EP1531829A2 - Infertility treatment with exemestane - Google Patents

Infertility treatment with exemestane

Info

Publication number
EP1531829A2
EP1531829A2 EP03762980A EP03762980A EP1531829A2 EP 1531829 A2 EP1531829 A2 EP 1531829A2 EP 03762980 A EP03762980 A EP 03762980A EP 03762980 A EP03762980 A EP 03762980A EP 1531829 A2 EP1531829 A2 EP 1531829A2
Authority
EP
European Patent Office
Prior art keywords
exemestane
host
female
female host
administered
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.)
Withdrawn
Application number
EP03762980A
Other languages
German (de)
French (fr)
Inventor
Charles P. Wajszczuk
Hendrik J. Dekoning Gans
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.)
Pharmacia and Upjohn Co LLC
Original Assignee
Pharmacia and Upjohn Co LLC
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
Application filed by Pharmacia and Upjohn Co LLC filed Critical Pharmacia and Upjohn Co LLC
Publication of EP1531829A2 publication Critical patent/EP1531829A2/en
Withdrawn legal-status Critical Current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
    • A61K31/56Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/565Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
    • A61K31/568Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol substituted in positions 10 and 13 by a chain having at least one carbon atom, e.g. androstanes, e.g. testosterone
    • A61K31/5685Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol substituted in positions 10 and 13 by a chain having at least one carbon atom, e.g. androstanes, e.g. testosterone having an oxo group in position 17, e.g. androsterone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/56Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/565Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol
    • A61K31/566Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids not substituted in position 17 beta by a carbon atom, e.g. estrane, estradiol having an oxo group in position 17, e.g. estrone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00Drugs for genital or sexual disorders; Contraceptives
    • A61P15/08Drugs for genital or sexual disorders; Contraceptives for gonadal disorders or for enhancing fertility, e.g. inducers of ovulation or of spermatogenesis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00Drugs for disorders of the endocrine system
    • A61P5/24Drugs for disorders of the endocrine system of the sex hormones

