WO1998016523A2 - Selective factor xa inhibitors - Google Patents

Selective factor xa inhibitors Download PDF

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Publication number
WO1998016523A2
WO1998016523A2 PCT/US1997/018291 US9718291W WO9816523A2 WO 1998016523 A2 WO1998016523 A2 WO 1998016523A2 US 9718291 W US9718291 W US 9718291W WO 9816523 A2 WO9816523 A2 WO 9816523A2
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compound
group
alkyl
aryl
integer
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PCT/US1997/018291
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French (fr)
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WO1998016523A9 (en
WO1998016523A3 (en
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Bing-Yan Zhu
Robert M. Scarborough
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Cor Therapeutics, Inc.
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Priority to JP51845498A priority Critical patent/JP2001504810A/en
Priority to CA002268281A priority patent/CA2268281A1/en
Priority to AU49809/97A priority patent/AU720513C/en
Priority to EP97912697A priority patent/EP0937073A2/en
Priority claimed from US08/948,672 external-priority patent/US6262047B1/en
Publication of WO1998016523A2 publication Critical patent/WO1998016523A2/en
Publication of WO1998016523A3 publication Critical patent/WO1998016523A3/en
Publication of WO1998016523A9 publication Critical patent/WO1998016523A9/en

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    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K5/00Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof
    • C07K5/04Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof containing only normal peptide links
    • C07K5/06Dipeptides
    • C07K5/06139Dipeptides with the first amino acid being heterocyclic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P7/00Drugs for disorders of the blood or the extracellular fluid
    • A61P7/02Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/10Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K5/00Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof
    • C07K5/02Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof containing at least one abnormal peptide link
    • C07K5/0202Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof containing at least one abnormal peptide link containing the structure -NH-X-X-C(=0)-, X being an optionally substituted carbon atom or a heteroatom, e.g. beta-amino acids
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K5/00Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof
    • C07K5/04Peptides containing up to four amino acids in a fully defined sequence; Derivatives thereof containing only normal peptide links
    • C07K5/06Dipeptides
    • C07K5/06191Dipeptides containing heteroatoms different from O, S, or N
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides

Definitions

  • This invention relates to novel heterocyclic compounds which are potent and highly selective inhibitors of factor Xa or factor Xa when assembled in the prothrombinase complex. These compounds show selectivity for factor Xa versus other proteases of the coagulation (e.g. thrombin, fVIIa, fIXa) or the fibrinolytic cascades (e.g. plasminogen activators, plasmin).
  • Blood coagulation protects mammalian species when the integrity of the blood vessel wall is damaged and uncontrolled loss of blood threatens survival. Coagulation, resulting in the clotting of blood is an important component of hemostasis. Under normal hemostatic circumstances, there is maintained an acute balance of clot formation and clot removal (fibrinolysis).
  • the blood coagulation cascade involves the conversion of a variety of inactive enzymes (zymogens) into active enzymes which ultimately convert the soluble plasma protein fibrinogen into an insoluble matrix of highly cross-linked fibrin.
  • thrombin A key enzyme in the coagulation cascade as well as in hemostasis, is thrombin.
  • Thrombin is intimately involved in the process of thrombus formation, but under normal circumstances can also play an anticoagulant role in hemostasis through its ability to convert protein C into activated protein C in a thrombomodulin-dependent manner.
  • Thrombin plays a central role in thrombosis through its ability to catalyze the penultimate conversion of fibrinogen into fibrin and through its potent platelet activation activity.
  • thrombin activity has been the focus of a variety of recent anticoagulant strategies as reviewed by Claeson "Synthetic Peptides and Peptidomimetics as Substrates and Inhibitors of Thrombin and Other Proteases in the Blood Coagulation System", Blood Coag. Fibrinol. 5:411-436 (1994).
  • the major classes of anticoagulants currently used in the clinic directly or indirectly affect thrombin (i.e. heparins, low-molecular weight heparins and coumarins).
  • thrombin i.e. heparins, low-molecular weight heparins and coumarins.
  • Thrombin is generated at the convergence of the intrinsic and extrinsic coagulation pathways by the prothrombinase complex.
  • the prothrombinase complex is formed when activated Factor X (factor Xa) and its non-enzymatic cofactor, factor Va assemble on phospholipid surfaces in a Ca +2 - dependent fashion as reviewed by Mann, et al, "Surface-Dependent Reactions of the Vitamin K-Dependent Enzymes” , Blood 76 : 1 - 16 ( 1990) .
  • Factor Xa Factor X
  • factor Va non-enzymatic cofactor
  • the prothrombinase complex converts the zymogen prothrombin into the active procoagulant thrombin.
  • prothrombinase complex The location of the prothrombinase complex at the convergence of the intrinsic and extrinsic coagulation pathways, and the significant amplification of thrombin generation (393,000-fold over uncomplexed factor Xa) mediated by the complex at a limited number of targeted catalytic units present at vascular lesion sites, suggests that inhibition of thrombin generation is an ideal method to block uncontrolled procoagulant activity.
  • factor Xa appears to have a single physiologic substrate, namely prothrombin.
  • Plasma contains an endogenous inhibitor of both the factor Vila-tissue factor (TF) complex and factor Xa called tissue factor pathway inhibitor (TFPI).
  • TFPI is a Kunitz- type protease inhibitor with three tandem Kunitz domains.
  • TFPI inhibits the TF/fVIIa complex in a two-step mechanism which includes the initial interaction of the second Kunitz domain of TFPI with the active site of factor Xa, thereby inhibiting the proteolytic activity of factor Xa.
  • the second step involves the inhibition of the TF/fVIIa complex by formation of a quaternary complex TF/fVIIa/TFPI/fXa as described by Girard, et al. "Functional Significance of the Kunitz-type Inhibitory Domains of Lipoprotein-associated Coagulation Inhibitor". Nature 338:518-520 (1989).
  • tick anticoagulant peptide Another potent and highly specific inhibitor of Factor Xa, tick anticoagulant peptide, has been isolated from the whole body extract of the soft tick Ornithidoros moubata, as reported by Waxman. et al. , "Tick Anticoagulant Peptide (TAP) is a Novel Inhibitor of Blood Coagulation Factor Xa", Science 248:593-596 (1990).
  • TRIP tick Anticoagulant Peptide
  • WO 96/18644 to Tamura, et al. describes aromatic heterocyclic thrombin inhibitors.
  • WO 95/35313 to Semple, et al pertains to 3-amino-2-oxo-l-piperidineacetic derivative thrombin inhibitors.
  • EP 0,512.831 and US Patent No. 5,281,585, both to Duggan, et al, describe fibrinogen receptor antagonists.
  • the present invention relates to novel peptide and peptide mimetic analogs, their pharmaceutically acceptable isomers, salts, hydrates, solvates and prodrug derivatives.
  • the present invention includes pharmaceutical compositions comprising a pharmaceutically effective amount of the compounds of this invention and a pharmaceutically acceptable carrier. These compositions are useful as potent and specific inhibitors of blood coagulation in mammals.
  • the invention relates to methods of using these inhibitors as therapeutic agents for disease states in mammals which have disorders of coagulation such as in the treatment or prevention of unstable angina, refractory angina, myocardial infarction, transient ischemic attacks, thrombotic stroke, embolic stroke, disseminated intravascular coagulation including the treatment of septic shock, deep venous thrombosis in the prevention of pulmonary embolism or the treatment of reocclusion or restenosis of reperfused coronary arteries.
  • These compositions may optionally include anticoagulants, antiplatelet agents, and thrombolytic agents.
  • the present invention provides compounds of general formula I:
  • R 1 is H, C,. 6 alkyl or C,. 3 alkylaryl
  • R 2 is H, C
  • m is an integer from 0-3;
  • n is an integer from 0-6;
  • p is an integer from 0-4;
  • s is an integer from 0-2;
  • q is an integer from 0-2;
  • A is selected from the group consisting of: a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; R 4 ; -NR 4 R 5 ;
  • R 4 , R ⁇ R 16 and R 17 are independently selected from the group consisting of H. -OH, C 1-6 alkyl, aryl and C alkylaryl;
  • R 18 is selected from the group consisting of H, -OH, C ⁇ -6 alkyl, aryl and or can be taken together with R 16 or R 17 to form a 5-6 membered ring;
  • R 19 is selected from the group consisting of H, -OH, C ⁇ . 6 alkyl, aryl and C 1-4 alkylaryl, or can be taken together with R 17 to form a 5-6 membered ring;
  • W is a direct link, C ⁇ . 6 alkyl, C 3-8 cycloalkyl, C]. 6 alkenyl, C 1-6 alkenylaryl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S;
  • D is a direct link, -CO-, -SO 2 -, -CH 2 -, -0-CO-, -NR 15 SO 2 - or -NR 15 -CO-, where R 15 is selected from the group consisting of H. -OH, C ⁇ -6 alkyl, aryl and C
  • K is selected from the group consisting of a direct link, C 3-8 cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S;
  • E is selected from the group consisting of R 26 , -NR 26 R 27 ,
  • R 27 , R 28 and R 29 are independently selected from the group consisting of H, -OH, C 1-6 alkyl, aryl and C 1-4 alkylaryl
  • R 30 is selected from the group consisting of H, C[. 6 alkyl, aryl and C 1-4 alkylaryl, or can be taken together with R 28 or R 29 to form a 5-6 membered ring
  • R 31 is selected from the group consisting of H, C ⁇ . 6 alkyl, aryl and Ci ⁇ alkylaryl, or can be taken together with R 29 to form a 5-6 membered ring; with the proviso that when E is R 26 , then K must contain at least one N atom
  • Y is selected from the group consisting of H,
  • R 13 and R 14 are independently selected from the group consisting of H, C 1-3 alkyl and aryl; and G is -COOR 20 , -CONR 20 R 21 , -CF 3 , -CF 2 CF 3 or a group having the formula:
  • R 22 is selected from the group consisting of H, C 1-6 alkyl, C 2 . 6 alkenyl, C 0-6 alkylaryl. C 2 . 6 alkenylaryl, C 0-6 alkylheterocyclo, C 2-6 alkenylheterocyclo. -CF 3 and -CF 2 CF 3 ;
  • U is -0-, -S-, -N- or -N(H)-;
  • V is -0-. -S-, -N- or -N(H)-; with the proviso that at least one of U or V is -N- or -N(H)-;
  • J is -S-, -SO-, -SO 2 -, -O- or -NR 6 -, where R 6 is H, C 1-6 alkyl or benzyl;
  • L is selected from the group consisting of:
  • R 9 and R 10 are independently selected from the group consisting of H, C 1 -6 alkyl, aryl, C 1-6 alkylaryl, -COOR 11 , -CONR"R 12 , -CN and -CF 3 ;
  • R 9 and R 10 are independently selected from the group consisting of H, C h alky 1, aryl, C ⁇ -6 alkylaryl, C alkyloxy, halogen, -N0 2 , -NR ⁇ R 12 , -NR"COR 12 , -O-R", -O-COR", -COOR 11 , -CONR u R 12 . -CN, -CF 3 , -SO 2 NR n R 12 and C 1-6 alkyl-0-R n ; and R 11 and R 12 are independently selected from the group
  • alkyl refers to saturated aliphatic groups including straight-chain, branched-chain, cyclic groups, and combinations thereof, having the number of carbon atoms specified, or if no number is specified, having up to 12 carbon atoms.
  • cycloalkyl refers to a mono-, bi-, or tricyclic aliphatic ring having 3 to 12 carbon atoms, preferably 3 to 7 carbon atoms.
  • alkenyl refers to unsaturated aliphatic groups including straight-chain, branched-chain, cyclic groups, and combinations thereof, having at least one double bond and having the number of carbon atoms specified.
  • aryl refers to an unsubstituted or substituted aromatic ring(s), substituted with one, two or three substituents such as, by way of example and not limitation, C, ,6 alkoxy, C j _ 6 alkyl, C 1 6 alkylamino, hydroxy, halogen, cyano (-CN), hydroxyl, mercapto, nitro (-NO 2 ), thioalkoxy, carboxaldehyde, carboxyl, carboalkoxy, carboxamide, -NR'R", -NR'COR", -OR, -OCOR, -COOR, -CONR'R", -CF 3 , -SO 2 NR'R" and
  • C ⁇ -6 alkyl-OR aryl, C ⁇ -6 alkylaryl (where the R groups can be H, C ⁇ -6 alkyl, C 1-3 alkylaryl and aryl), including but not limited to carbocyclic aryl, heterocyclic aryl, biarvl and triaryl groups and the like, all of which may be optionally substituted.
  • Preferred aryl groups include phenyl, halophenyl, C,_ 6 alkylphenyl, naphthyl, biphenyl, phenanthrenyl, naphthacenyl, and aromatic heterocyclics or heteroaryls, the latter of which is an aryl group containing one to four heteroatoms selected from the group consisting of nitrogen, oxygen and sulfur.
  • Aryl groups preferably have 5-14 carbon atoms making up the ring(s) structure, while heteroaryls preferably have 1-4 heteroatoms, with the remaining 4-10 atoms being carbon atoms.
  • heterocyclo and “hetero cyclic ring system” as used herein refer to any saturated or unsaturated mono- or bicyclic ring system, containing from one to four heteroatoms, selected from the group consisting of nitrogen, oxygen and sulfur.
  • a typical heterocyclic ring system will have five to ten members, 1-4 of which are heteroatoms.
  • monocyclic ring systems include piperidinyl, pyrrolidinyl, pyridinyl, piperidonyl, pyrrolidonyl and thiazolyl
  • bicyclic ring systems include benzimidazolyl, benzothiazolyl and benzoxazolyl, all of which may be substituted.
  • carrier ring refers to any saturated or unsaturated ring containing from three to six carbon atoms.
  • alkylaryl and alkenylaryl refer to an alkyl group or alkenyl group, respectively, having the number of carbon atoms designated, appended to one, two, or three aryl groups.
  • benzyl refers to -CH 2 -C 6 H 5 .
  • alkoxy refers to an alkyl linked to an oxygen atom, such as methoxy, ethoxy, and so forth.
  • halogen refers to Cl, Br, F or I substituents.
  • direct link refers to a bond directly linking the substituents on each side of the direct link. When two adjacent substituents are defined as each being a “direct link”, it is considered to be a single bond.
  • Two substituents are "taken together to form a 5-6 membered ring” means that an ethylene or a propylene bridge, respectively, is formed between the two substituents.
  • pharmaceutically acceptable salts includes salts of compounds derived from the combination of a compound and an organic or inorganic acid. These compounds are useful in both free base and salt form. In practice, the use of the salt form amounts to use of the base form; both acid and base addition salts are within the scope of the present invention.
  • “Pharmaceutically acceptable acid addition salt” refers to those salts which retain the biological effectiveness and properties of the free bases and which are not biologically or otherwise undesirable, formed with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid and the like, and organic acids such as acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like.
  • inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid and the like
  • organic acids such as acetic acid, propionic acid, glycolic acid, pyruvic acid
  • “Pharmaceutically acceptable base addition salts” include those derived from inorganic bases such as sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, and aluminum bases, and the like. Particularly preferred are the ammonium, potassium, sodium, calcium and magnesium salts. Salts derived from pharmaceutically acceptable organic nontoxic bases include salts of primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins, such as isopropylamine. trimethylamine, diethylamine.
  • Particularly preferred organic nontoxic bases are isopropylamine, diethylamine, ethanolamine, trimethamine, dicyclohexylamine, choline, and caffeine.
  • Bio property for the purposes herein means an in vivo effector or antigenic function or activity that is directly or indirectly performed by a compound of this invention. Effector functions include receptor or ligand binding, any enzyme activity or enzyme modulatory activity, any carrier binding activity, any hormonal activity, any activity in promoting or inhibiting adhesion of cells to an extracellular matrix or cell surface molecules, or any structural role. Antigenic functions include possession of an epitope or antigenic site that is capable of reacting with antibodies raised against it. The biological properties of the compounds of the present invention can be readily characterized by the methods described in Examples 14 and 15 and by such other methods as are well known in the art.
  • Boc refers to t-butoxycarbonyl
  • BOP refers to benzotriazol-l-yloxy-tris-(dimethylamino) phosphonium hexafluorophosphate.
  • CBZ refers to benzyloxycarbonyl.
  • DIEA diisopropylethylamine
  • DMF N,N-dimethylformamide
  • Et 2 0 refers to diethyl ether
  • EtOAc refers to ethyl acetate
  • HF hydrogen fluoride
  • HOAc hydrogen fluoride
  • Mel refers to methyl iodide.
  • MeOH refers to methanol.
  • MeSEt refers to methyl ethyl sulfide.
  • TFA trifluoroacetic acid.
  • THF tetrahydrofuran.
  • Tos refers to -toluenesulfonyl.
  • carbon atoms bonded to four non-identical substituents are asymmetric. Accordingly, the compounds may exist as diastereoisomers, enantiomers or mixtures thereof.
  • the syntheses described herein may employ racemates, enantiomers or diastereomers as starting materials or intermediates. Diastereomeric products resulting from such syntheses may be separated by chromatographic or crystallization methods, or by other methods known in the art.
  • enantiomeric product mixtures may be separated using the same techniques or by other methods known in the art.
  • Each of the asymmetric carbon atoms when present in the compounds of this invention, may be in one of two configurations (R or S) and both are within the scope of the present invention.
  • the final products may, in some cases, contain a small amount of diastereomeric or enantiomeric products, however these products do not affect their therapeutic or diagnostic application.
  • This replacement can be made by methods known in the art.
  • This invention relates to a new class of peptide derivatives selected from those of general formula I which are potent and specific inhibitors of Xa, their pharmaceutically acceptable compositions thereof, and the methods of using them as therapeutic agents for disease states in mammals characterized by abnormal thrombosis:
  • R 1 is H, C ⁇ -6 alkyl or C, -3 alkylaryl
  • R 2 is H, C ⁇ -6 alkyl, C 3-6 cycloalkyl, C ⁇ -3 alkylaryl, C, -3 alkyl-C 3 . 8 cycloalkyl or aryl and R 3 is H, C 1-6 alkyl, or R 2 and R 3 are taken together to form a carbocyclic ring;
  • m is an integer from 0-3;
  • n is an integer from 0-6;
  • p is an integer from 0-4;
  • s is an integer from 0-2;
  • q is an integer from 0-2;
  • A is selected from the group consisting of: a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; R 4 ; -NR 4 R 5 ;
  • R 4 , R D , R 16 and R 17 are independently selected from the group consisting of H, -OH, C ⁇ . 6 alkyl, aryl and R 18 is selected from the group consisting of H, -OH, Ci. 6 alkyl, aryl and C ⁇ -4 alkylaryl, or can be taken together with R 16 or R 17 to form a 5-6 membered ring; and R 19 is selected from the group consisting of H, -OH, C 1-6 alkyl, aryl and or can be taken together with R 17 to form a 5-6 membered ring;
  • W is a direct link, C
  • D is a direct link, -CO-, -SO 2 -, -CH 2 -, -0-CO-, -NR 15 SO 2 - or -NR 15 -CO-, where R 15 is selected from the group consisting of H, -OH, C 1-6 alkyl, aryl and C 1-4 alkylaryl;
  • K is selected from the group consisting of a direct link, C 3-8 cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing 1 -4 heteroatoms selected from the group consisting of N, O and S;
  • E is selected from the group consisting of R 26 , -NR )26r R>27 , where R 26 , R 27 , R 28 and R 29 are independently selected from the group consisting of H, -OH, C ⁇ -6 alkyl, aryl and C l-4 alkylaryl; R 30 is selected from the group consisting of H, C ⁇ -6 alkyl, aryl and C ⁇ currently ⁇ alkylaryl, or can be taken together with R 28 or R 29 to form a 5-6 membered ring; and R 31 is selected from the group consisting of H, C ⁇ -6 alkyl, aryl and C ⁇ alkylaryl, or can be taken together with R 29 to form a 5-6 membered ring; with the proviso that when E is R 26 , then K must contain at least one N atom; Y is selected from the group consisting of H,
  • R 13 and R 14 are independently selected from the group consisting of H, C ⁇ -3 alkyl and aryl; and G is -COOR 20 , -CONR 20 R 21 , -CF 3 , -CF 2 CF 3 or a group having the formula:
  • R 22 is selected from the group consisting of H, C 1-6 alkyl, C 2 . 6 alkenyl, C 0 . 6 alkylaryl,
  • U is -O-, -S-, -N- or -N(H)-;
  • V is -O-, -S-, -N- or -N(H)-; with the proviso that at least one of U or V is -N- or -N(H)-; J is -S-, -SO-, -S0 2 -, -O- or -NR 6 -.
  • R 6 is H, C,. 6 alkyl or benzyl; and L is selected from the group consisting of:
  • R 9 and R 10 a C 6-10 heterocyclic ring system substituted by R 9 and R 10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-2; R 7 and R 8 are independently selected from the group consisting of H, C
  • R 9 and R 10 are independently selected from the group consisting of H, C ⁇ 6 alkyl, aryl, C 1-6 alkylaryl, C
  • R 1 substituents are H and C ⁇ -6 alkyl; more preferably H.
  • R 2 substituents are H and C 1-6 alkyl; more preferably H.
  • R 3 is preferably H.
  • the integer "m” is preferably from 0-1 ; more preferably 0.
  • n is preferably from 1-4.
  • the integer "p” is preferably 3.
  • the integer "s" is preferably 0.
  • the integer "q” is preferably from 0-1.
  • Preferred "A" substituents are R 4 , -NR 4 R 5 ,
  • R 4 is preferably H, -OH or C 1-6 alkyl; more preferably H, -OH or methyl.
  • R 3 is preferably H, -OH or C ⁇ -6 alkyl; more preferably H, -OH or methyl.
  • Preferred "W" substituents are C 5-6 cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing at least one N heteroatom; more preferably aryl, or a five to ten membered heterocyclic ring system containing at least one N heteroatom.
  • Preferred "D" substituents are -CO-, -SO 2 - and -CH 2 -; more preferably -CO- and -SO 2 -.
  • K is preferably a direct link.
  • R 26 , R 27 , R 28 , R 29 , R 30 and R 31 are independently selected from the group consisting of H and C ⁇ alkyl, more preferably H and methyl.
  • R 13 is preferably H.
  • R 14 is preferably H.
  • the "G" substituent is preferably a group having the formula:
  • the "J" substituent is preferably -S-, -O- or -NR 6 0 -.
  • is preferably H.
  • the "L” substituent is preferably:
  • R 7 is preferably H.
  • R 8 is preferably H.
  • R 9 is preferably H, -O-R", -COOR 1 1 , -CONR ⁇ R 12 or -CF 3 ; more preferably H.
  • R 10 is preferably H, -O-R 11 , -COOR 11 , -CONR ⁇ R 12 or -CF 3 ; more preferably H.
  • R 1 ' is preferably H.
  • R 12 is preferably H.
  • A is selected from the group consisting of R 4 , -NR 4 R 5
  • R 4 , R 3 , R 16 , R 17 , R 18 and R 19 are independently selected from the group consisting of H, -OH and C l-6 alkyl.
  • W is C
  • L is selected from the group consisting of: a C 6-10 heterocyclic ring system substituted by R 9 and R 10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-1 ; R 7 and R 8 are independently selected from the group consisting of H, C )-6 alkyl, aryl, C ⁇ -6 alkylaryl, -COOR 11 , -CONR"R 12 , -CN and -CF 3 ; R 9 and R 10 are independently selected from the group consisting of H, C ⁇ -6 alkyl, aryl, C ⁇ .
  • R 9 and R 10 are H. This is also illustrated as a preferred group of compounds defined by the general structural formula III as:
  • A is selected from the group consisting of R 4 , -NR 4 R 3 ;
  • R , R D , R and R are independently selected from the group consisting of H, -OH and C ⁇ -6 alkyl;
  • W is C 1-6 alkyl, C - cycloalkyl, C ⁇ -6 alkenyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; with the proviso that when A is R 4 , then W must contain at least one N atom;
  • D is -CO- or -SO 2 -; and all optical isomers thereof.
  • This invention also encompasses all pharmaceutically acceptable isomers, salts, hydrates and solvates of the compounds of formulas I, II and III.
  • the compounds of formulas I, II and III can exist in various isomeric and tautomeric forms, and all such forms are meant to be included in the invention, along with pharmaceutically acceptable salts, hydrates and solvates of such isomers and tautomers.
  • the compounds of this invention may be isolated as the free acid or base or converted to salts of various inorganic and organic acids and bases. Such salts are within the scope of this invention. Non-toxic and physiologically compatible salts are particularly useful although other less desirable salts may have use in the processes of isolation and purification.
  • the free acid or free base form of a compound of one of the formulas above can be reacted with one or more molar equivalents of the desired acid or base in a solvent or solvent mixture in which the salt is insoluble, or in a solvent like water after which the solvent is removed by evaporation, distillation or freeze drying.
  • the free acid or base form of the product may be passed over an ion exchange resin to form the desired salt or one salt form of the product may be converted to another using the same general process.
  • prodrug refers to a pharmacologically inactive derivative of a parent drug molecule that requires biotransformation, either spontaneous or enzymatic, within the organism to release the active drug.
  • Prodrugs are variations or derivatives of the compounds of this invention which have groups cleavable under metabolic conditions. Prodrugs become the compounds of the invention which are pharmaceutically active in vivo, when they undergo solvolysis under physiological conditions or undergo enzymatic degradation. Prodrug compounds of this invention may be called single, double, triple etc., depending on the number of biotransformation steps required to release the active drug within the organism, and indicating the number of functionalities present in a precursor-type form.
  • Prodrug forms often offer advantages of solubility, tissue compatibility, or delayed release in the mammalian organism (see, Bundgard, Design of Prodrugs, pp. 7-9, 21-24, Elsevier, Amsterdam 1985 and Silverman, The Organic Chemistry of Drug Design and Drug Action, pp. 352-401, Academic Press, San Diego,
  • Prodrugs commonly known in the art include acid derivatives well known to practitioners of the art, such as, for example, esters prepared by reaction of the parent acids with a suitable alcohol, or amides prepared by reaction of the parent acid compound with an amine, or basic groups reacted to form an acylated base derivative.
  • the prodrug derivatives of this invention may be combined with other features herein taught to enhance bioavailability.
  • the compounds of this invention find utility as therapeutic agents for disease states in mammals which have disorders of coagulation such as in the treatment or prevention of unstable angina, refractory angina, myocardial infarction, transient ischemic attacks, thrombotic stroke, embolic stroke, disseminated intravascular coagulation including the treatment of septic shock, deep venous thrombosis in the prevention of pulmonary embolism or the treatment of reocclusion or restenosis of reperfused coronary arteries. Further, these compounds are useful for the treatment or prophylaxis of those diseases which involve the production and/or action of factor Xa/prothrombinase complex.
  • thrombotic and prothrombotic states in which the coagulation cascade is activated which include but are not limited to, deep venous " thrombosis, pulmonary embolism, myocardial infarction, stroke, thromboembolic complications of surgery and peripheral arterial occlusion.
  • a method for preventing or treating a condition in a mammal characterized by undesired thrombosis comprises administering to the mammal a therapeutically effective amount of a compound of this invention.
  • diseases treatable or preventable by the administration of compounds of this invention include, without limitation, occlusive coronary thrombus formation resulting from either thrombolytic therapy or percutaneous transluminal coronary angioplasty.
  • the compounds of the invention also find utility in a method for inhibiting the coagulation biological samples, which comprises the administration of a compound of the invention.
  • the compounds of the present invention may also be used in combination with other therapeutic or diagnostic agents.
  • the compounds of this invention may be coadministered along with other compounds typically prescribed for these conditions according to generally accepted medical practice such as anticoagulant agents, thrombolytic agents, or other antithrombotics, including platelet aggregation inhibitors, tissue plasminogen activators, urokinase, prourokinase, streptokinase, heparin, aspirin, or warfarin.
  • anticoagulant agents thrombolytic agents
  • other antithrombotics including platelet aggregation inhibitors, tissue plasminogen activators, urokinase, prourokinase, streptokinase, heparin, aspirin, or warfarin.
  • the compounds of the present invention may act in a synergistic fashion to prevent reocclusion following a successful thromholytic therapy and/or reduce the time to reperfusion. These compounds may also allow for reduced doses of the thrombolytic agents to be used and therefore minimize potential hemorrhagic
  • the compounds of this invention can be utilized in vivo, ordinarily in mammals such as primates, (e.g. humans), sheep, horses, cattle, pigs, dogs, cats, rats and mice, or in vitro.
  • mammals such as primates, (e.g. humans), sheep, horses, cattle, pigs, dogs, cats, rats and mice, or in vitro.
  • the biological properties of the compounds of the present invention can be readily characterized by methods that are well known in the art, for example by the in vitro protease activity assays and in vivo studies to evaluate antithrombotic efficacy, and effects on hemostasis and hematological parameters, such as are illustrated in the examples.
  • Diagnostic applications of the compounds of this invention will typically utilize formulations in the form of solutions or suspensions.
  • the compounds of this invention may be utilized in compositions such as tablets, capsules or elixirs for oral administration, suppositories, sterile solutions or suspensions or injectable administration, and the like, or incorporated into shaped articles.
  • Subjects in need of treatment (typically mammalian) using the compounds of this invention can be administered dosages that will provide optimal efficacy.
  • the dose and method of administration will vary from subject to subject and be dependent upon such factors as the type of mammal being treated, its sex, weight, diet, concurrent medication, overall clinical condition, the particular compounds employed, the specific use for which these compounds are employed, and other factors which those skilled in the medical arts will recognize.
  • Formulations of the compounds of this invention are prepared for storage or administration by mixing the compound having a desired degree of purity with physiologically acceptable carriers, excipients, stabilizers etc., and may be provided in sustained release or timed release formulations.
