US20050048123A1 - In situ gelling drug delivery system - Google Patents

In situ gelling drug delivery system Download PDF

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US20050048123A1
US20050048123A1 US10/877,758 US87775804A US2005048123A1 US 20050048123 A1 US20050048123 A1 US 20050048123A1 US 87775804 A US87775804 A US 87775804A US 2005048123 A1 US2005048123 A1 US 2005048123A1
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drug
plga
drug substance
polyethylene glycol
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Dongling Su
Paul Ashton
Jianbing Chen
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Eyepoint Pharmaceuticals Inc
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Control Delivery Systems Inc
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Priority to US10/877,758 priority Critical patent/US20050048123A1/en
Assigned to CONTROL DELIVERY SYSTEMS, INC. reassignment CONTROL DELIVERY SYSTEMS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: ASHTON, PAUL, CHEN, JIANBING, SU, DONGLING
Publication of US20050048123A1 publication Critical patent/US20050048123A1/en
Assigned to PSIVIDA INC. reassignment PSIVIDA INC. MERGER (SEE DOCUMENT FOR DETAILS). Assignors: CONTROL DELIVERY SYSTEMS, INC.
Priority to US12/870,616 priority patent/US20110165242A1/en
Priority to US13/612,076 priority patent/US20130101656A1/en
Priority to US14/444,338 priority patent/US9566336B2/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/34Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/185Acids; Anhydrides, halides or salts thereof, e.g. sulfur acids, imidic, hydrazonic or hydroximic acids
    • A61K31/19Carboxylic acids, e.g. valproic acid
    • A61K31/195Carboxylic acids, e.g. valproic acid having an amino group
    • A61K31/196Carboxylic acids, e.g. valproic acid having an amino group the amino group being directly attached to a ring, e.g. anthranilic acid, mefenamic acid, diclofenac, chlorambucil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K31/33Heterocyclic compounds
    • A61K31/38Heterocyclic compounds having sulfur as a ring hetero atom
    • A61K31/382Heterocyclic compounds having sulfur as a ring hetero atom having six-membered rings, e.g. thioxanthenes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/435Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with one nitrogen as the only ring hetero atom
    • A61K31/47Quinolines; Isoquinolines
    • A61K31/485Morphinan derivatives, e.g. morphine, codeine
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    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/54Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame
    • A61K31/542Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one sulfur as the ring hetero atoms, e.g. sulthiame ortho- or peri-condensed with heterocyclic ring systems
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    • A61K47/50Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/54Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound
    • A61K47/55Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic compound the modifying agent being also a pharmacologically or therapeutically active agent, i.e. the entire conjugate being a codrug, i.e. a dimer, oligomer or polymer of pharmacologically or therapeutically active compounds
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    • A61K47/50Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/56Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule
    • A61K47/59Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyureas or polyurethanes
    • A61K47/60Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being an organic macromolecular compound, e.g. an oligomeric, polymeric or dendrimeric molecule obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyureas or polyurethanes the organic macromolecular compound being a polyoxyalkylene oligomer, polymer or dendrimer, e.g. PEG, PPG, PEO or polyglycerol
    • AHUMAN NECESSITIES
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    • A61K47/50Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/69Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
    • A61K47/6903Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being semi-solid, e.g. an ointment, a gel, a hydrogel or a solidifying gel
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0019Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A61K9/0024Solid, semi-solid or solidifying implants, which are implanted or injected in body tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0048Eye, e.g. artificial tears
    • A61K9/0051Ocular inserts, ocular implants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0087Galenical forms not covered by A61K9/02 - A61K9/7023
    • A61K9/0092Hollow drug-filled fibres, tubes of the core-shell type, coated fibres, coated rods, microtubules or nanotubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/06Ointments; Bases therefor; Other semi-solid forms, e.g. creams, sticks, gels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P25/00Drugs for disorders of the nervous system
    • A61P25/04Centrally acting analgesics, e.g. opioids
    • AHUMAN NECESSITIES
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    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the present invention relates to the field of controlled-release and sustained-release drug delivery systems, and particularly to the field of injectable drug delivery implants.
  • the product can be implanted directly at the site where drug action is needed and hence systemic exposure of the drug can be reduced. This becomes especially important for toxic drugs which are related to various systemic side effects (such as the chemotherapeutic drugs).
