US20040242552A1

US20040242552A1 - New use of antimineralocorticoid compounds against narcotic withdrawal syndrome

Info

Publication number: US20040242552A1
Application number: US10/858,320
Authority: US
Inventors: Francis Petit; Daniel Philibert; Nick Goeders
Original assignee: Aventis Pharma SA
Current assignee: Aventis Pharma SA
Priority date: 1995-09-21
Filing date: 2004-06-01
Publication date: 2004-12-02
Also published as: ES2166001T3; FR2739029B1; US6147066A; PT863760E; ATE209920T1; EP0863760A1; DK0863760T3; JP2000513704A; WO1997010827A1; DE69617729D1; EP0863760B1; US6759399B1; FR2739029A1; DE69617729T2

Abstract

A method of treating narcotic withdrawal symptoms in warm-blooded animals comprising administering to warm-blooded animals in need thereof an amount of a compound having anti-mineralocorticoid activity sufficient to treat narcotic withdrawal sypmtoms.

Description

Use of compounds having an antimineralocorticoid activity for the preparation of medicaments intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics and the compositions containing them.

The products having an antimineralocorticoid activity are known as being able to be used as medicaments. They are, in particular, antagonists of aldosterone and they increase salt and water diuresis with conservation of organic potassium; moreover they have, for some, the advantage of being devoid of hormonal side-effects, in particular anti-androgen and anti-estrogen effects. They can therefore be used to combat, in particular, arterial hypertension and cardiac insufficiencies.

There are two major types of glucocorticoid receptor at the level of the central nervous system, the type I receptor and the type II receptor (R. Ahima et al. J. Comp. Neurol. 313 (1991) 522-528; Neuroscience 39 (1990) 579-604).

The type I receptor, at the level of the brain, is identical to the standard mineralocorticoid receptor found at the level of the kidney, and it has a high affinity and a low bonding capacity for the endogenous glucocorticoids. In others terms, an antimineralocorticoid behaves at the level the central nervous system as a type I antiglucocorticoid.

The Applicant has demonstrated the new and unexpected use of these products, mentioned above.

It has previously been shown that the glucocorticoids (dexamethasone type) antagonize the analgesic activity of morphine while an antagonist of the glucocorticoids, of 17β-hydroxy 11β-(4-dimethylaminophenyl) 17α-(prop-1-ynyl) estra 4,9-diene-3-one type, or a suprarenalectomy, potentializes this activity (Capasso et al. Life Science 51 139 (1992), Ratka et al. Neuroendocrinology 49 439 (1988) Pieretti et al. Gen. Pharmacol. 22 929 (1991)).

However, to the knowledge of the Applicant, nobody has demonstrated the activity of an antimineralocorticoid vis-à-vis the undesirable effects of opiates and in particular of the induction of a physical or psychological dependent state and the withdrawal syndrome associated with this state. These dependence and withdrawal phenomena involve complex central mechanisms, multiple and different from those which are observed in the analgesic activity of opiates.

On the other hand, recent data has been reported on the important role that the endogenous glucocorticoids could play in the symptoms of narcotic withdrawal, as well as in the dependence phenomena induced by opiates or ***e. Thus, hypercortisolism has been observed in man over the course of clinical trials, during withdrawal spontaneous or induced by naloxone consecutive with taking heroin or morphine (Cami et al. Br. J. Addict 87 1145 (1992), Higgins et al. Drug Alcohol Depend. 30 13 (1992). Other elements reported in animals show an activation of the hypothalamo-surrenal axis by ***e (Borowsky and Kuhn, J. Pharmacol. Exp. Ther. (1991) 256, 204) administered in an acute or repeated treatment with an increase in plasmatic levels of corticosterone and ACTH (Moldow and Fischman, Peptides 8 819 (1987), Yang et al. Pharmacol. Biochem Behau. 41 643 (1992), Saphier et al. Neuroendocrinology 57 54 (1993)) consecutive with a mediation of monoaminergic origin (dopamine for example). For example the involvement of the dopaminergic system appears confirmed by the fact that haloperidol and metoclopramide (dopaminergic antagonists) oppose respectively the increase in corticosterone levels induced by ***e and the phenomenon of morphinic withdrawal (Ramaswamy and Bapna, Life Science 40 807 (1987)).

This data appears to show that the endogenous glucocorticoids could intervene in the phenomena of withdrawal and dependence, in the same way as dopaminergic mechanisms but at a stage further upstream than the latter.

These different elements have justified the study of antagonists of mineralocorticoids in particular vis-à-vis the phenomena of physical and psychological dependence or morphinic withdrawal syndrome induced by naloxone in animals since no data is currently available on the activity of this therapeutic class in this axis.

In fact, while an increase in endogenous glucocorticoid levels has been reported in opiate withdrawal phenomena, it has not been demonstrated that this increase could have a physiopathological repercussion and that in particular the blocking of these endogenous glucocorticoids at the level of their receptors by an antimineralocorticoid would be translated into a beneficial effect on physical and psychological dependence and on the symptoms of the withdrawal syndrome.

Thus, the Applicant has demonstrated a new and unexpected use of antimineralocorticoids.

Therefore a subject of the present invention is the use of compounds having an antimineralocorticoid activity for the preparation of medicaments intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics.

By compounds having an antimineralocorticoid activity is meant,

either compounds which are antagonists of the aldosterone receptor, which compounds are competitive inhibitors of the steroid bond to its receptor, thus preventing the natural hormone from carrying out its activity,

or compounds which inhibit the biosynthesis of aldosterone, by inhibiting in particular 18-hydroxylase. In fact, the oxidation in position 18 constitutes the last stage of the biosynthesis of aldosterone and a selective inhibition of this stage allows, in principle, the inhibition of biosynthesis of other essential steroid hormones such as cortisol or androstanedione to be avoided. These compounds are essentially represented by the compounds of Figure (I _j) described below in which R_4jis an alkenyl or alkynyl group and R_5jis either a hydroxyl radical, or a hydrogen atom.

