KR20190073598A - Pharmaceutical composition comprising drospirenone and contraceptive kit - Google Patents

Abstract

The present invention relates to the field of pharmaceutical compositions and methods of contraception. The present invention provides a pharmaceutical composition comprising drospirenone, characterized by a slow in vitro dissolution rate and an improved pharmacokinetic profile of drospirenone. The contraceptive method and use of the composition in a contraceptive kit are also provided.

Description

Pharmaceutical compositions comprising drospirenone and pharmaceutical compositions comprising drospirenone and contraceptive kit

The present invention relates to a shinning kit, composition for parenteral administration, and a method of contraception.

Several contraceptives, including synthetic progestogens and no oestrogens, are commercially available. These contraceptives, referred to as "progestogen-only contraceptives," encompass an implant, a uterine delivery system and a pill.

Progestogen-only Pills (POPs) have the advantage of being able to prevent the combined administration of estrogen as compared to traditional contraceptive pills.

However, POP has several major drawbacks. Because of its low contraceptive credibility, POPs should be taken at the same time each day without a pill-free placebo interval.

Because amenorrhea or unexpected menstrual or spotting can occur, the menstrual pattern of women who consume POPs can also be highly altered compared to natural menstrual cycles.

Despite their potential benefits, the use of POPs is poor and generally shows the recommended results for women without estrogen tolerance, postpartum women and breastfeeding women (Amy, Tripathi, 2009, BMJ, 339, 563 Mandisk, 2008, Obstetric Medicine, 1,78-87).

Drospirenone (CAS: 67392-87-4; 6?, 7 ?, 15 ?, 16? -Dimethylene-3-oxo-17- 7β, 15β, 16β-dimethylen-3-oxo-17a-pregn4-ene-21,17-carbo-lactone) is a synthetic progestogen with a very similar pharmacological profile with respect to natural progesterone.

Drospirenone (or DRSP) has no androgenic, glucocorticoid, and antiglucocorticoid activities, but has strong antimineralocorticoid and antiandrogenic properties. It has been shown that oral dosing at least 3 mg of drospirenone daily can prevent ovulation during a single 21-day treatment period. The combination of 3 mg drospirenone / 30 μg ethinylestradiol provides adequate room for contraceptive safety by blocking ovulation at a low frequency of follicular maturation (Rosenbaum et al ., 2000, The European Journal of Contraception and Reproductive Health Care, 5, 16-24).

Therefore, drospirenone (DRSP) is a suitable progestin that can prevent side effects such as weight gain and breast tension when using conventional synthetic progestogens when mixing estrogen for contraceptive use. Component. DRSP can also minimize fluid retention and can also have neutral effects on metabolic and vascular risk (Blode et al ., 2000, The European Journal of Contraception and Reproductive Health Care, 5, 256-264; Sitruk-Ware, 2006, Human Reproduction Update, 12, 169-178). Drospirenone has also been reported to be able to treat moderate acne due to well-established characteristics of anti-androgens.

Drospirenone as a contraceptive is a combination of Yasmin® (3 mg DRSP / 30 μg ethinyl estradiol), Yaz® (3 mg DRSP / 20 μg ethinyl estradiol) and Yasminelle® (3 mg DRSP / 20 μg ethinyl estradiol) in the marketplace. These agents include ethynylestradiol which acts to increase the effect of drospirenone on ovulation and to ensure pregnancy and cycle stability.

The patent application WO2008031631 discloses a composite oral contraceptive agent wherein drospirenone is used as a progetative substance and ethinylestradiol replaces phytoestrogen 8-prenylnaringenin. These contraceptives are characterized as a controlled release form of drospirenone and 8-pronylnaringenin, which is capable of continuously feeding the active ingredient during the gastro-intestinal residence time (transit time) of 12 h to 16 h .

The above commercially available contraceptives Yasmine®, YAZ® and Yasmin®® have been used in the microwized form of Drosophila to promote rapid dissolution in vitro and to ensure good oral bioavailability Lennon. Angeliq® is also a hormone replacement drug that is a mixture of drospirenone and estradiol.

However, such formulations are characterized by having high plasma concentration peaks of drospirenone after oral ingestion.

Usually low tolerances when the hormone level, respectively, and the daily changes is very large daily (general tolerance) as well as higher C _max ≪ / RTI > and any undesirable side effects, high plasma concentrations are not preferred for patients treating drospirenone.

There is still a need in the art for new pharmaceutical compositions comprising the novel shampoo kits and drospinones.

SUMMARY OF THE INVENTION

The present invention relates to a pacing kit comprising one or more packaging units, each packaging unit comprising a daily active dose unit of from 21 to 28 days, wherein, when orally administered in a fasted state, Is adjusted to provide a pharmacokinetic profile of drospirenone with the following characteristics.

(I) an average t _max of at least about 2.2 h and

(Ii) an average C _{max of} less than about 30 ng / ml.

The invention also relates to a pacing kit comprising one or more packaging units, each said packaging unit comprising a daily active dose unit of 21 to 28 days, each active daily dose unit comprising: It includes the same type of drospirenone.

When the daily active dose unit is subjected to an in vitro dissolution test USP XXIII When the paddle method is applied, the percentage of drospirenone related to the amount of drospirenone initially present in the daily active dose unit is

(I) less than 50% of the drospirenone initially present in the daily active dose unit is dissolved within 30 minutes

(Ii) at least 50% of the drospirenone is dissolved over a period of time ranging from 3 hours to 4 hours.

Each daily active dose unit consists of a pharmaceutical composition comprising drospirenone without estrogen.

It is another object of the present invention to provide a pharmaceutical composition comprising drospirenone for use as a birth control pills.

It is a further object of the present invention to provide a method of contraception for female patients in need of contraception.

BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1: Particle size distribution
Figure 1 shows cumulative distribution curves (cdf, filled diamonds) and probability density function curves (pdf, filled squares) of drospirenone (DRSP) arrangement 080053. Distribution experiment data were obtained by laser diffraction method. X-coordinate: Particle size (탆) in logarithmic coordinate system. Left Y-coordinate: cumulative distribution in%. Right Y-coordinate: probability density function
Figure 2 : In vitro dissolution profiles
FIG. 2 is a graph showing the results of a comparison between the tablets (A-3mg) (experimental group, curve n ° 2) obtained in DRSP batch 080053 described in Example 1 and comparative tablets, namely yasmine elur (curve n ° 4) n ° 3) and purified CO2-3 mg (curve n ° 1). Each tablet contains 3 mg of DRSP. The ex vivo dissolution profile was determined by the USP XXIII paddle method as described in Example 2. [
X-coordinate: time expressed in hours, Y-axis: average elution percentage of DRSP relative to the initial content of DRSP contained in the tablets being tested
Figures 3a and 3b : Mean drospirenone serum concentration vs. time curve
Figure 3a shows the results of a single tablet of the reference product, i. E., After administration of Yasmin Ell? (Empty square) or after administration of a single tablet (experimental product, filled square) obtained in DRSP Place 080053 as described in Example 1, Plasma average concentration versus time curve. In both cases the dose of DRSP was 3 mg. These clinical data are presented to 14 healthy female volunteers as described in Example 3, Part 1 in a monocentric, open, randomized, single-dose, Was obtained by performing a crossover clinical trial of two periods. Each volunteer was always given a single dose of either one tablet of the test product or one of the Yasmine El ® tablets in two single cases in a random fashion under fasting conditions. The study period was separated by the actual wash period of 7 days. In each study, blood samples were collected before the administration of the tablet (time 0) and for the analysis of the DRSP plasma concentration at 0:30, 1:00, 1:30, 2:00, 3:00, 4 : 00, 5:00, 6:00, 8:00, 12:00, 24:00, 48:00 and 72:00.
X-coordinate: time (expressed in hours) after oral administration of the tablet. Y-coordinate: Mean plasma concentration of DRSP expressed in ng / ml (arithmetic mean).
Figure 3b shows the results of a single tablet of reference product under fasting conditions, i.e. after administration of yasmine elur (empty squares) or after oral administration of a single tablet of CO 1-3 mg (filled diamonds) Shows the curve of average plasma concentration of DRSP vs. time obtained after oral administration (see Example 3, Part 2)
X-coordinate: the time (expressed in hours) since oral administration of the tablet. Y-coordinate: mean plasma concentration of DRSP expressed in ng / ml (arithmetic mean)
Figures 4a, 4b and 4c : Simulations based on the pharmacokinetic results obtained in the clinical trials described in Example 3
Figures 4 (a) and 4 (b) show the results of oral administration (A-3 mg, experimental group, hollow triangle) of the single tablet described in Example 1 (i) Oral administration of a single tablet of yasmine elle (comparative group, filled squares) The experimental DRSP plasma mean concentration versus time curve obtained from this study is shown. Yasmin Ell® Tablets and Tablets A-3 mg all contain 3 mg DRSP. Figures 4a and 4b also show the expected mean DRSP plasma concentration versus time curve (experimental group, empty diamonds) obtained in the administration of tablets similar to those described in Example 1 (Tablets A-4mg), also containing 4mg of DRSP . These curves were estimated by experimental pharmacokinetic data obtained in the clinical trials described in Example 3, Part 1.
X-coordinate: time (expressed in hours) after oral administration of the tablet. Y-coordinate: Mean plasma concentration of DRSP expressed in ng / ml.
Figure 4c shows repeated dosing (curve n ° 2) of tablet A-3mg, repeated administration (curve n ° 3) and tablet A-4mg repeatedly (curve n ° 2) Lt; RTI ID = 0.0 > DRSP < / RTI > concentration vs. time curve.
X-coordinate: time (expressed in hours) since oral administration of the first tablet. Y-coordinate: mean plasma concentration of DRSP expressed in ng / ml
Figures 5a and 5b: Tablets containing 4 mg of DRSP (B-4 mg) in vitro elution profile and mean drospirenone serum concentration vs time curve
Figure 5 shows the in vitro extrapolated mean elution profile of the tablets obtained in the DRSP batch N ° PR100003 described in Example 5 (see Part 1). The tablet contains 4 mg of DRSP.
X-coordinate: time in hours, Y-coordinate: average elution percentage of DRSP relative to the initial amount of DRSP contained in the tablets being tested
Under fasting conditions, Figure 5b shows the DRSP plasma mean concentration versus time curve obtained after oral administration of the reference product, i.e., a single tablet of yasmine elur (empty square) or after oral administration of B-4 mg single tablet (filled square).
X-coordinate: time after oral administration of tablet (expressed in hours), Y-coordinate: mean plasma concentration of DRSP expressed in ng / ml
Figures 6a and 6b : Plasma levels of progesterone and estradiol in patients during treatment and follow-up periods, respectively
6A and 6B show clinical test results for explaining the contraceptive efficacy of the parenteral composition according to the present invention. The methodology of clinical trials is described in Example 4. Briefly, the treatment period included two treatment cycles, and subjects received a DRSP 4 mg pill (Tablet B-4 mg) for 1 to 24 days of each treatment cycle, and placebo tablets were administered 25-28 days At a given time. On the 5th and 13th days of the second cycle, pill intake was delayed by 24 hours (i.e., the pill was not taken on the fifth and thirteen days, and two pills were taken on the sixth and fourteenth days, respectively. The study consisted of a 56-day treatment period and a post-treatment follow-up period of 28 days. The tablets are consistent with tablets B-4 mg.
Figure 6a shows the change in plasma levels of progestor's individual during the treatment period and the follow-up period. X-coordinate: time expressed in days after the first pill Y-coordinate: level of progesterone expressed in ng / ml
Figure 6b shows the changes in plasma levels within an individual of estradiol during the treatment and follow-up periods. X-coordinate: time expressed in days after the first pill taken Y-coordinate: level of estradiol expressed in ng / ml

The present invention relates to a pacing kit comprising a plurality of active daily dose units. Each daily dose unit consists of a pharmaceutical composition comprising drospirenone. In a preferred embodiment, the pharmaceutical composition comprises drospirenone without estrogen. That is, the pacing kit is preferably a progestogen-independent pacing kit.

