WO2006002349A1 - Amido compounds and their use as pharmaceuticals - Google Patents

Amido compounds and their use as pharmaceuticals Download PDF

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Publication number
WO2006002349A1
WO2006002349A1 PCT/US2005/022411 US2005022411W WO2006002349A1 WO 2006002349 A1 WO2006002349 A1 WO 2006002349A1 US 2005022411 W US2005022411 W US 2005022411W WO 2006002349 A1 WO2006002349 A1 WO 2006002349A1
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WIPO (PCT)
Prior art keywords
pyrrolidin
spiro
benzofuran
methylpropanoyl
optionally substituted
Prior art date
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PCT/US2005/022411
Other languages
French (fr)
Inventor
Wenqing Yao
Meizhong Xu
Colin Zhang
Konstantinos Agrios
Brian Metcalf
Jincong Zhuo
Original Assignee
Incyte Corporation
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Publication date
Application filed by Incyte Corporation filed Critical Incyte Corporation
Priority to BRPI0512410-7A priority Critical patent/BRPI0512410A/en
Priority to JP2007518299A priority patent/JP2008504278A/en
Priority to EA200700118A priority patent/EA200700118A1/en
Priority to NZ551602A priority patent/NZ551602A/en
Priority to CA002571258A priority patent/CA2571258A1/en
Priority to MXPA06014572A priority patent/MXPA06014572A/en
Priority to EP05762543A priority patent/EP1758582A4/en
Publication of WO2006002349A1 publication Critical patent/WO2006002349A1/en
Priority to IL179519A priority patent/IL179519A/en
Priority to NO20070372A priority patent/NO20070372L/en

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    • C07—ORGANIC CHEMISTRY
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    • C07D217/00—Heterocyclic compounds containing isoquinoline or hydrogenated isoquinoline ring systems
    • C07D217/02—Heterocyclic compounds containing isoquinoline or hydrogenated isoquinoline ring systems with only hydrogen atoms or radicals containing only carbon and hydrogen atoms, directly attached to carbon atoms of the nitrogen-containing ring; Alkylene-bis-isoquinolines
    • C07D217/04—Heterocyclic compounds containing isoquinoline or hydrogenated isoquinoline ring systems with only hydrogen atoms or radicals containing only carbon and hydrogen atoms, directly attached to carbon atoms of the nitrogen-containing ring; Alkylene-bis-isoquinolines with hydrocarbon or substituted hydrocarbon radicals attached to the ring nitrogen atom
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    • C07D207/04—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members
    • C07D207/08—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members with hydrocarbon radicals, substituted by hetero atoms, attached to ring carbon atoms
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    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
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Definitions

  • the present invention relates to modulators of 11- ⁇ hydroxyl steroid dehydrogenase type 1 (ll ⁇ HSDl) and/or mineralocorticoid receptor (MR), compositions thereof and methods of using the same.
  • ll ⁇ HSDl 11- ⁇ hydroxyl steroid dehydrogenase type 1
  • MR mineralocorticoid receptor
  • Glucocorticoids are steroid hormones that regulate fat metabolism, function and distribution. In vertebrates, glucocorticoids also have profound and diverse physiological effects on development, neurobiology, inflammation, blood pressure, metabolism and programmed cell death. In humans, the primary endogenously-produced glucocorticoid is Cortisol. Cortisol is synthesized in the zona fasciculate of the adrenal cortex under the control of a short-term neuroendocrine feedback circuit called the hypothalamic-pituitary-adrenal (HPA) axis.
  • HPA hypothalamic-pituitary-adrenal
  • Adrenal production of Cortisol proceeds under the control of adrenocorticotrophic hormone (ACTH), a factor produced and secreted by the anterior pituitary.
  • ACTH adrenocorticotrophic hormone
  • Production of ACTH in the anterior pituitary is itself highly regulated, driven by corticotropin releasing hormone (CRH) produced by the paraventricular nucleus of the hypothalamus.
  • the HPA axis maintains circulating Cortisol concentrations within restricted limits, with forward drive at the diurnal maximum or during periods of stress, and is rapidly attenuated by a negative feedback loop resulting from the ability of Cortisol to suppress ACTH production in the anterior pituitary and CRH production in the hypothalamus.
  • Aldosterone is another hormone produced by the adrenal cortex; aldosterone regulates sodium and potassium homeostasis. Fifty years ago, a role for aldosterone excess in human disease was reported in a description of the syndrome of primary aldosteronism (Conn, (1955), J. Lab. Clin. Med. 45: 6-17). It is now clear that elevated levels of aldosterone are associated with deleterious effects on the heart and kidneys, and are a major contributing factor to morbidity and mortality in both heart failure and hypertension.
  • glucocorticoid receptor GR
  • mineralocorticoid receptor MR
  • Cortisol a member of the nuclear hormone receptor superfamily
  • GR glucocorticoid receptor
  • MR mineralocorticoid receptor
  • Cortisol the primary intracellular receptor for aldosterone
  • 'ligand-dependent transcription factors ' 1 because their functionality is dependent on the receptor being bound to its ligand (for example, Cortisol); upon ligand-binding these receptors directly modulate transcription via DNA-binding zinc finger domains and transcriptional activation domains.
  • glucocorticoid action was attributed to three primary factors: 1) circulating levels of glucocorticoid (driven primarily by the HPA axis), 2) protein binding of glucocorticoids in circulation, and 3) intracellular receptor density inside target tissues.
  • tissue-specific pre-receptor metabolism by glucocorticoid-activating and -inactivating enzymes.
  • 11-beta-hydroxysteroid dehydrogenase (11- ⁇ -HSD) enzymes act as pre-receptor control enzymes that modulate activation of the GR and MR by regulation of glucocorticoid hormones.
  • l l ⁇ HSDl also known as 11-beta-HSD type 1, l lbetaHSDl, HSDI lBl, HDL, and HSDI lL
  • l l ⁇ HSD2 catalyze the interconversion of hormonally active Cortisol (corticosterone in rodents) and inactive cortisone (11- dehydrocorticosterone in rodents).
  • l l ⁇ HSDl is widely distributed in rat and human tissues; expression of the enzyme and corresponding mRNA have been detected in lung, testis, and most abundantly in liver and adipose tissue.
  • l l ⁇ HSDl catalyzes both 11-beta-dehydrogenation and the reverse 11-oxoreduction reaction, although l l ⁇ HSDl acts predominantly as a NADPH-dependent oxoreductase in intact cells and tissues, catalyzing the activation of Cortisol from inert cortisone (Low et al. (1994) J. MoI. Endocrin. 13: 167-174) and has been reported to regulate glucocorticoid access to the GR.
  • 11 ⁇ HSD2 expression is found mainly in mineralocorticoid target tissues such as kidney, placenta, colon and salivary gland, acts as an NAD-dependent dehydrogenase catalyzing the inactivation of Cortisol to cortisone (Albiston et al. (1994) MoI. Cell. Endocrin. 105: RI l -Rl 7), and has been found to protect the MR from glucocorticoid excess, such as high levels of receptor-active Cortisol (Blum, et al., (2003) Prog. Nucl. Acid Res. MoI. Biol. 75:173-216).
  • the MR binds Cortisol and aldosterone with equal affinity.
  • tissue specificity of aldosterone activity is conferred by the expression of l l ⁇ HSD2 (Funder et al. (1988), Science 242: 583-585).
  • the inactivation of Cortisol to cortisone by l l ⁇ HSD2 at the site of the MR enables aldosterone to bind to this receptor in vivo.
  • the binding of aldosterone to the MR results in dissociation of the ligand-activated MR from a multiprotein complex containing chaperone proteins, translocation of the MR into the nucleus, and its binding to hormone response elements in regulatory regions of target gene promoters.
  • ACE angiotensin- converting enzyme
  • ATlR angiotensin type 1 receptor
  • RAAS rennin-angiotensin-aldosterone system
  • ACE inhibition and ATlR antagonism initially reduce aldosterone concentrations
  • circulating concentrations of this hormone return to baseline levels with chronic therapy (known as 'aldosterone escape').
  • co-administration of the MR antagonist Spironolactone or Eplerenone directly blocks the deleterious effects of this escape mechanism and dramatically reduces patient mortality (Pitt et al, New England J. Med. (1999), 341: 709-719; Pitt et al., New England J. Med.
  • MR antagonism may be an important treatment strategy for many patients with hypertension and cardiovascular disease, particularly those hypertensive patients at risk for target-organ damage.
  • Mutations in either of the genes encoding the 11-beta-HSD enzymes are associated with human pathology.
  • l l ⁇ HSD2 is expressed in aldosterone-sensitive tissues such as the distal nephron, salivary gland, and colonic mucosa where its Cortisol dehydrogenase activity serves to protect the intrinsically non-selective MR from illicit occupation by Cortisol (Edwards et al. (1988) Lancet 2: 986-989).
  • ll ⁇ HSDl a primary regulator of tissue-specific glucocorticoid bioavailability
  • H6PD hexose 6-phosphate dehydrogenase
  • CRD cortisone reductase deficiency
  • cortisone metabolites tetrahydrocortisone
  • Cortisol metabolites tetrahydrocortisols
  • CRD patients When challenged with oral cortisone, CRD patients exhibit abnormally low plasma Cortisol concentrations. These individuals present with ACTH-mediated androgen excess (hirsutism, menstrual irregularity, hyperandrogenism), a phenotype resembling polycystic ovary syndrome (PCOS) (Draper et al. (2003) Nat. Genet. 34: 434-439).
  • PCOS polycystic ovary syndrome
  • l l ⁇ HSDl is expressed in many key GR-rich tissues, including tissues of considerable metabolic importance such as liver, adipose, and skeletal muscle, and, as such, has been postulated to aid in the tissue-specific potentiation of glucocorticoid-mediated antagonism of insulin function.
  • 1 l ⁇ HSDl has been shown to be upregulated in adipose tissue of obese rodents and humans (Livingstone et al. (2000) Endocrinology 131: 560-563; Rask et al. (2001) J. Clin. Endocrinol. Metab. 86: 1418-1421; Lindsay et al. (2003) J. Clin. Endocrinol. Metab. 88: 2738-2744; Wake et al. (2003) J. Clin. Endocrinol. Metab. 88: 3983-3988). Additional support for this notion has come from studies in mouse transgenic models.
  • Adipose-specific overexpression of l l ⁇ HSDl under the control of the aP2 promoter in mouse produces a phenotype remarkably reminiscent of human metabolic syndrome (Masuzaki et al. (2001) Science 294: 2166-2170; Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). Importantly, this phenotype occurs without an increase in total circulating corticosterone, but rather is driven by a local production of corticosterone within the adipose depots.
  • the increased activity of l l ⁇ HSDl in these mice (2-3 fold) is very similar to that observed in human obesity (Rask et al. (2001) J. Clin. Endocrinol.
  • mice are completely devoid of 11-keto reductase activity, confirming that 1 l ⁇ HSDl encodes the only activity capable of generating active corticosterone from inert 11-dehydrocorticosterone.
  • l l ⁇ HSDl- deficient mice are resistant to diet- and stress-induced hyperglycemia, exhibit attenuated induction of hepatic gluconeogenic en2ymes (PEPCK, G6P), show increased insulin sensitivity within adipose, and have an improved lipid profile (decreased triglycerides and increased cardio-protective HDL).
  • Increased expression of the l l ⁇ HSDl gene is associated with metabolic abnormalities in obese women and that increased expression of this gene is suspected to contribute to the increased local conversion of cortisone to Cortisol in adipose tissue of obese individuals (Engeli, et al., (2004) Obes. Res. 12: 9-17).
  • a new class of l l ⁇ HSDl inhibitors, the arylsulfonamidothiazoles was shown to improve hepatic insulin sensitivity and reduce blood glucose levels in hyperglycemic strains of mice (Barf et al. (2002) J. Med. Chem. 45: 3813-3815; Alberts et al. Endocrinology (2003) 144: 4755-4762).
  • l l ⁇ HSDl is a promising pharmaceutical target for the treatment of the Metabolic Syndrome (Masuzaki, et al., (2003) Curr. Drug Targets Immune Endocr. Metabol. Disord. 3: 255-62).
  • Glucocorticoids are known antagonists of insulin action, and reductions in local glucocorticoid levels by inhibition of intracellular cortisone to Cortisol conversion should increase hepatic and/or peripheral insulin sensitivity and potentially reduce visceral adiposity.
  • 1 l ⁇ HSDl knockout mice are resistant to hyperglycemia, exhibit attenuated induction of key hepatic gluconeogenic enzymes, show markedly increased insulin sensitivity within adipose, and have an improved lipid profile. Additionally, these animals show resistance to high fat diet-induced obesity (Kotelevstev et al. (1997) Proc. Natl. Acad. Sci. 94: 14924-14929; Morton et al. (2001) J. Biol. Chem. 276: 41293- 41300; Morton et al. (2004) Diabetes 53 : 931 -938).
  • inhibition of 11 ⁇ HSD 1 is predicted to have multiple beneficial effects in the liver, adipose, and/or skeletal muscle, particularly related to alleviation of component(s) of the metabolic syndrome and/or obesity.
  • Glucocorticoids are known to inhibit the glucose-stimulated secretion of insulin from pancreatic beta-cells (Billaudel and Sutter (1979) Horm. Metab. Res. 11 : 555-560). In both Cushing's syndrome and diabetic Zucker fa/fa rats, glucose-stimulated insulin secretion is markedly reduced (Ogawa et al. (1992) J. Clin. Invest. 90: 497-504). 1 l ⁇ HSDl mRNA and activity has been reported in the pancreatic islet cells of ob/ob mice and inhibition of this activity with carbenoxolone, an 11 ⁇ HSD 1 inhibitor, improves glucose-stimulated insulin release (Davani et al. (2000) J. Biol. Chem. 275: 34841-34844). Thus, inhibition of l l ⁇ HSDl is predicted to have beneficial effects on the pancreas, including the enhancement of glucose-stimulated insulin release.
  • C. Cognition and dementia Mild cognitive impairment is a common feature of aging that may be ultimately related to the progression of dementia.
  • inter-individual differences in general cognitive function have been linked to variability in the long-term exposure to glucocorticoids (Lupien et al. (1998) Nat. Neurosci. 1: 69-73).
  • dysregulation of the HPA axis resulting in chronic exposure to glucocorticoid excess in certain brain subregions has been proposed to contribute to the decline of cognitive function (McEwen and Sapolsky (1995) Curr. Opin. Neurobiol. 5: 205- 216).
  • l l ⁇ HSDl is abundant in the brain, and is expressed in multiple subregions including the hippocampus, frontal cortex, and cerebellum (Sandeep et al. (2004) Proc. Natl. Acad. Sci. Early Edition: 1-6).
  • Treatment of primary hippocampal cells with the l l ⁇ HSDl inhibitor carbenoxolone protects the cells from glucocorticoid-mediated exacerbation of excitatory amino acid neurotoxicity (Rajan et al. (1996) J. Neurosci. 16: 65-70).
  • l l ⁇ HSDl -deficient mice are protected from glucocorticoid-associated hippocampal dysfunction that is associated with aging (Yau et al.
  • IOP intra-ocular pressure
  • NPE non-pigmented epithelial cells
  • Adipocyte-derived hypertensive substances such as leptin and angiotensinogen have been proposed to be involved in the pathogenesis of obesity-related hypertension (Matsuzawa et al. (1999) Ann. N.Y. Acad. Sci. 892: 146-154; Wajchenberg (2000) Endocr. Rev. 21: 697-738).
  • Leptin which is secreted in excess in aP2-l l ⁇ HSDl transgenic mice (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90), can activate various sympathetic nervous system pathways, including those that regulate blood pressure (Matsuzawa et al. (1999) Ann. N.Y. Acad. Sci.
  • renin- angiotensin system has been shown to be a major determinant of blood pressure (Walker et al. (1979) Hypertension 1 : 287-291).
  • Angiotensinogen which is produced in liver and adipose tissue, is the key substrate for renin and drives RAS activation.
  • Plasma angiotensinogen levels are markedly elevated in aP2-l l ⁇ HSDl transgenic mice, as are angiotensin II and aldosterone (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). These forces likely drive the elevated blood pressure observed in aP2-l l ⁇ HSDl transgenic mice.
  • amide-based inhibitors are reported in WO 2004/089470, WO 2004/089896, WO 2004/056745, and WO 2004/065351.
  • Antagonists of 1 l ⁇ HSDl have been evaluated in human clinical trials (Kurukulasuriya , et al., (2003) Curr. Med. Chem. 10: 123-53).
  • the MR binds to aldosterone (its natural ligand) and Cortisol with equal affinities
  • compounds that are designed to interact with the active site of l l ⁇ HSDl which binds to cortisone/cortisol may also interact with the MR and act as antagonists.
  • MR antagonists are desirable and may also be useful in treating complex cardiovascular, renal, and inflammatory pathologies including disorders of lipid metabolism including dyslipidemia or hyperlipoproteinaemia, diabetic dyslipidemia, mixed dyslipidemia, hypercholesterolemia, hypertriglyceridemia, as well as those associated with type 1 diabetes, type 2 diabetes, obesity, metabolic syndrome, and insulin resistance, and general aldosterone-related target- organ damage.
  • disorders of lipid metabolism including dyslipidemia or hyperlipoproteinaemia, diabetic dyslipidemia, mixed dyslipidemia, hypercholesterolemia, hypertriglyceridemia, as well as those associated with type 1 diabetes, type 2 diabetes, obesity, metabolic syndrome, and insulin resistance, and general aldosterone-related target- organ damage.
  • the present invention further provides compositions comprising compounds of the invention and a pharmaceutically acceptable carrier.
  • the present invention further provides methods of modulating 1 l ⁇ HSDl or MR by contacting said 1 l ⁇ HSDl or MR with a compound of the invention.
  • the present invention further provides methods of inhibiting l l ⁇ HSDl or MR by contacting said 1 l ⁇ HSDl or MR with a compound of the invention.
  • the present invention further provides methods of inhibiting conversion of cortisone to Cortisol in a cell.
  • the present invention further provides methods of inhibiting production of Cortisol in a cell.
  • the present invention further provides methods of increasing insulin sensitivity in a cell.
  • the present invention further provides methods of treating diseases associated with activity or expression of 1 l ⁇ HSDl or MR.
  • the present invention further provides use of the compounds and compositions of the invention in therapy.
  • the present invention further provides the compounds or compositions of the invention for use in the preparation of a medicament for use in therapy.
  • Cy is aryl, heteroaryl, cycloalkyl, or heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z;
  • L is absent, (CR 13 R 14 ) m , (CR 13 R 14 ) n O(CR 13 R 14 ) p , (CR 13 R 14 ) n S(CR 13 R 14 ) p , (CR 13 R 14 ) n SO 2 (CR 13 R w ) , (CR 13 R 14 ) n SO(CR 13 R 14 ) p , (CR 13 R 14 ) n CO(CR 13 R 14 ) p , or (CR 13 R 14 ) n NR 15 (CR 13 R 14 ) p ;
  • R 1 and R 2 are each, independently, C 1 ⁇ alkyl optionally substituted by halo, C(O)OR a or C(O)NR 0 R 1 ;
  • R 3 are each, independently, C 1 ⁇ al
  • X, X' and X" are each, independently, absent, Ci -8 alkylenyl, C 2-8 alkenylenyl, C 2-8 alkynylenyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, arylalkenyl, cycloalkylalkenyl, heteroarylalkenyl, heterocycloalkylalkenyl, arylalkynyl, cycloalkylalkynyl, heteroarylalkynyl, heterocycloalkylalkynyl, each of which is optionally substituted by one or more halo, CN, NO 2 , OH, C ⁇ 4 alkoxy, Ci -4 haloalk
  • 6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, Ci -4 alkoxy, Ci. 4 haloalkoxy, amino, Ci -4 alkylamino or C 2 .
  • dialkylamino; Z, Z' and Z" are each, independently, H, halo, CN, NO 2 , OH, Ci -4 alkoxy, Ci -4 haloalkoxy, amino, C ]-4 alkylamino or C 2-8 dialkylamino, Ci -6 alkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl, wherein said Ci -6 alkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl is optionally substituted by 1, 2 or 3 halo, Ci -6 alkyl, C 2-6 alkeny
  • R 3 and R 4 are both other than H.
  • R 5 and R 6 are both other than H.
  • R 7 and R 8 are both other than H.
  • R 9 and R 10 are both other than H.
  • R 7 and R 8 when q is 1 and one of R 7 and R 8 is phenyl, the other of R 7 and R 8 is Ci-6 alkyl, Ci -6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, or cycloalkyl; In some embodiments, when q is 1 and one of R 7 and R 8 is OH, the other of R 7 and R 8 is other than 3-(trifluoromethyl)-phenyl; and In some embodiments, when q is 1, R 7 and R 8 together with the carbon to which they are attached form a moiety other than that having the structure:
  • each R 22 is independently, H or -W'-X'-Y'-Z', and wherein q7 is 0, 1, 2 or 3.
  • Cy is aryl optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z.
  • Cy is heteroaryl optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z.
  • Cy is phenyl optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z.
  • Cy is 6-membered aryl or 6-membered heteroaryl optionally substituted by 1 or 2 halo, cyano, Ci -4 cyanoalkyl, nitro, Ci -4 nitroalkyl, Ci -4 alkyl, C 1-4 haloalkyl, Ci -4 alkoxy, C 1-4 haloalkoxy, OH, Ci -8 alkoxyalkyl, amino, Ci -4 alkylamino, C 2- S dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl.
  • Cy is phenyl optionally substituted by 1 or 2 halo, CN, cynanoalkyl, or pyridyl. In some embodiments, Cy is substituted. In some embodiments, L is absent. In some embodiments, L is (CR 13 R 1 V (CR 13 R 14 ) n O(CR 13 R 14 ) p , (CR 13 R 14 ) n S(CR 13 R 14 ) p , (CR 13 R 14 ) n S(CR 13 R 14 ) p , (CR 13 R 14 ) n SO 2 (CR 13 R 14 ) p , (CR 13 R 14 ) n CO(CR 13 R 14 ) p , or (CR 13 R 14 ) n NR 8 (CR 13 R 14 ) p .
  • L is (CR 6 R 7 ) D O(CR 6 R 7 ) P or (CR 6 R 7 ) n S(CR 6 R 7 ) p .
  • L is S or SCH 2 .
  • L is S.
  • L is O or OCH 2 .
  • L is O.
  • R 1 and R 2 are each, independently, methyl, ethyl or propyl. In some embodiments, R 1 and R 2 are both methyl.
  • -W-X-Y-Z is halo, cyano, Ci -4 cyanoalkyl, nitro, Ci -4 nitroalkyl, C ⁇ alkyl, Ci -4 haloalkyl, Ci -4 alkoxy, C ⁇ haloalkoxy, OH, C 1-8 alkoxyalkyl, amino, Ci -4 alkylamino, C 2-8 dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl.
  • -W-X-Y-Z is halo, cyano, cyanoalkyl or pyridyl.
  • -W'-X'-Y'-Z' is halo, Ci -4 alkyl, Ci -4 haloalkyl, OH, Ci -4 alkoxy, C L4 haloalkoxy, hydroxyalkyl, alkoxyalkyl, aryl, heteroaryl, aryl substituted by halo, heteroaryl substituted by halo.
  • -W"-X"-Y"-Z is halo, cyano, C L4 cyanoalkyl, nitro, Ci -8 alkyl, Ci -8 alkenyl, Ci -8 haloalkyl, Ci 0 .
  • Ci -4 haloalkoxy, OH, Ci -8 alkoxyalkyl, amino, Ci -4 alkylamino, C 2-8 dialkylamino, OC(O)NR c R d , NR°C(O)R d , NR°C( NCN)NR d , NR c C(0)0R a , aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl; wherein each of said Ci -8 alkyl, Ci -8 alkenyl, Ci -8 alkenyl
  • -W"-X"-Y"-Z is halo, cyano, Ci -4 cyanoalkyl, nitro, Ci -4 nitroalkyl, Ci -4 alkyl, Ci -4 haloalkyl, Ci -4 alkoxy, Ci -4 haloalkoxy, OH, Ci -8 alkoxyalkyl, amino, Ci -4 alkylamino, C 2- S dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl.
  • R 3 , R 4 , R 5 , R 6 , R 9 , R 10 , R 11 , and R 12 are each H. In some embodiments, R 3 , R 4 , R 5 , R 6 , R 7 , R 8 , R 11 , and R 12 are each H. In some embodiments, R 3 , R 4 , R 7 , R 8 , R 9 , R 10 , R 11 , and R 12 are each H. In some embodiments, R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11 , and R 12 are each H.
  • R 3 , R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , and R 10 are each H.
  • R 3 and R 4 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z.
  • R 5 and R 6 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
  • R 7 and R 8 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
  • R 9 and R 10 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
  • R 11 and R 12 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"-Y"-Z".
  • q is 1.
  • q is 0.
  • compounds of the invention have Formula II:
  • ring A is a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group; and r is 0, 1 or 2. amd the remaining variables are defined hereinabove.
  • ring A is monocyclic, bicyclic, or tricyclic.
  • ring A is bicyclic or tricyclic.
  • ring A is bicyclic.
  • ring A has 6, 7, 8, 9, 10, 11, 12, 13, or 14 ring-forming carbon atoms.
  • ring A has 6, 7, 8, 9, 10, 11, 12, 13, or 14 ring-forming carbon atoms and at least one ring-forming heteroatom selected from O, N and S.
  • the compounds of the invention have Formula II and R 3 , R 4 , R 5 , R 6 , R 9 , R 10 , R 11 , and R 12 are each H.
  • the compounds of the invention have Formula II and q is 1.
  • the compounds of the invention have Formula II and q is 0.
  • the compounds of the invention have Formula II and r is 0.
  • the compounds of the invention have Formula II and r is 1.
  • the compounds of the invention have Formula II and r is 2.
  • the compounds of the invention have Formula II and -W"-X"-Y"-Z" is halo, cyano, Q.
  • the compounds of the invention have Formula Ilia or IHb:
  • ring B is a fused 5 or 6-membered aryl or fused 5 or 6-membered heteroaryl group
  • Q 1 is O, S, NH, CH 2 , CO, CS, SO, SO 2 , OCH 2 , SCH 2 , NHCH 2 , CH 2 CH 2 , COCH 2 , CONH, COO, SOCH 2 , SONH, SO 2 CH 2 , or SO 2 NH
  • Q 2 is O, S, NH, CH 2 , CO, CS, SO, SO 2 , OCH 2 , SCH 2 , NHCH 2 , CH 2 CH 2 , COCH 2 , CONH, COO, SOCH 2 , SONH, SO 2 CH 2 , or SO 2 NH
  • r is O, 1 or 2
  • s is O, 1 or 2
  • the sum of r and s is O, 1 or 2; and the remaining variable are defined hereinabove.
  • the compounds of the invention have Formula Ilia or IHb and Q 1 is O, S, NH, CH 2 or CO, wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula Ilia or HIb and Q 2 is O, S, NH, CH 2 , CO, or SO 2 wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"- Z".
  • the compounds of the invention have Formula Ilia or IHb and one of Q 1 and Q 2 is CO and the other is O, NH, or CH 2 wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula IHa or HIb and one of Q 1 and Q 2 is CH 2 and the other is O, S, NH, or CH 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula ⁇ ia or HIb and one of Q 1 and Q 2 is CO.
  • the compounds of the invention have Formula IHa or IHb and ring B is phenyl or pyridyl. In some embodiments, the compounds of the invention have Formula IHa or IHb and ring B is phenyl. In some embodiments, the compounds of the invention have Formula ⁇ ia or IHb and r is O. In some embodiments, the compounds of the invention have Formula Ilia or nib and s is O or 1. In some embodiments, the compound of the invention have Formula IV:
  • Q 1 is O, S, NH, CH 2 , CO, CS, SO, SO 2 , OCH 2 , SCH 2 , NHCH 2 , CH 2 CH 2 , COCH 2 , CONH, COO, SOCH 2 , SONH, SO 2 CH 2 , or SO 2 NH;
  • Q 2 is O, S, NH, CH 2 , CO, CS, SO, SO 2 , OCH 2 , SCH 2 , NHCH 2 , CH 2 CH 2 , COCH 2 , CONH, COO, SOCH 2 , SONH, SO 2 CH 2 , or SO 2 NH;
  • Q 3 and Q 4 are each, independently, CH or N; r is O, 1 or 2; s is O, 1 or 2; and the sum of r and s is O, 1 or 2; and the remaining variable are defined hereinabove.
  • the compounds of the invention have Formula IV and Q 1 is O, NH, CH 2 or CO, wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula IV and Q 2 is O, S, NH, CH 2 , CO, or SO 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula IV and wherein one of Q 1 and Q 2 is CO and the other is O, NH, or CH 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z" .
  • the compounds of the invention have Formula IV and wherein one of Q 1 and Q 2 is CH 2 and the other is O, S, NH, or CH 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z" .
  • the compounds of the invention have Formula IV and one of Q 1 and Q 2 is O and the other is CO or CONH, wherein said CONH is optionally substituted by -W"-X"-Y"- Z".
  • the compounds of the invention have Formula IV and Q 3 is CH optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula IV and Q 3 is N.
  • the compounds of the invention have Formula IV and Q 4 is CH optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula IV and Q 4 is N. In some embodiments, the compounds of the invention have Formula FV and r is O or 1. In some embodiments, the compounds of the invention have Formula IV and s is O or 1. In some embodiments, the compounds of the inventioin have Formula V:
  • Q 1 is O, S, NH, CH 2 , CO, CS, SO, SO 2 , OCH 2 , SCH 2 , NHCH 2 , CH 2 CH 2 , COCH 2 , CONH, COO, SOCH 2 , SONH, SO 2 CH 2 , or SO 2 NH;
  • Q 2 is 0, S, NH, CH 2 , CO, CS, SO, SO 2 , OCH 2 , SCH 2 , NHCH 2 , CH 2 CH 2 , COCH 2 , CONH, COO, SOCH 2 , SONH, SO 2 CH 2 , or SO 2 NH;
  • Q 3 and Q 4 are each, independently, CH or N; r is O, 1 or 2; s is O, 1 or 2; and the sum of r and s is O, 1 or 2; and remaining variables are defined hereinabove.
  • the compounds of the invention have Formula V and Q 1 is O, NH, CH 2 or CO, wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula V and Q 2 is O, S, NH, CH 2 , CO, or SO 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula V and wherein one of Q 1 and Q 2 is CO and the other is O, NH, or CH 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z" .
  • the compounds of the invention have Formula V and one of Q 1 and Q 2 is CH 2 and the other is O, S, NH, or CH 2 , wherein each of said NH and CH 2 is optionally substituted by -W"-X"-Y"-Z" .
  • the compounds of the invention have Formula V and one of Q 1 and Q 2 is O and the other is CO or CONH, wherein said CONH is optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula V and Q 3 is CH optionally substituted by -W"-X"-Y"-Z".
  • the compounds of the invention have Formula V and Q 3 is N.
  • the compounds of the invention have Formula V and Q 4 is CH optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula V and Q 4 is N. In some embodiments, the compounds of the invention have Formula V and r is O or 1. In some embodiments, the compounds of the invention have Formula V and s is O or 1. In some embodiments, Q 1 and Q 2 are selected to form a 1- , 2- , or 3- atom spacer. In further embodiments, Q 1 and Q 2 when bonded together form a spacer group having other than an O-O or 0-S ring-forming bond.
