Drug – bio-affecting and body treating compositions – Designated organic active ingredient containing – Having -c- – wherein x is chalcogen – bonded directly to...
Patent
1997-05-22
2000-08-08
Cook, Rebecca
Drug, bio-affecting and body treating compositions
Designated organic active ingredient containing
Having -c-, wherein x is chalcogen, bonded directly to...
514234, A61K 31505
Patent
active
061002704
DESCRIPTION:
BRIEF SUMMARY
This is a National Stage filing under 35 USC 371 based on PCT/EP95/04065 which was filed internationally on Oct. 16, 1995.
This invention relates to the use of certain pyrazolo[4,3-d]pyrimidin-7-ones, pyrazolo[3,4-d]pyrimidin-4-ones, quinazolin-4-ones, purin-6-ones and pyrido[3,2-d]pyrimidin-4-ones for the treatment of impotence.
Impotence can be defined literally as a lack of power, in the male, to copulate and may involve an inability to achieve penile erection or ejaculation, or both. More specifically, erectile impotence or dysfunction may be defined as an inability to obtain or sustain an erection adequate for intercourse. Its prevalence is claimed to be between 2 and 7% of the human male population, increasing with age, up to 50 years, and between 18 and 75% between 55 and 80 years of age. In the USA alone, for example, it has been estimated that there are up to 10 million impotent males, with the majority suffering from problems of organic rather than of psychogenic origin.
Reports of well-controlled clinical trials in man are few and the efficacy of orally administered drugs is low. Although many different drugs have been shown to induce penile erection, they are only effective after direct injection into the penis, e.g. intraurethrally or intracavernosally (i.c.), and are not approved for erectile dysfunction. Current medical treatment is based on the i.c injection of vasoactive substances and good results have been claimed with phenoxybenzamine, phentolamine, papaverine and prostaglandin E.sub.1, either alone or in combination; however, pain, priapism and fibrosis of the penis are associated with the i.c. administration of some of these agents. Potassium channel openers (KCO) and vasoactive intestinal polypeptide (VIP) have also been shown to be active i.c., but cost and stability issues could limit development of the latter. An alternative to the i.c. route is the use of glyceryl trinitrate (GTN) patches applied to the penis, which has been shown to be effective but produces side-effects in both patient and partner.
As a general alternative to pharmacological intervention, a variety of penile prostheses has been used to assist achievement of an erection. The short term success rate is good, but problems with infection and ischaemia, especially in diabetic men, make this type of treatment a final option rather than first-line therapy.
The compounds of the invention are potent inhibitors of cyclic guanosine 3', 5'-monophosphate phosphodiesterases (CGMP PDEs) in contrast to their inhibition of cyclic adenosine 3', 5'-monophosphate phosphodiesterases (cAMP PDEs). This selective enzyme inhibition leads to elevated cGMP levels which, in turn, provides the basis for the utilities already disclosed for the said compounds in WO-A-93/06104, WO-A-93/07149, WO-A-93/12095, WO-A-94/00453 and WO-A-94/05661 respectively, namely in the treatment of stable, unstable and variant (Prinzmetal) angina, hypertension, pulmonary hypertension, congestive heart failure, atherosclerosis, conditions of reduced blood vessel patency e.g. post-percutaneous transluminal coronary angioplasty (post-PTCA), peripheral vascular disease, stroke, bronchitis, allergic asthma, chronic asthma, allergic rhinitis, glaucoma, and diseases characterised by disorders of gut motility, e.g. irritable bowel syndrome (IBS).
Unexpectedly, it has now been found that these disclosed compounds are useful in the treatment of erectile dysfunction. Furthermore the compounds may be administered orally, thereby obviating the disadvantages associated with i.c. administration. Thus the present invention concerns the use of a compound of formula (I): ##STR1## wherein R.sup.1 is methyl or ethyl; R.sup.2 is ethyl or n-propyl; optionally substituted with C.sub.5 -C.sub.7 cycloalkyl or with morpholino; ##STR2## wherein R.sup.1 is C.sub.1 -C.sub.6 alkyl; R.sup.2 is H; methyl or ethyl; R.sup.6, CN, CONR.sup.5 R.sup.6 or CO.sub.2 R.sup.7 ; C.sub.2 -C.sub.4 alkenyl optionally substituted with CN, CONR.sup.5 R.sup.6 or CO.sub.2 R.sup.7 ; C.sub.2 -C.sub.4 alkanoyl opti
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Benson Gregg C.
Cook Rebecca
Jones James T.
Pfizer Inc.
Richardson Peter C.
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