Claims for Patent: 8,236,766

Summary for Patent: 8,236,766

Title:	Uses of synthetic peptide amides
Abstract:	The invention relates to synthetic peptide amides that are 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. The synthetic peptide amides of the invention conform to the structure: ##STR00001## wherein Xaa is a D-amino acid and G is selected from the following three groups: ##STR00002## The compounds are useful in the prophylaxis and treatment of pain, pruritus and inflammation associated with a variety of diseases and conditions.
Inventor(s):	Schteingart; Claudio D. (San Diego, CA), Menzaghi; Frederique (Rye, NY), Jiang; Guangcheng (San Diego, CA), Alexander; Roberta Vezza (San Diego, CA), Sueiras-Diaz; Javier (La Jolla, CA), Spencer; Robert H. (New Hope, PA), Chalmers; Derek T. (Riverside, CT), Luo; Zhiyong (New City, NY)
Assignee:	Cara Therapeutics, Inc. (Shelton, CT)
Application Number:	12/480,059
Patent Claims:	1. A method of prophylaxis or treatment of a kappa opioid receptor-associated disease or condition selected from the group consisting of pain, pancreatitis and pruritis, in a mammal, the method comprising administering to the mammal a composition comprising an effective amount of a synthetic peptide amide having the formula: ##STR00088## 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, .beta.-(E)D-Ala and tert-butyl-D-Gly, 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, --CONH.sub.2, and wherein each (E) is independently selected from the group consisting of tert-butyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, furyl, pyridyl, thienyl, thiazolyl and benzothienyl; Xaa.sub.2 is selected from the group consisting of (A)(A')D-Phe, (A)(A')(.alpha.-Me)D-Phe, D-1NaI, D-2NaI, 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.-amidino-propionic acid, .alpha.-amino-4-piperidineacetic acid, cis-.alpha.,4-diaminocyclohexane acetic acid, trans-.alpha.,4-diaminocyclohexaneacetic acid, cis-.alpha.-amino-4-methyl-aminocyclo-hexane acetic acid, trans-.alpha.-amino-4-methylaminocyclohexane acetic acid, .alpha.-amino-1-amidino-4-piperidineacetic acid, cis-.alpha.-amino-4-guanidino-cyclohexane 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); wherein G is ##STR00089## and wherein p is 1; and the moiety ##STR00090## is an optionally substituted 4 to 8-membered heterocyclic ring moiety wherein Y is C or N and Z is C, N, O, S, SO, or SO.sub.2; provided that when such ring moiety is a 6-, 7- or 8-membered ring, Y and Z are separated by at least two ring atoms; and provided further that when such ring moiety is aromatic, then Y is carbon; wherein 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; wherein 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 (a) R.sub.1 is --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', or 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 substituted singly or doubly 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 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'', or --COOH; or (b) 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 (c) 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 (d) 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 comprising a single ring heteroatom and wherein such heteroatom is N, 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 comprising two ring heteroatoms, both Y and Z are N, W is null, and -V.sub.e(R.sub.1)(R.sub.2) is attached to Z, then -V.sub.e(R.sub.1)(R.sub.2) is selected from the group consisting of amidino, C.sub.1-C.sub.6 alkyl-substituted amidino, dihydroimidazole, --CH.sub.2COOH, and --H.sub.2C(O)NH.sub.2; and lastly, provided that if the Y and Z-containing ring moiety is a six membered ring comprising an S or O ring heteroatom, or if the Y and Z-containing ring moiety is a six membered ring comprising two ring heteroatoms, wherein both Y and Z are N and W is null, or if the Y and Z-containing ring moiety is a six membered aromatic ring comprising a single ring heteroatom, which heteroatom is N, then, when e is zero, R.sub.1 and R.sub.2 are not both --H. 2. The method according to claim 1, wherein the moiety: ##STR00091## is selected from the group consisting of: ##STR00092## ##STR00093## ##STR00094## 3. The method according to claim 2, wherein the kappa opioid receptor-associated disease or condition is pain and wherein the pain is inflammatory pain. 4. A method of prophylaxis or treatment of a kappa opioid receptor-associated disease or condition selected from the group consisting of pain, pancreatitis and pruritis, in a mammal, the method comprising administering to the mammal a composition comprising an effective amount of a synthetic peptide amide having a formula selected from the group consisting of: D-Phe-D-Phe-D-Leu-(.epsilon.-Me)D-Lys-[4-amidinohomopiperazine amide]: ##STR00095## D-Phe-D-Phe-D-Leu-D-Lys-[.omega.(4-aminopiperidine-4-carboxylic acid)]-OH: ##STR00096## D-Phe-D-Phe-D-Leu-(.epsilon.-Me)D-Lys-[.omega.(4-aminopiperidine-4-carbox- ylic acid)]-OH: ##STR00097## D-Phe-D-Phe-D-Leu-D-Lys-[N-(4-piperidinyl)-L-proline]-OH: ##STR00098## D-Phe-D-Phe-D-Leu-D-Har-[N-(4-piperidinyl)-L-proline]-OH: ##STR00099## D-Phe-D-Phe-D-Leu-(.epsilon.-Me)D-Lys-[N-(4-piperidinyl)-L-proline]-OH: ##STR00100## D-Phe-D-Phe-D-Leu-D-Orn-[4-(N-methyl)amidino-homopiperazine amide]: ##STR00101## and D-Phe-D-Phe-D-Leu-D-Orn-[4-(4,5-dihydro-1H-imidazol-2-yl) homopiperazine amide]: ##STR00102## 5. The method according to claim 1, wherein the wherein the kappa opioid receptor-associated disease or condition is pain and wherein the pain is inflammatory pain. 6. The method according to claim 5, wherein the inflammatory pain is post injury inflammatory pain. 7. The method according to claim 5, wherein the inflammatory pain is pancreatic inflammatory pain. 8. The method according to claim 5, wherein the inflammatory pain is associated with inflammatory swelling. 9. The method according to claim 8, wherein the inflammatory pain is associated with rheumatoid arthritis. 10. The method according to claim 1, wherein the pain is associated with inflammatory swelling. 11. The method according to claim 10, wherein the inflammatory swelling is associated with rheumatoid arthritis. 12. The method according to claim 4, wherein the pain is inflammatory pain associated with rheumatoid arthritis. 13. The method according to claim 12, wherein the inflammatory pain is associated with inflammatory swelling.