WO1998008855A2 - N6 heterocyclic substituted adenosine derivatives - Google Patents

N6 heterocyclic substituted adenosine derivatives Download PDF

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Publication number
WO1998008855A2
WO1998008855A2 PCT/US1997/014724 US9714724W WO9808855A2 WO 1998008855 A2 WO1998008855 A2 WO 1998008855A2 US 9714724 W US9714724 W US 9714724W WO 9808855 A2 WO9808855 A2 WO 9808855A2
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Prior art keywords
substituted
composition
group
lower alkyl
aryl
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PCT/US1997/014724
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French (fr)
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WO1998008855A3 (en
Inventor
Robert T. Lum
Jurg R. Pfister
Steven R. Schow
Michael M. Wick
Marek G. Nelson
George F. Schreiner
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Gilead Palo Alto Inc
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CV Therapeutics Inc
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Priority to HU0001640A priority Critical patent/HU226057B1/en
Priority to DE69705312T priority patent/DE69705312T2/en
Priority to PL97331853A priority patent/PL187635B1/en
Priority to EP97938502A priority patent/EP0920438B1/en
Priority to IL12865297A priority patent/IL128652A0/en
Priority to DK97938502T priority patent/DK0920438T3/en
Priority to AT97938502T priority patent/ATE202361T1/en
Priority to AU40809/97A priority patent/AU726597B2/en
Priority to BR9711444-8A priority patent/BR9711444A/en
Priority to UA99021148A priority patent/UA62936C2/en
Priority to HK99106191.6A priority patent/HK1020967B/en
Application filed by CV Therapeutics Inc filed Critical CV Therapeutics Inc
Priority to CA002264155A priority patent/CA2264155C/en
Priority to NZ334095A priority patent/NZ334095A/en
Publication of WO1998008855A2 publication Critical patent/WO1998008855A2/en
Publication of WO1998008855A3 publication Critical patent/WO1998008855A3/en
Priority to NO19990787A priority patent/NO312679B1/en
Priority to IL128652A priority patent/IL128652A/en
Anticipated expiration legal-status Critical
Priority to GR20010401184T priority patent/GR3036332T3/en
Priority to NO20020759A priority patent/NO20020759D0/en
Priority to NO20020758A priority patent/NO322459B1/en
Ceased legal-status Critical Current

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    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07HSUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
    • C07H19/00Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
    • C07H19/02Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
    • C07H19/04Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
    • C07H19/16Purine radicals
    • C07H19/167Purine radicals with ribosyl as the saccharide radical
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07HSUGARS; DERIVATIVES THEREOF; NUCLEOSIDES; NUCLEOTIDES; NUCLEIC ACIDS
    • C07H19/00Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof
    • C07H19/02Compounds containing a hetero ring sharing one ring hetero atom with a saccharide radical; Nucleosides; Mononucleotides; Anhydro-derivatives thereof sharing nitrogen
    • C07H19/04Heterocyclic radicals containing only nitrogen atoms as ring hetero atom
    • C07H19/16Purine radicals
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/28Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00Drugs for disorders of the endocrine system
    • A61P5/24Drugs for disorders of the endocrine system of the sex hormones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/06Antiarrhythmics

Definitions

  • This invention encompasses optimally substituted N 6 -oxa, thia, thioxa and azacycloalkyl substituted adenosine derivatives that are selective adenosine type 1 receptor agonists, and as such, are potentially useful agents for the treatment cardiovascular diseases and central nervous system disorders.
  • A adenosine receptors
  • a 2 adenosine receptors
  • Each subtype effects different physiological functions. Stimulation of the A, adenosine receptor induces two distinct physiological responses. The first is the inhibition of the stimulatory effects of catecholamine. This effect is mediated via the inhibition of cyclic AMP synthesis. The second effect mediated by A, receptors is the slowing of the heart rate and impulse propagation through the AV node. The effect is independent of cAMP metabolism and is associated with A, adenosine receptor activation of the inwardly rectifying K+ channel. This effect is unique to the A, receptor; there is no role for the A 2 receptor in modulating the function of this channel.
  • Stimulation of the adenosine A, receptor accordingly shortens the duration and decreases the amplitude of the action potential of AV nodal cells and subsequently prolongs the refractory period of the cells.
  • the consequence of these effects is to limit the number of impulses conducted from the atria to the ventricles. This forms the basis of the clinical utility of A, receptor agonists for the treatment of supraventricular tachycardias, including atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
  • A agonists therefore would be in the treatment of acute and chronic disorders of heart rhythm, especially those diseases characterized by rapid heart rate where the rate is driven by abnormalities in the at ⁇ a.
  • the disorders include but are not limited to atrial fibrillation, supra ventricular tachycardia and atrial flutter.
  • Exposure to A, agonists causes a reduction in the heart rate and a regulanzation of the abnormal rhythm thereby restoring improved hemodynamic blood flow.
  • A agonists, through their ability to inhibit the catecholamine induced increase in cAMP, should have beneficial effects in the failing heart where increased sympathetic tone causing enhanced cAMP has been associated with increased likelihood of ventricular arrhythmias and sudden death.
  • An object of this invention is novel heterocyclic substituted adenosine derivatives.
  • Another object of this invention is novel heterocyclic substituted adenosine derivatives that are useful as A, receptor agonists.
