AU728988B2

AU728988B2 - Antagonists of gonadotropin releasing hormone

Info

Publication number: AU728988B2
Application number: AU77149/98A
Authority: AU
Inventors: Mark Goulet; Feroze Ujjainwalla; Thomas F. Walsh; Matthew J. Wyvratt Jr.
Original assignee: Merck and Co Inc
Current assignee: Merck and Co Inc
Priority date: 1997-06-05
Filing date: 1998-06-01
Publication date: 2001-01-25
Anticipated expiration: 2018-06-01
Also published as: EP0986385A4; CA2292881A1; EP0986385A1; JP2002502427A; AU7714998A; WO1998055116A1

Description

WO 98/55116 PCT/US98/ 1207 TITLE OF THE INVENTION ANTAGONISTS OF GONADOTROPIN RELEASING HORMONE BACKGROUND OF THE INVENTION The gonadotropin-releasing hormone (GnRH), also referred to as luteinizing hormone-releasing hormone (LHRH), is a decapeptide that plays a key role in human reproduction. The hormone is released from the hypothalamus and acts on the pituitary gland to stimulate the biosynthesis and secretion of luteinizing hormone (LH) and folliclestimulating hormone (FSH). LH released from the pituitary gland is primarily responsible for the regulation of gonadal steroid production in both sexes, whereas FSH regulates spermatogenesis in males and follicular development in females. GnRH agonists and antagonists have proven effective in the treatment of certain conditions which require inhibition of LH/FSH release. In particular, GnRH-based therapies have proven effective in the treatment of endometriosis, uterine fibroids, polycystic ovarian disease, precocious puberty and several gonadal steroid-dependent neoplasia, most notably cancers of the prostate, breast and ovary. GnRH agonists and antagonists have also been utilized in various assisted fertilization techniques and have been investigated as a potential contraceptive in both men and women. They have also shown possible utility in the treatment of pituitary gonadotrophe adenomas, sleep disorders such as sleep apnea, irritable bowel syndrome, premenstrual syndrome, benign prostatic hyperplasia, hirsutism, as an adjunct to growth hormone therapy in growth hormone deficient children, and in murine models of lupus.

Current GnRH antagonists are GnRH-like decapeptides which are generally administered intravenously or subcutaneously presumably because of negligible oral activity. These have amino acid substitutions usually at positions one, two, three, six and ten.

Non-peptide GnRH antagonists offer the possible advantage of oral adminstration. Non-peptide GnRH antagonists have been described in European Application 0 219 292 and in De, B. et al., J. Med.

Chem., 32, 2036-2038 (1989), in WO 95/28405, WO 95/29900 and EP 0679642 all to Takeda Chemical Industries, Ltd.

-1- WO 98/55116 PCT/US98/11207 Substituted indoles known in the art include those described in the following patents and patent applications. US Patent No. 5,030,640 discloses alpha-heterocyclic ethanol aminoalkyl indoles which are potent B-agonists. US Patent No. 4,544,663 discloses indolamine derivatives which are allegedly useful as male anti-fertility agents.

WO 90/05721 discloses alpha-amino-indole-3-acetic acids useful as anti-diabetic, anti-obesity and anti-atherosclerotic agents. French patent 2,181,559 discloses indole derivatives with sedative, neuroleptic, analgesic, hypotensive, antiserotonin and adrenolytic activity. Belgian patent 879381 discloses 3-aminoalkyl-lH-indole-5-thioamide and carboxamide derivatives as cardiovascular agents used to treat hypertension, Raynaud's disease and migraine. WO 97/21435, WO 97/21703, WO 97/21707 and WO 97/21704 disclose non-peptidyl, indole derivatives as GnRH antagonists.

SUMMARY OF THE INVENTION The present invention relates to compounds which are non-peptide antagonists of GnRH which can be used to treat a variety of sex-hormone related conditions in men and women, to methods for their preparation, and to methods and pharmaceutical compositions containing said compounds for use in mammals.

Because of their activity as antagonists of the hormone GnRH, the compounds of the present invention are useful to treat a variety of sex-hormone related conditions in both men and women.

These conditions include endometriosis, uterine fibroids, polycystic ovarian disease, hirsutism, precocious puberty, gonadal steroiddependent neoplasias such as cancers of the prostate, breast and ovary, gonadotrophe pituitary adenomas, sleep apnea, irritable bowel syndrome, premenstrual syndrome and benign prostatic hypertophy.

They are also useful as an adjunct to treatment of growth hormone deficiency and short stature, and for the treatment of systemic lupus erythematosis. Further, the compounds of the invention may be useful in in vitro fertilization and as contraceptives. The compounds may also be useful in combination with androgens, estrogens, progesterones, antiestrogens and antiprogestogens for the treatment of endometriosis, -2- WO 98/55116 PCT/US98/11207 fibroids and in contraception. They may also be useful in combination with testosterone or other androgens or antiprogestogens in men as a contraceptive. The compounds may also be used in combination with an angiotensin-converting enzyme inhibitor such as Enalapril or Captopril, an angiotensin II-receptor antagonist such as Losartan or a renin inhibitor for the treatment of uterine fibroids. Additionally, the compounds of the invention may also be used in combination with bisphosphonates (bisphosphonic acids) and other agents, such as growth hormone secretagogues, e.g. MK-0677, for the treatment and prevention of disturbances of calcium, phosphate and bone metabolism, in particular, for the prevention of bone loss during therapy with the GnRH antagonist, and in combination with estrogens, progesterones, antiestrogens, antiprogestins and/or androgens for the prevention or treatment of bone loss or hypogonadal symptoms such as hot flashes during therapy with the GnRH antagonist.

Additionally, a compound of the present invention may be co-administered with a 5a-reductase 2 inhibitor, such as finasteride or epristeride; a 5a-reductase 1 inhibitor such as 4,7b-dimethyl-4-aza-5acholestan-3-one, 3 -oxo-4-aza-4,7b-dimethyl-16b-(4-chlorophenoxy)-5aandrostane, and 3-oxo-4-aza-4,7b-dimethyl-1 6 as disclosed in WO 93/23420 and WO 95/11254; dual inhibitors of reductase 1 and 5a-reductase 2 such as 3-oxo-4-aza-17b-(2,5as disclosed in WO 95/07927; antiandrogens such as flutamide, casodex and cyproterone acetate, and alpha-1 blockers such as prazosin, terazosin, doxazosin, tamsulosin, and alfuzosin.

Further, a compound of the present invention may be used in combination with growth hormone, growth hormone releasing hormone or growth hormone secretagogues, to delay puberty in growth hormone deficient children, which will allow them to continue to gain height before fusion of the epiphyses and cessation of growth at puberty.

Further, a compound of the present invention may be used in combination or co-administered with a compound having luteinizing hormone releasing activity such as a peptide or natural t. 35 hormone or analog thereof. Such peptide compounds include -3- W098 5114 WA QR~11~PCTIUS98/1 1207 leuprorelin, gonadorelin,' buserelin, triptorelin, goserelin, nafarelin, histrelin, deslorelin, meterlin and recirelin.

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to compounds of the general formula R2

(CR

9

R

9 a)<N

R

1 mRioa wherein A is B is Ro is R22-[aryl]-R 2 2 or R22- [substituted aryl]-R22-; optionally absent, -0R22-,

-C(=O)R

2 2 -S(O)nR22-, -NR18R2 2 -OC(0)R 2 2 -C(0O)0R 2 2 -OS(O)nR22- or -S(O)nOR22-; hydrogen, CI-C6 alkyl, substituted C1-C6 alkyl, wherein the substituents are as defined below; aryl, substituted aryl, aralkyl or substituted aralkyl, wherein the substituents are as defined for R3, R4 and R1 is 4- WO 98/55116 WO 9855116PCT/US98/1 1207

R

14

R

1 5 R4R 15 Z R 15 R'~V R 1 4

R

13 R14

R

13

R

14 R 1 5

R

13 z

R

(.R

1

N

R

1 5 R 14 R 15 E N

Z

R

1 4

R

1 3

Z'

-1

IN

R

1 3

R

14

R

19

(ZN

N-I

NR19 R13 N N-N. 1

R

13

R

1 5 N 14 0 N N-R11

N=N

0 N N-R 1,

N

R

15

R

1 4 N !R13

R

5

N

R

13

R

13

K-

the nitrogen atoms contained in the R1 heteroaromatic rings may exist either as drawn or, when chemically allowed, in their oxidized O) state; R2 is hydrogen, 01-06 alkyl, substituted 01-06 alkyl, aralkyl, substituted aralkyl, aryl, substituted aryl,; or R2 and A can optionally be taken together to form a ring of 5-7 atoms; R3, R4 and R5 are independently hydrogen, 01-06 alkyl, substituted C 1-06 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, ON, nitro, C 1-03 perfluoroalkyl, Cl-C3 perfluoroalkoxy, aryl, substituted aryl, aralkyl, substituted aralkyl, R11O(CH2)p-, WO 98/55116 PCT/US98/11207 R3 and R4 R6 is R7 is R8 is (CH2)pS(O)nRl 7 or halogen; wherein R17 is hydrogen, C1- C6 alkyl, C1-C3 perfluoroalkyl, aryl or substituted aryl; or taken together form a carbocyclic ring of 3-7 carbon atoms or a heterocyclic ring containing 1-3 heteroatoms selected from N, O and S; hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl, aryl, substituted aryl, C1-C3 perfluoroalkyl, CN, N02, halogen, R160(CH2)p-; hydrogen, C1-C6 alkyl, or substituted C1-C6 alkyl, unless X is hydrogen or halogen, then R7 is absent; hydrogen, C(0)OR9, C(O)NR11R1 2 NR11R1 2 C(O)R11, NR12C(O)Rll, NR12C(O)NRllR1 2 NR12S(0)2Rll, NR12S(0)2NR11R1 2 OC(O)R11, OC(O)NR11R12, OR1l, SOnRll, S(O)nNR11R12,, a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and C1-C6 alkyl or substituted C1-C6 alkyl, unless X is hydrogen or halogen, then R8 is absent; or taken together form a heterocyclic ring containing one or more heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R5; or R7 and R8 0 R7 and R8 taken together form a carbocyclic ring of 3-7 atoms or when m0O; R9 and R9a are independently hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl; aryl or substituted aryl, aralkyl or substituted aralkyl when m O; or 0 R9 and R9a taken together form a carbocyclic ring of 3-7 atoms or when m 0; and Rl0a are independently hydrogen, C1-C6 alkyl, substituted C1- C6 alkyl, aryl, substituted aryl, aralkyl or substituted aralkyl; or -6- WO 98/55116 PCTIUS98/,11207 Ri a d ic t k e t g e h e f r m a ar oc cl c in o 3 7 to s r 0 R9O and R0 he taken together form a carbocyclic ring of 3-7 arbono atoms or a heterocyclic ring containing one or more heteroatoms when m O; or R9 and R2 taken together form a heterocyclic ring containing 3-7 carbon atoms and one or more heteroatoms when m or RIO and R2 taken together form a heterocyclic ring containing 3-7 carbon atoms and one or more heteroatoms; RII and R12 are independently a bond, hydrogen, Ci-C6 alkyl, substituted Cl-C6 alkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, a carbocyclic ring of 3-7 atoms, a substituted carbocyclic ring containing 3-7 atoms, a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R5, Cl-C6-alkyl substituted by a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroato'ms selected from N, 0 or S which can be optionally substituted by R3, R4 and RII and R12 when taken together can form an optionally substituted ring of 3-9 atoms; R13 is hydrogen, OH, NR7R 8 NRi6SO2(Ci-C 6 alkyl), NRi6SO2(substituted Cl-C 6 alkyl), NR16SO2(arYI), NR16SO2(substituted aryl), NR16SO 2 (C i-C3 perfluoroalkyl); SO2NR16(Cl-C 6 alkyl), SO2NR1i(substituted Ci-C 6 alkyl), SO2NR1i(aryl), SO2NR16(substituted aryl), SO2NR16(Ci-C 3 perfluoroalkyl); SO2NRi6(C(O)Ci-C 6 alkyl); SO2NRlG(C(O).

substituted Ci-C 6 alkyl); SO2NR16(C(O)-ayl); SO2NR16(C(O)..substituted aryl); S(O)n(C 1-C6 alkyl); S(O)n(substituted Cl-C 6 alkyl), S(O)n(aryl), S(O)n(substituted aryl), C i-C3 perfluoroalkyl, Cl-C 3 perfluoroalkoxy, Cl-C6 alkoxy, substituted Cl-C6 alkoxy, COOH, halogen, N02 or

CN;

7- WO 98/55116 PCT/US98/11207 R14 and R15 are independently hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, CN, nitro, C1-C3 perfluoroalkyl, C1-C3 perfluoroalkoxy, aryl, substituted aryl, aralkyl, substituted aralkyl, R160(CH 2 R16C(O)O(CH2)p-, R160C(O)(CH2)p-, -(CH2)pS(O)nRl7, (CH2)pC(O) N(R16) 2 or halogen; wherein R17 is hydrogen, C1-C6 alkyl, C1-C3 perfluoroalkyl, aryl or substituted aryl; R16 is hydrogen Cl-C6 alkyl, substituted Cl-C6 alkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, a carbocyclic ring of 3-7 atoms or a substituted carbocyclic ring containing 3-7 atoms; R18 is hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl, C(0)OR16, C(O)N(R16) 2 C(O)R16, S(O)nR16; R19 is either the definition of R13 or R14; R22 is CO-C4 alkyl, substituted C1-C4 alkyl; X is N, 0, S(0)n, (CR11R12)p, a single bond to R8, C2-C6 alkenyl, substituted C2-C6 alkenyl,C2-C6 alkynyl, or substituted C2-C6 alkynyl; when X is 0, S(0)n, or CR11R12 only R8 is possible; Z is 0, S or NR11; m is 0, 1, 2 or 3; n is 0, 1 or 2; p is 0, 1, 2, 3 or 4; and the alkyl, cycloalkyl, alkenyl and alkynyl substituents are selected from C1-C6 alkyl, C3-C7 cycloalkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, hydroxy, oxo, cyano, C1-C6 alkoxy, fluoro, C(O)OR11, aryl C1-C3 alkoxy, substituted aryl C1-C3 alkoxy, and the aryl substituents are as defined for R3, R4 and or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof.

