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Definitions

• the present invention relates to inhibitors of 11 ⁇ -hydroxysteroid dehydrogenase type 1 (11 ⁇ -HSD1), pharmaceutical compositions thereof and methods of using the same.
• Glucocorticoids such as Cortisol (hydrocortisone) are steroid hormones that regulate fat metabolism, function and distribution, and play a role in carbohydrate, protein and fat metabolism. Glucocorticoids are also known to have physiological effects on development, neurobiology, inflammation, blood pressure, metabolism and programmed cell death. Cortisol and other corticosteroids bind both the glucocorticoid receptor (GR) and the mineralocorticoid receptor (MR), which are members of the nuclear hormone receptor superfamily and have been shown to mediate Cortisol function in vivo. These receptors directly modulate transcription via DNA-binding zinc finger domains and transcriptional activation domains.
• Cortisol hydrocortisone
• glucocorticoid action was attributed to three primary factors: (1) circulating levels of glucocorticoid (driven primarily by the hypothalamic-pituitary-adrenal (HPA) axis); (2) protein binding of glucocorticoids in circulation; and (3) intracellular receptor density inside target tissues.
• HPA hypothalamic-pituitary-adrenal
• glucocorticoid function has been identified: tissue-specific pre-receptor metabolism by glucocorticoid-activating and -inactivating enzymes.
• 11 ⁇ - hydroxysteroid dehydrogenase pre-receptor control enzymes modulate activation of GR and MR by regulation of glucocorticoid hormones.
• 11 ⁇ -HSD1 also known as 11-beta-HSD type 1 , 11 betaHSD1 , HSD11B1 , HDL, and HSD11 L
• 11 ⁇ -HSD2 also known as 11-beta-HSD type 1 , 11 betaHSD1 , HSD11B1 , HDL, and HSD11 L
• 1 1 ⁇ - HSD1 is a bi-directional oxidoreductase that regenerates active Cortisol from inactive 11- keto forms, whereas 11 ⁇ -HSD2 is a unidirectional dehydrogenase that inactivates biologically active Cortisol by converting it into cortisone.
• 11 ⁇ -HSD1 is widely distributed in rat and human tissues; expression of the enzyme and corresponding mRNA have been detected in human liver, adipose tissue, lung, testis, bone and ciliary epithelium. In adipose tissue, increased Cortisol concentrations stimulate adipocyte differentiation and may play a role in promoting visceral obesity. In the eye, 11 ⁇ -HSD1 may regulate intraocular pressure and may contribute to glaucoma; some data suggest that inhibition of 11 ⁇ -HSD1 may cause a drop in intraocular pressure in patients with intraocular hypertension (Kotelevstev et al.
• 11 ⁇ -HSD1 catalyzes both 11-beta- dehydrogenation and the reverse 11-oxoreduction reaction
• 11 ⁇ -HSD1 acts predominantly as a NADPH-dependent oxoreductase in intact cells and tissues, catalyzing the formation of active Cortisol from inert cortisone (Low et al. (1994) J. MoI. Endocrin. 13: 167-174).
• 11 ⁇ -HSD2 expression is found mainly in mineralocorticoid target tissues such as kidney (cortex and medulla), placenta, sigmoid and rectal colon, salivary gland and colonic epithelial cell lines.
• 11 ⁇ -HSD2 acts as an NAD-dependent dehydrogenase catalyzing the inactivation of Cortisol to cortisone (Albiston et al. (1994) MoI. Cell. Endocrin. 105: R11-R17), and has been shown to protect the MR from glucocorticoid excess (e.g., high levels of receptor-active Cortisol) (Blum, et al. (2003) Prog. Nucl. Acid Res. MoI. Biol. 75:173-216).
• H6PD cortisone reductase deficiency
• PCOS polycystic ovary syndrome
• 11 ⁇ -HSD1 contributes to increased local conversion of cortisone to Cortisol in adipose tissue and hence that 11 ⁇ -HSD1 plays a role in the pathogenesis of central obesity and the appearance of the metabolic syndrome in humans (Engeli, et al , (2004) Obes Res 12 9-17) Therefore, 11 ⁇ - HSD1 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) Furthermore, inhibition of 11 ⁇ -HSD1 activity may prove beneficial in treating numerous glucocorticoid-related disorders.
• 11 ⁇ -HSD1 inhibitors could be effective in combating obesity and/or aspects of the metabolic syndrome cluster, including glucose intolerance, insulin resistance, hyperglycemia, hypertension, and/or hyperlipidemia (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 ⁇ -HSD1 activity may have beneficial effects on the pancreas, including the enhancement of glucose-stimulated insulin release (Billaudel and Sutter (1979) Horm. Metab. Res.
• Transgenic aP2-1 1 ⁇ HSD1 mice exhibit high arterial blood pressure and have increased sensitivity to dietary salt. Moreover, plasma angiotensinogen levels are elevated in the transgenic mice, as are angiotensin Il and aldosterone; and treatment of the mice with an angiotensin Il antagonist alleviates the hypertension (Masuzaki et al. (2003) J. Clinical Invest. 112: 83-90). This suggests that hypertension may be caused or exacerbated by 11 ⁇ -HSD1 activity. Thus, 11 ⁇ -HSD1 inhibitors may be useful for treatment of hypertension and hypertension-related cardiovascular disorders.