  • Acceptable carriers or diluents for therapeutic use are well known in the pharmaceutical field, and are described, for example, in Remington's Pharmaceutical Sciences, Mack Publishing Co., (A.R. Gennaro edit. 1985).
  • Such materials are nontoxic to the recipients at the dosages and concentrations employed, and include buffers such as phosphate, citrate, acetate and other organic acid salts, antioxidants such as ascorbic acid, low molecular weight (less than about ten residues) peptides such as polyarginine, proteins, such as serum albumin, gelatin, or immunoglobulins, hydrophilic polymers such as polyvinylpyrrolidinone.
  • buffers such as phosphate, citrate, acetate and other organic acid salts
  • antioxidants such as ascorbic acid
  • low molecular weight (less than about ten residues) peptides such as polyarginine
  • proteins such as serum albumin, gelatin, or immunoglobulins
  • hydrophilic polymers such as polyvinylpyrrolidinone.
  • amino acids such as glycine, glutamic acid, aspartic acid, or arginine, monosaccharides, disaccharides, and other carbohydrates including cellulose or its derivatives, glucose, mannose or dextrins, chelating agents such as EDTA, sugar alcohols such as mannitol or sorbitol, counterions such as sodium and/or nonionic surfactants such as Tween, Pluronics or polyethyleneglycol.
  • Dosage formulations of the compounds of this invention to be used for therapeutic administration must be sterile. Sterility is readily accomplished by filtration through sterile membranes such as 0.2 micron membranes, or by other conventional methods. Formulations typically will be stored in lyophilized form or as an aqueous solution.
  • the pH of the preparations of this invention typically will be 3-1 1, more preferably 5-9 and most preferably 7-8. It will be understood that use of certain of the foregoing excipients, carriers, or stabilizers will result in the formation of cyclic polypeptide salts.
  • While the preferred route of administration is by injection, other methods of administration are also anticipated such as orally, intravenously (bolus and/or infusion), subcutaneously, intramuscularly, colonically, rectally, nasally, transdermally or intraperitoneally, employing a variety of dosage forms such as suppositories, implanted pellets or small cylinders, aerosols, oral dosage formulations and topical formulations such as ointments, drops and dermal patches.
  • the compounds of this invention are desirably incorporated into shaped articles such as implants which may employ inert materials such as biodegradable polymers or synthetic silicones, for example, Silastic, silicone rubber or other polymers commercially available.
  • the compounds of the invention may also be administered in the form of liposome delivery systems, such as small unilamellar vesicles, large unilamellar vesicles and multilamellar vesicles.
  • Liposomes can be formed from a variety of lipids, such as cholesterol, stearylamine or phosphatidylcholines.
  • the compounds of this invention may also be delivered by the use of antibodies, antibody fragments, growth factors, hormones, or other targeting moieties, to which the compound molecules are coupled.
  • the compounds of this invention may also be coupled with suitable polymers as targetable drug carriers.
  • Such polymers can include polyvinylpyrrolidinone, pyran copolymer, polyhydroxy-propyl-methacrylamide-phenol, polyhydroxyethyl-aspartamide-phenol, or polyethyleneoxide-polylysine substituted with palmitoyl residues.
  • compounds of the invention may be coupled to a class of biodegradable polymers useful in achieving controlled release of a drug, for example polylactic acid, polyglycolic acid, copolymers of polylactic and polyglycolic acid, polyepsilon caprolactone, polyhydroxy butyric acid, polyorthoesters, polyacetals, polydihydropyrans, polycyanoacrylates and cross linked or amphipathic block copolymers of hydrogels.
  • Polymers and semipermeable polymer matrices may be formed into shaped articles, such as valves, stents, tubing, prostheses and the like.
  • Therapeutic compound liquid formulations generally are placed into a container having a sterile access port, for example, an intravenous solution bag or vial having a stopper pierceable by hypodermic injection needle.
  • Therapeutically effective dosages may be determined by either in vitro or in vivo methods. For each particular compound of the present invention, individual determinations may be made to determine the optimal dosage required.
  • the range of therapeutically effective dosages will be influenced by the route of administration, the therapeutic objectives and the condition of the patient. For injection by hypodermic needle, it may be assumed the dosage is delivered into the body's fluids. For other routes of administration, the absorption efficiency must be individually determined for each compound by methods well known in pharmacology. Accordingly, it may be necessary for the therapist to titer the dosage and modify the route of administration as required to obtain the optimal therapeutic effect.
  • the determination of effective dosage levels that is, the dosage levels necessary to achieve the desired result, will be readily determined by one skilled in the art.
  • the compounds of the invention can be administered orally or parenterally in an effective amount within the dosage range of about 0.1 to 100 mg/kg, preferably about 0.5 to 50 mg/kg and more preferably about 1 to 20 mg/kg on a regimen in a single or 2 to 4 divided daily doses and/or continuous infusion.
  • a compound or mixture of compounds of this invention is compounded with a physiologically acceptable vehicle, carrier, excipient. binder, preservative, stabilizer, dye, flavor etc., as called for by accepted pharmaceutical practice.
  • a physiologically acceptable vehicle carrier, excipient. binder, preservative, stabilizer, dye, flavor etc., as called for by accepted pharmaceutical practice.
  • the amount of active ingredient in these compositions is such that a suitable dosage in the range indicated is obtained.
  • Typical adjuvants which may be incorporated into tablets, capsules and the like are binders such as acacia, corn starch or gelatin, and excipients such as microcrystalline cellulose, disintegrating agents like corn starch or alginic acid, lubricants such as magnesium stearate, sweetening agents such as sucrose or lactose, or flavoring agents.
  • a dosage form is a capsule, in addition to the above materials it may also contain liquid carriers such as water, saline, or a fatty oil. Other materials of various types may be used as coatings or as modifiers of the physical form of the dosage unit.
  • Sterile compositions for injection can be formulated according to conventional pharmaceutical practice. For example, dissolution or suspension of the active compound in a vehicle such as an oil or a synthetic fatty vehicle like ethyl oleate, or into a liposome may be desired. Buffers, preservatives, antioxidants and the like can be incorporated according to accepted pharmaceutical practice.
  • the compounds of the present invention may be synthesized by either solid or liquid phase methods described and referenced in standard textbooks, or by a combination of both methods. These methods are well known in the art. See, Bodanszky, "The Principles of Peptide Synthesis", Hafner, et al, Eds., Springer-Verlag, Berlin, 1984. Starting materials used in any of these methods are commercially available from chemical vendors such as Aldrich, Sigma, Nova Biochemicals, Bachem Biosciences, and the like, or may be readily synthesized by known procedures.
  • Reactions are carried out in standard laboratory glassware and reaction vessels under reaction conditions of standard temperature and pressure, except where otherwise indicated.
  • reaction products are isolated and purified by conventional methods, typically by solvent extraction into a compatible solvent.
  • the products may be further purified by column chromatography or other appropriate methods.
  • the peptide derivatives can be prepared by sequence coupling of protected Fragment-
  • Fragment-2 can be first coupled to Fragment- 1 to yield an intermediate to which Fragment-3 can then be coupled (Scheme II).
  • the protecting groups are finally removed by HF-cleavage.
  • P is a protecting group
  • P is a protecting group
  • the "D" substituent illustrated in Fragment- 1 is -CO-. Fragments similar to the structure of Fragment- 1, where D is -SO , -CH 2 -, -O-CO-, -NR 15 S0 2 - or -NR 15 -CO-, can easily be synthesized by techniques such as those described in Semple, et al. , WO 95/35311.
  • the "R 1 " and "R 2 " substituents illustrated in Fragment-2 are -H. Fragments similar to the structure of Fragment-2, where R l is C ⁇ -6 alkyl or C ⁇ . 3 alkylaryl, and/or where R 2 is C !-6 alkyl, C . 6 cycloalkyl, C ⁇ -3 alkylaryl, or aryl, can easily be synthesized by techniques that are well known in the art.
  • Fragments similar to the structure of Fragment-3, where G is: and J is -SO- or -S0 - can easily be synthesized by techniques that are well known in the art. Fragments where J is -O- can be synthesized by techniques illustrated in J. Am. Chem. Soc. 1 14: 1854-1863 (1992), J. Med. Chem. 38:76-85 (1995), and J. Med. Chem. 37:3492-3502 (1994). Lastly, fragments where J is -NR ⁇ -, where is H, C,. 6 alkyl or benzyl, can be synthesized by techniques illustrated in J. Med. Chem. 37:3492-3502 (1994). All of these references are incorporated herein by reference. Fragments similar to the structure of Fragment-3, where G is:
  • R 7 , R 8 , R 9 and R 10 are not H, can also be easily synthesized by techniques that are well known in the art.
  • Fragments similar to the structure of Fragment-3, where G is -COOR 20 , -CONR 20 R 21 , -CF 3 or -CF 2 CF 3 can easily be synthesized by techniques that are well known in the art.
  • Fragments similar to the structure of Fragment-3, where "Y" is a boron-containing group can easily be synthesized by techniques that are well known in the art. See for example, J. Org. Chem. 60:3717-3722 (1995). The mechanisms for coupling the various fragments used to synthesize the compounds of the instant invention, are also well known in the art.
  • N- ⁇ -Boc-N- ⁇ -CBZ-L-ornithine (10 g, 0.027 mol) is dissolved in a solution of MeOH
  • TLC showed clean conversion to N- ⁇ -Boc-L-ornithine.
  • the crude intermediate is dissolved in dry DMF (60 mL) and heated to 50-60°C for 2.5 hours. The solvent is removed under vacuum. The oil residue is dissolved in 50 mL of CH 2 C1 2 and extracted with 50 mL of 1 N NaOH. The aqueous solution is extracted with 50 mL of CH 2 C1 2 , acidified with cooling with 50 mL of IN HCl, re-extracted with 5 X 50 mL of CH 2 C1 2 . The combined organic layers are dried over MgS0 4 , filtered and evaporated to afford 5 g of the compound shown above, as a solidifying oil.
  • Example 3 The compounds of Example 3 (1 mmol) and Example 4 (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C. The solution is neutralized with DIEA (1 mL) followed by addition of coupling reagent BOP (1.1 mmol). The solution is stirred for 1-2 hours and HPLC analysis showed the completion of reaction. Solvent is removed by vacuum at 30°C. The residue is dissolved in a mixture of EtOAc-H 2 0 (50 mL:10 mL). The organic layer is washed with sat. NaHCO 3 (2 X 10 mL), sat. NaCI (2 X 10 mL), dried over MgS0 4 , filtered and solvent evaporated. The oil residue is purified by flash column on SiO 2 to give the compound shown above, as a powder.
  • Example 4 The compound of Example 4 (1 mmol) is dissolved in 1 mL of MeOH, cooled to 0°C and treated dropwise with sat. HCl in MeOH (4 mL). The solution is stirred at 0°C for 1 hour and then warmed to room temperature and stirred for 14 hours. The solution is concentrated under vacuum to afford the compound shown above, as a clear oil which is used directly in the next example.
  • Example 9 The compounds of Example 9 (1 mmol) and 4-(Di-CBZ-guanidine)-butanoic acid (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C. The solution is neutralized with DIEA (1 mL) followed by addition of coupling reagent BOP (1.1 mmol). The solution is stirred for 1-2 hours and HPLC analysis showed the completion of reaction. Solvent is removed by vacuum at 30°C. The residue is dissolved in a mixture of EtOAc-H 2 O (50 mL: 10 mL) and aqueous layer is discarded. The organic layer is washed with sat. NaHCO 3 (2 X 10 mL), sat. NaCI (2 X 10 mL), dried over MgSO 4 , filtered and evaporated. The oil residue is purified by flash column on SiO 2 to give the compound shown above, as a powder.
  • Example 10 The compound of Example 10 (1 mmol) is dissolved in MeOH (1 mL) and cooled to 0°C. 5 mL of 1 N LiOH is added dropwise to the mixture and the solution is stirred at
  • Example 1 1 (1 mmol) and Example 3 (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C.
  • the solution is neutralized with DIEA (1 mL) followed by the addition of coupling reagent BOP (1.1 mmol).
  • the solution is stirred for 1-2 hours and HPLC analysis shows the completion of reaction.
  • Solvent is removed by vacuum at 30°C.
  • the residue is dissolved in a mixture of EtOAc-H 2 O (50 mL:10 mL) and aqueous layer is discarded.
  • the organic layer is washed with sat. NaHC0 3 (2 X 10 mL), sat. NaCI (2 X 10 mL), dried over MgSO 4 , filtered and evaporated.
  • the oil residue is purified by flash column on Si0 2 to give the compound shown above, as a powder.
  • EXAMPLE 14 Determination of ICsn
  • the compounds of the present invention are first dissolved in a buffer to give solutions containing concentrations such that assay concentrations range from 0-100 ⁇ M.
  • a synthetic chromogenic substrate In assays for thrombin, prothrombinase and factor Xa, a synthetic chromogenic substrate would be added to a solution containing a test compound and the enzyme of interest and the residual catalytic activity of that enzyme would then be determined spectrophotometrically.
  • the IC 50 of a compound is determined from the substrate turnover.
  • the IC 50 is the concentration of test compound giving 50% inhibition of the substrate turnover.
  • Preferred compounds of the invention desirably have an IC 50 of less than 500 nM in the factor Xa assay, preferably less than 200 nM, and more preferably less than 100 nM.
  • Preferred compounds of the invention desirably have an IC 50 of less than 4.0 ⁇ M in the prothrombinase assay, preferably less than 200 nM, and more preferably less than 10 nM.
  • Preferred compounds of the invention desirably have an IC 50 of greater than 1.0 ⁇ M in the thrombin assay, preferably greater than 10.0 ⁇ M, and more preferably greater than 100.0 ⁇ M.
  • Amidolytic Assays for determining protease inhibition activity Factor Xa and thrombin assays are performed at room temperature, in 0.02 M Tris HCl buffer, pH 7.5, containing 0.15 M NaCI.
  • the rates of hydrolysis of the para- nitroanilide substrate S-2765 (Chromogenix) for factor Xa, and the substrate Chromozym TH (Boehringer Mannheim) for thrombin following preincubation of the enzyme with the test compound for 5 minutes at room temperature are determined using a Softmax 96-well plate reader (Molecular Devices), monitored at 405 nm to measure the time dependent appearance of p-nitroanilide.
  • prothrombinase inhibition assay is performed in a plasma free system with modifications to the method as described by Sinha, et al, Thromb. Res., 75:427-436
  • the activity of the prothrombinase complex is determined by measuring the time course of thrombin generation using the p-nitroanilide substrate Chromozym TH.
  • the assay consists of a 5 minute preincubation of selected compounds to be tested as inhibitors with the complex formed from factor Xa (0.5 nM), factor Va (2 nM), phosphatidyl serine ⁇ hosphatidyl choline (25:75, 20 ⁇ M) in 20 mM Tris HCl buffer, pH
  • the antithrombotic efficacy of the compounds of this invention can readily be evaluated using a series of studies in rabbits, as described below. These studies are also useful in evaluating a compounds effects on hemostasis and its the hematological parameters.
