Cyclic inhibitors of 11beta-hydroxysteroid dehydrogenase 1

Abstract

This invention relates to novel compounds of the Formula Ik, Im 1 , Im 2 , Im 5 , In 1 , In 2 , In 5 , Io 1 , Io 2 , Io 5 , Ip 1 , Ip 3 , pharmaceutically acceptable salts thereof, and pharmaceutical compositions thereof, which are useful for the therapeutic treatment of diseases associated with the modulation or inhibition of 11β-HSD1 in mammals. The invention further relates to pharmaceutical compositions of the novel compounds and methods for their use in the reduction or control of the production of cortisol in a cell or the inhibition of the conversion of cortisone to cortisol in a cell.

1 . A compound of Formula (Io 1 ) 
       
         
           
           
               
               
           
         
         wherein:
 n is 0, 1, 2, or 3; 
 G 1  is fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C 1 -C 6 )alkyl, hydroxy(C 1 -C 6 )alkyl, (C 3 -C 6 )cycloalkyl, hydroxy(C 3 -C 6 )cycloalkyl, (C 4 -C 7 )cycloalkylalkyl, (C 2 -C 6 )alkenyl, halo(C 2 -C 6 )alkenyl, hydroxy(C 2 -C 6 )alkenyl, (C 2 -C 6 )alkynyl, (C 3 -C 6 )cycloalkyl(C 2 -C 4 )alkynyl, halo(C 1 -C 6 )alkyl, halo(C 3 -C 6 )cycloalkyl, halo(C 4 -C 7 )cycloalkylalkyl, (C 1 -C 6 )alkoxy, (C 3 -C 6 )cycloalkoxy, (C 4 -C 7 )cycloalkylalkoxy, halo(C 1 -C 6 )alkoxy, halo(C 3 -C 6 )cycloalkoxy, halo(C 4 -C 7 )cycloalkylalkoxy, (C 1 -C 6 )alkylthio, (C 3 -C 6 )cycloalkythio, (C 4 -C 7 )cycloalkylalkylthio, halo(C 1 -C 6 )alkylthio, halo(C 3 -C 6 )cycloalkylthio, halo(C 4 -C 7 )cycloalkylalkylthio, (C 1 -C 6 )alkanesulfinyl, (C 3 -C 6 )cycloalkanesulfinyl, (C 4 -C 7 )cycloalkylalkanesulfinyl, halo(C 1 -C 6 )alkanesulfinyl, halo(C 3 -C 6 )cycloalkanesulfinyl, halo(C 4 -C 7 )cycloalkylalkanesulfinyl, (C 1 -C 6 )alkanesulfonyl, (C 3 -C 6 )cycloalkanesulfonyl, (C 4 -C 7 )cycloalkylalkanesulfonyl, halo(C 1 -C 6 )alkanesulfonyl, halo(C 3 -C 6 )cycloalkanesulfonyl, halo(C 4 -C 7 )cyclo-alkylalkanesulfonyl, (C 1 -C 6 )alkylamino, di(C 1 -C 6 )alkylamino, (C 1 -C 6 )alkoxy(C 1 -C 6 )alkoxy, halo(C 1 -C 6 )alkoxy(C 1 -C 6 )alkoxy, (C 1 -C 6 )alkoxycarbonyl, H 2 NCO, H 2 NSO 2 , (C 1 -C 6 )alkylaminocarbonyl, di(C 1 -C 6 )alkylaminocarbonyl, (C 1 -C 3 )alkoxy(C 1 -C 3 )alkylaminocarbonyl, heterocyclylcarbonyl, (C 1 -C 6 )alkylaminosulfonyl, di(C 1 -C 6 )alkylaminosulfonyl, heterocyclylsulfonyl, (C 1 -C 6 )alkylcarbonylamino, (C 1 -C 6 )alkylcarbonylamino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylsulfonylamino, (C 1 -C 6 )alkylsulfonylamino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkoxycarbonyl(C 