BE1013411A3 - NEW CRYSTALLINE FORM OF 6-HYDROXY HYDROCHLORIDE-3- (4- (2- (piperidin-1-yl) ethoxy) phenoxy) -2- (4-methoxyphenyl) -benzo (b) thiophene. - Google Patents

Abstract

De huidige uitvinding betreft een dakbekkingssysteem bestaande uit een hoeveelheid elementen (1) die elk bestaan uit een metalen drager (2) waaraan een isolerend volume is bevestigd. De specifieke vorm van de aansluitgroeven (4) aan de zijden van de metalen drager en van de inkeping (9) aan één zijde en een uitkraging (6) aan de andere zijde in het isolerend volume laten toe naburige elementen onder een relatieve hoek te bevestigen . De elementen van het dakbedekkingsysteem volgens de huidige uitvinding kunnen voorzien zijn van kanalen (3), waardoor het dakbedekkingsysteem kan werken als warmtewisselaar, zowel voor opname van warmte uit de omgeving, als voor opname van warmteende won.

Description

       

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 EMI1.1
 



  NEW CRYSTALLINE FORM OF 6-HYDROXY -3- (4- [2- (PIPERIDIN-1- YL) ETHOXY] PHENOXY) CHLORHYDRATE -2- (4-METHOXYPHENYL) BENZO [b] TH IOPHEN E
Basis of the invention
6-hydroxy-3- (4- [2- (piperidin-1- yl) ethoxy] phenoxy) -2- (4-methoxypheny)) benzo [b] thiophene (arzoxifene) hydrochloride has been described for the first time from a generic point of view in the patent of the United States of America US-A-5,510. 357 and was specifically revealed in United States patent US-A-5,723. 474 ('474) and in European patent application EP-A-0 729 956.



  Arzoxifen is a nonsteroidal mixed estrogen antagonist / agonist useful, among other things, for lowering serum cholesterol levels and for inhibiting hyperlipidemia, osteoporosis, estrogen-dependent cancers including breast and uterine cancer , endometriosis, disorders of the central nervous system including Alzheimer's disease, proliferation of smooth muscle cells in the aorta and restenosis.



   Specifically, arzoxifen is useful for the treatment of receptor positive metastatic breast cancer, for the adjuvant treatment of receptor positive patients, following appropriate systemic or local therapy, for reducing the recurrence of cancer invasive and non-invasive breast and for reduction of

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 the incidence of invasive breast cancer and ductal carcinoma in situ (DCIS), and has been the subject of a clinical evaluation for these treatments and these reductions. Arzoxifen is also useful in combination with radiation therapy, aromatase inhibitors, LH-RH analogs (luteinostimulin releasing hormone) and acetylcholinesterase inhibitors (AChE).



   Powder X-ray (XRD), thermogravimetric analysis (TGA), proton nuclear magnetic resonance (1 H NMR) and Karl Fischer analyzes (KF) of crude arzoxifene isolated by the methods disclosed in the '474 patent subsequently indicated that said material was hydrated, weakly crystalline and contained varying amounts of a volatile organic compound (ethyl acetate) in its network.



   Weakly crystalline materials are specifically less desirable than strongly crystalline materials for formulation processing. In addition, it is generally undesirable to formulate pharmaceuticals containing significant amounts of organic solvents (e.g. ethyl acetate) because of the potential toxicity of the solvent to its recipient and because of changes in with regard to pharmaceutical activity which depend on the solvent.



   Although arzoxifene prepared by the methods disclosed in the '474 patent could have been used as a pharmaceutical, it would be very desirable and advantageous to find a more crystalline form of arzoxifene which does not contain an organic solvent in its crystal lattice and which can be prepared reproducibly and economically on an industrial scale.



   Summary of the invention
The present invention relates to a new hydrated non-stoichiometric crystalline form of 6-hydroxy-3- (4- [2- (piperidin-1-yt) ethoxy] phenoxy) -2- (4-methoxyphenyt) benzo [b] thiophene hydrochloride

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 EMI3.1
 (F1) having an X-ray diffraction pattern which includes the following peaks: 7, 9 0, 2, 10, 7 0, 2, 14, 9 0, 2, 15, 9 0, 2, 18, 3 0, 2 and 20, 6 + 0, 2 in 29, when obtained from a source of copper lines.



   Furthermore, the present invention relates to a pharmaceutical formulation comprising F-! ; one or more pharmaceutical carriers, diluents or excipients and, where appropriate, estrogens, where appropriate progestins, where appropriate an aromatase inhibitor, where appropriate an LH-RH analog and where appropriate an inhibitor of acetylcholinesterase (AChE).



   Furthermore, the present invention relates to methods for using F-t for the purpose of inhibiting pathological conditions such as subinvolution of the uterus, endometriosis, proliferation of smooth muscle cells.
 EMI3.2
 aorta, restenosis, breast cancer, uterine cancer, prostate cancer, enlarged prostate, bone thinning, osteoporosis, cardiovascular disease, hyperlipidemia, central nervous system disorders and Alzheimer's disease and to use Ft for the manufacture of a medicament for the purpose of inhibiting the pathological conditions mentioned.



   The present invention further relates to methods for using F-t for the purpose of upregulating cholineacetyltransferase (ChAT) and for using F-t for the manufacture of a medicament for upregulating the mentioned enzyme.



   Brief description of the figures
Figure 1 is a representative plot of S-II obtained by differential analysis calorimetry (DSC) / TGA.
 EMI3.3
 



  Figure 2 is a representative plot of F-t via DSC / TGA. Figure 3 is a representative plot of F-lil via DSC / TGA.



   Figure 4 describes isothermal absorption curves for F-t and F-t) t.

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   Figure 5 describes the desolvation of 8-11 as a function of drying time and temperature.



   Detailed description of the invention
The crude arzoxifen prepared by the process revealed in document 474 is characterized by the XRD technique (example 41, crystallization from a mixture of ethanol and ethyl acetate, filtration and drying of the filter cake under vacuum until (until a constant weight is obtained at room temperature) and it turns out to be weakly crystalline. The 1 H NMR analysis confirms that the raw material contains ethyl acetate up to 6%.



   The crystallization process disclosed in document '474 was subsequently modified so that ethanol was added to a suspension of crude arzoxifene in ethyl acetate heated to reflux.



  After cooling and vacuum filtration, the solid product which is obtained from this modified process is a mixed solvation product of ethyl acetate / arzoxifene water with high crystallinity (hereinafter designated by the abbreviation 8-11) which later proved to be a starting material for Ft.



   F-t can be prepared by removing ethyl acetate from the crystal lattice of S-tut by vacuum drying / annealing F-11 at elevated temperatures. The time and temperature required for the annealing of S-tut in order to prepare Ft will vary from batch to batch, but they are specifically in the range of 5 days to around 5 C. High temperatures are necessary to obtain the conversion of F-ll to Ft via this process,

   since the transformation of F-II into a thick paste at room temperature or the storage of a sample under a relative humidity of 98% for three weeks does not give rise to a conversion into F-t. In addition, drying F-II in a convection oven at high temperatures does not result in

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 desolvation of the material, which suggests that a vacuum is also required to remove ethyl acetate from the 8-11 network.



   Preferably, F-t is easily prepared and isolated at room temperature by crystallization of arzoxifen (or any polymorphic variety / solvate thereof) from tetrahydrofuran. This crystallization is preferably carried out by first dissolving arzoxifene in wet tetrahydrofuran (from 1 to 10% of water by volume, preferably from 2.5 to 7.5%, very preferably 4.5 to 5.5%), this dissolution being followed by the elimination of said water by distillation under atmospheric pressure. An example of this crystallization is detailed below in Example 2.

   When preparing F-t using this advanced crystallization process, you can expect a total related substance level (TRS) <0.5%.



   A suitable arzoxifen starting material includes, but is not limited to, 8-11, F-lil, arzoxifen prepared by the methods disclosed in document '474 or any of their mixtures. The starting form of arzoxifene is not important, since crystallization from tetrahydrofuran according to the process described here gives rise to crystals of F-t. For a synthesis of F-t on an industrial scale, it may prove advantageous to seed the crystallization with F-t.



   F-lil, another non-stoichiometric hydrate of arzoxifene, is readily prepared, and isolated at room temperature by crystallization of arzoxifene (or any polymorphic variety or any solvate of this last) from a mixture of isopropyl alcohol (IPA) and water. The ratio of water to IPA (volume: volume) is generally about 1: 1 to 9: 1. More preferably, the ratio is between 2.5 and 5.6: 1. far preferred, the ratio is between 3 and 5.6: 1.

   The ratio of IPA to water is not critical to effect crystallization of F-lil, but it does affect the yield.

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 For a synthesis of F-III on an industrial scale, it may prove advantageous to seed the crystallization with F-ttt. An arzoxifen starting material suitable for the above crystallization includes, but is not limited to, S-tt, F-), arzoxifen prepared by the methods disclosed in document '474 or any of their mixtures .



   Characterization and differentiation of S-tt. of F-I and F-III
DSC / TGA and XRD methods are used to characterize S-H, F-I and F-ttt. TGA is often very helpful in distinguishing between different solid forms of a material since the temperature or temperatures at which a physical change in the material takes place are usually characteristic of the polymorphic variety or solvate. DSC represents a technique that is often used to detect compounds with regard to their polymorphic variation and their solvation. Finally, XRD is a technique that detects long-range order in crystalline matter.



   Arzoxifen prepared by the methods disclosed in '474 provides XRD models with poor signal-to-noise ratios and an elevated baseline, which indicates a weak crystalline material. Consequently, comparisons are made of Ft and F-III with the material (S-II) prepared by the modified method of crystallization of arzoxifene mentioned above (addition of ethanol to a suspension of arzoxifene in ethyl acetate heated to reflux).



   In Figures 1,2 and 3 respectively, representative plots of S-II, F-t and F-III are indicated via DSC / TGA. The DSC plot for S-tt indicates a large endotherm starting at around 620C which corresponds to the loss of ethyl acetate and water from the network. The endotherm starting at around 152 C represents a melt. The weight loss of approximately 2.5% indicated by the TGA appears simultaneously with the first transition while the remaining weight loss of 0.5% by weight appears with the trigger

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 of the melting, which suggests that a number of molecules of the solvent stay more firmly in the network.



