KR101089049B1 - 친지성 약물의 제형 - Google Patents
친지성 약물의 제형 Download PDFInfo
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- KR101089049B1 KR101089049B1 KR1020057004755A KR20057004755A KR101089049B1 KR 101089049 B1 KR101089049 B1 KR 101089049B1 KR 1020057004755 A KR1020057004755 A KR 1020057004755A KR 20057004755 A KR20057004755 A KR 20057004755A KR 101089049 B1 KR101089049 B1 KR 101089049B1
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Abstract
본 발명은 대량의 수성 비이클에 용해되는 친지성 치료제의 약제학적 제형과, 이 제형을 제조하고 사용하는 방법에 관한 것이다.
친지성 약물, 비이온성 가용화제, 친지성 항산화제, 수성 비이클, 선택적 성분, 비타민 D 화합물.
Description
관련된 출원의 상호참조
이 출원은 2002년 9월 18일에 출원된 미국 특허출원 제10/247,765호의 우선권 이익을 주장한다.
연방으로 후원을 받은 조사 또는 개발에 대한 진술
적용되지 않음.
본 발명은 대량의 수성 비이클에 가용된 친지성 치료제의 약제학적 제형과 그러한 제형의 사용에 관한 것이다. 제형은 수계 비이클에서 안정하고, 치료와 상업적으로 유용한 활성 성분의 농도를 갖는다.
다수의 약물학적 활성 성분은 드물게 또는 무시할 수 있는 정도로 수용성이며 대부분은 친지성이다. 친지성 치료제는 생리학적 및/또는 약물학적 활성 성분의 전체 범위에 해당한다. 예를 들면, 이들은 특정 진통제, 항염증제, 항천식제, 항세균제, 항바이러스제, 항응고제, 항우울제, 항종양제, 면역억제형, ß-차단제, 코르티코스테로이드, 마약성 진통제, 지질농도조절제, 불안완화제, 진정제, 수면제 및 신경이완제를 포함한다.
특히, 쉽게 살균과 투여가 가능한 균질의 수용액이 필요할 때 이러한 친지성 약물의 물에 녹기 어려운 점이 제형화에 있어 주요한 어려움이 되고 있다. 효과적인 수계 제형은 전신 투여, 특히 비경구투여(예, 주사용액)와 특정 액상 제제, 예를 들면 국소적 부인과, 피부과적 안과 등에서의 사용과 구강 점막에서의 사용에 있어 특별히 다루기에 어려웠다.
물에 잘 녹지 않는 약의 수성 조성물을 수득하기 위한 수많은 접근 방법이 알려져 있다. 용해도를 높이기 위한 이러한 접근 방법들은 결과적으로 거의 녹지 않거나 친지성인 활성 약물의 제형화를 쉽게 하고 생체이용율을 높인다. 이러한 접근 방법 중 하나는 이온 또는 이온화할 수 있는 그룹 또는 융점을 낮추는 그룹을 도입하여 친지성 약물의 화학적 변형을 포함한다. 전자는 일반적으로 다양한 종류의 에스테르를 형성하는 데 사용될 수 있는 수산화기나 카르복시기를 가지고 있는 친지성 약물에서 사용된다. 후자는 용해되기 위해서는 분자가 결정격자를 떠나야 한다는 개념에 근거한다. 융점을 낮추는 분자의 어떠한 변형도 결정격자의 에너지를 감소시켜 결과적으로 임의 용매에 대한 용해도를 높이는 결과를 초래한다.
또 다른 방법은 예로 치료제를 용해시켜 운반하는 계면활성 미셀(micelle)을 사용하는 것과 같이 계면활성제로 미셀에서 가용화하는 물리-화학적 가용화 기술을 포함한다. 미셀은 특정 조건에서 양쪽 친매성 화합물에 의해 형성된 교질 상태의 덩어리이다. 미셀 및 미셀을 포함하는 약제학적 조성물은 광범위하게 연구되었고 문헌에 상세히 기술되었다. 수용액에서, 미셀은 미셀의 탄화수소의 중심에 친지성 치료제를 결합할 수 있거나 미셀 벽의 다양한 위치에 당해 치료제를 얽히게(entangle) 할 수 있다. 비록 미셀제형이 다양한 친지성 치료제를 가용화할 수 있지만, 통상적 미셀제형의 하중용량은 미셀 계면활성제에서 치료제의 용해도에 의해 제한된다. 많은 친지성 치료제에서 이러한 용해도는 치료적으로 유효량을 전달할 수 있는 제형을 제공하기에 너무 낮다.
적합한 중합체를 사용함으로써 고용체와 고체분산체인 복합체의 형성은 약제학적 활성 성분의 수용성을 증가시키는 다른 접근 방법이다. 이런 경우에 있어서, 활성 성분은 약물과 중합체 기질 사이에 특정 전형적인 공유결합을 형성하지 않고, 용해도와 생체이용율을 높이는 적합한 친수성 운반자에 결합한다. 고용체와 고체 분산체와의 차이는 전형적으로 활성 성분의 형태에 따른다. 고용체에서, 활성성분은 무정형의 분자형태로 존재하나 분산체에서는 가능한 정제된 결정체로 존재한다.
좀 더 널리 알려지고 연구되는 것은 진정한 복합체를 형성하는 중합체와 약물사이의 상호작용의 이용이고, 여기에는 비공유성 화학 결합도 포함한다. 약제학적 분야에서 사용되는 복합체화 중합체로 예를 들어 폴리에틸렌 글리콜, 폴리프로 필렌 글리콜, 사이클로덱스트린, 카복시메틸셀룰로오스, 폴리비닐피롤리돈(PVP)를 포함한다.
공침은 증가된 용해도를 가진 복합체의 제조에 여전히 널리 알려진 또 다른 방법이다. 이 방법으로 물질과 중합체는 둘 다 용해될 수 있는 유기 용매에 용해되고 용액은 치료약의 복합체로 사실상 제조된 건조된 제품을 생산하기 위해서 진공상태에서 분무건조 또는 동결건조에 의해 대기압에서 증발된다. 이러한 복합체는 분쇄기에서 성분을 분쇄하고 섞는 기타의 다른 방법을 적용하거나, 소량의 물과 함께 두 제품을 포함하는 페이스트의 압출 등에 의해 얻어질 수 있다. 전형적으로 복합체는 출발약물과 비교시 수용성이 상당히 향상되는 것으로 나타난다.
복합체화에 의해 약물을 가용화하는 실용적인 방법을 고안하는 데 있어서, 활성성분의 용해도에 직접적으로 영향을 미치는 중합체의 분자량을 고려하는 것이 필요하다. 일반적으로, 작은 분자량이 중간 내지 큰 분자량보다 더 적합하다.
다른 방법은 다양한 보조용매계의 사용이다. 즉, 물과 하나 이상의 유기용매를 포함하는 용매 혼합물을 사용하는 조성물이다. 수계에서 친지성 약제를 가용화하는 하나의 접근법은 알코올과 글리콜의 특정 결합을 이용하는 것이다(참조: PDA J.Pharm. Sci.Technol. 50(5) 1996; 미국 특허 제6,136,799호; 제6,361,758호 및 제5,858,999호). 50% 또는 그 이상의 유기 성분이 제조, 저장 및 투여하는 동안 용해도를 보장하기 위해 종종 요구된다. 비록 높은 유기물질 수준이 낮은 용적의 비경구투여에 있어 LD50 미만이라 할 지라도 그 양은 전형적으로 여전히 바람직하지 않다. 많은 양의 유기 용매는 주입시 통증과 조직 괴사를 일으킬 수 있다.
다른 방법은 구연산, 주석산, 아미노산, 티오글리콜산, 에데테이트 이나트륨과 같은 킬레이트제를 첨가하여 복합체를 형성시키는 것을 포함한다. 그 밖에 아세테이트, 시트르산염, 글루타민산염 및 인산염과 같은 완충제를 사용한다. 그러나, 완충제와 킬레이트제는 생성물 내에 부작용을 일으키는 알루미늄 수준을 3.5ppm을 초과하는 양으로 부여하는 것과 연관이 있다(참조: 국제 특허 출원공보 WO 96/36340). 게다가, EDTA같은 특정 킬레이트제는 신장 독성과 세뇨관 괴사와 같은 부작용과 관련이 있다(참조: 미국 특허 제 6,361,758호).
