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  • A61K31/44—Non condensed pyridines; Hydrogenated derivatives thereof
  • A61K31/4427—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems
  • A61K31/444—Non condensed pyridines; Hydrogenated derivatives thereof containing further heterocyclic ring systems containing a six-membered ring with nitrogen as a ring heteroatom, e.g. amrinone
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  • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
  • A61K31/496—Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene or sparfloxacin
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  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/506—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim not condensed and containing further heterocyclic rings
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  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/513—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
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  • A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
  • A61K31/5375—1,4-Oxazines, e.g. morpholine
  • A61K31/5377—1,4-Oxazines, e.g. morpholine not condensed and containing further heterocyclic rings, e.g. timolol
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  • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
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  • C07D221/02—Heterocyclic compounds containing six-membered rings having one nitrogen atom as the only ring hetero atom, not provided for by groups C07D211/00 - C07D219/00 condensed with carbocyclic rings or ring systems
  • C07D221/04—Ortho- or peri-condensed ring systems
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  • C07D401/02—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings
  • C07D401/12—Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
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  • C07D417/12—Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group C07D415/00 containing two hetero rings linked by a chain containing hetero atoms as chain links

Definitions

• Diabetes mellitus is a disease derived from multiple causative factors and characterized by elevated levels of plasma glucose (hyperglycemia) in the fasting state or after administration of glucose during an oral glucose tolerance test.
• diabetes There are two generally recognized forms of diabetes.
• IDDM insulin-dependent diabetes mellitus
• Type 2 diabetes or noninsulin-dependent diabetes mellitus (NIDDM)
• NIDDM noninsulin-dependent diabetes mellitus
• Patients having Type 2 diabetes have a resistance to the effects of insulin in stimulating glucose and lipid metabolism in the main insulin-sensitive tissues, which are muscle, liver and adipose tissues.
• Insulin resistance is not primarily caused by a diminished number of insulin receptors but rather by a post-insulin receptor binding defect that is not yet completely understood. This lack of responsiveness to insulin results in insufficient insulin-mediated activation of uptake, oxidation and storage of glucose in muscle, and inadequate insulin- mediated repression of lipolysis in adipose tissue and of glucose production and secretion in the liver.
• Persistent or uncontrolled hyperglycemia that occurs with diabetes is associated with increased and premature morbidity and mortality. Often abnormal glucose homeostasis is associated both directly and indirectly with obesity, hypertension, and alterations of the lipid, lipoprotein and apolipoprotein metabolism, as well as other metabolic and hemodynamic disease. Patients with Type 2 diabetes mellitus have a significantly increased risk of macrovascular and microvascular complications, including atherosclerosis, coronary heart disease, stroke, peripheral vascular disease, hypertension, nephropathy, neuropathy, and retinopathy. Therefore, therapeutic control of glucose homeostasis, lipid metabolism, obesity, and hypertension are critically important in the clinical management and treatment of diabetes mellitus.
• a patient having Metabolic Syndrome is characterized as having three or more symptoms selected from the following group of five symptoms: (1) abdominal obesity; (2) hypertriglyceridemia; (3) low high-density lipoprotein cholesterol (HDL); (4) high blood pressure; and (5) elevated fasting glucose, which may be in the range characteristic of Type 2 diabetes if the patient is also diabetic.
• Type 2 diabetes There are several available treatments for Type 2 diabetes, each of which has its own limitations and potential risks. Physical exercise and a reduction in dietary intake of calories often dramatically improve the diabetic condition and are the usual recommended first-line treatment of Type 2 diabetes and of pre-diabetic conditions associated with insulin resistance. Compliance with this treatment is generally very poor because of well-entrenched sedentary lifestyles and excess food consumption, especially of foods containing high amounts of fat and carbohydrates.
• hepatic glucose production biguanides, such as phenformin and metformin
• PPAR agonists such as rosiglitazone, troglitazone, engliazone, balaglitazone, MCC-555, netoglitazone, T-131, LY-300512, LY-818 and
• insulin secretion sulfonylureas, such as tolbutamide, glipizide and
• glimipiride (4) incretin hormone mimetics (GLP-1 derivatives and analogs, such as exenatide and liraglitide); and (5) inhibitors of incretin hormone degradation (DPP-4 inhibitors, such as sitagliptin, alogliptin, vildagliptin, linagliptin, denagliptin, and saxagliptin).
• GLP-1 derivatives and analogs such as exenatide and liraglitide
• DPP-4 inhibitors such as sitagliptin, alogliptin, vildagliptin, linagliptin, denagliptin, and saxagliptin.
• the biguanides are a class of drugs that are widely used to treat Type 2 diabetes.
• the two best known biguanides, phenformin and metformin cause some correction of hyperglycemia.
• the biguanides act primarily by inhibiting hepatic glucose production, and they also are believed to modestly improve insulin sensitivity.
• the biguanides can be used as monotherapy or in combination with other anti-diabetic drugs, such as insulin or an insulin secretagogue, without increasing the risk of hypoglycemia.
• phenformin and metformin can induce lactic acidosis and nausea/diarrhea. Metformin has a lower risk of side effects than phenformin and is widely prescribed for the treatment of Type 2 diabetes.
• the glitazones are a newer class of compounds that can ameliorate hyperglycemia and other symptoms of Type 2 diabetes.
• the glitazones that are currently marketed are agonists of the peroxisome proliferator activated receptor (PPAR) gamma subtype.
• PPAR peroxisome proliferator activated receptor
• the PPAR-gamma agonists substantially increase insulin sensitivity in muscle, liver and adipose tissue in several animal models of Type 2 diabetes, resulting in partial or complete correction of elevated plasma glucose levels without the occurrence of hypoglycemia.
• PPAR-gamma agonism is believed to be responsible for the improved insulin sensititization that is observed in human patients who are treated with the glitazones.
• New PPAR agonists are currently being developed. Many of the newer PPAR compounds are agonists of one or more of the PPAR alpha, gamma and delta subtypes. Compounds that are agonists of both the PPAR alpha and PPAR gamma subtypes (PPAR alpha/gamma dual agonists) have been made and tested, but so far none have been approved by the regulatory authorities.
• the currently marketed PPAR gamma agonists are modestly effective in reducing plasma glucose and HemoglobinAlC.
• SPPARM Selective PPAR Gamma Partial Agonists
• insulin secretagogues such as the sulfonylureas (e.g. tolbutamide, glipizide, and glimepiride).
• sulfonylureas e.g. tolbutamide, glipizide, and glimepiride.
• these drugs increase the plasma level of insulin by stimulating the pancreatic ⁇ -cells to secrete more insulin.
• Insulin secretion in the pancreatic ⁇ -cell is under strict regulation by glucose and an array of metabolic, neural and hormonal signals. Glucose stimulates insulin production and secretion through its metabolism to generate ATP and other signaling molecules, whereas other extracellular signals act as potentiators or inhibitors of insulin secretion through GPCR's present on the plasma membrane.
• Sulfonylureas and related insulin secretagogues act by blocking the ATP-dependent K+ channel in ⁇ -cells, which causes depolarization of the cell and the opening of the voltage- dependent Ca2+ channels with stimulation of insulin release.
• This mechanism is non-glucose dependent, and hence insulin secretion can occur regardless of the ambient glucose levels. This can cause insulin secretion even if the glucose level is low, resulting in hypoglycemia, which can be fatal in severe cases.
• the administration of insulin secretagogues must therefore be carefully controlled.
• the insulin secretagogues are often used as a first-line drug treatment for Type 2 diabetes.
• Dipeptidyl peptidase IV (DPP-4) inhibitors e.g., sitagliptin, vildagliptin, alogliptin, linagliptin, denagliptin, and saxagliptin
• DPP-4 is a cell surface protein with broad tissue distribution that has been implicated in a wide range of biological functions.
• DPP-4 is identical to the T-cell activation marker CD26 and can cleave a number of immunoregulatory, endocrine, and neurological peptides in vitro.
• GLP-1 glucose-like peptide- 1
• GIP glycose-dependent insulinotropic peptide; also known as gastric inhibitory peptide
• GLP-1 glucagon- like peptide- 1
• GIP glycose-dependent insulinotropic peptide; also known as gastric inhibitory peptide
• Incretins are carried through the circulation to beta cells in the pancreas and cause the beta cells to secrete more insulin in anticipation of an increase of blood glucose resulting from the digesting meal.
• DPP-4 inhibition increases the steady state concentrations of GLP-1 and GIP, resulting in improved glucose tolerance. Inactivation of these peptides by DPP-4 may also play a role in glucose homeostasis.
• DPP-4 inhibitors therefore have utility in the treatment of Type 2 diabetes and in the treatment and prevention of the numerous conditions that often accompany Type 2 diabetes, including Metabolic Syndrome, reactive hypoglycemia, and diabetic dyslipidemia.
• GLP-1 has other effects that help to lower blood glucose and contribute to glucose homeostasis.
• GLP-1 inhibits glucagon secretion from the liver. Glucagon is a hormone that increases blood glucose levels by stimulating glucose production from glycogen stores in the liver.
• GLP-1 also delays stomach emptying, which helps to spread glucose absorption out over time, and thus limit hyperglycemia. Also, studies in animals have shown that GLP-1 can increase the number of beta cells, either through promoting growth or by inhibiting apoptosis. Thus, potentiation of GLP-1 action by preventing its degradation offers several mechanisms to attenuate hyperglycemia associated with Type 2 diabetes.
• GPCR G-protein coupled receptors
• GPR40 agonists are capable of augmenting the release of insulin from islet cells.
• the specificity of this response is suggested by results showing that the inhibition of GPR40 activity by siRNA attenuates FA-induced amplification of GSIS.
• GPR40 As a potential target for the treatment of Type 2 diabetes.
• the limited tissue distribution of GPR40 suggests that there would be less chance for side effects associated with GPR40 activity in other tissues.
• G-protein-coupled receptor 40 may be useful to treat type 2 diabetes mellitus, obesity, hypertension, dyslipidemia, cancer, and metabolic syndrome, as well as cardiovascular diseases, such as myocardial infarction and stroke, by improving glucose and lipid metabolism and by reducing body weight.
• cardiovascular diseases such as myocardial infarction and stroke, by improving glucose and lipid metabolism and by reducing body weight.
• potent GPR40 agonists that have pharmacokinetic and pharmacodynamic properties suitable for use as human pharmaceuticals.
• Benzimidazole compounds are disclosed in WO 2010/051206; WO 2010/051176; WO
• G-protein-coupled receptor 40 (GPR40) agonists are disclosed in WO 2007/136572, WO 2007/136573, WO 2009/058237, WO 2006/083612, WO 2006/083781, WO 2010/085522, WO 2010/085525, WO 2010/085528, WO 2010/091176, WO 2004/041266, EP 2004/1630152, WO 2004/022551, WO 2005/051890, WO 2005/051373, EP 2004/1698624, WO 2005/086661, WO 2007/213364, WO 2005/063729, WO 2005/087710, WO 2006/127503, WO 2007/1013689, WO 2006/038738, WO 2007/033002, WO 2007/106469, WO 2007/123225, WO 2008/001931, WO 2008/030618, WO 2008/054674, WO 2008/054675, WO 2008/066097, WO 2008/130514, WO 2009/048527
• the present invention relates to novel substituted compounds of structural formula I:
• the compounds of structural formula I, and embodiments thereof, are agonists of G-protein-coupled receptor 40 (GPR40) and may be useful in the treatment, prevention and suppression of diseases, disorders and conditions mediated by agonism of the G-protein-coupled receptor 40, such as Type 2 diabetes mellitus, insulin resistance, hyperglycemia, dyslipidemia, lipid disorders, obesity, hypertension, Metabolic Syndrome and atherosclerosis.
• GPR40 G-protein-coupled receptor 40
• the present invention also relates to pharmaceutical compositions comprising the compounds of the present invention and a pharmaceutically acceptable carrier.
• the present invention also relates to methods for the treatment, control or prevention of disorders, diseases, and conditions that may be responsive to agonism of the G-protein-coupled receptor 40 in a subject in need thereof by administering the compounds and pharmaceutical compositions of the present invention.
• the present invention also relates to the use of compounds of the present invention for manufacture of a medicament useful in treating diseases, disorders and conditions that may be responsive to the agonism of the G-protein-coupled receptor 40.
• the present invention is also concerned with treatment of these diseases, disorders and conditions by administering the compounds of the present invention in combination with a therapeutically effective amount of another agent that may be useful to treat the disease, disorder and condition.
• the invention is further concerned with processes for preparing the compounds of this invention.
• the present invention is concerned with novel compounds of structural Formula I:
• X is selected from the group consisting of:
• T is selected from the group consisting of: CH, N and N-oxide
• U is selected from the group consisting of: CH, N and N-oxide
• V is selected from the group consisting of: CH, N and N-oxide
• T, U and V is N or N-oxide
• A is selected from the group consisting of:
• A is unsubstituted or substituted with one to five substituents selected from R a ;
• B is selected from the group consisting of:
• R 1 is selected from the group consisting of:
• each -Ci_ 6 alkyl and -C 3 _ 6 cycloalkyl is unsubstituted or substituted with one to three substituents selected from R 1 ;
• R is selected from the group consisting of:
• each -Ci_ 6 alkyl and -C 3 _ 6 cycloalkyl is unsubstituted or substituted with one to three substituents selected from R J ;
• R is selected from the group consisting of:
• Ci_ 6 alkyl, C 2 _ 6 alkenyl, C 2 - 6 alkynyl, and C 3 _ 6 cycloalkyl is unsubstituted or substituted with one to three substituents selected from R L ;
• R 4 is selected from the group consisting of:
• each -Ci_ 6 alkyl, -C 2 -6alkenyl, -C 2 _ 6 alkynyl, and -C 3 _ 6 cycloalkyl is unsubstituted substituted with one to three substituents selected from R L ;
• R 5 is selected from the group consisting of:
• R 6 is selected from the group consisting of:
• R 5 and R 6 can together form oxo
• R a is selected from the group consisting of:
• Rb is unsubstituted or substituted with one to five substituents selected from Rk;
• R c and R d are each independently selected from the group consisting of:
• RC and Rd together with the atom(s) to which they are attached form a cycloheteroalkyl ring of 4 to 7 members containing 0-2 additional heteroatoms independently selected from oxygen, sulfur and N-Rg, and wherein each Rc and Rd is unsubstituted or substituted with one to three substituents independently selected from Rf;
• each R e is independently selected from the group consisting of:
• each Re is unsubstituted or substituted with one to three substituents selected from Rh; each Rf is selected from the group consisting of:
• each Cl-lO alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 ;
• each RB is selected from the group consisting of:
• each Rh is selected from the group consisting of:
• each Cl-lO alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 ;
• R 1 is independently selected from the group consisting of:
• each Rk is independently selected from the group consisting of:
• each Cl-10 alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, -OCl-6alkyl, halogen, cyano, and -S(0)2Cl-6alkyl; RL is selected from the group consisting of:
• each n is independently 0, 1, 2, 3 or 4;
• each m is independently 0, 1 or 2;
• each p is independently selected from: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10.
• the invention has numerous embodiments, which are summarized below.
• the invention includes the compounds as shown, and also includes individual diastereoisomers, enantiomers, and epimers of the compounds, and mixtures of diastereoisomers and/or enantiomers thereof including racemic mixtures.
• X is selected from the group consisting of: oxygen, and -NH. In a class of this embodiment, X is oxygen. In another class of this embodiment, X is NH.
• T is selected from the group consisting of: CH, N and N-oxide. In a class of this embodiment, T is selected from the group consisting of: CH and N. In another class of this embodiment, T is CH. In another class of this embodiment, T is N or N-oxide. In another class of this embodiment, T is N.
• U is selected from the group consisting of: CH, N and N-oxide. In a class of this embodiment, U is selected from the group consisting of: CH and N. In another class of this embodiment, U is CH. In another class of this embodiment, U is N or N-oxide. In another class of this embodiment, U is N.
• V is selected from the group consisting of: CH, N and N-oxide. In a class of this embodiment, V is selected from the group consisting of: CH and N. In another class of this embodiment, V is CH. In another class of this embodiment, V is N or N-oxide. In another class of this embodiment, V is N.
• T is CH, U is CH, and V is N or N- oxide.
• T is CH, U is CH, and V is N.
• T is CH, U is N or N-oxide, and V is CH.
• T is CH, U is N, and V is CH.
• T is N or N-oxide
• U is CH
• V is CH
• T is N
• U is CH
• V is CH
• T is CH, U is N or N-oxide, and V is N or N-oxide.
• T is CH, U is N, and V is N.
• T is N or N-oxide
• U is CH
• V is N or N-oxide.
• T is N, U is CH, and V is N.
• T is N or N-oxide
• U is N or N-oxide
• V is CH.
• T is N
• U is N
• V is CH.
• A is selected from the group consisting of: aryl and heteroaryl, wherein A is unsubstituted or substituted with one to five substituents selected from R a .
• A is unsubstituted or substituted with one to four substituents selected from R a .
• A is unsubstituted or substituted with one to three substituents selected from R a .
• A is unsubstituted or substituted with one to two substituents selected from R a .
• A is selected from the group consisting of: phenyl and pyridine, wherein A is unsubstituted or substituted with one to five substituents selected from R a .
• A is unsubstituted or substituted with one to four substituents selected from R a .
• A is unsubstituted or substituted with one to three substituents selected from R a .
• A is unsubstituted or substituted with one to two substituents selected from R a .
• A is aryl, wherein A is unsubstituted or substituted with one to five substituents selected from R a .
• A is unsubstituted or substituted with one to four substituents selected from R a .
• A is unsubstituted or substituted with one to three substituents selected from R a .