In a preferred embodiment, there are disclosed compounds of formula I wherein -8- WO 98/55116 PCT/US98/11207 A is R22-[phenyl]-R22- or R22- [substituted phenyl]-R22-; B is optionally absent or -C(=O)R22 RO is hydrogen; 5 R1 is

R^

R 13 Rl 5

R

14 the nitrogen atoms contained in the R1 heteroaromatic rings may exist either as drawn or, when chemically allowed, in their oxidized state; R3, R4 and R5 are independently hydrogen, C1-C6 alkyl, substituted C 1-C6 alkyl or halogen; R8 is C(O)NRj1R12; Rll and R12 are independently a bond, hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, a carbocyclic ring of 3-7 atoms, a substituted carbocyclic ring containing 3-7 atoms, a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R5, C1-C6-alkyl substituted by a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R11 and R12 when taken together can form an optionally substituted ring of 3-9 atoms; X is (CR11R12)p; or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof.

Preferred substituents when Rl1 and R12 are taken together include 7 -aza-bicyclo[2.2.1]heptane and 2-aza-bicyclo[2.2.2] octane.

-9- WO 98/55116 PCT/US98/11207 Unless otherwise stated or indicated, the following definitions shall apply throughout the specification and claims.

When any variable aryl, heterocycle, RI, etc.) occurs more than one time in any constituent or in formula I, its definition on each occurrence is independent of its definition at every other occurrence. Also, combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.

The term "alkyl" is intended to include both branched- and straight-chain saturated aliphatic hydrocarbon groups having the specified number of carbon atoms, methyl ethyl propyl, butyl, pentyl, hexyl, heptyl, octyl, nonanyl, decyl, undecyl, dodecyl, and the isomers thereof such as isopropyl isobutyl sec-butyl (s- Bu), tert-butyl isopentane, isohexane, etc.

The term "aryl" includes phenyl and naphthyl. Preferably, aryl is phenyl.

The term "heteroaryl" is intended to include the compounds shown below:

C.

10 WO 98/55116 WO 9855116PCT/US98'1 1207 x% -R 13

R

14

R

15

R

13

N

R

14 R 15

R

13 J~R14

R

1 3

R

15

N

R

14

R

13 4R13

(Z.

R

19 3 N N-R 11 R 13

R

14 0 0 N' 2 N N

(N

Rig

ZIN

R

13

R

15

R

14 R 15 N R 14

N

K -N

R

13

R

1 5 R 1 4

N

N-N.

N

Y/ \JR13

R

1 5 R1 N R

R

15 R1 RR13 iuv j R 13'

R

15 R1 Rs N* R 14 R13II

R

13 KW where Z is 0, S, or NRii.

The term "halogen" or "halo" is intended to include fluorine, chlorine, bromine and iodine.

The term "heterocycle" or "heterocyclic ring" is defined by all non-aromatic, heterocyclic rings of 3-7 atoms containing 1-3 heteroatoms selected from N, 0, and S, such as oxirane, oxetane, tetrahydrofuran, tetrahydropyran, pyrrolidine, piperidine, tetrahydropyridine, tetrahydropyrimidine, tetrahydrothiophene, tetrahydrothiopyran, morpholine, hydantoin, valerolactam, pyrrolidinone, and the like.

As used herein, the term "composition", is intended to encompass a product comprising the specified ingredients in the specified amounts, as well as any product which results, directly or 11 WO 98/55116 PCT/US98/11207 indirectly, from combination of the specified ingredients in the specified amounts.

In addition, it is well known to those skilled in the art that many of the foregoing heterocyclic groups can exist in more than one tautomeric form. It is intended that all such tautomers be included within the ambit of this invention.

The optical isomeric forms, that is mixtures of enantiomers, racemates, or diastereomers as well as individual enantiomers or diastereomers of the instant compound are included.

These individual enantiomers are commonly designated according to the optical rotation they effect by the symbols and and (1) and or combinations thereof. These isomers may also be designated according to their absolute spatial configuration by and which stands for sinister and rectus, respectively.

The individual optical isomers may be prepared using conventional resolution procedures, treatment with an appropriate optically active acid, separating the diastereomers and then recovering the desired isomer. In addition, the individual optical isomers may be prepared by asymmetric synthesis.

Additionally, a given chemical formula or name shall encompass pharmaceutically acceptable addition salts thereof and solvates thereof, such as hydrates.

The compounds of the present invention, while effective themselves, may be formulated and administered in the form of their pharmaceutically acceptable addition salts for purposes of stability, convenience of crystallization, increased solubility and other desirable properties.

The compounds of the present invention may be administered in the form of pharmaceutically acceptable salts. The term "pharmaceutically acceptable salt" is intended to include all acceptable salts. Examples of acid salts are hydrochloric, nitric, sulfuric, phosphoric, formic, acetic, trifluoroacetic, propionic, maleic, succinic, malonic, methane sulfonic and the like which can be used as a dosage form for modifying the solubility or hydrolysis characteristics or S 35 can be used in sustained release or prodrug formulations. Depending 12 WO 98/55116 PCT/US98/11207 on the particular functionality of the compound of the present invention, pharmaceutically acceptable salts of the compounds of this invention include those formed from cations such as sodium, potassium, aluminum, calcium, lithium, magnesium, zinc, and from bases such as ammonia, ethylenediamine, N-methyl-glutamine, lysine, arginine, ornithine, choline, N,N'-dibenzylethylenediamine, chloroprocaine, diethanolamine, procaine, N-benzylphenethylamine, diethylamine, piperazine, tris(hydroxymethyl)aminomethane, and tetramethylammonium hydroxide. These salts may be prepared by standard procedures, e.g. by reacting a free acid with a suitable organic or inorganic base, or alternatively by reacting a free base with a suitable organic or inorganic acid.

Also, in the case of an acid (-COOH) or alcohol group being present, pharmaceutically acceptable esters can be employed, e.g.

methyl, ethyl, butyl, acetate, maleate, pivaloyloxymethyl, and the like, and those esters known in the art for modifying solubility or hydrolysis characteristics for use as sustained release or prodrug formulations.

The compounds of the present invention may have chiral centers other than those centers whose stereochemistry is depicted in formula I, and therefore may occur as racemates, racemic mixtures and as individual enantiomers or diastereomers, with all such isomeric forms being included in the present invention as well as mixtures thereof. Furthermore, some of the crystalline forms for compounds of the present invention may exist as polymorphs and as such are intended to be included in the present invention. In addition, some of the compounds of the instant invention may form solvates with water or common organic solvents. Such solvates are encompassed within the scope of this invention.

The compounds of the invention are prepared by the following reaction schemes. All substituents are as defined above unless indicated otherwise.

Scheme A 13 WO 98/55116 WO 9855116PCTIUS98/I 1207

NH

2 ROa 0

THF

pyridine*HBraBr 2 THE/C HCI 3

B(OH)

2

R

4 Na 2

CO

3

LICI

Pd(PPh 3 4 toluene/EtOH R~8 0 Ri'Xr R 9 a R 9 R7>- I I Rj 0 RioaO N N Br 3

H

2

NNH

2 TH F/EtOH 14 WO 98/55116 PCT/US98/11207 Reaction Scheme A As shown in reaction Scheme A, treatment of tryptamine with N-carboxyphthalimide in an inert organic solvent such as tetrahydrofuran at a temperature of 20-65°C, preferably 65°C, for a period of 12-48 hours gives the corresponding N-phthalimidotryptamine derivative The N-phthalimidotryptamine could be further modified by treatment with a brominating agent such as pyridinium hydrobromide perbromide, pyrrolidone hydrotribromide, or the like in an inert organic solvent such as tetrahydrofuran, methylene chloride, chloroform, or mixtures thereof at 0-25°C for a period of 30 minutes to 4 hours to provide the 2 -bromotryptamine Bromide may be reacted with an arylboronic acid (prepared essentially as described in Gronowitz, Hornfeldt, Yang, Chem. Scr. 1986, 26, 311- 314.) with palladium catalysis, a weak base such as aqueous sodium carbonate or the like, and a chloride source such as lithium chloride in an inert solvent like toluene, benzene, ethanol, propanol or mixtures thereof at a temperature of 25 0 -100 0 C, preferably 80°C, for a period of 1-6 hours to give the 2 -aryltryptamine derivative Finally, the phthalimido group may be removed by treatment of with aqueous hydrazine in an inert solvent such as methanol or ethanol at a temperature of 0 0 -25°C for a period of 4-24 hours to give tryptamine 15 WO 98/55116 PCT/US98/11207 Scheme B HO 0 6 X Ra R 9 EDC, HOBt

R

7 NHR 2 NMM, CH 2

CI

2 6 I IR, Rioa or N X (B)

R

O R3

R

5

R

4 8 triethylamine CH2CI2

R

8 X

R

9a R R 2 R7- N 6 1R RioaO N I

R

o R3 7.

R

5

R

4 Reaction Scheme B As shown in reaction Scheme B, the 2 -aryltryptamine may be condensed with a carboxylic acid of type using the coupling reagent 1-( 3 -dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC), 1,3-dicyclohexylcarbodiimide (DCC) or the like with or without 1-hydroxybenzotriazole (HOBt) and a tertiary amine base such as Nmethylmorpholine (NMM), triethylamine or the like in an inert organic solvent such as methylene chloride, chloroform, dimethylformamide, or mixtures thereof at or near room temperature for a period of 3-24 hours to provide the corresponding amide derivative Alternatively, 2aryltryptamine can be treated with an active ester or acid chloride of type in an inert organic solvent such as methylene chloride, 16 WO 98/55116 PCT/US98/11207 chloroform, tetrahydrofuran, diethyl ether, or the like and a tertiary amine base such as triethylamine, diisopropylethylamine, pyridine or the like at a temperature of 0 0 -25 0 C for 30 minutes to 4 hours to give Scheme C

R

8 I

R

7 x X IRga R 9 1 2

R

5

R

4

BH

3

THF

or LiAIH 4

THF

Reaction Scheme C As shown in reaction Scheme C, the amide carbonyl of (7) can be reduced by treatment with borane, lithium aluminum hydride, or equivalent hydride sources in an inert organic solvent such as tetrahydrofuran, diethyl ether, 1,4-dioxane or the like at 25°-100°C preferably 65 0 C, for a period of 1-8 hours to give the corresponding amine compound 17 WO 98/55116 PCT/US98/11207 Scheme D 0 O

II

(R

2 TFA, 3 A sieves NaCNBH 3 MeOH or Ri TFA, 3 A sieves NaCNBH 3 MeOH

R

4 11

R

o

R

5

R

4 Reaction Scheme D As shown in reaction Scheme D, the 2-aryltryptamine (23 or can be modified by treatment with an aldehyde or ketone of type (10a or in the presence of a weak acid such as trifluoroacetic acid (TFA), acetic acid or the like, with or without a dessicant such as 3A molecular sieves or magnesium sulfate, and a hydride source such as sodium borohydride or sodium cyanoborohydride, in an inert organic solvent such as methanol, ethanol, isopropanol, tetrahydrofuran, dichloromethane, chloroform, or mixtures thereof at a temperature of 0 0 18 WO 98/55116 PCT/US98/11207 for a period of 1-12 hours to give the corresponding secondary or tertiary amine derivative (11).

