CN100431540C - Treatment of diabetes with thiazolidinedione and metformin - Google Patents

Treatment of diabetes with thiazolidinedione and metformin Download PDF

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Publication number
CN100431540C
CN100431540C CNB2005101163187A CN200510116318A CN100431540C CN 100431540 C CN100431540 C CN 100431540C CN B2005101163187 A CNB2005101163187 A CN B2005101163187A CN 200510116318 A CN200510116318 A CN 200510116318A CN 100431540 C CN100431540 C CN 100431540C
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compound
compositions
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metformin
chemical compound
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CN1781483A (en
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S·A·史密斯
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SmithKline Beecham Ltd
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Abstract

A method for the treatment and/or prophylaxis of diabetes mellitus, conditions associated with diabetes mellitus and certain complications thereof, in a mammal which method comprises administering an effective non-toxic and pharmaceutically acceptable amount of an insulin sensitiser and a biguanide antihyperglycaemic agent, to a mammal in need thereof and a pharmaceutical composition comprising an insulin sensitiser and a biguanide antihyperglycaemic agent.

Description

With thiazolidinedione and metformin treatment diabetes
The application is the dividing an application that be on June 15th, 1998, denomination of invention the applying date for No. 02156128.1 patent application of " treating diabetes " with thiazolidinedione and metformin.
The present invention relates to a kind of Therapeutic Method, particularly treat diabetes, especially noninsulindependent diabetes (NIDDM) or I type i diabetes and with the method for diabetes diseases associated.
The biguanides antihyperglycemic agents is usually used in treating NIDDM (or type ii diabetes).1,1-dimethyl biguanide (or metformin) is an example of biguanides antihyperglycemic agents.
European patent application discloses the 0th, 306, relates to certain thiazolidine diketone derivative No. 228, discloses it and has hyperglycemia and short serum lipids reduces active.Disclosed a kind of specific thiazole alkane diketone is 5-[4-[2-(N-methyl-N-(2-pyridine radicals) amino) ethyoxyl among the EP 0306228] benzyl] thiazolidine-2,4-diketone (hereinafter being called " chemical compound (I) ").WO94/05659 discloses some salt of chemical compound (I), comprises the maleate of embodiment 1.
Chemical compound (I) is the example that a class is considered to the antihyperglycemic agents of " insulin sensitizer ".Particularly, chemical compound (I) is the thiazolidinediones insulin sensitizer.
European patent application discloses the 0008203rd, 0139421,0032128,0428312,0489663,0155845,0257781,0208420,0177353,0319189,0332331,0332332,0528734, No. 0508740; Some thiazolidinediones insulin sensitizer is also disclosed in No. the 92/18501st, 93/02079,93/22445, international patent application and United States Patent (USP) the 5104888th and No. 5478852.
It is to be those of representative with disclosed chemical compound in international patent application WO93/21166 and WO94/01420 number that another series is considered to have the active chemical compound of insulin sensitizer usually.These chemical compounds are referred to as " acyclic insulin sensitizer " in this article.Other examples of acyclic insulin sensitizer are those disclosed among No. the 5232945th, United States Patent (USP) and international patent application WO92/03425 and the WO91/19702.
The example of other insulin sensitizers is that european patent application discloses those disclosed in No. the 5264451st, No. 0522933, No. the 05271204th, Japanese Patent Application Publication and the United States Patent (USP).
The top publication of mentioning all is incorporated herein by reference.
Now, there is wonderful demonstration to show, chemical compound (I) can provide useful especially glycemic control effect and not observe side effect with the combination medicine form of biguanides antihyperglycemic agents, therefore this combination medicine form is particularly useful for treating diabetes, especially type ii diabetes and with the diabetes diseases associated.
Therefore, the invention provides a kind of mammal such as people's treatment of diabetes method, especially type ii diabetes and with the Therapeutic Method of diabetes diseases associated, this method comprises insulin sensitizer such as the chemical compound (I) and the biguanides antihyperglycemic agents of effective, the nontoxic and pharmaceutically acceptable amount of the mammal that needs this treatment.