Definitions

  • the present invention relates to a method for treating infertility in a female host in need thereof comprising the administration of an ovarian follicular stimulating effective amount of exemestane to the female host.
  • infertility is defined as the inability to conceive after 12 months of unprotected sexual intercourse.
  • infertility can be attributed primarily to male factors in 25%, female factors in 58%, and is unexplained in about 17% of couples.
  • Ovulation is the process where an ovum or ova are released from the ovaries. The timing of ovulation within the menstrual cycle is of foremost importance for fertilization. It is well known that follicles acquire the ability to ovulate following growth and maturation stimulated by the pituitary gonadotropins.
  • Ovulation induction is a therapeutic procedure commonly used to manage infertile patients. Ovulation induction is employed in particular for the following two purposes: 1 ) to treat anovulation in patients with hypogonadotropic hypogonadism, polycystic ovary syndrome and other menstrual cycle disorders and 2) to stimulate multiple folliculogenesis in patients (mostly with normal menstrual cycles) who are candidates for assisted reproduction techniques. These procedures are also termed controlled ovarian stimulation or hyperstimulation. However there are several complications caused by ovulation induction, including for instance multiple gestations and ovarian hyperstimulation syndrome. The complications mostly occur in polycystic ovary syndrome patients and/or full-dose gonadotropin regimens are employed. The inventor of the present invention has found that exemestane can be safely used in ovarian follicular stimulation for treating infertility in a host in need thereof, namely without causing the above side effects.
  • Exemestane was first taught by US patent 4,808,616 and it is currently administered orally at the dosage of 25 mg/day in treating breast cancer in postmenopausal women. Exemestane is endowed with a peculiar mechanism of aromatase inhibition.
  • the aromatase enzyme (450 arO m) is a specific form of cytochrome P450 hemoprotein composed of a P450 (heme) moiety and a peptidic moiety. The enzyme catalyzes a multistep reaction leading to aromatization of the A ring of the androgen substrate (mainly androstenedione) to estrone, requiring the presence of the cofactor NADPH.
  • exemestane The newly found therapeutic utility of exemestane is actually surprising. From the pharmacological point of view, the ovarian follicular stimulating activity of exemestane may be found in several concurrent factors, including its peculiar mechanism of aromatase inactivation, the dosage and the treatment schedule.
  • a first object of the present invention is to provide a method for treating infertility in a female host in need thereof comprising the administration of a therapeutically effective follicular stimulating amount of exemestane to said host.
  • a method is provided for inducing ovarian follicular stimulation in a female host in need thereof comprising the administration and subsequent removal of a therapeutically effective follicular stimulating and/or inhibiting amount of exemestane to said host.
  • a female host is for instance a mammalian female, in particular a woman.
  • Preferred examples of such hosts are patients with hypogonadotropic hypogonadism, polycystic ovary syndrome and other menstrual cycle disorders, and patients who otherwise are candidate for assisted reproduction techniques.
  • the clinical terms as used herein have their plain meanings, well known in the art.
  • anovulation refers to lack of ovulation, of course.
  • Ovarian follicular stimulation refers to the process wherein exemestane is used to bring about ovulation in female hosts, who are otherwise anovulatory, resulting in induction of follicular rupture and ovulation of fertilizable oocytes.
  • a therapeutically effective follicular stimulating amount refers to an amount which is effective, upon single or multiple dose administration to the patient, in treating infertility e.g. by inducing ovarian follicular stimulation either when being taken or after its stoppage causing a rebound hyperstimulation of the ovaries.
  • a method for inducing ovarian follicular stimulation in a female host suffering from hypogonadotropic hypogonadism, polycystic ovary syndrome and other menstrual cycle disorders, or who is candidates for assisted reproduction techniques comprising the administration of a therapeutically effective follicular stimulating amount of exemestane to said host.
  • a further object of the invention is the use of exemestane in the manufacture of a medicament for use in treating infertility in a female host.
  • the invention also provides the use of exemestane in the manufacture of a medicament for use in inducing ovarian follicular stimulation in a female host.
  • the effect of exemestane on ovarian follicular stimulation can for instance be seen in animal models once its administration is stopped with a resultant increase in follicle development and rupture.
  • exemestane can be administered in any form or mode, which makes the compound bioavailable in therapeutically effective amounts.
  • routes of administration include oral, sublingual, intranasal, subcutaneous, intradermal, intraperitoneal, intramuscularly, intravenous, transdermal, vaginal, rectal and the like.
  • Oral or intramuscular administration is generally preferred.
  • suitable oral forms are tablets, capsules, sugar and film coated tablets.
  • the dosage of exemestane to be used is, of course, dependent on various factors such as the host to be treated (e.g.
  • Exemestane can be administered to a woman, for instance orally, at a dosage range varying from about 5 mg/day to about 200 mg/day, possibly in divided doses, e.g. from 2 to 3 or 4.
  • exemestane is administered in the early part of the menstrual cycle (day 5 to day 7) and then stopped or it is administered throughout the entire cycle and then discontinued, in order to achieve the desired effective hematic follicular stimulating hormone level.

Landscapes

  • Health & Medical Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medicinal Chemistry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Epidemiology (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Endocrinology (AREA)
  • Organic Chemistry (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Reproductive Health (AREA)
  • Pregnancy & Childbirth (AREA)
  • Gynecology & Obstetrics (AREA)
  • Diabetes (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Steroid Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

A therapy method for treating infertility in a female host, comprising the administration of an ovarian follicular stimulating effective amount of exemestane, is provided.

