ZA200200997B - Use of CGRP antagonists and CGRP release inhibitors for controlling menopausal hot flushes. - Google Patents

Use of CGRP antagonists and CGRP release inhibitors for controlling menopausal hot flushes. Download PDF

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ZA200200997B
ZA200200997B ZA200200997A ZA200200997A ZA200200997B ZA 200200997 B ZA200200997 B ZA 200200997B ZA 200200997 A ZA200200997 A ZA 200200997A ZA 200200997 A ZA200200997 A ZA 200200997A ZA 200200997 B ZA200200997 B ZA 200200997B
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piperidinyl
carbonyl
dihydro
dibromo
amino
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ZA200200997A
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Henri Doods
Klaus Rudolf
Wolfgang Eberlein
Wolfard Engel
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Boehringer Ingelheim Pharma
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • A61K31/551Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445Non condensed piperidines, e.g. piperocaine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic 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
    • A61K31/496Non-condensed piperazines containing further heterocyclic rings, e.g. rifampin, thiothixene
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic 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
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/513Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim having oxo groups directly attached to the heterocyclic ring, e.g. cytosine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic 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
    • A61K31/505Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/517Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with carbocyclic ring systems, e.g. quinazoline, perimidine
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/54Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
    • A61K31/5415Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with carbocyclic ring systems, e.g. phenothiazine, chlorpromazine, piroxicam
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • A61P15/12Drugs for genital or sexual disorders; Contraceptives for climacteric disorders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00Drugs for disorders of the endocrine system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00Drugs for disorders of the endocrine system
    • A61P5/18Drugs for disorders of the endocrine system of the parathyroid hormones
    • A61P5/22Drugs for disorders of the endocrine system of the parathyroid hormones for decreasing, blocking or antagonising the activity of calcitonin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00Drugs for disorders of the endocrine system
    • A61P5/24Drugs for disorders of the endocrine system of the sex hormones
    • A61P5/30Oestrogens
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system

Description

. ® 2002/0997 * 72625pri
Boehringer Ingelheim Pharma KG Case 5/1268-Ro
D-55216 Ingelheim/Rhein foreign filing
Use of CGRP antagonists and CGRP release inhibitors for combating menopausal hot flushes
Hot flushes are a common symptom of peri/post-menopausal syndrome the physiology of which is still not fully understood. Apart from hormone replacement therapy, which is a complex intervention and frequently cannot be used long-term owing to its side effects, there has up until now been no simple therapy largely free from side effects for this generally troublesome condition. " Hot flushes are caused by vasodilatation and increased blood flow. A number of publications have mentioned the possibility that CGRP (calcitonin gene-related peptide) plays a part in the occurrence of menopausal hot flushes in oestrogen- deficient women owing to the vasodilatory properties of this neuropeptide ([1]: J. Endocrinol. (1995), 146(3), 431-437;
[2] : Acta Physiol. Scand. (1998), 162(4), 517-522; [3]: Am. J.
Obstet. Gynecol. (1996), 175(3, Pt. 1), 638-642). The therapeutic use of CGRP antagonists for treating menopausal syndrome has not previously been proposed in the literature.
It has now been found that the symptoms of menopausal hot flushes can be effectively prevented or their distressing effects substantially alleviated by substances which antagonise the effects of CGRP (CGRP antagonists) or inhibit or reduce the release of CGRP from sensory nerve endings (CGRP release inhibitors), this therapeutic approach being superior to hormone replacement therapy in particular because of its lack of side effects.
The present invention thus relates to the use of CGRP antagonists and/or CGRP release inhibitors for combating
Lo 200270997 _ < - 2 - menopausal hot flushes, including both prevention and acute treatment. The use according to the invention preferably comprises monotherapy with a single substance, but also includes combined therapy with a number of substances from the specified groups of active substances. Moreover, the treatment according to the invention may be carried out in addition to conventional hormone replacement therapy.