• Glucocorticoids can have adverse effects on skeletal tissues; and prolonged exposure to even moderate glucocorticoid doses can result in osteoporosis (Cannalis (1996) J. Clin. Endocrinol. Metab. 81 : 3441-3447).
• 11 ⁇ -HSD1 has been shown to be present in cultures of human primary osteoblasts as well as cells from adult bone (Cooper et al. (2000) Bone 27: 375-381), and the 11 ⁇ -HSD1 inhibitor carbenoxolone has been shown to attenuate the negative effects of glucocorticoids on bone nodule formation (Bellows et al. (1998) Bone 23: 119-125).
• 11 ⁇ -HSD1 is predicted to decrease the local glucocorticoid concentration within osteoblasts and osteoclasts, thereby producing beneficial effects in various forms of bone disease, including osteoporosis.
• novel compounds of the instant invention are effective inhibitors of 11 ⁇ -HSD1.
• the present invention provides, inter alia, compounds of Formula I or pharmaceutically acceptable salts or prodrugs thereof, wherein constituent members are defined herein as follows:
• Q is NR 3 , O or S
• R 1 is selected from the group consisting of (1) H; or (2) (C-C ⁇ Jalkyl, (C 3 -C 7 )cycloalkyl, heterocyclyl, (C 1 -C 4 )alkoxy(C 1 -C 4 )alkyl, (C 1 -
• X is independently selected from the group consisting of halogen, OH, CH 2 OH, (Ci-C 3 )alkyl, (Ci-C 3 )haloalkyl, OR* , 0((C r C 3 )haloalkyl), CN, CH 2 CN, NO 2 , CH 2 NO 2 , SH, SR*, SO 2 H, CH 2 SO 2 H, SO 2 R*,CH 2 SO 2 R*, , SO 2 NH 2 , SO 2 NHR*, SO 2 NR* 2 , CH 2 SO 2 NH 2 , CH 2 SO 2 NHR*, CH 2 SO 2 NR* 2 , SO 2 CF 3 , CH 2 SO 2 CF 3 , CONH 2 , CONHR*, CONR * 2 , CH 2 CONH 2 , CH 2 CONHR*, CH 2 CONR* 2 , CO 2 H, CH 2 CO 2 H, NH 2 , NHR*, NR * 2 , (C r C 3 )alkyl
• X can also be oxo, such that a carbonyl group or an N-oxide is formed
• n O, 1 , 2 or 3;
• R 2 and R 3 are independently selected from the group consisting of (1) H; or (2) (CrC 8 )alkyl, (C 3 -C 7 )cycloalkyl, heterocyclyl, (d-COalkoxy ⁇ -C ⁇ alkyl, (Ci-
• R 1 and R 2 are not both hydrogen when E is a bond; and 2) R 1 is not hydrogen when m is greater than O;
• each R* is independently d-C 3 alkyl
• E is a bond, CH 2 , CHMe, CMe 2 , CH 2 CH 2 , OCH 2 , OCHMe, OCMe 2 , SCH 2 , SCHMe, SCMe 2 , provided that O and S are attached to R 1 ;
• G is a 1 , 2, or 3 carbon alkylene chain
• Y is independently selected from the group consisting of halogen, (C ⁇ C 3 )alkyl, CF 3 , CONH 2 , CH 2 CONH 2 , CO 2 H, CH 2 CO 2 H, (C 1 -C 3 )alkylamino(C 1 -C 3 )alkyl and di(C 1 -C 3 )alkylamino(C 1 - C 3 )alkyl;
• n O, 1 , 2 or 3;
• A is a bond, CH 2 , CHMe, CMe 2 , or CH 2 CH 2 ;
• Cy is (C 7 -C 12 )bicycloalkyl or (C 9 -C 12 )tricycloalkyl in which 1-2 carbon atoms are optionally replaced with heteroatoms independently selected from N and O, and which is optionally substituted with 1 - 3 groups independently selected from halogen, cyano, (Ci-C 3 )alkyl, halo(C 1 -C 3 )alkyl, hydroxy, hydroxy(C 1 -C 3 )alkyl, amino, (Ci-C 4 )acylamino, (Ci-
• Q is O or NR 3 , and the values of the remaining variables are as described in Formula (I) More preferably, Q is NH or NMe, R 1 is (d-C 6 )alkyl, (C 3 -C 7 )cycloalkyl or phenyl, R 2 is Me, G(Y) n is CH 2 or CH 2 CH 2 and Cy is 1- adamantyl, 2-adamantyl, 1-hydroxy-4-adamantyl, 1-hydroxymethyl-4-adamantyl, or 1- carbamoyl-4-adamantyl and the values of the remaining variables are as described in Formula (I).
• Q is O
• R 1 is (C r C 6 )alkyl, (C 3 -C 7 )cycloalkyl or phenyl
• R 2 is Me
• G(Y) n is CH 2 or CH 2 CH 2 and Cy is 1-adamantyl, 2-adamantyl, 1-hydroxy-4-adamantyl, 1- hydroxymethyl-4-adamantyl, or 1-carbamoyl-4-adamantyl and the values of the remaining variables are as described in Formula (I).
• the invention is a compound of Formula I 1 wherein n is 0, and E is a bond and the values of the remaining variables are as described above. More preferably, R 1 is tert-butyl.
• the invention is a compound of Formula I, wherein E is a bond, R 1 is phenyl, X is fluorine and m is O 1 1 or 2, and values for the remainder of the variables are as described above for Formula (I).
