COMPOUNDS AND COMPOSITIONS FOR TREATING CONDITIONS ASSOCIATED WITH NLRP ACTIVITY

TECHNICAL FIELD

This disclosure features chemical entities (e.g., a compound that modulates (e.g., antagonizes) NLRP3, or a pharmaceutically acceptable salt, and/or hydrate, and/or cocrystal, and/or drug combination of the compound) that are useful, e.g., for treating a condition, disease or disorder in which a decrease or increase in NLRP3 activity (e.g., an increase, e.g., a condition, disease or disorder associated with NLRP3 signaling) contributes to the pathology and/or symptoms and/or progression of the condition, disease or disorder in a subject (e.g., a human). This disclosure also features compositions as well as other methods of using and making the same. The present disclosure also relates to, in part, methods and compositions for treating anti-TNFα resistance in a subject with an NLRP3 antagonist. The present disclosure also relates, in part, to methods, combinations and compositions for treating TFNα related diseases and anti-TNFα resistance in a subject that include administration of an NLRP3 antagonist, an NLRP3 antagonist and an anti-TNFα agent, or a composition encompassing an NLRP3 antagonist and an anti-TNFα agent.

BACKGROUND

The NLRP3 inflammasome is a component of the inflammatory process and its aberrant activation is pathogenic in inherited disorders such as the cryopyrin associated periodic syndromes (CAPS). The inherited CAPS Muckle-Wells syndrome (MWS), familial cold autoinflammatory syndrome (FCAS) and neonatal onset multi-system inflammatory disease (NOMID) are examples of indications that have been reported to be associated with gain of function mutations in NLRP3.

NLRP3 can form a complex and has been implicated in the pathogenesis of a number of complex diseases, including but not limited to metabolic disorders such as type 2 diabetes, atherosclerosis, obesity and gout, as well as diseases of the central nervous system, such as Alzheimer's disease and multiple sclerosis and Amyotrophic Lateral Sclerosis and Parkinson disease, lung disease, such as asthma and COPD and pulmonary idiopathic fibrosis, liver disease, such as NASH syndrome, viral hepatitis and cirrhosis, pancreatic disease, such as acute and chronic pancreatitis, kidney disease, such as acute and chronic kidney injury, intestinal disease such as Crohn's disease and Ulcerative Colitis, skin disease such as psoriasis, musculoskeletal disease such as scleroderma, vessel disorders, such as giant cell arteritis, disorders of the bones, such as Osteoarthritis, osteoporosis and osteopetrosis disorders eye disease, such as glaucoma and macular degeneration, diseased caused by viral infection such as HIV and AIDS, autoimmune disease such as Rheumatoid Arthritis, Systemic Lupus Erythematosus, Autoimmune Thyroiditis, Addison's disease, pernicious anemia, cancer and aging.

In light of the above, it would be desirable to provide compounds that modulate (e.g., antagonize) NLRP3.

Several patients having inflammatory or autoimmune diseases are treated with anti-TNFα agents. A subpopulation of such patients develop resistance to treatment with the anti-TNFα agents. It is desirable to develop methods for reducing a patient's resistance to anti-TNFα agents. In light of the this, it would also be desirable to provide alternative therapies for treating inflammatory or autoimmune diseases (for example NLRP3 inflammasome inhibitors) to avoid or minimise the use of anti-TNFα agents.

Intestinal bowel disease (IBD), encompassing Ulcerative Colitis (UC) and Crohn's disease (CD), are chronic diseases characterized by barrier dysfunction and uncontrolled inflammation and mucosal immune reactions in the gut. A number of inflammatory pathways have been implicated in the progression of IBD, and anti-inflammatory therapy such as tumor necrosis factor-alpha (TNF-α) blockade has shown efficacy in the clinic (Rutgeerts P et al N Engl J Med 2005; 353:2462-76). Anti-TNFα therapies, however, do not show complete efficacy, however, other cytokines such as IL-1β, IL-6, IL-12, IL-18, IL-21, and IL-23 have been shown to drive inflammatory disease pathology in IBD (Neurath M F Nat Rev Immunol 2014; 14; 329-42). IL-1β and IL-18 are produced by the NLRP3 inflammasome in response to pathogenic danger signals, and have been shown to play a role in IBD. Anti-IL-1β therapy is efficacious in patients with IBD driven by genetic mutations in CARD8 or IL-1 OR (Mao L et al J Clin Invest 2018; 238:1793-1806, Shouval D S et al Gastroenterology 2016; 151:1100-1104), IL-18 genetic polymorphisms have been linked to UC (Kanai T et al, Curr Drug Targets 2013; 14:1392-9), and NLRP3 inflammasome inhibitors have been shown to be efficacious in murine models of IBD (Perera A P et al Sci Rep 2018; 8:8618). Resident gut immune cells isolated from the lamina propria of IBD patients can produce IL-1β, either spontaneously or when stimulated by LPS, and this IL-1β production can be blocked by the ex vivo addition of a NLRP3 antagonist. Based on strong clinical and preclinical evidence showing that inflammasome-driven IL-1β and IL-18 play a role in IBD pathology, it is clear that NLRP3 inflammasome inhibitors could be an efficacious treatment option for UC, Crohn's disease, or subsets of IBD patients. These subsets of patients could be defined by their peripheral or gut levels of inflammasome related cytokines including IL-1β, IL-6, and IL-18, by genetic factors that pre-dispose IBD patients to having NLRP3 inflammasome activation such as mutations in genes including ATG16L1, CARD8, IL-10R, or PTPN2 (Saitoh T et al, Nature 2008; 456; 264, Spalinger M R, Cell Rep 2018; 22:1835), or by other clinical rationale such as non-response to TNF therapy.