   The DSC plot of F-1 has a large endotherm starting at
 EMI7.1
 around 75 C, followed by a second endotherm starting at around 155 C corresponding to a melt. The TGA plot of F-t represents a progressive weight loss of 0.3% followed by a sudden loss of 1.5% which jointly represent the dehydration of the network. The triggering of the first DSC transition and the corresponding TGA weight loss are slightly offset due to the differences in heating rates.

   The initial weight loss represents water of hydration which remains weakly maintained, while the second weight loss corresponds to an amount of approximately 0.5 mole of water present in the network at very low relative humidities ( below 5% - see humidity absorption data).



   The DSC plot of F-III is characterized by a wide low temperature endotherm at around 30 C followed by a second wide and relatively weak endotherm starting at around 70 C, as well as a final transition starting at around 146 C corresponding to a melt. The abrupt weight loss of 1.5% (0.5 mole) in the TGA coinciding with the first endotherm corresponds to the loss of water molecules which are weakly maintained, while the additional weight loss of approximately 1, 6% above 60 C represents the loss of the water molecules which are more firmly maintained, that is to say those which are present at very low relative humidities.

   The weight loss observed after 170 C corresponds to the decomposition of F-ttt.



   The XRD diagrams of F-t and F-III are characterized by well-marked peaks and by a flat baseline indicating strongly crystalline materials. The angular positions of the peaks in 28 and the corresponding 1110 data for representative samples of F-t, F-III and S-II are shown in Table 1. Although a large

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 many of the intense reflections generally form similar diffraction angles, each of the forms provides a different powder radiogram, which allows a clear distinction to be made between S-ll, F- tetF-ttt.



   It is well known in the art of crystallography that, for any given polymorphic variety, the relative intensities of the diffraction peaks can vary depending on the preferred orientation resulting from factors such as crystal morphology. When the effects of the preferred orientation are present, the intensities of the peaks change, but the positions of the peaks characteristic of the polymorphic variety remain unchanged. See, for example, The United States Pharmacopeia &num; 23, National Formular &num; 18, pages 1843-1844,1995.



  Thus, based on the intensities of the peaks, as well as on the positions of the peaks, one can identify F-1 by the presence of peaks at 7.9 0, 2.10, 7
 EMI8.1
 0, 2, 14, 9 0, 2, 15, 9 0, 2, 18, 3 0, 2 and 20, 6 0, 2 in 28, when we obtain the diagram from a source of copper lines .

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 EMI9.1
 Table 1
 EMI9.2
 
 <tb>
 <tb> 8-11 <SEP> F-1 <SEP> F-I11
 <tb> 20 <SEP> (0) <SEP> I / Io <SEP> (%) <SEP> 28 <SEP> (0) <SEP> I / lp <SEP> (%) <SEP> 20 <SEP> () <SEP> 1 / Io <SEP> (%)
 <tb> 4. <SEP> 67 <SEP> 1. <SEP> 3 <SEP> 4.92 <SEP> 2.6 <SEP> 4.63 <SEP> 20.8
 <tb> 5.03 <SEP> 6 <SEP> 7.69 <SEP> 34.6 <SEP> 7.82 <SEP> 100
 <tb> 6.83 <SEP> 5.8 <SEP> 7.91 <SEP> 100 <SEP> 9.29 <SEP> 16.9
 <tb> 7. <SEP> 17 <SEP> 16.1 <SEP> 9.89 <SEP> 2.5 <SEP> 10.16 <SEP> 22.7
 <tb> 7.73 <SEP> 100 <SEP> 10.22 <SEP> 2 <SEP> 10.35 <SEP> 5.

    <SEP> 4
 <tb> 9.03 <SEP> 1. <SEP> 3 <SEP> 10. <SEP> 74 <SEP> 7.4 <SEP> 13.77 <SEP> 10.7
 <tb> 9.31 <SEP> 1.7 <SEP> 14.86 <SEP> 9.1 <SEP> 13.97 <SEP> 15.2
 <tb> 9.66 <SEP> 2.4 <SEP> 15.45 <SEP> 2.3 <SEP> 15. <SEP> 06 <SEP> 6.9
 <tb> 10.27 <SEP> 1.6 <SEP> 15.92 <SEP> 15. <SEP> 9 <SEP> 15. <SEP> 71 <SEP> 22.3
 <tb> 10.47 <SEP> 2.2 <SEP> 16.67 <SEP> 1.7 <SEP> 15.87 <SEP> 7.4
 <tb> 10. <SEP> 91 <SEP> 6. <SEP> 3 <SEP> 16. <SEP> 98 <SEP> 3.1 <SEP> 16.35 <SEP> 34.5
 <tb> 13.63 <SEP> 2.1 <SEP> 18.28 <SEP> 17.8 <SEP> 16.77 <SEP> 12.3
 <tb> 14.09 <SEP> 4.6 <SEP> 18.56 <SEP> 7 <SEP> 17.28 <SEP> 10
 <tb> 15.10 <SEP> 4.1 <SEP> 20.58 <SEP> 13.1 <SEP> 17.62 <SEP> 47.9
 <tb> 15.52 <SEP> 10.5 <SEP> 20.

    <SEP> 85 <SEP> 8.8 <SEP> 18.09 <SEP> 43.9
 <tb> 16.45 <SEP> 9.1 <SEP> 21.64 <SEP> 3.9 <SEP> 20.43 <SEP> 42
 <tb> 16.67 <SEP> 7.6 <SEP> 22.19 <SEP> 4.8 <SEP> 20.80 <SEP> 33.6
 <tb> 17.21 <SEP> 4.9 <SEP> 22.65 <SEP> 2.9 <SEP> 21.31 <SEP> 42.7
 <tb> 17.53 <SEP> 2.4 <SEP> 23.28 <SEP> 3.4 <SEP> 21.71 <SEP> 13
 <tb> 18.33 <SEP> 28.2 <SEP> 23.97 <SEP> 11.8 <SEP> 21.85 <SEP> 14.5
 <tb> 18.69 <SEP> 11.1 <SEP> 24.31 <SEP> 6.3 <SEP> 22.13 <SEP> 12.8
 <tb> 19.37 <SEP> 3.5 <SEP> 25.52 <SEP> 3.9 <SEP> 22.26 <SEP> 16.3
 <tb> 20.29 <SEP> 8.6 <SEP> 26.20 <SEP> 3.4 <SEP> 23.51 <SEP> 13.2
 <tb> 20.64 <SEP> 17.2 <SEP> 26.47 <SEP> 3.1 <SEP> 23.69 <SEP> 15.9
 <tb> 21.02 <SEP> 12.7 <SEP> 28.84 <SEP> 6.4 <SEP> 23. <SEP> 91 <SEP> 25.6
 <tb> 21.68 <SEP> 5.1 <SEP> 30.13 <SEP> 3.5 <SEP> 24.31 <SEP> 38.7
 <tb> 22.01 <SEP> 8.3 <SEP> 31.12 <SEP> 2.9 <SEP> 25.22 <SEP> 8
 <tb> 22.29 <SEP> 8 <SEP> 25.

    <SEP> 67 <SEP> 8.9
 <tb> 23.17 <SEP> 7. <SEP> 8 <SEP> 27. <SEP> 05 <SEP> 18.9
 <tb> 23.39 <SEP> 9. <SEP> 1 <SEP> 27. <SEP> 89 <SEP> 13.3
 <tb> 24.30 <SEP> 13. <SEP> 6 <SEP> 28. <SEP> 24 <SEP> 8.6
 <tb> 25.76 <SEP> 3. <SEP> 4 <SEP> 28. <SEP> 71 <SEP> 21.3
 <tb> 26.05 <SEP> 4 <SEP> 29. <SEP> 89 <SEP> 8.9
 <tb> 26.63 <SEP> 5. <SEP> 5 <SEP> 30. <SEP> 24 <SEP> 18.7
 <tb> 27.01 <SEP> 3. <SEP> 1 <SEP> 30. <SEP> 88 <SEP> 5.8
 <tb> 27.49 <SEP> 2. <SEP> 8 <SEP> 31. <SEP> 44 <SEP> 7.6
 <tb> 28.10 <SEP> 1. <SEP> 8 <SEP> 33. <SEP> 06 <SEP> 4.5
 <tb> 28.73 <SEP> 10. <SEP> 9 <SEP> 34. <SEP> 36 <SEP> 6
 <tb> 29.42 <SEP> 3. <SEP> 2
 <tb>
 

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 EMI10.1
 Table 1 (continued)
 EMI10.2
 
 <tb>
 <tb> S-II <SEP> F-I <SEP> F-III
 <tb> 2 # <SEP> (cl) <SEP> I / Io <SEP> (%) <SEP> 20 <SEP> (0) <SEP> l / lp <SEP> (%) <SEP> 20 <SEP> (e) <SEP> I / Io <SEP> (%)
 <tb> 30.00 <SEP> 3.

    <SEP> 7
 <tb> 30.89 <SEP> 2.1
 <tb> 31. <SEP> 34 <SEP> 2. <SEP> 4
 <tb> 31.70 <SEP> 1.1
 <tb> 32.81 <SEP> 1
 <tb> 32. <SEP> 91 <SEP> 0. <SEP> 8
 <tb> 33. <SEP> 48 <SEP> 2
 <tb>
 
Subsequent characterization of F-I and F-III
Hygroscopicity studies are being performed on F-t and F-III. The humidity absorption isotherms for F1 and for F-) t) are shown in FIG. 4. When the samples are initially exposed to a relative humidity of approximately 5%, there is an immediate weight gain of 1.5% and a humidity of 1.7% for FI and for F-III, respectively, equivalent to approximately 0.5 mole of water.

   Both forms have continuous moisture absorption across the entire moisture range, which is likely due to the incorporation of water molecules into the networks.



   The difference in moisture absorption manifested by the two forms probably reflects the amount of water that can be incorporated into the two networks (i.e. the amount of space available in the network into which can come water molecules). A lack of hysteresis in the absorption-desorption isotherms of F-t and F-III indicates that the crystal forms equilibrate quickly at any given humidity.



