EP2083825A1 - Compositions de traitement de l'hépatite c et procédés d'utilisation des compositions de traitement de l'hépatite c - Google Patents

Compositions de traitement de l'hépatite c et procédés d'utilisation des compositions de traitement de l'hépatite c

Info

Publication number
EP2083825A1
EP2083825A1 EP06815317A EP06815317A EP2083825A1 EP 2083825 A1 EP2083825 A1 EP 2083825A1 EP 06815317 A EP06815317 A EP 06815317A EP 06815317 A EP06815317 A EP 06815317A EP 2083825 A1 EP2083825 A1 EP 2083825A1
Authority
EP
European Patent Office
Prior art keywords
ibogaine
composition
noribogaine
ibogamine
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Withdrawn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
EP06815317A
Other languages
German (de)
English (en)
Other versions
EP2083825A4 (fr
Inventor
Howard L. Lotsof
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.)
Addiction Research Institute Inc
Original Assignee
Addiction Research Institute Inc
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 Addiction Research Institute Inc filed Critical Addiction Research Institute Inc
Publication of EP2083825A1 publication Critical patent/EP2083825A1/fr
Publication of EP2083825A4 publication Critical patent/EP2083825A4/fr
Withdrawn legal-status Critical Current

Links

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
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
    • 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
    • A61K31/22—Esters, e.g. nitroglycerine, selenocyanates of carboxylic acids of acyclic acids, e.g. pravastatin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/14—Antivirals for RNA viruses

