EP2285383A2 - Administration séquentielle de 20,20,21,21-pentafluoro-17-hydroxy-11 -ý4-(hydroxyacétyl)phényl-19-nor-17 -pregna-4,9-diène-3-one et d'un ou plusieurs progestatifs pour traiter des troubles gynécologiques - Google Patents

Administration séquentielle de 20,20,21,21-pentafluoro-17-hydroxy-11 -ý4-(hydroxyacétyl)phényl-19-nor-17 -pregna-4,9-diène-3-one et d'un ou plusieurs progestatifs pour traiter des troubles gynécologiques

Info

Publication number
EP2285383A2
EP2285383A2 EP09745520A EP09745520A EP2285383A2 EP 2285383 A2 EP2285383 A2 EP 2285383A2 EP 09745520 A EP09745520 A EP 09745520A EP 09745520 A EP09745520 A EP 09745520A EP 2285383 A2 EP2285383 A2 EP 2285383A2
Authority
EP
European Patent Office
Prior art keywords
pentafluoro
hydroxy
pregna
treatment
phenyl
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Withdrawn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
EP09745520A
Other languages
German (de)
English (en)
Inventor
Ulrike Fuhrmann
Wolfgang Schwede
Carsten Möller
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.)
Bayer Pharma AG
Original Assignee
Bayer Schering Pharma AG
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 Bayer Schering Pharma AG filed Critical Bayer Schering Pharma AG
Priority to EP09745520A priority Critical patent/EP2285383A2/fr
Publication of EP2285383A2 publication Critical patent/EP2285383A2/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Withdrawn legal-status Critical Current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
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/565—Compounds 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
    • A61K31/567—Compounds 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 position 17 alpha, e.g. mestranol, norethandrolone
    • 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
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/57—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids substituted in position 17 beta by a chain of two carbon atoms, e.g. pregnane or progesterone
    • 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
    • A61K31/56—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids
    • A61K31/58—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin
    • A61K31/585—Compounds containing cyclopenta[a]hydrophenanthrene ring systems; Derivatives thereof, e.g. steroids containing heterocyclic rings, e.g. danazol, stanozolol, pancuronium or digitogenin containing lactone rings, e.g. oxandrolone, bufalin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00—Drugs for disorders of the endocrine system
    • A61P5/24—Drugs for disorders of the endocrine system of the sex hormones
    • A61P5/34—Gestagens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P5/00—Drugs for disorders of the endocrine system
    • A61P5/24—Drugs for disorders of the endocrine system of the sex hormones
    • A61P5/36—Antigestagens

