Enhanced erythropoiesis and iron metabolism

A method of treating anemia in a human subject comprising administering to the human subject an effective amount of a compound, wherein the human subject has a transferrin saturation (TSAT) level below 20% prior to said administering and wherein the compound is a compound of Formula I

• wherein
• A is —CR5R6 and R5 and R6 are each hydrogen;
• B is —CO2H;
• X is O;
• Q is O;
• R4 is hydrogen
• Y is CR3;
• R1, R2 and R3 are identical or different and are hydrogen, hydroxyl, halogen, cyano, trifluoromethyl, nitro, carboxyl, (C1-C20)-alkyl, (C3-C8)-cycloalkyl, (C3-C8)cycloalkyl-(C1-C12)-alkyl, (C3-C8)-cycloalkoxy, (C3-C8)-cycloalkyl-(C1-C12)-alkoxy, (C3-C8)-cycloalkyloxy-(C1-C12)-alkyl, (C3-C8)-cycloalkyloxy-(C1-C12)-alkoxy, (C3-C8)-cycloalkyl-(C1-C8)-alkyl-(C1-C6)-alkoxy, (C3-C8)-cycloalkyl-(C1-C8)-alkoxy-(C1-C6)-alkyl, (C3-C8)-cycloalkyloxy-(C1-C8)-alkoxy-(C1-C6)-alkyl, (C3-C8)-cycloalkoxy-(C1-C8)-alkoxy-(C1-C8)-alkoxy, (C6-C2)-aryl, (C7-C16)-aralkyl, (C7-C16)-aralkenyl, (C7-C16)-aralkynyl, (C2-C20)-alkenyl, (C2-C20)-alkynyl, (C1-C20)-alkoxy, (C2-C20)-alkenyloxy, (C2-C20)-alkynyloxy, retinyloxy, (C1-C20)-alkoxy-(C1-C12)-alkyl, (C1-C12)-alkoxy-(C1-C12)-alkoxy, (C1-C12)-alkoxy-(C1-C8)-alkoxy-(C1-C8)-alkyl, (C6-C12)-aryloxy, (C7-C16)-aralkyloxy, (C6-C12)-aryloxy-(C1-C6)-alkoxy, (C7-C16)-aralkoxy-(C1-C6)-alkoxy, (C1-C16)-hydroxyalkyl, (C6-C16)-aryloxy-(C1-C8)-alkyl, (C7-C16)-aralkoxy-(C1-C8)-alkyl, (C6-C12)-aryloxy-(C1-C8)-alkoxy-(C1-C6)-alkyl, (C7-C12)-aralkyloxy-(C1-C8)-alkoxy-(C1-C6)-alkyl, (C2-C20)-alkenyloxy-(C1-C6)-alkyl, (C2-C20)-alkynyloxy-(C1-C6)-alkyl, retinyloxy-(C1-C6)-alkyl, —O—[CH2]xCfH(2f+1−g)Fg, —OCF2Cl, —OCF2—CHFCl, (C1-C20)-alkylcarbonyl, (C3-C8)-cycloalkylcarbonyl, (C6-C12)-arylcarbonyl, (C7-C16)-aralkylcarbonyl, cinnamoyl, (C2-C20)-alkenylcarbonyl, (C2-C20)-alkynylcarbonyl, (C1-C20)-alkoxycarbonyl, (C1-C12)-alkoxy-(C1-C12)-alkoxycarbonyl, (C6-C12)-aryloxycarbonyl, (C7-C16)-aralkoxycarbonyl, (C3-C8)-cycloalkoxycarbonyl, (C2-C20)-alkenyloxycarbonyl, retinyloxycarbonyl, (C2-C20)-alkynyloxycarbonyl, (C6-C12)-aryloxy-(C1-C6)-alkoxycarbonyl, (C7-C16)-aralkoxy-(C1-C6)-alkoxycarbonyl, (C3-C8)-cycloalkyl-(C1-C6)-alkoxycarbonyl, (C3-C8)-cycloalkoxy-(C1-C6)-alkoxycarbonyl, (C1-C12)-alkylcarbonyloxy, (C3-C8)-cycloalkylcarbonyloxy, (C6-C12)-arylcarbonyloxy, (C7-C16)-aralkylcarbonyloxy, cinnamoyloxy, (C2-C12)-alkenylcarbonyloxy, (C2