CA2517573A1 - Substituted azetidinone compounds, formulations and uses thereof for the treatment of hypercholesterolemia - Google Patents

Substituted azetidinone compounds, formulations and uses thereof for the treatment of hypercholesterolemia Download PDF

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CA2517573A1
CA2517573A1 CA002517573A CA2517573A CA2517573A1 CA 2517573 A1 CA2517573 A1 CA 2517573A1 CA 002517573 A CA002517573 A CA 002517573A CA 2517573 A CA2517573 A CA 2517573A CA 2517573 A1 CA2517573 A1 CA 2517573A1
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alkylene
nr6r7
alkyl
residue
group
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CA2517573C (en
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Duane A. Burnett
John W. Clader
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Merck Sharp and Dohme Corp
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Schering Corporation
Duane A. Burnett
John W. Clader
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    • C—CHEMISTRY; METALLURGY
    • C07—ORGANIC CHEMISTRY
    • C07D—HETEROCYCLIC COMPOUNDS
    • C07D405/00—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom
    • C07D405/02—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom containing two hetero rings
    • C07D405/12—Heterocyclic compounds containing both one or more hetero rings having oxygen atoms as the only ring hetero atoms, and one or more rings having nitrogen as the only ring hetero atom containing two hetero rings linked by a chain containing hetero atoms as chain links
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00—Drugs for disorders of the nervous system
    • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/04—Anorexiants; Antiobesity agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/06—Antihyperlipidemics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00—Drugs for disorders of the metabolism
    • A61P3/08—Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10—Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00—Drugs for disorders of the cardiovascular system
    • A61P9/02—Non-specific cardiovascular stimulants, e.g. drugs for syncope, antihypotensives
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S930/00—Peptide or protein sequence
    • Y10S930/01—Peptide or protein sequence
    • Y10S930/28—Bound to a nonpeptide drug, nonpeptide label, nonpeptide carrier, or a nonpeptide resin

Abstract

The present invention provides substituted azetidinone compounds of formula (1), formulations and processes for preparing the same which can be useful for treating vascular conditions such as atherosclerosis or hypercholesterolemia, diabetes, obesity, stroke, demyelination and lowering plasma levels of sterols and/or stanols in a subject.

Claims (18)

1. A compound represented by the structural formula (I):
or pharmaceutically acceptable isomers, salts, solvates or esters of the compound of Formula (I), wherein in Formula (I) above:
X, Y and Z can be the same or different and each is independently selected from the group consisting of -CH2-, -CH(alkyl)- and -C(alkyl)2-;