The invention also relates to the use of CGRP antagonists and/or CGRP release inhibitors for preparing a pharmaceutical composition for treating menopausal hot flushes as well as the corresponding pharmaceutical compositions containing as active substance one or more CGRP antagonists and/or CGRP release inhibitors. © Any pharmaceutically acceptable active substances which antagonise the known effects of CGRP or inhibit the release of
CGRP from sensory nerve endings may be used for the purposes of the present invention.
Examples of CGRP antagonists include the amino acid derivatives described in WO 98/11128 or DE 199 11 039, as well as the non-peptidic active substances described in WO 98/56779, WO 98/09630 and WO 97/09046.
Examples of CGRP release inhibitors include serotonin 5-HT,;- agonists such as avitriptan, eletriptan, naratriptan, rizatriptan, sumatriptan or zolmitriptan, as well as 5-HT- agonists or NPY-agonists.
Of the CGRP antagonists described in WO 98/11128, the following compounds, for example, may be used for the treatment of menopausal hot flushes, for the preparation of a corresponding pharmaceutical composition and as an ingredient of a corresponding pharmaceutical composition:
B - 3 - (B) 1-[N2-[3,5-dibromo-N- [[4-(3,4-dihydro-2 (1H) - oxoquinazolin-3-yl) -l-piperidinyl] carbonyl] -D-tyrosyl] -L- lysyl] -4- (4-pyridinyl) -piperazine, (B) 1-[4-amino-3,5-dibromo-N-[[4-(2,3,4,5-tetrahydro-2 (1H) - ox0-1,3-benzodiazepin-3-yl)-1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4-(1-piperidinyl) -piperidine, (C) 1- [N2- [4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -L- lysyl]l -4- (4-pyridinyl) -piperazine, (D) 1-[N2-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -L- lysyl] -4- (4-pyridinyl) -piperidine, (E) 1-[N2-[3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) -oxo- imidazol-1-yl) -1-piperidinyl] carbonyl] -D-tyrosyl]-L-1lysyl] - 4- (4-pyridinyl) -piperazine, (F) 1-[N2-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl- 2 (2H) -oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -L-1lysyl] -4- (4-pyridinyl) -piperazine, (G) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxothieno[3,4-d]- pyrimidin-3-yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4- (1- piperidinyl) -piperidine, (H) 1-[4-amino-3,5-dibromo-N-[[4-(2,4-dihydro-5-phenyl-3 (3H) - oxo-1,2,4-triazol-2-yl)-1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-methyl-4-piperidinyl) -piperidine, (1) 1-[4-amino-3,5-dibromo-N-[[4-(2,4-dihydro-5-phenyl-3 (3H) - oxo-1,2,4-triazol-2-yl)-1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-piperidinyl) -piperidine,
(J) 1- [4-amino-3,5-dibromo-N-{[4-(2,4-dihydro-5-phenyl-3 (3H) - oxo-1,2,4-triazol-2-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-methyl-4-piperidinyl) -piperazine, (K) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- thieno[3,2-d]pyrimidin-3-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl]-4- (1-piperidinyl) -piperidine, (L) 1-{4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3-(tri- fluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1- piperidinyll carbonyl] -D-phenylalanyl] -4-(l-ethyl-4- piperidinyl) -piperidine, (M) 1-[4-amino-3,5-dibromo-N-[[4-([3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-hexyl-4-piperidinyl) -piperidine, (N) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl]-1-piperidinyl] carbonyl] -D-phenylalanyl]-4- (1-cyclopropylmethyl-4-piperidinyl) -piperidine, (0) 1-[N-{[4-[3,4-dihydro-2 (1H) -~oxoquinazolin-3-yl]-1-pipe- ridinyl]) carbonyl] -3-ethenyl-D,L-phenylalanyl] -4- (hexahydro-1H- l-azepinyl) -piperidine, (P) (R,8)-1-[4-[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3-yl)-1- piperidinyll]l-2-[(4-hydroxy-3,5-dimethylphenyl) methyl] -1,4-di- oxobutyl] -4- (1-piperidinyl) -piperidine, (Q) 1-[4-amino-3,5-dibromo-N-[ [4 -~ [N- (aminocarbonyl) -N-phenyl-