Though anti-TNF therapy is an effective treatment option for Crohn's disease, 40% of patients fail to respond. One-third of non-responsive CD patients fail to respond to anti-TNF therapy at the onset of treatment, while another third lose response to treatment over time (secondary non-response). Secondary non-response can be due to the generation of anti-drug antibodies, or a change in the immune compartment that desensitizes the patient to anti-TNF (Ben-Horin S et al, Autoimmun Rev 2014; 13; 24-30, Steenholdt C et al Gut 2014; 63; 9I9-27).

Anti-TNF reduces inflammation in IBD by causing pathogenic T cell apoptosis in the intestine, therefore eliminating the T cell mediated inflammatory response (Van den Brande et al Gut 2007:56:509-17). There is increased NLRP3 expression and increased production of IL-1β in the gut of TNF-non-responsive CD patients (Leal R F et al Gut 2015; 64:233-42) compared to TNF-responsive patients, suggesting NLRP3 inflammasome pathway activation. Furthermore, there is increased expression of TNF-receptor 2 (TNF-R2), which allows for TNF-mediated proliferation of T cells (Schmitt H et al Gut 2018; 0:1-15). IL-1β signaling in the gut promotes T cell differentiation toward Th1/17 cells which can escape anti-TNF-α mediated apoptosis. It is therefore likely that NLRP3 inflammasome activation can cause non-responsiveness in CD patients to anti-TNF-α therapy by sensitizing pathogenic T cells in the gut to anti-TNF-α mediated apoptosis. Experimental data from immune cells isolated from the gut of TNF-resistant Crohn's patients show that these cells spontaneously release IL-1β, which can be inhibited by the addition of an NLRP3 antagonist. NLRP3 inflammasome antagonists—in part by blocking IL-1β secretion—would be expected to inhibit the mechanism leading to anti-TNF non-responsiveness, re-sensitizing the patient to anti-TNF therapy. In IBD patients who are naive to anti-TNF therapy, treatment with an NLRP3 antagonist would be expected to prevent primary- and secondary-non responsiveness by blocking the mechanism leading to non-response.

NLRP3 antagonists that are efficacious locally in the gut can be efficacious drugs to treat IBD; in particular in the treatment of TNF-resistant CD alone or in combination with anti-TNF therapy. Systemic inhibition of both IL-1β and TNF-α has been shown to increase the risk of opportunistic infections (Genovese M C et al, Arthritis Rheum 2004; 50:1412), therefore, only blocking the NLRP3 inflammasome at the site of inflammation would reduce the infection risk inherent in neutralizing both IL-1β and TNF-α. NLRP3 antagonists that are potent in NLRP3-inflammasome driven cytokine secretion assays in cells, but have low permeability in vitro in a permeability assay such as an MDCK assay, have poor systemic bioavailability in a rat or mouse pharmacokinetic experiment, but high levels of compound in the colon and/or small intestine could be a useful therapeutic option for gut restricted purposes.

In light of the above, the present invention also provides alternative therapies for the treatment of inflammatory or autoimmune diseases, including IBD, that solves the above problems associated with anti-TNFα agents.

SUMMARY

In some embodiments, provided herein is a compound of Formula AA

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or a pharmaceutically acceptable salt thereof, wherein the variables in Formula AA can be as defined anywhere herein.

The present invention is also relates to the Applicant's discovery that inhibition of NLRP3 inflammasomes can increase a subject's sensitivity to an anti-TNFα agent or can overcome resistance to an anti-TNFα agent in a subject, or indeed provide an alternative therapy to anti-TNFα agents.

Provided herein are methods of treating a subject that include: (a) identifying a subject having a cell that has an elevated level of NLRP3 inflammasome activity and/or expression as compared to a reference level; and (b) administering to the identified subject a therapeutically effective amount of an compound of Formula I or a pharmaceutically acceptable salt, solvate, or co-crystal thereof.

Provided herein are methods for the treatment of inflammatory or autoimmune disease including IBD, such as UC and CD in a subject in need thereof, comprising administering to said subject a therapeutically effective amount a compound for Formula I or a pharmaceutically acceptable salt, solvate, or co-crystal thereof, wherein the NLRP3 antagonist is a gut-targeted NLRP3 antagonist.

Provided herein are methods of treating a subject in need thereof, that include: (a) identifying a subject having resistance to an anti-TNFα agent; and (b) administering a treatment comprising a therapeutically effective amount of a compound for Formula I, or a pharmaceutically acceptable salt, solvate, or co-crystal thereof to the identified subject.

Provided herein are methods of treating a subject in need thereof, that include: administering a treatment comprising a therapeutically effective amount of a compound for Formula I or a pharmaceutically acceptable salt, solvate, or co-crystal thereof to a subject identified as having resistance to an anti-TNFα agent.

Provided herein are methods of selecting a treatment for a subject in need thereof, that include: (a) identifying a subject having resistance to an anti-TNFα agent; and (b) selecting for the identified subject a treatment comprising a therapeutically effective amount of a compound for Formula I or a pharmaceutically acceptable salt, solvate, or co-crystal thereof.

Provided herein are methods of selecting a treatment for a subject in need thereof, that include selecting a treatment comprising a therapeutically effective amount of a compound for Formula I or a pharmaceutically acceptable salt, solvate, or co-crystal thereof for a subject identified as having resistance to an anti-TNFα agent.

In some embodiments of any of the methods described herein, the treatment further includes a therapeutically effective amount of an anti-TNFα agent, in addition to the NLRP3 antagonist.

This disclosure also features compositions as well as other methods of using and making the same.

An “antagonist” of NLRP3 includes compounds that inhibit the ability of NLRP3 to induce the production of IL-1β and/or IL-18 by directly binding to NLRP3, or by inactivating, destabilizing, altering distribution, of NLRP3 or otherwise.

In one aspect, pharmaceutical compositions are featured that include a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same) and one or more pharmaceutically acceptable excipients.

