US20080132527A1 - Compositions For Delivering Acyclovir - Google Patents

Compositions For Delivering Acyclovir Download PDF

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US20080132527A1
US20080132527A1 US11/568,826 US56882605A US2008132527A1 US 20080132527 A1 US20080132527 A1 US 20080132527A1 US 56882605 A US56882605 A US 56882605A US 2008132527 A1 US2008132527 A1 US 2008132527A1
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acyclovir
alkyl
alkenyl
delivery agent
pharmaceutical composition
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Amy C. Adams
Brahma N. Singh
Nikhil Dhoot
Shingai Majuru
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Novo Nordisk North America Operations AS
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Emisphere Technologies Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/16—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing nitrogen, e.g. nitro-, nitroso-, azo-compounds, nitriles, cyanates
    • A61K47/18—Amines; Amides; Ureas; Quaternary ammonium compounds; Amino acids; Oligopeptides having up to five amino acids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/14—Esters of carboxylic acids, e.g. fatty acid monoglycerides, medium-chain triglycerides, parabens or PEG fatty acid esters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/505—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim
    • A61K31/519—Pyrimidines; Hydrogenated pyrimidines, e.g. trimethoprim ortho- or peri-condensed with heterocyclic rings
    • A61K31/52—Purines, e.g. adenine
    • A61K31/522—Purines, e.g. adenine having oxo groups directly attached to the heterocyclic ring, e.g. hypoxanthine, guanine, acyclovir
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/06—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite
    • A61K47/08—Organic compounds, e.g. natural or synthetic hydrocarbons, polyolefins, mineral oil, petrolatum or ozokerite containing oxygen, e.g. ethers, acetals, ketones, quinones, aldehydes, peroxides
    • A61K47/12—Carboxylic acids; Salts or anhydrides thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/0012—Galenical forms characterised by the site of application
    • A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/08—Solutions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/20—Pills, tablets, discs, rods
    • A61K9/2004—Excipients; Inactive ingredients
    • A61K9/2013—Organic compounds, e.g. phospholipids, fats
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P15/00—Drugs for genital or sexual disorders; Contraceptives
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P27/00—Drugs for disorders of the senses
    • A61P27/02—Ophthalmic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/12—Antivirals
    • A61P31/20—Antivirals for DNA viruses
    • A61P31/22—Antivirals for DNA viruses for herpes viruses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P35/00—Antineoplastic agents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00

Definitions

  • the present invention relates to an acyclovir formulation having improved bioavailability resulting in improved efficacy and/or requiring less frequent administration.
  • Acyclovir (9-((2-hydroxyethoxy)methyl)guanine) is an antiviral which inhibits human herpes viruses, including herpes simplex types 1 (HSV-1) and 2 (HSV-2), varicella zoster, Epstein-Barr virus (EBV) and cytomegalovirus (CMV).
  • HSV-1 herpes simplex types 1
  • HSV-2 herpes simplex types 1
  • HBV-2 herpes simplex types 1
  • EBV Epstein-Barr virus
  • CMV cytomegalovirus
  • the inhibitory activity of acyclovir is highly selective for these viruses. O'Brien and Campoli-Richards, Drugs, 37:233-309 (1989).
  • the chemical composition of acyclovir is reported in Shaffer, et al. ( J. Med. Chem. 14:367 (1971)), U.S. Pat. No. 4,199,574, and UK Patent Specification No. 1,523,865, all of which are hereby incorporated by
  • Acyclovir has been demonstrated to be a potent antiviral agent, particularly against herpes viruses. Shaffer, et al. Nature 272:583-585 (1978). Acyclovir has also been demonstrated to effectively suppress reactivated or newly acquired viral diseases such as genital herpes simplex, shingles, and varicella-zoster, as well as acute varicella-zoster infections. Balfour, J. Med. Virology, S1:74-81 (1993). Morbidity and mortality from viral disease have been reduced by pre- and postoperative prophylaxis with long-term (>6 months) oral acyclovir therapy. Prentice et al., Lancet 343:749-753 (1994).
  • acyclovir and AZT azidothymidine
  • AZT azidothymidine
  • acyclovir therapy for acute varicella-zoster disease reduces fever, chronic pain, and the progression of rash and accelerates cutaneous healing.
  • HSV herpes simplex infections
  • HSV human immunodeficiency virus
  • acyclovir is effective therapy for varicella-zoster infections, herpes zoster (shingles, zoster), cytomegalovirus infections, infections and disorders associated with Epstein-Barr virus, and the Center for Disease Control states that oral acyclovir may be used in pregnant women.
  • AHFS Drug Information American Society of Health System Pharmacists, Bethesda, Md., 2005, which is incorporated by reference herein.