• the invention is a compound of Formula I, wherein E is a bond, R 1 is phenyl, X is monofluorophenyl or difluorophenyl and m is 1, and values for the remainder of the variables are as described above for Formula (I).
• the invention is a compound of Formula I, wherein E is a bond, R 1 is phenyl, X is optionally substituted pyridyl or X is an oxo-substituted heterocyclyl optionally further substituted with alkyl, haloalkyl or hydroxy and m is 1 , and values for the remainder of the variables are as described above for Formula (I)
• the invention is a compound of Formula I wherein: Q is NR 3 , or O;
• R 3 is H, or (C-C ⁇ Jalkyl
• E is a bond, CH 2 , CHMe, CMe 2 , or CH 2 CH 2 ;
• R 1 is H, (C 1 -C 8 )alkyl, (C 3 -C 7 )cycloalkyl, phenyl, phenyl(d-C 4 )alkyl, heteroaryl, or heteroaryKCrCOalkyl;
• X is F, Cl, Br, CN, OH, (Ci-C 3 )alkyl, halo(d-C 3 )alkyl, (C 1 -C 3 JaIkOXy, (d-CaJalkylsulfonyl, or CONH 2 ;
• m O 1 1 , 2 or 3;
• R 2 is H, Me, Or CH 2 OH
• R 1 and R 2 are not both hydrogen when E is a bond; and 2) R 1 is not hydrogen when m is greater than O;
• G(Y) n is CH 2 , CH(C 1 -C 3 )alkyl, C((C 1 -C 3 )alkyl) 2 , or CH 2 CH 2 ;
• n O, 1 or 2;
• A is a bond, CH 2 ;
• Cy is (C 7 -C 12 )bicycloalkyl and (C 9 -Ci 2 )tricycloalkyl in which 1 -2 carbon atoms are optionally replaced with heteroatoms independently selected from N and O, and which is optionally substituted with 1 - 3 groups independently selected from halogen, cyano, (CrC 3 )alkyl, halo(CrC 3 )alkyl, hydroxy, hydroxy(CrC 3 )alkyl, amino, (Ci-C 4 )acylamino, (Ci- C 3 )alkylsulfonylamino, CH 2 CH 2 CO 2 H, (Ci-C 3 )alkylcarbamoyl, di(Ci-C 3 )alkylcarbamoyl, (Ci- C 3 )alkylaminosulfonyl, di(Ci-C 3 )alkylaminosulfonyl, optionally substituted aryl, optionally substituted
• Cy are 1-adamantyl, 2-adama ⁇ tyl, 1-hydroxy-3-adamantyl, 1-(hydroxymethyl)-3- adamantyl, 1-carbamoyl-3-adamantyl, 1-hydroxy-4-adamantyl, 1 -(hydroxy methyl)-4- adamantyl, i-carbamoyl-4-adamantyl, 1-bicyclo[2.2.2]octyl, 1-carbamoyl-4- bicyclo[2.2.2]octyl, 9-bicyclo[3.3.1]nonyl or 3-carbamoyt-9-bicyclo[3.3.1]nonyl;
• each R 4 is independently hydrogen, (C 1 -Ci 0 ) alkyl, aryl or aralkyl;
• R 3 is H or Me; E is a bond or methylene; R 1 is H, (C r C 8 )alkyl, or (C 3 -C 7 )cycloalkyl; X is Cl, Br or OH; m is 0 or 1; R 2 is H, Me, or CH 2 OH; G(Y) n is CH 2 , CHCH 3 , or CH 2 CH 2 ; A is a bond or methylene; and Cy is 1-adamantyl, 2-adamantyl, 1- hydroxy-4-adamantyl, 1-hydroxymethyl-4-adamantyl, or 1-carbamoyl-4-adamantyl. The values of the remaining variables are as described above. More preferred are compounds of Formula I wherein:
• Q is NR 3 , or O
• R 3 is H 1 or Me
• E is a bond, or CH 2 ;
• R 1 is H, methyl, ethyl, isopropyl, isobutyl, tert-butyl, cyclohexyl, or Ph;
• X is Cl, Br, or OH
• n 0 or 1 ;
• R 2 is H, Me, or CH 2 OH
• G(Y) n is CH 2 , CHMe, or CH 2 CH 2 ;
• n 0 or 1 ;
• A is a bond, or CH 2 ;
• Cy is 1-adamantyl, 2-adamantyl, or 1-hydroxy-4-adamantyl;
• Specifically preferred compounds of the Formula I are:
• the present invention further provides methods of inhibiting 11 ⁇ -HSD1 by contacting 11 ⁇ -HSD1 with a compound of Formula I of the invention.
• the present invention further provides methods of inhibiting the conversion of cortisone to Cortisol in a cell using a compound of Formula I of the invention.
• the present invention further provides methods of inhibiting production of Cortisol in a cell using a compound of Formula I of the invention.
• the present invention further provides methods of increasing insulin sensitivity using a compound of Formula I of the invention.
• the present invention further provides methods of preventing or treating diseases associated with activity of expression of 11 ⁇ -HSD1 using a compound of Formula I of the invention.
• alkyl means a straight or branched hydrocarbon radical having 1-10 carbon atoms and includes, for example, methyl, ethyl, n-propyl, isopropyl, n-butyl, sec- butyl, isobutyl, tert-butyl, n-pentyl, n-hexyl, n-heptyl, n-octyl, n-nonyl, n-decyl and the like.
