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1. (WO2010008341) A COMBINATION OF (A) GLUCOCORTICOID RECEPTOR MODULATOR AND (B) A MUSCARINIC ANTAGONIST
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CLAIMS

1. A pharmaceutical product for treating an airway disease comprising, in combination, (a) a first active ingredient, which is a compound of formula (III)


wherein:

A is Ci_3hydroxyalkyl, C3-5cycloalkyl, Ci_3haloalkyl Or NR5R6C(O);

R1 and Rla are independently selected from hydrogen and Ci_3alkyl; R2 is hydrogen;

R3 is C5-ioaryl
or Cs-ioheteroaryl, which may be optionally substituted by one or more substituents independently selected from B;

B is Ci_3alkoxy or Ci_3alkylS(O)n; n is 2; R4 is hydrogen;

W is phenyl which is optionally substituted by one or more halo;

X is O;

Y is hydrogen;

Z is O; R5 and R6 are independently selected from hydrogen and Ci_3alkyl; and

Rx is hydrogen; or a pharmaceutically acceptable salt thereof, and

(b) a second active ingredient, which is a muscarinic antagonist selected from a [2-((S)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-(3-phenoxy-propyl)-ammonium salt, [2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-(3-phenoxy-propyl)-ammonium salt,

[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5 -ylmethyl] - dimethyl-(2-phenethyloxy-ethyl)-ammonium salt, [2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]- [3-(3,4-dichloro-phenoxy)-propyl] dimethyl-ammonium salt,

[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-[2-(3,4-dichloro-benzyloxy)-ethyl]- dimethyl-ammonium salt;

[2-(4-Chloro-benzyloxy)-ethyl]-[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]- dimethyl-ammonium salt,

(R)- 1 -[2-(4-Fluoro-phenyl)-ethyl]-3-((5)-2-phenyl-2-piperidin- 1 -yl-propionyloxy)- 1 -azonia-bicyclo[2.2.2]octane salt and

(R)-3 -( 1 -Phenyl-cycloheptanecarbonyloxy)- 1 -(pyridin-2-ylcarbamoylmethyl)- 1 -azonia-bicyclo[2.2.2]octane salt

2. The pharmaceutical product according to claim 1, wherein the first active ingredient is selected from:

N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-phenyl-propan-2-yl]cyclopropanecarboxamide, 2,2,2-trifluoro-N-[( 1 R,2S)- 1 -[ 1 -(4-fluorophenyl)indazol-5-yl]oxy- 1 -phenyl-propan-2-yljacetamide,

N-[( 1 R,2S)- 1 -[ 1 -(4-fluorophenyl)indazol-5-yl]oxy- 1 -phenyl-propan-2-yl]propanamide, methyl N-[( 1 R,2S)- 1 - [ 1 -(4-fluorophenyl)indazol-5 -yl]oxy- 1 -phenyl-propan-2-yl] carbamate, N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-phenyl-propan-2-yl]-2-hydroxy-2-methyl-propanamide,

2,2,2-trifluoro-N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-(3-methoxyphenyl)propan-2-yl]acetamide,

N-[(lR,2S)-l-(4-ethylphenyl)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-propan-2-yl]-2-hydroxy-acetamide, N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-(3-methoxyphenyl)propan-2-yl]-2,2-dimethyl-propanamide,

N-[( 1 R,2S)- 1 -[ 1 -(4-fluorophenyl)indazol-5-yl]oxy- 1 -(4-methylsulfonylphenyl)propan-2-yl] -2-hydroxy-acetamide, N-[( 1 R,2S)- 1 -[ 1 -(4-fluorophenyl)indazol-5-yl]oxy- 1 -phenyl-propan-2-yl]-2-hydroxy-acetamide,

N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-(6-methoxypyridin-3-yl)propan-2-yl] cyclopropanecarboxamide,

N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-(6-methoxypyridin-3-yl)propan-2-yl] cyclopropanecarboxamide,

N-[(lR,2S)-l-(2,5-dioxabicyclo[4.4.0]deca-7,9,l l-trien-8-yl)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-propan-2-yl]-2,2,2-trifluoro-acetamide,

2,2,2-trifluoro-N-[( 1 R,2S)- 1 -[ 1 -(4-fluorophenyl)indazol-5-yl]oxy- 1 -naphthalen-2-yl-propan-2-yl]acetamide, N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-naphthalen-2-yl-propan-2-yl]-2-hydroxy-acetamide,

N-[(lR,2S)-l-(3-ethylphenyl)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-propan-2-yl]-2,2,2-trifluoro-acetamide,

N-[(lR,2S)-l-(3-ethylphenyl)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-propan-2-yl]-2-hydroxy-acetamide, and

2,2,2-trifluoro-N-[(lR,2S)-l-[l-(4-fluorophenyl)indazol-5-yl]oxy-l-(3-methylphenyl)propan-2-yl]acetamide, or a pharmaceutically acceptable salt thereof.

3. The pharmaceutical product according to any one of claims 1 to 2, wherein both active ingredients are in a composition suitable for inhalation.

4. Use of the pharmaceutical product according to any one of claims 1 to 3, in the manufacture of a medicament for the treatment of airway diseases.

5. Use according to claim 4, wherein the airway disease is chronic obstructive pulmonary disease or asthma.

6. A method of treating airway diseases, or chronic obstructive pulmonary disease or asthma, which comprises simultaneously, sequentially or separately administering:

(a) a (therapeutically effective) dose of a first active ingredient, which is a glucocorticoid receptor modulator as defined in any one of claims 1, 2 or 3, or a pharmaceutically acceptable salt thereof; and

(b) a (therapeutically effective) dose of a second active ingredient, which is a muscarinic antagonist selected from a

[2-((S)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-(3-phenoxy-propyl)-ammonium salt,

[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-dimethyl-(3-phenoxy-propyl)-ammonium salt, [2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5 -ylmethyl] - dimethyl-(2-phenethyloxy-ethyl)-ammonium salt,

[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]- [3-(3,4-dichloro-phenoxy)-propyl] dimethyl-ammonium salt,

[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]-[2-(3,4-dichloro-benzyloxy)-ethyl]- dimethyl-ammonium salt;

[2-(4-Chloro-benzyloxy)-ethyl]-[2-((R)-Cyclohexyl-hydroxy-phenyl-methyl)-oxazol-5-ylmethyl]- dimethyl-ammonium salt,

(R)- 1 -[2-(4-Fluoro-phenyl)-ethyl]-3-((5)-2-phenyl-2-piperidin- 1 -yl-propionyloxy)- 1 -azonia-bicyclo[2.2.2]octane salt, and (i?)-3 -( 1 -Phenyl-cycloheptanecarbonyloxy)- 1 -(pyridin-2-ylcarbamoylmethyl)- 1 -azonia-bicyclo[2.2.2]octane salt.