CA2562982A1 - Combinations of peroxisome proliferator-activated receptor (ppar) activator(s) and sterol absorption inhibitor(s) and treatments for vascular indications - Google Patents

Combinations of peroxisome proliferator-activated receptor (ppar) activator(s) and sterol absorption inhibitor(s) and treatments for vascular indications Download PDF

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CA2562982A1
CA2562982A1 CA002562982A CA2562982A CA2562982A1 CA 2562982 A1 CA2562982 A1 CA 2562982A1 CA 002562982 A CA002562982 A CA 002562982A CA 2562982 A CA2562982 A CA 2562982A CA 2562982 A1 CA2562982 A1 CA 2562982A1
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aryl
independently selected
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CA2562982C (en
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Teddy Kosoglou
Harry R. Davis
Gilles Jean Bernard Picard
Wing-Kee Philip Cho
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Merck Sharp and Dohme Corp
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Schering Corporation
Teddy Kosoglou
Harry R. Davis
Gilles Jean Bernard Picard
Wing-Kee Philip Cho
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/02—Halogenated hydrocarbons
    • A61K31/025—Halogenated hydrocarbons carbocyclic
    • A61K31/03—Halogenated hydrocarbons carbocyclic aromatic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/045—Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
    • A61K31/05—Phenols
    • A61K31/055—Phenols the aromatic ring being substituted by halogen
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/16—Amides, e.g. hydroxamic acids
    • A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
    • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
    • A61K31/216—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acids having aromatic rings, e.g. benactizyne, clofibrate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/397—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having four-membered rings, e.g. azetidine
    • 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
    • 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
    • A61P9/04—Inotropic agents, i.e. stimulants of cardiac contraction; Drugs for heart failure
    • 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
    • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis

Abstract

The present invention provides compositions, therapeutic combinations and methods including: (a) at least one peroxisome proliferator-activated receptor activator; and (b) at least one substituted azetidinone or substituted b-lactam sterol absorption inhibitor which can be useful for treating vascular conditions, diabetes, obesity and lowering plasma levels of sterols.

Claims (76)

1. A composition comprising:
(a) a compound represented by Formula (II) below:
or a pharmaceutically acceptable salt or solvate thereof, (b) lactose monohydrate;
(c) microcrystalline cellulose;
(d) povidone;
(e) croscarmellose sodium;
(f) sodium lauryl sulfate; and (g) magnesium stearate.
2. The composition according to claim 1, wherein (a) is said compound represented by Formula (II) is:
(II).
3. The composition according to claim 1 or 2, wherein the composition compnses:
Ingredient Weight percent of ingredient Compound of Formula (II),or a 10 pharmaceutically acceptable salt or solvate thereof Lactose monohydrate 55 Microcrystalline cellulose 20 Povidone 4 Croscarmellose sodium 8 Sodium lauryl sulfate 2 Magnesium stearate 1 Total 100.
4. The composition according to claim 1 or 2, wherein the composition compasses:
Ingredient milligrams of ingredient Compound of Formula (II) or a 10 pharmaceutically acceptable salt or solvate thereof, Lactose monohydrate 55 Microcrystalline cellulose 20 Povidone 4 Croscarmellose sodium 8 Sodium lauryl sulfate 2 Magnesium stearate 1 Total 100.
5. A composition comprising:
(a) a compound represented by Formula (II) below:
or a pharmaceutically acceptable salt or solvate thereof, (b)lactose;
(c)cellulose; and (d)povidone.
6. The composition according to claim 5, wherein the composition further comprises croscarmellose sodium.
7. The composition according to any one of claims 1 to 6, wherein the composition comprises about 0.1 to about 1000 milligrams of the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
8. The composition according to claim 7, wherein the composition or therapeutic combination comprises about 0.25 to about 50 milligrams of the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
9. The composition according to claim 8, wherein the composition comprises about 10 milligrams of the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
10. The composition according to any one of claims 1 to 9, wherein the composition comprises about 0.1 to about 90 weight percent of lactose monohydrate based upon total weight of the composition.
11. The composition according to claim 10, wherein the composition comprises about 55 milligrams of lactose monohydrate.
12. The composition according to any one of claims 1 to 11, wherein the composition comprises about 0.1 to about 90 weight percent of microcrystalline cellulose based upon total weight of the composition.
13. The composition according to claim 12, wherein the composition comprises about 20 milligrams of microcrystalline cellulose.
14. The composition according to any one of claims 1 to 13, wherein the composition comprises about 0.1 to about 90 weight percent of povidone based upon total weight of the composition.
15. The composition or therapeutic combination according to claim 14, wherein the composition or therapeutic combination comprises about 4 milligrams of povidone.
16. The composition according to any one of claims 1 to 15, wherein the composition comprises about 0.1 to about 90 weight percent of croscarmellose sodium based upon total weight of the composition.
17. The composition according to claim 16, wherein the composition or therapeutic combination comprises about 8 milligrams of croscarmellose sodium.
18. The composition according to any one of claims 1 to 17, wherein the composition comprises about 0.1 to about 90 weight percent of sodium lauryl sulfate based upon total weight of the composition.
19. The composition according to claim 18, wherein the composition comprises about 2 milligrams of sodium lauryl sulfate.
20. The composition according to any one of claims 1 to 19, wherein the composition comprises about 0.1 to about 90 weight percent of magnesium stearate based upon total weight of the composition.
21. The composition according to claim 20, wherein the composition comprises about 1 milligram of magnesium stearate.
22. The composition according to any one of claims 1 to 21, wherein the composition further comprises at least one peroxisome proliferator-activated receptor activator.
23. The composition according to claim 22, wherein the at least one peroxisome proliferator-activated receptor activator is a fabric acid derivative selected from the group consisting of fenofibrate, clofibrate, gemfibrozil, ciprofibrate, bezafibrate, clinofibrate, binifibrate, lifibrol and mixtures thereof.
24. The composition according to claim 23, wherein the fabric acid derivative is fenofibrate.
25. The composition according to claim 23, wherein the fabric acid derivative is gemfibrozil.
26. The composition according to any one of claims 1 to 25, wherein the composition further comprises at least one cholesterol biosynthesis inhibitor.
27. The composition according to claim 26, wherein the at least one cholesterol biosynthesis inhibitor comprises at least one HMG CoA reductase inhibitor.
28. The composition according to claim 27, wherein the at least one HMG CoA reductase inhibitor is selected from the group consisting of lovastatin, pravastatin, fluvastatin, simvastatin, atorvastatin, rosuvastatin, cerivastatin and mixtures thereof.
29. The composition according to claim 28, wherein the at least one HMG CoA reductase inhibitor is simvastatin.
30. The composition according to claim 28, wherein the at least one HMG CoA reductase inhibitor is atorvastatin.
31. The composition or therapeutic combination according to claim 28, wherein the at least one HMG CoA reductase inhibitor is rosuvastatin.
32. The composition according to any one of claims 1 to 31, further comprising at least one lipid-lowering agent selected from the group consisting of bile acid sequestrants, nicotinic acid or derivatives thereof, CETP
inhibitors, IBAT
inhibitors, AcylCoA:Cholesterol O-acyltransferase Inhibitors, probucol or derivatives thereof, low-density lipoprotein receptor activators, Omega 3 fatty acids, natural water soluble fibers, plant sterols, plant stanols and fatty acid esters of plant stanols.
33. The composition according to any one of claims 1 to 32, further comprising at least one additive selected from the group consisting of antioxidants, vitamins, hormone replacement therapy compositions, obesity control medications, blood modifiers, cardiovascular agents different from the compound of Formula II and antidiabetic medications.
34. A therapeutic combination comprising:
(a) a first amount of at least one cholesterol biosynthesis inhibitor;