Definitions

  • the present invention relates to compositions for the treatment of Hepatitis. More specifically, the present invention is directed to a composition including ibogaine and/or noribogaine, and methods of using the same. Still more specifically, the present invention is directed to a composition and the use of a composition comprising one or more of ibogaine, its active salts and principal metabolite noribogaine to treat somatic complaints, elevated liver enzymes and viral load in patients with susceptible hepatitis C.
  • Hepatitis C is a member of the group of viruses known as Flaviviridae.
  • the virus was isolated from a blood-borne non-A, non-B viral hepatitis genome and is identified as nonA, nonB.
  • the virus duplicates by RNA replication and is prone to mutation.
  • Chronic HCV affects three to four million individuals in the United States and occurs in greater than 80 percent of the individuals infected with acute HCV. A minority of patients, approximately 15 percent, may clear the virus naturally.
  • the infection however, is lifelong in the majority of infected individuals and may be life threatening to them.
  • the virus is principally transferred through blood, though other vectors cannot be ruled out.
  • Subsets of the population including intravenous drug users and intravenous drug users in recovery may have chronic HCV infection rates of 70 to 90 percent.
  • Chronic HCV may progress rapidly or slowly and there is significant diversity of progression. Symptoms for chronic HCV tend to be nonspecific including fatigue, high ALT and AST levels, muscle and joint pain and right-upper-quadrant discomfort or tenderness of the liver.
  • HCV infection is a major risk factor for cirrhosis and liver cancer. An estimated 8,000 to 10,000 fatalities a year are caused by hepatitis C in the United States.
  • the principal conventional therapy for the treatment of chronic HCV is a therapy of interferon or pegylated interferon in combination with riboviron (as set forth in U.S . Patent Nos. 6,172,046 and 6,824,768). This therapy leaves much to be desired. Dose regimens, depending on genotype, are 24 or 48 weeks and may be required to be extended or repeated if not efficacious in obtaining a sustained virologic response (SVR) that is the desired outcome for this combination therapy.
  • SVR sustained virologic response
  • This therapy depending on the form and dose of interferon, the genotype of HCV and other factors, demonstrates efficacy of 2 percent to 75 percent.
  • Relapse depending on study, dose, genotype and other factors, may be as high as 48 percent in subjects who demonstrated a SVR at the completion of combination therapy.
  • Adverse events and side effects including possible fatal adverse events due to interferon riboviron combination therapy are significant.
  • Side effects and medication warnings consist of neuropsychiatric events that may include suicide, depression, return to drug abuse, psychosis, hallucinations, bipolar disorders and mania.
  • Other side effects may be bone marrow toxicity including cytopenias, thyroid disorders, hyperglycemia, diabetes; cardiovascular disorders including hypotension, arrhythmia, tachycardia, cardiomyopathy, angina pectoris and myocardial infarction.
  • interferon riboviron combination therapy Respiratory failure or collapse including death, fatal and nonfatal ulcerative hemorrhagic/ischemic colitis, abdominal pain, bloody diarrhea, fatal and nonfatal pancreatitis, rheumatoid arthritis, systemic lupus, loss of vision, retinopathy, and retinal hemorrhages. Anaphylaxis may occur and interferon riboviron combination therapy should be considered as a mutagen effecting DNA and as a possible carcinogen.
  • Interferon riboviron combination therapy is also dangerous to pregnant women directly and indirectly when used as a therapy in the significant other of a pregnant woman or a woman who may become pregnant. This therapy is anticipated to be an abortifacient.
  • Ibogaine, ibogamine and tabernanthine are among at least 12 alkaloids found in the Tabernanthe iboga plant of Gabon, West Africa.
  • the Gabonese, as well as Africans in other countries on that continent, have used the iboga alkaloids in the Bwiti religion and Mbiri medical societies principally during the last century or two by European accounts.
  • Ibogaine has also been used as an adjunctive agent in psychotherapy and psychoanalysis, and more recently has been described as an agent that may be able to suppress symptoms of dependence or withdrawal from drugs having dependence liability.
  • Discovery of this property of ibogaine led to the issuance of a number of U.S. patents to Howard S. Lotsof, including patents for ibogaine to treat narcotic dependency (U.S. Pat. No. 4,449,096), cocaine and amphetamine abuse (U.S. Pat. No. 4,587,243), alcohol dependency (U.S. Pat. No. 4,857,523), nicotine dependence (U.S. Pat. No. 5,026,697), poly-drug dependence (U.S. Pat. No. 5,152,994) and U.S. Patent No. 5,591,738 for the treatment of chemical dependence with combinations of iboga and betacarboline alkaloids.
  • iboga alkaloids are effective in treating hepatitis C symptoms, including liver swelling, increased ALT, AST and GGT levels and to reduce HCV RNA viral counts.