: amino] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-
piperidinyl) -piperidine, (R) 1- [4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) - oxoquinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (5-methoxy-4-pyrimidinyl) -piperazine,
pt - 5 - (8S) 1-[4-amino-3,5-dibromo-N-[[4-(1,1-dioxido-3 (4H) -oxo- 1,2,4-benzothiadiazin-2-yl)-1-piperidinyl] carbonyl] -D- phenylalanyl] -4- (1-piperidinyl) -piperidine, (T) 1-[4-amino-3,5-dibromo-N-[[4-[2 (1H) -oxoquinolin-3-y1l]-1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-piperidinyl) - piperidine, (U) 1-{4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- [3- (dimethylamino) propyl] -piperazine, (Vv) 1-[4-amino-3,5-dibromo-N-[[4- [3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (4-methyl-1-piperazinyl) -piperidine, (W) 1-[4-amino-3,5-dibromo-N-{[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- [(1-methyl-4-piperidinyl) carbonyl] -piperazine, (X) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- [(1-methyl-4-piperazinyl) carbonyl] -piperazine, (Y) 1-[4-amino-3,5-dibromo-N-[[4- (3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] - 4-[4-[4- (dimethylamino)butyl]lphenyl] -piperazine, (2) 1-[4-amino-3,5-dibromo-N-[[4- (3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -l-piperidinyl] carbonyl] -D-phenylalanyl] - 4-[4-(dimethylamino) -1-piperidinyl] -piperidine, (AA) 1-[N2-[[4-(1,3-dihydro-4-phenyl-2 (2H) -oxoimidazol-1-y1) - 1l-piperidinyl] carbonyl] -N'-methyl-D-tryptyl] -4- (4-methyl-1- piperazinyl) -piperidine,

Claims (10)

Patent Claims
1. Use of an active substance selected from CGRP antagonists and CGRP release inhibitors for treating menopausal hot flushes.
2. Use according to claim 1, characterised in that it is effected as a monotherapy with a single active substance.
3. Use according to claim 1, characterised in that it is effected as a supplement to hormone replacement therapy.
4. Use according to claim 1, characterised in that the active substance is a CGRP antagonist.
5. Use according to claim 4, characterised in that the CGRP antagonist is selected from among: (RA) 1- [N2- [3,5-dibromo-N- [[4- (3, 4-dihydro-2 (1H) - oxoquinazolin-3-yl)-1-piperidinyl] carbonyl] -D-tyrosyl] -L- lysyl]l -4- (4-pyridinyl) -piperazine, (B) 1-[4-amino-3,5-dibromo-N-[[4-(2,3,4,5-tetrahydro-2 (1H) - oxo-1,3-benzodiazepin-3-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-piperidinyl) -piperidine, (C) 1- [N2- [4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl)-1-piperidinyl] carbonyl] -D-phenylalanyl]-L- lysyll -4- (4-pyridinyl) -piperazine, (D) 1- [N2-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl]-L- lysyl] -4- (4-pyridinyl) -piperidine,
-~ - 31 - (E) 1- [N2-[3,5-dibromo-N-[[4- (1, 3-dihydro-4-phenyl-2 (2H) -oxo- imidazol-1-yl)-1-piperidinyl]} carbonyl} -D-tyrosyl] -L-1lysyl]-4- (4-pyridinyl) -piperazine, (F) 1- [N2- [4-amino-3,5-dibromo-N- [[4- (1,3-dihydro-4-phenyl- 2 (2H) -oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -L-1lysyl] -4- (4-pyridinyl) -piperazine, (G) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxothieno[3,4-d] - pyrimidin-3-yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4-(1- piperidinyl) -piperidine, (H) 1-[4-amino-3,5-dibromo-N-[[4-(2,4-dihydro-5-phenyl-3 (3H) - oxo-1,2,4-triazol-2-yl)-1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-methyl-4-piperidinyl) -piperidine, (1) 1-[4-amino-3,5-dibromo-N-[[4-(2,4-dihydro-5-phenyl-3 (3H) - oxo-1,2,4-triazol-2-yl)-1-piperidinyl]l carbonyl] -D-phenyl- alanyl] -4- (1-piperidinyl) -piperidine, (J) 1-[4-amino-3,5-dibromo-N-[[4-(2,4-dihydro-5-phenyl-3 (3H) - oxo-1,2,4-triazol-2-yl)-1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-methyl-4-piperidinyl) -piperazine, (K) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- thieno([3,2-d]pyrimidin-3-yl)-1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-piperidinyl) -piperidine, (L) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3-(tri- fluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-ethyl-4- piperidinyl) -piperidine, (M) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-hexyl-4-piperidinyl) -piperidine,
(N) 1- [4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl]-4- (1-cyclopropylmethyl-4-piperidinyl) -piperidine, (0) 1-[N-[[4-[3,4-dihydro-2 (1H) -oxoquinazolin-3-yl]-1-pipe- ridinyl] carbonyl] -3-ethenyl-D,L-phenylalanyl] -4- (hexahydro-1H- l-azepinyl) -piperidine, (P) (R,8)-1-[4-[4-(3,4-dihydro-2 (1H) -oxoguinazolin-3-yl)-1- piperidinyl] -2-[(4-hydroxy-3,5-dimethylphenyl) methyl] -1,4-di- oxobutyl] -4- (1-piperidinyl) -piperidine, (Q) 1-[4-amino-3,5-dibromo-N-[[4- [N- (aminocarbonyl) -N-phenyl- amino] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1- piperidinyl) -piperidine, (R) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) - oxoquinazolin-3-yl) -1l-piperidinyl] carbonyl] -D-phenylalanyl] -4- (5-methoxy-4-pyrimidinyl) -piperazine, (8S) 1-[4-amino-3,5-dibromo-N-[[4-(1,1-dioxido-3 (4H) -oxo- 1,2,4-benzothiadiazin-2-yl) -1-piperidinyl] carbonyl] -D- phenylalanyl] -4- (1-piperidinyl) -piperidine,
(T) 1-[4-amino-3,5-dibromo-N-[[4-[2 (1H) -oxoquinolin-3-yl1]-1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-piperidinyl) - piperidine,
(U) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- [3- (dimethylamino) propyl] -piperazine,
(Vv) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (4-methyl-1-piperazinyl) -piperidine,
N - 33 - (W) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) - oxoguinazolin-3-yl]-1l-piperidinyl] carbonyl] -D-phenylalanyl]-4- [(1-methyl-4-piperidinyl) carbonyl] -piperazine, (X) 1-[4-amino-3,5-dibromo-N-[{4-[3,4-dihydro-2 (1H) - oxoquinazolin-3-yl]-1-piperidinyl] carbonyl] -D-phenylalanyl] -4- [(1-methyl-4-piperazinyl) carbonyl] -piperazine, (Y) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -l-piperidinyl] carbonyl] -D-phenylalanyl]-4- [4- [4- (dimethylamino)butyll phenyl] -piperazine, (z) 1-{4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl]-4- [4- (dimethylamino) -1-piperidinyl] -piperidine, (AA) 1-[N2-[[4-(1,3-dihydro-4-phenyl-2 (2H) -oxoimidazol-1-yl) - 1-piperidinyl] carbonyl] -N' -methyl-D-tryptyl] -4- (4-methyl-1- piperazinyl) -piperidine, (AB) 1-[N2-[[4-(1,3-dihydro-4-phenyl-2 (2H) -oxoimidazol-1-yl) - l-piperidinyl]} carbonyl] -N'-(1,1-dimethylethoxycarbonyl) -D- tryptyl] -4- (1-methyl-4-piperidinyl) -piperidine, (AC) (R,S)-1-[4-[4-(3,4-dihydro-2(1H) -oxoquinazolin-3-yl)-1- piperidinyl] -2-[(3,5-dibromo-4-methylphenyl) methyl] -1,4-dioxo- butyl] -4- (4-methyl-1-piperazinyl) -piperidine, (AD) (R,S)-1-[4-[4-(3,4-dihydro-2(1H) -oxoquinazolin-3-yl)-1- piperidinyl] -2-[(3,5-dibromo-4-methoxyphenyl) methyl] -1,4- dioxobutyl] -4- (1-methyl-4-piperidinyl) -piperidine, (AE) (R,S)-1-[4-1[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3-yl)-1- piperidinyl] -2-[(3,4-dibromophenyl)methyl] -1,4-dioxobutyl] -4- (4-methyl-1-piperazinyl) -piperidine,
