Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Having -c- – wherein x is chalcogen – bonded directly to...
Reexamination Certificate
2000-10-24
2003-02-04
Stockton, Laura L. (Department: 1626)
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Having -c-, wherein x is chalcogen, bonded directly to...
C514S469000, C549S051000, C549S469000, C549S471000
Reexamination Certificate
active
06515015
ABSTRACT:
BACKGROUND OF THE INVENTION
Diabetes refers to a disease process derived from multiple causative factors and characterized by elevated levels of plasma glucose or hyperglycemia. Uncontrolled hyperglycemia is associated with increased and premature mortality due to an increased risk for microvascular and macrovascular disease, including nephropathy, neuropathy, retinopathy, hypertension, stroke, and heart disease. Therefore, glucose homeostasis is critically important for the treatment of diabetes.
Type I diabetes (IDDM) is associated with a deficiency of insulin. Type II, noninsulin dependent diabetes mellitus (NIDDM) is associated with a resistance to the stimulating or regulatory effect of insulin on glucose and lipid metabolism in the main insulin-sensitive tissues, namely, the muscle, liver and adipose tissue. This resistance to to the effect of insulin results in insufficient activation of glucose uptake, oxidation and storage in muscle, inadequate repression of lipolysis in adipose tissue and inadequate supression of glucose production and secretion in liver.
Standard treatments for NIDDM, which have not changed substantially in years, are all associated with limitations. Physical exercise and reduction in calorie intake improves the diabetic condition; however compliance is generally poor. Increasing the plasma level of insulin, either by administering an oral hypoglycemic such as a sulfonylurea (e.g. tolbutamide or glipizide) or by injecting insulin results in insulin levels which are sufficient to stimulate insulin-resistant tissues. However, low levels of plasma glucose and a heightened level of insulin resistance can result.
Thiazolidinediones (glitazones) were suggested to ameliorate many symptoms of NIDDM. These agents increase insulin sensitivity in muscle, liver and adipose tissue in several animal models of NIDDM, hopefully resulting in normalized levels of plasma glucose, triglycerides and nonesterified free fatty acids. However, serious undesirable effects have been observed, including cardiac hypertrophy, hemodilution and liver toxicity.
Hyperlipidemia is a condition that is characterized by an abnormally high level of serum lipids. This includes cholesterol, triglycerides and phospholipids. These lipids do not circulate freely in solution in plasma, but are bound to proteins and transported as macromolecular complexes called lipoproteins. See the
Merck Manual,
16th Ed. 1992 (see for example pp. 1039-1040) and “Structure and Metabolism of Plasma Lipoproteins” in
Metabolic Basis of Inherited Disease,
6th Ed. 1989, pp. 1129-1138. One form of hyperlipidemia is hypercholesterolemia, which is characterized by elevated LDL cholesterol levels. The initial treatment for hypercholesterolemia is often reduced dietary fat and cholesterol. Coupled with an appropriate exercise regimen, this can be an effective means by which to reduce hyperlipidemia. More typically, this means of lowering hyperlipidemia is insufficient, making drug therapy to reduce serum LDL-cholesterol more appropriate.
Although it is desirable to lower elevated levels of LDL cholesterol, it is also desirable to increase levels of HDL cholesterol, since increased levels of HDL are associated with a reduced risk for coronary heart disease (CHD). See, for example, Gordon, et al., Am. J. Med., 62, 707-714 (1977); Stampfer, et al., N. England J. Med., 325, 373-381 (1991); and Kannel, et al., Ann. Internal Med., 90, 85-91 (1979). An example of an HDL raising agent is nicotinic acid.
It is suggested that thiazolidinedione compounds exert their effects by binding to the peroxisome proliferator activated receptor (PPAR) family of receptors, controlling certain transcription elements having to do with the biological entities listed above. See Hulin et al., Current Pharm. Design (1996) 2, 85-102. Three sub-types of PPARs have been discovered and described: PPAR&agr;, PPAR&ggr; and PPAR&dgr;. PPAR&agr; is activated by a number of medium and long-chain fatty acids. It is involved in stimulating &bgr;-oxidation of fatty acids. PPAR&agr; is also activated by compounds known as fibric acid derivatives. These fibric acid derivatives, such as clofibrate, fenofibrate, bezafibrate, ciprofibrate, beclofibrate and etofibrate, as well as gemfibrozil reduce plasma triglycerides along with LDL cholesterol, and they are primarily used for the treatment of hypertriglyceridemia.