  • Acyclovir is currently marketed as capsules, tablets and suspension for oral administration. Orally administered acyclovir is slowly and erratically absorbed with 15-30% bioavailability. Barnhart (ed.), Physicians' Desk Reference, Oradell, N.J.: Medical Economics Data (1994). Over half the dose of the currently marketed formulation is recovered in the feces. Schaeffer et al., Nature, 272:583-585 (1978). Failure to respond to acyclovir therapy may arise from an inadequate dose (frequency of dose or total daily dose); patient noncompliance; malabsorption in the intestine; or, resistant viral strains. Mindel, J. Med. Virology, S1:39-44 (1993).
  • U.S. Pat. No. 5,883,103 discloses a microemulsion system for the oral delivery of acyclovir.
  • the system includes a water-in-oil emulsion with acyclovir dispersed in aqueous phase droplets.
  • the droplets have an average droplet size of 20-40 nanometers and are uniformly dispersed in the continuous oil phase.
  • the present invention provides a composition (e.g., a pharmaceutical composition) comprising (a) at least one delivery agent compound and (b) acyclovir or a salt, ester, or prodrug thereof.
  • the composition includes a therapeutically effective amount of acyclovir and the delivery agent compound.
  • the composition of the present invention facilitates the delivery of acyclovir and increases its bioavailability compared to administration without the delivery agent compound.
  • the composition is particularly well suited for oral administration.
  • the composition provides bioavailability (i.e., AUC) substantially equivalent to the current acyclovir formulations marketed as Zovirax® (U.S. FDA NDA No. 18828, 19909, or 20089) when:
  • Preferred delivery agent compounds include, but are not limited to, N-(8-[2-hydroxybenzoyl]amino)caprylic acid, N-(10-[2-hydroxybenzoyl]amino)decanoic acid, 4-[(4-chloro-2-hydroxy-benzoyl)amino]butanoic acid (also known as 4-[(2-hydroxy-4-chlorobenzoyl)amino]butanoate), 8-(N-2-hydroxy-5-chlorobenzoyl)aminocaprylic acid, 8-(N-2-hydroxy-4-methoxybenzoyl)-amino-caprylic acid, and salts (e.g., pharmaceutically acceptable salts) thereof, and solvates and hydrates thereof.
  • the salt can be, for example, a sodium salt, such as a monosodium or disodium salt.
  • the composition comprises acyclovir or a salt, ester, or prodrug thereof and at least one delivery agent of the following structure or a salt (e.g., a pharmaceutically acceptable salt) thereof:
  • Ar is phenyl or naphthyl
  • Ar is optionally substituted with one or more of —OH, halogen, C 1 -C 4 alkyl, C 1 -C 4 alkenyl, C 1 -C 4 alkoxy or C 1 -C 4 haloalkoxy;
  • R 7 is C 4 -C 20 alkyl, C 4 -C 20 alkenyl, phenyl, naphthyl, (C 1 -C 10 alkyl) phenyl, (C 1 -C 10 alkenyl)phenyl, (C 1 -C 10 alkyl) naphthyl, (C 1 -C 10 alkenyl) naphthyl, phenyl(C 1 -C 10 alkyl), phenyl(C 1 -C 10 alkenyl), naphthyl(C 1 -C 10 alkyl), or naphthyl(C 1 -C 10 alkenyl);
  • R 8 is hydrogen, C 1 to C 4 alkyl, C 2 to C 4 alkenyl, C 1 to C 4 alkoxy, or C 1 -C 4 haloalkoxy;
  • R 7 is optionally substituted with C 1 to C 4 alkyl, C 2 to C 4 alkenyl, C 1 to C 4 alkoxy, C 1 -C 4 haloalkoxy, —OH, —SH, —CO 2 R 9 , or any combination thereof;
  • R 9 is hydrogen, C 1 to C 4 alkyl, or C 2 to C 4 alkenyl
  • R 7 is optionally interrupted by oxygen, nitrogen, sulfur or any combination thereof. According to one embodiment, the compounds are not substituted with an amino group in the position alpha to the acid group.