이런 선행하는 방법들은 그 자체의 고유한 한계를 가지고 있다. 많은 약제학적 성분에서 위에 언급한 하나 또는 다른 방법으로 달성될 수 있는 용해도 수준은 수계에 바탕을 둔 시판되는 유용한 제품을 만드는 데 여전히 불충분하다.
친지성 약제의 전형적이고 중요한 부류는 비타민 D 화합물이다. 적당하게 대사된 비타민 D 화합물은 건강한 뼈의 유지에 필수적이고 그 이상의 기타 생리학적 활성을 보여 주는 것으로 알려져 있다. 천연의 비타민 D와 많은 알려진 비타민 D의 합성 유사체들의 친지성 때문에 신장 투석 환자에서 선호되는 비경구 투여 제형과 같이 유효한 제형을 제조하는 데 어려움이 있다.
게다가, 다른 친지성 화합물 중에서도 비타민 D 화합물은 산소에 민감하여 공기에 노출시 산화되어 무결성(integrity)을 잃는 것으로 알려져 있다. 이런 문제를 우회하는 하나의 접근법은 약물 제형에 직접 항산화제를 첨가하는 것이다. 그러나 물에 매우 잘 녹는 아스코르빈산과 아스코르빈산염과 같은 특정 항산화제는 그 기능을 수행하는 과정에서 변색될 것이다. 또한, 완충제 및/또는 킬레이트제가 산소 감수성을 감소시켜 활성 약물의 효력을 유지시키기 위해 첨가되었다(참조: 미국 특허 제4,308,264호; 제4,948,788호; 제5,182,274호). 그러나, 위에서 언급한 바와 같이 완충제와 킬레이트제는 제품에 바람직하지 않은 수준의 알루미늄을 도입하는 것으로 알려져 있다.
따라서, 많이 알려진 접근법의 한계를 극복한 친지성 치료제의 약제학적 제형이 필요하다.
발명의 간결한 요약
본 발명은 친지성 약물의 비경구 제형과 관련된 문제들을 해결하는 약제학적 제형을 제공하는 것이다. 본 발명은 종국적으로 멸균될 수 있고 알코올 같은 유기용매를 거의 또는 전혀 포함하지 않는 제형을 제공하는 것이다. 놀랍게도 또한 본 발명의 신규한 제형이 상승적인 가용화 및 항산화 작용을 나타내는 것으로 밝혀졌다. 게다가 본 발명에서는 의도된 용도 및/또는 취급에 따라서 방부제를 포함 또는 제외시킬 수 있다.
본 발명은 수성 비이클에서 (1) 치료학적 유효량의 친지성 치료제, (2) 비이온성 가용화제, (3) 친지성 항산화제 및 (4) 임의로 유기용매나 방부제(예, 살균제) 또는 이들 둘 다를 포함하는 약제학적 제형을 제공한다. 본 발명의 제형에 있어서 사용에 적합한 친지성 치료제는 특별히 제한되어 있지 않다. 특히 흥미로운 약품은 비타민 D 화합물 및 이의 유사체이다. 수용성 항산화제를 사용하는 알려진 제형과 비교하여 친지성, 즉, 지용성의 소량의 항산화제를 사용할 수 있다.
본 발명의 제형은 몇몇 환자에게 자극을 일으킬 수 있는 고 함량의 유기용매의 필요를 배제한다. 게다가, 본 발명의 제형은 완충제와 킬레이트제를 사용하지 않는다. 예를 들면, 특정의 종전 비타민 D 제형에서는 완충제나 킬레이트제를 사용하면 바람직하지 않은 알루미늄 수준이 제품에 도입되어 환자에게 전달되는 것과 관련되어 있었다.
본 발명은 또한 본 발명에 따른 제형이 필요한 환자들에게 비경구적으로 투여하는 것을 포함하는 특정 질환와 장애의 치료 및/또는 예방법에 관한 것이다. 예를 들면, 비타민 D 화합물 또는 유사체를 포함하는 제형에 있어서는 이러한 질병은 골연화증과 같은 칼슘대사이상 및 건선과 같은 비정상적인 세포 분화 및/또는 세포 증식에 관련된 질환 뿐 아니라 2차적인 부갑상선기능항진증과 같은 부갑상선기능항진증, 췌장, 유방, 결장 또는 전립선과 같은 암질환을 포함한다.
본 발명의 다른 장점과 발명의 특이한 속성은 발명의 상세한 설명과 첨부된 청구항으로부터 더 잘 이해될 것이다.
본 발명은 비이온성 가용화제와 친지성 항산화제를 사용하여 수성 비이클에서 친지성 치료제의 안정적이고 자가-방부되는 약제학적 제형에 관한 것이다. 제형은 비경구투여에 적합하다.
본원에서 치료제 또는 약물에 관하여 "친지성"이라는 용어는, 생리적으로 또는 약제학적으로 활성 성분, 또는 치료나 예방 효과를 가지고 사람을 포함한 포유류에 해로운 질환과 장애의 치료나 예방, 또는 동물이나 사람의 생리학적인 조건의 조절에 유용한 항원 포함 물질이 아주 소량( 또는 불충분한, 약간 녹는, 거의 녹지 않는) 녹는다는 의미로 쓰여졌다. 그리고, 실온에서 친지성 약물의 수용성은 전형적으로 너무 낮아 활성 성분으로서 화합물을 포함하는 충분히 유효하거나 상업적으로 유익한 특정 수성의 제형을 제조할 수 없다. 친지성 치료제는 물에 거의 또는 전혀 녹지 않는 성분, 전형적으로 화합물을 포함한다. 본 발명에서 사용할 수 있는 친지성 치료제의 본래의 물에 대한 용해도(즉 이온화되지 않은 형태의 물에 대한 용해도)는 예를 들면, 약 1중량% 미만의 용해도와 전형적으로는 약 0.1중량% 또는 0.01중량% 미만 또는 예를 들어 약 10㎍/mL 미만을 포함한다.
본 발명의 제형의 용도에 있어 적합한 친지성 치료제는 본 발명의 방법이 다양한 종류의 친지성 치료제를 가용화하고 전달하는 놀라운 능력 때문에 특별히 제한되어 있지 않다. 본 발명의 제형에 활용될 수 있는 치료제는 가용화제 없이는 수계에서 적당한 용해도가 부족한 다양한 생리학적 및/또는 약물학적 활성 성분의 범위로부터 선택될 수 있다. 이러한 치료제는 약, 전구체(즉 활성성분로 변형되는 약물), 영양제(기능성식품) 및 화장품(화장품약리학)과 같이 동물에게 특히 포유류에게 투여할 때 다른 가치 또는 치료 효과를 갖는 임의의 제제를 포함한다. 이러한 치료제를 본 발명에 따른 제형에서 사용하여 비경구투여에 유효한 치료용량을 수득할 수 있다. 당해 성분이 본 제형에 가용될 수 있는 한, 성분의 정확한 생리학적 및/또는 약리 활성은 중요하지 않다.
