This invention is directed to compounds of the formula and the pharmaceutically-acceptable salts thereof, where the substituents are as defined in the Specification, which are
growth hormone secretogogues and which increase the level of endogenous
growth hormone. The compounds of this invention are useful for the treatment and prevention of
osteoporosis and / or frailty, congestive
heart failure, frailty associated with aging,
obesity; accelerating
bone fracture repair, attenuating
protein catabolic response after a major operation, reducing
cachexia and
protein loss due to chronic illness, accelerating
wound healing, or accelerating the
recovery of burn patients or patients having undergone major
surgery; improving
muscle strength, mobility, maintenance of
skin thickness, metabolic
homeostasis or renal
homeostasis. The compounds of the present invention are also useful in treating
osteoporosis and / or frailty when used in combination with: a
bisphosphonate compound such as alendronate;
estrogen, conjugated estrogens, and optionally progesterone; an
estrogen agonist or
antagonist; or
calcitonin, and pharmaceutical compositions useful therefor. Further, the present invention is directed to pharmaceutical compositions useful for increasing the endogenous production or release of
growth hormone in a human or other animal which comprises an effective amount of a compound of the present invention and a
growth hormone secretagogue selected from GHRP-6, Hexarelin, GHRP-1, growth
hormone releasing factor (GRF), IGF-1, IGF-2 or B-HT920. The invention is also directed to intermediates useful in the preparation of compounds of Formula I.