Modulators of 11-β hydroxyl steroid dehydrogenase type 1, pharmaceutical compositions thereof, and methods of using the same

1. A compound of Formula III:

or pharmaceutically acceptable salt thereof, wherein:

R N is H, C 1-6 alkyl, C 2-6 alkenyl, C 2-6 alkynyl, —C(O)—R 8a , —C(O)O—R 8b , —SO q —R 8a , —(CR 1a R 1b ) a -Cy 1 , or —(CR 1a R 1b ) a —C(O)—(CR 1a R 1b ) b -Cy 1 , wherein said C 1-6 alkyl, C 2-6 alkenyl, or C 2-6 alkynyl is optionally substituted by 1, 2, 3, 4, or 5 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, arylalkyl, cycloalkylalkyl, heteroarylalkyl, heterocycloalkylalkyl, halosulfanyl, CN, N 3 , NO 2 , OR a1 , SR a1 , C(O)R b1 , C(O)NR c1 R d1 , C(O)OR a1 , OC(O)R b1 , OC(O)NR c1 R d1 , NR c1 R d1 , NR c1 C(O)R d1 , NR c1 C(O)OR a1 , S(O)R b1 , S(O)NR c1 R d1 , S(O) 2 R b1 , and S(O) 2 NR c1 R d1 ;

R 1 is C 1-6 alkyl, C 2-12 alkoxyalkyl, or —(CR 2a R 2b ) c -Cy 2 ;

R 2 together with R 7 form —CH 2 —CH 2 —;

R 3 , R 4 , R 5 , and R 6 are independently selected from H, halo, C 1-4 alkyl, C 1-4 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, —(CR 1a R 1b ) a -Cy 4 , halosulfanyl, CN, NO 2 , OR a , SR a , C(O)R b , C(O)NR c R d , C(O)OR a , OC(O)R b , OC(O)NR c R d , NR c R d , NR c C(O)R d , NR c C(O)OR a , S(O)R b , S(O)NR c R d , S(O) 2 R b , and S(O) 2 NR c R d , wherein said C 1-4 alkyl, C 2-6 alkenyl, or C 2-6 alkynyl are optionally substituted with 1, 2 or 3 substituents selected from halo, halosulfanyl, CN, NO 2 , OR a , SR a , C(O)R b , C(O)NR c R d , C(O)OR a , OC(O)R b , OC(O)NR c R d , NR c R d , NR c C(O)R d , NR c C(O)OR a , S(O)R b , S(O)NR c R d , S(O) 2 R b , and S(O) 2 NR c R d ;

or two of R 3 , R 4 , R 5 , and R 6 are attached to the same atom of ring A and together with the atom to which they are attached form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group, each optionally substituted by 1, 2, or 3 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, halosulfanyl, CN, NO 2 , OR 1 , SR a , C(O)R b , C(O)NR c R d , C(O)OR a , OC(O)R b , OC(O)NR c R d , NR c R d , NR c C(O)R d , NR c C(O)OR a , S(O)R b , S(O)NR c R d , S(O) 2 R b , and S(O) 2 NR c R d ;

R 8a is H, C 1-6 alkyl, NR c1 R d1 , or Cy 3 , wherein said C 1-6 alkyl is optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO 2 , OR a1 , SR a1 , C(O)R b1 , C(O)NR c1 R d1 , C(O)OR a1 , OC(O)R b1 , OC(O)NR c1 R d1 , NR c1 R d1 , NR c1 C(O)R d1 , NR c1 C(O)OR a1 , S(O)R b1 , S(O)NR c1 R d1 , S(O) 2 R b1 , and S(O) 2 NR c1 R d1 ;

R 8b is H, C 1-6 alkyl, or Cy 3 , wherein said C 1-6 alkyl is optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO 2 , OR a1 , SR a1 , C(O)R b1 , C(O)NR c1 R d1 , C(O)OR a1 , OC(O)R b1 , OC(O)NR c1 R d1 , NR c1 R d1 , NR c1 C(O)R d1 , NR c1 C(O)OR a1 , S(O)R b1 , S(O)NR c1 R d1 , S(O) 2 R b1 and S(O) 2 NR c1 R d1 ;

