HRP960196A2 - NOVEL USE OF (S)-ADENOSYL-L-METHIONINE (SAMe) - Google Patents

NOVEL USE OF (S)-ADENOSYL-L-METHIONINE (SAMe) Download PDF

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Publication number
HRP960196A2
HRP960196A2 HR19515275.1A HRP960196A HRP960196A2 HR P960196 A2 HRP960196 A2 HR P960196A2 HR P960196 A HRP960196 A HR P960196A HR P960196 A2 HRP960196 A2 HR P960196A2
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Croatia
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same
adenosyl
methionine
ischemia
day
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HR19515275.1A
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Croatian (hr)
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Georg Nemeth
Carlo Di Padova
Laszlo Szabo
Gerhard Gross
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Knoll Ag
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7042Compounds having saccharide radicals and heterocyclic rings
    • A61K31/7052Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides
    • A61K31/706Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom
    • A61K31/7064Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines
    • A61K31/7076Compounds having saccharide radicals and heterocyclic rings having nitrogen as a ring hetero atom, e.g. nucleosides, nucleotides containing six-membered rings with nitrogen as a ring hetero atom containing condensed or non-condensed pyrimidines containing purines, e.g. adenosine, adenylic acid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Epidemiology (AREA)
  • Molecular Biology (AREA)
  • Engineering & Computer Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • General Chemical & Material Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Organic Chemistry (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Saccharide Compounds (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)

Description

(S)-adenosil-L-metionina (SAMe) i njegove soli su već poznate, usporedi EP-PS 162.323. Također je opisano da SAMe posjeduje načelnu antiishemijsku učinkovitost (Eur. J. Pharmacol. 144: 211, 1987; Jpn. J. Pharmacol. 46: 225, 1988; Eur. J. Pharmacol. 166: 231, 1989; Jpn. J. Pharmacol. 52: 141, 1990). Prema JP-PS 1.686.947 SAMe se može upotrijebiti kod različitih indikacija koje se odnose na središnja ozljede. U tom spisu navode se dnevne doze od 100 mg do 1550 mg. (S)-adenosyl-L-methionine (SAMe) and its salts are already known, compare EP-PS 162,323. SAMe has also been described to possess in principle anti-ischemic efficacy (Eur. J. Pharmacol. 144: 211, 1987; Jpn. J. Pharmacol. 46: 225, 1988; Eur. J. Pharmacol. 166: 231, 1989; Jpn. J. Pharmacol. 52: 141, 1990). According to JP-PS 1,686,947 SAMe can be used for various indications related to central injuries. In that file, daily doses from 100 mg to 1550 mg are stated.

Iz Atti e Memorie della Societa Medica del Lazio, Anno I, Nr. 3, 1983, 1-14, poznato je da se s dozama SAMe od 3, odnosno 5 g/dnevno liječe pacijenti kojima su otkazali bubrezi. From Atti e Memorie della Societa Medica del Lazio, Anno I, Nr. 3, 1983, 1-14, it is known that SAMe doses of 3 and 5 g/day are used to treat patients with kidney failure.

U Japan, J. Pharmacol. 49, 119-124 (1989) opisuje se učinak SAMe na sadržaj kalcija i metabolizam glukoze, te na smrtnost štakora nakon prevladavanja ishemije kod doziranja od 100 mg/kg. In Japan, J. Pharmacol. 49, 119-124 (1989) describes the effect of SAMe on calcium content and glucose metabolism, and on rat mortality after overcoming ischemia at a dosage of 100 mg/kg.