  • the composition comprises acyclovir or a salt, ester, or prodrug thereof and at least one delivery agent of the following structure or a salt (e.g., a pharmaceutically acceptable salt) thereof:
  • R 1 , R 2 , R 3 , and R 4 are independently H, —OH, halogen, C 1 -C 4 alkyl, C 2 -C 4 alkenyl, C 1 -C 4 alkoxy, —C(O)R 8 , —NO 2 , —NR 9 R 10 , or —N + R 9 R 10 R 11 (R 12 )—;
  • R 5 is H, —OH, —NO 2 , halogen, —CF 3 , —NR 14 R 15 , —N + R 14 R 15 R 16 (R 13 )—, aride, C 1 -C 12 alkoxy, C 1 -C 12 alkyl, C 2 -C 12 alkenyl, carbamate, carbonate, urea, or —C(O)R 18 ;
  • R 5 is optionally substituted with halogen, —OH, —SH, or —COOH;
  • R 6 is optionally interrupted by O, N, S, or —C(O)—;
  • R 6 is a C 1 -C 12 alkylene, C 2 -C 12 alkenylene, or arylene;
  • R 6 is optionally substituted with a C 1 -C 4 alkyl, C 2 -C 4 alkenyl, C 1 -C 4 alkoxy, —OH, —SH, halogen, —NH 2 , or —CO 2 R 8 ;
  • R 6 is optionally interrupted by O or N;
  • R 7 is a bond or arylene
  • R 7 is optionally substituted with —OH, halogen, —C(O)CH 3 , —NR 10 R 11 , or —N + R 10 R 11 R 12 (R 13 )—;
  • each occurrence of R 8 is independently H, C 1 -C 4 alkyl, C 2 -C 4 alkenyl, or —NH 2 ;
  • R 9 , R 10 , R 11 , and R 12 independently H or C 1 -C 10 alkyl
  • R 13 is a halide, hydroxide, sulfate, tetrafluoroborate, or phosphate
  • R 14 , R 15 and R 16 are independently H, C 1 -C 10 alkyl, C 1 -C 10 alkyl substituted with —COOH, C 2 -C 12 alkenyl, C 2 -C 12 alkenyl substituted with —COOH, or —C(O)R 17 ;
  • R 17 is —OH, C 1 -C 10 alkyl, or C 2 -C 12 alkenyl
  • R 1 is H, C 1 -C 6 alkyl, —OH, —NR 14 R 15 , or N + R 14 R 15 R 16 (R 13 )—.
  • R 6 is not a C 1 -C 6 , C 9 or C 10 alkyl.
  • R 1 , R 2 , R 3 , and R 4 are H, R 5 is —OH, R 7 is a bond then R 6 is not a C 1 -C 3 alkyl.
  • R 1 , R 2 , R 3 , and R 4 are not H, R 5 is —OH, R 7 is a bond, then R 6 is not a C 1 -C 4 alkyl.
  • R 1 , R 2 , and R 3 are H, R 4 is —OCH 3 , R 5 is —C(O)CH 3 , and R 6 is a bond then R 7 is not a C 3 alkyl.
  • R 1 , R 2 , R 4 , and R 5 are H, R 3 is —OH, and R 7 is a bond then R 6 is not a methyl.
  • composition comprises acyclovir or a salt, ester, or prodrug thereof and at least one delivery agent of the following structure or a salt (e.g., a pharmaceutically acceptable salt) thereof:
  • R 1 , R 2 , R 3 , R 4 and R 5 are independently H, —CN, —OH, —OCH 3 , or halogen, at least one of R 1 , R 2 , R 3 , R 4 and R 5 being —CN; and
  • R 6 is a C 1 -C 12 linear or branched alkylene, alkenylene, arylene, alkyl(arylene) or aryl(alkylene).
  • R 6 is not methylene ((CH 2 ) 1 ).
  • a dosage unit form (e.g., an oral dosage unit form) comprising the composition of the present invention.
  • the dosage unit form may be in the form of a liquid or a solid, such as a tablet, capsule or particle, including a powder or sachet.
  • Another embodiment is a method for administering acyclovir or a salt, ester, or prodrug thereof to an animal (preferably a mammal and more preferably a human) in need thereof, by administering the composition or dosage unit form(s) of the present invention to the animal.
  • the preferred route of administration is oral.
  • Yet another embodiment is a method of treating conditions or disorders caused by a virus in an animal (preferably a mammal and more preferably a human)in need thereof by administering an effective amount of the composition or dosage unit form(s) of the present invention to the animal.
  • an effective amount of the delivery agent compound to facilitate the delivery of the acyclovir or a salt, ester, or prodrug thereof and an effective amount (e.g., a therapeutically effective amount) of acyclovir is administered.
  • Yet another embodiment is a method for treating conditions or disorders caused by a virus in an animal (preferably a mammal and more preferably a human) by administering to the animal a therapeutically effective amount of the composition or dosage unit form(s) of the present invention.
  • Such conditions and disorders include but are not limited to, those caused by viruses of the herpes family, for example, herpes simplex 1 and 2 viruses (HSV 1 and HSV 2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and other herpes virus infections (e.g. feline herpes virus infections).
  • Another embodiment is a method of treating virus infections, especially herpes infections such as herpes simplex 1 and 2 viruses (HSV 1, HSV 2), varicella zoster virus (VZV), cytomegalovirus (CMV) and Epstein-Barr virus (EBV), and other herpes virus infections (e.g. feline herpes virus infections) in a human or non-human animal by administering an effective amount of the composition or dosage unit form of the present invention.
