sGC stimulators
Compounds of Formulae I′ and I are described, which are useful as stimulators of sGC, particularly NO-independent, heme-dependent stimulators. These compounds are also useful for treating, preventing or managing various disorders that are herein disclosed.
1. A method of treating diabetic nephropathy in a subject in need of treatment, comprising administering a therapeutically effective amount of compound 1-324
or a pharmaceutically acceptable salt thereof, to the subject in need of treatment.
2. The method of claim 1 , further comprising administering an effective amount of one or more additional therapeutic agents to the subject.
3. The method of claim 2 , wherein the one or more additional therapeutic agents are selected from anti-diabetic agents, neprilysin inhibitors, angiotensin receptor blockers (ARB), angiotensin converting enzyme (ACE) inhibitors, mineralocorticoid receptor (MR) antagonists, endothelin receptor antagonists (ERAs), calcium channel blockers, beta blockers, prostacyclin derivatives or analogues, diuretics, and antihyperlipidemics, wherein prostacyclin derivatives or analogues are selected from prostacyclin, epoprostenol, treprostinil, iloprost, and beraprost.
4. The method of claim 3 , wherein the one or more additional therapeutic agents are anti-diabetic agents selected from insulin and insulin mimetics, sulfonylureas, biguanides, α-glucosidase inhibitors, thiazolidinone compounds, insulin sensitizers, insulin secretagogues, GLP-1 receptor agonists, SGLT-2 inhibitors, incretin mimetics, amylin analogues, glucose lowering agents, dipeptidyl peptidase IV (DPP4) inhibitors, and tolimidone.
5. The method of claim 4 , wherein the insulin and insulin mimetics are selected from insulin degludec, insulin degludec combined with insulin aspart, insulin human (rDNA origin) inhalation powder, recombinant human insulin, hepatic-directed vesicle insulin, human isophane insulin, insulin tregopi (IN-105), insulin degludec combined with liraglutide, insulin peglispro (LY-2605541), insulin glargine (LY-2963016), and nodlin; wherein the sulfonylureas are selected from glyburide, glybenclamide, glipizide, gliclazide, gliquidone, glimepiride, atorvastatin calcium combined with glimerpiride, meglinatide, tolbutamide, chlorpropamide, acetohexamide, and tolazimide; the α-glucosidase inhibitors are selected from acarbose, epalrestat, voglibose, and miglitol; the thiazolidinone compounds are selected from rosiglitazone, troglitazone, ciglitazone, pioglitazone, englitazone, lobeglitazone sulfate, and balaglitazone; the insulin sensitizers are selected from pioglitazone and rosiglitazone; the insulin secretagogues are selected from repaglinide, nateglinide, and mitiglinide; the GLP-1 receptor agonists are selected from lixisenatide, lixisenatide combined with insulin glargine, albiglutide, dulaglutide, and pegapamodutide (TT-401); the SGLT-2 inhibitors are selected from dapagliflozin, tofoglifozin (CSG-452), canagliflozin, canagliflozin combined with metformin hydrochloride, dapagliflozin combined with metformin hydrochloride, empagliflozin, empaglifozin combined with linagliptin, luseoglifozin, and ipragliflozin L-proline; the incretin mimetics are selected from exanatide and liraglutide; the amylin analogue is pramlintide; and the dipeptidyl peptidase IV inhibitors are selected from sitagliptin, vildagliptin, saxagliptin, alogliptin, linagliptin, alogliptin benzoate combined with metformin hydrochloride, anagliptin, teneligliptin, atorvastatin calcium and glimepiride, empagliflozin combined with linagliptin, gemigliptin, sitagliptin phosphate monohydrate combined with pioglitazone hydrochloride, sitagliptin combined with atorvastatin calcium, and (2S,4S)-1-[2-(1,1-dimethyl-3-oxo-3-pyrrolidin-1-yl-propylamino)acetyl]-4-fluoro-pyrrolidine-2-carbonitrile (DBPR-108).
6. The method of claim 4 , wherein the one or more additional therapeutic agents is the biguanide metformin.
7. The method of claim 4 , wherein the one or more additional therapeutic agents is a GLP-1 receptor agonist.
8. The method of claim 3 , wherein the one or more additional therapeutic agents are SGLT-2 inhibitors selected from dapagliflozin, tofoglifozin (CSG-452), canagliflozin, canagliflozin combined with metformin hydrochloride, dapagliflozin combined with metformin hydrochloride, empagliflozin, empaglifozin combined with linagliptin, luseoglifozin, and ipragliflozin L-proline.
9. The method of claim 3 , wherein the one or more additional therapeutic agents are selected from neprilysin inhibitors.
10. The method of claim 3 , wherein the one or more additional therapeutic agents are angiotensin converting enzyme (ACE) inhibitors.
11. The method of claim 10 , wherein the angiotensin converting enzyme (ACE) inhibitors selected from sulfhydryl-containing agents, dicarboxylate-containing agents, phosphonate-containing agents, naturally occurring ACE inhibitors, alacepril, delapril, cilazapril, imidapril, trandolapril, temocapril, moexipril, and spirapril.
12. The method of claim 3 , wherein the one or more additional therapeutic agents are mineralocorticoid receptor (MR) antagonists.
