Biphenyl compounds useful as muscarinic receptor antagonists
This invention provides compounds of formula I: wherein a, b, c, d, m, n, p, s, t, W, Ar 1 , R 1 , R 2 , R 3 , R 4 , R 6 , R 7 , and R 8 are as defined in the specification. The compounds of formula I are muscarinic receptor antagonists. The invention also provides pharmaceutical compositions containing such compounds, processes and intermediates for preparing such compounds and methods of using such compounds to treat pulmonary disorders.
1. A pharmaceutical composition comprising:
(a) biphenyl-2-ylcarbamic acid 1-(2-{[4-(4-carbamoylpiperidin-1-ylmethyl)benzoyl]methylamino}ethyl)piperidin-4-yl ester or a pharmaceutically acceptable salt thereof;
(b) an agent selected from (i) a β 2 adrenergic receptor agonist; (ii) a steroidal anti-inflammatory agent; (iii) a phosphodiesterase-4 inhibitor; and (iv) a combination thereof; and
(c) a pharmaceutically acceptable carrier.
2. The pharmaceutical composition of claim 1 , wherein the agent is a β 2 adrenergic receptor agonist.
3. The pharmaceutical composition of claim 2 , wherein the β 2 adrenergic receptor agonist is selected from salmeterol, salbutamol, formoterol, salmefamol, fenoterol, terbutaline, albuterol, isoetharine, metaproterenol, bitolterol, pirbuterol, levalbuterol, and a pharmaceutically acceptable salt thereof.
4. The pharmaceutical composition of claim 3 , wherein the β 2 adrenergic receptor agonist is salmeterol or a pharmaceutically acceptable salt thereof.
5. The pharmaceutical composition of claim 3 , wherein the β 2 adrenergic receptor agonist is formoterol or a pharmaceutically acceptable salt thereof.
6. The pharmaceutical composition of claim 1 , wherein the agent is a steroidal anti-inflammatory agent.
7. The pharmaceutical composition of claim 6 , wherein the steroidal anti-inflammatory agent is selected from: methyl prednisolone; prednisolone; dexamethasone; fluticasone propionate; 6α,9α-difluoro-17α-[(2-furanylcarbonyl)oxy]-11β-hydroxy-16α-methyl-3-oxoandrosta-1,4-diene-17β-carbothioic acid S-fluoromethyl ester; 6α,9α-difluoro-11β-hydroxy-16α-methyl-3-oxo-17α-propionyloxy-androsta-1,4-diene-17β-carbothioic acid S-(2-oxo-tetrahydrofuran-3S-yl)ester; beclomethasone esters; budesonide; flunisolide; mometasone esters; triamcinolone acetonide; rofleponide; ciclesonide; butixocort propionate; RPR-106541; ST-126; and a pharmaceutically acceptable salt thereof.
8. The pharmaceutical composition of claim 7 , wherein the steroidal anti-inflammatory agent is fluticasone propionate.
9. The pharmaceutical composition of claim 7 , wherein the steroidal anti-inflammatory agent is budesonide.
10. The pharmaceutical composition of claim 1 , wherein the agent is a phosphodiesterase-4 inhibitor.
11. The pharmaceutical composition of claim 10 , wherein the phosphodiesterase-4 inhibitor is selected from: c is 4-cyano-4-(3-cyclopentyloxy-4-methoxyphenyl)cyclohexan-1-carboxylic acid; 2-carbomethoxy-4-cyano-4-(3-cyclopropylmethoxy-4-difluoromethoxyphenyl)cyclohexan-1-one; cis-[4-cyano-4-(3-cyclopropylmethoxy-4-difluoromethoxyphenyl)cyclohexan-1-ol]; cis-4-cyano-4[3-(cyclopentyloxy)-4-methoxyphenyl]cyclohexane-1-carboxylic acid; and a pharmaceutically acceptable salt thereof.
12. The pharmaceutical composition of claim 1 , wherein the agent is a combination of a β 2 adrenergic receptor agonist and a steroidal anti-inflammatory agent.
13. The pharmaceutical composition of claim 12 , wherein the β 2 adrenergic receptor agonist is salmeterol or a pharmaceutically acceptable salt thereof.
14. The pharmaceutical composition of claim 12 , wherein the β 2 adrenergic receptor agonist is formoterol or a pharmaceutically acceptable salt thereof.
15. The pharmaceutical composition of claim 12 , wherein the steroidal anti-inflammatory agent is fluticasone propionate.
16. The pharmaceutical composition of claim 12 , wherein the steroidal anti-inflammatory agent is budesonide.
17. The pharmaceutical composition of claim 12 , wherein the β 2 adrenergic receptor agonist is salmeterol or a pharmaceutically acceptable salt thereof and the steroidal anti-inflammatory agent is fluticasone propionate.
18. The pharmaceutical composition of claim 1 , which is suitable for administration by inhalation.
19. The pharmaceutical composition of claim 18 , which is an aerosol.
20. The pharmaceutical composition of claim 18 , which is a powder.
21. The pharmaceutical composition of claim 18 , which is a solution.
22. The pharmaceutical composition of claim 18 , wherein (a) is micronized.
23. The pharmaceutical composition of claim 22 , wherein (a) is combined with the carrier to form a suspension.
24. The pharmaceutical composition of claim 23 , wherein the carrier is an isotonic aqueous solution.
25. The pharmaceutical composition of claim 22 , wherein (a) is combined with the carrier to form a free flowing powder.
26. The pharmaceutical composition of claim 25 , wherein the carrier is lactose or starch.
27. The pharmaceutical composition of claim 18 , which further comprises a liquefied propellant.
28. The pharmaceutical composition of claim 18 , which is administered using a nebulizer inhaler.
29. The pharmaceutical composition of claim 18 , which is administered using a metered-dose inhaler.
30. The pharmaceutical composition of claim 18 , which is administered using a dry powder inhaler.