Description

INFERTILITY TREATMENT WITH EXEMESTANE
Field of the invention The present invention relates to a method for treating infertility in a female host in need thereof comprising the administration of an ovarian follicular stimulating effective amount of exemestane to the female host.
Background of the invention According to Harrison Dictionary, human infertility is defined as the inability to conceive after 12 months of unprotected sexual intercourse. There is a spectrum of infertility, ranging from reduced conception rates or the need of medical intervention to irreversible causes of infertility. Infertility can be attributed primarily to male factors in 25%, female factors in 58%, and is unexplained in about 17% of couples. Ovulation is the process where an ovum or ova are released from the ovaries. The timing of ovulation within the menstrual cycle is of foremost importance for fertilization. It is well known that follicles acquire the ability to ovulate following growth and maturation stimulated by the pituitary gonadotropins. Ovulation induction is a therapeutic procedure commonly used to manage infertile patients. Ovulation induction is employed in particular for the following two purposes: 1 ) to treat anovulation in patients with hypogonadotropic hypogonadism, polycystic ovary syndrome and other menstrual cycle disorders and 2) to stimulate multiple folliculogenesis in patients (mostly with normal menstrual cycles) who are candidates for assisted reproduction techniques. These procedures are also termed controlled ovarian stimulation or hyperstimulation. However there are several complications caused by ovulation induction, including for instance multiple gestations and ovarian hyperstimulation syndrome. The complications mostly occur in polycystic ovary syndrome patients and/or full-dose gonadotropin regimens are employed. The inventor of the present invention has found that exemestane can be safely used in ovarian follicular stimulation for treating infertility in a host in need thereof, namely without causing the above side effects.
Exemestane was first taught by US patent 4,808,616 and it is currently administered orally at the dosage of 25 mg/day in treating breast cancer in postmenopausal women. Exemestane is endowed with a peculiar mechanism of aromatase inhibition. The aromatase enzyme (450arOm) is a specific form of cytochrome P450 hemoprotein composed of a P450 (heme) moiety and a peptidic moiety. The enzyme catalyzes a multistep reaction leading to aromatization of the A ring of the androgen substrate (mainly androstenedione) to estrone, requiring the presence of the cofactor NADPH. After this enzymatic reaction, the enzyme molecule is once more available to perform a new aromatization. The exemestane's mechanism of aromatase inhibition has been extensively studied and the compound has been found to cause enzyme inactivation. In fact exemestane, structurally related to the natural substrate androstenedione, is initially recognized by the aromatase enzyme as a false substrate, therefore it competes with androstenedione at the active site of the enzyme. The compound is then transformed (through a NADPH-dependent mechanism) to an intermediate which binds irreversibly to the enzyme causing its inactivation (also known as suicide inhibition). Therefore the enzyme is definitely inactivated and e novo enzyme synthesis is required for oestrogen production.
The newly found therapeutic utility of exemestane is actually surprising. From the pharmacological point of view, the ovarian follicular stimulating activity of exemestane may be found in several concurrent factors, including its peculiar mechanism of aromatase inactivation, the dosage and the treatment schedule.
Description of the invention
A first object of the present invention is to provide a method for treating infertility in a female host in need thereof comprising the administration of a therapeutically effective follicular stimulating amount of exemestane to said host. According to a preferred embodiment of the invention, a method is provided for inducing ovarian follicular stimulation in a female host in need thereof comprising the administration and subsequent removal of a therapeutically effective follicular stimulating and/or inhibiting amount of exemestane to said host. A female host, according to the invention, is for instance a mammalian female, in particular a woman. Preferred examples of such hosts are patients with hypogonadotropic hypogonadism, polycystic ovary syndrome and other menstrual cycle disorders, and patients who otherwise are candidate for assisted reproduction techniques. The clinical terms as used herein have their plain meanings, well known in the art.
In any case, anovulation refers to lack of ovulation, of course. Ovarian follicular stimulation refers to the process wherein exemestane is used to bring about ovulation in female hosts, who are otherwise anovulatory, resulting in induction of follicular rupture and ovulation of fertilizable oocytes. As used herein, the term "a therapeutically effective follicular stimulating amount" refers to an amount which is effective, upon single or multiple dose administration to the patient, in treating infertility e.g. by inducing ovarian follicular stimulation either when being taken or after its stoppage causing a rebound hyperstimulation of the ovaries.
According to a further preferred embodiment of the invention, a method is provided for inducing ovarian follicular stimulation in a female host suffering from hypogonadotropic hypogonadism, polycystic ovary syndrome and other menstrual cycle disorders, or who is candidates for assisted reproduction techniques, comprising the administration of a therapeutically effective follicular stimulating amount of exemestane to said host.
A further object of the invention is the use of exemestane in the manufacture of a medicament for use in treating infertility in a female host.
The invention also provides the use of exemestane in the manufacture of a medicament for use in inducing ovarian follicular stimulation in a female host. The effect of exemestane on ovarian follicular stimulation can for instance be seen in animal models once its administration is stopped with a resultant increase in follicle development and rupture.
In effecting treatment according to the invention, exemestane can be administered in any form or mode, which makes the compound bioavailable in therapeutically effective amounts. For example, routes of administration include oral, sublingual, intranasal, subcutaneous, intradermal, intraperitoneal, intramuscularly, intravenous, transdermal, vaginal, rectal and the like. Oral or intramuscular administration is generally preferred. One skilled in the art of preparing formulations can readily select the proper form and mode of administration depending upon the particular circumstances. For instance, examples of suitable oral forms are tablets, capsules, sugar and film coated tablets. The dosage of exemestane to be used is, of course, dependent on various factors such as the host to be treated (e.g. age, weight and general status of health), and the schedule of the treatment. Exemestane can be administered to a woman, for instance orally, at a dosage range varying from about 5 mg/day to about 200 mg/day, possibly in divided doses, e.g. from 2 to 3 or 4.
According to a preferred schedule of treatment, exemestane is administered in the early part of the menstrual cycle (day 5 to day 7) and then stopped or it is administered throughout the entire cycle and then discontinued, in order to achieve the desired effective hematic follicular stimulating hormone level.