본 발명의 제형에 사용될 수 있는 친지성 치료제의 특별히 제한되지 않는 예는 다음의 대표적 화합물과 그들의 약제학적으로 허용되는 염, 이성질체, 에스테르, 에테르 및 다른 유도체가 있다. 이들은 다음과 같다:
알록시프린, 오라노핀, 아자프로파존, 베노릴레이트, 캡사이신, 셀레콕십, 디클로페낙, 디플루니살, 에토돌락(etodolac), 펜부펜(fenbufen), 페노프로펜칼슘, 플루비프로펜, 이부프로펜, 인도메타신, 케토프로펜, 케토롤락, 레플루노미드, 메클로페나민산, 메페나믹산, 나부메톤, 나프록센, 옥사프로진, 옥시펜부타존, 페닐부타존, 피록시캄, 로페콕십, 술린닥, 테트라하이드로카나비놀, 트라마돌 및 트로메타민과 같은 진통제와 항염증제;
알벤다졸, 베페니움 하이드록시나프토에이트, 캄벤다졸, 디클로로펜, 아이버멕틴, 메벤다졸, 옥삼니퀸, 옥스펜다졸, 옥센탈 엠보네이트, 피라지퀸텔, 피랜텔 엠보네이트, 티아벤다졸과 같은 구충제;
염산 아미오다론, 디소피라미드, 플레카이나이드 아세테이트 및 퀴니딘 설페이트와 같은 항부정맥제;
질루톤 (zileuton), 자퍼루카스트(zafirlukast), 터부탈린 설페이트, 몬테루카스트(montelukast) 및 알부테롤(albuterol)과 같은 항천식제;
알라트로플록사신, 아지스로마이신, 바클로펜, 벤자틴 페니실린, 시녹사신, 염산시프로플록사신, 클라리스로마이신, 클로파지민, 클록사실린, 데메클로사이클린, 디리스로마이신, 독시사이클린, 에리스로마이신, 에티오나마이드, 푸라졸리돈, 그레파플록사신, 이미페넴, 레보플록사신, 로레플록사신, 염산목시플록사신, 날리딕식산, 니트로푸란토인, 노플록사신, 오플록사신, 리팜피신, 리파부틴, 리파펜틴, 스파플록사신, 스피라마이신, 설파벤자미드, 설파독신, 설파메라진, 설파세타미드, 설파디아진, 설파푸라졸, 설파메톡사졸, 설파피리딘, 테트라사이클린, 트리메토프림, 트로바플록사신 및 반코마이신과 같은 항세균제;
아바카버, 암프레나버, 데라버딘, 에파비렌즈, 인디나버, 라미부딘, 넬피나버, 네비라핀, 리토나버, 사퀴나버 및 스타부딘과 같은 항바이러스제;
실로스타졸, 클로피도그렐, 디쿠마롤, 디피리다몰, 니쿠마론, 오프렐벡킨, 페닌디온, 티클로피딘 및 티로피반과 같은 항응고제;
아목사핀, 부프로피온, 시타로프람, 클로미프라민(clomipramine), 염산플루옥세틴, 염산마프로틸린, 염산미안세린, 염산노트립틀린, 염산파로세틴, 염산세트랄린, 염산트라조돈, 트리미프라민 말레에이트 및 염산벤라팍신과 같은 항우울제;
아세토헥사미드, 클로르프로파미드, 글리벤클라미드, 글리클라지드, 글리피지드, 글리메피리드, 미글리톨, 피오글리타존, 레파글리니드, 로시글리타존, 톨라자마이드, 톨부타마이드 및 트로글리타존과 같은 당뇨병치료제;
베클라미드, 카바마제핀, 클로나제팜, 소토인(thotoin), 펠바메이트, 나트륨포스페닌토인, 라모트리진, 메쏘인(methoin), 메트석시미드, 메틸페노바비톤, 옥스카바제핀, 파라메타디온, 페나세미드, 페노바비톤, 페니토인, 펜석시미드, 프리미돈, 설티암, 염산 티아가빈, 토피라메이트, 발프로익산 및 비가바트린과 같은 항간질제;
암포테리신, 염산부테나핀, 부토코나졸 나이트레이트, 클로트리마졸, 에코나졸 나이트레이트, 플루코나졸, 플루시토신, 그리세오플린, 이트라코나졸, 케토코나졸, 미코나졸, 나타마이신, 니스타틴, 술코나졸 나이트레이트, 옥시코나졸, 염산테르비나핀, 테르코나졸, 티오코나졸 및 운데센산과 같은 항진균제;
알로푸리놀, 프로베네시드 및 설핀피라존과 같은 통풍치료제;
암로디핀, 베니디핀, 베네제프릴, 칸데사탄, 켑토프릴, 다로디핀, 염산딜리타젬, 디아족사이드, 염산 독사조신, 에날라프릴, 에포사탄, 로사탄 메실레이트, 펠로디핀, 페놀도팜, 페세노프릴, 구아나벤즈 아세테이트, 일베사탄, 이스라디핀, 리시노프릴, 미녹시딜, 염산 니카디핀, 니페디핀, 니모디핀, 니솔디핀, 염산페녹시벤자민, 염산피라조신, 퀴나프릴, 레저핀, 염산테라조신, 텔미사탄 및 발사탄과 같은 항고혈압제;
아모디아퀸, 클로로퀸, 염산클로로프로구아닐, 염산할로판트린, 염산메플로퀸, 염산프로구아닌, 피리메타민 및 퀴닌설페이트와 같은 항말라리아제;
디하이드로에르고타민 메실레이트, 에르고타민 타르트레이트, 프로바트립탄, 메틸세르지드 말레에이트, 염산나라트립탄, 피조티펜 말레에이트, 리자트립탄 벤조에이트, 수마트립탄 석시네이트 및 졸미트립탄과 같은 항편두통약;
아트로핀, 염산벤즈헥솔, 비페리덴, 염산에소프로파진, 히오시아민, 브롬메펜졸레이트, 염산옥시펜시클리민 및 트로피카미드와 같은 항무스카린제;
아미노글루테티미드, 암사크린, 아자티오프린, 비칼루타미드, 비산트렌, 부설판, 캄토테신, 카페시타빈, 클로람부실, 사이클로스포린, 다카바진, 엘립티신, 에스트라무스틴, 에토포사이드, 이리노테칸, 로무스틴, 멜팔란, 머캅토푸린, 메토트렉세이트, 미토마이신, 미토탄, 미토산트론, 모페틸 미코페놀레이트, 니루타미드, 파클리탁셀, 염산 프로카바진, 시롤리무스, 타크롤리무스, 타목시펜 시트레이트, 테니포사이드, 테스토락톤, 염산토포테칸 및 토레미펜 사이트레이트와 같은 항종양제와 면역억제제;
아토바쿠온, 벤즈니다졸, 클리오퀴놀, 데코퀴네이트, 디요오도하이드록시퀴놀린, 딜로사니드 푸로에이트, 디니톨미드, 푸라졸리돈, 메트로니다졸, 니모라졸, 니트로퓨라존, 오니다졸 및 티니다졸과 같은 항원충제;
카비마졸과 프로필티오우라실과 같은 항갑상선제;
벤조나테이트와 같은 진해제;
알프라졸람, 아밀로바비톤, 바비톤, 벤타제팜, 브로마제팜, 브롬페리돌, 브로티졸람, 부토바비톤, 카브로말, 클로르디아제폭사이드, 클로르메티아졸, 클로르프로마진, 클로르프록시센, 클로나제팜, 클로바잠, 클로티아제팜, 클로자핀, 디아제팜, 드로페리돌, 에티나메이트, 플루나니손, 플루니트라제팜, 트리플루프로마진, 플루펜틱솔 데카노에이트(flupenthixol decanoate), 플루휀틱솔 데카노에이트(fluphenthixol decanoate), 플루라제팜, 가바펜틴, 할로페리돌, 로라제팜, 로메타제팜, 메다제팜, 메프로바메이트, 메조리다진, 메타쿠알론, 메틸페니데이트, 미다졸람, 모린돈, 니트라제팜, 오란자판, 옥사제팜, 펜토바비톤, 페페나진 피모지드, 프로클로페라진, 슈도에페드린, 쿠에티아핀(quetiapine), 리스페리돈(risperidone), 세르틴돌(sertindole), 설피리드, 테마제팜, 티오리다진, 트리아졸람, 졸피뎀 및 조피클론과 같은 불안완화제, 진정제, 수면제, 근이완제;
아세부톨롤, 알프레놀롤, 아테놀올, 라베탈롤, 메토프롤롤, 나돌롤, 옥스프레놀롤, 핀돌롤 및 프로프라놀롤과 같은 β-차단제;
암리논, 디기톡신, 디곡신, 에녹시몬, 라나토사이드C 및 메디곡신과 같은 심근수축제;
베클로메타손, 베타메타손, 부데소나이드, 코티손 아세테이트, 데속시메타손, 덱사메타손, 플루드로코티손 아세테이트, 플루니솔리드, 플루오코톨론(fluocortolone), 플루티카손 프로피오네이트, 하이드로코티손, 메틸프레드니솔론, 프레드니솔론, 프레드니손 및 트리암시놀론과 같은 코르티코스테로이드제;