By narcotics is meant all drugs entailing a psychological and physical dependence phenomenon and the spontaneous or induced stopping of which leads to a withdrawal syndrome. There can be mentioned:

1) natural morphinomimetics such as:

a) the opium alkaloids, for example morphine,

b) the alkaloid derivatives of morphine, for example heroin or codeine,

2) synthetic morphinomimetics such as:

a) piperidine derivatives, for example pethidine or

b) methadone and its derivatives, for example dextromoramide,

3) ***e,

as well as all combinations containing two or more of these narcotic products.

A more particular subject of the present invention is the use of compounds having an antimineralocorticoid activity for the preparation of medicaments intended for the prevention or treatment of symptoms linked to dependence or spontaneous or precipitated withdrawal syndrome caused by morphinomimetic narcotics chosen from heroin, morphine and methadone.

A more particular subject of the present invention is the use of compounds having an antimineralocorticoid activity for the preparation of medicaments intended for the prevention or treatment of symptoms linked to dependence or spontaneous or precipitated withdrawal syndrome caused by ***e.

A more particular subject of the present invention is the use as defined previously, characterized in that compounds having an antimineralocorticoid activity correspond to general formula (I):

in which rings A, B and C have one of the following structures:

and in which:

either X and Y represent the groups:

Alk ₁representing an alkyl group containing at most 8 carbon atoms,

or X represents a hydroxyl, acetyloxy, propionyloxy, methoxy or ethoxy radical and Y represents a CH ₂CH₂CO₂M, CH₂CH₂SO₂M or CH₂CH₂CH₂OH radical, M being a hydrogen atom, an alkali metal atom or an ammonium radical,

or X represents a COCH ₂Z radical, in which Z represents a hydrogen atom, a hydroxyl radical or an acyloxy radical containing 1 to 18 carbon atoms, and Y represents a hydrogen atom,

or X represents a

radical, S being an alkyl radical containing at most 8 carbon atoms, or a hydrogen atom and Y represents a hydrogen atom, A and B are hydrogen atoms or together form a methylenic bridge in position 15α,16α or 15β,16β, A′ and B′ are hydrogen atoms, alkyl radicals containing 1 to 4 carbon atoms, or form with the carbon which carries them a cyclopropyl radical, R ₁represents a methyl radical or a C

C—W group, in which W represents

either a hydrogen atom,

or an alkyl radical containing at most 8 carbon atoms optionally substituted by a hydroxyl, free, esterified or salified carboxy, amino, tritylamino, chloroacetylamino, trifluoroacetylamino, halogen, monoalkylamino, dialkylamino radical, each alkyl radical containing at most 8 carbon atoms,

or an aryl or aralkyl radical containing at most 14 carbon atoms, optionally substituted by a hydroxyl, free esterified or salified carboxy, amino, monoalkylamino, dialkylamino, alkyl, alkoxy or alkylthio radical, each alkyl radical containing at most 8 carbon atoms,

or a halogen atom,

or a trialkylsilyl radical, each alkyl radical containing at most 8 carbon atoms,

R ₂and R₃are such that

either R ₂and R₃form together a methylenic bridge in position 6α,7α or 6β,7β,

or R ₂and R₃are hydrogen atoms,

or R ₃is a hydrogen atom and R₂represents a SCOCH3, CO2Alk group, Alk being an alkyl radical containing at most 8 carbon atoms, alkyl, alkenyl or alkynyl radicals containing at most 8 carbon atoms and optionally substituted by a hydroxyl, free, esterified or salified carboxy, halogen, amino, monoalkylamino, dialkylamino radical, each alkyl radical containing at most 8 carbon atoms, R₄represents an alkyl, alkenyl or alkynyl radical containing at most 8 carbon atoms, R₅represents either an allenyl radical, or a hydroxyl radical, or a hydrogen atom, the dotted lines represent a possible second bond, the wavy lines indicate that the substituents are in position α or β, as well as the salts of the products of formula (I) with pharmaceutically acceptable acids and bases.

By alkyl group containing at most 8 carbon atoms, is meant linear or branched alkyl radicals such as methyl, ethyl, n-propyl, iso-propyl, butyl, isobutyl, sec-butyl, tert-butyl, pentyl, isopentyl, sec-pentyl, tert-pentyl, neopentyl, hexyl, isohexyl, sec-hexyl, tert-hexyl, heptyl or octyl.

Alkyl radicals having at most 4 carbon atoms are preferred and in particular methyl, ethyl, propyl and isopropyl radicals.

When R ₄is an alkyl group, it is quite particularly the methyl radical.

The alkali metal atom which can be represented by M is preferably sodium, potassium or lithium.

By acyloxy radical is meant in particular formyloxy, acetoxy, propionyloxy, butyryloxy or benzoyloxy radicals.

As preferred values of W, there can be mentioned the hydrogen atom and alkyl radicals containing 1 to 8 carbon atoms optionally substituted by the radicals as described previously, and quite particularly the methyl radical.

As the preferred value of Rl, there can be mentioned the C≡C—H and C≡C—Me group.

The term optionally esterified carboxy designates alkyloxycarbonyl radicals containing at most 9 carbon atoms, such as for example methoxycarbonyl, ethoxycarbonyl, propoxycarbonyl, n-butyloxycarbonyl, tert-butyloxycarbonyl or also benzyloxycarbonyl radicals.

The terms monoalkylamino and dialkylamino designate the amino radical substituted by one or two alkyl radicals as defined above. In particular it is the methylamino and dimethylamino radicals.

