Modulators of Cystic Fibrosis Transmembrane Conductance Regulator

1 . A pharmaceutical composition comprising:

A Compound of Formula I

or pharmaceutically acceptable salts thereof, wherein:

ring A is selected from:

R 1 is —CF 3 , —CN, or —C≡CCH 2 N(CH 3 ) 2 ;

R 2 is hydrogen, —CH 3 , —CF 3 , —OH, or —CH 2 OH;

R 3 is hydrogen, —CH 3 , —OCH 3 , or —CN;

provided that both R 2 and R 3 are not simultaneously hydrogen; and

one or both of the following:

B. A Compound of Formula II

or pharmaceutically acceptable salts thereof, wherein:

T is —CH 2 —, —CH 2 CH 2 —, —CF 2 —, —C(CH 3 ) 2 —, or —C(O)—;

R 1 ′ is H, C 1-6 aliphatic, halo, CF 3 , CHF 2 , O(C 1-6 aliphatic); and

R D1 or R D2 is Z D R 9

wherein:

Z D is a bond, CONH, SO 2 NH, SO 2 N(C 1-6 alkyl), CH 2 NHSO 2 , CH 2 N(CH 3 )SO 2 , CH 2 NHCO, COO, SO 2 , or CO; and

R 9 is H, C 1-6 aliphatic, or aryl; and/or

C. A Compound of Formula III

or pharmaceutically acceptable salts thereof, wherein:

R is H, OH, OCH 3 or two R taken together form —OCH 2 O— or —OCF 2 O—;

R 4 is H or alkyl;

R 5 is H or F;

R 6 is H or CN;

R 7 is H, —CH 2 CH(OH)CH 2 OH, —CH 2 CH 2 N + (CH 3 ) 3 , or —CH 2 CH 2 OH;

R 8 is H, OH, —CH 2 CH(OH)CH 2 OH, —CH 2 OH, or R 7 and R 8 taken together form a five membered ring.

2 . The pharmaceutical composition of claim 1 , comprising a Compound of Formula I and Compound of Formula II.

3 . The pharmaceutical composition of claim 1 , comprising a Compound of Formula I and Compound of Formula III.

4 . The pharmaceutical composition of claim 1 , comprising a Compound of Formula I, a Compound of Formula II and a Compound of Formula III.

5 . The pharmaceutical composition of claim 1 , wherein the Compound of Formula I is Compound 1

6 . The pharmaceutical composition of claim 1 , wherein the Compound of Formula II is Compound 2

7 . The pharmaceutical composition of claim 1 , wherein the Compound of Formula III is Compound 3

8 . The pharmaceutical composition of claim 2 , wherein the Compound of Formula I is Compound 1

and

the Compound of Formula II is Compound 2

9 . The pharmaceutical composition of claim 3 , wherein the Compound of Formula I is Compound 1

and

the Compound of Formula II is Compound 2

10 . The pharmaceutical composition of claim 4 , wherein the Compound of Formula I is Compound 1

the Compound of Formula II is Compound 2

and

the Compound of Formula III is Compound 3

11 . A method of treating a CFTR mediated disease in a human comprising administering to the human an effective amount of a pharmaceutical composition according to claim 1 .