  • Still another object of this invention is novel heterocyclic substituted adenosine derivatives that are useful for treating supraventricular tachycardias, including atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
  • this invention is a composition of matter having the formula:
  • R is a monocyclic or polycyclic heterocyclic group containing from 3 to 15 atoms, at least one of which is N, 0, S, P and wherein R, may be mono or polysubstituted with one or more compounds selected from the group consisting of halogen, oxo, hydroxyl, lower
  • alkyl substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof wherein R, does not contain an epoxide group.
  • this invention is a method for stimulating coronary activity in a mammal experiencing a coronary electrical disorder that can be treated by stimulating an A, heart adenosine receptor by administering a therapeutically effective amount of the composition disclosed above to the mammal.
  • this invention is a pharmaceutical composition of matter comprising the composition of this invention and one or more pharmaceutical excipients.
  • Figure 1 is a plot of the effect of the concentration compound II of Example 2 on atrial AV nodal conductance for the A, adenosine receptor (-•-) and for the A 2 adenosine receptor (-0-).
  • Figure 2 is a plot of the effect of the concentration of compound I of Example 2 on atrial AV nodal conductance and specifically on the response of the A, adenosine receptor (-•-
  • This invention comprises adenosine derivatives which are selective adenosine type 1 receptor agonists.
  • the compositions are optimally substituted as described below.
  • R is a cycloalkyl group, containing 3 to 15 atoms either monocyclic or polycyclic heterocyclic groups, at least one of which is a heteroatom selected from the group consisting of N, O, P, and S-(O) 0 . 2 .
  • R may optionally be mono or polysubstituted with halogen, oxo, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, and cyano.
  • R cannot contain an epoxy group.
  • R is preferably a monocyclic, bicyclic, or t ⁇ cychc group containing from 3 to 15 atoms, at least one of which is selected from the group consisting of 0 or S-(O) 0 2 wherein R, may be mono or polysubstituted with one or more compounds selected from the group consisting of halogen, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof.
  • R is:
  • R, R/ ⁇ R*" and R,'" are individually selected from the group halogen, oxo, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof and X is O, or S (-O) 0 2 .
  • R, ⁇ R,”, R,” ⁇ and R,”" are individually selected from the group H, lower alkyl, substituted lower alkyl, alkoxy, aryl, and substituted aryl.
  • R, ⁇ R, ' , R,”", and R, x , ' % may each be a different component, each may be the same component, e.g., hydrogen, or some of the components may be the same and some different. It is most preferred that when R, is the composition set forth above, that R, ⁇ R,”, R,'", and R, "" are individually selected from the group H, lower alkyl, and substituted lower alkyl. R, ' " and R,”” may also be a single oxygen atom.
  • R is selected from the group consisting of:
  • each R may individually selected from the group consisting of H, lower alkyl, and substituted lower alkyl and wherein X is O, or S (-O) 0 2 .
  • R is selected from the group consisting of 3-tetrahydrofuranyl, 3-tetrahydroth ⁇ ofuranyl, 4-pyranyl and 4- thiopyranyl
  • halogen refers to fluorine, bromine, chlorine, and iodine atoms.
  • hydroxyl refers to the group -OH
  • lower alkyl refers to a cyclic, branched or straight chain, alkyl group of one to ten carbon atoms. This term is further exemplified by such groups as methyl, ethyl, n-propyl, i-propyl, n-butyl, t-butyl, l-butyl (or 2-methylpropyl), cyclopropylmefhyl, l-amyl, n-amyl,
  • substituted lower alkyl refers to lower alkyl as just desc ⁇ bed including one or more groups such as hydroxyl, thiol, alkylthiol, halogen, alkoxy, ammo, amido, carboxyl, cycloalkyl, substituted cycloalkyl, heterocycle, cycloheteroalkyl, substituted cycloheteroalkyl, acyl, carboxyl, aryl, substituted aryl, aryloxy, hetaryl, substituted hetaryl, aralkyl, heteroaralkyl, alkyl alkenyl, alkyl alkynyl, alkyl cycloalkyl, alkyl cycloheteroalkyl, and cyano. These groups may be attached to any carbon atom of the lower alkyl moiety.
  • alkoxy refers to the group -OR, where R is lower alkyl, substituted lower alkyl, acyl, aryl, substituted aryl, aralkyl, substituted aralkyl, heteroalkyl, heteroarylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted cycloheteroalkyl as defined below.
  • acyl denotes groups -C(O)R, where R is hydrogen, lower alkyl substituted lower alkyl, aryl, substituted aryl, amino, and the like as defined below.
  • aryloxy denotes groups -OAr, where Ar is an aryl, substituted aryl, heteroaryl, or substituted heteroaryl group as defined below.
  • amino refers to the group NR 2 R 2 ', where R 2 and R 2 ' may independently by hydrogen, lower alkyl, substituted lower alkyl, aryl, substituted aryl, hetaryl, or substituted hetaryl as defined herein.
  • Carboxyl denotes the group -C(O)OR, where R may independently be hydrogen, lower alkyl, substituted lower alkyl, aryl, substituted aryl, hetaryl, substituted hetaryl and the like as defined herein.
  • aryl refers to an aromatic carbocyclic group having at least one aromatic ring (e.g., phenyl or biphenyl) or multiple condensed rings in which at least one ring is aromatic, (e.g., 1,2,3,4-tetrahydronaphthyl, naphthyl, anthryl, or phenanthryl).
  • substituted aryl refers to aryl optionally substituted with one or more functional groups, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol sulfamido and the like.
  • functional groups e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol sulfamido and the like.