  • herpes infections such as herpes simplex 1 and 2 viruses (HSV 1, HSV 2), varicella zoster virus (VZV), cytomegalovirus (CMV) and Epstein-Barr virus (EBV)
  • Yet another embodiment is a method of treating clinical conditions or symptoms which are caused by the viruses enumerated above, including herpetic karatitis, herpetic encaphalitis, cold sores and genital infections (caused by herpes simplex), chicken pox and shingles (caused by varicella zoster) and CMV-pneumonia and retinitis, particularly in immunocompromised patients including renal and bone marrow transplant patients and patients with Acquired Immune Deficiency Syndrome (AIDS) by administering an effective amount of the composition or dosage unit form of the present invention.
  • herpetic karatitis herpetic encaphalitis
  • cold sores and genital infections caused by herpes simplex
  • chicken pox and shingles caused by varicella zoster
  • CMV-pneumonia and retinitis particularly in immunocompromised patients including renal and bone marrow transplant patients and patients with Acquired Immune Deficiency Syndrome (AIDS) by administering an effective
  • Epstein-Barr virus causes infectious mononucleosis, and is also suggested as the causative agent of nasopharyngeal cancer, immunoblastic lymphoma, Burkitt's lymphoma and hairy leukoplakia.
  • Yet another embodiment is a method of treating viral infections in an animal (preferably a mammal and more preferably a human) in need thereof by administering to the animal a therapeutically effective amount of the composition or dosage unit form(s) of the present invention.
  • the viral infections are those treatable with acyclovir or a salt, ester, or prodrug thereof.
  • Yet another embodiment is a method for acute treatment of herpes zoster (also known as shingles) in a human in need thereof by administering (preferably orally) an effective amount of the pharmaceutical composition of the present invention.
  • the pharmaceutical composition is orally administered every 5 or more hours and less than 5 times daily.
  • the pharmaceutical composition provides bioavailability (i.e., AUC) substantially equivalent to the current acyclovir formulations marketed as Zovirax® (U.S. FDA NDA No. 18828, 19909, or 20089) when 200 mg of acyclovir is administered every 4 hours 5 times daily.
  • the treatment may be continued for 7 to 10 days.
  • Yet another embodiment is a method for treatment of initial episodes and/or the management of recurrent episodes of genital herpes in a human in need thereof by administering (preferably orally) an effective amount of the pharmaceutical composition of the present invention.
  • the pharmaceutical composition e.g., 400 mg of acyclovir or a molar equivalent of a salt or prodrug thereof
  • the pharmaceutical composition provides bioavailability (i.e., AUC) substantially equivalent to the current acyclovir formulations marketed as Zovirax® (U.S. FDA NDA No. 18828, 19909, or 20089) when 800 mg of acyclovir is administered every 4 hours 5 times daily.
  • the composition is administered once daily or less frequently.
  • the treatment may be continued for up to 12 months, followed by re-evaluation.
  • the composition provides bioavailability (i.e., AUC) substantially equivalent to the current acyclovir formulations marketed as Zovirax® (U.S. FDA NDA No. 18828, 19909, or 20089) when:
  • Treatment may be continued for up to 12 months, followed by re-evaluation.
  • Yet another embodiment is a method for treatment of chickenpox in a human in need thereof by administering (preferably orally) an effective amount of the composition of the present invention.
  • the composition e.g., 80 mg/kg/day of acyclovir or a molar equivalent of a salt or prodrug thereof
  • an amount of the composition can be orally administered to provide the equivalent bioavailability as 20 mg/kg per dose 4 times daily of the current acyclovir formulations marketed as Zoviraxe (U.S. FDA NDA No. 18828, 19909, or 20089).
  • an amount of the composition can be orally administered to provide the equivalent bioavailability as 800 mg of the current acyclovir formulations marketed as Zovirax® (U.S. FDA NDA No. 18828, 19909, or 20089) administered 4 times daily.
  • Yet another embodiment is a method of preparing a composition of the present invention by mixing at least one delivery agent compound and acyclovir or a salt, ester, or prodrug thereof.
  • FIG. 1 is a graph of the serum concentrations (ng/ml ⁇ standard error) of acyclovir versus time after oral administration with and without the delivery agent SNAC or SNAD by the procedure described in Example 1.
  • FIGS. 2 , 4 , and 6 - 10 are graphs of the serum concentrations (ng/ml ⁇ standard error) of acyclovir versus time after intravenous or oral administration with or without the delivery agent SNAC of formulations 1, 3, and 5-9 shown in table 2, respectively, by the procedure described in Example 2.
  • FIG. 3 shows graphs of the serum concentrations (ng/ml ⁇ standard error) of acyclovir versus time after oral administration of (1) 400 mg of acyclovir (without a delivery agent) of formulation 5 (shown in table 2) or (2) 80 mg of acyclovir and 240 mg of the delivery agent SNAC of formulation 2 (shown in table 2), respectively, by the procedure described in Example 2.
  • FIG. 5 is a graph of the serum concentration (ng/ml ⁇ standard error) of acyclovir versus time after oral administration of valacyclovir (without a delivery agent) of formulation 4 shown in table 2, respectively, by the procedure described in Example 2.
