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  • C07D405/00—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom
  • C07D405/02—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom containing two hetero rings
  • C07D405/12—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom containing two hetero rings linked by a chain containing hetero atoms as chain links
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  • C07D207/00—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom
  • C07D207/02—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D207/04—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members
  • C07D207/10—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
  • C07D207/16—Carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
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  • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
  • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
• • A—HUMAN NECESSITIES
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  • A61P13/02—Drugs for disorders of the urinary system of urine or of the urinary tract, e.g. urine acidifiers
• • A—HUMAN NECESSITIES
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  • A61P13/00—Drugs for disorders of the urinary system
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• • A—HUMAN NECESSITIES
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  • A61P15/10—Drugs for genital or sexual disorders; Contraceptives for impotence
• • A—HUMAN NECESSITIES
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  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
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  • A61P15/12—Drugs for genital or sexual disorders; Contraceptives for climacteric disorders
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  • A61P25/00—Drugs for disorders of the nervous system
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  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/04—Centrally acting analgesics, e.g. opioids
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
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• • C—CHEMISTRY; METALLURGY
  • C07—ORGANIC CHEMISTRY
  • C07D—HETEROCYCLIC COMPOUNDS
  • C07D207/00—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom
  • C07D207/02—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom
  • C07D207/04—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members
  • C07D207/10—Heterocyclic compounds containing five-membered rings not condensed with other rings, with one nitrogen atom as the only ring hetero atom with only hydrogen or carbon atoms directly attached to the ring nitrogen atom having no double bonds between ring members or between ring members and non-ring members with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to ring carbon atoms
  • C07D207/14—Nitrogen atoms not forming part of a nitro radical

Definitions

• This invention relates to novel amide compounds which inhibit monoamine re-uptake, to processes for their preparation, to pharmaceutical compositions containing them and to their use in medicine.
• the compounds of the invention exhibit activity as serotonin and/or noradrenaline re-uptake inhibitors and therefore have utility in a variety of therapeutic areas.
• the compounds of the invention are of use in the treatment of disorders in which the regulation of monoamine transporter function is implicated, more particularly disorders in which inhibition of re-uptake of serotonin or noradrenaline is implicated.
• the compounds of the invention are of use in disorders in which inhibition of both serotonin and noradrenaline is implicated, such as urinary incontinence.
• the compounds of the invention are of use in disorders in which it may be desired to inhibit preferentially the reuptake of one of noradrenaline or serotonin compared with the other, such as pain, fibromyalgia, ADHD and depression.
• the invention provides a compound of formula (I),
• R 1 , R 2 , R 3 and R 20 are each independently H, Cl, Br, F, I, CF 3 , OCF 3 , Me or Et;
• R 4 is het or C 3 . 7 cycloalkyl, optionally substituted by C 1 . 4 alkyl, C 1 . 4 alkoxy, alkoxyalkyl containing 2 to 4 carbon atoms, or -S-(C 1-4 alkyl); a is 0 or 1 ; and het is a non-aromatic 4-, 5- or 6- membered heterocycle which contains at least one N, O or S heteroatom, optionally fused to a 5- or 6- membered carbocyclic group or a second 4-, 5- or 6-membered heterocycle which contains at least one N, O or S heteroatom, wherein the het group is optionally substituted by at least one substituent independently selected from d- ⁇ alkyl, Ci. 8 alkoxy, OH, halo, CF 3 ,
• R 1 is Cl, Br, F, I, CF 3 , Me or Et; and R 2 and R 3 are each independently H, Cl, Br, F, I 1 CF 3 , Me or Et.
• R 1 and R 2 are each independently Cl, Br, F, I, CF 3 , Me or Et and R 3 is H, Cl, Br, F, I, CF 3 , Me or Et.
• R 1 is Cl, Me or CF 3 ;
• R 2 is H, Cl or F; and R 3 is H, Cl or F.
• R 2 and R 20 are other than H. In such an embodiment, R 2 and R 20 may each be independently Cl, F, CF 3 , Me or Et.
• R 1 , R 2 and R 20 are other than H.
• R 1 , R 2 and R 20 may each be independently Cl, F, CF 3 , Me or Et.
• R , R and R are other than H.
• R 1 , R 3 and R 20 may each be independently Cl, F, CF 3 , Me or Et.
• R 4 may be C 3-7 cycloalkyl, optionally substituted by C 1 . 4 alkyl, C 1-4 alkoxy, alkoxyalkyl containing 2 to 4 carbon atoms or -S-(C 1-4 alkyl). According to a further embodiment, R 4 may be C 3-7 cycloalkyl, optionally substituted by Me or Et.
• a may be 0.
• the het group may be substituted by one, two or three substituents independently selected from halo, OH, Ci. 4 alkyl and CF 3 .
• the het group of a compound as defined above with reference to the first aspect of the invention and any of the specific embodiments may be unsubstituted.
• the invention provides a compound selected from:
• pharmaceutically and/or veterinarily acceptable derivative it is meant any pharmaceutically or veterinarily acceptable salt, solvate, ester or amide, or salt or solvate of such ester or amide, of the compound of formula (I), or any other compound which upon administration to the recipient is capable of providing (directly or indirectly) a compound of formula (I) or an active metabolite or residue thereof.
• the salts referred to above will be the pharmaceutically or veterinarily acceptable salts, but other salts may find use, for example in the preparation of a compounds of formula (I) and the pharmaceutically or veterinarily acceptable salts thereof.
• the aforementioned pharmaceutically or veterinarily acceptable salts include the acid addition salts thereof and the base salts thereof-
• Suitable acid addition salts are formed from acids which form non-toxic salts. Examples include the acetate, aspartate, benzoate, besylate, bicarbonate/carbonate, bisulphate/sulphate, camsylate, citrate, hemicitrate, edisylate, hemiedisylate, esylate, fumarate, gluceptate, gluconate, glucuronate, hibenzate, hvdrochloride/chloride, hydrobromide/bromide, hvdroiodide/iodide. isethionate. lactate, malate, maleate, malonate, mesylate. methylsulphate. 2-napsylate. nicotinate. nitrate, orotate, pamoate, phosphate/hydrogen phosphate/dihydrogen phosphate, saccharate, stearate, succinate, tartrate and tosylate salts.
• Suitable base salts are formed from bases which form non-toxic salts. Examples include the aluminium, arginine, benzathine, calcium, choline,_diethylamine, diolamine, glycine, lysine, magnesium, meglumine, olamine, potassium, sodium, tromethamine and zinc salts.
• a pharmaceutically acceptable salt of a compound of formula (I) may be readily prepared by mixing together solutions of the compound and the desired acid or base, as appropriate.
• the salt may precipitate from solution and be collected by filtration or may be recovered by evaporation of the solvent.
• the degree of ionisation in the salt may vary from completely ionised to almost non-ionised.
• solvates in accordance with the invention include hydrates and solvates of the compound of formula (I).
• complexes such as clathrates, drug-host inclusion complexes wherein, in contrast to the aforementioned solvates, the drug and host are present in stoichiometric or non-stoichiometric amounts.
• complexes of the pharmaceutical drug which contain two or more organic and/or inorganic components which may be in stoichiometric or non- stoichiometric amounts.
• the resulting complexes may be ionised, partially ionised, or non-ionised.
• the compounds of formula (I) may be modified to provide pharmaceutically or veterinarily acceptable derivatives thereof at any of the functional groups in the compounds. Examples of such derivatives are described in: Drugs of Today, Volume 19, Number 9, 1983, pp 499 - 538; Topics in Chemistry, Chapter 31 , pp 306 - 316; and in "Design of Prodrugs" by H.
• the compounds of formula (I) contain one or more chiral centres, by virtue of the asymmetric carbon atom of the pyrrolidin-3-yl moiety and further asymmetric carbon atoms as may be defined by certain meanings of R 4 . Although the stereochemistry at the 3-position is fixed, any further chiral centres may exist in any possible stereoisomeric form.
• the present invention encompasses all isomers of the compounds of the invention, including all geometric, tautomeric and optical forms (with the exception of the chiral centre at the 3-position of the pyrrolidinyl moiety), and mixtures thereof (e.g. tautomeric or racemic mixtures).
• the compounds of the invention may exist in one or more tautomeric forms. All tautomers and mixtures thereof are included in the scope of the present invention. For example, a claim to 2-hydroxypyridinyl would also cover its tautomeric form ⁇ -pyridonyl.
• polymorphism The compounds of formula (I) and their pharmaceutically and veterinarily acceptable derivatives thereof may also be able to exist in more than one crystal form, a characteristic known as polymorphism. All such polymorphic forms (“polymorphs”) are encompassed within the scope of the invention. Polymorphism generally can occur as a response to changes in temperature or pressure or both, and can also result from variations in the crystallisation process. Polymorphs can be distinguished by various physical characteristics, and typically the x-ray diffraction patterns, solubility behaviour, and melting point of the compound are used to distinguish polymorphs.
• any alkyl group may be straight or branched and is of 1 to 8 carbon atoms, such as 1 to 6 carbon atoms or 1 to 4 carbon atoms, for example a methyl, ethyl, n-propyl, i-propyl, n- butyl, i-butyl, s-butyl or t-butyl group.
• the alkyl group contains more than one carbon atom, it may be unsaturated.
• the term d. 6 alkyl includes C 2-6 alkenyl and C 2-6 alkynyl.
• the term C ⁇ 8 alkyl includes C 2 . 8 alkenyl and C 2 . 8 alkynyl
• the term C 1 . 4 alkyl includes C 2 . 4 alkenyl and C 2-4 alkynyl.
• halogen is used to represent fluorine, chlorine, bromine or iodine.
• the term het includes any non-aromatic, saturated or unsaturated 4-, 5- or 6- membered heterocycle which contains up to 4 heteroatoms selected from N, O and S.
