AU2020202459A1 - Cyclosporin compositions - Google Patents
Cyclosporin compositions Download PDFInfo
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Abstract
Disclosed herein are therapeutic methods, compositions,
and medicaments related to cyclosporine.
Description
This application is based, and claims priority under 35 U.S.C.
§ 120 to U.S. Provisional Application Serial No. 60/820,239, filed
July 25, 2006; U.S. Provisional Application Serial No. 60/829,796,
filed October 17, 2006; U.S. Provisional Application Serial No.
60/829,808, filed October 17, 2006; U.S. Provisional Application
Serial No. 60/883,525, filed January 5, 2007; U.S. Provisional
Application Serial No. 60/916,352, filed May 7, 2007; and U.S.
Provisional Application Serial No. 60/869,459, filed December 11,
2006; each of which is hereby incorporated by reference in their
entirety.
Abnormalities associated with the function of the lacrimal
gland or with tearing often cause discomfort to mammals who suffer
from these abnormalities.
Fig. 1 Mean (±SD) cornea cyclosporine A concentrations (semi
log) following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Fig. 2 Mean (±SD) conjunctiva cyclosporine A concentrations
(semi-log) following a single bilateral topical ocular
instillation of one of three 0.05% cyclosporine A
formulations to New Zealand White rabbits.
Fig. 3 Mean (±SD) sclera cyclosporine A concentrations (semi
log) following a single bilateral topical ocular
instillation of one of three 0.05% cyclosporine A
formulations to New Zealand White rabbits.
Fig. 4 Mean (±SD) eyelid margin cyclosporine A (concentrations
(semi-log) following a single bilateral topical ocular
instillation of one of three 0.05% cyclosporine A
formulations to New Zealand White rabbits.
Fig. 5 Mean (iSD) nasolacrimal duct cyclosporine A
concentrations (semi-log) following a single bilateral
topical ocular instillation of one of three 0.05%
cyclosporine A formulations to New Zealand White rabbits.
A composition comprising cyclosporin A at a concentration of
from about 0.0001% (w/v) to less than about 0.05% (w/v) is
disclosed herein.
We have surprisingly discovered that compositions of
cyclosporin A at a concentration of less than about 0.05% (w/v) can
be prepared that will be therapeutically effective.
In one embodiment, the compositions disclosed herein are
administered to an eye of a mammal in need thereof to enhance or
restore lacrimal gland tearing.
In another embodiment, the compositions disclosed herein are
administered to an eye of a mammal in need thereof to increase tear
production in a tear-deficient eye.
In another embodiment, the compositions disclosed herein are
administered to an eye of a mammal in need thereof to treat
keratoconjunctivitis sicca.
In another embodiment, the compositions disclosed herein are
administered to an eye of a mammal in need thereof to treat dry eye
disease.
H 3C \3C H CH 3
--- H CH 3 0 I || ly
I MeLeu-MeVaI-N-C-C-Abu-MeG H MeLeu-D-Ala-Ala-MeLeu-Val-MeLeu
Cyclosporin A
Cyclosporin A is a cyclic peptide with immunosuppressive
properties having the structure shown above. It is also known by
other names including cyclosporine, cyclosporine A, ciclosporin,
and ciclosporin A.
Treatment Methods
One embodiment is a method of treating dry eye disease comprising topically administering to a mammal in need thereof a composition comprising cyclosporin A at a concentration of from 0.0001% (w/v) to less than about 0.05% (w/v). The treatment generally comprises administering 10-50 piL drops of the compositions disclosed herein topically to the eye or eyes of the mammal or human. Determination of the number of drops administered per day to the person or mammal to provide effective relief is within the skill of the ordinary artisan. In one embodiment, the composition is administered from 1 to 4 times per day. In another embodiment, the composition is administered twice a day. In another embodiment, the composition is administered only once a day. In another embodiment, less than 14% of patients suffer ocular burning when the composition is administered only once a day for a period of three months. In another embodiment, less than 10% of patients suffer ocular burning when the composition is administered only once a day for a period of three months. In another embodiment, less than 8% of patients suffer ocular burning when the composition is administered only once a day for a period of three months. For the purposes of this disclosure, "treat," "treating," or "treatment" refer to the use of a compound, composition, therapeutically active agent, or drug in the diagnosis, cure, mitigation, treatment, prevention of disease or other undesirable condition, or to affect the structure or any function of the body of man or other animals.
Compositions
The concentration of cyclosporin A is less than about 0.05%.
This is intended to mean that the concentration is lower than the
concentration in the commercially available 0.05% cyclosporin A
emulsion known as Restasis*.
In another embodiment, the concentration of cyclosporin A is
from about 0.005% (w/v) to about 0.04% (w/v).
In another embodiment, the concentration of cyclosporin A is
from about 0.02% (w/v) to about 0.04% (w/v).
In another embodiment, the concentration of cyclosporine A is
about 0.005% (w/v).
In another embodiment, the concentration of cyclosporine A is
about 0.015% (w/v).
In another embodiment, the concentration of cyclosporine A is
about 0.02% (w/v).
In another embodiment, the concentration of cyclosporine A is
about 0.03% (w/v).
In another embodiment, the concentration of cyclosporine A is
about 0.04% (w/v).
A liquid which is ophthalmically acceptable is formulated such
that it can be administered topically to the eye. The comfort
should be maximized as much as practicable, although sometimes
formulation considerations (e.g. drug stability, bioavailability,
etc.) may necessitate less than optimal comfort. In the case that comfort cannot be maximized, the liquid should be formulated such that the liquid is tolerable to the patient for topical ophthalmic use. Additionally, an ophthalmically acceptable liquid should either be packaged for single use, or contain a preservative to prevent contamination over multiple uses. For ophthalmic application, solutions or medicaments are often prepared using a physiological saline solution as a major vehicle.
Ophthalmic solutions are often maintained at a comfortable pH with an appropriate buffer system. The formulations may also contain conventional, pharmaceutically acceptable preservatives, stabilizers and surfactants. Various buffers and means for adjusting pH may be used so long as the resulting preparation is ophthalmically acceptable. Accordingly, buffers include, but are not limited to, acetate buffers, citrate buffers, phosphate buffers and borate buffers. Acids or bases may be used to adjust the pH of these formulations as needed. In another embodiment, the composition contains a preservative. Preservatives that may be used in the pharmaceutical compositions disclosed herein include, but are not limited to, cationic preservatives such as quaternary ammonium compounds including benzalkonium chloride, polyquad, and the like; guanidine-based preservatives including PHMB, chlorhexidine, and the like; chlorobutanol; mercury preservatives such as thimerosal, phenylmercuric acetate and phenylmercuric nitrate; and oxidizing preservatives such as stabilized oxychloro complexes (e.g. Purite"). In another embodiment, the composition contains a surfactant. A surfactant may be used for assisting in dissolving an excipient or an active agent, dispersing a solid or liquid in a composition, enhancing wetting, modifying drop size, or a number of other purposes. Useful surfactants include, but are not limited to surfactants of the following classes: alcohols; amine oxides; block polymers; carboxylated alcohol or alkylphenol ethoxylates; carboxylic acids/fatty acids; ethoxylated alcohols; ethoxylated alkylphenols; ethoxylated aryl phenols; ethoxylated fatty acids; ethoxylated; fatty esters or oils (animal & veg.); fatty esters; fatty acid methyl ester ethoxylates; glycerol esters; glycol esters; lanolin-based derivatives; lecithin and lecithin derivatives; lignin and lignin derivatives; methyl esters; monoglycerides and derivatives; polyethylene glycols; polymeric surfactants; propoxylated & ethoxylated fatty acids, alcohols, or alkyl phenols; protein-based surfactants; sarcosine derivatives; sorbitan derivatives; sucrose and glucose esters and derivatives. In particular, ethoxylate surfactants are useful. An ethoxylate surfactants is one that comprises the moiety O(CH 2 CH 2O),-OH, wherein n is at least about 1. In one embodiment n is from about 1 to about 10,000. In another embodiment, n is from 1 to about 1000. In another embodiment, n is from about 1 to about 500. Some ethoxylates contain one ethoxylate moiety. In other words, there is a single ethoxylate chain on each molecule. Examples of surfactants with one ethoxylate moiety, include, but are not limited to:
Ethoxylated alcohols wherein the alcohol has a single hydroxyl
unit; alkylphenol ethoxylates; ethoxylated fatty acids; fatty acid
methyl ester ethoxylates; polyethylene glycols; and the like.
Ethoxylates may comprise more than one ethoxylate moiety. In
other words, there may be ethoxylate moieties attached to several
different parts of the molecule. Examples include, but are not
limited to: block polymers; ethoxylated oils; sorbitan derivatives;
sucrose and glucose ethoxylates; and the like.
Block Polymers: These are polymers with the structure A-B-A',
wherein A and A' are polyethylene chains of 1 or more ethylene
units, and B is a polypropylene chain of one or more propylene
units. Generally, but not necessarily, A and A' are approximately
the same length.
In one embodiment, A and A' contain from about 2 to about 200
ethylene units.
In another embodiment, A and A' contain from about 5 to about 100
ethylene units.
In another embodiment, A and A' contain about 7 to about 15
ethylene units.
In another embodiment, A and A' contain about 7, about 8, or about
12 ethylene units.
In another embodiment, B contains from about 25 to about 100
propylene units.
In another embodiment, B contains from about 30 to about 55
propylene units.
In another embodiment, B contains about 30, about 34, or about 54
propylene units.
In another embodiment, the molecular weight is from about 1000 to
about 20000.
In another embodiment, the molecular weight is from about 2000 to
about 10000. In another embodiment, the molecular weight is about 2500, about
3000, about 3800, or about 8400. These include but are not limited to:
Poloxalene: wherein A has about 12 ethylene oxide units, B has
about 34 propylene oxide units, A' has about 12 ethylene oxide
units, and the average molecular weight is about 3000.
Poloxamer 182: wherein A has about 8 ethylene oxide units, B has
about 30 propylene oxide units, A' has about 8 ethylene oxide
units, and the average molecular weight is about 2500
Poloxamer 188: wherein A has about 75 ethylene oxide units, B has
about 30 propylene oxide units, A' has about 75 ethylene oxide
units, and the average molecular weight is about 8400.
Poloxamer 331: wherein A has about 7 ethylene oxide units, B has
about 54 propylene oxide units, A' has about 7 ethylene oxide
units, and the average molecular weight is about 3800;
Ethoxylated Alcohols
These include but are not limited to:
Ethoxylates of linear alcohols having from about 6 to about 20
carbon atoms.
In one embodiment, the linear alcohol has from about 10 to about 16
carbon atoms.
In another embodiment, n is from about 1 to about 100.
In another embodiment, n is from about 1 to about 50.
In another embodiment, n is from about 5 to about 50 ethylene oxide
units.
In another embodiment, n is from about 1 to about 20 ethylene oxide
units.