  • the present invention provides compounds of Formula VI:
  • R is phenyl, Cy-S-, Cy-(CR 13 R 14 ) m -S- or wherein said phenyl is optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Cy is aryl, heteroaryl, cycloalkyl, or heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Cy 1 is aryl or cycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Hy is:
  • R 1 and R 2 are each, independently, C 1-6 alkyl optionally substituted by halo, C(0)0R a or C(O)NR 0 R 1 ;
  • R 13 and R 14 are each, independently, H, halo, C 1-4 alkyl, C 1 ⁇ haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO 2 , OR 3' , SR 3' , C(O)R b' , C(O)NR° ' R d> , C(O)OR 3' , OC(O)R b' , OC(O)NR c> R d> , NR c' R d> , NR° ' C(0)R d' , NR° ' C(O)OR 3' , S(O)R b' , S(0)NR c R d' , S(O) 2 R b' , or S(O) 2
  • 6 alkenylenyl, C 2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, C 1-4 alkoxy, Q -4 haloalkoxy, amino, Ci -4 alkylamino or C 2-8 dialkylamino;
  • X, X' and X" are each, independently, absent, Ci -8 alkylenyl, C 2-8 alkenylenyl, C 2-8 alkynylenyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, arylalkenyl, cycloalkylalkenyl, heteroarylalkenyl, heterocycloalkylalkenyl, arylalkynyl, cycloalkynylalkyl, heteroarylalkynyl, heterocyclo
  • R 18 when ring A' is phenyl, then R 18 is other than COOR a or C(O)NR c R d ;
  • R 19 when R 19 is phenyl, then R 20 is H, Ci -6 alkyl, Ci -6 haloalkyl, C 2-6 alkenyl, C 2 . 6 alkynyl, aryl, or cycloalkyl; and
  • R 20 when R 20 is OH, then R 19 is other than 3-(trifluoromethyl)-phenyl.
  • R 17 is aryl or heteroaryl, each optionally substituted one or more -W"-X"-Y"-Z".
  • substituents of compounds of the invention are disclosed in groups or in ranges. It is specifically intended that the invention include each and every individual subcombination of the members of such groups and ranges.
  • the term "Ci -6 alkyl” is specifically intended to individually disclose methyl, ethyl, C 3 alkyl, C 4 alkyl, C 5 alkyl, and C 6 alkyl. It is further appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, can also be provided in combination in a single embodiment.
  • n-membered where n is an integer typically describes the number of ring-forming atoms in a moiety where the number of ring-forming atoms is n.
  • piperidinyl is an example of a 6-membered heterocycloalkyl ring
  • 1,2,3,4-tetrahydro-naphthalene is an example of a 10-membered cycloalkyl group.
  • each variable can be a different moiety selected from the Markush group defining the variable.
  • the two R groups can represent different moieties selected from the Markush group defined for R.
  • an optionally multiple substituent is designated in the form:
  • substituent R can occur s number of times on the ring, and R can be a different moiety at each occurrence.
  • variable Q be defined to include hydrogens, such as when Q is said to be CH 2 , NH, etc.
  • any floating substituent such as R in the above example can replace a hydrogen of the Q variable as well as a hydrogen in any other non- variable component of the ring.
  • the compounds of the invention are stable. As used herein "stable" refers to a compound that is sufficiently robust to survive isolation to a useful degree of purity from a reaction mixture, and preferably capable of formulation into an efficacious therapeutic agent.
  • alkyl is meant to refer to a saturated hydrocarbon group which is straight-chained or branched.
  • Example alkyl groups include methyl (Me), ethyl (Et), propyl (e.g., n- propyl and isopropyl), butyl (e.g., n-butyl, isobutyl, t-butyl), pentyl (e.g., n-pentyl, isopentyl, neopentyl), and the like.
  • An alkyl group can contain from 1 to about 20, from 2 to about 20, from 1 to about 10, from 1 to about 8, from 1 to about 6, from 1 to about 4, or from 1 to about 3 carbon atoms.
  • alkylenyl refers to a divalent alkyl linking group.
  • alkenyl refers to an alkyl group having one or more double carbon-carbon bonds.
  • Example alkenyl groups include ethenyl, propenyl, and the like.
  • alkenylenyl refers to a divalent linking alkenyl group.
  • alkynyl refers to an alkyl group having one or more triple carbon-carbon bonds.
  • Example alkynyl groups include ethynyl, propynyl, and the like.
  • alkynylenyl refers to a divalent linking alkynyl group.
  • haloalkyl refers to an alkyl group having one or more halogen substituents.
  • Example haloalkyl groups include CF 3 , C 2 F 5 , CHF 2 , CCl 3 , CHCl 2 , C 2 Cl 5 , and the like.
  • aryl refers to monocyclic or polycyclic (e.g., having 2, 3 or 4 fused rings) aromatic hydrocarbons such as, for example, phenyl, naphthyl, anthracenyl, phenanthrenyl, indanyl, indenyl, and the like. In some embodiments, aryl groups have from 6 to about 20 carbon atoms.
  • cycloalkyl refers to non-aromatic cyclic hydrocarbons including cyclized alkyl, alkenyl, and alkynyl groups. Cycloalkyl groups can include mono- or polycyclic (e.g., having 2, 3 or 4 fused rings) ring systems as well as spiro ring systems.
  • Ring-forming carbon atoms of a cycloalkyl group can be optionally substituted by oxo or sulfide
  • Example cycloalkyl groups include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclopentenyl, cyclohexenyl, cyclohexadienyl, cycloheptatrienyl, norbornyl, norpinyl, norcarnyl, adamantyl, and the like.
  • cycloalkyl moieties that have one or more aromatic rings fused (i.e., having a bond in common with) to the cycloalkyl ring, for example, benzo or thienyl derivatives of pentane, pentene, hexane, and the like.
  • heteroaryl groups refer to an aromatic heterocycle having at least one heteroatom ring member such as sulfur, oxygen, or nitrogen. Heteroaryl groups include monocyclic and polycyclic (e.g., having 2, 3 or 4 fused rings) systems.
  • heteroaryl groups include without limitation, pyridyl, pyrimidinyl, pyrazinyl, pyridazinyl, triazinyl, furyl, quinolyl, isoquinolyl, thienyl, imidazolyl, thiazolyl, indolyl, pyrryl, oxazolyl, benzofuryl, benzothienyl, benzthiazolyl, isoxazolyl, pyrazolyl, triazolyl, tetrazolyl, indazolyl, 1,2,4-thiadiazolyl, isothiazolyl, benzothienyl, purinyl, carbazolyl, benzimidazolyl, indolinyl, and the like.
  • the heteroaryl group has from 1 to about 20 carbon atoms, and in further embodiments from about 3 to about 20 carbon atoms. In some embodiments, the heteroaryl group contains 3 to about 14, 3 to about 7, or 5 to 6 ring-forming atoms. In some embodiments, the heteroaryl group has 1 to about 4, 1 to about 3, or 1 to 2 heteroatoms.
  • heterocycloalkyl refers to non-aromatic heterocycles including cyclized alkyl, alkenyl, and alkynyl groups where one or more of the ring-forming carbon atoms is replaced by a heteroatom such as an O, N, or S atom.
  • Heterocycloalkyl groups can be mono- or polycyclic (e.g., having 2, 3, 4 or more fused rings or having a 2-ring, 3-ring, 4-ring spiro system (e.g., having 8 to 20 ring-forming atoms)).
  • heterocycloalkyl groups include morpholino, thiomorpholino, piperazinyl, tetrahydrofuranyl, tetrahydrothienyl, 2,3-dihydrobenzofuryl, 1,3-benzodioxole, benzo- 1,4-dioxane, piperidinyl, pyrrolidinyl, isoxazolidinyl, isothiazolidinyl, pyrazolidinyl, oxazolidinyl, thiazolidinyl, imidazolidinyl, and the like.
  • Ring-forming carbon atoms and heteroatoms of a heterocycloalkyl group can be optionally substituted by oxo or sulfide
  • Also included in the definition of heterocycloalkyl are moieties that have one or more aromatic rings fused (i.e., having a bond in common with) to the nonaromatic heterocyclic ring, for example phthaliniidyl, naphthalimidyl, and benzo derivatives of heterocycles such as indolene and isoindolene groups.
  • the heterocycloalkyl group has from 1 to about 20 carbon atoms, and in further embodiments from about 3 to about 20 carbon atoms.
  • the heterocycloalkyl group contains 3 to about 14, 3 to about 7, or 5 to 6 ring-forming atoms. In some embodiments, the heterocycloalkyl group has 1 to about 4, 1 to about 3, or 1 to 2 heteroatoms. In some embodiments, the heterocycloalkyl group contains 0 to 3 double bonds. In some embodiments, the heterocycloalkyl group contains 0 to 2 triple bonds.
  • halo or “halogen” includes fluoro, chloro, bromo, and iodo.
  • alkoxy refers to an -O-alkyl group.
  • Example alkoxy groups include methoxy, ethoxy, propoxy (e.g., n-propoxy and isopropoxy), t-butoxy, and the like.
  • haloalkoxy refers to an -0-haloalkyl group.
  • An example haloalkoxy group is OCF 3 .
  • arylalkyl refers to alkyl substituted by aryl and “cycloalkylalkyl” refers to alkyl substituted by cycloalkyl.
  • An example arylalkyl group is benzyl.
  • amino refers to NH 2 .
  • alkylamino refers to an amino group substituted by an alkyl group.
  • dialkylamino refers to an amino group substituted by two alkyl groups.
  • the compounds described herein can be asymmetric (e.g., having one or more stereocenters). All stereoisomers, such as enantiomers and diastereomers, are intended unless otherwise indicated.
  • Compounds of the present invention that contain asymmetrically substituted carbon atoms can be isolated in optically active or racemic forms. Methods on how to prepare optically active forms from optically active starting materials are known in the art, such as by resolution of racemic mixtures or by stereoselective synthesis.
  • Cis and trans geometric isomers of the compounds of the present invention are described and may be isolated as a mixture of isomers or as separated isomeric forms. Resolution of racemic mixtures of compounds can be carried out by any of numerous methods known in the art.
  • An example method includes fractional recrystallizaion using a "chiral resolving acid" which is an optically active, salt-forming organic acid.
  • Suitable resolving agents for fractional recrystallization methods are, for example, optically active acids, such as the D and L forms of tartaric acid, diacetyltartaric acid, dibenzoyltartaric acid, mandelic acid, malic acid, lactic acid or the various optically active camphorsulfonic acids such as ⁇ -camphorsulfonic acid.
  • optically active acids such as the D and L forms of tartaric acid, diacetyltartaric acid, dibenzoyltartaric acid, mandelic acid, malic acid, lactic acid or the various optically active camphorsulfonic acids such as ⁇ -camphorsulfonic acid.
  • resolving agents suitable for fractional crystallization methods include stereoisomerically pure forms of ⁇ - methylbenzylamine (e.g., S and R forms, or diastereomerically pure forms), 2-phenylglycinol, norephedrine, ephedrine, N-methylephedrine, cyclohexylethylamine, 1,2-diaminocyclohexane, and the like. Resolution of racemic mixtures can also be carried out by elution on a column packed with an optically active resolving agent (e.g., dinitrobenzoylphenylglycine). Suitable elution solvent composition can be determined by one skilled in the art.
  • Compounds of the invention also include tautomeric forms, such as keto-enol tautomers.
  • Compounds of the invention can also include all isotopes of atoms occurring in the intermediates or final compounds. Isotopes include those atoms having the same atomic number but different mass numbers.
  • isotopes of hydrogen include tritium and deuterium.
  • pharmaceutically acceptable is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgement, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.
  • the present invention also includes pharmaceutically acceptable salts of the compounds described herein.
  • pharmaceutically acceptable salts refers to derivatives of the disclosed compounds wherein the parent compound is modified by converting an existing acid or base moiety to its salt form.
  • pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like.
  • the pharmaceutically acceptable salts of the present invention include the conventional non-toxic salts or the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids.
  • the pharmaceutically acceptable salts of the present invention can be synthesized from the parent compound which contains a basic or acidic moiety by conventional chemical methods.
  • such salts can be prepared by reacting the free acid or base forms of these compounds with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred. Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., 1985, p.
  • prodrugs refer to any covalently bonded carriers which release the active parent drug when administered to a mammalian subject. Prodrugs can be prepared by modifying functional groups present in the compounds in such a way that the modifications are cleaved, either in routine manipulation or in vivo, to the parent compounds.
  • Prodrugs include compounds wherein hydroxyl, amino, sulfhydryl, or carboxyl groups are bonded to any group that, when administered to a mammalian subject, cleaves to form a free hydroxyl, amino, sulfhydryl, or carboxyl group respectively.
  • Examples of prodrugs include, but are not limited to, acetate, formate and benzoate derivatives of alcohol and amine functional groups in the compounds of the invention. Preparation and use of prodrugs is discussed in T. Higuchi and V. Stella, "Pro-drugs as Novel Delivery Systems," Vol. 14 of the A.C.S. Symposium Series, and in Bioreversible Carriers in Drug Design, ed. Edward B. Roche, American Pharmaceutical Association and Pergamon Press, 1987, both of which are hereby incorporated by reference in their entirety.
  • novel compounds of the present invention can be prepared in a variety of ways known to one skilled in the art of organic synthesis.
  • the compounds of the present invention can be synthesized using the methods as hereinafter described below, together with synthetic methods known in the art of synthetic organic chemistry or variations thereon as appreciated by those skilled in the art.
  • the compounds of this invention can be prepared from readily available starting materials using the following general methods and procedures. It will be appreciated that where typical or preferred process conditions (i.e., reaction temperatures, times, mole ratios of reactants, solvents, pressures, etc.) are given; other process conditions can also be used unless otherwise stated. Optimum reaction conditions may vary with the particular reactants or solvent used, but such conditions can be determined by one skilled in the art by routine optimization procedures.
  • product formation can be monitored by spectroscopic means, such as nuclear magnetic resonance spectroscopy (e.g., 1 H or 13 C) infrared spectroscopy, spectrophotometry (e.g., UV-visible), or mass spectrometry, or by chromatography such as high performance liquid chromatograpy (HPLC) or thin layer chromatography.
  • spectroscopic means such as nuclear magnetic resonance spectroscopy (e.g., 1 H or 13 C) infrared spectroscopy, spectrophotometry (e.g., UV-visible), or mass spectrometry
  • chromatography such as high performance liquid chromatograpy (HPLC) or thin layer chromatography.
  • Preparation of compounds can involve the protection and deprotection of various chemical groups. The need for protection and deprotection, and the selection of appropriate protecting groups can be readily determined by one skilled in the art.
  • the chemistry of protecting groups can be found, for example, in Greene, et al., Protective Groups in Organic Synthesis, 2d. Ed., Wiley & Sons, 1991, which is incorporated herein by reference in its entirety.
  • the reactions of the processes described herein can be carried out in suitable solvents which can be readily selected by one of skill in the art of organic synthesis. Suitable solvents can be substantially nonreactive with the starting materials (reactants), the intermediates, or products at the temperatures at which the reactions are carried out, i.e., temperatures which can range from the solvent's freezing temperature to the solvent's boiling temperature.
  • a given reaction can be carried out in one solvent or a mixture of more than one solvent.
  • suitable solvents for a particular reaction step can be selected.
  • the compounds of the invention can be prepared, for example, using the reaction pathways and techniques as described below.
  • a series of carboxamides of formula 2 are prepared by the method outlined in Scheme 1.
  • Carboxylic acids 1 can be coupled to a cyclic amine (e.g., piperidine, pyrrolidine, etc. wherein a is e.g., 0 to 10 and R' represents any of R 3 , R 4 , R 5 , R 6 , R 7 , R 8 , R 9 , R 10 , R 11 , or R 12 ) using a coupling reagent such as BOP to provide the desired products 2.
  • a coupling reagent such as BOP
  • a series of carboxylic acids of formula 6 (wherein L can be S, O, etc) can be prepared according to the method outlined in Scheme 2.
  • Reaction of the appropriate thiol or alcohol 3 with methyl bromoacetate in the presence of a base such as potassium or sodium carbonate, triethylamine or sodium hydride in a solvent such as tetrahydrofiiran, acetonitrile or dichloromethane provides thioethers or ethers 4.
  • Treatment of 4 with excess of an alkyl bromide or iodide in the presence of sodium hydride and DMF or LDA and THF or any other suitable base/solvent combination provides methyl esters 5, which upon basic hydrolysis yield the desired carboxylic acids 6.
  • O- or S-alkylation of compounds 13 with a suitable chloride or bromide provides methyl esters 14.
  • Alkylation of 7 with the appropriate alkyl bromide or iodide in the presence of LDA yields methyl esters 15, which can undergo a second alkylation with another alkyl bromide or iodide in the presence of NaH in DMSO to provide the corresponding esters 16.
  • basic hydrolysis yields the desired carboxylic acids 17.
  • carboxylic acids 27 can be prepared by the reaction of the appropriate alcohol with thioglycolic acid 22 in the presence of a Lewis acid such as zinc trifluoromethanesulfonate, under refluxing conditions. Then 23 can be processed to the desired carboxylic acids 27 in the standard fashion as shown in Scheme 7.
  • a Lewis acid such as zinc trifluoromethanesulfonate
  • Thioether 28 can be oxidized to the corresponding sulfone 29 with 3-chloroperoxybenzoic acid. Following Scheme 8, as previously described, a series of carboxylic acids of formula 31 can be prepared. The same sequence (conversion of the thioether to a sulfone) can be employed in any of the Schemes described earlier.
  • a series of carboxylic acids of formula 36 can be prepared by the method outlined in Scheme 9.
  • N-Boc glycine methyl ester, 32 can undergo C ⁇ alkylation in the standard fashion to provide compounds 33.
  • an N-alkylation with the appropriate alkyl bromide or iodide leads to the formation of methyl esters 35, which upon basic hydrolysis provide the desired carboxylic acids 36.
  • a series of carboxylic acids of formula 40 can be prepared by the method outlined in Scheme 11. Reaction of Cbz protected amine 37 with 2-bromo methyl acetate provides methyl esters 38. Alkylation(s) in the standard fashion as shown below provides methyl esters 39. Then, basic hydrolysis yields the desired carboxylic acids 40. The Cbz group can be removed under hydrogenolysis conditions at the appropriate stage.
  • a series of 3 -substituted pyrrolidine 43 and 45 can be prepared by the method outlined in Scheme 12 (where R' is, e.g., -W'-X'-Y'-Z').
  • Compound 41 can be treated with an organolithium or a Grinard reagent to provide alcohol 42.
  • the Boc protecting group of 42 can be removed by treatment with TFA to give 3 -substituted pyrrolidine 43.
  • 42 can be treated with HCl to provide the alkene 44, followed by hydrogenation to give 3 -substituted pyrrolidine 45.
  • a series of 3 -substituted pyrrolidines 47 can be prepared by the method outlined in Scheme 13 (where Ar is an aromatic moiety).
  • a sequence of a Pd catalyzed coupling reaction of alkene 46 with aryl bromides or heteroaryl bromides, followed by hydrogenation provides the desired 3- substituted pyrrolidines 47.
  • a series of 3-hydroxyl-4-substituted pyrrolidines 49 can be prepared by the method outlined in Scheme 14 (where Ar is an aromatic moiety).
  • Alkene 46 can react with mCPBA to provide the corresponding epoxide, which upon treatment with an organolithium or a Grignard reagent in the presence of Al(Me) 3 or other Lewis acid gives alcohols 48.
  • hydrogenolysis provides the desired amines 49.
  • a series of 3,3-disubstituted pyrrolidines or piperidines 53 can be prepared by the method outlined in Scheme 15 (Ar is, for example, aryl or heteroaryl; n is 1 or 2 and m is 1 or 2).
  • Ketone 50 can be treated with the appropriate Wittig reagent to provide olefinic compound 51.
  • Reaction of 51 with an organocuprate A ⁇ CuLi provides the corresponding 1,4 addition products 52.
  • the Cbz protecting group of 52 can be cleaved by hydrogenation to provide the desired 3,3-disubstituted pyrrolidines or 3,3-disubstituted piperidines 53.
  • Pyrrolidine 56 can also be prepared according to Scheme 16. Halogen metal exchange between aryl iodide 54 and isopropylmagnesium bromide followed by reaction with N-Boc-3-oxo- pyrrolidine provides spiral lactone 55 which upon acidic cleavage of the Boc group yields the desired pyrrolidine 56.
  • pyrrolidine 59 can be prepared according to Scheme 17. Ortho lithiation of carboxylic acid 57, followed by reaction of the resulting organolithium with N-Boc-3-oxo-pyrrolidine yields spiral lactone 58, which upon acidic cleavage of the Boc group provides the desired pyrrolidine 59.
  • Pyrrolidine 64 can be prepared according to the method outlined in Scheme 18.
  • Scheme 18 64 N-Boc-2-Arylpiperazines of formula 68 can be prepared according to Scheme 19 (where Ar is an aromatic moiety).
  • ⁇ -Bromo esters 65 react with ethylenediamine in the presence of EtONa to provide 2-aryl-3-oxo-piperazines 66. Protection with BOC 2 O followed by LAH reduction yields the desired monoprotected 2-arylpiperazines 68.
  • Scheme 19 where Ar is an aromatic moiety.
  • a series of compounds 71 can be prepared by the method outlined in Scheme 20 (where R 1 and R" are each, independently, H, C 1-6 alkyl, cycloalkyl, aryl, etc.).
  • Carboxylic acids 1 can couple with an amine such as the pyrrolidine shown using BOP or any other coupling reagent to provide 69.
  • the hydroxyl group of 69 can be alkylated with 2-bromoacetate to give compounds 70.
  • Hydrolysis of the r-butyl ester with TFA, followed by the standard coupling reaction with a variety of amines yields compounds 71.
  • the hydroxyl group of compound 69 can be alkylated with N-Boc-protected 2-amino ethyl bromide to give compounds 72.
  • the N-Boc group of 72 can be removed by TFA.
  • the resulting free amino group of compounds 73 can be converted into a variety of analogs of formula 74 by routine methods.
  • a series of compounds 78 can be prepared by the method outlined in Scheme 22 (where Ar can be an aromatic moiety, alkyl or the like, R 1 and R" are each, independently, H, C 1 ⁇ alkyl, cycloalkyl, aryl, etc.; R 1 " and R ⁇ v are, e.g., H, alkyl, carbocycle, heterocycle, alkylcarbonyl, aminocarbonyl, alkylsulfonyl, alkoxycarbonyl, etc).
  • Carboxylic acids 1 can couple with 2- arylpiperazine 68 using BOP or any other coupling reagent to provide 75. After removal of the Boc group, 76 can be alkylated with 2-bromoacetate to give compounds 77. Hydrolysis of the t- butyl ester with TFA, followed by the standard coupling reaction with a variety of amines can yield compounds 78.
  • R 111 and R 1V are, e.g., H, alkyl, carbocycle, heterocycle, alkylcarbonyl, aminocarbonyl, alkylsulfonyl, alkoxycarbonyl, etc
  • 76 can be alkylated with N-Boc-protected 2-amino ethyl bromide to provide compounds 79.
  • the N-Boc group of 79 can be removed with TFA.
  • the resulting free amino group of compounds 79 can be converted into a variety of analogs of formula 80 by routine methods.
  • Compounds of the invention can modulate activity of ll ⁇ HSDl and/or MR.
  • modulate is meant to refer to an ability to increase or decrease activity of an enzyme or receptor.
  • compounds of the invention can be used in methods of modulating ll ⁇ HSDl and/or MR by contacting the enzyme or receptor with any one or more of the compounds or compositions described herein.
  • compounds of the present invention can act as inhibitors of ll ⁇ HSDl and/or MR.
  • the compounds of the invention can be used to modulate activity of ll ⁇ HSDl and/or MR in an individual in need of modulation of the enzyme or receptor by administering a modulating amount of a compound of the invention.
  • the present invention further provides methods of inhibiting the conversion of cortisone to Cortisol in a cell, or inhibiting the production of Cortisol in a cell, where conversion to or production of Cortisol is mediated, at least in part, by 1 l ⁇ HSDl activity. Methods of measuring conversion rates of cortisone to Cortisol and vice versa, as well as methods for measuring levels of cortisone and Cortisol in cells, are routine in the art.
  • the present invention further provides methods of increasing insulin sensitivity of a cell by contacting the cell with a compound of the invention. Methods of measuring insulin sensitivity are routine in the art.
  • the present invention further provides methods of treating disease associated with activity or expression, including abnormal activity and overexpression, of ll ⁇ HSDl and/or MR in an individual (e.g., patient) by administering to the individual in need of such treatment a therapeutically effective amount or dose of a compound of the present invention or a pharmaceutical composition thereof.
  • Example diseases can include any disease, disorder or condition that is directly or indirectly linked to expression or activity of the enzyme or receptor.
  • An l l ⁇ HSDl -associated disease can also include any disease, disorder or condition that can be prevented, ameliorated, or cured by modulating enzyme activity.
  • l l ⁇ HSDl -associated diseases include obesity, diabetes, glucose intolerance, insulin resistance, hyperglycemia, hypertension, hyperlipidemia, cognitive impairment, dementia, glaucoma, cardiovascular disorders, osteoporosis, and inflammation.
  • Further examples of l l ⁇ HSDl - associated diseases include metabolic syndrome, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) and polycystic ovary syndrome (PCOS).
  • the present invention further provides methods of modulating MR activity by contacting the MR with a compound of the invention, pharmaceutically acceptable salt, prodrug, or composition thereof. In some embodiments, the modulation can be inhibition.
  • methods of inhibiting aldosterone binding to the MR are provided.
  • Methods of measuring MR activity and inhibition of aldosterone binding are routine in the art.
  • the present invention further provides methods of treating a disease associated with activity or expression of the MR.
  • diseases associated with activity or expression of the MR include, but are not limited to hypertension, as well as cardiovascular, renal, and inflammatory pathologies such as heart failure, atherosclerosis, arteriosclerosis, coronary artery disease, thrombosis, angina, peripheral vascular disease, vascular wall damage, stroke, dyslipidemia, hyperlipoproteinaemia, diabetic dyslipidemia, mixed dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and those associated with type 1 diabetes, type 2 diabetes, obesity metabolic syndrome, insulin resistance and general aldosterone-related target organ damage.
  • the term "cell” is meant to refer to a cell that is in vitro, ex vivo or in vivo.
  • an ex vivo cell can be part of a tissue sample excised from an organism such as a mammal.
  • an in vitro cell can be a cell in a cell culture.
  • an in vivo cell is a cell living in an organism such as a mammal.
  • the cell is an adipocyte, a pancreatic cell, a hepatocyte, neuron, or cell comprising the eye.
  • the term "contacting" refers to the bringing together of indicated moieties in an in vitro system or an in vivo system.
  • "contacting" the l l ⁇ HSDl enzyme with a compound of the invention includes the administration of a compound of the present invention to an individual or patient, such as a human, having l l ⁇ HSDl, as well as, for example, introducing a compound of the invention into a sample containing a cellular or purified preparation containing the l l ⁇ HSDl enzyme.
  • the term "individual” or “patient,” used interchangeably, refers to any animal, including mammals, preferably mice, rats, other rodents, rabbits, dogs, cats, swine, cattle, sheep, horses, or primates, and most preferably humans.
  • the phrase "therapeutically effective amount” refers to the amount of active compound or pharmaceutical agent that elicits the biological or medicinal response that is being sought in a tissue, system, animal, individual or human by a researcher, veterinarian, medical doctor or other clinician, which includes one or more of the following: (1) preventing the disease; for example, preventing a disease, condition or disorder in an individual who may be predisposed to the disease, condition or disorder but does not yet experience or display the pathology or symptomatology of the disease (non-limiting examples are preventing metabolic syndrome, hypertension, obesity, insulin resistance, hyperglycemia, hyperlipidemia, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) and polycystic ovary syndrome (PCOS); (2) inhibiting the disease; for example, inhibiting a disease, condition or disorder in an individual who is experiencing or displaying the pathology or symptomatology of the disease, condition or disorder (i.e., arresting further development of the pathology and/or
  • compositions When employed as pharmaceuticals, the compounds of Formula I can be administered in the form of pharmaceutical compositions. These compositions can be prepared in a manner well known in the pharmaceutical art, and can be administered by a variety of routes, depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be topical (including ophthalmic and to muco ⁇ s membranes including intranasal, vaginal and rectal delivery), pulmonary (e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal), ocular, oral or parenteral.
  • topical including ophthalmic and to muco ⁇ s membranes including intranasal, vaginal and rectal delivery
  • pulmonary e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal
  • Methods for ocular delivery can include topical administration (eye drops), subconjunctival, periocular or intravitreal injection or introduction by balloon catheter or ophthalmic inserts surgically placed in the conjunctival sac.
  • Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, e.g., intrathecal or intraventricular, administration.
  • Parenteral administration can be in the form of a single bolus dose, or may be, for example, by a continuous perfusion pump.
  • Pharmaceutical compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids and powders.
  • compositions which contain, as the active ingredient, one or more of the compounds of the invention above in combination with one or more pharmaceutically acceptable carriers, hi making the compositions of the invention, the active ingredient is typically mixed with an excipient, diluted by an excipient or enclosed within such a carrier in the form of, for example, a capsule, sachet, paper, or other container.
  • the excipient serves as a diluent, it can be a solid, semi-solid, or liquid material, which acts as a vehicle, carrier or medium for the active ingredient.
  • compositions can be in the form of tablets, pills, powders, lozenges, sachets, cachets, elixirs, suspensions, emulsions, solutions, syrups, aerosols (as a solid or in a liquid medium), ointments containing, for example, up to 10 % by weight of the active compound, soft and hard gelatin capsules, suppositories, sterile injectable solutions, and sterile packaged powders.
  • the active compound can be milled to provide the appropriate particle size prior to combining with the other ingredients. If the active compound is substantially insoluble, it can be milled to a particle size of less than 200 mesh.
  • the particle size can be adjusted by milling to provide a substantially uniform distribution in the formulation, e.g. about 40 mesh.
  • suitable excipients include lactose, dextrose, sucrose, sorbitol, mannitol, starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water, syrup, and methyl cellulose.
  • the formulations can additionally include: lubricating agents such as talc, magnesium stearate, and mineral oil; wetting agents; emulsifying and suspending agents; preserving agents such as methyl- and propylhydroxy-benzoates; sweetening agents; and flavoring agents.
  • lubricating agents such as talc, magnesium stearate, and mineral oil
  • wetting agents such as talc, magnesium stearate, and mineral oil
  • emulsifying and suspending agents such as methyl- and propylhydroxy-benzoates
  • sweetening agents and flavoring agents.
  • the compositions of the invention can be formulated so as to provide quick, sustained or delayed release of the active ingredient after administration to the patient by employing procedures known in the art.
  • the compositions can be formulated in a unit dosage form, each dosage containing from about 5 to about 100 mg, more usually about 10 to about 30 mg, of the active ingredient.
  • unit dosage forms refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical excipient.
  • the active compound can be effective over a wide dosage range and is generally administered in a pharmaceutically effective amount. It will be understood, however, that the amount of the compound actually administered will usually be determined by a physician, according to the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual compound administered, the age, weight, and response of the individual patient, the severity of the patient's symptoms, and the like.
