US2012220558A1PendingUtilityA1

Methods of Treating Hormone-Related Conditions Using Thio-Oxindole Derivatives

46
Assignee: FENSOME ANDREWPriority: Jun 25, 2002Filed: May 8, 2012Published: Aug 30, 2012
Est. expiryJun 25, 2022(expired)· nominal 20-yr term from priority
A61P 35/00A61P 5/24A61P 7/04A61K 31/404A61P 15/12A61P 15/18A61P 15/00A61P 13/08A61P 11/00A61P 1/00A61K 45/06
46
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Claims

Abstract

The present invention provides methods of inducing contraception which includes delivering to a female a composition containing a compound of formula I, or tautomers thereof, in a regimen which involves delivering one or more of a selective estrogen receptor modulator, wherein formula I is: and wherein R 1 -R 5 and Q 1 are defined as described herein. Methods of providing hormone replacement therapy and for treating carcinomas, dysfunctional bleeding, uterine leiomyomata, endometriosis, and polycystic ovary syndrome is provided which includes delivering a compound of formula I and a selective estrogen receptor modulator are also described.

Claims

exact text as granted — not AI-modified
1 . A method of treating carcinomas, said method comprising delivering to a mammal in need thereof a composition comprising a compound of formula I, or a tautomer thereof, in a regimen which involves delivering a pharmaceutically effective amount of one or more of a selective estrogen receptor modulator to a mammal, wherein formula I is: 
       
         
           
           
               
               
           
         
         wherein:
 R 1  and R 2  are selected from the group consisting of H, alkyl, substituted alkyl, OH, O(alkyl), O(substituted alkyl), O(acetyl), aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, alkylaryl, substituted alkylaryl, alkylheteroaryl, substituted alkylheteroaryl, 1-propynyl, substituted 1-propynyl, 3-propynyl, and substituted 3-propynyl; 
 or R 1  and R 2  are joined to form a ring selected from the group consisting of —CH 2 (CH 2 ) n CH 2 —, —CH 2 CH 2 C(CH 3 ) 2 CH 2 CH 2 —, —O(CH 2 ) m CH 2 —, —O(CH 2 ) p O—, —CH 2 CH 2 OCH 2 CH 2 —, —CH 2 CH 2 N(H)CH 2 CH 2 —, and —CH 2 CH 2 N(alkyl)CH 2 CH 2 —; 
 m is an integer from 1 to 4; 
 n is an integer from 1 to 5; 
 p is an integer from 1 to 4; 
 or R 1  and R 2  form a double bond to C(CH 3 ) 2 , C(cycloalkyl), O, or C(cycloether); 
 R 3  is selected from the group consisting of H, OH, NH 2 , C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 6  alkenyl, substituted C 3  to C 6  alkenyl, alkynyl, substituted alkynyl, and COR A ; 
 R A  is selected from the group consisting of H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, and substituted C 1  to C 3  aminoalkyl; 
 R 4  is selected from the group consisting of H, halogen, CN, NH 2 , C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 1  to C 6  alkoxy, substituted C 1  to C 6  alkoxy, C 1  to C 6  aminoalkyl, and substituted C 1  to C 6  aminoalkyl; 
 R 5  is selected from the group consisting of a), b) and c): 
 a) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           
             X is selected from the group consisting of halogen, OH, CN, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  thioalkyl, substituted C 1  to C 3  thioalkyl, S(O)alkyl, S(O) 2 alkyl, C 1  to C 3  aminoalkyl, substituted C 1  to C 3  aminoalkyl, NO 2 , C 1  to C 3  perfluoroalkyl, substituted C 1  to C 3  perfluoroalkyl, 5 or 6 membered heterocyclic ring having 1 to 3 heteroatoms, CONH 2 , CSNH 2 , CNHNHOH, CNH 2 NOH, CNHNOH, COR B , CSR B , OCOR B , and NR C COR B ; 
             R B  is selected from the group consisting of H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, aryl, substituted aryl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, and substituted C 1  to C 3  aminoalkyl; 
             R C  is H, C 1  to C 3  alkyl, or substituted C 1  to C 3  alkyl; 
             Y and Z are independently selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 4  alkyl, substituted C 1  to C 4  alkyl, C 1  to C 3  thioalkyl, and substituted C 1  to C 3  thioalkyl; 
           
