MACROCYCLIC CFTR MODULATORS

1 . A compound of Formula (I)

wherein

X represents —CR X1 R X2 , wherein

R X1 and R X2 together with the carbon atom to which they are attached form a ring which is:

C 3-6 -cycloalkan-1,1-diyl;

C 3-6 -cycloalkan-1,1-diyl, wherein said C 3-6 -cycloalkan-1,1-diyl group independently is mono-substituted with C 1-3 -alkoxy, fluoro, or hydroxy; or di-substituted with fluoro;

C 4-6 -heterocycloalkan-diyl, wherein said C 4-6 -heterocycloalkan-diyl contains one ring nitrogen atom, wherein said nitrogen when having a free valency is unsubstituted or mono-substituted wherein the substitutents are independently selected from C 1-4 -alkyl, and —COO—C 1-3 -alkyl; or

C 4-6 -heterocycloalkan-diyl, wherein said C 4-6 -heterocycloalkan-diyl contains one ring oxygen atom; or

R X1 represents hydrogen, and

R X2 represents

C 1-6 -alkyl;

C 1-4 -fluoroalkyl;

C 3-6 -cycloalkyl;

C 1-3 -alkyl wherein said C 1-3 -alkyl is mono-substituted with

hydroxy;

C 1-4 -alkoxy; or

-L X2 -Ar X2 wherein

-L X2 independently represents a direct bond, or C 1-3 -alkylene; and

Ar X2 independently represents 5- to 6-membered heteroaryl; wherein said group Ar X2 independently is unsubstituted, mono-, or di-substituted wherein the substituents are independently selected from C 1-4 -alkyl, C 1-3 -alkoxy, halogen, C 3-6 -cycloalkyl, and C 1-3 -fluoroalkyl; and

R 1 represents C 1-4 -alkyl;

or the fragment

represents a heterocyclic ring which is

R 2 represents C 1-4 -alkyl;

R 3 represents C 1-6 -alkyl;

R 4 represents 5-membered heteroaryl, wherein said 5-membered heteroaryl is independently unsubstituted, mono-, di- or tri-substituted, wherein the substituents are independently selected from C 1-4 -alkyl; C 1-4 -alkoxy; C 1-3 -fluoroalkyl; C 1-3 -fluoroalkoxy; halogen; cyano; and C 3-6 -cycloalkyl;

Ar 1 represents 8- to 10-membered bicyclic heteroarylene; wherein said 8- to 10-membered bicyclic heteroarylene independently is unsubstituted, mono-, or di-substituted, wherein the substituents are independently selected from C 1-4 -alkyl, C 1-3 -fluoroalkyl, C 1-4 -alkoxy, C 1-3 -fluoroalkoxy, cyano, and halogen;

[wherein it is understood that in the above groups Ar 1 the —CO— group and the oxygen (i.e. the groups linking Ar 1 to the rest of the molecule) are attached in ortho arrangement to aromatic ring carbon atoms of Ar 1 as depicted in Formula (I)]; and

Ar 2 represents

phenyl, or 5- to 6-membered heteroaryl, wherein said phenyl or 5- to 6-membered heteroaryl is unsubstituted, mono- or di-substituted wherein the substituents are independently selected from C 1-4 -alkyl, C 1-3 -fluoroalkyl, halogen, cyano, C 3-6 -cycloalkyl, C l-alkoxy, and C 1-3 -fluoroalkoxy;

or a pharmaceutically acceptable salt thereof.

2 . A compound of Formula (I) as defined for claim 1 , wherein the compound is a compound of Formula (I E ):

or a pharmaceutically acceptable salt thereof.

3 . A compound according to claim 1 ; wherein

X represents —CR X1 R X2 , wherein

R X1 and R X2 together with the carbon atom to which they are attached form a ring which is C 3-6 -cycloalkan-1,1-diyl; or

R X1 represents hydrogen, and

R X2 represents

C 1-6 -alkyl;

C 1-4 -fluoroalkyl; or

-L X2 -Ar X2 wherein

-L X2 independently represents methylene; and

Ar X2 independently represents 5-membered heteroaryl; wherein said group Ar X2 independently is mono-substituted wherein the substituents are independently selected from C 1-4 -alkyl, C 1-3 -alkoxy, halogen, C 3-6 -cycloalkyl, and C 1-3 -fluoroalkyl; and

R 1 represents C 1-4 -alkyl;

or the fragment

represents a heterocyclic ring which is

or a pharmaceutically acceptable salt thereof.