   The moisture absorption profiles for F-1 and for F-III reveal that these forms represent essentially non-stoichiometric hydrates. At ambient relative humidity (relative humidity about 50%), F-t contains approximately 1.7% of water,

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 corresponding to 0.5 mole of water, while for F-) tt, there is an absorption of water up to about 3.0% which corresponds to about 0.85 mole of water. The raw forms of F-t and F-III quickly equilibrate with the atmosphere, so that the water content observed by analytical techniques reflects the relative humidity during data collection.

   Differences from batch to batch, observed in the DSC data, are likely due to the fact that the samples were hydrated in different measures, due to different ambient conditions during storage.



   XRD diagrams are obtained for samples of F-I and F-III stored under different relative humidities (0.22, 50 and 80%). There is a gradual shift in the initial peaks of F-!)) (Relative humidity of 0%) to around 13.8, 17.6, 18.0, 20.5 and 24.00 in 28, as well as a slight shifting of less intense peaks, as the relative humidity increases.

   These changes observed in the XRD diagrams of F-))) indicate that the dimensions of the unit cells are probably modified to take into account water molecules which are kept weak as the relative humidity increases. The continuous shift peaks with humidity show a good correlation with the humidity absorption data which indicate a progressive weight gain in this relative humidity range; there is thus proof of a variable hydrate formation.



   We carry out a similar experiment on F-t to determine whether or not varying the relative humidity will have a similar effect on its network (relative humidities of 0.25, 52.73 and 95%). There is a very slight shift of the relative humidity peaks from 0% to around 7.7,
18.3, 18.5, 20, 8 in 20, as the relative humidity increases. The peaks at about 7.7, 20.8 and 24.1 also show slight widening and lower resolution at relative humidities

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 higher, indicating that water is absorbed in the amorphous components (or plasticizes the solid product) in particular at relative humidities of 73 and 95%.

   The shift of the peaks in the XRD diagram of F-t is less spectacular than the shift of the peaks observed when exposing F-! t! at different relative humidities. This difference suggests that the F-! does not undergo the same dilation and / or the same contraction as the F-ttt network.



     F-t and F-III are found to be stable across the entire relative humidity range despite the ability of F-III to absorb approximately twice the amount of water. Both forms are found to have comparable crystal size, morphology, aqueous solubilities and dissolution rates.



   A drying study is carried out to monitor the desolvation of S-II as a function of drying time and drying temperature (see Figure 5). XRD diagrams are constructed at various times during the desolvation experiments. A large number of diffraction peaks from the S-tut desolvation study appear by forming angles similar to those of F-I confirming that the networks of S-tut and F-1 are very similar. The disappearance of the diffraction peaks at about 6.8, 7.2 and 14.00 in 28 after only minimal drying suggests that these reflections can be attributed to crystallographic planes containing a partial electron density of ethyl acetate molecules .



   Extending the annealing of the material subjected to vacuum solvation at elevated temperatures provides F-). F-I prepared in this way manifests a high degree of crystallinity via XRD. As a result, a material generated by crystallization from a solution of ethanol and ethyl acetate followed by vacuum drying for only a few hours as disclosed in the document

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 '474 exhibits very poor crystallinity since such a process gives rise to S-ll having undergone partial desolvation.



     F-1 and F-lil have various advantages over the prior art form of arzoxifen described above. Compared to arzoxifene prepared via the methods disclosed in document '474, Ft and F-III are more stable at room temperature and are therefore more likely to undergo pharmaceutical development, i.e. development a dosage formulation. In addition, F-t and F-III are much more crystalline than the form disclosed in document '474.

   Crystalline materials are generally less hygroscopic and more stable (for example; are less sensitive to chemical degradation and maintain constant activity) than amorphous materials and are therefore more desirable for treatment related to a formulation.



  In addition, unlike the form of arzoxifen produced by the processes disclosed in document '474, which contains ethyl acetate and water in its network, Ft and F-III contain only water .



   Characterization procedures
DSC measurements are carried out on a modulated DSC 2920 from TA Instruments attached to a Thermal Analyst 3100 equipped with a cooling by refrigeration system. The samples are heated (3-5 mg) in aluminum crimped cuvettes from a temperature of 10 to 240 C at a heating rate of 2 C / min.



   TGA analyzes are carried out on a Thermogravimetric Analyzer 2050 from TA Instruments attached to a Thermal Analyst 3100. The samples (5-10 mg) are heated in open cuvettes from 25 C to 250 C at a heating rate of 5 C / min.



   XRD diagrams are obtained on a D5000 powder radiogram from Siemens equipped with a CuKa source (λ = 1.54056 Å) and a Kevex monolithic detector working at 50 kV and 40 mA. We sweep each sample between 4o and 35o in 28. We leave the samples

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 equilibrate for a period of at least 30 minutes at the desired temperature and / or at the desired relative humidity before collecting the data.



   Hygroscopicity measurements are performed for F-1 and for F-lil using the VTI method as follows. Each sample is dried under vacuum at 60 ° C until no further weight loss is detected, at which point the sampling chamber is brought to a relative humidity of 0%. The humidity absorption isotherms are obtained at 25 C using a VTI vacuum humidity balancing device having the following conditions: sample size 10-15 mg, adsorption interval / 0-95% relative humidity desorption, 5% interval between steps, 10 minute interval between samples.



   The following examples further illustrate the processes for preparing the hydrates of the present invention. The examples are not intended to limit the scope of these methods in any way and should not be viewed in this way.



  Preparations
 EMI14.1
 Preparation 1 S-ll In 28 ml of ethyl acetate, crude arzoxifen (1.58 g of material prepared by the method of Example 41 of the patent of the United States of America) is suspended -A-5,723,474 (the teachings of which are incorporated herein by reference) and heated to reflux. Ethanol (18 mL) is added to dissolve. The solution is maintained at reflux for 20 minutes, then allowed to cool to room temperature.

   The precipitate is isolated by vacuum filtration and washed with 30 ml of ethyl acetate to obtain 1.05 g of a white powdery solid product.

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Examples
Example 1 F-l from S-t!
 EMI15.1
 It is dried in a vacuum oven (-25 inches Hg) at 100 C for 118 hours to obtain F-t.



   Example 2
Improved process for preparing F-1 from arzoxifene
A 1 L round-bottomed, three-tube flask equipped with a reflux condenser and a suspended agitator is loaded with 25.0 g of arzoxifene, 475 mL of tetrahydrofuran and 25 mL of water. The reaction vessel is then equipped for simple distillation. The reaction mixture is heated to reflux and 250 ml of the distillation product are removed. The heat source is briefly interrupted and 250 ml of fresh anhydrous tetrahydrofuran are added to the container. The distillation is continued at atmospheric pressure, eliminating an additional quantity of distillation product. The heat source is briefly switched off, 250 ml of fresh tetrahydrofuran are added and an additional 250 ml of distillation product is eliminated.

   An additional 250 mL of tetrahydrofuran is added and the reaction mixture is maintained at reflux. With this addition of tetrahydrofuran, a white precipitate is formed. The stirred reaction mixture is allowed to cool slowly for 3 hours, during which time additional products precipitate and the thick paste reaches room temperature. The thick crystalline paste is filtered and dried under vacuum at 50 ° C. for 48 hours with a slight nitrogen purge. 22.50 g are obtained (corresponding to a yield of 90.0% of theory). Analysis by XRD indicates that the spectra of the wet cake and the dry solid product are essentially identical and essentially identical to that of F-t prepared as indicated above.

   DSC analysis indicates a melting point of 157 C, while

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 TGA analysis indicates a loss of mass of 1.5% between room temperature and 100 C. The HPLC purity calculated in the form of the free base amounts to 88.1% compared to a theoretical activity of 92.9 %. HPLC analysis indicates a rate of total related substances of 0.44%.



   Example 3
 EMI16.1
 F-1 from 6-benzyloxy-3- [4- [2- (piperidin-1-yl) ethoxy] phenoxy] - 2 - (4-methoxyphenyl)] benzo [b] thiophene- (S-oxide)
Combine tetrahydrofuran (261 mL), water (45 mL), concentrated sulfuric acid (6.14 g) and 6-benzyloxy-3- [4- [2- (piperidin-1- yl ) ethoxy] phenoxy] -2- (4-methoxyphenyl)] benzo [b] thiophene- (S-oxide) (activity by HPLC: 99%; total content of related substances via HPLC: 0.35%) and stirred combination until a homogeneous combination is obtained. To 10% palladium-on-carbon (5.6 g transformed into a thick paste in 22 ml of water), 5 ml of rinsing water is added. The resulting thick paste is vacuumed and covered with 60 psi of hydrogen.

   The temperature of the reaction mixture is adjusted to 30 C. After 2 hours, water (30 ml) is added to 10% palladium-on-carbon (5.6 g). The hydrogenation is continued at 60 psi and 300C for an additional 22 hours. An additional 4.40 g of 10% palladium on carbon in 30 ml of water is added and the hydrogenation is continued at 60 psi and 30 ° C. for an additional 2.5 hours.



  The catalyst is removed by filtration and the pH of the filtrate is adjusted to 7.24 with 50% sodium hydroxide. Sodium chloride (8.66 g) dissolved in water (18 mL) is added and the biphasic solution is stirred for 30 minutes. The phases are separated and the aqueous phase is extracted in return with 50 ml of tetrahydrofuran. The organic phases are combined and concentrated by distillation under atmospheric pressure until a volume of 50 ml is obtained. To the concentrate at 24 ° C., methanol (180 ml) is added over a period of 1 hour. The resulting thick crystalline paste is stirred for

  <Desc / Clms Page number 17>

 30 minutes at 24 C, cooled to 0 C and stirred for one hour.

   Orf isolates the solid products by filtration and they are washed successively with 39 ml of water and with 39 ml of methanol, then dried under vacuum overnight at 50 C. We obtain 15.52 g corresponding to a yield of 67, 8% of theory.



   A portion of the product of the above preparation (10 g) is recrystallized from tetrahydrofuran and water as described in Example 2.



