Sodium glucose co-transporter inhibitors and methods of their use

Abstract

Sulfanyl-tetrahydropyran-based compounds, pharmaceutical compositions comprising them, and methods of their use for the treatment of diseases and disorders such as diabetes and obesity are disclosed.

What is claimed is: 
     
         1 . A compound of the formula: 
       
         
           
           
               
               
           
         
         or a pharmaceutically acceptable salt thereof, wherein:
 A is optionally substituted aryl, cycloalkyl, or heterocycle; 
 B is optionally substituted aryl, cycloalkyl, or heterocycle; 
 Y is O, S, SO, SO 2 , NR 4 , (C(R 5 ) 2 ) p , (C(R 5 ) 2 ) q —C(O)—(C(R 5 ) 2 ) q , (C(R 5 ) 2 ) q —C(O)O—(C(R 5 ) 2 ) q , (C(R 5 ) 2 ) q —OC(O)—(C(R 5 ) 2 ) q , (C(R 5 ) 2 ) q —C(O)NR 4 —(C(R 5 ) 2 ) q , (C(R 5 ) 2 ) q —NR 4 C(O)—(C(R 5 ) 2 ) q , or (C(R 5 ) 2 ) q —NR 4 C(O)NR 4 —(C(R 5 ) 2 ) q ; 
 R 1A  is independently hydrogen or optionally substituted alkyl, aryl or heterocycle; 
 R 2  is fluoro or OR 2A ; 
 each of R 2A , R 2B , and R 2C  is independently hydrogen, optionally substituted alkyl, C(O)alkyl, C(O)aryl, or aryl; 
 each R 4  is independently hydrogen or optionally substituted alkyl; 
 each R 5  is independently hydrogen, hydroxyl, halogen, amino, cyano, OR 5A , SR 5A , or optionally substituted alkyl; 
 each R 5A  is independently optionally substituted alkyl; 
 p is 0-3; and 
 each q is independently 0-2. 
 
       
     
     
         2 . The compound of  claim 1 , which is of the formula: 
       
         
           
           
               
               
           
         
       
     
     
         3 . The compound of  claim 2 , which is of the formula: 
       
         
           
           
               
               
           
         
         wherein:
 each R 6  is independently hydrogen, hydroxyl, halogen, amino, cyano, nitro, C≡CR 6A , OR 6A , SR 6A , SOR 6A , SO 2 R 6A , C(O)R 6A , CO 2 R 6A , CO 2 H, CON(R 6A )(R 6A ), CONH(R 6A ), CONH 2 , NHC(O)R 6A , NHSO 2 R 6A , or optionally substituted alkyl, aryl or heterocycle; 
 each R 6A  is independently optionally substituted alkyl, aryl or heterocycle; 
 each R 7  is independently hydrogen, hydroxyl, halogen, amino, cyano, nitro, C≡CR 7A , OR 7A , SR 7A , SOR 7A , SO 2 R 7A , C(O)R 7A , CO 2 R 7A , CO 2 H, CON(R 7A )(R 7A ), CONH(R 7A ), CONH 2 , NHC(O)R 7A , NHSO 2 R 7A , or optionally substituted alkyl, aryl or heterocycle; 
 each R 7A  is independently optionally substituted alkyl, aryl or heterocycle; 
 m is 1-3; and 
 n is 1-3. 
 
       
     
     
         4 . The compound of  claim 3 , which is of the formula: 
       
         
           
           
               
               
           
         
       
     
     
         5 . The compound of  claim 4 , wherein Y is (C(R 4 ) 2 ) p . 
     
     
         6 . The compound of  claim 5 , wherein p is 1. 
     
     
         7 . The compound of  claim 4 , wherein Y is (C(R 5 ) 2 ) q —C(O)—(C(R 5 ) 2 ) q . 
     
     
         8 . The compound of  claim 7 , wherein each q is independently 0 or 1. 
     
     
         9 . The compound of  claim 4 , wherein R 1A  is hydrogen. 
     
     
         10 . The compound of  claim 4 , wherein R 1A  is optionally substituted alkyl. 
     
     
         11 . The compound of  claim 4 , wherein R 6  is hydrogen, hydroxyl, halogen, OR 6A , or optionally substituted lower alkyl. 
     
     
         12 . The compound of  claim 11 , wherein R 6  is hydrogen. 
     
     
         13 . The compound of  claim 11 , wherein R 6  is halogen. 
     
     
         14 . The compound of  claim 11 , wherein R 6  is hydroxyl. 
     
     
         15 . The compound of  claim 11 , wherein R 6  is OR 6A . 
     
     
         16 . The compound of  claim 11 , wherein R 6  is optionally substituted methyl. 
     
     
         17 . The compound of  claim 4 , wherein R 7  is hydrogen, C≡CR 7A , OR 7A , or optionally substituted lower alkyl. 
     