• A is unsubstituted or substituted with one to two substituents selected from R a .
• A is phenyl, wherein A is unsubstituted or substituted with one to five substituents selected from R a .
• A is unsubstituted or substituted with one to four substituents selected from R a .
• A is unsubstituted or substituted with one to three substituents selected from R a .
• A is unsubstituted or substituted with one to two substituents selected from R a .
• A is heteroaryl, wherein A is unsubstituted or substituted with one to five substituents selected from R a .
• A is unsubstituted or substituted with one to four substituents selected from R a .
• A is unsubstituted or substituted with one to three substituents selected from R a .
• A is unsubstituted or substituted with one to two substituents selected from R a .
• A is pyridine, wherein A is unsubstituted or substituted with one to five substituents selected from R a .
• A is unsubstituted or substituted with one to four substituents selected from R a .
• A is unsubstituted or substituted with one to three substituents selected from R a .
• A is unsubstituted or substituted with one to two substituents selected from R a .
• B is selected from the group consisting of: aryl, aryl-O-, C 3 _ 6 cycloalkyl-, C 3 _ 6 cycloalkyl-Cl-I0alkyl-, C 3 _ 6 cycloalkyl-Cl-l0alkyl-O-, C 2 _ 5Cycloheteroalkyl-, heteroaryl, heteroaryl-O-, aryl-Cl-10 alkyl-, and heteroaryl-Cl-lO alkyl-, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b . In another class of this embodiment, B is unsubstituted or substituted with one to three substituents selected from R b . In another class of this embodiment, B is unsubstituted or substituted with one to two substituents selected from R b .
• B is selected from the group consisting of: aryl, and heteroaryl, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is selected from the group consisting of phenyl, pyridine, pyrimidine, thiazole, benzimidazole, benzthiazole, benzoxazole, and benzisoxazole, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b . In another class of this embodiment, B is unsubstituted or substituted with one to two substituents selected from R b .
• B is selected from the group consisting of: aryl, and heteroaryl, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is selected from the group consisting of phenyl, pyridine, pyrimidine, thiazole and benzimidazole, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b .
• B is unsubstituted or substituted with one to two substituents selected from R b .
• B is aryl, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b .
• B is unsubstituted or substituted with one to two substituents selected from R b .
• B is phenyl, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b .
• B is unsubstituted or substituted with one to two substituents selected from R b .
• B is heteroaryl, wherein B is
• B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b .
• B is unsubstituted or substituted with one to two substituents selected from R b .
• B is selected from the group consisting of: pyridine, pyrimidine, thiazole, benzimidazole, benzthiazole, benzoxazole, and benzisoxazole, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is selected from the group consisting of:
• B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b .
• B is unsubstituted or substituted with one to two substituents selected from R b .
• B is pyridine or benzimidazole, wherein B is unsubstituted or substituted with one to five substituents selected from R b .
• B is unsubstituted or substituted with one to four substituents selected from R b .
• B is unsubstituted or substituted with one to three substituents selected from R b .
• B is unsubstituted or substituted with one to two substituents selected from R b .
• R 1 is selected from the group consisting of: halogen, -ORe, -CN, -Ci_ 6 alkyl, and C3_ 6 cycloalkyl, wherein each Ci_ 6 alkyl and C 3 _
• R 1 is selected from the group consisting of: halogen, -ORe, -CN, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R 1 .
• R 1 is selected from the group consisting of: halogen, -CN, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R 1 .
• R 1 is -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R 1 . 2
• R is selected from the group consisting of: hydrogen, -Ci_ 6 alkyl, and C 3 _ 6 cycloalkyl, wherein each Ci_ 6 alkyl and C 3 _ 6 cycloalkyl is unsubstituted or substituted with one to three substituents selected from R J .
• R is selected from the group consisting of: hydrogen, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R J .
• R is -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R J .
• R is hydrogen.
• R is selected from the group consisting of: hydrogen, halogen, -ORe, -Ci_ 6 alkyl, -C 2 - 6 alkenyl, -C 2 _ 6 alkynyl, and -C 3 _ 6 cycloalkyl, wherein each -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, -C 2 _ 6 alkynyl, and -C 3 _ 6 cycloalkyl is unsubstituted or substituted
• R is selected from the group consisting of: hydrogen, halogen, -ORe, -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, and -C 2 _ 6 alkynyl, wherein each -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, and -C 2 _ 6 alkynyl is unsubstituted or substituted with one to three substituents selected from R L .
• R 3 is selected from the group consisting of: hydrogen, halogen, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R L .
• R is selected from the group consisting of: hydrogen, halogen, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from
• R is selected from the group consisting of: hydrogen, F and -CH 3 .
• R is hydrogen
• R 4 is selected from the group consisting of: hydrogen, halogen, -ORe, -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, -C 2 _ 6 alkynyl, and -C 3 _ 6 cycloalkyl, wherein each -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, -C 2 _ 6 alkynyl, and -C 3 _ 6 cycloalkyl is unsubstituted or substituted with one to three substituents selected from R L .
• R 4 is selected from the group consisting of: hydrogen, halogen, -ORe, -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, and -C 2 _ 6 alkynyl, wherein each -Ci_ 6 alkyl, -C 2 _ 6 alkenyl, and -C 2 _ 6 alkynyl is unsubstituted or substituted with one to three substituents selected from R L .
• R 4 is selected from the group consisting of: hydrogen, halogen, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R L .
• R 4 is selected from the group consisting of: hydrogen, halogen, and -Ci_ 6 alkyl, wherein each Ci_ 6 alkyl is unsubstituted or substituted with one to three substituents selected from R L .
• R 4 is selected from the group consisting of: hydrogen, F and -CH 3 .
• R 4 is hydrogen.
• R 5 is selected from the group consisting of: hydrogen, -Ci_ 3 alkyl, and halogen. In a class of this embodiment, R 5 is selected from the group consisting of: hydrogen, -Ci_ 3 alkyl, and halogen. In another class of this embodiment, R 5 is selected from the group consisting of: hydrogen, and -Ci_ 3 alkyl. In another class of this embodiment, R 5 is -Ci_ 3 alkyl. In another class of this embodiment, R 5 is hydrogen.
• R 6 is selected from the group consisting of: hydrogen, -Ci_ 3 alkyl, and halogen, or R 5 and R 6 can together form oxo.
• R 6 is selected from the group consisting of: hydrogen, -Ci_ 3 alkyl, and halogen.
• R 6 is selected from the group consisting of: hydrogen, and -Ci_ 3 alkyl.
• R 6 is -Ci_ 3 alkyl.
• R 6 is hydrogen
• R a is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -ORe, -NRCS(0) m R e , -S(0) m R e , -S(0) m NRCRd, -NRCRd, -C(0)Re, - OC(0)Re -C02R e , -CN, -C(0)NRCRd -NRCC(0)Re, -NRCC(0)ORe, -NRCC(0)NRCRd, .
• R a is not selected from: -Ci_ 6 alkyl and halogen.
• R a is selected from the group consisting of: -Ci_6alkyl, halogen, -OR e , -NR c S(0) m R e , -S(0) m R e , - S(0) m NRCRd, -NRCRd, -C(0)Re, -OC(0)Re, -C02R e , -CN, -C(0)NRCRd, -NRCC(0)Re, - NRCC(0)ORe, -NRCC(0)NRCRd, -CF3, -OCF3, -OCHF2, -C 3 - 6 cycloalkyl, and -C 2 _
• R a is not selected from: -CH3 and F.
• R a is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -ORe, -NRCS(0) m R e , -S(0) m R e , -S(0) m NRCRd, -NRCRd, -C(0)Re, - OC(0)Re, -C02R e , -CN, -C(0)NRCRd, -NRCC(0)Re, -NRCC(0)ORe, -NRCC(0)NRCRd, .
• R a is not selected from: -Ci_ 6 alkyl and halogen.
• R a is selected from the group consisting of: -Ci_ 6 alkyl, halogen, - ORe, -NRcS(0) m R e , -S(0) m R e , -S(0) m NRCRd, -NRCRd, -C(0)Re, -OC(0)Re, -C02R e , - CN, -C(0)NRCRd -NRCC(0)Re, -NRCC(0)ORe, -NRCC(0)NRCRd, -CF3, -OCF3, -OCHF2,
• R a is not selected from: -CH3 and F.
• R a is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -ORe, -NRCS(0) m R e , -S(0) m R e , -S(0) m NRCRd, -NRCRd, -C(0)Re, - OC(0)Re, -C02R e , -CN, -C(0)NRCRd, -NRCC(0)Re, -NRCC(0)ORe, -NRCC(0)NRCRd, -CF3, -OCF3, -OCHF2, -C3_6cycloalkyl, and -C 2 -5cycloheteroalkyl.
• R a is selected from the group consisting of: -Ci_6alkyl, halogen, -OR e , -NR c S(0) m R e , -S(0) m R e , - S(0) m NRCRd -NRCRd, -C(0)Re, -OC(0)Re, -C02R e , -CN, -C(0)NRCRd, -NRCC(0)Re, - NRCC(0)ORe, -NRCC(0)NRCRd, -CF3, -OCF3, and -OCHF2.
• R a is selected from the group consisting of: -Ci_6alkyl, halogen, -OR e , -S(0) m R e , - NRCRd, -CN, -CF3, -OCF3, and -OCHF2.
• R a is selected from the group consisting of: -Ci_6alkyl, halogen, -CN, -CF3, -OCF3, and -OCHF2.
• R a is selected from the group consisting of: -Ci_ 6 alkyl, halogen, and - CF3.
• R a is selected from the group consisting of: -CH3, F, and -CF3.
• R a is selected from the group consisting of: -Ci_ 6 alkyl and halogen. In a subclass of this class, R a is selected from the group consisting of: -CH3, and F. In another class of this embodiment, R a is -Ci_ 6 alkyl. In a subclass of this class, R a is -CH3. In another class of this embodiment, R a is halogen. In a subclass of this class, R a is F.
• R a is selected from the group consisting of: halogen, -ORe, -NRcS(0) m Re, -S(0) m Re, -S(0) m NRCRd -NRCRd -C(0)Re -OC(0)Re - C02R e , -CN, -C(0)NRCRd -NRcC(0)Re, -NRcC(0)ORe, -NRcC(0)NRCRd -CF3, -OCF3, - OCHF2, -C 3 _ 6 cycloalkyl, and -C 2 _ 5 cycloheteroalkyl.
• R a is selected from the group consisting of: halogen, -ORe, -NRcS(0) m Re, -S(0) m Re, -S(0) m NRCRd .
• R a is selected from the group consisting of: halogen, -ORe, -S(0) m Re, -NRCRd -CN, -CF3, -OCF3, and -OCHF2.
• R a is selected from the group consisting of: halogen, -CN, -CF3, -OCF3, and -OCHF2.
• R a is selected from the group consisting of: halogen, and -CF3. In a subclass of this class, R a is selected from the group consisting of: F, and -CF3. In a subclass of this class, R a is -CF3. In another class of this embodiment, R a is F.
• R a is selected from the group consisting of: -ORe, -NRcS(0) m Re, -S(0) m Re, -S(0) m NRCRd -NRCRd -C(0)Re ? -OC(0)Re ? -C02R e , - CN, -C(0)NRCRd -NRcC(0)Re, -NRcC(0)ORe, -NRcC(0)NRCRd, -CF3, -OCF3, -OCHF2, -
• R a is selected from the group consisting of: -ORe, -NRcS(0) m Re, -S(0) m Re, -S(0) m NRCRd, -NRCRd -C(0)Re ? - OC(0)Re ? -C02R e , -CN, -C(0)NRCRd, -NRcC(0)Re, -NRcC(0)ORe, -NRcC(0)NRCRd, -CF3, -OCF3, and -OCHF2.
• R a is selected from the group consisting of: -ORe, -S(0) m Re, -NRCRd -CN, -CF3, -OCF3, and -OCHF2. In another class of this embodiment, R a is selected from the group consisting of: -CN, -CF3, -OCF3, and -OCHF2. In another class of this embodiment, R a is -CF3.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -C2-10 alkenyl, halogen, -OH, -OCi-ioalkyl, -OC2-10 alkenyl, -0(CH2)pOCi-i()alkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3-6cycloalkyl-Ci-io alkyl-, -O(CH2)pC2-10cycloheteroalkyl, -0(CH2)pC 2 _5cycloheteroalkyl-Ci-io alkyl-, -O-aryl, - O-heteroaryl, -O-aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m Re, - S(0) m Re, - S
• Rb is unsubstituted or substituted with one to five substituents selected from Rk, provided that when B is phenyl or imidazopyridine, then Rb is not selected from: halogen, -OCi-ioalkyl, - 0(CH2)pO-C2- lOcycloheteroalkyl, and -CF3.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -C2-10 alkenyl, halogen, -OH, -OCi_ lOalkyl, -OC2- 10 alkenyl, -0(CH2)pOCi_ioalkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3_ 6cycloalkyl-Ci-io alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pC 2 _ 5 cycloheteroalkyl-Ci- 10 alkyl-, -O-aryl, -O-heteroaryl, -O-aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -C2- 10 alkenyl, halogen, -OH, -OCi-ioalkyl, -OC2-10 alkenyl, -0(CH2)pOCi_ioalkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3-6cycloalkyl-Ci_io alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pC 2 _ 5 cycloheteroalkyl-Ci_ 10 alkyl-, -O-aryl, - O-heteroaryl, -O-aryl-Q-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m Re, - S(0) m Re, -
• Rb is unsubstituted or substituted with one to five substituents selected from Rk, provided that when B is phenyl or imidazopyridine, then Rb is not selected from halogen, and -OCi-ioalkyl.
• R b is independently selected from the group consisting of: -Ci_ lOalkyl, -C2- 10 alkenyl, halogen, -OH, -OCi-ioalkyl, -OC2- 10 alkenyl, -0(CH2)pOCi_ioalkyl, -0(CH2)pC3-6cycloalkyl, -0(CH2)pC3_6cycloalkyl-Ci-io alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pC 2 _ 5 cycloheteroalkyl-Ci_io alkyl-, -O-aryl, -O-heteroaryl, -O- aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m Re
• Rb is not selected from F, CI, and -OCH3.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -C2-10 alkenyl, halogen, -OH, -OCl-lOalkyl, -OC2-10 alkenyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3-6cycloalkyl, -O(CH2)pC3-6cycloalkyl-Cl-l0 alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -O(CH2)pC 2 -5cycloheteroalkyl-Cl-l0 alkyl-, -O-aryl, - O-heteroaryl, -O-aryl-Cl-lO alkyl-, -O-heteroaryl-Cl-lO alkyl-l-lO alkyl--
• Rb is unsubstituted or substituted with one to five substituents selected from Rk, provided that when B is phenyl or imidazopyridine, then Rb is not selected from: -OCl-lOalkyl.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -C2- 10 alkenyl, halogen, -OH, -OCl-lOalkyl, -OC2- 10 alkenyl, -O(CH2)pOCl-l0alkyl, - 0(CH2)pC3-6cycloalkyl, -O(CH2)pC3_6cycloalkyl-Cl-l0 alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -O(CH2)pC 2 _5Cycloheteroalkyl-Cl-l0 alkyl-, -O-aryl, -O-heter
• Rb is not selected from: -OCH3.
