Claims for Patent: 7,727,963

Summary for Patent: 7,727,963

Title:	Synthetic peptide amides
Abstract:	The invention relates to synthetic tetrapeptide amide ligands of the kappa opioid receptor and particularly to agonists of the kappa opioid receptor that exhibit low P.sub.450 CYP inhibition and low penetration into the brain. An exemplary synthetic tetrapeptide amide of the invention is D-Phe-D-Phe-D-Leu-(.epsilon.-Me) D-Lys-[4-Amidinohomopiperazine amide]: ##STR00001## Pharmaceutical compositions containing these compounds are useful in the prophylaxis and treatment of pain and inflammation associated with a variety of diseases and conditions. Such treatable pain includes visceral pain, neuropathic pain and hyperalgesia. Inflammation associated with conditions such as IBD and IBS, ocular and otic inflammation, other disorders and conditions such as pruritis, edema, hyponatremia, hypokalemia, ileus, tussis and glaucoma are treatable or preventable with the pharmaceutical compositions of the invention.
Inventor(s):	Schteingart; Claudio D. (San Diego, CA), Jiang; Guangcheng (San Diego, CA), Alexander; Roberta Vezza (San Diego, CA), Sueiras-Diaz; Javier (La Jolla, CA), Luo; Zhiyong (New City, NY)
Assignee:	Cara Therapeutics, Inc. (Shelton, CT)
Application Number:	12/176,279
Patent Claims:	1. A synthetic peptide amide having the formula: ##STR00049## or a stereoisomer, mixture of stereoisomers, pharmaceutically acceptable salt, hydrate, acid salt hydrate, or N-oxide thereof; wherein Xaa.sub.1 is selected from the group consisting of (A)(A')D-Phe, (A)(A')(.alpha.-Me)D-Phe, D-Tyr, D-Tic, D-tert-leucine, D-neopentylglycine, D-phenylglycine, D-homophenylalanine, and .beta.-(E)D-Ala, wherein each (A) and each (A') are phenyl ring substituents independently selected from the group consisting of --H, --F, --Cl, --NO.sub.2, --CH.sub.3, --CF.sub.3, --CN, and --CONH.sub.2, and wherein each (E) is independently selected from the group consisting of cyclobutyl, cyclopentyl, cyclohexyl, pyridyl, thienyl and thiazolyl; Xaa.sub.2 is selected from the group consisting of (A)(A')D-Phe, 3,4-dichloro-D-Phe, (A)(A')(.alpha.-Me)D-Phe, D-1Nal, D-2Nal, D-Tyr, (E)D-Ala and D-Trp; Xaa.sub.3 is selected from the group consisting of D-Nle, D-Phe, (E)D-Ala, D-Leu, (.alpha.-Me)D-Leu, D-Hle, D-Val, and D-Met; Xaa.sub.4 is selected from the group consisting of (B).sub.2D-Arg, (B).sub.2D-Nar, (B).sub.2D-Har, .zeta.-(B)D-Hlys, D-Dap, .epsilon.-(B)D-Lys, .epsilon.-(B).sub.2-D-Lys, D-Amf, amidino-D-Amf, .gamma.-(B).sub.2D-Dbu, .delta.-(B).sub.2.alpha.-(B')D-Orn, D-2-amino-3(4-piperidyl)propionic acid, D-2-amino -3(2-aminopyrrolidyl)propionic acid, D-.alpha.-amino-.beta.-amidinopropionic acid, .alpha.-amino-4-piperidineacetic acid, cis-.alpha., 4-diaminocyclohexane acetic acid, trans-.alpha.,4-diaminocyclohexaneacetic acid, cis-.alpha.-amino-4-methylaminocyclo-hexane acetic acid, trans-.alpha.-amino-4-methylaminocyclohexane acetic acid, .alpha.-amino -1-amidino-4-piperidineacetic acid, cis-.alpha.-amino-4-guanidinocyclohexane acetic acid, and trans-.alpha.