Drospirenone may be present as a single contraceptive ingredient in a pharmaceutical composition.

The active daily dose unit makes it possible to prevent pregnancy when it is daily administered to women of child-bearing age over a continuous period of 21 to 28 days.

The quantity of active daily dose units contained in the prevention kit may vary depending on the intended method of contraception for which the prevention kit is to be used.

(I) a pharmaceutical composition of the active daily dose unit of said kit, and (ii) a method of contraception for said kit, as described in Chapters 1 and 2 Lt; / RTI > In Chapter 3, a specific embodiment of the shim kit of the present invention is also disclosed.

1. Pharmaceutical composition

Commercially available drospirenone-containing parenteral preparations include both ethinyl-estradiol and micronized drospirenone. According to EP1214076, the undifferentiated form of drospirenone promotes rapid elution in vitro . Such in vitro exudation is claimed to be an essential condition for obtaining good bioavailability through oral routes. The rapid dissolution rate of drospirenone in vitro is considered to be correlated with the rapid absorption of DRSP in vivo , which prevents its degradation by stomach or intestinal environment.

Describes a drospirenone composition showing rapid dissolution of drospirenone in vitro , such as several other patents and patent applications, WO2006128907 or WO2009138224.

Thus, international application WO 2006128907 teaches that surfactants can improve the dissolution rate of non-micronized drospirenone with a specific surface area of less than 10 000 cm ² / g. International application WO2009138224 describes that the dissolution rate of drospirenone can be significantly improved by co-milling drospirenone with an appropriate carrier to obtain drospirenone in an amorphous state.

Rapid dissolution of drospirenone in vitro , as mentioned in EP1214076, generally results in in vitro dissolution analysis such as USP XXIII paddle method II in which at least 70% of the drospirenone is 30 Means dissolving in minutes.

Surprisingly, the Applicant has opposed this prejudice and has shown through in vivo pharmacokinetic analysis that rapid elution of drospirenone in vitro is not required to obtain good oral bioavailability gave. In this regard, the Applicant has a slow dissolution rate of drospirenone in vitro and has a similar average AUC value (Area Under the Curve) when compared to Yasmine Elle when administered orally to a patient. RTI ID = 0.0 > drospirenone-containing < / RTI >

In addition, the Applicant also barely contemplated a DRSP-containing composition showing a significantly reduced mean C _max value (maximum plasma concentration) associated with a delayed mean t _max value of drospirenone when compared to Yasmine ELR®.

Reduction of the DRSP _Cmax can improve tolerance of DRSP-containing compositions by avoiding or reducing side effects associated with plasma levels of potassium in particular.

Drospirenone has the property of anti-mineral corticosteroids leading to increased potassium excretion and leading to elevated potassium plasma levels. C _max of fluorenone draw RY have been proposed that are related to the C _max value of the potassium release after administration fluorenone draw RY. This increase in potassium plasma concentration following the administration of drospirenone is believed to be associated with hyperkalemia, which is known to cause a variety of diseases such as dizziness, palpitations, muscle weakness and cardiac arrhythmia (hyperkalemia) can lead to.

When administered orally, the DRSP-containing composition according to the present invention induces a C _max of reduced plasma of drospirenone. The reduced _Cmax of DRSP is expected to reduce the reduction of potassium release in plasma. As a result, in the case of the composition according to the present invention, a medicament susceptible to hyperkalemia is administered daily to treat women who are vulnerable to hyperkalemia, women suffering from kidney, liver, or adrenal diseases and chronic diseases The resistance of drospirenone can be improved for women who are being treated for a long time. Potent agents for hyperkalemia include nonsteroidal anti-inflammatory drugs, potassium-sparing diuretics, potassium supplementation, angiotensin-converting enzyme (ACE) inhibitors, angiotensin-II But are not limited to, angiotensin-II receptor antagonists and heparin.

Consequently, the DRSP-containing composition according to the present invention may be particularly suitable for the preparation of any oral medicament whose mean _Cmax value of DRSP should be adjusted to improve the resistance of drospirenone. For example, a composition according to the present invention may be used to prepare a hormone replacement therapy (HRT).

DRSP- comprising the composition according to the invention with a reduced delay t _max C _max And AUC _{0h - tlast} sufficient to provide a contraceptive effect, the composition may be suitable for use as a progestogen-only agent.

As described in Example 3 of Chapter 3, the Applicant has shown that the composition according to the present invention provides an effective and stable parenteral drospirenone blood level when administered daily to female patients. Therefore, no co-adminstration of estrogen is required to ensure contraception and periodic stability.

Since the average _Cmax value is significantly reduced, the parenteral composition according to the present invention provides a more stable drospirenone plasma concentration, i. E., A small change in DRSP plasma concentration between two successive administrations. This characteristic can reduce the occurrence of more unexpected dot hemorrhage and hemorrhage, thus significantly improving bleeding profile compared to conventional POP.

As described in Example 5, the Applicant has also shown that the composition has a contraceptive effect even when the placebo period is introduced in the contraceptive regimen and when the formulation is withdrawn for several days. Therefore, it is expected that the composition will show higher contraceptive reliability than other progestogen alone pills, even if the patients are less compliant with treatment without the risk of unwanted pregnancy.

It is also anticipated that the parenteral compositions of the present invention will be effective as combined oral formulations that do not induce side effects associated with estrogen-free estrogen, especially those that do not increase the risk of cardiovascular events.

Therefore, in some embodiments of the present invention, the pharmaceutical composition is suitable for use as an oral contraceptive. In some other specific embodiments, the pharmaceutical compositions according to the present invention are used as progestogen-only preparations.

As used herein, "progestogen-single pill," or "progestogen-exclusive agent" means a contraceptive or formulation containing progestogen as a single contraceptive component without any estrogen.

As used herein, a "composition with an improved pharmacokinetic profile of drospirenone" means that when oral administration of a single daily dose unit of the drospirenone-containing composition is compared to administration of a single daily dosage unit of yasmine el Means a pharmacokinetic profile of drospirenone characterized by a delayed mean t _max and a reduced mean C _max .

The pharmacokinetic profile of Yasmin Ell ® is described in Example 3.

In some aspects, the invention provides a pharmacokinetic profile with a mean C _max DRSP of less than 85% of the mean C _max obtained after oral dosing of a single dose unit of Yasmine El R 1 when administered orally Or a pharmaceutically acceptable salt thereof.

The pharmaceutical DRSP-containing compositions according to the invention may also be formulated so that when administered orally, the single daily dosage unit of the composition has an average tmax of at least 150% of the average tmax obtained after oral administration of a single dose unit of yasmine el Lt; RTI ID = 0.0 > DRSP. ≪ / RTI >

Average sufficient to provide a pharmaceutical or biological effect that administration of a single dose unit of the composition is sought by the administration of a fluorenone draw RY AUC _{0h - tlast} To It is natural to provide.

When the pharmaceutical composition according to the present invention is used as a birth control pill, it is also required that the average AUC _{0h - tlast} obtained in the administration of a single daily dose unit of the composition is at least 70% of the average AUC _0h-tlast obtained in the case of Yasmin _Ele .

That is, in certain aspects of the present invention, the daily dose unit of the pharmaceutical composition according to the present invention may be physiologically and / or physiologically modified to provide a pharmacokinetic profile when administered orally, wherein the single daily dosage unit has the following characteristics: And a combination of chemical properties.

- (i) an average C _{max of} less than 85% of the average C _max obtained after oral administration of a single dose unit of yasmine el

- (ii) an average t _max of at least 150% of the mean t _max obtained after oral administration of a single dose unit of yasmine el

And optionally, an average AUC _0h-tlast of at least 70% of the average AUC _0h-tlast obtained after oral administration of a single dose unit of _{yasmine elle}

In some embodiments, the mean AUC _{0h - tlast} is at least 85% of the mean AUC _0h-tlast obtained after oral administration of a single dose unit of _{yasmine elle} .

In some embodiments, the pharmaceutical compositions of the present invention show all the pharmacokinetic features mentioned previously.

The AUC _{0h - tlast ,} the C _max and the t _max are determined based on the drospirenone plasma concentration versus time curve.

In accordance with the present invention, in a drospirenone-containing composition, the drospirenone plasma concentration versus time curve is determined by measuring the plasma concentration of plasma drospirenone after about a single oral ingestion of one daily dose unit of the drospirenone- Can be determined depending on the concentration.

A single oral administration of the drospirenone-containing composition is preferably performed in a fasted state, for example, not close to a meal time without food ingestion (e.g., generally after about 6h-10h after a meal) Because ingestion of food can change the absorption rate of drospirenone in the gastrointestinal tractus.

The t _max and C _max values refer to the maximum DRSP plasma concentration and the time to reach it, respectively, after ingesting a single daily dose unit of the DRSP-containing composition of interest.

That is, t _max and C _max refer to the characteristic of the drospenone plasma concentration measured after oral ingestion of a single daily dose unit of the composition of interest.

The AUC _{0h - tlast} corresponds to the area obtained by integrating the drospirenone plasma concentration over time during the [0h-tlast] interval, where the "0h" points to the oral uptake of a single daily dose unit of the composition of interest , And the term "t _last " refers to the last time the plasma concentration of DRSP can be quantified.

DRSP plasma concentrations can be determined by conventional well-known methods. For example, a suitable method of quantification involves the extraction of DRSP from human plasma and quantification thereof using liquid chromatography coupled with tandem mass spectrometry.

In a preferred embodiment, a person skilled in the art can adapt to the analytical method described in Kirk et al (Rapid Communication in Mass Spectrometry, 2006; 20: 1247-1252). This method involves derivatizing drospirenone using a Girard P hydrazine solution to increase the response of DRSP during subsequent MS analysis. This method is generally suitable for quantifying DRSP in human EDTA plasma over a concentration range of about 0.25 to 100 ng / ml.

As used herein, the average AUC _{0h - tlast ,} the average C _max And The mean t _max is calculated as an arithmetic average value determined by the individual pharmacokinetic data obtained by performing a single oral administration of one daily dose unit of the drospirenone-containing composition to a group of healthy female volunteers of age capable of having a child Quot;

A group of healthy female volunteers includes enough numbers to provide statistically reliable pharmacokinetic results. Preferably, said group comprises at least 10 healthy women of age capable of having a child.

As used herein, a healthy woman of childbearing age has no prevalence of pre-menopause Caucasian, between the ages of 18 and 40, with normal weight and health problems, Refers to a person without metabolic, kidney, liver or gynecologic disorder. "Normal weight" refers to a range of body weight index (BMI) of 18 to 29 kg / m ² .

Preferably, these volunteers did not ingest any hormone-containing compositions during the three months prior to testing to determine the pharmacokinetic parameters of interest.

Includes the average C _max, t _max and AUC of the composition _0h-Yasmin Elle ® and drospirenone in accordance with the present invention _tlast is determined through the same female patient group. Between the administration of a single daily dose unit of yasmine elur® and the administration of a DRSP-containing composition according to the invention, the female volunteer has a washout period for a period of at least 7 days.

The mean C _max , mean t _max , and mean AUC _{0h - tlast} of the _DRSP can be determined through individual pharmacokinetic data that are not processed by conventional well-known statistical methods.

For example, all of the endpoints listed above can be determined in a model-independent manner. The highest concentration actually measured and its time registered after each dose to any given volunteer is NC_PKP.sas. Can be regarded as C _max and t _max , respectively, according to the algorithm of the program.

The daily dose unit of a composition comprising a DRSP according to the present invention comprises at least 2 mg of drospelluron.

Daily doses of DRSP from 3 mg to 4.5 mg may be preferred when the compositions of the present invention are used as birth control pills.

