US2011130432A1PendingUtilityA1
Heterocyclic Carboxamides For Use As Thrombin Inhibitors
Est. expiryJun 23, 2028(~1.9 yrs left)· nominal 20-yr term from priority
C07D 405/14A61P 43/00C07D 413/12C07D 403/12A61P 7/02A61P 7/00A61K 31/4155
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Claims
Abstract
This invention relates to novel pharmaceutically useful compounds of formula (I), in particular compounds that are competitive inhibitors of trypsin-like serine proteases, especially thrombin, their use as medicaments, pharmaceutical compositions containing them and synthetic routes to their production. Formula (I)
Claims
exact text as granted — not AI-modified1 . A compound of formula (I)
wherein
X is N, O or NH;
Y is CH 2 when X is O or NH, with X and Y connected via a single bond, or, alternatively,
Y is CH when X is N, with X and Y connected via a double bond;
R 1 is a 5-membered heteroaryl ring containing 2, 3 or 4 heteroatoms, selected from N, O and S, wherein at least 2 heteroatoms are N, and 0 or 1 heteroatoms are O or S, wherein said 5-membered heteroaryl ring is substituted, at any carbon ring atom, by 0, 1 or 2 substituents independently selected from C 1-6 alkyl and a 6-membered heteroaryl ring containing 1 or 2 nitrogen atoms, wherein said 6-membered heteroaryl ring is substituted, at any carbon ring atom, by 0, 1, 2 or 3 substituents independently selected from C 1-6 alkyl;
R 2 is H, halogen, cyano, C 1-6 alkyl and C 1-6 alkoxy, wherein said C 1-6 alkyl or C 1-6 alkoxy is substituted by 0, 1, 2, 3, 4 or 5 halogen;
G represents
wherein
R 3 is H, R 5 , C 1-6 alkyl, C 2-6 alkenyl, C 2-6 alkynyl or C 3-6 cycloalkyl, wherein each of said C 1-6 alkyl, C 2-6 alkenyl, C 2-6 alkynyl and C 3-6 cycloalkyl are independently substituted by 0, 1, 2, 3, 4 or 5 substituents selected from halogen and 0, 1 or 2 substituents selected from OH, oxo, cyano, NH 2 , NH(C 1-4 alkyl), N(C 1-4 alkyl) 2 , C 1-4 alkyl, C 3-6 cycloalkyl, C 4-7 cycloalkenyl, cycloheteroalkyl, R 5 and R 6 ;
R 5 is phenyl,
a 5 or 6-membered heteroaromatic ring containing 1, 2 or 3 heteroatoms independently selected from O, S and N,
a 4-, 5- or 6-membered cycloheteroalkyl ring containing 1 or 2 heteroatoms independently selected from O, S and N or
a phenyl-fused 5- or 6-membered cycloheteroalkyl ring containing 1 or 2 heteroatoms independently selected from O, S and N, wherein said phenyl, said heteroaromatic ring, said cycloheteroalkyl ring and said phenyl-fused cycloheteroalkyl ring are substituted, at any carbon ring atom, by 0, 1, 2, 3, 4 or 5 substituents independently selected from COOH, OH, halogen, CF 3 , CHF 2 , CH 2 F, cyano, C 1-6 alkyl, R 6 and SO 2 R 7 ;
R 6 is C 1-6 alkoxy, wherein said C 1-6 alkoxy is substituted by 0, 1, 2, 3, 4 or 5 halogen;
R 7 is C 1-6 alkyl;
R 4 is OH, OC(O)R 7 , OC(O)R 8 or NHR 9 ;
R 8 is phenyl, wherein said phenyl is substituted by 0, 1, 2, 3, 4 or 5 substituents independently selected from C 1-4 alkyl, C 1-4 alkoxy, cyano, F, CF 3 , CHF 2 and CH 2 F or C 1-4 alkyl, wherein said C 1-4 alkyl is substituted by 0, 1, 2 or 3 substituents independently selected from methyl and ethyl and 0 or 1 substituents selected from phenyl, wherein said phenyl is substituted by 0, 1, 2, 3, 4 or 5 substituents independently selected from C 1-4 alkyl, C 1-4 alkoxy, cyano, F, CF 3 , CHF 2 , CH 2 F and OC(O)R 7 ;
R 9 is H, COOR 7 or SO 2 R 7 wherein said R 7 is substituted by 0, 1, 2 or 3 substituents independently selected from OH, halogen, cyano, R 6 and C 3-7 cycloalkyl;
Q is O, CH 2 or S(O) n ;
W is C or N;
n is independently 0, 1 or 2;
each t is independently 0, 1 or 2;
u is independently 0 or 1;