• Rb is independently selected from the group consisting of: -Cl-lOalkyl, -C2- 10 alkenyl, halogen, -OH, -OCl-lOalkyl, -OC2- 10 alkenyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3-6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Cl-10 alkyl-, - 0(CH2)pC2- lOcycloheteroalkyl, -O(CH2)pC 2 _ 5 cycloheteroalkyl-Cl-l0 alkyl- -O-aryl, -O- heteroaryl, -O-aryl-Cl-lO alkyl-, -O-heteroaryl-Cl-lO alkyl-, -NR C S(0) m R e , -S(0) m R e
• Rb is independently selected from the group consisting of: -Cl-lOalkyl, -C2- 10 alkenyl, halogen, -OH, -OCl-lOalkyl, -OC2- 10 alkenyl, -0(CH2)pOCl- lOalkyl, -0(CH2)pC3-6cycloalkyl, -0(CH2)pC3-6 cycloalkyl-Cl-10 alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -O(CH2)pC 2 _5Cycloheteroalkyl-Cl-l0 alkyl- -O-aryl, -O-heteroaryl, -O- aryl-Cl-10 alkyl-, -O-heteroaryl-Cl-lO alkyl-, -NR C S(0) m R e , -S(0) m R
• R b is independently selected from the group consisting of: -Cl-lOalkyl, halogen, -OH, -OCl-lOalkyl, -O(CH2)pOCl-l0alkyl, - 0(CH2)pC3-6cycloalkyl, -0(CH2)pC2- 1 Ocycloheteroalkyl, -0(CH2)pO-C2- 1 Ocycloheteroalkyl, -CF3, -OCF3, -OCHF2, -(CH2)p-C2-l Ocycloheteroalkyl, and -S(O)2Cl-l0alkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk, or a
• R b is
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk, or a pharmaceutically acceptable salt thereof.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, halogen, -OH, -OCl-lOalkyl, -O(CH2)pOCl-l0alkyl, - 0(CH2)pC3-6cycloalkyl, -0(CH2)pC2-l Ocycloheteroalkyl, -CF3, -OCF3, -OCHF2, -(CH2)p- C2-1 Ocycloheteroalkyl, -0-Cl-6alkyl-0-isosorbide and -O- Cl-6alkyl-0-isomannide, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, halogen, -OH, -OCl-lOalkyl, -0(CH2)pC2-l Ocycloheteroalkyl, -CF3, -(CH2)p-C2- 1 Ocycloheteroalkyl, -0-Cl-6alkyl-0-isosorbide and -O- Cl-6alkyl-0-isomannide, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 0H, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S02CH3, F, CI, I, -OH, -OCl-lOalkyl, -OCH 3 , -OCH 2 C(CH 3 ) 2 OH, -
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S02CH3, F, CI, I, -OH, -OCl-lOalkyl, -OCH 3 , -OCH 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, -OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , - 0(CH2)3S02CH3, -OCH 2 CH(OH)CH 2 OH, -OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH2) 3 C(CH 3 ) 2 CN, -O- (
• R b is independently selected from the group consisting of: -CH3, - (CH2)4S02CH3, F, I, -OH, -OCl-lOalkyl, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, -OCH 2 C(CH 2 OH) 2 CH 3 , - 0(CH2)3C(CH 3 ) 2 CN, -OCH2-oxetane, -OCH2-tetrahydropyran, -CF3, and pyrrolidine, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -C2-10 alkenyl, halogen, -OH, -OCl-lOalkyl, -OC2-10 alkenyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3-6cycloalkyl, -0(CH2)pC3-6 cycloalkyl-Cl-lO alkyl-, - O(CH2)pC2-10cycloheteroalkyl, -O(CH2)pC 2 _ 5 cycloheteroalkyl-Cl-l0 alkyl-, -O-aryl, -O- heteroaryl, -O-aryl-Cl-lO alkyl-, -O-heteroaryl-Cl-lO alkyl-; -NR C S(0) m R e , -S(0) m R e ,
• Rb is independently selected from the group consisting of: -Cl-lOalkyl, halogen, -OH, -OCl-lOalkyl, -O(CH2)pOCl-l0alkyl, -
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -C2- 10 alkenyl, halogen, -OH, -OCl-lOalkyl, -0(CH2)pOCl- lOalkyl, -0(CH2)pC3-6cycloalkyl, -O(CH2)pC2-10cycloheteroalkyl, -CF3, -OCF3, -OCHF2, - (CH2)p-C3-6cycloalkyl, -(CH2)p-C2-10cycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, halogen, -OH, -OCl-lOalkyl, -O(CH2)pOCl-l0alkyl, -
• R b is independently selected from the group consisting of: -Ci-ioalkyl, halogen, -OH, -OCi-ioalkyl, -0(CH2)pC2- lOcycloheteroalkyl, -CF3, -(CH2)p-C2-10cycloheteroalkyl,
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 0H, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S02CH3, F, CI, I, -OH, -OCi-ioalkyl, -OCH 3 , -OCH 2 C(CH 3 ) 2 OH, -
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, - (CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, -(CH 2 )4S0 2 CH3, F, CI, I, -OH, -OCi-iOalkyl, -OCH 3 ,
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S0 2 CH 3 , F, CI, I, -OH, -OCH 3 , -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, - OCH 2 CH(OH)CH 2 OH, -OCH 2 C(CH 2 OH) 2 CH 3 , -OCH2CF2CF3, -0(CH2) 3 C(CH 3 ) 2 CN, - 0(CH3, 0(CH 2
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 0H, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S0 2 CH 3 , F, CI, I, -OH, -OCH 3 , -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, - OCH 2 CH(OH)CH 2 OH, -OCH 2 C
• R b is independently selected from the group consisting of: -CH3, -(CH2)4S02CH3, F, I, -OH, -OCH 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH 2 )3S0 2 CH3, - OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH2) 3 C(CH 3 ) 2 CN, -OCH2-methyloxetane, -OC3 ⁇ 4- fluorotetrahydropyran, -CF3, and (methylsulfonyl)methylpyrrolidine, wherein each Rb
• Rb is independently selected from the group consisting of: -Ci-ioalkyl, -C2-10 alkenyl, -OH, -OC2-10 a lkyl, -OC2-10 alkenyl, - 0(CH2)pOCi-ioalkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Ci-io alkyl-, - 0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pC 2 _ 5 cycloheteroalkyl-Ci_ 10 alkyl- -O-aryl, -O- heteroaryl, -O-aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m Re, - S(0)
• Rb is independently selected from the group consisting of: -Ci-ioalkyl, -C2- 10 alkenyl, -OH, -OC2-10alkyl, -OC2- 10 alkenyl, -0(CH2)pOCi_ioalkyl, -0(CH2)pC3-6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Ci-io alkyl-, -0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pC 2 _ 5 cycloheteroalkyl-Ci_io alkyl- -O-aryl, -O-heteroaryl, -O- aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m Re, -S(0) m Re, -S
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -OH, -OC2-10alkyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3- 6cycloalkyl, -0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pO-C2- lOcycloheteroalkyl, -CF3, - OCF3, -OCHF2, -(CH2)p-C2- lOcycloheteroalkyl, and -S(O)2Cl-l0alkyl, wherein each R is unsubstituted or substituted with one to five substituents selected from Rk, or a pharmaceutically acceptable salt thereof.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, halogen, -OH, -OCl-lOalkyl, -0(CH2)pC2- lOcycloheteroalkyl, -0(CH2)pO-C2- lOcycloheteroalkyl, -CF3, -(CH2)p-C2- lOcycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk, or a pharmaceutically acceptable salt thereof.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -OH, -OC2-10alkyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3- 6cycloalkyl, -0(CH2)pC2- lOcycloheteroalkyl, -CF3, -OCF3, -OCHF2, -(CH2)p-C2- 1 ocycloheteroalkyl, -O-C 1 -6alkyl-0-isosorbide and -O- C 1 _6alkyl-0-isomannide, wherein each
• Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -OH, - OC2-10alkyl, -0(CH2)pC2- lOcycloheteroalkyl, -CF3, -(CH2)p-C2- lOcycloheteroalkyl, -O-Ci- 6alkyl-0-isosorbide and -O- Cl-6alkyl-0-isomannide, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -CH3, - CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, -(CH2)4S02CH 3i -OH, -OCH 2 C(CH 3 ) 2 OH,
• R b is independently selected from the group consisting of: -CH3, - (CH2)4S0 2 CH 3 , -OH, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, - 0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S0 2 CH 3 , -OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH 2 ) C(CH 3 ) 2 CN, - OCH2-oxetane, -OCH2-tetrahydropyran, -CF3, and pyrrolidine, wherein each Rb is
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -C2-10 alkenyl, -OH, -OC2-10 a lkyl, -OC2-10 alkenyl, - 0(CH2)pOCi-ioalkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Ci-io alkyl-, - O(CH2)pC2-10cycloheteroalkyl, -0(CH2)pC 2 _ 5 cycloheteroalkyl-Ci_ 10 alkyl-, -O-aryl, -O- heteroaryl, -O-aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-; -NRcS(0) m Re, -S(0) m Re, - S(0)
• Rb is independently selected from the group consisting of: -Ci-ioalkyl, -OH, -OC2-10 a lkyl, -0(CH2)pOCi_ioalkyl, -0(CH2)pC3_ 6cycloalkyl, -O(CH2)pC2-10cycloheteroalkyl, -O-aryl, -O-heteroaryl, -CF3, -OCF3, -OCHF2, - (CH2)p-C3_6cycloalkyl, -(CH2)p-C2-10cycloheteroalkyl, aryl, and heteroaryl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -C2- 10 alkenyl, -OH, -OC2-10 a lkyl, -0(CH2)pOCi_ioalkyl, - 0(CH2)pC3_6cycloalkyl, -O(CH2)pC2-10cycloheteroalkyl, -CF3, -OCF3, -OCHF2, -(CH2)p- C3_6cycloalkyl, -(CH2)p-C2-10cycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -OH, -OC2-10 a lkyl, -0(CH2)pOCi_ioalkyl, -0(CH2)pC3_ 6cycloalkyl, -O(CH2)pC2-10cycloheteroalkyl, -CF3, -OCF3, -OCHF2, -(CH2)p-C2- lOcycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -OH, -OC2-10 a lkyl, -O(CH2)pC2-10cycloheteroalkyl, -CF3, - (CH2)p-C2-10cycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S0 2 CH 3 , -OH, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, - OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, -OCH 2 CH(OH)CH 2 OH, - OCH 2 C(CH 2 OH) 2 CH 3 , -
• R b is independently selected from the group consisting of: -CH3, -(CH2)4S02CH3, -OH, -OC2-10alkyl, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, - 0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S0 2 CH 3 , -OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH 2 ) C(CH 3 ) 2 CN, - OCH2-oxetane, -OCH2-tetrahydropyran, -CF3, and pyrrolidine, wherein each Rb is
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, z
• R b is independently selected from the group consisting of: -CH 3 , -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, -(CH 2 )4S0 2 CH3, -OH, -
• R b is independently selected from the group consisting of: -CH3, -(CH2)4S02CH3, -OH, -OCH 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH 2 )3S0 2 CH3, - OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH2) 3 C(CH 3 ) 2 CN, -OCH2-methyloxetane, -OC3 ⁇ 4- fluorotetrahydropyran, -CF3, and (methylsulfonyl)methyl -pyrrolidine, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• Rb is independently selected from the group consisting of: -Ci-ioalkyl, -C2-10 alkenyl, OH, -OC2-10 a lkyl, -OC2-10 alkenyl, - 0(CH2)pOCi-ioalkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Ci-io alkyl-, -O- aryl, -O-heteroaryl, -O-aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, - S(0) m Re, -S(0) m NRCRd -NRCRd, -C(0)Re -OC(0)Re -C02R e , -CN, -C(0)NRCRd, - NRcC(0)
• Rb is independently selected from the group consisting of: -Ci-ioalkyl, -C2- 10 alkenyl, OH, -OC2-10alkyl, -OC2- 10 alkenyl, -0(CH2)pOCi_ioalkyl, - 0(CH2)pC3-6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Ci-io alkyl-, -O-aryl, -O-heteroaryl, -O- aryl-Ci-io alkyl-, -O-heteroaryl-Ci-io alkyl-, -NRcS(0) m Re, -S(0) m Re, -S(0) m NRCRd, - NRCRd, -C(0)Re -OC(0)Re -C02R e , -CN, -C(0)NRCRd, -NRcC(0)
• R b is independently selected from the group consisting of: -Ci-ioalkyl, OH, -OC2-10 a lkyl, -0(CH2)pOCi-ioalkyl, -0(CH2)pC3_ 6cycloalkyl, -0(CH2)pO-C2- lOcycloheteroalkyl, -OCF3, -OCHF2, -(CH2)p-C2- lOcycloheteroalkyl, and -S(0)2Ci_ioalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk, or a pharmaceutically acceptable salt thereof.
• R b is independently selected from the group consisting of: -Ci_ 1 oalkyl, -OC2- 10alkyl,-O(CH2)pO-C2- 1 Qcycloheteroalkyl, -(CH2)p-C2- 1 Qcycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk, or a pharmaceutically acceptable salt thereof.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, OH, -OC2-10 a lkyl, -0(CH2)pOCi_i()alkyl, -0(CH2)pC3_ 6 c y c l° a lkyl, -OCF3, -OCHF2, -(CH2)p-C2-10cycloheteroalkyl, -0-Ci_6alkyl-0-isosorbide and - 0-Ci_6alkyl-0-isomannide, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, OH, -OC2-10 a lkyl, -0-Ci_6alkyl-0-isosorbide and -O- Ci_ galkyl-O-isomannide, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, OH, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, -(CH2)4S0 2 CH 3 , -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, - OCH 2 CH(OH)CH 2 OH, -OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH2) C(CH 3 ) 2 CN, -0-(CH2>2-0- CH2C(CH 3 ) 2 OH, -0(CH 2 ) 2 CN, -0-(
• R b is independently selected from the group consisting of: -CH3, -(CH2)4S02CH3, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, -OCH 2 C(CH 2 OH) 2 CH 3 , -
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Ci-ioalkyl, -C2-10 alkenyl, -OC2-10 a lkyl, -OC2-10 alkenyl, - 0(CH2)pOCi-ioalkyl, -0(CH2)pC3_6cycloalkyl, -0(CH2)pC3_6 cycloalkyl-Ci-io alkyl.
• Rb is independently selected from the group consisting of: -Cl-lOalkyl, -OC2-10alkyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3-
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -C2-10 alkenyl, -OC2-10alkyl, -O(CH2)pOCl-l0alkyl, - 0(CH2)pC3-6cycloalkyl, -OCF3, -OCHF2, -(CH2)p-C3_6cycloalkyl, -(CH2)p-C2- lOcycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -OC2-10alkyl, -O(CH2)pOCl-l0alkyl, -0(CH2)pC3- 6cycloalkyl, -OCF3, -OCHF2, -(CH2)p-C2- lOcycloheteroalkyl, wherein each Rb is
• R b is independently selected from the group consisting of: -Cl-lOalkyl, -OC2- lOalkyl, -(CH2)p-C2- lOcycloheteroalkyl, wherein each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S02CH3, -OC2-10alkyl, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, - OCH 2 CH(OH)CH 2 OH, -OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH2) 3 C(CH 3 ) 2 CN, -0-(CH2)2-0- CH2C(CH 3 ) 2 OH, -0(CH 2
• R b is independently selected from the group consisting of: -CH3, -CH2CH3, -(CH 2 ) 2 C(CH 3 ) 2 OH, -(CH 2 ) 3 C(CH 3 ) 2 OH, - (CH2)4S0 2 CH 3 , -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, -0(CH 2 ) 3 C(CH 3 ) 2 OH, - OCH 2 CH(OH)CH 3 , -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S02CH3, -OCH 2 CH(OH)CH 2 OH, - OCH 2 C(CH 2 OH) 2 CH 3 , -0(CH 2 ) 3 , -0(CH2)3S02CH3, -OCH 2 CH(OH)CH 2 OH, - OCH 2 C(CH 2 OH) 2 CH 3 , -0(
• R b is independently selected from the group consisting of: -CH3, -(CH2)4S02CH3, -OCH 2 C(CH 3 ) 2 OH, -0(CH 2 ) 2 C(CH 3 ) 2 OH, - 0(CH 2 ) 3 C(CH 3 ) 2 OH, -0(CH 2 ) 2 CH(OH)CH 3 , -0(CH2)3S0 2 CH 3 , -OCH 2 C(CH 2 OH) 2 CH 3 , -
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• Rb is -OCi-ioalkyl, wherein Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• Rb is -OC2-10 a lkyl, wherein Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• Rb is -OC3-ioalkyl, wherein Rb is unsubstituted or substituted with one to five substituents selected from Rk.
• Rb is - 0(CH 2 )3S0 2 CH 3 .
• R c and R ⁇ are each independently selected from the group consisting of: hydrogen, -Ci_ioalkyl, -C2-10 a lkenyl, -C3_6cycloalkyl, - C3-6 cycloalkyl-Ci-iQalkyl-, -C2-5cycloheteroalkyl, -C2-5cycloheteroalkyl-Ci_ioalkyl-, aryl, heteroaryl, aryl-Cl-l()alkyl-, and heteroaryl-Cl-lOalkyl-, or R c and Rd together with the atom(s) to which they are attached form a cycloheteroalkyl ring of 4 to 7 members containing 0-2 additional heteroatoms independently selected from oxygen, sulfur and N-Rg, and wherein each Rc and Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• R c and Rd are each independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10alkenyl, -C3-6cycloalkyl, -C2- 5 cycloheteroalkyl, aryl, and heteroaryl, or R c and Rd together with the atom(s) to which they are attached form a cycloheteroalkyl ring of 4 to 7 members containing 0-2 additional heteroatoms independently selected from oxygen, sulfur and N-Rg, and wherein each Rc and Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• R c and Rd are each independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, and -C2-10 a lkenyl, or Rc and Rd together with the atom(s) to which they are attached form a cycloheteroalkyl ring of 4 to 7 members containing 0-2 additional heteroatoms independently selected from oxygen, sulfur and N-Rg, and wherein each Rc and Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• R c and Rd are each independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10 a lkenyl, -C3-6cycloalkyl, - C3-6 cycloalkyl-Cl-lOalkyl-, -C2-5 cycloheteroalkyl, -C2-5cycloheteroalkyl-Cl-l0alkyl-, aryl, heteroaryl, aryl-C 1.1 Oalkyl-, and heteroaryl-C 1.1 Oalkyl-, wherein each R c and Rd is
• R c and Rd are each independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10 a lkenyl, -C3-6cycloalkyl, -C2-5 cycloheteroalkyl, aryl, and heteroaryl, wherein each Rc and Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• R c and Rd are each independently selected from the group consisting of: hydrogen, -Cl-l Oalkyl, and -C2-10 a lkenyl, wherein each Rc and Rd is unsubstituted or substituted with one to three substituents
• R c is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10 a lkenyl, -C3-6cycloalkyl, -C3-6 cycloalkyl- Cl-ioalkyl-, -C2-5 cycloheteroalkyl, -C2-5cycloheteroalkyl-Cl-l Oalkyl-, aryl, heteroaryl, aryl- Cl-ioalkyl-, and heteroaryl-C l-l Oalkyl-, wherein each Rc is unsubstituted or substituted with one to three substituents independently selected from Rf.
• R c is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10 a lkenyl, -C3- 6cycloalkyl, -C2-5 cycloheteroalkyl, aryl, and heteroaryl, wherein each Rc is unsubstituted or substituted with one to three substituents independently selected from Rf.
• R c is independently selected from the group consisting of: hydrogen, -Cl-lQalkyl, and -C2-10 a lkenyl, wherein each Re is unsubstituted or substituted with one to three substituents independently selected from Rf.
