Inhibitors of the renal outer medullary potassium channel
The present invention provides compounds of Formula (I) and the pharmaceutically acceptable salts thereof, which are inhibitors of the ROMK (Kir1.1) channel. The compounds may be used as diuretic and/or natriuretic agents and for the therapy and prophylaxis of medical conditions including cardiovascular diseases such as hypertension, heart failure and chronic kidney disease and conditions associated with excessive salt and water retention.
1. A compound having structural Formula I
or a pharmaceutically acceptable salt thereof wherein:
ring A is
(1) aryl, wherein the aryl ring is unsubstituted or substituted by R 6
(2) 5- or 6-membered heteroaryl, containing 1-3 heteroatoms independently selected from the group consisting of N, O, and S, wherein the heteroaryl ring is substituted by R 6 , or
(3) fused tricyclic heteroaryl, containing 2-6 N heteroatoms;
R 1 is
(1) hydrogen, or
(2) (C 1-3 )alkyl;
R 2a and R 2b are independently
(1) hydrogen, or
(2) (C 1-3 )alkyl;
R 3 is
(1) hydrogen, or
(2) (C 1-3 )alkyl;
R 4 is
(1) hydrogen,
(2) (C 1-6 )alkyl,
(3) hydroxy(C 1-6 )alkyl,
(4) (C 1-3 )alkylC(O)N(R 7 ) 2 , or
(5) (C 1-3 )alkyl-heteroaryl, wherein heteroaryl is a 5- or 6-membered monocyclic ring and contains 1-3 heteroatoms independently selected from the group consisting of N, O, and S;
each R 5 is
(1) oxo
(2) (C 1-3 )alkyl, or
(3) halo;
R 6 is a five-membered heteroaryl containing 1-4 heteroatoms independently selected from the group consisting of N, O, and S;
each R 7 is
(1) hydrogen, or
(2) (C 1-3 )alkyl;
X is —(C 1-3 )alkyl-, optionally substituted by hydroxy; and
n is 0, 1, 2, or 3.
2. The compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein:
X is
3. The compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein R 1 is hydrogen or methyl.
4. The compound of claim 1 or a pharmaceutically acceptable salt thereof wherein ring A is phenyl, wherein the aryl ring is substituted by R 6 .
5. The compound of claim 1 or a pharmaceutically acceptable salt thereof wherein ring A is 5- or 6-membered heteroaryl, containing 1-3 heteroatoms independently selected from the group consisting of N, O, and S, wherein the heteroaryl ring is substituted by R 6 .
6. The compound of claim 5 or a pharmaceutically acceptable salt thereof, wherein ring A is pyridinyl, pyrazinyl, pyridazinyl, or thiazolyl, wherein each ring is substituted by R 6 .
7. The compound of claim 4 or a pharmaceutically acceptable salt thereof, wherein R 6 is tetrazolyl.
8. The compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein ring A is 1,3-dihydroisobenzofuran.
9. The compound of claim 1 or a pharmaceutically acceptable salt thereof, wherein ring A is 5H-tetrazolo[5,1-a]isoindole, 4,5-dihydrotetrazolo[1,5-a]quinolone, 8H-tetrazolo[1′,5′:1,2]pyrrolo[3,4-b]pyridine, or tetrazolo[1,5-a]quinoline.
10. The compound having structural Formula I-d
or a pharmaceutically acceptable salt thereof, wherein:
R 1 is hydrogen or methyl;
R 2a and R 2b are independently hydrogen, or methyl;
R 3 is hydrogen or methyl;
R 4 is hydrogen or methyl;
R 5 is methyl;
R 6 is tetrazolyl;
X is
and
n is 0, 1, or 2.
11. The compound of claim 1 which is:
or a pharmaceutically acceptable salt thereof.
12. A pharmaceutical composition comprised of a compound of claim 1 or a pharmaceutically acceptable salt thereof and a pharmaceutically acceptable carrier.
13. The pharmaceutical composition of claim 12 further comprising an additional active agent selected from losartan, valsartan, candesartan, olmesartan, telmesartan, eprosartan, irbesartan, amlodipine, alacepril, benazepril, captopril, ceronapril, cilazapril, delapril, enalapril, enalaprilat, fosinopril, imidapril, lisinopril, moveltipril, perindopril, quinapril, ramipril, spirapril, temocapril, trandolapril, amiloride, spironolactone, epleranone, triamterene, a pro-drug, or a pharmaceutically acceptable salt of any of the foregoing.
14. A method for inhibiting ROMK comprising administering a compound of claim 1 or a pharmaceutically acceptable salt thereof in a ROMK-inhibitory effective amount to a patient in need thereof.
15. A method for causing diueresis, natriuresis or both, comprising administering a compound of claim 1 or a pharmaceutically acceptable salt thereof in a therapeutically effective amount to a patient in need thereof.
16. A method for the treatment of one or more disorders selected from hypertension, acute heart failure, chronic heart failure, pulmonary arterial hypertension, cardiovascular disease, diabetes, endothelial dysfunction, diastolic dysfunction, stable and unstable angina pectoris, thromboses, restenosis, myocardial infarction, stroke, cardiac insufficiency, pulmonary hypertonia, atherosclerosis, hepatic cirrhosis, ascitis, pre-eclampsia, cerebral edema, nephropathy, nephrotic syndrome, acute kidney insufficiency, chronic kidney disease, hypercalcemia, Dent's disease, Meniere's disease, or edematous states comprising administering a compound of claim 1 or a pharmaceutically acceptable salt thereof in a therapeutically effective amount to a patient in need thereof.