  • Rabbits are anesthetized with I.M. injections of Ketamine, Xylazine, and Acepromazine cocktail.
  • a standardized protocol consists of insertion of a thrombogenic cotton thread and copper wire apparatus into the abdominal vena cava of the anesthetized rabbit.
  • a non- occlusive thrombus is allowed to develop in the central venous circulation and inhibition of thrombus growth is then used as a measure of the antithrombotic activity of the compound being evaluated.
  • Test agents or control saline are administered through a marginal ear vein catheter.
  • a femoral vein catheter is used for blood sampling prior to and during steady state infusion of the compound being evaluated. Initiation of thrombus formation will begin immediately after advancement of the cotton thread apparatus into the central venous circulation.
  • the rabbits are euthanized and the thrombus excised by surgical dissection and characterized by weight and histology. Blood samples are then analyzed for changes in hematological and coagulation parameters.

Abstract

Novel compounds, their salts and compositions related thereto having activity against mammalian factor Xa are disclosed. The compounds are useful in vitro or in vivo for preventing or treating coagulation disorders. Their formula is (I) where the meaning of the various symbols is provided in the description.

Description

Selective Factor Xa Inhibitors Field of the Invention This invention relates to novel heterocyclic compounds which are potent and highly selective inhibitors of factor Xa or factor Xa when assembled in the prothrombinase complex. These compounds show selectivity for factor Xa versus other proteases of the coagulation (e.g. thrombin, fVIIa, fIXa) or the fibrinolytic cascades (e.g. plasminogen activators, plasmin).
Background of the Invention Blood coagulation protects mammalian species when the integrity of the blood vessel wall is damaged and uncontrolled loss of blood threatens survival. Coagulation, resulting in the clotting of blood is an important component of hemostasis. Under normal hemostatic circumstances, there is maintained an acute balance of clot formation and clot removal (fibrinolysis). The blood coagulation cascade involves the conversion of a variety of inactive enzymes (zymogens) into active enzymes which ultimately convert the soluble plasma protein fibrinogen into an insoluble matrix of highly cross-linked fibrin.
See Davie. et al., "The Coagulation Cascade: Initiation, Maintenance and Regulation" Biochemistry 30:10363-10370 (1991). Blood platelets which adhere to damaged blood vessels are activated and incorporated into the clot and thus play a major role in the initial formation and stabilization of hemostatic "plugs". In certain diseases of the cardiovascular system, deviations from normal hemostasis push the balance of clot formation and clot dissolution towards life-threatening thrombus formation when thrombi occlude blood flow in coronary vessels (myocardial infarctions) or limb and pulmonary veins (venous thrombosis). Although platelets and blood coagulation are both involved in thrombus formation, certain components of the coagulation cascade are primarily responsible for the amplification or acceleration of the processes involved in platelet aggregation and fibrin deposition.
A key enzyme in the coagulation cascade as well as in hemostasis, is thrombin. Thrombin is intimately involved in the process of thrombus formation, but under normal circumstances can also play an anticoagulant role in hemostasis through its ability to convert protein C into activated protein C in a thrombomodulin-dependent manner. Thrombin plays a central role in thrombosis through its ability to catalyze the penultimate conversion of fibrinogen into fibrin and through its potent platelet activation activity. Direct or indirect inhibition of thrombin activity has been the focus of a variety of recent anticoagulant strategies as reviewed by Claeson "Synthetic Peptides and Peptidomimetics as Substrates and Inhibitors of Thrombin and Other Proteases in the Blood Coagulation System", Blood Coag. Fibrinol. 5:411-436 (1994). The major classes of anticoagulants currently used in the clinic directly or indirectly affect thrombin (i.e. heparins, low-molecular weight heparins and coumarins). Thrombin is generated at the convergence of the intrinsic and extrinsic coagulation pathways by the prothrombinase complex. The prothrombinase complex is formed when activated Factor X (factor Xa) and its non-enzymatic cofactor, factor Va assemble on phospholipid surfaces in a Ca+2- dependent fashion as reviewed by Mann, et al, "Surface-Dependent Reactions of the Vitamin K-Dependent Enzymes" , Blood 76 : 1 - 16 ( 1990) . The prothrombinase complex converts the zymogen prothrombin into the active procoagulant thrombin.
The location of the prothrombinase complex at the convergence of the intrinsic and extrinsic coagulation pathways, and the significant amplification of thrombin generation (393,000-fold over uncomplexed factor Xa) mediated by the complex at a limited number of targeted catalytic units present at vascular lesion sites, suggests that inhibition of thrombin generation is an ideal method to block uncontrolled procoagulant activity. Unlike thrombin, which acts on a variety of protein substrates as well as at a specific receptor, factor Xa appears to have a single physiologic substrate, namely prothrombin. Plasma contains an endogenous inhibitor of both the factor Vila-tissue factor (TF) complex and factor Xa called tissue factor pathway inhibitor (TFPI). TFPI is a Kunitz- type protease inhibitor with three tandem Kunitz domains. TFPI inhibits the TF/fVIIa complex in a two-step mechanism which includes the initial interaction of the second Kunitz domain of TFPI with the active site of factor Xa, thereby inhibiting the proteolytic activity of factor Xa. The second step involves the inhibition of the TF/fVIIa complex by formation of a quaternary complex TF/fVIIa/TFPI/fXa as described by Girard, et al. "Functional Significance of the Kunitz-type Inhibitory Domains of Lipoprotein-associated Coagulation Inhibitor". Nature 338:518-520 (1989). Polypeptides derived from hematophagous organisms have been reported which are highly potent and specific inhibitors of factor Xa. U. S. Patent No. 4,588,587 awarded to Gasic, describes anticoagulant activity in the saliva of the Mexican leech, Haemente a offwinalis. A principal component of this saliva is shown to be the polypeptide factor Xa inhibitor, antistasin, by Nutt, et al, "The Amino Acid Sequence of Antistasin, a Potent Inhibitor of Factor Xa Reveals a Repeated Internal Structure", J. Biol. Chem.
263: 10162-10167 (1988).
Another potent and highly specific inhibitor of Factor Xa, tick anticoagulant peptide, has been isolated from the whole body extract of the soft tick Ornithidoros moubata, as reported by Waxman. et al. , "Tick Anticoagulant Peptide (TAP) is a Novel Inhibitor of Blood Coagulation Factor Xa", Science 248:593-596 (1990).
Other polypeptide type inhibitors of factor Xa have been reported including the following citations by: Condra, et al, "Isolation and Structural Characterization of a Potent Inhibitor of Coagulation Factor Xa from the Leech Haemente a ghilianii", Thromb. Haemost. 61 :437-441 (1989); Blankenship, et al, "Amino Acid Sequence of Ghilanten: Anti-coagulant-antimetastatic Principle of the South American Leech.
Haementeήa ghilianii". Biochem. Biophys. Res. Commun. 166:1384-1389 (1990); Brankamp, et al, "Ghilantens: Anticoagulants, Antimetastatic Proteins from the South American Leech Haementeήa ghilianii", J. Lab. Gin. Med. 1 15:89-97 (1990); Jacobs, et al, "Isolation and Characterization of a Coagulation Factor Xa Inhibitor from Black Fly Salivary Glands", Thromb. Haemost. 64:235-238 (1990); Rigbi, et al, "Bovine Factor Xa
Inhibiting Factor and Pharmaceutical Compositions Containing the Same", European Patent Application. 352,903 (1990); Cox, "Coagulation Factor X Inhibitor From the Hundred-pace Snake Deinagkistrodon aculus venom", Toxicon 31 : 1445-1457 (1993); Cappello, et al., "Ancylostoma Factor Xa Inhibitor: Partial Purification and its Identification as a Major Hookworm-derived Anticoagulant In Vitro", J. Infect. Pis. 167:1474-1477 (1993); Seymour, et al, "Ecotin is a Potent Anticoagulant and Reversible Tight-binding Inhibitor of Factor Xa", Biochemistry 33:3949-3958 (1994). Factor Xa inhibitory compounds which are not large polypeptide-type inhibitors have also been reported including: Tidwell, et al, "Strategies for Anticoagulation With Synthetic Protease Inhibitors. Xa Inhibitors Versus Thrombin Inhibitors", Thromb. Res. 19:339-349 (1980); Turner, et al, "p-Amidino Esters as Irreversible Inhibitors of Factor IXa and Xa and Thrombin", Biochemistry 25:4929-4935 (1986); Hitomi, et al, "Inhibitory Effect of New Synthetic Protease Inhibitor (FUT-175) on the Coagulation
System", Haemostasis 15:164-168 (1985); Sturzebecher, et al, "Synthetic Inhibitors of Bovine Factor Xa and Thrombin. Comparison of Their Anticoagulant Efficiency", Thromb. Res. 54:245-252 (1989); Kam, et al, "Mechanism Based Isocoumarin Inhibitors for Trypsin and Blood Coagulation Serine Proteases: New Anticoagulants", Biochemistry 27:2547-2557 (1988); Hauptmann, et al, "Comparison of the Anticoagulant and
Antithrombotic Effects of Synthetic Thrombin and Factor Xa Inhibitors", Thromb. Haemost. 63:220-223 (1990); Miyadera, et al, Japanese Patent Application JP 6327488 (1994); Nagahara, et al, "Dibasic (Amidinoaryl)propanoic Acid Derivatives as Novel Blood Coagulation Factor Xa Inhibitors", J. Med. Chem. 37:1200-1207 (1994); Vlasuk, et al, "Inhibitors of Thrombosis" European Patent Application, WO 93/15756 (1993); and
Brunck, et al, "Novel Inhibitors of Factor Xa", European Patent Application, WO 94/13693 (1994). Al-obeidi, et al., "Factor Xa Inhibitors", WO patent 95/29189, discloses pentapeptide X1-Y-I-R-X2 derivatives as factor Xa inhibitors. Said compounds are useful for inhibiting blood clotting in the treatment of thrombosis, stroke, and myocardial infarction.
WO 96/18644 to Tamura, et al., describes aromatic heterocyclic thrombin inhibitors. WO 95/35313 to Semple, et al, pertains to 3-amino-2-oxo-l-piperidineacetic derivative thrombin inhibitors. EP 0,512.831 and US Patent No. 5,281,585, both to Duggan, et al, describe fibrinogen receptor antagonists.
SUMMARY OF THE INVENTION The present invention relates to novel peptide and peptide mimetic analogs, their pharmaceutically acceptable isomers, salts, hydrates, solvates and prodrug derivatives.
In another aspect, the present invention includes pharmaceutical compositions comprising a pharmaceutically effective amount of the compounds of this invention and a pharmaceutically acceptable carrier. These compositions are useful as potent and specific inhibitors of blood coagulation in mammals.
In yet another aspect, the invention relates to methods of using these inhibitors as therapeutic agents for disease states in mammals which have disorders of coagulation such as in the treatment or prevention of unstable angina, refractory angina, myocardial infarction, transient ischemic attacks, thrombotic stroke, embolic stroke, disseminated intravascular coagulation including the treatment of septic shock, deep venous thrombosis in the prevention of pulmonary embolism or the treatment of reocclusion or restenosis of reperfused coronary arteries. These compositions may optionally include anticoagulants, antiplatelet agents, and thrombolytic agents.
In other aspects of the invention compounds are provided which are useful as diagnostic reagents.
In preferred embodiments, the present invention provides compounds of general formula I:
Figure imgf000007_0001
Wherein:
R1 is H, C,.6alkyl or C,.3alkylaryl;
R2 is H, C|.6alkyl, C3.6cycloalkyl, C1-3alkylaryl, Cι.3alkyl-C3.8cycloalkyl or aryl and R3 is H. Cι.6alkyl, or R2 and R3 are taken together to form a carbocyclic ring; m is an integer from 0-3; n is an integer from 0-6; p is an integer from 0-4; s is an integer from 0-2; q is an integer from 0-2;
A is selected from the group consisting of: a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; R4; -NR4R5;
Figure imgf000008_0001
where R4, R\ R16 and R17 are independently selected from the group consisting of H. -OH, C1-6alkyl, aryl and C alkylaryl; R18 is selected from the group consisting of H, -OH, Cι-6alkyl, aryl and
Figure imgf000008_0002
or can be taken together with R16 or R17 to form a 5-6 membered ring; and R19 is selected from the group consisting of H, -OH, Cι.6alkyl, aryl and C1-4alkylaryl, or can be taken together with R17 to form a 5-6 membered ring;
W is a direct link, Cι.6alkyl, C3-8cycloalkyl, C].6alkenyl, C1-6alkenylaryl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S;
D is a direct link, -CO-, -SO2-, -CH2-, -0-CO-, -NR15SO2- or -NR15-CO-, where R15 is selected from the group consisting of H. -OH, Cι-6alkyl, aryl and C|.4alkylaryl;
K is selected from the group consisting of a direct link, C3-8cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S;
E is selected from the group consisting of R26, -NR26R27,
Figure imgf000009_0001
where R26. R27, R28 and R29 are independently selected from the group consisting of H, -OH, C1-6alkyl, aryl and C1-4alkylaryl; R30 is selected from the group consisting of H, C[.6alkyl, aryl and C1-4alkylaryl, or can be taken together with R28 or R29 to form a 5-6 membered ring; and R31 is selected from the group consisting of H, Cι.6alkyl, aryl and Ci^alkylaryl, or can be taken together with R29 to form a 5-6 membered ring; with the proviso that when E is R26, then K must contain at least one N atom; Y is selected from the group consisting of H,
Figure imgf000009_0002
where R13 and R14 are independently selected from the group consisting of H, C1-3alkyl and aryl; and G is -COOR20, -CONR20R21, -CF3, -CF2CF3 or a group having the formula:
Figure imgf000009_0003
where: R22 is selected from the group consisting of H, C1-6alkyl, C2.6alkenyl, C0-6alkylaryl. C2.6alkenylaryl, C0-6alkylheterocyclo, C2-6alkenylheterocyclo. -CF3 and -CF2CF3;
U is -0-, -S-, -N- or -N(H)-; and
V is -0-. -S-, -N- or -N(H)-; with the proviso that at least one of U or V is -N- or -N(H)-;
J is -S-, -SO-, -SO2-, -O- or -NR6-, where R6 is H, C1-6alkyl or benzyl; and
L is selected from the group consisting of:
Figure imgf000010_0001
a C6-l0 heterocyclic ring system substituted by R9 and R10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-2; R7 and R8 are independently selected from the group consisting of H, C1 -6alkyl, aryl, C1-6alkylaryl, -COOR11, -CONR"R12, -CN and -CF3; R9 and R10 are independently selected from the group consisting of H, Chalky 1, aryl, Cι-6alkylaryl, C alkyloxy, halogen, -N02, -NRπR12, -NR"COR12, -O-R", -O-COR", -COOR11, -CONRuR12. -CN, -CF3, -SO2NRnR12 and C1-6alkyl-0-Rn; and R11 and R12 are independently selected from the group consisting of
H, C|.6alkyl, C1-3alkylaryl and aryl; and all optical isomers thereof.