• cycloalkyl means a saturated hydrocarbon ring having 3-8 carbon atoms and includes, for example, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, and the like.
• bicycloalkyl means two saturated hydrocarbon rings having a total of 7- 12 carbon atoms which are joined by 1 ,1 -fusion, 1,2-fusion or 1 ,n-fusion to give spirocyclic ring systems, fused ring systems and bridged ring systems respectively.
• Spirocyclic ring systems include, for example, spiro[2.4]heptane, spiro[2.5]octane, spiro[4.4] ⁇ onane, spiro[4.5]decane, spiro[5.5]undecane and the like.
• Fused ring systems include, for example, bicyclo[4.1.0]heptane, octahydro-1H-indene, decahydronaphthalene and the like.
• Bridged ring systems include for example, bicyclo[3.3.1]nonane, bicyclo[2.2.2]octane, bicyclo[2.2.1]heptane and the like.
• tricycloalkyl means three saturated hydrocarbon ring having a total of 9- 12 carbon atoms which are joined by any combination of 1 ,1-fusion, 1 ,2-fusion or 1 ,n-fusion and includes, for example, adamantyl, noradamantyl and the like.
• alkoxy and thioalkoxy are O-alkyl or S-alkyl of from 1-6 carbon atoms.
• aryl means an aromatic radical which is a phenyl group, a phenylalkyl group, a phenyl group substituted with 1-4 substituents selected from alkyl, alkoxy, thioalkoxy, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO 2 H, CONH 2 , N-monoalkyl-substituted amido and N,N-dialkyl-substituted amido.
• heteroaryl means a 5- and 6-membered heteroaromatic radical which may optionally be fused to a ring containing 1-4 heteroatoms selected from N, O, and S and includes, for example, a heteroaromatic radical which is 2- or 3-thienyl, 2- or 3-furanyl, 2- or 3- pyrrolyl, 2-,3-, or 4-pyridinyl, 2-pyrazinyl, 2-, 4-, or 5-pyrimidinyl, 3- or 4-pyridazinyl, 1 H- indol-6-yl, 1H-indol-5-yl, 1 H-benzimidazol-6-yl, 1H-benzimidazol-5-yl, 2-, 4-, or 5-thiazolyl, 3- , 4-, or 5-pyrazolyl, 2-, 4-, or 5-imidazolyl and the like optionally substituted by a substituent selected from alkyl, alkoxy, thioalkoxy, alkylsulfonyl,
• heterocyclyl means a 4-, 5-, 6- and 7-membered saturated or partially unsaturated heterocyclic ring containing 1 to 4 heteroatoms independently selected from N, O, and S, and include pyrrolidine, piperidine, tetrahydrofuran, tetrahydropyran, tetrahydrothiophene, tetrahydrothiopyran, isoxazolidine, 1 ,3-dioxolane, 1,3-dithiolane, 1 ,3- dioxane, 1 ,4-dioxane, 1 ,3-dithiane, 1,4-dithiane, morpholine, thiomorpholine, thiomorpholine 1 ,1 -dioxide, tetrahydro-2H-1 ,2-thiazine 1 ,1 -dioxide, and isothiazolidine 1 ,1 -dioxide and azetidine.
• oxo-substituted heterocyclyl means a 4-, 5-, 6- and 7-membered saturated or partially unsaturated heterocyclic ring containing 1 to 4 heteroatoms independently selected from N, O, and S, and include pyrrolidin-2-one, piperidin-2-one, 1 ,2- dihydro-2-oxopyridine, 3,4-dihydro-4-oxopyrimidine, tetrahydropyrimidin-2(1H)-one.
• a heterocyclyl substituted at a ring carbon with oxo forms a ketone at said position; and a heterocyclyl substituted at a ring nitrogen with oxo forms an n-oxide at said position.
• a heterocyclyl group can be optionally substituted with 1-4 substituents.
• substituents include oxo, alkyl, haloalkyl and hydroxy.
• adamantyl means an adamantane moiety bonded to another atom via the 1- or 2- position of adamantane.
• Suitable adamantyl groups include 1- adamantyl, 2-adamantyl, 1-hydroxy-3-adamantyl, 1-(hydroxymethyl)-3-adamantyl, 1- carbamoyl-3-adamantyl, 1-hydroxy-4-adamantyl, 1-(hydroxymethyl)-4-adamantyl, 1- carbamoyl-4-adamantyl, 1-bicyclo[2.2.2]octyl, 1-carbamoyl-4-bicyclo[2.2.2]octyl, 9- bicyclo[3.3.1]nonyl or 3-carbamoyl-9-bicyclo[3.3.1]nonyl;
• mamal as used herein includes all mammals, including, but not limited to, humans.
• the terms “subject” and “patient” may be used interchangeably, and means a mammal in need of treatment, e.g., companion animals (e.g., dogs, cats, and the like), farm animals (e.g., cows, pigs, horses, sheep, goats and the like) and laboratory animals (e.g., rats, mice, guinea pigs and the like).
• the subject is a human in need of treatment.
• the term "treating" or 'treatment” refers to obtaining desired pharmacological and/or physiological effect.
• the effect can be prophylactic or therapeutic, which includes achieving, partially or substantially, one or more of the following results: partially or totally reducing the extent of the disease, disorder or syndrome; ameliorating or improving a clinical symptom or indicator associated with the disorder; delaying, inhibiting or decreasing the likelihood of the progression of the disease, disorder or syndrome; or partially or totally delaying, inhibiting or reducing the likelihood of the onset or development of disease, disorder or syndrome.
