Gamma-lactam compounds for promoting bone growth
The present invention provides compounds, compositions and methods for promoting bone growth. Compounds useful in the methods of the present invention include compounds of Formula I, wherein each R 1 and R 2 is H, halogen, C 1-6 alkyl, C 1-6 alkoxy, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, C 1-6 haloalkoxy, —OR 4 , —NR 4 R 5 , —SR 4 , —C(O)R 4 , —C(O)OR 4 , —C(O)NR 4 R 5 , —N(R 4 )C(O)R 5 , —N(R 4 )C(O)OR 5 , —N(R 4 )C(O)NR 4 R 5 , —OP(O)(OR 4 ) 2 , —S(O) 2 OR 4 , —S(O) 2 NR 4 R 5 , —CN, cycloalkyl, heterocycloalkyl, aryl or heteroaryl. Each R 4 and R 5 is H or C 1-6 alkyl. X is O, S or NR 4 . Y is an aryl ring system having 6-10 ring members or a heteroaryl ring system having 5-10 ring members where 1-3 ring members are each N, O or S. Subscript n is 1 or 2. The compounds also include salts, hydrates and isomers of the compounds of the present invention.
1. A method of promoting bone growth in a subject in need thereof, comprising administering to the subject a therapeutically effective amount of a compound of Formula I:
wherein
each R 1 and R 2 is independently selected from the group consisting of H, halogen, C 1-6 alkyl, C 1-6 alkoxy, C 1-6 haloalkyl, C 2-6 alkenyl, C 2-6 alkynyl, C 1-6 haloalkoxy, —OR 4 , —NR 4 R 5 , —SR 4 , —C(O)R 4 , —C(O)OR 4 , —C(O)NR 4 R 5 , —N(R 4 )C(O)R 5 , —N(R 4 )C(O)OR 5 , —N(R 4 )C(O)NR 4 R 5 , —OP(O)(OR 4 ) 2 , —S(O) 2 OR 4 , —S(O) 2 NR 4 R 5 , —CN, cycloalkyl, heterocycloalkyl, aryl and heteroaryl;
each R 4 and R 5 is independently selected from the group consisting of H and C 1-6 alkyl;
X is selected from the group consisting of O, S and NR 4 ;
Y is selected from the group consisting of an aryl ring system having 6-10 ring members and a heteroaryl ring system having 5-10 ring members where 1-3 ring members are each independently selected from the group consisting of N, O and S;
subscript n is 1 or 2; and
salts, hydrates and isomers thereof, thereby promoting bone growth in the subject.
2. The method of claim 1 , wherein the bone growth is promoted at a site of injury or localized condition.
3. The method of claim 2 , wherein the bone growth is promoted at a site selected from the group consisting of a bone fracture and weakened bone.
4. The method of claim 2 , wherein the subject requires a spinal fusion, arthrodesis or an orthopedic or periodontal synthetic bone graft or implant.
5. The method of claim 2 , further comprising the step of administering to the subject an osteoconductive matrix.
6. The method of claim 5 , wherein the osteoconductive matrix comprises an osteoinductive agent selected from the group consisting of bone allograft, bone autograft, demineralized bone and periodontal ligament cells.
7. The method of claim 5 , wherein the osteoconductive matrix comprises a calcium salt, calcium sulfate, calcium phosphate, a calcium phosphate cement, hydroxyapatite, coralline based hydroyxapatite (HA), dicalcium phosphate, tricalcium phosphate (TCP), calcium carbonate, collagen, plaster of Paris, phosphosphoryn, a borosilicate, a biocompatible ceramic, a calcium phosphate ceramic and polytetrafluoroethylene.
8. The method of claim 1 , wherein the bone growth is systemic.
9. The method of claim 8 , wherein the subject suffers from a low bone mass phenotype disease.
10. The method of claim 9 , wherein the low bone mass phenotype disease is selected from the group consisting of osteoporosis, osteopenia, and osteoporosis-pseudoglioma syndrome (OPPG).
11. The method of claim 1 , wherein the compound is administered in combination with an antiresorptive drug.
12. The method of claim 11 , wherein the antiresorptive drug is selected from the group consisting of denosumab, a RankL inhibitor, a bisphosphonate, a selective estrogen receptor modulator (SERM), calcitonin, a calcitonin analog, Vitamin D and a Vitamin D analog.
13. The method of claim 11 , wherein the bone growth is systemic.
14. The method of claim 11 , wherein the bone growth is promoted by a local application of the compound and the antiresorptive drug.
15. A method of treating renal damage, comprising administering to a subject in need thereof, a therapeutically effective amount of a compound of claim 1 .
16. An orthopedic or periodontal medical device comprising a structural support, wherein an implantable portion of the structural support is adapted to be permanently implanted within a subject, wherein the implantable portion is attached to a bone, the structural support bearing at least a partial external coating comprising a compound of claim 1 .
17. A pharmaceutical composition comprising a pharmaceutically acceptable excipient and a compound of Formula Ia:
wherein
each R 1 and R 2 is independently selected from the group consisting of H, C 1-6 alkyl, C 1-6 alkoxy and —OH; and
salts, hydrates and isomers thereof.
18. The composition of claim 17 , wherein at least one R 2 is hydroxy.
19. The composition of claim 18 , wherein the compound has the formula:
20. The composition of claim 19 , wherein the compound has the following formula:
21. The composition of claim 20 , wherein the compound has the following formula:
22. The composition of claim 17 , further comprising an osteoconductive matrix.