DETAILED DESCRIPTION OF THE INVENTION DEFINITIONS
In accordance with the present invention and as used herein, the following terms are defined with the following meanings, unless explicitly stated otherwise.
The term "alkyl" refers to saturated aliphatic groups including straight-chain, branched-chain, cyclic groups, and combinations thereof, having the number of carbon atoms specified, or if no number is specified, having up to 12 carbon atoms. The term "cycloalkyl" refers to a mono-, bi-, or tricyclic aliphatic ring having 3 to 12 carbon atoms, preferably 3 to 7 carbon atoms.
The term "alkenyl" refers to unsaturated aliphatic groups including straight-chain, branched-chain, cyclic groups, and combinations thereof, having at least one double bond and having the number of carbon atoms specified.
The term "aryl" refers to an unsubstituted or substituted aromatic ring(s), substituted with one, two or three substituents such as, by way of example and not limitation, C,,6alkoxy, Cj_6alkyl, C1 6 alkylamino, hydroxy, halogen, cyano (-CN), hydroxyl, mercapto, nitro (-NO2), thioalkoxy, carboxaldehyde, carboxyl, carboalkoxy, carboxamide, -NR'R", -NR'COR", -OR, -OCOR, -COOR, -CONR'R", -CF3, -SO2NR'R" and
-6alkyl-OR; aryl, Cι-6alkylaryl (where the R groups can be H, Cι-6alkyl, C1-3alkylaryl and aryl), including but not limited to carbocyclic aryl, heterocyclic aryl, biarvl and triaryl groups and the like, all of which may be optionally substituted. Preferred aryl groups include phenyl, halophenyl, C,_6alkylphenyl, naphthyl, biphenyl, phenanthrenyl, naphthacenyl, and aromatic heterocyclics or heteroaryls, the latter of which is an aryl group containing one to four heteroatoms selected from the group consisting of nitrogen, oxygen and sulfur. Aryl groups preferably have 5-14 carbon atoms making up the ring(s) structure, while heteroaryls preferably have 1-4 heteroatoms, with the remaining 4-10 atoms being carbon atoms. The terms "heterocyclo" and "hetero cyclic ring system" as used herein refer to any saturated or unsaturated mono- or bicyclic ring system, containing from one to four heteroatoms, selected from the group consisting of nitrogen, oxygen and sulfur. A typical heterocyclic ring system will have five to ten members, 1-4 of which are heteroatoms. Typical examples of monocyclic ring systems include piperidinyl, pyrrolidinyl, pyridinyl, piperidonyl, pyrrolidonyl and thiazolyl, while examples of bicyclic ring systems include benzimidazolyl, benzothiazolyl and benzoxazolyl, all of which may be substituted.
The term "carbocyclic ring" as used herein refers to any saturated or unsaturated ring containing from three to six carbon atoms.
The terms "alkylaryl"and "alkenylaryl" as used herein refer to an alkyl group or alkenyl group, respectively, having the number of carbon atoms designated, appended to one, two, or three aryl groups. The term benzyl as used herein refers to -CH2-C6H5. The term "alkoxy" as used herein refers to an alkyl linked to an oxygen atom, such as methoxy, ethoxy, and so forth.
The terms "halogen" as used herein refer to Cl, Br, F or I substituents. The term "direct link" as used herein refers to a bond directly linking the substituents on each side of the direct link. When two adjacent substituents are defined as each being a "direct link", it is considered to be a single bond.
Two substituents are "taken together to form a 5-6 membered ring" means that an ethylene or a propylene bridge, respectively, is formed between the two substituents. The term "pharmaceutically acceptable salts" includes salts of compounds derived from the combination of a compound and an organic or inorganic acid. These compounds are useful in both free base and salt form. In practice, the use of the salt form amounts to use of the base form; both acid and base addition salts are within the scope of the present invention.
"Pharmaceutically acceptable acid addition salt" refers to those salts which retain the biological effectiveness and properties of the free bases and which are not biologically or otherwise undesirable, formed with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid and the like, and organic acids such as acetic acid, propionic acid, glycolic acid, pyruvic acid, oxalic acid, maleic acid, malonic acid, succinic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like.
"Pharmaceutically acceptable base addition salts" include those derived from inorganic bases such as sodium, potassium, lithium, ammonium, calcium, magnesium, iron, zinc, copper, manganese, and aluminum bases, and the like. Particularly preferred are the ammonium, potassium, sodium, calcium and magnesium salts. Salts derived from pharmaceutically acceptable organic nontoxic bases include salts of primary, secondary, and tertiary amines, substituted amines including naturally occurring substituted amines, cyclic amines and basic ion exchange resins, such as isopropylamine. trimethylamine, diethylamine. triethylamine, tripropylamine, ethanolamine, 2-diethylaminoethanol, trimethamine, dicyclohexylamine, lysine, arginine, histidine, caffeine, procaine, hydrabamine, choline, betaine, ethylenediamine, glucosamine, methylglucamine, theobromine, purines, piperizine, piperidine, N-ethylpiperidine, polyamine resins and the like. Particularly preferred organic nontoxic bases are isopropylamine, diethylamine, ethanolamine, trimethamine, dicyclohexylamine, choline, and caffeine.
"Biological property" for the purposes herein means an in vivo effector or antigenic function or activity that is directly or indirectly performed by a compound of this invention. Effector functions include receptor or ligand binding, any enzyme activity or enzyme modulatory activity, any carrier binding activity, any hormonal activity, any activity in promoting or inhibiting adhesion of cells to an extracellular matrix or cell surface molecules, or any structural role. Antigenic functions include possession of an epitope or antigenic site that is capable of reacting with antibodies raised against it. The biological properties of the compounds of the present invention can be readily characterized by the methods described in Examples 14 and 15 and by such other methods as are well known in the art.
In addition, the following abbreviations are used in this application: "Boc" refers to t-butoxycarbonyl.
"BOP" refers to benzotriazol-l-yloxy-tris-(dimethylamino) phosphonium hexafluorophosphate. "CBZ" refers to benzyloxycarbonyl.
"DIEA" refers to diisopropylethylamine. "DMF" refers to N,N-dimethylformamide. "Et20" refers to diethyl ether. "EtOAc" refers to ethyl acetate. "HF" refers to hydrogen fluoride. "HOAc" refers to acetic acid. "Mel" refers to methyl iodide. "MeOH" refers to methanol.
"MeSEt" refers to methyl ethyl sulfide. "TFA" refers to trifluoroacetic acid. "THF" refers to tetrahydrofuran. "Tos" refers to -toluenesulfonyl. In the compounds of this invention, carbon atoms bonded to four non-identical substituents are asymmetric. Accordingly, the compounds may exist as diastereoisomers, enantiomers or mixtures thereof. The syntheses described herein may employ racemates, enantiomers or diastereomers as starting materials or intermediates. Diastereomeric products resulting from such syntheses may be separated by chromatographic or crystallization methods, or by other methods known in the art. Likewise, enantiomeric product mixtures may be separated using the same techniques or by other methods known in the art. Each of the asymmetric carbon atoms, when present in the compounds of this invention, may be in one of two configurations (R or S) and both are within the scope of the present invention. In the processes described above, the final products may, in some cases, contain a small amount of diastereomeric or enantiomeric products, however these products do not affect their therapeutic or diagnostic application.
In all of the peptides of the invention, one or more amide linkages (-CO-NH-) may optionally be replaced with another linkage which is an isostere such as -CH2NH-, -CH2S-, -CH2-O-, -CH2CH2-, -CH=CH- (cis and trans), -COCH2-, -CH(OH)CH2-, -CH2SO-, and -CH2SO2-. This replacement can be made by methods known in the art.
The following references describe preparation of peptide analogs which include these alternative-linking moieties: Spatola, "Peptide Backbone Modifications" (general review) Vega Data. Vol. 1, Issue 3, (March 1983); Spatola, "Chemistry and Biochemistry of Amino Acids, Peptides and Proteins," (general review) B. Weinstein, eds., Marcel Dekker, New York, p. 267 (1983); Morley, Trends Pharm. Sci. (general review) pp. 463- 468 (1980); Hudson, et al. Int. J. Pept. Prot. Res. 14:177-185 (1979) (-CH2NH-, - CH2CH2-); Spatola, et al, Life Sci. 38:1243-1249 (1986) (-CH2-S); Harm, J. Chem. Soc. Perkin Trans. I pp.307-314 (1982) (-CH=CH-, cis and trans); Almquist, et al, J Med. Chem. 23: 1392-1398 (1980) (-COCH2-); Jennings-White, et al, Tetrahedron Lett. 23:2533 (-COCH2-) (1982); Szelke, et al, European Application EP 45665: CA:97:39405 (1982) (-CH(OH)CH2-); Holladay, et al, Tetrahedron Lett 24:4401-4404 (1983) (-CH(OH)CH2-); and Hruby, Life Sci. 31 :189-199 (1982) (-CH2-S-).
PREFERRED EMBODIMENTS
This invention relates to a new class of peptide derivatives selected from those of general formula I which are potent and specific inhibitors of Xa, their pharmaceutically acceptable compositions thereof, and the methods of using them as therapeutic agents for disease states in mammals characterized by abnormal thrombosis:
A-(CH2)m-W- (I)
Figure imgf000015_0001
Wherein:
R1 is H, Cι-6alkyl or C,-3alkylaryl;
R2 is H, Cι-6alkyl, C3-6cycloalkyl, Cι-3alkylaryl, C,-3alkyl-C3.8cycloalkyl or aryl and R3 is H, C1-6alkyl, or R2 and R3 are taken together to form a carbocyclic ring; m is an integer from 0-3; n is an integer from 0-6; p is an integer from 0-4; s is an integer from 0-2; q is an integer from 0-2;
A is selected from the group consisting of: a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; R4; -NR4R5;
Figure imgf000016_0001
where R4, RD, R16 and R17 are independently selected from the group consisting of H, -OH, Cι.6alkyl, aryl and
Figure imgf000016_0002
R18 is selected from the group consisting of H, -OH, Ci.6alkyl, aryl and Cι-4alkylaryl, or can be taken together with R16 or R17 to form a 5-6 membered ring; and R19 is selected from the group consisting of H, -OH, C1-6alkyl, aryl and
Figure imgf000016_0003
or can be taken together with R17 to form a 5-6 membered ring;
W is a direct link, C|.6alkyl, C3-8cycloalkyl, C1-6alkenyl, Cι-6alkenylaryl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S;
D is a direct link, -CO-, -SO2-, -CH2-, -0-CO-, -NR15SO2- or -NR15-CO-, where R15 is selected from the group consisting of H, -OH, C1-6alkyl, aryl and C1-4alkylaryl;
K is selected from the group consisting of a direct link, C3-8cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing 1 -4 heteroatoms selected from the group consisting of N, O and S;
E is selected from the group consisting of R 26 , -NR )26r R>27 ,
Figure imgf000017_0001
where R26, R27, R28 and R29 are independently selected from the group consisting of H, -OH, Cι-6alkyl, aryl and Cl-4alkylaryl; R30 is selected from the group consisting of H, Cι-6alkyl, aryl and Cι„ιalkylaryl, or can be taken together with R28 or R29 to form a 5-6 membered ring; and R31 is selected from the group consisting of H, Cι-6alkyl, aryl and C^alkylaryl, or can be taken together with R29 to form a 5-6 membered ring; with the proviso that when E is R26, then K must contain at least one N atom; Y is selected from the group consisting of H,
Figure imgf000017_0002
where R13 and R14 are independently selected from the group consisting of H, Cι-3alkyl and aryl; and G is -COOR20, -CONR20R21, -CF3, -CF2CF3 or a group having the formula:
Figure imgf000017_0003
where:
R22 is selected from the group consisting of H, C1-6alkyl, C2.6alkenyl, C0.6alkylaryl,
C2.6alkenylaryl, C0-6alkylheterocyclo, C2-6alkenylheterocyclo, -CF3 and -CF2CF3;
U is -O-, -S-, -N- or -N(H)-; and
V is -O-, -S-, -N- or -N(H)-; with the proviso that at least one of U or V is -N- or -N(H)-; J is -S-, -SO-, -S02-, -O- or -NR6-. where R6 is H, C,.6alkyl or benzyl; and L is selected from the group consisting of:
Figure imgf000018_0001
a C6-10 heterocyclic ring system substituted by R9 and R10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-2; R7 and R8 are independently selected from the group consisting of H, C|.6alkyl, aryl, Cι.6alkylaryl, -COOR11, -CONRπR12, -CN and -CF3; R9 and R10 are independently selected from the group consisting of H, Cμ6alkyl, aryl, C1-6alkylaryl, C|- alkyloxy, halogen, -N02, -NRπR12, -NR"COR12, -O-R11, -O-COR", -COOR1 1, -CONRπR12, -CN, -CF3, -S02NRπR12 and C|.6alkyl-0-Rπ; and R11 and R12 are independently selected from the group consisting of H, Cι-6alkyl, C|.3alkylaryl and aryl; and all optical isomers thereof.
Preferred R1 substituents are H and Cι-6alkyl; more preferably H.
Preferred R2 substituents are H and C1-6alkyl; more preferably H.
R3 is preferably H.
The integer "m" is preferably from 0-1 ; more preferably 0.
The integer "n" is preferably from 1-4.
The integer "p" is preferably 3.
The integer "s" is preferably 0.
The integer "q" is preferably from 0-1.
Preferred "A" substituents are R4, -NR4R5,
Figure imgf000019_0001
R4 is preferably H, -OH or C1-6alkyl; more preferably H, -OH or methyl.
R3 is preferably H, -OH or Cι-6alkyl; more preferably H, -OH or methyl.
Preferred "W" substituents are
Figure imgf000019_0002
C5-6cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing at least one N heteroatom; more preferably aryl, or a five to ten membered heterocyclic ring system containing at least one N heteroatom.
Preferred "D" substituents are -CO-, -SO2- and -CH2-; more preferably -CO- and -SO2-.
K is preferably a direct link.
In the "E" substituent, it is preferred that R26 , R27, R28, R29, R30 and R31 are independently selected from the group consisting of H and C^alkyl, more preferably H and methyl. Particularly preferred "E" substituents are -NH2, -NHC(=NH)-NH2 and -SC(=NH)-NH2; more preferably -NHC(-NH)-NH2 and -SC(=NH)-NH2.
Preferred "Y" substituents are:
Figure imgf000019_0003
R13 is preferably H. R14 is preferably H. The "G" substituent is preferably a group having the formula:
Figure imgf000019_0004
The "J" substituent is preferably -S-, -O- or -NR 60-. R° is preferably H.
The "L" substituent is preferably:
Figure imgf000020_0001
more preferably:
Figure imgf000020_0002
R7 is preferably H. R8 is preferably H.