Međutim, antiishemijska učinkovitost SAMe bila je pokazana kod liječenja globalne i prijenosne cerebralne ishemije. Uzrok globalne cerebralne ishemije potpuni prekid cerebralnog snabdijevanja krvlju, kako se pojavljuje primjerice tijekom zaustavljanja srca. Poznato je da terapeutski učinak tvari kod globalne ishemije nije prenosiv na ishemijska oboljenja mozga druge vrste, naročito ne na folaknu ishemiju, koju izaziva npr. začepljenje intrakranijalnih krvnih žila (Cerebrovasc. Brain Metab. Rev. 2: 1, 1990). However, the anti-ischemic efficacy of SAMe has been demonstrated in the treatment of global and transient cerebral ischemia. The cause of global cerebral ischemia is a complete interruption of the cerebral blood supply, as occurs, for example, during cardiac arrest. It is known that the therapeutic effect of the substance in global ischemia is not transferable to ischemic brain diseases of another type, especially not to folate ischemia, which is caused, for example, by blockage of intracranial blood vessels (Cerebrovasc. Brain Metab. Rev. 2: 1, 1990).

Najvažnije patogeneze fokalne ishemije, kod kojih se mogu pojaviti ozljede, sve do letalnog ishoda, jesu slijedeće: The most important pathogenesis of focal ischemia, which can cause injuries, up to a fatal outcome, are the following:

- Akutna embolijska ishemija, npr. kardijalna embolija, masna i zračna embolija. - Acute embolic ischemia, eg cardiac embolism, fat and air embolism.

- Trombotička ishemija, u koju spadaju takozvane cerebralne mikro- i makroangiopatije. - Thrombotic ischemia, which includes the so-called cerebral micro- and macroangiopathies.

- Hemodinamičke, tj. npr. fokalne ishemije uzrokovane vazospazmama. - Hemodynamic, i.e. focal ischemia caused by vasospasms.

- Ishemije izazvane imunološkim, upalnim mehanizmima. Tu spadaju također i fokalne ishemije izazvane hemostaziološkim i imunološkim sistemskim oboljenjima. - Ischemia caused by immune, inflammatory mechanisms. This also includes focal ischemia caused by hemostasiological and immune system diseases.

- Fokalne ishemije, koje su povezane s posebnim oblicima procesa u krvnim žilama i drugim neobičnim uzrocima. - Focal ischemias, which are associated with special forms of processes in blood vessels and other unusual causes.

- Traumatska oštećenja mozga i kičmene moždine, koje izravno ili posredno dovode do fokalne ishemije (kao npr. intracerebralna, subduralna, epiduralna krvarenja, kontuzije mozga koji traže prostor i laceracije). - Traumatic damage to the brain and spinal cord, which directly or indirectly leads to focal ischemia (such as intracerebral, subdural, epidural hemorrhages, contusions of the brain that require space and lacerations).

Predmet predloženog izuma je upotreba SAMe i njegovih fiziološki podnošljivih soli u dozama od najmanje 2000 mg/dan/pacijentu za parenteralno liječenje ozljeda koje izaziva fokalna permanentna ishemija. The subject of the proposed invention is the use of SAMe and its physiologically tolerable salts in doses of at least 2000 mg/day/patient for parenteral treatment of injuries caused by focal permanent ischemia.

SAMe se upotrebljava ponajprije u obliku soli s fiziološki podnošljivim kiselinama. Kiseline su ponajprije: solna kiselina, sumporna kiselina, fosforna kiselina, mravlja kiselina, octena kiselina, limunska kiselina, vinska kiselina, metansulfonska kiselina, p-toluol-sulfonska kiselina i butandisulfonska kiselina. SAMe is used primarily in the form of salts with physiologically tolerable acids. The acids are preferably: hydrochloric acid, sulfuric acid, phosphoric acid, formic acid, acetic acid, citric acid, tartaric acid, methanesulfonic acid, p-toluenesulfonic acid and butanedisulfonic acid.

SAMe, odnosno njegove soli za gore navedene indikacije predviđaju se, odnosno preporučuju količinama od najmanje 2000 mg/danu/pacijentu, naročito najmanje 3000 mg/danu/pacijentu, i ponajprije u dozama od najmanje 7000 mg/danu/pacijentu. Navod visoke doze prema izumu je uglavnom mjerilo kod očigledne priprave lijeka. SAMe, i.e. its salts for the above-mentioned indications are prescribed or recommended in amounts of at least 2000 mg/day/patient, especially at least 3000 mg/day/patient, and preferably in doses of at least 7000 mg/day/patient. The indication of a high dose according to the invention is mainly a criterion in the obvious preparation of the drug.