• a disclosed compound or its pharmaceutically acceptable salt is named or depicted by structure, it is to be understood that solvates or hydrates of the compound or its pharmaceutically acceptable salts are also included.
• Solvates refer to crystalline forms wherein solvent molecules are incorporated into the crystal lattice during crystallization.
• Solvate may include water or nonaqueous solvents such as ethanol, isopropanol, DMSO, acetic acid, ethanolamine, and EtOAc.
• Solvates, wherein water is the solvent molecule incorporated into the crystal lattice are typically referred to as "hydrates.” Hydrates include stoichiometric hydrates as well as compositions containing variable amounts of water.
• Stereoisomers are compounds that differ only in their spatial arrangement. Enantiomers are pairs of stereoisomers whose mirror images are not superimposable, most commonly because they contain an asymmetrically substituted carbon atom that acts as a chiral center.
• Enantiomer means one of a pair of molecules that are mirror images of each other and are not supe ⁇ mposable Diastereomers are stereoisomers that are not related as mirror images, most commonly because they contain two or more asymmetrically substituted carbon atoms
• the symbol "*" in a structural formula represents the presence of a chiral carbon center "R' and “S” represent the configuration of substituents around one or more chiral carbon atoms
• R* and S * denote the relative configurations of substituents around one or more chiral carbon atoms
• Racemate or “racemic mixture” means a compound of equimolar quantities of two enantiomers, wherein such mixtures exhibit no optical activity, i e , they do not rotate the plane of polarized light
• “Geometric isomer” means isomers that differ in the orientation of substituent atoms in relationship to a carbon-carbon double bond, to a cycloalkyl ring, or to a bridged bicyclic system Atoms (other than H) on each side of a carbon-carbon double bond may be in an E (substituents are on opposite sides of the carbon-carbon double bond) or Z (substituents are oriented on the same side) configuration
• the compounds of the invention may be prepared as individual isomers by either isomer-specific synthesis or resolved from an isomeric mixture
• Conventional resolution techniques include forming the salt of a free base of each isomer of an isomeric pair using an optically active acid (followed by fractional crystallization and regeneration of the free base), forming the salt of the acid form of each isomer of an isomeric pair using an optically active amine (followed by fractional crystallization and regeneration of the free acid), forming an ester or amide of each of the isomers of an isomeric pair using an optically pure acid, amine or alcohol (followed by chromatographic separation and removal of the chiral auxiliary), or resolving an isomeric mixture of either a starting material or a final product using various well known chromatographic methods
• the stereochemistry of a disclosed compound is named or depicted by structure
• the named or depicted stereoisomer is at least 60%, 70%, 80%, 90%, 99% or 99 9% by weight pure relative to the other stereoisomers
• the depicted or named enantiomer is at least 60%, 70%, 80%, 90%, 99% or 99 9% by weight optically pure
• Percent optical purity by weight is the ratio of the weight of the enantiomer over the weight of the enantiomer plus the weight of its optical isomer
• a disclosed compound is named or depicted by structure without indicating the stereochemistry, and the compound has at least one chiral center, it is to be understood that the name or structure encompasses one enantiomer of compound free from the corresponding optical isomer, a racemic mixture of the compound and mixtures enriched in one enantiomer relative to its corresponding optical isomer
• the compounds of the invention may be present in the form of pharmaceutically acceptable salts
• the salts of the compounds of the invention refer to non-toxic "pharmaceutically acceptable salts"
• Pharmaceutically acceptable salt forms include pharmaceutically acceptable acidic/anionic or basic/cationic salts
• Pharmaceutically acceptable basic/cationic salts include, the sodium, potassium, calcium, magnesium, diethanolamine, n-methyl-D-glucamine, L-lysine, L-arginine, ammonium, ethanolamme, piperazine and t ⁇ ethanolamine salts
• Pharmaceutically acceptable acidic/anionic salts include, the acetate, benzenesulfonate, benzoate, bicarbonate, bitartrate, bromide, calcium edetate, camsylate, carbonate, chloride, citrate, dihydrochloride, edetate, edisylate, estolate, esylate, fumarate, glyceptate, gluconate, glutamate, glycollylarsanilate, hexylresorcinate, hydrobromide, hydrochloride, hydroxynaphthoate, iodide, isethionate, lactate, lactobionate, malate, maleate, malonate, mandelate, mesylate, methylsulfate, mucate, napsylate, nitrate, pamoate, pantothenate, phosphate/diphospate, polygalacturonate, salicylate, stearate, subacetate, succinate, s
• reagent III is especially convenient because they are commercially available.
• III is phosgene.
• Z 1 and Z 2 are both 1-imidazolyl
• III is carbonyl diimidazole.
• Z 1 is chloride and Z 2 is p- nitrophenoxide
• III is p-nitrophenyl chloroformate.
• Z 1 and Z 2 are both OCCI 3
• III is triphosgene and as little as one third of molar equivalent can be used.