R9 is preferably H, -O-R", -COOR1 1, -CONRπR12 or -CF3; more preferably H. R10 is preferably H, -O-R11, -COOR11, -CONRπR12 or -CF3; more preferably H. R1 ' is preferably H. R12 is preferably H.
In one embodiment of the invention, R1, R2 and R3 are H, p=3, s=0, K is a direct link, E is -NHC(=NH)-NH2 and Y is -CO-G, where G is a group having the formula:
Figure imgf000020_0003
where J and L are as defined above. This is also illustrated as a preferred group of compounds defined by the general structural formula II as: I)
A-
Figure imgf000021_0001
wherein: m is an integer from 0-3; n is an integer from 0-6; q is an integer from 0-2;
A is selected from the group consisting of R4, -NR4R5
Figure imgf000021_0002
where R4, R3, R16, R17, R18 and R19 are independently selected from the group consisting of H, -OH and Cl-6alkyl. W is C|.6alkyl, C3-8cycloalkyl, C1-6alkenyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; with the proviso that when A is R4, then W must contain at least one N atom;
D is -CO-, or -SO2-; J is -S-, -SO-, -SO2-, -O- or -NR6-, where R6 is H; and
L is selected from the group consisting of:
Figure imgf000022_0001
a C6-10 heterocyclic ring system substituted by R9 and R10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-1 ; R7 and R8 are independently selected from the group consisting of H, C)-6alkyl, aryl, Cι-6alkylaryl, -COOR11, -CONR"R12, -CN and -CF3; R9 and R10 are independently selected from the group consisting of H, Cι-6alkyl, aryl, Cι.6alkylaryl,
Figure imgf000022_0002
halogen, -N02, -NRπR12, -NR"COR12, -O-R11, -0-COR11, -COOR1 1, -CONRuR12, -CN, -CF3, -SO2NRπR12 and Cι.6alkyl-O-Rn; and R1 1 and R12 are independently selected from the group consisting of H, Cι-6alkyl, Cι-3alkylaryl and aryl; and all optical isomers thereof.
A preferred embodiment of compounds of general formula II have the following stereochemistry:
Figure imgf000022_0003
In yet another embodiment of the invention, R1, R2 and R3 are H, p=3, s=0, K is a direct link, E is -NHC(=NH)-NH2, and Y is -CO-G, where G is a group having the formula: N
> where J is -S- and L is the group:
Figure imgf000023_0001
where R9 and R10 are H. This is also illustrated as a preferred group of compounds defined by the general structural formula III as:
Figure imgf000023_0002
wherein: m is an integer from 0-3; n is an integer from 0-6; q is an integer from 0-2;
A is selected from the group consisting of R4, -NR4R3;
Figure imgf000023_0003
Figure imgf000023_0004
where R , RD, R and R are independently selected from the group consisting of H, -OH and Cι-6alkyl;
W is C1-6alkyl, C - cycloalkyl, Cι-6alkenyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; with the proviso that when A is R4, then W must contain at least one N atom;
D is -CO- or -SO2-; and all optical isomers thereof.
A preferred embodiment of compounds of general formula III have the following stereochemistry:
Figure imgf000024_0001
This invention also encompasses all pharmaceutically acceptable isomers, salts, hydrates and solvates of the compounds of formulas I, II and III. In addition, the compounds of formulas I, II and III can exist in various isomeric and tautomeric forms, and all such forms are meant to be included in the invention, along with pharmaceutically acceptable salts, hydrates and solvates of such isomers and tautomers.
The compounds of this invention may be isolated as the free acid or base or converted to salts of various inorganic and organic acids and bases. Such salts are within the scope of this invention. Non-toxic and physiologically compatible salts are particularly useful although other less desirable salts may have use in the processes of isolation and purification.
A number of methods are useful for the preparation of the salts described above and are known to those skilled in the art. For example, the free acid or free base form of a compound of one of the formulas above can be reacted with one or more molar equivalents of the desired acid or base in a solvent or solvent mixture in which the salt is insoluble, or in a solvent like water after which the solvent is removed by evaporation, distillation or freeze drying. Alternatively, the free acid or base form of the product may be passed over an ion exchange resin to form the desired salt or one salt form of the product may be converted to another using the same general process.
This invention also encompasses prodrug derivatives of the compounds contained herein. The term "prodrug" refers to a pharmacologically inactive derivative of a parent drug molecule that requires biotransformation, either spontaneous or enzymatic, within the organism to release the active drug. Prodrugs are variations or derivatives of the compounds of this invention which have groups cleavable under metabolic conditions. Prodrugs become the compounds of the invention which are pharmaceutically active in vivo, when they undergo solvolysis under physiological conditions or undergo enzymatic degradation. Prodrug compounds of this invention may be called single, double, triple etc., depending on the number of biotransformation steps required to release the active drug within the organism, and indicating the number of functionalities present in a precursor-type form. Prodrug forms often offer advantages of solubility, tissue compatibility, or delayed release in the mammalian organism (see, Bundgard, Design of Prodrugs, pp. 7-9, 21-24, Elsevier, Amsterdam 1985 and Silverman, The Organic Chemistry of Drug Design and Drug Action, pp. 352-401, Academic Press, San Diego,
CA, 1992). Prodrugs commonly known in the art include acid derivatives well known to practitioners of the art, such as, for example, esters prepared by reaction of the parent acids with a suitable alcohol, or amides prepared by reaction of the parent acid compound with an amine, or basic groups reacted to form an acylated base derivative. Moreover, the prodrug derivatives of this invention may be combined with other features herein taught to enhance bioavailability.
The following structures are illustrative of the compounds of the present invention and are not intended to be limiting in any manner:
Figure imgf000026_0001
Figure imgf000027_0001
Figure imgf000028_0001
Figure imgf000028_0002
Figure imgf000028_0003
Figure imgf000028_0004
As mentioned above, the compounds of this invention find utility as therapeutic agents for disease states in mammals which have disorders of coagulation such as in the treatment or prevention of unstable angina, refractory angina, myocardial infarction, transient ischemic attacks, thrombotic stroke, embolic stroke, disseminated intravascular coagulation including the treatment of septic shock, deep venous thrombosis in the prevention of pulmonary embolism or the treatment of reocclusion or restenosis of reperfused coronary arteries. Further, these compounds are useful for the treatment or prophylaxis of those diseases which involve the production and/or action of factor Xa/prothrombinase complex. This includes a number of thrombotic and prothrombotic states in which the coagulation cascade is activated which include but are not limited to, deep venous "thrombosis, pulmonary embolism, myocardial infarction, stroke, thromboembolic complications of surgery and peripheral arterial occlusion.
Accordingly, a method for preventing or treating a condition in a mammal characterized by undesired thrombosis comprises administering to the mammal a therapeutically effective amount of a compound of this invention. In addition to the disease states noted above, other diseases treatable or preventable by the administration of compounds of this invention include, without limitation, occlusive coronary thrombus formation resulting from either thrombolytic therapy or percutaneous transluminal coronary angioplasty. thrombus formation in the venous vasculature, disseminated intravascular coagulopathy, a condition wherein there is rapid consumption of coagulation factors and systemic coagulation which results in the formation of life-threatening thrombi occurring throughout the microvasculature leading to widespread organ failure, hemorrhagic stroke, renal dialysis, blood oxygenation, and cardiac catheterization. The compounds of the invention also find utility in a method for inhibiting the coagulation biological samples, which comprises the administration of a compound of the invention. The compounds of the present invention may also be used in combination with other therapeutic or diagnostic agents. In certain preferred embodiments, the compounds of this invention may be coadministered along with other compounds typically prescribed for these conditions according to generally accepted medical practice such as anticoagulant agents, thrombolytic agents, or other antithrombotics, including platelet aggregation inhibitors, tissue plasminogen activators, urokinase, prourokinase, streptokinase, heparin, aspirin, or warfarin. The compounds of the present invention may act in a synergistic fashion to prevent reocclusion following a successful thromholytic therapy and/or reduce the time to reperfusion. These compounds may also allow for reduced doses of the thrombolytic agents to be used and therefore minimize potential hemorrhagic side-effects. The compounds of this invention can be utilized in vivo, ordinarily in mammals such as primates, (e.g. humans), sheep, horses, cattle, pigs, dogs, cats, rats and mice, or in vitro. The biological properties of the compounds of the present invention can be readily characterized by methods that are well known in the art, for example by the in vitro protease activity assays and in vivo studies to evaluate antithrombotic efficacy, and effects on hemostasis and hematological parameters, such as are illustrated in the examples.
Diagnostic applications of the compounds of this invention will typically utilize formulations in the form of solutions or suspensions. In the management of thrombotic disorders the compounds of this invention may be utilized in compositions such as tablets, capsules or elixirs for oral administration, suppositories, sterile solutions or suspensions or injectable administration, and the like, or incorporated into shaped articles. Subjects in need of treatment (typically mammalian) using the compounds of this invention can be administered dosages that will provide optimal efficacy. The dose and method of administration will vary from subject to subject and be dependent upon such factors as the type of mammal being treated, its sex, weight, diet, concurrent medication, overall clinical condition, the particular compounds employed, the specific use for which these compounds are employed, and other factors which those skilled in the medical arts will recognize.
Formulations of the compounds of this invention are prepared for storage or administration by mixing the compound having a desired degree of purity with physiologically acceptable carriers, excipients, stabilizers etc., and may be provided in sustained release or timed release formulations. Acceptable carriers or diluents for therapeutic use are well known in the pharmaceutical field, and are described, for example, in Remington's Pharmaceutical Sciences, Mack Publishing Co., (A.R. Gennaro edit. 1985). Such materials are nontoxic to the recipients at the dosages and concentrations employed, and include buffers such as phosphate, citrate, acetate and other organic acid salts, antioxidants such as ascorbic acid, low molecular weight (less than about ten residues) peptides such as polyarginine, proteins, such as serum albumin, gelatin, or immunoglobulins, hydrophilic polymers such as polyvinylpyrrolidinone. amino acids such as glycine, glutamic acid, aspartic acid, or arginine, monosaccharides, disaccharides, and other carbohydrates including cellulose or its derivatives, glucose, mannose or dextrins, chelating agents such as EDTA, sugar alcohols such as mannitol or sorbitol, counterions such as sodium and/or nonionic surfactants such as Tween, Pluronics or polyethyleneglycol.
Dosage formulations of the compounds of this invention to be used for therapeutic administration must be sterile. Sterility is readily accomplished by filtration through sterile membranes such as 0.2 micron membranes, or by other conventional methods. Formulations typically will be stored in lyophilized form or as an aqueous solution. The pH of the preparations of this invention typically will be 3-1 1, more preferably 5-9 and most preferably 7-8. It will be understood that use of certain of the foregoing excipients, carriers, or stabilizers will result in the formation of cyclic polypeptide salts. While the preferred route of administration is by injection, other methods of administration are also anticipated such as orally, intravenously (bolus and/or infusion), subcutaneously, intramuscularly, colonically, rectally, nasally, transdermally or intraperitoneally, employing a variety of dosage forms such as suppositories, implanted pellets or small cylinders, aerosols, oral dosage formulations and topical formulations such as ointments, drops and dermal patches. The compounds of this invention are desirably incorporated into shaped articles such as implants which may employ inert materials such as biodegradable polymers or synthetic silicones, for example, Silastic, silicone rubber or other polymers commercially available. The compounds of the invention may also be administered in the form of liposome delivery systems, such as small unilamellar vesicles, large unilamellar vesicles and multilamellar vesicles. Liposomes can be formed from a variety of lipids, such as cholesterol, stearylamine or phosphatidylcholines. The compounds of this invention may also be delivered by the use of antibodies, antibody fragments, growth factors, hormones, or other targeting moieties, to which the compound molecules are coupled. The compounds of this invention may also be coupled with suitable polymers as targetable drug carriers. Such polymers can include polyvinylpyrrolidinone, pyran copolymer, polyhydroxy-propyl-methacrylamide-phenol, polyhydroxyethyl-aspartamide-phenol, or polyethyleneoxide-polylysine substituted with palmitoyl residues. Furthermore, compounds of the invention may be coupled to a class of biodegradable polymers useful in achieving controlled release of a drug, for example polylactic acid, polyglycolic acid, copolymers of polylactic and polyglycolic acid, polyepsilon caprolactone, polyhydroxy butyric acid, polyorthoesters, polyacetals, polydihydropyrans, polycyanoacrylates and cross linked or amphipathic block copolymers of hydrogels. Polymers and semipermeable polymer matrices may be formed into shaped articles, such as valves, stents, tubing, prostheses and the like.
Therapeutic compound liquid formulations generally are placed into a container having a sterile access port, for example, an intravenous solution bag or vial having a stopper pierceable by hypodermic injection needle.
Therapeutically effective dosages may be determined by either in vitro or in vivo methods. For each particular compound of the present invention, individual determinations may be made to determine the optimal dosage required. The range of therapeutically effective dosages will be influenced by the route of administration, the therapeutic objectives and the condition of the patient. For injection by hypodermic needle, it may be assumed the dosage is delivered into the body's fluids. For other routes of administration, the absorption efficiency must be individually determined for each compound by methods well known in pharmacology. Accordingly, it may be necessary for the therapist to titer the dosage and modify the route of administration as required to obtain the optimal therapeutic effect. The determination of effective dosage levels, that is, the dosage levels necessary to achieve the desired result, will be readily determined by one skilled in the art. Typically, applications of compound are commenced at lower dosage levels, with dosage levels being increased until the desired effect is achieved. The compounds of the invention can be administered orally or parenterally in an effective amount within the dosage range of about 0.1 to 100 mg/kg, preferably about 0.5 to 50 mg/kg and more preferably about 1 to 20 mg/kg on a regimen in a single or 2 to 4 divided daily doses and/or continuous infusion.
Typically, about 5 to 500 mg of a compound or mixture of compounds of this invention, as the free acid or base form or as a pharmaceutically acceptable salt, is compounded with a physiologically acceptable vehicle, carrier, excipient. binder, preservative, stabilizer, dye, flavor etc., as called for by accepted pharmaceutical practice. The amount of active ingredient in these compositions is such that a suitable dosage in the range indicated is obtained.
Typical adjuvants which may be incorporated into tablets, capsules and the like are binders such as acacia, corn starch or gelatin, and excipients such as microcrystalline cellulose, disintegrating agents like corn starch or alginic acid, lubricants such as magnesium stearate, sweetening agents such as sucrose or lactose, or flavoring agents.
When a dosage form is a capsule, in addition to the above materials it may also contain liquid carriers such as water, saline, or a fatty oil. Other materials of various types may be used as coatings or as modifiers of the physical form of the dosage unit. Sterile compositions for injection can be formulated according to conventional pharmaceutical practice. For example, dissolution or suspension of the active compound in a vehicle such as an oil or a synthetic fatty vehicle like ethyl oleate, or into a liposome may be desired. Buffers, preservatives, antioxidants and the like can be incorporated according to accepted pharmaceutical practice.
