Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/33—Heterocyclic compounds
  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • 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
  • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
  • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/12—Drugs for disorders of the urinary system of the kidneys
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
  • A61P21/04—Drugs for disorders of the muscular or neuromuscular system for myasthenia gravis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P29/00—Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/12—Antihypertensives

Definitions

• the field relates to the administration of inhibitors of phosphodiesterase 1 (PDEl) for the treatment of diseases or disorders characterized by disruption of or damage to certain cGMP/PKG mediated pathways (e.g., in cardiac tissue).
• the field further relates to inhibitors of phosphodiesterase 1 (PDEl) for treatment of cardiovascular disease and related disorders, e.g., congestive heart disease, atherosclerosis, myocardial infarction, and stroke.
• PDEs phosphodiesterases
• CaM-PDEs Ca 2+ -calmodulin-dependent phosphodiesterases
• PDEIA is expressed throughout the brain with higher levels of expression in the CA1 to CA3 layers of the hippocampus and cerebellum and at a low level in the striatum.
• PDEIA is also expressed in the lung and heart.
• PDEIB is predominately expressed in the striatum, dentate gyrus, olfactory tract and cerebellum, and its expression correlates with brain regions having high levels of dopaminergic innervation.
• PDEIB is primarily expressed in the central nervous system, it may be detected in the heart.
• PDE1C is expressed in olfactory epithelium, cerebellar granule cells, striatum, heart, and vascular smooth muscle.
• PDE1 the major PDE activity in the human cardiac ventricle is PDE1.
• PDE1 has been shown to promote human arterial smooth muscle cell proliferation.
• cGMP cGMP
• PDE1 has potential as a hypertrophy regulator.
• Cyclic nucleotide phosphodiesterases downregulate intracellular cAMP and cGMP signaling by hydrolyzing these cyclic nucleotides to their respective inactive 5'- monophosphates (5 ⁇ and 5'GMP).
• cGMP is a central intracellular second- messenger regulating numerous cellular functions. In the cardiac myocyte, cGMP mediates effects of nitric oxide and atrial natriuretic peptide, whereas its counterpart, cAMP, mediates catecholamine signaling.
• Each cyclic nucleotide has a corresponding primary targeted protein kinase, PKA for cAMP, and PKG for cGMP.
• PKA stimulation is associated with enhanced contractility and can stimulate growth, whereas PKG acts as a brake in the heart, capable of countering cAMP-PKA-contractile stimulation and inhibiting hypertrophy.
• duration and magnitude of these signaling cascades are determined not only by generation of cyclic nucleotides, but also by their hydrolysis catalyzed by phosphodiesterases (PDEs).
• PDEs phosphodiesterases
• PDE regulation is quite potent - often suppressing an acute rise in a given cyclic nucleotide back to baseline within seconds to minutes. It is also compartmentalized within the cell, so that specific targeted proteins can be regulated by the same "generic" cyclic nucleotide.
• Heart disease is typically a chronic and progressive illness that kills more than 2.4 million Americans each year. There are approximately 500,000 new cases of heart failure per year, with an estimated 5 million patients in the United States alone having this disease. Early intervention is likely to be most effective in preserving cardiac function. It would be most desirable to prevent as well to reverse the morphological, cellular, and molecular remodeling that is associated with heart disease.
• Some of the most important indicators of cardiac risk are age, hereditary factors, weight, smoking, blood pressure, exercise history, and diabetes.
• Other indicators of cardiac risk include the subject's lipid profile, which is typically assayed using a blood test, or any other biomarker associated with heart disease or hypertension. Other methods for assaying cardiac risk include, but are not limited to, an EKG stress test, thallium stress test, EKG, CT scan, echocardiogram, magnetic resonance imaging study, non-invasive and invasive arteriogram, and cardiac catheterization.
• Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein, and/or pulmonary capillaries. It is a very serious condition, potentially leading to shortness of breath, dizziness, fainting, decreased exercise tolerance, heart failure, pulmonary edema, and death. It can be one of five different groups, classified by the World Health Organization as follows:
• IP AH Idiopathic
• FPAH Familial
• APAH collagen vascular disease (e.g. scleroderma), congenital shunts between the systemic and pulmonary circulation, portal hypertension, HIV infection, drugs, toxins, or other diseases or disorder.
• APAH Associated with venous or capillary disease
• Pulmonary arterial hypertension involves the vasoconstriction or tightening of blood vessels connected to and within the lungs. This makes it harder for the heart to pump blood through the lungs, much as it is harder to make water flow through a narrow pipe as opposed to a wide one. Over time, the affected blood vessels become both stiffer and thicker, in a process known as fibrosis. This further increases the blood pressure within the lungs and impairs their blood flow. In addition, the increased workload of the heart causes thickening and enlargement of the right ventricle, making the heart less able to pump blood through the lungs, causing right heart failure. As the blood flowing through the lungs decreases, the left side of the heart receives less blood. This blood may also carry less oxygen than normal. Therefore it becomes more and more difficult for the left side of the heart to pump to supply sufficient oxygen to the rest of the body, especially during physical activity.
• WHO Group II Pulmonary hypertension associated with left heart disease a. Atrial or ventricular disease b. Valvular disease (e.g. mitral stenosis)
• pulmonary venous hypertension there may not be any obstruction to blood flow in the lungs. Instead, the left heart fails to pump blood efficiently out of the heart into the body, leading to pooling of blood in veins leading from the lungs to the left heart (congestive heart failure or CHF). This causes pulmonary edema and pleural effusions. The fluid build-up and damage to the lungs may also lead to hypoxia and consequent vasoconstriction of the pulmonary arteries, so that the pathology may come to resemble that of Group 1 or III.
• WHO Group III Pulmonary hypertension associated with lung diseases and/or hypoxemia a.
• COPD chronic obstructive pulmonary disease
• ILD interstitial lung disease
• Antihypertensive drugs that work by dilating the peripheral arteries are frequently ineffective on the pulmonary vasculature.
• calcium channel blockers are effective in only about 5% of patients with IP AH.
• Left ventricular function can often be improved by the use of diuretics, beta blockers, ACE inhibitors, etc., or by
• Newer drugs targeting the pulmonary arteries include endothelin receptor antagonists (e.g., bosentan, sitaxentan, ambrisentan), phosphodiesterase type 5 inhibitors (e.g., sildenafil, tadalafil), prostacyclin derivatives (e.g., epoprostenol, treprostenil, iloprost, beroprost), and soluble guanylate cyclase (sGC) activators (e.g., cinaciguat and riociguat).
• Surgical approaches to PAH include atrial septostomy to create a
• Heart failure and acute myocardial infarction are common and serious conditions frequently associated with thrombosis and/or plaque build-up in the coronary arteries.
• Cardiovascular disease or dysfunction may also be associated with diseases or disorders typically thought of as affecting skeletal muscle.
• DMD Duchenne muscular dystrophy
• DMD is a disorder that primarily affects skeletal muscle development but can also result in cardiac dysfunction and cardiomyopathy.
• the disorder is caused by a mutation in the dystrophin gene, located on the human X chromosome, which codes for the protein dystrophin, an important structural component within muscle tissue that provides structural stability to the dystroglycan complex (DGC) of the cell membrane. While both sexes can carry the mutation, females rarely exhibit signs of the disease.
• DGC dystroglycan complex
• Patients with DMD lack expression of the protein dystrophin as a result of mutations in the X-linked dystrophin gene. Additionally, the loss of dystrophin leads to severe skeletal muscle pathologies as well as cardiomyopathy, which manifests as congestive heart failure and arrhythmias. The absence of a functional dystrophin protein is believed to lead to reduced expression and mis-localization of dystrophin-associated proteins including neuronal nitric oxide (NO) synthase. Disruption of nNOS signaling may result in muscle fatigue and unopposed sympathetic vasoconstriction during exercise, thereby increasing contraction-induced damage in dystrophin-deficient muscles. The loss of normal nNOS signaling during exercise is central to the vascular dysfunction proposed to be an important pathogenic mechanism in DMD.
• NO neuronal nitric oxide
• cardiovascular disease and disorders e.g. congestive heart disease
• diseases and disorders which may result in cardiac dysfunction or cardiomyopathy e.g., Duchenne
• PDE1A and PDE1C are believed to be abundantly expressed in cardiac, vascular, and lung tissues.
• PDEl is also believed to be up-regulated in chronic disease conditions such as atherosclerosis, cardiac pressure-load stress and heart failure, as well as in response to long-term exposure to nitrates.
• the compounds of the present invention are able to modulate cGMP/PKG mediated pathways. Consequently, the PDEl inhibitors disclosed herein are believed to have significant modulatory activity (e.g., enhancement of cGMP) in those areas of the body where PDEl isoforms are predominately located: e.g., cardiac, vascular, and lung tissue.
• PDEl inhibitors may have relatively little impact on resting function, but rather maintain the ability to potently modulate acute contractile tone in cells stimulated by vasoactive agonists.
• PDEl may modulate acute contractile tone in cells that are activated by hypertrophic stimuli. Consequently, without being bound by theory, it is believed that in one embodiment that the application or administration of the PDEl inhibitors disclosed herein could work to prevent hypertrophic responses and possibly reverse any existing tissue hypertrophy.
• the selective PDEl inhibitors e.g., Compounds of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and XI described herein, may be involved in regulating cGMP/PKG involvement in cardiac hypertrophy.
• Previous studies have demonstrated that intracellular Ca2+/CaM- dependent signaling promotes maladaptive hypertrophic gene expression in
• cardiomyocytes through various effectors such as the protein phosphatase calcineurin, Ca2+/CaM-dependent kinase II (CaMKII).
• CaMKII Ca2+/CaM-dependent kinase II
• Endogenous cGMP/PKG-dependent signaling may be able to negatively regulate cardiac hypertrophy, by suppressing Gq/11 activation and normalizing Ca2+ signaling.