Scheme E 0 Sl R 9 a *HCI R /4 R" 13

NHNH

2

R

5

R

10 Rloa 1D X R 9 a R 9 n-butanol R7

NH

2 R6 -or- R6 R, Roa

N

R X R 8 R R R

H

12 R 5

R

4

R

10 RiOa

R

5 14 methanol/t-butanol Reaction Scheme E As shown in reaction Scheme E, treatment of an arylhydrazine or arylhydrazine hydrochloride (12) with an arylcyclopropylketone of type (13) in a polar organic solvent such as methanol, ethanol, n-propanol, isopropanol, n-butanol, t-butanol, preferably n-butanol, at a temperature of 70 0 -120°C for a period of 8-24 hours gives 2 -aryltryptamine Alternatively, when an arylhydrazine or arylhydrazine hydrochloride (12) is treated with an arylbutyl ketone of type (14) containing a leaving group (chloride, bromide, iodide, O-methansulfonate, O-trifluoromethansulfonate, or the like) at the 4-position in a polar solvent such as methanol, ethanol, n-propanol, isopropanol, n-butanol, t-butanol, or mixtures thereof at room temperature for a period of 30 minutes to 2 hours followed by heating to a temperature of 65 0 -100 0 C for 4-24 hours, 2-aryltryptamine is produced.

19 WO 98/55116 PCT/US98/11207 Scheme F

R

R4T Pd(PPh 3 4 CuBr, Et 3

N

R

3 R 4

NH

2 9 v^ R6- I PdCl 2

CH

3

CN

16 R7' x R 8

R

5

R

4 3 Reaction Scheme F As shown in reaction Scheme F, iodoanilines of type may be reacted with aryl acetylenes, an appropriate palladium (0) catalyst such as tetrakis(triphenylphosphine)palladium, a copper (I) halide such as cuprous bromide in an inert organic solvent such as triethylamine at a temperature of 50°-88°C for a period of 30 minutes to hours to provide the diarylacetylene Acetylene (16) may be further modified by treatment with a palladium (II) catalyst such as palladium (II) chloride or palladium (II) acetate in an inert organic solvent such as acetonitrile at a temperature of 50°- 82 0 C for a period of 30 minutes to 6 hours to give 2-arylindole (17).

20 WO 98/55116 PCT/US98/11207 Scheme G 0 iClh Cor dichloroethane- R8 0 R7 C1

R-A

Ro R 18 R o

R

3

R

5 R 4 R2 19 THF19

THF

R

7 U R2 k 0 R3

BH

3

THF

R LiAor-

R

5

R

4 LiAIH 4

THF

R2 N- R, Rs

R

4 Reaction Scheme G As shown in reaction Scheme G, treatment of 2-arylindole (17) with oxalyl chloride neat or in an inert organic solvent such as methylene chloride, chloroform, dichloroethane, tetrahydrofuran or the like at a temperature of 25 0 -65 0 C for a period of 3-24 hours gives the acylchloride adduct The crude product (18) may be reacted with an amine of type (19) in an inert organic solvent such as diethylether, tetrahydrofuran, methylene chloride, chloroform or the like and an amine base such as triethylamine, diisopropylethylamine or pyridine at a temperature of 0°C-25 0 C for a period of 30 minutes to 4 hours to provide the amide derivative Amide (20) may be further modified by treatment with a reducing agent such as borane or lithium aluminum 21 WO 98/55116 PCT/US98/ 1207 hydride in an inert organic solvent such as tetrahydrofuran at elevated temperatures, preferably reflux, for a period of 1-5 hours to give compound (21).

Scheme H R8 Ar X Rga R 9 r R 7 R6 I RI R ioaR

N

H -R 3 22a

R

5

R

4 Pd(OH) 2

/C

Do- 22b

H

R

1 IU Reaction Scheme H As shown in reaction Scheme H, N-benzyl derivatives of type (22a) or N-benzyloxycarbonyl derivatives of type (22b) may be reduced to provide the secondary amine analogs by treatment with hydrogen (1 atm) and an appropriate catalyst such as palladium on carbon, 22 WO 98/55116 PCT/US98/ 1207 palladium hydroxide on carbon, or the like in an inert organic solvent such as tetrahydrofuran, ethyl acetate, methanol, ethanol, or mixtures thereof to which has been added a weak acid such as 30% aqueous acetic acid for a period of 10 minutes to 3 hours or until the aryl group has been removed to give the secondary amine.

Scheme I

O

2 N R 9 a R 9 R2 R6- IR Rioa H 2 Raney® Ni N lo a ethanol 24

R

5

R

4

H

2 N R 9 a R 9 R2 N- R R6 R

N

R o /\R3

R

5

R

4 Reaction Scheme I As shown in reaction Scheme I, treatment of a nitroindole of type (24) with hydrogen (1 atm) and an appropriate catalyst such as Raney® Nickel in an inert organic solvent such as ethanol, methanol, or the like at room temperature for a period of 2-12 hours gives the corresponding aminoindole derivative 23 WO 98/55116 PCT/US98/11207 Scheme J R 7

R

HX R 9 a R 9 R 2 N- R6 I I R 1 ioa R 0 -R 3

R

11 CI R 11

COOH,

;or EDC, HOBt,

R

5

R

4 diisopropyl- NMM, CH 2 Cl 2 ethyl amine R7 CH 2 C1 2 X R 9 a R 9 2 O 1 R6- I I R, Roa

N

R0

'R

3 26 R4 Reaction Scheme J As shown in reaction Scheme J, amino- or hydroxyindole may be modified by acylation under a variety of conditions. For example, treatment of (25) with an acid chloride, acid anhydride or active ester and an amine base such as triethylamine, diisopropylethylamine, pyridine, or the like in an inert organic solvent such as methylene chloride, chloroform, tetrahydrofuran, or mixtures thereof at 0 C to room temperature for a period of 1 to 12 hours gives the corresponding amide or ester derivatives Alternatively (25) may be coupled with a carboxylic acid by one of the many dehydrating agents commonly employed. For instance, treatment of aminoindole (25) with an appropriate carboxylic acid and 1-(3-dimethylaminopropyl)-3ethylcarbodiimide hydrochloride (EDC), 1,3-dicyclohexylcarbodiimide (DCC) or the like with or without 1-hydroxybenzotriazole (HOBt) and a tertiary amine base such as N-methylmorpholine (NMM), triethylamine or the like in an inert organic solvent such as methylene chloride, 24 WO 98/55116 PCT/US98/11207 chloroform, dimethylformamide, or mixtures thereof at or near room temperature for a period of 3-24 hours provides the corresponding amide or ester derivative (26).

Scheme K R.HX R9a

R

9 R2( B)-R R R 4 0 R11 N CI 27a R12 R 1 1 27b diisopropyl- or diisopropyl- or ethyl amine ethyl amine

CH

2 C0 2 CH 2

CI

2 i. triphosgene pyridine ii. R12R11NH

O.

R 2 1

R

5

R

4 Reaction Scheme K As shown in reaction Scheme K, urea or carbamate derivatives of (25) can be prepared by treatment with a carbamoyl chloride of type (27a), or alternatively with an isocyanate reagent of type (27b), and an amine base such as pyridine, triethylamine, diisopropylethylamine, N-methylmorpholine or the like in an inert organic solvent such as methylene chloride, chloroform, dimethylformamide, tetrahydrofuran or mixtures thereof at a temperature of 0°-65°C for a period of 1-72 hours to give Compound (25) can also be modified by treatment with a bis(electrophilic) reagent such as phosgene, triphosgene, 1,1'-carbonyldiimidazole, N,N'-disuccinimidyl carbonate, or the like with or without the addition of an amine base such as pyridine, triethylamine, diisopropylethylamine, N-methylmorpholine 25 WO 98/55116 PCT/US98/11207 in an inert solvent such as methylene chloride, chloroform, or the like at a temperature of -20 0 -0 0 C for a period of 20 minutes to 2 hours. After this time, the reaction mixture is treated with an appropriate mono- or disubstituted amine at -20° to 25°C for a period of 1-5 hours to give the urea or carbamate analog (28).

Scheme L

,R

9 I2

R

1

R

5

R

4 R7

R

11 ,N Rga RR2 oS a N- R, S,0 0 2 R Rio R 29 _N 10

R

1 1 'Cl

NR

diisopropyl- 31 R R ethyl amine R5 R4

CH

2

CI

2 0,,0 R12,N S'-Cl R 11 7 N N R 9 a\ 9 R2

R

1 2" S a 1 R, Ra R 6

R

5

R

32 R5 R4 diisopropylethyl amine

CH

2

CI

2 Reaction Scheme L As shown in reaction Scheme L, amine (25) can be modified by treatment with an appropriate sulfonyl chloride of type (29) or sulfamyl chloride of type (30) with an amine base such as pyridine, 26 WO 98/55116 PCT/US98/11207 triethylamine, diisopropylethylamine, N-methylmorpholine in an inert solvent such as methylene chloride, chloroform, dichloroethane or the like at a temperature of -20 0 -25°C for a period of 20 minutes to 2 hours to give the corresponding N-sulfonamide (31) or N-sulfamylamide (32) derivatives, respectively.

Scheme M R8 R X Rga R 9 R2 O R7 _NH I R6 R R 34

NN

R -R MeOH 33 0, 3

R

5

R

4 R8 X R 9

R

9 R2 OH N R R- I Ri 2

SR

5 R 4 0 l 3 Rs R4 Reaction Scheme M As shown in reaction Scheme M, the 2-aryltryptamine (33) can be modified by treatment with an epoxide such as (34) in an inert organic solvent such as methanol, ethanol, isopropanol, butanol, tertbutanol, or mixtures thereof at a temperature of 65 0 -110 0 C for a period of 8-20 hours to give the corresponding amino-alcohol derivative 27 WO 98/55116 PCT/US98/11207 Scheme N

O

HO -(R 12 RC) R 9 a R 9 R2 p(R'2R9Ca N-A)-(B)-Rj

R

6 10 _Ra

R

12

R

11

NH,

Ro R 3 PyBOP 36 R 5 R4 CH 2

CI

2

/THF

S(R12RC) R R23

N

37

R

5 R 4 Reaction Scheme N As shown in reaction Scheme N, amide derivatives of an acid-containing indole derivative such as (36) can be prepared by treatment with an appropriate amine (R12R11 NH) and a suitable coupling agent such as benzotriazol-l-yloxy-tris(pyrrolidino) phosphonium hexafluorophosphate (PyBOP), benzotriazol-1-yloxytris(dimethylamino)phosphonium hexafluorophosphate (BOP), 1-(3dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC), 1,3dicyclohexylcarbodiimide (DCC) or the like with or without 1hydroxybenzotriazole (HOBt) and a tertiary amine base such as Nmethylmorpholine (NMM), triethylamine or the like in an inert organic solvent such as methylene chloride, chloroform, tetrahydrofuran, dimethylformamide, or mixtures thereof at or near room temperature for a period of 3 hours to 7 days provides the corresponding amide derivative (37).

28- WO 98/55116 PCT/US98/1 1207 Scheme 0 R, O

R

5 R 4

R

10

H

(CRqR 9 N- I'

R

1 Oa 2,4-dinitrobenzene -sulfonyl chloride 2,4,6-collidine

CH

2 01 2 -O N02

(B)-R

1 39 N02 PPh 3

DEAD

NO

2 benzene 2. n-propylamine

R

5

R

4 Rj 0

H

(CRq 9 N- R 1 mRoa Reaction cheme 0 .As shown in reaction Scheme 0, the tryptamine can be modified by reaction with an arylsufonyl chloride such as 2 -nitrobenzenesulfonyl chloride, 4 -nitrobenzenesulfonyl chloride or 2 4 -dinitrobenzenesulfonyl chloride and a hindered amine base such as 2 ,4,6-collidine, 2 ,6-lutidjne or the like in an inert organic solvent such as methylene chloride to provide the corresponding sulfonamide 38. Sulfonamides such as 38 can be further modified by reaction with 29 WO 98/55116 PCT/US98/11207 an alcohol of type 39 in the presence of triphenylphosphine and an activating agent such as diethyl azodicarboxylate (DEAD), diisopropyl azodicaboxylate or the like in an inert organic solvent such as benzene, toluene, tetrahydrofuran or mixtures thereof to give the dialkylsulfonamide adduct. Removal of the sulfonyl group is accomplished by treatment with a nucleophilic amine such as n-propylamine or the like in an inert organic solvent such as methylene chloride to give secondary amines of type 23.

