CA2223629A1 - Therapeutic use of d-threo-methylphenidate - Google Patents

Therapeutic use of d-threo-methylphenidate Download PDF

Info

Publication number
CA2223629A1
CA2223629A1 CA002223629A CA2223629A CA2223629A1 CA 2223629 A1 CA2223629 A1 CA 2223629A1 CA 002223629 A CA002223629 A CA 002223629A CA 2223629 A CA2223629 A CA 2223629A CA 2223629 A1 CA2223629 A1 CA 2223629A1
Authority
CA
Canada
Prior art keywords
methylphenidate
patient
threo
treatment
susceptible
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002223629A
Other languages
French (fr)
Inventor
Nicholas Robert Pope
Ruth Elizabeth Wills
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Darwin Discovery Ltd
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from GBGB9514416.8A external-priority patent/GB9514416D0/en
Priority claimed from GBGB9605523.1A external-priority patent/GB9605523D0/en
Application filed by Individual filed Critical Individual
Publication of CA2223629A1 publication Critical patent/CA2223629A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/44Non condensed pyridines; Hydrogenated derivatives thereof
    • A61K31/445Non condensed piperidines, e.g. piperocaine
    • A61K31/4458Non condensed piperidines, e.g. piperocaine only substituted in position 2, e.g. methylphenidate
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics

Abstract

A method for the treatment of a human patient having a condition susceptible to treatment with methylphenidate, and wherein the patient exhibits or is susceptible to hepatic dysfunction, comprises the administration of d-threo-methylphenidate.

Description

T~APEUTIC USE OF d-t~rec il~l~Y~Nl~ATE
Field of the Invention This invention relates to new therapeutic uses of d-threo-methylphenidate (abbreviated herein as dtmp).
Back4Lol~rd o~ ~he Invention Methylphenidate is a known drug. It is used primarily to treat hyperactive children. It may have to be administered over a prolonged period of time, and is a controlled substance.
Methylphenidate is a chiral molecule. The properties of the enantiomers have been investigated to some extent, although the drug is still a~ ; n; ~tered as the racemate.
It is generaly thought that dtmp is the active material, and that its antipode (ltmp) is metabolised more rapidly.
Methylphenidate is often al~ ; n; ~tered in a sustained-release formulation. For example, a coated tablet comprising racemic methylph~nidate is administered, with a view to maint~;nin~ a therapeutically-effective level of the drug. This formulation does not always provide a reproducible or a sustained effect.
Roberts et al, Life Sci. 55:269-281 (1994), found that racemic methylphenidate caused hepatic dysfunction in the mouse, manifest as elevated liver enzyme levels and/or coagulative necrosis, on morphological investigation of the liver. Also, the National Toxicity P~o~amme (NTP TR439) of the USA recently (1995) found that racemic methylph~n;date caused, in the mouse, hepatocellular and centri-lobular hypertrophy, formation of foci of damaged cells and hepatic tumours.
Mehta et al, J. Clin. Gastroenterol. 6:149-151 (1984), report hepatic dysfunction due to intravenous abuse of methylphenidate hydrochloride. Goodman, New York State Journal of Medicine 72:2339-40 (15 September 1972), reports hepatoxicity due to methylphenidate hydrochloride. Stecyk et al, Annals of Emergency Medicine 14:597/113-599/115 (6 June 1985), report multiple organ failure resulting from intravenous abuse of methylphenidate hydrochloride.