• heterocyclic groups included furyl, thienyl, pyrrolyl, pyrrolinyl, pyrrolidinyl, imidazolyl, dioxolanyl, oxazolyl, thiazolyl, imidazolyl, imidazolinyl, imidazolidinyl, pyrazolyl, pyrazolinyl, pyrazolidinyl, isoxazolyl, isothiazolyl, oxadiazolyl, triazolyl, thiadiazolyl, pyranyl, tetrahydropyranyl, pyridyl, piperidinyl, dioxanyl, morpholino, dithianyl, thiomorpholino, pyridazinyl, pyrimi
• heterocycle includes fused heterocyclyl groups, for example benzimidazolyl, benzoxazolyl, imidazopyridinyl, benzoxazinyl, benzothiazinyl, oxazolopyridinyl, benzofuranyl, quinolinyl, quinazolinyl, quinoxalinyl, dihydroquinazdinyl, benzothiazolyl, phthalimido, benzodiazepinyl, indolyl and isoindolyl.
• heterocyclyl and heterocyclic should be similarly construed.
• substituted means substituted by one or more defined groups.
• groups may be selected from a number of alternative groups, the selected groups may be the same or different.
• the term independently means that where more than one substituent is selected from a number of possible substituents, those substituents may be the same or different.
• the compounds of the invention are the pharmaceutically and veterinarily acceptable derivatives of compounds of formula (I), such as the pharmaceutically or veterinarily acceptable salts or solvates of compounds of formula (I) (e.g. pharmaceutically or veterinarily acceptable salts of compounds of formula (I)).
• a compound of the invention which is an inhibitor of serotonin and/or noradrenaline monoamine re-uptake, having SRI or NRI Ki values of 20OnM or less.
• the compound has SRI and/or NRI Ki values of 10OnM or less.
• the compound has SRI or NRI Ki values of 5OnM or less.
• the compound has SRI and NRI Ki values of 5OnM or less.
• the compound has SRI and NRI Ki values of 25nM or less.
• compounds of Formula (V) may be prepared from compounds of Formula (Vl) by reaction with an aldehyde R 4 CHO, followed by reaction with an acid or acid halide as shown (i.e. where X is OH or halo) and deprotection.
• R 1 , R 2 , R 3 , R 4 and R 20 are as defined above, a is 1 and PG is a suitable protecting group.
• the reaction of the 1° amine (Vl) with the aldehyde to form the 2° amine (VII) is a reductive amination reaction, in which the dehydration of the amine and the aldehyde is followed by reduction of the formed imine by a metal hydride reagent or hydrogenation, in a suitable solvent at room temperature.
• equimolar amounts of amine and aldehyde are typically treated with either sodium triacetoxyborohydride (STAB), NaCN(BH) 3 or NaBH 4 , in a suitable solvent (e.g. DCM, THF) at room temperature for 1 to 24 hours.
• a suitable solvent e.g. DCM, THF
• an excess of a reducing agent e.g. NaBH 4 , LiAIH 4 , STAB
• a suitable solvent e.g. THF, MeOH, EtOH
• a drying agent e.g. molecular sieve
• a suitable solvent e.g.
• a further alternative involves catalytic hydrogenation in the presence of a palladium or nickel catalyst (e.g. Pd/C, Raney® Ni) under an atmosphere of H 2 , optionally at elevated temperature and pressure, in a suitable solvent (e.g. EtOH).
• a palladium or nickel catalyst e.g. Pd/C, Raney® Ni
• a more specific example of the reductive amination involves treatment of the aldehyde with the amine in the presence of either 10% Pd/C, optionally in the presence of triethylamine, in ethanol under about 415 kPa (about 60psi) of hydrogen at room temperature for 18 hours, or an excess of sodium borohydride in methanol at room temperature for 6 hours.
• this may be generated in-situ by standard methodology and then reacted with the amine (VII) and triethylamine in dichloromethane at 70°C for 90 minutes.
• PG is a suitable amine-protecting group, preferably BOC, trifluoroacetate or benzyl
• the removal of PG from (VIII), to form the unprotected amine (V) is performed by a method selective to the protecting group as detailed in "Protective Groups in Organic Synthesis", 3 rd edition, by TW Greene and PGM Wuts. John Wiley and Sons, Inc., 1999, incorporated herein by reference.
• the deprotection involves treatment of (VIII) with a base (e.g. K 2 CO 3 , Na 2 CO 3 , NH 3 , Ba(OH) 2 ) in an alcoholic solvent (e.g. MeOH, EtOH), optionally with water and optionally at elevated temperature.
• a base e.g. K 2 CO 3 , Na 2 CO 3 , NH 3 , Ba(OH) 2
• an alcoholic solvent e.g. MeOH, EtOH
• the deprotection involves either transfer hydrogenation with a transition metal or transition metal salt hydrogenation catalyst (e.g. Pd/C, Pd(OH) 2 ) in the presence of a hydrogen donor (e.g. NH 4 + HCO 2 " ) in a polar solvent (e.g. tetrahydrofuran, ethanol, methanol) optionally at elevated temperature and/or pressure, or catalytic hydrogenation in the presence of a palladium or nickel catalyst (e.g. Pd/C, Raney® Ni) under an atmosphere of H 2 , optionally at elevated temperature and pressure, in a suitable solvent.
• a transition metal or transition metal salt hydrogenation catalyst e.g. Pd/C, Pd(OH) 2
• a hydrogen donor e.g. NH 4 + HCO 2 "
• a polar solvent e.g. tetrahydrofuran, ethanol, methanol
• a palladium or nickel catalyst e.g. Pd/C, Raney® Ni
• the deprotection involves treatment with either an excess of 4M hydrochloric acid in dioxan for 18 hours at room temperature or with TFA in DCM for 4.5 hours at RT.
• the deprotection involves treatment with K 2 CO 3 in methanol:water mixture (5:1 to 10:1) at room temperature for 18 hours.
• the deprotection involves treatment with NH 4 + HCO 2 ' and 10% Pd/C in ethanol under gentle reflux for between 6 and 20 hours.
• PG is a suitable protecting group and R 4 is as defined above.
• compounds of formula VII can be prepared from compounds of formula Vl by reaction with a sulfonyl chloride, followed by alkylation of the resulting sulfonyl amide, and then removal of the sulfonyl moiety
• the sulfonylamide of formula XAA is alkylated using an activated alkylating agent XBB, where X is a leaving group such as halogen (such as a iodo, a bromo or a chloro) or a sulfonyl ester (such as a mesylate) in the presence of an organic or an inorganic base, in a suitable solvent (such as DMF or THF).
• halogen such as a iodo, a bromo or a chloro
• a sulfonyl ester such as a mesylate
• alkylation of sulfonylamide of formula XAA can be achieved using an alcohol XBB (where X is OH) 1 a phosphane (such as triphenyl phosphane) and an azodicarboxylate compound (such as DIAD) in a suitable solvent, such as THF, for up to 24 hours at a temperature between -20C and 45C.
• a suitable solvent such as THF
• a compound of formula XCC is treated with an organic base (such as triethyl amine) or an inorganic base (such as a carbonate or a hydroxide) in a suitable solvent (such as DCM, THF or a lower alcohol) and with a thiol (such as mercaptoacetic acid) for up to 24 hours, optionally at an elevated temperature.
• an organic base such as triethyl amine
• an inorganic base such as a carbonate or a hydroxide
• a suitable solvent such as DCM, THF or a lower alcohol
• a thiol such as mercaptoacetic acid
• R 4 is as defined above and PG is a protecting group.
• compounds of Formula (VII) may be prepared from 1° amine of Formula (Vl) by reaction with a carboxylic acid or acid halide AAA (optionally prepared in-situ) R 4 COX (where X is OH or halo), followed by reaction with a reducing agent, such as borane.
• a carboxylic acid or acid halide AAA optionally prepared in-situ
• R 4 COX where X is OH or halo
• a reducing agent such as borane.
• reaction examples include: (iv) An acid chloride (optionally generated in-situ) is reacted with an excess of the amine (Vl), optionally with an excess of 3° amine such as Et 3 N, H ⁇ nig's base or NMM, in DCM or dioxane, optionally at elevated temperature for 1 to 24 hrs; (V) An acid, WSCDI / DCCI / TBTU and HOBT / HOAT is reacted with an excess of amine (Vl) and an excess of NMM, Et 3 N, H ⁇ nig's base in THF, DCM or EtOAc, at rt. for 4 to 48 hrs; or
• a more specific example of the amide formation involves treatment of the acid with the amine in the presence of 1 -propyl phosphonic ester cyclic anhydride and in the presence of triethylamine in DCM at room temperature for 1 hour.
• this may be generated in-situ by standard methodology and then reacted with the amine (Vl) and triethylamine in dichloromethane at 70 0 C for 90 minutes
• the reaction (y) is a reduction of the amide for example by a hydride reducing agent under suitable conditions.
• the reduction of the amide is carried out in the presence of Borane in THF at reflux for 2 hours, followed by addition of methanol and aqueous ammonium chloride at reflux for 4 hours.
• compounds of Formula (IX) may be prepared from compounds of Formula (Vl) by reaction with R 4 -(CH 2 ) a -L, where a is as defined above and L is a leaving group, under suitable conditions.
• the resulting compound of Formula (IX) may then be converted to a compound of Formula (I) by amide formation and deprotection in a manner analogous to that described above in relation to Scheme 1.
• R 1 , R 2 , R 3 , R 4 , R 20 and a are as defined above, PG is a suitable protecting group and L is a leaving group, whose meaning will depend, inter alia, on the nature of the reaction and the specific reaction conditions employed. Suitable leaving groups will be readily apparent to the skilled person and are described in many standard organic chemistry texts, for example: “Advanced Organic Chemistry", Jerry March, Third Edition, Wiley (1985), page 587, incorporated herein by reference; they include halogen (e.g. Br) and sulfonate esters (e.g. methanesulfonate or trifluoromethanesulfonate).
• halogen e.g. Br
• sulfonate esters e.g. methanesulfonate or trifluoromethanesulfonate.