In another embodiment, n is from about 30 to about 50 ethylene oxide units. Ethoxylated Alkylphenols These are alkylphenols that are ethoxylated, i.e. the phenolic OH is replaced with an ethoxylate moiety. These include but are not limited to: octylphenol ethoxylate, i.e. C 8H 1 7Ph(OCH 2 CH2 0)nH. nonylphenol ethoxylate, i.e. C 9HigPh(OCH 2 CH2 0)nH. alkyphenols of the above formula wherein n is from about 1 to about 100. alkyphenols of the above formula wherein n is from about 1 to about 50. alkyphenols of the above formula wherein n is from about 9 to about 15. Octyl Phenol 1.5 Mole Ethoxylate (i.e. n is an average of about 1.5); Octyl Phenol 5 Mole Ethoxylate;; Octyl Phenol 7 Mole Ethoxylate;Octyl Phenol 9 Mole Ethoxylate; Octyl Phenol 12 Mole Ethoxylate; Octyl Phenol 40 Mole Ethoxylate; Nonyl Phenol 1.5 Mole Ethoxylate; Nonyl Phenol 4 Mole Ethoxylate; Nonyl Phenol 6 Mole Ethoxylate; Nonyl Phenol 9 Mole Ethoxylate; Nonyl Phenol 10 Mole Ethoxylate; Nonyl Phenol 10.5 Mole Ethoxylate; Nonyl Phenol 12 Mole Ethoxylate; Nonyl Phenol 15 Mole Ethoxylate; Nonyl Phenol 15 Mole Ethoxylate; Nonyl Phenol 30 Mole Ethoxylate; and Nonyl Phenol 40 Mole Ethoxylate; Ethoxylated Fatty Acids, These include but are not limited to: ethoxylates which are esterified to form either: monoesters, i.e. RCO 2 (CH 2CH 2 0),OH, where RCO 2 H is a fatty acid; or diesters, i.e. RCO 2 (CH 2CH 2 0)nC(=0)R.
Fatty acids include, but are not limited to:
Saturated fatty acids, which have no C=C moieties and include
myristic acid, palmitic acid, stearic acid, arachidic acid, behenic
acid, lignoceric acid.
Unsaturated fatty acids, including the following:
monounsaturated fatty acids, which have one C=C group such as
palmitoleic acid, oleic acid, and nervonic acid;
diunsaturated fatty acids, which have two C=C groups, such as
linoleic acid;
triiunsaturated fatty acids, which have three C=C groups, such
as a-linolenic acid and y-linolenic acid;
tetraunsaturated fatty acids, which have four C=C groups, such
as arachidonic acid; and
pentaunsaturated fatty acids, which have five C=C groups, such
as eicosapentaenoic acid.
The following may also be used:
Lauric Acid; 14 carbon fatty acids such as myristic acid; 16 carbon
fatty acids such as palmitic and palmitoleic acid; 18 carbon fatty
acids such as stearic acid, oleic acid, linoleic acid, a-linolenic
acid, and y-linolenic acid; 20 carbon fatty acids such as
eicosapentaenoic acid; 22 carbon fatty acids such as arachidic
acid; and 24 carbon carbon fatty acids such as lignoceric acid and
nervonic acid.
In one embodiment, n is from about 2 to about 100.
In another embodiment, n is from about 5 to about 50.
In another embodiment, n is from about 30 to 50. Ethoxylated Fatty Esters or Oils (Animal & Veg.).
These are the products which result from reacting ethylene oxide
with a fatty ester or an oil. When a fatty oil is used, the products is a mixture of ethoxylates of the fatty acids present in the oil, ethoxylates of glycerine, ethoxylates of mono and diglycerides, and the like.
Specific examples include, but are not limited to:
Ethoxylates of the following oils: Anise oil, Castor oil, Clove
oil, Cassia oil, Cinnamon oil; Almond oil, Corn oil, Arachis oil,
Cottonseed oil, Safflower oil, Maize oil, Linseed oil, Rapeseed
oil, Soybean oil, Olive oil, Caraway oil, Rosemary oil, Peanut oil,
Peppermint oil, Sunflower oil, Eucalyptus oil and Sesame oil;
Coriander oil, Lavender oil, Citronella oil, Juniper oil, Lemon
oil, orange oil, Clary sage oil, Nutmeg oil, Tea tree oil, coconut
oil, tallow oil, and lard;
In one embodiment, from 1 to about 50 moles of ethylene oxide is
used per mole of the oil triglyceride.
In another embodiment, from about 30 to about 40 moles of ethylene
oxide is used per mole of the oil triglyceride.
Ethylene oxide may also react with a fatty acid ester with a
formula RCO 2 R' to form RCO 2 (CH 2 CH 2 0)nR'. Thus, surfactants having
the formula RCO 2 (CH 2 CH 2 0)nR', where RCO 2 H is a fatty acid and R' is
alkyl having from 1 to 6 carbons are contemplated.
One embodiment is a fatty acid methyl ester ethoxylate,
wherein R' is methyl.
In another embodiment, RCO 2 H is Lauric Acid; a 14 carbon fatty
acid such as myristic acid; a 16 carbon fatty acid such as palmitic
and palmitoleic acid; an 18 carbon fatty acids such as stearic
acid, oleic acid, linoleic acid, o-linolenic acid, and y-linolenic
acid; a 20 carbon fatty acids such as eicosapentaenoic acid; a 22
carbon fatty acids such as arachidic acid; or a 24 carbon carbon
fatty acids such as lignoceric acid and nervonic acid.
Polyethylene Glycols are ethoxylates that are unsubstituted, or
terminated with oxygen on both ends, i.e. HO(CH 2 CH 2O)nH,
Sorbitan Derivatives: These are ethoxylated sorbates having a fatty acid capping one or
more of the ethoxylated chains. For example, polysorbate 80 has an
oleate cap as shown in the structure below. HO(CH 2 CH 2 0). ,(OCH 2CH 2 )xOH
(OCH 2 CH 2)yOH 0 0
(OCH 2CH 2),-0 1 7 H 33 C Polysorbate 80 (Sum of w, x, y, and z is 20) These compounds are named as POE (w+x+y+z) sorbitan mono (or di- or
tri-) fatty acid.
For example, Polysorbate 80 is POE (20) sorbitan monooleate.
Thus, the number in parenthesis is the total number of ethylene
oxide units on the molecule, and the ending is the number of acid
caps and the capping acid.
These include but are not limited to:
Sorbitan derivatives wherein the total number of ethylene oxide
units is from 3 to 30;
Sorbitan derivatives wherein the total number of ethylene oxide
units is 4, 5, or 20;
Sorbitan derivatives wherein the capping acid is laurate,
palmitate, stearate, or oleate;
The sorbitan derivative may be a POE sorbitan monolaurate;
a POE sorbitan dilaurate;
a POE sorbitan trilaurate;
a POE sorbitan monopalmitate; a POE sorbitan dipalmitate; a POE sorbitan tripalmitate; a POE sorbitan monostearate; a POE sorbitan distearate; a POE sorbitan tristearate; a POE sorbitan monooleate; a POE sorbitan dioleate; or a POE sorbitan trioleate;
Specific examples include:
POE (20) sorbitan monolaurate; POE (4) sorbitan monolaurate; POE
(20) sorbitan monopalmitate; POE (20) monostearate; POE (20)
sorbitan monostearate; POE (4) sorbitan monostearate; POE (20)
sorbitan tristearate; POE (20) sorbitan monoleate; POE (20)
sorbitan 15 monoleate; POE (5) sorbitan 10 monoleate; POE (20)
sorbitan trioleate; and
Sucrose and Glucose Esters and Derivatives: Although there are a number of sucrose and glucose based
surfactants, some sucrose and glucose esters and derivatives are
similar to the sorbate derivatives described above. In other words,
one, several, or all of the hydroxyl moieties of the sugar are
ethoxylated, and one or more of the ethoxylate chains are capped
with a carboxylic acid. Other sucrose and glucose esters are simply
ethoxylated, but do not have a capping carboxylic acid. Other
sucrose and glucose esters may be ethoxylated and capped with an
alkyl group formed by reaction with an alcohol. Other sucrose and
glucose esters may be esters or ethers of the sugars with
hydrophobic chains and have ethoxylates substituted in other
positions on the sugar.
Various useful vehicles may be used in the ophthalmic preparations disclosed herein. These vehicles include, but are not limited to, polyvinyl alcohol, povidone, hydroxypropyl methyl cellulose, poloxamers, carboxymethyl cellulose, hydroxyethyl cellulose, and acrylates (e.g. Pemulen@). Tonicity adjustors may be added as needed or convenient. They include, but are not limited to, salts, particularly sodium chloride, potassium chloride, mannitol and glycerin, or any other suitable ophthalmically acceptable tonicity adjustor. In a similar vein, an ophthalmically acceptable antioxidant includes, but is not limited to, sodium metabisulfite, sodium thiosulfate, acetylcysteine, butylated hydroxyanisole and butylated hydroxytoluene. Other excipient components which may be included in the ophthalmic preparations are cheating agents. A useful cheating agent is edetate disodium, although other chelating agents may also be used in place or in conjunction with it. Compositions may be aqueous solutions or emulsions, or some other acceptable liquid form. For an emulsion, one or more oils will be used to form the emulsion, and in some instances one or more surfactants will be required. Suitable oils include, but are not limited to anise oil, castor oil, clove oil, cassia oil, cinnamon oil, almond oil, corn oil, arachis oil, cottonseed oil, safflower oil, maize oil, linseed oil, rapeseed oil, soybean oil, olive oil, caraway oil, rosemary oil, peanut oil, peppermint oil, sunflower oil, eucalpytus oil, sesame oil, and the like. In one embodiment, the composition is an aqueous solution. In another embodiment, the composition contains no ethanol.
In another embodiment, the composition contains no hyauronic
acid.
In another embodiment, the composition contains no vitamin E
In another embodiment, the composition contains no
cyclodextrin A.
In another embodiment, the composition contains no
cyclodextrin.
Example 1
Ingredients Percent Amount needed (g) Ingredients for a 1 liter batch (% w/v)
Cyclosporine 0% for Placebo 0 grams for Placebo (P) (P) 0.03% (A) 0.30 (A) 0.04% (B) 0.40 (B) 0.05% (C) 0.5 (C) Carboxymethylcellulose 0.5 5.0 sodium Polysorbate 80 1.0 10.0 Glycerin 1.0 10.0 Mannitol 0.5 5.0 Sodium Citrate 0.4 4.0 Dihydrate Boric Acid 0.25 2.5 Sodium Borate 0.41 4.1 Decahydrate Potassium Chloride 0.14 1.4 Purite 0.01 0.1 Purified Water q.s. to 100% q.s to 100%
Compositions P, A, B and C, are prepared according to the
following procedure.
1. Measure Purified Water to about 90% of the batch size and place
in an appropriate beaker or container.
2. Begin mixing the water with a strong mixer (Rotosolver) to
obtain a strong vortex.
3. Add the pre-weighed carboxymethylcellulose sodium into the
strong vortex. Continue strong mixing for at least 1 hour.
4. Slow mixer to a slow speed.
5. Add and dissolve the pre-weighed polysorbate 80.
6. Add and dissolve the pre-weighed glycerin.
7. Add and dissolve the pre-weighed mannitol.
8. Add and dissolve the pre-weighed sodium citrate dehydrate.
9. Add and dissolve the pre-weighed boric acid.
10. Add and dissolve the pre-weighed sodium borate decahydrate.
11. Add and dissolve the pre-weighed potassium chloride.
12. Check pH and adjust if necessary. Target pH is 7.5 +/- 0.1.
13. Add and dissolve the pre-weighed Purite.
14. Add sufficient quantity of Purified Water to attain the final batch volume. This will provide the finished placebo formulation (P).