R 10 is 0, 1, 2, 3, 4 or 5 substituents selected from halogen, OH, oxo, cyano, C 1-4 alkyl, C 3-6 cycloalkyl, R 5 and R 6 , wherein said C 1-4 alkyl is substituted by 0 or 1 substituent selected from R 5 , NH 2 , NH(C 1-4 alkyl) or N(C 1-4 alkyl) 2 ; and
R 11 is 0, 1, 2, 3, 4 or 5 substituents selected from halogen, OH, cyano, C 1-4 alkyl, C 3-6 cycloalkyl, R 5 and R 6 , wherein said C 1-4 alkyl is substituted by 0 or 1 substituent selected from R 5 , NH 2 , NH(C 1-4 alkyl) or N(C 1-4 alkyl) 2 ;
or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
2 . A compound according to claim 1 , wherein G is
or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
3 . A compound according to claim 2 , wherein
R 1 is a 5-membered heteroaryl ring containing 2, 3 or 4 heteroatoms, selected from N, O and S, wherein at least 2 heteroatoms are N, and 0 or 1 heteroatoms are O or S; R 2 is H or halogen; R 3 is C 1-6 alkyl, C 3-6 cycloalkyl, a 5 or 6-membered heteroaromatic ring containing 1, 2 or 3 heteroatoms independently selected from O, S and N, a 4-, 5- or 6-membered cycloheteroalkyl ring containing 1 or 2 heteroatoms independently selected from O, S and N, or R 12 , wherein said C 1-6 alkyl, said C 3-6 cycloalkyl, said heteroaromatic ring and said cycloheteroalkyl ring are substituted by 0 or 1 substituents selected from NH 2 , NH(C 1-4 alkyl), N(C 1-4 alkyl) 2 , C 3 cycloalkyl, R 6 or R 12 ; R 12 is phenyl, wherein said phenyl is substituted by 0, 1 or 2 substituents selected from halogen and R 6 ; and R 4 is OH, OC(O)R 7 , OC(O)R 8 or NH 2 ; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
4 . A compound according to claim 3 , wherein
R 1 is tetrazole; R 2 is H, Cl or F; R 3 is C 3-6 cycloalkyl, R 12 or C 1-6 alkyl, wherein said C 1-6 alkyl is substituted by 0 or 1 substituents selected from C 3 cycloalkyl, N(C 1-4 alkyl) 2 , R 6 or R 12 ; and R 4 is OH or OC(O)R 7 ; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
5 . A compound according to claim 3 , wherein the stereochemical configuration around the carbon in the pyrazolidine, dihydropyrazole or isoxazolidine, i.e. the ring containing X and Y, which is covalently bound to the carbonyl is (S) and the stereochemical configuration around the carbon substituted by R 3 and R 4 in G is (R);
or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
6 . A compound according to claim 1 , wherein G is
or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
7 . A compound according to claim 6 , wherein
R 1 is a 5-membered heteroaryl ring containing 2, 3 or 4 heteroatoms, selected from N, O and S, wherein at least 2 heteroatoms are N, and 0 or 1 heteroatoms are O or S; R 2 is H or halogen; Q is O or CH 2 ; each t is independently 0 or 1; R 10 is 0, 1 or 2 substituents selected from oxo, C 1-4 alkyl, R 5 and R 6 ; and R 5 is phenyl, which is substituted, by 0, 1, 2, 3, 4 or 5 substituents independently selected from COOH, OH, halogen, CF 3 , cyano, C 1-6 alkyl, R 6 and SO 2 R 7 ; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
8 . A compound according to claim 7 , wherein
R 1 is tetrazole; R 2 is H, Cl or F; and R 10 is 0, 1 or 2 substituents selected from oxo and C 1-4 alkyl; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
9 . A compound according to claim 1 , wherein G is
or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
10 . A compound according to claim 9 , wherein
R 1 is a 5-membered heteroaryl ring containing 2, 3 or 4 heteroatoms, selected from N, O and S, wherein at least 2 heteroatoms are N, and 0 or 1 heteroatoms are O or S; R 2 is H or halogen; R 4 is OH, OC(O)R 7 , OC(O)R 8 or NH 2 ; Q is O or CH 2 ; u is independently 0 or 1; R 10 is 0, 1 or 2 substituents selected from C 1-4 alkyl, halogen and R 6 ; and R 11 is 0, 1 or 2 substituents selected from C 1-4 alkyl, halogen and R 6 ; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
11 . A compound according to claim 10 , wherein
