Compounds of structural formula (I) are modulators of the androgen
receptor (AR) in a tissue selective manner. They are useful as agonists
of the androgen receptor in bone and/or muscle tissue while antagonizing
the AR in the prostate of a male patient or in the uterus of a female
patient. These compounds are therefore useful in the enhancement of
weakened muscle tone and the treatment of conditions caused by androgen
deficiency or which can be ameliorated by androgen administration,
including osteoporosis, osteopenia, glucocorticoid-induced osteoporosis,
periodontal disease, bone fracture, bone damage following bone
reconstructive surgery, sarcopenia, frailty, aging skin, male
hypogonadism, postmenopausal symptoms in women, atherosclerosis,
hypercholesterolemia, hyperlipidemia, obesity, aplastic anemia and other
hematopoietic disorders, inflammatory arthritis and joint repair,
HIV-wasting, prostate cancer, cancer cachexia, Alzheimer's disease,
muscular dystrophies, cognitive impairment, decreased libido, premature
ovarian failure, and autoimmune disease, alone or in combination with
other active agents.