Q1 and Q2 can be the same or different and each is independently selected from the group consisting of H, -(C0-C30 alkylene)-G, -OR6, -OC(O)R6, -OC(O)OR9, ~OC(O)NR6R7, and -L-M;
Q3 is 1 to 5 substituents independently selected from the group consisting of alkyl, alkenyl, alkynyl, -(C0-C30 alkylene)-G, -(C0-C10 alkylene)-OR6, -(C0-C10 alkylene)-C(O)R6, -(C0-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-OC(O)R6, -(C0-C10 alkylene)-OC(O)OR9, -CH=CH-C(O)R6, -CH=CH-C(O)OR6, -C~C-C(O)OR6,7 -C~C-C(O)R6, -O-(C1-C10 alkylene)-OR6, -O-(C1-C10 alkylene)-C(O)R6, -O-(C1-C10 alkylene)-C(O)OR6, -CN, -O-(C1-C10 alkylene)-C(O)NR6R7, -O-(C0-C10 alkylene)-C(O)NR6NR7C(O)OR6, -O-(C1-C10 alkylene)-C(O)(aryl)-N-N=N-, -OC(O)-(C1-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-C(O)NR6R7, -(C0-C10 alkylene)-OC(O)NR6R7, -NO2, -(C0-C10 alkylene)-NR6R7, -O-(C2-C10 alkylene)-NR6R7, -NR6C(O)R7, -NR6C(O)OR9, -NR6C(O)NR7R8, -NR6S(O)0-2R9, -S(S(O)0-2R9)2, -CHNOR6, -C(O)NR6R7, -C(O)NR6NR6R7, -S(O)0-2NR6R7, -S(O)0-2R9, -O-C(O)-(C1-C10 alkylene)-C(O)NR6R7, -OC(O)-(C1-C10 alkylene)-NR6C(O)O-(alkylaryl), -P(O)(OR10)2, -(C1-C10 alkylene)-OSi(alkyl)3, -CF3, -OCF3, halo, alkoxyalkoxy, alkoxyalkoxyalkoxy, alkoxycarbonylalkoxy, alkoxyarylalkoxy, alkoxyiminoalkyl, alkyldioyl, allyloxy, aryl, arylalkyl, aryloxy, arylalkoxy, aroyl, aroyloxy, aroylaroyloxy, arylalkoxycarbonyl, benzoylbenzoyloxy, heteroaryl, heteroarylalkyl, heteroarylalkoxy, dioxolanyl, heterocyclyl, heterocyclylalkyl, heterocyclylcarbonyl, heterocyclylcarbonylalkoxy and ~L-M;
Q4 is 1 to 5 substituents independently selected from the group consisting of alkyl, alkenyl, alkynyl, -(C0-C30 alkylene)-G, -(C0-C10 alkylene)-OR6, -(C0-C10 alkylene)-C(O)R6, -(C0-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-OC(O)R6, -(C0-C10 alkylene)-OC(O)OR9, -CH=CH-C(O)R6, -CH=CH-C(O)OR6, -C~C-C(O)OR6, -C~C-C(O)R6, -O-(C1-C10 alkylene)-OR6, -O-(C1-C10 alkylene)-C(O)R6, -O-(C1-C10 alkylene)-C(O)OR6, -CN, -O-(C1-C10 alkylene)-C(O)NR6R7, -O-(C0-C10 alkylene)-C(O)NR6NR7C(O)OR6, -O-(C1-C10 alkylene)-C(O)(aryl)-N-N=N-, -OC(O)-(C1-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-C(O)NR6R7, -(C0-C10 alkylene)-OC(O)NR6R7, -NO2, -(C0-C10 alkylene)-NR6R7, -O-(C2-C10 alkylene)-NR6R7, -NR6C(O)R7, -NR6C(O)OR9, -NR6C(O)NR7R8, -NR6S(O)0-2R9, -N(S(O)0-2R9)2, -CHNOR6, -C(O)NR6R7, -C(O)NR6NR6R7, -S(O)0-2NR6R7, -S(O)0-2R9, -O-C(O)-(C1-C10 alkylene)-C(O)NR6R7, -OC(O)-(C1-C10 alkylene)-NR6C(O)O-(alkylaryl), -P(O)(OR10)2, -(C1-C10 alkylene)-OSi(alkyl)3, -CF3, -OCF3, halo, alkoxyalkoxy, alkoxyalkoxyalkoxy, alkoxycarbonylalkoxy, alkoxyarylalkoxy, alkoxyiminoalkyl, alkyldioyl, allyloxy, aryl, arylalkyl, aryloxy, arylalkoxy, aroyl, aroyloxy, aroylaroyloxy, arylalkoxycarbonyl, benzoylbenzoyloxy, heteroaryl, heteroarylalkyl, heteroarylalkoxy, dioxolanyl, heterocyclyl, heterocyclylalkyl, heterocyclylcarbonyl, heterocyclylcarbonylalkoxy and ~L-M;
