Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
  • A61P15/12—Drugs for genital or sexual disorders; Contraceptives for climacteric disorders
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
  • A61P15/18—Feminine contraceptives
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P19/00—Drugs for skeletal disorders
  • A61P19/08—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease
  • A61P19/10—Drugs for skeletal disorders for bone diseases, e.g. rachitism, Paget's disease for osteoporosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P5/00—Drugs for disorders of the endocrine system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P5/00—Drugs for disorders of the endocrine system
  • A61P5/24—Drugs for disorders of the endocrine system of the sex hormones
  • A61P5/30—Oestrogens
• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07J—STEROIDS
  • C07J1/00—Normal steroids containing carbon, hydrogen, halogen or oxygen, not substituted in position 17 beta by a carbon atom, e.g. estrane, androstane

Definitions

• the present invention relates to a 15 ⁇ -substituted steroidal compound having selective estrogenic activity, a pharmaceutical composition comprising said compound, said compound for use in therapy, and to the use of said compound for the manufacture of a medicament for the treatment or prevention of estrogen receptor-related diseases or regulation or treatment or prevention of other estrogen receptor-related physiological conditions.
• estrogen receptor ligands Compounds with affinity for estrogen receptors have, for many years, found widespread use for the treatment of a range of medical conditions. Since the tissue distribution of estrogen receptors is broad, the therapeutic utility of estrogen receptor ligands is significant. In particular, their use has been implicated in contraception and the prevention or treatment of: • climacteric complaints: hot flushes, sweating and mood swings;
• osteoporosis osteoarthritis
• hypocalcemia hypercalcemia
• Paget's disease osteomalacia
• osteohalisteresis multiple myeloma
• cardiovascular disease high cholesterol levels, high LDL levels, coagulation disease, restenosis, vascular smooth muscle cell proliferation.
• ERa and ER ⁇ there now exists the possibility to discover subtype-selective estrogen receptor ligands. Since the two subtypes have different distribution in human tissues, such subtype-selective compounds may provide effective treatment or prevention of estrogen receptor-related conditions with minimal side-effects.
• R 1 is H, Ci -5 alkyl, acyl, di-(Ci -5 alkyl)aminocarbonyl, (Ci -5 alkyl)oxycarbonyl or sulfamoyl,
• R 2 is H, Ci -3 alkyl, C 2-3 alkenyl or C 2-3 alkynyl, each of which may be optionally substituted with a halogen,
• R 3 is Ci- 2 alkyl, ethenyl or ethynyl, each of which may be optionally substituted with a halogen, and
• R 4 is H or Ci-12 acyl.
• the steroids wherein R 1 and/or R 4 are/is not hydrogen are so-called prodrugs.
• Ci -5 alkyl represents a branched or unbranched alkyl group having 1-5 carbon atoms. Examples of such groups are methyl, ethyl, isopropyl, tertiary butyl and pentyl.
• Ci -3 alkyl and Ci- 2 alkyl mean a(n) (branched or unbranched) alkyl group having 1-3 and 1-2 carbon atoms, respectively.
• C 2-3 alkenyl represents a branched or unbranched alkenyl group having 2-3 carbon atoms and one double bond. Examples of such groups include ethenyl and propen-2-yl.
• C 2-3 alkynyl represents an alkynyl group having 2-3 carbon atoms and one triple bond. Examples of such groups include ethynyl and propynyl.
• C M2 acyl represents an acyl group derived from a carboxylic acid having 1- 12 carbon atoms.
• the acyl group can comprise a hydrocarbon which may be branched, unbranched, saturated or unsaturated. Examples of such groups include formyl, acetyl, propanoyl, propenoyl, pivaloyl, heptanoyl, decanoyl, and undecanoyl.
• groups derived from dicarboxylic acids like hemi-maloyl, hemi-succinoyl and hemi-glutaroyl.
• An example of a di-(Ci -5 alkyl)aminocarbonyl group is dimethylcarbamoyl.