           b) a five or six membered heterocyclic ring having 1, 2, or 3 heteroatoms selected from the group consisting of O, S, SO, SO 2  and NR 6  and having one or two independent substituents from the group consisting of H, halogen, CN, NO 2 , C 1  to C 4  alkyl, substituted C 1  to C 4  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, substituted C 1  to C 3  aminoalkyl, COR D , CSR D , and NR E COR D ;
 R D  is H, NH 2 , C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, aryl, substituted aryl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, or substituted C 1  to C 3  aminoalkyl; 
 R E  is H, C 1  to C 3  alkyl, or substituted C 1  to C 3  alkyl; 
 R 6  is H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, or C 1  to C 4 CO 2 alkyl; 
 
         
         or
 c) an indol-4-yl, indol-7-yl or benzo-2-thiophene moiety, wherein said moiety is optionally substituted by from 1 to 3 substituents selected from the group consisting of halogen, alkyl, substituted alkyl, CN, NO 2 , alkoxy, substituted alkoxy, and CF 3 ; 
 Q 1  is S, NR 7 , or CR 8 R 9 ; 
 R 7  is selected from the group consisting of CN, C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 8  cycloalkyl, substituted C 3  to C 8  cycloalkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, acyl, substituted acyl, aroyl, substituted aroyl, SO 2 CF 3 , OR 11 , and NR 11 R 12 ; 
 R 8  and R 9  are independent substituents selected from the group consisting of H, C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 8  cycloalkyl, substituted C 3  to C 8  cycloalkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, NO 2 , CN, and CO 2 R 16 ; 
 R 10  is C 1  to C 3  alkyl or substituted C 1  to C 3  alkyl; 
 or CR 8 R 9  comprise a six membered ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           R 11  and R 12  are independently selected from the group consisting of H, alkyl, substituted alkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, acyl, substituted acyl, aroyl, substituted aroyl, sulfonyl, and substituted sulfonyl; 
         
         or a pharmaceutically acceptable salt, tautomer, metabolite, or prodrug thereof. 
       
     
     
         2 . The method according to  claim 1 , wherein said carcinomas are selected from the group consisting of ovary, breast, colon, endometrial, uterine, and prostate carcinomas. 
     
     
         3 . The method according to  claim 1 , wherein R 1  and R 2  are alkyl or substituted alkyl and R 3  is H. 
     
     
         4 . The method according to  claim 1 , wherein:
 R 1  and R 2  are joined to form a ring selected from the group consisting of —CH 2 (CH 2 ) n CH 2 —, —CH 2 CH 2 C(CH 3 ) 2 CH 2 CH 2 —, —O(CH 2 ) m CH 2 —, —O(CH 2 ) p O—, —CH 2 CH 2 OCH 2 CH 2 —, —CH 2 CH 2 N(H)CH 2 CH 2 —, and —CH 2 CH 2 N(alkyl)CH 2 CH 2 —; and   R 3  is H.   
     
     
         5 . The method according to  claim 1 , wherein:
 R 3  is H; and   Q 1  is S or NR 7 .   
     