By halogen atom, is meant quite particularly chlorine and bromine atoms.

The aryl and aralkyl radicals which can be represented by W are preferably a phenyl, benzyl or phenethyl radical.

The term alkoxy designates alkoxy radicals containing 1 to 8 carbon atoms such as for example methoxy or ethoxy.

The term alkylthio designates alkylthio radicals containing 1 to 8 carbon atoms such as for example methylthio or ethylthio.

The term alkenyl designates a linear or branched alkenyl radical such as for example vinyl, allyl, 1-propenyl, butenyl, pentenyl or hexenyl radicals.

Among the alkenyl radicals, there are preferred those with 4 carbon atoms such as allyl, propenyl or butenyl radicals.

The term alkynyl designates a linear or branched alkynyl radical, having at most 12 carbon atoms such as ethynyl, propargyl, butynyl, pentynyl or hexynyl radicals.

Among the alkynyl radicals, there are preferred those with 4 carbon atoms such as the propargyl radical.

When R ₄is an alkenyl or alkynyl group, it is quite particularly a CH₂—C≡CH or CH₂—CH═CH₂radical.

When R ₃is a hydrogen atom and when the dotted line does not represent a double bond, R₂is preferably found in position α.

When the products of formula (I) contain a carboxy function, this can be salified. Among the possible salts, there can be mentioned for example the salts of sodium, potassium, lithium, calcium, magnesium or ammonium. There can be mentioned, for the organic bases, methylamine, propylamine, trimethylamine, diethylamine, triethylamine, N,N-dimethylethanolamine, tri-(hydroxymethyl) amino methane, ethanolamine, pyridine, picoline, dicyclohexylamine, morpholine, benzylamine, procaine, lysine, arginine, histidine, N-methylglucamine.

When the products of formula (I) contain a function which can be salified with an acid and in particular an amino function, addition salts are obtained with acids.

The invention naturally extends to the addition salts with acids of the compounds of formula (I), which can be salified, such as for example salts formed with the following acids: hydrochloric, hydrobromic, nitric, sulphuric, phosphoric, acetic, formic, propionic, benzoic, maleic, fumaric, succinic, tartaric, citric, oxalic, glyoxylic, aspartic, alkane sulphonics such as methane or ethane sulphonics, arylsulphonics, such as benzene or paratoluene sulphonics and arylcarboxylics.

The products of formula (I) are known or are prepared according to methods known to a person skilled in the art.

A more precise subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity corresponding to general formula (I _a):

in which:

either X _aand Y_arepresent the groups

Alk ₁being as defined previously,

or Xa represents a hydroxyl, acetyloxy, propionyloxy, methoxy or ethoxy radical and Y _arepresents a CH₂CH₂CO₂M, CH₂CH₂SO₂M or CH₂CH₂CH₂OH radical, M being as defined previously,

R _2a, R_3aand W_arespectively have the same values as R₂, R₃and W as defined previously and the dotted or wavy lines retain the same meaning as previously.

A quite particular subject of the present invention is the use as defined previously of the products corresponding to general formula (I _a) chosen from the following list:

γ-lactone of 10β-ethynyl 17β-hydroxy 3-oxo-19-nor-17α-pregna-4,9 (11)-diene-21-carboxylic acid,

γ-lactone of 17β-hydroxy 3-oxo-10β-(1-propynyl)-19-nor-17α-pregna-4,9 (11)-diene-21-carboxylic acid,

γ-lactone of 17β-hydroxy 3-oxo-10β-(1-propynyl)-19-nor-17α-pregn-4-ene-21-carboxylic acid,

γ-lactone of 10β-ethynyl 17β-hydroxy 3-oxo-19-nor-17α-pregn-4-ene-21-carboxylic acid.

The products of general formula (I _a) are described and prepared in the Patent Applications EP 0176399-A1 and EP 0237397-A1 and by methods known to a person skilled in the art.

A more precise subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I _b):

in which:

either X _band Y_brepresent the groups

or X _brepresents a hydroxyl radical and Y_brepresents a CH₂CH₂CO₂M radical, M being as defined previously,

R _2band R_3bare such that

either R _2brepresents an alkyl, alkenyl or alkynyl radical optionally substituted as defined previously and R_3bis a hydrogen atom,

or R _2band R_3btogether form a methylenic bridge in position 6α,7α or in position 6β,7β.

When R _2bis an alkyl group, it will be quite particularly the propyl radical in position α.

A quite particular subject of the present invention is the use as defined previously, of the products corresponding to general formula (I _b) chosen from the following list:

(17R)-6β,7β-methylene-2′-oxydospiro-(androst-4-ene-17,5′-(1′,2′)-oxathiolane)-3-one

(17R)-6α,7α-methylene-2′-oxydospiro-(androst-4-ene-17,5′-(1′,2′)-oxathiolane)-3-one

(17R)-7α-methyl-2′-oxydospiro-(androst-4-ene-17,5′-(1′,2′)-oxathiolane)-3-one

(17R)-7α-n-propyl-2′-oxydospiro-(androst-4-ene-17,5′-(1′,2′)-oxathiolane)-3-one

γ-lactone of 17β-hydroxy-3-oxo-7α-propyl-17α-pregna-1,4-diene-21-carboxylic acid,

potassium 17β-hydroxy-3-oxo-7α-propyl-17α-pregna-1,4-diene-21-carboxylate,

γ-lactone of 17β-hydroxy-3-oxo-7α-propyl-(17α)-pregn-4-ene-21-carboxylic acid,

potassium 17β-hydroxy-3-oxo-7α-propyl-(17α)-pregn-4-ene-21-carboxylate

The products of formula (Ib) are prepared in the Patent Applications EP 0018245A, EP 0055170A, FR 2344286, FR 2421913, FR 2465749, and by methods known to a person skilled in the art.

