JP2006513990A - インターフェロンβを用いる慢性炎症性脱髄性多発性ニューロパシーの治療 - Google Patents
インターフェロンβを用いる慢性炎症性脱髄性多発性ニューロパシーの治療 Download PDFInfo
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Abstract
Description
慢性炎症性脱髄性多発性ニューロパシー(CIDP)は、ゆっくりした進行性の衰弱および脚および腕の感覚の機能障害によって特徴づけられる神経学的障害である。この疾患は、末梢神経のミエリン鞘に対する損傷によって引き起こされる。神経根の膨潤がまた、この疾患の特徴である。任意の年齢および両性において生じ得るが、CIDPは、若い成人において、女性よりも男性においてより一般的である。症状としては、うずきまたはしびれ(つま先および指において生じる)、腕および脚の衰弱、筋肉の疼痛、深部腱反射の喪失(反射消失)、疲労、ならびに異常な感覚が挙げられる。
1つの実施形態において、本発明は、哺乳動物において慢性脱髄性運動ニューロパシーを処置するための方法を提供する。この方法は、哺乳動物への、治療有効量のIFN−β治療剤を投与する工程を包含する。IFN−β治療剤は、非皮下の非経口経路(例えば、筋肉内)を介して投与され得る。好ましい実施形態において、ニューロパシーは、慢性炎症性脱髄性ニューロパシー(CIDP)である。
本発明は、慢性脱髄性ニューロパシー(例えば、CIDP)を処置するための方法を提供し、この方法は、薬学的有効量のIFN−β治療剤を投与する工程を包含する。
特許請求される本発明の主題をより明瞭かつ正確に指摘するために、記載される説明および添付の特許請求の範囲において使用される特定の用語について、以下の定義が、提供される。
本発明に従って使用され得るIFN−β治療剤は、野生型IFN−βおよびそれらの生物学的活性改変体(例えば、天然に存在する改変体および非天然の改変体)を含む。野生型天然ヒトIFN−βのヌクレオチド配列およびアミノ酸配列を、配列番号1および配列番号2にそれぞれ示し、これらは、GenBank Accessionの第M28622および第AAA36040にそれぞれ、同一である。これらのIFNはまた、例えば、Seghal(1985)J.Interferon Res.5:521に記載される。全長ヒトIFN−βタンパク質は、187アミノ酸の長さであり、配列番号1のコード配列はヌクレオチド76〜639に対応する。このシグナル配列は、アミノ酸の1〜21に対応する。このIFN−βの成熟形態のアミノ酸配列は、アミノ酸の22〜187(配列番号1のヌクレオチドの139〜639)に対応する。このような配列をコードする、成熟ヒトIFN−βタンパク質配列および成熟ヒトIFN−βヌクレオチド配列を、配列番号4および配列番号3として、それぞれ示す。
本発明のIFN−β治療剤は、任意の適切な方法(例えば、IFN−β治療剤をコードする核酸を構築することおよび適切な形質転換された宿主内にこの核酸を発現することを含む方法)により産生され得る。この方法は、組換えIFN−β治療剤を産生する。IFN−β治療剤はまた、化学的合成または化学的合成および組換えDNA技術との組合せにより産生され得る。
本発明は、被験体において、必要に応じて別の治療に対する添加剤として、治療的に有効量のIFN−β治療剤を被験体に投与する工程を含む、ニューロパシーを処置するかまたは予防するための方法を提供する。一実施形態において、ニューロパシーは、脱髄性ニューロパシー(例えば、慢性脱髄性ニューロパシー)である。慢性脱髄性ニューロパシーの例としては、CIDPおよび多病巣性運動ニューロパシーが挙げられる。好ましい実施形態において、ニューロパシーは、CIDPである。
(i)pH5.0の20mM酢酸緩衝液(この緩衝液は、好ましくは事前に凍結乾燥されておらず、この緩衝液は、IFN−βおよび(a)150mMアルギニン−HCl;(b)100mM塩化ナトリウムおよび70mMグリシン;(c)150mMアルギニン−HClおよび15mg/ml ヒト血清アルブミン;(d)150mMアルギニン−HClおよび0.1%Pluronic F−68;(e)140mM塩化ナトリウム;(f)140mM塩化ナトリウムおよび15mg/mlヒト血清アルブミン;および(g)140mM塩化ナトリウムおよび0.1%Pluronic F−68より選択される少なくとも一種の成分を含む);
(ii)IFN−βまたはその改変体、170mM L−グルタミン酸、および150mM水酸化ナトリウムを含むpH5.0の液体(この液体は、好ましくは事前に凍結乾燥されていない);および