PPAR&ggr; receptor subtypes are involved in adipocyte differentiation. The DNA sequences for the PPAR&ggr; receptors are described in Elbrecht, et al., BBRC 224;431-437 (1996). Although peroxisome proliferators, including the fibrates and fatty acids, activate the transcriptional activity of PPARs, only prostaglandin J
2
derivatives have been identified as natural ligands of the PPAR&ggr; subtype, which also binds to thiazolidinedione antidiabetic agents with high affinity. The glitazones have been shown to bind to the PPAR&ggr; subtype.
The human nuclear receptor gene PPAR&dgr; (hPPAR&dgr;) has been cloned from a human osteosarcoma cell cDNA library and is fully described in A. Schmidt et al.,
Molecular Endocrinology,
6 :1634-1641 (1992), herein incorporated by reference. PPAR&dgr; is also referred as PPAR&bgr; and NUC1.
SUMMARY OF THE INVENTION
The present invention is directed to a compound represented by formula I or Ia:
or a pharmaceutically acceptable salt thereof, wherein:
A is optionally a single or double bonded carbon or a single or double bond;
R
1
is selected from a group consisting of: H, C
1-5
alkyl, C
2-15
alkenyl, C
2-15
alkynyl and C
3-10
cycloalkyl, said alkyl, alkenyl, alkynyl, and cycloalkyl optionally substituted with 1 to 3 groups of R
a
;
R
2
is selected from a group consisting of: H, C
1-15
alkyl, C
2-15
alkenyl, OR
3
, CO
2
alkyl, COalkyl, OH, —OC(O)R
3
, C
2-15
alkynyl, C
5-10
aryl, C
5-10
heteroaryl, said alkyl, alkenyl, alkynyl, aryl and heteroaryl optionally substituted with 1 to 3 groups of R
a
;
R
3
is selected from a group consisting of: H, NHR
1
, NHacyl, C
1-15
alkyl, C
2-15
alkenyl, C
1-15
alkoxy, CO
2
alkyl, OH, C
2-15
alkynyl, C
5-10
aryl, C
5-10
heteroaryl said alkyl, alkenyl, alkynyl, aryl and heteroaryl optionally substituted with 1 to 3 groups of R
a
;
R
4
is selected from the group consisting of: R
2
, —D—R
5
or
R
5
is selected from the group consisting of: C
5-10
aryl and C
5-10
heteroaryl, said aryl and heteroaryl optionally substituted with 1 to 3 groups of R
a
;
R
8
is selected from the group consisting of CR
6
R
7
, O, NR
6
, and S(O)
P
;
R
6
and R
7
are independently selected from the group consisting of H, C
1-6
alkyl;
B is a 5 or 6 membered heterocycle containing 0 to 2 double bonds, and 0 to 3 heteroatoms selected from the group consisting of O, S and N, the heteroatom being substituted at any position on the five or six membered heterocycle, the heterocycle being optionally unsubstituted or substituted with 1 to 3 groups of R
a
;
D is selected from the group consisting of: O, S(O)p and NR
1
;
X
1
and X
2
are independently selected from a group consisting of: H, OH, C
1-15
alkyl, C
2-15
alkenyl, C
2-15
alkynyl, halo, OR
3
, C
5-10
aryl, C
5-10
aralkyl, C
5-10
heteroaryl and C
1-10
acyl, said alkyl, alkenyl, alkynyl, aryl and heteroaryl optionally substituted with 1 to 3 groups of R
a
;
R
a
represents a member selected from the group consisting of: halo, aryl, heteroaryl, CF
3
, OCF
3
, —O—, CN, NO
2
, R
3
, OR
3
; SR
3
, S(O)R
3
, SO
2
R
3
, NR
3
R
3
, NR
3
COR
3
, NR
3
CO
2
R
3
, NR
3
CON(R
3
)
2
, NR
3
SO
2
R
3
, COR
3
, CO
2
R
3
, CON(R
3
)
2
, SO
2
N(R
3
)
2
, OCON(R
3
)
2
said aryl and heteroaryl optionally substituted with 1 to 3 groups of halo or C1-6 alkyl;
Y is selected from the group consisting of: S(O)
p
, —CH
2
—, CO, NR
1
, O, SO
2
NH, NHSO
2
;
Y
2
is selected from the group consisting of: O, N(C
1-15
) alkyl, N(CO
2
)alkyl, N—Oalkyl, N—Oacyl and N—OH, with the proviso that if Y
2
is O and R
3
is CH
3
then n is 2;
Y
1
is selected from the group consisting of: O, NH, S(O)
p
and C;
Z is selected from the group consisting of: CO
2
R
3
, R
3
Adams Alan
Koyama Hiroo
Langen Derek Von
Tolman Richard
McGinnis James L.
Merck & Co. , Inc.
Stockton Laura L.
Winokur Melvin
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