• An example of a (Ci -5 alkyl)oxycarbonyl group is ethoxycarbonyl.
• a halogen may be one or more halogen atoms, such as one or more chlorine or fluorine atoms.
• R 2 is Ci -3 alkyl, C 2-3 alkenyl or C 2-3 alkynyl, each of which may be optionally substituted with a halogen.
• R 1 and R 4 are both H.
• R 1 is H
• R 2 is H, Ci -3 alkyl, C 2-3 alkenyl or C 2-3 alkynyl
• R 3 is Ci -2 alkyl, ethenyl or ethynyl
• R 4 is H
• R 1 is H
• R 2 is H or Ci -3 alkyl optionally substituted with a halogen
• R 3 is Ci -2 alkyl optionally substituted with a halogen
• R 4 is H.
• R 1 is H
• R 2 is H or Ci -3 alkyl
• R 3 is Ci -2 alkyl
• R 4 is H .
• R 1 is H
• R 2 is H or Ci -2 alkyl
• R 3 is methyl
• R 4 is H.
• the compound is 7 ⁇ -ethyl-15 ⁇ -methyl-19-nor-17 ⁇ -pregna- 1 ,3,5(10)-trien-20-yne-3,17 ⁇ -diol.
• R 1 is H, Ci -5 alkyl or C M2 acyl
• R 2 is H or Ci -3 alkyl
• R 3 is Ci -2 alkyl
• R 4 is H or C M2 acyl.
• R 1 is H, Ci -5 alkyl or C M2 acyl
• R 2 is Ci -3 alkyl
• R 3 is methyl
• R 4 is H or C M2 acyl.
• R 1 is H, Ci -5 alkyl or C M2 acyl
• R 2 is ethyl
• R 3 is methyl
• R 4 is H or C M2 acyl.
• R 1 is H or C M2 acyl
• R 2 is H or Ci -3 alkyl
• R 3 is Ci -2 alkyl
• R 4 is H or C M2 acyl.
• R 1 is H or C M2 acyl
• R 2 is H or Ci -3 alkyl
• R 3 is methyl
• R 4 is H or C M2 acyl
• R 1 is H or C M2 acyl
• R 2 is ethyl
• R 3 is methyl
• R 4 is H or C M2 acyl
• the compounds of the present invention can be synthesised according to methods well known in the art of organic chemistry in general and especially in the art of steroid chemistry. See, for example, Fried, J. and Edwards, J.A., 'Organic Reactions in Steroid Chemistry,' Volumes I and II, van Nostrand Reinhold Company, New York, 1972; and C. Djerassi, 'Steroid Reactions,' Holden-Day, Inc., San Francisco, 1963.
• the general synthetic procedure used to prepare the compounds described in the examples below is depicted in Scheme I. Variations to this scheme can easily be made by one skilled in the art. Scheme I
• Substrate A the starting material for the synthetic procedure shown in Scheme I is synthesised in 4 steps. Firstly, conjugate additions of organometallic species (e.g., cuprates) to C17-protected estra-4,6-dien-3-ones provide the required 7 ⁇ -substituted estr-4-en-3-ones. Minor amounts of 7 ⁇ -isomers formed can be readily removed either by chromatography or crystallisation at this stage of the synthesis, or occasionally at later stages.
• the 7 ⁇ -substituted estrenones are aromatised readily by using e.g., halogenation/ dehalogenation procedures, to 7 ⁇ -estrones, which upon alkylation at C3 and deprotection at C17 provide substrate A.
• the ⁇ , ⁇ -unsaturated ketone C is obtained upon oxidation of the silyl enol ether B using, e.g., palladium diacetate.
• Michael addition to C using an organometallic species, e.g., a dialkyl cuprate then provides the adduct D.
• the methyl estrone D upon deprotection using, e.g., boron trifluoride dimethylsulphide complex then provides the phenol E, which is reprotected as, e.g., the silyl ether F.