-C12)-alkynylcarbonyloxy, (C1-C12)-alkoxycarbonyloxy, (C1-C2)-alkoxy-(C1-C12)-alkoxycarbonyloxy, (C6-C12)-aryloxycarbonyloxy, (C7-C16)-aralkyloxycarbonyloxy, (C3-C8)-cycloalkoxycarbonyloxy, (C2-C12)-alkenyloxycarbonyloxy, (C2-C12)-alkynyloxycarbonyloxy, carbamoyl, N—(C1-C12)-alkylcarbamoyl, N,N-di-(C1-C12)-alkylcarbamoyl, N—(C3-C8)-cycloalkylcarbamoyl, N,N-dicyclo-(C3-C8)-alkylcarbamoyl, N—(C1-C10)-alkyl-N—(C3-C8)-cycloalkylcarbamoyl, N—((C3-C8)-cycloalkyl-(C1-C6)-alkyl)-carbamoyl, N—(C1-C6)-alkyl-N—((C3-C8)-cycloalkyl-(C1-C6)-alkyl)-carbamoyl, N-(+)-dehydroabietylcarbamoyl, N—(C1-C6)-alkyl-N-(+)-dehydroabietylcarbamoyl, N—(C6-C12)-arylcarbamoyl, N—(C7-C16)-aralkylcarbamoyl, N—(C1-C10)-alkyl-N—(C6-C16)-arylcarbamoyl, N—(C1-C10)-alkyl-N—(C7-C16)-aralkylcarbamoyl, N—((C1-C18)-alkoxy-(C1-C10)-alkyl)-carbamoyl, N—((C6-C16)-aryloxy-(C1-C10)-alkyl)-carbamoyl, N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)-carbamoyl, N—(C1-C10)-alkyl-N—((C1-C10)-alkoxy-(C1-C10)-alkyl)-carbamoyl, N—(C1-C10)-alkyl-N—((C6-C12)-aryloxy-(C1-C10)-alkyl)-carbamoyl, N—(C1-C10)-alkyl-N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)-carbamoyl;
• CON(CH2)h, in which a CH2 group can be replaced by O, S, N—(C1-C8)-alkylimino, N—(C3-C8)-cycloalkylimino, N—(C3-C8)-cycloalkyl-(C1-C4)-alkylimino, N—(C6-C12)-arylimino, N—(C7-C16)-aralkylimino, N—(C1-C4)-alkoxy-(C1-C6)-alkylimino, and h is from 3 to 7;
• a carbamoyl radical of the formula R
• in which
• Rx and Rv are each independently selected from hydrogen, (C1-C6)-alkyl, (C3-C7)-cycloalkyl, aryl, or the substituent of an α-carbon of an α-amino acid, to which the L- and D-amino acids belong,
• s is 1-5,
• T is OH, or NR*R**, and R*, R** and R*** are identical or different and are selected from hydrogen, (C6-C12)-aryl, (C7-C11)-aralkyl, (C1-C8)-alkyl, (C3-C8)-cycloalkyl, (+)-dehydroabietyl, (C1-C8)-alkoxy-(C1-C8)-alkyl, (C7-C12)-aralkoxy-(C1-C8)-alkyl, (C6-C12)-aryloxy-(C1-C8)-alkyl, (C1-C10)-alkanoyl, optionally substituted (C7-C16)-aralkanoyl, optionally substituted (C6-C12)-aroyl;
• or R* and R** together are —[CH2]h, in which a CH2 group can be replaced by O, S, SO, SO2, N-acylamino, N—(C1-C10)-alkoxycarbonylimino, N—(C1-C8)-alkylimino, N—(C3-C8)-cycloalkylimino, N—(C3-C8)-cycloalkyl-(C1-C4)-alkylimino, N—(C6-C12)-arylimino, N—(C7-C16)-aralkylimino, N—(C1-C4)-alkoxy-(C1-C6)-alkylimino, and h is from 3 to 7;
