NEUROACTIVE STEROIDS, COMPOSITIONS, AND USES THEREOF

Described herein are neuro-active steroids of the Formula (I): (I) or a pharmaceutically acceptable salt thereof; wherein R1, R2, Ra, G, X, Y, Z, and n are as defined herein. Such compounds are envisioned, in certain embodiments, to behave as GABA modulators. Also provided are pharmaceutical compositions comprising a compound described herein and methods of use and treatment, e.g., such for inducing sedation and/or anesthesia.

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Description
RELATED APPLICATIONS

The present application claims priority under 35 U.S.C. § 119(e) to U.S. provisional patent application U.S. Ser. No. 62/118,884, filed Feb. 20, 2015, which is incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

Brain excitability is defined as the level of arousal of an animal, a continuum that ranges from coma to convulsions, and is regulated by various neurotransmitters. In general, neurotransmitters are responsible for regulating the conductance of ions across neuronal membranes. At rest, the neuronal membrane possesses a potential (or membrane voltage) of approximately −70 mV, the cell interior being negative with respect to the cell exterior. The potential (voltage) is the result of ion (K+, Na+, Cl, organic anions) balance across the neuronal semipermeable membrane. Neurotransmitters are stored in presynaptic vesicles and are released under the influence of neuronal action potentials. When released into the synaptic cleft, an excitatory chemical transmitter such as acetylcholine will cause membrane depolarization, e.g., a change of potential from −70 mV to −50 mV. This effect is mediated by postsynaptic nicotinic receptors which are stimulated by acetylcholine to increase membrane permeability to Na+ ions. The reduced membrane potential stimulates neuronal excitability in the form of a postsynaptic action potential.

In the case of the GABA receptor complex (GRC), the effect on brain excitability is mediated by GABA, a neurotransmitter. GABA has a profound influence on overall brain excitability because up to 40% of the neurons in the brain utilize GABA as a neurotransmitter. GABA regulates the excitability of individual neurons by regulating the conductance of chloride ions across the neuronal membrane. GABA interacts with its recognition site on the GRC to facilitate the flow of chloride ions down an electrochemical gradient of the GRC into the cell. An intracellular increase in the levels of this anion causes hyperpolarization of the transmembrane potential, rendering the neuron less susceptible to excitatory inputs, i.e., reduced neuron excitability. In other words, the higher the chloride ion concentration in the neuron, the lower the brain excitability and level of arousal.

It is well-documented that the GRC is responsible for the mediation of anxiety, seizure activity, and sedation. Thus, GABA and drugs that act like GABA or facilitate the effects of GABA (e.g., the therapeutically useful barbiturates and benzodiazepines (BZs), such as Valium®) produce their therapeutically useful effects by interacting with specific regulatory sites on the GRC. Accumulated evidence has now indicated that in addition to the benzodiazepine and barbiturate binding site, the GRC contains a distinct site for neuroactive steroids. See, e.g., Lan, N. C. et al., Neurochem. Res. (1991) 16:347-356.

Neuroactive steroids can occur endogenously. The most potent endogenous neuroactive steroids are 3α-hydroxy-5-reduced pregnan-20-one and 3α-21-dihydroxy-5-reduced pregnan-20-one, metabolites of hormonal steroids progesterone and deoxycorticosterone, respectively. The ability of these steroid metabolites to alter brain excitability was recognized in 1986 (Majewska, M. D. et al., Science 232:1004-1007 (1986); Harrison, N. L. et al., J Pharmacol. Exp. Ther. 241:346-353 (1987)).

The ovarian hormone progesterone and its metabolites have been demonstrated to have profound effects on brain excitability (Backstrom, T. et al., Acta Obstet. Gynecol. Scand. Suppl. 130:19-24 (1985); Pfaff, D. W and McEwen, B. S., Science 219:808-814 (1983); Gyermek et al., J Med Chem. 11: 117 (1968); Lambert, J. et al., Trends Pharmacol. Sci. 8:224-227 (1987)). The levels of progesterone and its metabolites vary with the phases of the menstrual cycle. It has been well documented that the levels of progesterone and its metabolites decrease prior to the onset of menses. The monthly recurrence of certain physical symptoms prior to the onset of menses has also been well documented. These symptoms, which have become associated with premenstrual syndrome (PMS), include stress, anxiety, and migraine headaches (Dalton, K., Premenstrual Syndrome and Progesterone Therapy, 2nd edition, Chicago Yearbook, Chicago (1984)). Subjects with PMS have a monthly recurrence of symptoms that are present in premenses and absent in postmenses.

In a similar fashion, a reduction in progesterone has also been temporally correlated with an increase in seizure frequency in female epileptics, i.e., catamenial epilepsy (Laidlaw, J., Lancet, 1235-1237 (1956)). A more direct correlation has been observed with a reduction in progesterone metabolites (Rosciszewska et al., J. Neurol. Neurosurg. Psych. 49:47-51 (1986)). In addition, for subjects with primary generalized petit mal epilepsy, the temporal incidence of seizures has been correlated with the incidence of the symptoms of premenstrual syndrome (Backstrom, T. et al., J. Psychosom. Obstet. Gynaecol. 2:8-20 (1983)). The steroid deoxycorticosterone has been found to be effective in treating subjects with epileptic spells correlated with their menstrual cycles (Aird, R. B. and Gordan, G., J. Amer. Med. Soc. 145:715-719 (1951)).

A syndrome also related to low progesterone levels is postnatal depression (PND). Immediately after birth, progesterone levels decrease dramatically leading to the onset of PND. The symptoms of PND range from mild depression to psychosis requiring hospitalization. PND is also associated with severe anxiety and irritability. PND-associated depression is not amenable to treatment by classic antidepressants, and women experiencing PND show an increased incidence of PMS (Dalton, K., Premenstrual Syndrome and Progesterone Therapy, 2nd edition, Chicago Yearbook, Chicago (1984)).

Collectively, these observations imply a crucial role for progesterone and deoxycorticosterone and more specifically their metabolites in the homeostatic regulation of brain excitability, which is manifested as an increase in seizure activity or symptoms associated with catamenial epilepsy, PMS, and PND. The correlation between reduced levels of progesterone and the symptoms associated with PMS, PND, and catamenial epilepsy (Backstrom, T. et al., J Psychosom. Obstet. Gynaecol. 2:8-20 (1983)); Dalton, K., Premenstrual Syndrome and Progesterone Therapy, 2nd edition, Chicago Yearbook, Chicago (1984)) has prompted the use of progesterone in their treatment (Mattson et al., “Medroxyprogesterone therapy of catamenial epilepsy,” in Advances in Epileptology: XVth Epilepsy International Symposium, Raven Press, New York (1984), pp. 279-282, and Dalton, K., Premenstrual Syndrome and Progesterone Therapy, 2nd edition, Chicago Yearbook, Chicago (1984)). However, progesterone is not consistently effective in the treatment of the aforementioned syndromes. For example, no dose-response relationship exists for progesterone in the treatment of PMS (Maddocks et al., Obstet. Gynecol. 154:573-581 (1986); Dennerstein et al., Brit. Med J 290:16-17 (1986)).

New and improved neuroactive steroids are needed that act as modulating agents for brain excitability, as well as agents for the prevention and treatment of CNS-related diseases. The compounds, compositions, and methods described herein are directed toward this end.

SUMMARY OF THE INVENTION

Provided herein are C21-substituted neuroactive steroids designed, for example, to act as GABA modulators. In certain embodiments, such compounds are envisioned to be useful as therapeutic agents for the inducement of anesthesia and/or sedation in a subject. In some embodiments, such compounds are envisioned to be useful as therapeutic agents for treating a CNS-related disorder (e.g., sleep disorder, a mood disorder, a schizophrenia spectrum disorder, a convulsive disorder, a disorder of memory and/or cognition, a movement disorder, a personality disorder, autism spectrum disorder, pain, traumatic brain injury, a vascular disease, a substance abuse disorder and/or withdrawal syndrome, or tinnitus) in a subject in need (e.g., a subject with Rett syndrome, Fragile X syndrome, or Angelman syndrome).

In one aspect, provided is a compound of Formula (I):

or a pharmaceutically acceptable salt thereof, wherein: each X, Y, and Z is independently CH or N; G is —C(R3a)(R3b)(OR1); R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, heterocyclyl, aryl, or heteroaryl; R2 is C1-C6 alkyl (e.g., C1-C6 haloalkyl), or C1-C6 alkoxy; each of R3a and R3b is independently H, D, or C1-C6 alkyl; Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl or C1-C6 hydroxyalkyl), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf; or two Ra groups, together with the atoms to which they are attached, form a 6-membered aryl or heteroaryl ring; Rb is C1-C6 alkyl, NRcRd, or ORf; each of Rc and Rd is independently H, C1-C6 alkyl, C(O)Re, or C(O)ORf; Re is C1-C6 alkyl or NRgRh; Rfis H or C1-C6 alkyl; each of Rg and Rh is independently H or C1-C6 alkyl; m is 0, 1, or 2; n is 0, 1, 2, 3, or 4; and the compound is not selected from a compound of Table 1.

Also provided herein are pharmaceutical compositions comprising a compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b), and methods of use and treatment, e.g., such as for inducing sedation and/or anesthesia, for treating a CNS-related disorder.

In another aspect, provided is a pharmaceutical composition comprising a compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b), and a pharmaceutically acceptable excipient. In certain embodiments, the compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b), is provided in an effective amount in the pharmaceutical composition. In certain embodiments, the compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b), is provided in a therapeutically effective amount. In certain embodiments, the compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b), is provided in a prophylactically effective amount.

Compounds as described herein, act, in certain embodiments, as GABA modulators, e.g., effecting the GABAA receptor in either a positive or negative manner. As modulators of the excitability of the central nervous system (CNS), as mediated by their ability to modulate GABAA receptor, such compounds are expected to have CNS-activity.

Thus, in another aspect, provided are methods of treating a CNS-related disorder in a subject in need thereof, comprising administering to the subject an effective amount of a compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b). In certain embodiments, the CNS-related disorder is selected from the group consisting of a sleep disorder, a mood disorder, a schizophrenia spectrum disorder, a convulsive disorder, a disorder of memory and/or cognition, a movement disorder, a personality disorder, autism spectrum disorder, pain, traumatic brain injury, a vascular disease, a substance abuse disorder and/or withdrawal syndrome, and tinnitus. In certain embodiments, the compound is administered orally, subcutaneously, intravenously, or intramuscularly. In certain embodiments, the compound is administered chronically. In certain embodiments, the compound is administered continuously, e.g., by continuous intravenous infusion.

Other objects and advantages will become apparent to those skilled in the art from a consideration of the ensuing Detailed Description, Examples, and Claims.

Definitions

Chemical Definitions

Definitions of specific functional groups and chemical terms are described in more detail below. The chemical elements are identified in accordance with the Periodic Table of the Elements, CAS version, Handbook of Chemistry and Physics, 75th Ed., inside cover, and specific functional groups are generally defined as described therein. Additionally, general principles of organic chemistry, as well as specific functional moieties and reactivity, are described in Thomas Sorrell, Organic Chemistry, University Science Books, Sausalito, 1999; Smith and March, March's Advanced Organic Chemistry, 5th Edition, John Wiley & Sons, Inc., New York, 2001; Larock, Comprehensive Organic Transformations, VCH Publishers, Inc., New York, 1989; and Carruthers, Some Modern Methods of Organic Synthesis, 3rd Edition, Cambridge University Press, Cambridge, 1987.

Compounds described herein can comprise one or more asymmetric centers, and thus can exist in various isomeric forms, e.g., enantiomers and/or diastereomers. For example, the compounds described herein can be in the form of an individual enantiomer, diastereomer or geometric isomer, or can be in the form of a mixture of stereoisomers, including racemic mixtures and mixtures enriched in one or more stereoisomer. Isomers can be isolated from mixtures by methods known to those skilled in the art, including chiral high pressure liquid chromatography (HPLC) and the formation and crystallization of chiral salts; or preferred isomers can be prepared by asymmetric syntheses. See, for example, Jacques et al., Enantiomers, Racemates and Resolutions (Wiley Interscience, New York, 1981); Wilen et al., Tetrahedron 33:2725 (1977); Eliel, Stereochemistry of Carbon Compounds (McGraw-Hill, N Y, 1962); and Wilen, Tables of Resolving Agents and Optical Resolutions p. 268 (E. L. Eliel, Ed., Univ. of Notre Dame Press, Notre Dame, Ind. 1972). The invention additionally encompasses compounds described herein as individual isomers substantially free of other isomers, and alternatively, as mixtures of various isomers.

As used herein a pure enantiomeric compound is substantially free from other enantiomers or stereoisomers of the compound (i.e., in enantiomeric excess). In other words, an “S” form of the compound is substantially free from the “R” form of the compound and is, thus, in enantiomeric excess of the “R” form. The term “enantiomerically pure” or “pure enantiomer” denotes that the compound comprises more than 75% by weight, more than 80% by weight, more than 85% by weight, more than 90% by weight, more than 91% by weight, more than 92% by weight, more than 93% by weight, more than 94% by weight, more than 95% by weight, more than 96% by weight, more than 97% by weight, more than 98% by weight, more than 98.5% by weight, more than 99% by weight, more than 99.2% by weight, more than 99.5% by weight, more than 99.6% by weight, more than 99.7% by weight, more than 99.8% by weight or more than 99.9% by weight, of the enantiomer. In certain embodiments, the weights are based upon total weight of all enantiomers or stereoisomers of the compound.

In the compositions provided herein, an enantiomerically pure compound can be present with other active or inactive ingredients. For example, a pharmaceutical composition comprising enantiomerically pure R-compound can comprise, for example, about 90% excipient and about 10% enantiomerically pure R-compound. In certain embodiments, the enantiomerically pure R-compound in such compositions can, for example, comprise, at least about 95% by weight R-compound and at most about 5% by weight S-compound, by total weight of the compound. For example, a pharmaceutical composition comprising enantiomerically pure S-compound can comprise, for example, about 90% excipient and about 10% enantiomerically pure S-compound. In certain embodiments, the enantiomerically pure S-compound in such compositions can, for example, comprise, at least about 95% by weight S-compound and at most about 5% by weight R-compound, by total weight of the compound. In certain embodiments, the active ingredient can be formulated with little or no excipient or carrier.

Compound described herein may also comprise one or more isotopic substitutions. For example, H may be in any isotopic form, including 1H, 2H (D or dueterium), and 3H (T or tritium); C may be in any isotopic form, including 12C, 13C, and 14C; O may be in any isotopic form, including 16O and 18O; and the like.

The articles “a” and “an” may be used herein to refer to one or to more than one (i.e. at least one) of the grammatical objects of the article. By way of example “an analogue” means one analogue or more than one analogue.

When a range of values is listed, it is intended to encompass each value and sub-range within the range. For example “C1-6 alkyl” is intended to encompass, C1, C2, C3, C4, C5, C6, C1-6, C1-5, C1-4, C1-3, C1-2, C2-6, C2-5, C2-4, C2-3, C3-6, C3-5, C3-4, C4-6, C4-5, and C5-6 alkyl.

The following terms are intended to have the meanings presented therewith below and are useful in understanding the description and intended scope of the present invention.

“Alkyl” refers to a radical of a straight-chain or branched saturated hydrocarbon group having from 1 to 20 carbon atoms (“C1-20 alkyl”). In some embodiments, an alkyl group has 1 to 12 carbon atoms (“C1-12 alkyl”). In some embodiments, an alkyl group has 1 to 8 carbon atoms (“C1-8 alkyl”). In some embodiments, an alkyl group has 1 to 6 carbon atoms (“C1-6 alkyl”, also referred to herein as “lower alkyl”). In some embodiments, an alkyl group has 1 to 5 carbon atoms (“C1-5 alkyl”). In some embodiments, an alkyl group has 1 to 4 carbon atoms (“C1-4 alkyl”). In some embodiments, an alkyl group has 1 to 3 carbon atoms (“C1-3 alkyl”). In some embodiments, an alkyl group has 1 to 2 carbon atoms (“C1-2 alkyl”). In some embodiments, an alkyl group has 1 carbon atom (“C1 alkyl”). In some embodiments, an alkyl group has 2 to 6 carbon atoms (“C2-6 alkyl”). Examples of C1-6 alkyl groups include methyl (C1), ethyl (C2), n-propyl (C3), isopropyl (C3), n-butyl (C4), tert-butyl (C4), sec-butyl (C4), iso-butyl (C4), n-pentyl (C5), 3-pentanyl (C5), amyl (C5), neopentyl (C5), 3-methyl-2-butanyl (C5), tertiary amyl (C5), and n-hexyl (C6). Additional examples of alkyl groups include n-heptyl (C7), n-octyl (C8) and the like. Unless otherwise specified, each instance of an alkyl group is independently optionally substituted, i.e., unsubstituted (an “unsubstituted alkyl”) or substituted (a “substituted alkyl”) with one or more substituents; e.g., for instance from 1 to 5 substituents, 1 to 3 substituents, or 1 substituent. In certain embodiments, the alkyl group is unsubstituted C1-10 alkyl (e.g., —CH3). In certain embodiments, the alkyl group is substituted C1-10 alkyl. Common alkyl abbreviations include Me (—CH3), Et (—CH2CH3), iPr (—CH(CH3)2), nPr (—CH2CH2CH3), n-Bu (—CH2CH2CH2CH3), or i-Bu (—CH2CH(CH3)2).

“Alkenyl” refers to a radical of a straight-chain or branched hydrocarbon group having from 2 to 20 carbon atoms, one or more carbon-carbon double bonds, and no triple bonds (“C2-20 alkenyl”). In some embodiments, an alkenyl group has 2 to 10 carbon atoms (“C2-10 alkenyl”). In some embodiments, an alkenyl group has 2 to 8 carbon atoms (“C2-8 alkenyl”). In some embodiments, an alkenyl group has 2 to 6 carbon atoms (“C2-6 alkenyl”). In some embodiments, an alkenyl group has 2 to 5 carbon atoms (“C2-5 alkenyl”). In some embodiments, an alkenyl group has 2 to 4 carbon atoms (“C2-4 alkenyl”). In some embodiments, an alkenyl group has 2 to 3 carbon atoms (“C2-3 alkenyl”). In some embodiments, an alkenyl group has 2 carbon atoms (“C2 alkenyl”). The one or more carbon-carbon double bonds can be internal (such as in 2-butenyl) or terminal (such as in 1-butenyl). Examples of C2-4 alkenyl groups include ethenyl (C2), 1-propenyl (C3), 2-propenyl (C3), 1-butenyl (C4), 2-butenyl (C4), butadienyl (C4), and the like. Examples of C2-6 alkenyl groups include the aforementioned C2-4 alkenyl groups as well as pentenyl (C5), pentadienyl (C5), hexenyl (C6), and the like. Additional examples of alkenyl include heptenyl (C7), octenyl (C8), octatrienyl (C8), and the like. Unless otherwise specified, each instance of an alkenyl group is independently optionally substituted, i.e., unsubstituted (an “unsubstituted alkenyl”) or substituted (a “substituted alkenyl”) with one or more substituents e.g., for instance from 1 to 5 substituents, 1 to 3 substituents, or 1 substituent. In certain embodiments, the alkenyl group is unsubstituted C2-10 alkenyl. In certain embodiments, the alkenyl group is substituted C2-10 alkenyl.

“Alkynyl” refers to a radical of a straight-chain or branched hydrocarbon group having from 2 to 20 carbon atoms, one or more carbon-carbon triple bonds, and optionally one or more double bonds (“C2-20 alkynyl”). In some embodiments, an alkynyl group has 2 to 10 carbon atoms (“C2-10 alkynyl”). In some embodiments, an alkynyl group has 2 to 8 carbon atoms (“C2-8 alkynyl”). In some embodiments, an alkynyl group has 2 to 6 carbon atoms (“C2-6 alkynyl”). In some embodiments, an alkynyl group has 2 to 5 carbon atoms (“C2-5 alkynyl”). In some embodiments, an alkynyl group has 2 to 4 carbon atoms (“C2-4 alkynyl”). In some embodiments, an alkynyl group has 2 to 3 carbon atoms (“C2-3 alkynyl”). In some embodiments, an alkynyl group has 2 carbon atoms (“C2 alkynyl”). The one or more carbon-carbon triple bonds can be internal (such as in 2-butynyl) or terminal (such as in 1-butynyl). Examples of C2-4 alkynyl groups include, without limitation, ethynyl (C2), 1-propynyl (C3), 2-propynyl (C3), 1-butynyl (C4), 2-butynyl (C4), and the like. Examples of C2-6 alkenyl groups include the aforementioned C2-4 alkynyl groups as well as pentynyl (C5), hexynyl (C6), and the like. Additional examples of alkynyl include heptynyl (C7), octynyl (C8), and the like. Unless otherwise specified, each instance of an alkynyl group is independently optionally substituted, i.e., unsubstituted (an “unsubstituted alkynyl”) or substituted (a “substituted alkynyl”) with one or more substituents; e.g., for instance from 1 to 5 substituents, 1 to 3 substituents, or 1 substituent. In certain embodiments, the alkynyl group is unsubstituted C2-10 alkynyl. In certain embodiments, the alkynyl group is substituted C2-10 alkynyl.

“Aryl” refers to a radical of a monocyclic or polycyclic (e.g., bicyclic or tricyclic) 4n+2 aromatic ring system (e.g., having 6, 10, or 14 π electrons shared in a cyclic array) having 6-14 ring carbon atoms and zero heteroatoms provided in the aromatic ring system (“C6-14 aryl”). In some embodiments, an aryl group has six ring carbon atoms (“C6 aryl”; e.g., phenyl). In some embodiments, an aryl group has ten ring carbon atoms (“C10 aryl”; e.g., naphthyl such as 1-naphthyl and 2-naphthyl). In some embodiments, an aryl group has fourteen ring carbon atoms (“C14 aryl”; e.g., anthracyl). “Aryl” also includes ring systems wherein the aryl ring, as defined above, is fused with one or more carbocyclyl or heterocyclyl groups wherein the radical or point of attachment is on the aryl ring, and in such instances, the number of carbon atoms continue to designate the number of carbon atoms in the aryl ring system. Aryl groups include, but are not limited to, phenyl, naphthyl, indenyl, and tetrahydronaphthyl. Unless otherwise specified, each instance of an aryl group is independently optionally substituted, i.e., unsubstituted (an “unsubstituted aryl”) or substituted (a “substituted aryl”) with one or more substituents. In certain embodiments, the aryl group is unsubstituted C6-14 aryl. In certain embodiments, the aryl group is substituted C6-14 aryl.

In certain embodiments, an aryl group substituted with one or more of groups selected from halo, C1-C8 alkyl, C1-C8 haloalkyl, cyano, hydroxy, C1-C8 alkoxy, and amino.

Examples of representative substituted aryls include the following

wherein one of R56 and R57 may be hydrogen and at least one of R56 and R57 is each independently selected from C1-C8 alkyl, C1-C8 haloalkyl, 4-10 membered heterocyclyl, alkanoyl, C1-C8 alkoxy, heteroaryloxy, alkylamino, arylamino, heteroarylamino, NR58COR59, NR58SOR59NR58SO2R59, COOalkyl, COOaryl, CONR58R59, CONR58OR59, NR58R59, SO2NR58R59, S-alkyl, SOalkyl, SO2alkyl, Saryl, SOaryl, SO2aryl; or R56 and R57 may be joined to form a cyclic ring (saturated or unsaturated) from 5 to 8 atoms, optionally containing one or more heteroatoms selected from the group N, O, or S. R60 and R61 are independently hydrogen, C1-C8 alkyl, C1-C4 haloalkyl, C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, substituted C6-C10 aryl, 5-10 membered heteroaryl, or substituted 5-10 membered heteroaryl.

Other representative aryl groups having a fused heterocyclyl group include the following:

wherein each W is selected from C(R66)2, NR66, O, and S; and each Y is selected from carbonyl, NR66, O and S; and R66 is independently hydrogen, C1-C8 alkyl, C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, and 5-10 membered heteroaryl.

“Halo” or “halogen,” independently or as part of another substituent, mean, unless otherwise stated, a fluorine (F), chlorine (Cl), bromine (Br), or iodine (I) atom. The term “halide” by itself or as part of another substituent, refers to a fluoride, chloride, bromide, or iodide atom. In certain embodiments, the halo group is either fluorine or chlorine.

“Haloalkyl” and “haloalkoxy” can include alkyl and alkoxy structures that are substituted with one or more halo groups or with combinations thereof. For example, the terms “fluoroalkyl” and “fluoroalkoxy” include haloalkyl and haloalkoxy groups, respectively, in which the halo is fluorine.

“Hydroxy” or “hydroxyl,” independently or as part of another substituent, mean, unless otherwise stated, a —OH group.

Hydroxyalkyl” or “hydroxylalkyl” can include alkyl structures that are substituted with one or more hydroxyl groups.

“Heteroaryl” refers to a radical of a 5-10 membered monocyclic or bicyclic 4n+2 aromatic ring system (e.g., having 6 or 10 π electrons shared in a cyclic array) having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen and sulfur (“5-10 membered heteroaryl”). In heteroaryl groups that contain one or more nitrogen atoms, the point of attachment can be a carbon or nitrogen atom, as valency permits. Heteroaryl bicyclic ring systems can include one or more heteroatoms in one or both rings. “Heteroaryl” includes ring systems wherein the heteroaryl ring, as defined above, is fused with one or more carbocyclyl or heterocyclyl groups wherein the point of attachment is on the heteroaryl ring, and in such instances, the number of ring members continue to designate the number of ring members in the heteroaryl ring system. “Heteroaryl” also includes ring systems wherein the heteroaryl ring, as defined above, is fused with one or more aryl groups wherein the point of attachment is either on the aryl or heteroaryl ring, and in such instances, the number of ring members designates the number of ring members in the fused (aryl/heteroaryl) ring system. Bicyclic heteroaryl groups wherein one ring does not contain a heteroatom (e.g., indolyl, quinolinyl, carbazolyl, and the like) the point of attachment can be on either ring, i.e., either the ring bearing a heteroatom (e.g., 2-indolyl) or the ring that does not contain a heteroatom (e.g., 5-indolyl).

In some embodiments, a heteroaryl group is a 5-10 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-10 membered heteroaryl”). In some embodiments, a heteroaryl group is a 5-8 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-8 membered heteroaryl”). In some embodiments, a heteroaryl group is a 5-6 membered aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms provided in the aromatic ring system, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-6 membered heteroaryl”). In some embodiments, the 5-6 membered heteroaryl has 1-3 ring heteroatoms selected from nitrogen, oxygen, and sulfur. In some embodiments, the 5-6 membered heteroaryl has 1-2 ring heteroatoms selected from nitrogen, oxygen, and sulfur. In some embodiments, the 5-6 membered heteroaryl has 1 ring heteroatom selected from nitrogen, oxygen, and sulfur. Unless otherwise specified, each instance of a heteroaryl group is independently optionally substituted, i.e., unsubstituted (an “unsubstituted heteroaryl”) or substituted (a “substituted heteroaryl”) with one or more substituents. In certain embodiments, the heteroaryl group is unsubstituted 5-14 membered heteroaryl. In certain embodiments, the heteroaryl group is substituted 5-14 membered heteroaryl.

Exemplary 5-membered heteroaryl groups containing one heteroatom include, without limitation, pyrrolyl, furanyl and thiophenyl. Exemplary 5-membered heteroaryl groups containing two heteroatoms include, without limitation, imidazolyl, pyrazolyl, oxazolyl, isoxazolyl, thiazolyl, and isothiazolyl. Exemplary 5-membered heteroaryl groups containing three heteroatoms include, without limitation, triazolyl, oxadiazolyl, and thiadiazolyl. Exemplary 5-membered heteroaryl groups containing four heteroatoms include, without limitation, tetrazolyl. Exemplary 6-membered heteroaryl groups containing one heteroatom include, without limitation, pyridinyl. Exemplary 6-membered heteroaryl groups containing two heteroatoms include, without limitation, pyridazinyl, pyrimidinyl, and pyrazinyl. Exemplary 6-membered heteroaryl groups containing three or four heteroatoms include, without limitation, triazinyl and tetrazinyl, respectively. Exemplary 7-membered heteroaryl groups containing one heteroatom include, without limitation, azepinyl, oxepinyl, and thiepinyl. Exemplary 5,6-bicyclic heteroaryl groups include, without limitation, indolyl, isoindolyl, indazolyl, benzotriazolyl, benzothiophenyl, isobenzothiophenyl, benzofuranyl, benzoisofuranyl, benzimidazolyl, benzoxazolyl, benzisoxazolyl, benzoxadiazolyl, benzthiazolyl, benzisothiazolyl, benzthiadiazolyl, indolizinyl, and purinyl. Exemplary 6,6-bicyclic heteroaryl groups include, without limitation, naphthyridinyl, pteridinyl, quinolinyl, isoquinolinyl, cinnolinyl, quinoxalinyl, phthalazinyl, and quinazolinyl.

Examples of representative heteroaryls include the following formulae:

wherein each Y is selected from carbonyl, N, NR65, O, and S; and R65 is independently hydrogen, C1-C8 alkyl, C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, and 5-10 membered heteroaryl.

“Carbocyclyl” or “carbocyclic” refers to a radical of a non-aromatic cyclic hydrocarbon group having from 3 to 10 ring carbon atoms (“C3-10 carbocyclyl”) and zero heteroatoms in the non-aromatic ring system. In some embodiments, a carbocyclyl group has 3 to 8 ring carbon atoms (“C3-8 carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 6 ring carbon atoms (“C3-6 carbocyclyl”). In some embodiments, a carbocyclyl group has 3 to 6 ring carbon atoms (“C3-6 carbocyclyl”). In some embodiments, a carbocyclyl group has 5 to 10 ring carbon atoms (“C5-10 carbocyclyl”). Exemplary C3-6 carbocyclyl groups include, without limitation, cyclopropyl (C3), cyclopropenyl (C3), cyclobutyl (C4), cyclobutenyl (C4), cyclopentyl (C5), cyclopentenyl (C5), cyclohexyl (C6), cyclohexenyl (C6), cyclohexadienyl (C6), and the like. Exemplary C3-8 carbocyclyl groups include, without limitation, the aforementioned C3-6 carbocyclyl groups as well as cycloheptyl (C7), cycloheptenyl (C7), cycloheptadienyl (C7), cycloheptatrienyl (C7), cyclooctyl (C8), cyclooctenyl (C8), bicyclo[2.2.1]heptanyl (C7), bicyclo[2.2.2]octanyl (C8), and the like. Exemplary C3-10 carbocyclyl groups include, without limitation, the aforementioned C3-8 carbocyclyl groups as well as cyclononyl (C9), cyclononenyl (C9), cyclodecyl (C10), cyclodecenyl (C10), octahydro-1H-indenyl (C9), decahydronaphthalenyl (C10), spiro[4.5]decanyl (C10), and the like. As the foregoing examples illustrate, in certain embodiments, the carbocyclyl group is either monocyclic (“monocyclic carbocyclyl”) or contain a fused, bridged or spiro ring system such as a bicyclic system (“bicyclic carbocyclyl”) and can be saturated or can be partially unsaturated. “Carbocyclyl” also includes ring systems wherein the carbocyclyl ring, as defined above, is fused with one or more aryl or heteroaryl groups wherein the point of attachment is on the carbocyclyl ring, and in such instances, the number of carbons continue to designate the number of carbons in the carbocyclic ring system. Unless otherwise specified, each instance of a carbocyclyl group is independently optionally substituted, i.e., unsubstituted (an “unsubstituted carbocyclyl”) or substituted (a “substituted carbocyclyl”) with one or more substituents. In certain embodiments, the carbocyclyl group is unsubstituted C3-10 carbocyclyl. In certain embodiments, the carbocyclyl group is a substituted C3-10 carbocyclyl.

In some embodiments, “carbocyclyl” is a monocyclic, saturated carbocyclyl group having from 3 to 10 ring carbon atoms (“C3-10 cycloalkyl”). In some embodiments, a cycloalkyl group has 3 to 8 ring carbon atoms (“C3-8 cycloalkyl”). In some embodiments, a cycloalkyl group has 3 to 6 ring carbon atoms (“C3-6 cycloalkyl”). In some embodiments, a cycloalkyl group has 5 to 6 ring carbon atoms (“C5-6 cycloalkyl”). In some embodiments, a cycloalkyl group has 5 to 10 ring carbon atoms (“C5-10 cycloalkyl”). Examples of C5-6 cycloalkyl groups include cyclopentyl (C5) and cyclohexyl (C5). Examples of C3-6 cycloalkyl groups include the aforementioned C5-6 cycloalkyl groups as well as cyclopropyl (C3) and cyclobutyl (C4). Examples of C3-8 cycloalkyl groups include the aforementioned C3-6 cycloalkyl groups as well as cycloheptyl (C7) and cyclooctyl (C8). Unless otherwise specified, each instance of a cycloalkyl group is independently unsubstituted (an “unsubstituted cycloalkyl”) or substituted (a “substituted cycloalkyl”) with one or more substituents. In certain embodiments, the cycloalkyl group is unsubstituted C3-10 cycloalkyl. In certain embodiments, the cycloalkyl group is substituted C3-10 cycloalkyl.

