Bicyclic-pyrimidinedione compounds
The present invention provides novel bicyclic pyrimidinedione compounds that are useful for the treatment of hypertrophic cardiomyopathy (HCM) and conditions associated with left ventricular hypertrophy or diastolic dysfunction. The synthesis and characterization of the compounds is described, as well as methods for treating HCM and other forms of heart disease.
1. A compound having the formula:
or a pharmaceutically acceptable salt thereof, wherein
the subscript m is an integer of from 0 to 2;
the subscript n is 0 or 1; and the sum of n+m is no more than 2;
R 1 is a member selected from the group consisting of C 1 -C 8 alkyl, C 3 -C 8 cycloalkyl, C 3 -C 8 cycloalkyl-C 1 -C 3 alkyl, 4- to 7-membered heterocycloalkyl, 4- to 7-membered heterocycloalkyl-C 1 -C 3 alkyl, phenyl, phenyl-C 1 -C 3 alkyl, 5- to 6-membered heteroaryl and 5- to 6-membered heteroaryl-C 1 -C 3 alkyl, wherein each R 1 is optionally substituted with from 1-5 R a ;
R 2 is a member selected from the group consisting of C 2 -C 8 alkyl, C 3 -C 8 cycloalkyl, C 3 -C 8 cycloalkyl-C 1 -C 3 alkyl, phenyl, phenyl-C 1 -C 3 alkyl, 4- to 7-membered heterocycloalkyl, 4- to 7-membered heterocycloalkyl-C 1 -C 3 alkyl, 5- to 6-membered heteroaryl and 5- to 6-membered heteroaryl-C 1 -C 3 alkyl, wherein each R 2 is optionally substituted with from 1-5 R b ;
each R a is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl, C 1 -C 4 alkoxy and —CO 2 —C 1 -C 8 alkyl;
each R b is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl, C 1 -C 4 alkoxy, —COR b1 , —CO 2 R b1 , —SO 2 R b1 , —SO 2 NR b1 R b2 , and —CONR b1 R b2 , wherein each R b1 and R b2 is independently selected from the group consisting of H and C 1 -C 4 alkyl or optionally two R b groups on the same carbon atom are combined to form oxo;
wherein the ring bearing R 2 is optionally further substituted with from one to five R c , each of which is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl and C 1 -C 4 alkoxy, or optionally two R c groups on the same carbon atom are combined to form oxo,
and wherein
the 5- to 6-membered heteroaryl of R 1 and R 2 comprises from 1 to 5 heteroatoms independently selected from the group consisting of N, O, and S, and
the 4- to 7-membered heterocycloalkyl of R 1 and R 2 comprises from 1 to 4 heteroatoms independently selected from the group consisting of N, O, and S.
2. A compound of claim 1 , having the formula:
or a pharmaceutically acceptable salt thereof, wherein
the subscript m is an integer of from 0 to 2;
the subscript n is 0 or 1; and the sum of n+m is no more than 2;
R 1 is a member selected from the group consisting of C 1 -C 8 alkyl, C 3 -C 8 cycloalkyl, C 3 -C 8 cycloalkyl-C 1 -C 3 alkyl, 4- to 7-membered heterocycloalkyl, 4- to 7-membered heterocycloalkyl-C 1 -C 3 alkyl, phenyl, phenyl-C 1 -C 3 alkyl, 5- to 6-membered heteroaryl and 5- to 6-membered heteroaryl-C 1 -C 3 alkyl, wherein each R 1 is optionally substituted with from 1-5 R a ;
R 2 is a member selected from the group consisting of C 2 -C 8 alkyl, C 3 -C 8 cycloalkyl, C 3 -C 8 cycloalkyl-C 1 -C 3 alkyl, phenyl, phenyl-C 1 -C 3 alkyl, 4- to 7-membered heterocycloalkyl, 4- to 7-membered heterocycloalkyl-C 1 -C 3 alkyl, 5- to 6-membered heteroaryl and 5- to 6-membered heteroaryl-C 1 -C 3 alkyl, wherein each R 2 is optionally substituted with from 1-5 R b ;
each R a is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl and C 1 -C 4 alkoxy;
each R b is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl, C 1 -C 4 alkoxy, —COR b1 , —CO 2 R b1 , —SO 2 R b1 , —SO 2 NR b1 R b2 , and —CONR b1 R b2 , wherein each R b1 and R b2 is independently selected from the group consisting of H and C 1 -C 4 alkyl or optionally two R b groups on the same carbon atom are combined to form oxo;
and wherein the ring bearing R 2 is optionally further substituted with from one to four R c , each of which is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl and C 1 -C 4 alkoxy, or optionally two R c groups on the same carbon atom are combined to form oxo.
3. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, wherein R 1 is a member selected from the group consisting of C 1 -C 8 alkyl, C 3 -C 8 cycloalkyl and C 3 -C 8 cycloalkyl-C 1 -C 3 alkyl, each of which is optionally substituted with from 1-3 R a .
4. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, wherein R 2 is C 3 -C 8 cycloalkyl, which is optionally substituted with from 1-3 R b .
5. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, wherein R 2 is phenyl, which is optionally substituted with from 1-3 R b .
6. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, wherein n is 0.
7. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, wherein m is 1 or 2.
8. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, wherein n is 0 and m is 1.
9. A compound of claim 1 , or a pharmaceutically acceptable salt thereof, having the formula:
wherein
R 1 is a member selected from the group consisting of C 1 -C 8 alkyl, C 3 -C 8 cycloalkyl and C 3 -C 8 cycloalkyl-C 1 -C 3 alkyl, each of which is optionally substituted with from 1-3 R a ;
R 2 is a member selected from the group consisting of C 5 -C 6 cycloalkyl and phenyl, each of which is optionally substituted with from 1-3 R b ;
each R a is independently selected from the group consisting of halo, CN, C 1 -C 4 alkyl, C 1 -C 4 and haloalkyl;
each R b is independently selected from the group consisting of halo, CN, hydroxyl, C 1 -C 4 alkyl, C 1 -C 4 haloalkyl and C 1 -C 4 alkoxy;
the subscript q is 0 to 2;
each R c is independently selected from the group consisting of halo, C 1 -C 4 alkyl and C 1 -C 4 haloalkyl; and
wherein the compound is substantially free of other isomers at the carbon atom bearing R 2 .
10. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, wherein R 2 is phenyl, which is optionally substituted with from 1-2 R b .
11. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, wherein R 2 is C 5 -C 6 cycloalkyl, which is optionally substituted with from 1-2 R b .
12. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, wherein q is 0.
13. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, wherein R 1 is C 2 -C 6 alkyl, and is optionally substituted with from 1-4 halo.
14. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, wherein R 1 is C 2 -C 6 alkyl.
15. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, having the formula:
wherein
R 1 is selected from the group consisting of ethyl, isopropyl, isobutyl, t-butyl, cyclopropylmethyl, 1-methylcyclopropyl, (S)-2-butyl, (R)-2-butyl, 2,2,2-trifluoroethyl and 2,2-difluoroethyl;
each R b is independently selected from the group consisting of halo, C 1 -C 4 alkyl, and C 1 -C 4 haloalkyl;
q is an integer of from 0 to 2; and
each R c is independently selected from the group consisting of halo, C 1 -C 4 alkyl and C 1 -C 4 haloalkyl.
16. A compound of claim 9 , or a pharmaceutically acceptable salt thereof, having a formula selected from the group consisting of:
wherein
R 1 is selected from the group consisting of ethyl, isopropyl, isobutyl, t-butyl, cyclopropylmethyl, 1-methylcyclopropyl, (S)-2-butyl, (R)-2-butyl, 2,2,2-trifluoroethyl and 2,2-difluoroethyl;
each R b is independently selected from the group consisting of halo, C 1 -C 4 alkyl, and C 1 -C 4 haloalkyl;
q is an integer of from 0 to 2; and
each R c is independently selected from the group consisting of halo, C 1 -C 4 alkyl and C 1 -C 4 haloalkyl.