• Intermediates of Formula Il wherein Q is O, G is CH 2 and n is 0 can be prepared by reduction of amides of Formula IV using a hydride reagent such as BH 3 THF solution, BH 3 -Me 2 S or LiAIH 4 in an inert solvent ethereal such as THF or DME at 20 0 C to 100 0 C for between 1 h and 48 h:
• a hydride reagent such as BH 3 THF solution, BH 3 -Me 2 S or LiAIH 4 in an inert solvent ethereal such as THF or DME
• Intermediates of Formula IV can be prepared by coupling of an ⁇ -hydroxyacid of Formula V with an amine of Formula Vl using standard peptide coupling reagents such as EDC in the presence of HOBt and N,N-diisopropylethylamine in an inert solvent such as CH 2 CI 2 at 0 - 30 0 C for between 1 h and 24 h:
• ⁇ -hydroxyacids of Formula V are commercially available.
• ⁇ -Hydroxyacids of Formula V can be prepared by diazotization of ⁇ -amino acids of Formula VII using NaNO 2 in H 2 SO 4 :
• V ⁇ -Hydroxyacids of Formula V can also be prepared from ketones Formula VIII via cyanohydrins of Formula IX:
• Amine intermediates of Formula Vl wherein A is CH 2 can be prepared by reduction of amides of Formula Xl using a hydride reagent such as BH 3 THF solution, BH 3 -Me 2 S or LiAIH 4 in an inert solvent ethereal such as THF or DME at 20 0 C to 100 0 C for between 1 h and 48 h:
• a hydride reagent such as BH 3 THF solution, BH 3 -Me 2 S or LiAIH 4 in an inert solvent ethereal such as THF or DME
• A CH 2 Amine intermediates of Formula Vl wherein A is a bond can be prepared from ketones of formula XII via oximes of Formula XIII:
• Epoxide compounds of formula XIV can, in turn, be prepared in a number of ways including, as described in Aube, J. "Epoxidation and Related Processes" Chapter 3.2 in Volume 1 of
• Analogously intermediates of Formula Il wherein G is CH 2 CH 2 can be prepared by reaction of oxetanes of Formula XV with amines of Formula Vl as described in Smith, M. B. and March, J. "March's Advanced Organic Chemistry” p 505, 5 th Edition, Wiley, New York,
• Amide intermediates of Formula XVI can be prepared by reaction of an amino- alcohol intermediate of Formula XVII with activated carboxylic acid of Formula XVIII wherein Z 3 is chloride or an activated ester, such as an N-hydroxysuccinimide ester:
• Amino-alcohol intermediates of Formula XVII wherein G is CH 2 and n is 0 can be prepared by reaction of an epoxide of Formula XIV with azide ion to give an azido-alcohol of Formula XIX followed by reduction of the azide moiety with hydrogen gas or using triphenylphosphine in the presence of water:
• Amino-alcohol intermediates of Formula XVII wherein G is CH 2 CH 2 and n is 0 can be prepared by reaction of an epoxide of Formula XIV with cyanide ion followed by reduction of the resulting hydroxynitrile of Formula XX with hydrogen gas in the presence of a catalyst or with a hydride source such as LiAIH 4 :
• a compound of Formula I wherein Q is O can be prepared by reaction of a carbamate intermediate of Formula XXVII wherein R a is alkyl or benzyl with an epoxide intermediate of Formula XIV in the presence of a strong base such as NaH in a solvent such as THF or DMF at 0 °C to 80 0 C:
• Carbamate intermediates of Formula XXVII can be prepared by reaction of amines of Formula Vl with chloroformates of Formula XXVIII in the presence of a base such as pyridine or triethylamine in an inert solvent such as CH 2 CI 2 or THF at 0 0 C to 25 0 C for between 1 h and 24 h:
• a compound of Formula I can be prepared from another compound of Formula I.
• a compound of Formula I can be prepared from another compound of Formula I.
• a compound of Formula I wherein Cy bears a CO 2 H substituent can be converted to the corresponding acid chloride by treatment with SOCI 2 or (COCI) 2 and then reacted with ammonia to give a compound of Formula I wherein Cy bears a CONH2 substituent.
• a compound of Formula I wherein Cy bears a CO 2 Me substituent can be reduced with for example LiBH 4 or LiAIH 4 in THF to give a compound of Formula I wherein Cy bears a CH 2 OH substituent.
• a compound of Formula I wherein Cy bears a CO 2 Me substituent can be reacted with an excess of MeLI or MeMgBr to give a compound of Formula I wherein Cy bears a C(CH 3 ) 2 OH substituent.
• a compound of Formula I wherein Q is NR 3 and R 3 is H can be reacted with a strong base such as NaH followed by an (C 1 -C 8 )BIkVl hahde, a (CrC 4 )alkoxy(Ci-C4)alkyl halide or a phenyl(C ⁇ C 4 )alkyl hahde to give a compound of Formula I wherein Q is NR 3 and R 3 is (Ci-C 8 )alkyl, (C 1 -C 4 )alkoxy(C 1 -C 4 )alkyl or phenyl ⁇ -C ⁇ alkyl
• HPLC high pressure liquid chromatography
• Step 5 4-(2-((1-adamantylmethyl)amino)-1-hydroxyethyl)phenol (50 mg, 0.166 mmol) and
• Step 3 A solution of N-(1-adamantylmethyl)-5-methyl-3-oxohexanamide (1.5 g, 5.1 mmol) in anhydrous THF (15 mL) was added slowly to a suspension of LAH (500 mg, 13.1 mmol) in anhydrous THF (5 mL) under N 2 at 0 0 C. The reaction mixture was heated to 70 0 C and stirred at this temperature overnight. Water (0.5 mL) and 10% aq NaOH (0.5 mL) were added to quench the reaction. The resulting slurry was filtered.