아세타졸라미드, 아밀로라이드, 벤드로플루메티아지드, 부메타니드, 클로로티아지드, 클로르탈리돈, 에타크린산, 프루세미드, 메톨라존, 스피로노락톤 및 트리암테렌과 같은 이뇨제;
브로모크립틴 메실레이트, 리수리드 말레에이트(lysuride maleate), 프라미페솔(pramipexole), 염산로피니롤 및 톨카폰과 같은 항파킨슨제;
비사코딜, 시메티딘, 시사프라이드, 염산디페녹실레이트, 돔페리돈, 파모티딘, 라노스프라졸, 로페라미드, 메살라진, 니자티딘, 오메프라졸, 염산온단세트론, 라베프라졸 나트륨, 염산라니티딘 및 설파살라진과 같은 위장관제;
아크리바스틴, 아스테미졸, 클로르페니라민, 신나리진, 세트리진, 클레마스틴 푸마레이트, 시클리진, 염산시프로헵타딘, 덱스클로르페니라민, 디멘히드리네이트, 펙소페나딘, 염산플루나리진, 로라타딘, 염산메클리진, 옥사토미드 및 테르페나딘과 같은 히스타민의 H1 및 H2-수용체 길항제;
아세트레틴, 칼시프로트리엔, 칼시페디올, 칼시트리올, 콜레칼시페롤, 에르고칼시페롤, 에트레티네이트(etretinate), 레티노이드, 타그레틴(targretin) 및 타자로틴(tazarotene)과 같은 각질용해제;
아토르바스타틴, 베자피브레이트, 세리바스타틴, 시프로피브레이트, 클로피브레이트, 페노피브레이트, 플루바스타틴, 젬피브로질, 프라바스타틴, 프로부콜 및 심바스타틴과 같은 지질조절제;
단트로레인 나트륨과 염산티자니딘과 같은 근이완제;
아밀 나이트레이트와 글리세릴 트리나이트레이트, 이소소비드 디나이트레이트, 이소소비드 모노나이트레이트와 펜타에리스리톨 테트라나이트레이트와 같은 나이트레이트류와 기타 항협심증제;
칼시트리올, 카로틴, 디하이드로타키스테롤, 필수 리포산, 비필수 리포산, 피토나디올, 비타민 A, 비타민 B2, 비타민 D, 비타민 E 및 비타민 K와 같은 영양제와 지용성 비타민제;
코데인, 덱스트로프로폭시펜, 디아몰핀, 디하이드로코데인, 펜타닐, 멥타지놀(meptazinol), 메타돈, 몰핀, 날부핀 및 펜타조신과 같은 마약성 진통제;
클로미펜 사이트레이트, 코티손 아세테이트, 다나졸, 데하이드로에피안드로스테론, 에티닐 에스트라디올, 피나스테라이드, 플루드로코디손, 플루옥시메스테론, 메드록시프로게스테론 아세테이트, 메게스테롤 아세테이트, 메스트라놀, 메틸테스토스테론, 노레티스테론, 노르게스테렐, 오에스트라디올, 결합형 에스트로겐, 프로게스테론, 리멕솔론, 스타노졸롤, 스틸베스트롤, 테스토스테론 및 티볼론과 같은 성호르몬제;
암페타민, 덱사암페타민, 덱스펜플루라민, 펜플루라민 및 마진돌과 같은 각성제;
베캅플레민, 염산도네페질, L-트리록신, 메톡살렌, 베르테포핀(verteporfin), 피조스티그민, 피리도스티그민, 염산랄로시펜, 염산시부트라민, 실데나필 사이트레이트, 타크린, 염산탐수로신(tamsulosin HCl) 및 톨테로딘과 같은, 발기부전치료제, 항골다공증제, 항비만제, 인지능력향상제, 항요실금제, 양성전립선비대증치료제와 같은 다른 종류들;
친지성 치료제의 목록과 치료학적 분류는 단지 예시에 불과한 것으로 이해되어야 한다. 실제로, 본 발명의 제형의 특별한 특징과 놀라운 장점은 기능에 따른 분류에 관계없이 넓은 범위의 친지성 치료제를 가용화하고 전달할 수 있는 제형의 능력이다. 물론, 친지성 치료제의 혼합물은 바람직한 경우에 또한 사용될 수 있다.
특별히 흥미로운 친지성 약품의 예는 활성 비타민 D 화합물이다. 여기서 사용되는 "활성화된 비타민 D" 또는 "활성 비타민 D"는 그 대사의 특정 단계에서 프로드럭(또는 프로호르몬), 전구체, 대사체 또는 유사체를 포함하는 특정 생리학적 활성 비타민 D 화합물을 포함하고자 하는 것이다. 비타민 D 화합물은 항종양제(미국 특허 제5,763,429호 참조)와 항부갑상선기능항진제(미국 특허 제5,602,116호 참조)로서 칼슘과 인산대사(미국 특허 제5,104,864호 참조)에서 다양한 생리학적 활성을 갖는 것으로 알려져 있고, 비타민 D의 생리적 활성형의 어떠한 형태도 본 발명에 따른 제형에 사용될 수 있다는 것이 고려된다. 일반적으로, 활성 비타민 D 또는 유사체는 적어도 분자의 C-1, C-24, C-25 위치, 및 화합물 그 자체 또는 비타민 D 수용체(VDR)에 결합한 그 대사체 중 어느 하나가 수산화되었다. 예로 프로드럭은 C-1에서 수산화된 비타민 D 화합물을 포함한다. 그 화합물은 생체내에서 더 수산화되고 그 대사체가 비타민 D 수용체에 결합한다.
전구체는 비타민의 열 이성질체인 1α-하이드록시프리비타민 D2, 1α,24-디하이드록시프리비타민 D2, 1α,25-디하이드록시프리비타민 D2, 24-하이드록시프리비타민 D2, 1α-하이드록시프리비타민 D3, 1α,25-디하이드록시프리비타민 D3와 같은 프리비타민류(previtamins)를 포함한다. 대사체는 일반적으로 수산화와 같은 대사 과정을 겪은 화합물 또는 유사체를 포함한다.
본 발명의 제형에 적합한 비타민 D 화합물의 예로는 제한 없이 1α,24-디하이드록시비타민 D2, 1α,2-디하이드록시비타민 D4, 1α,24-디하이드록시비타민 D2, 1α, 25-디하이드록시비타민 D3(칼시트리올), 1α하이드록시비타민 D3(α-칼시돌), 1α,25-디하이드록시비타민 D2, 1α,25-디하이드록시비타민 D4, 1α,24,25-디하이드록시비타민 D2, 세오칼시톨(EB-1089), 칼시포트리올, 22-옥사칼시트리올(맥사칼시톨), 팔레칼시트리올과 같은 불화된 화합물, 파리칼시톨과 같은 19-노르 화합물이다. C-24와 같은 측쇄에 키랄중심을 가진 화합물 중에서, 에피머 모두(예: R와 S)와 에피머 혼합물은 본 발명의 범위 내에 있는 것으로 이해된다.
여기서 인용된 특정 수치는 낮은 값으로부터 높은 값까지 모든 수치를 포함한다. 예를 들면, 농도범위가 1% 내지 50%로 적혀 있다면, 2% 내지 40%, 10% 내지 30%, 1% 내지 3%등과 같은 값은 이 명세서에서 명확히 열거된 것을 의도하는 것이다. 이것은 특별히 의도된 것의 유일한 예이다. 그리고, 열거된 가장 낮은 값과 가장 높은 값 사이에 수치의 가능한 모든 결합은 이 출원서에서 명확히 언급되는 것으로 생각된다.
선택되는 치료제의 양은 본 발명에 중요하지 않고 특별한 환자에게 바람직한 치료 결과를 얻기 위해서 다양화될 수 있다. 발명의 제형에서 치료제의 양은 부분적으로 특별히 사용된 계면활성제의 용해도와 그 사용된 용도에 의존한다. 기술분야에서 전문 지식을 가진 자가 불필요한 실험없이 비율을 조정할 수 있다. 선택된 투여량은 특별한 치료제의 활성, 투여경로, 치료될 상태의 심각성 및 특별한 환자의 상태와 병력에 따라 다르다. 예를 들어, 비타민 D 타입의 화합물의 치료 용량은 1회 복용량이 약 2㎍과 약 100㎍ 사이일 수 있다.