As here, Yasmin Ell® is a complex oral formulation commercialized by Bayer / Schering. The daily dose unit of Yasmin Ell® is a coated tablet comprising an ethinyl estradiol betadex clathrate in concert with 20 mg of 3 mg of undifferentiated drospirenone and ethinylestradiol . The tablets also contain lactose monohydrate, maize starch, and magnesium stearate as the main excipients. The coating of the tablet includes hypromellose, talc, titanium oxide and iron oxide red.

cialit

) 65052799과 관련된 프랑스 마케팅 허가증으로 포장되었으며, 2009년 9월 17일에 개정된 약학 제품을 일컫는다.The Yasmin Ell® (sold under the name Jasminelle® in France) used here is the CIS number (Code d'Identification de Sp

cialit

) 65052799 and refers to the pharmacy product as amended on September 17, 2009.

For a preferred embodiment, the pharmacokinetic parameters (i.e., C _max, t _max and AUC _{0h - tlast)} is determined after the first oral administration of a single unit dose of interest include the DRSP- composition, the first oral administration, fasted It is what happens in the state.

In a more general aspect, the present invention is directed to a pharmaceutical DRSP wherein, when orally administered, the single daily dosage unit of the composition is adjusted to provide a pharmacokinetic profile of a DRSP having an average _Cmax of less than about 30 ng / ml - containing composition. The pharmaceutical DRSP-containing composition may also be characterized in that, when orally administered, the single daily dose unit of the composition is adjusted to provide a pharmacokinetic profile of DRSP with an average t _max of at least about 2.2 h.

Administration of a single dose unit of the composition is sufficient average AUC _0h to indicate the pharmaceutical or biological effect to be obtained in the administration of fluorenone draw RY _- It is natural for the _tlast is displayed.

When the compositions of the present invention are used as birth control pills, the average AUC _{0h - tlast} obtained in administration of a single daily dose unit of the composition may require at least about 300 ng * ml / h.

That is, in some embodiments, the daily dose unit of the pharmaceutical composition according to the present invention is administered orally, wherein the daily dose unit has a physical and / or chemical property adjusted to provide a pharmacokinetic profile having the following characteristics: Combination.

(I) a mean C _{max of} less than about 30 ng / ml

(Ii) an average t _max of at least about 2.2 h

And, optionally, a mean AUC _0h-tlast of at least about 300 ng * h / ml

In some embodiments, the pharmaceutical compositions according to the present invention show all the pharmacokinetic characteristics mentioned previously.

As used herein, the expression "about" before "concrete value" is defined as a range of "10% of minus specific value of concrete value" For example, about 50 is defined as a range of 45 to 55.

At least mean AUC _0h approximately 300ng * h / mL _{- tlast} at least about 310ng * h / mL, at least about 320ng * h / mL, at least about 330ng * h / mL, at least about 340ng * h / mL, at least about 350ng * h / mL, at least about 360 ng * h / mL, at least about 370 ng * h / mL, at least about 380 ng * h / mL, at least about 420 ng * h / mL, and at least about 430 ng * h / mL of _AUC0h-tlast .

In some embodiments, the mean AUC _0h-tlast is at least about 350 ng * h / mL.

Mean tmax of at least about 2.2h comprises at least about 2.5h, 3.0h, at least, at least about 3.5h, the average t _max of at least 4h.

In a preferred embodiment, the average t _max does not exceed 6 hours so as not to significantly impair the bioavailability of the DRSP. The average tmax is therefore preferably 2.2 to 6 hours.

In some embodiments, t _max in the range of 3.0 hours to 4.0 hours is preferred.

An average C _max of less than about 30 ng / ml is less than about 20 ng / ml, less than about 26 ng / ml, less than about 24 ng / ml, less than about 22 ng / ml, less than about 19 ng / ml Ml, smaller than about 18 ng / ml, less than about 17 ng / ml, less than about 16 ng / ml, less than about 15 ng / ml, less than about 14 ng / ml.

In some embodiments, the average C _max ranges from 15 ng / ml to 30 ng / ml.

In another embodiment, the average C _max ranges from 15 ng / ml to 26 mg / ml.

In certain embodiments, the daily dose unit of a pharmaceutical composition according to the present invention is adjusted to provide a pharmacokinetic profile with the following characteristics.

When the daily dosage unit is administered in a fasted state.

(I) an average _Cmax ranging from 15 ng / ml to 30 ng / ml,

(Ii) an average t _max ranging from 2.2 hours to 6 hours, and

(Iii) optionally, an AUC _0h-tlast of at least about 300 ng * h / ml

In a preferred embodiment, the pharmacokinetic parameters (i.e., C _max , t _max and AUC _{0h - tlast} ) are determined after the first oral administration of a single unit dose of the _DRSP- containing composition of interest, It is what happens in the state.

The pharmaceutical composition of the present invention is particularly suitable when it is used as a contraceptive, especially when it is used as a sole-progestogen contraceptive.

The pharmaceutical composition of the present invention may also be used to prepare other medicines for which improvement of DRSP resistance is sought.

Such agents include, but are not limited to, HRT agents.

Without wishing to be bound by any theory, the Applicant believes that the in vitro dissolution rate of drospirenone is related to its pharmacokinetic profile in vivo .

Compositions showing the pharmacokinetic profile of drospirenone as fully described above have the advantage that the slow drop in vitro , such as less than 50% of the drosparenone initially present in the composition dissolves within 30 minutes You can show the dissolution rate of Lennon.

In one aspect, the present invention provides a pharmaceutical composition comprising drospirenone characterized by a slow dissolution rate of drospirenone in vitro .

As used herein, "slow dissolution rate of drospirenone in vitro" means that less than 50% of the drospirenone initially present in the composition dissolves within 30 minutes when the composition is subjected to the elution test The release of drospirenone.

As contemplated herein, less than 50% of drospirenone is present in the pharmaceutical composition at 45%, 40%, 35%, 30%, 25%, 20%, 15%, 10% .

In some embodiments, not more than 40% of the drospirenone initially present in the composition dissolves within 30 minutes.

As used herein, the percentage of drospirenone is related to the amount of drospirenone initially present in the coating composition.

The in vitro dissolution rate of drospirenone can be assessed by anyone skilled in the art as described in the prior art.

The in vitro dissolution rate of drospirenone can preferably be evaluated by the USP XXXIII paddle method. Briefly, tablets consisting of the parenteral composition containing drospirenone to be tested are placed in 900 mL of water at 37 DEG C (+/- 0.5 DEG C). The elution test is carried out using a USP dissolution test apparutus 2 at a strring rate of 50 rpm.

In some embodiments of the invention, the pharmaceutical composition is a parenteral composition.

As used herein, "composition for parenteral" means a composition capable of preventing pregnancy when administered daily in an effective amount to a female patient over a period of 21 to 28 consecutive days. The composition for parenteral administration may be caused by various biological effects to prevent pregnancy. For example, by inhibiting ovulation, preventing thickening of the cervical mucus (reducing the viability and penetration of the sperm) and / or implantation of the embryo, .

The term "drospirenone" refers to drospirenone itself, that is, a chemical entity distinguished by CAS registry number 57392-87-4, a drosphenol solvate, and a prodrug or derivative of drospirenone, Quot;

Drospirenone can be prepared by the well-known methods described in the prior art, such as those described in US 4129564, WO 9806738, EP 11746101 or WO2006061309. The method described by WO2006061309 is particularly suitable for preparing drospirenone.

It is natural that the method of preparing drospirenone is carried out to meet the requirements of good manufacturing practice (GMP).

To ensure good bioavailability of drospirenone, a significant amount of drospirenone initially contained in the fouling composition must be released within a reasonable time span.

Applicants believe that the good bioavailability of drospirenone is due to the fact that the dissolution rate of drospirenone in vitro is at least 50% of the drospirenone initially present in the composition is dissolved in the range of 3 hours to 4 hours Lt; / RTI > is obtained in the case of a composition comprising lenone.

Accordingly, it is an object of the present invention to provide a parenteral composition comprising the throat drospirenone of the present invention, wherein the dissolution rate of the drospirenone in vitro is less than 50% of the drospirenone in 30 minutes At least 50% of the drospirenone is dissolved during a period of time ranging from 3 hours to 4 hours.

The time range from 3 hours to 4 hours covers the time range from 3,25 hours to 3,5 hours, up to 3,75 hours, and up to 4 hours.

At least 50% of the drospirenone comprises at least 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, at least 88%, at least 90%, at least 91%, at least 92% 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, at least 99%, at least 99,5%.

In some embodiments, at least 60% of the initially present DRSP is dissolved over a time range of 3 hours to 4 hours.

In some other embodiments, the parenteral composition is also characterized in that at least 70% of the drospirenone is dissolved within 6 hours.

The present application shows that the specific surface area of DRSP directly affects the dissolution rate in vitro of drospirenone and its pharmacokinetic profile in vivo.

One method of obtaining the DRSP-containing compositions of the present invention is to use drospirenone in the form of particles having an appropriate specific surface area.

Drospirenone is present in the form of non-micronized particles in the pharmaceutical composition of the present invention.

It is also believed that drospirenone in the form of particles having a specific surface area of from about 2000 cm ² / g to about 8500 cm ² / g may be suitable for obtaining the contraceptive composition of the present invention. The specific surface area can be obtained experimentally using a BET method (gas adsorption method).

In some embodiments, the parenteral composition of the present invention comprises drospirenone in the form of particles having a specific surface area of from about 2000 cm ² / g to about 8500 cm ² / g.

This specific surface area is about ^{2000 cm 2 / g, 2500 cm} 2 / g, 3000 cm 2 / g, 3500 cm 2 / g, 4000 cm 2 / g, 4500 cm 2 / g, 5000 cm 2 / g, 5500 cm 2 ^{/ g, 6000 cm 2 / g} , 6100 cm 2 / g, 6200 cm 2 / g, 6300 cm 2 / g, 6400 cm 2 / g, 6500 cm 2 / g, 6600 cm 2 / g, 6700 cm 2 / g , 6800 cm ² / g, 6900 cm ² / g, 7000 cm ² / g, 7500 cm ² / g, 8000 cm ² / g and 8500 cm ² / g.

With respect to the particle size distribution, drospirenone particles having a diameter of more than 200 [mu] m have been found to elute in vitro and thus also to reduce bioavailability in vivo , since these particles are poorly soluble And thus can be limited not to significantly damage it.

Drospirenone may preferably have a d50 of less than 70 [mu] m. A preferred embodiment is that the d50 of the particles of drospirenone ranges from 10 [mu] m to 60 [mu] m.

The range of d50 of from about 10 占 퐉 to about 60 占 퐉 is inclusive of d50 of 10 占 퐉, 15 占 퐉, 20 占 퐉, 25 占 퐉, 30 占 퐉, 35 占 퐉, 40 占 퐉, 45 占 퐉, 50 占 퐉, 55 占 퐉 and 60 占 퐉.

In some embodiments, the particle size distribution of drospirenone present in the composition according to the present invention is characterized as follows.

(i) a d90 particle size of less than about 100 [mu] m, and / or

(ii) a d50 particle size in the range of about 10 [mu] m to about 60 [mu] m, and / or

(iii) a d10 particle size greater than about 3 < RTI ID = 0.0 >

In some other embodiments, the d50 of the droospielenone particles ranges from about 10 [mu] m to about 30 [mu] m. In this embodiment, the particle size distribution of drospirenone present in the composition according to the present invention is characterized by at least one of the following characteristics.

(i) a d90 particle size of less than about 100 [mu] m,

(ii) a d50 particle size in the range of about 10 [mu] m to about 60 [

(iii) a d10 particle size greater than about 3 < RTI ID = 0.0 >

As used herein, the term "about" before "specific value" is defined as a range from "10% of a specific value minus a specific value" For example, "about 50" defines a range of 45 to 55.

As used herein, "d90 particle size" means that the particle size distribution means that at least 90% of the particles have a smaller particle size diameter than a specified value.

As used herein, "d50 particle size" means that the particle size distribution means that at least 50% of the particles have a smaller particle size diameter than a specified value.

As used herein, "d10 particle size" means that the distribution of particle sizes has a particle size diameter at least 10% of the particles have a smaller particle size than the specified value.