  • the polymer matrix protects the drug from the physiological environment, particularly circulating enzymes, thereby improving stability in vivo. This makes the technology particularly attractive for the delivery of labile proteins and peptides.
  • One class of existing implants consists of preformed devices, ranging in size from matchstick-sized cylindrical rods such as the NorplantTM (levonorgestrel) and ZoladexTM (goserelin acetate) implants, to microspheres such as are sold under the trade name Lupron DepotTM (leuprolide acetate).
  • a major disadvantage of the macroscopic devices is their physical size. Implantation of ZoladexTM rods, for instance, requires the use of 14- or 16-gauge needles, and implantation of NorplantTM rods requires a surgical incision under local anesthesia, with similar subsequent procedures to replace and/or remove them. (The ZoladexTM rods are bioerodable, whereas NorplantTM implants are based on a non-bioerodable silicone.) Self-administration of such implants is not feasible, and the required intervention of trained medical personnel greatly raises the cost and inconvenience of such treatments.
  • Drug-containing polymer implants have been reduced in size by the expedient of grinding or milling a mixture of a drug substance and a gel-forming polymer at low temperature, as described in U.S. Pat. No. 5,385,738.
  • the resulting powder is then suspended in a non-aqueous viscous solvent, such polyethylene glycol or a biocompatible oil, to obtain an injectable composition.
  • microsphere implants which can be administered (and self-administered where appropriate) by injection of an aqueous suspension of the microspheres.
  • Lupron DepotTM for example, can be comfortably injected with a 22- or 23-gauge needle.
  • microspheres are not retrievable from the body, they are necessarily based on bioerodable polymers.
  • an aqueous suspension of microspheres is stored for any length of time, the drug will diffuse from the particles into the aqueous phase, furthermore the bioerodable matrix itself is prone to hydrolysis in an aqueous environment.
  • the injectable aqueous suspension must be prepared at the time of injection.
  • a second disadvantage is the need for intramuscular injection.
  • preparation of the microspheres is a complex process that is not easily carried out reproducibly and reliably, and regulatory validation of the manufacturing process can be a significant obstacle to commercialization of such products.
  • Another class of implants differing from pre-formed solid devices is injectable liquids. Upon injection, these are transformed in situ into solid implants.
  • This class of implants is typified by compositions that transform from a drug-containing liquid phase to a drug-infused gel phase upon exposure to a physiological environment.
  • Such in situ gelling compositions have several advantages: they can be readily and reliably manufactured by standard methods, they can be stored in the form of easily-injected liquids, they can be placed locally to achieve local delivery, and they can flow prior to gelling so as to fill voids and create a less-visible subcutaneous implant.
  • a gelling implant can serve as a scaffold for cellular colonization and tissue growth.
  • Temperature-sensitive in situ gelling compositions generally change from a sol to a gel when the temperature exceeds a critical solution temperature, which in the case of drug delivery systems must be reasonably close to body temperature.
  • a critical solution temperature which in the case of drug delivery systems must be reasonably close to body temperature.
  • An example is the polyethylene oxide-polypropylene oxide block copolymer, sold under the trade name PluronicTM F 127.
  • PluronicTM F 127 polyethylene oxide-polypropylene oxide block copolymer
  • a 25-40% aqueous solution of this material will gel at about body temperature, and drug release from such a gel occurs over a period of up to one week.
  • Such compositions have the disadvantage that they must be carefully protected from premature gelling, through refrigerated storage, and no bioerodable polymer has yet been developed that undergoes a sol-gel transition at about body temperature.
  • compositions form gels upon contact with water.
  • GMO glycerol monooleate
  • a drug can be injected as a liquid lamellar phase, which upon injection and exposure to water forms a highly viscous cubic-phase hydrate. The drug is released from the cubic phase over the course of several days.
  • An example of an injectable drug depot product based on GMO is the metronidazole dental gel formulation marketed under the trade name ElyzolTM. Due to the high water content of the cubic phase, GMO formulations are prone to rapid drug release and are limited in duration of effect to no more than about five days.
  • the AtrigelTM drug delivery system consists of a bioerodable poly(DL-lactide-glycolide) (PLGA) copolymer (75:25 molar ratio) dissolved in N-methyl-2-pyrrolidone (NMP). Pharmaceuticals may be blended into this PLGA solution at the point of manufacture, or they may be added by the physician at the time of use.