• Rd is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10 a lkenyl, -C3-6cycloalkyl, -C3-6 cycloalkyl- Cl-lOalkyl-, -C2-5cycloheteroalkyl, -C2-5cycloheteroalkyl-Cl-l0alkyl-, aryl, heteroaryl, aryl- Cl-ioalkyl-, and heteroaryl-Cl-lOalkyl-, wherein each Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• Rd is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2-10alkenyl, -C3- 6cycloalkyl, -C2-5 cycloheteroalkyl, aryl, and heteroaryl, wherein each Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• Rd is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, and -C2-10alkenyl, wherein each Rd is unsubstituted or substituted with one to three substituents independently selected from Rf.
• each R e is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2- 10 alkenyl, -C3-6 cycloalkyl, -C3-6 cycloalkyl-Cl-lOalkyl-, -cycloheteroalkyl, cycloheteroalkyl-Cl-lOalkyl-, aryl, heteroaryl, aryl- Cl-ioalkyl-, and heteroaryl-Cl-lOalkyl-, wherein each Re is unsubstituted or substituted with one to three substituents selected from Rh.
• each R e is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, -C2- 10 alkenyl, -C3-6 cycloalkyl, -C3-6 cycloalkyl-Cl-lOalkyl-, -cycloheteroalkyl, cycloheteroalkyl-C
• each R e is independently selected from the group consisting of: hydrogen, -Cl-lOalkyl, and -C2- 10 alkenyl, wherein each Re is unsubstituted or substituted with one to three substituents selected from Rh.
• each R e is independently selected from the group consisting of: hydrogen, and -Cl-lOalkyl, wherein each Re is unsubstituted or substituted with one to three substituents selected from Rh.
• each R e is -Cl- lOalkyl, wherein each Re is unsubstituted or substituted with one to three substituents selected from Rh.
• each R e is -Cl-lOalkyl.
• each R e is hydrogen.
• each Rf is selected from the group consisting of: halogen, -Cl-lOalkyl, -OH, -0-Cl-4alkyl, -S(0) m -Cl-4alkyl, -CN, -CF3, - OCHF2, and -OCF3, wherein each Cl-10 alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each Rf is selected from the group consisting of: halogen, -Cl_ lOalkyl, -OH, -0-Cl-4alkyl, -CN, -CF3, -OCHF2, and -OCF3, wherein each Cl-10 alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each Rf is selected from the group consisting of: halogen, -Ci-ioalkyl, -OH, -CN, -CF3, -OCHF2, and -OCF3, wherein each C i-io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each Rf is selected from the group consisting of: halogen, and -C i-ioalkyl, wherein each C i_io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each RB is selected from the group consisting of: hydrogen, -C(0)Re, and -Ci-ioalkyl, wherein -Ci-ioalkyl is unsubstituted or substituted with one to five fluorines.
• each Rh is selected from the group consisting of: halogen, -Ci-ioalkyl, -OH, -0-Ci_4alkyl, -S(0) m -C i-4alkyl, -CN, -CF3, - OCHF2, and -OCF3, wherein each C i-io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each Rh is selected from the group consisting of: halogen, -Ci-ioalkyl, -OH, -O- Ci-4alkyl, -CN, -CF3, -OCHF2, and -OCF3, wherein each C i-io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each Rh is selected from the group consisting of: halogen, -Ci-ioalkyl, -OH, -CN, -CF3, -OCHF2, and -OCF3, wherein each Ci-io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• each Rh is selected from the group consisting of: halogen, and -C i-ioalkyl, wherein each C i_io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, halogen, cyano, and -S(0) 2 CH 3 .
• R 1 is independently selected from the group consisting of: -Ci_ 6 alkyl, -ORe, -NRcS(0) m Re, halogen, -S(0) m Re, -S(0) m NRCRd, . NRCRd -C(0)Re -OC(0)Re -C02R e , -CN, -C(0)NRCRd, -NRcC(0)Re, -NRcC(0)ORe, - NRcC(0)NRCRd -CF3, -OCF3, -OCHF2, -C 3 _ 6 cycloalkyl, and -C 2 _ 5 cycloheteroalkyl.
• R 1 is selected from the group consisting of: -Ci_ 6 alkyl, halogen, - ORe, -NRCRd, -C(0)Re -OC(0)Re -C02R e , -CN, -CF3, -OCF3, and -OCHF2.
• R 1 is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -CN, - CF3, -OCF3, and -OCHF2.
• R 1 is -CF3.
• RJ is independently selected from the group consisting of: -Ci_ 6 alkyl, -ORe, -NRcS(0) m Re, halogen, -S(0) m Re, -S(0) m NRCRd, . NRCRd, -C(0)Re ? -OC(0)Re ? -C02R e , -CN, -C(0)NRCRd, -NRcC(0)Re, -NRcC(0)ORe, - NRcC(0)NRCRd, -CF3, -OCF3, -OCHF2, -C 3 _ 6 cycloalkyl, and -C 2 _ 5 cycloheteroalkyl.
• RJ is selected from the group consisting of: -Ci_ 6 alkyl, halogen, - ORe, -NRCRd, -C(0)Re ? -OC(0)Re ? -C02R e , -CN, -CF3, -OCF3, and -OCHF2.
• RJ is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -CN, - CF3, -OCF3, and -OCHF2.
• RJ is -CF3.
• each Rk is independently selected from the group consisting of: -CH 3 , -CH 2 OH, -OH, F, -SO2CH3, - CH2SO2CH3, CN and -P(0)(OCH3)2, wherein each -CH 3 is unsubstituted or substituted with one to three substituents independently selected from: -OH, -OCi_6alkyl, halogen, cyano, and - S(0) 2 Ci-6alkyl.
• each Rk is independently selected from the group consisting of: -CH 3 , -CH 2 OH, -OH, F, -SO2CH3, -CH2SO2CH3, CN and -P(0)(OCH3)2, wherein each -CH3 is unsubstituted or substituted with one to three -OH.
• each Rk is independently selected from the group consisting of: -CH 3 , -CH 2 OH, -OH, F, -SO2CH3, -CH2SO2CH3 and -P(0)(OCH3)2,
• each Rk is independently selected from the group consisting of: -Ci-io alkyl, -OH, halogen, - SO2-C1-6 alkyl, -Ci-6 alkyl-S02Ci_6alkyl, and -CN, wherein each Ci-io alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, -OCi_6alkyl, halogen, cyano, and -S(0) 2 Ci-6alkyl.
• each Rk is independently selected from the group consisting of: -CH 3 , -CH 2 OH, -OH, F, -SO2CH3, -CH2SO2CH3, and
• each Rk is independently selected from the group consisting of: - CH 3 , -CH 2 OH, -OH, F, -SO2CH3, -CH2SO2CH3, and CN, wherein each -CH 3 is unsubstituted or substituted with one to three -OH.
• each Rk is independently selected from the group consisting of: -CH 3 , -CH 2 OH, -OH, F, -SO2CH3, -CH2SO2CH3.
• each Rk is independently selected from the group consisting of: - CH 3 , OCH3,_-CH 2 OH, -OH, F, -SO2CH3, -CH2SO2CH3, and CN, wherein each -CH 3 is unsubstituted or substituted with one to three -OH.
• each Rk is independently selected from the group consisting of: -Cl-10 alkyl, -OH, halogen, - SO2-CI-6 alkyl, -Cl-6 alkyl-S02Cl-6alkyl, and -CN, wherein each Cl-6 alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, -OCl-6alkyl, halogen, cyano, and -S(0) 2 Cl-6alkyl.
• each Rk is independently selected from the group consisting of: -SO2-CI-6 alkyl, and -Cl-6 alkyl-S02Cl-6alkyl, wherein each Cl-6 alkyl is unsubstituted or substituted with one to three substituents independently selected from: - OH, -OCl-6alkyl, halogen, cyano, and -S(0) 2 Cl-6alkyl.
• each Rk is independently selected from the group consisting of: -SO2CH3, and -CH2SO2CH3, wherein each -CH 3 is unsubstituted or substituted with one to three -OH.
• each Rk is independently selected from the group consisting of: -SO2CH3, and - CH2SO2CH3.
• RL is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -ORe, -NRCS(0) m R e , -S(0) m R e , -S(0) m NRCRd -NRCRd -C(0)Re - OC(0)Re -C02R e , -CN, -C(0)NRCRd -NRCC(0)Re, -NRCC(0)ORe, -NRCC(0)NRCRd -CF3, -OCF3, -OCHF2, -C3_ 6 cycloalkyl, and -C 2 - 5 cycloheteroalkyl.
• R ⁇ is selected from the group consisting of: -Ci_ 6 alkyl, halogen, -OR e , -NR c Rd, -C(0)R e ? - OC(0)Re -C02R e , -CN, -CF3, -OCF3, and -OCHF2.
• R L is selected from the group consisting of: -Ci_6alkyl, halogen, -CN, -CF3, -OCF3, and -OCHF2.
• R ⁇ is -CF3.
• n is 0, 1, 2, 3 or 4. In a class of this embodiment, n is 0, 1, 2 or 3. In another class of this embodiment, n is 0, 1 or 2. In a class of this embodiment, n is 0 or 1. In a class of this embodiment, n is 1, 2, 3 or 4. In another class of this embodiment, n is 1, 2 or 3. In another class of this embodiment, n is 1 or 2. In another class of this embodiment, n is 0. In another class of this embodiment, n is 1. In another class of this embodiment, n is 2. In another class of this embodiment, n is 3. In another class of this embodiment, n is 4.
• m is 0, 1 or 2. In a class of this embodiment, m is 0 or 1. In another class of this embodiment, m is 1 or 2. In another class of this embodiment, m is 0. In another class of this embodiment, m is 1. In another class of this embodiment, m is 2. In another embodiment of the present invention, p is 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10. In another embodiment of the present invention, p is 0, 1, 2, 3, 4, 5, 6, 7 or 8. In another embodiment of the present invention, p is 0, 1, 2, 3, 4, 5 or 6. In another embodiment of the present invention, p is 0, 1, 2, 3 or 4. a class of this embodiment, p is 0, 1, 2 or 3. In a class of this embodiment, p is 0, 1 or 2.
• p is 1, 2, 3, 4, 5, 6, 7, 8, 9 or 10. In another embodiment of the present invention, p is 1, 2, 3, 4, 5, 6, 7 or 8. In another embodiment of the present invention, p is 1, 2, 3, 4, 5 or 6. In another embodiment of the present invention, p is 1, 2, 3 or 4. In a class of this embodiment, p is 1, 2 or 3. In a class of this embodiment, p is 1 or 2. In another class of this embodiment, p is 0 or 1. In another class of this embodiment, p is 0 or 2. In another class of this embodiment, p is 0. In another class of this embodiment, p is 1. In another class of this embodiment, p is 2. In another class of this embodiment, p is 3. In another class of this embodiment, p is 4.
• p is 5. In another class of this embodiment, p is 6. In another class of this embodiment, p is 7. In another class of this embodiment, p is 8. In another class of this embodiment, p is 9. In another class of this embodiment, p is 10.
• the invention relates to compounds of structural formula la
• the invention relates to compounds of structural formula lb:
• the invention relates to compounds of structural formula I
• the invention relates to compounds of structural formula I
• the invention relates to compounds of structural formula
• the invention relates to compounds of structural formula If:
• the compound of structural formula I includes the compounds of structural formulas la, lb, Ic, Id, Ie, If and lg, and pharmaceutically acceptable salts, hydrates and solvates thereof.
• n 1;
• X is oxygen
• T CH
• V is CH
• A is selected from the group consisting of: aryl and heteroaryl, wherein A is unsubstituted or substituted with one to five substituents selected from R a ;
• B is selected from the group consisting of: aryl and heteroaryl, wherein B is unsubstituted or substituted with one to five substituents selected from R b ,
• R 1 , R 2 , R 5 and R 6 are hydrogen
• R 3 and R 4 are selected from the group consisting of: hydrogen, halogen, and -Ci_ 6 alkyl, wherein each Ci_6alkyl is unsubstituted or substituted with one to three substituents selected from R L ; or a pharmaceutically acceptable salt thereof.
• n 1;
• X is oxygen
• T CH
• V is CH;
• A is selected from the group consisting of: phenyl and pyridine, wherein A is unsubstituted or substituted with one to five substituents selected from R a ;
• B is selected from the group consisting of phenyl, pyridine, pyrimidine, thiazole, benzimidazole, benzthiazole, benzoxazole, and benzisoxazole, wherein B is unsubstituted or substituted with one to five substituents selected from R b ;
• R 1 , R 2 , R 3 , R 4 , R 5 and R 6 are hydrogen
• R a is selected from the group consisting of: -Ci_6alkyl, halogen, and -CF3;
• R ⁇ is independently selected from the group consisting of:
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk;
• each Rk is independently selected from the group consisting of:
• each Cl-10 alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, -OC l-6alkyl, halogen, cyano, and -S(0) 2 Cl-6alkyl; or a pharmaceutically acceptable salt thereof.
• n 1;
• X is oxygen
• T CH
• V is CH
• A is phenyl, wherein phenyl is unsubstituted or substituted with one to five substituents selected from R a ;
• B is selected from the group consisting of phenyl, and pyridine, wherein B is unsubstituted or substituted with one to five substituents selected from R b ;
• R 1 , R 2 , R 3 , R 4 , R 5 and R 6 are hydrogen
• R a is selected from the group consisting of: -Ci_ 6 alkyl, halogen, and -CF3;
• Rb is independently selected from the group consisting of:
• each Rb is unsubstituted or substituted with one to five substituents selected from Rk;
• each Rk is independently selected from the group consisting of:
• each Cl-10 alkyl is unsubstituted or substituted with one to three substituents independently selected from: -OH, -OCl-6alkyl, halogen, cyano, and -S(0) 2 Cl-6alkyl;
• the compounds of formula I have the absolute stereochemistry at the two stereogenic carbon centers as indicated in the compound of structural formul
• stereoisomers including diastereoisomers, enantiomers, epimers, and mixtures of these may also have utility in treating GPR40 mediated diseases.
• Alkyl means saturated carbon chains which may be linear or branched or combinations thereof, unless the carbon chain is defined otherwise.
• alkyl groups include methyl, ethyl, propyl, isopropyl, butyl, sec- and tert-butyl, pentyl, hexyl, heptyl, octyl, nonyl, and the like.
• alkenyl means carbon chains which contain at least one carbon-carbon double bond, and which may be linear or branched, or combinations thereof, unless otherwise defined. Examples of alkenyl include vinyl, allyl, isopropenyl, pentenyl, hexenyl, heptenyl, 1-propenyl, 2- butenyl, 2-methyl-2-butenyl, and the like.
• Alkynyl means carbon chains which contain at least one carbon-carbon triple bond, and which may be linear or branched, or combinations thereof, unless otherwise defined. Examples of alkynyl include ethynyl, propargyl, 3-methyl-l-pentynyl, 2-heptynyl and the like.
• Cycloalkyl means a saturated monocyclic, bicyclic or bridged carbocyclic ring, having a specified number of carbon atoms. The term may also be used to describe a carbocyclic ring fused to an aryl group.
• cycloalkyl examples include cyclopropyl, cyclopentyl, cyclohexyl, cycloheptyl, and the like. In one embodiment of the present invention, cycloalkyl is selected from: cyclopropane, cyclobutane and cyclohexane.
• Cycloalkenyl means a nonaromatic monocyclic or bicyclic carbocylic ring containing at least one double bond.
• Examples of cycloalkenyl include cyclopropenyl, cyclobutenyl, cyclopentenyl, cyclohexenyl, cycloheptenyl, cyclooxtenyl and the like.
• Cycloheteroalkyl means a saturated or partly unsaturated non-aromatic monocyclic, bicyclic or bridged carbocyclic ring or ring system containing at least one ring heteroatom selected from N, NH, S (including SO and S02) and O.
• the cycloheteroalkyl ring may be substituted on the ring carbons and/or the ring nitrogen(s).
• cycloheteroalkyl examples include tetrahydrofuran, pyrrolidine, tetrahydrothiophene, azetidine, piperazine, piperidine, morpholine, oxetane and tetrahydropyran, hexose, pentose, isosorbide and isomannide, dianhydromannitol, 1, 4:3, 6-dianhydromannitol, 1, 4:3, 6-dianhydro[D]mannitol,
• cycloheteroalkyl is selected from: hexose, pentose, isosorbide and isomannide. In another embodiment of the present invention, cycloheteroalkyl is selected from: isosorbide and isomannide. In another embodiment of of the present invention, cycloheteroalkyl is selected from: oxetane, tetrahydropyran, azetidine, tetrahydrothiopyran and pyrrolidine.
• cycloheteroalkyl is selected from: oxetane, - piperazine, azetidine, pyrrolidine, morpholine and spiro(indene-l,4-piperidine).
• cycloheteroalkyl is oxetane.
• Cycloheteroalkenyl means a nonaromatic monocyclic, bicyclic or bridged carbocyclic ring or ring system containing at least one double bond and contaiing at least one heteroatom selected from N, NH, S and O.
• Aryl means a monocyclic, bicyclic or tricyclic carbocyclic aromatic ring or ring system containing 5-14 carbon atoms, wherein at least one of the rings is aromatic.
• aryl include phenyl and naphthyl. In one embodiment of the present invention, aryl is phenyl.
• Heteroaryl means monocyclic, bicyclic or tricyclic ring or ring system containing 5-14 carbon atoms and containing at least one ring heteroatom selected from N, NH, S (including SO and SO2) and O, wherein at least one of the heteroatom containing rings is aromatic.