On the other hand, the invention provides a kind of insulin sensitizer, such as chemical compound (I), with the biguanides antihyperglycemic agents, treatment diabetes especially type ii diabetes and with the method for diabetes diseases associated in purposes.
This method comprises insulin sensitizer such as chemical compound (I) and the administration simultaneously of biguanides antihyperglycemic agents or the two order administration.
Administration simultaneously comprises and gives a kind of preparation that comprises insulin sensitizer such as chemical compound (I) and biguanides antihyperglycemic agents, perhaps with the independent preparation administration simultaneously basically of every kind of activating agent.
On the other hand, the invention provides insulin sensitizer such as chemical compound (I) and biguanides antihyperglycemic agents and be used for the treatment of diabetes in preparation, especially type ii diabetes and with the compositions of diabetes diseases associated in purposes.
Suitable biguanides antihyperglycemic agents is metformin, two fourth guanidine or phenformin, especially metformin.
Suitable thiazolidinediones insulin sensitizer is chemical compound (I).
Other suitable thiazolidinediones insulin sensitizers comprise (+)-5-[[4-[(3,4-dihydro-6-hydroxyl-2,5,7,8-tetramethyl-2H-1-.alpha.-5:6-benzopyran-2-yl) methoxyl group] phenyl] methyl]-2,4-thiazolidinedione (or troglitazone), the 5-[4-[(1-methylcyclohexyl) methoxyl group] benzyl] thiazolidine-2,4-diketone (or ciglitazone), 5-[4-[2-(5-ethylpyridine-2-yl) ethyoxyl] benzyl] thiazolidine-2,4-diketone (or pioglitazone) or 5-[(2-benzyl-2, the 3-dihydrobenzopyrans)-the 5-ylmethyl] thiazolidine-2,4-diketone (or englitazone).
A particular aspects, this method comprises and gives 2-12mg chemical compound (I), especially when the every day administration.
Particularly, this method comprises and gives 2-4,4-8 or 8-12mg chemical compound (I) every day.
Particularly, this method comprises and gives 2-4mg chemical compound (I), especially when the every day administration.
Particularly, this method comprises and gives 4-8mg chemical compound (I), especially when the every day administration.
Particularly, this method comprises and gives 8-12mg chemical compound (I), especially when the every day administration.
Preferably, this method comprises and gives 2mg chemical compound (I), especially when the every day administration.
Preferably, this method comprises and gives 4mg chemical compound (I), especially when the every day administration.
Preferably, this method comprises and gives 8mg chemical compound (I), especially when the every day administration.
Be to be understood that, insulin sensitizer such as chemical compound (I) and biguanides antihyperglycemic agents be respectively with its pharmaceutically acceptable form as suitable related drugs active agent delivery, comprise its pharmaceutically acceptable derivates such as pharmaceutically acceptable salt, ester and solvate, under some situation in this article, the title that is used for relevant biguanide may relate to the certain drug form of this related activity agent: should be understood that all pharmaceutically acceptable forms that the present invention includes activating agent itself.
Those that describe in the publication of being mentioned above the suitable pharmaceutically acceptable form of insulin sensitizer comprises.
The suitable pharmaceutically acceptable form of chemical compound (I) comprises those that put down in writing among EP 0306228 and the WO94/05659, particularly the pharmaceutically acceptable salt form.The salt of preferred pharmaceutical compositions is maleate.
The suitable pharmaceutically acceptable solvation form of chemical compound (I) comprises those that put down in writing among EP 0306228 and the WO94/05659, particularly hydrate.
It is fixed that the suitable pharmaceutically acceptable form of biguanides antihyperglycemic agents is come according to used particular active agent, but comprise the known pharmaceutically acceptable form of selected specific compound.These derivants can find in canonical reference book such as Britain and American Pharmacopeia, Remington ' s pharmaceutical science (Remington ' s Pharmaceutical Sciences) (Mack publishing company), Extra Pharmacopoeia Martindale (London, The Pharmaceutical publishing house) (for example referring to the 31st edition the 341st page and wherein referer) or be referred.
The suitable pharmaceutically acceptable form of metformin is an acid-addition salts, such as hydrochlorate.