In one aspect, methods for modulating (e.g., agonizing, partially agonizing, antagonizing) NLRP3 activity are featured that include contacting NLRP3 with a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same). Methods include in vitro methods, e.g., contacting a sample that includes one or more cells comprising NLRP3, as well as in vivo methods.

In a further aspect, methods of treatment of a disease in which NLRP3 signaling contributes to the pathology and/or symptoms and/or progression of the disease are featured that include administering to a subject in need of such treatment an effective amount of a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same).

In a further aspect, methods of treatment are featured that include administering to a subject a chemical entity described herein (e.g., a compound described generically or specifically herein or a pharmaceutically acceptable salt thereof or compositions containing the same), wherein the chemical entity is administered in an amount effective to treat a disease in which NLRP3 signaling contributes to the pathology and/or symptoms and/or progression of the disease, thereby treating the disease.

Embodiments can include one or more of the following features.

The chemical entity can be administered in combination with one or more additional therapies with one or more agents suitable for the treatment of the condition, disease or disorder.

Examples of the indications that may be treated by the compounds disclosed herein include but are not limited to metabolic disorders such as type 2 diabetes, atherosclerosis, obesity and gout, as well as diseases of the central nervous system, such as Alzheimer's disease and multiple sclerosis and Amyotrophic Lateral Sclerosis and Parkinson disease, lung disease, such as asthma and COPD and pulmonary idiopathic fibrosis, liver disease, such as NASH syndrome, viral hepatitis and cirrhosis, pancreatic disease, such as acute and chronic pancreatitis, kidney disease, such as acute and chronic kidney injury, intestinal disease such as Crohn's disease and Ulcerative Colitis, skin disease such as psoriasis, musculoskeletal disease such as scleroderma, vessel disorders, such as giant cell arteritis, disorders of the bones, such as osteoarthritis, osteoporosis and osteopetrosis disorders, eye disease, such as glaucoma and macular degeneration, diseases caused by viral infection such as HIV and AIDS, autoimmune disease such as rheumatoid arthritis, systemic Lupus erythematosus, autoimmune thyroiditis; Addison's disease, pernicious anemia, cancer and aging.

The methods can further include identifying the subject.

Other embodiments include those described in the Detailed Description and/or in the claims.

Additional Definitions

To facilitate understanding of the disclosure set forth herein, a number of additional terms are defined below. Generally, the nomenclature used herein and the laboratory procedures in organic chemistry, medicinal chemistry, and pharmacology described herein are those well-known and commonly employed in the art. Unless defined otherwise, all technical and scientific terms used herein generally have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure belongs. Each of the patents, applications, published applications, and other publications that are mentioned throughout the specification and the attached appendices are incorporated herein by reference in their entireties.

As used herein, the term “NLRP3” is meant to include, without limitation, nucleic acids, polynucleotides, oligonucleotides, sense and antisense polynucleotide strands, complementary sequences, peptides, polypeptides, proteins, homologous and/or orthologous NLRP3 molecules, isoforms, precursors, mutants, variants, derivatives, splice variants, alleles, different species, and active fragments thereof.

The term “acceptable” with respect to a formulation, composition or ingredient, as used herein, means having no persistent detrimental effect on the general health of the subject being treated.

“API” refers to an active pharmaceutical ingredient.

The terms “effective amount” or “therapeutically effective amount,” as used herein, refer to a sufficient amount of a chemical entity (e.g., a compound exhibiting activity as a modulator of NLRP3, or a pharmaceutically acceptable salt and/or hydrate and/or cocrystal thereof;) being administered which will relieve to some extent one or more of the symptoms of the disease or condition being treated. The result includes reduction and/or alleviation of the signs, symptoms, or causes of a disease, or any other desired alteration of a biological system. For example, an “effective amount” for therapeutic uses is the amount of the composition comprising a compound as disclosed herein required to provide a clinically significant decrease in disease symptoms. An appropriate “effective” amount in any individual case is determined using any suitable technique, such as a dose escalation study.

The term “excipient” or “pharmaceutically acceptable excipient” means a pharmaceutically-acceptable material, composition, or vehicle, such as a liquid or solid filler, diluent, carrier, solvent, or encapsulating material. In one embodiment, each component is “pharmaceutically acceptable” in the sense of being compatible with the other ingredients of a pharmaceutical formulation, and suitable for use in contact with the tissue or organ of humans and animals without excessive toxicity, irritation, allergic response, immunogenicity, or other problems or complications, commensurate with a reasonable benefit/risk ratio. See, e.g., Remington; The Science and Practice of Pharmacy, 21st ed.; Lippincott Williams & Wilkins: Philadelphia, Pa., 2005; Handbook of Pharmaceutical Excipients, 6th ed.; Rowe et al, Eds.; The Pharmaceutical Press and the American Pharmaceutical Association: 2009; Handbook of Pharmaceutical Additives, 3rd ed.; Ash and Ash Eds.; Gower Publishing Company: 2007; Pharmaceutical Preformulation and Formulation, 2nd ed.; Gibson Ed.; CRC Press LLC: Boca Raton, Fla., 2009.