“Heterocyclyl” or “heterocyclic” refers to a radical of a 3-to 10-membered non-aromatic ring system having ring carbon atoms and 1 to 4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, sulfur, boron, phosphorus, and silicon (“3-10 membered heterocyclyl”). In heterocyclyl groups that contain one or more nitrogen atoms, the point of attachment can be a carbon or nitrogen atom, as valency permits. A heterocyclyl group can either be monocyclic (“monocyclic heterocyclyl”) or a fused, bridged or spiro ring system such as a bicyclic system (“bicyclic heterocyclyl”), and can be saturated or can be partially unsaturated. Heterocyclyl bicyclic ring systems can include one or more heteroatoms in one or both rings. “Heterocyclyl” also includes ring systems wherein the heterocyclyl ring, as defined above, is fused with one or more carbocyclyl groups wherein the point of attachment is either on the carbocyclyl or heterocyclyl ring, or ring systems wherein the heterocyclyl ring, as defined above, is fused with one or more aryl or heteroaryl groups, wherein the point of attachment is on the heterocyclyl ring, and in such instances, the number of ring members continue to designate the number of ring members in the heterocyclyl ring system. Unless otherwise specified, each instance of heterocyclyl is independently optionally substituted, i.e., unsubstituted (an “unsubstituted heterocyclyl”) or substituted (a “substituted heterocyclyl”) with one or more substituents. In certain embodiments, the heterocyclyl group is unsubstituted 3-10 membered heterocyclyl. In certain embodiments, the heterocyclyl group is substituted 3-10 membered heterocyclyl.

In some embodiments, a heterocyclyl group is a 5-10 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, sulfur, boron, phosphorus, and silicon (“5-10 membered heterocyclyl”). In some embodiments, a heterocyclyl group is a 5-8 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-8 membered heterocyclyl”). In some embodiments, a heterocyclyl group is a 5-6 membered non-aromatic ring system having ring carbon atoms and 1-4 ring heteroatoms, wherein each heteroatom is independently selected from nitrogen, oxygen, and sulfur (“5-6 membered heterocyclyl”). In some embodiments, the 5-6 membered heterocyclyl has 1-3 ring heteroatoms selected from nitrogen, oxygen, and sulfur. In some embodiments, the 5-6 membered heterocyclyl has 1-2 ring heteroatoms selected from nitrogen, oxygen, and sulfur. In some embodiments, the 5-6 membered heterocyclyl has one ring heteroatom selected from nitrogen, oxygen, and sulfur.

Exemplary 3-membered heterocyclyl groups containing one heteroatom include, without limitation, azirdinyl, oxiranyl, thiorenyl. Exemplary 4-membered heterocyclyl groups containing one heteroatom include, without limitation, azetidinyl, oxetanyl and thietanyl. Exemplary 5-membered heterocyclyl groups containing one heteroatom include, without limitation, tetrahydrofuranyl, dihydrofuranyl, tetrahydrothiophenyl, dihydrothiophenyl, pyrrolidinyl, dihydropyrrolyl and pyrrolyl-2,5-dione. Exemplary 5-membered heterocyclyl groups containing two heteroatoms include, without limitation, dioxolanyl, oxasulfuranyl, disulfuranyl, and oxazolidin-2-one. Exemplary 5-membered heterocyclyl groups containing three heteroatoms include, without limitation, triazolinyl, oxadiazolinyl, and thiadiazolinyl. Exemplary 6-membered heterocyclyl groups containing one heteroatom include, without limitation, piperidinyl, tetrahydropyranyl, dihydropyridinyl, and thianyl. Exemplary 6-membered heterocyclyl groups containing two heteroatoms include, without limitation, piperazinyl, morpholinyl, dithianyl, dioxanyl. Exemplary 6-membered heterocyclyl groups containing two heteroatoms include, without limitation, triazinanyl. Exemplary 7-membered heterocyclyl groups containing one heteroatom include, without limitation, azepanyl, oxepanyl and thiepanyl. Exemplary 8-membered heterocyclyl groups containing one heteroatom include, without limitation, azocanyl, oxecanyl and thiocanyl. Exemplary 5-membered heterocyclyl groups fused to a C6 aryl ring (also referred to herein as a 5,6-bicyclic heterocyclic ring) include, without limitation, indolinyl, isoindolinyl, dihydrobenzofuranyl, dihydrobenzothienyl, benzoxazolinonyl, and the like. Exemplary 6-membered heterocyclyl groups fused to an aryl ring (also referred to herein as a 6,6-bicyclic heterocyclic ring) include, without limitation, tetrahydroquinolinyl, tetrahydroisoquinolinyl, and the like.

Particular examples of heterocyclyl groups are shown in the following illustrative examples:

wherein each W is selected from CR67, C(R67)2, NR67, O, and S; and each Y is selected from NR67, O, and S; and R67 is independently hydrogen, C1-C8 alkyl, C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, and 5-10-membered heteroaryl. These heterocyclyl rings may be optionally substituted with one or more groups selected from the group consisting of acyl, acylamino, acyloxy, alkoxy, alkoxycarbonyl, alkoxycarbonylamino, amino, substituted amino, aminocarbonyl (e.g., amido), aminocarbonylamino, aminosulfonyl, sulfonylamino, aryl, aryloxy, azido, carboxyl, cyano, cycloalkyl, halogen, hydroxy, keto, nitro, thiol, —S-alkyl, —S-aryl, —S(O)-alkyl, —S(O)-aryl, —S(O)2-alkyl, and —S(O)2-aryl. Substituting groups include carbonyl or thiocarbonyl which provide, for example, lactam and urea derivatives.

“Acyl” refers to a radical —C(O)R20, where R20 is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, substituted or unsubstituted carbocyclyl, substituted or unsubstituted heterocyclyl, substituted or unsubstituted aryl, or substituted or unsubstituted heteroaryl, as defined herein. “Alkanoyl” is an acyl group wherein R20 is a group other than hydrogen. Representative acyl groups include, but are not limited to, formyl (—CHO), acetyl (—C(═O)CH3), cyclohexylcarbonyl, cyclohexylmethylcarbonyl, benzoyl (—C(═O)Ph), benzylcarbonyl (—C(═O)CH2Ph), —C(O)—C1-C8 alkyl, —C(O)—(CH2)t(C6-C10 aryl), —C(O)—(CH2)t(5-10 membered heteroaryl), —C(O)—(CH2)t(C3-C10 cycloalkyl), and —C(O)—(CH2)t(4-10 membered heterocyclyl), wherein t is an integer from 0 to 4. In certain embodiments, R21 is C1-C8 alkyl, substituted with halo or hydroxy; or C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, arylalkyl, 5-10 membered heteroaryl or heteroarylalkyl, each of which is substituted with unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy.

“Acylamino” refers to a radical —NR22C(O)R23, where each instance of R22 and R23 is independently hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, substituted or unsubstituted carbocyclyl, substituted or unsubstituted heterocyclyl, substituted or unsubstituted aryl, or substituted or unsubstituted heteroaryl, as defined herein, or R22 is an amino protecting group. Exemplary “acylamino” groups include, but are not limited to, formylamino, acetylamino, cyclohexylcarbonylamino, cyclohexylmethyl-carbonylamino, benzoylamino and benzylcarbonylamino. Particular exemplary “acylamino” groups are —NR24C(O)—C1-C8 alkyl, —NR24C(O)—(CH2)t(C6-C10 aryl), —NR24C(O)—(CH2)t(5-10 membered heteroaryl), —NR24C(O)—(CH2)t(C3-C10 cycloalkyl), and —NR24C(O)—(CH2)t(4-10 membered heterocyclyl), wherein t is an integer from 0 to 4, and each R24 independently represents hydrogen or C1-C8 alkyl. In certain embodiments, R25 is H, C1-C8 alkyl, substituted with halo or hydroxy; C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, arylalkyl, 5-10 membered heteroaryl or heteroarylalkyl, each of which is substituted with unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy; and R26 is H, C1-C8 alkyl, substituted with halo or hydroxy; C3-C10 cycloalkyl, 4-10-membered heterocyclyl, C6-C10 aryl, arylalkyl, 5-10-membered heteroaryl or heteroarylalkyl, each of which is substituted with unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy; provided at least one of R25 and R26 is other than H.

“Acyloxy” refers to a radical —OC(O)R27, where R27 is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, substituted or unsubstituted carbocyclyl, substituted or unsubstituted heterocyclyl, substituted or unsubstituted aryl, or substituted or unsubstituted heteroaryl, as defined herein. Representative examples include, but are not limited to, formyl, acetyl, cyclohexylcarbonyl, cyclohexylmethylcarbonyl, benzoyl, and benzylcarbonyl. In certain embodiments, R28 is C1-C8 alkyl, substituted with halo or hydroxy; C3-C10 cycloalkyl, 4-10-membered heterocyclyl, C6-C10 aryl, arylalkyl, 5-10-membered heteroaryl or heteroarylalkyl, each of which is substituted with unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy.

“Alkoxy” refers to the group —OR29 where R29 is substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, substituted or unsubstituted carbocyclyl, substituted or unsubstituted heterocyclyl, substituted or unsubstituted aryl, or substituted or unsubstituted heteroaryl. Particular alkoxy groups are methoxy, ethoxy, n-propoxy, isopropoxy, n-butoxy, tert-butoxy, sec-butoxy, n-pentoxy, n-hexoxy, and 1,2-dimethylbutoxy. Particular alkoxy groups are lower alkoxy, i.e., with between 1 and 6 carbon atoms. Further particular alkoxy groups have between 1 and 4 carbon atoms.

In certain embodiments, R29 is a group that has 1 or more substituents, for instance from 1 to 5 substituents, and particularly from 1 to 3 substituents, in particular 1 substituent, selected from the group consisting of amino, substituted amino, C6-C10 aryl, aryloxy, carboxyl, cyano, C3-C10 cycloalkyl, 4-10 membered heterocyclyl, halogen, 5-10 membered heteroaryl, hydroxy, nitro, thioalkoxy, thioaryloxy, thiol, alkyl-S(O)—, aryl-S(O)—, alkyl-S(O)2—and aryl-S(O)2—. Exemplary “substituted alkoxy” groups include, but are not limited to, —O—(CH2)t(C6-C10 aryl), —O—(CH2)t(5-10 membered heteroaryl), —O—(CH2)t(C3-C10 cycloalkyl), and —O—(CH2)t(4-10 membered heterocyclyl), wherein t is an integer from 0 to 4 and any aryl, heteroaryl, cycloalkyl or heterocyclyl groups present, may themselves be substituted by unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy. Particular exemplary ‘substituted alkoxy’ groups are —OCF3, —OCH2CF3, —OCH2Ph, —OCH2-cyclopropyl, —OCH2CH2OH, and —OCH2CH2NMe2.

“Amino” refers to the radical —NH2.

“Substituted amino” refers to an amino group of the formula —N(R38)2 wherein R38 is hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, substituted or unsubstituted carbocyclyl, substituted or unsubstituted heterocyclyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, or an amino protecting group, wherein at least one of R38 is not a hydrogen. In certain embodiments, each R38 is independently selected from hydrogen, C1-C8 alkyl, C3-C8 alkenyl, C3-C8 alkynyl, C6-C10 aryl, 5-10 membered heteroaryl, 4-10 membered heterocyclyl, or C3-C10 cycloalkyl; or C1-C8 alkyl, substituted with halo or hydroxy; C3-C8 alkenyl, substituted with halo or hydroxy; C3-C8 alkynyl, substituted with halo or hydroxy, or —(CH2)t(C6-C10 aryl), —(CH2)t(5-10 membered heteroaryl), —(CH2)t(C3-C10 cycloalkyl), or —(CH2)t(4-10 membered heterocyclyl), wherein t is an integer between 0 and 8, each of which is substituted by unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy; or both R38 groups are joined to form an alkylene group.

Exemplary “substituted amino” groups include, but are not limited to, —NR39—C1-C8 alkyl, —NR39—(CH2)t(C6-C10 aryl), —NR39—(CH2)t(5-10 membered heteroaryl), —NR39—(CH2)t(C3-C10 cycloalkyl), and —NR39—(CH2)t(4-10 membered heterocyclyl), wherein t is an integer from 0 to 4, for instance 1 or 2, each R39 independently represents hydrogen or C1-C8 alkyl; and any alkyl groups present, may themselves be substituted by halo, substituted or unsubstituted amino, or hydroxy; and any aryl, heteroaryl, cycloalkyl, or heterocyclyl groups present, may themselves be substituted by unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy. For the avoidance of doubt the term ‘substituted amino’ includes the groups alkylamino, substituted alkylamino, alkylarylamino, substituted alkylarylamino, arylamino, substituted arylamino, dialkylamino, and substituted dialkylamino as defined below. Substituted amino encompasses both monosubstituted amino and disubstituted amino groups.

“Azido” refers to the radical —N3.

“Carbamoyl” or “amido” refers to the radical —C(O)NH2.

“Substituted carbamoyl” or “substituted amido” refers to the radical —C(O)N(R62)2 wherein each R62 is independently hydrogen, substituted or unsubstituted alkyl, substituted or unsubstituted alkenyl, substituted or unsubstituted alkynyl, substituted or unsubstituted carbocyclyl, substituted or unsubstituted heterocyclyl, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, or an amino protecting group, wherein at least one of R62 is not a hydrogen. In certain embodiments, R62 is selected from H, C1-C8 alkyl, C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, and 5-10 membered heteroaryl; or C1-C8 alkyl substituted with halo or hydroxy; or C3-C10 cycloalkyl, 4-10 membered heterocyclyl, C6-C10 aryl, or 5-10 membered heteroaryl, each of which is substituted by unsubstituted C1-C4 alkyl, halo, unsubstituted C1-C4 alkoxy, unsubstituted C1-C4 haloalkyl, unsubstituted C1-C4 hydroxyalkyl, or unsubstituted C1-C4 haloalkoxy or hydroxy; provided that at least one R62 is other than H.

“Carboxy” refers to the radical —C(O)OH.

“Cyano” refers to the radical —CN.

“Nitro” refers to the radical —NO2.

“Ethenyl” refers to substituted or unsubstituted —(C═C)—. “Ethylene” refers to substituted or unsubstituted —(C—C)—. “Ethynyl” refers to —(C≡C)—.

“Nitrogen-containing heterocyclyl” group means a 4-to 7-membered non-aromatic cyclic group containing at least one nitrogen atom, for example, but without limitation, morpholine, piperidine (e.g. 2-piperidinyl, 3-piperidinyl and 4-piperidinyl), pyrrolidine (e.g. 2-pyrrolidinyl and 3-pyrrolidinyl), azetidine, pyrrolidone, imidazoline, imidazolidinone, 2-pyrazoline, pyrazolidine, piperazine, and N-alkyl piperazines such as N-methyl piperazine. Particular examples include azetidine, piperidone and piperazone.

Alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl groups, as defined herein, are optionally substituted (e.g., “substituted” or “unsubstituted” alkyl, “substituted” or “unsubstituted” alkenyl, “substituted” or “unsubstituted” alkynyl, “substituted” or “unsubstituted” carbocyclyl, “substituted” or “unsubstituted” heterocyclyl, “substituted” or “unsubstituted” aryl or “substituted” or “unsubstituted” heteroaryl group). In general, the term “substituted”, whether preceded by the term “optionally” or not, means that at least one hydrogen present on a group (e.g., a carbon or nitrogen atom) is replaced with a permissible substituent, e.g., a substituent which upon substitution results in a stable compound, e.g., a compound which does not spontaneously undergo transformation such as by rearrangement, cyclization, elimination, or other reaction. Unless otherwise indicated, a “substituted” group has a substituent at one or more substitutable positions of the group, and when more than one position in any given structure is substituted, the substituent is either the same or different at each position. The term “substituted” is contemplated to include substitution with all permissible substituents of organic compounds, any of the substituents described herein that results in the formation of a stable compound. The present invention contemplates any and all such combinations in order to arrive at a stable compound. For purposes of this invention, heteroatoms such as nitrogen may have hydrogen substituents and/or any suitable substituent as described herein which satisfy the valencies of the heteroatoms and results in the formation of a stable moiety.

Exemplary carbon atom substituents include, but are not limited to, halogen, —CN, —NO2, —N3, —SO2H, —SO3H, —OH, —ORaa, —ON(Rbb)2, —N(Rbb)2, —N(Rbb)3+X, —N(ORcc)Rbb, —SH, —SRaa, —SSRcc, —C(═O)Raa, —CO2H, —CHO, —C(ORcc)2, —CO2Raa, —OC(═O)Raa, —OCO2Raa, —C(═O)N(Rbb)2, —OC(═O)N(Rbb)2, —NRbbC(═O)Raa, —NRbbCO2Raa, —NRbbC(═O)N(Rbb)2, —C(═NRbb)Raa, —C(═NRbb)ORaa, —OC(═NRbb)ORaa, —OC(═NRbb)ORaa, —C(═NRbb)N(Bbb)2, —OC(═NRbb)N(Rbb)2, —NRbbC(═NRbb)N(Rbb)2, —C(═O)NRbbSO2Raa, —NRbbSO2Raa, —SO2N(Rbb)2, —SO2Raa, —SO2ORaa, —OSO2Raa, —S(═O)Raa, —OS(═O)Raa, —Si(Raa)3, —OSi(Raa)3—C(═S)N(Rbb)2, —C(═O)SRaa, —C(═S)SRaa, —SC(═S)SRaa, —SC(═O)SRaa, —OC(═O)SRaa, —SC(═O)ORaa, —SC(═O)Raa, —P(═O)2Raa, —OP(═O)2Raa, —P(═O)(Raa)2, —OP(═O)(Raa)2, —OP(═O)(ORcc)2, —P(═O)2N(Rbb)2, —OP(═O)2N(Rbb)2, —P(═O)(NRbb)2, —OP(═O)(NRbb)2, —NRbbP(═O)(ORcc)2, —NRbbP(═O)(NRbb)2, —P(Rcc)2, —P(Rcc)3, —OP(Rcc)2, —OP(Rcc)3, —B(Raa)2, —B(ORcc)2, —BRaa(ORcc), C1-10 alkyl, C1-10 perhaloalkyl, C2-10 alkenyl, C2-10 alkynyl, C3-10 carbocyclyl, 3-14 membered heterocyclyl, C6-14 aryl, and 5-14 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rdd groups;

each instance of Raa is, independently, selected from C1-10 alkyl, C1-10 perhaloalkyl, C2-10 alkenyl, C2-10 alkynyl, C3-10 carbocyclyl, 3-14 membered heterocyclyl, C6-14 aryl, and 5-14 membered heteroaryl, or two Raa groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rdd groups;

each instance of Rbb is, independently, selected from hydrogen, —OH, —ORaa, —N(Rcc)2, —CN, —C(═O)Raa, —C(═O)N(Rcc)2, —CO2Raa, —SO2Raa, —C(═NRcc)ORaa, —C(═NRcc)N(Rcc)2, —SO2N(Rcc)2, —SO2Rcc, —SO2ORcc, —SORaa, —C(═S)N(Rcc)2, —C(═O)SRcc, —C(═S)SRcc, —P(═O)2Raa, —P(═O)(Raa)2, —P(═O)2N(Rcc)2, —P(═O)(NRcc)2, C1-10 alkyl, C1-10 perhaloalkyl, C2-10 alkenyl, C2-10 alkynyl, C3-10 carbocyclyl, 3-14 membered heterocyclyl, C6-14 aryl, and 5-14 membered heteroaryl, or two Rbb groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rdd groups;

each instance of Rcc is, independently, selected from hydrogen, C1-10 alkyl, C1-10 perhaloalkyl, C2-10 alkenyl, C2-10 alkynyl, C3-10 carbocyclyl, 3-14 membered heterocyclyl, C6-14 aryl, and 5-14 membered heteroaryl, or two Rcc groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rdd groups;

each instance of Rdd is, independently, selected from halogen, —CN, —NO2, —N3, —SO2H, —SO3H, —OH, —ORcc, —ON(Rff)2, —N(Rff)2, —N(Rff)3+X, —N(ORee)Rff, —SH, —SRee, —SSRee, —C(═O)Ree, —CO2H, —CO2Ree, —OC(═O)Ree, —OCO2Ree, —C(═O)N(Rff)2, —OC(═O)N(Rff)2, —NRffC(═O)Ree, —NRffCO2Ree, —NRffC(═O)N(Rff)2, —C(═NRff)ORee, —OC(═NRff)Ree, —OC(═NRff)ORee, —C(═NRff)N(Rff)2, —OC(═NRff)N(Rff)2, —NRffC(═NRff)N(Rff)2, —NRffSO2Ree, —SO2N(Rff)2, —SO2Ree, —SO2ORee, —OSO2Ree, —S(═O)Ree, —Si(Ree)3, —OSi(Ree)3, —C(═S)N(Rff)2, —C(═O)SRee, —C(═S)SRee, —SC(═S)SRee, —P(═O)2Ree, —P(═O)(Ree)2, —OP(═O)(Ree)2, —OP(═O)(ORee)2, C1-6 alkyl, C1-6 perhaloalkyl, C2-6 alkenyl, C2-6 alkynyl, C3-10 carbocyclyl, 3-10 membered heterocyclyl, C6-10 aryl, 5-10 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rgg groups;

each instance of Ree is, independently, selected from C1-6 alkyl, C1-6 perhaloalkyl, C2-6 alkenyl, C2-6 alkynyl, C3-10 carbocyclyl, C6-10 aryl, 3-10 membered heterocyclyl, and 3-10 membered heteroaryl, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rgg groups;

each instance of Rff is, independently, selected from hydrogen, C1-6 alkyl, C1-6 perhaloalkyl, C2-6 alkenyl, C2-6 alkynyl, C3-10 carbocyclyl, 3-10 membered heterocyclyl, C6-10 aryl and 5-10 membered heteroaryl, or two Rff groups are joined to form a 3-14 membered heterocyclyl or 5-14 membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rgg groups; and

each instance of Rgg is, independently, halogen, —CN, —NO2, —N3, —SO2H, —SO3H, —OH, —OC1-6 alkyl, —ON(C1-6 alkyl)2, —N(C1-6 alkyl)2, —N(C1-6 alkyl)3+X, —NH(C1-6 alkyl)2+X, —NH2(C1-6 alkyl)+X, —NH3+X, —N(OC1-6 alkyl)(C1-6 alkyl), —N(OH)(C1-6 alkyl), —NH(OH), —SH, —SC1-6 alkyl, —SS(C1-6 alkyl), —C(═O)(C1-6 alkyl), —CO2H, —OC2(C1-6 alkyl), —OC(═O)(C1-6 alkyl), —OCO2(C1-6 alkyl), —C(═O)NH2, —C(═O)N(C1-6 alkyl)2, —OC(═O)NH(C1-6 alkyl), —NHC(═O)(C1-6 alkyl), —N(C1-6 alkyl)C(═O)(C1-6 alkyl), —NHCO2(C1-6 alkyl), —NHC(═O)N(C1-6 alkyl)2, —NHC(═O)NH(C1-6 alkyl), —NHC(═O)NH2, —C(═NH)O(C1-6 alkyl), —OC(═NH)(C1-6 alkyl), —OC(═NH)OC1-6 alkyl, —C(═NH)N(C1-6 alkyl)2, —C(═NH)NH(C1-6 alkyl), —C(═NH)NH2, —OC(═NH)N(C1-6 alkyl)2, —OC(NH)NH(C1-6 alkyl), —OC(NH)NH2, —NHC(NH)N(C1-6 alkyl)2, —NHC(═NH)NH2, —NHSO2(C1-6 alkyl), —SO2N(C1-6 alkyl)2, —SO2NH(C1-6 alkyl), —SO2NH2, —SO2C1-6 alkyl, —SO2OC1-6 alkyl, —OSO2C1-6 alkyl, —SOC1-6 alkyl, —Si(C1-6 alkyl)3, —OSi(C1-6 alkyl)3-C(═S)N(C1-6 alkyl)2, C(═S)NH(C1-6 alkyl), C(═S)NH2, —C(═O)S(C1-6 alkyl), —C(═S)SC1-6 alkyl, —SC(═S)SC1-6 alkyl, —P(═O)2(C1-6 alkyl), —P(═O)(C1-6 alkyl)2, —OP(═O)(C1-6 alkyl)2, —OP(═O)(OC1-6 alkyl)2, C1-6 alkyl, C1-6 perhaloalkyl, C2-6 alkenyl, C2-6 alkynyl, C3-10 carbocyclyl, C6-10 aryl, 3-10 membered heterocyclyl, 5-10 membered heteroaryl; wherein Xis a counterion.

A “counterion” or “anionic counterion” is a negatively charged group associated with a cationic quaternary amino group in order to maintain electronic neutrality. Exemplary counterions include halide ions (e.g., F, Cl, Br, I), NO3, ClO4, OH, H2PO4, HSO4, sulfonate ions (e.g., methanesulfonate, trifluoromethanesulfonate, p-toluenesulfonate, benzenesulfonate, 10-camphor sulfonate, naphthalene-2-sulfonate, naphthalene-1-sulfonic acid-5-sulfonate, ethan-1-sulfonic acid-2-sulfonate, and the like), and carboxylate ions (e.g., acetate, ethanoate, propanoate, benzoate, glycerate, lactate, tartrate, glycolate, and the like).

Nitrogen atoms can be substituted or unsubstituted as valency permits, and include primary, secondary, tertiary, and quaternary nitrogen atoms. Exemplary nitrogen atom substitutents include, but are not limited to, hydrogen, —OH, —ORaa, —N(Rcc)2, —CN, —C(═O)Raa, —C(═O)N(Rcc)2, —CO2Raa, —SO2Raa, —C(═NRbb)Raa, —C(═NRcc)ORaa, —C(═NRcc)N(Rcc)2, —SO2N(Rcc)2, —SO2Rcc, —SO2ORcc, —SORaa, —C(═S)N(Rcc)2, —C(═O)SRcc, —C(═S)SRcc, —P(═O)2Raa, —P(═O)(Raa)2, —P(═O)2N(Rcc)2, —P(═O)(NRcc)2, C1-10 alkyl, C1-10 perhaloalkyl, C2-10 alkenyl, C2-10 alkynyl, C3-10 carbocyclyl, 3-14 membered heterocyclyl, C6-14 aryl, and 5-14-membered heteroaryl, or two Rcc groups attached to a nitrogen atom are joined to form a 3-14-membered heterocyclyl or 5-14-membered heteroaryl ring, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rdd groups, and wherein Raa, Rbb, Rcc and Rdd are as defined above.

In certain embodiments, the substituent present on a nitrogen atom is an amino protecting group (also referred to herein as a nitrogen protecting group). Amino protecting groups include, but are not limited to, —OH, —ORaa, —N(Rcc)2, —C(═O)Raa, —C(═O)ORaa, —C(═O)N(Rcc)2, —S(═O)2Raa, —C(═NRcc)Raa, —C(═NRcc)ORaa, —C(═NRcc)N(Rcc)2, —SO2N(Rcc)2, —SO2Rcc, —SO2ORcc, —SORaa, —C(═S)N(Rcc)2, —C(═O)SRcc, —C(═S)SRcc, C1-10 alkyl, C2-10 alkenyl, C2-10 alkynyl, C3-10 carbocyclyl, 3-14-membered heterocyclyl, C6-14 aryl, and 5-14-membered heteroaryl groups, wherein each alkyl, alkenyl, alkynyl, carbocyclyl, heterocyclyl, aryl, and heteroaryl is independently substituted with 0, 1, 2, 3, 4, or 5 Rdd groups, and wherein Raa, Rbb, Rcc and Rdd are as defined herein. Amino protecting groups are well known in the art and include those described in detail in Protecting Groups in Organic Synthesis, T. W. Greene and P. G. M. Wuts, 3rd edition, John Wiley & Sons, 1999, incorporated herein by reference.

Exemplary amino protecting groups include, but are not limited to amide groups (e.g., —C(═O)Raa), which include, but are not limited to, formamide and acetamide; carbamate groups (e.g., —C(═O)ORaa), which include, but are not limited to, 9-fluorenylmethyl carbamate (Fmoc), t-butyl carbamate (BOC), and benzyl carbamate (Cbz); sulfonamide groups (e.g., —S(═O)2Raa), which include, but are not limited to, p-toluenesulfonamide (Ts), methanesulfonamide (Ms), and N-[2-(trimethylsilyl)ethoxy]methylamine (SEM).

In certain embodiments, the substituent present on an oxygen atom is an oxygen protecting group (also referred to as a hydroxyl protecting group). Oxygen protecting groups include, but are not limited to, —Raa, —N(Rbb)2, —C(═O)SRaa, —C(═O)Raa, —CO2Raa, —C(═O)N(Rbb)2, —C(═NRbb)Raa, —C(═NRbb)ORaa, —C(═NRbb)N(Rbb)2, —S(═O)Raa, —SO2Raa, —Si(Raa)3, —P(Rcc)2, —P(Rcc)3, —P(═O)2Raa, —P(═O)(Raa)2, —P(═O)(ORcc)2, —P(═O)2N(Rbb)2, and —P(═O)(NRbb)2, wherein Raa, Rbb, and Rcc are as defined herein. Oxygen protecting groups are well known in the art and include those described in detail in Protecting Groups in Organic Synthesis, T. W. Greene and P. G. M. Wuts, 3rd edition, John Wiley & Sons, 1999, incorporated herein by reference.

Exemplary oxygen protecting groups include, but are not limited to, methyl, methoxylmethyl (MOM), 2-methoxyethoxymethyl (MEM), benzyl (Bn), triisopropylsilyl (TIPS), t-butyldimethylsilyl (TBDMS), t-butylmethoxyphenylsilyl (TBMPS), methanesulfonate (mesylate), and tosylate (Ts).

In certain embodiments, the substituent present on an sulfur atom is an sulfur protecting group (also referred to as a thiol protecting group). Sulfur protecting groups include, but are not limited to, —Raa, —N(Rbb)2, —C(═O)SRaa, —C(═O)Raa, —CO2Raa, —C(═O)N(Rbb)2, —C(═NRbb)Raa, —C(═NRbb)ORaa, —C(═NRbb)N(Rbb)2, —S(═O)Raa, —SO2Raa, —Si(Raa)3, —P(Rcc)2, —P(Rcc)3, —P(═O)2Raa, —P(═O)(Raa)2, —P(═O)(ORcc)2, —P(═O)2N(Rbb)2, and —P(═O)(NRbb)2, wherein Raa, Rbb, and Rcc are as defined herein. Sulfur protecting groups are well known in the art and include those described in detail in Protecting Groups in Organic Synthesis, T. W. Greene and P. G. M. Wuts, 3rd edition, John Wiley & Sons, 1999, incorporated herein by reference.

These and other exemplary substituents are described in more detail in the Detailed Description, Examples, and Claims. The invention is not intended to be limited in any manner by the above exemplary listing of substituents.

Other Definitions

As used herein, the term “modulation” refers to the inhibition or potentiation of GABA receptor function. A “modulator” (e.g., a modulator compound) may be, for example, an agonist, partial agonist, antagonist, or partial antagonist of the GABA receptor.

“Pharmaceutically acceptable” means approved or approvable by a regulatory agency of the Federal or a state government or the corresponding agency in countries other than the United States, or that is listed in the U.S. Pharmacopoeia or other generally recognized pharmacopoeia for use in animals, and more particularly, in humans.