본 발명의 제형화를 위한 적합한 가용화제는 비이온성 가용화제를 포함한다. 비이온성 가용화제는 가용화제의 친수성 부분이 전하를 운반하지 않지만 수산기나 폴리옥시에틸렌 그룹과 같은 극성이 높은 그룹으로부터 수용성을 유도한다. 약제학 분야에서 사용되는 것으로 알려진 특정 계면활성제는 또한 용해시키는 기능을 가진다.
일반적으로 가용화제는 제한되지 않지만 폴리옥시알킬렌 덱스트란, 사카로즈의 지방산 에스테르, 올리고글루코사이드의 지방 알코올 에테르(예:TRITONTM과 같은 알킬폴리글루코사이드), 글리세롤의 지방산 에스테르(예: 글리세롤 모노/디스테아레이트 또는 글리세롤 모노라우레이트) 및 폴리옥시에틸렌 형태의 화합물(예: POE, PEG, PEO, SOLUTOLTM, CREOMOPHORTMS, MACROGOL, CARBOWAX, POLYOXYL)가 있다. 후자는 솔비탄의 폴리에톡실레이트된 지방산 에스테르(예: TWEENTMs, SPANTMs와 같은 폴리솔베이트), 폴리(에틸렌 옥사이드)의 지방산 에스테르(예: 폴리옥시에틸렌 스테아레이트), 폴리(에틸렌옥사이드)의 지방 알코올 에테르(예: 폴리옥시에틸화된 라우릴 에테르), 폴리(에틸렌 옥사이드)의 알킬페놀 에테르(예: 폴리에톡실화된 옥틸페놀), 폴리옥시에틸렌-폴리옥시프로필렌 블록 공중합체("플루로닉"과 같은 폭록사머로도 알려진), 에톡시화된 지방과 오일(예: 폴리에틸렌 글리콜-글리세릴 트리리시놀레에이트로도 알려진 에톡시화 피마자유, 또는 폴리옥시에틸화된 피마자유)을 포함한다. 가용화제의 혼합물은 발명의 범위 내에 있다. 이러한 혼합물은 표준 상업적인 원천으로부터 쉽게 이용가능하다. 특별히 흥미로운 가용화제는 TWEENTM과 같은 폴리소르베이트를 포함한다. 본 발명의 제형에서 존재하는 이러한 가용화제의 양은 약 0.05%에서 약 5% w/w를 포함한다.
적합한 친지성 항산화제는 제한되는 것은 아니지만, 부틸화된 하이드록시톨루엔(BHT), 리포산, 리코펜, 루테인, 리코필, 크산토필, 카로틴, 제아잔틴, 비타민 E 및/또는 이의 에스테르류를 포함한다. 친지성 항산화제는 예를 들면 약 20에서 약 2000ppm의 매우 소량이 존재하지만 유효한 양이다.
바람직하다면, 본 발명의 제형은 운반계에서 친지성 치료제의 용해도를 높이기 위해 추가적인 성분을 임의로 포함할 수 있다. 이러한 선택적 성분의 예로는 유기 용매, 방부제 또는 이들 둘 다를 포함한다. 이러한 성분은 에탄올, 벤질알코올, 클로로부타놀, 이소프로판올, 부타놀, 에틸렌 글리콜, 프로필렌 글리콜, 부탄디올, 글리세롤, 펜타에리스리톨, 솔비톨, 만니톨, 트란스큐톨, 디메틸 이소소르비드, 폴리에틸렌 글리콜, 폴리프로필렌 글리콜, 폴리비닐알코올, 하이드록시프로필 메틸세룰로오스 및 기타 셀룰로오스 유도체, 사이클로덱스트린 및 사이클로덱스트린 유도체와 같은 알코올류과 폴리올류를 포함한다. 선택적인 약품의 양은 유기용매 같은 경우 0% 내지 약 30% w/w를 포함한다. 실용적인 범위는 0% 내지 약 10% w/w이고 특히 실용적인 범위는 약 1% 내지 약 3%이다.
따라서, 본 발명에 따른 제형은 친지성 약품(예: 물에서 용해도가 10㎍/mL미만인 약품), 약 0.05% 내지 약 5% w/w의 비이온성 가용화제, 약 20 내지 약 2000ppm인 친지성 항산화제 및 0% 내지 약 30% w/w의 선택적 성분을 포함한다. 2차적인 부갑상선기능항진증 치료를 위한 특별한 제형은 2-6㎍/mL의 1α-하이드록시비타민 D2(독세르칼시페롤), 2.5% w/w의 벤질 알코올, 0.5% 내지 2.5% w/w의 TWEENTM-20 및 20ppm의 BHT를 포함한다. 벤질 알코올 또는 에탄올과 같은 선택적 성분의 양은 0에서 30% w/w 범위일 수 있고; 매우 유용한 범위는 1% 내지 3% w/w를 포함한다. 비타민 D 제형(예: 독세르칼시페롤 제형) 사용시 선택적 성분의 가장 유용한 양은 2.5% w/w를 포함한다.
본 발명에 따른 약제학적 제형은 수성 비이클을 포함한다. 수성 비이클은 물론 물을 함유하나 pH조절제, 안정화제, 가용화제(앞에서 언급한 내용을 참고), 등장조절제, 용매(예: 앞에서 언급한 유기용매)를 역시 더 포함한다. 본 발명에 따른 제형은 특정 환자에게 자극을 일으킬 수 있는 고농도의 유기용매를 사용하지 않아도 된다. 그러나, 특정 경우에서는 유기용매 또는 공용매를 포함하는 것이 적당할 수 있다. 본 발명에 따른 제형에서 물의 양은 일반적으로 적어도 약 50%에서 약 99% w/w이다.
본 발명의 약제학적 제형에서, 투여의 의도된 경로의 예로 동물 또는 인체에 주입하는 용도와 같은 비경구가 적합하다. 이러한 경로는 정맥, 근육내 및 피하 주사를 포함한다. 2차적인 부갑상선기능항진증 또는 종양등과 관련된 용도로는 정맥주사가 특별히 본 발명의 제형으로는 적합하다.
그러나, 본 발명에 따른 제형은 필요한 경우 경구 투여, 국소 투여, 경비투여 같은 다른 투여 경로에로 사용하는 것도 적합할 수 있다. 이러한 경우에서, 기술분야에서 전문지식을 가진 자가 활성 성분의 농도와 제형에 포함되는 다른 성분에 대해 필요한 어떤 조정을 할 수 있다.
본 발명에 따른 제형은 수용액으로 일반적으로 제공된다. 그러나, 국소투여나 경구투여에 의한 제형의 투여 같은 특정 경우에서는 본 발명에 따른 제형이 용액 또는 겔 상태로 제공될 수 있는 액상 화합물을 포함할 수 있다.
약제학적 제형은 적당한 농도에서 생성용액을 제조할 수 있는 모액에서 제조된 시약이 있는 약전 인정시약을 사용해 쉽게 조제될 수 있다. 일단 모액의 적당량과 결합되면, 혼합물 위로 부드럽게 질소 가스를 몇 분 동안 불어주면서 즉 질소가스를 씌우면서 시약을 교반하는 것이 바람직하다. 주입을 위한 탈가스된 물은 그 후에 바람직한 최종 용적에 맞추어 첨가되고, 계속된 또 다른 몇 분 동안 질소 가스 존재하에서 교반한다.