The term “pharmaceutically acceptable salt” may refer to pharmaceutically acceptable addition salts prepared from pharmaceutically acceptable non-toxic acids including inorganic and organic acids. In certain instances, pharmaceutically acceptable salts are obtained by reacting a compound described herein, with acids such as hydrochloric acid, hydrobromic acid, sulfuric acid, nitric acid, phosphoric acid, methanesulfonic acid, ethanesulfonic acid, p-toluenesulfonic acid, salicylic acid and the like. The term “pharmaceutically acceptable salt” may also refer to pharmaceutically acceptable addition salts prepared by reacting a compound having an acidic group with a base to form a salt such as an ammonium salt, an alkali metal salt, such as a sodium or a potassium salt, an alkaline earth metal salt, such as a calcium or a magnesium salt, a salt of organic bases such as dicyclohexylamine, A-methyl-D-glucamine, tris(hydroxymethyl)methylamine, and salts with amino acids such as arginine, lysine, and the like, or by other methods previously determined. The pharmacologically acceptable salt s not specifically limited as far as it can be used in medicaments. Examples of a salt that the compounds described hereinform with a base include the following: salts thereof with inorganic bases such as sodium, potassium, magnesium, calcium, and aluminum; salts thereof with organic bases such as methylamine, ethylamine and ethanolamine; salts thereof with basic amino acids such as lysine and ornithine; and ammonium salt. The salts may be acid addition salts, which are specifically exemplified by acid addition salts with the following: mineral acids such as hydrochloric acid, hydrobromic acid, hydroiodic acid, sulfuric acid, nitric acid, and phosphoric acid:organic acids such as formic acid, acetic acid, propionic acid, oxalic acid, malonic acid, succinic acid, fumaric acid, maleic acid, lactic acid, malic acid, tartaric acid, citric acid, methanesulfonic acid, and ethanesulfonic acid; acidic amino acids such as aspartic acid and glutamic acid.

The term “pharmaceutical composition” refers to a mixture of a compound described herein with other chemical components (referred to collectively herein as “excipients”), such as carriers, stabilizers, diluents, dispersing agents, suspending agents, and/or thickening agents. The pharmaceutical composition facilitates administration of the compound to an organism. Multiple techniques of administering a compound exist in the art including, but not limited to: rectal, oral, intravenous, aerosol, parenteral, ophthalmic, pulmonary, and topical administration.

The term “subject” refers to an animal, including, but not limited to, a primate (e.g., human), monkey, cow, pig, sheep, goat, horse, dog, cat, rabbit, rat, or mouse. The terms “subject” and “patient” are used interchangeably herein in reference, for example, to a mammalian subject, such as a human.

The terms “treat”, “treating”, and “treatment”, in the context of treating a disease or disorder, are meant to include alleviating or abrogating a disorder, disease, or condition, or one or more of the symptoms associated with the disorder, disease, or condition; or to slowing the progression, spread or worsening of a disease, disorder or condition or of one or more symptoms thereof.

As used herein, the term “prevent”, “preventing” or “prevention” in connection to a disease or disorder refers to the prophylactic treatment of a subject who is at risk of developing a condition (e.g., specific disease or disorder or clinical symptom thereof) resulting in a decrease in the probability that the subject will develop the condition.

The terms “hydrogen” and “H” are used interchangeably herein.

The term “halo” refers to fluoro (F), chloro (Cl), bromo (Br), or iodo (I).

The term “alkyl” refers to a hydrocarbon chain that may be a straight chain or branched chain, saturated or unsaturated, containing the indicated number of carbon atoms. For example, C_1-10indicates that the group may have from 1 to 10 (inclusive) carbon atoms in it. Non-limiting examples include methyl, ethyl, iso-propyl, tert-butyl, n-hexyl.

The term “haloalkyl” refers to an alkyl, in which one or more hydrogen atoms is/are replaced with an independently selected halo.

The term “alkoxy” refers to an —O-alkyl radical (e.g., —OCH₃).

The term “carbocyclic ring” as used herein includes an aromatic or nonaromatic cyclic hydrocarbon group having 3 to 10 carbons, such as 3 to 8 carbons, such as 3 to 7 carbons, which may be optionally substituted. Examples of carbocyclic rings include five-membered, six-membered, and seven-membered carbocyclic rings.

The term “heterocyclic ring” refers to an aromatic or nonaromatic 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring system having 1-3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2, or 3 atoms of each ring may be substituted by a substituent. Examples of heterocyclic rings include five-membered, six-membered, and seven-membered heterocyclic rings.

The term “cycloalkyl” as used herein includes an nonaromatic cyclic, bicylic, fused, or spiro hydrocarbon radical having 3 to 10 carbons, such as 3 to 8 carbons, such as 3 to 7 carbons, wherein the cycloalkyl group which may be optionally substituted. Examples of cycloalkyls include five-membered, six-membered, and seven-membered rings. Examples include cyclopropyl, cyclobutyl, cyclopentyl, cyclopentenyl, cyclohexyl, cyclohexenyl, cycloheptyl, and cyclooctyl.

The term “heterocycloalkyl” refers to an nonaromatic 5-8 membered monocyclic, 8-12 membered bicyclic, or 11-14 membered tricyclic ring, fused, or spiro system radical having 1-3 heteroatoms if monocyclic, 1-6 heteroatoms if bicyclic, or 1-9 heteroatoms if tricyclic, said heteroatoms selected from O, N, or S (e.g., carbon atoms and 1-3, 1-6, or 1-9 heteroatoms of N, O, or S if monocyclic, bicyclic, or tricyclic, respectively), wherein 0, 1, 2, or 3 atoms of each ring may be substituted by a substituent. Examples of heterocycloalkyls include five-membered, six-membered, and seven-membered heterocyclic rings. Examples include piperazinyl, pyrrolidinyl, dioxanyl, morpholinyl, tetrahydrofuranyl, and the like.

The term “aryl” is intended to mean an aromatic ring radical containing 6 to 10 ring carbons. Examples include phenyl and naphthyl.

The term “arylene” is intended to mean a aromatic ring diradical containing 6 to 10 ring carbons. Examples include phenyl and naphthyl.