     
         18 . The compound of  claim 17 , wherein R 7  is hydrogen. 
     
     
         19 . The compound of  claim 17 , wherein R 7  is C≡CR 7A . 
     
     
         20 . The compound of  claim 19 , wherein R 7A  is optionally substituted monocyclic aryl or heterocycle. 
     
     
         21 . The compound of  claim 17 , wherein R 7  is OR 7A . 
     
     
         22 . The compound of  claim 17 , wherein R 7  is acetylenyl or optionally substituted methyl or ethyl. 
     
     
         23 . A compound of the formula: 
       
         
           
           
               
               
           
         
         or a pharmaceutically acceptable salt thereof, wherein:
 R 1A  is independently hydrogen or optionally substituted alkyl, aryl or heterocycle; 
 R 2  is fluoro or OR 2A ; 
 each of R 2A , R 2B , and R 2C  is independently hydrogen, optionally substituted alkyl, C(O)alkyl, C(O)aryl, or aryl; 
 each R 6  is independently hydrogen, hydroxyl, halogen, amino, cyano, nitro, C≡CR 6A , OR 6A , SR 6A , SOR 6A , SO 2 R 6A , C(O)R 6A , CO 2 R 6A , CO 2 H, CON(R 6A )(R 6A ), CONH(R 6A ), CONH 2 , NHC(O)R 6A , NHSO 2 R 6A , or optionally substituted alkyl, aryl or heterocycle; 
 each R 6A  is independently optionally substituted alkyl, aryl or heterocycle; 
 each R 7  is independently hydrogen, hydroxyl, halogen, amino, cyano, nitro, C≡CR 7A , OR 7A , SR 7A , SOR 7A , SO 2 R 7A , C(O)R 7A , CO 2 R 7A , CO 2 H, CON(R 7A )(R 7A ), CONH(R 7A ), CONH 2 , NHC(O)R 7A , NHSO 2 R 7A , or optionally substituted alkyl, aryl or heterocycle; 
 each R 7A  is independently optionally substituted alkyl, aryl or heterocycle; 
 m is 1-3; and 
 n is 1-3. 
 
       
     
     
         24 . A compound of the formula: 
       
         
           
           
               
               
           
         
         or a pharmaceutically acceptable salt thereof, wherein:
 R 1A  is independently hydrogen or optionally substituted alkyl, aryl or heterocycle; 
 each R 6  is independently hydrogen, hydroxyl, halogen, amino, cyano, nitro, C≡CR 6A , OR 6A , SR 6A , SOR 6A , SO 2 R 6A , C(O)R 6A , CO 2 R 6A , CO 2 H, CON(R 6A )(R 6A ), CONH(R 6A ), CONH 2 , NHC(O)R 6A , NHSO 2 R 6A , or optionally substituted alkyl, aryl or heterocycle; 
 each R 6A  is independently optionally substituted alkyl, aryl or heterocycle; 
 each R 7  is independently hydrogen, hydroxyl, halogen, amino, cyano, nitro, C≡CR 7A , OR 7A , SR 7A , SOR 7A , SO 2 R 7A , C(O)R 7A , CO 2 R 7A , CO 2 H, CON(R 7A )(R 7A ), CONH(R 7A ), CONH 2 , NHC(O)R 7A , NHSO 2 R 7A , or optionally substituted alkyl, aryl or heterocycle; 
 each R 7A  is independently optionally substituted alkyl, aryl or heterocycle; 
 m is 1-3; and 
 n is 1-3. 
 
       
     
     
         25 . A pharmaceutical formulation comprising a compound of  claim 1  and a pharmaceutically acceptable diluent or excipient. 
     
     
         26 . A method of inhibiting sodium glucose co-transporter 2 activity, which comprises contacting sodium glucose co-transporter 2 with an effective amount of a compound of  claim 1 . 
     
     
         27 . A method of decreasing blood glucose in a patient, which comprises administering to the patient an effective amount of a compound of  claim 1 . 
     
     
         28 . A method of increasing the excretion of glucose in the urine of a patient, which comprises administering to the patient an effective amount of a compound of  claim 1 . 
     
     
         29 . A method of restoring insulin sensitivity in a patient, which comprises administering to a patient in need thereof an effective amount of a compound of  claim 1 . 
     
     
         30 . A method of treating a disease or disorder in a patient, which comprises administering to a patient in need thereof a therapeutically effective amount of a compound of  claim 1 , wherein the disease or disorder is atherosclerosis, cardiovascular disease, diabetes (type 1 or 2), hyperglycemia, hypertension, lipid disorders, obesity, or Syndrome X. 
     
     
         31 . The method of  claim 30 , wherein the disease or disorder is type 2 diabetes.