• heteroaryl examples include pyrrolyl, isoxazolyl, isothiazolyl, pyrazolyl, pyridyl, oxazolyl, oxadiazolyl, thiadiazolyl, thiazolyl, imidazolyl, triazolyl, tetrazolyl, furanyl, triazinyl, thienyl, pyrimidyl, pyridazinyl, pyrazinyl, benzisoxazolyl, benzoxazolyl, benzothiazolyl, benzimidazolyl, benzofuranyl, benzothiophenyl (including S-oxide and dioxide), furo(2,3- b)pyridyl, quinolyl, indolyl, isoquinolyl, quinazolinyl, dibenzofuranyl, and the like.
• heteroaryl is selected from: pyridine, pyrimidine, thiazole, benzimidazole, benzthiazole, benzoxazole, and benzisoxazole.
• heteroaryl is pyridine.
• heteroaryl is imidazopyridine.
• Halogen includes fluorine, chlorine, bromine and iodine.
• any variable e.g., Rl, R a , etc.
• its definition on each occurrence is independent of its definition at every other occurrence.
• combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.
• a squiggly line across a bond in a substituent variable represents the point of attachment.
• substituted shall be deemed to include multiple degrees of substitution by a named substitutent. Where multiple substituent moieties are disclosed or claimed, the substituted compound can be independently substituted by one or more of the disclosed or claimed substituent moieties, singly or plurally. By independently substituted, it is meant that the (two or more) substituents can be the same or different.
• phrases "pharmaceutically acceptable” is employed herein to refer to those compounds, materials, compositions, salts and/or dosage forms which are, using sound medical judgment, and following all applicable government regulations, safe and suitable for
• % enantiomeric excess (abbreviated “ee) shall mean the % major enantiomer less the % minor enantiomer. Thus, a 70% enantiomeric excess corresponds to formation of 85% of one enantiomer and 15% of the other.
• enantiomeric excess is synonymous with the term “optical purity.”
• Compounds of Formula I may contain one or more asymmetric centers and can thus occur as racemates and racemic mixtures, single enantiomers, diastereomeric mixtures and individual diastereomers.
• the present invention is meant to encompass all such isomeric forms of the compounds of Formula I.
• the independent syntheses of optical isomers and diastereoisomers or their chromatographic separations may be achieved as known in the art by appropriate modification of the methodology disclosed herein.
• Their absolute stereochemistry may be determined by the X- ray crystallography of crystalline products or crystalline intermediates which are derivatized, if necessary, with a reagent containing an asymmetric center of known absolute configuration.
• racemic mixtures of the compounds may be separated so that the individual enantiomers are isolated.
• the separation can be carried out by methods well-known in the art, such as the coupling of a racemic mixture of compounds to an enantiomerically pure compound to form a diastereoisomeric mixture, followed by separation of the individual diastereoisomers by standard methods, such as fractional crystallization or chromatography.
• the coupling reaction is often the formation of salts using an enantiomerically pure acid or base.
• the diasteromeric derivatives may then be converted to the pure enantiomers by cleavage of the added chiral residue.
• the racemic mixture of the compounds can also be separated directly by
• any enantiomer of a compound may be obtained by stereoselective synthesis using optically pure starting materials or reagents of known configuration by methods well known in the art.
• Tautomers are defined as compounds that undergo rapid proton shifts from one atom of the compound to another atom of the compound. Some of the compounds described herein may exist as tautomers with different points of attachment of hydrogen. Such an example may be a ketone and its enol form known as keto-enol tautomers. The individual tautomers as well as mixture thereof are encompassed with compounds of Formula I.
• the atoms may exhibit their natural isotopic abundances, or one or more of the atoms may be artificially enriched in a particular isotope having the same atomic number, but an atomic mass or mass number different from the atomic mass or mass number predominately found in nature.
• the present invention is meant to include all suitable isotopic variations of the compounds of structural formula I.
• different isotopic forms of hydrogen (H) include protium ( 1 H), deuterium (2 H), and tritium ( 3 H).
• Protium is the predominant hydrogen isotope found in nature.
• Enriching for deuterium may afford certain therapeutic advantages, such as increasing in vivo half-life or reducing dosage requirements, or may provide a compound useful as a standard for characterization of biological samples.
• Tritium is radioactive and may therefore provide for a radiolabeled compound, useful as a tracer in metabolic or kinetic studies.
• Isotopically-enriched compounds within structural formula I can be prepared without undue experimentation by conventional techniques well known to those skilled in the art or by processes analogous to those described in the Schemes and Examples herein using appropriate isotopically-enriched reagents and/or intermediates.
• crystalline forms for compounds of the present invention may exist as polymorphs and as such are intended to be included in the present invention.
• some of the compounds of the instant invention may form solvates with water or common organic solvents. Such solvates are encompassed within the scope of this invention.
• Racemic mixtures can be separated into their individual enantiomers by any of a number of conventional methods. These include chiral chromatography, derivatization with a chiral auxiliary followed by separation by chromatography or
• references to the compounds of the present invention are meant to also include the pharmaceutically acceptable salts, and also salts that are not pharmaceutically acceptable when they are used as precursors to the free compounds or their pharmaceutically acceptable salts or in other synthetic manipulations.
• the compounds of the present invention may be administered in the form of a
• pharmaceutically acceptable salt refers to salts prepared from pharmaceutically acceptable non-toxic bases or acids including inorganic or organic bases and inorganic or organic acids. Salts of basic compounds encompassed within the term “pharmaceutically acceptable salt” refer to non-toxic salts of the compounds of this invention which are generally prepared by reacting the free base with a suitable organic or inorganic acid.
• Representative salts of basic compounds of the present invention include, but are not limited to, the following: acetate, benzenesulfonate, benzoate, bicarbonate, bisulfate, bitartrate, borate, bromide, camsylate, carbonate, chloride, clavulanate, citrate, dihydrochloride, edetate, edisylate, estolate, esylate, fumarate, gluceptate, gluconate, glutamate,
• glycollylarsanilate hexylresorcinate, hydrabamine, hydrobromide, hydrochloride
• suitable pharmaceutically acceptable salts thereof include, but are not limited to, salts derived from inorganic bases including aluminum, ammonium, calcium, copper, ferric, ferrous, lithium, magnesium, manganic, mangamous, potassium, sodium, zinc, and the like. Particularly preferred are the ammonium, calcium, magnesium, potassium, and sodium salts.
• Salts derived from pharmaceutically acceptable organic non-toxic bases include salts of primary, secondary, and tertiary amines, cyclic amines, and basic ion-exchange resins, such as arginine, betaine, caffeine, choline, N,N- dibenzylethylenediamine, diethylamine, 2-diethylaminoethanol, 2-dimethylaminoethanol, ethanolamine, ethylenediamine, N-ethylmorpholine, N-ethylpiperidine, glucamine, glucosamine, histidine, hydrabamine, isopropylamine, lysine, methylglucamine, morpholine, piperazine, piperidine, polyamine resins, procaine, purines, theobromine, triethylamine, trimethylamine, tripropylamine, tromethamine, and the like.
• basic ion-exchange resins such as arginine, betaine, caffeine, choline
• esters of carboxylic acid derivatives such as methyl, ethyl, or pivaloyloxymethyl
• acyl derivatives of alcohols such as O-acetyl, O-pivaloyl, O-benzoyl, and O-aminoacyl
• esters and acyl groups known in the art for modifying the solubility or hydrolysis characteristics for use as sustained-release or prodrug formulations.
• Solvates, and in particular, the hydrates of the compounds of the present invention are included in the present invention as well.
• the compounds of the present invention are potent agonists of the GPR40 receptor.
• the compounds, and pharmaceutically acceptable salts thereof, may be efficacious in the treatment of diseases that are modulated by GPR40 ligands, which are generally agonists. Many of these diseases are summarized below.
• One or more of these diseases may be treated by the administration of a therapeutically effective amount of a compound of the present invention, or a pharmaceutically acceptable salt thereof, to a patient in need of treatment.
• the compounds of the present invention may be used for the manufacture of a medicament which may be useful for treating one or more of these diseases:
• non-insulin dependent diabetes mellitus Type 2 diabetes
• hypertriglyceridemia elevated levels of triglyceride-rich-lipoproteins
• Preferred uses of the compounds may be for the treatment of one or more of the following diseases by administering a therapeutically effective amount to a patient in need of treatment.
• the compounds may be used for manufacturing a medicament for the treatment of one or more of these diseases:
• Type 2 diabetes and specifically hyperglycemia associated with Type 2 diabetes
• the compounds may be effective in lowering glucose and lipids in diabetic patients and in non-diabetic patients who have impaired glucose tolerance and/or are in a pre-diabetic condition.
• the compounds may ameliorate hyperinsulinemia, which often occurs in diabetic or pre-diabetic patients, by modulating the swings in the level of serum glucose that often occurs in these patients.
• the compounds may also be effective in treating or reducing insulin resistance.
• the compounds may be effective in treating or preventing gestational diabetes.
• the compounds may also be effective in treating or preventing lipid disorders.
• the compounds may be effective in treating or preventing diabetes related disorders.
• the compounds may also be effective in treating or preventing obesity related disorders.
• the compounds of this invention may also have utility in improving or restoring ⁇ -cell function, so that they may be useful in treating Type 1 diabetes or in delaying or preventing a patient with Type 2 diabetes from needing insulin therapy.
• the invention also includes pharmaceutically acceptable salts of the compounds, and pharmaceutical compositions comprising the compounds and a pharmaceutically acceptable carrier.
• the compounds may be useful in treating insulin resistance, Type 2 diabetes, hypperglycemia, and dyslipidemia that is associated with Type 2 diabetes and insulin resistance.
• the compounds may also be useful for the treatment of obesity
• a compound of the present invention may be used in the manufacture of a medicament for the treatment of Type 2 diabetes in a human or other mammalian patient.
• a method of treating Type 2 diabetes comprises the administration of a therapeutically effective amount of a compound of the present invention, or a pharmaceutically acceptable salt thereof, or a pharmaceutical composition comprising the compound, to a patient in need of treatment.
• Other medical uses of the compounds of the present invention are described herein.
• the compounds of the present invention in which at least one of T, U and V is N or N- oxide, such as compounds A-l, A-2, A-3 and A-4 in Table A, have the unexpected benefit of increased intrinsic potency (2-20 fold) in the GPR40 Inositol Phosphate Turnover (IP1) Assay (+/- 100% human serum) compared to the compounds in which T is CH, U is CH and V is CH, such as compounds B-1 , B-2, B-3 and B-4 in Table A. Due to their increased potency in this assay, the compounds of the present invention are expected to exhibit glucose lowering efficacy at reduced plasma exposures, and can require a lower dose.
• IP1 Inositol Phosphate Turnover
• the compounds of the present invention also have the unexpected benefit of decreased binding (5-10-fold) to the ion channel, Kvl 1.1 compared to the compounds in which T is CH, U is CH and V is CH, such as compounds B-1 and B-3 in Table A.
• This ion channel also called the hERG channel, is implicated in sometimes fatal cardiac arrythymias (QTc interval prolongation).
• QTc interval prolongation This decreased off-target ion channel binding to ion channel Kvl 1.1 , taken together with increased on-target GPR40 activity, results in the compounds of the present invention having an unexpected benefit of 20-100-fold improved selectivity, due to incorporating a single nitrogen atom into the molecule.
• the compounds of the present invention in which at least one of T, U and V is N or N-oxide, such as compounds A-1 , A-2, A-3 and A-4 in Table A have the unexpected benefit of greater solubility (2-5 fold) in aqueous media, such as Phosphate Buffered Saline (PBS) solution at pH 7, and/or biorelevant media, such as FaSSIF (Fasted State Simulated Intestinal Fluid) at pH 7, compared to the compounds in which T is CH, U is CH and V is CH, such as compounds B-1 , B-2, B-3 and B-4 in Table A.
• PBS Phosphate Buffered Saline
• FaSSIF Fested State Simulated Intestinal Fluid
• diabetes includes both insulin-dependent diabetes mellitus (i.e., IDDM, also known as type 1 diabetes) and non-insulin-dependent diabetes mellitus (i.e., NIDDM, also known as Type 2 diabetes).
• IDDM insulin-dependent diabetes mellitus
• NIDDM non-insulin-dependent diabetes mellitus
• Type 1 diabetes or insulin-dependent diabetes
• Type 2 diabetes or insulin-independent diabetes (i.e., non-insulin-dependent diabetes mellitus)
• Most of the Type 2 diabetics are also obese.
• the compositions of the present invention may be useful for treating both Type 1 and
• Type 2 diabetes Type 2 diabetes.
• diabetes associated with obesity refers to diabetes caused by obesity or resulting from obesity.
• Diabetes is characterized by a fasting plasma glucose level of greater than or equal to 126 mg/dl.
• a diabetic subject has a fasting plasma glucose level of greater than or equal to 126 mg/dl.
• a pre diabetic subject is someone suffering from prediabetes. Prediabetes is
• FPG fasting plasma glucose
• prediabetic subject is a subject with impaired fasting glucose (a fasting plasma glucose (FPG) level of greater than or equal to 110 mg/dl and less than 126 mg/dl); or impaired glucose tolerance (a 2 hour plasma glucose level of > 140 mg/dl and ⁇ 200 mg/dl); or insulin resistance, resulting in an increased risk of developing diabetes.
• FPG fasting plasma glucose
• Treatment of diabetes mellitus refers to the administration of a compound or combination of the present invention to treat a diabetic subject.
• One outcome of treatment may be decreasing the glucose level in a subject with elevated glucose levels.
• Another outcome of treatment may be decreasing insulin levels in a subject with elevated insulin levels.
• Another outcome of treatment may be decreasing plasma triglycerides in a subject with elevated plasma triglycerides.
• Another outcome of treatment is decreasing LDL cholesterol in a subject with high LDL cholesterol levels.
• Another outcome of treatment may be increasing HDL cholesterol in a subject with low HDL cholesterol levels.
• Another outcome of treatment is increasing insulin sensivity.
• Another outcome of treatment may be enhancing glucose tolerance in a subject with glucose intolerance.
• Yet another outcome of treatment may be decreasing insulin resistance in a subject with increased insulin resistance or elevated levels of insulin.
• Prevention of diabetes mellitus refers to the administration of a compound or combination of the present invention to prevent the onset of diabetes in a subject in need thereof.
• a subject in need of preventing diabetes is a prediabetic subject that is overweight or obese.
• diabetes related disorders should be understood to mean disorders that are associated with, caused by, or result from diabetes. Examples of diabetes related disorders include retinal damage, kidney disease, and nerve damage.
• Atherosclerosis encompasses vascular diseases and conditions that are recognized and understood by physicians practicing in the relevant fields of medicine.
• Atherosclerotic cardiovascular disease, coronary heart disease (also known as coronary artery disease or ischemic heart disease), cerebrovascular disease and peripheral vessel disease are all clinical manifestations of atherosclerosis and are therefore encompassed by the terms
• the combination comprised of a therapeutically effective amount of an anti-obesity agent in combination with a therapeutically effective amount of an anti-hypertensive agent may be administered to prevent or reduce the risk of occurrence, or recurrence where the potential exists, of a coronary heart disease event, a cerebrovascular event, or intermittent claudication.
• Coronary heart disease events are intended to include CHD death, myocardial infarction (i.e., a heart attack), and coronary revascularization procedures.
• Cerebrovascular events are intended to include ischemic or hemorrhagic stroke (also known as cerebrovascular accidents) and transient ischemic attacks. Intermittent claudication is a clinical manifestation of peripheral vessel disease.
• the term "atherosclerotic disease event” as used herein is intended to encompass coronary heart disease events, cerebrovascular events, and intermittent claudication. It is intended that persons who have previously experienced one or more non-fatal atherosclerotic disease events are those for whom the potential for recurrence of such an event exists.
• the term "atherosclerosis related disorders” should be understood to mean disorders associated with, caused by, or resulting from atherosclerosis.
• hypertension includes essential, or primary, hypertension wherein the cause is not known or where hypertension is due to greater than one cause, such as changes in both the heart and blood vessels; and secondary hypertension wherein the cause is known.
• causes of secondary hypertension include, but are not limited to obesity; kidney disease; hormonal disorders; use of certain drugs, such as oral contraceptives, corticosteroids,
• hypertension encompasses high blood pressure, in which both the systolic and diastolic pressure levels are elevated (>140 mmHg/>90 mmHg), and isolated systolic hypertension, in which only the systolic pressure is elevated to greater than or equal to 140 mm Hg, while the diastolic pressure is less than 90 mm Hg.
• Normal blood pressure may be defined as less than 120 mmHg systolic and less than 80 mmHg diastolic.
• a hypertensive subject is a subject with hypertension.
• a pre -hypertensive subject is a subject with a blood pressure that is between 120 mmHg over 80 mmHg and 139 mmHg over 89 mmHg.
• One outcome of treatment is decreasing blood pressure in a subject with high blood pressure.
• Treatment of hypertension refers to the administration of the compounds and combinations of the present invention to treat hypertension in a hypertensive subject.
• Treatment of hypertension- related disorder refers to the administration of a compound or combination of the present invention to treat the hypertension-related disorder.
• hypertension related disorder refers to the administration of the combinations of the present invention to a pre -hypertensive subject to prevent the onset of hypertension or a hypertension related disorder.
• the hypertension-related disorders herein are associated with, caused by, or result from hypertension. Examples of hypertension-related disorders include, but are not limited to: heart disease, heart failure, heart attack, kidney failure, and stroke.
• Dyslipidemias and lipid disorders are disorders of lipid metabolism including various conditions characterized by abnormal concentrations of one or more lipids (i.e. cholesterol and triglycerides), and/or apolipoproteins (i.e., apolipoproteins A, B, C and E), and/or lipoproteins (i.e., the macromolecular complexes formed by the lipid and the apolipoprotein that allow lipids to circulate in blood, such as LDL, VLDL and IDL).