  • hydrate as used herein includes, but is not limited to, (i) a substance containing water combined in the molecular form and (ii) a crystalline substance containing one or more molecules of water of crystallization or a crystalline material containing free water.
  • solvate includes, but is not limited to, a molecular or ionic complex of molecules or ions of a solvent with molecules or ions of the delivery agent compound or salt thereof, or hydrate or solvate thereof.
  • delivery agent refers to any of the delivery agent compounds disclosed herein.
  • SNAC refers to the monosodium salt of N-(8-[2-hydroxybenzoyl]-amino)caprylic acid, unless otherwise indicated. Unless otherwise noted, the term “SNAC” refers to all forms of SNAC, including all amorphous and polymorphic forms of SNAC, such as SNAC trihydrate and those described in U.S. Ser. Nos. 60/619,418 and 60/569,476, both of which are hereby incorporated by reference.
  • SNAC trihydrate refers to a crystalline form of SNAC in which three molecules of water are associated with each molecule of SNAC. SNAC can be prepared by the procedures described in U.S. Pat. No. 5,650,386 and International Publication Nos. WO00/46182 and WO00/59863.
  • SNAD refers to the monosodium salt of N-(10-[2-hydroxybenzoyl]-amino)decanoic acid, unless otherwise indicated.
  • disodium salt of SNAD refers to the disodium salt of N-(10-[2-hydroxybenzoyl]-amino)decanoic acid.
  • an “effective amount of acyclovir” is an amount of acyclovir which is effective to treat or prevent a condition in a living organism to whom it is administered over some period of time, e.g., provides a therapeutic effect during a desired dosing interval.
  • an “effective amount of delivery agent” is an amount of the delivery agent which enables and/or facilitates the absorption of a desired amount of acyclovir via any route of administration (such as those discussed in this application including, but not limited to, the oral (e.g., across a biological membrane in the gastrointestinal tract), nasal, pulmonary, dermal, buccal, vaginal, and/or ocular route).
  • mean when preceding a pharmacokinetic value (e.g., mean Peak) represents the arithmetic mean value of the pharmacokinetic value unless otherwise specified.
  • alkyl and alkenyl as used herein include linear and branched alkyl and alkenyl substituents, respectively.
  • phrases “pharmaceutically acceptable” refers to additives or compositions that are physiologically tolerable and do not typically produce an allergic or similar untoward reaction, such as gastric upset, dizziness and the like, when administered to a mammal.
  • condition or disorder caused by a virus is meant any condition or disorder in an animal that is either caused by, complicated by, or aggravated by a virus.
  • conditions or disorders include, but are not limited to, those caused by viruses of the herpes family, for example, herpes simplex 1 and 2 viruses (HSV 1, HSV 2), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and other herpes virus infections (e.g. feline herpes virus infections).
  • treat includes one or more of the following:
  • acyclovir refers to 9-(2-hydroxyethoxymethyl) guanine.
  • Suitable salts e.g., pharmaceutically acceptable salts
  • esters of acyclovir are described in U.S. Pat. No. 4,199,574, which is hereby incorporated by reference, and include, but are not limited to, sodium acyclovir and acyclovir valerate.
  • Acyclovir also forms acid addition salts, such as with hydrochloric, sulphuric, phosphoric, maleic, fumaric, citric, tartaric, lactic and acetic acid.
  • a synthesis of acyclovir is disclosed in U.S. Pat. No. 4,199,574, which is hereby incorporated by reference.
  • Acyclovir is commercially available from GlaxoSmithKline (Research Triangle Park, N.C.) under the tradename ZoviraxTM.
  • prodrug as used herein includes pharmaceutically acceptable salts of the drug.
  • Acyclovir prodrugs include, substituted purines of the formula:
  • R is hydrogen, hydroxy, or amino
  • X is oxygen or sulphur
  • Y is hydrogen or hydroxymethyl
  • Z is —H, C 1-16 alkyl, or —OCOCH(R 1 )NH 2 , wherein R 1 is —CH[CH 3 ] 2 .
  • Suitable acyclovir prodrugs include but are not limited to, those described in U.S. Pat. Nos. 4,609,662, 4,758,572 and 4,957,924, all of which are hereby incorporated by reference.
  • a non-limiting example of such a prodrug is 2-[(2-amino-1,6-dihydro-6-oxo-9H-purin-9-yl)methoxy]ethyl ester (valacyclovir) and its pharmaceutically acceptable salts.
  • Valacyclovir is commercially available as its hydrochloride salt from Glaxo SmithKline (Research Triangle Park, N.C.) under the tradename ValtrexTM.
  • Therapeutically effective amounts of a acyclovir for use in treatment of all conditions and disorders described herein is an amount sufficient to suppress or alleviate conditions associated with the viral infection.