The compounds of the present invention are useful in the treatment of various sex-hormone related conditions in men and women. This utility is manifested in their ability to act as antagonists of the neuropeptide hormone GnRH as demonstrated by activity in the following in vitro assays.

Human GnRH receptor binding assay Crude membranes prepared from CHO cells expressing human GnRH receptors were the sources for GnRH receptor. 1 2 5 ]Buserelin (a peptidyl GnRH analog) was used as the radiolabelled ligand. The binding activity was determined as an IC50 which is the antagonist concentration required to inhibit the specific binding of 12 5 I]buserelin to GnRH receptors by Rat pituitary GnRH receptor binding assay: Crude plasma membranes prepared from rat pituitary tissues were incubated in a Tris.HCl buffer (50 mM, PH. 7.5) containing bovine serum albumin [I-125]D-t-Bu-Ser6-Pro9-ethyl amide-GnRH, and the desired concentration of a test compound. The assay mixtures were incubated at 4°C for 90-120 minutes followed by rapid filtration and repeated washings through a glass fiber filter. The radioactivity of membrane bound radioligands was determined in a gamma-counter.

From this data, the IC50 of the radioligand binding to GnRH receptors in the presence of test compound was estimated.

30 WO 98/55116 PCT/US98/11207 Inhibition of LH release assay: Active compounds from the GnRH receptor binding assay were further evaluated with an in vitro LH release assay to confirm their antagonist activity (blocking GnRH-induced LH release).

1. Sample Preparation The compounds to be assayed were dissolved and diluted in DMSO. The final concentration of DMSO in the incubation medium was 2. Assay The Wistar male rats (150-200 grams) were obtained from Charles River Laboratories (Wilmington, MA). Rats were maintained at a constant temperature (25 0 C) on a 12-hr light, 12-hr dark cycle. Rat chow and water were available ad libitum. The animals were sacrificed by decapitation and pituitary glands were aseptically removed and placed in Hank's Balanced Salt Solution (HBSS) in a 50-mL polypropylene centrifuge tube. The collection tube was centrifuged for 5 min at 250 x g, and HBSS was removed by aspiration. Pituitary glands were transferred to a disposable petri plate and minced with a scalpel. The minced tissue was then transferred to a 50-mL disposable centrifuge tube by suspending the tissue fragments in three successive 10-mL aliquots of HBSS containing 0.2% collagenase and 0.2% hyaluronidase. The cell dispersion was carried out in a water bath at 37 0 C with gentle stirring for 30 min. At the end of the incubation, the cells were aspirated 20 to times with a pipet and the undigested pituitary fragments were allowed to settle for 3 to 5 min. The suspended cells were removed by aspiration, and then subjected to a 1200 x g centrifugation for 5 min. The cells were then resuspended in Culture medium. The undigested pituitary fragments were treated with 30 mL aliquots of the digestion enzymes as above for a total of 3 digestions with the collagenase/hyaluronidase mixture. The resulting cell suspensions were pooled, counted and diluted to a concentration of 3 x 105 cells/ml, and 1.0 ml of this suspension was placed in each well of a 24-well tray (Costar, Cambridge, MA). Cells were maintained in a humidified 5% C02-95% air 31 WO 98/55116 PCT/US98/11207 atmosphere at 37 0 C for 3 to 4 days. The culture medium consisted of DMEM containing 0.37% NaHCO 3 10% horse serum, 2.5% fetal bovine serum, 1% non-essential amino acids, 1% glutamine, and 0.1% gentamycin. On the day of an experiment, cells were washed three times 1 1/2 hrs prior to and two more times immediately before the start of the experiment with DMEM containing 0.37% NaHCO3, 10% horse serum, 2.5% fetal bovine serum, 1% non-essential amino acids(100X), 1% glutamine(100X), 1% Penicillin/Streptomycin(10,000 Units of Penicillin and 10,000 micrograms of Streptomycin per ml), and 25 mM HEPES, pH 7.4. LH release was initiated by adding 1 ml of fresh medium containing test compounds in the presence of 2 nM GnRH to each well in duplicate. Incubation was carried out at 37 0 C for 3 hr.

After incubation, medium was removed and centrifuged at 2,000 x g for min to remove any cellular material. The supernatant fluid was removed and assayed for LH content with a double antibody

RIA

procedure using materials obtained from Dr. A. F. Parlow (Harbor- UCLA Medical Center, Torrance,

CA).

The compounds of formula I are useful in a number of areas affected by GnRH. They may be useful in sex-hormone related conditions, sex-hormone dependent cancers, benign prostatic hypertrophy or myoma of the uterus. Sex-hormone dependent cancers which may benefit from the administration of the compounds of this invention include prostatic cancer, uterine cancer, breast cancer and pituitary gonadotrophe adenomas. Other sex-hormone dependent conditions which may benefit from the administration of the compounds of this invention include endometriosis, polycystic ovarian disease, uterine fibroids and precocious puberty. The compounds may also be used in combination with an angiotensin-converting enzyme inhibitor such as Enalapril or Captopril, an angiotensin II-receptor antagonist such as Losartan or a renin inhibitor for the treatment of uterine fibroids.

The compounds of the invention may also be useful for controlling pregnancy, as a contraceptive in both men and women, for in vitro fertilization, in the treatment of premenstrual syndrome, in the treatment of lupus erythematosis, in the treatment of hirsutism, in the 32 WO 98/55116 PCT/US98/11207 treatment of irritable bowel syndrome and for the treatment of sleep disorders such as sleep apnea.

A further use of the compounds of this invention is as an adjunct to growth hormone therapy in growth hormone deficient children. The compounds may be administered with growth hormone or a compound which increases the endogenous production or release of growth hormone. Certain compounds have been developed which stimulate the release of endogenous growth hormone. Peptides which are known to stimulate the release of endogenous growth hormone include growth hormone releasing hormone, the growth hormone releasing peptides GHRP-6 and GHRP-1 (described in U.S. Patent No.

4,411,890, PCT Patent Pub. No. WO 89/07110, and PCT Patent Pub. No.

WO 89/07111) and GHRP-2 (described in PCT Patent Pub. No.

WO 93/04081), as well as hexarelin Endocrinol Invest., 15(Suppl 4), 45 (1992)). Other compounds which stimulate the release of endogenous growth hormone are disclosed, for example, in the following: U.S.

Patent No. 3,239,345; U.S. Patent No. 4,036,979; U.S. Patent No. 4,411,890; U.S. Patent No. 5,206,235; U.S. Patent No. 5,283,241; U.S. Patent No.

5,284,841; U.S. Patent No. 5,310,737; U.S. Patent No. 5,317,017; U.S.

Patent No. 5,374,721; U.S. Patent No. 5,430,144; U.S. Patent No. 5,434,261; U.S. Patent No. 5,438,136; EPO Patent Pub. No. 0,144,230; EPO Patent Pub. No. 0,513,974; PCT Patent Pub. No. WO 94/07486; PCT Patent Pub.

No. WO 94/08583; PCT Patent Pub. No. WO 94/11012; PCT Patent Pub. No.

WO 94/13696; PCT Patent Pub. No. WO 94/19367; PCT Patent Pub. No.

WO 95/03289; PCT Patent Pub. No. WO 95/03290; PCT Patent Pub. No.

WO 95/09633; PCT Patent Pub. No. WO 95/11029; PCT Patent Pub. No.

WO 95/12598; PCT Patent Pub. No. WO 95/13069; PCT Patent Pub. No.

WO 95/14666; PCT Patent Pub. No. WO 95/16675; PCT Patent Pub. No.

WO 95/16692; PCT Patent Pub. No. WO 95/17422; PCT Patent Pub. No.

WO 95/17423; Science, 260., 1640-1643 (June 11, 1993); Ann. Rep. Med.

Chem., 28, 177-186 (1993); Bioorg. Med. Chem. Ltrs., 4(22), 2709-2714 (1994); and Proc. Natl. Acad. Sci. USA 92, 7001-7005 (July 1995).

Representative preferred growth hormone secretagoues employed in the present combination include the following: 33 WO 98/55116 PCT/US98/1 1207 1) N- 1,2-Dihydro- l-methanesulfonylspiro[3H-indole-3, 4 1piperidin l'-yl)carbonyl] lH-indol-3-yl)ethylj 2 -amino-2-inethyl.

propanamide; 2) N- ,2-Dihydro- l-methanecarbonylspiro [3H-indole-3,4'piperidin] -l'-yl)carbonyll 1H-indol-3-yl)ethyl] 2 -amino-2-methylpropanamide; 3) N- ,2-Dihydro- l-benzenesulfonylspiro [3H-indole-3 piperidin] -1'-yl)carbonylj 1H-indol-3-yl)ethyl] 2 -amino-2-xnethyl.

propanamide; 4) N- ,4-Dihydro-spiro [2H- l-benzopyran-2,4'.piperiin]l'-yl) carbonyll lH-indolb3-yl)ethyl] 2 -amino-2-methylpropanamide; N- [(2-Acetyl-1 2 3 4 -tetrahydrospiro [isoquinolin-4,4'-pipeiin]- 1 '-yl)carbonyl] -2-(indol-3-yl)ethyl] 2 -amino-2-methyl..propanamide; 6) N- 1,2-Dihydro- l-methanesulfonylspiro [3H-indole-3,4'piperidinl'-yl)carbonyl] 2 -(phenylmethyloxy)ethyl] -2-amino-2methyipropanamide; 7) N- ,2-Dihydro- l-methanesulfonylspiro[3Hindole3, 4 piperidin] -1'-yl)carbonyl] 2 -(phenylmethyloxy)ethyll -2-amino-2methyipropanamide methanesulfonate; 8) N- 2 -Dihydro-1-methanesulfonylspiro [3H-indole-3,4'piperidin] -1'-yl)carbonyll 6 -difluorophenylmethyloxy)ethy1I -2amino- 2 -xnethylpropanamide; 9) N- 1,2-Dihydro- l-methanesulfonyl-5fluorospiro [3H-indole-3,4'piperidin] -1'-yl)carbonyl] 2 -(phenylmethyloxy)ethyll -2-amino-2methylpropanamide; 34 WO 98/55116 WO 9855116PCTIUS98/1 1207 N- ,2-Dihydro- 1-methanesulfonyispiro [3H-indole-3,4'piperidin l'-yl) carbonyl] -2-(phenylmethylthio)ethyl] -2-amino-2methyipropanamide; 11) N- [(1,2-Dihydro- 1-methanesulfonyispiro [3H-indole-3 piperidin] -1'-yl)carbonyl] -3-phenyipropyl] -2-amino-2-methylpropanamide; 12) N- ,2-Dihydro- 1-methanesulfonyispiro [3H-indole-3,4'piperidin] -1 -yl)carbonyl] -3-.cyclohexyipropyll -2-amino-2-methylpropanamide; 13) N- 1,2-Dihydro- l-methanesulfonylspiro [3H-indole-3,4'piperidin) -1'-yl)carbonyl] -4-phenylbutyl] -2-amino-2-methylpropanamide; 14) N- ,2-Dihydro- 1-methanesulfonyispiro [3H-indole-3,4'piperidin] -1'-yl)carbonyl] -2-(5-fluoro- 1H-indol-3-yl)ethyll -2-amino-2methyipropanamide; 15) N- ,2-Dihiydro- l-methanesulfonyl-5-fluorospiro [3H-indole- 3,4'-piperidin]l '-yl)carbonyll -2-(5-fluoro- 1H-indol-3-yl)ethyl] -2-amino-2methyipropanamide; 16) N- 2 -Dihydro-l-(2-ethoxycarbonyl)methylsulfonylspiro-[3Hindole-3 ,4'-piperidin] '-yb~carbonyl] 1H-indol-3-yl)ethyl] -2-amino-2methyipropanamide; 17) N- 1(1 ,2-Dihydro-1 ,1-dioxospiro [3H-benzothiophene-3,4'piperidin] -1'-yl)carbonyl] 2 -(phenylmethyloxy)ethyl] -2-amino-2methylpropanamide; and pharmaceutically acceptable salts thereof.

The compounds of the invention may also be used in combination with bisphosphonates (bisphosphonic acids) and other agents, such as growth hormone secretagogues, e.g. NM-0677, for the 35 WO 98/55116 PCT/US98/11207 treatment and the prevention of disturbances of calcium, phosphate and bone metabolism, in particular, for the prevention of bone loss during therapy with the GnRH antagonist, and in combination with estrogens, progesterones and or androgens for the prevention or treatment of bone loss or hypogonadal symptoms such as hot flashes during therapy with the GnRH antagonist.

Bisphosphonates (bisphosphonic acids) are known to inhibit bone resorption and are useful for the treatment of bone lithiasis as disclosed in U.S. Patent 4,621,077 to Rosini, et al.