The term “heteroaryl” is intended to mean an aromatic ring system radical containing 5 to 14 aromatic ring atoms that may be a single ring, two fused rings or three fused rings wherein at least one aromatic ring atom is a heteroatom selected from, but not limited to, the group consisting of O, S and N. Examples include furanyl, thienyl, pyrrolyl, imidazolyl, oxazolyl, thiazolyl, isoxazolyl, pyrazolyl, isothiazolyl, oxadiazolyl, triazolyl, thiadiazolyl, pyridinyl, pyrazinyl, pyrimidinyl, pyridazinyl, triazinyl and the like. Examples also include carbazolyl, quinolizinyl, quinolinyl, isoquinolinyl, cinnolinyl, phthalazinyl, quinazolinyl, quinoxalinyl, triazinyl, indolyl, isoindolyl, indazolyl, indolizinyl, purinyl, naphthyridinyl, pteridinyl, carbazolyl, acridinyl. phenazinyl, phenothiazinyl, phenoxazinyl, benzoxazolyl, benzothiazolyl, 1H-benzimidazolyl, imidazopyridinyl, benzothienyl, benzofuranyl, isobenzofuran and the like.

The term “heteroarylene” is intended to mean a aromatic ring system diradical containing 5 to 14 aromatic ring atoms that may be a single ring, two fused rings or three fused rings wherein at least one aromatic ring atom is a heteroatom selected from, but not limited to, the group consisting of O, S and N. Examples include furanylene, thienylene, pyrrolylene, imidazolylene, oxazolylene, thiazolylene, isoxazolylene, pyrazolylene, isothiazolylene, oxadiazolylene, triazolylene, thiadiazolylene, pyridinylene, pyrazinylene, pyrimidinylene, pyridazinylene, triazinylene and the like. Examples also include carbazolylene, quinolizinylene, quinolinylene, isoquinolinylene, cinnolinylene, phthalazinylene, quinazolinylene, quinoxalinylene, triazinylene, indolylene, isoindolylene, indazolylene, indolizinylene, purinylene, naphthyridinylene, pteridinylene, carbazolylene, acridinylene. phenazinylene, phenothiazinylene, phenoxazinylene, benzoxazolylene, benzothiazolylene, 1H-benzimidazolylene, imidazopyridinylene, benzothienylene, benzofuranylene, isobenzofuranylene and the like.

The term “hydroxy” refers to an OH group.

The term “amino” refers to an NH₂group.

The term “oxo” refers to O. By way of example, substitution of a CH₂a group with oxo gives a C═O group.

As used herein, the terms “the ring A” or “A” are used interchangeably to denote

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in formula AA, wherein the bond that is shown as being broken by the wavy line custom-character connects A to the X moiety of Formula AA.

As used herein, the terms “the ring B” or “B” are used interchangeably to denote

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in formula AA wherein the bond that is shown as being broken by the wavy line custom-character connects B to the ring C of Formula AA.

As used herein, the terms “the ring C” or “C” are used interchangeably to denote

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in formula AA wherein the bond that (i) is shown as being broken by the wavy line custom-character and (ii) is spatially closest to the asterisk connects C to the X group of Formula AA; and the bond that (i) is shown as being broken by the wavy line and (ii) is spatially furthest from the asterisk connects C to the ring B of Formula AA.

As used herein, the term “the optionally substituted ring A” is used to denote

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in formula AA, wherein the bond that is shown as being broken by the wavy line custom-character connects A to the X moiety Formula AA.

As used herein, the term “the substituted ring B” is used to denote

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in formula AA, wherein the bond that is shown as being broken by the wavy line custom-character connects B to the ring C of Formula AA.

As used herein, the terms “the optionally substituted ring C” is used to denote

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As used herein, the recitation “S(O₂)”, alone or as part of a larger recitation, refers to the group

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In addition, atoms making up the compounds of the present embodiments are intended to include all isotopic forms of such atoms. Isotopes, as used herein, include those atoms having the same atomic number but different mass numbers. By way of general example and without limitation, isotopes of hydrogen include tritium and deuterium, and isotopes of carbon include ¹³C and ¹⁴C.

The scope of the compounds disclosed herein includes tautomeric form of the compounds. Thus, by way of example, a compound that is represented as containing the moiety

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is also intended to include the tautomeric form containing the moiety

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Non-limiting exemplified compounds of the formulae described herein may include one or more stereogenic atoms (e.g., carbon or sulfur). This disclosure provides examples of stereoisomer mixtures (e.g., racemic mixture of enantiomers; mixture of diastereomers). This disclosure may also describe and exemplify methods for separating individual components of said stereoisomer mixtures (e.g., resolving the enantiomers of a racemic mixture). In cases of compounds containing a stereogenic atom sulfur, resolved enantiomers are graphically depicted using one of the two following formats: formulas A/B (hashed and solid wedge three-dimensional representation); and formula C (“flat structures with *-labelled stereogenic atom (e.g., carbon or sulfur))

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In reaction schemes showing resolution of a racemic mixture, Formulas A/B and C are intended only to convey that the constituent enantiomers were resolved in enantiopure pure form (about 98% ee or greater). The schemes that show resolution products using the formula A/B format are not intended to disclose or imply any correlation between absolute configuration and order of elution. Some of the compounds shown in the tables below are graphically represented using the formula A/B format.

For clarity, the present invention shall not encompass the following compound:

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or 5-(1-(2,3-dihydro-1H-inden-4-yl)-3-(thiophen-2-ylmethyl)-1H-1,2,4-triazol-5-yl)piperidin-2-one, which is hence disclaimed throughout the invention.

DESCRIPTION OF THE DRAWINGS

FIG. 1: Expression levels of RNA encoding NLRP3 in Crohn's Disease patients who are responsive and non-responsive to infliximab.

FIG. 2: Expression levels of RNA encoding IL-1β in Crohn's Disease patients who are responsive and non-responsive to infliximab.

FIG. 3: Expression levels of RNA encoding NLRP3 in Ulcerative Colitis (UC) patients who are responsive and non-responsive to infliximab.

FIG. 4: Expression levels of RNA encoding IL-1β in Ulcerative Colitis (UC) patients who are responsive and non-responsive to infliximab.

FIG. 5: Layout of the microplate to measure the THP-1 activity of the tested compounds.

