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Ep 1380299 A1 Europäisches Patentamt *EP001380299A1* (19) European Patent Office Office européen des brevets (11) EP 1 380 299 A1 (12) EUROPEAN PATENT APPLICATION published in accordance with Art. 158(3) EPC (43) Date of publication: (51) Int Cl.7: A61K 31/55, A61P 13/08, 14.01.2004 Bulletin 2004/03 A61P 13/10 // C07D495:04 (21) Application number: 02713257.0 (86) International application number: (22) Date of filing: 29.03.2002 PCT/JP2002/003169 (87) International publication number: WO 2002/078712 (10.10.2002 Gazette 2002/41) (84) Designated Contracting States: • ATSUKI, Kaoru, c/o Kyowa Hakko Kogyo Co., Ltd AT BE CH CY DE DK ES FI FR GB GR IE IT LI LU Sunto-gun, Shizuoka 411-8731 (JP) MC NL PT SE TR • OHNO, Tetsuji, c/o Kyowa Hakko Kogyo Co., Ltd Designated Extension States: Sunto-gun, Shizuoka 411-8731 (JP) AL LT LV MK RO SI • SHIRAKURA, Shiro, c/o Kyowa Hakko Kogyo Co., Ltd (30) Priority: 30.03.2001 JP 2001099799 Sunto-gun, Shizuoka 411-8731 (JP) • KARASAWA, Akira, (71) Applicant: KYOWA HAKKO KOGYO CO., LTD. c/o Kyowa Hakko Kogyo Co., Ltd Chiyoda-ku, Tokyo 100-8185 (JP) Sunto-gun, Shizuoka 411-8731 (JP) (72) Inventors: (74) Representative: VOSSIUS & PARTNER • YAMAGATA, Tsuyoshi, Siebertstrasse 4 c/o Kyowa Hakko Kogyo Co., Ltd 81675 München (DE) Sunto-gun, Shizuoka 411-8731 (JP) (54) REMEDIES FOR VESICAL STIMULATION IN ASSOCIATION WITH PROSTATAUXE 1 2 3 5 6 7 8 6 (57) The present invention provides a therapeutic X -X -X represents CR =CR -CR =CR , N(O)m=CR - 7 8 5 6 8 5 6 7 agent for bladder irritative symptoms associated with CR =CR ,CR=CR -N(O)m=CR ,CR=CR -CR =N 5 6 5 6 7 8 7 benign prostatic hyperplasia comprising, as an active in- (O)m,CR=CR -O, CR =CR -S, O-CR =CR ,S-CR= gredient, a tricyclic compound represented by formula CR8 or O-CR7=N; (I): Y represents -CH2S-, -CH2SO-, -CH2SO2-, -CH2O-, -CH=CH-, - (CH2)p-, -SCH2-, -SOCH2-, -SO2CH2-or -OCH2-; and R2 represents a hydrogen atom, substituted or unsub- stituted lower alkyl, substituted or unsubstituted lower alkenyl, substituted or unsubstituted lower alkoxy, ami- no, mono(substituted or unsubstituted lower alkyl)-sub- stituted amino, di(substituted or unsubstituted lower alkyl)-substituted amino, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkylamino, substituted or unsubsti- [wherein R1 represents a hydrogen atom, substituted or tuted arylamino or a substituted or unsubstituted heter- unsubstituted lower alkyl, substituted or unsubstituted oalicyclic group] or a pharmaceutically acceptable salt lower alkoxy or halogen; thereof. EP 1 380 299 A1 Printed by Jouve, 75001 PARIS (FR) EP 1 380 299 A1 Description Technical Field 5 [0001] The present invention relates to a therapeutic agent for bladder irritative symptoms associated with benign prostatic hyperplasia. Background Art 10 [0002] Benign prostatic hyperplasia is benign adenoma generated in a transitional zone of the prostate that wraps the urethra. Patients with benign prostatic hyperplasia complain of bladder outlet obstructive symptoms or bladder irritative symptoms. Examples of bladder outlet obstructive symptoms include a hesitation before urine flow starts, straining, a weak urinary stream, an intermittent urinary stream, dribbling at the end of urination, prolongation of uri- nation and overflow incontinence. Examples of bladder irritative symptoms include urinary frequency at daytime, urinary 15 frequency at night, urinary urgency, a feeling of incomplete emptying and a reduced voided volume per micturition. Functional obstruction and mechanical obstruction are involved in the development of these urinary disturbances due to benign prostatic hyperplasia. Further, these functional and mechanical obstructions cause secondary changes in detrusor muscle or nerves, which induce the complicated pathological phenomena such as bladder irritative symptoms and bladder outlet obstructive symptoms. 20 [0003] At present, for examples, α1-receptor blockers, anti-androgen agents, plant preparations, amino acid prepa- rations, or the like are used as a therapeutic agent for benign prostatic hyperplasia. Among these, examples of the α1- receptor blockers include tamsulosin hydrochloride, prazosin hydrochloride, terazosin hydrochloride and urapidil. Ex- amples of the anti-androgen agents include chlormadinone acetate, allylestrenol, gestonorone caproate, oxendolone and finasteride. The α1-receptor blockers inhibit the functional urethral obstruction, that is, contractions of prostatic 25 smooth muscle induced by noradrenaline, secreted by stimulation of the sympathetic nerve, via the α1-receptor. The anti-androgen agents inhibit the mechanical obstruction, that is, a rise in urethral resistance resulting from the pressure caused by the enlarged prostate itself. However, although