Procedure for either 0.03% (A), 0.04% (B), 0.05% (C)
15. Measure the exact amount of Placebo (9815X) needed to satisfy the batch size requirements and place in a media bottle that contains a magnetic stir bar.
16. Add and dissolve the pre-weighed cyclosporine. Stir at a slow speed to avoid foaming. It will usually take overnight mixing to completely dissolve the cyclosporine.
17. After overnight mixing is completed, pump the cyclosporine solution through a Millipore Milligard pre-filter and a Pall Suporlife sterilizing filter and collect the filtrate aseptically.
18. The sterile filtrate can then be aseptically dispensed into multidose dropper bottles suitable for ophthalmic purpose.
19. The finished product should be tested for cyclosporine assay, pH, osmolality, viscosity, Purite, sterility, and antimicrobial effectiveness.
20. The finished product should be store at room temperature and
protected from light.
Example 2
The following formulations were prepared. D and E were
prepared by standard methods known in the art. F was prepared as
described above for A-C except that Pemulen TR-2 was substituted
for carboxymethylcellulose sodium, and the addition of the citrate
and borate buffers were omitted.
D E F Emulsion Emulsion Solution Cyclosporin A 0.05 0.05 0.05 Castor Oil 1.25 0.30 N/A Polyoxyethylene 40 Stearate, NF N/A 0.30 N/A Polysorbate 80 1.00 0.30 1.00 Glycerin 2.20 1.00 1.00 Mannitol N/A 2.00 2.00 Pemulen TR-2 0.05 0.10 0.10 Sodium Hydroxide pH pH pH (IN) adjustment adjustment adjustment Purified Water QS QS QS pH pH=7.4 7.39 7.35
Bioavailability The compositions disclosed and used herein provide a
therapeutically effective amount of cyclosporin A to a mammal.
However, while not intending to limit the scope of the invention in
any way, concentrations of cyclosporin A in the compositions may be
significantly lower than those normally associated with a therapeutically effective concentration. For example, one commercial preparation, marketed as Restasis© by Allergan, Inc., is a 0.05% cyclosporin A castor oil emulsion. Other compositions currently in development have concentrations of 0.1% or higher.
Reported herein are pharmacokinetic data for in vivo
experiments on rabbits. However, the rabbit experiments are
believed to be useful models for bioavailability in other mammals
including humans. Thus, although bioavailability parameters are
disclosed and featured in the claims, they should not be construed as limiting the treatment to rabbits only, but the compositions
characterized and defined by bioavailability in rabbits are also
contemplated for use in treatment in other mammals, particularly
humans.
In one embodiment, the composition provides more cyclosporin A
to the cornea of a person than Composition AA.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition BB.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition CC.
In one embodiment, the composition provides more cyclosporin A
to the cornea of a person than Composition DD.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition EE.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition FF.
In one embodiment, the composition provides more cyclosporin A
to the cornea of a person than Composition GG.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition HH.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition II.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition JJ.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition KK.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition LL.
In another embodiment, the composition provides more
cyclosporin A to the cornea of a person than Composition MM.
In one embodiment, the composition provides more cyclosporin A
to the conjunctiva of a person than Composition AA.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition BB.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition CC.
In one embodiment, the composition provides more cyclosporin A
to the conjunctiva of a person than Composition DD.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition EE.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition FF.
In one embodiment, the composition provides more cyclosporin A
to the conjunctiva of a person than Composition GG.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition HH.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition II.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition JJ.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition KK.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition LL.
In another embodiment, the composition provides more
cyclosporin A to the conjunctiva of a person than Composition MM.
In another embodiment, topical administration of one 35 iL
drop of said composition to each eye of a female New Zealand white
rabbit provides to the corneas of said rabbit at least about 500 ng
of cyclosporin A per gram of cornea of said rabbit at 30 minutes
after said topical administration.
In another embodiment, wherein topical administration of one
35 pL drop of said composition to each eye of a female New Zealand
white rabbit provides to the corneas of said rabbit at least about
1000 ng of cyclosporin A per gram of cornea of said rabbit at 30
minutes after said topical administration.
In another embodiment, topical administration of one 35 pL
drop of said composition to each eye of a female New Zealand white
rabbit provides to the corneas of said rabbit at least about 1400
ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes
after said topical administration.
In another embodiment, wherein topical administration of one
35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about
2000 ng of cyclosporin A per gram of cornea of said rabbit at 30
minutes after said topical administration.
In another embodiment, topical administration of one 35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about 2400 ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes after said topical administration. In another embodiment, topical administration of one 35 iL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about 17000 ng of cyclosporin A per gram of cornea of said rabbit over a period of 24 hours after said topical administration. In another embodiment, said composition is an aqueous solution containing from 0.005% to about 0.04% cyclosporin A, wherein topical administration of one 35 IL drop of said composition to each eye of a New Zealand rabbit provides at least about 17000 ng of cyclosporin A per gram of cornea to the corneas of said rabbit as determined by: topically administering said composition to each eye of each of 15 female New Zealand white rabbit test subjects; and determining the amount of cyclosporin A in the corneas of three subjects at times of about 0.5 hours, about 2 hours, about 6 hours, about 12 hours, and about 24 after administration to said subject; wherein the amount of cyclosporin A in the cornea is determined only once for each subject. In another embodiment said composition to each eye of a New Zealand rabbit provides at least about 30000 ng of cyclosporin A per gram of cornea to the corneas of said rabbit.
In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 45000 ng of cyclosporin A
per gram of cornea to the corneas of said rabbit.
In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 95000 ng of cyclosporin A
per gram of cornea to the corneas of said rabbit.
In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 155000 ng of cyclosporin A
per gram of cornea to the corneas of said rabbit. In another embodiment, topical administration of one 35 IL
drop of said composition to each eye of a female New Zealand white
rabbit provides to the conjunctivas of said rabbit at least about
6000 ng of cyclosporin A per gram of conjunctiva of said rabbit
over a period of 24 hours after said topical administration.
In another embodiment, said composition is an aqueous solution
containing from 0.005% to about 0.04% cyclosporin A, wherein
topical administration of one 35 pL drop of said composition to
each eye of a New Zealand rabbit provides at least about 6000 ng of
cyclosporin A per gram of conjunctiva to the conjunctivas of said
rabbit as determined by:
topically administering said composition to each eye of each of
15 female New Zealand white rabbit test subjects; and
determining the amount of cyclosporin A in the conjunctivas of
three subjects at times of about 0.5 hours, about 2 hours, about
6 hours, about 12 hours, and about 24 after administration to
said subject;
wherein the amount of cyclosporin A in the conjunctiva is
determined only a single time for each subject.
In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 5000 ng of cyclosporin A per
gram of conjunctiva to the conjunctiva of said rabbit.
In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 7000 ng of cyclosporin A per
gram of conjunctiva to the conjunctiva of said rabbit.
In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 10000 ng of cyclosporin A
per gram of conjunctiva to the conjunctiva of said rabbit. In another embodiment said composition to each eye of a New
Zealand rabbit provides at least about 17000 ng of cyclosporin A
per gram of conjunctiva to the conjunctiva of said rabbit.
In another embodiment, the blood level of cyclosporin A is less
than 0.1 mg/mL for a person for whom the composition has been
administered twice a day topically to both eyes in 35 microliter
drops for twelve months.
Pharmacokinetic Study 1 A 35 pL aliquot of one of three test formulations was
topically administered to each eye of a female New Zealand White
rabbit (n=3 rabbits/time point). At 0.5, 2, 6, 12, 24, 48 and 144
hours post-dose, cornea, conjunctiva, sclera, eyelid margin,
nasolacrimal duct, and blood samples were collected. Samples
collected from naive rabbits (n=2) served as pre-dose samples. The
quantitation ranges were 0.2-40 ng/mL in blood, 0.1-200 ng in
cornea and conjunctiva, 0.1-100 ng in eyelid margin and
nasolacrimal duct, and 0.1-20 ng in sclera and lacrimal gland.
The pharmacokinetic parameters of cyclosporine A in ocular tissues following a single ophthalmic instillation of one of three 0.05% cyclosporine A formulations are summarized in Table 1 below: Table 1
Tissue/Matrix Composition F Composition E Compositon D C-a AUCO-t t1/2 C- AUCO-t t1/2 C-z AUCO-t ti/2 (ng/g) (ng-hr/g) (hr) (ng/g) (ng-hr/g) (hr) (ng/g) (ng-hr/g) (hr) Cornea 4050 163000 41.3 1100 76200 41.7 536 29300 49.8 Conjunctiva 4460 18100 11.3 2560 11600 5.57 694 5290 4.55 Sclera 545 6110 29.7 136 2840 24.8 53.0 1040 18.7 Eyelid Margin 3120 38300 42.5 2020 42200 38.1 2450 27700 24.4 Nasolacrimal 195 2190 NC 74.4 1190 NC 72.0 279 NC Duct Blood 2.21 NC NC 0.441 NC NC BLQ BLQ NC NC = Not calculable BLQ = Below the limit of quantitation
Briefly summarizing, following a single ocular instillation of a
0.05% cyclosporine A formulation, the highest cyclosporine A ocular tissue exposure levels were observed from Composition F, followed by the Composition F, followed by Composition D.
Materials Test Articles
Compositions D, E, and F, as described above, were used for
these experiments.
Chemicals, Reagents and Supplies All other chemicals were reagent grade or better. Animals Species, Strain, Sex, Age, Size, Source, and Identification Female New Zealand White rabbits weighing 1.8 to 2.6 kg were
purchased from Charles River (St. Constant, Quebec, Canada). A permanent ear tag was used to identify animals.
Justification Similarities between the ocular anatomies of rabbits and humans make the rabbit an attractive animal model.
Animal Husbandry All animals were housed in environmentally-controlled facility with a time-controlled fluorescent lighting system providing a daily 12-hour light/12-hour dark period. Room temperature was maintained between 61 and 72°F, and relative humidity between 30 and 70%. Airflow ranged from 10 to 30 air changes per hour. Temperature, humidity, and airflow were monitored by the Edstrom Watchdog system version 4.0. The animals were provided Certified Hi-Fiber Rabbit Diet. Diet certification and analysis were provided by the vendor. No analysis outside those provided by the manufacturer was performed. Drinking water that was purified by a reverse osmosis process was offered ad libitum. Water was periodically analyzed for any contaminants that may interfere with the conduct of this study. The manufacturer conducted analysis of animal feed.
Animal Acclimation During the acclimatization period at Allergan, animals were kept under daily observation for any change in general health or behavior. Rabbits were quarantined for at least five days prior to the start of the study. All animals appeared healthy prior to and for the duration of the study.
Animal Termination and Disposal
Animals were euthanized via injection of at least 1 mL of sodium pentobarbital into a marginal ear vein.