Chemical compound (I), or its pharmaceutically acceptable salt, or its pharmaceutically acceptable solvate can utilize the known method preparation, for example those disclosed among EP 0306228 and the WO94/05659.The open text of EP 0306228 and WO94/05659 is incorporated herein by reference.
Chemical compound (I) can be with a kind of existence the in the multiple tautomeric form, and all tautomers all are included in the term chemical compound (I), can be independent tautomer or its mixture.Chemical compound (I) contains chiral carbon atom, therefore can exist with maximum two kinds of stereoisomeric forms in any ratio, and term chemical compound (I) comprises all these isomeric forms, no matter is independent isomer, or mixture of isomers, comprises racemic modification.
Selected insulin sensitizer or biguanides antihyperglycemic agents prepare according to known method, these methods are at the canonical reference book, such as Britain and American Pharmacopeia, Remington ' s pharmaceutical science (Remington ' s Pharmaceutical Science) (Mack publishing company), Extra Pharmacopoeia Martindale (London, The Pharmaceutical publishing house) find in (for example referring to the 31st edition the 341st page and wherein referer) or referred, or put down in writing in the publication above-mentioned.
Term used herein " with the diabetes diseases associated " comprise those diseases relevant with the prediabetes state, with diabetes self diseases associated and with the diabetes complications associated with arterial system.
Term used herein " with prediabetes state diseases associated " comprises such as the insulin resistance disease, comprises heritability insulin resistance, glucose tolerance weakening and hyperinsulinemia.
" with diabetes self diseases associated " comprises hyperglycemia, and insulin resistance comprises insulin resistance and the obesity day after tomorrow.Other and diabetes self diseases associated comprise hypertension and cardiovascular disease, especially atherosclerosis and with the insulin resistance diseases associated.Comprise polycystic ovary syndrome and inductive insulin resistance of steroid and gestational diabetes with the insulin resistance diseases associated.
" with the diabetes complications associated with arterial system " comprises kidney disease, especially relevant with type ii diabetes kidney disease, neuropathy and retinopathy.
The kidney disease relevant with type ii diabetes comprises nephropathy, glomerulonephritis, glomerulosclerosis, nephrotic syndrome, hypertensive nephrosclerosis and late period kidney disease.
Term used herein " pharmaceutically acceptable " comprises people and veterinary purpose: for example term " pharmaceutically acceptable " comprises veterinarily acceptable chemical compound.
For fear of query, when the scalar that provides formula (I) chemical compound of pharmaceutically acceptable form herein, when comprising the mg amount, this scalar itself provides about chemical compound (I): for example the formula of 2mg maleate form (I) chemical compound is meant, contains the amount of the maleate of 2mg chemical compound (I).
Diabetes are preferably type ii diabetes.
The useful especially glycemic control effect that provides by treatment of the present invention is designated as with respect to the synergism that contrasts, and this contrast is contemplated to the effect summation of independent active agents.
Glycemic control can utilize conventional method to describe its feature, for example by measuring glycemic control index commonly used, such as fasting plasma glucose or glycosylated hemoglobin (Hb Alc).These indexes can utilize standard method to determine, for example at Tuescher A, Richterich, P., Schweiz.med.Wschr.101 (1971), in 345 and 390 and Frank P., " measuring the monitoring diabetics ", those that describe in the clinical prods (ClinicalProducts) 1988 with glycosylated hemoglobin.
One preferred aspect, when treatment and when using according to the present invention, the dosage level of used various activating agents will less than reach add merely and the glycemic control effect dosage that may need.
Also have indication to show, with respect to each independent activating agent, Therapeutic Method of the present invention will improve the concentration that advanced glycosylation end product (AGE), dish Pu Ting (leptin) and serum lipids comprise T-CHOL, HDL-cholesterol, LDL-cholesterol, comprise the ratio of improving them, particularly improve serum lipids, comprising that T-CHOL, HDL-cholesterol, LDL-cholesterol level comprise improves its ratio.
In the methods of the invention, active medicine is preferably with the form administration of pharmaceutical composition.As implied above, this compositions can comprise multiple medicine or only a kind of medicine.