“Pharmaceutically acceptable salt” refers to a salt of a compound of the invention that is pharmaceutically acceptable and that possesses the desired pharmacological activity of the parent compound. In particular, such salts are non-toxic may be inorganic or organic acid addition salts and base addition salts. Specifically, such salts include: (1) acid addition salts, formed with inorganic acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, and the like; or formed with organic acids such as acetic acid, propionic acid, hexanoic acid, cyclopentanepropionic acid, glycolic acid, pyruvic acid, lactic acid, malonic acid, succinic acid, malic acid, maleic acid, fumaric acid, tartaric acid, citric acid, benzoic acid, 3-(4-hydroxybenzoyl) benzoic acid, cinnamic acid, mandelic acid, methanesulfonic acid, ethanesulfonic acid, 1,2-ethane-disulfonic acid, 2-hydroxyethanesulfonic acid, benzenesulfonic acid, 4-chlorobenzenesulfonic acid, 2-naphthalenesulfonic acid, 4-toluenesulfonic acid, camphorsulfonic acid, 4-methylbicyclo[2.2.2]-oct-2-ene-1-carboxylic acid, glucoheptonic acid, 3-phenylpropionic acid, trimethylacetic acid, tertiary butylacetic acid, lauryl sulfuric acid, gluconic acid, glutamic acid, hydroxynaphthoic acid, salicylic acid, stearic acid, muconic acid, and the like; or (2) salts formed when an acidic proton present in the parent compound either is replaced by a metal ion, e.g., an alkali metal ion, an alkaline earth ion, or an aluminum ion; or coordinates with an organic base such as ethanolamine, diethanolamine, triethanolamine, N-methylglucamine and the like. Salts further include, by way of example only, sodium, potassium, calcium, magnesium, ammonium, tetraalkylammonium, and the like; and when the compound contains a basic functionality, salts of non-toxic organic or inorganic acids, such as hydrochloride, hydrobromide, tartrate, mesylate, acetate, maleate, oxalate and the like. The term “pharmaceutically acceptable cation” refers to an acceptable cationic counter-ion of an acidic functional group. Such cations are exemplified by sodium, potassium, calcium, magnesium, ammonium, tetraalkylammonium cations, and the like. See, e.g., Berge, et al., J. Pharm. Sci. (1977) 66(1): 1-79.

“Solvate” refers to forms of the compound that are associated with a solvent or water (also referred to as “hydrate”), usually by a solvolysis reaction. This physical association includes hydrogen bonding. Conventional solvents include water, ethanol, acetic acid, and the like. The compounds of the invention may be prepared e.g. in crystalline form and may be solvated or hydrated. Suitable solvates include pharmaceutically acceptable solvates, such as hydrates, and further include both stoichiometric solvates and non-stoichiometric solvates. In certain instances the solvate will be capable of isolation, for example when one or more solvent molecules are incorporated in the crystal lattice of the crystalline solid. “Solvate” encompasses both solution-phase and isolable solvates. Representative solvates include hydrates, ethanolates and methanolates.

As used herein, the term “isotopic variant” refers to a compound that contains unnatural proportions of isotopes at one or more of the atoms that constitute such compound. For example, an “isotopic variant” of a compound can contain one or more non-radioactive isotopes, such as for example, deuterium (2H or D), carbon-13 (13C), nitrogen-15 (15N), or the like. It will be understood that, in a compound where such isotopic substitution is made, the following atoms, where present, may vary, so that for example, any hydrogen may be 2H/D, any carbon may be 13C, or any nitrogen may be 15N, and that the presence and placement of such atoms may be determined within the skill of the art. Likewise, the invention may include the preparation of isotopic variants with radioisotopes, in the instance for example, where the resulting compounds may be used for drug and/or substrate tissue distribution studies. The radioactive isotopes tritium, i.e., 3H, and carbon-14, i.e., 14C, are particularly useful for this purpose in view of their ease of incorporation and ready means of detection. Further, compounds may be prepared that are substituted with positron emitting isotopes, such as 11C, 18F, 15O, and 13N, and would be useful in Positron Emission Topography (PET) studies for examining substrate receptor occupancy. All isotopic variants of the compounds provided herein, radioactive or not, are intended to be encompassed within the scope of the invention.

“Stereoisomers”: It is also to be understood that compounds that have the same molecular formula but differ in the nature or sequence of bonding of their atoms or the arrangement of their atoms in space are termed “isomers.” Isomers that differ in the arrangement of their atoms in space are termed “stereoisomers.” Stereoisomers that are not mirror images of one another are termed “diastereomers” and those that are non-superimposable mirror images of each other are termed “enantiomers.” When a compound has an asymmetric center, for example, it is bonded to four different groups, a pair of enantiomers is possible. An enantiomer can be characterized by the absolute configuration of its asymmetric center and is described by the R- and S-sequencing rules of Cahn and Prelog, or by the manner in which the molecule rotates the plane of polarized light and designated as dextrorotatory or levorotatory (i.e., as (+) or (−)-isomers respectively). A chiral compound can exist as either individual enantiomer or as a mixture thereof. A mixture containing equal proportions of the enantiomers is called a “racemic mixture”.

“Tautomers” refer to compounds that are interchangeable forms of a particular compound structure, and that vary in the displacement of hydrogen atoms and electrons. Thus, two structures may be in equilibrium through the movement of π electrons and an atom (usually H). For example, enols and ketones are tautomers because they are rapidly interconverted by treatment with either acid or base. Another example of tautomerism is the aci- and nitro-forms of phenylnitromethane, that are likewise formed by treatment with acid or base. Tautomeric forms may be relevant to the attainment of the optimal chemical reactivity and biological activity of a compound of interest.

A “subject” to which administration is contemplated includes, but is not limited to, humans (i.e., a male or female of any age group, e.g., a pediatric subject (e.g, infant, child, adolescent) or adult subject (e.g., young adult, middle-aged adult or senior adult)) and/or a non-human animal, e.g., a mammal such as primates (e.g., cynomolgus monkeys, rhesus monkeys), cattle, pigs, horses, sheep, goats, rodents, cats, and/or dogs. In certain embodiments, the subject is a human. In certain embodiments, the subject is a non-human animal. The terms “human,” “patient,” and “subject” are used interchangeably herein.

Disease, disorder, and condition are used interchangeably herein.

As used herein, and unless otherwise specified, the terms “treat,” “treating” and “treatment” contemplate an action that occurs while a subject is suffering from the specified disease, disorder or condition, which reduces the severity of the disease, disorder or condition, or retards or slows the progression of the disease, disorder or condition (“therapeutic treatment”), and also contemplates an action that occurs before a subject begins to suffer from the specified disease, disorder or condition (“prophylactic treatment”).

In general, the “effective amount” of a compound refers to an amount sufficient to elicit the desired biological response, e.g., to treat a CNS-related disorder, is sufficient to induce anesthesia or sedation. As will be appreciated by those of ordinary skill in this art, the effective amount of a compound of the invention may vary depending on such factors as the desired biological endpoint, the pharmacokinetics of the compound, the disease being treated, the mode of administration, and the age, weight, health, and condition of the subject. An effective amount encompasses therapeutic and prophylactic treatment.

As used herein, and unless otherwise specified, a “therapeutically effective amount” of a compound is an amount sufficient to provide a therapeutic benefit in the treatment of a disease, disorder or condition, or to delay or minimize one or more symptoms associated with the disease, disorder or condition. A therapeutically effective amount of a compound means an amount of therapeutic agent, alone or in combination with other therapies, which provides a therapeutic benefit in the treatment of the disease, disorder or condition. The term “therapeutically effective amount” can encompass an amount that improves overall therapy, reduces or avoids symptoms or causes of disease or condition, or enhances the therapeutic efficacy of another therapeutic agent.

As used herein, and unless otherwise specified, a “prophylactically effective amount” of a compound is an amount sufficient to prevent a disease, disorder or condition, or one or more symptoms associated with the disease, disorder or condition, or prevent its recurrence. A prophylactically effective amount of a compound means an amount of a therapeutic agent, alone or in combination with other agents, which provides a prophylactic benefit in the prevention of the disease, disorder or condition. The term “prophylactically effective amount” can encompass an amount that improves overall prophylaxis or enhances the prophylactic efficacy of another prophylactic agent.

DETAILED DESCRIPTION OF CERTAIN EMBODIMENTS OF THE INVENTION

As generally described herein, provided herein are C21-substituted neuroactive steroids designed, for example, to act as GABA modulators. In certain embodiments, such compounds are envisioned to be useful as therapeutic agents for the inducement of anesthesia and/or sedation in a subject. In certain embodiments, such compounds are envisioned to be useful as therapeutic agents for treating a CNS-related disorder.

Compounds

In one aspect, provided is a compound of Formula (I):

or a pharmaceutically acceptable salt thereof, wherein: each X, Y, and Z is independently CH or N; G is —C(R3a)(R3b)(OR1); R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, heterocyclyl, aryl, or heteroaryl; R2 is C1-C6 alkyl (e.g., C1-C6 haloalkyl), or C1-C6 alkoxy; each of R3a and R3b is independently H, D, or C1-C6 alkyl; Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl or C1-C6 hydroxyalkyl), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf; or two Ra groups, together with the atoms to which they are attached, form a 6-membered aryl or heteroaryl ring; Rb is C1-C6 alkyl, NRcRd, or ORf; each of Rc and Rd is independently H, C1-C6 alkyl, C(O)Re, or C(O)ORf; Re is C1-C6 alkyl or NRgRh; Rf is H or C1-C6 alkyl; each of Rg and Rh is independently H or C1-C6 alkyl; m is 0, 1, or 2; and n is 0, 1, 2, 3, or 4.

In some embodiments, the compound is not selected from a compound of Table 1.

In some embodiments, X is N. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, Y and Z are CH.

In some embodiments, Y is N. In some embodiments, Y is N, and X and Z are CH.

In some embodiments, Z is N. In some embodiments, X and Z are N, and Y is CH. In some embodiments, X, Y, and Z are N.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2. In some embodiments, R1 is —CH3. In some embodiments, R1 is —CH2CH3. In some embodiments, R1 is —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, each of R3a and R3b is independently H or D. In some embodiments, each of R3a and R3b is independently H. In some embodiments, each of R3a and R3b is independently D. In some embodiments, one of R3a and R3b is H, D, or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H. In some embodiments, one of R3a and R3b is D or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is cyano, halogen (e.g., F or Cl), or nitro. In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is NRcRd, wherein Rc and Rd are each independently H or C(O)Re (e.g., C(O)CH3). In some embodiments, Ra is C(O)Re, wherein Re is NRgRh (e.g., NH2). In some embodiments, Ra is C(O)ORf, wherein Rf is H or C1-C6 alkyl (e.g., CH3).

In some embodiments, n is 1 or 2, and Ra is cyano, halogen, nitro, or C1-C6 alkoxy. In some embodiments, n is 2, and Ra is halogen (e.g., F, Cl). In some embodiments, n is 1 and R1 is C1-C6 alkyl. In some embodiments, n is 1 and Ra is substituted C1-C6 alkyl (e.g., —CH2OH).

In some embodiments, n is 2, and two Ra groups, together with the atoms to which they are attached, form a 6-membered aryl or heteroaryl ring (e.g., a phenyl or pyridyl ring). In some embodiments, n is 2, and two Ra groups, together with the atoms to which they are attached, form a 6-membered unsubstituted aryl or unsubstituted heteroaryl ring (e.g., a phenyl or pyridyl ring). In some embodiments, n is 2, and two Ra groups, together with the atoms to which they are attached, form a 6-membered substituted aryl or substituted heteroaryl ring (e.g., a phenyl or pyridyl ring). In some embodiments, the 6-membered substituted aryl or substituted heteroaryl ring (e.g., a phenyl or pyridyl ring) is substituted with cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf.

In some embodiments, the compound of Formula (I) is a compound of Formula (I-a) or (I-b):

In some embodiments, X is N. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, Y and Z are CH.

In some embodiments, Y is N. In some embodiments, Y is N, and X and Z are CH.

In some embodiments, Z is N. In some embodiments, X and Z are N, and Y is CH. In some embodiments, X, Y, and Z are N.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2. In some embodiments, R1 is —CH3. In some embodiments, R1 is —CH2CH3. In some embodiments, R1 is —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, each of R3a and R3b is independently H or D. In some embodiments, each of R3a and R3b is independently H. In some embodiments, each of R3a and R3b is independently D. In some embodiments, one of R3a− and R3b is H, D, or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H. In some embodiments, one of R3a and R3b is D or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is cyano, halogen (e.g., F or Cl), or nitro. In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is NRcRd, wherein Re and Rd are each independently H or C(O)Re (e.g., C(O)CH3). In some embodiments, Ra is C(O)Re, wherein Re is NRgRh (e.g., NH2). In some embodiments, Ra is C(O)ORf, wherein Rf is H or C1-C6 alkyl (e.g., CH3).

In some embodiments, n is 1 or 2, and Ra is cyano, halogen, nitro, or C1-C6 alkoxy. In some embodiments, n is 2, and Ra is halogen (e.g., F, Cl). In some embodiments, n is 1 and R1 is C1-C6 alkyl. In some embodiments, n is 1 and Ra is substituted C1-C6 alkyl (e.g., —CH2OH).

In some embodiments, n is 2, and two Ra groups, together with the atoms to which they are attached, form a 6-membered aryl or heteroaryl ring (e.g., a phenyl or pyridyl ring). In some embodiments, n is 2, and two Ra groups, together with the atoms to which they are attached, form a 6-membered unsubstituted aryl or unsubstituted heteroaryl ring (e.g., a phenyl or pyridyl ring). In some embodiments, n is 2, and two Ra groups, together with the atoms to which they are attached, form a 6-membered substituted aryl or substituted heteroaryl ring (e.g., a phenyl or pyridyl ring). In some embodiments, the 6-membered substituted aryl or substituted heteroaryl ring (e.g., a phenyl or pyridyl ring) is substituted with cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf.

In some embodiments, the compound of Formula (I) is a compound of Formula (I-c):

or a pharmaceutically acceptable salt thereof, wherein: each X, Y, and Z is independently CH or N; R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, or heterocyclyl; R2 is C1-C6 alkyl (e.g., C1-C6 haloalkyl), or C1-C6 alkoxy; Ra is cyano, halogen, C1-C6 alkyl, C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), or S(O)mRb; or two Ra groups, together with the atoms to which they are attached, form a 6-membered aryl or heteroaryl ring; Rb is C1-C6 alkyl; m is 0 or 1; and is 0, 1, 2, 3, or 4.

In some embodiments, X is N. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, Y and Z are CH.

In some embodiments, Y is N. In some embodiments, Y is N, and X and Z are CH.

In some embodiments, Z is N. In some embodiments, X and Z are N, and Y is CH. In some embodiments, X, Y, and Z are N.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), or S(O)mRb. In some embodiments, Ra is cyano or halogen (e.g., F or Cl). In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3).

In some embodiments, n is 1 or 2, and Ra is cyano, halogen, or C1-C6 alkoxy. In some embodiments, n is 2, and Ra is halogen (e.g., F, Cl). In some embodiments, n is 1 and R1 is C1-C6 alkyl. In some embodiments, n is 1 and Ra is substituted C1-C6 alkyl (e.g., —CH2OH).

In some embodiments, the compound of Formula (I) (e.g., a compound of Formula (I-a), (I-b), or (I-c)) is not a compound selected from the group of depicted in Table 1.

TABLE 1

In another aspect, provided is a compound of Formula (II):

or a pharmaceutically acceptable salt thereof, wherein: each X, Y, and Z is independently CH or N; G is —C(R3a)(R3b)(OR1); R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, heterocyclyl, aryl, or heteroaryl; R2 is C1-C6 alkyl (e.g., C1-C6 haloalkyl), or C1-C6 alkoxy; each of R3a and R3b is independently H, D, or C1-C6 alkyl; Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl or C1-C6 hydroxyalkyl), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRh, NRcRd, C(O)Re, or C(O)ORf; Rb is C1-C6 alkyl, NRcRd, or ORf; each of Rc and Rd is independently H, C1-C6 alkyl, C(O)Re, or C(O)ORf; Re is C1-C6 alkyl or NRgRh; Rf is H or C1-C6 alkyl; each of Rg and Rh is independently H or C1-C6 alkyl; m is 0, 1, or 2; and n is 0, 1, 2, 3, or 4.

In some embodiments, X is N. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, Y and Z are CH.

In some embodiments, Y is N. In some embodiments, Y is N, and X and Z are CH.

In some embodiments, Z is N. In some embodiments, X and Z are N, and Y is CH. In some embodiments, X, Y, and Z are N.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2. In some embodiments, R1 is —CH3. In some embodiments, R1 is —CH2CH3. In some embodiments, R1 is —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, each of R3a and R3b is independently H or D. In some embodiments, each of R3a and R3b is independently H. In some embodiments, each of R3a and R3b is independently D. In some embodiments, one of R3a and R3b is H, D, or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H. In some embodiments, one of R3a and R3b is D or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is cyano, halogen (e.g., F or Cl), or nitro. In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is NRcRd, wherein Rc and Rd are each independently H or C(O)Re (e.g., C(O)CH3). In some embodiments, Ra is C(O)Re, wherein Re is NRgRh (e.g., NH2). In some embodiments, Ra is C(O)ORf, wherein Rf is H or C1-C6 alkyl (e.g., CH3).

In some embodiments, n is 1 or 2, and Ra is cyano, halogen, nitro, or C1-C6 alkoxy. In some embodiments, n is 2, and Ra is halogen (e.g., F, Cl). In some embodiments, n is 1 and R1 is C1-C6 alkyl. In some embodiments, n is 1 and Ra is substituted C1-C6 alkyl (e.g., —CH2OH).

In some embodiments, the compound of Formula (II) is a compound of Formula (II-a) or (II-b):

In some embodiments, X is N. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, Y and Z are CH.

In some embodiments, Y is N. In some embodiments, Y is N, and X and Z are CH.

In some embodiments, Z is N. In some embodiments, X and Z are N, and Y is CH. In some embodiments, X, Y, and Z are N.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2. In some embodiments, R1 is —CH3. In some embodiments, R1 is —CH2CH3. In some embodiments, R1 is —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, each of R3a and R3b is independently H or D. In some embodiments, each of R3a and R3b is independently H. In some embodiments, each of R3a and R3b is independently D. In some embodiments, one of R3a and R3b is H, D, or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H. In some embodiments, one of R3a and R3b is D or C1-C6 alkyl (e.g., CH3), and the other of R3a and R3b is H.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, nitro, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is cyano, halogen (e.g., F or Cl), or nitro. In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb, NRcRd, C(O)Re, or C(O)ORf. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is NRcRd, wherein Rc and Rd are each independently H or C(O)Re (e.g., C(O)CH3). In some embodiments, Ra is C(O)Re, wherein Re is NRgRh (e.g., NH2). In some embodiments, Ra is C(O)ORf, wherein Rf is H or C1-C6 alkyl (e.g., CH3).

In some embodiments, n is 1 or 2, and Ra is cyano, halogen, nitro, or C1-C6 alkoxy. In some embodiments, n is 2, and Ra is halogen (e.g., F, Cl). In some embodiments, n is 1 and R1 is C1-C6 alkyl. In some embodiments, n is 1 and Ra is substituted C1-C6 alkyl (e.g., —CH2OH).

In some embodiments, the compound of Formula (II) is a compound of Formula (II-c):

or a pharmaceutically acceptable salt thereof, wherein: each X, Y, and Z is independently CH or N; R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, or heterocyclyl; R2 is C1-C6 alkyl (e.g., C1-C6 haloalkyl), or C1-C6 alkoxy; Ra is cyano, halogen, C1-C6 alkyl (e.g., substituted C1-C6 alkyl (e.g., —CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), or S(O)mRb; Rb is C1-C6 alkyl; m is 0 or 1; and n is 0, 1, 2, 3, or 4.

In some embodiments, X is N. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, Y and Z are CH.

In some embodiments, Y is N. In some embodiments, Y is N, and X and Z are CH.

In some embodiments, Z is N. In some embodiments, X and Z are N, and Y is CH. In some embodiments, X, Y, and Z are N.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), or S(O)mRb. In some embodiments, Ra is cyano or halogen (e.g., F or Cl). In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3).

In some embodiments, n is 1 or 2, and Ra is cyano, halogen, or C1-C6 alkoxy. In some embodiments, n is 2, and Ra is halogen (e.g., F, Cl). In some embodiments, n is 1 and R1 is C1-C6 alkyl. In some embodiments, n is 1 and Ra is substituted C1-C6 alkyl (e.g., —CH2OH).

In some embodiments, the compound of Formula (II) is a compound of Formula (II-d):

In some embodiments, X is N. In some embodiments, Y and Z are CH. In some embodiments, X is N, and Y and Z are CH.

In some embodiments, R1 is C1-C6 alkyl. In some embodiments, R1 is —CH3, —CH2CH3, or —CH(CH3)2.

In some embodiments, R2 is C1-C6 alkyl. In some embodiments, R2 is —CH3.

In some embodiments, R2 is C1-C6 haloalkyl. In some embodiments, R2 is —CF3.

In some embodiments, n is 1 or 2. In some embodiments, n is 1. In some embodiments, n is 2.

In some embodiments, Ra is cyano, halogen, C1-C6 alkyl (e.g., C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), C1-C6 alkoxy (e.g., C1-C6 haloalkoxy), or S(O)mRb. In some embodiments, Ra is cyano or halogen (e.g., F or Cl). In some embodiments, Ra is C1-C6 alkyl (e.g., CH3, C1-C6 haloalkyl (e.g., CF3) or C1-C6 hydroxyalkyl (e.g., CH2OH)), or C1-C6 alkoxy (e.g., C1-C6 haloalkoxy).

In some embodiments, Ra is S(O)mRb. In some embodiments, Ra is S(O)mRb, wherein m is 0 or 1 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 0 and Rb is C1-C6 alkyl (e.g., CH3). In some embodiments, Ra is S(O)mRb, wherein m is 1 and Rb is C1-C6 alkyl (e.g., CH3).

In some embodiments, the compound of Formula (II) is a compound of Formula (II-e):

In some embodiments, Ra is C1-C6 alkyl. In some embodiments, Ra is substituted C1-C6 alkyl (e.g., —CH2OH)). In some embodiments, Ra is C1-C6 alkoxy (e.g., —OCH3, —OCH2(CH3)2, C1-C6 haloalkoxy (e.g., —OCF3)). In some embodiments, Ra is S(O)mRb. In some embodiments, m is 0 or 1, and C1-C6 alkyl (e.g., —CH3). In some embodiments, Ra is SCH3 or S(O)CH3.

In some embodiments, the compound of Formula (II) (e.g., a compound of Formula (II-a), (II-b), (II-c), (II-d), or (II-e)) is not a compound selected from a compound of Table 1.

In some embodiments, the compound of Formula (I) is a compound of Formula (III-a):

In some embodiments, the compound of Formula (I) is a compound of Formula (III-b):

wherein Rb is C1-C6 alkyl (e.g., —CH3) and m is 0 or 1.

In some embodiments, the compound of Formula (I) or Formula (II) is selected from:

or pharmaceutically acceptable salt thereof.

In one aspect, provided is a compound selected from:

or a pharmaceutically acceptable salt thereof.

Pharmaceutical Compositions

In one aspect, the invention provides a pharmaceutical composition comprising a compound described herein (also referred to as the “active ingredient”) and a pharmaceutically acceptable excipient. In certain embodiments, the pharmaceutical composition comprises an effective amount of the active ingredient. In certain embodiments, the pharmaceutical composition comprises a therapeutically effective amount of the active ingredient. In certain embodiments, the pharmaceutical composition comprises a prophylactically effective amount of the active ingredient.

The pharmaceutical compositions provided herein can be administered by a variety of routes including, but not limited to, oral (enteral) administration, parenteral (by injection) administration, rectal administration, transdermal administration, intradermal administration, intrathecal administration, subcutaneous (SC) administration, intravenous (IV) administration, intramuscular (IM) administration, and intranasal administration.

Generally, the compounds provided herein are administered in an effective amount. The amount of the compound actually administered will typically be determined by a physician, in the light of the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual compound administered, the age, weight, and response of the individual patient, the severity of the patient's symptoms, and the like.

When used to prevent the onset of a CNS-disorder, the compounds provided herein will be administered to a subject at risk for developing the condition, typically on the advice and under the supervision of a physician, at the dosage levels described above. Subjects at risk for developing a particular condition generally include those that have a family history of the condition, or those who have been identified by genetic testing or screening to be particularly susceptible to developing the condition.

The pharmaceutical compositions provided herein can also be administered chronically (“chronic administration”). Chronic administration refers to administration of a compound or pharmaceutical composition thereof over an extended period of time, e.g., for example, over 3 months, 6 months, 1 year, 2 years, 3 years, 5 years, etc, or may be continued indefinitely, for example, for the rest of the subject's life. In certain embodiments, the chronic administration is intended to provide a constant level of the compound in the blood, e.g., within the therapeutic window over the extended period of time.

The pharmaceutical compostions described herein may be further delivered using a variety of dosing methods. For example, in certain embodiments, the pharmaceutical composition may be given as a bolus, e.g., in order to raise the concentration of the compound in the blood to an effective level. The placement of the bolus dose depends on the systemic levels of the active ingredient desired throughout the body, e.g., an intramuscular or subcutaneous bolus dose allows a slow release of the active ingredient, while a bolus delivered directly to the veins (e.g., through an IV drip) allows a much faster delivery which quickly raises the concentration of the active ingredient in the blood to an effective level. In other embodiments, the pharmaceutical composition may be administered as a continuous infusion, e.g., by IV drip, to provide maintenance of a steady-state concentration of the active ingredient in the subject's body. Furthermore, in still yet other embodiments, the pharmaceutical composition may be administered as first as a bolus dose, followed by continuous infusion.

The compositions for oral administration can take the form of bulk liquid solutions or suspensions, or bulk powders. More commonly, however, the compositions are presented in unit dosage forms to facilitate accurate dosing. The term “unit dosage forms” refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical excipient. Typical unit dosage forms include prefilled, premeasured ampules or syringes of the liquid compositions or pills, tablets, capsules or the like in the case of solid compositions. In such compositions, the compound is usually a minor component (from about 0.1 to about 50% by weight or preferably from about 1 to about 40% by weight) with the remainder being various vehicles or excipients and processing aids helpful for forming the desired dosing form.

With oral dosing, one to five and especially two to four and typically three oral doses per day are representative regimens. Using these dosing patterns, each dose provides from about 0.01 to about 20 mg/kg of the compound provided herein, with preferred doses each providing from about 0.1 to about 10 mg/kg, and especially about 1 to about 5 mg/kg.

Transdermal doses are generally selected to provide similar or lower blood levels than are achieved using injection doses, generally in an amount ranging from about 0.01 to about 20% by weight, preferably from about 0.1 to about 20% by weight, preferably from about 0.1 to about 10% by weight, and more preferably from about 0.5 to about 15% by weight.

Injection dose levels range from about 0.1 mg/kg/hour to at least 20 mg/kg/hour, all for from about 1 to about 120 hours and especially 24 to 96 hours. A preloading bolus of from about 0.1 mg/kg to about 10 mg/kg or more may also be administered to achieve adequate steady state levels. The maximum total dose is not expected to exceed about 5 g/day for a 40 to 80 kg human patient.

Liquid forms suitable for oral administration may include a suitable aqueous or nonaqueous vehicle with buffers, suspending and dispensing agents, colorants, flavors and the like. Solid forms may include, for example, any of the following ingredients, or compounds of a similar nature: a binder such as microcrystalline cellulose, gum tragacanth or gelatin; an excipient such as starch or lactose, a disintegrating agent such as alginic acid, Primogel, or corn starch; a lubricant such as magnesium stearate; a glidant such as colloidal silicon dioxide; a sweetening agent such as sucrose or saccharin; or a flavoring agent such as peppermint, methyl salicylate, or orange flavoring.

Injectable compositions are typically based upon injectable sterile saline or phosphate-buffered saline or other injectable excipients known in the art. As before, the active compound in such compositions is typically a minor component, often being from about 0.05 to 10% by weight with the remainder being the injectable excipient and the like.

Transdermal compositions are typically formulated as a topical ointment or cream containing the active ingredient(s). When formulated as a ointment, the active ingredients will typically be combined with either a paraffinic or a water-miscible ointment base. Alternatively, the active ingredients may be formulated in a cream with, for example an oil-in-water cream base. Such transdermal formulations are well-known in the art and generally include additional ingredients to enhance the dermal penetration of stability of the active ingredients or Formulation. All such known transdermal formulations and ingredients are included within the scope provided herein.

The compounds provided herein can also be administered by a transdermal device. Accordingly, transdermal administration can be accomplished using a patch either of the reservoir or porous membrane type, or of a solid matrix variety.

The above-described components for orally administrable, injectable or topically administrable compositions are merely representative. Other materials as well as processing techniques and the like are set forth in Part 8 of Remington's Pharmaceutical Sciences, 17th edition, 1985, Mack Publishing Company, Easton, Pa., which is incorporated herein by reference.

The compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b), can also be administered in sustained release forms or from sustained release drug delivery systems. A description of representative sustained release materials can be found in Remington's Pharmaceutical Sciences.

The present invention also relates to the pharmaceutically acceptable acid addition salt of a compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b). The acid which may be used to prepare the pharmaceutically acceptable salt is that which forms a non-toxic acid addition salt, i.e., a salt containing pharmacologically acceptable anions such as the hydrochloride, hydroiodide, hydrobromide, nitrate, sulfate, bisulfate, phosphate, acetate, lactate, citrate, tartrate, succinate, maleate, fumarate, benzoate, para-toluenesulfonate, and the like.

In another aspect, the invention provides a pharmaceutical composition comprising a compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b) and a pharmaceutically acceptable excipient, e.g., a composition suitable for injection, such as for intravenous (IV) administration.

Pharmaceutically acceptable excipients include any and all diluents or other liquid vehicles, dispersion or suspension aids, surface active agents, isotonic agents, preservatives, lubricants and the like, as suited to the particular dosage form desired, e.g., injection. General considerations in the formulation and/or manufacture of pharmaceutical compositions agents can be found, for example, in Remington's Pharmaceutical Sciences, Sixteenth Edition, E. W. Martin (Mack Publishing Co., Easton, Pa., 1980), and Remington: The Science and Practice of Pharmacy, 21st Edition (Lippincott Williams & Wilkins, 2005).

For example, injectable preparations, such as sterile injectable aqueous suspensions, can be formulated according to the known art using suitable dispersing or wetting agents and suspending agents. Exemplary excipients that can be employed include, but are not limited to, water, sterile saline or phosphate-buffered saline, or Ringer's solution.

In certain embodiments, the pharmaceutical composition further comprises a cyclodextrin derivative. The most common cyclodextrins are α-, β- and γ-cyclodextrins consisting of 6, 7 and 8 α-1,4-linked glucose units, respectively, optionally comprising one or more substituents on the linked sugar moieties, which include, but are not limited to, substituted or unsubstituted methylated, hydroxyalkylated, acylated, and sulfoalkylether substitution. In certain embodiments, the cyclodextrin is a sulfoalkyl ether β-cyclodextrin, e.g., for example, sulfobutyl ether β-cyclodextrin, also known as Captisol®. See, e.g., U.S. Pat. No. 5,376,645. In certain embodiments, the composition comprises hexapropyl-β-cyclodextrin. In a more particular embodiment, the composition comprises hexapropyl-β-cyclodextrin (10-50% in water).

The injectable composition can be sterilized, for example, by filtration through a bacterial-retaining filter, or by incorporating sterilizing agents in the form of sterile solid compositions which can be dissolved or dispersed in sterile water or other sterile injectable medium prior to use.

Generally, the compounds provided herein are administered in an effective amount. The amount of the compound actually administered will typically be determined by a physician, in the light of the relevant circumstances, including the condition to be treated, the chosen route of administration, the actual compound administered, the age, weight, response of the individual patient, the severity of the patient's symptoms, and the like.

The compositions are presented in unit dosage forms to facilitate accurate dosing. The term “unit dosage forms” refers to physically discrete units suitable as unitary dosages for human subjects and other mammals, each unit containing a predetermined quantity of active material calculated to produce the desired therapeutic effect, in association with a suitable pharmaceutical excipient. Typical unit dosage forms include pre-filled, pre-measured ampules or syringes of the liquid compositions. In such compositions, the compound is usually a minor component (from about 0.1% to about 50% by weight or preferably from about 1% to about 40% by weight) with the remainder being various vehicles or carriers and processing aids helpful for forming the desired dosing form.

The compounds provided herein can be administered as the sole active agent, or they can be administered in combination with other active agents. In one aspect, the present invention provides a combination of a compound of the present invention and another pharmacologically active agent. Administration in combination can proceed by any technique apparent to those of skill in the art including, for example, separate, sequential, concurrent, and alternating administration.