The d90 particle size smaller than about 100 占 퐉 is 90 占 퐉, 80 占 퐉, 70 占 퐉, 60 占 퐉, 55 占 퐉, 50 占 퐉, 45 占 퐉, 40 占 퐉, 38 占 퐉, 36 占 퐉, 34 占 퐉, 32 占 퐉, 30 占 퐉, 28 占 퐉 , 26 microns, 24 microns, 22 microns, and less than 20 microns.

The d50 particle size in the range of about 10 microns to about 30 microns is about 10 microns, 11 microns, 12 microns, 13 microns, 14 microns, 15 microns, 16 microns, 18 microns, 19 microns, 20 microns, 21 microns, 22 microns , 23 占 퐉, 24 占 퐉, 25 占 퐉, 26 占 퐉, 27 占 퐉, 28 占 퐉, 29 占 퐉 and 30 占 퐉.

D10 particle sizes greater than about 3 microns include d10 particle size values greater than about 3 microns, 3.5 microns 4.5 microns, 5 microns, 6 microns, 7 microns, 8 microns, 9 microns, 10 microns, 11 microns, 12 microns .

It is natural that the d10 particle size value is smaller than the d50 particle size value and the d50 particle size value is smaller than the d90 particle size.

The drospirenone particle size distribution, in particular the d90, d10 and d50 values, can be determined using conventional techniques such as sieve analysis, laser diffraction method, photoanalysis or optical counting method Can be determined in a well-known manner. The ray diffraction method is particularly preferred. As described in Example 1, the particle size distribution can be determined by laser diffraction of wet dispersion. The dispersant is preferably water.

In some embodiments, the pharmaceutical composition according to the present invention comprises drospirenone in the form of particles having a particle size distribution of a combination of two features selected below.

(i) a d90 particle size of less than about 100 [mu] m,

(ii) a d50 particle size in the range of about 10 [mu] m to about 60 [

(iii) a d10 particle size greater than about 3 < RTI ID = 0.0 >

That is, the particle size distribution of the DRSP shows the combination of the feature (i) and the feature (ii), the feature (i) and the feature (iii), and the feature (ii) and feature (iii).

In some other embodiments, the pharmaceutical composition of the present invention comprises drospirenone in a non-undifferentiated form with a particle size distribution characterized by:

(i) a d90 particle size of less than about 100 [mu] m,

(ii) a d50 particle size in the range of about 10 [mu] m to about 60 [

(iii) a d10 particle size greater than about 3 < RTI ID = 0.0 >

In a preferred embodiment, the particle size distribution is also characterized in that the d90 particle size value is less than 50 [mu] m and there is no particle having a size greater than 80 [mu] m.

In some embodiments, the parenteral composition of the present invention has a d90 particle size in the range of about 20 占 퐉 to about 40 占 퐉, a d50 particle size in the range of about 10 占 퐉 to about 30 占 퐉 and a d50 particle size in the range of about 3 占 퐉 to about 9 占 퐉 d10, no droplets of size greater than 80 microns, and more preferably no more than 60 microns in size.

In some other embodiments, the parenteral composition of the present invention comprises drospirenone in the following particle form.

(i) a d90 particle size in the range of about 30 [mu] m to about 40 [mu] m,

(ii) a d50 particle size in the range of about 15 [mu] m to about 25 [

(iii) d10 of about 5 [mu] m to about 9 [mu] m and no particles larger than 80 [mu] m, more preferably no particles larger than 60 [

For the purpose of illustrating this, an appropriate particle size distribution of drospirenone according to the present invention is shown in Fig.

In some embodiments, the parenteral composition according to the present invention comprises drospirenone in the form of particles having a d50 particle size from 10 mu m to 60 mu m, with a specific surface area of from about 2000 cm ² / g to about 8000 cm ² / g do.

In order to obtain drospirenone in the form of particles having a specific surface area and / or particle size distribution as described above, those skilled in the art will appreciate that in the prior art, such as being mixed with a seive process, It can be used in a known way.

For example, drospirenone, the drospirenone obtained from all in the synthetic method described in the prior art, may be run in a ball mill or hammer mill step, optionally followed by a vibrating sieve step. The continuous oscillator stage can remove the largest finest particles of drospirenone that compromise the elution profile in the pharmacokinetic profile and in vitro of drospirenone.

A person skilled in the art can adjust the parameters of the milling and sieving steps of an ordinary experiment to obtain a suitable particle shape of drospirenone. Suitable mills that may be used include fluid energy mills, ball mills or rod mills, hammer mills, cutting mills or oscillating granulators.

The appropriate particle form of drospirenone can also be prepared by mixing with a crystallization or precipitation process, optionally a sieving process, to fully control the size of the droospielenone particle. The precipitation process induces precipitation of drospirenone by (i) dissolving drospirenone in a water-miscible solvent and then (ii) dispersing the solution result of cold water under stirring. The drospirenone particles can then be recovered through the filtration process.

The water-miscible solvent is generally selected from the group consisting of methanol, ethanol, isopropanol, dimethylformamide, tetrahydrofuran, dioxane or dimethyl sulfoxide, dimethyl Can be used in crystallization or precipitation processes such as dimethylacetamide or acetone.

This process essentially makes it possible to obtain the crystallization form of drospirenone.

Through such routine experimentation, one skilled in the art can determine the parameters of the settling used to obtain the appropriate form of drospirenone.

One skilled in the art can adjust the parameters of the precipitation process (the amount of solvent, water and optionally the amount of surfactant used) by routine experimentation.

As described above, when the pharmaceutical composition of the present invention is a composition for parenteral administration, the composition is preferably such that the pharmacokinetic profile of drospirenone is not required for the presence of a compound of estrogen to ensure the efficiency of contraception of the composition ≪ / RTI >

Thus, in a preferred embodiment, the parenteral composition of the present invention does not comprise estrogen and comprises a phytoestrogen. As used herein, the term "estrogen " refers to a compound such as phytoestrogen, mestranol, or phytoestrogen 8-prenylnaringenin that captures and activates an active estrogen receptor. That is, the DRSP is present as a parenteral composition without estrogen, i.e., the DRSP is not complexed with or associated with estrogen, as in the case of a combined oral formulation.

In some preferred embodiments, drospirenone is the sole active ingredient that can prevent pregnancy when administered to a single parenteral component comprising a parenteral composition, i. E., A female patient of age who may have a child.

However, in some specific embodiments of this alias, drospirenone may be mixed with one or more progestogens.

As used herein, the term " progestogen "refers to any compound that captures and activates progesterone receptors.

Progesterone is also known as 17-hydroxy progesterone ester, 19-nor-17-hydroxy progesterone ester, 17α-ethinyltestosterone ) And derivatives thereof, 17? -Ethinyl-19-nor-testosterone and derivatives thereof, norethindrone, norethindrone acetate norethindrone acetate, ethynodiol diacetate, dydrogesterone, medroxy-progesterone acetate, norethynodrel, allylestrenol, Lynoestrenol, fuingestanol acetate, medrogestone, norgestrienone, dimethiderome, ethisterone, and the like. Shif Acetic acid, cyproterone acetate, levonorgestrel, norgestrel, d-17? -Acetoxy-13? -Ethyl-17? -A-ethynyl- (4-en-3-one oxime), cyproterone acetate, gestodene, des gestrell but are not limited to, desogestrel, etonorgestrel, norgestimate, norelgestromin, chlormadione, and dienogest.

In some other embodiments, drospirenone may be mixed with an active ingredient that does not have one or more firming activity. Such active ingredients may include antiemetic ingredients, folic acid, vitamin B12, vitamin D, vitamins such as minerals, iron, iodine, selenium and the like, and the like. It is not limited.

The parenteral compositions of the present invention comprise an amount of drospirenone that is consistent with the daily dose that prevents pregnancy when the parenteral composition is administered to a female during a single treatment period of 21 to 28 days.

As described in Example 3 with respect to clinical studies, Applicants have found that oral administration of a single daily dose unit of a composition according to the present invention and 3 mg of DRSP comprises an average of a single dose of < RTI ID = 0.0 > showed that enables the value of the _tlast obtain a 368 ng * h / ml _-, average AUC _0h consistent with 88% of _{tlast -} AUC _0h.

In a preferred embodiment, the pharmaceutical composition of the present invention is a parenteral composition comprising drospirenone in an amount consistent with a daily dose of at least 2 mg of drospirenone. At least 2 mg of drospirenone comprises at least 3 mg of drospirenone, at least 3.5 mg of drospirenone, and at least 4 mg of drospirenone.

In some embodiments, the active daily dose unit comprising the parenteral composition described above may comprise an amount of DRSP in the range of about 2 mg to about 6 mg.

A daily dose ranging from about 2 mg to about 6 mg encompasses a daily dose of 2.0 mg, 2.5 mg, 3.0 mg, 3.5 mg, 4.0 mg, 4.5 mg, 5.0 mg, 5.5 mg and 6 mg.

In a preferred embodiment, the parenteral composition of the present invention comprises an amount of DRSP that is consistent with the daily dose that ensures ovulation inhibition when the parenteral composition is administered to a female during a single treatment period of 21 to 28 days.

Preferably, the daily dose of drospirenone ranges from about 3 mg to about 6 mg, more preferably from 3 mg to 4.5 mg. In some embodiments, the amount of drospirenone corresponds to a daily dose of about 4.0 mg.

However, the daily dose of drospirenone administered to a female patient in need of these can also be adjusted by individual factors such as the age, weight, general health, and diet of the female patient. The daily dose can also be varied depending on possible drug interactions. The daily dose may also be altered by additional biological effects rather than preventing pregnancy to be achieved through administration of DRSP.

The daily dose of drospirenone administered daily to a female patient may be lower or higher than the previously mentioned dose. For example, a premenopausal female patient may be required to raise or lower her daily dose of drospirenone to improve her general condition and, for example, her menstrual cycle regularly.

Adjustment of the daily dose can be generally determined by the practitioner.

In a preferred embodiment, the pharmaceutical compositions of the present invention may also comprise one or more pharmaceutically acceptable excipients.

The pharmaceutical composition of the present invention can be formulated according to standard methods as described in Remington: The Science and Practice of Pharmacy (Lippincott Williams &Wilkins; Twenty first Edition, 2005).

Pharmaceutically acceptable excipients that can be used to formulate the parenteral compositions of the present invention are described in particular in the Pharmaceutical Excipient Handbook, Pharmaceutical Press (6th Revised edition, 2009).

Examples of suitable excipients include fillers, carriers, diluents, binders, anti-caking agents, plasticizers, disintegrants, lubricants, and the like. Flavorings, buffering agents, stabilizers, colorants, dyes, anti-oxidants, anti-adherents, softeners, preservatives preservative, glidant, and the like.

In some embodiments, the parenteral composition of the present invention comprises one or more excipients selected from binders, fillers, lubricants and lubricants.

Examples of fillers are lactose anhydrous, microcrystalline cellulose, starch. Pregelatinized starch, modified starch, dibasic calcium phosphate dihydrate, calcium sulfate trihydrate, calcium sulfate dihydrate, calcium carbonate dihydrate, but are not limited to, calcium carbonate, lactose, dextrose, sucrose, mannitol and sorbitol, and combinations thereof.

Examples of lubricants include, but are not limited to, magnesium stearate, calcium stearate, zinc stearate, talc, propylene glycol, PEG, stearic acid, Vegetable oil, sodium benzoate, sodium lauryl sulfate, magnesium lauryl sulfate, mineral oil polyoxyethylene monostearate, and the like. And combinations thereof.

Examples of binders are, for example, potato starch, wheat starch, corn starch; Gums such as gum, gum tragacanth, acacia gum gelatin; Microcrystalline cellulose, hydroxypropyl cellulose, hydroxyethyl cellulose, and hydroxypropylmethyl cellulose; cellulose derivatives such as hydroxypropylmethylcellulose, hydroxypropylmethylcellulose, hydroxypropylmethylcellulose and hydroxypropylmethylcellulose; But are not limited to, polyvinyl pyrrolidone, and combinations thereof.

Examples of lubricants include silicon dioxide, magnesium trisilicate, powdered cellulose, starch, talc and tribasic calcium phosphate.

