JP2012102112A - 下痢型過敏性腸症候群におけるアミノサリチル酸の使用法 - Google Patents
下痢型過敏性腸症候群におけるアミノサリチル酸の使用法 Download PDFInfo
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- JP2012102112A JP2012102112A JP2011279890A JP2011279890A JP2012102112A JP 2012102112 A JP2012102112 A JP 2012102112A JP 2011279890 A JP2011279890 A JP 2011279890A JP 2011279890 A JP2011279890 A JP 2011279890A JP 2012102112 A JP2012102112 A JP 2012102112A
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- Prior art keywords
- diarrhea
- balsalazide
- bowel syndrome
- irritable bowel
- bowel disease
- 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.)
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Abstract
【解決手段】バルサラジド、あるいは4-ABA側鎖を含むように修飾された4-ASAもしくは5-ASA化合物またはその塩もしくは誘導体、あるいはバルサラジド、修飾されたその化合物またはその塩もしくは誘導体を適切な担体とともに含む組成物をそのような治療または予防を必要とする患者に投与する段階を含む方法。非炎症性腸疾患、下痢型過敏性腸症候群、または他の非特異的な腸疾患の治療用または予防用の薬剤を製造するための、バルサラジド、あるいは4-ABA側鎖を含むように修飾された4-ASAもしくは5-ASA化合物またはその塩もしくは誘導体の使用。
【選択図】なし
Description
下痢型IBSは、明らかではない原因から生じることが知られている病態である。特に、非炎症性腸疾患として定義されている過敏性腸症候群は、1種または複数種の病原生物による任意の検出可能な感染によって引き起こされるのではないことが知られている。
上記の不都合な点のうちの少なくとも1つを克服または実質的に改善すること、あるいは、適切な代替法を少なくとも提供することが、少なくとも好ましい態様における、本発明の目的である。
第1の局面によれば、非炎症性腸疾患、下痢型過敏性腸症候群、または他の非特異的な腸疾患を治療または予防するための方法であって、有効量の、バルサラジドまたはその塩もしくは誘導体、あるいはバルサラジドまたはその塩もしくは誘導体を適切な担体とともに含む組成物を、そのような治療または予防を必要とする患者に投与する段階を含む方法が提供される。
以下の定義は、一般的な定義として意図され、本発明の範囲をそれらの用語のみに決して限定すべきではないが、以下の説明をより良く理解するために示される。
憩室症/憩室炎、下痢型過敏性腸症候群、または便秘、鼓脹、下痢便秘交替型IBS、もしくは便秘型IBSを含む他の非特異的な腸疾患を含む非炎症性腸疾患を治療または予防するための方法が提供される。この方法は、有効量の、バルサラジドまたはその塩もしくは誘導体、あるいはバルサラジドまたはその塩もしくは誘導体を適切な担体とともに含む組成物を、そのような治療または予防を必要とする患者に投与する段階を含む。患者は、ヒトを含む哺乳動物であってもよい。
次に、例を用いて本発明を説明する。これらの実施例は、本発明の範囲を制限するものとして決して解釈すべきではない。
ある34歳の女性は、悪化性の下痢(水様性6〜12回/日)、便意切迫、筋痙攣、下腹部痛、および時には便失禁の7年の病歴を有した。明確な先行する疾患も抗生物質の使用もなかった。彼女は、一般開業医が指示する糞便培養、血液検査、超音波検査、およびCTスキャン検査から始めて、多数の検査を受けた。時間の経過とともに、彼女は、一部の食品が症状の悪化を引き起こすことに気づき、ある自然療法医に、「食物アレルギー」に罹患していると告げられた。この患者は食事を制限し、これは、症状を軽減するうえでいくらかためになったが、徐々に体重減少が進んだ。彼女は胃腸科医の診察を受け、組織学的に腹腔疾患を考慮に入れない小腸の内視鏡生検、ならびに生検を伴う結腸鏡検査およびさらなる糞便培養検査を受けた。すべての試験結果が診断に役立たなかったため、彼女は、重度の下痢型IBSであると告げられた。彼女は食事制限を継続し、カウンセリングおよび催眠療法を受けるよう言われた。その後の6〜12ヶ月の間、彼女の体重は次第に減少し、症状は食事療法によってわずかばかり抑制されるだけであった。バルサラジドの用量を一日あたり1.5グラムから3グラムに増量し始めてから2週間以内に、大便が徐々に形を成し、頻度が一日あたり1〜2回の有形便に減少した。疼痛は完全に消失し、便意切迫は無くなり、彼女は食事内容を拡大した。治療の6週間後までに、彼女の体重は7kg戻った。バルサラジドによって、彼女は26週間、ほぼ完全に症状が無い状態を継続する。
ある67歳の女性は、交替性の便秘を伴う下痢、鼓脹、疼痛、鼓腸、および酸逆流を伴う悪心を20年以上訴えていた。彼女は、糞便検査、血液検査、X線撮像、および結腸鏡検査を含むいくつかの総合的な医療検査を受けたことがあったが、憩室症の存在以外は陰性所見であった。慢性のIBSと診断されたため、彼女は、繊維摂取量を増やし、ストレスを管理し、食事を変更してみたが、すべて役に立たなかった。1.5g/日のバルサラジドを開始し、用量を最大4.5g/日に増加するとすぐ、下痢、疼痛、鼓腸、および悪心が軽減された。より高い用量では、便秘も無くなった。これらの改善効果は、26週間維持されたままである。