• Ca2+/CaM by activating PDEl A, may decrease cGMP levels and PKG activity. In turn, this process may lead to potentiated cardiomyocyte hypertrophy. Additionally, upregulation of PDEl A expression upon neurohumoral or biomechanical stress during cardiac hypertrophy may further enhance PDEl A activity and attenuates cGMP/PKG signaling. Accordingly, without being bound by any theory, it is believed that inhibition of PDEl A, for example, could reverse or prevent the attenuation of cGMP/PKG signaling. Therefore, administration of a preferred PDEl inhibitor as described herein could provide a potential means to regulate cardiac hypertrophy, and by extension provide a treatment for various cardiovascular diseases and disorders.
• the invention provides a new method of treatment or prophylaxis of cardiovascular disease and disorders (e.g., atherosclerosis, pulmonary arterial hypertension, myocardial infarction) that may be ameliorated by administration of a specific inhibitor of phosphodiedsterase type I (e.g., PDEl inhibitor, e.g., a PDEl A or PDE1C inhibitor) (e.g., a PDEl inhibitor of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and/or XI as herein described).
• a specific inhibitor of phosphodiedsterase type I e.g., PDEl inhibitor, e.g., a PDEl A or PDE1C inhibitor
• a PDEl inhibitor of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and/or XI as herein described e.g., a PDEl inhibitor of Formula I, II, III, IV, V, VI
• the cardiovascular disease or disorder may selected from the group consisting of: hypertension, congestive heart failure, angina, stroke, essential hypertension, pulmonary hypertension, secondary pulmonary hypertension, isolated systolic hypertension, hypertension associated with diabetes, hypertension associated with atherosclerosis, renovascular hypertension, congestive heart failure, angina, stroke.
• the cardiovascular disease or disorder to be treated may also relate to impaired cGMP/PKG-dependent signaling.
• the PDEl inhibitor (e.g., a PDEl inhibitor of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and/or XI as herein described) may be administered in combination with an angiotensin II receptor antagonist.
• angiotensin II receptor antagonists for use with the invention include candesartan, eprosartan, irbesartan, losartan, olmesartan, olmesartan medoxomil, saralasin, telmisartan and valsartan.
• the invention also provides a new method of treatment or prophylaxis of cardiovascular disease or disorder that is associated with a muscular dystrophy (e.g,
• DMD Duchenne muscular dystrophy
• DMD is caused by the absence of a functional dystrophin protein, which in turn leads to reduced expression and mis- localization of dystrophin-associated proteins; which can include neuronal nitric oxide (NO) synthase.
• NO neuronal nitric oxide
• Disruption of nNOS signaling may result in muscle fatigue and unopposed sympathetic vasoconstriction during exercise, thereby increasing contraction- induced damage in dystrophin-deficient muscles.
• the loss of normal nNOS signaling during exercise may be central to the vascular dysfunction proposed to be an important pathogenic mechanism in DMD.
• PDE1A, PDE1C e.g., administering or using a PDE1 inhibitor of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and/or XI as herein described
• at least one mechanism of the compounds described herein may be to circumvent defective nNOS signaling in dystrophic skeletal and/or cardiac muscle; thereby potentially improving cardiac outcomes in, at least, DMD patients.
• the invention provides a novel method of treatment or prophylaxis for cardiac dysfunction associated with Duchenne muscular dystrophy that may be ameliorated by administration of a phosphodiesterase type I (PDE1 inhibitor, e.g., a PDE1 inhibitor of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and/or XI as herein described) as described herein.
• PDE1 inhibitor e.g., a PDE1 inhibitor of Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and/or XI as herein described
• the PDE1 inhibitor is administered to a patient with a type of muscular dystrophy which may be selected from the group consisting of: Becker, limb-girdle, myotonic, and Emery- Dreifuss muscular dystrophy.
• the invention provides for the treatment of cardiovascular disease or disorder which may be associated with impaired cGMP signaling (e.g., cGMP/PKG signaling), wherein the disease or disorder may be selected from the group consisting of: angina, stroke, essential hypertension, pulmonary hypertension, secondary hypertension, isolated systolic hypertension, hypertension associated with diabetes, hypertension associated with atherosclerosis, renovascular hypertension, congestive heart failure, angina, stroke, hypertension, fibrosis, an inflammatory disease or disorder, cardiac hypertrophy, and an connective tissue disease or disorder (e.g., Marfan
• the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are optionally substituted 4,5,7, 8-tetrahydro-2H- imidazo[l,2-a]pyrrolo[3,4-e]pyrimidine or 4,5,7, 8,9-pentahydro-2H-pyrimido[ 1,2- a]pyrrolo[3,4-e]pyrimidine, e.g., a Compound of Formula II, e.g., II-A or II-B:
• L is a single bond, -N(H)-, -CH 2 -, -S-, -S(O)- or -S(0 2 )-;
• Ri is H or C 1-4 alkyl (e.g., methyl);
• P4 is H or Ci_ 6 alkyl (e.g., methyl or isopropyl) and R 2 and R 3 are,
• Ci-ealkyl e.g., methyl, isopropyl
• halo or hydroxy e.g., R 2 and R 3 are both methyl, or R 2 is H and R 3 is methyl, ethyl, isopropyl or hydroxyethyl
• aryl e.g., aryl,
• R 2 and R 3 together form a 3- to 6-membered ring
• R 2 is H and R 3 and R 4 together form a di-, tri- or tetramethylene bridge (pref. wherein the R 3 and R 4 together have the cis configuration, e.g., where the carbons carrying R 3 and R 4 have the R and S configurations, respectively);
• D is C ⁇ alkylene (e.g., methylene, ethylene or prop-2-yn-l-ylene);
• E is a single bond, C 2 - 4 alkynylene (e.g., -C ⁇ C-), arylene (e.g., phenylene) or heteroarylene (e.g., pyridylene);
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl, diazolyl, triazolyl, for example, pyrid-
• halo e.g., F, Br, CI
• haloC ⁇ alkyl e.g., trifluoromethyl
• C 3 _ 7 cycloalkyl optionally containing at least one atom selected from a group consisting of N or O (e.g., cyclopentyl, cyclohexyl, pyrrolidinyl (e.g., pyrrolidin-3-yl), tetrahydro- 2H-pyran-4-yl, or morpholinyl);
• N or O e.g., cyclopentyl, cyclohexyl, pyrrolidinyl (e.g., pyrrolidin-3-yl), tetrahydro- 2H-pyran-4-yl, or morpholinyl
• D, E and F are independently and optionally substituted with one or more halo (e.g., F, CI or Br), C 1-4 alkyl (e.g., methyl), haloC ⁇ alkyl (e.g., trifluoromethyl), C 1-4 alkoxy (e.g., methoxy), hydroxy, C 1-4 carboxy, or an additional aryl or heteroaryl (e.g., biphenyl or pyridylphenyl),
• halo e.g., F, CI or Br
• C 1-4 alkyl e.g., methyl
• haloC ⁇ alkyl e.g., trifluoromethyl
• C 1-4 alkoxy e.g., methoxy
• hydroxy C 1-4 carboxy
• an additional aryl or heteroaryl e.g., biphenyl or pyridylphenyl
• F is heteroaryl, e.g., pyridyl substituted with one or more halo (e.g., 6-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6- fluoropyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 4,6- dichloropyrid-2-yl), haloCi ⁇ alkyl (e.g., 5-trifluoromethylpyrid- 2-yl) or Ci ⁇ alkyl (e.g., 5-methylpyrid-2-yl), or F is aryl, e.g., phenyl, substituted with one or more halo (e.g., 4- fluorophenyl) or F is a C 3 _ 7 heterocycloalkyl (e.g., pyrrolidinyl) optionally substituted with a Ci-ealkyl (e.g., l-methylpyrrolidin-3
• X, Y and Z are, independently, N or C, and Rg, R9, Rn and R 12 are independently H or halogen (e.g., CI or F), and R 10 is halogen,
• haloCi ⁇ alkyl e.g., triflouromethyl
• heteroC 3 _ 7 cycloalkyl e.g., pyrrolidinyl or piperidinyl
• Ci ⁇ haloalkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl (for example pyrid-2-yl or pyrid-4-yl), or thiadiazolyl (e.g., l,2,3-thiadiazol-4-yl)
• diazolyl e.g., imidazol- l-yl
• triazolyl e.g., 1,2,4-triazol-l-yl
• arylcarbonyl e.g., benzoyl
• alkylsulfonyl e.g., methylsulfonyl
• heteroarylcarbonyl or alkoxycarbonyl