Therefore, in one aspect of the invention, it provides a kind of pharmaceutical composition, and said composition comprises especially insulin sensitizer such as chemical compound (I), biguanides antihyperglycemic agents and the pharmaceutically acceptable carrier of 2-12mg.
Such compositions can be by especially insulin sensitizer such as chemical compound (I), biguanides antihyperglycemic agents and the mixing of pharmaceutically acceptable carrier of 2-12mg prepare.
Usually said composition is suitable for oral administration.But they also are fit to other administering mode, for example parenteral, sublingual administration or percutaneous dosing.
Said composition can be tablet, capsule, powder, granule, lozenge, suppository, can reconstruct powder or such as liquid preparation forms such as oral or aseptic parenteral solution or suspensions.
In order to reach the concordance of administration, the present composition is preferably single agent form.
The single agent representation that is used for oral administration can be tablet and capsule, and can contain conventional excipients such as binding agent, for example syrup, arabic gum, gelatin, sorbitol, tragacanth or polyvinylpyrrolidone; Filler, for example lactose, sugar, corn starch, calcium phosphate, sorbitol or glycine; Tabletting lubricant, for example magnesium stearate; Disintegrating agent, for example starch, polyvinylpyrrolidone, Explotab or microcrystalline Cellulose; Or pharmaceutically acceptable wetting agent, such as sodium lauryl sulphate.
These compositionss are preferably to make unit dosage forms with the amount that relevant daily dose suits.
The unit dose of suitable formula (I) chemical compound comprises 1,2,3,4,5,6,7,8,9,10,11 or 12mg chemical compound (I).
Compositions of the present invention can the administration every day 1-6 time, but most preferably administration every day 1 or 2 times.
The given dose of chemical compound (I) is 2mg/ days, 4mg/ days, comprises one day twice, one time 2mg and 8mg/ days comprising 4mg one day twice, one time.
The suitable unit dose of insulin sensitizer or biguanides antihyperglycemic agents such as metformin comprises the known dose of these chemical compounds, as what describe or mention in handbook such as Britain and American Pharmacopeia, Remington ' s pharmaceutical science (Remington ' s Pharmaceutical Sciences) (Mack publishing company), Extra Pharmacopoeia Martindale (London, The Pharmaceutical publishing house) (for example referring to the 31st edition the 341st page and wherein referer) or the top publication of mentioning.
The proper dosage of metformin comprises and is no more than 3000mg every day, and with the unit dose administration of 500mg (for example administration every day 2 or 3 times) or 850mg (for example administration every day is 2 times), an example of metformin dosage is each 500mg, every day 5 times.
Therefore, an example of this method comprises that to give 4-8mg chemical compound (I) (be respectively twice of every day, each 2mg, or twice of every day, each 4mg) and 1000mg or 2500mg metformin (be respectively twice of every day, each 500mg, or every day 5 times, 500mg at every turn).
Solid oral composition can prepare with conventional mixing, filling or pressed disc method.Repeating married operation can be used for activating agent fully is distributed to the compositions of using a large amount of filleies.Conventional in such operation yes this area.Well-known method coating during tablet can prepare according to conventional medicine, particularly enteric coated.
Oral liquid can be the form of example emulsion, syrup or elixir, perhaps can be used as dry products and exists, and water or other suitable carriers reconstitute again before the use.This liquid preparation can contain conventional additives, such as suspending agent, and for example sorbitol, syrup, methylcellulose, gelatin, hydroxyethyl-cellulose, carboxymethyl cellulose, aluminium stearate gel, hydrogenation edible fat; Emulsifying agent, for example lecithin, anhydro sorbitol monooleate or arabic gum; Anhydrous carrier (can comprise edible oil), for example almond oil, heating up in a steamer Oleum Cocois, oily ester such as glyceride, propylene glycol or ethanol; Antiseptic, for example methyl parahydroxybenzoate or propyl ester or sorbic acid; If desired, also can add conventional flavoring agent or coloring agent.