ある28歳の男性は、長期にわたる下痢型過敏性腸症候群を理由に紹介された。その症状は、「粥状」、時には水様性または爆発的であると説明され、背中にまで及ぶ、筋痙攣による腹痛を伴った。鼓脹は無かったが、著しい鼓腸があり、悪心は無く、いくらか酸逆流があった。この男性は、糞便検査および結腸鏡検査などの試験によって大規模な検査を以前にされていたが、症状の原因は発見されなかった。多くの標準治療法を試した後、この男性はさらなる検査を受けた。下痢型IBS患者に対する進行中の臨床試験が実施されていたため、その男性患者は臨床試験中の製品(Salofalk(商標)経口顆粒剤、1グラム、1日2回)から開始した。Salofalk(商標)は、この疾患を有する患者において有用であることが判明している5アミノサリチル酸(メサラジン)のある特定の形態である。しかし、症状は続いた。用量を徐々に増やして2グラムを1日2回、次いで3グラムを1日2回にした後でさえ、重症度は少し軽減されたものの、これらの症状はなお続いた。より高い用量を与えるようにはこの男性患者は用意されなかった(そのような用量は臨床的にも使用されていない)。
本発明は、非炎症性腸疾患、下痢型過敏性腸症候群、または他の非特異的な腸疾患を治療または予防する方法に関する。
Claims (13)
- 非炎症性腸疾患、下痢型(diarrhoea-predominant)過敏性腸症候群、または他の非特異的な腸疾患を治療または予防するための方法であって、有効量の、バルサラジドまたはその塩もしくは誘導体、あるいはバルサラジドまたはその塩もしくは誘導体を適切な担体とともに含む組成物を、そのような治療または予防を必要とする患者に投与する段階を含む方法。
- 下痢便秘交替型(altering diarrhoea and constipation type)過敏性腸症候群または便秘型(constipation-predominant)過敏性腸症候群の症状を軽減する、請求項1記載の方法。
- 非炎症性腸疾患、憩室症、憩室炎、下痢型過敏性腸症候群、過敏性腸症候群、鼓脹、下痢、筋痙攣、疼痛、下腹部痛、膨満、腸内ガス、鼓腸、ガス産生、液体分泌、粘液産生、便秘、便意切迫(urgency)、非潰瘍性消化不良、痙攣性結腸、不安定型結腸神経症、痙攣性結腸炎、粘液性結腸炎、交替性の便秘/下痢、失禁、下痢便秘交替型IBS、または便秘型IBSのうちの1種または複数種を治療または予防するための、請求項1記載の方法。
- 患者が哺乳動物である、請求項1記載の方法。
- 患者がヒトである、請求項4記載の方法。
- バルサラジドが、4ASAまたは5ASA化合物のうちの1種または複数種とともに投与される、請求項1記載の方法。
- 5-ASAまたは4-ASA化合物が、メサラジン、オルサラジン、スルファサラジン、イプサラジド、ベンザルアジン、パラアミノサリチル酸(4-アミノサリチル酸)、および薬学的に許容されるその塩である、請求項6記載の方法。
- バルサラジドが、下痢型、便秘型、または下痢便秘交替型過敏性腸症候群の治療または予防のためにオルサラジンとともに投与される、請求項1記載の方法。
- バルサラジドが、下痢型過敏性腸症候群の治療または予防のためにメサラジンとともに投与される、請求項1記載の方法。
- バルサラジドが、抗コリン作用薬、プロバイオティクス、抗生物質、または鎮痙薬とともに投与される、請求項1記載の方法。
- 非炎症性腸疾患、下痢型過敏性腸症候群、または他の非特異的な腸疾患を治療または予防するための方法であって、有効量の、4-ABA側鎖を含むように修飾された4-ASAもしくは5-ASA化合物またはその塩もしくは誘導体、あるいは化合物またはその塩もしくは誘導体を適切な担体とともに含む組成物を、そのような治療または予防を必要とする患者に投与する段階を含む方法。
- 非炎症性腸疾患、下痢型過敏性腸症候群、または他の非特異的な腸疾患の治療用または予防用の薬剤を製造するための、バルサラジドまたはその塩もしくは誘導体の使用。
- 非炎症性腸疾患、下痢型過敏性腸症候群、または他の非特異的な腸疾患の治療用または予防用の薬剤を製造するための、4-ABA側鎖を含むように修飾された4-ASAもしくは5-ASA化合物またはその塩もしくは誘導体の使用。
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EP1720536B1 (en) | 2012-04-25 |
US9937190B2 (en) | 2018-04-10 |
EP1720536A1 (en) | 2006-11-15 |
ATE554752T1 (de) | 2012-05-15 |
AU2005209948B2 (en) | 2009-09-10 |
US20180250315A1 (en) | 2018-09-06 |
AU2005209948A1 (en) | 2005-08-18 |
WO2005074908A1 (en) | 2005-08-18 |
US20070213304A1 (en) | 2007-09-13 |
EP2361620A1 (en) | 2011-08-31 |
CA2555304A1 (en) | 2005-08-18 |
US20130231308A1 (en) | 2013-09-05 |
ZA200607435B (en) | 2009-05-27 |
CA2555304C (en) | 2016-06-28 |
JP5558456B2 (ja) | 2014-07-23 |
EP2361620B1 (en) | 2016-04-06 |
US20150164923A1 (en) | 2015-06-18 |
NZ549661A (en) | 2010-07-30 |
US10328088B2 (en) | 2019-06-25 |
JP2007520495A (ja) | 2007-07-26 |
PL2361620T3 (pl) | 2016-12-30 |
EP1720536A4 (en) | 2008-03-05 |
HUE029189T2 (en) | 2017-02-28 |
ES2571252T3 (es) | 2016-05-24 |
US20200101090A1 (en) | 2020-04-02 |
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