PREPARATION OF THE DISCLOSED COMPOUNDS The compounds of the present invention may be synthesized by either solid or liquid phase methods described and referenced in standard textbooks, or by a combination of both methods. These methods are well known in the art. See, Bodanszky, "The Principles of Peptide Synthesis", Hafner, et al, Eds., Springer-Verlag, Berlin, 1984. Starting materials used in any of these methods are commercially available from chemical vendors such as Aldrich, Sigma, Nova Biochemicals, Bachem Biosciences, and the like, or may be readily synthesized by known procedures.
Reactions are carried out in standard laboratory glassware and reaction vessels under reaction conditions of standard temperature and pressure, except where otherwise indicated.
During the synthesis of these compounds, the functional groups of the amino acid derivatives used in these methods are protected by blocking groups to prevent cross reaction during the coupling procedure. Examples of suitable blocking groups and their use are described in "The Peptides: Analysis, Synthesis, Biology", Academic Press, Vol. 3 (Gross, et al, Eds., 1981) and Vol. 9 (1987), the disclosures of which are incorporated herein by reference.
Two exemplary synthesis schemes are outlined directly below, and the specific syntheses are described in the Examples. The reaction products are isolated and purified by conventional methods, typically by solvent extraction into a compatible solvent. The products may be further purified by column chromatography or other appropriate methods.
Figure imgf000034_0001
Formula IV
The peptide derivatives can be prepared by sequence coupling of protected Fragment-
3 to protected Fragment-2 followed by coupling with protected Fragment- 1 (Scheme I). Alternatively, Fragment-2 can be first coupled to Fragment- 1 to yield an intermediate to which Fragment-3 can then be coupled (Scheme II). The protecting groups are finally removed by HF-cleavage.
Most compounds are purified by reversed-phase HPLC and characterized by ion- spray MS spectrometry.
Scheme I
Figure imgf000035_0001
P is a protecting group
Scheme II
Figure imgf000035_0002
P-A-(CH2)m-W-(CH2)nCOOH P-A-(CH2)m-W-(CH2)n-Cα.ll ,Ns/COOCH3
BOP
-Tos
Figure imgf000036_0001
Figure imgf000036_0002
P is a protecting group
The chemical reactions described in Schemes I and II can easily be modified and combined with other techniques that are well known in the art to produce other compounds within the family of formula I.
Methods of incorporating "A" substituents such as R4, -NR4R5;
7
Figure imgf000036_0003
are well known in the art. The chemistry of using the various R substituents (H, -OH, C|.6alkyl, aryl and Cl-4alkylaryl) is also well known in the art. Methods of incorporating "W" substituents such as Cι.6alkyl, C -8cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S, are also well known in the art. In addition, different A and W substituents are illustrated in Examples 8 and 13.
The "D" substituent illustrated in Fragment- 1 is -CO-. Fragments similar to the structure of Fragment- 1, where D is -SO , -CH2-, -O-CO-, -NR15S02- or -NR15-CO-, can easily be synthesized by techniques such as those described in Semple, et al. , WO 95/35311.
The "R1" and "R2" substituents illustrated in Fragment-2 are -H. Fragments similar to the structure of Fragment-2, where Rl is Cι-6alkyl or Cι.3alkylaryl, and/or where R2 is C!-6alkyl, C .6cycloalkyl, Cι-3alkylaryl, or aryl, can easily be synthesized by techniques that are well known in the art. The "E" substituent illustrated in Fragment-3 (-NHC(=NH)-NH2) is merely illustrative of one of the various "E" substituents encompassed by the invention. Fragments similar to the structure of Fragment-3, where E is -NH2, -SC(-NH)-NH2 or -C(=NH)-NH2, can easily be synthesized by techniques that are well known in the art.
The "Y" substituent illustrated in Fragment-3 is -CO-G, where G is:
Figure imgf000037_0001
where: J is -S- and L is
Figure imgf000037_0002
and R > a„n„dj D R10 are H. Fragments similar to the structure of Fragment-3, where G is:
Figure imgf000038_0001
and J is -SO- or -S0 - can easily be synthesized by techniques that are well known in the art. Fragments where J is -O- can be synthesized by techniques illustrated in J. Am. Chem. Soc. 1 14: 1854-1863 (1992), J. Med. Chem. 38:76-85 (1995), and J. Med. Chem. 37:3492-3502 (1994). Lastly, fragments where J is -NRβ-, where is H, C,.6alkyl or benzyl, can be synthesized by techniques illustrated in J. Med. Chem. 37:3492-3502 (1994). All of these references are incorporated herein by reference. Fragments similar to the structure of Fragment-3, where G is:
Figure imgf000038_0002
and L is:
Figure imgf000038_0003
where R7, R8, R9 and R10 are not H, can also be easily synthesized by techniques that are well known in the art.
Fragments similar to the structure of Fragment-3, where G is -COOR20, -CONR20R21, -CF3 or -CF2CF3, can easily be synthesized by techniques that are well known in the art.
Fragments similar to the structure of Fragment-3, where G is:
Figure imgf000038_0004
and U and V are the various substituents (-O-, -S-, -N-, -N(H)-) can also easily be synthesized by well known techniques illustrated in J. Med. Chem. 38: 1355-1371 (1995) and J. Med. Chem. 37 : 2421 -2436 ( 1994).
Fragments similar to the structure of Fragment-3, where "Y" is a boron-containing group can easily be synthesized by techniques that are well known in the art. See for example, J. Org. Chem. 60:3717-3722 (1995). The mechanisms for coupling the various fragments used to synthesize the compounds of the instant invention, are also well known in the art.
Without further elaboration, it is believed that one skilled in the art can utilized the present invention to its fullest extent. Therefore, the following preferred specific embodiments are to be construed as merely illustrative and do not limit the remainder of the disclosure in any way whatsoever.
EXAMPLE 1
Figure imgf000039_0001
To a suspension of Boc-Arg(Tos)-OH (2 g, 4.7 mmol) in DMF (20 mL) at 0°C is added MeNHOMeHCl (1 g, 10.3 mmol), DIEA (6 mL) and BOP (2.5 g, 5.6 mmol). The solution is stirred at 0°C for 10 hours. DMF is evaporated by vacuum. The oily residue is dissolved in EtOAc (200 mL) and water (20 mL). The organic layer is washed with sat. NaHCO3, water (20 mL), 1 M HCl ( 10 mL) and sat. NaCI (2 X 20 mL). The organic layer is dried over MgSO , filtered and evaporated to give a suspension. The suspension is filtered, washed with cold EtOAc (10 mL) and dried to give Boc-Arg(Tos)-
N(Me)OMe, shown above, (1.5 g, 70 % yield). FAB-MS (M+H)+ = 472 EXAMPLE 2
Figure imgf000040_0001
To a solution of thiazole (2.5 g, 29 mmol) in THF (25 mL) at -78°C is added n-BuLi (1.6 M in hexane, 19 mL) dropwise. The mixture is stirred for 30 minutes. Then a solution of Boc-Arg(Tos)-N(Me)OMe, from Example 1, (1.7 g, 3.6 mmol) in THF (50 mL) is added to the lithiothiazole mixture at -78°C. The solution is stirred for 2 hours. IM HCl (30 mL) is added to the reaction mixture and warmed to room temperature. The mixture is extracted with EtOAc (100 mL). The organic layer is washed with sat. NaCI (30 mL), dried over MgS04, filtered and evaporated. The crude oily residue is purified by flash column over Si02 (50% EtOAc in CH2C12) to give Boc-Arg(Tos)-Thiazole, shown above, (1.5 g, 84% yield) as a powder. DCI -MS (M+H)+ = 496
EXAMPLE 3
Figure imgf000040_0002
To a solution of Boc-Arg(Tos)-Thiazole, from Example 2, (300 mg, 0.6 mmol) in
CH2C12 (10 mL) at 0°C is added TFA (10 mL). The solution is stirred at 0°C for 2 hours.
The solvent and excess TFA are evaporated to an oily residue which is used directly without further purification. EXAMPLE 4
Figure imgf000041_0001
N-α-Boc-N-δ-CBZ-L-ornithine (10 g, 0.027 mol) is dissolved in a solution of MeOH
(45 mL), water (30 mL) and acetic acid (5 mL). After purging with Argon, 10% Pd/C (1 g) is added and the mixture is hydrogenated on a Parr apparatus at 35 psi for 3 hours.
TLC showed clean conversion to N-α-Boc-L-ornithine.
After purging with argon, glyoxylic acid (3 g, 0.03 mol) is added, the mixture is stirred for 50 hours at room temperature and then hydrogenated at 35 psi for 17 hours, and the catalyst is filtered off. A fresh portion of 10% Pd/C (0.5 g) is added and the mixture is hydrogenated for a further 20 hours at 40 psi. The catalyst is removed by filtration and the filtrate is concentrated to dryness under vacuum. The residue is taken up in MeOH and re-evaporated. This process is repeated and the residue is pumped overnight to afford a yellow foam.
The crude intermediate is dissolved in dry DMF (60 mL) and heated to 50-60°C for 2.5 hours. The solvent is removed under vacuum. The oil residue is dissolved in 50 mL of CH2C12 and extracted with 50 mL of 1 N NaOH. The aqueous solution is extracted with 50 mL of CH2C12, acidified with cooling with 50 mL of IN HCl, re-extracted with 5 X 50 mL of CH2C12. The combined organic layers are dried over MgS04, filtered and evaporated to afford 5 g of the compound shown above, as a solidifying oil.
EXAMPLE 5
Tos-NH^ . NH
Figure imgf000041_0002
The compounds of Example 3 (1 mmol) and Example 4 (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C. The solution is neutralized with DIEA (1 mL) followed by addition of coupling reagent BOP (1.1 mmol). The solution is stirred for 1-2 hours and HPLC analysis showed the completion of reaction. Solvent is removed by vacuum at 30°C. The residue is dissolved in a mixture of EtOAc-H20 (50 mL:10 mL). The organic layer is washed with sat. NaHCO3 (2 X 10 mL), sat. NaCI (2 X 10 mL), dried over MgS04, filtered and solvent evaporated. The oil residue is purified by flash column on SiO2 to give the compound shown above, as a powder.
EXAMPLE 6
Figure imgf000042_0001
To a solution of the compound of Example 5 (1 mmol) in CH2C12 (10 mL) at 0°C is added TFA (10 mL). The solution is stirred at 0°C for 2 hours. The solvent and excess TFA are evaporated to an oily residue which is used without further purification.
EXAMPLE 7
Tos-NH^ . NH
Figure imgf000042_0002
The compound of Example 6 (1 mmol) and N-Boc-4-piperidine-propanoic acid (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C. The solution is neutralized with DIEA (1 mL) followed by addition of coupling reagent BOP (1.1 mmol). The solution is stirred for 1-2 hours and HPLC analysis shows the completion of reaction. Solvent is removed by vacuum at 30°C. The residue is dissolved in a mixture of EtOAc-H20 (50 mL: 10 mL) and aqueous layer is discarded. The organic layer is washed with sat. NaHCO3 (2 10 mL), sat. NaCI (2 X 10 mL), dried over MgS04, filtered and evaporated. The oil residue is purified by flash column on SiO to give the compound shown above, as a powder.
EXAMPLE 8
NH2^ ^ NH
Figure imgf000043_0001
100 mg of the compound of Example 7, 1 ml of anisole and 4 drops of MeSEt are placed in HF-cleavage vessel and cooled under liquid N2. 10 ml of HF is then condensed and the mixture is stirred at 0°C for 1.25 hours. HF is removed under vacuum to give a gum-like residue. The residue is triturated with 20 ml of 50%Et2O-hexane and the solvent removed by filtration. The gum residue is dissolved in 30 ml of 30% aq. HOAc and filtered through the above sintered funnel. The filtrate is lyophilized to give a powder which is purified by RP-HPLC to give the compound shown above, as a powder.
EXAMPLE 9
Figure imgf000043_0002
The compound of Example 4 (1 mmol) is dissolved in 1 mL of MeOH, cooled to 0°C and treated dropwise with sat. HCl in MeOH (4 mL). The solution is stirred at 0°C for 1 hour and then warmed to room temperature and stirred for 14 hours. The solution is concentrated under vacuum to afford the compound shown above, as a clear oil which is used directly in the next example.
EXAMPLE 10
Figure imgf000044_0001
The compounds of Example 9 (1 mmol) and 4-(Di-CBZ-guanidine)-butanoic acid (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C. The solution is neutralized with DIEA (1 mL) followed by addition of coupling reagent BOP (1.1 mmol). The solution is stirred for 1-2 hours and HPLC analysis showed the completion of reaction. Solvent is removed by vacuum at 30°C. The residue is dissolved in a mixture of EtOAc-H2O (50 mL: 10 mL) and aqueous layer is discarded. The organic layer is washed with sat. NaHCO3 (2 X 10 mL), sat. NaCI (2 X 10 mL), dried over MgSO4, filtered and evaporated. The oil residue is purified by flash column on SiO2 to give the compound shown above, as a powder.
EXAMPLE 1 1
Figure imgf000044_0002
The compound of Example 10 (1 mmol) is dissolved in MeOH (1 mL) and cooled to 0°C. 5 mL of 1 N LiOH is added dropwise to the mixture and the solution is stirred at
0°C for 2 hours. TLC analysis showed the completion of reaction. Mixture is concentrated and acidified with 1 N HCl (5 mL). The crude product is purified by reversed-phase HPLC to give the compound shown above, as a powder. EXAMPLE 12
Tos-NH^ - NH
Figure imgf000045_0001
The compounds of Example 1 1 (1 mmol) and Example 3 (1 mmol) are dissolved in DMF (5 mL) and cooled to 0°C. The solution is neutralized with DIEA (1 mL) followed by the addition of coupling reagent BOP (1.1 mmol). The solution is stirred for 1-2 hours and HPLC analysis shows the completion of reaction. Solvent is removed by vacuum at 30°C. The residue is dissolved in a mixture of EtOAc-H2O (50 mL:10 mL) and aqueous layer is discarded. The organic layer is washed with sat. NaHC03 (2 X 10 mL), sat. NaCI (2 X 10 mL), dried over MgSO4, filtered and evaporated. The oil residue is purified by flash column on Si02 to give the compound shown above, as a powder.
EXAMPLE 13
Figure imgf000045_0002
100 mg of the compound of Example 12, 1 ml of anisole and 4 drops of MeSEt are placed in HF-cleavage vessel and cooled under liquid N2. 10 ml of HF is then condensed and the mixture is stirred at 0°C for 1.25 hours. HF is removed under vacuum to give a gum-like residue. The residue is triturated with 20 ml of 50% Et2O-hexane and the solvent removed by filtration. The gum residue is dissolved in 30 ml of 30% aq. HO Ac and filtered through the above sintered funnel. The filtrate is lyophilized to give a powder which is purified by RP-HPLC to give the compound shown above, as a powder. By following similar synthetic procedures to those in Examples 1-12 and this Example 13, the following compounds were also prepared.
