申请人:——
公开号:US20030176421A1
公开(公告)日:2003-09-18
Stasis is treated or prevented in all or any part or parts of the stomach of a patient, especially a human patient, in need of such treatment, where said stasis results from hypomotility in the stomach, particularly gastric hypomotility with delayed emptying of the liquid and/or solid contents of the stomach. Gastric or gastrointestinal disorders are also treated which are characterized by one or more symptoms selected from pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion and gastroesophageal reflux. Such treatment or prevention is achieved by administering to the patient a therapeutically effective amount of an inhibitor of phosphodiesterase-4 (PDE4), including isozyme subtypes thereof, sufficient to treat or prevent such hypomotility or gastric or gastrointestinal disorder in said patient. The PDE4 inhibitor comprises a compound of Formula (IA) or (IB):
1
where in a preferred embodiment, R is cyclopentyl or cyclohexyl; R
1
is (C
1
-C
2
) alkyl; one of R
2
a
and R
2
b
is hydrogen and the other is a substituent of partial Formula (1.0.0) above, where the dashed line represents a single bond, m is 0, R
113
and R
114
are in a cis relationship to each other, R
113
is cyano, R
115
is hydrogen, and R
114
is carboxy, —CH
2
OH, or —CH
2
C(═O)NH
2
.
Pharmaceutical compositions are also described which are useful for carrying out the above-mentioned methods of treatment and prevention, and which are also useful in the treatment of a gastric or gastrointestinal disorder in a patient which comprises with respect to said patient, (i) a sign or concomitant of diabetic neuropathy, anorexia nervosa, achlorhydria, gastrointestinal surgery, post-surgical recovery in the period of emergence from general anesthesia; or the administration of morphine and morphine-like opioids; (ii) a secondary aspect of a primary disease or disorder in said patient which is organic, wherein said disease or disorder involves particularly a gastroenteric or gastroesophageal organ or tissue, or an organ or tissue of the central nervous system of said patient; or (iii) an adverse side effect of a different therapeutic agent administered to said patient in the course of treating another unrelated disease or disorder in said patient.
本发明涉及一种治疗或预防患者(尤其是人类患者)胃部任何部位或全部的停滞,其中该停滞是由于胃肠道低动力性,尤其是胃肠道低动力性导致胃液和/或固体食物的排空延迟。同时,本发明还涉及治疗或预防胃或胃肠道疾病,这些疾病的特征是疼痛、恶心、呕吐、胃灼热、餐后不适、消化不良和胃食管反流中的一个或多个症状。通过向患者施用磷酸二酯酶-4(PDE4)的抑制剂,包括其同工酶亚型,治疗或预防该患者的低动力性或胃或胃肠道疾病所需的治疗剂量就可以实现。所述PDE4抑制剂包括化合物公式(IA)或(IB)的化合物:其中在一种优选实施例中,R为环戊基或环己基;R1为(C1-C2)烷基;R2a和R2b中的一个是氢,另一个是上述部分式(1.0.0)的取代基,其中虚线表示单键,m为0,R113和R114在相互的顺式关系下,R113为氰基,R115为氢,R114为羧基,-CH2OH或-CH2C(═ O)NH2。本发明还描述了药物组合物,用于执行上述治疗和预防方法,并且还用于治疗患者的胃或胃肠道疾病,该患者具有以下特征:(i)糖尿病神经病变、厌食症、无酸胃、胃肠道手术、全身麻醉恢复期间的术后恢复;或吗啡和吗啡样的阿片类药物的使用的标志或伴随症状;(ii)该患者的原发性疾病或疾病的次要方面是器质性疾病或疾病,其中该疾病或疾病特别涉及该患者的胃肠道或胃食管器官或组织,或该患者的中枢神经系统的器官或组织;或(iii)在治疗该患者的另一种无关疾病或疾病的过程中向该患者施用的不同治疗剂的不良副作用。