Neprilysin inhibitors

1. A method of treating a disease mediated at least in part by neprilysin in a subject in need thereof, comprising administering to the subject an effective amount of a compound of formula V:

or a pharmaceutically acceptable salt thereof, wherein:

R a is selected from Cl and F and R b is H; or R a is H and R b is selected from Cl, F, —CH 3 , and —CN; or R a is F and R b is Cl;

R 2 is selected from H, —C 1-6 alkyl, —(CH 2 ) 2-3 OR e , and —(CH 2 ) 2-3 NR e R e ;

R 3 is selected from —OH, —OCH 3 , —OCH 2 CH 3 , and —C 1-4 alkyl;

R 7 is selected from H, —C 1-6 alkyl, —[(CH 2 ) 2 O] 1-3 CH 3 , —CHR c OC(O)—C 1-4 alkyl, —CH 2 OC(O)CHR d —NH 2 , —CH 2 OC(O)CHR d —NHC(O)O—C 1-6 alkyl, —CHR c OC(O)O—C 2-4 alkyl, —CHR c OC(O)O-cyclohexyl, —CH 2 CH(NH 2 )C(O)OCH 3 , —C 2-4 alkylene-N(CH 3 ) 2 , —C 0-6 alkylenemorpholinyl, and

R c is selected from H and —C 1-3 alkyl;

R d is selected from H, —CH 3 , —CH(CH 3 ) 2 , phenyl, and benzyl; and

each R e is independently selected from H and —CH 3 .

2. The method of claim 1 , wherein the disease is selected from hypertension, heart failure, and renal disease.

3. The method of claim 1 , further comprising administering a therapeutic agent selected from an adenosine receptor antagonist, an α-adrenergic receptor antagonist, a β 1 -adrenergic receptor antagonist, a β 2 -adrenergic receptor agonist, a dual-acting β-adrenergic receptor antagonist/α 1 -receptor antagonist, an advanced glycation end product breaker, an aldosterone antagonist, an aldosterone synthase inhibitor, an aminopeptidase N inhibitor, an androgen, an angiotensin-converting enzyme inhibitor, a dual-acting angiotensin-converting enzyme/neprilysin inhibitor, an angiotensin-converting enzyme 2 activator, an angiotensin-converting enzyme 2 stimulator, an angiotensin-II vaccine, an anticoagulant, an anti-diabetic agent, an antidiarrheal agent, an anti-glaucoma agent, an anti-lipid agent, an antinociceptive agent, an anti-thrombotic agent, an AT 1 receptor antagonist, a dual-acting AT 1 receptor antagonist/neprilysin inhibitor, a multifunctional angiotensin receptor blocker, a bradykinin receptor antagonist, a calcium channel blocker, a chymase inhibitor, digoxin, a diuretic, a dopamine agonist, an endothelin converting enzyme inhibitor, an endothelin receptor antagonist, HMG-CoA reductase inhibitor, an estrogen, an estrogen receptor agonist, an estrogen receptor antagonist, a monoamine reuptake inhibitor, a muscle relaxant, a natriuretic peptide, a natriuretic peptide analog, a natriuretic peptide clearance receptor antagonist, a neprilysin inhibitor, a nitric oxide donor, a non-steroidal anti-inflammatory agent, an N-methyl d-aspartate receptor antagonist, an opioid receptor agonist, a phosphodiesterase inhibitor, a prostaglandin analog, a prostaglandin receptor agonist, a renin inhibitor, a selective serotonin reuptake inhibitor, a sodium channel blocker, a soluble guanylate cyclase stimulator, a soluble guanylate cyclase activator, a tricyclic antidepressant, and a vasopressin receptor antagonist, or a combination thereof.

4. The method of claim 1 , further comprising administering an AT 1 receptor antagonist.

5. The method of claim 4 , wherein the AT 1 receptor antagonist is selected from abitesartan, azilsartan, azilsartan medoxomil, benzyllosartan, candesartan, candesartan cilexetil, elisartan, embusartan, enoltasosartan, eprosartan, EXP3174, fonsartan, forasartan, glycyllosartan, irbesartan, isoteoline, losartan, medoximil, milfasartan, olmesartan, olmesartan medoxomil, opomisartan, pratosartan, ripisartan, saprisartan, saralasin, sarmesin, TAK-591, tasosartan, telmisartan, valsartan, and zolasartan.