Study Design and Experimental Procedures Study Design
Table 1 Study design
Animal species and Rabbit, New Zealand White strain Gender Female Number 3 rabbits/time point 2 rabbits at pre-dose (bioanalytical controls) Body Weights 1.8-2.8 kg Dosing Regimen Topical ocular, single dose, bilateral Dose Volume 35 pL Test Article Formulations containing 0.05% AGN 192371 (cyclosporine A) Time Points 0.5, 2, 6, 12, 24, 48, and 144 hours post-dose Tissues/Matrices Cornea, conjunctiva, sclera, nasolacrimal duct, eyelid margin and blood Assay Method LC-MS/MS Analyte AGN 192371 (Cyclosporine A) Quantitation Range Blood: 0.5-40 ng/mL Cornea: 0.1-200 ng Conjunctiva: 0.1-200 ng Eyelid Margin: 0.1-100 ng Nasolacrimal Duct: 0.1-100 ng Sclera:: 0.1-20 ng
Single bilateral dose, 3 rabbits (6 eyes and 3 blood samples) per time point. Two animals in group 4 were not dosed and were used as bioanalytical controls. Prior to dosing, 65 animals were weighed and assigned to 4 study groups. The study design is presented in Table 1. The four study groups are presented in the
Table 2 below:
Table 2
Group Treatment Dose Frequency n
3F per time 1 Composition F 35 Single Bilateral point (total of 21F)
Singl Bilaeral 3F per time 2 Composition E 35 SingleD lateral point (total of 21F) 3F per time 3 CompositionSingle Bilateral point (total of 21F) 2F 4 No Dose -- (total of 2F) n = Number of animals per group F = Female
Pretreatment Examinations Prior to placement on study, a physical examination was
performed on each animal. Gross observations were recorded prior to
drug administration and immediately after ocular dose using a
standardized data collection sheet.
Randomization Prior to dosing, 65 animals were weighed and randomly assigned
to four study groups.
Dosing Procedure:
Animals were dosed once by ocular instillation bilaterally at
Hour 0 of the study. Immediately prior to dosing, the eye was
inspected for any abnormalities, such as infection, red eye, or
visible damage. Only animals without visible abnormalities were
used. The lower eyelid was gently pulled out and away from the
eye. Using a Gilson precision pipette, 35 gL of dosing solution
was instilled into the lower cul-de-sac of each eye. The time of
dose administration was recorded. The eye was gently held closed
for approximately 5 seconds to ensure even dose distribution around
the eye. Gross ocular observations were performed following
dosing. The animal, including the dosed eyes, were subjectively
evaluated for signs of irritation. Observations were recorded.
Mortality/Morbidity Animals were observed for mortality/morbidity during the
study.
Body Weights Animals were weighed the day before dose administration and
subsequently randomized.
Pre-necropsy Blood Collection
Blood was collected from each rabbit prior to
euthanasia/necropsy. Animals were anesthetized with an intravenous
injection of a ketamine/xylazine cocktail (87 mg/mL ketamine,
13 mg/mL xylazine) at a volume of 0.1 mL/kg. Blood was collected
via cardiac puncture. Approximately 5 mL of blood was collected
into 10 mL lavender top (K3 EDTA) tubes. Blood samples were stored
at or below approximately -15°C until bioanalysis.
Euthanasia Animals were euthanized with an intravenous injection of
commercial euthanasia solution following blood collection.
Necropsy and Collection of Ocular Tissues Ocular samples were collected from both eyes, blotted dry
where applicable, weighed and placed in separate, appropriately
labeled, silanized vials, at the time of necropsy. Both eyes were
rinsed with LENS PLUS® in order to clear residual surface
formulation remaining on the ocular surface.
Conjunctiva
The upper and lower conjunctiva from each eye were removed and
pooled, weight recorded, placed into separate screw-cap glass
13x100 silanized test tubes and immediately placed on ice. Samples
were stored at or below -15°C until bioanalysis.
Cornea
The entire cornea was removed from each eye; weight recorded,
placed into separate screw-cap glass 13x100 silanized test tubes
and immediately placed on ice. Samples were stored at or below
150C until bioanalysis.
Sclera
The sclera was removed from each eye; weight recorded, placed
into separate screw-cap glass 13x100 silanized test tubes and
immediately placed on ice. Samples were stored at or below -15°C
until bioanalysis.
Nasolacrimal Duct Tissue containing the nasolacrimal duct associated with each
eye was removed; weight recorded, placed into screw-cap glass
13x100 silanized test tubes and immediately placed on ice. Samples
were stored at or below -15°C until bioanalysis.
Eyelid Margin The eyelid margins were removed from each eye; weight
recorded, placed into separate screw-cap glass 13x100 silanized
test tubes and immediately placed on ice. Samples were stored at
or below -15°C until bioanalysis.
Sample Storage Blood and ocular tissue samples were stored at or below -15°C
until bicanalysis.
Bioanalysis Ocular tissue and blood concentrations were quantified using
the following method.
Ocular tissue samples were extracted by soaking over night
with 2.0 mL methanol at 4°C. This was followed by a second soak
with 2.0 mL methanol and shaking for approximately one hour at room
temperature. An aliquot of 1 mL from a total of 4 mL organic
extract was removed (all 4 mL were analyzed for lacrimal gland
samples), and internal standard added (20 pL of 500 ng/mL of CsG).
The methanolic extract was evaporated to dryness and reconstituted
with 200 pL of 2 mM ammonium acetate/0.4% formic acid in 50:50
acetonitrile:water for LC MS/MS analysis. The bioanalytical procedure for analysis of blood samples involved addition of internal standard, CsG (10 pL of 500 ng/mL) to 0.5 mL aliquots of
K3 EDTA-treated rabbit blood.
Following incubation of blood sample for 30 minutes at 37 0 C,
the samples were acidified with 0.1 N HCL (2 mL). Methyl t-butyl
ether (4 mL) was added to each sample and mixed for 15 minutes. The
organic layer was removed and made basic by addition of 0.1 N NaOH
(2 mL). The organic extract was separated from the aqueous layer,
evaporated to dryness and reconstituted with 200 pL of 2 mM
ammonium acetate/0.4% formic acid in 50:50 acetonitrile:water for
LC MS/MS analysis. Aliquots (50 pL) of the reconstituted samples
were analyzed by LC-MS/MS using a PE Sciex API 3000 mass
spectrometer (Applied Biosystems, Foster City, CA), Leap
autosampler (Carrboro, NC), and HPLC pumps (Shimadzu Scientific
Instruments,Columbia, MD). Reverse-phase HPLC was performed on a
Keystone BDS C8 column (3 pm, 2.1 x 50 mm, 65 °C) with solvent
gradient elution (A=2mM ammonium acetate/0.4% formic acid in water
and B=2mM ammonium acetate/0.4% formic acid in acetonitrile) at a
flow rate of 0.3 mL/min. The precursor-product ion pairs used in
MRM analysis were: 1203 (MH)v'->425.5 for CsA and m/z 1217 (MH)J->
425.5 for IS(Cyclosporin G). The total analysis time was 5 min,
with retention times of CsA and CsG at approximately 1.82 and 1.86
minutes, respectively.
Data Treatment
Data Collection
* Pre and post treatment gross ocular examinations
* Body Weights: Randomization at Day -1 a Dosing Notes
0 Mortality/Morbidity
• Blood Samples: Pre-necropsy
* Ocular Tissue Samples: Post-necropsy
Data Calculation and Outlier Analysis
All data was used in calculations unless omitted for reasons
justified in the raw data.
Pharmacokinetic Analysis Thermo Electron WatsonTM (Philadelphia, PA) and Microsoft®
Excel (Redmond, Washington) were used for pharmacokinetic
calculations. The pharmacokinetic parameters listed below were
calculated using a known non-compartmental approach (see Tang-Lui,
et. al. Pharmaceutical Research, Vol 5, No. 4, 1988, 238-241). The
pharmacokinetic data was described using descriptive statistics
such as mean and standard deviation whenever possible. Area under
the concentration-time profile (AUC) values were reported as a
composite AUC and whenever possible, ± standard error of the mean
PK Parameter Description C.ax (ng/mL) or Maximum observed concentration (ng/g)
T.ax (hr) Time corresponding to maximum observed concentration AUC o0- (ng-hr/g) Area under concentration time curve from time zero to the last quantifiable time point using the random method for non-sequential sampling t 11 (hr) Half-life MRT (hr) Mean residence time
Values below the Limit of Quantitation and Number Rounding
If more than half of the concentration values contributing to
a calculation of the mean were below limit of quantitation (BLQ),
then the statistics were reported as non-calculable (NC). If half
or more of the values were quantifiable, then any BLQ values were
replaced with a value of "D", and the mean and its standard
deviation (SD) were calculated with these replaced values. The
mean and standard deviation of the mean were calculated at each
sampling time point within each treatment group. Whenever the
sample size was less than or equal to 2, only mean values were
listed. All mean values were reported to 3 significant figures and
standard deviations were reported to the same decimal place as
their respective mean values.
Protocol Deviations o Prior to collection of ocular tissue samples at the 6 hour time point, the eyes were not rinsed with Lens Plus* to clear any residual surface formulation remaining on the ocular surface. It is believed that this deviation will have minimal impact on the results derived from this study since in general this drug is rapidly absorbed from the ocular surface. In addition, blinking by the rabbits over 6 hours should also act to clear any residual surface formulation.
o Abbreviations
ACN Acetonitrile LLOQ Lower Limit of Quantitation
ALQ Above Limits of Quantitation M Male
AUC Area Under the Plasma or Blood N, n, No., no. Number Drug Concentration - Time Curve
AUC-t p Extrapolated Area Under the N/A, N.A., or Not Applicable Plasma or Blood Drug n/a Concentration Time Curve from Time 0 to the Last Quantifiable Timepoint BID Two Times Daily N/C, N.C., NC, Not Calculable or n/a
BLQ Below Limit of Quantitation NR No Result / Not Reported BMS Bioanalytical Mass Spectrometry NS No Sample
CFR Code of Federal Regulations NZW New Zealand White
CO or C Extrapolated Plasma or Blood OD Right Eye Drug Concentrations at the Time 0 Cmax or Cmax Maximal Drug Concentration OU Both Eyes
CONC Concentration PKDM Pharmacokinetics and Drug Metabolism
DG Day of Gestation PDO By Mouth
DESE Drug Safety Evaluation QID Four Times Daily
EDTA(K 3 ) Potassium QNS Quantity Not Sufficient Ethylenediaminetetraacetic Acid
F Female SD, S.D., or Standard Deviation sd
GD Gestation Day SE Standard Error
FDA United States Food and Drug Sec Seconds Administration
GLP Good Laboratory Practice SMP Sample
ID Intracardiao TI/2 or T11 2 Drug Half Life
Is Insufficient Sample Received TA Triamcinolone Acetonide
IM Intramuscular TID Three Times Daily
IU International Units TK Toxicokinetic
IV Intravenous Tmax or Tax Time at which C_ is Observed IVT Intravitreal U Units
LC-MS/MS Liquid Chromatography Tandem ULOQ Upper Limit of Mass Spetrometry Quantitation Note: Not all abbreviations listed may appear in thia report.