13. The method of claim 12 , wherein the one or more additional therapeutic agents are mineralocorticoid receptor (MR) antagonists selected from spironolactone, amiloride hydrochloride combined with spironolactone, apararenone or MT-3995, and finerenone or BAY-94-8862.
14. The method of claim 3 , wherein the one or more additional therapeutic agents are endothelin receptor antagonists.
15. The method of claim 3 , wherein the one or more additional therapeutic agents are SGLT-2 inhibitors.
16. The method of claim 8 , wherein the one or more additional therapeutic agents are SGLT-2 inhibitors selected from dapagliflozin, canagliflozin, canagliflozin combined with metformin hydrochloride, dapagliflozin combined with metformin hydrochloride, empagliflozin, and empaglifozin combined with linagliptin.
17. The method of claim 3 , wherein the one or more additional therapeutic agents are angiotensin receptor blockers (ARB).
18. The method of claim 3 , wherein the one or more additional therapeutic agents are calcium channel blockers.
19. The method of claim 3 , wherein the one or more additional therapeutic agents are beta blockers.
20. The method of claim 3 , wherein the one or more additional therapeutic agents are selected from selexipag, alprostadil, prostacyclin, epoprostenol, treprostinil, iloprost, and beraprost.
21. The method of claim 3 , wherein the one or more additional therapeutic agents are antihyperlipidemics.
22. The method of claim 3 , wherein the one or more additional therapeutic agents are diuretics.
23. The method of claim 11 , wherein sulfhydryl-containing agents are selected from captopril and zofenopril; the dicarboxylate-containing agents are selected from enalapril, ramipril, quinapril, perindopril, lisinopril and benazepril; the phosphonate-containing agent is fosinopril; and the naturally occurring ACE inhibitors are selected from casokinins, lactokinins and lactotripeptides Val-Pro-Pro and Ile-Pro-Pro.
24. The method of claim 14 , wherein the endothelin receptor antagonists are selected from bosentan, sitaxentan, ambrisentan, actelion-1 and macitentan.
25. The method of claim 17 , wherein the angiotensin receptor blockers (ARB) are selected from losartan, balsartan, candesartan cilexetil, eprosaran, irbesartan, telmisartan, olmesartran medoxomil and azilsartan medoxomil.
26. The method of claim 18 , wherein the calcium channel blockers are selected from:
i. dihydropyridine calcium channel blockers selected from amlodipine, aranidipine, azelnidipine, barnidipine, benidipine, cilnidipine, clevidipin, diltiazem, efonidipine, felodipin, lacidipine, lercanidipine, manidipine, nicardipine, nifedipine, nilvadipine, nimodipine, nisoldipine, nitrendipine, pranidipine and isradipine;
ii. phenylalkylamine calcium channel blockers selected from verapamil and gallopamil;
iii. benzothiazepine calcium channel blocker diltiazem; and
iv. nonselective calcium channel inhibitors selected from mibefradil, bepridil, fluspirilene and fendiline.
27. The method of claim 19 , wherein the beta blockers are selected from alprenolol, bucindolol, carteolol, carvedilol, labetalol, nadolol, penbutolol, pindolol, oxprenonol, acebutolol, sotalol, mepindolol, celiprolol, arotinolol, tertatolol, amosulalol, nipradilol, propranolol, timolol, acebutolol, atenolol, betaxolol, bisoprolol, celiprolol, dobutamine hydrochloride, irsogladine maleate, carvedilol, talinolol, esmolol, metoprolol and nebivolol.
28. The method of claim 21 , wherein the antihyperlipidemics are selected from (i) bile acid sequestrants selected from cholestyramine, colestipol, colestilan and colesevelam; (ii) statins selected from atorvastatin, simvastatin, lovastatin, fluvastatin, pitavastatin, rosuvastatin and pravastatin; (iii) cholesterol absorption inhibitors selected from ezetimibe; (iv) other lipid lowering agents selected from icosapent ethyl ester, omega-3-acid ethyl esters, reducol; (v) fibric acid derivatives selected from clofibrate, bezafibrate, clinofibrate, gemfibrozil, ronifibrate, binifibrate, fenofirate, ciprofibrate, choline and fenofibrate; (vi) nicotinic acid derivatives selected from acipimox and niacin; (vii) combinations of statins, niacin, intestinal cholesterol absorption-inhibiting supplement ezetimibe, and fibrates; and (viii) antiplatelet therapy clopidogrel bisulfate.
29. The method of claim 22 , wherein the diuretics are selected from (i) thiazide diuretics selected from chlorothiazide, chlorthalidone, hydrochlorothiazide, bendroflumethiazide, cyclopenthiazide, methyclothiazide, polythiazide, quinethazone, xipamide, metolazone, indapamide, cicletanine; (ii) loop diuretics selected from furosemide and toresamide; (iii) potassium-sparing diuretics selected from amiloride, spironolactone, canrenoate potassium, eplerenone and triamterene; (iv) other diuretics selected from acetazolamid and carperitide.
30. The method of claim 3 , wherein the one or more additional therapeutic agents are selected from neprilysin inhibitors and angiotensin receptor blockers.
31. The method of claim 30 , wherein the one or more additional therapeutic agents are a combination of sacubitril and valsartan.