DETAILED DESCRIPTION

In embodiment one, disclosed herein is a compound of Formula AA

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wherein

m=0, 1, or 2;

n=0, 1, or 2;

o=1 or 2;

p=0, 1, 2, or 3;

r=0, 1, 2, or 3;

wherein

A is a 5- to 10-membered monocyclic or bicyclic heteroaryl or a C₆-C₁₀monocyclic or bicyclic aryl;

X is selected from the group consisting of —C(O)—, —S(O)_q—, —O—, —NR¹⁴—, —S(O)(NH)—, —S(O)(NR¹⁴), CHCH₂NHCOC₁-C₆aryl, and CR³NHR⁴;

C is a 5- to 10-membered monocyclic or bicyclic heteroarylene or a C₆-C₁₀monocyclic or bicyclic arylene;

B is a 5-10 membered monocyclic or bicyclic heteroaryl, or a C₆-C₁₀monocyclic or bicyclic aryl;

wherein

at least one R⁶is ortho to the bond connecting the B ring to the ring C of Formula AA;

R¹and R²are each independently selected from C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, C₁-C₆haloalkoxy, halo, CN, NO₂, COC₁-C₆alkyl, CO—C₆-C₁₀aryl; CO(5- to 10-membered heteroaryl); CO₂C₁-C₆alkyl, CO₂C₃-C₈cycloalkyl, OCOC₁-C₆alkyl, OCOC₆-C₁₀aryl, OCO(5- to 10-membered heteroaryl), OCO(3- to 7-membered heterocycloalkyl), C₆-C₁₀aryl, 5- to 10-membered heteroaryl, NH₂, NHC₁-C₆alkyl, N(C₁-C₆alkyl)₂, NHCOC₁-C₆alkyl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl), NHCO(3- to 7-membered heterocycloalkyl), NHCOC₂-C₆alkynyl, NHCOOC₁-C₆alkyl, NH—(C═NR¹³)NR¹¹R¹², CONR⁸R⁹, SF₅, SC₁-C₆alkyl, S(O₂)C₁-C₆alkyl, S(O)C₁-C₆alkyl, S(O₂)NR¹¹R¹², C₃-C₇cycloalkyl and 3- to 7-membered heterocycloalkyl,

wherein the C₁-C₆alkyl, C₁-C₆haloalkyl, C₃-C₇cycloalkyl and 3- to 7-membered heterocycloalkyl is optionally substituted with one or more substituents each independently selected from hydroxy, halo, CN, oxo, C₁-C₆alkyl, C₁-C₆alkoxy, NR⁸R⁹, ═NR¹⁰, COOC₁-C₆alkyl, CONR⁸R⁹, 3- to 7-membered heterocycloalkyl, C₆-C₁₀aryl, 5- to 10-membered heteroaryl, OCOC₁-C₆alkyl, OCOC₆-C₁₀aryl, OCO(5- to 10-membered heteroaryl), OCO(3- to 7-membered heterocycloalkyl), NHCOC₁-C₆alkyl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl), NHCO(3- to 7-membered heterocycloalkyl), and NHCOC₂-C₆alkynyl;

- wherein each C₁-C₆alkyl substituent and each C₁-C₆alkoxy substituent of the R¹or R²C₃-C₇cycloalkyl or of the R¹or R²3- to 7-membered heterocycloalkyl is further optionally independently substituted with one to three hydroxy, halo, NR⁸R⁹, or oxo;
- wherein the 3- to 7-membered heterocycloalkyl, C₆-C₁₀aryl, 5- to 10-membered heteroaryl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl) and NHCO(3- to 7-membered heterocycloalkyl) are optionally substituted with one or more substituents independently selected from halo, C₁-C₆alkyl, and OC₁-C₆alkyl;
  
  or at least one pair of R¹and R²on adjacent atoms, taken together with the atoms connecting them, independently form at least one C₄-C₈carbocyclic ring or at least one 5- to 8-membered heterocyclic ring containing 1 or 2 heteroatoms independently selected from O, N, and S, wherein the carbocyclic ring or heterocyclic ring is optionally independently substituted with one or more substituents independently selected from hydroxy, halo, oxo, C₁-C₆alkyl, C₁-C₆alkoxy, NR⁸R⁹, ═NR¹⁰, COOC₁-C₆alkyl, C₆-C₁₀aryl, and CONR⁸R⁹wherein the C₁-C₆alkyl and C₁-C₆alkoxy are optionally substituted with hydroxy, halo, oxo, NR⁸R⁹, ═NR¹⁰, COOC₁-C₆alkyl, C₆-C₁₀aryl, and CONR⁸R⁹;
  
  each occurrence of R⁵is independently selected from C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, C₁-C₆haloalkoxy, halo, CN, NO₂, COC₁-C₆alkyl, CO—C₆-C₁₀aryl; CO(5- to 10-membered heteroaryl); CO₂C₁-C₆alkyl, CO₂C₃-C₈cycloalkyl, OCOC₁-C₆alkyl, OCOC₆-C₁₀aryl, OCO(5- to 10-membered heteroaryl), OCO(3- to 7-membered heterocycloalkyl), C₆-C₁₀aryl, 5- to 10-membered heteroaryl, NH₂, NHC₁-C₆alkyl, N(C₁-C₆alkyl)₂, NHCOC₁-C₆alkyl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl), NHCO(3- to 7-membered heterocycloalkyl), NHCOC₂-C₆alkynyl, NHCOOC₁-C₆alkyl, NH—(C═NR¹³)NR¹¹R¹², CONR⁸R⁹, SF₅, SC₁-C₆alkyl, S(O₂)C₁-C₆alkyl, S(O)C₁-C₆alkyl, S(O₂)NR¹¹R¹², C₃-C₇cycloalkyl and 3- to 7-membered heterocycloalkyl,
  