• compounds of Formula (IX) may be prepared from a ketone of Formula (XII) by reaction with a primary amine R 4 -(CH 2 ) a -NH 2 under suitable conditions.
• the resulting compound of Formula (IX) may then be converted to a compound of Formula (I) by amide formation and deprotection in a manner analogous to that described above in relation to Scheme 1.
• R 1 , R 2 , R 3 , R 4 , R 20 and a are as defined above and PG is a suitable protecting group.
• the reaction (e) of the primary amine R 4 -(CH 2 ) a -NH 2 with the ketone (XII) may conveniently be a reductive amination reaction in which the dehydration of the amine and the ketone is followed by reduction of the resultant imine, for example by a metal hydride reagent or hydrogenation, under suitable conditions.
• reaction of the amine and the ketone is carried out in the presence of titanium (IV) tetraisopropoxide in THF at room temperature for 18 hours, followed by reduction by an excess of sodium borohydride in methanol at room temperature for 5 hours.
• one or more sensitive functional groups may need to be protected and deprotected during the synthesis of a compound of Formula (I). This may be achieved by conventional techniques, for example as described in "Protective Groups in Organic Synthesis", 3 rd edition, by TW Greene and PGM Wuts. John Wiley and Sons, Inc., 1999, incorporated herein by reference, which also describes methods for the removal of such groups.
• R 4 and a are as defined above and PG is a protecting group, with an acid or acyl halide of Formula (II):
• the compound of Formula (IX) may be prepared by reacting a compound of Formula (Vl) with an aldehyde R 4 CHO.
• the compound of Formula (IX) may be prepared by reacting a compound of Formula (Vl) with a compound R 4 -(CH 2 ) a -L, where L is a leaving group, optionally selected from halide, methanesulfonate and trifluoromethanesulfonate.
• the compound of Formula (IX) may be prepared by reacting a compound of Formula (XII) with a compound R 4 -(CH 2 ) a -NH 2 .
• Racemic compounds may be separated either using preparative HPLC and a column with a chiral stationary phase, or resolved to yield individual enantiomers utilizing methods known to those skilled in the art.
• chiral intermediate compounds may be resolved and used to prepare chiral compounds of the invention.
• the compounds of the invention may have the advantage that they are more potent, have a longer duration of action, have a broader range of activity, are more stable, have fewer side effects, are more selective, have better tabletting properties, or have other more useful properties than the compounds of the prior art.
• the compounds of the invention are useful because they have pharmacological activity in mammals, including humans. Thus, they are useful in the treatment or prevention of disorders in which the regulation of monoamine transporter function is implicated, more particularly disorders in which inhibition of re ⁇ uptake of serotonin or noradrenaline is implicated, and especially those in which inhibition of serotonin and noradrenaline re-uptake is implicated.
• the compounds of the invention are useful in the treatment of urinary incontinence, such as genuine stress incontinence (GSI) 1 stress urinary incontinence (SUI) or urinary incontinence in the elderly; overactive bladder (OAB), including idiopathic detrusor instability, detrusor overactivity secondary to neurological diseases (e.g. Parkinson's disease, multiple sclerosis, spinal cord injury and stroke) and detrusor overactivity secondary to bladder outflow obstruction (e.g. benign prostatic hyperplasia (BPH), urethral stricture or stenosis); nocturnal eneuresis; urinary incontinence due to a combination of the above conditions (e.g. stress incontinence associated with overactive bladder); and lower urinary tract symptoms, such as frequency and urgency.
• OAB is intended to encompass both OAB wet and OAB dry.
• the compounds of the invention are also useful in the treatment of depression, such as major depression, recurrent depression, single episode depression, subsyndromal symptomatic depression, depression in cancer patients, depression in Parkinson's patients, postmyocardial infarction depression, paediatric depression, child abuse induced depression, depression in infertile women, post partum depression, premenstrual dysphoria and grumpy old man syndrome.
• depression such as major depression, recurrent depression, single episode depression, subsyndromal symptomatic depression, depression in cancer patients, depression in Parkinson's patients, postmyocardial infarction depression, paediatric depression, child abuse induced depression, depression in infertile women, post partum depression, premenstrual dysphoria and grumpy old man syndrome.
• the compounds of the invention are also useful in the treatment of cognitive disorders such as dementia, particularly degenerative dementia (including senile dementia, Alzheimer's disease, Pick's disease, Huntingdon's chorea, Parkinson's disease and Creutzfeldt- Jakob disease) and vascular dementia (including multi-infarct dementia), as well as dementia associated with intracranial space occupying lesions, trauma, infections and related conditions (including HIV infection), metabolism, toxins, anoxia and vitamin deficiency; mild cognitive impairment associated with ageing, particularly age associated memory impairment (AAMI), amnestic disorder and age-related cognitive decline (ARCD); psychotic disorders, such as schizophrenia and mania; anxiety disorders, such as generalised anxiety disorder, phobias (e.g.
• agoraphobia social phobia and simple phobias
• panic disorder obsessive compulsive disorder
• post traumatic stress disorder mixed anxiety and depression
• personality disorders such as avoidant personality disorder and attention deficit hyperactivity disorder (ADHD)
• sexual dysfunction such as premature ejaculation, male erectile dysfunction (MED) and female sexual dysfunction (FSD) (e.g.
• FSAD female sexual arousal disorder
• SAD seasonal affective disorder
• eating disorders such as anorexia nervosa and bulimia nervosa
• obesity appetite suppression
• chemical dependencies resulting from addiction to drugs or substances of abuse such as addictions to nicotine, alcohol, ***e, heroin, phenobarbital and benzodiazepines
• withdrawal syndromes such as those that may arise from the aforementioed chemical dependencies
• cephalic pain such as migraine, cluster headache, chronic paroxysmal hemicrania, headache associated with vascular disorders, headache associated with chemical dependencies or withdrawal syndromes resulting from chemical dependencies, and tension headache
• pain Parkinson's diseases, such as dementia in Parkinson's disease, neuroleptic-induced Parkinsonism and tardive dyskinesias
• endocrine disorders such as hyperprolactinaemia
• vasospasm such as in the cerebral vasculature
• Tourette's syndrome trichosted fibros syndrome
• ADHD is of particular interest.
• the diagnosis of ADHD is based on clinical evaluation (M. Dulcan, et al. J Am Acad Child Adol ⁇ sc Psychaitry, Oct. 1997, 36(10 Suppl), 85S-121 S; National Institutes of Health, 1998).
• "The essential feature of ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparative level of development” (Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), American Psychiatric Association, Washington, D.C., 1994).
• DSM-IV Diagnostic and Statistical Manual of Mental Disorders
• patients In order to be diagnosed with ADHD, patients must demonstrate symptoms of ADHD that cause impairment before the age of seven years, and symptoms must have been ongoing for longer than six months in at least two settings (e.g., school [or work] and home). (See DSM-IV).
• the compounds of the invention are also useful in the treatment of a number of other conditions or disorders, including hypotension; gastrointestinal tract disorders (involving changes in motility and secretion) such as irritable bowel syndrome (IBS), ileus (e.g. post-operative ileus and ileus during sepsis), gastroparesis (e.g. diabetic gastroparesis), peptic ulcer, gastroesophageal reflux disease (GORD, or its synonym GERD), flatulence and other functional bowel disorders, such as dyspepsia (e.g. non-ulcerative dyspepsia (NUD)) and non-cardiac chest pain (NCCP); and fibromyalgia syndrome.
• IBS irritable bowel syndrome
• ileus e.g. post-operative ileus and ileus during sepsis
• gastroparesis e.g. diabetic gastroparesis
• GORD gastroesophageal reflux disease
• the compounds of the invention being serotonin and/or noradrenaline reuptake inhibitors are potentially useful in the treatment of a range of disorders, including pain.
• Physiological pain is an important protective mechanism designed to warn of danger from potentially injurious stimuli from the external environment.
• the system operates through a specific set of primary sensory neurones and is activated by noxious stimuli via peripheral transducing mechanisms (see Millan, 1999, Prog. Neurobiol., 57, 1-164 for a review).
• These sensory fibres are known as nociceptors and are characteristically small diameter axons with slow conduction velocities. Nociceptors encode the intensity, duration and quality of noxious stimulus and by virtue of their topographically organised projection to the spinal cord, the location of the stimulus.
• nociceptive nerve fibres of which there are two main types, A-delta fibres (myelinated) and C fibres (non-myelinated).
• A-delta fibres myelinated
• C fibres non-myelinated.
• the activity generated by nociceptor input is transferred, after complex processing in the dorsal horn, either directly, or via brain stem relay nuclei, to the ventrobasal thalamus and then on to the cortex, where the sensation of pain is generated.
• Pain may generally be classified as acute or chronic. Acute pain begins suddenly and is short-lived (usually in twelve weeks or less). It is usually associated with a specific cause such as a specific injury and is often sharp and severe. It is the kind of pain that can occur after specific injuries resulting from surgery, dental work, a strain or a sprain. Acute pain does not generally result in any persistent psychological response. In contrast, chronic pain is long-term pain, typically persisting for more than three months and leading to significant psychological and emotional problems. Common examples of chronic pain are neuropathic pain (e.g. painful diabetic neuropathy, postherpetic neuralgia), carpal tunnel syndrome, back pain, headache, cancer pain, arthritic pain and chronic post-surgical pain.
• neuropathic pain e.g. painful diabetic neuropathy, postherpetic neuralgia
• carpal tunnel syndrome e.g. painful diabetic neuropathy, postherpetic neuralgia
• back pain e.g. painful diabetic neuropathy, postherpetic neuralgia
• Clinical pain is present when discomfort and abnormal sensitivity feature among the patient's symptoms. Patients tend to be quite heterogeneous and may present with various pain symptoms. Such symptoms include: 1) spontaneous pain which may be dull, burning, or stabbing; 2) exaggerated pain responses to noxious stimuli (hyperalgesia); and 3) pain produced by normally innocuous stimuli (allodynia - Meyer et al., 1994, Textbook of Pain, 13-44). Although patients suffering from various forms of acute and chronic pain may have similar symptoms, the underlying mechanisms may be different and may, therefore, require different treatment strategies. Pain can also therefore be divided into a number of different subtypes according to differing pathophysiology, including nociceptive, inflammatory and neuropathic pain.