   Utilities
As used herein, the term "effective amount" means an amount of F-1 which is capable of inhibiting the conditions described herein or their harmful effects. When Ft is administered in combination with estrogens, progestins, an aromatase inhibitor, an LH-RH analog or an AChE inhibitor, the term "effective amount" also means an amount of such agent capable of producing the desired effect.



   The terms "inhibiting" and "inhibiting" encompass their generally accepted meaning, that is, prevention, prohibition, restriction, relief, improvement, slowing, stopping or reversing progression or the severity of a pathological condition, or its sequelae, as described here.
 EMI17.1
 



  The terms "prevention", "prophylaxis", "prophylactic" and "prevent" are used interchangeably here and mean to reduce the likelihood that an Ft recipient will contract or develop any of the pathological conditions or of their after-effects described here.



   The terms "estrogen deficient" and "lack of estrogen" refer to a condition, either naturally occurring or clinically induced, in which a woman cannot produce a sufficient amount of endogenous female sex hormones to maintain function dependent on estrogen for example the

  <Desc / Clms Page number 18>

 menstruation, homeostasis of bone mass, neuronal functions, cardiovascular state, etc.

   Such estrogen deficiency situations arise from, but are not limited to, menopause and surgical or chemical oophorectomy, including its functional equivalents, for example medication with an aromatase inhibitor, agonists or antagonists of the GnRH (gonadoliberine), ICI 182780 and the like. Conditions associated with estrogen deficiency include but are not limited to: bone thinning, osteoporosis, cardiovascular disease and hyperlipidemia.



   As used herein, the term "estrogen" encompasses steroidal compounds having estrogenic activity such as for example 17ss-estradiol, estrone, conjugated estrogens (Premarin &commat;), equine estrogens, 17ss-ethynyl-estradiol , and the like. A preferred estrogen-based compound is Premarin &commat; and norethylnodrel.



   As used herein the term "progestins" embraces compounds having progestational activity, such as for example
 EMI18.1
 progesterone, norethylnodrel, nongestrel, megestrol acetate, norethindrone, and the like. Norethindrone is a preferred progestogen-based agent.



   As used herein, the term "aromatase inhibitor" includes compounds capable of inhibiting aromatase, for example commercially available inhibitors such as aminoglutemide (CYTANDREN &commat;), anastrazole (ARIMIDEX &commat;), letrozole (FEMARA &commat;), formestane (LENATRON &commat;), exemestane (AROMASIN &commat;), and the like.



   As used herein, the term "LH-RH analog" refers to an analog of the luteinostimulin releasing hormone which inhibits estrogen production in premenopausal women, including

  <Desc / Clms Page number 19>

 for example   ! to taste! ine (ZOLADEX &commat;),! e teuprotide (LUPRON &commat;) and the like.



   As used herein, the term "acetylcholinesterase inhibitor (AChE)" embraces compounds that inhibit acetylcholinesterase, for example physostigmine salicylate, tacrine hydrochloride, donepezil hydrochloride and the like.



   As used herein, the expression "upregulation of ChAT" denotes an increase in the enzymatic activity of ChAT, that is to say the fact of promoting the conversion of choline to acetylcholine. This favorable effect includes an increase in the efficiency and / or reaction rate of ChAT and choline and / or an increase in the amount of ChAT present at the site of action. This increase in the amount of the enzyme present may be due to gene regulation or another step in the synthesis of enzyme formation and / or a decrease in deactivation and enzyme metabolism.



   Selected test procedures
General Rat Preparation Process: 75-day-old Sprague Dawley female rats (unless otherwise noted) (mean weight range 200-225 g) are obtained from Charles River Laboratories (Portage, MI). The animals underwent either a bilateral oophorectomy (OVX) or a dummy surgery at Charles River Laboratories, and were shipped after a week. When they arrive, they are placed in metal cages suspended in groups of 3 or 4 per cage and they are given free access to food (calcium content approximately 0.5%) and water for one week. The ambient temperature is maintained at 22.2
1.7 C at a minimum relative humidity of 40%.

   The lighting period in the room includes 12 hours of light and 12 hours of darkness.



   Dosage-tissue harvest dosage: After a one week acclimatization period (therefore two weeks after

  <Desc / Clms Page number 20>

 OVX), a daily dosage is started with F- !. 17a-ethynyl-estradiol or F-1 is administered orally, unless indicated otherwise, as a suspension in 1% carboxymethylcellulose or as a solution in 20% cyclodextrin. The animals are subjected to this daily dosage for 4 days. Following the dosing schedule, the animals are weighed and anesthetized with a mixture of ketamine: xylazine (2: 1, volume: volume). A blood sample is collected by cardiac puncture.

   Then, the animals are sacrificed by asphyxiation with CO 2, the uterus is removed via a midline incision and the weight of the uterus in the wet state is determined. 17a-Ethynyl-Estradiol is purchased from Sigma Chemical Co., St. Louis, MO.



   Cardiovascular disease / hyperlipidemia
The above blood samples are allowed to coagulate at room temperature for 2 hours and serum is obtained after centrifugation for 10 minutes at 3000 rpm. Serum cholesterol content is determined using a high performance cholesterol assay from Boehringer Mannheim Diagnostics. To put it briefly, we oxidize cholesterol to get cholest-4-en-3-one and hydrogen peroxide. The hydrogen peroxide is then reacted with phenol and 4-aminophenazone in the presence of peroxidase to obtain a p-quinone-imine dye which is read spectrophotometrically at 500 nm. Next, the cholesterol concentration is calculated against a standard curve.

   The entire assay is carried out automatically using a Biomek Automated Workstation.



   Determination of eosinophilic peroxidase (EPO) in the uterus
The uteri are kept at 4 ° C until the enzymatic analysis is carried out. The uteri are then homogenized in 50 volumes of 50 mM Tris buffer (pH 8.0) containing Triton X-100 at

  <Desc / Clms Page number 21>

 competition of 0.005%. After adding 0.01% hydrogen peroxide and 10 mM o-phenylene diamine (final concentrations) to the Tris buffer, the increase in absorption is monitored for 1 minute at 450 nm. The presence of eosinophils in the uterus is an indication of the estrogenic activity of a compound. The maximum speed is determined over an interval of 15 seconds relative to the initial linear portion of the reaction curve.



   Bone rarefaction inhibition (osteoporosis) test method
Following the general preparation process described above, the rats were subjected to daily treatment for 35 days (six rats per treatment group) and were sacrificed by carbon dioxide asphyxiation on the 36th day. The time span of 35 days is sufficient to allow maximum reduction in bone density, as measured as described here. At the time of sacrifice, the uteri are removed, separated from the foreign tissue by dissection, and the fluid they contain is expelled before determining the wet weight in order to confirm an estrogen deficiency associated with an oophorectomy. complete. Usually, the weight of the uterus undergoes a reduction of about 75% in response to the oophorectomy.

   The uteri are then placed in 10% neutral buffered formalin for later histological analysis.



   The right femurs are excised and the generated X-rays are digitized, then analyzed via an image analysis program (NIH image) with the distal metaphysis. The proximal aspect of the tibias of these animals is also scanned by quantitative tomography. In accordance with the methods described above, test animals are administered orally F-t or ethynyl-estradiol (EE2) in 20% hydroxypropyl-pcyclodextrin. F-t is also useful in combination with estrogens or progestins.

  <Desc / Clms Page number 22>

 



   Assay of MCF-7 proliferation
MCF-7 breast adenocarcinoma cells (ATCC HTB 22) are maintained in MEM medium (minimal essential medium free of phenol red, Sigma, St. Louis, MO) to which fetal bovine serum (FBS) has been added. ) up to 10% (volume / volume), Lglutamin (2 mM), sodium pyruvate (1 mM), HEPES {(N- [2-hydroxyethyt acid] piperazine-N'- [2 -ethanesutfonic] 10 mM}, non-essential amino acids and bovine insulin (1 ug / ml) (maintenance medium) Ten days before the assay, the MCF-7 cells are passed through a maintenance medium to which a 10% assay medium containing fatal bovine serum purified with charcoal coated with dextran (DCC-FBS) was added instead of 10% FBS to deplete internal steroid stocks.

   The MCF-7 cells are removed from the holding flasks using a cell dissociation medium (HBSS free of Ca ++ / Mg ++ (free of phenol red) to which 10 mM HEPES and 2 mM EDTA have been added). The cells are washed twice with the assay medium and the concentration is adjusted to obtain 80,000 cells / ml. Approximately 100 µL (8,000 cells) are added to flat-bottom microculture wells (Costar 3596) and incubated at 37 ° C in an incubator moistened with 5% CO2 for 48 hours to allow cell adhesion and balancing after transfer. Serial dilutions of drugs, or DMSO as a control diluent, are prepared in the assay medium and 50 ml are transferred to microcultures in triplicate, then 50 ml of the assay medium to obtain a final volume of 200 ml .

   After an additional 48 hours at 37 ° C., in an incubator humidified with 5% CO 2, the microcultures are subjected to pulses with tritium-labeled thymidine (1 μCi / well) for 4 hours. The cultures are stopped by freezing at -70 ° C. for 24 hours, then by thawing and micro-cultures are harvested using a semi-cell harvesting device.

  <Desc / Clms Page number 23>

 Skatron automatic. Samples are counted by liquid scintillation using a Wallac BetaPlace ss counter.



   DMBA-induced mammary tumor inhibition
Estrogen-dependent mammary tumors are produced in female Sprague-Dawley rats which are obtained from Harlan, Industries, Indianapolis, Indiana. After approximately 55 days of age, rats receive a single oral administration of 20 mg of 7,12-dimethylbenz [a] anthracene (DMBA). Approximately 6 weeks after administration of DMBA, the mammary glands are palpated at 1 week intervals to detect the appearance of tumors. Each time one or more tumors appear, the maximum and minimum diameters of each tumor are measured with a metric probe, the measurements are recorded and this animal is selected for experimentation.

   Attempts are made to distribute the different sizes of tumors uniformly in the treated groups and in the control groups so that medium-sized tumors are distributed equally between the test groups. The control groups and the test groups for each experiment comprise from 5 to 9 animals.



