiro[2.5]oct-7-yl; when R 9 is piperazinyl substituted in position 3, it has the R or S configuration.
- the present invention also includes a process for the preparation of a compound of formula I which process comprises reacting a compound of formula II wherein R a and R b are as defined above,
- the process may conveniently be effected in the presence of a strong base, e.g. t-BuOK, e.g. as disclosed in WO02/38561, the contents of which being incorporated herein by reference, and as illustrated in the Examples.
- a strong base e.g. t-BuOK, e.g. as disclosed in WO02/38561, the contents of which being incorporated herein by reference, and as illustrated in the Examples.
- RT room temperature
- THF tetrahydrofuran
- FCC flash column chromatography
- TBAF tetrabutyl ammonium fluoride
- BINAP 2,2′-bis(diphenylphosphino)-1,1′-binaphthyl
- Pd 2 (dba) 3 Pd(0)-bis(dibenzylidenacetone)
- 2-[2-Chloro-3-methyl-5-(4-methyl-piperazin-1-yl)-phenyl]-acetamide used as starting material may be prepared as follows: (5-Bromo-2-chloro-3-methyl-phenyl)-acetic acid methyl ester (2.0 g, 7.2 mmol), N-methylpiperazine (960 ⁇ L, 8.6 mmol) and Cs 2 CO 3 (3.3 g, 10.1 mmol) are suspended in toluene (80 mL). Pd(OAc) 2 (81 mg, 0.36 mmol) and BINAP (224 mg, 0.36 mmol) are added and the reaction is stirred at 100° C. overnight. The mixture is filtered through Celite and the solvent is evaporated.
- reaction mixture is warmed to RT, and after 1 h a RT, TLC analysis indicates complete consumption of starting material.
- the reaction mixture is diluted with EtOAc and washed twice with H 2 O.
- the combined organic layers are dried over Na 2 SO 4 , the solvent is removed, and the residue is purified by FCC (hexanes/EtOAc 100:0 to 97:3 to 95:5 to 93:7 to 90:10) to yield the title compound.
- This solution is canulated into a second two-necked flask, containing Pd 2 (dba) 3 (1.39 g, 1.51 mmol) and (2′-Dicyclohexylphosphanyl-biphenyl-2-yl)-dimethyl-amine (1.25 g, 3.18 mmol).
- Pd 2 (dba) 3 (1.39 g, 1.51 mmol)
- (2′-Dicyclohexylphosphanyl-biphenyl-2-yl)-dimethyl-amine (1.25 g, 3.18 mmol).
- Acetic acid tert-butyl ester (15.7 ml, 13.5 g, 116.1 mmol) is added during 5 min.
- 1,3-Dichloro-isoquinoline (10.0 g, 50.49 mmol) is added in one portion.
- the compounds of formula I in free form or in pharmaceutically acceptable salt form exhibit valuable pharmacological properties, e.g. inhibiting Protein Kinase C (PKC), e.g. PKC isoforms like ⁇ , ⁇ , ⁇ , 68 , ⁇ or ⁇ activity, inhibiting T-cell activation and proliferation, e.g. by inhibiting production by T-cells or cytokines, e,g, IL-2, by inhibiting the proliferative response of T-cells to cytokines, e.g. IL-2, e.g. as indicated in in vitro and in vivo tests and are therefore indicated for therapy.
- PKC Protein Kinase C
- the compounds of formula I are tested for their activity on different PKC isoforms according to a published method (D. Geiges et al. Biochem. Pharmacol. 1997;53:865-875)
- the assay is performed in a 96-well polypropylene microtiterplate (Costar 3794) that has been previously siliconized with Sigmacote (Sigma SL-2).
- the reaction mixture (50 ⁇ l) contains 10 ⁇ l of the relevant PKC isozyme together with 25 ⁇ l of the test compound and 15 ⁇ l of a mix solution that contains 200 ⁇ g/ml protamine sulfate, 10 mM Mg(NO 3 ) 2 , 10 ⁇ M ATP (Boehringer 519987) and 3750 Bq of 33 P-ATP (Hartmann Analytic SFC301, 110TBq/mmol) in 20 mM Tris-buffer pH 7.4+0.1% BSA. Incubation is performed for 15 min at 32° C. in a microtiterplate shaking incubator (Biolabo Scientific Instruments). Reaction is stopped by adding 10 ⁇ l of 0.5 M Na 2 EDTA, pH 7.4.