• Nociceptive pain is induced by tissue injury or by intense stimuli with the potential to cause injury. Pain afferents are activated by transduction of stimuli by nociceptors at the site of injury and activate neurons in the spinal cord at the level of their termination. This is then relayed up the spinal tracts to the brain where pain is perceived (Meyer et al., 1994, Textbook of Pain, 13-44). The activation of nociceptors activates two types of afferent nerve fibres. Myelinated A-delta fibres transmit rapidly and are responsible for sharp and stabbing pain sensations, whilst unmyelinated C fibres transmit at a slower rate and convey a dull or aching pain.
• Moderate to severe acute nociceptive pain is a prominent feature of pain from central nervous system trauma, strains/sprains, burns, myocardial infarction and acute pancreatitis, post ⁇ operative pain (pain following any type of surgical procedure), posttraumatic pain, renal colic, cancer pain and back pain.
• Cancer pain may be chronic pain such as tumour related pain (e.g. bone pain, headache, facial pain or visceral pain) or pain associated with cancer therapy (e.g. postchemotherapy syndrome, chronic postsurgical pain syndrome or post radiation syndrome). Cancer pain may also occur in response to chemotherapy, immunotherapy, hormonal therapy or radiotherapy.
• Back pain may be due to herniated or ruptured intervertebral discs or abnormalities of the lumber facet joints, sacroiliac joints, paraspinal muscles or the posterior longitudinal ligament. Back pain may resolve naturally but in some patients, where it lasts over 12 weeks, it becomes a chronic condition which can be particularly debilitating.
• Neuropathic pain is currently defined as pain initiated or caused by a primary lesion or dysfunction in the nervous system. Nerve damage can be caused by trauma and disease and thus the term 'neuropathic pain' encompasses many disorders with diverse aetiologies. These include, but are not limited to, peripheral neuropathy, diabetic neuropathy, post herpetic neuralgia, trigeminal neuralgia, back pain, cancer neuropathy, HIV neuropathy, phantom limb pain, carpal tunnel syndrome, central post-stroke pain and pain associated with chronic alcoholism, hypothyroidism, uremia, multiple sclerosis, spinal cord injury, Parkinson's disease, epilepsy and vitamin deficiency. Neuropathic pain is pathological as it has no protective role.
• neuropathic pain are difficult to treat, as they are often heterogeneous even between patients with the same disease (Woolf & Decosterd, 1999, Pain Supp., 6, S141-S147; Woolf and Mannion, 1999, Lancet, 353, 1959-1964). They include spontaneous pain, which can be continuous, and paroxysmal or abnormal evoked pain, such as hyperalgesia (increased sensitivity to a noxious stimulus) and allodynia (sensitivity to a normally innocuous stimulus).
• the inflammatory process is a complex series of biochemical and cellular events, activated in response to tissue injury or the presence of foreign substances, which results in swelling and pain (Levine and Taiwo, 1994, Textbook of Pain, 45-56).
• Arthritic pain is the most common inflammatory pain.
• Rheumatoid disease is one of the commonest chronic inflammatory conditions in developed countries and rheumatoid arthritis is a common cause of disability. The exact aetiology of rheumatoid arthritis is unknown, but current hypotheses suggest that both genetic and microbiological factors may be important (Grennan & Jayson, 1994, Textbook of Pain, 397-407).
• Visceral pain is pain associated with the viscera, which encompass the organs of the abdominal cavity. These organs include the sex organs, spleen and part of the digestive system. Pain associated with the viscera can be divided into digestive visceral pain and non-digestive visceral pain.
• Gl gastrointestinal
• FBD functional bowel disorder
• IBD inflammatory bowel disease
• Gl disorders include a wide range of disease states that are currently only moderately controlled, including, in respect of FBD, gastro-esophageal reflux, dyspepsia, irritable bowel syndrome (IBS) and functional abdominal pain syndrome (FAPS), and, in respect of IBD, Crohn's disease, ileitis and ulcerative colitis, all of which regularly produce visceral pain.
• Other types of visceral pain include the pain associated with dysmenorrhea, cystitis and pancreatitis and pelvic pain.
• pain include: • pain resulting from musculoskeletal disorders, including myalgia, fibromyalgia, spondylitis, sero ⁇ negative (non-rheumatoid) arthropathies, non-articular rheumatism, dystrophinopathy, glycogenosis, polymyositis and pyomyositis;
• heart and vascular pain including pain caused by angina, myocardical infarction, mitral stenosis, pericarditis, Raynaud's phenomenon, scleredoma and skeletal muscle ischemia;
• head pain such as migraine (including migraine with aura and migraine without aura), cluster headache, tension-type headache mixed headache and headache associated with vascular disorders; and
• orofacial pain including dental pain, otic pain, burning mouth syndrome and temporomandibular myofascial pain.
• disorders of particular interest include urinary incontinence, such as mixed incontinence, GSI and USI; pain; depression; anxiety disorders, such as obsessive-compulsive disorder and post traumatic stress disorder; personality disorders, such as ADHD; sexual dysfunction; and chemical dependencies and withdrawal syndromes resulting from chemical dependencies.
• the invention provides:
• a compound of the invention for use in the treatment of a disorder in which the regulation of monoamine transporter function is implicated, such as urinary incontinence;
• a compound of the invention for use in the treatment of urinary incontinence such as GSI or USI
• a compound of the invention for use in the treatment of urinary incontinence such as GSI or USI
• a compound of the invention in the manufacture of a medicament for the treatment of urinary incontinence such as GSI or USI
• a method of treatment of a disorder in which the regulation of monoamine transporter function is implicated which comprises administering a therapeutically effective amount of a compound of the invention to a patient in need of such treatment;
• xi a method of treatment of a disorder in which the regulation of serotonin or noradrenaline is implicated which comprises administering a therapeutically effective amount of a compound of the invention to a patient in need of such treatment;
• xii a method of treatment of a disorder in which the regulation of serotonin and noradrenaline is implicated which comprises administering a therapeutically effective amount of a compound of the invention to a patient in need of such treatment;
• xiii) a method of treatment of urinary incontinence, such as GSl or USI, which comprises administering a therapeutically effective amount of a compound of the invention to a patient in need of such treatment.
• the compounds of the invention may be administered alone or as part of a combination therapy. If a combination of therapeutic agents is administered, then the active ingredients may be administered either sequentially or simultaneously in separate or combined pharmaceutical formulations.
• Suitable agents for adjunctive therapy include:
• an opioid analgesic e.g. morphine, heroin, hydromorphone, oxymorphone, levorphanol, levallorphan, methadone, meperidine, fentanyl, ***e, codeine, dihydrocodeine, oxycodone, hydrocodone, propoxyphene, nalmefene, nalorphine, naloxone, naltrexone, buprenorphine, butorphanol, nalbuphine or pentazocine;
• NSAID nonsteroidal antiinflammatory drug
• NSAID nonsteroidal antiinflammatory drug
• diclofenac diflusinal, etodolac
• fenbufen fenoprofen
• flufenisal flurbiprofen
• ibuprofen indomethacin
• ketoprofen ketorolac
• meclofenamic acid mefenamic acid, meloxicam
• nabumetone naproxen
• nimesulide nitroflurbiprofen
• olsalazine oxaprozin
• phenylbutazone piroxicam
• sulfasalazine sulindac
• tolmetin or zomepirac a barbiturate sedative
• dextromethorphan (+)-3-hydroxy-N-methylmorphinan) or its metabolite dextrorphan ((+)-3-hydroxy-N-methylmorphinan), ketamine, memantine, pyrroloquinoline quinine, cis-4-(phosphonomethyl)-2-piperidinecarboxylic acid, budipine, EN-3231
• doxazosin tamsulosin, clonidine, guanfacine, dexmetatomidine, modafinil, phentolamine, terazasin, prazasin or 4-amino-6,7-dimethoxy-2-(5-methane- sulfonamido-1 ,2,3,4-tetrahydroisoquinol-2-yl)-5-(2-pyridyl) quinazoline; a tricyclic antidepressant, e.g. desipramine, imipramine, amitriptyline or nortriptyline; an anticonvulsant, e.g.