The literature discloses a variety of bisphosphonic acids which are useful in the treatment and prevention of diseases involving bone resorption. Representative examples may be found in the following: U.S. Patent No. 3,251,907; U.S. Patent No. 3,422,137; U.S.

Patent No. 3,584,125; U.S. Patent No. 3,940,436; U.S. Patent No. 3,944,599; U.S. Patent No. 3,962,432; U.S. Patent No. 4,054,598; U.S. Patent No.

4,267,108; U.S. Patent No. 4,327,039; U.S. Patent No. 4,407,761; U.S.

Patent No. 4,578,376; U.S. Patent No. 4,621,077; U.S. Patent No. 4,624,947; U.S. Patent No. 4,746,654; U.S. Patent No. 4,761,406; U.S. Patent No.

4,922,007; U.S. Patent No. 4,942,157; U.S. Patent No. 5,227,506; U.S.

Patent No. 5,270,365; EPO Patent Pub. No. 0,252,504; and J. Org. Chem., 36, 3843 (1971).

The preparation of bisphosphonic acids and halobisphosphonic acids is well known in the art. Representative examples may be found in the above mentioned references which disclose the compounds as being useful for the treatment of disturbances of calcium or phosphate metabolism, in particular, as inhibitors of bone resorption.

Preferred bisphosphonates are selected from the group of the following compounds: alendronic acid, etidrononic acid, clodronic acid, pamidronic acid, tiludronic acid, risedronic acid, 6-amino-ihydroxy-hexylidene-bisphosphonic acid, and 1-hydroxy- 3 (methylpentylamino)-propylidene-bisphosphonic acid; or any pharmaceutically acceptable salt thereof. A particularly preferred bisphosphonate is alendronic acid (alendronate), or a pharmaceutically acceptable salt thereof. An especially preferred bisphosphonate is alendronate sodium, including alendronate sodium 36 WO 98/55116 PCT/US98/11207 trihydrate. Alendronate sodium has received regulatory approval for marketing in the United States under the trademark FOSAMAX®.

Additionally, a compound of the present invention may be co-administered with a 5a-reductase 2 inhibitor, such as finasteride or epristeride; a 5a-reductase 1 inhibitor such as 4,7b-dimethyl-4-aza-5acholestan-3-one, 3-oxo-4-aza-4,7b-dimethyl-16b-(4-chlorophenoxy)-5aandrostane, and 3-oxo-4-aza-4,7b-dimethyl-1 6 as disclosed in WO 93/23420 and WO 95/11254; dual inhibitors of reductase 1 and 5a-reductase 2 such as 3-oxo-4-aza-17b-(2,5trifluoromethylphenyl-carbamoyl)-5a-androstane as disclosed in WO 95/07927; antiandrogens such as flutamide, casodex and cyproterone acetate, and alpha-1 blockers such as prazosin, terazosin, doxazosin, tamsulosin, and alfuzosin.

For combination treatment with more than one active agent, where the active agents are in separate dosage formulations, the active agents may be administered separately or in conjunction. In addition, the administration of one element may be prior to, concurrent to, or subsequent to the administration of the other agent.

The pharmaceutical compositions containing the active ingredient may be in a form suitable for oral use, for example, as tablets, troches, lozenges, aqueous or oily suspensions, dispersible powders or granules, emulsions, hard or soft capsules, or syrups or elixirs.

Compositions intended for oral use may be prepared according to any method known to the art for the manufacture of pharmaceutical compositions and such compositions may contain one or more agents selected from the group consisting of sweetening agents, flavoring agents, coloring agents and preserving agents in order to provide pharmaceutically elegant and palatable preparations. Tablets contain the active ingredient in admixture with non-toxic pharmaceutically acceptable excipients which are suitable for the manufacture of tablets.

37 WO 98/55116 PCT/US98/11207 These excipients may be for example, inert diluents, such as calcium carbonate, sodium carbonate, lactose, calcium phosphate or sodium phosphate; granulating and disintegrating agents, for example, corn starch, or alginic acid; binding agents, for example starch, gelatin or acacia, and lubricating agents, for example, magnesium stearate, stearic acid or talc. The tablets may be uncoated or they may be coated by known techniques to delay disintegration and absorption in the gastrointestinal tract and thereby provide a sustained action over a longer period. For example, a time delay material such as glyceryl monostearate or glyceryl distearate may be employed. They may also be coated by the technique described in the U.S. Patent 4,256,108; 4,166,452; and 4,265,874 to form osmotic therapeutic tablets for control release.

Formulations for oral use may also be presented as hard gelatin capsules wherein the active ingredient is mixed with an inert solid diluent, for example, calcium carbonate, calcium phosphate or kaolin, or as soft gelatin capsules wherein the active ingredient is mixed with water or an oil medium, for example peanut oil, liquid paraffin, or olive oil.

Aqueous suspensions contain the active material in admixture with excipients suitable for the manufacture of aqueous suspensions. Such excipients are suspending agents, for example sodium carboxymethylcellulose, methylcellulose, hydroxypropylmethylcellulose, sodium alginate, polyvinyl-pyrrolidone, gum tragacanth and gum acacia; dispersing or wetting agents may be a naturally-occurring phosphatide, for example lecithin, or condensation products of an alkylene oxide with fatty acids, for example polyoxyethylene stearate, or condensation products of ethylene oxide with long chain aliphatic alcohols, for example heptadecaethylene-oxycetanol, or condensation products of ethylene oxide with partial esters derived from fatty acids and a hexitol such as polyoxyethylene sorbitol monooleate, or condensation products of ethylene oxide with partial esters derived from fatty acids and hexitol anhydrides, for example polyethylene sorbitan monooleate. The aqueous suspensions may also contain one or more preservatives, for example ethyl, or n-propyl, p-hydroxybenzoate, one or 38 WO 98/55116 PCTIUS98/11207 more coloring agents, one or more flavoring agents, and one or more sweetening agents, such as sucrose, saccharin or aspartame.

Oily suspensions may be formulated by suspending the active ingredient in a vegetable oil, for example arachis oil, olive oil, sesame oil or coconut oil, or in mineral oil such as liquid paraffin. The oily suspensions may contain a thickening agent, for example beeswax, hard paraffin or cetyl alcohol. Sweetening agents such as those set forth above, and flavoring agents may be added to provide a palatable oral preparation. These compositions may be preserved by the addition of an anti-oxidant such as ascorbic acid.

Dispersible powders and granules suitable for preparation of an aqueous suspension by the addition of water provide the active ingredient in admixture with a dispersing or wetting agent, suspending agent and one or more preservatives. Suitable dispersing or wetting agents and suspending agents are exemplified by those already mentioned above. Additional excipients, for example sweetening, flavoring and coloring agents, may also be present.

The pharmaceutical compositions of the invention may also be in the form of an oil-in-water emulsions. The oily phase may be a vegetable oil, for example olive oil or arachis oil, or a mineral oil, for example liquid paraffin or mixtures of these. Suitable emulsifying agents may be naturally-occurring phosphatides, for example soy beans, lecithin, and esters or partial esters derived from fatty acids and hexitol anhydrides, for example sorbitan monooleate, and condensation products of the said partial esters with ethylene oxide, for example polyoxyethylene sorbitan monooleate. The emulsions may also contain sweetening and flavouring agents.

Syrups and elixirs may be formulated with sweetening agents, for example glycerol, propylene glycol, sorbitol or sucrose.

Such formulations may also contain a demulcent, a preservative and flavoring and coloring agents.

The pharmaceutical compositions may be in the form of a sterile injectable aqueous or oleagenous suspension. This suspension may be formulated according to the known art using those suitable dispersing or wetting agents and suspending agents which have been 39 WO 98/55116 PCT/US98/11207 mentioned above. The sterile injectable preparation may also be a sterile injectable solution or suspension in a non-toxic parenterally-acceptable diluent or solvent, for example as a solution in 1,3-butane diol. Among the acceptable vehicles and solvents that may be employed are water, Ringer's solution and isotonic sodium chloride solution. In addition, sterile, fixed oils are conventionally employed as a solvent or suspending medium. For this purpose any bland fixed oil may be employed including synthetic mono- or diglycerides. In addition, fatty acids such as oleic acid find use in the preparation of injectables.

Compounds of Formula I may also be administered in the form of a suppositories for rectal administration of the drug. These compositions can be prepared by mixing the drug with a suitable nonirritating excipient which is solid at ordinary temperatures but liquid at the rectal temperature and will therefore melt in the rectum to release the drug. Such materials are cocoa butter and polyethylene glycols.

For topical use, creams, ointments, jellies, solutions or suspensions, etc., containing the compound of Formula I are employed.

(For purposes of this application, topical application shall include mouth washes and gargles.) The compounds for the present invention can be administered in intranasal form via topical use of suitable intranasal vehicles, or via transdermal routes, using those forms of transdermal skin patches well known to those of ordinary skill in the art. To be administered in the form of a transdermal delivery system, the dosage administration will, of course, be continuous rather than intermittent throughout the dosage regimen. Compounds of the present invention may also be delivered as a suppository employing bases such as cocoa butter, glycerinated gelatin, hydrogenated vegetable oils, mixtures of polyethylene glycols of various molecular weights and fatty acid esters of polyethylene glycol.

The dosage regimen utilizing the compounds of the present invention is selected in accordance with a variety of factors including type, species, age, weight, sex and medical condition of the patient; the severity of the condition to be treated; the route of administration; the renal and hepatic function of the patient; and the WO 98/55116 PCT/US98/11207 particular compound thereof employed. A physician or veterinarian of ordinary skill can readily determine and prescribe the effective amount of the drug required to prevent, counter, arrest or reverse the progress of the condition. Optimal precision in achieving concentration of drug within the range that yields efficacy without toxicity requires a regimen based on the kinetics of the drug's availability to target sites. This involves a consideration of the distribution, equilibrium, and elimination of a drug. Preferably, doses of the compound of structural formula I useful in the method of the present invention range from 0.01 to 1000 mg per adult human per day. Most preferably, dosages range from 0.1 to 500 mg/day. For oral administration, the compositions are preferably provided in the form of tablets containing 0.01 to 1000 milligrams of the active ingredient, particularly 0.01, 0.05, 0.1, 0.5, 1.0, 2.5, 5.0, 10.0, 15.0, 25.0, 50.0, 100 and 500 milligrams of the active ingredient for the symptomatic adjustment of the dosage to the patient to be treated. An effective amount of the drug is ordinarily supplied at a dosage level of from about 0.0002 mg/kg to about 50 mg/kg of body weight per day.

The range is more particularly from about 0.001 mg/kg to 1 mg/kg of body weight per day.

Advantageously, the active agent of the present invention may be administered in a single daily dose, or the total daily dosage may be administered in dividend doses of two, three or four times daily.

The amount of active ingredient that may be combined with the carrier materials to produce a single dosage form will vary depending upon the host treated and the particular mode of administration.

It will be understood, however, that the specific dose level for any particular patient will depend upon a variety of factors including the age, body weight, general health, sex, diet, time of administration, route of administration, rate of excretion, drug combination and the severity of the particular disease undergoing therapy.

41 WO 98/55116 PCT/US98/11207 The following examples illustrate the preparation of some of the compounds of the invention and are not to be construed as limiting the invention disclosed herein.

EXAMPLE 1

N

Me MeMe N Me 1-(7-Aza-bicvclo[2.2.11hept-7-vl)-2-[3-12-[bis-(4-pyridin-3-vl-benzvl)aminolethyll-2-(3,5-dimethylphenyl)- 1H-indol-5-yll-2-methyl-propan- 1-one Step 1A 2-[3-(2-Aminoethyl)-2-(3,5-dimethyl-phenyl)- 1H-indol-5-vll-2methylpropionic acid ethyl ester A mixture of 10.50 g of ethyl 2-(4-hydrazinophenyl)-2methylpropionate 10.55 g of 3-chloropropyl 3,5-dimethylphenyl ketone, and 200 mL of absolute ethanol was stirred under nitrogen and heated to reflux. After 12 hours, the mixture was cooled and filtered. The solid on the filter was washed with additional small volumes of ethanol. The filtrate was treated with 4 mL of concentrated sulfuric acid and stirred at reflux under nitrogen for 4 days. The cooled mixture was stirred in an ice bath as a solution of sodium ethoxide (21% w/w in ethanol) was added dropwise until the mixture was basic by pH paper. The mixture was filtered and concentrated in vacuo at 30 The residue was partitioned between diethyl ether and water, with some saturated aqueous sodium chloride solution added to assist in separation of the layers. The aqueous phase was washed with an additional 100 mL of ether. The combined organic extracts were dried over sodium sulfate, filtered, and concentrated in vacuo. The residual gum was purified by 42 WO 98/55116 PCT/US98/11207 flash chromatograpy on silica gel (elution with 97:3:0.3 and then 95:5:0.5 methylene chloride:methanol:ammonium hydroxide) to give the title compound (3.9g).