~m~ of the Invention This invention is based on the discovery that dtmp can satisfactorily be used to treat human patients exhibiting or susceptible to hepatic dysfunction, or to reduce the likelihood of such symptoms occurring. dtmp may also be used instead of the racemate in therapy involving the use of other drugs that have effects likely to be exacerbated by use of the racemate. Such effects may include hepatic dysfunction. The patient may be an adult, e.g. in the treatment of compulsive shopping disorder or narcolepsy, or a child, e.g. a pre-pubertal child suffering from attention-deficit hyperactivity disorder (which, for the purposes of this specification, includes attention-deficit disorder).
The discovery is based on the finding that, in an animal model, dtmp is surprisingly less hepatotoxic than racemic methylphenidate.
Descri~tion of the Invention The dtmp that is used in this invention is substantially free of ltmp, e.g. in an enantiomeric excess (ee) of at least 70%, preferably at least 90%, and more preferably at least 95%. The dtmp may be substantially enantiopure. It may be used in the form of any suitable salt, e.g. the hydrochloride.
The dtmp may be administered by the same means as is known for racemic methylphenidate, in a sustained-release formulation, e.g. a coated tablet. It may be administered in any other conventional sustained-release formulation, via any suitable route of administration. Conventional dosing parameters may be adopted, i.e. those which are known to or adapted to the practice of those skilled in the art. For example, the daily dosage of dtmp may be 5 to 60 mg, but will be chosen according to the age, weight and health of the subject, and other factors that are routinely considered by the man skilled in the art.
Other advantages of the use of dtmp may include the reduction of exposure to a controlled substance, reduced side-effects (which include anorexia, insomnia, stomach ache and headache), reduced abuse potential, reduced C~x, a reduced level of active material even when chewed, reduced patient variability, reduced interaction with ltmp or other drugs, and less variability ~etween fed and fasted subjects.
By controlling the nature of the formulation, it is possible to control dissolution in vitro, and thus match or exceed the US National Formulary (NF) drug release profile for methylphenidate hydrochloride. Further, when administered to a healthy subject, a serum level of dtmp can be attained that is at least 50~ of C~x, over a period of at least 8 hours, e.g. 8-16, 8-12 or 8-lO hours. Thus, for example, a shorter release period may be preferred or a different period before the serum level drops below a different p~o~o~Lion of C~x.
The serum level may be also controlled so that it remains high during the day, after taking a dosage in the morning, and is reduced in the evening, before it can have any undesirable effect on sleeping patterns.
A formulation of the invention may be a unit dosage such as a tablet, capsule or suspension. A sust~;ne~-release formulation may be in matrix, coating, reservoir, osmotic, ion-~Ych~nge or density ~Yçh~nge form. It may comprise a soluble polymer coating which is dissolved or eroded, after administration. Alternatively, there may be an insoluble coating, e.g. of a polymer, through which the active ingredient permeates, as from a reservoir, diffuses, e.g. through a porous matrix, or undergoes osmotic exchange. A further option for a sustained-release formulation involves density exchange, e.g. in the case where the formulation alters on administration, e.g. from microparticles to a gel, so that the active ingredient diffuses or permeates out. Ion-based resins may also be used, the active component being released by ionic ~Y~h~ge, and wherein the rate of release can be controlled by using cationic or anionic forms of the drug.

:

It is pre~erred to use a formulation in this invention that is resistant to chewing, e.g. micronised particles that are individually coated and which do not immediately release the active component on chewing, or possibly even actively discourage chewing by their consistency. Many effects, benefits etc. described herein apply also to formulations providing immediate release. The various effects etc. may be due to the use of dtmp and/or the absence of ltmp.
Various circumstances may cause hepatic dysfunction, or render a patient susceptible to such a problem. Such circumst~c~C include the administration of a therapeutic agent in which liver dysfunction, is a side-effect, or the taking of drugs of abuse known to cause liver dysfunction, e.g. alcohol or ecstasy.
Hepatic dysfunction may be evident in terms of interference with enzyme function, or changes in the levels of certain enzymes such as ~l~;ne aminotransferase (ALT), or in terms of gross alterations such as cirrhosis or cancer of the liver. Hepatic dysfunction can be determined by the skilled man, as may be susceptibility or predisposition to such dysfunction.
MethYlPhenidate-Induced HePatotoxity in Mice Experiments were carried out to investigate the differing toxicity effects of dtmp and racemic methylphenidate characterised by elevated liver enzyme levels and inst~nr-~C of coagulative necrosis in the liver.
The procedures followed were as described in Roberts et al, supra .
Groups of 21 male mice of the Crl:CD-l(ICR)BR strain were given a single intraperitoneal dose of the compounds in a saline solution with an injection volume of 10 ml/kg body weight. The animals were housed in groups of three in polypropylene cages with a steel mesh floor in a single, exclusive room, air conditioned to provide a minimum of 15 air changes/hour. ~n; ~l quarters were temperature and humidity controlled with a 12 hour light/dark cycle.

Blood samples were obtained from all An; -ls at 16 hours after dosing for determination of serum alanine aminotransferase (ALT) activity. The results are tabulated below.
Livers were removed 24 hours after dosing and preserved in fixative of 10% neutral buffered formalin for histopathological examination. The livers were embedded in paraffin wax, ~ectioned at a n~ inA~ 5 ~m, stained with haematoxylin and eosin, and examined using light microscopy. The results are tabulated below.