Results and Discussion
Cornea The mean concentrations and pharmacokinetic parameters are summarized in Tables 3 and 4. The concentration-time profiles of cyclosporine A in cornea following a single bilateral ocular administration of one of three 0.05% cyclosporine A formulations to rabbits are presented in Figure 1. Table 3 Mean cornea concentrations of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits. Cyclosporine A concentration (ng/g) Composition F Composition E Composition D Time Mean SD Mean SD Mean SD (hr) 0.5 4050 1220 1020 330 295 201 2 2740 620 1100 190 432 142 6 3030 750 1010 170 536 138 12 2530 430 858 267 417 127 24 1570a 390 891a 115 256a 28.2 48 1240a 230 622a 118 238 76.6 144 222a 61 125a 47 52.5a 13.2 Mean values represent an average of n=6 a Concentration time points used to calculate t ,
Table 4 Pharmacokinetic parameters in cornea of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits. Parameter Composition F Composition E Composition D Cmax (ng/g) 4050 ± 1220 1100 ± 190 536 ± 138 Tmax (hr) 0.500 2.00 6.00 AUC O-t 163000 ± 7000 76200 ± 3300 29300 ± 2000 (ng-hr/g)a AUC [-24 59000 22100 9450 (ng hr/g)
t (hr) 41.3 42.2 49.8 MRT (hr) 50.3 56.5 61.6 a An AUC interval of 0-144 hours was used for calculations for the three formulations
Composition F
Following a single bilateral ocular instillation of
Composition F, cyclosporine A was rapidly absorbed into the cornea
with a peak corneal concentration (Cmax) of 4050 ± 1220 ng/g,
occurring 0.500 hours post-dose. The area under the concentration
time curve (AUCO_t) value through the last quantifiable time point
was 163000 ± 7000 ng-hr/g and the AUCO_ 24 value was 59000 ng-hr/g.
The terminal half-life (tI7 2 ) was 41.3 hours and the mean residence
time (MRT) was 50.3 hours.
Composition E
Following a single bilateral ocular instillation of
Composition E, cyclosporine A was absorbed into the cornea with Cmax
value of 1100 ± 190 ng/g, occurring 2.00 hours post-dose. The AUCO_
t value was 76200 ± 3300 ng-hr/g and the AUCO- 24 value was 22100 ng-hr/g. The terminal t1/ 2 was 41.7 hours and the MRT was 56.5 hours.
Composition D
Following a single bilateral ocular instillation of
Composition D, cyclosporine A was absorbed into the cornea with a
Cmax value of 536 i 138 ng/g, occurring 6.00 hours post-dose. The
AUCo-t value was 29300 ± 2000 ng-hr/g and the AUCo- 24 value was 9450
ng-hr/g. The terminal t1/ 2 was 49.8 hours and the MRT was 61.6
hours.
Conjunctiva
The mean concentrations and pharmacokinetic parameters are
summarized in Tables 5 and 6. The concentration-time profiles of
cyclosporine A in conjunctiva following a single bilateral ocular
administration of one of three 0.05% cyclosporine A formulations to
rabbits are presented in Figure 2.
Table 5 Mean conjunctiva concentrations of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Cyclosporine A concentration (ng/g) Composition F Composition E Composition D Time Mean SD Mean SD Mean SD (hr)
0.5 4460 650 2560 1070 694 410 2 2170 530 1410 330 665 266 6 739 208 630a 197 330a 143 12 292a 97 178a 34 1102 52.3 24 58.2a 12.5 60.5a 32.5 20.5a 13.2 48 26.9a 19.1 BLQ - BLQ 144 BLQ - BLQ - BLQ Mean values represent an average of n=6 BLQ=Below the limit of quantitation Concentration time points used to calculate t 112
Table 6 Pharmacokinetic parameters in conjunctiva of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits. Parameter Composition F Composition E Composition D
Cmax (ng/g) 4460 ± 650 2560 ± 1070 694 ± 410 Tmax (hr) 0.500 0.500 0.500 AUC O-t 18100 ± 800a 11600 ± 7 0 0b 5290 ± 4 8 0b (ng-hr/g) AUC0_ 2 4 17100 11600 5290 (ng-hr/g) t a (hr) 11.3 5.57 4.55 MRT (hr) 7.37 5.93 6.07 ' An AUC interval of 0-48 hours was used for calculations b An AUC interval of C-24 hours was used for calculations
Composition F
Following a single bilateral ocular instillation of
Composition F, cyclosporine A was rapidly absorbed into the
conjunctiva with a Cmx value of 4460 ± 650 ng/g, occurring 0.500
hours post-dose. The AUCo 0 t value was 18100 ± 800 ng-hr/g and the
AUCO- 24 value was 17100 ng-hr/g. The terminal t1 /2 was 11.3 hours
and the MRT was 7.37 hours.
Composition E
Following a single bilateral ocular instillation of
Composition E, cyclosporine A was rapidly absorbed into the
conjunctiva with a Cmx value of 2560 ± 1070 ng/g, occurring 0.500
hours post-dose. The AUCOt value was 11600 ± 700 ng-hr/g. The
terminal t1 /2 was 5.57 hours and the MRT was 5.93 hours.
Composition D
Following a single bilateral ocular instillation of
Composition D, cyclosporine A was rapidly absorbed into the
conjunctiva with a Cmnax value of 694 ± 410 ng/g, occurring 0.500
hours post-dose. The AUC0 -t value was 5290 ± 480 ng-hr/g. The
terminal t1 /2 was 4.55 hours and the MRT was 6.07 hours.
Sclera
The mean concentrations and pharmacokinetic parameters are
summarized in Tables 7 and 8. The concentration-time profiles of
cyclosporine A in sclera following a single bilateral ocular
administration of one of three 0.05% cyclosporine A formulations to
rabbits are presented in Figure 3.
Table 7 Mean sclera concentrations of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Cyclosporine A concentration (ng/g) Composition F Composition E Composition D
Time Mean SD Mean SD Mean SD (hr) 0.5 545 98 136 44 52.5 29.3 2 294 74 120 34 49.4 24.5 6 210 58 83.7 14.0 53.0 10.9 12 133 25 51.0 19.1 28.63 3.7 24 51.4a 9.4 36.5a 9.9 13.5a 2.3 48 24.2a 7.1 13.Oa 3.61 7.10a 3.09 144 2.92a 0.40 1.14a 1.27 BLQ Mean values represent an average of n=6 BLQ=Below the limit of quantitation a Concentration time points used to calculate t 1m2
Table 8 Pharmacokinetic parameters in sclera of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Parameter Composition F Composition E Composition D Cmax (ng/g) 545 ± 98 136 ± 43 53.0 ± 10.9 Tmax (hr) 0.500 0.500 6.00 AUC O-t 6110 ± 260a 2840 ± 150a 1040 ± 5 0b (ng.hr/g) AUC 0-24 3900 1560 792 (ng.hr/g)
t a (hr) 29.7 24.8 18.7 MRT (hr) 25.3 26.9 23.8 a An AUC interval of 0-144 hours was used for calculations b An AUC interval of 0-48 hours was used for calculations
Composition F
Following a single bilateral ocular instillation of
Composition F, cyclosporine A was rapidly absorbed into the sclera
with a Cmax value of 545 ± 98 ng/g, occurring 0.500 hours post-dose.
The AUCo>t value was 6110 260 ng-hr/g and the AUCO- 24 value was
3900 ng-hr/g. The terminal tL/2 was 29.7 hours and the MRT was 25.3
hours.
Composition E
Following a single bilateral ocular instillation of Composition E, cyclosporine A was rapidly absorbed into the sclera
with a Cmax value of 136 ± 43 ng/g, occurring 0.500 hours post-dose.
The AUCO-t value was 2840 ± 150 ng-hr/g and the AUCO- 24 value was
1560 ng-hr/g. The terminal t 1 2 was 24.8 hours and the MRT was 26.7
hours.
Composition D
Following a single bilateral ocular instillation of
Composition D, cyclosporine A was absorbed into the sclera with a
Cmx value of 53.0 ± 10.9 ng/g, occurring 6.00 hours post-dose. The
AUCO-t value was 1040 ± 50 ng-hr/g and the AUCO- 24 value was 792
ng-hr/g. The terminal t1 /2 was 18.7 hours and the MRT was 23.8
hours.
Eyelid Margin
The mean concentrations and pharmacokinetic parameters are
summarized in Tables 9 and 10. The concentration-time profiles of
cyclosporine A in the eyelid margin following a single bilateral
ocular administration of one of three 0.05% cyclosporine A
formulations to rabbits are presented in Figure 4.
Table 9 Mean eyelid margin concentrations of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Cyclosporine A concentration (ng/g) Composition F Composition E Composition D Time Mean SD Mean SD Mean SD (hr) 0.5 3120 1040 2020 980 1800 900 2 1710 300 1380 630 2450 970 6 679 135 547 300 430 214 12 787 280 910 199 662 506 24 263a 158 138a 87 222a 172 48 223a 207 3624 437 112a 82 144 40.0a 22.5 24.9a 23.4 7.30a 12.64 Mean values represent an average of n=6 a Concentration time points used to calculate t 112
Table 10 Pharmacokinetic parameters in eyelid margin of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Parameter Composition F Composition E Composition D
Cmax (ng/g) 3120 ± 1040 2020 ± 980 2450 ± 970 Tmax (hr) 0.500 0.500 2.00 AUC O-t 38300 ± 5300 42200 ± 10800 27700 ± 3300 (ng-hr/g)a AUC 0-24 19900 17600 18000 (nq-hr/g) t , (hr) 42.5 38.2 24.4 MRT (hr) 40.5 38.4 21.9 a An AUC interval of 0-144 hours was used for calculations for the three formulations
Composition F
Following a single bilateral ocular instillation of
Composition F, cyclosporine A was rapidly absorbed into the eyelid
margin with a Cmax value of 3120 ± 1040 ng/g, occurring 0.500 hours
post-dose. The AUCo-t value was 38300 ± 5300 ng-hr/g and the AUCO- 24 value was 19900 ng-hr/g. The terminal t 1 2 was 42.5 hours and the
MRT was 40.5 hours.
Composition E
Following a single bilateral ocular instillation of
Composition E, cyclosporine A was rapidly absorbed into the eyelid
margin with a Cmax value of 2020 ± 980 ng/g, occurring 0.500 hours
post-dose. The AUCo-t value was 42200 ± 10800 ng-hr/g and the AUCo_
24 value was 17600 ng-hr/g. The terminal t1/ 2 was 38.1 hours and the
MRT was 38.4 hours.
Composition D
Following a single bilateral ocular instillation of
Composition D, cyclosporine A was absorbed into the eyelid margin
with a Cma, value of 2450 ± 970 ng/g, occurring 2.00 hours post
dose. The AUCo-t value was 27700 ± 3300 ng-hr/g and the AUCO-2 4 value was 18000 ng-hr/g. The terminal t 1 2 was 24.4 hours and the
MRT was 21.9 hours.
Nasolacrimal Duct
The mean concentrations and pharmacokinetic parameters are
summarized in Tables 11 and 12. The concentration-time profiles of
cyclosporine A in nasolacrimal duct tissue following a single bilateral ocular administration of one of three 0.05% cyclosporine A formulations to rabbits are presented in Figure 5.