위에서 언급한 성분과 같이 비타민 D 화합물 또는 비타민 D 유사체를 포함하는 본 발명에 따른 약제학적 제형은 (ⅰ)질병 또는 비정상적인 세포의 분화로 특징된 상태 및/또는 건선과 각질 형성의 다른 방해와 같이 세포과증식, 췌장, 유방, 결장 및 전립선, 피부암와 같은 종양성질환과 암과 (ⅱ) 숙주편대이식 그리고 이식편대숙주반응과 이식 거부과 같은 면역체계에서의 질환 또는 불균형, 원판상 전신성 홍반성 루푸스, 당뇨병 및 경피증과 심상성 천포창과 같은 자기면역타입의 만성 피부질환, (ⅲ) 관절염과 같은 염증성질환 뿐 만 아니라 (ⅳ)부갑상선기능항진증, 특별히 신장손상으로 인한 2차적인 부갑상선기능항진증을 포함하는 수많은 질환 또는 병적 상태의 치료 및/또는 예방과 (ⅴ)골 생성촉진과 골다공증과 골연화증에서 골 손실의 치료/예방에 사용하기에 적합하다(치료와 예방을 위한 비타민 D 화합물의 사용은 미국특허 제5,9722,917호; 제5,798,345호; 제5,763,428호; 제5,602,116호; 제5,869,386호; 제5,104,864호; 제5,403,831호; 제5,880,114호; 제5,561,123호 참조). 본 발명에 따른 비타민 D 제형은 특별히 골연화증과 같은 칼슘대사이상과 췌장, 유방, 결장, 전립선암과 같은 종양성 질환과 같은 세포 과증식질환의 치료에 적합하다. 치료 방법은 세포를 치료하고/하거나 질환이나 장애를 호전시키거나 예방하기에 유효한 양으로 본 발명에 따른 제형을 필요한 환자에게 투여하는 것으로 이루어진다. 예를 들면, 과증식성 또는 종양성 질환의 치료를 위한 유효량은 성장을 방해하는 양이다. 매일 투여 및 간헐적 투여, 예를 들면, 일주일에 1회 내지 일주일에 3회 같은 투여가 고려될 수 있다.
게다가, 앞에서 언급한 바와 같이 본 발명에 따른 비타민 D 화합물은 추가적인 수산화같이 생체내에서 더 대사되는 것이 요구되는 약제와 같은 프로드럭을 포함한다. 치료제로서 유효한 비타민 D 화합물의 프로드럭은 일반적으로 디하이드록시천연 호르몬, 1α,25-디하이드록시비타민 D3보다 덜 반응성이다. 이 화합물들은 제형에서의 사용에 있어 더 장점을 제공할 수 있다.
게다가, 본 발명의 제형은 궁극적으로 고압소독기와 같은 예로 멸균될 수 있다.
본 발명은 본 발명의 범위를 제한하는 것으로 해석되지 않는 다음의 실시예에 의해 더 잘 설명된다.
모액의 조제
실시예 1 :
독세르칼시페롤
(
1α
-하이드록시
비타민 D
2
) 모액
독세르칼시페롤 12.558mg을 칭량하여 10mL 용적 플라스크에 옮겼다. 고체는 에탄올을 사용하여 희석하고 고체를 용해시키기 위해 플라스크를 격렬히 진탕시켰다.
실시예 2 :
부틸화된
하이드록시
톨루엔
(
BHT
) 모액
BHT 2.22g을 100mL 용적 플라스크에 옮겼다. 당해 고체는 에탄올을 사용하여 희석하고 고체를 용해시키기 위해 플라스크를 격렬히 진탕시켰다.
실시예 3 : 10%
TWEEN
TM
-20
100g의 TWEENTM-20KR을 1L 용적 플라스크에 옮기고, 주입용 탈가스된 물로 희석했다. 교반용 막대 자석을 넣고 혼합물을 교반하여 혼합하였다.
제형
실시예 4 :
독세르칼시페롤
제형
독세르칼시페롤제형을 조제하는 일반적 과정은 다음과 같다. 유리조제용기에 독세르칼시페롤 모액, 10% TWEENTM-20, BHT모액 및 에탄올을 적힌 순서대로 넣었다. 질소가스를 혼합물의 위에서 부드럽게 불어 보냈다. 교반 막대기를 혼합물에 넣고 질소가스투입이 계속되는 동안 20분 이상 교반하였다.
주입용 탈가스된 물을 가하여 최종 양을 1L가 되도록 하였다. 혼합물은 질소가스투입이 계속되는 동안 20분이상 교반하였다. 제형을 제조하는 데 사용된 각 화합물의 용적은 아래 표 1에 작성되었다.
[표 1]
: 독세르칼시페롤제형의 조제
독세르칼시페롤모액(mL) | TWEENTM-20모액 (mL) |
BHT모액(mL) | 에탄올(mL) | 주입용 물(mL) |
2.0 | 50 | 1.0 | 27 | 920 |
6.0 | 250 | 1.0 | 23 | 720 |
제형의 용도
실시예 5 : 2차적인
부갑상선기능항진증을
보이는 말기 신장 질환(
ESRD
) 환자의
이중맹실험
미국의 주요 도시 두 곳에서의 다기관에서, 이중맹실험으로, 위약비교연구로 만성적인 혈액투석을 하는 120명의 말기 신장 질환 환자를 대상으로 조사하였다. 미국 대륙의 두 주요 수도권에 거주하는 선택된 환자들은 20세에서 75세 사이이고, 2차적인 부갑상선기능항진증의 병력을 가지고 있었다. 그들은 적어도 4개월 동안에 혈액투석을 해 왔고, 혈청 알부민은 정상이거나 정상에 가까우며 혈청 인(종종 경구투여용 칼슘인 결합제를 사용함으로써)을 조절하였다.
조사를 참가하는 데 있어서, 각 환자는 무작위적으로 두 치료 그룹 중 하나로 결정되었다. 이 그룹 중 하나는 1α-하이드록시비타민 D2(독세르칼시페롤)로 두 연속되는 12주 과정의 치료를 받았고; 나머지는 위약치료의 12주 과정에 연속적으로 1α-하이드록시비타민 D2로 12주 과정의 치료를 받았다. 각 환자는 1α-하이드록시비타민 D2(2.5% w/w 벤질알코올, 0.5%- 2.5% w/w의 TWEENTM-20 및 BHT 20ppm으로 제조된 일일 용량 4㎍의 독세르칼시페롤)치료를 시작하기 전에 8주 동안 1α,25-디하이드록시비타민 D3치료를 중단하였다. 이 8주 동안의 세척(또는 조절)기간과 두 연속하는 12주 동안의 치료기간을 통해 환자들을 주마다 혈청 칼슘과 인을 모니터했다. 혈청의 본래의 부갑상선호르몬(PTH)은 주마다 또는 2주마다 모니터했다. 골혈청표지자, 혈청 비타민 D 대사체, 혈청 알부민, 혈액화학, 헤모글로빈 및 헤마토크릿을 선택된 간격으로 모니터했다.
조사중에, 환자들은 칼슘 1.24mM 투석액을 사용하여 상례적인 혈액투석(일주일에 3회)을 하였고 조절된 혈청 인 농도인 1dL당 6.9mg을 유지하기에 충분한 칼슘 인 결합제(탄산칼슘 또는 아세트산칼슘)를 섭취하였다. 치료기간 동안에 지속적인 가벼운 고칼슘혈증 또는 가벼운 고인산혈증을 나타내는 환자들은 1α-하이드록시비타민 D2를 일주일에 3회씩(또는 그 미만) 4㎍으로 줄였다. 현저한 고칼슘혈증 또는 현저한 고인산혈증을 보이는 환자들은 즉각 치료를 보류하였다. 이러한 환자들은 혈청 칼슘 또는 인 농도가 정상화될 때까지 일주일에 두 번의 간격으로 모니터했다. 그리고 1α-하이드록시비타민 D2는 일주일에 3회씩 (또는 그 미만) 4㎍을 투여하는 정도로 다시 시작하였다.
8주의 세척기간 동안, 혈청 부갑상선호르몬 수준의 평균치는 혁신적으로 유의하게 증가되었다. 1α-하이드록시비타민 D2 투여의 초기 후에는, 혈청 부갑상선호르몬의 평균치는 치료 전 수준의 50%보다 더 낮게 유의적으로 감소되었다. 혈청 부갑상선호르몬의 이런 하락으로 인해, 몇 명의 환자들은 과도하게 혈청 부갑상선 호르몬농도를 억제하는 것을 방지하기 위해 1α-하이드록시비타민 D2를 일주일에 3회(또는 심지어 그 미만) 4㎍으로 줄였다. 혈청 부갑상선호르몬의 과도한 억제를 보이는 환자에서는 일시적으로 1α-하이드록시비타민 D2 용량을 적당히 감소하여 바로잡을 수 있는 가벼운 고칼슘혈증이 관찰되었다.