4 . A compound according to claim 1 ; wherein the fragment

represents:

or a pharmaceutically acceptable salt thereof.

5 . A compound according to claim 1 ; wherein R 2 represents methyl;

or a pharmaceutically acceptable salt thereof.

6 . A compound according to claim 1 ; wherein R 3 represents isobutyl;

or a pharmaceutically acceptable salt thereof.

7 . A compound according to claim 1 ; wherein R 4 represents 5-membered heteroaryl, wherein said 5-membered heteroaryl is independently mono-, or di-substituted, wherein the substituents are independently selected from C 1-4 -alkoxy; halogen; and C 3-6 -cycloalkyl;

or a pharmaceutically acceptable salt thereof.

8 . A compound according to claim 1 ; wherein Ar 2 represents

phenyl, wherein said phenyl is unsubstituted; or

6-membered heteroaryl, wherein said 6-membered heteroaryl independently is unsubstituted, mono-, or di-substituted wherein the substituents are independently selected from C 1-4 -alkyl, C 1-3 -fluoroalkyl, halogen, C 3-6 -cycloalkyl, C 1-6 -alkoxy, and C 1-3 -fluoroalkoxy;

or a pharmaceutically acceptable salt thereof.

9 . A compound according to claim 1 , wherein Ar 1 represents quinoline-diyl which is mono-, or di-substituted, wherein the substituents are independently selected from C 1-4 -alkyl, C 1-3 -fluoroalkyl, C 1-4 -alkoxy, C 1-3 -fluoroalkoxy, cyano, and halogen;

or a pharmaceutically acceptable salt thereof.

10 . A compound according to claim 1 , wherein said compound is:

(3S,7S,10R,13R)-13-benzyl-20-fluoro-7-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-22-((6-methoxypyridin-2-yl)methyl)-12-methyl-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aS,22R)-5-fluoro-13-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-22-((6-methoxypyridin-2-yl)methyl)-12-methyl-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)—N-(2-(5-cyclopropyl-2H-tetrazol-2-yl)ethyl)-5-fluoro-13-isobutyl-22-((6-methoxypyridin-2-yl)methyl)-12-methyl-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-22-((6-methoxypyridin-2-yl)methyl)-12-methyl-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(3S,7S,10R,13R)-13-benzyl-10-(2,2-difluoroethyl)-20-fluoro-7-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-6,9-dimethyl-1,5,8,11-tetraoxo-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10S,13R)-20-fluoro-7-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(3-methoxy-1,2,4-oxadiazol-5-yl)ethyl)-12-methyl-7,11,14,20-tetraoxo-22-(pyridin-2-ylmethyl)-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-12-methyl-7,11,14,20-tetraoxo-22-(pyridin-2-ylmethyl)-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-12-methyl-7,11,14,20-tetraoxo-22-(pyridin-2-ylmethyl)-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)—N-(2-(5-cyclopropyl-2H-tetrazol-2-yl)ethyl)-5-fluoro-13-isobutyl-12-methyl-7,11,14,20-tetraoxo-22-(pyridin-2-ylmethyl)-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(3-methoxy-1,2,4-oxadiazol-5-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)—N-(2-(5-cyclopropyl-2H-tetrazol-2-yl)ethyl)-20-fluoro-7-isobutyl-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-6,9-dimethyl-1,5,8,11-tetraoxo-13-(pyridin-2-ylmethyl)-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-N-(2-(4-fluoro-3-methoxyisoxazol-5-yl)ethyl)-7-isobutyl-6,9-dimethyl-1,5,8,11-tetraoxo-13-(pyridin-2-ylmethyl)-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9,10-trimethyl-1,5,8,11-tetraoxo-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9,10-trimethyl-1,5,8,11-tetraoxo-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3'S,7'S,13′R)-20′-fluoro-7′-isobutyl-N-(2-(3-methoxy-1,2,4-oxadiazol-5-yl)ethyl)-13′-((6-methoxypyridin-2-yl)methyl)-6′,9′-dimethyl-1′,5′,8′,11′-tetraoxo-2′,3′,4′,5′,6′,7′,8′,9′,11′,12′,13′,14′-dodecahydro-1′H-spiro[cyclopropane-1,10′-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline]-3′-carboxamide;