Although the descriptions of pharmaceutical compositions provided herein are principally directed to pharmaceutical compositions which are suitable for administration to humans, it will be understood by the skilled artisan that such compositions are generally suitable for administration to animals of all sorts. Modification of pharmaceutical compositions suitable for administration to humans in order to render the compositions suitable for administration to various animals is well understood, and the ordinarily skilled veterinary pharmacologist can design and/or perform such modification with ordinary experimentation. General considerations in the formulation and/or manufacture of pharmaceutical compositions can be found, for example, in Remington: The Science and Practice of Pharmacy 21st ed., Lippincott Williams & Wilkins, 2005.

In one aspect, provided is a kit comprising a solid composition comprising a compound as described herein, e.g., a compound of Formula (I), (I-a), (I-b), (I-c), (II), (II-a), (II-b), (II-c), (II-d), (II-e), (III-a), or (III-b) and a sterile diluent.

Methods of Use and Treatment

As generally described herein, the present invention is directed to C21-substituted neuroactive steroids designed, for example, to act as GABA modulators. In certain embodiments, such compounds are envisioned to be useful as therapeutic agents for the inducement of anesthesia and/or sedation in a subject. In some embodiments, such compounds are envisioned to be useful as therapeutic agents for treating a CNS-related disorder (e.g., sleep disorder, a mood disorder (e.g., depression, for example severe depression or postpartum depression; or anxiety disorders), a schizophrenia spectrum disorder, a convulsive disorder, a disorder of memory and/or cognition, a movement disorder (e.g., tremor, for example essential tremor), a personality disorder, autism spectrum disorder, pain, traumatic brain injury, a vascular disease, a substance abuse disorder and/or withdrawal syndrome, or tinnitus) in a subject in need (e.g., a subject with Rett syndrome, Fragile X syndrome, or Angelman syndrome).

Thus, in one aspect, the present invention provides a method of inducing sedation and/or anesthesia in a subject, comprising administering to the subject an effective amount of a compound of the present invention or a composition thereof. In certain embodiments, the compound is administered by intravenous administration.

Earlier studies (see, e.g., Gee et al., European Journal of Pharmacology, 136:419-423 (1987)) demonstrated that certain 3α-hydroxylated steroids are orders of magnitude more potent as modulators of the GABA receptor complex (GRC) than others had reported (see, e.g., Majewska et al., Science 232:1004-1007 (1986); Harrison et al., J Pharmacol. Exp. Ther. 241:346-353 (1987)). Majewska et al. and Harrison et al. taught that 3α-hydroxylated-5-reduced steroids are only capable of much lower levels of effectiveness. In vitro and in vivo experimental data have now demonstrated that the high potency of these steroids allows them to be therapeutically useful in the modulation of brain excitability via the GRC (see, e.g., Gee et al., European Journal of Pharmacology, 136:419-423 (1987); Wieland et al., Psychopharmacology 118(1):65-71 (1995)).

Various synthetic steroids have also been prepared as neuroactive steroids. See, for example, U.S. Pat. No. 5,232,917, which discloses neuroactive steroid compounds useful in treating stress, anxiety, insomnia, seizure disorders, and mood disorders, that are amenable to GRC-active agents, such as depression, in a therapeutically beneficial manner. Furthermore, it has been previously demonstrated that these steroids interact at a unique site on the GRC which is distinct from other known sites of interaction (e.g., barbiturates, benzodiazepines, and GABA) where therapeutically beneficial effects on stress, anxiety, sleep, mood disorders and seizure disorders have been previously elicited (see, e.g., Gee, K. W. and Yamamura, H. I., “Benzodiazepines and Barbiturates: Drugs for the Treatment of Anxiety, Insomnia and Seizure Disorders,” in Central Nervous System Disorders, Horvell, ed., Marcel-Dekker, New York (1985), pp. 123-147; Lloyd, K. G. and Morselli, P. L., “Psychopharmacology of GABAergic Drugs,” in Psychopharmacology: The Third Generation of Progress, H. Y. Meltzer, ed., Raven Press, N.Y. (1987), pp. 183-195; and Gee et al., European Journal of Pharmacology, 136:419-423 (1987). These compounds are desirable for their duration, potency, and oral activity (along with other forms of administration).

Compounds of the present invention, as described herein, are generally designed to modulate GABA function, and therefore to act as neuroactive steroids for the treatment and prevention of CNS-related conditions in a subject. Modulation, as used herein, refers to the inhibition or potentiation of GABA receptor function. Accordingly, the compounds and pharmaceutical compositions provided herein find use as therapeutics for preventing and/or treating CNS conditions in mammals including humans and non-human mammals. Thus, and as stated earlier, the present invention includes within its scope, and extends to, the recited methods of treatment, as well as to the compounds for such methods, and to the use of such compounds for the preparation of medicaments useful for such methods.

Exemplary CNS conditions related to GABA-modulation include, but are not limited to, sleep disorders [e.g., insomnia], mood disorders [e.g., depression, dysthymic disorder (e.g., mild depression), bipolar disorder (e.g., I and/or II), anxiety disorders (e.g., generalized anxiety disorder (GAD), social anxiety disorder), stress, post-traumatic stress disorder (PTSD), compulsive disorders (e.g., obsessive compulsive disorder (OCD))], schizophrenia spectrum disorders [e.g., schizophrenia, schizoaffective disorder], convulsive disorders [e.g., epilepsy (e.g., status epilepticus (SE)), seizures], disorders of memory and/or cognition [e.g., attention disorders (e.g., attention deficit hyperactivity disorder (ADHD)), dementia (e.g., Alzheimer's type dementia, Lewis body type dementia, vascular type dementia], movement disorders [e.g., Huntington's disease, Parkinson's disease, tremor (e.g., essential tremor)], personality disorders [e.g., anti-social personality disorder, obsessive compulsive personality disorder], autism spectrum disorders (ASD) [e.g., autism, monogenetic causes of autism such as synaptophathy's, e.g., Rett syndrome, Fragile X syndrome, Angelman syndrome], pain [e.g., neuropathic pain, injury related pain syndromes, acute pain, chronic pain], traumatic brain injury (TBI), vascular diseases [e.g., stroke, ischemia, vascular malformations], substance abuse disorders and/or withdrawal syndromes [e.g., addition to opiates, cocaine, and/or alcohol], and tinnitus.

In yet another aspect, provided is a combination of a compound of the present invention and another pharmacologically active agent. The compounds provided herein can be administered as the sole active agent or they can be administered in combination with other agents. Administration in combination can proceed by any technique apparent to those of skill in the art including, for example, separate, sequential, concurrent and alternating administration.

In another aspect, provided is a method of treating or preventing brain excitability in a subject susceptible to or afflicted with a condition associated with brain excitability, comprising administering to the subject an effective amount of a compound of the present invention to the subject.

In yet another aspect, provided is a method of treating or preventing stress or anxiety in a subject, comprising administering to the subject in need of such treatment an effective amount of a compound of the present invention, or a composition thereof.

In yet another aspect, provided is a method of alleviating or preventing movement disorder (e.g., tremor, for example essential tremor) in a subject, comprising administering to the subject in need of such treatment an effective amount of a compound of the present invention. In certain embodiments the movement disorder is tremor. In certain embodiments the tremor is essential tremor.

In yet another aspect, provided is a method of alleviating or preventing seizure activity in a subject, comprising administering to the subject in need of such treatment an effective amount of a compound of the present invention.

In yet another aspect, provided is a method of alleviating or preventing insomnia in a subject, comprising administering to the subject in need of such treatment an effective amount of a compound of the present invention, or a composition thereof.

In yet another aspect, provided is a method of inducing sleep and maintaining substantially the level of REM sleep that is found in normal sleep, wherein substantial rebound insomnia is not induced, comprising administering an effective amount of a compound of the present invention.

In yet another aspect, provided is a method of alleviating or preventing PMS or PND in a subject, comprising administering to the subject in need of such treatment an effective amount of a compound of the present invention.

In yet another aspect, provided is a method of treating or preventing mood disorders in a subject, comprising administering to the subject in need of such treatment an effective amount of a compound of the present invention. In certain embodiments the mood disorder is an anxiety disorder. In certain embodiments the mood disorder is depression. In certain embodiments the depression is severe depression. In certain embodiment the depression is post-partum depression.

In yet another aspect, provided is a method of inducing anesthesia in a subject, comprising administering to the subject an effective amount of a compound of the present invention.

In yet another aspect, provided is a method of cognition enhancement or treating memory disorder by administering to the subject a therapeutically effective amount of a compound of the present invention. In certain embodiments, the disorder is Alzheimer's disease. In certain embodiments, the disorder is Rett syndrome.

In yet another aspect, provided is a method of treating attention disorders by administering to the subject a therapeutically effective amount of a compound of the present invention. In certain embodiments, the attention disorder is ADHD.

In certain embodiments, the compound is administered to the subject chronically. In certain embodiments, the compound is administered to the subject orally, subcutaneously, intramuscularly, or intravenously.

Anesthesia/Sedation

Anesthesia is a pharmacologically induced and reversible state of amnesia, analgesia, loss of responsiveness, loss of skeletal muscle reflexes, decreased stress response, or all of these simultaneously. These effects can be obtained from a single drug which alone provides the correct combination of effects, or occasionally with a combination of drugs (e.g., hypnotics, sedatives, paralytics, analgesics) to achieve very specific combinations of results. Anesthesia allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience.

Sedation is the reduction of irritability or agitation by administration of a pharmacological agent, generally to facilitate a medical procedure or diagnostic procedure.

Sedation and analgesia include a continuum of states of consciousness ranging from minimal sedation (anxiolysis) to general anesthesia.

Minimal sedation is also known as anxiolysis. Minimal sedation is a drug-induced state during which the patient responds normally to verbal commands. Cognitive function and coordination may be impaired. Ventilatory and cardiovascular functions are typically unaffected.

Moderate sedation/analgesia (conscious sedation) is a drug-induced depression of consciousness during which the patient responds purposefully to verbal command, either alone or accompanied by light tactile stimulation. No interventions are usually necessary to maintain a patent airway. Spontaneous ventilation is typically adequate. Cardiovascular function is usually maintained.

Deep sedation/analgesia is a drug-induced depression of consciousness during which the patient cannot be easily aroused, but responds purposefully (not a reflex withdrawal from a painful stimulus) following repeated or painful stimulation. Independent ventilatory function may be impaired and the patient may require assistance to maintain a patent airway. Spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

General anesthesia is a drug-induced loss of consciousness during which the patient is not arousable, even to painful stimuli. The ability to maintain independent ventilatory function is often impaired and assistance is often required to maintain a patent airway. Positive pressure ventilation may be required due to depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.

Sedation in the intensive care unit (ICU) allows the depression of patients' awareness of the environment and reduction of their response to external stimulation. It can play a role in the care of the critically ill patient, and encompasses a wide spectrum of symptom control that will vary between patients, and among individuals throughout the course of their illnesses. Heavy sedation in critical care has been used to facilitate endotracheal tube tolerance and ventilator synchronization, often with neuromuscular blocking agents.

In some embodiments, sedation (e.g., long-term sedation, continuous sedation) is induced and maintained in the ICU for a prolonged period of time (e.g., 1 day, 2 days, 3 days, 5 days, 1 week, 2 week, 3 weeks, 1 month, 2 months). Long-term sedation agents may have long duration of action. Sedation agents in the ICU may have short elimination half-life.

Procedural sedation and analgesia, also referred to as conscious sedation, is a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows a subject to tolerate unpleasant procedures while maintaining cardiorespiratory function.

Neuroendocrine Disorders and Dysfunction

Provided herein are methods that can be used for treating neuroendocrine disorders and dysfunction. As used herein, “neuroendocrine disorder” or “neuroendocrine dysfunction” refers to a variety of conditions caused by imbalances in the body's hormone production directly related to the brain. Neuroendocrine disorders involve interactions between the nervous system and the endocrine system. Because the hypothalamus and the pituitary gland are two areas of the brain that regulate the production of hormones, damage to the hypothalamus or pituitary gland, e.g., by traumatic brain injury, may impact the production of hormones and other neuroendocrine functions of the brain.

Symptoms of neuroendocrine disorder include, but are not limited to, behavioral, emotional, and sleep-related symptoms, symptoms related to reproductive function, and somatic symptoms; including but not limited to fatigue, poor memory, anxiety, depression, weight gain or loss, emotional lability, lack of concentration, attention difficulties, loss of lipido, infertility, amenorrhea, loss of muscle mass, increased belly body fat, low blood pressure, reduced heart rate, hair loss, anemia, constipation, cold intolerance, and dry skin.

Neurodegenerative Diseases and Disorders

Provided herein are methods that can be used for treating neurodegenerative diseases and disorders. The term “neurodegenerative disease” includes diseases and disorders that are associated with the progressive loss of structure or function of neurons, or death of neurons. Neurodegenerative diseases and disorders include, but are not limited to, Alzheimer's disease (including the associated symptoms of mild, moderate, or severe cognitive impairment); amyotrophic lateral sclerosis (ALS); anoxic and ischemic injuries; ataxia and convulsion (including for the treatment and prevention and prevention of seizures that are caused by schizoaffective disorder or by drugs used to treat schizophrenia); benign forgetfulness; brain edema; cerebellar ataxia including McLeod neuroacanthocytosis syndrome (MLS); closed head injury; coma; contusive injuries (e.g., spinal cord injury and head injury); dementias including multi-infarct dementia and senile dementia; disturbances of consciousness; Down syndrome; drug-induced or medication-induced Parkinsonism (such as neuroleptic-induced acute akathisia, acute dystonia, Parkinsonism, or tardive dyskinesia, neuroleptic malignant syndrome, or medication-induced postural tremor); epilepsy; fragile X syndrome; Gilles de la Tourette's syndrome; head trauma; hearing impairment and loss; Huntington's disease; Lennox syndrome; levodopa-induced dyskinesia; mental retardation; movement disorders including akinesias and akinetic (rigid) syndromes (including basal ganglia calcification, corticobasal degeneration, multiple system atrophy, Parkinsonism-ALS dementia complex, Parkinson's disease, postencephalitic parkinsonism, and progressively supranuclear palsy); muscular spasms and disorders associated with muscular spasticity or weakness including chorea (such as benign hereditary chorea, drug-induced chorea, hemiballism, Huntington's disease, neuroacanthocytosis, Sydenham's chorea, and symptomatic chorea), dyskinesia (including tics such as complex tics, simple tics, and symptomatic tics), myoclonus (including generalized myoclonus and focal cyloclonus), tremor (such as rest tremor, postural tremor, essential tremor and intention tremor) and dystonia (including axial dystonia, dystonic writer's cramp, hemiplegic dystonia, paroxysmal dystonia, and focal dystonia such as blepharospasm, oromandibular dystonia, and spasmodic dysphonia and torticollis); neuronal damage including ocular damage, retinopathy or macular degeneration of the eye; neurotoxic injury which follows cerebral stroke, thromboembolic stroke, hemorrhagic stroke, cerebral ischemia, cerebral vasospasm, hypoglycemia, amnesia, hypoxia, anoxia, perinatal asphyxia and cardiac arrest; Parkinson's disease; seizure; status epilecticus; stroke; tinnitus; tubular sclerosis, and viral infection induced neurodegeneration (e.g., caused by acquired immunodeficiency syndrome (AIDS) and encephalopathies). Neurodegenerative diseases also include, but are not limited to, neurotoxic injury which follows cerebral stroke, thromboembolic stroke, hemorrhagic stroke, cerebral ischemia, cerebral vasospasm, hypoglycemia, amnesia, hypoxia, anoxia, perinatal asphyxia and cardiac arrest. Methods of treating or preventing a neurodegenerative disease also include treating or preventing loss of neuronal function characteristic of neurodegenerative disorder.

Epilepsy

Epilepsy is a brain disorder characterized by repeated seizures over time. Types of epilepsy can include, but are not limited to generalized epilepsy, e.g., childhood absence epilepsy, juvenile nyoclonic epilepsy, epilepsy with grand-mal seizures on awakening, West syndrome, Lennox-Gastaut syndrome, partial epilepsy, e.g., temporal lobe epilepsy, frontal lobe epilepsy, benign focal epilepsy of childhood.

Status Epilepticus (SE)

Status epilepticus (SE) can include, e.g., convulsive status epilepticus, e.g., early status epilepticus, established status epilepticus, refractory status epilepticus, super-refractory status epilepticus; non-convulsive status epilepticus, e.g., generalized status epilepticus, complex partial status epilepticus; generalized periodic epileptiform discharges; and periodic lateralized epileptiform discharges. Convulsive status epilepticus is characterized by the presence of convulsive status epileptic seizures, and can include early status epilepticus, established status epilepticus, refractory status epilepticus, super-refractory status epilepticus. Early status epilepticus is treated with a first line therapy. Established status epilepticus is characterized by status epileptic seizures which persist despite treatment with a first line therapy, and a second line therapy is administered. Refractory status epilepticus is characterized by status epileptic seizures which persist despite treatment with a first line and a second line therapy, and a general anesthetic is generally administered. Super refractory status epilepticus is characterized by status epileptic seizures which persist despite treatment with a first line therapy, a second line therapy, and a general anesthetic for 24 hours or more.

Non-convulsive status epilepticus can include, e.g., focal non-convulsive status epilepticus, e.g., complex partial non-convulsive status epilepticus, simple partial non-convulsive status epilepticus, subtle non-convulsive status epilepticus; generalized non-convulsive status epilepticus, e.g., late onset absence non-convulsive status epilepticus, atypical absence non-convulsive status epilepticus, or typical absence non-convulsive status epilepticus.

Compositions described herein can also be administered as a prophylactic to a subject having a CNS disorder e.g., a traumatic brain injury, status epilepticus, e.g., convulsive status epilepticus, e.g., early status epilepticus, established status epilepticus, refractory status epilepticus, super-refractory status epilepticus; non-convulsive status epilepticus, e.g., generalized status epilepticus, complex partial status epilepticus; generalized periodic epileptiform discharges; and periodic lateralized epileptiform discharges; prior to the onset of a seizure.

Seizure

A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. The term “seizure” is often used interchangeably with “convulsion.” Convulsions are when a person's body shakes rapidly and uncontrollably. During convulsions, the person's muscles contract and relax repeatedly.

Based on the type of behavior and brain activity, seizures are divided into two broad categories: generalized and partial (also called local or focal). Classifying the type of seizure helps doctors diagnose whether or not a patient has epilepsy.

Generalized seizures are produced by electrical impulses from throughout the entire brain, whereas partial seizures are produced (at least initially) by electrical impulses in a relatively small part of the brain. The part of the brain generating the seizures is sometimes called the focus.

There are six types of generalized seizures. The most common and dramatic, and therefore the most well known, is the generalized convulsion, also called the grand-mal seizure. In this type of seizure, the patient loses consciousness and usually collapses. The loss of consciousness is followed by generalized body stiffening (called the “tonic” phase of the seizure) for 30 to 60 seconds, then by violent jerking (the “clonic” phase) for 30 to 60 seconds, after which the patient goes into a deep sleep (the “postictal” or after-seizure phase). During grand-mal seizures, injuries and accidents may occur, such as tongue biting and urinary incontinence.

Absence seizures cause a short loss of consciousness (just a few seconds) with few or no symptoms. The patient, most often a child, typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are usually not aware that they are having a seizure, except that they may be aware of “losing time.”

Myoclonic seizures consist of sporadic jerks, usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent, these seizures may result in dropping or involuntarily throwing objects.

Clonic seizures are repetitive, rhythmic jerks that involve both sides of the body at the same time.

Tonic seizures are characterized by stiffening of the muscles.

Atonic seizures consist of a sudden and general loss of muscle tone, particularly in the arms and legs, which often results in a fall.

Seizures described herein can include epileptic seizures; acute repetitive seizures; cluster seizures; continuous seizures; unremitting seizures; prolonged seizures; recurrent seizures; status epilepticus seizures, e.g., refractory convulsive status epilepticus, non-convulsive status epilepticus seizures; refractory seizures; myoclonic seizures; tonic seizures; tonic-clonic seizures; simple partial seizures; complex partial seizures; secondarily generalized seizures; atypical absence seizures; absence seizures; atonic seizures; benign Rolandic seizures; febrile seizures; emotional seizures; focal seizures; gelastic seizures; generalized onset seizures; infantile spasms; Jacksonian seizures; massive bilateral myoclonus seizures; multifocal seizures; neonatal onset seizures; nocturnal seizures; occipital lobe seizures; post traumatic seizures; subtle seizures; Sylvan seizures; visual reflex seizures; or withdrawal seizures.

Movement Disorders

Also described herein are methods for treating a movement disorder. As used herein, “movement disorders” refers to a variety of diseases and disorders that are associated with hyperkinetic movement disorders and related abnormalities in muscle control. Exemplary movement disorders include, but are not limited to, Parkinson's disease and parkinsonism (defined particularly by bradykinesia), dystonia, chorea and Huntington's disease, ataxia, tremor (e.g., essential tremor), myoclonus and startle, tics and Tourette syndrome, Restless legs syndrome, stiff person syndrome, and gait disorders.

Tremor

The methods described herein can be used to treat tremor, for example cerebellar tremor or intention tremor, dystonic tremor, essential tremor, orthostatic tremor, parkinsonian tremor, physiological tremor, psychogenic tremor, or rubral tremor. Tremor includes hereditary, degenerative, and idiopathic disorders such as Wilson's disease, Parkinson's disease, and essential tremor, respectively; metabolic diseases (e.g., thyoid-parathyroid-, liver disease and hypoglycemia); peripheral neuropathies (associated with Charcot-Marie-Tooth, Roussy-Levy, diabetes mellitus, complex regional pain syndrome); toxins (nicotine, mercury, lead, CO, Manganese, arsenic, toluene); drug-induced (narcoleptics, tricyclics, lithium, cocaine, alcohol, adrenaline, bronchodilators, theophylline, caffeine, steroids, valproate, amiodarone, thyroid hormones, vincristine); and psychogenic disorders. Clinical tremor can be classified into physiologic tremor, enhanced physiologic tremor, essential tremor syndromes (including classical essential tremor, primary orthostatic tremor, and task- and position-specific tremor), dystonic tremor, parkinsonian tremor, cerebellar tremor, Holmes' tremor (i.e., rubral tremor), palatal tremor, neuropathic tremor, toxic or drug-induced tremor, and psychogenic tremor.

Tremor is an involuntary, at times rhythmic, muscle contraction and relaxation that can involve oscillations or twitching of one or more body parts (e.g., hands, arms, eyes, face, head, vocal folds, trunk, legs).

Cerebellar tremor or intention tremor is a slow, broad tremor of the extremities that occurs after a purposeful movement. Cerebellar tremor is caused by lesions in or damage to the cerebellum resulting from, e.g., tumor, stroke, disease (e.g., multiple sclerosis, an inherited degenerative disorder).

Dystonic tremor occurs in individuals affected by dystonia, a movement disorder in which sustained involuntary muscle contractions cause twisting and repetitive motions and/or painful and abnormal postures or positions. Dystonic tremor may affect any muscle in the body. Dystonic tremors occurs irregularly and often can be relieved by complete rest.

Essential tremor or benign essential tremor is the most common type of tremor. Essential tremor may be mild and nonprogressive in some, and may be slowly progressive, starting on one side of the body but affect both sides within 3 years. The hands are most often affected, but the head, voice, tongue, legs, and trunk may also be involved. Tremor frequency may decrease as the person ages, but severity may increase. Heightened emotion, stress, fever, physical exhaustion, or low blood sugar may trigger tremors and/or increase their severity. Symptoms generally evolve over time and can be both visible and persistent following onset.

Orthostatic tremor is characterized by fast (e.g., greater than 12 Hz) rhythmic muscle contractions that occurs in the legs and trunk immediately after standing. Cramps are felt in the thighs and legs and the patient may shake uncontrollably when asked to stand in one spot. Orthostatic tremor may occurs in patients with essential tremor.

Parkinsonian tremor is caused by damage to structures within the brain that control movement. Parkinsonian tremor is often a precursor to Parkinson's disease and is typically seen as a “pill-rolling” action of the hands that may also affect the chin, lips, legs, and trunk. Onset of parkinsonian tremor typically begins after age 60. Movement starts in one limb or on one side of the body and can progress to include the other side.

Physiological tremor can occur in normal individuals and have no clinical significance. It can be seen in all voluntary muscle groups. Physiological tremor can be caused by certain drugs, alcohol withdrawal, or medical conditions including an overactive thyroid and hypoglycemia. The tremor classically has a frequency of about 10 Hz.

Psychogenic tremor or hysterical tremor can occur at rest or during postural or kinetic movement. Patient with psychogenic tremor may have a conversion disorder or another psychiatric disease.

Rubral tremor is characterized by coarse slow tremor which can be present at rest, at posture, and with intention. The tremor is associated with conditions that affect the red nucleus in the midbrain, classical unusual strokes.

Parkinson's Disease affects nerve cells in the brain that produce dopamine. Symptoms include muscle rigidity, tremors, and changes in speech and gait. Parkinsonism is characterized by tremor, bradykinesia, rigidity, and postural instability. Parkinsonism shares symptoms found in Parkinson's Disease, but is a symptom complex rather than a progressive neurodegenerative disease.

Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive movements or postures. Dystonic movements can be patterned, twisting, and may be tremulous. Dystonia is often initiated or worsened by voluntary action and associated with overflow muscle activation.

Chorea is a neurological disorder characterized by jerky involuntary movements typically affecting the shoulders, hips, and face. Huntington's Disease is an inherited disease that causes nerve cells in the brain to waste away. Symptoms include uncontrolled movements, clumsiness, and balance problems. Huntington's disease can hinder walk, talk, and swallowing.

Ataxia refers to the loss of full control of bodily movements, and may affect the fingers, hands, arms, legs, body, speech, and eye movements.

Myloclonus and Startle is a response to a sudden and unexpected stimulus, which can be acoustic, tactile, visual, or vestibular.

Tics are an involuntary movement usually onset suddenly, brief, repetitive, but non-rhythmical, typically imitating normal behavior and often occurring out of a background of normal activity. Tics can be classified as motor or vocal, motor tics associated with movements while vocal tics associated with sound. Tics can be characterized as simple or complex. For example simple motor tics involve only a few muscles restricted to a specific body part. Tourette Syndrome is an inherited neuropsychiatric disorder with onset in childhood, characterized by multiple motor tics and at least one vocal tic.

Restless Legs Syndrome is a neurologic sensorimotor disorder characterized by an overwhelming urge to move the legs when at rest.

Stiff Person Syndrome is a progressive movement disorder characterized by involuntary painful spasms and rigidity of muscles, usually involving the lower back and legs. Stiff-legged gait with exaggerated lumbar hyperlordosis typically results. Characteristic abnormality on EMG recordings with continuous motor unit activity of the paraspinal axial muscles is typically observed. Variants include “stiff-limb syndrome” producing focal stiffness typically affecting distal legs and feet.

Gait disorders refer to an abnormality in the manner or style of walking, which results from neuromuscular, arthritic, or other body changes. Gait is classified according to the system responsible for abnormal locomotion, and include hemiplegic gait, diplegic gait, neuropathic gait, myopathic gait, parkinsonian gait, choreiform gait, ataxic gait, and sensory gait.

Mood Disorders

Clinical depression is also known as major depression, major depressive disorder (MDD), unipolar depression, unipolar disorder, and recurrent depression, and refers to a mental disorder characterized by pervasive and persistent low mood that is accompanied by low self-esteem and loss of interest or pleasure in normally enjoyable activities. Some people with clinical depression have trouble sleeping, lose weight, and generally feel agitated and irritable. Clinical depression affects how an individual feels, thinks, and behaves and may lead to a variety of emotional and physical problems. Individuals with clinical depression may have trouble doing day-to-day activities and make an individual feel as if life is not worth living.

Postnatal depression (PND) is also referred to as postpartum depression (PPD), and refers to a type of clinical depression that affects women after childbirth. Symptoms can include sadness, fatigue, changes in sleeping and eating habits, reduced sexual desire, crying episodes, anxiety, and irritability.

Atypical depression (AD) is characterized by mood reactivity (e.g., paradoxical anhedonia) and positivity, significant weight gain or increased appetite. Patients suffering from AD also may have excessive sleep or somnolence (hypersomnia), a sensation of limb heaviness, and significant social impairment as a consequence of hypersensitivity to perceived interpersonal rejection.

Melancholic depression is characterized by loss of pleasure (anhedonia) in most or all activities, failures to react to pleasurable stimuli, depressed mood more pronounced than that of grief or loss, excessive weight loss, or excessive guilt.

Psychotic major depression (PMD) or psychotic depression refers to a major depressive episode, in particular of melancholic nature, where the individual experiences psychotic symptoms such as delusions and hallucinations.

Catatonic depression refers to major depression involving disturbances of motor behavior and other symptoms. An individual may become mute and stuporose, and either is immobile or exhibits purposeless or bizarre movements.

Seasonal affective disorder (SAD) refers to a type of seasonal depression wherein an individual has seasonal patterns of depressive episodes coming on in the fall or winter.

Dysthymia refers to a condition related to unipolar depression, where the same physical and cognitive problems are evident. They are not as severe and tend to last longer (e.g., at least 2 years).

Double depression refers to fairly depressed mood (dysthymia) that lasts for at least 2 years and is punctuated by periods of major depression.

Depressive Personality Disorder (DPD) refers to a personality disorder with depressive features.

Recurrent Brief Depression (RBD) refers to a condition in which individuals have depressive episodes about once per month, each episode lasting 2 weeks or less and typically less than 2-3 days.

Minor depressive disorder or minor depression refers to a depression in which at least 2 symptoms are present for 2 weeks.

Bipolar disorder or manic depressive disorder causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). During periods of mania the individual may feel or act abnormally happy, energetic, or irritable. They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. During periods of depression there may be crying, poor eye contact with others, and a negative outlook on life. The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self harm occurs in 30-40%. Other mental health issues such as anxiety disorder and substance use disorder are commonly associated with bipolar disorder.

Depression caused by chronic medical conditions refers to depression caused by chronic medical conditions such as cancer or chronic pain, chemotherapy, chronic stress.

Treatment-resistant depression refers to a condition where the individuals have been treated for depression, but the symptoms do not improve. For example, antidepressants or psychological counseling (psychotherapy) do not ease depression symptoms for individuals with treatment-resistant depression. In some cases, individuals with treatment-resistant depression improve symptoms, but come back. Refractory depression occurs in patients suffering from depression who are resistant to standard pharmacological treatments, including tricyclic antidepressants, MAOIs, SSRIs, and double and triple uptake inhibitors and/or anxiolytic drugs, as well as non-pharmacological treatments (e.g., psychotherapy, electroconvulsive therapy, vagus nerve stimulation and/or transcranial magnetic stimulation).

Suicidality, suicidal ideation, suicidal behavior refers to the tendency of an individual to commit suicide. Suicidal ideation concerns thoughts about or an unusual preoccupation with suicide. The range of suicidal ideation varies greatly, from e.g., fleeting thoughts to extensive thoughts, detailed planning, role playing, incomplete attempts. Symptoms include talking about suicide, getting the means to commit suicide, withdrawing from social contact, being preoccupied with death, feeling trapped or hopeless about a situation, increasing use of alcohol or drugs, doing risky or self-destructive things, saying goodbye to people as if they won't be seen again.

Symptoms of depression include persistent anxious or sad feelings, feelings of helplessness, hopelessness, pessimism, worthlessness, low energy, restlessness, difficulty sleeping, sleeplessness, irritability, fatigue, motor challenges, loss of interest in pleasurable activities or hobbies, loss of concentration, loss of energy, poor self-esteem, absence of positive thoughts or plans, excessive sleeping, overeating, appetite loss, insomnia, self-harm, thoughts of suicide, and suicide attempts. The presence, severity, frequency, and duration of symptoms may vary on a case to case basis. Symptoms of depression, and relief of the same, may be ascertained by a physician or psychologist (e.g., by a mental state examination).

Anxiety Disorders

Provided herein are methods for treating anxiety disorders. Anxiety disorder is a blanket term covering several different forms of abnormal and pathological fear and anxiety. Current psychiatric diagnostic criteria recognize a wide variety of anxiety disorders.

Generalized anxiety disorder is a common chronic disorder characterized by long-lasting anxiety that is not focused on any one object or situation. Those suffering from generalized anxiety experience non-specific persistent fear and worry and become overly concerned with everyday matters. Generalized anxiety disorder is the most common anxiety disorder to affect older adults.