  • the principal active ingredient is mixed with a pharmaceutical excipient to form a solid preformulation composition containing a homogeneous mixture of a compound of the present invention.
  • a solid preformulation composition containing a homogeneous mixture of a compound of the present invention.
  • the active ingredient is typically dispersed evenly throughout the composition so that the composition can be readily subdivided into equally effective unit dosage forms such as tablets, pills and capsules.
  • This solid preformulation is then subdivided into unit dosage forms of the type described above containing from, for example, 0.1 to about 500 mg of the active ingredient of the present invention.
  • the tablets or pills of the present invention can be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action.
  • the tablet or pill can comprise an inner dosage and an outer dosage component, the latter being in the form of an envelope over the former.
  • the two components can be separated by an enteric layer which serves to resist disintegration in the stomach and permit the inner component to pass intact into the duodenum or to be delayed in release.
  • enteric layers or coatings such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol, and cellulose acetate.
  • compositions for inhalation or insufflation include solutions and suspensions in pharmaceutically acceptable, aqueous or organic solvents, or mixtures thereof, and powders.
  • the liquid or solid compositions may contain suitable pharmaceutically acceptable excipients as described supra.
  • the compositions are administered by the oral or nasal respiratory route for local or systemic effect.
  • compositions in can be nebulized by use of inert gases. Nebulized solutions may be breathed directly from the nebulizing device or the nebulizing device can be attached to a face masks tent, or intermittent positive pressure breathing machine. Solution, suspension, or powder compositions can be administered orally or nasally from devices which deliver the formulation in an appropriate manner.
  • the amount of compound or composition administered to a patient will vary depending upon what is being administered, the purpose of the administration, such as prophylaxis or therapy, the state of the patient, the manner of administration, and the like. In therapeutic applications, compositions can be administered to a patient already suffering from a disease in an amount sufficient to cure or at least partially arrest the symptoms of the disease and its complications.
  • compositions administered to a patient can be in the form of pharmaceutical compositions described above. These compositions can be sterilized by conventional sterilization techniques, or may be sterile filtered. Aqueous solutions can be packaged for use as is, or lyophilized, the lyophilized preparation being combined with a sterile aqueous carrier prior to administration.
  • the pH of the compound preparations typically will be between 3 and 11, more preferably from 5 to 9 and most preferably from 7 to 8.
  • the therapeutic dosage of the compounds of the present invention can vary according to, for example, the particular use for which the treatment is made, the manner of administration of the compound, the health and condition of the patient, and the judgment of the prescribing physician.
  • the proportion or concentration of a compound of the invention in a pharmaceutical composition can vary depending upon a number of factors including dosage, chemical characteristics (e.g., hydrophobicity), and the route of administration.
  • the compounds of the invention can be provided in an aqueous physiological buffer solution containing about 0.1 to about 10% w/v of the compound for parenteral adminstration.
  • Some typical dose ranges are from about 1 ⁇ g/kg to about 1 g/kg of body weight per day. In some embodiments, the dose range is from about 0.01 mg/kg to about 100 mg/kg of body weight per day.
  • the dosage is likely to depend on such variables as the type and extent of progression of the disease or disorder, the overall health status of the particular patient, the relative biological efficacy of the compound selected, formulation of the excipient, and its route of administration. Effective doses can be extrapolated from dose-response curves derived from in vitro or animal model test systems.
  • the compounds of the invention can also be formulated in combination with one or more additional active ingredients which can include any pharmaceutical agent such as anti-viral agents, antibodies, immune suppressants, anti-inflammatory agents and the like.
  • radio-labeled compounds of the invention that would be useful not only in radio-imaging but also in assays, both in vitro and in vivo, for localizing and quantitating the enzyme in tissue samples, including human, and for identifying ligands by inhibition binding of a radio-labeled compound.
  • the present invention includes enzyme assays that contain such radio-labeled compounds.
  • the present invention further includes isotopically-labeled compounds of the invention.
  • An "isotopically" or "radio-labeled" compound is a compound of the invention where one or more atoms are replaced or substituted by an atom having an atomic mass or mass number different from the 11
  • radionuclides that may be incorporated in compounds of the present invention include but are not limited to 2 H (also written as D for deuterium), 3 H (also written as T for tritium), 11 C, 13 C, 14 C, 13 N, 15 N, 15 O, 17 0, 18 O, 18 F, 35 S, 36 Cl, 82 Br, 75 Br, 76 Br, 77 Br, 123 I, 124 I, 125 I and 131 I.
  • the radionuclide that is 5 incorporated in the instant radio-labeled compounds will depend on the specific application of that radio-labeled compound.
  • radio-labeled or “labeled compound” is a compound that has O incorporated at least one radionuclide.
  • the radionuclide is selected from the group consisting of 3 H, 14 C, 125 1 , 35 S and 82 Br. Synthetic methods for incorporating radio-isotopes into organic compounds are applicable to compounds of the invention and are well known in the art.
  • a radio-labeled compound of the invention can be used in a screening assay to 5 identify/evaluate compounds.
  • a newly synthesized or identified compound i.e., test compound
  • a test compound can be evaluated for its ability to reduce binding of the radio-labeled compound of the invention to the enzyme. Accordingly, the ability of a test compound to compete with the radio ⁇ labeled compound for binding to the enzyme directly correlates to its binding affinity.
  • kits useful for example, in the treatment or prevention of ll ⁇ HSDl -associated diseases or disorders, obesity, diabetes and other diseases referred to herein which include one or more containers containing a pharmaceutical composition comprising a therapeutically effective amount of a compound of the invention.
  • kits can further 5 include, if desired, one or more of various conventional pharmaceutical kit components, such as, for example, containers with one or more pharmaceutically acceptable carriers, additional containers, etc., as will be readily apparent to those skilled in the art.
  • Instructions, either as inserts or as labels, indicating quantities of the components to be administered, guidelines for administration, and/or guidelines for mixing the components, can also be included in the kit. 0
  • the invention will be described in greater detail by way of specific examples.
  • Step 3 4-[l , l-Dimethyl-2-oxo-2-(3-oxo-l 'H,3H-spiro[2-henzofuran-l ,3 '-pyrrolidinj-l '- yl) ethoxyjbenzonitrile 2-(4-Cyanophenoxy)-2-methylpropanoic acid (0.040 g, 0.19 mmol) was dissolved in DMF (1.9 mL) and treated with BOP reagent (0.103 g, 0.234 mmol).
  • Example 28 Ethyl 2-(4-bromophenoxy)-2-methylpropanoate (0.400 g, 1.39 mmol) of Example 28 was dissolved in dry toluene (16 niL) in a schlenck flask under nitrogen. To that solution was added successively 2-(tributylstannyl)pyridine (0.673 g, 1.46 mmol) and tetrakis(triphenylphosphine)palladium(0) (0.080 g, 0.07 mmol). The reaction mixture was evacuated and flushed with nitrogen four times and then stirred at 110 0 C overnight. It was brought to ambient temperature and filtered through a short silica gel pad (hexanes: ethyl acetate, 3:1 to 1:1).
  • Step 3 1 '-[2-Methyl-2-(4-pyridin-2-ylphenoyy)propanoyl]-3H-spiro[2-benzofuran-l,3 '-pyrrolidin]-3- one 2-Methyl-2-(4-pyridin-2-ylphenoxy)propanoic acid (0.030 g, 0.12 mmol) was dissolved in DMF (1.2 mL) and treated with BOP reagent (0.062 g, 0.140 mmol).
  • the reaction was quenched by adding saturated NH 4 CI and then extracted with ethyl acetate and the combined extract was washed with water, brine, dried and concentrated.
  • the product was purified by CombiFlash using Hexane/Ethyl acetate.
  • Step 3 2-(p-Chlorophenoxy)-2-methylpropanoic acid (0.030 g, 0.12 mmol) was dissolved in DMF [0 (1.3 mL) and treated with BOP reagent (0.062 g, 0.139 mmol). After stirring for 10 minutes, (1 S)-(+> 10-camphorsulfonic acid salt of (lR)-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one(l:l) (0.054 g, 0.128 mmol) was added followed by N,N-diisopropylethylamine (0.061 mL, 0.348 mmol). The reaction mixture was stirred at ambient temperature overnight.
  • Step 1 Synthesis of7H-spiro[furo[3,4-b]pyridine-5,3'-pyrrolidin]-7-one
  • a solution of 2,2,6,6-tetramethyl-piperidine (0.820 niL, 0.00486 mol) in tetrahydrofuran (5 mL, 0.06 mol) at -75 Celsius was added 1.600 M of n-butyllithium in hexane (4.05 mL). After stirred for 15 min, a solution of 2-pyridinecarboxylic acid (199 mg, 0.00162 mmol) was added. The mixture was continue stir at -75 Celsius 10 min, then stir at -20 Celsius for 30 min.
  • Stepl Benzyl 3-oxo-l 'H,3H-spiro[2-ben ⁇ ofuran-l ,3 '-pyrrolidine] -1 'carboxylate
  • a solution of methyl-2-iodobenzoate(8.8 niL, 0.060 mol) in THF (300 mL) at -60 0 C was slowly added a solution of isopropylmagnesium bromide in THF (1.0 M, 66.0 mL) and the mixture was stirred below -50 0 C for 1 h.
  • Step 4 methyl 4-(4- ⁇ l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]- r-yl]ethyl ⁇ phenyl)piperazine-l-carboxylate
  • Methyl chloroformate (8.3 uL, 0.00011 mol) was added to a mixture of (IR)-I '-[2-methyl-2- (4-piperazin-l-ylphenyl)propanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one (18 mg, 0.000043 mol) and 4-methylmorpholine (19 uL, 0.00017 mol) in acetonitrile (1.0 mL, 0.0
  • Example 73 (12 ⁇ )-l'- ⁇ 2-Methyl-2-[4-(4-propionyIpiperazin-l-yl)phenyl]propanoyl ⁇ -3H-spiro[2-benzofuran- l,3'-pyrrolidin]-3-one
  • This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63.
  • LCMS: (M+H) + 476.3.
  • Example 81 3-(4-Chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-yl]-3-methyI-4-oxobutanoic acid
  • a mixture of tert-butyl 3-(4-chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-yl]-3-methyl-4- oxobutanoate (0.100 g, 0.000216 mol, prepared as example 66) in trifluoroacetic acid (1.0 mL, 0.013 mol) and methylene chloride (10 mL, 0.2 mol) was stirred at rt for 2 hours. The volatiles were removed in-vacuo to yield 70 mg of the desired product.
  • LCMS: (M+H) + 407.1.
  • Example 105 S-C ⁇ ll j l-Dimethyl-l-oxo-l-ICl ⁇ -S-oxo-l ⁇ H-spiroP-benzofuran-ljS'-pyrrolidinl-l'-yljethyl ⁇ - 3-fluorophenyI)-N,N-dimethylpyridine-2-carboxamide
  • This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103.
  • LCMS: (M+H) + 402.2.
  • Example A Enzymatic assay of ll ⁇ HSDl All in vitro assays were performed with clarified lysates as the source of ll ⁇ HSDl activity.
  • HEK-293 transient transfectants expressing an epitope-tagged version of full-length human ll ⁇ HSDl were harvested by centrifugation.
  • Roughly 2 x 10 7 cells were resuspended in 40 rnL of lysis buffer (25 mM Tris-HCl, pH 7.5, 0.1M NaCl, 1 mM MgCl 2 and 25OmM sucrose) and lysed in a microfluidizer. Lysates were clarified by centrifugation and the supernatants were aliquoted and frozen.
  • SPA Scintillation Proximity Assay
  • Reactions were initiated by addition of 20 ⁇ L of substrate- cofactor mix in assay buffer (25 mM Tris-HCl, pH 7.5, 0.1M NaCl, 1 mM MgCl 2 ) to final concentrations of 400 ⁇ M NADPH, 25 nM 3 H-cortisone and 0.007% Triton X-IOO. Plates were incubated at 37 0 C for one hour. Reactions were quenched by addition of 40 ⁇ L of anti-mouse coated SPA beads that had been pre-incubated with 10 ⁇ M carbenoxolone and a cortisol-specific monoclonal antibody.
  • assay buffer 25 mM Tris-HCl, pH 7.5, 0.1M NaCl, 1 mM MgCl 2
  • PBMCs Peripheral blood mononuclear cells
  • AIM V Gibco- BRL
  • IL-4 R&D Systems
  • 200 nM cortisone Sigma was added in the presence or absence of various concentrations of compound.
  • the cells were incubated for 48 hours and then supernatants were harvested. Conversion of cortisone to Cortisol was determined by a commercially available ELISA (Assay Design). Test compounds having an IC 5O value less than about 20 ⁇ M according to this assay were considered active.
  • Example C Cellular assay to evaluate MR antagonism Assays for MR antagonism can be performed essentially as described (Jausons-Loffreda et al. J Biolumin and Chemilumin, 1994, 9: 217-221). Briefly, HEK293/MSR cells (Invitrogen Corp.) are US2005/022411
  • plasmids co-transfected with three plasmids: 1) one designed to express a fusion protein of the GAL4 DNA binding domain and the mineralocorticoid receptor ligand binding domain, 2) one containing the GAL4 upstream activation sequence positioned upstream of a firefly luciferase reporter gene (pFR- LUC, Stratagene, Inc.), and 3) one containing the Renilla luciferase reporter gene cloned downstream of a thymidine kinase promoter (Promega). Transfections are performed using the FuGENE ⁇ reagent (Roche). Transfected cells are typically ready for use in subsequent assays 24 hours post-transfection.
  • test compounds are diluted in cell culture medium (E-MEM, 10% charcoal-stripped FBS, 2 mM L-glutamine) supplemented with 1 nM aldosterone and applied to the transfected cells for 16-18 hours. After the incubation of the cells with the test compound and aldosterone, the activity of firefly luciferase (indicative of MR agonism by aldosterone) and Renilla luciferase (normalization control) are determined using the Dual-Glo Luciferae Assay System (Promega).
  • E-MEM 10% charcoal-stripped FBS, 2 mM L-glutamine
  • Antagonism of the mineralocorticoid receptor is determined by monitoring the ability of a test compound to attenuate the aldosterone-induced firefly luciferase activity. Compounds having an IC 50 of 100 ⁇ M or less are considered active.

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Abstract

The present invention relates to inhibitors of 11-ß hydroxyl steroid dehydrogenase type 1, antagonists of the mineralocorticoid receptor (MR), and pharmaceutical compositions thereof. The compounds of the invention can be useful in the treatment of various diseases associated with expression or activity of 11-ß hydroxyl steroid dehydrogenase type 1 and/or diseases associated with aldosterone excess.

Description

AMIDO COMPOUNDS AND THEIR USE AS PHARMACEUTICALS
FIELD OF THE INVENTION The present invention relates to modulators of 11-β hydroxyl steroid dehydrogenase type 1 (llβHSDl) and/or mineralocorticoid receptor (MR), compositions thereof and methods of using the same.
BACKGROUND OF THE INVENTION Glucocorticoids are steroid hormones that regulate fat metabolism, function and distribution. In vertebrates, glucocorticoids also have profound and diverse physiological effects on development, neurobiology, inflammation, blood pressure, metabolism and programmed cell death. In humans, the primary endogenously-produced glucocorticoid is Cortisol. Cortisol is synthesized in the zona fasciculate of the adrenal cortex under the control of a short-term neuroendocrine feedback circuit called the hypothalamic-pituitary-adrenal (HPA) axis. Adrenal production of Cortisol proceeds under the control of adrenocorticotrophic hormone (ACTH), a factor produced and secreted by the anterior pituitary. Production of ACTH in the anterior pituitary is itself highly regulated, driven by corticotropin releasing hormone (CRH) produced by the paraventricular nucleus of the hypothalamus. The HPA axis maintains circulating Cortisol concentrations within restricted limits, with forward drive at the diurnal maximum or during periods of stress, and is rapidly attenuated by a negative feedback loop resulting from the ability of Cortisol to suppress ACTH production in the anterior pituitary and CRH production in the hypothalamus. Aldosterone is another hormone produced by the adrenal cortex; aldosterone regulates sodium and potassium homeostasis. Fifty years ago, a role for aldosterone excess in human disease was reported in a description of the syndrome of primary aldosteronism (Conn, (1955), J. Lab. Clin. Med. 45: 6-17). It is now clear that elevated levels of aldosterone are associated with deleterious effects on the heart and kidneys, and are a major contributing factor to morbidity and mortality in both heart failure and hypertension. Two members of the nuclear hormone receptor superfamily, glucocorticoid receptor (GR) and mineralocorticoid receptor (MR), mediate Cortisol function in vivo, while the primary intracellular receptor for aldosterone is the MR. These receptors are also referred to as 'ligand-dependent transcription factors,'1 because their functionality is dependent on the receptor being bound to its ligand (for example, Cortisol); upon ligand-binding these receptors directly modulate transcription via DNA-binding zinc finger domains and transcriptional activation domains. Historically, the major determinants of glucocorticoid action were attributed to three primary factors: 1) circulating levels of glucocorticoid (driven primarily by the HPA axis), 2) protein binding of glucocorticoids in circulation, and 3) intracellular receptor density inside target tissues. Recently, a fourth determinant of glucocorticoid function was identified: tissue-specific pre-receptor metabolism by glucocorticoid-activating and -inactivating enzymes. These 11-beta-hydroxysteroid dehydrogenase (11-β-HSD) enzymes act as pre-receptor control enzymes that modulate activation of the GR and MR by regulation of glucocorticoid hormones. To date, two distinct isozymes of 11-beta-HSD have been cloned and characterized: l lβHSDl (also known as 11-beta-HSD type 1, l lbetaHSDl, HSDI lBl, HDL, and HSDI lL) and l lβHSD2. l lβHSDl and llβHSD2 catalyze the interconversion of hormonally active Cortisol (corticosterone in rodents) and inactive cortisone (11- dehydrocorticosterone in rodents). l lβHSDl is widely distributed in rat and human tissues; expression of the enzyme and corresponding mRNA have been detected in lung, testis, and most abundantly in liver and adipose tissue. l lβHSDl catalyzes both 11-beta-dehydrogenation and the reverse 11-oxoreduction reaction, although l lβHSDl acts predominantly as a NADPH-dependent oxoreductase in intact cells and tissues, catalyzing the activation of Cortisol from inert cortisone (Low et al. (1994) J. MoI. Endocrin. 13: 167-174) and has been reported to regulate glucocorticoid access to the GR. Conversely, 11 βHSD2 expression is found mainly in mineralocorticoid target tissues such as kidney, placenta, colon and salivary gland, acts as an NAD-dependent dehydrogenase catalyzing the inactivation of Cortisol to cortisone (Albiston et al. (1994) MoI. Cell. Endocrin. 105: RI l -Rl 7), and has been found to protect the MR from glucocorticoid excess, such as high levels of receptor-active Cortisol (Blum, et al., (2003) Prog. Nucl. Acid Res. MoI. Biol. 75:173-216). In vitro, the MR binds Cortisol and aldosterone with equal affinity. The tissue specificity of aldosterone activity, however, is conferred by the expression of l lβHSD2 (Funder et al. (1988), Science 242: 583-585). The inactivation of Cortisol to cortisone by l lβHSD2 at the site of the MR enables aldosterone to bind to this receptor in vivo. The binding of aldosterone to the MR results in dissociation of the ligand-activated MR from a multiprotein complex containing chaperone proteins, translocation of the MR into the nucleus, and its binding to hormone response elements in regulatory regions of target gene promoters. Within the distal nephron of the kidney, induction of serum and glucocorticoid inducible kinase-1 (sgk-1) expression leads to the absorption Of Na+ ions and water through the epithelial sodium channel, as well as potassium excretion with subsequent volume expansion and hypertension (Bhargava et al., (2001), Endo 142: 1587-1594). In humans, elevated aldosterone concentrations are associated with endothelial dysfunction, myocardial infarction, left ventricular atrophy, and death. In attempts to modulate these ill effects, multiple intervention strategies have been adopted to control aldosterone overactivity and attenuate the resultant hypertension and its associated cardiovascular consequences. Inhibition of angiotensin- converting enzyme (ACE) and blockade of the angiotensin type 1 receptor (ATlR) are two strategies that directly impact the rennin-angiotensin-aldosterone system (RAAS). However, although ACE inhibition and ATlR antagonism initially reduce aldosterone concentrations, circulating concentrations of this hormone return to baseline levels with chronic therapy (known as 'aldosterone escape'). Importantly, co-administration of the MR antagonist Spironolactone or Eplerenone directly blocks the deleterious effects of this escape mechanism and dramatically reduces patient mortality (Pitt et al, New England J. Med. (1999), 341: 709-719; Pitt et al., New England J. Med. (2003), 348: 1309-1321). Therefore, MR antagonism may be an important treatment strategy for many patients with hypertension and cardiovascular disease, particularly those hypertensive patients at risk for target-organ damage. Mutations in either of the genes encoding the 11-beta-HSD enzymes are associated with human pathology. For example, l lβHSD2 is expressed in aldosterone-sensitive tissues such as the distal nephron, salivary gland, and colonic mucosa where its Cortisol dehydrogenase activity serves to protect the intrinsically non-selective MR from illicit occupation by Cortisol (Edwards et al. (1988) Lancet 2: 986-989). Individuals with mutations in 1 lβHSD2 are deficient in this cortisol-inactivation activity and, as a result, present with a syndrome of apparent mineralocorticoid excess (also referred to as 'SAME') characterized by hypertension, hypokalemia, and sodium retention (Wilson et al. (1998) Proc. Natl. Acad. Sci. 95: 10200-10205). Likewise, mutations in llβHSDl, a primary regulator of tissue-specific glucocorticoid bioavailability, and in the gene encoding a co-localized NADPH-generating enzyme, hexose 6-phosphate dehydrogenase (H6PD), can result in cortisone reductase deficiency (CRD), in which activation of cortisone to Cortisol does not occur, resulting in adrenocorticotropin-mediated androgen excess. CRD patients excrete virtually all glucocorticoids as cortisone metabolites (tetrahydrocortisone) with low or absent Cortisol metabolites (tetrahydrocortisols). When challenged with oral cortisone, CRD patients exhibit abnormally low plasma Cortisol concentrations. These individuals present with ACTH-mediated androgen excess (hirsutism, menstrual irregularity, hyperandrogenism), a phenotype resembling polycystic ovary syndrome (PCOS) (Draper et al. (2003) Nat. Genet. 34: 434-439). The importance of the HPA axis in controlling glucocorticoid excursions is evident from the fact that disruption of homeostasis in the HPA axis by either excess or deficient secretion or action results in Cushing's syndrome or Addison's disease, respectively (Miller and Chrousos (2001) Endocrinology and Metabolism, eds. Felig and Frohman (McGraw-Hill, New York), 4th Ed.: 387- 524). Patients with Cushing's syndrome (a rare disease characterized by systemic glucocorticoid excess originating from the adrenal or pituitary tumors) or receiving glucocorticoid therapy develop reversible visceral fat obesity. Interestingly, the phenotype of Cushing's syndrome patients closely resembles that of Reaven's metabolic syndrome (also known as Syndrome X or insulin resistance syndrome) the symptoms of which include visceral obesity, glucose intolerance, insulin resistance, hypertension, type 2 diabetes and hyperlipidemia (Reaven (1993) Ann. Rev. Med. 44: 121-131). However, the role of glucocorticoids in prevalent forms of human obesity has remained obscure because circulating glucocorticoid concentrations are not elevated in the majority of metabolic syndrome patients. In fact, glucocorticoid action on target tissue depends not only on circulating levels but also on intracellular concentration, locally enhanced action of glucocorticoids in adipose tissue and skeletal muscle has been demonstrated in metabolic syndrome. Evidence has accumulated that enzyme activity of l lβHSDl, which regenerates active glucocorticoids from inactive forms and plays a central role in regulating intracellular glucocorticoid concentration, is commonly elevated in fat depots from obese individuals. This suggests a role for local glucocorticoid reactivation in obesity and metabolic syndrome. Given the ability of l lβHSDl to regenerate Cortisol from inert circulating cortisone, considerable attention has been given to its role in the amplification of glucocorticoid function. l lβHSDl is expressed in many key GR-rich tissues, including tissues of considerable metabolic importance such as liver, adipose, and skeletal muscle, and, as such, has been postulated to aid in the tissue-specific potentiation of glucocorticoid-mediated antagonism of insulin function. Considering a) the phenotypic similarity between glucocorticoid excess (Cushing's syndrome) and the metabolic syndrome with normal circulating glucocorticoids in the latter, as well as b) the ability of 1 lβHSDl to generate active Cortisol from inactive cortisone in a tissue-specific manner, it has been suggested that central obesity and the associated metabolic complications in syndrome X result from increased activity of l lβHSDl within adipose tissue, resulting in 'Cushing's disease of the omentum' (Bujalska et al. (1997) Lancet 349: 1210-1213). Indeed, 1 lβHSDl has been shown to be upregulated in adipose tissue of obese rodents and humans (Livingstone et al. (2000) Endocrinology 131: 560-563; Rask et al. (2001) J. Clin. Endocrinol. Metab. 86: 1418-1421; Lindsay et al. (2003) J. Clin. Endocrinol. Metab. 88: 2738-2744; Wake et al. (2003) J. Clin. Endocrinol. Metab. 88: 3983-3988). Additional support for this notion has come from studies in mouse transgenic models. Adipose-specific overexpression of l lβHSDl under the control of the aP2 promoter in mouse produces a phenotype remarkably reminiscent of human metabolic syndrome (Masuzaki et al. (2001) Science 294: 2166-2170; Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). Importantly, this phenotype occurs without an increase in total circulating corticosterone, but rather is driven by a local production of corticosterone within the adipose depots. The increased activity of l lβHSDl in these mice (2-3 fold) is very similar to that observed in human obesity (Rask et al. (2001) J. Clin. Endocrinol. Metab. 86: 1418-1421). This suggests that local llβHSDl -mediated conversion of inert glucocorticoid to active glucocorticoid can have profound influences whole body insulin sensitivity. Based on this data, it would be predicted that the loss of 1 lβHSDl would lead to an increase in insulin sensitivity and glucose tolerance due to a tissue-specific deficiency in active glucocorticoid levels. This is, in fact, the case as shown in studies with l lβHSDl -deficient mice produced by homologous recombination (Kotelevstev et al. (1997) Proc. Natl. Acad. Sci. 94: 14924-14929; Morton et al. (2001) J. Biol. Chem. 276: 41293-41300; Morton et al. (2004) Diabetes 53: 931-938). These mice are completely devoid of 11-keto reductase activity, confirming that 1 lβHSDl encodes the only activity capable of generating active corticosterone from inert 11-dehydrocorticosterone. l lβHSDl- deficient mice are resistant to diet- and stress-induced hyperglycemia, exhibit attenuated induction of hepatic gluconeogenic en2ymes (PEPCK, G6P), show increased insulin sensitivity within adipose, and have an improved lipid profile (decreased triglycerides and increased cardio-protective HDL). Additionally, these animals show resistance to high fat diet-induced obesity. Taken together, these transgenic mouse studies confirm a role for local reactivation of glucocorticoids in controlling hepatic and peripheral insulin sensitivity, and suggest that inhibition of l lβHSDl activity may prove beneficial in treating a number of glucocorticoid-related disorders, including obesity, insulin resistance, hyperglycemia, and hyperlipidemia. Data in support of this hypothesis has been published. Recently, it was reported that l lβHSDl plays a role in the pathogenesis of central obesity and the appearance of the metabolic syndrome in humans. Increased expression of the l lβHSDl gene is associated with metabolic abnormalities in obese women and that increased expression of this gene is suspected to contribute to the increased local conversion of cortisone to Cortisol in adipose tissue of obese individuals (Engeli, et al., (2004) Obes. Res. 12: 9-17). A new class of l lβHSDl inhibitors, the arylsulfonamidothiazoles, was shown to improve hepatic insulin sensitivity and reduce blood glucose levels in hyperglycemic strains of mice (Barf et al. (2002) J. Med. Chem. 45: 3813-3815; Alberts et al. Endocrinology (2003) 144: 4755-4762). Furthermore, it was recently reported that selective inhibitors of l lβHSDl can ameliorate severe hyperglycemia in genetically diabetic obese mice. Thus, l lβHSDl is a promising pharmaceutical target for the treatment of the Metabolic Syndrome (Masuzaki, et al., (2003) Curr. Drug Targets Immune Endocr. Metabol. Disord. 3: 255-62).
A. Obesity and metabolic syndrome As described above, multiple lines of evidence suggest that inhibition of l lβHSDl activity can be effective in combating obesity and/or aspects of the metabolic syndrome cluster, including glucose intolerance, insulin resistance, hyperglycemia, hypertension, and/or hyperlipidemia. Glucocorticoids are known antagonists of insulin action, and reductions in local glucocorticoid levels by inhibition of intracellular cortisone to Cortisol conversion should increase hepatic and/or peripheral insulin sensitivity and potentially reduce visceral adiposity. As described above, 1 lβHSDl knockout mice are resistant to hyperglycemia, exhibit attenuated induction of key hepatic gluconeogenic enzymes, show markedly increased insulin sensitivity within adipose, and have an improved lipid profile. Additionally, these animals show resistance to high fat diet-induced obesity (Kotelevstev et al. (1997) Proc. Natl. Acad. Sci. 94: 14924-14929; Morton et al. (2001) J. Biol. Chem. 276: 41293- 41300; Morton et al. (2004) Diabetes 53 : 931 -938). Thus, inhibition of 11 βHSD 1 is predicted to have multiple beneficial effects in the liver, adipose, and/or skeletal muscle, particularly related to alleviation of component(s) of the metabolic syndrome and/or obesity.
B. Pancreatic function Glucocorticoids are known to inhibit the glucose-stimulated secretion of insulin from pancreatic beta-cells (Billaudel and Sutter (1979) Horm. Metab. Res. 11 : 555-560). In both Cushing's syndrome and diabetic Zucker fa/fa rats, glucose-stimulated insulin secretion is markedly reduced (Ogawa et al. (1992) J. Clin. Invest. 90: 497-504). 1 lβHSDl mRNA and activity has been reported in the pancreatic islet cells of ob/ob mice and inhibition of this activity with carbenoxolone, an 11 βHSD 1 inhibitor, improves glucose-stimulated insulin release (Davani et al. (2000) J. Biol. Chem. 275: 34841-34844). Thus, inhibition of l lβHSDl is predicted to have beneficial effects on the pancreas, including the enhancement of glucose-stimulated insulin release.