(iii)pH7.2の20mMリン酸緩衝液(この緩衝液は、好ましくは事前に凍結乾燥されておらず、この緩衝液は、IFN−βおよび(a)140mMアルギニン−HClならびに(b)100mM塩化ナトリウムおよび70mMグリシンより選択される少なくとも一種の成分を含む);
を含む。
1ml用量あたりの処方:
30mcgインターフェロン−β−1a(6百万国際単位(MIU))
50mMリン酸ナトリウム
100mM塩化ナトリウム
15mgヒト血清アルブミン
pH7.2
からなる、凍結乾燥粉末として、市販される。AVONEX(登録商標)インターフェロンの比活性は、2×108単位/mg(すなわち、IFN−β−1aタンパク質1ミリグラムあたり200MUの抗ウイルス活性)である。患者は、1週間ごとに一度、1mlの筋肉内注射の前に、滅菌水を用いてこの粉末を再構成する。AVONEX(登録商標)はまた、以下:
0.5ml用量あたりの処方:
30mcg(μg)インターフェロン−β−1a(6百万国際単位(MIU))
20mM酢酸塩(酢酸ナトリウムおよび酢酸)
150mMアルギニンHCl
0.005%w.vポリソルベート20
注射用水
pH4.8
からなる、液体処方物として調製され得る。この処方物を、あらかじめ充填したシリンジ内にパッケージし得る。患者は、提供された通りに、手でシリンジを使用しても、または自動注入装置と組み合わせて使用してもよい。投与計画は、1週間ごとに1度、筋肉内に6MUI(すなわち、30mcg)である。
2.0ml用量あたり処方:
3MIUのIFN−β−1a
マンニトール
HSA
酢酸ナトリウム
pH5.5
からなる。
REBIF(登録商標)インターフェロンの比活性は、2.7×108単位/mg(すなわち、IFN−β−1aタンパク質1ミリグラムごとに270MUの抗ウイルス活性)である。患者は、1週間に3回、皮下注射の前に、塩化ナトリウム溶液(0.9%NaCl)を用いてこの粉末を再構成する。液体REBIF(登録商標)の処方は、以下の通りである:
0.5ml用量あたりの処方:
6MIUまたは12MIUのIFN−β−1a
4mgまたは2mgのHSA
27.3mgマンニトール
0.4mg酢酸ナトリウム
注射用水。
この液体処方物を、あらかじめ充填したシリンジ内にパッケージし、そして1週間ごとに3回(6MIUまたは12MIU(それぞれ66μg/週または132μg/週に相当する))、自動注入装置(Rebiject)を使用してか、または使用せずに、皮下に投与する。
IVIgで処置したCIDP患者を、以下のIFN−β 1α処置に転換する。
当業者は、本明細書中に記載した本発明の特定の実施形態の多くの等価物を認識し、または慣用実験に過ぎないものを使用して、これらを確認することができる。このような等価物は、添付の特許請求の範囲により包含されることが意図される。
Claims (74)
- 慢性脱髄性運動ニューロパシーの処置のための医薬品の製造におけるIFN−β治療剤の使用。
- 前記IFN−β治療剤が、非皮下非経口経路を介して投与される、請求項1に記載の使用。
- 前記IFN−β治療剤が、筋肉内投与される、請求項2に記載の使用。
- 前記慢性脱髄性運動ニューロパシーが、慢性炎症性脱髄性ニューロパシー(CIDP)である、請求項1〜3のいずれか1項に記載の使用。
- 前記IFN−β治療剤が、成熟IFN−βを含有する、請求項1〜4のいずれか1項に記載の使用。
- 前記IFN−β治療剤が、第1メチオニンを欠失する、請求項1〜5のいずれか1項に記載の使用。
- 前記IFN−βが、ヒトIFN−βである、請求項1〜6のいずれか1項に記載の使用。
- 前記IFN−βが、配列番号4を有する全長成熟ヒトIFN−βと少なくとも約95%同一である、請求項7に記載の使用。
- 前記IFN−βが、配列番号4を含む、請求項8に記載の使用。
- 前記IFN−βが、グリコシル化されている、請求項1〜9のいずれか1項に記載の使用。
- 前記IFN−βが、グリコシル化されていない、請求項1〜9のいずれか1項に記載の使用。
- 前記IFN−βが、IFN−β−1aである、請求項7に記載の使用。
- 前記IFN−βが、IFN−β−1bである、請求項7に記載の使用。
- 前記IFN−β治療剤が、免疫グロブリン分子の定常ドメインと融合したIFN−βを含有する、請求項1〜13のいずれか1項に記載の使用。
- 前記免疫グロブリン分子が、ヒト免疫グロブリン分子である、請求項14に記載の使用。
- 前記免疫グロブリン分子が、IgG1の重鎖である、請求項15に記載の使用。
- 前記IFN−βが、配列番号14を含む、請求項16に記載の使用。
- 前記IFN−β治療剤が、ペグ化IFN−βを含有する、請求項1〜17のいずれか1項に記載の使用。