Cy 1 , Cy 2 , Cy 3 , and Cy 4 are independently selected from aryl, heteroaryl, cycloalkyl, and heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected from Cy 5 , halo, C 1-4 alkyl, C 2-4 alkenyl, C 2-4 alkynyl, C 1-4 haloalkyl, halosulfanyl, CN, NO 2 , OR a3 , SR a3 , C(O)R b3 , C(O)NR c3 R d3 , C(O)OR a3 , OC(O)R b3 , OC(O)NR c3 R d3 , NR c3 R d3 , NR c3 C(O)R b3 , NR c3 C(O)OR a3 , S(O)R b3 , S(O)NR c3 R d3 , S(O) 2 R b3 , and S(O) 2 NR c3 R d3 ;

Cy 5 is aryl, heteroaryl, cycloalkyl, and heterocycloalkyl, each optionally substituted by 1, 2, 3, 4 or 5 substituents independently selected from halo, C 1-4 alkyl, C 2-4 alkenyl, C 2-4 alkynyl, C 1-4 haloalkyl, halosulfanyl, CN, NO 2 , OR a6 , SR a6 , C(O)R b6 , C(O)NR c6 R d6 , C(O)OR a6 , OC(O)R b6 , OC(O)NR c6 R d6 , NR c6 R d6 , NR c6 C(O)R b6 , NR c6 C(O)OR a6 , S(O)R b6 , S(O)NR c6 R d6 , S(O) 2 R b6 , and S(O) 2 NR c6 R d6 ;

R 1a and R 1b are independently selected from H, halo, C 1-4 alkyl, C 2-4 alkenyl, C 2-4 alkynyl, C 1-4 alkoxy, C 1-4 haloalkyl, C 1-4 haloalkoxy, OH, amino, C 1-4 alkylamino, and C 2-8 dialkylamino;

R 2a and R 2b are independently selected from halo, C 1-4 alkyl, C 2-4 alkenyl, C 2-4 alkynyl, C 1-4 alkoxy, C 1-4 haloalkyl, C 1-4 haloalkoxy, OH, amino, C 1-4 alkylamino, and C 2-8 dialkylamino;

R a , R a1 and R a3 are independently selected from H, C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, Cy 5 , and —(C 1-6 alkyl)-Cy 5 , wherein said C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, or C 2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

R b , R b1 , R b2 , R b3 are independently selected from H, C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, Cy 5 , and —(C 1-6 alkyl)-Cy 5 , wherein said C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, or C 2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

R c , R c1 , R c2 , R c3 , R d , R d1 and R d3 are independently selected from H, C 1-10 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl or heterocycloalkylalkyl, wherein said C 1-10 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

or R c and R d together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl or heterocycloalkyl;

or R c1 and R d1 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

or R c3 and R d3 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

R a6 is H, C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, or C 2-6 alkynyl, wherein said C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, or C 2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

R b6 is H, C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, or C 2-6 alkynyl, wherein said C 1-6 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, or C 2-6 alkynyl is optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

R c6 and R d6 are independently selected from H, C 1-10 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl or heterocycloalkylalkyl, wherein said C 1-10 alkyl, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl or heterocycloalkylalkyl is optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl and heterocycloalkyl;

or R c6 and R d6 together with the N atom to which they are attached form a 4-, 5-, 6- or 7-membered heterocycloalkyl group optionally substituted with 1, 2, or 3 substituents independently selected from OH, CN, amino, halo, C 1-6 alkyl, C 1-6 haloalkyl, C 1-6 haloalkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloalkyl or heterocycloalkyl;

a, b, and c are independently selected from 0, 1, 2, 3, 4, and 5;

q is 0, 1, or 2; and

r is 0, 1, or 2.

2. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R N is C 1-6 alkyl, —C(O)—R 8a , —C(O)O—R 8b , —SO q —R 8a , —(CR 1a R 1b ) a -Cy 1 , or —(CR 1a R 1b ) a —C(O)—(CR 1a R 1b ) b -Cy 1 .

3. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R N is C 1-4 alkyl, cycloalkylalkyl, heterocycloalkylalkyl, arylalkyl, heteroarylalkyl, aryl, heteroaryl, arylsulfonyl, alkylsulfonyl, —C(O)O—(C 1-4 alkyl), —C(O)-aryl, —C(O)-heteroaryl, or —C(O)-cycloalkyl, each optionally substituted by 1, 2 or 3 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, C 1-4 haloalkoxy, CN, and NO 2 .

4. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 3 , R 4 , R 5 , and R 6 are independently selected from H, halo, C 1-4 alkyl, C 1-4 haloalkyl, OR a , or OC(O)R b .

5. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 3 , R 4 , R 5 , and R 6 are independently selected from H, F, Me, or OH.

6. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 3 , R 4 , R 5 , and R 6 are each H.

7. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein two of R 3 , R 4 , R 5 , and R 6 are attached to the same atom and together with the atom to which they are attached form a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group, each optionally substituted by 1, 2, or 3 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO 2 , OR a , SR a , C(O)R b , C(O)NR c R d , C(O)OR a , OC(O)R b , OC(O)NR c R d , NR c R d , NR c C(O)R d , NR c C(O)OR a , S(O)R b , S(O)NR c R d , S(O) 2 R b , and S(O) 2 NR c R d .

8. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein two of R 3 , R 4 , R 5 , and R 6 are attached to the same atom and together with the atom to which they are attached form a 3-7 membered cycloalkyl group or 3-7 membered heterocycloalkyl group.

9. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein two of R 3 , R 4 , R 5 , and R 6 are attached to the same atom and together with the atom to which they are attached form a cyclopropyl group.

10. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is —(CR 2a R 2b ) c -Cy 2 .

11. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl each optionally substituted by 1, 2 or 3 substituents selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, CN, NO 2 , and OR a3 .

12. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is aryl, heteroaryl, cycloalkyl, heterocycloalkyl, arylalkyl, heteroarylalkyl, cycloalkylalkyl, or heterocycloalkylalkyl each optionally substituted by 1, 2 or 3 halo.

13. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is —(CR 2a R 2b ) c -Cy 2 and Cy 2 is aryl, heteroaryl, cycloalkyl, and heterocycloalkyl, each optionally substituted by 1 or 2 substituents independently selected from halo and OR a3 .

14. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is —(CR 2a R 2b ) c -Cy 2 and Cy 2 is aryl, heteroaryl, cycloalkyl, and heterocycloalkyl, each optionally substituted by 1 or 2 substituents independently selected from methoxy, OH, and Cl.

15. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is —(CR 2a R 2b ) c -Cy 2 and Cy 2 is cycloalkyl optionally substituted by 1 or 2 substituents independently selected from methoxy, OH, and Cl.

16. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is —(CR 2a R 2b ) c -Cy 2 and Cy 2 is cyclohexyl optionally substituted by 1 or 2 substituents independently selected from methoxy and OH.

17. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein R 1 is —(CR 2a R 2b ) c -Cy 2 and Cy 2 is cyclohexyl.

18. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein the compound is a compound according to Formula IV:

19. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein the compound is a compound according to Formula Va or Vb:

20. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein the compound is a compound according to Formula VI:

wherein ring B is a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group, each optionally substituted by 1, 2, or 3 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO 2 , OR a , SR a , C(O)R b , C(O)N c R d , C(O)OR a , OC(O)R b , OC(O)NR c R d , NR c R d , NR a C(O)R d , NR c C(O)OR a , S(O)R b , S(O)NR c R d , S(O) 2 R b , and S(O) 2 NR c R d .

21. The compound of claim 1 , or pharmaceutically acceptable salt thereof, wherein the compound is a compound according to Formula VII:

wherein ring B is a 3-20 membered cycloalkyl group or 3-20 membered heterocycloalkyl group, each optionally substituted by 1, 2, or 3 substituents independently selected from halo, C 1-4 alkyl, C 1-4 haloalkyl, aryl, cycloalkyl, heteroaryl, heterocycloalkyl, CN, NO 2 , OR a , SR a , C(O)R b , C(O)NR c R d , C(O)OR a , OC(O)R b , OC(O)NR c R d , NR c R d , NR c C(O)R d , NR c C(O)OR a , S(O)R b , S(O)NR c R d , S(O) 2 R b , and S(O) 2 NR c R d .