In a preferred embodiment, the pharmaceutical composition according to the invention does not comprise a significant content of surfactant. A significant amount of surfactant can impair the dissolution profile of DRSP in vitro by increasing its initial dissolution rate. Surfactants include nonionic surfactants such as polyoxyethylene sorbitan fatty acid esters and ionic surfactants such as sodium lauryl sulfate.

In some embodiments, the pharmaceutical composition of the present invention comprises drospirenone, at least one binder, and at least one filler,

Percentage by weight of the total composition

(i) the content of drospirenone in a weight of 1% to 10%

(ii) a content of at least one binder that occupies 50% to 65% by weight, and

(iii) a content of at least one filler that is 25% to 35% by weight

.

In some embodiments, the padding composition further comprises at least one lubricant and at least one lubricant,

Percentage by weight of the total composition

(iv) a content of at least one lubricant of from 0.2% to 6% by weight, and

(v) a content of at least one lubricant of 0.2% to 0.6% by weight

.

It is to be understood that the drospirenone used may be in the form of particles having a specific surface area and / or d90, d10 and d50 particle sizes well described herein.

The parenteral composition may optionally comprise additional excipients which can take up from about 0.1% to 10% by weight.

In some other embodiments, the parenteral composition of the present invention comprises drospirenone, at least one binder, at least one filler, at least one lubricant, and at least one lubricant,

(i) the at least one binder is selected from the group consisting of microcrystalline cellulose

(ii) at least one filler is anhydrous lactose

(iii) at least one lubricant is selected from the group consisting of silicon dioxide and

(iv) at least one lubricant is magnesium stearate.

The composition for parenteral administration according to the present invention may be formulated into a galenic form suitable for oral administration. Such forms include, but are not limited to, tablets, caplets, granules, pills, capsules, powders, and suspensions.

In a preferred embodiment, the parenteral compositions are formulated in solid form for oral administration such as tablets, capsules, granules, caplets and pills.

Such solid forms are particularly suitable when used as a daily active dose unit of a pacing kit according to the present invention.

When the pharmaceutical composition is formulated in the form of a solid such as tablets or pills, the solid form may be formulated with one or more of hydroxypropylmethylcellulose, hydroxypropyl cellulose or ethyl cellulose, For example, softeners such as glycerol, propylene glycol, diethylphthalate or glycerol triacetate, fillers such as sucrose, sorbitol, xylitol, glucoses and lactose, Dyes such as hydroxides, etc. may be coated with suitable film-forming components such as may optionally be added.

Pharmaceutical compositions in tablet, pill or granule form may be prepared by typical methods such as direct compression, dry granulation and wet granulation.

In some embodiments, the solid form is obtained by direct tabletting.

Another aspect of the present invention is to provide a method of making a composition for pliability comprising the steps described in the following.

(i) the step of providing drospirenone in the form of particles as previously described fully herein

(ii) providing one or more pharmaceutically acceptable excipients; And

(iii) mixing drospirenone provided in step (i) and one or more excipients provided in step (ii)

As fully described above, Applicants provide technical guidelines for obtaining a composition comprising a DRSP of the form below.

(i) less than 50% of the drospirenone initially present in the composition is dissolved within 30 minutes,

(ii) at least 50% of the drospirenone is dissolved over a period of time ranging from 3 hours to 4 hours.

Wherein when the composition is applied to an in vitro dissolution test, the percentage of drospirenone is a percentage of the initial amount of drospirenone present in the composition.

DRSP-containing compositions having a well-described in vitro dissolution profile or an in vivo pharmacokinetic profile as described above can also be obtained by a variety of other methods.

By way of routine experimentation and general knowledge, one of skill in the art will be able to determine the elution profile and in vivo pharmacokinetic profile in vitro as described in the present application and other alternative compositions (I) the particle size distribution of DRSP and (ii) the content and nature of excipients.

For example, a person skilled in the art can devise a composition containing (i) undrawn DRSP and (ii) a slow release component to reduce the dissolution rate of the DRSP.

Persons skilled in the art may also consider mixing (i) a large particle of DRSP with (ii) a surfactant and / or a wetting agent to ensure dissolution of the DRSP.

From a general point of view, non-micronized and essentially crystallized forms of DRSP are preferred for use in preparing the pharmaceutical compositions of the present invention.

2. Method of contraception

When administered orally, significantly improved the draw fluorenone RY to a similar AUC _[0h-tlast], characterized by a delay t _max and reduced C _max, when the pharmaceutical composition according to the invention compared to that obtained in Yasmin Elle ® Provide a pharmacokinetic profile.

In order to devise a birth control pill based on the above pharmaceutical composition, the presence of estrogen such as ethinyl estradiol or 8-prlenylgarginin is not necessary to ensure cycle stability and inhibition of ovulation.

In addition, such compositions are expected to be more reliable than the POPs described in the prior art.

The parenteral compositions of the present invention that do not contain estrogen are therefore particularly suitable for use as progestogen-only birth control pills.

Thus, it is the use of the pharmaceutical compositions described herein to prepare another progestogen-free preparation of the present invention or to provide a shunt kit.

Comprising administering to the female patient an active daily dosage unit consisting of a pharmaceutical composition as described herein fully described for a number of consecutive days, preferably for a period of from 21 to 28 days, to the women in need of the present invention And a method for oral contraception.

The contraceptive methods used here are related to how to prevent pregnancy. As used herein, "active daily dose unit" means a unit of dosage that can prevent pregnancy when it is daily administered to a female patient over a selected period of time from 21 to 28 consecutive days.

In a preferred embodiment, the active daily dose unit is able to inhibit ovulation when it is daily administered to a female patient for a selected period of time from 21 to 28 consecutive days.

The female patients used here refer to women of childbearing age, that is, from puberty to menopausal age. Women of childbearing age may also include women of peri-menopause.

In a preferred embodiment, the daily dose unit does not contain estrogen.

In some embodiments, drospirenone is the sole pesticide component included in the parenteral composition.

The contraceptive methods of the present invention can generally be performed for a period that coincides with the average length of the menstrual cycle, i.e., 28 days, and can be repeated for several successive months, even years.

In some embodiments, the method of contraception of the present invention consists of administering a daily dose of the invention "continuously ". This method does not include free-contraceptive, ie, the period during which the contraceptive is not administered.

In another embodiment, the method of contraception of the present invention comprises two successive phases.

The first period, the first period, is when the active daily dose unit of the invention, which does not contain estrogen, is administered to a female patient over a period of 21 to 27 consecutive days,

The second period, the second period, is the period during which the parenteral composition is not administered to a female patient during a continuous period of 1 to 7 days

The consecutive period of 1 to 7 days used herein is a period of 1 day, 2 consecutive days, 3 consecutive days, 4 consecutive days, 5 consecutive days, 6 consecutive days, 7 consecutive days .

The consecutive periods of 21 to 27 used here consist of a continuous period of 21 days, a continuous period of 22 days, a continuous period of 23 days, a continuous period of 24 days, a continuous period of 25 days, a continuous period of 26 days, Lt; / RTI >

As noted herein, the period of time plus the first and second periods is preferably 28 days.

In the first episode, the composition of the active daily dosage unit may be maintained, especially the daily dose of drospirenone.

In some other embodiments, the composition of the active daily dosage unit may be varied, in particular the daily dose of drospirenone.

The second period is the period of no-contraception, ie, the period during which the fecal component is not administered to a female patient. During this second period, the daily placebo dose unit may be administered to a female patient. In some other cases, the pill is not administered to the female patient.

The second period allows periodic menstrual bleeding to occur and therefore mimic the natural menstrual cycle.

In addition, it is believed that the second period may enable the secretion of endogenous estradiol, which may have some advantages in bone metabolism in female patients.

As used herein, an "active daily dose unit" refers to a unit suitably physically discrete as a single dose consisting of a composition for parenteral application as described hereinabove. As previously mentioned, the active daily dose unit generally comprises an amount of about 3.0 mg to about 6.0 mg, more preferably about 3.5 mg to 4.5 mg of drospirenone.

In some embodiments, the first period of the contraception method lasts from 21 to 24 consecutive days and the second period of contraception method lasts from 4 to 7 consecutive days.

In some embodiments, the first step of the contraception method lasts for 24 consecutive days, and the second step of contraception method continues for 4 consecutive days.

The contraceptive method of the present invention can provide high efficiency without the disadvantages found in progestogen-only contraceptive methods sold on the market such as cerazette® (i.e., spot bleeding, irregular menstrual flow ...).

The contraceptive method can show higher reliability than other progestogen-only contraceptive methods by allowing patients to follow less treatment (i.e., to miss the drug intermittently) without the risk of unwanted pregnancy 4)

The contraceptive method of the present invention is suitable for women who can have children.

The contraceptive method of the present invention is suitable for women whose health condition does not match the high peak of drospirenone plasma concentration. These women include, but are not limited to, subjects with kidney disease, women susceptible to hyperkalemia, and subjects who receive ancillary potassium sparing drug.

The method of contraception of the present invention is also particularly suitable for women who are not particularly recommended for administration of estrogen. These women include, but are not limited to, women who are vulnerable to cardiovascular disease, women who smoke, and women who breastfeed.

3. Protection Kit

The present invention also provides a purging kit based on the parenteral composition as fully described herein. Such kits are particularly suitable for use with contraceptive methods such as those described above.

The protection kit includes one or more packaging units. One or more packaging units include, but are not limited to, one packaging unit, two packaging units, three packaging units, four packaging units, five packaging units and six packaging units.

Each packaging unit contains 21 to 28 days of active dose units. As fully described above, each daily active dose unit consists of the parenteral composition of the present invention.

In some embodiments, the pacing kit comprises one or more packaging units, each packaging unit comprising a daily active dose unit for 21 to 28 days, and each said daily active dose unit is Non-micronized drospirenone.

When the daily active dose unit is tested in vitro for a dissolution test, the percentage of drospirenone associated with the initial amount of drospirenone present in the daily active dose unit is

(i) less than 50% of the nadrospirenone present in the beginning of the daily active dose unit is dissolved within 30 minutes,

(ii) at least 50% of the drospirenone is dissolved over a time range of 3 hours to 4 hours.

In another embodiment, the shampoo kit comprises one or more packaging units, each packaging unit comprising a daily active dose unit for 21 to 28 days, wherein the oral administration of the daily active dosage unit has the following characteristics: The pharmacokinetic profile of the DRSP is provided.

(i) an average t _max of at least about 2.2 hours and

(ii) an average C _{max of} at least about 30 ng / ml

In some embodiments, the oral administration of the daily active dose unit provides a pharmacokinetic profile characterized by an average AUC _{0h- tlast} of at least 300 ng * ml / h, more preferably at least 350 ng * ml / h.

As fully described above, the daily active dose unit preferably does not include any estrogen or estrogen derivative such as ethinyl estradiol, mestranol or 8-prenylnarginine. That is, preferably the DRSP is present in the daily active dose unit without estrogen.

In a more preferred embodiment, DRSP is the sole parenteral component contained in the daily active dose unit.

In some other embodiments, the shampoo kit comprises one or more packaging units, wherein the packaging unit comprises daily active dose units for 21 to 28 days,

(a) without estrogen, the amount of drospirenone in each daily active dose unit is at least 2 mg, and

(b) Oral administration of a daily active dose unit provides a pharmacokinetic profile of DRSP characterized by the following characteristics.

(I) an average t _max ranging from 2.2 hours to 6 hours and

(Ii) an average C _{max of} less than about 30 ng / ml

In another embodiment, the shim kit comprises one or more packaging units, wherein the packaging unit comprises daily active dose units for 21 to 28 days,

(a) without estrogen, the amount of drospirenone in each daily active dose unit is at least 2 mg, and

(b) each daily active dose unit comprises drospirenone in the following form:

The percent of drospirenone associated with the amount of drospirenone initially present in the daily active dose unit when the daily active dose unit was subjected to the in vitro dissolution test according to the USP XXIII paddle method

(i) less than 50% of the drospirenone initially present in the daily active dose unit is dissolved within 30 minutes,

(ii) at least 50% of said drospirenone is dissolved and tangled over a time range of 3 hours to 4 hours.

