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Pharmaceutical use of substituted amidesRelated Patent Categories: Drug, Bio-affecting And Body Treating Compositions, Designated Organic Active Ingredient Containing (doai), Heterocyclic Carbon Compounds Containing A Hetero Ring Having Chalcogen (i.e., O,s,se Or Te) Or Nitrogen As The Only Ring Hetero Atoms Doai, Hetero Ring Is Seven-membered Consisting Of One Nitrogen And Six Carbons, Polycyclo Ring System Having The Seven-membered Hetero Ring As One Of The Cyclos, Ring Nitrogen Of The Seven-membered Hetero Ring Is Shared By An Additional Cyclo Of The Polycyclo Ring System, Two Of The Cyclos Share At Least Three Ring Members (i.e., Bridged)Pharmaceutical use of substituted amides description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20080108598, Pharmaceutical use of substituted amides. Brief Patent Description - Full Patent Description - Patent Application Claims
CROSS-REFERENCE TO RELATED APPLICATIONS [0001] This application is a continuation of U.S. application Ser. No. 11/265,794 filed Oct. 11, 2005, which is a continuation of International Application No. PCT/DK2004/000250, filed Apr. 6, 2004, which claims priority from Danish Patent Application Nos. PA 2003 00565, filed Apr. 11, 2003; PA 2003 00972, filed Jun. 27, 2003; PA 2003 00988, filed Jun. 30, 2003; PA 2003 00989, filed Jun. 30, 2003; PA 2003 00990, filed Jun. 30, 2003; PA 2003 00998, filed Jul. 2, 2003; PA 2003 01910, filed Dec. 22, 2003; and PA 2004 00009, filed Jan. 6, 2004; and U.S. Patent Application Nos. 60/467,800, filed May 2, 2003; 60/486,095, filed Jul. 10, 2003; 60/486,097, filed Jul. 10, 2003; 60/486,094, filed Jul. 10, 2003; 60/486,078, filed Jul. 10, 2003; 60/486,098, filed Jul. 10, 2003; and 60/537,099, filed Jan. 16, 2004. FIELD OF INVENTION [0002] The present invention relates to use of substituted amides and pharmaceutical compositions comprising the compounds for treating disorders where it is desirable to modulate the activity of 11.beta.-hydroxysteroid dehydrogenase type 1 (11.beta.HSD1). [0003] The present invention also relates to novel substituted amides, to their use in therapy, to pharmaceutical compositions comprising the compounds, to the use of said compounds in the manufacture of medicaments, and to therapeutic methods comprising the administration of said compounds. The present compounds modulate the activity of 11.beta.-hydroxysteroid dehydrogenase type 1 (11.beta.HSD1) and are accordingly useful in the treatment of diseases in which such a modulation is beneficial, such as the metabolic syndrome. BACKGROUND OF THE INVENTION [0004] The metabolic syndrome is a major global health problem. In the US, the prevalence in the adult population is currently estimated to be approximately 25%, and it continues to increase both in the US and worldwide. The metabolic syndrome is characterised by a combination of insulin resistance, dyslipidemia, obesity and hypertension leading to increased morbidity and mortality of cardiovascular diseases. People with the metabolic syndrome are at increased risk of developing frank type 2 diabetes, the prevalence of which is equally escalating. [0005] In type 2 diabetes, obesity and dyslipidemia are also highly prevalent and around 70% of people with type 2 diabetes additionally have hypertension once again leading to increased mortality of cardiovascular diseases. [0006] In the clinical setting, it has long been known that glucocorticoids are able to induce all of the cardinal features of the metabolic syndrome and type 2 diabetes. [0007] 11.beta.-hydroxysteroid dehydrogenase type 1 (11.beta.HSD1) catalyses the local generation of active glucocorticoid in several tissues and organs including predominantly the liver and adipose tissue, but also e.g. skeletal muscle, bone, pancreas, endothelium, ocular tissue and certain parts of the central nervous system. Thus, 11.beta.HSD1 serves as a local regulator of glucocorticoid actions in the tissues and organs where it is expressed (Tannin et al., J. Biol. Chem., 266, 16653 (1991); Bujalska et al., Endocrinology, 140, 3188 (1999); Whorwood et al., J Clin Endocrinol Metab., 86, 2296 (2001); Cooper et al., Bone, 27, 375 (2000); Davani et al., J. Biol. Chem., 275, 34841 (2000); Brem et al., Hypertension, 31, 459 (1998); Rauz et al., Invest. Ophthalmol. Vis. Sci., 42, 2037 (2001); Moisan et al., Endocrinology, 127, 1450 (1990)). [0008] The role of 11.beta.HSD1 in the metabolic syndrome and type 2 diabetes is supported by several lines of evidence. In humans, treatment with the non-specific 11.beta.HSD1 inhibitor carbenoxolone improves insulin sensitivity in lean healthy volunteers and people with type 2 diabetes. Likewise, 11.beta.HSD1 knock-out mice are resistant to insulin resistance induced by obesity and stress. Additionally, the knock-out mice present with an anti-atherogenic lipid profile of decreased VLDL triglycerides and increased HDL-cholesterol. Conversely, mice that overexpress 11.beta.HSD1 in adipocytes develop insulin resistance, hyperlipidemia and visceral obesity, a phenotype that resembles the human metabolic syndrome (Andrews et al., J. Clin. Endocrinol. Metab., 88, 285 (2003); Walker et al., J. Clin. Endocrinol. Metab., 80, 3155 (1995); Morton et al., J. Biol. Chem., 276, 41293 (2001); Kotelevtsev et al., Proc. Natl. Acad. Sci. USA, 94, 14924 (1997); Masuzaki et al., Science, 294, 2166 (2001)). [0009] The more mechanistic aspects of 11.beta.HSD1 modulation and thereby modulation of intracellular levels of active glucocorticoid have been investigated in several rodent models and different cellular systems. 