(AF) 1-[N2-[N-[[4-(1,3-dihydro-2 (2H) -oxobenzimidazol-1-yl)- l-piperidinyl] carbonyl] -3,5~dibromo-D-tyrosyl] -L-1lysyl] - 4- (4-pyridinyl) -piperazine, (AG) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-6-hydroxy- 2 (2H) -oxobenzimidazol-1-yl) -1-piperidinyl] carbonyl] -D- phenylalanyl] -4- (1-piperidinyl) -piperidine, (AH) 1- [N2-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-2 (2H) -oxo- benzimidazol-1-yl)-1-piperidinyl] carbonyl] -D-phenylalanyl] - N6,N6-dimethyl-L-1lysyl]l -4- (4-pyridinyl) -piperazine, (AI) 1-[N2-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl)-1-piperidinyl] carbonyl] -D-phenylalanyl] - N6,N6-dimethyl-L-1lysyl] -4- (4-pyridinyl) -piperazine, (AJ) (R,S8)-1-[2-(4-amino-3,5-dibromobenzoyl) -4- [4-(3,4- dihydro-2 (1H) -oxoquinazolin-3-yl) -1-piperidinyl] -4-oxobutyl] - 4-(l-piperidinyl) -piperidine, (AK) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2,2-dioxido- 2,1,3-benzothiadiazin-3-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-piperidinyl) -piperidine, (AL) 1-{4-amino-3,5-dibromo-N-[{4-[1,3-dihydro-2 (2H) -oxoimi- dazo[4,5-clquinolin-3-yl] -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-piperidinyl) carbonyl] -piperidine, (AM) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) - oxogquinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-piperidinyl) -piperidine, (AN) 1-[N2-[3,5-dibromo-N-[{4-(3,4-dihydro-2 (1H) - oxoquinazolin-3-yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -N6,N6- dimethyl-L-1lysyl]-4- (4-pyridinyl) ~piperazine,
@
(a0) 1-[4-amino-N-[[4-[4- (3-bromophenyl)-1,3-dihydro-2 (2H) - oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -3,5-dibromo-D- phenylalanyl] -4- (1-methyl-4-piperidinyl) -piperidine, (AP) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl]-1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (4-methyl-1-piperazinyl) -piperidine, (AQ) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3-(tri- fluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-piperidinyl) - piperidine, (AR) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3-(tri- fluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl]-1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (exo-8-methyl-8- azabicyclo[3,2,1loct-3-yl) -piperazine, (AS) 1-[3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) -oxo- imidazol-1-yl) -1l-piperidinyl] carbonyl] -D-tyrosyl]-4-(1- piperidinyl) -piperidine, (AT) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3- (trifluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl]-1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-ethyl-4- piperidinyl) -piperazine, (AU) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl]-1-piperidinyl]carbonyl]-D-phenylalanyl] -4- (hexahydro-4-methyl-1H-1,4-diazepin-1-yl)piperidine, (AV) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3- yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4-[1- (methylsulphonyl) - 4-piperidinyl] -piperidine,