• Hyperlipidemia is associated with abnormally high levels of lipids, LDL and VLDL cholesterol, and/or triglycerides.
• Treatment of dyslipidemia refers to the administration of the combinations of the present invention to a dyslipidemic subject.
• Prevention of dyslipidemia refers to the administration of the
• a pre-dyslipidemic subject is a subject with higher than normal lipid levels, that is not yet dyslipidemic.
• dyslipidemia related disorders and “lipid disorder related disorders” should be understood to mean disorders associated with, caused by, or resulting from dyslipidemia or lipid disorders.
• dylipidemia related disorder and lipid disorder related disorders include, but are not limited to: hyperlipidemia, hypertriglyceridemia, hypercholesterolemia, low high density lipoprotein (HDL) levels, high plasma low density lipoprotein (LDL) levels, atherosclerosis and its sequelae, coronary artery or carotid artery disease, heart attack, and stroke.
• the term "obesity” as used herein is a condition in which there is an excess of body fat.
• the operational definition of obesity is based on the Body Mass Index (BMI), which is calculated as body weight per height in meters squared (kg/m2).
• BMI Body Mass Index
• "Obesity” refers to a condition whereby an otherwise healthy subject has a Body Mass Index (BMI) greater than or equal to 30 kg/m2, or a condition whereby a subject with at least one co-morbidity has a BMI greater than or equal to 27 kg/m2.
• An "obese subject” is an otherwise healthy subject with a Body Mass Index (BMI) greater than or equal to 30 kg/m2 or a subject with at least one co-morbidity with a BMI greater than or equal to 27 kg/m2.
• An overweight subject is a subject at risk of obesity.
• a "subject at risk of obesity” is an otherwise healthy subject with a BMI of 25 kg/m2 to less than 30 kg/m2 or a subject with at least one co-morbidity with a BMI of 25 kg/m2 to less than 27 kg/m2.
• BMI Body Mass Index
• “obesity” refers to a condition whereby a subject with at least one obesity-induced or obesity-related co-morbidity, that requires weight reduction or that would be improved by weight reduction, has a BMI greater than or equal to 25 kg/m2.
• an “obese subject” refers to a subject with at least one obesity- induced or obesity-related co-morbidity that requires weight reduction or that would be improved by weight reduction, with a BMI greater than or equal to 25 kg/m2.
• a "subject at risk of obesity” is a subject with a BMI of greater than 23 kg/m2 to less than 25 kg/m2.
• obesity is meant to encompass all of the above definitions of obesity.
• Obesity-induced or obesity-related co-morbidities include, but are not limited to, diabetes mellitus, non-insulin dependent diabetes mellitus - type 2, diabetes associated with obesity, impaired glucose tolerance, impaired fasting glucose, insulin resistance syndrome, dyslipidemia, hypertension, hypertension associated with obesity, hyperuricacidemia, gout, coronary artery disease, myocardial infarction, angina pectoris, sleep apnea syndrome, Pickwickian syndrome, fatty liver; cerebral infarction, cerebral thrombosis, transient ischemic attack, orthopedic disorders, arthritis deformans, lumbodynia, emmeniopathy, and infertility.
• comorbidities include: hypertension, hyperlipidemia, dyslipidemia, glucose intolerance, cardiovascular disease, sleep apnea, and other obesity-related conditions.
• Treatment of obesity and obesity-related disorders refers to the administration of the compounds of the present invention to reduce or maintain the body weight of an obese subject.
• One outcome of treatment may be reducing the body weight of an obese subject relative to that subject's body weight immediately before the administration of the compounds of the present invention.
• Another outcome of treatment may be preventing body weight regain of body weight previously lost as a result of diet, exercise, or pharmacotherapy.
• Another outcome of treatment may be decreasing the occurrence of and/or the severity of obesity-related diseases.
• the treatment may suitably result in a reduction in food or calorie intake by the subject, including a reduction in total food intake, or a reduction of intake of specific components of the diet such as carbohydrates or fats; and/or the inhibition of nutrient absorption; and/or the inhibition of the reduction of metabolic rate; and in weight reduction in patients in need thereof.
• the treatment may also result in an alteration of metabolic rate, such as an increase in metabolic rate, rather than or in addition to an inhibition of the reduction of metabolic rate; and/or in minimization of the metabolic resistance that normally results from weight loss.
• Prevention of obesity and obesity-related disorders refers to the administration of the compounds of the present invention to reduce or maintain the body weight of a subject at risk of obesity.
• One outcome of prevention may be reducing the body weight of a subject at risk of obesity relative to that subject's body weight immediately before the administration of the compounds of the present invention.
• Another outcome of prevention may be preventing body weight regain of body weight previously lost as a result of diet, exercise, or pharmacotherapy.
• Another outcome of prevention may be preventing obesity from occurring if the treatment is administered prior to the onset of obesity in a subject at risk of obesity.
• Another outcome of prevention may be decreasing the occurrence and/or severity of obesity-related disorders if the treatment is administered prior to the onset of obesity in a subject at risk of obesity.
• Such treatment may prevent the occurrence, progression or severity of obesity-related disorders, such as, but not limited to, arteriosclerosis, Type II diabetes, polycystic ovarian disease, cardiovascular diseases, osteoarthritis,
• dermatological disorders hypertension, insulin resistance, hypercholesterolemia,
• hypertriglyceridemia and cholelithiasis.
• the obesity-related disorders herein are associated with, caused by, or result from obesity.
• obesity-related disorders include overeating and bulimia, hypertension, diabetes, elevated plasma insulin concentrations and insulin resistance, dyslipidemias, hyperlipidemia, endometrial, breast, prostate and colon cancer, osteoarthritis, obstructive sleep apnea,
• cholelithiasis gallstones, heart disease, abnormal heart rhythms and arrythmias, myocardial infarction, congestive heart failure, coronary heart disease, sudden death, stroke, polycystic ovarian disease, craniopharyngioma, the Prader-Willi Syndrome, Frohlich's syndrome, GH- deficient subjects, normal variant short stature, Turner's syndrome, and other pathological conditions showing reduced metabolic activity or a decrease in resting energy expenditure as a percentage of total fat-free mass, e.g, children with acute lymphoblastic leukemia.
• metabolic syndrome also known as syndrome X, insulin resistance syndrome, sexual and reproductive dysfunction, such as infertility,
• hypogonadism in males and hirsutism in females gastrointestinal motility disorders, such as obesity-related gastro -esophageal reflux, respiratory disorders, such as obesity-hypoventilation syndrome (Pickwickian syndrome), cardiovascular disorders, inflammation, such as systemic inflammation of the vasculature, arteriosclerosis, hypercholesterolemia, hyperuricaemia, lower back pain, gallbladder disease, gout, and kidney cancer.
• the compounds of the present invention are also useful for reducing the risk of secondary outcomes of obesity, such as reducing the risk of left ventricular hypertrophy.
• metabolic syndrome also known as syndrome X
• syndrome X is defined in the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, or ATP III), National Institutes of Health, 2001, NIH Publication No. 01-3670. E.S. Ford et al, JAMA, vol. 287 (3), Jan. 16, 2002, pp 356-359.
• a person is defined as having metabolic syndrome if the person has three or more of the following disorders: abdominal obesity, hypertriglyceridemia, low HDL cholesterol, high blood pressure, and high fasting plasma glucose. The criteria for these are defined in ATP -III.
• Treatment of metabolic syndrome refers to the administration of the combinations of the present invention to a subject with metabolic syndrome.
• Prevention of metabolic syndrome refers to the administration of the combinations of the present invention to a subject with two of the disorders that define metabolic syndrome.
• a subject with two of the disorders that define metabolic syndrome is a subject that has developed two of the disorders that define metabolic syndrome, but has not yet developed three or more of the disorders that define metabolic syndrome.
• administering a should be understood to mean providing a compound of the invention or a prodrug of a compound of the invention to the individual or mammal in need of treatment.
• the administration of the compound of structural formula I in order to practice the present methods of therapy is carried out by administering an effective amount of the compound of structural formula I to the mammal in need of such treatment or prophylaxis.
• the need for a prophylactic administration according to the methods of the present invention is determined via the use of well known risk factors.
• the effective amount of an individual compound is determined, in the final analysis, by the physician or veterinarian in charge of the case, but depends on factors such as the exact disease to be treated, the severity of the disease and other diseases or conditions from which the patient suffers, the chosen route of administration other drugs and treatments which the patient may concomitantly require, and other factors in the physician's judgment.
• Any suitable route of administration may be employed for providing a mammal, especially a human, with an effective dose of a compound of the present invention.
• oral, rectal, topical, parenteral, ocular, pulmonary, nasal, and the like may be employed.
• Dosage forms include tablets, troches, dispersions, suspensions, solutions, capsules, creams, ointments, aerosols, and the like.
• compounds of the present invention are administered orally.
• an appropriate dosage level will generally be about 0.01 to 500 mg per kg patient body weight per day which can be administered in single or multiple doses.
• the dosage level will be about 0.1 to about 250 mg/kg per day; more preferably about 0.5 to about 100 mg/kg per day.
• a suitable dosage level may be about 0.01 to 250 mg/kg per day, about 0.05 to 100 mg/kg per day, or about 0.1 to 50 mg/kg per day. Within this range the dosage may be 0.05 to 0.5, 0.5 to 5 or 5 to 50 mg/kg per day.
• compositions are preferably provided in the form of tablets containing 1.0 to 1000 mg of the active ingredient, particularly 1.0, 5.0, 10.0, 15.0, 20.0, 25.0, 50.0, 75.0, 100.0, 150.0, 200.0, 250.0, 300.0, 400.0, 500.0, 600.0, 750.0, 800.0, 900.0, and 1000.0 mg of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated.
• the compounds may be administered on a regimen of 1 to 4 times per day, preferably once or twice per day.
• the compounds of the present invention are administered at a daily dosage of from about 0.1 mg to about 100 mg per kilogram of animal body weight, preferably given as a single daily dose or in divided doses two to six times a day, or in sustained release form.
• the total daily dosage is from about 1.0 mg to about 1000 mg, preferably from about 1 mg to about 50 mg. In the case of a 70 kg adult human, the total daily dose will generally be from about 7 mg to about 350 mg. This dosage regimen may be adjusted to provide the optimal therapeutic response.
• an appropriate dosage level will generally be about 0.01 to 500 mg per kg patient body weight per week, which can be administered in single or multiple doses.
• the dosage level will be about 0.1 to about 250 mg/kg per week; more preferably about 0.5 to about 100 mg/kg per week.
• a suitable dosage level may be about 0.01 to 250 mg/kg per week, about 0.05 to 100 mg/kg per week, or about 0.1 to 50 mg/kg per week. Within this range the dosage may be 0.05 to 0.5, 0.5 to 5 or 5 to 50 mg/kg per week.
• compositions are preferably provided in the form of tablets containing 1.0 to 1000 mg of the active ingredient, particularly 1.0, 5.0, 10.0, 15.0, 20.0, 25.0, 50.0, 75.0, 100.0, 150.0, 200.0, 250.0, 300.0, 400.0, 500.0, 600.0, 750.0, 800.0, 900.0, and 1000.0 mg of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated.
• the compounds may also be administered on a regimen of 1 to 4 times per week, preferably once or twice per week.
• diabetes mellitus and/or hyperglycemia When treating or preventing diabetes mellitus and/or hyperglycemia or
• the compounds of the present invention are administered at a weekly dosage of from about 0.1 mg to about 100 mg per kilogram of animal body weight, preferably given as a single weekly dose or in divided doses two to six times a week, or in sustained release form.
• the total weekly dosage is from about 1.0 mg to about 1000 mg, preferably from about 1 mg to about 50 mg. In the case of a 70 kg adult human, the total weekly dose will generally be from about 7 mg to about 350 mg. This dosage regimen may be adjusted to provide the optimal therapeutic response.
• the compounds of this invention may be used in pharmaceutical compositions comprising (a) the compound(s) or pharmaceutically acceptable salts thereof, and (b) a pharmaceutically acceptable carrier.
• the compounds of this invention may be used in
• compositions that include one or more other active pharmaceutical ingredients.
• the compounds of this invention may also be used in pharmaceutical compositions in which the compound of the present invention or a pharmaceutically acceptable salt thereof is the only active ingredient.
• composition as in pharmaceutical composition, is intended to encompass a product comprising the active ingredient(s), and the inert ingredient(s) that make up the carrier, as well as any product which results, directly or indirectly, from combination, complexation or aggregation of any two or more of the ingredients, or from dissociation of one or more of the ingredients, or from other types of reactions or interactions of one or more of the ingredients.
• pharmaceutical compositions of the present invention encompass any composition made by admixing a compound of the present invention and a pharmaceutically acceptable carrier.
• Compounds of the present invention may be used in combination with other drugs that may also be useful in the treatment or amelioration of the diseases or conditions for which compounds of the present invention are useful.
• Such other drugs may be administered, by a route and in an amount commonly used therefor, contemporaneously or sequentially with a compound of the present invention.
• more than one drug is commonly administered.
• the compounds of this invention may generally be administered to a patient who is already taking one or more other drugs for these conditions.
• the compounds will be administered to a patient who is already being treated with one or more antidiabetic compound, such as metformin, sulfonylureas, and/or PPARy agonists, when the patient's glycemic levels are not adequately responding to treatment.
• one or more antidiabetic compound such as metformin, sulfonylureas, and/or PPARy agonists
• a pharmaceutical composition in unit dosage form containing such other drugs and the compound of the present invention is preferred.
• the combination therapy also includes therapies in which the compound of the present invention and one or more other drugs are administered on different overlapping schedules. It is also contemplated that when used in combination with one or more other active ingredients, the compound of the present invention and the other active ingredients may be used in lower doses than when each is used singly.
• compositions of the present invention include those that contain one or more other active ingredients, in addition to a compound of the present invention.
• Examples of other active ingredients that may be administered separately or in the same pharmaceutical composition in combination with a compound of the formulas described herein include, but are not limited to:
• DPP-4 dipeptidyl peptidase-IV
• DPP-4 inhibitors e.g., sitagliptin, alogliptin, linagliptin, vildagliptin, saxagliptin, teneligliptin, omarigliptin
• sitagliptin e.g., sitagliptin, alogliptin, linagliptin, vildagliptin, saxagliptin, teneligliptin, omarigliptin
• insulin sensitizers including (i) PPARy agonists, such as the glitazones (e.g.
• PPARa/ ⁇ e.g., ZYH2, ZYH1, GFT505, chiglitazar, muraglitazar, aleglitazar, sodelglitazar, and naveglitazar
• PPARa agonists such as fenofibric acid derivatives (e.g., gemfibrozil, clofibrate, ciprofibrate, fenofibrate, bezafibrate)
• SPPARyM's selective PPARy modulators
• PPARy metformin and its pharmaceutically acceptable salts in particular, metformin hydrochloride, and extended-release formulations thereof, such as GlumetzaTM, FortametTM, and GlucophageXRTM; and (iii) protein tyrosine phosphatase- IB (PTP-IB) inhibitors (e.g., ISIS-113715 and TTP814);
• PTP-IB protein tyrosine phosphatase- IB
• insulin or insulin analogs e.g., insulin detemir, insulin glulisine, insulin degludec, insulin glargine, insulin lispro, SBS1000 and oral and inhalable formulations of insulin and insulin analogs
• amylin and amylin analogs e.g., pramlintide
• sulfonylurea and non-sulfonylurea insulin secretagogues e.g., tolbutamide, glyburide, glipizide, glimepiride, mitiglinide, meglitinides, nateglinide and repaglinide
• insulin secretagogues e.g., tolbutamide, glyburide, glipizide, glimepiride, mitiglinide, meglitinides, nateglinide and repaglinide
• a-glucosidase inhibitors e.g., acarbose, voglibose and miglitol
• glucagon receptor antagonists e.g., NOXG15, LY2409021
• incretin mimetics such as GLP-1, GLP-1 analogs, derivatives, and mimetics
• GLP-1 receptor agonists e.g., dulaglutide, semaglutide, albiglutide, exenatide, liraglutide, lixisenatide, taspoglutide, GSK2374697, ADX72231, RG7685, NN9924, ZYOG1, CJC-1131, and BIM-51077, including intranasal, transdermal, and once-weekly formulations thereof
• oxyntomodulin and oxyntomodulin analogs and derivatives e.g., NOXG15, LY2409021
• incretin mimetics such as GLP-1, GLP-1 analogs, derivatives, and mimetics
• GLP-1 receptor agonists e.g., dulaglutide, semaglutide, albig
• LDL cholesterol lowering agents such as (i) HMG-CoA reductase inhibitors (e.g., simvastatin, lovastatin, pravastatin, crivastatin, fluvastatin, atorvastatin, pitavastatin and rosuvastatin), (ii) bile acid sequestering agents (e.g., colestilan, colestimide, colesevalam hydrochloride, colestipol, cholestyramine, and dialkylaminoalkyl derivatives of a cross-linked dextran), (iii) inhibitors of cholesterol absorption, (e.g., ezetimibe), and (iv) acyl CoAxholesterol acyltransferase inhibitors, (e.g., avasimibe);
• HMG-CoA reductase inhibitors e.g., simvastatin, lovastatin, pravastatin, crivastatin, fluvastat
• HDL-raising drugs e.g., niacin and nicotinic acid receptor agonists, and extended- release versions thereof; MK-524A, which is a combination of niacin extended-release and the DP-1 antagonist MK-524);
• agents intended for use in inflammatory conditions such as aspirin, non-steroidal anti-inflammatory drugs or NSAIDs, glucocorticoids, and selective cyclooxygenase-2 or COX-2 inhibitors;
• antihypertensive agents such as ACE inhibitors (e.g.,lisinopril, enalapril, ramipril, captopril, quinapril, and tandolapril), A-II receptor blockers (e.g., losartan, candesartan, irbesartan, olmesartan medoxomil, valsartan, telmisartan, and eprosartan), renin inhibitors (e.g., aliskiren), beta blockers, and calcium channel blockers;
• ACE inhibitors e.g.,lisinopril, enalapril, ramipril, captopril, quinapril, and tandolapril
• A-II receptor blockers e.g., losartan, candesartan, irbesartan, olmesartan medoxomil, valsartan, telmisart
• GKAs glucokinase activators
• inhibitors of 11 ⁇ -hydroxysteroid dehydrogenase type 1, e.g., such as those disclosed in U.S. Patent No. 6,730,690, and LY-2523199;
• CETP inhibitors e.g., anacetrapib, evacetrapib and torcetrapib
• inhibitors of fructose 1,6-bisphosphatase e.g., such as those disclosed in U.S. Patent Nos. 6,054,587; 6,110,903; 6,284,748; 6,399,782; and 6,489,476);
• inhibitors of acetyl CoA carboxylase-1 or 2 (ACC1 or ACC2);
• AMP-activated Protein Kinase (AMPK) activators such as MB1055, ETC 1002;
• GPR-109 other agonists of the G-protein-coupled receptors: (i) GPR-109, (ii) GPR-119 (e.g., MBX2982, APD597, GSK1292263, HM47000, and PSN821), and (iii) GPR-40 (e.g., TAK875, MR 1704, TUG 469, TUG499, ASP 4178);
• GPR-109 e.g., MBX2982, APD597, GSK1292263, HM47000, and PSN821
• GPR-40 e.g., TAK875, MR 1704, TUG 469, TUG499, ASP 4178
• neuromedin U receptor agonists e.g., such as those disclosed in WO 2009/042053, including, but not limited to, neuromedin S (NMS)
• NMS neuromedin S
• SGLT inhibitors e.g., ASP1941, SGLT-3, empagliflozin, dapagliflozin,
• TGR5 receptor also known as GPBAR1, BG37, GPCR19, GPR131, and M-BAR
• PACAP PACAP
• PACAP mimetics PACAP
• PACAP receptor 3 agonists PACAP, PACAP mimetics, and PACAP receptor 3 agonists
• PTP- 1 B protein tyrosine phosphatase- 1 B (PTP- 1 B) inhibitors
• IL-lb antibodies e.g., XOMA052 and canakinumab
• GPR 120 agonists such as KDT501.