(b) a second amount of a compound represented by Formula (II) below:

or a pharmaceutically acceptable salt or solvate thereof;
(c) lactose monohydrate;
(d) microcrystalline cellulose;
(e) povidone;
(f) croscarmellose sodium;
(g) sodium lauryl sulfate; and (h) magnesium stearate, wherein the first amount and the second amount together comprise a therapeutically effective amount for the treatment or prevention of a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
35. The therapeutic combination according to claim 34, wherein the at least one cholesterol biosynthesis inhibitor is in a form for concomitant administration with the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
36. The therapeutic combination according to claim 34, wherein the at least one cholesterol biosynthesis inhibitor and the compound of Formula (II), or a pharmaceutically acceptable salt or solvate thereof, are present in separate treatment compositions.
37. The therapeutic combination according to any one of claims 34 to 36, wherein the therapeutic combination comprises about 0.1 to about 1000 milligrams of the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
38. The therapeutic combination according to claim 37, wherein the therapeutic combination comprises about 0.25 to about 50 milligrams of the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
39. The composition or therapeutic combination according to claim 38, wherein the composition or therapeutic combination comprises about 10 milligrams of the compound of Formula (II) or a pharmaceutically acceptable salt or solvate thereof.
40. The therapeutic combination according to any one of claims 34 to 39, wherein the therapeutic combination comprises about 0.1 to about 90 weight percent of lactose monohydrate based upon total weight of the combination.
41. The therapeutic combination according to claim 40, wherein the therapeutic combination comprises about 55 milligrams of lactose monohydrate.
42. The therapeutic combination according to any one of claims 34 to 41, wherein the therapeutic combination comprises about 0.1 to about 90 weight percent of microcrystalline cellulose based upon total weight of the combination.
43. The therapeutic combination according to claim 42, wherein the therapeutic combination comprises about 20 milligrams of microcrystalline cellulose.
44. The therapeutic combination according to any one of claims 34 to 43, wherein the therapeutic combination comprises about 0.1 to about 90 weight percent of povidone based upon total weight of the combination.
45. The therapeutic combination according to claim 44, wherein the therapeutic combination comprises about 4 milligrams of povidone.
46. The therapeutic combination according to any one of claims 34 to 45, wherein the therapeutic combination comprises about 0.1 to about 90 weight percent of croscarmellose sodium based upon total weight of the combination.
47. The therapeutic combination according to claim 46, wherein the therapeutic combination comprises about 8 milligrams of croscarmellose sodium.
48. The therapeutic combination according to any one of claims 34 to 47, wherein the therapeutic combination comprises about 0.1 to about 90 weight percent of sodium lauryl sulfate based upon total weight of the combination.
49. The therapeutic combination according to claim 48, wherein the therapeutic combination comprises about 2 milligrams of sodium lauryl sulfate.
50. The therapeutic combination according to any one of claims 34 to 49, wherein the therapeutic combination comprises about 0.1 to about 90 weight percent of magnesium stearate based upon total weight of the combination.
51. The therapeutic combination according to claim 50, wherein the therapeutic combination comprises about 1 milligram of magnesium stearate.
52. The therapeutic combination according to any one of claims 1 to 51, wherein the composition or therapeutic combination further comprises at least one peroxisome proliferator-activated receptor activator.
53. The therapeutic combination according to claim 52, wherein the at least one peroxisome proliferator-activated receptor activator is a fabric acid derivative selected from the group consisting of fenofibrate, clofibrate, gemfibrozil, ciprofibrate, bezafibrate, clinofibrate, binifibrate, lifibrol and mixtures thereof.
54. The therapeutic combination according to claim 53, wherein the fabric acid derivative is fenofibrate.
55. The therapeutic combination according to claim 53, wherein the fabric acid derivative is gemfibrozil.
56. The therapeutic combination according to any one of claims 34 to 55, wherein the therapeutic combination further comprises at least one cholesterol biosynthesis inhibitor.
57. The therapeutic combination according to claim 56, wherein the at least one cholesterol biosynthesis inhibitor comprises at least one HMG CoA
reductase inhibitor.
58. The therapeutic combination according to claim 57, wherein the at least one HMG CoA reductase inhibitor is selected from the group consisting of lovastatin, pravastatin, fluvastatin, simvastatin, atorvastatin, rosuvastatin, cerivastatin and mixtures thereof.
59. The therapeutic combination according to claim 58, wherein the at least one HMG CoA reductase inhibitor is simvastatin.
60. The therapeutic combination according to claim 58, wherein the at least one HMG CoA reductase inhibitor is atorvastatin.
61. The therapeutic combination according to claim 58, wherein the at least one HMG CoA reductase inhibitor is rosuvastatin.
62. The therapeutic combination according to any one of claims 34 to 61, further comprising at least one lipid-lowering agent selected from the group consisting of bile acid sequestrants, nicotinic acid or derivatives thereof, CETP
inhibitors, IBAT inhibitors, AcylCoA:Cholesterol O-acyltransferase Inhibitors, probucol or derivatives thereof, low-density lipoprotein receptor activators, Omega 3 fatty acids, natural water soluble fibers, plant sterols, plant stanols and fatty acid esters of plant stanols.
63. The therapeutic combination according to any one of claims 34 to 62, further comprising at least one additive selected from the group consisting of antioxidants, vitamins, hormone replacement therapy compositions, obesity control medications, blood modifiers, cardiovascular agents different from the compound of Formula II and antidiabetic medications.
64. A pharmaceutical composition comprising a therapeutically effective amount of the composition of any one of claims 1 to 33, in association with a pharmaceutically acceptable carrier.
65. A pharmaceutical composition comprising a therapeutically effective amount of the therapeutic combination of any one of claims 34 to 63, in association with a pharmaceutically acceptable carrier.
66. The composition of any one of claims 1 to 33 for use in treating or preventing a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
67. The therapeutic combination of any one of claims 34 to 63, for use in treating or preventing a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
68. A composition comprising:

(a) at least one sterol absorption inhibitor selected from the group consisting of:
(1) a sterol absorption inhibitor represented by Formula (I):

or a pharmaceutically acceptable salt or solvate thereof, wherein in Formula (I) above:
Ar1 and Ar2 are independently selected from the group consisting of aryl and R4-substituted aryl;
Ar3 is aryl or R5-substituted aryl;
X, Y and Z are independently selected from the group consisting of -CH2-, -CH(lower alkyl)- and -C(dilower alkyl)-;
R and R2 are independently selected from the group consisting of -OR6, -O(CO)R6, -O(CO)OR9 and -O(CO)NR6R7;
R1 and R3 are independently selected from the group consisting of hydrogen, lower alkyl and aryl;
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;
R4 is 1-5 substituents independently selected from the group consisting of lower alkyl, -OR6, -O(CO)R6, -O(CO)OR9, -O(CH2)1-5OR6, -O(CO)NR6R7, -NR6R7, -NR6(CO)R7, -NR6(CO)OR9, -NR6(CO)NR7R8, -NR6SO2R9, -COOR6, -CONR6R7, -COR6, -SO2NR6R7, S(O)0-2R9, -O(CH2)1-10-COOR6, -O(CH2)1-10CONR6R7, -(lower alkylene)COOR6, -CH=CH-COOR6, -CF3, -CN, -NO2 and halogen;

R5 is 1-5 substituents independently selected from the group consisting of -OR6, -O(CO)R6, -O(CO)OR9, -O(CH2)1-5OR6, -O(CO)NR6R7, -NR6R7, -NR6(CO)R7, -NR6(CO)OR9, -NR6(CO)NR7R8, -NR6SO2R9, -COOR6, -CONR6R7, -COR6, -SO2NR6R7, S(O)0-2R9, -O(CH2)1-10-COOR6, -O(CH2)1-10CONR6R7, -(lower alkylene)COOR6 and -CH=CH-COOR6;
R6, R7 and R8 are independently selected from the group consisting of hydrogen, lower alkyl, aryl and aryl-substituted lower alkyl; and R9 is lower alkyl, aryl or aryl-substituted lower alkyl;
(2) a sterol absorption inhibitor represented by Formula (III):

or a pharmaceutically acceptable salt or solvate thereof, wherein in Formula (III) above:
Ar1 is R3-substituted aryl;
Ar2 is R4-substituted aryl;
Ar3 is R5-substituted aryl;
Y and Z are independently selected from the group consisting of -CH2-, -CH(lower alkyl)- and -C(dilower alkyl)-;
A is selected from -O-, -S-, -S(O)- or -S(O)2-;
R1 is selected from the group consisting of -OR6, -O(CO)R6, -O(CO)OR9 and -O(CO)NR6R7;
R2 is selected from the group consisting of hydrogen, lower alkyl and aryl;
or R1 and R2 together are =O;
q is 1, 2 or 3;
p is 0, 1, 2, 3 or 4;
R5 is 1-3 substituents independently selected from the group consisting of -OR6, -O(CO)R6, -O(CO)OR9, -O(CH2)1-5OR9, -O(CO)NR6R7, -NR6R7, -NR6(CO)R7, -NR6(CO)OR9, -NR6(CO)NR7R8, -NR6SO2-lower alkyl, -NR6S02-aryl, -CONR6R7, -COR6, -SO2NR6R7, S(O)0-2-alkyl, S(O)0-2-aryl, -O(CH2)1-10-COOR6, -O(CH2)1-10CONR6R7, o-halogeno, m-halogeno, o-lower alkyl, m-lower alkyl, -(lower alkylene)-COOR6, and -CH=CH-COOR6;
R3 and R4 are independently 1-3 substituents independently selected from the group consisting of R5, hydrogen, p-lower alkyl, aryl, -NO2, -CF3 and p-halogeno;
R6, R7 and R8 are independently selected from the group consisting of hydrogen, lower alkyl, aryl and aryl-substituted lower alkyl; and R9 is lower alkyl, aryl or aryl-substituted lower alkyl;
(3) a sterol absorption inhibitor represented by Formula (IV):