- IC 50 measurement is performed on a routine basis by incubating a serial dilution of inhibitor at concentrations ranging between 1-1000 ⁇ M according to the method described above. IC 50 values are calculated from the graph by sigmoidal curve fitting.
- Human recombinant PKC ⁇ is used under the assay conditions as described above.
- compounds of formula I inhibit PKC ⁇ with an IC 50 ⁇ 1 ⁇ M.
- Compound of Examples 33 and 69 inhibit PKC ⁇ in this assay with an IC 50 6.8 and 12.1 nM, respectively.
- Human recombinant PKC ⁇ was obtained from PanVera and is used under the assay conditions as described under Section A.1 above. In this assay, compounds of formula I inhibit PKC ⁇ with an IC 5 ⁇ 1 ⁇ M. Compound of Example 29 inhibits PKC ⁇ in this assay with an IC 50 of 27.4 nM.
- the assay is performed with Jurkat cells transfected with a human interleukin-2 promoter/reporter gene construct as described by Baumann G et al. in Transplant.Proc. 1992;24:43-8, the ⁇ -galactosidase reporter gene being replaced by the luciferase gene (de Wet J., et al., Mol. Cell Biol. 1987, 7(2), 725-737).
- Cells are stimulated by solid phase-coupled antibodies or phorbol myristate acetate (PMA) and the Ca ++ ionophore ionomycin as follows.
- Microlite TM1 microtiter plates (Dynatech) are coated with 3 ⁇ g/ml goat anti-mouse IgG Fc antibodies (Jackson) in 55 ⁇ l phosphate-buffered saline (PBS) per well for three hours at RT. Plates are blocked after removing the antibodies by incubation with 2% bovine serum albumin (BSA) in PBS (300 ⁇ l per well) for 2 hours at RT.
- BSA bovine serum albumin
- test compounds in duplicates in assay medium RPMI 1640/10% fetal calf serum (FCS) containing 50 ⁇ M 2-mercaptoethanol, 100 units/ml penicillin and 100 ⁇ g/ml streptomycin
- FCS fetal calf serum
- 100 ⁇ l of this mixture containing 1 ⁇ 10 5 cells are then transferred to the antibody-coated assay plates.
- 100 ⁇ l are incubated with 40 ng/ml PMA and 2 ⁇ M ionomycin. After incubation for 5.5 hours at 37° C.
- the level of luciferase is determined by bioluminescence measurement.
- the plates are centrifuged for 10 min at 500 g and the supernatant is removed by flicking.
- Lysis buffer containing 25 mM Tris-phosphate, pH 7.8, 2 mM DTT, 2 mM 1.2-diaminocyclohexane-N,N,N′,N-tetraacetic acid, 10% (v/v) glycerol and 1% (v/v) Triton X-100 is added (20 ⁇ l per well). The plates are incubated at RT for 10 minutes under constant shaking.
- Luciferase activity is assessed with a bioluminescence reader (Labsystem, Helsinki, Finland) after automatic addition of 50 ⁇ l per well luciferase reaction buffer containing 20 mM Tricine, 1.07 mM (MgCO 3 ) 4 Mg(OH) 2 ⁇ 5H 2 O, 2.67 mM MgSO 4 , 0.1 mM EDTA, 33.3 mM DTT, 270 ⁇ M coenzyme A, 470 ⁇ M luciferin (Chemie Brunschwig AG), 530 ⁇ M ATP, pH 7.8.
- Lag time is 0.5 seconds, total measuring time is 1 or 2 seconds.
- Low control values are light units from anti-T cell receptor- or PMA-stimulated cells
- high controls are from anti-T cell receptor/anti-CD28- or PMA/ionomycin-stimulated cells without any test sample.