A more precise subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity, corresponding to general formula (I _c):

in which

either X _cand Y_crepresent a group

or X _crepresents a hydroxyl radical and Y_crepresents a CH₂CH₂CO₂M or CH₂CH₂SO₂M group, M being as defined previously,

or X _crepresents a COCH₂Z radical in which Z is as defined previously and Y_cis a hydrogen atom,

A′ _cand B′_crespectively have the same values as A′ and B′ as defined previously,

R _4cis a methyl or ethyl radical, R_5cis either a hydrogen atom, or an allenyl radical, it being understood that when R_5cis an allenyl radical, A′_cand B′_care hydrogen atoms, R_4cis a methyl radical, X_cand Y_ctogether form a

group, the dotted lines in position 9-10 form a second bond, and those in position 11-12 do not form a second bond.

A quite particular subject of the present invention is the use as defined previously of the products corresponding to general formula (I _c) chosen from the following list:

2,2-dimethyl 19-nor pregn-4-ene-3,20-dione,

21-acetoxy 2,2-dimethyl 19-nor-pregn-4-ene 3,20-dione,

2,2-dimethyl 21-hydroxy 19-nor-pregn-4-ene 3,20-dione,

2,2-dimethyl 19-nor-pregna-4,9-diene 3,20-dione,

21-acetoxy 2,2-dimethyl 19-nor-pregna-4,9-dien 3,20-dione,

2,2-dimethyl 21-hydroxy 19-nor-pregna-4,9-dien 3,20-dione,

2,2-dimethyl 19-nor-pregna-4,9,11-triene 3,20-dione,

21-acetoxy 2,2-dimethyl 19-nor-pregna-4,9,11-triene 3,20-dione,

2,2-dimethyl 21-hydroxy 19-nor-pregna-4,9,11-triene 3,20-dione,

(17R) 2′-oxydospiro-(estra-4,9-diene-17,5′-(1′,2′)-oxathiolane) 3-one,

(17R) 2′-oxydospiro-(estra-4,9,11-triene-17,5′-(1′,2′)-oxathiolane) 3-one,

(17R) 11β-hydroxy 2′-oxydospiro-(estra-4,9-diene-17,5′-(1′,2′)-oxathiolane) 3-one,

2,2-dimethyl-13-ethyl-21-hydroxy-18,19-dinor-pregn-4-ene 3,20-dione,

γ-lactone of 11β-allenyl-17β-hydroxy-3-oxo-19-nor-17-pregna-4,9-diene-21-carboxylic acid.

The products of general formula (I _c) are described and prepared in Patent Applications FR 2364655, FR 2374037, EP 0012641, in the following publication: G. AUZOU et al. J. Med. Chem. (1993) 36 2404-2407, and by methods known to a person skilled in the art.

A more precise subject of the present invention is the use as defined previously characterized in that the compounds having an antimineralocorticoid activity corresponding to general formula (I _d):

in which:

either X _dand Y_drepresent the group

or X _drepresents a hydroxyl radical and Y_drepresents a CH₂CH₂CO₂M radical, M being as defined previously,

A _dand B_drespectively have the same values as A and B as defined previously,

R _2drepresents either a thioacetyl radical, or a CO₂Alk radical, Alk being an alkyl radical containing at most 8 carbon atoms. It is preferably a methyl, ethyl and isopropyl radical, and the dotted or wavy lines keep the same meaning as previously.

A quite particular subject of the present invention is the use as defined previously of the products corresponding to general formula (I _d) chosen from the following list:

γ-lactone of 7α-acetylthio-17β-hydroxy-15β,16β-methylene-3-oxo-17α-pregna-1,4-diene-21-carboxylic acid (Mespirenone),

γ-lactone of 17β-hydroxy-7α-methoxycarbonyl-15β,16β-methylene-3-oxo-17α-pregn-4-ene-21-carboxylic acid (ZK91587),

γ-lactone of 7α-acetylthio-17β-hydroxy-3-oxo-17α-pregn-4-ene-21-carboxylic acid (Spironolactone),

γ-lactone of 17β-hydroxy-7α-methoxycarbonyl-3-oxo-17α-pregn-4-ene-21-carboxylic acid (Mexrenone),

the potassium salt of 17β-hydroxy-7α-methoxycarbonyl-3-oxo-pregn-4-ene-21-carboxylic acid.

The products of formula (I _d) are commercial products or are prepared or described in the following Patent Applications or publications:

Mespirenone: Drug of the Future Vol. 12 No. 1 (1987) 27,

Mexrenone: G. B. Cutler et al. J. Pharmacol. and Exp. Ther. (1979) 209 144,

ZK 91587: H. J. Grill et al. J. Ster. Biochem, 23 (Suppl.) Abst. 19 (1985),

Spironolactone: J. A. Cella and C. M. Kawaga J. Am. Chem. Soc. (1957) 79 4808,

K. Mexrenoate: L. M. Hoffmann et al. The Journal of Pharmacol. and Exp. Ther. (1977) 102 (3) 762, or according to methods known to a person skilled in the art.