  • heterocycle refers to a saturated, unsaturated, or aromatic carbocyclic group having a single ring (e.g., morpholino, pyridyl or furyl) or multiple condensed rings (e.g., naphthpyridyl, quinoxalyl, quinolinyl, indolizinyl or benzo[b]thienyl) and having at least one hetero atom, such as N, O or S, within the ring, which can optionally be unsubstituted or substituted with, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, sulfamido and the like.
  • a single ring e.g., morpholino,
  • heteroaryl or “hetar” refers to a heterocycle in which at least one heterocyclic ring is aromatic.
  • substituted heteroaryl refers to a heterocycle optionally mono or poly substituted with one or more functional groups, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, sulfamido and the like.
  • functional groups e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, sulfamido and the like.
  • cycloalkyl refers to a divalent cyclic or polycyclic alkyl group containing 3 to 15 carbon atoms.
  • substituted cycloalkyl refers to a cycloalkyl group comprising one or more substituents with, e.g., halogen, lower alkyl, substituted lower alkyl, alkoxy, alkylthio, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol,
  • compositions of this invention are useful as A, receptor agonists for the treatment of coronary electrical disorders such as supravcntricular tachycardias, including atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
  • the compositions may be administered orally, intravenously, through the epidermis or by any other means known in the art for administering a therapeutic agents.
  • the method of treatment comprises the administration of an effective quantity of the chosen compound, preferably dispersed in a pharmaceutical carrier.
  • Dosage units of the active ingredient are generally selected from the range of 0.01 to 100 mg/kg, but will be readily determined by one skilled in the art depending upon the route of administration, age and condition of the patient. These dosage units may be administered one to ten times daily for acute or chronic disorders. No unacceptable toxicological effects are expected when compounds of the invention are administered in accordance with the present invention.
  • an acid addition salt may be prepared.
  • Acid addition salts of the compounds are prepared in a standard manner in a suitable solvent from the parent compound and an excess of acid, such as hydrochloric, hydrobromic, sulfuric, phosphoric, acetic, maleic, succinic, or methane sulfonic.
  • the hydrochloric salt form is especially useful.
  • cationic salts may be prepared.
  • the parent compound is treated with an excess of an alkaline reagent, such as hydroxide, carbonate or alkoxide, containing the appropriate cation.
  • Cations such as Na + , K Ca +2 and NH 4 + are examples of cations present in pharmaceutically acceptable salts.
  • Certain of the compounds form inner salts or zwittcrions which may also be acceptable.
  • compositions including the compounds of this invention, and/or derivatives thereof may be formulated as solutions or lyophilized powders for parenteral administration. Powders may be reconstituted by addition of a suitable diluent or other pharmaceutically acceptable carrier prior to use. If used in liquid form the compositions of this invention are preferably incorporated into a buffered, isotonic, aqueous solution. Examples of suitable diluents are normal isotonic saline solution, standard 5% dextrose in water and buffered sodium or ammonium acetate solution. Such liquid formulations are suitable for parenteral administration, but may also be used for oral administration.
  • compositions including compounds of this invention may be desirable to add excipients such as polyvinylpyrrolidinone, gelatin, hydroxy cellulose, acacia, polyethylene glycol, mannitol, sodium chloride, sodium citrate or any other excipient known to one of skill in the art to pharmaceutical compositions including compounds of this invention.
  • the pharmaceutical compounds may be encapsulated, tableted or prepared in an emulsion or syrup for oral administration.
  • Pharmaceutically acceptable solid or liquid carriers may be added to enhance or stabilize the composition, or to facilitate preparation of the composition.
  • Liquid carriers include syrup, peanut oil, olive oil, glycerin, saline, alcohols and water.
  • Solid carriers include starch, lactose, calcium sulfate, dihydrate, teffa alba, magnesium stearate or stearic acid, talc, pectin, acacia, agar or gelatin.
  • the carrier may also include a sustained release material such as glycerol monostearate or glycerol distearate, alone or with a wax.
  • the amount of solid carrier varies but, preferably, will be between about 20 mg to about 1 gram per dosage unit.
  • the pharmaceutical dosages are made using conventional techniques such as milling, mixing, granulation, and compressing, when necessary, for tablet forms; or milling, mixing and filling for hard gelatin capsule forms.
  • a liquid carrier When a liquid carrier is used, the preparation will be in the form of a syrup, elixir, emulsion or an aqueous or non-aqueous suspension. Such a liquid formulation may be administered directly or filled into a soft gelatin capsule.
  • the compounds of this invention may be prepared by conventional methods of organic chemistry.
  • the reaction sequence outlined below, is a general method, useful for the preparation of compounds of this invention.
  • oxacycloalkyl carboxylic acid is heated in a mixture of dioxane, diphenylphosphoryazide and triethylamine for 1 hour.
  • benzyl alcohol is added to this mixture.
  • intermediate compound 1 is dissolved in methanol.
  • concentrated HC1, Pd/C is added and the mixture is placed under hydrogen at 1 atm.
  • the mixture is stirred overnight at room temperature and filtered.
  • the residue is recrystallized to give intermediate compound 2.
  • 6-chloropurine riboside is combined and the mixture is compound 2 dissolved in methanol and treated with triethylamine.
  • the reaction is heated to 80° C for 30 hours. Isolation and purification leads to Compound 3.
  • each derivative was effective in slowing the atrial rate and prolonging the AV nodal conduction time of spontaneously beating hearts in a concentration-dependent manner, demonstrating efficacy as adenosine A, receptor agonists in the intact heart.