C. Cognition and dementia Mild cognitive impairment is a common feature of aging that may be ultimately related to the progression of dementia. In both aged animals and humans, inter-individual differences in general cognitive function have been linked to variability in the long-term exposure to glucocorticoids (Lupien et al. (1998) Nat. Neurosci. 1: 69-73). Further, dysregulation of the HPA axis resulting in chronic exposure to glucocorticoid excess in certain brain subregions has been proposed to contribute to the decline of cognitive function (McEwen and Sapolsky (1995) Curr. Opin. Neurobiol. 5: 205- 216). l lβHSDl is abundant in the brain, and is expressed in multiple subregions including the hippocampus, frontal cortex, and cerebellum (Sandeep et al. (2004) Proc. Natl. Acad. Sci. Early Edition: 1-6). Treatment of primary hippocampal cells with the l lβHSDl inhibitor carbenoxolone protects the cells from glucocorticoid-mediated exacerbation of excitatory amino acid neurotoxicity (Rajan et al. (1996) J. Neurosci. 16: 65-70). Additionally, l lβHSDl -deficient mice are protected from glucocorticoid-associated hippocampal dysfunction that is associated with aging (Yau et al. (2001) Proc. Natl. Acad. Sci. 98: 4716-4721). In two randomized, double-blind, placebo-controlled crossover studies, administration of carbenoxolone improved verbal fluency and verbal memory (Sandeep et al. (2004) Proc. Natl. Acad. Sci. Early Edition: 1-6). Thus, inhibition of l lβHSDl is predicted to reduce exposure to glucocorticoids in the brain and protect against deleterious glucocorticoid effects on neuronal function, including cognitive impairment, dementia, and/or depression. D. Intra-ocular pressure Glucocorticoids can be used topically and systemically for a wide range of conditions in clinical ophthalmology. One particular complication with these treatment regimens is corticosteroid- induced glaucoma. This pathology is characterized by a significant increase in intra-ocular pressure (IOP). In its most advanced and untreated form, IOP can lead to partial visual field loss and eventually blindness. IOP is produced by the relationship between aqueous humour production and drainage. Aqueous humour production occurs in the non-pigmented epithelial cells (NPE) and its drainage is through the cells of the trabecular meshwork. 1 lβHSDl has been localized to NPE cells (Stokes et al. (2000) Invest. Ophthalmol. Vis. Sci. 41 : 1629-1683; Rauz et al. (2001) Invest. Ophthalmol. Vis. Sci. 42: 2037-2042) and its function is likely relevant to the amplification of glucocorticoid activity within these cells. This notion has been confirmed by the observation that free Cortisol concentration greatly exceeds that of cortisone in the aqueous humour (14:1 ratio). The functional significance of 1 lβHSDl in the eye has been evaluated using the inhibitor carbenoxolone in healthy volunteers (Rauz et al. (2001) Invest. Ophthalmol. Vis. Sci. 42: 2037-2042). After seven days of carbenoxolone treatment, IOP was reduced by 18%. Thus, inhibition of 1 lβHSDl in the eye is predicted to reduce local glucocorticoid concentrations and IOP, producing beneficial effects in the management of glaucoma and other visual disorders.
E. Hypertension Adipocyte-derived hypertensive substances such as leptin and angiotensinogen have been proposed to be involved in the pathogenesis of obesity-related hypertension (Matsuzawa et al. (1999) Ann. N.Y. Acad. Sci. 892: 146-154; Wajchenberg (2000) Endocr. Rev. 21: 697-738). Leptin, which is secreted in excess in aP2-l lβHSDl transgenic mice (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90), can activate various sympathetic nervous system pathways, including those that regulate blood pressure (Matsuzawa et al. (1999) Ann. N.Y. Acad. Sci. 892: 146-154). Additionally, the renin- angiotensin system (RAS) has been shown to be a major determinant of blood pressure (Walker et al. (1979) Hypertension 1 : 287-291). Angiotensinogen, which is produced in liver and adipose tissue, is the key substrate for renin and drives RAS activation. Plasma angiotensinogen levels are markedly elevated in aP2-l lβHSDl transgenic mice, as are angiotensin II and aldosterone (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). These forces likely drive the elevated blood pressure observed in aP2-l lβHSDl transgenic mice. Treatment of these mice with low doses of an angiotensin II receptor antagonist abolishes this hypertension (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). This data illustrates the importance of local glucocorticoid reactivation in adipose tissue and liver, and suggests that hypertension may be caused or exacerbated by 1 lβHSDl activity. Thus, inhibition of 1 lβHSDl and reduction in adipose and/or hepatic glucocorticoid levels is predicted to have beneficial effects on hypertension and hypertension-related cardiovascular disorders. F. Bone disease Glucocorticoids can have adverse effects on skeletal tissues. Continued exposure to even moderate glucocorticoid doses can result in osteoporosis (Cannalis (1996) J. Clin. Endocrinol. Metab. 81 : 3441-3447) and increased risk for fractures. Experiments in vitro confirm the deleterious effects of glucocorticoids on both bone-resorbing cells (also known as osteoclasts) and bone forming cells (osteoblasts). l lβHSDl has been shown to be present in cultures of human primary osteoblasts as well as cells from adult bone, likely a mixture of osteoclasts and osteoblasts (Cooper et al. (2000) Bone 27: 375-381), and the l lβHSDl inhibitor carbenoxolone has been shown to attenuate the negative effects of glucocorticoids on bone nodule formation (Bellows et al. (1998) Bone 23: 119- 125). Thus, inhibition of l lβHSDl is predicted to decrease the local glucocorticoid concentration within osteoblasts and osteoclasts, producing beneficial effects in various forms of bone disease, including osteoporosis. Small molecule inhibitors of l lβHSDl are currently being developed to treat or prevent l lβHSDl -related diseases such as those described above. For example, certain amide-based inhibitors are reported in WO 2004/089470, WO 2004/089896, WO 2004/056745, and WO 2004/065351. Antagonists of 1 lβHSDl have been evaluated in human clinical trials (Kurukulasuriya , et al., (2003) Curr. Med. Chem. 10: 123-53). In light of the experimental data indicating a role for l lβHSDl in glucocorticoid-related disorders, metabolic syndrome, hypertension, obesity, insulin resistance, hyperglycemia, hyperlipidemia, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) and polycystic ovary syndrome (PCOS), therapeutic agents aimed at augmentation or suppression of these metabolic pathways, by modulating glucocorticoid signal transduction at the level of 1 lβHSDl are desirable. Furthermore, because the MR binds to aldosterone (its natural ligand) and Cortisol with equal affinities, compounds that are designed to interact with the active site of l lβHSDl (which binds to cortisone/cortisol) may also interact with the MR and act as antagonists. Because the MR is implicated in heart failure, hypertension, and related pathologies including atherosclerosis, arteriosclerosis, coronary artery disease, thrombosis, angina, peripheral vascular disease, vascular wall damage, and stroke, MR antagonists are desirable and may also be useful in treating complex cardiovascular, renal, and inflammatory pathologies including disorders of lipid metabolism including dyslipidemia or hyperlipoproteinaemia, diabetic dyslipidemia, mixed dyslipidemia, hypercholesterolemia, hypertriglyceridemia, as well as those associated with type 1 diabetes, type 2 diabetes, obesity, metabolic syndrome, and insulin resistance, and general aldosterone-related target- organ damage. As evidenced herein, there is a continuing need for new and improved drugs that target l lβHSDl and/or MR. The compounds, compositions and methods described herein help meet this and other needs.
SUMMARY OF THE INVENTION The present invention provides, inter alia, compounds of Formula I:
Figure imgf000010_0001
I or pharmaceutically acceptable salts or prodrugs thereof, wherein constituent members are defined herein. In another aspect, the present invention provides compounds of Formula VI:
Figure imgf000010_0002
VI or pharmaceutically acceptable salts or prodrugs thereof, wherein constituent members are defined herein. The present invention further provides compositions comprising compounds of the invention and a pharmaceutically acceptable carrier. The present invention further provides methods of modulating 1 lβHSDl or MR by contacting said 1 lβHSDl or MR with a compound of the invention. The present invention further provides methods of inhibiting l lβHSDl or MR by contacting said 1 lβHSDl or MR with a compound of the invention. The present invention further provides methods of inhibiting conversion of cortisone to Cortisol in a cell. The present invention further provides methods of inhibiting production of Cortisol in a cell. The present invention further provides methods of increasing insulin sensitivity in a cell. The present invention further provides methods of treating diseases associated with activity or expression of 1 lβHSDl or MR. The present invention further provides use of the compounds and compositions of the invention in therapy. The present invention further provides the compounds or compositions of the invention for use in the preparation of a medicament for use in therapy.
DETAILED DESCRIPTION The present invention provides, inter alia, compounds of Formula I:
Figure imgf000011_0001
I or pharmaceutically acceptable salt or prodrug thereof, wherein: Cy is aryl, heteroaryl, cycloalkyl, or heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; L is absent, (CR13R14)m, (CR13R14)nO(CR13R14)p, (CR13R14)nS(CR13R14)p, (CR13R14)nSO2(CR13Rw)p, (CR13R14)nSO(CR13R14)p, (CR13R14)nCO(CR13R14)p, or (CR13R14)nNR15(CR13R14)p; R1 and R2 are each, independently, C1^ alkyl optionally substituted by halo, C(O)ORa or C(O)NR0R1; R3, R4, R5, R6, R7, R8, R9, R10, R11, and R12 are each, independently, H or -W'-X'-Y'-Z'; or R3 and R4 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W- X"_Y"-Z"; or R5 and R6 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- χ».γ"-Z"; or R7 and R8 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"-Y"-Z"; or R9 and R10 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"_Y"-Z"; or R11 and R12 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"-Y"-Z"; or R3 and R12 together form an C1-4alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R3 and R10 together form an C1-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R3 and R8 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R5 and R12 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R5 and R10 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R7 and R12 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; R13 and R14 are each, independently, H, halo, Ci-4 alkyl, Ci-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, ORa>, SRa', C(O)Rb>, C(0)NR°'Rd', C(O)OR3', OC(O)Rb', 0C(0)NR°'Rd', NR°'Rd>, NRc'C(0)Rd', NR0 C(O)OR3', S(O)Rb>, S(0)NR° Rd', S(O)2Rb>, or S(0)2NRc'Rd'; R15 is H, Ci-4 alkyl, Ci-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, OH, C(0)Rb', C(0)NR°'Rd>, C(O)OR3', S(O)Rb>, S(0)NRc Rd', S(O)2Rb>, or S(0)2NRc>Rd>; W, W and W" are each, independently, absent, Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, C0NRe, SO, SO2, SONRe, or NReC0NRf, wherein said Cj-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, C1-4 alkoxy, Ci.4haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; X, X' and X" are each, independently, absent, Ci-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, arylalkenyl, cycloalkylalkenyl, heteroarylalkenyl, heterocycloalkylalkenyl, arylalkynyl, cycloalkylalkynyl, heteroarylalkynyl, heterocycloalkylalkynyl, each of which is optionally substituted by one or more halo, CN, NO2, OH, Cμ4 alkoxy, Ci-4haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; Y, Y' and Y" are each, independently, absent, Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, C0NRe, SO, SO2, S0NRe, or NReC0NRf, wherein said Ci-6 alkylenyl, C2-6 alkenylenyl, C2.6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, Ci-4 alkoxy, Ci.4haloalkoxy, amino, Ci-4 alkylamino or C2.s dialkylamino; Z, Z' and Z" are each, independently, H, halo, CN, NO2, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, C]-4 alkylamino or C2-8 dialkylamino, Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl, wherein said Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl is optionally substituted by 1, 2 or 3 halo, Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, Ci-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR3, SRa, C(0)Rb, C(O)NRcRd, C(O)OR3, OC(O)R\ OC(O)NR°Rd, NRcRd, NR°C(O)Rd, NR0C(O)OR3, NR°C(=NCN)NRd, S(0)Rb, S(O)NR°Rd, S(O)2Rb, or S(O)2NR°Rd; wherein two -W-X-Y-Z together with the atom to which they are both attached optionally form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group optionally substituted by 1, 2 or 3 -W"-X"-Y"-Z"; wherein two -W'-X'-Y'-Z' together with the atom to which they are both attached optionally form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group optionally substituted by 1, 2 or 3 -W"-X"-Y"-Z"; wherein -W-X-Y-Z is other than H; wherein -W'-X'-Y'-Z' is other than H; wherein -W' '-X"-Y' '-Z' ' is other than H; Ra and Ra> are each, independently, H, C1-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; Rb and Rb are each, independently, H, C1-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; R° and Rd are each, independently, H, C1-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2.6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Rc and Rd together with the N atom to which they are attached form a A-, 5-, 6- or 7- membered heterocycloalkyl group; R° and Rd are each, independently, H, Ci-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or R° and Rd together with the N atom to which they are attached form a A-, 5-, 6- or 7- membered heterocycloalkyl group; Re and Rf are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Re and Rf together with the N atom to which they are attached form a A-, 5-, 6- or 7- membered heterocycloalkyl group; m is 1, 2, 3 or 4; n is 0, 1, 2 or 3; p is 0, 1, 2 or 3; and q is 0, 1, or 2.
In some embodiments, R3 and R4 are both other than H. In some embodiments, R5 and R6 are both other than H. In some embodiments, R7 and R8 are both other than H. In some embodiments, R9 and R10 are both other than H. In some embodiments, when q is 1 and one of R7 and R8 is phenyl, the other of R7 and R8 is Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, or cycloalkyl; In some embodiments, when q is 1 and one of R7 and R8 is OH, the other of R7 and R8 is other than 3-(trifluoromethyl)-phenyl; and In some embodiments, when q is 1, R7 and R8 together with the carbon to which they are attached form a moiety other than that having the structure:
Figure imgf000014_0001
wherein each R22 is independently, H or -W'-X'-Y'-Z', and wherein q7 is 0, 1, 2 or 3. In some embodiments, Cy is aryl optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z. In some embodiments, Cy is heteroaryl optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z. In some embodiments, Cy is phenyl optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z. In some embodiments, Cy is 6-membered aryl or 6-membered heteroaryl optionally substituted by 1 or 2 halo, cyano, Ci-4 cyanoalkyl, nitro, Ci-4nitroalkyl, Ci-4 alkyl, C1-4 haloalkyl, Ci-4 alkoxy, C1-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-S dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl. In some embodiments, Cy is phenyl optionally substituted by 1 or 2 halo, CN, cynanoalkyl, or pyridyl. In some embodiments, Cy is substituted. In some embodiments, L is absent. In some embodiments, L is (CR13R1V (CR13R14)nO(CR13R14)p, (CR13R14)nS(CR13R14)p, (CR13R14)nS(CR13R14)p, (CR13R14)nSO2(CR13R14)p, (CR13R14)nCO(CR13R14)p, or (CR13R14)nNR8(CR13R14)p. In some embodiments, L is (CR6R7)DO(CR6R7)P or (CR6R7)nS(CR6R7)p. In some embodiments, L is S or SCH2. In some embodiments, L is S. In some embodiments, L is O or OCH2. In some embodiments, L is O. In some embodiments, R1 and R2 are each, independently, methyl, ethyl or propyl. In some embodiments, R1 and R2 are both methyl. In some embodiments, -W-X-Y-Z is halo, cyano, Ci-4 cyanoalkyl, nitro, Ci-8 alkyl, Ci-8 alkenyl, Ci-8haloalkyl, Ci0.alkoxy, Ci-4haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, C]-4 alkylamino, C2-8 dialkylamino, OC(O)NR°Rd, NRcC(O)Rd, NR°C(=NCN)NRd, NRcC(O)ORa, aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl; wherein each of said Ci-8 alkyl, Ci-8 alkenyl, Ci-8haloalkyl, Q-8 alkoxy, aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl is optionally substituted by 1, 2, or 3 halo, cyano, nitro, hydroxyl-(Ci-6 alkyl), aminoalkyl, dialkylaminoalkyl, CM alkyl, Ci-4haloalkyl, Ci-4 alkoxy, Q-4 haloalkoxy, OH, Q-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-8 dialkylamino, C(O)NRcRd, C(O)ORa , NR°C(O)Rd, NR°S(O)2Rd, (Q-4 alkyl)sulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, or heterocycloalkyl. In some embodiments, -W-X-Y-Z is halo, cyano, Ci-4 cyanoalkyl, nitro, Ci-4 nitroalkyl, Cμ alkyl, Ci-4 haloalkyl, Ci-4 alkoxy, Cμ haloalkoxy, OH, C1-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-8 dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl. In some embodiments, -W-X-Y-Z is halo, cyano, cyanoalkyl or pyridyl. In some embodiments, -W'-X'-Y'-Z' is halo, Ci-4 alkyl, Ci-4 haloalkyl, OH, Ci-4 alkoxy, CL4 haloalkoxy, hydroxyalkyl, alkoxyalkyl, aryl, heteroaryl, aryl substituted by halo, heteroaryl substituted by halo. In some embodiments, -W"-X"-Y"-Z" is halo, cyano, CL4 cyanoalkyl, nitro, Ci-8 alkyl, Ci-8 alkenyl, Ci-8 haloalkyl, Ci0. alkoxy, Ci-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-8 dialkylamino, OC(O)NRcRd, NR°C(O)Rd, NR°C(=NCN)NRd, NRcC(0)0Ra, aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl; wherein each of said Ci-8 alkyl, Ci-8 alkenyl, Ci-8 haloalkyl, Cμ8 alkoxy, aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl is optionally substituted by 1, 2, or 3 halo, cyano, nitro, hydroxyl-(Ci-6 alkyl), aminoalkyl, dialkylaminoalkyl, Ci-4 alkyl, Q4 haloalkyl, Ci-4 alkoxy, Ci-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-8 dialkylamino, C(0)NR°Rd, C(O)OR3 , NR°C(0)Rd, NR0S(O)2R1, (Ci-4 alkyl)sulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, or heterocycloalkyl. In some embodiments, -W"-X"-Y"-Z" is halo, cyano, Ci-4 cyanoalkyl, nitro, Ci-4 nitroalkyl, Ci-4 alkyl, Ci-4 haloalkyl, Ci-4 alkoxy, Ci-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-S dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl. In some embodiments, R3, R4, R5, R6, R9, R10, R11, and R12 are each H. In some embodiments, R3, R4, R5, R6, R7, R8, R11, and R12 are each H. In some embodiments, R3, R4, R7, R8, R9, R10, R11, and R12 are each H. In some embodiments, R5, R6, R7, R8, R9, R10, R11, and R12 are each H. In some embodiments, R3, R4, R5, R6, R7, R8, R9, and R10 are each H. In some embodiments, R3 and R4 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z". In some embodiments, R5 and R6 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z". In some embodiments, R7 and R8 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z". In some embodiments, R9 and R10 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z". R11 and R12 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"-Y"-Z". In some embodiments, q is 1. In some embodiments, q is 0. In some embodiments, compounds of the invention have Formula II:
Figure imgf000016_0001
II wherein: ring A is a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group; and r is 0, 1 or 2. amd the remaining variables are defined hereinabove. In some embodiments, ring A is monocyclic, bicyclic, or tricyclic. In some embodiments, ring A is bicyclic or tricyclic. In some embodiments, ring A is bicyclic. In some embodiments, ring A has 6, 7, 8, 9, 10, 11, 12, 13, or 14 ring-forming carbon atoms. In some embodiments, ring A has 6, 7, 8, 9, 10, 11, 12, 13, or 14 ring-forming carbon atoms and at least one ring-forming heteroatom selected from O, N and S. In some embodiments, the compounds of the invention have Formula II and R3, R4, R5, R6, R9, R10, R11, and R12 are each H. In some embodiments, the compounds of the invention have Formula II and q is 1. In some embodiments, the compounds of the invention have Formula II and q is 0. In some embodiments, the compounds of the invention have Formula II and r is 0. In some embodiments, the compounds of the invention have Formula II and r is 1. In some embodiments, the compounds of the invention have Formula II and r is 2. In some embodiments, the compounds of the invention have Formula II and -W"-X"-Y"-Z" is halo, cyano, Q.4 cyanoalkyl, nitro, Ci-4 nitroalkyl, Ci-4 alkyl, Cϊ-4 haloalkyl, Cj-4 alkoxy, Ci-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-8 dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl. In some embodiments, the compounds of the invention have Formula Ilia or IHb:
Figure imgf000017_0001
Ilia
Figure imgf000017_0002
nib wherein: ring B is a fused 5 or 6-membered aryl or fused 5 or 6-membered heteroaryl group; Q1 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q2 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; r is O, 1 or 2; s is O, 1 or 2; and the sum of r and s is O, 1 or 2; and the remaining variable are defined hereinabove. In some embodiments, the compounds of the invention have Formula Ilia or IHb and Q1 is O, S, NH, CH2 or CO, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula Ilia or HIb and Q2 is O, S, NH, CH2, CO, or SO2 wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"- Z". In some embodiments, the compounds of the invention have Formula Ilia or IHb and one of Q1 and Q2 is CO and the other is O, NH, or CH2 wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula IHa or HIb and one of Q1 and Q2 is CH2 and the other is O, S, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula πia or HIb and one of Q1 and Q2 is CO. In some embodiments, the compounds of the invention have Formula IHa or IHb and ring B is phenyl or pyridyl. In some embodiments, the compounds of the invention have Formula IHa or IHb and ring B is phenyl. In some embodiments, the compounds of the invention have Formula πia or IHb and r is O. In some embodiments, the compounds of the invention have Formula Ilia or nib and s is O or 1. In some embodiments, the compound of the invention have Formula IV:
Figure imgf000018_0001
IV wherein: Q1 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q2 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q3 and Q4 are each, independently, CH or N; r is O, 1 or 2; s is O, 1 or 2; and the sum of r and s is O, 1 or 2; and the remaining variable are defined hereinabove. In some embodiments, the compounds of the invention have Formula IV and Q1 is O, NH, CH2 or CO, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula IV and Q2 is O, S, NH, CH2, CO, or SO2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula IV and wherein one of Q1 and Q2 is CO and the other is O, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" . In some embodiments, the compounds of the invention have Formula IV and wherein one of Q1 and Q2 is CH2 and the other is O, S, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" . In some embodiments, the compounds of the invention have Formula IV and one of Q1 and Q2 is O and the other is CO or CONH, wherein said CONH is optionally substituted by -W"-X"-Y"- Z". In some embodiments, the compounds of the invention have Formula IV and Q3 is CH optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula IV and Q3 is N. In some embodiments, the compounds of the invention have Formula IV and Q4 is CH optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula IV and Q4 is N. In some embodiments, the compounds of the invention have Formula FV and r is O or 1. In some embodiments, the compounds of the invention have Formula IV and s is O or 1. In some embodiments, the compounds of the inventioin have Formula V:
Figure imgf000019_0001
wherein: Q1 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q2 is 0, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q3 and Q4 are each, independently, CH or N; r is O, 1 or 2; s is O, 1 or 2; and the sum of r and s is O, 1 or 2; and remaining variables are defined hereinabove. In some embodiments, the compounds of the invention have Formula V and Q1 is O, NH, CH2 or CO, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula V and Q2 is O, S, NH, CH2, CO, or SO2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula V and wherein one of Q1 and Q2 is CO and the other is O, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" . In some embodiments, the compounds of the invention have Formula V and one of Q1 and Q2 is CH2 and the other is O, S, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" . In some embodiments, the compounds of the invention have Formula V and one of Q1 and Q2 is O and the other is CO or CONH, wherein said CONH is optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula V and Q3 is CH optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula V and Q3 is N. In some embodiments, the compounds of the invention have Formula V and Q4 is CH optionally substituted by -W"-X"-Y"-Z". In some embodiments, the compounds of the invention have Formula V and Q4 is N. In some embodiments, the compounds of the invention have Formula V and r is O or 1. In some embodiments, the compounds of the invention have Formula V and s is O or 1. In some embodiments, Q1 and Q2 are selected to form a 1- , 2- , or 3- atom spacer. In further embodiments, Q1 and Q2 when bonded together form a spacer group having other than an O-O or 0-S ring-forming bond.
In another aspect, the present invention provides compounds of Formula VI:
Figure imgf000020_0001
VI or pharmaceutically acceptable salts or prodrugs thereof, wherein: R is phenyl, Cy-S-, Cy-(CR13R14)m-S- or
Figure imgf000021_0001
wherein said phenyl is optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Cy is aryl, heteroaryl, cycloalkyl, or heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Cy1 is aryl or cycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Hy is:
Figure imgf000021_0002
Hy3 Hy4 Hy5
R1 and R2 are each, independently, C1-6 alkyl optionally substituted by halo, C(0)0Ra or C(O)NR0R1; R13 and R14 are each, independently, H, halo, C1-4 alkyl, C1^ haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR3', SR3', C(O)Rb', C(O)NR°'Rd>, C(O)OR3', OC(O)Rb', OC(O)NRc>Rd>, NRc'Rd>, NR°'C(0)Rd', NR°'C(O)OR3', S(O)Rb', S(0)NRc Rd', S(O)2Rb', or S(O)2NRc'Rd'; R17 is aryl, heteroaryl, arylalkyl or heteroarylalkyl, each optionally substituted one or more - W"-X"-Y"-Z"; R18 is H or -W'-X'-Y'-Z'; R19 is aryl or heteroaryl, each optionally substituted one or more -W"-X"-Y"-Z"; R20 is H or -W'-X'-Y'-Z'; R21 is H or -W-X-Y-Z; R22 is aryl, heteroaryl, arylalkyl or heteroarylalkyl, each optionally substituted one or more - W"-X"-Y"-Z"; ring A' is a fused 5- or 6-membered aryl or fused 5- or 6-membered heteroaryl group, a fused 3-14 membered cycloalkyl group or a fused 3-14 membered heterocycloalkyl group; W, W and W" are each, independently, absent, Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, C0NRe, SO, SO2, SONRe, or NReC0NRf, wherein said C1-6 alkylenyl, C2.6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, C1-4 alkoxy, Q-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; X, X' and X" are each, independently, absent, Ci-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, arylalkenyl, cycloalkylalkenyl, heteroarylalkenyl, heterocycloalkylalkenyl, arylalkynyl, cycloalkylalkynyl, heteroarylalkynyl, heterocycloalkylalkynyl, each of which is optionally substituted by one or more halo, CN, NO2, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; Y, Y' and Y" are each, independently, absent, Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, C0NRe, SO, SO2, SONRe, or NReC0NRf, wherein said Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, Ci-4 alkoxy, Q-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; Z, Z' and Z' ' are each, independently, H, halo, CN, NO2, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino, C]-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl, wherein said Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl is optionally substituted by 1, 2 or 3 halo, Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, C1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, 0Ra, SRa, C(0)Rb, C(0)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NR°Rd, NR°Rd, NR°C(O)Rd, NR0C(O)OR3, NR°C(=NCN)NRd, S(O)Rb, S(0)NR°Rd, S(O)2Rb, or S(0)2NR°Rd; wherein two -W'-X'-Y'-Z' together with the atom to which they are both attached optionally form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group optionally substituted by 1, 2 or 3 -W"-X"-Y"-Z"; wherein -W-X-Y-Z is other than H; wherein -W'-X'-Y'-Z' is other than H; wherein -W"-X"-Y"-Z" is other than H; Ra and Ra are each, independently, H, Ci-6 alkyl, Cμ6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; Rb and Rb> are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; Rc and Rd are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or R° and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; R° and Rd are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2.6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; Re and Rf are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Re and Rf together with the N atom to which they are attached form a A-, 5-, 6- or 7- membered heterocycloalkyl group; m is 1, 2, 3 or 4; rl, r2, r3, r4 and r6 are each, independently, 0, 1, 2 or 3; r5 is 1, 2, 3 or 4; and ql and q2 are each, independently, 0, 1, or 2. In some embodiments of compounds having Formula VI of the present invention, when ring A' is phenyl, then R18 is other than COORa or C(O)NRcRd; In some embodiments of compounds having Formula VI of the present invention, when R19 is phenyl, then R20 is H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2.6 alkynyl, aryl, or cycloalkyl; and In some embodiments of compounds having Formula VI of the present invention, when R20 is OH, then R19 is other than 3-(trifluoromethyl)-phenyl. In some embodiments of compounds having Formula VI of the present invention, R17 is aryl or heteroaryl, each optionally substituted one or more -W"-X"-Y"-Z". At various places in the present specification, substituents of compounds of the invention are disclosed in groups or in ranges. It is specifically intended that the invention include each and every individual subcombination of the members of such groups and ranges. For example, the term "Ci-6 alkyl" is specifically intended to individually disclose methyl, ethyl, C3 alkyl, C4 alkyl, C5 alkyl, and C6 alkyl. It is further appreciated that certain features of the invention, which are, for clarity, described in the context of separate embodiments, can also be provided in combination in a single embodiment. Conversely, various features of the invention which are, for brevity, described in the context of a single embodiment, can also be provided separately or in any suitable subcombination. The term "n-membered" where n is an integer typically describes the number of ring-forming atoms in a moiety where the number of ring-forming atoms is n. For example, piperidinyl is an example of a 6-membered heterocycloalkyl ring and 1,2,3,4-tetrahydro-naphthalene is an example of a 10-membered cycloalkyl group. For compounds of the invention in which a variable appears more than once, each variable can be a different moiety selected from the Markush group defining the variable. For example, where a structure is described having two R groups that are simultaneously present on the same compound; the two R groups can represent different moieties selected from the Markush group defined for R. In another example, when an optionally multiple substituent is designated in the form:
Figure imgf000024_0001
then it is understood that substituent R can occur s number of times on the ring, and R can be a different moiety at each occurrence. Further, in the above example, should the variable Q be defined to include hydrogens, such as when Q is said to be CH2, NH, etc., any floating substituent such as R in the above example, can replace a hydrogen of the Q variable as well as a hydrogen in any other non- variable component of the ring. It is further intended that the compounds of the invention are stable. As used herein "stable" refers to a compound that is sufficiently robust to survive isolation to a useful degree of purity from a reaction mixture, and preferably capable of formulation into an efficacious therapeutic agent. As used herein, the term "alkyl" is meant to refer to a saturated hydrocarbon group which is straight-chained or branched. Example alkyl groups include methyl (Me), ethyl (Et), propyl (e.g., n- propyl and isopropyl), butyl (e.g., n-butyl, isobutyl, t-butyl), pentyl (e.g., n-pentyl, isopentyl, neopentyl), and the like. An alkyl group can contain from 1 to about 20, from 2 to about 20, from 1 to about 10, from 1 to about 8, from 1 to about 6, from 1 to about 4, or from 1 to about 3 carbon atoms. The term "alkylenyl" refers to a divalent alkyl linking group. As used herein, "alkenyl" refers to an alkyl group having one or more double carbon-carbon bonds. Example alkenyl groups include ethenyl, propenyl, and the like. The term "alkenylenyl" refers to a divalent linking alkenyl group. As used herein, "alkynyl" refers to an alkyl group having one or more triple carbon-carbon bonds. Example alkynyl groups include ethynyl, propynyl, and the like. The term "alkynylenyl" refers to a divalent linking alkynyl group. As used herein, "haloalkyl" refers to an alkyl group having one or more halogen substituents. Example haloalkyl groups include CF3, C2F5, CHF2, CCl3, CHCl2, C2Cl5, and the like. As used herein, "aryl" refers to monocyclic or polycyclic (e.g., having 2, 3 or 4 fused rings) aromatic hydrocarbons such as, for example, phenyl, naphthyl, anthracenyl, phenanthrenyl, indanyl, indenyl, and the like. In some embodiments, aryl groups have from 6 to about 20 carbon atoms. As used herein, "cycloalkyl" refers to non-aromatic cyclic hydrocarbons including cyclized alkyl, alkenyl, and alkynyl groups. Cycloalkyl groups can include mono- or polycyclic (e.g., having 2, 3 or 4 fused rings) ring systems as well as spiro ring systems. Ring-forming carbon atoms of a cycloalkyl group can be optionally substituted by oxo or sulfide Example cycloalkyl groups include cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclopentenyl, cyclohexenyl, cyclohexadienyl, cycloheptatrienyl, norbornyl, norpinyl, norcarnyl, adamantyl, and the like. Also included in the definition of cycloalkyl are moieties that have one or more aromatic rings fused (i.e., having a bond in common with) to the cycloalkyl ring, for example, benzo or thienyl derivatives of pentane, pentene, hexane, and the like. As used herein, "heteroaryl" groups refer to an aromatic heterocycle having at least one heteroatom ring member such as sulfur, oxygen, or nitrogen. Heteroaryl groups include monocyclic and polycyclic (e.g., having 2, 3 or 4 fused rings) systems. Examples of heteroaryl groups include without limitation, pyridyl, pyrimidinyl, pyrazinyl, pyridazinyl, triazinyl, furyl, quinolyl, isoquinolyl, thienyl, imidazolyl, thiazolyl, indolyl, pyrryl, oxazolyl, benzofuryl, benzothienyl, benzthiazolyl, isoxazolyl, pyrazolyl, triazolyl, tetrazolyl, indazolyl, 1,2,4-thiadiazolyl, isothiazolyl, benzothienyl, purinyl, carbazolyl, benzimidazolyl, indolinyl, and the like. In some embodiments, the heteroaryl group has from 1 to about 20 carbon atoms, and in further embodiments from about 3 to about 20 carbon atoms. In some embodiments, the heteroaryl group contains 3 to about 14, 3 to about 7, or 5 to 6 ring-forming atoms. In some embodiments, the heteroaryl group has 1 to about 4, 1 to about 3, or 1 to 2 heteroatoms. As used herein, "heterocycloalkyl" refers to non-aromatic heterocycles including cyclized alkyl, alkenyl, and alkynyl groups where one or more of the ring-forming carbon atoms is replaced by a heteroatom such as an O, N, or S atom. Heterocycloalkyl groups can be mono- or polycyclic (e.g., having 2, 3, 4 or more fused rings or having a 2-ring, 3-ring, 4-ring spiro system (e.g., having 8 to 20 ring-forming atoms)). Example "heterocycloalkyl" groups include morpholino, thiomorpholino, piperazinyl, tetrahydrofuranyl, tetrahydrothienyl, 2,3-dihydrobenzofuryl, 1,3-benzodioxole, benzo- 1,4-dioxane, piperidinyl, pyrrolidinyl, isoxazolidinyl, isothiazolidinyl, pyrazolidinyl, oxazolidinyl, thiazolidinyl, imidazolidinyl, and the like. Ring-forming carbon atoms and heteroatoms of a heterocycloalkyl group can be optionally substituted by oxo or sulfide Also included in the definition of heterocycloalkyl are moieties that have one or more aromatic rings fused (i.e., having a bond in common with) to the nonaromatic heterocyclic ring, for example phthaliniidyl, naphthalimidyl, and benzo derivatives of heterocycles such as indolene and isoindolene groups. In some embodiments, the heterocycloalkyl group has from 1 to about 20 carbon atoms, and in further embodiments from about 3 to about 20 carbon atoms. In some embodiments, the heterocycloalkyl group contains 3 to about 14, 3 to about 7, or 5 to 6 ring-forming atoms. In some embodiments, the heterocycloalkyl group has 1 to about 4, 1 to about 3, or 1 to 2 heteroatoms. In some embodiments, the heterocycloalkyl group contains 0 to 3 double bonds. In some embodiments, the heterocycloalkyl group contains 0 to 2 triple bonds. As used herein, "halo" or "halogen" includes fluoro, chloro, bromo, and iodo. As used herein, "alkoxy" refers to an -O-alkyl group. Example alkoxy groups include methoxy, ethoxy, propoxy (e.g., n-propoxy and isopropoxy), t-butoxy, and the like. As used here, "haloalkoxy" refers to an -0-haloalkyl group. An example haloalkoxy group is OCF3. As used herein, "arylalkyl" refers to alkyl substituted by aryl and "cycloalkylalkyl" refers to alkyl substituted by cycloalkyl. An example arylalkyl group is benzyl. As used herein, "amino" refers to NH2. As used herein, "alkylamino" refers to an amino group substituted by an alkyl group. As used herein, "dialkylamino" refers to an amino group substituted by two alkyl groups. The compounds described herein can be asymmetric (e.g., having one or more stereocenters). All stereoisomers, such as enantiomers and diastereomers, are intended unless otherwise indicated. Compounds of the present invention that contain asymmetrically substituted carbon atoms can be isolated in optically active or racemic forms. Methods on how to prepare optically active forms from optically active starting materials are known in the art, such as by resolution of racemic mixtures or by stereoselective synthesis. Many geometric isomers of olefins, C=N double bonds, and the like can also be present in the compounds described herein, and all such stable isomers are contemplated in the present invention. Cis and trans geometric isomers of the compounds of the present invention are described and may be isolated as a mixture of isomers or as separated isomeric forms. Resolution of racemic mixtures of compounds can be carried out by any of numerous methods known in the art. An example method includes fractional recrystallizaion using a "chiral resolving acid" which is an optically active, salt-forming organic acid. Suitable resolving agents for fractional recrystallization methods are, for example, optically active acids, such as the D and L forms of tartaric acid, diacetyltartaric acid, dibenzoyltartaric acid, mandelic acid, malic acid, lactic acid or the various optically active camphorsulfonic acids such as β-camphorsulfonic acid. Other resolving agents suitable for fractional crystallization methods include stereoisomerically pure forms of α- methylbenzylamine (e.g., S and R forms, or diastereomerically pure forms), 2-phenylglycinol, norephedrine, ephedrine, N-methylephedrine, cyclohexylethylamine, 1,2-diaminocyclohexane, and the like. Resolution of racemic mixtures can also be carried out by elution on a column packed with an optically active resolving agent (e.g., dinitrobenzoylphenylglycine). Suitable elution solvent composition can be determined by one skilled in the art. Compounds of the invention also include tautomeric forms, such as keto-enol tautomers. Compounds of the invention can also include all isotopes of atoms occurring in the intermediates or final compounds. Isotopes include those atoms having the same atomic number but different mass numbers. For example, isotopes of hydrogen include tritium and deuterium. The phrase "pharmaceutically acceptable" is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgement, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio. The present invention also includes pharmaceutically acceptable salts of the compounds described herein. As used herein, "pharmaceutically acceptable salts" refers to derivatives of the disclosed compounds wherein the parent compound is modified by converting an existing acid or base moiety to its salt form. Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like. The pharmaceutically acceptable salts of the present invention include the conventional non-toxic salts or the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids. The pharmaceutically acceptable salts of the present invention can be synthesized from the parent compound which contains a basic or acidic moiety by conventional chemical methods. Generally, such salts can be prepared by reacting the free acid or base forms of these compounds with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred. Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., 1985, p. 1418 and Journal of Pharmaceutical Science, 66, 2 (1977), each of which is incorporated herein by reference in its entirety. The present invention also includes prodrugs of the compounds described herein. As used herein, "prodrugs" refer to any covalently bonded carriers which release the active parent drug when administered to a mammalian subject. Prodrugs can be prepared by modifying functional groups present in the compounds in such a way that the modifications are cleaved, either in routine manipulation or in vivo, to the parent compounds. Prodrugs include compounds wherein hydroxyl, amino, sulfhydryl, or carboxyl groups are bonded to any group that, when administered to a mammalian subject, cleaves to form a free hydroxyl, amino, sulfhydryl, or carboxyl group respectively. Examples of prodrugs include, but are not limited to, acetate, formate and benzoate derivatives of alcohol and amine functional groups in the compounds of the invention. Preparation and use of prodrugs is discussed in T. Higuchi and V. Stella, "Pro-drugs as Novel Delivery Systems," Vol. 14 of the A.C.S. Symposium Series, and in Bioreversible Carriers in Drug Design, ed. Edward B. Roche, American Pharmaceutical Association and Pergamon Press, 1987, both of which are hereby incorporated by reference in their entirety.
