Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/185—Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
  • A61K31/19—Carboxylic acids, e.g. valproic acid
  • A61K31/195—Carboxylic acids, e.g. valproic acid having an amino group
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
  • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
  • A61K31/216—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acids having aromatic rings, e.g. benactizyne, clofibrate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K31/00—Medicinal preparations containing organic active ingredients
  • A61K31/21—Esters, e.g. nitroglycerine, selenocyanates
  • A61K31/215—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids
  • A61K31/235—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids having an aromatic ring attached to a carboxyl group
  • A61K31/24—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids having an aromatic ring attached to a carboxyl group having an amino or nitro group
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P13/00—Drugs for disorders of the urinary system
  • A61P13/08—Drugs for disorders of the urinary system of the prostate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

• This invention relates to the use of beta-3 adrenoceptor agonists for the treatment of conditions associated with pathological changes or irritation of the prostate. These include complaints associated with benign changes in the prostate gland, especially benign prostatic hyperplasia (BPH), or discomfort such as prostatitis, whether due to inflammatory processes or chronic irritation.
• BPH benign prostatic hyperplasia
• Benign prostatic hyperplasia is a disease of unknown etiology that occurs in over 50% of men over the age of 50, resulting in enlargement of the prostate gland.
• the symptomatic complex BPH may be associated with benign prostatic enlargement (BPE), bladder outlet obstruction (BOO) or irritating lower urogenital symptoms.
• BPE benign prostatic enlargement
• BOO bladder outlet obstruction
• irritating lower urogenital symptoms BPH
• Benign Prostate Syndrome - BPS in order to define an umbrella term for the pathophysiologically very variable relationship between symptoms irritant complaints in the lower urinary tract, prostate enlargement (BPE) and obstruction (BOO or BPO).
• LUTS lower genitourinary tract
• BPH benign prostatic hyperplasia
• the urethra can be narrowed in this area and the complete emptying of the bladder can be hampered.
• the disorder may be accompanied by bladder dysfunction, which may increase the irritative symptoms. It can also develop an overflow bladder or total urinary retention.
• neighboring organs such as the kidney may also be affected (eg hydronephrosis, progressive renal failure). The risk of developing an acute or chronic urinary tract infection in the presence of benign prostatic hyperplasia is often elevated.
• alpha-adrenoceptor antagonists and 5-alpha reductase inhibitors are used.
• Representatives of the class of alpha adrenoceptor antagonists can selectively and competitively bind to the postsynaptic alpha-1 receptors. This relaxes the smooth muscles of the prostate and urethra and reduces the tone of the smooth muscles of the prostate and urethra. As a result, the urinary flow rate is increased.
• 5-alpha-reductase inhibitors inhibit the enzyme 5-alpha reductase. This enzyme converts the body's own testosterone into dihydrotestosterone, which directly stimulates the growth of prostate tissue.
• Symptoms similar to BPH may also develop in the context of other pathological processes of the prostate, e.g. in prostatitis.
• the term prostatitis in turn includes a heterogeneous clinical picture with multiple, often unrecognized or unrecognized causes.
• the current National Institutes of Health (NIH) classification identifies four categories of prostatitis: acute prostatitis (NIH I), chronic bacterial prostatitis (NIH II), chronic abacterial prostatitis (NIH III), and asymptomatic prostatitis (NIH IV).
• Chronic abacterial prostatitis (NIH III) is also referred to as chronic pelvic pain syndrome and is subdivided into a chronic abacterial inflammatory form (NIH IHa) and a noninflammatory pain syndrome (NIH HIb). While the diagnosis of acute prostatitis (NIH I) can usually be unambiguous, the differential diagnosis of chronic forms is difficult.
• Bacterial prostatitis (NIH I and II) can be triggered by urogenous or hematogenous infections or by spreading an inflammation of the neighboring organs. As a result, acute bacterial prostatitis may develop into inflammatory chronic prostatitis that may remain bacterial or become abacterial.
• the neurogenic causes include, for example, neuropathies and neuritis, especially in the area of the small pelvis, but also in the area of the large pelvis, the adjacent intestinal areas or in the area of the anus.
• the muscular trigger factors count unconscious and frequent tensing of the pelvic floor muscles, the lumbar muscles and other located in the vicinity of the prostate muscles. This permanent muscle tension with little or no muscle relaxation can appear as an unconscious response to periods of stress, aggressiveness, frustration, and more.