  • N-benzyloxycarbonyl-4-aminopyran (1.85 gm, 7.87 mmol) was dissolved in MeOH (50 ml) along with cone. HC1 and Pd-C ( 10%, 300 mg). The vessel was charged with hydrogen at 1 atm and the mixture was allowed to stir for 18 hours at room temperature. The mixture was filtered through a pad of eelite and concentrated. The residue was co-evaporated twice with MeOH/EtOAc and recrystallized from MeOH/EtOAc to afford 980 mg (91 %) of white needles (mp 228-230° C).
  • N-benzyloxycarbonyl-3-aminotetrahydrofuran (3.4 gm, 15 mmol) was dissolved in MeOH (50 ml) along with cone. HC1 and Pd-C (10%, 300 mg). The vessel was charged with hydrogen at 1 atm and the mixture was allowed to stir for 18 hours at room temperature. The mixture was filtered through a pad of celite and concentrated. The residue was co-evaporated two times with MeOH/EtOAc and recrystallized from MeOH/EtOAc to give 1.9 g of a yellow solid.

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Abstract

A substituted N6-oxa, thia, thioxa and azacycloalkyl substituted adenosine derivative of formula (I) and a method for using the composition as an A¿1? heart adenosine receptor. In said formula, R1 is a monocyclic or polycyclic heterocyclic group containing from 3 to 15 atoms, at least one of which is selected from the group consisting of N, O, P and S-(O)o-2 and wherein R1 does not contain an epoxide group.

Description

TITLE: N6 HETEROCYCLIC SUBSTITUTED ADENOSINE DERIVATIVES
BACKGROUND OF THE INVENTION
Field of Invention
This invention encompasses optimally substituted N6-oxa, thia, thioxa and azacycloalkyl substituted adenosine derivatives that are selective adenosine type 1 receptor agonists, and as such, are potentially useful agents for the treatment cardiovascular diseases and central nervous system disorders.
Description of the Art
There are two subtypes of adenosine receptors in the heart: A, and A2. Each subtype effects different physiological functions. Stimulation of the A, adenosine receptor induces two distinct physiological responses. The first is the inhibition of the stimulatory effects of catecholamine. This effect is mediated via the inhibition of cyclic AMP synthesis. The second effect mediated by A, receptors is the slowing of the heart rate and impulse propagation through the AV node. The effect is independent of cAMP metabolism and is associated with A, adenosine receptor activation of the inwardly rectifying K+ channel. This effect is unique to the A, receptor; there is no role for the A2 receptor in modulating the function of this channel. Stimulation of the adenosine A, receptor accordingly shortens the duration and decreases the amplitude of the action potential of AV nodal cells and subsequently prolongs the refractory period of the cells. The consequence of these effects is to limit the number of impulses conducted from the atria to the ventricles. This forms the basis of the clinical utility of A, receptor agonists for the treatment of supraventricular tachycardias, including atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
The clinical utility of A, agonists therefore would be in the treatment of acute and chronic disorders of heart rhythm, especially those diseases characterized by rapid heart rate where the rate is driven by abnormalities in the atπa. The disorders include but are not limited to atrial fibrillation, supra ventricular tachycardia and atrial flutter. Exposure to A, agonists causes a reduction in the heart rate and a regulanzation of the abnormal rhythm thereby restoring improved hemodynamic blood flow.
A, agonists, through their ability to inhibit the catecholamine induced increase in cAMP, should have beneficial effects in the failing heart where increased sympathetic tone causing enhanced cAMP has been associated with increased likelihood of ventricular arrhythmias and sudden death.
SUMMARY OF THE INVENTION
An object of this invention is novel heterocyclic substituted adenosine derivatives.
Another object of this invention is novel heterocyclic substituted adenosine derivatives that are useful as A, receptor agonists.
Still another object of this invention is novel heterocyclic substituted adenosine derivatives that are useful for treating supraventricular tachycardias, including atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
In one embodiment, this invention is a composition of matter having the formula:
Figure imgf000005_0001
wherein R, is a monocyclic or polycyclic heterocyclic group containing from 3 to 15 atoms, at least one of which is N, 0, S, P and wherein R, may be mono or polysubstituted with one or more compounds selected from the group consisting of halogen, oxo, hydroxyl, lower
alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof wherein R, does not contain an epoxide group.
In another embodiment, this invention is a method for stimulating coronary activity in a mammal experiencing a coronary electrical disorder that can be treated by stimulating an A, heart adenosine receptor by administering a therapeutically effective amount of the composition disclosed above to the mammal.
In still another embodiment, this invention is a pharmaceutical composition of matter comprising the composition of this invention and one or more pharmaceutical excipients.
DESCRIPTION OF THE FIGURES
Figure 1 is a plot of the effect of the concentration compound II of Example 2 on atrial AV nodal conductance for the A, adenosine receptor (-•-) and for the A2 adenosine receptor (-0-). Figure 2 is a plot of the effect of the concentration of compound I of Example 2 on atrial AV nodal conductance and specifically on the response of the A, adenosine receptor (-•-
) and on the response of the A2 adenosine receptor (-0-).
DESCRIPTION OF THE CURRENT EMBODIMENT
This invention comprises adenosine derivatives which are selective adenosine type 1 receptor agonists. The compositions are optimally substituted as described below.