     
         6 . The method according to  claim 1 , wherein said compound is selected from the group consisting of:
 5′-(3-chlorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-thione,   3-(1′,2′-dihydro-2′-thioxospiro[cyclohexane-1,3′-[3H]indol]-5′-yl)benzonitrile,   4-(1′,2′-dihydro-2′-thioxospiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-2-thiophenecarbonitrile,   3-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-5-fluorobenzonitrile,   4-methyl-5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]-indol]-5-yl)-2-thiophenethioamide,   5-(1,2-dihydro-2-thioxospiro[cyclopentane-1,3-[3H]indol]-5′-yl)-1H-pyrrole-2-carbonitrile,   5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-1-(tert-butoxycarbonyl)-pyrrole-2-carbonitrile,   5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-1-H-pyrrole-2-carbonitrile,   5-(2′-thioxospiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-1-methyl-pyrrole-2-carbonitrile,   5-(1,2-dihydro-2-thioxospiro[cyclopentane-1,3-[3H]indol]-5-yl)-3-thiophenecarbonitrile,   5-(1,2-dihydro-thioxospiro[cyclopentane-1,3-[3H]indol]-5-yl)-2-thiophenecarbonitrile,   5-(3-fluoro-4-methoxyphenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(2-amino-5-pyrimidinyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   3-(1,2-dihydro-2-thioxospiro[cyclopentane-1,3-[3H]indol]-5-yl)-5-fluorobenzonitrile,   5-(3-chlorophenyl)-3,3-dimethyl-1,3-dihydro-2H-indole-2-thione,   3-benzyl-5-(3-chlorophenyl)-3-methyl-1,3-dihydro-2H-indole-2-thione,   4-(3,3-dimethyl-2-thioxo-2,3-dihydro-1H-indol-5-yl)-2-furonitrile,   5-(3-methoxyphenyl)-3,3-dimethyl-1,3-dihydro-2H-indole-2-thione,   3-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-4-fluorobenzonitrile,   5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-3-pyridinecarbonitrile,   5-(3,4-difluorophenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(5-chloro-2-thienyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-3-furancarbonitrile,   5-(3-chloro-4-fluorophenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(3-chloro-5-fluorophenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(3,5-difluorophenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-4-propyl-2-thiophenecarbonitrile,   5-(3-fluoro-4-nitrophenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   4-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-2-furancarbonitrile,   5″-(3-chlorophenyl)spiro[cyclobutane-1,3″-[3H]indol]-2″(1″H)-thione,   5″-(2-chlorophenyl)spiro[cyclohexane-1,3″-[3H]indol]-2″(1″H)-thione,   5″-(4-chlorophenyl)spiro[cyclohexane-1,3″-[3H]indol]-2″(1″H)-thione,   5-(1″,2″-dihydro-2″-thioxospiro[cyclohexane-1,3″-[3H]indol]-5″-yl)-4-methyl-2-thiophenecarbonitrile,   5-(1″,2″-dihydro-2″-thioxospiro[cyclohexane-1,3″-[3H]indol]-5″-yl)-2-thiophenecarbonitrile,   5″-(3-fluorophenyl)spiro[cyclohexane-1,3″-[3H]indol]-2″(1″H)-thione,   5-(3-hydroxyphenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(3-chlorophenyl)-3,3-diethyl-1,3-dihydro-2H-indole-2-thione,   5-(4-fluoro-3-(trifluoromethyl)phenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   4-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-2-fluorobenzonitrile,   5-(1,2-dihydro-2-thioxospiro[cyclohexane-1,3-[3H]indol]-5-yl)-4-n-butyl-2-thiophenecarbonitrile,   5-(3-fluoro-5-methoxyphenyl)spiro[cyclohexane-1,3-[3H]indol]-2(1H)-thione,   5-(3-chlorophenyl)-N-hydroxyspiro[cyclohexane-1,3′-[3H]indol]-2-amine,   N-(acetyloxy)-5′-(3-chlorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2″-amine,   5′-(3-fluorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   5′-(2-fluorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   5′-(4-fluorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   5′-(3,4-difluorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   5′-(3-methoxyphenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   5′-(3-nitrophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   5′-(3-cyanophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′(1′H)-one oxime,   3-(1′,2′-dihydro-2′-(hydroxyimino)spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-5-fluorobenzonitrile,   5-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-4-methyl-2-thiophenecarbonitrile,   5-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-2-thiophenecarbonitrile,   4-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-2-thiophenecarbonitrile,   5-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-1H-pyrrole-1-methyl-2-carbonitrile,   5-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-1H-pyrrole-2-carbonitrile,   4-(spiro[cyclohexane-1,3′-[3H]indol]-2′(acetoxyimino)-5′-yl)-2-thiophenecarbonitrile,   3-fluoro-N′-hydroxy-5-(2′-(hydroxyamino)spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)benzenecarboximidamide,   N′-hydroxy-5-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-4-methyl-2-thiophenecarboximidamide,   N′-hydroxy-4-(spiro[cyclohexane-1,3′-[3H]indol]-2′-hydroxyimino)-5′-yl-2-thiophenecarboximidamide,   N′-hydroxy-5-(spiro[cyclohexane-1,3′-[3H]indol]-2′-(hydroxyimino)-5′-yl)-2-thiophenecarboxidamide,   5′-(3-chlorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′-ylidenecyanamide,   5′-(3-cyano-5-fluorophenyl)spiro[cyclohexane-1,3′-[3H]indol]-2′-ylidenecyanamide,   5′-(5-cyano-1H-pyrrol-2-yl)spiro[cyclohexane-1,3′-[3H]indol]-2-ylidenecyanamide,   5′-(5-cyano-thiophen-2-yl)spiro[cyclohexane-1,3′-[3H]indol]-2′-ylidenecyanamide,   5′-(5-cyano-3-methyl-thiophen-2-yl)spiro[cyclohexane-1,3′-[3H]indol]-2′-ylidenecyanamide,   5′-(5-cyano-thiophen-3-yl)spiro[cyclohexane-1,3′-[3H]indol]-2′-ylidenecyanamide,   3-(2′-cyanomethylene-spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-5-fluoro-benzonitrile,   5-(2′-cyanomethylene-spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-1H-pyrrole-2-carbonitrile,   5-(2′-cyanomethylene-spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-1-methyl-1H-pyrrole-2-carbonitrile,   5-(2′-cyanomethylene-spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-thiophene-2-carbonitrile,   5-(2′-cyanomethylene-spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-4-methyl-thiophene-2-carbonitrile, and   4-(2′-cyanomethylene-spiro[cyclohexane-1,3′-[3H]indol]-5′-yl)-thiophene-2-carbonitrile, or a pharmaceutically acceptable salt, tautomer, metabolite, or prodrug thereof.   
     