SAMe se daje na uobičajen način parenteralno (intravenski, intraarterijski ili intramuskularno), pri čemu intravensko davanje predstavlja oblik aplikacije kojem se daje prednost. Gore navedene količine mogu se infundirati pacijentu više dana u vremenskom razmaku od 1 do 24 sata. SAMe is conventionally administered parenterally (intravenously, intra-arterially or intramuscularly), with intravenous administration being the preferred form of administration. The above amounts can be infused into the patient over several days at intervals of 1 to 24 hours.

SAMe, odnosno njegove soli mogu se primijeniti tekući u galenski upotrebljivim alikacijskim oblicima, npr. kao otopine. Aplikacijski oblici sadrže aktivnu tvar normalno količinom od 1 do 50%, ponajprije 5 do 20%. SAMe, i.e. its salts, can be applied liquid in galenically usable aliquot forms, for example as solutions. Application forms contain the active substance normally in an amount of 1 to 50%, preferably 5 to 20%.

Za upotrebu prema izumu naročiti su prikladni aplikacijski oblici koji sadrže 6-18 mas. % SAMe s lizinom u vodi. Jedan takav aplikacijski oblik može imati npr. slijedeći sastav: 400 mg SAMe, 324,3 mg L-lizina, 11,5 mg NaOH i 472,1 mg vode za injekcije. For use according to the invention, application forms containing 6-18 wt. % SAMe with lysine in water. One such application form can have, for example, the following composition: 400 mg of SAMe, 324.3 mg of L-lysine, 11.5 mg of NaOH and 472.1 mg of water for injections.

Iznenađujuće se je pokazalo, da se kod upotrebe SAMe u području doza većih od 2000 mg kod liječenja fokalne ishemije, u usporedbi prema drugim terapijama, pojavljuje učinak smanjenja smrtnosti. Surprisingly, it has been shown that when SAMe is used in the range of doses higher than 2000 mg in the treatment of focal ischemia, compared to other therapies, the effect of reducing mortality appears.

Učinak smanjenja smrtnosti SAMe kod ozljeda zbog ishemije pokazuju slijedeća klinička istraživanja na primjeru mozga: The effect of reducing the mortality of SAMe in injuries due to ischemia is shown by the following clinical studies on the example of the brain:

Na pacijentima s udarom kapi, pod uvjetima dvostruke slijepe probe, bile su provedene dvije studije kontrolirane s placebom. Pacijenti podijeljeni u dvije skupine bili su liječeni intravenski 14 dana s 2400 ili 3200 mg SAMe dnevno. Pod tim uvjetima nisu se pojavili nikakvi sporedni efekti vrijedni spomena. Kako se vidi iz tablice 1, liječenje sa SAMe dovelo je u obje skupine do signifikantno niže smrtnosti nego u skupini koja je dobivala placebo. Posebnost ove studije je, da je liječenje pacijenata u pravilu započelo između 12-24 sati nakon ishemijskog inzulta, tj. da se je više sati nakon pojave poremećaja protoka krvi još uvijek mogao dokazati klinički učinak. Two placebo-controlled studies were conducted on stroke patients under double-blind conditions. Patients divided into two groups were treated intravenously for 14 days with 2400 or 3200 mg of SAMe per day. Under these conditions, no side effects worth mentioning appeared. As can be seen from table 1, treatment with SAMe led to significantly lower mortality in both groups than in the placebo group. The peculiarity of this study is that, as a rule, the treatment of patients started between 12-24 hours after the ischemic insult, i.e. that many hours after the onset of blood flow disorders, a clinical effect could still be demonstrated.