Definitions

  • the present invention relates to treatment regimens and combination preparations of 20, 20, 21, 21, pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4,9-diene 3-on the formula
  • this invention relates to sequential regimens for the treatment of gynecological diseases in which the progesterone antagonist mentioned above is administered in a first phase and a progestogen in a second phase.
  • the invention also relates to treatment regimens in which 11 ⁇ - (4-acetylphenyl) -20,20,21,21,21-pentafluoro-17-hydroxy-19-nor-17 ⁇ -pregna-4,9-dien-3-one ( Lonaprisan) is used.
  • PR antagonists and SPRMs or selective progesterone receptor modulators leads to changes in the endometrial morphology if it takes place over a longer period of time. These changes are important for all long-term applications, whether for the treatment of gynecological diseases such as endometriosis, uterine leiomyomas or for the treatment of abnormal or dysfunctional menstrual bleeding.
  • PR antagonistic compounds have an antiproliferative effect on endometrial cells. This is also called a non-competitive anti-estrogenic effect.
  • the object of the present invention is to provide a pharmaceutical which is suitable for the safe long-term treatment of gynecological diseases such as endometriosis, uterine leiomyomas or dysfunctional menstrual bleeding.
  • this medicinal product is intended to ensure both a reversibility of the described effects on the endometrium and thus an increased safety of the uterus, to allow a controlled menstruation and to prevent possible misdiagnosis due to the potentially induced endometrial thickness.
  • the present invention solves this problem by the discontinuous use of the progesterone receptor antagonist 20,20, 21, 21, 21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4, 9-dien-3-one.
  • the progesterone receptor antagonist 20 20, 21, 21-pentafluoro-17-hydroxy-11 ⁇ - [4]
  • gestagen-containing gestagen monopreparations or Gestagen combination preparations, for example with estrogens, such as commercial contraceptives or preparations for hormone replacement therapy
  • gestagentransport dosage units containing other drugs or no dosage units administered.
  • the duration of this second treatment period is 1 to 30, preferably 5 to 20, particularly preferably 7 to 14 days.
  • second treatment periods with a duration of 7, 10, 11, 12, 14, 21 or 28 days are conceivable.
  • Progestogens are substances which have a contraceptive effect and are able to induce withdrawal bleeding. These include z. Chlormanidone acetate, cyproterone acetate, desogestrel, dienogest, drospirenone, dydrogesterone, ethynodiol diacetate, etonorgestrel, gestodene, levonorgestrel, medrogestone, medroxyprogesterone and medroxyprogesterone acetate, norethindrone, norethisterone and norethisterone acetate, norgestimate, norgestrel, progesterone, promegestone or trimegestone.
  • the next cycle of treatment would begin with the progesterone receptor antagonist as described above. Due to the direct application of the progesterone receptor antagonist following the administration of the gestagen, menstruation is expected to be induced.
  • gestagen-free dosage units containing other active substances or no dosage units are administered in the second treatment period, then with the next treatment cycle - ie the re-administration of the progesterone receptor antagonist in the first treatment period of the following Treatment cycle - to be maintained until the onset of menstruation (flexible break). As expected, this should be done within 30 days of stopping the progesterone receptor antagonist in most women. In individual cases, this menstrual-free period may take longer. Preferred here is a period of 2 - 4 weeks.
  • the second treatment period of each treatment cycle into two further treatment periods, wherein in the first treatment period the gestagen-containing, optionally also supplementary estrogen-containing dosage units, in the immediately subsequent second treatment period, the gestagentransport dosage units containing other agents or none Dose units are administered.
  • the next treatment cycle - ie the re-administration of the progesterone receptor antagonist in the first treatment period of the following treatment cycle - should be awaited until menstruation occurs. As expected, this is done after weaning of the gestagen. Also possible is the beginning of the next treatment cycle after the end of menstruation.
  • the progesterone receptor antagonist is primarily 20,20,21,21,21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4,9-dien-3-one Question.
  • progestagens come primarily drospirenone, dienogest or levonorgestrel in question.
  • the progestogen / estrogen combination is predominantly commercially - e.g. in oral contraceptives - available combinations are considered.
  • Placebo not only means a drug-free dosage form, but also dosage forms that contain different Wirkstoff ⁇ i of progesterone receptor antagonists, gestagens or progestogen / estrogen combinations in particular folic acid, its salts or metafolin.
  • periods of the first treatment period at least for blocks 1 to 9, periods of 10, 11 and 12 days are also considered.
  • Progesterone receptor antagonist by 20,20,21,21,21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4,9-dien-3-one and progestogen by drospirenone;
  • Progesterone receptor antagonist by 20,20,21,21,21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4,9-dien-3-one and progestogen by dienogest;
  • Progesterone receptor antagonist by 20,20,21,21,21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4,9-dien-3-one and progestogen by levonorgestrel or - Progesterone receptor antagonist by 20,20,21, 21, 21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4,9-dien-3-one and
  • a combination preparation containing the progesterone receptor antagonist 20,20,21, 21,21-pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] is also used, in particular for the treatment of endometriosis.
  • the formulation as a fixed combination is also a separate formulation of the progesterone receptor antagonist 20,20,21, 21, 21 -pentafluoro-17-hydroxy-11 ⁇ - [4- (hydroxyacetyl) phenyl] -19-nor-17 ⁇ -pregna-4 , 9-dien-3-one and the gestagen, if these are intended for simultaneous use - especially if they are packaged together.
  • oral dosage forms for single daily administration are preferred. These can be summarized in a drug package for sequential use and summarized with a leaflet that informs about the correct revenue sequence.
  • Formulations of progestogens and progestogen / estrogen combinations are also prior art and can be taken from this.
  • the following examples serve to illustrate the invention without limiting it in any way.