(AW) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl]-4- (1-methyl-4-piperidinyl) -piperidine, (AX) 1-[3,5-dibromo-N-[[4-[1,3-dihydro-4-[3- (trifluoromethyl) - phenyl] -2 (2H) -oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -D- tyrosyl] -4- (hexahydro-1H-1-azepinyl) -piperidine, (AY) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3- yl) -1-piperidinyl] carbonyl] -D-tyrosyl]-4- (1-methyl-4- piperidinyl) -piperidine, (AZ) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (exo-8-methyl-8-azabicyclo[3,2,1]loct-3-yl) -piperazine, (BA) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl)-1l-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-methyl-4-piperidinyl) -piperazine, (BB) 1-[3,5-dibromo-N-[[4-[1,3-dihydro-4-[3- (trifluoromethyl) - phenyl] -2 (2H) -oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -D- tyrosyl] -4- (1-piperidinyl) -piperidine, (BC) 1- [N6-Acetyl-N2-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) - oxoquinazolin-3-yl)-1-piperidinyl] carbonyl] -D-tyrosyl] -L- lysyl] -4- (4-pyridinyl) -piperazine, (BD) 1-[3,5-dibromo-N-[{4-(1,3-dihydro-4-phenyl-2 (2H) -oxoimi- dazol-1-yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4- (hexahydro- 1H-1-azepinyl) -piperidine, (BE) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-(3-thienyl) - 2 (2H) -oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-methyl-4-piperidinyl) -piperidine,
@
(BF) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3- (trifluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-methyl-4- piperidinyl) -piperidine,
(BG) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3- yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4- [1- (hydroxycarbonyl- methyl) -4-piperidinyl] -piperidine,
(BH) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) -oxo-~ quinazolin-3-yl]-1l-piperidinyl]carbonyl]-D-phenylalanyl]-4-(1- methylsulphonyl-4-piperidinyl) -piperidine,
(RI) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3- yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4- (4-piperidinyl) - piperidine,
(BJ) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2(2H) - oxoimidazol-1-yl)-1-piperidinyl] carbonyl] -D-phenylalanyl] - 4-(l-ethyl-4-piperidinyl) -piperidine,
(BK) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-(3-hydroxy- phenyl) -2 (2H) -oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D- phenylalanyl] -4- (1-methyl-4-piperidinyl) -piperidine,
(BL) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3- yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4- (hexahydro-1H-1- azepinyl) -piperidine,
(BM) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl)-1l-piperidinyl] carbonyl] -D-phenylalanyl] -4- (1-piperidinyl) -piperidine,
(BN) 1-[4-amino-3,5-dibromo-N-{[4-[4- (3-bromophenyl)-1,3-di- hydro-2 (2H) -oxoimidazol-1-yl] ~1-piperidinyl] carbonyl] -D-phe- nylalanyl] -4- (exo-8-methyl-8-azabicyclo[3,2,1]loct-3-yl) - piperazine,
'@
(BO) 1- [4-amino-3,5-dibromo-N- [[4- (3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl)-1l-piperidinyl] carbonyl] -D-phenylalanyl] - 4-(l-ethyl-4-piperidinyl) -piperidine, (BP) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] - 4-(l-ethyl-4-piperidinyl) -piperazine, (BQ) 1-[4-amino-3,5-dibromo-N-{{4-{1,3-dihydro-4-(3-methoxy- phenyl) -2 (2H) -oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -D- phenylalanyl] -4- (exo-8-methyl-8-azabicyclo[3,2,1]loct-3-yl) - piperazine, (BR) 1-[3,5-dibromo-N-[[4-(3,4-dihydro-2 (1H) -oxoquinazolin-3- yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4-[1- (cyclopropyl- methyl) -4-piperidinyl] -piperidine, (BS) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2(1H) - oxoquinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (hexahydro-1H-1-azepinyl) -piperidine, (BT) 1-[4-amino-3,5-dibromo-N-[[4-(3,4-dihydro-2(1H) -oxo- quinazolin-3-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (4-piperidinyl) -piperidine, (BU) 1-[3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) -oxo- imidazol-1-yl) -1-piperidinyl] carbonyl] -D-tyrosyl]-4-(4- pyridinyl) -piperidine, (BV) 1-[3,5-dibromo-N-[[4-[1,3-dihydro-4-[3- (trifluoromethyl) - phenyl] -2 (2H) -oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -D- tyrosyl] -4- (1-methyl-4-piperidinyl) -piperazine, (BW) 1-[N2-[3,5-dibromo-N-[[4-[1,3-dihydro-4-[3-(trifluorome- thyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1-piperidinyl] carbonyl] - D-tyrosyl] -L-1ysyl] -4- (4-pyridinyl) -piperazine,