or a pharmaceutically acceptable salt or solvate thereof, wherein, in Formula (IV) above:
A is selected from the group consisting of R2-substituted heterocycloalkyl, R2-substituted heteroaryl, R2-substituted benzofused heterocycloalkyl, and R2-substituted benzofused heteroaryl;
Ar1 is aryl or R3-substituted aryl;
Ar2 is aryl or R4-substituted aryl;
Q is a bond or, with the 3-position ring carbon of the azetidinone, forms the spiro group and R1 is selected from the group consisting of:
-(CH2)q-, wherein q is 2-6, provided that when Q forms a spiro ring, q can also be zero or 1;
-(CH2)e-G-(CH2)r-, wherein G is -O-, -C(O)-, phenylene, -NR8- or -S(O)0-2-, e is 0-5 and r is 0-5, provided that the sum of e and r is 1-6;
-(C2-C6 alkenylene)-; and -(CH3)f-V-(CH2)g-, wherein V is C3-C6 cycloalkylene, f is 1-5 and g is 0-5, provided that the sum of f and g is 1-6;
R5 is selected from:

R6 and R7 are independently selected from the group consisting of -CH2-, -CH(C1-C6 alkyl)-, -C(di-(C1-C6) alkyl), -CH=CH- and -C(C1-C6 alkyl)=CH-; or R5 together with an adjacent R6, or R5 together with an adjacent R7, form a -CH=CH- or a -CH=C(C1-C6 alkyl)- group;
a and b are independently 0, 1, 2 or 3, provided both are not zero; provided that when R6 is -CH=CH- or -C(C1-C6 alkyl)=CH-, a is l; provided that when R7 is -CH=CH- or -C(C1-C6 alkyl)=CH-, b is 1; provided that when a is 2 or 3, the R6's can be the same or different; and provided that when b is 2 or 3, the R7's can be the same or different;
and when Q is a bond, R1 also can be selected from:

where M is -O-, -S-, -S(O)- or -S(O)2-;
X, Y and Z are independently selected from the group consisting of -CH2-, -CH(C1-C6 alkyl)- and -C(di-(C1-C6) alkyl);
R10 and R12 are independently selected from the group consisting of -OR14, -O(CO)R14, -O(CO)OR16 and -O(CO)NR14R15, R11 and R13 are independently selected from the group consisting of hydrogen, (C1-C6)alkyl and aryl; or R10 and R11 together are =O, or R12 and together are =O;
d is 1, 2 or 3;
h is 0, 1, 2, 3 or 4;
s is 0 or 1; t is 0 or 1; m, n and p are independently 0-4; provided that at least one of s and t is 1, and the sum of m, n, p, s and t is 1-6; provided that when p is 0 and t is 1, the sum of m, s and n is 1-5; and provided that when p is 0 and s is 1, the sum of m, t and n is 1-5;
v is 0 or 1;

j and k are independently 1-5, provided that the sum of j, k and v is 1-5;
R2 is 1-3 substituents on the ring carbon atoms selected from the group consisting of hydrogen, (C1-C10)alkyl, (C2-C10)alkenyl, (C2-C10)alkynyl, (C3-C6)cycloalkyl, (C3-C6)cycloalkenyl, R17-substituted aryl, R17-substituted benzyl, R17-substituted benzyloxy, R17-substituted aryloxy, halogeno, -NR14R15 NR14R15(C1-C6 alkylene)-, NR14R15C(O)(C1-C6 alkylene)-,-NHC(O)R16, OH, C1-C6 alkoxy, -OC(O)R16, -COR14, hydroxy(C1-C6)alkyl, (C1-C6)alkoxy(C1-C6)alkyl, NO2, -S(O)0-2R16, -SO2NR14R15 and -(C1-C6 alkylene)COOR14; when R2 is a substituent on a heterocycloalkyl ring, R2 is as defined, or is =O or ; and, where R2 is a substituent on a substitutable ring nitrogen, it is hydrogen, (C1-C6)alkyl, aryl, (C1-C6)alkoxy, aryloxy, (C1-C6)alkylcarbonyl, arylcarbonyl, hydroxy, -(CH2)1-6CONR18R18, wherein J is -O-, -NH-, -NR18- or -CH2-;
R3 and R4 are independently selected from the group consisting of 1-3 substituents independently selected from the group consisting of (C1-C6)alkyl, -OR14 -O(CO)R14, -O(CO)OR16, -O(CH2)OR14, -O(CO)NR14R15, -NR14R15, -NR14(CO)R15, -NR14(CO)OR16, -NR14(CO)NR15R19, -NR14SO2R16, -COOR14, -CONR14R15, -COR14, -SO2NR14R15, S(O)0-2R16, -O(CH2)1-10-COOR14, -O(CH2)1-10CONR14R15, -(C1-C6 alkylene)-COOR14, -CH=CH-COOR14, -CF3, -CN, -NO2 and halogen;
R8 is hydrogen, (C1-C6)alkyl, aryl (C1-C6)alkyl, -C(O)R14 or -COOR14, R9 and R17 are independently 1-3 groups independently selected from the group consisting of hydrogen, (C1-C6)alkyl, (C1-C6)alkoxy, -COOH, NO2, -NR14R15, OH and halogeno;
R14 and R15 are independently selected from the group consisting of hydrogen, (C1-C6)alkyl, aryl and aryl-substituted (C1-C6)alkyl;