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  • Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Epidemiology (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Endocrinology (AREA)
  • Engineering & Computer Science (AREA)
  • Diabetes (AREA)
  • Reproductive Health (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Steroid Compounds (AREA)

Abstract

L'invention concerne un traitement et des préparations combinées de 20,20,21,21,21-pentaflluoro-17-hydroxy-11ß-[4-hydroxyacétyl)phényl-19-nor-17a-pregna-4,9-diène-3-one représentées par la formule. Elle concerne, en particulier, un traitement séquentiel de troubles gynécologiques qui consiste à administrer, en une première phase, l'antagoniste de progestérone susmentionné et, en une deuxième phase, un progestatif.
EP09745520A 2008-05-14 2009-05-07 Administration séquentielle de 20,20,21,21-pentafluoro-17-hydroxy-11 -ý4-(hydroxyacétyl)phényl-19-nor-17 -pregna-4,9-diène-3-one et d'un ou plusieurs progestatifs pour traiter des troubles gynécologiques Withdrawn EP2285383A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP09745520A EP2285383A2 (fr) 2008-05-14 2009-05-07 Administration séquentielle de 20,20,21,21-pentafluoro-17-hydroxy-11 -ý4-(hydroxyacétyl)phényl-19-nor-17 -pregna-4,9-diène-3-one et d'un ou plusieurs progestatifs pour traiter des troubles gynécologiques

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US7172508P 2008-05-14 2008-05-14
EP08075496A EP2123279A1 (fr) 2008-05-14 2008-05-14 Administration séquentielle de 20,20,21,21,21-Ppentafluor-17-hydroxy-1 1bêta-[4-(hydroxyacétyl) phényl]-19-nor-17alpha-pregna-4,9-dien-3-on et un ou plusieurs gestagènes destinés au traitement de maladies gynécologiques
PCT/EP2009/003249 WO2009138186A2 (fr) 2008-05-14 2009-05-07 ADMINISTRATION SÉQUENTIELLE DE 20,20,21,21-PENTAFLUORO-17-HYDROXY-11β-[4-(HYDROXYACÉTYL)PHÉNYL-19-NOR-17α-PREGNA-4,9-DIÈNE-3-ONE ET D'UN OU PLUSIEURS PROGESTATIFS POUR TRAITER DES TROUBLES GYNÉCOLOGIQUES
EP09745520A EP2285383A2 (fr) 2008-05-14 2009-05-07 Administration séquentielle de 20,20,21,21-pentafluoro-17-hydroxy-11 -ý4-(hydroxyacétyl)phényl-19-nor-17 -pregna-4,9-diène-3-one et d'un ou plusieurs progestatifs pour traiter des troubles gynécologiques

Publications (1)

Publication Number Publication Date
EP2285383A2 true EP2285383A2 (fr) 2011-02-23

Family

ID=39865702

Family Applications (2)

Application Number Title Priority Date Filing Date
EP08075496A Withdrawn EP2123279A1 (fr) 2008-05-14 2008-05-14 Administration séquentielle de 20,20,21,21,21-Ppentafluor-17-hydroxy-1 1bêta-[4-(hydroxyacétyl) phényl]-19-nor-17alpha-pregna-4,9-dien-3-on et un ou plusieurs gestagènes destinés au traitement de maladies gynécologiques
EP09745520A Withdrawn EP2285383A2 (fr) 2008-05-14 2009-05-07 Administration séquentielle de 20,20,21,21-pentafluoro-17-hydroxy-11 -ý4-(hydroxyacétyl)phényl-19-nor-17 -pregna-4,9-diène-3-one et d'un ou plusieurs progestatifs pour traiter des troubles gynécologiques

Family Applications Before (1)