• a tachykinin (NK) antagonist particularly an NK-3, NK-2 or NK-1 antagonist, e.g. ( ⁇ R,9R)-7-[3,5- bis(thfluoromethyl)benzyl]-8,9,10,11 -tetrahydro-9-methyl-5-(4-methylphenyl)-7H-
• NK tachykinin
• resinferatoxin) or antagonist e.g. capsazepine
• beta-adrenergic such as propranolol
• a local anaesthetic such as mexiletine
• a corticosteroid such as dexamethasone
• a 5-HT receptor agonist or antagonist particularly a 5-HT 1 B/ ID agonist such as eletriptan, sumatriptan, naratriptan, zolmitriptan or rizatriptan
• a 5-HT 2A receptor antagonist such as R(+)-alpha-(2,3-dimethoxy-phenyl)-1-[2-(4- fluorophenylethyl)]-4-piperidinemethanol (MDL-100907);
• a cholinergic (nicotinic) analgesic such as ispronicline (TC-1734), (E)-N-methyl-4-(3-pyridinyl)-3- buten-1 -amine (RJR-2403), (R
• a PDEV inhibitor such as 5-[2-ethoxy-5-(4-methyl-1-piperazinyl-sulphonyl)phenyl]-1-methyl-3-n- propyl-1 ,6-dihydro-7H-pyrazolo[4,3-d]pyrimidin-7-one (sildenafil), (6R,12aR)-2,3,6,7,12,12a- hexahydro-2-methyi-6-(3,4-methylenedioxyphenyl)-pyrazino[2',1':6,1]-pyrido[3,4-b]indole-1 ,4-dione
• a PDEV inhibitor such as 5-[2-ethoxy-5-(4-methyl-1-piperazinyl-sulphonyl)phenyl]-1-methyl-3-n- propyl-1 ,6-dihydro-7H-pyrazolo[4,3-d]pyrimidin-7-one (sildenafil), (6R,12
• [1 ,2,4]oxadiazol-5-one C-[1 -(1 H-tetrazol- ⁇ -ylmethylJ-cycloheptylJ-methylamine, (3S,4S)-(1 - aminomethyl-3,4-dimethyl-cyclopentyl)-acetic acid, (3S,5R)-3-aminomethyl-5-methyl-octanoic acid, (3S,5R)-3-amino-5-methyl-nonanoic acid, (3S,5R)-3-amino-5-methyl-octanoic acid,
• an inducible nitric oxide synthase (iNOS) inhibitor such as S-[2-[(1-iminoethyl)amino]ethyl]-L- homocysteine, S-[2-[(1 -iminoethyl)-amino]ethyl]-4,4-dioxo-L-cysteine, S-[2-[(1 - iminoethyl)amino]ethyl]-2-methyl-L-cysteine, (2S,5Z)-2-amino-2-methyl-7-[(1-iminoethyl)amino]-5- heptenoic acid, 2-[[(1 R,3S)-3-amino-4- hydroxy-1-(5-thiazolyl)-butyl]thio]-5-chloro-3- pyridinecarbonitrile; 2-[[(1 R,3S)-3-amino-4-hydroxy-1-(5-thiazo
• an acetylcholinesterase inhibitor such as donepezil
• a prostaglandin E 2 subtype 4 (EP4) antagonist such as N-[( ⁇ 2-[4-(2-ethyl-4,6-dimethyl-1 H- imidazo[4,5-c]pyridin-1 -yl)phenyl]ethyl ⁇ amino)-carbonyl]-4-methylbenzenesulfonamide or 4-[(1 S)- 1-( ⁇ [5-chloro-2-(3-fluorophenoxy)pyridin-3-yl]carbonyl ⁇ amino)ethyl]benzoic acid;
• a leukotriene B4 antagonist such as 1-(3-biphenyl-4-ylmethyl-4-hydroxy-chroman-7-yl)- cyclopentanecarboxylic acid (CP-105696), 5-[2-(2-Carboxyethyl)-3-[6-(4-methoxyphenyl)-5E- hexenyl]oxyphenoxy]-valeric acid (ONO-4057) or DPC-11870,
• a 5-lipoxygenase inhibitor such as zileuton, 6-[(3-fluoro-5-[4-methoxy-3,4,5,6-tetrahydro-2H- pyran-4-yl])phenoxy-methyl]-1 -methyl-2-quinolone (ZD-2138), or 2,3,5-trimethyl-6-(3- pyridylmethyl),1 ,4-benzoquinone (CV-6504);
• a sodium channel blocker such as lidocaine
• a 5-HT3 antagonist such as ondansetron, granisetron, tropisetron, azasetron, dolasetron or alosetron;
• an oestrogen agonist or selective oestrogen receptor modulator e.g. HRT therapies or lasofoxifene
• an alpha-adrenergic receptor agonist such as phenylpropanolamine or R-450
• a dopamine receptor agonist e.g. apomorphine, teachings on the use of which as a pharmaceutical may be found in US-A-5945117
• a dopamine D2 receptor agonist e.g. premiprixal, Pharmacia Upjohn compound number PNU95666; or ropinirole
• a PGE1 agonist e.g. alprostadil
• the invention thus provides, in a further aspect, a combination comprising a compound of the invention together with a further therapeutic agent.
• a suitable pharmaceutical excipient, diluent or carrier selected with regard to the intended route of administration and standard pharmaceutical practice.
• the compounds of the invention can be administered orally, buccally or sublingually in the form of tablets, capsules (including soft gel capsules), ovules, elixirs, solutions or suspensions, which may contain flavouring or colouring agents, for immediate-, delayed-, modified-, sustained-, dual-, controlled- release or pulsatile delivery applications.
• the compounds of the invention may also be administered via intracavernosal injection.
• the compounds of the invention may also be administered via fast dispersing or fast dissolving dosage forms.
• Such tablets may contain excipients such as microcrystalline cellulose, lactose, sodium citrate, calcium carbonate, dibasic calcium phosphate, glycine, and starch (preferably corn, potato or tapioca starch), disintegrants such as sodium starch glycollate, croscarmellose sodium and certain complex silicates, and granulation binders such as polyvinylpyrrolidone, hydroxypropylmethylcellulose (HPMC), hydroxypropylcellulose (HPC), sucrose, gelatin and acacia. Additionally, lubricating agents such as magnesium stearate, stearic acid, glyceryl behenate and talc may be included.
• excipients such as microcrystalline cellulose, lactose, sodium citrate, calcium carbonate, dibasic calcium phosphate, glycine, and starch (preferably corn, potato or tapioca starch), disintegrants such as sodium starch glycollate, croscarmellose sodium and certain complex silicates, and
• Solid compositions of a similar type may also be employed as fillers in gelatin capsules.
• Preferred excipients in this regard include lactose, starch, a cellulose, milk sugar or high molecular weight polyethylene glycols.
• the compounds of the invention, and their pharmaceutically acceptable salts may be combined with various sweetening or flavouring agents, colouring matter or dyes, with emulsifying and/or suspending agents and with diluents such as water, ethanol, propylene glycol and glycerin, and combinations thereof.
• Modified release and pulsatile release dosage forms may contain excipients such as those detailed for immediate release dosage forms together with additional excipients that act as release rate modifiers, these being coated on and/or included in the body of the device.
• Release rate modifiers include, but are not exclusively limited to, hydroxypropylmethyl cellulose, methyl cellulose, sodium carboxymethylcellulose, ethyl cellulose, cellulose acetate, polyethylene oxide, Xanthan gum, Carbomer, ammonio methacrylate copolymer, hydrogenated castor oil, carnauba wax, paraffin wax, cellulose acetate phthalate, hydroxypropylmethyl cellulose phthalate, methacrylic acid copolymer and mixtures thereof.
• Modified release and pulsatile release dosage forms may contain one or a combination of release rate modifying excipients.
• Release rate modifying excipients may be present both within the dosage form i.e. within the matrix, and/or on the dosage form, i.e. upon the surface or coating.
• Fast dispersing or dissolving dosage formulations may contain the following ingredients: aspartame, acesulfame potassium, citric acid, croscarmellose sodium, crospovidone, diascorbic acid, ethyl acrylate, ethyl cellulose, gelatin, hydroxypropylmethyl cellulose, magnesium stearate, mannitol, methyl methacrylate, mint flavouring, polyethylene glycol, fumed silica, silicon dioxide, sodium starch glycolate, sodium stearyl fumarate, sorbitol, xylitol.
• dispersing or dissolving as used herein to describe FDDFs are dependent upon the solubility of the drug substance used i.e. where the drug substance is insoluble a fast dispersing dosage form can be prepared and where the drug substance is soluble a fast dissolving dosage form can be prepared.
• the compounds of the invention can also be administered parenterally, for example, intravenously, intra- arterially, intraperitoneally, intrathecal ⁇ , intraventricular ⁇ , intraurethrally, intrastemally, intracranially, intramuscularly or subcutaneously, or they may be administered by infusion techniques.
• parenteral administration they are best used in the form of a sterile aqueous solution which may contain other substances, for example, enough salts or glucose to make the solution isotonic with blood.
• the aqueous solutions should be suitably buffered (preferably to a pH of from 3 to 9), if necessary.
• the preparation of suitable parenteral formulations under sterile conditions is readily accomplished by standard pharmaceutical techniques well known to those skilled in the art.
• the daily dosage level of the compounds of the invention or salts or solvates thereof will usually be from 10 to 500 mg (in single or divided doses).
• tablets or capsules of the compounds of the invention or salts or solvates thereof may contain from 5 mg to 250 mg of active compound for administration singly or two or more at a time, as appropriate.
• the physician in any event will determine the actual dosage which will be most suitable for any individual patient and it will vary with the age, weight and response of the particular patient.
• the above dosages are exemplary of the average case. There can, of course, be individual instances where higher or lower dosage ranges are merited and such are within the scope of this invention.
• compounds of the invention may be taken as a single dose on an "as required" basis (i.e. as needed or desired).
• a tablet formulation could typically contain between about 0.01 mg and 500mg of a compound according to the present invention (or a salt thereof) whilst tablet fill weights may range from 50mg to 1000mg.
• An example formulation for a 10mg tablet is illustrated:
• the compounds of the invention can also be administered intranasal ⁇ or by inhalation and are conveniently delivered in the form of a dry powder inhaler or an aerosol spray presentation from a pressurised container, pump, spray or nebulizer with the use of a suitable propellant, e.g.
• the dosage unit may be determined by providing a valve to deliver a metered amount.
• the pressurised container, pump, spray or nebulizer may contain a solution or suspension of the active compound, e.g.
• Capsules and cartridges (made, for example, from gelatin) for use in an inhaler or insufflator may be formulated to contain a powder mix of a compound of the invention and a suitable powder base such as lactose or starch.
• Aerosol or dry powder formulations are preferably arranged so that each metered dose or "puff" contains from 1 to 50 mg of a compound of the invention for delivery to the patient.
• the overall daily dose with an aerosol will be in the range of from 1 to 50 mg which may be administered in a single dose or, more usually, in divided doses throughout the day.
• the compounds of the invention may also be formulated for delivery via an atomiser.
• Formulations for atomiser devices may contain the following ingredients as solubilisers, emulsifiers or suspending agents: water, ethanol, glycerol, propylene glycol, low molecular weight polyethylene glycols, sodium chloride, fluorocarbons, polyethylene glycol ethers, sorbitan trioleate, oleic acid.