22. A compound selected from:

7-(2-chlorophenyl)-1-isobutyl-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-(cyclopropylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-(tetrahydrofuran-3-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-(1H-imidazol-4-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-(1H-indol-5-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-(5-nitropyridin-2-yl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-[5-(trifluoromethyl)pyridin-2-yl]-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-{[4-(difluoromethoxy)phenyl]sulfonyl}-1,7-diazaspiro[4.4]nonan-6-one;

7-(1-adamantyl)-1-isobutyl-1,7-diazaspiro[4.4]nonan-6-one;

7-(1-adamantyl)-1-(pyridin-2-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(1-adamantyl)-1-(cyclopentylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(1-adamantyl)-1-[5-(trifluoromethyl)pyridin-2-yl]-1,7-diazaspiro[4.4]nonan-6-one;

7-(1-adamantyl)-1-[3-chloro-5-(trifluoromethyl)pyridin-2-yl]-1,7-diazaspiro[4.4]nonan-6-one;

6-[7-(1-adamantyl)-6-oxo-1,7-diazaspiro[4.4]non-1-yl]nicotinonitrile;

7-cyclohexyl-1-(cyclopentylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

4-[(7-cyclohexyl-6-oxo-1,7-diazaspiro[4.4]non-1-yl)methyl]benzonitrile;

1-(4-chlorobenzyl)-7-cyclohexyl-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(2,4-difluorobenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-{[6-(trifluoromethyl)pyridin-3-yl]methyl}-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(1H-indol-3-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

ethyl 7-cyclohexyl-6-oxo-1,7-diazaspiro[4.4]nonane-1-carboxylate;

7-cyclohexyl-1-[2-fluoro-5-(trifluoromethyl)benzoyl]-1,7-diazaspiro[4.4]nonan-6-one;

1-(cyclobutylcarbonyl)-7-cyclohexyl-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(pyridin-2-ylcarbonyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-(2-chlorophenyl)-1-(ethylsulfonyl)-1,7-diazaspiro[4.4]nonan-6-one;

2-cyclohexyl-6-isobutyl-2,6-diazaspiro[4.5]decan-1-one;

2-cyclohexyl-6-(cyclopentylmethyl)-2,6-diazaspiro[4.5]decan-1-one;

2-cyclohexyl-6-(pyridin-2-ylmethyl)-2,6-diazaspiro[4.5]decan-1-one;

2-cyclohexyl-6-[5-(trifluoromethyl)pyridin-2-yl]-2,6-diazaspiro[4.5]decan-1-one;

(3R)-1-(4-chlorobenzyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-(1-cyclohexylethyl)-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-(cyclohexylmethyl)-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-1-[2-(3-bromophenyl)-1-methylethyl]-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-(1-cyclopropylethyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-1-(4-bromobenzyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-1-(1-cyclobutylethyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

3-{1-[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]ethyl}-benzonitrile;

(3R)-7-cyclohexyl-3-hydroxy-1-[1-(3-methyl-2-oxotetrahydrofuran-3-yl)ethyl]-1,7-diazaspiro[4.4]nonan-6-one;

5-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-2-fluorophenyl)-N-isopropylpyridine-2-carboxamide;

(3R)-7-cyclohexyl-3-hydroxy-1-(4-pyridin-4-ylbenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

5-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-phenyl)-N-ethylpyridine-2-carboxamide;

5-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-3-fluorophenyl)-N-ethylpyridine-2-carboxamide;

(3R)-1-[1-(4-bromophenyl)ethyl]-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]-nonan-6-one;

(3R)-7-cyclohexyl-1-[(2-fluorobiphenyl-4-Amethyl]-3-hydroxy-1,7-diazaspiro-[4.4]nonan-6-one;

(3R)-7-cyclohexyl-3-hydroxy-1-{4-[3-(trifluoromethyl)phenoxy]benzyl}-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-[4-(dimethylamino)benzyl]-3-hydroxy-1,7-diazaspiro[4.4]-nonan-6-one;

(3R)-7-cyclohexyl-3-hydroxy-1-(4-morpholin-4-ylbenzyl)-1,7-diazaspiro[4.4]-nonan-6-one;