처음 12주의 치료기간의 종기에, 혈청 부갑상선호르몬의 평균치는 1mL당 130내지 240pg로 바람직한 범위 안에 있었다. 그리고, 칼슘과 인의 혈청농도도 말기 신장질환 환자에서 정상이거나 정상에 가까웠다. 두 번째 12주 치료기간의 종기에(1α-하이드록시비타민 D2투여를 중지하고 위약치료를 받은 동안), 혈청 부갑상선호르몬의 평균치는 치료 전 수준으로 현저히 증가하였다. 이 조사는 (1)1α-하이드록시비타민 D2가 혈청 부갑상선호르몬수준을 감소하는 데 효과적이라는 것과 (2) 1α-하이드록시비타민 D2의 고용량투여과 동시에 작용하는 경구용 칼슘인 결합제의 많은 양의 사용에도 불구하고 현재 사용되는 치료법보다 더 안전하다는 것을 증명한다.
실시예 6 : 2차적인
부갑상선기능항진증으로
인해
상승된
혈중 부갑상선호르몬을 가진 노인을 대상으로 한 개방 표지 조사
2차적인 부갑상선기능항진증을 가진 30명의 노인환자들은 개방표지조사에 참여하였다. 선택된 환자들은 60세와 100세 사이였고 혈청 부갑상선호르몬수준이 상승(젊은 정상인의 상한치보다 더 많은)되었다. 또한, 환자들은 대퇴골 골감소증(대퇴골 골 미네랄이 0.70㎍/cm2)을 가지고 있었다.
환자들은 칼슘보충제를 사용하지 않고 하루에 대략 500mg의 칼슘을 섭취하는 규정식을 유지하도록 하였다. 치료의 12주 동안에 환자들은 일일 2.5㎍의 1α-하이드록시비타민 D2(예; 독세르칼시페롤 2.5㎍, 2.5%w/w의 벤질알코올, 0.5%-2.5%w/w의 TWEENTM-20 및 20ppm의 BHT)을 자가 경구투여하였다. 치료기간 동안에 규칙적인 간격으로 환자들의 혈청 부갑상선호르몬, 혈청 칼슘과 인 및 뇨중 칼슘과 인 수치를 모니터했다. 효능은 치료 전과 후의 혈청 부갑상선호르몬의 수준과 비교해 평가되었다. 안정성은 혈청과 뇨중 칼슘과 인 수치로 평가하였다.
1α-하이드록시비타민 D2의 투여로 유의적이지 않은 고칼슘혈증, 고인산혈증, 칼슘과잉뇨증 및 인산과잉뇨증의 출현과 함께 유의적으로 부갑상선호르몬이 감소되었다.
실시예 7 : 전립선암 치료에 있어서
1α
, 24-디하이드록시
비타민 D
2
의 임상조사
진행성 안드로겐- 비의존성 전립선암을 가진 환자들은 1α, 24-디하이드록시비타민 D2의 개방 표지 조사에 참가하였다. 자격을 갖춘 환자는 적어도 40세이고 전립선의 선악성 종양의 병력학적 증거가 있으며 앞서 호르몬에 의한 간섭에 반응했던 진행성 질환을 가지고 있다. 조사에 참가하는 데 있어서, 환자들에게 사전에 칼슘보충제, 비타민 D 보충제, 비타민 D 호르몬 대체요법의 어떤 사용도 중지시키며 지속적인 26주 동안 1α, 24-디하이드록시비타민 D2 를 정맥주사하였다. 치료기간 동안에, (1) 고칼슘혈증, 고인산혈증, 칼슘과잉뇨증, 인산과잉뇨증 및 기타 독성과; (2) 전이 질병의 진행에 있어서 변화의 징조; 및 (3) 처방된 테스트용 약의 용량에 따라 응하는 지 여부를 규칙적인 간격으로 환자들을 모니터했다.
이 조사는 두 단계로 관리되었다. 첫 단계 동안에, 일일 1α, 24-디하이드록시비타민 D2의 최대내약용량은 환자의 연속군에 점진적인 고 용량을 투여함으로써 결정되었다. 모든 약은 아침 식사 전인 아침에 투여되었다. 환자들의 첫 그룹에게 1α,24-디하이드록시비타민 D2(예; 2.5%w/w의 벤질알코올, 0.5%-2.5%w/w의 TWEENTM-20 및 20ppm의 BHT로 조제된)을 25.0㎍투여하였다. 환자의 연속군에는 일일 50.0, 75.0 및 100.0㎍를 투여하였다. 조사기간 동안에, 복용은 혈청의 칼슘이 11.6mg/dL를 넘지 않거나, 기타 독성이 3 또는 4 등급으로 관찰되지 않는 한 중단되지 않고 계속되었다. 이러한 경우에 있어서는 관찰된 독성이 해결될 때까지 투약을 일시 멈추고 10.0㎍으로 낮추어진 양으로 다시 시작하였다.
조사의 첫 단계의 결과는 일일 1α,24-디하이드록시비타민 D2의 최대내약용량은 20.0㎍이상이었고, 이것은 1α,25-디하이드록시비타민 D2으로 얻을 수 있는 것의 10 내지 40배 수준이었다. 참가한 환자를 규칙적인 간격으로 혈액샘플을 채취해 분석한 결과는 순환하는 1α,24-디하이드록시비타민 D2의 수치가 투여된 용량에 비례해서 증가되는 것으로 나타났다. 가장 고용량에서 100pg/mL이상의 최대기준으로 상승하였고, 1α,25-디하이드록시비타민 D2의 순환하는 수준은 자주 감지할 수 없는 수준으로 억제되었다. 혈청과 뇨 중 칼슘은 투여량에 반응하는 방식으로 상승하였다. 적어도 6개월 동안 1α,24-디하이드록시비타민 D2의 최대내약용량을 투여받은 환자들은 전이성 질환과 관련된 골통이 감소되었다.
두 번째 단계 동안에, 환자들은 24개월 동안 1α,24-디하이드록시비타민 D2을 최대내약용량의 0.5와 1.0배를 투여받았다. 치료의 1년과 2년 후에, 전이성 질환의 경과를 평가하기 위해 사용된 단층촬영영상법, X레이 및 골스캔은 적은 용량을 투여받은 많은 환자에서는 질병이 안정상태를 유지하거나 부분적으로 완화되었고 고용량을 투여 받은 많은 환자에서는 질병이 안정상태를 유지하거나 부분적으로 또는 완전한 완화를 보였다.
실시예 8 :
1α
-하이드록시
비타민 D
2
실시예 7의 조사는 활성비타민 D 화합물인 1α-하이드록시비타민 D2( 2.5% w/w의 벤질알코올, 0.5%-2.5%w/w의 TWEENTM-20 및 20ppm의 BHT로 조제된)로 반복되었다. 단계 1 조사의 결과는 1α-하이드록시비타민 D2의 최대내약용량을 적어도 6개월 동안 투여받은 환자들은 전이성 질환과 관련된 골통이 유의적으로 감소되었다는 것을 보여준다. 단계 2 조사의 결과는 2년 후에 전이성 질환의 경과를 진단하기 위해 사용된 단층촬영영상법, X레이 및 골스캔에서 적은 용량으로 투여받은 많은 환자에 있어서는 질병이 안정상태를 유지하거나 부분적으로 완화되었고, 고용량을 투여받은 많은 환자에 있어서는 질병이 안정상태를 유지하거나 부분적 또는 완전히 완화되었다. 요약하면, 본 발명은 수성 비이클에서는 아주 조금 용해되는 친지성 약물의 제형화를 향상시킨다. 친지성 약물에 추가해서 제형은 친지성 항산화제, 비이온성 가용화제 또는 계면활성제와 선택적 성분인 유기용매/방부제를 포함한다.
본원에서 인용된 모든 특허, 간행물 및 참고문헌은 참조에 의해 본원에 그 전문내용이 포함된다. 본 기술내용과 포함된 특허, 간행물 및 참고문헌 사이에 충돌이 있는 경우에 본 기술 내용을 조절할 수 있다.
