Androgen receptor modulators and uses thereof
Described herein are compounds that are androgen receptor modulators. Also described are pharmaceutical compositions and medicaments that include the compounds described herein, as well as methods of using such androgen receptor modulators, alone and in combination with other compounds, for treating diseases or conditions that are mediated or dependent upon androgen receptors.
1. A compound of Formula (Ia), or a pharmaceutically acceptable salt, or N-oxide thereof:
wherein,
ring A is pyridinyl;
m is 1, 2, 3 or 4;
each R A is independently halogen, —CN, —NO 2 , —OH, —OR 9 , —SR 9 , —S(═O)R 10 , —S(═O) 2 R 10 , —N(R 11 )S(═O) 2 R 10 , —S(═O) 2 N(R 9 ) 2 , —C(═O)R 10 , —OC(═O)R 10 , —CO 2 R 9 , —N(R 9 ) 2 , —C(═O)N(R 9 ) 2 , C 1 -C 6 alkyl, C 1 -C 6 fluoroalkyl, C 1 -C 6 fluoroalkoxy, C 1 -C 6 alkoxy, or C 1 -C 6 heteroalkyl;
both R 1 are taken together with the carbon atom to which they are attached to form a C 3 -C 6 cycloalkyl;
X is S or O;
ring B is phenyl;
n is 1, or 2;
each R 4 is independently hydrogen, halogen, —CN, —NO 2 , —OH, —OR 9 , —SR 9 , —S(═O)R 10 , —S(═O) 2 R 10 , —N(R 11 )S(═O) 2 R 10 , —S(═O) 2 N(R 9 ) 2 , —C(═O)R 10 , —OC(═O)R 10 , —CO 2 R 9 , —OCO 2 R 10 , —N(R 9 ) 2 , —C(═O)N(R 9 ) 2 , —OC(═O)N(R 9 ) 2 , —NR 11 C(═O)N(R 9 ) 2 , —NR 11 C(═O)R 10 , —NR 11 C(═O)OR 10 , C 1 -C 6 alkyl, C 1 -C 6 fluoroalkyl, C 1 -C 6 fluoroalkoxy, or C 1 -C 6 alkoxy;
R 5 is -L 1 -L 2 -R 6 ; and
(i) L 1 is —O—, —S—, —S(═O)—, —S(═O) 2 —, —NH—, —N(CH 3 )—; —C(═O)—, —C(═O)NH—, —NHC(═O)—, —NHC(═O)O—, —NHC(═O)NH—, —C(═O)O—, —OC(═O)—OC(═O)O—, —OC(═O)NH—, —NHS(═O) 2 —, or —S(═O) 2 NH—; and
(ii) L 2 is C 1 -C 6 alkylene, C 1 -C 6 fluoroalkylene or C 1 -C 6 heteroalkylene;
or
R 5 is L 1 -R 7 ; and L 1 is —O—, —S—, —S(O)—, —S(O) 2 —, —C(═O)—, —C(═O)NH—, —NHC(═O)—, —NHC(═O)O—, —NHC(═O)NH—, —C(═O)O—, —OC(═O)—, —OC(═O)O—, —OC(═O)NH—, —NHS(═O) 2 —, or —S(═O) 2 NH—;
R 6 and R 7 are independently optionally substituted piperidinyl;
said optional substituents including at least one of alkyl, fluoroalkyl, —CN, halo, —C(O)—O—(C 1-6 alkyl), —CH 2 —C(O)—O—(C 1-6 alkyl), —NH 2 , —NH(CH 3 ), —N(CH 3 ) 2 , —OH, —CO 2 H, —C(O)NH 2 , —C(O)NH(alkyl), —C(O)N(alkyl) 2 , alkoxy, fluoroalkoxy, -(alkyl)sulfonyl, -(alkylene)-OH, or —C(O)-(alkyl);
each R 9 is independently H, C 1 -C 6 alkyl, or C 1 -C 6 fluoroalkyl;
R 10 is C 1 -C 6 alkyl; and
R 11 is independently H or C 1 -C 4 alkyl.
2. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein:
both R 1 are taken together with the carbon atom to which they are attached to form a cyclopropyl, cyclobutyl, cyclopentyl, or cyclohexyl;
X is S; and
each R A is independently halogen, —CN, —NO 2 , —OH, C 1 -C 6 alkyl, C 1 -C 6 fluoroalkyl, C 1 -C 6 fluoroalkoxy, or C 1 -C 6 alkoxy; and
R 6 and R 7 are independently piperidinyl optionally substituted with at least one alkyl, —C(O)—O—(C 1-6 alkyl), —CH 2 —C(O)—O—(C 1-6 alkyl), —NH 2 , —NH(CH 3 ), —N(CH 3 ) 2 , —OH, —CO 2 H, —C(O)NH 2 , —C(O)NH(alkyl), —C(O)N(alkyl) 2 , -(alkyl)sulfonyl, -(alkylene)-OH, or —C(O)(C 1-6 alkyl).
3. The compound of claim 2 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein:
each R 4 is independently hydrogen, halogen, —CN, —NO 2 , —OH, C 1 -C 4 alkyl, C 1 -C 4 fluoroalkyl, C 1 -C 4 fluoroalkoxy, or C 1 -C 4 alkoxy;
R 5 is -L 1 -L 2 -R 6 ; and
(i) L 1 is —O—, —S—, —S(═O)—, —S(═O) 2 —, —NH—, —C(═O)—, —C(═O)NH—, —NHC(═O)—, —NHS(═O) 2 —, or —S(═O) 2 NH—; and
(ii) L 2 is C 1 -C 6 alkylene, C 1 -C 6 fluoroalkylene or C 1 -C 6 heteroalkylene;
or R 5 is -L 1 -R 7 ; and L 1 is —O—, —S—, —S(═O)—, —S(═O) 2 —, —C(═O)—, —C(═O)NH—, —NHC(═O)—, —NHC(═O)O—, —NHC(═O)NH—, —C(═O)O—, —OC(═O)—, —OC(═O)O—, —OC(═O)NH—, —NHS(═O) 2 —, or —S(═O) 2 NH.
4. The compound of claim 1 , wherein the compound of Formula (Ia) has the structure of Formula (II):
m is 2;
one R A is —CN, —NO 2 , —S(═O) 2 R 10 , —S(═O) 2 N(R 9 ) 2 , —C(═O)R 10 , —CO 2 R 9 , or —C(═O)N(R 9 ) 2 ; and the other R A is halogen, —OH, C 1 -C 6 alkyl, C 1 -C 6 fluoroalkyl, C 1 -C 6 fluoroalkoxy, or C 1 -C 6 alkoxy;
n is 1;
each R 4 is independently hydrogen, halogen, C 1 -C 6 alkyl, C 1 -C 6 fluoroalkyl, C 1 -C 6 fluoroalkoxy, or C 1 -C 6 alkoxy;
R 5 is -L 1 -L 2 -R 6 ; and (i) L 1 is —O—, or —C(═O)NH—; and (ii) L 2 is C 1 -C 6 alkylene, C 1 -C 6 fluoroalkylene or C 1 -C 6 heteroalkylene;
or
R 5 is L 1 -R 7 ; and L 1 is —O—, or —C(═O)NH—;
or is a pharmaceutically acceptable salt, or N-oxide thereof.