• the compounds of the invention can be administered in the form of a suppository or pessary, or they may be applied topically in the form of a gel, hydrogel, lotion, solution, cream, ointment or dusting powder.
• the compounds of the invention may also be dermally or transdermal ⁇ administered, for example, by the use of a skin patch. They may also be administered by the ocular, pulmonary or rectal routes.
• the compounds can be formulated as micron ized suspensions in isotonic, pH adjusted, sterile saline, or, preferably, as solutions in isotonic, pH adjusted, sterile saline, optionally in combination with a preservative such as a benzylalkonium chloride.
• a preservative such as a benzylalkonium chloride.
• they may be formulated in an ointment such as petrolatum.
• the compounds of the invention can be formulated as a suitable ointment containing the active compound suspended or dissolved in, for example, a mixture with one or more of the following: mineral oil, liquid petrolatum, white petrolatum, propylene glycol, polyoxyethylene polyoxypropylene compound, emulsifying wax and water.
• they can be formulated as a suitable lotion or cream, suspended or dissolved in, for example, a mixture of one or more of the following: mineral oil, sorbitan monostearate, a polyethylene glycol, liquid paraffin, polysorbate 60, cetyl esters, wax, cetearyl alcohol, 2-octyldodecanol, benzyl alcohol and water.
• the compounds of the invention may also be used in combination with a cyclodextrin.
• Cyclodextrins are known to form inclusion and non-inclusion complexes with drug molecules. Formation of a drug- cyclodextrin complex may modify the solubility, dissolution rate, bioavailability and/or stability property of a drug molecule. Drug-cyclodextrin complexes are generally useful for most dosage forms and administration routes.
• the cyclodextrin may be used as an auxiliary additive, e.g. as a carrier, diluent or solubiliser.
• Alpha-, beta- and gamma-cyclodexthns are most commonly used and suitable examples are described in WO-A-91/11172, WO-A-94/02518 and WO- A-98/55148.
• the daily dosage levels of compounds of formula (I), and their pharmaceutically acceptable salts will be from 0.01 to 30 mg/kg (in single or divided doses) and preferably will be in the range 0.01 to 5 mg/kg.
• tablets will contain 1mg to 0.4g of compound for administration singly or two or more at a time, as appropriate.
• the physician will in any event determine the actual dosage which will be most suitable for any particular patient and it will vary with the age, weight and response of the particular patient.
• the above dosages are, of course only exemplary of the average case and there may be instances where higher or lower doses are merited, and such are within the scope of the invention.
• Oral administration is preferred.
• a compound of the invention is administered as a suitably acceptable formulation in accordance with normal veterinary practice and the veterinary surgeon will determine the dosing regimen and route of administration which will be most appropriate for a particular animal.
• the invention provides a pharmaceutical formulation containing a compound of the invention and a pharmaceutically acceptable adjuvant, diluent or carrier.
• compositions comprising a combination as defined above together with a pharmaceutically acceptable adjuvant, diluent or carrier comprise a further aspect of the invention.
• the individual components of such combinations may be administered either sequentially or simultaneously in separate or combined pharmaceutical formulations.
• dose of each compound may differ from that when the compound is used alone Appropriate doses will be readily appreciated by those skilled in the art
• compounds of the invention are isolated following work-up in the form of the free base, but pharmaceutically acceptable acid addition salts of the compounds of the invention may be prepared using conventional means.
• Solvates e.g. hydrates
• a compound of the invention may be formed during the work-up procedure of one of the aforementioned process steps.
• reaction times, number of equivalents of reagents and reaction temperatures may be modified for each specific reaction, and that it may nevertheless be necessary or desirable to employ different work-up or purification conditions.
• Triethylamine (24ml, 170mmol) was added to a solution of the amine of preparation 1 (36.1 g, 142mmol) in dichloromethane (350ml) under nitrogen.
• the reaction mixture was cooled to O 0 C and 2,3-dichloro-benzoyl chloride (29.8g, 142mmol) in dichloromethane was added dropwise keeping the temperature below 5 0 C.
• the reaction mixture was then stirred for 6 hours. Water (200ml) was added and the organic phase collected. The aqueous layer was extracted with dichloromethane (250ml).
• Oxalyl chloride (2 13ml, 24 4mmol) was added to a suspension of 2,3-d ⁇ chloro-4-fluoro benzoic acid (4 25g, 20 33mmol) (see EP0600317, example 15) in dry dichloromethane (41 ml) at room temperature under nitrogen N,N-d ⁇ methylformam ⁇ de (80 ⁇ l, 1 mmol) was added and the reaction mixture stirred for 1 hour Solvent was removed by evaporation under reduced pressure to produce a yellow solid, which was dissolved in dichloromethane (20ml) and added dropwise to solution of triethylamine (4 72ml, 33 9mmol) and the amine of preparation 1 (4 31 g, 16 95mmol) in dichloromethane (36ml) under nitrogen After stirring for 18 hours at room temperature, the resultant mixture was diluted with dichloromethane (100ml) and 1 M aqueous potassium carbonate (90ml) The organic phase was dried over magnesium sulfate, filtered and
• tert-butyl (3S)-3-(cyclohexylam ⁇ no)pyrrol ⁇ d ⁇ ne-1-carboxylate was prepared by a method similar to that described in preparation 1 using tert-butyl (3S)-3-am ⁇ nopyrrol ⁇ d ⁇ ne-1-carboxylate and cyclohexanone to yield the desired product, 5 9g (82%) 1 HNMR(CDCI 3 , 400MHz) ⁇ : 1.09(m, 2H) 1 1.24(m, 3H), 1.45(s, 9H), 1.62(m, 2H), 1.72(m, 2H), 1.88(m, 2H),
• fert-butyl (SSJ-S-fcyclobutylaminoJpyrrolidine-i-carboxylate was prepared by a method similar to that described in preparation 1 using tert-butyl (3S)-3-aminopyrrolidine-1-carboxylate and cyclobutanone (15 equivalents: 10 eq. added first, 5 eq. added before the second azeotropic removal of water) except that the crude product was purified by column chromatography on silica gel to yield the title compound, 542mg
• tert-butyl (3S)-3-aminopyrrolidine-1-carboxylate (5g, 27mmol) was added to a solution of 2,6-lutidine (6.2mL, 54mmol) in dichloromethane (150ml) under nitrogen.
• the reaction mixture was cooled down to 0 0 C and a solution of 2,4-dinitrobenzenesulphonyl chloride (7.15g, 27mmol) in dichloromethane (100ml) was slowly added over 15 minutes at 0 0 C.
• the reaction mixture was then stirred at room temperature for 48 hours under nitrogen. Water (100ml) was added followed by 2N aqueous hydrogen chloride until the aqueous layer reached pH 2.
• Tetrahydrofuran was evaporated and the residue taken up in dichloromethane (20ml). Triethylamine (0.53ml, 3.84mmol) and mercapto acetic acid (0.16ml, 2.3mmol) were added and the reaction mixture was stirred at room temperature for 2 hours. It was then washed with 2N aqueous hydrogen chloride. The aqueous layer was basified to pH11 with 2M sodium hydroxide and back-extracted three times with ethyl acetate. The organic phases were then concentrated in vacuo to provide the title compound (151mg,
• fert-butyl (3S)-3-(cyclopropylmethylamino)pyrrolidine-1-carboxylate was prepared by a method similar to that described in preparation 1 using tert-butyl (3S)-3-aminopyrrolidine-1-carboxylate and cyclopropane carboxaldehyde except that the crude product was purified by chromatography on silica gel eluting with a solvent gradient of dichloromethane changing to dichloromethane:methanol:0.88 ammonia (90:10:1 by volume) to yield the title compound, 5.2g (81%).
• tert-butyl (3S)-3-aminopyrrolidine-1-carboxylate was added to a solution of tetrahydro-4H-pyran-4-one and 10% Pd/C (300mg) in ethanol and the reaction mixture left under about 415 kPa (about 60psi) of hydrogen gas for 18 hours.
• the reaction mixture was filtered through Arbocel®, washing through thoroughly with ethyl acetate. The filtrate was concentrated in vacuo and the crude product purified by column chromatography on silica gel to yield the desired product, 6.7g (61%).
• fert-Butyl-(3S)-3-[(2-chlorobenzoyl)(cyclopentyl)amino]pyrrolidine-1 -carboxylate was prepared by a method similar to that described in preparation 2 (using Toluene as solvent, N-Methyl Morpholine as base, and heating the reaction mixture at 60 0 C for 18 hours) using the amine of preparation 1 and 2-chlorobenzoyl chloride to yield the desired product, 1.16g (75%).
• fe/f-butyl (3S)-3-(cycloheptylamino)pyrrolidine-1-carboxylate was prepared by a method similar to that described in preparation 14 using tert-butyl (3S)-3-aminopyrrolidine-1-carboxylate and cycloheptanone to yield the desired product, 4.54g (100%).
• fert-Butyl- ⁇ S ⁇ -S-fcyclopentyip-OrifluoromethylJbenzoyllaminoJpyrrolidine-i -carboxylate was prepared by a method similar to that described in preparation 2 (using Toluene as solvent, N-Methyl Morpholine as base, and heating the reaction mixture at 60 0 C for 18 hours) using the amine of preparation 1 and 2- (trifluoromethyl)benzoyl chloride to yield the desired product, 910mg (54%).
• tert-Butyl(3S)-3- ⁇ (2,3-dichlorobenzoyl)[(1 -methylcyclopropyl)methyl]amino ⁇ pyrrolidine-1 -carboxylate was prepared by a method similar to that described in Preparation 2 using the amine of Preparation 24 and 2,3-dichlorobenzoyl chloride to yield the desired product (448mg, 85%).