Step 1B 2 3 2 -tert-Butoxvcarbonylaminoethyl)-2-(3.5dimethylphenvl)-lH-indol-5-vl-2-methylpropionic acid ethyl ester To a solution of 2 3 2 -aminoethyl)-2-(3,5-dimethyl-phenyl)- 1H-indol-5-yl]-2-methylpropionic acid ethyl ester (763 mg in 7 mL tetrahydrofuran) at 0 °C was added a solution of 682 mg di-tert-butyl dicarbonate in 3 mL tetrahydrofuran followed by a solution of 432 mg poatssium carbonate in 3 mL water and the resulting suspension stirred vigourously at 0 After 10 minutes, the reaction was concentrated in vacuo and the residue dissolved in ethyl acetate. The organic portion was washed with brine then dried over magnesium sulfate and concentrated in vacuo. The residue was purified by flash chromatography on silica gel (hexane:ethyl acetate, 90:10; then 80:20; then 70:30) to give the title compound (910 mg).

Step 1C 2 3 2 -tert-Butoxvcarbonylaminoethyl)-2-(3,5dimethylphenvyl)-1H-indol-5-vl-2-methylpropionic acid A suspension of 2-[ 3 2 -tert-butoxycarbonylaminoethyl)-2-(3,5- 2 -methylpropionic acid ethyl ester (910 mg in 30 mL methanol and 9.5 mL of 2N aqueous potassium hydroxide) was heated to 95 °C on an oil bath. After 8 hours, the mixture was cooled to room temperature and the volatile organics removed in vacuo. The aqueous portion was washed with ethyl acetate and the acidified to pH 4 by the addition of 1N hydrochloric acid. This was then extracted with ethyl acetate and the organic portion dried over magnesium sulfate.

Concentration in vacuo gave the crude title compound in quantitative yield.

Step 1D 12-[5-[2-(7-Azabicyclo[2.2.1hept-7-yl)-l.1-dimethvl-2-oxoethyll-2-(3.5-dimethylphenvl)-1H-indol-3yllethyl carbamicacid tert-butvl ester 43 WO 98/55116 PCT/US98/ 1207 To a suspension of 2 -[3-(2-tert-butoxycarbonylaminoethyl)- 2-(3,5-dimethylphenyl)-lH-indol-5-yl]-2-methylpropionic acid (856 mg in mL methylene chloride) at 0° C was added 310 mg of 1-hydroxybenzotriazole (HOBt)followed by 400 mg 1-( 3 -dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) and the mixture stirred at low temperature for 90 minutes. At this time, a solution of 7-azabicyclo[2.2.1]heptane hydrochloride (632 mg in a mixture of 2.0 mL methylene chloride and 0.66 mL triethylamine) was added and the mixture warmed to room temperature. The reaction was quenched after 24 hours by dilution with methylene chloride and washing with halfsaturated brine. The combined organics were dried over magnesium sulfate and the concentrate purified by flash chromatography on silica gel (hexane:ethyl acetate, 70:30; then 60:40; then 50:50; then 40:60) to give the title compound (736 mg).

Step 1E 2-f 3 2 -Aminoethyl)-2-(3.5-dimethylphenyl)-lH-indol-5-yl -1- (7-azabicyclo [2.2.11hept-7-yl)-2-methyl-propan- 1-one To a solution of 12-[5-[2-(7-azabicyclo[2.2.1]hept-7-yl)-l,1dimethyl-2-oxo-ethyl]-2-(3,5-dimethylphenyl)-lH-indol-3-yl]ethyl} carbamic acid tert-butyl ester (728 mg in 30 mL methylene chloride) at 0°C was added 1.5 mL anisole followed by 10.5 mL trifluoroacetic acid and the mixture stirred at 0 After 2 hours, the mixture was concentrated in vacuo and the residual acid quenched by the addition of 10% ammonium hydroxide in methanol. The concentrated was then purified by flash chromatography on silica gel (methylene ammonium hydroxide in methanol, 95:5; then 92:8) to give the title compound (627 mg).

Step 1F 1-(7-Aza-bicyclo[2.2.llhept-7-vl)-2-[3-12-[bis-(4-pvridin-3-ylbenzyl)aminol-ethyll-2-(3.5-dimethylphenvl)-1H-indol-5-yll- 2-methyl-propan-1-one To a solution of 2.5 equivalents 4-pyridin-3-yl-benzaldehyde in a mixture of methanol and glacial acetic acid is added aminoethyl)-2-(3,5-dimethylphenyl)-1H-indol-5-yl]-l-(7-azabicyclo t.

-44 WO 98/55116 PCT/US98/11207 2 2 .1]hept- 7 -yl)-2-methyl-propan-l-one followed by 3A powdered molecular seives. To this mixture, an excess of sodium cyanoborohydride is added and the pH adjusted to 5.5 by the addition of methanolic acetic acid. After completion, the reaction is quenched by the addition of saturated sodium bicarbonate and the mixture extracted with ethyl acetate. The organic portion is washed successively with saturated ammonium chloride, sodium bicarbonate and brine, then dried over sodium sulfate. Purification of the concentrate by flash chromatography on silica gel gives the title compound. MASS: 764

(M+H)

PREPARATION OF SYNTHETIC INTERMEDIATES Ethyl 2 4 -hydrazinophenyl)-2-methylpropionate Step A: Ethyl 2 4 -nitrophenvl)propionate To a solution of 9.76 g (50 mmol) of nitrophenyl)propionic acid in 150 mL of absolute ethanol was added mL of concentrated sulfuric acid. The resulting solution was stirred at reflux under nitrogen. After 6 hours, the solution was cooled and stirred vigorously as 250 mL of saturated aqueous sodium bicarbonate solution was added gradually (Caution: foaming). The mixture was then partitioned between 750 mL of ethyl acetate and 500 mL of water.

The organic layer was washed with 100 mL of saturated aqueous sodium bicarbonate solution and then with 100 mL of saturated aqueous sodium chloride solution. The organic phase was dried over magnesium sulfate, filtered, and concentrated in vacuo to give 10.86 g of an oil; homogeneous by TLC in 9:1 hexane-ethyl acetate. 400 MHz 1 H NMR (CDC13) was consistent with the assigned structure.

Step B: Ethyl 2 -methvl- 2 -(4-nitrophenvl)propionate A suspension of 924 (23 mmol) of sodium hydride in oil) in 21 mL of dry N,N-dimethylformamide was stirred under nitrogen in an ice bath as a solution of 4.68 g (21 mmol) of ethyl 35 nitrophenyl)propionate in 20.5 mL of dry N,N-dimethylformamide was 45 WO 98/55116 PCT/US98/11207 added gradually over about 10 minutes. An intense violet color developed during the addition. The mixture was then allowed to warm to room temperature. After about 1 hour, the mixture was again cooled in an ice bath as a solution of 1.44 mL (3.28 g; 23 mmol) of methyl iodide in 5 mL of dry N,N-dimethylformamide was added dropwise by syringe over about minutes, while maintaining the internal temperature at 10-15 "C.

The mixture was allowed to warm to room temperature, and the color changed to brown. After 1 hour, an additional 187 mL (426 mg, 3 mmol) of iodomethane was added. By the next day, the mixture consisted of a suspension of some grayish solid in a golden liquid. It was stirred vigorously and quenched by gradual addition of 10 mL of 5% aqueous potassium bisulfate solution. The mixture was partitioned between 400 mL of diethyl ether and 400 mL of water. The organic layer was washed with an additonal 3 x 400 mL of water and then with 50 mL of saturated aqueous sodium chloride solution. The organic phase was then dried over magnesium sulfate, filtered, and concentrated in vacuo. Flash chromatography of the residue on silica gel (elution with 19:1 hexaneethyl acetete) yielded 4.31 g of an oil; homogeneous by TLC in 9:1 hexane-ethyl acetete. 400 MHz 1 H NMR (CDC13) was consistent with the assigned structure.

Step C: Ethyl 2 4 -Aminophenyl)-2-methylpropionate A mixture of 4.27 g (18 mmol) of ethyl 2-methyl-2-(4nitrophenyl)propionate, 200 mg of 10% palladium on carbon, and 120 mL of absolute ethanol was shaken with hydrogen (initial hydrogen pressure 47 psig) in a pressure vessel for 2 hours. The catalyst was removed by filtration through Celite under nitrogen, and the filter cake was washed with additional ethanol. Concentration of the filtrate in vacuo at up to 50 °C gave 3.74 g (100%) of an oil; homogeneous by TLC in 4:1 hexane-EtOAc. 400 MHz 1 H NMR (CDC13) was consistent with the assigned structure. Mass spectrum (ESI): m/e 208 (M H).

Step D: Ethyl 2 4 -hdrazinophenyl)-2-methylpropionate A solution of 3.725 g (18 mmol) of ethyl 2-(4-aminophenyl)-2methylpropionate in 18 mL of concentrated hydrochloric acid was stirred 46 WO 98/55116 PCT/US98/11207 at -10 to -5 °C in an ice-acetone bath as a solution of 1.29 g (18.7 mmol) of sodium nitrite in 7.5 mL of water was added dropwise over about minutes. Stirring was continued at this temperature for an additional minutes. Next, a small amount of insoluble solid was removed by filtration into a cold receiving flask. The filtrate was then added dropwise over 10-15 minutes to a solution of 20.3 g (90 mmol) of stannous chloride dihydrate in 14.5 mL of concentrated hydrochloric acid stirred under nitrogen in an ice-acetone bath. The addition was carried out at such a rate that the internal temperature remained at about -5 A gummy material separated during the addition. After completion of the addition, stirring was continued at -10 to -5 "C for 1 hour. The aqueous phase was decanted, and the residual gum was dissolved in 250 mL of ethyl acetate. The ethyl acetate solution was treated cautiously with 250 mL of saturated aqueous sodium bicarbonate solution and shaken in a separatory funnel. The ethyl acetate layer was washed with 50 mL of saturated aqueous sodium chloride solution. The entire mixture was filtered before separation of the phases. The ethyl acetate phase was dried over magnesium sulfate, filtered, and concentrated in vacuo at room temperature to yield 2.59 g of an oil. 500 MHz 1H NMR (CDC13) was consistent with the assigned structure and indicated that only minor impurities were present.

3-Chloropropyl 3.5-dimethylphenyl ketone Step AA: 4 -Chloro-N-methoxy-N-methylbutyramide To a solution of 4-chlorobutyryl chloride (10.0 g in 200 mL of dry methylene chloride) was added 10.4 g of N,O-dimethylhydroxylamine hydrochloride. The mixture was stirred under nitrogen and maintained below 25 °C by cooling in an ice bath as necessary while triethylamine (29.1 mL)was added dropwise over about 20 minutes, resulting in precipitation. After 1.5 hours at room temperature, the mixture was concentrated in vacuo. The residue was partitioned between 100 mL of diethyl ether and 100 mL of saturated aqueous sodium bicarbonate solution. The organic layer was washed with an additional 100 mL of saturated sodium bicarbonate, and the aqueous fractions were back- 47 WO 98/55116 PCTIUS98/11207 extracted with ether. The combined organic phases were dried over sodium sulfate, filtered, and concentrated in vacuo to give 10.5 g of an oil, which had satisfactory purity by 1 H NMR (CDC13). Mass spectrum (PB-NH3/CI): m/e 166 (M H).

Step BB: 3-Chloropropyl 3.5-dimethylphenyl ketone A solution of 10.2 mL (13.9 g; 72 mmol) in 200 mL of anhydrous tetrahydrofuran was stirred under nitrogen at -78 0 C as 35.8 mL (84 mmol) of 2.5 M n-butyllithium in tetrahydrofuran was added dropwise. After 15 minutes at -78 a solution of 10.0 g mmol) of 4 -chloro-N-methoxy-N-methylbutyramide in 30 mL of anhydrous tetrahydrofuran was added dropwise over 25-30 minutes.

The resulting solution was maintained at -78 °C for 45 minutes and then warmed briefly to room temperature. The reaction was quenched by addition of 40 mL of 2 N hydrochloric acid and then partitioned between ethyl acetate and water. The organic phase was washed with saturated aqueous sodium bicarbonate solution and then saturated aqueous sodium chloride solution. The organic solution was dried over sodium sulfate, filtered, and concentrated in vacuo. Flash chromatography of the residue afforded 8.91 g of an oil, which had satisfactory purity by 1H NMR (CDC13).