- 前記IFN−β治療剤が、安定化剤を含有する、請求項1〜18のいずれか1項に記載の使用。
- 前記安定化剤が、酸性アミノ酸である、請求項19に記載の使用。
- 前記安定化剤が、アルギニンである、請求項20に記載の使用。
- 前記IFN−β治療剤が、約4.0と7.2との間のpHを有する、請求項1〜21のいずれか1項に記載の使用。
- 前記IFN−β治療剤が、静脈内(i.v.)投与される、請求項1〜2および請求項4〜22のいずれか1項に記載の使用。
- 前記哺乳動物に、数回用量のIFN−β治療剤を投与する工程を包含する、請求項1〜23のいずれか1項に記載の使用。
- 前記IFN−β治療剤が、約6MIUの用量で週1回投与される、請求項24に記載の使用。
- 前記IFN−β治療剤が、約6MIUの用量で週2回投与される、請求項24に記載の使用。
- 前記IFN−β治療剤が、約12MIUの用量で週1回投与される、請求項24に記載の使用。
- 前記IFN−β治療剤が、約12MIUの用量で週2回投与される、請求項24に記載の使用。
- 前記哺乳動物が、ヒトである、請求項1〜28のいずれか1項に記載の使用。
- 医薬品の調製のための、請求項1〜29のいずれか1項に記載の使用であって、該医薬品が、慢性脱髄性ニューロパシーのための他の処置に耐性であることがあらかじめ見出されていない被験体に投与される、使用。
- 前記医薬品が、免疫抑制剤または血漿瀉血を含む組み合わせ処置において投与される、請求項1〜30のいずれか1項に記載の使用。
- 前記医薬品が、ステロイド、アザチオプリン、シクロスポリン、シクロホスファミドおよびマイコフェノレートからなる群から選択される免疫抑制剤を含む組み合わせ処置において投与される、請求項30に記載の使用。
- 前記医薬品が、第2のCIDP処置を含む組み合わせ処置において投与される、請求項2〜32のいずれか1項に記載の使用であって、ここで、前記IFN−β治療剤の投与は、非皮下非経口経路を介する、使用。
- 前記医薬品が、第2のCIDP処置を含む組み合わせ処置において投与される、請求項2〜32のいずれか1項に記載の使用であって、ここで、前記IFN−β治療剤の投与は、週1回である、使用。
- 請求項33または請求項34に記載の使用であって、前記第2のCIDP処置が、IVIgの投与;ステロイドの投与;抗炎症薬物の投与および血漿瀉血からなる群から選択される、使用。
- 前記医薬品が、慢性脱髄性運動ニューロパシーのための別の処置で処置される被験体に投与される、請求項1〜30のいずれか1項に記載の使用であって、該処置は、他の処置を段階的に減らす工程をさらに包含する、使用。
- 哺乳動物において慢性脱髄性運動ニューロパシーを処置する方法であって、該方法は、該哺乳動物に治療有効量のIFN−β治療剤を投与する工程を包含する、方法。
- 前記IFN−β治療剤が、非皮下非経口経路を介して投与される、請求項37に記載の方法。
- 前記IFN−β治療剤が、筋肉内投与される、請求項37に記載の方法。
- 前記慢性脱髄性運動ニューロパシーが、慢性炎症性脱髄性ニューロパシー(CIDP)である、請求項37に記載の方法。
- 前記IFN−β治療剤が、成熟IFN−βを含有する、請求項37〜40のいずれか1項に記載の方法。
- 前記IFN−β治療剤が、第1メチオニンを欠失する、請求項37〜41のいずれか1項に記載の方法。
- 前記IFN−βが、ヒトIFN−βである、請求項37〜42のいずれか1項に記載の方法。
- 前記IFN−βが、配列番号4を有する全長成熟ヒトIFN−βと少なくとも約95%同一である、請求項43に記載の方法。
- 前記IFN−βが、配列番号4を含む、請求項44に記載の方法。
- 前記IFN−βが、グリコシル化されている、請求項37〜45のいずれか1項に記載の方法。
- 前記IFN−βが、グリコシル化されていない、請求項37〜46のいずれか1項に記載の方法。
- 前記IFN−βが、IFN−β−1aである、請求項43に記載の方法。
- 前記IFN−βが、IFN−β−1bである、請求項43に記載の方法。
- 前記IFN−β治療剤が、免疫グロブリン分子の定常ドメインと融合したIFN−βを含有する、請求項37〜49のいずれか1項に記載の方法。
- 前記免疫グロブリン分子が、ヒト免疫グロブリン分子である、請求項50に記載の方法。
- 前記免疫グロブリン分子が、IgG1の重鎖である、請求項51に記載の方法。
- 前記IFN−βが、配列番号14を含む、請求項52に記載の方法。
- 前記IFN−β治療剤が、ペグ化IFN−βを含有する、請求項37〜53のいずれか1項に記載の方法。
- 前記IFN−β治療剤が、安定化剤を含有する、請求項37〜54のいずれか1項に記載の方法。