• carbamoyloxy, N—(C1-C12)-alkylcarbamoyloxy, N,N-di-(C1-C12)-alkylcarbamoyloxy, N—(C3-C8)-cycloalkylcarbamoyloxy, N—(C6-C12)-arylcarbamoyloxy, N—(C7-c16)-aralkylcarbamoyloxy, N—(C1-C10)-alkyl-N—(C6-C12)-arylcarbamoyloxy, N—(C1-C10)-alkyl-N—(C7-C16)-aralkylcarbamoyloxy, N—((C1-C10)-alkyl)-carbamoyloxy, N—((C6-C12)-aryloxy-(C1-C10)-alkyl)-carbamoyloxy, N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)-carbamoyloxy, N—(C1-C10)-alkyl-N—((C1-C10)-alkoxy-(C1-C10)-alkyl)-carbamoyloxy, N—(C1-C10)-alkyl-N—((C6-C12)-aryloxy-(C1-C10)-alkyl)-carbamoyloxy, N—(C1-C10)-alkyl-N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)-carbamoyloxyamino, (C1-C12)-alkylamino, di-(C1-C12)-alkylamino, (C3-C8)-cycloalkylamino, (C3-C12)-alkenylamino, (C3-C12)-alkynylamino, N—(C6-C12)-arylamino, N—(C7-C11)-aralkylamino, N-alkyl-aralkylamino, N-alkyl-arylamino, (C1-C12)-alkoxyamino, (C1-C12)-alkoxy-N—(C1-C10)-alkylamino, (C1-C12)-alkanoylamino, (C3-C8)-cycloalkanoylamino, (C6-C12)-aroylamino, (C7-C16)-aralkanoylamino, (C1-C12)-alkanoyl-N—(C1-C10)-alkylamino, (C3-C8)-cycloalkanoyl-N—(C1-C10)-alkylamino, (C6-C12)-aroyl-N—(C1-C10)-alkylamino, (C7-C11)-aralkanoyl-N—(C1-C10)-alkylamino, (C1-C12)-alkanoylamino-(C1-C8)-alkyl, (C3-C8)-cycloalkanoylamino-(C1-C8)-alkyl, (C6-C12)-aroylamino-(C1-C8)-alkyl, (C7-C16)-aralkanoylamino-(C1-C8)-alkyl, amino-(C1-C10)-alkyl, N—(C1-C10)-alkylamino-(C1-C10)-alkyl, N,N-di(C1-C10)-alkylamino-(C1-C10)-alkyl, (C3-C8)-cycloalkylamino(C1-C10)-alkyl, (C1-C20)-alkylmercapto, (C1-C20)-alkylsulfinyl, (C1-C20)-alkylsulfonyl, (C6-C12)-arylmercapto, (C6-C12)-arylsulfinyl, (C6-C12)-arylsulfonyl, (C7-C16)-aralkylmercapto, (C7-C16)-aralkylsulfinyl, (C7-C16)-aralkylsulfonyl, (C1-C12)-alkylmercapto-(C1-C6)-alkyl, (C1-C12)-alkylsulfinyl-(C1-C6)-alkyl, (C1-C12)-alkylsulfonyl-(C1-C6)-alkyl, (C6-C12)-arylmercapto-(C1-C6)-alkyl, (C6-C12)-arylsulfinyl-(C1-C6)-alkyl, (C6-C12)-arylsulfonyl-(C1-C6)-alkyl, (C7-C16)-aralkylmercapto-(C1-C6)-alkyl, (C7-C16)-aralkylsulfinyl-(C1-C6)-alkyl, (C7-C16)-aralkylsulfonyl-(C1-C6)-alkyl, sulfamoyl, N—(C1-C10)-alkylsulfamoyl, N,N-di-(C1-C10)-alkylsulfamoyl, (C3-C8)-cycloalkylsulfamoyl, N—(C6-C12)-arylsulfamoyl, N—(C7-C16)-aralkylsulfamoyl, N—(C1-C10)-alkyl-N—(C6-C12)-arylsulfamoyl, N—(C1-C10)-alkyl-N—(C7-C16)-aralkylsulfamoyl, (C1-C10)-alkylsulfonamido, N—((C1-C10)-alkyl)-(C1-C10)-alkylsulfonamido, (C7-C16)-aralkylsulfonamido, and N—((C1-C10)-alkyl-(C7-C16)-aralkylsulfonamido;