• the Boc protected product of preparation 2 (46g, 107mmol) was dissolved in dichloromethane (85ml) under nitrogen and the reaction mixture treated with trifluoroacetic acid (85ml, 1 mol) added dropwise at 0 0 C. The reaction mixture was then stirred at room temperature for 4 hours, evaporated under reduced pressure, azeotroped twice with toluene and concentrated in vacuo. The residue was taken up in dichloromethane (400ml) and washed with 1 M aqueous sodium hydroxide (200ml). The organic phase was separated, dried over magnesium sulfate and concentrated in vacuo.
• the solid was recrystallised from isopropanol/ methanol (700ml of isopropanol and minimal amount of methanol required to achieve solubility) and dried under high vacuum to provide the title compound as a white solid (13.94g).
• tert-Butyl(3S)-3-[cyclopentyl(3-chloro-2-methylbenzoyl)amino]pyrrolidine-1-carboxylate was prepared by a method similar to that described in preparation 3 using the amine of preparation 1 and 3-chloro-2-methyl benzoic acid to yield the desired product, 606mg (crude). MS APCI+ m/z 407 [MH] + .
• te/t-Butyl(3S)-3-[(2-chloro-3-fluorobenzoyl)(cyclopentyl)amino]pyrrolidine-1-carboxylate was prepared by a method similar to that described in preparation 3 using the amine of preparation 1 and 2-chloro-3-fluoro benzoic acid to yield the desired product.
• 2,3-dichloro- ⁇ /-cyclobutyl- ⁇ /-[(3S)-pyrrolidin-3-yl]benzamide hydrochloride was prepared from the compound of preparation 9 by a method similar to that described in example 2 to yield the title product as a solid, 311 mg (99%).
• 2,3-dichloro- ⁇ /-(cyclopropylmethyl)- ⁇ /-[(3S)-pyrrolidin-3-yl]benzamide_hydrochloride was prepared from the foregoing compound by a method similar to that described in example 1 , purification by chromatography, and formation of the hydrogen chloride salt, yielding the title product as a gum, 393mg (77%).
• 2,3-dichloro- ⁇ /-t(3S)-pyrrolidin-3-yl]- ⁇ /-t ⁇ trahydro-2H-pyran-4-yibenzamide was prepared from the compound of preparation 15 by a method similar to that described in example 2 (the free base was obtained by column chromatography on silica gel using a gradient of Methylene Chloride: Methanol:
• ⁇ /-cycloheptyl- ⁇ /-[(3S)-pyrrolidin-3-yl]-2-(trifluoromethyl)benzamide was prepared from the compound of preparation 20 by a method similar to that described in example 1 to yield the title product, 502mg (72%).
• ⁇ /-cyclohexyl- ⁇ /-[(3S)-pyrrolidin-3-yl]-2-(trifluoromethyl)benzamide was prepared from the compound of preparation 21 by a method similar to that described in example 1 to yield the title product, 460mg (69%).
• NRI Ki and SRI Ki of the compounds of Examples 1 to 21 were determined as follows. A selection of the results are set out below in Table 1. All of the Example compounds exhibited an NRI Ki and an SRI Ki of less than 10OnM. Biological activity
• the compounds were tested for biological activity by their ability to inhibit binding of selective radioligands at the human serotonin and noradrenaline transporters (SERT and NET, respectively), using scintillation proximity assay (SPA) technology.
• the SPA binding was performed using cellular membrane preparations prepared from cell lines expressing human cDNA encoding either SERT or NET (hSERT, hNET), using the radioligands 3 H-citalopram and 3 H-nisoxetine.
• Human embryonic kidney cells (HEK-293) expressing each transporter were maintained as a continuous culture, using standard cell culture techniques, in 50 ml_ of growth medium (see Media and Buffers for composition) in 225 cm 2 flasks, at 37 S C in a humidified atmosphere with 5 % CO 2 present. Cells were passaged from a 90 % confluent monolayer at a ratio of 1 :3 - 1 :4.
• the growth medium was removed from the monolayer and the cells were incubated with cell dissociation solution (Sigma) until showing signs of dissociation.
• the cells were subsequently knocked from the base of the flask and pelleted by centrifugation for storage (frozen at - 80 B C) prior to further use.
• Cell pellets were thawed on ice and resuspended in 3 mL of membrane preparation buffer (see Media and Buffers for composition) per 1 mL of packed cell volume, using a vortex mixer to disperse the cell pellet. After incubation on ice for 10 minutes, the suspension was homogenised for four individual 10 second intervals using a hand-held homogeniser. The homogenate was then centrifuged at 1075 x g for 20 minutes at 4 5 C.
• membrane preparation buffer see Media and Buffers for composition
• the pooled supernatants were centrifuged at 35000 x g for 30 minutes at 4 B C, and the supernatants discarded.
• the pellets (P2) were then resuspended in 1 mL of membrane preparation buffer per 1 mL of the original packed cell volume. Protein concentrations were then measured and the membrane suspension was finally frozen in aliquots of set volume and stored at - 80 9 C prior to use in assays.
• Tritiated radioligands specific to each transporter 3 H-citalopram for hSERT and 3 H-nisoxetine for hNET were used.
• the assay free radioligand concentration was expressed as a percentage of the total free radioligand concentration to give an estimate of the radioligand depletion.
• the radioligand depletion in assays for both transporters was less than 30% to ensure that there was sufficient radioligand available for binding.
• the ligand depletion value was also used for selecting the optimal assay conditions when using new batches of membranes.
• the affinity of the specific radioligand for the respective transporter was determined for each membrane batch at the selected protein and bead concentrations. This was achieved by the determination of the K D , the concentration of free radioligand at which 50 % of the transporter binding sites were occupied.
• the mean K D for a radioligand at a batch of membranes was determined from data from a minimum of three separate assays. The mean K D was subsequently used for all assays using the membrane batch profiled to enable determination of K 1 values of compounds studied using the method determined by Cheng and Prussoff (Cheng YC and Prusoff WH. Relationship between the inhibition constant (K 1 ) and the concentration of inhibitor which causes 50% inhibition of an enzymatic reaction. Biochem Pharmacol 1973: 22:2099-3108.)
• the bead/membrane complex was spun down at 865 x g for 5 minutes.
• the resulting pellet was resuspended in assay buffer and this spin/wash step then repeated.
• the final pellet was then resuspended in assay buffer at the specific concentration required for the final assay.
• test compounds were prepared at a concentration of 4 mM in 100 % dimethyl sulphoxide (DMSO) from dry samples. Compounds were diluted in 0.75 % DMSO in ddH 2 O to give appropriate test concentrations in a 384 well plate to give a final volume of 20 ⁇ L.
• DMSO dimethyl sulphoxide
• the assay window (specific binding) per plate was calculated by subtracting the mean NSB readings (in counts per minute, or cpm) from the mean of total binding readings. Subsequently the cpm read per well
• IC 50 value the concentration of compound required to inhibit 50% of the specific binding at the neurotransmitter transporter.
• the inhibitory dissociation constant (K 1 ) value was then calculated from the IC 50 value using the Cheng-
• the compounds can also be tested in specific disease models, such as the pain models as follows:
• the activity of a compound in the treatment of neuropathic pain may be measured according to the following test protocol.
• the CCI of sciatic nerve is performed as previously described by Bennett and Xie (Bennett GJ, Xie YK. A peripheral mononeuropathy in rat that produces disorders of pain sensation like those seen in man. Pain:33:87-107, 1988).
• Animals are anaesthetised with a 2% isofluorane/O2 mixture.
• the right hind thigh is shaved and swabbed with 1% iodine.
• Animals are then transferred to a homeothermic blanket for the duration of the procedure and anaesthesia maintained during surgery via a nose cone.
• the skin is cut along the line of the thighbone.
• the common sciatic nerve is exposed at the middle of the thigh by blunt dissection through biceps femoris. About 7mm of nerve is freed proximal to the sciatic trifurcation, by inserting forceps under the nerve and the nerve gently lifted out of the thigh. Suture is pulled under the nerve using forceps and tied in a simple knot until slight resistance is felt and then double knotted. The procedure is repeated until 4 ligatures (4-0 silk) are tied loosely around the nerve with approx 1mm spacing. The incision is closed in layers and the wound treated with topical antibiotics.
• Diabetes is induced by a single intraperitoneal injection of streptozotocin (50mg/kg) freshly dissolved in 0.9% sterile saline. Streptozotocin injection induces a reproducible mechanical allodynia within 3 weeks, lasting for at least 7 weeks (Chen and Pan, Hypersensitivity of Spinothalamic Tract Neurons Associated With Diabetic Neuropathic Pain in Rats. J Neurophysiol 87: 2726-2733, 2002).
• Static allodynia is evaluated by application of von Frey hairs (Stoelting, Wood Dale, Illinois, USA.) in ascending order of force (0.6, 1 , 1.4, 2, 4, 6, 8, 10, 15 and 26 grams) to the plantar surface of hind paws. Each von Frey hair is applied to the paw for a maximum of 6 sec, or until a withdrawal response occurred. Once a withdrawal response to a von Frey hair is established, the paw is re-tested, starting with the filament below the one that produced a withdrawal, and subsequently with the remaining filaments in descending force sequence until no withdrawal occurrs.
• paw withdrawal threshold PWT
• Static allodynia is defined as present if animals respond to a stimulus of, or less than, 4g, which is innocuous in naive rats (Field MJ, Bramwell S, Hughes J, Singh L. Detection of static and dynamic components of mechanical allodynia in rat models of neuropathic pain: are they signalled by distinct primary sensory neurones? Pain,1999;83:303-11).
• Dynamic allodynia is assessed by lightly stroking the plantar surface of the hind paw with a cotton bud. To avoid recording general motor activity, care is taken to perform this procedure in fully habituated rats that are not active. At least two measurements are taken at each time point, the mean of which represents the paw withdrawal latency (PWL). If no reaction is exhibited within 15 sec the procedure is terminated and animals are assigned this withdrawal time. A pain withdrawal response is often accompanied with repeated flinching or licking of the paw. Dynamic allodynia is considered to be present if animals respond to the cotton stimulus within 8 sec of commencing stroking (Field et al, 1999).