Q5 is 1 to 5 substituents independently selected from the group consisting of alkyl, alkenyl, alkynyl, -(C0-C30 alkylene)-G, -(C0-C10 alkylene)-OR6, -(C0-C10 alkylene)-C(O)R6, -(C0-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-OC(O)R6, -(C0-C10 alkylene)-OC(O)OR9, -CH=CH-C(O)R6, -CH=CH-C(O)OR6, -C~C-C(O)OR6, -C~C-C(O)R6, -O-(C1-C10 alkylene)-OR6, -O-(C1-C10 alkylene)-C(O)R6, -O-(C1-C10 alkylene)-C(O)OR6, -CN, -O-(C1-C10 alkylene)-C(O)NR6R7, -O-(C0-C10 alkylene)-C(O)NR6NR7C(O)OR6, -O-(C1-C10 alkylene)-C(O)(aryl)-N-N=N-, -OC(O)-(C1-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-C(O)NR6R7, -(C0-C10 alkylene)-OC(O)NR6R7, -NO2, -(C0-C10 alkylene)-NR6R7, -O-(C2-C10 alkylene)-NR6R7, -NR6C(O)R7, -NR8C(O)OR9, -NR6C(O)NR7R8, -NR6S(O)0-2R9, -N(S(O)0-2R9)2, -CHNOR6, -C(O)NR6R7, -C(O)NR6NR6R7, -S(O)0-2NR6R7, -S(O)0-2R9, -O-C(O)-(C1-C10 alkylene)-C(O)NR6R7, -OC(O)-(C1-C10 alkylene)-NR6C(O)O-(alkylaryl), -P(O)(OR10)2, -(C1-C10 alkylene)-OSi(alkyl)3, -CF3, -OCF3, halo, alkoxyalkoxy, alkoxyalkoxyalkoxy, alkoxycarbonylalkoxy, alkoxyarylalkoxy, alkoxyiminoalkyl, alkyldioyl, allyloxy, aryl, arylalkyl, aryloxy, arylalkoxy, aroyl, aroyloxy, aroylaroyloxy, arylalkoxycarbonyl, benzoylbenzoyloxy, heteroaryl, heteroarylalkyl, heteroarylalkoxy, dioxolanyl, heterocyclyl, heterocyclylalkyl, heterocyclylcarbonyl, heterocyclylcarbonylalkoxy and ~L-M;
wherein optionally one or more carbon atoms of the ~(C0-C30 alkylene)- radical of Q1, Q2, Q3, Q4 and Q5 is independently replaced by ~O-, -C(O)-, -CH=CH-, -C~C-, -N(alkyl)-, -N(alkylaryl)- or ~NH-;
G is selected from the group consisting of a sugar residue, disugar residue, trisugar residue, tetrasugar residue, sugar acid, amino sugar, amino acid residue, oligopeptide residue comprising 2 to 9 amino acids, trialkylammoniumalkyl radical and ~S(O)2-OH, wherein optionally the sugar residue, disugar residue, trisugar residue, tetrasugar residue, sugar acid, amino sugar, amino acid residue or oligopeptide residue of G is substituted with ~L-M;
L is selected from the group consisting of wherein Me is methyl;
M is selected from the group of moieties consisting of pharmaceutically acceptable salts of the moieties (M1) and (M3) to (M10) and free acids of the moieties (M1) and (M3) to (M10);
R2 and R3 can be the same or different and each is independently selected from the group consisting of hydrogen, alkyl and aryl;
R6, R7 and R8 can be the same or different and each is independently selected from the group consisting of hydrogen, alkyl, aryl and arylalkyl; and each R9 is independently alkyl, aryl or arylalkyl.
each R10 is independently H or alkyl;
q is 0 or 1;
r is 0 or 1;
m, n and p are independently selected from 0, 1, 2, 3 or 4; provided that at least one of q and r is 1, and the sum of m, n, p, q and r is 1, 2, 3, 4, 5 or 6; and provided that when p is 0 and r is 1, the seam of m, q and n is 1, 2, 3, 4 or 5;
x1 is 1 to 10;
x2 is 1 to 10;
x3 is 1 to 10;
x4 is 1 to 10;
x5 is 1 to 10;

x6 is 1 to 10;
x7 is 1 to 10;
x8 is 1 to 10;
x9 is 1 to 10;
x10 is 1 to 10;
x11 is 1 to 10;
x12 is 1 to 10;
x13 is 1 to 10;
x14 is 1 to 10;
x15 is 1 to 10; and x16 is 1 to 10;
x17 is 1 to 10; and x18 is 1 to 10;
with the proviso that at least one of Q1, Q2, Q3, Q4 and Q5 is ~L-M or the sugar residue, disugar residue, trisugar residue, tetrasugar residue, sugar acid, amino sugar, amino acid residue or oligopeptide residue of G is substituted with ~L-M.