- 前記安定化剤が、酸性アミノ酸である、請求項55に記載の方法。
- 前記安定化剤が、アルギニンである、請求項56に記載の方法。
- 前記IFN−β治療剤が、約4.0と7.2との間のpHを有する、請求項37〜57のいずれか1項に記載の方法。
- 前記IFN−β治療剤が、静脈内(i.v.)投与される、請求項37〜38および請求項40〜58のいずれか1項に記載の方法。
- 前記哺乳動物に、数回用量のIFN−β治療剤を投与する工程を包含する、請求項37〜60のいずれか1項に記載の方法。
- 前記IFN−β治療剤が、約6MIUの用量で週1回投与される、請求項60に記載の方法。
- 前記IFN−β治療剤が、約6MIUの用量で週2回投与される、請求項60に記載の方法。
- 前記IFN−β治療剤が、約12MIUの用量で週1回投与される、請求項60に記載の方法。
- 前記IFN−β治療剤が、約12MIUの用量で週2回投与される、請求項60に記載の方法。
- 前記哺乳動物が、ヒトである、請求項37〜64のいずれか1項に記載の方法。
- CIDPを処置するための方法であって、該方法は、CIDPを有する被験体に、薬学的有効量のIFN−β治療剤を投与する工程、および該被験体に免疫抑制剤をさらに投与する工程または該被験体に血漿瀉血を行う工程を包含する、方法。
- 前被験体に、ステロイド、アザチオプリン、シクロスポリン、シクロホスファミドおよびマイコフェノレートからなる群から選択される免疫抑制剤を投与する工程を包含する、請求項66に記載の方法。
- CIDPを処置するための方法であって、該方法は、CIDPを有する被験体に、薬学的有効量のIFN−β治療剤を第2のCIDP処置と組み合わせて投与する工程を包含し、ここで、該IFN−β治療剤の投与は、非皮下非経口経路を介する、方法。
- 請求項68に記載の方法であって、前記第2のCIDP処置が、IVIgの投与;ステロイドの投与;抗炎症薬物の投与および血漿瀉血からなる群から選択される、方法。
- CIDPを処置するための方法であって、該方法は、CIDPを有する被験体に、薬学的有効量のIFN−β治療剤を第2のCIDP処置と組み合わせて投与する工程を包含し、ここで、該IFN−β治療剤の投与は、週1回である、方法。
- 請求項70に記載の方法であって、前記第2のCIDP処置が、IVIgの投与;ステロイドの投与;抗炎症薬物の投与および血漿瀉血からなる群から選択される、方法。
- ステロイドの投与;抗炎症薬物の投与;IVIGの投与および血漿瀉血からなる群から選択される第1CIDP処置を受けている被験体におけるCIDP処置の方法における改善であって、該改善は、該被験体に、該第1CIDP処置に加えて、該第1CIDP処置の用量または頻度を有意に減少するために有効な量のIFN−β治療剤の用量を投与する工程を包含し、ここで、該IFN−β治療剤の投与は、非皮下非経口経路を介し、CIDPの症状の有効な軽減を提供する、改善。
- ステロイドの投与;抗炎症薬物の投与;IVIGの投与および血漿瀉血からなる群から選択される第1CIDP処置を受けている被験体におけるCIDP処置の方法における改善であって、該改善は、該被験体に、該第1CIDP処置に加えて、該第1CIDP処置の用量または頻度を有意に減少するために有効な量のIFN−β治療剤の用量を、週1回投与する工程を包含し、CIDPの症状の有効な軽減を提供する、改善。
- ステロイドの投与;抗炎症薬物の投与;および血漿瀉血からなる群から選択される第1CIDP処置を受けている被験体におけるCIDP処置の方法における改善であって、該改善は、該被験体に、該第1CIDP処置に加えて、該第1CIDP処置の用量または頻度を有意に減少するために有効な量のIFN−β治療剤の用量を投与する工程を包含し、CIDPの症状の有効な軽減を提供する、改善。
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JP2007039463A (ja) * | 2002-09-27 | 2007-02-15 | Biogen Idec Ma Inc | インターフェロンβを用いる慢性炎症性脱髄性多発性ニューロパシーの治療 |
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WO2008130382A2 (en) | 2006-10-31 | 2008-10-30 | East Carolina University | Fusion proteins comprising an anti -inflammatory cytokine and an antigen for treatment of immune disorders |