(3R)-7-cyclohexyl-3-hydroxy-1-[4-(pyrimidin-2-yloxy)benzyl]-1,7-diazaspiro-[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-(3-fluorobenzyl)-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-3-hydroxy-1-(4-nitrobenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

2-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-benzonitrile;

(3R)-7-cyclohexyl-3-hydroxy-1-{4-[3-(trifluoromethyl)-1H-pyrazol-1-yl]benzyl}-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-3-hydroxy-1-[4-(2-oxopyrrolidin-1-yl)benzyl]-1,7-diazaspiro-[4.4]nonan-6-one;

5-(5-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-2-fluorophenyl)-N-ethylpyridine-2-carboxamide;

(3R)-7-cyclohexyl-1-{[6-(4-fluorophenyl)pyridin-3-yl]methyl}-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

3-(5-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-pyridin-2-yl)benzonitrile;

(3R)-7-cyclohexyl-1-{[6-(3,5-dimethylisoxazol-4-yl)pyridin-3-yl]methyl}-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

5-(3-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-phenyl)-N-ethylpyridine-2-carboxamide;

(3R)-7-cyclohexyl-1-(1-ethylpropyl)-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-cyclopentyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3S)-1-(4-chlorobenzyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-7-cyclohexyl-1-(cyclopentylmethyl)-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

5-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-2-fluorophenyl)-N,N-dimethylpyridine-2-carboxamide;

5-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-phenyl)-N,N-dimethylpyridine-2-carboxamide;

2-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-phenyl)isonicotinonitrile;

(3R)-1-[4-(5-chloropyridin-3-yl)benzyl]-7-cyclohexyl-3-hydroxy-1,7-diazaspiro-[4.4]nonan-6-one;

3-(4-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-phenyl)pyrazine-2-carbonitrile;

(3R)-7-cyclohexyl-1-[4-(3-fluoropyridin-4-yl)benzyl]-3-hydroxy-1,7-diazaspiro-[4.4]nonan-6-one;

(3R)-7-cyclohexyl-3-hydroxy-1-(4-pyrazin-2-ylbenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

(3R)-1-[2-(4-bromophenyl)ethyl]-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]-nonan-6-one;

(3R)-7-cyclohexyl-1-{[5-(3,4-difluorophenyl)pyridin-2-yl]methyl}-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

3-(6-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-pyridin-3-yl)benzonitrile;

6′-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-N-methyl-3,3′-bipyridine-6-carboxamide;

(3R)-1-{[1-(4-chlorophenyl)cyclopropyl]methyl}-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

4-(6-{[(3R)-7-cyclohexyl-3-hydroxy-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-pyridin-3-yl)-N-cyclopropylbenzamide;

(3R)-7-cyclohexyl-1-(cyclopropylmethyl)-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-chlorobenzyl)-7-cyclohexyl-3-hydroxy-3-methyl-1,7-diazaspiro[4.4]nonan-6-one;

(5S)-1-(4-chlorobenzyl)-7-cyclohexyl-3,3-difluoro-1,7-diazaspiro[4.4]nonan-6-one;

(3S)-1-(4-chlorobenzyl)-7-cyclohexyl-3-fluoro-1,7-diazaspiro[4.4]nonan-6-one;

5-(4-{[(3S)-7-cyclohexyl-3-fluoro-6-oxo-1,7-diazaspiro[4.4]non-1-yl]methyl}-phenyl)-N-methylpyridine-2-carboxamide;

1-(4-chlorobenzyl)-7-cycloheptyl-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-chlorobenzyl)-7-cyclopentyl-1,7-diazaspiro[4.4]nonan-6-one;

5-{4-[(7-cyclohexyl-6-oxo-1,7-diazaspiro[4.4]non-1-yl)methyl]phenyl}-N-ethyl-pyridine-2-carboxamide;

7-cyclohexyl-1-[4-(5-methoxypyridin-3-yl)benzyl]-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(4-pyridin-4-ylbenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[4-(difluoromethoxy)benzyl]-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[(6-methoxypyridin-3-yl)methyl]-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(4-phenoxybenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[4-(trifluoromethyl)benzyl]-1,7-diazaspiro[4.4]nonan-6-one;