   F-t is administered either by intraperitoneal injections in 2% acacia gum or orally. Compounds administered orally are either dissolved or suspended in 0.2 mL corn oil. Each treatment, including control treatments with acacia gum and corn oil, is administered once daily to each test animal. After the initial measurement of the tumor and selection of the test animals, the tumors are measured weekly using the method mentioned above. The treatment and measurements of the animals are continued for a period of 3 to 5 weeks, after which the final surface areas corresponding to the tumors are determined.

   For each treatment with a compound and for each

  <Desc / Clms Page number 24>

 control treatment, the change in the average surface area occupied by the tumor is determined.



   Uterine subinvolution testing procedures Trial 1: A number between 3 and 20 women suffering from a uterine subinvolution is administered F-). The amount of the compound administered is 0.1 to 1000 mg / day and the administration period is 3 months. Women are observed during the administration period and up to 3 months after stopping administration to detect effects on the subinvolution of the uterus.



  Test 2: The same procedure as in test 1 is used, with the exception that the administration period extends over 6 months.



  Test 3: The same procedure as in test 1 is used, with the exception that the administration period extends over 1 year.



  Test 4: A prolonged stimulation of estrogens is used in female guinea pigs in genital maturity to induce a leiomyoma. Animals are given a dose of estradiol 3-5 times a week by injection for 2-4 months or until tumors appear. Treatments consisting of F-i or a vehicle are administered daily for 3-16 weeks, then the animals are sacrificed and the uteri are harvested and analyzed for tumor regression.



  Test 5: Tissues originating from human leiomyomas are implanted in the peritoneal cavity and / or in the muscular coat of the uterus of athymic female mice in genital maturity and castrated. Foreign estrogens are introduced to induce the growth of the implanted tissue.



  In some cases, harvested tumor cells are cultured in vitro before implantation. The treatment consisting of F-t or a vehicle is administered by gastric lavage on a daily basis for 3- 16 weeks and the implants are removed and their growth or

  <Desc / Clms Page number 25>

 regression. At the time of sacrifice, the uterus is harvested to assess the state of the organ.



  Test 6: Tissues originating from human uterine fibroids are harvested and maintained in vitro in the form of unprocessed primary cultures. Surgical samples are passed through a sterile screen or mesh or, alternatively, dissociated from surrounding tissue to obtain a suspension containing only cells. The cells are maintained in media containing 10% serum and antibiotics. Growth rates are determined in the presence and absence of estrogens. The cells are assayed for their ability to produce the complement component C3 and for their response to growth factors and growth hormone.

   In vitro cultures are analyzed for their proliferating response following treatment with progestins, with GnRH, with F-1 and with a vehicle. Steroid hormone receptor levels are assessed once a week to determine whether important cell characteristics are retained in vitro. Tissues from 5-25 patients are used.



  Test 7: The Ability of F1 to Inhibit an Energized Proliferation by Estrogens of ELT Cell Lines Derived from Leiomyomas is Measured Essentially as Described in Fuchs-Young et al "Inhibition of Estrogen-Stimulated Growth of Uterine Leiomyomas by Selective Estrogen Receptor Modulators" , Mol. Char., 17 (3): 151-159 (1966), the teachings of which are incorporated here for reference.



   Endometriosis test procedures Test 1: As test animals, 12 to 30 adult female rats of CD strain are used. They are divided into three groups containing an equal number of animals. We monitor the oestrus cycle of all animals. On the day of the pro-estrus, we perform a surgical operation on

  <Desc / Clms Page number 26>

 each female. The females in each group are removed from the left fallopian tube, sectioned into small squares, and the sutures are lightly sutured at various sites adjacent to the flow of mesenteric blood. In addition, the ovaries of group 2 females are removed.

   The day after the surgical operation, the animals corresponding to groups 1 and 2 receive injections of water intraperitoneally for 14 days, while the animals of group 3 receive injections intraperitoneally of 1.0 mg of Ft per kg of bodyweight during the same period. After 14 days of treatment, each female is sacrificed and the endometrial explants, adrenal glands, uterine remains and ovaries are removed, as appropriate, and prepared for histological examination. Weigh the ovaries and adrenal glands.



  Test 2: As test animals, 12 to 30 adult female rats of CD strain are used. They are divided into two equal groups. We monitor the oestrus cycle of all animals. On pro-oestrus day, a surgical operation is performed on each female. The females, in each group, are removed from the left fallopian tube, cut into small squares, and lightly sutured the squares at various sites adjacent to the flow of mesenteric blood. Approximately 50 days after surgery, animals assigned to group 1 receive intraperitoneal water injections for 21 days, while animals in group 2 receive intraperitoneal injections of 1.0 mg Ft per kg of body weight during the same period.

   After 21 days of treatment, each female is sacrificed and the endometrial explants and adrenal glands are removed and weighed.



   The explants are measured to get an indication of growth. We monitor the oestrus cycles.



   Trial 3: Autografts of endometrial tissue are used to induce endometriosis in rats and / or rabbits. Female animals in reproductive maturity are subjected to a bilateral oophorectomy

  <Desc / Clms Page number 27>

 and estrogens are introduced exogenously to thereby obtain a specific and constant concentration of hormones. Autologous endometrial tissue is implanted into the peritoneum of 5-150 animals and estrogens are introduced to induce the growth of the explanted tissue. The treatment consisting of a compound of the present invention is applied by gastric lavage on a daily basis for 3-16 weeks and the implants are removed, then measured to detect growth or regression. At the time of sacrifice, the intact fallopian tube is harvested to assess the state of the endometrium.



  Test 4: Tissues from human endometrial lesions are implanted in the peritoneum of athymic female mice in genital maturity and castrated. Exogenous estrogens are introduced to induce the growth of explanted tissue. In some cases, harvested endometrial cells are cultured in vitro before implantation. The F-t treatment administered via gastric lavage is administered daily for 3-16 weeks, the implants are removed and measured to detect growth or regression. At the time of sacrifice, the uteri are harvested to assess the condition of the intact endometrium.



  Test 5: Tissues from human endometrial lesions are harvested and maintained in vitro in the form of unprocessed primary cultures. Surgical samples are passed through a sterile screen or mesh or, alternatively, dissociated from surrounding tissue to obtain a suspension containing only cells. The cells are kept in media containing serum at
10% and antibiotics. Growth rates are determined in the presence and absence of estrogens. The cells are assayed for their ability to produce the complement component C3 and for their response to growth factors and growth hormone.

   In vitro cultures are analyzed for their proliferative response following treatment with progestins, with GnRH, with

  <Desc / Clms Page number 28>

   F-t and with a vehicle. Steroid hormone receptor levels are assessed once a week to determine whether important cell characteristics are retained in vitro. Tissues from 5-25 patients are used.



   Central nervous system disorders including Alzheimer's disease
Estrogens, such as 17ss-estradiol, regulate gene transcription by binding to estrogen receptors (ERs) that reside in the cytoplasm of certain cell populations. The activation of the ER ligand constitutes a prerequisite for the nuclear transport of the complex in which the binding to a consensus DNA palindrome of 13 base pairs (element of response to estrogens or ERE) starts the assembly of a transcription, which culminates in the activation of appropriate target genes.

   A variety of genes have been identified that are regulated by estrogens. They include cytotoxic proteins, enzymes and biosynthetic and metabolic receptors serving as neurotransmitters, as well as other hormones and neuropeptides.



  EREs have been identified in a large number of estrogen response genes, including vitellogenin, the c-fos gene, prolactin, and the luteinizing hormone.



   ERE-like sequences, important in the central nervous system, have been identified in p75ngr and trkA which both serve as signaling molecules for neurotrophins: nerve cell growth factor (NGF), cell growth factor nerve derived from the brain (BDNGF) and neurotrophin-3.



   BDNGF, like NGF, has been shown to promote the survival of cholinergic neurons in culture. It is hypothesized that if the interactions between neurotrophins and estrogens are important for the development and survival of the basic neurons of the forebrain (which manifest degeneration in Alzheimer's disease) clinical conditions in which there is a deficiency

  <Desc / Clms Page number 29>

 estrogens (as is the case after menopause) can contribute to the loss of these neurons.



   The following experiment was carried out on ovariectomized rats (prepared as described above) in order to determine the similarities and / or the differences between F-! and estrogens in terms of how they affect gene expression in different regions of the brain. 6-week-old rats are administered daily doses of estradiol benzoate (0.03 mg / kg), F-t or vehicle (control) via subcutaneous injections. After 5 weeks of treatment, the animals are sacrificed, their brains are removed and their seahorses are harvested by microdissection. Seahorses are flash frozen in liquid nitrogen and stored at -70 C.

   Total RNA is prepared from pooled tissue from the appropriate treatment groups and control groups and subjected to reverse transcription by
 EMI29.1
 using a 3 ′ oligonucleotide primer which has been selected for specific (poly +) mRNA populations. Polymerase chain reaction (PCR) is carried out in a cocktail consisting of: 5 'random oligonucleotides (having a length of 10 base pairs; 150 in total), a reaction buffer, the Taq polymerase and a 32PdTCP.



   After 40 amplification cycles, the reaction products are subjected to size fractionation on a 6% TBE-urea TBE gel, dried and exposed to x-ray film. The resulting mRNA display patterns are compared between the treatment groups.



   Use of F-t in conjunction with estrogens
Peri-and post-menopausal women are often subjected to hormone replacement therapy (HRT) to combat the negative consequences associated with the drop in the number of estrogens

  <Desc / Clms Page number 30>

 endogenous in circulation, for example to treat hot flushes. However, HRT is associated with an increased risk associated with certain cancers including uterine cancer and breast cancer. F-t can be used in conjunction with HRT to inhibit these risks.



   Use of F-1 in conjunction with an aromatase inhibitor
By definition, the ovaries of a postmenopausal woman are no longer in function. Its only source of estrogen is dependent on the conversion of adrenal androgens to estrogens via the enzyme aromatase which is found in peripheral tissues (including, fats, muscles and the cancerous tumor itself). For example, drugs that inhibit aromatase (aromatase inhibitors) deplete circulating estrogens in postmenopausal women. Estrogen deficiency through aromatase inhibition represents an important treatment option for patients with metastatic breast cancer.