A more precise subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity correspond general formula (I _e):

in which:

either X _eand Y_erepresent the group

or X _erepresents a hydroxyl radical and Y_erepresents a CH₂CH₂CO₂M radical, M being as defined previously,

R _2eor R_3eare such that:

either R _2eand R_3etogether form a methylenic bridge in position 6α,7α or 6β,7β,

or R _2eand R_3eare hydrogen atoms,

A _eand B_erespectively have the same values as A and B as defined previously, the dotted or wavy lines keeping their previous meaning. A quite particular subject of the present invention is the use as defined previously of the products corresponding to general formula (I_e), chosen from the following list:

γ-lactone of 17β-hydroxy-6β,7β,15β,16β-dimethylene-3-oxo-17α-pregna-1,4-diene-21-carboxylic acid (Spirorenone),

γ-lactone of 17β-hydroxy-6β,7β,15β,16β-dimethylene-3-oxo-17α-pregna-4-ene-21-carboxylic acid (dihydrospirorenone),

γ-lactone of 17β-hydroxy-3-oxo-17α-pregna-4,6,11-triene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-3-oxo-17α-pregna-4,6-diene-21-carboxylic acid (Canrenone),

the potassium salt of 17β-hydroxy-3-oxo-17α-pregna-4,6-diene-21-carboxylic acid (potassium Canrenoate),

γ-lactone of 17β-hydroxy-6β,7β-methylene-3-oxo-17α-pregn-4-ene-21-carboxylic acid (Prorenone),

potassium salt of 17β-hydroxy-6β,7β-methylene-3-oxo-17α-pregn-4-en-21-carboxylic acid (potassium protenoate).

The products of formula (I _e) are commercial products or are prepared or described in the following Patent Applications or publications:

Spirorenone: W. Losert et al. Arzneim-Forsch/Drug. Res. (1986) 36 1583,

Dihydrospirorenone: DE 2652761-A,

K canrenoate: L. E. Ramsay et al. Adrenal Steroid Antagonism. Ed. M. K. Agarwal Berlin, N.Y. 1984,

Prorenone, K prorenoate: J. Casals-Stenzel et al. Arch. Pharmacol. Suppl. 316 (1981) R49,

γ-lactone of 17β-hydroxy-3-oxo-17α-pregna-4,6,11-triene-21-carboxylic acid, Anu. Drug. Data Rep. (1985) 7 (2) 94.

A quite particular subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I _f):

in which S represents an alkyl radical containing 1 to 8 carbon atoms, or a hydrogen atom.

The products of general formula (I _f) are described in Patent Application EP 402857-A.

A more particular subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I _g):

in which A _gand B_grespectively have the same values as A and B as defined previously, the dotted or wavy lines keeping the same meaning as previously.

The products of general formula (I _g) are described in Anu. Drug. Data Rep. (1986) 8 (9) 824.

A more particular subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity corresponding to general formula (I _h):

in which A _h, B_hand R_2hrespectively have the same values as A, B and R₂as defined previously.

The products of general formula (I _h) are described in Anu. Drug. Data Rep. (1985) 7(5) 295, (1986) 8(2) 152.

A more particular subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity correspond general formula (I _i):

in which A _i, B_i, R_2iand R_3irespectively have the same values as A, B, R₂and R₃as defined previously.

The products of general formula products (I _i) are described in Anu. Drug. Data Rep. (1985) 7(5) 295, (1986) 8(9) 824.

A more precise subject of the present invention is the use as defined previously, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I _j):

in which R _4jis an alkenyl or alkynyl group containing 1 to 8 carbon atoms and R_5jis a hydroxyl radical or a hydrogen atom.

A quite particular subject of the present invention is the use as defined previously, of the products corresponding to general formula (I _j) in which

either R _4jis a CH₂—CH═CH₂, CH═CH₂, CH₂—C≡CH radical and R_5jis a hydrogen,

or R _4jis a —CH₂—C≡CH radical and R_5jis an OH radical.

The products of formula (I _j) are inhibitors of the biosynthesis of aldosterone. They are described in the following publications:

A. Viger et al., Tetrahedron (1988) 44 1127, J. Steroid Biochem. (1988) 30 469,

B. W. Metcalf et al., Tet. Lett. (1985) 26 1137-1140.

The invention extends to the pharmaceutical compositions containing at least one medicament as defined above as active ingredient, intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics.

The compounds of the invention are used by digestive, parenteral or local route, for example by percutaneous route. They can be prescribed in the form of plain or sugar-coated tablets, capsules, granules, suppositories, pessaries, injectable preparations, ointments, creams, gels, microspheres, implants, patches, which are prepared according to the usual methods.

The active ingredient or ingredients can be incorporated with excipients usually employed in these pharmaceutical compositions, such as talc, gum arabic, lactose, starch, magnesium stearate, cocoa butter, aqueous or non-aqueous vehicles, fatty substances of animal or vegetable origin, paraffin derivatives, glycols, various wetting, dispersing or emulsifying agents, preservatives.

In particular, the invention extends to the pharmaceutical compositions containing as active principle at least one medicament as defined above, corresponding to any one of general formulae (I), (I _a), (I_b), (I_c), (I_d), (I_e), (I_f), (I_g), (I_h), (I_i) or (I_j), as defined previously. More particularly the invention extends to the pharmaceutical compositions containing as active principle at least one medicament as defined above, chosen from the following list:

γ-lactone of 10β-ethynyl,17β-hydroxy 3-oxo-19-nor-17α-pregna-4,9(11)-diene-21-carboxylic acid,

potassium 17β-hydroxy-3-oxo-7α-propyl-17α-pregn-4-ene-21-carboxylate,

γ-lactone of 11β-allenyl-17β-hydroxy-3-oxo-19-nor-17α-pregna-4,9(11)-diene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-7α-methoxycarbonyl-15β,16β-methylene-3-oxo-17α-pregn-4-ene-21-carboxylic acid,

γ-lactone of 7α-acetylthio-17β-hydroxy-3-oxo-17α-pregn-4-ene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-7α-methoxycarbonyl-3-oxo-17α-pregn-4-ene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-3-oxo-17α-pregn-4,6-diene-21-carboxylic acid

13β-(propen-2-yl)-18-nor-pregn-4-ene-3,20-dione.