Figure imgf000046_0001
Figure imgf000046_0002
Figure imgf000046_0003
Figure imgf000046_0004
EXAMPLE 14 (Determination of ICsn) The compounds of the present invention are first dissolved in a buffer to give solutions containing concentrations such that assay concentrations range from 0-100 μM.
In assays for thrombin, prothrombinase and factor Xa, a synthetic chromogenic substrate would be added to a solution containing a test compound and the enzyme of interest and the residual catalytic activity of that enzyme would then be determined spectrophotometrically.
The IC50 of a compound is determined from the substrate turnover. The IC50 is the concentration of test compound giving 50% inhibition of the substrate turnover. Preferred compounds of the invention desirably have an IC50 of less than 500 nM in the factor Xa assay, preferably less than 200 nM, and more preferably less than 100 nM.
Preferred compounds of the invention desirably have an IC50 of less than 4.0 μM in the prothrombinase assay, preferably less than 200 nM, and more preferably less than 10 nM. Preferred compounds of the invention desirably have an IC50 of greater than 1.0 μM in the thrombin assay, preferably greater than 10.0 μM, and more preferably greater than 100.0 μM.
Amidolytic Assays for determining protease inhibition activity Factor Xa and thrombin assays are performed at room temperature, in 0.02 M Tris HCl buffer, pH 7.5, containing 0.15 M NaCI. The rates of hydrolysis of the para- nitroanilide substrate S-2765 (Chromogenix) for factor Xa, and the substrate Chromozym TH (Boehringer Mannheim) for thrombin following preincubation of the enzyme with the test compound for 5 minutes at room temperature are determined using a Softmax 96-well plate reader (Molecular Devices), monitored at 405 nm to measure the time dependent appearance of p-nitroanilide.
The prothrombinase inhibition assay is performed in a plasma free system with modifications to the method as described by Sinha, et al, Thromb. Res., 75:427-436
(1994). The activity of the prothrombinase complex is determined by measuring the time course of thrombin generation using the p-nitroanilide substrate Chromozym TH. The assay consists of a 5 minute preincubation of selected compounds to be tested as inhibitors with the complex formed from factor Xa (0.5 nM), factor Va (2 nM), phosphatidyl serineφhosphatidyl choline (25:75, 20 μM) in 20 mM Tris HCl buffer, pH
7.5, containing 0.15 M NaCI, 5 mM CaCl2 and 0.1% bovine serum albumin. Aliquots from the complex-test compound mixture are added to prothrombin (1 nM) and Chromozym TH (0.1 mM). The rate of substrate cleavage is monitored at 405 nm for two minutes. Several concentrations of a given test compound are assayed in duplicate. A standard curve of thrombin generation by an equivalent amount of untreated complex is then used for determination of percent inhibition.
EXAMPLE 15
The antithrombotic efficacy of the compounds of this invention can readily be evaluated using a series of studies in rabbits, as described below. These studies are also useful in evaluating a compounds effects on hemostasis and its the hematological parameters. Antithrombotic Efficacv in a Rabbit Model of Venous Thrombosis
A rabbit deep vein thrombosis model as described by Hollenbach, et al, Thromb. Haemost. 71 :357-362 (1994), is used to determine the in vivo antithrombotic activity of the compounds of the present invention. Rabbits are anesthetized with I.M. injections of Ketamine, Xylazine, and Acepromazine cocktail. A standardized protocol consists of insertion of a thrombogenic cotton thread and copper wire apparatus into the abdominal vena cava of the anesthetized rabbit. A non- occlusive thrombus is allowed to develop in the central venous circulation and inhibition of thrombus growth is then used as a measure of the antithrombotic activity of the compound being evaluated. Test agents or control saline are administered through a marginal ear vein catheter. A femoral vein catheter is used for blood sampling prior to and during steady state infusion of the compound being evaluated. Initiation of thrombus formation will begin immediately after advancement of the cotton thread apparatus into the central venous circulation. The compounds being evaluated are administered from time=30 minutes to time=150 minutes at which point the experiment is terminated. The rabbits are euthanized and the thrombus excised by surgical dissection and characterized by weight and histology. Blood samples are then analyzed for changes in hematological and coagulation parameters.
Although the invention has been described with reference to the disclosed embodiments, those skilled in the art will readily appreciate that the specific experiments detailed are only illustrative of the invention. It should be understood that various modifications can be made without departing from the spirit of the invention. Accordingly,' the invention is limited only by the following claims.

Claims

CLAIMSWhat is claimed is:
1. A compound having the formula:
A- (CH2)m-W- (l)
Figure imgf000050_0001
Wherein:
R1 is H, C,.6alkyl or C,-3alkylaryl;
R2 is H, C1-6alkyl. C3.6cycloalkyl, C1- alkylaryl, C1-3alkyl-C3.8cycloalkyl or aryl and R3 is H, C|.6alkyl, or R2 and R3 are taken together to form a carbocyclic ring; m is an integer from 0-3 ; n is an integer from 0-6; p is an integer from 0-4; s is an integer from 0-2; q is an integer from 0-2; A is selected from the group consisting of: a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; R4; -NR4R5;
7
Figure imgf000051_0001
where R4, R\ R16 and R17 are independently selected from the group consisting of H, -OH, C1-6alkyl, aryl and C alkylaryl; R18 is selected from the group consisting of H, -OH, C1-6alkyl, aryl and
Figure imgf000051_0002
or can be taken together with R16 or R17 to form a 5-6 membered ring; and R19 is selected from the group consisting of H, -OH, Ct.6alkyl, aryl and Cι-4alkylaryl, or can be taken together with R17 to form a 5-6 membered ring;
W is a direct link, C!-6alkyl, C3.8cycloalkyl, Ct.6alkenyl, Ci-6alkenylaryl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; D is a direct link, -CO-, -SO2-, -CH2-, -O-CO-, -NR15SO2- or -NR15-CO-, where R15 is selected from the group consisting of H, -OH, C1-6alkyl, aryl and Cι-4alkylaryl;
K is selected from the group consisting of a direct link, C3-8cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of N, O and S; E is selected from the group consisting of R26, -NR26R27,
Figure imgf000051_0003
where R26, R27, R28 and R29 are independently selected from the group consisting of H, -OH, C1-6alkyl, aryl and Ci^alkylaryl; R30 is selected from the group consisting of H, Cι-6alkyl, aryl and C1-4alkylaryl, or can be taken together with R28 or R29 to form a 5-6 membered ring; and R31 is selected from the group consisting of H, Cι.6alkyl, aryl and
Figure imgf000052_0001
or can be taken together with R29 to form a 5-6 membered ring; with the proviso that when E is R26, then must contain at least one N atom; Y is selected from the group consisting of H,
Figure imgf000052_0002
where R13 and R14 are independently selected from the group consisting of H, C1-3alkyl and aryl; and G is -COOR20, -CONR20R21, -CF3, -CF2CF3 or a group having the formula:
Figure imgf000052_0003
where:
R22 is selected from the group consisting of H, C1-6alkyl, C2-6alkenyl, C0. alkylaryl, C2-6alkenylaryl, C0.6alkylheterocyclo, C2.6alkenylheterocyclo, -CF3 and -CF2CF3;
U is -O-, -S-, -N- or -N(H)-; and
V is -O-, -S-, -N- or -N(H)-; with the proviso that at least one of U or V is -N- or -N(H)-;
J is -S-, -SO-, -SO2-, -O- or -NR6-, where R6 is H, C,.6alkyl or benzyl; and
L is selected from the group consisting of:
Figure imgf000052_0004
a CO- 10 heterocyclic ring system substituted by R9 and R10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-2; R7 and R8 are independently selected from the group consisting of H, C1 -6alkyl, aryl, Cι-6alkylaryl, -COOR", -CONR"R12; -CN and -CF3; R9 and R10 are independently selected from the group consisting of H, C(.6alkyl, aryl, C1-6alkylaryl, C1-4alkyloxy, halogen, -N02, -NRπR12, -NR"COR12. -O-R", -O-COR", -COOR1 1, -CONRπR12, -CN, -CF3, -S02NRπR12 and Cι-6alkyl-O-R"; and R11 and R12 are independently selected from the group consisting of H, Cι-6alkyl, Cι.3alkylaryl and aryl; and all optical isomers thereof.
2. The compound of Claim 1 where R1 is H or C1-6alkyl.
3. The compound of Claim 1 where R2 is H or C,-6alkyl.
4. The compound of Claim 1 where R3 is H.
5. The compound of Claim 1 where m is an integer from 0-1.
6. The compound of Claim 1 where n is an integer from 1-4.
7. The compound of Claim 1 where p is 3.
8. The compound of Claim 1 where s is 0.
9. The compound of Claim 1 where q is an integer from 0-1.
10. The compound of Claim 1 where A is selected from the group consisiting of R4, -NR4R5,
Figure imgf000054_0001
1 1. The compound of Claim 10 where R4 is H, -OH or C1-6alkyl.
12. The compound of Claim 10 where RD is H, -OH or C1-6alkyl.
13. The compound of Claim 1 where W is
Figure imgf000054_0002
C5-6cycloalkyl, aryl. or a five to ten membered heterocyclic ring system containing at least one N heteroatom.
14. The compound of Claim 1 where D is -CO-, -S02- or -CH2-.
15. The compound of Claim 1 where K is a direct link.
16. The compound of Claim 1 where E is -NH2, -NHC(=NH)-NH2 or -SC(=NH)-NH2
17. The compound of Claim 1 where Y is:
Figure imgf000054_0003
18. The compound of Claim 17 where R13 is H.
19. The compound of Claim 17 where R14 is H.
20. The compound of Claim 17 where G is a group having the formula:
Figure imgf000055_0001
21. The compound of Claim 20 where J is preferably -S-, -O- or -NR6
22. The compound of Claim 21 where R6 is H.
23. The compound of Claim 20 where L is:
Figure imgf000055_0002
24. The compound of Claim 23 where R9 is H, -O-R11, -COOR11, -CONRπR12 or -CF3
25. The compound of Claim 23 where R10 is H, -O-R11, -COOR11, -CONRπR12 or -CF3
26. The compound of Claim 1 where R11 is H.
27. The compound of Claim 1 where R12 is H.
28. A compound having the formula:
Figure imgf000056_0001
wherein: m is an integer from 0-3; n is an integer from 0-6; q is an integer from 0-2;
A is selected from the group consisting of R4, -NR4R5
Figure imgf000056_0002
where R4, R\ R16, R17, R18 and R19 are independently selected from the group consisting of H, -OH and C,.6alkyl; W is C[.6alkyl, C3-8cycloalkyl,
Figure imgf000056_0003
aryl, or a five to ten membered heterocyclic ring system containing 1 -4 heteroatoms selected from the group consisting of N, O and S; with the proviso that when A is R4, then W must contain at least one N atom;
D is -CO-, or -SO2-; J is -S-, -SO-, -SO , -O- or -NR6-, where R6 is H; and
L is selected from the group consisting of:
Figure imgf000057_0001
a C6-ιo heterocyclic ring system substituted by R9 and R10 and containing 1-4 heteroatoms selected from N, S and O; where r is an integer from 0-1 ; R7 and R8 are independently selected from the group consisting of H, Ci.6alkyl, aryl, Ct-6alkylaryl, -COOR11, -CONR"R12, -CN and -CF3; R9 and R10 are independently selected from the group consisting of H, Chalky., aryl, Cι-6alkylaryl,
Figure imgf000057_0002
halogen, -NO , -NRπR12, -NR"COR12, -O-R", -O-COR", -COOR11, -CONRπR12, -CN, -CF3, -SO2NRnR12 and C|-6alkyl-O-Rn; and Ru and Rι2 are independently selected from the group consisting of H, C1-6alkyl, C|-3alkylaryl and aryl; and all optical isomers thereof.
29. The compound of Claim 28 where A is selected from the group consisiting of R4, -NR4R5,
Figure imgf000057_0003
30. The compound of Claim 29 where R4 and R5 are independently selected from the group consisting of H, -OH and methyl.
31. The compound of Claim 28 where W is
Figure imgf000057_0004
C5.6cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing at least one N heteroatom.
32. The compound of Claim 28 where J is preferably -S-, -O- or -NR6-, where R6 is H.
33. The compound of Claim 28 where L is:
Figure imgf000058_0001
34. The compound of Claim 33 where R9 is H, -O-R11, -COOR", -CONRuR12 or -CF3
35. The compound of Claim 33 where R10 is H, -O-R11, -COOR11, -CONRuR12 or -CF3
36. The compound of Claim 28 having the following stereochemistry:
Figure imgf000058_0002
37. A compound having the formula:
Figure imgf000058_0003
wherein: m is an integer from 0-3; n is an integer from 0-6; q is an integer from 0-2;
A is selected from the group consisting of R4, -NR4R3;
Figure imgf000059_0001
Figure imgf000059_0002
H2 where R4, R5, R18 and R19 are independently selected from the group consisting of H, -OH and Cι-6alkyl;
W is C|.6alkyl, C3-8cycloalkyl, Cι.6alkenyl, aryl, or a five to ten membered heterocyclic ring system containing 1-4 heteroatoms selected from the group consisting of
N, O and S; with the proviso that when A is R4, then W must contain at least one N atom;
D is -CO-, or -SO2-; and all optical isomers thereof.
38. The compound of Claim 37 where A is selected from the group consisiting of R4, -NR4R5,
Figure imgf000059_0003
39. The compound of Claim 38 where R4 and R5 are independently selected from the group consisting of H, -OH and methyl.
40. The compound of Claim 37 where W is C!-4alkyl, C5.6cycloalkyl, aryl, or a five to ten membered heterocyclic ring system containing at least one N heteroatom.
41. The compound of Claim 37 having the following stereochemistry:
Figure imgf000060_0001
42. A pharmaceutical composition for preventing or treating a condition in a mammal characterized by undesired thrombosis comprising a pharmaceutically acceptable carrier and the compound of claim 1.
43. A method for preventing or treating a condition in a mammal characterized by undesired thrombosis comprising administering to said mammal a therapeutically effective amount of the compound of claim 1.
44. The method of claim 43, wherein the condition is selected from the group consisting of: the treatment or prevention of unstable angina, refractory angina, myocardial infarction, transient ischemic attacks, thrombotic stroke, embolic stroke, disseminated intravascular coagulation including the treatment of septic shock, deep venous thrombosis in the prevention of pulmonary embolism or the treatment of reocclusion or restenosis of reperfused coronary arteries, deep venous thrombosis, pulmonary embolism, myocardial infarction, stroke, thromboembolic complications of surgery and peripheral arterial occlusion, occlusive coronary thrombus formation resulting from either thrombolytic therapy or percutaneous transluminal coronary angioplasty, thrombus formation in the venous vascύlature and disseminated intravascular coagulopathy.
44. A method for inhibiting the coagulation of biological samples, comprising the administration of the compound of claim 1.
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