  • the present invention thus provides methods of treating somatic complaints, reducing liver enzyme values and reducing viral load of susceptible hepatitis C in animals by administering to a subject a therapeutically effective dose of iboga alkaloids comprising one or more of ibogaine, ibogamine, tabernanthine, their nontoxic salts and/or the converted principal metabolite noribogaine in a dose and time sufficient to accomplish those effects.
  • the present invention further provides for the administration of effective doses of the prodrug ibogaine, converted to noribogaine and producing plasma levels of ibogaine and/or noribogaine sufficient to reduce somatic complaints, liver enzyme levels and viral RNA in patients.
  • the present invention also provides effective doses and dose regimens of the prodrug ibogaine, its salts and therapeutic metabolites.
  • the present invention further provides for the administration of effective doses and dose regimens to be provided in single or multiple doses on a single day or over a period of days in therapeutically effective doses between 0.1 mg/kg and 25 mg/kg of the prodrug ibogaine, converted to noribogaine and producing plasma levels of ibogaine and/or noribogaine sufficient to reduce somatic complaints, liver enzyme levels and viral
  • compositions and methods of treating hepatitis C and hepatitis C-related complications comprise iboga alkaloids comprising one or more of ibogaine, ibogamine, tabernanthine, their nontoxic salts and/or the converted principal metabolite noribogaine in a therapeutic formulation.
  • the agents in the compositions are less harmful and less toxic than present anti-hepatitis C therapies.
  • compositions of the present invention and administering to the host a therapeutically effective amount of a composition of this invention are further disclosed.
  • the present invention further provides a method of treating somatic complaints, reducing liver enzyme values and reducing viral load of susceptible hepatitis C, comprising administering to a host a therapeutically effective amount of a composition of this invention.
  • Another aspect of the present invention is the shortness of the treatment period, as compared to existing therapies, in that the present treatment period may be a single day or a period of approximately two weeks.
  • the basis of the present invention is the finding that certain plants contain iboga alkaloids that assist in the treatment of hepatitis C and hepatitis C-related complications. This offers the advantage of allowing therapeutically effective doses of natural agents to be used as compared to the dose of synthetic substances that would be required in order to achieve the same or similar therapeutic effect.
  • natural agents extracted from the Tabernanthe iboga plant of Gabon, West Africa could be combined into one single formulation that would possess the ability to treat hepatitis C and hepatitis C-related complications.
  • the effective amount or effective dose is an amount of the composition to be administered to the host that treats hepatitis C and hepatitis C-related complications.
  • Suitable doses of a composition can be determined readily by various methods known to one skilled in the art, including generating an empirical dose-response curve, and other methods used in the pharmaceutical sciences.
  • the agents used in the compositions of this invention may be provided in the form of pure substances, or as root bark of the natural plant containing the natural agents in concentrations between about 1 to 6 per cent of which approximately fifty percent is ibogaine, or as concentrated plant extracts containing the natural agents in concentrations between about 5 to 40 percent of which one half is ibogaine. Doses of the root bark or total alkaloid extract would be extrapolated to correspond to doses of purified ibogaine in keeping with the dose recommendations and regimens for purified ibogaine and associated alkaloids as described in the present invention.
  • the amount of agent contained in a composition of this invention will depend in part on the desired results of the treatment, the stage of hepatitis C, its associated complications, and/or the health of the patient.
  • Another embodiment of the present invention includes improved methods for using the agents. It was discovered that various methods of administering the present invention to a host achieve therapeutically effective results, thus allowing therapeutically effective doses of agents to be administered to patients that suffer from various medical conditions, for example, conditions that make oral administration and digestion difficult. Until this invention, it was not known that the agents of the present invention could be administered by methods that would treat hepatitis C and hepatitis C-related complications in the host.
  • the present invention thus provides methods of treating hepatitis C and hepatitis C-related complications comprising administering a composition of this invention to a host in need of therapy.
  • the doses, routes of administration, and carriers and/or adjuvants used may vary based on the view of known procedures for treatment of hepatitis C and hepatitis C-related complications or the delivery of any manner of drug product known to those familiar with the art. 6 037231
  • composition can be administered in the form of a tablet, capsule or other pharmacologically appropriate carrier, in a parenteral solution, in a suppository, in a rectal solution, in the form of a tea, or in the form without plant material in a tablet, capsule, transdermal technology or other pharmacological carrier, in a parenteral solution, or in a suppository which contains at least one of the agents comprising iboga alkaloids.