For parenteral, can utilize this chemical compound and sterile carrier to prepare the liquid unit dosage forms, and, can suspend or be dissolved in the carrier according to used concentration.When preparation solution, can be filled in bottle or the ampoule afterwards and sealing with this compound dissolution in water for injection and filtration sterilization.Advantageously, adjuvant such as local anesthetic, antiseptic and buffer agent can be dissolved in this carrier.For enhanced stability, recharge in the bottle after can be with said composition freezing, and under vacuum, remove moisture.The parenteral suspension is to prepare with identical in fact mode, and just chemical compound (I) is not to be dissolved in the carrier, but is suspended in the carrier, and sterilization is not accomplished by filtration.This chemical compound can be sterilized in sterile carrier by contact the back resuspending with oxirane.Advantageously, in said composition, comprise surfactant or wetting agent to promote the uniform distribution of this chemical compound.
According to different medications, compositions can contain the active substance of 0.1% to 99% weight, preferred 10-60% weight.
If desired, compositions can be to follow the packaged form of the operation instruction of written or printing.
These compositionss are prepared according to conventional method, such as in the canonical reference book, those disclosed in Britain and American Pharmacopeia, Remington ' s pharmaceutical science (Remington ' s PharmaceuticalScience) (Mack publishing company), Extra Pharmacopoeia Martindale (London, ThePharmaceutical publishing house) (for example referring to the 31st edition the 341st page and wherein referer) and Harry ' s cosmetic conduct and learning (Leonard Hill Books) for example.
On the other hand, the present invention also provides a kind of pharmaceutical composition as the active treatment material, and said composition comprises especially insulin sensitizer such as chemical compound (I), biguanides antihyperglycemic agents and the pharmaceutically acceptable carrier of 2-12mg.
Particularly, the invention provides a kind of be used for the treatment of diabetes, especially type ii diabetes and with the pharmaceutical composition of diabetes diseases associated, this pharmaceutical composition comprises especially insulin sensitizer such as chemical compound (I), biguanides antihyperglycemic agents and the pharmaceutically acceptable carrier of 2-12mg.
Scope 2-4mg comprises 2.1-4,2.2-4,2.3-4,2.4-4,2.5-4,2.6-4,2.7-4,2.8-4,2.9-4 or 3-4mg.
Scope 4-8mg comprises 4.1-8,4.2-8,4.3-8,4.4-8,4.5-8,4.6-8,4.7-8,4.8-8,4.9-8,5-8,6-8 or 7-8mg.
Scope 8-12mg comprises 8.1-12,8.2-12,8.3-12,8.4-12,8.5-12,8.6-12,8.7-12,8.8-12,8.9-12,9-12,10-12 or 11-12mg.
Compositions of the present invention or method have confirmed there is not disadvantageous toxicology effect in above-mentioned dosage range.
Following examples have further been set forth the present invention and have not been played any restriction.
Embodiment
Chemical compound (I) has been assessed in this research and metformin (M) is individually dosed and the pharmacokinetics (PK) during in conjunction with administration.16 ages are 22 to 55 years old male volunteers oral administration of compound (I) (per 12 hours clothes 2mg), and M (per 12 hours clothes 500mg), or the mixture of the two all took 4 days for every kind.The blood plasma of gathering during with the 4th day is measured the concentration of chemical compound (I) and M.The oral dose of individually dosed chemical compound (I) and M or the mixture of the two is safety and can well accepts.Hypoglycemia do not occur, and administration does not simultaneously cause blood lactic acid concentration to raise.
Mixing=chemical compound (I)+M administration simultaneously
Chemical compound (I) and M administration does not simultaneously influence pharmacokinetics balance (AUC (0-12), the C of these two kinds of medicines Max, T Max, or T1/2).Because the plasma concentration of M is uninfluenced, administration simultaneously or chemical compound (I) will can not increase the weight of the concentration dependent toxicity of M.
Chemical compound (I) compositions
The A concentrate formulation
The sieve that about 2/3rds lactose monohydrates are suitable excessively also mixes with the maleate of levigate chemical compound (I).The sieve that Explotab, hydroxypropyl emthylcellulose, microcrystalline Cellulose and remaining lactose is suitable excessively also joins in this mixture, continues then to mix.The gained mixture is with the wet granulation of purifying waste water.Then this wet granular is sieved, dry on fluidized bed dryer, dried granule further sieves, and finally makes it even.