-amino-4-guanidinocyclohexane acetic acid, wherein each (B) is independently selected from the group consisting of H and C.sub.1-C.sub.4 alkyl, and (B') is H or (.alpha.-Me); W is selected from the group consisting of: Null, provided that when W is null, Y is N; --NH--(CH.sub.2).sub.b-- with b equal to zero, 1, 2, 3, 4, 5, or 6; and --NH--(CH.sub.2).sub.c--O-- with c equal to 2, or 3, provided that Y is C; the moiety ##STR00050## is an optionally substituted 4 to 8-membered heterocyclic ring moiety wherein all ring heteroatoms in said ring moiety are N; wherein Y and Z are each independently C or N; provided that when such ring moiety is a six, seven or eight-membered ring, Y and Z are separated by at least two ring atoms; and provided that when such ring moiety has a single ring heteroatom which is N, then such ring moiety is non-aromatic; V is C.sub.1-C.sub.6 alkyl, and e is zero or 1, wherein when e is zero, then V is null and R.sub.1 and R.sub.2 are directly bonded to the same or different ring atoms; wherein (i) R.sub.1 is selected from the group consisting of --H, --OH, halo, --CF.sub.3, --NH.sub.2, --COOH, C.sub.1-C.sub.6 alkyl, C.sub.1-C.sub.6 alkoxy, amidino, C.sub.1-C.sub.6 alkyl-substituted amidino, aryl, optionally substituted heterocyclyl, Pro-amide, Pro, Gly, Ala, Val, Leu, Ile, Lys, Arg, Orn, Ser, Thr, --CN, --CONH.sub.2, --COR', --SO.sub.2R', --CONR'R'', --NHCOR', OR' and SO.sub.2NR'R''; wherein said optionally substituted heterocyclyl is optionally singly or doubly substituted with substituents independently selected from the group consisting of C.sub.1-C.sub.6 alkyl, C.sub.1-C.sub.6 alkoxy, oxo, --OH, --Cl, --F, --NH.sub.2, --NO.sub.2, --CN, --COOH, and amidino; wherein R' and R'' are each independently --H, C.sub.1-C.sub.8 alkyl, aryl, or heterocyclyl or R' and R'' are combined to form a 4- to 8-membered ring, which ring is optionally singly or doubly substituted with substituents independently selected from the group consisting of C.sub.1-C.sub.6 alkyl, --C.sub.1-C.sub.6 alkoxy, --OH, --Cl, --F, --NH.sub.2, --NO.sub.2, --CN, --COOH and amidino; and R.sub.2 is selected from the group consisting of --H, amidino, singly or doubly C.sub.1-C.sub.6 alkyl-substituted amidino, --CN, --CONH.sub.2, --CONR'R'', --NHCOR', --SO.sub.2NR'R'' and --COOH; or (ii) R.sub.1 and R.sub.2 taken together can form an optionally substituted 4- to 9-membered heterocyclic monocyclic or bicyclic ring moiety which is bonded to a single ring atom of the Y and Z-containing ring moiety; or (iii) R.sub.1 and R.sub.2 taken together with a single ring atom of the Y and Z-containing ring moiety can form an optionally substituted 4- to 8-membered heterocyclic ring moiety to form a spiro structure; or (iv) R.sub.1 and R.sub.2 taken together with two or more adjacent ring atoms of the Y and Z-containing ring moiety can form an optionally substituted 4- to 9-membered heterocyclic monocyclic or bicyclic ring moiety fused to the Y and Z-containing ring moiety; wherein each of said optionally substituted 4-, 5-, 6,-, 7-, 8- and 9-membered heterocyclic ring moieties comprising