1 -C 6 )alkoxy, (C 1 -C 6 )alkoxy(C 1 -C 6 )alkyl, halo(C 1 -C 6 )alkoxy(C 1 -C 6 )alkyl, hydroxy(C 1 -C 6 )alkoxy, heteroaryl, amino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylamino(C 1 -C 6 )alkyl, di(C 1 -C 6 )alkylamino(C 1 -C 6 )alkyl amino(C 2 -C 6 )alkoxy, (C 1 -C 6 )alkylamino(C 2 -C 6 )alkoxy, di(C 1 -C 6 )alkylamino(C 2 -C 6 )alkoxy, (C 1 -C 6 )alkylcarbonyl, (C 3 -C 6 )cycloalkylcarbonyl, (C 3 -C 6 )cycloalkylaminocarbonyl, {(C 3 -C 6 )cycloalkyl}{(C 1 -C 6 )alkyl}aminocarbonyl, di(C 3 -C 6 )cycloalkylaminocarbonyl, (C 3 -C 6 )cycloalkylaminosulfonyl, {(C 3 -C 6 )cycloalkyl}{(C 1 -C 6 )alkyl}aminosulfonyl, di(C 3 -C 6 )cycloalkylaminosulfonyl, cyano(C 1 -C 6 )alkyl, aminocarbonyl(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylaminocarbonyl(C 1 -C 6 )alkyl, di(C 1 -C 6 )alkylaminocarbonyl(C 1 -C 6 )alkyl, (C 3 -C 6 )cycloalkylaminocarbonyl(C 1 -C 6 )alkyl, {(C 3 -C 6 )cycloalkyl}{(C 1 -C 6 )alkyl}aminocarbonyl(C 1 -C 6 )alkyl and di(C 3 -C 6 )cycloalkylaminocarbonyl(C 1 -C 6 )alkyl; 
 the oxodihydropyridyl ring in Formula Io 1  is optionally substituted on a substitutable ring nitrogen atom with (C 3 -C 4 )cycloalkyl or (C 3 -C 4 )cycloalkyl(C 1 -C 2 )alkyl; and the oxodihydropyridyl ring in Formula Io 1  is optionally substituted on a ring carbon atom with fluorine, chlorine, cyano, hydroxy, amino, (C 1 -C 4 )alkyl, (C 3 -C 4 )cycloalkyl, (C 3 -C 4 )cycloalkyl(C 1 -C 2 )alkyl, halo(C 1 -C 4 )alkyl, (C 1 -C 4 )alkoxy, (C 1 -C 4 )haloalkoxy, CONH 2 , (C 1 -C 4 )alkylaminocarbonyl, di(C 1 -C 4 )alkylaminocarbonyl or (C 1 -C 4 )alkylcarbonylamino; 
 R 1  is (a) absent or (b) is selected from (C 1 -C 6 )alkyl, (C 2 -C 6 )alkenyl, (C 2 -C 6 )alkynyl, (C 1 -C 3 )alkoxy(C 1 -C 3 )alkoxy, or (C 1 -C 3 )alkoxy(C 1 -C 3 )alkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R 4 , R 4 O—, (R 4 ) 2 N—, R 4 O 2 C—, R 4 S, R 4 S(═O)—, R 4 S(═O) 2 —, R 4 C(═O)NR 4 —, (R 4 ) 2 NC(═O)—, (R 4 ) 2 NC(═O)O—, (R 4 ) 2 NC(═O)NR 4 —, R 4 OC(═O)NR 4 —, (R 4 ) 2 NC(═NCN)NR 4 —, (R 4 O) 2 P(═O)O—, (R 4 O) 2 P(═O)NR 4 —, R 4 OS(═O) 2 NR 4 —, (R 4 ) 2 NS(═O) 2 O— (R 4 ) 2 NS(═O) 2 NR 4 —, R 4 S(═O) 2 NR 4 —, R 4 S(═O) 2 NHC(═O)—, R 4 S(═O) 2 NHC(═O)O—, R 4 S(═O) 2 NHC(═O)NR 4 —, R 4 OS(═O) 2 NHC(═O)—, R 4 OS(═O) 2 NHC(═O)O—, R 4 OS(═O) 2 NHC(═O)NR 4 —, (R 4 ) 2 NS(═O) 2 NHC(═O)—, (R 4 ) 2 NS(═O) 2 NHC(═O)O—, (R 4 ) 2 NS(═O) 2 NHC(═O)NR 4 —, R 4 C(═O)NHS(═O) 2 —, R 4 C(═O)NHS(═O) 2 O—, R 4 C(═O)NHS(═O) 2 NR 4 —, R 4 OC(═O)NHS(═O) 2 —, R 4 OC(═O)NHS(═O) 2 O—, R 4 OC(═O)NHS(═O) 2 NR 4 —, (R 4 ) 2 NC(═O)NHS(═O) 2 —, (R 4 ) 2 NC(═O)NHS(═O) 2 O—, (R 4 ) 2 NC(═O)NHS(═O) 2 NR 4 —, heterocyclyl, heteroaryl, aryl-amino and heteroarylamino; 