In panic disorder, a person suffers from brief attacks of intense terror and apprehension, often marked by trembling, shaking, confusion, dizziness, nausea, difficulty breathing. These panic attacks, defined by the APA as fear or discomfort that abruptly arises and peaks in less than ten minutes, can last for several hours and can be triggered by stress, fear, or even exercise; although the specific cause is not always apparent. In addition to recurrent unexpected panic attacks, a diagnosis of panic disorder also requires that said attacks have chronic consequences: either worry over the attacks' potential implications, persistent fear of future attacks, or significant changes in behavior related to the attacks. Accordingly, those suffering from panic disorder experience symptoms even outside of specific panic episodes. Often, normal changes in heartbeat are noticed by a panic sufferer, leading them to think something is wrong with their heart or they are about to have another panic attack. In some cases, a heightened awareness (hypervigilance) of body functioning occurs during panic attacks, wherein any perceived physiological change is interpreted as a possible life threatening illness (i.e. extreme hypochondriasis).

Obsessive compulsive disorder is a type of anxiety disorder primarily characterized by repetitive obsessions (distressing, persistent, and intrusive thoughts or images) and compulsions (urges to perform specific acts or rituals). The OCD thought pattern may be likened to superstitions insofar as it involves a belief in a causative relationship where, in reality, one does not exist. Often the process is entirely illogical; for example, the compulsion of walking in a certain pattern may be employed to alleviate the obsession of impending harm. And in many cases, the compulsion is entirely inexplicable, simply an urge to complete a ritual triggered by nervousness. In a minority of cases, sufferers of OCD may only experience obsessions, with no overt compulsions; a much smaller number of sufferers experience only compulsions.

The single largest category of anxiety disorders is that of phobia, which includes all cases in which fear and anxiety is triggered by a specific stimulus or situation. Sufferers typically anticipate terrifying consequences from encountering the object of their fear, which can be anything from an animal to a location to a bodily fluid.

Post-traumatic stress disorder or PTSD is an anxiety disorder which results from a traumatic experience. Post-traumatic stress can result from an extreme situation, such as combat, rape, hostage situations, or even serious accident. It can also result from long term (chronic) exposure to a severe stressor, for example soldiers who endure individual battles but cannot cope with continuous combat. Common symptoms include flashbacks, avoidant behaviors, and depression.

Equivalents and Scope

In the claims articles such as “a,” “an,” and “the” may mean one or more than one unless indicated to the contrary or otherwise evident from the context. Claims or descriptions that include “or” between one or more members of a group are considered satisfied if one, more than one, or all of the group members are present in, employed in, or otherwise relevant to a given product or process unless indicated to the contrary or otherwise evident from the context. The invention includes embodiments in which exactly one member of the group is present in, employed in, or otherwise relevant to a given product or process. The invention includes embodiments in which more than one, or all of the group members are present in, employed in, or otherwise relevant to a given product or process.

Furthermore, the invention encompasses all variations, combinations, and permutations in which one or more limitations, elements, clauses, and descriptive terms from one or more of the listed claims is introduced into another claim. For example, any claim that is dependent on another claim can be modified to include one or more limitations found in any other claim that is dependent on the same base claim. Where elements are presented as lists, e.g., in Markush group format, each subgroup of the elements is also disclosed, and any element(s) can be removed from the group. It should it be understood that, in general, where the invention, or aspects of the invention, is/are referred to as comprising particular elements and/or features, certain embodiments of the invention or aspects of the invention consist, or consist essentially of, such elements and/or features. For purposes of simplicity, those embodiments have not been specifically set forth in haec verba herein. It is also noted that the terms “comprising” and “containing” are intended to be open and permits the inclusion of additional elements or steps. Where ranges are given, endpoints are included. Furthermore, unless otherwise indicated or otherwise evident from the context and understanding of one of ordinary skill in the art, values that are expressed as ranges can assume any specific value or sub-range within the stated ranges in different embodiments of the invention, to the tenth of the unit of the lower limit of the range, unless the context clearly dictates otherwise.

This application refers to various issued patents, published patent applications, journal articles, and other publications, all of which are incorporated herein by reference. If there is a conflict between any of the incorporated references and the instant specification, the specification shall control. In addition, any particular embodiment described herein that falls within the prior art may be explicitly excluded from any one or more of the claims. Because such embodiments are deemed to be known to one of ordinary skill in the art, they may be excluded even if the exclusion is not set forth explicitly herein. Any particular embodiment of the invention can be excluded from any claim, for any reason, whether or not related to the existence of prior art.

Those skilled in the art will recognize or be able to ascertain using no more than routine experimentation many equivalents to the specific embodiments described herein. The scope of the present embodiments described herein is not intended to be limited to the above Description, but rather is as set forth in the appended claims. Those of ordinary skill in the art will appreciate that various changes and modifications to this description may be made without departing from the spirit or scope of the present invention, as defined in the following claims.

EXAMPLES

In order that the invention described herein may be more fully understood, the following examples are set forth. The synthetic and biological examples described in this application are offered to illustrate the compounds, pharmaceutical compositions and methods provided herein and are not to be construed in any way as limiting their scope.

Materials and Methods

The compounds provided herein can be prepared from readily available starting materials using the following general methods and procedures. For example, starting materials described herein can be prepared from the methods and procedures described in PCT/US2014/052417. It will be appreciated that where typical or preferred process conditions (i.e., reaction temperatures, times, mole ratios of reactants, solvents, pressures, etc.) are given, other process conditions can also be used unless otherwise stated. Optimum reaction conditions may vary with the particular reactants or solvent used, but such conditions can be determined by one skilled in the art by routine optimization.

Additionally, as will be apparent to those skilled in the art, conventional protecting groups may be necessary to prevent certain functional groups from undergoing undesired reactions. The choice of a suitable protecting group for a particular functional group as well as suitable conditions for protection and deprotection are well known in the art. For example, numerous protecting groups, and their introduction and removal, are described in T. W. Greene and P. G. M. Wuts, Protecting Groups in Organic Synthesis, Second Edition, Wiley, New York, 1991, and references cited therein.

The compounds provided herein may be isolated and purified by known standard procedures. Such procedures include (but are not limited to) recrystallization, column chromatography, HPLC, or supercritical fluid chromatography (SFC). The following schemes are presented with details as to the preparation of representative heteroaryls and heterocyclyls that have been listed herein. The compounds provided herein may be prepared from known or commercially available starting materials and reagents by one skilled in the art of organic synthesis. Exemplary chiral columns available for use in the separation/purification of the enantiomers/diastereomers provided herein include, but are not limited to, CHIRALPAK® AD-10, CHIRALCEL® OB, CHIRALCEL® OB—H, CHIRALCEL® OD, CHIRALCEL® OD-H, CHIRALCEL® OF, CHIRALCEL® OG, CHIRALCEL® OJ and CHIRALCEL® OK.

1H-NMR reported herein (e.g., for intermediates) may be a partial representation of the full NMR spectrum of a compound, e.g., a compound described herein. For example, the reported 1H NMR may exclude or partially represent the region between δ(ppm) of about 1 to about 2.5 ppm. For example, the reported 1H NMR may include residual solvent or water.

Exemplary general method for preparative HPLC: Column: Waters RBridge prep 10 μm C18, 19*250 mm. Mobile phase: aectonitrile, water (NH4HCO3) (30 L water, 24 g NH4HCO3, 30 mL NH3.H2O). Flow rate: 25 mL/min

Exemplary general method for analytical HPLC: Mobile phase: A: water (10 mM NH4HCO3), B: acetonitrileGradient: 5%-95% B in 1.6 or 2 min Flow rate: 1.8 or 2 mL/min; Column: XBridge C18, 4.6*50 mm, 3.5 μm at 45 C.

Abbreviaton List

THF: tetrahydrofuran; PE: petroleum ether; DCM: dichloromethane; EtOAc: ethylacetate; PCC: pyridinium chlorochromate; t-BuOK: potassium tert-butoxide; TBAF: tetra-n-butylammonium fluoride; TBSC1: tert-Butyl(chloro)dimethylsilane; DMP: Dess-Martin periodinane; (i-PrO)4Ti: titanium tetraisopropoxide; LAH: lithium aluminium hydride; MAD: methyl aluminum bis(2,6-di-t-butyl-4-methylphenoxide); BHT: 2,6-di-t-butyl-p-cresol (butylated hydroxytoluene); DIEA: diisopropylethylamine; NCS: N-chlorosuccinimide.

Synthetic Methods

Example 1. Synthesis of Compounds 1 and 2

To a solution of C1 (1 g, 2.26 mmol) in acetone (150 mL) was added K2CO3 (937 mg) and 5-chloro-2H-benzo[d][1,2,3]triazole (520 mg, 3.39 mmol). The mixture was stirred at 25° C. for 2 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (80 mL) and EtOAc (120 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×100 mL). The combined organic layers were washed with brine (200 mL), dried over Na2SO4, filtered and evaporated to afford crude product, which was purified by preparative HPLC to give two compounds. The further purification was conducted by SFC to afford compound 2 (157 mg, 13%) and compound 1 (100 mg, 9%).

1: 1H NMR (400 MHz, CDCl3) δ 7.99 (d, J=9.3 Hz, 1H), 7.37-7.31 (m, 2H), 5.44-5.30 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.22 (d, J=9.3 Hz, 1H), 2.74-2.66 (m, 1H), 2.28-1.71 (m, 8H), 1.70-1.46 (m, 9H), 1.45-1.20 (m, 9H), 0.71 (s, 3H). LCMS Rt=0.943 min in 1.5 min chromatography, MS ESI calcd. for C29H41ClN3O3 [M+H]+ 514, found 514.

2: 1H NMR (400 MHz, CDCl3) δ 8.05 (d, J=1.5 Hz, 1H), 7.44 (dd, J=8.7 Hz, 1.6 Hz, 1H), 7.24-7.29 (m, 1H), 5.46-5.31 (m, 2H), 3.53 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.74-2.63 (m, 1H), 2.38-1.67 (m, 9H), 1.57-1.06 (m, 17H), 0.69 (s, 3H). LCMS Rt=0.945 min in 1.5 min chromatography, MS ESI calcd. for C29H41ClN3O3 [M+H]+ 514, found 514.

Example 2. Synthesis of Compounds 7 and 8

The synthesis of compounds 7 and 8 were carried out in a similar manner to the protocol outlined in Example 1.

7: 1H NMR (400 MHz, CDCl3) δ 7.41-7.34 (m, 1H), 7.08-7.04 (m, 1H), 5.41-5.34 (m, 2H), 3.55 (d, J=9.2 Hz, 1H), 3.48-3.41 (m, 2H), 3.26 (d, J=9.2 Hz, 1H), 2.73-2.68 (m, 1H), 2.25-2.10 (m, 2H), 2.00-1.90 (m, 2H), 1.85-1.35 (m, 17H), 1.30-1.10 (m, 8H), 0.69 (s, 3H). LCMS Rt=2.503 min in 3 min chromatography, MS ESI calcd. for C30H40F2N3O2 [M+H—H2O]+512, found 512.

8: 1H NMR (400 MHz, CDCl3) δ 7.66-7.63 (m, 1H), 7.32-7.25 (m, 1H), 5.58-5.50 (m, 2H), 3.56 (d, J=9.2 Hz, 1H), 3.48-3.41 (m, 2H), 3.26 (d, J=9.2 Hz, 1H), 2.70-2.61 (m, 1H), 2.25-2.10 (m, 2H), 2.00-1.90 (m, 2H), 1.85-1.35 (m, 17H), 1.30-1.10 (m, 8H), 0.72 (s, 3H). LCMS Rt=2.168 min in 3 min chromatography, MS ESI calcd. for C30H40F2N3O2 [M+H—H2O]+512, found 512.

Example 3. Synthesis of Compounds 9 and 10

To a solution of C1 (1 g, 2.26 mmol) in acetone (150 mL) was added K2CO3 (937 mg, 6.78 mmol) and 4,6-difluoro-2H-benzo[d][1,2,3]triazole (525 mg, 3.39 mmol). The mixture was stirred at 25° C. for 2 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (80 mL) and EtOAc (120 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×100 mL). The combined organic layers were washed with brine (200 mL), dried over Na2SO4, filtered and concentrated to afford crude product, which was purified by preparative HPLC to give a mixture of two compounds. The further purification was conducted by SFC to give 9 (168.9 mg, crude) and 10 (25 mg, 2%). Compound 9 was purified by SFC second time to afford compound 9 (91.3 mg, 8%).

9: 1H NMR (400 MHz, CDCl3) δ 6.86 (dt, J=1.8, 9.5 Hz, 1H), 6.79 (dd, J=1.6, 7.4 Hz, 1H), 5.44-5.30 (m, 2H), 3.52 (d, J=9.0 Hz, 1H), 3.32 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.74-2.64 (m, 1H), 2.26-1.64 (m, 9H), 1.59-1.05 (m, 17H), 0.68 (s, 3H). LCMS Rt=0.929 min in 1.5 min chromatography, MS ESI calcd. for C29H38F2N3O2[M+H—H2O]+ 498, found 498

10: 1H NMR (400 MHz, CDCl3) δ 7.31 (dd, J=1.8, 8.3 Hz, 1H), 6.95-6.87 (m, 1H), 5.57-5.44 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.69-2.60 (m, 1H), 2.28-1.65 (m, 7H), 1.56-1.08 (m, 19H), 0.73 (s, 3H). LCMS Rt=1.389 min in 2 min chromatography, MS ESI calcd. for C29H38F2N3O2[M+H—H2O]+ 498, found 498

Example 4. Synthesis of Compounds 11, 12, and 13

To a solution of C1 (200 mg, 0.453 mmol) in acetone (4 mL) was added K2CO3 (186 mg) and 6-chloro-2H-[1,2,3]triazolo[4,5-b]pyridine (104 mg, 0.679 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (4 mL) and EtOAc (5 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×5 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4. The solvent was removed by the rotary evaporator, and the residue was purified by preparative HPLC to give compound 11 (89.6 mg, 38%), compound 12 (28.2 mg, 12%) and compound 13 (33.6 mg, 14%).

11: (400 MHz, CDCl3) δ 8.68 (d, J=2.0 Hz, 1H), 7.76 (d, J=2.0 Hz, 1H), 5.53-5.45 (m, 1H), 5.40-5.32 (m, 1H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.22 (d, J=9.0 Hz, 1H), 2.78-2.69 (m, 1H), 2.29-2.12 (m, 2H), 2.02-1.61 (m, 9H), 1.55-1.11 (m, 15H), 0.70 (s, 3H). LCMS Rt=0.906 min in 1.5 min chromatography, MS ESI calcd. for C28H38ClN4O2 [M+H-H2O]+ 497, found 497.

12: (400 MHz, CDCl3) δ 8.58 (d, J=2.0 Hz, 1H), 8.37 (d, J=2.0 Hz, 1H), 5.56-5.42 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.23 (d, J=9.0 Hz, 1H), 2.78-2.69 (m, 1H), 2.29-2.17 (m, 2H), 2.02-1.62 (m, 8H), 1.55-1.10 (m, 16H), 0.72 (s, 3H). LCMS Rt=0.932 min in 1.5 min chromatography, MS ESI calcd. for C28H38ClN4O2 [M+H-H2O]+497, found 497.

13: (400 MHz, CDCl3) δ 8.73 (d, J=2.3 Hz, 1H), 8.22 (d, J=2.3 Hz, 1H), 5.59-5.47 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.70-2.59 (m, 1H), 2.28-1.62 (m, 9H), 1.56-1.08 (m, 17H), 0.73 (s, 3H). LCMS Rt=0.928 min in 1.5 min chromatography, 5-95AB, purity 100%, MS ESI calcd. for C28H38ClN4O2 [M+H-H2O]+ 497, found 497.

Example 5. Synthesis of Compounds 14 and 15

To a solution of C1 (150 mg, 0.339 mmol) in acetone (3 mL) was added K2CO3 (139 mg) and 6-fluoro-2H-indazole (69.1 mg, 0.508 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (4 mL) and EtOAc (5 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×5 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4. The solvent was removed by the rotary evaporator, and the residue was purified by preparative HPLC to give compound 14 (11.5 mg, 7%) and 15 (60.2 mg, 36%).

14: 1H NMR (400 MHz, CDCl3) δ 7.93 (s, 1H), 7.63 (dd, J=5.3, 9.0 Hz, 1H), 7.31-7.22 (m, 1H), 6.95-6.83 (m, 1H), 5.25-5.07 (m, 2H), 3.53 (d, J=9.0 Hz, 1H), 3.32 (s, 3H), 3.20 (d, J=9.0 Hz, 1H), 2.62 (t, J=8.5 Hz, 1H), 2.28-2.15 (m, 1H), 2.15-2.06 (m, 1H), 2.01-1.67 (m, 8H), 1.56-1.07 (m, 16H), 0.69 (s, 3H). LCMS Rt=0.915 min in 1.5 min chromatography, MS ESI calcd. for C30H42FN2O3 [M+H]+ 497, found 497.

15: 1H NMR (400 MHz, CDCl3) δ 8.01 (s, 1H), 7.68 (dd, J=5.0, 8.8 Hz, 1H), 6.93 (dt, J=2.0, 9.0 Hz, 1H), 6.84 (d, J=9.0 Hz, 1H), 5.14-5.00 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.67-2.56 (m, 1H), 2.25-2.06 (m, 2H), 1.98-1.86 (m, 2H), 1.82-1.62 (m, 5H), 1.58-1.06 (m, 17H), 0.70 (s, 3H). LCMS Rt=0.935 min in 1.5 min chromatography, MS ESI calcd. for C30H42FN2O3 [M+H]+ 497, found 497.

Example 6. Synthesis of Compounds 16 and 17

To a solution of C1 (150 mg, 0.339 mmol) in acetone (3 mL) was added K2CO3 (139 mg) and 5-fluoro-2H-indazole (69.1 mg, 0.508 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (4 mL) and EtOAc (5 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×5 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and evaporated to afford crude product, which was purified by preparative HPLC to give compound 16 (20.4 mg, 12%) and compound 17 (69.3 mg, 41%).

16: 1H NMR (400 MHz, CDCl3) δ 7.89 (s, 1H), 7.67 (dd, J=4.5, 9.3 Hz, 1H), 7.28-7.21 (m, 1H), 7.14-7.06 (m, 1H), 5.27-5.12 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.20 (d, J=9.0 Hz, 1H), 2.67-2.58 (m, 1H), 2.27-2.06 (m, 2H), 2.02-1.62 (m, 10H), 1.51-1.11 (m, 14H), 0.69 (s, 3H). LCMS Rt=0.913 min in 1.5 min chromatography, MS ESI calcd. for C30H42FN2O3 [M+H]+ 497, found 497.

17: 1H NMR (400 MHz, CDCl3) δ 8.00 (s, 1H), 7.40-7.33 (m, 1H), 7.18-7.11 (m, 2H), 5.18-5.06 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.61 (t, J=8.9 Hz, 1H), 2.24-2.06 (m, 2H), 2.02-1.85 (m, 3H), 1.82-1.62 (m, 4H), 1.56-1.06 (m, 17H), 0.69 (s, 3H). LCMS Rt=0.939 min in 1.5 min chromatography, MS ESI calcd. for C30H42FN2O3 [M+H]+ 497, found 497.

Example 7. Synthesis of Compounds 18 and 19

To a solution of C1 (150 mg, 0.339 mmol) in acetone (3 mL) was added K2CO3 (139 mg) and 2H-benzo[d][1,2,3]triazole (60.5 mg, 0.508 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (4 mL) and EtOAc (5 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×5 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and evaporated to give crude product, which was purified by preparative HPLC to afford compound 18 (51.9 mg, 32%) and compound 19 (8.9 mg, 6%).

18: 1H NMR (400 MHz, CDCl3) δ 8.07 (d, J=8.3 Hz, 1H), 7.52-7.44 (m, 1H), 7.41-7.29 (m, 2H), 5.46-5.35 (m, 2H), 3.53 (d, J=9.0 Hz, 1H), 3.32 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.73-2.64 (m, 1H), 2.14 (d, J=12.0 Hz, 2H), 2.00-1.86 (m, 2H), 1.81-1.62 (m, 6H), 1.55-1.10 (m, 16H), 0.70 (s, 3H). LCMS Rt=0.894 min in 1.5 min chromatography, MS ESI calcd. for C29H42N3O3 [M+H]+ 480, found 480.

19: 1H NMR (400 MHz, CDCl3) δ 7.93-7.83 (m, 2H), 7.45-7.35 (m, 2H), 5.57-5.46 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.69-2.60 (m, 1H), 2.29-2.11 (m, 2H), 1.99-1.87 (m, 2H), 1.84-1.63 (m, 5H), 1.57-1.10 (m, 17H), 0.74 (s, 3H). LCMS Rt=0.931 min in 1.5 min chromatography, MS ESI calcd. for C29H40N3O2 [M+H-H2O]+ 462, found 462.

Example 8. Synthesis of Compound 20

To a solution of C1 (200 mg, 0.453 mmol) in acetone (4 mL) was added K2CO3 (186 mg) and 5-fluoro-2H-benzo[d][1,2,3]triazole (137 mg, 0.679 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (5 mL) and EtOAc (6 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×6 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and evaporated to give crude product, which was purified by preparative HPLC to afford compound 20 (34.3 mg, 13%).

20: 1H NMR (400 MHz, CDCl3) δ 7.91 (d, J=9.3 Hz, 1H), 7.72 (s, 1H), 7.30-7.25 (m, 1H), 5.58-5.44 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.70-2.61 (m, 1H), 2.31-2.09 (m, 2H), 1.95-1.63 (m, 6H), 1.59-1.06 (m, 18H), 0.73 (s, 3H). LCMS Rt=1.035 min in 1.5 min chromatography, MS ESI calcd. for C30H39F3N3O3 [M+H-H2O]+ 546, found 546.

Example 9. Synthesis of Compounds 21 and 22

Step 1. To a solution of C1 (300 mg, 0.679 mmol) in acetone (6 mL) was added K2CO3 (280 mg) and 4-(methylthio)-1H-pyrazole (115 mg, 1.01 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (6 mL) and EtOAc (8 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×8 mL). The combined organic layers was washed with brine (10 mL), dried over Na2SO4, filtered and evaporated to give a residue, which was purified by preparative HPLC to afford compound 21 (30.3 mg, 75%).

21: (400 MHz, CDCl3) δ 7.53 (s, 1H), 7.41 (s, 1H), 4.94-4.87 (m, 1H), 4.86-4.78 (m, 1H), 3.53 (d, J=9.0 Hz, 1H), 3.32 (s, 3H), 3.18 (d, J=9.0 Hz, 1H), 2.61-2.52 (m, 1H), 2.34 (s, 3H), 2.24-2.13 (m, 1H), 2.08-1.99 (m, 1H), 1.96-1.86 (m, 2H), 1.79-1.61 (m, 8H), 1.52-1.35 (m, 5H), 1.27 (s, 9H), 0.66 (s, 3H). LCMS Rt=0.900 min in 1.5 min chromatography, MS ESI calcd. for C27H42N2O3SNa [M+Na]+ 497, found 497

Step 2. To a solution of compound 21 (105 mg, 0.221 mmol) in DCM (20 mL) was added MCPBA (42 mg, 0.243 mmol) at −78° C. The reaction mixture was stirred at −78° C. for 6 hrs. The reaction was quenched with saturated aqueous Na2S2O3 (15 mL) and extracted with EtOAc (2×40 mL). The combined organic phase was washed with saturated aqueous NaHCO3 (20 mL) and brine (2×40 mL), dried over Na2SO4, and concentrated in vacuum. The residue was purified by column chromatograph on silica gel (PE/EtOAc=5/1 to EtOH/MeOH=9/1) to give compound 22 (60 mg, 56%).

22: 1H NMR (400 MHz, CDCl3) δ 7.84-7.77 (m, 2H), 5.06-4.83 (m, 2H), 3.56-3.48 (m, 1H), 3.31 (s, 3H), 3.18 (d, J=9.0 Hz, 1H), 2.88 (d, J=1.5 Hz, 3H), 2.63-2.54 (m, 1H), 2.26-2.12 (m, 1H), 2.08-1.65 (m, 9H), 1.54-1.38 (m, 6H), 1.34-1.03 (m, 10H), 0.65 (s, 3H). LCMS Rt=1.075 min in 2 min chromatography, MS ESI calcd. for C27H41N2O3S [M+H-H2O]+ 473, found 473

Example 10. Synthesis of Compounds 23 and 24

To a solution of C1 (150 mg, 0.339 mmol) in acetone (3 mL) was added K2CO3 (139 mg) and 5-chloro-4-fluoro-2H-benzo[d] (87.1 mg, 0.508 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (3 mL) and EtOAc (4 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×4 mL). The combined organic layers was washed with brine (6 mL), dried over Na2SO4, filtered and evaporated to give the crude product, which was purified by preparative HPLC to give compound 23 (69.2 mg, 38%) and compound 24 (40.3 mg, 22%).

23: 1H NMR (400 MHz, CDCl3) δ 7.47 (dd, J=6.1, 8.7 Hz, 1H), 7.07 (d, J=8.8 Hz, 1H), 5.48-5.33 (m, 2H), 3.53 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.22 (d, J=9.3 Hz, 1H), 2.74-2.66 (m, 1H), 2.27-2.09 (m, 2H), 2.02-1.88 (m, 2H), 1.85-1.58 (m, 7H), 1.52-1.09 (m, 15H), 0.70 (s, 3H). LCMS Rt=1.378 min in 2 min chromatography, MS ESI calcd. for C29H38ClFN3O2 [M+H-H2O]+ 514, found 514.

24: 1H NMR (400 MHz, CDCl3) δ 7.63 (d, J=9.0 Hz, 1H), 7.36 (dd, J=6.5, 9.0 Hz, 1H), 5.57-5.46 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.70-2.60 (m, 1H), 2.29-2.09 (m, 2H), 1.96-1.60 (m, 7H), 1.56-1.13 (m, 17H), 0.73 (s, 3H). LCMS Rt=1.431 min in 2 min chromatography, MS ESI calcd. for C29H38ClFN3O2 [M+H-H2O]+ 514, found 514.

Example 11. Synthesis of Compounds 25, 26, and 27

To a solution of C1 (200 mg, 0.453 mmol) in acetone (4 mL) was added K2CO3 (186 mg) and 5-methoxy-2H-benzo[d][1,2,3]triazole (101 mg, 0.679 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (5 mL) and EtOAc (6 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×6 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and evaporated to give crude product, which was purified by preparative HPLC to afford compound 25 (50.8 mg, 22%) and compound 26 (20.5 mg, 9%), compound 27 (28 mg, 12%).

25: 1H NMR (400 MHz, CDCl3) δ 7.92 (d, J=9.0 Hz, 1H), 7.26 (s, 1H), 7.04-6.99 (m, 1H), 6.60 (d, J=2.0 Hz, 1H), 5.42-5.24 (m, 2H), 3.86 (s, 3H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.73-2.63 (m, 1H), 2.29-2.11 (m, 2H), 1.97-1.64 (m, 6H), 1.57-1.05 (m, 17H), 0.71 (s, 3H). LCMS Rt=0.886 min in 1.5 min chromatography, MS ESI calcd. for C30H44N3O4 [M+H]+ 510, found 510.

26: 1H NMR (400 MHz, CDCl3) δ 7.37 (d, J=1.8 Hz, 1H), 7.22-7.17 (m, 1H), 7.16-7.10 (m, 1H), 5.41-5.29 (m, 2H), 3.88 (s, 3H), 3.53 (d, J=9.0 Hz, 1H), 3.32 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.71-2.61 (m, 1H), 2.28-2.07 (m, 2H), 1.97-1.61 (m, 8H), 1.55-1.08 (m, 16H), 0.69 (s, 3H). LCMS Rt=0.885 min in 1.5 min chromatography, MS ESI calcd. for C30H44N3O4 [M+H]+ 510, found 510.

27: 1H NMR (400 MHz, CDCl3) δ 7.76-7.70 (m, 1H), 7.10-7.04 (m, 2H), 5.49-5.37 (m, 2H), 3.88 (s, 3H), 3.55 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.20 (d, J=9.0 Hz, 1H), 2.66-2.57 (m, 1H), 2.28-2.08 (m, 2H), 2.02-1.59 (m, 8H), 1.54-1.11 (m, 16H), 0.72 (s, 3H). LCMS Rt=1.319 min in 2 min chromatography, MS ESI calcd. for C30H44N3O4 [M+H]+ 510, found 510.

Example 12. Synthesis of Compounds 28, 29, and 30

To a solution of C1 (150 mg, 0.339 mmol) in acetone (3 mL) was added K2CO3 (140 mg) and 4-methoxy-2H-benzo[d][1,2,3]triazole (75.7 mg, 0.508 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (3 mL) and EtOAc (4 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×5 mL). The combined organic layers was washed with brine (8 mL), dried over Na2SO4, filtered and evaporated to afford crude product, which was purified by preparative HPLC to give compound 29 (10.4 mg, 6%), compound 28 (15.6 mg, 9%) and compound 30 (11.1 mg, 6%).

28: 1H NMR (400 MHz, CDCl3) δ 7.40 (t, J=8.0 Hz, 1H), 6.88 (d, J=8.3 Hz, 1H), 6.72 (d, J=7.8 Hz, 1H), 5.38 (s, 2H), 4.14 (s, 3H), 3.56 (d, J=9.0 Hz, 1H), 3.35 (s, 3H), 3.23 (d, J=9.0 Hz, 1H), 2.74-2.63 (m, 1H), 2.28-2.12 (m, 2H), 1.99-1.89 (m, 2H), 1.83-1.69 (m, 4H), 1.58-1.43 (m, 7H), 1.34-1.29 (m, 6H), 0.97-0.81 (m, 5H), 0.70 (s, 3H). LCMS Rt=0.892 min in 1.5 min chromatography, MS ESI calcd. for C30H44N3O4 [M+H]+ 510, found 510.

29: 1H NMR (400 MHz, CDCl3) δ 7.63 (d, J=8.3 Hz, 1H), 7.25-7.21 (m, 1H), 6.76 (d, J=7.5 Hz, 1H), 5.57 (s, 2H), 3.89 (s, 3H), 3.56 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.71-2.61 (m, 1H), 2.26-2.08 (m, 2H), 1.93 (d, J=6.3 Hz, 2H), 1.84-1.63 (m, 5H), 1.53-1.10 (m, 17H), 0.75-0.68 (m, 3H). LCMS Rt=0.898 min in 1.5 min chromatography, MS ESI calcd. for C30H44N3O4 [M+H]+ 510, found 510.

30: 1H NMR (400 MHz, CDCl3) δ 7.43 (d, J=8.5 Hz, 1H), 7.34-7.27 (m, 1H), 6.64 (d, J=7.5 Hz, 1H), 5.49 (s, 2H), 4.07-4.00 (m, 3H), 3.55 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.19 (d, J=9.0 Hz, 1H), 2.65-2.58 (m, 1H), 2.26-2.08 (m, 2H), 1.97-1.62 (m, 8H), 1.54-1.36 (m, 8H), 0.95-0.79 (m, 8H), 0.72 (s, 3H). LCMS Rt=2.092 min in 3 min chromatography, MS ESI calcd. for C30H44N3O4 [M+H]+ 510, found 510.

Example 13. Synthesis of Compounds 31, 32, and 33

To a solution of C1 (150 mg, 0.339 mmol) in acetone (3 mL) was added K2CO3 (139 mg) and 5-chloro-4-fluoro-2H-benzo[d] (87.1 mg, 0.508 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (3 mL) and EtOAc (4 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×4 mL). The combined organic layers was washed with brine (6 mL), dried over Na2SO4, filtered and evaporated to afford crude product, which was purified by preparative HPLC to give compound 31 (5.2 mg, 3%), compound 32 (40.3 mg, 22%) and compound 33 (33, 69.2 mg, 38%).

31: 1H NMR (400 MHz, CDCl3) δ 7.80 (d, J=8.8 Hz, 1H), 7.35 (dd, J=6.4, 8.7 Hz, 1H), 5.58-5.46 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.22 (d, J=9.0 Hz, 1H), 2.71 (t, J=8.9 Hz, 1H), 2.27-2.09 (m, 2H), 2.03-1.62 (m, 7H), 1.44-1.12 (m, 16H), 0.88 (t, J=6.7 Hz, 1H), 0.72 (s, 3H). LCMS Rt=1.328 min in 2 min chromatography, MS ESI calcd. for C29H38ClFN3O2 [M+H-H2O]+ 514, found 514.

32: 1H NMR (400 MHz, CDCl3) δ 7.63 (d, J=9.0 Hz, 1H), 7.36 (dd, J=6.5, 9.0 Hz, 1H), 5.57-5.46 (m, 2H), 3.55 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.70-2.60 (m, 1H), 2.29-2.09 (m, 2H), 1.96-1.60 (m, 7H), 1.56-1.13 (m, 17H), 0.73 (s, 3H). LCMS Rt=1.431 min in 2 min chromatography, MS ESI calcd. for C29H38ClFN3O2 [M+H-H2O]+ 514, found 514.