R.sub.1 and R.sub.2 is optionally singly or doubly substituted with substituents independently selected from the group consisting of C.sub.1-C.sub.6 alkyl, C.sub.1-C.sub.6 alkoxy, optionally substituted phenyl, oxo, --OH, --Cl, --F, --NH.sub.2, --NO.sub.2, --CN, --COOH, and amidino; provided that when the Y and Z-containing ring moiety is a six or seven membered ring having a single ring heteroatom and e is zero, then R.sub.1 is not --OH, and R.sub.1 and R.sub.2 are not both --H; provided further that when the Y and Z-containing ring moiety is a six membered ring having two ring heteroatoms, both Y and Z are N and W is null, then --(V).sub.eR.sub.1R.sub.2 is attached to a ring atom other than Z; and if e is zero, then R.sub.1 and R.sub.2 are not both --H; and lastly, provided that when Xaa.sub.3 is D-Nle, then Xaa.sub.4 is not (B).sub.2D-Arg, and when Xaa.sub.3 is D-Leu or (.alpha.Me)D-Leu, then Xaa.sub.4 is not .delta.-(B).sub.2.alpha.-(B')D-Orn. 2. The synthetic peptide amide of claim 1 wherein Xaa.sub.1Xaa.sub.2 is D-Phe-D-Phe, Xaa.sub.3 is D-Leu or D-Nle and Xaa.sub.4 is selected from the group consisting of (B).sub.2D-Arg, D-Lys, (B).sub.2D-Har, .zeta.-(B)D-Hlys, D-Dap, .epsilon.-(B)D-Lys, .epsilon.-(B).sub.2-D-Lys, D-Amf, amidino-D-Amf, .gamma.-(B).sub.2D-Dbu and .delta.-(B).sub.2.alpha.-(B')D-Orn. 3. The synthetic peptide amide of claim 2 wherein Xaa.sub.4 is selected from the group consisting of D-Lys, (B).sub.2D-Har, .epsilon.-(B)D-Lys and .epsilon.-(B).sub.2-D-Lys. 4. The synthetic peptide amide of claim 1 wherein W is null, Y is N and Z is C. 5. The synthetic peptide amide of claim 4 wherein the Y and Z-containing ring moiety is a six-membered saturated ring comprising a single ring heteroatom. 6. The synthetic peptide amide of claim 1 wherein Y and Z are both N and are the only ring heteroatoms in the Y and Z-containing ring moiety. 7. The synthetic peptide amide of claim 1 wherein R.sub.1 and R.sub.2 taken together with zero, one or two ring atoms of the Y and Z-containing ring moiety comprise a monocyclic or bicyclic 4-9 membered heterocyclic ring moiety. 8. The synthetic peptide amide of claim 7 wherein R.sub.1 and R.sub.2 taken together with one ring atom of the Y and Z-containing ring moiety comprise a 4- to 8-membered heterocyclic ring moiety which with the Y and Z-containing ring moiety forms a spiro structure and W is null. 9. The synthetic peptide amide of claim 1 wherein e is zero and R.sub.1 and R.sub.2 are bonded directly to the same ring atom, R.sub.1 is H, OH, --NH.sub.2, --COOH, --CH.sub.2COOH, C.sub.1--C.sub.3 alkyl, amidino, C.sub.1-C.sub.3 alkyl-substituted amidino, dihydroimidazole, D-Pro, D-Pro amide, or CONH.sub.2 and R.sub.2 is H, --COOH, or C.sub.1-C.sub.1 alkyl. 