     
         7 . The method according to  claim 1 , wherein said compound is 5′-(5-cyano-1-methyl-1H-pyrrol-2-yl)spiro[cyclohexane-1,3′-[3H]indol]-2′-ylidenecyanamide, or a pharmaceutically acceptable salt, tautomer, metabolite, or prodrug thereof. 
     
     
         8 . The method according to  claim 1 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 11  is selected from the group consisting of H, acyl, substituted acyl, aroyl, substituted aroyl, sulfonyl, and substituted sulfonyl; 
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNHOH, CNH 2 NOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring comprising 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CNHNHOH, CNH 2 NOH, CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F, and C 1  to C 4  alkyl; or 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         9 . The method according to  claim 1 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring comprising 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 
             Y′ is selected from the group consisting of H, F and C 1  to C 4  alkyl; or 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         10 . The method according to  claim 1 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 8  is selected from the group consisting of H, CO 2 R 10 , acyl, substituted acyl, aroyl, substituted aroyl, alkyl, substituted alkyl, and CN; 
 R 10  is C 1  to C 3  alkyl; 
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring comprising 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F and C 1  to C 4  alkyl; 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         11 . The method according to  claim 1 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring comprising 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F, and C 1  to C 4  alkyl; 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         12 . The method according to  claim 1 , wherein said selective estrogen receptor modulator is selected from the group consisting of tamoxifene, 4-hydroxy-tamoxifene, raloxifene, droloxifene, toremifene, iodotamoxifen, idoxifene, ICI182780, EM-800, EM-652, arzoxifene, lasofoxifene, clomiphene, pipendoxifene, tibolone, levormeloxifene, centchroman, bazedoxifene, ZK186619, cycladiene, nafoxidine, nitromifene citrate, 13-ethyl-17α-ethynyl-17β-hydroxygona-4-9-11-trien-3-one, diphenol hydrochryscne, erythro-MEA, allenolic acid, cyclofenyl, chlorotrianisene, ethamoxytriphetol, triparanol, CI-626, CI-680, U-11,555A, U-11,100A, ICI-46,669, ICI-46,474, and CN-55,945 or a salt thereof. 
     