Claims

Claims
1. Method for treating infertility in a female host in need thereof comprising the administration of a therapeutically effective follicular stimulating amount of exemestane to said host.
2. Method for inducing ovarian follicular stimulation in a female host in need thereof comprising the administration of a therapeutically effective follicular stimulating amount of exemestane to said host.
3. A method as claimed in claims 1 or 2, wherein the female host is a mammalian female.
4. A method as claimed in claims 1 or 2, wherein the female host is a woman.
5. A method as claimed in claims 1 or 2, wherein the female host is suffering from hypogonadotropic hypogonadism.
6. A method as claimed in claims 1 or 2, wherein the female host is suffering from polycystic ovary syndrome.
7. A method as claimed in claims 1 or 2, wherein the female host is candidates for assisted reproduction technique.
8. A method as claimed in claims 1 or 2, wherein exemestane is administered at a dosage range varying from about 5 mg/day to about 200 mg/day.
9. A method according to claim 8, wherein exemestane is administered in divided doses.
10. A method as claimed in claims 1 or 2, wherein exemestane is administered in the early part of the menstrual cycle and then stopped.
11. A method as claimed in claims 1 or 2, wherein exemestane is administered throughout the entire cycle and then discontinued
12. Use of exemestane in the manufacture of a medicament for use in treating infertility in a female host.
13. Use of exemestane in the manufacture of a medicament for use in inducing ovarian follicular stimulation in a female host.
EP03762980A 2002-07-02 2003-07-02 Infertility treatment with exemestane Withdrawn EP1531829A2 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US39332002P 2002-07-02 2002-07-02
US393320P 2002-07-02
PCT/US2003/016252 WO2004004634A2 (en) 2002-07-02 2003-07-02 Infertility treatment with exemestane

Publications (1)

Publication Number Publication Date
EP1531829A2 true EP1531829A2 (en) 2005-05-25

Family

ID=30115565

Family Applications (1)

Application Number Title Priority Date Filing Date
EP03762980A Withdrawn EP1531829A2 (en) 2002-07-02 2003-07-02 Infertility treatment with exemestane

Country Status (12)

Country Link
EP (1) EP1531829A2 (en)
JP (1) JP2005536490A (en)
KR (1) KR20050077045A (en)
CN (1) CN1665516A (en)
AU (1) AU2003247404A1 (en)
BR (1) BR0312393A (en)
CA (1) CA2491372A1 (en)
IL (1) IL165813A0 (en)
MX (1) MXPA05000251A (en)
PL (1) PL373219A1 (en)
WO (1) WO2004004634A2 (en)
ZA (1) ZA200410135B (en)

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Publication number Priority date Publication date Assignee Title
KR102432156B1 (en) * 2020-05-18 2022-08-11 제주대학교 산학협력단 Composition comprising chemical material for inhibiting gonadal maturation in fishes and method for inhibiting gonadal maturation in fishes using the same

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004526764A (en) * 2001-04-17 2004-09-02 アレス トレーディング ソシエテ アノニム Aromatase inhibitors for enhancing assisted reproduction
EA011310B1 (en) * 2001-04-17 2009-02-27 Арес Трейдинг С.А. Single dose aromatase inhibitor for treating infertility

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2004004634A2 *

Also Published As

Publication number Publication date
ZA200410135B (en) 2006-07-26
CA2491372A1 (en) 2004-01-15
AU2003247404A1 (en) 2004-01-23
CN1665516A (en) 2005-09-07
IL165813A0 (en) 2006-01-15
MXPA05000251A (en) 2005-07-15
KR20050077045A (en) 2005-07-29
WO2004004634A3 (en) 2004-04-08
PL373219A1 (en) 2005-08-22
BR0312393A (en) 2005-04-12
JP2005536490A (en) 2005-12-02
WO2004004634A2 (en) 2004-01-15

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