 R 2  is (C 1 -C 6 )alkyl, aryl, heteroaryl, cycloalkyl or heterocyclyl and optionally substituted with up to 4 groups independently selected from fluorine, chlorine, bromine, iodine, cyano, nitro, amino, hydroxy, carboxy, (C 1 -C 6 )alkyl, hydroxy(C 1 -C 6 )alkyl, (C 3 -C 6 )cycloalkyl, hydroxy(C 3 -C 6 )cycloalkyl, (C 4 -C 7 )cycloalkylalkyl, (C 2 -C 6 )alkenyl, halo(C 2 -C 6 )alkenyl, hydroxy(C 2 -C 6 )alkenyl, (C 2 -C 6 )alkynyl, (C 3 -C 6 )cycloalkyl(C 2 -C 4 )alkynyl, halo(C 1 -C 6 )alkyl, halo(C 3 -C 6 )cycloalkyl, halo(C 4 -C 7 )cycloalkylalkyl, (C 1 -C 6 )alkoxy, (C 3 -C 6 )cycloalkoxy, (C 4 -C 7 )cycloalkylalkoxy, halo(C 1 -C 6 )alkoxy, halo(C 3 -C 6 )cycloalkoxy, halo(C 4 -C 7 )cycloalkylalkoxy, (C 1 -C 6 )alkylthio, (C 3 -C 6 )cycloalkythio, (C 4 -C 7 )cycloalkylalkylthio, halo(C 1 -C 6 )alkylthio, halo(C 3 -C 6 )cycloalkythio, halo(C 4 -C 7 )cycloalkylalkylthio, (C 1 -C 6 )alkanesulfinyl, (C 3 -C 6 )cycloalkanesulfinyl, (C 4 -C 7 )cycloalkylalkanesulfinyl, halo(C 1 -C 6 )alkanesulfinyl, halo(C 3 -C 6 )cycloalkanesulfinyl, halo(C 4 -C 7 )cycloalkylalkanesulfinyl, (C 1 -C 6 )alkanesulfonyl, (3-C 6 )cycloalkanesulfonyl, (C 4 -C 7 )cycloalkylalkanesulfonyl, halo(C 1 -C 6 )alkanesulfonyl, halo(C 3 -C 6 )cycloalkanesulfonyl, halo(C 4 -C 7 )cyclo-alkylalkanesulfonyl, (C 1 -C 6 )alkylamino, di(C 1 -C 6 )alkylamino, (C 1 -C 6 )alkoxy(C 1 -C 6 )alkoxy, halo(C 1 -C 6 )alkoxy(C 1 -C 6 )alkoxy, (C 1 -C 6 )alkoxycarbonyl, H 2 NCO, H 2 NSO 2 , (C 1 -C 6 )alkylaminocarbonyl, di(C 1 -C 6 )alkylaminocarbonyl, (C 1 -C 3 )alkoxy(C 1 -C 3 )alkylaminocarbonyl, heterocyclylcarbonyl, (C 1 -C 6 )alkylaminosulfonyl, di(C 1 -C 6 )alkylaminosulfonyl, heterocyclylsulfonyl, (C 1 -C 6 )alkylcarbonylamino, (C 1 -C 6 )alkylcarbonylamino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylsulfonylamino, (C 1 -C 6 )alkylsulfonylamino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkoxycarbonyl(C 1 -C 6 )alkoxy, (C 1 -C 6 )alkoxy(C 1 -C 6 )alkyl, halo(C 1 -C 6 )alkoxy(C 1 -C 6 )alkyl, hydroxy(C 1 -C 6 )alkoxy, heteroaryl, oxo, amino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylamino(C 1 -C 6 )alkyl, di(C 1 -C 6 )alkylamino(C 1 -C 6 )alkyl amino(C 2 -C 6 )alkoxy, (C 1 -C 6 )alkylamino(C 2 -C 6 )alkoxy, di(C 1 -C 6 )alkylamino(C 2 -C 6 )alkoxy, (C 1 -C 6 )alkylcarbonyl, (C 3 -C 6 )cycloalkylcarbonyl, (C 3 -C 6 )cycloalkylaminocarbonyl, {(C 3 -C 6 )cycloalkyl}{(C 1 -C 6 )alkyl}aminocarbonyl, di(C 3 -C 6 )cycloalkylaminocarbonyl, (C 3 -C 6 )cycloalkylaminosulfonyl, {(C 3 -C 6 )cycloalkyl}{(C 1 -C 6 )alkyl}aminosulfonyl, di(C 3 -C 6 )cycloalkylaminosulfonyl, cyano(C 1 -C 6 )alkyl, aminocarbonyl(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylaminocarbonyl(C 1 -C 6 )alkyl, di(C 1 -C 6 )alkylaminocarbonyl(C 1 -C 6 )alkyl, (C 3 -C 6 )cycloalkylaminocarbonyl(C 1 -C 6 )alkyl, {(C 3 -C 6 )cycloalkyl}{(C 1 -C 6 )alkyl}aminocarbonyl(C 1 -C 6 )alkyl and di(C 3 -C 6 )cycloalkylaminocarbonyl(C 1 -C 6 )alkyl; 
 R 3  is selected from (C 1 -C 6 )alkyl, (C 2 -C 6 )alkenyl, (C 2 -C 6 )alkynyl, (C 3 -C 5 )cycloalkyl(C 1 -C 4 )alkyl, (C 1 -C 3 )alkoxy(C 1 -C 3 )alkoxy, or (C 1 -C 3 )alkoxy(C 1 -C 3 )alkyl and is optionally substituted with up to four groups independently selected from fluorine, cyano, oxo, R 4 , R 4 O—, (R 4 ) 2 N—, R 4 O 2 C—, R 4 C(═O)O—, R 4 S, R 4 S(═O)—, R 4 S(═O) 2 —, R 4 C(═O)NR 4 —, (R 4 ) 2 NC(═O)—, (R 4 ) 2 NC(═O)O—, (R 4 ) 2 NC(═O)NR 4 —, R 4 OC(═O)NR 4 —, (R 4 ) 2 NC(═NCN)NR 4 —, (R 4 O) 2 P(═O)O—, (R 4 O) 2 P(═O)NR 4 —, R 4 OS(═O) 2 NR 4 —, (R 4 ) 2 NS(═O) 2 O—, (R 4 ) 2 NS(═O) 2 NR 4 —, R 4 S(═O) 2 NR 4 —, R 4 S(═O) 2 NHC(═O)—, R 4 S(═O) 2 NHC(═O)O—, R 4 S(═O) 2 NHC(═O)NR 4 —, R 4 OS(═O) 2 NHC(═O)—, R 4 OS(═O) 2 NHC(═O)O—, R 4 OS(═O) 2 NHC(═O)NR 4 —, (R 4 ) 2 NS(═O) 2 NHC(═O)—, (R 4 ) 2 NS(═O) 2 NHC(═O)O—, (R 4 ) 2 NS(═O) 2 NHC(═O)NR 4 —, R 4 C(═O)NHS(═O) 2 —, R 4 C(═O)NHS(═O) 2 O—, R 4 C(═O)NHS(═O) 2 NR 4 —, R 4 OC(═O)NHS(═O) 2 —, R 4 OC(═O)NHS(═O) 2 O—, R 4 OC(═O)NHS(═O) 2 NR 4 —(R 4 ) 2 NC(═O)NHS(═O) 2 —, (R 4 ) 2 NC(═O)NHS(═O) 2 O—, (R 4 ) 2 NC(═O)NHS(═O) 2 NR 4 —, spirocycloalkyl; heterocyclyl (optionally substituted with alkyl, haloalkyl, halogen or oxo), heteroaryl (optionally substituted with alkyl, haloalkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO 2 H, CONH 2 , N-monoalkyl-substituted amido, N,N-dialkyl-substituted amido, or oxo), arylamino (optionally substituted with alkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO 2 H, CONH 2 , N-monoalkyl-substituted amido and N,N-dialkyl-substituted amido) and heteroarylamino (optionally substituted with alkyl, haloalkyl, alkoxy, alkylthio, alkylsulfonyl, halogen, trifluoromethyl, dialkylamino, nitro, cyano, CO 2 H, CONH 2 , N-monoalkyl-substituted amido, N,N-dialkyl-substituted amido, or oxo); and 
 R 4  is independently selected from H, (C 1 -C 6 )alkyl, halo(C 1 -C 6 )alkyl, amino(C 1 -C 6 )alkyl, (C 1 -C 6 )alkylamino(C 1 -C 6 )alkyl, di(C 1 -C 6 )alkylamino(C 1 -C 6 )alkyl, hydroxy(C 1 -C 6 )alkyl and (C 1 -C 6 )alkoxy(C 1 -C 6 )alkyl; 
 