  • the liquid product is injected subcutaneously or intramuscularly through a small gauge needle, whereupon displacement of the NMP carrier with water in the tissue fluids causes the PLGA to precipitate, forming a solid film or implant.
  • the drug incorporated within the implant is then released in a controlled manner as the polymer matrix erodes with time in the body.
  • PLGA-based implants of this type can release drug over a period of several months.
  • An example of a product employing this technology is the leuprolide acetate formulation marketed under the trade name EligardTM.
  • the AtrigelTM system uses N-methylpyrrolidinone (NMP) as a solvent for the PLGA copolymer.
  • NMP N-methylpyrrolidinone
  • NMP is a water-miscible, low-molecular-weight and low-viscosity solvent that rapidly diffuses from the implant. Rapid solvent escape from the injected composition can lead to rapid and uneven precipitation of the polymer, shrinking of the implant, and local irritation or even necrosis due to exposure of tissues to a high local concentration of solvent.
  • liquid polymers as solvents for in situ gel-forming compositions has been described in U.S. Pat. No. 5,607,686 and in U.S. application Ser. No. 10/169,012 (US 2003/0082234), corresponding to international patent application PCT/KR00/01508 (WO 01/45742).
  • polyethylene glycol is not suitable as a solvent for PLGA.
  • In situ polymer-precipitation systems solve many of the problems associated with implants, but some difficulties remain. There is a need for in situ gelling drug delivery systems with improved properties, a simple preparation procedure and low toxicity of excipient.
  • PEGs have the advantage of solubilizing different drugs than NMP; in particular pegylated proteins can be expected to be more soluble and/or miscible in PEGs than in NMP.
  • An additional advantage is that PEGs are available in different molecular weights and have different viscosities. In many instances it important to be able to control the viscosity of the injected gelling agent, which is not possible with NMP.
  • the morphology of the polymer gel produced during the precipitation process is dependent upon the nature of the organic solvent, which can vary from a dense sponge-like structure to an open meshwork with numerous voids and channels (P. D. Graham et al., J. Controlled Release 58:233-245 (1999)). This morphology in turn affects both the initial burst and the sustained release kinetics of the gel. Solvents used to date for this purpose have largely been selected from the chemist's traditional menu of low-molecular weight species, such as NMP, DMA, alcohols, and the like, as described for example in U.S. Pat. No. 5,780,044.
  • polyethylene glycol can serve as the solvent for PLGA, and have found that the gel phase produced upon exchange of the PEG with water exhibits desirable sustained-release kinetics for small-molecule drugs.
  • the present invention provides an in situ gelling drug delivery formulation comprising a drug substance and a PLGA polymer, dissolved dispersed or suspended in PEG as the liquid phase solvent.
  • the liquid phase solvent may include, or even consist essentially of, a prodrug of the drug substance combined with PEG.
  • the present invention also provides methods for making in situ gelling drug delivery formulations comprising a drug substance and a PLGA polymer, dissolved dispersed or suspended in PEG as the liquid phase solvent.
  • the invention also provides methods for preparing sustained-release drug depots in situ by the use of such formulations.
  • FIG. 1 shows the release profiles for morphine from three different morphine-diclofenac co-drug/PLGA (70:30)/PEG 400 formulations.
  • FIG. 2 shows the release profile for morphine from a morphine-diclofenac co-drug/PLGA (50:50)/PEG 400 formulation (5% w/v PLGA in PEG).
  • FIG. 3 shows the release profile for morphine from a morphine-diclofenac co-drug/PLGA (70:30)/DMA formulation.
  • FIG. 4 shows the release profile for morphine from a morphine-diclofenac co-drug/PLGA (70:30)/benzyl benzoate formulation (20% w/v PLGA in benzyl benzoate).
  • the present invention provides injectable in situ gelling pharmaceutical compositions, comprising: (a) a drug substance; (b) a liquid, semi-solid, or wax polyethylene glycol (PEG); and (c) a biocompatible and bioerodable polymer that is dissolved, dispersed, or suspended in the PEG.
  • a drug substance comprising: (a) a drug substance; (b) a liquid, semi-solid, or wax polyethylene glycol (PEG); and (c) a biocompatible and bioerodable polymer that is dissolved, dispersed, or suspended in the PEG.