5-[(7-cyclohexyl-6-oxo-1,7-diazaspiro[4.4]non-1-yl)methyl]-2-fluorobenzonitrile;

7-cyclohexyl-1-[4-(methylsulfonyl)benzyl]-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[(1-methyl-1H-pyrrol-2-yl)methyl]-1,7-diazaspiro[4.4]nonan-6-one;

1-[2-chloro-4-(methylsulfonyl)benzyl]-7-cyclohexyl-1,7-diazaspiro[4.4]nonan-6-one;

N-{4-[(7-cyclohexyl-6-oxo-1,7-diazaspiro[4.4]non-1-yl)methyl]phenyl}acetamide;

1-(biphenyl-4-ylmethyl)-7-cyclohexyl-1,7-diazaspiro[4.4]nonan-6-one;

1-(biphenyl-2-ylmethyl)-7-cyclohexyl-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(1,2,3-thiadiazol-4-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-chlorobenzyl)-7-(2-methoxybenzyl)-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-chlorobenzyl)-7-(trans-4-hydroxycyclohexyl)-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-chlorobenzyl)-7-(tetrahydro-2H-pyran-4-yl)-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-fluorobenzyl)-7-(tetrahydro-2H-pyran-4-yl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(cyclopropylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(pyridin-3-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(pyridin-2-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-(pyridin-4-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[(1-methyl-1H-imidazol-2-yl)methyl]-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[(2,5-dimethyl-1,3-thiazol-4-yl)methyl]-1,7-diazaspiro[4.4]nonan-6-one;

7-cyclohexyl-1-[4-(1,2,3-thiadiazol-4-yl)benzyl]-1,7-diazaspiro[4.4]nonan-6-one;

1-(4-chlorobenzyl)-7-(2-methoxy-1-methylethyl)-1,7-diazaspiro[4.4]nonan-6-one; and

1-(4-chlorobenzyl)-7-(pyridin-4-ylmethyl)-1,7-diazaspiro[4.4]nonan-6-one; and

pharmaceutically acceptable salts thereof.

23. A composition comprising a compound of claim 1 , or pharmaceutically acceptable salt thereof, and at least one pharmaceutically acceptable carrier.

24. A method of inhibiting 11βHSD1 comprising contacting said 11βHSD1 with a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

25. A method of ameliorating obesity, diabetes, glucose intolerance, insulin resistance, hyperglycemia, hyperlipidemia, or metabolic syndrome, in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

26. A method of ameliorating type 2 diabetes in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

27. A compound according to claim 10 , or a pharmaceutically acceptable salt thereof, wherein c is 0.

28. A compound according to claim 13 , or a pharmaceutically acceptable salt thereof, wherein c is 0.

29. A compound according to claim 14 , or a pharmaceutically acceptable salt thereof, wherein c is 0.

30. A compound according to claim 15 , or a pharmaceutically acceptable salt thereof, wherein c is 0.

31. A compound according to claim 16 , or a pharmaceutically acceptable salt thereof, wherein c is 0.

32. A compound according to claim 17 , or a pharmaceutically acceptable salt thereof, wherein c is 0.

33. A compound according to claim 1 , wherein the compound is 1-(4-chlorobenzyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one, or a pharmaceutically acceptable salt thereof.

34. A compound according to claim 1 , wherein the compound is (3R)-1-(4-chlorobenzyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one, or a pharmaceutically acceptable salt thereof.

35. A compound according to claim 1 , wherein the compound is (3S)-1-(4-chlorobenzyl)-7-cyclohexyl-3-hydroxy-1,7-diazaspiro[4.4]nonan-6-one, or a pharmaceutically acceptable salt thereof.

36. A method of ameliorating obesity in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

37. A method of ameliorating diabetes in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

38. A method of ameliorating glucose intolerance in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

39. A method of ameliorating insulin resistance in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

40. A method of ameliorating hypergylcemia in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

41. A method of ameliorating hyperlipidemia in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.

42. A method of ameliorating metabolic syndrome in a patient in need thereof, comprising administering to said patient a therapeutically effective amount of a compound according to claim 1 , or a pharmaceutically acceptable salt thereof.