11.beta.HSD1 promotes the features of the metabolic syndrome by increasing hepatic expression of the rate-limiting enzymes in gluconeogenesis, namely phosphoenolpyuvate carboxykinase and glucose-6-phosphatase, promoting the differentiation of preadipocytes into adipocytes thus facilitating obesity, directly and indirectly stimulating hepatic VLDL secretion, decreasing hepatic LDL uptake and increasing vessel contractility (Kotelevtsev et al., Proc. Natl. Acad. Sci. USA, 94, 14924 (1997); Morton et al., J. Biol. Chem. 276, 41293 (2001); Bujalska et al., Endocrinology, 140, 3188 (1999); Souness et al., Steroids, 67, 195 (2002), Brindley & Salter, Prog. Lipid Res., 30, 349 (1991)). [0010] WO 01/90090, WO 01/90091, WO 01/90092, WO 01/90093 and WO 01/90094 discloses various thiazol-sulfonamides as inhibitors of the human 11.beta.-hydroxysteroid dehydrogenase type 1 enzyme, and further states that said compounds may be useful in treating diabetes, obesity, glaucoma, osteoporosis, cognitive disorders, immune disorders and depression. [0011] We have now found substituted amides that modulate the activity of 11.beta.HSD1 leading to altered intracellular concentrations of active glucocorticoid. More specifically, the present compounds inhibit the activity of 11.beta.HSD1 leading to decreased intracellular concentrations of active glucocorticoid. Thus, the present compounds can be used to treat disorders where a decreased level of active intracellular glucocorticoid is desirable, such as e.g. the metabolic syndrome, type 2 diabetes, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), dyslipidemia, obesity, hypertension, diabetic late complications, cardiovascular diseases, arteriosclerosis, atherosclerosis, myopathy, muscle wasting, osteoporosis, neurodegenerative and psychiatric disorders, and adverse effects of treatment or therapy with glucocorticoid receptor agonists. [0012] One object of the present invention is to provide compounds, pharmaceutical compositions and use of compounds that modulate the activity of 11.beta.HSD1. DEFINITIONS [0013] In the following structural formulas and throughout the present specification, the following terms have the indicated meaning: [0014] The term "halo" includes fluorine, chlorine, bromine, and iodine. [0015] The term "trihalomethyl" includes trifluoromethyl, trichloromethyl, tribromomethyl, and triiodomethyl. [0016] The term "trihalomethoxy" includes trifluorometoxy, trichlorometoxy, tribromometoxy, and triiodometoxy. [0017] The term "alkyl" includes C.sub.1-C.sub.8 straight chain saturated and methylene aliphatic hydrocarbon groups, C.sub.3-C.sub.8 branched saturated hydrocarbon groups having the specified number of carbon atoms. For example, this definition shall include but is not limited to methyl (Me), ethyl (Et), propyl (Pr), butyl (Bu), pentyl, hexyl, isopropyl (i-Pr), isobutyl (i-Bu), tert-butyl (t-Bu), secbutyl (s-Bu), isopentyl, neopentyl, and the like. [0018] The term "alkenyl" includes C.sub.2-C.sub.6 straight chain unsaturated aliphatic hydrocarbon groups and branched C.sub.3-C.sub.6 unsaturated aliphatic hydrocarbon groups having the specified number of carbon atoms. For example, this definition shall include but is not limited to ethenyl, propenyl, butenyl, pentenyl, hexenyl, methylpropenyl, methylbutenyl and the like. [0019] The term "alkynyl" includes C.sub.2-C.sub.6 straight chain unsaturated aliphatic hydrocarbon groups and C.sub.4-C.sub.6 branched unsaturated aliphatic hydrocarbon groups having the specified number of carbon atoms. For example, this definition shall include but is not limited to ethynyl, propynyl, butynyl, pentynyl, hexynyl, methylbutynyl, and the like. [0020] The term "saturated or partially saturated cyclic, bicyclic or tricyclic ring system" represents but are not limit to aziridinyl, azepanyl, azocanyl, pyrrolinyl, pyrrolidinyl, 2-imidazolinyl, imidazolidinyl, 2-pyrazolinyl, morpholinyl, piperidinyl, thiomorpholinyl, piperazinyl, phthalimide, 1,2,3,4-tetrahydro-quinolinyl, 1,2,3,4-tetrahydro-isoquinolinyl, 1,2,3,4-tetrahydro-quinoxalinyl, indolinyl, 1,6-aza-bicyclo[3.2.1]octane, 2-aza-bicyclo[4.1.1]octane, 2-aza-bicyclo[3.2.1]octanyl, 7-aza-bicyclo[4.1.1]octanyl, 9-aza-bicyclo[3.3.2]decanyl, 4-aza-tricyclo[4.3.1.1.sup.3,8]undecanyl, 9-aza-tricyclo[3.3.2.0.sup.3,7]decanyl. Continue reading about Pharmaceutical use of substituted amides... 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