• the tension of the pelvic floor muscles can also be the result of long periods of sitting and other one-sided behaviors, such as cycling.
• This form of prostatitis is also referred to as pelvic non-inflammatory chronic pain syndrome, pelvic myoneuropathy, prostatic dysplasia, or prostateopathy.
• the symptoms of prostatitis are similar to the symptoms of BPH or LUTS. These include dysuria, pollakisuria, defecation pain, urinary retention, urination burning, pain and discomfort around the prostate, pain in ejaculation and others.
• Selective beta-3 adrenoceptor agonists are discussed for their suitability for various indications. These include u.a. Obesity, diabetes and urinary incontinence. Since 1995 it is known to use selective beta-3-adrenoceptor agonists in the therapy of urinary incontinence (EP 0 958 835).
• the object of the present invention is to treat complaints in the lower urogenital tract, in particular of the prostate, which are due to acute or preferably chronic inflammations or irritations of the prostate or to a benign prostate enlargement (BPH).
• An object of the invention relates to the treatment of BPH in all its symptomatic manifestations. Another object is the treatment of acute or preferably chronic prostatitis.
• a further object relates to the treatment of the chronic pain syndrome of the pelvis, pelvic myoneuropathy, prostate dynia or prostateopathy.
• Another object is the treatment of man's obstructive bladder voiding disorders (BOO).
• Another object is the treatment of the symptom complex of LUTS (lower urinary tract symptoms) in men.
• beta-3-adrenoceptor agonists or pharmaceutical compositions comprising compounds from this class of active agents is presented.
• a novel pharmaceutical composition comprising at least one beta-3 adrenoceptor agonist in a pharmaceutically effective amount as an active ingredient.
• For the basic compounds are as acids to Salt formation exemplified: vinegar, benzenesulfone (besylat-), benzoic, p-bromophenylsulfone, camphorsulfone, carbon, citric, ethanesulfonic, fumaric, gluconic, glutaric, hydrobromic, hydrochloric, hydrogen iodide , Isethionic, lactic, maleic, malic, almond, methanesulfonic (mesylate), mucin, nitric, oxalic, pamoic, pantothenic, phosphoric, succinic, sulfuric, tartaric, , p-toluenesulfonic acid and the like.
• acids to Salt formation exemplified: vinegar, benzenesulfone (besylat-), benzoic, p-bromophenylsulfone, camphorsulfone, carbon, citric, ethane
• beta-3-adrenoceptor agonists used according to the invention are preferably phenoxyacetic acid derivatives. These are preferably selected from the following group according to formula I:
• n can be 0 or 1;
• n can be 0 or 1.
• less than the stated amount may be sufficient, while in other cases a larger total amount may be necessary.
• the total daily dose may be taken in one or more portions depending on the regiment regimen.
• the therapy regiment can also dictate intervals between incomes that are longer than a day.
• the average daily dose of the beta-3 agonist for an adult male is about 1 mg to 1000 mg, preferably 10 mg to about 750 mg per day, preferably 20 to 500 mg, more preferably 20 to 200 mg. This amount is preferably administered as a single dose or as a double dose per day.
• compositions of the present invention may conveniently be administered in a pharmaceutical composition containing the active component in combination with a suitable carrier.
• suitable carrier can be prepared by methods and include carriers that are well known in the art. The skilled worker is generally recognized in this regard sutician available.
• compositions of the present invention may be administered parenterally (eg, by intravenous, intraperitoneal, subcutaneous or intramuscular injection), topically, orally, be administered intranasally, transdermally, rectally, pulmonarily by inhalation or nasal inhalation, with oral administration being particularly preferred.
• enteric formulations may be preferred. In this case enteric-coated capsules or enteric-coated tablets are preferred, which in both cases can be realized, for example, with an enteric coating.
• composition of the invention may be combined with one or more carriers and in the form of ingestible tablets, buccal tablets, sublingual tablets, sugar-coated tablets, powders, powders, lozenges, dragees, granules, capsules, elixirs, suspensions, solutions, Syrups, wafers, chewing gum, food and the like.
• a powder can be prepared in which the particles of the active substance are brought to a suitable size by grinding.
• Diluted powders can be prepared by finely grinding the powdered substance with a non-toxic carrier material such as lactose and applying it as a powder.