Figure imgf000008_0001
where:
R, is a cycloalkyl group, containing 3 to 15 atoms either monocyclic or polycyclic heterocyclic groups, at least one of which is a heteroatom selected from the group consisting of N, O, P, and S-(O)0.2. R,, in turn, may optionally be mono or polysubstituted with halogen, oxo, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, and cyano. However, R, cannot contain an epoxy group. R, is preferably a monocyclic, bicyclic, or tπcychc group containing from 3 to 15 atoms, at least one of which is selected from the group consisting of 0 or S-(O)0 2 wherein R, may be mono or polysubstituted with one or more compounds selected from the group consisting of halogen, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof.
In a more preferred embodiment, R, is:
Figure imgf000009_0001
wherein R, R/\ R*" and R,'"" are individually selected from the group halogen, oxo, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof and X is O, or S (-O)0 2. Preferably, R,\ R,", R,"\ and R,"" are individually selected from the group H, lower alkyl, substituted lower alkyl, alkoxy, aryl, and substituted aryl. By "individually selected" it is meant that R,\ R, ', R,"", and R,x , '% may each be a different component, each may be the same component, e.g., hydrogen, or some of the components may be the same and some different. It is most preferred that when R, is the composition set forth above, that R,\ R,", R,'", and R, "" are individually selected from the group H, lower alkyl, and substituted lower alkyl. R, ' " and R,"" may also be a single oxygen atom.
In an alternative embodiment, R, is selected from the group consisting of:
Figure imgf000010_0001
wherein each R may individually selected from the group consisting of H, lower alkyl, and substituted lower alkyl and wherein X is O, or S (-O)0 2. In a most preferred embodiment, R, is selected from the group consisting of 3-tetrahydrofuranyl, 3-tetrahydrothιofuranyl, 4-pyranyl and 4- thiopyranyl The following definitions apply to terms as used herein The term "halogen" refers to fluorine, bromine, chlorine, and iodine atoms. The term "oxo" refers to =O. The term "hydroxyl" refers to the group -OH
The term "lower alkyl" refers to a cyclic, branched or straight chain, alkyl group of one to ten carbon atoms. This term is further exemplified by such groups as methyl, ethyl, n-propyl, i-propyl, n-butyl, t-butyl, l-butyl (or 2-methylpropyl), cyclopropylmefhyl, l-amyl, n-amyl,
hexyl and the like. The term "substituted lower alkyl" refers to lower alkyl as just descπbed including one or more groups such as hydroxyl, thiol, alkylthiol, halogen, alkoxy, ammo, amido, carboxyl, cycloalkyl, substituted cycloalkyl, heterocycle, cycloheteroalkyl, substituted cycloheteroalkyl, acyl, carboxyl, aryl, substituted aryl, aryloxy, hetaryl, substituted hetaryl, aralkyl, heteroaralkyl, alkyl alkenyl, alkyl alkynyl, alkyl cycloalkyl, alkyl cycloheteroalkyl, and cyano. These groups may be attached to any carbon atom of the lower alkyl moiety.
The term "alkoxy" refers to the group -OR, where R is lower alkyl, substituted lower alkyl, acyl, aryl, substituted aryl, aralkyl, substituted aralkyl, heteroalkyl, heteroarylalkyl, cycloalkyl, substituted cycloalkyl, cycloheteroalkyl, or substituted cycloheteroalkyl as defined below.
The term "acyl" denotes groups -C(O)R, where R is hydrogen, lower alkyl substituted lower alkyl, aryl, substituted aryl, amino, and the like as defined below.
The term "aryloxy" denotes groups -OAr, where Ar is an aryl, substituted aryl, heteroaryl, or substituted heteroaryl group as defined below.
The term "amino" refers to the group NR2R2', where R2 and R2' may independently by hydrogen, lower alkyl, substituted lower alkyl, aryl, substituted aryl, hetaryl, or substituted hetaryl as defined herein.
The term "carboxyl" denotes the group -C(O)OR, where R may independently be hydrogen, lower alkyl, substituted lower alkyl, aryl, substituted aryl, hetaryl, substituted hetaryl and the like as defined herein.
The term "aryl" or "Ar" refers to an aromatic carbocyclic group having at least one aromatic ring (e.g., phenyl or biphenyl) or multiple condensed rings in which at least one ring is aromatic, (e.g., 1,2,3,4-tetrahydronaphthyl, naphthyl, anthryl, or phenanthryl).
The term "substituted aryl" refers to aryl optionally substituted with one or more functional groups, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol sulfamido and the like.
The term "heterocycle" refers to a saturated, unsaturated, or aromatic carbocyclic group having a single ring (e.g., morpholino, pyridyl or furyl) or multiple condensed rings (e.g., naphthpyridyl, quinoxalyl, quinolinyl, indolizinyl or benzo[b]thienyl) and having at least one hetero atom, such as N, O or S, within the ring, which can optionally be unsubstituted or substituted with, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, sulfamido and the like.
The term "heteroaryl" or "hetar" refers to a heterocycle in which at least one heterocyclic ring is aromatic.
The term "substituted heteroaryl" refers to a heterocycle optionally mono or poly substituted with one or more functional groups, e.g., halogen, lower alkyl, lower alkoxy, lower alkylthio, trifluoromethyl, amino, amido, carboxyl, hydroxyl, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol, sulfamido and the like.