• aryl, heteroaryl, cycloalkyl or heterocycloalkyl is independently, optionally substituted with one or more C . 4alkyl (e.g., methyl), halogen (e.g., chloro or fluoro), haloCi- 4alkyl (e.g., trifluoromethyl), hydroxy, C 1-4 carboxy, -SH or an additional aryl, heteroaryl (e.g., biphenyl or pyridylphenyl) or C 3 _gcycloalkyl,
• C . 4alkyl e.g., methyl
• halogen e.g., chloro or fluoro
• haloCi- 4alkyl e.g., trifluoromethyl
• R 10 is phenyl, pyridyl, piperidinyl or pyrrolidinyl
• C ⁇ alkyl e.g., methyl, ethyl, n-propyl, isobutyl
• C 3 _ 7 cycloalkyl e.g., cyclopentyl or cyclohexyl
• heteroC 3 _ 7 cycloalkyl e.g., pyrrolidinyl, piperidinyl, morpholinyl
• aryl e.g., phenyl
• heteroaryl e.g., pyrid-4-yl
• arylC ⁇ alkyl e.g., benzyl
• arylamino e.g., phenylamino
• aryl and heteroaryl are optionally substituted with one or more C ⁇ alkyl (e.g., methyl), halogen (e.g., chloro or fluoro), haloCi ⁇ alkyl (e.g., trifluoromethyl), hydroxy, C 1-4 carboxy, or an additional aryl, heteroaryl (e.g., biphenyl or pyridylphenyl) or C 3 _ gcycloalkyl;
• C ⁇ alkyl e.g., methyl
• halogen e.g., chloro or fluoro
• haloCi ⁇ alkyl e.g., trifluoromethyl
• hydroxy, C 1-4 carboxy or an additional aryl, heteroaryl (e.g., biphenyl or pyridylphenyl) or C 3 _ gcycloalkyl
• R 7 is H, C 1-6 alkyl (e.g., methyl or ethyl), halogen (e.g., CI), -N(R 18 )(R 19 ), hydroxy or Q-ealkoxy;
• n 0 or 1 ;
• A is -C(R 13 R 14 )-, wherein R 13 and R 14> are, independently, H or C 1-4 alkyl, aryl, heteroaryl, (optionally hetero)arylC 1 _ 4 alkoxy, (optionally hetero)arylC 1 _ 4 alkyl or R 14 can form a bridge with R 2 or *;
• Ri5 is C 1-4 alkyl, haloC 1-4 alkyl, -OH or -OC 1-4 alkyl (e.g., -OCH 3 )
• R 16 and R 17 are independently H or C 1-4 alkyl
• C h alky e.g., methyl, ethyl, n-propyl, isobutyl
• C 3 _ 8 cycloalky e.g., cyclohexyl or cyclopenyl
• heteroC 3 _ 8 cycloalky e.g., pyrrolidinyl, piperidinyl, morpholinyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl
• halo e.g., fluorophenyl, e.g., 4-fluorophenyl
• hydroxy e.g., hydroxyphenyl, e.g., 4-hydroxyphenyl or 2- hydroxyphenyl
• C 1- alkyl e.g., methyl
• haloC ⁇ alkyl e.g., trifluoromethyl
• R 20 is H, C ⁇ alkyl or C 3 _ 7 cycloalkyl
• the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are Compound of Formula I, e.g. Formula I-A and I-B:
• ( ⁇ ) L is a single bond, -N(H)-, -CH 2 -, -S-, -S(O)- or -S(0 2 )-;
• Ri is H or C 1-4 alkyl (e.g., methyl);
• R 4 is H or Ci- 6 alkyl (e.g., methyl or isopropyl) and R 2 and R 3 are,
• H or C ⁇ ancyl e.g., methyl, isopropyl
• optionally substituted with halo or hydroxy e.g., R 2 and R 3 are both methyl, or R 2 is H and R 3 is methyl, ethyl, isopropyl or hydroxyethyl
• R 2 is H and R 3 and R 4 together form a di-, tri- or tetramethylene bridge (pref. wherein the R 3 and R 4 together have the cis configuration, e.g., where the carbons carrying R 3 and R 4 have the R and S configurations, respectively);
• D is C ⁇ alkylene (e.g., methylene, ethylene or prop-2-yn-l-ylene);
• E is a single bond, C 2 - 4 alkynylene (e.g., -C ⁇ C-), arylene (e.g., phenylene) or heteroarylene (e.g., pyridylene);
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl, diazolyl, triazolyl, for example, pyrid-
• halo e.g., F, Br, CI
• haloC 1 _ 4 alkyl e.g., trifluoromethyl
• C3_ 7 cycloalkyl optionally containing at least one atom selected from a group consisting of N or O (e.g., cyclopentyl, cyclohexyl, pyrrolidinyl (e.g., pyrrolidin-3-yl), tetrahydro- 2H-pyran-4-yl, or morpholinyl);
• N or O e.g., cyclopentyl, cyclohexyl, pyrrolidinyl (e.g., pyrrolidin-3-yl), tetrahydro- 2H-pyran-4-yl, or morpholinyl
• D, E and F are independently and optionally substituted with one or more halo (e.g., F, CI or Br), C 1-4 alkyl (e.g., methyl), haloCi ⁇ alkyl (e.g., trifluoromethyl), for example, F is heteroaryl, e.g., pyridyl substituted with one or more halo (e.g., 6-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6-fluoropyrid-2-yl, 3- fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 4,6-dichloropyrid-2-yl), haloC ⁇ alkyl (e.g., 5-trifluoromethylpyrid-2-yl) or C 1-4 alkyl (e.g., 5-methylpyrid-2-yl), or F is aryl, e.g., phenyl, substituted with one or more halo (e
• X, Y and Z are, independently, N or C, and R 8 , R 9 , Rn and R 12 are independently H or halogen (e.g., CI or F), and R 10 is halogen,
• C 1 _ 4 haloalkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl (for example pyrid-2-yl), or
• thiadiazolyl e.g., l,2,3-thiadiazol-4-yl
• diazolyl triazolyl
• tetrazolyl e.g., l,2,3-thiadiazol-4-yl
• arylcarbonyl e.g., benzoyl
• alkylsulfonyl e.g., methylsulfonyl
• C 3 _ 7 cycloalkyl e.g., cyclopentyl
• aryl e.g., phenyl
• heteroaryl e.g., pyrid-4-yl
• arylC ⁇ alkyl e.g., benzyl
• arylamino e.g., phenylamino
• N-aryl-N-(arylC 1-4 alkyl)amino e.g., N-phenyl-N-(l,l'-biphen-4- ylmethyl)amino
• N-aryl-N-(arylC 1-4 alkyl)amino e.g., N-phenyl-N-(l,l'-biphen-4- ylmethyl)amino
• aryl or heteroaryl is optionally substituted with one or more halo (e.g., F, CI), hydroxy or Ci ⁇ alkoxy;
• R 7 is H, Ci-ealkyl, halogen (e.g., CI), -N(Ri 8 )(Ri 9 );
• n 0 or 1 ;
• A is -C(R 13 R 14 )-, wherein R 13 and R 14> are, independently, H or C 1-4 alkyl, aryl, heteroaryl, (optionally hetero)arylC 1 _ 4 alkoxy or (optionally hetero)arylC 1-4 alkyl;
• R 15 is Ci_ 4 alkyl, haloC ⁇ alkyl, -OH or -OC ⁇ alkyl (e.g., -OCH 3 )
• R 16 and R 17 are independently H or C 1-4 alkyl
• R 18 and R 19 are independently H, C 1-4 alky or aryl (e.g., phenyl) wherein said aryl is optionally substituted with one or more halo (e.g.,
• fluorophenyl e.g., 4-fluorophenyl
• hydroxy e.g., hydroxyphenyl, e.g., 4-hydroxyphenyl or 2-hydroxyphenyl
• R 2 o is H, C ⁇ alkyl or C 3 _ 7 cycloalkyl
• phosphodiesterase-mediated e.g., PDEl -mediated, especially PDE1B- mediated
• hydrolysis of cGMP e.g., with an IC 50 of less than ⁇ , preferably less than 750 nM, more preferably less than 500 nM, more preferably less than 50 nM in an immobilized-metal affinity particle reagent PDE assay,
• the invention further provides optionally substituted 4,5,7, 8-tetrahydro- (optionally 4-thioxo or 4-imino)-(lH or 2H)-imidazo[l,2-a]pyrazolo[4,3-e]pyrimidine or 4,5,7,8,9-pentahydro-(lH or 2H)-pyrimido[l,2-a]pyrazolo[4,3-e]pyrimidine compounds, in free or salt form, e.g., (1 or 2 and/or 3 and/or 5)-substituted 4,5,7, 8-tetrahydro-lH- imidazo[l,2-a]pyrazolo[4,3-e]pyrimidine, 4,5,7, 8-tetrahydro-2H-imidazo[ 1,2- a]pyrazolo[4,3-e]pyrimidine, 4,5,7, 8-tetrahydro-(lH or 2H)-pyrimid
• (xv) L is a single bond, -N(H)-, -CH 2 -;
• Ri is H or C 1-4 alkyl (e.g., methyl or ethyl);
• R 4 is H or Ci_ 6 alkyl (e.g., methyl, isopropyl) and R 2 and R 3 are,
• H or C ⁇ ancyl e.g., methyl or isopropyl
• optionally substituted with halo or hydroxy e.g., R 2 and R 3 are both methyl, or R 2 is H and R 3 is methyl, ethyl, isopropyl or hydroxyethyl
• aryl
• R 2 and R 3 together form a 3- to 6-membered ring
• R 2 is H and R 3 and R 4 together form a di-, tri- or tetramethylene bridge (pref. wherein the R 3 and R 4 together have the cis configuration, e.g., where the carbons carrying R 3 and R 4 have the R and S configurations, respectively);
• D is C ⁇ alkylene (e.g., methylene, ethylene or prop-2-yn-l-ylene);
• E is a single bond, C 2 _ 4 alkynylene (e.g., -C ⁇ C-), arylene (e.g., phenylene) or heteroarylene (e.g., pyridylene);
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl, diazolyl, triazolyl, for example, pyrid- 2-yl, imidazol-l-yl, 1,2,4-triazol-l-yl), halo (e.g., F, Br, CI),
• haloC ⁇ alkyl e.g., trifluoromethyl
• C 3 _ 7 cycloalkyl optionally containing at least one atom selected from a group consisting of N or O (e.g., cyclopentyl, cyclohexyl, pyrrolidinyl (e.g., pyrrolidin-3-yl), tetrahydro-
• D, E and F are independently and optionally substituted with one or more :
• halo e.g., F, CI or Br
• Ci_ 4 alkyl e.g., methyl
• haloC ⁇ alkyl e.g., trifluoromethyl
• C 1-4 alkyl e.g., 5-methylpyrid-2-yl
• F is heteroaryl, e.g., pyridyl substituted with one or more halo (e.g., 6-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6- fluoropyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 4,6- dichloropyrid-2- yl) ,
• F is aryl, e.g., phenyl, substituted with one or more halo (e.g.,
• F is a C 3 _ 7 heterocycloalkyl (e.g., pyrrolidinyl) optionally
• Ci-ealkyl e.g., l-methylpyrrolidin-3-yl