  wherein the C₁-C₆alkyl, C₁-C₆haloalkyl, C₃-C₇cycloalkyl and 3- to 7-membered heterocycloalkyl is optionally substituted with one or more substituents each independently selected from hydroxy, halo, CN, oxo, C₁-C₆alkyl, C₁-C₆alkoxy, NR⁸R⁹, ═NR¹⁰, COOC₁-C₆alkyl, CONR⁸R⁹, 3- to 7-membered heterocycloalkyl, C₆-C₁₀aryl, OC₆-C₁₀aryl, 5- to 10-membered heteroaryl, OCOC₁-C₆alkyl, OCOC₆-C₁₀aryl, OCO(5- to 10-membered heteroaryl), OCO(3- to 7-membered heterocycloalkyl), NHCOC₁-C₆alkyl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl), NHCO(3- to 7-membered heterocycloalkyl), and NHCOC₂-C₆alkynyl;
- wherein each C₁-C₆alkyl substituent and each C₁-C₆alkoxy substituent of the R⁵C₃-C₇cycloalkyl or of the R⁵3- to 7-membered heterocycloalkyl is further optionally independently substituted with one to three hydroxy, halo, NR⁸R⁹, or oxo;
- wherein the 3- to 7-membered heterocycloalkyl, C₆-C₁₀aryl, 5- to 10-membered heteroaryl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl) and NHCO(3- to 7-membered heterocycloalkyl) are optionally substituted with one or more substituents independently selected from halo, C₁-C₆alkyl, and OC₁-C₆alkyl;
  
  q is 0, 1, or 2;
  
  R³is selected from H and C₁-C₆alkyl;
  
  R⁴is selected from H and COOC₁-C₆alkyl optionally substituted with one or more C₆-C₁₀aryl; R⁶and R⁷are each independently selected from C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, C₁-C₆haloalkoxy, halo, CN, NO₂, COC₁-C₆alkyl, CO₂C₁-C₆alkyl, CO₂C₃-C₈cycloalkyl, OCOC₁-C₆alkyl, OCOC₆-C₁₀aryl, OCO(5- to 10-membered heteroaryl), OCO(3- to 7-membered heterocycloalkyl), C₆-C₁₀aryl, 5- to 10-membered heteroaryl, NH₂, NHC₁-C₆alkyl, N(C₁-C₆alkyl)₂, CONR⁸R⁹, SF₅, S(O₂)C₁-C₆alkyl, C₃-C₁₀cycloalkyl and 3- to 10-membered heterocycloalkyl, and a C₂-C₆alkenyl,
  
  wherein R⁶and R⁷are each optionally substituted with one or more substituents independently selected from hydroxy, halo, CN, oxo, C₁-C₆alkyl, C₁-C₆alkoxy, NR⁸R⁹, ═NR¹⁰, COOC₁-C₆alkyl, CONR⁸R⁹, 3- to 7-membered heterocycloalkyl, C₆-C₁₀aryl, 5- to 10-membered heteroaryl, OCOC₁-C₆alkyl, OCOC₆-C₁₀aryl, OCO(5- to 10-membered heteroaryl), OCO(3- to 7-membered heterocycloalkyl), NHCOC₁-C₆alkyl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl), NHCO(3- to 7-membered heterocycloalkyl), NHCOC₂-C₆alkynyl, C₆-C₁₀aryloxy, and S(O₂)C₁-C₆alkyl; and wherein the C₁-C₆alkyl or C₁-C₆alkoxy that R⁶or R⁷is substituted with is optionally substituted with one or more hydroxyl, C₆-C₁₀aryl or NR⁸R⁹, or wherein R⁶or R⁷is optionally fused to a five- to -seven-membered carbocyclic ring or heterocyclic ring containing one or two heteroatoms independently selected from oxygen, sulfur and nitrogen;
- wherein the 3- to 7-membered heterocycloalkyl, C₆-C₁₀aryl, 5- to 10-membered heteroaryl, NHCOC₆-C₁₀aryl, NHCO(5- to 10-membered heteroaryl) and NHCO(3- to 7-membered heterocycloalkyl) are optionally substituted with one or more substituents independently selected from halo, C₁-C₆alkyl, and OC₁-C₆alkyl;
  
  or at least one pair of R⁶and R⁷on adjacent atoms, taken together with the atoms connecting them, independently form at least one C₄-C₈carbocyclic ring or at least one 5- to 8-membered heterocyclic ring containing 1 or 2 heteroatoms independently selected from O, N, and S, wherein the carbocyclic ring or heterocyclic ring is optionally independently substituted with one or more substituents independently selected from hydroxy, hydroxymethyl, halo, oxo, C₁-C₆alkyl, C₁-C₆alkoxy, NR⁸R⁹, CH₂NR⁸R⁹, ═NR¹⁰, COOC₁-C₆alkyl, C₆-C₁₀aryl, and CONR⁸R⁹;
  
  R¹⁰is C₁-C₆alkyl;
  
  each of R⁸and R⁹at each occurrence is independently selected from hydrogen, C₁-C₆alkyl, (C═NR¹³)NR¹¹R¹², S(O₂)C₁-C₆alkyl, S(O₂)NR¹¹R¹², COR¹³, CO₂R¹³and CONR¹¹R¹²; wherein the C₁-C₆alkyl is optionally substituted with one or more hydroxy, halo, C₁-C₆alkoxy, C₆-C₁₀aryl, 5- to 10-membered heteroaryl, C₃-C₇cycloalkyl or 3- to 7-membered heterocycloalkyl; or R⁸and R⁹taken together with the nitrogen they are attached to form a 3- to 7-membered ring optionally containing one or more heteroatoms in addition to the nitrogen they are attached to; R¹³is C₁-C₆alkyl, C₆-C₁₀aryl, or 5- to 10-membered heteroaryl;
  
  each of R¹¹and R¹²at each occurrence is independently selected from hydrogen and C₁-C₆alkyl;
  
  wherein the C₁-C₂alkylene group is optionally substituted by oxo; and
  
  R¹⁴is hydrogen, C₁-C₆alkyl, 5- to 10-membered monocyclic or bicyclic heteroaryl or C₆-C₁₀monocyclic or bicyclic aryl, wherein each C₁-C₆alkyl, aryl or heteroaryl is optionally independently substituted with 1 or 2 R⁶;
  
  with the proviso that a compound of Formula AA is not 5-(1-(2,3-dihydro-1H-inden-4-yl)-3-(thiophen-2-ylmethyl)-1H-1,2,4-triazol-5-yl)piperidin-2-one;
  
  or a pharmaceutically acceptable salt thereof.
  