'@
YS - 39 - (BX) 1-1[3,5-dibromo-N-[[4-(1,3-dihydro-4-(3-thienyl)-2(2H)- oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-tyrosyl] -4-(1- piperidinyl) -piperidine, (BY) 1-[4-amino-N-[[4-[4-(3-chlorophenyl)-1,3-dihydro-2 (2H) - oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -3,5-dibromo-D- phenylalanyl] -4- (1-methyl-4-piperidinyl) -piperidine, (BZ) 1-[4-amino-3,5-dibromo-N-{[4-(1,3-dihydro-4-[3- (trifluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1- piperidinyl] carbonyl] -D-phenylalanyl] -4- (hexahydro-1H-1- azepinyl) -piperidine, (CA) 1-[4-amino-3,5-dibromo-N-[[4-[1,3-dihydro-4-[3- (trifluoromethyl) phenyl] -2 (2H) -oxoimidazol-1-yl] -1- piperidinyl] carbonyl] -D-phenylalanyl] -4-(1-methyl-4- piperidinyl) -piperazine, (CB) 1-[4-amino-N-[[4-[4-(3-chlorophenyl)-1,3-dihydro-2(2H) - oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -3,5-dibromo-D- phenylalanyl] -4- (hexahydro-1H-1-azepinyl) -piperidine, (CC) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- (4-pyridinyl) -piperazine, (cD) 1-[3,5-dibromo-N-{{4-(1,3-dihydro-4-phenyl-2 (2H) -oxoimi- dazol-1-yl) -1-piperidinyl] carbonyl] -D-tyrosyl]-4- (1-methyl-4- piperidinyl) -piperidine, (CE) 1-[4-amino-3,5-dibromo-N-[[4~[1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -D-phenylalanyl] -4- [4- (1-oxoethyl)phenyl] -piperazine,
"@ (CF) 1-[3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) -oxoquinazolin-3- yl] -1-piperidinyl] carbonyl] -D-tyrosyl] -4- (1-methyl-4- piperidinyl) -piperazine, (CG) 1-[4-amino-3,5-dibromo-N-[[4-([1,3-dihydro-4-(3-nitro- phenyl) -2 (2H) -oxoimidazol-1-yl] -1-piperidinyl] carbonyl] -D-phe- nylalanyl] -4- (1-methyl-4-piperidinyl) -piperidine, (CH) 1-[4-amino-3,5-dibromo-N-[[4-[3,4-dihydro-2 (1H) -oxo- gquinazolin-3-yl]-1-piperidinyl]jcarbonyl]-D-phenylalanylj-4-(1- pyrrolidinyl) -piperidine, (CI) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-phenyl-2 (2H) - oxoimidazol-1-yl)-1l-piperidinyl] carbonyl] -D-phenylalanyl] -4- (hexahydro-1H-1-azepinyl) -piperidine and (¢J) 1-[4-amino-3,5-dibromo-N-[[4-(1,3-dihydro-4-(3-thienyl) - 2 (2H) -oxoimidazol-1-yl) -1-piperidinyl] carbonyl] -D-phenyl- alanyl] -4- (1-methyl-4-piperidinyl) -piperazine, the tautomers, the diastereomers, the enantiomers, the mixtures thereof and the physiologically acceptable salts thereof.
6. Use of an active substance selected from CGRP antagonists and CGRP release inhibitors for the preparation of a pharmaceutical composition for treating menopausal hot flushes.
7. Use according to claim 6, characterised in that the pharmaceutical composition contains only one active substance.
8. Use according to claim 6, characterised in that the active substance is a CGRP antagonist.
9. Use according to claim 8, characterised in that the CGRP antagonist is selected from the group according to claim 5.
< ee Yo WA : /
10. Pharmaceutical composition for treating menopausal hot flushes, containing as active substance one or more CGRP antagonists selected from the group according to claim 5 optionally together with one or more inert carriers and/or diluents. )
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