Table 11 Mean nasolacrimal duct concentrations of cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Cyclosporine A concentration (ng/g) Composition F Composition E Composition D Time Mean SD Mean SD Mean SD (hr) 0.5 194 201 74.4 20.9 72.0 91.7 2 43.7 44.1 37.2 43.6 37.4 13.8 6 18.2 15.2 BLQ - 11.8 10.0 12 24.2 12.0 35.5 21.5 14.9 8.4 24 BLQ - BLQ - BLQ 48 BLQ - 4.68 5.15 BLQ 144 1.71 1.93 BLQ - BLQ Mean values represent an average of n=6 BLQ=Below the limit of quantitation
Table 12 Pharmacokinetic parameters in nasolacrimal duct of Cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits. Parameter Composition F Composition E Composition D
Cmax (ng/g) 195 ± 201 74.4 ± 20.9 72.0 ± 91.7 Tmax (hr) 0.500 0.500 0.500 AUC O-t 2190 ± 350a 1190 ± 2 1 2b 279 ± 39c (ng-hr/g)
AUC 0-12 478 ± 86 465 ± 106 279 ± 39 (ng-hr/g)
t , (hr) NC NC NC MRT (hr)d 17.6 24.7 12.1 NC=Not calculable a An AUC interval of 0-144 hours was used for calculations b An AUC interval of 0-48 hours was used for calculations ° An AUC interval of 0-12 hours was used for calculations a A time interval of 0-12 hours was used for calculations
Composition F
Following a single bilateral ocular instillation of
Composition F, cyclosporine A rapidly drained into and was then
absorbed into the nasolacrimal duct tissue with a Cmax value of 195
± 201 ng/g, occurring 0.500 hours post-dose. The AUCoGt value was
2190 ± 350 ng-hr/g and the AUCO- 1 2 value was 478 ± 86 ng-hr/g. The
MRT was 17.6 hours.
Composition E
Following a single bilateral ocular instillation of
Composition E, cyclosporine A rapidly drained into and was then
absorbed into the nasolacrimal duct tissue with a Cmax value of 74.4
20.9 ng/g, occurring 0.500 hours post-dose. The AUCO-t value was
1190 i 210 ng-hr/g and the AUCO 12 value was 465 ± 106 ng-hr/g. The
MRT was 24.7 hours.
Composition D
Following a single bilateral ocular instillation of
Composition D, cyclosporine A rapidly drained into and was then
absorbed into the nasolacrimal duct tissue with a Cmax value of 72.0
± 91.7 ng/g, occurring 0.500 hours post-dose. The AUCO-t value was
279 ± 39 ng-hr/g. The MRT was 12.1 hours.
Blood
The mean concentrations of cyclosporine A in blood are
summarized in Table 13.
Table 13 Mean blood concentrations of Cyclosporine A following a single bilateral topical ocular instillation of one of three 0.05% cyclosporine A formulations to New Zealand White rabbits.
Cyclosporine A concentration (ng/mL) Composition F Composition E Composition D
Time Mean SD Mean SD Mean SD (hr) 0.5 2.21 0.33 0.441 0.126 BLQ 2 0.463 0.021 BLQ - BLQ 6 BLQ - BLQ - BLQ
12 BLQ - BLQ - BLQ
24 BLQ - BLQ - BLQ
48 BLQ - BLQ - BLQ
144 BLQ - BLQ - BLQ Mean values represent an average of n=3 BLQ=Below the limit of quantitation
Composition F
Following a single bilateral ocular instillation of
Composition F, cyclosporine A was detected at 0.5 and 2 hours post
dose in the blood at concentrations of 2.21 ± 0.33 ng/mL and 0.463
± 0.021 ng/mL, respectively. Cyclosporine A levels were below the
limit of quantitation at all subsequent time points.
Composition E
Following a single bilateral ocular instillation of
Composition E, cyclosporine A was detected at 0.5 hours post-dose
in the blood at a concentration of 0.441 ± 0.126 ng/mL. Cyclosporine A levels were below the limit of quantitation at all
subsequent time points.
Composition D
Following a single bilateral ocular instillation of
Composition D, cyclosporine A levels were below the limit of
quantitation at all time points.
Administration of Composition F to rabbits generally delivered
the highest levels of cyclosporine A to ocular tissues, on average
a 5-fold increase in area under the concentration-time profile
(AUC) was observed when compared to Composition D. Administration
of Composition E to rabbits resulted on average in a 2-fold
increase in AUC when compared to Composition D. The
pharmacokinetic profile observed following Composition D
administration to New Zealand White rabbits in this study was in
good agreement with previously reported data.
In general, the terminal half-life and mean residence time
observed were greatest for Composition F, followed by the
Composition E, followed by Composition D. Thus, AUC values were
reported to the last quantifiable time point, in addition to AUC
through 24 hours for cornea, conjunctiva, sclera and eyelid margin
and AUC through 12 hours for nasolacrimal duct to make an
assessment over the same interval as to the drug levels achieved
following once a day dosing. Overall, the trends observed when
comparing AUCont values were consistent with the trends observed
when comparing AUCO 24 or AUC0 12 .
In conclusion, following a single ocular instillation of a
0.05% cyclosporine A formulation, the highest cyclosporine A ocular
tissue exposure levels were observed when drug was formulated as an
aqueous Composition F, followed by the Composition E followed by
Composition D. A concomitant trend was observed in blood drug
exposure.
While not intending to limit the scope of the invention, it is
believed that these pharmacokinetic results suggest that
significantly lower concentrations of cyclosporin A may be used in
topical ophthalmic compositions than previously known and still
achieve a therapeutically effective amount cyclosporin A.
Pharmacokinetic Study 2 The compositions below were prepared in an analogous manner to
compositions D, E, and F.
CompositionCompositionComposition Formulations G H D Aqueous Aqueous Ingredients Solution Solution Emulsion Cyclosporine A 0.020 0.030 0.050 0.01% (100 0.01% (100 0.0% (0 Purite ppm) ppm) ppm) Polysorbate 80 1.0 1.0 1.0 Glycerin 1.0 1.0 2.2 Mannitol 0.5 0.5 N/A Sodium Carboxymethylcellulose (CMC) - 7LFPH 0.5 0.5 N/A Sodium Citrate Dihydrate 0.4 0.4 N/A Boric Acid 0.25 0.25 N/A Sodium Borate Decahydrate 0.41 0.41 N/A Potassium Chloride 0.14 0.14 N/A Castor Oil N/A N/A 1.25 Pemulen TR-2 N/A N/A 0.05 Sodium Hydroxide N/A N/A pH 7.4 Purified Water QS QS N/A
A pharmacokinetic study was carried out using similar
analytical methods to those already described. The parameters are
shown below.
* Test Formulations: G,H, and D
• Animal species/strain: Rabbit NZW
• Gender: Female
• Number: 2 rabbits/timepoint (2 rabbits blanks)
• Dosing Route: Topical ocular
• Dosing Regimen: Bilateral,QD(Aqueous)/BID (Composition D)-5days
• Dose Volume: 35 pL
• Time points: Day 1 and Day 5-0.5, 2, 6, 12, 24 hr post dose
• Assay Method: LC-MS/MS
• Analyte: Cyclosporine A
• Data Analysis: Cmax, AUCO-24, AUC dose normalized
The results in cornea, tear, and blood are shown in the tables
below.
Table 14. Cyclosporin bioavailability in the cornea.
Composition G Composition Composition D H Emulsion, BID
Day 1 Day 5 Day 1 Day 5 Day 1 Day 5
Cmax 810 2570 1420 3020 583 1670 (ng/g) i530 ±650 ±930 ±440 ±209 ±170
AUC 0 - 2 4 14700 33900 22100 48800 12100 27900 (ng-hr/g) ±2500 ±2200 ±2800 ±3900 ±700 ±1000 AUC/Dose 2.12 4.93 2.12 4.71 0.349 0.807 (ng hr/g/ng)
Total 7000 7000 10500 10500 35000 35000 Dose/24hr (ng)
Table 15. Cyclosporin bioavailability in the blood.
0.02% CsA 0.03% CsA Restasis@ Aqueous, QD Aqueous, QD (0.05%) Emulsion, BID
Day 1 Day 5 Day 1 Day 5 Day 1 Day 5
CO.5hr 0.741 0.883 0.727 0.604 BLQ BLQ (ng/mL) n=2 rabbits/timepoint BLQ-Below the limit of detection (0.2 ng/mL)
Table 16. Cyclosporin bioavailability in the tears.
0.02% CsA 0.03% CsA Restasis® Aqueous, QD Aqueous, QD (0.05%) Emulsion, BID ay I Day Day Day 5 Day Day 5
Cmax 182 50.1 -1.4 39.4 44.2 83.5 (ng/mL) . ±29.2 ±4,2 ±9.7 ±18.4 ±33.2
AUC 0 -2 4 1'9 371 327 397 368 663 (ng-hr/mL) 15 ±62 +121 ±127 ±I ±110
Standard Compositions
These compositions (AA-MM) are particularly contemplated for
use as standards for comparison for characterization of the
compositions disclosed herein.
The following compositions are intended to mean those
identical to those disclosed in Kanai et. al., Transplantation
Proceedings, Vol 21, No 1 (February), 1989: 3150-3152, which is
incorporated by reference herein:
Composition AA: a solution consisting of 0.025% cyclosporin A,
40 mg/mL alpha cyclodextrin, and water;
Composition BB: a solution consisting of 0.009% cyclosporin A,
20 mg/mL alpha cyclodextrin, and water; and
Composition CC: a solution consisting of 0.003% cyclosporin A,
10 mg/mL alpha cyclodextrin, and water.
The following composition is intended to mean those identical
to that disclosed in Cheeks et. al., Current Eye Research, Vol 11,
No 7 (1992), 641-649, which is incorporated by reference herein:
Composition DD: an alpha cyclodextrin solution at 40 mg/mL
containing 0.025% cyclosporin A.
The following composition is intended to mean that identical
that disclosed in Tamilvanan, Stp Pharma Sci Nov-Dec; 11(6):421
426, which is incorporated by reference herein, except that the
concentration of cyclosporin A is different.
Composition EE: an emulsion consisting of cyclosporin A (0.05
w/w%), castor oil (2.5 w/w%), stearylamine (0.12 w/w%), a
tocopherol (0.01 w/w%), benzalkonium chloride (0.01 w/w%) and
water up to 100 w/w%.
The following compositions are intended to mean those
identical to Samples C-E disclosed in United States Patent No.
5,051,402 (column 7). The entire disclosure is incorporated herein
by reference.
Composition FF: 0.25 mL/mL of cyclosporin A, 40 mg/mL of a
cyclodextrin, and 7.79 mg/mL of sodium chloride;
Composition GG: 0.10 mL/mL of cyclosporin A, 20 mg/mL of a
cyclodextrin, and 8.40 mg/mL of sodium chloride; and
Composition HH: 0.05 mL/mL of cyclosporin A, 10 mg/mL of a
cyclodextrin, and 8.70 mg/mL of sodium chloride.
The following composition is intended to mean that identical
that disclosed in Abdulrizak, Stp Pharma Sci Nov-Dec; 11(6):427
432, which is incorporated by reference herein, except that the
concentration of cyclosporin A is different.