5. The compound of claim 1 , wherein the compound of Formula (Ia) has the structure of Formula (VI):
wherein,
one R A is —CN, —NO 2 , —S(═O) 2 R 10 , —S(═O) 2 N(R 9 ) 2 , —C(═O)R 10 , —CO 2 R 9 , or —C(═O)N(R 9 ) 2 ; and the other R A is H, halogen, —OH, C 1 -C 6 alkyl, C 1 -C 6 fluoroalkyl, C 1 -C 6 fluoroalkoxy, or C 1 -C 6 alkoxy;
both R 1 are taken together with the carbon atom to which they are attached to form a C 3 -C 6 cycloalkyl;
R 4 is hydrogen, halogen, C 1 -C 4 alkyl, C 1 -C 4 fluoroalkyl, C 1 -C 4 fluoroalkoxy, or C 1 -C 4 alkoxy,
R 6 and R 7 are piperidinyl optionally substituted with at least one alkyl, —C(O)—O—(C 1-6 alkyl), —CH 2 —C(O)—O—(C 1-6 alkyl), —CO 2 H, —C(O)NH 2 , —C(O)NH(alkyl), —C(O)N(alkyl) 2 , -(alkyl)sulfonyl, -(alkylene)-OH, or —C(O)—(C 1-6 alkyl);
or is a pharmaceutically acceptable salt, or N-oxide thereof.
6. The compound of claim 1 , wherein the compound is:
5-(5-(4-((1-Methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(3-Fluoro-4-(2-(piperidin-1-yl)ethoxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(2-Fluoro-4-(2-(piperidin-1-yl)ethoxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(2-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(5-(4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(8-oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(8-Oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(8-Oxo-5-(4-((1-propionylpiperidin-4-yl)oxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-Isobutyrylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
Ethyl 4-(4-(7-(6-cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidine-1-carboxylate;
5-(5-(4-((1-Acetylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-Ethylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-Hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-Hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-(Methylsulfonyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-Isopropylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
Ethyl 2-(4-(4-(7-(6-cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidin-1-yl)acetate;
4-(4-(7-(6-Cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidine-1-carboxamide;
4-(7-(6-Cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)-2-fluoro-N-(1-methylpiperidin-4-yl)benzamide;
or a pharmaceutically acceptable salt thereof or N-oxide thereof.
7. A compound of claim 1 of Formula (VIIIa), or a pharmaceutically acceptable salt, or N-oxide thereof:
wherein,
R A is C 1 -C 6 alkyl or C 1 -C 6 fluoroalkyl.
8. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein:
X is S;
R 4 is hydrogen, halogen, C 1 -C 3 alkyl, C 1 -C 3 fluoroalkyl, C 1 -C 3 fluoroalkoxy, or C 1 -C 3 alkoxy; and
R 6 and R 7 are independently piperidinyl optionally substituted with at least one alkyl, —C(O)—O—(C 1-6 alkyl), —CH 2 —C(O)—O—(C 1-6 alkyl), -(alkyl)sulfonyl, -(alkylene)-OH, —C(O)—(C 1-6 alkyl), or carbamoyl.
9. The compound of claim 8 , wherein the compound of Formula (VIIIa) has the structure of Formula (IXa):
or is a pharmaceutically acceptable salt, or N-oxide thereof.
10. The compound of claim 9 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein:
L 2 is C 1 -C 6 alkylene;
R 6 or R 7 are independently piperidinyl optionally substituted with at least one alkyl, —C(O)—O-(alkyl), —CH 2 —C(O)—O—(C 1-6 alkyl), -(alkyl)sulfonyl, -(alkylene)-OH, —CH 2 —C(O)—(C 1-6 alkyl), or carbamoyl.
11. The compound of claim 10 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein:
R A is —CH 3 or CF 3 .
12. The compound of claim 1 , wherein the compound is:
3-Methyl-5-(5-(4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-Methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(8-oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(5-(4-((1-acetylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-Ethylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-Hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(8-Oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
or a pharmaceutically acceptable salt thereof or N-oxide thereof.