• X, Y and Z are, independently, N or C, and Rg, R 9 , Rn and R 12 are independently H or halogen (e.g., CI or F), and R 10 is: halogen,
• hetC 3 _ 7 cycloalkyl e.g., pyrrolidinyl or piperidinyl
• C 1 _ 4 haloalkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl (for example pyrid-2-yl), or
• thiadiazolyl e.g., l,2,3-thiadiazol-4-yl
• diazolyl triazolyl
• tetrazolyl e.g., arylcarbonyl (e.g., benzoyl)
• alkylsulfonyl e.g., methylsulfonyl
• R 0 is phenyl, pyridyl, piperidinyl or pyrrolidinyl
• C3_ 7 cycloalkyl e.g., cyclopentyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl, for example, pyrid-4-yl
• arylC ⁇ alkyl e.g., benzyl
• arylamino e.g., phenylamino
• N-aryl-N-(arylCMalkyl)amino e.g., N-phenyl-N-(l,l '-biphen-4- ylmethyl)amino
• aryl or heteroaryl is optionally substituted with one or more halo (e.g., F, CI), hydroxy, Ci ⁇ alkyl, Ci ⁇ alkoxy, C 3 _ gcycloalkyl, for example, R 6 is 4-hydroxyphenyl or 4-fluorophenyl,
• n 0 or 1 ;
• A is -C(R 13 R 14 )-, wherein R 13 and R 14> are, independently, H or C 1-4 alkyl, aryl, heteroaryl, (optionally hetero)arylC 1 _ 4 alkoxy,(optionally hetero)arylC 1 _ 4 alkyl or R 13 or R 14 can form a bridge with R 2 or R 4 ;
• R 15 is C 1-4 alkyl, haloCi_ 4 alkyl, -OH or -OCi_ 4 alkyl (e.g., -OCH 3 )
• R 16 and R 17 are independently H or C 1-4 alkyl
• aryl e.g., phenyl
• aryl or heteroaryl is optionally substituted with one or more
• halo e.g., fluorophenyl, e.g., 4-fluorophenyl
• hydroxy e.g., hydroxyphenyl, e.g., 4-hydroxyphenyl or 2- hydroxyphenyl
• R 2 o is H, C ⁇ alkyl (e.g., methyl) or C 3 _ 7 cycloalkyl,
• R 21 is C 1-6 alkyl
• the invention also provides a Compound of Formula IV:
• L is a single bond, -N(H)-, -CH 2 -;
• Ri is H or Ci-4 alkyl (e.g., methyl or ethyl);
• R 4 is H or Ci- 6 alkyl (e.g., methyl, isopropyl) and R 2 and R 3 are, independently, H or C ⁇ ancyl (e.g., methyl or isopropyl) optionally substituted with halo or hydroxy (e.g., R 2 and R 3 are both methyl, or R 2 is
• H and R 3 is methyl, ethyl, isopropyl or hydroxyethyl), aryl, heteroaryl,
• R 2 is H and R 3 and R 4 together form a di-, tri- or tetramethylene bridge (pref. wherein the R 3 and R 4 together have the cis configuration, e.g., where the carbons carrying R 3 and R 4 have the R and S configurations, respectively);
• D is Ci ⁇ alkylene (e.g., methylene, ethylene or prop-2-yn-l-ylene);
• E is a single bond, C 2 _ 4 alkynylene (e.g., -C ⁇ C-), arylene (e.g., phenylene) or heteroarylene (e.g., pyridylene);
• F is H, aryl (e.g., phenyl), heteroaryl (e.g., pyridyl, diazolyl,
• triazolyl for example, pyrid-2-yl, imidazol-l-yl, 1,2,4-triazol- 1- yl), halo (e.g., F, Br, CI), haloC ⁇ alkyl (e.g.,
• D, E and F are independently and optionally substituted with one or more :
• halo e.g., F, CI or Br
• Ci ⁇ alkyl e.g., methyl
• haloC 1 _ 4 alkyl e.g., trifluoromethyl
• F is heteroaryl, e.g., pyridyl substituted with one or more halo (e.g., 6-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6- fluoropyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 4,6- dichloropyrid-2-yl), haloC 1 _ 4 alkyl (e.g., 5-trifluoromethylpyrid-
• F is aryl, e.g., phenyl, substituted with one or more halo (e.g., 4- fluorophenyl)
• F is a C 3 _ 7 heterocycloalkyl (e.g., pyrrolidinyl) optionally
• Ci-ealkyl e.g., l-methylpyrrolidin-3-yl
• X, Y and Z are, independently, N or C, and Rg, R9, Rn and R 12 are independently H or halogen (e.g., CI or F), and R 10 is halogen,
• C 1 _ 4 haloalkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl (for example pyrid-2-yl), or thiadiazolyl (e.g., l,2,3-thiadiazol-4-yl)
• diazolyl e.g., diazolyl, triazolyl, tetrazolyl,
• arylcarbonyl e.g., benzoyl
• alkylsulfonyl e.g., methylsulfonyl
• C 3 _ 7 cycloalkyl e.g., cyclopentyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl, for example, pyrid-4-yl
• arylC ⁇ alkyl e.g., benzyl
• arylamino e.g., phenylamino
• N-aryl-N-(arylC 1-4 alkyl)amino e.g., N-phenyl-N-(l,l '-biphen-4- ylmethyl)amino
• N-aryl-N-(arylC 1-4 alkyl)amino e.g., N-phenyl-N-(l,l '-biphen-4- ylmethyl)amino
• R 6 is 4-hydroxyphenyl or 4-fluorophenyl
• A is -C(R 13 R 14 )-, wherein R 13 and R 14> are, independently, H or C 1-4 alkyl, aryl, heteroaryl, (optionally hetero)arylC 1 _ 4 alkoxy or (optionally hetero)arylC 1 _ 4 alkyl;
• Ri5 is C 1-4 alkyl, haloC ⁇ alkyl, -OH or -OCi_ 4 alkyl (e.g., -OCH 3 )
• R 16 and R 17 are independently H or C 1-4 alkyl
• Ri8 and R ⁇ are independently H, C 1-4 alky or aryl (e.g., phenyl) wherein said aryl is optionally substituted with one or more halo (e.g.,
• fluorophenyl e.g., 4-fluorophenyl
• hydroxy e.g., hydroxyphenyl, e.g., 4-hydroxyphenyl or 2-hydroxyphenyl
• R 2 o is H, Ci ⁇ alkyl (e.g., methyl) or C 3 _ 7 cycloalkyl,
• R 21 is C 1-6 alkyl
• the invention provides that the PDEl inhibitors for use in the methods of treatment and prophylaxis which are described herein are selected from any of the Applicant's own publications: US 2008-0188492 Al, US 2010- 0173878 Al, US 2010-0273754 Al, US 2010-0273753 Al, WO 2010/065153, WO 2010/065151, WO 2010/065151, WO 2010/065149, WO 2010/065147, WO
• the invention provides that the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are compounds of Formula
• Ri is H or C 1-4 alkyl (e.g., methyl);
• P4 is H or C 1-4 alkyl and R 2 and R 3 are, independently, H or C 1-4 alkyl (e.g., R 2 and R 3 are both methyl, or R 2 is H and R 3 is isopropyl), aryl, heteroaryl, (optionally hetero)arylalkoxy, or (optionally hetero)arylalkyl;
• R 2 is H and R 3 and R 4 together form a di-, tri- or tetramethylene bridge (pref. wherein the R 3 and R 4 together have the cis configuration, e.g., where the carbons carrying R 3 and R 4 have the R and S configurations, respectively);
• R 5 is a substituted heteroarylalkyl, e.g., substituted with haloalkyl or
• R5 is attached to one of the nitrogens on the pyrazolo portion of Formula V and is a moiety of Formula A
• halogen e.g., CI or F
• Rio is halogen, alkyl, cycloalkyl, haloalkyl (e.g., trifluoro methyl), aryl (e.g., phenyl), heteroaryl (e.g., pyridyl (for example pyrid-2-yl), or thiadiazolyl (e.g., l,2,3-thiadiazol-4-yl)), diazolyl, triazolyl, tetrazolyl, arylcarbonyl (e.g., benzoyl), alkylsulfonyl (e.g., methylsulfonyl), heteroarylcarbonyl, or alkoxycarbonyl; provided that when X, Y, or Z is nitrogen, Rg, R9, or Rio, respectively, is not present; and
• R 6 is H, alkyl, aryl, heteroaryl, arylalkyl (e.g., benzyl), arylamino (e.g., phenylamino), heterarylamino, N,N-dialkylamino, ⁇ , ⁇ -diarylamino, or N-aryl-N- (arylakyl)amino (e.g., N-phenyl-N-(l, l '-biphen-4-ylmethyl)amino); and
• A is -C(R 13 R 14 )- wherein R 13 and R 14> are, independently, H or C 1-4 alkyl, aryl, heteroaryl, (optionally hetero)arylalkoxy or (optionally hetero)arylalkyl;
• the invention provides that the PDEl inhibitors for use in the methods of treatment and proph laxis described herein are compounds of Formula VI:
• Ri is H or alkyl
• R 2 is H, alkyl, cycloalkyl, haloalkyl, alkylaminoalkyl, hydroxyalkyl, arylalkyl, heteroarylalkyl, or alkoxyarylalkyl;
• R 3 is heteroarylmethyl or formula A
• R 8 , R 9 , Rn and R 12 are independently H or halogen; and R 10 is halogen, alkyl, cycloalkyl, haloalkyl, aryl, heteroaryl, alkyl sulfonyl, arylcarbonyl, heteroarylcarbonyl, alkoxycarbonyl, or aminocarbonyl;
• R 4 is aryl or heteroaryl
• R 5 is H, alkyl, cycloalkyl, heteroaryl, aryl, p-benzylaryl;
• PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are compounds of Formula VII:
• Ci_ 6 alkylene e.g., methylene, ethylene or prop-2-yn-l-ylene
• Z is H, aryl (e.g., phenyl), heteroaryl (e.g., pyridyl, e.g., pyrid-2-yl), halo (e.g., F, Br, CI), haloCi_ 6 alkyl (e.g., trifluoromethyl),— C(O)— R 1 ,— N(R 2 )(R 3 ), or C 3 - 7 cycloalkyl optionally containing at least one atom selected from a group consisting of N or O (e.g., cyclopentyl, cyclohexyl, tetrahydro-2H-pyran-4-yl, or morpholinyl);
• R 1 is Ci_ 6 alkyl, haloCi_ 6 alkyl,—OH or— OCi_ 6 alkyl (e.g.,— OCH 3 );
• R 2 and R 3 are independently H or Ci ⁇ alkyl
• R 4 and R 5 are independently H, Ci_ 6 alky or aryl (e.g., phenyl) optionally substituted with one or more halo (e.g., fluorophenyl, e.g., 4-fluorophenyl), hydroxy (e.g., hydroxyphenyl, e.g., 4-hydroxyphenyl or 2-hydroxyphenyl) or Ci ⁇ alkoxy;