• a non-toxic carrier material such as lactose
• suitable carrier materials in this regard are others
• Carbohydrates such as starch or mannitol.
• these powders are optionally, these powders
• Flavorings, preservatives, dispersing agents, colorants and other pharmacological auxiliaries Flavorings, preservatives, dispersing agents, colorants and other pharmacological auxiliaries.
• Capsules can be prepared from a powder of the above mentioned kind or other powders, which are introduced into a capsule, preferably a gelatin capsule, and the capsule is then closed. It is also possible that lubricants known from the prior art are introduced into the capsule or used for the closure of the two capsule parts.
• the effectiveness of a capsule on oral ingestion may be enhanced by adding disintegrating or solubilizing agents, such as carboxymethylcellulose, carboxymethylcellulose calcium, low-substituted ones
• Hydroxypropyl cellulose calcium carbonate, sodium carbonate and other substances.
• the active ingredient can be present in the capsule not only as a solid but also suspended, for example in vegetable oil, polyethylene glycol, glycerol with the aid of surface-active substances, etc.
• Tablets can be prepared by pressing the powdered mixture and then adding e.g. is processed into granules.
• the tablets may contain various adjuvants, such as e.g. Starches, lactose, cane sugar, glucose, sodium chloride, urea for solution u. Injectable tablets, amylose, various types of celluloses as described above and others.
• glycerol or starch can be used as a humectant center.
• Starch alginic acid, calcium alginate, pectic acid, powdered agar-agar, formaldehyde gelatin, calcium carbonate, sodium bicarbonate, magnesium peroxide, amylose can be used as disintegrating agents, for example.
• cane sugar, stearin, solid paraffin preferably having a melting range of 50-52 ° C.
• cocoa fat preferably having a melting range of 50-52 ° C.
• disintegrants may be: corn starch, potato starch, alginic acid and the like.
• Suitable absorption enhancers include quaternary ammonium compounds, sodium lauryl sulfate, saponins.
• ethers can be used as the binder distributor and cetyl alcohol, glycerol monostearate, starch, maize starch, lactose, wetting agents (for example Aerosol OT, Pluronics, Tweens), tragacanth gum, gum arabic, gelatin and others as hydrophilizing agents or disintegrating accelerators.
• sucrose, fructose, lactose or aspartame can be used or as flavoring peppermint, wintergreen oil, cherry flavor u.v.m.
• Tablets can be made, for example, by direct compression.
• Tablets and similar orally applicable solid forms may be coated.
• tablets, pills or capsules may be coated with gelatin, wax, shellac or sugar and the like.
• enteric formulations are preferred for the oral dosage forms.
• enteric coatings are preferred for tablets or capsules.
• sucrose or fructose may be included as a sweetener, methyl and propylparaben as a preservative, a dye and a flavoring such as cherry or orange flavor.
• compositions such as solutions, syrups, elixirs, etc. can also be prepared.
• the compound can be microencapsulated.
• Parenteral administration can be achieved by dissolving the compound in a liquid and injecting it subcutaneously, intramuscularly or intravenously.
• Suitable solvents are, for example, water or oily media.
• the compound can be formulated with low melting and water soluble or water insoluble materials such as polyethylene glycol, cocoa butter, higher esters (eg, Moerysthyl, palmitate) or mixtures thereof.
• any material used in the preparation of any unit dosage form should be pharmaceutically acceptable and substantially non-toxic in the amounts used.
• the active components may be incorporated into sustained release preparations and devices which include, but are not limited to, those based on osmotic pressures to achieve a desired release profile.
• sustained release preparations and devices which include, but are not limited to, those based on osmotic pressures to achieve a desired release profile.
• One-time formulations for each of the active components are specifically included.
• compositions and preparations should contain at least 0.001% active compound.
• percentage of compositions and preparations may be varied and may conveniently be between about 0.1 to about 100% of the weight of a given unit dosage form.
• the amount of active compound in such therapeutically useful compositions is such that an effective dosage amount is obtained.
• any of the compounds listed as beta-3 adrenoceptor agonists may be used for the treatment or prophylaxis, among others.
• irritative symptoms or diseases of the lower urinary tract of the man especially the prostate or corresponding Begeleitsymptome: benign prostatic hyperplasia, prostatitis, especially chronic abacterial Prostatitis, neurogenic, muscular or bacterial Origin, chronic pelvic pain syndrome, pelvic myoneuropathy, prostate dysynia, lower urinary tract symptoms (LUTS), obstructive bladder dysfunction (BOO) and / or prostate disease.