     
         13 . A method of treating dysfunctional bleeding, uterine leiomyomata, endometriosis, polycystic ovary syndrome, or combinations thereof, said method comprising delivering to a female in need thereof a composition comprising a compound of formula I, or a tautomer thereof, in a regimen which involves delivering a pharmaceutically effective amount of one or more of a selective estrogen receptor modulator to said female, wherein formula I is: 
       
         
           
           
               
               
           
         
         wherein:
 R 1  and R 2  are selected from the group consisting of H, alkyl, substituted alkyl, OH, O(alkyl), O(substituted alkyl), O(Acetyl), aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, alkylaryl, substituted alkylaryl, alkylheteroaryl, substituted alkylheteroaryl, 1-propynyl, substituted 1-propynyl, 3-propynyl, and substituted 3-propynyl; 
 or R 1  and R 2  are joined to form a ring selected from the group consisting of —CH 2 (CH 2 ) n CH 2 —, —CH 2 CH 2 C(CH 3 ) 2 CH 2 CH 2 —, —O(CH 2 ) m CH 2 —, —O(CH 2 ) p O—, —CH 2 CH 2 OCH 2 CH 2 —, —CH 2 CH 2 N(H)CH 2 CH 2 —, and —CH 2 CH 2 N(alkyl)CH 2 CH 2 —; 
 m is an integer from 1 to 4; 
 n is an integer from 1 to 5; 
 p is an integer from 1 to 4; 
 or R 1  and R 2  form a double bond to C(CH 3 ) 2 , C(cycloalkyl), O, or C(cycloether); 
 R 3  is selected from the group consisting of H, OH, NH 2 , C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 6  alkenyl, substituted C 3  to C 6  alkenyl, alkynyl, substituted alkynyl, and COR A ; 
 R A  is selected from the group consisting of H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, and substituted C 1  to C 3  aminoalkyl; 
 R 4  is selected from the group consisting of H, halogen, CN, NH 2 , C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 1  to C 6  alkoxy, substituted C 1  to C 6  alkoxy, C 1  to C 6  aminoalkyl, and substituted C 1  to C 6  aminoalkyl; 
 R 5  is selected from the group consisting of a), b) and c): 
 a) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           
             X is selected from the group consisting of halogen, OH, CN, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  thioalkyl, substituted C 1  to C 3  thioalkyl, S(O)alkyl, S(O) 2 alkyl, C 1  to C 3  aminoalkyl, substituted C 1  to C 3  aminoalkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 or 6 membered heterocyclic ring having 1 to 3 heteroatoms, CONH 2 , CSNH 2 , CNHNHOH, CNH 2 NOH, CNHNOH, COR B , CSR B , OCOR B , and NRCCOR B ; 
             R B  is selected from the group consisting of H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, aryl, substituted aryl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, and substituted C 1  to C 3  aminoalkyl; 
             R C  is H, C 1  to C 3  alkyl, or substituted C 1  to C 3  alkyl; 
             Y and Z are independently selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 4  alkyl, substituted C 1  to C 4  alkyl, C 1  to C 3  thioalkyl, and substituted C 1  to C 3  thioalkyl; 
           
           b) a five or six membered heterocyclic ring having 1, 2, or 3 heteroatoms selected from the group consisting of O, S, SO, SO 2  and NR 6  and having one or two independent substituents from the group consisting of H, halogen, CN, NO 2 , C 1  to C 4  alkyl, substituted C 1  to C 4  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, substituted C 1  to C 3  aminoalkyl, COR D , CSR D , and NR E COR D ;
 R D  is H, NH 2 , C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, aryl, substituted aryl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, or substituted C 1  to C 3  aminoalkyl; 
 R E  is H, C 1  to C 3  alkyl, or substituted C 1  to C 3  alkyl; 
 R 6  is H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, or C 1  to C 4 CO 2  alkyl; 
 