본 발명을 본원에 기술하고 특이하게 예시화 하였음에도 불구하고 이 기술분야에서 전문 지식을 가진 사람은 언급된 내용에 변화, 추가 및 생략을 포함한 다양한 변형이 이루어질 수 있음을 이해할 것이다. 따라서, 이러한 변형은 본 발명의 범위에 포함되어야 하고 본 발명의 보호범위는 첨부된 청구항에 법적으로 일치될 수 있는 가장 넓은 해석에 의해서만 제한하고자 한다.
Claims (39)
- 독세르칼시페롤, 0.05% 내지 5% w/w 농도의 폴리소르베이트 20, 20 내지 2000 ppm 농도의 부틸화된 하이드록시톨루엔(BHT), 선택적 성분으로서 0% 초과 30% 이하 w/w의 농도의 에탄올, 및 수성 비히클을 포함하는 비경구용 제형.
- 제1항에 있어서, 선택적 성분이 0% 초과 10% 이하 w/w의 농도로 존재하는 비경구용 제형.
- 제1항에 있어서, 선택적 성분이 1% 내지 3% w/w의 농도로 존재하는 비경구용 제형.
- 제2항 또는 제3항에 있어서, 독세르칼시페롤이 2-10㎍/mL의 농도로 존재하는 비경구용 제형.
- 2-10 ㎍/mL의 독세르칼시페롤, 0.5%-2.5% w/w 폴리소르베이트 20, 20 ppm의 BHT 및 2.5% w/w의 에탄올을 포함하고, 2차적인 부갑상선기능항진증의 치료에 사용되는 비경구용 제형.
- 10-100 ㎍/mL의 독세르칼시페롤, 0.5%-2.5% w/w 폴리소르베이트 20, 20 ppm의 BHT 및 2.5% w/w의 벤질 알코올을 포함하고, 종양성 질환의 치료에 사용되는 비경구용 제형.
- 제4항에 있어서, 부갑상선기능항진증 환자에게 투여되는, 증가된 혈중 부갑상선호르몬 수준을 낮추거나 낮아진 혈중 부갑상선호르몬 수준을 유지하기 위한 것인 비경구용 제형.
- 제7항에 있어서, 부갑상선기능항진증이 2차적인 부갑상선기능항진증인 비경구용 제형.
- 제2항 또는 제3항에 있어서, 과증식세포의 성장을 억제하기 위한 비경구용 제형.
- 제9항에 있어서, 제형이 이를 필요로 하는 사람 환자에게 과증식세포의 성장을 억제하는데 효과적인 양으로 투여되는 것인 비경구용 제형.
- 제10항에 있어서, 세포가 유방, 결장, 전립선 및 췌장의 암세포를 포함하는 것인 비경구용 제형.
- 제10항에 있어서, 세포가 건선으로 인한 것인 비경구용 제형.
- 제2항 또는 제3항에 있어서, 칼슘 대사 이상을 치료하기 위한 비경구용 제형.
- 제1항에 있어서, 폴리소르베이트 20이 0.5% 내지 2.5% w/w의 농도로 존재하고, 부틸화된 하이드록시톨루엔(BHT)이 20 ppm의 농도로 존재하고, 그리고 에탄올이 2.5% w/w의 농도로 존재하는 것인 비경구용 제형.
- 제14항에 있어서, 독세르칼시페롤이 2-10 ㎍/mL의 농도로 존재하는 비경구용 제형.
- 2-10 ㎍/mL 범위의 양의 독세르칼시페롤,0.05% 내지 5% w/w 범위의 양의 폴리소르베이트 20,20 내지 2000 ppm 범위의 양의 부틸화된 하이드록시톨루엔,0% 초과 10% 이하 w/w 범위의 양의 에탄올, 및제형의 50% 내지 99% w/w의 양의 물을 포함하는 수성 비히클을 포함하는 비경구용 제형으로서,상기 비경구용 제형은 독세르칼시페롤이 용해된 수성 용액이고, 주사용인 비경구용 제형.
- 제16항에 있어서, 독세르칼시페롤이 2 ㎍/mL의 양으로 존재하고, 폴리소르베이트 20이 0.5% 내지 2.5% w/w 범위의 양으로 존재하고, 부틸화된 하이드록시톨루엔이 20 ppm의 양으로 존재하고, 그리고 에탄올이 3% 내지 10% w/w 범위의 양으로 존재하는 비경구용 제형.
- 제17항에 있어서, 종국적으로 멸균된 것인 비경구용 제형.
- 2-10 ㎍/mL 범위의 양의 독세르칼시페롤,0.5% 내지 5% w/w 범위의 양의 폴리소르베이트 20,20 내지 2000 ppm 범위의 양의 부틸화된 하이드록시톨루엔,1% 초과 10% 이하 w/w 범위의 양의 에탄올, 및제형의 50% 내지 99% w/w의 양의 물을 포함하는 수성 비히클을 포함하는 비경구용 제형으로서,상기 비경구용 제형은 독세르칼시페롤이 용해된 수성 용액이고, 주사용인 비경구용 제형.
- 제19항에 있어서, 제형 내의 물이 72% 내지 99% w/w의 양인 비경구용 제형.
- 제20항에 있어서, 독세르칼시페롤이 2 ㎍/mL의 양으로 존재하고, 폴리소르베이트 20이 0.5% 내지 2.5% w/w 범위의 양으로 존재하고, 부틸화된 하이드록시톨루엔이 20 ppm의 양으로 존재하고, 그리고 에탄올이 3% 내지 10% w/w 범위의 양으로 존재하는 비경구용 제형.
- 제21항에 있어서, 폴리소르베이트 20이 1% w/w의 양으로 존재하는 비경구용 제형.
- 제21항에 있어서, 제형 내의 물이 92% 내지 99% w/w의 양인 비경구용 제형.
- 제23항에 있어서, 에탄올이 3% 내지 4% w/w 범위의 양으로 존재하고, 폴리소르베이트 20이 1% w/w의 양으로 존재하는 비경구용 제형.
- 제24항에 있어서, 종국적으로 멸균된 것인 비경구용 제형.
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-
2002
- 2002-09-18 US US10/247,765 patent/US7148211B2/en not_active Expired - Lifetime
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2003
- 2003-09-10 KR KR1020057004755A patent/KR101089049B1/ko active IP Right Grant
- 2003-09-10 CN CNB038222035A patent/CN100349573C/zh not_active Expired - Fee Related
- 2003-09-10 EP EP03749606A patent/EP1553956A4/en not_active Withdrawn
- 2003-09-10 AU AU2003267131A patent/AU2003267131B2/en not_active Ceased
- 2003-09-10 MX MXPA05002814A patent/MXPA05002814A/es active IP Right Grant
- 2003-09-10 BR BR0314354-6A patent/BR0314354A/pt not_active IP Right Cessation
- 2003-09-10 JP JP2004537767A patent/JP5137293B2/ja not_active Expired - Fee Related
- 2003-09-10 CA CA002498331A patent/CA2498331A1/en not_active Abandoned
- 2003-09-10 WO PCT/US2003/028499 patent/WO2004026231A2/en active Application Filing
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- 2006-04-20 US US11/379,423 patent/US20060183722A1/en not_active Abandoned
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MXPA05002814A (es) | 2005-05-27 |
US20120214773A1 (en) | 2012-08-23 |
US7148211B2 (en) | 2006-12-12 |
US20060183722A1 (en) | 2006-08-17 |
AU2003267131A1 (en) | 2004-04-08 |
EP1553956A2 (en) | 2005-07-20 |
JP2006502185A (ja) | 2006-01-19 |
AU2003267131B2 (en) | 2009-08-13 |
IL167309A (en) | 2009-08-03 |
WO2004026231A3 (en) | 2004-08-12 |
BR0314354A (pt) | 2005-07-19 |
CN100349573C (zh) | 2007-11-21 |
JP5137293B2 (ja) | 2013-02-06 |
CN1684691A (zh) | 2005-10-19 |
US20040053894A1 (en) | 2004-03-18 |
CA2498331A1 (en) | 2004-04-01 |
US20100197641A1 (en) | 2010-08-05 |
WO2004026231A2 (en) | 2004-04-01 |
EP1553956A4 (en) | 2009-11-11 |
KR20050047119A (ko) | 2005-05-19 |
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