• Nociceptive pain The activity of a compound in the treatment of nociceptive pain may be measured according to the following test protocols.
• mice Male Sprague Dawley rats are placed on a hot plate (Ugo Basile, Italy) maintained at 55 ⁇ 5 9 C. The time between placement of the animal on the hot plate and occurrence of either licking of fore or hind paw, shaking or jumping off the surface is measured. Baseline measurements are made and animals reassessed following drug administration. The cut off time for hot plate latencies is set at 20 seconds to prevent tissue damage.
• Ovariohysterectomy (OVX)
• mice Female Sprague Dawley rats are placed into an anaesthetic chamber and anaesthetised with a 2% isofluorane O 2 mixture. During surgery, anaesthesia is maintained via a nose cone. OVX is performed via a midline incision (2cm in length) in the linea alba, whilst the animal is on a heat blanket. The ovarian ligaments and cervix are ligated with 5-0 silk, using a single clamp technique. The ovaries and uterus are then removed. The abdominal wall is closed using 4 simple interrupted sutures and the skin closed using 4 wound clips. Immediately after surgery animals are placed in individual plexiglass chambers.
• Postures scored are humpback position, contraction of the muscle of the abdomen associated with inward movements of the hind limb, stretching of the body and squashing of the lower abdomen against the floor. Each of these behaviours is scored as one posture.
• mice Male Sprague Dawley rats are placed into an anaesthetic chamber and anaesthetised with a 2% isofluorane O 2 mixture. During surgery, anaesthesia is maintained via a nose cone. The plantar aspect of the right hind paw is cleaned with 50% ethanol. A 1cm long longitudinal incision is made with a number 11 blade through the skin and fascia of the plantar aspect of the foot, starting 0.5cm from the proximal edge of the heel and extending toward the toes. The plantaris muscle is elevated using forceps and incised longitudinally, the muscle origin and insertion remain intact. After haemostasis with gentle pressure, the skin is closed with two simple sutures of braided silk.
• MIA Mono-lodoacetate
• mice Female SLC, Shizuoka, Japan.
• the mice are housed in accordance with National Institutes of Health guidelines in a vivarium maintained at 22 0 C with a 12- hour alternating light-dark cycle, and were given food and water ad libitum.
• the sarcoma injection protocol which is used has been described. After induction of general anesthesia with an inhalation of isofluran (2%), a superficial incision is made in the skin overlying the patella, using Mora scissors. The patellar ligament is then cut, exposing the condyles of the distal femur.
• a 30-gauge needle is inserted at the level of the intercondylar notch and into the medullary canal to create an initial core pathway. After the initial core is made, a 29-gauge needle is used to make the final pathway into the bone. A 0.5-mm depression is then made using a half-round bur in a pneumatic dental high speed handpiece, to serve as mechanical retention for the dental resin plug. Then, 20 ⁇ *l S-minimum essential media (Sigma; sham injection) or 20 M media containing 1 X10 5 2472 osteolytic sarcoma cells (American Type Culture Collection, Rockville, Maryland; sarcoma injection) is injected using a 29-gauge needle and a .25 cc syringe.
• the injection site is closed with dental resin, followed by copious irrigation with filtered water.
• Wound closure is achieved using auto wound clips (Becton Dickinson, San Jose, California). Wound clips are removed at day 5 to prevent interference with behavioral testing.
• Static allodynia is evaluated by application of von Frey hairs (Stoelting, Wood Dale, Illinois, USA.) in ascending order of force (0.6, 1 , 1.4, 2, 4, 6, 8, 10, 15 and 26 grams) to the plantar surface of hind paws. Each von Frey hair is applied to the paw for a maximum of 6 sec, or until a withdrawal response occurrs. Once a withdrawal response to a von Frey hair is established, the paw is re-tested, starting with the filament below the one that produces a withdrawal, and subsequently with the remaining filaments in descending force sequence until no withdrawal occurrs.
• paw withdrawal threshold PWT
• Static allodynia is defined as present if animals respond to a stimulus of, or less than, 4g, which is innocuous in naive rats (Field MJ, Bramwell S, Hughes J, Singh L. Detection of static and dynamic components of mechanical allodynia in rat models of neuropathic pain: are they signalled by distinct primary sensory neurones? Pain,1999;83:303-11).
• Dynamic allodvnia Dynamic allodynia is assessed by lightly stroking the plantar surface of the hind paw with a cotton bud. To avoid recording general motor activity, care is taken to perform this procedure in fully habituated rats that are not active. At least two measurements are taken at each time point, the mean of which represents the paw withdrawal latency (PWL). If no reaction is exhibited within 15 sec the procedure is terminated and animals are assigned this withdrawal time. A pain withdrawal response is often accompanied with repeated flinching or licking of the paw. Dynamic allodynia is considered to be present if animals respond to the cotton stimulus within 8 sec of commencing stroking (Field et al, 1999).
• the activity of compound in the treatment of inflammatory pain may be measured according to the following test protocol.
• CFA 300 ⁇ g of Mycobacterium Tuberculosis H37 RA (Difco Laboratories) in 100 ⁇ L of liquid paraffin (Wako)
• Wako liquid paraffin
• the test compound suspended in 0.1% MC (Wako) is administered orally in a volume of 1 mL per 100 g body weight. Each animal is placed in the apparatus and the weight load exerted by the hind paws is measured before, 1 , 2 and 4 hours after drug administration.
• Hyperalgesia is induced by intraplantar injection of Lambda ' -carrageenin (0.1 ml of 1% w/v solution in saline, Zushikagaku).
• the test compound (1 ml of 0.1% methylcellulose/10Og body weight) is given orally at 5.5 hours after the carrageenin injection.
• the paw withdrawal threshold (gram) is measured by analgesimeter (Ugo Basile) at 3.5, 4.5, 6.5 and 7.5 hours after the carrageenin injection. (Randall LO. & Selitto IJ. , Arch. Int. Pharmacodyn. 111 , 409-419, 1957)
• Thermal hyperalgesia is assessed using the rat plantar test (Ugo Basile, Comerio, Italy), according to a method modified by Hargreaves et al. (1988). Briefly, rats are habituated to the apparatus that consists of three individual Perspex boxes on a glass table. A mobile radiant heat source is located under the table and focused onto the desired paw. Paw withdrawal latencies (PWLs) are recorded three times for both hind paws of each animal, the mean of which represents baseline for left and right hind paws. The apparatus is calibrated to give a PWL of approximately 10 s in na ⁇ ve rats. To prevent tissue damage of the plantar zone, a 22.5 sec cut-off is observed. Lambda carrageenan is injected intraplantarly (100 ⁇ l, 20 mg/ml) the right hind paw and baseline recordings of PWT are taken 2 hr post administration.
• PWLs Paw withdrawal latencies
• the activity of a compound in the treatment of visceral pain may be measured according to the following test protocols.
• TNBS thnitrobenzenesulfonic acid
• mice Male Sprague-Dawley rats are used. The animals are housed 3 per cage in a regulated environment (20 ⁇ 1 0 C, 50 ⁇ 5 % humidity, with light 8:00 am to 8:00 pm). At day 0, under anesthesia (ketamine 80 mg/kg i.p.; acepromazine 12 mg/kg Lp.), the injection of TNBS (50 mg/kg in ethanol 30 %), or saline (1.5 ml/kg) for control rats, is performed into the proximal colon wall (1 cm from the cecum). After the surgery, animals are individually housed in polypropylene cages and kept in a regulated environment (20 ⁇ 1 0 C, 50 ⁇ 5 % humidity, with light 8:00 a.m.
• a balloon (5-6 cm length) is inserted by anus, and kept in position (tip of balloon 5 cm from the anus) by taping the catheter to the base of the tail.
• Oral administration of the test compound is performed 1 h before the colonic distension cycle: the balloon is progressively inflated by steps of 5 mm Hg (0.667 kPa), from 0 to 75 mm Hg, each step of inflation lasting 30 s.
• Each cycle of colonic distension is controlled by a standard barostat.
• the threshold (mm Hg) corresponds to the pressure which produced the first abdominal contraction, and the cycle of distension is then discontinued.
• the colonic threshold is determined after performance of four cycles of distension on the same animal.
• LPS lipo-polysaccharide
• Animals are surgically prepared for electromyography: rats are anaesthetized by intraperitoneal injection of acepromazine (0.6 mg/kg) and ketamine (120 mg/kg). Three groups of three electrodes are implanted in the abdominal external oblique musculature, just superior to the inguinal ligament. Electrodes are exteriorized on the back of the neck and protected by a glass tube attached to the skin. Animals are individually housed in polypropylene cages and kept in a temperature-controlled room (21 0 C). Food (UAR pellets, Epinay, France) and water are provided ad libitum.
• Electromyographic recordings begin five days after surgery.
• the electrical activity of abdominal striated muscles is recorded with an electroencephalograph machine (Mini VIII Alvar, Paris, France) using a short time constant (0.03 s) to remove low-frequency signals ( ⁇ 3 Hz) and a paper speed of 3.6 cm/min. Spike bursts are recorded as an index of abdominal contractions.
• Distension procedure Rats are placed in plastic tunnels (6 cm diameter x 25 cm long), where they cannot move, escape, or turn around, in order to prevent damage to the balloon. Animals are accustomed to this procedure for four days before rectal distension in order to minimize stress reactions during experiments.
• the balloon used for distension is an arterial embolectomy catheter (Fogarty, Edwards Laboratories Inc.). Rectal distension is performed by insertion of the balloon (2 mm diameter x 2 cm long) into the rectum, at 1 cm from the anus, and catheter is fixed at the base of the tail. It is inflated progressively with tepid water by steps of 0.4 ml, from 0 to 1.2 ml, each step of inflation lasting 5 min. To detect possible leakage, the volume of water introduced in the balloon is checked by complete removal with a syringe at the end of the distension period.

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