the α1-receptor blockers and anti-androgen agents are recognized to be effective for bladder outlet obstructive symptoms of benign prostatic hyperplasia, their effects on improvement of bladder irritative symptoms are insufficient. The plant preparations and amino acid preparations, which 30 have anti-inflammatory activity, anti-edema activity, or the like, improve the bladder irritative symptoms by alleviating the outflow obstruction at the bladder neck; but their effects are weak and the dose required is large so that they are a burden to aged people. Under these circumstances, there exists a need for a therapeutic agent to alleviate bladder irritative symptoms. [0004] Tricyclic compounds having the activity to prolong the intervals of bladder contractions and pharmaceutically 35 acceptable salts thereof are known as therapeutic agents for urinary incontinence (WO97/14672 and WO98/46587). However, it is not known that the compound groups have the activity to remit bladder irritative symptoms associated with benign prostatic hyperplasia. Disclosure of the Invention 40 [0005] The present invention relates to the following (1) to (27). (1) A therapeutic agent for bladder irritative symptoms associated with benign prostatic hyperplasia comprising, as an active ingredient, a tricyclic compound represented by formula (I): 45 50 55 [wherein R1 represents a hydrogen atom, substituted or unsubstituted lower alkyl, substituted or unsubstituted lower alkoxy or halogen; X1-X2-X3 represents CR5=CR6-CR7=CR8 (wherein R5,R6,R7and R8, which may be the same or different, each represent a hydrogen atom, substituted or unsubstituted lower alkyl, hydroxy, substituted or unsubstituted lower alkoxy, nitro, amino, mono(lower alkyl)-substituted amino, di(lower alkyl)-substituted amino, 2 EP 1 380 299 A1 6 7 8 6 7 8 substituted or unsubstituted lower alkanoylamino or halogen), N(O)m=CR -CR =CR (wherein R ,R and R have 5 6 8 the same significances as defined above, respectively, and m represents 0 or 1), CR =CR -N(O)m=CR (wherein 5 6 8 5 6 7 R ,R ,R and m have the same significances as defined above, respectively), CR =CR -CR =N (O)m (wherein R5,R6,R7and m have the same significances as defined above, respectively), CR5=CR6-O (wherein R5 and R6 5 have the same significances as defined above, respectively), CR5=CR6-S (wherein R5 and R6 have the same significances as defined above, respectively), O-CR7=CR8 (wherein R7 and R8 have the same significances as defined above, respectively), S-CR7=CR8 (wherein R7 and R8 have the same significances as defined above, 7 7 respectively) or O-CR =N (wherein R has the same significance as defined above); Y represents -CH2S-, -CH2SO-, -CH2SO2-, -CH2O-, -CH=CH-, 10 2 - (CH2)p- (wherein p represents an integer of 0 to 2), -SCH2-, -SOCH2-, -SO2CH2- or -OCH2-; and R represents a hydrogen atom, substituted or unsubstituted lower alkyl, substituted or unsubstituted lower alkenyl, substituted or unsubstituted lower alkoxy, amino, mono(substituted or unsubstituted lower alkyl)-substituted amino, di(substi- tuted or unsubstituted lower alkyl)-substituted amino, substituted or unsubstituted aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkylamino, substituted or unsubstituted arylamino or a substituted or 15 unsubstituted heteroalicyclic group] or a pharmaceutically acceptable salt thereof. (2) A therapeutic agent for bladder irritative symptoms associated with benign prostatic hyperplasia comprising, as an active ingredient, a tricyclic compound represented by formula (Ia): 20 25 [wherein R1 and X1-X2-X3 have the same significances as defined above, respectively; a Y represents -CH2SO2-, -SCH2-, -SOCH2-, -SO2CH2- or -OCH2-; and a when Y is -CH2SO2-, -SCH2-, -SOCH2- or -SO2CH2-, 30 R2a represents a hydrogen atom, substituted or unsubstituted lower alkyl, substituted or unsubstituted lower alke- nyl, trifluoromethyl, substituted or unsubstituted lower alkoxy, amino, mono(substituted or unsubstituted lower alkyl)-substituted amino, di(substituted or unsubstituted lower alkyl)-substituted amino, substituted or unsubstitut- ed aryl, substituted or unsubstituted heteroaryl, substituted or unsubstituted aralkylamino, substituted or unsub- stituted arylamino, a substituted or unsubstituted heteroalicyclic group or formula (II) : 35 40 (wherein n is 0 or 1; R3 and R4, which may be the same or different, each represent a hydrogen atom, substituted or unsubstituted lower alkyl, substituted or unsubstituted cycloalkyl, substituted or unsubstituted aryl, substituted or unsubstituted aralkyl or trifluoromethyl, or R3 and R4 may be combined together with the adjacent carbon atom 45 to form cycloalkyl; and Q represents hydroxy, substituted or unsubstituted lower alkoxy, amino
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