2. A compound represented by the structural formula (IA):
or pharmaceutically acceptable isomers, salts, solvates or esters of the compound of Formula (IA), wherein in Formula (IA) above:
X, Y and Z can be the same or different and each is independently selected from the group consisting of -CH2-, -CH(alkyl)- and -C(alkyl)2-;
Q1 and Q2 can be the same or different and each is independently selected from the group consisting of H, -(C0-C30 alkylene)-G, -OR6, -OC(O)R6, -OC(O)OR9, ~OC(O)NR6R7, and ~L-M;
Q3 is 1 to 5 substituents independently selected from the group consisting of alkyl, alkenyl, alkynyl, -(C0-C30 alkylene)-G, -(C0-C10 alkylene)-OR6, -(C0-C10 alkylene)-C(O)R6, -(C0-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-OC(O)R6, -(C0-C10 alkylene)-OC(O)OR9, -CH=CH-C(O)R6, -CH=CH-C(O)OR6, -C~C-C(O)OR6, -C~C-C(O)R6, -O-(C1-C10 alkylene)-OR6, -O-(C1-C10 alkylene)-C(O)R6, -O-(C1-C10 alkylene)-C(O)OR6, -CN, -O-(C1-C10 alkylene)-C(O)NR6R7, -O-(C0-C10 alkylene)-C(O)NR6NR7C(O)OR6, -O-(C1-C10 alkylene)-C(O)(aryl)-N-N=N-, -OC(O)-(C1-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-C(O)NR6R7, -(C0-C10 alkylene)-OC(O)NR6R7, -NO2, -(C0-C10 alkylene)-NR6R7, -O-(C2-C10 alkylene)-NR6R7, -NR6C(O)R7, -NR6C(O)OR9, -NR6C(O)NR7R8, -NR6S(O)0-2R9, -N(S(O)0-2R9)2, -CHNOR6, -C(O)NR6R7, -C(O)NR6NR6R7, -S(O)0-2NR6R7, -S(O)0-2R9, -O-C(O)-(C1-C10 alkylene)-C(O)NR6R7, -OC(O)-(C1-C10 alkylene)-NR6C(O)O-(alkylaryl), -P(O)(OR10)2, -(C1-C10 alkylene)-OSi(alkyl)3, -CF3, -OCF3, halo, alkoxyalkoxy, alkoxyalkoxyalkoxy, alkoxycarbonylalkoxy, alkoxyarylalkoxy, alkoxyiminoalkyl, alkyldioyl, allyloxy, aryl, arylalkyl, aryloxy, arylalkoxy, aroyl, aroyloxy, aroylaroyloxy, arylalkoxycarbonyl, benzoylbenzoyloxy, heteroaryl, heteroarylalkyl, heteroarylalkoxy, dioxolanyl, heterocyclyl, heterocyclylalkyl, heterocyclylcarbonyl, heterocyclylcarbonylalkoxy and ~L-M;
Q4 is 1 to 5 substituents independently selected from the group consisting of alkyl, alkenyl, alkynyl, -(C0-C30 alkylene)-G, -(C0-C10 alkylene)-OR6, -(C0-C10 alkylene)-C(O)R6, -(C0-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-OC(O)R6, -(C0-C10 alkylene)-OC(O)OR9, -CH=CH-C(O)R6, -CH=CH-C(O)OR6, -C~C-C(O)OR6, -C~C-C(O)R6, -O-(C1-C10 alkylene)-OR6, -O-(C1-C10 alkylene)-C(O)R6, -O-(C1-C10 alkylene)-C(O)OR6, -CN, -O-(C1-C10 alkylene)-C(O)NR6R7, -O-(C0-C10 alkylene)-C(O)NR6NR7C(O)OR6, -O-(C1-C10 alkylene)-C(O)(aryl)-N-N=N-, -OC(O)-(C1-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-C(O)NR6R7, -(C0-C10 alkylene)-OC(O)NR6R7, -NO2, -(C0-C10 alkylene)-NR6R7, -O-(C2-C10 alkylene)-NR6R7, -NR6C(O)R7, -NR6C(O)OR9, -NR6C(O)NR7R8, -NR6S(O)0-2R9, -N(S(O)0-2R9)2, -CHNOR6, -C(O)NR6R7, -C(O)NR6NR6R7, -S(O)0-2NR6R7, -S(O)0-2R9, -O-C(O)-(C1-C10 alkylene)-C(O)NR6R7, -OC(O)-(C1-C10 alkylene)-NR6C(O)O-(alkylaryl), -P(O)(OR10)2, -(C1-C10 alkylene)-OSi(alkyl)3, -CF3, -OCF3, halo, alkoxyalkoxy, alkoxyalkoxyalkoxy, alkoxycarbonylalkoxy, alkoxyarylalkoxy, alkoxyiminoalkyl, alkyldioyl, allyloxy, aryl, arylalkyl, aryloxy, arylalkoxy, aroyl, aroyloxy, aroylaroyloxy, arylalkoxycarbonyl, benzoylbenzoyloxy, heteroaryl, heteroarylalkyl, heteroarylalkoxy, dioxolanyl, heterocyclyl, heterocyclylalkyl, heterocyclylcarbonyl, heterocyclylcarbonylalkoxy and ~L-M;