           or 
           c) an indol-4-yl, indol-7-yl or benzo-2-thiophene moiety, wherein said moiety is optionally substituted by from 1 to 3 substituents selected from the group consisting of halogen, alkyl, substituted alkyl, CN, NO 2 , alkoxy, substituted alkoxy, and CF 3 ; 
           Q 1  is S, NR 7 , or CR 8 R 9 ; 
           R 7  is selected from the group consisting of CN, C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 8  cycloalkyl, substituted C 3  to C 8  cycloalkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, acyl, substituted acyl, aroyl, substituted aroyl, SO 2 CF 3 , OR 11 , and NR 11 R 12 ; 
           R 8  and R 9  are independent substituents selected from the group consisting of H, C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 8  cycloalkyl, substituted C 3  to C 8  cycloalkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, NO 2 , CN, and CO 2 R 16 ; 
           R 10  isl C 1  to C 3  alkyl or substituted C 1  to C 3  alkyl; 
           or CR 8 R 9  comprise a six membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           R 11  and R 12  are independently selected from the group consisting of H, alkyl, substituted alkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, acyl, substituted acyl, aroyl, substituted aroyl, sulfonyl, and substituted sulfonyl; 
         
         or a pharmaceutically acceptable salt, tautomer, metabolite, or prodrug thereof. 
       
     
     
         14 . The method according to  claim 13 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 11  is selected from the group consisting of H, acyl, substituted acyl, aroyl, substituted aroyl, sulfonyl, and substituted sulfonyl; 
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNHOH, CNH 2 NOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CNHNHOH, CNH 2 NOH, CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F, and C 1  to C 4  alkyl; or 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         15 . The method according to  claim 13 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F and C 1  to C 4  alkyl; or 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         16 . The method according to  claim 13 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 8  is selected from the group consisting of H, CO 2 R 10 , acyl, substituted acyl, aroyl, substituted aroyl, alkyl, substituted alkyl, and CN; 
 R 10  is C 1  to C 3  alkyl; 
 
         R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
           (ii) a five membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F and C 1  to C 4  alkyl; 
 
           (iii) a six membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 ; 
 
         
         or a pharmaceutically acceptable salt, tautomer, metabolite, or prodrug thereof. 
       
     
     
         17 . The method according to  claim 13 , wherein said compound is: 
       
         
           
           
               
               
           
         
         wherein:
 R 5  is (i), (ii), or (iii):
 (i) a substituted benzene ring having the structure: 
 
 
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F, and C 1  to C 4  alkyl; 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 . 
 
           
         
       
     
     
         18 . The method according to  claim 13 , wherein said selective estrogen receptor modulator is selected from the group consisting of tamoxifene, 4-hydroxy-tamoxifene, raloxifene, droloxifene, toremifene, iodotamoxifen, idoxifene, ICI182780, EM-800, EM-652, arzoxifene, lasofoxifene, clomiphene, pipendoxifene, tibolone, levormeloxifene, centchroman, bazedoxifene, ZK186619, cycladiene, nafoxidine, nitromifene citrate, 13-ethyl-17α-ethynyl-17β-hydroxygona-4-9-11-trien-3-one, diphenol hydrochryscne, erythro-MEA, allenolic acid, cyclofenyl, chlorotrianisene, ethamoxytriphetol, triparanol, CI-626, CI-680, U-11,555A, U-11,100A, ICI-46,669, ICI-46,474, and CN-55,945 or a salt thereof. 
     