  • an effective amount of therapeutic agent will vary with many factors including the potency of the acyclovir or salt, ester, or prodrug thereof, the age and weight of the patient, and the severity of the condition or disorder to be treated.
  • the acyclovir (or a salt, ester, prodrug thereof) is administered (e.g. peripherally) at a dose of about 0.1 to about 250 mg per kilogram of body weight of the recipient per day (mg/kg/day), about 1 to about 100 mg/kg/day, or about 5 to about 20 mg/kg/day (based on the weight of acyclovir).
  • the dose is about 10 mg/kg/day.
  • the desired dose may be administered either as a single or divided dose.
  • the acyclovir and delivery agent compound may be administered separately or together with one or more other active agents.
  • the acyclovir and delivery agent compound may be administered separately or together with compounds or compositions that exhibit antiviral activity, such as compounds used to treat retroviral infections (particularly HIV infections), e.g., 3′-azido-3′-deoxythymidine (AZT) and/or compounds or compositions that exhibit activity as ribonucleotide reductase inhibitors.
  • Suitable ribonucleotide reductase inhibitors include, but are not limited to, thiocarbonohydrazone ribonucleotide reductase inhibitors, such as those disclosed in U.S. Pat. No. 5,393,883, which is hereby incorporated by reference.
  • the delivery agent compound may be any of those described in Pat. Nos. 6,699,467, 6,663,898, 6,693,208, 6,693,073, 6,693,898, 6,663,887, 6,646,162, 6,642,411, 6,627,228, 6,623,731, 6,610,329, 6,558,706, 6,525,020, 6,461,643, 6,461,545, 6,440,929, 6,428,780, 6,413,550, 6,399,798, 6,395,774, 6,391,303, 6,384,278, 6,375,983, 6,358,504, 6,346,242, 6,344,213, 6,331,318, 6,313,088, 6,245,359, 6,242,495, 6,221,367, 6,180,140, 6,100,298, 6,100,285, 6,099,856, 6,090,958, 6,084,112, 6,071,510, 6,060,513, 6,051,561, 6,051,258, 6,001,347, 5,990,166, 5,989,539, 5,
  • Non-limiting examples of delivery agent compounds include N-(8-[2-hydroxybenzoyl]-amino)caprylic acid, N-(10-[2-hydroxybenzoyl]-amino)decanoic acid, 8-(2-hydroxy-4-methoxybenzoylainino)octanoic acid, 8-(2,6-dihydroxybenzoylamino)octanoic acid, 8-(2-hydroxy-5-bromobenzoylamino)octanoic acid, 8-(2-hydroxy-5-chlorobenzoylamino)octanoic acid, 8-(2-hydroxy-5-iodobenzoylamino)octanoic acid, 8-(2-hydroxy-5-methylbenzoylamino)octanoic acid, 8-(2-hydroxy-5-fluorobenzoylamino)octanoic acid, 8-(2-hydroxy-5-methoxybenzoylamino)octanoic acid,
  • the delivery agent compounds may be in the form of the carboxylic acid or pharmaceutically acceptable salts thereof, such as sodium salts, and hydrates and solvates thereof.
  • the salts may be mono- or multi-valent salts, such as monosodium salts and disodium salts.
  • the delivery agent compounds may contain different counter ions chosen for example due to their effect on modifying the dissolution profile of the carrier.
  • the delivery agent compounds may be prepared by methods known in the art, such as those discussed in the aforementioned publications (e.g., International Publication Nos. WO 98/34632, WO 00/07979, WO 01/44199, WO 01/32596, WO 02/20466, and WO 03/045306).
  • SNAC, SNAD, and the free acid and other salts thereof may be prepared by methods known in the art, such as those described in U.S. Pat. Nos. 5,650,386 and 5,866,536.
  • Salts of the delivery agent compounds of the present invention may be prepared by methods known in the art.
  • sodium salts may be prepared by dissolving the delivery agent compound in ethanol and adding aqueous sodium hydroxide.
  • the delivery agent compound may be purified by recrystallization or by fractionation on one or more solid chromatographic supports, alone or linked in tandem.
  • Suitable recrystallization solvent systems include, but are not limited to, acetonitrile, methanol, and tetrahydrofuran. Fractionation may be performed on a suitable chromatographic support such as alumina, using methanol/n-propanol mixtures as the mobile phase; reverse phase chromatography using trifluoroacetic acid/acetonitrile mixtures as the mobile phase; and ion exchange chromatography using water or an appropriate buffer as the mobile phase.
  • anion exchange chromatography preferably a 0-500 mM sodium chloride gradient is employed.
  • composition of the present invention comprises one or more delivery agent compounds of the present invention and acyclovir.
  • the delivery agent compound and acyclovir are typically mixed prior to administration to form an administration composition.
  • the administration compositions may be in the form of a liquid.
  • the solution medium may be water, 25% aqueous propylene glycol, or phosphate buffer.