  In another embodiment the compound of Formula AA is

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wherein

m=0, 1, or 2;

n=0, 1, or 2;

o=1 or 2;

p=0, 1, 2, or 3;

r=0, 1, 2, or 3;

wherein A is a 5- to 6-membered monocyclic heteroaryl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R²;

X is selected from the group consisting of —C(O)—, —S(O)_q—, —O—, —NR¹⁴—, —S(O)(NH)—, —S(O)(NR¹⁴), CHCH₂NHCOC₁-C₆aryl, and CR³NHR⁴;

ring C is a 5- to 6-membered monocyclic heteroarylene; wherein ring B is

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substituted with 1 or 2 R⁶and substituted with 1 or 2 R⁷; or wherein B is phenyl substituted with 1 or 2 R⁶and optionally substituted with 1, 2, or 3 R⁷, with the proviso that the substitution on a ring B contains at least one annulated cyclopentane ring;

wherein

at least one R⁶is ortho to the bond connecting the B ring to the C ring of Formula AA;

and wherein the remaining variables are as defined in embodiment 1, with the proviso that a compound of Formula AA is not 5-(1-(2,3-dihydro-1H-inden-4-yl)-3-(thiophen-2-ylmethyl)-1H-1,2,4-triazol-5-yl)piperidin-2-one;

or a pharmaceutically acceptable salt thereof.

In some embodiments the variables shown in any of the formulae herein are as follows:

The Variables m and n

In some embodiments m=0, 1, or 2. In some embodiments m=0 or 1. In some embodiments m=1 or 2. In some embodiments m=0 or 2. In some embodiments m=0. In some embodiments m=1. In some embodiments m=2. In some embodiments n=0, 1, or 2. In some embodiments n=0 or 1. In some embodiments n=1 or 2. In some embodiments n=0 or 2. In some embodiments n=0. In some embodiments n=1. In some embodiments n=2. In some embodiments, m=0 and n=0. In some embodiments, m=1 and n=0. In some embodiments, m=1 and n=1.

The Variable r

In some embodiments r=0, 1, 2, or 3. In some embodiments r=0, 1, or 2. In some embodiments r=0, 1, or 3. In some embodiments r=0, 2, or 3. In some embodiments r=1, 2, or 3. In some embodiments r=0 or 1. In some embodiments r=0 or 2. In some embodiments r=0 or 3. In some embodiments r=1 or 2. In some embodiments r=1 or 3. In some embodiments r=2 or 3. In some embodiments r=0. In some embodiments r=1. In some embodiments r=2. In some embodiments r=3.

The Ring a and Substitutions on the Ring A

In some embodiments, A is a 5- to 10-membered (e.g., 5- to 6-membered) monocyclic or bicyclic heteroaryl or a C₆-C₁₀(e.g., C₆) monocyclic or bicyclic aryl, such as phenyl.

In some embodiments, A is a 5- to 10-membered (e.g., 5- to 6-membered) monocyclic or bicyclic heteroaryl. In some embodiments, A is a 5- to 6-membered monocyclic heteroaryl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is a 5-membered heteroaryl containing a sulfur and optionally one or more nitrogens. In some embodiments, A is a C₆-C₁₀monocyclic or bicyclic aryl. In some embodiments, A is phenyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is naphthyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is furanyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 R². In some embodiments, A is furanyl optionally substituted with 1 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is thiophenyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is oxazolyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is thiazolyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is oxazolyl optionally substituted with 2 R¹or optionally substituted with 2 R². In some embodiments, A is thiazolyl optionally substituted with 2 R¹or optionally substituted with 2 R². In some embodiments, A is pyrazolyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is pyrazolyl optionally substituted with 1 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is pyrazolyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 R². In some embodiments, A is pyridyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is indazolyl optionally substituted with 1 or 2 R¹and optionally substituted with 1 or 2 R². In some embodiments, A is phenyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is naphthyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is furanyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is thiophenyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is oxazolyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is thiazolyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is pyrazolyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is pyridyl substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is indazolyl optionally substituted with 1 R¹and optionally substituted with 1 R². In some embodiments, A is phenyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is furanyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is thiophenyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is oxazolyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is thiazolyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is pyrazolyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is pyridyl substituted with 1 R¹and substituted with 1 R². In some embodiments, A is phenyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is furanyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is thiophenyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is oxazolyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is thiazolyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is pyrazolyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is pyridyl, m is 0 or 1, and n is 0, 1, or 2. In some embodiments, A is indazolyl, m is 0 or 1, and

- n is 0, 1, or 2. In some embodiments, A is phenyl, m is 0, and n is 0 or 1. In some embodiments, A is furanyl, m is 0, and n is 0 or 1. In some embodiments, A is thiophenyl, m is 0, and n is 0 or 1. In some embodiments, A is oxazolyl, m is 0, and n is 0 or 1. In some embodiments, A is thiazolyl, m is 0, and n is 0 or 1. In some embodiments, A is pyrazolyl, m is 0, and n is 0 or 1. In some embodiments, A is pyridyl, m is 0, and n is 0 or 1. In some embodiments, A is one of the rings disclosed hereinbelow optionally substituted as disclosed hereinbelow, wherein in each case the bond that is shown as being broken by the wavy line connects A to the X moiety of Formula AA. In some embodiments, the optionally substituted ring A

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