CA2757287C (en) | 2009-03-31 | 2019-09-10 | East Carolina University | Cytokines and neuroantigens for treatment of immune disorders |
CA2850469C (en) * | 2011-10-01 | 2020-07-07 | Glytech, Inc. | Glycosylated polypeptide and pharmaceutical composition containing same |
GB201212878D0 (en) | 2012-07-20 | 2012-09-05 | Pike Justin | Authentication method and system |
EP3072513A1 (en) | 2015-03-26 | 2016-09-28 | Medday | Biotin for treating Amyotrophic lateral sclerosis |
GB201520741D0 (en) | 2015-05-27 | 2016-01-06 | Mypinpad Ltd And Licentia Group Ltd | Authentication methods and systems |
KR102454376B1 (ko) * | 2018-07-04 | 2022-10-17 | 서울대학교산학협력단 | 신경손상의 면역세포치료 |
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JP2007039463A (ja) * | 2002-09-27 | 2007-02-15 | Biogen Idec Ma Inc | インターフェロンβを用いる慢性炎症性脱髄性多発性ニューロパシーの治療 |
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JP2011132248A (ja) | 2011-07-07 |
EA200500545A3 (ru) | 2007-04-27 |
KR20050059195A (ko) | 2005-06-17 |
EP1575531B1 (en) | 2011-08-17 |
EA200500545A2 (ru) | 2005-08-25 |
BR0314548A (pt) | 2005-08-09 |
NO20052059L (no) | 2005-06-27 |
RS20050255A (en) | 2007-08-03 |
WO2004028472A2 (en) | 2004-04-08 |
CN102038938A (zh) | 2011-05-04 |
MXPA05003243A (es) | 2005-09-12 |
US20060182715A1 (en) | 2006-08-17 |
AU2003277006B2 (en) | 2009-09-10 |
EP1575531A4 (en) | 2008-01-23 |
GEP20094699B (en) | 2009-06-10 |
EP1575531B9 (en) | 2012-02-22 |
WO2004028472A3 (en) | 2006-01-19 |
EA009289B1 (ru) | 2007-12-28 |
CN1802170A (zh) | 2006-07-12 |
DK1575531T3 (da) | 2011-11-21 |
CA2500189A1 (en) | 2004-04-08 |
AU2003277006C1 (en) | 2010-04-01 |
US20120058083A1 (en) | 2012-03-08 |
PL377612A1 (pl) | 2006-02-06 |
NZ565990A (en) | 2009-10-30 |
ZA200502416B (en) | 2005-10-20 |
JP2007039463A (ja) | 2007-02-15 |
IS7746A (is) | 2005-03-15 |
UA86749C2 (en) | 2009-05-25 |
EP1575531A2 (en) | 2005-09-21 |
NO20052059D0 (no) | 2005-04-27 |
AU2003277006A1 (en) | 2004-04-19 |
ATE520412T1 (de) | 2011-09-15 |
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