  • Other dosing vehicles include polyethylene glycol.
  • Dosing solutions may be prepared by mixing a solution of the delivery agent compound with a solution of the active agent, just prior to administration. Alternately, a solution of the delivery agent compound (or acyclovir) may be mixed with the solid form of acyclovir (or delivery agent compound). The delivery agent compound and acyclovir may also be mixed as dry powders. The delivery agent compound and acyclovir can also be admixed during the manufacturing process.
  • the dosing solutions may optionally contain additives such as phosphate buffer salts, citric acid, glycols, or other dispersing agents. Stabilizing additives may be incorporated into the solution, preferably at a concentration ranging between about 0.1 and 20% (w/v).
  • compositions useful in the invention can be provided as parenteral compositions (e. g., injection or infusion).
  • the composition is suspended in an aqueous carrier, such as in an isotonic buffer solution at a pH of about 3.0 to about 8.0.
  • Suitable buffers include, but are not limited to, sodium citrate-citric acid and sodium phosphate-phosphoric acid, and sodium acetate/acetic acid buffers.
  • a form of repository or “depot” slow release preparation may also be used so that therapeutically effective amounts of the preparation are delivered into the bloodstream over many hours or days following transdermal injection or delivery.
  • the administration compositions may alternately be in the form of a solid, such as a tablet, capsule or particle, such as a powder or sachet.
  • Solid dosage forms may be prepared by mixing the solid form of the compound with the solid form of acyclovir.
  • a solid may be obtained from a solution of compound and acyclovir by methods known in the art, such as freeze-drying (lyophilization), precipitation, crystallization and solid dispersion.
  • the administration can be a semi-solid, in the form of a gel, paste, colloid, gelatin, emulsion, suspension and the like.
  • the administration compositions of the present invention may also include one or more enzyme inhibitors.
  • enzyme inhibitors include, but are not limited to, compounds such as actinonin or epiactinonin and derivatives thereof.
  • Other enzyme inhibitors include, but are not limited to, aprotinin (Trasylol) and Bowman-Birk inhibitor.
  • the amount of acyclovir used in an administration composition of the present invention is an amount effective to treat the target indication. However, the amount can be less than that amount when the composition is used in a dosage unit form because the dosage unit form may contain a plurality of delivery agent compound/acyclovir, such compositions may contain a divided effective amount. The total effective amount can then be administered in cumulative units containing, in total, an effective amount of acyclovir. Moreover, those skilled in the filed will recognize that an effective amount of acyclovir will vary with many factors including the age and weight of the patient, the patient's physical condition, as well as other factors.
  • compositions of the invention may deliver acyclovir more efficiently than compositions containing acyclovir lower amounts of acyclovir than those used in prior dosage unit forms or delivery systems can be administered to the subject, while still achieving the same blood levels and/or therapeutic effects.
  • the acyclovir (or a salt, ester, prodrug thereof) is administered (e.g. peripherally) at a dose of about 0.1 to about 250 mg per kilogram of body weight of the recipient per day (mg/kg/day), about 1 to about 100 mg/kg/day, or about 5 to about 20 mg/kg/day (based on the weight of acyclovir).
  • the dose is about 10 mg/kg/day.
  • the desired dose may be administered either as a single or divided dose.
  • the present invention also includes pharmaceutical compositions and dosage forms which include the aforementioned amounts of acyclovir and at least one delivery agent
  • an effective amount of delivery agent to facilitate the delivery acyclovir is administered with acyclovir.
  • the amount of delivery agent to acyclovir on a molar basis ranges from about 20:1 to about 1:1, from about 10:1 to about 2:1, or from about 5:1 to about 2:1.
  • the presently disclosed delivery agent compounds facilitate the delivery of acyclovir, particularly in oral, intranasal, sublingual, intraduodenal, subcutaneous, buccal, intracolonic, rectal, vaginal, mucosal, pulmonary, transdermal, intradermal, parenteral, intraperitoneal, intravenous, intramuscular and ocular systems, as well as traversing the blood-brain barrier.
  • the compositions and dosage unit forms of the present invention can be administered by any of the aforementioned routes.
  • Dosage unit forms can also include any one or combination of excipients, diluents, disintegrants, lubricants, plasticizers, colorants, flavorants, taste-masking agents, sugars, sweeteners, salts, and dosing vehicles, including, but not limited to, water, 1,2-propane diol, ethanol, olive oil, or any combination thereof.
  • compositions of the subject invention are useful for administering biologically or chemically active agents to any animals, including but not limited to birds such as chickens; fish, reptiles, mammals, such as rodents, cows, pigs, dogs, cats, primates, and particularly humans, and insects.
  • composition of the present invention can treat any disorder which is treatable with acyclovir or its salts (e.g., acyclovir sodium) or prodrugs (e.g., valacyclovir), including those described in the Physicians' Desk Reference (58 th Ed., 2004, Medical Economics Company, Inc., Montvale, N.J.).