Each package unit optionally comprises a daily dose unit of 1 to 7 days of pharmaceutically acceptable placebo.

In some embodiments, the shampoo kit is characterized in that each packaging unit comprises a daily dosage unit of 28 days and does not include a daily dose unit of a pharmaceutically acceptable placebo. Such a pacing kit is particularly well suited to perform the contraceptive method of the present invention consisting of consecutively administering a DRSP without a no-contraception period (see paragraph 2 above).

In another embodiment, each package includes:

- an active daily dose unit of 21 to 27 days consisting of the parenteral composition well described in the present invention

- optionally a pharmaceutically acceptable < RTI ID = 0.0 > 1 -7 < / RTI >

Such a pacing kit is particularly suitable for carrying out a method of contraception comprising the following aspects of the present invention.

The first period, the active daily dose unit of the present invention, which does not contain estrogen, is administered to a female patient during a continuous day of 21 to 27 days,

- the second phase, the female patient is not administered the pacing composition over a period of 1 to 7 consecutive days.

In some other embodiments, each packaging unit of the kit comprises a 24-day dose unit comprising an effective content of the parenteral composition described herein, and optionally a 4-day dosage unit of a pharmaceutically acceptable placebo.

The packaging unit described above has one of the typical forms commonly used for oral contraceptives.

For example, the packaging unit may include a suitable number of dosage units packed with a suitable cover and sealed with a blister pack with a cardboard, paperboard, foil or plastic backing, Lt; RTI ID = 0.0 > blister pack. Each blister container can be numbered or displayed conveniently to facilitate compliance.

The packaging unit may optionally comprise at least 7 empty bottles, or 7 or fewer pharmaceutical quantities, starting with at least 21 dose units, including combinations of drospirenone, for their ingestion, And may include a daily dose unit of an acceptable placebo.

The kit of the present invention may comprise suitable configurations such as instructions for use.

The following embodiments are illustrative and are not intended to limit the scope of the claimed invention.

Example

Example 1 Preparation of Tablets

a. Preparation of Drospirenone

Drospirenone was prepared following a similar procedure to that described in WO2006 / 061309. In order to obtain a DRSP with an appropriate particle size distribution, the DRSP was subjected to an additional step of precipitation as described in this application.

Five batches of DRSP were prepared through a modification of the above-mentioned precipitation process.

Analysis of the distribution of particle sizes of each batch was performed by laser diffraction in wet dispersion (Helos sensor, Sympatec with the wet disperser Quixel). The dispersing agent was water. All particle dispersion was ensured by ultrasonication.

Table 1 : Particle size distribution parameters and specific area of DRSP batches

DRSP  arrangement PR100003 080169 080204 080257 080053 d50 (μ) 22.4 24.5 13.1 12.6  19.8 d 90 (μ) 37.4 37.1 24.8 23.4 34.2 d10 (mu) 5.9 2.9 4.4 5.3 7.2 d99 (μ) 56.1 48.9 34.5 35.3 44.8 Specific surface area (m ² / g) 0.26 0.45 0.83 0.77 0.63

The cumulative branching and probability density functions of the 080053 batch are shown in FIG.

b. Preparation of tablets according to the invention

The tablets were prepared by direct compession. The composition of the tablet is described below.

Table 2 : Composition of tablets (A-3 mg, experimental group)

matter mg / tablet (%) Drospirenone (batch 080053) 3.00 4.74 Microcrystalline cellulose 102 36.48 57.60 Anhydrous lactose DCL21 20.16 31.83 Silicon dioxide 3.36 5.31 Magnesium stearate 0.33 0.53 all 63.33 100.00

Example  2: In vitro dissolution profile

a. A-3 mg ( Experimental group )and Yasmin Ellr Comparison of ® (comparison group)

The dissolution rate of drospirenone from the tablet (A-3 mg) prepared in Example 1 was determined through the USP XXIII paddle method using a USP dissolution test apparatus 2 including six covered glass vessels and six paddles .

The tablets were placed in 900 ml of water at a temperature of 37 ° C ± (0.5 ° C) and stirred at 50 rpm. The amount of drospirenone released into water was measured over several hours. The average percentage of DRSP released (which was related to the amount of drospirenone initially present in each tablet) was calculated to provide a dissolution profile in vitro of DRSP and plotted with respect to time .

The elution profile in vitro of the A-3 mg tablet (experimental group) is shown in FIG. 2 (see n ° 2 curve).

Figure 2 also provides the dissolution profile obtained in Yasmine ELR® (comparison group) containing undifferentiated DRSP (see n ° 4 curve).

The initial dissolution rate of the tablets (A-3 mg) obtained in Example 1 was significantly reduced compared to the Yasmine El® tablets, since only about 22% of the DRSPs initially present in the tablet within 30 minutes were released Is almost 100%). The final elution percentage of DRSP from the tablets obtained in Example 1 was greater than 80%. This in vitro dissolution profile described in Example 3, Part 1 is associated with an improved pharmacokinetic profile as compared to Yasmin Ell®.

b. Example  Other in vitro dissolution profiles

Two different types of DRSP-containing tablets (comparative groups) were prepared to account for the association between elution profile of drospirenone and its pharmacokinetic profile in vitro in oral administration. The composition of this tablet is distinct from that of the A-3 mg tablet. Each tablet contains 3 mg of undifferentiated DRSP.

The first type of tablets (CO1-3 mg) provides rapid dissolution in vitro because about 60% of the DRSP present at the beginning of the tablet was released within 30 minutes according to the USP XXIII paddle method (n ° 3 in FIG. 2 Curve)

The second type of tablet (CO2-3mg) shows a very low dissolution rate of DRSP from the outside of the body. Less than 5% of the DRSP initially present in the tablet was released within 30 minutes and less than about 40% of the DRSP was eluted within 4 hours (see the n ° 1 curve in Figure 2)

Example  3: Pharmacokinetic study

Part 1 : Evaluation of the pharmacokinetic parameters of the composition according to the invention (A-3 mg) in comparison with yasmine elur®

goal:

Following the oral administration of a single dose of drospirenone 3.0 mg under fasting conditions during two different periods separated by a small 7-day interval, the main goal of the study was to compare the market standard (Yasmin El® Schering AG, (Hereinafter referred to as "test product") described in Example 1 obtained in batch 080053 (hereinafter referred to as " test product ") containing 3.0 mg of drospirenone To evaluate the utilization rate. Yasmin Ell® contains 3.0 mg of DRSP in undifferentiated form and 0.030 mg of ethinylestradiol.

To investigate the relative bioavailability of the product, the endpoint (endpoint) _- a 90% confidence (draw Sperry discuss AUC _{0 tlast} and C _max) within (intra-individual) ratios (see Test vs) Object of the period was determined.

The second objective of this study is to investigate the safety of both preparative substances based on safety clinical and laboratory tests (from the beginning to the end of the trial) and adverse events (adverse events) and / or registration of adverse drug reactions I was doing.

methodology:

The study was designed to provide healthy female volunteers with a monocentric, open, randomized, and non-irritable dose during a wash-out period of about 12 hours to 13 hours of hospitalization and 7 days after dosing on day 1 Randomized, single-dose, two-period crossover test.

Target (planned or analyzed):

- Planned for complete: 10

- Registered: 19

- only screened: 5

- Randomized: 14

- Drop-out: 0

- Completed as protocol: 14

- Data settings for pharmacokinetic analysis: 14

- Data settings for statistical analysis: 1

- Data settings for safety analysis: 14

Included  Diagnosis and main criteria for:

[1] Women of Caucasian origin

[2] Age between 18 and 40

[3] Physically and mentally healthy as judged by means of medical, stnadard laboratory and gynecological examination

[4] Since at least 6 months of non-aspiration (identified as urine cotinine test)

[5] Use of effective non-hormonal methods of contraception

List of allowed contraceptive methods

- Combination of two disability methods (female / male condoms, diaphragm, spermicide)

- Intrauterine devices (inactive Or copper release IUD)

- sterilization (presence of sterilization (female tubal occlusion)

Duration of treatment:

Each volunteer randomly received a single oral dose of one tablet of the test product or reference drug in two single occasions, always in a fasted state in any way. The two study periods were separated by at least 7 days of actual wash time.

Sampling time of blood in each study period:

Pre-dose, with separation of plasma, and after administration, 0:30, 1:00, 1:30, 2:00, 3:00, 4:00, 5:00, 6:00, 8 : 00, 12:00, 24:00, 48:00 and 72:00

For each endpoint, quantification of plasma DRSP was performed according to the assay methodology as adapted in Kirk et al., Rapid Communications in mass Spectrometry, 2006, 20: 1247-1252.

Briefly, drospirenone was solid-phase extracted from an HLB 60 mg oasis cartridge in human EDTA plasma, after which it was derivatized with a Girard-P solution and then injected into liquid chromatography with a direct mass spectrometry instrument . This method enables the determination of drospirenone in human EDTA plasma in the range of 0.25 to 100.40 ng / mL.

Criteria for evaluation:

Pharmacokinetics:

Initial endpoint: AUC _{0 - tlast} and C _{max of drospirenone}

Second end point: t _{max of} drospirenone

Additional Endpoints: Not Planned

safety

Adverse events, clinical and experimental screening parameters

Statistical methods:

Pharmacokinetic End point  relation

● Parametric method of AUC _{0 - tlast} and C _max of _drospirenone (ANOVA-log)

● covariates in the model: order, treatment, duration, order within the applicant

● Non-parametric method of t _max of drospirenone (Hauschke et al. 1990

● 90% confidence interval of AUC _{0 - tlast} and C _max ratios of _drospirenone (see test vs.)

Safety assessment related

● descriptive statistical evaluation alone.

Bioavailability:

The 90% confidence interval of the log-transformed value is the test of the AUC _{0 -tlast} and C _max of _{drosparennone} vs.. The individual-to-total ratios of the references were calculated, then only interpreted in a narrative way, and each parameter (CPMP / EWP / QWP / 1401), such as the current study (not having the purpose of establishing bioequivalence) / 98, July 2001). The difference in t _max (test - see), the 90% confidence interval of the person - to - person ratio was calculated and assessed descriptively.

result

Pharmacokinetics:

All 14 volunteers completed the protocol-specific tests. A sample of 14 volunteers was analyzed and 14 volunteers received a statistical evaluation. To 14 volunteers with pharmacokinetic and statistical evaluations, one tablet of test drug (= drospirenone 3.0 mg) or one film-coated tablet of reference product (= 0.3 mg / 3 mg of thienyl estradiol and drospirenone ) Is summarized in Table 3 below. ≪ tb > < TABLE > Id = Table 3 Columns = 2 < tb >

Table 3: Pharmacokinetic endpoints (first, second, and additional) of drospirenone in the test product (test) and reference product (reference)

Test (N = 14) variable Geometric mean (geom.mean) Arithmetic mean (arithm.mean) SD CV Range Median AUC0-tlast [ng * h / mL] 360.96 368.55 75.83 20.6 234.72 - 482.91 359.33 AUC0-inf [ng * h / mL] 452.93 462.00 93.26 20.2 312.60 - 624.12 463.65 AUCres [%] 19.12 20.04 6.62 33.0 12.13 - 33.70 17.70 Cmax [ng / mL] 16.46 17.36 5.50 31.6 6.39 - 27.79 17.41 tmax - 3.57 1.01 28.3 2.00 - 5.00 3.50 MRT [h] - 44.08 9.69 22.0 33.64 - 64.18 40.89 t ^1/2 [h] - 31.87 6.29 19.7 24.59 - 44.43 29.42 Reference (N = 14) variable Geometric mean (geom.mean) Arithmetic mean (arithm.mean) SD CV Range Median AUC0-tlast [ng * h / mL] 414.60 418.58 60.46 14.4 337.80 - 527.81 397.70 AUC0-inf [ng * h / mL] 503.65 509.25 77.76 15.3 386.08 - 654.48 510.74 AUCres [%] 17.12 17.58 4.18 23.8 11.19 - 27.61 18.47 Cmax [ng / mL] 34.91 35.43 6.32 17.8 24.30 - 45.96 35.24 tmax - 1.57 0.55 35.0 1.00 - 3.00 1.50 MRT [h] - 38.81 6.45 16.6 29.68 - 56.00 39.39 t ^1/2 [h] - 29.78 4.41 14.8 25.21 - 43.30 28.47

The 90% confidence intervals of the AUC _{0 -tlast} and C _{max intracutual} ratios (test / reference) of drospirenone as well as the difference in t _max of drospirenone (test-see) are shown in Table 4 below.