   During therapy with an aromatase inhibitor, the lack of circulating estrogens can give rise to unexpected negative side effects for example on serum lipid levels. F-t can be used to inhibit these negative effects.



   Use of F-t in conjunction with an LH-RH analog
Continuous exposure to an LH-RH analog (luteinizing hormone releasing hormone) inhibits estrogen production in premenopausal women by desensitizing the pituitary gland which no longer stimulates the ovaries to produce estrogen. The clinical effect is a "medical oophorectomy" which is reversible when exposure to the LH-RH analog is ended. During therapy with an LH-RH analogue, a lack of circulating estrogens can give rise to unexpected negative side effects for example on serum lipid levels. F-1 can be used to inhibit these negative effects.

  <Desc / Clms Page number 31>

 



   Increased acetylcholine levels
It is known that patients suffering from Alzheimer's disease manifest a remarkably lower level of cholinergic neurons in the hippocampus than their peers who do not suffer from Alzheimer's disease. The gradual loss of these cholinergic neurons reflects the gradual loss of memory and cognitive function in these patients. It is believed that one reason for the decline of these neurons is the loss or decrease in the function of acetylcholine acting as a neurotransmitter.



   The level of acetylcholine in a neuron is basically determined by where the balance between its biosynthesis and its biodegradation comes into play. The enzyme choline acetyltransferase (ChAT) is mainly responsible for its synthesis and acetylcholinesterase (AChE) is mainly responsible for its degradation.



   In order to determine the effect of Ft on the levels of ChAT, the experiment is carried out below: by following the general preparation process for rats described above, 40 rats are administered a daily dose, by injection subcutaneously or by oral gavage, of F-I at a rate of 3 mg / kg / day in a vehicle containing cyclodextrin at 10%, of estradiol benzoate at a rate of 0.03 or 0, 3 mg / kg / day or from a control vehicle. Animals are treated for 3 days or 10 days. Twenty animals are affected by each regimen. At appropriate time intervals, the animals are sacrificed and their brains are dissected. The particular portions of the brains are homogenized and dosed.

   Homogenization products from the hippocampus and the frontal cortex are treated and the activity of ChAT is determined using a radiolabelled assay of the biosynthesis of acetylcholine. This process is available in Schoepp et al., J. Neural Transmiss., 78: 183-193,1989, the teachings of which are incorporated here for reference.

  <Desc / Clms Page number 32>

 



   As would be expected, in OVX animals, the CHAT levels show a reduction> 50% (p <0.001) compared to witnesses subjected to a dummy operation.



   In another embodiment of the invention, F-t is used in combination with an AChE inhibitor. Using an AChE inhibitor increases acetylcholine levels by blocking its breakdown by inhibiting AChE.



   Prostate enlargement (BPH)
For information concerning the link between the action of estrogens and the treatment of BPH and prostate carcinoma, reference is made to PCT application No. WO 98/07274, date of international publication: October 15, 1998.



   In the experiments described below, the ability of F-t to bind to estrogen receptors in different human prostate cancer cell lines is evaluated.



   Iysates of human prostate cancer cell lines LNCaP, DU-45 and PC-3 are prepared in a TEG medium comprising 50 nM Tris. HCI, pH 7.4, 1.5 mM ethylenediaminetetraacetic acid (EDTA), 0.4 M KCI, 10% glycerol, 0.5 mM 2-ME and 10 mM sodium molybdat additionally containing the protease inhibitors
 EMI32.1
 after: pepstatin (1 mg / ml), leupeptin (2 mg / ml), aprotinin (5 mg / ml) and phenyl-methylsulfonyl fluoride (PMSF, 0.1 mM) (TEGP).



   The cell lysates are centrifuged and the pellets are resuspended in cold TEGP (1 ml of TEGP / 100 mg of pellets) and subjected to ultrasound treatment for 30 seconds (working cycle: 70%, output: 1, 8) on a Branson Model 450 ultrasound treatment device. The Iysates are pelleted by centrifugation at 10,000 xg for 15 minutes at 4 ° C .; after which the supernatants are removed and either used immediately or stored at -70 C.

  <Desc / Clms Page number 33>

 



   Assay using a competitive bond between two substances: the binding buffer is TEG in which the 0.4 M KCI is replaced by 50 mM NaCI and to which 1 mg / ml of ovalbumin (TEGO) is subsequently added. We say) F-! up to 20 nM in TEGO, then successive dilutions are prepared in triplicate. Assays are carried out in polypropylene microplates with a round bottom in microwells in triplicate.

   35 ml of 17ss-tritium-labeled estradiol (0.5 nM, specific activity 60.1 Ci / mmol, Dupont-New England Nuclear, Boston, MA) and 35 ml of cold competition test compound are introduced into each well. (0.1 nM-5 mM) or TEGO and, following an incubation for 5 minutes at 4 ° C. while shaking, 70 ml of Iysate of the cell line MC-7.



   The plates are incubated for 24 hours at 4 ° C .; after which, 70 ml of charcoal coated with dextran (DCC) are added to each well and the mixture is vigorously stirred for 8 minutes at 4 "C. The plates are then centrifuged at 1500 xg for 10 minutes at 4 C. The supernatant is collected of each well in a flexible polystyrene microplate for scintillation counting purposes in a Wallac Micobeta Model 1450 counter. Radioactivity is expressed by the number of disintegrations per minute (DPM) after having made a correction to take into account the counting efficiency (35-40%) and background noise Additional controls in the form of total counts and total counts + DCC are used to define the lower limit of countings extractable from DCC.

   The results of these assays using a competitive bond between two substances are expressed as an average in percent in the bound state (bound percent) +/- standard deviation with reference to the formula:

  <Desc / Clms Page number 34>

 
 EMI34.1
 
Breast cancer prevention
The present invention also relates to the administration of F-1 to a recipient who is at risk of developing de novo breast cancer. The expression "de novo" as used herein designates the lack of transformation or metamorphosis of normal breast cells into cancerous or malignant cells in the first instance.

   Such a transformation can appear in stages in the same cells or in daughter cells via an evolutionary process or it can appear during a single essential event. This de novo process is opposed to metastasis, colonization or proliferation of already transformed or malignant cells from the primary tumor site to new places.



   A person who has no particular risk of developing breast cancer is one who may develop de novo type breast cancer, who has no signs or suspicion of potentially developing the disease, - above normal risk, and who has never presented a diagnosis revealing the disease. The maximum risk factor contributing to the development of breast carcinoma is the fact of having been affected by the disease during her personal history or even a previous manifestation of the disease, even if she is in remission or without any proof of her presence. Another risk factor is a family history related to the disease.



   The induction of mammary tumors in rats by the administration of N-nitroso-N-methylurea as a carcinogen is a well-accepted animal model for the study of breast cancer and has been

  <Desc / Clms Page number 35>

 proven to be suitable for analyzing the effect of chemotherapeutic preventive agents.



   In two separate studies, a dose of 50 mg N-nitroso-N-methylurea per kg bodyweight is administered intravenously (study 1) or peritoneally (study 2) one week before feeding ad libitum with a diet in which various amounts of F-!, base (Z) -2- [4- (1, 2-diphenyl-1-butenyl) phenoxy] -N, Ndimethylethanamine (tamoxifen base) or a control are mixed .



   In Study 1, the dietary doses of 60 mg / kg diet and 20 mg / kg diet translate into roughly comparable doses of 3 and 1 mg / kg bodyweight for animals. trial.



   In Study 2, the dietary doses of 20.6, 2 and 0.6 mg / kg of diet translate into roughly comparable doses of 1.0, 3.0, 1 and 0.03 mg / kg of body weight for test animals.



   The rats are observed for a manifestation of toxicity and are weighed and palpated for tumor formation once a week. The animals are sacrificed after thirteen weeks (study 1) or after eighteen weeks (study 2) and the presence of tumors is confirmed and weighed after autopsy.



   Formulations
The term "pharmaceutical" when used herein as an adjective essentially means being harmless to the recipient mammal. By the expression "pharmaceutical formulation", it is meant that the support, the diluent, the excipients, the active ingredient or ingredients must be compatible with the other ingredients of the formulation and be harmless for their recipient.



   Preferably, F-t is formulated before administration. The selection of the formulation should be left to the decision of the attending physician in

  <Desc / Clms Page number 36>

 taking into account the same factors as those involved in determining the effective amount.



   The active ingredients in their entirety comprising in such formulations from 0.1% to 99.9% by weight of the formulation. Preferably, said formulation does not contain more than two active ingredients. By this we mean that we prefer to formulate F-t with a second active ingredient chosen from the group comprising an estrogen, a progestogen, an aromatase inhibitor, an LH-RH analog and an AChE inhibitor. Far preferred formulations are those in which F-1 is the only active ingredient.



   The pharmaceutical formulations of the present invention are prepared by methods known in the art using well known and readily available ingredients. For example, we formulate F-), either alone or in combination with an estrogen, with a progestogen, with an aromatase inhibitor, with an LHRH analog or with an AChE inhibitor, with excipients, common diluents or carriers and processed into tablets, capsules, suspensions, solutions, injectables, aerosols, powders and the like.



   Pharmaceutical compositions of the present invention for parenteral administration include sterile aqueous or non-aqueous solutions, dispersions, suspensions or emulsions, as well as sterile powders which are reconstituted immediately before use to obtain solutions or sterile suspensions.

   Examples of suitable sterile aqueous and non-aqueous carriers, diluents, solvents or vehicles include water, physiological saline, ethanol, polyols (such as glycerol, propylene glycol, polyethylene glycol, and the like) , as well as suitable mixtures of these polyols, vegetable oils (such as olive oil) and injectable organic esters

  <Desc / Clms Page number 37>

 such as ethyl oleate. An appropriate fluidity is maintained, for example by using coating materials such as lecithin, by maintaining an appropriate particle size in the case of dispersions and suspensions and by using surfactants.