• where an aryl radical may be substituted by 1 to 5 substituents selected from hydroxyl, halogen, cyano, trifluoromethyl, nitro, carboxyl, (C2-C16)-alkyl, (C3-C8)-cycloalkyl, (C3-C8)-cycloalkyl-(C1-C12)-alkyl, (C3-C8)-cycloalkoxy, (C3-C8)-cycloalkyl-(C1-C12)-alkoxy, (C3-C8)-cycloalkyloxy-(C1-C12)-alkyl, (C3-C8)-cycloalkyloxy-(C1-C12)-alkoxy, (C3-C8)-cycloalkyl-(C1-C8)-alkyl-(C1-C6)-alkoxy, (C3-C8)-cycloalkyl(C1-C8)-alkoxy-(C1-C6)-alkyl, (C3-C8)-cycloalkyloxy-(C1-C8)-alkoxy-(C1-C6)-alkyl, (C3-C8)-cycloalkoxy-(C1-C8)-alkoxy-(C1-C8)-alkoxy, (C6-C12)-aryl, (C7-C16)-aralkyl, (C2-C16)-alkenyl, (C2-C12)-alkynyl, (C1-C16)-alkoxy, (C1-C16)-alkenyloxy, (C1-C12)-alkoxy-(C1-C12)-alkyl, (C1-C12)-alkoxy-(C1-C12)-alkoxy, (C1-C12)-alkoxy(C1-C8)-alkoxy-(C1-C8)-alkyl, (C6-C12)-aryloxy, (C7-C16)-aralkyloxy, (C6-C12)-aryloxy-(C1-C6)-alkoxy, (C7-C16)-aralkoxy-(C1-C6)-alkoxy, (C1-C8)-hydroxyalkyl, (C6-C16)-aryloxy-(C1-C8)-alkyl, (C7-C16)-aralkoxy-(C1-C8)-alkyl, (C6-C12)-aryloxy-(C1-C8)-alkoxy-(C1-C6)-alkyl, (C7-C12)-aralkyloxy-(C1-C8)-alkoxy-(C1-C6)-alkyl, —O—[CH2]xCfH(2f+1−g)Fg, —OCF2Cl, —OCF2—CHFCl, (C1-C12)-alkylcarbonyl, (C3-C8)- cycloalkylcarbonyl, (C6-C12)-arylcarbonyl, (C7-C16)-aralkylcarbonyl, (C1-C12)-alkoxycarbonyl, (C1-C12)-alkoxy-(C1-C12)-alkoxycarbonyl, (C6-C12)-aryloxycarbonyl, (C7-C16)-aralkoxycarbonyl, (C3-C8)-cycloalkoxycarbonyl, (C2-C12)-alkenyloxycarbonyl, (C2-C12)-alkynyloxycarbonyl, (C6-C12)-aryloxy-(C1-C6)-alkoxycarbonyl, (C7-C16)-aralkoxy-(C1-C6)-alkoxycarbonyl, (C3-C8)-cycloalkyl-(C1-C6)-alkoxycarbonyl, (C3-C8)-cycloalkoxy-(C1-C6)-alkoxycarbonyl, (C1-C12)-alkylcarbonyloxy, (C3-C8)-cycloalkylcarbonyloxy, (C6-C12)-arylcarbonyloxy, (C7-C16)-aralkylcarbonyloxy, cinnamoyloxy, (C2-C12)-alkenylcarbonyloxy, (C2-C12)-alkynylcarbonyloxy, (C1-C12)-alkoxycarbonyloxy, (C1-C12)-alkoxy-(C1-C12)-alkoxycarbonyloxy, (C6-C12)-aryloxycarbonyloxy, (C7-C16)-aralkyloxycarbonyloxy, (C3-C8)-cycloalkoxycarbonyloxy, (C2-C12)-alkenyloxycarbonyloxy, (C2-C12)-alkynyloxycarbonyloxy, carbamoyl, N—(C1-C12)-alkylcarbamoyl, N,N-di(C1-C12)-alkylcarbamoyl, N—(C3-C8)-cycloalkylcarbamoyl, N,N-dicyclo-(C3-C8)-alkylcarbamoyl, N—(C1-C10)-alkyl-N—(C3-C8)-cycloalkylcarbamoyl, N—((C3-C8)-cycloalkyl-(C1-C6)-alkyl)carbamoyl, N—(C1-C6)-alkyl-N—((C3-C8)-cycloalkyl-(C1-C6)-alkyl)carbamoyl, N-(+)-dehydroabietylcarbamoyl, N—(C1-C6)-alkyl-N-(+)-dehydroabietylcarbamoyl, N—(C6-C12)-arylcarbamoyl, N—(C7-C16)-aralkylcarbamoyl, N—(C1-C10)-alkyl-N—(C6-C16)-arylcarbamoyl, N—(C1-C10)-alkyl-N—(C7-C16)-aralkylcarbamoyl, N—((C1-C16)-alkoxy-(C1-C10)-alkyl)carbamoyl, N—((C6-C16)-aryloxy-(C1-C10)-alkyl)carbamoyl, N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)carbamoyl, N—(C1-C10)-alkyl-N—((C1-C10)-alkoxy-(C1-C10)-alkyl)carbamoyl, N—(C1-C10)-alkyl-N—((C6-C12)-aryloxy-(C1-C10)-alkyl)carbamoyl, N—(C1-C10)-alkyl-N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)-carbamoyl, CON(CH2)h, in which a CH2 group can be replaced by, O, S, N—(C1-C8)-alkylimino, N—(C3-C8)-cycloalkylimino, N—(C3-C8)-cycloalkyl-(C1-C4)-alkylimino, N—(C6-C12)-arylimino, N—(C7-C16)-aralkylimino, N—(C1-C4)-alkoxy-(C1-C6)-alkylimino, and h is from 3 to 7;
• carbamoyloxy, N—(C1-C12)-alkylcarbamoyloxy, N,N-di-(C1-C12)-alkylcarbamoyloxy, N—(C3-C8)-cycloalkylcarbamoyloxy, N—(C6-C16)-arylcarbamoyloxy, N—(C7-C16)-aralkylcarbamoyloxy, N—(C1-C10)-alkyl-N—(C6-C12)-arylcarbamoyloxy, N—(C1-C10)-alkyl-N—(C7-C16)-aralkylcarbamoyloxy, N—((C1-C10)-alkyl)carbamoyloxy, N—((C6-C12)-aryloxy-(C1-C10)-alkyl)carbamoyloxy, N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)carbamoyloxy, N—(C1-C10)-alkyl-N—((C1-C10)-alkoxy-(C1-C10)-alkyl)carbamoyloxy, N—(C1-C10)-alkyl-N—((C6-C12)-aryloxy-(C1-C10)-alkyl)carbamoyloxy, N—(C1-C10)-alkyl-N—((C7-C16)-aralkyloxy-(C1-C10)-alkyl)carbamoyloxy, amino, (C1-C12)-alkylamino, di-(C1-C12)-alkylamino, (C3-C8)-cycloalkylamino, (C3-C12)-alkenylamino, (C3-C12)-alkynylamino, N—(C6-C12)-arylamino, N—(C7-C11)-aralkylamino, N-alkyl-aralkylamino, N-alkyl-arylamino, (C1-C12)-alkoxyamino, (C1-C12)-alkoxy-N—(C1-C10)-alkylamino, (C1-C12)-alkanoylamino, (C3-C8)-cycloalkanoylamino, (C6-C12)-aroylamino, (C7-C16)-aralkanoylamino, (C1-C12)-alkanoyl-N—(C1-C10)-alkylamino, (C3-C8)-cycloalkanoyl-N—(C1-C10)-alkylamino, (C6-C12)-aroyl-N—(C1-C10)-alkylamino, (C7-C11)-aralkanoyl-N—(C1-C10)-alkylamino, (C1-C12)-alkanoylamino-(C1-C8)-alkyl, (C3-C8)-cycloalkanoylamino-(C1-C8)-alkyl, (C6-C12)-aroylamino-(C1-C8)-alkyl, (C7-C16)-aralkanoylamino-(C1-C8)-alkyl, amino-(C1-C10)-alkyl, N—(C1-C10)-alkylamino-(C1-C10)-alkyl, N,N-di-(C1-C10)-alkylamino-(C1-C10)-alkyl, (C3-C8)-cycloalkylamino-(C1-C10)-alkyl, (C1-C12)-alkylmercapto, (C1-C12)-alkylsulfinyl, (C1-C12)-alkylsulfonyl, (C6-C16)-arylmercapto, (C6-C16)-arylsulfinyl, (C6-C16)-arylsulfonyl, (C7-C16)-aralkylmercapto, (C7-C16)-aralkylsulfinyl, or (C7-C16)-aralkylsulfonyl;
• including the physiologically active salts derived therefrom.