• Step 2 A stirred solution of N-((1S,2R)-1-hydroxy-1-phenylpropan-2-yl)adamantane-1- carboxamide (3.07 g, 9.8 mmol) in dry THF (50 mL) was cooled in an ice bath and 1M BH 3 in THF (50 mL, 50 mmol) was added. The ice bath was allowed to melt and the mixture was stirred over the weekend at rt. The mixture was poured into 5% aq HCI (50 mL). The mixture was concentrated on the rotary evaporator to leave a white solid which was taken up in 5% aq HCI (75 mL) and washed with ether (150 mL).
• the compounds of the present invention can be prepared and administered in a wide variety of oral and parenteral dosage forms.
• the compounds of the present invention can be administered by injection, that is, intravenously, intramuscularly, intracutaneous ⁇ , subcutaneously, intraduodenally, or intraperitoneal ⁇ .
• the compounds of the present invention can be administered intranasally or transdermally.
• the following dosage forms may comprise as the active ingredient, either compounds or a corresponding pharmaceutically acceptable salt of a compound of the present invention.
• pharmaceutically acceptable carriers can either be solid or liquid.
• Solid form preparations include powders, tablets, pills, capsules, cachets, suppositories, and dispersible granules.
• a solid carrier can be one or more substances which may also act as diluents, flavoring agents, solubilizers, lubricants, suspending agents, binders, preservatives, tablet disintegrating agents, or an encapsulating material.
• the carrier is a finely divided solid which is in a mixture with the finely divided active ingredient.
• the active ingredient is mixed with the carrier having the necessary binding properties in suitable proportions and compacted in the shape and size desired.
• the powders and tablets preferably contain from about one to about seventy percent of the active ingredient.
• Suitable carriers are magnesium carbonate, magnesium stearate, talc, sugar, lactose, pectin, dextrin, starch, gelatin, tragacanth, methylcellulose, sodium caboxymethylcellulose, a low-melting wax, cocoa butter, and the like. Tablets, powders, cachets, lozenges, fast-melt strips, capsules and pills can be used as solid dosage forms containing the active ingredient suitable for oral administration.
• a low-melting wax such as a mixture of fatty acid glycerides or cocoa butter
• the active ingredient is dispersed homogeneously therein, as by stirring.
• the molten homogeneous mixture is then poured into convenient sized molds, allowed to cool, and thereby to solidify.
• Liquid form preparations include solutions, suspensions, retention enemas, and emulsions, for example, water or water propylene glycol solutions.
• liquid preparations can be formulated in solution in aqueous polyethylene glycol solution.
• Aqueous solutions suitable for oral administration can be prepared by dissolving the active ingredient in water and adding suitable colorants, flavors, stabilizing, and thickening agents as desired.
• Aqueous suspensions for oral administration can be prepared by dispersing the finely divided active ingredient in water with viscous material, such as natural or synthetic gums , resins, methylcellulose, sodium carboxymethylcellulose, and other well- known suspending agents.
• the pharmaceutical composition is preferably in unit dosage form.
• the composition is subdivided into unit doses containing appropriate quantities of the active ingredient.
• the unit dosage form can be a packaged preparation, the package containing discrete quantities of, for example, tablets, powders, and capsules in vials or ampules.
• the unit dosage form can be a tablet, cachet, capsule, or lozenge itself, or it can be the appropriate amount of any of these in packaged form.
• the quantity of active ingredient in a unit dose preparation may be varied or adjusted from about 0.1 mg to about 1000.0 mg, preferably from about 0.1 mg to about 100 mg.
• the dosages may be varied depending upon the requirements of the patient, the severity of the condition being treated, and the compound being employed. Determination of the proper dosage for a particular situation is within the skill in the art.
• the pharmaceutical composition may contain, if desired, other compatible therapeutic agents.
• the active ingredient is preferably administered orally in a solid dosage form as disclosed above in an amount of about 0.1 mg to about 100 mg per daily dose where the dose is administered once or more than once daily.
• the inhibition of purified 11 ⁇ -HSD1 by compounds of Formula I was measured as follows using a Scintillation Proximity Assay. All reactions were carried out at room temperature in 96 well flexible Microbeta reaction plates. The assay begins by adding 1 microliter of a 0.1 mM solution of a compound of Formula I in DMSO previously diluted in half-log increments (8 points) starting at 1 micromolar final concentration. To this dot was added 50 microliters of substrate solution (5OmM HEPES 1 pH 7.4, 10OmM KCI, 5mM NaCI, 2mM MgCI2 containing 20 microliters of 3 H cortisone, 1mM NADPH).
• substrate solution 5OmM HEPES 1 pH 7.4, 10OmM KCI, 5mM NaCI, 2mM MgCI2 containing 20 microliters of 3 H cortisone, 1mM NADPH).