• Suitable active ingredients/pharmaceutical agents that may be administered in combination with a compound of the present invention, and either administered separately or in the same pharmaceutical composition, include, but are not limited to:
• anti-diabetic agents such as (1) PPARy agonists such as glitazones (e.g. ciglitazone; darglitazone; englitazone; isaglitazone (MCC-555); pioglitazone (ACTOS); rosiglitazone (AVANDIA); troglitazone; rivoglitazone, BRL49653; CLX-0921; 5-BTZD, GW-0207, LG- 100641, R483, and LY-300512, and the like and compounds disclosed in WO97/10813,
• PPARy agonists such as glitazones (e.g. ciglitazone; darglitazone; englitazone; isaglitazone (MCC-555); pioglitazone (ACTOS); rosiglitazone (AVANDIA); troglitazone; rivoglitazone, BRL49653; CLX-0921; 5-
• glibenclamide glipizide; glyburide; glimepiride; gliclazide; glipentide; gliquidone; glisolamide; tolazamide; and tolbutamide, and the like;
• meglitinides such as repaglinide, metiglinide (GLUFAST) and nateglinide, and the like;
• alpha glucoside hydrolase inhibitors such as acarbose; adiposine; camiglibose; emiglitate; miglitol; voglibose; pradimicin-Q; salbostatin; CKD-711; MDL-25,637; MDL-73,945; and MOR 14, and the like;
• alpha-amylase inhibitors such as tendamistat, trestatin, and Al-3688, and the like
• insulin secreatagogues such as linogliride nateglinide, mitiglinide
• non-thiazolidinediones such as JT-501, and farglitazar (GW-2570/GI-262579), and the like
• PPARa/ ⁇ dual agonists such as AVE 0847, CLX-0940, GW-1536, GW1929, GW-2433, KRP-297, L-796449, LBM 642, LR-90, LY510919, MK-0767, ONO 5129, SB 219994, TAK-559, TAK-654, 677954 (GlaxoSmithkline), E-3030 (Eisai), LY510929 (Lilly), AK109 (Asahi), DRF2655 (Dr. Reddy), DRF8351 (Dr. Reddy),
• MC3002 (Maxocore), TY51501 (ToaEiyo), farglitazar, naveglitazar, muraglitazar, peliglitazar, tesaglitazar (GALIDA), reglitazar (JT-501), chiglitazar, and those disclosed in WO 99/16758, WO 99/19313, WO 99/20614, WO 99/38850, WO 00/23415, WO 00/23417, WO 00/23445, WO 00/50414, WO 01/00579, WO 01/79150, WO 02/062799, WO 03/033481, WO 03/033450, WO 03/033453; and (14), insulin, insulin mimetics and other insulin sensitizing drugs; (15) VPAC2 receptor agonists; (16) GLK modulators, such as PSN105, RO 281675, RO 274375 and those disclosed in WO 03/015774, WO 03/000262,
• ATP consumption promotors such as those disclosed in WO 03/007990; (21) fixed combinations of PPAR ⁇ agonists and metformin such as AVANDAMET; (22) PPAR pan agonists such as GSK 677954; (23) GPR40 (G-protein coupled receptor 40) also called SNORF 55 such as BG 700, and those disclosed in WO
• GPR119 G-protein coupled receptor 119, also called RUP3; SNORF 25) such as RUP3, HGPRBMY26, PFI 007, SNORF 25; (25) adenosine receptor 2B antagonists such as ATL-618, AT1-802, E3080, and the like; (26) carnitine palmitoyl transferase inhibitors such as ST 1327, and ST 1326, and the like; (27) Fructose 1,6- bisphospohatase inhibitors such as CS-917, MB7803, and the like; (28) glucagon antagonists such as AT77077, BAY 694326, GW 4123X, NN2501, and those disclosed in WO 03/064404, WO 05/00781, US 2004/0209928, US 2004/029943, and the like; (30) glucose-6-phosphase inhibitors; (31) phosphoenolpyruvate carb
• anti-dyslipidemic agents such as (1) bile acid sequestrants such as, cholestyramine, colesevelem, colestipol, dialkylaminoalkyl derivatives of a cross-linked dextran; Colestid®; LoCholest®; and Questran®, and the like; (2) HMG-CoA reductase inhibitors such as atorvastatin, itavastatin, pitavastatin, fiuvastatin, lovastatin, pravastatin, rivastatin, simvastatin, rosuvastatin (ZD-4522), and other statins, particularly simvastatin; (3) HMG-CoA synthase inhibitors; (4) cholesterol absorption inhibitors such as FMVP4 (Forbes Medi-Tech), KT6-971 (Kotobuki Pharmaceutical), FM-VA12 (Forbes Medi-Tech), FM-VP-24 (Forbes Medi-Tech), stanol esters, beta-sitoste,
• DRF10945 (Dr. Reddy), NS-220/R1593 (Nippon Shinyaku/Roche, ST1929 (Sigma Tau) MC3001/MC3004 (MaxoCore Pharmaceuticals, gemcabene calcium, other fibric acid derivatives, such as Atromid®, Lopid® and Tricor®, and those disclosed in US 6,548,538, and the like; (10) FXR receptor modulators such as GW 4064 (GlaxoSmithkline), SR 103912,
• LXR receptor modulators such as GW 3965 (GlaxoSmithkline), T9013137, and XTC0179628 (X-Ceptor Therapeutics/Sanyo), and those disclosed in WO 03/031408, WO 03/063796, WO 04/072041, and the like
• lipoprotein synthesis inhibitors such as niacin
• renin angiotensin system inhibitors e.g., renin angiotensin system inhibitors
• PPAR ⁇ partial agonists such as those disclosed in WO 03/024395
• bile acid reabsorption inhibitors such as BARI 1453, SC435, PHA384640, S8921, AZD7706, and the like
• bile acid sequesterants such as colesevelam (WELCHOL/ CHOLESTAGEL), colestipol, cholestyramine,
• PHA384640E Pfizer
• S8921 Shionogi
• AZD7806 AstrZeneca
• AK105 Asah Kasei
• Lp-PLA2 inhibitors such as SB480848 (GlaxoSmithkline), 659032 (GlaxoSmithkline), 677116 (GlaxoSmithkline), and the like
• other agents which affect lipic composition including ETC 1001/ESP31015 (Pfizer), ESP-55016 (Pfizer), AGI1067 (AtheroGenics), AC3056 (Amylin), AZD4619 (AstrZeneca); and
• anti-hypertensive agents such as (1) diuretics, such as thiazides, including chlorthalidone, chlorthiazide, dichlorophenamide, hydroflumethiazide, indapamide, and hydrochlorothiazide; loop diuretics, such as bumetanide, ethacrynic acid, furosemide, and torsemide; potassium sparing agents, such as amiloride, and triamterene; and aldosterone antagonists, such as spironolactone, epirenone, and the like; (2) beta-adrenergic blockers such as acebutolol, atenolol, betaxolol, bevantolol, bisoprolol, bopindolol, carteolol, carvedilol, celiprolol, esmolol, indenolol, metaprolol, nadolol, nebivolol
• tenocapril trandolapril, and zofenopril, and the like; (5) neutral endopeptidase inhibitors such as omapatrilat, cadoxatril and ecadotril, fosidotril, sampatrilat, AVE7688, ER4030, and the like; (6) endothelin antagonists such as tezosentan, A308165, and YM62899, and the like; (7)
• vasodilators such as hydralazine, clonidine, minoxidil, and nicotinyl alcohol, nicotinic acid or salt thereof, and the like;
• angiotensin II receptor antagonists such as candesartan, eprosartan, irbesartan, losartan, pratosartan, tasosartan, telmisartan, valsartan, and EXP-3137, FI6828K, and
• alpha 1 blockers such as terazosin, urapidil, prazosin, bunazosin, trimazosin, doxazosin, naftopidil, indoramin, WHIP 164, and XEN010, and the like
• alpha 2 agonists such as lofexidine, tiamenidine, moxonidine, rilmenidine and guanobenz, and the like
• aldosterone inhibitors and the like
• angiopoietin-2-binding agents such as those disclosed in WO 03/030833; and
• anti-obesity agents such as (1) 5HT (serotonin) transporter inhibitors, such as paroxetine, fluoxetine, fenfluramine, fluvoxamine, sertraline, and imipramine, and those disclosed in WO 03/00663, as well as serotonin/noradrenaline re uptake inhibitors such as sibutramine (MERIDIA/REDUCTIL) and dopamine uptake inhibitor/Norepenephrine uptake inhibitors such as radafaxine hydrochloride, 353162 (GlaxoSmithkline), and the like; (2) NE (norepinephrine) transporter inhibitors, such as GW 320659, despiramine, talsupram, and nomifensine; (3) CB1 (cannabinoid-1 receptor) antagonist/inverse agonists, such as taranabant, rimonabant (ACCOMPLIA Sanofi Synthelabo), SR- 147778 (Sanofi)
• H3 histamine H3 antagonist/inverse agonists, such as thioperamide, 3-(lH-imidazol-4-yl)propyl N-(4-pentenyl)carbamate), clobenpropit, iodophenpropit, imoproxifan, GT2394 (Gl
• MCH1R melanin-concentrating hormone 1 receptor
• T-226296 Takeda
• T71 Takeda/Amgen
• AMGN- 608450 AMGN-503796
• Amgen 856464
• A798 Abbott
• ATC0175/AR224349 Arena Pharmaceuticals
• GW803430 Gaxo Smithkine
• NBI- 1A Neurorocrine Biosciences
• NGX-1 Neurogen
• SNP-7941 Synaptic
• SNAP9847 Synaptic
• T-226293 Schering Plough
• TPI-1361-17 Saitama Medical School/University of California Irvine
• JP 13226269, JP 1437059, JP2004315511, and the like (7) MCH2R (melanin concentrating hormone 2R) agonist/antagonists; (8) NPY1 (neuropeptide Y Yl) antagonists, such as BMS205749, BIBP3226, J-l 15814, BIBO 3304, LY-357897, CP-671906, and GI-264879A; and those disclosed in U.S. Patent No.
• Neuropeptide Y Y5 Neuropeptide Y Y5
• antagonists such as 152,804, S2367 (Shionogi), E-6999 (Esteve), GW- 569180A, GW-594884A (GlaxoSmithkline), GW-587081X, GW-548118X; FR 235,208;
• leptin such as recombinant human leptin (PEG-OB, Hoffman La Roche) and recombinant methionyl human leptin (Amgen);
• leptin derivatives such as those disclosed in Patent Nos.
• opioid antagonists such as nalmefene (Revex ®), 3-methoxynaltrexone, naloxone, and naltrexone; and those disclosed in WO
• Patent No. 6358951 U.S. Patent Application Nos. 2002/049196 and 2002/022637; and WO 01/56592, and WO 02/32888; (19) 5HT2c (serotonin receptor 2c) agonists, such as APD3546/AR10A (Arena Pharmaceuticals),
• ATH88651 (Athersys), ATH88740 (Athersys), BVT933 (Biovitrum/GSK), DPCA37215 (BMS), IK264; LY448100 (Lilly), PNU 22394; WAY 470 (Wyeth), WAY629 (Wyeth), WAY161503 (Biovitrum), R-1065, VR1065 (Vernalis/Roche) YM 348; and those disclosed in U.S. Patent No. 3,914,250; and PCT Publications 01/66548, 02/36596, 02/48124, 02/10169, 02/44152;
• Mc3r melanocortin 3 receptor
• Mc4r melanocortin 4 receptor agonists, such as CHIR86036 (Chiron), CHIR915 (Chiron); ME- 10142 (Melacure), ME- 10145 (Melacure), HS-131 (Melacure),
• NBI72432 Neurosciences
• NNC 70-619 Novo Nordisk
• TTP2435 Transtech
• GLP-1 glucagon-like peptide 1
• Topiramate Topimax®
• phytopharm compound 57 CP 644,673
• ACC2 acetyl-CoA carboxylase-2
• ⁇ 3 beta adrenergic receptor 3) agonists, such as rafebergron/AD9677/TAK677 (Dainippon/ Takeda), CL-316,243, SB 418790, BRL- 37344, L-796568, BMS-196085, BRL-35135A, CGP12177A, BTA-243, GRC1087 (Glenmark Pharmaceuticals)
• GW 427353 solabegron hydrochloride
• Trecadrine Zeneca D7114, N-5984 (Nisshin Kyorin)
• WO98/04526 W098/32753, WO 01/74782, WO 02/32897, WO 03/014113, WO 03/016276, WO 03/016307, WO 03/024948, WO 03/024953, WO 03/037881, WO 04/108674, and the like;
• DGAT1 diacylglycerol acyltransferase 1 inhibitors
• DGAT2 diacylglycerol acyltransferase 2inhibitors
• PDE phosphodiesterase
• inhibitors such as theophylline, pentoxifylline, zaprinast, sildenafil, amrinone, milrinone, cilostamide, rolipram, and cilomilast, as well as those described in WO 03/037432, WO 03/0378
• UCP-1 uncoupling protein 1
• activators such as phytanic acid, 4-[(E)- 2-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-napthalenyl)-l-propenyl]benzoic acid (TTNPB), and retinoic acid; and those disclosed in WO 99/00123; (35) acyl-estrogens, such as oleoyl-estrone, disclosed in del Mar-Grasa, M. et al, Obesity Research, 9:202-9 (2001); (36) glucocorticoid receptor antagonists, such as CP472555 (Pfizer), KB 3305, and those disclosed in WO
• dehydrogenase type 1) inhibitors such as BVT 3498 (AMG 331), BVT 2733, 3-(l-adamantyl)-4- ethyl-5 -(ethylthio)-4H- 1 ,2,4-triazole, 3 -( 1 -adamantyl)-5 -(3 ,4,5 -trimethoxyphenyl)-4-methyl-4H- 1 ,2,4-triazole, 3-adamantanyl-4,5,6,7,8,9, 10,11 , 12,3a-decahydro-l ,2,4-triazolo[4,3- a][l l]annulene, and those compounds disclosed in WO 01/90091, 01/90090, 01/90092,
• SCD-1 stearoyl-CoA desaturase-1 inhibitors
• DPP-4 dipeptidyl peptidase IV inhibitors, such as isoleucine thiazolidide, valine pyrrolidide, sitagliptin
• lipase inhibitors such as tetrahydrolipstatin (orlistat/XENICAL), ATL962 (Alizyme/Takeda), GT389255 (Genzyme/Peptimmune)Triton WR1339, RHC80267, lipstatin, teasaponin, and diethylumbelliferyl phosphate, FL-386, WAY-121898, Bay-N-3176, valilactone, esteracin, ebelactone A, ebelactone B, and RHC 80267, and those disclosed in WO 01/77094, WO
• anorectic agents suitable for use in combination with a compound of the present invention include, but are not limited to, aminorex, amphechloral, amphetamine, benzphetamine, chlorphentermine, clobenzorex, cloforex, clominorex, clortermine, cyclexedrine,
• dexfenfluramine dextroamphetamine, diethylpropion, diphemethoxidine, N-ethylamphetamine, fenbutrazate, fenfluramine, fenisorex, fenproporex, fludorex, fluminorex,
• furfurylmethylamphetamine levamfetamine, levophacetoperane, mazindol, mefenorex, metamfepramone, methamphetamine, norpseudoephedrine, pentorex, phendimetrazine, phenmetrazine, phentermine, phenylpropanolamine, picilorex and sibutramine;
• a particularly suitable class of anorectic agent are the halogenated amphetamine derivatives, including chlorphentermine, cloforex, clortermine, dexfenfluramine, fenfluramine, picilorex and sibutramine; and pharmaceutically acceptable salts thereof.