Tablica 1 Table 1

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Claims (4)

1. Upotreba (S)-adenosil-L-metionina (SAMe) i njegovih fiziološki podnošljivih soli, naznačena time, da se daje u dozama od najmanje 2000 mg/danu/pacijentu za parenteralno liječenje ozljeda izazvanih fokalnom permanentnom ishemijom.1. Use of (S)-adenosyl-L-methionine (SAMe) and its physiologically tolerable salts, indicated to be administered in doses of at least 2000 mg/day/patient for parenteral treatment of injuries caused by focal permanent ischemia. 2. Upotreba prema zahtjevu 1, naznačena time, da su (SAMe) ili njegove fiziološki podnošljive soli predviđene u dozama od najmanje 3000 mg/danu/pacijentu.2. Use according to claim 1, characterized in that (SAMe) or its physiologically tolerable salts are provided in doses of at least 3000 mg/day/patient. 3. Upotreba (S)-adenosil-L-metionina (SAMe) i njegovih fiziološki podnošljivih soli za proizvodnju lijeka, naznačena time, da se za parenteralno liječenje ozljeda izazvanih fokalnom permanentnom ishemijom predviđa u dozama od najmanje 2000 mg/danu/pacijentu.3. The use of (S)-adenosyl-L-methionine (SAMe) and its physiologically tolerable salts for the production of medicine, indicated that for the parenteral treatment of injuries caused by focal permanent ischemia, doses of at least 2000 mg/day/patient are provided. 4. Metoda liječenja pacijenata koji pate od ozljeda izazvanih fokalnom permanentnom ishemijom, naznačena time, da se (S)-adenosil-L-metionin (SAMe) daje u dozama od najmanje 2000 mg/danu/pacijentu.4. A method of treating patients suffering from injuries caused by focal permanent ischemia, characterized in that (S)-adenosyl-L-methionine (SAMe) is administered in doses of at least 2000 mg/day/patient.
HR19515275.1A 1995-04-26 1996-04-24 NOVEL USE OF (S)-ADENOSYL-L-METHIONINE (SAMe) HRP960196A2 (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE19515275A DE19515275A1 (en) 1995-04-26 1995-04-26 New use of (S) -denosyl-L-methionine (SAMe)

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HRP960196A2 true HRP960196A2 (en) 1998-02-28

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EP (1) EP0822820A1 (en)
JP (1) JPH11504023A (en)
KR (1) KR19990008061A (en)
CN (1) CN1182367A (en)
AR (1) AR001687A1 (en)
AU (1) AU5646396A (en)
CA (1) CA2216854A1 (en)
CZ (1) CZ330597A3 (en)
DE (1) DE19515275A1 (en)
HR (1) HRP960196A2 (en)
IL (1) IL117844A0 (en)
MX (1) MX9707735A (en)
NO (1) NO974941D0 (en)
WO (1) WO1996033727A1 (en)
ZA (1) ZA963296B (en)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IE37913B1 (en) * 1972-08-02 1977-11-09 Bioresearch Sas Salt of s-adenosyl-l-methionine
JPS59139319A (en) * 1983-01-31 1984-08-10 Fuji Kagaku Kogyo Kk Remedy for body dysfunction caused by cerebral disorder
JPH02290896A (en) * 1989-04-28 1990-11-30 Fuji Kagaku Kogyo Kk Novel s-adenosylmethionine derivative
DE4425280C2 (en) * 1994-07-16 1997-05-07 Knoll Ag Use of (S) -denosyl-L-methionine and its physiologically tolerable salts for the treatment of reperfusion damage that is triggered after temporary focal ischemia

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AR001687A1 (en) 1997-11-26
KR19990008061A (en) 1999-01-25
JPH11504023A (en) 1999-04-06
CA2216854A1 (en) 1996-10-13
MX9707735A (en) 1997-12-31
ZA963296B (en) 1997-10-27
IL117844A0 (en) 1996-08-04
NO974941L (en) 1997-10-24
NO974941D0 (en) 1997-10-24
EP0822820A1 (en) 1998-02-11
CZ330597A3 (en) 1998-02-18
CN1182367A (en) 1998-05-20
WO1996033727A1 (en) 1996-10-31
AU5646396A (en) 1996-11-18
DE19515275A1 (en) 1996-10-31

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