6. The method of claim 1 , wherein R 2 is —C 1-6 alkyl.

7. The method of claim 1 , wherein R 3 is —OH.

8. The method of claim 1 , wherein R 7 is H or —C 1-6 alkyl.

9. The method of claim 1 , wherein R a is F and R b is Cl.

10. The method of claim 1 , wherein R 2 is —C 1-6 alkyl; R 3 is —OH; R 7 is H; R a is F; and R b is Cl.

11. The method of claim 1 , wherein the compound is:

or a pharmaceutically acceptable salt thereof.

12. A method of inhibiting activity of a neprilysin enzyme, comprising contacting the neprilysin enzyme with a compound of formula V:

or a pharmaceutically acceptable salt thereof, wherein:

R a is selected from Cl and F and R b is H; or R a is H and R b is selected from Cl, F, —CH 3 , and —CN; or R a is F and R b is Cl;

R 2 is selected from H, —C 1-6 alkyl, —(CH 2 ) 2-3 OR e , and —(CH 2 ) 2-3 NR e R e ;

R 3 is selected from —OH, —OCH 3 , —OCH 2 CH 3 , and —C 1-4 alkyl;

R 7 is selected from H, —C 1-6 alkyl, —[(CH 2 ) 2 O] 1-3 CH 3 , —CHR c OC(O)—C 1-4 alkyl, —CH 2 OC(O)CHR d —NH 2 , —CH 2 OC(O)CHR d —NHC(O)O—C 1-6 alkyl, —CHR c OC(O)O—C 2-4 alkyl, —CHR c OC(O)O-cyclohexyl, —CH 2 CH(NH 2 )C(O)OCH 3 , —C 2-4 alkylene-N(CH 3 ) 2 , —C 0-6 alkylenemorpholinyl, and

R c is selected from H and —C 1-3 alkyl;

R d is selected from H, —CH 3 , —CH(CH 3 ) 2 , phenyl, and benzyl; and

each R e is independently selected from H and —CH 3 .

13. The method of claim 12 , wherein the compound is:

or a pharmaceutically acceptable salt thereof.

14. A method of treating hypertension, heart failure, or renal disease in a subject in need thereof, comprising administering to the subject an AT 1 receptor antagonist and an effective amount of a compound of formula V:

or a pharmaceutically acceptable salt thereof, wherein:

R a is selected from Cl and F and R b is H; or R a is H and R b is selected from Cl, F, —CH 3 , and —CN; or R a is F and R b is Cl;

R 2 is selected from H, —C 1-6 alkyl, —(CH 2 ) 2-3 OR e , and —(CH 2 ) 2-3 NR e R e ;

R 3 is selected from —OH, —OCH 3 , —OCH 2 CH 3 , and —C 1-4 alkyl;

R 7 is selected from H, —C 1-6 alkyl, —[(CH 2 ) 2 O] 1-3 CH 3 , —CHR c OC(O)—C 1-4 alkyl, —CH 2 OC(O)CHR d —NH 2 , —CH 2 OC(O)CHR d —NHC(O)O—C 1-6 alkyl, —CHR c OC(O)O—C 2-4 alkyl, —CHR c OC(O)O-cyclohexyl, —CH 2 CH(NH 2 )C(O)OCH 3 , —C 2-4 alkylene-N(CH 3 ) 2 , —C 0-6 alkylenemorpholinyl, and

R c is selected from H and —C 1-3 alkyl;

R d is selected from H, —CH 3 , —CH(CH 3 ) 2 , phenyl, and benzyl; and

each R e is independently selected from H and —CH 3 .

15. The method of claim 14 , wherein the AT 1 receptor antagonist is selected from abitesartan, azilsartan, azilsartan medoxomil, benzyllosartan, candesartan, candesartan cilexetil, elisartan, embusartan, enoltasosartan, eprosartan, EXP3174, fonsartan, forasartan, glycyllosartan, irbesartan, isoteoline, losartan, medoximil, milfasartan, olmesartan, olmesartan medoxomil, opomisartan, pratosartan, ripisartan, saprisartan, saralasin, sarmesin, TAK-591, tasosartan, telmisartan, valsartan, and zolasartan.

16. The method of claim 14 , wherein R 2 is —C 1-6 alkyl.

17. The method of claim 14 , wherein R 3 is —OH.

18. The method of claim 14 , wherein R 7 is H or —C 1-6 alkyl.

19. The method of claim 14 , wherein R 2 is —C 1-6 alkyl; R 3 is —OH; R 7 is H; R a is F; and R b is Cl.

20. The method of claim 14 , wherein the compound is:

or a pharmaceutically acceptable salt thereof.