17. A pharmaceutical composition comprising a compound of claim 1 , and a pharmaceutically acceptable excipient.
18. A compound of claim 1 , selected from the group consisting of
or a pharmaceutically acceptable salt thereof.
19. A compound of claim 1 , selected from the group consisting of
or a pharmaceutically acceptable salt thereof.
20. A compound of claim 1 , selected from the group consisting of:
or a pharmaceutically acceptable salt thereof.
21. A compound of claim 1 , having the formula:
or a pharmaceutically acceptable salt thereof, wherein
R 1 is selected from the group consisting of methyl, ethyl, 2,2,2-trifluoroethyl, 2,2-difluoroethyl, propyl, isopropyl, cyclopropyl, n-butyl, isobutyl, (S)-2-butyl, (R)-2-butyl, cyclopropylmethyl, 1-methylcyclopropyl, cyclobutyl, 3,3-difluorocyclobut-1-yl, oxetan-3-yl, N-methoxycarbonylazetidin-3-yl, cyclopentyl, (S)-3,3-difluorocyclopent-1-yl, (R)-3,3-difluorocyclopent-1-yl, (S)-tetrahydrofur-3-yl, (R)-tetrahydrofur-3-yl, (R)—N-methoxycarbonylpyrrolidin-3-yl, (S)—N-methoxycarbonylpyrrolidin-3-yl, cyclohexyl, 4,4-difluorocyclohex-1-yl, tetrahydro-2H-pyran-4-yl, N-methoxycarbonylpiperidin-4-yl, 1-methylpyrazol-3-yl, 1-methylpyrazol-4-yl, isoxazol-3-yl, 4-methylisoxazol-3-yl, 5-methylisoxazol-3-yl, phenyl, 2-methylphenyl, 2-fluorophenyl, 3-fluorophenyl, 4-fluorophenyl, 2,3-difluorophenyl, 2,4-difluorophenyl, 2,5-difluorophenyl, 3,5-difluorophenyl, pyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6-fluoropyrid-2-yl, and 6-methylpyrid-2-yl;
R 2 is selected from the group consisting of cyclopentyl, (S)-3,3-difluorocyclopent-1-yl, (R)-3,3-difluorocyclopent-1-yl, (S)-tetrahydrofur-3-yl, (R)-tetrahydrofur-3-yl, (R)—N-methoxycarbonylpyrrolidin-3-yl, (S)—N-methoxycarbonylpyrrolidin-3-yl, cyclohexyl, 4,4-difluorocyclohex-1-yl, tetrahydro-2H-pyran-4-yl, N-methoxycarbonylpiperidin-4-yl, 1-methylpyrazol-3-yl, 1-methylpyrazol-4-yl, isoxazol-3-yl, 4-methylisoxazol-3-yl, 5-methylisoxazol-3-yl, phenyl, 2-methylphenyl, 3-methylphenyl, 4-methylphenyl, 2-chlorophenyl, 3-chlorophenyl, 4-chlorophenyl, 2-trifluoromethylphenyl, 3-trifluoromethylphenyl, 4-trifluoromethylphenyl, 2-fluorophenyl, 3-fluorophenyl, 4-fluorophenyl, 2,3-difluorophenyl, 2,4-difluorophenyl, 2,5-difluorophenyl, 3,5-difluorophenyl, 3-chloro-2-fluorophenyl, 5-chloro-2-fluorophenyl, 3-chloro-5-fluorophenyl, 2-fluoro-3-trifluoromethylphenyl, 2-fluoro-4-trifluoromethylphenyl, 2-fluoro-5-trifluoromethylphenyl, 3-fluoro-4-trifluoromethylphenyl, 3-fluoro-5-trifluoromethylphenyl, pyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6-fluoropyrid-2-yl, 6-methylpyrid-2-yl, phenylmethyl, 2-fluorophenylmethyl, 3-fluorophenylmethyl, 4-fluorophenylmethyl, 2,3-difluorophenylmethyl, 2,4-difluorophenylmethyl, 2,5-difluorophenylmethyl, 2,6-difluorophenylmethyl, 3,4-difluorophenylmethyl, 3,5-difluorophenylmethyl, (5)-1-phenylethyl, (R)-1-phenylethyl, and phenyldifluoromethyl;
R c5 is selected from the group consisting of hydrogen, deuterium, methyl, difluoromethyl, trifluoromethyl, ethyl, 2,2,2-trifluoroethyl, 2,2-difluoroethyl, propyl, isopropyl, n-butyl, isobutyl, (S)-2-butyl, (R)-2-butyl, and tert-butyl; and
R c1 , R c2 , R c3 , R c4 are independently selected from the group consisting of hydrogen, deuterium, fluoro, methyl, difluoromethyl, and trifluoromethyl.