• Such a compound is an agonist at the estrogen ⁇ -receptor and is at least 10-fold less active at the estrogen ⁇ -receptor and/or is a partial agonist at the estrogen ⁇ -receptor, with an efficacy equal to or less than 60% of the maximal activation as induced by 17 ⁇ - estradiol.
• This results in high functional selectivity for the estrogen ⁇ -receptor i.e. selectively activating the estrogen ⁇ -receptor whilst not or only partially activating the estrogen ⁇ -receptor.
• the steroids of Formula I wherein R 1 and/or R 4 are/is not hydrogen are prodrugs, which do not necessarily meet the above definitions. These prodrugs are converted by metabolic processes within the body into compounds wherein R 1 and R 4 are hydrogen, which compounds do meet said definitions.
• the selective (estrogenic) ligands of the present invention surprisingly do not induce a high degree of endometrial proliferation (follicular phase-like changes) and can therefore be used as a medicament for (long-term) treatment and/or prevention of peri- and/or post-menopausal (climacteric) complaints and osteoporosis without addition of a progestagenic compound.
• the selective estrogen receptor activation profile of the compounds of the present invention makes them suitable for application in therapy.
• the present invention further relates to the use of a compound according to Formula I for the manufacture of a medicament for the treatment or prevention of estrogen receptor-related diseases or regulation or treatment or prevention of other estrogen receptor-related physiological conditions.
• the invention relates to the use of a compound of Formula I for the manufacture of a medicament for hormone replacement therapy or hormone treatment.
• a compound of Formula I for the manufacture of a medicament for hormone replacement therapy or hormone treatment.
• Such use is particularly suitable in women for the indications of peri- and/or post-menopausal (climacteric) complaints and osteoporosis.
• the invention relates to the use of a compound of Formula I for the manufacture of a medicament for use in contraception.
• a compound according to the invention may be administered as part of a treatment regime involving also administration of an appropriate amount of a progestagen. Such regimes are well known in the field of contraception.
• the present invention therefore also relates to a pharmaceutical composition or dosage form comprising a compound according to the present invention mixed with (a) pharmaceutically acceptable excipient(s), such as the ones described in Gennaro et al., Remmington: The Science and Practice of Pharmacy, 20 th Edition, Lippincott, Williams and Wilkins, 2000; see especially part 5: pharmaceutical manufacturing.
• a pharmaceutically acceptable excipient(s) such as the ones described in Gennaro et al., Remmington: The Science and Practice of Pharmacy, 20 th Edition, Lippincott, Williams and Wilkins, 2000; see especially part 5: pharmaceutical manufacturing.
• suitable excipients are described e.g., in the Handbook of Pharmaceutical Excipients, 2 nd Edition; Editors A. Wade and P.J.Weller, American Pharmaceutical Association, Washington, The Pharmaceutical Press, London, 1994.
• the mixtures of a compound according to the present invention and (a) pharmaceutically acceptable excipient(s) may be compressed into solid dosage units, such as tablets, or be processed into capsules or suppositories.
• solid dosage units such as tablets
• the compounds can also be applied as an injection preparation in the form of a solution, suspension, emulsion, or as a spray, e.g., a nasal or buccal spray.
• a spray e.g., a nasal or buccal spray.
• dosage units e.g., tablets
• conventional additives such as fillers, colorants, polymeric binders and the like is contemplated.
• any pharmaceutically acceptable additive can be used.
• the compounds of the invention may also be included in an implant, a vaginal ring, a patch, a gel or any other preparation for immediate and/or sustained release.
• Suitable fillers with which the pharmaceutical compositions can be prepared and administered include lactose, starch, cellulose and derivatives thereof, and the like, or mixtures thereof used in suitable amounts.
• the dosage amounts of the present invention will be in the normal order for estrogenic compounds, e.g., in the order of 0.01 to 100 mg, more in particular 0.1 to 10 m g per administration.