R16 is (C1-C6)alkyl, aryl or R17-substituted aryl;
R18 is hydrogen or (C1-C6)alkyl; and R19 is hydrogen, hydroxy or (C1-C6)alkoxy;
(4) a sterol absorption inhibitor represented by Formula (V):
(5) or a pharmaceutically acceptable salt or solvate thereof, wherein in Formula (V) above:
Ar1 is aryl, R10-substituted aryl or heteroaryl;
Ar2 is aryl or R4-substituted aryl;
Ar3 is aryl or R5-substituted aryl;
X and Y are independently selected from the group consisting of -CH2-, -CH(lower alkyl)- and -C(dilower alkyl)-;
R is -OR6, -O(CO)R6, -O(CO)OR9 or -O(CO)NR6R7; R1 is hydrogen, lower alkyl or aryl; or R and R1 together are =O;
q is 0 or 1;
r is 0, 1 or 2;
m and n are independently 0, 1, 2, 3, 4 or 5; provided that the sum of m, n and q is 1,2,3,4 or 5;
R4 is 1-5 substituents independently selected from the group consisting of lower alkyl, -OR6, -O(CO)R6, -O(CO)OR9, -O(CH2)1-5OR6, -O(CO)NR6R7, -NR6R7, -NR6(CO)R7, -NR6(CO)OR9, -NR6(CO)NR7R8, -NR6SO2R9, -COOR6, -CONR6R7, -COR6, -SO2NR6R7, S(O)0-2R9, -O(CH2)1-10-COOR6, -O(CH2)1-10CONR6R7, -(lower alkylene)COOR6 and -CH=CH-COOR6;
R5 is 1-5 substituents independently selected from the group consisting of -OR6, -O(CO)R6, -O(CO)OR9, -O(CH2)1-5OR6, -O(CO)NR6R7, -NR6R7, -NR6 (CO)R7, -NR6(CO)OR9, -NR6(CO)NR7R8, -NR6SO2R9, -COOR6, -CONR6R7, -COR6, -SO2NR6R7, S(O)0-2R9, -O(CH2)1-10-COOR6, -O(CH2)1-10CONR6R7, -CF3, -CN, -NO2, halogen, -(lower alkylene)COOR6 and -CH=CH-COOR6;

R6, R7 and R8 are independently selected from the group consisting of hydrogen, lower alkyl, aryl and aryl-substituted lower alkyl;
R9 is lower alkyl, aryl or aryl-substituted lower alkyl; and R10 is 1-5 substituents independently selected from the group consisting of lower alkyl, -OR6, -O(CO)R6, -O(CO)OR9, -O(CH2)1-5OR6, -O(CO)NR6R7, -NR6R7, -NR6(CO)R7, -NR6(CO)OR9, -NR6(CO)NR7R8, -NR6SO2R9, -COOR6, -CONR6R7, -COR6, -SO2NR6R7, -S(O)0-2R9, -O(CH2)1-10-COOR6, -O(CH2)1-10CONR6R7, -CF3, -CN, -NO2 and halogen;
(6) a sterol absorption inhibitor represented by Formula (VI):

or a pharmaceutically acceptable salt or solvate thereof, wherein in Formula VI
above:

R1 is -~H-, -C(lower alkyl)-, -~F-, -~(OH)-, -~(C6H5)-, -~(C6H4-R15)-, -~- or -+~O- ;
R2 and R3 are independently selected from the group consisting of:
-CH2-, -CH(lower alkyl)-, -C(di-lower alkyl)-, -CH=CH- and -C(lower alkyl)=CH-; or R1 together with an adjacent R2, or R1 together with an adjacent R3, form a -CH=CH- or a -CH=C(lower alkyl)- group;
u and v are independently 0, 1, 2 or 3, provided both are not zero; provided that when R2 is -CH=CH- or -C(lower alkyl)=CH-, v is 1; provided that when R3 is -CH=CH- or -C(lower alkyl)=CH-, u is 1; provided that when v is 2 or 3, the R2's can be the same or different; and provided that when a is 2 or 3, the R3's can be the same or different;
R4 is selected from B-(CH2)m C(O)-, wherein m is 0, 1, 2, 3, 4 or 5;