(3'S,7'S,13′R)-20′-fluoro-7′-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-13′-((6-methoxypyridin-2-yl)methyl)-6′,9′-dimethyl-1′,5′,8′,11′-tetraoxo-2′,3′,4′,5′,6′,7′,8′,9′,11′,12′,13′,14′-dodecahydro-1′H-spiro[cyclopropane-1,10′-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline]-3′-carboxamide;

(3'S,7'S,13′R)-20′-fluoro-N-(2-(4-fluoro-3-methoxyisoxazol-5-yl)ethyl)-7′-isobutyl-13′-((6-methoxypyridin-2-yl)methyl)-6′,9′-dimethyl-1′,5′,8′,11′-tetraoxo-2′,3′,4′,5′,6′,7′,8′,9′,11′,12′,13′,14′-dodecahydro-1′H-spiro[cyclopropane-1,10′-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline]-3′-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(3-methoxy-1,2,4-oxadiazol-5-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-((3-(trifluoromethyl)-1,2,4-oxadiazol-5-yl)methyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-((3-(trifluoromethyl)-1,2,4-oxadiazol-5-yl)methyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-7-isobutyl-N-(2-(4-methoxy-2H-1,2,3-triazol-2-yl)ethyl)-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-((3-(trifluoromethyl)-1,2,4-oxadiazol-5-yl)methyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)—N-(2-(5-cyclopropyl-2H-tetrazol-2-yl)ethyl)-20-fluoro-7-isobutyl-13-((6-methoxypyridin-2-yl)methyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-((3-(trifluoromethyl)-1,2,4-oxadiazol-5-yl)methyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

((3S,7S,10R,13R)-20-fluoro-13-((5-fluoropyridin-2-yl)methyl)-7-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(3S,7S,10R,13R)-20-fluoro-13-((5-fluoropyridin-2-yl)methyl)-7-isobutyl-N-(2-(3-methoxy-1,2,4-oxadiazol-5-yl)ethyl)-6,9-dimethyl-1,5,8,11-tetraoxo-10-(2,2,2-trifluoroethyl)-1,2,3,4,5,6,7,8,9,10,11,12,13,14-tetradecahydro-[1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-3-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-12-methyl-22-((6-methylpyridin-2-yl)methyl)-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-13-isobutyl-N-(2-(3-methoxy-1,2,4-oxadiazol-5-yl)ethyl)-12-methyl-22-(oxazol-4-ylmethyl)-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

(9S,13S,19aR,22R)-5-fluoro-22-((5-fluoro-6-methylpyridin-2-yl)methyl)-13-isobutyl-N-(2-(3-methoxyisoxazol-5-yl)ethyl)-12-methyl-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide; or

(9S,13S,19aR,22R)—N-(2-(5-cyclopropyl-2H-tetrazol-2-yl)ethyl)-5-fluoro-22-((5-fluoro-6-methylpyridin-2-yl)methyl)-13-isobutyl-12-methyl-7,11,14,20-tetraoxo-7,8,9,10,11,12,13,14,17,18,19,19a,20,21,22,23-hexadecahydro-16H-pyrido[2′,1′:6,7][1]oxa[4,7,10,14]tetraazacycloheptadecino[16,17-f]quinoline-9-carboxamide;

or a pharmaceutically acceptable salt thereof.

11 . A pharmaceutical composition comprising a compound according to claim 1 , or a pharmaceutically acceptable salt thereof, and at least one therapeutically inert excipient.

12 - 14 . (canceled)

15 . A method of treatment of CFTR-related diseases and disorders, said method comprising administering to a subject in need thereof an effective amount of a compound according to claim 1 , or of a pharmaceutically acceptable salt thereof.

16 . A pharmaceutical composition comprising a compound according to claim 10 , or a pharmaceutically acceptable salt thereof, and at least one therapeutically inert excipient.

17 . A method of treatment of cystic fibrosis, said method comprising administering to a subject in need thereof an effective amount of a compound according to claim 1 , or of a pharmaceutically acceptable salt thereof.

18 . A method of treatment of CFTR-related diseases and disorders, said method comprising administering to a subject in need thereof an effective amount of a compound according to claim 10 , or of a pharmaceutically acceptable salt thereof.

19 . A method of treatment of cystic fibrosis, said method comprising administering to a subject in need thereof an effective amount of a compound according to claim 10 , or of a pharmaceutically acceptable salt thereof.