Table 4: 90% confidence intervals of drospirenone

variable Point estimator Confidence limits *** ANOVA -log ( % ) AUC0-tlast (test / reference rate) 0.8706 * 0.8081 - 0.9380 * 11.1% Cmax (test / reference ratio) 0.4715 * 0.3930 - 0.5658 * 27.6% tmax [h] (test / reference difference) 1.7650 ** 1.5000 - 2.5000 ** - *: The parametric confidence interval
**: Non-parametric confidence interval
***: 14 volunteers for statistical evaluation

The concentration-time curve of drospirenone after administration of one tablet of the test agent and a single oral dose of the tablet of the reference product is shown in Figure 3a (arithmetic mean) for the two drugs.

The first end point of the AUC ₀ fluorenone draw _RY-tlast and bioavailability assessment of the C _max was the basis of the parametric methods (ANOVA-log).

ANOVA-log for the first end point by means, AUC _0-tlast object of the 90% confidence interval of the ratio within the (T / R) was between 0.8081 and 0.9380. The 90% confidence interval of the intrinsic ratio (T / R) of the C _max of the second endpoint drospirenone calculated by the ANOVA-log means was between 0.3930 and 0.5658.

90% of the individual-within-the-t _max of the confidence interval were associated with the second endpoint of 1.5000 and 2.5000 hrs. The point estimate of the difference in t _max of drospirenone was 106 min (the highest concentration observed after administration of the test agent)

It is well known in the art that drospirenone is isomerized in an inert isomeric form, including acidic conditions, such as when it is in contact with human beings, under biologically acidic conditions.

In carrying out this pharmacokinetic study, analyzes are being conducted to find the final presence of an inactive isomer of drospirenone in the plasma of the treated woman. The results show that the amount of the inactive isomer of drospirenone in clinically tested plasma samples collected in female subjects was below the detectable level (< 1 ng / ml), indicating that the pharmaceutical composition being used was a complete Quot; means that the content is adjusted to release into the target organ in a biologically active form.

safety:

Test formulations and reference drugs were well tolerated. Seventeen non-serious adverse events (AEs) were enrolled in 11 subjects during the course of the study.

After the administration of the test product, nine adverse events (AEs) were found in eight subjects.

• After the administration of the reference drug, eight adverse events (AEs) were found in seven subjects.

All adverse events were evaluated as not serious. All adverse events were evaluated by investigators. All AEs were completely resolved in a relatively short time. Experimental results did not show any evidence of adverse events or adverse drug reactions.

result

AUC ₀ Lennon draw RY _- based on _tlast, absorption range of the test product were similar to the absorption range of the reference product, the water absorption was characterized by the increase in t _max is significantly delayed and reduced C _max. The resistance of the test product and the reference product was comparable.

Part 2 : Yasmin Ellr Evaluation of other comparative tablets of CO1-3 mg and CO2-mg compared to

The main goal of this second study is to demonstrate the association between the in vitro dissolution profiles and pharmacokinetic parameters of oral tablets containing DRSP.

Oral test tablets each showed fast in vitro dissolution rates of DRSP or very low DRSP-3 mg of tablets showing a dissolution rate of DRSP and -3 mg of purified CO2 (see Example 2b).

The reference product was YASMIN ELLE®. The methodology of the second test is similar to that of the method described in Part 1 above.

Bioavailability of the two oral test agents (ie, CO 1-3 mg and CO 2 -3 mg) (JASMINELLE, Schering AG) as compared to the drug, which is a brief market standard, was measured under fasting conditions during three separate periods at 7 day intervals Was assessed following oral administration of a single tablet in each case (consistent with 3 mg of DRPS). To investigate the relative bioavailability of the product, a 90% confidence level of the endogenous (AUC _0-tlast and C _{max of drospirenone} ) intracellular ratios (CO 1-3 mg vs. reference material and CO 2 -3 mg vs. reference material) Section.

The study was conducted in a hospital setting for about 12 hours to 13 hours after taking the drug, and was administered to healthy female volunteers as monocentric, open, randomized, single-dose, - three-period crossover test.

Each volunteer received an oral single dose of 3.0 mg drospirenone in three single cases under fasting conditions in a random fashion (one test tablet COl -3 mg or one test tablet CO2-3 mg or one of the films of Yasmine ELR® - one of the coated tablets)

The three study periods were separated into actual wash periods between 7 and 10 days.

Target (planned or analyzed):

- Planned for perfection: 10

- Registered: 18

- only selected: 4

- Randomized: 14

- Drop-out: 0

- Completed as protocol: 14

- Data settings for pharmacokinetic analysis: 14

- Data settings for statistical analysis: 14

- Data settings for safety analysis: 14

result

The concentration-time curves of drospirenone after administration of a single oral dose of one tablet of each product (i.e., CO 1-3 mg, CO 2 -3 mg and yasmine elu) can be seen in Figure 3b (arithmetic mean)

To remind again, CO 1-3 mg showed a fast dissolution rate in vitro (60% in about 30 minutes). As expected, the pharmacokinetic profiles obtained at CO 1-3 mg are very similar to the C _max predicted at Yasmine Ele ®. Interestingly, the average C _max of CO 1-3 mg was 30 ng / ml versus 36 ng / ml for yasmine elur ®. AUC _{0h - tlast} of _{CO 1-3 mg} (410.58 ng * h / ml vs. 440.14 ng * h / ml).

On the other hand, CO2-3 mg shows a very slow dissolution rate of DRSP from the outside of the body because less than 5% of the DRSP present in the initial stage of purification is released within 30 minutes and less than 40% of the DRSP is dissolved in 4 hours. As expected, the composition shows a reduced C _max and a delayed t _max as compared to Yasmine El®. However, the average AUC of the composition was low. These compositions are not suitable for use as progestogen-only preparations because they show low birth controllability.

This pharmacokinetic outcome, along with the in vivo outcome described in Example 2, illustrates the relationship between the in vitro dissolution rate of DRSP and its pharmacokinetic profile (particularly C _max and t _max ) when orally administered.

Example 4: Simulation curve based on experimental data obtained from the clinical trial described in Example 3, Part 1

The DRSP mean plasma concentration versus time curve, as predicted from the oral administration of tablets containing 4 mg of DRSP as described in Table 2, from the DRSP from batch 80053, shows that the experimental data obtained in the clinical trial described in Example 3, And was assumed to be proportional to the amount administered orally.

The purification curve results of A-4 mg are shown in Figures 3a and 4a as compared to Yasmin Ell® and the A-3 mg tablet described in Table 2. [

As described in Figures 4A and 4B, the increase in the DRSP content of 3 mg to 4 mg in the tablets described in Table 2 is not expected to alter the t _max which causes significant retardation when compared to Yasmin Ell®. _Cmax is expected to increase, but is expected to remain significantly lower than Yasminimel® (less than 60% of Yasminimel®). Interestingly, the mean plasma concentration is expected to be higher after the concentration peak than Yasmine EL ®.

Figure 4c shows the results of repeated administration of one Yasmine ELLE® tablet (curve n ° 1), one A-3 mg tablet (curve n ° 3) and one A-4 mg tablet (curve n ° 2) every 24 hours 0.0 &gt; DRSP &lt; / RTI &gt;

The curves obtained in the compositions of the present invention (i.e., curves n ° 3 and n ° 2) show a small difference between the mean C _max and the mean C _min , relative to the Yasmine El® composition. It is anticipated that repeated administration of the compositions of the present invention will therefore provide a more stable DRSP plasma concentration with a lower _Cmax than Yasmine ELR. This fact is expected to improve the menstrual profile and reduce side effects when the compositions of the present invention are used as birth control pills.

It should be emphasized that in the case of tablet A-4 mg, the mean plasma concentration is expected to be higher than that obtained with yasmine elle during the period of time between t _max and the next tablet ingestion, which provides higher contraceptive credibility.

Therefore, Tablet A-4mg is expected to be suitable for use as progestogen-alone formulation.

Example  5: Another composition of the composition according to the invention Example

chapter 1 : Ex vivo dissolution profile

Tablets (B-4 mg) were prepared as described in Example 1 of DRSP batch N ° PR100003. Each tablet contains 4.0 mg of DRSP and contains excipients similar to those described in Example 1. Tablets (B-4 mg) were also coated with the appropriate film-forming ingredients as described in the specification.

The elution test was carried out in vitro as described in Example 2 for the purification results. The average dissolution profiles in vitro of the tablets are shown in Figure 5a.

The initial dissolution rate of DRSP was significantly reduced when compared to Yasmine ELLE®, since only about 22% of the DRSP present at the beginning of the purification is released in 30 minutes.

However, about 66% and about 77% of the DRSP present in the beginning of the tablet are released within 4 hours and 6 hours, respectively.

The in vitro dissolution profile of tablets B-4 mg is similar to that of A-3 mg tablets (see Example 1). This fact explains that if the DRSP exhibits the appropriate d50, d90 and d10, the specific surface area of the DRPS does not significantly impair the ex vivo dissolution.

Part 2 : Evaluation of the pharmacokinetic parameters of the composition according to the invention (Tablet B-4 mg) compared to Yasmin Ell®

a. methodology

The pharmacokinetic profile of Tablet B-4 mg was determined as described in Example 1, Part 1.

Briefly, the bioavailability of the test agent (i.e., B-4mg) compared to the market standard (JASMINELLE, Schering AG) was determined by oral administration of a single tablet in each case under fasting conditions for three different periods at 7 day intervals .

Oral dosing of DRSP was with Yaskinel® 3 mg versus B-4 mg (experimental group).

To investigate the relative bioavailability of the product, a 90% confidence interval of the endogenous endpoint (AUC _0- tlast and C _max of drospirenone) was determined to be 90% confidence interval (B-4 mg vs. yasmine elu).

The study was conducted in a hospital setting for about 12 hours to 13 hours after taking the drug, and was administered to healthy female volunteers as monocentric, open, randomized, single-dose, - three-period cross-over test

Each volunteer received a single oral dose of drospirenone in two single cases under fasting conditions in a random fashion (one test tablet B-4 mg or one yasmine elur®)

Two study periods were separated into actual wash periods between 7 and 10 days.

Target (planned or analyzed):

- Planned for perfection: 10

- Registered: 15

- only selected: 5

- Randomized: 10

- Drop-out: 0

- Completed as protocol: 10

- Data settings for pharmacokinetic analysis: 10

- Data settings for statistical analysis: 10

- Data settings for safety analysis: 10

b. result

Yasmine El ® and the test product were well tolerated by all patients.

The concentration-time curve of drospirenone after single oral administration of each product (i.e., tablet B-4 mg and yasmine elu) is shown in Figure 5b (arithmetic mean). The results of this test are also shown in Table 5 below.

Table 5: Pharmacokinetic endpoints of Drospinone in tablets B-4 mg (test) and Yasmin Ell® (see)

Test (N = 10) variable Geometric mean Arithmetic mean SD CV range median AUC0-tlast [ng * h / mL] 428.07 438.85 104.53 23.8 320.74 - 634.58 419.05 Cmax [ng / mL] 18.96 19.81 6.14 31.0 12.42 - 30.17 19.40 tmax [h] - 3.900 0.876 22.5 3.000 - 5.000 4.000 Reference (N = 10) variable Geometric mean Arithmetic mean SD CV range median AUC0-tlast [ng * h / mL] 386.68 394.88 90.22 22.8 217.57 - 615.65 391.49 Cmax [ngh / mL] 32.52 32.85 4.85 14.8 23.97 - 42.80 33.39 tmax [h] - 1.700 0.979 54.1 1.000 - 4.000 1.500

The pharmacokinetic profile of DRSP obtained after oral administration of the B-4 mg tablet was associated with the expected pharmacokinetic profile of DRSP based on the simulation (see Example 4).