   Compositions for parenteral administration may also contain adjuvants such as preservatives, wetting agents, emulsifiers and dispersing agents. Protection against the action of microorganisms is guaranteed by the inclusion of anti-bacterial and anti-fungal agents, for example methyl and propyl para-hydroxybenzoates, chlorobutanol, phenol, sorbic acid and the like. It may also be desirable to include isotonic agents such as sugars, sodium chloride and the like. Prolonged absorption of injectable formulations can be provided by the inclusion of agents that delay absorption such as aluminum monostearate and gelatin.



   In some cases, in order to prolong the effect of the drug, it is desirable to slow the absorption of the drug following injection by the subcutaneous or intramuscular route. This slowing can be achieved by using a liquid suspension of a crystalline material having a low solubility in water or by dissolving or alternatively by suspending the drug in an oily vehicle. In the case of a subcutaneous or intramuscular injection of a suspension containing a form of the drug having low water solubility, the rate of absorption of the drug depends on its rate of dissolution.



   "Delay-effect" Ft injectable formulations are prepared by forming microencapsulated matrices of the drug in biodegradable polymers such as polylactic acid, polyglycolic acid, copolymers of lactic acid and glycolic acid, polyorthoesters and polyanhydrides, these materials being described in

  <Desc / Clms Page number 38>

 technical. Depending on the ratio of drug to polymer and the characteristics of the particular polymer used, the rate of drug release can be adjusted.



   Injectable formulations are sterilized for example by filtration through filters retaining the bacteria or by prior sterilization of the components of the mixture before mixing them either at the time of their manufacture, or just before their administration (as is the case for example in two-chamber syringe packaging).



   Solid dosage forms for oral administration include capsules, tablets, pills, powders and granules. In solid dosage forms of this type, Ft is mixed with at least one inert pharmaceutical carrier such as sodium citrate or dicalcium phosphate and / or (a) fillers or extenders such as starches, sugars including lactose and glucose, mannitol and silicic acid, (b) binders such as carboxymethyl cellulose and other derivatives of cellulose, alginates, gelatin, polyvinylpyrrolidone, sucrose and acacia gum, (c) moistening agents such as glycerol, (d) disintegrating agents such as agar-agar, calcium carbonate, sodium bicarbonate,

   potato or tapioca starch, alginic acid, silicates and sodium carbonate, (e) hydrating agents such as glycerol, (f) agents delaying dissolution such as paraffin, (g) absorption accelerating agents such as quaternary ammonium compounds, (h) wetting agents such as cetyl alcohol and glycerol monostearate, (i) absorption agents such as kaolin and bentonite clay and 0) lubricants such as talc, calcium stearate, magnesium stearate, solid polyethylene glycols, sodium lauryl sulfate and mixtures thereof.
In the case of capsules, tablets and pills, the dosage form may also contain buffering agents.

   

  <Desc / Clms Page number 39>

 



   Solid compositions of similar type may also include filling capsules with soft or hard gelatin using excipients such as lactose, as well as high molecular weight polyethylene glycols and the like.



   Solid dosage forms such as tablets, dragees, capsules, pills and granules can also be prepared using coatings or envelopes such as enteric and enteric coatings or other coatings well known in the art. the formulation technique of pharmaceutical products. the coatings may contain opacifiers or agents which release the active ingredient or ingredients into a particular part of the digestive tract, such as for example acid-soluble coatings to release the active ingredient or ingredients into the stomach or base-soluble coatings to release the active ingredient (s) into the intestine.



   The active ingredient or ingredients may also be microencapsulated in a sustained release coating, the microcapsules being part of a pill or capsule formulation.



   Liquid dosage forms for oral administration of F-t include solutions, emulsions, suspensions, syrups and elixirs. In addition to the active components, the liquid formulations can include inert diluents commonly used in the art such as water or other pharmaceutical solvents, solubilizers and emulsifiers such as ethanol,
 EMI39.1
 isopropanol, ethyl carbonate, ethyl acetate, benzyl alcohol, benzyl benzoate, propylene glycol, 1,3-butylene glycol, dimethylformamide, oils (in particular, cotton seeds, crushed walnut oil, corn oil, sprout oil, olive oil, beaver oil and sesame oil), glycerol, tetrahydrofurfuryl alcohol ,

   polyethylene glycols, fatty acid esters

  <Desc / Clms Page number 40>

 sorbitol and mixtures thereof. In addition to inert diluents, liquid formulations for oral administration may also include adjuvants such as wetting agents, emulsifiers and suspending agents, as well as sweeteners, flavorings and fragrances.



   Liquid suspensions may contain, in addition to the active ingredient or ingredients, suspending agents such as ethoxylated isostearyl alcohol, polyoxyethylenesorbitol and sorbitan esters, microcrystalline cellulose, aluminum metahydroxide, bentonite clay, agar-agar and tragacanth, and mixtures thereof.



   Compositions for rectal or intravaginal administration are prepared by mixing F1 with suitable non-irritating excipients such as cocoa butter, polyethylene glycol or any suppository wax, which is solid at room temperature but liquid at body temperature and therefore melts in the rectal or vaginal cavity to release the active component (s). The compounds are dissolved in the melted wax, are shaped to obtain the desired shape and are cured to obtain the ready-to-use suppository formulation.



     F-t can also be administered in the form of liposomes.



  As is known in the art, liposomes are generally derived from phospholipids or other lipid substances. Liposome formulations are prepared via monolamellar or multilamellar hydrated liquid crystals which are dispersed in an aqueous medium. Any non-toxic, pharmaceutical and metabolizable lipid capable of forming liposomes can be used. The compositions of the present invention in the form of liposomes may contain in addition to F-t, stabilizers, excipients, preservatives and the like.

  <Desc / Clms Page number 41>

 The preferred lipids are phospholipids and phosphatidylcholines (lecithins), both natural and synthetic.



   Methods for forming liposomes are known in the art, as described for example in Prescott, Ed., Methods in Cell Biology, volume XIV, Academic Press, New York, N. Y. (1976), pages 33 and following.



   The examples of formulations below are only given by way of illustration and are not intended to limit the scope of the present invention.



  Formulation 1: gelatin capsules
Hard gelatin capsules are prepared using the following ingredients:
 EMI41.1
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / capsule)
 <tb> F-I <SEP> 0, <SEP> 1-1000
 <tb> Starch, <SEP> NF <SEP> 0-650
 <tb> Powder Starch <SEP> <SEP> suitable <SEP> to <SEP> the flow <SEP> 0 <SEP> - <SEP> 650
 <tb> Fluid <SEP> from <SEP> silicone <SEP> 350 <SEP> centistokes <SEP> 0-15
 <tb>
 The above wording can be modified while respecting reasonable variations envisaged.



   A tablet formulation is prepared using the ingredients below.



  Formulation 2: tablets
 EMI41.2
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / tablet)
 <tb> F-I <SEP> 2, <SEP> 5 <SEP> - <SEP> 1000
 <tb> Cellulose <SEP> microcrystalline <SEP> 200 <SEP> - <SEP> 650
 <tb> Dioxide <SEP> from <SEP> silicon <SEP> smoked <SEP> 10 <SEP> - <SEP> 650
 <tb> Acid <SEP> stearic <SEP> 5-15
 <tb>
 

  <Desc / Clms Page number 42>

 The components are mixed thoroughly and compressed to obtain tablets.



  Formulation 3: Tablets containing approximately 10 and 50 mg, respectively, of F-1 can be prepared as follows:
 EMI42.1
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> Quantity
 <tb> (mg / tablet) <SEP> (mg / tablet)
 <tb> 'Fi) <SEP> 11, <SEP> 3 <SEP> 56, <SEP> 5
 <tb> Lactose <SEP> anhydrous <SEP> 176.8 <SEP> 128.2
 <tb> Spray <SEP> from <SEP> lactose <SEP> dried <SEP> special <SEP> 44.2 <SEP> 32.0
 <tb> Povidone <SEP> 11, <SEP> 0 <SEP> 13.0
 <tb> Polysorbate <SEP> 80 <SEP> 2.5 <SEP> 2.6
 <tb> Crosspovidone <SEP> (interior) <SEP> 6.25 <SEP> 6.24
 <tb> Crosspovidone <SEP> (exterior) <SEP> 6.25 <SEP> 6.5
 <tb> Stearate <SEP> from <SEP> magnesium <SEP> 1.5 <SEP> 1.7
 <tb> Cellulose <SEP> microcrystalline <SEP> (exterior) <SEP> 0.0 <SEP> 13.0
 <tb>
 The components are mixed thoroughly and compressed to obtain tablets.



   As a variant, tablets are prepared as follows, each containing 2.5 to 1000 mg of F-1:

  <Desc / Clms Page number 43>

 Formulation 4: tablets
 EMI43.1
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / tablet)
 <tb> F-25-1000
 <tb> Starch <SEP> 45
 <tb> Cellulose <SEP> microcrystalline <SEP> 35
 <tb> Polyvinylpyrrolidone <SEP> 4
 <tb> (under <SEP> form <SEP> of a <SEP> solution <SEP> to <SEP> 10% <SEP> in <SEP> from <SEP> water)
 <tb> Carboxymethylcellulose <SEP> from <SEP> sodium <SEP> 4.5
 <tb> Stearate <SEP> from <SEP> magnesium <SEP> 0.5
 <tb> Talc <SEP> 1
 <tb>
 F-t, starch and cellulose are passed through a 45 mesh U. S. screen and thoroughly mixed. The polyvinylpyrrolidone solution is mixed with the resulting powders which are then passed through a 14 mesh U. S. sieve.

   The granules thus obtained are dried at 50 ° -60 ° C. and passed through a sieve of 18 US mesh. The sodium carboxymethyl starch, magnesium stearate and talc are then added to the granules, which have been passed beforehand. through a 60 mesh US sieve; then, the granules are compressed, after having mixed them, to obtain tablets on a machine intended for this purpose.