• halo e.g., fluorophenyl, e.g., 4-fluorophenyl
• hydroxy e.g., hydroxyphenyl, e.g., 4-hydroxyphenyl or 2-hydroxyphenyl
• Ci ⁇ alkoxy e.g., Ci ⁇ alkoxy
• X, Y and Z are independently and optionally substituted with one or more halo (e.g., F, CI or Br), Ci ⁇ alkyl (e.g., methyl), haloCi ⁇ alkyl (e.g., trifluoro methyl), for example, Z is heteroaryl, e.g., pyridyl substituted with one or more halo (e.g., 6- fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6-fluoropyrid-2-yl, 3-fluoropyrid-2-yl, 4- fluoropyrid-2-yl, 4,6-dichloropyrid-2-yl), haloCi-ealkyl (e.g., 5-trifluoromethylpyrid-2-yl) or Ci- 6 -alkyl (e.g., 5-methylpyrid-2-yl), or Z is aryl, e.g., phenyl, substituted with one or
• the invention provides that the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are compounds of Formula VIII:
• Ri is H or C 1-6 alkyl
• Ci-ealkoxyarylCi-ealkyl or
• G is a single bond or, alkylene
• J is cycloalkyl or heterocycloalkyl optionally substituted with alkyl
• R 3 is a) -D-E-F wherein
• D is single bond, Ci ⁇ alkylene or arylCi ⁇ alkylene
• E is a Ci-ealkylene, arylene, Ci-ealkylarylene, aminoCi- 6alkylene- or amino;
• F is heteroC 3 _ 8 cycloalkyl optionally substituted with Ci- 6alkyl;
• R 4 is aryl optionally substituted with one or more halo, hydroxy£JTQ or Ci_ 6alkoxy[[,]]; heteroaryl; or heteroC 3 _ 6 cycloalkyl; and
• R 5 is H, Ci- 6 alkyl, C 3 _ 8 cycloalkyl, heteroaryl, aryl or p-benzylaryl;
• alk refers to C 1-6 alkyl and "cycloalkyl” refers to C 3 _gcycloalkyl;
• the invention provides that the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are compounds of Formula IX:
• Ri is H or Ci ⁇ alkyl (e.g., methyl or ethyl);
• Ci-ealkyl e.g., isopropyl, isobutyl, 2-methylbutyl or 2,2- dimethylpropyl
• said alkyl group is optionally substituted with one or more halo (e.g., fluoro) or hydroxy
• hydroxyCi-ealkyl for example l-hydroxyprop-2-yl or 3- hydroxy-2-methylpropyl
• haloCi-ealkyl e.g., trifluoromethyl or 2,2,2-trifluoroethyl
• N(R 1 4)(R 1 5)-C 1 _ 6 alkyl e.g., 2-(dimethylamino)ethyl or 2- aminopropyl
• arylCo- 6 alkyl e.g., phenyl or benzyl
• Ci-ealkoxy for example, Ci-ealkoxyarylCo-ealkyl (e.g., 4-methoxybenzyl), heteroarylCo- 6 alkyl (e.g., pyridinylmethyl), wherein said heteroaryl is optionally substituted with one or more Ci-ealkoxy (e.g., Ci_ 6alkoxyheteroarylC i-ealkyl) ;
• Ci-ealkoxyarylCo-ealkyl e.g., 4-methoxybenzyl
• heteroarylCo- 6 alkyl e.g., pyridinylmethyl
• Ci-ealkoxy e.g., Ci_ 6alkoxyheteroarylC i-ealkyl
• G is a single bond or Ci ⁇ alkylene (e.g., methylene) and J is C 3 _ 8 cycloalkyl or heteroC 3 _ 8 cycloalkyl (e.g., oxetan-2- yl, pyrrolidin-3-yl, pyrrolidin-2-yl) wherein the cycloalkyl and heterocycloalkyl group are optionally substituted with one or more Ci ⁇ alkyl or amino, for example,
• cycloalkyl e.g., -Co- 4 alkyl-cyclopentyl, -Co- 4alkyl-cyclohexyl or -Co- 4 alkyl-cyclopropyl
• said cycloalkyl is optionally substituted with one or more Ci- 6 alkyl or amino (for example, 2- aminocyclopentyl or 2-aminocyclohexyl)
• -Co- 4 alkyl-C 3 _gheterocycloalkyl e.g., -Co- 4 alkyl- pyrrolidinyl, for example, -Co- 4 alkylpyrrolidin-3-yl
• said heterocycloalkyl is optionally substituted with Ci- 6 alkyl (e.g., methyl), for example, 1- methylpyrrolidin-3-yl, l-methyl-pyrrolindin-2-yl, 1- methyl-pyrrolindin-2-yl-methyl or 1-methyl- pyrrolindin-3-yl-methyl) ;
• Ci ⁇ alkylene e.g., methylene
• arylQ- 6alkylene e.g., benzylene or -CH 2 C 6 H 4 -
• C ⁇ alkylene e.g., methylene, ethynylene, prop-2-yn- l-ylene
• Co- 4 alkylarylene e.g., phenylene or -C 6 H 4 -, -benzylene- or -
• heteroarylene e.g., pyridinylene or pyrimidinylene
• aminoCi-ealkylene e.g., -CH 2 N(H)-
• heteroatom selected from N or O e.g., piperidinylene
• halo e.g., F, Br, CI
• Ci ⁇ alkyl e.g., isopropyl or isobutyl
• haloCi-ealkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• C 3 _gcycloalkyl optionally containing one or more atom selected from a group consisting of N, S or O (e.g., cyclopentyl, cyclohexyl, piperidinyl, pyrrolidinyl, tetrahydro-2H-pyran- 4-yl, or morpholinyl), and optionally substituted with one or more Ci-ealkyl (e.g., methyl or isopropyl), for example, l-methylpyrrolidin-2-yl, pyrrolidin- l-yl, pyrrolidin-2-yl, piperidin-2-yl, l-methylpiperidin-2-yl, l-ethylpiperidin-2- yi,
• heteroaryl e.g., pyridyl (for example, pyrid-2-yl), pyrimidinyl (for example, pyrimidin-2-yl), thiadiazolyl (for example, l,2,3-thiadiazol-4-yl), diazolyl (e.g., pyrazolyl (for example, pyrazol-l-yl) or imidazolyl (for example, imidazol-l-yl, 4-methylimidazolyl, l-methylimidazol-2- yl)), triazolyl (e.g., 1,2,4-triazol-l-yl), tetrazolyl (e.g., tetrazol-5-yl), alkyloxadiazolyl (e.g., 5 -methyl- 1,2,4- oxadiazol), wherein said heteroaryl is optionally substituted with one or more C 1-6 alkyl, halo (e.g., fluoro) or
• -0-haloCi_ 6 alkyl e.g., -0-CF 3
• Ci- 6 alkylsulfonyl for example, methylsulfonyl or -S(0) 2 CH 3 ), -C(0)-Ri3, wherein R 13 is -N(Ri 4 )(Ris), Ci_ 6 alkyl (e.g.,
• a substituted heteroarylCi-eaklyl e.g., substituted with haloCi- 6alkyl
• X, Y and Z are, independently, N or C, R-8, R9, R 11 and R 12 are independently H or halogen (e.g., CI or F); and
• halogen e.g., fluoro or chloro
• heteroC 3 _gcycloalkyl e.g., pyrrolidinyl or piperidinyl
• haloCi-ealkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl
• pyrid-2-yl or e.g., thiadiazolyl (for example, l,2,3-thiadiazol-4-yl), diazolyl, triazolyl (e.g., 1,2,4-triazol-l-yl), tetrazolyl (e.g., tetrazol-5- yl), alkyloxadiazolyl (e.g., 5-methyl- 1,2,4- oxadiazol), pyrazolyl (e.g., pyrazol-l-yl), wherein said aryl, heteroaryl, cycloalkyl or
• heterocycloalkyl is optionally substituted with one or more Ci ⁇ alkyl (e.g., methyl), halogen (e.g., chloro or fluoro), haloCi ⁇ alkyl (e.g.,
• Ci- 6 alkyl sulfonyl e.g., methyl sulfonyl
• arylcarbonyl e.g., benzoyl
• Ci-ealkoxycarbonyl (e.g., methoxycarbonyl)
• R 10 is phenyl, pyridyl, piperidinyl or
• pyrrolidinyl optionally substituted with the substituents previously defined, e.g. optionally substituted with halo or alkyl; provided that when X, Y or X is nitrogen, Rg, R9 or R ⁇ , respectively, is not present;
• R 4 and R5 are independently:
• Ci-ealkyl e.g., methyl, isopropyl, isobutyl, n-propyl
• C 3 _gcycloalkyl e.g., cyclopentyl or cyclohexyl
• C 3 _gheterocycloalkyl e.g., pyrrolidinyl (for example pyrrolidin-3- yl or pyrrolidin- l-yl), piperidinyl (for example, piperidin-l-yl), morpholinyl),
• -Co- 6 alkylaryl e.g., phenyl or benzyl
• aryl or heteroaryl is optionally substituted with one or more halo (e.g., 4-fluorophenyl), hydroxy (e.g., 4- hydroxyphenyl), Ci- 6 alkyl, Ci ⁇ alkoxy or another aryl group (e.g., biphenyl-4-ylmethyl);
• halo e.g., 4-fluorophenyl
• hydroxy e.g., 4- hydroxyphenyl
• Ci- 6 alkyl Ci ⁇ alkoxy or another aryl group (e.g., biphenyl-4-ylmethyl);
• R 6 is H, C 1-6 alkyl (e.g., methyl or ethyl) or C 3 _gcycloalkyl;
• R 14 and R 15 are independently H or Ci- 6 alkyl
• the invention provides that the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are Formula X, e.g.:
• Ri is H or Ci ⁇ alkyl (e.g., methyl or ethyl);
• R 2 is H, Q-ealkyl (e.g., isopropyl, isobutyl, 2-methylbutyl, 2,2- dimethylpropyl) wherein said alkyl group is optionally substituted with halo (e.g., fluoro) or hydroxy (e.g., 1- hydroxypropan-2-yl, 3-hydroxy-2- methylpropyl), for example, R 2 may be a trifluoromethyl or 2,2,2- trifluoroethyl, ⁇ ( ⁇ 14 )( ⁇ 15 )- Ci-ealkyl (e.g., 2-(dimethylamino)ethyl or 2- aminopropyl), arylCi-ealkyl (e.g., phenyl or benzyl), heteroaryl Ci-ealkyl (e.g., pyridinylmethyl), Ci-ealkoxyaryl-Ci ⁇ alkyl (e.g., 4-methoxybenzyl); -
• G is a single bond or, alkylene (e.g., methylene); J is cycloalkyl or heterocycloalkyl (e.g., oxetan-2-yl, pyrolyin-3-yl, pyrolyin-2-yl) optionally substituted with one or more Ci-ealkyl (e.g., (1- methylpyrolidin-2-yl)), amino (e.g., -NH 2 ), for example, -G-J may be -Co- 4 alkyl-C3_ 8 cycloalkyl (e.g., cyclopentyl, cyclohexyl or cyclopropylmethyl) optionally substituted with one or more Ci_ 6 alkyl, amino (e.g., -NH 2 ), for example, 2-aminocyclopentyl or 2- aminocyclohexyl,wherein said cycloalkyl optionally contains one or more heteroatom selected from N and O (e.g.