  • PEG polyethylene glycol
  • a “liquid” PEG is a polyethylene glycol that is a liquid at 20-30° C. and ambient pressure. In certain preferred embodiments, the average MW of the liquid PEG is between about 200 and about 400.
  • the polyethylene glycol may be linear or it may be a bioabsorbable branched PEG, for example as disclosed in U.S. patent application Ser. No. 2002/0032298.
  • the PEG may be a semi-solid or wax, in which case the M n will be larger, for example 3,000 to 6,000. It will be understood that compositions comprising semi-solid and waxy PEGs may not be amenable to injection, and will accordingly be implanted by alternative means.
  • the drug substance is dissolved in the polyethylene glycol, while in other embodiments the drug substance is dispersed or suspended in the PEG in the form of solid particles.
  • the drug substance may be encapsulated or otherwise incorporated into particles, such as microspheres, nanospheres, liposomes, lipospheres, micelles, and the like, or it may be conjugated to a polymeric carrier. Any such particles are preferably less than about 500 microns in diameter, more preferably less than about 150 microns.
  • the present invention also provides for macroscopic drug delivery devices, for example in the form of hollow particles, capsules or open tubes, which contain an in situ gelling composition of the invention.
  • the devices may be permeable to the drug substance, or they may be impermeable with one or more openings through which the drug substance may exit the device.
  • Such devices which are well-known in the art, provide additional control over the release rate of the drug substance, by controlling the diffusion rate and/or surface area through which the drug substance is released.
  • the drug substance in certain embodiments is a peptide or protein, which optionally may be pegylated, while in other embodiments the drug substance is a prodrug or a co-drug.
  • the drug substance may be in the form of a salt, which may be a low-solubility salt.
  • the drug substance is the diclofenate ester of morphine.
  • compositions of the invention may optionally contain additives, such as pore-forming agents (e.g., sugars, salts, and water-soluble polymers) and release rate modifiers (e.g., sterols, fatty acids, glycerol esters, and the like).
  • additives such as pore-forming agents (e.g., sugars, salts, and water-soluble polymers) and release rate modifiers (e.g., sterols, fatty acids, glycerol esters, and the like).
  • the invention provides a method for administering a drug substance to a subject, which comprises injecting into the subject a composition comprising (a) a drug substance; (b) a liquid PEG; and (c) a biocompatible and bioerodable PLGA polymer that is dissolved in the PEG.
  • a composition comprising (a) a drug substance; (b) a liquid PEG; and (c) a biocompatible and bioerodable PLGA polymer that is dissolved in the PEG.
  • subject refers to both human and animal patients to whom the drug is to be administered.
  • the invention provides a method for forming a polymeric sustained-release drug delivery gel in a subject, which comprises injecting into the subject a composition comprising (a) a drug substance; (b) a liquid PEG; and (c) a biocompatible and bioerodable PLGA polymer that is dissolved in the polyethylene glycol.
  • the present invention also provides for the co-administration of a PEG/polymer/drug fluid with an aqueous fluid, which may be for example normal saline or a hydrogel.
  • a PEG/polymer/drug fluid with an aqueous fluid, which may be for example normal saline or a hydrogel.
  • the two fluids are either administered at the same time via a double lumen needle, or mixed immediately before administration.
  • the two fluids may be in contained in attached syringes.
  • Co-administration reduces the local irritation that may be caused by direct application of highly concentrated PEGs.
  • the polymer may be any biocompatible PLGA polymer that is soluble in or miscible with PEG, and is less soluble in water. It is preferably water-insoluble, and is preferably a bioerodable polymer.
  • the carboxyl termini of the lactide- and glycolide-containing polymer may optionally be capped, e.g., by esterification, and the hydroxyl termini may optionally be capped, e.g., by etherification or esterification.
  • the polymer is PLGA having a lactide:glycolide molar ratio of between 20:80 and 90:10, more preferably between 50:50 and 85:15.
  • Bioerodable polymers are polymers which gradually degrade to smaller chemical fragments when placed in the subject's body. Two types of degradable polymers are included under this definition: biodegradable polymers (whose biodegradation is enzymatically mediated) and bioabsorbable polymers (which degrade to smaller fragments in the presence of water and/or other chemical species in the body). Some bioerodable polymers, e.g., certain block co-polymers, may be subject to both modes of degradation.