Q5 is 1 to 5 substituents independently selected from the group consisting of alkyl, alkenyl, alkynyl, -(C0-C30 alkylene)-G, -(C0-C10 alkylene)-OR6, -(C0-C10 alkylene)-C(O)R6, -(C0-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-OC(O)R6, -(C0-C10 alkylene)-OC(O)OR9, -CH=CH-C(O)R6, -CH=CH-C(O)OR6, -C~C-C(O)OR6, -C~C-C(O)R6, -O-(C1-C10 alkylene)-OR6, -O-(C1-C10 alkylene)-C(O)R6, -O-(C1-C10 alkylene)-C(O)OR6, -CN, -O-(C1-C10 alkylene)-C(O)NR6R7, -O-(C0-C10 alkylene)-C(O)NR6NR7C(O)OR6, -O-(C1-C10 alkylene)-C(O)(aryl)-N-N=N-, -OC(O)-(C1-C10 alkylene)-C(O)OR6, -(C0-C10 alkylene)-C(O)NR6R7, -(C0-C10 alkylene)-OC(O)NR6R7, -NO2, -(C0-C10 alkylene)-NR6R7, -O-(C2-C10 alkylene)-NR6R7, -NR6C(O)R7, -NR6C(O)OR9, -NR6C(O)NR7R8, -NR6S(O)0-2R9, -N(S(O)0-2R9)2, -CHNOR6, -C(O)NR6R7, -C(O)NR6NR6R7, -S(O)0-2NR6R7, -S(O)0-2R9, -O-C(O)-(C1-C10 alkylene)-C(O)NR6R7, -OC(O)-(C1-C10 alkylene)-NR6C(O)O-(alkylaryl), -P(O)(OR10)2, -(C1-C10 alkylene)-OSi(alkyl)3, -CF3, -OCF3, halo, alkoxyalkoxy, alkoxyalkoxyalkoxy, alkoxycarbonylalkoxy, alkoxyarylalkoxy, alkoxyiminoalkyl, alkyldioyl, allyloxy, aryl, arylalkyl, aryloxy, arylalkoxy, aroyl, aroyloxy, aroylaroyloxy, arylalkoxycarbonyl, benzoylbenzoyloxy, heteroaryl, heteroarylalkyl, heteroarylalkoxy, dioxolanyl, heterocyclyl, heterocyclylalkyl, heterocyclylcarbonyl, heterocyclylcarbonylalkoxy and ~L-M;

wherein optionally one or more carbon atoms of the ~(C0-C30 alkylene)- radical of Q1, Q2, Q3, Q4 and Q5 is independently replaced by ~O-, -C(O)-, -CH=CH-, -C~C-, -N(alkyl)-, -N(alkylaryl)- or ~NH-;
G is selected from the group consisting of a sugar residue, disugar residue, trisugar residue, tetrasugar residue, sugar acid, amino sugar, amino acid residue, oligopeptide residue comprising 2 to 9 amino acids, trialkylammoniumalkyl radical and ~S(O)2-OH, wherein optionally the sugar residue, disugar residue, trisugar residue, tetrasugar residue, sugar acid, amino sugar, amino acid residue or oligopeptide residue of G is substituted with ~L-M;
L is selected from the group consisting of wherein Me is methyl;
M is selected from the group of moieties consisting of and pharmaceutically acceptable salts of moieties (M1) to (M33);
R2 and R3 can be the same or different and each is independently selected from the group consisting of hydrogen, alkyl and aryl;
R6, R7 and R8 can be the same or different and each is independently selected from the group consisting of hydrogen, alkyl, aryl and arylalkyl; and each R9 is independently alkyl, aryl or arylalkyl.
each R10 is independently H or alkyl;
q is 0 or 1;
r is 0 or 1;
m, n and p are independently selected from 0, 1, 2, 3 or 4; provided that at least one of q and r is 1, and the sum of m, n, p, q and r is 1, 2, 3, 4, 5 or 6; and provided that when p is 0 and r is 1, the sum of m, q and n is 1, 2, 3, 4 or 5;
x8 is 1 to 10;
x9 is 1 to 10;
x10 is 1 to 10;
x11 is 1 to 10;
x12 is 1 to 10;
x13 is 1 to 10;

x14 is 1 to 10;
x15 is 1 to 10; and x16 is 1 to 10;
x17 is 1 t0 10; and x15 is 1 to 10;
with the proviso that at least one of Q1, Q2, Q3, Q4 and Q5 is ~L-M or the sugar residue, disugar residue, trisugar residue, tetrasugar residue, sugar acid, amino sugar, amino acid residue or oligopeptide residue of C is substituted with ~L-M.