Composition II: an emulsion consisting of cyclosporin A (0.05
w/w%), castor oil (2.5 w/w%), Poloxamer 188, (0.425 w/w%),
glycerol (2.25 w/w%), Lipoid E-80 (0.5 w/w%), stearylamine (0.12
w/w%), tocopherol (0.01 w/w%), benzalkonium chloride (0.01
w/w%), and water.
The following composition is intended to mean that identical
to that disclosed in Kuwano Mitsuaki et al. Pharm Res 2002
Aug;19(l):108-111.
Composition JJ: a solution consisting of cyclosporine A
(0.0865%), ethanol (0.1%), MYS-40 (2%), HPMC (0.3 w/v%), sodium
dihydrogen phosphate (0.2 w/v%), and disodium EDTA (0.01% w/v%),
sodium chloride to adjust the tonicity to 287 mOsm, and water.
Composition KK is intended to mean that disclosed in
US20010041671, incorporated by reference herein, as Formulation 1,
on Table 1. Composition LL is that disclosed in US20010041671 as
Formulation 3, except that the concentration of cyclosporine is
reduced.
Composition KK: cyclosporine A (0.02%), sodium hyaluronate
(0.05%), Tween 80 (0.05%), Na 2 HPO 4 -12H 2 0 (0.08%), sorbitol
(5.46%), purified water added to 100 mL, pH 7.0-7.4, and mosm/L
= 295-305.
Composition LL: cyclosporine A (0.2%), sodium hyaluronate
(0.10%), Tween 80 (5.00%), Na 2 HPO4 •12H 20 (0.08%), sorbitol
(5.16%), purified water added to 100 mL, pH 7.0-7.4, and mosm/L
= 295-305.
The following composition is intended to mean that disclosed
in Example 2 of US 5,951,971, incorporated herein by reference.
Composition MM: cyclosporine A (0.025 g), polyoxyl 40 stearate
(0.5g), hydroxypropyl methylcellulose (0.2g), butylated
hydroxytoluene (0.0005 g), ethanol (0.1 g), sodium chloride (0.73
g), sodium dihydrogen phosphate (0.2 g), sodium edethate (0.1 g),
sodium hydroxide to adjust pH to 6.0, and water to make 100 mL.
In another embodiment the composition provides more
cyclosporin A than Composition AA provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition AA,
wherein the drop of said composition and the drop of Composition AA
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition BB provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition BB,
wherein the drop of said composition and the drop of Composition BB
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition CC provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition CC,
wherein the drop of said composition and the drop of Composition CC
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition DD provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition DD,
wherein the drop of said composition and the drop of Composition DD
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition EE provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition EE,
wherein the drop of said composition and the drop of Composition EE
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition FF provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition FF,
wherein the drop of said composition and the drop of composition FF
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition GG provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition GG,
wherein the drop of said composition and the drop of composition GG
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition HH provides to the cornea of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition HH, wherein the drop of said composition and the drop of composition HH are the same volume. In another embodiment the composition provides more cyclosporin A than Composition II provides to the cornea of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition II, wherein the drop of said composition and the drop of composition II are the same volume. In another embodiment the composition provides more cyclosporin A than Composition JJ provides to the cornea of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition JJ, wherein the drop of said composition and the drop of composition JJ are the same volume. In another embodiment the composition provides more cyclosporin A than Composition KK provides to the cornea of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition KK, wherein the drop of said composition and the drop of composition KK are the same volume. In another embodiment the composition provides more cyclosporin A than Composition LL provides to the cornea of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition LL, wherein the drop of said composition and the drop of composition LL are the same volume. In another embodiment the composition provides more cyclosporin A than Composition MM provides to the cornea of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition MM, wherein the drop of said composition and the drop of composition MM are the same volume. In another embodiment the composition provides more cyclosporin A than Composition AA provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition AA, wherein the drop of said composition and the drop of Composition AA are the same volume. In another embodiment the composition provides more cyclosporin A than Composition BB provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition BB, wherein the drop of said composition and the drop of Composition BB are the same volume. In another embodiment the composition provides more cyclosporin A than Composition CC provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition CC, wherein the drop of said composition and the drop of Composition CC are the same volume. In another embodiment the composition provides more cyclosporin A than Composition DD provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition DD, wherein the drop of said composition and the drop of Composition DD are the same volume. In another embodiment the composition provides more cyclosporin A than Composition EE provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition EE, wherein the drop of said composition and the drop of Composition EE are the same volume. In another embodiment the composition provides more cyclosporin A than Composition FF provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition FF, wherein the drop of said composition and the drop of composition FF are the same volume. In another embodiment the composition provides more cyclosporin A than Composition GG provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition GG, wherein the drop of said composition and the drop of composition GG are the same volume. In another embodiment the composition provides more cyclosporin A than Composition HH provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition HH, wherein the drop of said composition and the drop of composition HH are the same volume. In another embodiment the composition provides more cyclosporin A than Composition II provides to the conjunctiva of a female New Zealand white rabbit 30 minutes after topical ocular administration of one drop of said composition or Composition II, wherein the drop of said composition and the drop of composition II are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition JJ provides to the conjunctiva of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition JJ,
wherein the drop of said composition and the drop of composition JJ
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition KK provides to the conjunctiva of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition KK,
wherein the drop of said composition and the drop of composition KK
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition LL provides to the conjunctiva of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition LL,
wherein the drop of said composition and the drop of composition LL
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition MM provides to the conjunctiva of a
female New Zealand white rabbit 30 minutes after topical ocular
administration of one drop of said composition or Composition MM,
wherein the drop of said composition and the drop of composition MM
are the same volume.
Comparison of two compositions in a person or animal can be
carried out by, among other means, administering the claimed
composition to one eye and the second composition to the second
eye.
In another embodiment the composition provides more
cyclosporin A than Composition AA provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition AA, wherein the drop of said composition and the drop
of Composition AA are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition BB provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition BB, wherein the drop of said composition and the drop
of Composition BB are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition CC provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition CC, wherein the drop of said composition and the drop
of Composition CC are the same volume.
In another embodiment the composition provides more cyclosporin A
than Composition DD provides to the cornea of a female New Zealand
white rabbit over a period of 24 hours after topical ocular
administration of one drop of said composition or Composition DD,
wherein the drop of said composition and the drop of Composition DD
are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition EE provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition EE, wherein the drop of said composition and the drop
of Composition EE are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition FF provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition FF, wherein the drop of said composition and the drop
of composition FF are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition GG provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition GG, wherein the drop of said composition and the drop
of composition GG are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition HH provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition HH, wherein the drop of said composition and the drop
of composition HH are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition II provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition II, wherein the drop of said composition and the drop
of composition II are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition JJ provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after topical ocular administration of one drop of said composition or
Composition JJ, wherein the drop of said composition and the drop
of composition JJ are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition KK provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition KK, wherein the drop of said composition and the drop
of composition KK are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition LL provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition LL, wherein the drop of said composition and the drop
of composition LL are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition MM provides to the cornea of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition MM, wherein the drop of said composition and the drop
of composition MM are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition AA provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition AA, wherein the drop of said composition and the drop
of Composition AA are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition BB provides to the conjunctiva of a female New Zealand white rabbit over a period of 24 hours after topical ocular administration of one drop of said composition or Composition BB, wherein the drop of said composition and the drop of Composition BB are the same volume. In another embodiment the composition provides more cyclosporin A than Composition CC provides to the conjunctiva of a female New Zealand white rabbit over a period of 24 hours after topical ocular administration of one drop of said composition or Composition CC, wherein the drop of said composition and the drop of Composition CC are the same volume. In another embodiment the composition provides more cyclosporin A than Composition DD provides to the conjunctiva of a female New Zealand white rabbit over a period of 24 hours after topical ocular administration of one drop of said composition or Composition DD, wherein the drop of said composition and the drop of Composition DD are the same volume. In another embodiment the composition provides more cyclosporin A than Composition EE provides to the conjunctiva of a female New Zealand white rabbit over a period of 24 hours after topical ocular administration of one drop of said composition or Composition EE, wherein the drop of said composition and the drop of Composition EE are the same volume. In another embodiment the composition provides more cyclosporin A than Composition FF provides to the conjunctiva of a female New Zealand white rabbit over a period of 24 hours after topical ocular administration of one drop of said composition or Composition FF, wherein the drop of said composition and the drop of composition FF are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition GG provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition GG, wherein the drop of said composition and the drop
of composition GG are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition HH provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition HH, wherein the drop of said composition and the drop
of composition HH are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition II provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition II, wherein the drop of said composition and the drop
of composition II are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition JJ provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition JJ, wherein the drop of said composition and the drop
of composition JJ are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition KK provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition KK, wherein the drop of said composition and the drop
of composition KK are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition LL provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition LL, wherein the drop of said composition and the drop
of composition LL are the same volume.
In another embodiment the composition provides more
cyclosporin A than Composition MM provides to the conjunctiva of a
female New Zealand white rabbit over a period of 24 hours after
topical ocular administration of one drop of said composition or
Composition MM, wherein the drop of said composition and the drop
of composition MM are the same volume.
In one embodiment, wherein topical administration of one 35 p1L
drop of said composition to each eye of a female New Zealand white
rabbit provides to the corneas of said rabbit at least about 500 ng
of cyclosporin A per gram of cornea of said rabbit at 30 minutes
after said topical administration.
In another embodiment, topical administration of one 35 pL
drop of said composition to each eye of a female New Zealand white
rabbit provides to the corneas of said rabbit at least about 2000
ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes
after said topical administration.
In another embodiment, topical administration of one 35 pL
drop of said composition to each eye of a female New Zealand white
rabbit provides to the corneas of said rabbit at least about 2400
ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes
after said topical administration.
In another embodiment, topical administration of one 35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about 17000 ng of cyclosporin A per gram of cornea of said rabbit over a period of 24 hours after said topical administration. In another embodiment, topical administration of one 35 iL drop of said composition to each eye of a female New Zealand white rabbit provides to the conjunctivas of said rabbit at least about 3300 ng of cyclosporin A per gram of conjunctiva of said rabbit over a period of 24 hours after said topical administration. In another embodiment, said composition is an aqueous solution containing from 0.005% to about 0.04% cyclosporin A, wherein topical administration of one 35 IL drop of said composition to each eye of a New Zealand rabbit provides at least about 17000 ng of cyclosporin A per gram of cornea to the corneas of said rabbit as determined by: topically administering said composition to each eye of each of 15 female New Zealand white rabbit test subjects, and determining the amount of cyclosporin A in the corneas of three subjects at times of about 0.5 hours, about 2 hours, about 6 hours, about 12 hours, and about 24 after administration to said subject, wherein the amount of cyclosporin A in the cornea is determined only once for each subject. In another embodiment, said composition is an aqueous solution containing from 0.005% to about 0.04% cyclosporin A, wherein topical administration of one 35 pjL drop of said composition to each eye of a New Zealand rabbit provides at least about 17000 ng of cyclosporin A per gram of conjunctiva to the conjunctivas of said rabbit as determined by: topically administering said composition to each eye of each of
15 female New Zealand white rabbit test subjects, and
determining the amount of cyclosporin A in the conjunctivas of
three subjects at times of about 0.5 hours, about 2 hours, about
6 hours, about 12 hours, and about 24 after administration to
said subject,
wherein the amount of cyclosporin A in the conjunctiva is
determined only a single time for each subject.