The term "cycloalkyl" refers to a divalent cyclic or polycyclic alkyl group containing 3 to 15 carbon atoms. The term "substituted cycloalkyl" refers to a cycloalkyl group comprising one or more substituents with, e.g., halogen, lower alkyl, substituted lower alkyl, alkoxy, alkylthio, aryl, aryloxy, heterocycle, hetaryl, substituted hetaryl, nitro, cyano, alkylthio, thiol,
sulfamido and the like.
The compositions of this invention are useful as A, receptor agonists for the treatment of coronary electrical disorders such as supravcntricular tachycardias, including atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia. The compositions may be administered orally, intravenously, through the epidermis or by any other means known in the art for administering a therapeutic agents.
The method of treatment comprises the administration of an effective quantity of the chosen compound, preferably dispersed in a pharmaceutical carrier. Dosage units of the active ingredient are generally selected from the range of 0.01 to 100 mg/kg, but will be readily determined by one skilled in the art depending upon the route of administration, age and condition of the patient. These dosage units may be administered one to ten times daily for acute or chronic disorders. No unacceptable toxicological effects are expected when compounds of the invention are administered in accordance with the present invention.
If the final compound of this invention contains a basic group, an acid addition salt may be prepared. Acid addition salts of the compounds are prepared in a standard manner in a suitable solvent from the parent compound and an excess of acid, such as hydrochloric, hydrobromic, sulfuric, phosphoric, acetic, maleic, succinic, or methane sulfonic. The hydrochloric salt form is especially useful. If the final compound contains an acidic group, cationic salts may be prepared. Typically the parent compound is treated with an excess of an alkaline reagent, such as hydroxide, carbonate or alkoxide, containing the appropriate cation. Cations such as Na+, K Ca+2 and NH4 + are examples of cations present in pharmaceutically acceptable salts. Certain of the compounds form inner salts or zwittcrions which may also be acceptable.
Pharmaceutical compositions including the compounds of this invention, and/or derivatives thereof, may be formulated as solutions or lyophilized powders for parenteral administration. Powders may be reconstituted by addition of a suitable diluent or other pharmaceutically acceptable carrier prior to use. If used in liquid form the compositions of this invention are preferably incorporated into a buffered, isotonic, aqueous solution. Examples of suitable diluents are normal isotonic saline solution, standard 5% dextrose in water and buffered sodium or ammonium acetate solution. Such liquid formulations are suitable for parenteral administration, but may also be used for oral administration. It may be desirable to add excipients such as polyvinylpyrrolidinone, gelatin, hydroxy cellulose, acacia, polyethylene glycol, mannitol, sodium chloride, sodium citrate or any other excipient known to one of skill in the art to pharmaceutical compositions including compounds of this invention. Alternatively, the pharmaceutical compounds may be encapsulated, tableted or prepared in an emulsion or syrup for oral administration. Pharmaceutically acceptable solid or liquid carriers may be added to enhance or stabilize the composition, or to facilitate preparation of the composition. Liquid carriers include syrup, peanut oil, olive oil, glycerin, saline, alcohols and water. Solid carriers include starch, lactose, calcium sulfate, dihydrate, teffa alba, magnesium stearate or stearic acid, talc, pectin, acacia, agar or gelatin. The carrier may also include a sustained release material such as glycerol monostearate or glycerol distearate, alone or with a wax. The amount of solid carrier varies but, preferably, will be between about 20 mg to about 1 gram per dosage unit. The pharmaceutical dosages are made using conventional techniques such as milling, mixing, granulation, and compressing, when necessary, for tablet forms; or milling, mixing and filling for hard gelatin capsule forms. When a liquid carrier is used, the preparation will be in the form of a syrup, elixir, emulsion or an aqueous or non-aqueous suspension. Such a liquid formulation may be administered directly or filled into a soft gelatin capsule.
The Examples which follow serve to illustrate this invention. The Examples are intended to in no way limit the scope of this invention, but are provided to show how to make and use the compounds of this invention. In the Examples, all temperatures are in degrees Centigrade. EXAMPLE 1
The compounds of this invention may be prepared by conventional methods of organic chemistry. The reaction sequence outlined below, is a general method, useful for the preparation of compounds of this invention.
Figure imgf000015_0001
Figure imgf000015_0002
According to this method, oxacycloalkyl carboxylic acid is heated in a mixture of dioxane, diphenylphosphoryazide and triethylamine for 1 hour. To this mixture is added benzyl alcohol and the reaction is further heated over night to give intermediate compound 1. Compound 1 is dissolved in methanol. Next, concentrated HC1, Pd/C is added and the mixture is placed under hydrogen at 1 atm. The mixture is stirred overnight at room temperature and filtered. The residue is recrystallized to give intermediate compound 2. 6-chloropurine riboside is combined and the mixture is compound 2 dissolved in methanol and treated with triethylamine. The reaction is heated to 80° C for 30 hours. Isolation and purification leads to Compound 3.
EXAMPLE 2
Compounds of this invention prepared according to the method of Example 1 were tested in two functional models specific for adenosine A, receptor agonist function. The first was the A , receptor mediated inhibition of isoproterenol stimulated cAMP accumulation in DDT cells. The EC50 of each derivative is shown in Table I. Also shown in Table I is the ability of each derivative to stimulate cAMP production in PC 12 cells, a function of agonist stimulation of adenosine A2 receptors. The ratio of the relative potency of each compound in stimulating either an A, receptor or an A2 receptor effect is termed the selectivity of each compound for the A, receptor. As can be seen in Table I, each derivative is relatively selective as an A, receptor agonist. The use of measuring cAMP metabolism as an assay for adenosine A , receptor function has been previously described (Scammells, P., Baker, S., Belardinelli, L., and Olsson, R. , 1994, Substituted 1 ,3-dipropylxanthines as irreversible antagonists of A, adenosine receptors. J. Med. Chem 37: 2794-2712, 1994).