  • acyclovir or its salts e.g., acyclovir sodium
  • prodrugs e.g., valacyclovir
  • Such disorders include, but are not limited to, those described above or in the patents or other publications above.
  • Non-limiting examples are:
  • the dose of Acyclovir used was 25 mg/kg body weight.
  • the dose of delivery agent was either 50 or 75 mg/kg body weight.
  • Approximately 6.25 mg/tablet of acyclovir was blended with either 12.5 or 18.75 mg/tablet (50 and 75 mg/kg, respectively) of delivery agent compound.
  • Upper punch, lower punch and die of a Carver 4350 manual pellet press with a Caplet shape model sold by Natoli Engineering Company, Inc. were treated with magnesium stearate (0.1%).
  • Approximately 6.25 mg (Acyclovir alone), 18.75 mg (Acyclovir+50 mg/kg delivery agent compound), or 25 mg (Acyclovir+75 mg/kg delivery agent compound) of mixed powder was fed into the die and a mini bead shape tablet was made at about 1000 PSI bar pressure.
  • the resulting solid dosage forms were 2.65 mm in diameter and approximately 8.40 mm in length for the 25 mg tablets, 6.3 mm in length for the 18.75 mg tablets, and 2.1 mm in length for the 6.25 mg tablets.
  • the dosing tube was inserted into the rat's mouth and carefully threaded down the pharynx and esophagus about 8 cm to about 15 cm depending on the weight of the rat (typically about 11 cm).
  • the solid dosage form was delivered into the distal esophagus and/or stomach by pressing the plunger of the oral dosing tube.
  • Plasma samples were collected serially from the retro-orbital sinus at 0, 15, 30, 45, and 60 minutes. Samples were collected on wet ice into heparin-containing tubes. Samples were centrifuged and plasma was extracted. Plasma samples were stored in a ⁇ 20° C. freezer until analysis. Plasma Acyclovir concentrations were quantified using a LC-MS-MS method (analysis performed by Quest Pharmaceutical Services, Newark, Del.). Results from the animals in each group were averaged for each time point. The maximum of these averages (i.e., the mean peak plasma Acyclovir concentration ⁇ standard deviation (SD)) is reported below in Table 1. The results are also shown in FIG. 1 .
  • SD standard deviation
  • Acyclovir of Acyclovir Delivery Agent dose (mg/kg) (mg/kg) (ng/ml) ⁇ SD None — 25 95.11 ⁇ 73.75 1 50 25 1719.32 ⁇ 676.52 1 75 25 2759.93 ⁇ 1699.39 2 50 25 778.12 ⁇ 491.9 2 75 25 1694.65 ⁇ 1133.57
  • Delivery Agent 1 is the monosodium salt of N-(8-[2-hydroxybenzoyl]-amino)caprylic acid (SNAC).
  • Delivery Agent 2 is the monosodium salt of N-(10-[2-hydroxybenzoyl]-amino)decanoic acid (SNAD).
  • unitary solid oral dosage forms comprising 80 mg of acyclovir and 240 mg of the delivery agent, the monosodium salt of N-(8-[2-hydroxybenzoyl]-amino)caprylic acid (SNAC), (2) a solid oral dosage form comprising 400 mg of acyclovir (ZoviraxTM, commercially available from GlaxoSmithKline), (3) a solid oral dosage form comprising 800 mg dosage of (ZoviraxTM, commercially available from GlaxoSmithKline), (4) a solid oral dosage form comprising 500 mg dosage of valacyclovir (ValtrexTM, commercially available from GlaxoSmithKline) and (6) unitary solid oral dosage comprising 240 mg of acyclovir and 240 mg of the delivery agent SNAC. Oral administration of acylcovir alone and with a delivery agent was compared to an interveneous dosage form comprising 80 mg of acyclovir (ZoviraxTM for injection, commercially available from GlaxoSmithKline).
  • Unitary dosages of acyclovir and delivery agent were prepared as follows. Approximately 240 mg/tablet of SNAC was blended with either 80 or 240 mg/tablet of acyclovir. Upper punch, lower punch and die of a Carver 4350 manual pellet press with a Caplet shape model sold by Natoli Engineering Company, Inc. were treated with magnesium stearate (0.1%). Approximately 320 mg (80 mg acyclovir and 240 mg SNAC), or 480 mg (240 mg acyclovir and 240 mg SNAC) of mixed powder was fed into the die and a mini bead shape tablet was made at about 1000 PSI bar pressure.
  • Plasma acyclovir concentrations were quantified using a LC-MS-MS method.
  • the maximum peak plasma acyclovir concentration and the area under the curve (AUC) are reported below in Table 2.
  • the results for experiments 1-9 are also shown in FIGS. 2-10 , respectively.

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KR20070036067A (ko) 2007-04-02

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