Synthesis The novel compounds of the present invention can be prepared in a variety of ways known to one skilled in the art of organic synthesis. The compounds of the present invention can be synthesized using the methods as hereinafter described below, together with synthetic methods known in the art of synthetic organic chemistry or variations thereon as appreciated by those skilled in the art. The compounds of this invention can be prepared from readily available starting materials using the following general methods and procedures. It will be appreciated that where typical or preferred process conditions (i.e., reaction temperatures, times, mole ratios of reactants, solvents, pressures, etc.) are given; other process conditions can also be used unless otherwise stated. Optimum reaction conditions may vary with the particular reactants or solvent used, but such conditions can be determined by one skilled in the art by routine optimization procedures. The processes described herein can be monitored according to any suitable method known in the art. For example, product formation can be monitored by spectroscopic means, such as nuclear magnetic resonance spectroscopy (e.g., 1H or 13C) infrared spectroscopy, spectrophotometry (e.g., UV-visible), or mass spectrometry, or by chromatography such as high performance liquid chromatograpy (HPLC) or thin layer chromatography. Preparation of compounds can involve the protection and deprotection of various chemical groups. The need for protection and deprotection, and the selection of appropriate protecting groups can be readily determined by one skilled in the art. The chemistry of protecting groups can be found, for example, in Greene, et al., Protective Groups in Organic Synthesis, 2d. Ed., Wiley & Sons, 1991, which is incorporated herein by reference in its entirety. The reactions of the processes described herein can be carried out in suitable solvents which can be readily selected by one of skill in the art of organic synthesis. Suitable solvents can be substantially nonreactive with the starting materials (reactants), the intermediates, or products at the temperatures at which the reactions are carried out, i.e., temperatures which can range from the solvent's freezing temperature to the solvent's boiling temperature. A given reaction can be carried out in one solvent or a mixture of more than one solvent. Depending on the particular reaction step, suitable solvents for a particular reaction step can be selected. The compounds of the invention can be prepared, for example, using the reaction pathways and techniques as described below. A series of carboxamides of formula 2 are prepared by the method outlined in Scheme 1. Carboxylic acids 1 can be coupled to a cyclic amine (e.g., piperidine, pyrrolidine, etc. wherein a is e.g., 0 to 10 and R' represents any of R3, R4, R5, R6, R7, R8, R9, R10, R11, or R12) using a coupling reagent such as BOP to provide the desired products 2. Scheme 1
Figure imgf000028_0001
A series of carboxylic acids of formula 6 (wherein L can be S, O, etc) can be prepared according to the method outlined in Scheme 2. Reaction of the appropriate thiol or alcohol 3 with methyl bromoacetate in the presence of a base such as potassium or sodium carbonate, triethylamine or sodium hydride in a solvent such as tetrahydrofiiran, acetonitrile or dichloromethane provides thioethers or ethers 4. Treatment of 4 with excess of an alkyl bromide or iodide in the presence of sodium hydride and DMF or LDA and THF or any other suitable base/solvent combination provides methyl esters 5, which upon basic hydrolysis yield the desired carboxylic acids 6.
Figure imgf000029_0001
When R1 is different than R2, the alkylation steps can take place sequentially as shown in Scheme 3. Alkylation of ethers or thioethers 4 with one equivalent of the appropriate bromide or iodide R1Br(I) in the presence of NaH or LDA or LiHMDS in DMF or THF, followed by a second alkylation with R2Br(I) in the presence of NaH and DMSO provides methyl esters 7, which upon basic hydrolysis yield the desired carboxylic acids 8.
Scheme 3
Figure imgf000029_0002
7 8
Alternatively, starting with the appropriate cyclic (aromatic or heteroaromatic) ketone or thioketone 9 and following Scheme 4, a series of carboxylic acids of formula 12 can be prepared. Scheme 4
Figure imgf000030_0001
A series of carboxylic acids of formula 17, wherein L = O, S, etc. can be prepared by the method outlined in Scheme 5. O- or S-alkylation of compounds 13 with a suitable chloride or bromide provides methyl esters 14. Alkylation of 7 with the appropriate alkyl bromide or iodide in the presence of LDA yields methyl esters 15, which can undergo a second alkylation with another alkyl bromide or iodide in the presence of NaH in DMSO to provide the corresponding esters 16. Finally, basic hydrolysis yields the desired carboxylic acids 17.
Scheme 5
Figure imgf000030_0002
X = S5 O
Figure imgf000030_0003
17 Alternatively, a series of carboxylic acids of formula 21 (wherein L = O, S, etc. and m = 1 or 2), can be prepared according to Scheme 6. Reaction of the appropriate alcohol or thiol 18 with chloroacetonitrile in the presence of sodium ethoxide under refluxing conditions provides nitriles 19. Alkylation(s) of 19 in the standard fashion as depicted in Scheme 6 provides nitriles 20, which upon basic hydrolysis provide the desired carboxylic acids 21.
Scheme 6
Figure imgf000031_0001
X = O5 S
Figure imgf000031_0002
21
Alternatively, (such as when Cy is heteroaryl) carboxylic acids 27 can be prepared by the reaction of the appropriate alcohol with thioglycolic acid 22 in the presence of a Lewis acid such as zinc trifluoromethanesulfonate, under refluxing conditions. Then 23 can be processed to the desired carboxylic acids 27 in the standard fashion as shown in Scheme 7.
Scheme 7
Figure imgf000031_0003
27 Thioether 28 can be oxidized to the corresponding sulfone 29 with 3-chloroperoxybenzoic acid. Following Scheme 8, as previously described, a series of carboxylic acids of formula 31 can be prepared. The same sequence (conversion of the thioether to a sulfone) can be employed in any of the Schemes described earlier.
Figure imgf000032_0001
A series of carboxylic acids of formula 36 can be prepared by the method outlined in Scheme 9. N-Boc glycine methyl ester, 32, can undergo Cα alkylation in the standard fashion to provide compounds 33. Following removal of the Boc group with TFA and an N-alkylation with the appropriate alkyl bromide or iodide leads to the formation of methyl esters 35, which upon basic hydrolysis provide the desired carboxylic acids 36.
Scheme 9
Figure imgf000032_0002
36 Alternatively, the same series of carboxylic acids of formula 36 can be prepared in a similar fashion as described above, employing a reductive amination after removal of the Boc group, according to Scheme 10.
Scheme 10
Figure imgf000033_0001
36
A series of carboxylic acids of formula 40 can be prepared by the method outlined in Scheme 11. Reaction of Cbz protected amine 37 with 2-bromo methyl acetate provides methyl esters 38. Alkylation(s) in the standard fashion as shown below provides methyl esters 39. Then, basic hydrolysis yields the desired carboxylic acids 40. The Cbz group can be removed under hydrogenolysis conditions at the appropriate stage.
Scheme 11
Figure imgf000033_0002
37 38 then R2Br(I), NaH, DMSO
Figure imgf000033_0003
39 40 A series of 3 -substituted pyrrolidine 43 and 45 can be prepared by the method outlined in Scheme 12 (where R' is, e.g., -W'-X'-Y'-Z'). Compound 41 can be treated with an organolithium or a Grinard reagent to provide alcohol 42. The Boc protecting group of 42 can be removed by treatment with TFA to give 3 -substituted pyrrolidine 43. Alternatively, 42 can be treated with HCl to provide the alkene 44, followed by hydrogenation to give 3 -substituted pyrrolidine 45.
Scheme 12
Figure imgf000034_0001
Figure imgf000034_0002
42 44 45
A series of 3 -substituted pyrrolidines 47 can be prepared by the method outlined in Scheme 13 (where Ar is an aromatic moiety). A sequence of a Pd catalyzed coupling reaction of alkene 46 with aryl bromides or heteroaryl bromides, followed by hydrogenation provides the desired 3- substituted pyrrolidines 47.
Scheme 13
Cbz-NQl 1, Ar-Br1 Pd(OAc)2 Ar 2, H2, Pd/C mCT 46 47
A series of 3-hydroxyl-4-substituted pyrrolidines 49 can be prepared by the method outlined in Scheme 14 (where Ar is an aromatic moiety). Alkene 46 can react with mCPBA to provide the corresponding epoxide, which upon treatment with an organolithium or a Grignard reagent in the presence of Al(Me)3 or other Lewis acid gives alcohols 48. Finally, hydrogenolysis provides the desired amines 49.
Scheme 14
CbZ
Figure imgf000034_0003
A series of 3,3-disubstituted pyrrolidines or piperidines 53 can be prepared by the method outlined in Scheme 15 (Ar is, for example, aryl or heteroaryl; n is 1 or 2 and m is 1 or 2). Ketone 50 can be treated with the appropriate Wittig reagent to provide olefinic compound 51. Reaction of 51 with an organocuprate A^CuLi provides the corresponding 1,4 addition products 52. The Cbz protecting group of 52 can be cleaved by hydrogenation to provide the desired 3,3-disubstituted pyrrolidines or 3,3-disubstituted piperidines 53.
Scheme 15
Figure imgf000035_0001
53
Pyrrolidine 56 can also be prepared according to Scheme 16. Halogen metal exchange between aryl iodide 54 and isopropylmagnesium bromide followed by reaction with N-Boc-3-oxo- pyrrolidine provides spiral lactone 55 which upon acidic cleavage of the Boc group yields the desired pyrrolidine 56.
Scheme 16
J-PrMgBr,
Figure imgf000035_0003
Figure imgf000035_0002
Figure imgf000035_0004
Alternatively, pyrrolidine 59 can be prepared according to Scheme 17. Ortho lithiation of carboxylic acid 57, followed by reaction of the resulting organolithium with N-Boc-3-oxo-pyrrolidine yields spiral lactone 58, which upon acidic cleavage of the Boc group provides the desired pyrrolidine 59. Scheme 17
Figure imgf000036_0001
Pyrrolidine 64 can be prepared according to the method outlined in Scheme 18. Scheme 18
Figure imgf000036_0002
64 N-Boc-2-Arylpiperazines of formula 68 can be prepared according to Scheme 19 (where Ar is an aromatic moiety). α-Bromo esters 65 react with ethylenediamine in the presence of EtONa to provide 2-aryl-3-oxo-piperazines 66. Protection with BOC2O followed by LAH reduction yields the desired monoprotected 2-arylpiperazines 68. Scheme 19
Figure imgf000037_0001
67 68
A series of compounds 71 can be prepared by the method outlined in Scheme 20 (where R1 and R" are each, independently, H, C1-6 alkyl, cycloalkyl, aryl, etc.). Carboxylic acids 1 can couple with an amine such as the pyrrolidine shown using BOP or any other coupling reagent to provide 69. The hydroxyl group of 69 can be alkylated with 2-bromoacetate to give compounds 70. Hydrolysis of the r-butyl ester with TFA, followed by the standard coupling reaction with a variety of amines yields compounds 71.
Scheme 20
Figure imgf000037_0002
69
Figure imgf000037_0003
70 71
According to Scheme 21 (where Ar is an aromatic moiety), the hydroxyl group of compound 69 can be alkylated with N-Boc-protected 2-amino ethyl bromide to give compounds 72. The N-Boc group of 72 can be removed by TFA. The resulting free amino group of compounds 73 can be converted into a variety of analogs of formula 74 by routine methods. Scheme 21
Figure imgf000038_0001
69 72
Figure imgf000038_0002
73 74
A series of compounds 78 can be prepared by the method outlined in Scheme 22 (where Ar can be an aromatic moiety, alkyl or the like, R1 and R" are each, independently, H, C1^ alkyl, cycloalkyl, aryl, etc.; R1" and Rιv are, e.g., H, alkyl, carbocycle, heterocycle, alkylcarbonyl, aminocarbonyl, alkylsulfonyl, alkoxycarbonyl, etc). Carboxylic acids 1 can couple with 2- arylpiperazine 68 using BOP or any other coupling reagent to provide 75. After removal of the Boc group, 76 can be alkylated with 2-bromoacetate to give compounds 77. Hydrolysis of the t- butyl ester with TFA, followed by the standard coupling reaction with a variety of amines can yield compounds 78. Scheme 22
Figure imgf000038_0003
According to the method outlined in Scheme 23 (R111 and R1V are, e.g., H, alkyl, carbocycle, heterocycle, alkylcarbonyl, aminocarbonyl, alkylsulfonyl, alkoxycarbonyl, etc), 76 can be alkylated with N-Boc-protected 2-amino ethyl bromide to provide compounds 79. The N-Boc group of 79 can be removed with TFA. The resulting free amino group of compounds 79 can be converted into a variety of analogs of formula 80 by routine methods.
Scheme 23
R;*r™ Br(CH2)2ΝHBoc K K2oCCOO3o
76
Figure imgf000039_0001
Figure imgf000039_0002
Compounds of the invention can modulate activity of llβHSDl and/or MR. The term "modulate" is meant to refer to an ability to increase or decrease activity of an enzyme or receptor. Accordingly, compounds of the invention can be used in methods of modulating llβHSDl and/or MR by contacting the enzyme or receptor with any one or more of the compounds or compositions described herein. In some embodiments, compounds of the present invention can act as inhibitors of llβHSDl and/or MR. In further embodiments, the compounds of the invention can be used to modulate activity of llβHSDl and/or MR in an individual in need of modulation of the enzyme or receptor by administering a modulating amount of a compound of the invention. The present invention further provides methods of inhibiting the conversion of cortisone to Cortisol in a cell, or inhibiting the production of Cortisol in a cell, where conversion to or production of Cortisol is mediated, at least in part, by 1 lβHSDl activity. Methods of measuring conversion rates of cortisone to Cortisol and vice versa, as well as methods for measuring levels of cortisone and Cortisol in cells, are routine in the art. The present invention further provides methods of increasing insulin sensitivity of a cell by contacting the cell with a compound of the invention. Methods of measuring insulin sensitivity are routine in the art. The present invention further provides methods of treating disease associated with activity or expression, including abnormal activity and overexpression, of llβHSDl and/or MR in an individual (e.g., patient) by administering to the individual in need of such treatment a therapeutically effective amount or dose of a compound of the present invention or a pharmaceutical composition thereof. Example diseases can include any disease, disorder or condition that is directly or indirectly linked to expression or activity of the enzyme or receptor. An l lβHSDl -associated disease can also include any disease, disorder or condition that can be prevented, ameliorated, or cured by modulating enzyme activity. Examples of l lβHSDl -associated diseases include obesity, diabetes, glucose intolerance, insulin resistance, hyperglycemia, hypertension, hyperlipidemia, cognitive impairment, dementia, glaucoma, cardiovascular disorders, osteoporosis, and inflammation. Further examples of l lβHSDl - associated diseases include metabolic syndrome, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) and polycystic ovary syndrome (PCOS). The present invention further provides methods of modulating MR activity by contacting the MR with a compound of the invention, pharmaceutically acceptable salt, prodrug, or composition thereof. In some embodiments, the modulation can be inhibition. In further embodiments, methods of inhibiting aldosterone binding to the MR (optionally in a cell) are provided. Methods of measuring MR activity and inhibition of aldosterone binding are routine in the art. The present invention further provides methods of treating a disease associated with activity or expression of the MR. Examples of diseases associated with activity or expression of the MR include, but are not limited to hypertension, as well as cardiovascular, renal, and inflammatory pathologies such as heart failure, atherosclerosis, arteriosclerosis, coronary artery disease, thrombosis, angina, peripheral vascular disease, vascular wall damage, stroke, dyslipidemia, hyperlipoproteinaemia, diabetic dyslipidemia, mixed dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and those associated with type 1 diabetes, type 2 diabetes, obesity metabolic syndrome, insulin resistance and general aldosterone-related target organ damage. As used herein, the term "cell" is meant to refer to a cell that is in vitro, ex vivo or in vivo. In some embodiments, an ex vivo cell can be part of a tissue sample excised from an organism such as a mammal. In some embodiments, an in vitro cell can be a cell in a cell culture. In some embodiments, an in vivo cell is a cell living in an organism such as a mammal. In some embodiments, the cell is an adipocyte, a pancreatic cell, a hepatocyte, neuron, or cell comprising the eye. As used herein, the term "contacting" refers to the bringing together of indicated moieties in an in vitro system or an in vivo system. For example, "contacting" the l lβHSDl enzyme with a compound of the invention includes the administration of a compound of the present invention to an individual or patient, such as a human, having l lβHSDl, as well as, for example, introducing a compound of the invention into a sample containing a cellular or purified preparation containing the l lβHSDl enzyme. As used herein, the term "individual" or "patient," used interchangeably, refers to any animal, including mammals, preferably mice, rats, other rodents, rabbits, dogs, cats, swine, cattle, sheep, horses, or primates, and most preferably humans. As used herein, the phrase "therapeutically effective amount" refers to the amount of active compound or pharmaceutical agent that elicits the biological or medicinal response that is being sought in a tissue, system, animal, individual or human by a researcher, veterinarian, medical doctor or other clinician, which includes one or more of the following: (1) preventing the disease; for example, preventing a disease, condition or disorder in an individual who may be predisposed to the disease, condition or disorder but does not yet experience or display the pathology or symptomatology of the disease (non-limiting examples are preventing metabolic syndrome, hypertension, obesity, insulin resistance, hyperglycemia, hyperlipidemia, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) and polycystic ovary syndrome (PCOS); (2) inhibiting the disease; for example, inhibiting a disease, condition or disorder in an individual who is experiencing or displaying the pathology or symptomatology of the disease, condition or disorder (i.e., arresting further development of the pathology and/or symptomatology) such as inhibiting the development of metabolic syndrome, hypertension, obesity, insulin resistance, hyperglycemia, hyperlipidemia, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) or polycystic ovary syndrome (PCOS), stabilizing viral load in the case of a viral infection; and (3) ameliorating the disease; for example, ameliorating a disease, condition or disorder in an individual who is experiencing or displaying the pathology or symptomatology of the disease, condition or disorder (i.e., reversing the pathology and/or symptomatology) such as decreasing the severity of metabolic syndrome, hypertension, obesity, insulin resistance, hyperglycemia, hyperlipidemia, type 2 diabetes, androgen excess (hirsutism, menstrual irregularity, hyperandrogenism) and polycystic ovary syndrome (PCOS), or lowering viral load in the case of a viral infection.
Pharmaceutical Formulations and Dosage Forms When employed as pharmaceuticals, the compounds of Formula I can be administered in the form of pharmaceutical compositions. These compositions can be prepared in a manner well known in the pharmaceutical art, and can be administered by a variety of routes, depending upon whether local or systemic treatment is desired and upon the area to be treated. Administration may be topical (including ophthalmic and to mucoμs membranes including intranasal, vaginal and rectal delivery), pulmonary (e.g., by inhalation or insufflation of powders or aerosols, including by nebulizer; intratracheal, intranasal, epidermal and transdermal), ocular, oral or parenteral. Methods for ocular delivery can include topical administration (eye drops), subconjunctival, periocular or intravitreal injection or introduction by balloon catheter or ophthalmic inserts surgically placed in the conjunctival sac. Parenteral administration includes intravenous, intraarterial, subcutaneous, intraperitoneal or intramuscular injection or infusion; or intracranial, e.g., intrathecal or intraventricular, administration. Parenteral administration can be in the form of a single bolus dose, or may be, for example, by a continuous perfusion pump. Pharmaceutical compositions and formulations for topical administration may include transdermal patches, ointments, lotions, creams, gels, drops, suppositories, sprays, liquids and powders. Conventional pharmaceutical carriers, aqueous, powder or oily bases, thickeners and the like may be necessary or desirable. This invention also includes pharmaceutical compositions which contain, as the active ingredient, one or more of the compounds of the invention above in combination with one or more pharmaceutically acceptable carriers, hi making the compositions of the invention, the active ingredient is typically mixed with an excipient, diluted by an excipient or enclosed within such a carrier in the form of, for example, a capsule, sachet, paper, or other container. When the excipient serves as a diluent, it can be a solid, semi-solid, or liquid material, which acts as a vehicle, carrier or medium for the active ingredient. Thus, the compositions can be in the form of tablets, pills, powders, lozenges, sachets, cachets, elixirs, suspensions, emulsions, solutions, syrups, aerosols (as a solid or in a liquid medium), ointments containing, for example, up to 10 % by weight of the active compound, soft and hard gelatin capsules, suppositories, sterile injectable solutions, and sterile packaged powders. In preparing a formulation, the active compound can be milled to provide the appropriate particle size prior to combining with the other ingredients. If the active compound is substantially insoluble, it can be milled to a particle size of less than 200 mesh. If the active compound is substantially water soluble, the particle size can be adjusted by milling to provide a substantially uniform distribution in the formulation, e.g. about 40 mesh. Some examples of suitable excipients include lactose, dextrose, sucrose, sorbitol, mannitol, starches, gum acacia, calcium phosphate, alginates, tragacanth, gelatin, calcium silicate, microcrystalline cellulose, polyvinylpyrrolidone, cellulose, water, syrup, and methyl cellulose. The formulations can additionally include: lubricating agents such as talc, magnesium stearate, and mineral oil; wetting agents; emulsifying and suspending agents; preserving agents such as methyl- and propylhydroxy-benzoates; sweetening agents; and flavoring agents. The compositions of the invention can be formulated so as to provide quick, sustained or delayed release of the active ingredient after administration to the patient by employing procedures known in the art. The compositions can be formulated in a unit dosage form, each dosage containing from about 5 to about 100 mg, more usually about 10 to about 30 mg, of the active ingredient. The term "unit dosage forms" refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical excipient. The active compound can be effective over a wide dosage range and is generally administered in a pharmaceutically effective amount. It will be understood, however, that the amount of the compound actually administered will usually be determined by a physician, according to the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual compound administered, the age, weight, and response of the individual patient, the severity of the patient's symptoms, and the like. For preparing solid compositions such as tablets, the principal active ingredient is mixed with a pharmaceutical excipient to form a solid preformulation composition containing a homogeneous mixture of a compound of the present invention. When referring to these preformulation compositions as homogeneous, the active ingredient is typically dispersed evenly throughout the composition so that the composition can be readily subdivided into equally effective unit dosage forms such as tablets, pills and capsules. This solid preformulation is then subdivided into unit dosage forms of the type described above containing from, for example, 0.1 to about 500 mg of the active ingredient of the present invention. The tablets or pills of the present invention can be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action. For example, the tablet or pill can comprise an inner dosage and an outer dosage component, the latter being in the form of an envelope over the former. The two components can be separated by an enteric layer which serves to resist disintegration in the stomach and permit the inner component to pass intact into the duodenum or to be delayed in release. A variety of materials can be used for such enteric layers or coatings, such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol, and cellulose acetate. The liquid forms in which the compounds and compositions of the present invention can be incorporated for administration orally or by injection include aqueous solutions, suitably flavored syrups, aqueous or oil suspensions, and flavored emulsions with edible oils such as cottonseed oil, sesame oil, coconut oil, or peanut oil, as well as elixirs and similar pharmaceutical vehicles. Compositions for inhalation or insufflation include solutions and suspensions in pharmaceutically acceptable, aqueous or organic solvents, or mixtures thereof, and powders. The liquid or solid compositions may contain suitable pharmaceutically acceptable excipients as described supra. In some embodiments, the compositions are administered by the oral or nasal respiratory route for local or systemic effect. Compositions in can be nebulized by use of inert gases. Nebulized solutions may be breathed directly from the nebulizing device or the nebulizing device can be attached to a face masks tent, or intermittent positive pressure breathing machine. Solution, suspension, or powder compositions can be administered orally or nasally from devices which deliver the formulation in an appropriate manner. The amount of compound or composition administered to a patient will vary depending upon what is being administered, the purpose of the administration, such as prophylaxis or therapy, the state of the patient, the manner of administration, and the like. In therapeutic applications, compositions can be administered to a patient already suffering from a disease in an amount sufficient to cure or at least partially arrest the symptoms of the disease and its complications. Effective doses will depend on the disease condition being treated as well as by the judgment of the attending clinician depending upon factors such as the severity of the disease, the age, weight and general condition of the patient, and the like. The compositions administered to a patient can be in the form of pharmaceutical compositions described above. These compositions can be sterilized by conventional sterilization techniques, or may be sterile filtered. Aqueous solutions can be packaged for use as is, or lyophilized, the lyophilized preparation being combined with a sterile aqueous carrier prior to administration. The pH of the compound preparations typically will be between 3 and 11, more preferably from 5 to 9 and most preferably from 7 to 8. It will be understood that use of certain of the foregoing excipients, carriers, or stabilizers will result in the formation of pharmaceutical salts. The therapeutic dosage of the compounds of the present invention can vary according to, for example, the particular use for which the treatment is made, the manner of administration of the compound, the health and condition of the patient, and the judgment of the prescribing physician. The proportion or concentration of a compound of the invention in a pharmaceutical composition can vary depending upon a number of factors including dosage, chemical characteristics (e.g., hydrophobicity), and the route of administration. For example, the compounds of the invention can be provided in an aqueous physiological buffer solution containing about 0.1 to about 10% w/v of the compound for parenteral adminstration. Some typical dose ranges are from about 1 μg/kg to about 1 g/kg of body weight per day. In some embodiments, the dose range is from about 0.01 mg/kg to about 100 mg/kg of body weight per day. The dosage is likely to depend on such variables as the type and extent of progression of the disease or disorder, the overall health status of the particular patient, the relative biological efficacy of the compound selected, formulation of the excipient, and its route of administration. Effective doses can be extrapolated from dose-response curves derived from in vitro or animal model test systems. The compounds of the invention can also be formulated in combination with one or more additional active ingredients which can include any pharmaceutical agent such as anti-viral agents, antibodies, immune suppressants, anti-inflammatory agents and the like.