- Low controls are subtracted from all values.
- the inhibition obtained in the presence of a test compound is calculated as percent inhibition of the high control.
- the concentration of test compounds resulting in 50% inhibition (IC 50 ) is determined from the dose-response curves.
- compounds of formula I inhibit anti-T cell receptor/anti-CD28 and PMA/ionomycin stimulated Jurkat cells with an IC 50 ⁇ 1 ⁇ M.
- Compound of Example 29 has an IC 50 of 20 nM in this assay.
- the two-way MLR is performed according to standard procedures ( J. Immunol. Methods, 1973, 2, 279 and Meo T. et al., Immunological Methods, New York, Academic Press, 1979, 227-39). Briefly, spleen cells from CBA and BALB/c mice (1.6 ⁇ 10 5 cells from each strain per well in flat bottom tissue culture microtiter plates, 3.2 ⁇ 10 5 in total) are incubated in RPMI medium containing 10% FCS, 100 U/ml penicillin, 100 ⁇ g/ml streptomycin (Gibco BRL, Basel, Switzerland), 50 ⁇ M 2-mercaptoethanol (Fluka, Buchs, Switzerland) and serially diluted compounds.
- the GSK-3 ⁇ binding assay is performed in 50 ⁇ l reactions in 96 well polypropylene plate, each reaction containing 20 mM magnesium chloride, 40 ⁇ M ATP, 2mM DTT, 88.51 ⁇ M biotinylated and phosphorylated CREB-peptide substrate (biotin-KRREILSRRPS(PO 4 )YR—OH; Q. M. Wang et al., J. Biol. Chem. 269, 14566-14574, 1994), [ ⁇ - 33 P]ATP (1 ⁇ Ci) and 2 ⁇ l of the compound to be tested in DMSO(various concentrations). 15 ⁇ l of GSK-3 ⁇ (various concentrations) is added and the mixture is incubated at 30° C.
- the strain combination used Male Lewis (RT 1 haplotype) and BN (RT 1 haplotype).
- the animals are anaesthetised using inhalational isofluorane. Following heparinisation of the donor rat through the abdominal inferior vena cava with simultaneous exsanguination via the aorta, the chest is opened and the heart rapidly cooled. The aorta is ligated and divided distal to the first branch and the brachiocephalic trunk is divided at the first bifurcation. The left pulmonary artery is ligated and divided and the right side divided but left open. All other vessels are dissected free, ligated and divided and the donor heart is removed into iced saline.
- the recipient is prepared by dissection and cross-clamping of the infra-renal abdominal aorta and vena cava.
- the graft is implanted with end-to-side anastomoses, using 10/0 monofilament suture, between the donor brachiocephalic trunk and the recipient aorta and the donor right pulmonary artery to the recipient vena cava.
- the clamps are removed, the graft tethered retroabdominally, the abdominal contents washed with warm saline and the animal is closed and allowed to recover under a heating lamp.
- Graft survival is monitored by daily palpation of the beating donor heart through the abdominal wall. Rejection is considered to be complete when heart beat stops. Increases of graft survival are obtained in animals treated with a compound of formula I administered orally at a daily dose of 1 to 30 mg/kg bid.
- Spleen cells (2 ⁇ 10 7 ) from Wistar/F rats are injected subcutaneously into the right hind footpad of (Wistar/F ⁇ Fischer 344)F 1 hybrid rats.
- the left footpad is left untreated.
- the animals are treated with the test compounds on 4 consecutive days (0-3).
- the popliteal lymph nodes are removed on day 7, and the weight differences between two corresponding lymph nodes are determined.
- the results are expressed as the inhibition of lymph node enlargement (given in percent) comparing the lymph node weight differences in the experimental groups to the weight difference between the corresponding lymph nodes from a group of animals left untreated with a test compound. In this assay, an inhibition of 100% is obtained with compound of Example 29 when administered at a dose of 30 mg/kg/day bid.