33: 1H NMR (400 MHz, CDCl3) δ 7.47 (dd, J=6.1, 8.7 Hz, 1H), 7.07 (d, J=8.8 Hz, 1H), 5.48-5.33 (m, 2H), 3.53 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.22 (d, J=9.3 Hz, 1H), 2.74-2.66 (m, 1H), 2.27-2.09 (m, 2H), 2.02-1.88 (m, 2H), 1.85-1.58 (m, 7H), 1.52-1.09 (m, 15H), 0.70 (s, 3H). LCMS Rt=1.378 min in 2 min chromatography, MS ESI calcd. for C29H38ClFN3O2 [M+H-H2O]+ 514, found 514.

Example 14. Synthesis of Compounds 34 and 35

Step 1. To a solution of A1 (300 mg, 0.679 mmol) in acetone (6 mL) was added K2CO3 (280 mg, 2.03 mmol) and 4-(methylthio)-1H-pyrazole (115 mg, 1.01 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (6 mL) and EtOAc (8 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×8 mL). The combined organic layers was washed with brine (10 mL), dried over Na2SO4, filtered and evaporated to afford a crude product, which was purified by preparative HPLC to give compound 34 (120 mg, 36%).

34: 1H NMR (400 MHz, CDCl3) δ 7.52 (s, 1H), 7.41 (s, 1H), 4.95-4.77 (m, 2H), 3.49-3.43 (m, 1H), 3.40-3.34 (m, 1H), 3.28 (s, 3H), 2.58 (t, J=8.7 Hz, 1H), 2.34 (s, 3H), 2.26-2.14 (m, 1H), 2.07-1.98 (m, 2H), 1.77-1.63 (m, 4H), 1.57-1.44 (m, 5H), 1.41-0.79 (m, 14H), 0.69 (s, 3H). LCMS Rt=0.927 min in 1.5 min chromatography, MS ESI calcd. for C27H42N2O3SNa [M+Na]+ 497, found 497.

Step 2. To a solution of compound 34 (50 mg, 0.105 mmol) in DCM (20 mL) was added MCPBA (19.8 mg, 0.115 mmol) at −78° C. The reaction mixture was stirred at −78° C. for 6 hrs. The reaction was quenched with saturated Na2S2O3 (15 mL). The reaction mixture was extracted with EtOAc (2×40 mL). The combined organic phase was washed with saturated NaHCO3 (20 mL), brine, dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by column chromatograph on silica gel (PE/EtOAc=5/1) to give compound 35 (27.5 mg, 53%).

35: 1H NMR (400 MHz, CDCl3) δ 7.80 (d, J=3.0 Hz, 2H), 5.06-4.84 (m, 2H), 3.49-3.43 (m, 1H), 3.40-3.34 (m, 1H), 3.28 (s, 3H), 2.89 (d, J=0.8 Hz, 3H), 2.60 (t, J=8.8 Hz, 1H), 2.28-2.15 (m, 1H), 2.08-1.97 (m, 2H), 1.81-1.60 (m, 7H), 1.50-0.80 (m, 16H), 0.69 (s, 3H). LCMS Rt=0.812 min in 1.5 min chromatography, MS ESI calcd. for C27H41N2O3S [M+H—H2O]+ 473, found 473.

Example 15. Synthesis of Compound 36

To a solution of A1 (150 mg, 0.339 mmol) in acetone (3 mL) was added 1H-imidazole-2-carbonitrile (47.2 mg, 0.508 mmol), followed by K2CO3 (93.7 mg, 0.678 mmol). The resulting reaction mixture was stirred at 40° C. for 16 hrs. To the mixture was added water (10 mL) and extracted with EtOAc (3×8 mL). The combined organic phase was dried over Na2SO4, filtered and concentrated to give a residue, which was purified by combi-flash (PE: EtOAc=100%-80%) to compound 36 (57 mg, 37%) as a white solid.

36: 1H NMR (400 MHz, CDCl3) δ 7.24 (s, 1H), 7.03 (s, 1H), 4.96-4.83 (m, 2H), 3.48-3.35 (m, 2H), 3.28 (s, 3H), 2.62 (t, J=8.8 Hz, 1H), 2.22-2.01 (m, 4H), 1.85-1.63 (m, 4H), 1.62-1.10 (m, 16H), 1.05-0.86 (m, 2H), 0.72 (s, 3H). LCMS Rt=1.256 min in 2 min chromatography, MS ESI calcd. for C27H40N3O3 [M+H]+ 454, found 454.

Example 16. Synthesis of Compound 37

To a solution of A1 (150 mg, 0.339 mmol) in acetone (3 mL) was added 4-methoxy-1H-pyrazole (49.8 mg, 0.508 mmol), followed by K2CO3 (93.7 mg, 0.678 mmol). The resulting reaction mixture was stirred at 40° C. for 16 hrs. To the mixture was added water (10 mL) and extracted with EtOAc (3×8 mL). The combined organic phase was concentrated to give a residue, which was purified by preparative HPLC to give compound 37 (10 mg, 7%),

37: 1H NMR (400 MHz, CDCl3) δ 7.28 (s, 1H), 7.09 (s, 1H), 4.87-4.75 (m, 2H), 3.76 (s, 3H), 3.47-3.31 (m, 2H), 3.28 (s, 3H), 2.56 (t, J=8.8 Hz, 1H), 2.17-2.01 (m, 4H), 1.71-1.42 (m, 8H), 1.41-0.92 (m, 12H), 0.91-0.84 (m, 2H), 0.69 (s, 3H). LCMS Rt=1.256 min in 2 min chromatography, MS ESI calcd. for C27H43N2O4 [M+H]+ 459, found 459.

Example 17. Synthesis of Compound 38

To a solution of A1 (150 mg, 0.339 mmol) in acetone (3 mL) was added 4-isopropoxy-1H-pyrazole (64 mg, 0.508 mmol), followed by K2CO3 (93.7 mg, 0.678 mmol). The resulting reaction mixture was stirred at 40° C. for 16 hrs. To the mixture was added water (10 mL) and extracted with EtOAc (3×8 mL). The combined organic phases was concentrated to give a residue, which was purified by preparative HPLC to yield compound 38 (36 mg, 22%) as an off-white solid.

38: 1H NMR (400 MHz, CDCl3) δ 7.26 (s, 1H), 7.06 (s, 1H), 4.84-4.77 (m, 2H), 4.18-4.14 (m, 1H), 3.47-3.35 (m, 2H), 3.28 (s, 3H), 2.55 (t, J=8.8 Hz, 1H), 2.04-1.70 (m, 3H), 1.68-1.45 (m, 10H), 1.41-1.01 (m, 17H), 0.98-0.83 (m, 2H), 0.69 (s, 3H). LCMS Rt=1.338 min in 2 min chromatography, MS ESI calcd. for C29H46N2O4Na [M+Na]+ 509, found 509.

Example 18. Synthesis of Compound 39

To a solution of A1 (150 mg, 0.339 mmol) in acetone (2 mL) was added (1H-pyrazol-4-yl)methanol (49.8 mg, 0.508 mmol), followed by K2CO3 (93.7 mg, 0.678 mmol). The resulting reaction mixture was stirred at 40° C. for 2 hrs. To the mixture was added water (10 mL) and extracted with EtOAc (3×8 mL). The combined organic phases was concentrated to give a residue, which was purified by preparative HPLC to give compound 39 (6 mg, 4%) as an off-white solid.

39: (yield 4%): 1H NMR (400 MHz, CDCl3) δ 7.54 (s, 1H), 7.41 (s, 1H), 4.96-4.61 (m, 2H), 4.61 (s, 2H), 3.47-3.36 (m, 2H), 3.28 (s, 3H), 2.59 (t, J=9.2 Hz, 1H), 2.05-2.01 (m, 4H), 1.71-1.58 (m, 4H), 1.56-0.84 (m, 19H), 0.69 (s, 3H). LCMS Rt=0.813 min in 1.5 min chromatography, MS ESI calcd. for C27H42N2O4Na [M+Na]+ 481, found 481.

Example 19. Synthesis of Compounds 40 and 41

To a solution of A1 (300 mg, 0.679 mmol) in acetone (4 mL) was added K2CO3 (280 mg, 2.03 mmol) and 7-methoxy-2H-indazole (149 mg, 1.01 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (5 mL) and EtOAc (6 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×6 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and concentrated to afford a residue, which was purified by preparative HPLC to give compound 40 (44.6 mg, 13%) and compound 41 (28.6 mg, 8%).

40: 1H NMR (400 MHz, CDCl3) δ 7.89 (s, 1H), 7.22 (d, J=8.5 Hz, 1H), 6.98 (t, J=7.9 Hz, 1H), 6.54 (d, J=7.3 Hz, 1H), 5.27-5.14 (m, 2H), 3.99 (s, 3H), 3.49-3.44 (m, 1H), 3.40-3.35 (m, 1H), 3.29 (s, 3H), 2.63 (t, J=8.7 Hz, 1H), 2.26-2.00 (m, 3H), 1.78-1.66 (m, 5H), 1.51-1.06 (m, 16H), 1.04-0.79 (m, 2H), 0.72 (s, 3H). LCMS Rt=1.345 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

41: 1H NMR (400 MHz, CDCl3) δ 7.96 (s, 1H), 7.29 (d, J=8.0 Hz, 1H), 7.02 (t, J=7.8 Hz, 1H), 6.68 (d, J=7.5 Hz, 1H), 5.49-5.42 (m, 1H), 5.37-5.30 (m, 1H), 3.86 (s, 3H), 3.51-3.46 (m, 1H), 3.41-3.35 (m, 1H), 3.30 (s, 3H), 2.61 (t, J=8.9 Hz, 1H), 2.25-2.01 (m, 3H), 1.79-1.61 (m, 6H), 1.54-1.46 (m, 3H), 1.38-1.06 (m, 12H), 1.03-0.80 (m, 2H), 0.72 (s, 3H). LCMS Rt=1.374 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

Example 20. Synthesis of Compounds 42 and 43

To a solution of A1 (300 mg, 0.679 mmol) in acetone (4 mL) was added K2CO3 (280 mg, 2.03 mmol) and 5-methoxy-2H-indazole (149 mg, 1.01 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (5 mL) and EtOAc (6 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×6 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and evaporated to afford a residue, which was purified by preparative HPLC to give compound 42 (37.2 mg, 11%) and compound 43 (71.6 mg, 21%).

42: 1H NMR (400 MHz, CDCl3) δ 7.79 (s, 1H), 7.59 (d, J=9.5 Hz, 1H), 6.99 (dd, J=2.3, 9.5 Hz, 1H), 6.87 (d, J=2.0 Hz, 1H), 5.23-5.07 (m, 2H), 3.83 (s, 3H), 3.48 (s, 1H), 3.40-3.35 (m, 1H), 3.29 (s, 3H), 2.62 (t, J=8.8 Hz, 1H), 2.28-2.17 (m, 1H), 2.13-1.98 (m, 2H), 1.80-1.61 (m, 5H), 1.57-1.07 (m, 16H), 1.03-0.80 (m, 2H), 0.72 (s, 3H). LCMS Rt=1.333 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

43: 1H NMR (400 MHz, CDCl3) δ 7.94 (s, 1H), 7.13-7.02 (m, 3H), 5.15-5.03 (m, 2H), 3.85 (s, 3H), 3.50-3.44 (m, 1H), 3.40-3.34 (m, 1H), 3.29 (s, 3H), 2.62 (t, J=8.8 Hz, 1H), 2.27-1.99 (m, 3H), 1.80-1.61 (m, 5H), 1.56-1.06 (m, 16H), 1.03-0.79 (m, 2H), 0.73 (s, 3H). LCMS Rt=1.347 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

Example 21. Synthesis of Compounds 44 and 45

To a solution of A1 (300 mg, 0.679 mmol) in acetone (4 mL) was added K2CO3 (280 mg, 2.03 mmol) and 4-methoxy-2H-indazole (149 mg, 1.01 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (5 mL) and EtOAc (6 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×6 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and evaporated to afford a residue, which was purified by preparative HPLC to give compound 44 (35.2 mg, 10%) and compound 45 (65.5 mg, 19%).

44: 1H NMR (400 MHz, CDCl3) δ 7.98 (s, 1H), 7.28 (s, 1H), 7.23-7.15 (m, 1H), 6.33 (d, J=7.3 Hz, 1H), 5.23-5.09 (m, 2H), 3.93 (s, 3H), 3.51-3.43 (m, 1H), 3.40-3.35 (m, 1H), 3.29 (s, 3H), 2.63 (t, J=8.8 Hz, 1H), 2.28-2.17 (m, 1H), 2.13-1.99 (m, 2H), 1.80-1.61 (m, 5H), 1.56-1.07 (m, 16H), 1.04-0.79 (m, 2H), 0.72 (s, 3H). LCMS Rt=1.342 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

45: 1H NMR (400 MHz, CDCl3) δ 8.10 (s, 1H), 7.32-7.27 (m, 1H), 6.77 (d, J=8.5 Hz, 1H), 6.48 (d, J=7.5 Hz, 1H), 5.14-5.03 (m, 2H), 4.00-3.93 (m, 3H), 3.50-3.44 (m, 1H), 3.40-3.34 (m, 1H), 3.29 (s, 3H), 2.62 (t, J=8.7 Hz, 1H), 2.25-1.99 (m, 3H), 1.81-1.59 (m, 6H), 1.55-1.06 (m, 15H), 1.04-0.79 (m, 2H), 0.73 (s, 3H). LCMS Rt=1.361 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4[M+H]+ 509, found 509.

Example 22. Synthesis of Compounds 46 and 47

To a solution of 2H-pyrazolo[3,4-c]pyridine (80.8 mg, 0.679 mmol) in THF (3 mL) was added NaH (32.4 mg, 1.35 mmol) at 25° C. The mixture was stirred at 20° C. for 30 mins, then a solution of C1 (200 mg, 0.453 mmol) in THF (2 mL) was added. The reaction mixture was stirred at 20° C. for 16 hrs. The mixture was quenched with water (10 mL), extracted with EtOAc (2×15 mL). The combined organic phase was washed with brine (30 mL), dried over Na2SO4 and concentrated in vacuum. The residue was purified by preparative TLC (eluted with EtOAc) to give compound 46 (9.9 mg, 5%) and compound 47 (17.3 mg, 8%).

46: 1H NMR (400 MHz, CDCl3) δ 9.31 (s, 1H), 8.19 (d, J=6.0 Hz, 1H), 8.00 (s, 1H), 7.62-7.52 (m, 1H), 5.38-5.18 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.33 (s, 3H), 3.21 (d, J=9.0 Hz, 1H), 2.71-2.61 (m, 1H), 2.29-2.10 (m, 2H), 1.98-1.60 (m, 9H), 1.50-1.27 (m, 11H), 1.22-1.09 (m, 2H), 0.91-0.76 (m, 2H), 0.70 (s, 3H). LCMS Rt=1.039 min in 2 min chromatography, MS ESI calcd. for C29H42N3O3[M+H]+ 480, found 480.

47: 1H NMR (400 MHz, CDCl3) δ 8.79 (s, 1H), 8.34 (d, J=5.5 Hz, 1H), 8.10 (s, 1H), 7.64 (dd, J=1.1, 5.6 Hz, 1H), 5.31-5.19 (m, 2H), 3.54 (d, J=9.0 Hz, 1H), 3.34 (s, 3H), 3.22 (d, J=9.0 Hz, 1H), 2.71-2.63 (m, 1H), 2.27-2.09 (m, 2H), 1.98-1.87 (m, 2H), 1.83-1.61 (m, 6H), 1.56-1.40 (m, 8H), 1.37-1.27 (m, 6H), 1.22-1.10 (m, 2H), 0.71 (s, 3H). LCMS Rt=1.069 min in 2 min chromatography, MS ESI calcd. for C29H42N3O3[M+H]+ 480, found 480.

Example 23. Synthesis of Compound 48 and 49

To a solution of A1 (300 mg, 0.679 mmol) in acetone (4 mL) was added K2CO3 (280 mg, 2.03 mmol) and 6-methoxy-2H-indazole (149 mg, 1.01 mmol). The mixture was stirred at 25° C. for 4 hrs. The solvent was removed by rotary evaporator. To the mixture was added water (5 mL) and EtOAc (6 mL). The organic layer was separated. The aqueous phase was extracted with EtOAc (2×6 mL). The combined organic layers was washed with brine (7 mL), dried over Na2SO4, filtered and concentrated to afford a residue, which was purified by preparative HPLC to give compound 49 (3.3 mg, 0.2%) and compound 48 (81.2 mg, 1%).

48: 1H NMR (400 MHz, CDCl3) δ 7.82 (s, 1H), 7.52 (d, J=9.0 Hz, 1H), 6.94 (s, 1H), 6.77 (dd, J=2.3, 9.0 Hz, 1H), 5.19-5.03 (m, 2H), 3.85 (s, 3H), 3.50-3.44 (m, 1H), 3.40-3.34 (m, 1H), 3.29 (s, 3H), 2.62 (t, J=8.8 Hz, 1H), 2.27-2.17 (m, 1H), 2.13-1.99 (m, 2H), 1.78-1.67 (m, 4H), 1.50-1.12 (m, 16H), 1.02-0.81 (m, 3H), 0.72 (s, 3H). LCMS Rt=1.326 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

49: 1H NMR (400 MHz, CDCl3) δ 7.93 (s, 1H), 7.58 (d, J=8.8 Hz, 1H), 6.81 (dd, J=2.0, 8.8 Hz, 1H), 6.53 (s, 1H), 5.13-4.99 (m, 2H), 3.84 (s, 3H), 3.51-3.44 (m, 1H), 3.41-3.34 (m, 1H), 3.29 (s, 3H), 2.63 (t, J=8.8 Hz, 1H), 2.25-2.01 (m, 3H), 1.79-1.65 (m, 5H), 1.55-1.10 (m, 16H), 1.04-0.79 (m, 2H), 0.74 (s, 3H). LCMS Rt=1.341 min in 2 min chromatography, MS ESI calcd. for C31H45N2O4 [M+H]+ 509, found 509.

Example 24. Synthesis of Compound 50

To a solution of C1 (200 mg, 0.453 mmol) and 6-chloro-2H-indazole (103 mg, 0.679 mmol) in acetone (5 mL) was added K2CO3 (93.8 mg, 0.679 mmol). The reaction mixture was stirred at 25° C. for 2 hrs. The reaction mixture was diluted with EtOAc (50 mL), washed with H2O (20 mL), brine (20 mL), dried over Na2SO4, filtered and concentrated to afford crude product, which was purified by preparative HPLC to give compound 50 (10 mg, 5%).

50: 1H NMR (400 MHz, CDCl3) δ 8.03 (s, 1H), 7.68 (d, J=8.5 Hz, 1H), 7.22 (s, 1H), 7.15 (d, J=8.5 Hz, 1H), 5.20-5.03 (m, 2H), 3.57 (d, J=9.0 Hz, 1H), 3.36 (s, 3H), 3.23 (d, J=9.0 Hz, 1H), 2.65 (t, J=8.7 Hz, 1H), 2.30-2.09 (m, 2H), 1.99-1.91 (m, 2H), 1.77-1.45 (m, 14H), 1.34-1.14 (m, 8H), 0.73 (s, 3H). LCMS tR=3.185 min in 4 min chromatography, MS ESI calcd. for C30H42ClN2O3 [M+H]+ 513, found 513.

Example 25. Synthesis of Compound 51

To a solution of A1 (200 mg, 0.47 mmol) in acetone (2 mL) was added 5-chloro-4-fluoro-2H-benzo[d][1,2,3]triazole (0.116 g, 0.68 mmol), followed by K2CO3 (0.124 g, 0.906 mmol). The resulting reaction mixture was stirred at 25° C. for 16 hrs. To the mixture was added water (4 mL) and extracted with EtOAc (3×2 mL). The combined organic phase was concentrated to give a residue, which was purified by preparative HPLC to give compound 51 (65.9 mg, 27%)

51: 1H NMR (400 MHz, CDCl3) δ 7.48 (dd, J=6.0, 8.8 Hz, 1H), 7.07 (d, J=7.6 Hz, 1H), 5.46-5.36 (m, 2H), 3.50-3.48 (m, 1H), 3.40-3.37 (m, 1H), 3.30 (s, 3H), 2.72 (t, J=8.6 Hz, 1H), 2.30-2.01 (m, 3H), 1.80-1.70 (m, 4H), 1.69-1.48 (m, 7H), 1.39-1.10 (m, 10H), 1.09-0.76 (m, 2H), 0.74 (s, 3H). LCMS Rt=1.374 min in 2 min chromatography, MS ESI calcd. for C29H40ClFN3O3 [M+H]+ 532, found 532.

Example 26. Synthesis of Compound 52

To a solution of C1 (100 mg, 0.226 mmol) in acetone (5 mL) was added K2CO3 (62.4 mg, 0.452 mmol) and 5-fluoro-1H-imidazole (29.1 mg, 0.339 mmol) at 15° C. The mixture was stirred at 45° C. for 12 h, then treated with water (20 mL) and extracted with EtOAc (2×30 mL). The organic phase was washed with brine (30 mL), dried over anhydrous Na2SO4, and concentrated in vacuum prior to being purified by preparative HPLC to afford compound 52 (18.3 mg) as an off-white solid.

52: 1H NMR (400 MHz, CDCl3) δ 7.00 (s, 1H), 6.37 (dd, J=1.2 Hz, 8.0 Hz, 1H), 4.60-4.59 (m, 2H), 3.50 (d, J=8.8 Hz, 1H), 3.31 (s, 3H), 3.21 (d, J=8.8 Hz, 1H), 2.57-2.55 (m, 1H), 2.23-2.10 (m, 1H), 1.91-1.85 (m, 3H), 1.80-1.1.65 (m, 6H), 1.64-1.14 (m, 16H), 0.65 (s, 3H). LCMS Rt=0.861 min in 1.5 min chromatography, MS ESI calcd. for C26H40FN2O3 [M+H]+ 447, found 447.

Example 27. Synthesis of Compound 53

To a solution of A1 (600 mg, 1.35 mmol) in 3 mL of acetone was added 4-nitro-1H-pyrazole (197 mg, 1.75 mmol) and K2CO3 (373 mg, 2.7 mmol) at 25° C. After stirring at 55° C. for 3 hrs, the reaction mixture was poured into ice-cold water, extracted with EtOAc (2×50 mL), washed with brine (2×30 mL), dried over Na2SO4, filtered, and evaporated under vacuum to give 500 mg of the crude product, which was purified by prep-HPLC to obtain compound 53 (30.0 mg, 23%) as an off-white solid.

53: 1H NMR (400 MHz, CDCl3): δ 8.17 (s, 1H), 8.08 (s, 1H), 5.00-4.86 (m, 2H), 3.48-3.44 (m, 1H), 3.37 (d, J=9.8 Hz, 1H), 3.28 (s, 3H), 2.61 (t, J=8.8 Hz, 1H), 2.26-2.18 (m, 1H), 2.03 (d, J=13.4 Hz, 2H), 1.77-1.69 (m, 4H), 1.55-1.47 (m, 4H), 1.46-1.04 (m, 13H), 1.03-0.95 (m, 1H), 0.90-0.81 (m, 1H), 0.69 (s, 3H). LCMS Rt=2.859 min in 4.0 min chromatography, MS ESI calcd. for C26H38N3O4 [M—H2O+H]+ 456, found 456.

Example 28. Synthesis of Compounds 54 and 55

Step 1. To a stirred solution of 53 (400 mg, 0.844 mmol) in 20 mL of MeOH was added Pd/C (200 mg). The reaction was stirred under H2 at 25° C. for 3 hrs, then the reaction mixture was filtered, washed with MeOH (20 mL) and evaporated under vacuum to give a crude product (300 mg), which was purified by HPLC to obtain compound 54 (15 mg, 90%) as an off-white solid.

54: 1H NMR 1H NMR (400 MHz, DMSO-d6,): □ 10.00 (br. s., 2H), 7.90 (s, 1H), 7.55 (s, 1H), 5.21-5.00 (m, 2H), 3.37-3.30 (m, 2H), 3.24-3.15 (m, 3H), 2.77-2.62 (m, 2H), 2.33 (br. s., 1H), 2.04 (d, J=9.6 Hz, 2H), 1.92-1.50 (m, 10H), 1.48-1.01 (m, 10H), 0.99-0.88 (m, 1H), 0.83-0.72 (m, 1H), 0.64-0.47 (m, 3H). LCMS Rt=1.984 min in 4.0 min chromatography, MS ESI calcd. for C26H42N3O3 [M+H]+ 444.2, found 444.2.

Step 2. To a stirred solution of compound 54 (200 mg, 0.450 mmol) in 5 mL of DCM was added Ac2O (45.9 mg, 0.450 mmol) and TEA (0.124 mL, 0.9 mmol) and DMAP (109 mg, 0.9 mmol) at 25° C. After stirring at 25° C. for 0.5 hrs, the reaction mixture was poured into water (20 mL), extracted with EtOAc (2×50 mL), washed with brine (2×30 mL), dried over Na2SO4, filtered and evaporated in vacuum. The crude product was purified by prep-HPLC to obtain compound 55 (30.7 mg, 14%) as an off-white solid.

55: 1H NMR (400 MHz, CDCl3): δ 7.89 (brs, 1H), 7.42 (brs, 1H), 7.30 (brs, 1H), 4.94-4.77 (m, 2H), 3.48-3.42 (m, 1H), 3.39-3.34 (m, 1H), 3.28 (s, 3H), 2.57 (brs, 1H), 2.23-2.10 (m, 4H), 2.06-1.99 (m, 2H), 1.76-1.62 (m, 9H), 1.51 (dd, J=12.6, 4.5 Hz, 3H), 1.33 (t, J=13.6 Hz, 2H), 1.25-1.18 (m, 5H), 1.16-1.05 (m, 2H), 1.02-0.92 (m, 1H), 0.83 (t, J=9.6 Hz, 1H), 0.68 (s, 3H). LCMS Rt=2.631 min in 4.0 min chromatography, MS ESI calcd. for C28H44N3O4 [M+H]′ 486.3, found 486.3.

Example 29. Synthesis of Compound 56

To a stirred solution of C1 (90 mg, 0.203 mmol) in 3 mL of acetone was added 1H-imidazole-2-carbonitrile (24.4 mg, 0.263 mmol) and K2CO3 (56.1 mg, 0.406 mmol) at 25° C. After stirring at 55° C. for 4 hrs, the reaction mixture was poured into ice-cold water, extracted with EtOAc (2×50 mL), washed with brine (2×30 mL), dried over Na2SO4, filtered and evaporated under vacuum. The crude product was purified by preparative HPLC to obtain compound 56 (25.6 mg, 28%) as an off-white solid.

56: 1H NMR (400 MHz, CDCl3): δ 7.26 (s, 1H), 7.13-6.98 (m, 1H), 5.02-4.79 (m, 2H), 3.57-3.50 (m, 1H), 3.33 (s, 3H), 3.20 (d, J=9.0 Hz, 1H), 2.62 (br. s., 1H), 2.22 (d, J=8.6 Hz, 1H), 2.08 (d, J=10.6 Hz, 1H), 1.92 (br. s., 2H), 1.79-1.57 (m, 11H), 1.52-1.42 (m, 4H), 1.29 (s, 5H), 1.24-1.09 (m, 2H), 0.70 (s, 3H). LCMS Rt=2.553 min in 4.0 min chromatography, MS ESI calcd. for C27H40N3O3 [M+H]′ 454.3, found 454.3.

Example 30. Synthesis of Compound 57

To a stirred solution of C1 (80 mg, 0.181 mmol) in 3 mL of acetone was added 4-isopropoxy-1H-pyrazole (29.6 mg, 0.235 mmol) and K2CO3 (50 mg, 0.362 mmol) at 25° C. After stirring at 55° C. for 4 hrs, the reaction mixture was poured into ice-cold water, extracted with EtOAc (2×50 mL, washed with brine (2×30 mL), dried over Na2SO4, filtered and evaporated under vacuum. The crude product was purified by preparative HPLC to obtain compound 57 (16.3 mg, 19%) as an off-white solid.

57: 1H NMR (400 MHz, CDCl3,): δ 7.26 (s, 1H), 7.06 (s, 1H), 4.84-4.72 (m, 2H), 4.17 (dt, J=12.2, 6.2 Hz, 1H), 3.54 (d, J=9.0 Hz, 1H), 3.32 (s, 3H), 3.18 (d, J=9.0 Hz, 1H), 2.54 (t, J=8.8 Hz, 1H), 2.22-2.13 (m, 1H), 2.03 (d, J=11.6 Hz, 1H), 1.91 (d, J=5.8 Hz, 2H), 1.80-1.66 (m, 4H), 1.56-1.34 (m, 11H), 1.33-1.26 (m, 9H), 1.24 (br. s., 4H), 0.65 (s, 3H). LCMS Rt=2.758 min in 4.0 min chromatography, MS ESI calcd. for C29H47N2O4 [M+H]+ 487.4, found 487.4.

Example 31. Synthesis of Compound 58

To a stirred solution of C1 (80 mg, 0.181 mmol) in 3 mL of acetone was added 4-ethoxy-1H-pyrazole (26.3 mg, 0.235 mmol) and K2CO3 (50 mg, 0.362 mmol) at 25° C. After stirring at 55° C. for 4 hrs, the reaction mixture was poured into ice-cold water, extracted with EtOAc (2×50 mL), washed with brine (2×30 mL), dried over Na2SO4, filtered and evaporated under vacuum. The crude product was purified by preparative HPLC to obtain compound 58 (12.3 mg, Yield:14%) as an off-white solid.

58: 1H NMR (400 MHz, CDCl3): δ 7.27 (br. s., 1H), 7.06 (s, 1H), 4.86-4.70 (m, 2H), 3.94 (q, J=6.8 Hz, 2H), 3.58-3.49 (m, 1H), 3.32 (s, 3H), 3.23-3.13 (m, 1H), 2.53 (t, J=8.4 Hz, 1H), 2.22-2.14 (m, 1H), 2.07-1.97 (m, 2H), 1.91 (d, J=4.8 Hz, 2H), 1.79-1.59 (m, 7H), 1.51-1.33 (m, 8H), 1.32-1.15 (m, 9H), 0.65 (s, 3H). LCMS Rt=2.686 min in 4.0 min chromatography, MS ESI calcd. for C28H45N2O4 [M+H]+ 473.3, found 473.3.

Example 32. Synthesis of Compound 59

To a solution of A1 (100 mg, 226 μmol) in acetone (5 mL) was added K2CO3 (62.4 mg, 452 μmol) and 5-fluoro-1H-imidazole (23.3 mg, 271 μmol) at 55° C. The mixture was stirred at 55° C. for 12 hrs, at which point H2O (10 mL) was added. The mixture was extracted with EtOAc (2×20 mL), and the combined organic layer was washed with brine (10 mL), dried over Na2SO4, filtered and concentrated under reduced pressure to give a crude product, which was purified by preparative HPLC to afford compound 59 (22 mg, 22%) as an off-white solid.

59: 1H NMR (400 MHz, CDCl3) δ 7.02 (s, 1H), 6.39 (dd, J=1.8, 8.0 Hz, 1H), 4.69-4.54 (m, 2H), 3.53-3.36 (m, 2H), 3.31 (s, 3H), 2.59 (t, J=8.9 Hz, 1H), 2.30-2.16 (m, 1H), 2.09-2.00 (m, 1H), 1.99-1.91 (m, 1H), 1.82-1.68 (m, 4H), 1.67-1.61 (m, 2H), 1.56-1.45 (m, 3H), 1.45-1.30 (m, 3H), 1.29-1.20 (m, 6H), 1.19-1.09 (m, 3H), 1.06-0.82 (m, 2H), 0.70 (s, 3H). LCMS Rt=0.992 min in 2 min chromatography, MS ESI calcd. for C26H40FN2O3 [M+H]+ 447, found 447.

Example 33. Synthesis of Compound 60

To a solution of A1 (200 mg, 0.453 mmol) in acetone (5 mL) was added K2CO3 (93.8 mg, 0.679 mmol) and 4-methyl-1H-pyrazole (44.5 mg, 0.543 mmol) at 50° C. The mixture was stirred at 50° C. for 12 hrs, then poured into water (10 mL) and extracted with EtOAc (2×20 mL). The combined organic layer was washed with brine (10 mL), dried over Na2SO4, filtered and concentrated under reduced pressure to give the crude product, which was purified by preparative HPLC to give compound 60 (107 mg, 53%) as an off-white solid.