• microsomal 11 ⁇ -HSD1 was carried out in the same manner
• the inhibition of 11 ⁇ -HSD1 by compounds of Formula I in whole cells was measured as follows Omental adipocytes cultured in 96-well plates were purchased from Zen-Bio, lnc and used at least two weeks after differentiation from precursor preadipocytes started in medium supplemented with adipogenic and lipogenic hormones (human insulin, dexamethasone, isobutylmethylxanthine and PPAR-gamma agonist)
• the cells were maintained in full adipocyte medium (DMEM/Ham's F-12 (1 1, v/v), HEPES pH 7 4, fetal bovine serum, penicillin, streptomycin and Amphotericin B, supplied by Zen-Bio, lnc ) at 37 degrees C, 5% CO2 and transferred into serum-free, phenol red free medium for overnight incubation
• the assay was performed in a total volume of 200 microliters
• the cells were pre-incubated with serum-free, phenol red free medium containing 0 1% (v/v) of
• the compounds of the invention are useful for ameliorating or treating disorders or diseases in which decreasing the level of Cortisol is effective in treating a disease state.
• the compounds of the invention can be used in the treatment or prevention of diabetes mellitus, obesity (especially abdominal obesity), symptoms of metabolic syndrome, prothrombotic state, proinflammatory state, glucose intolerance, hyperglycemica, hypertension, hyperlipidemia, insulin resistance, cardiovascular disease, dyslipidemia, atherosclerosis, lipodystrophy, osteoporosis, glaucoma, Cushing's syndrome, Addison's Disease, visceral fat obesity associated with glucocorticoid therapy, depression, anxiety, Alzheimer's disease, dementia, cognitive decline (including age-related cognitive decline), polycystic ovarian syndrome, infertility and hypergonadism.
• the compounds modulate the function of B and T cells of the immune system and can therefore be used to treat diseases such as tuberculosis, leprosy and psoriasis. They can also be used to promote wound healing, particularly in diabetic patients.
• Additional diseases or disorders that are related to 11 include those selected from the group consisting of lipid disorders, hypretriglyceridemia, hypercholesterolemia, low HDL levels, high LDL levels, vascular restenosis, pancreatitis, abdominal obesity, neurodegenerative disease, retinopathy, nephropathy, neuropathy, diabetes, coronary heart disease, stroke, peripheral vascular disease, Cushing's syndrome, hyperinsulinemia, viral diseases, and Syndrome X.
• a pharmaceutical composition of the invention may, alternatively or in addition to a compound of Formula I, comprise a pharmaceutically acceptable salt of a compound of Formula I or a prodrug or pharmaceutically active metabolite of such a compound or salt and one or more pharmaceutically acceptable carriers therefore.
• compositions of the invention are 11 ⁇ -HSD1 inhibitors.
• Said compositions contain compounds having a mean inhibition constant (IC5 0 ) against 11 ⁇ -HSD1 of between about 1 ,000 nM to about 0.001 nM; preferably between about 50 nM to about 0.001 nM; and more preferably between about 5 nM to about 0.001 nM,
• the invention includes a therapeutic method for treating or ameliorating an 11 ⁇ - HSD1 mediated disorder in a subject in need thereof comprising administering to a subject in need thereof an effective amount of a compound of Formula I 1 or the enantiomers, diastereomers, or salts thereof of composition thereof.
• An embodiment of the invention includes administering an 11 ⁇ -HSD1 inhibiting compound of Formula I or composition thereof alone or in a combination therapy with one or more additional agents for the treatment of diabetes, dyslipidemia, cardiovascular disease, hypertension, obesity, cancer or glaucoma.
• Agents for the treatment of diabetes include insulins, such as Humulin® (EIi Lilly), Lantus® (Sanofi Aventis), Novolin (Novo
• PPAR gamma agonists such as Avandia® (rosiglitizone maleate, GSK) and Actos® (pioglitazone hydrochloride, Takeda/Eli Lilly); sulfonylureas, such as Amaryl® (glimepiride, Sanofi Aventis), Diabeta® (glyburide, Sanofi Aventis), Micronase®/Glynase® (glyburide, Pfizer), and Glucotrol®/Glucotrol XL® and (glipizide, Pfizer); meglitinides, such as Prandin®/NovoNorm® (repaglinide, Novo Nordisk), Starlix® (nateglinide, Novartis), and Glufast® (mitiglinide, Takeda); biguanides, such as Glucophase®/Glucophase XR® (metformin HCI, Bristol
• Agents for the treatment of dyslipidemia and cardiovascular disease include statins, fibrates, and ezetimbe.
• Agents for the treatment of hypertension include alpha-blockers, beta- blockers, calcium channel blockers, diuretics, angiotensin converting enzyme (ACE) inhibitors, dual ACE and neutral endopeptidase (NEP) inhibitors, angiotensin-receptor blockers (ARBs), aldosterone synthase inhibitor, aldosterone-receptor antagonists, or endothelin receptor antagonist.
• Agents for the treatment of obesity include orlistat, phentermine, sibutramine and rimonabant.
• An embodiment of the invention includes administering an 11 ⁇ -HSD1 inhibiting compound of Formula I or composition thereof in a combination therapy with one or more other 11 ⁇ -HSD1 inhibitors (whether such inhibitors are also compounds of Formula I or are compounds of a different class/genus), or with combination products, such as Avandamet® (metformin HCI and rosiglitazone maleate, GSK); Avandaryl® (glimepiride and rosiglitazone maleate, GSK); Metaglip® (glipizide and metformin HCI, Bristol Myers Squibb); and Glucovance® (glyburide and metformin HCI, Bristol Myers Squibb).
• Avandamet® metalformin HCI and rosiglitazone maleate, GSK
• Avandaryl® glimepiride and rosiglitazone maleate, GSK
• Metaglip® glipizide and metformin HCI, Bristol Myers Squibb

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• 2008
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