As mentioned above, these compositions are suitable for use in
other mammals other than rabbits, including humans. Thus, any
composition in the claims or elsewhere which is characterized by in
vivo rabbit bioavailability testing is contemplated for use in a
person or in another mammal. Defining a composition in terms of
bioavailability in rabbits should not be construed to limit a
method of treatment using the composition to use on rabbits, but
treatment with the composition should be construed to include
treatment on humans and other mammals.
The foregoing description details specific methods and
compositions that can be employed to practice the present invention,
and represents the best mode contemplated. However, it is apparent
for one of ordinary skill in the art that further compositions with
the desired pharmacological properties can be prepared in an
analogous manner. Thus, however detailed the foregoing may appear
in text, it should not be construed as limiting the overall scope
hereof; rather, the ambit of the present invention is to be governed
only by the lawful construction of the claims.
Claims (39)
- What is claimed is: 1. A composition comprising cyclosporin A at a concentration offrom about 0.0001% (w/v) to less than about 0.05% (w/v).
- 2. The composition of claim 1 which is an aqueous solution.
- 3. The concentration of claim 1 wherein the concentration ofcyclosporin A is from about 0.02% (w/v) to about 0.04% (w/v).
- 4. The composition of claim 2 wherein the concentration ofcyclosporin A is from about 0.02% (w/v) to about 0.04% (w/v).
- 5. The composition of claim 2 containing no ethanol.
- 6. The composition of claim 2 containing no hyaluronic acid.
- 7. The composition of claim 2 containing no cyclodextrin A.
- 8. The composition of claim 6 containing no cyclodextrin.
- 9. The composition of claim 8 containing no ethanol.
- 10. The composition of claim 9 containing no vitamin E TPGS.
- 11. The composition of claim 9 containing no hyaluronic acid.
- 12. The composition claim 1 wherein topical administration ofone 35 pL drop of said composition to each eye of a female NewZealand white rabbit provides to the corneas of said rabbit atleast about 500 ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes after said topical administration.
- 13. The composition of claim 1 wherein topical administration of one 35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about 1000 ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes after said topical administration.
- 14. The composition of claim 1 wherein topical administration of one 35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about 1400 ng of cyclosporin A per gram of cornea of said rabbit at 30 minutes after said topical administration.
- 15. The compositon of claim 1 wherein topical administration of one 35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the corneas of said rabbit at least about 17000 ng-hr of cyclosporin A per gram of cornea of said rabbit over a period of 24 hours after said topical administration.
- 16. The composition of claim 2 wherein topical administration of one 35 pL drop of said composition to each eye of a female New Zealand white rabbit provides to the conjunctivas of said rabbit at least about 3300 ng-hr of cyclosporin A per gram of conjunctiva of said rabbit over a period of 24 hours after said topical administration.
- 17. The composition of claim 2 wherein said composition is an aqueous solution containing from 0.005% (w/v) to about 0.04% (w/v) cyclosporin A, wherein topical administration of one 35 iL drop of said composition to each eye of a New Zealand rabbit provides at least about 17000 ng-hr of cyclosporin A per gram of cornea to the corneas of said rabbit as determined by: topically administering said composition to each eye of each of 15 female New Zealand white rabbit test subjects; and determining the amount of cyclosporin A in the corneas of three subjects at times of about 0.5 hours, about 2 hours, about 6 hours, about 12 hours, and about 24 after administration to said subject; wherein the amount of cyclosporin A in the cornea is determined only once for each subject.
- 18. The composition of claim 2 wherein said composition is an aqueous solution containing from 0.005% (w/v) to about 0.04% (w/v) cyclosporin A, wherein topical administration of one 35 iL drop of said composition to each eye of a New Zealand rabbit provides at least about 6000 ng of cyclosporin A per gram of conjunctiva to the conjunctivas of said rabbit as determined by: topically administering said composition to each eye of each of 15 female New Zealand white rabbit test subjects; and determining the amount of cyclosporin A in the conjunctivas of three subjects at times of about 0.5 hours, about 2 hours, about 6 hours, about 12 hours, and about 24 after administration to said subject; wherein the amount of cyclosporin A in the conjunctiva is determined only a single time for each subject.
- 19. The composition of claim 1 further comprising a surfactant.
- 20. The composition of claim 1 further comprising apreservative.
- 21. A method comprising topically administering a compositionaccording to claim 1 to an eye of a mammal in need thereof toenhance or restore lacrimal gland tearing.
- 22. The method of claim 21, wherein said method increases tearproduction in a tear-deficient eye.
- 23. The method of claim 21, wherein said method is effective intreating keratoconjunctivitis sicca.
- 24. The method of claim 21, wherein said method is effective intreating dry eye disease.
- 25. The method of claim 21 wherein the mammal is a humanpatient, and wherein less than 10% of human patients suffer burningor stinging when said composition is administered only once a dayfor a period of three months.
- 26. The method of claim 21 wherein the mammal is a humanpatient, and wherein less than 10% of human patients suffer ocular burningwhen said composition is administered only once a day for a period of three months.
- 27. The method of claim 21 wherein the composition is administered only once a day.
- 28. An aqueous solution comprising cyclosporin A at a concentration of from 0.01% (w/v) to 0.019% (w/v).
- 29. The composition of claim 28 wherein the concentration of cyclosporin A is about 0.015% (w/v).
- 30. An aqueous solution comprising cyclosporin A at a concentration of from 0.01% (w/v) to 0.02% (w/v) and more than 95% (w/w) water.
- 31. An aqueous solution comprising cyclosporin A at a concentration of from 0.01% (w/v) to 0.02% (w/v) and does not contain sodium hyaluronate at a concentration of 0.05% (w/v).
- 32. The aqueous solution of claim 31 which contains no sodium hyaluronate.
- 33. An aqueous solution comprising cyclosporin A at a concentration of from 0.01% (w/v) to 0.02% (w/v) and does not contain polysorbate 80 at a concentration of 0.05% (w/v).
- 34. The aqueous solution of claim 31 which contains from 0.1% to 1% polysorbate 80.
- 35. An kit comprising a container comprising an aqueous solution comprising cyclosporin A at a concentration of from 0.005% (w/v) to 0.03% (w/v), wherein said container is capable of dispensing eye drops, and wherein said composition has been stored in said container for at least two months.
- 36. A composition comprising cyclosporin A at a concentration of from 0.01% (w/v) to 0.02% (w/v) and a preservative.
- 37. The composition of claim 36 wherein the concentration of cyclosporin A is about 0.015% (w/v).
- 38. The composition of claim 2 wherein the cyclosporin A concentration is about 0.04% (w/v).
- 39. The composition of claim 2 wherein the cyclosporin A concentration is about 0.005% (w/v).
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| AU2020202459A AU2020202459A1 (en) | 2006-07-25 | 2020-04-09 | Cyclosporin compositions |
| AU2022202326A AU2022202326A1 (en) | 2006-07-25 | 2022-04-07 | Cyclosporin compositions |
Applications Claiming Priority (11)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US60/820,239 | 2006-07-25 | ||
| US60/829,808 | 2006-10-17 | ||
| US60/829,796 | 2006-10-17 | ||
| US60/869,459 | 2006-12-11 | ||
| US60/883,525 | 2007-01-05 | ||
| US60/916,352 | 2007-05-07 | ||
| AU2007276815A AU2007276815B2 (en) | 2006-07-25 | 2007-07-23 | Cyclosporin compositions |
| AU2013213743A AU2013213743A1 (en) | 2006-07-25 | 2013-08-09 | Cyclosporin compositions |
| AU2016203191A AU2016203191B2 (en) | 2006-07-25 | 2016-05-17 | Cyclosporin compositions |
| AU2018203825A AU2018203825A1 (en) | 2006-07-25 | 2018-05-31 | Cyclosporin compositions |
| AU2020202459A AU2020202459A1 (en) | 2006-07-25 | 2020-04-09 | Cyclosporin compositions |
Related Parent Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| AU2018203825A Division AU2018203825A1 (en) | 2006-07-25 | 2018-05-31 | Cyclosporin compositions |
Related Child Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| AU2022202326A Division AU2022202326A1 (en) | 2006-07-25 | 2022-04-07 | Cyclosporin compositions |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| AU2020202459A1 true AU2020202459A1 (en) | 2020-05-07 |
Family
ID=56113128
Family Applications (3)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| AU2016203191A Ceased AU2016203191B2 (en) | 2006-07-25 | 2016-05-17 | Cyclosporin compositions |
| AU2018203825A Abandoned AU2018203825A1 (en) | 2006-07-25 | 2018-05-31 | Cyclosporin compositions |
| AU2020202459A Abandoned AU2020202459A1 (en) | 2006-07-25 | 2020-04-09 | Cyclosporin compositions |
Family Applications Before (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| AU2016203191A Ceased AU2016203191B2 (en) | 2006-07-25 | 2016-05-17 | Cyclosporin compositions |
| AU2018203825A Abandoned AU2018203825A1 (en) | 2006-07-25 | 2018-05-31 | Cyclosporin compositions |
Country Status (1)
| Country | Link |
|---|---|
| AU (3) | AU2016203191B2 (en) |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2577049B2 (en) * | 1987-06-04 | 1997-01-29 | 三共株式会社 | Cyclosporine preparation |
| ES2098739T3 (en) * | 1992-05-13 | 1997-05-01 | Sandoz Ltd | OPHTHALMIC COMPOSITIONS CONTAINING A CYCLOSPORIN. |
| TR200302105T4 (en) * | 2000-04-07 | 2004-02-23 | Laboratoire Medidom S. A. | Eye formulations containing cyclosporine, hyaluronic acid and polysorbate. |
| KR20020050135A (en) * | 2000-12-20 | 2002-06-26 | 조명재 | Compositions for prevention and alleviation of skin wrinkles |
| EP1929996B1 (en) * | 2004-11-09 | 2011-02-16 | Novagali Pharma S.A. | Ophthalmic emulsions containing an immunosuppressive agent |
| US7288520B2 (en) * | 2005-07-13 | 2007-10-30 | Allergan, Inc. | Cyclosporin compositions |
| US9561178B2 (en) * | 2006-07-25 | 2017-02-07 | Allergan, Inc. | Cyclosporin compositions |
-
2016
- 2016-05-17 AU AU2016203191A patent/AU2016203191B2/en not_active Ceased
-
2018
- 2018-05-31 AU AU2018203825A patent/AU2018203825A1/en not_active Abandoned
-
2020
- 2020-04-09 AU AU2020202459A patent/AU2020202459A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| AU2016203191A1 (en) | 2016-06-09 |
| AU2016203191B2 (en) | 2018-03-01 |
| AU2018203825A1 (en) | 2018-06-21 |
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