The useful dose varies as a function of the type of withdrawal or dependence to be prevented or treated and the administration route. It can vary from 1 to 1000 mg per day for an adult by oral route.

PHARMACOLOGICAL STUDY

A) Evaluation of the Withdrawal Syndrome Induced by Naloxone in Mice. [0195]
1—Equipment and Method. [0196]
1.1 Animals. [0197]
The experiments were carried out with male Swiss mice (Charles River, France) of a body weight comprised between 20 and 25 g. During the tests, the animals had free access to food and drinking water. The number of animals per group is 10 to 13 mice. [0198]
1.2 Products. [0199]
The following antimineralocorticoids (AM): [0200]
AM1 Spironolactone, [0201]
AM2 potassium 17β-hydroxy 3-oxo 7α-propyl-(17α)-pregn-4-ene-21-carboxylate. [0202]
were suspended in 0.5% methyl cellulose and administered by oral route (p.o). The morphine was put into solution in physiological serum and administered by sub-cutaneous (s.c) route. Finally, the naloxone hydrochloride was solubilized in distilled water and injected by intra-peritoneal route. [0203]
All the products were administered to the animal under a volume of 25 ml/kg. [0204]
1.3 Treatment Methods and Doses Administered. [0205]
1.3.1 Treatment with Morphine: Induction of Morphinic Dependent State. [0206]
The first day (D1), the animals received 5 sub-cutaneous injections with increasing doses of morphine spread through the morning and at the beginning of the afternoon, at one hour intervals. On the following 3 days (D2, D3, D4), these same animals were treated in the morning with two administrations of the maximum dose used on day 1. [0207]

Morphine-Doses (mg/kg, s.c.) Cumulative

D1 D2 D3 D4 dose(mg/kg)

8 100 100 100 799

16 100 100 100

25

50

100
1.3.2 Repeated Treatment with the Studied Products. [0208]
The antimineralocorticoids AM1 and AM2 were administered by oral route in the form of a daily treatment 2 hours before administration of the morphine and this took place for 4 days. [0209]
1.4 Operating Method [0210]
The technique used is inspired by that described by Way et al. J. Pharmacol. Exp. Ther. (1969), 167: 1-8 and Huidobro and Maggiolo Acta Physiol. Pharmacol. Latinoam. (1961), 11: 201-9. Thus, the repeated administration of a morphinic induces a phenomenon of physical dependence which can be easily demonstrated by the induction of a withdrawal syndrome using an opiate antagonist such as naloxone. This syndrome manifests itself, in mice in the form of stereotyped behaviour characterized by the appearance of repetitive jumps the number of which is related to the duration and intensity of the treatment by the morphinic. [0211]
The animals' withdrawal was carried out on the fourth day; three hours after the last treatment, using naloxone hydrochloride injected by intraperitoneal route at a dose of 100 mg/kg. Immediately after this injection, the animals were placed individually in Plexiglas cylinders (height 40 cm, diameter=20 cm). The number of consecutive jumps as a result of withdrawal and carried out by each animal was counted over a period of 10 minutes. [0212]
The results shown in tables represent the averages of thr individual values together with the standard error of the mean (m±sem). [0213]
2. Results [0214]

2.1 Withdrawal Induced by Naloxone in Normal Mice Treated with Morphine.



		Number of
		jumps/10
		minutes
	Doses (mg/kg	(m ± sem)	% protection

Controls	0	7 ± 5
Morphine	799 s.c.	76 ± 15
	(cumulative over 4 days)
AM1	4 × 10 p.o.	3 ± 2
Morphine + AM1	799 s.c. + 4 × 10 p.o.	51 ± 7	−33
Controls	0	0
Morphine	799 s.c.	114 ± 8
	(cumulative over 4 days)
AM1	4 × 20 p.o.	11 ± 4
Morphine + AM1	799 s.c. + 4 × 20 p.o.	77 ± 8**	−32



		Number of
		jumps/10
		minutes
	Doses (mg/kg	(m ± sem)	% protection

Controls	0	0
Morphine	799 s.c.	99 ± 13
	(cumulative over 4 days)
AM2	4 × 20 p.o.	4 ± 4
Morphine + AM2	799 s.c. + 4 × 20 p.o.	51 ± 8	−48
Controls	0	7 ± 3
Morphine	799 s.c.	102 ± 10
	(cumulative over 4 days)
AM2	4 × 10 p.o.	2 ± 2
AM2	4 × 50 p.o.	3 ± 2
Morphine + AM2	799 s.c. + 4 × 10 p.o.	76 ± 16	−25
Morphine + AM2	799 s.c. + 4 × 50 p.o.	61 ± 8**	−40

Discussion—Conclusion

Co-administered for four days with morphine, the compound AM2 (4×20 mg/kg, p.o) significantly inhibits (−48%) the withdrawal syndrome induced by naloxone in mice dependent on morphine. [0217]
In conclusion, these results confirm the participation of endogenous glucocorticoids in the morphinic withdrawal syndrome, such as demonstrates itself in mice by stereotyped behaviour of jumping, since the latter is inhibited by antimineralocorticoids. [0218]
The antimineralocorticoid activity, through the results obtained with compounds AM1 and AM2 shows that an antagonist of the mineralocorticoids can have a beneficial effect in human clinical medicine in the prevention and treatment of narcotic withdrawal syndrome. [0219]
B) Evaluation of Dependence Induced by Cocaine [0220]
1—Method. [0221]
The anti-mineralocorticoid product AM2 was tested on 5 rats which were trained in the self-administration of ***e during daily periods of one hour. [0222]
These rats were pre-treated 1 hour before the start of the self-administration sessions. [0223]
The product AM2 dissolved in a saline solution was administered by intra-peritoneal route. The doses range from 10 to 100 mg/kg. [0224]
2—Result. [0225]
The pre-treatment with 10 or 20 mg/kg of product AM2 has little or no effect on the self-administration of ***e. [0226]
However, pre-treatment with 50 or 75 mg/kg of product AM2 leads to a significant reduction in the self-administration of ***e. [0227]
3—Conclusion. [0228]
On the one hand these results suggest that the mineralocorticoid receptors are involved in the strengthening behaviour to ***e. [0229]
On the other hand the antimineralocorticoid activity, through the results obtained with compound AM2 shows that an antagonist of the mineralocorticoids can have a beneficial effect in human clinical medicine in the treatment of dependence on narcotics and in particular ***e. [0230]