The component % of granule concentrate
Figure C20051011631800121
* remove in the course of processing.
B is mixed with tablet with concentrate
The granule that makes is above placed the tipping bucket type blender.About 2/3rds lactose are sieved and add this blender.Microcrystalline Cellulose, starch ethanol sodium, magnesium stearate and residue lactose are sieved and add this blender, this mixture is blended together.Gained mixture rotary tablet machine tabletting then, 1,2 and the 4mg tablet respectively suppress 150mg, 300mg is pressed into the 8mg tablet.Then these tablet cores are transferred in the tablet coating device, with hot-air (about 65 ℃) preheating and carry out film coating, increased 2.0%-3.5% up to tablet weight.
Figure C20051011631800122

Claims (22)

1. pharmaceutical composition, this pharmaceutical composition comprises the Compound I of 2-8mg: 5-[4-[2-(N-methyl-N-(2-pyridine radicals) amino) ethyoxyl] benzyl] thiazolidine-2, the pharmaceutically acceptable derivates of 4-diketone, be no more than metformin or hydrochloric acid metformin and the pharmaceutically acceptable carrier of 3000mg.
2. the compositions of claim 1, wherein the pharmaceutically acceptable derivates of Compound I is salt, ester or the solvate of Compound I.
3. claim 1 or 2 compositions, wherein the derivant of Compound I is the maleate of Compound I.
4. each compositions of claim 1-3, it comprises 2,4 or the derivant of the Compound I of 8mg.
5. each compositions of claim 1-3, it comprises the derivant of the Compound I of 2-4mg.
6. each compositions of claim 1-3, it comprises the derivant of the Compound I of 4-8mg.
7. each compositions of claim 1-3, it comprises the derivant of the Compound I of 2mg.
8. each compositions of claim 1-3, it comprises the derivant of the Compound I of 4mg.
9. each compositions of claim 1-3, it comprises the derivant of the Compound I of 8mg.
10. each compositions of claim 1-8, it comprises 500mg or 850mg metformin or hydrochloric acid metformin.
11.2-8mg Compound I: 5-[4-[2-(N-methyl-N-(2-pyridine radicals) amino) ethyoxyl] benzyl] thiazolidine-2, the pharmaceutically acceptable derivates of 4-diketone, with be no more than 3000mg metformin or hydrochloric acid metformin, preparation be used for the treatment of diabetes or with the pharmaceutical composition of diabetes diseases associated or the purposes in the combination medicine form.
12. the purposes of claim 11, wherein the pharmaceutically acceptable derivates of Compound I is salt, ester or the solvate of Compound I.
13. the purposes of claim 11 or 12, wherein the derivant of Compound I is the maleate of Compound I.
14. each purposes of claim 11-13, wherein compositions comprises 2,4 or the derivant of the Compound I of 8mg.
15. each purposes of claim 11-13, wherein compositions comprises the derivant of the Compound I of 2-4mg.
16. each purposes of claim 11-13, wherein compositions comprises the derivant of the Compound I of 4-8mg.
17. each purposes of claim 11-13, wherein compositions comprises the derivant of the Compound I of 2mg.
18. each purposes of claim 11-13, wherein compositions comprises the derivant of the Compound I of 4mg.
19. each purposes of claim 11-13, wherein compositions comprises the derivant of the Compound I of 8mg.
20. each purposes of claim 11-13, wherein compositions comprises 500mg or 850mg metformin or hydrochloric acid metformin.
21. each purposes of claim 11-20, wherein the derivant of Compound I and the metformin or the hydrochloric acid metformin that are no more than 3000mg are configured to single pharmaceutical composition.
22. each purposes of claim 11-20, wherein the derivant of Compound I and the metformin or the hydrochloric acid metformin that are no more than 3000mg are configured to isolating pharmaceutical composition.
CNB2005101163187A 1997-06-18 1998-06-15 Treatment of diabetes with thiazolidinedione and metformin Expired - Fee Related CN100431540C (en)

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CN1230171C (en) * 1997-06-18 2005-12-07 史密丝克莱恩比彻姆有限公司 Treating diabetes by thiazolidine-diketo and dimethylbiguanide

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