• D is a single bond
• Ci_ 6 alkylene e.g., methylene
• arylalkylene e.g., p-benzylene or -CH 2 C 6 H 4 -
• E is a single bond
• Ci-ealkylene e.g., methylene
• C 2 _ 6 alkynylene e.g., ethynylene, prop-2-yn- 1- ylene),ethynylene, prop-2-yn- 1 -ylene
• -Co ⁇ alkylarylene e.g., phenylene or -C 6 H 4 -, -benzyle ⁇ - or - CH 2 C 6 H 4 -
• the arylene group is optionally substituted with halo (e.g., CI or F), heteroarylene (e.g., pyridinylene or pyrimidinylene), aminoCi_ 6 alkylene (e.g., - CH 2 N(H)-), amino (e.g., -N(H)-);
• C3_ 8 cycloalkylene optionally containing one or more heteroatom selected from N or O (e.g., piperidinylene),
• Ci ⁇ alkyl e.g., isopropyl or isobutyl
• haloCi ⁇ alkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• C3_ 8 cycloalkyl optionally containing at least one atom selected from a group consisting of N or O (e.g., cyclopentyl, N cyclohexyl, piperidinyl, pyrrolidinyl, tetrahydro-2H-pyran- 4-yl, or morpholinyl), said cycloalkyl is optionally substituted with Ci-ealkyl (e.g., methyl or isopropyl), for example, l-methylpyrrolidin-2-yl, pyrrolidin-l-yl, pyrrolidin-2-yl, piperidin-2-yl, l-methyrpiperidin-2
• Ci-ealkyl e.g.,
• Ci-ealkoxy e.g., methoxy
• C 3 _gcycloalkyl e.g., C 3 _gcycloalkyl
• heteroC 3 _gcycloalkyl e.g.,
• pyrrolidinyl) haloCi-ealkyl e.g., trifluoromethyl
• aryl e.g., phenyl
• heteroaryl e.g., pyridyl, (for example, pyrid-2-yl) or e.g., thiadiazolyl (for example, 1,2,3- thiadiazol-4-yl)
• diazolyl e.g., imidazolyl or pyrazolyl
• triazolyl e.g., 1,2,4- triazol-l-yl
• tetrazolyl e.g., tetrazol-5-yl
• alkoxadiazolyl e.g., 5-methyl-l,2,4- oxadiazol
• pyrazolyl e.g., pyrazol-l-yl
• Ci ⁇ alkyl sulfonyl e.g., methyl sulfon
• C 3 _gcycloalkyl e.g., cyclopentyl
• C 3 _gheterocycloalkyl e.g., pyrrolidin-3-yl
• aryl e.g., phenyl
• heteroaryl e.g., pyrid-4-yl, pyrid-2-yl or pyrazol-3-yl
• said aryl or heteroaryl is optionally substituted with halo (e.g., 4-fluorophenyl), hydroxy (e.g., 4-hydroxyphenyl), Ci_ 6 alkyl, Ci- 6 alkoxy or another aryl group (e.g., biphenyl-4- ylmethyl);
• R 7 is H, Ci ⁇ alkyl (e.g., methyl) or C 3 _ 8 cycloalkyl wherein said cycloalkyl is optionally substituted with one or more oxo (e.g., 2,5-dioxopyrrolidin-l- yl);
• R 13 is -N(R 14 )(R 15 ), C ⁇ alkyl (e.g., methyl), -Od_ 6 alkyl (e.g., -OCH 3 ), haloCi-ealkyl (trifluoromethyl), aryl (e.g., phenyl), or heteroaryl; and
• R 14 and R 15 are independently H or Ci- 6 alkyl
• Ri 6 and R 17 are independently H, Ci-ealkyl, aryl (e.g., phenyl), heteroaryl, wherein said aryl or heteroaryl is optionally substituted with halo (e.g., fluoro), Ci ⁇ alkoxy (e.g.,methoxy); in free or salt form.
• halo e.g., fluoro
• Ci ⁇ alkoxy e.g.,methoxy
• the invention provides that the PDEl inhibitors for use in the methods of treatment and prophylaxis described herein are Formula XI:
• L is S, SO or S0 2 ;
• R 2 is H or Ci ⁇ alkyl (e.g., methyl or ethyl); (iii) R 2 is
• Ci-ealkyl e.g., isopropyl, isobutyl, neopentyl, 2-methylbutyl, 2,2-dimethylpropyl
• said alkyl group is optionally substituted with halo (e.g., fluoro) or hydroxy (e.g., 1- hydroxypropan-2-yl, 3-hydroxy-2-methylpropyl), -Co- 4 alkyl-C 3 _ gcycloalkyl (e.g., cyclopentyl, cyclohexyl) optionally substituted with one or more amino (e.g., -NH 2 ), for example, 2-aminocyclopentyl or 2- aminocyclohexyl),wherein said cycloalkyl optionally contains one or more heteroatom selected from N and O and is optionally substituted with Ci- 6 alkyl (e.g., 1-methyl- pyrrolindin-2-yl, l-methyl-pyrrolindin-3-yl, 1-methyl
• C 3 .gheterocycloalkyl e.g., pyrrolidinyl, for example, pyrrolidin-3-yl
• Ci- 6 alkyl e.g., methyl
• C 3 _ gcycloalkyl-Ci-ealkyl e.g.,cyclopropylmethyl
• haloCi ⁇ alkyl e.g.,
• J is cycloalkyl or heterocycloalkyl (e.g., oxetan-2-yl, pyrolyin-3-yl, pyrolyin-2-yl) optionally substituted with C 6 alkyl (e.g., (l-methylpyrolidin-2-yl));
• R 3 is attached to one of the nitrogens on the pyrazolo portion of Formula I and is a moiety of Formula A
• Rn and R 12 are independently H or halogen (e.g., CI or F); and R 10 is halogen, C 1-6 alkyl, C 3 _ 8 cycloalkyl, heteroC 3 _ 8 cycloalkyl (e.g., pyrrolidinyl or piperidinyl) haloQ-ealkyl (e.g., trifluoromethyl), aryl (e.g., phenyl), heteroaryl (e.g., pyridyl, (for example, pyrid-2-yl) or e.g., thiadiazolyl (for example, l,2,3-thiadiazol-4- 15 yl), diazolyl, triazolyl (e.g., 1,2,4- triazol-l-yl), tetrazolyl (e.g., tetrazol-5-yl), alkoxadiazolyl (e.g., 5-methyl-l,2,4- o
• R 4 is a phenyl, pyridyl, e.g., 2-pyridyl, piperidinyl, or pyrrolidinyl; wherein the aryl, heteroaryl cycloalkyl or heterocycloalkyl is optionally substituted with one or more halo (e.g., F or CI), C 1-6 alkly, Ci ⁇ alkoxy, Ci- 4 haloalkyl (e.g., trifluoromethyl), and/or -SH, provided that when X, Y or X is nitrogen, Rg, R9 or R 10 , respectively, is not present; (v) R 4 is a halo (e.g., F or CI), C 1-6 alkly, Ci ⁇ alkoxy, Ci- 4 haloalkyl (e.g., trifluoromethyl), and/or -SH, provided that when X, Y or X is nitrogen, Rg, R9 or R 10 , respectively, is not present
• Ci-ealkyl e.g., methyl, isopropyl
• C 3 _ 8 cycloalkyl e.g., cyclopentyl
• C 3 _ 8 heterocycloalkyl e.g., pyrrolidin-3-yl
• aryl e.g., phenyl
• heteroaryl e.g., pyrid-4-yl, pyrid-2-yl or pyrazol-3-yl
• said aryl or heteroaryl is optionally substituted with halo (e.g., 4-fluorophenyl), hydroxy (e.g., 4-hydroxyphenyl), C 1-6 alkyl, Ci-ealkoxy or another aryl group (e.g., biphenyl-4- ylmethyl);
• R 14 and R 15 are independently H or Ci- 6 alkyl, in free or salt form.