       
       or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. 
     
     
         2 . The compound of  claim 1 , wherein R 1  is methyl or ethyl. 
     
     
         3 . The compound of  claim 1 , wherein R 1  is methyl or ethyl; and R 3  is MeSO 2 NHCH 2 CH 2 CH 2 , H 2 NC(═O)CH 2 CH 2 , H 2 NC(═O)CMe 2 CH 2 , 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. 
     
     
         4 . The compound of  claim 1 , wherein R 1  is methyl or ethyl; R 2  is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH 2 , (C 1 -C 4 )alkyl, (C 1 -C 4 )haloalkyl and SO 2 Me; and R 3  is MeSO 2 NHCH 2 CH 2 CH 2 , H 2 NC(═O)CH 2 CH 2 , H 2 NC(═O)CMe 2 CH 2 , 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. 
     
     
         5 . The compound of  claim 1 , wherein the compound is of Formula (Ip 1 ): 
       
         
           
           
               
               
           
         
         or a pharmaceutically acceptable salt thereof; and 
         wherein:
 n is 0, 1 or 2; 
 G 2a  is (C 3 -C 4 )cycloalkyl or (C 3 -C 4 )cycloalkyl(C 1 -C 2 )alkyl; and 
 G 2b  is hydrogen, fluorine, chlorine, cyano, hydroxy, amino, (C 1 -C 4 )alkyl, (C 3 -C 4 )cycloalkyl, (C 3 -C 4 )cycloalkyl(C 1 -C 2 )alkyl, halo(C 1 -C 4 )alkyl, (C 1 -C 4 )alkoxy, (C 1 -C 4 )haloalkoxy, CONH 2 , (C 1 -C 4 )alkylaminocarbonyl, di(C 1 -C 4 )alkylaminocarbonyl or (C 1 -C 4 )alkylcarbonylamino. 
 
       
     
     
         6 . The compound of  claim 5 , wherein R 1  is methyl or ethyl. 
     
     
         7 . The compound of  claim 5 , wherein R 1  is methyl or ethyl; and R 3  is MeSO 2 NHCH 2 CH 2 CH 2 , H 2 NC(═O)CH 2 CH 2 , H 2 NC(═O)CMe 2 CH 2 , 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. 
     
     
         8 . The compound of  claim 5 , wherein R 1  is methyl or ethyl; R 2  is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH 2 , (C 1 -C 4 )alkyl, (C 1 -C 4 )haloalkyl and SO 2 Me; and R 3  is MeSO 2 NHCH 2 CH 2 CH 2 , H 2 NC(═O)CH 2 CH 2 , H 2 NC(═O)CMe 2 CH 2 , 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. 
     