     
         19 . A method of contraception, said method comprising delivering to a female of child-bearing age a composition comprising a compound of formula I, or a tautomer thereof, in a regimen which involves delivering a pharmaceutically effective amount of one or more of a selective estrogen receptor modulator to said female, wherein formula I is: 
       
         
           
           
               
               
           
         
         wherein:
 R 1  and R 2  are selected from the group consisting of H, alkyl, substituted alkyl, OH, O(alkyl), O(substituted alkyl), O(Acetyl), aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, alkylaryl, substituted alkylaryl, alkylheteroaryl, substituted alkylheteroaryl, 1-propynyl, substituted 1-propynyl, 3-propynyl, and substituted 3-propynyl; 
 or R 1  and R 2  are joined to form a ring selected from the group consisting of —CH 2 (CH 2 ) n CH 2 —, —CH 2 CH 2 C(CH 3 ) 2 CH 2 CH 2 —, —O(CH 2 ) m CH 2 —, —O(CH 2 ) p O—, —CH 2 CH 2 OCH 2 CH 2 —, —CH 2 CH 2 N(H)CH 2 CH 2 —, and —CH 2 CH 2 N(alkyl)CH 2 CH 2 —; 
 m is an integer from 1 to 4; 
 n is an integer from 1 to 5; 
 p is an integer from 1 to 4; 
 or R 1  and R 2  form a double bond to C(CH 3 ) 2 , C(cycloalkyl), O, or C(cycloether); 
 R 3  is selected from the group consisting of H, OH, NH 2 , C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 6  alkenyl, substituted C 3  to C 6  alkenyl, alkynyl, substituted alkynyl, and COR A ; 
 R A  is selected from the group consisting of H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, and substituted C 1  to C 3  aminoalkyl; 
 R 4  is selected from the group consisting of H, halogen, CN, NH 2 , C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 1  to C 6  alkoxy, substituted C 1  to C 6  alkoxy, C 1  to C 6  aminoalkyl, and substituted C 1  to C 6  aminoalkyl; 
 R 5  is selected from the group consisting of a), b) and c): 
 a) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           
             X is selected from the group consisting of halogen, OH, CN, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  thioalkyl, substituted C 1  to C 3  thioalkyl, S(O)alkyl, S(O) 2 alkyl, C 1  to C 3  aminoalkyl, substituted C 1  to C 3  aminoalkyl, NO 2 , C 1  to C 3  perfluoroalkyl, substituted C 1  to C 3  perfluoroalkyl, 5 or 6 membered heterocyclic ring having 1 to 3 heteroatoms, CONH 2 , CSNH 2 , CNHNHOH, CNH 2 NOH, CNHNOH, COR B , CSR B , OCOR B , and NR C COR B ; 
             R B  is selected from the group consisting of H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, aryl, substituted aryl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, and substituted C 1  to C 3  aminoalkyl; 
             R C  is H, C 1  to C 3  alkyl, or substituted C 1  to C 3  alkyl; 
             Y and Z are independently selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 4  alkyl, substituted C 1  to C 4  alkyl, C 1  to C 3  thioalkyl, and substituted C 1  to C 3  thioalkyl; 
           
           b) a five or six membered heterocyclic ring having 1, 2, or 3 heteroatoms selected from the group consisting of O, S, SO, SO 2  and NR 6  and having one or two independent substituents from the group consisting of H, halogen, CN, NO 2 , C 1  to C 4  alkyl, substituted C 1  to C 4  alkyl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, substituted C 1  to C 3  aminoalkyl, COR D , CSR D , and NR E COR D ;
 R D  is H, NH 2 , C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, aryl, substituted aryl, C 1  to C 3  alkoxy, substituted C 1  to C 3  alkoxy, C 1  to C 3  aminoalkyl, or substituted C 1  to C 3  aminoalkyl; 
 R E  is H, C 1  to C 3  alkyl, or substituted C 1  to C 3  alkyl; 
 R 6  is H, C 1  to C 3  alkyl, substituted C 1  to C 3  alkyl, or C 1  to C 4 CO 2 alkyl; or 
 