  • Biocompatible polymers are those polymers which, when injected or implanted in the subject's body, do not cause inflammation or irritation, do not induce an immune reaction, and do not exhibit toxicity.
  • the in situ gelling compositions of the present invention are suitable for delivering small organic molecules as well as peptides, proteins, polysaccharides, and nucleic acids.
  • the drug substance may be a pharmaceutically active substance, a pro-drug that is converted in vivo into a pharmaceutically active substance, or a co-drug that is converted in vivo into two or more pharmaceutically active substances.
  • co-drug is meant a combination of two or more drugs whose molecules are physically linked, for example by covalent or ionic bonds. Examples of suitable co-drugs are described in U.S. patent application Ser. No. 10/134,033 (publication US 2003/0039689) and U.S. patent application Ser. No. 10/349,202, which are incorporated herein by reference.
  • the drug substance may be soluble or insoluble in PEG. If insoluble, the drug substance is preferably suspended in the PEG in the form of fine particles.
  • drug substances suitable for use in the present invention include physiologically active peptides and/or proteins, antineoplastic agents, antibiotics, analgesics, anti-inflammatory agents, muscle relaxants, anti-epileptics, anti-ulcerative agents, anti-allergic agents, cardiotonics, anti-arrhythmic agents, vasodilators, antihypertensive agents, anti-diabetic agents, anti-hyperlipidemics, anticoagulants, hemolytic agents, antituberculous agents, hormones, narcotic antagonists, osteoclastic suppressants, osteogenic promoters, angiogenesis suppressors, and various mixtures, salts, prodrugs and co-drugs thereof.
  • Physiologically active peptides and/or proteins range in molecular weight from 200 to 100,000 and include but are not limited to human growth hormone, growth hormone releasing hormone, growth hormone releasing peptide, interferons, colony stimulating factors, interleukins, macrophage activating factors, macrophage peptide, B-cell factors, T-cell factors, protein A, allergy repressors, immunotoxins, lymphotoxins, tumor necrosis factors, tumor repression factors, vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), metastasis growth factors, alpha-1 antitrypsin, apolipoprotein-E, erythropoietin, Factor VII, Factor VIII, Factor IX, plasminogen activating factors, urokinase, streptokinase, Protein C, C-reactive protein, superoxide dismutase, platelet-derived growth factors, epidermal growth factors, osteogenic growth factors, osteogenesis-promoting proteins, calc
  • Antiproliferative/antimitotic drugs and prodrugs include natural products such as vinca alkaloids (e.g., vinblastine, vincristine, and vinorelbine), paclitaxel, epidipodophyllotoxins (e.g., etoposide, teniposide), antibiotics (e.g., actinomycins, daunorubicin, doxorubicin and idarubicin), anthracyclines, mitoxantrone, bleomycins, plicamycin (mithramycin) and mitomycin, enzymes (e.g., L-asparaginase); antiplatelet prodrugs; antiproliferative/antimitotic alkylating prodrugs such as nitrogen mustards (mechlorethamine, cyclophosphamide and analogs, melphalan, chlorambucil), ethylenimines and methylmelamines (hexamethylmelamine and thiotepa
  • the drug substance is a prodrug or co-drug of an opioid analgesic or an opioid antagonist.
  • opioids include morphine and morphine derivatives, such as apomorphine, buprenorphine, codeine, dihydrocodeine, dihydroetorphine, diprenorphine, etorphine, hydrocodone, hydromorphone, levorphanol, meperidine, metopon, o-methylnaltrexone, naloxone, naltrexone, normorphine, oxycodone, and oxymorphone.
  • morphine and morphine derivatives such as apomorphine, buprenorphine, codeine, dihydrocodeine, dihydroetorphine, diprenorphine, etorphine, hydrocodone, hydromorphone, levorphanol, meperidine, metopon, o-methylnaltrexone, naloxone, naltrexone, normorphine,
  • the opiod is fentanyl or a fentanyl derivative which can be derivatized to form a prodrug or co-drug, such as beta-hydroxy-3-methylfentanyl.
  • the drug substances may optionally be in pharmaceutically acceptable salt forms.