     
         9 . The compound of  claim 5 , wherein R 1  is methyl or ethyl; R 2  is phenyl or fluorophenyl; R 3  is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; the substituent G 2a  is (C 3 -C 4 )cycloalkyl; and G 2b  is optionally selected from hydrogen, methyl or ethyl. 
     
     
         10 - 12 . (canceled) 
     
     
         13 . The compound of  claim 1 , wherein the compound is of Formula (Ip 3 ): 
       
         
           
           
               
               
           
         
         or a pharmaceutically acceptable salt thereof; and 
         wherein:
 n is 0, 1 or 2; 
 G 2a  is (C 3 -C 4 )cycloalkyl or (C 3 -C 4 )cycloalkyl(C 1 -C 2 )alkyl; 
 G 2b  is hydrogen, fluorine, chlorine, cyano, hydroxy, amino, (C 1 -C 4 )alkyl, (C 3 -C 4 )cycloalkyl, (C 3 -C 4 )cycloalkyl(C 1 -C 2 )alkyl, halo(C 1 -C 4 )alkyl, (C 1 -C 4 )alkoxy, (C 1 -C 4 )haloalkoxy, CONH 2 , (C 1 -C 4 )alkylaminocarbonyl, di(C 1 -C 4 )alkylaminocarbonyl or (C 1 -C 4 )alkylcarbonylamino. 
 
       
     
     
         14 . The compound of  claim 13 , wherein R 1  is methyl or ethyl. 
     
     
         15 . The compound of  claim 13 , wherein R 1  is methyl or ethyl; and R 3  is MeSO 2 NHCH 2 CH 2 CH 2 , H 2 NC(═O)CH 2 CH 2 , H 2 NC(═O)CMe 2 CH 2 , 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. 
     
     
         16 . The compound of  claim 13 , wherein R 1  is methyl or ethyl; R 2  is phenyl optionally substituted with 1, 2 or 3 substituents selected from halo, cyano, CONH 2 , (C 1 -C 4 )alkyl, (C 1 -C 4 )haloalkyl and SO 2 Me; and R 3  is MeSO 2 NHCH 2 CH 2 CH 2 , H 2 NC(═O)CH 2 CH 2 , H 2 NC(═O)CMe 2 CH 2 , 3-hydroxypropyl, 3-hydroxy-3-methylbutyl, 2-hydroxyethyl, 
       2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl. 
     
     
         17 . The compound of  claim 13 , wherein R 1  is methyl or ethyl; R 2  is phenyl or fluorophenyl; R 3  is 2-hydroxy-2-methylpropyl or 2-cyano-2-methylpropyl; the substituent G 2a  is (C 3 -C 4 )cycloalkyl; and G 2b  is optionally selected from hydrogen, methyl or ethyl. 
     
     
         18 . The compound of  claim 15 , wherein the compound is selected from the following Formula: 
       
         
           
           
               
               
           
         
         or a pharmaceutically acceptable salt thereof. 
       
     
     
         19 - 20 . (canceled) 
     
     
         21 . A method of treating a subject with a disease associated with the activity or expression of 11β-HSD1, comprising the step of administering to the subject an effective amount of the compound in  claim 1 ; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. 
     
     
         22 . A method of inhibiting 11β-HSD1 activity comprising the step of administering to a mammal in need of such treatment an effective amount of the compound in  claim 1 ; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. 
     
     
         23 . A pharmaceutical composition comprising: i) a pharmaceutically acceptable carrier or diluent; and ii) the compound in  claim 1 ; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. 
     
     
         24 . A method of treating a human with a disease associated with the activity or expression of 11β-HSD1, comprising the step of administering to the human an effective amount of the compound in  claim 1 ; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. 
     
     
         25 . A method of inhibiting 11β-HSD1 activity comprising the step of administering to a human in need of such treatment an effective amount of the compound in  claim 1 ; or a pharmaceutically acceptable salt, enantiomer or diastereomer thereof. 
     
     
         26 . The method of  claim 21  wherein the disease or condition is diabetes mellitus.