60: 1H NMR (400 MHz, CDCl3) δ 7.38 (s, 1H), 7.20 (s, 1H), 4.97-4.82 (m, 2H), 3.51-3.35 (m, 2H), 3.30 (s, 3H), 2.63-2.55 (m, 1H), 2.28-2.16 (m, 1H), 2.12 (s, 3H), 2.08-2.00 (m, 2H), 1.79-1.66 (m, 5H), 1.63-1.56 (m, 3H), 1.53-1.47 (m, 3H), 1.42-1.30 (m, 2H), 1.27-1.19 (m, 6H), 1.18-1.07 (m, 2H), 1.05-0.92 (m, 1H), 0.91-0.80 (m, 1H), 0.71 (s, 3H). LCMS Rt=1.028 min in 2 min chromatography, MS ESI calcd. for C27H43N2O3 [M+H]+ 443, found 443.

Example 34. Synthesis of Compound 61

To a solution of A1 (80 mg, 0.181 mmol) in acetone (3 mL) was added 4-ethoxy-1H-pyrazole (30.3 mg, 0.271 mmol) and K2CO3 (49.9 mg, 0.362 mmol) at 15° C. The mixture was stirred at 40° C. for 15 hrs, then was diluted with DCM (10 mL) and filtered. The filtrate was concentrated to get the crude product, which was purified by preparative HPLC to afford compound 61 (17.6 mg, 21%).

61: 1H NMR (400 MHz, CD3OD) δ 7.30 (s, 1H), 7.24 (s, 1H), 4.64 (br. s., 2H), 3.96 (q, J=7.0 Hz, 2H), 3.54-3.40 (m, 2H), 3.31 (s, 3H), 2.72-2.64 (m, 1H), 2.22-1.94 (m, 5H), 1.82-1.12 (m, 19H), 1.09-0.81 (m, 4H), 0.71 (s, 3H). LCMS Rt=1.840 min in 3.0 min chromatography, MS ESI calcd. for C28H45N2O4 [M+H]+ 473, found 473.

Example 35. Synthesis of Compounds 62 and 63

Step 1. To a solution of D1 (2 g, 6.01 mmol) in 40 mL of anhydrous dichloromethane was added PCC (2.58 g, 12 mmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The solution was filtered and the filter cake was washed with DCM (2×50 mL). The combined filtrate was concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=10/1) to afford D2 (1.6 g77%) as an off-white solid.

D2: 1H NMR (400 MHz, CDCl3) δ 9.75 (s, 1H), 5.17-5.08 (m, 1H), 2.42-2.28 (m, 2H), 2.26-2.12 (m, 1H), 2.04-1.80 (m, 3H), 1.78-1.67 (m, 1H), 1.67-1.59 (m, 6H), 1.58-1.45 (m, 6H), 1.40-1.33 (m, 3H), 1.32-1.25 (m, 4H), 1.24-1.07 (m, 3H), 0.93 (s, 3H).

Step 2. To a solution of D2 (1.2 g, 3.63 mmol) in MeOH (10 mL) and THF (10 mL) was added NaBD4 (227 mg, 5.44 mmol) at 25° C. The reaction mixture was stirred at 25° C. for 2 hrs. The reaction was poured into water (100 mL) and extracted with (2×50 mL). The combined organic layer was washed with brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum to afford D3 (1.1 g, crude) as an off-white solid.

D3: 1H NMR (400 MHz, CDCl3) δ 5.18-5.06 (m, 1H), 3.54-3.48 (m, 1H), 2.41-2.31 (m, 1H), 2.29-2.11 (m, 2H), 2.01-1.84 (m, 2H), 1.82-1.71 (m, 1H), 1.67-1.59 (m, 5H), 1.54-1.34 (m, 5H), 1.33-1.08 (m, 12H), 0.85 (s, 3H).

Step 3. To a solution of D3 (1 g, 2.99 mmol) in DMF (15 mL) was added NaH (358 mg, 8.97 mmol, 60%) at 25° C. The mixture was stirred at 25° C. for 30 mins. Me2SO4 (377 mg, 2.99 mmol, 100 mg/mL in THF) was added and the reaction mixture was stirred at 25° C. for 12 h. The mixture was poured into ice water (20 mL) and extracted with EtOAc (2×30 mL). The combined organic phase was washed with brine (20 mL), dried over anhydrous Na2SO4, filtered and concentrated under vacuum. The residue was purified by column chromatography on silica gel (PE/EtOAc=10/1) to afford D4 (506 mg, 44%) as a colorless oil.

D4: 1H NMR (400 MHz, CDCl3) δ 5.19-5.00 (m, 1H), 3.36 (s, 3H), 2.44-2.12 (m, 3H), 2.02-1.88 (m, 2H), 1.85-1.71 (m, 1H), 1.66-1.40 (m, 10H), 1.41-1.12 (m, 12H), 0.96-0.82 (m, 5H).

Step 4. To a solution of D4 (506 mg, 1.45 mmol) in THF (3 mL) was added drop wise a solution of BH3-Me2S (1.44 mL, 14.4 mmol) at 0° C. The solution was stirred at 25° C. for 16 hrs. After cooling to 0° C., a solution of NaOH (4.8 mL, 3M) was added very slowly. After the addition, H2O2 (3 mL, 33%) was added slowly and the inner temperature was maintained below 10° C. The resulting solution was stirred at 25° C. for 2 hrs. The resulting solution was extracted with EtOAc (2×20 mL). The combined organic layer was washed with saturated Na2S2O3 (2×50 mL), brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum to give D5 (410 mg, crude) as an off-white solid, which was used for the next step without further purification.

D5: 1H NMR (400 MHz, CDCl3) δ 3.78-3.72 (m, 1H), 3.35 (s, 3H), 3.18 (m, 1H), 1.96-1.94 (m, 3H), 1.59-1.45 (m, 11H), 1.29-1.10 (m, 16H), 0.88-0.75 (m, 1H), 0.75-0.56 (m, 3H).

Step 5. To a solution of D5 (410 mg, 1.12 mmol) in THF (2 mL) and DCM (8 mL) was added PCC (481 mg, 2.24 mmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The solution was filtered and the filter cake was washed with DCM (2×50 mL). The combined filtrate was concentrated in vacuum, and the residue was purified by silica gel column eluted with (PE/EtOAc=6/1) to afford D6 (242 mg, 56%) as an off-white solid.

D6: 1H NMR (400 MHz, CDCl3) δ 3.52-3.15 (m, 4H), 2.52 (t, J=8.9 Hz, 1H), 2.20-2.08 (m, 4H), 2.04-1.84 (m, 3H), 1.81-1.60 (m, 4H), 1.55-1.34 (m, 8H), 1.31-1.05 (m, 10H), 0.60 (s, 3H).

Step 6. To a solution of D6 (242 mg, 0.665 mmol) and HBr (0.05 mL, 48% in water) in MeOH (5 mL) was added bromine (127 mg, 0.798 mmol). The reaction mixture was stirred at 25° C. for 2 hrs. The reaction was quenched by saturated NaHCO3 (20 mL) and pH was adjusted to 7-8. The mixture was extracted with EtOAc (2×30 mL). The combined organic layers was washed with brine (50 mL), dried over Na2SO4 filtered and concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=10/1) to afford D7 (180 mg, 58%) as an off-white solid.

D7: 1H NMR (400 MHz, CDCl3) δ 3.95-3.85 (m, 2H), 3.52-3.14 (m, 4H), 2.85-2.77 (m, 1H), 2.24-2.10 (m, 1H), 1.96-1.85 (m, 3H), 1.81-1.66 (m, 3H), 1.57-1.35 (m, 6H), 1.31-1.09 (m, 11H), 0.92-0.81 (m, 2H), 0.62 (s, 3H).

Step 7. To a solution of D7 (180 mg, 0.406 mmol) in acetone (3 mL) was added K2CO3 (112 mg, 0.812 mmol) and 5-methyl-2H-tetrazole (84.9 mg, 1.01 mmol). The mixture was stirred at 25° C. for 12 hrs. The mixture was poured into water (30 mL) and extracted with EtOAc (2×30 mL). The combined organic layers was washed with brine (20 mL), dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by preparative HPLC to give compounds 62 (40 mg, 22%) and 63 (33 mg, 18%) as an off-white solid.

62: 1H NMR (400 MHz, CDCl3) δ 5.34 (s, 2H), 3.52-3.19 (m, 4H), 2.65-2.59 (m, 1H), 2.57 (s, 3H), 2.28-2.15 (m, 1H), 2.10-2.05 (m, 1H), 1.98-1.87 (m, 2H), 1.84-1.70 (m, 3H), 1.67-1.62 (m, 1H), 1.60-1.40 (m, 8H), 1.37-1.09 (m, 10H), 0.70 (s, 3H). LCMS Rt=0.979 min in 2.0 min chromatography, MS ESI calcd. for C25H38DN4O2 [M+H-H2O]+ 428, found 428.

63: 1H NMR (400 MHz, CDCl3) δ 5.19-5.01 (m, 2H), 3.50-3.20 (m, 4H), 2.69-2.61 (m, 1H), 2.47 (s, 3H), 2.26-2.14 (m, 1H), 2.10-2.05 (m, 1H), 1.98-1.87 (m, 2H), 1.85-1.71 (m, 3H), 1.68-1.62 (m, 2H), 1.61-1.59 (m, 1H), 1.57-1.41 (m, 7H), 1.39-1.10 (m, 9H), 0.67 (s, 3H). Rt=0.897 min in 2.0 min chromatography, MS ESI calcd. for C25H38DN4O2 [M+H-H2O]+ 428, found 428.

Example 36. Synthesis of Compound 64

To a solution of C1 (110 mg, 249 μmol) in acetone (5 mL) was added K2CO3 (51.5 mg, 373 μmol) and 2-methyl-1H-imidazole (24.4 mg, 298 μmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The mixture was poured into water (10 mL) and extracted with EtOAc (2×20 mL). The combined organic layer was washed with brine (10 mL), dried over Na2SO4 filtered and concentrated under reduced pressure to give the crud product, which was purified by HPLC to give compound 64 (9.5 mg, 9%) as an off-white solid.

64: 1H NMR (400 MHz, DMSO-d6) δ 6.86 (s, 1H), 6.70 (s, 1H), 4.98-4.69 (m, 2H), 3.47 (d, J=9.3 Hz, 1H), 3.20 (s, 3H), 3.15 (d, J=9.0 Hz, 1H), 2.67 (m, 1H), 2.07 (s, 3H), 2.02-1.56 (m, 7H), 1.56-1.32 (m, 8H), 1.32-0.96 (m, 11H), 0.53 (s, 3H). LCMS Rt=0.742 min in 2.0 min chromatography, MS ESI calcd. for C27H43N2O3 [M+H]+ 443, found 443.

Example 37. Synthesis of Compounds 65 and 66

Step 1. To a solution of C1 (450 mg, 1.01 mmol) in acetone (20 mL) was added K2CO3 (208 mg, 1.51 mmol) and 4-nitro-1H-pyrazole (136 mg, 1.21 mmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The mixture was poured into water (10 mL) and extracted with EtOAc (2×20 mL). The combined organic layer was washed with brine (10 mL), dried over Na2SO4, filtered and concentrated under reduced pressure to give the crude product (450 mg), of which 150 mg which was purified by preparative HPLC to give compound 65 (36.9 mg, 7%) as an off-white solid.

65: 1H NMR (400 MHz, CDCl3) δ 8.20 (s, 1H), 8.10 (s, 1H), 5.04-4.88 (m, 2H), 3.55 (d, J=8.8 Hz, 1H), 3.35 (s, 3H), 3.23 (d, J=9.2 Hz, 1H), 2.68-2.58 (m, 1H), 2.29-2.18 (m, 1H), 2.12-2.02 (m, 1H), 1.97-1.89 (m, 2H), 1.85-1.73 (m, 3H), 1.71-1.59 (m, 3H), 1.56-1.44 (m, 7H), 1.40-1.15 (m, 9H), 0.69 (s, 3H). LCMS Rt=1.030 min in 2.0 min chromatography, MS ESI calcd. for C26H38N3O4 [M+H-H2O]+ 456, found 456.

Step 2. To a solution of 65 (300 mg, 633 μmol) in MeOH (5 mL) was added Pd/C (10%, 300 mg) under N2. The suspension was degassed under vacuum and purged with H2 several times. The mixture was stirred under H2 (15 psi) at 25° C. for 12 hrs. The reaction mixture was filtered and concentrated under reduced pressure to give the crude product (300 mg), 150 mg of which was purified by preparative HPLC to give 66 (17 mg, 6%) as an off-white solid.

66: 1H NMR (400 MHz, DMSO-d6) δ 6.97 (s, 1H), 6.92 (s, 1H), 4.90-4.72 (m, 2H), 4.25 (s, 1H), 3.84 (br. s., 2H), 3.49 (d, J=9.2 Hz, 1H), 3.25 (s, 3H), 3.17 (d, J=9.2 Hz, 1H), 2.62-2.54 (m, 1H), 2.08-1.96 (m, 2H), 1.88-1.73 (m, 3H), 1.72-1.56 (m, 3H), 1.55-1.44 (m, 4H), 1.43-1.32 (m, 4H), 1.30-1.00 (m, 9H), 0.55 (s, 3H). LCMS Rt=0.604 min in 2.0 min chromatography, MS ESI calcd. for C26H41N3O3Na [M+Na]+ 466, found 466.

Example 38. Synthesis of Compound 67

To a solution of C1 (110 mg, 249 μmol) in acetone (5 mL) was added K2CO3 (51.5 mg, 373 μmol) and 4-(trifluoromethyl)-1H-pyrazole (40.5 mg, 298 μmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The mixture was poured into water (10 mL) and extracted with EtOAc (2×20 mL), and the combined organic layer was washed with brine (10 mL), dried over Na2SO4, filtered and concentrated under reduced pressure to give the crud product, which was purified by HPLC to give 67 (33.8 mg, 27%) as an off-white solid.

67: 1H NMR (400 MHz, CDCl3) δ 7.74 (s, 2H), 5.06-4.86 (m, 2H), 3.56 (d, J=9.2 Hz, 1H), 3.35 (s, 3H), 3.22 (d, J=8.8 Hz, 1H), 2.66-2.57 (m, 1H), 2.28-2.03 (m, 2H), 1.98-1.90 (m, 2H), 1.84-1.72 (m, 3H), 1.57-1.39 (m, 9H), 1.38-1.10 (m, 10H), 0.69 (s, 3H). LCMS Rt=1.083 min in 2.0 min chromatography, MS ESI calcd. for C27H40F3N2O3 [M+H]+ 497, found 497.

Example 39. Synthesis of Compounds 68, 69, and 70

Step 1. To a mixture of propan-2-ol (27.7 g, 462 mmol) and TEA (46.6 g, 462 mmol) in DCM (100 mL) was added sulfurous dichloride (25 g, 210 mmol) dropwise at 0° C. The reaction mixture was stirred at 70° C. for 3 hrs. The reaction mixture was cooled to 15° C., washed with water (2×200 mL), brine (200 mL), dried over Na2SO4, filtered and evaporated to give diisopropyl sulfite (28.0 g, crude) as a brown oil. 1H NMR (400 MHz, CDCl3) δ 4.82-4.73 (m, 2H), 1.38-1.26 (m, 12H).

Step 2. To a solution of diisopropyl sulfite (24 g, 144 mmol) in CCl4 (20 mL), MeCN (20 mL) and water (30 mL) was added sodium periodate (92.4 g, 432 mmol) in portions followed by ruthenium(III) chloride (8.96 mg, 43.2 mmol) at 15° C. The reaction mixture was stirred at 15° C. for 1 h. The reaction mixture was filtered. The filtered cake was washed with EtOAc (4×250 mL). The organic layer was separated and washed with water (220 mL), saturated Na2S2O3 (3×220 mL), dried over Na2SO4, filtered and concentrated under vacuum to give diisopropyl sulfate (26 g, 99%) as colorless oil. 1H NMR (400 MHz, CDCl3) δ 4.88 (sept, J=6.4 Hz, 2H), 1.42 (d, J=6.4 Hz, 12H).

Step 3. NaH (251 mg, 6.30 mmol) was added to a solution of D1 (300 mg, 1.05 mmol) in THF (35 mL) at 0° C. under nitrogen. After that, diisopropyl sulfate (765 mg, 4.20 mmol) was added portion wise. The mixture was slowly warmed to room temperature and heated to 65° C. The reaction mixture was stirred at 65° C. for 2 hrs. The mixture was diluted with water (200 mL) and extracted with EtOAc (3×200 mL). The combined organic layers were washed with saturated NH4Cl (100 mL), dried with anhydrous sodium sulfate and filtered. The solvents were removed under reduced pressure and the residue was purified by column chromatography on silica gel (PE/EtOAc=4/1) to afford D8 (300 mg, 76%) as an off-white solid.

D8: 1H NMR (400 MHz, CDCl3) δ 5.10 (q, J=6.8 Hz, 1H), 3.58 (d, J=9.2 Hz, 1H), 3.47-3.41 (m, 1H), 3.21 (d, J=9.2 Hz, 1H), 2.41-2.29 (m, 1H), 2.28-2.09 (m, 2H), 2.00-1.85 (m, 2H), 1.83-1.70 (m, 1H), 1.68-1.38 (m, 14H), 1.37-1.16 (m, 9H), 1.13 (d, J=6.0 Hz, 6H), 0.85 (s, 3H).

Step 4. To a solution of D8 (380 mg, 1.01 mmol) in THF (15 mL) was added dropwise a solution of BH3-Me2S (1.01 mL, 10 M, 10.1 mmol) at 0° C. The solution was stirred at 25° C. for 12 hrs. After cooling to 0° C., NaOH aqueous (3.36 mL, 3M, 10.1 mmol) was added slowly. After the addition, hydrogen peroxide (1.03 g, 33% w/w in water, 10.1 mmol) was added slowly and the inner temperature maintained below 10° C. The resulting solution was stirred at 25° C. for 2 hrs. The resulting solution was extracted with EtOAc (3×80 mL). The combined organic solution was washed with saturated Na2S2O3 (2×80 mL), brine (30 mL), dried over Na2SO4, filtered, and concentrated in vacuum to give D9 (401 mg, crude) as a white solid, which was used for the next step without further purification.

Step 5. To a solution of D9 (401 mg, 1.02 mmol) in DCM (30 mL) was added PCC (393 mg, 1.83 mmol) and MgSO4 (612 mg, 5.10 mmol) at 15° C. The reaction mixture was stirred at 15° C. for 4 hrs. The reaction mixture was filtered. The filtrate was concentrated under vacuum to give a residue, which was purified by silica gel chromatography (PE/EtOAc=4/1) to afford D10 (280 mg, 70%) as an off-white solid.

D10: 1H NMR (400 MHz, CDCl3) δ 3.59-3.51 (m, 1H), 3.49-3.41 (m, 1H), 3.22-3.19 (m, 1H), 2.53 (t, J=8.8 Hz, 1H), 2.20-2.08 (m, 4H), 2.05-1.95 (m, 1H), 1.94-1.85 (m, 2H), 1.82-1.70 (m, 2H), 1.69-1.40 (m, 10H), 1.39-1.16 (m, 10H), 1.13 (d, J=6.0 Hz, 6H), 0.60 (s, 3H).

Step 6. To a solution of D10 (150 mg, 384 μmol) in MeOH (20 mL) was added HBr (1 drop, 48% w/w in water) at 15° C. Liquid bromine (67.4 mg, 422 μmol) was added at 15° C. The reaction mixture was stirred at 15° C. for 2 hrs. The mixture was quenched by saturated NaHCO3 aqueous (20 mL) at 0° C. The mixture was extracted with EtOAc (3×80 mL), and the combined organic phase was washed with water (100 mL), brine (100 mL), dried over Na2SO4, filtered, and evaporated under vacuum to give a residue, which was purified by silica gel chromatography (PE/EtOAc=5/1) to afford D11 (220 mg, impure) as an off-white solid.

D11: 1H NMR (400 MHz, CDCl3) δ 3.96-3.83 (m, 2H), 3.53 (d, J=8.8 Hz, 1H), 3.45 (m, 1H), 3.21 (d, J=8.8 Hz, 1H), 2.81 (t, J=8.8 Hz, 1H), 2.24-2.09 (m, 1H), 1.98-1.85 (m, 3H), 1.82-1.67 (m, 3H), 1.65-1.31 (m, 11H), 1.29-1.16 (m, 8H), 1.12 (d, J=6.0 Hz, 6H), 0.63 (s, 3H).

Step 7. To a solution of D11 (145 mg, 0.3088 mmol) in acetone (10 mL) was added 4,5-difluoro-2H-benzo[d][1,2,3]triazole (71.8 mg, 0.4632 mmol), followed by K2CO3 (85.2 mg, 0.6176 mmol) at 15° C. The reaction mixture was stirred at 15° C. for 16 hrs, and the organic phase was washed with water (2×100 mL), brine (120 mL), dried over Na2SO4, filtered, concentrated under vacuum to give a residue, which was purified by preparative HPLC to afford 68 (37.7 mg, 22%), 69 (4.6 mg, 3%) and 70 (20.8 mg, 12%).

68: 1H NMR (400 MHz, CDCl3) δ 7.45-7.30 (m, 1H), 7.10-7.00 (m, 1H), 5.49-5.33 (m, 2H), 3.54 (d, J=8.8 Hz, 1H), 3.49-3.45 (m, 1H), 3.25 (d, J=8.8 Hz, 1H), 2.76-2.66 (m, 1H), 2.28-2.09 (m, 2H), 1.99-1.87 (m, 2H), 1.85-1.71 (m, 3H), 1.69-1.34 (m, 11H), 1.34-1.16 (m, 8H), 1.14 (d, J=6.0 Hz, 6H), 0.71 (s, 3H). LCMS Rt=4.647 min in 7 min chromatography, MS ESI calcd. For C31H42F2N3O2 [M+H-H2O]+ 526, found 526.

69: 1H NMR (400 MHz, CDCl3) δ 7.85-7.75 (m, 1H), 7.25-7.15 (m, 1H), 5.57-5.47 (m, 2H), 3.54 (d, J=8.8 Hz, 1H), 3.49-3.45 (m, 1H), 3.25 (d, J=8.8 Hz, 1H), 2.70-2.62 (m, 1H), 2.29-2.09 (m, 2H), 1.99-1.86 (m, 2H), 1.84-1.69 (m, 3H), 1.69-1.17 (m, 19H), 1.14 (d, J=6.0 Hz, 6H), 0.74 (s, 3H). LCMS Rt=4.835 min in 7 min chromatography, MS ESI calcd. for C31H44F2N3O3 [M+H]+ 544, found 544.

70: 1H NMR (400 MHz, CDCl3) δ 7.70-7.60 (m, 1H), 7.35-7.27 (m, 1H), 5.60-5.44 (m, 2H), 3.54 (d, J=9.2 Hz, 1H), 3.49-3.45 (m, 1H), 3.25 (d, J=9.2 Hz, 1H), 2.70-2.62 (m, 1H), 2.29-2.09 (m, 2H), 1.99-1.86 (m, 2H), 1.84-1.69 (m, 3H), 1.69-1.17 (m, 19H), 1.14 (d, J=6.0 Hz, 6H), 0.74 (s, 3H). LCMS Rt=5.104 min in 7 min chromatography, MS ESI calcd. for C31H42F2N3O2 [M+H-H2O]+ 526, found 526.

Example 40. Synthesis of Compounds 71 and 72

To a solution of D11 (170 mg, 0.3620 mmol) in acetone (15 mL) was added 2H-tetrazole (38.0 mg, 0.543 mmol), followed by K2CO3 (99.9 mg, 0.724 mmol) at 15° C. The reaction mixture was stirred at 15° C. for 16 hrs. The reaction mixture was diluted with DCM (80 mL), washed with water (3×50 mL), brine (60 mL), dried over Na2SO4, filtered and concentrated under vacuum to give a solid, which was purified by preparative HPLC to give 71 (33 mg, 20%) as a white solid and crude 72 (45 mg, impure) which was further purified by silica gel chromatography (PE:EtOAc=3:1) to give 72 (13 mg, 8%) as an off-white solid.

71: 1H NMR (400 MHz, CDCl3) δ 8.74 (s, 1H), 5.38-5.12 (m, 2H), 3.52 (d, J=8.8 Hz, 1H), 3.50-3.40 (m, 1H), 3.24 (d, J=8.8 Hz, 1H), 2.66 (t, J=8.4 Hz, 1H), 2.30-2.15 (m, 1H), 2.10-2.00 (m, 1H), 1.97-1.86 (m, 2H), 1.85-1.71 (m, 3H), 1.69-1.41 (m, 10H), 1.40-1.16 (m, 9H), 1.13 (d, J=6.0 Hz, 6H), 0.66 (s, 3H). LCMS Rt=3.394 min in 7 min chromatography, MS ESI calcd. for C26H41N4O2 [M+H-H2O]+ 441, found 441.

72: 1H NMR (400 MHz, CDCl3) δ 8.57 (s, 1H), 5.45 (s, 2H), 3.53 (d, J=9.0 Hz, 1H), 3.50-3.40 (m, 1H), 3.24 (d, J=9.0 Hz, 1H), 2.69-2.59 (m, 1H), 2.27-2.15 (m, 1H), 2.15-2.00 (m, 1H), 1.99-1.86 (m, 2H), 1.85-1.70 (m, 3H), 1.68-1.33 (m, 13H), 1.33-1.18 (m, 6H), 1.13 (d, J=6.0 Hz, 6H), 0.71 (s, 3H). LCMS Rt=3.670 min in 7 min chromatography, MS ESI calcd. for C26H41N4O2 [M+H-H2O]+ 441, found 441.

Example 41. Synthesis of Compounds 73 and 74

Step 1. To a solution of D7 (3 g, 8.99 mmol) in DCM (50 mL) was added PCC (3.84 g, 17.9 mmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The solution was filtered and the filter cake was washed with DCM (2×50 mL). The combined filtrate was concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=8/1) to afford D12 (2.7 g, 86%, D/H=7/1) as an off-white solid.

D12: 1H NMR (400 MHz, CDCl3) δ 9.75 (s, 0.14H), 5.16-5.10 (m, 1H), 2.44-2.26 (m, 2H), 2.24-2.11 (m, 1H), 2.03-1.77 (m, 4H), 1.75-1.63 (m, 6H), 1.59-1.45 (m, 6H), 1.40-1.26 (m, 7H), 1.24-1.08 (m, 3H), 0.93 (s, 3H).

Step 2. To a solution of D12 (2.7 g, 8.14 mmol) in MeOH (20 mL) and THF (20 mL) was added NaBD4 (510 mg, 12.2 mmol) at 25° C. The reaction mixture was stirred at 25° C. for 2 hrs. The reaction was poured into water (100 mL) and extracted with EtOAc (2×100 mL). The combined organic layer was washed with brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum to afford D13 (2.6 g, crude, D/H=7/1) as an off-white solid.

D13: 1H NMR (400 MHz, CDCl3) δ 5.16-5.12 (m, 1H), 2.39-2.29 (m, 1H), 2.28-2.25 (m, 2H), 1.98-1.95 (m, 2H), 1.67-1.66 (m, 1H), 1.65-1.64 (m, 6H), 1.63-1.52 (m, 6H), 1.52-1.21 (m, 12H), 0.87 (s, 3H).

Step 3. To a solution of D13 (2.6 g, 7.77 mmol) in DCM (40 mL) was added PCC (3.33 g, 15.5 mmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The solution was filtered and the filter cake was washed with DCM (2×50 mL). The combined filtrate was concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=8/1) to afford D14 (2.2 g, 81%, D/H=40/1) as an off-white solid.

D14: 1H NMR (400 MHz, CDCl3) δ 9.77 (s, 0.024H), 5.18-5.13 (m, 1H), 2.43-2.36 (m, 3H), 1.97-1.94 (m, 4H), 1.69-1.61 (m, 12H), 1.56-1.49 (m, 7H), 1.33-1.21 (m, 3H), 0.95 (s, 3H).

Step 4. To a solution of D14 (2.2 g, 6.63 mmol, D/H=40/1)) in MeOH (20 mL) and THF (20 mL) was added NaBD4 (416 mg, 9.94 mmol) at 25° C. The reaction mixture was stirred at 25° C. for 2 hrs. The reaction was poured into water (100 mL) and extracted with EtOAc (2×50 mL). The combined organic layer was washed with brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum to afford D15 (1.8 g, crude) as an off-white solid.

D15: 1H NMR (400 MHz, CDCl3) δ 5.13-5.10 (m, 1H), 2.38-2.23 (m, 3H), 1.95-1.92 (m, 2H), 1.64-1.63 (m, 1H), 1.62-1.50 (m, 12H), 1.47-1.19 (m, 12H), 0.84 (s, 3H).

Step 5. To a solution of D15 (1.8 g, 5.38 mmol) in DMF (20 mL) was added NaH (643 mg, 16.1 mmol, 60%) at 25° C. The mixture was stirred at 25° C. for 30 min. Me2SO4 (678 mg, 5.38 mmol) was added to the mixture. The reaction mixture was stirred at 25° C. for 12 hrs. The mixture was poured into ice water (50 mL) and extracted with EtOAc (2×50 mL). The combined organic phase was washed with saturated brine (50 mL), dried with anhydrous Na2SO4, filtered and concentrated in vacuum. The residue was purified by column chromatography on silica gel (PE/EtOAc=10/1) to afford D16 (800 mg, 34%) as colorless oil.

D16: 1H NMR (400 MHz, CDCl3) δ 5.13-5.08 (m, 1H), 3.33 (s, 3H), 2.32-2.23 (m, 3H), 1.92-1.91 (m, 2H), 1.65-1.64 (m, 1H), 1.57-1.48 (m, 8H), 1.45-1.22 (m, 15H), 0.85 (s, 3H).

Step 6. To a solution of D16 (800 mg, 2.29 mmol) in THF (10 mL) was added drop wise a solution of BH3-Me2S (2.29 mL, 22.9 mmol) at 0° C. The solution was stirred at 25° C. for 16 hrs. After cooling to 0° C., a solution of NaOH (7.63 mL, 3M) was added very slowly. After the addition was complete, H2O2 (4.7 mL, 33%) was added slowly and the inner temperature was maintained below 10° C. The resulting solution was stirred at 25° C. for 2 hrs. The resulting solution was extracted with EtOAc (2×20 mL). The combined organic layer was washed with saturated aqueous Na2S2O3 (2×50 mL), brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum to give D17 (780 mg, crude) as an off-white solid. The crude product was used for the next step without further purification.

Step 7. To a solution of D17 (780 mg, 2.12 mmol) in THF (5 mL) and DCM (20 mL) was added PCC (911 mg, 4.24 mmol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The solution was filtered and the filter cake was washed with DCM (2×50 mL). The combined filtrate was concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=6/1) to afford D18 (340 mg, 40%) as an off-white solid.

D18: 1H NMR (400 MHz, CDCl3) δ 3.33 (s, 3H), 2.55-2.53 (m, 1H), 2.19-2.10 (m, 4H), 2.07-1.88 (m, 3H), 1.81-1.60 (m, 4H), 1.57-1.51 (m, 3H), 1.50-1.35 (m, 5H), 1.30-1.07 (m, 10H), 0.60 (s, 3H).

Step 8. To a solution of D18 (340 mg, 0.932 mmol) and HBr (0.1 mL, 48% in water) in MeOH (8 mL) was added drop wise bromine (177 mg, 1.11 mmol). The reaction mixture was stirred at 25° C. for 2 hrs. The reaction was quenched by saturated aqueous NaHCO3 (20 mL) and the pH was adjusted to 7-8. The mixture was extracted with EtOAc (2×30 mL), and the combined organic layers was washed with brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=8/1) to afford D19 (240 mg, 52%) as colorless oil.

D19: 1H NMR (400 MHz, CDCl3) δ 3.94-3.86 (m, 2H), 3.32 (s, 3H), 2.84-2.79 (m, 1H), 2.23-2.13 (m, 1H), 1.97-1.87 (m, 3H), 1.82-1.67 (m, 3H), 1.54-1.35 (m, 7H), 1.31-1.10 (m, 9H), 0.91-0.83 (m, 3H), 0.63 (s, 3H).