As expected, the mean t _max of tablets B-4 mg was significantly delayed (3.9 hours versus 1.7 hours) as compared to Yasmin Ell®. In addition, the mean _Cmax obtained from tablets B-4mg was significantly lower than that of yasmine elu (19.8 vs. 32.9 ng * h / ml)

The mean _Cmax of tablets B-4mg was consistent with about 58% of yasmine els, whereas the mean _Cmax of A-3mg in Example 1 was consistent with 49% of yasmine els: an increase in DRSP dose in tablets Did not induce a significant change in the mean C _max value.

On the other hand, since the mean AUC _{0h - tlast} of tablets B-4mg was 111% of _{yasmine elu,} the increase in the DRSP dose was significantly higher than the mean AUC _{0h - tlast} . In Example 1, Tablets A-3 mg of mean AUC _{0h - tlast} Was only 86% of Yasmine Elle®.

That is, the present results clearly show that the composition according to the present invention allows a high average AUC _{0h - tlast} to be obtained with a low average C _max and a delayed average t _max value of DRSP as compared to Yasmine _EL® .

Repeated administration of purified B-4 mg every 24 hours naturally provides a DRSP plasma concentration profile similar to that expected in Tablet A-4 mg (see curve n ° 2 in Figure 4C).

As a result, it can be considered to be suitable for use as a contraceptive-only preparation, such as the pharmaceutical tablet of the present invention, Tablet A-4mg and Tablet B-4mg. These birth control pills have good tolerance, It is expected to suppress the occurrence of side effects related to plasma concentration.

Part 3 : Evaluation of contraceptive efficacy of pharmaceutical compositions according to the invention

It is described that the pill regimen according to the present invention, which comprises the small DRSP of the present study as a sole contraceptive component and administered in a 24/4 regimen, makes it possible to inhibit ovulation even when the formulation is delayed intermittently.

Contraceptive preparations consist of 24 tablets of B-4mg as defined in Example 5, Part 2 above and 4 placebo tablets.

a. methodology

This study was an open-label single center test.

Subjects who were eligible for this study were 20-30 years of age, had a body mass index <30 kg / m ² , had a regular menstrual cycle (at least 4 regular cycles during the past 6 months) Were used. (Suspected) pregnancy, active or past thromboembolic disorder, current or past severe hepatic disease, carcinoma of the endometrium, estrogen-dependent disease, Subjects who were diagnosed with vaginal bleeding, enzyme-inducing drugs, and other drugs that were suspected or otherwise known to be suspected of being neoplasia were excluded.

The total number of women enrolled in this study was 20, and 2 treatments and 2 follow-up cycles were performed.

Table 6: Parameters of Registered Patients

age Weight (kg) BMI (Kg / m ² ) Systolic blood pressure (mmHg) Olic blood pressure (mmHg) Heart rate (beats / mm) Mean ± SD
(Mean 占 Std dev) 24.6 ± 2.4 60.28 + - 7.95 22.76 3.19 110.3 + - 10.3 64.1 ± 7.0 65.4 ± 5.7 median 24.5 59.1 22.39 115.0 62.5 64.0 maximum minimum 20; 29 50.0; 79.2 18.1; 30.0 90; 120 50; 80 58; 80

Subjects were treated daily with tablets containing 4 mg of DRSP in a 24/4 regimen for two cycles. After a screening visit, subjects began treatment on the first day of the cycle (ie the first day of the onset of vaginal bleeding). Subjects were fed a single tablet of DRSP 4 mg at a fixed time from day 1 to day 24 of the treatment cycle, taking placebo tablets at a fixed time from day 25 to day 28 of the treatment cycle, and at day 5 of the second cycle And the 13th day. On these two days, the tablet intake was delayed by 24 hours (ie, the tablets were not taken on days 5 and 13 and two tablets were taken on days 6 and 15, respectively). Complete study consisted of a 56-day treatment period and a follow-up period after 28 days treatment. After obtaining prior consent, subjects were subjected to gynecological and general medical tests, 12-lead ECG, hematology, biochemistry and urinalysis laboratory tests. After adherence to eligibility criteria was confirmed and the urine pregnancy test performed a negative result on the first day of vaginal bleeding, the subject was included in the study and study treatment was initiated.

Blood sampling of hormone crystals (progesterone, 17-beta-estradiol, FSH and LH) was performed every 3 days for 1 to 84 days and weight, blood pressure, and heart rate were evaluated every visit. Serum progesterone, 17-beta-estradiol, FSH and LH concentrations were measured using an approved commercial in vitro diagnostic kit (VlDAS, ELFA Biomerieux). Internal adjustments were included in each set of samples.

Two urine pregnancy tests were performed during the study.

■ On the first day of the first cycle to confirm the exclusion criteria for "pregnant women" just prior to initiating the study: subjects were excluded if they were positive in this test.

■ On the 7th day of the follow-up cycle

The occurrence of ovulation during treatment was determined on the basis of serum progesterone concentration using the criteria of Landgren et al. Therefore, ovulation was judged to occur when the progesterone concentration > 5.04 ng / ml was maintained in at least two consecutive progesterone samples.

b. result

Figures 6a and 6b graphically show the respective values of plasma progesterone level and plasma estradiol level, respectively.

For all women, systematically the level of progesterone levels was lower than 5.04 ng / ml for all treatment periods (including the placebo period). The highest value of progesterone was observed only once in women (including the placebo period) during treatment and 3 ng / ml for single women.

These results show that during 2 cycles, ovulation did not occur. Conversely, during a 28-day follow-up cycle, when there is discontinuation of treatment, the progestogen level improves to 5.04 ng / ml or higher in 17 out of 20, indicating that ovulation returns. The minimum time for the first level of progestogen to be above 5.04 ng / ml was 15 days after the placebo purification.

During the second cycle of treatment, the level of the average estradiol was significantly lower than the value measured during subsequent cycles.

Significantly, the secretion of estradiol is not completely inhibited during the treatment period.

In conclusion, this data confirms that the composition of the present invention provides reliable ovulation inhibition even when a placebo period is present when 24/4 therapy is used as a POP.

From the standpoint of such experimental data, it is expected that the single-progestogen contraceptive of the present invention exhibits similar reliability and efficacy as traditional combination preparations such as Yasmin®, while having small side effects on the cardiovascular system.

Example  6: Another according to the present invention Example  Furtherance

Tablets (C-4 mg) containing 4 mg of drospirenone were prepared by direct tabletting. The adjustment of the tablet is as described below.

Table 7: Composition of tablets (C-4 mg, experimental group)

matter mg / tablet Drospirenone (PR100311) 4.00 Microcrystalline cellulose PH102 33.02 Anhydrous lactose PS = 20%, <45 μm 17.50 Silicon dioxide 0.29 Magnesium stearate 0.33 Coating (Opadry II 85F18422 white) 1.65 TOTAL 56.75

The DRSP batch PR100311 is characterized by a specific surface area of 0.66 m ² / g.

The in vitro dissolution rate and pharmacokinetic parameters of these tablets were determined as described in Example 2 and Example 3, respectively.

Table 8: Pharmacokinetic profile of DRSP dissolution rate and DRSP in vitro of purified C-4mg

Ex vivo excretion % Of DRSP dissolved within 30 min. 45.8 % Of DRSP dissolved within 4 hours &lt; RTI ID = 0.0 &gt; 88.3 Pharmacokinetics Mean C _max (ng / ml) 26 The average t _max (h) 3.6 Mean AUC _{0 - tlast} (ng * h / mL) 643

Claims (16)

A pacing kit comprising one or more packaging units,
Wherein each said packaging unit comprises a daily active dosage unit of from 21 to 28 days,
(a) each daily active dose unit comprises drospirenone in an amount of at least 2 mg, without estrogen, and
(b) when administered orally to a fasted state, the single daily active dose unit is adjusted to provide a pharmacokinetic profile of drospirenone having the following characteristics:
(I) an average t _{max in} the range of 2.2 h to 6 h and
(Ii) an average C _{max of} less than about 30 ng / ml. The method according to claim 1,
Wherein the pharmacokinetic profile of drospirenone has an AUC0 _h-tlast of at least 300 ng.h / ml, preferably at least 350 ng.h / ml. 4. The method according to any one of claims 1 to 3,
_Wherein the average _Cmax is from 15 ng / ml to 30 ng / ml. A pacing kit comprising one or more packaging units,
Wherein each said packaging unit comprises between 21 and 28 days of daily active dose units,
(a) the content of drospirenone in each daily active dose unit is at least 2 mg without estrogen,
(b) each daily active dose unit comprises a drospirenone of the following form:
(I) less than 50% of the drospirenone initially present in the daily active dose unit is dissolved within 30 minutes
(Ii) at least 50% of the drospirenone is dissolved over a time range of 3 hours to 4 hours,
Wherein when the daily active dose unit is applied to an in vitro dissolution test according to the USP XXIII paddle method, the percentage of drospirenone is a percentage of the amount of drospirenone initially present in the daily active dose unit . 5. The method according to any one of claims 1 to 4,
Wherein the drospirenone is a sole contraceptive component. 6. The method according to any one of claims 1 to 5,
Wherein the drospirenone content in each daily active dose unit is in the range of from about 2.0 mg to about 6.0 mg, preferably from about 3.0 mg to about 4.5 mg. 7. The method according to any one of claims 1 to 6,
Wherein said one or more packaging units further comprise a daily dose unit of 1 to 7 days of pharmaceutically acceptable placebo. 8. The method according to any one of claims 1 to 7,
Wherein each of the packaging units comprises a daily active dose unit of 24 days. 9. The method of claim 8,
And a daily placebo dose unit of 4 days. A method of contraception for a female patient in need of contraception,
Comprising administering to said female patient an active daily dose unit as defined in any one of claims 1 to 9 for a period of 21 to 28 consecutive days. 11. The method of claim 10,
Contraceptive methods that involve two phases:
The first time the active daily dose unit is administered to the female patient for a continuous period of 21 to 27 days,
- a second period when the contraceptive is not administered to the female patient during a continuous period of 1 to 7 days. 12. The method of claim 11,
RTI ID = 0.0 &gt; 1, &lt; / RTI &gt; wherein the daily placebo dose unit is administered during said second period. 13. The method according to claim 11 or 12,
Wherein said first period lasts for 24 consecutive days and said second period lasts for 4 consecutive days. A pharmaceutical composition for contraceptive use for female patients comprising drospirenone and requiring contraception,
(a) the daily active dose unit of the composition comprises, without estrogen, at least 2 mg of drospirenone,
(b) when administered orally in a fasted state, said single daily active dose unit is adapted to provide a pharmacokinetic profile of drospirenone having the following characteristics:
(I) an average t _{max in} the range of 2.2 h to 6 h and
(Ii) an average C _{max of} less than about 30 ng / ml. A pharmaceutical composition for contraceptive use for female patients comprising drospirenone and requiring contraception,
(a) the daily active dose unit of the composition comprises, without estrogen, at least 2 mg of drospirenone,
(b) the daily active dose unit comprises a drospirenone of the following form:
(I) less than 50% of the drospirenone initially present in the daily active dose unit is dissolved within 30 minutes
(Ii) at least 50% of the drospirenone is dissolved over a time range of 3 hours to 4 hours,
Wherein when the daily active dose unit is applied to an in vitro dissolution test according to the USP XXIII paddle method, the percentage of drospirenone is a percentage of the amount of drospirenone initially present in the daily active dose unit . 16. The method according to claim 14 or 15,
Wherein the daily dose unit of the composition is administered as defined in any one of claims 10 to 13.

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