Claims

1) Use of compounds having an antimineralocorticoid activity for the preparation of medicaments intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics and mixtures of narcotics.

2) Use according to claim 1, characterized in that the narcotic is a morphinomimetic chosen from heroin, morphine and methadone.

3) Use according to claim 1, characterized in that the narcotic is ***e.

4) Use according to any one of claims 1 to 3, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I):

in which rings A, B and C have one of the following structures:

and in which:

either X and Y represent the groups:

Alk₁representing an alkyl group containing at most 8 carbon atoms,

or X represents a hydroxyl, acetyloxy, propionyloxy, methoxy or ethoxy radical and Y represents a CH₂CH₂CO₂M, CH₂CH₂SO₂M or CH₂CH₂CH₂OH radical, M being a hydrogen atom, an alkali metal atom or an ammonium radical,

or X represents a COCH₂Z radical, in which Z represents a hydrogen atom, a hydroxyl radical or an acyloxy radical containing 1 to 18 carbon atoms, and Y represents a hydrogen atom,

or X represents a

radical, S being an alkyl radical containing at most 8 carbon atoms, or a hydrogen atom and Y represents a hydrogen atom, A and B are hydrogen atoms or together form a methylenic bridge in position 15α,16α or 15β, 16β, A′ and B′ are hydrogen atoms, alkyl radicals containing 1 to 4 carbon atoms, or form with the carbon which carries them a cyclopropyl radical, R₁represents a methyl radical or a C

C—W group, in which W represents either a hydrogen atom,

or a halogen atom,

R₂and R₃are such that

either R₂and R₃form together a methylenic bridge in position 6α, 7α or 6β, 7β,

or R₂and R₃are hydrogen atoms,

or R₃is a hydrogen atom and R₂represents a SCOCH₃, CO₂Alk group, Alk being an alkyl radical containing at most 8 carbon atoms, alkyl, alkenyl or alkynyl radicals containing at most 8 carbon atoms and optionally substituted by a hydroxyl, free, esterified or salified carboxy, halogen, amino, monoalkylamino, dialkylamino radical, each alkyl radical containing at most 8 carbon atoms, R₄represents an alkyl, alkenyl or alkynyl radical containing at most 8 carbon atoms, R₅represents either an allenyl radical, or a hydroxyl radical, or a hydrogen atom, the dotted lines represent a possible second bond, the wavy lines indicate that the substituents are in position α or β, as well as the salts of the products of formula (I) with pharmaceutically acceptable acids and bases.

5) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_a):

in which:

either X_aand Y_arepresent the groups

Alk₁being as defined in claim 4,

or X_arepresents a hydroxyl, acetyloxy, propionyloxy, methoxy or ethoxy radical and Y_arepresents a CH₂CH₂CO₂M, CH₂CH₂SO₂M or CH₂CH₂CH₂OH radical, M being as defined in claim 4,

R_2a, R_3aand W_arespectively have the same values as R₂, R₃and W as defined previously and the dotted or wavy lines have the meaning indicated in claim 4.

6) Use according to claims 4 or 5, characterized in that the compounds corresponding to general formulae (I) and (I_a) are chosen from the following list:

γ-lactone of 10β-ethynyl 17β-hydroxy 3-oxo-19-nor-17α-pregna-4,9(11)-diene-21-carboxylic acid,

γ-lactone of 17β-hydroxy 3-oxo-10β-(1-propynyl)-19-nor-17α-pregna-4,9(11)-diene-21-carboxylic acid,

7) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_b):

in which:

either X_band Y_brepresent the groups

or X_brepresents a hydroxyl radical and Y_brepresents a CH₂CH₂CO₂M radical, M being as defined in claim 4,

R_2band R_3bare such that

either R_2brepresents an alkyl, alkenyl or alkynyl radical optionally substituted as defined previously and R_3bis a hydrogen atom,

or R_2band R_3btogether form a methylenic bridge in position 6α,7α or in position 6β,7β.

8) Use according to one of claims 4 or 7, characterized in that the compounds corresponding to general formulae (I) or (I_b) are chosen from the following list:

potassium 17β-hydroxy-3-oxo-7α-propyl-17α-pregna-1,4-diene-21-carboxylate,

potassium 17β-hydroxy-3-oxo-7α-propyl-(17α)-pregn-4-ene-21-carboxylate.

9) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity, corresponding to general formula (I_c):

in which

either X_cand Y_crepresent a group

or X_crepresents a hydroxyl radical and Y_crepresents a CH₂CH₂CO₂M or CH₂CH₂SO₂M group, M being as defined in claim 4,

or X_crepresents a COCH₂Z radical in which Z is as defined in claim 4 and Y_cis a hydrogen atom,

A′_cand B′_crespectively have the same values as A′ and B′ as defined in claim 4,

R_4cis a methyl or ethyl radical, R_5cis either a hydrogen atom, or an allenyl radical, it being understood that when R_5cis an allenyl radical, A′_cand B′_care hydrogen atoms, R_4cis a methyl radical, X_cand Y_ctogether form a

10) Use according to any one of claims 4 or 9, characterized in that the compounds corresponding to general formulae (I) or (I_c) chosen from the following list:

2,2-dimethyl 19-nor pregn-4-ene-3,20-dione,

21-acetoxy 2,2-dimethyl 19-nor-pregn-4-ene 3,20-dione,

2,2-dimethyl 21-hydroxy 19-nor-pregn-4-ene 3,20-dione,

2,2-dimethyl 19-nor-pregna-4,9-diene 3,20-dione,

21-acetoxy 2,2-dimethyl 19-nor-pregna-4,9-diene 3,20-dione,

2,2-dimethyl 21-hydroxy 19-nor-pregna-4,9-diene 3,20-dione,

2,2-dimethyl 19-nor-pregna-4,9,11-triene 3,20-dione,

21-acetoxy 2,2-dimethyl 19-nor-pregna-4,9,11-triene 3,20-dione,

2,2-dimethyl 21-hydroxy 19-nor-pregna-4,9,11-triene 3,20-dione,

(17R) 2′-oxydospiro-(estra-4,9-diene-17,5′-(1′,2′)-oxathiolane) 3-one,

2,2-dimethyl-13-ethyl-21-hydroxy-18,19-dinor-pregn-4-ene 3,20-dione,

γ-lactone of 11β-allenyl-17β-hydroxy-3-oxo-19-nor-17α-pregna-4,9-diene-21-carboxylic acid.

11) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_d):

in which:

either X_dand Y_drepresent the group

or X_drepresents a hydroxyl radical and Y_drepresents a CH₂CH₂CO₂M radical, M being as defined in claim 4,

A_dand B_drespectively have the same values as A and B as defined in claim 4,

R_2drepresents either a thioacetyl radical, or a CO₂Alk radical, Alk being an alkyl radical containing at most 8 carbon atoms and the dotted line in position 1-2 represents an optional double bond.

12) Use according to one of claims 4 or 11, characterized in that the compounds corresponding to general formula (I) or (I_d) are chosen from the following list:

γ-lactone of 7α-acetylthio-17β-hydroxy-15β,16β-methylene-3-oxo-17α-pregna-1,4-diene-21-carboxylic acid,

13) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_e):

in which:

either X_eand Y_erepresent the group

or X_erepresents a hydroxyl radical and Y_erepresents a CH₂CH₂CO₂M radical, M being as defined previously,

R_2eor R_3eare such that:

either R_2eand R_3etogether form a methylenic bridge in position 6α,7α or 6β,7β,

or R_2eand R_3eare hydrogen atoms,

A_eand B_erespectively have the same values as A and B as defined in claim 4, the dotted or wavy lines keeping the same meaning as in claim 4.

14) Use according to one of claims 4 or 11, characterized in that the compounds corresponding to general formula (I) or (I_e), are chosen from the following list:

γ-lactone of 17β-hydroxy-6β,7β,15β,16β-dimethylene-3-oxo-17α-pregna-1,4-diene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-6β,7β,15β,16β-dimethylene-3-oxo-17α-pregna-4-ene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-3-oxo-17α-pregna-4,6-diene-21-carboxylic acid,

the potassium salt of 17β-hydroxy-3-oxo-17α-pregna-4,6-diene-21-carboxylic acid

γ-lactone of 17β-hydroxy-3-oxo-17α-pregna-4,6,11-triene-21-carboxylic acid,

γ-lactone of 17β-hydroxy-6β,7β-methylene-3-oxo-17α-pregn-4-ene-21-carboxylic acid,

potassium salt of 17β-hydroxy-6β,7β-methylene-3-oxo-17α-pregn-4-ene-21-carboxylic acid.

15) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_f):

16) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_g):

in which A_gand B_grespectively have the same values as A and B as defined in claim 4.

17) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_h):

in which A_h, B_hand R_2hrespectively have the same values as A, B and R₂as defined in claim 4.

18) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_i):

in which A_i, B_i, R_2iand R_3irespectively have the same values A, B, R₂and R₃as defined in claim 4.

19) Use according to claim 4, characterized in that the compounds having an antimineralocorticoid activity correspond to general formula (I_j):

in which R_4jis an alkenyl or alkynyl group containing 1 to 8 carbon atoms and R_5jis a hydroxyl radical or a hydrogen atom.

20) The pharmaceutical compositions, containing as active ingredient at least one medicament as defined in claim 1, intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics.

21) The pharmaceutical compositions according to claim 20, containing as active ingredient at least one medicament as defined in any one of claims 2 or 3, intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics.

22) The pharmaceutical compositions according to claim 20, containing as active ingredient at least one medicament as defined in claim 4, intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics.

23) The pharmaceutical compositions according to claim 20, containing as active ingredient at least one medicament as defined in any one of claims 5, 7, 9, 11, 13, 15, 16, 17, 18 or 19, intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics.

24) The pharmaceutical compositions according to claim 20, containing as active ingredient at least one medicament as defined in claim 4, intended for the prevention or treatment of symptoms linked to drug dependence or to the spontaneous or induced withdrawal syndrome, caused by narcotics or mixtures of narcotics, chosen form the following list:

γ-lactone of 10β-ethynyl, 17β-hydroxy 3-oxo-19-nor-17α-pregna-4,9(11)-diene-21-carboxylic acid,

potassium 17β-hydroxy-3-oxo-7α-propyl-17α-pregn-4-ene-21-carboxylate,

γ-lactone of 17β-hydroxy-3-oxo-17α-pregna-4,6-diene-21-carboxylic acid

13β-(propen-2-yl)-18-nor-pregn-4-ene-3,20-dione.