  • the polyethylene glycol solvent may be a PEG that is liquid at room temperature and ambient pressure, having an average MW of between about 100 and about 600, preferably between about 200 and about 400. Alternatively it may be a semi-solid or wax PEG, having an average molecular weight up to about 6,000.
  • the ratio of polyethylene glycol to polymer will typically range from about 25:1 to about 1:20 by weight.
  • compositions of the invention can be used to maintain therapeutically effective systemic levels of suitably potent drugs that have an appropriate elimination rate.
  • the invention can also be used to maintain therapeutically effective localized levels of suitably potent drugs having appropriate clearance rates.
  • compositions of the invention may be prepared by stirring PEG, the drug substance, and polymer together until solution is obtained. Dissolution may be accelerated by heating and agitation.
  • the drug substance is preferably provided in the form of a microparticulate or nanoparticulate powder that will form a suspension in the polymer-PEG solution.
  • the drug substance may be covalently linked to a polyoxyethylene ether (e.g., PEG), wherein the covalent bonds are cleavable in vivo so as to release the drug substance.
  • PEG polyoxyethylene ether
  • the drug substance is released in a sustained manner.
  • the drug substance is a pegylated prodrug of another drug substance.
  • the drug substance may be included in compounds having structure 1 below: A(-L-) m S n 1 wherein A is a residue of a pharmaceutically active agent A′, L represents a covalent bond or a linker moiety, and S is a polyoxyethylene ether group having the formula—(OCH 2 CH 2 ) p OR, where p is 2-12 and R is a C 1 -C 4 alkyl group.
  • the biocompatible fluid may comprise a mixture of compounds having a range of values of p; but in preferred embodiments p has a single value and the composition comprises only one compound of structure 1.
  • the bond or linker L is cleavable in vivo so as to release the active agent A′.
  • the agent A′ will typically feature one or more functional groups to which linkers L can be readily attached.
  • functional groups include but are not limited to —CO 2 H, —CONH 2 , —CHO, ⁇ O, —OH, —NH 2 , and —SH groups.
  • bonds and linkages which are cleavable in vivo include but are not limited to esters, amides, carbamates, carbonates, orthoesters, cyclic ketals, thioesters, thioamides, thiocarbamates, thiocarbonates, xanthates, disulfides, and phosphate esters. Ester linkages, carbonate linkers, and/or amino acid linker moieties are preferred. Enzymatically cleavable linkers for polyoxyethylene derivatives have been described, for example, in U.S. Pat. No. 6,127,355, Ulbrich et al., Makromol. Chem .
  • m and n will typically range from 1 to 4, although larger values are within the scope of the invention.
  • the linker is divalent and m and n will have the same value, but multiple links to a single moiety S, as for example in a ketal or orthoester linkage, may be employed.
  • multiple moieties S may be appended via a single linker L, for example by esterification of the agent A with a moiety such as —C( ⁇ O)CH[(OCH 2 CH 2 ) p OR] 2 or —P( ⁇ O)[(OCH 2 CH 2 ) p OR] 2 .
  • m>1 and/or n>1 each incidence of L and S may be the same or different.
  • the residue represented by A may be derived from any drug substance, including but not limited to steroids (preferably corticosteroids), retinoids, NSAIDs, vitamin D3 and vitamin D3 analogs, antibiotics, and antiviral agents.
  • steroids preferably corticosteroids
  • retinoids preferably retinoids
  • NSAIDs preferably corticosteroids
  • vitamin D3 and vitamin D3 analogs include antibiotics, and antiviral agents.
  • Other suitable agents include enzymes, peptides and other large molecules.
  • all-trans retinoic acid is excluded from the residues represented by A, while in other embodiments retinoids are excluded from the residues represented by A.
  • Suitable steroids include but are not limited to androgenic and estrogenic steroid hormones, androgen receptor antagonists and 5- ⁇ -reductase inhibitors, and corticosteroids. Specific examples include but are not limited to alclometasone, clobetasol, fluocinolone, fluocortolone, diflucortolone, fluticasone, halcinonide, mometasone, prednisone, prednisolone, methylprednisolone, triamcinolone, betamethasone, and dexamethasone, and various esters and acetonides thereof.
  • Suitable retinoids include but are not limited to retinol, retinal, isotretinoin, acitretin, adapalene, tazarotene, and bexarotene.