3. The compound according to claim 1 or 2, wherein m, n and r are each zero, q is 1, p is 2, and Z is -CH2-.
4. The compound according to claim 1 or 2, wherein m, n and r are each zero, q is 1, p is 2, and Z is -CH2-, Q1 is -OR6, wherein R6 is hydrogen and Q5 is fluorine.
5. The compound according to claim 1 or 2, wherein R2 and R3 are each preferably hydrogen.
6. The compound according to claim 1 or 2, wherein Q1 and Q2 are each independently selected from the group consisting of -OR6, -O(CO)R6, -O(CO)OR9 and -O(CO)NR6R7.
7. The compound according to claim 1 or 2, wherein Q4 is halo or -OR6.
8. The compound according to claim 1 or 2, wherein Q1 is ~OR6 wherein R6 is H.
9. The compound according to claim 1 or 2, wherein Q1, Q2, Q3, Q4 or Q5 is~L-M.
10. The compound according to claim 1 or 2, wherein Q1, Q2, Q3, Q4 or Q5 is -(C0-C30 alkylene)-G.
11. The compound according to claim 1 or 2, wherein G is selected from the group consisting of:
wherein R, R a and R b can be the same or different and each is independently selected from the group consisting of H, -OH, halo, -NH2, azido, alkoxyalkoxy or -W-R30;
W is independently selected from the group consisting of -NH-C(O)-, -O-C(O)-, -O-C(O)-N(R31)-, -NH-C(O)-N(R31)- and -O-C(S)-N(R31)-;
R2a and R6a can be the same or different and each is independently selected from the group consisting of H, alkyl, acetyl, aryl and arylalkyl;
R3a, R4a, R5a, R7a, R3b and R4b can be the same or different and each is independently selected from the group consisting of H, alkyl, acetyl, arylalkyl, -C(O)alkyl and -C(O)aryl;
R30 is independently selected from the group consisting of R32-substituted T, R32-substituted-T-alkyl, R32-substituted-alkenyl, R32-substituted-alkyl, R32-substituted-cycloalkyl and R32-substituted-cycloalkylalkyl;
R31 is independently selected from the group consisting of H and alkyl;

T is independently selected from the group consisting of phenyl, furyl, thienyl, pyrrolyl, oxazolyl, isoxazolyl, thiazolyl, isothiazolyl, benzothiazolyl, thiadiazolyl, pyrazolyl, imidazolyl and pyridyl;
R32 is 1 to 3 substituents which are each independently selected from the group consisting of H, halo, alkyl, -OH, phenoxy, -CF3, -NO2, alkoxy, methylenedioxy, oxo, alkylsulfanyl, alkylsulfinyl, alkylsulfonyl, -N(CH3)2, -C(O)-NHalkyl, -C(O)-N(alkyl)2, -C(O)-alkyl, -C(O)-alkoxy and pyrrolidinylcarbonyl; or R32 is a covalent bond and R31, the nitrogen to which it is attached and R32 form a pyrrolidinyl, piperidinyl, N-methyl-piperazinyl, indolinyl or morpholinyl group, or a alkoxycarbonyl-substituted pyrrolidinyl, piperidinyl, N-methylpiperazinyl, indolinyl or morpholinyl group.
12. The compound according to claim 11, wherein G is selected from:
wherein Ac is acetyl and Ph is phenyl.
13. The compound according to claim 1 or 2, wherein optionally one or more carbon atoms of the ~(C0-C30 alkylene)- radical of Q1, Q2, Q3, Q4 and Q5 is independently replaced by ~O-.
14. The compound according to claim 1 or 2, which is
15. A pharmaceutical composition for the treatment or prevention of a vascular condition, diabetes, obesity, stroke, lowering a concentration of a sterol or stanol in plasma of a mammal, preventing demyelination or treating Alzheimer's disease and/or regulating levels of amyloid is .beta. peptides in a subject comprising a therapeutically effective amount of a compound of claim 1 or 2 in a pharmaceutically acceptable carrier.
16. A pharmaceutical composition comprising a cholesterol-lowering effective amount of a compound of claim 1 or tin a pharmaceutically acceptable carrier.
17. A method of treating or preventing a vascular condition, diabetes, obesity, stroke, lowering a concentration of a sterol or stanol in plasma of e. mammal, preventing demyelination or treating Alzheimer's disease or regulating a level of an amyloid .beta. peptide in a subject comprising the step of administering to a subject in need of such treatment an effective amount of a compound of claim 1 or 2.
18. A method of lowering cholesterol level in plasma of a mammal in need of such treatment comprising administering a pharmaceutically effective amount of the compound of claim 1 or 2.
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