           c) an indol-4-yl, indol-7-yl or benzo-2-thiophene moiety, wherein said moiety is optionally substituted by from 1 to 3 substituents selected from the group consisting of halogen, alkyl, substituted alkyl, CN, NO 2 , alkoxy, substituted alkoxy, and CF 3 ; 
           Q 1  is S, NR 7 , or CR 8 R 9 ; 
           R 7  is selected from the group consisting of CN, C 1  to C 6  alkyl, substituted C 1  to C 6  alkyl, C 3  to C 8  cycloalkyl, substituted C 3  to C 8  cycloalkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, acyl, substituted acyl, aroyl, substituted aroyl, SO 2 CF 3 , OR 11 , and NR 11 R 12 ; 
           R 8  and R 9  are independent substituents selected from the group consisting of H, alkyl, substituted alkyl, acyl, substituted acyl, aroyl, substituted aroyl, C 3  to C 8  cycloalkyl, substituted C 3  to C 8  cycloalkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, NO 2 , CN, and CO 2 R 16 ; 
           R 10  is C 1  to C 3  alkyl or substituted C 1  to C 3  alkyl; 
           or CR 8 R 9  comprise a six membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           R 11  and R 12  are independently selected from the group consisting of H, alkyl, substituted alkyl, aryl, substituted aryl, heterocyclic ring, substituted heterocyclic ring, acyl, substituted acyl, aroyl, substituted aroyl, sulfonyl, and substituted sulfonyl; 
         
         or a pharmaceutically acceptable salt, tautomer, metabolite, or prodrug thereof. 
       
     
     
         20 . The method according to  claim 19 , wherein said compound is selected from the group consisting of (a), (b), (c), and (d): 
       
         
           
           
               
               
           
         
         wherein:
 R 11  is selected from the group consisting of H, acyl, substituted acyl, aroyl, substituted aroyl, sulfonyl, and substituted sulfonyl; 
 R 5  is (i), (ii), or (iii): 
 (i) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNHOH, CNH 2 NOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
           (ii) a five membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CNHNHOH, CNH 2 NOH, CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F, and C 1  to C 4  alkyl; or 
 
           (iii) a six membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 ; 
 
         
       
       
         
           
           
               
               
           
         
         wherein:
 R 5  is (i), (ii), or (iii): 
 (i) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
           (ii) a five membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F and C 1  to C 4  alkyl; or 
 
           (iii) a six membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 7 , CSN(alkyl), or NO 2 ; 
 
         
       
       
         
           
           
               
               
           
         
         wherein:
 R 8  is selected from the group consisting of H, CO 2 R 10 , acyl, substituted acyl, aroyl, substituted aroyl, alkyl, substituted alkyl, and CN; 
 R 10  is C 1  to C 3  alkyl; 
 R 5  is (i), (ii), or (iii): 
 (i) a substituted benzene ring having the structure: 
 
       
       
         
           
           
               
               
           
         
         
           wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C1 to C3 alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
           (ii) a five membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F and C 1  to C 4  alkyl; 
 
           (iii) a six membered ring having the structure: 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 ; and 
 
         
       
       
         
           
           
               
               
           
         
         
           wherein:
 R 5  is (i), (ii), or (iii): 
 (i) a substituted benzene ring having the structure: 
 
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X is selected from the group consisting of halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , CNHNOH, C 1  to C 3  alkoxy, C 1  to C 3  alkyl, NO 2 , C 1  to C 3  perfluoroalkyl, 5 membered heterocyclic ring having 1 to 3 heteroatoms, and C 1  to C 3  thioalkyl; 
 Y is selected from the group consisting of H, halogen, CN, NO 2 , C 1  to C 3  alkoxy, C 1  to C 4  alkyl, and C 1  to C 3  thioalkyl; 
 
             (ii) a five membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 U is O, S, or NR 6 ; 
 R 6  is H, C 1  to C 3  alkyl, or C 1  to C 4  CO 2 alkyl; 
 X′ is selected from the group consisting of halogen, CN, NO 2 , CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2 , C 1  to C 3  alkyl, and C 1  to C 3  alkoxy; 
 Y′ is selected from the group consisting of H, F, and C 1  to C 4  alkyl; 
 
             (iii) a six membered ring having the structure: 
           
         
       
       
         
           
           
               
               
           
         
         
           
             wherein:
 X 1  is N or CX 2 ; 
 X 2  is halogen, CN, CONH 2 , CSNH 2 , CONHalkyl, CSNHalkyl, CON(alkyl) 2 , CSN(alkyl) 2  or NO 2 .

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