- the compounds of formula I are, therefore, useful in the treatment and/or prevention of diseases or disorders mediated by T lymphocytes and/or PKC, e.g. acute or chronic rejection of organ or tissue allo- or xenografts, graft versus host diseases, atherosclerosis, vascular occlusion due to vascular injury such as angioplasty, restenosis, obesity, syndrome X, impaired glucose tolerance, polycystic ovary syndrome, hypertension, heart failure, chronic obstructive pulmonary disease, CNS diseases such as Alzheimer disease or amyotrophic lateral sclerosis, cancer, infectious diseases such as AIDS, septic shock or adult respiratory distress syndrome, ischemia/reperfusion injury e.g.
- the compounds of formula I are also useful in the treatment and/or prevention of T-cell mediated acute or chronic inflammatory diseases or disorders or autoimmune diseases e.g. rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, Hashimoto's thyroidis, multiple sclerosis, myasthenia gravis, diabetes type I or II and the disorders associated therewith, e.g.
- angiopathy diabetic proliferative retinopathy, diabetic macular edema, nephropathy, neuropathy and dawn phenomenon
- respiratory diseases such as asthma or inflammatory lung injury, inflammatory liver injury, inflammatory glomerular injury, cutaneous manifestations of immunologically-mediated disorders or illnesses, inflammatory and hyperproliferative skin diseases (such as psoriasis, atopic dermatitis, allergic contact dermatitis, irritant contact dermatitis and further eczematous dermatitises, seborrhoeic dermatitis), inflammatory eye diseases, e.g.
- Sjoegren's syndrome, keratoconjunctivitis or uveitis, inflammatory bowel disease, Crohn's disease or ulcerative colitis For the above uses the required dosage will of course vary depending on the mode of administration, the particular condition to be treated and the effect desired. In general, satisfactory results are indicated to be obtained systemically at daily dosages of from about 0.1 to about 100 mg/kg body weight.
- An indicated daily dosage in the larger mammal, e.g. humans, is in the range from about 0.5 mg to about 2000 mg, conveniently administered, for example, in divided doses up to four times a day or in retard form.
- the compounds of formula I may be administered by any conventional route, in particular enterally, e.g. orally, e.g. in the form of tablets or capsules, or parenterally, e.g. in the form of injectable solutions or suspensions, topically, e.g. in the form of lotions, gels, ointments or creams, or in a nasal or a suppository form.
- Pharmaceutical compositions comprising a compound of formula I in free form or in pharmaceutically acceptable salt form in association with at least one pharmaceutical acceptable carrier or diluent may be manufactured in conventional manner by mixing with a pharmaceutically acceptable carrier or diluent.
- Unit dosage forms for oral administration contain, for example, from about 0.1 mg to about 500 mg of active substance.
- Topical administration is e.g. to the skin.
- a further form of topical administration is to the eye.
- the compounds of formula I may be administered in free form or in pharmaceutically acceptable salt form e.g. as indicated above.
- Such salts may be prepared in conventional manner and exhibit the same order of activity as the free compounds.
- the present invention further provides:
- Compounds of formula I may be administered as the sole active ingredient or together with other drugs in immunomodulating regimens or other anti-inflammatory agents e.g. for the treatment or prevention of allo- or xenograft acute or chronic rejection or inflammatory or autoimmune disorders.
- they may be used in combination with cyclosporines, or ascomycines or their immunosuppressive analogs or derivatives, e.g. cyclosporin A, ISA Tx247, FK-506, ABT-281, ASM 981; an mTOR inhibitor, e.g. rapamycin, 40-O-(2-hydroxy)ethyl-rapamycin, CC1779, ABT578 or a rapalog, e.g.
- AP23573 etc. corticosteroids; cyclophosphamide; azathioprene; methotrexate; an EDG receptor agonist having accelerating lymphocyte homing properties, e.g. FTY 720 or an analogue thereof; leflunomide or analogs thereof; mizoribine; mycophenolic acid; mycophenolate mofetil; 15-deoxyspergualine or analogs thereof; immunosuppressive monoclonal antibodies, e.g., monoclonal antibodies to leukocyte receptors, e.g., MHC, CD2, CD3, CD4, CD 11 a/CD1 8, CD7, CD25, CD 27, B7, CD40, CD45, CD58, CD 137, ICOS, CD150 (SLAM), OX40, 4-1BB or their ligands, e.g.