4 -Pvridin-3-vl-benzaldehyde Step AAA: 4-Iodobenzoic acid methyl ester A solution of 4-iodobenzoic acid (5.0 g in a mixture of 50 mL methanol and 2.2 mL of conc. sulfuric acid) was heated to reflux on an oil bath. After 15 hours, the mixture was concentrated to half-volume in vacuo then poured into saturated sodium bicarbonate. This mixture was extracted with diethyl ether and the organic portion washed with brine and dried over magnesium sulfate. Purification of the concentrate by flash chromatography on silica gel (hexane:ethyl acetate, 95:5) gave the title compound (5.12 g).

Step BBB: Pyridine-3-boronic acid 48 WO 98/55116 PCT/US98/11207 To a solution of n-butyllithium (16 mL of a 2.5M solution in hexane 50 mL dry diethyl ether) at -780 C was added a solution of 3 -bromopyridine (6 g in 15 mL diethyl ether) and the mixture stirred for minutes. At this time trimethyl borate (4.3 mL) was added and the mixture allowed to warm to room temperature. After 1 hour the reaction was quenched by the addition of 10 mL glacial acetic acid and mL water and the mixture stirred for 18 hours at room temperature.

The pH of the mixture was adjusted to pH12 by the addition of 2M sodium hydroxide and extracted with diethyl ether. The aqueous layer was acidified to pH 6 by the dropwise addition of 1N hydrochloric acid and extracted with methylene chloride. The combined organics were dried over magnesium sulfate and concentrated in vacuo. The residue was triturated with 20 mL acetonitrile:water and filtered to give the title compound (1.0 g).

Step CCC: 4-Pyridin-3-vl-benzoic acid methyl ester To a mixture of 1.18 g 4-iodobenzoic acid methyl ester, 830 mg pyridine-3-boronic acid, and 158 mg bis(triphenylphosphine) palladium(II) chloride was added solvent (18 mL toluene and 5 mL methanol) followed by 4.5 mL of 2M sodium carbonate and the mixture heated to 80 °C on an oil bath. After 16 hours the mixture was cooled to room temperature diluted with ethyl acetate and filtered through diatomaceous earth. The organic portion was washed sequentially with 1.25N sodium hydroxide and brine, dried over magnesium sulfate and concentrated in vacuo. Purification by flash chromatography on silica gel (hexane:ethyl acetate, 80:20; then 70:30; then 60:40) gave the title compound (810 mg).

Step DDD: 4 -Pyridin-3-yl-phenyl)-methanol To a solution of 4-pyridin-3-yl-benzoic acid methyl ester (124 mg in 5.0 mL dry methylene chloride) at -78 °C was added 1.46 mL of a 1M solution of diisobutylaluminum hydride in methylene chloride and the mixture stirred at low temperature. After 2 hours, the reaction was quenched by the addition of acetone, warmed to room temperature and stirred for 20 minutes with 1.5 mL of a 1M solution of tartaric acid. At 49 WO 98/55116 PCT/US98/11207 this time the mixture was extracted with methylene chloride and the combined organics dried over sodium sulfate. Purification of the concentrate by flash chromatography on silica gel (ethyl acetate:hexane, 1:1; then methylene chloride:methanol, 95:5) gave the title compound (104 mg).

Step EEE: 4 -Pyridin-3-yl-benzaldehyde To a solution of 4 -pyridin-3-yl-phenyl)-methanol (20 mg in 1.0 mL methylene chloride) was added 25 mg 4 -methylmorpholine N-oxide, 20 mg 4A molecular sieves and 4 mg tetrapropylammonium perruthenate and the mixture stirred at room temperature. After 2 hours, the mixture was applied to a silica gel column and purified by flash chromatography (hexane:ethyl acetate, 40:60; then 60:40) to give the title compound (11.2 mg).

Following a procedure similar to that described above, the following compounds were prepared: Me Me R2 N NN-

R,

Ex. R2 m/e 1A 764 (M+H)

,N

50 WO 98/55116 PCTIUS98/11207 1B I 764 (M+H) 1C 0

NN

I

D N 791 (M+H) A Me N EXAMPLE 2 Following a procedure similar to that described above, the following compounds were prepared: Me Me R2 V N- R1 51 WO 98/55116 PCT/US98/1 1207 EXAMPLE 3 Me 0 MeA Nk Me ',Me fBis-(4-pvridin-3-y1-benzvl)aminoI ethvl)-2-(3..5-dimethylphenl).

acid disoproylamide Step 3A N N-iorov~.nitrobenzamide A solution of 3.51 mL (2.53 g, 25 mmol) of diisopropylainine and 3.62 mL (2.63 g, 26 mmol) of triethylamine in 50 mL of anhydrous tetrahydrofuran was stirred under nitrogen and maintained at -5 *C as a solution of 4.11 g (22.1 mmol) in 10 mL of anhydrous tetrahydrofuran was added dropwise over 15 minutes. The mixture was allowed to warm gradually to room temperature. After 2 hours, the mixture was filtered, and the filtrate was partitioned between diethyl ether and 1 N hydrochloric acid. The organic phase was then washed with saturated 52 WO 98/55116 PCTIUS98/11207 sodium carbonate 3 solution, then dried over sodium sulfate and filtered.

The filtrate was concentrated in vacuo, and the residue was flashchromatographed on silica gel (gradient elution with 2-5% MeOH in CH2C12) to yield 4.77 g of yellowish crystals, mp 141.5-142 °C; homogeneous by TLC 2:1 hexane-EtOAc. 500 MHz 1 H NMR (CDCl3) was consistent with the assigned structure.

Step 3B 4 -Amino-NN-diisopropylbenzamide A mixture of 4.70 g (18.8 mmol) of NN-diisopropyl-4nitrobenzamide, 200 mg of 10% palladium on carbon, and 200 mL of 2methoxyethanol was shaken with hydrogen at approx. 50 psig for hours. The catalyst was removed by filtration through diatomaceous earth under nitrogen. Concentration of the filtrate in vacuo afforded a quantitative yield of a yellow solid, mp 169.5-170 homogeneous by TLC in 95:5 CH2Cl2-MeOH. 500 MHz 1 H NMR (CDC13) was consistent with the assigned structure. Mass spectrum (PB-NH 3 m/e 221 (M

H).

Step 3C 4 -Hydrazino-NN-diisopropylbenzamide Treatment of 4.2 g (19 mmol) of 4-amino-NNdiisopropylbenzamide with 15 mL of concentrated hydrochloric acid and mL of water was followed by agitation. The resulting solution was maintained at approx. -3°C as a solution of 1.32 g (19.1 mmol) of sodium nitrite in 9 mL of water was added dropwise. After being stirred for an additional 30 minutes at this temperature, this solution was added portionwise to a vigorously stirred solution of 15.1 g (66.7 mmol) of stannous chloride dihydrate in 15 mL of concentrated hydrochloric acid, which was maintained at about -10 After completion of the addition, the mixture was stirred at this temperature for 5 minutes and then allowed to warm to room temperature. At this point, it was again cooled and basified by gradual addition of 25 mL of 50% sodium hydroxide. The resulting precipitate was collected on a filter and partitioned between tetrahydrofuran and 5 N sodium hydroxide in a 2:1 ratio. The aqueous layer was extracted 3 times with tetrahydrofuran. The combined 53 WO 98/55116 PCT/US98/11207 organic fractions were concentrated in vacuo. The residue was taken up in CH2Cl2-EtOAc, dried over sodium sulfate, filtered, and reconcentrated to give 3.55 g of semisolid; homogeneous by TLC in 95:5 CH2Cl2-MeOH. 500 MHz 1 H NMR (CDC13) was consistent with the assigned structure. Mass spectrum (PB-NH 3 m/e 236 (M H).

Step 3D 3-(2-Aminoethyl)-2-(3.5-dimethylphenvl)- carboxylic acid diisopropylamide A solution of 3.51 g (14.9 mmol) 4-hydrazino-N,Ndiisopropylbenzamide (from Step 3) in 18 mL of 2 -methoxyethanol was stirred at 100'C under nitrogen as 3.77 g (17.8 mmol) of 3 -chloropropyl ketone in 7 mL of 2-methoxyethanol was added dropwise over 20 minutes. The solution was stirred at this temperature for 5 hours, then cooled and filtered to remove a solid (a tetrahydropyridazine by-product). The filtrate was concentrated in vacuo, and the residue was purified by flash chromatography on silica gel (elution with 95:5 CH2Cl2-MeOH followed by a gradient of 98:2:0.2 to 92:8:0.8 CH 2 Cl 2 MeOH-concd.

NH

4 0H) gave 1.78 g of a brownish, stiff foam; satisfactory purity by TLC in 95:5:0.5 CH2Cl2-MeOH-concd. NH40H. 500 MHz 1 H NMR (CDC13) was consistent with the assigned structure.

Mass spectrum (PB-NH3/CI): m/e 392.2 (M H).

Step 3E 3-f2-[Bis-(4-pvridin-3-vl-benzvl)aminolethvll-2-(3.5acid diisopropylamide To a solution of 2.5 equivalents 4 -pyridin-3-yl-benzaldehyde in a mixture of methanol and glacial acetic acid is added 3 -(2-aminoethyl)- 2-(3,5-dimethylphenyl)-lH-indole-5-carboxylic acid diisopropylamide followed by 3A powdered molecular seives. To this mixture, an excess of sodium cyanoborohydride is added and the pH adjusted to 5.5 by the addition of 10% methanolic acetic acid. After completion, the reaction is quenched by the addition of saturated sodium bicarbonate and the mixture extracted with ethyl acetate. The organic portion is washed successively with saturated ammonium chloride, sodium bicarbonate and brine, then dried over sodium sulfate. Purification of the 54 WO 98/55116 PCTIUS98/11207 concentrate by flash chromatography on silica gel gives the title compound.