B-(CH2)q-, wherein q is 0, 1, 2, 3, 4, 5 or 6;
B-(CH2)e-Z-(CH2)r-, wherein Z is -O-, -C(O)-, phenylene, -N(R8)- or -S(O)0-2-, e is 0, 1, 2, 3, 4 or 5 and r is 0, 1, 2, 3, 4 or 5, provided that the sum of e and r is 0, 1, 2, 3, 4, 5 or 6;
B-(C2-C6 alkenylene)-;
B-(C4-C6 alkadienylene)-;
B-(CH2)t-Z-(C2-C6 alkenylene)-, wherein Z is as defined above, and wherein t is 0, 1, 2 or 3, provided that the sum of t and the number of carbon atoms in the alkenylene chain is 2, 3, 4, 5 or 6;
B-(CH2)f-V-(CH2)g-, wherein V is C3-C6 cycloalkylene, f is 1, 2, 3, 4 or 5 and g is 0, 1, 2, 3, 4 or 5, provided that the sum of f and g is 1, 2, 3, 4, 5 or 6;
B-(CH2)t-V-(C2-C6 alkenylene)- or B-(C2-C6 alkenylene)-V-(CH2)t-, wherein V and t are as defined above, provided that the sum of t and the number of carbon atoms in the alkenylene chain is 2, 3, 4, or 6;
B-(CH2)a-Z-(CH2)b-V-(CH2)d-, wherein Z and V are as defined above and a, b and d are independently 0, 1, 2, 3, 4, 5 or 6, provided that the sum of a, b and d is 0, 1, 2, 3, 4, 5 or 6; or T-(CH2)s-, wherein T is cycloalkyl of 3-6 carbon atoms and s is 0, 1, 2, 3, 4, 5 or 6; or R1 and R4 together form the group B-CH=~- ;
B is selected from indanyl, indenyl, naphthyl, tetrahydronaphthyl, heteroaryl or W-substituted heteroaryl, wherein heteroaryl is selected from the group consisting of pyrrolyl, pyridinyl, pyrimidinyl, pyrazinyl, triazinyl, imidazolyl, thiazolyl, pyrazolyl, thienyl, oxazolyl and furanyl, and for nitrogen-containing heteroaryls, the N-oxides thereof, or W is 1 to 3 substituents independently selected from the group consisting of lower alkyl, hydroxy lower alkyl, lower alkoxy, alkoxyalkyl, alkoxyalkoxy, alkoxycarbonylalkoxy, (lower alkoxyimino)-lower alkyl, lower alkanedioyl, lower alkyl lower alkanedioyl, allyloxy, -CF3, -OCF3, benzyl, R7-benzyl, benzyloxy, R7-benzyloxy, phenoxy, R7-phenoxy, dioxolanyl, NO2, -N(R8)(R9), N(R8)(R9)-lower alkylene-, N(R8)(R9)-lower alkylenyloxy-, OH, halogeno, -CN, -N3, -NHC(O)OR10, -NHC(O)R10, R11O2SNH-, (R11O2S)2N-, -S(O)2NH2, -S(O)0-2R8, tert-butyldimethyl-silyloxymethyl, -C(O)R12, -COOR19, -CON(R8)(R9), -CH=CHC(O)R12, -lower alkylene-C(O)R12, R10C(O)(lower alkylenyloxy)-, N(R8)(R9)C(O)(lower alkylenyloxy)- and for substitution on ring carbon atoms, and the substituents on the substituted heteroaryl ring nitrogen atoms, when present, are selected from the group consisting of lower alkyl, lower alkoxy, -C(O)OR10, -C(O)R10, OH, N(R8)(R9)-lower alkylene-,N(R8)(R9)-lower alkylenyloxy-, -S(O)2NH2 and 2-(trimethylsilyl)-ethoxymethyl;
R7 is 1-3 groups independently selected from the group consisting of lower alkyl, lower alkoxy, -COOH, NO2, -N(R8)(R9), OH, and halogeno;
R8 and R9 are independently selected from H or lower alkyl;
R10 is selected from lower alkyl, phenyl, R7-phenyl, benzyl or R7-benzyl;
R11 is selected from OH, lower alkyl, phenyl, benzyl, R7-phenyl or R7-benzyl;
R12 is selected from H, OH, alkoxy, phenoxy, benzyloxy, , -N(R8)(R9), lower alkyl, phenyl or R7-phenyl;
R13 is selected from -O-, -CH2-, -NH-, -N(lower alkyl)- or -NC(O)R19;
R15, R16 and R17 are independently selected from the group consisting of H and the groups defined for W; or R15 is hydrogen and R16 and R17, together with adjacent carbon atoms to which they are attached, form a dioxolanyl ring;
R19 is H, lower alkyl, phenyl or phenyl lower alkyl; and R20 and R21 are independently selected from the group consisting of phenyl, W-substituted phenyl, naphthyl, W-substituted naphthyl, indanyl, indenyl, tetrahydronaphthyl, benzodioxolyl, heteroaryl, W-substituted heteroaryl, benzofused heteroaryl, W-substituted benzofused heteroaryl and cyclopropyl, wherein heteroaryl is as defined above;
(8) a sterol absorption inhibitor represented by Formula (VII):

(9) or a pharmaceutically acceptable salt or solvate thereof, wherein in Formula (VII):

A is -CH=CH-, -C.ident.C- or -(CH2)p- wherein p is 0, 1 or 2;
B is E is C10 to C20 alkyl or -C(O)-(C9 to C19)-alkyl, wherein the alkyl is straight or branched, saturated or containing one or more double bonds;
R is hydrogen, C1-C15 alkyl, straight or branched, saturated or containing one or more double bonds, or B-(CH2)r-, wherein r is 0, 1, 2, or 3;
R1, R2, and R3 are independently selected from the group consisting of hydrogen, lower alkyl, lower alkoxy, carboxy, NO2, NH2, OH, halogeno, lower alkylamino, dilower alkylamino, -NHC(O)OR5, R6O2SNH- and -S(O)2NH2;
R4 is wherein n is 0, 1, 2 or 3;
R5 is lower alkyl; and R6 is OH, lower alkyl, phenyl, benzyl or substituted phenyl wherein the substituents are 1-3 groups independently selected from the group consisting of lower alkyl, lower alkoxy, carboxy, NO2, NH2, OH, halogeno, lower alkylamino and dilower alkylamino;