10. The synthetic peptide amide of claim 1 wherein when W is null, the Y- and Z-containing ring moiety is a saturated 5-membered ring with only a single heteroatom, e is zero and either R.sub.1 or R.sub.2 is attached to a ring carbon atom adjacent to Y, then R.sub.1 is selected from the group consisting of --H, --OH, halo, --CF.sub.3, --NH.sub.2, C.sub.1-C.sub.6 alkyl, amidino, C.sub.1-C.sub.6 alkyl-substituted-amidino, aryl, Pro, Gly, Ala, Val, Leu, Ile, Lys, Arg, Orn, Ser, Thr, --CN, --SO.sub.2R', --NHCOR, --OR' and --SO.sub.2NR'R'' and R.sub.2 is selected from the group consisting of --H, amidino, singly or doubly C.sub.1-C.sub.6 alkyl -substituted amidino, --CN, --NHCOR' and SO.sub.2NR'R''. 11. The synthetic peptide amide of claim 1, wherein the moiety: ##STR00051## is selected from the group consisting of: ##STR00052## ##STR00053## 12. The synthetic peptide amide of claim 11, wherein Xaa.sub.1Xaa.sub.2 is D-Phe-D-Phe, Xaa.sub.3 is D-Leu or D-Nle and Xaa.sub.4 is selected from the group consisting of (B).sub.2D-Arg, D-Lys, (B).sub.2D-Har, .zeta.-(B)D-Hlys, D-Dap, .epsilon.-(B)D-Lys, .delta.-(B).sub.2-D-Lys, D-Amf, amidino-D-Amf, .gamma.-(B).sub.2D-Dbu and .delta.-(B).sub.2.alpha.-(B')D-Orn. 13. A pharmaceutical composition comprising the synthetic peptide amide according to claim 1 and a pharmaceutically acceptable excipient or carrier. 14. A synthetic peptide amide according to claim 1, selected from the group consisting of: D-Phe-D-Phe-D-Leu-(.epsilon.-Me)D-Lys-[4-Amidinohomopiperazine amide], ##STR00054## D-Phe-D-Phe-D-Leu-D-Lys-[.omega.(4-aminopiperidine-4-carboxylic acid)]--OH, ##STR00055## D-Phe-D-Phe-D-Leu-(.epsilon.-Me)D-Lys-[.omega.(4-aminopiperidine-4-carbox- ylic acid)]--OH, ##STR00056## D-Phe-D-Phe-D-Leu-D-Lys-[N-(4-piperidinyl)-L-proline]--OH, ##STR00057## D-Phe-D-Phe-D-Leu-D-Har-[N-(4-piperidinyl)-L-proline]--OH, ##STR00058## D-Phe-D-Phe-D-Leu-(.epsilon.-Me)D-Lys-[N-(4-piperidinyl)-L-proline]--OH, ##STR00059## D-Phe-D-Phe-D-Leu-D-Arg-[homopiperazine amide], ##STR00060## D-Phe-D-Phe-D-Leu-D-Har-[.omega.(4-aminopiperidine-4-carboxylic acid)]--OH, ##STR00061## D-Phe-D-Phe-D-Leu-(.epsilon.-iPr)D-Lys-[.omega.(4-aminopiperidine-4-carbo- xylic acid)]--OH, ##STR00062## D-Phe-D-Phe-D-Leu-(.beta.-amidino)D-Dap-[.omega.(4-aminopiperidine-4-carb- oxylic acid)]--OH, ##STR00063## D-Phe-D-Phe-D-Leu-D-Nar-[.omega.(4-aminopiperidine-4-carboxylic acid)]--OH, ##STR00064## D-Phe-D-Phe-D-Leu-D-Dbu-[N-(4-piperidinyl)-L-proline]--OH, ##STR00065## D-Phe-D-Phe-D-Leu-D-Nar-[N-(4-piperidinyl)-L-proline]--OH, ##STR00066## D-Phe-D-Phe-D-Leu-D-Dap(amidino)-[N-(4-piperidinyl)-L-proline]--OH, ##STR00067## D-Phe-D-Phe-D-Leu-D-Lys-[4-Amidinohomopiperazine amide], ##STR00068## D-Phe-D-Phe-D-Leu-D-Har-[4-Amidinohomopiperazine amide], ##STR00069## D-Phe-D-Phe-D-Leu-(.epsilon.-iPr)D-Lys-[4-Amidinohomopiperazine amide], ##STR00070## D-Phe-D-Phe-D-Leu-(.beta.-amidino)D-Dap-[4-Amidinohomopiperazine amide], ##STR00071## D-Phe-D-Phe-D-Nle-(.beta.-amidino)D-Dap-[4-Amidinohomopiperazine amide], ##STR00072## D-Phe-D-Phe-D-Leu-(.beta.-amidino)D-Dap-[homopiperazine amide], ##STR00073## D-Phe-D-Phe-D-Nle-(.beta.