Labeled Compounds and Assay Methods Another aspect of the present invention relates to radio-labeled compounds of the invention that would be useful not only in radio-imaging but also in assays, both in vitro and in vivo, for localizing and quantitating the enzyme in tissue samples, including human, and for identifying ligands by inhibition binding of a radio-labeled compound. Accordingly, the present invention includes enzyme assays that contain such radio-labeled compounds. The present invention further includes isotopically-labeled compounds of the invention. An "isotopically" or "radio-labeled" compound is a compound of the invention where one or more atoms are replaced or substituted by an atom having an atomic mass or mass number different from the 11
atomic mass or mass number typically found in nature (i.e., naturally occurring). Suitable radionuclides that may be incorporated in compounds of the present invention include but are not limited to 2H (also written as D for deuterium), 3H (also written as T for tritium), 11C, 13C, 14C, 13N, 15N, 15O, 170, 18O, 18F, 35S, 36Cl, 82Br, 75Br, 76Br, 77Br, 123I, 124I, 125I and 131I. The radionuclide that is 5 incorporated in the instant radio-labeled compounds will depend on the specific application of that radio-labeled compound. For example, for in vitro receptor labeling and competition assays, compounds that incorporate 3H, 14C, 82Br, 1251 , 1311, 35S or will generally be most useful. For radio- imaging applications 11C, 18F, 1251, 1231, 1241, 1311, 75Br, 76Br or 77Br will generally be most useful. It is understood that a "radio-labeled " or "labeled compound" is a compound that has O incorporated at least one radionuclide. In some embodiments the radionuclide is selected from the group consisting of 3H, 14C, 1251 , 35S and 82Br. Synthetic methods for incorporating radio-isotopes into organic compounds are applicable to compounds of the invention and are well known in the art. A radio-labeled compound of the invention can be used in a screening assay to 5 identify/evaluate compounds. In general terms, a newly synthesized or identified compound (i.e., test compound) can be evaluated for its ability to reduce binding of the radio-labeled compound of the invention to the enzyme. Accordingly, the ability of a test compound to compete with the radio¬ labeled compound for binding to the enzyme directly correlates to its binding affinity.
»0 Kits The present invention also includes pharmaceutical kits useful, for example, in the treatment or prevention of llβHSDl -associated diseases or disorders, obesity, diabetes and other diseases referred to herein which include one or more containers containing a pharmaceutical composition comprising a therapeutically effective amount of a compound of the invention. Such kits can further 5 include, if desired, one or more of various conventional pharmaceutical kit components, such as, for example, containers with one or more pharmaceutically acceptable carriers, additional containers, etc., as will be readily apparent to those skilled in the art. Instructions, either as inserts or as labels, indicating quantities of the components to be administered, guidelines for administration, and/or guidelines for mixing the components, can also be included in the kit. 0 The invention will be described in greater detail by way of specific examples. The following examples are offered for illustrative purposes, and are not intended to limit the invention in any manner. Those of skill in the art will readily recognize a variety of noncritical parameters which can be changed or modified to yield essentially the same results. The compounds of the example section were found to be inhibitors or antagonists of 1 lβHSDl or MR according to one or more of the assays 5 provided herein. EXAMPLES Example 1
Figure imgf000046_0001
{(lS)-2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l,2,3,4-tetrahydroisoquinolin-l-yl}methanol BOP (200 μL, 0.25 M in DMF, 50 μmol) was added to a solution of the 2-(4-chlorophenyl)-2- methylpropanoic acid (200 μL, 0.25 M in DMF, 50 μmol) at RT, followed by addition of N-methyl morpholine (40 μL). The mixture was stirred at RT for 15 min, then a solution of (1S)-1,2,3,4- tetrahydroisoquinolin-1-ylmethanol in DMF (200 μL, 0.25 M in DMF, 50 μmol) was added. The resulting mixture was stirred at RT for 3 h, and then was adjusted by TFA to PH = 2.0, and diluted with DMSO (1100 μL). The resulting solution was purified by prep.-HPLC to afford the desired product ((lS)-2-[2-(4-chlorophenyl)-2-methylpropanoyl]-l,2,3,4-tetrahydroisoquinolin-l- yl)methanol. LCMS: (M+FT)+ = 344.0/346.0.
Figure imgf000046_0002
2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l,2,3,4-tetrahydroisoquinoline This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 314.0/316.0.
Example 3
Figure imgf000046_0003
6-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4,5,6,7-tetrahydrothieno[2,3-c]pyridine This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 320.0/322.0.
Figure imgf000046_0004
3-PhenyI-l-[2-(4-chIorophenyl)-2-methyIpropanoyl]piperidine This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 342.0/344.1.
Figure imgf000047_0001
l'-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l,3-dihydrospiro[indene-2,4'-piperidine] This compound was prepared using procedures analogous to those for example 1. LCMS: (MH-H)+ = 368.1/370.1.
Figure imgf000047_0002
2-Methyl- l-phenyl-4- [2-(4-chlorophenyl)-2-methylpropanoyl] piperazine This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 357.1/359.1.
Example 7
Figure imgf000047_0003
2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-2,3,3a,4,5,9b-hexahydro-lH-benzo[e]isoindoIe This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 354.1/356.0.
Figure imgf000047_0004
3-(3-Fluorophenyl)-l-[2-(4-chlorophenyl)-2-methylpropanoyl]pyrrolidine This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 346.0/348.0.
Figure imgf000048_0001
1 '- [2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin]-3-one This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 370.0/372.0. Example 10
Figure imgf000048_0002
((lS)-2-[2-Methyl-2-(phenylthio)propanoyl]-l,2,3,4-tetrahydroisoquinolin-l-yl)methanoI Step 1. Methyl 2-methyl-2-(phenylthio)propanoate
Figure imgf000048_0003
Sodium hydride (60% in mineral oil, 1.08 g, 27.1 mmol) was suspended in DMF (20 niL) and cooled to 0 0C. A solution of methyl(phenylthio)acetate (2.15 g, 11.8 mmol) in THF (40 mL) was added via cannula at 0 0C. After stirring for 10 min at 0 0C, methyl iodide (3.67 mL, 59.0 mmol) was added dropwise at 0 0C. The reaction mixture was stirred at rt overnight. It was quenched by the addition of water and EtOAc. After stirring for a few min to dissolve all solids, the layers were separated. The organic layer was dried over MgSO4, filtered and concentrated. The residue was flash chromatographed (silica, hexanes: ether, 2:1) to provide the desired product (2.25 g, 90.7% yield). Step 2, 2-Methyl-2-(phenylthio)propanoic acid
Figure imgf000048_0004
Methyl 2-methyl-2-(phenylthio)propanoate (1.126 g, 5.35 mmol) was dissolved in THF (15 mL) and methanol (5 mL). That solution was treated with an aqueous solution of lithium hydroxide monohydrate (1.12 g, 26.8 mmol in 5 mL of water). The reaction mixture was stirred at rt overnight. The volatiles were removed and the remaining aqueous solution was acidified with a 1 N HCl solution 5 022411
to pH 2. Ethyl acetate was added and the layers were separated. The organic layer was dried over MgSO4, filtered and concentrated to provide the desired carboxylic acid as a white solid (1.020 g, 97.1% yield).
Step 3. The final compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 342.0.
Figure imgf000049_0001
2-[2-Methyl-2-(phenylthio)propanoyl]-l,2,3,4-tetrahydroisoquinoline This compound was prepared using procedures analogous to those for Example 10. LCMS: (MH-H)+ = 312.0.
Figure imgf000049_0002
6-[2-Methyl-2-(phenylthio)propanoyl]-4,5,6,7-tetrahydrothieno[2,3-c]pyridine This compound was prepared using procedures analogous to those for Example 10. LCMS: (M+H)+ = 318.0.
Figure imgf000049_0003
3-PhenyI-l-[2-methyl-2-(phenylthio)propanoyl]piperidine This compound was prepared using procedures analogous to those for Example 10. LCMS: (M+H)+ = 340.1.
Example 14
Figure imgf000049_0004
11
l'-[2-Methyl-2-(phenylthio)propanoyl]-l,3-dihydrospiro[indene-2,4'-piperidine This compound was prepared using procedures analogous to those for Example 10. LCMS: (M+H)+ : 366.1.
Example 15
Figure imgf000050_0001
2-Methyl-l-phenyl-4-[2-methyl-2-(phenylthio)propanoyl]piperazine This compound was prepared using procedures analogous to those for Example 10. LCMS: (M+H)+ = 355.1.
Example 16
Figure imgf000050_0002
2-[2-Methyl-2-(phenylthio)propanoyl]-2,3,3a,4,5,9b-hexahydro-lH-benzo[e]isoindole This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 352.1.
Example 17
Figure imgf000050_0003
3-(3-Fluorophenyl)- 1- [2-methyl-2-(phenylthio)propanoyl] pyrrolidine This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 344.0.
Example 18
Figure imgf000050_0004
l'-[2-Methyl-2-(phenylthio)propanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 368.0. 11
Example 19
Figure imgf000051_0001
((lS)-2-{2-[(2-ChlorobenzyI)thio]-2-methylpropanoyl}-l,2,3,4-tetrahydroisoquinolin-l- yl)methanol This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 390.0/392.0.
Example 20
Figure imgf000051_0002
2-{2-[(2-Chlorobenzyl)thio]-2-methyIpropanoyl}-l,2,3,4-tetrahydroisoquinoline This compound was prepared using procedures analogous to those for example 1. LCMS: (M+H)+ = 360.0/362.0.
Example 21
Figure imgf000051_0003
6-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-4,5,6,7-tetrahydrothieno[2,3-c]pyridine This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 366.0/368.0.
Example 22
Figure imgf000051_0004
3-Phenyl-l-{2-[(2-chlorobenzyl)thio]-2-methylpropanoyl}piperidine This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 388.0/390.0. 22411
Example 23
Figure imgf000052_0001
l'-{2-[(2-ChIorobenzyl)thio]-2-methyIpropanoyl}-l,3-dihydrospiro[indene-2,4'-piperidine This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 414.0/416.0.
Example 24
Figure imgf000052_0002
2-Methyl-l-phenyl-4-{2-[(2-chlorobenzyl)thio]-2-methylpropanoyl}piperazine This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 403.0/405.0.
Example 25
Figure imgf000052_0003
2-{2-[(2-Chloroben2yl)thio]-2-methylpropanoyl}-2,3,3a,4,5,9b-hexahydro-lH-benzo[e]isoindole This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 400.0/402.1.
Example 26
Figure imgf000052_0004
T7US2005/022411
3-(3-Fluorophenyl)-l-{2-[(2-chlorobenzyl)thio]-2-methyIpropanoyl}pyrrolidine This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 392.0/394.0.
Example 27
Figure imgf000053_0001
l'-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared using procedures analogous to those for example 10. LCMS: (M+H)+ = 416.0/418.0.
Example 28
Figure imgf000053_0002
4-[l,l-Dimethyl-2-oxo-2-(3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy]benzonitrile Step 1: Ethyl 2-(4-cyanophenoxy)-2-methylpropanoate
Figure imgf000053_0003
4-Hydroxybenzoic acid nitrile (1. 00 g, 8.39 mmol) was dissolved in dry acetone (32 mL) and treated with potassium carbonate (3.48 g, 25.2 mmol). The reaction mixture was stirred at ambient temperature for 30 minutes and then propanoic acid, 2-bromo-2-methyl-, ethyl ester (3.70 mL, 25.2 mmol) was added. The reaction mixture was stirred under refluxing for 16 hours. Then, it was brought to ambient temperature, poured into water and extracted with dichloromethane. The organic layer was dried over magnesium sulfate, filtered and concentrated. The residue was flash chromatographed (silica, hexanes:ethyl acetate, 9:1 to 6:1 to 3:1) to provide the title compound as a colorless oil (0.918 g, 46.9% yield).
Step 2: 2-(4-Cyanophenoxy)-2-methylpropanoic acid
Figure imgf000054_0001
Ethyl 2-(4-cyanophenoxy)-2-methylpropanoate (0.890 g, 3.82 mmol) was dissolved in tetrahydrofuran (45 mL) and methanol (15 mL) and treated with a solution of lithium hydroxide, monohydrate (0.800 g, 19.1 mmol) in water (15 mL). The reaction mixture was stirred at ambient temperature overnight. The volatiles were removed under reduced pressure and the remaining aqueous solution was acidified with a 1 N HCl solution to pH 2. Ethyl acetate was added and the layers were separated. The organic layer was dried over magnesium sulfate, filtered and concentrated to provide the title compound as a white solid (0.749 g, 95.7 % yield).
Step 3: 4-[l , l-Dimethyl-2-oxo-2-(3-oxo-l 'H,3H-spiro[2-henzofuran-l ,3 '-pyrrolidinj-l '- yl) ethoxyjbenzonitrile 2-(4-Cyanophenoxy)-2-methylpropanoic acid (0.040 g, 0.19 mmol) was dissolved in DMF (1.9 mL) and treated with BOP reagent (0.103 g, 0.234 mmol). After stirring for 10 minutes, 3H- spiro[2-benzofuran-l,3'-pyrrolidin]-3-one hydrochloride (0.048 g, 0.214 mmol) was added followed by N,N-diisopropylethylamine (0.102 mL, 0.585 mmol). The reaction mixture was stirred at ambient temperature overnight. It was poured into a saturated sodium bicarbonate solution and extracted with ethyl acetate. The organic layer was washed successively with water and brine, dried over magnesium sulfate, filtered and concentrated. The residue was flash chromatographed (silica, hexanes:ethyl acetate, 1:1 to 1:2 to 1:3) to provide the title compound as an off white solid (0.068 g, 93% yield). LCMS: m/z 377.1 (M+H)+.
Figure imgf000054_0002
l'-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrroIidin]-3-one 2005/022411
The title compound was prepared according to the procedures described for Example 28. LCMS: m/z 386.1 (M+H)+.
Figure imgf000055_0001
{4-[l,l-DimethyI-2-oxo-2-(3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yϊ)ethoxy]phenyl}acetonitrile The title compound was prepared according to the procedures described for example 1. LCMS: m/z 391.2 (M+H)+.
Figure imgf000055_0002
{4-[l,l-Dimethyl-2-oxo-2-(l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy] phenyl} acetonitrile 2-[4-(Cyanomethyl)phenoxy]-2-methylpropanoic acid, prepared according to the procedures described for Example 28, (0.020 g, 0.1 mmol) was dissolved in dichloromethane (0.39 niL) and treated with BOP reagent (0.040 g, 0.1 mmol). After stirring for 10 minutes, 3H-spiro[2-benzofuran- 1,3 '-pyrrolidine] hydrochloride (0.016 g, 0.1 mmol) was added followed by N,N- diisopropylethylamine (0.040 mL, 0.228 mmol). The reaction mixture was stirred at ambient temperature overnight. Following concentration, the residue was flash chromatographed (silica, hexanes:ethyl acetate, 1:1 to 1:2) to provide the title compound (0.0125 g, 43.7% yield). LCMS: m/z 377.2 (M+H)+.
Figure imgf000055_0003
l'-[2-Methyl-2-(4-pyridin-2-ylphenoxy)propanoyI]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one Step 1: Ethyl 2-methyl-2-(4-pyridin-2-ylphenoxy)propanoate
Figure imgf000056_0001
Ethyl 2-(4-bromophenoxy)-2-methylpropanoate (0.400 g, 1.39 mmol) of Example 28 was dissolved in dry toluene (16 niL) in a schlenck flask under nitrogen. To that solution was added successively 2-(tributylstannyl)pyridine (0.673 g, 1.46 mmol) and tetrakis(triphenylphosphine)palladium(0) (0.080 g, 0.07 mmol). The reaction mixture was evacuated and flushed with nitrogen four times and then stirred at 110 0C overnight. It was brought to ambient temperature and filtered through a short silica gel pad (hexanes: ethyl acetate, 3:1 to 1:1). The filtrate was concentrated and the residue was flash chromatographed (silica, hexanes: ethyl acetate, 6:1 to 4:1 to 2:1 to 1:1) to provide the title compound as a colorless oil (0.352 g, 88.6% yield).
Step 2: 2-Methyl-2-(4-pyridin-2-ylphenoxy)propanoic acid
Figure imgf000056_0002
Ethyl 2-methyl-2-(4-pyridin-2-ylphenoxy)propanoate (0.352 g, 1.23 mmol) was dissolved in tetrahydrofuran (15 niL) and methanol (5 mL) and treated with a solution of lithium hydroxide, monohydrate (0.259 g, 6.17 mmol) in water (5 mL). The reaction mixture was stirred at ambient temperature overnight. The volatiles were removed under reduced pressure and the remaining aqueous solution was acidified with a 1 N HCl solution to pH 2. Ethyl acetate was added and the layers were separated. The organic layer was dried over magnesium sulfate, filtered and concentrated to provide the title compound as a white solid (0.245 g, 77.2 % yield).
Step 3: 1 '-[2-Methyl-2-(4-pyridin-2-ylphenoyy)propanoyl]-3H-spiro[2-benzofuran-l,3 '-pyrrolidin]-3- one
Figure imgf000057_0001
2-Methyl-2-(4-pyridin-2-ylphenoxy)propanoic acid (0.030 g, 0.12 mmol) was dissolved in DMF (1.2 mL) and treated with BOP reagent (0.062 g, 0.140 mmol). After stirring for 10 minutes, 3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one hydrochloride (0.029 g, 0.128 mmol) was added followed by N,N-diisopropylethylamine (0.061 mL, 0.350 mmol). The reaction mixture was stirred at ambient temperature overnight. It was poured into a saturated sodium bicarbonate solution and extracted with ethyl acetate. The organic layer was washed successively with water and brine, dried over magnesium sulfate, filtered and concentrated. The residue was flash chromatographed (silica, hexanes:ethyl acetate, 1:2 to 1:3) to provide the title compound as an off white solid (0.045 g, 90% yield). LCMS: m/z 429.1 (M+H)+.
Figure imgf000057_0002
l'-{2-[(4'-FIuorobiphenyl-4-yl)oxy]-2-methyIpropanoyl}-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one The title compound prepared according to the procedures described for Example 32. LCMS: m/z 446.1 (M+H)+.
Example 34
Figure imgf000057_0003
l'-{2-[(4'-Fluorobiphenyl-4-yl)oxy]-2-methylpropanoyI}-3H-spiro[2-benzofuran-l,3'- pyrrolidine] 2-[(4'-Fluorobiphenyl-4-yl)oxy]-2-methylpropanoic acid, prepared according to the procedures described for Example 32, (0.020 g, 0.07 mmol) was dissolved in dichloromethane (0.38 niL) and treated with BOP reagent (0.039 g, 0.088 mmol). After stirring for 10 minutes, 3H-spiro[2- benzofuran- 1,3 '-pyrrolidine] hydrochloride (0.015 g, 0.073 mmol) was added followed by N5N- diisopropylethylamine (0.038 niL, 0.219 mmol). The reaction mixture was stirred at ambient temperature overnight. Following concentration, the residue was flash chromatographed (silica, hexanes:ethyl acetate, 1:1 to 1:2 to 1:3) to provide the title compound (0.026 g, 80% yield). LCMS: m/z 432.2 (M+H)+.
Figure imgf000058_0001
(lR)-l'-[2-(4-Chlorophenoxy)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one Step 1. Benzyl 3-oxo-l 'H,3H-spiro[2-benzofuran-l ,3 ' -pyrrolidine] -1 'carboxylate
Figure imgf000058_0002
To a solution of methyl-2-iodobenzoate(8.8 niL, 0.060 mol) in THF (300 mL) at -60 0C was slowly added a solution of isopropylmagnesium bromide in THF (1.0 M, 66.0 mL) and the mixture was stirred below -50 0C for 1 h. A solution of benzy 1-3 -oxopyrrolidine-1 -carboxylate (11.0 g, 0.05 mol) in THF (20.0 mL) was added to the above mixture and the reaction was stirred below -20 0C for 20 2 h. The reaction was quenched by adding saturated NH4CI and then extracted with ethyl acetate and the combined extract was washed with water, brine, dried and concentrated. The product was purified by CombiFlash using Hexane/Ethyl acetate.
Step 2. (lS)-(+)-l 0-Camphorsulfonic acid 3H-spiro-[2-benzofuran-l ,3 '-pyrrolidinJ-3-one
Figure imgf000058_0003
Palladium on carbon (10%, 0.5 g) was added to a solution of benzyl 3-oxo-l'H,3H-spiro[2- benzofuran-l,3'-pyrrolidine]-rcarboxylate (5.0 g, 15.5 mmol) in methanol (100 rnL) and the mixture was stirred under hydrogen balloon for 4 h (HPLC completion). The solvent was removed under vacuum. The residue was dissolved in acetonitrile (200 mL) and (lS)-(+)-10-camphorsulfonic acid 5 (3.6 g, 15.5 mmol) in acetonitrile (20 mL) was slowly added at 50 0C . The formed solid was filtered and dried to give the desired product. LC-MS : 190.1 (M+H)+.
Step 3. 2-(p-Chlorophenoxy)-2-methylpropanoic acid (0.030 g, 0.12 mmol) was dissolved in DMF [0 (1.3 mL) and treated with BOP reagent (0.062 g, 0.139 mmol). After stirring for 10 minutes, (1 S)-(+> 10-camphorsulfonic acid salt of (lR)-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one(l:l) (0.054 g, 0.128 mmol) was added followed by N,N-diisopropylethylamine (0.061 mL, 0.348 mmol). The reaction mixture was stirred at ambient temperature overnight. It was poured into a saturated sodium bicarbonate solution and extracted with ethyl acetate. The organic layer was washed successively with 5 water and brine, dried over magnesium sulfate, filtered and concentrated. The residue was flash chromatographed (silica, hexanes:ethyl acetate, 1:1) to provide the title compound as a white solid (0.042 g, 94% yield). LCMS: m/z 386.1 (M+H)+.
Figure imgf000059_0001
(lR)-l'-[2-(2,4-DichIorophenoxy)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrroIidin]- 3-one The title compound was prepared according to the procedures described in Example 35. LCMS: m/z 421.0 (M+H)+. 5 Example 37
Figure imgf000059_0002
T7US2005/022411
(l^-l'-P-CS^-Dichloropheno^-l-methylpropanoyll-SH-spiro^-benzofuran-lβ'-pyrrolidin]- 3-one The title compound was prepared according to the procedures described for Example 35. LCMS: m/z 421.0 (M+H)+.
Example 38 l'-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one
Figure imgf000060_0001
This compound was prepared using procedures analogous step Ib in example 35. MS (ESI): 370.1(M + H4)
Example 39 (lR)-l'-[2-(4-chlorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one
Figure imgf000060_0002
This compound was prepared using procedures analogous Ib in example 35. MS (ESI): 370.1(M + H+)
Example 40 l'-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-3-one
Figure imgf000060_0003
Step 1: Synthesis of7H-spiro[furo[3,4-b]pyridine-5,3'-pyrrolidin]-7-one A solution of 2,2,6,6-tetramethyl-piperidine (0.820 niL, 0.00486 mol) in tetrahydrofuran (5 mL, 0.06 mol) at -75 Celsius was added 1.600 M of n-butyllithium in hexane (4.05 mL). After stirred for 15 min, a solution of 2-pyridinecarboxylic acid (199 mg, 0.00162 mmol) was added. The mixture was continue stir at -75 Celsius 10 min, then stir at -20 Celsius for 30 min. A solution of tert-butyl 3- oxopyrrolidine-1-carboxylate (250 mg, 0.0013 mol) in THF 2 mL was added to the above mixture. The reaction mixture was continued to stir at -20 Celsius for 20 min, then warm up to r.t. and stirred for additional 1 hours. The reaction was quenched with water and concentrated to remove THF and acidified to pH ~1 using 6M HCl aq. solution, stir at r.t. overnight. The residue was extracted with methylene chloride. The water layer was concentrated and the residue was directly purified by flash 0 chromatography on silica gel column with 10% methanol in methylene chloride to give the desired compound. MS (ESI): 190.9 (M + H+).
Example 41 l'-[2-(4-chlorophenyl)-2-methylpropanoyl]-7H-spiro[furo[3,4-b]pyridine-5,3'-pyrrolidin]-7-one
Figure imgf000061_0001
This compound was prepared using procedures analogous to example 40. MS (ESI): 371.1(M + H+).
Example 42
Figure imgf000061_0002
(4aR,8aS)-2-{2-[(4-Chlorophenyl)thio]-2-methylpropanoyl}decahydroisoquinoline This compound was prepared using procedures analogous to those described for the synthesis of example 10. LCMS: (M+H)+ = 352.7/354.7.
Figure imgf000061_0003
l'-{2-[(4-Chlorophenyl)thio]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'-pyrroIidin]-3-one
Figure imgf000062_0001
Stepl. Benzyl 3-oxo-l 'H,3H-spiro[2-ben∑ofuran-l ,3 '-pyrrolidine] -1 'carboxylate To a solution of methyl-2-iodobenzoate(8.8 niL, 0.060 mol) in THF (300 mL) at -60 0C was slowly added a solution of isopropylmagnesium bromide in THF (1.0 M, 66.0 mL) and the mixture was stirred below -50 0C for 1 h. A solution of benzy 1-3 -oxopyrrolidine-1 -carboxylate (11.0 g, 0.05 mol) in THF (20.0 mL) was added to the above mixture and the reaction mixture was stirred below - 20 0C for 2 h. The reaction was quenched by the addition of saturated NH4CI aqueous solution, and the resulting mixture was extracted with ethyl acetate several times. The combined extract was washed with water followed by brine, then dried and then concentrated. The product was purified by CombiFlash using hexane/ethyl acetate.
Step 2. 3H-spiro-[2-benzofuran-l,3 '-pyrrolidin]-3-one
Figure imgf000062_0002
Palladium on carbon (10%, 0.5 g) was added to a solution of benzyl 3-oxo-l'H,3H-spiro[2- benzofuran- 1,3' -pyrrolidine] -1' carboxylate (5.0 g, 15.5 mmol) in methanol (100 mL) and the mixture was stirred under a hydrogen balloon for 4 h (HPLC completion). The volatiles were removed under vacuum to afford the desired product. LCMS : 190.1 (M+H)+.
Step 3. The title compound was prepared using procedures analogous to those described for the synthesis of example 10. LCMS: (M+H)+ = 402.7/404.7.
Figure imgf000062_0003
l'-{2-[(4-ChIorophenyl)thio]-2-methylpropanoyI}-3H-spiro[2-benzofuran-l,3'-pyrrolidine] This compound was prepared using procedures analogous to those described for the synthesis of example 10. LCMS: (M+H)+ = 387.7/389.7.
Figure imgf000063_0001
l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-methoxyphenyl)piperidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 312.1131 A.I.
Figure imgf000063_0002
l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-trifluoromethylphenyl)piperidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 426.7/428.7.
Figure imgf000063_0003
l-[2-(4-ChlorophenyI)-2-methyIpropanoyl]-4-(2-fluorophenyl)piperidin-4-ol This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 376.6/378.6.
Example 48
Figure imgf000063_0004
1- [2-(4-ChlorophenyI)-2-methylpropanoyl] azepane This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 280.6/282.6.
Figure imgf000064_0001
l-[2-(4-ChIorophenyl)-2-methylpropanoyl]-3-phenyI-2,5-dihydro-lH-pyrrole This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 326.6/328.6.
Figure imgf000064_0002
3-{l-[2-(4-Chlorophenyl)-2-methylpropanoyl]pyrroIidin-3-yl}pyridine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 329.6/330.6.
Figure imgf000064_0003
l-[2-(4-Chlorophenyl)-2-methylpropanoyI]-4-methyl-4-phenylpiperidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 356.7/358.7.
Figure imgf000064_0004
l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-methyIphenyl)piperidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ - 356.7/358.7.
Example 53
Figure imgf000065_0001
l-[2-(4-ChlorophenyI)-2-methylpropanoyl]-3-(2-phenylethyI)pyrrolidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 356.7/358.7.
Figure imgf000065_0002
3-(3-Chlorophenyl)-l-[2-(3-chlorophenyl)-2-methylpropanoyl] pyrrolidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 362.1/364.1.
Figure imgf000065_0003
4-{l-[2-(4-Chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-yl}pyridine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 329.6/330.6.
Figure imgf000065_0004
3-(3-ChIorophenyl)-l-[2-(3,4-dichlorophenyl)-2-methylpropanoyI]pyrrolidine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 396.1/398.1/340.1.
Figure imgf000065_0005
4-{l-[2-(3,4-Dichlorophenyl)-2-methylpropanoyl]pyrrolidin-3-yl}pyridine This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 364.1/366.1.
Figure imgf000066_0001
l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-phenylpyrrolidin-2-yl}methanoI This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = 358.7/360.7.
Figure imgf000066_0002
{(2S,4R)-l-[2-(4-ChIorophenyl)-2-methylpropanoyl]-4-phenylpyrrolidin-2-yl}methanol This compound was prepared using procedures analogous to those described for the synthesis of example 44 followed by separation of the diastereoisomers via purification using a chiral column. 5 LCMS: (M+H)+ = 358.7/360.7.
Example 60
Figure imgf000066_0003
2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l,2,3,3a,4,9b-hexahydrochromeno[3,4-c]pyrrole 0 Step 1. 2-[l-[2-(4-chlorophenyl)-2-methylpropanoyl]-4-φydroxymethyl)pyrrolidin-3-yl]phenol This compound was prepared using procedures analogous to those described for the synthesis of example 1. LCMS: (M+H)+ = Hl A.I βl 6.1.