   Suspensions each containing 0.1 to 1000 mg of drug per 5 ml dose are prepared as follows:

  <Desc / Clms Page number 44>

 Formulation 5: suspensions
 EMI44.1
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / 5 <SEP> mL)
 <tb> F-1 <SEP> 0, <SEP> 1-1000 <SEP> mg
 <tb> Carboxymethylcellulose <SEP> from <SEP> sodium <SEP> 50 <SEP> mg
 <tb> Syrup <SEP> 1.25 <SEP> mg
 <tb> Solution <SEP> of acid <SEP> benzoic <SEP> 0.10 <SEP> mL
 <tb> Flavoring <SEP> to <SEP> see
 <tb> Dye <SEP> to <SEP> see
 <tb> Water Purified <SEP> <SEP> for <SEP> complete <SEP> to <SEP> 5 <SEP> mL
 <tb>
 The drug is passed through a 45 mesh U. S. sieve and mixed with sodium carboxymethylcellulose and syrup to obtain a uniform paste.

   The benzoic acid solution, flavoring agent and color are diluted with a small amount of water and added while stirring. Then add the sufficient amount of water to obtain the required volume.



   An aerosol solution containing the following ingredients is prepared: Formulation 6: aerosol
 EMI44.2
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (% <SEP> in <SEP> weight)
 <tb> - <SEP> 0, <SEP> 25
 <tb> Ethanol <SEP> 25.75
 <tb> Pulser <SEP> 22 <SEP> (chlorodifluoromethane) <SEP> 70.00
 <tb>
 F-1 is mixed with ethanol and the mixture is added to a portion of the blower 22, cooled to 300C and transferred to a filling device. The required quantity is then conveyed to a stainless steel container and diluted with the rest of the pulser.

   The valve units are then adapted to the container.

  <Desc / Clms Page number 45>

 
Suppositories are prepared as follows: Formulation 7: suppositories
 EMI45.1
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / suppository)
 <tb> - <SEP> 250
 <tb> Glycerides <SEP> of acids <SEP> bold <SEP> saturated <SEP> 2000
 <tb>
 F-I is passed through a 60 mesh U. S. sieve and suspended in the glycerides of saturated fatty acids which have been previously melted using the minimum heat required. The mixture is poured into a suppository mold with a nominal capacity of 2 g and allowed to cool.



   A formulation for intravenous administration is prepared as follows: Formulation 8: solution for intravenous administration
 EMI45.2
 
 <tb>
 <tb> Ingredient <SEP> Quantity
 <tb>! <SEP> 50 <SEP> mg
 <tb> Solution <SEP> saline Isotonic <SEP> <SEP> 1.000 <SEP> mL
 <tb>
 
The solution of the above ingredients is administered intravenously to a patient at a rate of approximately 1 mL / min.



  Formulation 9: combination capsule 1
 EMI45.3
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / capsule)
 <tb> 'Fi) <SEP> 50
 <tb> Pre <SEP> sailor <SEP> 1
 <tb> Avicel <SEP> pH <SEP> 101 <SEP> 50
 <tb> Starch <SEP> 1500 <SEP> 117, <SEP> 50
 <tb> Oil <SEP> from <SEP> silicone <SEP> 2
 <tb> Tween <SEP> 80 <SEP> 0.50
 <tb> Cab-O-Sil <SEP> 0, <SEP> 25
 <tb>
 

  <Desc / Clms Page number 46>

 
 EMI46.1
 Formulation 10: combination capsule Il
 EMI46.2
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / capsule)
 <tb> Zu
 <tb> Norethylnodrel <SEP> 5
 <tb> Avicel <SEP> pH <SEP> 101 <SEP> 82.50
 <tb> Starch <SEP> 1500 <SEP> 90
 <tb> Oil <SEP> from <SEP> silicone <SEP> 2
 <tb> Tween <SEP> 80 <SEP> 0.50
 <tb>
 Formulation 11:

   combination tablet
 EMI46.3
 
 <tb>
 <tb> Ingredient <SEP> Quantity <SEP> (mg / capsule)
 <tb> - <SEP> 50
 <tb> Pre <SEP> sailor <SEP> 1
 <tb> Starch <SEP> from <SEP> corn <SEP> NF <SEP> 50
 <tb> Povidone, <SEP> K29-32 <SEP> 6
 <tb> Avicel <SEP> pH <SEP> 101 <SEP> 41.50
 <tb> Avicel <SEP> pH <SEP> 102 <SEP> 136.50
 <tb> Crospovidone <SEP> XLIO <SEP> 2.50
 <tb> Stearate <SEP> from <SEP> magnesium <SEP> 0.50
 <tb> Cab-O-Sil <SEP> 0.50
 <tb>
 
Dosage
The specific dose of F-t administered in accordance with the present invention is determined by the particular circumstances surrounding each situation.

   These circumstances include the route of administration, the recipient's previous medical history, the medical condition or symptom being treated, the severity of the condition / symptom being treated, as well as the age and gender of recipient.

  <Desc / Clms Page number 47>

 



   In general, a minimum effective daily dose of F-1 is approximately 1.5, 10.15 or 20 mg. Specifically, a maximum effective dose is approximately 800,100, 60.50 or 40 mg. Specifically, the dose is in the range of 15 mg to 60 mg. The exact dose may be determined in accordance with standard practice in the medical art of subjecting the recipient to an "increase in dose"; by this is meant that a low dose of the compound is first administered and that the dose is gradually increased until the desired therapeutic effect is observed.



   Although it may be necessary to subject the recipient to a "dose increase" compared to the combination therapies discussed above, specific doses of active ingredients other than Ft are: ethynyl-estrogen ( 0.01-0.03 mg / day), mestranol (0.05-0.15 mg / day), combined estrogen hormones (e.g. Premarin &commat;,Wyeth-Ayerst;

   0.3-2.5 mg / day), medroxyprogesterone (2.5-10 mg / day), norethylnodrel (1.0-10-10 mg / day), nonethindrone (0.5-2.0 mg / day) ), aminoglutemide (250-1250 mg / day, preferably 250 mg four times a day), anastrazole (1-5 mg / day, preferably 1 mg once a day), letrozole (2, 5-10 mg / day , preferably 2.5 mg once daily), formestane (250-1250 mg / week, preferably 250 mg twice weekly), exemestane (25-100 mg / day, preferably 25 mg once daily) , goserlin (3-15 mg / three months, preferably 3-6.2 7.2 mg once every three months) and leuprolide (3-15 mg / month, preferably 3.75-7.5 mg once per month).



   Routes of administration
F-t can be administered via a variety of routes including the oral route, the rectal route, the transdermal route, the subcutaneous route, the intravenous route, the intramuscular route and the intranasal route. The method of administration of each estrogen and progestogen agent

  <Desc / Clms Page number 48>

 is in accordance with what is known in the art. F-!, Alone or in combination with an estrogen, a progestin, or an AChE inhibitor will generally be administered in an adequate formulation.



   The pharmaceutical compositions of the present invention can be administered to humans and other mammals (e.g., dogs, cats, horses, pigs, and the like) orally, rectally, intravaginally, parenterally, locally, buccally or sublingually, or even nasally. the term "parenteral administration" here refers to modes of administration which include injections or infusions by the intravenous route, the intramuscular route, the intraperitoneal route, the intrasternal route, the subcutaneous route or the intraarticular.



   Mode / duration of administration
For most of the methods of the present invention, it is
 EMI48.1
 give F-l continuously, 1 to 3 times a day or as often as necessary to deliver an effective amount of F-l to the recipient. Cyclic therapy can be particularly useful in the treatment of endometriosis or it can be used during attacks of the disease causing acute pain. In the case of restenosis, therapy may be limited to short intervals (1 to 6 months) following medical procedures such as angioplasty.


    

Claims (16)

 CLAIMS 1. Hydrated crystalline form of 6-hydroxy-3- (4- [2-  EMI49.1  (piperidin-1-yl) ethoxy] phenoxy) -2- (4-methoxyphenyl) benzo [b] thiophene (F-)) having an X-ray diffraction diagram which includes the following peaks: 7, 9: t 0.2, 10.7 0, 2.14, 9 0, 2.15, 9 0, 2. 18.3 0, 2 and 20.6 0.2 in 20, when obtained from 'a source of copper lines. 2. Pharmaceutical formulation comprising the crystalline compound according to claim 1, one or more pharmaceutical carriers, diluents or excipients and, where appropriate, estrogens, where appropriate progestins, where appropriate an aromatase inhibitor, where appropriate a analog of LH-RH and if necessary an acetylcholinesterase inhibitor (AChE). 3. The formulation according to claim 2, which comprises the crystalline compound according to claim 1, one or more pharmaceutical carriers, diluents or excipients and estrogens. 4. The formulation of claim 3, wherein ('estrogen is Premarin &commat;. 5. The formulation according to claim 2, which comprises the crystalline compound according to claim 1, one or more pharmaceutical carriers, diluents or excipients and progestins. 6. Formulation according to claim 5, the progestogen is chosen from the group consisting of norethylnodrel and norethindrone. 7. The formulation according to claim 2, which comprises the crystalline compound according to claim 1, one or more pharmaceutical carriers, diluents or excipients and an AChE inhibitor. 8. The formulation of claim 7, wherein the AChE inhibitor is selected from the group consisting of physostigmine salicylate, tacrine hydrochloride and donepezil hydrochloride.  <Desc / Clms Page number 50>   9. The formulation according to claim 2, which comprises the crystalline compound according to claim 1, one or more pharmaceutical carriers, diluents or excipients, estrogens and progestins. 10. Compound according to claim 1, for inhibiting a pathological condition chosen from the group consisting of subinvolution of the uterus, endometriosis, proliferation of smooth muscle cells.  EMI50.1  aorta, restenosis, breast cancer, uterine cancer, prostate cancer, enlarged prostate, bone thinning, osteoporosis, cardiovascular disease, hyperlipidemia, central nervous system disorders and Alzheimer's disease. 11. A compound according to claim 10, for inhibiting breast cancer. 12. Compound according to claim 11, in which the mode of inhibition is of the prophylactic type. 13. A compound according to claim 10, for inhibiting ovarian cancer. 14. A compound according to claim 10, for inhibiting endometrial cancer. 15. A compound according to claim 1, for the upregulation of choline acetyltransferase (ChAT) in mammals. 16. A process for preparing a compound according to claim 1, which comprises crystallizing 6-hydroxy-3- (4- [2- (piperidin-1-yl) ethoxy] phenoxy) -2- (4-methoxyphenyl) hydrochloride benzo [b] thiophene in tetrahydro-furan.