- CD154 or other immunomodulatory compounds, e.g. a recombinant binding molecule having at least a portion of the extracellular domain of CTLA4 or a mutant thereof, e.g. an at least extracellular portion of CTLA4 or a mutant thereof joined to a non-CTLA4 protein sequence, e.g. CTLA41g (for ex. designated ATCC 68629) or a mutant thereof, e.g. LEA29Y, or other adhesion molecule inhibitors, e.g. mAbs or low molecular weight inhibitors including LFA-1 antagonists, Selectin antagonists and VLA-4 antagonists.
- Compounds of formula I may also be administered together with an antiproliferative drug, e.g.
- a chemotherapeutic drug e.g. as used in cancer treatment, including but not limited to aromatase inhibitors, antiestrogens, topoisomerase I inhibitors, topoisomerase 11 inhibitors, microtubule active agents, alkylating agents, histone deacetylase inhibitors, farnesyl transferase inhibitors, COX-2 inhibitors, MMP inhibitors, mTOR inhibitors, antineoplastic antimetabolites, platin compounds, compounds decreasing the protein kinase activity and further anti-angiogenic compounds, gonadorelin agonists, anti-androgens, bengamides, bisphosphonates, antiproliferative antibodies and temozolomide, or with an anti-diabetic drug, an insulin secretagogue or insulin secretion enhancer, e.g.
- a sulphonyl urea e.g. tolbutamide, chlorpropamide, tolazamide, acetohexamide, 4-chloro-N-[(1-pyrolidinylamino)carbonyl]-benzensulfonamide (glycopyramide), glibenclamide (glyburide), gliclazide, 1-butyl-3-metanilylurea, carbutamide, glibonuride, glipizide, gliquidone, glisoxepid, glybuthiazole, glibuzole, glyhexamide, glymidine, glypinamide, phenbutamide or tolylcyclamide, an oral insulinotropic agent derivative, e.g.
- an oral insulinotropic agent derivative e.g.
- a short acting insulin enhancer e.g. meglitinide, repaglinide, a phenyl acetic acid derivative, e.g.nateglinide, a DPP IV inhibitor, e.g. 1- ⁇ 2-[(5-cyanopyridin-2-yl)amino]ethylamino ⁇ racetyl-(2S)-cyano-pyrrolidine dihydrochloride, LAF237, GLP-1 or a GLP-1 agonist analog, or an insulin sensitizer e.g. a peroxisome proliferator activated receptor ⁇ agonist (PPAR ⁇ ), e.g.
- PPAR ⁇ peroxisome proliferator activated receptor ⁇ agonist
- a glitazone a non-giltazone type such as a N-(2-benzoylphenyl)-L-tyrosine analogue, e.g. GI-262570, or an oxolidinedione, e.g. JTT501, a dual PPAR ⁇ /PPAR ⁇ agonist, e.g. DRF-554158, NC-2100 or NN-622, a retinoid X receptor agonist or a rexinoid, e.g.
- an inhibitor of GSK-3 ⁇ , PKC or of T-cell activation and proliferation e.g. a compound of formula I
- other immunosuppressive/immunomo-dulatory, anti-inflammatory, antiproliferative or anti-diabetic therapy e.g. for preventing or treating acute or chronic graft rejection or inflammatory or autoimmune disorders as hereinabove specified
- dosages of the co-administered immunosuppressant, immunomodulatory, anti-inflammatory, antiproliferative or anti-diabetic compound will of course vary depending on the type of co-drug employed, e.g. whether it is a steroid or a cyclosporine, on the specific drug employed, on the condition being treated and so forth.
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US11/546,693 US7235555B2 (en) | 2002-04-03 | 2006-10-12 | Indolylmaleimide derivatives |
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US11/977,565 US20080108628A1 (en) | 2002-04-03 | 2007-10-25 | Indolylmaleimide derivatives |
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