Step 9. To a solution of D19 (120 mg, 0.27 mmol) in acetone (3 mL) was added K2CO3 (74.6 mg, 0.54 mmol) and 5-methyl-2H-tetrazole (34 mg, 0.405 mmol) at 25° C. The mixture was stirred at 25° C. for 3 hrs. The mixture was poured into water (30 mL) and extracted with ethyl acetate (2×30 mL). The combined organic layers was washed with brine (20 mL), dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by preparative HPLC to give 73 (23.8 mg, 20%) and 74 (30.3 mg, 25%) as an off-white solid.

73: 1H NMR (400 MHz, CDCl3) δ 5.34 (s, 2H), 3.33 (s, 3H), 2.65-2.58 (m, 1H), 2.56 (s, 3H), 2.27-2.14 (m, 1H), 2.11-2.03 (m, 1H), 1.98-1.87 (m, 2H), 1.84-1.69 (m, 3H), 1.67-1.56 (m, 3H), 1.52-1.38 (m, 6H), 1.37-1.09 (m, 10H), 0.70 (s, 3H). LCMS Rt=0.954 min in 2.0 min chromatography, MS ESI calcd. for C25H37D2N4O2 [M+H—H2O]+ 429, found 429.

74: 1H NMR (400 MHz, CDCl3) δ 5.16-5.02 (m, 2H), 3.33 (s, 3H), 2.67-2.63 (m, 1H), 2.47 (s, 3H), 2.29-2.14 (m, 1H), 2.10-2.02 (m, 1H), 1.97-1.85 (m, 2H), 1.84-1.70 (m, 3H), 1.67-1.57 (m, 3H), 1.49-1.40 (m, 6H), 1.38-1.08 (m, 10H), 0.67 (s, 3H). LCMS Rt=0.886 min in 2.0 min chromatography, MS ESI calcd. for C25H37D2N4O2 [M+H-H2O]+ 429, found 429.

Example 42. Synthesis of Compound 75

To a solution of A1 (200 mg, 453 mol) in acetone (2 mL) was added 5-fluoro-2H-pyrazolo[3,4-c]pyridine (74.4 mg, 543 mol) and K2CO3 (125 mg, 906 mol) at 25° C. The mixture was stirred at 25° C. for 12 hrs, poured into water (10 mL), and extracted with EtOAc (2×20 mL). The combined organic solution was washed with brine (10 mL) and dried over Na2SO4. The organic layer was filtered and concentrated under reduced pressure to give crude product, which was purified by preparative HPLC to give 75 (17 mg, 7%) as an off-white solid.

75: 1H NMR (400 MHz, CDCl3) δ 8.93 (s, 1H), 7.97 (s, 1H), 7.07 (s, 1H), 5.35-5.17 (m, 2H), 3.51-3.35 (m, 2H), 3.30 (s, 3H), 2.68 (t, J=8.9 Hz, 1H), 2.29-2.00 (m, 3H), 1.80-1.69 (m, 4H), 1.55-1.38 (m, 8H), 1.35-1.09 (m, 9H), 1.06-0.83 (m, 2H), 0.73 (s, 3H). LCMS Rt=1.018 min in 1.5 min chromatography, MS ESI calcd. for C29H41FN3O3 [M+H]+ 498, found 498.

Example 43. Synthesis of Compound 76

Step 1. To a solution of E1 (6 g, 19.7 mmol) in toluene (100 mL) was added pyridine hydrochloride (453 mg, 3.94 mmol) and ethane-1,2-diol (6.1 g, 98.4 mmol). The mixture was stirred at 130° C. for 16 hrs, then concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=5/1) to afford E2 (5.4 g, 66%) as an off-white solid.

E2: 1H NMR (400 MHz, CDCl3) δ 3.98-3.80 (m, 9H), 3.58-3.55 (m, 1H), 2.10-2.01 (m, 1H), 1.99-1.91 (m, 2H), 1.84-1.60 (m, 5H), 1.59-1.33 (m, 10H), 1.30-1.17 (m, 4H), 1.15-1.02 (m, 1H), 0.82 (s, 3H).

Step 2. To a solution of E2 (5.3 g, 13.5 mmol) in DCM (60 mL) was added PCC (4.34 g, 20.2 mmol) at 25° C. The mixture was stirred at 25° C. for 30 mins. The solution was filtered and the filtered cake was washed with DCM (2×100 mL). The combined filtrate was washed with saturated NaHCO3 (100 mL) and brine (100 mL), dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=8/1) to afford E3 (3.1 g, 53%) as a colorless oil.

E3: 1H NMR (400 MHz, CDCl3) δ 9.58 (s, 1H), 4.00-3.84 (m, 8H), 2.25-2.15 (m, 1H), 2.03-1.88 (m, 2H), 1.84-1.59 (m, 7H), 1.56-1.32 (m, 10H), 1.30-1.17 (m, 1H), 1.13-0.99 (m, 1H), 0.92 (s, 3H).

Step 3. To a solution of E3 (3 g, 7.68 mmol) in THF (50 mL) was added MeMgBr (5.1 mL, 15.3 mmol, 3M in ethyl ether) at 0° C. The mixture was stirred at 25° C. for 2 hrs. The reaction was poured into water (100 mL) and extracted with EtOAc (2×100 mL). The combined organic layer was washed with brine (100 mL), dried over Na2SO4, filtered and concentrated in vacuum to afford E4 (2.8 g, 81%) as colorless oil.

E4: 1H NMR (400 MHz, CDCl3) δ 4.42 (m, 1H), 3.97-3.81 (m, 8H), 2.03-1.92 (m, 2H), 1.90-1.74 (m, 5H), 1.71-1.64 (m, 1H), 1.60-1.34 (m, 9H), 1.30-1.22 (m, 4H), 1.21-1.11 (m, 5H), 0.87 (s, 3H).

Step 4. To a solution of E4 (2.7 g, 6.64 mmol) in DMF (20 mL) was added NaH (795 mg, 19.9 mmol, 60%) at 25° C. The mixture was stirred at 50° C. for 30 mins. MeI (2.82 g, 19.9 mmol) was added drop wise to the reaction. The mixture was stirred at 50° C. for 2 hrs, followed by addition of another aliquot of MeI (2.82 g, 19.9 mmol). The mixture was stirred at 50° C. for 1 h, then poured into ice water (50 mL) and extracted with EtOAc (2×60 mL). The combined organic phase was washed with saturated brine (100 mL), dried with anhydrous Na2SO4, filtered and concentrated in vacuum. The residue was purified by column chromatography on silica gel (PE/EtOAc=10/1) to afford E5 (2 g, 64%) as an off-white solid.

E5: 1H NMR (400 MHz, CDCl3) δ 3.97-3.83 (m, 8H), 3.79-3.74 (m, 1H), 3.29 (s, 3H), 2.08-1.93 (m, 2H), 1.91-1.75 (m, 3H), 1.73-1.57 (m, 3H), 1.54-1.36 (m, 8H), 1.31-1.05 (m, 9H), 0.88 (s, 3H).

Step 5. To a solution of E5 (2 g, 4.75 mmol) in THF (30 mL) was added aq. HCl (4.75 mL, 4M, 19 mmol). The mixture was stirred at 25° C. for 16 hrs, then poured into water (100 mL) and extracted with EtOAc (2×50 mL). The combined organic layers were washed with saturated aqueous NaHCO3 (50 mL), brine (50 mL), dried over Na2SO4 and concentrated in vacuum to afford E6 (1.4 g, 80%) as an off-white solid.

E6: 1H NMR (400 MHz, CDCl3) δ 3.86-3.82 (m, 1H), 3.31 (s, 3H), 2.77-2.67 (m, 1H), 2.54-2.43 (m, 1H), 2.32-2.19 (m, 3H), 2.16-1.94 (m, 4H), 1.91-1.78 (m, 3H), 1.75-1.60 (m, 4H), 1.55-1.35 (m, 2H), 1.30-1.16 (m, 4H), 1.10-1.05 (m, 3H), 0.93 (s, 3H).

Step 6. To a solution of BHT (5.56 g, 25.2 mmol) in toluene (50 mL) was added dropwise AlMe3 (6.3 mL, 12.6 mmol, 2 M in toluene) at 0° C. The mixture was stirred at 25° C. for 1 h. A solution of E6 (1.4 g, 4.21 mmol) in toluene (20 mL) was added drop wise to the mixture at −65° C. After stirring at −65° C. for 1 h, MeMgBr (4.19 mL, 12.6 mmol, 3M in ethyl ether) was added drop wise at −65° C. The resulting solution was stirred at −65° C. for 3 hrs. The reaction was quenched by saturated aqueous NH4Cl (50 mL) at −65° C. After stirring at 25° C. for 0.5 h, the resulting mixture was filtered through a celite pad and the pad was washed with EtOAc (100 mL). The combined organic layer was separated, washed with brine (2×100 mL), dried over Na2SO4, filtered and concentrated in vacuum. The crude product was purified by silica gel column eluted with PE/EtOAc=5/1 to give E7 (1.1 g, 68%) as an off-white solid.

E7: 1H NMR (400 MHz, CDCl3) δ 3.80-3.75 (m, 1H), 3.29 (s, 3H), 2.48-2.41 (m, 1H), 2.15-2.02 (m, 1H), 2.00-1.77 (m, 4H), 1.74-1.63 (m, 4H), 1.57-1.33 (m, 7H), 1.29-1.13 (m, 9H), 1.08 (d, J=6.4 Hz, 3H), 0.89 (s, 3H). LCMS Rt=0.954 min in 2.0 min chromatography, MS ESI calcd. For C21H31O [M+H—H2O-MeOH]+ 299, found 299.

Step 7. To a solution of PPh3EtBr (3.18 g, 8.58 mmol) in THF (15 mL) was added t-BuOK (962 mg, 8.58 mmol) at 25° C. After stirring at 60° C. for 1 h, a solution of E7 (1 g, 2.86 mmol) in THF (5 mL) was added dropwise at 60° C. The reaction mixture was stirred at 60° C. for 16 hrs, and the mixture was poured into ice-water (100 mL) and extracted with EtOAc (2×50 mL). The organic layer was washed with brine (50 mL), dried over Na2SO4 and filtered, concentrated in vacuum. The residue was purified by silica gel column eluted with PE/EtOAc=15/1 to afford E8 (1 g, 78%) as an off-white solid.

E8: 1H NMR (400 MHz, CDCl3) δ 5.18-4.99 (m, 1H), 3.83-3.71 (m, 1H), 3.30 (s, 3H), 2.45-2.09 (m, 3H), 2.01-1.81 (m, 3H), 1.68-1.58 (m, 6H), 1.58-1.37 (m, 7H), 1.31-1.12 (m, 10H), 1.08-1.03 (m, 3H), 0.91 (s, 3H).

Step 8. To a solution of E8 (1 g, 2.77 mmol) in THF (20 mL) was added dropwise a solution of BH3-Me2S (2.77 mL, 27.7 mmol) at 0° C. The solution was stirred at 25° C. for 16 hrs. After cooling to 0° C., a solution of NaOH (9.23 mL, 3M) was added very slowly. After the addition was complete, H2O2 (4.5 mL, 33%) was added slowly and the inner temperature was maintained below 10° C. The resulting solution was stirred at 25° C. for 2 hrs. The resulting solution was extract with EtOAc (2×20 mL), and the combined organic layer was washed with saturated aqueous Na2S2O3 (2×50 mL), brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum to give E9 (0.9 g, crude) as an off-white solid. The crude product was used for the next step without further purification.

Step 9. To a solution of E9 (800 mg, 2.11 mmol) in DCM (10 mL) was added PCC (907 mg, 4.22 mol) at 25° C. The mixture was stirred at 25° C. for 2 hrs. The solution was filtered and the filter cake was washed with DCM (2×50 mL). The combined filtrate was concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=5/1) to afford 76 (600 mg, 68%) as a white solid.

76: 1H NMR (400 MHz, CDCl3) δ 3.78-3.74 (m, 1H), 3.27 (s, 3H), 2.56-2.51 (m, 1H), 2.22-2.16 (m, 1H), 2.12 (s, 3H), 2.06-1.94 (m, 2H), 1.91-1.79 (m, 1H), 1.74-1.61 (m, 6H), 1.50-1.32 (m, 6H), 1.29-1.10 (m, 10H), 1.06 (d, J=6.0 Hz, 3H), 0.64 (s, 3H). LCMS Rt=1.067 min in 2.0 min chromatography, MS ESI calcd. For C23H35O [M+H-H2O-MeOH]+ 327, found 327.

Example 44. Synthesis of Compounds 77 and 78

Step 1. To a solution of 76 (300 mg, 0.796 mmol) and HBr (0.1 mL, 48% in water) in MeOH (5 mL) was added drop wise bromine (190 mg, 1.19 mmol). The reaction mixture was stirred at 25° C. for 2 hrs. The reaction was quenched by saturated aqueous NaHCO3 (20 mL) and the pH was adjusted to 7-8. The mixture was extracted with EtOAc (2×30 mL), and the combined organic layers was washed with brine (50 mL), dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by silica gel column eluted with (PE/EtOAc=8/1) to afford E10 (240 mg, 60%) as an off-white solid.

E10: 1H NMR (400 MHz, CDCl3) δ 3.98-3.86 (m, 2H), 3.77-3.73 (m, 1H), 3.26 (s, 3H), 2.85-2.83 (m, 1H), 2.27-2.13 (m, 1H), 2.02-1.83 (m, 3H), 1.77-1.61 (m, 5H), 1.54-1.33 (m, 7H), 1.31-1.11 (m, 8H), 1.08-1.02 (m, 3H), 0.91-0.80 (m, 2H), 0.67 (s, 3H).

Step 2. To a solution of E10 (120 mg, 0.263 mmol) in acetone (3 mL) was added K2CO3 (72.5 mg, 0.526 mmol) and 5-methyl-2H-tetrazole (44.2 mg, 0.526 mmol) at 25° C. The mixture was stirred at 25° C. for 16 hrs. The mixture was poured into water (30 mL) and extracted with EtOAc (2×30 mL). The combined organic layers was washed with brine (20 mL), dried over Na2SO4, filtered and concentrated in vacuum. The residue was purified by preparative HPLC to give 77 (15 mg, 12%) and 78 (32 mg, 27%) as an off-white solid.

77: 1H NMR (400 MHz, CDCl3) δ 5.43-5.29 (m, 2H), 3.79-3.74 (m, 1H), 3.27 (s, 3H), 2.65-2.60 (m, 1H), 2.57 (s, 3H), 2.30-2.16 (m, 1H), 2.11-2.08 (m, 1H), 2.01-1.95 (m, 1H), 1.76-1.65 (m, 1H), 1.80-1.63 (m, 6H), 1.52-1.34 (m, 6H), 1.33-1.10 (m, 10H), 1.07 (d, J=6.4 Hz, 3H), 0.74 (s, 3H). LCMS Rt=0.990 min in 2.0 min chromatography, MS ESI calcd. for C26H41N4O2 [M+H-H2O]+ 441, found 441.

78: 1H NMR (400 MHz, CDCl3) δ 5.21-5.02 (m, 2H), 3.79-3.74 (m, 1H), 3.28 (s, 3H), 2.71-2.61 (m, 1H), 2.48 (s, 3H), 2.29-2.17 (m, 1H), 2.09-2.06 (m, 1H), 2.03-1.93 (m, 1H), 1.90-1.87 (m, 1H), 1.83-1.62 (m, 6H), 1.53-1.41 (m, 6H), 1.39-1.11 (m, 10H), 1.07 (d, J=6.4 Hz, 3H), 0.71 (s, 3H). LCMS Rt=0.910 min in 2.0 min chromatography, MS ESI calcd. for C26H41N4O2 [M+H-H2O]+ 441, found 441.

Example 45. Synthesis of Compounds 79 and 80

To a solution of A1 (6 g, 13.5 mmol) in acetone (60 mL) was added K2CO3 (3.73 g, 27.0 mmol) and ethyl 2H-1,2,3-triazole-4-carboxylate (2.85 g, 20.2 mmol). The mixture was stirred at 25° C. for 2 hrs, then filtered. The filtrate was washed with brine (40 mL), dried over Na2SO4, filtered and concentrated. The residue was purified by column chromatography on silica gel (PE/EtOAc=2/1-1/1) to give 79 (2.26 g, crude) and 80 (2.47 g, crude) as an off-white solid. 100 mg of crude 79 and 80 were purified by preparative HPLC to give 79 (20 mg) and 80 (20 mg). 1H NMR (400 MHz, CDCl3) δ 8.10 (s, 1H), 5.33-5.23 (m, 2H), 4.42 (q, J=7.2 Hz, 2H), 3.48-3.36 (m, 2H), 3.28 (s, 3H), 2.61-2.59 (m, 1H), 2.21-0.84 (m, 29H), 0.72 (s, 3H). LCMS Rt=1.314 min in 2 min chromatography, 10-80AB; MS ESI calcd. for C28H43N3O5 [M+Na]+ 524, found 524.

80: 1H NMR (400 MHz, CDCl3) δ 8.16 (s, 1H), 5.30-5.14 (m, 2H), 4.43 (q, J=7.2 Hz, 2H), 3.48-3.36 (m, 2H), 3.28 (s, 3H), 2.67-2.60 (m, 1H), 2.22-2.00 (m, 4H), 1.75-0.86 (m, 25H), 0.68 (s, 3H). LCMS Rt=1.247 min in 2 min chromatography, MS ESI calcd. for: C28H44N3O5 [M+H]+ 502, found 502.

Example 46. Synthesis of Compound 81

To a solution of 79 (4 g, 7.97 mmol) in EtOH/H2O (30 mL/30 mL) was added LiOH.H2O (1.33 g, 31.8 mmol). The mixture was stirred at 25° C. for 2 hrs, at which point H2O (30 mL) was added. The mixture was acidified to pH=3 with 2N HCl, followed by removal of EtOH by evaporation. The aqueous phase was extracted with EtOAc (3×20 mL), and the combined organic layer was washed with brine (50 mL), dried over Na2SO4, filtered and concentrated to give 81 (3.6 g, crude). 100 mg of crude 81 was purified by preparative-HPLC to give 81 (21.2 mg, 21%).

81: 1H NMR (400 MHz, CDCl3) δ 8.16 (s, 1H), 5.35-5.26 (m, 2H), 3.47-3.36 (m, 2H), 3.28 (s, 3H), 2.62-2.60 (m, 1H), 2.20-0.85 (m, 27H), 0.72 (s, 3H). LCMS Rt=1.185 min in 2 min chromatography, MS ESI calcd. for C26H39N3O5Na [M+Na]+ 496, found 496.

Example 47. Synthesis of Compound 82

To a solution of 80 (3.7 g, 7.37 mmol) in EtOH/H2O (30 mL/30 mL) was added lithium hydroxide hydrate (1.23 g, 29.4 mmol). The mixture was stirred at 25° C. for 2 hrs, at which point H2O (30 mL) was added. The mixture was acidified to pH=3 with 2N HCl, then EtOH was removed under evaporation. The aqueous layer was extracted with EtOAc (3×50 mL), and the combined organic layer was washed with brine (100 mL), dried over Na2SO4, filtered and concentrated to give 82 (2.34 g, crude). 100 mg of crude 82 was purified by preparative HPLC to give 82 (21 mg 21%).

82: 1H NMR (400 MHz, CDCl3) δ 8.25 (s, 1H), 5.32-5.17 (m, 2H), 3.48-3.36 (m, 2H), 3.29 (s, 3H), 2.68-2.64 (m, 1H), 2.35-2.03 (m, 4H), 1.76-1.40 (m, 4H), 1.39-1.28 (m, 8H), 1.25-0.87 (m, 11H), 0.69 (s, 3H). LCMS Rt=1.135 min in 2 min chromatography, MS ESI calcd. for C26H40N3O5 [M+H]+ 474, found 474.

Example 48. Synthesis of Compound 83

To a solution of 81 (200 mg, 0.42 mmol) in DCM (20 mL) was added TEA (213 mg, 2.11 mmol) and HATU (240 mg, 0.63 mmol). After stirring for 30 mins at 25° C., NH4Cl (35.7 mg, 0.675 mmol) was added and the mixture was stirred for another 30 mins. The reaction mixture was washed with water (2×20 mL) and the organic layer was concentrated in vacuum to give 83 (150 mg, crude). 50 mg of crude 83 was purified by preparative HPLC to give 83 (21, 42%).

83: 1H NMR (400 MHz, CDCl3) δ 8.13 (s, 1H), δ 6.57 (br, 1H), δ 5.50 (br, 1H), 5.29-5.17 (m, 2H), 3.49-3.36 (m, 2H), 3.29 (s, 3H), 2.64-2.60 (m, 1H), 2.21-2.02 (m, 3H), 1.76-1.40 (m, 4H), 1.39-1.28 (m, 8H), 1.25-0.87 (m, 11H), 0.73 (s, 3H). LCMS Rt=1.243 min in 2 min chromatography, MS ESI calcd. for C26H40N4O4Na [M+Na]+ 495, found 495.

Example 49. Synthesis of Compound 84

To a solution of 82 (200 mg, 0.422 mmol) in DCM (20 mL) was added TEA (213 mg, 2.11 mmol) and HATU (240 mg, 0.63 mmol). After stirring 30 min at 25° C., NH4Cl (35.7 mg, 0.675 mmol) was added and the mixture was stirred for another 30 min. The reaction mixture was washed with water (2×20 mL) and the organic layer was concentrated under vacuum to give 84 (150 mg, crude). 50 mg of crude 84 was purified by preparative HPLC to give 84 (20 mg, 40%).

84: 1H NMR (400 MHz, CDCl3) δ 8.13 (s, 1H), δ 7.03 (br, 1H), δ 5.59 (br, 1H), 5.28-5.12 (m, 2H), 3.48-3.36 (m, 2H), 3.29 (s, 3H), 2.67-2.63 (m, 1H), 2.27-2.04 (m, 3H), 1.76-1.40 (m, 4H), 1.39-1.28 (m, 8H), 1.25-0.87 (m, 11H), 0.69 (s, 3H). LCMS Rt=1.201 min in 2 min chromatography, MS ESI calcd. for C26H39N4O3 [M+H-H2O]+ 455, found 455.

Example 50. Synthesis of Compound 85

To a stirred solution of A1 (100 mg, 0.226 mmol) in acetone (10 mL) was added K2CO3 (62.4 mg, 0.452 mmol) and (1H-1,2,3-triazol-4-yl)methanol (33.5 mg, 0.339 mmol) at 25° C. The reaction mixture was stirred for 2 hrs at 25° C., at which point the reaction mixture was filtered, and the filtrate was concentrated. The residue was purified by preparative HPLC to give 85 (66 mg, 64%) as a white solid.

85: 1H NMR (400 MHz, CDCl3) δ 7.65 (s 1H), 5.25-5.14 (m, 2H), 4.80-4.75 (m, 2H), 2.61-2.59 (m, 1H), 2.19-2.05 (m, 4H), 1.72-1.40 (m, 16H), 1.38-1.05 (m, 10H), 1.04-0.85 (m, 2H), 0.72 (s, 3H). LCMS Rt=1.231 min in 2 min chromatography, MS ESI calcd. for C26H41N3O4Na [M+Na]+ 482, found 482.

Assay Methods

Compounds provided herein can be evaluated using various assays; examples of which are described below.

Steroid Inhibition of TBPS Binding

TBPS binding assays using rat brain cortical membranes in the presence of 5 μM GABA has been described (Gee et al, J. Pharmacol. Exp. Ther. 1987, 241, 346-353; Hawkinson et al, Mol. Pharmacol. 1994, 46, 977-985; Lewin, A. H et al., Mol. Pharmacol. 1989, 35, 189-194).

Briefly, cortices are rapidly removed following decapitation of carbon dioxide-anesthetized Sprague-Dawley rats (200-250 g). The cortices are homogenized in 10 volumes of ice-cold 0.32 M sucrose using a glass/teflon homogenizer and centrifuged at 1500×g for 10 min at 4° C. The resultant supernatants are centrifuged at 10,000×g for 20 min at 4° C. to obtain the P2 pellets. The P2 pellets are resuspended in 200 mM NaCl/50 mM Na—K phosphate pH 7.4 buffer and centrifuged at 10,000×g for 10 min at 4° C. This washing procedure is repeated twice and the pellets are resuspended in 10 volumes of buffer. Aliquots (100 μL) of the membrane suspensions are incubated with 3 nM [35S]-TBPS and 5 μL aliquots of test drug dissolved in dimethyl sulfoxide (DMSO) (final 0.5%) in the presence of 5 μM GABA. The incubation is brought to a final volume of 1.0 mL with buffer. Nonspecific binding is determined in the presence of 2 μM unlabeled TBPS and ranged from 15 to 25%. Following a 90 min incubation at room temp, the assays are terminated by filtration through glass fiber filters (Schleicher and Schuell No. 32) using a cell harvester (Brandel) and rinsed three times with ice-cold buffer. Filter bound radioactivity is measured by liquid scintillation spectrometry. Non-linear curve fitting of the overall data for each drug averaged for each concentration is done using Prism (GraphPad). The data are fit to a partial instead of a full inhibition model if the sum of squares is significantly lower by F-test. Similarly, the data are fit to a two component instead of a one component inhibition model if the sum of squares is significantly lower by F-test. The concentration of test compound producing 50% inhibition (IC50) of specific binding and the maximal extent of inhibition (Imax) are determined for the individual experiments with the same model used for the overall data and then the means ±SEM.s of the individual experiments are calculated. Picrotoxin serves as the positive control for these studies as it has been demonstrated to robustly inhibit TBPS binding.

Various compounds are or can be screened to determine their potential as modulators of [35S]-TBPS binding in vitro. These assays are or can be performed in accordance with the above discussed procedures.

For Table 2, “A” indicates an IC50<10 nM, “B” indicates an IC50 of 10 nM to 50 nM, “C” indicates an IC50 of 50 nM to 100 nM, “D” indicates an IC50 of 100 nM to 500 nM, and “E” indicates IC50>500 nM.

TABLE 2 35S-TBPS Radioligand Compound Displacement (IC50) 1 A 2 A 7 A 8 A 9 A 10 A 11 A 12 A 13 A 14 A 15 A 16 A 17 B 18 A 19 A 20 A 21 A 22 D 23 A 24 A 25 A 26 A 27 A 28 A 29 A 30 A 34 B 35 E 36 D 37 D 38 C 40 C 41 C 42 B 43 C 44 B 45 C 46 B 47 B 48 C 49 C 51 A 52 B 59 D 60 D 61 D 62 B 63 D 64 D 65 A 66 B 67 B 68 A 69 A 70 A 71 B 72 A 73 B 74 D 75 D 80 D 81 E 82 E 83 D 84 D 85 E

Claims

1-66. (canceled)

67. A method for therapeutically treating a CNS-related disorder in a human subject in need thereof, comprising administering to the human subject a therapeutically effective amount of (a) a compound of Formula (I) or a pharmaceutically acceptable salt thereof or (b) a pharmaceutical composition comprising a compound of Formula (I) or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable excipient, wherein: and wherein the CNS-related disorder is selected from anxiety disorder and seizure.

each X, Y, and Z is independently CH or N;
G is —C(R3a)(R3b)(OR1);
R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, heterocyclyl, aryl, or heteroaryl;
R2 is C1-C6 alkyl or C1-C6 alkoxy;
each of R3a and R3b is independently —H, -D, or C1-C6 alkyl;
Ra is cyano, halogen, nitro, C1-C6 alkyl, C1-C6 alkoxy, —S(O)mRb, —NRcRd, —C(O)Re, or —C(O)ORf;
Rb is C1-C6 alkyl, —NRcRd, or —ORf;
each of Rc and Rd is independently —H, C1-C6 alkyl, —C(O)Re, or —C(O)ORf;
Re is C1-C6 alkyl or —NRgRh;
Rf is —H or C1-C6 alkyl;
each of Rg and Rh is independently —H or C1-C6 alkyl;
m is 0, 1, or 2;
n is 0, 1, 2, 3, or 4; and
the compound is not selected from a compound selected from:

68. The method of claim 67, wherein R1 is C1-C6 alkyl.

69. The method of claim 68, wherein R1 is —CH3, —CH2CH3, or —CH(CH3)2.

70. The method of claim 67, wherein R2 is C1-C6 alkyl.

71. The method of claim 70, wherein R2 is —CH3.

72. The method of claim 67, wherein each of R3a and R3b is independently —H or -D.

73. The method of claim 67, wherein each of R3a and R3b is independently —H.

74. The method of claim 67, wherein one of R3a and R3b is —H, -D, or C1-C6 alkyl, and the other of R3a and R3b is —H.

75. The method of claim 67, wherein the compound Formula (I) is a compound of Formula (I-a):

76. The method of claim 75, wherein X is N, and Y and Z are CH.

77. The method of claim 75, wherein X and Z are N, and Y is CH.

78. The method of claim 75, wherein X, Y, and Z are N.

79. The method of claim 75, wherein R1 is C1-C6 alkyl.

80. The method of claim 75, wherein R2 is C1-C6 alkyl.

81. The method of claim 75, wherein each of R3a and R3b is independently —H or -D.

82. The method of claim 75, wherein one of R3a and R3b is —H, -D, or C1-C6 alkyl, and the other of R3a and R3b is —H.

83. The method of claim 75, wherein one of R3a and R3b is -D or C1-C6 alkyl, and the other of R3a and R3b is —H.

84. The method of claim 75, wherein n is 1.

85. The method of claim 75, wherein Ra is C1-C6 alkyl or C1-C6 alkoxy.

86. The method of claim 75, wherein Ra is —S(O)mRb, —NRcRd, —C(O)Re, or —C(O)ORf.

87. The method of claim 75, wherein Ra is halogen.

88. The method of claim 75, wherein n is 1 or 2, and Ra is cyano, halogen, nitro, or C1-C6 alkoxy.

89. The method of claim 67, wherein the compound Formula (I) is a compound of Formula (I-b):

90. The method of claim 67, wherein the compound is selected from: and a pharmaceutically acceptable salt thereof.

91. The method of claim 67, wherein the CNS-related disorder is anxiety disorder.

92. The method of claim 91, wherein the anxiety disorder is selected from generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), phobia, and post-traumatic stress disorder (PTSD).

93. The method of claim 67, wherein the CNS-related disorder is seizure.

94. A method for positively modulating a GABAA receptor in a subject in need thereof, comprising administering to the subject an effective amount of a pharmaceutical composition comprising a compound of Formula (I) or a pharmaceutically acceptable salt thereof, and a pharmaceutically acceptable excipient, wherein: and

each X, Y, and Z is independently CH or N;
G is —C(R3a)(R3b)(OR1);
R1 is C1-C6 alkyl, C1-C6 alkenyl, C1-C6 alkynyl, carbocyclyl, heterocyclyl, aryl, or heteroaryl;
R2 is C1-C6 alkyl or C1-C6 alkoxy;
each of R3a and R3b is independently —H, -D, or C1-C6 alkyl;
Ra is cyano, halogen, nitro, C1-C6 alkyl, C1-C6 alkoxy, —S(O)mRb, —NRcRd, —C(O)Re, or —C(O)ORf;
Rb is C1-C6 alkyl, —NRcRd, or —ORf;
each of Rc and Rd is independently —H, C1-C6 alkyl, —C(O)Re, or —C(O)ORf;
Re is C1-C6 alkyl or —NRgRh;
Rf is H or C1-C6 alkyl;
each of Rg and Rh is independently —H or C1-C6 alkyl;
m is 0, 1, or 2;
n is 0, 1, 2, 3, or 4; and
the compound is not selected from a compound selected from:
wherein the subject has a CNS-related disorder selected from anxiety disorder and seizure.

95. The method of claim 94, wherein the pharmaceutical composition is administered orally, subcutaneously, intravenously, or intramuscularly.

96. The method of claim 94, wherein the pharmaceutical composition is administered chronically.

97. The method of claim 94, wherein the CNS-related disorder is anxiety disorder.

98. The method of claim 97, wherein the anxiety disorder is selected from generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), phobia, and post-traumatic stress disorder (PTSD).

99. The method of claim 94, wherein the CNS-related disorder is seizure.

100. The method of claim 95, wherein the pharmaceutical composition is administered orally.

101. The method of claim 95, wherein the pharmaceutical composition is administered intravenously.

Patent History
Publication number: 20210347812
Type: Application
Filed: Jan 8, 2021
Publication Date: Nov 11, 2021
Inventors: Albert Jean Robichaud (Boston, MA), Francesco G. Salituro, JR. (Marlborough, MA), Boyd L. Harrison (Princeton Junction, NJ), Gabriel Martinez Botella (Wayland, MA)
Application Number: 17/144,302
Classifications
International Classification: C07J 43/00 (20060101); A61K 45/06 (20060101); A61K 31/58 (20060101); C07J 7/00 (20060101);