  • compositions of this invention may also be administered as a solution and other oral or parenteral administration can be used.
  • a compound with poor solubility in acidic media may show poor or erratic bioavailability when absorbed orally.
  • intravenous administration requires that a drug be administered in a soluble form.
  • Compounds that are intended for oral administration but are susceptible to rapid degradation at low pH (i.e. gastric acids) will likely require protection from low pH environments like the stomach. Protection can often be afforded by administering the drug in a dosage form with an acid-resistant coating.
  • the compositions may also be administered as part of a formulation.
  • compositions of this invention can be used in the form of tablets, capsules, granules, powders, lozenges, syrups, elixirs, solutions, suspensions, and the like, in accordance with standard pharmaceutical practice.
  • a dried extract can be compounded into tablets, capsules, or other solid-dosage form.
  • a solubilized liquid formulation can be combined with syrup or other agent to formulate suspensions, solutions, elixirs, or tinctures to improve the taste, potency, or shelf life.
  • parenteral administration which includes intramuscular, intraperitoneal, subcutaneous and intravenous use, sterile solutions of the agents are usually prepared, and the pH of the solutions are suitably adjusted and buffered.
  • Carriers useful in formulating the preparations are commonly used pharmaceutically acceptable non-toxic carriers such as gelatin, lactose sodium citrate, salts of phosphoric acid, starch, magnesium stearate, sodium lauryl sulfate, talc, polyethylene glycol, etc.
  • the carrier may be used with other additives such as diluents, binders, buffer agents, preservatives, sweetening agents, flavoring agents, glazes, disintegrators, coating agents emulsifying agents, suspending agents, etc.
  • the dosage regimen may be regulated according to the potency of the individual agents utilized in the compositions of this invention, the mode of administration, and the needs of the host depending on factors such as the degree and severity of the disease state and age and general condition of the host being treated. Dosing ranges from 0.1 to 25 milligrams of the composition of the present invention per kilogram of body weight, once or multiple times daily, for one day to four weeks or longer depending upon the severity and length of hepatitis C infection and the response of the patient.
  • the present invention also provides methods of treating hepatitis C and related complications in the significant other or sexual partner of a pregnant female without having an observable toxic effect on the fetus.
  • a further embodiment of the present invention provides for the treatment of hepatitis C symptoms, including liver swelling, increased liver enzyme levels, including ⁇ -glutamyl transferase (GGT), Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) and Alkaline Phosphatase levels, and for the reduction in HCV RNA viral counts.
  • Elevated levels of GGT, ALT, AST and Alkaline Phosphatase indicate injury or trauma to the liver.
  • reduced levels of GGT, AST, ALT and Alkaline Phosphatase indicate reduced trauma or injury of the liver.
  • Another embodiment of the present invention is that it can be effective in a chemically dependent population - a population which has greater tendency to be susceptible to hepatitis C infection.
  • Another embodiment of the present invention is that it can concurrently treat signs and symptoms of hepatitis C infection and chemical dependence disorders.
  • Example 1 A thirty-three year old male diagnosed as HCV positive and using 1/2 gram of heroin per day was administered 25 mg/kg of ibogaine HCl. Following the administration of ibogaine, heroin use ceased along with swelling of the liver and pain in the area of the liver.
  • AST was reduced from pretreatment level of 201 to post treatment level of 25.
  • ALT was reduced from pretreatment level of 410 to post treatment level of 50.
  • GGT level was reduced from 155 to 33.
  • Pretreatment Alkaline Phosphatase was 99, AST was 103 and ALT 195.
  • Post treatment Alkaline Phosphatase 88, AST 89 and ALT 127.
  • An additional 250 mg of ibogaine HCl further reduced HCV RNA IU/mL to 384,000.
  • a final dose within this regimen of 250 mg ibogaine was administered reducing the HCV RNA IU/mL to 154,000.
  • Example 4 A forty-two year old female weighing 160 lbs tested positive HCV RNA genotype
  • RNA IU/mL was 12,600,000. Subject was administered a total of 27 mg/kg of ibogaine HCl over a period of 48 hours in the following regimen: 2 mg/kg, 2 mg/kg, 2 mg/kg, 2 mg/kg, 2 mg/kg, 12 mg/kg, and 3 mg/kg. HCV RNA IU/mL was reduced to 50,100. Prior to ibogaine therapy patient's urine was dark and stool light. Post treatment color of urine and stool were normal.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Animal Behavior & Ethology (AREA)
  • Epidemiology (AREA)
  • Virology (AREA)
  • Oncology (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Communicable Diseases (AREA)
  • Molecular Biology (AREA)
  • Emergency Medicine (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