  • Suitable NSAIDs include but are not limited to naproxen, suprofen, ketoprofen, ibuprofen, flurbiprofen, diclofenac, indomethacin, celecoxib, and rofecoxib.
  • Suitable vitamin D3 analogues include but are not limited to doxercalciferol, seocalcitol, calcipotriene, tacalcitol, calcitriol, ergocalciferol, and calcifediol.
  • Suitable antiviral agents include but are not limited to trifluridine, cidofovir, acyclovir, penciclovir, famciclovir, valcyclovir, gancyclovir, and docosanol.
  • Suitable antibacterial agents include but are not limited to metronidazole, clindamycin, erythromycin, vancomycin, ciprofloxacin, ofloxacin, lomefloxacin, bacitracin, neomycin, mupirocin, and polymyxin B.
  • the antiviral and antibacterial prodrugs of the invention may be used to treat appropriately responsive systemic infections.
  • the linker L is cleavable in vivo, meaning that the compound of the invention is hydrolyzed or otherwise cleaved, with or without enzymatic catalysis, so as to generate in situ the active drug substance.
  • Suitable linkers include, but are not limited to, —CH 2 O—, —OCH 2 O—, —C( ⁇ O)—O—, —OC( ⁇ O)—O—, —C( ⁇ O)—(CH 2 ) 1-4 —O—, and —C( ⁇ O)—(CH 2 ) 1-4 —, —C( ⁇ O)—NH—, and —C( ⁇ S)—NH—.
  • suitable linkers may be found in Prodrugs: Topical and Ocular Drug Delivery , 1992, K. B. Sloan (Ed.), Drugs and the Pharmaceutical Sciences, Vol 53 (Marcel Dekker).
  • the linker or bond L may be attached to any suitable heteroatom present in the topically active agent that carries an exchangeable hydrogen, such as —OH, SH, NH 2 , and COOH groups.
  • an exchangeable hydrogen such as —OH, SH, NH 2 , and COOH groups.
  • the free hydroxyl group of triamcinolone acetonide may be acylated with the moiety —C( ⁇ O)(OCH 2 CH 2 ) p OR.
  • the active drug substance comprises a carboxylic acid group
  • the carboxylic acid group is esterified with a polyoxyethylene ether of formula HO(CH 2 CH 2 O) p R.
  • Examples include but are not limited to structures I, II, and III shown below:
  • the active drug substance comprises a hydroxyl group
  • the hydroxyl group is acylated with a polyoxyethylene ether carbonyl moiety of formula —CO(OCH 2 CH 2 ) p OR.
  • Examples include but are not limited to structures IV and V shown below:
  • n is an integer from 2 to 6 inclusive.
  • the identities of the group R may be methyl, ethyl, or any other organic moiety.
  • the use of prodrug linkages in connection with a drug substance may improve the solubility of an agent in water or in polymer.
  • the use of a pegylated prodrug may improve the solubility of an agent in the biocompatible fluid, and thereby improve the injectability of the invention.
  • the use of prodrug linkages may also lower the melting point of a solid drug substance, or increase the solubility of a drug substance in physiological fluids, thereby improving the injectability of the drug substance.
  • the drug substance may be dissolved, dispersed or suspended in the biocompatible core, whereupon it may leach out of the core and into surrounding fluid.
  • the drug substance may rapidly escape from an injection mixture after injection into a physiological system.
  • residue when applied to an agent means a part of an agent that is substantially identical to the agent from which it is derived, with minor differences arising by virtue of having one or more atoms removed to provide points of attachment for the linker(s) L.
  • at least one functional group of the residue will be altered (relative to the parent pharmaceutically active agent) to accommodate the covalent linker. This will typically involve removal of an exchangeable hydrogen and/or a single heteroatom, leaving a free valence for attachment of the linkage L.
  • the residue of the agent formed by removal of a hydroxyl group may form an ester bond with a hydroxyl group on a polyoxyethylene ether residue, which itself is formed by removal of a hydrogen atom from a hydroxyl group from the polyoxyethylene ether.
  • the term “residue” as used herein is analogous to the sense of the word as it is used in peptide and protein chemistry to refer to a residue of an amino acid in a peptide.
  • linker refers to a direct bond or to a multivalent group of atoms incorporating and connecting the functional groups of the active drug substance and a polyoxyethylene ether, which is metabolized under physiological conditions to release the active agent A′.