• the invention further provides the use of PDEl inhibitors of any of the preceding formulae (e.g., Formula I, II, III, IV, V, VI, VII, VIII, IX, X, XI), wherein the compound is selected from any of the following:
• selective PDEl inhibitors of the any of the preceding formulae are compounds that inhibit phosphodiesterase-mediated (e.g., PDEl -mediated, especially PDEIA or PDE1C- mediated) hydrolysis of cGMP, e.g., the preferred compounds have an an IC 50 of less than ⁇ , preferably less than 500 nM, preferably less than 50 nM, and preferably less than 5nM in an immobilized-metal affinity particle reagent PDE assay, in free or salt form.
• phosphodiesterase-mediated e.g., PDEl -mediated, especially PDEIA or PDE1C- mediated
• the preferred compounds have an an IC 50 of less than ⁇ , preferably less than 500 nM, preferably less than 50 nM, and preferably less than 5nM in an immobilized-metal affinity particle reagent PDE assay, in free or salt form.
• Alkyl as used herein is a saturated or unsaturated hydrocarbon moiety, preferably saturated, preferably having one to six carbon atoms, which may be linear or branched, and may be optionally mono-, di- or tri- substituted, e.g., with halogen (e.g., chloro or fluoro), hydroxy, or carboxy.
• halogen e.g., chloro or fluoro
• Cycloalkyl as used herein is a saturated or unsaturated nonaromatic hydrocarbon moiety, preferably saturated, preferably comprising three to nine carbon atoms, at least some of which form a nonaromatic mono- or bicyclic, or bridged cyclic structure, and which may be optionally substituted, e.g., with halogen (e.g., chloro or fluoro), hydroxy, or carboxy.
• halogen e.g., chloro or fluoro
• the cycloalkyl optionally contains one or more atoms selected from N and O and/or S, said cycloalkyl may also be a saturated or unsaturated nonaromatic hydrocarbon moiety, preferably saturated, preferably comprising three to nine carbon atoms, at least some of which form a nonaromatic mono- or bicyclic, or bridged cyclic structure, and which may be optionally substituted, e.g., with halogen (e.g., chloro or fluoro),
• Heterocycloalkyl is, unless otherwise indicated, saturated or unsaturated nonaromatic hydrocarbon moiety, preferably saturated, preferably comprising three to nine carbon atoms, at least some of which form a nonaromatic mono- or bicyclic, or bridged cyclic structure, wherein at least one carbon atom is replaced with N, O or S, which heterocycloalkyl may be optionally substituted, e.g., with halogen (e.g., chloro or fluoro), hydroxy, or carboxy.
• halogen e.g., chloro or fluoro
• Aryl as used herein is a mono or bicyclic aromatic hydrocarbon
• phenyl optionally substituted, e.g., with alkyl (e.g., methyl), halogen (e.g., chloro or fluoro), haloalkyl (e.g., trifluoromethyl), hydroxy, carboxy, or an additional aryl or heteroaryl (e.g., biphenyl or pyridylphenyl).
• alkyl e.g., methyl
• halogen e.g., chloro or fluoro
• haloalkyl e.g., trifluoromethyl
• hydroxy carboxy
• an additional aryl or heteroaryl e.g., biphenyl or pyridylphenyl
• Heteroaryl as used herein is an aromatic moiety wherein one or more of the atoms making up the aromatic ring is sulfur or nitrogen rather than carbon, e.g., pyridyl or thiadiazolyl, which may be optionally substituted, e.g., with alkyl, halogen, haloalkyl, hydroxy or carboxy.
• Compounds of the Invention e.g., substituted 4,5,7, 8-tetrahydro-2H-imidazo[ 1,2- a]pyrrolo[3,4-e]pyrimidine or 4,5,7, 8,9-pentahydro-2H-pyrimido[l,2-a]pyrrolo[3,4- e]pyrimidine, e.g., Compounds of Formula I (Formula I-A and TB), or a Compound of Formula II (e.g., II-A or ITB), may exist in free or salt form, e.g., as acid addition salts.
• Compounds of the Invention may in some cases also exist in prodrug form.
• a prodrug form is compound which converts in the body to a Compound of the Invention.
• these substituents may form physiologically hydrolysable and acceptable esters.
• physiologically hydrolysable and acceptable ester means esters of Compounds of the Invention which are hydrolysable under physiological conditions to yield acids (in the case of Compounds of the Invention which have hydroxy substituents) or alcohols (in the case of Compounds of the Invention which have carboxy substituents) which are themselves physiologically tolerable at doses to be administered.
• the Compound of the Invention contains a hydroxy group, for example, Compound-OH
• the acyl ester prodrug of such compound i.e., Compound-0-C(0)-C 1 _ 4 alkyl
• the invention further provides a pharmaceutical composition comprising a Compound of the Invention, in free or pharmaceutically acceptable salt form, in admixture with a pharmaceutically acceptable carrier.
• Compounds of the Invention may in some cases also exist in prodrug form.
• a prodrug form is compound which converts in the body to a Compound of the Invention.
• these substituents may form physiologically hydrolysable and acceptable esters.
• physiologically hydrolysable and acceptable ester means esters of Compounds of the Invention which are hydrolysable under physiological conditions to yield acids (in the case of Compounds of the Invention which have hydroxy substituents) or alcohols (in the case of Compounds of the Invention which have carboxy substituents) which are themselves physiologically tolerable at doses to be administered.
• the Compound of the Invention contains a hydroxy group, for example, Compound-OH
• the acyl ester prodrug of such compound i.e., Compound-0-C(0)-C 1 _ 4 alkyl
• the invention further provides a pharmaceutical composition comprising a Compound of the Invention, in free, pharmaceutically acceptable salt or prodrug form, in admixture with a pharmaceutically acceptable carrier.
• the compounds of the Invention and their pharmaceutically acceptable salts may be made using the methods as described and exemplified herein and by methods similar thereto and by methods known in the chemical art. Such methods include, but not limited to, those described below. If not commercially available, starting materials for these processes may be made by procedures, which are selected from the chemical art using techniques which are similar or analogous to the synthesis of known compounds.
• the Compounds of the Invention include their enantiomers, diastereoisomers and racemates, as well as their polymorphs, hydrates, solvates and complexes.
• Some individual compounds within the scope of this invention may contain double bonds. Representations of double bonds in this invention are meant to include both the E and the Z isomer of the double bond.
• some compounds within the scope of this invention may contain one or more asymmetric centers. This invention includes the use of any of the optically pure stereoisomers as well as any combination of stereoisomers.
• Stable isotopes are nonradioactive isotopes which contain one additional neutron compared to the abundant nuclides of the same species (i.e., element). It is expected that the activity of compounds comprising such isotopes would be retained, and such compound would also have utility for measuring pharmacokinetics of the non- isotopic analogs. For example, the hydrogen atom at a certain position on the
• Compounds of the Invention may be replaced with deuterium (a stable isotope which is non-raradioactive).
• stable isotopes include, but not limited to, deuterium, 13 C, 15 N, 18 O.
• unstable isotopes which are radioactive isotopes which contain additional neutrons compared to the abundant nuclides of the same species (i.e., element), e.g., 123 I, 131 I, 125 I, 11 C, 18 F, may replace the corresponding abundant species of I, C and F.
• Another example of useful isotope of the compound of the invention is the n C isotope.
• NMR data is in the delta values of major diagnostic protons, given in parts per million (ppm) relative to tetramethylsilane (TMS) as an internal standard. Conventional abbreviations for signal shape are used. Coupling constants (J) are given in Hz. For mass spectra (MS), the lowest mass major ion is reported for molecules where isotope splitting results in multiple mass spectral peaks Solvent mixture compositions are given as volume percentages or volume ratios. In cases where the NMR spectra are complex, only diagnostic signals are reported.
• Bu OH te/ -butyl alcohol
• DIPEA diisopropylethylamine
• NCS N-chlorosuccinimide
• NaHC0 3 sodium bicarbonate
• POCl 3 phosphorous oxychloride
• TFA trifluoroacetic acid
• TFMSA trifluoromethanesulfonic acid
• THF tetrahedrofuran
• the Compounds of the Invention are useful in the treatment of diseases characterized by disruption of or damage to cGMP/PKG mediated pathways, e.g., as a result of increased expression of PDEl or decreased expression of cGMP/PKG activity due to inhibition or reduced levels of inducers of cyclic nucleotide synthesis, such as dopamine and nitric oxide (NO). It is believed that by inhibiting PDEl A, for example, that this action could reverse or prevent the attenuation of cGMP/PKG signaling (e.g., enhance cGMP) and that this action could modulate cardiac hypertrophy.
• inducers of cyclic nucleotide synthesis such as dopamine and nitric oxide (NO).
• a preferred PDEl inhibitor as described herein e.g., a PDEl inhibitor as hereinbefore described, e.g., a Compound of Formula la, lb, Ila, lib, III, IV, V, VI, VII, VIII, IX, X, XI, could provide a potential means to regulate cardiac hypertrophy (e.g., prevent and/or reverse cardiac hypertrophy), and in certain
• a selective PDEl inhibitor of the present invention (e.g., of Formula la, lb, Ila, lib, III, IV, V, VI, VII, VIII, IX, X, XI), exhibit good oral availability in plasma with very minimal brain penetration in mice.
• the half-life of the compounds is less than 2 hours.
• the Tmax is less than 1 hour.
• the blood / plasma ratio in mice administered the selective PDE1 inhibitor of the present invention is preferably less than .20.
