Macrocyclic spirocarbamate derivatives as factor XIa inhibitors, pharmaceutically acceptable compositions and their use

1. A compound of the Formula (I):

or a pharmaceutically acceptable salt thereof, wherein:

Y 1 is CR 3 or N;

Y 2 is CR 3 or N;

Y 3 is CR 3 or N;

Y 4 is CR 3 or N,

such that three of Y 1 , Y 2 , Y 3 and Y 4 are not simultaneously N, and all four of Y 1 , Y 2 , Y 3 and Y 4 are not simultaneously N;

each R 3 is independently hydrogen, C 1-3 alkyl, C 3-6 cycloalkyl, halo, cyano or hydroxy, wherein said C 1-3 alkyl and said C 3-6 cycloalkyl groups are optionally independently substituted with one to three groups independently selected from halo or hydroxyl;

U is a bond or NH;

—Z 1 —X 1 — is selected from the group consisting of: —C(O)O—, —C(O)CH 2 —, —C(O)NH—, —S(O) 2 O—, —S(O) 2 CH 2 —, —S(O) 2 NH—, —S(O)CH 2 —, —S(O)NH—, —C(O)—, and —S(O) 2 —;

n is 1, 2, or 3;

{circle around (A)} is aryl or heteroaryl, each of which is optionally substituted with one to three groups independently selected from the group consisting of halo, cyano, R 6 , OR 6 , C(O)OR 6 , NR 6 R 7 , NHC(O)O(C 1 -C 6 )alkyl, NHC(O)OC 3-6 cycloalkyl, —NHSO 2 (C 1 -C 6 )alkyl, CONR 7 R 8 , and —CH 2 CONR 7 R 8 ;

{circle around (B)} is aryl or heteroaryl, each of which is optionally substituted with one to three groups independently selected from the group consisting of halo, cyano, oxo, R 6 , OR 6 , C(O)OR 6 , C 1-3 alkyl-C(O)OR 6 , C(O)NR 6 R 7 and NR 6 R 7 ;

—Y—X— is selected from the group consisting of —C(O)—NR 6 —, —CH(OC(O)—NR 6 —, —CH(C(O)OR 7 )—NR 6 —, —C(O)—O—, —NR 6 —C(O)—, —CH(C(O)N(R 6 R 7 ))—NR 6 —, —CH(CR 6 R 7 OR 8 )—NR 6 —, —CH(CR 6 R 7 NR 6 R 7 )—NR 6 —, —OC(O)—NR 6 —, —NR 6 —C(O)O—, —NR 6 —C(O)NR 6 —, and —S(O) 2 —NR 6 —;

R 5 is fluoro or C 1-6 alkyl;

Z is C 3-8 alkylene or C 3-8 alkenylene, wherein one of the carbon atoms in said alkylene and alkenylene, where chemically permitted, may be replaced with O, NR 6 , C(O), C(O)NR 6 , NR 6 C(O), S, SO or SO 2 ;

each R 6 is independently hydrogen or C 1-6 alkyl, which is optionally substituted with one to three groups independently selected from the group consisting of halo, hydroxyl, (C 1 -C 3 )alkoxyl, C(O)OH, and C(O)O(C 1 -C 3 )alkyl;

each R 7 is independently hydrogen, C 1-6 alkyl, heteroaryl or heterocyclyl, wherein said alkyl group is optionally substituted with one to three groups independently selected from the group consisting of halo and hydroxy; and

each R 8 is independently hydrogen or C 1-6 alkyl.

2. A compound having a structural Formula (III):

or a pharmaceutically acceptable salt thereof, wherein:

{circle around (A)} is aryl or heteroaryl, each of which is optionally substituted with one to three groups independently selected from the group consisting of halo, cyano, R 6 , OR 6 , C(O)OR 6 , NR 6 R 7 , NHC(O)O(C 1 -C 6 )alkyl, NHC(O)OC 3-6 cycloalkyl, —NHSO 2 (C 1 -C 6 )alkyl, CONR 7 R 8 , and —CH 2 CONR 7 R 8 ,

{circle around (B)} is aryl or heteroaryl, each of which is optionally substituted with one to three groups independently selected from the group consisting of halo, cyano, oxo, R 6 , OR 6 , C(O)OR 6 , C 1-3 alkyl-C(O)OR 6 , C(O)NR 6 R 7 and NR 6 R 7 ,

each R 6 is independently hydrogen or C 1-6 alkyl, which is optionally substituted with one to three groups independently selected from the group consisting of halo, hydroxyl, (C 1 -C 3 )alkoxyl, C(O)OH, and C(O)O(C 1 -C 3 )alkyl,

each R 7 is independently hydrogen, C 1-6 alkyl, heteroaryl or heterocyclyl, wherein said alkyl group is optionally substituted with one to three groups independently selected from the group consisting of halo and hydroxy;

each R 8 is independently hydrogen or C 1-6 alkyl;

Y is selected from the group consisting of —C(O), —CH(R 5 )C(O) and —CH(C(O)OR 7 );

U is a bond or NH;

R 5 is fluoro or C 1-6 alkyl;

n is 1, 2, or 3;

p is 0, 1 or 2;

the dotted line represents a single or double bond;

R 3a is halo; and

R 3b is selected from the group consisting of H and halo.

3. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

n is 1.

4. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

n is 2.

5. The compound according to claim 2 , or a pharmaceutically acceptable salt thereof, wherein:

R 3a is chloro and R 3b is selected from the group consisting of H, chloro and fluoro.

6. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

—Y—X— is —C(O)—NR 6 —.

7. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

—Y—X— is —CH(R 5 )C(O)—NR 6 —.

8. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

—Y—X— is —CH(C(O)OR 7 )—NR 6 —.

9. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

{circle around (A)} is

or phenyl which is optionally substituted with one to three groups independently selected from the group consisting of halo, cyano, R 6 , OR 6 , C(O)OR 6 , NR 6 R 7 , NHC(O)O(C 1 -C 6 )alkyl, NHC(O)OC 3-6 cycloalkyl, —NHSO 2 (C 1 -C 6 )alkyl, CONR 7 R 8 , and —CH 2 CONR 7 R 8 .

10. The compound according to claim 1 , or a pharmaceutically acceptable salt thereof, wherein:

{circle around (B)} is selected from the group consisting of phenyl, pyridinyl, oxazolyl, and imidazoyl, wherein each said phenyl, pyridinyl, and imidazoyl, is unsubstituted or substituted with one to three groups independently selected from the group consisting of halo, cyano, oxo, R 6 , OR 6 , C(O)OR 6 , C 1-3 alkyl-C(O)OR 6 , C(O)NR 6 R 7 and NR 6 R 7 .

11. The compound of claim 1 , or a pharmaceutically acceptable salt thereof, said compound having a structure selected from the group consisting of:

12. A pharmaceutically acceptable composition comprising a compound according to claim 1 , or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable carrier.

13. A method for inhibiting thrombus formation in blood or treating thrombus formation in blood comprising administering a composition of claim 12 to a mammal in need of thereof.

14. A method for preventing thrombus formation in blood comprising administering a composition of claim 12 to a mammal in need thereof.

15. A method of treating venous thromboembolism and or pulmonary embolism in a mammal comprising administering a composition of claim 12 to a mammal in need thereof.

16. A method of treating deep vein thrombosis in a mammal comprising administering a composition of claim 12 to a mammal in need thereof.

17. A method of treating thromboembolic stroke in a human comprising administering a composition of claim 12 to a mammal in need thereof.