• Particular halogenated amphetamine derivatives of use in combination with a compound of the present invention include: fenfluramine and dexfenfluramine, and pharmaceutically acceptable salts thereof.
• Specific compounds of use in combination with a compound of the present invention include: simvastatin, mevastatin, ezetimibe, atorvastatin, sitagliptin, metformin, sibutramine, orlistat, Qnexa, topiramate, naltrexone, bupriopion, phentermine, and losartan, losartan with hydrochlorothiazide.
• Specific CB1 antagonists/inverse agonists of use in combination with a compound of the present invention include: those described in WO03/077847, including: N-[3- (4-chlorophenyl)-2(S)-phenyl- 1 (S)-methylpropyl] -2-(4-trifluoromethyl-2-pyrimidyloxy)-2- methylpropanamide, N- [3 -(4-chlorophenyl)-2-(3 -cyanophenyl)- 1 -methylpropyl] -2-(5 - trifluoromethyl-2-pyridyloxy)-2-methylpropanamide, N-[3-(4-chlorophenyl)-2-(5-chloro-3- pyridyl)- 1 -methylpropyl] -2-(5 -trifluoromethyl-2-pyridyloxy)-2-methylpropanamide, and pharmaceutically acceptable salts thereof; as well as those in WO05/000809,
• NPY5 antagonists of use in combination with a compound of the present invention include: 3-oxo-N-(5-phenyl-2-pyrazinyl)-spiro[isobenzofuran-l(3H),4'-piperidine]-l '- carboxamide, 3-oxo-N-(7-trifluoromethylpyrido[3,2-b]pyridin-2-yl)spiro-[isobenzofuran- 1 (3H),4 ' -piperidine] - 1 ' -carboxamide, N- [5 -(3 -fluorophenyl)-2-pyrimidinyl] -3 -oxospiro- [isobenzofuran-l(3H),4'-piperidine]- -carboxamide, trans-3 '-oxo-N-(5 -phenyl-2- pyrimidinyl)spiro[cyclohexane-l , 1 '(3 'H
• Specific ACC-1/2 inhibitors of use in combination with a compound of the present invention include: -[(4,8-dimethoxyquinolin-2-yl)carbonyl]-6-(lH-tetrazol-5-yl)spiro[chroman- 2,4'-piperidin]-4-one; (5- ⁇ -[(4,8-dimethoxyquinolin-2-yl)carbonyl]-4-oxospiro[chroman-2,4'- piperidin]-6-yl ⁇ -2H-tetrazol-2-yl)methyl pivalate; 5- ⁇ 1 '-[(8-cyclopropyl-4-methoxyquinolin-2- yl)carbonyl]-4-oxospiro[chroman-2,4'-piperidin]-6-yl ⁇ nicotinic acid; l'-(8-methoxy-4- morpholin-4-yl-2-naphthoyl)-6-(lH-tetrazol-5
• Specific MCH1R antagonist compounds of use in combination with a compound of the persent invention include: l- ⁇ 4-[(l- ethylazetidin-3-yl)oxy]phenyl ⁇ -4-[(4-fluorobenzyl)oxy]pyridin-2(lH)-one, 4-[(4- fluorobenzyl)oxy]- 1 - ⁇ 4-[(l -isopropylazetidin-3-yl)oxy]phenyl ⁇ pyridin-2(lH)-one, 1 -[4- (azetidin-3-yloxy)phenyl]-4-[(5-chloropyridin-2-yl)methoxy]pyridin-2(lH)-one, 4-[(5- chloropyridin-2-yl)methoxy] - 1 - ⁇ 4- [( 1 -ethylazetidin-3 -yl)oxy]phenyl ⁇ pyridin-2( 1 H)-one
• Specific DP-IV inhibitors of use in combination with a compound of the present invention are selected from Januvia, 7-[(3R)-3-amino-4-(2,4,5-trifluorophenyl)butanoyl]-3- (trifluoromethyl)-5,6,7,8-tetrahydro-l,2,4-triazolo[4,3-a]pyrazine.
• the compound of formula I is favorably combined with 7-[(3R)-3-amino-4-(2,4,5-trifluorophenyl)butanoyl]-3- (trifluoromethyl)-5,6,7,8-tetrahydro-l ,2,4-triazolo[4,3-a]pyrazine, and pharmaceutically acceptable salts thereof.
• H3 (histamine H3) antagonists/inverse agonists of use in combination with a compound of the present invention include: those described in WO05/077905, including:3- ⁇ 4- [(1 -cyclobutyl-4-piperidinyl)oxy]phenyl ⁇ -2-ethylpyrido[2,3-d]-pyrimidin-4(3H)-one, 3- ⁇ 4-[(l - cyclobutyl-4-piperidinyl)oxy]phenyl ⁇ -2-methylpyrido[4,3-d]pyrimidin-4(3H)-one, 2-ethyl-3-(4- ⁇ 3-[(3S)-3-methylpiperidin-l-yl]propoxy ⁇ phenyl)pyrido[2,3-d]pyrimidin-4(3H)-one 2-methyl-3- (4- ⁇ 3-[(3S)-3-methylpiperidin-l-yl]propoxy ⁇ phenyl)pyrido[4,3-d
• Specific CCK1R agonists of use in combination with a compound of the present invention include: 3-(4- ⁇ [l-(3-ethoxyphenyl)-2-(4-methylphenyl)-lH -imidazol-4-yl]carbonyl ⁇ - l-piperazinyl)-l -naphthoic acid; 3-(4- ⁇ [l-(3-ethoxyphenyl)-2-(2-fluoro-4-methylphenyl)-lH - imidazol-4-yl]carbonyl ⁇ - 1 -piperazinyl)- 1 -naphthoic acid; 3-(4- ⁇ [ 1 -(3-ethoxyphenyl)-2-(4- fluorophenyl)-lH -imidazol-4-yl]carbonyl ⁇ -l -piperazinyl)- 1 -naphthoic acid; 3-(4- ⁇ [l-(3- ethoxyphen
• Specific MC4R agonists of use in combination with a compound of the present invention include: 1 ) (5 S)- 1 '- ⁇ [(3R,4R)- 1 -tert-butyl-3-(2,3 ,4-trifluorophenyl)piperidin-4-yl]carbonyl ⁇ -3- chloro-2-methyl-5-[l -methyl- 1-(1 -methyl- lH-l,2,4-triazol-5-yl)ethyl]-5H-spiro[furo[3,4- b]pyridine-7,4'-piperidine]; 2) (5R)-r- ⁇ [(3R,4R)-l-tert-butyl-3-(2,3,4-trifluorophenyl)- piperidin-4-yl]carbonyl ⁇ -3 -chloro-2-methyl-5 - [ 1 -methyl- 1 -( 1 -methyl- 1 H- 1 ,2,4-triazol-5 - yl
• Suitable neurokinin- 1 (NK-1) receptor antagonists may be favorably employed with the AMP -kinase activators of the present invention.
• NK-1 receptor antagonists of use in the present invention are fully described in the art.
• Specific neurokinin- 1 receptor antagonists of use in the present invention include: ( ⁇ )-(2R3R,2S3S)-N- ⁇ [2-cyclopropoxy-5-(trifluoromethoxy)- phenyl]methyl ⁇ -2-phenylpiperidin-3-amine; 2-(R)-(l-(R)-(3,5-bis(trifluoromethyl)- phenyl)ethoxy)-3-(S)-(4-fluorophenyl)-4-(3-(5-oxo-lH,4H-l,2,4-triazolo)methyl)morpholine; aperpitant; CJ17493; GW597599; GW679769; R673; R067319; R1124; R1204
• the above combinations include combinations of a compound of the present invention not only with one other active compound, but also with two or more other active compounds.
• Non-limiting examples include combinations of compounds with two or more active compounds selected from biguanides, sulfonylureas, HMG-CoA reductase inhibitors, PPARy agonists, DPP- 4 inhibitors, anti-obesity compounds, and anti-hypertensive agents.
• the present invention also provides a method for the treatment or prevention of a G- protein coupled receptor 40 (GPR40) mediated disease, which method comprises administration to a patient in need of such treatment or at risk of developing a GPR40 mediated disease of an amount of a GPR40 agonist and an amount of one or more active ingredients, such that together they give effective relief.
• GPR40 G- protein coupled receptor 40
• a pharmaceutical composition comprising a GPR40 agonist and one or more active ingredients, together with at least one pharmaceutically acceptable carrier or excipient.
• a GPR40 agonist and one or more active ingredients for the manufacture of a medicament for the treatment or prevention of a GPR40 mediated disease.
• a product comprising a GPR40 agonist and one or more active ingredients as a combined preparation for simultaneous, separate or sequential use in the treatment or prevention of a GPR40 mediated disease.
• Such a combined preparation may be, for example, in the form of a twin pack.
• a compound of the present invention may be used in conjunction with another pharmaceutical agent effective to treat that disorder.
• the present invention also provides a method for the treatment or prevention of diabetes, obesity, hypertension, Metabolic Syndrome, dyslipidemia, cancer, atherosclerosis, and related disorders thereof, which method comprises administration to a patient in need of such treatment an amount of a compound of the present invention and an amount of another pharmaceutical agent effective to threat that disorder, such that together they give effective relief.
• the present invention also provides a method for the treatment or prevention of diabetes, obesity, hypertension, Metabolic Syndrome, dyslipidemia, cancer, atherosclerosis, and related disorders thereof, which method comprises administration to a patient in need of such treatment an amount of a compound of the present invention and an amount of another pharmaceutical agent useful in treating that particular condition, such that together they give effective relief.
• terapéuticaally effective amount means the amount the compound of structural formula I that will elicit the biological or medical response of a tissue, system, animal or human that is being sought by the researcher, veterinarian, medical doctor or other clinician, which includes alleviation of the symptoms of the disorder being treated.
• the novel methods of treatment of this invention are for disorders known to those skilled in the art.
• “mammal” includes humans, and companion animals such as dogs and cats.
• the weight ratio of the compound of the Formula I to the second active ingredient may be varied and will depend upon the effective dose of each ingredient. Generally, an effective dose of each will be used. Thus, for example, when a compound of the Formula I is combined with a DPIV inhibitor the weight ratio of the compound of the Formula I to the DPIV inhibitor will generally range from about 1000: 1 to about 1 : 1000, preferably about 200: 1 to about 1 :200.
• Combinations of a compound of the Formula I and other active ingredients will generally also be within the aforementioned range, but in each case, an effective dose of each active ingredient should be used.
• the compounds of the present invention can be prepared according to the procedures of the following Examples, using appropriate materials.
• the compounds illustrated in the examples are not, however, to be construed as forming the only genus that is considered as the invention.
• the Examples further illustrate details for the preparation of the compounds of the present invention.
• Those skilled in the art will readily understand that known variations of protecting groups, as well as of the conditions and processes of the following preparative procedures, can be used to prepare these compounds.
• a chemical reagent such as a boronic acid or a boronate is not commercially available, such a chemical reagent can be readily prepared following one of numerous methods described in the literature. All temperatures are degrees Celsius unless otherwise noted.
• Mass spectra (MS) were measured either by electrospray ion-mass spectroscopy (ESMS) or by atmospheric pressure chemical ionization mass spectroscopy (APCI).
• NaHMDS is sodium hexamethyldisilazide
• NaOH is sodium hydroxide
• Na 2 S0 4 is sodium sulfate
• NH 4 OAc is ammonium acetate
• NBS is N-bromo succinamide
• NIS is N-iodo succinamide
• NMO is 4-methyl morpholine N-oxide
• NMP is l-methyl-2-pyrrolidinone
• NMR nuclear magnetic resonance spectroscopy
• PE is petroleum ether
• PG is protecting group
• P(Cy) 3 is tricyclohexyl phosphine
• Pd 2 (dba) 3 is tris(dibenzylideneacetone)dipalladium(0)
• Pd[P(t-Bu) 3 ] 2 is bis(tri-tert-butylphosphine)palladium (0)
• Pd(dppf)Cl 2 is [ ⁇ , ⁇ - bis(diphenylphosphino)fer
• TLC or prep-TLC, or prep TLC is preparative thin layer chromatography;
• RBF round bottom flask;
• RCM ring closing metathesis reaction;
• rt or r.t. or RT room temperature;
• s singlet;
• SFC supercritical fluid chromatography;
• s-phos is 2-dicyclohexylphosphino-2',6'-dimethoxybiphenyl;
• t is triplet;
• TBTU is A .A ⁇ N'.N'-Tetramethyl-O- ⁇ enzotriazol-l-y ⁇ uronium tetrafluoroborate;
• TEA is triethyl amine;
• Ti(OiPr) 4 is titanium isopropoxide;
• TFA trifluoroacetic acid;
• TLC thin-layer chromatography;
• TMSC1 is trimethyl silyl chloride;
• Step C (4-Bromo-5-vinyl-pyridin-2-yl)-bis-(4-methoxy-benzyl)-amine (1-4)
• Step D (4-Allyl-5-vinyl-pyridin-2-yl)-bis-(4-methoxy-benzyl)-amine (1-5)
• Step E Bis-(4-methoxy-benzyl)-(5H-[21pyrindin-3-yl)-amine (1-6)
• Step F 4-[Bis-(4-methoxy-benzyl)-amino "
• Step G 4-Amino-l,la,6,6a-tetrahydro-3-aza-cyclopropa[alindene-l-carboxylic acid ethyl ester
• Step H 4-Hydroxy-l,la,6,6a-tetrahydro-3-aza-cyclopropa[alindene-l-carboxylic acid ethyl ester
• Step A (5-bromo-2-methoxyisonicotinaldehyde (39-1)
• Step C (E)-methyl 4-(3-ethoxy-3-oxoprop-l-en-l-yl)-6-methoxynicotinate (39-3)
• Step D methyl 4-(3-ethoxy-3-oxopropyl)-6-methoxynicotinate (39-4) " ⁇ COOI le ⁇ COOMe
• Step E ethyl 3-methoxy-7-oxo-6,7-dihydro-5H-cyclopenta[clpyridine-6-carboxylate (39-5)
• Step F 3-methoxy-5H-cyclopenta[clpyridin-7(6H)-one (39-6)
• Step G 3-methoxy-6,7-dihydro-5H-cyclopenta[clpyridin-7-ol (39-7)
• Step I ethyl 3-methoxy-5,5a,6,6a-tetrahydrocyclopropa[4,51cyclopenta[l,2-clpyridine-6- carboxylate (39-9)
• Step J ethyl 3-hydroxy-5,5a,6,6a-tetrahydrocyclopropa[4,51cyclopenta[l,2-clpyridine-6- carboxylate (1-9)
• Step A [2-Fluoro-5-(4,4,5,5-tetramethyl-[l ,3,21dioxaborolan-2-yl)-phenyll-methanol (2-2)
• Step B 2-(3-Bromomethyl-4-fluoro-phenyl)-4,4,5,5-tetramethyl-[l ,3,21dioxaborolane (2-3)
• Step C 4-r2-Fluoro-5-(4,4,5.5-tetramethyl-ri.3.21dioxaborolan-2-vn-benzyloxy1-l , la,6.6a- tetrahydro-3-aza -cyclopropa
• Reference Example 2-5 was prepared in a similar manner to Reference Example 2-4 using the appropriate commercially available starting materials.
• Step B 3-bromo-2,4-dimethyl-6-(3-(methylthio)propoxy)pyridine (3-2)
• Step C 3-bromo-2,4-dimethyl-6-(3-(methylsulfonyl)propoxy)pyridine (3-3)
• Step A 3-(methylthio)propyl 4-methylbenzenesulfonate (34-1)
• Step B 3-(methylsulfonyl)propyl 4-methylbenzenesulfonate (34-2)
• Step D (2',6'-dimethyl-4'-(3 -(methylsulfonyl)propoxy)- [ 1 , 1 '-biphenyl] -3 -yPmethanol (34-4)
• Step E 3 , -(bromomethyl)-2,6-dimethyl-4-(3-(methylsulfonyl)propoxy)- 1 , 1 '-biphenyl (34-5)
• PBr 3 6.8 g, 25.2 mmol
• the reaction solution was stirred 0 °C for lh, then the mixture was warmed to 20 °C and stirred for 16 h.
• the mixture was then quenched with water, added to a saturated aqueous solution of NaHC0 3 to neutralize the mixture to pH 7.
• Step A 3 -((4-bromo-3 ,5 -dimethylphenoxy)methyl)-3 -methyloxetane (3-2)
• Step B (5aR,6S,6aS -ethyl 3-((2 , ,6 , -dimethyl-4 , -((3-methyloxetan-3-vnmethoxy - ⁇ . ⁇ - biphenyll-3-yl)methoxy)-5,5a,6,6a-tetrahydrocyclopropa[4,51cyclopenta[l,2-clpyridine-6- carboxylate (3-3)
• Step C (5aR,6S,6aS -3-((2 , ,6 , -dimethyl-4 , -((3-methyloxetan-3-vnmethoxy - ⁇ J'-biphenyll-3 - yl) methoxy)-5, 5a, 6, 6a-tetrahydrocyclopropa [4,5] cyclopenta [1,2-c pyridine- 6-carboxylic acid (3-4)
• Step A methyl 3-(4-bromo-3,5-dimethylphenoxy)propanoate (4-2)

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