Table I
Compound R EC50 (nM) ECS, (nM) A,/A2 A-/A, DDT cells PC 12 cells
I 4-arninopyran 12 970 0.012 80.0
II (±)-3-aminotetrahydrofuran 13 1400 0.0093 107.6
III (R)-3-aminotetrahydrofuran 1.08 448 0.0024 414
IV ( 1 )-caprolactam 161 181 0.889 1.12
V (S)-3-aminotetrahydrofuran 3.40 7680 0.00044 2258
Compounds were also tested in a whole organ model of A, receptor activation with respect to atrial and AV nodal function. In this model, guinea pig hearts are isolated and perfused with saline containing compound while atrial rate and AV nodal conduction time are assessed by electrographic measurement of atrial cycle length and AV intervals, as detailed in Belardinelli, L, Lu, J. Dennis, D. Martens, J, and Shryock J. (1994); The cardiac effects of a novel A,-adenosine receptor agonist in guinea pig isolated heart. J. Pharm. Exp. Therap. 271:1371-1382 (1994). As shown in Figure 1, each derivative was effective in slowing the atrial rate and prolonging the AV nodal conduction time of spontaneously beating hearts in a concentration-dependent manner, demonstrating efficacy as adenosine A, receptor agonists in the intact heart.
EXAMPLE 3
Preparation ofN-benzyloxycarbonyl-4-aminopyran.
A mixture of 4-pyranylcarboxylic acid (2.28 gm, 20 mmol), diphenylphosphorylazide (4.31 ml, 20 mmol), triethylamine (2.78 ml, 20 mmol) in dioxane (40 ml) was heated in a 100° C oil bath under dry nitrogen for 1 hour. Benzyl alcohol (2.7 ml, 26 mmol) was added, and heating was continued at 100° C for 22 hours. The mixture was cooled, filtered from a white precipitate and concentrated. The residue was dissolved in 2N HC1 and extracted twice with EtOAc. The extracts were washed with water, sodium bicarbonate, brine and then dried over MgSO4, and concentrated to an oil which solidified upon standing. The oil was chromatographed (30% to 60% EtO Ac/Hex) to give 1.85 g of a white solid (40%).
Preparation of 4-aminopyran.
N-benzyloxycarbonyl-4-aminopyran (1.85 gm, 7.87 mmol) was dissolved in MeOH (50 ml) along with cone. HC1 and Pd-C ( 10%, 300 mg). The vessel was charged with hydrogen at 1 atm and the mixture was allowed to stir for 18 hours at room temperature. The mixture was filtered through a pad of eelite and concentrated. The residue was co-evaporated twice with MeOH/EtOAc and recrystallized from MeOH/EtOAc to afford 980 mg (91 %) of white needles (mp 228-230° C).
Preparation of 6-(4-aminopyran)-purine riboside. A mixture of 6-chloropurine riboside (0.318 gm, 1. 1 mmol), 4-aminopyran-HCl
(0.220 mg,
1.6 mmol) and triethylamine (0.385 ml, 2.5 mmol) in methanol (10 ml) was heated to 80° C for 30 hours. The mixture was cooled, concentrated and the residue chromatographed (90: 10: 1, CH2 Cl2/MeOH/PrNH2). The appropriate fractions were collected and recliromatographed using a chromatotron
(2 mm plate, 90: 10: 1, CH2 Cl2/MeOH/PrNH2) to give an off white foam (0.37 gm, 95%).
EXAMPLE 4
Preparation of N-benzyloxycarbonyl-3-aminotetrahydrofuran. A mixture of 3-tetrahydrofuroic acid (3.5 gm, 30 mmol), diphenylphosphorylazide (6.82 ml, 32 mmol), triethylamine (5 ml, 36 mmol) in dioxane (35 ml) was stirred at RT for 20 min then heated in a 100° C oil bath under dry nitrogen for 2 hours. Benzyl alcohol (4.7 ml, 45 mmol) was added, and continued heating at 100° C for 22 hours. The mixture was cooled, filtered from a white precipitate and concentrated. The residue was dissolved in 2N HC1 and extracted twice using EtOAc. The extracts were washed with water, sodium bicarbonate, brine dried over MgSO4, and then concentrated to an oil which solidifies upon standing. The oil was chromatographed (30% to 60% EtO Ac/Hex) to give 3.4 g of an oil (51
%).
Preparation of 3-aminotetrahydrofuran.
N-benzyloxycarbonyl-3-aminotetrahydrofuran (3.4 gm, 15 mmol) was dissolved in MeOH (50 ml) along with cone. HC1 and Pd-C (10%, 300 mg). The vessel was charged with hydrogen at 1 atm and the mixture was allowed to stir for 18 hours at room temperature. The mixture was filtered through a pad of celite and concentrated. The residue was co-evaporated two times with MeOH/EtOAc and recrystallized from MeOH/EtOAc to give 1.9 g of a yellow solid.