La présente invention concerne une composition qui comprend un indole alcaloïde, l'ibogaïne, ses sels actifs et son principal métabolite, la noribogaïne, forme dé-méthylée de l'ibogaïne, et qui est destinée au traitement de l'hépatite C et des complications liées à l'hépatite C lorsqu'elle est administrée dans des schémas à dose unique ou multiple efficaces pour réduire les symptômes somatiques, les valeurs des enzymes hépatiques et la charge virale causée par l'hépatite C chronique chez les patients. L'invention concerne également des procédés d'utilisation de ladite composition.
EP06815317A 2006-09-26 2006-09-26 Compositions de traitement de l'hépatite c et procédés d'utilisation des compositions de traitement de l'hépatite c Withdrawn EP2083825A4 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2006/037231 WO2008039179A1 (fr) 2006-09-26 2006-09-26 Compositions de traitement de l'hépatite c et procédés d'utilisation des compositions de traitement de l'hépatite c

Publications (2)

Publication Number Publication Date
EP2083825A1 true EP2083825A1 (fr) 2009-08-05
EP2083825A4 EP2083825A4 (fr) 2009-11-04

Family

ID=39230475

Family Applications (1)

Application Number Title Priority Date Filing Date
EP06815317A Withdrawn EP2083825A4 (fr) 2006-09-26 2006-09-26 Compositions de traitement de l'hépatite c et procédés d'utilisation des compositions de traitement de l'hépatite c

Country Status (4)

Country Link
EP (1) EP2083825A4 (fr)
CA (1) CA2664935A1 (fr)
IL (1) IL197804A0 (fr)
WO (1) WO2008039179A1 (fr)

Families Citing this family (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TR201107537A2 (tr) 2011-08-01 2012-01-23 Tataroğlu Vedat Hepatit c hastalığınınn iyileştirilmesi için bitkisel bir kompozisyon ve bu bitkisel kompozisyonun kullanım yöntemi.
ES2527544T1 (es) 2011-10-21 2015-01-26 Abbvie Inc. Tratamiento mono (PSI-7977) o de combinación con AAD para su uso en el tratamiento del VHC
US8492386B2 (en) 2011-10-21 2013-07-23 Abbvie Inc. Methods for treating HCV
AR088463A1 (es) 2011-10-21 2014-06-11 Abbvie Inc Metodos para el tratamiento de hcv
US8466159B2 (en) 2011-10-21 2013-06-18 Abbvie Inc. Methods for treating HCV
EP2874312B1 (fr) * 2012-07-11 2019-04-17 Skyworks Filter Solutions Japan Co., Ltd. Composant électronique
CA2978537C (fr) * 2014-03-03 2023-10-24 Demerx, Inc. Utilisations therapeutiques de l'ibogaine et composes associes
US20150246055A1 (en) * 2014-03-03 2015-09-03 Demerx, Inc. Methods for acute and long-term treatment of opioid and opioid-like drug addiction
US9561233B2 (en) 2014-03-13 2017-02-07 Demerx, Inc. Use of ibogaine for the treatment of pain
US9592239B2 (en) 2014-09-12 2017-03-14 Demerx, Inc. Methods and compositions for ibogaine treatment of impulse control disorder, anxiety-related disorders, violence and/or anger, or regulating food intake
WO2017189978A1 (fr) 2016-04-28 2017-11-02 Emory University Compositions thérapeutiques à base de nucléotides et nucléosides contenant un alcyne et utilisations associées
GB2571696B (en) 2017-10-09 2020-05-27 Compass Pathways Ltd Large scale method for the preparation of Psilocybin and formulations of Psilocybin so produced
EP3955936A1 (fr) 2019-04-17 2022-02-23 COMPASS Pathfinder Limited Traitement de la dépression et de divers autres troubles au moyen de psilocybine
US12016829B2 (en) 2019-10-11 2024-06-25 Pike Therapeutics Inc. Pharmaceutical composition and method for treating seizure disorders
AU2020366147B2 (en) 2019-10-14 2024-09-05 Pike Therapeutics Inc. Transdermal delivery of cannabidiol

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001070203A2 (fr) * 2000-03-22 2001-09-27 Nowicky Wassili Agent de traitement de l'hepatite c

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5152994A (en) * 1990-05-31 1992-10-06 Lotsof Howard S Rapid method for interrupting or attenuating poly-drug dependency syndromes

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001070203A2 (fr) * 2000-03-22 2001-09-27 Nowicky Wassili Agent de traitement de l'hepatite c

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of WO2008039179A1 *

Also Published As

Publication number Publication date
EP2083825A4 (fr) 2009-11-04
CA2664935A1 (fr) 2008-04-03
WO2008039179A1 (fr) 2008-04-03
IL197804A0 (en) 2009-12-24

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