55

Claims

1. A compound of the formula R8 R I X (CRR 9 a)k O R R< m Rioa N R 5 R 4 (I wherein A is R22-[ary1]-R22- or R22- [substituted aryl]-R22-,; B is optionally absent, -0R22-, -C(0)R22-, -S(O)nR22-, -NR18R22-, 0OC(0)R22-, -C(0)R22, 0OS(O)nR22- or -S(O)nOR22-; RO is hydrogen, C 1-06 alkyl, substituted C1-C6 alkyl, wherein the substituents are as defined below; aryl, substituted aryl, aralkyl. or substituted aralkyl, wherein the substituents are as defined for R3, R4 and R1iis N zN R 1 R 1 1 4 R 15 R 14 R 15 R 13 R 1 R 13 Z 14 R 15 14 13R A R 13 R 13 13R 19 R 1 3 R 14 56 WO 98/55116 PCT/US98/11207 N N N NI N Ns 'N NN- R R, R, N R 1 N-N N-N N=N R19 R 19 1 R 11 0 N N N R 13 'k 13 -R 13 L 'R13- R 5 R,N R 15 N R R RN R 14 9 R 1 5 R14 R 1 R 14 1 R 1 5 R1 I -yR% 1 R 13 KN R 15 R14 R13 the nitrogen atoms contained in the Ri heteroaromatic rings may exist either as drawn or, when chemically allowed, in their oxidized state; R2 is hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl, aralkyl, substituted aralkyl, aryl, substituted aryl,; or R2 and A can optionally be taken together to form a ring of 5-7 atoms; R3, R4 and R5 are independently hydrogen, C1-C6 alkyl, substituted Cl-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, CN, nitro, C1-C3 perfluoroalkyl, C1-C3 perfluoroalkoxy, aryl, substituted aryl, aralkyl, substituted aralkyl, R110(CH2)p-, (CH2)pS(O)nRl7 or halogen; wherein R17 is hydrogen, C1- C6 alkyl, Cl-C 3 perfluoroalkyl, aryl or substituted aryl; or R3 and R4 taken together form a carbocyclic ring of 3-7 carbon atoms or a heterocyclic ring containing 1-3 heteroatoms selected from N, 0 and S; R6 is hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl, aryl, substituted aryl, C1-03 perfluoroalkyl, CN, N02, halogen, R160(CH2)p-; R7 is hydrogen, C1-C6 alkyl, or substituted C1-C6 alkyl, unless X is hydrogen or halogen, then R7 is absent; 57 WO 98/55116 PCT/US98/11207 R8 is hydrogen, C(O)OR9, C(O)NR11R12, NR11R12, C(O)R11, NR12C(O)R11, NR12C(O)NR1R12, NR12S(0)2Rll, NR12S(0)2NR11R1 2 OC(O)R11, OC(O)NR11R12, OR1l, SOnRll, S(O)nNR11R12,, a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and C1-C6 alkyl or substituted C1-C6 alkyl, unless X is hydrogen or halogen, then R8 is absent; or taken together form a heterocyclic ring containing one or more heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R5; or R7 and R8 O R7 and R8 taken together form a carbocyclic ring of 3-7 atoms or when m0; R9 and R9a are independently hydrogen, C1-C6 alkyl, substituted C1-C6 alkyl; aryl or substituted aryl, aralkyl or substituted aralkyl when m O; or 0 R9 and R9a taken together form a carbocyclic ring of 3-7 atoms or when m0; and R10a are independently hydrogen, CI-C6 alkyl, substituted Ci- C6 alkyl, aryl, substituted aryl, aralkyl or substituted aralkyl; or 0 and RlO0a taken together form a carbocyclic ring of 3-7 atoms or R9 and R10 when taken together form a carbocyclic ring of 3-7 carbon atoms or a heterocyclic ring containing one or more heteroatoms when m 0; or R9 and R2 taken together form a heterocyclic ring containing 3-7 carbon atoms and one or more heteroatoms when m 0; or and R2 taken together form a heterocyclic ring containing 3-7 carbon atoms and one or more heteroatoms; R11 and R12 are independently a bond, hydrogen C1-C6 alkyl, substituted C1-C6 alkyl, aryl, substituted aryl, aralkyl, 58 WO 98/55116 PCT/US98/I 1207 substituted aralkyl, a carbocyclic ring of 3-7 atoms, a substituted carbocyclic ring containing 3-7 atoms, a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R5, C1-C6-alkyl substituted by a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R11 and R12 when taken together can form an optionally substituted ring of 3-9 atoms; R13 is hydrogen, OH, NR7R8, NR16S02(C1-C6 alkyl), NR16SO2(substituted C 1-C6 alkyl), NR16SO2(aryl), NR16SO2(substituted aryl), N-Rl6SO2(C 1-C3 perfluoroalkyl); SO2NR16(C1-C 6 alkyl), SO2NIR11(substituted C1-C6 alkyl), SO2NR1 i(aryl), S02NR16(substituted aryl), SO2NR16(C 1-C3 perfluoroalkyl); SO2N'R16(C(O)C 1-C6 alkyl); SO2NR16(C(O)- substituted C l-C6 alkyl); SO2NR16(C(O)-aryl); SO2NR16(C(O)-substituted aryl); S(O)n(C l-C6 alkyl); S(O)n(substituted C l-C6 alkyl), S(O)n(aryl), S(O)n(substituted aryl), Ci-C3 perfluoroalkyl, Ci-C3 perfluoroalkoxy, Cl-C6 alkoxy, substituted C1-C6 alkoxy, COOH, halogen, N02 or CN; R14 and R15 are independently hydrogen, C1-C6 alkyl, substituted Cl-C6 alkyl, C2-C6 alkenyl, substituted C2-C6 alkenyl, CN, nitro, Cl-C3 perfluoroalkyl, C1-C3 perfluoroalkoxy, aryl, substituted aryl, aralkyl, substituted aralkyl, R160(CH2)p-, Rl6C(O)O(CH2)p-, R16OC(O)(CH 2 -(CH2)pS(O)nRl7, (CH2)pC(O) N(Rl6) 2 or halogen; wherein R17 is hydrogen, Cl-C6 alkyl, Cl-C3 perfluoroalkyl, aryl or substituted aryl; R16 is hydrogen, Cl-C6 alkyl, substituted Cl-C6 alkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, a carbocyclic ring of 3-7 atoms or a substituted carbocyclic ring containing

3-7 atoms; R18 is hydrogen, Cl-C 6 alkyl, substituted Cl-C6 alkyl, C(O)0R16, C(O)N(R16) 2 C(O)R16, S(O)nRl6; 59 WO 98/55116 WO 9855116PCTJUS98ii 1207 R19 is either the definition of R13 or R14; R22 is CO-C4 alkyl, substituted Cl-C4 alkyl; X is N, 0, S(0)n, (CR11Rl2)p, a single bond to R8, C2-C 6 alkenyl, substituted C2-C6 alkenyl,C2-C6 alkynyl, or substituted C2-C6 alkynyl; when X is 0, S(0)n, or CR11R12 only R8 is possible; Z is 0, Sor N-R1; m is 0, 1, 2or 3; n is O 1or 2; p is 0,1, 2,3 or 4;and the alkyl, cycloalkyl, alkenyl and alkynyl substituents are selected from Cl-C6 alkyl, C3-C7 cycloalkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, hydroxy, oxo, cyano, Cl-C6 alkoxy, fluoro, C(0)0R 1 1 aryl CI-C3 alkoxy, substituted aryl Cl-C3 alkoxy, and the aryl substituents are as defined for R3, R4 and or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof. 2. The compound according to Claim 1 of the formula R8 R2 10 (C 9 1 N R 5 R 4 (I A is R22-[phenylI-R22 or R22-I[substituted phenylI-R22-; B is optionally absent or -C(=0)R22 RO is hydrogen; R1 is 60 WO 98/55116 PCTIUS98/11207 L I R 1 3 R 1 5 R 1 4 the nitrogen atoms contained in the Ri heteroaromatic rings may exist either as drawn or, when chemically allowed, in their oxidized state; R3, R4 and R5 are independently hydrogen, CI-C6 alkyl, substituted C1-C6 alkyl or halogen; R8 is C(O)NR11R1 2 Rll and R12 are independently a bond, hydrogen C1-C6 alkyl, substituted C1-C6 alkyl, aryl, substituted aryl, aralkyl, substituted aralkyl, a carbocyclic ring of 3-7 atoms, a substituted carbocyclic ring containing 3-7 atoms, a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and R5, C1-C6-alkyl substituted by a heterocyclic ring or bicyclic heterocyclic ring with from 1 to 4 heteroatoms selected from N, 0 or S which can be optionally substituted by R3, R4 and Rll and R12 when taken together can form an optionally substituted ring of 3-9 atoms; X is (CRl1R12)p; or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof. 3. The compound according to Claim 1 of the formula 61 WO 98/55116 PCT/US98/11207 or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof; wherein R2 are as indicated in the table below: 62 WO 98/55116 PCT/US98/11207

4. The compound according to Claim 1 of the formula Me 0 N N Me NMe Me )Mej N \me Me or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof. The compound according to Claim 1 of the formula 63 H CH 3 or a pharmaceutically acceptable addition salt and/or hydrate thereof, or where applicable, a geometric or optical isomer or racemic mixture thereof.

6. A 2-phenyl-lH-indole antagonist of gonadotropin releasing hormone, said being substantially as hereinbefore described with reference to any one of the examples.

7. A pharmaceutical composition including or consisting of an effective amount of at least one compound according to any one of claims 1 to 6, together with a pharmaceutically acceptable carrier, diluent or adjuvant therefor.

8. A pharmaceutical composition made by combining a compound according to any one of claims 1 to 6 and a pharmaceutically acceptable carrier, diluent or adjuvant.

9. A composition according to claim 7 or claim 8, which further includes at least one compound which stimulates the endogenous production or release of growth hormone.

10. A composition according to claim 7 or claim 8, which further includes at least one compound having lutenising hormone releasing hormone activity. s1 11. A composition according to claim 10, wherein the compound having lutenising hormone releasing hormone activity is a peptide compound.

12. A composition according to claim 11, wherein the peptide compound is a natural hormone or an analogue thereof. 2 13. A composition according to claim 11, wherein the peptide compound is leuprorelin, z" 20 gonadorelin, buserelin, triptorelin, goserelin, nafarelin, histrelin, deslorelin, meterelin or recirelin.

14. A process for making a pharmaceutical composition comprising combining a compound Saccording to any one of claims 1 to 6 and a pharmaceutically acceptable carrier, diluent or adjuvant.

15. A method for the treatment or prevention of a gonadotropin releasing hormone disorder in a mammal, which method includes or consists of administering to said mammal an effective amount 25 of at least one compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8.

16. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 when used in the treatment or prevention of a gonadotropin releasing hormone disorder.

17. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 for use in the treatment or prevention of a gonadotropin releasing hormone disorder. RA7 18. The use of a compound according to any one of claims 1 to 6 for the manufacture of a "/'edicament for the treatment or prevention of a gonadotropin releasing hormone disorder. C07998

19. The method, compound, composition or use according to any one of claims 15 to 18, wherein the gonadotropin releasing hormone disorder is a sex hormone related condition. The method, compound, composition or use according to claim 19, wherein the gonadotropin releasing hormone disorder is a sex hormone dependent cancer, benign prostatic hypertrophy or myoma of the uterus.

21. The method, compound, composition or use according to claim 20, wherein the sex hormone dependent cancer is prostatic cancer, uterine cancer, breast cancer or a pituitary gonadotrophe adenoma.

22. The method, compound, composition or use according to claim 19, wherein the sex hormone related condition is endometriosis, polycystic ovarian disease, uterine fibroid or precocious puberty.

23. A method for the prevention of pregnancy in a mammal, which method includes or consists of administering to said mammal an effective amount of at least one compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8.

24. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 when used in the prevention of pregnancy. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 for use in the prevention of pregnancy.

26. The use of a compound according to any one of claims 1 to 6 for the manufacture of a 20 medicament for the prevention of pregnancy.

27. A method for the treatment or prevention of lupus erythematosis in a mammal, which method includes or consists of administering to said mammal an effective amount of at least one compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8.

28. A compound according to any one of claims 1 to 6 orac a c omposition according to claim 7 or claim 8 when used in the treatment or prevention of lupus erythematosis. S29. A compound according to any one of claims 1 to 6 or a composition according to claim 7 Sor claim 8 for use in the treatment or prevention of lupus erythematosis. The use of a compound according to any one of claims 1 to 6 for the manufacture of a medicament for the treatment or prevention of lupus erythematosis. 30 31. A method for the treatment or prevention of irritable bowel syndrome in a mammal, which method includes or consists of administering to said mammal an effective amount of at least one *compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8.

32. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 when used in the treatment or prevention of irritable bowel syndrome.

33. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 for use in the treatment or prevention of irritable bowel syndrome.

34. The use of a compound according to any one of claims 1 to 6 for the manufacture of a medicament for the treatment or prevention of irritable bowel syndrome. C07998 66 A method for the treatment or prevention of premenstrual syndrome in a mammal, which method includes or consists of administering to said mammal an effective amount of at least one compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8.

36. A compound according to any one of claims 1 to 6 or a composition according to claim 7 s or claim 8 when used in the treatment or prevention of premenstrual syndrome.

37. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 for use in the treatment or prevention of premenstrual syndrome.

38. The use of a compound according to any one of claims 1 to 6 for the manufacture of a medicament for the treatment or prevention of premenstrual syndrome.

39. A method for the treatment or prevention of hirsutism in a mammal, which method includes or consists of administering to said mammal an effective amount of at least one compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 when used in the treatment or prevention of hirsutism.

41. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 for use in the treatment or prevention of hirsutism.

42. The use of a compound according to any one of claims 1 to 6 for the manufacture of a medicament for the treatment or prevention of hirsutism.

43. A method for the treatment or prevention of sleep disorders in a mammal, which method 20 includes or consists of administering to said mammal an effective amount of at least one compound according to any one of claims 1 to 6, or of a composition according to claim 7 or claim 8. S44. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 when used in the treatment or prevention of sleep disorders.

45. A compound according to any one of claims 1 to 6 or a composition according to claim 7 or claim 8 for use in the treatment or prevention of sleep disorders. S46. The use of a compound according to any one of claims 1 to 6 for the manufacture of a medicament for the treatment or prevention of sleep disorders.

47. The method, compound, composition or use according to any one of claims 43 to 46, wherein the sleep disorder is sleep apnea. 30 48. A method for the treatment or prevention of short stature or a growth hormone deficiency S in a mammal, which method includes or consists of administering to said mammal an effective amount of at least one compound which stimulates the endogenous production or release of growth hormone and at least one compound according to any one of claims 1 to 6, or of a composition according to claim 9.

49. A compound which stimulates the endogenous production or release of growth hormone and a compound according to any one of claims 1 to 6 or a composition according to claim 9 when used in the treatment or prevention of short stature or a growth hormone deficiency. A compound which stimulates the endogenous production or release of growth hormone R and a compound according to any one of claims 1 to 6 or a composition according to claim 9 for use in Sthe treatment or prevention of short stature or a growth hormone deficiency. C07998 67

51. The use of a compound which stimulates the endogenous production or release of growth hormone and a compound according to any one of claims 1 to 6 for the manufacture of a medicament for the treatment or prevention of short stature or a growth hormone deficiency. Dated 14 December 1999 MERCK CO., INC. Patent Attorneys for the Applicant/Nominated Person SPRUSON FERGUSON SS S *o*o* oo.oo S S. S Se g oo go *ooo *OO C07998