C~ ulld DoseALT LevelsCoagulant (mg/kg~(IU/L) Necrosis Control (water) 0 81 0 Racemate 75 185 2 dtmp 75 76 0 The results show that there is a marked beneficial effect of treatment with dtmp relative to treatment with racemic methyl~nidate~ in that plasma levels of the liver enzyme ~l An i~ aminotransferase were not increased. The histopathology data further support the finding that dtmp treatment has beneficial advantages over treatment with the racemate. Coagulant necrosis was detected in two animals out of 21 in the group receiving racemic methyl rh~ idate~
whereas there were no cases with dtmp. Thus, the results show a marked difference.

Claims (9)

1. A method for the treatment of a human patient having a condition susceptible to treatment with methylphenidate, and wherein the patient exhibits or is susceptible to hepatic dysfunction, which comprises the administration of d-threo-methylphenidate substantially free of 1-threo-methylphenidate.
2. A method for the treatment of a human patient having a condition susceptible to treatment with methylphenidate, wherein the patient is or has been exposed to circumstances that cause, or render the patient susceptible to, hepatic dysfunction, which comprises the administration of d-threo-methylphenidate substantially free of 1-threo-methylphenidate.
3. A method according to claim 1 or claim 2, wherein the patient has previously undergone, or is simultaneously undergoing, administration of a therapeutic agent that may cause or render the patient susceptible to hepatic dysfunction.
4. A method according to claim 3, wherein said therapeutic agent is racemic methylphenidate.
5. A method according to claim 1 or claim 2, wherein the patient has previously, or is simultaneously, taking a drug of abuse known to cause liver dysfunction or damage, including alcohol or ecstasy.
6. A method according to any preceding claim, wherein the patient has abnormal levels of at least one liver enzyme.
7. A method according to claim 6, wherein the at least one liver enzyme is CYP2D6 or another P450 cytochrome enzyme.
8. A method according to any preceding claim, wherein the condition is selected from depression, compulsive shopping disorder, narcolepsy, insomnia and attention-deficit hyperactivity disorder.
9. A product containing d-threo-methylphenidate substantially free of 1-threo-methylphenidate, and a therapeutic agent as defined in claim 3, as a combined preparation for simultaneous, separate or sequential use in the treatment of a condition as defined in claim 1 or claim 2 and a condition susceptible to treatment with said therapeutic agent.
CA002223629A 1995-07-14 1996-07-15 Therapeutic use of d-threo-methylphenidate Abandoned CA2223629A1 (en)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
GBGB9514416.8A GB9514416D0 (en) 1995-07-14 1995-07-14 Therapeutic use
GB9514416.8 1995-07-14
GBGB9605523.1A GB9605523D0 (en) 1996-03-15 1996-03-15 Therapeutic use
GB9605523.1 1996-03-15

Publications (1)

Publication Number Publication Date
CA2223629A1 true CA2223629A1 (en) 1997-02-06

Family

ID=26307400

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002223629A Abandoned CA2223629A1 (en) 1995-07-14 1996-07-15 Therapeutic use of d-threo-methylphenidate

Country Status (5)

Country Link
EP (1) EP0839038A1 (en)
JP (1) JPH11509227A (en)
AU (1) AU702801B2 (en)
CA (1) CA2223629A1 (en)
WO (1) WO1997003672A1 (en)