(10) a sterol absorption inhibitor represented by Formula (VIII):
(11) or a pharmaceutically acceptable salt or solvate thereof, wherein in Formula (VIII) above:
R26 is H or OG1;
G and G1 are independently selected from the group consisting of ; provided that when R26 is H or OH, G is not H;
R, R a and R b are independently selected from the group consisting of H, -OH, halogeno, -NH2, azido, (C1-C6)alkoxy(C1-C6)-alkoxy 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)-;
R2 and R6 are independently selected from the group consisting of H, (C1-C6)alkyl, aryl and aryl(C1-C6)alkyl;
R3, R4, R5, R7, R3a and R4a are independently selected from the group consisting of H, (C1-C6)alkyl, aryl(C1-C6)alkyl, -C(O)(C1-C6)alkyl and -C(O) aryl;
R30 is selected from the group consisting of R32-substituted T, R32-substituted-T-(C1-C6)alkyl, R32-substituted-(C2-C4)alkenyl, R32-substituted-(C1-C6)alkyl, R32-substituted-(C3-C7)cycloalkyl and R32-substituted-(C3-C7)cycloalkyl(C1-C6)alkyl;
R31 is selected from the group consisting of H and (C1-C4)alkyl;
T is selected from the group consisting of phenyl, furyl, thienyl, pyrrolyl, oxazolyl, isoxazolyl, thiazolyl, iosthiazolyl, benzothiazolyl, thiadiazolyl, pyrazolyl, imidazolyl and pyridyl;
R32 is independently selected from 1-3 substituents independently selected from the group consisting of halogeno, (C1-C4)alkyl, -OH, phenoxy, -CF3, -NO2, (C1-C4)alkoxy, methylenedioxy, oxo, (C1-C4)alkylsulfanyl, (C1-C4)alkylsulfinyl, (C1-C4)alkylsulfonyl, -N(CH3)2, -C(O)-NH(C1-C4)alkyl, -C(O)-N((C1-C4)alkyl)2, -C(O)-(C1-C4)alkyl, -C(O)-(C1-C4)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 (C1-C4)alkoxycarbonyl-substituted pyrrolidinyl, piperidinyl, N-methylpiperazinyl, indolinyl or morpholinyl group;
Ar1 is aryl or R10-substituted aryl;
Ar2 is aryl or R11-substituted aryl;
Q is a bond or, with the 3-position ring carbon of the azetidinone, forms the spiro group ; and R1 is selected from the group consisting of -(CH2)q-, wherein q is 2-6, provided that when Q forms a spiro ring, q can also be zero or 1;
-(CH2)e-E-(CH2)r-, wherein E is -O-, -C(O)-, phenylene, -NR22- or -S(O)0-2-, e is 0-5 and r is 0-5, provided that the sum of e and r is 1-6;
-(C2-C6)alkenylene-; and -(CH2)-f-V-(CH2)g-, wherein V is C3-C6 cycloalkylene, f is 1-5 and g is 0-5, provided that the sum of f and g is 1-6;
R12 is R13 and R14 are independently selected from the group consisting of -CH2-, -CH(C1-C6 alkyl)-, -C(di-(C1-C6) alkyl), -CH=CH- and -C(C1-C6 alkyl)=CH-; or R12 together with an adjacent R13, or R12 together with an adjacent R14, form a -CH=CH- or a -CH=C(C1-C6 alkyl)- group;
a and b are independently 0, 1, 2 or 3, provided both are not zero;
provided that when R13 is -CH=CH- or -C(C1-C6 alkyl)=CH-, a is 1;
provided that when R14 is -CH=CH- or -C(C1-C6 alkyl)=CH-, b is 1;
provided that when a is 2 or 3, the R13's can be the same or different; and provided that when b is 2 or 3, the R14's can be the same or different;
and when Q is a bond, R1 also can be:

M is -O-, -S-, -S(O)- or -S(O)2-;
X, Y and Z are independently selected from the group consisting of -CH2-, -CH(C1-C6)alkyl- and -C(di-(C1-C6)alkyl);
R10 and R11 are independently selected from the group consisting of 1-3 substituents independently selected from the group consisting of (C1-C6)alkyl, -OR19, -O(CO)R19, -O(CO)OR21, -O(CH2)1-5OR19, -O(CO)NR19R20, -NR19R20, -NR19(CO)R20, -NR19(CO)OR21, -NR19(CO)NR20R25, -NR19SO2R21, -COOR19, -CONR19R20, -COR19, -SO2NR19R20, S(O)0-2R21, -O(CH2)1-10-COOR19, -O(CH2)1-10CONR19R20, -(C1-C6 alkylene)-COOR19, -CH=CH-COOR19, -CF3, -CN, -NO2 and halogen;
R15 and R17 are independently selected from the group consisting of -OR19, -O(CO)R19, -O(CO)OR21 and -O(CO)NR19R20;
R16 and R18 are independently selected from the group consisting of H, (C1-C6)alkyl and aryl; or R15 and R16 together are =O, or R17 and R18 together are =O;
d is 1, 2 or 3;
h is 0, 1, 2, 3 or 4;
s is 0 or 1; t is 0 or 1; m, n and p are independently 0-4;

provided that at least one of s and t is 1, and the sum of m, n, p, s and t is 6;
provided that when p is 0 and t is 1, the sum of m, s and n is 1-5; and provided that when p is 0 and s is 1, the sum of m, t and n is 1-5;
v is 0 or 1;
j and k are independently 1-5, provided that the sum of j, k and v is 1-5;

and when Q is a bond and R1 is , Ar1 can also be ~
pyridyl, isoxazolyl, furanyl, pyrrolyl, thienyl, imidazolyl, pyrazolyl, thiazolyl, pyrazinyl, pyrimidinyl or pyridazinyl;
R19 and R20 are independently selected from the group consisting of H, (C1-C6)alkyl, aryl and aryl-substituted (C1-C6)alkyl;
R21 is (C1-C6)alkyl, aryl or R24-substituted aryl;
R22 is H, (C1-C6)alkyl, aryl (C1-C6)alkyl, -C(O)R19 or -COOR19;
R23 and R24 are independently 1-3 groups independently selected from the group consisting of H, (C1-C6)alkyl, (C1-C6)alkoxy, -COOH, NO2, -NR19R20, -OH and halogeno; and R25 is H, -OH or (C1-C6)alkoxy; and (12) a sterol absorption inhibitor represented by Formula (IX):
(13) or a pharmaceutically acceptable salt or solvate thereof, wherein, in Formula (IX) above, R26 is selected from the group consisting of:
a) OH;
b) OCH3;
c) fluorine and d) chlorine;