22. A compound of claim 1 , having the formula:
or a pharmaceutically acceptable salt thereof, wherein
R 1 is selected from the group consisting of methyl, ethyl, 2,2,2-trifluoroethyl, 2,2-difluoroethyl, propyl, isopropyl, cyclopropyl, n-butyl, isobutyl, (S)-2-butyl, (R)-2-butyl, cyclopropylmethyl, 1-methylcyclopropyl, cyclobutyl, 3,3-difluorocyclobut-1-yl, oxetan-3-yl, N-methoxycarbonylazetidin-3-yl, cyclopentyl, (5)-3,3-difluorocyclopent-1-yl, (R)-3,3-difluorocyclopent-1-yl, (S)-tetrahydrofur-3-yl, (R)-tetrahydrofur-3-yl, (R)—N-methoxycarbonylpyrrolidin-3-yl, (S)—N-methoxycarbonylpyrrolidin-3-yl, cyclohexyl, 4,4-difluorocyclohex-1-yl, tetrahydro-2H-pyran-4-yl, N-methoxycarbonylpiperidin-4-yl, 1-methylpyrazol-3-yl, 1-methylpyrazol-4-yl, isoxazol-3-yl, 4-methylisoxazol-3-yl, 5-methylisoxazol-3-yl, phenyl, 2-methylphenyl, 2-fluorophenyl, 3-fluorophenyl, 4-fluorophenyl, 2,3-difluorophenyl, 2,4-difluorophenyl, 2,5-difluorophenyl, 3,5-difluorophenyl, pyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6-fluoropyrid-2-yl, and 6-methylpyrid-2-yl;
R 2 is selected from the group consisting of cyclopentyl, (S)-3,3-difluorocyclopent-1-yl, (R)-3,3-difluorocyclopent-1-yl, (S)-tetrahydrofur-3-yl, (R)-tetrahydrofur-3-yl, (R)—N-methoxycarbonylpyrrolidin-3-yl, (S)—N-methoxycarbonylpyrrolidin-3-yl, cyclohexyl, 4,4-difluorocyclohex-1-yl, tetrahydro-2H-pyran-4-yl, N-methoxycarbonylpiperidin-4-yl, 1-methylpyrazol-3-yl, 1-methylpyrazol-4-yl, isoxazol-3-yl, 4-methylisoxazol-3-yl, 5-methylisoxazol-3-yl, phenyl, 2-methylphenyl, 3-methylphenyl, 4-methylphenyl, 2-chlorophenyl, 3-chlorophenyl, 4-chlorophenyl, 2-trifluoromethylphenyl, 3-trifluoromethylphenyl, 4-trifluoromethylphenyl, 2-fluorophenyl, 3-fluorophenyl, 4-fluorophenyl, 2,3-difluorophenyl, 2,4-difluorophenyl, 2,5-difluorophenyl, 3,5-difluorophenyl, 3-chloro-2-fluorophenyl, 5-chloro-2-fluorophenyl, 3-chloro-5-fluorophenyl, 2-fluoro-3-trifluoromethylphenyl, 2-fluoro-4-trifluoromethylphenyl, 2-fluoro-5-trifluoromethylphenyl, 3-fluoro-4-trifluoromethylphenyl, 3-fluoro-5-trifluoromethylphenyl, pyrid-2-yl, 3-fluoropyrid-2-yl, 4-fluoropyrid-2-yl, 5-fluoropyrid-2-yl, 6-fluoropyrid-2-yl, 6-methylpyrid-2-yl, phenylmethyl, 2-fluorophenylmethyl, 3-fluorophenylmethyl, 4-fluorophenylmethyl, 2,3-difluorophenylmethyl, 2,4-difluorophenylmethyl, 2,5-difluorophenylmethyl, 2,6-difluorophenylmethyl, 3,4-difluorophenylmethyl, 3,5-difluorophenylmethyl, (5)-1-phenylethyl, (R)-1-phenylethyl, and phenyldifluoromethyl;
R c5 is selected from the group consisting of hydrogen, deuterium, methyl, difluoromethyl, trifluoromethyl, ethyl, 2,2,2-trifluoroethyl, 2,2-difluoroethyl, propyl, isopropyl, n-butyl, isobutyl, (S)-2-butyl, (R)-2-butyl, and tert-butyl;
R c1 and R c2 are independently selected from the group consisting of hydrogen, deuterium, fluoro, methyl, difluoromethyl, and trifluoromethyl.