12 . The method of claim 11 , wherein the CFTR mediated disease is selected from cystic fibrosis, asthma, smoke induced COPD, chronic bronchitis, rhinosinusitis, constipation, pancreatitis, pancreatic insufficiency, male infertility caused by congenital bilateral absence of the vas deferens (CBAVD), mild pulmonary disease, idiopathic pancreatitis, allergic bronchopulmonary aspergillosis (ABPA), liver disease, hereditary emphysema, hereditary hemochromatosis, coagulation-fibrinolysis deficiencies, such as protein C deficiency, Type 1 hereditary angioedema, lipid processing deficiencies, such as familial hypercholesterolemia, Type 1 chylomicronemia, abetalipoproteinemia, lysosomal storage diseases, such as I-cell disease/pseudo-Hurler, mucopolysaccharidoses, Sandhof/Tay-Sachs, Crigler-Najjar type II, polyendocrinopathy/hyperinsulemia, Diabetes mellitus, Laron dwarfism, myleoperoxidase deficiency, primary hypoparathyroidism, melanoma, glycanosis CDG type 1, congenital hyperthyroidism, osteogenesis imperfecta, hereditary hypofibrinogenemia, ACT deficiency, Diabetes insipidus (DI), neurophyseal DI, neprogenic DI, Charcot-Marie Tooth syndrome, Perlizaeus-Merzbacher disease, neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, progressive supranuclear palsy, Pick's disease, several polyglutamine neurological disorders such as Huntington's, spinocerebullar ataxia type I, spinal and bulbar muscular atrophy, dentatorubal pallidoluysian, and myotonic dystrophy, as well as spongiform encephalopathies, such as hereditary Creutzfeldt-Jakob disease (due to prion protein processing defect), Fabry disease, Straussler-Scheinker syndrome, COPD, dry-eye disease, or Sjogren's disease, Osteoporosis, Osteopenia, bone healing and bone growth (including bone repair, bone regeneration, reducing bone resorption and increasing bone deposition), Gorham's Syndrome, chloride channelopathies such as myotonia congenita (Thomson and Becker forms), Bartter's syndrome type III, Dent's disease, hyperekplexia, epilepsy, lysosomal storage disease, Angelman syndrome, and Primary Ciliary Dyskinesia (PCD), a term for inherited disorders of the structure and/or function of cilia, including PCD with situs inversus (also known as Kartagener syndrome), PCD without situs inversus and ciliary aplasia.

13 . The method of claim 12 , wherein the CFTR mediated disease is cystic fibrosis, COPD, emphysema, dry-eye disease or osteoporosis.

14 . The method of claim 13 , wherein the CFTR mediated disease is cystic fibrosis.

15 . The method of claim 14 , wherein the patient possesses one or more of the following mutations of human CFTR: ΔF508, R117H, and G551D.

16 . The method of claim 15 , wherein the method includes treating or lessening the severity of cystic fibrosis in a patient possessing the ΔF508 mutation of human CFTR.

17 . The method of claim 15 , wherein the method includes treating or lessening the severity of cystic fibrosis in a patient possessing the G551D mutation of human CFTR.

18 . The method of claim 16 , wherein the method includes treating or lessening the severity of cystic fibrosis in a patient possessing the ΔF508 mutation of human CFTR on at least one allele.

19 . The method of claim 16 , wherein the method includes treating or lessening the severity of cystic fibrosis in a patient possessing the ΔF508 mutation of human CFTR on both alleles.

20 . The method of claim 17 , wherein the method includes treating or lessening the severity of cystic fibrosis in a patient possessing the G551D mutation of human CFTR on at least one allele.

21 . The method of claim 17 , wherein the method includes treating or lessening the severity of cystic fibrosis in a patient possessing the G551D mutation of human CFTR on both alleles.

22 . A kit for use in measuring the activity of a CFTR or a fragment thereof in a biological sample in vitro or in vivo, comprising:

a pharmaceutical composition according to claim 1 ;

(ii) instructions for:

a) contacting the composition with the biological sample;

b) measuring activity of said CFTR or a fragment thereof.

23 . The kit of claim 22 further comprising instructions for

a) contacting an additional compound with the biological sample;

b) measuring the activity of said CFTR or a fragment thereof in the presence of said additional compound, and

c) comparing the activity of said CFTR or fragment thereof in the presence of said additional compound with the activity of the CFTR or fragment thereof in the presence of a composition comprising a pharmaceutical composition according to claim 1 .

24 . The kit of claim 23 , wherein the step of comparing the activity of said CFTR or fragment thereof provides a measure of the density of said CFTR or fragment thereof.