Step 2. 2-[2-(4-Chlorophenyl)-2-methylpropanoylJ-l,2,3,3a,4,9b-hexahydrochromeno[3,4-c]pyrrole 5 A mixture of 2-[ 1 -[2-(4-chlorophenyl)-2-methylpropanoyl]-4-(hydroxymethyl)pyrrolidin-3 - yl]phenol (14.5 mg, 0.0000388 mol), triphenylphosphine (20.0 mg, 0.0000762 mol) and diisopropyl azodicarboxylate (15.0 uL, 0.0000762 mol) in tetrahydrofuran (1.0 niL, 0.012 mol) was stirred at it for 4 h. The mixture was diluted with methanol (0.80 niL) and purified by prep-HPLC to give the desired product. LCMS: (M+H)+ = 356.7/358.7.
Figure imgf000067_0001
(lJΪ)-l'-(2-Methyl-2-pyridin-3-ylpropanoyl)-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one Step 1. (lS)-(+)-10-Camphorsulfonic acid-3H-spiro-[2-benzofuran-l,3 '-pyrrolidin]-3-one This compound was prepared according to the procedure that was outlined in the synthesis of example 29, steps 1 and 2 with the exception that the product from step 2, 3H-spiro-[2-benzofuran- l,3'-pyrrolidin]-3-one, was dissolved in acetonitrile (200 mL), and (lS)-(+)-10-camphorsulfonic acid (3.6 g, 15.5 mmol) in acetonitrile (20 mL) was then slowly added at 50 0C . The formed solid was filtered and dried to give the desired product. LC-MS : 190.1 (M+H)+. Step 2. The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 1 starting from the above compound and 2-methyl-2-pyridin-3-ylpropanoic acid. LCMS: (M+H)+ = 337.1.
Figure imgf000067_0002
(ϋ?)-l'-[2-(4-ChIorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 61, steps 1 and 2. LCMS: (M+H)+ = 370.7/372.7.
Figure imgf000067_0003
Methyl 4-(4-{l,l-dimethyl-2-oxo-2-[(liϊ)-3-oxo-lΗ,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethyl}phenyl)piperazine-l-carboxylate
Step 1. 2-{4-[4-(tert-butoxycarbonyl)piperazin~l-yl]phenyl}-2-methylpropanoic acid A mixture of 2-(4-chlorophenyl)-2-methylpropanoic acid (199 mg, 0.00100 mol), tert-butyl piperazine-1-carboxylate (224 mg, 0.00120 mol), sodium tert-butoxide (231 mg, 0.00240 mol), palladium acetate (6.74 mg, 0.0000300 mol), and 2-(di-tert-butylphosphino)biphenyl (8.95 mg, 0.0000300 mol) in 1,4-dioxane (5.00 mL, 0.0641 mol) was heated at 110 0C and stirred for 16.h. After cooling to rt, the reaction mixture was poured into ice-water and the pH was adjusted to pH ~3. The product was extracted with ethyl acetate (3 x 5 mL) and the combined organic phases were washed with brine; dried over MgSO4, filtered and concentrated in-vacuo. The residue was purified by flash chromatography to afford the desired product. Step 2. tert-butyl 4-(4-{l, l-dimethyl-2-oxo-2-[(lR)-3-oxo-l 'H, 3H-spiro[2-benzofuran-l, 3 '- pyrrolidin]-l'-yl]ethyl}pherιyl)piperazine-l-carboxylate 4-Methylmorpholine (5.0E2 uL, 0.0046 mol) was added to a mixture of 2-{4-[4-(tert- butoxycarbonyl)piperazin-l-yl]phenyl}-2-methylpropanoic acid (400 mg, 0.001 mol), [(lR,4S)-7,7- dimethyl-2-oxobicyclo[2.2.1]hept-l-yl]methanesulfonic acid-(lR)-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one (1:1) (720 mg, 0.0017 mol), benzotriazol-l-yloxytris(dimethylamino)phosphonium hexafluorophosphate (610 mg, 0.0014 mol) in methylene chloride (4.0 mL, 0.062 mol). The reaction mixture was stirred at rt for 2 h and then purified directly by prep-LCMS to afford the desired product. LCMS: (M+H)+ = 520.3. Step 3. (IR)-I '-[2-methyl-2-(4-piperazin-l-ylphenyl)propanoyl]-3H-spiro[2-benzofuran-l, 3 '- pyrrolidin] -3-one 4.0 M HCl in dioxane (4.0M) was added to tert-butyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3- oxo-lΗ,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-r-yl]ethyl}phenyl)piperazine-l-carboxylate (320 mg, 0.00062 mol). After stirring the reaction mixture at rt for 30 min., the volatiles were removed in- vacuo and the crude residue was used in the following step without further purification. Step 4. methyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]- r-yl]ethyl}phenyl)piperazine-l-carboxylate Methyl chloroformate (8.3 uL, 0.00011 mol) was added to a mixture of (IR)-I '-[2-methyl-2- (4-piperazin-l-ylphenyl)propanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one (18 mg, 0.000043 mol) and 4-methylmorpholine (19 uL, 0.00017 mol) in acetonitrile (1.0 mL, 0.019 mol) and the resulting solution was stirred at room temperature for 30 minutes. The crude product was purified by prep-LCMS. LCMS: (M+H)+ = 478.2.
Example 64
Figure imgf000069_0001
Propyl 4-(4-{l,l-dimethyI-2-oxo-2-[(li-)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethyl}phenyl)piperazine-l-carboxylate This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 506.3.
Example 65
Figure imgf000069_0002
Isobutyl 4-(4-{l,l-diinethyl-2-oxo-2-[(li?)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethyl}phenyl)piperazine-l-carboxylate This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 520.3.
Example 66
Figure imgf000069_0003
Isopropyl 4-(4-{l,l-dimethyI-2-oxo-2-[(lϋ)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]- l'-yl]ethyl}phenyl)piperazine-l-carboxylate This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 506.3.
Example 67
Figure imgf000070_0001
Ethyl 4-(4-{l,l-dimethyl-2- yl]ethyl}phenyl)piperazine-l-carboxylate This compound was prepared by using a procedure that was analogous to that described for 5 the synthesis of example 63. LCMS: (M+H)+ = 492.3.
Example 68
Figure imgf000070_0002
(lJΪ)-l'-(2-Methyl-2-{4-[4-(methylsulfonyl)piperazin-l-yl]phenyl}propanoyl)-3H-spiro[2- L O benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 498.2.
Figure imgf000070_0003
(lΛ)-l'-(2-{4-[4-(Ethylsulfonyl)piperazin-l-yl]phenyl}-2-methylpropanoyl)-3H-spiro[2- benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 512.2. 0 Example 70
Figure imgf000071_0001
(lΛ)-l'-(2-{4-[4-(Butylsulfony pipe:razin-l-yl]phenyl}-2-methylpropanoyl)-3H-spiro[2- benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 540.3.
Example 71
Figure imgf000071_0002
(li?)-l'-[2-MethyI-2-(4-{4-[(trifluoromethyl)sulfonyl]piperazin-l-yl}phenyl)propanoyl]-3H- spiro[2-benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 552.2.
Example 72
Figure imgf000071_0003
(l/?)-l'-{2-[4-(4-Acetylpiperazin-l-yl)phenyl]-2-methyIpropanoyl}-3H-spiro[2-benzofuran-l,3'- pyr rolidin] -3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 462.2.
Example 73
Figure imgf000072_0001
(12ϊ)-l'-{2-Methyl-2-[4-(4-propionyIpiperazin-l-yl)phenyl]propanoyl}-3H-spiro[2-benzofuran- l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 476.3.
Example 74
Figure imgf000072_0002
(l/ϊ)-l'-(2-{4-[4-(Cyclopropylcarbonyl)piperazin-l-yl]phenyl}-2-methylpropanoyl)-3H-spiro[2- benzofuran-l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 488.3.
Example 75
Figure imgf000072_0003
(l/-)-l'-{2-[4-(4-Isobutyrylpiperazin-l-yl)phenyl]-2-methylpropanoyl}-3H-spiro[2-benzofuran- l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 63. LCMS: (M+H)+ = 490.3.
Example 76
Figure imgf000073_0001
(ljR)-l'-{2-Methyl-2-[4-(2-oxopyrrolidin-l-yl)phenyl]propanoyl}-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one Step 1. (IR)-I '-[2-(4-bromophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l, 3 '-pyrrolidin]-3- one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 61. LCMS: (M+H)+ = 415.1. Step 2. (IR)-I '-{2-Methyl-2-[4-(2-oxopyrrolidin-l-yl)phenyl]propanoyl}-3H-spiro[2-benzofuran-l, 3 '- pyrrolidin]-3-one A stirred mixture of (li?)-r-[2-(4-bromophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3T- pyrrolidin]-3-one (600.0 mg, 0.001448 mol), copper(I) iodide (28 mg, 0.00014 mol), potassium carbonate (0.500 g, 0.00362 mol), 2-pyrrolidinone (167 uL, 0.00217 mol) and (1S,2S)-N,N'- dimethylcyclohexane-l,2-diamine (47 uL, 0.00029 mol) in anhydrous diglyme (7.0 mL, 0.049 mol) was heated at 180 0C by microwave irradiation for 1 h. The reaction mixture was filtered and the filtrate was purified by prep-HPLC to give the product as a colorless solid (581.6 mg, 96% yield). (M+H) = 419.2.
Example 77
Figure imgf000073_0002
(lR)-l'-[3-(4-Chlorophenyl)-2,2-dimethylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 61. LCMS: (M+H)+ = 384.6/386.6.
Example 78
Figure imgf000073_0003
l'-[2-(4-Chlorophenyl)-2-methyIpropanoyl]-3H-spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-3-one This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 1 starting from 2-(4-chlorophenyl)-2-methylpropanoic acid and 3H- spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-3-one, which was prepared by using a procedure that was analogous to that described for the synthesis of example 43, steps 1-2. LCMS: (M+H)+ = 371.6/373.6.
Figure imgf000074_0001
l'-[2-(4-ChIorophenyl)-2-methylpropanoyl]-7H-spiro[furo[3,4-b]pyridine-5,3'-pyrrolidin]-7-one Step 1. l-[2-(4-chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-ol This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 1. LCMS: (M+H)+ = 268.5. Step 2. 1 -[2-(4-chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-one To a solution of l-[2-(4-chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-ol (2.72 g, 0.0102 mol) in acetone (50 mL, 0.7 mol) was added 8.00 M of Jone's oxidant in water (2.54 mL) at 0 °C. After stirring at rt for 1 h, the reaction mixture was filtered through celite and the filtrate was concentrated in-vacuo. The resulting residue was dissolved in AcOEt, washed with water and brine, dried with MgSO4, and concentrated in-vacuo. The crude product was purified by CombiFlash, eluting with 40% AcOEt in hexanes. LCMS: (M+H)+ = 266.5. Step 3. r-[2-(4-chlorophenyl)-2-methylpropanoyl]-7H-spiro[furo[3,4-b]pyridine-5,3'-pyrrolidin]-7- one To a solution of piperidine, 2,2,6,6-tetramethyl- (1.42 mL, 0.00840 mol) in tetrahydrofuran (30 mL, 0.4 mol) at -75 °C was added 2.5 M of n-butyllithium in hexane (4.5 mL). After stirring for 15 min., a suspension of 2-pyridinecarboxylic acid (0.345 g, 0.00280 mol) in THF was added. Stirring was continued at -75 °C for 10 min. and then at 0 °C for 30 min. A solution of l-[2-(4- chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-one (620 mg, 0.0023 mol) in THF (2mL) was added to the above mixture and stirring was continued at 0 °C for 3 h. The reaction mixture was acidified to pH ~1 using concentrated HCl aq. solution and stirred at rt overnight. The solution was neutralized to pH ~7 using solid NaHCU3 and extracted with AcOEt. The combined organic phases were washed with brine, dried with MgSO4, and concentrated in-vacuo. The crude product was purified by CombiFlash eluting with EtOAc/hexanes and the enantiomers were separated using a chiral HPLC column. LCMS: (M+H)+ = 371.6.
Example 80 22411
Figure imgf000075_0001
tert-Butyl 3-(4-chlorophenyl)-4- [3-(3-chIorophenyl)pyrrolidin- 1-yl] -3-methyl-4-oxobutanoate Step 1. methyl 2-(4-chlorophenyl)propanoate To a solution of methyl (4-chlorophenyl)acetate (5.00 g, 0.0271 mol) in tetrahydrofuran (30 mL, 0.4 mol) at -78 °C was added 1.00 M of sodium bis(trimethylsilyl)amide in tetrahydrofuran (35.2 niL) dropwise. The mixture was stirred at -78 0C for 1 h prior to the addition of methyl iodide (2.53 mL, 0.0406 mol). After stirring at -78 0C for 2 h, the reaction was quenched by the addition of saturated ammonium chloride. The product was extracted with AcOEt and the combined organic phases were washed with water, brine, dried with MgSO4, and concentrated in-vacuo to afford the desired product. Step 2. 4-tert-butyl 1-methyl 2-(4-chlorophenyl)-2-methylsuccinate To a -78 °C solution of methyl 2-(4-chlorophenyl)propanoate (1.00 g, 0.00503 mol) in tetrahydrofuran (7.0 mL, 0.086 mol) was added 1.0 M of lithium hexamethyldisilazide in hexane (6.0 mL). After stirring at -78 °C for 30 min., 1,1-dimethylethyl bromoacetate (0.892 mL, 0.00604 mol) was added. After stirring for 1 h, the reaction mixture was allowed to gradually warm to rt and stirred at rt for 2 h. The reaction was quenched with IN HCl and the product was extracted with ethyl acetate. The extract was washed with water (x2), brine; dried over Na2SO4 and concentrated in-vauo. The resulting residue was purified by CombiFlash, eluting with EtOAc/hexanes, to afford 0.73 g of the desired product. 1H NMR confirmed the formation of the desired product. Step 3. 4-tert-butoxy-2-(4-chlorophenyl)-2-methyl-4-oxohutanoic acid A mixture of 4-tert-butyl 1-methyl 2-(4-chlorophenyl)-2-methylsuccinate (0.730 g, 0.00233 mol), lithium hydroxide, monohydrate (0.643 g), tetrahydrofuran (7.0 mL, 0.086 mol), and water (2.0 mL, 0.11 mol) was stirred at 40 °C for 16 hours. The volatiles were removed in-vacuo to afford 673 mg of the desired product, which was used in the subsequent step without further purification. Step 4. tert-butyl 3-(4-chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-ylJ-3-methyl-4-oxobutanoate This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 1. LCMS: m/z 406.0(M-t-Bu)+. 484.0 (M+Na)\
Example 81
Figure imgf000076_0001
3-(4-Chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-yl]-3-methyI-4-oxobutanoic acid A mixture of tert-butyl 3-(4-chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-yl]-3-methyl-4- oxobutanoate (0.100 g, 0.000216 mol, prepared as example 66) in trifluoroacetic acid (1.0 mL, 0.013 mol) and methylene chloride (10 mL, 0.2 mol) was stirred at rt for 2 hours. The volatiles were removed in-vacuo to yield 70 mg of the desired product. LCMS: (M+H)+ = 407.1.
Example 82
Figure imgf000076_0002
3-(4-Chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-yl]-N,N,3-trimethyl-4-oxobutanamide A mixture of 3 -(4-chlorophenyl)-4-[3 -(3 -chlorophenyl)pyrrolidin- 1 -y 1] -3 -methyl-4- oxobutanoic acid (18.7 mg, 0.0000460 mol, prepared as example 67), 2.0 M of dimethylamine in tetrahydrofuran (28 uL), benzotriazol-l-yloxytris(dimethylamino) phosphonium hexafluorophosphate (21.4 mg, 0.0000483 mol), and NN-diisopropylethylamine (12.0 uL, 0.0000690 mol) in tetrahydrofuran (250 uL, 0.0031 mol) was stirred at rt for 2 hours. The crude reaction mixture was purified by prep-HPLC to afford 5 mg of the desired product. LCMS: m/z 433.0; 435.0.
Figure imgf000076_0003
(li-)-l'-(2-Methyl-2-phenoxypropanoyl)-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one Step 1. ethyl 2-methyl-2-phenoxypropanoate Phenol was dissolved in anhydrous acetone and treated with potassium carbonate. After stirring at rt for 30 min., the reaction was refluxed for 36 h. The reaction mixture was poured into water and extracted with DCM. The combined organic layers were dried over MgSO4, filtered, and concentrated in-vacuo. The crude product was purified by flash column chromatography, eluting with EtOAc/hexanes, to afford the desired product, 1H ΝMR confirmed that the product was formed. Step 2. 2-methyl-2-phenoxypropanoic acid A solution of the above ethyl ester in THF/MeOH was treated with LiOH dissolved in H2O. The reaction mixture was stirred at rt overnight. The volatiles were removed and the remaining aqueous solution was acidified with 1 N HCl to pH 2. Following extraction with EtOAc, the organic phase was dried over MgSO4, filtered and concentrated to provide the desired acid as a yellow solid (665 mg). The product was confirmed by 1HNMR. Step 3. (IR)-I '-(2-Methyl-2-phenoxypropanoyl)-3H-spiro[2-benzofuran-l, 3 '-pyrrolidinJ-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 61, steps 1 and 2. LCMS: (M+H)+ = 352.2.
Figure imgf000077_0001
(li?)-l'-[2-(4-ChIorophenoxy)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrroIidin]-3- o ne The title compound was prepared using a procedure that was analogous to that described for [ 5 the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 386.6/388.6.
Figure imgf000077_0002
(l/?)-l'-[2-(3,4-Dichlorophenoxy)-2-methyϊpropanoyI]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]- 0 3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 421.1/423.1.
Example 86
Figure imgf000077_0003
(l/ϊ)-l'-[2-(2,4-Dichlorophenoxy)-2-methylpropanoyI]-3H-spiro[2-benzofuran-l,3'-pyrroIidin]- 3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 421.1/423.1.
Example 87
Figure imgf000078_0001
(lJR)-l'-{2-[4-Chloro-3-(trifluoromethyl)phenoxy]-2-methylpropanoyl}-3H-spiro[2-benzofuran- l,3'-pyrroIidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 454.6/456.6.
Figure imgf000078_0002
(l/Z)-l'-[2-(4-Chloro-3-fluorophenoxy)-2-methyIpropanoyI]-3H-spiro[2-benzofuran-l,3'- pyrroIidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 404.6/406.6.
Figure imgf000078_0003
(lϋ)-l'-[2-(4-Chloro-2-methylphenoxy)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 400.6/402.6
Example 90
Figure imgf000078_0004
(li?)-l'-{2-Methyl-2-[4-(trifluoromethyl)phenoxy]propanoyI}-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83, steps 1-3. LCMS: (M+H)+ = 420.1
Example 91
Figure imgf000079_0001
l'-[2-methyl-2-(4-pyridin-2-ylphenoxy)propanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 1 starting from 3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one hydrochloride, which was prepared as example 29, steps 1-2, and 2-methyl-2-(4-pyridin-2-ylphenoxy)proρanoic acid, which was prepared by using a procedure that was analogous to that described for the synthesis of example 83, steps 1-2. LCMS: (M+H)+ = 429.2
Example 92
Figure imgf000079_0002
4-[l,l-Dimethyl-2-oxo-2-(3-oxo-llH,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-ll- yl)ethoxy] benzonitrile The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 377.1.
Example 93
Figure imgf000079_0003
{4-[l,l-Dimethyl-2-oxo-2-(3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy] phenyl} acetonitrile The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 390.1.
Example 94
Figure imgf000080_0001
{4-[l,l-Dimethyl-2-oxo-2-(l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy]phenyl}acetonitrile The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 377.2.
Example 95
Figure imgf000080_0002
l'-{2-[(4'-Fluorobiphenyl-4-yl)oxy]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 446.2.
Example 96
Figure imgf000080_0003
terf-Butyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lJS:)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]- l'-yl]ethoxy}phenyl)piperazine-l-carboxylate The title compound was prepared using a Hartwig coupling procedure that was analogous to that described for the synthesis of example 49, step 1 starting from tert-butyl piperazine-1-carboxylate and (lS)-r-[2-(4-chlorophenoxy)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one, which was prepared as example 84. LCMS: (M+H)+ = 536.4. Example 97
Figure imgf000081_0001
(lΛ)-l'-[2-Methyl-2-(4-piperazin-l-ylphenoxy)propanoyl]-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one hydrochloride The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 49, step 3, starting from tert-butyl 4-(4-{l,l-dimethyl-2-oxo-2-[(li?)-3-oxo- l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-r-yl]ethoxy}phenyl)piperazine-l-carboxy late (prepared as example 96). LCMS: (M+H)+ = 436.2.
Example 98
Figure imgf000081_0002
Methyl 4-(4-{l,l-dimethyl-2-oxo-2-[(l/-)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethoxy}phenyl)piperazine-l-carboxylate The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 49, step 4, starting from (li?)-l'-[2-Methyl-2-(4-piperazin-l- ylphenoxy)propanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one hydrochloride (prepared as example 97). LCMS: (M+H)+ = 494.2.
Figure imgf000081_0003
l'-[2-(4-Chlorophenoxy)-2-methylpropanoyl]-3H-spiro[furo[3,4-c]pyridine-l,3'-pyrroIidin]-3- one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 387.5/389.5. Example 100
Figure imgf000082_0001
l'-[2-(4-ChIorophenoxy)-2-methyIpropanoyl]-7-fluoro-3H-spiro[furo[3,4-c]pyridine-l,3'- pyrrolidin]-3-one The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 405.7/407.7.
Example 101
Figure imgf000082_0002
l-[2-(4-Chlorophenoxy)-2-methylpropanoyl]-3-phenylpiperazine The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 83. LCMS: (M+H)+ = 359.7/361.7.
Example 102
Figure imgf000082_0003
l'-{2-[(4'-Fluorobiphenyl-4-yl)oxy]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'- pyrrolidine] The title compound was prepared using a procedure that was analogous to that described for the synthesis of example 91. LCMS: (M+H)+ = 432.2.
Example 103
Figure imgf000082_0004
5-(4-{l,l-DimethyI-2-oxo-2-[(lR)-3-oxo-lΗ,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethyl}phenyI)-N-methylpyridine-2-carboxamide Step 1. (lR)-l'-{2-metiiyl-2-[4-(4,4,5,5-tetramethyl-l,3,2-dioxaborolan-2-yl)phenyl]propanoyl}-3H- spiro[2-benzofuran-l, 3 '-pyrrolidin]-3-one 5 A stirred mixture of (lR)-l'-[2-(4-bromophenyl)-2-methylproρanoyl]-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one (1.000 g, 0.002414 mol, prepared by using a procedure that was analogous to that described for the synthesis of example 62), 4,4,5,5,4',4',5',5'-octamethyl- [2,2']bi[[l,3,2]dioxaborolanyl] (688 mg, 0.00266 mol), potassium acetate (718 mg, 0.00724 mol) and [l,l'-bis(diphenylphosphino)ferrocene] dichloropalladium(II),complex with dichloromethane (1:1) 0 (99.6 mg, 0.000121 mol) in anhydrous 1,4-dioxane (10.0 mL, 0.128 mol) was heated at 120 °C via microwave for 1 h. The reaction mixture was filtered through a pad of Celite and concentrated in- vacuo to give the crude product as a solid (1.387 g, 80% pure, 100% in yield). LCMS: (M+H)+ = 462.2.
L 5 Step 2. 5-(4-{lJ-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H>3H-spiro[2-benzofuran-l,3'-pyrrolidin]-r~ yl]ethyl}phenyl)-N-methylpyridine-2-carboxamide A stirred mixture of (lR)-l'-{2-methyl-2-[4-(4,4,5,5-tetramethyl-l,3,2-dioxaborolan-2- yl)phenyl]propanoyl}-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one (750.0 mg, 0.001300 mol), 5- bromo-N-methylρyridine-2-carboxamide (559 mg, 0.00260 mol) , [1,1'- 0 bis(diphenylphosphino)ferrocene]dichloropalladium(II),complex with dichloromethane (1 : 1) (64 mg, 0.000078 mol) and potassium carbonate (539 mg, 0.00390 mol) in anhydrous N5N- dimethylformamide (3.0 mL, 0.039 mol) and 1,4-dioxane (3.5 mL, 0.045 mol) was heated at 150 °C (oil bath) for 15 h. The reaction mixture was filtered and purified by prep-HPLC to give the product as a solid (237.9 mg, 39% in yield for 2 steps). LCMS: (M+H)+ = 470.2. 5 Example 104
Figure imgf000083_0001
5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl] ethyl} phenyl)-N,N-dimethylpyridine-2-carboxamide 0 This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 484.2.
Example 105
Figure imgf000084_0001
S-C^lljl-Dimethyl-l-oxo-l-ICl^-S-oxo-lΗβH-spiroP-benzofuran-ljS'-pyrrolidinl-l'-yljethyl}- 3-fluorophenyI)-N,N-dimethylpyridine-2-carboxamide This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 402.2.
Example 106
Figure imgf000084_0002
5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'-yl]ethyl}- 3-fluorophenyl)-N-methylpyridine-2-carboxamide This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 488.3.
Example 107
Figure imgf000084_0003
5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'-yl]ethyl}- 3-fluorophenyl)-N,N-diethylpyridine-2-carboxamide This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 530.1.
Example 108
Figure imgf000085_0001
5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-l'- yI]ethyl}-3-fluorophenyl)-N-methylpyridine-2-carboxamide This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 489.1.
Example 109
Figure imgf000085_0002
5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-l'- yI]ethyl}-3-fluorophenyl)-N,N-dimethylpyridine-2-carboxamide This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 503.2.
Example 110
Figure imgf000085_0003
5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-lI- yl]ethyl}-3-fluorophenyl)-N,N-diethylpyridine-2-carboxamide This compound was prepared by using a procedure that was analogous to that described for the synthesis of example 103. LCMS: (M+H)+ = 531.1.
Example A Enzymatic assay of llβHSDl All in vitro assays were performed with clarified lysates as the source of llβHSDl activity. HEK-293 transient transfectants expressing an epitope-tagged version of full-length human llβHSDl were harvested by centrifugation. Roughly 2 x 107 cells were resuspended in 40 rnL of lysis buffer (25 mM Tris-HCl, pH 7.5, 0.1M NaCl, 1 mM MgCl2 and 25OmM sucrose) and lysed in a microfluidizer. Lysates were clarified by centrifugation and the supernatants were aliquoted and frozen. Inhibition of l lβHSDl by test compounds was assessed in vitro by a Scintillation Proximity Assay (SPA). Dry test compounds were dissolved at 5 mM in DMSO. These were diluted in DMSO to suitable concentrations for the SPA assay. 0.8 μL of 2-fold serial dilutions of compounds were dotted on 384 well plates in DMSO such that 3 logs of compound concentration were covered. 20 μL of clarified lysate was added to each well. Reactions were initiated by addition of 20 μL of substrate- cofactor mix in assay buffer (25 mM Tris-HCl, pH 7.5, 0.1M NaCl, 1 mM MgCl2) to final concentrations of 400 μM NADPH, 25 nM 3H-cortisone and 0.007% Triton X-IOO. Plates were incubated at 37 0C for one hour. Reactions were quenched by addition of 40 μL of anti-mouse coated SPA beads that had been pre-incubated with 10 μM carbenoxolone and a cortisol-specific monoclonal antibody. Quenched plates were incubated for a minimum of 30 minutes at RT prior to reading on a Topcount scintillation counter. Controls with no lysate, inhibited lysate, and with no mAb were run routinely. Roughly 30% of input cortisone is reduced by l lβHSDl in the uninhibited reaction under these conditions. Test compounds having an IC50 value less than about 20 μM according to this assay were considered active.
Example B Cell-based assays for HSD activity Peripheral blood mononuclear cells (PBMCs) were isolated from normal human volunteers by Ficoll density centrifugation. Cells were plated at 4x105 cells/well in 200 μL of AIM V (Gibco- BRL) media in 96 well plates. The cells were stimulated overnight with 50 ng/mL recombinant human IL-4 (R&D Systems). The following morning, 200 nM cortisone (Sigma) was added in the presence or absence of various concentrations of compound. The cells were incubated for 48 hours and then supernatants were harvested. Conversion of cortisone to Cortisol was determined by a commercially available ELISA (Assay Design). Test compounds having an IC5O value less than about 20 μM according to this assay were considered active.
Example C Cellular assay to evaluate MR antagonism Assays for MR antagonism can be performed essentially as described (Jausons-Loffreda et al. J Biolumin and Chemilumin, 1994, 9: 217-221). Briefly, HEK293/MSR cells (Invitrogen Corp.) are US2005/022411
co-transfected with three plasmids: 1) one designed to express a fusion protein of the GAL4 DNA binding domain and the mineralocorticoid receptor ligand binding domain, 2) one containing the GAL4 upstream activation sequence positioned upstream of a firefly luciferase reporter gene (pFR- LUC, Stratagene, Inc.), and 3) one containing the Renilla luciferase reporter gene cloned downstream of a thymidine kinase promoter (Promega). Transfections are performed using the FuGENEβ reagent (Roche). Transfected cells are typically ready for use in subsequent assays 24 hours post-transfection. In order to evaluate a compound's ability to antagonize the MR, test compounds are diluted in cell culture medium (E-MEM, 10% charcoal-stripped FBS, 2 mM L-glutamine) supplemented with 1 nM aldosterone and applied to the transfected cells for 16-18 hours. After the incubation of the cells with the test compound and aldosterone, the activity of firefly luciferase (indicative of MR agonism by aldosterone) and Renilla luciferase (normalization control) are determined using the Dual-Glo Luciferae Assay System (Promega). Antagonism of the mineralocorticoid receptor is determined by monitoring the ability of a test compound to attenuate the aldosterone-induced firefly luciferase activity. Compounds having an IC50 of 100 μM or less are considered active.
Various modifications of the invention, in addition to those described herein, will be apparent to those skilled in the art from the foregoing description. Such modifications are also intended to fall within the scope of the appended claims. Each reference, including all patent, patent applications, and publications, cited in the present application is incorporated herein by reference in its entirety.