Families Citing this family (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6486177B2 (en) 1995-12-04 2002-11-26 Celgene Corporation Methods for treatment of cognitive and menopausal disorders with D-threo methylphenidate
US6355656B1 (en) 1995-12-04 2002-03-12 Celgene Corporation Phenidate drug formulations having diminished abuse potential
US5922736A (en) * 1995-12-04 1999-07-13 Celegene Corporation Chronic, bolus administration of D-threo methylphenidate
US5908850A (en) * 1995-12-04 1999-06-01 Celgene Corporation Method of treating attention deficit disorders with d-threo methylphenidate
US5837284A (en) 1995-12-04 1998-11-17 Mehta; Atul M. Delivery of multiple doses of medications
US5733756A (en) * 1996-01-05 1998-03-31 Celgene Corporation Lactams and processes for stereoselective enrichment of lactams, amides, and esters
US6962997B1 (en) 1997-05-22 2005-11-08 Celgene Corporation Process and intermediates for resolving piperidyl acetamide steroisomers
DK1126826T6 (en) 1998-11-02 2019-06-24 Alkermes Pharma Ireland Ltd Multiparticulate modified release of methylphenidate
US6419960B1 (en) 1998-12-17 2002-07-16 Euro-Celtique S.A. Controlled release formulations having rapid onset and rapid decline of effective plasma drug concentrations
US7083808B2 (en) 1998-12-17 2006-08-01 Euro-Celtique S.A. Controlled/modified release oral methylphenidate formulations
US6673367B1 (en) 1998-12-17 2004-01-06 Euro-Celtique, S.A. Controlled/modified release oral methylphenidate formulations
US6395752B1 (en) * 1999-03-04 2002-05-28 Pharmaquest Limited Method of treating depression using 1-threo-methylphenidate
US6127385A (en) * 1999-03-04 2000-10-03 Pharmaquest Limited Method of treating depression using l-threo-methylphenidate
NZ529928A (en) 1999-10-29 2005-10-28 Euro Celtique Sa Controlled release hydrocodone formulations
US10179130B2 (en) 1999-10-29 2019-01-15 Purdue Pharma L.P. Controlled release hydrocodone formulations
KR101045144B1 (en) 2000-10-30 2011-06-30 유로-셀티크 소시에떼 아노뉨 Controlled release hydrocodone formulations
US6913768B2 (en) 2002-09-24 2005-07-05 Shire Laboratories, Inc. Sustained release delivery of amphetamine salts
US20050239830A1 (en) * 2004-04-26 2005-10-27 Vikram Khetani Methods of diminishing co-abuse potential
ES2703874T3 (en) 2004-08-23 2019-03-12 Pejo Iserlohn Heilmittel Und Diaet Gmbh & Co Kg Psychostimulant containing a pharmaceutical composition
US8709477B2 (en) 2009-08-13 2014-04-29 Kremers Urban Pharmaceuticals, Inc` Pharmaceutical dosage form
WO2014174387A1 (en) 2013-03-29 2014-10-30 Wockhardt Limited Modified release pharmaceutical compositions of dexmethylphenidate or salts thereof
CA2936741C (en) 2014-10-31 2018-11-06 Purdue Pharma Methods and compositions particularly for treatment of attention deficit disorder
US10722473B2 (en) 2018-11-19 2020-07-28 Purdue Pharma L.P. Methods and compositions particularly for treatment of attention deficit disorder

Also Published As

Publication number Publication date
EP0839038A1 (en) 1998-05-06
JPH11509227A (en) 1999-08-17
WO1997003672A1 (en) 1997-02-06
AU702801B2 (en) 1999-03-04
AU6466096A (en) 1997-02-18

Similar Documents

Publication Publication Date Title
AU702801B2 (en) Therapeutic use of D-threo-methylphenidate
US5874090A (en) Sustained-release formulation of methylphenidate
AU708873B2 (en) Composition comprising d-threo-methylphenidate and another drug
US11103494B2 (en) Methylphenidate extended release chewable tablet
CN116712434A (en) Methods of administering certain VMAT2 inhibitors
US20030170181A1 (en) Method for preventing abuse of methylphenidate
KR20200066661A (en) Methods of administering certain VMAT2 inhibitors
CN111372567A (en) High dose formulations of valphenazine and compositions, methods and kits related thereto
JP2021038224A (en) Methods and compositions for treating particularly attention deficit disorders
CN109069480A (en) For treating the method and composition of illness relevant to epilepsy
US20020132793A1 (en) Use of methylphenidate compounds to enhance memory
US20080279952A1 (en) Controlled-Release Flupirtine Compositions, Compacts, Kits and Methods of Making and Use Thereof
CA2420569A1 (en) Use of threo-methylphenidate compounds to enhance memory
JP5561885B2 (en) A new formulation of mirtazapine
JP2003512311A (en) Sustained release formulations for treating CNS mediated disorders
US20210308057A1 (en) Pediatric formulation of tyrosine kinase inhibitors
US11590081B1 (en) Extended release amphetamine tablets

Legal Events

Date Code Title Description
EEER Examination request
FZDE Dead