R1 is selected from the group consisting of -SO3H; natural and unnatural amino acids;
R, R a and R b are independently selected from the group consisting of H, -OH, halogeno, -NH2, azido, (C1-C6)alkoxy(C1-C6)-alkoxy and -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)-;
R2 and R6 are independently selected from the group consisting of H, (C1-C6)alkyl, aryl and aryl(C1-C6)alkyl;
R3, R4, R5, R7, R3a and R4a are independently selected from the group consisting of H, (C1-C6)alkyl, aryl(C1-C6)alkyl, -C(O)(C1-C6)alkyl and -C(O)aryl;
R30 is independently selected form the group consisting of R32-substituted T, R32-substituted-T-(C1-C6)alkyl, R32-substituted-(C2-C4)alkenyl, R32-substituted-(C1-C6)alkyl, R32-substituted-(C3-C7)cycloalkyl and R32-substituted-(C3-C7)cycloalkyl(C1-C6)alkyl;
R31 is independently selected from the group consisting of H and (C1-C4)alkyl;
T is independently selected from the group consisting of phenyl, furyl, thienyl, pyrrolyl, oxazolyl, isoxazolyl, thiazolyl, iosthiazolyl, benzothiazolyl;
thiadiazolyl, pyrazolyl, imidazolyl and pyridyl;
R32 is independently selected from 1-3 substituents independently selected from the group consisting of H, halogeno, (C1-C4)alkyl, -OH, phenoxy, -CF3, -NO2, (C1-C4)alkoxy, methylenedioxy, oxo, (C1-C4)alkylsulfanyl, (C1-C4)alkylsulfinyl, (C1-C4)alkylsulfonyl, -N(CH3)2, -C(O)-NH(C1-C4)alkyl, -C(O)-N((C1-C4)alkyl)2, -C(O)-(C1-C4)alkyl, -C(O)-(C1-C4)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 (C1-C4)alkoxycarbonyl-substituted pyrrolidinyl, piperidinyl, N-methylpiperazinyl, indolinyl or morpholinyl group;
Ar1 is aryl, R10-substituted aryl; pyridyl, isoxazolyl, furanyl, pyrrolyl, thienyl, imidazolyl, pyrazolyl, thiazolyl, pyrazinyl, pyrimidinyl or pyridazinyl;
Ar2 is aryl or R11-substituted aryl;
Q is -(CH2)q-, wherein q is 2-6, or, with the 3-position ring carbon of the azetidinone, forms the spiro group ;
R12 is R13 and R14 are independently selected from the group consisting of -CH2-, -CH(C1-C6 alkyl)-, -C(di-(C1-C6) alkyl), -CH=CH- and -C(C1-C6 alkyl)=CH-;
or R12 together with an adjacent R13, or R12 together with an adjacent R14, form a -CH=CH- or a -CH=C(C1-C6 alkyl)- group;
a and b are independently 0, 1, 2 or 3, provided both are not zero; provided that when R13 is -CH=CH- or -C(C1-C6 alkyl)=CH-, a is 1; provided that when R14 is -CH=CH- or -C(C1-C6 alkyl)=CH-, b is 1; provided that when a is 2 or 3, the R13's can be the same or different; and provided that when b is 2 or 3, the R14's can be the same or different;
R10 and R11 are independently selected from the group consisting of 1-3 substituents independently selected from the group consisting of (C1-C6)alkyl, -OR19, -O(CO)R19, -O(CO)OR21, -O(CH2)1-5OR19, -O(CO)NR19R20, -NR19R20, -NR19(CO)R20, -NR19(CO)OR21, -NR19(CO)NR20R25, -NR19SO2R21, -COOR19, -CONR19R20, -COR19, -SO2NR19R20, -S(O)0-2R21, -O(CH2)1-10-COOR19, -O(CH2)1-10CONR19R20, -(C1-C6 alkylene)-COOR19, -CH=CH-COOR19, -CF3, -CN, -NO2 and halogen;

R19 and R20 are independently selected from the group consisting of H, (C1-C6)alkyl, aryl and aryl-substituted (C1-C6)alkyl;
R21 is (C1-C6)alkyl, aryl or R24-substituted aryl;
R22 is H, (C1-C6)alkyl, aryl (C1-C6)alkyl, -C(O)R19 or -COOR19;
R23 and R24 are independently 1-3 groups independently selected from the group consisting of H, (C1-C6)alkyl, (C1-C6)alkoxy, -COOH, NO2, -NR19R20, -OH and halogeno; and R25 is H, -OH or (C1-C6)alkoxy;
(b) lactose monohydrate;
(c) microcrystalline cellulose;
(d) povidone;
(e) croscarmellose sodium;
(f) sodium lauryl sulfate; and (g) magnesium stearate.
69. The composition according to claim 68, wherein the sterol absorption inhibitor is represented by Formula (X):

or a pharmaceutically acceptable salt or solvate of the compound of Formula (X), wherein R1 is defined as in Formula (IX) in claim 68.
70. The composition according to claim 68, wherein the sterol absorption inhibitor is represented by Formula (XI):

or a pharmaceutically acceptable salt or solvate of the compound of Formula (XI).
71. A composition of any one of claims 68 to 70 for use in the treatment or prevention of a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
72. Use of a composition of any one of claims 68 to 70 in the manufacture of a medicament for treating or preventing a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
73. A therapeutic combination comprising:
(a) a first amount of the composition of any one of claims 68 to 70; and (b) at least one cholesterol biosynthesis inhibitor, wherein the first amount and the second amount together comprise a therapeutically effective amount for the treatment or prevention of a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
74. Use of the composition of any one of claims 68 to 70, in the manufacture of a medicament for treating or preventing a vascular condition, obesity, diabetes or lowering a concentration of a sterol in plasma of a mammal.
75. Use of a composition of any one of claims 1 to 33, for preparation of a medicament for treating or preventing a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
76. Use of a therapeutic combination of any one of claims 34 to 63, for preparation of a medicament for treating or preventing a vascular condition, diabetes, obesity or lowering a concentration of a sterol in plasma of a mammal.
CA2562982A 2001-01-26 2002-01-25 Combinations of peroxisome proliferator-activated receptor (ppar) activator(s) and sterol absorption inhibitor(s) and treatments for vascular indications Expired - Fee Related CA2562982C (en)

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