R 1 is tetrazole; R 2 is Cl; R 4 is OH or OC(O)R 7 ; R 10 is 0, 1 or 2 substituents selected from C 1-4 alkyl, F, Cl, OCH 3 , OCF 3 , OCHF 2 and OCH 2 F; and R 11 is 0, 1 or 2 substituents selected from C 1-4 alkyl, F, Cl, OCH 3 , OCF 3 , OCHF 2 and OCH 2 F; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
12 . A compound according to claim 7 , wherein
the stereochemical configuration around the carbon in the pyrazolidine, dihydropyrazole or isoxazolidine, i.e. the ring containing X and Y, which is covalently bound to the carbonyl is (S); or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
13 . A compound according to claim 3 , wherein
X is NH and Y is CH 2 , with X and Y connected via a single bond; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
14 . A compound according to claim 3 , wherein
X is O and Y is CH 2 , with X and Y connected via a single bond; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
15 . A compound according to claim 3 , wherein
X is N and Y is CH, with X and Y connected via a double bond; or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
16 . A compound according to claim 1 which is selected from
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-(4-fluorophenyl)-2-hydroxyacetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2,3-difluorophenyl)(hydroxy)acetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)-1-[(2R)-3-tert-Butoxy-2-hydroxypropanoyl]-N-[5-chloro-2-(1H-tetrazol-1-yl)benzyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(3,5-difluorophenyl)(hydroxy)acetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-cyclopentyl-2-hydroxyacetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2,4-difluorophenyl)(hydroxy)acetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-2-(3-methylphenyl)acetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-5-methylhexanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2-fluorophenyl)(hydroxy)acetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxyhexanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-3-(1-methylcyclopropyl)propanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(4-hydroxy-3,4-dihydro-2H-chromen-4-yl)carbonyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-2-phenylacetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-4,4-dimethylpentanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-cyclohexyl-2-hydroxyacetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-3-methoxy-3-methylbutanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-3-phenylpropanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-(4-methyl-D-leucyl)-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-3-cyclopropyl-2-hydroxypropanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2R)-2-hydroxy-3,3-dimethylbutanoyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(3-cyanophenyl)(hydroxy)acetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
(5S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-1-[(2S)-2-(4-fluorophenyl)-2-hydroxyacetyl]-4,5-dihydro-1H-pyrazole-5-carboxamide,
[(1R)-2-[(5S)-5-[[5-Chloro-2-(tetrazol-1-yl)phenyl]methylcarbamoyl]-4,5-dihydropyrazol-1-yl]-1-(4-fluorophenyl)-2-oxo-ethyl]acetate,
(1R)-2-[(5S)-5-{[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]carbamoyl}-4,5-dihydro-1H-pyrazol-1-yl]-1-(4-fluorophenyl)-2-oxoethyl 3-methylbutanoate,
(1R)-2-[(5S)-5-{[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]carbamoyl}-4,5-dihydro-1H-pyrazol-1-yl]-1-(4-fluorophenyl)-2-oxoethyl butanoate,
(1R)-2-[(5S)-5-{[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]carbamoyl}-4,5-dihydro-1H-pyrazol-1-yl]-1-(4-fluorophenyl)-2-oxoethyl 2-methylpropanoate,
(1R)-2-[(5S)-5-{[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]carbamoyl}-4,5-dihydro-1H-pyrazol-1-yl]-1-(4-fluorophenyl)-2-oxoethyl pentanoate,