• Begeleitsymptome benign prostatic hyperplasia, prostatitis, especially chronic abacterial Prostatitis, neurogenic, muscular or bacterial Origin, chronic pelvic pain syndrome, pelvic myoneuropathy, prostate dysynia, lower urinary tract symptoms (LUTS), obstructive bladder dysfunction (BOO) and / or prostate disease.
• the use according to the invention is aimed not only at the causal treatment of the pathological alteration of the prostate or the pelvic musculature, which is accompanied by the mentioned indications, but also at the treatment of the concomitant symptoms, in particular the possibly associated pain or the urinary diversion problem.
• these include dysuria, pollakisuria, urinary retention, suppressible, imperative urgency, associated with or without urge incontinence, increased frequency of urination, nocturnal urination (dysuria and nocturia), residual urination, urination, pain and discomfort in the vicinity of the prostate or lower urinary tract, including the Penis, pain in erection or ejaculation, pain in defecation, erectile dysfunction.
• symptomatic treatment is meant that the symptoms associated with the accompanying symptoms are less perceived or relieve the symptoms.
• both diseases are included whose cause lies in an organ dysfunction or disease whose cause is due to a bacterial inflammation, to mechanical overstress or to diseases or disorders of the central and / or peripheral nervous system.
• another embodiment of the present invention comprises the use of the composition of the invention for the manufacture of a medicament for the treatment or prevention of any of the indications mentioned in the preceding paragraph.
• Treatment of the above diseases or disorders is accomplished by delivery of a therapeutically effective amount of the composition of the invention to a mammal. In most cases this is human but the treatment of food animals (eg livestock) and pets (eg dogs, cats and horses) is expressly covered herein.
• the dosages to be used may be different than the dosages given herein.
• the new composition will provide a rapid relief with a minimum level of deleterious side effects in those suffering from the above diseases and disorders.
• the beta-3 adrenoceptor agonist may also be combined with other drugs.
• some co-minmation partners are mentioned.
• the active compounds may optionally be used in the form of the neutral compound or in the form of salts. By way of example, but not conclusively, some possibilities are given.
• combination partners are: ⁇ 1 -adrenoceptor antagonists such as tamsulosin, tamsulosin hydrochloride, alfuzosin, bunazosin, doxazosin, indoramine, naftopidil, prazosin, terazosin, urapidil, silodosin, moxisylyt, metazosine, fiduxosin, upidosine, SNAP-5089 (5 (N- (3- (4,4-diphenyl-piperidin-1-yl) -propyl-carbamoyl) -2,6-dimethyl-4 (R) - (4-nitrophenyl) -l, 4-dihydropyridine-3-carboxylic acid methyl ester) , AIO-8507L, SL-890591 ((2- (3- (4- (5-chloro-2-methoxyphenyl) piperazine-1-yl) per p
• Antimuscarinica such as (S) -N- ⁇ 3- [4- (2- (2,3-dihydrobenzofuran-5-yl) -l-methylethyl) ethylamino] -methyl-piperidin-1-yl] -3-oxopropyl ⁇ -methanesulfonamide, [1,1'-biphenyl] -2- ylcarbamic acid l-azabicyclo [2.2.2] oct-4-yl ester monohydrochloride, 2-methyl-alpha, alpha-diphenyl-1H-imidazole, AH-9700, benzhydryl-carbamic acid N- (4-methylanimo-benzyl) - piperidin-4-yl ester, bethanchol chloride, darifenacin, darifenacin chloride, dicyclomine hydrochloride, emepronium chloride, fesoterodine, FK-584,

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• 2005
  • 2005-10-12 JP JP2007536082A patent/JP2008516909A/ja active Pending
  • 2005-10-12 EP EP05799213A patent/EP1804778A1/de not_active Withdrawn
  • 2005-10-12 CA CA002580170A patent/CA2580170A1/en not_active Abandoned
  • 2005-10-12 WO PCT/EP2005/010975 patent/WO2006042679A1/de active Application Filing
  • 2005-10-17 TW TW094136193A patent/TW200630083A/zh unknown
  • 2005-10-18 US US11/252,838 patent/US20060084700A1/en not_active Abandoned

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