Claims

What is claimed is: 1. A compound of Formula I:
Figure imgf000088_0001
I or pharmaceutically acceptable salt or prodrug thereof, wherein: Cy is aryl, heteroaryl, cycloalkyl, or heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; L is absent, (CR13R14)m, (CR13R14)nO(CR13R14)p, (CR13R14)nS(CR13R14)p, (CR13R14)nSO2(CR13R14)p, (CR13R14)nSO(CR13R14)p, (CR13R14)nCO(CR13R14)p, or (CR13R14)nNR15(CR13R14)p; R1 and R2 are each, independently, C1-6 alkyl optionally substituted by halo, C(O)ORa or C(O)NR°Rd; R3, R4, R5, R6, R7, R8, R9, R10, R11, and R12 are each, independently, H or -W'-X'-Y'-Z'; or R3 and R4 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"-Y"-Z"; or R5 and R6 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 — W"- X"_Y"-Z"; or R7 and R8 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X"-Y"-Z"; or R9 and R10 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 — W"- X"_Y"-Z"; or R11 and R12 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"- X»-Y"-Z"; or R3 and R12 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R3 and R10 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R3 and R8 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R5 and R12 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R5 and R10 together form an Ci-4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; or R7 and R12 together form an Ci.4 alkylene bridge optionally substituted by 1 or 2 -W"-X"-Y"-Z"; R13 and R14 are each, independently, H, halo, Ci-4 alkyl, Ci-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR3', SRa>, C(O)Rb>, C(O)NR°'Rd>, C(O)OR3', OC(O)Rb', OC(O)NR°'Rd', NRc'Rd', NRc'C(O)Rd', NR°'C(O)ORa', S(O)Rb', S(0)NRc Rd', S(O)2Rb>, or S(O)2NR°'Rd'; R15 is H, CM alkyl, CM haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, OH, C(O)Rb', C(0)NR° Rd', C(O)OR3', S(O)Rb>, S(0)NR°'Rd', S(O)2Rb', or S(O)2NR° Rd'; W, W and W" are each, independently, absent, Ci-6alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, C0NRe, SO, SO2, SONRe, or NReC0NRf, wherein said C1-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; X, X' and X" are each, independently, absent, Ci-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, arylalkenyl, cycloalkylalkenyl, heteroarylalkenyl, heterocycloalkylalkenyl, arylalkynyl, cycloalkylalkynyl, heteroarylalkynyl, heterocycloalkylalkynyl, each of which is optionally substituted by one or more halo, CN, NO2, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; Y, Y' and Y" are each, independently, absent, Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, C0NRe, SO, SO2, SONRe, or NReCONRf, wherein said Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; Z, Z' and Z" are each, independently, H, halo, CN, NO2, OH, Ci-4 alkoxy, Ci-4 haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino, Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl, wherein said Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl is optionally substituted by 1, 2 or 3 halo, Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, Ci-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR3, SR3, C(0)Rb, C(O)NR0R", C(O)OR3, 0C(0)Rb, 0C(0)NR°Rd, NRcRd, NRcC(0)Rd, NR0C(O)OR3, NR°C(=NCN)NRd, S(O)Rb, S(O)NR°Rd, S(O)2Rb, or S(O)2NRcRd; wherein two -W-X-Y-Z together with the atom to which they are both attached optionally form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group optionally substituted by 1, 2 or 3 -W"-X"-Y"-Z"; wherein two -W'-X'-Y'-Z' together with the atom to which they are both attached optionally form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group optionally substituted by 1, 2 or 3 -W"-X"-Y"-Z"; wherein -W-X-Y-Z is other than H; wherein -W'-X'-Y'-Z' is other than H; wherein -W"-X"-Y"-Z" is other than H; Ra and Ra are each, independently, H, Ci.6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; Rb and Rb are each, independently, H, Ci-6 alkyl, CL6 haloalkyl, C2-6 alkenyl, C2.6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; Rc and Rd are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or RG and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; Rc and Rd are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; Re and Rf are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2.6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Re and Rf together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; m is 1, 2, 3 or 4; n is O, 1, 2 or 3; p is 0, 1, 2 or 3; and q is 0, 1, or 2; with the provisos: (a) R3 and R4 are both other than H, or R5 and R6 are both other than H, or R7 and R8 are both other than H, or R9 and R10 are both other than H; (b) when q is 1 and one of R7 and R8 is phenyl, then the other of R7 and R8 is Ci-6 alkyl, C1-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, or cycloalkyl; (c) when q is 1 and one of R7 and R8 is OH, then the other of R7 and R8 is other than 3- (trifluoromethyl)-phenyl; and (d) when q is 1 , then R7 and R8 together with the carbon to which they are attached form a moiety other than that having the structure:
Figure imgf000091_0001
wherein each R is independently, H or -W'-X'-Y'-Z', and wherein q7 is 0, 1, 2 or 3.
2. The compound of claim 1 wherein Cy is aryl optionally substituted by 1, 2, 3, 4 or 5 -W-X- Y-Z.
3. The compound of claim 1 wherein Cy is phenyl optionally substituted by 1, 2, 3, 4 or 5 -W- X-Y-Z.
4. The compound of claim 1 wherein Cy is phenyl optionally substituted by 1 or 2 halo, CN, cynanoalkyl, or pyridyl.
5. The compound of claim 1 wherein Cy is substituted.
6. The compound of claim 1 wherein L is absent.
7. The compound of claim 1 wherein L is (CR6R7)nO(CR6R7)p or (CR6R7)nS(CR6R7)p.
8. The compound of claim 1 wherein L is S.
9. The compound of claim 1 wherein L is O.
10. The compound of claim 1 wherein R1 and R2 are both methyl.
11. The compound of claim 1 wherein -W-X-Y-Z is halo, cyano, C1-4 cyanoalkyl, nitro, Ci-8 alkyl, Ci-galkenyl, Ci-8 haloalkyl, Ci0.alkoxy, Ci-4haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, C1.4 alkylamino, C2-8 dialkylamino, OC(O)NR°Rd, NR°C(O)Rd, NR°C(=NCN)NRd, NR0C(O)OR3, aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl; wherein each of said Q.galkyl, Q.g alkenyl, C1^ haloalkyl, Cμg alkoxy, aryloxy, heteroaryloxy, arylalkyloxy, heteroarylalkyloxy, heteroaryloxyalkyl, aryloxyalkyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, arylalkenyl, arylalkynyl, heteroarylalkyl, heteroarylalkenyl , heteroarylalkynyl, cycloalkylalkyl, or heterocycloalkylalkyl is optionally substituted by 1, 2, or 3 halo, cyano, nitro, hydroxyl-(Ci_6 alkyl), aminoalkyl, dialkylaminoalkyl, C^alkyl, Q-4 haloalkyl, Ci-4 alkoxy, Ci-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-8 dialkylamino, C(O)NRcRd, C(O)OR3 , NR°C(0)Rd, NR°S(0)2Rd, (Ci4 alkyl)sulfonyl, arylsulfonyl, aryl, heteroaryl, cycloalkyl, or heterocycloalkyl.
12. The compound of claim 1 wherein -W-X-Y-Z is halo, cyano, CL4 cyanoalkyl, nitro, Ci-4 nitroalkyl, Ci-4 alkyl, Ci-4 haloalkyl, Ci-4 alkoxy, Ci-4 haloalkoxy, OH, Ci-8 alkoxyalkyl, amino, Ci-4 alkylamino, C2-S dialkylamino, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl.
13. The compound of claim 1 wherein — W-X-Y-Z is halo, cyano, cyanoalkyl or pyridyl.
14. The compound of claim 1 wherein -W'-X'-Y'-Z' is halo, Chalky., Ci-4 haloalkyl, OH, Ci-4 alkoxy, Ci.4 haloalkoxy, hydroxyalkyl, alkoxyalkyl, aryl, heteroaryl, aryl substituted by halo, heteroaryl substituted by halo.
15. The compound of claim 1 wherein R3 and R4 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
16. The compound of claim 1 wherein R5 and R6 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
17. The compound of claim 1 wherein R7 and R8 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
18. The compound of claim 1 wherein R9 and R10 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
19. The compound of claim 1 wherein R11 and R12 together with the C atom to which they are attached form a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group optionally substituted by 1 or 2 -W"-X"-Y"-Z".
20. The compound of claim 1 wherein q is 1.
21. The compound of claim 1 wherein q is 0.
22. A compound of claim 1 having Formula II:
Figure imgf000093_0001
wherein: ring A is a 4-20 membered cycloalkyl group or a 4-20 membered heterocycloalkyl group; and r is 0, 1 or 2.
23. The compound of claim 1 having Formula Ilia or IHb:
Figure imgf000093_0002
Figure imgf000094_0001
HIb wherein: ring B is a fused 5 or 6-membered aryl or fused 5 or 6-membered heteroaryl group; Q1 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q2 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; r is 0, 1 or 2; s is 0, 1 or 2; and the sum of r and s is O, 1 or 2.
24. The compound of claim 1 having Formula IV:
Figure imgf000094_0002
IV wherein: Q1 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q2 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q3 and Q4 are each, independently, CH or N; r is 0, 1 or 2; s is O, 1 or 2; and the sum of r and s is O, 1 or 2.
25. The compound of claim 24 wherein Q1 is O, NH, CH2 or CO, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z". 22411
26. The compound of claim 24 wherein Q2 is O, S, NH, CH2, CO, or SO2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z".
27. The compound of claim 24 wherein one of Q1 and Q2 is CO and the other is O, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" .
28. The compound of claim 24 wherein one of Q1 and Q2 is CH2 and the other is O, S, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" .
29. The compound of claim 24 wherein one of Q1 and Q2 is O and the other is CO or CONH, wherein said CONH is optionally substituted by -W"-X"-Y"-Z".
30. The compound of claim 24 wherein Q3 is CH optionally substituted by -W"-X"-Y"-Z".
31. The compound of claim 1 having Formula V:
Figure imgf000095_0001
V wherein: Q1 is O, S, NH, CH2, CO, CS, SO, SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q2 is O, S, NH, CH2, CO, CS5 SO5 SO2, OCH2, SCH2, NHCH2, CH2CH2, COCH2, CONH, COO, SOCH2, SONH, SO2CH2, or SO2NH; Q3 and Q4 are each, independently, CH or N; r is 0, 1 or 2; s is O, 1 or 2; and the sum of r and s is 0, 1 or 2.
32. The compound of claim 31 wherein Q1 is O, NH, CH2 or CO, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z".
33. The compound of claim 31 wherein Q2 is O, S, NH, CH2, CO, or SO2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z".
34. The compound of claim 31 wherein one of Q1 and Q2 is CO and the other is O, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" .
35. The compound of claim 31 wherein one of Q1 and Q2 is CH2 and the other is O, S, NH, or CH2, wherein each of said NH and CH2 is optionally substituted by -W"-X"-Y"-Z" .
36. The compound of claim 31 wherein one of Q1 and Q2 is O and the other is CO or CONH, wherein said CONH is optionally substituted by -W"-X"-Y"-Z".
37. The compound of claim 31 wherein Q3 is CH optionally substituted by -W"-X"-Y"-Z".
38. A compound of Formula VI:
Figure imgf000096_0001
VI or pharmaceutically acceptable salt or prodrug thereof, wherein: R is phenyl, Cy-S-, Cy-(CR13Rl4)m-S- or Cy^(CR13R14),,,-, wherein said phenyl is optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Cy is aryl, heteroaryl, cycloalkyl, or heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Cy1 is aryl or cycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 -W-X-Y-Z; Hy is:
Figure imgf000096_0002
Figure imgf000097_0001
Hy3 Hy4 Hy5
R1 and R2 are each, independently, Ci-6 alkyl optionally substituted by halo, C(O)ORa or C(O)NR°Rd; R13 and R14 are each, independently, H, halo, C1-4 alkyl, Ci-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, OR3', SRa', C(O)Rb', C(O)NRcRd>, C(O)OR3', OC(O)Rb', 0C(0)NRc'Rd', NRc'Rd', NRc'C(0)Rd', NRc>C(0)0R3>, S(O)Rb', S(O)NRc>Rd>, S(O)2Rb>, or S(0)2NRc'Rd'; R17 is aryl, heteroaryl, arylalkyl or heteroarylalkyl, each optionally substituted one or more - W"-X"-Y"-Z"; R18 is H or -W'-X'-Y'-Z'; R19 is aryl or heteroaryl, each optionally substituted one or more -W"-X"-Y"-Z"; R20 is H or -W'-X'-Y'-Z'; R21 is H or -W-X-Y-Z; R22 is aryl, heteroaryl, arylalkyl or heteroarylalkyl, each optionally substituted one or more - W"-X"-Y"-Z"; ring A' is a fused 5- or 6-membered aryl or fused 5 or 6-membered heteroaryl group, a fused 3-14 membered cycloalkyl group or a fused 3-14 membered heterocycloalkyl group; W, W' and W" are each, independently, absent, C1-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, CONRe, SO, SO2, S0NRe, or NReC0NRf, wherein said Ci-6 alkylenyl, C2.6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, C1.4 alkoxy, Ci-4haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; X, X' and X" are each, independently, absent, C1-8 alkylenyl, C2-8 alkenylenyl, C2-8 alkynylenyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, arylalkenyl, cycloalkylalkenyl, heteroarylalkenyl, heterocycloalkylalkenyl, arylalkynyl, cycloalkylalkynyl, heteroarylalkynyl, heterocycloalkylalkynyl, each of which is optionally substituted by one or more halo, CN, NO2, OH, C1.4 alkoxy, Ci_4haloalkoxy, amino, C^4 alkylamino or C2-8 dialkylamino; Y, Y' and Y" are each, independently, absent, Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl, O, S, NRe, CO, COO, CONRe, SO, SO2, S0NRe, or NReCONRf, wherein said Ci-6 alkylenyl, C2-6 alkenylenyl, C2-6 alkynylenyl are each optionally substituted by 1, 2 or 3 halo, OH, Ci-4 alkoxy, Ci.4haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino; Z, Z' and Z" are each, independently, H, halo, CN, NO2, OH, C1-4 alkoxy, Ci-4haloalkoxy, amino, Ci-4 alkylamino or C2-8 dialkylamino, Ci-6 alkyl, C2_6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl, wherein said Ci.6 alkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl is optionally substituted by 1, 2 or 3 halo, Ci-6 alkyl, C2-6 alkenyl, C2-6 alkynyl, C1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO2, ORa, SRa, C(0)Rb, C(0)NRcRd, C(O)ORa, OC(O)Rb, OC(O)NRcRd, NRcRd, NRcC(0)Rd, NR0C(O)OR3, NR°C(=NCN)NRd, S(O)Rb, S(0)NR°Rd, S(O)2Rb, or S(0)2NR°Rd; wherein two -W'-X'-Y'-Z' together with the atom to which they are both attached optionally form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group optionally substituted by 1, 2 or 3 -W"-X"-Y"-Z"; wherein -W-X-Y-Z is other than H; wherein -W'-X'-Y'-Z' is other than H; wherein -W"-X"-Y"-Z" is other than H; Ra and Ra> are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; Rb and Rb are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, heteroaryl or heterocycloalkyl; R° and Rd are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Rc and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; R0' and Rd> are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2.6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or R° and Rd together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; Re and Rf are each, independently, H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, cycloalkyl, arylalkyl, or cycloalkylalkyl; or Re and Rf together with the N atom to which they are attached form a 4-, 5-, 6- or 7- membered heterocycloalkyl group; m is 1, 2, 3 or 4; rl, r2, r3, r4 and r6 are each, independently, 0, 1, 2 or 3; r5 is 1, 2, 3 or 4; and ql and q2 are each, independently, 0, 1, or 2; with the provisos: (a) when ring A' is phenyl, R18 is other than COORa or C(O)NR°Rd; (b) when R19 is phenyl, R20 is H, Ci-6 alkyl, Ci-6 haloalkyl, C2-6 alkenyl, C2-6 alkynyl, aryl, or cycloalkyl; and (c) when R20 is OH, R19 is other than 3-(trifluoromethyl)-phenyl.
39. A compound selected from: {(1 S)-2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l ,2,3,4-tetrahydroisoquinolin-l - yl} methanol; 2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l,2,3,4-tetrahydroisoquinoline; 6-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4J5,6,7-tetrahydrothieno[2,3-c]pyridine; 3-Phenyl-l-[2-(4-chlorophenyl)-2-methylpropanoyl]piperidine; 1 '-[2-(4-Chlorophenyl)-2-methylpropanoy 1] -1,3 -dihydrospiro [indene-2,4'-piperidine] ; 2-Methyl-l-phenyl-4-[2-(4-chlorophenyl)-2-methylpropanoyl]piperazine;; 2- [2-(4-Chlorophenyl)-2-methylpropanoyl] -2,3 ,3 a,4, 5 ,9b-hexahydro- 1 H-benzo [e] isoindole; 3-(3-Fluorophenyl)-l-[2-(4-chlorophenyl)-2-methylpropanoyl]pyrrolidine;; l'-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofiiran-l,3'-pyrrolidin]-3-one; ((lS)-2-[2-Methyl-2-(phenylthio)propanoyl]-l,2,3,4-tetrahydroisoquinolin-l-yl)methanol; 2- [2-Methy l-2-(phenylthio)propanoyl] - 1 ,2,3 ,4-tetrahydroisoquinoline; ; 6-[2-Methyl-2-(phenylthio)propanoyl]-4,5,6,7-tetrahydrothieno[2,3-c]pyridine; 3-Phenyl-l-[2-methyl-2-(phenylthio)propanoyl]piperidine;; 1 '-[2-Methy l-2-(phenylthio)propanoyl] -1,3 -dihydrospiro [indene-2,4'-piperidine] ; 2-Methyl-l-phenyl-4-[2-methyl-2-(phenylthio)propanoyl]piperazine; 2-[2-Methyl-2-(phenylthio)propanoyl]-2,3,3a,4,5,9b-hexahydro-lH-benzo[e]isoindole; 3-(3-Fluorophenyl)-l-[2-methyl-2-(phenylthio)propanoyl]pyrrolidine; 1 '-[2-Methy l-2-(pheny lthio)propanoyl] -3 H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 -one; (( 1 S)-2- {2-[(2-Chlorobenzyl)thio] -2-methylpropanoyl} -1,2,3 ,4-tetrahy droisoquinolin- 1 - yl)methanol; 2-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-l,2,3,4-tetrahydroisoquinoline; 6-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-4,5,6,7-tetrahydrothieno[2,3-c]pyridine; 3-Phenyl-l-{2-[(2-chlorobenzyl)thio]-2-methylpropanoyl}piperidine; r-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-l,3-dihydrospiro[indene-2,4'-piperidine]; 2-Methyl-l-phenyl-4-{2-[(2-chlorobenzyl)thio]-2-methylpropanoyl}piperazine; 2-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-2,3,3a,4,5,9b-hexahydro-lH- benzo [e] isoindole; 3-(3-Fluorophenyl)-l-{2-[(2-chlorobenzyl)thio]-2-methylpropanoyl}pyrrolidine; r-{2-[(2-Chlorobenzyl)thio]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one; 4-[l,l-Dimethyl-2-oxo-2-(3-oxo-lΗ,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-r- yl)ethoxy]benzonitrile; r-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3-one; {4-[l,l-Dimethyl-2-oxo-2-(3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy]phenyl} acetonitrile; {4-[l,l-Dimethyl-2-oxo-2-(l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy]phenyl} acetonitrile; 1 '-[2-Methyl-2-(4-pyridin-2-ylphenoxy)propanoyl]-3H-spiro[2-benzofuran-l ,3 '-pyrrolidin]- 3-one; 1 ' - {2- [(4 ' -Fluorobiphenyl-4-yl)oxy] -2-methy lpropanoyl} -3H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; 1 ' - {2- [(4 ' -Fluorobiphenyl-4-yl)oxy] -2-methy lpropanoyl} -3 H-spiro [2-benzofuran- 1,3'- pyrrolidine]; ( 1 R)- 1 ' -[2-(4-Chlorophenoxy)-2-methy lpropanoyl] -3 H-spiro [2-benzofuran- 1,3' -pyrrolidin] - 3-one; ( 1 R)- 1 ' -[2-(2,4-Dichlorophenoxy)-2-methylpropanoy l]-3 H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; ( 1 R)- 1 ' -[2-(3 ,4-Dichlorophenoxy)-2-methylpropanoyl]-3 H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; 1 '- [2-(4-Chlorophenyl)-2-methy lpropanoyl] -3 H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 -one; ( 1 R)- 1'- [2-(4-chlorophenyl)-2-methylpropanoy l]-3 H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 - one; 1 '-[2-(4-Chlorophenyl)-2-methy lpropanoyl] -3 H-spiro [furo [3 ,4-c]pyr idine- 1 ,3 '-pyrrolidin] -3 - one; 1 '-[2-(4-chlorophenyl)-2-methy lpropanoyl] -7H-spiro [furo [3 ,4-b]pyridine-5 ,3 '-pyrrolidin] -7- one; (4aR,8aS)-2-{2-[(4-Chlorophenyl)thio]-2-methylpropanoyl}decahydroisoquinoline; r-{2-[(4-Chlorophenyl)thio]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one; r-{2-[(4-Chlorophenyl)thio]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'-pyrrolidine]; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-methoxyphenyl)piperidine ; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-trifluoromethylphenyl)piperidine ; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-fluorophenyl)piperidin-4-ol ; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]azepane; 1 - [2-(4-Chlorophenyl)-2-methy lpropanoyl] -3 -phenyl-2, 5 -dihydro- 1 H-pyrrole; 3-{l-[2-(4-Chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-yl}pyridine ; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-methyl-4-phenylpiperidine ; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-(2-methylphenyl)piperidine ; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3-(2-phenylethyl)pyrrolidine; 3-(3-Chlorophenyl)-l-[2-(3-chlorophenyl)-2-methylpropanoyl]pyrrolidine ; 11
4-{ 1 -[2-(4-Chlorophenyl)-2-methylpropanoyl]pyrrolidin-3-yl}pyridine ; 3-(3-Chlorophenyl)-l-[2-(334-dichlorophenyl)-2-methylpropanoyl]ρyrrolidine ; 4-{l-[2-(3,4-Dichlorophenyl)-2-methylpropanoyl]pyrrolidin-3-yl}pyridine; l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-phenylpyrrolidin-2-yl}methanol ; {(2S,4R)-l-[2-(4-Chlorophenyl)-2-methylpropanoyl]-4-phenylpyrrolidin-2-yl}methanol ; 2-[2-(4-Chlorophenyl)-2-methylpropanoyl]-l,2,3,3a,4,9b-hexahydrochromeno[3,4-c]pyrrole ; (1 R)- 1 '-(2-Methyl-2-pyridin-3 -ylpropanoy l)-3H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 -one ; (lR)-r-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one; Methyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofUran-l,3'-pyrrolidin]- 1 '-yl] ethyl} phenyl)piperazine- 1 -carboxylate; Propyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]- l'-yl]ethyl}phenyl)piperazine-l-carboxylate; Isobutyl 4-(4-{ 1 , 1 -dimethyl-2-oxo-2-[(lR)-3-oxo-l 'H,3H-spiro [2-benzofuran- 1 ,3'- pyrrolidin]-l'-yl]ethyl}phenyl)piperazine-l-carboxylate; Isopropyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-lΗ,3H-spiro[2-benzofuran-l,3'- pyrrolidin] - 1 '-yl] ethyl} pheny l)piperazine- 1 -carboxylate; Ethyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethyl}phenyl)piperazine-l-carboxylate; (lR)-l'-(2-Methyl-2-{4-[4-(methylsulfonyl)piperazin-l-yl]phenyl}propanoyl)-3H-spiro[2- benzofuran-l,3'-pyrrolidin]-3-one ; (lR)-l'-(2-{4-[4-(Ethylsulfonyl)piperazin-l-yl]phenyl}-2-methylpropanoyl)-3H-spiro[2- benzofuran-l,3'-pyrrolidin]-3-one ; ( 1 R)- 1 '-(2- {4-[4-(Buty lsulfony l)piperazin- 1 -y l]pheny 1} -2-methylpropanoyl)-3H-spiro [2- benzofuran-l,3'-pyrrolidin]-3-one ; (lR)-r-[2-Methyl-2-(4-{4-[(trifluoromethyl)sulfonyl]piperazin-l-yl}phenyl)propanoyl]-3H- spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 -one ; (lR)-r-{2-[4-(4-Acetylpiperazin-l-yl)phenyl]-2-methylpropanoyl}-3H-spiro[2-benzofuran- l,3'-pyrrolidin]-3-one; (lR)-r-{2-Methyl-2-[4-(4-propionylpiperazin-l-yl)phenyl]proρanoyl}-3H-spiro[2- benzofuran-l,3'-pyrrolidin]-3-one; (1 R)-I '-(2- {4-[4-(Cyclopropylcarbonyl)piperazin- 1 -yl]phenyl} -2-methylpropanoyl)-3H- spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 -one; ( 1 R)- 1 '- {2-[4-(4-Isobutyry lpiperazin- 1 -yl)phenyl] -2-methylpropanoy 1} -3 H-spiro [2- benzofuran- 1 ,3 '-pyrrolidin]-3 -one; (lR)-l'-{2-Methyl-2-[4-(2-oxopyrrolidin-l-yl)phenyl]propanoyl}-3H-spiro[2-benzofuran- l,3'-pyrrolidin]-3-one; (lR)-l'-[3-(4-Chlorophenyl)-2,2-dimethylpropanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]- 3-one; (lR)-l'-[2-(4-Chlorophenyl)-2-methylpropanoyl]-3H-spiro[furo[3,4-c]pyridine-l,3'- pyrrolidin]-3-one; (lR)-r-[2-(4-Chlorophenyl)-2-methylpropanoyl]-7H-spiro[furo[3,4-b]pyridine-5,3'- pyrrolidin]-7-one; tert-Butyl 3 -(4-chloropheny l)-4-[3 -(3 -chlorophenyl)pyrrolidin- 1 -yl] -3 -methy 1-4- oxobutanoate; 3-(4-Chlorophenyl)-4-[3-(3-chlorophenyl)pyrrolidin-l-yl]-3-methyl-4-oxobutanoic acid; 3 -(4-Chloropheny l)-4-[3 -(3 -chlorophenyl)pyrrolidin- 1 -yl] -N,N,3 -tr imethy 1-4-oxobutanamide; ( 1 R)- 1 '-(2-Methyl-2-phenoxypropanoyl)-3H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 -one; ( 1 R)- 1 '-[2-(4-Chlorophenoxy)-2-methylpropanoyl] -3H-spiro [2-benzofuran- 1 ,3 '-pyrrolidin] -3 - one; ( 1 R)- 1'-[2-(3 ,4-Dichlorophenoxy)-2-methy lpropanoyl]-3 H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; (lR)-r-[2-(2,4-Dichlorophenoxy)-2-methylpropanoyl]-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one; (lR)-r-{2-[4-Chloro-3-(trifluoromethyl)phenoxy]-2-methylpropanoyl}-3H-spiro[2- benzofuran- 1 ,3 '-pyrrolidin]-3 -one ; ( 1 R)- 1 '-[2-(4-Chloro-3 -fluorophenoxy)-2-methylpropanoyl] -3 H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; ( 1 R)- 1'- [2-(4-Chloro-2-methylphenoxy)-2-methy lpropanoy 1] -3 H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; ( 1 R)- 1 '- {2-Methy l-2-[4-(trifluoromethyl)phenoxy]propanoy 1} -3 H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one; r-[2-methyl-2-(4-pyridin-2-ylphenoxy)propanoyl]-3H-spiro[2-benzofuran-l,3'-pyrrolidin]-3- one; 4-[l,l-Dimethyl-2-oxo-2-(3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy]benzonitrile; {4-[l,l-Dimethyl-2-oxo-2-(3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl)ethoxy]phenyl} acetonitrile; {4-[ 1 , 1 -Dimethyl-2-oxo-2-(l Η,3H-spiro[2-benzofuran- 1 ,3 '-pyrrolidin]-l '- yl)ethoxy]phenyl} acetonitrile; r-{2-[(4'-Fluorobiphenyl-4-yl)oxy]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'- pyrrolidin]-3-one; tert-Butyl 4-(4-{ 1 , 1 -dimethyl-2-oxo-2-[(lR)-3-oxo-l Η,3H-spiro[2-benzofuran-l ,3'- pyrrolidin] - 1 '-yl] ethoxy } phenyl)piperazine- 1 -carboxylate; ( 1 R)- 1 '-[2-Methy l-2-(4-piperazin- 1 -ylphenoxy)propanoyl] -3H-spiro [2-benzofuran- 1,3'- pyrrolidin]-3-one hydrochloride; Methyl 4-(4-{l,l-dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]- 1 '-yl]ethoxy}phenyl)piperazine-l -carboxylate; r-[2-(4-Chlorophenoxy)-2-methylpropanoyl]-3H-spiro[furo[3,4-c]pyridine-l,3'-pyrrolidin]-3- one; l'-[2-(4-Chlorophenoxy)-2-methylpropanoyl]-7-fluoro-3H-spiro[furo[3,4-c]pyridine-l,3'- pyrrolidin]-3-one; 1 -[2-(4-Chlorophenoxy)-2-methylpropanoyl]-3 -phenylpiperazine; r-{2-[(4'-Fluorobiphenyl-4-yl)oxy]-2-methylpropanoyl}-3H-spiro[2-benzofuran-l,3'- pyrrolidine]; 5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-r- yl]ethyl}phenyl)-N-methylpyridine-2-carboxamide; 5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzoruran-l,3'-pyrrolidin]-l'- yl]ethyl}phenyl)-N,N-dimethylpyridine-2-carboxamide; 5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-lΗ,3H-spiro[2-benzofuran-l,3'-pyrrolidin]-l'- yl]ethyl}-3-fluorophenyl)-N,N-dimethylpyridine-2-carboxamide; 5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[2-benzoruran-l,3'-pyrrolidin]-r- yl]ethyl}-3-fluorophenyl)-N-methylpyridine-2-carboxamide; 5-(4-{ 1 ,1 -Dimethyl-2-oxo-2-[(lR)-3-oxo-lΗ,3H-spiro[2-benzoruran-l ,3'-pyrrolidin]-r- yl]ethyl}-3-fluorophenyl)-N,N-diethylpyridine-2-carboxamide; S^-f Ul-Dimethyl^-oxo^-tClR^-oxo-l'H^H-spirotruro^^-clpyridine-l^'-pyrrolidin]- r-yl]ethyl}-3-fluorophenyl)-N-methylpyridine-2-carboxamide; 5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-lΗ,3H-spiro[ruro[3,4-c]pyridine-l,3'-pyrrolidin]- r-yl]ethyl}-3-fluorophenyl)-N,N-dimethylpyridine-2-carboxamide; and 5-(4-{l,l-Dimethyl-2-oxo-2-[(lR)-3-oxo-l'H,3H-spiro[ruro[3,4-c]pyridine-l,3l-pyrrolidin]- r-yl]ethyl}-3-fluorophenyl)-N,N-diethylpyridine-2-carboxamide, or pharmaceutically acceptable salt thereof.
40. A composition comprising a compound of claim 1, 38, or 39 and a pharmaceutically acceptable carrier.
41. A method of modulating 11 βHSD 1 or MR comprising contacting said 11 βHSD 1 or MR with a compound of claim 1, 38, or 39.
42. A method of inhibiting 11 βHSD 1 or MR comprising contacting said 11 βHSD 1 or MR with a compound of claim 1, 38, or 39.
43. A method of treating a disease in a patient, wherein said disease is associated with expression or activity of 1 lβHSDl or MR, comprising administering to said patient a therapeutically effective amount of a compound of claim 1, 38, or 39.
44. The method of claim 43 wherein said disease is obesity, diabetes, glucose intolerance, insulin resistance, hyperglycemia, hypertension, hyperlipidemia, cognitive impairment, depression, dementia, glaucoma, cardiovascular disorders, osteoporosis, inflammation, a cardiovascular, renal or inflammatory disease, heart failure, atherosclerosis, arteriosclerosis, coronary artery disease, thrombosis, angina, peripheral vascular disease, vascular wall damage, stroke, dyslipidemia, hyperlipoproteinaemia, diabetic dyslipidemia, mixed dyslipidemia, hypercholesterolemia, hypertriglyceridemia, metabolic syndrome or general aldosterone-related target organ damage.
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IL179519A0 (en) 2007-05-15
SG163518A1 (en) 2010-08-30
BRPI0512410A (en) 2008-03-04
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US20060009471A1 (en) 2006-01-12
MXPA06014572A (en) 2007-03-12
EA200700118A1 (en) 2007-08-31
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