23. A method of treating hypertrophic cardiomyopathy (HCM), or a cardiac disorder having a pathophysiological feature of HCM, comprising administering to a subject in need thereof an effective amount of a compound of claim 1 .
24. A method of treating a disease or disorder selected from the group consisting of diastolic heart failure with preserved ejection fraction, ischemic heart disease, angina pectoris, and restrictive cardiomyopathy, comprising administering to a subject in need thereof an effective amount of a compound of claim 1 or a pharmaceutically acceptable salt thereof.
25. A method of treating a disease or disorder characterized by left ventricular hypertrophy due to volume or pressure overload, said disease or disorder selected from the group consisting of chronic mitral regurgitation, chronic aortic stenosis, and chronic systemic hypertension; in conjunction with therapies aimed at correcting or alleviating the primary cause of volume or pressure overload said therapies selected from the group consisting of valve repair/replacement and effective antihypertensive therapy, comprising administering to a subject in need thereof an effective amount of a compound of claim 1 or a pharmaceutically acceptable salt thereof.
26. A method of treating hypertrophic cardiomyopathy (HCM), or a cardiac disorder having a pathophysiological feature associated with HCM, comprising administering to a subject in need thereof an effective amount of a compound of claim 1 or a pharmaceutically acceptable salt thereof, combined with therapies that retard the progression of heart failure by down-regulating neurohormonal stimulation of the heart and attempt to prevent cardiac remodeling, said therapies selected from the group consisting of ACE inhibitors, angiotensin receptor blockers (ARBs), β-blockers, aldosterone receptor antagonists, and neural endopeptidase inhibitors.
27. A method of treating hypertrophic cardiomyopathy (HCM), or a cardiac disorder having a pathophysiological feature associated with HCM, comprising administering to a subject in need thereof an effective amount of a compound of claim 1 or a pharmaceutically acceptable salt thereof, combined with therapies that improve cardiac function by stimulating cardiac contractility, said therapy being one or more positive inotropic agents.
28. The method of claim 27 , where in the positive inotropic agent is the β-adrenergic agonist dobutamine or the phosphodiesterase inhibitor milrinone.
29. A method of treating hypertrophic cardiomyopathy (HCM), or a cardiac disorder having a pathophysiological feature associated with HCM, comprising administering to a subject in need thereof an effective amount of a compound of claim 1 or a pharmaceutically acceptable salt thereof, combined with therapies that reduce cardiac preload or afterload, wherein
the therapies that reduce cardiac preload are diuretics, and
the therapies that reduce cardiac afterload are vasodilators.
30. A method of claim 29 , wherein the diuretic is furosemide.
31. A method of claim 29 , wherein the vasodilators are selected from the group consisting of calcium channel blockers, phosphodiesterase inhibitors, endothelin receptor antagonists, renin inhibitors, and smooth muscle myosin modulators.