Application Number Title Priority Date Filing Date
EP08075496A Withdrawn EP2123279A1 (fr) 2008-05-14 2008-05-14 Administration séquentielle de 20,20,21,21,21-Ppentafluor-17-hydroxy-1 1bêta-[4-(hydroxyacétyl) phényl]-19-nor-17alpha-pregna-4,9-dien-3-on et un ou plusieurs gestagènes destinés au traitement de maladies gynécologiques

Country Status (5)

Country Link
US (1) US20110112057A1 (fr)
EP (2) EP2123279A1 (fr)
JP (1) JP2011520820A (fr)
CA (1) CA2724030A1 (fr)
WO (1) WO2009138186A2 (fr)

Families Citing this family (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102009034366A1 (de) 2009-07-20 2011-01-27 Bayer Schering Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-methylenoxyalkylenaryl-Derivate, Verfahren zu ihrer Herstellung und ihre Verwendung zur Behandlung von Krankheiten
DE102009034362A1 (de) 2009-07-20 2011-01-27 Bayer Schering Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-aryl-Derivate, Verfahren zu ihrer Herstellung und ihre Verwendung zur Behandlung von Krankheiten
DE102009034368A1 (de) 2009-07-20 2011-01-27 Bayer Schering Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-acyloxyalkylenphenyl-Derivate, Verfahren zu ihrer Herstellung und ihre Verwendung zur Behandlung von Krankheiten
DE102009034367A1 (de) 2009-07-20 2011-01-27 Bayer Schering Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-benzyliden-Derivate, Verfahren zu deren Herstellung und deren Verwendung zur Behandlung von Krankheiten
DE102009034525A1 (de) 2009-07-21 2011-01-27 Bayer Schering Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-aryl-Derivate, Verfahren zu ihrer Herstellung und ihre Verwendung zur Behandlung von Krankheiten
DE102009034526A1 (de) 2009-07-21 2011-02-10 Bayer Schering Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-ethinylphenyl-Derivate, Verfahren zu deren Herstellung und deren Verwendung zur Behandlung von Krankheiten
US20120238533A1 (en) * 2009-09-11 2012-09-20 Bayer Pharma Aktiengesellschaft (Heteroarylmethyl) Thiohydantoins as anticancer drugs
DE102010007722A1 (de) * 2010-02-10 2011-08-11 Bayer Schering Pharma Aktiengesellschaft, 13353 Progesteronrezeptorantagonisten
DE102010007719A1 (de) 2010-02-10 2011-08-11 Bayer Schering Pharma Aktiengesellschaft, 13353 Progesteronrezeptorantagonisten
DE102011004899A1 (de) 2011-03-01 2012-09-06 Bayer Pharma Aktiengesellschaft 17-Hydroxy-17-pentafluorethyl-estra-4,9(10)-dien-11-aryl-Derivate, Verfahren zu ihrer Herstellung und ihre Verwendung zur Behandlung von Krankheiten
US20180155388A1 (en) * 2015-05-18 2018-06-07 Bayer Pharma Aktiengesellschaft Selective progesterone receptor modulator (sprm) regimen

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1993021926A1 (fr) * 1992-05-06 1993-11-11 Medical College Of Hampton Roads Reduction des hemorragies uterines secondaires liees a la prise de progesterone
DE4426601A1 (de) * 1994-07-27 1996-02-01 Schering Ag Verwendung eines Kombinationsproduktes enthaltend einen kompetitiven Progesteronantagonisten und ein Gestagen zur Herstellung eines Arzneimittels zur Behandlung der Endometriose oder des Leiomyomata uteri
DE19706061A1 (de) * 1997-02-07 1998-08-13 Schering Ag Antigestagen wirksame Steroide mit fluorierter 17alpha-Alkylkette
DE102006054535A1 (de) * 2006-11-15 2008-05-21 Bayer Schering Pharma Aktiengesellschaft Progesteronrezeptorantagonisten

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2009138186A2 *

Also Published As

Publication number Publication date
EP2123279A1 (fr) 2009-11-25
WO2009138186A3 (fr) 2010-01-14
US20110112057A1 (en) 2011-05-12
JP2011520820A (ja) 2011-07-21
WO2009138186A2 (fr) 2009-11-19
CA2724030A1 (fr) 2009-11-19

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