(1R)-2-[(5S)-5-{[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]carbamoyl}-4,5-dihydro-1H-pyrazol-1-yl]-1-(4-fluorophenyl)-2-oxoethyl propanoate,
(1R)-2-[(5S)-5-{[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]carbamoyl}-4,5-dihydro-1H-pyrazol-1-yl]-1-(4-fluorophenyl)-2-oxoethyl benzoate,
(R)-2-((S)-5-(5-Chloro-2-(1H-tetrazol-1-yl)benzylcarbamoyl)-4,5-dihydro-1H-pyrazol-1-yl)-1-(4-fluorophenyl)-2-oxoethyl 3-(2,4-dimethyl-6-(propionyloxy)phenyl)-3-methylbutanoate,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-(4-fluorophenyl)-2-hydroxyacetyl]isoxazolidine-3-carboxamide,
(3S)-2-(O-tert-Butyl-D-seryl)-N-[5-chloro-2-(1H-tetrazol-1-yl)benzyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2,4-difluorophenyl)(hydroxy)acetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2,3-difluorophenyl)(hydroxy)acetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(3,5-difluorophenyl)(hydroxy)acetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2-fluorophenyl)(hydroxy)acetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[hydroxy(3-methylphenyl)acetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxyhexanoyl]isoxazolidine-3-carboxamide,
3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-5-methylhexanoyl]isoxazolidine-3-carboxamide,
(3S)-2-[(2R)-3-tert-Butoxy-2-hydroxypropanoyl]-N-[5-chloro-2-(1H-tetrazol-1-yl)benzyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-cyclopentyl-2-hydroxyacetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-cyclohexyl-2-hydroxyacetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-3-(1-methylcyclopropyl)propanoyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-2-phenylacetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-3,3-dimethylbutanoyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-4,4-dimethylpentanoyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-3-phenylpropanoyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(3-cyanophenyl)(hydroxy)acetyl]isoxazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-2-phenylacetyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2-fluorophenyl)(hydroxy)acetyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2,4-difluorophenyl)(hydroxy)acetyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-(4-fluorophenyl)-2-hydroxyacetyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(4-hydroxy-3,4-dihydro-2H-chromen-4-yl)carbonyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-4,4-dimethylpentanoyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-cyclohexyl-2-hydroxyacetyl]pyrazolidine-3-carboxamide,
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-3-phenylpropanoyl]pyrazolidine-3-carboxamide or
(3S)—N-[5-Chloro-2-(1H-tetrazol-1-yl)benzyl]-2-[(2R)-2-hydroxy-3,3-dimethylbutanoyl]pyrazolidine-3-carboxamide;
or a pharmaceutically acceptable salt or an enantiomer or a pharmaceutically acceptable salt of said enantiomer.
17 . A pharmaceutical formulation comprising a compound of formula (I) according to claim 1 in admixture with at least one pharmaceutically acceptable carrier, excipient or diluent.
18 - 23 . (canceled)
24 . A method of treatment of a condition where inhibition of thrombin is beneficial, which method comprises administration of a therapeutically effective amount of a compound as defined in claim 1 to a person suffering from, or susceptible to, such a condition.
25 . A method of treatment and prevention of thromboembolic disorders, which method comprises administration of a therapeutically effective amount of a compound as defined in claim 1 to a person suffering from, or susceptible to, thrombophilia conditions.Join the waitlist — get patent alerts
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