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.