Preparation of 6-(3-aminotetrahydrofuranyl)purine riboside. A mixture of 6-chloropurine riboside (0.5 gm, 1.74 mmol), 3-aminotetrahydrofuran
(0.325 gm, 2.6 mmol) and triethylamine (0.73 ml, 5.22 mmol) in methanol (10 ml) was heated to 80° C for 40 hours. The mixture was cooled, and concentrated. The residue was filtered through a short column of silica gel eluting with 90/10/1 (CH2Cl2/MeOH/PrNH2), the fractions containing the product were combined and concentrated. The residue was chromatorgraphed on the chromatotron (2 mm plate, 92.5/7.5/1 , CH2CL2/MeOH/P.NH2). The resulting white solid was recrystallized from MeOH/EtOAc to give 0.27 gm of white crystals (mp 128-130° C).
EXAMPLE 5
Resolution of 3-arninotetrahydrofuran hydrochloride
A mixture of 3-aminotetrahydrofuran hydrochloride (0.5 gm, 4 mmol) and
(S)-(+)-10-camphorsulfonyl chloride (1.1 gm, 4.4 mmol) in pyridine (10 ml) was stirred for 4 hours at room temperature and then concentrated. The residue was dissolved in EtOAc and washed with 0.5N HC1, sodium bicarbonate and brine. The organic layer was dried over MgSO4, filtered and concentrated to give 1. 17 g of a brown oil (97%) which was chromatographed on silica gel (25% to 70% EtOAc/Hex). The white solid obtained was repeatedly recrystallized from acetone and the crystals and supernatant pooled until an enhancement of greater than 90% by 1H NMR was acheived.
Preparation of 3-(S)-aminotetrahydrofuran hydrochloride.
The sulfonamide (170 mg, 0.56 mmol) was dissolved in cone. HCl/AcOH (2 mL each), stirred for 20 hours at room temperature, washed three times with CH2C12 (10 ml) and concentrated to dryness to give 75 mg (qaunt ) of a white solid Preparation of 6-(3-(S)-aminotetrahydrofuranyl)puπne riboside.
A mixture of 6-chloropurιne riboside (30 mg, 0.10 mmol),
3-(S)-amιnotetrahydrofuran hydrochloride (19 mg, 0.15 mmol) and triethylamine (45 ml, 0.32 mmol) in methanol
(0.5 ml) was heated to 80° C for 18 hours. The mixture was cooled, concentrated and chromatographed with 95/5 (CH2Cl /MeOH) to give 8 mg (24%) of a white solid.

Claims

What we claim is:
1. A composition of matter having the formula:
Figure imgf000024_0001
wherein R, is a monocyclic or polycyclic heterocyclic group containing from 3 to 15 atoms, at least one of which is selected from the group consisting of N, 0, P and S-(O)0.2 and wherein R, does not contain an epoxide group.
2. The composition of claim 1 wherein R, is mono or polysubstituted with one or more compounds selected from the group consisting of halogen, oxo, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof.
3. The composition of matter of claim 1 wherein R, is a monocyclic, bicyclic, or tricyclic cycloalkyl group containing from 3 to 15 atoms, at least one of which is selected
from the group consisting of 0 or S-(0)„.?.
4. The composition of claim 3 wherein R, is mono or polysubstituted with one or
11 more compounds selected from the group consisting of halogen, oxo, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof.
5. The composition of claim 3 wherein R, is:
Figure imgf000025_0001
wherein R, \ R \ R,"\ and R,, , , % are individually selected from the group halogen, hydroxyl, lower alkyl, substituted lower alkyl, alkoxy, aryl, acyl, aryloxy, carboxyl, substituted aryl, heterocycle, heteroaryl, substituted heteroaryl, cycloalkyl, substituted cycloalkyl, nitro, cyano and mixtures thereof and X is O, or S (-O)ϋ 2.
6. The composition of claim 5 wherein R," v and R,"" can be a single oxygen
atom.
7. The composition of claim 5 wherein R,\ R,", R,% '\ and R1"<' are individually selected from the group H, lower alkyl, substitute lower alkyl, alkoxy, aryl, and substituted aryl.
8. The composition of claim 5 wherein R,\ R,' \ R,"\ and R, " are individually selected from the group H, lower alkyl, and substitute lower alkyl.
9. The composition of claim 1 wherein R, is selected from the group consisting of:
Figure imgf000026_0001
wherein each R may individually selected from the group consisting of H, lower alkyl, and substituted lower alkyl and wherein X is O, or S (-O)„ 2.
10. The composition of claim 1 wherein R, is selected from the group consisting of 3-tetrahydrofuranyl, 3-tetrahydrothiofuranyl, 4-pyranyl, and 4 thiopyranyl.
1 1. An adenosine type 1 receptor agonist comprising the composition of claim 1.
12. A method for stimulating coronary activity in a mammal experiencing a coronary electrical disorder that can be treated by stimulating an A, hear adenosine receptor comprising cell proliferation in mammals comprising administering a therapeutically effective amount of the composition of claim 1 to the mammal.
13. The method of claim 12 wherein the therapeutically effective amount ranges from about 0.01 to about 100 mg/kg weight of the mammal.
14. The method of claim 12 wherein the composition is administered to a mammal experiencing a coronary electrical disorder selected from the group consisting of supraventricular tachycardias, atrial fibrillation, atrial flutter, and AV nodal re-entrant tachycardia.
15. The method of claim 14 wherein the mammal is a human.
16. A pharmaceutical composition of matter comprising the composition of claim 1 and one or more pharmaceutical excipients.
17. The pharmaceutical composition of matter of claim 16 wherein the pharmaceutical composition is in the form of a solution.
18. The pharmaceutical composition of matter of claim 16 wherein the pharmaceutical composition is in the form of a tablet.
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