• Diseases and disorders that may be prevented or ameliorated by the enhancement of cGMP/PKG signaling include, but are not limited to: angina, stroke, renal failure, essential hypertension, pulmonary hypertension, secondary hypertension, isolated systolic hypertension, hypertension associated with diabetes, hypertension associated with atherosclerosis, renovascular hypertension, congestive heart failure, myocardial , angina, stroke and renal failure, hypertension, an inflammatory disease or disorder, fibrosis, cardiac hypertrophy, vascular remodeling, and an connective tissue disease or disorder (e.g., Marfan Syndrome).
• angina, stroke, renal failure essential hypertension, pulmonary hypertension, secondary hypertension, isolated systolic hypertension, hypertension associated with diabetes, hypertension associated with atherosclerosis, renovascular hypertension, congestive heart failure, myocardial , angina, stroke and renal failure, hypertension, an inflammatory disease or disorder, fibrosis, cardiac hypertrophy, vascular remodeling, and an connective tissue disease or disorder (
• the compounds of the invention as described herein are useful in the treatment or prevention of stroke by treating or preventing transient ischemic attacks (TIA).
• TIA transient ischemic attacks
• the compounds may prevent or treat the risk of transient ischemic attacks by actually increasing the amount and/or concentration of blood flow to the brain. It is contemplated that the compounds as described herein could increase the blood flow to the brain without significant passage across the blood brain barrier.
• the invention further provides using the compounds of the invention (e.g., a Compound of Formula la, lb, Ila, lib, III, IV, V, VI, VII, VIII, IX, X, XI) for treatment of disease and disorders as follows: Duchenne muscular dystrophy, Becker muscular dystrophy, limb-girdle muscular dystrophy, myotonic dystrophy, and Emery-Dreifuss muscular dystrophy.
• the compounds of the present invention are useful in treating cardiac dysfunction associated with aforementioned types of muscular dystrophy.
• the compounds as described herein may potentially reduce or reverse the cardiac hypertrophy that may be associated with these aforementioned types of muscular dystrophy.
• PDEl inhibitor as used herein describes a compound(s) which selectively inhibit phosphodiesterase-mediated (e.g., PDEl -mediated, especially PDElB-mediated) hydrolysis of cGMP, e.g., with an IC 50 of less than ⁇ , preferably less than 750 nM, more preferably less than 500 nM, more preferably less than 50 nM in an immobilized- metal affinity particle reagent PDE assay.
• IC 50 of less than ⁇ , preferably less than 750 nM, more preferably less than 500 nM, more preferably less than 50 nM in an immobilized- metal affinity particle reagent PDE assay.
• Compounds of the Invention or “PDE 1 inhibitors of the Invention”, or like terms, encompasses any and all of the compounds disclosed herewith, e.g., a Compound of Formula I, Formula II, Formula III, Formula IV, Formula V, Formula VI, Formula VII, Formula VIII, Formula IX, Formula X, or Formula XL
• treatment and “treating” are to be understood accordingly as embracing prophylaxis and treatment or amelioration of symptoms of disease as well as treatment of the cause of the disease.
• the word “effective amount” is intended to encompass a therapeutically effective amount to treat a specific disease or disorder.
• the term “pulmonary hypertension” is intended to encompass pulmonary arterial hypertension.
• patient include human or non-human (i.e., animal) patient.
• the invention encompasses both human and nonhuman.
• the invention encompasses nonhuman.
• the term encompasses human.
• Compounds of the Invention e.g., Formula I, II, III, IV, V, VI, VII, VIII, IX, X, and XI as hereinbefore described, in free or pharmaceutically acceptable salt form, may be used as a sole therapeutic agent, but may also be used in combination or for coadministration with other active agents.
• Dosages employed in practicing the present invention will of course vary depending, e.g. on the particular disease or condition to be treated, the particular
• Compounds of the Invention may be administered by any suitable route, including orally, parenterally, transdermally, or by inhalation, but are preferably administered orally.
• satisfactory results, e.g. for the treatment of diseases as hereinbefore set forth are indicated to be obtained on oral administration at dosages of the order from about 0.01 to 2.0 mg/kg.
• an indicated daily dosage for oral administration will accordingly be in the range of from about 0.75 to 150 mg, conveniently administered once, or in divided doses 2 to 4 times, daily or in sustained release form.
• Unit dosage forms for oral administration thus for example may comprise from about 0.2 to 75 or 150 mg, e.g.
• compositions comprising Compounds of the Invention may be prepared using conventional diluents or excipients and techniques known in the galenic art.
• oral dosage forms may include tablets, capsules, solutions, suspensions and the like.
• Phosphodiesterase I B (PDEIB) is a calcium/calmodulin dependent
• phosphodiesterase enzyme that converts cyclic guanosine monophosphate (cGMP) to 5'- guanosine monophosphate (5'-GMP).
• PDEIB can also convert a modified cGMP substrate, such as the fluorescent molecule cGMP-fluorescein, to the corresponding GMP-fluorescein.
• the generation of GMP-fluorescein from cGMP-fluorescein can be quantitated, using, for example, the IMAP (Molecular Devices, Sunnyvale, CA) immobilized-metal affinity particle reagent.
• the IMAP reagent binds with high affinity to the free 5'- phosphate that is found in GMP-fluorescein and not in cGMP-fluorescein.
• the resulting GMP- fluorescein— IMAP complex is large relative to cGMP-fluorescein.
• Small fluorophores that are bound up in a large, slowly tumbling, complex can be distinguished from unbound fluorophores, because the photons emitted as they fluoresce retain the same polarity as the photons used to excite the fluorescence.
• the following phosphodiesterase enzymes may be used: 3',5'-cyclic- nucleotide- specific bovine brain phosphodiesterase (Sigma, St. Louis, MO) (predominantly PDEIB) and recombinant full length human PDE1 A and PDEIB (r- hPDEl A and r-hPDElB respectively) which may be produced e.g., in HEK or SF9 cells by one skilled in the art.
• the PDE1 enzyme is reconstituted with 50% glycerol to 2.5 U/ml. One unit of enzyme will hydrolyze 1.0 ⁇ of 3',5'-cAMP to 5'-AMP per min at pH 7.5 at 30°C.
• reaction buffer (30 ⁇ CaCl 2 , 10 U/ml of calmodulin (Sigma P2277), lOmM Tris-HCl pH 7.2, lOmM MgCl 2 , 0.1% BSA, 0.05% NaN 3 ) to yield a final concentration of 1.25mU/ml.
• 99 ⁇ of diluted enzyme solution is added into each well in a flat bottom 96-well polystyrene plate to which 1 ⁇ of test compound dissolved in 100% DMSO is added. The compounds are mixed and pre-incubated with the enzyme for 10 min at room temperature.
• the FL-GMP conversion reaction is initiated by combining 4 parts enzyme and inhibitor mix with 1 part substrate solution (0.225 ⁇ ) in a 384-well microtiter plate. The reaction is incubated in dark at room temperature for 15 min. The reaction is halted by addition of 60 ⁇ of binding reagent (1 :400 dilution of IMAP beads in binding buffer supplemented with 1: 1800 dilution of antifoam) to each well of the 384-well plate. The plate is incubated at room temperature for 1 hour to allow IMAP binding to proceed to completion, and then placed in an Envision multimode microplate reader (PerkinElmer, Shelton, CT) to measure the fluorescence polarization (Amp).
• Envision multimode microplate reader PerkinElmer, Shelton, CT
• IC50 values are determined by measuring enzyme activity in the presence of 8 to 16 concentrations of compound ranging from 0.0037 nM to 80,000 nM and then plotting drug concentration versus AmP, which allows IC50 values to be estimated using nonlinear regression software (XLFit; IDBS, Cambridge, MA).
• XLFit nonlinear regression software
• a selective PDEl inhibitor of the present invention is tested in a mouse model where the mice are treated with isoproterenol. Such a model can be useful for extrapolating to diseases or disorders involving an enlargement of the heart or cardiac tissue, e.g., congestive heart disease.
• Isoproterenol treatment in mice increases cardiac size in mice untreated with a selective PDEl inhibitor of the present invention. Size is indicated by heart weight (g) / tibia length (mm).
• administration of the selective PDEl inhibitor of the present invention significantly decreases cardiac hypertrophy in mice which are treated with isoproterenol.
• a selective PDEl inhibitor of the present Invention also significantly prevent cardiac hypertrophy at administration of 10 mg/kg.
• cGMP is an important moderator of cell function that prevents hypertrophic responses that are the mark of Heart Disease, and PDE1C is abundant in these cells.
• a selective PDEl inhibitor of the present invention elevates cGMP in Human Cardiomyocytes in Culture. When measured in conjunction with Sildenafil, the selective PDEl inhibitor is about 100-fold more potent than Sildenafil in enhancing cGMP. Such potency would have various application in various cardiovascular applications.
• Atrial natriuretic peptide is a peptide which binds the natriuretic peptide receptor-A (NPRA) and which may trigger activation of its guanylyl cyclase domain increasing cGMP production.
• NPRA natriuretic peptide receptor-A
• VASM vascular aortic smooth muscle
• part of the inflammatory component of Heart Disease PDE1B may be up-regulated during the process of differentiation from
• Immortalized Human Neutrophil Line (HL60 Cells) are used to study the Macrophage differentiation (inflammatory) process.
• a selective PDEl inhibitor of the present invention amplifies the effect of Atrial Natriuretic Peptide (ANF), wherein cGMP production increases as compared to cells where a selective PDEl inhibitor is not used in combination with ANF.
• ANF Atrial Natriuretic Peptide
• the mdx mouse model is used to understand muscle degeneration and regeneration in Duchenne Muscular Dystrophy.
• the dystrophic mdx mouse has a point mutation within its dystrophin gene. This mutation has changed a codon representing glutamine amino acid to one representing thymine amino acid. This single amino acid change causes the cell's machinery to stop; when this happens, the synthesis of dystrophin stops prematurely (known as premature stop codon). As a result, the mouse has no functional dystrophin in its muscles.
• a selective PDEl inhibitor of the present invention demonstrates a cardio-protective effect in an mdx Mouse Model of diastolic heart failure.

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