-amidino)D-Dap-[homopiperazine amide], ##STR00074## D-Phe-D-Phe-D-Leu-D-Dbu-[4-Amidinohomopiperazine amide], ##STR00075## D-Phe-D-Phe-D-Leu-D-Nar-[4-Amidinohomopiperazine amide], ##STR00076## D-Phe-D-Phe-D-Leu-D-Arg-[4-Amidinohomopiperazine amide], ##STR00077## D-Phe-D-Phe-D-Leu-D-Lys-[2,8-diazaspiro[4,5]decan-1-one amide], ##STR00078## D-Phe-D-Phe-D-Leu-D-Lys-[2-methyl-2,8-diazaspiro[4,5]decan-1-one amide], ##STR00079## D-Phe-D-Phe-D-Leu-D-Lys-[1,3,8-triazaspiro[4,5]decane-2,4-dione amide], ##STR00080## D-Phe-D-Phe-D-Leu-D-Lys-[5-chloro-1-(piperidin-4-yl)-1H-benzo[d]imidazol-- 2(3)H-one amide], ##STR00081## D-Phe-D-Phe-D-Leu-D-Lys-[morpholino(piperidin-4-yl)methanone amide], ##STR00082## D-Phe-D-Phe-D-Leu-D-Lys-[4-phenyl-1-(piperidin-yl-1H-imidazol-2(3H)-one amide], ##STR00083## D-Phe-D-Phe-D-Leu-D-Lys-[4-(3,5-dimethyl-4H-1,2,4-triazol-4-yl)piperidine amide], ##STR00084## D-Phe-D-Phe-D-Leu-D-Lys-[1-(piperidin-4-yl)indolin-2-one amide], ##STR00085## D-Phe-D-Phe-D-Leu-D-Lys-[1-phenyl-1,3,8-triazaspiro[4,5]decan-4-one amide], ##STR00086## D-Phe-D-Phe-D-Leu-D-Lys-[imidazo[1,2-a]pyridine-2-ylmethyl amide], ##STR00087## D-Phe-D-Phe-D-Leu-D-Lys-[(5-methylpyrazin-2-yl)methyl amide], ##STR00088## D-Phe-D-Phe-D-Leu-D-Lys-[1-(piperidin-4-yl)-1H-benzo[d]imidazol-2(3H)-one amide], ##STR00089## D-Phe-D-Phe-D-Leu-D-Lys-[4,5,6,7-tetrahydro-1H-pyrazolo[4,3-c]pyridine amide], ##STR00090## 15. A method of treating or inhibiting a kappa opioid receptor-associated disease or condition in a mammal, the method comprising administering to the mammal a composition comprising an effective amount of a synthetic peptide amide according to claim 1, wherein the kappa opioid receptor-associated disease or condition is pain, pancreatitis, or pruritis. 16. The method according to claim 15, wherein the kappa opioid receptor-associated disease or condition is chronic pain or acute pain. 17. The method according to claim 15, wherein the kappa opioid receptor-associated disease or condition is selected from the group consisting of neuropathic pain, somatic pain, visceral pain, cutaneous pain, and ocular pain. 18. The method according to claim 15, wherein the kappa opioid receptor-associated disease or condition is post injury pain or postoperative pain. 19. The method according to claim 15, wherein the kappa opioid receptor-associated disease or condition is post-surgical pain. 20. The method according to claim 19, wherein the post-surgical pain arises from a surgical procedure selected from the group consisting of appendectomy, open colorectal surgery, hernia repair, prostatectomy, colonic resection, gastrectomy, splenectomy, colectomy, colostomy, pelvic laparoscopy, tubal ligation, hysterectomy, vasectomy and cholecystecomy. 21. The method according to claim 15, wherein the kappa opioid receptor-associated disease or condition is post medical procedure pain. 22. The method according to claim 21, wherein the post medical procedure pain arises from a medical procedure selected from the group consisting of colonoscopy, cystoscopy, hysteroscopy, cervical and endometrial biopsy. 23. The method according to claim 15, wherein the kappa opioid receptor-associated disease or condition is selected from the group consisting of atopic pruritis, pruritis associated with kidney dialysis, ocular pruritis, otic pruritis, insect-bite pruritis and opioid-induced pruritis.