  • the linker is a substantially linear moiety having no more than 25 atoms, more preferably less than 10 atoms.
  • Preferred linkers are ones which, upon release of the topically active agent, and when further metabolized, generate byproducts that are non-toxic and inert at the effective dosing concentration. Direct bonds between the residue A and the polyoxyethylene moiety S are particularly preferred.
  • Formulation A was formulated at about 10 mg/ml morphine-diclofenac co-drug in PLGA (70:30)/PEG 400 solution ( ⁇ 5% (w/v) PLGA in PEG).
  • Formulation B was formulated at about 10 mg/ml morphine-diclofenac co-drug in PLGA (70:30)/PEG 400 solution ( ⁇ 10% (w/v) PLGA in PEG).
  • Formulation C was formulated at about 10 mg/ml morphine-diclofenac co-drug in PLGA (70:30)/PEG 400 solution ( ⁇ 20% (w/v) PLGA in PEG).
  • Each formulation was loaded into a 1-ml syringe, and 100 ⁇ l aliquot was injected into a tube containing 10 ml of 10% plasma in HA (hyaluronic acid) phosphate buffer, pH 7.4. The samples were placed in a water bath at 37° C. for release study. At each time point, the entire release medium was removed and replaced with 10 ml fresh buffer. The removed solution was analyzed for morphine, diclofenac and the co-drug contents by HPLC.
  • HA hyaluronic acid
  • the formulation was prepared with 12 mg/ml morphine-diclofenac co-drug in PLGA (50:50)/PEG 400 solution ( ⁇ 5% (w/v) PLGA in PEG) and loaded into a 1-ml syringe, and 100 ⁇ l aliquot was injected into a test tube containing 10 ml of 10% plasma in HA (hyaluronic acid) phosphate buffer, pH 7.4. The samples were placed in a 37° C. water bath. At each time point, the entire release medium was removed and replaced with 10 ml fresh buffer. The removed solutions were analyzed for morphine, diclofenac and the co-drug contents by HPLC.
  • Formulation A was formulated at about 8 mg/ml morphine-diclofenac co-drug in PLGA (70:30)/DMA solution (40% (w/v) PLGA in DMA).
  • Formulation B was formulated at about 10 mg/ml morphine-diclofenac co-drug in PLGA (70:30)/benzyl benzoate solution (20% (w/v) PLGA in benzyl benzoate).
  • Each formulation was loaded into a 1-ml syringe, and 100 ⁇ l aliquot was injected into a tube containing 10 ml of 10% plasma in HA (hyaluronic acid) phosphate buffer, pH 7.4.
  • the samples were placed in a water bath at 37° C. for release study.
  • the entire release medium for the DMA formulation was removed and replaced with 10 ml fresh buffer, while only 5 ml release medium for the benzyl benzoate formulation was removed and replaced with 5 ml fresh buffer.
  • the removed solutions were analyzed for morphine, diclofenac and the co-drug contents by HPLC.
  • the results are shown in FIGS. 3 (DMA) and 4 (benzyl benzoate).
  • the morphine release profile from the DMA formulation is very similar to that from the formulation with 5% (w/v) PLGA in Example 2, although the concentration of PLGA in the DMA formulation was 40% (w/v). However, morphine release was slower in the benzyl benzoate formulation. At day 35 about 46% morphine was released.
  • DMA is more hydrophilic than benzyl benzoate, which is an oily solvent. By adding these organic solvent(s) to PLGA formulations, drug release rate can be adjusted.

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CN1863557A (zh) 2006-11-15
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EP1635875A2 (de) 2006-03-22
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CA2530136C (en) 2012-10-16
JP5229768B2 (ja) 2013-07-03
ATE410186T1 (de) 2008-10-15
US20110165242A1 (en) 2011-07-07
US20140336278A1 (en) 2014-11-13
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TWI377958B (en) 2012-12-01
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WO2005002625A2 (en) 2005-01-13
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US20130101656A1 (en) 2013-04-25
TW200514581A (en) 2005-05-01
CN1863557B (zh) 2010-06-16
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CN101862455A (zh) 2010-10-20
JP2007524628A (ja) 2007-08-30
US9566336B2 (en) 2017-02-14

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