13. A compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is
3-Methyl-5-(5-(4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(5-(4-((1-Methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(3-Fluoro-4-(2-(piperidin-1-yl)ethoxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(2-Fluoro-4-(2-(piperidin-1-yl)ethoxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(2-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(8-oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(8-Oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(8-Oxo-5-(4-((1-propionylpiperidin-4-yl)oxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-isobutyrylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
Ethyl 4-(4-(7-(6-cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidine-1-carboxylate;
5-(5-(4-((1-Acetylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-Ethylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-Hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-(Methylsulfonyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-Isopropylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
Ethyl 2-(4-(4-(7-(6-cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidin-1-yl)acetate;
4-(4-(7-(6-Cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidine-1-carboxamide; or
4-(7-(6-Cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)-2-fluoro-N-(1-methylpiperidin-4-yl)benzamide.
14. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 1 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
15. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 12 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
16. The compound of claim 1 , wherein the compound is:
5-(5-(4-((1-Methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(2-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(5-(4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methyl-picolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)-picolinonitrile;
3-Methyl-5-(8-oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(8-Oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
or a pharmaceutically acceptable salt thereof.
17. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 5-(5-(4-((1-Methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile.
18. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 5-(5-(2-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile.
19. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 3-Methyl-5-(5-(4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile.
20. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methyl-picolinonitrile.
21. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)-picolinonitrile.
22. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 3-Methyl-5-(8-oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile.
23. The compound of claim 1 , or a pharmaceutically acceptable salt, or N-oxide thereof, wherein the compound is 5-(8-Oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile.
24. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 16 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
25. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 17 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
26. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 18 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
27. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 19 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
28. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 20 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
29. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 21 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
30. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 22 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
31. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 23 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.
32. The compound of claim 1 , or is a pharmaceutically acceptable salt, or N-oxide thereof, wherein
R 5 is L 1 -R 7 ; and
L 1 is —O—.
33. The compound of claim 4 , or is a pharmaceutically acceptable salt, or N-oxide thereof, wherein
R 5 is L 1 -R 7 ; and
L 1 is —O—.
34. The compound of claim 5 , or is a pharmaceutically acceptable salt, or N-oxide thereof, wherein
R 5 is L 1 -R 7 ; and
L 1 is —O—.
35. The compound of claim 7 , or is a pharmaceutically acceptable salt, or N-oxide thereof, wherein
R 5 is L 1 -R 7 ; and
L 1 is —O—.
36. The compound of claim 9 , or is a pharmaceutically acceptable salt, or N-oxide thereof, wherein
R 5 is L 1 -R 7 ; and
L 1 is —O—.
37. The compound of claim 1 , wherein the compound is
5-(5-(4-((1-Methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(2-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(5-(4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(3-Fluoro-4-((1-methylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
3-Methyl-5-(8-oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)picolinonitrile;
5-(8-Oxo-5-(4-(piperidin-4-yloxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(8-Oxo-5-(4-(1-propionylpiperidin-4-yl)oxy)phenyl)-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-Isobutyrylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
Ethyl 4-(4-(7-(6-cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidine-1-carboxylate;
5-(5-(4-((1-Acetylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-Ethylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-Hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-methylpicolinonitrile;
5-(5-(4-((1-(2-Hydroxyethyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-(Methylsulfonyl)piperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
5-(5-(4-((1-Isopropylpiperidin-4-yl)oxy)phenyl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-7-yl)-3-(trifluoromethyl)picolinonitrile;
Ethyl 2-(4-(4-(7-(6-cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidin-1-yl)acetate;
4-(4-(7-(6-Cyano-5-(trifluoromethyl)pyridin-3-yl)-8-oxo-6-thioxo-5,7-diazaspiro[3.4]octan-5-yl)phenoxy)piperidine-1-carboxamide;
or a pharmaceutically acceptable salt thereof or N-oxide thereof.
38. A pharmaceutical composition comprising a pharmaceutically acceptable carrier or excipient and a compound of claim 37 , or a pharmaceutically acceptable salt thereof or N-oxide thereof.