• 7 ⁇ -Ethyl-3-methoxyestrone 1 was prepared from 17 ⁇ -17-(acetyloxy)-estra-4,6-dien- 3-one and ethylmagnesium bromide in analogy with the method described in EP 0869132 A1 (see Example I and Scheme I, Compounds 1-5).
• a solution of Li-acetylide was generated by dropwise addition of n-butyllithium (1.6 M in hexane, 5 ml) to 1,2-dibromoethene (300 ⁇ l) in dry THF (6 ml) at -60 0 C. After stirring for 20 minutes, a solution of 6 (220 mg) in THF (2 ml) was added, the cooling device was removed and the reaction was stirred for 1 hr at 0 0 C. Then 5% NH 4 CI (50 ml) was added, followed by extraction with ethyl acetate.
• the agonistic activity of compounds on the estrogen receptors was determined in an in vitro bioassay with recombinant Chinese hamster ovary (CHO) cells stably co- transfected with the human estrogen receptor ⁇ (hER ⁇ ) or ⁇ (hER ⁇ ), the rat oxytocin promoter (RO) and the luciferase reporter gene (LUC).
• CHO Chinese hamster ovary
• RO rat oxytocin promoter
• LOC luciferase reporter gene
• ER ⁇ /ER ⁇ selectivity is defined as the ratio ER ⁇ -potency/ER ⁇ -potency.
• Compounds of the invention are agonistic at the estrogen ⁇ -receptor, with a potency equal to or higher than 1.0% (relative to 17 ⁇ -estradiol) and are at least 10-fold less active at the estrogen ⁇ -receptor (ER ⁇ /ER ⁇ selectivity is equal to or higher than 10) and/or are partial agonists at the estrogen ⁇ -receptor, with an efficacy equal to or less than 60% of the maximal activation as induced by 17 ⁇ -estradiol.
• Cynomolgus monkey uterine tissue Histopathological evaluation of Cynomolgus monkey uterine tissue was performed by a pathologist after an 8 week oral treatment with the test compound in four animals per treatment group. Comparative Compound X was dosed once daily at 40 ⁇ g/kg, Comparative Compound Y at 200 ⁇ g/kg and Compound 8 at 40 and 200 ⁇ g/kg. The following morphological characteristics were examined in H&E stained sections, based on the uterine phases of the normal menstrual cycle in Cynomolgus monkeys.
• grade 1 minimal, very few, very small
• grade 3 moderate, moderate number, moderate size .
• grade 4 marked, many, large
• a favourable endometrial safety profile for a compound is characterized by less compound-induced follicular phase-like activity combined with more luteal phase-like characteristics and/or atrophic endometrium.
• Table 1 demonstrate that compounds of the invention have a consistently better functional selectivity for the estrogen receptor ⁇ -subtype combined with a high estrogen ⁇ -receptor potency, i.e. selectively activating the estrogen ⁇ -receptor whilst not or only partially activating the estrogen ⁇ -receptor.
• Compound 8 shows an estrogen ⁇ -receptor potency of 23.45% and is 15.2-fold selective for the estrogen ⁇ -receptor over the estrogen ⁇ -receptor and is a partial agonist at the estrogen ⁇ -receptor with an efficacy of 40%.
• Rat female sexual behavior is hormone dependent.
• progesterone clearly enhances female sexual or lordosis behavior.
• progesterone is not effective in inducing lordosis in ovariectomised females that have not received estrogen (see also J. B. Becker, S. M. Breedlove and D. Crews (Eds.), Behavioral Endocrinology, 1992, pp. 82-84).
• test compounds to facilitate progesterone-induced lordosis behavior in female ovariectomised rats was used to demonstrate in vivo estrogenic activity upon oral dosing of such compounds.
• Females were pre-treated for three days with test compound followed by treatment with a progestagen on the fourth day.
• progesterone treatment sexual behavior of the female rat was measured in the presence of a male rat by counting the number of lordosis responses during 10 minutes.

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